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Anesthesia and Analgesia 1975A 27-year-old, generally healthy, woman became acutely hypotensive during a diagnostic laparoscopy. Her blood pressure returned to preoperative levels and remained...
A 27-year-old, generally healthy, woman became acutely hypotensive during a diagnostic laparoscopy. Her blood pressure returned to preoperative levels and remained stable after decrease in intra-abdominal pressure. The author suggests five possible causes of hypotension during laparoscopy.
Topics: Abdomen; Acute Disease; Adult; Female; Humans; Hypotension; Laparoscopy; Pressure
PubMed: 123131
DOI: 10.1213/00000539-197501000-00035 -
Quantitative Imaging in Medicine and... May 2022To evaluate the accuracy of two-dimensional (2D) shear wave elastography (SWE), develop and validate a novel prognostic model in predicting acute-on-chronic liver...
BACKGROUND
To evaluate the accuracy of two-dimensional (2D) shear wave elastography (SWE), develop and validate a novel prognostic model in predicting acute-on-chronic liver failure (ACLF) development in patients with acutely decompensated hepatitis B cirrhosis.
METHODS
This prospective cohort study enrolled 221 patients in the First Affiliated Hospital of Nanchang University from September 2019 to January 2021, and randomly assigned them to the derivation and validation cohorts (7:3 ratio). Ultrasound, 2D SWE, clinical and laboratory data were collected, and outcome (ACLF developed) was recorded during a 90-day follow-up period. We evaluated the ability of 2D SWE to predict the outcome, developed a model for predicting ACLF development in the derivation cohort, and assessed the model in the validation cohort.
RESULTS
2D SWE values were significantly higher in patients with ACLF development (P<0.05). The accuracy of 2D SWE in predicting the outcome was better than that of serum parameters of liver fibrosis (all P<0.05). The SWE model for ACLF development had good calibration and discrimination [concordance index (C-index): 0.855 and 0.840 respectively] in derivation and validation cohorts, outperforming serum prognostic scores (all P<0.05).
CONCLUSIONS
The SWE model, superior to serum prognostic scores in predicting ACLF development, could be a noninvasive tool to guide the individual management of patients with acutely decompensated hepatitis B cirrhosis.
PubMed: 35502396
DOI: 10.21037/qims-21-871 -
Journal of Clinical Psychology Mar 1989One hundred and ten outpatients with either acute or chronic low-back pain completed the McGill Pain Questionnaire, Beck Depression Inventory, State-Trait Anxiety...
One hundred and ten outpatients with either acute or chronic low-back pain completed the McGill Pain Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventory, and Life Experiences Survey. Acutes and chronics did not differ on dimensions of pain, but significant correlations between pain dimensions and depression and state anxiety were found for chronics. Both groups showed elevated state anxiety; chronics also evidenced mild depression. Combined scores on depression, anxiety, and negative life change predicted sensory and affective pain for the pooled sample. These results confirm the role of psychological variables in the experience of clinical pain and underscore the highly affective nature of chronic pain.
Topics: Adaptation, Psychological; Adult; Anxiety Disorders; Back Pain; Depressive Disorder; Female; Humans; Life Change Events; Male; Middle Aged; Pain Measurement; Psychological Tests; Psychometrics
PubMed: 2524505
DOI: 10.1002/1097-4679(198903)45:2<223::aid-jclp2270450208>3.0.co;2-y -
Journal of Athletic Training Oct 2020Previous researchers have examined factor structures for common concussion symptom inventories. However, they failed to discriminate between the acute (<72 hours) and...
CONTEXT
Previous researchers have examined factor structures for common concussion symptom inventories. However, they failed to discriminate between the acute (<72 hours) and subacute (3 days-3 months) periods after concussion. The Sport Concussion Assessment Tool (SCAT) is an acute assessment that, when compared with other concussion symptom inventories, includes or excludes symptoms that may result in different symptom factors.
OBJECTIVE
The primary purpose was to investigate the symptom factor structure of the 22-item SCAT symptom inventory in healthy, uninjured and acutely concussed high school and collegiate athletes. The secondary purpose was to document the frequency of the unique SCAT symptom inventory items.
