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Sabina Martí Gamboa, Olga Redrado Giménez, Jara Pascual Mancho, María Lapresta Moros, Julia Ruiz Sada, Sergio Castan Mateo
Objective The objective of this study was to determine ability to detect neonatal acidemia and interobserver agreement with the FIGO 3-tier and 5-tier fetal heart rate (FHR) classification systems. Design This was a case-control study. Setting This study was set at the University Medical Center. Population A total of 202 FHR tracings of 102 women who delivered an acidemic fetus (umbilical arterial cord gas pH ≤ 7.10 and BE < - 8) and 100 who delivered a nonacidemic fetus (umbilical arterial cord gas pH > 7...
October 25, 2016: American Journal of Perinatology
Firas Zahr Eldeen, Garrett R Roll, Carlos Derosas, Rajashankar Rao, Muhammad S Khan, Bridget K Gunson, James Hodson, Hynek Mergental, Ben-Hur Ferraz-Neto, John Isaac, Paolo Muiesan, Darius F Mirza, Asim Iqbal, M Thamara P R Perera
BACKGROUND: Whilst causes of hepatic artery thrombosis (HAT) after liver transplantation (LT) are multifactorial, early HAT (E-HAT) remains pertinent complication impacting on graft and patient survival. Currently there is no screening tool that would identify patients with increased risk of developing E-HAT. METHODS: We analyzed the native procoagulant state of LT recipients, identified through pretransplant thromboelastographic (TEG) data among other known risk factors, to identify risk factors for E-HAT...
November 2016: Transplantation
Arne Ring, Tom Morris, Marcin Wozniak, Nikol Sullo, William Dott, Veerle Verheyden, Tracy Kumar, Nigel Brunskill, Rakesh Vaja, Gavin J Murphy
BACKGROUND: Acute kidney injury (AKI) is a common and severe complication of cardiac surgery. There is no effective prevention or treatment. Sildenafil citrate (Revatio®, Pfizer Inc), a phosphodiesterase type 5 inhibitor, prevents post cardiac surgery AKI in pre-clinical studies, however its use is contraindicated in patients with symptomatic cardiovascular disease. METHODS: To assess the safety and pharmacokinetics of intravenous sildenafil in cardiac surgery patients we conducted an open label, dose escalation study with 6 patients per dose level...
October 25, 2016: British Journal of Clinical Pharmacology
Shuichi Kaneyama, Masatoshi Sumi, Masato Takabatake, Koichi Kasahara, Aritetsu Kanemura, Hiroaki Hirata, Bruce V Darden
STUDY DESIGN: Clinical case series and risk factor analysis of dysphagia after occipitospinal fusion (OSF). OBJECTIVE: To develop new criteria to avoid postoperative dysphagia by analyzing the relationship among the craniocervical alignment, the oropharyngeal space and the incidence of dysphagia after OSF. SUMMARY OF BACKGROUND DATA: Craniocervical malalignment after OSF is considered to be one of the primary triggers of postoperative dysphagia...
October 24, 2016: Spine
Arne Liebau, Olivia Pogorzelski, Alec N Salt, Stefan K Plontke
OBJECTIVE: Controlled and uncontrolled studies with primary intratympanic or combined intratympanic and systemic application of glucocorticosteroids for idiopathic sudden hearing loss were analyzed by means of a meta-analysis in an attempt to establish optimal local drug delivery protocols. STUDY DESIGN: A total of 25 studies with 28 treatment groups between January 2000 and June 2014 were selected that adequately described drug delivery protocols. Cochlear drug levels were calculated by a validated computer model of drug dispersion in the inner ear fluids based on the concentration and volume of glucocorticoids applied, the time the drug remained in the middle ear, and the specific timing of injections...
October 21, 2016: Otology & Neurotology
Christoph Töpper, Cathérine Louise Steinbach, Christoph Dorn, Alexander Kratzer, Sebastian G Wicha, Michael Schleibinger, Uwe Liebchen, Frieder Kees, Bernd Salzberger, Martin G Kees
BACKGROUND: Standard doses of linezolid may not be suitable for all patient groups. ICU patients in particular may be at risk of inadequate concentrations. This study investigated variability of drug exposure and its potential sources in this population. PATIENTS AND METHODS: Plasma concentrations of linezolid were determined by HPLC in a convenience sample of 20 ICU patients treated with intravenous linezolid 600 mg twice daily. Ultrafiltration applying physiological conditions (pH 7...
October 24, 2016: Therapeutic Drug Monitoring
Joseph J Ryan, David S Kreiner, Laura Glass Umfleet, Samuel T Gontkovsky, Allison Myers-Fabian
We examined relationships between the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) General Ability Index (GAI) and Cognitive Proficiency Index (CPI) in two clinical samples. The mean pattern produced by 42 individuals with multiple sclerosis (MS) and 47 with traumatic brain injury (TBI) was the same, GAI > CPI. This pattern occurred in 61.9% and 78.7% of the protocols of patients with MS or TBI, respectively. The MS sample earned a significantly larger CPI mean than did patients with TBI...
