The Experts below are selected from a list of 13992 Experts worldwide ranked by ideXlab platform

Anahi Perlas - One of the best experts on this subject based on the ideXlab platform.

  • ultrasound to assess Gastric Content and fluid volume new kid on the block for aspiration risk assessment in critically ill patients
    Netherlands Journal of Critical Care, 2019
    Co-Authors: S A Soeloekmooi, Anahi Perlas, N S Tjahjadi, P Van De Putte, P R Tuinman
    Abstract:

    Introduction: Aspiration is associated with significant morbidity and mortality. Fasting guidelines do not apply to critically ill and emergency patients. Gastric point-of-care ultrasound (PoCUS) is a promising approach to assess aspiration risk. This review discusses its feasibility, clinical implications, limitations and future perspectives. Methods: This is a narrative review. A search in PubMed and EMBASE to find relevant articles was performed. Results: Gastric PoCUS provides both qualitative and quantitative information about Gastric Content and fluid volume. Based on qualitative findings, the antrum is empty or contains fluids or solids. Based on quantitative findings, a fluid volume of up to 500 ml is accurately measured. Gastric PoCUS is feasible in over 90% of subjects. An algorithm for clinical application is presented. Conclusion: Gastric PoCUS is a promising tool to assess Gastric Content and fluid volume in critical care and emergency patients. Further research on whether the information obtained improves patient outcome is needed.

  • interrater reliability of qualitative ultrasound assessment of Gastric Content in the third trimester of pregnancy
    BJA: British Journal of Anaesthesia, 2014
    Co-Authors: Cristian Arzola, Javier Cubillos, Anahi Perlas, Kristi Downey, Jose C A Carvalho
    Abstract:

    Background Pulmonary aspiration of Gastric Contents in pregnant women undergoing general anaesthesia is one of the most feared complications in obstetric anaesthesia. Bedside Gastric ultrasonography is a feasible imaging tool to assess the Gastric Content. The purpose of this study was to investigate the reliability of qualitative bedside assessment of the Gastric Content performed by anaesthesiologists on third trimester pregnant women. Methods Pregnant women (≥32 weeks gestational age) were randomized to undergo ultrasound (US) assessments of their stomach in a fasting state (>8 h), or after ingestion of clear fluids only, or solid food. Three anaesthesiologists trained in Gastric ultrasonography performed the assessments using a low-frequency curved-array US transducer (5–2 MHz). Primary outcome of the study was the consistency of raters in diagnosing the correct status of the Gastric Content, which was used to determine the interrater reliability among the three anaesthesiologists. Secondary outcomes were overall proportion of correct and incorrect diagnoses and the specific proportions of correct diagnosis across the three Gastric Content groups. Results We analysed 32 pregnant women. The interrater reliability displayed a kappa statistic of 0.74 (bias corrected 95% CI: 0.68–0.84). The overall proportion of correct diagnosis was 87.5% (84 of 96). The odds of correct diagnosis for ‘solid Contents' were 16.7 times the odds for ‘empty', and 14.3 times for ‘clear fluid'. Conclusions Our results show the consistency of the qualitative US assessment of Gastric Contents of pregnant women in the third trimester by anaesthesiologists. A kappa of 0.74 suggests substantial agreement in terms of interrater reliability for this diagnostic measurement. Clinical trial registration ClinicalTrials.gov identifier: NCT01564030.

  • anesthesiologists learning curves for bedside qualitative ultrasound assessment of Gastric Content a cohort study
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2013
    Co-Authors: Cristian Arzola, Javier Cubillos, Jose C A Carvalho, Anahi Perlas
    Abstract:

    Purpose Focused assessment of the Gastric antrum by ultrasound is a feasible tool to evaluate the quality of the stomach Content. We aimed to determine the amount of training an anesthesiologist would need to achieve competence in the bedside ultrasound technique for qualitative assessment of Gastric Content.

  • bedside ultrasound assessment of Gastric Content an observational study
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2012
    Co-Authors: Javier Cubillos, Cyrus Tse, Vincent W S Chan, Anahi Perlas
    Abstract:

    Purpose There is a growing interest in the use of bedside ultrasonography to assess Gastric Content and volume. It has been suggested that the Gastric antrum in particular can be assessed reliably by sonography. The aim of this observational study was to provide a qualitative description of the sonographic characteristics of the Gastric antrum when the stomach is empty and following the ingestion of clear fluid, milk, and solid Content.

