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https://www.readbyqxmd.com/read/28650929/oxygen-flow-pressure-targets-for-resuscitation-in-critical-hemodynamic-therapy
#1
Huaiwu He, Yun Long, Xiang Zhou, Xiaoting Wang, Hongmin Zhang, Wenzhao Chai, Na Cui, Hao Wang, Dawei Liu
Far from traditional "vital signs," the field of hemodynamic monitoring is developing rapidly. However, it is also easy to misunderstand hemodynamic therapy as merely hemodynamic monitoring and some concrete bundles or guidelines for circulation support. Here, we describe the concept of "critical hemodynamic therapy (CHT)" and clarify the concepts of the "therapeutic target" and "therapeutic endpoint" in clinical practice.Three main targets (Oxygen Delivery - Blood Flow - Perfusion Pressure, OFP) for resuscitation are reviewed in critically ill patients according to the sepsis guidelines and hemodynamic consensus...
June 23, 2017: Shock
https://www.readbyqxmd.com/read/28649597/early-diagnosis-of-mild-cognitive-impairment-and-alzheimer-s-disease-based-on-salivary-lactoferrin
#2
Eva Carro, Fernando Bartolomé, Félix Bermejo-Pareja, Alberto Villarejo-Galende, José Antonio Molina, Pablo Ortiz, Miguel Calero, Alberto Rabano, José Luis Cantero, Gorka Orive
INTRODUCTION: The Alzheimer's disease (AD) process is likely initiated many years before clinical onset. Biomarkers of preclinical disease are critical for the development of disease-modifying or even preventative therapies. Current biomarkers for early disease, including cerebrospinal fluid tau and amyloid β (Aβ) levels, structural and functional magnetic resonance imaging, and the use of brain amyloid imaging, are limited because they are very invasive or expensive. Noninvasive biomarkers may be a more accessible alternative, but none can currently detect preclinical AD with the required sensitivity and specificity...
2017: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
https://www.readbyqxmd.com/read/28649563/symptomatic-congenital-cytomegalovirus-infection-in-children-of-seropositive-women
#3
Ines Mack, Marie-Anne Burckhardt, Ulrich Heininger, Friederike Prüfer, Sven Schulzke, Sven Wellmann
Cytomegalovirus (CMV) is the most frequent congenital virus infection worldwide. The risk of congenital CMV (cCMV) transmission is highest in seronegative women who acquire primary CMV infection during pregnancy. A growing body of evidence indicates that secondary CMV infections in pregnant women with preconceptual immunity (either through reactivation of latent virus or re-infection with a new strain of CMV) contribute to a much greater proportion of symptomatic cCMV than was previously thought. Here, we describe a case of symptomatic cCMV infection in the newborn of a woman with proven immunity prior to pregnancy...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28648014/-clinical-efficacy-observation-of-atomization-inhalation-combined-with-oral-administration-of-oseltamivir-in-4-cases-with-h7n9-avian-influenza
#4
Z Li, X Y Fu, X B Fang, J Li, T Chen, L M Qiu, J Cai, W L Wang, Z Q Pan, Y Zhang, J L Zhou
Objective: To investigate the clinical efficacy of atomization inhalation combined with oral administration of oseltamivir in treatment of human infection with H7N9 avian influenza. Methods: To analyze the clinical data of 4 patients hospitalized from Mar 6th 2017 to Apr 12th 2017 with avian influenza(H7N9) infection treated by conventional therapy(oseltamivir, 150 mg, po, Bid) plus with oseltamivir inhalation(75 mg dissolved in 20 ml N. S, Bid) and administered with antibacterial treatment, blood purification and immunomodulators...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28647800/safety-and-effectiveness-of-tolvaptan-for-fluid-management-after-pediatric-cardiovascular-surgery
#5
Yuzo Katayama, Tsukasa Ozawa, Noritsugu Shiono, Hiroshi Masuhara, Takeshiro Fujii, Yoshinori Watanabe
BACKGROUND: Postoperative fluid management is important after open heart surgery, because cardiopulmonary bypass evokes an abnormal inflammatory response and increases vascular permeability, especially in pediatric patients. We assessed the safety and effectiveness of tolvaptan for management of postoperative fluid retention after congenital heart surgery. METHODS AND RESULTS: This retrospective study analyzed data from 43 children with uncomplicated congenital heart disease who underwent open heart surgery between September 2013 and August 2016...
