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Emily L Fargo, Frank D'Amico, Aaron Pickering, Kathleen Fowler, Ronald Campbell, Megan Baumgartner
BACKGROUND:  Sepsis is a serious medical condition that can lead to organ dysfunction and death. Research shows that each hour delay in antibiotic administration increases mortality. The Surviving Sepsis Campaign Bundles created standards to assist in the timely treatment of patients with suspected sepsis to improve outcomes and reduce mortality. OBJECTIVE:  This article determines if the use of an electronic physician order-set decreases time to antibiotic ordering for patients with sepsis in the emergency department (ED)...
October 2018: Applied Clinical Informatics
Isil Eser Simsek, Mujde Tuba Cogurlu, Metin Aydogan
BACKGROUND: Most children diagnosed with β-lactam allergy based only on history are not truly allergic, and mislabeling leads to use of less effective and more costly alternative broader-spectrum antibiotics, significantly increasing drug resistance. OBJECTIVE: To determine the frequency and risk factors of confirmed allergy in patients with β-lactam allergy reported by parents or their doctors and evaluate cross-reactivity between β-lactams in children with confirmed allergy...
December 5, 2018: International Archives of Allergy and Immunology
Shaikh M Ahmad, Md J Alam, Afsana Khanam, Mamunur Rashid, Sharmin Islam, Yearul Kabir, Rubhana Raqib, Mark C Steinhoff
Background: In the growing embryo, the vitamin A requirement is tightly regulated. Maternal vitamin A deficiency during pregnancy may alter maternal immune function to accommodate the fetus. Objective: Our primary objective was to determine the effect of oral vitamin A supplementation (VAS) during pregnancy and until 6 mo postpartum on pandemic H1N1-vaccine responses in mothers and their infants at 6 mo of age. Methods: In this randomized controlled clinical trial, pregnant women (n = 112) during the second trimester (mean ± SD: 14 ± 1 wk) were assigned to receive either an oral dose of 10,000 IU vitamin A or placebo weekly until 6 mo postpartum...
December 1, 2018: Journal of Nutrition
Claes Ohlsson, Maria Bygdell, Maria Nethander, Annika Rosengren, Jenny M Kindblom
Objective: The aim of this study was to determine the role of change in body mass index (BMI) during puberty, independent of childhood overweight, for the risk of adult type 2 diabetes in men. Study design, population and outcome: We included 36,176 men who had weight and height measured at age 8 (childhood) and 20 (young adult age) available from the BMI Epidemiology Study (BEST) and the Conscription register. Information on type 2 diabetes (n=1,777) was retrieved from the Swedish National Patient Register...
December 4, 2018: Journal of Clinical Endocrinology and Metabolism
Chuangshi Wang, Shrikant I Bangdiwala, Sumathy Rangarajan, Scott A Lear, Khalid F AlHabib, Viswanathan Mohan, Koon Teo, Paul Poirier, Lap Ah Tse, Zhiguang Liu, Annika Rosengren, Rajesh Kumar, Patricio Lopez-Jaramillo, Khalid Yusoff, Nahed Monsef, Vijayakumar Krishnapillai, Noorhassim Ismail, Pamela Seron, Antonio L Dans, Lanthé Kruger, Karen Yeates, Lloyd Leach, Rita Yusuf, Andres Orlandini, Maria Wolyniec, Ahmad Bahonar, Indu Mohan, Rasha Khatib, Ahmet Temizhan, Wei Li, Salim Yusuf
Aims: To investigate the association of estimated total daily sleep duration and daytime nap duration with deaths and major cardiovascular events. Methods and results: We estimated the durations of total daily sleep and daytime naps based on the amount of time in bed and self-reported napping time and examined the associations between them and the composite outcome of deaths and major cardiovascular events in 116 632 participants from seven regions. After a median follow-up of 7...
December 5, 2018: European Heart Journal
Qing Peng, Carrie A Karvonen-Gutierrez, John F Randolph, Bin Nan, Daniel McConnell, Siobán D Harlow
Context: Women with polycystic ovary syndrome (PCOS) have a higher prevalence of metabolic syndrome (MetS), but whether they develop MetS earlier than women without PCOS is unknown. Understanding the impact of PCOS on the timing of MetS onset is important for screening and clinical care in this population. Design: Women with PCOS-like status ("PCOSp") were identified from participants of the Michigan Bone Health and Metabolism Study based upon history of irregular menstrual cycles, high free-androgen index and high levels of anti-müllerian hormone...
