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https://www.readbyqxmd.com/read/27923205/spontaneous-rupture-of-splenic-hematoma-in-a-malaria-patient-case-report-and-review-of-literature
#1
Bassem M Abou Hussein, Ali M Al Ani, Omar Al-Mayoofi, Mahpara Mehraj, Afra A Joher, Juanita A Bonilla, Alya S Al-Mazrouei, Faisal M Badri
INTRODUCTION: Blunt abdominal trauma is the most common cause of splenic rupture. Malaria is the most frequent tropical infectious cause of spontaneous splenic rupture. The exact mechanism is not well-defined. CASE REPORT: We report a case of thirty-year-old male patient known to have malaria who presented with spontaneous splenic rupture. A trial of conservative treatment failed and splenecomy was done to control bleeding. CONCLUSION: Spontaneous splenic rupture should be kept in mind in malaria patients presenting with left upper quadrant pain and signs of hypovolemia...
October 11, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27884959/cardiac-responses-to-exercise-distinguish-postural-orthostatic-tachycardia-syndrome-variants
#2
Paolo T Pianosi, Darrell R Schroeder, Philip R Fischer
We previously showed that one-third of adolescents with postural orthostatic tachycardia syndrome (POTS) have hyperkinetic circulation. In a subsequent cohort, we compare participants with POTS grouped according to cardiac output (Q˙) versus oxygen uptake (V˙O2) function, whose circulatory response to exercise lay at the lower end of this distribution. We hypothesized that such grouping determines the circulatory response to incremental-protocol, upright, cycle ergometry by whatever blend of flow and resistance adjustments best maintains normal blood pressure...
November 2016: Physiological Reports
https://www.readbyqxmd.com/read/27865972/paediatric-urolithiasis-in-emerging-economies
#3
REVIEW
S Adibul Hasan Rizvi, Sajid Sultan, Mirza Naqi Zafar, Sadaf Aba Umar, Bashir Ahmed, S A Anwar Naqvi
BACKGROUND: Paediatric urolithiasis remains endemic in low resource countries. This review highlights the epidemiology, causation and management of urolithiasis in an Asian country in the context of emerging economies. METHODS: A literature review of recent articles with key words paediatric urolithiasis, developing countries, endemic stone disease, stone composition, metabolic risk factors, management of paediatric urolithiasis was undertaken and 51 relevant articles were selected with the main focus on experience of this center in managing stone disease in the last two decades...
November 16, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27864916/enhanced-contractility-of-intraparenchymal-arterioles-after-global-cerebral-ischemia-in-rat-new-insights-into-the-development-of-delayed-cerebral-hypoperfusion
#4
Stine Spray, Sara Ellinor Johansson, Aneta Radziwon-Balicka, Kristian Agmund Haanes, Karin Warfvinge, Gro Klitgaard Povlsen, Paul A T Kelly, Lars Edvinsson
AIM: Delayed cerebral hypoperfusion is a secondary complication found in the days after transient global cerebral ischemia that worsens the ischemic damage inflicted by the initial transient episode of global cerebral ischemia. A recent study demonstrated increased cerebral vasoconstriction in the large arteries on the brain surface (pial arteries) after global cerebral ischemia. However, smaller arterioles inside the brain (parenchymal arterioles) are equally important in the regulation of cerebral blood flow and yet their pathophysiology after global cerebral ischemia is largely unknown...
November 19, 2016: Acta Physiologica
https://www.readbyqxmd.com/read/27863908/role-of-echocardiography-for-catheter-based-management-of-valvular-heart-disease
#5
REVIEW
Takahiro Shiota
Catheter-based treatment of valvular heart disease, such as transvalvular aortic valve replacement (TAVR) or mitral clip procedure, has been increasingly accepted as a treatment choice for the past several years. Such new treatment options have been changing the management of patients with valvular heart disease drastically while socio-economic factors regarding their application need to be taken into consideration. The use of echocardiography, including transesophageal echocardiography (TEE), for such catheter-based treatments is essential for the success of the procedures...
