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https://www.readbyqxmd.com/read/29458204/a-review-of-implantable-biosensors-for-closed-loop-glucose-control-and-other-drug-delivery-applications
#1
Kee Scholten, Ellis Meng
Closed-loop drug delivery promises autonomous control of pharmacotherapy through the continuous monitoring of biomarker levels. For decades, researchers have strived for portable closed-loop systems, capable of treating ambulatory patients with chronic conditions such as diabetes mellitus. After years of development, the first of these systems have left the laboratory and entered commercial use. This long-awaited advance reflects recent development of chronically stable implantable biosensors, able to accurately measure biomarker levels in vivo...
February 16, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29457945/factors-that-influence-nurses-assessment-of-patient-acuity-and-response-to-acute-deterioration
#2
Mark Dalton, John Harrison, Anitra Malin, Conan Leavey
BACKGROUND: nurses play a crucial role in the early recognition and management of the deteriorating patient. They are responsible for the care they provide to their patients, part of which is the monitoring of vital signs (blood pressure, pulse, respiratory rate and temperature), which are fundamental in the surveillance of deterioration. The aim of this study was to discover what factors influence how nurses assess patient acuity and their response to acute deterioration. METHODS: a generic qualitative approach was used...
February 22, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29457869/assessment-of-the-spectrum-of-hepatic-encephalopathy-a-multi-center-study
#3
Bradley Reuter, Kara Walter, Julien Bissonnette, Michael D Leise, Jennifer Lai, Puneeta Tandon, Patrick S Kamath, Scott W Biggins, Christopher F Rose, James B Wade, Jasmohan S Bajaj
Hepatic encephalopathy (HE) is a major cause of morbidity in cirrhosis. However its severity assessment is often subjective, which needs to be studied systematically. AIM: To determine how accurately trainee and non-trainee practitioners grade and manage HE patients throughout its severity. METHODS: We performed a survey study using standardized simulated patient videos at 4 US and 3 Canadian centers. Participants were trainees (gastroenterology/hepatology fellows) and non-trainees (faculty, nurse practitioners, physician assistants)...
February 19, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29457694/exploring-self-management-on-glycemic-control-using-a-modified-information-motivation-behavioral-skills-model-in-type-2-diabetes-mellitus-patients-in-shanghai-china-a-cross-sectional-study
#4
Qi Chen, Huwen Wang, Yichen Wang, Zezhou Wang, DaiJun Zhao, Yong Cai
BACKGROUND: The utility and maturity of the original Information-Motivation-Behavioral Skills (IMB) model have been verified in Type 2 Diabetes Mellitus (T2DM) patients. But little research has clarified whether the model has effect on glycemic control. The main purpose of this study is to modify the IMB model to explore self-management on glycemic control in T2DM patients in Shanghai, China. METHODS: A cross-sectional study was conducted using a convenience sampling method between June and August 2015 in three tertiary hospitals and four community health service centers...
February 19, 2018: Journal of Diabetes
https://www.readbyqxmd.com/read/29456933/pediatricians-lack-knowledge-for-the-diagnosis-and-management-of-functional-constipation-in-children-over-6-mo-of-age
#5
Ariani Widodo, Badriul Hegar, Yvan Vandenplas
AIM: To assess the knowledge of general pediatricians througout Indonesia about the diagnosis and treatment of childhood constipation. METHODS: A comprehensive questionnaire was distributed to general pediatricians from several teaching hospitals and government hospitals all over Indonesia. RESULTS: Data were obtained from 100 pediatricians, with a mean of 78.34 ± 18.00 mo clinical practice, from 20 cities throughout Indonesia. Suspicion of constipation in a child over 6 mo of age arises when the child presents with a decreased frequency of bowel movements (according to 87% of participants) with a mean of one bowel movement per 3...
February 8, 2018: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/29456430/effect-of-medical-nutrition-therapy-for-patients-with-type-2-diabetes-in-a-low-no-cost-clinic-a-propensity-score-matched-cohort-study
#6
Mark D Agee, Zane Gates, Patrick M Irwin
Background: Although many studies have been conducted regarding the effectiveness of medical nutrition therapy (MNT) for type 2 diabetes management, less is known about the effectiveness of MNT for low-income adults. This study evaluated the contribution of MNT in improving A1C and blood pressure in a population of low-income adults with type 2 diabetes. Methods: This was a population-based, propensity score-matched cohort study using provincial health data from Altoona, Blair County, Pa...
February 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29456423/evaluating-the-implementation-of-the-endotool-glycemic-control-software-system
#7
Samuel M John, Kacie Lauren Waters, Khatija Jivani
Purpose: The purpose of this study was to compare achievement of glycemic control on insulin drips before and after the implementation of EndoTool, a glucose management software system used in a community hospital setting. Methods: A retrospective chart review was performed of patients on an insulin drip who were managed before and after implementation of the EndoTool software. Fifty patients were selected for each group. Statistical analyses were run to compare metrics gathered between groups...
