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https://www.readbyqxmd.com/read/28547318/a-systematic-review-of-alpha-2-agonists-for-sedation-in-mechanically-ventilated-neurocritical-care-patients
#1
Alexandre Tran, Henrietta Blinder, Brian Hutton, Shane W English
The use of sedative medications is commonplace in intensive care units (ICUs) and an invaluable clinical tool for the intensive care physician. Sedation for critically ill, mechanically ventilated patients provides an opportunity to reduce anxiety, discomfort as well as ventilator intolerance and dyssynchrony. Alpha-2 agonists in particular have become increasingly popular for use in the neurocritical care population due to their proposed effectiveness in facilitating examinations and procedures as well as reducing the need for adjunctive agents...
May 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28547175/influence-of-body-mass-index-and-type-of-low-level-exercise-on-the-side-effect-profile-of-regadenoson
#2
Carlos Salgado-Garcia, Amelia Jimenez-Heffernan, Juana Lopez-Martin, Manuela Molina-Mora, Tarik Aroui, Elena Sanchez de Mora, Carlos Ramos-Font, Francisco Rivera de Los Santos, Carlos Ruiz-Frutos
PURPOSE: Regadenoson, an A2A adenosine receptor pharmacologic stress agent for radionuclide myocardial perfusion imaging (MPI), is administered as a single, fixed dose. We studied the side effect profile of regadenoson combined with two types of low-level exercise, according to body mass index (BMI). METHODS: Three hundred and fifty-six patients (46.1% men, mean age 67.7±10.7 years, range 31-90 years) underwent regadenoson stress testing combined with low-level exercise...
May 25, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28547004/ocular-arterial-occlusive-disorders-and-carotid-artery-disease
#3
Sohan Singh Hayreh, M Bridget Zimmerman
OBJECTIVE: To compare prevalence of carotid artery disease and its various types of lesions in different types of ocular arterial occlusive disorders. DESIGN: Cohort study. SUBJECTS: 614 consecutive patients (728 eyes) with ocular arterial occlusive disorders. METHODS: At first visit, all patients had a detailed ophthalmic and medical history, comprehensive ophthalmic evaluation, and carotid artery evaluation (by Doppler/angiography) on the side of ocular arterial occlusion, and echocardiography...
January 2017: Ophthalmol Retina
https://www.readbyqxmd.com/read/28542659/-digestive-and-kidney-complications-by-indomethacin-and-ibuprofen-in-extreme-preterm-infants-with-patent-ductus-arteriosus
#4
Rodrigo Salas, Pablo Lavín, Yohanna Rincón, Juan Miranda, María López
The symptomatic patent ductus arteriosus (sPDA) is common in extremely premature infants (EPI). In order to decrease the hemodynamic repercussion and avoid complications it is necessary to close it. Indomethacin or ibuprofen are used for this purpose with its associated risks. OBJECTIVE: Characterize digestive and renal complications in EPI who received indomethacin or ibuprofen as sPDA treatment. PATIENTS AND METHOD: Retrospective study on EPI between January-2004 and December-2013...
April 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28541602/three-dimensional-printing-in-cardiology-current-applications-and-future-challenges
#5
Hongxing Luo, Jarosław Meyer-Szary, Zhongmin Wang, Robert Sabiniewicz, Yuhao Liu
Three-dimensional (3D) printing has attracted a huge interest in recent years. Broadly speaking, it refers to the technology which converts a predesigned virtual model to a touchable object. In clinical medicine, it usually converts a series of two-dimensional medical images acquired through computed tomography, magnetic resonance imaging or 3D echocardiography into a physical model. Medical 3D printing consists of three main steps: image acquisition, virtual reconstruction and 3D manufacturing. It is a promising tool for preoperative evaluation, medical device design, hemodynamic simulation and medical education, it is also likely to reduce operative risk and increase operative success...
