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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/29145543/association-of-ipilimumab-with-safety-and-antitumor-activity-in-women-with-metastatic-or-recurrent-human-papillomavirus-related-cervical-carcinoma
#2
Stephanie Lheureux, Marcus O Butler, Blaise Clarke, Mihaela C Cristea, Lainie P Martin, Katia Tonkin, Gini F Fleming, Anna V Tinker, Hal W Hirte, Daliah Tsoref, Helen Mackay, Neesha C Dhani, Prafull Ghatage, Johanne Weberpals, Stephen Welch, Nhu-An Pham, Vinicius Motta, Valentin Sotov, Lisa Wang, Katherine Karakasis, Smitha Udagani, Suzanne Kamel-Reid, Howard Z Streicher, Patricia Shaw, Amit M Oza
Importance: Based on evidence of human papillomavirus (HPV)-induced immune evasion, immunotherapy may be an attractive strategy in cervical cancer. Ipilimumab is a fully humanized monoclonal antibody that blocks cytotoxic T-lymphocyte antigen-4 (CTLA-4), which acts to downregulate the T-cell immune response. Objective: To assess the safety and antitumor activity of ipilimumab in recurrent cervical cancer. Design, Setting, and Participants: A multicenter trial was designed for patients with metastatic cervical cancer (squamous cell carcinoma or adenocarcinoma) with measurable disease and progression after at least 1 line of platinum chemotherapy...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29145470/active-immunization-in-patients-transplanted-for-hepatitis-b-virus-related-liver-diseases-a-prospective-study
#3
Anli Yang, Zhiyong Guo, Qingqi Ren, Linwei Wu, Yi Ma, Anbin Hu, Dongping Wang, Haidan Ye, Xiaofeng Zhu, Weiqiang Ju, Xiaoshun He
INTRODUCTION: Prophylactic administration of hepatitis B immunoglobulin (HBIG) and nucleos(t)ide analogues (NAs) is the standard treatment for controlling hepatitis B virus (HBV) recurrence after liver transplantation (LT). Since lifelong use of HBIG is expensive and inconvenient and the antibodies level in anti-hepatitis B surface (HBs) is not sustainable and stable, an alternative strategy is to produce anti-HBs antibodies by active immunization. Our present study aimed to prospectively investigate the efficacy and safety of procedural HBV vaccination in transplanted patients...
2017: PloS One
https://www.readbyqxmd.com/read/29145310/successful-treatment-with-rivaroxaban-of-cerebral-venous-thrombosis-and-bone-marrow-necrosis-induced-by-pegaspargase-a-case-report-and-literature-review
#4
Jingrui Sui, Yongming Zhang, Liqing Yang, Hui Wang, Junqing Xu, Rongxia Wei, Yaping Hao, Xiaolei Wang, Jun Peng, Junjie Ma
RATIONALE: Pegaspargase has been used in the treatment of acute lymphoblastic leukemia with promising results. However, it has also been associated with several potentially serious complications, including thrombosis. Pegaspargase-induced cerebral venous thrombosis and bone marrow necrosis are very rare. PATIENT CONCERNS: A 50-year-old female developed headache, weakness of the right lower extremity, fever, and bone pain after chemotherapy including pegaspargase for the treatment of acute lymphoblastic leukemia...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145278/safety-of-continuing-aspirin-therapy-during-spinal-surgery-a-systematic-review-and-meta-analysis
#5
Chenggui Zhang, Guodong Wang, Xiaoyang Liu, Yang Li, Jianmin Sun
BACKGROUND: Questions whether to continue or discontinue aspirin administration in the perioperative period of spinal surgery has not been systematically evaluated. OBJECTIVE: The present systematic review is carried out to assess the impact of continuing aspirin administration on the bleeding and cardiovascular events in perispinal surgery period. METHODS: Studies were retrieved through MEDLINE, EMBASE, and Springer Link Databases (search terms, aspirin, continue or discontinue, and spinal fusion), bibliographies of the articles retrieved, and the authors' reference files...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145272/the-efficiency-of-intravenous-acetaminophen-for-pain-control-following-total-knee-and-hip-arthroplasty-a-systematic-review-and-meta-analysis
