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https://www.readbyqxmd.com/read/28533665/new-flexible-endoscopic-controlled-stapler-technique-for-the-treatment-of-zenker-s-diverticulum-a-case-series
#1
Johanna Wilmsen, Robert Baumbach, Dietmar Stüker, Vincens Weingart, Frank Neser, Stefan Karl Gölder, Christof Pfundstein, Ellen Claudia Nötzel, Thomas Rösch, Siegbert Faiss
AIM: To report about the combination and advantages of a stapler-assisted diverticulotomy performed by flexible endoscopy. METHODS: From November 2014 till December 2015 17 patients (8 female, 9 male, average age 69.8 years) with a symptomatic Zenker diverticulum (mean size 3.5 cm) were treated by inserting a new 5 mm fully rotatable surgical stapler (MicroCutter30 Xchange, Cardica Inc.) next to an ultrathin flexible endoscope through an overtube. The Patients were under conscious sedation with the head reclined in left position, the stapler placed centrally and pushed forward to the bottom of the diverticulum...
May 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28512046/risk-factors-for-preoperative-seizures-and-loss-of-seizure-control-in-patients-undergoing-surgery-for-metastatic-brain-tumors
#2
Adela Wu, Jon D Weingart, Gary L Gallia, Michael Lim, Henry Brem, Chetan Bettegowda, Kaisorn L Chaichana
OBJECTIVE: Metastatic brain tumors are the most common brain tumors in adults. Patients with metastatic brain tumors have poor prognoses with median survival of 6-12 months. Seizures are a major presenting symptom and cause of morbidity and mortality. Risk factors for the onset of preoperative seizures and postoperative seizure control are examined. METHODS: Adult patients who underwent resection of one or more brain metastases at a single institution between 1998 and 2011 were retrospectively reviewed...
May 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28467753/the-effect-of-mantram-repetition-on-burnout-and-stress-among-va-staff
#3
Sheryl Leary, Kimberly Weingart, Robert Topp, Jill Bormann
In this study, the authors determined the effect of a structured Internet-delivered Mantram Repetition Program (MRP) on burnout and stress of conscience (SOC), stress related to ambiguity from ethical or moral conflicts among health care workers (HCWs) within the Veteran Affairs (VA) Healthcare System. A secondary purpose was to determine whether practicing meditation prior to the study combined with MRP affected burnout or SOC. The MRP teaches the mindful practices of repeating a mantram, slowing down, and one-pointed attention for managing stress...
May 1, 2017: Workplace Health & Safety
https://www.readbyqxmd.com/read/28460863/psychological-skills-to-improve-emergency-care-providers-performance-under-stress
#4
Michael J Lauria, Isabelle A Gallo, Stephen Rush, Jason Brooks, Rory Spiegel, Scott D Weingart
Stress experienced by emergency medical providers during the resuscitation of critically ill or injured patients can cause cognitive and technical performance to deteriorate. Psychological skills training offers a reasonable and easily implemented solution to this problem. In this article, a specific set of 4 performance-enhancing psychological skills is introduced: breathe, talk, see, and focus. These skills comprise breathing techniques, positive self-talk, visualization or mental practice, and implementing a focus "trigger word...
April 28, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28378024/examining-perceptions-of-computerized-physician-order-entry-in-a-neonatal-intensive-care-unit
#5
Kristyn S Beam, Megan Cardoso, Megan Sweeney, Geoff Binney, Saul N Weingart
BACKGROUND: Computerized provider order entry (CPOE) is a technology with potential to transform care delivery. While CPOE systems have been studied in adult populations, less is known about the implementation of CPOE in the neonatal intensive care unit (NICU) and perceptions of nurses and physicians using the system. OBJECTIVE: To examine perceptions of clinicians before and after CPOE implementation in the NICU of a pediatric hospital. METHODS: A cross-sectional survey of clinicians working in a Level III NICU was conducted...
