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Circulatory physiology

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https://www.readbyqxmd.com/read/27908338/fluid-resuscitation-in-severe-sepsis
#1
REVIEW
Rob Loflin, Michael E Winters
Since its original description in 1832, fluid resuscitation has become the cornerstone of early and aggressive treatment of severe sepsis and septic shock. However, questions remain about optimal fluid composition, dose, and rate of administration for critically ill patients. This article reviews pertinent physiology of the circulatory system, pathogenesis of septic shock, and phases of sepsis resuscitation, and then focuses on the type, rate, and amount of fluid administration for severe sepsis and septic shock, so providers can choose the right fluid, for the right patient, at the right time...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27906830/heterotopic-abdominal-rat-heart-transplantation-as-a-model-to-investigate-volume-dependency-of-myocardial-remodeling
#2
Kálmán Benke, Alex Ali Sayour, Csaba Mátyás, Bence Ágg, Balázs Tamás Németh, Attila Oláh, Mihály Ruppert, István Hartyánszky, Zoltán Szabolcs, Tamás Radovits, Béla Merkely, Gábor Szabó
Heterotopic abdominal rat heart transplantation has been extensively used to investigate ischemic/reperfusion injury, immunological consequences during heart transplantations and also to study remodeling of the myocardium due to volume unloading. We provide a unique review on the latter and present a summary of the experimental studies on rat heart transplantation to illustrate changes that occur to the myocardium due to volume unloading. We divided the literature based on whether normal or failing rat heart models were used...
December 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27898678/leukocyte-telomere-length-in-relation-to-17-biomarkers-of-cardiovascular-disease-risk-a-cross-sectional-study-of-us-adults
#3
David H Rehkopf, Belinda L Needham, Jue Lin, Elizabeth H Blackburn, Ami R Zota, Janet M Wojcicki, Elissa S Epel
BACKGROUND: Leukocyte telomere length (LTL) is a putative biological marker of immune system age, and there are demonstrated associations between LTL and cardiovascular disease. This may be due in part to the relationship of LTL with other biomarkers associated with cardiovascular disease risk. However, the strength of associations between LTL and adiposity, metabolic, proinflammatory, and cardiovascular biomarkers has not been systematically evaluated in a United States nationally representative population...
November 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27892719/is-a-pulse-absolutely-necessary-during-cardiopulmonary-bypass
#4
Gengo Sunagawa, Marijan Koprivanac, Jamshid H Karimov, Nader Moazami, Kiyotaka Fukamachi
The benefits and disadvantages of pulsatility in mechanical circulatory support devices have been argued since before the first use of cardiopulmonary bypass (CPB) with a nonpulsatile pump. The debate over the superiority of either pulsatile or nonpulsatile perfusion during CPB persists, but recently, the evidence in favor of pulsatile perfusion during CPB is increasing. Complications associated with chronic nonpulsatile flow in patients implanted with left ventricular assist devices have renewed interest in generating pulsatility with these devices...
November 28, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27892505/in-vivo-measurement-of-hemodynamic-information-in-stenosed-rat-blood-vessels-using-x-ray-piv
#5
Hanwook Park, Jun Hong Park, Sang Joon Lee
Measurements of the hemodynamic information of blood flows, especially wall shear stress (WSS), in animal models with circulatory vascular diseases (CVDs) are important to understand the pathological mechanism of CVDs. In this study, X-ray particle image velocimetry (PIV) with high spatial resolution was applied to obtain velocity field information in stenosed blood vessels with high WSS. 3D clips fabricated with a 3D printer were applied to the abdominal aorta of a rat cadaver to induce artificial stenosis in the real blood vessel of an animal model...
