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https://www.readbyqxmd.com/read/28938477/growth-hormone-and-the-epithelial-to-mesenchymal-transition
#1
Alison L Brittain, Reetobrata Basu, Yanrong Qian, John J Kopchick
Context: Previous studies have implicated growth hormone (GH) in the progression of several cancers, including breast, colorectal and pancreatic. A mechanism by which GH may play this role in cancer is through the induction of the epithelial-to-mesenchymal transition (EMT). During the EMT process, epithelial cells lose their defining phenotypes causing loss of cellular adhesion and increased cell migration. This review aims to carefully summarize the previous two decades of research that points to GH as an initiator of EMT, in both cancerous and non-cancerous tissues...
August 4, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28938291/feasibility-and-safety-of-controlled-active-hypothermia-treatment-during-transport-in-neonates-with-hypoxic-ischemic-encephalopathy
#2
Eniko Szakmar, Kata Kovacs, Unoke Meder, Agnes Nagy, Andras Szell, Bojan Bundzsity, Zsolt Somogyvari, Attila J Szabo, Miklos Szabo, Agnes Jermendy
OBJECTIVES: To evaluate the feasibility and safety of controlled active hypothermia versus standard intensive care during neonatal transport in patients with hypoxic-ischemic encephalopathy. DESIGN: Cohort study with a historic control group. SETTING: All infants were transported by Neonatal Emergency & Transport Services to a Level-III neonatal ICU. PATIENTS: Two hundred fourteen term newborns with moderate-to-severe hypoxic-ischemic encephalopathy...
September 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28938252/emotional-impact-of-end-of-life-decisions-on-professional-relationships-in-the-icu-an-obstacle-to-collegiality
#3
Alexandra Laurent, Magalie Bonnet, Gilles Capellier, Pierre Aslanian, Paul Hebert
OBJECTIVES: End-of-life decisions are not only common in the ICU but also frequently elicit strong feelings among health professionals. Even though we seek to develop more collegial interprofessional approaches to care and health decision-making, there are many barriers to successfully managing complex decisions. The aim of this study is to better understand how emotions influence the end-of-life decision-making process among professionals working in ICU. DESIGN: Qualitative study with clinical interviews...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28938234/is-early-total-care-a-safe-and-effective-alternative-to-staged-protocol-for-the-treatment-of-schatzker-iv-vi-tibial-plateau-fractures-in-patients-older-than-50-years
#4
Amrut Borade, Harish Kempegowda, Raveesh Richard, Jove Graham, Michael Suk, Daniel S Horwitz
OBJECTIVES: To compare "Early Total Care" (ETC) with "Staged Protocol" (SP) for the treatment of Schatzker IV-VI tibial plateau fractures in patients older than 50 years regarding safety and effectiveness. DESIGN: Retrospective cohort study. SETTING: An academic level 1 US trauma center. PATIENTS/PARTICIPANTS: Eighty-one patients older than 50 years with Schatzker grade IV-VI tibial plateau fractures were included. INTERVENTION: Fifty-three patients were treated under SP with immediate external fixation followed by definitive internal fixation...
September 19, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28937535/validation-of-a-commercial-assay-and-decision-support-tool-for-routine-paclitaxel-therapeutic-drug-monitoring-tdm
#5
Markus Joerger, Stefanie Kraff, Ulrich Jaehde, Ralf A Hilger, Jodi B Courtney, Daniel J Cline, Sonali Jog, Irina Baburina, M C Miller, Salvatore J Salamone
BACKGROUND: The value of therapeutic drug monitoring (TDM) for paclitaxel was recently demonstrated in the largest TDM trial ever conducted in oncology. The trial demonstrated significant reduction in neuropathy when using TDM. Dose adjustment for paclitaxel was based on time above a threshold concentration (Tc>0.05). Tc>0.05 must be calculated with a pharmacokinetic model and complex non-linear mixed effects (NLME) software. The use of the software and chromatographic methods to measure paclitaxel require specialized expertise...