December 3, 2018: Journal of Clinical Endocrinology and Metabolism
Alois Honek, Zdenka Martinkova, Helen E Roy, Anthony F G Dixon, Jiri Skuhrovec, Stano Pekár, Marek Brabec
Harmonia axyridis (Pallas), an invasive non-native species in central Europe, can outcompete other aphidophagous species. The distribution and abundance of H. axyridis vary depending on different host plants, and its effects on native coccinellid communities may change accordingly. The distribution and abundance of coccinellids in central Europe (50°N, 14°E) were investigated from 2010 to 2016. Coccinellids were counted at regular intervals on cereals (Avena, Hordeum, and Triticum), herbaceous plants (Matricaria and Urtica) and trees (Acer, Betula, and Tilia)...
December 4, 2018: Environmental Entomology
Antônio Rafael da Silva, Pedro Martins Lima Neto, Leonardo Hunaldo Dos Santos, Raina Jansen Cutrim Propp Lima, Pedro Luiz Tauil, Eloísa da Graça do Rosário Gonçalves
INTRODUCTION: The Integrated Program of Leprosy Control was initiated in the municipality of Buriticupu, Maranhão, Brazil, an area considered hyperendemic for leprosy in 2003. It aims at assessing the clinical and epidemiological characteristics of the disease to reduce the detection rate of new cases until 2015. Here, we present the evolution of the indicators of leprosy within the period from 2003 to 2015. METHODS: We conducted a descriptive analytical study based on the active search for and voluntary referral of cases of leprosy...
November 2018: Revista da Sociedade Brasileira de Medicina Tropical
Akram Hernández-Vásquez, Carlos Rojas-Roque, Marilina Santero, Francisco Javier Prado-Galbarro, Diego Rosselli
OBJECTIVES: . To estimate out-of-pocket spending on health (GBS) and identify its associated factors in Peruvian older adults. MATERIALS AND METHODS.: Analytical cross-sectional study of the National Household Survey on Living Conditions and Poverty (ENAHO) 2017. Older adults were considered to be all individuals aged 60 and over and the GBS was considered the main study variable. Prevalence ratios (PR) and adjusted prevalence ratios (PRa) were estimated for each of the factors associated with GBS...
July 2018: Revista Peruana de Medicina Experimental y Salud Pública
Max Moura de Oliveira, Silvânia Suely Caribé de Araújo Andrade, Sheila Rizzato Stopa, Deborah Carvalho Malta
INTRODUCTION: Knowing the profile of individuals who demand health services or professionals could help in the improvement and reorganization of services. However, this subject is still underexplored among adolescents. This study aimed to describe and identify characteristics related to the demand for health services or professionals by Brazilian students. METHODS: Using data from the 2015 National School Health Survey, the prevalence and respective 95% confidence intervals (95%CI) of the demand for health services or professionals among students were estimated, and Poisson regression adjusted by age and region of residence was used to identify the associated factors...
November 29, 2018: Revista Brasileira de Epidemiologia, Brazilian Journal of Epidemiology
Lucyana Silva Luz, Ruth Minamisava, Carmen Gracinda Silvan Scochi, Ana Karina Marques Salge, Laiane Medeiros Ribeiro, Thaíla Corrêa Castral
OBJECTIVE: to evaluate the incidence of exclusive breastfeeding and the risk factors associated to its interruption in premature infants after hospital discharge. METHOD: this is a prospective cohort with 113 premature infants in a neonatal unit, whom were followed-up from 7 to 15 days after hospital discharge. The outcome was the interruption of exclusive breastfeeding. Maternal and neonatal exposure variables were evaluated by a regression model and described by the confidence interval (95%) and risk ratio...
