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https://www.readbyqxmd.com/read/28224105/nutrient-stimulation-of-mesenteric-blood-flow-implications-for-older-critically-ill-patients
#1
REVIEW
Thu An Nguyen, Yasmine Ali Abdelhamid, Liza K Phillips, Leeanne S Chapple, Michael Horowitz, Karen L Jones, Adam M Deane
Nutrient ingestion induces a substantial increase in mesenteric blood flow. In older persons (aged ≥ 65 years), particularly those with chronic medical conditions, the cardiovascular compensatory response may be inadequate to maintain systemic blood pressure during mesenteric blood pooling, leading to postprandial hypotension. In older ambulatory persons, postprandial hypotension is an important pathophysiological condition associated with an increased propensity for syncope, falls, coronary vascular events, stroke and death...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#2
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28215131/angiotensin-ii-for-the-treatment-of-high-output-shock-3-athos-3-protocol-for-a-phase-iii-double-blind-randomised-controlled-trial
#3
Lakhmir S Chawla, James A Russell, Sean M Bagshaw, Andrew D Shaw, Stuart L Goldstein, Mitchell P Fink, George F Tidmarsh
OBJECTIVE: Catecholamine-resistant hypotension (CRH) is characterised by inadequate response to standard doses of vasopressors, and increased mortality. Our Angiotensin II for the Treatment of High-Output Shock 3 (ATHOS-3) trial compares the efficacy and safety of angiotensin II (ANGII) versus placebo in CRH. DESIGN, SETTING AND PARTICIPANTS: A phase III, multicentre, randomised, placebo-controlled trial of LJPC-501 (synthetic ANGII) for CRH in up to 120 intensive care units...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28213597/retrospective-examination-of-lipid-lowering-treatment-patterns-in-a-real-world-high-risk-cohort-in-the-uk-in-2014-comparison-with-the-national-institute-for-health-and-care-excellence-nice-2014-lipid-modification-guidelines
#4
Dylan L Steen, Irfan Khan, David Ansell, Robert J Sanchez, Kausik K Ray
BACKGROUND: In 2014, guidelines from the National Institute for Health and Care Excellence (NICE) provided updated recommendations on lipid-modifying therapy (LMT). We assessed clinical practice contemporaneous to release of these guidelines in a UK general practice setting for secondary and high-risk primary-prevention populations, and extrapolated the findings to UK nation level. METHODS: Patients from The Health Improvement Network database with the following criteria were included: lipid profile in 2014 (index date); ≥20 years of age; ≥2 years representation in database prior to index; ≥1 statin indication either for atherosclerotic cardiovascular disease (ASCVD) or the non-ASCVD conditions high-risk diabetes mellitus and/or chronic kidney disease...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28203417/clinical-factors-associated-with-weaning-failure-in-patients-requiring-prolonged-mechanical-ventilation
#5
Hong-Joon Shin, Jin-Sun Chang, Seong Ahn, Tae-Ok Kim, Cheol-Kyu Park, Jung-Hwan Lim, In-Jae Oh, Yu-Il Kim, Sung-Chul Lim, Young-Chul Kim, Yong-Soo Kwon
BACKGROUND: For patients requiring prolonged mechanical ventilation (PMV), weaning is difficult and mortality is very high. PMV has been defined recently, by consensus, as constituting ≥21 consecutive days of mechanical ventilation (MV) for ≥6 hours per day. This study aimed to evaluate the clinical factors predicting weaning failure in patients undergoing PMV in medical intensive care unit (ICU). METHODS: We retrospectively reviewed the clinical and laboratory characteristics of 127 patients who received MV for more than 21 days in the medical ICU at Chonnam National University Hospital in South Korea between January 2005 and December 2014...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28197025/current-perioperative-management-of-pheochromocytomas
#6
REVIEW
Rashmi Ramachandran, Vimi Rewari