November 15, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27849306/eisenmenger-syndrome-in-pregnancy
#6
Shi-Min Yuan
Eisenmenger syndrome is very rare in pregnant women. Debates remain concerning the management of Eisenmenger syndrome in this patient population and the prognosis is unclear in terms of maternal and fetoneonatal outcomes. Epidural analgesia is preferred for Cesarean section as it alleviates perioperative pain and reduces the pulmonary and systemic vascular resistances. Maternal mortality in the presence of Eisenmenger syndrome is reported as 30-50% and even up to 65% in those with Cesarean section. The major causes of death could be hypovolemia, thromboembolism and preeclampsia...
July 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27848268/use-of-intravenous-fluids-solutions-a-narrative-review
#7
N El Gkotmi, C Kosmeri, T D Filippatos, M S Elisaf
OBJECTIVE: Intravenous fluids are broadly categorized into colloids and crystalloids. The aim of this review is to present under a clinical point of view the characteristics of intravenous fluids that make them more or less appropriate either for maintaining hydration when enteral intake is contraindicated or for treating hypovolemia. METHODS: We considered randomized trials and meta-analyses as well as narrative reviews evaluating the effects of colloids or crystalloids in patients with hypovolemia or as maintenance fluids published in PubMed and Cochrane databases...
November 16, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27822741/isolated-brain-trauma-in-cats-triggers-rapid-onset-of-hypovolemia
#8
Peter Bentzer, Per-Olof Grände
BACKGROUND: Hemodynamic instability responsive to fluid resuscitation is common after a traumatic brain injury (TBI), also in the absence of systemic hemorrhage. The present study tests if an isolated severe TBI induces a decrease in plasma volume (PV). METHODS: The study was performed in three groups of anesthetized and tracheostomized male cats (n = 21). In one group (n = 8), the cats were prepared with a cranial borehole (10 mm i.d) used to expose the brain to a fluid percussion brain injury (FPI) (1...
November 7, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27805528/splenic-peliosis-resulting-in-spontaneous-splenic-rupture-in-a-concomitant-hepatic-and-renal-allograft-recipient
#9
Pelin Börcek, B Handan Özdemir, Eda Yılmaz Akçay, Mehmet Haberal
Splenic peliosis is an exceedingly rare complication following liver and kidney transplant, with few previously reported cases. A 24-year-old man with chronic renal and hepatic failure due to primary oxalosis underwent concomitant renal and hepatic transplant. On the eighth day of successful transplant, he showed signs and symptoms of hypovolemia with suspicion of intra-abdominal bleeding. Diagnostic laparotomy was performed, yielding splenic rupture, and a splenectomy was performed. Macroscopically, the spleen was ruptured, and the cut surface displayed multiple parenchymal blood-filled cysts...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27788791/intraoperative-pleth-variability-index-is-linked-to-delayed-graft-function-after-kidney-transplantation
#10
O Collange, L Jazaerli, A Lejay, C Biermann, S Caillard, B Moulin, N Chakfe, F Severac, M Schaeffer, P-M Mertes, A Steib
BACKGROUND: Delayed graft function (DGF) is an early postoperative complication of kidney transplantation (KT) predisposing to acute rejection and lower graft survival. Intraoperative arterial hypotension and hypovolemia are associated with DGF. Central venous pressure (CVP) is used to estimate volemia but its reliability has been criticized. Pleth variability index (PVI) is a hemodynamic parameter predicting fluid responsiveness. The aim of this study was to examine the relationship between intraoperative PVI and CVP values and the occurrence of DGF...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27746553/prevention-of-hypotension-induced-by-combined-spinal-epidural-anesthesia-using-continuous-infusion-of-vasopressin-a-randomized-trial
#11
Chetna Shamshery, Ashish Kannaujia, Rajashree Madabushi, Dinesh Singh, Divya Srivastava, Shobhana Jafa