October 25, 2016: Applied Neuropsychology. Adult
Jaroslav Meluzin, Zdenek Starek, Tomas Kulik, Jiri Jez, Frantisek Lehar, Josef Tomandl, Ladislav Dusek, Jiri Wolf, Pavel Leinveber, Miroslav Novak
BACKGROUND: Noninvasive diagnosis of exercise-induced elevation of left ventricular filling pressure is difficult and remains unsatisfactory. The aim of this study was to assess the accuracy of the ratio of early diastolic transmitral (E) to mitral annular (e') velocity and to determine new parameters or parameter combinations with the ability to predict exercise-induced left atrial pressure (LAP) elevation. METHODS AND RESULTS: Eighty patients with paroxysmal atrial fibrillation (AF) referred for catheter AF ablation underwent simultaneous exercise echocardiography and direct invasive LAP measurements, as well as a resting and postexercise biomarker analysis...
October 25, 2016: Echocardiography
Hyo Jung Cho, Bohyun Kim, Jung-Dong Lee, Dae Ryong Kang, Jai Keun Kim, Jei Hee Lee, Sung Jae Shin, Kee Myung Lee, Byung Moo Yoo, Kwang Jae Lee, Soon Sun Kim, Jae Youn Cheong, Sung Won Cho
OBJECTIVES: This study was performed to evaluate long-term outcome of indeterminate nodules detected on cirrhotic liver and to develop risk prediction model for hepatocellular carcinoma (HCC) progression of indeterminate nodules on hepatitis B virus (HBV)-related cirrhotic liver. METHODS: Indeterminate nodules up to 2 cm with uncertain malignant potential detected on computed tomography of cirrhotic liver during HCC surveillance were analyzed retrospectively. HCC risk prediction model of indeterminate nodules in HBV-related cirrhotic liver was deduced based on result of Cox regression analysis...
October 25, 2016: American Journal of Gastroenterology
Qin Zhou, Xiang-Ping Chai, Zhen-Fei Fang, Xin-Qun Hu, Liang Tang
BACKGROUND: Acute aortic dissection is a life-threatening cardiovascular emergency. Pentraxin-3 (PTX3) is proposed as a prognostic marker and found to be related to worse clinical outcomes in various cardiovascular diseases. This study sought to investigate the association of circulating PTX3 levels with in-hospital mortality in patients with acute Type A aortic dissection (TAAD). METHODS: A total of 98 patients with TAAD between January 2012 and December 2015 were enrolled in this study...
2016: Chinese Medical Journal
Huang Huang, Yan Shi, Jietao Huang, Xiaohui Wang, Rui Zhang, Hong Chen
OBJECTIVES: Accumulating evidences demonstrated that circulating tumor cells (CTCs) show significant high concentration in plasma of lung cancer patients compared to control cohorts, suggesting that CTCs may be a promising biomarker for lung cancer. The meta-analysis was used to evaluate potential diagnostic value of CTCs in diagnosing lung cancer. METHODS: Relevant literatures were searched in PubMed, Embase, Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Technology of Chongqing (VIP), and Wan Fang Data...
October 25, 2016: Clinical Respiratory Journal
K Ravi, D M Geno, M F Vela, M D Crowell, D A Katzka
BACKGROUND: Baseline impedance measured with ambulatory impedance pH monitoring (MII-pH) and a mucosal impedance catheter detects gastroesophageal reflux disease (GERD). However, these tools are limited by cost or patient tolerance. We investigated whether baseline impedance measured during high-resolution impedance manometry (HRIM) distinguishes GERD patients from controls. METHODS: Consecutive patients with clinical HRIM and MII-pH testing were identified. Gastroesophageal reflux disease was defined by esophageal pH <4 for ≥5% of both the supine and total study time, whereas controls had an esophageal pH <4 for ≤3% of the study performed off PPI...
October 24, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Cosimo De Nunzio, Fabrizio Presicce, Riccardo Lombardo, Simon Carter, Carlo Vicentini, Andrea Tubaro
AIMS: To evaluate the role of Bladder wall thickness (BWT) as a predictor of Detrusor overactivity (DO) in patients with Lower urinary tract symptoms (LUTS)/Benign prostatic enlargement without Bladder Outlet Obstruction. METHODS: From January 1996 to December 2000, each new patient, aged 45 years or older with LUTS, underwent standard diagnostic assessment, urodynamic studies (cystometry and pressure flow studies), and ultrasound measurements of the bladder wall thickness (BWT) in two centers...
October 24, 2016: Neurourology and Urodynamics
F Sörgel, R Höhl, R Glaser, C Stelzer, M Munz, M Vormittag, M Kinzig, J Bulitta, C Landersdorfer, A Junger, M Christ, M Wilhelm, U Holzgrabe
Optimized dosage regimens of antibiotics have remained obscure since their introduction. During the last two decades pharmacokinetic(PK)-pharmacodynamic(PD) relationships, originally established in animal experiments, have been increasingly used in patients. The action of betalactams is believed to be governed by the time the plasma concentration is above the minimum inhibitory concentration (MIC). Aminoglycosides act as planned when the peak concentration is a multiple of the MIC and vancomycin seems to work best when the area under the plasma vs...
