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https://www.readbyqxmd.com/read/29156625/gene-based-pathogen-detection-can-we-use-qpcr-to-predict-the-outcome-of-diagnostic-metagenomics
#1
Sandra Christine Andersen, Mette Sofie Rousing Fachmann, Kristoffer Kiil, Eva Møller Nielsen, Jeffrey Hoorfar
In microbial food safety, molecular methods such as quantitative PCR (qPCR) and next-generation sequencing (NGS) of bacterial isolates can potentially be replaced by diagnostic shotgun metagenomics. However, the methods for pre-analytical sample preparation are often optimized for qPCR, and do not necessarily perform equally well for qPCR and sequencing. The present study investigates, through screening of methods, whether qPCR can be used as an indicator for the optimization of sample preparation for NGS-based shotgun metagenomics with a diagnostic focus...
November 20, 2017: Genes
https://www.readbyqxmd.com/read/29156481/-why-and-how-should-i-assess-frailty-a-guide-for-the-preoperative-anesthesia-clinic
#2
Oliver Birkelbach, Rudolf Mörgeli, Felix Balzer, Maria Olbert, Sascha Treskatsch, Rainer Kiefmann, Ursula Müller-Werdan, Anett Reisshauer, Christine Schwedtke, Bruno Neuner, Claudia Spies
Introduction: Frailty is a condition of decreased physiological reserves seen in approx. one third of elderly anesthesiological patients, and affecting many aspects of treatment as well as outcome. Although there are over 60 measurement instruments, frailty assessment is still poorly implemented. Understanding why and how to assess frailty is key to its implementation in preoperative anesthesia clinics. Method: After presenting the impact of perioperative frailty and the benefits of an early diagnosis on health related quality of life, we present an overview of the most important tools that can be used in the preoperative frailty assessment...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29156253/exploring-the-impact-of-using-measured-or-estimated-values-for-height-and-weight-on-the-relationship-between-bmi-and-acute-hospital-mortality
#3
Anne P Toft-Petersen, Jerome Wulff, David A Harrison, Marlies Ostermann, Mike Margarson, Kathryn M Rowan, Deborah Dawson
PURPOSE: Studies have demonstrated an association between height and weight and mortality among patients in the Intensive Care Unit (ICU) and the optimal body mass index (BMI) might be well above the optimal values in the general population. Most of these studies have relied on estimated values, the validity of which is not known. MATERIAL AND METHODS: Admissions to adult general ICUs from 1 April 2009 to 31 March 2016 in the Case Mix Programme (CMP) Database were described by height and weight assessment methods (measured or estimated)...
November 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29156199/how-can-one-optimize-induction-therapy-in-aml
#4
REVIEW
Selina M Luger
Induction therapy for acute myeloid leukemia has not changed much since 1973, when the 7 + 3 regimen of cytarabine and daunorubicin was born. Since then, various strategies have been evaluated to improve patient response, including dose intensification, the incorporation of additional agents into the regimen, the development of novel agents, and modified approaches for older patients. Recently, two novel agents, CPX-351 and gemtuzumab ozogamicin, have been approved by the US Food and Drug Administration. This review discusses each of the induction strategies and their impact on patient outcomes...
December 2017: Best Practice & Research. Clinical Haematology
https://www.readbyqxmd.com/read/29156189/obesity-in-pregnancy-optimizing-outcomes-for-mom-and-baby
#5
REVIEW
Heidi Dutton, Sarah Jean Borengasser, Laura Marie Gaudet, Linda A Barbour, Erin Joanne Keely
Obesity is common in women of childbearing age, and management of this population around the time of pregnancy involves specific challenges. Weight and medical comorbidities should be optimized both before and during pregnancy. During pregnancy, gestational weight gain should be limited, comorbidities should be appropriately screened for and managed, and fetal health should be monitored. Consideration should be given to the optimal timing of delivery and to reducing surgical and anesthetic complications. In the postpartum period, breastfeeding and weight loss should be promoted...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156160/treating-charcot-arthropathy-is-a-challenge-explaining-why-my-treatment-algorithm-has-changed
#6
REVIEW
Lawrence DiDomenico, Zachary Flynn, Michael Reed
Charcot deformity is a challenge that foot and ankle surgeons struggle to manage successfully. Despite the advances in knowledge, technology, and treatment modalities, limb loss is still greater than 10%. This article discusses the efficacy of conservative measures and traditional surgical approaches. It proposes a multidisciplinary team approach, medical optimization, and lifestyle modification to put the patient in the best position to heal. Also discussed is the authors' staged surgical treatment protocol to enhance outcomes and decrease the rate of limb loss...
