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https://www.readbyqxmd.com/read/28325788/decompression-illness-with-hypovolemic-shock-and-neurological-failure-symptoms-after-two-risky-dives-a-case-report
#1
Sebastian Klapa, Johannes Meyne, Wataru Kähler, Frauke Tillmans, Henning Werr, Andreas Binder, Andreas Koch
Hypovolemia is known to be a predisposing factor of decompression illness (DCI) while diving. The typical clinically impressive neurological symptoms of DCI may distract from other symptoms such as an incipient hypovolemic shock. We report the case of a 61-year-old male Caucasian, who presented with an increasing central and peripheral neural failure syndrome and massive hypovolemia after two risky dives. Computed tomography (CT) scans of the chest and Magnetic resonance imaging scans of the head revealed multiple cerebral and pulmonary thromboembolisms...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28323187/activation-of-cytotoxic-natural-killer-cells-after-aneurysmal-subarachnoid-haemorrhage
#2
Daniel Spitzer, Nina Johanna Spitzer, Monika Deininger, Christian Rainer Wirtz, Ralph König, Timo Burster, Thomas Kapapa
OBJECTIVE: Cell-mediated inflammation is critical in development of cerebrovascular complications after aneurysmal subarachnoid haemorrhage (aSAH). We analysed the course for activated CD16(bright)CD56(dim) cytotoxic NKCSF cells (NK) in cerebrospinal fluid (CSF) of 15 patients. METHODS: Patients were classified by occurrence of cerebral vasospasm and delayed cerebral ischemia. NK were monitored by flow cytometry between day 1 and 14 after haemorrhage. RESULTS: 12 (80%) patients developed CV with a mean day of detection at 3...
March 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28320890/a-biophysical-vascular-bubble-model-for-devising-decompression-procedures
#3
Ran Arieli, Abraham Marmur
Vascular bubble models, which present a realistic biophysical approach, hold great promise for devising suitable diver decompression procedures. Nanobubbles were found to nucleate on a flat hydrophobic surface, expanding to form bubbles after decompression. Such active hydrophobic spots (AHS) were formed from lung surfactants on the luminal aspect of ovine blood vessels. Many of the phenomena observed in these bubbling vessels correlated with those known to occur in diving. On the basis of our previous studies, which proposed a new model for the formation of arterial bubbles, we now suggest the biophysical model presented herein...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28319954/comparison-of-initial-vasopressors-used-for-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#4
Bhaskar Roy, Louise D McCullough, Rajat Dhar, James Grady, Yu-Bo Wang, Robert J Brown
BACKGROUND: The main reason for morbidity after aneurysmal subarachnoid hemorrhage (aSAH) is delayed cerebral ischemia (DCI). The mainstay of medical therapy for treating DCI is induced hypertension with vasopressors to restore cerebral perfusion. Both phenylephrine (PE) and norepinephrine (NE) are commonly used for induced hypertension, but the impact of the initial choice of vasopressor on the efficacy, adverse effects, or outcome after hemodynamic therapy for DCI is unknown. METHODS: Sixty-three patients with aSAH between January 2012 and October 2014, who developed DCI (defined as new focal deficit or decline in Glasgow Coma Score) and in which PE (n = 45) or NE (n = 18) treatment was initiated were evaluated in this retrospective study...
March 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28298035/effect-of-intrathecal-milrinone-injection-via-lumbar-catheter-on-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#5
Masaomi Koyanagi, Hitoshi Fukuda, Benjamin Lo, Minami Uezato, Yoshitaka Kurosaki, Nobutake Sadamasa, Akira Handa, Masaki Chin, Sen Yamagata
OBJECTIVE Delayed cerebral ischemia (DCI) is an important complication after aneurysmal subarachnoid hemorrhage (aSAH). Although intrathecal milrinone injection via lumbar catheter to prevent DCI has been previously reported to be safe and feasible, its effectiveness remains unknown. The goal of this study was to evaluate whether intrathecal milrinone injection treatment after aSAH significantly reduced the incidence of DCI. METHODS The prospectively maintained aSAH database was used to identify patients treated between January 2010 and December 2015...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28277491/manometric-subtypes-of-ineffective-esophageal-motility
#6
Mirjam Hiestand, Ala' Abdel Jalil, Donald O Castell
OBJECTIVES: Ineffective esophageal motility (IEM) is characterized by well-defined manometric criteria. However, much variation exists within the diagnosis: Some patients exhibit exactly the required five weak swallows to make the diagnosis. Others show consistently ineffective swallows with total absence of any normal swallow. "We hypothesize" there are two different manometric subtypes of IEM; IEM Alternans (IEM-A) and IEM Persistens (IEM-P). METHODS: A total of 231 IEM patients were identified by high-resolution manometry (HRM)...
