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https://www.readbyqxmd.com/read/28812394/the-use-of-sustained-low-efficiency-dialysis-sled-in-massive-paracetamol-overdose
#1
Anselm Wong, Roger L K Tong, Liam Ryan, Tim Crozier, Andis Graudins
CONTEXT: Massive paracetamol ingestion causing mitochondrial dysfunction is uncommon. Use of sustained low-efficiency dialysis (SLED) to improve acidaemia and enhance paracetamol elimination has not been previously described. CASE DETAILS: A 44-year-old male presented to the emergency department 2.5 hours post overdose of 200 g (2.5 g/kg) of paracetamol. Examination revealed a BP 85/60 mmHg, pulse 112 bpm, temperature 33.9 °C and blood glucose of 13...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28807212/comparison-of-normothermic-and-hypothermic-perfusion-in-porcine-kidneys-donated-after-cardiac-death
#2
Matthew F Blum, Qiang Liu, Basem Soliman, Paul Dreher, Toshihiro Okamoto, Emilio D Poggio, David A Goldfarb, William M Baldwin, Cristiano Quintini
BACKGROUND: Normothermic machine perfusion (NMP) is an alternative strategy for preserving kidneys donated after cardiac death (DCD). The relative efficacy of prolonged NMP compared to hypothermic machine perfusion (HMP) in DCD kidneys with moderate ischemic injury is undetermined. This study compares NMP and HMP kidney preservation in a porcine DCD model. METHODS: Ten porcine kidneys underwent NMP or HMP preservation following 45 minutes of warm ischemia and 5 hours of cold ischemia...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28795667/-predictive-value-of-sofa-qsofa-score-and-traditional-evaluation-index-on-sepsis-prognosis
#3
Ying Wang, Difen Wang, Jiangquan Fu, Ying Liu
OBJECTIVE: Assess the value of several biomarkers and disease severity scores for the prognostic assessment of sepsis. METHODS: The clinical data of adult patients, who met the diagnostic criteria for Sepsis-3 and admitted to the intensive care unit (ICU) of Affiliated Hospital of Guizhou Medical University from January 2015 to December 2016 were retrospectively analyzed. These patients were divided into survival group and death group. The levels of serum lactate (Lac), lactate clearance rate of 24 hours later (24 h LCR), procalcitonin (PCT), quick sequential organ failure assessment (qSOFA) score, SOFA score, simplified acute physiology score II (SAPS II), acute physiology and chronic health evaluation scoring system II (APACHE II) score were determined, and the receiver operating characteristic curve (ROC) were used to analyze the prognostic value of the indicators above...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28774367/-myocardial-protective-effect-of-l-carnitine-in-children-with-hand-foot-and-mouth-disease-caused-by-coxsackie-a16-virus
#4
Ya-Jie Cui, Chun-Lan Song, Fang Chen, Peng Li, Yi-Bing Cheng
OBJECTIVE: To investigate the myocardial protective effect of L-carnitine in children with hand, foot and mouth disease (HFMD) caused by Coxsackie A16 virus and possible mechanisms. METHODS: A total of 60 HFMD children with abnormal myocardial enzyme after Coxsackie A16 virus infection were enrolled and randomly divided into L-carnitine group and fructose-1,6-diphosphate group (fructose group), with 30 children in each group. The two groups were given L-carnitine or fructose diphosphate in addition to antiviral and heat clearance treatment...
August 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28772222/hyperlactatemia-in-icu-patients-incidence-causes-and-associated-mortality
#5
Mireia Ferreruela, Joan Maria Raurich, Ignacio Ayestarán, Juan Antonio Llompart-Pou
PURPOSE: To describe the incidence, causes and associated mortality of hyperlactatemia in critically ill patients and to evaluate the association between lactate clearance and in-hospital survival. METHODS: Retrospective cohort study of patients with hyperlactatemia admitted to the ICU. Hyperlactatemia was defined as a blood lactate concentration ≥5mmol/L and high-grade hyperlactatemia a lactate level ≥10mmol/L. Lactate clearance was calculated as the percentage of decrease in lactate concentration from the peak value...