January 2018: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/29156052/primary-adrenal-insufficiency-managing-mineralocorticoid-replacement-therapy
#7
Daniela Esposito, Daniela Pasquali, Gudmundur Johannsson
Context: Mineralocorticoid (MC) replacement therapy in patients with primary adrenal insufficiency (PAI) was introduced more than 60 years ago. Still, there are limited data on how MC substitution should be optimized, since MC dosing regimens have only been systematically investigated in a few studies. We review the management of current standard MC replacement therapy in PAI and its plausible impact on outcome. Evidence Acquisition: Using PubMed, we conducted a systematic review of the literature from 1939 to 2017, with the following keywords: 'adrenal insufficiency', 'mineralocorticoid deficiency', 'aldosterone', 'cardiovascular disease', 'hypertension', and 'heart failure'...
November 15, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29156049/management-of-pregnant-women-and-children-focusing-on-preventing-mother-to-infant-transmission
#8
Huey-Ling Chen, Wan-Hsin Wen, Mei-Hwei Chang
Hepatitis B virus (HBV) immunization has been effectively preventing chronic HBV infection with >90% efficacy in countries with universal neonatal immunization. Perinatal mother-to-infant transmission of HBV remains the major cause of chronic HBV infection despite immunization. Maternal hepatitis B e-antigen (HBeAg) and high viral load have been noted to be the most important risk factors for transmission. In recent years, short-term antiviral therapy for pregnant women in the third trimester has been shown to be highly effective in reducing 90% of vaccine failure in children...
November 16, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29156007/desmoplastic-nodular-medulloblastoma-in-young-children-a-management-dilemma
#9
Mohamed S AbdelBaki, Daniel R Boué, Jonathan L Finlay, Mark W Kieran
Background: Children with desmoplastic nodular medulloblastoma (DNMB) have excellent survival, leading multiple groups globally to attempt reduction of treatment-related morbidity. In 2013, the Children's Oncology Group began a clinical trial (ACNS1221) eliminating both radiation therapy (RT) and intraventricular methotrexate for children under 3 years of age with localized DNMB, aiming to build upon the excellent outcomes of the German (HIT) trials. ACNS1221 has recently closed due to increased incidence of recurrences noted at the 2-year interim analysis, raising important questions regarding optimal therapy for DNMB...
November 15, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/29155776/differential-effects-of-lipid-lowering-drugs-in-modulating-morphology-of-cholesterol-particles
#10
Shanmugavel Madasamy, David Liu, Jason Lundry, Benjamin Alderete, Raymond Kong, J Paul Robinson, Alan H B Wu, Edward P Amento
Treatment of dyslipidemia patients with lipid-lowering drugs leads to a significant reduction in low-density lipoproteins (LDL) level and a low to moderate level of increase in high-density lipoprotein (HDL) cholesterol in plasma. However, a possible role of these drugs in altering morphology and distribution of cholesterol particles is poorly understood. Here, we describe the in vitro evaluation of lipid-lowering drug effects in modulating morphological features of cholesterol particles using the plaque array method in combination with imaging flow cytometry...
November 10, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29155532/the-restorability-assessment-and-endodontic-access-cavity-interface
#11
Graham Quilligan, Gerald McKenna, P Finbarr Allen
Successful root canal treatment requires management of the bacterial infection within the root canal space and protection of residual tooth structure with direct/indirect restorations. Long-term success depends upon prevention of re-infection of the root canal space as well as ensuring favourable distribution of the occlusal forces throughout the residual tooth structure. Appropriate planning and design of the final restoration prior to initiating root canal treatment is paramount in achieving this objective...
