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Quality Of Death

Guilherme F Mendes, Daniel R Stuginski, Selene M C Loibel, Karen de Morais-Zani, Marisa Maria T da Rocha, Wilson Fernandes, Sávio S Sant'Anna, Kathleen F Grego
Envenoming and deaths resulting from snakebites are a particularly important public health problem in rural tropical areas of Africa, Asia, Latin America and New Guinea. In 2015 The Lancet highlighted snake-bite envenoming as a neglected tropical disease and urged the world to increase antivenom production. In Brazil around 20,000 snakebites occur per year affecting mostly agricultural workers and children, of which 1% are caused by coral snakes (Micrurus sp). Although human envenoming by coral snakes are relatively rare due to their semifossorial habits and non-aggressive behavior, they are always considered severe due to the neurotoxic, myotoxic, hemorrhagic and cardiovascular actions of their venom, which is highly toxic when compared to the venom of other Brazilian venomous snakes as Bothrops sp (pit vipers), Crotalus sp (rattlesnakes) and Lachesis sp (bushmasters)...
December 12, 2018: Journal of Animal Science
Pauline Berneau, Trang Nguyen Phuc Thu, Patrick Pladys, Alain Beuchée
INTRODUCTION: Most infants born before 30 weeks gestational age (GA) develop respiratory distress syndrome soon after birth. Methods of surfactant administration that avoid ventilation have been recently introduced. The aim of this study was to evaluate the impact of implementing a new procedure of less invasive surfactant administration (LISA) and determine whether it is associated with an improvement in respiratory outcome. METHODS: This single center cohort quality improvement study analyzed preterm infants born before 30 weeks GA between May 2010 and April 2016...
2018: PloS One
Åsa B Gustafsson, Gerald W Dorn
The central functions fulfilled by mitochondria as both energy generators essential for tissue homeostasis and gateways to programmed apoptotic and necrotic cell death mandate tight control over the quality and quantity of these ubiquitous endosymbiotic organelles. Mitophagy, the targeted engulfment and destruction of mitochondria by the cellular autophagy apparatus, has conventionally been considered as the mechanism primarily responsible for mitochondrial quality control. However, our understanding of how, why, and under what specific conditions mitophagy is activated has grown tremendously over the past decade...
January 1, 2019: Physiological Reviews
Alberto Lucchini, Stefano Bambi, Alessandro Galazzi, Stefano Elli, Cristina Negrini, Stefania Vaccino, Silvia Triantafillidis, Alessandra Biancardi, Mattia Cozzari, Roberto Fumagalli, Giuseppe Foti
BACKGROUND AND AIM: Unplanned extubation (UE) in Intensive Care Units (ICU) is an indicator of quality and safety of care. UEs are classified in: accidental extubations, if involuntarily caused during nursing care or medical procedures; self-extubation, if determined by the patient him/herself.  In scientific literature, the cumulative incidence of UEs varies from 0.3% to 35.8%. The aim of this study is to explore the incidence of UEs in an Italian university general ICU adopting a well-established protocol of tracheal tube nursing management and fixation...
December 7, 2018: Acta Bio-medica: Atenei Parmensis
Ying-Ying Su, Wei-Bi Chen, Gang Liu, Lin-Lin Fan, Yan Zhang, Hong Ye, Dai-Quan Gao, Yi-Fei Liu, Meng-Di Jiang
Background: Brain death is the irreversible cessation of the function of the brain including the brainstem. In 2013, the Brain Injury Evaluation Quality Control Centre (BQCC) of the National Health and Family Planning Commission issued criteria and practical guidelines for the determination of brain death. This study aimed to evaluate whether the institutions have adopted these guidelines and to make suggestions for the improvement of the current criteria and practical guidelines for brain death determination in China...
December 20, 2018: Chinese Medical Journal
Amer Harky, Perry Maskell, Mika Burgess
OBJECTIVE: Peripheral artery disease is a major clinical co-morbidity that can significantly affect quality of life, especially in the presence of diabetes mellitus and older age. The focus of this literature review is on medical management, through anti-platelet and anti-coagulation, of peripheral artery disease prior to undergoing surgical or endovascular management. METHOD: Extensive electronic literature search performed in four major databases (PubMed, SCOPUD, Embase and Ovid) to identify the published randomized and non-randomized studies that compared and discussed the management of peripheral artery disease with different anti-thrombotic agents...
