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    Procedural Techniques for the Management of Severe Transvalvular and Paravalvular Aortic Regurgitation During TAVR.
    J Heart Valve Dis 2017 Jan;26(1):18-21
    Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine and the Elaine and Sydney Sussman Cardiac Catheterization Laboratory, University of Miami Hospital, Miami, USA.
    Aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) is associated with an increased risk of mortality. In severe cases, abrupt hemodynamic changes may occur with a sudden increase in left ventricular end-diastolic pressure that results in frank pulmonary edema, hypoxia, and cardiogenic shock. Here, the case is reported of a patient who developed severe AR immediately after valve deployment that led to severe hemodynamic compromise. Read More

    A method for maintaining vascular access when Impella exchange is required.
    Catheter Cardiovasc Interv 2017 May 22. Epub 2017 May 22.
    Department of Cardiology, University of Tennessee Medical Center, Knoxville, Tennessee.
    A 45-year old male with no prior cardiac history, presented with cardiogenic shock in the setting of an anterolateral ST elevation myocardial infarction. We first placed a 2.5 Impella for hemodynamic support, and proceeded with emergent percutaneous coronary intervention to the proximal LAD. Read More

    Biventricular Impella placement via complete venous access.
    Catheter Cardiovasc Interv 2017 May 22. Epub 2017 May 22.
    Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia.
    Impella (Abiomed, Danvers, MA) is an effective option for emergent treatment of critical refractory cardiogenic shock. However, in patients who have inadequate peripheral arterial access, Impella for left ventricular support sometimes requires surgical access, leading to disadvantages for emergent procedures or invasiveness for very sick patients. In addition, Impella for right ventricular support was recently reported to contribute to the management of severe biventricular dysfunction. Read More

    Primary splenic pregnancy with hemorrhagic shock.
    J Obstet Gynaecol Res 2017 May 19. Epub 2017 May 19.
    Department of Obstetrics and Gynecology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
    Primary splenic pregnancy, a type of abdominal pregnancy, is very rare and potentially life-threatening, particularly without an accurate preoperative diagnosis. Herein we describe the case of a 27-year-old woman who had primary splenic pregnancy with hemorrhagic shock due to spleen rupture, who was successfully treated by laparotomy. Read More

    "Heat shock protein 70 in pancreatic diseases: Friend or foe".
    J Surg Oncol 2017 May 22. Epub 2017 May 22.
    Department of Surgery and Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida.
    The heat shock response in pancreatitis that is activated via HSP70 protects acinar cells through multiple simultaneous mechanisms. It inhibits trypsinogen activation and modulates NF-κB signaling to limit acinar cell injury. On the other hand, HSP70 is overexpressed in pancreatic cancer and is hijacked by the cellular machinery to inhibit apoptosis. Read More

    Optimization of screw fixation in rat bone with extracorporeal shock waves.
    J Orthop Res 2017 May 24. Epub 2017 May 24.
    Department of Orthopaedics, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands.
    Screw fixation in osteoporotic patients is becoming an increasing problem in orthopaedic surgery as deterioration of cortical and cancellous bone hamper biomechanical stability and screw fixation. This might result in delayed weight-bearing or failure of instrumentation. We hypothesized that local peri-operative shock wave treatment can optimize osseointegration and subsequent screw fixation. Read More

    Baroreceptor stimulation in a patient with preexisting subcutaneous implantable cardioverter-defibrillator.
    Pacing Clin Electrophysiol 2017 May 24. Epub 2017 May 24.
    University of Giessen, Department of Internal Medicine I, Division of Cardiology, Germany.
    Background: Many patients with severe heart failure (HF) have an indication for baroreflex activation therapy (BAT) and an ICD. Concerns about device-device interactions were addressed in a study with small sample size that concluded combined BAT and ICD therapy is safe. There are no published data, however, concerning device-device interactions between BAT and a subcutaneous ICD (S-ICD). Read More

    The Hematocrit Affects the Volume of Plasma Treated With Coupled Plasma Filtration and Adsorption With Predilution.
    Artif Organs 2017 May;41(5):E26-E29
    IRCCS-Mario Negri Institute for Pharmacological Research, Ranica, Italy.
    Coupled plasma filtration and adsorption (CPFA) is an extracorporeal blood purification technique proposed for the treatment of septic-shock. By removing pro- and anti-inflammatory mediators from plasma, CPFA is supposed to have a therapeutic effect on the abnormal inflammatory response seen in this condition. Recently, blood predilution with citrate solution has been adopted to prevent clotting in the CPFA circuit-one of the main problems of the technique. Read More