#6
Limin Liang, Ying Cai, Aixiang Li, Chuangen Ma
BACKGROUND: This meta-analysis aimed to evaluate the efficiency and safety of intravenous acetaminophen as an adjunct to multimodal analgesia for pain control after total joint arthroplasty (TJA). METHODS: PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) and non-RCTs were included. Fixed/random effect model was used according to the heterogeneity tested by I statistic. Meta-analysis was performed using Stata 11...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145233/prospective-evaluation-of-the-feasibility-safety-and-efficacy-of-cocoon-duct-occluder-for-transcatheter-closure-of-large-patent-ductus-arteriosus-a-single-center-study-with-short-and-medium-term-follow-up-results
#7
Santosh Kumar Sinha, Mahmadula Razi, Rama Niwas Pandey, Prakash Kumar, Vinay Krishna, Mukesh Jitendra Jha, Vikas Mishra, Mohammad Asif, Nasar Abdali, Pradyot Tewari, Ramesh Thakur, Umeshwar Pandey, Chandra Mohan Varma
OBJECTIVE: To evaluate the feasibility, safety, and efficacy of a novel Cocoon Duct Occluder device for the transcatheter closure (TCC) of large patent ductus arteriosus (PDA). METHODS: In this prospective, non-randomized study, consecutive patients with large PDA (narrowest diameter: ≥3.5/4.0 mm in symptomatic/asymptomatic patients, respectively), who underwent TCC with Cocoon Duct Occluder at our institute between November, 2012 and June, 2016 were examined...
November 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29145216/comparison-of-warfarin-use-in-terms-of-efficacy-and-safety-in-two-different-polyclinics
#8
Salih Kılıç, Hatice Soner Kemal, Elif İlkay Yüce, Evrim Şimşek, Burcu Yağmur, Nuray Memişoğlu Akgül, Cahide Soydaş Çınar, Mehdi Zoghi, Cemil Gürgün
OBJECTIVE: This study compared the efficacy and safety of warfarin in specialized international normalized ratio (INR) outpatient clinic (INR-C) and in general cardiology outpatient clinic (General-C). METHODS: Herein, 381 consecutive patients with a regular follow-up at INR-C (n=233) or General-C (n=148) for at least 1 year were retrospectively included. While INR-C patients were followed by a single experienced trained nurse, General-C patients were followed by a different cardiologist who worked in a rotational principle every month...
November 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29145215/comparison-of-efficacy-and-safety-of-liraglutide-3-0-mg-in-individuals-with-bmi-above-and-below-35-kg-m%C3%A2-a-post-hoc-analysis
#9
Carel le Roux, Vanita Aroda, Joanna Hemmingsson, Ana Paula Cancino, Rune Christensen, Xavier Pi-Sunyer
OBJECTIVE: To investigate whether the efficacy and safety of liraglutide 3.0 mg differed between two subgroups, BMI 27 to <35 and BMI ≥ 35 kg/m², in individuals without and with type 2 diabetes (T2D). METHODS: A post-hoc analysis of two 56-week, randomized, double-blind, placebo-controlled trials (SCALE Obesity and Prediabetes; SCALE Diabetes). Subgroup differences in treatment effects of liraglutide 3.0 mg were evaluated by testing the interaction between treatment group and baseline BMI subgroup...
November 17, 2017: Obesity Facts
https://www.readbyqxmd.com/read/29145039/a-first-in-human-phase-i-study-of-sar125844-a-selective-met-tyrosine-kinase-inhibitor-in-patients-with-advanced-solid-tumours-with-met-amplification
#10
Eric Angevin, Gianluca Spitaleri, Jordi Rodon, Katia Dotti, Nicolas Isambert, Stefania Salvagni, Victor Moreno, Sylvie Assadourian, Corinne Gomez, Marzia Harnois, Antoine Hollebecque, Analia Azaro, Alice Hervieu, Karim Rihawi, Filippo De Marinis
PURPOSE: Dysregulated MET signalling is implicated in oncogenesis. The safety and preliminary efficacy of a highly selective MET kinase inhibitor (SAR125844) was investigated in patients with advanced solid tumours and MET dysregulation. METHODS: This was a phase I dose-escalation (3 + 3 design [50-740 mg/m(2)]) and dose-expansion study. In the dose escalation, patients had high total MET (t-MET) expression by immunohistochemistry (IHC) or MET amplification by fluorescence in situ hybridisation...