July 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28766535/-adult-b-cell-acute-lymphoblastic-leukemias-conclusions-of-the-russian-prospective-multicenter-study-all-2009
#6
E N Parovichnikova, V V Troitskaya, A N Sokolov, S N Bondarenko, O A Gavrilina, G A Baskhaeva, B V Biderman, I A Lukyanova, L A Kuz'mina, G A Klyasova, S K Kravchenko, E O Gribanova, E E Zvonkov, Z Kh Akhmerzaeva, O Yu Baranova, T S Kaporskaya, T V Ryltsova, E N Zotina, E E Zinina, O S Samoilova, K D Kaplanov, L V Gavrilova, T S Konstantinova, V A Lapin, A S Pristupa, A S Eluferyeva, T N Obukhova, I S Piskunova, I V Gal'tseva, V N Dvirnyk, M A Rusinov, S M Kulikov, V G Savchenko
AIM: To analyze the efficiency and reproducibility of the ALL-2009 protocol within the Russian prospective multicenter study based on different principles of cytostatic effects (non-intensive, but continuous cytotoxic treatment and a small number of allogeneic hematopoietic stem cells). SUBJECTS AND METHODS: The ALL-2009 (NCT01193933) study conducted in April 2009 to December 2016 included 194 patients (95 males and 99 females) aged 15 to 55 years (median age 28 years) with Ph-negative B-cell acute lymphoblastic leukemia (ALL)...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28685832/assessment-of-genotoxicity-and-biodistribution-of-nano-and-micron-sized-yttrium-oxide-in-rats-after-acute-oral-treatment
#7
Archana Panyala, Srinivas Chinde, Srinivas Indu Kumari, Paramjit Grover
The increasing use of yttrium oxide (Y2 O3 ) nanoparticles (NPs) entails an improved understanding of their potential impact on the environmental and human health. In the present study, the acute oral toxicity of Y2 O3 NPs and their microparticles (MPs) was carried out in female albino Wistar rats with 250, 500 and 1000 mg kg(-1) body weight doses. Before the genotoxicity evaluation, characterization of the particles by transmission electron microscopy, dynamic light scattering and laser Doppler velocimetry was performed...
July 7, 2017: Journal of Applied Toxicology: JAT
https://www.readbyqxmd.com/read/28672145/lactate-and-lactate-clearance-as-valuable-tool-to-evaluate-ecmo-therapy-in-cardiogenic-shock
#8
Ingo Slottosch, Oliver Liakopoulos, Elmar Kuhn, Maximilian Scherner, Antje-Christin Deppe, Anton Sabashnikov, Navid Mader, Yeong-Hoon Choi, Jens Wippermann, Thorsten Wahlers
PURPOSE: ECMO support is an ultimate ratio therapy for patients in refractory cardiogenic shock and is linked to high mortality. We assessed the dynamic characteristics of lactate during ECMO therapy and its predictive role on 30-day mortality. MATERIALS AND METHODS: Data were retrospectively collected in all patients receiving ECMO support longer than 48h for cardiogenic shock from 01/2008 to 12/2016. Blood lactate was recorded before ECMO implantation, at prespecified timepoints during ECMO support, 1h and 6h post-ECMO as well as peak lactate during ECMO and peak within 24h after ECMO support...
June 23, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28659919/the-%C3%AE-d-endoglucuronidase-heparanase-is-a-danger-molecule-that-drives-systemic-inflammation-and-correlates-with-clinical-course-after-open-and-endovascular-thoracoabdominal-aortic-aneurysm-repair-lessons-learnt-from-mice-and-men
#9
Lukas Martin, Alexander Gombert, Jianmin Chen, Julia Liebens, Julia Verleger, Johannes Kalder, Gernot Marx, Michael Jacobs, Christoph Thiemermann, Tobias Schuerholz
Thoracoabdominal aortic aneurysm (TAAA) is a highly lethal disorder requiring open or endovascular TAAA repair, both of which are rare, but extensive and complex surgical procedures associated with a significant systemic inflammatory response and high post-operative morbidity and mortality. Heparanase is a β-d-endoglucuronidase that remodels the endothelial glycocalyx by degrading heparan sulfate in many diseases/conditions associated with systemic inflammation including sepsis, trauma, and major surgery. We hypothesized that (a) perioperative serum levels of heparanase and heparan sulfate are associated with the clinical course after open or endovascular TAAA repair and (b) induce a systemic inflammatory response and renal injury/dysfunction in mice...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28651888/how-can-lifeguards-recover-better-a-cross-over-study-comparing-resting-running-and-foam-rolling
#10
Anton Kalén, Alexandra Pérez-Ferreirós, Roberto Barcala-Furelos, María Fernández-Méndez, Alexis Padrón-Cabo, Jose A Prieto, Andrés Ríos-Ave, Cristian Abelairas-Gómez
PURPOSE: The aim of this study is to compare the effectiveness of active recovery in form of running or foam rolling on clearing blood lactate compared to remain sitting after a water rescue. METHOD: A quasi experimental cross-over design was used to test the effectiveness of two active recovery methods: foam rolling (FR) and running (RR), compared with passive recovery (PR) on the blood lactate clearance after performing a water rescue. Twelve lifeguards from Marín (Pontevedra) completed the study...
