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Background Long-term treatment with supplemental oxygen has unknown efficacy in patients with stable chronic obstructive pulmonary disease (COPD) and resting or exercise-induced moderate desaturation. Methods We originally designed the trial to test whether long-term treatment with supplemental oxygen would result in a longer time to death than no use of supplemental oxygen among patients who had stable COPD with moderate resting desaturation (oxyhemoglobin saturation as measured by pulse oximetry [Spo2], 89 to 93%)...
October 27, 2016: New England Journal of Medicine
Eva Wiberg-Itzel, Andrea B Pembe, Hans Järnbert-Pettersson, Margareta Norman, Anna-Carin Wihlbäck, Irene Hoesli, Monya Todesco Bernasconi, Elie Azria, Helena Åkerud, Elisabet Darj
BACKGROUND: One of the major complications related to delivery is labor dystocia, or an arrested labor progress. Many dystocic deliveries end vaginally after administration of oxytocin, but a large numbers of women with labor dystocia will undergo a long and unsafe parturition. As a result of the exertion required in labor, the uterus produces lactate. The uterine production of lactate is mirrored by the level of lactate in amniotic fluid (AFL). OBJECTIVES: To evaluate whether the level of AFL, analysed in a sample of amniotic fluid collected vaginally at arrested labor when oxytocin was needed, could predict labor outcome in nulliparous deliveries...
2016: PloS One
Fernando J Martinez, David Mannino, Nancy Kline Leidy, Karen G Malley, Elizabeth D Bacci, R Graham Barr, Russ P Bowler, MeiLan K Han, Julia F Houfek, Barry Make, Catherine A Meldrum, Stephen Rennard, Byron Thomashow, John Walsh, Barbara P Yawn
OBJECTIVE: Develop a method for identifying undiagnosed COPD requiring treatment with currently available therapies (FEV1 <60% predicted and/or exacerbation risk). METHODS: Multi-site, cross-sectional, case-control study in U.S. pulmonary and primary care clinics that recruited subjects from primary care settings. CASES: COPD and ≥ 1 exacerbation past year or FEV1 <60% predicted without exacerbation past year. CONTROLS: No COPD or mild COPD (FEV1 ≥ 60% predicted, no exacerbation past year)...
October 26, 2016: American Journal of Respiratory and Critical Care Medicine
Paul Oxley, Joseph Wihbey
We provide experimental and theoretical details of a simple technique to determine absolute line-of-sight integrated atomic beam densities based on resonant laser absorption. In our experiments, a thermal lithium beam is chopped on and off while the frequency of a laser crossing the beam at right angles is scanned slowly across the resonance transition. A lock-in amplifier detects the laser absorption signal at the chop frequency from which the atomic density is determined. The accuracy of our experimental method is confirmed using the related technique of wavelength modulation spectroscopy...
September 2016: Review of Scientific Instruments
Fujian Ji, Xuedong Fang, Junnan Jiang, Yuanyu Wu, Ye Feng, Huiling Guo
OBJECTIVE: To evaluate the value of en-bloc mesogastric excision (EME) in the treatment of advanced gastric cancer. METHODS: A retrospective analysis on clinical data of 98 gastric cancer patients who underwent total gastrectomy in China-Japan Union Hospital of Jilin University from January 2013 to December 2015 was carried out, including EME group of 48 cases (according to the mesangial space) and D2 radical group of 50 cases(D2 lymphadenectomy according to the vascular markers)...
October 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
R DeRossi, R C Pagliosa, A Q de Carvalho, G G Macedo, L C Hermeto
Six healthy, female, mixed-breed 18-24-month-old sheep weighing 30-48 kg were submitted to lumbosacral epidural bupivacaine in combination with either methadone or fentanyl. Epidural catheters were placed in six sheep that were given three treatments: (Bup) bupivacaine (0.5 mg/kg) alone; (BupMet) bupivacaine (0.25 mg/kg) plus methadone (0.3 mg/kg); and (BupFent) bupivacaine (0.25 mg/kg) plus fentanyl (0.002 mg/kg). Haemodynamic variables, respiratory rate, rectal temperature, analgesia by applying a standard painful stimulus, motor block and sedative scores were compared among the three treatments...
October 25, 2016: Veterinary Record
Jayantee Kalita, Sanjeev K Bhoi, Usha K Misra
BACKGROUND: Sensitization and impaired habituation of cortical neurons have been reported in migraineurs. Repetitive transcranial magnetic stimulation (rTMS) may change these phenomena and be the basis of therapeutic response. We report the effect of 10 Hz rTMS on sensitization and habituation of median somatosensory evoked potential (SEP) in migraineurs, and correlate these changes with clinical response. METHODS: Migraineurs having four or more episodes of headache per month were included and their clinical details were noted...