November 28, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27873328/liposome-encapsulated-hemoglobin-improves-tumor-oxygenation-as-detected-by-near-infrared-spectroscopy-in-colon-carcinoma-in-mice
#6
Fumio Kawaguchi, Akira T Kawaguchi, Chieko Murayama, Akemi Kamijo, Munetaka Haida
Liposome-encapsulated hemoglobin (LEH) with high (h-LEH, P50 O2  = 10 mm Hg) or low O2 affinity (l-LEH, P50 O2  = 40 mm Hg) may improve O2 delivery to sensitize tumor tissues for radiotherapy. A total of 10 mL/kg of h-LEH, l-LEH, red blood cells (RBCs), or saline was infused in mice transplanted with murine colon carcinoma with near-infrared spectroscopy (NIRS) detectors set at the tumor (right leg) and intact muscle (left leg). NIRS recorded changes in the amount of oxyhemoglobin (oxyHb), deoxyhemoglobin (deoxyHb), and their sum (tHb) with the animals spontaneously breathing room air (10 min), pure O2 (5 min), and then back to room air...
November 22, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27856715/highlighted-topics-recovery-from-exercise-recovery-responses-of-testosterone-growth-hormone-and-igf-1-after-resistance-exercise
#7
William J Kraemer, Nicholas A Ratamess, Bradley J Nindl
The complexity of the endocrine pathways during recovery related to anabolic function belie an over simplistic approach to its study. This review is to examines the role of resistance exercise (RE) on the recovery responses of three major anabolic hormones testosterone, growth hormone(s) and insulin-like growth factor-I. Each hormone has a complexity related to differential pathways of action as well as interactions with binding proteins and receptor interactions. Testosterone is the primary anabolic hormone and its concentration changes during the recovery period depending upon the up- or down-regulation of the androgen receptor...
November 17, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27837125/abdominal-aortic-aneurysms
#8
Jeffrey S Legg, Lynn M Legg
Abdominal aortic aneurysm (AAA) is a significant disease affecting the circulatory system. Risk factors include smoking, hypertension, sex, and a possible hereditary predisposition. AAAs remain asymptomatic for years, and various imaging methods are used in their detection, diagnosis, and treatment. This article reviews the anatomy and physiology of the aorta as well as the signs and symptoms, pathophysiology, epidemiology, and risk factors for the development of AAA. The use of ultrasonography and other imaging modalities for pre- and post-treatment is discussed, as is endovascular aortic repair...
November 2016: Radiologic Technology
https://www.readbyqxmd.com/read/27829071/finite-element-model-of-oxygen-transport-for-the-design-of-geometrically-complex-microfluidic-devices-used-in-biological-studies
#9
Richard J Sové, Graham M Fraser, Daniel Goldman, Christopher G Ellis
Red blood cells play a crucial role in the local regulation of oxygen supply in the microcirculation through the oxygen dependent release of ATP. Since red blood cells serve as an oxygen sensor for the circulatory system, the dynamics of ATP release determine the effectiveness of red blood cells to relate the oxygen levels to the vessels. Previous work has focused on the feasibility of developing a microfluidic system to measure the dynamics of ATP release. The objective was to determine if a steep oxygen gradient could be developed in the channel to cause a rapid decrease in hemoglobin oxygen saturation in order to measure the corresponding levels of ATP released from the red blood cells...
2016: PloS One
https://www.readbyqxmd.com/read/27813829/vascular-and-immunobiology-of-the-circulatory-sphingosine-1-phosphate-gradient
#10
Keisuke Yanagida, Timothy Hla
Vertebrates are endowed with a closed circulatory system, the evolution of which required novel structural and regulatory changes. Furthermore, immune cell trafficking paradigms adapted to the barriers imposed by the closed circulatory system. How did such changes occur mechanistically? We propose that spatial compartmentalization of the lipid mediator sphingosine 1-phosphate (S1P) may be one such mechanism. In vertebrates, S1P is spatially compartmentalized in the blood and lymphatic circulation, thus comprising a sharp S1P gradient across the endothelial barrier...