DESIGN
Case series.
SETTING
High school and college.
PATIENTS OR OTHER PARTICIPANTS
A total of 1334 healthy, uninjured and 200 acutely concussed high school and collegiate athletes.
MAIN OUTCOME MEASURE(S)
Healthy, uninjured participants completed the SCAT symptom inventory at a single assessment. Participants in the acutely concussed sample completed the SCAT symptom inventory within 72 hours after concussion. Two separate exploratory factor analyses (EFAs) using a principal component analysis and varimax extraction method were conducted.
RESULTS
A 3-factor solution accounted for 48.1% of the total variance for the healthy, uninjured sample: cognitive-fatigue (eg, feeling "in a fog" and "don't feel right"), migraine (eg, neck pain and headache), and affective (eg, more emotional and sadness) symptom factors. A 3-factor solution accounted for 55.0% of the variance for the acutely concussed sample: migraine-fatigue (eg, headache and "pressure in the head"), affective (eg, sadness and more emotional), and cognitive-ocular (eg, difficulty remembering and balance problems) symptom factors.
CONCLUSIONS
The inclusion of unique SCAT symptom inventory items did not alter the symptom factor structure for the healthy, uninjured sample. For the acutely concussed sample, all but 1 unique SCAT symptom inventory item (neck pain) loaded onto a factor.
Topics: Adolescent; Adult; Athletes; Athletic Injuries; Child; Female; Humans; Male; Mental Recall; Neuropsychological Tests; Post-Concussion Syndrome; Sports Medicine; Young Adult
PubMed: 33108797
DOI: 10.4085/1062-6050-393-19 -
Journal of Neuroendovascular Therapy 2022The purpose of this study was to report the results of stent-assisted embolization performed at our hospital for acutely ruptured aneurysms.
OBJECTIVE
The purpose of this study was to report the results of stent-assisted embolization performed at our hospital for acutely ruptured aneurysms.
METHODS
This study consisted of 19 patients (4 men and 15 women) with acutely ruptured wide neck aneurysm who underwent stent-assisted coil embolization in acute stage between December 2016 and October 2020. Stent-assisted embolization in the acute stage was performed for very wide neck ruptured aneurysm only when balloon-assisted embolization was failed or was thought to be impossible. Factors related to poor clinical outcome were examined.
RESULTS
There were nine internal carotid artery (ICA) aneurysms, four anterior communicating artery (AcomA) aneurysms, three basilar artery (BA) aneurysms, two vertebral artery (VA) aneurysms and one anterior cerebral artery (ACA) aneurysm. The stents used were one Neuroform EZ and 18 Neuroform Atlas (Stryker). The contrast of the bleb disappeared in all cases with obvious bleb. Complete obliteration was achieved in two cases, neck remnant was in ten, and body filling was in seven. Both of the complete obliteration cases developed thrombotic complications. Modified Rankin score of 0-2 was observed in eight patients (good clinical outcome), whereas that of 4-6 was observed in 11 patients (poor clinical outcome). Several factors possibly affected to poor clinical outcome were examined and only age over 80 years was statically different. Complications related to procedure occurred in five patients; two cases of in-stent thrombosis, one case each of MCA perforation, stent occlusion, and coil fracture.
CONCLUSION
Stent-assisted coil embolization using Neuroform EZ and Neuroform Atlas could be considered as an emergency treatment for acutely ruptured cerebral aneurysms with very wide neck. It is rarely indicated in patients with age over 80 years.
PubMed: 37502640
DOI: 10.5797/jnet.oa.2021-0010 -
Journal of Athletic Training Sep 2020Previous researchers have examined factor structures for common concussion symptom inventories. However, they failed to discriminate between the acute (<72 hours) and...
CONTEXT
Previous researchers have examined factor structures for common concussion symptom inventories. However, they failed to discriminate between the acute (<72 hours) and subacute (3 days-3 months) periods after concussion. The Sport Concussion Assessment Tool (SCAT) is an acute assessment that, when compared with other concussion symptom inventories, includes or excludes symptoms that may result in different symptom factors.
