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https://www.readbyqxmd.com/read/28936626/the-impact-of-frailty-on-icu-and-30-day-mortality-and-the-level-of-care-in-very-elderly-patients-%C3%A2-%C3%A2-80%C3%A2-years
#1
Hans Flaatten, Dylan W De Lange, Alessandro Morandi, Finn H Andersen, Antonio Artigas, Guido Bertolini, Ariane Boumendil, Maurizio Cecconi, Steffen Christensen, Loredana Faraldi, Jesper Fjølner, Christian Jung, Brian Marsh, Rui Moreno, Sandra Oeyen, Christina Agwald Öhman, Bernardo Bollen Pinto, Ivo W Soliman, Wojciech Szczeklik, Andreas Valentin, Ximena Watson, Tilemachos Zaferidis, Bertrand Guidet
PURPOSE: Very old critical ill patients are a rapid expanding group in the ICU. Indications for admission, triage criteria and level of care are frequently discussed for such patients. However, most relevant outcome studies in this group frequently find an increased mortality and a reduced quality of life in survivors. The main objective was to study the impact of frailty compared with other variables with regards to short-term outcome in the very old ICU population. METHODS: A transnational prospective cohort study from October 2016 to May 2017 with 30 days follow-up was set up by the European Society of Intensive Care Medicine...
September 21, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28930813/temporal-changes-in-prescription-of-neuropharmacologic-drugs-and-utilization-of-resources-related-to-neurologic-morbidity-in-mechanically-ventilated-children-with-bronchiolitis
#2
Steven L Shein, Katherine Slain, Deanne Wilson-Costello, Bryan McKee, Alexandre T Rotta
OBJECTIVES: Critically ill children with bronchiolitis may require neuropharmacologic medications and support for neuro-functional sequelae, but current practices are not well described. We aimed to describe recent trends in neuropharmacology and utilization of neuro-rehabilitation resources in mechanically ventilated children with bronchiolitis. DESIGN: Analysis of the multicenter Pediatric Health Information System database. SETTING: Forty-seven U...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28925895/cardiovascular-drug-therapy-for-human-newborn-review-of-pharmacodynamic-data
#3
Ebru Ergenekon, Héctor Rojas-Anaya, María Carmen Bravo, Charalampos Kotidis, Liam Mahoney, Heike Rabe
BACKGROUND: Circulatory failure in preterm and term newborn infants is commonly treated with inotropes or vasoactive medications. In this structured literature review, the available data on pharmacodynamic effects of the inotropes adrenaline, dobutamine, dopamine, levosimendan, milrinone, noradrenaline, and the vasoactive drugs vasopressin and hydrocortisone are presented. METHODS: Structured searches were conducted to identify relevant articles according to pre-defined inclusion criteria which were human clinical trials published after 2000...
September 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28905639/clinical-manifestations-of-kawasaki-disease-shock-syndrome
#4
Le Ma, Ya-Yuan Zhang, Hai-Guo Yu
A case-control study was performed to ascertain clinical features of children who had been diagnosed as Kawasaki disease shock syndrome (KDSS), a severe condition related to Kawasaki disease (KD). Hospitalized patients were selected in Nanjing Children's Hospital. Demographic characteristics, clinical presentation, laboratory data, cardiovascular findings, and therapies were analyzed. Compared with the control group, KDSS patients were older and had more serious skin rash. The proportions of leukocytosis, neutrophilia, and hypoalbuminemia was higher, as was the level of while blood cell count, C-reactive protein, brain natriuretic peptide, and ferroprotein...
September 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28904875/the-influence-of-hypophosphatemia-on-outcomes-of-low-and-high-intensity-continuous-renal-replacement-therapy-in-critically-ill-patients-with-acute-kidney-injury
#5
Soo Young Kim, Ye Na Kim, Ho Sik Shin, Yeonsoon Jung, Hark Rim
BACKGROUND: The purpose of this study was to assess the role of hypophosphatemia in major clinical outcomes of patients treated with low- or high-intensity continuous renal replacement therapy (CRRT). METHODS: We performed a retrospective analysis of data collected from 492 patients. We divided patients into two CRRT groups based on treatment intensity (greater than or equal to or less than 40 mL/kg/hour of effluent generation) and measured serum phosphate level daily during CRRT...
