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https://www.readbyqxmd.com/read/28324468/ascariasis-and-hyperosmolar-hyperglycemic-state-a-surprising-ultrasound-finding-in-the-emergency-department
#1
Giles N Cattermole, Jean-Paul Nzabandora
BACKGROUND: We report the ultrasound finding of ascariasis in a patient with hyperosmolar hyperglycemic state (HHS). Although ascariasis is common in low-resource settings, there has been no previous report associating ascariasis with HHS. CASE PRESENTATION: A 26-year-old Rwandan man was admitted to the emergency department in coma, with a glycemia of 600 mg/dl. He was resuscitated with fluids, intubated and ventilated, and treated with insulin and antibiotics...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28319185/real-time-monitoring-of-human-blood-brain-barrier-disruption
#2
Vesa Kiviniemi, Vesa Korhonen, Jukka Kortelainen, Seppo Rytky, Tuija Keinänen, Timo Tuovinen, Matti Isokangas, Eila Sonkajärvi, Topi Siniluoto, Juha Nikkinen, Seppo Alahuhta, Osmo Tervonen, Taina Turpeenniemi-Hujanen, Teemu Myllylä, Outi Kuittinen, Juha Voipio
Chemotherapy aided by opening of the blood-brain barrier with intra-arterial infusion of hyperosmolar mannitol improves the outcome in primary central nervous system lymphoma. Proper opening of the blood-brain barrier is crucial for the treatment, yet there are no means available for its real-time monitoring. The intact blood-brain barrier maintains a mV-level electrical potential difference between blood and brain tissue, giving rise to a measurable electrical signal at the scalp. Therefore, we used direct-current electroencephalography (DC-EEG) to characterize the spatiotemporal behavior of scalp-recorded slow electrical signals during blood-brain barrier opening...
2017: PloS One
https://www.readbyqxmd.com/read/28318850/safety-and-efficacy-of-hyperosmolar-irrigation-solution-in-shoulder-arthroscopy
#3
Nicholas M Capito, James L Cook, Bernardo Yahuaca, Marie D Capito, Seth L Sherman, Matthew J Smith
BACKGROUND: A hyperosmolar irrigation solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar solution were compared with a standard isotonic solution when used for shoulder arthroscopy. METHODS: A prospective, double-blind, randomized controlled trial was performed to compare isotonic (273 mOsm/L) and hyperosmolar (593 mOsm/L) irrigation solutions used for arthroscopic rotator cuff repair...
March 15, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28303369/clinical-aspects-of-changes-in-water-and-sodium-homeostasis-in-the-elderly
#4
REVIEW
Christian A Koch, Tibor Fulop
The population of elderly individuals is increasing worldwide. With aging, various hormonal and kidney changes occur, both affecting water homeostasis. Aging is a risk factor for chronic kidney disease (CKD) and many features of CKD are reproduced in the aging kidney. Dehydration and hyperosmolarity can be triggered by diminished thirst perception in this population. Elderly with dementia are especially susceptible to abnormalities of their electrolyte and body water homeostasis and should be (re-)assessed for polypharmacy...
March 16, 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/28266015/understanding-of-decreased-sialylation-of-fc-fusion-protein-in-hyperosmotic-recombinant-chinese-hamster-ovary-cell-culture-n-glycosylation-gene-expression-and-n-linked-glycan-antennary-profile
#5
Jong Hyun Lee, Yeong Ran Jeong, Yeon-Gu Kim, Gyun Min Lee
To understand the effects of hyperosmolality on protein glycosylation, recombinant Chinese hamster ovary (rCHO) cells producing the Fc-fusion protein were cultivated in hyperosmolar medium resulting from adding NaCl (415 mOsm/kg). The hyperosmotic culture showed increased specific Fc-fusion protein productivity (qFc ) but a decreased proportion of acidic isoforms and sialic acid content of the Fc-fusion protein. The intracellular and extracellular sialidase activities in the hyperosmotic cultures were similar to those in the control culture (314 mOsm/kg), indicating that reduced sialylation of Fc-fusion protein at hyperosmolality was not due to elevated sialidase activity...
