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Marc Sørensen, Lars Willy Andersen
Limiting intensive care is paid increasing attention. In the echoing call for physicians' ethical self-restriction, it is easily overlooked, however, that ethics needs a critical epistemological analysis before it can suffice as an emergency brake to futile treatment. This analysis is provided by the present essay. The authors suggest that the difficulties of resolving moral dilemmas related to limiting intensive care may just be due to the unclarified epistemological status of moral claims. Even if normative ethics cannot prescribe right decisions, but only draw conclusions from defined premises, the premises may or may not be true...
October 20, 2018: Bioethics
Sinem Ermin, Akın Çinkooğlu, Seher Susam, Özgür Batum, Ufuk Yılmaz
INTRODUCTION: Pulmonary thromboembolism(PTE) is a clinical condition that can result in sudden death. Computed tomography pulmonary angiography(CTPA) is the most sensitive imaging technique for the diagnosis of PTE. Filling defects in the pulmonary veins, which can be identified in areas adjacent to PTE, have been named the "pulmonary vein sign"(PVS). OBJECTIVES: The aim of our study is to determine the frequency, sensitivity, and specificity of PVS due to decreased venous drainage in the affected area in PTE patients...
October 20, 2018: Clinical Respiratory Journal
H Fu, Q Chen
BACKGROUND: Mesenchymal stem cell (MSC) treatment has emerged as an important adjunct therapy for heart failure. However, the use of MSC to treat heart failure has not been well established. We conducted a systematic review and meta-analysis to evaluate the efficacy of MSC treatment for heart failure. METHODS: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched. Randomized controlled trials (RCTs) assessing the influence of MSC treatment on cardiac function in heart failure were included in this analysis...
October 19, 2018: Herz
Michelle N Messmer, Annelise G Snyder, Andrew Oberst
Our conception of programmed cell death has expanded beyond apoptosis to encompass additional forms of cell suicide, including necroptosis and pyroptosis; these cell death modalities are notable for their diverse and emerging roles in engaging the immune system. Concurrently, treatments that activate the immune system to combat cancer have achieved remarkable success in the clinic. These two scientific narratives converge to provide new perspectives on the role of programmed cell death in cancer therapy. This review focuses on our current understanding of the relationship between apoptosis and antitumor immune responses and the emerging evidence that induction of alternate death pathways such as necroptosis could improve therapeutic outcomes...
October 19, 2018: Cell Death and Differentiation
Stephen T Higgins
This Special Issue of Preventive Medicine (PM) is the 5th in a series on behavior change, health, and health disparities. Unhealthy behavior patterns (i.e., lifestyle choices) including cigarette smoking and other substance abuse, physical inactivity, unhealthy food choices, and non-adherence with recommended medical regimens, undermine U.S. population health by increasing risk for chronic disease and premature death. This Special Issue brings together scholarly contributions from the emerging area of tobacco regulatory science to examine current topics of critical importance to reducing the burden of cigarette smoking on U...
December 2018: Preventive Medicine
Godfrey Mbaruku, Michelle Skaer Therrien, Robert Tillya, Selemani Mbuyita, Zacharia Mtema, Iddajovana Kinyonge, Ritha Godfrey, Silas Temu, Suellen Miller
BACKGROUND: Obstetric hemorrhage (OH) remains one of the leading causes of maternal mortality, particularly in rural Africa. Tanzania has a high maternal mortality ratio, and approximately 80% of the population accesses health care lower level facilities, unable to provide Comprehensive Emergency Obstetric Care (CEmOC). The non-pneumatic anti-shock garment (NASG) has been demonstrated to reduce mortality as it buys time for women in shock to be transported to or to overcome delays at referral facilities...
October 19, 2018: Reproductive Health
Carl Magnusson, Johan Herlitz, Thomas Karlsson, Christer Axelsson
BACKGROUND: The assessment of children in the Emergency Medical Service (EMS) is infrequent representing 5.4% of the patients in an urban area in the western part of Sweden. In Sweden, patients are assessed on scene by an EMS nurse whom independently decides on interventions and level of care. To aid the EMS nurse in the assessment a triage instrument, Rapid Emergency Triage and Treatment System-paediatrics (RETTS-p) developed for Emergency Department (ED) purpose has been in use the last 5 years...
October 19, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Lonneke I M Lenferink, Angela Nickerson, Jos de Keijser, Geert E Smid, Paul A Boelen
BACKGROUND: Previous latent trajectory studies in adult bereaved people have identified individual differences in reactions postloss. However, prior findings may not reflect the complete picture of distress postloss, because they were focused on depression symptoms following nonviolent death. We examined trajectories of symptom-levels of persistent complex bereavement disorder (PCBD), depression, and posttraumatic stress disorder (PTSD) in a disaster-bereaved sample. We also investigated associations among these trajectories and background and loss-related factors, psychological support, and previous mental health complaints...
