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https://www.readbyqxmd.com/read/28699134/intraoperative-tumor-detection-using-a-ratiometric-activatable-fluorescent-peptide-a-first-in-human-phase-1-study
#1
Jonathan T Unkart, Steven L Chen, Irene L Wapnir, Jesús E González, Alec Harootunian, Anne M Wallace
BACKGROUND: Positive surgical margins remain a significant challenge in breast cancer surgery. This report describes the use of a novel, first-in-human ratiometric activatable cell-penetrating peptide in breast cancer surgery. METHODS: A two-part, multi-institutional phase 1 trial of AVB-620 with a 3+3 dose escalation and dose-expansion cohorts was conducted. The patients received an infusion of AVB-620 2-20 h before planned lumpectomy/mastectomy and sentinel node biopsy/axillary dissection...
July 11, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28695649/single-center-experience-of-antifungal-prophylaxis-for-coccidioidomycosis-in-heart-transplant-recipients-within-an-endemic-area
#2
Graham M Lohrmann, Darko Vucicevic, Romy Lawrence, D Eric Steidley, Robert L Scott, Shimon Kusne, Janis E Blair
In endemic regions, coccidioidomycosis causes substantial morbidity and mortality for patients receiving solid organ transplants. We aimed to demonstrate the effect of antifungal coccidioidal prophylaxis in heart transplant (HT) recipients. We retrospectively reviewed the electronic health records of all patients who received HTs between October 19, 2005, and December 13, 2014. We collected information regarding antifungal regimens and determined whether patients subsequently developed infections. Our 174-person cohort all received antifungal prophylaxis for at least 6 months (mean follow-up, 53...
July 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28679836/effects-of-the-i-pass-nursing-handoff-bundle-on-communication-quality-and-workflow
#3
Amy J Starmer, Kumiko O Schnock, Aimee Lyons, Rebecca S Hehn, Dionne A Graham, Carol Keohane, Christopher P Landrigan
BACKGROUND AND OBJECTIVE: Handoff communication errors are a leading source of sentinel events. We sought to determine the impact of a handoff improvement programme for nurses. METHODS: We conducted a prospective pre-post intervention study on a paediatric intensive care unit in 2011-2012. The I-PASS Nursing Handoff Bundle intervention consisted of educational training, verbal handoff I-PASS mnemonic implementation, and visual materials to provide reinforcement and sustainability...
July 5, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28679809/challenges-of-measuring-quality-of-community-based-programs-for-seriously-ill-individuals-and-their-families
#4
Joan M Teno, Rebecca Anhang Price, Lena K Makaroun
For many individuals and their families, acknowledging and confronting a serious illness such as cancer or advanced heart failure is a sentinel life event. From a health policy perspective, many individuals confronting such illnesses are high-need, high-cost patients who are increasingly cared for by community-based programs that may have competing goals: improving quality and reducing costs. Providing care to high-need, high-cost patients tests a health care system's ability to coordinate care and adapt to highly variable disease trajectories that could result in improved health for some, sudden and unexpected death for others, and a prolonged period of functional impairment for the majority...
July 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28671180/-evaluation-of-the-notification-of-dysphonia-on-the-voice-profesionals-as-a-sentinel-event-in-navarra-period-2013-2015
#5
Sara Arrizabalaga Baigorri, Vega García López
OBJECTIVE: Among the lesions produced by the professional use of the voice since 2007, the Vocal Nodules (VN) are recognized in Spain as an Occupational Disease. With the aim of promoting its notification in Navarre, the Sentinel Program was incorporated in 2013 and, with this study, we seek to verify its efficacy. METHODS: The study population were voice professionals reported for dysphonia as sentinel events during the years 2013 to 2015 in Navarre. Its effectiveness was validated by the cumulative incidence of 100,000 workers for each of the years and Positive Predictive Value as an indicator of suspicion...
