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https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#1
Lorenzo Ball, Federico Costantino, Giulia Orefice, Karthikka Chandrapatham, Paolo Pelosi
Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review is to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28527880/intensive-monitoring-of-urine-output-is-associated-with-increased-detection-of-acute-kidney-injury-and-improved-outcomes
#2
Kui Jin, Raghavan Murugan, Florentina E Sileanu, Emily Foldes, Priyanka Priyanka, Gilles Clermont, John A Kellum
BACKGROUND: Urine output (UO) is a vital sign for critical ill patients but standards for monitoring and reporting vary widely between ICUs. Careful monitoring of UO could lead to earlier recognition of acute kidney injury (AKI) and better fluid management. We sought to determine if intensity of UO monitoring is associated with outcomes in patients with and without AKI. METHODS: Retrospective cohort study including 15,724 adults admitted to ICUs from 2000-2008. Intensive UO monitoring was defined as hourly recordings and no gaps >3 hours for the first 48 hours after ICU admission...
May 17, 2017: Chest
https://www.readbyqxmd.com/read/28527145/an-appraisal-of-indonesia-s-immense-peat-carbon-stock-using-national-peatland-maps-uncertainties-and-potential-losses-from-conversion
#3
REVIEW
Matthew Warren, Kristell Hergoualc'h, J Boone Kauffman, Daniel Murdiyarso, Randall Kolka
BACKGROUND: A large proportion of the world's tropical peatlands occur in Indonesia where rapid conversion and associated losses of carbon, biodiversity and ecosystem services have brought peatland management to the forefront of Indonesia's climate mitigation efforts. We evaluated peat volume from two commonly referenced maps of peat distribution and depth published by Wetlands International (WI) and the Indonesian Ministry of Agriculture (MoA), and used regionally specific values of carbon density to calculate carbon stocks...
December 2017: Carbon Balance and Management
https://www.readbyqxmd.com/read/28527004/comparative-volumetric-analysis-of-the-extent-of-resection-of-molecularly-and-histologically-distinct-low-grade-gliomas-and-its-role-on-survival
#4
Chikezie I Eseonu, Francisco Eguia, Karim ReFaey, Oscar Garcia, Fausto J Rodriguez, Kaisorn Chaichana, Alfredo Quinones-Hinojosa
The authors investigate the role of extent of resection (EOR) and genetic markers on patient outcome and survival for LGGs. We conducted a retrospective cohort between 2005 and 2015, of 109 adult patients who underwent surgery for a LGG by a single surgeon. Volumetric computations of MRI studies were conducted to evaluate the EOR, and genetic markers (IDH1, 1p/19q co-deletion, and p53) were assessed and their effects on survival and neurological outcome were evaluated. The median EOR was 88.1%. Permanent postoperative neurological deficits were seen in 4...
May 19, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28526665/the-sensor-study-protocol-for-a-mixed-methods-study-of-self-management-checks-to-predict-exacerbations-of-pseudomonas-aeruginosa-in-patients-with-long-term-respiratory-conditions
#5
Claire Roberts, Thomas L Jones, Samal Gunatilake, Will Storrar, Scott Elliott, Sharon Glaysher, Ben Green, Steven Rule, Carole Fogg, Ann Dewey, Kevin A Auton, Anoop J Chauhan
BACKGROUND: There are an estimated three million people in the United Kingdom with chronic obstructive pulmonary disease (COPD), and the incidence of bronchiectasis is estimated at around 0.1% but is more common in COPD and severe asthma. Both COPD and bronchiectasis are characterized by exacerbations in which bacteria play a central role. Pseudomonas aeruginosa is isolated from sputum samples from 4% to 15% of adults with COPD and is more likely to be isolated from patients with severe disease...
May 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28525663/management-of-male-and-female-neurogenic-stress-urinary-incontinence-in-spinal-cord-injured-sci-patients-using-adjustable-continence-therapy
#6
Enrico Ammirati, Alberto Manassero, Alessandro Giammò, Roberto Carone
INTRODUCTION: Artificial urinary sphincter (AUS) is an option for the treatment of neurogenic stress urinary incontinence (nSUI), but complications and re-operation rates are high, and there is no clear indication from guidelines (1). The aim of our study is to evaluate the effectiveness of a less invasive continence device in neurogenic population: Adjustable Continence Therapy ProACT/ACT®. METHODS: We retrospectively includedpatients with spinal cord injuries in this study, complaining of nSUI and treated at our Institution with Pro-ACT/ACT® implantation...
