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https://www.readbyqxmd.com/read/29140948/hypertonic-saline-resuscitation-following-emergent-laparotomy-and-temporary-abdominal-closure
#1
Tyler J Loftus, Philip A Efron, Trina M Bala, Martin D Rosenthal, Chasen A Croft, R Stephen Smith, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Our objective was to establish the safety of 3% hypertonic saline (HTS) resuscitation for trauma and acute care surgery patients undergoing emergent laparotomy and temporary abdominal closure (TAC) with the hypothesis that HTS administration would be associated with hyperosmolar hypercholoremic acidosis, lower resuscitation volumes, and higher fascial closure rates, without adversely affecting renal function. METHODS: We performed a retrospective cohort analysis of 189 trauma and acute care surgery patients who underwent emergent laparotomy and TAC, comparing patients with normal baseline renal function who received 3% HTS at 30 mL/h (n=36) to patients with standard resuscitation (n=153) by baseline characteristics, resuscitation parameters, and outcomes including primary fascial closure and KDIGO stages of acute kidney injury...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29135618/pathway-for-the-management-of-hyperglycemia-in-the-cardiac-care-unit
#2
Seyed Hamed Hosseini Dehkordi, Jeanine Albu, Emad F Aziz, Eyal Herzog
Inpatient hyperglycemia has been associated with increased morbidity and mortality in critically ill patients. Optimal control of blood glucose (BG) levels using insulin infusion protocols has been shown to improve clinical outcomes. Protocols have been developed to prescribe a safe and effective rate of insulin infusion for optimal control of BG levels; however, a major obstacle in their implementation is their complexity. We have revised and updated our previously published pathway for the management of hyperglycemia, which introduces the "wheel" concept for insulin dosing...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29134276/-novel-current-and-future-therapy-options-for-treatment-of-dry-eye-disease
#3
REVIEW
E M Messmer
Dry eye disease was redefined by the dry eye workshop (DEWS II) in May 2017. According to the new definition "dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film and accompanied by ocular symptoms". The current definition encompasses etiological factors, such as instability and hyperosmolarity of the tear film, ocular surface inflammation and damage as well as a new aspect compared to the former definition, neurosensory abnormalities. Recent and future therapeutic options for dry eye focus on treatment of the aforementioned pathogenetic events...
November 13, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/29126968/jnk-signaling-pathway-regulates-sorbitol-induced-tau-proteolysis-and-apoptosis-in-sh-sy5y-cells-by-targeting-caspase-3
#4
Marta Olivera Santa-Catalina, Montaña Caballero Bermejo, Ricardo Argent, Juan C Alonso, Francisco Centeno, María J Lorenzo
Growing evidence suggests that Diabetes Mellitus increases the risk of developing Alzheimer's disease. It is well known that hyperglycemia, a key feature of Diabetes Mellitus, may induce plasma osmolarity disturbances. Both hyperglycemia and hyperosmolarity promote the altered post-translational regulation of microtubule-associated protein Tau. Interestingly, abnormal hyperphosphorylation and cleavage of Tau have been proven to lead to the genesis of filamentous structures referred to as neurofibrillary tangles, the main pathological hallmark of Alzheimer's disease...
November 7, 2017: Archives of Biochemistry and Biophysics
https://www.readbyqxmd.com/read/29118841/management-of-severe-dehydration
#5
Stephanie Ruth Strachan, Lucy Francesca Morris
The presented case is one of severe dehydration and acute kidney injury with significant resultant complications that required considerable fluid and electrolyte replacement. Approaches to fluid resuscitation in the context of hypernatraemia and the hyperosmolar state were considered and then judiciously combined to manage a complex case with a successful outcome. Conflicting guidance in this domain is discussed with recommendations for a future management strategy that is tailored to individual patients.
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29115899/therapeutic-inhibitors-for-the-treatment-of-dry-eye-syndrome
#6
Candela Rodríguez-Pomar, Jesus Pintor, Basilio Colligris, Gonzalo Carracedo
Dry eye disease (DED), defined as a multifactorial disease of tears and ocular surface, results in symptoms of discomfort, ocular irritation, visual disturbance and tear film instability. This syndrome is accompanied of ocular surface inflammation and it is produced by a deficient activity of the lacrimal functional unit. In addition, it is associated with systemic autoimmune diseases such as Sjögren´s Syndrome, rheumatoid arthritis, systemic lupus erythematosus and some drug administration. The treatment of dry eye disease is based on the typical signs and symptoms of dry eye, which are associated with hyperosmolarity, ocular surface inflammation, discomfort, visual disturbance, and tear film instability...
November 14, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29111837/conjunctival-tear-layer-temperature-evaporation-hyperosmolarity-inflammation-hyperemia-tissue-damage-and-symptoms-a-review-of-an-amplifying-cascade
#7
Charles W McMonnies
PURPOSE: This review examines the evidence for and significance of pre-conjunctival tear temperature being higher than central pre-corneal temperature with associated more rapid evaporation of warmer pre-conjunctival tears in normal eyes but especially in hyperemic dry eye disease. METHODS: PubMed searches using the terms "evaporative dry eye," "conjunctival tear evaporation," "tear evaporation," and "dry eye conjunctival hyperemia" indicated 157, 49, 309, and 96 potentially relevant papers, respectively...
