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Level of care

Divendu Bhushan, Ramesh Kumar
Background: Dengue is one of the commonest tropical infections in India. This study was aimed to evaluate clinical profile, magnitude and spectrum of hepatic dysfunctions, outcome and clinical predictors of mortality in patients with dengue. Methodology: In an observational study, data of 183 consecutive admitted dengue patients were prospectively collected. The magnitude of hepatitis and its association with outcome were studied. Results: The transaminases elevation was seen in 156 (85%) patients, with 21 (11...
March 2018: Journal of the Association of Physicians of India
Alexandre Camiré, Julie Espinasse, Bruno Chabot, André Lajeunesse
Emerging contaminants present a challenge for water preservation, threatening humans' health and all ecosystems. They consist of a variety of molecules ranging from pharmaceutical and personal care products to pesticides and endocrine disruptors detectable in wastewater, sewage effluent, surface water, drinking water, and ground waters at trace level concentrations (e.g., ng/L, μg/L). Conventional wastewater treatment plants (WWTPs) possess low efficiency to remove them. Therefore, new technologies capable of removing such residues are needed...
October 19, 2018: Environmental Science and Pollution Research International
S P D Chrisman, K G Harmon, J D Schmidt, T W Kaminski, T A Buckley, A P Kontos, J R Clugston, M McCrea, T McAllister, S P Broglio, J Ortega
The King-Devick (K-D) test is often used as part of a multimodal assessment to screen for sport-related concussion. However, the test involves reading numbers, and little is known about variation in baseline performance on the K-D by reading skill level. We conducted a cross-sectional study analyzing data from the Concussion Assessment, Research and Education (CARE) Consortium to assess differences in baseline performance on the K-D associated with factors that impact reading skill level (learning disorder [LD] and primary home language other than English [PHLOTE]), while controlling for covariates (gender, type of sport, attentional issues, history of concussion and modality of administration)...
October 12, 2018: Annals of Biomedical Engineering
Manish K Jha, Madhukar H Trivedi
The standard of care for antidepressant treatment in major depressive disorder (MDD) is a trial-and-error approach. Patients often have to undergo multiple medication trials for weeks to months before finding an effective treatment. Clinical factors such as severity of baseline symptoms and the presence of specific individual (anhedonia or insomnia) or cluster (atypical, melancholic, or anxious) of symptoms are commonly used without any evidence of their utility in selecting among currently available antidepressants...
October 20, 2018: Handbook of Experimental Pharmacology
Elena Ierardi, Valentino Ferro, Annamaria Trovato, Renata Tambelli, Cristina Riva Crugnola
While there have been studies on the effects of maternal depression and anxiety on mother-infant styles of interaction in infancy, there have been no studies on the effects of paternal depression and anxiety or on the joint effects of maternal and paternal depression and anxiety on mother-infant styles of interaction. The aims of the study were to examine the associations between maternal depression and anxiety and paternal depression and anxiety and to examine the relationship between maternal and paternal depression and anxiety and mother-infant styles of interaction at infant 3 months...
October 19, 2018: Archives of Women's Mental Health
Dhurata Ivziku, Marco Clari, Michela Piredda, Maria Grazia De Marinis, Maria Matarese
PURPOSE: We aimed to assess the influence of anxiety and depression on the physical and mental quality of life (QoL) in patient with chronic obstructive pulmonary disease (COPD) and caregiver dyads, detect the simultaneous effect of anxiety and depression of each partner on the other's QoL and determine the dyadic patterns. METHODS: A cross-sectional descriptive design was used. The actor-partner interdependence model estimated by structural equation modeling was used for the dyadic analysis...
October 19, 2018: Quality of Life Research
E Eyzop, A Vanier, J Leboucher, H Morvan, M Poulette, M Grall-Bronnec, G Challet-Bouju
Gambling has an inherent structural monetary component, and financial motive is one of the main motivations for gambling. Despite this, and contrary to other addictive behaviours that involve money such as compulsive buying, gambling has never been studied from a materialism perspective. The objective of the present study was to explore the links between materialism and gambling disorder (GD) and whether this relationship is mediated by financial motives for gambling. We compared 65 pathological gamblers (PGs) seeking treatment to 65 matched non-problem gamblers...
October 19, 2018: Journal of Gambling Studies
Supriya Saini, Praveen Vats, Susovon Bayen, Priya Gaur, Koushik Ray, Krishna Kishore, Meerim Sartmyrzaeva, Almaz Akunov, Abdirashit Maripov, Akpay Sarybaev, Bhuvnesh Kumar, Shashi Bala Singh
High altitude (HA) is associated with number of stresses. Response of these stresses may vary in different populations depending upon altitude, duration of residency, ancestry, geographical variation, lifestyle, and ethnicities. For understanding population variability in transcriptome, array-based global gene expression profiling was performed on extracted RNA of male volunteers of two different lowland population groups, i.e., Indians and Kyrgyz, at baseline and day 7 of HA exposure (3200 m). A total of 97 genes were differentially expressed at basal in Kyrgyz as compared to Indians (82 downregulated and 15 upregulated), and 196 were differentially expressed on day 7 of HA (118 downregulated and 78 upregulated)...