December 2016: Dental Update
https://www.readbyqxmd.com/read/29155474/visual-biofeedback-using-trans-perineal-ultrasound-during-the-second-stage-of-labor
#12
Yinon Gilboa, Tahl I Frenkel, Yael Schlesinger, Sofie Rousseau, Daniel Hamiel, Reuven Achiron, Sharon Perlman
OBJECTIVES: to assess the obstetrical and psychological effect of visual biofeedback using trans-perineal ultrasound (TPU) during the second stage of labor. METHODS: Visual biofeedback using TPU was performed prospectively during the second stage of labor in twenty-six low risk nulliparous women. Pushing efficacy was assessed by the angle of progression at rest and during pushing efforts before and after observing the ultrasound screen. Obstetrical outcomes included level of perineal tearing, mode of delivery and length of the second stage...
November 20, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29155436/enzyme-replacement-therapy-for-infantile-onset-pompe-disease
#13
REVIEW
Min Chen, Lingli Zhang, Shuyan Quan
BACKGROUND: Infantile-onset Pompe disease is a rare and progressive autosomal-recessive disorder caused by a deficiency of the lysosomal enzyme acid alpha-glucosidase (GAA). Current treatment involves enzyme replacement therapy (with recombinant human alglucosidase alfa) and symptomatic therapies (e.g. to control secretions). Children who are cross-reactive immunological material (CRIM)-negative require immunomodulation prior to commencing enzyme replacement therapy.Enzyme replacement therapy was developed as the most promising therapeutic approach for Pompe disease; however, the evidence is lacking, especially regarding the optimal dose and dose frequency...
November 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29155341/outpatient-elective-posterior-lumbar-fusions-appear-to-be-safely-considered-for-appropriately-selected-patients
#14
Patawut Bovonratwet, Taylor D Ottesen, Raj J Gala, Daniel R Rubio, Nathaniel T Ondeck, Ryan P McLynn, Jonathan N Grauer
BACKGROUND CONTEXT: There has been growing interest in performing posterior lumbar fusions (PLFs) in the outpatient setting to optimize patient satisfaction and reduce cost. Although still done in only a small percentage of cases, this has been more possible due to advances in surgical techniques and anesthesia. However, data on the perioperative course of outpatient compared to inpatient PLF in a large sample size is scarce. PURPOSE: To compare perioperative complications between outpatient and inpatient PLF in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155337/photodynamic-therapy-in-fibrosarcoma-balb-c-animal-model-observation-of-the-rebound-effect
#15
Etcheverry María Eugenia, Pasquale Miguel Ángel, Gutiérrez Anabella, Bibé Solange, Ponzinibbio Carlos, Poteca Horacio, Garavaglia Mario
In vivo spectrofluorometric analysis during photodynamic therapy (PDT) is a fundamental tool to obtain information about the drug bleaching kinetics. Using a portable spectrofluorometer with an excitation source emitting at 400nm wavelength and a spectral analyzer ranging from 500nm to 800nm, the evolution of the meta-tetra(hydroxyphenyl) chlorin (m-THPC) photosensitizer fluorescence spectrum at the tumoral tissue of BALB/c murines with fibrosarcoma located at their flank was followed up. Ex vivo fluorescence measurements of the tumor and skin were also performed with the aim of better characterizing the in vivo signal at different parts of the tumor...