September 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28902231/risk-factors-for-the-progression-of-chronic-kidney-disease-after-acute-kidney-injury
#6
Benedito Jorge Pereira, Silvana Barreto, Thais Gentil, Larissa S Assis, Emília Md Soeiro, Isac de Castro, Sandra M Laranja
Introduction: The incidence of chronic kidney disease (CKD) is increasing with the increasing age of the population and the increasing number of elderly survivors of acute kidney injury (AKI). The risk factors for the progression of CKD after AKI are unclear. Objective: To investigate the association between AKI and its progression to CKD and the risk factors involved. Methods: An observational, retrospective study of AKI patients followed from 2009 to 2012 was carried out...
August 28, 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28899749/cyp4a-cyp2c-modulation-of-the-interaction-of-calcium-channel-blockers-with-cyclosporine-on-edhf-mediated-renal-vasodilations-in-rats
#7
Safaa H Hammoud, Amal G Omar, Assaad A Eid, Mahmoud M El-Mas
The endothelium-derived hyperpolarizing factor (EDHF) serves as a back-up mechanism that compensates for reduced nitric oxide (NO)/prostanoids bioavailability. Here we investigated whether (i) under conditions of vascular endothelium dysfunction, the immunosuppressant drug cyclosporine (CSA) upregulates EDHF-dependent renal vasodilations through altering CYP4A/CYP2C signaling, and (ii) calcium channel blockers modulate the CSA/EDHF/CYP interaction. Rats were treated with CSA, verapamil, nifedipine, or their combinations for 7days...
September 9, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/28880931/restrictive-intraoperative-fluid-optimisation-algorithm-improves-outcomes-in-patients-undergoing-pancreaticoduodenectomy-a-prospective-multicentre-randomized-controlled-trial
#8
Laurence Weinberg, Damian Ianno, Leonid Churilov, Ian Chao, Nick Scurrah, Clive Rachbuch, Jonathan Banting, Vijaragavan Muralidharan, David Story, Rinaldo Bellomo, Chris Christophi, Mehrdad Nikfarjam
We aimed to evaluate perioperative outcomes in patients undergoing pancreaticoduodenectomy with or without a cardiac output goal directed therapy (GDT) algorithm. We conducted a multicentre randomised controlled trial in four high volume hepatobiliary-pancreatic surgery centres. We evaluated whether the additional impact of a intraoperative fluid optimisation algorithm would influence the amount of fluid delivered, reduce fluid related complications, and improve length of hospital stay. Fifty-two consecutive adult patients were recruited...
2017: PloS One
https://www.readbyqxmd.com/read/28869020/-administration-of-norepinephrine-in-peripheral-venous-catheter-on-surgical-patients
#9
Sophie Amalie Ekeløf, Sarah Ekeløf, Jesper N Bech, Peter Ekeløf
Hypotension is a common event during surgery and can cause serious post-operative complication, but vasoactive drugs can stabilize the cardiovascular system and reduce the risk of post-operative complications. Norepinephrine is an ideal vasopressor. Due to the risk of extravasation and ischaemic tissue damage norepinephrine is often administered via a central venous catheter. Administration of norepinephrine via a peripheral venous catheter may be a safe alternative during surgery, if the drug is administered correctly...
August 21, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28866974/the-plasma-lyte-148-v-saline-plus-study-protocol-a-multicentre-randomised-controlled-trial-of-the-effect-of-intensive-care-fluid-therapy-on-mortality
#10
Naomi E Hammond, Rinaldo Bellomo, Martin Gallagher, David Gattas, Parisa Glass, Diane Mackle, Sharon Micallef, John Myburgh, Manoj Saxena, Colman Taylor, Paul Young, Simon Finfer
BACKGROUND: 0.9% sodium chloride (saline) is the most commonly administered resuscitation fluid on a global basis but emerging evidence suggests that its high chloride content may have important adverse effects. OBJECTIVE: To describe the study protocol for the Plasma- Lyte 148 v Saline study, which will test the hypothesis that in critically ill adult patients the use of Plasma-Lyte 148 (a buffered crystalloid solution) for fluid therapy results in different 90-day all-cause mortality when compared with saline...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28852523/variceal-bleeding-in-cirrhotic-patients
#11
REVIEW
Maxime Mallet, Marika Rudler, Dominique Thabut
Variceal bleeding is one of the major causes of death in cirrhotic patients. The management during the acute phase and the secondary prophylaxis is well defined. Recent recommendations (2015 Baveno VI expert consensus) are available and should be followed for an optimal management, which must be performed as an emergency in a liver or general intensive-care unit. It is based on the early administration of a vasoactive drug (before endoscopy), an antibiotic prophylaxis and a restrictive transfusion strategy (hemoglobin target of 7 g/dL)...