    Syndecan-1 Limits the Progression of Liver Injury and Promotes Liver Repair in Acetaminophen-Induced Liver Injury.
    Hepatology 2017 May 22. Epub 2017 May 22.
    Division of Respiratory Diseases, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115.
    Accidental or intentional misuse of acetaminophen (APAP) is the leading cause of acute liver failure in the Western world. While mechanisms that trigger APAP-induced liver injury are well known, those that halt the progression of APAP liver disease and facilitate liver recovery are less understood. Heparan sulfate proteoglycans (HSPGs) bind to and regulate various tissue injury factors through their heparan sulfate (HS) chains, but the importance of HSPGs in liver injury in vivo remains unknown. Read More

    Mechanism of graphene-induced cytotoxicity: Role of endonucleases.
    J Appl Toxicol 2017 May 24. Epub 2017 May 24.
    Department of Pharmacology and Toxicology, University of Arkansas for Medical Science, Little Rock, AR, USA.
    Graphene, a crystalline allotrope or carbon, presents numerous useful properties; however, its toxicity is yet to be determined. One of the most dramatic and irreversible toxic abilities of carbon nanomaterials is the induction of DNA fragmentation produced by endogenous cellular endonucleases. This study demonstrated that pristine graphene exposed to cultured kidney tubular epithelial cells is capable of inducing DNA fragmentation measured by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay, which is usually associated with cell death. Read More

    [Dengue with unusual clinical features in an infant: Case report].
    Rev Chil Pediatr 2017 Apr;88(2):275-279
    Hospital General Dr. Agustín O’Horán, Mérida, Yucatán, México.
    The state of Yucatan, in Mexico, is an endemic area for dengue. During 2015, there was an unpredicted increase in the number of expected cases of dengue fever.

    Objective: To describe and analyse the clinical presentation, progress, and management of a case of dengue infection with non-specific clinical manifestations in an infant which resulted in a dengue shock syndrome. Read More

    Stably engineered nanobubbles and ultrasound - An effective platform for enhanced macromolecular delivery to representative cells of the retina.
    PLoS One 2017 25;12(5):e0178305. Epub 2017 May 25.
    School of Pharmacy, The University of Queensland, Woolloongabba, Queensland, Australia.
    Herein we showcase the potential of ultrasound-responsive nanobubbles in enhancing macromolecular permeation through layers of the retina, ultimately leading to significant and direct intracellular delivery; this being effectively demonstrated across three relevant and distinct retinal cell lines. Stably engineered nanobubbles of a highly homogenous and echogenic nature were fully characterised using dynamic light scattering, B-scan ultrasound and transmission electron microscopy (TEM). The nanobubbles appeared as spherical liposome-like structures under TEM, accompanied by an opaque luminal core and darkened corona around their periphery, with both features indicative of efficient gas entrapment and adsorption, respectively. Read More

    Plasma kallistatin in critically ill patients with severe sepsis and septic shock.
    PLoS One 2017 24;12(5):e0178387. Epub 2017 May 24.
    Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Kallistatin, an endogenous serine proteinase inhibitor, is protective against sepsis in animal models. The aim of this study was to determine the plasma concentration of kallistatin in intensive care unit (ICU) patients with severe sepsis and septic shock and to determine their potential correlation with disease severity and outcomes. We enrolled 86 ICU patients with severe sepsis and septic shock. Read More

    The small-molecule kinase inhibitor D11 counteracts 17-AAG-mediated up-regulation of HSP70 in brain cancer cells.
    PLoS One 2017 18;12(5):e0177706. Epub 2017 May 18.
    Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark.
    Many types of cancer express high levels of heat shock proteins (HSPs) that are molecular chaperones regulating protein folding and stability ensuring protection of cells from potentially lethal stress. HSPs in cancer cells promote survival, growth and spreading even in situations of growth factors deprivation by associating with oncogenic proteins responsible for cell transformation. Hence, it is not surprising that the identification of potent inhibitors of HSPs, notably HSP90, has been the primary research focus, in recent years. Read More