June 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28642717/the-lactate-minimum-test-concept-methodological-aspects-and-insights-for-future-investigations-in-human-and-animal-models
#11
REVIEW
Leonardo H D Messias, Claudio A Gobatto, Wladimir R Beck, Fúlvia B Manchado-Gobatto
In 1993, Uwe Tegtbur proposed a useful physiological protocol named the lactate minimum test (LMT). This test consists of three distinct phases. Firstly, subjects must perform high intensity efforts to induce hyperlactatemia (phase 1). Subsequently, 8 min of recovery are allowed for transposition of lactate from myocytes (for instance) to the bloodstream (phase 2). Right after the recovery, subjects are submitted to an incremental test until exhaustion (phase 3). The blood lactate concentration is expected to fall during the first stages of the incremental test and as the intensity increases in subsequent stages, to rise again forming a "U" shaped blood lactate kinetic...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28625256/-comparison-of-effect-of-norepinephrine-and-terlipressin-on-patients-with-ards-combined-with-septic-shock-a-prospective-single-blind-randomized-controlled-trial
#12
Zhi Chen, Ping Zhou, Yuanhua Lu, Chunli Yang
OBJECTIVE: To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock. METHODS: A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28611673/reversing-egfr-mediated-immunoescape-by-targeted-monoclonal-antibody-therapy
#13
REVIEW
Fernando Concha-Benavente, Robert L Ferris
Uncontrolled growth is a signature of carcinogenesis, in part mediated by overexpression or overstimulation of growth factor receptors. The epidermal growth factor receptor (EGFR) mediates activation of multiple oncogenic signaling pathways and escape from recognition by the host immune system. We discuss how EGFR signaling downregulates tumor antigen presentation, upregulates suppressive checkpoint receptor ligand programmed death ligand (PD-L1), induces secretion of inhibitory molecules such as transforming growth factor beta (TGFβ) and reprograms the metabolic pathways in cancer cells to upregulate aerobic glycolysis and lactate secretion that ultimately lead to impaired cellular immunity mediated by natural killer (NK) cell and cytotoxic T lymphocytes (CTL)...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28599714/effects-of-moderate-alcohol-consumption-on-gene-expression-related-to-colonic-inflammation-and-antioxidant-enzymes-in-rats
#14
DawnKylee S Klarich, Jerrold Penprase, Patricia Cintora, Octavio Medrano, Danielle Erwin, Susan M Brasser, Mee Young Hong
Excessive alcohol consumption is a risk factor associated with colorectal cancer; however, some studies have reported that moderate alcohol consumption may not contribute additional risk for developing colorectal cancer while others suggest that moderate alcohol consumption provides a protective effect that reduces colorectal cancer risk. The purpose of this study was to determine the effects of moderate voluntary alcohol (20% ethanol) intake on alternate days for 3 months in outbred Wistar rats on risk factors associated with colorectal cancer development...
June 2017: Alcohol
https://www.readbyqxmd.com/read/28591008/plasma-resuscitation-improved-survival-in-a-cecal-ligation-and-puncture-rat-model-of-sepsis
#15
Ronald Chang, John B Holcomb, Par I Johansson, Shibani Pati, Martin A Schreiber, Charles E Wade
BACKGROUND: The paradigm shift from crystalloid to plasma resuscitation of traumatic hemorrhagic shock has improved patient outcomes due in part to plasma-mediated reversal of catecholamine and inflammation-induced endothelial injury, decreasing vascular permeability and attenuating organ injury. Since sepsis induces a similar endothelial injury as seen in hemorrhage, we hypothesized that plasma resuscitation would increase 48-hour survival in a rat sepsis model. METHODS: Adult male Sprague-Dawley rats (375-425 g) were subjected to 35% cecal ligation and puncture (CLP) (t = 0 h)...