July 7, 2017: Revista Española de Salud Pública
https://www.readbyqxmd.com/read/28670270/using-meg-to-understand-the-progression-of-light-sleep-and-the-emergence-and-functional-roles-of-spindles-and-k-complexes
#6
Andreas A Ioannides, Lichan Liu, Vahe Poghosyan, George K Kostopoulos
We used tomographic analysis of MEG signals to characterize regional spectral changes in the brain at sleep onset and during light sleep. We identified two key processes that may causally link to loss of consciousness during the quiet or "core" periods of NREM1. First, active inhibition in the frontal lobe leads to delta and theta spectral power increases. Second, activation suppression leads to sharp drop of spectral power in alpha and higher frequencies in posterior parietal cortex. During NREM2 core periods, the changes identified in NREM1 become more widespread, but focal increases also emerge in alpha and low sigma band power in frontal midline cortical structures, suggesting reemergence of some monitoring of internal and external environment...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28659474/phylogeography-of-coxsackievirus-a16-reveals-global-transmission-pathways-and-recent-emergence-and-spread-of-a-recombinant-genogroup
#7
Chervin Hassel, Audrey Mirand, Agnes Farkas, Sabine Diedrich, Hartwig P Huemer, Hélène Peigue-Lafeuille, Christine Archimbaud, Cécile Henquell, Jean-Luc Bailly
Coxsackievirus A16 (CV-A16; Picornaviridae) is an enterovirus (EV) type associated with hand-foot-and-mouth disease (HFMD) in children. To investigate the spatial spread of CV-A16, we used viral sequence data sampled during a prospective sentinel surveillance of HFMD in France (2010--2014) and phylogenetic reconstruction. A dataset of 168 VP1 sequences was assembled with 416 publicly available sequences of various geographic origins. The CV-A16 sequences reported were assigned to two clades, genogroup B and a previously uncharacterized clade D...
June 28, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28657914/enhancing-communication-to-improve-patient-safety-and-to-increase-patient-satisfaction
#8
Audrey M Burgener
With the continuous rise of sentinel and adverse events due to ineffective communication, it is time for health care organizations to start implementing a focus on enhancing effective communication in which will, in turn, improve patient safety and experience, boosting the bottom line. This article identifies and discusses different communication protocols that can be used to enhance the consistency of more efficient and effective communication within a health care organization to overall improve patient care and patient satisfaction...
June 28, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28650355/axillary-dissection-and-nodal-irradiation-can-be-avoided-for-most-node-positive-z0011-eligible-breast-cancers-a-prospective-validation-study-of-793-patients
#9
Monica Morrow, Kimberly J Van Zee, Sujata Patil, Oriana Petruolo, Anita Mamtani, Andrea V Barrio, Deborah Capko, Mahmoud El-Tamer, Mary L Gemignani, Alexandra S Heerdt, Laurie Kirstein, Melissa Pilewskie, George Plitas, Virgilio S Sacchini, Lisa M Sclafani, Alice Ho, Hiram S Cody
OBJECTIVE: To determine rates of axillary dissection (ALND) and nodal recurrence in patients eligible for ACOSOG Z0011. BACKGROUND: Z0011 demonstrated that patients with cT1-2N0 breast cancers and 1 to 2 involved sentinel lymph nodes (SLNs) having breast-conserving therapy had no difference in locoregional recurrence or survival after SLN biopsy alone or ALND. The generalizability of the results and importance of nodal radiotherapy (RT) is unclear. METHODS: Patients eligible for Z0011 had SLN biopsy alone...
July 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28630102/the-phenotype-and-function-of-preterm-infant-monocytes-implications-for-susceptibility-to-infection
#10
REVIEW
Emma de Jong, Tobias Strunk, David Burgner, Pascal M Lavoie, Andrew Currie
The extreme vulnerability of preterm infants to invasive microbial infections has been attributed to "immature" innate immune defenses. Monocytes are important innate immune sentinel cells critical in the defense against infection in blood. They achieve this via diverse mechanisms that include pathogen recognition receptor- and inflammasome-mediated detection of microbes, migration into infected tissues, and differentiation into Mϕs and dendritic cells, initiation of the inflammatory cascade by free radicals and cytokine/chemokine production, pathogen clearance by phagocytosis and intracellular killing, and the removal of apoptotic cells...