September 18, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28936948/control-of-clostridium-difficile-infection-by-defined-microbial-communities
#6
James Collins, Jennifer M Auchtung
Each year in the United States, billions of dollars are spent combating almost half a million Clostridium difficile infections (CDIs) and trying to reduce the ∼29,000 patient deaths in which C. difficile has an attributed role. In Europe, disease prevalence varies by country and level of surveillance, though yearly costs are estimated at €3 billion. One factor contributing to the significant health care burden of C. difficile is the relatively high frequency of recurrent CDIs. Recurrent CDI, i.e., a second episode of symptomatic CDI occurring within 8 weeks of successful initial CDI treatment, occurs in ∼25% of patients, with 35 to 65% of these patients experiencing multiple episodes of recurrent disease...
September 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28936910/modulation-of-the-gut-microbiota-a-focus-on-treatments-for-irritable-bowel-syndrome
#7
Lucinda A Harris, Noemi Baffy
Irritable bowel syndrome (IBS), which is characterized by recurrent abdominal pain and disordered bowel habits, is one of the most common functional bowel disorders. IBS is a substantial burden on both patient health-related quality of life and health care costs. Several pathophysiologic mechanisms have been postulated for the occurrence of IBS, including altered gastrointestinal motility, visceral hypersensitivity, changes in gut permeability, immune activation, gut-brain dysregulation, autonomic nervous system dysfunction, and changes in the gut microbiota...
September 22, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28936756/clinical-utility-of-mri-brain-in-children-with-non-traumatic-coma
#8
Jatinder Khipal, Naveen Sankhyan, Sunit C Singhi, Pratibha Singhi, Niranjan Khandelwal
OBJECTIVES: To determine characteristics that help identify children with acute encephalopathy who benefit from an MRI (magnetic resonance imaging) of the brain. The secondary objective was to determine the adverse events associated with the MRI procedure. METHODS: In this single center, prospective, observational study. Children (2 mo - 12 y) presenting with impaired consciousness were screened. Those with acute non-traumatic encephalopathy (Glasgow Coma Score of 12 or less) undergoing their first in-patient MRI brain were included...
September 22, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28936626/the-impact-of-frailty-on-icu-and-30-day-mortality-and-the-level-of-care-in-very-elderly-patients-%C3%A2-%C3%A2-80%C3%A2-years
#9
Hans Flaatten, Dylan W De Lange, Alessandro Morandi, Finn H Andersen, Antonio Artigas, Guido Bertolini, Ariane Boumendil, Maurizio Cecconi, Steffen Christensen, Loredana Faraldi, Jesper Fjølner, Christian Jung, Brian Marsh, Rui Moreno, Sandra Oeyen, Christina Agwald Öhman, Bernardo Bollen Pinto, Ivo W Soliman, Wojciech Szczeklik, Andreas Valentin, Ximena Watson, Tilemachos Zaferidis, Bertrand Guidet
PURPOSE: Very old critical ill patients are a rapid expanding group in the ICU. Indications for admission, triage criteria and level of care are frequently discussed for such patients. However, most relevant outcome studies in this group frequently find an increased mortality and a reduced quality of life in survivors. The main objective was to study the impact of frailty compared with other variables with regards to short-term outcome in the very old ICU population. METHODS: A transnational prospective cohort study from October 2016 to May 2017 with 30 days follow-up was set up by the European Society of Intensive Care Medicine...
September 21, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936586/role-of-structured-individual-patient-education-in-the-prevention-of-vascular-complications-in-newly-diagnosed-type-2-diabetes-the-individual-therapeutic-education-in-newly-diagnosed-type-2-diabetes-intend-randomized-controlled-trial
#10
Adriana Coppola, Livio Luzi, Tiziana Montalcini, Andrea Giustina, Carmine Gazzaruso
OBJECTIVE: Recent studies showed that a structured patient therapeutic education (PTE) may decrease both mortality and the development of diabetes complications. Nevertheless, no data are available in the literature on the impact of individual PTE on the complications in newly diagnosed type 2 diabetic patients. Aim of the present randomized controlled trial is to evaluate the impact of individual PTE on the occurrence of macrovascular complications in newly diagnosed type 2 diabetic patients when compared to usual care (UC) and group PTE...
