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https://www.readbyqxmd.com/read/28741014/post-resuscitation-care
#1
Sohil Pothiawala
Following return of spontaneous circulation (ROSC) after cardiac arrest, the challenge is to institute measures that ensure a higher likelihood of neurologically intact survival. Regardless of the cause of collapse, multiple organ systems may be affected secondary to post-cardiac arrest syndrome. Interventions required for post-ROSC care are bundled into a care regimen: prompt identification and treatment of the cause of cardiac arrest; and treatment of electrolyte abnormalities. It is also essential to establish definitive airway management to maintain normocapnic ventilation, prevent hyperoxia, and optimise haemodynamic management via judicious intravenous fluids and vasoactive drugs...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28720331/a-novel-antihypertension-agent-sargachromenol-d-from-marine-brown-algae-sargassum-siliquastrum-exerts-dual-action-as-an-l-type-ca-2-channel-blocker-and-endothelin-a-b2-receptor-antagonist
#2
Byong-Gon Park, Woon-Seob Shin, Sangtae Oh, Gab-Man Park, Nam Ik Kim, Seokjoon Lee
We isolated the novel vasoactive marine natural products, (5E,10E)-14-hydroxy-2,6,10-trimethylpentadeca-5,10-dien-4-one (4) and sargachromenol D (5), from Sargassum siliquastrum collected from the coast of the East Sea in South Korea by using activity-guided HPLC purification. The compounds effectively dilated depolarization (50mMK(+))-induced basilar artery contraction with EC50 values of 3.52±0.42 and 1.62±0.63μM, respectively, but only sargachromenol D (5) showed a vasodilatory effect on endothelin-1 (ET-1)-induced basilar artery contraction (EC50=9...
July 6, 2017: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/28718228/early-initiation-of-beta-blockers-following-primary-endoscopic-therapy-for-bleeding-oesophageal-varices-in-cirrhotics
#3
Adnan Salim, Kashif Malik, Muhammad Omer Farooq, Umair Butt, Arshad Kamal Butt, Altaf Alam
BACKGROUND AND AIMS: Beta-blockers provide secondary prophylaxis following endoscopic therapy for variceal bleeding. Guidelines recommend starting beta-blockers 6 days after endoscopy to prevent masking hemodynamic signs of re-bleeding. We aimed to see safety of earlier initiation of betablockers. METHODS: Cirrhotic patients with upper GI bleed were given intravenous vasoactive agents until undergoing endoscopy. Patients with only oesophageal varices as source of bleed were recruited...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28710184/diagnostic-value-of-four-dimensional-ct-angiography-in-arterial-erectile-dysfunction-using-320-detector-row-dynamic-volume-ct
#4
Cheng-Cheng Xu, Xin-Zhong Ruan, Yi-Fan Tang, Jiao-Hai Pan, Guo-Yao Wang, Qiu-Li Huang
The study aims to evaluate the diagnostic value of four-dimensional CT angiography (4D-CTA) in the diagnosis of arterial erectile dysfunction (ED) using 320-detector row dynamic volume CT. Arterial ED patients attributed to arterial insufficiency were enrolled. To induce penile erection, an intracavernous injection of corpus cavernosum with a vasoactive drug was administered. Patients were assigned into the erection hardness score (EHS) 1/2 group or EHS 3/4 group. Color duplex Doppler ultrasound (CDDU) was used to analyze blood flow spectrum...
July 14, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/28709443/severity-of-acute-gastrointestinal-injury-grade-is-a-predictor-of-all-cause-mortality-in-critically-ill-patients-a-multicenter-prospective-observational-study
#5
Bangchuan Hu, Renhua Sun, Aiping Wu, Yin Ni, Jingquan Liu, Feng Guo, Lijun Ying, Guoping Ge, Aijun Ding, Yunchao Shi, Changwen Liu, Lei Xu, Ronglin Jiang, Jun Lu, Ronghai Lin, Yannan Zhu, Weidong Wu, Bo Xie
BACKGROUND: In 2012, the European Society of Intensive Care Medicine proposed a definition for acute gastrointestinal injury (AGI) based on current medical evidence and expert opinion. The aim of the present study was to evaluate the feasibility of using the current AGI grading system and to investigate the association between AGI severity grades with clinical outcome in critically ill patients. METHODS: Adult patients at 14 general intensive care units (ICUs) with an expected ICU stay ≥24 h were prospectively studied...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28707585/migraine-neurogenic-inflammation-drug-development-pharmacochemical-aspects
#6
Melinda Lukács, János Tajti, Ferenc Fülöp, József Toldi, Lars Edvinsson, László Vécsei
BACKGROUND: Migraine is a primary headache disorder. Despite numerous studies conducted with the aim to understand the pathophysiology of migraine, several aspects are still unclear. The trigeminovascular system plays a key role. Neurogenic inflammation is presumed to be an important factor in migraine pathophysiology, mediated by the activation of primary neurons, leading to the release of various pro-inflammatory neuropeptides and neurotransmitters such as Calcitonin Gene-Related Peptide (CGRP), substance P (SP), and vasoactive intestinal peptide (VIP)...