    HSP90 inhibitors potentiate PGF2α-induced IL-6 synthesis via p38 MAP kinase in osteoblasts.
    PLoS One 2017 19;12(5):e0177878. Epub 2017 May 19.
    Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
    Heat shock protein 90 (HSP90) that is ubiquitously expressed in various tissues, is recognized to be a major molecular chaperone. We have previously reported that prostaglandin F2α (PGF2α), a potent bone remodeling mediator, stimulates the synthesis of interleukin-6 (IL-6) through p44/p42 mitogen-activated protein (MAP) kinase and p38 MAP kinase in osteoblast-like MC3T3-E1 cells, and that Rho-kinase acts at a point upstream of p38 MAP kinase. In the present study, we investigated the involvement of HSP90 in the PGF2α-stimulated IL-6 synthesis and the underlying mechanism in MC3T3-E1 cells. Read More

    The Impact of the Sepsis-3 Septic Shock Definition on Previously Defined Septic Shock Patients.
    Crit Care Med 2017 May 24. Epub 2017 May 24.
    1Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, MS. 2Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL.
    Objective: The Third International Consensus Definitions Task Force (Sepsis-3) recently recommended changes to the definitions of sepsis. The impact of these changes remains unclear. Our objective was to determine the outcomes of patients meeting Sepsis-3 septic shock criteria versus patients meeting the "old" (1991) criteria of septic shock only. Read More

    Epinephrine but not vasopressin attenuates the airway response to anaphylactic shock in rats.
    Exp Lung Res 2017 May 25:1-9. Epub 2017 May 25.
    b Service d'Anesthésie-Réanimation Chirurgicale, Pôle Anesthésie, Réanimations Chirurgicales, SAMU-SMUR, Nouvel Hôpital Civil , Hôpitaux Universitaires de Strasbourg , Strasbourg , France.
    Purpose: The two life-threatening signs of anaphylactic shock (AS) are severe arterial hypotension and bronchospasm. Guidelines recommend epinephrine as first-line treatment. Arginine vasopressin (AVP) has been proposed as an alternative if epinephrine does not correct arterial hypotension. Read More

    Exposure to febrile-range hyperthermia potentiates Wnt signalling and epithelial-mesenchymal transition gene expression in lung epithelium.
    Int J Hyperthermia 2017 Apr 26:1-10. Epub 2017 Apr 26.
    a Department of Medicine , University of Maryland School of Medicine , Baltimore , MD , USA.
    Background: As environmental and body temperatures vary, lung epithelial cells experience temperatures significantly different from normal core temperature. Our previous studies in human lung epithelium showed that: (i) heat shock accelerates wound healing and activates profibrotic gene expression through heat shock factor-1 (HSF1); (ii) HSF1 is activated at febrile temperatures (38-41 °C) and (iii) hypothermia (32 °C) activates and hyperthermia (39.5 °C) reduces expression of a subset of miRNAs that target protein kinase-Cα (PKCα) and enhance proliferation. Read More

    Diagnostic accuracy of focused cardiac and venous ultrasound examinations in patients with shock and suspected pulmonary embolism.
    Intern Emerg Med 2017 May 24. Epub 2017 May 24.
    Department of Emergency Medicine, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.
    Evaluating the diagnostic performance of focused cardiac ultrasound (US) alone and combination with venous US in patients with shock and suspected pulmonary embolism (PE). Consecutive adult patients with shock and suspected PE, presenting to two Italian emergency departments, were included. Patients underwent cardiac and venous US at presentation with the aim of detecting right ventricular (RV) dilatation and proximal deep venous thrombosis (DVT). Read More

    [Anaphylactic reactions to vaccines : Chicken egg allergy and the influenza H1N1 vaccination].
    HNO 2017 May 24. Epub 2017 May 24.
    HNO-Universitätsklinik Mannheim, Mannheim, Deutschland.
    Background: Allergic reactions to influenza vaccinations are a well-known phenomenon; however, only a few published statistics give information on the risks. Patients with a chicken egg allergy must be particularly carefully handled during an influenza epidemic where vaccines produced using embryonated chicken eggs are primarily employed.

    Methods: A selective literature review and analysis of the problem of allergic reactions to vaccinations was performed. Read More

    Transient Inactivation of Shell Part of Nucleus Accumbens Inhibits and Exacerbates Stress-Induced Metabolic Alterations in Wistar Rats.
    Basic Clin Neurosci 2017 Mar-Apr;8(2):121-128
    Department of Biology, Faculty of Science, Campus of Shahid Bahonar, Farhangiaan University, Hamadan, Iran.
    Introduction: The role of different parts of the extended amygdala in metabolic signs of stress is not well understood. In the present study, we decided to evaluate the impact of the shell part of nucleus accumbens (NAc) on metabolic disturbance induced by electro foot shock stress using transient inactivation method in the rat.