October 25, 2016: Cephalalgia: An International Journal of Headache
Thomas Sproat, Richard Hearn, Sundeep Harigopal
OBJECTIVE: Current resuscitation guidelines suggest that it is reasonable to consider stopping resuscitation where no heart rate (cardiac activity) has been detected for 10 min in a newborn baby from birth. We aimed to determine the mortality rate and 2-year neurodevelopmental outcome of all babies born with no heart rate before 10 min of age where resuscitation was attempted in a tertiary referral centre over a 5-year period. DESIGN: To identify all babies with no heart rate before age 10 min we examined two groups:▸ All babies classified as live born who received cardiac massage at birth between January 2009 and December 2013...
October 25, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Katherine Croft, Patricia J Mattingly, Patrick Bosse, R Wendel Naumann
STUDY OBJECTIVE: To determine if educating surgeons about their controllable instrumentation costs by providing cost data for total laparoscopic hysterectomy (LH) would reduce the cost of this procedure. DESIGN: Prospective Cohort Study. DESIGN: Classification: Level III Evidence SETTING: Academic affiliated community hospital. PATIENTS: Patients undergoing LH between April 2014 and March 2015 with surgeons who performed at least 10 LHs in that time period and a second group who had undergone LH with the same cohort of surgeons from July 2015 to September 2015...
October 22, 2016: Journal of Minimally Invasive Gynecology
Joohyun Kim, Tae Kim, Kwan Soo Hong, Hyeyoung Moon, In-Kyung Oh, Sang Mok Lee, Mark D Hohenwalter, Michael A Zimmerman, David C Cronin, Johnny C Hong
BACKGROUND: Gadoxetic acid is a liver-specific intravenous T1 magnetic resonance (MR) contrast agent that is excreted via the hepatobiliary system. We hypothesize that hepatocyte expressions of bile transporters (OATP1 and MRP2) correlate with dynamic profile of Gadoxetic acid enhanced (GE)-MR imaging (MRI). METHODS: Two groups of rats, control (n = 6) and cirrhosis (n = 12), received gadoxetic acid enhanced MRI followed by 70% hepatectomy. The change in MR signal intensity from the baseline before the contrast injection (ΔSI) was analyzed every minute for 30 min...
October 26, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Ethan Frank, Joshua Park, Alfred Simental, Christopher Vuong, Yuan Liu, Daniel Kwon, Yi Lin, Pedro Andrade Filho
Minimally invasive video-assisted thyroidectomy (MIVAT) has gained acceptance as an alternative to conventional thyroidectomy. This technique results in less bleeding, postoperative pain, shorter recovery time, and better cosmetic results without increasing morbidity. We retrospectively assessed outcomes in 583 patients having MIVAT from May 2005 to September 2014. The study population was divided into groups according to periods: 2005 to 2009 and 2010 to 2014. Operative data, complications, and length of stay were collected and compared...
October 2016: American Surgeon
Ho Yong Choi, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
STUDY DESIGN: Retrospective case series. OBJECTIVE: To evaluate and compare the surgical, radiographic, and clinical outcomes of pedicle subtraction osteotomy (PSO) according to surgeon's experience. SUMMARY OF BACKGROUND DATA: Although PSO has been widely used to correct spinal deformities, it still remains technically demanding procedure with high complications. METHODS: Comparative analysis of 40 consecutive patients treated with lumbar PSOs was performed...
October 24, 2016: Spine
K Ravi, D M Geno, M F Vela, M D Crowell, D A Katzka
BACKGROUND: Baseline impedance measured with ambulatory impedance pH monitoring (MII-pH) and a mucosal impedance catheter detects gastroesophageal reflux disease (GERD). However, these tools are limited by cost or patient tolerance. We investigated whether baseline impedance measured during high-resolution impedance manometry (HRIM) distinguishes GERD patients from controls. METHODS: Consecutive patients with clinical HRIM and MII-pH testing were identified. Gastroesophageal reflux disease was defined by esophageal pH <4 for ≥5% of both the supine and total study time, whereas controls had an esophageal pH <4 for ≤3% of the study performed off PPI...
