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https://www.readbyqxmd.com/read/28109052/the-use-of-methadone-to-facilitate-opioid-weaning-in-pediatric-critical-care-patients-a-systematic-review-of-the-literature-and-meta-analysis
#1
REVIEW
Leslie A Dervan, Beryl Yaghmai, Robert Scott Watson, Fredric M Wolf
BACKGROUND: Continuous opioid infusion therapy is commonly utilized in the pediatric intensive care setting to treat pain and facilitate tolerance of invasive therapies. Transitioning to methadone is one common strategy for weaning from continuous opioid infusions, but in practice this transition can be challenging, and many children still experience iatrogenic withdrawal. AIM: We reviewed the literature to evaluate the best available evidence to guide methadone therapy in this setting, and to summarize associated adverse events...
January 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28108967/specific-sites-of-metastases-in-invasive-lobular-carcinoma-a-retrospective-cohort-study-of-metastatic-breast-cancer
#2
Masayuki Inoue, Hiroshi Nakagomi, Haruka Nakada, Kazushige Furuya, Kou Ikegame, Hideki Watanabe, Masao Omata, Toshio Oyama
BACKGROUND: Invasive lobular carcinoma (ILC) is known to be the second most common histological type following invasive ductal carcinoma (IDC). Definitive clinical features of ILC are controversial. METHODS: We retrospectively analyzed a cohort of 330 patients with metastatic breast cancer, 303 of IDC, 19 of ILC, and 8 of others. We compared the patient age and tumor-node-metastasis factors, disease-free survival (DFS), estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) expression at the primary site between ILC and IDC...
January 20, 2017: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/28108936/a-group-mediated-physical-activity-intervention-in-older-knee-osteoarthritis-patients-effects-on-social-cognitive-outcomes
#3
Brian C Focht, Matthew J Garver, Alexander R Lucas, Steven T Devor, Charles F Emery, Kevin V Hackshaw, Ciaran M Fairman, Jessica Bowman, W Jack Rejeski
The objective of the present study was to compare a group-mediated cognitive behavioral (GMCB) physical activity intervention with traditional exercise therapy (TRAD) upon select social cognitive outcomes in sedentary knee osteoarthritis (knee OA) patients. A total of 80 patients (mean age = 63.5 years; 84% women) were recruited using clinic and community-based strategies to a 12-month, single-blind, two-arm, randomized controlled trial. Mobility-related self-efficacy, self-regulatory self-efficacy (SRSE), and satisfaction with physical function (SPF) were assessed at baseline, 3, and 12 months...
January 20, 2017: Journal of Behavioral Medicine
https://www.readbyqxmd.com/read/28108930/controlling-tumor-progression-with-cyclophosphamide-vincristine-and-dacarbazine-treatment-improves-survival-in-patients-with-metastatic-and-unresectable-malignant-pheochromocytomas-paragangliomas
#4
Shiko Asai, Takuyuki Katabami, Mika Tsuiki, Yasushi Tanaka, Mitsuhide Naruse
Evidence has not been established to support that combination chemotherapy with cyclophosphamide, vincristine, and dacarbazine (CVD) improves survival in patients with malignant pheochromocytoma and paraganglioma (M-PPGL). To investigate the efficacy of CVD for this disease, we retrospectively analyzed data of 23 patients with metastatic and unresectable M-PPGL (mean age, 41.7 ± 15.4 years) who received at least 2 cycles of this regimen. The follow-up period after initiation of CVD ranged from 0.3 to 13...
January 20, 2017: Hormones & Cancer
https://www.readbyqxmd.com/read/28108904/intravitreal-anti-vegf-treatment-for-subretinal-neovascularisation-secondary-to-type-2-idiopathic-juxtafoveolar-telangiectasia
#5
Teresa Barth, Florian Zeman, Horst Helbig, Maria-Andreea Gamulescu
PURPOSE: To assess the long-term outcome of patients with subretinal neovascular membrane (SRNVM) secondary to type 2 idiopathic juxtafoveolar telangiectasia (IJT) receiving intravitreal anti-VEGF (vascular endothelial growth factor) injections. METHODS: A total of 14 eyes of 12 patients treated with intravitreal anti-VEGF for SRNVM related to type 2 IJT were retrospectively assessed. RESULTS: Nine men and 3 women with a mean age of 66 years (SD 12, range 47-87 years) were diagnosed with IJT-related SRNVM...
