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https://www.readbyqxmd.com/read/29145711/timing-of-antibiotics-in-the-management-of-community-acquired-sepsis-can-a-randomised-controlled-trial-of-prehospital-therapy-provide-answers
#1
Andrew A Udy, Karen Smith, Stephen Bernard
Significant tension surrounds the application of antibiotics in suspected infection. Guidelines stress the importance of early empirical broad-spectrum therapy, with select observational data suggesting inferior outcomes when this is delayed. In contrast, microbiological resistance is an ever increasing global problem, with many advocating for a more restricted, culture-driven approach to antibiotic prescription. Controlled trial data are urgently needed, although many clinicians would find withholding of antibiotic therapy unethical...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29145553/tumour-boards-in-geriatric-oncology
#2
Tanya Marya Wildes, Anita O'Donovan, Giuseppe Ferdinando Colloca, Kwok-Leung Cheung
Multidisciplinary tumour board is an integral part of cancer treatment planning. Although no definite survival benefits have yet been shown by mostly observational studies, other benefits of multidisciplinary tumour board have been identified. Traditionally the multidisciplinary tumour board involves participation of treating clinicians-medical, radiation and surgical oncologists. They tend to focus on the cancer alone. There is an increasing awareness that the treatment goal for cancer in older adults is not primarily on prolonging survival, with functional preservation and quality of life being particularly important for this population...
November 14, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29145519/stigmatizing-attitudes-toward-people-living-with-hiv-among-general-adult-thai-population-results-from-the-5th-thai-national-health-examination-survey-nhes
#3
Kriengkrai Srithanaviboonchai, Suwat Chariyalertsak, Jiraluck Nontarak, Sawitri Assanangkornchai, Pattapong Kessomboon, Panwadee Putwatana, Surasak Taneepanichskul, Wichai Aekplakorn
BACKGROUND: HIV-related stigma and discrimination is a significant driver of the HIV and AIDS epidemic. UNAIDS encourages all nations to monitor progress toward elimination of this problem. This study measured the level of stigmatizing attitudes toward people living with HIV (PLHIV) among Thai adults in the general population using recommended global tools. METHODS: Data from the 5th National Health Examination Survey, conducted in 2014 were used. The survey utilized six questions recommended by the Global Stigma and Discrimination Indicator Working Group and was administered to participants aged 20-59 years old...
2017: PloS One
https://www.readbyqxmd.com/read/29145486/geography-of-current-and-future-global-mammal-extinction-risk
#4
Ana D Davidson, Kevin T Shoemaker, Ben Weinstein, Gabriel C Costa, Thomas M Brooks, Gerardo Ceballos, Volker C Radeloff, Carlo Rondinini, Catherine H Graham
Identifying which species are at greatest risk, what makes them vulnerable, and where they are distributed are central goals for conservation science. While knowledge of which factors influence extinction risk is increasingly available for some taxonomic groups, a deeper understanding of extinction correlates and the geography of risk remains lacking. Here, we develop a predictive random forest model using both geospatial and mammalian species' trait data to uncover the statistical and geographic distributions of extinction correlates...
2017: PloS One
https://www.readbyqxmd.com/read/29145465/hospital-associated-methicillin-resistant-staphylococcus-aureus-a-cross-sectional-analysis-of-risk-factors-in-south-african-tertiary-public-hospitals
#5
Liliwe L Shuping, Lazarus Kuonza, Alfred Musekiwa, Samantha Iyaloo, Olga Perovic
INTRODUCTION: Hospital-associated methicillin-resistant S. aureus (HA-MRSA) remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa. METHODS: We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture...