March 9, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28259675/maternal-care-associates-with-differences-in-morphological-complexity-in-the-medial-preoptic-area
#7
Carine Parent, Xianglan Wen, Sabine K Dhir, Richard Ryan, Josie Diorio, Tie-Yuan Zhang
The medial preoptic area (MPOA) is implicated in the expression of maternal behavior including the frequency of pup licking/grooming (LG) in the rat. Cyclic adenosine monophosphate (cAMP) responsive element-binding protein (CREB) is a transcription factor that regulates the expression of many genes. We found that lactating rats that are more maternal towards their pups showing increased licking/grooming (i.e. high-LG mothers) had increased levels of phosphorylated CREB (pCREB) in the MPOA following a nursing bout and they displayed a reduced population of greater dendritic complexity index (DCI) neurons compared to less maternal rats showing decreased licking/grooming (i...
March 1, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28258936/epileptiform-abnormalities-predict-delayed-cerebral-ischemia-in-subarachnoid-hemorrhage
#8
J A Kim, E S Rosenthal, S Biswal, S Zafar, A V Shenoy, K L O'Connor, S C Bechek, J Valdery Moura, M M Shafi, A B Patel, S S Cash, M B Westover
OBJECTIVE: To identify whether abnormal neural activity, in the form of epileptiform discharges and rhythmic or periodic activity, which we term here ictal-interictal continuum abnormalities (IICAs), are associated with delayed cerebral ischemia (DCI). METHODS: Retrospective analysis of continuous electroencephalography (cEEG) reports and medical records from 124 patients with moderate to severe grade subarachnoid hemorrhage (SAH). We identified daily occurrence of seizures and IICAs...
January 29, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28254540/endothelial-nitric-oxide-synthase-polymorphism-is-associated-with-delayed-cerebral-ischemia-following-aneurysmal-subarachnoid-hemorrhage
#9
Philipp Hendrix, Paul M Foreman, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Minkuan Lin, Beverly C Walters, R Shane Tubbs, Mohammadali M Shoja, Jean-Francois Pittet, Mali Mathru, Christoph J Griessenauer
BACKGROUND: and Purpose: Nitric oxide (NO) is critical in the regulation of cerebral blood flow and smooth muscle proliferation. It is synthesized by three nitric oxide synthase (NOS) isoforms: neuronal (nNOS), inducible (iNOS), and endothelial NOS (eNOS). Aneurysmal subarachnoid hemorrhage (aSAH) causes endothelial dysfunction which, in turn, contributes to pathophysiological processes surrounding aSAH. Previous studies reported an association of an eNOS single nucleotide polymorphism (SNP) with the clinical sequelae of aSAH...
February 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28244000/changes-in-cerebral-perfusion-with-induced-hypertension-in-aneurysmal-subarachnoid-hemorrhage-a-pilot-and-feasibility-study
#10
Amanda Murphy, Airton Leonardo de Oliveira Manoel, R Loch Macdonald, Andrew Baker, Ting-Yim Lee, Tom Marotta, Walter Montanera, Richard Aviv, Aditya Bharatha
BACKGROUND: The effects of induced hypertension (IH) on cerebral perfusion after subarachnoid hemorrhage (SAH) are unclear. The objectives of this investigation are to: (1) determine whether there are differences in cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) measured with computed tomography perfusion (CTP) before and after IH; (2) evaluate differences in the presence of infarction and clinical outcome between patients with and without IH. METHODS: We performed a retrospective cohort analysis of 25 aneurysmal SAH patients...