January 21, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28108832/beat-by-beat-assessment-of-cardiac-afterload-using-descending-aortic-velocity-pressure-loop-during-general-anesthesia-a-pilot-study
#6
Fabrice Vallée, Arthur Le Gall, Jona Joachim, Olivier Passouant, Joaquim Matéo, Arnaud Mari, Sandrine Millasseau, Alexandre Mebazaa, Etienne Gayat
Continuous cardiac afterload evaluation could represent a useful tool during general anesthesia (GA) to titrate vasopressor effect. Using beat to beat descending aortic pressure(P)/flow velocity(U) loop obtained from esophageal Doppler and femoral pressure signals might allow to track afterload changes. Methods We defined three angles characterizing the PU loop (alpha, beta and Global After-Load Angle (GALA)). Augmentation index (AIx) and total arterial compliance (Ctot) were measured via radial tonometry. Peripheral Vascular Resistances (PVR) were also calculated...
January 20, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28108827/the-prognostic-impact-of-unplanned-excisions-in-a-cohort-of-728-soft-tissue-sarcoma-patients-a-multicentre-study
#7
Maria Anna Smolle, Per-Ulf Tunn, Elisabeth Goldenitsch, Florian Posch, Joanna Szkandera, Marko Bergovec, Bernadette Liegl-Atzwanger, Andreas Leithner
BACKGROUND: Unplanned excisions (UE) of soft tissue sarcomas (STS) carry a high risk for local recurrence (LR) due to marginal/intralesional resections. However, there are reports about improved prognosis for UE patients who have re-resection compared with patients who undergo planned surgery. The present multicentre study was designed to define characteristics of UE patients and to investigate the impact of UE on subsequent therapy and patient outcomes. METHODS: A total of 728 STS patients (376 males, 352 females; mean age: 58 years) who underwent definite surgery at one of three tumour centres were retrospectively included...
January 20, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28108821/the-relationship-between-patient-activation-confidence-to-self-manage-side-effects-and-adherence-to-oral-oncolytics-a-pilot-study-with-michigan-oncology-practices
#8
Teresa M Salgado, Emily Mackler, Jane A Severson, Jamie Lindsay, Peter Batra, Laura Petersen, Karen B Farris
PURPOSE: The Michigan Oncology Quality Consortium (MOQC) is a continuous quality improvement collaborative seeking to improve oncology care in Michigan, including for patients taking oral chemotherapy. The aim of this study was to assess the relationship between patient activation, confidence to self-manage side effects, and adherence to oral oncolytics to inform future oncology care. METHODS: A multicenter cross-sectional observational study was conducted using an online survey to examine patient activation (patient activation measure, PAM), health literacy, symptom burden (Edmonton Symptom Assessment System, ESAS), confidence to self-manage side effects (fatigue, nausea, and diarrhea), and adherence to oral oncolytics...
January 20, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28108788/outpatient-application-of-formalin-for-chronic-rectal-bleeding-after-prostate-irradiation-a-quasi-experimental-study
#9
Gustavo Arruda Viani, Aline Sakamoto
PURPOSE: The aim of this quasi-experimental study is to evaluate a novel technique for an outpatient application of formalin for chronic rectal bleeding after prostate irradiation. METHODS: This is a quasi- experimental clinical trial developed between January 2010 and July 2015, including 35 patients with chronic radiation rectitis (CRP) due to a previous prostate radiation course. The study's eligibility was (1) completed external beam radiation therapy for prostate carcinoma >6 months previously, (2) rectal bleeding, defined as a frequency of >1× per week and/or needing of blood transfusions, and (3) diagnosis of chronic proctitis at colonoscopy...
January 20, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28108642/the-potential-role-for-smartphones-among-older-adults-with-chronic-noncancer-pain-a-qualitative-study
#10
Joshua E Richardson, Jennifer I Lee, Anita Nirenberg, M Carrington Reid
: OBJECTIVE : To determine the role that smartphones may play in supporting older adults with chronic noncancer pain (CNCP) in order to improve pain management in this expanding population. DESIGN:  Qualitative study. SETTING:  One academically affiliated primary care practice serving older adults with CNCP in New York City. SUBJECTS : Thirteen older adults (age 65-85 years) with CNCP on chronic opioid therapy, that is, continuous use of opioids for at least six months...