October 21, 2016: Annual Review of Physiology
https://www.readbyqxmd.com/read/27813055/physiological-changes-associated-with-routine-nursing-procedures-in-critically-ill-are-common-an-observational-pilot-study
#11
J Engström, E Bruno, H Reinius, C Fröjd, H Jonsson, J Sannervik, A Larsson
BACKGROUND: Nursing procedures that are routinely performed in the intensive care unit (ICU) are assumed to have minimal side effects. However, these procedures may sometimes cause physiological changes that negatively affect the patient. We hypothesized that physiological changes associated with routine nursing procedures in the ICU are common. METHODS: A clinical observational study of 16 critically ill patients in a nine-bed mixed university hospital ICU. All nursing procedures were observed, and physiological data were collected and subsequently analyzed...
November 3, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27805506/only-time-will-tell-the-future-of-donation-after-circulatory-death
#12
Joseph R Scalea, Hans W Sollinger
The rapid rise of transplantation over the past 60 years has been marked by a number of critical milestones. Donation after circulatory death (DCD) has played an important role in the development of this young field. Although early observations by Dr. Tom Starzl touched on the importance of warm ischemic time, new and exciting data may be changing our views of ischemia. Indeed, as we learn more about the importance of time-to-death for DCD donors after circulatory death, the hemodynamic changes experienced by DCD donors, and the other physiologic perturbations surrounding all forms of death, we are beginning to drill down to the factors that drive recipient outcomes after deceased donor transplant...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27802958/the-evolving-paradigm-of-individualized-postresuscitation-care-after-cardiac-arrest
#13
REVIEW
David B Seder, Christine Lord, David J Gagnon
The postresuscitation period after a cardiac arrest is characterized by a wide range of physiological derangements. Variations between patients include preexisting medical problems, the underlying cause of the cardiac arrest, presence or absence of hemodynamic and circulatory instability, severity of the ischemia-reperfusion injury, and resuscitation-related injuries such as pulmonary aspiration and rib or sternal fractures. Although protocols can be applied to many elements of postresuscitation care, the widely disparate clinical condition of cardiac arrest survivors requires an individualized approach that stratifies patients according to their clinical profile and targets specific treatments to patients most likely to benefit...
November 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27798767/practical-management-of-anaesthesia-in-the-elderly
#14
Camilla Strøm, Lars Simon Rasmussen, Jacob Steinmetz
The elderly population is rapidly growing and particularly diverse. Ageing leads to reduced organ function and a decline in physiologic reserve. Elderly patients are characterised by great inter-individual variability in physiological function with a high prevalence of chronic disease. In general, older patients have a higher risk of postoperative adverse outcomes, and frailty is a very important risk factor. This review article aims to provide a practical guide to anaesthetic management of the elderly surgical patient...
October 31, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27782333/the-immune-system-s-role-in-sepsis-progression-resolution-and-long-term-outcome
#15
REVIEW
Matthew J Delano, Peter A Ward
Sepsis occurs when an infection exceeds local tissue containment and induces a series of dysregulated physiologic responses that result in organ dysfunction. A subset of patients with sepsis progress to septic shock, defined by profound circulatory, cellular, and metabolic abnormalities, and associated with a greater mortality. Historically, sepsis-induced organ dysfunction and lethality were attributed to the complex interplay between the initial inflammatory and later anti-inflammatory responses. With advances in intensive care medicine and goal-directed interventions, early 30-day sepsis mortality has diminished, only to steadily escalate long after "recovery" from acute events...
November 2016: Immunological Reviews
https://www.readbyqxmd.com/read/27773843/using-tiletamine-zolazepam-xylazine-anesthesia-compared-to-co2-inhalation-for-terminal-clinical-chemistry-hematology-and-coagulation-analysis-in-mice
#16
Oksana N Khokhlova, Elena A Tukhovskaya, Irina N Kravchenko, Elena S Sadovnikova, Irina A Pakhomova, Elena A Kalabina, Alexander V Lobanov, Elvira R Shaykhutdinova, Alina M Ismailova, Arkady N Murashev
INTRODUCTION: It is important that the method of anesthesia of mice does not considerably alter the animal's physiological and metabolic status before terminal blood sampling taken in order to analyze clinical pathology parameters. METHODS: Hematology, hemostasis, and clinical chemistry parameters were compared in male and female BALB/c mice exposed to either tiletamine-zolazepam-xylazine (TZX) anesthesia or euthanasia in carbon dioxide (CO2) chamber to reveal an alternative method of anesthesia vs...