Neuroendocrine tumors which have the potential to secrete catecholamines are either associated with sympathetic adrenal (pheochromocytoma) or nonadrenal (paraganglioma) tissue. Surgical removal of these tumors is always indicated to cure and prevent cardiovascular and other organ system complications associated with catecholamine excess. Some of these tumors have malignant potential as well. The diagnosis, localization and anatomical delineation of these tumors involve measurement of catecholamines and their metabolic end products in plasma and urine, (123)I-metaiodobenzylguanidine scintigraphy, computed tomography, and/or magnetic resonance imaging...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28194410/acute-feasibility-of-neuromuscular-electrical-stimulation-in-severely-obese-patients-with-obstructive-sleep-apnea-syndrome-a-pilot-study
#7
RANDOMIZED CONTROLLED TRIAL
Isabelle Vivodtzev, Nicola A Maffiuletti, Anne-Laure Borel, Angélique Grangier, Bernard Wuyam, Renaud Tamisier, Jean-Louis Pépin
Objective. Obesity and obstructive sleep apnea (OSA) are closely interconnected conditions both leading to high cardiovascular risk. Inactivity is frequent and physical activity programs remain difficult in these patients. We investigated the acute feasibility of two neuromuscular electrical stimulation (NMES) modalities in extremely inactive obese patients with OSA. Design. A randomized cross-over study, with two experimental sessions (one per condition: multipath NMES versus conventional NMES). Setting. Outpatient research hospital...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28193194/the-objective-physical-activity-and-cardiovascular-disease-health-in-older-women-opach-study
#8
Andrea Z LaCroix, Eileen Rillamas-Sun, David Buchner, Kelly R Evenson, Chongzhi Di, I-Min Lee, Steve Marshall, Michael J LaMonte, Julie Hunt, Lesley Fels Tinker, Marcia Stefanick, Cora E Lewis, John Bellettiere, Amy H Herring
BACKGROUND: Limited evidence exists to inform physical activity (PA) and sedentary behavior guidelines for older people, especially women. Rigorous evidence on the amounts, intensities, and movement patterns associated with better health in later life is needed. METHODS/DESIGN: The Objective PA and Cardiovascular Health (OPACH) Study is an ancillary study to the Women's Health Initiative (WHI) Program that examines associations of accelerometer-assessed PA and sedentary behavior with cardiovascular and fall events...
February 14, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28190429/the-scope-of-neurology-of-critical-illness
#9
E F M Wijdicks
Critical illness increases the probability of a neurologic complication. There are many reasons to consult a neurologist in a critically ill patient and most often it is altered alertness with no intuitive plausible explanation. Other common clinical neurologic problems facing the intensive care specialist and consulting neurologist in everyday decisions are coma following prolonged cardiovascular surgery, newly perceived motor asymmetry, seizures or other abnormal movements, and generalized muscle weakness...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187344/evaluation-of-implementing-a-community-based-exercise-intervention-during-pregnancy
#10
Lene A H Haakstad, Birgitte Sanda, Ingvild Vistad, Linda Reme Sagedal, Hilde Lohne Seiler, Monica K Torstveit
OBJECTIVE: to evaluate the implementation of a community-based exercise intervention (the Norwegian Fit for Delivery study) during pregnancy. DESIGN: descriptive, explorative. SETTING: healthcare clinics in southern Norway, including urban and rural settings. PARTICIPANTS: healthy, nulliparous women with singleton pregnancy of ≤20 gestational weeks, age ≥18 years and body mass index ≥19kg/m(2). METHODS: women were randomised to either twice-weekly supervised exercise sessions combined with nutritional counselling (n=303) or standard prenatal care (n=303)...
