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https://www.readbyqxmd.com/read/28543052/norepinephrine-reduces-arterial-compliance-less-than-phenylephrine-when-treating-general-anesthesia-induced-arterial-hypotension
#1
F Vallée, O Passouant, A Le Gall, J Joachim, J Mateo, A Mebazaa, E Gayat
INTRODUCTION: During general anesthesia, arterial hypotension is frequent and may be an important contributor to perioperative morbidity. We assessed the effect of a 5 μg bolus of Norepinephrine (NA) when compared with 50 μg bolus of Phenylephrine (PE) administered to treat hypotension during maintenance anesthesia, on MAP, derived cardiac output and arterial stiffness parameters. METHODS: Patients scheduled for a neurosurgical procedure under general anesthesia were prospectively included...
May 22, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28537969/thoracic-epidural-analgesia-with-levobupivacaine-reduces-remifentanil-and-propofol-consumption-evaluated-by-closed-loop-titration-guided-by-the-bispectral-index-a-double-blind-placebo-controlled-study
#2
Virginie Dumans-Nizard, Morgan Le Guen, Edouard Sage, Thierry Chazot, Marc Fischler, Ngai Liu
BACKGROUND: Thoracic epidural analgesia (TEA) combined with general anesthesia decreases anesthetic requirements by half when hemodynamic criteria are used for the titration of analgesia. We therefore determined the impact of TEA on anesthetic requirements, when a closed-loop controller was used allowing the automated coadministration of propofol-remifentanil guided solely by the Bispectral index. METHODS: This single-center double-blind study enrolled patients scheduled for elective posterolateral thoracotomy using TEA...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28489830/-clinical-and-laboratory-characteristics-of-patients-with-pulmonary-hypertension-and-pulmonary-vascular-complications-hospitalized-at-the-instituto-nacional-de-salud-del-ni%C3%A3-o
#3
Alexis Jose Ormeño Julca, Carlos Melchor Alvarez Murillo, Pedro Miguel Amoretti Alvino, Angel Aladino Florian Florian, Rosa Aurora Castro Johanson, Maria Danisa Celi Perez, Olga Rocío Huamán Prado
The hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PPHN) are distinct pulmonary vascular complications of portal hypertension (PHT) and are associated with increased morbidity and mortality. OBJECTIVES: To describe the clinical and laboratory characteristics of patients with pulmonary hypertension and pulmonary vascular complications hospitalized at the Instituto Nacional de Salud del Niño. MATERIALS AND METHODS: We included patients with HTP hospitalized from January 2012 to June 2013 and that during its evolution progressed with SHP or HTPP...
January 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28487619/one-step-minilaparotomy-assisted-transmesenteric-portal-vein-recanalization-combined-with-transjugular-intrahepatic-portosystemic-shunt-placement-a-novel-surgical-proposal-in-pediatrics
#4
Gloria Pelizzo, Pietro Quaretti, Lorenzo Paolo Moramarco, Riccardo Corti, Marcello Maestri, Giulio Iacob, Valeria Calcaterra
Transjugular intrahepatic portosystemic shunt (TIPS) placement is a standard procedure for the treatment of portal hypertension complications. When this conventional approach is not feasible, alternative procedures for systemic diversion of portal blood have been proposed. A one-step interventional approach, combining minilaparotomy-assisted transmesenteric (MAT) antegrade portal recanalization and TIPS, is described in an adolescent with recurrent esophageal varice bleeding and portal cavernoma (PC). A 16-year-old girl was admitted to our Unit because of repeated bleeding episodes over a short period of time due to esophageal varices in the context of a PC...
April 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28391426/comparison-of-stroke-volume-measurement-between-non-invasive-bioreactance-and-esophageal-doppler-in-patients-undergoing-major-abdominal-pelvic-surgery
#5
Gennaro De Pascale, Mervyn Singer, David Brealey
PURPOSE: Bioreactance is a non-invasive technology for measuring stroke volume (SV) in the operating room and critical care setting. We evaluated how the NICOM(®) bioreactance device performed against the CardioQ(®) esophageal Doppler monitor in patients undergoing major abdominal-pelvic surgery, focusing on the effect of different hemodynamic interventions. METHODS: SVNICOM and SVODM were simultaneously measured intraoperatively, including before and after interventions including fluid challenge, vasopressor boluses, peritoneal gas insufflation/removal, and Trendelenburg/reverse Trendelenburg patient positioning...
