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Neurogenic Shock

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1. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: an AUA/SUFU Guideline

Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: an AUA/SUFU Guideline 1 Purpose: The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of non-neurogenic overactive bladder (OAB). Methods: The primary source of evidence for the original version of this guideline was the systematic review and data extraction conducted as part of the Agency for Healthcare Research and Quality (AHRQ) Evidence Report/Technology Assessment (...) ’ disclosure of potential conflicts of interest and author/staff contributions appear at the end of the article. © 2019 by the American Urological Association American Urological Association (AUA)/ Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Guideline DIAGNOSIS AND TREATMENT OF OVERACTIVE BLADDER (Non-Neurogenic) IN ADULTS: AUA/SUFU GUIDELINE E. Ann Gormley, Deborah J. Lightner, Kathryn L. Burgio, Toby C. Chai, J. Quentin Clemens, Daniel J. Culkin, Anurag Kumar Das

2019 American Urological Association

2. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults

Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults Overactive Bladder (OAB) Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology Online (...) Managers' Network (PMN) Patient Safety and Quality of Care Accreditations and Reporting Patient Education Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults (2019) AUA/SUFU Guideline: Published 2012; Amended 2014, 2019 The clinical guideline on Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults discusses patient presentation, diagnosis, treatment, and follow-up of patients based on the currently available data. [pdf] [pdf] Panel Members E. Ann Gormley

2019 American Urological Association

3. Presentation of neurogenic shock within the emergency department. (PubMed)

Presentation of neurogenic shock within the emergency department. Injury to the spinal cord can result in loss of sympathetic innervation causing a drop in BP and HR, this condition is known as neurogenic shock. There is debate among the literature on how and when neurogenic shock presents and what values of HR and BP should be used to define it. Previous studies do not take into account multiple prehospital and emergency department recordings.To improve understanding of how neurogenic shock (...) presents in humans, allowing better identification and treatment.The Trauma Audit and Research Network database for an adult major trauma centre was used to isolate patients with a spinal cord injury. Qualifying patients had all available BPs and HRs collated into a database. Patients with neurogenic shock were isolated, allowing data analysis.Out of 3069 trauma patients, 33 met the inclusion criteria, of which 15 experienced neurogenic shock. 87% of the patients who had neurogenic shock experienced

2016 Emergency Medicine Journal

4. Neurogenic Shock

Neurogenic Shock Neurogenic Shock Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Neurogenic Shock Neurogenic Shock Aka: Neurogenic (...) Shock , Vasogenic Shock From Related Chapters II. Definitions Neurogenic Shock Distributive shock from neurogenic vasodilation mediated by loss of sympathetic tone Follows cerebral or spinal cord injury (above T6) affecting sympathtic nervous system In contrast to Neurogenic Shock, is not a true shock syndrome Results in and loss below level of spinal cord injury III. Pathophysiology Results from or upper spine injury (above T6) Peripheral denervation results in ungoverned activity Loss of vasomotor

2018 FP Notebook

5. The 4 Physiologic Etiologies of Shock, and the 3 Etiologies of Cardiogenic Shock

thrombosis. This was not ACS. This was not Left Main occlusion. Comment: Shock has 4 basic etiologies: 1. Obstructive (pulm embolism, tension pneumothorax, tamponade, atrial myxoma, etc.) These were all ruled out 2. Distributive (sepsis, neurogenic, beriberi, etc.). The patient showed no signs of high output 3. Hypovolemic (dehydration, hemorrhage, third spacing) The IVC was plump 4. Cardiogenic -- the likely culprit Cardiogenic shock has 3 basic physiologic etiologies: 1. Poor pump function (diastolic (...) The 4 Physiologic Etiologies of Shock, and the 3 Etiologies of Cardiogenic Shock Dr. Smith's ECG Blog: The 4 Physiologic Etiologies of Shock, and the 3 Etiologies of Cardiogenic Shock Friday, November 30, 2018 A 60-something presented with hypotension, bradycardia, chest pain and back pain. She had a h/o aortic aneurysm, aortic insufficiency, peripheral vascular disease, and hypertension. She had a mechanical aortic valve. She was on anti-hypertensives including atenolol, and on coumadin

2019 Dr Smith's ECG Blog

6. Does the Addition of Vasopressin to Catecholamine Vasopressors Affect Outcomes in Patients With Distributive Shock?

for the European Society of Intensive Care Medicine, the Society of Critical Care Medicine, and the American Thoracic Society. Study Selection Studies included randomized trials comparing vasopressin (or analogues), with or without catecholamine vasopressors, with catecholamine vasopressors alone in adults with distributive shock. Distributive shock was defined as septic shock, post–cardiovascular surgery vasoplegia, neurogenic shock, or anaphylaxis. Any dose, duration, and other cointerventions were allowed (...) –4.12) 0 CI , Confidence interval; AF , atrial fibrillation; RRT , renal replacement therapy. The search identified 1,210 unique citations, with 23 randomized trials, totaling 3,088 patients, included in the review. Twenty-one studies enrolled patients with septic shock, one study enrolled post–cardiac surgery patients, and one study included both patient types. There were no studies of patients with anaphylaxis or neurogenic shock. Vasopressin was studied in 13 trials, and terlipressin (8 trials