OBJECTIVE
The primary purpose was to investigate the symptom factor structure of the 22-item SCAT symptom inventory in healthy, uninjured and acutely concussed high school and collegiate athletes. The secondary purpose was to document the frequency of the unique SCAT symptom inventory items.
DESIGN
Case series.
SETTING
High school and college.
PATIENTS OR OTHER PARTICIPANTS
A total of 1334 healthy, uninjured and 200 acutely concussed high school and collegiate athletes.
MAIN OUTCOME MEASURE(S)
Healthy, uninjured participants completed the SCAT symptom inventory at a single assessment. Participants in the acutely concussed sample completed the SCAT symptom inventory within 72 hours after concussion. Two separate exploratory factor analyses (EFAs) using a principal component analysis and varimax extraction method were conducted.
RESULTS
A 3-factor solution accounted for 48.1% of the total variance for the healthy, uninjured sample: cognitive fatigue (eg, feeling "in a fog" and "don't feel right"), migraine (eg, neck pain and headache), and affective (eg, more emotional and sadness) symptom factors. A 3-factor solution accounted for 55.0% of the variance for the acutely concussed sample: migraine fatigue (eg, headache and "pressure in the head"), affective (eg, sadness and more emotional), and cognitive ocular (eg, difficulty remembering and balance problems) symptom factors.
CONCLUSIONS
The inclusion of unique SCAT symptom inventory items did not alter the symptom factor structure for the healthy, uninjured sample. For the acute concussed sample, all but 1 unique SCAT symptom inventory item (neck pain) loaded onto a factor.
PubMed: 32905590
DOI: 10.4085/1062-6050-393.19 -
Nutrients May 2023The beneficial impact of dietary fiber on the prevention and management of several chronic conditions associated with aging, including diabetes, neurodegenerative,... (Review)
Review
The beneficial impact of dietary fiber on the prevention and management of several chronic conditions associated with aging, including diabetes, neurodegenerative, cardiovascular diseases, and cancer, is well-known. High fiber intake has been associated with reduced inflammatory mediators counteracting the low-grade chronic inflammation typical of older age. In addition, dietary fiber improves postprandial glucose response and insulin resistance. In contrast, during acute diseases, its effects on insulin resistance and modulation of immune response are unclear. The aim of this narrative is to summarize the evidence for the potential impact of dietary fiber on inflammation and insulin resistance in older adults, with a particular focus on those acutely ill. Available evidence suggests that dietary fiber has the potential to counteract acute inflammation and to improve metabolic health. In addition, modulation of gut microbiota composition may contribute to improved immune function, particularly in the setting of aging-associated dysbiosis. This phenomenon has relevant implications in those acutely ill, in whom dysbiosis can be exacerbated. Our review leads to the conclusion that dietary interventions based on fiber manipulation could exploit its beneficial effects on inflammation and insulin resistance, if conducted from a precision nutrition perspective. This could also be true for the acutely ill patient, even though strong evidence is lacking.
Topics: Humans; Aged; Insulin Resistance; Dysbiosis; Inflammation; Dietary Fiber; Glucose
PubMed: 37242248
DOI: 10.3390/nu15102365 -
Pflugers Archiv : European Journal of... Nov 1979Clearance studies have been performed in order to examine the acute effects of hydrocortisone on the reabsorption of inorganic phosphage (Pi) in normal, acutely...
Clearance studies have been performed in order to examine the acute effects of hydrocortisone on the reabsorption of inorganic phosphage (Pi) in normal, acutely adrenalectomized (Adr. X) and acutely parathyroidectomized (PTX) rats. Hydrocortisone increased the glomerular filtration rates in all groups, normalized the capacity to excrete water in the Adr. X animals, did not change consistently the fractional reabsorption of sodium in all series and diminished the fraction reabsorption of inorganic phosphate in Adr. X rats from 91.4 +/- 6.5 (mean +/- S.D.) to 78.2 +/- 8.5% (P less than 0.001). It is concluded that the decrease of the fractional reabsorption of Pi in the Adr. X animals was rather the result of the increased filtered load than a direct effect of hydrocortisone on the Pi transport.
