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Volume management

Jamie Harshman, Mélissa Roy, Robert Cartotto
Background: Good burn care starts with correct management of the burn patient prior to transfer to a burn center. The purpose of this study was to perform a systematic review of the medical literature describing pre-burn center care. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for this review. Studies were included if they were published from a burn center and they measured or evaluated any aspect of pre-burn center care of adult or pediatric acute burn patients referred to that burn center...
November 19, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Maria Teresa B C Bonanomi, Osmar C Saito, Patricia Picciarelli de Lima, Roberta Chizzotti Bonanomi, Maria Cristina Chammas
Purpose: To use color Doppler to analyze blood flow in the retrobulbar central retinal artery (CRA) and central retinal vein (CRV) in monocular retinoblastoma. Methods: This prospective study included patients with group D and E retinoblastomas managed with only enucleation. Peak blood velocities were assessed in the CRA and CRV of tumor-containing eyes (CRAv and CRVv, respectively). The resistivity index in the CRA (RIa) and pulse index in the CRV (PIv) were calculated and related to optic nerve invasion (ONi), choroid invasion (mCHi), and tumor volume...
November 1, 2018: Investigative Ophthalmology & Visual Science
Jaya Mini Gill, Janice Frost, Rachelle Park, Marlon G Saria
Venous flare reaction, a localized allergic response associated with the administration of an irritant, is one of the most common chemotherapy infusion-related reactions. Etoposide, a drug commonly used in patients with lung cancer, has been reported to be an irritant with vesicant properties depending on the volume administered. This article presents the case of a patient who has a venous flare reaction immediately following the administration of etoposide for the treatment of diffuse large B-cell lymphoma...
December 1, 2018: Clinical Journal of Oncology Nursing
Jack Kit-Chung Ng, Philip Kam-Tao Li
PURPOSE OF REVIEW: Maintaining euvolaemia is an essential yet challenging objective in management of patients on peritoneal dialysis. Optimal method to assess volume status remains to be determined. In this review, we will discuss the risk factors and clinical outcomes of fluid overload in PD patients, and examine the role of bioimpedance study in fluid management. RECENT FINDINGS: Applying bioimpedance study to measure body composition has attracted increasing attention because it is noninvasive and provides point-of-care assessment of fluid status...
November 16, 2018: Current Opinion in Nephrology and Hypertension
Joyce Chew, Ravi Mahadeva
Chronic obstructive pulmonary disease (COPD) is a complex disease and the management is focused on improving breathlessness, quality of life and healthcare utilisation. Our understanding of COPD phenotypes has improved in recent years and there is an increased drive towards delivering phenotype-based therapies. Lung volume reduction can offer the prospect of life changing benefit in breathlessness and quality of life in a select group of patients with severe emphysema already receiving maximum medical treatment...
October 2018: Journal of Thoracic Disease
R Pagoti, S O'Brien, J Blaney, E Doran, D Beverland
Background: Reduced flexion following knee arthroplasty (TKA) may compromise patient's function and outcome. The timing of manipulation under anaesthesia (MUA) has been controversial. We present our experience in a high volume practice and analyse the impact of timing. Methods: All TKA patients requiring MUA from February 1996 to June 2015 under the care of a single surgeon were analysed. MUA was offered to patients who had ≤ 75° of flexion post-op, providing that they had 30° more flexion preoperatively...
October 2018: Journal of Clinical Orthopaedics and Trauma
Victoria Chin, Stephanie Cope, Calvin Hsiung Yeh, Troy Thompson, Barto Nascimento, Katerina Pavenski, Jeannie Callum
BACKGROUND: Massive hemorrhage protocols (MHP) are critical to standardized delivery of timely, safe, and resource-effective coordinated care for patients with life-threatening bleeding. METHODS: A standardized MHP survey was sent to all hospitals (n = 150) in Ontario with a transfusion service. This study aim was to determine the proportion of hospitals with an MHP and assess for variability. RESULTS: The overall survey completion rate was 133 of 150 hospitals (89%) (remaining 17 providing negative affirmation that they did not have an MHP)...
November 12, 2018: Injury
Sudip Mondal, Ranjan Kumar Maji, Zhumur Ghosh, Sunirmal Khatua
The exponential growth of next generation sequence (NGS) data has put forward the challenge for its storage as well as its efficient and faster analysis. Storing the entire amount of data for a particular experiment and its alignment to the reference genome is an essential step for any quantitative analysis on NGS data. Here, we introduce streaming access technique 'ParStream-seq' that splits the bulk sequence data, accessed from a remote repository into short manageable packets followed by executing their alignment process in parallel in each of the compute core...