2019 Annals of Emergency Medicine Systematic Review Snapshots

7. Heart Rate Beat to Beat Variability of Trauma Patient in Neurogenic Shock State: Time to Introduce New Symptoms (Full text)

Heart Rate Beat to Beat Variability of Trauma Patient in Neurogenic Shock State: Time to Introduce New Symptoms 28795056 2018 11 13 2322-2522 5 3 2017 Jul Bulletin of emergency and trauma Bull Emerg Trauma Heart Rate Beat to Beat Variability of Trauma Patient in Neurogenic Shock State: Time to Introduce New Symptoms. 141-142 Paydar Shahram S Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. Karami Mohammad Yasin MY Student (...) , Iran. Ghaffarpasand Fariborz F Student Research Committee, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran. eng Editorial Iran Bull Emerg Trauma 101614018 2322-2522 Heart Rate Neurogenic Shock State Patient Trauma 2017 8 11 6 0 2017 8 11 6 0 2017 8 11 6 1 ppublish 28795056 PMC5547199 J Spinal Cord Med. 2014 Mar;37(2):162-70 24559419 Spinal Cord. 2016 Oct;54(10 ):872-877 26882491 Neuropsychol Rehabil. 2016;26(1):103-25 25627984 Prog Brain Res. 2006;152:275-88 16198707

2017 Bulletin of emergency & trauma PubMed

8. Assessment of shock

with fluid third spacing or haemorrhage Burns Excessive renal loss Pulmonary embolism Septic shock Anaphylaxis Poisoning and adverse drug reaction Cardiomyopathy Cardiac valve disease Heat stroke and/or insensible fluid losses Tension pneumothorax Cardiac tamponade Neurogenic shock Adrenal crisis Thiamine deficiency Arteriovenous fistulae Contributors Authors Professor Fielding School of Public Health Professor The David Geffen School of Medicine University of California Los Angeles CA Disclosures SJS (...) Assessment of shock Assessment of shock - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of shock Last reviewed: February 2019 Last updated: June 2018 Summary Shock is best defined as a state of reduced end-organ oxygenation caused by an imbalance between tissue oxygen delivery and demand resulting in an oxygen debt. Oxygen delivery is determined by cardiac output, vascular integrity, and oxygen content

2018 BMJ Best Practice

9. CRACKCast E197 – Shock

Table 6.1 – Five categories of shock according to primary treatment of causes and problems. Treatment Modality Cause of Shock Infusion of volume – Hemorrhagic shock – trauma, GIB, etc. – Hypovolemia – GI losses, dehydration, third space sequestration from inflammation Volume infusion & Vasopressors – Septic Shock – Anaphylactic ShockNeurogenic Shock – Toxidromes – various overdoses Improve pump function (inotropic support, or reverse cause of pump dysfunction) – Myocardial ischemia (...) to the process. [5] What is neurogenic shock, and how does it differ from spinal shock? Neurogenic shock = interrupted sympathetic and parasympathetic input from spinal cord to heart and vasculature. Classically – vasodilation and bradycardia (but can have a wide variation in heart rate depending on other factors). Spinal shock = loss of sensation and motor function following spinal cord injury. reflexes are depressed or absent distal to site of injury. This may last for hours to weeks post-injury. The end

2019 CandiEM

10. Extracorporeal Shock Wave Therapy for Painful Chronic Neurogenic Heterotopic Ossification After Traumatic Brain Injury: A Case Report (Full text)

Extracorporeal Shock Wave Therapy for Painful Chronic Neurogenic Heterotopic Ossification After Traumatic Brain Injury: A Case Report Neurogenic heterotopic ossification (NHO) is a process of benign bone formation and growth in soft tissues surrounding major synovial joints and is associated with central nervous system (CNS) injuries. It is a common complication in major CNS injuries, such as traumatic brain injury, spinal cord injury, and stroke. Here, we report the case of a 72-year-old male (...) , who experienced a traumatic brain injury and painful chronic NHO around the left hip joint. Three applications of extracorporeal shock wave therapy (ESWT) were administered to the area of NHO, which resulted in pain relief and an improvement in the loss of motion in the left hip joint. Improvements were also noted in walking performance and activities of daily living, although the size of NHO remained unchanged. Therapeutic effects of ESWT lasted for 12 weeks.