December 12, 2018: Vascular
Chung-Ho Sun, Kristian Berg, Henry Hirschberg
Nonviral gene transfection overcomes some of the disadvantages of viral vectors, such as undesired immune responses, safety concerns, issues relating to bulk production, payload capacity, and quality control, but generally have low transfection efficiency. Here we describe the effects of a modified form of photodynamic therapy (PDT), i.e., photochemical internalization (PCI) to: (1) greatly increase nonviral cytosine deaminase gene (CD) transfection into tumor cells, significantly increasing the conversion of 5-fluorocytosine (5-FC) to 5-fluorouracil (5-FU), and (2) enhance the toxic efficacy of the locally produced 5-FU to induce cell death on both transfected and non-transfected bystander cells...
2019: Methods in Molecular Biology
Piyush Mishra, Veena Ammanathan, Ravi Manjithaya
Growing amount of evidence in the last two decades highlight that macroautophagy (generally referred to as autophagy) is not only indispensable for survival in yeast but also equally important to maintain cellular quality control in higher eukaryotes as well. Importantly, dysfunctional autophagy has been explicitly shown to be involved in various physiological and pathological conditions such as cell death, cancer, neurodegenerative, and other diseases. Therefore, modulation and regulation of the autophagy pathway has emerged as an alternative strategy for the treatment of various disease conditions in the recent years...
2018: Frontiers in Cell and Developmental Biology
Jiri Polivka, Jiri Polivka, Vladimir Rohan
The model of centralized stroke care in the Czech Republic was created in 2010-2012 by Ministry of Health (MH) in cooperation with professional organization-Cerebrovascular Section of the Czech Neurological Society (CSCNS). It defines priorities of stroke care, stroke centers, triage of suspected stroke patients, stroke care quality indicators, their monitoring, and reporting. Thirteen complex cerebrovascular centers (CCC) provide sophisticated stroke care, including intravenous thrombolysis (IVT), mechanical thrombectomy (MTE), as well as other endovascular (stenting, coiling) and neurosurgical procedures...
December 2018: EPMA Journal
Martin Donnelley, David W Parsons
Cystic fibrosis (CF) is a progressive, chronic and debilitating genetic disease caused by mutations in the CF Transmembrane-Conductance Regulator ( CFTR ) gene. Unrelenting airway disease begins in infancy and produces a steady deterioration in quality of life, ultimately leading to premature death. While life expectancy has improved, current treatments for CF are neither preventive nor curative. Since the discovery of CFTR the vision of correcting the underlying genetic defect - not just treating the symptoms - has been developed to where it is poised to become a transformative technology...
2018: Frontiers in Pharmacology
David N Ranney, Judson B Williams, Hillary Mulder, Daniel Wojdyla, Morgan L Cox, C Michael Gibson, Michael J Mack, Mani A Daneshmand, John H Alexander, Renato D Lopes
Although in situ internal mammary artery (is-IMA) grafting remains the most frequent conduit in coronary artery bypass grafting (CABG), circumstances may necessitate free grafting of the IMA (f-IMA), though differences in outcomes have not been fully characterized. The purpose of this study was to compare clinical and angiographic outcomes of is-IMA versus f-IMA coronary bypass grafts in patients who underwent elective CABG surgery. In 1,829 patients in the angiographic cohort of PREVENT IV, 1,572 (85.9%) had at least 1 IMA graft; of these, 34 (2...
November 24, 2018: American Journal of Cardiology
Boris Zernikow, Katharina Szybalski, Bettina Hübner-Möhler, Julia Wager, Michael Paulussen, Lisa Lassay, Norbert Jorch, Carola Weber, Dominik T Schneider, Gisela Janßen, Prasad T Oommen, Michaela Kuhlen, Thomas Brune, Regina Wieland, Michael Schündeln, Bernhard Kremens, Alfred Längler, Aram Prokop, Rita Kiener, Tim Niehues, Martina Rose, Margit Baumann-Köhler, Monika Pöppelmann, Heike Thorer, Martin Irnich, Kumar Sinha, Joanne Wolfe, Pia Schmidt
BACKGROUND: About one quarter of children affected with cancer die. For children and their families, the end-of-life period is highly distressing. AIM: This study focused on how end-of-life care in pediatric cancer patients changed over a period of 10 years and if changes in pediatric palliative care structures were associated with quality of care. DESIGN: Over a 10-year period, all pediatric oncology departments in one German federal state were invited to participate in a repeated cross-sectional cohort study at three time-points (2005, 2010, 2015)...
December 12, 2018: Palliative Medicine
Isabele Picada Emanuelli, Camila Bortoliero Costa, Luciana Simões Rafagnin Marinho, Marcelo Marcondes Seneda, Flávio Vieira Meirelles
This study investigated the interactions between cumulus cells (CCs) and oocytes and programmed cell death in bovine cumulus-oocyte complexes (COCs) with different morphological characteristics. DNA fragmentation was assessed in CCs at 0 and 24 h of maturation, as well as parthenogenetic developmental competence on the 9th day post-activation, blastocyst quality and BCL-2 and BAX transcript levels in matured CCs. Most immature oocytes in the COC-A group (full cumulus and several compact layers) were in the initial germinal vesicle (iGV) stage, exhibiting minimal or no DNA damage...