June 6, 2017: Shock
https://www.readbyqxmd.com/read/28589286/extracorporeal-cytokine-elimination-as-rescue-therapy-in-refractory-septic-shock-a-prospective-single-center-study
#16
Sigrun Friesecke, Stephanie-Susanne Stecher, Stefan Gross, Stephan B Felix, Axel Nierhaus
Sepsis is the most common cause of death in medical intensive care units (ICU). If sepsis progresses to refractory septic shock, mortality may reach 90-100% despite optimum current therapy. Extracorporeal cytokine adsorption in addition to regular therapy was studied prospectively in refractory septic shock patients on a medical ICU. Refractory shock was defined as increasing vasopressor dose required to maintain mean arterial blood pressure above 65 mmHg or increasing lactate levels despite protocol-guided shock therapy for 6 h...
June 6, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28569187/the-effects-of-acute-renal-denervation-on-kidney-perfusion-and-metabolism-in-experimental-septic-shock
#17
Emiel Hendrik Post, Fuhong Su, Koji Hosokawa, Fabio Silvio Taccone, Antoine Herpain, Jacques Creteur, Daniel De Backer, Jean-Louis Vincent
BACKGROUND: Perfusion deficits likely play an important role in the development of renal dysfunction in sepsis. Renal denervation may improve kidney perfusion and metabolism. METHODS: We randomized 14 female sheep to undergo bilateral surgical renal denervation (n = 7) or sham procedure (n = 7) prior to induction of sepsis. Renal blood flow (RBF) was measured with a pre-calibrated flowprobe. Laser Doppler probes were implanted to measure cortical and medullary perfusion...
May 31, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28557718/combination-clearance-therapy-and-barbiturate-coma-for-severe-carbamazepine-overdose
#18
Asya Agulnik, Daniel P Kelly, Rebecca Bruccoleri, Christopher Yuskaitis, Darius Ebrahimi-Fakhari, Mustafa Sahin, Michele M Burns, Daniel S Kohane
A 15-year-old female subject presented comatose, in respiratory failure and shock, after the intentional ingestion of ∼280 extended-release 200-mg carbamazepine tablets with a peak serum concentration of 138 µg/mL (583.74 µmol/L). The patient developed clinical seizures and an EEG pattern of stimulus-induced rhythmic, periodic, or ictal discharges, suggestive of significant cortical dysfunction. Due to the extremely high drug serum concentration and clinical instability, a combination of therapies was used, including lipid emulsion therapy, plasmapheresis, hemodialysis, continuous venovenous hemodiafiltration, and endoscopic intestinal decontamination...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28538624/comparison-of-compensatory-reserve-and-arterial-lactate-as-markers-of-shock-and-resuscitation
#19
Michael Johnson, Abdul Alarhayem, Victor Convertino, Robert Carter, Kevin Chung, Ronald Stewart, John Myers, Daniel Dent, Lilian Liao, Ramon Cestero, Susannah Nicholson, Mark Muir, Martin Schwaca, David Wampler, Mark DeRosa, Brian Eastridge
BACKGROUND: During traumatic hemorrhage, the ability to identify shock and intervene prior to decompensation is paramount to survival. Lactate is extremely sensitive to shock and its clearance has been demonstrated a useful gauge of shock and resuscitation status. Though lactate can be measured in the field, logistical constraints render it impractical in certain environments. The Compensatory Reserve represents a new clinical measurement reflecting the remaining capacity to compensate for hypoperfusion...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538441/hyperlactatemia-lactate-kinetics-and-prediction-of-citrate-accumulation-in-critically-ill-patients-undergoing-continuous-renal-replacement-therapy-with-regional-citrate-anticoagulation
#20
Dmytro Khadzhynov, Annette Dahlinger, Christin Schelter, Harm Peters, Detlef Kindgen-Milles, Klemens Budde, Lukas Johannes Lehner, Fabian Halleck, Oliver Staeck, Torsten Slowinski
OBJECTIVES: Citrate accumulation is a major complication of regional citrate anticoagulation during continuous renal replacement therapy. We studied the prediction of citrate accumulation during continuous veno-venous hemodialysis with regional citrate anticoagulation by initial lactate concentrations and lactate kinetics. DESIGN: A retrospective follow-up analysis from a cohort of critically ill patients. SETTING: Mixed medical-surgical ICUs at a university hospital...
September 2017: Critical Care Medicine
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