April 5, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28359843/it-takes-a-village-to-raise-a-branch-cellular-mechanisms-of-the-initiation-of-axon-collateral-branches
#6
REVIEW
Lorena Armijo-Weingart, Gianluca Gallo
The formation of axon collateral branches from the pre-existing shafts of axons is an important aspect of neurodevelopment and the response of the nervous system to injury. This article provides an overview of the role of the cytoskeleton and signaling mechanisms in the formation of axon collateral branches. Both the actin filament and microtubule components of the cytoskeleton are required for the formation of axon branches. Recent work has begun to shed light on how these two elements of the cytoskeleton are integrated by proteins that functionally or physically link the cytoskeleton...
March 27, 2017: Molecular and Cellular Neurosciences
https://www.readbyqxmd.com/read/28348753/delayed-recognition-of-fatal-invasive-meningococcal-disease-in-adults
#7
Frederick W Nagel, Ifeoma Ezeoke, Mike Antwi, Paula E Del Rosso, Marie Dorsinville, Beth M Isaac, Althea Hayden, Robert S Hoffman, Scott D Weingart, Don Weiss
INTRODUCTION: Invasive meningococcal disease can be difficult to detect early in its course when patients may appear well and the severity of their illness is obscured by non-specific complaints. CASE PRESENTATION: We report five cases of meningococcal sepsis in adult patients who presented to an emergency department early in the course of their disease, but whose severity of illness was not recognized. CONCLUSION: Suspicion of meningococcal sepsis should be heightened in the setting of hypotension, tachycardia, elevated shock index, leukopaenia with left shift, thrombocytopaenia and hypokalaemia, prompting early sepsis care...
June 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28334584/delayed-workup-of-rectal-bleeding-in-adult-primary-care-examining-process-of-care-failures
#8
Saul N Weingart, Elena M Stoffel, Daniel C Chung, Thomas D Sequist, Ruth I Lederman, Stephen R Pelletier, Helen M Shields
BACKGROUND: Although delayed colorectal cancer diagnoses figure prominently in medical malpractice claims, little is known about the quality of primary care clinicians' workup of rectal bleeding. METHODS: In this study, 438 patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for rectal bleeding, hemorrhoids, and blood in the stool at 10 Boston adult primary care practices. Following nurse chart abstraction, physician reviewers assessed the overall quality of care and key care processes...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28143726/metastatic-atypical-and-anaplastic-meningioma-a-case-series-and-review-of-the-literature
#9
Remi A Kessler, Tomas Garzon-Muvdi, Wuyang Yang, Jon Weingart, Alessandro Olivi, Judy Huang, Henry Brem, Michael Lim
BACKGROUND: Atypical (World Health Organization grade II) and anaplastic (World Health Organization grade III) meningiomas are rare, accounting for less than 5% of all meningiomas. Histologic grading has a significant impact on prognosis, risk of recurrence, and the need for adjuvant radiation or chemotherapy. Extracranial metastases are even more infrequent and occur in 0.1% of all cases. METHODS: Retrospective chart review of 168 patients with diagnosis of WHO grade II and III meningiomas was performed...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28137795/structure-and-function-of-the-piua-and-pira-siderophore-drug-receptors-from-pseudomonas-aeruginosa-and-acinetobacter-baumannii
#10
Lucile Moynié, Alexandre Luscher, Dora Rolo, Daniel Pletzer, Antoni Tortajada, Helge Weingart, Yvonne Braun, Malcolm G P Page, James H Naismith, Thilo Köhler
The outer membrane of Gram-negative bacteria presents an efficient barrier to the permeation of antimicrobial molecules. One strategy pursued to circumvent this obstacle is to hijack transport systems for essential nutrients, such as iron. BAL30072 and MC-1 are two monobactams conjugated to a dihydroxypyridone siderophore that are active against Pseudomonas aeruginosa and Acinetobacter baumannii Here, we investigated the mechanism of action of these molecules in A. baumannii We identified two novel TonB-dependent receptors, termed Ab-PiuA and Ab-PirA, that are required for the antimicrobial activity of both agents...