July 12, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28702263/factors-associated-with-the-incidence-and-severity-of-new-onset-atrial-fibrillation-in-adult-critically-ill-patients
#7
Péricles A D Duarte, Gustavo Elias Leichtweis, Luiza Andriolo, Yasmim A Delevatti, Amaury C Jorge, Andreia C Fumagalli, Luiz Claudio Santos, Cecilia K Miura, Sergio K Saito
BACKGROUND: Acute Atrial Fibrillation (AF) is common in critically ill patients, with significant morbidity and mortality; however, its incidence and severity in Intensive Care Units (ICUs) from low-income countries are poorly studied. Additionally, impact of vasoactive drugs on its incidence and severity is still not understood. This study aimed to assess epidemiology and risk factors for acute new-onset AF in critically ill adult patients and the role of vasoactive drugs. METHOD: Cohort performed in seven general ICUs (including cardiac surgery) in three cities in Paraná State (southern Brazil) for 45 days...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28692439/lipid-emulsion-in-local-anesthetic-toxicity
#8
Martyn Harvey, Grant Cave
PURPOSE OF REVIEW: Enthusiasm for regional anesthesia has been driven by multimodal benefits to patient outcomes. Despite widespread awareness and improved techniques (including the increasing use of ultrasound guidance for block placement), intravascular sequestration and the attendant risk of local anesthetic systemic toxicity (LAST) remains. Intravenous lipid emulsion (ILE) for the treatment of LAST has been endorsed by anesthetic regulatory societies on the basis of animal study and human case report data...
July 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28683817/the-effects-of-intravenous-lignocaine-on-depth-of-anaesthesia-and-intraoperative-haemodynamics-during-open-radical-prostatectomy
#9
Laurence Weinberg, Jae Jang, Clive Rachbuch, Chong Tan, Raymond Hu, Larry McNicol
BACKGROUND: Lignocaine is a local anaesthetic agent, which is also commonly used as a perioperative analgesic adjunct to accelerate rehabilitation and enhance recovery after surgery. Lignocaine's systemic effects on intraoperative haemodynamics and volatile anaesthetic requirements are not well explored. Therefore, we evaluated the effects of intravenous lignocaine on intraoperative volatile agent requirements and haemodynamics in patients undergoing major abdominal surgery. METHODS: We performed an analysis of 76 participants who underwent elective open radical retropubic prostatectomy...
July 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28648859/ceftriaxone-versus-ceftriaxone-plus-a-macrolide-for-community-acquired-pneumonia-in-hospitalized-patients-with-hiv-aids-a-randomized-controlled-trial
#10
Claudia Figueiredo-Mello, Pontus Naucler, Marinella D Negra, Anna S Levin
OBJECTIVES: Evaluate if treatment with ceftriaxone and a macrolide, improved patient outcome when compared with monotherapy with ceftriaxone, in hospitalized patients with HIV/AIDS with community-acquired pneumonia (CAP). METHODS: Adult patients with HIV hospitalized due to suspected CAP were randomized to receive one of two regimens, ceftriaxone plus macrolide or ceftriaxone plus placebo, at a 1:1 proportion (Brazilian Clinical Trials Registry: RBR-8wtq2b). The primary outcome was in-hospital mortality and the secondary outcomes were mortality within 14 days, need for vasoactive drugs, need for mechanical ventilation, time to clinical stability and length of hospitalization...
