Journal of the Chinese Medical Association : JCMA
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Acute blood loss linked to severe hypovolemia and hemorrhagic shock is a critical condition in pediatric intensive care. This study was to investigate the role of various fluid resuscitation approaches to cerebral tissue oxygenation using a piglet model of hemorrhagic shock. ⋯ Effective resuscitation using a high concentration of inspired oxygen and adequate fluid infusion, either as a single-dose bolus of NS or combining this with a subsequent transfusion of WB, LR, or NS, helped to stabilize the cardiovascular condition of the tested young subjects and improved cerebral tissue oxygenation over the emergent first four hours. Furthermore, WB was the best fluid choice when used in addition to the bolus NS challenge for maintaining better brain tissue oxygenation when treating hemorrhagic shock.
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Chronic graft-versus-host disease (cGVHD) is one of the most frequent and serious complications of allogeneic hematopoietic stem cell transplantation (HSCT). Nephrotic syndrome (NS) is an uncommon and underrecognized manifestation of cGVHD. We report a patient who developed NS 18 months after allogeneic bone marrow transplantation. ⋯ Monitoring of renal parameters, especially proteinuria, is important in cGVHD patients. Our case indicated that post-transplant NS, occurring without history of tapering or following immunosuppressant withdrawal, presents a more severe activity of cGVHD and a relatively severe clinical course. IVIG may modify and control the refractory GVHD-related NS, and can be one of the choices of treatment.
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Three ghrelin gene-derived peptides, acyl ghrelin, des-acyl ghrelin and obestatin, are implicated in the regulation of feeding, adipogenesis and glucose metabolism, as well as gut motility. The effects of ghrelin gene-derived peptides on lower esophageal sphincter motility, however, were unknown. ⋯ Since the contractile effects of carbachol and relaxant responses of papaverine on the lower esophageal sphincter were confirmed, our results demonstrate that acyl ghrelin, des-acyl ghrelin and obestatin have no direct effects on rat lower esophageal sphincter motility in vitro.
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Spleen artery embolization (SAE) may increase the success rate of nonoperative management (NOM). The present study investigated the clinical outcome after the installation of SAE in the management of blunt splenic injury. ⋯ Performance of SAE for the patients with blunt splenic injury could increase the successful rate of NOM significantly and safely. An algorithm including the angioembolization might be beneficial in the management of patients with blunt spleen trauma.
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Osteoarthritis (OA) is the most widespread chronic joint disease worldwide. Symptomatic knee OA is observed in approximately 12% of individuals more than 60 years of age. Conservative treatments models may not be effective always, and that some of them have serious adverse effects that prompted the researchers to research different treatment methods. In this study, we investigated short- and mid-term effectiveness of intra-articular pulsed radiofrequency (PRF) applied in patients with chronic knee pain due to OA. ⋯ PRF applied to the knee joint appears to be an effective and safe method.