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https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#1
Lorenzo Ball, Federico Costantino, Giulia Orefice, Karthikka Chandrapatham, Paolo Pelosi
Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review is to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28528510/immunogenomics-using-genomics-to-personalize-cancer-immunotherapy
#2
Rance C Siniard, Shuko Harada
While the use of genomic data has the potential to revolutionize patient care, there is still much work to be done with regard to the transformation of host-tumor interactions into favorable clinical outcomes for our patients. High-throughput technologies, such as next-generation sequencing (NGS), have rapidly advanced our understanding of oncology, and we are learning that most tumors do not simply possess consistently mutated genes that are responsible for tumorigenesis, facilitating the need for personalized cancer therapy...
May 20, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28528487/role-of-medicines-of-unknown-identity-in-adverse-drug-reaction-related-hospitalizations-in-developing-countries-evidence-from-a-cross-sectional-study-in-a-teaching-hospital-in-the-lao-people-s-democratic-republic
#3
Céline Caillet, Chanvilay Sichanh, Gaëtan Assemat, Myriam Malet-Martino, Agnès Sommet, Haleh Bagheri, Noudy Sengxeu, Niphonh Mongkhonmath, Mayfong Mayxay, Lamphone Syhakhang, Maryse Lapeyre-Mestre, Paul N Newton, Anne Roussin
INTRODUCTION: The health dangers of medicines of unknown identity (MUIs) [loose pharmaceutical units repackaged in individual bags without labelling of their identity] have been suspected in L/MICs. Using visual and analytical tools to identify MUIs, we investigated the frequency of, and factors associated with, adverse drug reaction (ADR)-related hospitalizations in a central hospital in Vientiane Capital, Lao People's Democratic Republic (PDR). METHODS: All unplanned admissions, except for acute trauma and intentional overdose, were prospectively recorded during a 7-week period in 2013, leading to include 453 adults hospitalized for ≥24 h...
May 20, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28528465/contrast-induced-nephropathy-cin-of-patients-with-renal-dysfunction-in-ct-examination
#4
Yasuhiro Fukushima, Hitomi Miyazawa, Junpei Nakamura, Ayako Taketomi-Takahashi, Takayuki Suto, Yoshito Tsushima
PURPOSE: To investigate the incidence and risk factors of contrast induced nephropathy (CIN) after contrast enhanced (CE) computed tomography (CT) in patients with renal dysfunction. MATERIALS AND METHODS: Two hundred sixteen inpatients with estimated glomerular filtration rates (eGFR) <60 ml/min/1.73 m(2) underwent CE CT using iodine doses of 420 or 480 mg I/kg. Data of all enrolled patients was collected for baseline serum creatinine level (SCr), post-CE CT SCr within 3 days after CE CT, and conditions considered risk factors for CIN [renal dysfunction, contrast media dose, advanced age, diabetes mellitus, no intravenous hydration, cardiac dysfunction (left ventricular ejection fraction <60%) and intensive-care unit (ICU) admission]...
May 20, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/28528421/end-of-life-care-for-glioblastoma-patients-at-a-large-academic-cancer-center
#5
Kamini E Kuchinad, Roy Strowd, Anne Evans, W Anthony Riley, Thomas J Smith
Glioblastoma (GBM) is a universally fatal disease, complicated by significant cognitive and physical disabilities, inherent to the disease course. The purpose of this study was to retrospectively analyze end-of-life care for GBM patients at an academic center and compare utilization of these services to national quality of care guidelines, with the goal of identifying opportunities to improve end-of-life care. Single center retrospective cohort study of GBM patients at Johns Hopkins Hospital (JHH) between 2009 and 2014, using electronic medical records and hospice records...
May 20, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28528376/isometric-handgrip-as-an-adjunct-for-blood-pressure-control-a-primer-for-clinicians
#6
REVIEW
Cheri L McGowan, David N Proctor, Ian Swaine, Robert D Brook, Elizabeth A Jackson, Phillip D Levy
Considered a global health crisis by the World Health Organization, hypertension (HTN) is the leading risk factor for death and disability. The majority of treated patients do not attain evidence-based clinical targets, which increases the risk of potentially fatal complications. HTN is the most common chronic condition seen in primary care; thus, implementing therapies that lower and maintain BP to within-target ranges is of tremendous public health importance. Isometric handgrip (IHG) training is a simple intervention endorsed by the American Heart Association as a potential adjuvant BP-lowering treatment...
June 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28528356/operating-room-fires-in-periocular-surgery
#7
Michael A Connor, Anne M Menke, Ivan Vrcek, John W Shore
AIM: A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery. METHODS: A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons...