June 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28647716/bilateral-recurrent-pyosalpinx-in-a-sexually-inactive-12-year-old-girl-secondary-to-rare-variant-of-mullerian-duct-anomaly
#6
Tareq Maraqa, Mohamed Mohamed, Daniel Coffey, Gul R Sachwani-Daswani, Crystal Alvarez, Leo Mercer
Pyosalpinx is a severe sequel of chronic pelvic inflammatory disease, whereby the fallopian tubes become filled with pus.(1 2) Pyosalpinx often affects sexually active women and rarely is seen in celibate adolescent girls.(3) We report a case of a 12-year-old girl with no prior sexual history who presented to our emergency department with complaints of severe right lower quadrant pain of 1-day duration. Ultrasonography and CT scan of the abdomen and pelvis revealed free fluid collections in the pelvis without visualisation of the appendix...
June 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28647651/concomitant-vasopressin-and-hydrocortisone-therapy-on-short-term-hemodynamic-effects-and-vasopressor-requirements-in-refractory-septic-shock
#7
Mitchell S Buckley, Robert MacLaren
PURPOSE: The objective of this study was to evaluate the short-term hemodynamic effects as well as vasopressor requirements with concomitant vasopressin (AVP) and hydrocortisone (HCT) compared to either agent alone in refractory septic shock. MATERIALS AND METHODS: This was a retrospective, cohort study conducted in adult septic shock patients. Patients received continuous infusion AVP at 0.04units/min and/or HCT 200-300mg intravenous daily in divided doses for refractory septic shock...
June 17, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28647469/intra-articular-injection-of-microrna-140-alleviates-osteoarthritis-progression-by-modulating-extracellular-matrix-homeostasis-in-rats
#8
Hai-Bo Si, Yi Zeng, Shu-Yun Liu, Zong-Ke Zhou, You-Nan Chen, Jing-Qiu Cheng, Yan-Rong Lu, Bin Shen
OBJECTIVE: Disruptions of extracellular matrix (ECM) homeostasis are key events in the pathogenesis of osteoarthritis (OA). MicroRNA-140 (miRNA-140) is expressed specifically in cartilage and regulates ECM-degrading enzymes. Our objective in this study was to determine if intra-articular injection of miRNA-140 can attenuate OA progression in rats. DESIGN: miRNA-140 levels in human normal and OA cartilage derived chondrocytes and synovial fluid were assessed by polymerase chain reaction (PCR)...
June 21, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28646272/rhesus-cochlear-and-vestibular-functions-are-preserved-after-inner-ear-injection-of-saline-volume-sufficient-for-gene-therapy-delivery
#9
Chenkai Dai, Mohamed Lehar, Daniel Q Sun, Lani Swarthout Rvt, John P Carey, Tim MacLachlan, Doug Brough, Hinrich Staecker, Alexandra M Della Santina, Timothy E Hullar, Charles C Della Santina
Sensorineural losses of hearing and vestibular sensation due to hair cell dysfunction are among the most common disabilities. Recent preclinical research demonstrates that treatment of the inner ear with a variety of compounds, including gene therapy agents, may elicit regeneration and/or repair of hair cells in animals exposed to ototoxic medications or other insults to the inner ear. Delivery of gene therapy may also offer a means for treatment of hereditary hearing loss. However, injection of a fluid volume sufficient to deliver an adequate dose of a pharmacologic agent could, in theory, cause inner ear trauma that compromises functional outcome...