October 24, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Ana Isabel Sánchez-Fructuoso, Isabel Pérez-Flores, Rosalia Valero, Maria Angeles Moreno, Miguel Fernandez-Arquero, Elena Urcelay, Cristina Fernández-Pérez, Jose Luis Santiago
The -308G/A SNP of tumor necrosis factor-alpha (TNF-α) gene affects TNF-α production. As its impact on transplant outcome remains open to debate, we decided to genotype it in a cohort of transplant subjects. A retrospective analysis of 439 first kidney recipients randomly divided into two subgroups (discovery and validation cohorts) was performed to identify the best predictors of acute rejection (AR). The effect on transplant outcome was analyzed by an adjusted logistic regression model. Carriers of the A allele, associated with elevated TNF-α production, presented a higher risk of AR (OR = 2...
2016: Journal of Immunology Research
Emmanuel Amabebe, Steven Reynolds, Victoria Stern, Graham Stafford, Martyn Paley, Dilly O C Anumba
Changes in vaginal microbiota that is associated with preterm birth (PTB) leave specific metabolite fingerprints that can be detected in the cervicovaginal fluid (CVF) using metabolomics techniques. In this study, we characterize and validate the CVF metabolite profile of pregnant women presenting with symptoms of threatened preterm labor (PTL) by both (1)H-nuclear magnetic resonance spectroscopy (NMR) and enzyme-based spectrophotometry. We also determine their predictive capacity for PTB, singly, and in combination, with current clinical screening tools - cervicovaginal fetal fibronectin (FFN) and ultrasound cervical length (CL)...
2016: Frontiers in Medicine
Jun-Hong Yan, Lei Pan, Xiao-Li Chen, Jian-Wei Chen, Li-Ming Yan, Bao Liu, Yong-Zhong Guo
Currently, whether endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is superior to conventional TBNA (cTBNA) in the diagnosis of mediastinal lymphadenopathy remains controversial. We undertook a meta-analysis of randomized controlled trials (RCTs) to evaluate the diagnostic yield of EBUS-TBNA versus cTBNA in the diagnosis of mediastinal lymphadenopathy, both in benign and malignant etiologies. Computer-based retrieval was performed on PubMed and EMBASE. The quality was evaluated according to the quality assessment of diagnostic accuracy studies-2, and Meta-Disc was adopted to perform meta-analysis...
2016: SpringerPlus
Allison C Sylvetsky, Rebecca J Brown, Jenny E Blau, Mary Walter, Kristina I Rother
BACKGROUND: Non-nutritive sweeteners (NNS), especially in form of diet soda, have been linked to metabolic derangements (e.g. obesity and diabetes) in epidemiologic studies. We aimed to test acute metabolic effects of NNS in isolation (water or seltzer) and in diet sodas. METHODS: We conducted a four-period, cross-over study at the National Institutes of Health Clinical Center (Bethesda, Maryland). Thirty healthy adults consumed 355 mL water with 0 mg, 68 mg, 170 mg, and 250 mg sucralose, and 31 individuals consumed 355 mL caffeine-free Diet Rite Cola™, Diet Mountain Dew™ (18 mg sucralose, 18 mg acesulfame-potassium, 57 mg aspartame), and seltzer water with NNS (68 mg sucralose and 41 mg acesulfame-potassium, equivalent to Diet Rite Cola™) in randomized order, prior to oral glucose tolerance tests...
2016: Nutrition & Metabolism
Antonio J Salazar, Javier A Romero, Oscar A Bernal, Angela P Moreno, Sofía C Velasco, Xavier A Díaz
Objective. The aim of this study was to evaluate and compare the clinical performance of different alternatives to implement low-cost screening telemammography. We compared computed radiography, film printed images, and digitized films produced with a specialized film digitizer and a digital camera. Material and Methods. The ethics committee of our institution approved this study. We assessed the equivalence of the clinical performance of observers for cancer detection. The factorial design included 70 screening patients, four technological alternatives, and cases interpreted by seven radiologists, for a total of 1,960 observations...
2016: International Journal of Telemedicine and Applications
Thabo Lapp, Antonia Hildebrand, Daniel Böhringer, Paola Kammrath Betancor, Günther Schlunck, Thomas Reinhard
PURPOSE: To evaluate the feasibility of anterior segment spectral domain optic coherence tomography (ASOCT) as rejection readout in a keratoplasty mouse model and to compare ASOCT against the current standard (i.e., a clinical score system). Furthermore, to compare both approaches with respect to intra- and inter-individual observer variability and to calculate a critical point that distinguishes between rejection and non-rejection in ASOCT analysis. METHODS: Allogeneic penetrating keratoplasties (PKs) were performed using C3H/He donor mice and BALB/c recipient mice; syngeneic transplantations served as controls using BALB/c donors and recipients...
2016: Molecular Vision
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