BACKGROUND: Central neuraxial blockade (CNB) is an established technique of providing anesthesia for surgeries of the lower limb and abdomen. Hypotension is the most common side effect of CNB. It was hypothesized that by supplementing the initial burst of vasopressin following hypovolemia, hypotension following combined spinal epidural anesthesia (CSEA) could be avoided. MATERIALS AND METHODS: A total of 122 patients undergoing lower limb and abdomen surgeries were included in the study, with 61 patients randomized into two groups - I and II...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27744630/metabolic-risk-factors-in-pediatric-stone-formers-a-report-from-an-emerging-economy
#12
Kiran Imran, Mirza Naqi Zafar, Uzma Ozair, Sadia Khan, Syed Adibul Hasan Rizvi
The goal of this study was to investigate metabolic risk factors in pediatric stone formers in an emerging economy. A prospective, data collection enrolled 250 children age <1-15 years at our center. Risk factors were evaluated by gender and in age groups <1-5, 6-10 and 11-15 years. Patients were evaluated for demographics, blood and 24 h urine for calcium, magnesium, phosphate, uric acid, electrolytes and additional protein, citrate, ammonia and oxalate in urine. All reported values were two sided and statistical significance was considered at p value ≤0...
October 15, 2016: Urolithiasis
https://www.readbyqxmd.com/read/27720915/validation-of-a-staging-system-for-acute-kidney-injury-in-patients-with-cirrhosis-and-association-with-acute-on-chronic-liver-failure
#13
Patricia Huelin, Salvatore Piano, Elsa Solà, Marialuisa Stanco, Cristina Solé, Rebeca Moreira, Elisa Pose, Silvano Fasolato, Nuria Fabrellas, Glòria de Prada, Chiara Pilutti, Isabel Graupera, Xavier Ariza, Antonietta Romano, Chiara Elia, Andrés Cárdenas, Javier Fernández, Paolo Angeli, Pere Ginès
BACKGROUND & AIMS: In patients with cirrhosis of the liver, acute kidney injury (AKI) is classified into 3 stages. Recent studies indicate that there are 2 subgroups of stage 1 disease, associated with different outcomes and serum levels of creatinine (SCr): stage 1A (SCr <1.5 mg/dL) and stage 1B (SCr ≥1.5 mg/dL). We performed a prospective study to validate, in a large series of patients with cirrhosis, the association between this new description and patient outcomes, and assess the relationship between AKI stage and the presence of acute-on-chronic liver failure...
October 5, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27712877/safety-and-feasibility-of-phlebotomy-with-controlled-hypovolemia-to-minimize-blood-loss-in-liver-resections
#14
Janelle Rekman, Christopher Wherrett, Sean Bennett, Miso Gostimir, Sara Saeed, Kristina Lemon, Richard Mimeault, Fady K Balaa, Guillaume Martel
BACKGROUND: Liver resection can be associated with significant blood loss and transfusion. Whole blood phlebotomy is an under-reported technique, distinct from acute normovolemic hemodilution, the goal of which is to minimize blood loss in liver operation. This work sought to report on its safety and feasibility and to describe technical considerations. METHODS: Consecutive patients who had an elective liver resection and concurrent phlebotomy between 2013 and 2016 were examined prospectively...
October 3, 2016: Surgery
https://www.readbyqxmd.com/read/27702883/internal-carotid-artery-blood-flow-in-healthy-awake-subjects-is-reduced-by-simulated-hypovolemia-and-noninvasive-mechanical-ventilation
#15
Maria Skytioti, Signe Søvik, Maja Elstad
Intact cerebral blood flow (CBF) is essential for cerebral metabolism and function, whereas hypoperfusion in relation to hypovolemia and hypocapnia can lead to severe cerebral damage. This study was designed to assess internal carotid artery blood flow (ICA-BF) during simulated hypovolemia and noninvasive positive pressure ventilation (PPV) in young healthy humans. Beat-by-beat blood velocity (ICA and aorta) were measured by Doppler ultrasound during normovolemia and simulated hypovolemia (lower body negative pressure), with or without PPV in 15 awake subjects...