February 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29456229/page-kidney-a-rare-but-surgically-treatable-cause-of-hypertension
#8
Ashok Kumar Sokhal, Gaurav Prakash, Durgesh Kumar Saini, Kawaljit Singh, Satyanarayan Sankhwar, Bhupendra Pal Singh
The Page kidney is a rare phenomenon. External renal parenchymal compression is the culprit. We report two cases of young males with flank pain, renal mass, and hypertension with history of blunt abdominal trauma. Initially, hypertension was controlled by angiotensin-converting enzyme (ACE) inhibitors but gradually became refractory to medical treatment. Laparoscopic nephrectomy was performed in both patients. We emphasize the Page kidney as a cause of hypertension in young patients, presenting with flank pain and renal mass with or without complications of hypertension...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29456216/the-cardiovascular-risk-factor-profiles-among-end-stage-renal-failure-patients-treated-with-continuous-ambulatory-peritoneal-dialysis-and-intermittent-hemodialysis
#9
S A K Sharifah Zamiah, Che Rosle Draman, Mohd Ramli Seman, A Fariz Safhan, R Rozalina, N I Nik Ruzni
Cardiovascular (CV) event is the most common cause of death in dialysis patients. Both traditional and nontraditional CV risk factors related to malnutrition, inflammation, and anemia are commonly found in this population. This study was conducted to evaluate the burden factors of CV risk factors and its management in our regularly dialyzed patients. It was a single-center, cross-sectional analysis of prevalent intermittent hemodialysis (IHD) and continuous ambulatory peritoneal dialysis (CAPD) patients followed up in our hospital...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29456124/a-multicenter-study-of-total-pancreatectomy-with-islet-autotransplantation-tpiat-post-prospective-observational-study-of-tpiat
#10
Melena D Bellin, Maisam Abu-El-Haija, Katherine Morgan, David Adams, Gregory J Beilman, Srinath Chinnakotla, Darwin L Conwell, Ty B Dunn, Martin L Freeman, Timothy Gardner, Varvara A Kirchner, Luis F Lara, Leslie Long-Simpson, Jaimie D Nathan, Bashoo Naziruddin, John A Nyman, Timothy L Pruett, Sarah J Schwarzenberg, Vikesh K Singh, Kerrington Smith, Jennifer L Steel, Martin Wijkstrom, Piotr Witkowski, James S Hodges
BACKGROUND/OBJECTIVES: Total pancreatectomy with islet autotransplantation (TPIAT) is considered for managing chronic pancreatitis in selected patients when medical and endoscopic interventions have not provided adequate relief from debilitating pain. Although more centers are performing TPIAT, we lack large, multi-center studies to guide decisions about selecting candidates for and timing of TPIAT. METHODS: Multiple centers across the United States (9 to date) performing TPIAT are prospectively enrolling patients undergoing TPIAT for chronic pancreatitis into the Prospective Observational Study of TPIAT (POST), a NIDDK funded study with a goal of accruing 450 TPIAT recipients...
February 6, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29456025/effectiveness-of-user-and-expert-driven-web-based-hypertension-programs-an-rct
#11
Sam Liu, Dina Brooks, Scott G Thomas, Gunther Eysenbach, Robert P Nolan
INTRODUCTION: The effectiveness of self-guided Internet-based lifestyle counseling (e-counseling) varies, depending on treatment protocol. Two dominant procedures in e-counseling are expert- and user-driven. The influence of these procedures on hypertension management remains unclear. The objective was to assess whether blood pressure improved with expert-driven or user-driven e-counseling over control intervention in patients with hypertension over a 4-month period. STUDY DESIGN: This study used a three-parallel group, double-blind randomized controlled design...
February 15, 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29455932/a-paradigm-shift-on-beta-thalassaemia-treatment-how-will-we-manage-this-old-disease-with-new-therapies
#12
REVIEW
Maria Domenica Cappellini, John B Porter, Vip Viprakasit, Ali T Taher
Beta-thalassaemia causes defective haemoglobin synthesis leading to ineffective erythropoiesis, chronic haemolytic anaemia, and subsequent clinical complications. Blood transfusion and iron chelation allow long-term disease control, and haematopoietic stem cell transplantation offers a potential cure for some patients. Nonetheless, there are still many challenges in the management of beta-thalassaemia. The main treatment option for most patients is supportive care; furthermore, the long-term efficacy and safety of current therapeutic strategies are limited and adherence is suboptimal...
February 12, 2018: Blood Reviews
https://www.readbyqxmd.com/read/29455840/cardiac-surgery-outcomes-in-patients-with-chronic-lymphocytic-leukemia
#13
Yuanjia Zhu, Andrew J Toth, Ashley M Lowry, Eugene H Blackstone, Brian T Hill, Stephanie L Mick
BACKGROUND: Surgical outcomes of patients with chronic lymphocytic leukemia (CLL) undergoing cardiac surgery are limited. Our objectives were to investigate hospital morbidity and mortality after open cardiac surgery in CLL versus non-CLL patients. METHODS: From May 1995 to May 2015, 157 patients with CLL and 55,917 without and older than 47 years underwent elective cardiac surgery at Cleveland Clinic. By Rai criteria, 79 CLL patients (56%) were low risk (class 0), 13 (9...