    Methods: Male Wistar rats (W: 230-250 g) were canuulated unilaterally in the shell part of nucleus accumbens and left one week for recovery. Read More

    Using bicistronic constructs to evaluate the chaperone activities of heat shock proteins in cells.
    Sci Rep 2017 May 24;7(1):2387. Epub 2017 May 24.
    Illawarra Health and Medical Research Institute, University of Wollongong, Northfields Ave, Wollongong, 2522, Australia.
    Heat shock proteins (Hsps) are molecular chaperones that prevent the aggregation of client proteins by facilitating their refolding, or trafficking them for degradation. The chaperone activities of Hsps are dependent on dynamic protein-protein interactions, including their oligomerisation into large multi-subunit complexes. Thus, tagging Hsps with fluorescent proteins can interfere with their chaperone activity. Read More

    Optogenetic excitation of cholinergic inputs to hippocampus primes future contextual fear associations.
    Sci Rep 2017 May 24;7(1):2333. Epub 2017 May 24.
    Department of Psychology and Psychiatry, University of California, Los Angeles, California, 90095, USA.
    Learning about context is essential for appropriate behavioral strategies, but important contingencies may not arise during initial learning. A variant of contextual fear conditioning, context pre-exposure facilitation, allows us to directly test the relationship between novelty-induced acetylcholine release and later contextual associability. We demonstrate that optogenetically-enhanced acetylcholine during initial contextual exploration leads to stronger fear after subsequent pairing with shock, suggesting that novelty-induced acetylcholine release primes future contextual associations. Read More

    Anti-HIV-1 ADCC antibodies following latency reversal and treatment interruption.
    J Virol 2017 May 24. Epub 2017 May 24.
    Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, VIC, Australia
    There is growing interest in utilizing antibody-dependent cellular cytotoxicity (ADCC) to eliminate infected cells following reactivation from HIV-1 latency. A potential barrier is that HIV-1-specific ADCC antibodies decline in patients on long-term antiretroviral therapy (ART) and may not be sufficient to eliminate reactivated latently infected cells. It is not known whether reactivation from latency with latency-reversing agents (LRA) could provide sufficient antigenic stimulus to boost HIV-1-specific ADCC. Read More

    Exposure to stressors facilitates long-term synaptic potentiation in the lateral habenula.
    J Neurosci 2017 May 24. Epub 2017 May 24.
    Department of Biological Sciences, Konkuk University, Seoul 05029, South Korea
    The lateral habenula (LHb) is a small part of the epithalamus that projects to monoamine centers in the brain. Previously, neurotransmission onto the LHb was shown to be abnormally potentiated in animal models of depression. However, synaptic plasticity in this brain area and the effect of stressor exposure on synaptic plasticity of the LHb have not been investigated. Read More

    Substrate binding by the yeast Hsp110 nucleotide exchange factor and molecular chaperone, Sse1, is not obligate for its biological activities.
    Mol Biol Cell 2017 May 24. Epub 2017 May 24.
    Department of Microbiology and Molecular Genetics, University of Texas McGovern Medical School at Houston, Houston, TX, 77030
    The highly conserved heat-shock protein 70 (Hsp70) is a ubiquitous molecular chaperone essential for maintaining cellular protein homeostasis. The related protein Hsp110 (Sse1/Sse2 in Saccharomyces cerevisiae) functions as a nucleotide exchange factor (NEF) to regulate the protein folding activity of Hsp70. Hsp110/Sse1 can additionally prevent protein aggregation in vitro via its substrate binding domain (SBD), but the cellular roles of this "holdase" activity remain poorly defined. Read More

    Synthetic anti-endotoxin peptides inhibit cytoplasmic LPS-mediated responses.
    Biochem Pharmacol 2017 May 21. Epub 2017 May 21.
    Freie Universität Berlin, Institute of Pharmacy (Pharmacology and Toxicology), Berlin, Germany. Electronic address:
    Toll-like receptor (TLR) 4-independent recognition of lipopolysaccharide (LPS) in the cytosol by inflammatory caspases leads to non-canonical inflammasome activation and induction of IL-1 secretion and pyroptosis. The discovery of this novel mechanism has potential implications for the development of effective drugs to treat sepsis since LPS-mediated hyperactivation of caspases is critically involved in endotoxic shock. Previously, we demonstrated that Pep19-2. Read More

    [Clinical and microbiological study of catheter-associated urinary tract infections in internal medicine services of a Venezuelan university hospital].
    Rev Peru Med Exp Salud Publica 2017 Jan-Mar;34(1):52-61
    Laboratorio de Microbiología Molecular, Universidad de Los Andes. Mérida, Venezuela.
    Objectives: To determine the clinical and microbiological characteristics of catheter-associated urinary tract infections (CA-UTI) in patients admitted to the Internal Medicine services of the Hospital Universitario de Los Andes (HULA), Mérida, Venezuela and to establish the clonal distribution of multi-resistant Enterobacteriaceae that produce this infection.