September 21, 2017: Endocrine
https://www.readbyqxmd.com/read/28936475/surgical-data-science-the-new-knowledge-domain
#11
S Swaroop Vedula, Gregory D Hager
Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care with the goal of maximizing quality and value of care. While innovations in diagnostic and therapeutic technologies have driven past improvements in quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytic techniques, and translation or integration of research findings into patient care...
April 2017: Innov Surg Sci
https://www.readbyqxmd.com/read/28936188/all-impostors-aren-t-alike-differentiating-the-impostor-phenomenon
#12
Mona Leonhardt, Myriam N Bechtoldt, Sonja Rohrmann
Following up on earlier investigations, the present paper analyzes construct validity of the impostor phenomenon. It examines the question whether the impostor phenomenon is a homogeneous construct or whether different types of persons with impostor self-concept can be distinguished on the basis of related characteristics. The study was conducted with professionals in leadership positions exhibiting a pronounced impostor self-concept (n = 183). Cluster-analytic procedures indicated the existence of two different types: one group which, in line with the literature (e...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28936054/patterns-of-intermediate-uveitis-in-children-presenting-at-a-tertiary-eye-care-center-in-south-india
#13
Radha Annamalai, Jyotirmay Biswas
PURPOSE: To study the patterns of intermediate uveitis in the pediatric age group in a referral eye care center in South India. METHODS: This is a study of twenty consecutive patients under 16 years of age with intermediate uveitis, conducted at a tertiary referral center. Numerous variables were assessed, including age and gender distribution, laboratory data, the presence of systemic diseases, onset and course of ocular inflammation, clinical features, their complications, therapeutic strategies with their outcomes, remission, final visual acuity (VA), and characteristics associated with poor visual outcome...
April 2017: Middle East African Journal of Ophthalmology
https://www.readbyqxmd.com/read/28936051/bacterial-contamination-of-multi-dose-eye-drops-at-ophthalmology-department-university-of-gondar-northwest-ethiopia
#14
Asegedech Tsegaw, Asamere Tsegaw, Tefera Abula, Yared Assefa
PURPOSE: Ophthalmic solutions used for both diagnostic and therapeutic purposes were found to be contaminated with bacteria pathogens and caused serious ocular infections such as keratitis and endophthalmitis. The objective was to assess the magnitude and pattern of bacterial contamination of multi-dose ophthalmic medications and investigate the drug susceptibility pattern of the isolates in the Department of Ophthalmology at Gondar University Teaching Hospital. METHODS: A total of 100 ophthalmic medications in-use by patients and eye-care workers have been taken and cultured for potential bacterial contamination in the Microbiology Department after 1 week and >1 week of use...
April 2017: Middle East African Journal of Ophthalmology
https://www.readbyqxmd.com/read/28935455/recent-directions-in-personalised-acute-respiratory-distress-syndrome-medicine
#15
REVIEW
Matthieu Jabaudon, Raiko Blondonnet, Jules Audard, Marianne Fournet, Thomas Godet, Vincent Sapin, Jean-Michel Constantin
Acute respiratory distress syndrome (ARDS) is heterogeneous by definition and patient response varies depending on underlying biology and their severity of illness. Although ARDS subtypes have been identified with different prognoses in past studies, the concept of phenotypes or endotypes does not extend to the clinical definition of ARDS. This has possibly hampered the development of therapeutic interventions that target select biological mechanisms of ARDS. Recently, a major advance may have been achieved as it may now be possible to identify ARDS subtypes that may confer different responses to therapy...
