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Safer conception

Jennifer Weller, Ian Civil, Jane Torrie, David Cumin, Alexander Garden, Arden Corter, Alan Merry
AIM: Unintended patient harm is a major contributor to poor outcomes for surgical patients and often reflects failures in teamwork. To address this we developed a Multidisciplinary Operating Room Simulation (MORSim) intervention to improve teamwork in the operating room (OR) and piloted it with 20 OR teams in two of the 20 District Health Boards in New Zealand prior to national implementation. In this study, we describe the experience of those exposed to the intervention, challenges to implementing changes in clinical practice and suggestions for successful implementation of the programme at a regional or national level...
October 14, 2016: New Zealand Medical Journal
Kristina Guyton, John C Alverdy
Surgery involving the gastrointestinal tract continues to prove challenging because of the persistence of unpredictable complications such as anastomotic leakage and life-threatening infections. Removal of diseased intestinal segments results in substantial catabolic stress and might require complex reconstructive surgery to maintain the functional continuity of the intestinal tract. As gastrointestinal surgery necessarily involves a breach of an epithelial barrier colonized by microorganisms, preoperative intestinal antisepsis is used to reduce infection-related complications...
October 12, 2016: Nature Reviews. Gastroenterology & Hepatology
Narendran Gopalan, Padmapriyadarsini Chandrasekaran, Soumya Swaminathan, Srikanth Tripathy
Human immunodeficiency virus (HIV) epidemic has undoubtedly increased the incidence of tuberculosis (TB) globally, posing a formidable global health challenge affecting 1.2 million cases. Pulmonary TB assumes utmost significance in the programmatic perspective as it is readily transmissible as well as easily diagnosable. HIV complicates every aspect of pulmonary tuberculosis from diagnosis to treatment, demanding a different approach to effectively tackle both the diseases. In order to control these converging epidemics, it is important to diagnose early, initiate appropriate therapy for both infections, prevent transmission and administer preventive therapy...
2016: AIDS Research and Therapy
Julia M Selfridge, Tetsuya Gotoh, Samuel Schiffhauer, JingJing Liu, Philip E Stauffer, Andrew Li, Daniel G S Capelluto, Carla V Finkielstein
Circadian rhythms are a collection of endogenously driven biochemical, physiological, and behavioral processes that oscillate in a 24-h cycle and can be entrained by external cues. Circadian clock molecules are responsible for the expression of regulatory components that modulate, among others, the cell's metabolism and energy consumption. In clinical practice, the regulation of clock mechanisms is relevant to biotransformation of therapeutics. Accordingly, xenobiotic metabolism and detoxification, the two processes that directly influence drug effectiveness and toxicity, are direct manifestations of the daily oscillations of the cellular and biochemical processes taking place within the gastrointestinal, hepatic/biliary, and renal/urologic systems...
October 3, 2016: Drugs
J C Petrozza
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Paolo Cravedi
Many prospective studies and a recent randomized controlled trial have shown that the B-cell-depleting monoclonal antibody, rituximab, safely promotes the remission of nephrotic syndrome in approximately 65% of patients with membranous nephropathy (MN). Mechanistic studies have indicated that rituximab-induced proteinuria reduction is associated with clearance of anti-podocyte antigens phospholipase 2 receptor autoantibodies and subepithelial immune complexes, the hallmarks of the disease. A recently published study reported results which, at first sight, looked less favorable and implied that, due to a publication bias against negative results, the efficacy of rituximab in MN might be overestimated...
September 28, 2016: Nephron
Benyamin Rahmani, Spyros Tzamtzis, Rose Sheridan, Michael J Mullen, John Yap, Alexander M Seifalian, Gaetano Burriesci
AIMS: The aim of this study was to introduce and demonstrate the feasibility in an acute preclinical model of a new transcatheter heart valve concept with a self-expanding wire frame, polymeric leaflets and a sealing component. METHODS AND RESULTS: The TRISKELE valve was developed based on a previously validated polymeric leaflet design, an adaptive sealing cuff and a novel nitinol wire frame which reduces stress on the leaflets and radial pressure on the surrounding tissue...