October 19, 2018: Depression and Anxiety
Ye Ge, Qiucheng Yao, Xianfu Wang, Hongliang Chai, Guohua Deng, Hualan Chen, Yuping Hua
Human infectious avian influenza virus (AIV) H7N9 emerged in China in 2013. The N9 gene of H7N9, which has the ability to cause death in humans, originated from an H11N9 influenza strain circulating in wild birds. To investigate the frequency and distribution of the N9 gene of the H11N9 and H7N9 influenza virus circulating in wild birds between 2006 and 2015, 35,604 samples were collected and tested. No H7N9 but four strains of the H11N9 subtype AIV were isolated, and phylogenetic analyses showed that the four H11N9 viruses were intra-subtype and inter-subtype reassortant viruses...
October 19, 2018: Transboundary and Emerging Diseases
Megan Culler Freeman, Carolyn B Coyne, Michael Green, John V Williams, Laurie A Silva
Recent years have brought a rise in newly emergent viral infections, primarily in the form of previously known arthropod-transmitted viruses that have increased significantly in both incidence and geographical range. Of particular note are DENV, CHIKV, and ZIKV, which are transmitted mostly by Aedes species of mosquitoes that exhibit a wide and increasing global distribution. Being important pathogens for the general population, these viruses have the potential to be devastating in the international transplant community, with graft rejection and death as possible outcomes of infection...
October 19, 2018: Pediatric Transplantation
Tomoya Nishino, Shinjirou Wakai, Hiromichi Aoki, Sadaki Inokuchi
Case: A 45-year-old man presented to our emergency department with disturbance of consciousness; he had mentioned to his family earlier about a drug overdose. When first responders arrived, he suffered cardiac arrest. Cardiac arrest due to drug overdose was diagnosed.The patient was supported with venoarterial extracorporeal membrane oxygenation. Arterial blood gas showed mixed acidosis, and electrocardiogram showed junctional rhythm and complete right bundle branch block. Outcome: The patient's blood pressure gradually decreased, and he died on the third day of hospitalization...
October 2018: Acute Medicine & Surgery
Syed Zahid Ali Shah, Deming Zhao, Tariq Hussain, Naveed Sabir, Mazhar Hussain Mangi, Lifeng Yang
Prion diseases are a group of fatal and debilitating neurodegenerative diseases affecting humans and animal species. The conversion of a non-pathogenic normal cellular protein (PrPc ) into an abnormal infectious, protease-resistant, pathogenic form prion protein scrapie (PrPSc ), is considered the etiology of these diseases. PrPSc accumulates in the affected individual's brain in the form of extracellular plaques. The molecular pathways leading to neuronal cell death in prion diseases are still unclear. The free radical damage, oxidative stress and mitochondrial dysfunction play a key role in the pathogenesis of the various neurodegenerative disorders including prion diseases...
2018: Frontiers in Molecular Neuroscience
Giorgio Ivan Russo, Tatiana Solinas, Daniele Urzì, Salvatore Privitera, Daniele Campisi, Andrea Cocci, Marco Carini, Massimo Madonia, Sebastiano Cimino, Giuseppe Morgia
Prostate cancer (PCa) is the second most frequently diagnosed cancer and the sixth leading cause of death from cancer worldwide. Countries following a Mediterranean-type dietary pattern, has been reported to have lower PCa incidence and mortality compared with other European regions. A population-based case-control study has been conducted from January 2015 to December 2016 in a single institution of the municipality of Catania, southern Italy. A total of 118 PCa and 238 population-based controls were collected...
October 18, 2018: International Journal of Impotence Research
Bruno Galvão-Filho, Júlia Teixeira de Castro, Maria Marta Figueiredo, Claudio Gonçalves Rosmaninho, Lis Ribeiro do Valle Antonelli, Ricardo Tostes Gazzinelli
Malaria-associated acute respiratory distress syndrome (MA-ARDS) and acute lung injury (ALI) are complications that cause lung damage and often leads to death. The MA-ARDS/ALI is associated with a Type 1 inflammatory response mediated by T lymphocytes and IFN-γ. Here, we used the Plasmodium berghei NK65 (PbN)-induced MA-ALI/ARDS model that resembles human disease and confirmed that lung CD4+ and CD8+ T cells predominantly expressed Tbet and IFN-γ. Surprisingly, we found that development of MA-ALI/ARDS was dependent on functional CCR4, known to mediate the recruitment of Th2 lymphocytes and regulatory T cells...