May 20, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28528347/discriminative-accuracy-of-physician-and-nurse-predictions-for-survival-and-functional-outcomes-6-months-after-an-icu-admission
#8
Michael E Detsky, Michael O Harhay, Dominique F Bayard, Aaron M Delman, Anna E Buehler, Saida A Kent, Isabella V Ciuffetelli, Elizabeth Cooney, Nicole B Gabler, Sarah J Ratcliffe, Mark E Mikkelsen, Scott D Halpern
Importance: Predictions of long-term survival and functional outcomes influence decision making for critically ill patients, yet little is known regarding their accuracy. Objective: To determine the discriminative accuracy of intensive care unit (ICU) physicians and nurses in predicting 6-month patient mortality and morbidity, including ambulation, toileting, and cognition. Design, Setting, and Participants: Prospective cohort study conducted in 5 ICUs in 3 hospitals in Philadelphia, Pennsylvania, and enrolling patients who spent at least 3 days in the ICU from October 2013 until May 2014 and required mechanical ventilation, vasopressors, or both...
May 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28528337/association-between-chronic-kidney-disease-and-risk-of-cataract-a-nationwide-retrospective-cohort-study
#9
Yin-Tzu Liu, Tzu-Yao Hung, Yi-Kung Lee, Ming-Yuan Huang, Chen-Yang Hsu, Yung-Cheng Su
BACKGROUND: Previous studies have established a relationship between chronic kidney disease (CKD) and cataract, but the relationship between the severity of renal impairment and risk of cataract is uncertain. This study investigates the relationship between the severity of renal disease and cataract in a nationwide sample from Taiwan. METHODS: The cohort from 1-million National Health Insurance beneficiaries from Taiwan was retrospectively analyzed. All adult beneficiaries were followed from January 1, 2005 until December 31, 2013, to identify patients who underwent cataract surgeries...
May 20, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28528323/c-graph-a-validated-scoring-system-for-early-stratification-of-neurologic-outcome-after-out-of-hospital-cardiac-arrest-treated-with-targeted-temperature-management
#10
Erich L Kiehl, Alex M Parker, Ralph M Matar, Matthew F Gottbrecht, Michelle C Johansen, Mark P Adams, Lori A Griffiths, Steven P Dunn, Katherine L Bidwell, Venu Menon, Kyle B Enfield, Lawrence W Gimple
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) results in significant morbidity and mortality, primarily from neurologic injury. Predicting neurologic outcome early post-OHCA remains difficult in patients receiving targeted temperature management. METHODS AND RESULTS: Retrospective analysis was performed on consecutive OHCA patients receiving targeted temperature management (32-34°C) for 24 hours at a tertiary-care center from 2008 to 2012 (development cohort, n=122)...
May 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28528268/optimistic-honesty-understanding-surgeon-and-patient-perspectives-on-hopeful-communication-in-pancreatic-cancer-care
#11
Kim Blakely, Paul J Karanicolas, Frances C Wright, Lesley Gotlib Conn
BACKGROUND: Prognosis conversations between surgical oncologists and patients with pancreatic cancer are critically important and challenging. Surgeons and their patients often have discrepant understandings of prognosis despite extensive conversations. Little is known about how surgeons approach prognosis conversations with these patients; patients' experiences with these conversations are also not well understood. This qualitative study sought to better understand surgeon and patient perspectives on communication in pancreatic cancer care with a view toward improvement...
May 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28528246/the-canadian-hypoglycemia-assessment-tool-program-insights-into-rates-and-implications-of-hypoglycemia-from-an-observational-study
#12
Ronnie Aronson, Ronald Goldenberg, Damir Boras, Rasmus Skovgaard, Harpreet Bajaj
OBJECTIVE: The true prevalence of hypoglycemia in insulin-treated patients with diabetes and its impact on patients, employers and healthcare providers is poorly appreciated owing to a paucity of real-world data. The global Hypoglycemia Assessment Tool (HAT) study addressed this issue, and here we report data from the Canadian cohort of patients. METHODS: This noninterventional, 6-month retrospective and 4-week prospective study enrolled patients aged ≥18 years receiving insulin treatment for >12 months from community endocrinology practices...
May 17, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28528210/do-patients-need-to-stay-in-bed-all-day-in-the-epilepsy-monitoring-unit-safety-data-from-a-non-restrictive-setting
#13
Laura Craciun, Jørgen Alving, Elena Gardella, Daniella Terney, Pirgit Meritam, Melita Cacic Hribljan, Sándor Beniczky
PURPOSE: To assess whether injuries occur more often in an Epilepsy Monitoring Unit (EMU) where portable EEG amplifiers are used, and where patients can freely move within a large area during the monitoring. METHODS: Patients were monitored at the Danish Epilepsy Center, in an EMU specifically designed for this purpose, and they were under continuous surveillance by personnel dedicated to the EMU. Adverse events (AEs) - including injuries, were prospectively noted, as part of the safety policy of the hospital...
May 13, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28528190/association-between-the-time-to-surgery-and-survival-among-patients-with-colon-cancer-a-population-based-study
#14
J A Flemming, S Nanji, X Wei, C Webber, P Groome, C M Booth
Factors associated with time-to-surgery (TTS) and survival in colon cancer has not been well studied. Cancer Care Ontario recommends surgery within 42 days of diagnosis and that 90% of patients meet this benchmark. We describe factors associated with TTS and survival in routine clinical practice. METHODS: Retrospective population-based cohort study of patients receiving elective colonic resection after diagnosis of colon cancer in Ontario, Canada from 2002 to 2008 followed until 2012...