April 8, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28319947/effects-of-capsaicin-on-older-patients-with-oropharyngeal-dysphagia-a-double-blind-placebo-controlled-crossover-study
#6
Rui Nakato, Noriaki Manabe, Sayako Shimizu, Kozo Hanayama, Akiko Shiotani, Jiro Hata, Ken Haruma
BACKGROUND/AIMS: The standard of care for older patients with oropharyngeal dysphagia (OD) is poor. Stimulation of transient receptor potential vanilloid 1 might become a pharmacological strategy for these patients. This study aimed to compare the therapeutic effect of film food containing 0.75 µg of capsaicin in these patients. METHODS: In a crossover, randomized trial, 49 patients with OD were provided capsaicin or identical placebo at least 7 days apart. Patients' reported symptoms during repeated swallowing, the volume, pH and substance P (SP) concentrations in saliva, and cervical esophageal wall motion evaluated by ultrasonographic tissue Doppler imaging were obtained before and after capsaicin or placebo administration...
March 21, 2017: Digestion
https://www.readbyqxmd.com/read/28228418/folic-acid-supplementation-increases-cutaneous-vasodilator-sensitivity-to-sympathetic-nerve-activity-in-older-adults
#7
Anna E Stanhewicz, Jody L Greaney, Lacy M Alexander, W Larry Kenney
During heat stress, blunted increases in skin sympathetic nervous system activity (SSNA) and reductions in end-organ vascular responsiveness contribute to the age-related reduction in reflex cutaneous vasodilation. In older adults, folic acid supplementation improves the cutaneous vascular conductance (CVC) response to passive heating; however, the influence of folic acid supplementation on SSNA:CVC transduction is unknown. Fourteen older adults (66±1yrs, 8M/6F) ingested folic acid (5mg·day(-1)) or placebo for 6 weeks in a randomized, double-blind, crossover design...
February 22, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28191357/metastatic-invasive-lobular-breast-cancer-presenting-clinically-with-esophageal-dysphagia
#8
Lilit Karapetyan, Heather Laird-Fick, Reuben Cuison
Background. Intra-abdominal metastases of invasive lobular breast cancer (ILBC) may be insidious. We report a case of metastatic ILBC that presented with dysphagia within weeks of a negative mammogram and before the development of intra-abdominal symptoms. Case. A 70-year-old female developed esophageal dysphagia. She underwent EGD which showed a short segment of stricture of the distal esophagus without significant mucosal changes. Biopsy was unremarkable and patient underwent lower esophageal sphincter (LES) dilation...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28108832/beat-by-beat-assessment-of-cardiac-afterload-using-descending-aortic-velocity-pressure-loop-during-general-anesthesia-a-pilot-study
#9
Fabrice Vallée, Arthur Le Gall, Jona Joachim, Olivier Passouant, Joaquim Matéo, Arnaud Mari, Sandrine Millasseau, Alexandre Mebazaa, Etienne Gayat
Continuous cardiac afterload evaluation could represent a useful tool during general anesthesia (GA) to titrate vasopressor effect. Using beat to beat descending aortic pressure(P)/flow velocity(U) loop obtained from esophageal Doppler and femoral pressure signals might allow to track afterload changes. Methods We defined three angles characterizing the PU loop (alpha, beta and Global After-Load Angle (GALA)). Augmentation index (AIx) and total arterial compliance (Ctot) were measured via radial tonometry. Peripheral Vascular Resistances (PVR) were also calculated...
January 20, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27991695/application-of-extended-bi-pedicle-anterolateral-thigh-free-flaps-for-reconstruction-of-large-defects-a-case-series
#10
Michele Maruccia, Georgios Orfaniotis, Pedro Ciudad, Fabio Nicoli, Emanuele Cigna, Giuseppe Giudice, Kidakorn Kiranantawat, Diego Ribuffo, Hung-Chi Chen
BACKGROUND: The anterolateral thigh flap is a workforce flap in reconstructive surgery, however, variations in it is vascular anatomy are not uncommon. These variations may affect flap design and survival, especially when large flaps are required. In some anatomical variants the anterolateral thigh flap is supplied by two separate dominant pedicles, and in these cases a bi-pedicle modification may be necessary to ensure complete flap viability. The aim of this report is to evaluate the outcomes, and present our approach in using bi-pedicle anterolateral thigh flaps as a method to reduce the risk of partial flap necrosis when reconstructing sizeable soft tissue defects...