September 18, 2016: EuroIntervention
Pedro David Delgado-López, Antonio Rodríguez-Salazar, Vicente Martín-Velasco, José Manuel Castilla-Díez, Javier Martín-Alonso, Ana Galacho-Harriero, Cecilia Gil-Polo, Elena Araus-Galdós
OBJECTIVE: To describe the specific surgical details and report the lessons learned with a series of patients suffering from spinal tumours that underwent total en bloc spondylectomy (TES). METHODS: A retrospective case series review is presented, together with an analysis of the clinical and technical variables, as well as the outcomes. RESULTS: A total of 10 patients underwent TES (2000-2016) for primary (osteosarcoma, chondrosarcoma, fibrosarcoma and chordoma) and secondary spinal tumours (lung, breast, thyroid, oesophagus, and meningioma metastases)...
September 14, 2016: Neurocirugía
Alexis T Laungani, Jodie Christner, Jason A Primus, Nirusha Lachman, Karla V Ballman, Anita Mohan, Michel Saint-Cyr
Background Perforator flaps remain challenging in their design, especially as free flaps. We used a cadaveric model to help refine the design of perforator flaps by studying their vascular features. We define the angle of perfusion of a perforator as a tool to achieve safer flap designs. Methods A total of 83 flaps were designed from 20 fresh cadaveric anterolateral thigh flaps. The most dominant perforator larger than 0.5 mm was used as the reference point on the midline of the flap, and the tip of the flap was set at 5 cm (n = 10), 2 cm (n = 5), or 10 cm (n = 5) from this perforator...
September 16, 2016: Journal of Reconstructive Microsurgery
Mazda K Turel, Mark Bernstein
The current trend in all fields of surgery is towards less invasive procedures with shorter hospital stays. The reasons for this change include convenience to patients, optimal resource utilization, and cost saving. Technological advances in neurosurgery, aided by improvements in anesthesia, have resulted in surgery that is faster, simpler, and safer with excellent perioperative recovery. As a result of improved outcomes, some centers are performing brain tumor surgery on an outpatient basis, wherein patients arrive at the hospital the morning of their procedure and leave the hospital the same evening, thus avoiding an overnight stay in the hospital...
September 2016: Neurology India
Deborah Lynne Jones, Ryan Cook, JoNell Efantis Potter, Talya Miron-Shatz, Nahida Chakhtoura, Andrew Spence, Margaret M Byrne
OBJECTIVE: Rates of pregnancy among women living with HIV (WLHIV) have increased with the availability of effective HIV treatment. Planning for pregnancy and childbirth is an increasingly important element of HIV care. Though rates of unintended pregnancies are high among women in general, among couples affected by HIV, significant planning and reproductive decisions must be considered to prevent negative health consequences for WLHIV and their neonates. To gain insight into this reproductive decision-making process among WLHIV, this study explored women's knowledge, attitudes and practices regarding fertility planning, reproductive desires, and safer conception practices...
2016: PloS One
Niyaz Ahmad, Rizwan Ahmad, Atta Abbas Naqvi, Mohammad Ashafaq, Md Aftab Alam, Farhan Jalees Ahmad, Mastour Safer Al-Ghamdi
Antioxidants, with reported neuroprotective activity, encounter free radical induced neural damage leading to reduced risk of cerebral ischemia-reperfusion (IR) injury. Safranal, an antioxidant drug with potential role in the amelioration of cerebral ischemia, endures low solubility and poor absorption property thus resulting a low serum and tissue bioavailability. This research aims to prepare nanoemulsion with the concept; to increase the bioavailability in order to reduce oxidative stress-induced brain injury as well as to evaluate the brain-drug targeting following non-invasive nasal route administration in middle cerebral artery occlusion (MCAO) animal model...
September 9, 2016: Artificial Cells, Nanomedicine, and Biotechnology
Rita Wegmüller, Amat Bah, Lindsay Kendall, Morgan M Goheen, Sarah Mulwa, Carla Cerami, Diego Moretti, Andrew M Prentice
BACKGROUND: Iron deficiency prevalence rates frequently exceed 50 % in young children in low-income countries. The World Health Organization (WHO) recommended universal supplementation of young children where anaemia rates are >40 %. However, large randomized trials have revealed that provision of iron to young children caused serious adverse effects because iron powerfully promotes microbial growth. Hepcidin - the master regulator of iron metabolism that integrates signals of infection and iron deficiency - offers the possibility of new solutions to diagnose and combat global iron deficiency...
