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https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#1
Daniel Dante Yeh, Catrina Cropano, Sadeq A Quraishi, Eva Fuentes, Haytham M A Kaafarani, Jarone Lee, Yuchiao Chang, George Velmahos
BACKGROUND: Macronutrient deficiency in critical illness is associated with worse outcomes. We hypothesized that an aggressive enteral nutrition (EN) protocol would result in higher macronutrient delivery and fewer late infections. METHODS: We enrolled adult surgical intensive care unit (ICU) patients receiving >72 hours of EN from July 2012 to June 2014. Our intervention consisted of increasing protein prescription (2.0-2.5 vs 1.5-2.0 g/kg/d) and compensatory feeds for EN interruption...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28107026/impact-of-mobile-intensive-care-unit-use-on-total-ischemic-time-and-clinical-outcomes-in-st-elevation-myocardial-infarction-patients-real-world-data-from-the-acute-coronary-syndrome-israeli-survey
#2
Edward Koifman, Roy Beigel, Zaza Iakobishvili, Nir Shlomo, Yitschak Biton, Avi Sabbag, Elad Asher, Shaul Atar, Shmuel Gottlieb, Ronny Alcalai, Doron Zahger, Amit Segev, Ilan Goldenberg, Rafael Strugo, Shlomi Matetzky
BACKGROUND: Ischemic time has prognostic importance in ST-elevation myocardial infarction patients. Mobile intensive care unit use can reduce components of total ischemic time by appropriate triage of ST-elevation myocardial infarction patients. METHODS: Data from the Acute Coronary Survey in Israel registry 2000-2010 were analyzed to evaluate factors associated with mobile intensive care unit use and its impact on total ischemic time and patient outcomes. RESULTS: The study comprised 5474 ST-elevation myocardial infarction patients enrolled in the Acute Coronary Survey in Israel registry, of whom 46% ( n=2538) arrived via mobile intensive care units...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28106560/face-name-associative-recognition-deficits-in-subjective-cognitive-decline-and-mild-cognitive-impairment
#3
Alexandra Polcher, Ingo Frommann, Alexander Koppara, Steffen Wolfsgruber, Frank Jessen, Michael Wagner
BACKGROUND: There is a need for more sensitive neuropsychological tests to detect subtle cognitive deficits emerging in the preclinical stage of Alzheimer's disease (AD). Associative memory is a cognitive function supported by the hippocampus and affected early in the process of AD. OBJECTIVE: We developed a short computerized face-name-associative-recognition test (FNART) and tested whether it would detect memory impairment in memory-clinic patients with mild cognitive impairment (MCI) and subjective cognitive decline (SCD)...
January 19, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28106557/blunted-respiratory-responses-in%C3%A2-the%C3%A2-streptozotocin-induced-alzheimer-s-disease-rat-model
#4
Dalton L Ebel, Christopher G Torkilsen, Tim D Ostrowski
Alzheimer's disease (AD) is known for the progressive decline of cognition and memory. In addition to these disease-defining symptoms, impairment of respiratory function is frequently observed and often expressed by sleep-disordered breathing or reduced ability to adjust respiration when oxygen demand is elevated. The mechanisms for this are widely unknown. Postmortem analysis from the brainstem of AD patients reveals pathological alterations, including in nuclei responsible for respiratory control. In this study, we analyzed respiratory responses and morphological changes in brainstem nuclei following intracerebroventricular (ICV) injections of streptozotocin (STZ), a rat model commonly used to mimic sporadic AD...
January 20, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28106498/performing-concurrent-operations-in-academic-vascular-neurosurgery-does-not-affect-patient-outcomes
#5
Corinna C Zygourakis, Janelle Lee, Julio Barba, Errol Lobo, Michael T Lawton
OBJECTIVE Concurrent surgeries, also known as "running two rooms" or simultaneous/overlapping operations, have recently come under intense scrutiny. The goal of this study was to evaluate the operative time and outcomes of concurrent versus nonconcurrent vascular neurosurgical procedures. METHODS The authors retrospectively reviewed 1219 procedures performed by 1 vascular neurosurgeon from 2012 to 2015 at the University of California, San Francisco. Data were collected on patient age, sex, severity of illness, risk of mortality, American Society of Anesthesiologists (ASA) status, procedure type, admission type, insurance, transfer source, procedure time, presence of resident or fellow in operating room (OR), number of co-surgeons, estimated blood loss (EBL), concurrent vs nonconcurrent case, severe sepsis, acute respiratory failure, postoperative stroke causing neurological deficit, unplanned return to OR, 30-day mortality, and 30-day unplanned readmission...
