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https://www.readbyqxmd.com/read/29332153/vasoactive-inotropic-score-as-a-predictor-of-morbidity-and-mortality-in-adults-after-cardiac-surgery-with-cardiopulmonary-bypass
#1
Yumiko Yamazaki, Koji Oba, Yoshiro Matsui, Yuji Morimoto
PURPOSE: The vasoactive-inotropic score (VIS) is a scale showing the amount of vasoactive and inotropic support. Recently, it was suggested that the VIS after cardiac surgery predicts morbidity and mortality in infants. The purpose of this study was to evaluate the VIS at the end of surgery as a predictor of morbidity and mortality in adult cardiac surgery. METHODS: A retrospective cohort study of 129 adult cardiac surgery patients was performed at a university hospital...
January 13, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29328649/phenylthiomethyl-ketone-based-fragments-show-selective-and-irreversible-inhibition-of-enteroviral-3c-proteases
#2
Robert Schulz, Amira Atef, Daniel Becker, Franziska Gottschalk, Carolin Tauber, Stefan Wagner, Christoph Arkona, Atef A Abdel-Hafez, Hassan H Farag, Jörg Rademann, Gerhard Wolber
Lead structure discovery mainly focuses on the identification of noncovalently binding ligands. Covalent linkage, however, is an essential binding mechanism for a multitude of successfully marketed drugs although discovered by serendipity in most cases. We present a concept for the design of fragments covalently binding to proteases. Covalent linkage enables fragment binding unrelated to affinity to shallow protein binding sites and at the same time allows differentiated targeted hit verification and binding location verification through mass spectrometry...
January 12, 2018: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29322099/outbreaks-caused-by-vancomycin-resistant-enterococcus-faecium-in-hematology-and-oncology-departments-a-systematic-review
#3
Nikos Ulrich, Ralf-Peter Vonberg, Petra Gastmeier
Background: Vancomycin-resistance in Enterococcus faecium (VRE) poses a major threat in health care settings. It is well known that patients in hematology and oncology departments are especially at risk of nosocomial VRE acquisition. This systematic review of the literature provides data on the main sources, transmission modes and potential risk factors for VRE acquisition as well as appropriate infection control measures in order to terminate such nosocomial outbreaks. Methods: Data on nosocomial VRE outbreaks on hematology and oncology wards was retrieved from the Outbreak Database and PubMed...
December 2017: Heliyon
https://www.readbyqxmd.com/read/29318114/the-impact-of-the-national-essential-medicines-policy-on-rational-drug-use-in-primary-care-institutions-in-jiangsu-province-of-china
#4
Jianqian Chao, Jiangyi Gu, Hua Zhang, Huanghui Chen, Zhenchun Wu
Background: Essential medicine policy is a successful global health policy to promote rational drug use. The aim of this study was to evaluate the impact of the National Essential Medicines Policy (NEMP) on the rational drug use in primary care institutions in Jiangsu Province of China. Methods: In this exploratory study, a multistage, stratified, random sampling was used to select 3400 prescriptions from 17 primary care institutions who implemented the NEMP before (Jan 2010) and after the implementation of the NEMP (Jan 2014)...
January 2018: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/29314539/viewpoint-rationing-and-surgical-care
#5
EDITORIAL
Derek Alderson
No abstract text is available yet for this article.
January 2018: BJU International
https://www.readbyqxmd.com/read/29314311/development-of-evidence-based-nursing-sensitive-quality-indicators-for-emergency-nursing-a-delphi-study
#6
Qiao-Yan Ju, Li-Hua Huang, Xue-Hong Zhao, Mei-Yuan Xing, Le-Wen Shao, Mei-Yun Zhang, Rong-Ya Shao
AIMS AND OBJECTIVE: To establish evidence-based nursing-sensitive quality indicators for emergency nursing in China. BACKGROUND: China lacks nursing-sensitive quality indicators necessary for assessing the quality of emergency nursing and essential to nursing management. DESIGN: Prospective. METHODS: A literature search for relevant evidence-based studies was performed using several databases from January 2009 to May 2014...
January 4, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29304796/referral-gynecological-ambulatory-clinic-principal-diagnosis-and-distribution-in-health-services
#7
Adna Thaysa Marcial da Silva, Camila Lohmann Menezes, Edige Felipe de Sousa Santos, Paulo Francisco Ramos Margarido, José Maria Soares, Edmund Chada Baracat, Luiz Carlos de Abreu, Isabel Cristina Esposito Sorpreso
BACKGROUND: The association between gynecological diagnoses and their distribution in the health sectors provides benefits in the field of women's health promotion and in medical and interdisciplinary education, along with rationalization according to level of care complexity. Thus, the objective is analyze the clinical-demographic characteristics, main diagnoses in gynecological ambulatory care, and their distribution in health services. METHOD: This is a research project of retrospective audit study design with a chart review of data from 428 women treated at University Ambulatory Clinic of Women's Health, the facility in gynecology and training for Family and Community Medical Residents, São Paulo, Brazil, from 2012 to 2014...