March 7, 2017: Biotechnology and Bioengineering
https://www.readbyqxmd.com/read/28255151/abdominal-wall-necrotising-fasciitis-a-rare-but-devastating-complication-of-the-percutaneous-endoscopic-gastrostomy-procedure
#6
M R Mohd Said, R Abdul Rani, R A Raja Ali, C S Ngiu
Percutaneous Endoscopic Gastrostomy (PEG) tubes were often offered to patients requiring long term enteral feeding. Even though the procedure is relatively safe, it is associated with various complications such as peritonitis or even death.1 We presented a case of a 54-year-old gentleman with underlying ischemic stroke and pus discharges from a recently inserted PEG tube. Computed Topography (CT) scan confirmed abdominal wall necrotising fasciitis complicated with hyperosmolar hyperglycaemia state (HHS) and later succumbed after 48 hours of admission...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28250152/acute-corneal-epithelial-debridement-unmasks-the-corneal-stromal-nerve-responses-to-ocular-stimulation-in-rats-implications-for-abnormal-sensations-of-the-eye
#7
Harumitsu Hirata, Kamila K Mizerska, Valentina A Dallacasagrande, Victor H Guaiquil, Mark I Rosenblatt
It is widely accepted that the mechanisms for transducing sensory information reside in the nerve terminals. Occasionally, however, studies have appeared demonstrating that similar mechanisms may exist in the axon to which these terminals are connected. We examined this issue using the cornea where nerve terminals in the epithelial cell layers are easily accessible for debridement, leaving the underlying stromal (axonal) nerves undisturbed. In isoflurane-anesthetized rats, we recorded extracellularly from single trigeminal ganglion neurons innervating the cornea that are excited by ocular dryness and cooling: low threshold (<2 oC cooling) and high threshold (>2 oC) cold-sensitive plus dry sensitive (LT-CS+DS and HT-CS+DS) neurons, playing possible roles in tearing and ocular pain...
March 1, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28245347/autologous-serum-eye-drops-for-dry-eye
#8
REVIEW
Qing Pan, Adla Angelina, Michael Marrone, Walter J Stark, Esen K Akpek
BACKGROUND: Theoretically, autologous serum eye drops (AS) offer a potential advantage over traditional therapies on the assumption that AS not only serve as a lacrimal substitute to provide lubrication but contain other biochemical components that allow them to mimic natural tears more closely. Application of AS has gained popularity as second-line therapy for patients with dry eye. Published studies on this subject indicate that autologous serum could be an effective treatment for dry eye...
February 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28238526/mitochondrial-dna-oxidation-induces-imbalanced-activity-of-nlrp3-nlrp6-inflammasomes-by-activation-of-caspase-8-and-brcc36-in-dry-eye
#9
Wei Chi, Xia Hua, Xin Chen, Fang Bian, Xiaoyong Yuan, Lili Zhang, Xiaoran Wang, Ding Chen, Ruzhi Deng, Zhijie Li, Yizhi Liu, Cintia S de Paiva, Stephen C Pflugfelder, De-Quan Li
The concept of innate immunity has been expanded to recognize environmental pathogens other than microbial components. However, whether and how the innate immunity is initiated by epithelium in response to environmental physical challenges such as low humidity and high osmolarity in an autoimmune disease, dry eye, is still largely unknown. Using two experimental dry eye models, primary human corneal epithelial cultures exposed to hyperosmolarity and mouse ocular surface facing desiccating stress, we uncovered novel innate immunity pathway by ocular surface epithelium, where oxidized mitochondrial DNA induces imbalanced activation of NLRP3/NLRP6 inflammasomes via stimulation of caspase-8 and BRCC36 in response to environmental stress...