    Materials And Methods: Seventy-three adult patients with bladder catheterization were studied between January and July 2015. The microbiological processing of the urine samples was performed using conventional and automatized methods. Read More

    Attenuation of hemorrhage-associated lung injury by adjuvant treatment with C23, an oligopeptide derived from cold-inducible RNA-binding protein (CIRP).
    J Trauma Acute Care Surg 2017 May 22. Epub 2017 May 22.
    1 Center for Immunology and Inflammation, Feinstein Institute for Medical Research, Manhasset, NY 11030, 2 Department of Surgery, Hofstra Northwell School of Medicine, Manhasset, NY 11030.
    Background: Hemorrhagic shock (HS) is an important cause of mortality. HS is associated with an elevated incidence of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), significantly contributing to HS morbidity and mortality. Cold-inducible RNA-binding protein (CIRP) is released into the circulation during HS and can cause lung injury. Read More

    Less is More? Antibiotic duration and outcomes in fournier's gangrene.
    J Trauma Acute Care Surg 2017 May 22. Epub 2017 May 22.
    a Division of Trauma and Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland, 22 South Greene St, Baltimore, MD, 21201. USA.
    Background: Antibiotic management of Fournier's gangrene (FG) is without evidence-based guidelines, and is based on expert opinion. The effect of duration of antibiotic therapy on outcomes in FG is unknown.

    Methods: A retrospective review was performed of FG patients from 2012-2015 at a single institution. Read More

    Development of the Emergency Preservation and Resuscitation for Cardiac Arrest from Trauma (EPR-CAT) Clinical Trial.
    J Trauma Acute Care Surg 2017 May 22. Epub 2017 May 22.
    University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD Department of Surgery, University of Michigan, Ann Arbor, MI Department of Surgery, Emory University, Atlanta, GA University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA Department of Surgery, University of Pittsburgh, Pittsburgh, PA Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA.
    Background: Patients who suffer a cardiac arrest from trauma rarely survive, even with aggressive resuscitation attempts, including an Emergency Department (ED) thoracotomy. Emergency Preservation and Resuscitation (EPR) was developed to utilize hypothermia to buy time to obtain hemostasis before irreversible organ damage occurs. Large animal studies have demonstrated that cooling to tympanic membrane temperature 10°C during exsanguination cardiac arrest can allow up to 2 hours of circulatory arrest and repair of simulated injuries with normal neurologic recovery. Read More

    Intestinal microcirculation and mucosal oxygenation during hemorrhagic shock and resuscitation at different inspired oxygen concentrations.
    J Trauma Acute Care Surg 2017 May 22. Epub 2017 May 22.
    1Laboratoire d'Etude de la Microcirculation, UMR 942, Université Paris 7, Hôpitaux Saint Louis Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France 2Service d'Anesthésie-Réanimation, Hopital d'instruction des armées Percy, Clamart, France 3Service d'Anesthésie-Réanimation Chirurgicale, UMR 942, Hôpital de Bicêtre, Université Paris-Sud, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France 4 Unité de recherche clinique, UMR 942, Université Paris 7, Hôpitaux Saint Louis Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France.
    Background: Hypotensive resuscitation is the standard of care of hemorrhagic shock resuscitation. The optimal level of arterial pressure is debated and there is a lack of data on relationships between arterial pressure, microcirculation and tissue oxygenation. We investigated the relationship between mean arterial pressure, intestinal microcirculation and mucosal oxygen tension during hemorrhagic shock and resuscitation at different inspired oxygen fraction concentration. Read More

    J Trauma Acute Care Surg 2017 May 22. Epub 2017 May 22.
    1 Tulane University School of Medicine, New Orleans Louisiana 2 Louisiana State University School of Medicine, New Orleans Louisiana 3 North Oaks Shock Trauma Program. Hammond Louisiana.
    Background: The Trauma Quality Improvement Project (TQIP) uses an injury prediction model for performance benchmarking. We hypothesize that at a level 1 high-volume penetrating trauma center, performance outcomes will be biased due to inclusion of patients with non-survivable injuries.