January 20, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28108574/influence-of-warfarin-therapy-on-the-occurrence-of-postoperative-endoleaks-and-aneurysm-sac-enlargement-after-endovascular-abdominal-aortic-aneurysm-repair
#11
Yoshimasa Seike, Hiroshi Tanaka, Tetsuya Fukuda, Tatsuya Itonaga, Yoshiaki Morita, Tatsuya Oda, Yosuke Inoue, Hiroaki Sasaki, Kenji Minatoya, Junjiro Kobayashi
OBJECTIVES: This study aims to determine whether warfarin therapy influences the occurrence of endoleaks or aneurysm sac enlargement after endovascular aortic repair (EVAR). METHODS: A total of 367 patients who underwent EVAR for abdominal aortic aneurysm between 2007 and 2013 were recruited for this study. Satisfactory follow-up data including completed computed tomography scan follow-up for more than 2 years were available for 209 patients, and the mean follow-up time was 37 ± 12 months...
January 19, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28108545/bombesin-antagonist-based-radiotherapy-of-prostate-cancer-combined-with-wst-11-vascular-targeted-photodynamic-therapy
#12
Kwanghee Kim, Hanwen Zhang, Stephen LaRosa, Sylvia Jebiwott, Pooja Desai, Simon Y Kimm, Avigdor J Scherz, Joseph A O'Donoghue, Wolfgang A Weber, Jonathan Coleman
PURPOSE: DOTA-AR, a bombesin-antagonist peptide, has potential clinical application for targeted imaging and therapy in Gastrin Releasing Peptide receptor (GRPr) positive malignancies when conjugated with a radioisotope such as 90Y. This therapeutic potential is limited by the fast washout of the conjugates from the target tumors. WST-11 (Weizmann STeba-11 drug; a negatively charged water-soluble palladium-bacteriochlorophyll derivative, Tookad® Soluble) Vascular targeted photodynamic therapy (VTP) is a local ablation approach recently approved for use in early stage prostate cancer...
January 20, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28108319/how-the-changes-in-the-system-affect-trauma-care-provision-the-assessment-of-and-implications-for-lithuanian-trauma-service-performance-in-2007-2012
#13
Žilvinas Dambrauskas, Vytautas Aukštakalnis, Aurika Karbonskienė, Dmitrijus Kačiurinas, Jolanta Vokietienė, Robertas Lapka, Algimantas Pamerneckas, Narūnas Porvaneckas, Kęstutis Stašaitis, Nedas Jasinskas, Paulius Dobožinskas, Dinas Vaitkaitis, Raimundas Lunevičius
OBJECTIVE: The aim of this study was to identify and assess the effects of changes in the Lithuanian trauma service from 2007 to 2012. We postulate that the implications derived from this study will be of importance to trauma policy planners and makers in Lithuania and throughout other countries of Eastern and Central Europe. MATERIALS AND METHODS: Out of 10,390 trauma admissions to four trauma centers in 2007, 294 patients (2.8%) were randomly selected for the first arm of a representative study sample...
January 6, 2017: Medicina
https://www.readbyqxmd.com/read/28108027/a-postoperative-scoring-system-for-distant-recurrence-in-node-positive-cervical-cancer-patients-after-radical-hysterectomy-and-pelvic-lymph-node-dissection-with-para-aortic-lymph-node-sampling-or-dissection
#14
Young-Jae Lee, Dae-Yeon Kim, Shin-Wha Lee, Jeong-Yeol Park, Dae-Shik Suh, Jong-Hyeok Kim, Yong-Man Kim, Young-Tak Kim, Joo-Hyun Nam
OBJECTIVE: To identify risk factors for distant recurrence in node-positive cervical cancer patients who underwent radical hysterectomy and pelvic lymph node dissection (PLND) with para-aortic lymph node sampling (PALNS) or para-aortic lymph node dissection (PALND). METHODS: A total of 299 patients in whom lymph node metastasis was confirmed after radical surgery at Asan Medical Center for stage IA2 to IIB cervical cancer from February 2001 to December 2012 were identified...