June 23, 2017: Journal of the Association for Research in Otolaryngology: JARO
https://www.readbyqxmd.com/read/28645586/venous-sinus-stenting-in-the-management-of-patients-with-intracranial-hypertension-manifesting-with-skull-base-cerebrospinal-fluid-leaks
#10
Rajiv R Iyer, David Solomon, Abhay Moghekar, C Rory Goodwin, Charles M Stewart, Masaru Ishii, Philippe Gailloud, Gary L Gallia
BACKGROUND: A subset of patients with skull base cerebrospinal fluid (CSF) leaks are found to have elevated intracranial pressure (ICP). In these patients, elevated ICP is thought to contribute to both the pathophysiology of the leak as well as postoperative leak recurrences. Current strategies for post-operative ICP control include medical therapy and shunting procedures. The aim of this study is to report the use of venous sinus stenting (VSS) in the management of patients with skull base CSF leaks due to elevated ICP...
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28644112/susac-syndrome-misdiagnosed-as-multiple-sclerosis-with-exacerbation-by-interferon-beta-therapy
#11
Hussein Algahtani, Bader Shirah, Muhammad Amin, Eyad Altarazi, Hashem Almarzouki
Susac syndrome is a rare autoimmune disorder characterised by the clinical triad of encephalopathy, retinopathy (branch retinal artery occlusions) and hearing loss. The diagnosis of Susac syndrome may be difficult initially, and it is not uncommon for patients with Susac syndrome to be misdiagnosed with multiple sclerosis. In this case report, we describe a patient who was diagnosed as having multiple sclerosis for three years, with further deterioration after starting treatment with interferon beta-1a. The patient had the triad of encephalopathy, branch retinal artery occlusions and sensorineural hearing loss...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28643237/small-airway-absorption-and-microdosimetry-of-inhaled-corticosteroid-particles-after-deposition
#12
P Worth Longest, Michael Hindle
PURPOSE: To predict the cellular-level epithelial absorbed dose from deposited inhaled corticosteroid (ICS) particles in a model of an expanding and contracting small airway segment for different particle forms. METHODS: A computational fluid dynamics (CFD)-based model of drug dissolution, absorption and clearance occurring in the surface liquid of a representative small airway generation (G13) was developed and used to evaluate epithelial dose for the same deposited drug mass of conventional microparticles, nanoaggregates and a true nanoaerosol...
June 22, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28643098/-importance-of-wound-irrigation-solutions-and-fluids-with-antiseptic-effects-in-therapy-and-prophylaxis-update-2017
#13
REVIEW
Christian Willy, Catharina Scheuermann-Poley, Marcus Stichling, Thomas von Stein, Axel Kramer
INTRODUCTION: Despite the use of modern antibiotics as well as complex perioperative, intraoperative and postoperative prophylactic measures, the rate of surgical site infections (SSI) could not be significantly reduced. The introduction of biocompatible antiseptic drugs with a high microbiocidal effect provided a successful alternative for infection prevention and therapy, particularly in a time of increasing occurrence of multi-drug resistant pathogens. Hence, questions about the risk-benefit ratio of antiseptic wound irrigation solutions, the prophylactic use of wound irrigation solutions for the reduction of SSI and the effect of negative pressure wound therapy combined with instillation (NPWTi) need to be answered...
June 22, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28641700/-molecular-imaging-in-vivo-detection-of-egfr-mutations-in-non-small-cell-lung-cancer
#14
Danjing Luo, Jin'an Ma, Jinming Zhang, Yanzhong Zhao
An ever increasing number of drugs directed as epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) bring a new revolution for non-small cell lung cancer (NSCLC) therapy, and many large scales of studies show that only people with EGFR-sensitive mutation can benefit from these drugs. The main method of EGFR mutation detection is to analyze the DNA sequence of EGFR, which can be the lung cancer tissue, pleural fluid tumor cells, circulating tumor cells and peripheral blood free DNA obtained by surgery or puncture, the biggest drawback is that the heterogeneity of EGFR mutation cannot be analyzed...
June 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/28641522/advances-on-ppar%C3%AE-research-in-the-emerging-era-of-precision-medicine
#15
Pinyi Lu, Zhongming Zhao
BACKGROUND: Peroxisome proliferator-activated receptor gamma (PPARγ) is a member of the nuclear receptor superfamily that functions as a ligand-inducible transcription factor. It regulates glucose and lipid metabolism, immunity, and cellular growth and differentiation. Thiazolidinediones (TZDs) are potent insulin sensitizers that function by activating PPARs, with a high specificity for PPARγ. Due to their ability to preserve pancreatic beta cell function and reduce insulin resistance, TZDs have become one of the most prescribed classes of medications for type 2 diabetes (T2D) since their approval by the US Food and Drug Administration (FDA) and initial use in 1997...