October 20, 2016: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/27768204/in-vitro-performance-investigation-of-syncardia%C3%A2-freedom%C3%A2-driver-via-patient-simulator-mock-loop
#17
Riccardo Toninato, Silvia Scuri, Vincenzo Tarzia, Gino Gerosa, Francesca M Susin
PURPOSE: The gold standard therapy for patients with advanced heart failure is heart transplant. The gap between donors and patients in waiting lists promoted the development of circulatory support devices, such as the total artificial heart (TAH). Focusing on in vitro tests performed with CardioWest™ TAH (CW) driven by the SynCardia Freedom® portable driver (FD) the present study goals are: i) prove the reliability of a hydraulic circuit used as patient simulator to replicate a quasi-physiological scenario for various hydrodynamic conditions, ii) investigate the hydrodynamic performance of the CW FD, iii) help clinicians in possible interpretation of clinical cases outcomes...
November 29, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27768066/long-term-high-resolution-intravital-microscopy-in-the-lung-with-a-vacuum-stabilized-imaging-window
#18
Carolina Rodriguez-Tirado, Takanori Kitamura, Yu Kato, Jeffery W Pollard, John S Condeelis, David Entenberg
Metastasis to secondary sites such as the lung, liver and bone is a traumatic event with a mortality rate of approximately 90% (1). Of these sites, the lung is the most difficult to assess using intravital optical imaging due to its enclosed position within the body, delicate nature and vital role in sustaining proper physiology. While clinical modalities (positron emission tomography (PET), magnetic resonance imaging (MRI) and computed tomography (CT)) are capable of providing noninvasive images of this tissue, they lack the resolution necessary to visualize the earliest seeding events, with a single pixel consisting of nearly a thousand cells...
October 6, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27760402/short-term-effects-of-palm-tocotrienol-and-palm-carotenes-on-vascular-function-and-cardiovascular-disease-risk-a-randomised-controlled-trial
#19
Welma Stonehouse, Grant D Brinkworth, Campbell H Thompson, Mahinda Y Abeywardena
BACKGROUND AND AIMS: In vitro, ex vivo and animal studies suggest palm-based tocotrienols and carotenes enhance vascular function, but limited data in humans exists. The aim was to examine the effects of palm-tocotrienols (TRF- 80) and palm-carotene (CC-60) supplementation on vascular function and cardiovascular disease (CVD) risk factors in adults at increased risk of impaired vascular function. METHODS: Ninety men and women (18-70 yr, 20-45 kg/m(2)) with type 2 diabetes, impaired fasting glucose and/or elevated waist circumference were randomised to consume either TRF-80 (420 mg/day tocotrienol + 132 mg/day tocopherol), CC-60 (21 mg/day carotenes) or placebo (palm olein) supplements for 8 weeks...
October 14, 2016: Atherosclerosis
https://www.readbyqxmd.com/read/27756855/inhibin-b-secretion-and-fsh-isoform-distribution-may-play-an-integral-part-of-follicular-selection-in-the-natural-menstrual-cycle
#20
REVIEW
C Yding Andersen
The aim of the present paper is to expand the concept on how follicular selection takes place in the follicular phase of the natural menstrual cycle. It is suggested that inhibin-B exerts a more intimate role in this process than previously understood. Inhibin-B shows a peak in the circulation around cycle day 7, simultaneous with selection of the dominant follicle, whereas levels of estradiol and inhibin-A only start to increase a few days later suggesting that inhibin-B is mainly responsible for downregulating pituitary FSH release...
October 18, 2016: Molecular Human Reproduction
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