May 16, 2017: Urologia
https://www.readbyqxmd.com/read/28524547/performance-of-a-new-generation-continuous-autotransfusion-device-including-fat-removal-and-consequences-for-quality-controls
#7
T F Seyfried, M Gruber, D Bitzinger, M T Pawlik, A Breu, B M Graf, E Hansen
BACKGROUND AND OBJECTIVES: Cell salvage plays a key role in blood conservation. To maintain high performance, quality management is recommended. Accordingly, a new-generation autotransfusion device was tested for its performance and compared with its predecessor. Two different calculations of quality parameters were applied. MATERIALS AND METHODS: In an experimental study, the continuous autotransfusion devices CATSmart and Continuous Autotransfusion System (C.A...
May 19, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28523862/transatlantic-medical-consultation-and-second-opinion-in-pediatric-cardiology-has-benefit-past-patient-care-a-case-study-in-videoconferencing
#8
Lubica Kovacikova, Martin Zahorec, Peter Skrak, Brian D Hanna, R Lee Vogel
BACKGROUND: Telemedicine is a rapidly evolving form of modern information and communication technology used to deliver clinical services and educational activities. OBJECTIVE: The aim of this article is to report and analyze our experience with transatlantic consultation via videoconferencing in pediatric cardiology. METHODS: In February, 2013, videoconferencing project was launched between a medium-volume pediatric cardiac center in Bratislava, Slovakia and subspecialty experts from a high-volume pediatric cardiac program at The Children's Hospital of Philadelphia (CHOP), USA...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28523763/proton-mr-spectroscopy-of-lesion-evolution-in-multiple-sclerosis-steady-state-metabolism-and-its-relationship-to-conventional-imaging
#9
Ivan I Kirov, Shu Liu, Assaf Tal, William E Wu, Matthew S Davitz, James S Babb, Henry Rusinek, Joseph Herbert, Oded Gonen
Although MRI assessment of white matter lesions is essential for the clinical management of multiple sclerosis, the processes leading to the formation of lesions and underlying their subsequent MRI appearance are incompletely understood. We used proton MR spectroscopy to study the evolution of N-acetyl-aspartate (NAA), creatine (Cr), choline (Cho), and myo-inositol (mI) in pre-lesional tissue, persistent and transient new lesions, as well as in chronic lesions, and related the results to quantitative MRI measures of T1-hypointensity and T2-volume...
May 19, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28521880/pharmacokinetics-of-oral-hydrocortisone-results-and-implications-from-a-randomized-controlled-trial
#10
Jorien Werumeus Buning, Daan J Touw, Pauline Brummelman, Robin P F Dullaart, Gerrit van den Berg, Melanie M van der Klauw, Jasper Kamp, Bruce H R Wolffenbuttel, André P van Beek
CONTEXT AND OBJECTIVE: This study aimed at comparing pharmacokinetics of two different doses of hydrocortisone (HC) in patients with secondary adrenal insufficiency (SAI). DESIGN, SETTING AND PATIENTS: Forty-six patients with SAI participated in this randomized double-blind crossover study. INTERVENTION: Patients received two different doses of HC (0.2-0.3mg HC/kg body weight/day and 0.4-0.6mg HC/kg body weight/day). MAIN OUTCOME MEASURES: One- and two-compartment population models for plasma free cortisol, plasma total cortisol and salivary cortisol were parameterized...
June 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28521839/associations-between-systemic-bone-mineral-density-and-early-knee-cartilage-changes-in-middle-aged-adults-without-clinical-knee-disease-a-prospective-cohort-study
#11
Andrew J Teichtahl, Yuanyuan Wang, Anita E Wluka, Boyd J Strauss, Joseph Proietto, John B Dixon, Graeme Jones, Flavia M Cicuttini
BACKGROUND: Osteoarthritis has a high prevalence in people with high bone mineral density (BMD). Nevertheless, whether high systemic BMD predates early structural features of knee osteoarthritis is unclear. This study examined the association between systemic BMD and knee cartilage defect progression and cartilage volume loss in middle-aged people without clinical knee disease. METHODS: Adults (n = 153) aged 25-60 years had total body, lumbar spine, and total hip BMD assessed by dual-energy X-ray absorptiometry at baseline (2005-2008), and tibial cartilage volume and tibiofemoral cartilage defects assessed by magnetic resonance imaging at baseline and follow up (2008-2010)...