August 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28830854/a-mobile-device-app-to-reduce-medication-errors-and-time-to-drug-delivery-during-pediatric-cardiopulmonary-resuscitation-study-protocol-of-a-multicenter-randomized-controlled-crossover-trial
#12
Johan N Siebert, Frederic Ehrler, Christian Lovis, Christophe Combescure, Kevin Haddad, Alain Gervaix, Sergio Manzano
BACKGROUND: During pediatric cardiopulmonary resuscitation (CPR), vasoactive drug preparation for continuous infusions is complex and time-consuming. The need for individual specific weight-based drug dose calculation and preparation places children at higher risk than adults for medication errors. Following an evidence-based and ergonomic driven approach, we developed a mobile device app called Pediatric Accurate Medication in Emergency Situations (PedAMINES), intended to guide caregivers step-by-step from preparation to delivery of drugs requiring continuous infusion...
August 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28811655/a-tissue-engineered-blood-vessel-model-of-hutchinson-gilford-progeria-syndrome-using-human-ipsc-derived-smooth-muscle-cells
#13
Leigh Atchison, Haoyue Zhang, Kan Cao, George A Truskey
Hutchison-Gilford Progeria Syndrome (HGPS) is a rare, accelerated aging disorder caused by nuclear accumulation of progerin, an altered form of the Lamin A gene. The primary cause of death is cardiovascular disease at about 14 years. Loss and dysfunction of smooth muscle cells (SMCs) in the vasculature may cause defects associated with HGPS. Due to limitations of 2D cell culture and mouse models, there is a need to develop improved models to discover novel therapeutics. To address this need, we produced a functional three-dimensional model of HGPS that replicates an arteriole-scale tissue engineered blood vessel (TEBV) using induced pluripotent stem cell (iPSC)-derived SMCs from an HGPS patient...
August 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28810191/structure-function-studies-of-bpp-brachynh2-and-synthetic-analogues-thereof-with-angiotensin-i-converting-enzyme
#14
Daniel D R Arcanjo, Andreanne G Vasconcelos, Lucas A Nascimento, Ana Carolina Mafud, Alexandra Plácido, Michel M M Alves, Cristina Delerue-Matos, Marcelo P Bemquerer, Nuno Vale, Paula Gomes, Eduardo B Oliveira, Francisco C A Lima, Yvonne P Mascarenhas, Fernando Aécio A Carvalho, Ulf Simonsen, Ricardo M Ramos, José Roberto S A Leite
The vasoactive proline-rich oligopeptide termed BPP-BrachyNH2 (H-WPPPKVSP-NH2) induces in vitro inhibitory activity of angiotensin I-converting enzyme (ACE) in rat blood serum. In the present study, the removal of N-terminal tryptophan or C-terminal proline from BPP-BrachyNH2 was investigated in order to predict which structural components are important or required for interaction with ACE. Furthermore, the toxicological profile was assessed by in silico prediction and in vitro MTT assay. Two BPP-BrachyNH2 analogues (des-Trp(1)-BPP-BrachyNH2 and des-Pro(8)-BPP-BrachyNH2) were synthesized, and in vitro and in silico ACE inhibitory activity and toxicological profile were assessed...
August 7, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28795349/association-between-elevated-central-venous-pressure-and-outcomes-in-critically-ill-patients
#15
Dong-Kai Li, Xiao-Ting Wang, Da-Wei Liu
BACKGROUND: Some prior studies have shown that elevated mean central venous pressure in certain patient populations and disease processes may lead to poor prognosis. However, these studies failed to generalize the concept of elevated central venous pressure (ECVP) load to all patients in critical care settings because of the limited cases and exclusive cohorts. The aim of the study was to investigate the association between elevated central venous pressure and outcomes in critical care...