June 19, 2017: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/28619165/the-use-of-animals-as-a-surveillance-tool-for-monitoring-environmental-health-hazards-human-health-hazards-and-bioterrorism
#11
REVIEW
Jacqueline Pei Shan Neo, Boon Huan Tan
This review discusses the utilization of wild or domestic animals as surveillance tools for monitoring naturally occurring environmental and human health hazards. Besides providing early warning to natural hazards, animals can also provide early warning to societal hazards like bioterrorism. Animals are ideal surveillance tools to humans because they share the same environment as humans and spend more time outdoors than humans, increasing their exposure risk. Furthermore, the biologically compressed lifespans of some animals may allow them to develop clinical signs more rapidly after exposure to specific pathogens...
May 2017: Veterinary Microbiology
https://www.readbyqxmd.com/read/28608612/factors-impacting-the-accuracy-of-intra-operative-evaluation-of-sentinel-lymph-nodes-in-breast-cancer
#12
Catherine L Akay, Constance Albarracin, Tiffany Torstenson, Roland Bassett, Elizabeth A Mittendorf, Min Yi, Henry M Kuerer, Gildy V Babiera, Isabelle Bedrosian, Kelly K Hunt, Rosa F Hwang
Sentinel lymph node dissection (SLND) is a standard axillary staging technique in breast cancer and intraoperative sentinel lymph node (SLN) assessment is important for decision-making regarding additional treatment and reconstruction. This study was undertaken to investigate clinicopathologic factors impacting the accuracy of intraoperative SLN evaluation. Records of patients with clinically node-negative, invasive breast cancer who underwent SLND with frozen section intraoperative pathologic evaluation from 2004 to 2007 were reviewed...
June 13, 2017: Breast Journal
https://www.readbyqxmd.com/read/28590337/spontaneous-pneumothorax-in-diffuse-cystic-lung-diseases
#13
Joseph Cooley, Yun Chor Gary Lee, Nishant Gupta
PURPOSE OF REVIEW: Diffuse cystic lung diseases (DCLDs) are a heterogeneous group of disorders with varying pathophysiologic mechanisms that are characterized by the presence of air-filled lung cysts. These cysts are prone to rupture, leading to the development of recurrent spontaneous pneumothoraces. In this article, we review the epidemiology, clinical features, and management DCLD-associated spontaneous pneumothorax, with a focus on lymphangioleiomyomatosis, Birt-Hogg-Dubé syndrome, and pulmonary Langerhans cell histiocytosis...
July 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28583789/prognostic-factors-in-merkel-cell-carcinoma-patients-undergoing-sentinel-node-biopsy
#14
I Mattavelli, R Patuzzo, V Torri, G Gallino, A Maurichi, M Lamera, B Valeri, E Bolzonaro, C Barbieri, E Tolomio, D Moglia, A M Nespoli, C Galeone, R Saw, M Santinami
INTRODUCTION: Debate remains about prognostic factors in primary Merkel cell carcinoma (MCC). We investigated clinicopathological factors as determinants of survival in patients with MCC submitted to sentinel node biopsy. METHODS: Sixty-four consecutive patients treated for a primary MCC were identified from a prospectively maintained database at Fondazione IRCCS Istituto Nazionale dei Tumori, Milan. Time to events outcome were described by product limit estimators and proportional hazards model was used to investigate the association between outcome and potential predictors...
May 25, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28578429/a-potential-role-of-esophageal-cancer-related-gene-4-for-atrial-fibrillation
#15
Li Huang, Hua Yu, Xinrong Fan, Xue Li, Liang Mao, Jun Cheng, Xiaorong Zeng, Xitong Dang
Epidemiological studies have shown a strong correlation between tumor and AF. However, the molecular link between tumor and AF remains unknown. ECRG4, a tumor suppressor gene that is expressed in the A-V node and in sporadic ventricular myocytes, inhibits tumorigenesis and monitors tissue homeostasis by functioning as a 'sentinel' molecule gauging inflammatory and cell proliferative responses. To explore the potential physiological function of Ecrg4 in heart, we evaluated its distribution in heart, analyzed its expression in patients with persistent AF and in a canine AF model, and dissected the molecular events downstream of Ecrg4...