2017: PloS One
https://www.readbyqxmd.com/read/29145340/open-repair-of-intraoperative-popliteal-artery-injury-during-total-knee-arthroplasty-in-a-patient-with-severe-hemophilia-a-a-case-report-and-literature-review
#6
Bin Feng, Ke Xiao, Jiang Shao, Yu Fan, Xisheng Weng
RATIONALE: Arterial injuries during total knee arthroplasty (TKA) though rare may occur. Hemophilia may further challenge the management of such injury. PATIENT CONCERNS: A 48-year-old male patient with severe hemophilia type A and stiff knee arthropathy underwent bilateral TKAs. Left popliteal artery injury was detected at the end of the left TKA. DIAGNOSES: Urgent angiography confirmed the diagnosis of the left popliteal artery transection...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145306/dynamic-noninvasive-markers-predict-hepatocellular-carcinoma-in-chronic-hepatitis-c-patients-without-sustained-virological-response-after-interferon-based-therapy-prioritize-who-needs-urgent-direct-acting-antiviral-agents
#7
Chao-Min Huang, Tsung-Hui Hu, Kuo-Chin Chang, Po-Lin Tseng, Sheng-Nan Lu, Chien-Hung Chen, Jing-Houng Wang, Chuan-Mo Lee, Ming-Chao Tsai, Ming-Tsung Lin, Yi-Hao Yen, Chao-Hung Hung, Chung-Lung Cho, Cheng-Kun Wu
Some patients with hepatitis C virus (HCV) infections who fail to achieve sustained virological responses (SVRs) after interferon (IFN) therapy do not develop hepatocellular carcinoma (HCC). Risk stratification of these patients may help identify those who would benefit most from treatment with direct-acting antivirals (DAAs).A total of 552 HCV-infected patients with non-SVR status were enrolled. Laboratory data before and after IFN treatment were analyzed to determine the relationship of changes in serum markers with development of HCC during the 7-year study period...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145243/obstructive-internal-hernia-caused-by-mesodiverticular-bands-in-children-two-case-reports-and-a-review-of-the-literature
#8
Mirko Bertozzi, Berardino Melissa, Elisa Magrini, Giuseppe Di Cara, Susanna Esposito, Antonino Apignani
INTRODUCTION: The mesodiverticular band (MDB) is an embryologic remnant of the vitelline circulation, which carries the arterial supply to the Meckel diverticulum. In the event of an error of involution, a patent or nonpatent arterial band persists and extends from the mesentery to the apex of the antimesenteric diverticulum. This creates a snare-like opening through which bowel loops may herniate and become obstructed. This report describes 2 rare cases of small bowel occlusion owing to an internal hernia caused by a MDB...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145150/microrna-146a-knockdown-suppresses-the-progression-of-ankylosing-spondylitis-by-targeting-dickkopf-1
#9
Guijuan Di, Lingli Kong, Qing Zhao, Tao Ding
Ankylosing spondylitis (AS) seriously threatens healthy and life quality of patients, however, there is no extremely effective drug to cure the disease. Therefore, it is urgent to understand molecular basis in the progression of AS. MicroRNA-146a (miR-146a) has been demonstrated to be associated with the development of AS. However, its molecular mechanism has not been fully established. In this study, it is found that the expression levels of miR-146a and dickkopf 1 (DKK1) were respectively upregulated and downregulated in hip capsule tissues of AS patients...
November 13, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29144441/g-protein-coupled-receptors-targeted-by-analgesic-venom-peptides
#10
REVIEW
James T Daniel, Richard J Clark
Chronic pain is a complex and debilitating condition associated with a large personal and socioeconomic burden. Current pharmacological approaches to treating chronic pain such as opioids, antidepressants and anticonvulsants exhibit limited efficacy in many patients and are associated with dose-limiting side effects that hinder their clinical use. Therefore, improved strategies for the pharmacological treatment of pathological pain are urgently needed. G-protein coupled receptors (GPCRs) are ubiquitously expressed on the surface of cells and act to transduce extracellular signals and regulate physiological processes...
November 16, 2017: Toxins
https://www.readbyqxmd.com/read/29144301/contamination-levels-and-potential-sources-of-organic-pollution-in-an-asian-river
#11
Chitsan Lin, Kim Anh Nguyen, Chi Thanh Vu, Delia Senoro, Maria Ching Villanueva
The Houjing River has long been an environmental victim of economic development. Industries that have settled along the bank of this river may have largely contributed to severe organic wastes pollution. This study collected water and sediment samples at various points along the river and measured concentrations of 61 volatile organic compounds (VOCs) and 128 semi-volatile organic compounds (SVOCs) for a period of 16 months (Feb 2014-June 2015). Our analyses show that elevated levels of VOCs were observed near two industrial areas, Dashe and Renwu industrial parks...
November 2017: Water Science and Technology: a Journal of the International Association on Water Pollution Research
https://www.readbyqxmd.com/read/29143762/executive-function-capacities-negative-driving-behavior-and-crashes-in-young-drivers
#12
REVIEW
Elizabeth A Walshe, Chelsea Ward McIntosh, Daniel Romer, Flaura K Winston
Motor vehicle crashes remain a leading cause of injury and death in adolescents, with teen drivers three times more likely to be in a fatal crash when compared to adults. One potential contributing risk factor is the ongoing development of executive functioning with maturation of the frontal lobe through adolescence and into early adulthood. Atypical development resulting in poor or impaired executive functioning (as in Attention-Deficit/Hyperactivity Disorder) has been associated with risky driving and crash outcomes...
October 28, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29143719/microbial-protein-targets-towards-understanding-and-intervention
#13
Paul W Denny
The rise of antimicrobial resistance, coupled with a lack of industrial focus on antimicrobial discovery over preceding decades, has brought the world to a crisis point. With both human and animal health set to decline due to increased disease burdens caused by near untreatable microbial pathogens, there is an urgent need to identify new antimicrobials. Central to this is the elucidation of new, robustly validated, drug targets. Informed by industrial practice and concerns, the use of both biological and chemical tools in validation is key...