May 25, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28539565/successful-treatment-of-congestive-heart-failure-due-to-severe-aortic-valve-stenosis-with-low-dose-tolvaptan-in-elderly-patients
#6
Kiyoshi Takasu, Tetsuro Miyazaki, Kanako Negoro, Shoichiro Yatsu, Megumi Shimizu, Azusa Murata, Takao Kato, Shoko Suda, Masaru Hiki, Takatoshi Kasai, Katsumi Miyauchi, Hiroyuki Daida
Medical therapy for severe aortic valve stenosis (AS) is necessary for inoperable patients due to comorbid conditions. Tolvaptan (TLV), unlike other diuretics, resulted in modest changes in filling pressures associated with an increase in urine output, suggesting that TLV improves congestive heart failure (CHF) due to severe AS without hemodynamic instability.We retrospectively investigated 14 consecutive patients ≥ 80 years of age admitted due to decompensated CHF with severe AS at Juntendo University Hospital from April 2014 to November 2015...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28538371/comparison-of-the-efficacy-and-safety-of-2-lidocaine-hcl-with-different-epinephrine-concentration-for-local-anesthesia-in-participants-undergoing-surgical-extraction-of-impacted-mandibular-third-molars-a-multicenter-randomized-double-blind-crossover-phase-iv
#7
Myong-Hwan Karm, Fiona Daye Park, Moonkyu Kang, Hyun Jeong Kim, Jeong Wan Kang, Seungoh Kim, Yong-Deok Kim, Cheul-Hong Kim, Kwang-Suk Seo, Kyung-Hwan Kwon, Chul-Hwan Kim, Jung-Woo Lee, Sung-Woon Hong, Mi Hyoung Lim, Seung Kwan Nam, Jae Min Cho
BACKGROUND: The most commonly impacted tooth is the third molar. An impacted third molar can ultimately cause acute pain, infection, tumors, cysts, caries, periodontal disease, and loss of adjacent teeth. Local anesthesia is employed for removing the third molar. This study aimed to evaluate the efficacy and safety of 2% lidocaine with 1:80,000 or 1:200,000 epinephrine for surgical extraction of bilateral impacted mandibular third molars. METHODS: Sixty-five healthy participants underwent surgical extraction of bilateral impacted mandibular third molars in 2 separate visits while under local anesthesia with 2% lidocaine with different epinephrine concentration (1:80,000 or 1:200,000) in a double-blind, randomized, crossover trial...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28536660/sorafenib-associated-heart-failure-complicated-by-cardiogenic-shock-after-treatment-of-advanced-stage-hepatocellular-carcinoma-a-clinical-case-discussion
#8
Candace Wu, Kamal Shemisa
Background. Sorafenib, an oral tyrosine kinase inhibitor (TKI), targets multiple tyrosine kinase receptors (TKRs) involved in angiogenesis and tumor growth. Studies suggest that inhibition of TKR impacts cardiomyocyte survival. Inhibition of VEGF signaling interrupts angiogenesis and is associated with the development of hypertension and compensatory hypertrophy. Compensated hypertrophy ultimately leads to heart failure. Case Description. A 76-year-old man with a past medical history of systolic heart failure due to ischemic cardiomyopathy and stage IIIC hepatocellular carcinoma (HCC) presented with symptoms of decompensated heart failure...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28535909/dynamic-simulation-and-doppler-ultrasonography-validation-of-blood-flow-behavior-in-abdominal-aortic-aneurysm
#9
Cristian C Botar, Árpád Á Tóth, Olivera R Klisurić, Dijana D Nićiforović, Viktorija A Vučaj Ćirilović, Viktor E Till
Criteria for rupture prediction of Abdominal Aortic Aneurysm (AAA) are based only on the diameter of AAA. This method does not consider complex hemodynamic forces exerted on AAA wall. The methodology used in our study combines Computer-Aided Design (CAD) with Computational Fluid Dynamics (CFD). Three-dimensional vascular structures reconstructions were based on Computed Tomography (CT) images and CAD. CFD theory was used for mathematical modeling and simulations. In this way, dynamic behavior of blood flow in bounded three-dimensional space was described...
