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High alert

James Buxbaum, Michael Quezada, Bradford Chong, Nikhil Gupta, Chung Yao Yu, Christianne Lane, Ben Da, Kenneth Leung, Ira Shulman, Stephen Pandol, Bechien Wu
OBJECTIVES: The Pancreatitis Activity Scoring System (PASS) has been derived by an international group of experts via a modified Delphi process. Our aim was to perform an external validation study to assess for concordance of the PASS score with high face validity clinical outcomes and determine specific meaningful thresholds to assist in application of this scoring system in a large prospectively ascertained cohort. METHODS: We analyzed data from a prospective cohort study of consecutive patients admitted to the Los Angeles County Hospital between March 2015 and March 2017...
March 15, 2018: American Journal of Gastroenterology
S Napp, N Majó, R Sánchez-Gónzalez, J Vergara-Alert
Circulation of highly pathogenic avian influenza (HPAI) viruses poses a continuous threat to animal and public health. After the 2005-2006 H5N1 and the 2014-2015 H5N8 epidemics, another H5N8 is currently affecting Europe. Up to August 2017, 1,112 outbreaks in domestic and 955 in wild birds in 30 European countries have been reported, the largest epidemic by a HPAI virus in the continent. Here, the main epidemiological findings are described. While some similarities with previous HPAI virus epidemics were observed, for example in the pattern of emergence, significant differences were also patent, in particular the size and extent of the epidemic...
March 14, 2018: Transboundary and Emerging Diseases
Pamela Oetting-Neumann, Karl Rohn, Martina Hoedemaker
OBJECTIVE: Determination of the frequency of subclinical hypocalcaemia, increased lipomobilisation and subclinical ketosis as problems in dairy herds and identification of possible risk factors. MATERIAL AND METHODS: Information was obtained from 51 dairy farms on husbandry, feeding, management of the cows and heifers, animal health and prophylactic treatments using a questionnaire. Blood samples from 20% of the cows and 30% of the heifers of each farm (= herd sample) were collected in the week ante partum (a...
February 2018: Tierärztliche Praxis. Ausgabe G, Grosstiere/Nutztiere
Lars O Karlsson, Staffan Nilsson, Magnus Bång, Lennart Nilsson, Emmanouil Charitakis, Magnus Janzon
BACKGROUND: Atrial fibrillation (AF) is associated with substantial morbidity, in particular stroke. Despite good evidence for the reduction of stroke risk with anticoagulant therapy, there remains significant undertreatment. The main aim of the current study was to investigate whether a clinical decision support tool (CDS) for stroke prevention integrated in the electronic health record could improve adherence to guidelines for stroke prevention in patients with AF. METHODS AND FINDINGS: We conducted a cluster-randomized trial where all 43 primary care clinics in the county of Östergötland, Sweden (population 444,347), were randomized to be part of the CDS intervention or to serve as controls...
March 2018: PLoS Medicine
Fei-Fei Chen, Ying-Jie Zhu, Feng Chen, Li-Ying Dong, Ri-Long Yang, Zhi-Chao Xiong
Wallpaper with multiple functions, such as fire resistance and an automatic alarm in fire disasters, will be attractive for the interior decoration of houses. Herein, we report a smart fire alarm wallpaper prepared using fire-resistant inorganic paper based on ultralong hydroxyapatite nanowires (HNs) and graphene oxide (GO) thermosensitive sensors. At room temperature, the GO thermosensitive sensor is in a state of electrical insulation; however, it becomes electrically conductive at high temperatures. In a fire disaster, high temperature will rapidly remove the oxygen-containing groups of GO, leading to the transformation process of GO from an electrically insulated state into an electrically conductive one...
March 13, 2018: ACS Nano
Salih Eker
BACKGROUND: Diabetes mellitus (DM) is one of the most prevalent diseases all over the world. Prevalence of DM in Turkey is 13.7%. Depression is another condition which has a high prevalence. All over the world, an estimated 300 million people of all ages suffer from depression. The relevance between depression and DM is a well - known condition. AIM: We aimed in this study to find out the prevalence of depression symptoms for DM in an attempt to better manage the disease...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
Ulf Andersson, Huan Yang, Helena Harris
Alarmins are preformed, endogenous molecules that can be promptly released to signal cell or tissue stress or damage. The ubiquitous nuclear molecule high-mobility group box 1 protein (HMGB1) is a prototypical alarmin activating innate immunity. HMGB1 serves a dual alarmin function. The protein can be emitted to alert adjacent cells about endangered homeostasis of the HMGB1-releasing cell. In addition to this expected path of an alarmin, extracellular HMGB1 can be internalized via RAGE-receptor mediated endocytosis to the endolysosomal compartment while attached to other extracellular proinflammatory molecules...