October 19, 2018: Functional & Integrative Genomics
Xin-Wen Ke, Xing Zeng, Xian Wei, Yuan-Qing Shen, Jia-Hua Gan, Ji-Hua Tian, Zhi-Quan Hu
This study was designed to explore the safety and feasibility of robotic-assisted laparoscopic nephrectomy with vein thrombectomy (RAL-NVT) for the treatment of renal cell carcinoma (RCC) with venous tumor thrombus (VTT). Clinical data of 6 patients treated with RAL-NVT between July 2016 and November 2017 in our hospital were retrospectively collected and analyzed. There were 5 males and 1 female with their age ranging from 48 years to 68 years. Five renal tumors were right-sided and one left-sided. Three cases fell in level 0 VTT, one in level I and two in level II...
October 2018: Current medical science
Nina C Silander, David J Chesire, Kamela S Scott
The primary medical goals of acute care are restoration of physical health and return to physical function. However, in response to traumatic events and injuries, psychological factors are critical to one's overall recovery. Both pre-morbid psychiatric comorbidities and post-injury psychological compromise affect physical and psychological recovery in inpatient trauma populations. The Psychological Services Program (PSP), a model trauma/acute care program, addresses these critical factors in a Level 1 Trauma Center...
October 19, 2018: Journal of Clinical Psychology in Medical Settings
Ji Wu, Xien Liu, Xiao Zhang, Zhiyang He, Ping Lv
Mastering of medical knowledge to human is a lengthy process that typically involves several years of school study and residency training. Recently, deep learning algorithms have shown potential in solving medical problems. Here we demonstrate mastering clinical medical knowledge at certificated-doctor-level via a deep learning framework Med3R, which utilizes a human-like learning and reasoning process. Med3R becomes the first AI system that has successfully passed the written test of National Medical Licensing Examination in China 2017 with 456 scores, surpassing 96...
October 19, 2018: Nature Communications
A Coello-Gómez, S Navarro-Suárez, J-M Diosdado-Cano, F Azcárate-Velazquez, P Bargiela-Pérez, M-A Serrera-Figallo, D Torres-Lagares, J-L Gutiérrez-Pérez
BACKGROUND: The main objective of the present study is to evaluate the effects and possible benefits with regard to the postoperative period of lower third molar extractions, comparing the intraalveolar application of a bioadhesive gel of 0.2% chlorhexidine (CHX) to the use of a mouthwash with a super-oxidized solution, (SOS) Dermacyn® Wound Care (Oculus Innovative Sciences lnc., California, USA). MATERIAL AND METHODS: A randomized double-blind study was carried out in 20 patients with a split-mouth design, with a total of 40 extractions of symmetrically impacted bilateral lower third molars...
October 20, 2018: Medicina Oral, Patología Oral y Cirugía Bucal
Jielin Zhou, Jie Sheng, Yong Fan, Xingmeng Zhu, Qi Tao, Yue He, Sufang Wang
OBJECTIVE: Increased serum amyloid A (SAA) levels have been investigated in various human malignancies, but a consistent perspective has not been established to date. This study systematically reviewed the association between SAA levels and cancers. METHODS: Cochrane Library, PubMed and Embase were carefully searched for available studies. The following keywords were used in database searches: 'serum amyloid A', 'SAA', 'cancer', 'tumour', 'carcinoma', 'nubble', 'knurl' and 'lump'...
October 19, 2018: Postgraduate Medical Journal
Alexis J Pillsbury, Catherine Glover, Peter Jacoby, Helen E Quinn, Parveen Fathima, Patrick Cashman, Alan Leeb, Christopher C Blyth, Michael S Gold, Thomas Snelling, Kristine K Macartney
OBJECTIVE: To actively solicit adverse events experienced in the days following immunisation with quadrivalent inactivated influenza vaccine using Australia's near real-time, participant-based vaccine safety surveillance system, AusVaxSafety. DESIGN AND SETTING: Observational cohort study conducted in 194 sentinel surveillance immunisation sites (primary care, hospital and community-based clinics) across Australia. PARTICIPANTS: Individuals aged ≥6 months who received a routine seasonal influenza vaccine at a participating site (n=102 911) and responded to a survey (via short message service or email) sent 3 days after vaccination about adverse events experienced (n=73 892; 71...