May 6, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28528172/cannabis-and-pregnancy-maternal-child-health-implications-during-a-period-of-drug-policy-liberalization
#15
Katrina Mark, Mishka Terplan
Cannabis use is common and increasing among women in the United States. State policies are changing with a movement towards decriminalization and legalization. We explore the implications of cannabis liberalization for maternal and child health. Most women who use cannabis quit or cut back during pregnancy. Although women are concerned about the possible health effects of cannabis, providers do a poor job of counseling. There is a theoretical potential for cannabis to interfere with neurodevelopment, however human data have not identified any long-term or long lasting meaningful differences between children exposed in utero to cannabis and those not...
May 17, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28528140/maternal-and-neonatal-outcomes-of-respiratory-failure-during-pregnancy
#16
Chen-Yiu Hung, Han-Chung Hu, Li-Chung Chiu, Chih-Hao Chang, Li-Fu Li, Chung-Chi Huang, Chuan-Chi Kao, Po-Jen Cheng, Kuo-Chin Kao
BACKGROUND: Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy. METHODS: Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. The characteristics and outcomes of mothers and fetuses were determined through a retrospective chart review and evaluated using Student's t test, chi-square test, and Fisher's exact test...
May 17, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28528132/the-perceived-medical-condition-self-management-scale-can-be-applied-to-patients-with-chronic-kidney-disease
#17
Marcus G Wild, Kenneth A Wallston, Jamie A Green, Lauren B Beach, Ebele Umeukeje, Julie A Wright Nunes, T Alp Ikizler, Julia Steed, Kerri L Cavanaugh
Chronic Kidney Disease (CKD) is a major burden on patients and the health care system. Treatment of CKD requires dedicated involvement from both caretakers and patients. Self-efficacy, also known as perceived competence, contributes to successful maintenance of patient's CKD self-management behaviors such as medication adherence and dietary regulations. Despite a clear association between self-efficacy and improved CKD outcomes, there remains a lack of validated self-report measures of CKD self-efficacy. To address this gap, the Perceived Kidney/Dialysis Self-Management Scale (PKDSMS) was adapted from the previously validated Perceived Medical Condition Self-Management Scale...
May 18, 2017: Kidney International
https://www.readbyqxmd.com/read/28528131/no-increase-in-the-incidence-of-acute-kidney-injury-in-a-population-based-annual-temporal-trends-epidemiology-study
#18
Kianoush Kashani, Min Shao, Guangxi Li, Amy W Williams, Andrew D Rule, Walter K Kremers, Michael Malinchoc, Ognjen Gajic, John C Lieske
Recent literature suggests an increase in the incidence of acute kidney injury (AKI). We evaluated population-based trends of AKI over the course of nine years, using a validated electronic health record tool to detect AKI. All adult residents (18 years of age and older) of Olmsted County, Minnesota (MN), admitted to the Mayo Clinic Hospital between 2006 and 2014 were included. The incidence rate of AKI was calculated and temporal trends in the annual AKI incident rates assessed. During the nine-year study period, 10,283, and 41,847 patients were admitted to the intensive care unit or general ward, with 1,740 and 2,811 developing AKI, respectively...
May 18, 2017: Kidney International
https://www.readbyqxmd.com/read/28528129/prophylactic-hydration-to-prevent-contrast-induced-nephropathy-much-ado-about-nothing
#19
Christina M Wyatt, Marianne Camargo, Steven G Coca
Clinical guidelines recommend prophylactic hydration to reduce the risk of contrast-induced nephropathy in high-risk patients, including those with chronic kidney disease. A recent single-center randomized trial showed no significant difference in the incidence of contrast-induced nephropathy in ambulatory patients with stage 3 chronic kidney disease who were randomized to no prophylactic hydration versus normal saline hydration. While these results may identify patients who are less likely to benefit from prophylactic hydration, nephrologists and interventionalists should carefully consider the generalizability of these results to individual patients...
May 18, 2017: Kidney International
https://www.readbyqxmd.com/read/28528064/transient-aphonia-after-mediastinoscopy
#20
Frank O Velez-Cubian, Kavian Toosi, Jessica Glover, Bharat Pancholy, Edward Hong
The most common adverse event after cervical mediastinoscopy is recurrent laryngeal nerve (RLN) injury, which has an incidence of 0.6% [1]. We report the case of a 68-year-old man with non-small cell lung cancer (NSCLC) who experienced transient bilateral vocal cord paralysis after mediastinoscopy, which manifested in complete aphonia. This patient's ability to maintain his airway was carefully followed up, but neither endotracheal intubation nor tracheostomy was required. The vocal cord paralysis resolved without intervention after 5 hours...
June 2017: Annals of Thoracic Surgery
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