October 2016: Physiological Reports
https://www.readbyqxmd.com/read/27698733/role-of-picco-monitoring-for-the-integrated-management-of-neurogenic-pulmonary-edema-following-traumatic-brain-injury-a-case-report-and-literature-review
#16
Xiaoping Lin, Zhijun Xu, Pengfei Wang, Yan Xu, Gensheng Zhang
Neurogenic pulmonary edema (NPE) is occasionally observed in patients with traumatic brain injury (TBI); however, this condition is often underappreciated. NPE is frequently misdiagnosed due to its atypical clinical performance, thus delaying appropriate treatment. A comprehensive management protocol of NPE in patients with TBI has yet to be established. The current study reported the case of a 67-year-old man with severe TBI who was transferred to our intensive care unit (ICU). On day 7 after hospitalization, the patient suddenly suffered tachypnea, tachycardia, systemic hypertension and hypoxemia during lumbar cistern drainage...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27688917/compartment-syndrome-as-a-result-of-systemic-capillary-leak-syndrome
#17
Kwadwo Kyeremanteng, Gianni D'Egidio, Cynthia Wan, Alan Baxter, Hans Rosenberg
Objective. To describe a single case of Systemic Capillary Leak Syndrome (SCLS) with a rare complication of compartment syndrome. Patient. Our patient is a 57-year-old male, referred to our hospital due to polycythemia (hemoglobin (Hgb) of 220 g/L), hypotension, acute renal failure, and bilateral calf pain. Measurements and Main Results. The patient required bilateral forearm, thigh, and calf fasciotomies during his ICU stay and continuous renal replacement therapy was instituted following onset of acute renal failure and oliguria...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27678094/genomic-and-nongenomic-effects-of-mifepristone-at-the-cardiovascular-level-a-review
#18
Joana Feiteiro, Melissa Mariana, Ignacio Verde, Elisa Cairrão
Mifepristone (RU 486) is a compound that is structurally related to steroid hormones, which is derived from the estrane progestins. This compound strongly binds the progesterone and glucocorticoid receptor and, to a lesser extent, the androgen receptor. This compound has its effects through different signaling pathways, related to genomic and nongenomic effects. The genomic effect involves the activation or blockage of nuclear or intracellular receptor, that in this case the progesterone, glucocorticoid, and androgen receptors...
September 27, 2016: Reproductive Sciences
https://www.readbyqxmd.com/read/27661862/ombitasvir-paritaprevir-ritonavir-dasabuvir-viekira-pak-induced-lactic-acidosis
#19
Catherine L Oberg, Robert J Hiensch, Hooman D Poor
OBJECTIVE: To report a case series of three patients with hepatitis C virus infection who all presented with severe type B lactic acidosis shortly after starting treatment with ombitasvir-paritaprevir-ritonavir-dasabuvir. DESIGN: Case series. SETTING: ICU. PATIENTS: Three patients, all who had HCV cirrhosis with mild hepatic impairment (Child-Pugh A) and had started taking ombitasvir-paritaprevir-ritonavir-dasabuvir within the preceding 2 weeks, presented with similar nonspecific symptoms of lethargy, fatigue, and nausea...
September 22, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27640108/early-and-repeated-use-of-plasma-for-the-management-of-ebola-patients-reflection-around-a-case
#20
F Dufour-Gaume, D Delaune, C Martinaud, A Sailliol
In December 2013, the most widespread epidemic of Ebola virus disease began in Guinea and continued for over 2 years. At the request of the Guinean state, France deployed a military field hospital to treat Ebola infected healthcare workers. From January to July 2015, our center supported 26 healthcare workers suffering from Ebola virus disease. Despite an individualized care and optimal treatment, the fatality rate remained high at 30.7%. Improved therapies are required to reduce mortality risk in Ebola virus disease...
September 14, 2016: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
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