January 21, 2017: Midwifery
https://www.readbyqxmd.com/read/28186442/clinical-determinants-and-treatment-gaps-in-familial-hypercholesterolemia-data-from-a-multi-ethnic-regional-health-service
#11
Barak Zafrir, Ayman Jubran, Gil Lavie, David A Halon, Moshe Y Flugelman, Chen Shapira
Background Familial hypercholesterolemia is characterized by markedly increased low-density lipoprotein cholesterol and risk for premature atherosclerotic cardiovascular disease. Models of care vary and reflect differing health policies and resources. The availability of electronic databases may enable better identification and assessment of familial hypercholesterolemia in the community. Methods A regional healthcare database was utilized to identify patients with a high probability of familial hypercholesterolemia, clinically defined by age-dependent-peak low-density lipoprotein cholesterol cutoffs and exclusion of secondary causes of severe hypercholesterolemia...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28166854/an-outbreak-of-burkholderia-cepacia-complex-infections-associated-with-contaminated-liquid-docusate
#12
Lucila Marquez, Katie N Jones, Elaine M Whaley, Tjin H Koy, Paula A Revell, Ruston S Taylor, M Brooke Bernhardt, Jeffrey L Wagner, James J Dunn, John J LiPuma, Judith R Campbell
OBJECTIVE To investigate an outbreak of Burkholderia cepacia complex and describe the measures that revealed the source. SETTING A 629-bed, tertiary-care, pediatric hospital in Houston, Texas. PATIENTS Pediatric patients without cystic fibrosis (CF) hospitalized in the pediatric and cardiovascular intensive care units. METHODS We investigated an outbreak of B. cepacia complex from February through July 2016. Isolates were evaluated for molecular relatedness with repetitive extragenic palindromic polymerase chain reaction (rep-PCR); specific species identification and genotyping were performed at an independent laboratory...
February 7, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28164259/five-year-mortality-in-patients-treated-for-severe-community-acquired-pneumonia-a-retrospective-study
#13
H Lenz, G O Norby, V Dahl, T E Ranheim, R E Haagensen
BACKGROUND: The mortality rate in patients with severe community-acquired pneumonia (SCAP) is high. We investigated the 5-year mortality rate and causes of death in a patient population treated for SCAP in our intensive care unit (ICU), and compared the mortality rate in patients with or without chronic obstructive pulmonary disease (COPD) as comorbidity. METHODS: This retrospective study, which covers a period of 10 years, included patients aged > 18 years admitted to our ICU with SCAP as primary diagnosis and in need of mechanical ventilation for more than 24 h...
February 5, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28160245/lipoprotein-a-hyperlipoproteinemia-as-cause-of-chronic-spinal-cord-ischemia-resulting-in-progressive-myelopathy-successful-treatment-with-lipoprotein-apheresis
#14
Franz Heigl, Reinhard Hettich, Erich Mauch, Reinhard Klingel, Cordula Fassbender
High concentrations of lipoprotein(a) (Lp(a)) represent an important independent and causal risk factor associated with adverse outcome in atherosclerotic cardiovascular disease (CVD). Effective Lp(a) lowering drug treatment is not available. Lipoprotein apheresis (LA) has been proven to prevent cardiovascular events in patients with Lp(a)-hyperlipoproteinemia (Lp(a)-HLP) and progressive CVD. Here we present the course of a male patient with established peripheral arterial occlusive disease (PAOD) at the early age of 41 and coronary artery disease (CAD), who during follow-up developed over 2 years a progressive syndrome of cerebellar and spinal cord deficits against the background of multifactorial cardiovascular risk including positive family history of CVD...
February 3, 2017: Clinical Research in Cardiology Supplements
https://www.readbyqxmd.com/read/28153104/outcomes-of-intensive-blood-pressure-lowering-in-older-hypertensive-patients
#15
Chirag Bavishi, Sripal Bangalore, Franz H Messerli
BACKGROUND: The 2014 Eighth Joint National Committee panel recommended a therapeutic target of systolic blood pressure (BP) <150 mm Hg in patients ≥60 years of age, a departure from prior recommendation of <140 mm Hg. OBJECTIVES: This study assessed the efficacy and safety of intensive BP-lowering strategies in older (age ≥65 years) hypertensive patients. METHODS: The MEDLINE, Scopus, EMBASE, and Cochrane databases were searched for all relevant randomized controlled trials from 1965 through July 1, 2016...