May 18, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28520803/multiple-modality-biomarker-prediction-of-cognitive-impairment-in-prospectively-followed-de-novo-parkinson-disease
#12
Chelsea Caspell-Garcia, Tanya Simuni, Duygu Tosun-Turgut, I-Wei Wu, Yu Zhang, Mike Nalls, Andrew Singleton, Leslie A Shaw, Ju-Hee Kang, John Q Trojanowski, Andrew Siderowf, Christopher Coffey, Shirley Lasch, Dag Aarsland, David Burn, Lana M Chahine, Alberto J Espay, Eric D Foster, Keith A Hawkins, Irene Litvan, Irene Richard, Daniel Weintraub
OBJECTIVES: To assess the neurobiological substrate of initial cognitive decline in Parkinson's disease (PD) to inform patient management, clinical trial design, and development of treatments. METHODS: We longitudinally assessed, up to 3 years, 423 newly diagnosed patients with idiopathic PD, untreated at baseline, from 33 international movement disorder centers. Study outcomes were four determinations of cognitive impairment or decline, and biomarker predictors were baseline dopamine transporter (DAT) single photon emission computed tomography (SPECT) scan, structural magnetic resonance imaging (MRI; volume and thickness), diffusion tensor imaging (mean diffusivity and fractional anisotropy), cerebrospinal fluid (CSF; amyloid beta [Aβ], tau and alpha synuclein), and 11 single nucleotide polymorphisms (SNPs) previously associated with PD cognition...
2017: PloS One
https://www.readbyqxmd.com/read/28520651/laparoscopic-management-of-hepatocellular-carcinoma-a-critical-reappraisal
#13
David Fuks, Luca Aldrighetti, Long R Jiao, Go Wakabayashi, Paolo Limongelli
Following the introduction of the first laparoscopic liver resection, after ∼25 years, a critical reappraisal seems to be warranted. Liver resection represents the first choice for curing early hepatocellular carcinoma (HCC) allowing a curative chance also in selected patients with intermediate stage tumors. The criteria for liver resectability by laparoscopy remains the same for open surgery, which is oncological criteria (absence of extrahepatic tumor location; completely resectable R0 resection), anatomic (resectability of involved segment with its own blood surely and biliary drainage; absence of vascular invasion of portal or hepatic veins) and technical (possibility to leave in place a residual volume ≥40%)...
May 17, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28517046/three-dimensional-proximal-flow-convergence-automatic-calculation-for-determining-mitral-valve-area-in-rheumatic-mitral-stenosis
#14
Francisco Sampaio, Ricardo Ladeiras-Lopes, João Almeida, Paulo Fonseca, Ricardo Fontes-Carvalho, José Ribeiro, Vasco Gama
PURPOSE: Management of patients with mitral stenosis (MS) depends heavily on the accurate quantification of mitral valve area (MVA) using echocardiography. All currently used two-dimensional (2D) methods have limitations. Estimation of MVA using the proximal isovelocity surface area (PISA) method with real time three-dimensional (3D) echocardiography may circumvent those limitations. We aimed to evaluate the accuracy of 3D direct measurement of PISA in the estimation of MVA. METHODS: Twenty-seven consecutive patients (median age of 63 years; 77...
May 18, 2017: Echocardiography
https://www.readbyqxmd.com/read/28516364/preserving-normal-facial-nerve-function-and-improving-hearing-outcome-in-large-vestibular-schwannomas-with-a-combined-approach-planned-subtotal-resection-followed-by-gamma-knife-radiosurgery
#15
Roy Thomas Daniel, Constantin Tuleasca, Mercy George, Etienne Pralong, Luis Schiappacasse, Michele Zeverino, Raphael Maire, Marc Levivier
OBJECTIVE: To perform planned subtotal resection followed by gamma knife surgery (GKRS) in a series of patients with large vestibular schwannoma (VS), aiming at an optimal functional outcome for facial and cochlear nerves. METHODS: Patient characteristics, surgical and dosimetric features, and outcome were collected prospectively at the time of treatment and during the follow-up. RESULTS: A consecutive series of 32 patients was treated between July 2010 and June 2016...