April 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28110990/quick-sofa-scores-predict-mortality-in-adult-emergency-department-patients-with-and-without-suspected-infection
#11
Adam J Singer, Jennifer Ng, Henry C Thode, Rory Spiegel, Scott Weingart
STUDY OBJECTIVE: The Quick Sequential Organ Failure Assessment (qSOFA) score (composed of respiratory rate ≥22 breaths/min, systolic blood pressure ≤100 mm Hg, and altered mental status) may identify patients with infection who are at risk of complications. We determined the association between qSOFA scores and outcomes in adult emergency department (ED) patients with and without suspected infection. METHODS: We performed a single-site, retrospective review of adult ED patients between January 2014 and March 2015...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28102730/alloimmunisation-in-transfused-patients-serial-cross-matching-in-a-population-of-hospitalised-cats
#12
Layla Hourani, Christiane Weingart, Barbara Kohn
Objectives Cross-matching is currently recommended as part of pre-transfusion testing for repeat transfusions in cats 4 days after having received an initial transfusion. This prospective study determined when and if cats developed positive cross-match (CM) results after having been transfused with AB-compatible blood. Methods Donors were selected according to standard transfusion safety protocols. Twenty-one hospitalised anaemic recipients (blood type A: n = 20; blood type B: n = 1) received 1-4 (median 2) whole-blood transfusions (WBTs) over 1-6 days (median 2) in 33 transfusion instances...
January 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28095173/performance-of-a-trigger-tool-for-identifying-adverse-events-in-oncology
#13
Allison Lipitz-Snyderman, David Classen, David Pfister, Aileen Killen, Coral L Atoria, Elizabeth Fortier, Andrew S Epstein, Christopher Anderson, Saul N Weingart
PURPOSE: Although patient safety is a priority in oncology, few tools measure adverse events (AEs) beyond treatment-related toxicities. The study objective was to assemble a set of clinical triggers in the medical record and assess the extent to which triggered events identified AEs. METHODS: We performed a retrospective cohort study to assess the performance of an oncology medical record screening tool at a comprehensive cancer center. The study cohort included 400 patients age 18 years or older diagnosed with breast (n = 128), colorectal (n = 136), or lung cancer (n = 136), observed as in- and outpatients for up to 1 year...
March 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28091521/mechanisms-of-intrinsic-resistance-and-acquired-susceptibility-of-pseudomonas-aeruginosa-isolated-from-cystic-fibrosis-patients-to-temocillin-a-revived-antibiotic
#14
Hussein Chalhoub, Daniel Pletzer, Helge Weingart, Yvonne Braun, Michael M Tunney, J Stuart Elborn, Hector Rodriguez-Villalobos, Patrick Plésiat, Barbara C Kahl, Olivier Denis, Mathias Winterhalter, Paul M Tulkens, Françoise Van Bambeke
The β-lactam antibiotic temocillin (6-α-methoxy-ticarcillin) shows stability to most extended spectrum β-lactamases, but is considered inactive against Pseudomonas aeruginosa. Mutations in the MexAB-OprM efflux system, naturally occurring in cystic fibrosis (CF) isolates, have been previously shown to reverse this intrinsic resistance. In the present study, we measured temocillin activity in a large collection (n = 333) of P. aeruginosa CF isolates. 29% of the isolates had MICs ≤ 16 mg/L (proposed clinical breakpoint for temocillin)...
January 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/27925145/the-oldest-old-in-the-emergency-department-impact-of-renal-function
#15
T Brünnler, M Drey, G Dirrigl, C Weingart, F Rockmann, C Sieber, U Hoffmann
OBJECTIVES: The ageing population implicates an increasing numbers of older adults attending Emergency Departments (ED). We assessed the effect of estimated glomerular filtration rate as a predictor of clinical outcomes in oldest-old patients ≥ 85 years attending the ED in an university teaching hospital. DESIGN: Within three years, 81831 patient contacts were made in our ED. 7799 (9.5%) were older than 85 years, in whom we analyzed the impact of renal function on various outcome parameters...