December 19, 2016: Microsurgery
https://www.readbyqxmd.com/read/27941723/doppler-assessment-of-hepatic-venous-waves-for-evaluation-of-large-varices-in-cirrhotic-patient
#11
M A Sangma, N Biswas, M U Ahmed, M M Rahman, M M Hossain, A Z Razi, P L Saha, M T Reza, L Fatema, M Hoshneara, K Begum
This cross sectional study was conducted to evaluate the role of doppler ultrasonography of hepatic venous waves for evaluation of large varices in cirrhotic patients from July 2013 to June 2015 in Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Patients getting admitted in the ward with a diagnosis of cirrhosis were enrolled in the study and purposive sampling technique was adopted. The sample size was 43. Data were collected by face to face interview and some data were gathered by records review and analyzed with the help of SPSS windows version - 12 software programs...
October 2016: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/27880982/safety-and-efficacy-of-ruxolitinib-in-splanchnic-vein-thrombosis-associated-with-myeloproliferative-neoplasms
#12
Lisa Pieri, Chiara Paoli, Umberto Arena, Fabio Marra, Fabio Mori, Mery Zucchini, Stefano Colagrande, Alessandro Castellani, Arianna Masciulli, Vittorio Rosti, Valerio De Stefano, Silvia Betti, Guido Finazzi, Maria Luisa Ferrari, Elisa Rumi, Marco Ruggeri, Ilaria Nichele, Paola Guglielmelli, Rajmonda Fjerza, Carmela Mannarelli, Tiziana Fanelli, Lucia Merli, Giuditta Corbizi Fattori, Margherita Massa, Giuseppe Cimino, Alessandro Rambaldi, Giovanni Barosi, Mario Cazzola, Tiziano Barbui, Alessandro M Vannucchi
Splanchnic vein thrombosis (SVT) is one of the vascular complications of myeloproliferative neoplasms (MPN). We designed a phase 2 clinical trial to evaluate safety and efficacy of ruxolitinib in reducing splenomegaly and improving disease-related symptoms in patients with MPN-associated SVT. Patients, diagnosed with myelofibrosis in 12 cases, polycythemia vera in 5 and essential thrombocythemia in 4, received ruxolitinib for 24 weeks in the core study period. Spleen volume was assessed by magnetic resonance imaging (MRI) and splanchnic vein circulation by echo-Doppler analysis...
November 23, 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27789772/blunted-increases-in-skin-sympathetic-nerve-activity-are-related-to-attenuated-reflex-vasodilation-in-aged-human-skin
#13
Anna E Stanhewicz, Jody L Greaney, Lacy M Alexander, W Larry Kenney
Reflex cutaneous vasodilation in response to passive heating is attenuated in human aging. This diminished response is mediated, in part, by age-associated reductions in endothelial function; however, the contribution of altered skin sympathetic nervous system activity (SSNA) is unknown. We hypothesized that 1) healthy older adults would demonstrate blunted SSNA responses to increased core temperature compared with young adults and 2) the decreased SSNA response would be associated with attenuated cutaneous vasodilation...
December 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27687456/comparison-of-esophageal-doppler-and-plethysmographic-variability-index-to-guide-intraoperative-fluid-therapy-for-low-risk-patients-undergoing-colorectal-surgery
#14
Samantha R Warnakulasuriya, Simon J Davies, R Jonathan T Wilson, David R A Yates
STUDY OBJECTIVE: This study aims to investigate if there is equivalence in volumes of fluid administered when intravenous fluid therapy is guided by Pleth Variability Index (PVI) compared to the established technology of esophageal Doppler in low-risk patients undergoing major colorectal surgery. DESIGN: Randomized controlled trial. SETTING: Operating room. PATIENTS: Forty low-risk patients undergoing elective colorectal surgery...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27532782/intraoperative-fluid-management-guided-by-esophageal-doppler-monitoring-in-major-abdominal-surgery-utilizing-the-enhanced-recovery-after-surgery-program-a-systematic-review-protocol
#15
Lindsay Wuellner, Lisa Sutton
The objectives of this review are to identify the effectiveness of esophageal Doppler monitoring (EDM) for goal-directed fluid therapy on postoperative outcomes during abdominal surgery when an enhanced recovery after surgery (ERAS) program is implemented.The specific question of this review is: does the guidance of fluid management by EDM versus fluid management without EDM affect the length of hospital stay, occurrence of postoperative infection, hemodynamic stability and 30-day postoperative complication rate in adult patients undergoing major abdominal surgery with ERAS or similar programs?...