May 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28535517/coupled-plasma-filtration-adsorption-application-for-liver-and-thyroid-toxins
#10
Gabriele Donati, Irene Capelli, Anna Laura Croci Chiocchini, Nicolò Natali, Anna Scrivo, Gaetano La Manna
Coupled plasma filtration and adsorption (CPFA) is a detoxification system that combines a plasma adsorption circuit and a continuous renal replacement therapy circuit. Its main application is for sepsis and septic shock with or without acute renal failure. Several recent studies have suggested that CPFA can reduce the mortality when the volume of plasma absorbed on the styrenic resin is at least >0.18 L/kg/day. At present, new applications for CPFA are under investigation, also in patients without significant kidney failure...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28527879/ventricular-diastolic-pressure-ratio-as-a-marker-of-treatment-response-in-pulmonary-hypertension
#11
Arun Jose, Christopher S King, Oksana A Shlobin, Joseph M Kiernan, Nicolas A Cossa, A Whitney Brown, Steven D Nathan
BACKGROUND: Pulmonary hypertension (PH) is diagnosed and classified through right heart catheterization (RHC), with a number of hemodynamic markers used to help guide treatment decisions. These markers may not reflect the complex remodeling of the right ventricle or the interplay between ventricles, and struggle to predict treatment response. This study investigates the use of a novel marker; the ratio of left to right ventricular end-diastolic pressures (LVEDP/RVEDP), in predicting treatment outcomes in a cohort of PH patients...
May 17, 2017: Chest
https://www.readbyqxmd.com/read/28527831/different-efficacy-of-inhaled-and-oral-medications-in-pulmonary-hypertension
#12
Batool J AbuHalimeh, Joseph G Parambil, Adriano R Tonelli
Pulmonary arterial hypertension (PAH) is progressive disorder characterized by elevated pulmonary vascular resistance that can lead to right heart failure and death. One of the main therapeutic options for PAH are medications targeting the prostacyclin pathway. Treprostinil is a prostacyclin analogue and selexipag is a selective IP receptor agonist. Treprostinil can be delivered by a variety of routes including oral, inhaled, subcutaneous and intravenous. Selexipag is currently approved as an oral formulation...
May 17, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28526148/cardiovascular-pharmacology-an-update-and-anesthesia-considerations
#13
REVIEW
Camellia Asgarian, Henry Liu, Alan D Kaye
Cardiovascular disease remains a leading cause of morbidity and mortality worldwide. The development of therapeutic agents for the treatment of cardiovascular diseases has always been a priority because of the huge potential market for these drugs. These medications should be part of the anesthesiologist's armamentarium because the typical surgical patient is older and has more comorbidities than in the past. This article reviews commonly used cardiovascular medications that are important in managing patients with unstable hemodynamics...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28524130/-creation-of-extracranial-intracranial-microvascular-anastomosis-under-regional-anesthesia-a-case-report-and-a-review-of-the-literature
#14
D Yu Usachev, V A Lukshin, A V Shmigel'skiy, A D Akhmedov, A D Sosnin, K A Kozlova
The article describes a case of successful surgical treatment of an 81-year-old male patient with symptomatic occlusion of the internal carotid artery that led to severe impairment of cerebral hemodynamics and was accompanied by severe gait and equilibrium disorders. Given the patient's age and his positive medical history, he underwent surgery for the creation of an extracranial-intracranial microvascular anastomosis under regional anesthesia, with spontaneous breathing and a baseline level of consciousness being maintained...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28521921/1-year-results-in-patients-undergoing-transcatheter-aortic-valve-replacement-with-failed-surgical-bioprostheses
#15
G Michael Deeb, Stanley J Chetcuti, Michael J Reardon, Himanshu J Patel, P Michael Grossman, Theodore Schreiber, John K Forrest, Tanvir K Bajwa, Daniel P O'Hair, George Petrossian, Newell Robinson, Stanley Katz, Alan Hartman, Harold L Dauerman, Joseph Schmoker, Kamal Khabbaz, Daniel R Watson, Steven J Yakubov, Jae K Oh, Shuzhen Li, Neal S Kleiman, David H Adams, Jeffrey J Popma
OBJECTIVES: This study evaluated the safety and effectiveness of self-expanding transcatheter aortic valve replacement (TAVR) in patients with surgical valve failure (SVF). BACKGROUND: Self-expanding TAVR is superior to medical therapy for patients with severe native aortic valve stenosis at increased surgical risk. METHODS: The CoreValve U.S. Expanded Use Study was a prospective, nonrandomized study that enrolled 233 patients with symptomatic SVF who were deemed unsuitable for reoperation...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28518095/use-of-a-central-venous-line-for-fluids-drugs-and-nutrient-administration-in-a-mouse-model-of-critical-illness
#16
Sarah Derde, Steven Thiessen, Chloë Goossens, Thomas Dufour, Greet Van den Berghe, Lies Langouche
This protocol describes a centrally catheterized mouse model of prolonged critical illness. We combine the cecal ligation and puncture method to induce sepsis with the use of a central venous line for fluids, drugs and nutrient administration to mimic the human clinical setting. Critically ill patients require intensive medical support in order to survive. While the majority of patients will recover within a few days, about a quarter of the patients need prolonged intensive care and are at high risk of dying from non-resolving multiple organ failure...
