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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/28528519/il-6-blockade-in-the-management-of-non-infectious-uveitis
#2
Giuseppe Lopalco, Claudia Fabiani, Jurgen Sota, Orso Maria Lucherini, Gian Marco Tosi, Bruno Frediani, Florenzo Iannone, Mauro Galeazzi, Rossella Franceschini, Donato Rigante, Luca Cantarini
Several pathogenetic studies have paved the way for a newer more rational therapeutic approach to non-infectious uveitis, and treatment of different forms of immune-driven uveitis has drastically evolved in recent years after the advent of biotechnological drugs. Tumor necrosis factor-α targeted therapies, the first-line recommended biologics in uveitis, have certainly led to remarkable results in patients with non-infectious uveitis. Nevertheless, the decision-making process turns out to be extremely difficult in anti-tumor necrosis factor or multidrug-resistant cases...
May 20, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28528495/dairy-farm-demographics-and-management-factors-that-played-a-role-in-the-re-emergence-of-brucellosis-on-dairy-cattle-farms-in-fiji
#3
Andrew Tukana, B Gummow
Little is published on risk factors associated with bovine brucellosis in Pacific island communities. The 2009 re-emergence of bovine brucellosis in Fiji enabled us to do an interview-based questionnaire survey of 81 farms in the Wainivesi locality of the Tailevu province on the main island of Fiji to investigate what risk factors could have played a role in the re-emergence of the disease. The survey was conducted on 68 farms that had no positive cases of bovine brucellosis and on 13 farms in the same area where cattle had returned a positive result to the Brucella Rose Bengal test...
May 20, 2017: Tropical Animal Health and Production
https://www.readbyqxmd.com/read/28528480/full-endoscopic-treatment-of-dural-tears-in-lumbar-spine-surgery
#4
Joachim M Oertel, Benedikt W Burkhardt
PURPOSE: An incidental durotomy is a common complication of spinal surgery. Its treatment remains challenging, especially in endoscopic procedures. The objective of this study is to describe a technique for endoscopic dural closure which is safe and effective. METHODS: From a prospective database all endoscopic spinal procedures with incidental durotomy were identified. Retrospectively, video recordings were analysed with a special reference to the applied technique of dural closure...
May 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28528478/the-diagnosis-and-management-of-a-vertebral-artery-loop-causing-cervical-radiculopathy
#5
L Wood, M Czyz, S Forster, Bronek M Boszczyk
BACKGROUND: Cervical radiculopathies are rarely caused by vertebral artery loop formation, which is estimated to be present in less than 3% of patients. It is uncertain what causes the loop formation: some propose an association with spondylotic changes or trauma, whilst others suggest hypertension and atherosclerosis may be responsible. CASE REPORT 1: A 35-year-old male patient presented with signs and symptoms of cervical radiculopathy that was not improved with anterior cervical discectomy and fusion surgery performed 2 years beforehand...
May 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28528469/multiple-sclerosis-treatment-with-fingolimod-profile-of-non-cardiologic-adverse-events
#6
REVIEW
Yara Dadalti Fragoso
Fingolimod was the first oral medication approved for management of multiple sclerosis and is currently used by tens of thousands patients worldwide. Fingolimod acts via the sphingosine 1-phosphate (S1P) receptor, maintaining peripheral lymphocytes entrapped in the lymph nodes. In consequence, there is a reduction in the infiltration of aggressive lymphocytes into the central nervous system. The drug is safe and effective, and its first hours of use are associated with related to S1P receptors in the heart...
May 20, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28528456/pharmacologic-treatment-of-dyslipidemia-in-diabetes-a-case-for-therapies-in-addition-to-statins
#7
REVIEW
Abeer Anabtawi, Patrick M Moriarty, John M Miles
PURPOSE OF REVIEW: The purpose of the study is to review the use of statins and the role of both non-statin lipid-lowering agents and diabetes-specific medications in the treatment of diabetic dyslipidemia. RECENT FINDINGS: Statins have a primary role in the treatment of dyslipidemia in people with type 2 diabetes, defined as triglyceride levels >200 mg/dl and HDL cholesterol levels <40 mg/dL. A number of clinical trials suggest that treatment with a fibrate may reduce cardiovascular events...
July 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28528436/the-unresolved-riddle-of-glucocorticoid-withdrawal
#8
REVIEW
F Guerrero Pérez, A P Marengo, C Villabona Artero
Glucocorticoid (GC) therapy is the most common cause of adrenal insufficiency (AI). The real prevalence of AI after GC is unknown but it could involve more than 30% of patients. Some gene variation has been associated with the variability of hypothalamic-pituitary-adrenal (HPA) axis and this issue could contribute to the individual variation of adrenal function after GC treatment. Symptoms and signs of AI are nonspecific and frequently the diagnosis is delayed. Dosage, duration of treatment, administration route and serum cortisol value are not completely useful to predict AI...