July 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27511606/temporal-and-spectral-properties-of-esophageal-mucosal-blood-perfusion-a-comparison-between-normal-subjects-and-nutcracker-esophagus-patients
#16
A Zifan, Y Jiang, R K Mittal
BACKGROUND: The mechanism of esophageal pain in patients with nutcracker esophagus (NE) and other esophageal motor disorders is not known. Our recent study shows that baseline esophageal mucosal perfusion, measured by laser Doppler perfusion monitoring, is lower in NE patients compared to controls. The goal of our current study was to perform a more detailed analysis of esophageal mucosal blood perfusion (EMBP) waveform of NE patients and controls to determine the optimal EMBP biomarkers that combined with suitable statistical learning models produce robust discrimination between the two groups...
February 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27290160/bedside-and-continuous-assessment-of-arterial-load-in-critically-ill-patients-by-combined-analysis-of-esophageal-doppler-blood-flow-and-arterial-pressure-waveform-preliminary-results
#17
M I Monge García, A Santos Oviedo, P Guijo González, M Gracia Romero, A Gil Cano
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27075496/diastolic-dysfunction-in-cirrhosis
#18
Søren Møller, Signe Wiese, Hanne Halgreen, Jens D Hove
Development of esophageal varices, ascites, and hepatic nephropathy is among the major complications of cirrhosis. The presence of cirrhotic cardiomyopathy, which includes a left ventricular diastolic dysfunction (DD), seems to deteriorate the course of the disease and the prognosis. Increased stiffness of the cirrhotic heart may decrease the compliance and result in DD. The prevalence of DD in cirrhotic patients averages about 50 %. It can be evaluated by transmitral Doppler echocardiography, tissue Doppler echocardiography, and cardiac magnetic resonance imaging...
September 2016: Heart Failure Reviews
https://www.readbyqxmd.com/read/27053652/influence-of-forearm-muscle-metaboreceptor-activation-on-sweating-and-cutaneous-vascular-responses-during-dynamic-exercise
#19
Tatsuro Amano, Masashi Ichinose, Yoshimitsu Inoue, Takeshi Nishiyasu, Shunsaku Koga, Glen P Kenny, Narihiko Kondo
We examined whether the sustained activation of metaboreceptor in forearm during cycling exercise can modulate sweating and cutaneous vasodilation. On separate days, 12 young participants performed a 1.5-min isometric handgrip exercise at 40% maximal voluntary contraction followed by 1) 9-min forearm ischemia (Occlusion, to activate metaboreceptor) or 2) no ischemia (Control) in thermoneutral conditions (27°C, 50%) with mean skin temperature clamped at 34°C. Thirty seconds after the handgrip exercise, participants cycled for 13...
June 1, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27039318/subtypes-and-clinical-significance-of-common-bile-duct-varices-in-portal-vein-thrombosis-diagnosis-and-follow-up-by-doppler-us-and-eus
#20
Ivica Grgurevic, Milan Kujundzic, Marko Banic, Rajko Kusec, Tomislav Bokun, Mirjana Vukelic-Markovic, Zoran Bogdanovic, Anita Lukic, Emmanouil Tsochatzis, Boris Brkljacic
PURPOSE: To investigate (1) diagnostic performance of transabdominal color doppler ultrasound (US) and endoscopic ultrasound (EUS) for detection and sub-classification of common bile duct varices (CBDV) in patients with portal vein thrombosis (PVT), and (2) clinical significance and natural history of CBDV subtypes. PATIENTS AND METHODS: During a 4-year period, 56 patients with PVT underwent US and EUS for the presence and subtypes of CBDV. Natural history was analyzed for patients who attended control visits...
March 2016: Abdominal Radiology
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