January 5, 2018: BMC Women's Health
https://www.readbyqxmd.com/read/29303276/-diagnostics-and-treatment-of-community-acquired-pneumonia-simplicity-is-the-key-to-success
#8
Vítězslav Kolek, Petr Jakubec, Stanislav Losse
Pneumonia is the most wide-spread infectious disease and requires unrelenting attention. It is defined as an acute inflammatory disease affecting pulmonary alveoli, respiratory bronchioles and the pulmonary interstitium. In recent years we have seen the endeavour to rationalize the approach to pneumonias and utilize the current methods of administering effective antibiotics to reduce occurrence of complications, limit the number of hospitalizations and shorten the length of treatment. With the awareness of all the potential agents it is empiric therapy which predominates, being supported by the knowledge of a regional epidemiological situation, good diagnosing and experience of rational antibiotic treatment...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29302597/ethical-challenges-involved-in-obtaining-consent-for-research-from-patients-hospitalized-in-the-intensive-care-unit
#9
Fiona Ecarnot, Jean-Pierre Quenot, Guillaume Besch, Gaël Piton
Clinical research remains a vital contributor to medical knowledge, and is an established and integral part of the practice of medicine worldwide. Respect for patient autonomy and ethical principles dictate that informed consent must be obtained from subjects before they can be enrolled into clinical research, yet these conditions may be difficult to apply in real practice in the intensive care unit (ICU). A number of factors serve to complexify the consent process in critically ill patients, notably decisional incapacity of the patient due to illness or sedation...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29298738/-cross-sectoral-collaboration-in-type-2-diabetes-management-in-denmark
#10
Lene Munch, Michael E Røder, Ida H Rasmussen, Helle Middelfart, Niels Kaarsberg, Birgitte Bennich, Fhilip K Knop, Tina Vilsbøll
To optimize medical care, Danish guidelines for type 2 diabetes emphasize cross-sectoral collaboration. Risk stratification is recommended as a model of organizing care in terms of distributing tasks and responsibilities between primary and secondary healthcare sectors. Collaboration between the sectors is expected to be beneficial for patients and ensure rational utilization of resources. Challenges such as inter-sectoral communication, sharing of data and unambiguous responsibility underline the need for continuous optimization of the organization of cross-sectorial diabetes management...
January 1, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29297617/recommendations-for-the-treatment-of-children-with-radiotherapy-in-low-and-middle-income-countries-lmic-a-position-paper-from-the-pediatric-radiation-oncology-society-pros-lmic-and-pediatric-oncology-in-developing-countries-podc-working-groups-of-the-international
#11
Jeannette Parkes, Clayton Hess, Hester Burger, Yavuz Anacak, Verity Ahern, Scott C Howard, Moawia Elhassan, Soha Ahmed, Mithra Ghalibafian, Ahmed Nadeem Abbasi, Bilal Mazhar Qureshi, Mohamed Zaghloul, Eduardo Zubizarreta, Pierre Bey, Alan Davidson, Eric Bouffet, Natia Esiashvili
Pediatric radiotherapy is a critical part of pediatric oncology protocols and the quality of the radiotherapy may determine the future quality of life for long-term survivors. Multidisciplinary team decision making provides the basis for high-quality care. However, delivery of high-quality radiotherapy is dependent on resources. This article provides guidelines for delivery of good quality radiation therapy in resource-limited countries based on rational procurement and maintenance planning, protocol development, three-dimensional planning, quality assurance, and adequate staff numbers and training...
December 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29295962/rational-approaches-for-combination-therapy-strategies-targeting-the-map-kinase-pathway-in-solid-tumors
#12
Anthony W Tolcher, Wei Peng, Emiliano Calvo
Molecular characterization of oncogenic mutations within genes in the MAPK and PI3K/AKT/mTOR pathways has led to the rational development of targeted therapies. Combining BRAF and MEK inhibitors to target two steps in the MAPK pathway (vertical inhibition) is now standard of care in advanced-stage melanoma harboring BRAF V600 mutation. Encouraging results have been seen in several tumor types with the same mutation, including BRAF V600-mutant non-small cell lung cancer. Yet similar results in other tumors, such as colorectal cancer, have not been observed, highlighting the unique nature of different tumors...
January 2018: Molecular Cancer Therapeutics
https://www.readbyqxmd.com/read/29294693/providing-health-care-in-the-shadow-of-violence-does-emotion-regulation-vary-among-hospital-workers-from-different-professions
#13
Hadass Goldblatt, Anat Freund, Anat Drach-Zahavy, Guy Enosh, Ilana Peterfreund, Neomi Edlis
Research into violence against health care staff by patients and their families within the health care services shows a rising frequency of incidents. The potentially damaging effects on health care staff are extensive, including diverse negative psychological and physical symptoms. The aim of this qualitative study was to examine how hospital workers from different professions reacted to patients' and visitors' violence against them or their colleagues, and how they regulated their emotional reactions during those incidents...