November 7, 2017: Current Eye Research
https://www.readbyqxmd.com/read/29109609/end-stage-renal-disease-increases-rates-of-adverse-glucose-events-when-treating-diabetic-ketoacidosis-or-hyperosmolar-hyperglycemic-state
#8
Caitlin M Schaapveld-Davis, Ana L Negrete, Joanna Q Hudson, Jagannath Saikumar, Christopher K Finch, Mehmet Kocak, Pan Hu, Megan A Van Berkel
IN BRIEF Treatment guidelines for diabetic emergencies are well described in patients with normal to moderately impaired kidney function. However, management of patients with end-stage renal disease (ESRD) is an ongoing challenge. This article describes a retrospective study comparing the rates of adverse glucose events (defined as hypoglycemia or a decrease in glucose >200 mg/dL/h) between patients with ESRD and those with normal kidney function who were admitted with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)...
October 2017: Clinical Diabetes: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29098537/duplex-tear-film-evaporation-analysis
#9
M R Stapf, R J Braun, P E King-Smith
Tear film thinning, hyperosmolarity, and breakup can cause irritation and damage to the human eye, and these form an area of active investigation for dry eye syndrome research. Recent research demonstrates that deficiencies in the lipid layer may cause locally increased evaporation, inducing conditions for breakup. In this paper, we explore the conditions for tear film breakup by considering a model for tear film dynamics with two mobile fluid layers, the aqueous and lipid layers. In addition, we include the effects of osmosis, evaporation as modified by the lipid, and the polar portion of the lipid layer...
November 2, 2017: Bulletin of Mathematical Biology
https://www.readbyqxmd.com/read/29095384/hyperglycemic-hyperosmolar-state-during-induction-chemotherapy-for-acute-lymphoblastic-leukemia
#10
Randall Yimbong Chan, Ankit V K Shah, Keith E Lewis, Jeffrey L Johnson, Paola Sequeira, Cynthia H Ho
We present the case of a 16-year-old boy who presented with fatigue, polyuria, and polydipsia while on chemotherapy for his relapsed acute lymphoblastic leukemia (ALL). Blood gas examination confirmed the diagnosis of hyperosmolar hyperglycemic state. The etiology for his hyperglycemia was most likely a result of oral glucocorticoid therapy combined with asparaginase therapy-both are a cornerstone of induction chemotherapy for ALL. The patient was aggressively rehydrated with saline, and medications were administered to correct his hyperkalemia...
October 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29088945/editorial-sodium-values-and-the-use-of-hyperosmolar-therapy-following-traumatic-brain-injury
#11
Gregory W J Hawryluk
No abstract text is available yet for this article.
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29081083/ionotropic-receptor-76b-is-required-for-gustatory-aversion-to-excessive-na-in-drosophila
#12
Min Jung Lee, Ha Yeon Sung, HyunJi Jo, Hyung-Wook Kim, Min Sung Choi, Jae Young Kwon, KyeongJin Kang
Avoiding ingestion of excessively salty food is essential for cation homeostasis that underlies various physiological processes in organisms. The molecular and cellular basis of the aversive salt taste, however, remains elusive. Through a behavioral reverse genetic screening, we discover that feeding suppression by Na(+)-rich food requires Ionotropic Receptor 76b (Ir76b) in Drosophila labellar gustatory receptor neurons (GRNs). Concentrated sodium solutions with various anions caused feeding suppression dependent on Ir76b...
October 2017: Molecules and Cells
https://www.readbyqxmd.com/read/29067261/active-cocaine-use-does-not-increase-the-likelihood-of-hyperglycemic-crisis
#13
Katherine L Modzelewski, Denis V Rybin, Janice M Weinberg, Sara M Alexanian, Marie E McDonnell, Devin W Steenkamp
OBJECTIVE: Hyperglycemic crisis encompasses a group of diabetes emergencies characterized by insulin deficiency with high morbidity and mortality. Cocaine use is increasingly prevalent in the United States and may be associated with increased risk of diabetic ketoacidosis. The objective was to determine if active cocaine use at hospital admission could be considered a risk factor for development of hyperglycemic crisis. METHODS: A retrospective case-control analysis was performed on 950 inpatients with hyperglycemia at an urban academic hospital...
September 2017: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29055361/the-pathophysiology-of-dry-eye-disease-what-we-know-and-future-directions-for-research
#14
REVIEW
Stephen C Pflugfelder, Cintia S de Paiva
Clinical and laboratory studies performed over the past few decades have discovered that dry eye is a chronic inflammatory disease that can be initiated by numerous extrinsic or intrinsic factors that promote an unstable and hyperosmolar tear film. These changes in tear composition, in some cases combined with systemic factors, lead to an inflammatory cycle that causes ocular surface epithelial disease and neural stimulation. Acute desiccation activates stress signaling pathways in the ocular surface epithelium and resident immune cells...
