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Hisato Takagi, Shohei Mitta, Tomo Ando
OBJECTIVE:  The objective of this study was to determine whether valve-in-valve transcatheter aortic valve implantation (VIV-TAVI) is associated with better survival than redo surgical aortic valve replacement (SAVR) in patients with degenerated aortic valve bioprostheses, and we performed a meta-analysis of comparative studies. METHODS:  To identify all comparative studies of VIV-TAVI versus redo SAVR; MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched through October 2017...
August 16, 2018: Thoracic and Cardiovascular Surgeon
Kazuhiro Uda, Chitose Koyama-Wakai, Kensuke Shoji, Noriyasu Iwase, Daisuke Motooka, Shota Nakamura, Isao Miyairi
BACKGROUND: WU polyomavirus (WUPyV) is a relatively new virus associated with respiratory infections. However, its role is unclear in children with severe respiratory failure. OBJECTIVES: We aimed to evaluate the characteristics of severe respiratory failure associated with WUPyV infection in children. STUDY DESIGN: We retrospectively reviewed cases of respiratory tract infection at a tertiary children's hospital in Japan and performed real-time polymerase chain reaction (PCR) for WUPyV using residual extracted nucleic acid samples taken from respiratory tract samples of pediatric patients primarily with respiratory failure...
August 9, 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Qi Zhao, Micheline S Z S Coelho, Shanshan Li, Paulo H N Saldiva, Kejia Hu, Michael J Abramson, Rachel R Huxley, Yuming Guo
BACKGROUND: Extreme temperature events are known to be adversely associated with a range of health outcomes, but little is known about the effect of less extreme, but more frequent fluctuation in temperature. We examined the spatiotemporal and demographic variation in the effect of temperature variability (TV) on nationwide hospitalizations in Brazil during 2000-2015. METHODS: Data on daily hospitalizations and weather variables were collected from 1814 cities, comprising 78...
August 13, 2018: Environment International
Feinberg Joshua, Flynn Lorna, Woodward Matthew, Pennell Christopher, Higham Helen, Morgan Lauren, Holman Lance, Tully Patrick, McCulloch Peter
INTRODUCTION: Methods to improve clinical systems safety suffer from significant difficulties in implementation and scaling up. We used an upscaling implementation strategy entitled Supported Champions in a quality and safety improvement programme for emergency surgery at regional level, focusing on patients with right iliac fossa pain. METHODS: A before-after study was conducted across four acute NHS Trusts: A 6 month intervention phase was preceded and followed by 3 months of data collection...
August 13, 2018: International Journal of Surgery
Matt S Zinter, Kevin L Delucchi, Michele Y Kong, Benjamin E Orwoll, Aaron S Spicer, Michelle J Lim, Mustafa F Alkhouli, Anna E Ratiu, Anne V McKenzie, Patrick S McQuillen, Christopher C Dvorak, Carolyn S Calfee, Michael A Matthay, Anil Sapru
RATIONALE: Matrix metalloproteinases (MMPs) and their endogenous tissue inhibitors (TIMPs) may contribute to lung injury through extracellular matrix degradation and modulation of inflammation and fibrosis. OBJECTIVES: To test for an association between MMP pathway proteins and inflammation, endothelial dysfunction, and clinical outcomes. METHODS: We measured MMPs in plasma collected on ARDS day 1 from 235 children at 5 hospitals between 2008-2017...
August 16, 2018: American Journal of Respiratory and Critical Care Medicine
Mustafa Raoof, Carolijn L M A Nota, Laleh G Melstrom, Susanne G Warner, Yanghee Woo, Gagandeep Singh, Yuman Fong
BACKGROUND: How the oncologic outcomes after robotic distal pancreatectomy (RDP) compare to those after laparoscopic distal pancreatectomy (LDP) remains unknown. METHODS: Using the National Cancer Database (NCDB), we analyzed all patients undergoing LDP or RDP for resectable pancreatic adenocarcinoma over a 4-year period (2010-2013). RESULTS: Of the 704 eligible patients, 605 (86%) underwent LDP and 99 (14%) underwent RDP. The median follow-up for patients was 25 months...
August 16, 2018: Journal of Surgical Oncology
Arnaud Ferraris, Camille Bouisse, Nicolas Mottard, Fabrice Thiollière, Sophie Anselin, Vincent Piriou, Bernard Allaouchiche
INTRODUCTION: Mottling score, defined by 5 areas over the knee is developed to evaluate tissue perfusion at bedside. Because of the subjective aspect of the score, we aimed to compare mottling score and skin temperature in septic shock with infrared thermography in ICU and the correlation to survival. METHODS: We conducted a prospective and observational study in a teaching hospital in France during 8 months in ICU. All patients with sepsis requiring vasoactive drugs were included...