March 1, 2017: Journal of Interpersonal Violence
https://www.readbyqxmd.com/read/29291233/in-silico-comparative-analysis-of-promoters-derived-from-plant-pararetroviruses
#14
Dipinte Gupta, Rajiv Ranjan
Promoters are specific sequence of nucleotides present upstream of gene coding region involved in initiation and regulation of transcription. Multiple cis-acting element forms the architecture of promoter to which trans-acting nucleic binding factors bind and regulates its activity. Since 1980 genome of pararetrovirus, are being exploited for developing efficient promoters. Among all of them Cauliflower mosaic virus is the most widely used promoter for gene expression. The basic rational behind the strength of promoter lies in the sequence of cis elements and the spacer nucleotide elements between them, thereby strength of these promoter fragments can be regulated by altering these nucleotide sequences...
December 2017: Virusdisease
https://www.readbyqxmd.com/read/29288291/transfusion-of-blood-products-in-the-neurocritical-care-unit-an-exploration-of-rationing-and-futility
#15
Deepa P Malaiyandi, Galen V Henderson, Michael A Rubin
Rationing is the allocation of scarce resources, which in healthcare necessarily requires withholding potentially beneficial treatments from some individuals. While it often entails a negative connotation, rationing is unavoidable because need is limitless and resources are not. How rationing occurs is important, because it not only affects individual lives, but also reflects society's most important values. At the core of any rationing, decision is how much a limited resource may benefit a patient, which can be particularly difficult to determine in the practice of neurocritical care, as prognosis is often uncertain...
December 29, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29285567/management-of-symptomatic-knee-osteoarthritis-in-obesity-a-survey-of-orthopaedic-surgeons-opinions-and-practice
#16
Daniel S Hill, Matthew Freudmann, Jamie C Sergeant, Tim Board
INTRODUCTION: The aim of this survey was to explore knee surgeons' opinions and practices regarding the management of symptomatic knee osteoarthritis in obesity. METHODS: Questionnaires were sent electronically to all consultant members of the British Association for Surgery of the Knee. RESULTS: The response rate was 52%. The survey showed considerable practice variation and divided opinion on the evidence base. The majority stated that weight loss should be the first-line treatment...
December 28, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29280167/from-applied-ethics-to-empirical-ethics-to-contextual-ethics
#17
Barry Hoffmaster
Bioethics became applied ethics when it was assimilated to moral philosophy. Because deduction is the rationality of moral philosophy, subsuming facts under moral principles to deduce conclusions about what ought to be done became the prescribed reasoning of bioethics, and bioethics became a theory comprised of moral principles. Bioethicists now realize that applied ethics is too abstract and spare to apprehend the specificity, particularity, complexity and contingency of real moral issues. Empirical ethics and contextual ethics are needed to incorporate these features into morality, not just bioethics...
December 27, 2017: Bioethics
https://www.readbyqxmd.com/read/29278249/governing-the-resilience-of-neoliberalism-through-biopolitics
#18
Luca Mavelli
Neoliberalism is widely regarded as the main culprit for the 2007/2008 global financial crisis. However, despite this abysmal failure, neoliberalism has not merely survived the crisis, but actually 'thrived'. How is it possible to account for the resilience of neoliberalism? Existing scholarship has answered this question either by focusing on the distinctive qualities of neoliberalism (such as adaptability, internal coherence and capacity to incorporate dissent) or on the biopolitical capacity of neoliberalism to produce resilient subjects...
September 2017: Eur J Int Relat
https://www.readbyqxmd.com/read/29277304/the-association-between-pulsatile-portal-flow-and-acute-kidney-injury-after-cardiac-surgery-a-retrospective-cohort-study
#19
William Beaubien-Souligny, Roberto Eljaiek, Annik Fortier, Yoan Lamarche, Mark Liszkowski, Josée Bouchard, André Y Denault
OBJECTIVE: Venous congestion is a possible mechanism leading to acute kidney injury (AKI) following cardiac surgery. Portal vein flow pulsatility is an echographic marker of cardiogenic portal hypertension and might identify clinically significant organ congestion. This exploratory study aims to assess if the presence of portal flow pulsatility measured by transthoracic echography in the postsurgical intensive care unit is associated with AKI after cardiac surgery. DESIGN: Retrospective cohort study...
November 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29276868/rational-drug-use-for-acute-bronchiolitis-in-emergency-care
#20
Metin Uysalol, Fatih Haşlak, Zeynep Güneş Özünal, Hayriye Vehid, Nedret Uzel
Uysalol M, Haşlak F, Özünal ZG, Vehid H, Uzel N. Rational drug use for acute bronchiolitis in emergency care. Turk J Pediatr 2017; 59: 155-161. Despite the large variety of inhaled treatment options of acute bronchiolitis, there is no generally agreed treatment regime. This study aimed to determine the most appropriate treatment option. This was a double-blind randomized prospective clinical trial and has been performed in emergency department. The mean age of the 378 infants included in the study was 7...
2017: Turkish Journal of Pediatrics
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