2015 Annals of rehabilitation medicine PubMed

11. Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline

Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline 1 Purpose: The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of non-neurogenic overactive bladder (OAB). Methods: The primary source of evidence for the original version of this guideline was the systematic review and data extraction conducted as part of the Agency for Healthcare Research and Quality (AHRQ) Evidence Report/Technology Assessment Number 187 (...) /SUFU Guideline DIAGNOSIS AND TREATMENT OF OVERACTIVE BLADDER (Non-Neurogenic) IN ADULTS: AUA/SUFU GUIDELINE E. Ann Gormley, Deborah J. Lightner, Kathryn L. Burgio, Toby C. Chai, J. Quentin Clemens, Daniel J. Culkin, Anurag Kumar Das, Harris Emilio Foster, Jr., Harriette Miles Scarpero, Christopher D. Tessier, Sandip Prasan Vasavada The Panel would like to acknowledge Martha M. Faraday, Ph.D., for her methodological expertise and invaluable contributions as well as the Vanderbilt Evidence- based

2014 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction

12. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: AUA/SUFU Guideline

Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: AUA/SUFU Guideline Overactive Bladder (OAB) Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum (...) and Reimbursement Practice Managers' Network (PMN) Patient Safety and Quality of Care Accreditations and Reporting Patient Education Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: AUA/SUFU Guideline (2012) AUA/SUFU Guideline: Published 2012; Amended 2014 The clinical guideline on Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: AUA/SUFU Guideline discusses patient presentation, diagnosis, treatment, and follow-up of patients based on the currently

2014 American Urological Association

13. Neurogenic Shock Immediately following Posterior Lumbar Interbody Fusion: Report of Two Cases (Full text)

Neurogenic Shock Immediately following Posterior Lumbar Interbody Fusion: Report of Two Cases Study Design Case report. Objective To present two cases of neurogenic shock that occurred immediately following posterior lumbar interbody fusion (PLIF) and that appeared to have been caused by the vasovagal reflex after dural injury and incarceration of the cauda equina. Case Report We present two cases of neurogenic shock that occurred immediately following PLIF. One patient had bradycardia (...) was performed to explore the cause of paralysis. At reoperation, a cerebrospinal fluid collection and the incarceration of multiple cauda equina rootlets through a small dural tear were observed. The incarcerated cauda equina rootlets were reduced, and the dural defect was closed. In both cases, the reoperation was uneventful. From the intraoperative findings at reoperation, it was thought that the pathology was neurogenic shock via the vasovagal reflex. Conclusion Incarceration of multiple cauda equina

2014 Global spine journal PubMed

14. CRACKCast E006 – Shock in the ER

. closure of PDA) critical idiopathic subaortic stenosis (HOCM) air embolism Distributive Shock Distributive shock has 5 main subtypes: septic shock anaphylactic shock central neurogenic shock drug overdose adrenal crisis Septic Shock: Most commonly caused by a bacterial organism, although only 50% of the time an organism is found The LPS of gram negative, or other gram positive bacteria are most common causes Thought to be responsible for three major systemic effects: Relative hypovolemia increased (...) is often life threatening if not treated urgently (SEVERE form of an allergic reaction) Central Neurogenic Shock this is NOT the same as spinal shock (more to come in future episodes) usually a diagnosis of EXCLUSION caused by an injury to the cervical or thoracic vertebrae causing peripheral sympathetic denervation look for the classic TRIAD : hypotension, bradycardia, and warm extremities Drug Overdose Due to a sympatholytic or sedative drug e.g. clonidine, TCA, mixed narcotic/benzo Adrenal Crisis

2016 CandiEM

15. Network Reconstruction Reveals that Valproic Acid Activates Neurogenic Transcriptional Programs in Adult Brain Following Traumatic Injury (Full text)

Network Reconstruction Reveals that Valproic Acid Activates Neurogenic Transcriptional Programs in Adult Brain Following Traumatic Injury To determine the mechanism of action of valproic acid (VPA) in the adult central nervous system (CNS) following traumatic brain injury (TBI) and hemorrhagic shock (HS).Data were analyzed from different sources, including experiments in a porcine model, data from postmortem human brain, published studies, public and commercial databases.The transcriptional

2017 Pharmaceutical research PubMed

16. Milrinone therapy for enterovirus 71-induced pulmonary edema and/or neurogenic shock in children: a randomized controlled trial. (PubMed)

Milrinone therapy for enterovirus 71-induced pulmonary edema and/or neurogenic shock in children: a randomized controlled trial. Enterovirus 71-induced brainstem encephalitis with pulmonary edema and/or neurogenic shock (stage 3B) is associated with rapid mortality in children. In a small pilot study, we found that milrinone reduced early mortality compared with historical controls. This prospective, randomized control trial was designed to provide more definitive evidence of the ability (...) in the milrinone treatment group (p = 0.01). There was no apparent neurologic sequela in the survivors in either group, and no drug-related adverse events were documented.Milrinone significantly reduced the 1-week mortality of enterovirus 71-induced pulmonary edema and/or neurogenic shock without adverse effects. Further studies are needed to determine whether milrinone might be useful to prevent progression of earlier stages of brainstem encephalitis.