November 13, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29145036/liver-immunotolerance-and-hepatocellular-carcinoma-patho-physiological-mechanisms-and-therapeutic-perspectives
#11
REVIEW
Gaël S Roth, Thomas Decaens
At the moment of the diagnosis of hepatocellular carcinoma (HCC), 70% of patients have only access to palliative treatments, with very few therapeutic options. Liver immunology is very specific, and liver immunotolerance is particularly developed because of the constant and massive influx of antigens. Deregulation of hepatic immunotolerance is implicated in chronic liver diseases development and particularly in liver carcinogenesis. For these reasons, HCC may be an excellent candidate for anticancer immunotherapies such as immune checkpoint inhibitors targeting CTLA-4 and PD-L1/PD-1...
November 13, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29144794/endoscopic-ultrasound-guided-fine-needle-aspiration-eus-fna-in-the-diagnosis-of-adrenal-metastasis-in-a-high-risk-population
#12
Catherine D Zhang, Dana Erickson, Michael J Levy, Ferga C Gleeson, Diva R Salomao, Danae A Delivanis, Irina Bancos
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in the diagnosis of adrenal metastasis in a high-risk population Objective: While the left adrenal gland is readily accessible via endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), data regarding the utility of EUS-FNA in the diagnosis of adrenal lesions remain limited. We aimed to 1) describe the clinical context, adverse event rate, and diagnostic performance of EUS-FNA and 2) compare the safety profile and diagnostic accuracy of EUS-FNA with percutaneous adrenal biopsy...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29144717/review-of-non-invasive-vagus-nerve-stimulation-gammacore-efficacy-safety-potential-impact-on-comorbidities-and-economic-burden-for-episodic-and-chronic-cluster-headache
#13
Mkaya Mwamburi, Eric J Liebler, Andrew T Tenaglia
The FDA has cleared gammaCore (non-invasive vagus nerve stimulator [nVNS]) for the treatment of episodic cluster headache (eCH). With the exception of subcutaneous sumatriptan, all other treatments are used off label and have many limitations. The FDA approval process for devices differs from that of drugs. We performed a review of the literature to evaluate new evidence on various aspects of gammaCore treatment and impact. The ACute Treatment of Cluster Headache Studies (ACT1 and ACT2), both double-blind sham-controlled randomized trials, did not meet the primary endpoints of the trials but each demonstrated significant superiority of gammaCore among patients with eCH...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144627/laparoscopic-nephrectomy-outside-gerota-fascia-and-en-bloc-ligation-of-the-renal-hilum-for-management-of-inflammatory-renal-diseases
#14
Liang Ma, Yanlan Yu, Guangju Ge, Gonghui Li
OBJECTIVES: This study aims to improve laparoscopic nephrectomy techniques for inflammatory renal diseases (IRD) and to reduce complications. MATERIALS AND METHODS: Thirty-three patients underwent laparoscopic nephrectomy for IRD, with a method of outside Gerota fascia dissection and en-bloc ligation and division of the renal pedicle. Operative time, blood loss, complications, analgesia requirement, post-operative recovery of intestinal function and hospital stay were recorded...
November 19, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29144514/catheter-ablation-of-atrial-fibrillation-in-elderly-population
#15
Josef Kautzner, Petr Peichl, Marek Sramko, Robert Cihak, Bashar Aldhoon, Dan Wichterle
Background: Although elderly patients have been included in published series of catheter ablation for atrial fibrillation (AF), clinical benefit and safety remain still less defined in this population. A retrospective analysis of the results of catheter ablation for AF in a large volume center focused on comparison of elderly patients with the rest of the patient cohort was conducted in this study. Methods: Consecutive patients who underwent catheter ablation for AF between January 2001 and December 2016 were analysed...