June 21, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28641048/updates-and-current-challenges-in-microrna-research-for-personalized-medicine-in-ovarian-cancer
#16
Victoria Mandilaras, Mégane Vernon, Matthieu Meryet-Figuière, Katherine Karakasis, Bernard Lambert, Laurent Poulain, Amit Oza, Christophe Denoyelle, Stephanie Lheureux
Ovarian cancer (OC) is the second most common and the most lethal of the gynecological malignancies. Currently, there exists no effective screening tool for OC. MicroRNAs (miRNAs) are endogenous 18-23 nucleotide non-coding RNAs that refine gene expression. MiRNAs have been found to be aberrantly expressed in OC tumor tissue as well as detectable in biological fluids such as the blood, urine, and ascites and have been proposed as biomarkers and therapeutic targets for OC. Areas covered: This review summarizes the current knowledge regarding the application of miRNAs as diagnostic, prognostic, and predictive biomarkers in OC...
June 22, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28641031/treatment-options-for-nonalcoholic-steatohepatitis-a-safety-evaluation
#17
Danny Issa, Julia Wattacheril, Arun J Sanyal
Introduction There is an urgent as yet unmet need to develop highly effective and safe therapeutics for nonalcoholic fatty liver disease (NAFLD). The remarkable progress in understanding NAFLD pathogenesis allowed the identification of injury pathways which may be recruited as therapy targets. Areas covered This article reviews the safety and tolerability data of the NAFLD therapies and explains the mechanistic basis for each of the established and investigational drugs. Treatment targets include: weight loss, anti-metabolic agents such as lipid lowering and anti-diabetic drugs, inflammation, fibrosis and others such as targeting gut microbiota, immune modulation and apoptosis...
June 22, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28640701/primary-cns-lymphoma
#18
Christian Grommes, Lisa M DeAngelis
Primary CNS lymphoma (PCNSL) is a rare form of extranodal non-Hodgkin lymphoma that is typically confined to the brain, eyes, and cerebrospinal fluid without evidence of systemic spread. The prognosis of patients with PCNSL has improved during the last decades with the introduction of high-dose methotrexate. However, despite recent progress, results after treatment are durable in half of patients, and therapy can be associated with late neurotoxicity. PCNSL is an uncommon tumor, and only four randomized trials and one phase III trial have been completed so far, all in the first-line setting...
June 22, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28640449/polycystic-kidney-disease
#19
Joseph Ghata, Benjamin D Cowley
Renal cysts, which arise from renal tubules, can be seen in a variety of hereditary and nonhereditary entities. Common mechanisms associated with renal cyst formation include increased cell proliferation, epithelial fluid secretion, and extracellular matrix remodeling. Hereditary polycystic kidney disease (PKD) is seen as a component of numerous diseases. Autosomal dominant (AD) PKD is the most common potentially fatal hereditary disease in humans, causes renal failure in approximately 50% of affected individuals, and accounts for approximately 5% of end stage renal disease cases in the United States...
June 18, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/28640151/a-case-report-of-hyperosmolar-hyperglycemic-state-in-a-7-year-old-child-an-unusual-presentation-of-first-appearance-of-type-1-diabetes-mellitus
#20
Young Min Cho, Byung Sung Park, Min Jae Kang
RATIONALE: A hyperosmolar hyperglycemic state (HHS) is a rare presentation of a hyperglycemic crisis in children with diabetes mellitus. As this condition can be fatal and has high morbidity, early recognition and proper management are necessary for a better outcome. Here, we report a rare case of HHS as the first presentation of type 1 diabetes mellitus (T1DM) in a 7-year-old girl. PATIENT CONCERNS: The patient was admitted due to polyuria and weight loss in the past few days...
June 2017: Medicine (Baltimore)
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