March 9, 2018: Seminars in Immunology
Cheryl L Maier, Phillip J Gross, Christina L Dean, Satheesh Chonat, Andrew Ip, Morgan McLemore, Fuad El Rassi, Sean R Stowell, Cassandra D Josephson, Ross M Fasano
BACKGROUND: Fever accompanying vaso-occlusive crisis is a common presentation in patients with sickle cell disease (SCD) and carries a broad differential diagnosis. Here, we report a case of transfusion-transmitted malaria in a patient with SCD presenting with acute vaso-occlusive crisis and rapidly decompensating to multisystem organ failure (MSOF). CASE REPORT: An 18-year-old African American male with SCD was admitted after multiple days of fever and severe generalized body pain...
March 9, 2018: Transfusion
Guy Cheron, Javier Márquez-Ruiz, Julian Cheron, Cynthia Prigogine, Claudia Ammann, Robert Lukowski, Peter Ruth, Bernard Dan
Purkinje cells (PC) control deep cerebellar nuclei (DCN), which in turn inhibit inferior olive nucleus, closing a positive feedback loop via climbing fibers. PC highly express potassium BK channels but their contribution to the olivo-cerebellar loop is not clear. Using multiple-unit recordings in alert mice we found in that selective deletion of BK channels in PC induces a decrease in their simple spike firing with a beta-range bursting pattern and fast intraburst frequency (~200 Hz). To determine the impact of this abnormal rhythm on the olivo-cerebellar loop we analyzed simultaneous rhythmicity in different cerebellar structures...
March 9, 2018: Scientific Reports
Hannu Jarvinen, Jad Farah, Teemu Siiskonen, Olivera Ciraj-Bjelac, Jérémie Dabin, Eleftheria Carinou, Joanna Domienik-Andrzejewska, Dariusz Kluszczynski, Željka Knežević, Renata Kopec, Marija Majer, Francoise Malchair, Anna Negri, Piotr Pankowski, Sandra Sarmento, Annalisa Trianni
PURPOSE: The feasibility of setting-up generic, hospital-independent dose alert levels to initiate vigilance on possible skin injuries in interventional procedures was studied for three high-dose procedures (chemoembolization (TACE) of the liver, neuro-embolization (NE) and percutaneous coronary intervention (PCI)) in 9 European countries. METHODS: Gafchromic® films and thermoluminescent dosimeters (TLD) were used to determine the Maximum Skin Dose (MSD). Correlation of the online dose indicators (fluoroscopy time, kerma- or dose-area product (KAP or DAP) and cumulative air kerma at interventional reference point (Ka,r )) with MSD was evaluated and used to establish the alert levels corresponding to a MSD of 2 Gy and 5 Gy...
February 2018: Physica Medica: PM
John Henry McDermott, Charles Reynard, Jonathan Perry, James W Dear, Fran Child, Rachel Jenner
BACKGROUND: Recent public health strategies have contributed towards a significant reduction in the incidence of carbon monoxide (CO) poisonings. When events do occur, symptoms can vary dramatically depending on the carboxyhaemoglobin level and individual factors. Most reports to date focus on individual cases or larger retrospective reviews of diverse cohorts. There are very few reports of CO exposure related to scuba diving activities. METHODS: We describe the clinical sequelae experienced by 10 children who were exposed to CO during a scuba diving lesson...
March 8, 2018: Clinical Toxicology
V L Ruggieri, C L Arberas
INTRODUCTION: Autism spectrum disorders are neurodevelopmental dysfunctions that are characterised by deficits in social integration and communication, associated with restricted interests and stereotypic behaviour. A high percentage are related to language disorders, sensory dysfunctions, attention deficit disorder, bipolarity, intellectual disability or epilepsy, among other comorbidities. It is estimated that around 30% of children with autism, with typical early development, may present regression in the first years of life, which was already reported by Kanner in one of his original cases...
March 1, 2018: Revista de Neurologia
Baptiste Dungu, Baratang A Lubisi, Tetsuro Ikegami
Rift Valley fever (RVF) is a zoonotic mosquito-borne bunyaviral disease associated with high abortion rates, neonatal deaths, and fetal malformations in ruminants, and mild to severe disease in humans. Outbreaks of RVF cause huge economic losses and public health impacts in endemic countries in Africa and the Arabian Peninsula. A proper vaccination strategy is important for preventing or minimizing outbreaks. Vaccination against RVF is not practiced in many countries, however, due to absence or irregular occurrences of outbreaks, despite serological evidence of RVF viral activity...