May 20, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28528419/a-risk-based-characterization-of-sediment-contamination-by-legacy-and-emergent-contaminants-of-concern-in-coastal-british-columbia-canada
#9
Carmen Morales-Caselles, Jean-Pierre W Desforges, Neil Dangerfield, Peter S Ross
Sediments have long been used to help describe pollution sources, contaminated sites, trends over time, and habitat quality for marine life. We collected surficial sediments from 12 sites at an average seawater depth of 25 m in three near-urban areas of the Salish Sea (British Columbia, Canada) to investigate habitat quality for marine life, including heavily contaminated killer whales. Samples were analyzed using high-resolution instrumentation for a wide variety of congeners of polychlorinated biphenyls (PCBs), polybrominated diphenylethers (PBDEs), hexabromocyclododecane (HBCDD), polybrominated biphenyls, polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans, organochlorine pesticides, and polychlorinated naphthalenes (PCNs)...
May 20, 2017: Archives of Environmental Contamination and Toxicology
https://www.readbyqxmd.com/read/28528400/influenza-and-the-patient-with-end-stage-renal-disease
#10
REVIEW
Brendan T Bowman, Mitchell H Rosner
Influenza is a commonly encountered and serious pathogen. Patients with end-stage renal disease are more susceptible to serious morbidity and mortality associated with influenza infection. Proper management of patients includes: vaccination, monitoring for symptoms and isolation of potentially infected patients as well as appropriate antiviral therapies. In some cases of exposure, chemoprophylaxis is warranted. Vaccination and appropriate therapies are associated with improved outcomes.
May 20, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28528391/dynamism-in-the-upstream-invasion-edge-of-a-freshwater-fish-exposes-range-boundary-constraints
#11
Erika S Rubenson, Julian D Olden
Studying the dynamics of species' borders can provide insight into the mechanisms limiting or promoting range expansion in response to environmental change. In the John Day River, Oregon (USA), rising stream temperatures are facilitating the upstream expansion of invasive smallmouth bass Micropterus dolomieu. Here, where smallmouth bass occupy the upstream limit of its thermal tolerance, we explore population structure and seasonal movement patterns to elucidate the environmental conditions and individual traits that define front edge (where individuals reside year-round) and leading edge (where individuals colonize, but may not establish) limits to its upstream distribution...
May 20, 2017: Oecologia
https://www.readbyqxmd.com/read/28528388/fertility-sparing-for-young-patients-with-gynecologic-cancer-how-mri-can-guide-patient-selection-prior-to-conservative-management
#12
REVIEW
Sinead H McEvoy, Stephanie Nougaret, Nadeem R Abu-Rustum, Hebert Alberto Vargas, Elizabeth A Sadowski, Christine O Menias, Fuki Shitano, Shinya Fujii, Ramon E Sosa, Joanna G Escalon, Evis Sala, Yulia Lakhman
Historically, cancer treatment has emphasized measures for the "cure" regardless of the long-term consequences. Advances in cancer detection and treatment have resulted in improved outcomes bringing to the fore various quality of life considerations including future fertility. For many young cancer patients, fertility preservation is now an integral component of clinical decision-making and treatment design. Optimal fertility-sparing options for young patients with gynecologic cancer are influenced by patient age, primary cancer, treatment regimens, and patient preferences...
May 20, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28528376/isometric-handgrip-as-an-adjunct-for-blood-pressure-control-a-primer-for-clinicians
#13
REVIEW
Cheri L McGowan, David N Proctor, Ian Swaine, Robert D Brook, Elizabeth A Jackson, Phillip D Levy
Considered a global health crisis by the World Health Organization, hypertension (HTN) is the leading risk factor for death and disability. The majority of treated patients do not attain evidence-based clinical targets, which increases the risk of potentially fatal complications. HTN is the most common chronic condition seen in primary care; thus, implementing therapies that lower and maintain BP to within-target ranges is of tremendous public health importance. Isometric handgrip (IHG) training is a simple intervention endorsed by the American Heart Association as a potential adjuvant BP-lowering treatment...