November 26, 2018: Theriogenology
Nicholas Chartres, Lisa A Bero, Susan L Norris
BACKGROUND: Approximately one quarter of all deaths globally are attributed to living or working in an unhealthy environment, with household and ambient air pollution, along with exposures to ultraviolet radiation and chemicals amongst the leading causes. At present there are no international standards for assessing the risks of these environmental hazards. The use of heterogeneous methods to identify health risks from environmental hazards may reduce the level of confidence the public has in the conclusions that are made...
December 8, 2018: Environment International
Mohamad El Moheb, Johny Nicolas, Assem M Khamis, Ghida Iskandarani, Elie A Akl, Marwan Refaat
BACKGROUND: There is evidence that implantable cardioverter-defibrillator (ICD) for primary prevention in people with an ischaemic cardiomyopathy improves survival rate. The evidence supporting this intervention in people with non-ischaemic cardiomyopathy is not as definitive, with the recently published DANISH trial finding no improvement in survival rate. A systematic review of all eligible studies was needed to evaluate the benefits and harms of using ICDs for primary prevention in people with non-ischaemic cardiomyopathy...
December 8, 2018: Cochrane Database of Systematic Reviews
Farrokh Habibzadeh, Mahboobeh Yadollahie, Ashraf Simi, Saeid Saeidimehr, Ali-Asghar Nasihatkon, Mohammad Sadegh Shamsollahi, Hojjatollah Javidi, Maryam Kucheki, Kourosh Hashemiasl, Heidarali Jamali, Mohammad Rafiei, Hamidreza Mahmoudi, Farhad Kalantari, Safdar Azadi, Vahid Maleki, Abbas Asnaashari, Mehrdad Hosseinzadeh, Habibollah Sami
BACKGROUND: The type of health insurance may affect the likelihood of mortality of insured people. We conducted this study to determine if accessing free quality health care services could decrease the premature mortality of people in a developing country. METHODS: In a multicenter cross sectional study, "years-life-lost" (YLL) due to premature death was evaluated in 202 671 insured people residing in six large regions in Iran. The participants had access to free quality health care services...
December 11, 2018: International Journal of Health Planning and Management
Reinhard Strametz, Martin N Bergold, Tobias Weberschock
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) is one of the most common bedside surgical procedures performed in critically ill adults, on intensive care units (ICUs), who require long-term ventilation. PDT is associated with relevant life-threatening complications: Cuff rupture or accidental extubation may lead to hypoxia, aspiration or loss of airway. Puncture of the oesophagus, or creating a false passage during dilatation or replacement of the tracheostomy tube, can lead to pneumothorax or emphysema...
November 15, 2018: Cochrane Database of Systematic Reviews
Derrick Y Tam, Harindra C Wijeysundera, Maral Ouzounian, Stephen E Fremes
OBJECTIVES: Our goal was to determine the range of perioperative mortality rates associated with the Ross procedure that results in a life expectancy similar to that seen with mechanical aortic valve replacement (mAVR) in young patients with aortic valve disease. METHODS: A fully probabilistic Markov microsimulation model with 1000 outer loops and 10 000 inner loops was constructed to compare gain in life expectancy and quality-adjusted life years between the index treatment with the Ross procedure versus mAVR for a theoretical cohort of young patients with aortic valve disease...
December 7, 2018: European Journal of Cardio-thoracic Surgery
Daisy J M Ermers, Karin J H van Bussel, Marieke Perry, Yvonne Engels, Henk J Schers
Background: Advance care planning (ACP) is a crucial element of palliative care. It improves the quality of end-of-life care and reduces aggressive and needless life-prolonging medical interventions. However, little is known about its application in daily practice. This study aims to examine the application of ACP for patients with cancer in general practice. Methods: We performed a retrospective cohort study in 11 general practices in the Netherlands. Electronic patient records (EPRs) of deceased patients with colorectal or lung cancer were analysed...
December 10, 2018: Family Practice
Sara A Morgan, Mohamed M Ali
Estimation of maternal mortality ratio (MMR) in humanitarian settings ('settings of conflict, displacement and natural disaster') is challenging, particularly where communities have dissolved and geographical areas are inaccessible. During humanitarian events, the reproduction of maternal mortality figures by the media is common, and are often based on inaccurate reports. In light of such uncertainties and challenges, the aim of this article was to review and appraise the methodology and data collection tools used to measure MMR in humanitarian settings...
December 10, 2018: Health Policy and Planning
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