November 16, 2017: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/29155320/risk-assessment-in-adult-t-cell-leukemia-lymphoma-treated-with-allogeneic-hematopoietic-stem-cell-transplantation
#16
Makoto Yoshimitsu, Ryuji Tanosaki, Koji Kato, Takashi Ishida, Ilseung Choi, Yoshifusa Takatsuka, Takahiro Fukuda, Tetsuya Eto, Michihiro Hidaka, Naoyuki Uchida, Toshihiro Miyamoto, Yasuhiro Nakashima, Yukiyoshi Moriuchi, Koji Nagafuji, Yasuhiko Miyazaki, Tatsuo Ichinohe, Minoko Takanashi, Yoshiko Atsuta, Atae Utsunomiya
Disease status at allogeneic hematopoietic cell transplantation (HCT) is an important pre-transplant prognostic factor of HCT in adult T-cell leukemia/lymphoma (ATL); however, other prognostic factors, including comorbidities, were not predictive in small cohort analyses. Several scoring systems (HCT-comorbidity index [CI]/modified European Society for Blood and Marrow Transplantation risk score [mEBMT]) have been adopted to predict HCT outcomes in other hematological malignancies. We retrospectively evaluated HCT-CI and mEBMT to predict non-relapse mortality (NRM) in 824 ATL patients registered in the Japan Society for Hematopoietic Cell Transplantation TRUMP database, from 2008 until 2013...
November 16, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29155187/when-chemotherapy-is-not-enough-management-of-prostatic-embryonal-rhabdomyosarcoma-in-an-infant
#17
Christina Carpenter, Joseph M Gleason
A baby boy was diagnosed with embryonal rhabdomyosarcoma causing left hydroureteronephrosis. A loop ureterostomy was performed, and he was treated per the RMS13 protocol. After three months of chemotherapy, his tumor burden increased, and he underwent radical cystoprostatectomy and right-to-left transureteroureterostomy (end-to-end fashion utilizing the distal limb of his ureterostomy). This innovative method was utilized because the child's tumor burden was too large to be treated effectively and safely with radiation...
November 16, 2017: Urology
https://www.readbyqxmd.com/read/29155168/improved-assessment-of-bolus-clearance-in-patients-with-achalasia-using-high-resolution-impedance-manometry
#18
Dustin A Carlson, Claire A Beveridge, Zhiyue Lin, Michelle Balla, Dyanna Gregory, Michael Tye, Katherine Ritter, Peter J Kahrilas, John E Pandolfino
BACKGROUND & AIMS: Esophageal retention is typically evaluated by timed barium esophagram in patients treated for achalasia. Esophageal bolus clearance can also be evaluated using high-resolution impedance manometry. We evaluated the associations of conventional and novel high-resolution impedance manometry metrics, esophagram, and patient-reported outcomes (PRO) in achalasia. METHODS: We performed a prospective study of 70 patients with achalasia (20-81 years old, 30 female) treated by pneumatic dilation or myotomy who underwent follow-up evaluations from April 2013 through December 2015 (median 12 months after treatment; range, 3-183 months)...
November 15, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29155115/transtentorial-distortion-syndrome-a-consistent-complication-following-lateral-and-fourth-ventricular-shunting-in-adults
#19
Claudia L Craven, Irene Baudracco, Simon D Thompson, Lewis Thorne, Laurence D Watkins, Ahmed K Toma
BACKGROUND: Complex hydrocephalus affecting lateral and fourth ventricles separately is occasionally managed with CSF diversion via supra- and infra-tentorial ventricular catheters. The optimal configuration to reduce complications is currently unknown in adults. We describe a consistently similar clinical presentation of patients with complex hydrocephalus and a fourth ventricle separately drained by infra-tentorial shunt insertion. METHODS: A retrospective single centre case series...
November 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29154970/patient-engagement-using-new-technology-to-improve-adherence-to-positive-airway-pressure-therapy-a-retrospective-analysis
#20
Atul Malhotra, Maureen E Crocker, Leslee Willes, Colleen Kelly, Sue Lynch, Adam V Benjafield
BACKGROUND: Sleep apnea has major neurocognitive and cardiovascular and metabolic risks. Treatment of sleep apnea is sub-optimal because of variable adherence to existing therapies. METHODS: This trial compared PAP adherence among patients who were provided active patient engagement (APE) technology versus those who received usual care monitoring (UCM). The primary outcome was defined by the U.S. Medicare definition of adherence. PARTICIPANTS: Adherence data from two cloud-based databases (AirView™ and myAir™) were analyzed for patients with sleep apnea...
November 15, 2017: Chest
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