November 15, 2018: Genomics
Sonia Pathania, Larry Z Slater, Courtney Vose, Ann-Margaret Navarra
BACKGROUND: Pain can negatively affect the inpatient hospitalization experience; however, in patients with compromised metabolic pathways who are more vulnerable to medication side effects, pain control becomes even more challenging. AIMS: This evidence-based practice quality improvement project explored the feasibility of implementing a music therapy intervention for improved pain management (pain intensity, analgesic volume) and patient satisfaction among patients with a diagnosis of cirrhotic end-stage liver disease in the acute care setting...
November 15, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
P Taourel, E Pages, I Millet, C Bourgier, P Rouanet, W Jacot, P Crochet, D Azria
This review discusses the clinical applications of magnetic resonance imaging (MRI) for the assessment of neo-adjuvant chemotherapy (NAC) indication, axillary lymph node status, preNAC cancer prognosis, early and intermediate response to NAC, and post-NAC residual disease in patients with breast cancer. Contrast-enhanced MRI with analysis of the tumor morphological features and qualitative enhancement kinetics must be considered as the standard method for pre-NAC breast cancer staging and post-NAC residual disease assessment...
December 2018: Critical Reviews in Oncology/hematology
Joshua T Waltzman, James E Zins, Rafael A Couto
After massive weight loss, deflation of the tissues and loss of skin elasticity in the face and neck can result in the appearance of accelerated facial aging. Surgical facial rejuvenation can be successfully performed with several modifications. Proper preoperative counseling and expectation management regarding staged or ancillary procedures is recommended. Wide undermining of the face and neck, and extended postauricular incisions are required to allow for mobilization of excess skin and access to the mobile superficial musculoaponeurotic system (SMAS)...
January 2019: Clinics in Plastic Surgery
Victor Volovici, Ari Ercole, Giuseppe Citerio, Nino Stocchetti, Iain K Haitsma, Jilske A Huijben, Clemens M F Dirven, Mathieu van der Jagt, Ewout W Steyerberg, David Nelson, Maryse C Cnossen, Andrew I R Maas, Suzanne Polinder, David K Menon, Hester F Lingsma
Within a prospective, observational, multi-center cohort study 68 hospitals (of which 66 responded), mostly academic (n = 60, 91%) level I trauma centers (n = 44, 67%) in 20 countries were asked to complete questionnaires regarding the "standard of care" for severe neurotrauma patients in their hospitals. From the questionnaire pertaining to ICU management, 12 questions related to admission criteria were selected for this analysis. The questionnaires were completed by 66 centers. The median number of TBI patients admitted to the ICU was 92 [interquartile range (IQR): 52-160] annually...
November 8, 2018: Journal of Critical Care
Michael Back, Dasantha Jayamanne, David Brazier, Dale Bailey, Edward Hsiao, Linxin Guo, Helen Wheeler
The role of maximal surgical debulking in isocitrate dehydrogenase (IDH) mutated anaplastic glioma prior to adjuvant radiation therapy remains uncertain. This study assessed the reduction in tumour volume following intensity modulated radiation therapy (IMRT) and temozolomide in this favourable and more responsive tumour pathology. 56 patients were managed from 2011 to 2014 and 53 had residual disease. To assess radiological response, tumour volumes were created on representative T1/T2Flair MRI sequences using identical slice-levels in three planes for pre-IMRT, month + 3 and month + 12 post-IMRT scans...
November 14, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Charles E Cook, Rodrigo Lopez, Oana Stroe, Guy Cochrane, Cath Brooksbank, Ewan Birney, Rolf Apweiler
The European Bioinformatics Institute ( archives, curates and analyses life sciences data produced by researchers throughout the world, and makes these data available for re-use globally ( Data volumes continue to grow exponentially: total raw storage capacity now exceeds 160 petabytes, and we manage these increasing data flows while maintaining the quality of our services. This year we have improved the efficiency of our computational infrastructure and doubled the bandwidth of our connection to the worldwide web...
