Articles: function.
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Intensive care medicine · May 2015
Randomized Controlled TrialEffects of a recruitment maneuver on plasma levels of soluble RAGE in patients with diffuse acute respiratory distress syndrome: a prospective randomized crossover study.
The soluble form of the receptor for advanced glycation end-products (sRAGE) is a promising marker for epithelial dysfunction, but it has not been fully characterized as a biomarker of acute respiratory distress syndrome (ARDS). Whether sRAGE could inform on the response to ventilator settings has been poorly investigated, and whether a recruitment maneuver (RM) may influence plasma sRAGE remains unknown. ⋯ We report the first kinetics study of plasma sRAGE after RM in ARDS. Our findings reinforce the value of plasma sRAGE as a biomarker of ARDS.
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To examine whether men and women with fibromyalgia syndrome (FMS) differ with respect to pain severity and functioning, pain-related beliefs, or pain-related coping. We hypothesized no significant sex differences in measures of pain and functioning, but that we would observe differences between men and women in how they view and how they cope with FMS-related pain. ⋯ The study findings suggest that women and men with FMS may think about and cope with pain somewhat differently, and may therefore benefit from different types of psychosocial pain intervention.
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Small-fiber neuropathy (SFN) is hallmarked by degeneration of small unmyelinated peripheral nerve fibers in the skin. Traditionally, it has been considered as a pure disorder of the peripheral nervous system. Nevertheless, previous work found that dysfunction of skin nerves led to abnormal recruitment of pain-related regions, suggesting that the brain may be affected in SFN. ⋯ Moreover, the degree of reduction in functional connectivity for the ACC to the amygdala and the precuneus was linearly correlated with the severity of intraepidermal nerve fiber depletion. Our findings suggest that SFN is not a pure peripheral nervous system disorder. The pain-related brain networks tend to break into functionally independent components, with severity linked to the degree of skin nerve degeneration.
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We sought to investigate the degree to which cognitive skills explain associations between health literacy and asthma-related medication use among older adults with asthma. ⋯ Among older patients with asthma, interventions to promote proper medication use should simplify tasks and patient roles to overcome cognitive load and suboptimal performance in self-care.
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 2015
[Perioperative heart failure - Acute intraoperative heart failure].
With respect to the fact that - with the notable exception of patients undergoing cardiac surgery - only sparse data and limited guideline recommendations on optimal treatment strategies in patients with intraoperative acute heart failure are available. Consecutively it is rather difficult to make clear suggestions for the optimal treatment of this complication. ⋯ Importantly, one has to to take into account that the use of beta-mimetic drugs for the treatment of acute heart failure is increasingly recognized as an isolated mortality factor. This suggests to use inotropes as restrictive as possible, and if inotropic treatment becomes inevitable, to use levosimendan as the only inotrope that has been shown to improve mortality in several meta-analyses.