February 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29455711/evaluation-of-the-benefits-of-de-escalation-for-patients-with-sepsis-in-the-emergency-intensive-care-unit
#14
Takahiro Niimura, Yoshito Zamami, Toru Imai, Kanako Nagao, Masafumi Kayano, Hidenori Sagara, Mitsuhiro Goda, Naoto Okada, Masayuki Chuma, Kenshi Takechi, Masaki Imanishi, Toshihiro Koyama, Tadashi Koga, Hironori Nakura, Toshiaki Sendo, Keisuke Ishizawa
PURPOSE: Although the 2016 Japanese guidelines for the management of sepsis recommend de-escalation of treatment after identification of the causative pathogen, adherence to this practice remain unknown. The objective of this study was to evaluate the benefits of de-escalating treatment for sepsis patients at an advanced critical care and emergency medical centre. METHODS: Based on electronic patient information, 85 patients who were transported to the centre by ambulance, and diagnosed with sepsis between January 2008 and September 2013 were enrolled and evaluated...
2018: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29455405/bariatric-surgery-in-patients-on-chronic-anticoagulation-therapy
#15
Gautam Sharma, Zubaidah Nor Hanipah, Ali Aminian, Suriya Punchai, Emre Bucak, Philip R Schauer, Stacy A Brethauer
BACKGROUND: Perioperative management of chronically anti-coagulated patients undergoing bariatric surgery requires a balance of managing hemorrhagic and thromboembolic risks. The aim of this study is to evaluate the incidence of hemorrhagic complications and their management in chronically anticoagulated (CAT) patients undergoing bariatric surgery. METHODS: A retrospective review of CAT patients undergoing bariatric surgery at an academic center from 2008 to 2015 was studied...
February 17, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29455335/evaluating-the-safety-and-tolerability-of-sacubitril-valsartan-for-hfref-managed-within-a-pharmacist-clinic
#16
Elizabeth K Pogge, Lindsay E Davis
OBJECTIVE: The objective of this research was to describe the use of pharmacist-managed sacubitril/valsartan therapy in a multi-center, outpatient cardiac group. BACKGROUND: Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNi), is a novel agent for the treatment of heart failure. An ARNi is recommended by national guidelines to be used in place of angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) therapy for patients who remain symptomatic...
February 17, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29454558/clinical-characteristics-and-management-of-patients-with-atrial-fibrillation-treated-with-direct-oral-anticoagulants-according-to-blood-pressure-control
#17
M de la Figuera, S Cinza, I Egocheaga, N Marín, M A Prieto
OBJECTIVE: To determine the clinical characteristics and management of hypertensive patients with nonvalvular atrial fibrillation (AF) treated with direct oral anticoagulants (DOACs) according to blood pressure (BP) control. METHODS: For this purpose, data from two observational, cross-sectional and multicenter studies were combined. In both studies, patients on chronic treatment with anticoagulants and that were on current treatment with DOACs at least for 3 months were included...
February 14, 2018: Hipertensión y Riesgo Vascular
https://www.readbyqxmd.com/read/29454441/the-hemodynamic-effects-of-pregnancy-on-the-lower-extremity-venous-system
#18
REVIEW
James Taylor, Caitlin W Hicks, Jennifer A Heller
OBJECTIVE: Pregnancy has significant effects on the lower extremity venous system. Increasing venous pressure and blood volume, in combination with reduced flow rates within the deep veins, predisposes pregnant women to both primary and secondary chronic venous insufficiency (CVI). This review article highlights the specific physiologic and hemodynamic changes that occur during pregnancy and examines the nonpharmacologic, pharmacologic, and invasive interventions that are appropriate for both prophylaxis and treatment of CVI and venous thromboembolism (VTE)...
March 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29454352/lower-pole-approach-in-retroperitoneal-laparoscopic-radical-nephrectomy-a-new-approach-for-the-management-of-renal-vascular-pedicle
#19
Bo Yuan, Yuantao Wang, Jialin Gao, Yongrui Zhang, Yaowen Fu, Wei An
BACKGROUND: The objective of this study was to examine the effectiveness and safety of lower pole (LP) approach in retroperitoneal laparoscopic radical nephrectomy (LRN). METHODS: One hundred thirty-two renal cancer patients were scheduled for selective retroperitoneal LRN. The surgery parameters and outcomes were compared. Out of 132 patients, 78 (59.1%) patients underwent LRN via LP approach, while 54 (40.9%) patients underwent LRN via lateroposterior space (LPS) approach...
February 17, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29452623/currently-available-radiopharmaceuticals-for-imaging-infection-and-the-holy-grail
#20
REVIEW
Ebru Salmanoglu, Sung Kim, Mathew L Thakur
Infection is ubiquitous. However, its management is challenging for both the patients and the health-care providers. Scintigraphic imaging of infection dates back nearly half a century. The advances in our understanding of the pathophysiology of disease at cellular and molecular levels have paved the way to the development of a large number of radiopharmaceuticals for scintigraphic imaging of infection. These include radiolabeling of blood elements such as serum proteins, white blood cells (WBCs), and cytokines, to name a few...
March 2018: Seminars in Nuclear Medicine
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