November 16, 2018: Nucleic Acids Research
David Messika-Zeitoun, Jae K Oh, Yan Topilsky, Ian G Burwash, Hector I Michelena, Maurice Enriquez Sarano
Up to 1/3 of patients with both reduced or preserved left ventricular ejection fraction (LVEF), harbor a mean pressure gradient (MPG) < 40 mm Hg (peak velocity (PV) < 4 m/sec), suggesting moderate aortic stenosis (AS) and an aortic valve area (AVA) < 1 cm2 suggesting severe AS but raising uncertainties regarding AS severity and appropriate management. In patients with reduced LVEF, increased transvalvular flow and stroke volume ≥ 20% (i.e. contractile reserve) during low-dose dobutamine echocardiography enables distinguishing patients with "true-severe AS" (severe AS with secondary LV dysfunction, PV ≥ 4 m/sec or MPG > 30-40 mm Hg at peak while AVA remains < 1 cm2 ) from patients with "pseudo-severe AS" (moderate AS with associated LV dysfunction due to ischemic or dilated cardiomyopathy, AVA at peak ≥ 1 cm2 with a MPG < 30-40 mm Hg)...
November 13, 2018: Progress in Cardiovascular Diseases
K McAdam, P Davis, L Ashmore, D Eaton, B Jakaj, A Eldridge, C Liu
There is increasing diversity of nicotine inhalation products worldwide. Next Generation Products (NGP) such as e-cigarettes, have gained mass popularity, and there is increasing use of electrical and carbon-based Tobacco-Heating Products (e-THP and c-THP respectively). Recently, emission levels from these products have been compared to conventional cigarettes (CC); however, few formal laboratory testing standards exist, and inconsistent puffing parameters have been used. We investigated the impact of how a number of NGPs, including two e-cigarettes, a carbon-heated THP, and both pulse- and continuously-heated e-THPs, are puffed on the magnitude of their emissions, examining the influence of puff profile, volume, frequency and duration, in comparison to standard CCs...
November 13, 2018: Regulatory Toxicology and Pharmacology: RTP
Tianye Lin, Zhichao Lai, Zhentao Zuo, Yuelei Lyu, Feng Feng, Hui You, Bo Hou, Jianxun Qu, Bing Wu, Changwei Liu
OBJECTIVES: Cerebral hyperperfusion (CH) could be a disastrous outcome causing complication after carotid revascularization if not managed properly and timely. The aim of this study was to investigate the association between preoperative arterial spin labelling (ASL) perfusion features and circle of Willis (CoW) pattern with CH. METHODS: Forty-eight consecutive carotid stenosis patients who underwent carotid endarterectomy (CEA) or carotid artery stenting (CAS) were enrolled...
November 15, 2018: European Radiology
Elisa Zambaiti, Federico Scottoni, Eleonora Rizzi, Simone Russo, Koichi Deguchi, Simon Eaton, Alessandro F Pellegata, Paolo De Coppi
BACKGROUND: Conditions leading to reduced gastric volume are difficult to manage and are associated to poor quality-of-life. Stomach augmentation using a tissue-engineered stomach is a potential solution to restore adequate physiology and food reservoir. Aim of this study was to evaluate the decellularisation of whole rat stomach using a detergent-enzymatic protocol. METHODS: Stomachs harvested from rats were decellularised through luminal and vascular cannulation using 24-h detergent-enzymatic treatment and completely characterized by appropriate staining, DNA and Extracellular matrix -component quantifications...
November 16, 2018: Pediatric Surgery International
Arum Park, Hyejung Chang, Kyoung Jun Lee
Objectives: This paper describes an experience of implementing seamless service trials online and offline by adopting Internet of Things (IoT) technology based on near-field communication (NFC) tags and Bluetooth low-energy (BLE) beacons. The services were provided for both patients and health professionals. Methods: The pilot services were implemented to enhance healthcare service quality, improve patient safety, and provide an effective business process to health professionals in a tertiary hospital in Seoul, Korea...
October 2018: Healthcare Informatics Research
Hye Jung Baek, Sun Eui Kim, Jong Kwang Kim, Dong Hoon Shin, Tae Hyun Kim, Kwang Gi Kim, Chu-Xia Deng, Sang Soo Kim
Despite the high incidence of BRCA1 -mutant breast cancer, few substantial improvements in preventing or treating such cancers have been made. Using a Brca1 -mutant mouse model, we examined the contribution of AKT to the incidence and growth of Brca1 -mutated mammary tumors. A haploinsufficiency of Akt1 in Brca1 -mutant mouse model significantly decreased mammary tumor formation from 54% in Brca1co/co MMTV-Cre mice to 22% in Brca1 co/co MMTV-Cre Akt1+/- mice. Notably, treatment of tumor-bearing Brca1 -mutant mice with the AKT-inhibitor, MK-2206, yielded partial response or stable disease up to 91% of mice in maximum response...
2018: International Journal of Biological Sciences
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