March 4, 2018: Current Opinion in Virology
L Apers, E Florence, T Crucitti, N Anwar
Objective of this study was to describe the patient characteristics and clinical presentation of laboratory confirmed lymphogranuloma venereum (LGV) cases, diagnosed at the Institute of Tropical Medicine (ITM), Antwerp, Belgium. Demographic and biomedical characteristics of all patients with chlamydia-positive sample results were retrieved for the years 2013 and 2014. Samples were obtained from both symptomatic and asymptomatic patients who consulted at the HIV/STI clinic. Fifty four patients with laboratory confirmed LGV were detected among 3885 nucleic acid amplification tests (NAATs) performed for the detection of chlamydia during the two years under review...
July 2017: Acta Gastro-enterologica Belgica
Itsaso Colás, Almudena Capilla, Ana B Chica
The relation between attention and consciousness is a highly debated topic in Cognitive Neuroscience. Although there is an agreement about their relationship at the functional level, there is still no consensus about how these two cognitive processes interact at the neural level. According to the gateway hypothesis (Posner, 1994), attention filters the information accessing to consciousness, resulting in both neural and functional modulations. Contrary to this idea, the cumulative influence hypothesis (Tallon-Baudry, 2012) proposes that both attention and consciousness independently impact decision processes about the perception of stimuli...
March 1, 2018: Neuropsychologia
Noelia Vicente Oliveros, Covadonga Pérez Menéndez Conde, Ana María Álvarez Díaz, Teresa Bermejo Vicedo, Sagrario Martín-Aragón Álvarez, Beatriz Montero Errasquín, José Luis Calleja López, María Angeles Gálvez Múgica, Gema Nieto Gómez, Gemma García Menéndez, Sonia Chamarro Rubio, Eva Delgado Silveira
OBJECTIVE: The aim of this study was to stratify medications used in hospital  care according to their potential risk. METHOD: The RAND/UCLA Appropriateness Method was used. Anatomical Therapeutic Chemical subgroups were classified according to their potential risk. A literature search, bulletins, and alerts issued by patient safety organizations were used to identify the potential safety risk of  these subgroups. Nine experts in patient/medication safety were selected to score the subgroups for their appropriateness in the classification...
March 1, 2018: Farmacia Hospitalaria
Neill B Baskerville, Laura L Struik, Darly Dash
BACKGROUND: Emerging evidence supports the use of smartphone apps for smoking cessation, especially in young adults given their high smoking rates and high smartphone ownership rates. Although evaluative evidence is encouraging for supporting smoking cessation, there remains a paucity of research describing the design and development processes of mobile health (mHealth) interventions. OBJECTIVE: The aim of this paper was to describe the process of developing Crush the Crave (CTC), an evidence-informed app to support smoking cessation in young adults, and the results of a formative evaluation of app usage behavior, as part of a broader program of research that seeks to establish the effectiveness of the CTC app...
March 2, 2018: JMIR MHealth and UHealth
Daniela V Pachito, Alan L Eckeli, Ahmed S Desouky, Mark A Corbett, Timo Partonen, Shantha Mw Rajaratnam, Rachel Riera
BACKGROUND: Exposure to light plays a crucial role in biological processes, influencing mood and alertness. Daytime workers may be exposed to insufficient or inappropriate light during daytime, leading to mood disturbances and decreases in levels of alertness. OBJECTIVES: To assess the effectiveness and safety of lighting interventions to improve alertness and mood in daytime workers. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, seven other databases; ClinicalTrials...
March 2, 2018: Cochrane Database of Systematic Reviews
Clémence Mahana Iti Gatti, Davide Lonati, Hélène Taiana Darius, Arturo Zancan, Mélanie Roué, Azzurra Schicchi, Carlo Alessandro Locatelli, Mireille Chinain
Ciguatera fish poisoning (CFP) is the most prevalent non-bacterial food-borne form of poisoning in French Polynesia, which results from the consumption of coral reef fish naturally contaminated with ciguatoxins produced by dinoflagellates in the genus Gambierdiscus . Since the early 2000s, this French territory has also witnessed the emergence of atypical forms of ciguatera, known as ciguatera shellfish poisoning (CSP), associated with the consumption of marine invertebrates. In June 2014, nine tourists simultaneously developed a major and persistent poisoning syndrome following the consumption of the gastropod Tectus niloticus collected in Anaho, a secluded bay of Nuku Hiva Island (Marquesas Archipelago, French Polynesia)...
February 28, 2018: Toxins
Lundy R Gunn, Robert Tunney, Kimberly Kelly
BACKGROUND:  Medication alert overrides remain persistently high over the past decade, influenced by factors such as "alert fatigue" and lack of provider acceptance. OBJECTIVE:  We compared the aggregate rate of fluoroquinolone (FQ) prescribing for the treatment of acute sinusitis, acute bronchitis, and uncomplicated urinary tract infections (UTIs) in adult inpatients prior to (historical control group) and after (prospective intervention group) implementation of a program requiring indication when ordering FQ antibiotics in combination with a nonmodal best-practice alert regarding the latest U...
January 2018: Applied Clinical Informatics
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