August 9, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28780608/sx-ella-stent-danis-effectively-controls-refractory-variceal-bleed-in-patients-with-acute-on-chronic-liver-failure
#16
Rakhi Maiwall, Kapil Dev Jamwal, Ankit Bhardwaj, Ajeet Singh Bhadoria, Jaswinder Singh Maras, Guresh Kumar, Ankur Jindal, Ashok Choudhury, Lovkesh Anand, Amrish Sahney, Awinash Kumar, Manoj Kumar Sharma, Barjesh Chander Sharma, Shiv Kumar Sarin
BACKGROUND AND AIMS: Almost 10% of bleeding episodes are refractory to combination of vasoactive agent and endotherapy, and are associated with a mortality up to 50%. Severity of liver disease and high portal pressure are mainly responsible for it. TIPS cannot be used in these patients due to high MELD score. We aimed to evaluate the efficacy of self-expandable DE stents for control of refractory variceal bleeds in patients with ACLF. METHODS: Acute-on-chronic liver failure patients (n = 88, mean age 47...
August 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28771434/cutaneous-temperature-sensitivity-alteration-in-subjects-with-chronic-stroke-sequelae-pharmacological-perspectives
#17
Artur Cesar Aquino Santos, Fábio Marcon Alfieri, Linamara Rizzo Battistella
BACKGROUND: Stroke can result in body temperature sensitivity changes. This study analyzed abnormal temperature perception of patients with stroke and the use of vasoactive drugs. METHODS: A cross-sectional retrospective study was carried out consisting of 100 patients (55.6±12.9 years old), from both genres, with either hemorrhagic or ischemic stroke, with unilateral hemiplegia or hemiparesis. Subjects had axillary temperature and different temperature sensitivities of the limbs measured using a visual analog scale (VAS)...
August 3, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/28767081/new-insights-in-the-design-of-bioactive-peptides-and-chelating-agents-for-imaging-and-therapy-in-oncology
#18
REVIEW
Anna Lucia Tornesello, Luigi Buonaguro, Maria Lina Tornesello, Franco Maria Buonaguro
Many synthetic peptides have been developed for diagnosis and therapy of human cancers based on their ability to target specific receptors on cancer cell surface or to penetrate the cell membrane. Chemical modifications of amino acid chains have significantly improved the biological activity, the stability and efficacy of peptide analogues currently employed as anticancer drugs or as molecular imaging tracers. The stability of somatostatin, integrins and bombesin analogues in the human body have been significantly increased by cyclization and/or insertion of non-natural amino acids in the peptide sequences...
August 2, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28761030/comparison-of-the-trendelenburg-position-versus-upper-limb-tourniquet-on-internal-jugular-vein-diameter
#19
Pelin Karaaslan, Banu Vural Gokay, Muhammet Ahmet Karakaya, Kamil Darcin, Afak Durur Karakaya, Tugrul Ormeci, Emine Arzu Kose
BACKGROUND: Central venous cannulation is a necessary invasive procedure for fluid management, haemodynamic monitoring and vasoactive drug therapy. The right internal jugular vein (RIJV) is the preferred site. Enlargement of the jugular vein area facilitates catheterization and reduces complication rates. Common methods to enlarge the RIJV cross-sectional area are the Trendelenburg position and the Valsalva maneuver. OBJECTIVE: Compare the Trendelenburg position with upper-extremity venous return blockage using the tourniquet technique...
July 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28759483/alarm-limits-for-intraoperative-drug-infusions-a-report-from-the-multicenter-perioperative-outcomes-group
#20
Mitchell F Berman, Nikhil Iyer, Leon Freudzon, Shuang Wang, Robert E Freundlich, Michelle Housey, Sachin Kheterpal
BACKGROUND: Continuous medication infusions are commonly used during surgical procedures. Alarm settings for infusion pumps are considered important for patient safety, but limits are not created in a standardized manner from actual usage data. We estimated 90th and 95th percentile infusion rates from a national database for potential use as upper limit alarm settings. METHODS: We extracted infusion rate data from 17 major hospitals using intraoperative records provided by Multicenter Perioperative Outcomes Group for adult surgery between 2008 and 2014...
October 2017: Anesthesia and Analgesia
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