February 27, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28237366/ct-perfusion-diagnoses-delayed-cerebral-ischemia-in-the-early-stage-of-the-time-window-after-aneurysmal-subarachnoid-hemorrhage
#11
Haogeng Sun, Wanjiang Li, Junpeng Ma, Yi Liu, Chao You
BACKGROUND AND PURPOSE: It has been acknowledged that delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH) can be diagnosed by CT perfusion (CTP) in the DCI time-window. We evaluated the diagnostic accuracy of CTP for DCI during the early stage of the time-window. MATERIALS AND METHODS: We prospectively enrolled patients with aneurysmal SAH. DCI was defined as both new cerebral infarction and clinical deterioration after SAH. CTP was performed by using a standardized protocol with predefined regions of interest in 4 to 6 days after SAH...
February 22, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28215402/development-of-an-efficient-fractionation-method-for-the-preparative-separation-of-sesquiterpenoids-from-tussilago-farfara-by-counter-current-chromatography
#12
Kwangho Song, Kyoung Jin Lee, Yeong Shik Kim
A novel application of counter-current chromatography (CCC) to enrich plant extracts using direct and continuous injection (CCC-DCI) was developed to fractionate sesquiterpenoids from the buds of Tussilago farfara L. In this study, an n-hexane-acetonitrile-water (HAcW) solvent system was separately pumped into the CCC column, and an extraction solution (45% acetonitrile) was directly and continuously injected into the CCC column. Since the extraction solution was used as a mobile phase in this method, solvent consumption could be greatly reduced...
March 17, 2017: Journal of Chromatography. A
https://www.readbyqxmd.com/read/28215029/an-introduction-to-the-pathophysiology-of-aneurysmal-subarachnoid-hemorrhage
#13
REVIEW
Jasper H van Lieshout, Maxine Dibué-Adjei, Jan F Cornelius, Philipp J Slotty, Toni Schneider, Tanja Restin, Hieronymus D Boogaarts, Hans-Jakob Steiger, Athanasios K Petridis, Marcel A Kamp
Pathophysiological processes following subarachnoid hemorrhage (SAH) present survivors of the initial bleeding with a high risk of morbidity and mortality during the course of the disease. As angiographic vasospasm is strongly associated with delayed cerebral ischemia (DCI) and clinical outcome, clinical trials in the last few decades focused on prevention of these angiographic spasms. Despite all efforts, no new pharmacological agents have shown to improve patient outcome. As such, it has become clear that our understanding of the pathophysiology of SAH is incomplete and we need to reevaluate our concepts on the complex pathophysiological process following SAH...
February 18, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28198781/biomechanical-analysis-of-two-level-cervical-disc-replacement-with-a-stand-alone-u-shaped-disc-implant
#14
Yang Li, Guy R Fogel, Zhenhua Liao, Rajnesh Tyagi, Gaolong Zhang, Weiqiang Liu
STUDY DESIGN: Biomechanical study using a three-dimensional nonlinear finite element (FE) model. OBJECTIVE: To analyze biomechanical changes with three prostheses based on two-level arthroplasty and to verify the biomechanical efficiency of dynamic cervical implants (DCIs) with a stand-alone U-shaped structure. SUMMARY OF BACKGROUND DATA: Few studies have compared biomechanical behavior of various prostheses as they relate to clinical results after two-level total disc replacement (TDR)...
February 14, 2017: Spine
https://www.readbyqxmd.com/read/28178386/evaluating-a-dignity-care-intervention-for-palliative-care-in-the-community-setting-community-nurses-perspectives
#15
Sonja McIlfatrick, Michael Connolly, Rita Collins, Tara Murphy, Bridget Johnston, Philip Larkin
AIM AND OBJECTIVES: To evaluate a Dignity Care Intervention (DCI) provided by community nurses seeking to address dignity concerns for people with advanced and life limiting conditions BACKGROUND: Evidence would suggest that dying people fear a loss of dignity and a central focus of palliative care is to assist people to die with dignity. Whilst community nurses have a key role to play in the delivery of palliative care, specific interventions for dignity are lacking. DESIGN: A mixed methods study using online survey and focus group interviews and thematic analysis to examine data...