November 16, 2017: Parasitology
https://www.readbyqxmd.com/read/29143692/non-pharmacological-interventions-for-lewy-body-dementia-a-systematic-review
#14
Michael H Connors, Lena Quinto, Ian McKeith, Henry Brodaty, Louise Allan, Claire Bamford, Alan Thomas, John-Paul Taylor, John T O'Brien
Lewy body dementia (consisting of dementia with Lewy bodies and Parkinson's disease dementia) is a common neurodegenerative disease characterised by visual hallucinations, fluctuating attention, motor disturbances, falls, and sensitivity to antipsychotics. This combination of features presents challenges for pharmacological management. Given this, we sought to review evidence for non-pharmacological interventions with patients with Lewy body dementia and their carers. Bibliographic databases were searched using a wide range of search terms and no restrictions were placed on study design, language, or clinical setting...
November 16, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/29143477/gastric-venous-congestion-and-bleeding-in-association-with-total-pancreatectomy
#15
Akimasa Nakao, Suguru Yamada, Tsutomu Fujii, Haruyoshi Tanaka, Kenji Oshima, Yukiko Oshima, Kiyotsugu Iede, Hironobu Kobayashi, Yasunori Kimura, Yasuhiro Kodera
BACKGROUND: Gastric venous congestion and bleeding in association with total pancreatectomy (TP) were evaluated. METHODS: Thirty-eight patients of TP were retrospectively analyzed. TP was classified as TP with distal gastrectomy (TPDG), pylorus-preserving TP (PPTP), subtotal stomach-preserving TP (SSPTP), and TP with segmental duodenectomy (TPSD). RESULTS: Portal vein or superior mesenteric vein resection and reconstruction was performed in 24 patients (62...
November 16, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/29143337/intraductal-papillary-mucinous-neoplasm-of-the-pancreas-rapidly-xenografts-in-chicken-eggs-and-predicts-aggressiveness
#16
Zhefu Zhao, Nathalie Bauer, Ewa Aleksandrowicz, Libo Yin, Jury Gladkich, Wolfgang Gross, Jörg Kaiser, Thilo Hackert, Oliver Strobel, Ingrid Herr
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas has a high risk of progressing to invasive pancreatic ductal adenocarcinoma (PDA), but experimental models for IPMN are largely missing. New experimental systems for the molecular characterization of IPMN and for personalized prognosis and treatment options for IPMN are urgently needed. We analyzed the potential use of fertilized chicken eggs for the culture of freshly resected IPMN tissue. We transplanted 49 freshly resected IPMN tissues into eggs and compared the growth characteristics to IPMN tissues transplanted into mice; this was followed by an analysis of histology, morphology and marker expression...
November 16, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/29142818/shortness-of-breath-on-exertion-a-cardiac-magnetic-resonance-picture-is-worth-a-thousand-words
#17
Chrysanthos Grigoratos, Andrea Barison, Giancarlo Todiere, Giovanni Donato Aquaro
This is the case of a 78-year-old male patient that underwent a cardiac magnetic resonance (CMR) due to shortness of breath. An unanticipated diagnosis of a giant pseudoaneurysm with a "guitar-like" appearance was made and patient was sent for urgent ventriculoplasty. CMR offered striking illustrative images allowing for previously unsuspected diagnosis to be made and patient's therapeutic management modified. Moreover, in this case, we emphasize the paramount importance of differentiating between true aneurysms, pseudoaneurysms, clefts, and diverticuli since each pathology has completely different management and prognosis that vary from benign to potentially fatal if not immediately treated...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29142793/a-ruptured-extra-dural-spinal-arterio-venous-malformation-presenting-as-horner-s-syndrome-the-first-case-report
#18
Sunil Munakomi
We report the first case of a young patient who presented with the features of Horner's syndrome following a spinal extradural hematoma resulting from a ruptured arterio-venous malformation (AVM). Since there were features of early compressive myelopathy as well, urgent magnetic resonance imaging (MRI) scan of the spine revealed features suggestive of an extradural hematoma in the cervico-thoracic junction. The patient underwent an emergent laminectomy with an evacuation of the hematoma. The histological features were consistent with that of an AVM...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29142774/urgent-look-why-neurosurgeons-are-being-evaluated-primarily-by-subjective-patient-s-satisfaction-survey-rather-than-objective-neurological-outcomes
#19
R F Ghaly, A Lissounov
No abstract text is available yet for this article.
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29142744/-who-has-to-do-it-at-the-end-of-the-day-programme-officials-or-hospital-authorities-airborne-infection-control-at-drug-resistant-tuberculosis-dr-tb-centres-of-karnataka-india-a-mixed-methods-study
#20
Kibballi Madhukeshwar Akshaya, Hemant Deepak Shewade, Ottapura Prabhakaran Aslesh, Sharath Burugina Nagaraja, Abhay Subashrao Nirgude, Anil Singarajipura, Anil G Jacob
Background: Drug resistant tuberculosis (DR-TB) centers admit patients with DR-TB for initiation of treatment and thereby concentrate the patients under one setting. It becomes imperative to assess the compliance of DR-TB centres to national airborne infection control (AIC) guidelines and explore the provider perspectives into reasons for unsatisfactory compliance. Methods: This mixed methods study (triangulation design) was carried out across all the six DR-TB centers of Karnataka state, India, between November 2016 and April 2017...
2017: Antimicrobial Resistance and Infection Control
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