2018: PloS One
Aalap C Shah, Kevin Ma, David Faraoni, Daniel C S Oh, G Alec Rooke, Gail A Van Norman
BACKGROUND: Pulmonary hypertension (PHTN) is associated with increased post-procedure morbidity and mortality. Pre-procedure echocardiography (ECHO) is a widely used tool for evaluation of these patients, but its accuracy in predicting post-procedure outcomes is unproven. Self-reported exercise tolerance has not been evaluated for operative risk stratification of PHTN patients. OBJECTIVE: We analyzed whether self-reported exercise tolerance predicts outcomes (hospital length-of-stay [LOS], mortality and morbidity) in PHTN patients (WHO Class I-V) undergoing anesthesia and surgery...
2018: PloS One
Ya-Lan Shih, Yu-Ching Hsu, Wei-Hsin Chiu, Co-Shi Chantal Chao
Preparing for a good death is an important and meaningful concept in Chinese culture because people hope to know residual life to make effort for their unfinished business. However, the family of terminally ill patients with cancer may be annoyed and frustrated about unexpected bereavement if they have unresolved conflicts with the loved one, missing a chance for declaring love, untimely apologizing and saying goodbye. The study aimed to explore this difficult issue. The medical records of 121 deceased terminally ill patients with cancer at National Cheng Kung University Hospital between December 2010 and February 2012 were reviewed...
September 2018: Holistic Nursing Practice
Shankar Prinja, Gunjeet Kaur, Rakesh Gupta, Saroj Kumar Rana, Arun Kumar Aggarwal
INTRODUCTION: In this paper, we present district level out-of-pocket (OOP) expenditures with respect to outpatient consultation within last 15 days and hospitalization in last 1 year for Haryana state. METHODS: The data from a large cross-sectional household survey covering all 21 districts of Haryana comprising of randomly selected 79 742 households were analyzed. Of the total sample, 56 056 households consisting of 314 639 individuals in 21 districts of Haryana state were surveyed to gather information on OOP expenditure incurred on outpatient consultation within last 15 days...
August 16, 2018: International Journal of Health Planning and Management
Kazushige Wakuda, Haruki Kobayashi, Shota Omori, Kazuhisa Nakashima, Akira Ono, Hirotsugu Kenmotsu, Tateaki Naito, Haruyasu Murakami, Masahiro Endo, Takashi Nakajima, Toshiaki Takahashi
Background: The treatment efficacy of second-line chemotherapy in poor-risk patients with refractory-relapsed small-cell lung cancer is unclear. Methods: We defined refractory relapse as treatment-free interval <90 days and poor-risk as Eastern Cooperative Oncology Group Performance Status ≥2. We retrospectively examined the medical record data of patients who were treated at our hospital between September 2002 and December 2014. Results: Twenty-three poor-risk patients with refractory-relapsed small-cell lung cancer were treated in our hospital...
August 3, 2018: Japanese Journal of Clinical Oncology
V V Bazylev, E V Rosseykin, M E Evdokimov, M A Pantyukhina
The article presents a clinical case of valve sparing aortic root replacement (David Procedure) in 36 year - old woman with the Marfan syndrome at the 27th week of gestation followed by successful prolongation of pregnancy. Indications for reconstructive intervention with cardiopulmonary bypass were: severe aortic valve insufficiency, Sinus of Valsalva Aneurysm (66 mm) and the ascending aorta dilatation (53 mm) with a rapid increase of aortic root dimension (12 mm during 9 weeks). The patient underwent a valve sparing aortic root replacement according to David procedure using Gelweave Valsalva graft (Vascutec) No 28 The time of cardiopulmonary bypass was 137 minutes; the time of aortic cross-clamping was 107 minutes...
2018: Khirurgiia
José A Parra, Luis Hernández, Patricia Muñoz, Gerardo Blanco, Regino Rodríguez-Álvarez, Daniel Romeu Vilar, Arístides de Alarcón, Miguel Angel Goenaga, Mar Moreno, María Carmen Fariñas
Extra-cardiac abdominal complications are common in left-side infective endocarditis (LS-IE). The aim of this work was to study whether patients with LS-IE presenting splenic, renal, or liver (SRL) involvement seen in abdominal computed tomography (CT) had different clinical features, therapeutic plans, and outcome than those without these findings on CT.From January 2008 to April 2010, multidisciplinary teams have prospectively collected all consecutive cases of IE, diagnosed according to the Duke criteria, in which abdominal CT was performed...