2016: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/27908335/the-past-present-and-future-of-the-centers-for-medicare-and-medicaid-services-quality-measure-sep-1-the-early-management-bundle-for-severe-sepsis-septic-shock
#16
REVIEW
Jeremy S Faust, Scott D Weingart
SEP-1, the new national quality measure on sepsis, resulted from an undertaking to standardize care for severe sepsis and septic shock regardless of the size of the emergency department where the patient is being treated. SEP-1 does not necessarily follow the best current evidence available. Nevertheless, a thorough understanding of SEP-1 is crucial because all hospitals and emergency providers will be accountable for meeting the requirements of this measure. SEP-1 is the first national quality measure on early management of sepsis care...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27743862/nerve-cell-mimicking-liposomes-as-biosensor-for-botulinum-neurotoxin-complete-physiological-activity
#17
Oliver G Weingart, Martin J Loessner
Botulinum neurotoxins (BoNT) are the most toxic substances known, and their neurotoxic properties and paralysing effects are exploited for medical treatment of a wide spectrum of disorders. To accurately quantify the potency of a pharmaceutical BoNT preparation, its physiological key activities (binding to membrane receptor, translocation, and proteolytic degradation of SNARE proteins) need to be determined. To date, this was only possible using animal models, or, to a limited extent, cell-based assays. We here report a novel in vitro system for BoNT/B analysis, based on nerve-cell mimicking liposomes presenting motoneuronal membrane receptors required for BoNT binding...
December 15, 2016: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/27631711/can-clinicians-predict-readmissions-a-prospective-cohort-study
#18
Matthew Wetherell, Megan Sweeney, Saul N Weingart
BACKGROUND: Current risk-stratification models insufficiently identify readmission risk. SETTING: Academic medical center in Boston, MA. PATIENTS: One hundred seventy-seven medicine inpatients. METHODS: We prospectively interviewed clinicians about whether they would be surprised if patients scheduled for discharge were readmitted within 30 days and to identify one patient at the highest risk. Multivariate models examined the impact of clinicians' judgment on readmission...
September 13, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27622509/deep-surgical-site-infections-after-open-radical-cystectomy-and-urinary-diversion-significantly-increase-hospitalisation-time-and-total-treatment-costs
#19
Mathias Wolters, Matthias Oelke, Bettina Lutze, Markus Weingart, Markus A Kuczyk, Iris F Chaberny, Karolin Graf
INTRODUCTION: Deep surgical site infections (DSSI) usually require secondary treatments. The aim of this study was to compare the total length of hospitalisation (LOH), intensive care unit (ICU) duration, and total treatment costs in patients with DSSI versus without DSSI after open radical cystectomy (ORC) and urinary diversion. MATERIAL AND METHODS: Prospective case-control study in a tertiary care hospital in patients after ORC with urinary diversion during April 2008 to July 2012...
2017: Urologia Internationalis
https://www.readbyqxmd.com/read/27586172/a-novel-method-for-investigating-burkholderia-cenocepacia-infections-in-patients-with-cystic-fibrosis-and-other-chronic-diseases-of-the-airways
#20
Christiaan D M Wijers, Ryan Vagedes, Christine Weingart
BACKGROUND: Burkholderia cenocepacia is a Gram-negative, opportunistic pathogen that is a cause of morbidity and mortality in patients with cystic fibrosis (CF). Research efforts over the past few decades contributed to our understanding of these infections by identifying virulence factors. However, little is known about how this pathogen adapts to the harsh environment found inside the CF airways, which is characterized by a unique mucus containing high concentrations of inflammatory markers...
2016: BMC Microbiology
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