February 23, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28212925/reversible-opercular-syndrome-secondary-to-osmotic-demyelination
#10
Shuchit Pandey, Vikram V Holla, Imran Rizvi, Rakesh Shukla
Opercular syndrome (OPS) is characterized by weakness of facial, masticatory, pharyngeal, laryngeal, tongue and brachial muscles on voluntary command with preservation of emotional and reflexive movements. We report a case of 45year old female who developed the features of OPS due to lesions of bilateral frontal opercular region induced by osmotic demyelination secondary to hyperosmolar hyperglycaemia. On follow up at 6 months, she had complete recovery.
February 11, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28176024/hyperosmotic-stress-induces-atp-release-and-changes-in-p2x7-receptor-levels-in-human-corneal-and-conjunctival-epithelial-cells
#11
Ana Guzman-Aranguez, María J Pérez de Lara, Jesús Pintor
Tear hyperosmolarity is a key event in dry eye. In this work, we analyzed whether hyperosmolar challenge induces ATP release on the ocular surface. Moreover, as extracellular ATP can activate P2X7 receptor, the changes in P2X7 protein levels and its involvement in pathological process triggered by hypertonic treatment were also examined. High-performance liquid chromatography analysis revealed that ATP levels significantly increased in human corneal and conjunctival epithelial cells exposed to hyperosmotic challenge as well as in dry eye patients as compared to control subjects...
February 7, 2017: Purinergic Signalling
https://www.readbyqxmd.com/read/28168986/gastric-emptying-is-reduced-in-experimental-nec-and-correlates-with-the-severity-of-intestinal-damage
#12
Yuhki Koike, Bo Li, Carol Lee, Shigang Cheng, Hiromu Miyake, Christopher Welsh, Alison Hock, Jaques Belik, Augusto Zani, Agostino Pierro
PURPOSE: The aim of this study is to assess gastric emptying in experimental necrotizing enterocolitis (NEC) and its diagnostic significance using non-invasive ultrasound imaging. METHODS: Fourteen neonatal mice (C57BL/6) were randomized into two groups: NEC [n=10] and control [n=4]. NEC was induced by gavage feeding of hyperosmolar formula, hypoxia, and lipopolysaccharide between postnatal day 5 (P5) and 9 (P9). Stomach volume was measured using a 40-MHz ultrasound transducer on P5 and P9...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28146363/keratitis-in-dry-eye-disease-and-topical-ciclosporin-a
#13
Andrea Leonardi, Bruno Flamion, Christophe Baudouin
Tear film alterations in dry eye disease (DED) include reduced tear volume and an increase in inflammatory cytokines. Instability and reduced tear production initiate a vicious cycle where hyperosmolarity, ocular inflammation, and apoptosis may induce damage of the ocular surface including keratitis. Topical cyclosporine (CsA) has been used for the treatment of moderate-to-severe DED; however, previous studies failed to demonstrate its benefits by the European Agency standards. A new formulation of CsA 0.1% has been recently approved in the EU to treat severe keratitis in DED patients...
February 1, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/28145211/-fatal-cerebral-oedema-during-the-treatment-of-diabetic-ketoacidosis-in-an-adult-male
#14
T J A Dekker, J A Janson, E J Hoorn, Y W J Sijpkens
Diabetic ketoacidosis is relatively common, but the optimal treatment of this condition is still controversial. Cerebral oedema is a rare, but potentially fatal complication. We present the case of an adult patient who presented with de novo diabetic ketoacidosis that was complicated by cerebral oedema during treatment. In this article we discuss factors that may have played a role in the development of this complication. A prolonged hyperosmolar state in diabetic ketoacidosis may increase the risk of cerebral oedema as a result of cerebral compensatory mechanisms...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28137665/diabetic-microangiopathy-pathogenetic-insights-and-novel-therapeutic-approaches
#15
REVIEW
Rosalinda Madonna, Carmela Rita Balistreri, Yong-Jian Geng, Raffaele De Caterina
Diabetic microangiopathy, including retinopathy, is characterized by abnormal growth and leakage of small blood vessels, resulting in local edema and functional impairment of the depending tissues. Mechanisms leading to the impairment of microcirculation in diabetes are multiple and still largely unclear. However, a dysregulated vascular regeneration appears to play a key role. In addition, oxidative and hyperosmolar stress, as well as the activation of inflammatory pathways triggered by advanced glycation end-products and toll-like receptors, have been recognized as key underlying events...