January 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28104545/trial-of-labour-and-vaginal-birth-after-previous-caesarean-section-a-population-based-study-of-eastern-african-immigrants-in-victoria-australia
#6
Fetene B Belihu, Rhonda Small, Mary-Ann Davey
OBJECTIVES: Variations in caesarean section (CS) between some immigrant groups and receiving country populations have been widely reported. Often, African immigrant women are at higher risk of CS than the receiving population in developed countries. However, evidence about subsequent mode of birth following CS for African women post-migration is lacking. The objective of this study was to examine differences in attempted and successful vaginal birth after previous caesarean (VBAC) for Eastern African immigrants (Eritrea, Ethiopia, Somalia and Sudan) compared with Australian-born women...
January 3, 2017: Midwifery
https://www.readbyqxmd.com/read/28104502/staying-away-from-the-optic-nerve-a-formula-for-modifying-glaucoma-drainage-device-surgery-in-pediatric-and-other-small-eyes
#7
Milica A Margeta, Anthony N Kuo, Alan D Proia, Sharon F Freedman
PURPOSE: To provide guidelines for safe implantation of glaucoma drainage devices (GDDs) in small and pediatric eyes to avoid contact between the optic nerve (ON) and the posterior edge of the GDD plate. METHODS: We developed a formula for calculating limbus-to-ON distance to estimate the available "real estate" for GDD placement in small eyes. The formula was validated using eyes of pediatric decedents undergoing clinical autopsy, with axial lengths (AL) of 15-24 mm...
January 16, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28104258/the-impact-of-betaplus-program-on-patient-treatment-satisfaction-with-interferon-beta-1b-in-multiple-sclerosis-multicentric-cross-sectional-survey-in-the-western-balkan-countries
#8
Jelena Drulovic, Mirjana Cukic, Sanja Grgic, Evica Dincic, Ranko Raicevic, Congor Nadj, Gordana Toncev, Slobodan Vojinovic, Sarlota Mesaros, Darija Kisic Tepavcevic, Irena Dujmovic, Daliborka Tadic, Svetlana Miletic-Drakulic, Jelena Dackovic, Smiljana Kostic, Jevto Erakovic, Lorand Sakalas, Dejan Savic, Vesna Suknjaja, Vanja Martinovic, Gorica Maric, Tatjana Pekmezovic
BACKGROUND: Long-term treatment adherence to disease-modifying drugs (DMDs) may have significant impact on clinical outcomes in multiple sclerosis (MS). It has been recently emphasized that low treatment satisfaction (TS) may be an important factor for achieving high rates of treatment adherence. Interferon (IFN) beta-1b was the first DMD approved for the treatment of MS. The aims of our study were to assess TS in subjects with relapsing-remitting (RR) MS treated with IFN beta-1b in Serbia, Montenegro and the Republika Srpska, Bosnia and Herzegovina (B&H), and additionally, to evaluate the impact of patient support program on TS and adherence...
January 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28104185/causes-and-outcomes-of-sepsis-in-southeast-asia-a-multinational-multicentre-cross-sectional-study
#9
(no author information available yet)
BACKGROUND: Improved understanding of pathogens that cause sepsis would aid management and antimicrobial selection. In this study, we aimed to identify the causative pathogens of sepsis in southeast Asia. METHODS: In this multinational multicentre cross-sectional study of community-acquired sepsis and severe sepsis, we prospectively recruited children (age ≥30 days and <18 years) and adults (age ≥18 years) at 13 public hospitals in Indonesia (n=3), Thailand (n=4), and Vietnam (n=6)...
February 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28103923/risk-adjustment-methods-for-all-payer-comparative-performance-reporting-in-vermont
#10
Karl Finison, MaryKate Mohlman, Craig Jones, Melanie Pinette, David Jorgenson, Amy Kinner, Tim Tremblay, Daniel Gottlieb
BACKGROUND: As the emphasis in health reform shifts to value-based payments, especially through multi-payer initiatives supported by the U.S. Center for Medicare & Medicaid Innovation, and with the increasing availability of statewide all-payer claims databases, the need for an all-payer, "whole-population" approach to facilitate the reporting of utilization, cost, and quality measures has grown. However, given the disparities between the different populations served by Medicare, Medicaid, and commercial payers, risk-adjustment methods for addressing these differences in a single measure have been a challenge...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28103821/genetic-polymorphisms-of-scn9a-are-associated-with-oxaliplatin-induced-neuropathy
#11
María Sereno, Gerardo Gutiérrez-Gutiérrez, Juan Moreno Rubio, María Apellániz-Ruiz, Lara Sánchez-Barroso, Enrique Casado, Sandra Falagan, Miriam López-Gómez, María Merino, César Gómez-Raposo, Nuria Rodriguez-Salas, Francisco Zambrana Tébar, Cristina Rodríguez-Antona
BACKGROUND: Oxaliplatin is a chemotherapy agent active against digestive tumors. Peripheral neuropathy is one of the most important dose-limiting toxicity of this drug. It occurs in around 60-80% of the patients, and 15% of them develop severe neuropathy. The pathophysiology of oxaliplatin neurotoxicity remains unclear. SCN9A is a gene codifying for a subtype sodium channel (type IX, subunit α) and mutations in this gene are involved in neuropathic perception. In this study we investigated whether SCN9A genetic variants were associated with risk of neurotoxicity in patients diagnosed of cancer on treatment with oxaliplatin...