2016: BMC Pediatrics
Linda Nguyen, Brandon P Lucke-Wold, Aric F Logsdon, Anna L Scandinaro, Jason D Huber, Rae R Matsumoto
Ketamine has been shown to produce rapid and robust antidepressant effects in depressed individuals; however, its abuse potential and adverse psychotomimetic effects limit its widespread use. Dextromethorphan (DM) may serve as a safer alternative on the basis of pharmacodynamic similarities to ketamine. In this proof-of-concept study, behavioral and biochemical analyses were carried out to evaluate the potential involvement of brain-derived neurotrophic factor (BDNF) in the antidepressant-like effects of DM in mice, with comparisons to ketamine and imipramine...
September 28, 2016: Neuroreport
Emma Öistämö, Fredrik Hjern, Lennart Blomqvist, Ylva Falkén, Klas Pekkari, Mirna Abraham-Nordling
BACKGROUND: Emergency surgery for colon cancer, as a result of obstruction, has been vitiated by a high frequency of complications and poor survival. The concept of "bridge to surgery" includes either placement of self-expanding metallic stents (SEMS) or diverting stoma of an obstructing tumour and subsequent planned resection. The aim of this study was to compare acute resection with stoma or stent and later resection regarding surgical and oncological outcomes and total hospital stay...
2016: World Journal of Surgical Oncology
H W Jiang
The primary goal of modern endodontic therapy is to achieve the long-term retention of a functional tooth by preventing or treating pulpitis or apical periodontitis is. The long-term retention of endodontically treated tooth is correlated with the remaining amount of tooth tissue and the quality of the restoration after root canal filling. In recent years, there has been rapid progress and development in the basic research of endodontic biology, instrument and applied materials, making treatment procedures safer, more accurate, and more efficient...
August 2016: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
Polyxeni Nicolopoulou-Stamati, Sotirios Maipas, Chrysanthi Kotampasi, Panagiotis Stamatis, Luc Hens
The industrialization of the agricultural sector has increased the chemical burden on natural ecosystems. Pesticides are agrochemicals used in agricultural lands, public health programs, and urban green areas in order to protect plants and humans from various diseases. However, due to their known ability to cause a large number of negative health and environmental effects, their side effects can be an important environmental health risk factor. The urgent need for a more sustainable and ecological approach has produced many innovative ideas, among them agriculture reforms and food production implementing sustainable practice evolving to food sovereignty...
2016: Frontiers in Public Health
Stephen Jung, Michele M Spence, Nina M Escasa, Eric A Lee, Rita L Hui, Nancy E Gibbs
BACKGROUND: Previous studies have shown an increased risk of pneumonia with benzodiazepines (BZD) and an increased risk of any infection with non-BZD hypnotics, but no analysis has specifically investigated the risk of pneumonia with non-BZD hypnotic use. OBJECTIVE: To evaluate the risk of pneumonia associated with non-BZD hypnotic use in the elderly. METHODS: This was a retrospective case-control study of members aged 65 years and older enrolled in an integrated health care system...
August 2016: Journal of Managed Care & Specialty Pharmacy
Ting-Min Hsieh, Tsung-Cheng Tsai, Yueh-Wei Liu, Ching-Hua Hsieh
BACKGROUND: High-grade blunt hepatic and/or splenic injuries (BHSI) remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of traumatic injuries in a Level I trauma center in southern Taiwan. METHODS: High-grade BHSI are defined as grade III-VI blunt hepatic injuries and grade III-V blunt splenic injuries...
2016: International Journal of Environmental Research and Public Health
Dominika L Seidman, Shannon Weber, Maria Teresa Timoney, Karishma K Oza, Elizabeth Mullins, Deborah L Cohan, Rodney L Wright
BACKGROUND: Pregnancy may increase a woman's susceptibility to HIV. Maternal HIV acquisition during pregnancy and lactation is associated with increased perinatal and lactational HIV transmission. There are no published reports of preexposure prophylaxis use after the first trimester of pregnancy or during lactation. OBJECTIVE: The purpose of this study was to report the use of preexposure prophylaxis and to identify gaps in HIV prevention services for women who were at substantial risk of HIV preconception and during pregnancy and lactation at 2 United States medical centers...
July 19, 2016: American Journal of Obstetrics and Gynecology
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