February 8, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28171804/hemodynamic-and-neuro-monitoring-for-neurocritically-ill-patients-an-international-survey-of-intensivists
#16
Sanjeev Sivakumar, Fabio S Taccone, Mohammed Rehman, Holly Hinson, Neeraj Naval, Christos Lazaridis
PURPOSE: To investigate multimodality systemic and neuro-monitoring practices in acute brain injury (ABI) and to analyze differences among "neurointensivists" (NI; clinical practice comprised >1/3 by neurocritical care), and other intensivists (OI). METHODS: Anonymous 22-question Web-based survey among physician members of SCCM and ESICM. RESULTS: Six hundred fifty-five responded (66% completion rate); 422 (65%) were OI, and 226 (35%) were NI...
January 21, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28169856/postinterventional-critical-care-management-of-aneurysmal-subarachnoid-hemorrhage
#17
Sudhir Datar, Alejandro A Rabinstein
PURPOSE OF REVIEW: Subarachnoid hemorrhage from a ruptured aneurysm (aSAH) is a complex disorder with the potential to have devastating effects on the brain as well as other organ systems. After more than 3 decades of research, the underlying pathophysiologic mechanisms remain incompletely understood and important questions remain regarding the evaluation and management of these patients. The purpose of this review is to analyze the recent literature and improve our understanding of certain key clinical aspects...
April 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28159246/low-concentration-of-sodium-bicarbonate-improves-the-bioactive-compound-levels-and-antioxidant-and-%C3%AE-glucosidase-inhibitory-activities-of-tartary-buckwheat-sprouts
#18
Peiyou Qin, Aichun Wei, Degang Zhao, Yang Yao, Xiushi Yang, Baoqing Dun, Guixing Ren
This study aimed to investigate the effects of different concentrations of sodium bicarbonate (NaHCO3) on the accumulation of flavonoids, total phenolics and d-chiro-inositol (DCI), as well as the antioxidant and α-glucosidase inhibitory activities, in tartary buckwheat sprouts. Treatment with low concentrations of NaHCO3 (0.05, 0.1, and 0.2%) resulted in an increase in flavonoids, total phenolic compounds and DCI concentrations, and improved DPPH radical-scavenging and α-glucosidase inhibition activities compared with the control (0%)...
June 1, 2017: Food Chemistry
https://www.readbyqxmd.com/read/28151871/antihypertensive-medications-and-risk-of-death-and-hospitalizations-in-us-hemodialysis-patients-evidence-from-a-cohort-study-to-inform-hypertension-treatment-practices
#19
Tariq Shafi, Stephen M Sozio, Jason Luly, Karen J Bandeen-Roche, Wendy L St Peter, Patti L Ephraim, Aidan McDermott, Charles A Herzog, Deidra C Crews, Julia J Scialla, Navdeep Tangri, Dana C Miskulin, Wieneke M Michels, Bernard G Jaar, Philip G Zager, Klemens B Meyer, Albert W Wu, L Ebony Boulware
Antihypertensive medications are commonly prescribed to hemodialysis patients but the optimal regimens to prevent morbidity and mortality are unknown. The goal of our study was to compare the association of routinely prescribed antihypertensive regimens with outcomes in US hemodialysis patients.We used 2 datasets for our analysis. Our primary cohort (US Renal Data System [USRDS]) included adult patients initiating in-center hemodialysis from July 1, 2006 to June 30, 2008 (n = 33,005) with follow-up through December 31, 2009...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28138916/a-systematic-and-meta-analysis-of-mortality-in-experimental-mouse-models-analyzing-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage
#20
Marcel A Kamp, Jasper H van Lieshout, Maxine Dibué-Adjei, Jasmin K Weber, Toni Schneider, Tanja Restin, Igor Fischer, Hans-Jakob Steiger
Animal models are established to display the pathophysiological changes following subarachnoid hemorrhage (SAH). The aim of the present study was to determine case fatality in mouse delayed cerebral ischemia (DCI) models, to compare mortality in mouse DCI models to case fatality in human SAH patients, and to identify factors influencing mouse mortality. A systematic search of the PubMed database was performed to identify all studies that assessed mouse DCI models. Mortality rates and predictor variables were extracted and compared to the human case fatality after SAH as previously reported...
January 30, 2017: Translational Stroke Research
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