February 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28151941/does-training-and-support-of-general-practitioners-in-intensive-treatment-of-people-with-screen-detected-diabetes-improve-medication-morbidity-and-mortality-in-people-with-clinically-diagnosed-diabetes-investigation-of-a-spill-over-effect-in-a-cluster-rct
#16
Morten Charles, Mette V Skriver, Simon J Griffin, Rebecca K Simmons, Daniel R Witte, Else-Marie Dalsgaard, Torsten Lauritzen, Annelli Sandbæk
INTRODUCTION: Very few studies have examined the potential spill-over effect of a trial intervention in general practice. We investigated whether training and support of general practitioners in the intensive treatment of people with screen-detected diabetes improved rates of redeemed medication, morbidity and mortality in people with clinically-diagnosed diabetes. METHODS: This is a secondary, post-hoc, register-based analysis linked to a cluster randomised trial...
2017: PloS One
https://www.readbyqxmd.com/read/28151539/non-pharmacological-and-pharmacological-interventions-in-patients-with-early-arthritis-a-systematic-literature-review-informing-the-2016-update-of-eular-recommendations-for-the-management-of-early-arthritis
#17
Claire Immediato Daien, Charlotte Hua, Bernard Combe, Robert Landewe
OBJECTIVE: To perform a systematic literature review (SLR) on pharmacological and non-pharmacological treatments, in order to inform the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis (EA). METHODS: The expert committee defined research questions concerning non-pharmacological interventions, patient information and education, non-steroidal anti-inflammatory drug, glucocorticoid (GC) and disease-modifying antirheumatic drugs (DMARDs) use, as well as on disease monitoring...
2017: RMD Open
https://www.readbyqxmd.com/read/28149560/glucose-insulin-potassium-correlates-with-hemodynamic-improvement-in-patients-with-septic-myocardial-dysfunction
#18
Won-Young Kim, Moon Seong Baek, Young Shin Kim, Jarim Seo, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Sang-Bum Hong
BACKGROUND: Glucose-insulin-potassium (GIK) demonstrates a cardioprotective effect by providing metabolic support and anti-inflammatory action, and may be useful in septic myocardial depression. The aim of this study was to examine the relationship between GIK and hemodynamic outcomes in septic shock patients with myocardial depression. METHODS: Between October 2012 and March 2014, 45 patients in the intensive care unit who fulfilled the criteria for severe sepsis/septic shock and were treated with GIK were recruited...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28149316/effect-of-intravenous-midazolam-on-cardiac-parameters-in-acute-tricyclic-antidepressants-poisoning
#19
Nastaran Eizadi-Mood, Elham Aboofazeli, Valiollah Hajhashemi, Farzad Gheshlaghi, Shirinsadat Badri, Ali Mohammad Sabzghabaee
BACKGROUND: Midazolam is commonly and safely used in poisoning management and intensive care for the control of agitated poisoned patients. Despite the introduction of newer and safer antidepressants, tricyclic antidepressants (TCAs) are still prescribed and used in many countries due to their cost-effectiveness. Severe morbidity and mortality associated with these drugs arises largely from their well-documented cardiovascular toxicity. In this study we aimed to investigate the probable effect of midazolam on some hemodynamic indices in TCAs-poisoned patients...
July 2016: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/28146458/moderate-hyperoxia-induces-inflammation-apoptosis-and-necrosis-in-human-umbilical-vein-endothelial-cells-an-in-vitro-study
#20
Christina Hafner, Jing Wu, Lourdes Soto-Gonzalez, Christoph Kaun, Stefan Stojkovic, Johann Wojta, Verena Tretter, Klaus Markstaller, Klaus U Klein
BACKGROUND: Perioperative oxygen (O2) therapy can cause hyperoxia. Extreme hyperoxia can injure the cardiovascular system and remote organs. OBJECTIVE: Our primary objective was to test the hypothesis that exposure to moderate hyperoxia will induce injury to human umbilical vein endothelial cells (HUVECs), a model for studying the vascular endothelium under controlled conditions. DESIGN: In-vitro cell culture study. SETTING: Department of Anaesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Austria...
March 2017: European Journal of Anaesthesiology
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