January 19, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28103458/-uterine-carcinosarcoma-clinicopathological-features-and-prognostic-factors
#12
Rita Luz, Joana Ferreira, Mara Rocha, Ana Francisca Jorge, Ana Félix
INTRODUCTION: Uterine carcinosarcoma is a rare and aggressive biphasic malignancy and is currently included in the high risk endometrial carcinoma group. The aims of this study were to determine the clinicopathological profile, treatment, recurrence/progression patterns, survival and prognostic factors. MATERIAL AND METHODS: Retrospective study of 42 patients, surgically staged and followed-up at a cancer centre, between 2005 and 2013. Clinical data was retrieved from records and pathological characteristics were reviewed for this study...
October 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28100438/high-dose-rifampicin-moxifloxacin-and-sq109-for-treating-tuberculosis-a-multi-arm-multi-stage-randomised-controlled-trial
#13
Martin J Boeree, Norbert Heinrich, Rob Aarnoutse, Andreas H Diacon, Rodney Dawson, Sunita Rehal, Gibson S Kibiki, Gavin Churchyard, Ian Sanne, Nyanda E Ntinginya, Lilian T Minja, Robert D Hunt, Salome Charalambous, Madeleine Hanekom, Hadija H Semvua, Stellah G Mpagama, Christina Manyama, Bariki Mtafya, Klaus Reither, Robert S Wallis, Amour Venter, Kim Narunsky, Anka Mekota, Sonja Henne, Angela Colbers, Georgette Plemper van Balen, Stephen H Gillespie, Patrick P J Phillips, Michael Hoelscher
BACKGROUND: Tuberculosis is the world's leading infectious disease killer. We aimed to identify shorter, safer drug regimens for the treatment of tuberculosis. METHODS: We did a randomised controlled, open-label trial with a multi-arm, multi-stage design. The trial was done in seven sites in South Africa and Tanzania, including hospitals, health centres, and clinical trial centres. Patients with newly diagnosed, rifampicin-sensitive, previously untreated pulmonary tuberculosis were randomly assigned in a 1:1:1:1:2 ratio to receive (all orally) either 35 mg/kg rifampicin per day with 15-20 mg/kg ethambutol, 20 mg/kg rifampicin per day with 400 mg moxifloxacin, 20 mg/kg rifampicin per day with 300 mg SQ109, 10 mg/kg rifampicin per day with 300 mg SQ109, or a daily standard control regimen (10 mg/kg rifampicin, 5 mg/kg isoniazid, 25 mg/kg pyrazinamide, and 15-20 mg/kg ethambutol)...
January 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28100432/effectiveness-and-impact-of-a-reduced-infant-schedule-of-4cmenb-vaccine-against-group-b-meningococcal-disease-in-england-a-national-observational-cohort-study
#14
Sydel R Parikh, Nick J Andrews, Kazim Beebeejaun, Helen Campbell, Sonia Ribeiro, Charlotte Ward, Joanne M White, Ray Borrow, Mary E Ramsay, Shamez N Ladhani
BACKGROUND: In September, 2015, the UK became the first country to introduce the multicomponent group B meningococcal (MenB) vaccine (4CMenB, Bexsero) into a publicly funded national immunisation programme. A reduced two-dose priming schedule was offered to infants at 2 months and 4 months, alongside an opportunistic catch-up for 3 month and 4 month olds. 4CMenB was predicted to protect against 73-88% of MenB strains. We aimed to assess the effectiveness and impact of 4CMenB in vaccine-eligible infants in England...
