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https://www.readbyqxmd.com/read/28098628/the-abcdef-bundle-science-and-philosophy-of-how-icu-liberation-serves-patients-and-families
#1
E Wesley Ely
Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the postintensive care syndrome." Patients with postintensive care syndrome are robbed of their normal cognitive, emotional, and physical capacity and cannot resume their previous life. The ICU Liberation Collaborative is a real-world quality improvement initiative being implemented across 76 ICUs designed to engage strategically the ABCDEF bundle through team- and evidence-based care...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28097194/the-mystery-of-the-z-score
#2
REVIEW
Alexander E Curtis, Tanya A Smith, Bulat A Ziganshin, John A Elefteriades
Reliable methods for measuring the thoracic aorta are critical for determining treatment strategies in aneurysmal disease. Z-scores are a pragmatic alternative to raw diameter sizes commonly used in adult medicine. They are particularly valuable in the pediatric population, who undergo rapid changes in physical development. The advantage of the Z-score is its inclusion of body surface area (BSA) in determining whether an aorta is within normal size limits. Therefore, Z-scores allow us to determine whether true pathology exists, which can be challenging in growing children...
August 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28089414/acupressure-effect-on-sleep-quality-a-systematic-review-and-meta-analysis
#3
REVIEW
Alexander Waits, You-Ren Tang, Hao-Min Cheng, Chen-Jei Tai, Li-Yin Chien
Acupressure is a non-invasive treatment in which pressure is applied to specific body points. Following public health concerns about poor sleep quality and increasing interest in alternative treatments, a systematic review and a meta-analysis were designed to evaluate the effects of acupressure on the quality of sleep. Ten English (PubMed, CENTRAL, CINAHL etc.) and five Chinese (CNKI, WANFANG etc.) databases were searched and the validity of the eligible studies was critically appraised. Thirty-two eligible randomized controlled trials of moderate to high quality which employed polysomnography, actigraphy, or self-assessment sleep quality tools were included...
December 22, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28088667/cell-laden-hydrogels-for-osteochondral-and-cartilage-tissue-engineering
#4
REVIEW
Jingzhou Yang, Yu Shrike Zhang, Kan Yue, Ali Khademhosseini
: Despite tremendous advances in the field of regenerative medicine, it still remains challenging to repair the osteochondral interface and full-thickness articular cartilage defects. This inefficiency largely originates from the lack of appropriate tissue engineered artificial matrices that can replace the damaged regions and promote tissue regeneration. Hydrogels are emerging as a promising class of biomaterials for both soft and hard tissue regeneration. Many critical properties of hydrogels, such as mechanical stiffness, elasticity, water content, bioactivity, and degradation, can be rationally designed and conveniently tuned by proper selection of the material and chemistry...
January 11, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28087924/clinical-testing-of-tuberculosis-vaccine-candidates
#5
Mark Hatherill, Dereck Tait, Helen McShane
It is almost 100 years since the development of bacille Calmette-Guérin (BCG), the only licensed vaccine against tuberculosis (TB). While BCG does confer consistent protection against disseminated disease, there is an urgent need for a more effective vaccine against pulmonary disease. There are several indications for such an improved vaccine, including prevention of infection, prevention of disease, and a therapeutic vaccine to prevent recurrent disease. The two main approaches to TB vaccine development are developing an improved whole mycobacterial priming agent to replace BCG and/or developing a subunit booster vaccine to be administered after a BCG or BCG replacement priming vaccination...
October 2016: Microbiology Spectrum
https://www.readbyqxmd.com/read/28078850/acupuncture-in-endocrine-disorders-a-critical-appraisal
#6
Y Z Deng, L B Li, L G Xu, D Zhou, L J Wei, Y Liu
Acupuncture is an integral part of ancient Chinese medical practice. The technique has been used extensively in pain relief and is being tried for many other chronic conditions. Industrial development and affluence lead to the increase in the prevalence of many endocrine disorders such as diabetes, obesity, and polycystic ovarian disease. The rising prevalence of the endocrine morbidity is observed in both the developing and developed nations. The management of these disorders involves major lifestyle modification coupled with a long-term drug intake...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28077195/evidence-based-medicine-in-the-era-of-social-media-scholarly-engagement-through-participation-and-online-interaction
#7
Teresa Chan, N Seth Trueger, Damian Roland, Brent Thoma
The integration of new knowledge into clinical practice continues to lag behind discovery. The use of Free Open Access Medical education (FOAM) has disrupted communication between emergency physicians, making it easy for practicing clinicians to interact with colleagues from around the world to discuss the latest and highest impact research. FOAM has the potential to decrease the knowledge translation gap, but the concerns raised about its growing influence are 1) research that is translated too quickly may cause harm if its findings are incorrect; 2) there is little editorial oversight of online material; and 3) eminent online individuals may develop an outsized influence on clinical practice...