June 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28528364/a-randomized-double-blind-placebo-controlled-trial-of-a-multi-strain-probiotic-in-treatment-of-symptomatic-uncomplicated-diverticular-disease
#14
Charlotte L Kvasnovsky, Ingvar Bjarnason, Ana Nora Donaldson, Roy A Sherwood, Savvas Papagrigoriadis
BACKGROUND: Diverticular disease is a significant burden on healthcare systems that is managed, surgically or medically, mainly as an emergency or acute condition. There are no standardized treatment recommendations for symptomatic uncomplicated disease. We hypothesized that a probiotic would reduce abdominal pain in such patients. METHODS: We conducted a single-center, double-blind, placebo-controlled trial of probiotic treatment (Symprove) in adult patients with moderate-to-severe chronic, non-acute symptomatic diverticular disease...
May 20, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/28528356/operating-room-fires-in-periocular-surgery
#15
Michael A Connor, Anne M Menke, Ivan Vrcek, John W Shore
AIM: A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery. METHODS: A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons...
May 20, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28528350/prevalence-and-impact-of-severe-fatigue-in-adolescent-and-young-adult-cancer-patients-in-comparison-with-population-based-controls
#16
Hanneke Poort, Suzanne E J Kaal, Hans Knoop, Rosemarie Jansen, Judith B Prins, Eveliene Manten-Horst, Petra Servaes, Olga Husson, Winette T A van der Graaf
PURPOSE: The current study determined the prevalence of severe fatigue in adolescent and young adult (AYA) cancer patients (aged 18-35 years at diagnosis) consulting a multidisciplinary AYA team in comparison with gender- and age-matched population-based controls. In addition, impact of severe fatigue on quality of life and correlates of fatigue severity were examined. METHODS: AYAs with cancer (n = 83) completed questionnaires including the Checklist Individual Strength (CIS-fatigue), Quality of Life (QoL)-Cancer Survivor, Hospital Anxiety and Depression Scale (reflecting psychological distress), and the Cancer Worry Scale (reflecting fear of cancer recurrence or progression)...
May 20, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28528323/c-graph-a-validated-scoring-system-for-early-stratification-of-neurologic-outcome-after-out-of-hospital-cardiac-arrest-treated-with-targeted-temperature-management
#17
Erich L Kiehl, Alex M Parker, Ralph M Matar, Matthew F Gottbrecht, Michelle C Johansen, Mark P Adams, Lori A Griffiths, Steven P Dunn, Katherine L Bidwell, Venu Menon, Kyle B Enfield, Lawrence W Gimple
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) results in significant morbidity and mortality, primarily from neurologic injury. Predicting neurologic outcome early post-OHCA remains difficult in patients receiving targeted temperature management. METHODS AND RESULTS: Retrospective analysis was performed on consecutive OHCA patients receiving targeted temperature management (32-34°C) for 24 hours at a tertiary-care center from 2008 to 2012 (development cohort, n=122)...
May 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28528282/management-options-in-the-treatment-of-femoral-pseudoaneurysms-secondary-to-intravenous-drug-abuse-a-case-series
#18
James Rammell, Nisheeth Kansal, Vish Bhattacharya
INTRODUCTION: Infected femoral pseudoaneurysms are a common presentation in intravenous drug users with little consensus as to the optimum management of these patients. Whilst emergency revascularisation options are available, excision and ligation of the femoral artery remains the most common operative intervention but risks leaving the patient with critical ischaemia or intermittent claudication. This case series reviewed the outcomes of 4 patients who underwent excision-ligation without revascularisation of an infected femoral pseudoaneurysm at a district general hospital...
May 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28528269/bariatric-surgery-for-the-obese-patients-undergoing-liver-transplantation-the-case-for
#19
Anya Adair
The incidence of obesity is rising exponentially. This is having a direct impact on liver transplantation due to an increase in NAFLD disease and numbers of overweight and obese patients requiring transplantation. There is now evidence suggesting that obesity has a negative impact on both graft and patient survival. There remains an imbalance between number of donors available and patients requiring transplantation. We therefore need to ensure we make the best use of the organs available, optimizing graft and patient survival in those fortunate enough to receive an organ...
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28528267/using-mri-to-non-invasively-and-accurately-quantify-preoperative-hepatic-steatosis
#20
Callisia N Clarke, Haesun Choi, Ping Hou, Catherine H Davis, Jingfei Ma, Asif Rashid, Jean-Nicolas Vauthey, Thomas A Aloia
BACKGROUND: The obesity epidemic has significantly increased the incidence and severity of hepatic steatosis in liver surgery patients and liver donors, potentially impacting postoperative liver regeneration and function. Development of a non-invasive means to quantify hepatic steatosis would facilitate selection of candidates for liver resection and transplant donation. METHODS: An IRB-approved protocol prospectively enrolled 28 patients with liver tumors requiring hepatic resection...
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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