October 24, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
B Büttner, A Mansur, M Bauer, J Hinz, I Bergmann
Unilateral spinal anesthesia is a cost-effective and rapidly performed anesthetic technique. An exclusively unilateral block only affects the sensory, motor and sympathetic functions on one side of the body and offers the advantages of a spinal block without the typical adverse side effects seen with a bilateral block. The lack of hypotension, in particular, makes unilateral spinal anesthesia suitable for patients with cardiovascular risk factors e. g. aortic valve stenosis or coronary artery disease. Increasing numbers of surgical procedures are now being performed on an outpatient basis...
October 24, 2016: Der Anaesthesist
Ute Blassmann, Anka C Roehr, Otto R Frey, Cornelia Vetter-Kerkhoff, Niklas Thon, William Hope, Josef Briegel, Volker Huge
BACKGROUND: Ventriculitis is a complication of temporary intraventricular drains. The limited penetration of meropenem into the cerebrospinal fluid (CSF) is well known. However, ventricular CSF pharmacokinetic data in patients with ventriculitis are lacking. The aim of this study was to evaluate meropenem pharmacokinetics in the serum and CSF of neurocritical care patients with proven or suspected ventriculitis. METHODS: We conducted an observational pharmacokinetic study of neurocritical care patients with proven or suspected ventriculitis receiving meropenem...
October 24, 2016: Critical Care: the Official Journal of the Critical Care Forum
Natalia Sanchez-Aguadero, Luis Garcia-Ortiz, Maria C Patino-Alonso, Sara Mora-Simon, Manuel A Gomez-Marcos, Rosario Alonso-Dominguez, Benigna Sanchez-Salgado, Jose I Recio-Rodriguez
BACKGROUND: Postprandial glycaemic response affects cognitive and vascular function. The acute effect of breakfast glycaemic index on vascular parameters is not sufficiently known. Also, the influence of breakfasts with different glycaemic index on cognitive performance has been mostly studied in children and adolescents with varying results. Therefore, the purpose of this study is to analyse the postprandial effect of high and low glycaemic index breakfasts on vascular function and cognitive performance and their relationship with postprandial glycaemic response in healthy young adults...
October 24, 2016: Trials
Marc Argilés, Genís Cardona, Elisabet Pérez-Cabré, Ramon Pérez-Magrané, Bernardo Morcego, Joan Gispets
PURPOSE: To develop and test the sensitivity of an ultrasound-based sensor to assess the viewing distance of visual display terminals operators in real-time conditions. METHODS: A modified ultrasound sensor was attached to a computer display to assess viewing distance in real time. Sensor functionality was tested on a sample of 20 healthy participants while they conducted four 10-minute randomly presented typical computer tasks (a match-three puzzle game, a video documentary, a task requiring participants to complete a series of sentences, and a predefined internet search)...
October 22, 2016: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Dallas M Smuin, William L Hennrikus
BACKGROUND: The pucker sign, also called skin tenting, indicates significant displacement of the supracondylar fracture and can be a cause for alarm. The purpose of this study is to compare a cohort of patients with type III supracondylar fractures presenting with a pucker sign to a group without a pucker sign by evaluating neurovascular injury at presentation, need for open reduction, persistent neurovascular injury, range of motion, and carrying angle at final follow-up. METHODS: A retrospective review was performed for Gartland type III extension type supracondylar fractures...
October 21, 2016: Journal of Pediatric Orthopedics
Patrick J McCormick, Matthew A Levin, Hung-Mo Lin, Daniel I Sessler, David L Reich
BACKGROUND: We tested the hypothesis that an electronic alert for a "double low" of mean arterial pressure less than 75 mmHg and a bispectral index less than 45 reduces the primary outcome of 90-day mortality. METHODS: Adults having noncardiac surgery were randomized to receive either intraoperative alerts for double-low events or no alerts. Anesthesiologists were not blinded and not required to alter care based upon the alerts. The primary outcome was all-cause 90-day mortality...
October 24, 2016: Anesthesiology
Hiroaki Iwata, Mayumi Kamaguchi, Hideyuki Ujiie, Machiko Nishimura, Kentaro Izumi, Ken Natsuga, Satoru Shinkuma, Wataru Nishie, Hiroshi Shimizu
Macropinocytosis is an endocytic pathway that is involved in the nonselective fluid uptake of extracellular fluid. Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease associated with autoantibodies to type XVII collagen (COL17), which is a component of hemidesmosome. When keratinocytes are treated with BP-IgG, COL17 internalizes into cells by way of the macropinocytosis. We investigated the mechanism of COL17 macropinocytosis using DJM-1 cells, a cutaneous squamous cell carcinoma cell line...
October 24, 2016: Laboratory Investigation; a Journal of Technical Methods and Pathology
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