June 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28558983/enhancing-global-vaccine-pharmacovigilance-proof-of-concept-study-on-aseptic-meningitis-and-immune-thrombocytopenic-purpura-following-measles-mumps-containing-vaccination
#16
Silvia Perez-Vilar, Daniel Weibel, Miriam Sturkenboom, Steven Black, Christine Maure, Jose Luis Castro, Pamela Bravo-Alcántara, Caitlin N Dodd, Silvana A Romio, Maria de Ridder, Swabra Nakato, Helvert Felipe Molina-León, Varalakshmi Elango, Patrick L F Zuber
New vaccines designed to prevent diseases endemic in low and middle-income countries (LMICs) are now being introduced without prior record of utilization in countries with robust pharmacovigilance systems. To address this deficit, our objective was to demonstrate feasibility of an international hospital-based network for the assessment of potential epidemiological associations between serious and rare adverse events and vaccines in any setting. This was done through a proof-of-concept evaluation of the risk of immune thrombocytopenic purpura (ITP) and aseptic meningitis (AM) following administration of the first dose of measles-mumps-containing vaccines using the self-controlled risk interval method in the primary analysis...
May 27, 2017: Vaccine
https://www.readbyqxmd.com/read/28549789/systematic-approaches-to-adverse-events-in-obstetrics-part-i-event-identification-and-classification
#17
Christian M Pettker
Despite our best intentions to improve health when a patient presents for care, adverse events are ubiquitous in medical practice today. Known complications related to the course of a patient's illness or condition or to the characteristics of the treatment have been an openly stated part of taking care of patients for centuries. However, it is only in the past decade that preventable adverse events, instances of harm related to error and deviations in accepted practice have become a primary part of these conversations...
April 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28538463/implementation-of-a-modified-bedside-handoff-for-a-postpartum-unit
#18
Christine A Wollenhaup, Eleanor L Stevenson, Julie Thompson, Helen A Gordon, Gloria Nunn
The most frequent cause of sentinel events is poor communication during the nurse-to-nurse handoff process. Standardized methods of handoff do not fit in every patient care setting. The aims of this quality improvement project were to successfully implement a modified bedside handoff model, with some report outside and some inside the patient's room, in a postpartum unit. A structured educational module and champion nurses were used. The new model was evaluated based on the change in compliance, patient satisfaction, and nursing satisfaction...
June 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28528017/-identification-of-sentinel-events-in-primary-care
#19
G Olivera Cañadas, A Cañada Dorado, M Drake Canela, B Fernández-Martínez, G Ordóñez León, M Cimas Ballesteros
OBJECTIVE: To identify and describe a list of sentinel events (SEs) for Primary Care (PC). METHODODOLOGY: A structured experts' consensus was obtained by using two online questionnaires. The participants were selected because of their expertise in PC and patient safety. The first questionnaire assessed the suitability of the hospital SEs established in the National Quality Forum 2006 for use in PC via responses of "yes", "no", or "yes but with modification". In the latter case, a re-wording of the SE was requested...
May 17, 2017: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/28527266/-risk-factors-associated-with-the-development-of-perinatal-asphyxia-in-neonates-at-the-hospital-universitario-del-valle-cali-colombia-2010-2011
#20
Javier Torres-Muñoz, Christian Rojas, Diana Mendoza-Urbano, Darly Marín-Cuero, Sandra Orobio, Carlos Echandía
INTRODUCTION: Perinatal asphyxia is one of the main causes of perinatal mortality and morbidity worldwide and it generates high costs for health systems; however, it has modifiable risk factors. OBJECTIVE: To identify the risk factors associated with the development of perinatal asphyxia in newborns at Hospital Universitario del Valle, Cali, Colombia. MATERIALS AND METHODS: Incident cases and concurrent controls were examined. Cases were defined as newborns with moderate to severe perinatal asphyxia who were older than or equal to 36 weeks of gestational age, needed advanced resuscitation and presented one of the following: early neurological disorders, multi-organ commitment or a sentinel event...
April 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
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