  • Gastric sonography in the fasted surgical patient a prospective descriptive study
    Anesthesia & Analgesia, 2011
    Co-Authors: Anahi Perlas, Liisa Davis, Masood Khan, Nicholas Mitsakakis, Vincent W S Chan
    Abstract:

    BACKGROUND:Aspiration pneumonia remains a serious anesthetic-related complication. A reliable diagnostic tool to assess Gastric volume is currently lacking. We recently demonstrated that Gastric sonography can provide reliable qualitative and quantitative information about Gastric Content and volume

Mohd Zaki Salleh - One of the best experts on this subject based on the ideXlab platform.

  • mechanism s of action underlying the gastroprotective effect of ethyl acetate fraction obtained from the crude methanolic leaves extract of muntingia calabura
    BMC Complementary and Alternative Medicine, 2016
    Co-Authors: Zainul Amiruddin Zakaria, Tavamani Balan, Ahmad Khusairi Azemi, Maizatul Hasyima Omar, Norhafizah Mohtarrudin, Zuraini Ahmad, Muhammad Nazrul Hakim Abdullah, Mohd Nasir Mohd Desa, Mohd Zaki Salleh
    Abstract:

    Muntingia calabura L. (family Muntingiaceae), commonly known as Jamaican cherry or kerukup siam in Malaysia, is used traditionally to treat various ailments. The aim of this study is to elucidate the possible underlying gastroprotective mechanisms of ethyl acetate fraction (EAF) of Muntingia calabura methanolic leaves extract (MEMC). MEMC and its fractions were subjected to HPLC analysis to identify and quantify the presence of its phyto-constituents. The mechanism of gastroptotection of EAF was further investigated using pylorus ligation-induced Gastric lesion rat model (100, 250, and 500 mg/kg). Macroscopic analysis of the stomach, evaluation of Gastric Content parameters such as volume, pH, free and total acidity, protein estimation, and quantification of mucus were carried out. The participation of nitric oxide (NO) and sulfhydryl (SH) compounds was evaluated and the superoxide dismutase (SOD), gluthathione (GSH), catalase (CAT), malondialdehyde (MDA), prostaglandin E2 (PGE2) and NO level in the ethanol induced stomach tissue homogenate was determined. HPLC analysis confirmed the presence of quercetin and gallic acid in EAF. In pylorus-ligation model, EAF significantly (p <0.001) prevent Gastric lesion formation. Volume of Gastric Content and total protein Content reduced significantly (p < 0.01 and p < 0.05, respectively), while free and total acidity reduced in the doses of 250 and 500 mg/kg (p <0.001 and p <0.05, respectively). EAF also augmented the mucus Content significantly (p < 0.001). Pre-treatment with N-nitro-L-arginine methyl ester (L-NAME) or N-ethylmaleimide (NEM) reversed the gastroprotective activity of EAF. EAF treatment markedly ameliorated the SOD, GSH and CAT activity and PGE2 and NO level while attenuating MDA level, relative to the vehicle group. In conclusion, the underlying gastroprotective mechanisms of EAF could be associated with the antisecretory, participation of mucus, antiperoxidative, improvement of antioxidant status, modulation of NO and SH compounds, stimulation of PGE2 as well as presence of quercetin and gallic acid.

Zainul Amiruddin Zakaria - One of the best experts on this subject based on the ideXlab platform.

  • mechanism s of action underlying the gastroprotective effect of ethyl acetate fraction obtained from the crude methanolic leaves extract of muntingia calabura
    BMC Complementary and Alternative Medicine, 2016
    Co-Authors: Zainul Amiruddin Zakaria, Tavamani Balan, Ahmad Khusairi Azemi, Maizatul Hasyima Omar, Norhafizah Mohtarrudin, Zuraini Ahmad, Muhammad Nazrul Hakim Abdullah, Mohd Nasir Mohd Desa, Mohd Zaki Salleh
    Abstract:

    Muntingia calabura L. (family Muntingiaceae), commonly known as Jamaican cherry or kerukup siam in Malaysia, is used traditionally to treat various ailments. The aim of this study is to elucidate the possible underlying gastroprotective mechanisms of ethyl acetate fraction (EAF) of Muntingia calabura methanolic leaves extract (MEMC). MEMC and its fractions were subjected to HPLC analysis to identify and quantify the presence of its phyto-constituents. The mechanism of gastroptotection of EAF was further investigated using pylorus ligation-induced Gastric lesion rat model (100, 250, and 500 mg/kg). Macroscopic analysis of the stomach, evaluation of Gastric Content parameters such as volume, pH, free and total acidity, protein estimation, and quantification of mucus were carried out. The participation of nitric oxide (NO) and sulfhydryl (SH) compounds was evaluated and the superoxide dismutase (SOD), gluthathione (GSH), catalase (CAT), malondialdehyde (MDA), prostaglandin E2 (PGE2) and NO level in the ethanol induced stomach tissue homogenate was determined. HPLC analysis confirmed the presence of quercetin and gallic acid in EAF. In pylorus-ligation model, EAF significantly (p <0.001) prevent Gastric lesion formation. Volume of Gastric Content and total protein Content reduced significantly (p < 0.01 and p < 0.05, respectively), while free and total acidity reduced in the doses of 250 and 500 mg/kg (p <0.001 and p <0.05, respectively). EAF also augmented the mucus Content significantly (p < 0.001). Pre-treatment with N-nitro-L-arginine methyl ester (L-NAME) or N-ethylmaleimide (NEM) reversed the gastroprotective activity of EAF. EAF treatment markedly ameliorated the SOD, GSH and CAT activity and PGE2 and NO level while attenuating MDA level, relative to the vehicle group. In conclusion, the underlying gastroprotective mechanisms of EAF could be associated with the antisecretory, participation of mucus, antiperoxidative, improvement of antioxidant status, modulation of NO and SH compounds, stimulation of PGE2 as well as presence of quercetin and gallic acid.

Jemima Schmidt - One of the best experts on this subject based on the ideXlab platform.

  • sodium fluoroacetate toxicity a case report of malicious poisoning in dogs across a phoenix arizona neighborhood
    Forensic Science Medicine and Pathology, 2017
    Co-Authors: Alexandra Brower, Jason Struthers, Jemima Schmidt
    Abstract:

    In May 2016, thirteen dogs housed in backyards within a single neighborhood were reported to have developed convulsions and died within a 24 h period. An investigation of the scene by law enforcement resulted in submission of eight dogs for postmortem examination. It was suspected that a rapid acting toxin was the cause of death. A gas chromatography-mass spectrophotometry (GC-MS) protocol combined with thin-layer chromatography that allows screening for common convulsants failed to identify a toxin in either pooled Gastric Content or liver samples from select cases. After consultation with a veterinary toxicologist, sodium fluoroacetate poisoning was investigated. Sodium fluoroacetate, also known as 1080, is a pesticide that was available in the United States from the 1940’s to the 1970’s, but since 1972 has been banned or under EPA restricted use. When Gastric Content was re-tested using a GC-MS protocol with selective fluoroacetate ion monitoring and carbon 14 radiolabeling to facilitate quantification, 379 ppb sodium fluoroacetate was detected in a pooled Gastric Content sample. In spite of its banned status, sodium fluoroacetate remains a rarely reported cause of malicious poisoning in domestic dogs in the United Sates. This compound is highly toxic and is capable of causing death in dogs, humans, other mammals, and insects in ingested quantities as small as a few droplets. Even when geographic or historical proximity to a source is not evident, this intoxication should be considered in dogs exhibiting compatible clinical signs.

Vincent W S Chan - One of the best experts on this subject based on the ideXlab platform.

  • bedside ultrasound assessment of Gastric Content an observational study
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2012
    Co-Authors: Javier Cubillos, Cyrus Tse, Vincent W S Chan, Anahi Perlas
    Abstract:

    Purpose There is a growing interest in the use of bedside ultrasonography to assess Gastric Content and volume. It has been suggested that the Gastric antrum in particular can be assessed reliably by sonography. The aim of this observational study was to provide a qualitative description of the sonographic characteristics of the Gastric antrum when the stomach is empty and following the ingestion of clear fluid, milk, and solid Content.

  • Gastric sonography in the fasted surgical patient a prospective descriptive study
    Anesthesia & Analgesia, 2011
    Co-Authors: Anahi Perlas, Liisa Davis, Masood Khan, Nicholas Mitsakakis, Vincent W S Chan
    Abstract:

    BACKGROUND:Aspiration pneumonia remains a serious anesthetic-related complication. A reliable diagnostic tool to assess Gastric volume is currently lacking. We recently demonstrated that Gastric sonography can provide reliable qualitative and quantitative information about Gastric Content and volume