March 2017: Vascular Pharmacology
https://www.readbyqxmd.com/read/28130014/-biology-and-mechanobiology-of-the-intervertebral-disc
#16
Emilio González Martínez, José García-Cosamalón, Iván Cosamalón-Gan, Marta Esteban Blanco, Olivia García-Suarez, José A Vega
The intervertebral disc (IVD) is noted for its low cell content, and being the largest avascular structure of human body. The low amount of cells in the disc have to adapt to an anaerobic metabolism with low oxygen pressure and acidic pH. Apart from surviving in an adverse microenvironment, they are exposed to a high level of mechanical stress. The biological adaptation of cells to acidosis and hyperosmolarity conditions are regulated by mechanoproteins, which are responsible for converting a mechanical signal into a cellular response, thus modifying its gene expression...
January 24, 2017: Neurocirugía
https://www.readbyqxmd.com/read/28122469/dexmedetomidine-for-refractory-intracranial-hypertension
#17
Kendra J Schomer, Christian M Sebat, Jason Y Adams, Jeremiah J Duby, Kiarash Shahlaie, Erin L Louie
Dexmedetomidine (DEX) is a selective α2 adrenergic agonist that is commonly used for sedation in the intensive care unit (ICU). The role of DEX for adjunctive treatment of refractory intracranial hypertension is poorly defined. The primary objective of this study was to determine the effect of DEX on the need for rescue therapy (ie, hyperosmolar boluses, extraventricular drain [EVD] drainages) for refractory intracranial hypertension. Secondary objectives included the number of intracranial pressure (ICP) excursions, bradycardic, hypotensive, and compromised cerebral perfusion pressure episodes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28114576/estimating-the-osmolarities-of-tears-during-evaporation-through-the-eyes-of-the-corneal-nerves
#18
Harumitsu Hirata, Kamila Mizerska, Valentina Dallacasagrande, Mark I Rosenblatt
Purpose: A population of corneal neurons in rats preferentially sense and monitor the hyperosmolar conditions of tears when the tears begin to evaporate during corneal dryness. The present study exploited this ability in an effort to estimate tear osmolarities by comparing the responses to corneal dryness to their responses to hyperosmolar stimuli. Methods: Extracellular recordings were performed from single neurons in the trigeminal ganglia innervating the corneas of rats...
January 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28112005/hemichorea-caused-by-nonketotic-hyperosmolar-state-a-case-report-and-review-of-the-literature
#19
Hafiz Khuram Raza, Jia Jing, Guiyun Cui, Xiaoqian Liang, Fang Hua, Zunsheng Zhang, Hai Tang, Hongjuan Shi, Hao Chen
Our report involves a case of hemichorea caused by the nonketotic hyperosmolar state. We have analyzed the clinical data and relevant features of a patient who presented herself to the Affiliated Hospital of Xuzhou Medical University. The patient had unilateral involuntary movements for 1 month. We discovered that her blood glucose levels were very high. The patient underwent computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance angiography (MRA), indicating right basal ganglia lesion...
January 22, 2017: Somatosensory & Motor Research
https://www.readbyqxmd.com/read/28107262/suspected-cerebral-edema-in-diabetic-ketoacidosis-is-there-still-a-role-for-head-ct-in-treatment-decisions
#20
Carmen L Soto-Rivera, Lisa A Asaro, Michael S D Agus, Danielle D DeCourcey
OBJECTIVES: Neurologic deterioration associated with cerebral edema in diabetic ketoacidosis is typically sudden in onset, progresses rapidly, and requires emergent treatment. The utility of brain imaging by head CT in decisions to treat for cerebral edema has not been previously studied. The objective of this study was to describe the characteristics of pediatric patients with diabetic ketoacidosis who develop altered mental status and evaluate the role of head CT in this cohort. DESIGN: Retrospective analysis of clinical, biochemical, and radiologic data...
March 2017: Pediatric Critical Care Medicine
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