January 17, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28107817/can-calculation-of-energy-expenditure-based-on-co2-measurements-replace-indirect-calorimetry
#15
Taku Oshima, Séverine Graf, Claudia-Paula Heidegger, Laurence Genton, Jérôme Pugin, Claude Pichard
BACKGROUND: Methods to calculate energy expenditure (EE) based on CO2 measurements (EEVCO2) have been proposed as a surrogate to indirect calorimetry. This study aimed at evaluating whether EEVCO2 could be considered as an alternative to EE measured by indirect calorimetry. METHODS: Indirect calorimetry measurements conducted for clinical purposes on 278 mechanically ventilated ICU patients were retrospectively analyzed. EEVCO2 was calculated by a converted Weir's equation using CO2 consumption (VCO2) measured by indirect calorimetry and assumed respiratory quotients (RQ): 0...
January 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28107569/use-of-higher-maximum-doses-and-infusion-rates-compared-with-those-used-in-standard-unfractionated-heparin-therapy-is-associated-with-adequate-anticoagulation-without-increased-bleeding-in-both-obese-and-nonobese-patients-with-cardiovascular-indications
#16
Catherine K Floroff, Nicole M Palm, Daniel H Steinberg, Eric R Powers, Barbara S Wiggins
STUDY OBJECTIVE: To evaluate the time to achieve therapeutic activated partial thromboplastin time (aPTT) values and occurrence of bleeding based on standard unfractionated heparin (UFH) weight-based dosing recommendations compared with an aggressive weight-based UFH dosing strategy using higher maximum doses and infusion rates in both obese and nonobese patients who presented with non-ST-Segment Elevation Myocardial Infarction or unstable angina (NSTEMI/UA) or atrial fibrillation. DESIGN: Retrospective cohort study...
January 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28107564/tattoo-removal-by-q-switched-yag-laser-client-satisfaction
#17
K Hutton Carlsen, J Esmann, J Serup
BACKGROUND: Tattoo removal by Q-switched lasers is golden standard; however, clients' satisfaction with treatment is little known. OBJECTIVE: To determine clients' satisfaction with tattoo removal. METHODS: 154 tattoo removal clients who had attended the private clinic "Centre for Laser Surgery", Hellerup, Denmark from 2001-2013 completed a questionnaire concerning outcome expectations, level of pain experiences and satisfaction with tattoo removal...
January 20, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28107437/hyperventilation-with-maintenance-of-isocapnia-an-old-new-method-in-carbon-monoxide-intoxication
#18
Jacek Sein Anand, Daria Schetz, Wojciech Waldman, Marek Wiśniewski
INTRODUCTION: Exposure to carbon monoxide (CO) is among the most common causes of acute and chronic poisonings worldwide. The crucial point of treatment of such acute poisonings is to eliminate CO from the body as fast as possible. There are currently two approaches to the management of the CO intoxication: hyperbaric oxygen therapy (HOT) and normobaric oxygen therapy (NOT). HOT is highly effective and capable of achieving the CO elimination half-time (T½) as low as 15 minutes. Unfortunately this method is expensive and not always readily available...
2017: PloS One
https://www.readbyqxmd.com/read/28107357/vasopressor-use-for-severe-hypotension-a-multicentre-prospective-observational-study
#19
Francois Lamontagne, Deborah J Cook, Maureen O Meade, Andrew Seely, Andrew G Day, Emmanuel Charbonney, Karim Serri, Yoanna Skrobik, Paul Hebert, Charles St-Arnaud, Hector Quiroz-Martinez, Michaël Mayette, Daren K Heyland
BACKGROUND: The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/28107284/postsurgical-perforation-of-the-esophagus-can-be-treated-using-a-fully-covered-stent-in-children
#20
Chantal Chauvet, Arnaud Bonnard, Alexis Mosca, Marc Bellaïche, Pascale Philippe-Chomette, Jérôme Viala
OBJECTIVES: Surgery and conservative treatment of esophageal or gastric perforations are both often associated with poor results and carry a high morbidity and mortality rate. The aim of the present study was to evaluate the effectiveness and safety of using fully covered self-expending metallic stents (SEMS) in children with upper digestive leaks. METHODS: This retrospective study reviewed all children with esophageal or gastric perforation who were treated with placement of an SEMS from January 2011 to January 2015...
February 2017: Journal of Pediatric Gastroenterology and Nutrition
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