Topics: Adrenal Glands; Adrenalectomy; Animals; Female; Hydrocortisone; Kidney Tubules; Parathyroid Glands; Phosphates; Rats
PubMed: 574262
DOI: 10.1007/BF00584212 -
Regulatory Toxicology and Pharmacology... Feb 2018In vivo acute systemic testing is a regulatory requirement for agrochemical formulations. GHS specifies an alternative computational approach (GHS additivity formula)...
In vivo acute systemic testing is a regulatory requirement for agrochemical formulations. GHS specifies an alternative computational approach (GHS additivity formula) for calculating the acute toxicity of mixtures. We collected acute systemic toxicity data from formulations that contained one of several acutely-toxic active ingredients. The resulting acute data set includes 210 formulations tested for oral toxicity, 128 formulations tested for inhalation toxicity and 31 formulations tested for dermal toxicity. The GHS additivity formula was applied to each of these formulations and compared with the experimental in vivo result. In the acute oral assay, the GHS additivity formula misclassified 110 formulations using the GHS classification criteria (48% accuracy) and 119 formulations using the USEPA classification criteria (43% accuracy). With acute inhalation, the GHS additivity formula misclassified 50 formulations using the GHS classification criteria (61% accuracy) and 34 formulations using the USEPA classification criteria (73% accuracy). For acute dermal toxicity, the GHS additivity formula misclassified 16 formulations using the GHS classification criteria (48% accuracy) and 20 formulations using the USEPA classification criteria (36% accuracy). This data indicates the acute systemic toxicity of many formulations is not the sum of the ingredients' toxicity (additivity); but rather, ingredients in a formulation can interact to result in lower or higher toxicity than predicted by the GHS additivity formula.
Topics: Administration, Cutaneous; Administration, Inhalation; Administration, Oral; Agrochemicals; Biological Assay; Chemistry, Pharmaceutical; United States; United States Environmental Protection Agency
PubMed: 29305950
DOI: 10.1016/j.yrtph.2017.12.024 -
Journal of Physiology and Pharmacology... Oct 2014Depression is the leading psychiatric disorder with a high risk of morbidity and mortality. Clinical studies report lower serum zinc in depressed patients, suggesting a...
Depression is the leading psychiatric disorder with a high risk of morbidity and mortality. Clinical studies report lower serum zinc in depressed patients, suggesting a strong link between zinc and mood disorders. Also copper as an antagonistic element to zinc seems to play a role in depression, where elevated concentration is observed. In the present study we investigated serum copper and zinc concentration after acute or chronic antidepressant (AD) treatment under pathological/zinc-deficient conditions. Zinc deficiency in mice was induced by a special diet administered for 6 weeks (zinc adequate diet - ZnA, contains 33.5 mgZn/kg; zinc deficient diet - ZnD, contains 0.2 mgZn/kg). Animals received acute or chronically saline (control), imipramine, escitalopram, reboxetine or bupropion. To evaluate changes in serum copper and zinc concentrations the total reflection X-ray fluorescence (TXRF) and flame atomic absorption spectrometry (FAAS) was performed. In ZnD animals serum zinc level was reduced after acute ADs treatment (similarly to vehicle treatment), however, as demonstrated in the previous study after chronic ADs administration no differences between both ZnA and ZnD groups were observed. Acute ADs in ZnD animals caused different changes in serum copper concentration with no changes after chronic ADs treatment. The calculated serum Zn/Cu ratio is reduced in ZnD animals (compared to ZnA subjects) treated with saline (acutely or chronically) and in animals treated acutely with ADs. However, chronic treatment with ADs normalized (by escitalopram, reboxetine or bupropion) or increased (by imipramine) this Zn/Cu ratio. Observed in this study normalization of serum Zn/Cu ratio in depression-like conditions by chronic (but not acute) antidepressants suggest that this ratio may be consider as a marker of depression or treatment efficacy.
Topics: Animals; Antidepressive Agents; Bupropion; Citalopram; Copper; Depression; Disease Models, Animal; Imipramine; Male; Mice; Morpholines; Reboxetine; Sodium Chloride; Zinc
PubMed: 25371526
DOI: No ID Found