September 18, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28935055/screening-and-management-of-substance-use-in-pregnancy-a-review
#16
REVIEW
Jocelynn L Cook, Courtney R Green, Sandra de la Ronde, Colleen A Dell, Lisa Graves, Lisa Morgan, Alice Ordean, James Ruiter, Megan Steeves, Suzanne Wong
Substance use during pregnancy has important implications for health care providers, policy makers, and can negatively impact a woman's health and the health of her children. Understanding trends, patterns of use and outcomes are critical to prevention campaigns, building awareness, and providing effective care. This review will discuss the current therapeutic approaches and recommendations for screening and patient management for substance use in pregnancy and during the postpartum period, and it is geared towards any care providers who care for patients or those who may care for patients who may be at risk for substance use during pregnancy...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28934249/variability-in-objective-and-subjective-measures-affects-baseline-values-in-studies-of-patients-with-copd
#17
Wayne H Anderson, Jae Wook Ha, David J Couper, Wanda K O'Neal, R Graham Barr, Eugene R Bleecker, Elizabeth E Carretta, Christopher B Cooper, Claire M Doerschuk, M Bradley Drummond, MeiLan K Han, Nadia N Hansel, Victor Kim, Eric C Kleerup, Fernando J Martinez, Stephen I Rennard, Donald Tashkin, Prescott G Woodruff, Robert Paine, Jeffrey L Curtis, Richard E Kanner
RATIONALE: Understanding the reliability and repeatability of clinical measurements used in the diagnosis, treatment and monitoring of disease progression is of critical importance across all disciplines of clinical practice and in clinical trials to assess therapeutic efficacy and safety. OBJECTIVES: Our goal is to understand normal variability for assessing true changes in health status and to more accurately utilize this data to differentiate disease characteristics and outcomes...
2017: PloS One
https://www.readbyqxmd.com/read/28933995/identification-assessment-and-management-of-breast-oedema-after-treatment-for-cancer
#18
Marie Todd
Advances in breast cancer management, including breast-conserving surgery, have resulted in an increase in the incidence of breast oedema. However, this is addressed by professionals less often than arm lymphoedema. Breast oedema results in significant physical and psychological morbidity, makes finding a comfortably fitting bra very difficult, and can act as a reminder of the initial breast cancer diagnosis. Psychological difficulties can be compounded by clinicians' failure to acknowledge the impact. Assessing and managing breast oedema requires a sensitive, skilled approach to ensure all the relevant issues are identified and addressed in a comprehensive care plan; taking time to listen to patients and acknowledging the impact can be very therapeutic...
September 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28933962/tool-to-assess-causality-of-direct-and-indirect-adverse-events-associated-with-therapeutic-interventions
#19
Liliane Zorzela, Silvano Mior, Heather Boon, Anita Gross, Jeromy Yager, Rose Carter, Sunita Vohra
OBJECTIVE: To develop and test a tool to assess causality of direct and indirect adverse events associated with therapeutic interventions. The intervention was one or more drugs and/or natural health products, a device, or practice (professional delivering the intervention). METHODS: Through the assessment of causality of adverse events, we can learn about factors contributing to the harm and consider what modification may prevent its reoccurrence. Existing scales (WHO-UMC, Naranjo and Horn) were adapted to develop a tool (algorithm and table) to evaluate cases of serious harmful events reported through a national surveillance study...
September 21, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28933696/a-novel-topical-wound-therapy-delivery-system
#20
Ingrid Herskovitz, Flor E MacQuhae, Luis J Borda, Stephanie Bhagwandin, Juan A Paredes, Thais Polanco, John C Lantis, Paul J Kim, Tania J Phillips, Robert S Kirsner
INTRODUCTION: Wound care dressings have evolved over time, from bandaging to the development of occlusive dressings to negative pressure wound therapy. A novel therapeutic delivery system dressing has been cleared by the United States Food and Drug Administration. This semi occlusive wound dressing has been developed to provide local, continuous delivery of aqueous topical agents, such as therapeutics (anesthetics, antiseptics, antibiotics, steroids, topical beta-blockers, immune modulatory agents, growth factors, and fibrinolytic agents, among others), at a rate of about ¾ mL per day, thus maintaining a hydrated environment and providing topical treatment...
September 2017: Wounds: a Compendium of Clinical Research and Practice
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