October 18, 2018: Mucosal Immunology
Enyuan Shang, Yiru Zhang, Chang Shu, Chiaki Tsuge Ishida, Elena Bianchetti, Mike-Andrew Westhoff, Georg Karpel-Massler, Markus D Siegelin
XPO1 has recently emerged as a viable treatment target for solid malignancies, including glioblastoma (GBM), the most common primary malignant brain tumor in adults. However, given that tumors become commonly resistant to single treatments, the identification of combination therapies is critical. Therefore, we tested the hypothesis that inhibition of anti-apoptotic Bcl-2 family members and XPO1 are synthetically lethal. To this purpose, two clinically validated drug compounds, the BH3-mimetic, ABT263, and the XPO1 inhibitor, Selinexor, were used in preclinical GBM model systems...
October 18, 2018: Scientific Reports
Zoe F Cairncross, Jeremy Herring, Trevor van Ingen, Brendan T Smith, Pamela Leece, Brian Schwartz, Karin Hohenadel
BACKGROUND: Negative health outcomes associated with the use of both prescribed and nonprescribed opioids are increasingly prevalent. We examined long-term trends in opioid-related harms in Ontario across a set of 6 indicators and the relation between harms and neighbourhood income in 2016. METHODS: We examined rates of neonatal abstinence syndrome, opioid poisoning (fatal and nonfatal) and nonpoisoning opioid-related events from 2003 to 2016 in Ontario using population-based health administrative databases...
October 2018: CMAJ Open
Nicolas Javaud, Louise Bonnin, Frederic Lapostolle, Marouane Boubaya, Alexandre Bardis, Romain Dufau, Aiham Ghazali, Paul-Georges Reuter, Dominique Pateron, Frederic Adnet
OBJECTIVES: Life threatening complications can occur at any stage of cirrhosis progression. There are few studies on the prognosis of cirrhotic patients managed in an Emergency Department (ED) although management of patients will occur in the ED. The objective of our study was to determine the risk factors for mortality in cirrhotic patients who visited to the ED. METHODS: All cirrhotic patients attending ED in three different university hospitals of Assistance Publique - Hôpitaux de Paris between January 2014 and June 2015 were identified by a retrospective analysis of digital records and included in the study...
October 12, 2018: American Journal of Emergency Medicine
P Ramachandran, R Morcus, M Tahir, I Onukogu, B Spinowitz, Jen C Wang
BACKGROUND: Lung cancer is among the top causes of cancer-related mortality in men and is the second most common cancer after breast cancer in women. There are approximately 234,030 new cases of lung cancer and 154,050 deaths from lung cancer in 2018 as per the latest American Cancer Society's report. Alectinib, a more potent orally active tyrosine kinase inhibitor which was approved by the US Food & Drug Administration for anaplastic lymphoma kinase-positive lung adenocarcinoma, has been shown to have a reasonable safety profile when compared with other anaplastic lymphoma kinase-targeted therapy...
October 19, 2018: Journal of Medical Case Reports
Ying Sun, Na An, Jiansheng Li, Jinchan Xia, Yange Tian, Peng Zhao, Xuefang Liu, Haiying Huang, Jianfeng Gao, Xiaoli Zhang
Chronic obstructive pulmonary disease (COPD) is a leading cause of death due to tis high morbidity and mortality. microRNAs have emerged as new biomarkers for the prognosis and diagnosis of patients with COPD. In this study, we aimed to investigate the expression of microRNA-206 (miR-206) in lung tissues from COPD patients and to explore the regulatory role of miR-206 in the human pulmonary microvascular endothelial cells (HPMECs). Our results showed that cigarette smoke extract (CSE) promoted cell apoptosis, increased caspase-3 activity, and upregulated the expression of miR-206 in HPMECs, which was significantly reversed by the miR-206 knockdown...
October 18, 2018: Journal of Cellular Biochemistry
William Vaughn McCall, Anilkumar Pillai, Doug Case, Laryssa McCloud, Tiffany Nolla, Fallon Branch, Nagy A Youssef, Jason Moraczewski, Liniya Tauhidul, Chirayu D Pandya, Peter B Rosenquist
PURPOSE/BACKGROUND: Observational studies show an association between nightmares and suicide. Prazosin is proposed as a nightmare treatment. This pilot, randomized clinical trial tested whether treatment of nightmares with prazosin would reduce suicidal ideas in suicidal posttraumatic stress disorder (PTSD) patients. METHODS/PROCEDURES: Twenty adult, suicidal PTSD patients with nightmares were blindly and randomly assigned 1:1 to escalating doses of prazosin versus placebo at bedtime only for 8 weeks...
October 17, 2018: Journal of Clinical Psychopharmacology
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