June 22, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28634688/acute-variceal-bleeding-risk-stratification-and-management-including-tips
#11
REVIEW
Virginia Hernández-Gea, Claudia Berbel, Anna Baiges, Juan C García-Pagán
Acute variceal bleeding should be suspected in all patients with cirrhosis presenting with upper gastrointestinal bleeding. Vasoactive drugs and prophylactic antibiotics must be started as soon as possible, even before performing the diagnostic endoscopy. Once the patient is hemodynamically stable, upper gastrointestinal endoscopy should be performed in order to confirm the diagnosis and provide endoscopic therapy (preferably banding ligation). After this initial approach, the most appropriate therapy to prevent both early and late rebleeding must be instituted following a risk stratification strategy...
June 20, 2017: Hepatology International
https://www.readbyqxmd.com/read/28627349/-clinical-application-of-cardiopulmonary-resuscitation-with-abdominal-lifting-and-compression-in-emergency-treatment
#12
Jie Wang, Guolan Wu, Ronghua Yang, Yonghong Wang, Shunping Wang, Honglin Li, Shouhui Wang, Manguo Zhao, Xusheng Li, Yan Peng
OBJECTIVE: To investigate the clinical value of cardiopulmonary resuscitation (CPR) with abdominal lifting and compression on patients with breathing and cardiac arrest induced by severe chest trauma. METHODS: Sixty-six breathing and cardiac arrest patients induced by severe chest trauma admitted to the General Hospital of Jingyuan Coal Industry Group Company from October 2011 to October 2016 were enrolled, and they were divided into abdominal lifting and compression group (n = 32) and unarmed abdominal compression group (n = 34) by random number table...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28621447/metformin-prevents-vascular-prostanoid-release-alterations-induced-by-a-high-fat-diet-in-rats
#13
H J Lee, S M Cantú, A S Donoso, M R Choi, H A Peredo, A M Puyó
Perivascular adipose tissue dysfunction induced by high-fat feeding leads to alterations in the modulation of inflammation, contractile activity of the vascular smooth muscle and endothelial function, all risk factors in the development of hypertension. Metformin, an activator of AMP-activated protein kinase (AMPK), is currently the first-line drug treatment for type 2 diabetes (T2DM) and metabolic syndrome. Besides its glucose-lowering effect, there is an interest in actions of this drug with potential relevance in cardiovascular diseases...
June 16, 2017: Autonomic & Autacoid Pharmacology
https://www.readbyqxmd.com/read/28619367/the-vasoprotective-axes-of-the-renin-angiotensin-system-physiological-relevance-and-therapeutic-implications-in-cardiovascular-hypertensive-and-kidney-diseases
#14
REVIEW
Xiao C Li, Jianfeng Zhang, Jia L Zhuo
The renin-angiotensin system (RAS) is undisputedly one of the most prominent endocrine (tissue-to-tissue), paracrine (cell-to-cell) and intracrine (intracellular/nuclear) vasoactive systems in the physiological regulation of neural, cardiovascular, blood pressure, and kidney function. The importance of the RAS in the development and pathogenesis of cardiovascular, hypertensive and kidney diseases has now been firmly established in clinical trials and practice using renin inhibitors, angiotensin-converting enzyme (ACE) inhibitors, type 1 (AT1) angiotensin II (ANG II) receptor blockers (ARBs), or aldosterone receptor antagonists as major therapeutic drugs...
June 12, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28610434/isoflavones-and-gastrointestinal-infection-two-potential-triggers-for-reversible-cerebral-vasoconstriction-syndrome
#15
Björn Machner, Tobias Boppel, Thomas Münte
Background Reversible cerebral vasoconstriction syndrome (RCVS) is an important differential diagnosis of singular or recurrent thunderclap headache. Prognosis is generally good, however complications of the transient segmental vasospasms of cerebral arteries such as stroke, subarachnoidal hemorrhage and brain edema may worsen the clinical outcome. Although the exact pathomechanism is still unclear, various vasoactive substances and conditions (e.g. post partum) have been identified as triggering RCVS. Cases We report on the clinical course and management of two cases of typical RCVS that were associated with two different precipitants previously not described: A gastrointestinal infection and isoflavones, which are phytoestrogens used for menopausal vasomotor symptoms...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28607130/s1pr1-sphingosine-1-phosphate-receptor-1-signaling-regulates-blood-flow-and-pressure
#16
Anna Cantalupo, Antonella Gargiulo, Elona Dautaj, Catherine Liu, Yi Zhang, Timothy Hla, Annarita Di Lorenzo
Nitric oxide is one of the major endothelial-derived vasoactive factors that regulate blood pressure (BP), and the bioactive lipid mediator S1P (sphingosine-1-phosphate) is a potent activator of endothelial nitric oxide synthase through G protein-coupled receptors. Endothelial-derived S1P and the autocrine/paracrine activation of S1PR (S1P receptors) play an important role in preserving vascular functions and BP homeostasis. Furthermore, FTY720 (fingolimod), binding to 4 out of 5 S1PRs recently approved by the Food and Drug Administration to treat autoimmune conditions, induces a modest and transient decrease in heart rate in both animals and humans, suggesting that drugs targeting sphingolipid signaling affect cardiovascular functions in vivo...