May 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28516313/dynamic-changes-in-aortic-impedance-after-transcatheter-aortic-valve-replacement-and-its-impact-on-exploratory-outcome
#16
Yukari Kobayashi, Juyong B Kim, Kegan J Moneghetti, Yuhei Kobayashi, Ran Zhang, Daniel A Brenner, Ryan O'Malley, Ingela Schnittger, Michael Fischbein, D Craig Miller, Alan C Yeung, David Liang, Francois Haddad, William F Fearon
Valvulo-arterial impedance (Zva) has been shown to predict worse outcome in medically managed aortic stenosis (AS) patients. We aimed to investigate the association between Zva and left ventricular (LV) adaptation and to explore the predictive value of Zva for cardiac functional recovery and outcome after transcatheter aortic valve replacement (TAVR). We prospectively enrolled 128 patients with AS who underwent TAVR. Zva was calculated as: (systolic blood pressure + mean transaortic gradient)/stroke volume index)...
May 17, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28514841/endoscopic-management-of-pancreatic-fluid-collections-in-children
#17
REVIEW
Zaheer Nabi, Rupjyoti Talukdar, D Nageshwar Reddy
The incidence of acute pancreatitis in children has increased over the last few decades. The development of pancreatic fluid collection is not uncommon after severe acute pancreatitis, although its natural course in children and adolescents is poorly understood. Asymptomatic fluid collections can be safely observed without any intervention. However, the presence of clinically significant symptoms warrants the drainage of these fluid collections. Endoscopic management of pancreatic fluid collection is safe and effective in adults...
May 19, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28513902/prospective-analysis-of-radiation-oncology-image-and-plan-driven-peer-review-for-head-and-neck-cancer
#18
Sakellarios Zairis, Danielle N Margalit, Trevor J Royce, William D Powlis, Roy B Tishler, Jonathan D Schoenfeld
BACKGROUND: Departmental "chart rounds" is an established form of review in radiation oncology, however, evidence is lacking that identifies links between features of a more subspecialized disease site-specific review and the likelihood and characteristics of recommendations made. We prospectively analyzed our head and neck group's review process to identify associations that could guide future practice. METHODS: Our group reviewed proposed management and treatment volumes for radiation simulated patients on a weekly basis, and we collected data encompassing recommendations made by individuals or group consensus...
May 17, 2017: Head & Neck
https://www.readbyqxmd.com/read/28512558/fdg-pet-scan-a-new-paradigm-for-follicular-lymphoma-management
#19
REVIEW
Andrea Gallamini, Anna Borra
In the present review, the reader will be led to the most relevant observations that prompted oncologists and haematologist to consider FDG-PET/CT as a new paradigm for FL management in clinical practice. The role of functional imaging in lymphoma staging, restaging, prognostication, and metabolic tumour volume computing will be reviewed in detail. Moreover, a special focus will be addressed to technical and practical aspects of PET scan reporting, which have been set during the last decade to ensure the reproducibility of the therapeutic results...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28512089/physician-age-and-outcomes-in-elderly-patients-in-hospital-in-the-us-observational-study
#20
Yusuke Tsugawa, Joseph P Newhouse, Alan M Zaslavsky, Daniel M Blumenthal, Anupam B Jena
Objectives To investigate whether outcomes of patients who were admitted to hospital differ between those treated by younger and older physicians.Design Observational study.Setting US acute care hospitals.Participants 20% random sample of Medicare fee-for-service beneficiaries aged ≥65 admitted to hospital with a medical condition in 2011-14 and treated by hospitalist physicians to whom they were assigned based on scheduled work shifts. To assess the generalizability of findings, analyses also included patients treated by general internists including both hospitalists and non-hospitalists...
May 16, 2017: BMJ: British Medical Journal
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