December 3, 2016: Lancet
https://www.readbyqxmd.com/read/28100357/-hemoptysis-in-adults-with-bronchiectasis-correlation-with-disease-severity-and-exacerbation-risk
#15
W J Guan, J J Yuan, Y H Gao, H M Li, N S Zhong, R C Chen
Objective: To investigate the association between hemoptysis and disease severity and risks of acute exacerbations in patients with bronchiectasis. Methods: Between September 2012 and January 2014, we recruited 148 patients (56 males, 92 females, mean age: 44.6 years) with clinically stable bronchiectasis, who were classified into hemoptysis group (36 males, 70 females, mean age: 45.6 years) and non-hemoptysis group (20 males, 22 females, mean age: 41.8 years). We inquired the past history, and evaluated chest imaging characteristics, lung function, cough sensitivity assessed using capsaicin cough challenge tests, and airway inflammation...
January 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28100341/-comparison-on-the-long-term-outcomes-post-percutaneous-coronary-intervention-or-coronary-artery-bypass-grafting-for-bifurcation-lesions-in-unprotected-left-main-coronary-artery
#16
B G Yang, X P Yu, F Chen, S Z Lyu, Q Li, J Q He, F Yuan
Objective: To compare the long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention(PCI) with drug-eluting stents (DES) for bifurcation lesions in unprotected left main coronary artery (ULMCA). Methods: A total of 663 consecutively patients with unprotected left main bifurcation disease (defined as stenosis≥50%) who received either drug-eluting stents (DES) implantation (n=316) or underwent CABG (n=347) between January 2003 and July 2009 in Beijing Anzhen Hospital were enrolled retrospectively in this study...
January 25, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28100170/interaction-between-acyl-ghrelin-and-bmi-predicts-clinical-outcomes-in-hemodialysis-patients
#17
Ilia Beberashvili, Inna Sinuani, Ada Azar, Gregory Shapiro, Leonid Feldman, Keren Doenyas-Barak, Kobi Stav, Shai Efrati
BACKGROUND: Ghrelin, a gastric orexigenic peptide, and body mass index (BMI) are known as inversely associated to each other and are both linked to cardiovascular (CV) risk and mortality in maintenance hemodialysis (MHD) patients. However, it is unclear whether the interaction between ghrelin and BMI is associated with a risk of all-cause and CV death in this population. METHODS: A prospective observational study was performed on 261 MHD outpatients (39% women, mean age 68...
January 18, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28100110/mortality-in-patients-with-septic-shock-by-multidrug-resistant-bacteria
#18
Stefano Busani, Giulia Serafini, Elena Mantovani, Claudia Venturelli, Maddalena Giannella, Pierluigi Viale, Cristina Mussini, Andrea Cossarizza, Massimo Girardis
BACKGROUND: Patients with septic shock by multidrug resistant (MDR) microorganism maybe considered a specific population of critical patients at very high risk of death in whom the effects of standard sepsis treatment has never been assessed. The objective of this retrospective analysis was to evaluate the risk factors for 30-day mortality and the impact of sepsis management in patients with septic shock caused by MDR bacteria. METHODS: Patients with septic shock by MDR bacteria admitted to the mixed intensive care unit (ICU) of Modena University Hospital during a 6-year period were studied...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28099907/increased-incidence-of-ectopic-pregnancy-after-in-vitro-fertilization-in-women-with-decreased-ovarian-reserve
#19
Shengli Lin, Rui Yang, Hongbin Chi, Ying Lian, Jiejing Wang, Shuo Huang, Cuiling Lu, Ping Liu, Jie Qiao
The incidence of ectopic pregnancy after assisted reproductive technology is increased approximately 2.5-5-fold compared with natural conceptions.Strategies were used to decrease the incidence of ectopic pregnancy, but ectopic pregnancy still occurs. In the present study, women were selected with decreased ovarian reserve (defined as FSH > 10 IU/L) aged 20 to 38 years who underwent IVF-ET between 2009 and 2014. These 2,061 women were age-matched with an equal number of women with normal ovarian reserve (defined as FSH ≤ 10 IU/L)...
January 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28099686/the-clinical-implementation-of-primary-hpv-screening
#20
REVIEW
Luciano Mariani, Sarah Igidbashian, Maria Teresa Sandri, Patrizia Vici, Fabio Landoni
OBJECTIVE: To evaluate, from a gynecology perspective, the transition from cytology-based HPV screening to primary HPV screening. METHOD: Studies examining switching from cytology-based screening to primary HPV-DNA testing with triaging of patients with positive test results were retrieved and reviewed, with a particular focus on screening in an Italian setting. RESULTS: The increased complexity of patient-management decisions when implementing HPV-based screening was a critical issue discussed in the literature...
November 21, 2016: International Journal of Gynaecology and Obstetrics
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