January 12, 2017: CJEM
https://www.readbyqxmd.com/read/28074823/pharmacological-update-new-drugs-in-cardiac-practice-a-critical-appraisal
#8
REVIEW
Rohan Magoon, Arindam Choudhury, Vishwas Malik, Ridhima Sharma, Poonam Malhotra Kapoor
Cardiac practice involves the application of a range of pharmacological therapies. An anesthesiologist needs to keep pace with the rampant drug developments in the field of cardiovascular medicine for appropriate management in both perioperative and intensive care set-up, to strengthen his/her role as a perioperative physician in practice. The article reviews the changing trends and the future perspectives in major classes of cardiovascular medicine.
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28071601/applications-of-nuclear-physics
#9
A C Hayes
Today the applications of nuclear physics span a very broad range of topics and fields. This review discusses a number of aspects of these applications, including selected topics and concepts in nuclear reactor physics, nuclear fusion, nuclear non-proliferation, nuclear-geophysics, and nuclear medicine. The review begins with a historic summary of the early years in applied nuclear physics, with an emphasis on the huge developments that took place around the time of World War II, and that underlie the physics involved in designs of nuclear explosions, controlled nuclear energy, and nuclear fusion...
February 2017: Reports on Progress in Physics
https://www.readbyqxmd.com/read/28068459/does-pharmacogenomic-testing-improve-clinical-outcomes-for-major-depressive-disorder-a-systematic-review-of-clinical-trials-and-cost-effectiveness-studies
#10
Joshua D Rosenblat, Yena Lee, Roger S McIntyre
OBJECTIVE: Pharmacogenomic testing has become scalable and available to the general public. Pharmacogenomics has shown promise for predicting antidepressant response and tolerability in the treatment of major depressive disorder (MDD). In theory, pharmacogenomics can improve clinical outcomes by guiding antidepressant selection and dosing. The current systematic review examines the extant literature to determine the impact of pharmacogenomic testing on clinical outcomes in MDD and assesses its cost-effectiveness...
January 3, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28068187/a-century-of-surgical-innovation-at-a-boston-hospital
#11
JaBaris D Swain, Gaurav Sharma, Rowza T Rumma, P Marco Fisichella, Edward Whang
BACKGROUND: Innovation has been a central focus of the Department of Surgery at the Brigham and Women's Hospital since its very inception. Here we review examples of innovations originating in this Department and analyze factors that have been critical to successful innovation. Finally, we discuss challenges to sustainability of innovation in this Department. METHODS: Narrative review of the literature, interviews, and personal observations. RESULTS: Examples of innovations reviewed here were each dependent on three critical elements: 1) multidisciplinary collaboration among surgical innovators and individuals outside of surgery who offered complementary skills and expertise, 2) a rich institutional environment that sustained a diverse complement of innovators working in close proximity, and 3) Department Chairmen who facilitated the work of innovators and promoted their contributions, rather than seeking personal prestige or financial gain...
January 9, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28065877/charles-estienne-1504-1564-his-life-work-and-contribution-to-anatomy-and-the-first-description-of-the-canal-in-the-spinal-cord
#12
REVIEW
Konstantinos Markatos, Demetrios Chytas, Demetrios Korres, Konstantinos Laios, Georgios Androutsos, Efstathios Chronopoulos
The purpose of this historic review is to summarize the life, work and contribution to anatomy of Charles Estienne (also known by the Latin name Carolus Stephanus). Charles Estienne was an early exponent of the science of anatomy in France. Although he remained under the influence of the Galenic tradition of medicine, anatomy and surgery throughout his distinguished career, he had a significant influence on the scientific revolution and anatomy reformation of the 16th century. Nevertheless he cannot be place in the same level of contribution as Vesalius due to his lack of discipline in his work, hesitation to diverge totally from traditional beliefs and his hesitation for a total criticism of the Galenic tradition...
January 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28064354/can-systematic-reviews-contribute-to-regulatory-decisions
#13
REVIEW
Corrado Barbui, Antonio Addis, Laura Amato, Giuseppe Traversa, Silvio Garattini
INTRODUCTION: The new call on independent research on drugs issued in October 2016 by the Italian Medicines Agency (AIFA) explicitly reported that proposals based on systematic reviews were not admissible, and no justification or explanation for this choice was given. Prompted by this policy decision, here, we briefly discuss the potential usefulness of systematic reviews in responding to regulatory needs. First, systematic reviews, by collecting, analysing and critically appraising all relevant studies on a specific topic, may be used by different stakeholders as a basis for making clinical and policy recommendations, including regulatory recommendations...