November 2017: Ophthalmology
https://www.readbyqxmd.com/read/29055358/meibomian-gland-disease-the-role-of-gland-dysfunction-in-dry-eye-disease
#15
REVIEW
Priyanka Chhadva, Raquel Goldhardt, Anat Galor
TOPIC: To discuss the pathology, causes, and ocular surface impact of meibomian gland disease (MGD), as well as its relationship to dry eye. CLINICAL RELEVANCE: MGD is a common disorder with various contributing mechanisms and clinical manifestations. Understanding MGD pathophysiology and its relationship to dry eye is important in order to optimize diagnosis and treatment algorithms. METHODS: A review of current literature was performed to discern MGD in terms of pathophysiology, risk factors, and ocular surface impact, and the relationship to dry eye...
November 2017: Ophthalmology
https://www.readbyqxmd.com/read/28992763/hyperosmolar-potassium-k-treatment-suppresses-osteoarthritic-chondrocyte-catabolic-and-inflammatory-protein-production-in-a-3-dimensional-in-vitro-model
#16
Josh Erndt-Marino, Erik Trinkle, Mariah S Hahn
Objective The main goal of this study was to provide a proof-of-concept demonstrating that hyperosmolar K(+) solutions can limit production of catabolic and inflammatory mediators in human osteoarthritic chondrocytes (OACs). Methods A 3-dimensional in vitro model with poly(ethylene glycol) diacrylate (PEGDA) hydrogels was used. Catabolic and pro-inflammatory protein production from encapsulated OACs was assessed following culture for 1 or 7 days in the presence or absence of 80 mM K(+) gluconate, 80 mM sodium (Na(+)) gluconate, or 160 mM sucrose, each added to culture media (final osmolarity ~490 mOsm)...
October 1, 2017: Cartilage
https://www.readbyqxmd.com/read/28988226/severe-complications-after-initial-management-of-hyperglycemic-hyperosmolar-syndrome-and-diabetic-ketoacidosis-with-a-standard-diabetic-ketoacidosis-protocol
#17
Bimota Nambam, Emily Menefee, Neslihan Gungor, Robert Mcvie
Hyperglycemic hyperosmolar syndrome (HHS) is a clinical entity not identical to diabetic ketoacidosis (DKA), and with a markedly higher mortality. Children with HHS can also present with concomitant DKA. Patients with HHS (with or without DKA) are profoundly dehydrated but often receive inadequate fluid resuscitation as well as intravenous insulin therapy based on traditional DKA protocols, and this can lead to devastating consequences. In this article, we briefly review HHS along with a report of an adolescent who presented with HHS and DKA and was initially managed as DKA...
October 26, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28974999/malignant-posterior-reversible-encephalopathy-syndrome-an-exacting-challenge-for-neurocritical-care-physicians
#18
Shahvaiz Magsi, Atif Zafar
We report a case of malignant posterior reversible encephalopathy syndrome (PRES) in a 62-year-old Caucasian female with a complex medical history and comorbidities admitted for bowel resection and lysis of iatrogenic bowel adhesions and enterocutaneous fistulas. Postoperatively, the patient developed sudden bilateral visual loss with no other neurologic deficits. Computed tomography scan showed very severe PRES-like changes, confirmed on magnetic resonance imaging (MRI). Systolic blood pressure remained around 170 mm HG...
October 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28958415/estimating-basal-tear-osmolarity-in-normal-and-dry-eye-subjects
#19
Catherine Willshire, Roger J Buckley, Anthony J Bron
PURPOSE: Tear osmolarity (tOsm) is used as a measure of severity in dry eye disease (DED) and has been proposed as an index of body hydration. In DED the level of tear hyperosmolarity is compared with that of a control population. It is proposed here that a better index of body hydration and a more valid reference point in DED can be acquired by measuring the tOsm after a period of evaporative suppression. METHOD: 8 normal and DED subjects were recruited, their tOsm measured in uncontrolled environmental 'clinic conditions'...
September 22, 2017: Contact Lens & Anterior Eye: the Journal of the British Contact Lens Association
https://www.readbyqxmd.com/read/28954970/effectiveness-of-levodopa-treatment-for-diabetic-chorea-with-reduced-striatal-accumulation-in-dopamine-transporter-spect-a-case-report
#20
Katsunori Yokoi, Tomoyuki Kazuta, Ryouta Torii, Toshihiro Endo, Amane Araki, Shinichi Terao
We report the case of a 77-year-old woman with diabetic chorea, which presented as hemiballism of the right limbs. Initial blood examination revealed that sugar and hemoglobin A1c levels were 732 mg/dl and 12.2%, respectively. Thus, a diagnosis of hyperglycemic hyperosmolar syndrome was made at a previous hospital. Ballism of the right limbs developed after 10 days and progressively worsened. After a month, the patient was admitted to our hospital. Brain MRI (axial T1-weighted imaging) revealed a high-signal-intensity area in the left striatum...
October 27, 2017: Rinshō Shinkeigaku, Clinical Neurology
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