May 2, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28516098/spontaneous-regression-of-a-large-iatrogenic-dissection-of-the-ascending-aorta
#17
Aurélien Roumy, Matthias Kirsch, René Prêtre, Lars Niclauss
A 74-year-old woman was admitted for right coronary angioplasty. During the procedure, she complained about chest pain, and contrast injection showed an iatrogenic dissection of the ascending aorta. A contrast computed tomography (CT) scan confirmed the diagnosis via visualization of a large non-circulating false lumen, which involved nearly the entire ascending aorta. The patient remained hemodynamically stable and asymptomatic while receiving medical therapy alone. Another CT scan performed 3 days later showed complete regression of the false lumen...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28514393/-subtraction-ct-angiopulmonographic-assessment-of-the-vascular-bed-and-lung-perfusion-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-a-pilot-study
#18
T N Veselova, A Yu Demchenkova, T V Martynyuk, N M Danilov, S K Ternovoy, I E Chazova
AIM: To evaluate the vascular bed and lung perfusion in patients with chronic thromboembolic pulmonary hypertension (CTEPH) by computed tomography (CT) and to compare the severity of pulmonary arterial (PA) thrombotic lesions concurrent with parenchymal perfusion disorders with angiopulmonographic findings and clinical and hemodynamic characteristics. SUBJECTS AND METHODS: In the period from November 2015 to May 2016, 22 patients (7 men, 15 women) aged 27 to 67 years with a verified diagnosis of CTEPH were examined using an Aquilion ONE VISION Edition 640 (Toshiba Medical Systems, Japan) CT scanner with a 320-row detector...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28514324/use-of-the-fluid-challenge-in-critically-ill-adult-patients-a-systematic-review
#19
Antonio Messina, Federico Longhini, Corinne Coppo, Aline Pagni, Ramona Lungu, Chiara Ronco, Marco Ambrogio Cattaneo, Simone Dore, Giovanni Sotgiu, Paolo Navalesi
The fluid challenge (FC) aims at identifying patients in whom fluid administration improves hemodynamics. Although the FC has been extensively studied, the implementation and definition of improvement are not standardized. This systematic review of studies published between January 1, 1994 and December 31, 2014 characterizes these key components of the FC for critically ill adult patients, as described in the medical literature in the last 20 years. A literature search was performed using MEDLINE, Embase, and Cochrane...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28512422/acute-onset-ocular-hypotony-after-coronary-artery-bypass-surgery
#20
Sarah Farukhi Ahmed, Audrey Xi Tai, Mason Schmutz, John Combs, Sameh Mosaed
IMPORTANCE: The purpose of this case report is to evaluate risk factors associated with post-coronary artery bypass graft (CABG) ocular hypotony compared to post-CABG ischemic optic neuropathy. OBSERVATIONS: The patient described here is a single case at the University of California, Irvine Medical Center, from July 2016. This case demonstrates the rare incidence of acute post-CABG ocular hypotony and vision loss in a patient with prior history of optic atrophy...
January 2017: Case Reports in Ophthalmology
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