August 2017: Hypertension
https://www.readbyqxmd.com/read/28569785/cytoprotective-effect-of-neuropeptides-on-cancer-stem-cells-vasoactive-intestinal-peptide-induced-antiapoptotic-signaling
#17
Konduru S Sastry, Aouatef Ismail Chouchane, Ena Wang, George Kulik, Francesco M Marincola, Lotfi Chouchane
Cancer stem cells (CSCs) are increasingly considered to be responsible for tumor initiation, metastasis and drug resistance. The drug resistance mechanisms activated in CSCs have not been thoroughly investigated. Although neuropeptides such as vasoactive intestinal peptide (VIP) can promote tumor growth and activate antiapoptotic signaling in differentiated cancer cells, it is not known whether they can activate antiapoptotic mechanisms in CSCs. The objectives of this study are to unravel the cytoprotective effects of neuropeptides and identify antiapoptotic mechanisms activated by neuropeptides in response to anticancer drug treatment in CSCs...
June 1, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28569130/meta-analysis-of-electroacupuncture-in-cardiac-anesthesia-and-intensive-care
#18
Sven Asmussen, Rene Przkora, Dirk M Maybauer, John F Fraser, Filippo Sanfilippo, Kristofer Jennings, Michael Adamzik, Marc O Maybauer
BACKGROUND: Acupuncture treatment has been employed in China for over 2500 years and it is used worldwide as analgesia in acute and chronic pain. Acupuncture is also used in general anesthesia (GA). The aim of this systematic review and meta-analysis was to assess the efficacy of electroacupuncture (EA) in addition to GA in patients undergoing cardiac surgery. METHODS: We searched 3 databases (Pubmed, Cochrane Library, and Web of Science-from 1965 until January 31, 2017) for randomized controlled trials (RCTs) including patients undergoing cardiac surgery and receiving GA alone or GA + EA...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28562790/validation-of-an-instrument-regarding-nursing-intervention-in-patients-in-vasoactive-therapy
#19
Ane Elisa Paim, Eliane Regina Pereira do Nascimento, Kátia Cilene Godinho Bertoncello, Karla Gomes Sifroni, Nadia Chiodelli Salum, Keyla Cristiane do Nascimento
Objective: to validate the content of a Standard Operational Procedure, regarding nursing interventions in emergency patients treated with vasoactive drugs. Method: methodological study, carried out from December 2015 to January 2016. Content validity was determined by 16 experts (13 nurses, 2 pharmacists and one biomedical scientist), who judged it through a four-point Likert scale. The items were evaluated in terms of: feasibility, objectivity, simplicity, clearness, pertinence and accuracy...
May 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28558082/analysis-of-the-use-of-extracorporeal-circulation-on-the-in-hospital-outcomes-of-dialytic-patients-who-underwent-myocardial-revascularization-surgery
#20
Matheus Miranda, João Nelson Rodrigues Branco, Guilherme Flora Vargas, Nelson Americo Hossne, Michele Costa Yoshimoto, José Honorio de Almeida Palma da Fonseca, José Osmar Medina de Abreu Pestana, Enio Buffolo
BACKGROUND: Myocardial revascularization surgery is the best treatment for dyalitic patients with multivessel coronary disease. However, the procedure still has high morbidity and mortality. The use of extracorporeal circulation (ECC) can have a negative impact on the in-hospital outcomes of these patients. OBJECTIVES: To evaluate the differences between the techniques with ECC and without ECC during the in-hospital course of dialytic patients who underwent surgical myocardial revascularization...
December 2016: Arquivos Brasileiros de Cardiologia
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