October 18, 2018: BMJ Open
Karin Hallin, Max Gordon, Olof Sköldenberg, Peter Henriksson, Anna Kiessling
OBJECTIVE: This study aimed to compare the rate of patient readmissions and mortality between care provided at an orthopaedic interprofessional training ward (IPTW) and usual care. DESIGN: Retrospective cohort study. SETTING: Orthopaedic wards at a level II trauma centre at a Swedish university teaching hospital between 2006 and 2011. PARTICIPANTS: Two cohorts were identified: (1) a control cohort that had not received care at the IPTW, and (2) patients who had been treated for at least 1 day at the IPTW...
October 18, 2018: BMJ Open
Claire Dahyot-Fizelier, Denis Frasca, Sigismond Lasocki, Karim Asehnoune, Dorothée Balayn, Anne-Laure Guerin, Pierre-François Perrigault, Thomas Geeraerts, Philippe Seguin, Bertrand Rozec, Djilali Elaroussi, Vincent Cottenceau, Clément Guyonnaud, Olivier Mimoz
INTRODUCTION: Ventilator-associated pneumonia (VAP) is the first cause of healthcare-associated infections in intensive care units (ICUs) and brain injury is one of the main risk factors for early-onset VAP. Antibiotic prophylaxis has been reported to decrease their occurrence in brain-injured patients, but a lack of controlled randomised trials and the risk of induction of bacterial resistance explain the low level of recommendations. The goal of this study is to determine whether a single dose of ceftriaxone within the 12 hours postintubation after severe brain injury can decrease the risk of early-onset VAP...
October 18, 2018: BMJ Open
Ryan H Sandefer, Bonnie L Westra, Saif S Khairat, David S Pieczkiewicz, Stuart M Speedie
BACKGROUND: The use of personal health care management (PHM) is increasing rapidly within the United States because of implementation of health technology across the health care continuum and increased regulatory requirements for health care providers and organizations promoting the use of PHM, particularly the use of text messaging (short message service), Web-based scheduling, and Web-based requests for prescription renewals. Limited research has been conducted comparing PHM use across groups based on chronic conditions...
October 18, 2018: Journal of Medical Internet Research
Nazli Bashi, Farhad Fatehi, Mina Fallah, Darren Walters, Mohanraj Karunanithi
BACKGROUND: Despite the plethora of evidence on mHealth interventions for patient education, there is a lack of information regarding their structures and delivery strategies. OBJECTIVE: This review aimed to investigate the structures and strategies of patient education programs delivered through smartphone apps for people with diverse conditions and illnesses. We also examined the aim of educational interventions in terms of health promotion, disease prevention, and illness management...
October 19, 2018: JMIR MHealth and UHealth
Stephanie W Hum, Nader Shaikh
OBJECTIVES: To identify factors associated with delayed antimicrobial treatment in febrile children with urinary tract infection (UTI). STUDY DESIGN: We reviewed data from 802 children with UTI enrolled in 2 previously conducted prospective studies (Randomized Intervention for Children with Vesicoureteral Reflux and Careful Urinary Tract Infection Evaluation) and extracted data on possible predictors of delayed treatment including age, sex, history of UTI, ethnicity, race, primary caregiver's education level, insurance, and income...
October 16, 2018: Journal of Pediatrics
Kyle J Foreman, Neal Marquez, Andrew Dolgert, Kai Fukutaki, Nancy Fullman, Madeline McGaughey, Martin A Pletcher, Amanda E Smith, Kendrick Tang, Chun-Wei Yuan, Jonathan C Brown, Joseph Friedman, Jiawei He, Kyle R Heuton, Mollie Holmberg, Disha J Patel, Patrick Reidy, Austin Carter, Kelly Cercy, Abigail Chapin, Dirk Douwes-Schultz, Tahvi Frank, Falko Goettsch, Patrick Y Liu, Vishnu Nandakumar, Marissa B Reitsma, Vince Reuter, Nafis Sadat, Reed J D Sorensen, Vinay Srinivasan, Rachel L Updike, Hunter York, Alan D Lopez, Rafael Lozano, Stephen S Lim, Ali H Mokdad, Stein Emil Vollset, Christopher J L Murray
BACKGROUND: Understanding potential trajectories in health and drivers of health is crucial to guiding long-term investments and policy implementation. Past work on forecasting has provided an incomplete landscape of future health scenarios, highlighting a need for a more robust modelling platform from which policy options and potential health trajectories can be assessed. This study provides a novel approach to modelling life expectancy, all-cause mortality and cause of death forecasts -and alternative future scenarios-for 250 causes of death from 2016 to 2040 in 195 countries and territories...
October 16, 2018: Lancet
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