August 2018: Medicine (Baltimore)
Alexander C Reynolds, Nicola King
BACKGROUND: Hybrid coronary revascularization (HCR) combining minimally invasive grafting of the left internal mammary artery to the left anterior descending artery with percutaneous coronary intervention has become a viable option for treating coronary artery disease. The aim of this meta-analysis was to compare HCR with conventional coronary artery bypass grafting (CABG) in a range of clinical outcomes and hospital costs. METHODS: To identify potential studies, systematic searches were carried out in various databases...
August 2018: Medicine (Baltimore)
Kamleshsingh Shadhu, Dadhija Ramlagun, Simeng Chen, Lijia Liu
Due to the rarity of Grynfelt hernia, there is no standardized surgical technique.From April 2010 to September 2017, 12 cases of primary superior lumbar hernia (Grynfelt hernia) were identified through medical records reviewing and included in our study. Perioperative data, surgical outcomes, and long-term follow-up results were retrospectively analysed.Male/female ratio of patients was 1:1, with age 69.5 (62, 74.5) [median (25 percentile, 75 percentile)] years old. Right/left side ratio of lumbar hernia was 9/3...
August 2018: Medicine (Baltimore)
Hiroyuki Hirai, Keisuke Kuwana, Yoshiro Kusano
RATIONALE: Adrenal incidentaloma is sometimes complicated with 21-hydroxylase deficiency (21-OHD). Latent nonclassical 21-OHD in incidentaloma is difficult to diagnose. Although adrenalectomy in 21-OHD has been conducted when malignancy could not be excluded, adrenal insufficiency sometimes occurs, and it might not be observed immediately after operation. Here, we report a case of a 71-year-old man who experienced adrenal insufficiency over 2 decades postadrenalectomy, leading to a diagnosis of latent nonclassical 21-OHD...
August 2018: Medicine (Baltimore)
R William F Breakey, Paul G M Knoops, Alessandro Borghi, Naiara Rodriguez-Florez, Justine O'Hara, Gregory James, David J Dunaway, Silvia Schievano, N U Owase Jeelani
OBJECTIVE: When analysing intracranial volume gain due to operative intervention in craniosynostosis, it is necessary to understand the underlying growth. We sought to create comprehensive intracranial volume (ICV) and occipitofrontal circumference (OFC) growth charts, as measured on unoperated craniosynostotic children. Furthermore, we aimed to investigate whether ICV and OFC could act as a proxy measure for each other. METHODS: All pre-operative Great Ormond Street Hospital (GOSH) patients with a diagnosis of Apert, Crouzon-Pfeiffer or Saethre-Chotzen syndrome from 2004 onwards were considered for this study...
August 11, 2018: Plastic and Reconstructive Surgery
Kathryn E Kasmire, Carolina Vega, Nicholas J Bennett, V Matt Laurich
OBJECTIVES: Diagnosis of sepsis in young infants can be challenging due to the nonspecific signs, which can include hypothermia. Whether the presence of hypothermia in young infants should prompt evaluation for serious infection is unclear. The objectives were to measure the prevalence of serious infection among infants ≤60 days of age with hypothermia in the emergency department (ED) and determine other clinical features of hypothermic infants who have serious infection. METHODS: This is a retrospective analysis of all infants ≤60 days seen in a children's hospital ED from April 2014 to February 2017...
August 14, 2018: Pediatric Emergency Care
Furqaan Sadiq, Vanessa L Kronzer, Troy S Wildes, Sherry L McKinnon, Anshuman Sharma, Daniel L Helsten, Lawrence M Scheier, Michael S Avidan, Arbi Ben Abdallah
BACKGROUND: Frailty is an important concept in the care of older adults although controversy remains regarding its defining features and clinical utility. Both the Fried phenotype and the Rockwood deficit accumulation approaches cast frailty as a "burden" without exploring the relative salience of its cardinal markers and their relevance to the patient. New multifactorial perspectives require a reliable assessment of frailty that can validly predict postoperative health outcomes...
August 14, 2018: Anesthesia and Analgesia
Guntaragorn Hongrattana, Potipong Reungjui, Panaya Tumsatan, Chulee Ubolsakka-Jones
AIM: The aim of the study was to obtain information about the incidence and risk factors for pulmonary atelectasis in mechanically ventilated patients in the trauma ICU (TMICU). Pulmonary atelectasis is a common complication leading to serious lung dysfunction in patients in the TMICU and early identification of patients at risk is important for their effective management. METHODS: All trauma patients admitted to the TMICU with mechanical ventilation for more than 1 day were included in a prospective 12-month study...
August 14, 2018: International Journal of Evidence-based Healthcare
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