January 7, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28064353/who-is-a-healthy-subject-consensus-results-on-pivotal-eligibility-criteria-for-clinical-trials
#14
REVIEW
Kerstin Breithaupt-Groegler, Christoph Coch, Martin Coenen, Frank Donath, Katharina Erb-Zohar, Klaus Francke, Karin Goehler, Mario Iovino, Klaus Peter Kammerer, Gerd Mikus, Jens Rengelshausen, Hildegard Sourgens, Reinhard Schinzel, Thomas Sudhop, Georg Wensing
INTRODUCTION/METHODS: A discussion forum was hosted by the German not-for-profit Association for Applied Human Pharmacology (AGAH e.V.) to critically review key eligibility criteria and stopping rules for clinical trials with healthy subjects, enrolling stakeholders from the pharmaceutical industry, contract research organisations, academia, ethics committees and competent authority. RESULTS: Pivotal eligibility criteria were defined for trials with new investigational medicinal products (IMPs) or with clinically established IMPs...
January 7, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28059952/atp-citrate-lyase-genetics-molecular-biology-and-therapeutic-target-for-dyslipidemia
#15
Amy C Burke, Murray W Huff
PURPOSE OF REVIEW: ATP-citrate lyase (ACLY) has re-emerged as a drug target for LDL cholesterol (LDL-C) lowering. We review ACLY as a therapeutic strategy, its genetics, its molecular and cellular biology, and also its inhibition. RECENT FINDINGS: ACLY is a critical enzyme linking glucose catabolism to lipogenesis by providing acetyl-CoA from mitochondrial citrate for fatty acid and cholesterol biosynthesis. Human genetic variants have been associated with enhanced growth and survival of several cancers, and with attenuated plasma triglyceride responses to dietary fish oil...
January 5, 2017: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/28059697/digital-literacy-knowledge-and-needs-of-pharmacy-staff-a-systematic-review
#16
Katie MacLure, Derek Stewart
OBJECTIVE: To explore the digital literacy knowledge and needs of pharmacy staff including pharmacists, graduate (pre-registration) pharmacists, pharmacy technicians, dispensing assistants and medicine counter assistants. METHODS: A systematic review was conducted following a pre-published protocol. Two reviewers systematically performed the reproducible search, followed by independent screening of titles/abstracts then full papers, before critical appraisal and data extraction...
October 7, 2016: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/28057792/a-novel-view-of-the-adult-stem-cell-compartment-from-the-perspective-of-a-quiescent-population-of-very-small-embryonic-like-stem-cells
#17
REVIEW
Mariusz Z Ratajczak, Janina Ratajczak, Malwina Suszynska, Donald M Miller, Magda Kucia, Dong-Myung Shin
Evidence has accumulated that adult hematopoietic tissues and other organs contain a population of dormant stem cells (SCs) that are more primitive than other, already restricted, monopotent tissue-committed SCs (TCSCs). These observations raise several questions, such as the developmental origin of these cells, their true pluripotent or multipotent nature, which surface markers they express, how they can be efficiently isolated from adult tissues, and what role they play in the adult organism. The phenotype of these cells and expression of some genes characteristic of embryonic SCs, epiblast SCs, and primordial germ cells suggests their early-embryonic deposition in developing tissues as precursors of adult SCs...
January 6, 2017: Circulation Research
https://www.readbyqxmd.com/read/28056457/personalised-medicine-a-new-approach-to-improving-health-in-indigenous-australian-populations
#18
Kym M Rae, Steve Grimson, Kirsty G Pringle
Personalised medicine is a newly emerging field with much to offer to all populations in improved clinical treatment options. Since the 1970s, clinicians and researchers have all been working towards improving the health of Indigenous Australians. However, there has been little research on the impact of genetics on Indigenous health, how genetic and environmental factors interact to contribute to poor health in Indigenous people, and how genetic factors specific to Indigenous people affect their responses to particular treatments...
January 6, 2017: Public Health Genomics
https://www.readbyqxmd.com/read/28054108/-cardiac-surgery-in-the-elderly
#19
B Wiegmann, I Ismai, A Haverich
Due to the increasing demographic changes and the fact that cardiovascular diseases are still the leading cause of death, the mean chronological age of patients undergoing cardiac surgery is steadily increasing. In 2015, 14.8% of these patients were aged 80 years and older. This meta-analysis reviewed if and under what circumstances elderly patients benefit from cardiac surgical procedures without running the risk of limitations in the quality of life and high rates of morbidity and mortality. Generally, the chronological age was not a risk factor for higher perioperative and postoperative morbidity and mortality but the biological age was the critical factor, in particular the associated comorbidities of patients and the timing of the surgical procedure in the course of the disease...
January 4, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28053890/medicinal-properties-of-terminalia-arjuna-roxb-wight-arn-a%C3%A2-review
#20
REVIEW
Augustine Amalraj, Sreeraj Gopi
Medicinal plants have been a main source of therapeutic agents from ancient time to cure diseases. Terminalia arjuna (Roxb.) Wight & Arn. (T. arjuna) is one of the most accepted and beneficial medicinal plants in indigenous system of medicine for the treatment of various critical diseases. This comprehensive review provides various aspects of its ethnomedical, phytochemical, pharmacognostical, pharmacological and clinical significance to different diseases particularly in cardiovascular conditions. This plant has a good safety outline when used in combination with other conventional drugs...
January 2017: Journal of Traditional and Complementary Medicine
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