2013 Critical Care Medicine

17. Milrinone Therapy for Enterovirus 71-Induced Pulmonary Edema and/or Neurogenic Shock in Children: A Randomized Controlled Trial* (PubMed)

Milrinone Therapy for Enterovirus 71-Induced Pulmonary Edema and/or Neurogenic Shock in Children: A Randomized Controlled Trial* Enterovirus 71-induced brainstem encephalitis with pulmonary edema and/or neurogenic shock (stage 3B) is associated with rapid mortality in children. In a small pilot study, we found that milrinone reduced early mortality compared with historical controls. This prospective, randomized control trial was designed to provide more definitive evidence of the ability (...) in the milrinone treatment group (p = 0.01). There was no apparent neurologic sequela in the survivors in either group, and no drug-related adverse events were documented.Milrinone significantly reduced the 1-week mortality of enterovirus 71-induced pulmonary edema and/or neurogenic shock without adverse effects. Further studies are needed to determine whether milrinone might be useful to prevent progression of earlier stages of brainstem encephalitis.

2013 Critical care medicine

18. Ultrasonic measurement of rectal diameter and area in neurogenic bowel with spinal cord injury (Full text)

in this study. We divided the patients by the type of neurogenic bowel: UMNB, patients with supraconal lesions and recovery state of spinal shock or LMNB, patients with infraconal/caudal lesions or spinal shock state).Ultrasound was applied on the abdomen and measured the diameter and area of the rectum were measured twice each before and after defecation, respectively.We compared rectal diameter and area before/after defecation between the two groups, and significant differences were found in both rectal (...) Ultrasonic measurement of rectal diameter and area in neurogenic bowel with spinal cord injury The aim of this study was to determine the efficacy of measuring the diameter and area of the rectum using ultrasonography as an additional parameter for the evaluation of neurogenic bowel in patients with spinal cord injury (SCI).In total, 32 patients with SCI (16 patients with upper motor neuron neurogenic bowel (UMNB) and 16 patients with lower motor neuron neurogenic bowel (LMNB)) participated

2016 The journal of spinal cord medicine PubMed

19. Primary Sacral Hydatid Cyst Mimicking a Neurogenic Tumor in Chronic Low Back Pain: Case Report and Review of the Literature (Full text)

Primary Sacral Hydatid Cyst Mimicking a Neurogenic Tumor in Chronic Low Back Pain: Case Report and Review of the Literature Hydatid disease is caused by infection of Echinococcus granulosus. Bone hydatid cyst presentation without hepatic affectation is infrequent and occurs in 0,5-2% of cases. This rare condition makes clinicians not always aware of the disease, and as a result, misdiagnosis of spinal echinococcosis is common. We present a case of a 48-year-old female patient with primary (...) sacral hydatidosis. Chronic low back pain radiating to the left buttock was the only symptom. The magnetic resonance imaging (MRI) suggested a neurogenic tumor versus giant cell tumor. Biopsy and pathological study revealed a hydatid cyst. Anthelmintic and surgical treatment was performed. At 12 months after surgery, the patient is free of recurrence. In patients with chronic low back pain and a MR suggestive of neurogenic tumor, spinal hydatid cyst should be considered in the differential diagnosis

2016 Journal of neurosciences in rural practice PubMed

20. Loss of neurogenesis in Hydra leads to compensatory regulation of neurogenic and neurotransmission genes in epithelial cells (Full text)

Loss of neurogenesis in Hydra leads to compensatory regulation of neurogenic and neurotransmission genes in epithelial cells Hydra continuously differentiates a sophisticated nervous system made of mechanosensory cells (nematocytes) and sensory-motor and ganglionic neurons from interstitial stem cells. However, this dynamic adult neurogenesis is dispensable for morphogenesis. Indeed animals depleted of their interstitial stem cells and interstitial progenitors lose their active behaviours (...) but maintain their developmental fitness, and regenerate and bud when force-fed. To characterize the impact of the loss of neurogenesis in Hydra, we first performed transcriptomic profiling at five positions along the body axis. We found neurogenic genes predominantly expressed along the central body column, which contains stem cells and progenitors, and neurotransmission genes predominantly expressed at the extremities, where the nervous system is dense. Next, we performed transcriptomics on animals

2016 Philosophical Transactions of the Royal Society B: Biological Sciences PubMed

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