    Methods: Retrospective chart review was conducted for all patients included in the institutional TQIP analysis from 2013-2014 with length of stay (LOS) < 1 day to determine survivability of the injuries. Read More

    The Evolution of Care Improves Outcome in Blunt Thoracic Aortic Injury: A Western Trauma Association Multicenter Study.
    J Trauma Acute Care Surg 2017 May 22. Epub 2017 May 22.
    1Trauma Service, Scripps Mercy Hospital, San Diego, California 2Trauma and Acute Care Surgery Service, Legacy Emanuel Medical Center, Portland, Oregon 3Division of Vascular Surgery, PeaceHealth Southwest Washington Medical Center, Vancouver, Washington 4Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, Portland, Oregon 5Department of Surgery, University of Colorado Denver School of Medicine, Aurora, Colorado 6Division of Trauma, Duke University Medical Center, Durham, North Carolina 7UC Health Medical Center of the Rockies, Loveland, CO 8R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD.
    Background: The management of blunt thoracic aortic injury (BTAI) has evolved radically in the last decade with changes in the processes of care and the introduction of thoracic endovascular repair (TEVAR). These changes have wrought improved outcome, but the direct effect of TEVAR on outcome remains in question as previous studies have lacked vigorous risk adjustment and long-term follow-up. To address these knowledge gaps, we compared the outcomes of TEVAR, open surgical repair, and nonoperative management for BTAI. Read More

    Comparison of Compensatory Reserve and Arterial Lactate as Markers of Shock and Resuscitation.
    J Trauma Acute Care Surg 2017 May 22. Epub 2017 May 22.
    *University of Texas Health Science Center at San Antonio ^US Army Institute of Surgical Research.
    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. Read More

    Impact of a Novel PI3-KINASE Inhibitor in Preventing Mitochondrial DNA Damage and Damage Associated Molecular Pattern Accumulation: Results from the Biochronicity Project.
    J Trauma Acute Care Surg 2017 May 22. Epub 2017 May 22.
    1Dept. of Surgery, Madigan Army Medical Center, Joint Base Lewis-McChord, Washington 2Dept. of Surgery, University of South Alabama, Mobile, Alabama 3Dept. of Pharmacology, University of South Alabama, Mobile, Alabama 4Basic Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 5Trauma and Acute Care Surgery Service, Legacy Emanuel Medical Center, Portland, Oregon.
    Background: Despite improvements in the management of severely injured patients, development of multiple organ dysfunction syndrome (MODS) remains a morbid complication of traumatic shock. One of the key attributes of MODS is a profound bioenergetics crisis, for which the mediators and mechanisms are poorly understood. We hypothesized that metabolic uncoupling using an experimental PI3-kinase inhibitor, LY294002 (LY), may prevent mitochondrial abnormalities that lead to the generation of mitochondrial DNA (mtDNA) damage and the release of mtDNA damage associated molecular patterns (DAMPs) METHODS: 16 swine were studied using LY294002 (LY), a non-selective PI3-KI: Animals were assigned to Trauma only (TO, N=3); LY drug only (LYO, N=3); and Experimental (N=10), trauma + drug (LY+T) groups. Read More

    How electronic health records can unmask the hidden value of PAs.
    JAAPA 2017 Jun;30(6):1-3
    Folusho Ogunfiditimi is administrative director of adult clinical services and advanced practice providers at Harper University/Hutzel Women's Hospital, part of Detroit (Mich.) Medical Center. Scott P. Sherry is an assistant professor at Oregon Health & Science University in Portland, Ore. Monica Foote is manager of advanced practice providers for HealthTexas Provider Network, Baylor Scott & White Health in Dallas. Sarah L. Christie is chief PA in the Department of Neurosurgery at Brigham and Women's Hospital in Boston, Mass. Lisa P. Shock is senior director of clinical operations at WakeMed/Key Community Care, Evolent Health, in Raleigh, N.C., and practices at WakeMed Raleigh, Essential Geriatric Care, and FastMed Urgent Care. James F. Cawley is professor of prevention and community health and professor of physician assistant studies at the George Washington University in Washington, D.C., and former senior research fellow at the American Academy of PAs in Alexandria, Va. Aaron Browne is senior director of healthcare technology services for Huron Consulting Group in Chicago, Ill. Ms. Shock discloses that Evolent Health is a medical records firm. The authors are members of the AAPA Fee for Value Task Force but have disclosed no other potential conflicts of interest, financial or otherwise.
    The Fee for Value (FFV) Task Force, a subgroup of the American Academy of PAs' Research and Strategic Initiatives Commission, has examined tools and mechanisms aimed at better clarifying the volume and value of PA work and how that work contributes to improving access to high-quality care. Establishing the value of PAs has been a challenging task for many healthcare providers. Often, PA value has been defined by their clinical productivity, without any clear direction as to what constitutes value versus productivity. Read More