September 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29144253/pediatric-orthopedic-hoverboard-injuries-a-prospectively-enrolled-cohort
#16
Andrew D Sobel, Daniel B Reid, Travis D Blood, Alan H Daniels, Aristides I Cruz
Hoverboards pose a significant risk of musculoskeletal injury to pediatric riders. A prospectively enrolled cohort yielded 9 pediatric patients injured while riding hoverboards in 2016. Eight of the injuries involved the upper extremity, and one involved the lower extremity. No riders wore any safety equipment and injury patterns modeled those seen in skateboard riders.
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29144241/shifting-risks-and-conflicting-outcomes-ecmo-for-neonates-with-congenital-diaphragmatic-hernia-in-the-modern-era
#17
Joseph W Turek, Joseph R Nellis, Brenton G Sherwood, Meera Kotagal, Andrew L Mesher, Ravi R Thiagarajan, Sonali S Patel, Jeffrey R Avansino, Peter T Rycus, D Michael McMullan, Thomas V Brogan
OBJECTIVES: To update previously described trends for neonates with congenital diaphragmatic hernia (CDH) receiving ECMO with changes in recommendations for care, and to determine how recent advancements in respiratory care have affected this patient population. STUDY DESIGN: This study is a retrospective review of more than 2500 neonates with CDH who received ECMO listed in the Extracorporeal Life Support Organization (ELSO) registry. Cochran-Armitage and multivariate regression analyses were used to analyze changes in the patient population over time and in mortality-related risk factors...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29144113/-can-we-transfer-the-mechanisms-of-the-generics-market-to-biosimilars
#18
Ch O Jacke, F Wild
Personalized medicines such as biologics and their generic equivalents, biosimilars, are pouring onto the pharmaceutical markets. Data of 16 private health insurance companies were used to describe the market shares of selected biosimilars available in 2014 and 2015. The purpose of this study focuses on the question of whether market access of biosimilars will lead to a price competition of the expense of innovation competition. The results show that prescriptions of biosimilars made up 37% of total prescriptions in 2015 compared to 35% in 2014, and that their share of prescription costs went up from 21% to 23% in the same period...
December 15, 2016: Versicherungsmedizin
https://www.readbyqxmd.com/read/29144061/saxagliptin-add-on-therapy-in-chinese-patients-with-type-2-diabetes-inadequately-controlled-by-insulin-with-or-without-metformin-results-from-the-super-study-a-randomized-double-blind-placebo-controlled-trial
#19
Yingli Chen, Xiaomin Liu, Quanmin Li, Jianhua Ma, Xiaofeng Lv, Lixin Guo, Changjiang Wang, Yongquan Shi, Yanbing Li, Eva Johnsson, Mei Wang, June Zhao, Linong Ji
This prospective, multicentre, phase 3 study (NCT02104804) evaluated the efficacy and safety of saxagliptin add-on therapy in Chinese patients with type 2 diabetes inadequately controlled by insulin ± metformin. Patients with glycated haemoglobin (HbA1c) 7.5%-10.5% and fasting plasma glucose (FPG) <270 mg/dL on stable insulin therapy (20-150 U/day) were randomized (1:1) to saxagliptin 5 mg once daily (N = 232) or placebo (N = 230) for 24 weeks, stratified by metformin use. The primary efficacy measure was change in HbA1c...
November 16, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29144056/oropharyngeal-dysphagia-profiles-in-individuals-with-oculopharyngeal-muscular-dystrophy
#20
L C Tabor, E K Plowman, C Romero-Clark, S Youssof
BACKGROUND: Although dysphagia represents a hallmark manifestation of oculopharyngeal muscular dystrophy (OPMD), limited knowledge exists regarding the underlying nature of oropharyngeal swallowing impairments in this patient population. We aimed to delineate global pharyngeal dysphagia profiles in OPMD and identify the prevalence and physiologic associations of impairments in swallowing safety and efficiency. METHODS: Twenty-two individuals with OPMD completed a videofluoroscopic swallowing evaluation...
November 16, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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