    Antimicrobial resistance patterns, clinical features, and risk factors for septic shock and death of nosocomial E coli bacteremia in adult patients with hematological disease: A monocenter retrospective study in China.
    Medicine (Baltimore) 2017 May;96(21):e6959
    Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
    The aim of this retrospective analysis was to evaluate the antimicrobial resistance, clinical features, and risk factors for septic shock and death of nosocomial E coli bacteremia in adult patients in a single hematological center in China. A retrospective case-control study of 157 adult hematological patients with 168 episodes of E coli bacteremia was initiated from April 2012 to July 2015. Antimicrobial susceptibility as well as antimicrobial co-resistance rates were analyzed. Read More

    GlnK Facilitates the Dynamic Regulation of Bacterial Nitrogen Assimilation.
    Biophys J 2017 May;112(10):2219-2230
    Department of Mathematics, Imperial College London, London, United Kingdom. Electronic address:
    Ammonium assimilation in Escherichia coli is regulated by two paralogous proteins (GlnB and GlnK), which orchestrate interactions with regulators of gene expression, transport proteins, and metabolic pathways. Yet how they conjointly modulate the activity of glutamine synthetase, the key enzyme for nitrogen assimilation, is poorly understood. We combine experiments and theory to study the dynamic roles of GlnB and GlnK during nitrogen starvation and upshift. Read More

    Sphingosine-1-phosphate Receptor-1 Agonist SEW2871 Causes Severe Cardiac Side Effects and does not Improve Microvascular Barrier Breakdown in Sepsis.
    Shock 2017 May 23. Epub 2017 May 23.
    *University of Würzburg, Department of General, Visceral, Vascular and Paediatric surgery (Department of Surgery I), Oberdürrbacherstraße 6, D-97080 Würzburg, Germany †University of Würzburg, Department of Anaesthesia and Critical Care, Oberdürrbacherstraße 6, D-97080 Würzburg, Germany ‡Department of Anesthesiology and Intensive Care Medicine, University Medical Center, Freiburg, Germany.
    Background: Endothelial barrier dysfunction is a hallmark in the pathogenesis of sepsis. Sphingosine-1-phosphate (S1P) has been proposed to be critically involved in the maintenance of endothelial barrier function predominately by activating S1P receptor-1 (S1P1). Previous studies have shown that the specific S1P1 agonist SEW2871 improves endothelial barrier function under inflammatory conditions. Read More

    Circulating Heparan Sulfate Fragments Attenuate Histone-Induced Lung Injury Independently of Histone Binding.
    Shock 2017 May 23. Epub 2017 May 23.
    *Research Center of Occupational Medicine, Third Hospital of Peking University, China †Department of Medicine, University of Colorado Denver, Aurora CO ‡Department of Medicine, Denver Health Medical Center, Denver CO.
    Extracellular histones are cationic damage-associated molecular pattern molecules capable of directly inducing cellular injury via charge-mediated interactions with plasma membranes. Accordingly, histones released into the plasma during critical illness are known to contribute to the onset and propagation of lung injury. Vascular injury (with consequent degradation of the endothelial glycocalyx) simultaneously releases anionic heparan sulfate fragments (hexa- to octasaccharides in size) into the plasma. Read More

    Low Serum Angiopoietin-1, High Serum Angiopoietin-2, and High Ang-2/Ang-1 Protein Ratio are Associated with Early Onset Sepsis in Surinamese Newborns.
    Shock 2017 May 22. Epub 2017 May 22.
    *Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands †Academic Pediatric Center Suriname ‡Scientific Research Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname §Department of Critical Care ||Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands ¶Department of Pediatrics, Diakonessen Hospital, Paramaribo, Suriname **Department of Pediatrics, Tergooi Hospitals, The Netherlands.
    Purpose: Vascular inflammation and leakage in sepsis is mediated by Angiopoietin-1 (Ang-1) and -2 (Ang-2) and their phosphorylation of the endothelial Tie-2 receptor. Levels of Ang-2 change in adults and children during sepsis, which is associated with severity of sepsis. This study investigates levels of Ang-1 and Ang-2 in newborns to gain insight in the vascular pathophysiology of early onset sepsis (EOS) within 72 hours after birth. Read More

    Lactate and microcirculation as suitable targets for hemodynamic optimization in resuscitation of circulatory shock.
    Curr Opin Crit Care 2017 May 22. Epub 2017 May 22.
    aDepartment of Anesthesiology bDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University Medical Center, NewYork-Presbyterian Hospital cDepartment of Pulmonary and Critical Care, Langone Medical Center-Bellevue Hospital, New York University, New York, New York, USA dDepartment of Intensive Care Adults, Erasmus MC University Medical Center, Rotterdam, The Netherlands eFacultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
    Purpose Of Review: A discussion of recent research exploring the feasibility of perfusion-guided resuscitation of acute circulatory failure with a focus on lactate and microcirculation.

    Recent Findings: Upon diagnosis of shock, hyperlactemia is associated with poor outcome and, under appropriate clinical circumstances, may reflect inadequate tissue perfusion. Persistent hyperlactemia despite resuscitation is even more strongly correlated with morbidity and mortality. Read More

    Sepsis: Current Definition, Pathophysiology, Diagnosis, and Management.
    Nutr Clin Pract 2017 Jun 17;32(3):296-308. Epub 2017 Mar 17.
    1 Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA.
    Sepsis is a clinical syndrome that results from the dysregulated inflammatory response to infection that leads to organ dysfunction. The resulting losses to society in terms of financial burden, morbidity, and mortality are enormous. We provide a review of sepsis, its underlying pathophysiology, and guidance for diagnosis and management of this common disease. Read More

    Efficacy of Dipeptide-Coated Magnetic Nanoparticles in Lung Cancer Models Under Pulsed Electromagnetic Field.
    Cancer Invest 2017 May 24:1-12. Epub 2017 May 24.
    a Department of Human Genetics , Sri Ramachandra University , Chennai , India.
    Lung cancer is the leading cause of cancer deaths and the overall 5-year survival rate is less than 17%. Hyperthermia is an alternative approach for the treatment of lung cancer and is associated with fewer side effects. We employed ironoxide nanoparticles in inducing localized hyperthermia in lung cancer cells using a pulsed electromagnetic field (PEMF). Read More

    An Hsp90 co-chaperone protein in yeast is functionally replaced by site-specific posttranslational modification in humans.
    Nat Commun 2017 May 24;8:15328. Epub 2017 May 24.
    Urologic Oncologic Branch, Center for Cancer Research, National Cancer Institute, 9000 Rockville Pike, Bethesda, Maryland 20892, USA.
    Heat shock protein 90 (Hsp90) is an essential eukaryotic molecular chaperone. To properly chaperone its clientele, Hsp90 proceeds through an ATP-dependent conformational cycle influenced by posttranslational modifications (PTMs) and assisted by a number of co-chaperone proteins. Although Hsp90 conformational changes in solution have been well-studied, regulation of these complex dynamics in cells remains unclear. Read More

    'I think a little bit of a kick is sometimes what you need': Women's accounts of whole-body scanning and likely impact on health-related behaviours.
    Psychol Health 2017 May 24:1-18. Epub 2017 May 24.
    b University of Manchester , Manchester , UK.
    Objective: This study was designed to investigate whether whole-body scanning might promote healthy eating and physical activity in women, and to explore the effects of scanning on body image.

    Design: Fourteen women aged 22-45 years without histories of eating disorders or whole-body scanning took part in semi-structured interviews before and after scanning. Data were analysed using inductive thematic analysis. Read More

    Fluid responsiveness predicted by transcutaneous partial pressure of oxygen in patients with circulatory failure: a prospective study.
    Ann Intensive Care 2017 Dec 23;7(1):56. Epub 2017 May 23.
    Department of Critical Care Medicine, Nanjing Zhongda Hospital, School of Medicine, Southeast University, 87 Dingjiaqiao Rd., Nanjing, 210009, People's Republic of China.
    Background: Significant effort has been devoted to defining parameters for predicting fluid responsiveness. Our goal was to study the feasibility of predicting fluid responsiveness by transcutaneous partial pressure of oxygen (PtcO2) in the critically ill patients.

    Methods: This was a single-center prospective study conducted in the intensive care unit of a tertiary care teaching hospital. Read More

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