November 2018: Revista Brasileira de Enfermagem
Rennan H R Moreira, Rodrigo F DE Oliveira, Jorge Y P Palencia, Marina A G Lemes, Marilane D Silva, Cesar A P Garbossa, Márvio L T DE Abreu, Giselle B DE Moura, Rony A Ferreira
The objective of this trial was to evaluate the behavioral patterns and performance of lactating sows and their litters under the effect of artificial vocalization. Twenty-eight sows and their litters were distributed in a completely randomized design in a 2x2 factorial scheme (artificial vocalization x lactation week). The behavior of the animals was monitored during 24 hours on the 7th and 15th days of lactation, analyzing the number, interval, and frequency of nursings. The body condition and performance of the sows were also evaluated...
October 2018: Anais da Academia Brasileira de Ciências
Ding Zhu, Mindan Wu, Yuan Cao, Shihua Lin, Nanxia Xuan, Chen Zhu, Wen Li, Huahao Shen
INTRODUCTION: We performed a meta-analysis on whether heated humidification during positive airway pressure (PAP) could improve compliance and subjective daytime sleepiness in obstructive sleep apnea syndrome (OSAS) patients. MATERIALS AND METHODS: We searched PubMed, EMBASE, Medline, Cochrane Library, Clinical Trials, Web of Science and Scopus from inception to Oct 29, 2017. We made meta-analysis on the all available randomized controlled trials (RCTs) which assessed effects of heated humidification intervention on PAP compliance and subjective daytime sleepiness, by subgroups of automatic adjusting positive airway pressure/ continuous positive airway pressure (APAP/CPAP) usage and patients with/without upper airway symptoms prior to PAP therapy...
2018: PloS One
Arnold Y L Wong, Dino Samartzis, Prudence W H Cheung, Jason Pui Yin Cheung
BACKGROUND: Adolescent idiopathic scoliosis (AIS) is the most common spine deformity in adolescent patients. Although structural deformity may affect spinal biomechanics of patients with AIS, little is known regarding various period prevalence proportions of back pain and chronic back pain and factors associated with back pain in such patients. QUESTIONS/PURPOSES: (1) What are the period prevalence rates of back pain among teenagers with AIS? (2) Is back pain in patients with AIS associated with curve severity? METHODS: A total of 987 patients with AIS who were treated without surgery were recruited from a single center's scoliosis clinic...
November 13, 2018: Clinical Orthopaedics and related Research
Bernd Bittersohl, Chiara Benedikter, Alexander Franz, Tobias Hesper, Christoph Schleich, Gerald Antoch, Harish S Hosalkar, Rüdiger Krauspe, Christoph Zilkens
BACKGROUND: Rowing exposes the femoral head and acetabulum to high levels of repetitive abutment motion and axial loading that may put elite athletes at an increased risk for developing early hip osteoarthritis. QUESTIONS/PURPOSES: Do elite rowers demonstrate characteristic hip cartilage lesions on T2 MRI sequences compared with asymptomatic individuals who do not row? METHODS: This study included 20 asymptomatic rowers (mean age, 23 ± 3 years; nine females, 11 males) who had a minimum of 5 years of intensive (≥ 12 hours/week) training...
November 27, 2018: Clinical Orthopaedics and related Research
Susan M Goobie, David Zurakowski, Michael P Glotzbecker, Mary E McCann, Daniel Hedequist, Robert M Brustowicz, Navil F Sethna, Lawerence I Karlin, John B Emans, M Timothy Hresko
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug that reduces surgical blood loss. Evidence supporting its efficacy in surgery for adolescent idiopathic scoliosis is not robust. This trial was designed to validate the clinical efficacy of TXA in surgery for adolescent idiopathic scoliosis. METHODS: This institutional review board-approved prospective double-blinded trial involved 111 patients with adolescent idiopathic scoliosis who were randomized to receive either a placebo or TXA (50-mg/kg loading dose and 10-mg/kg/h infusion)...
December 5, 2018: Journal of Bone and Joint Surgery. American Volume
Matthieu Schmidt, Guillaume Franchineau, Alain Combes
PURPOSE OF REVIEW: To summarize results of the most recent trials on venovenous extracorporeal membrane oxygenation (VV-ECMO) in severe acute respiratory distress syndrome (ARDS) and to elaborate on the unmet needs regarding VV-ECMO management in this setting. RECENT FINDINGS: Although it was terminated early for futility (i.e., failure to demonstrate a difference in 60-day mortality of 20%), the ECMO to Rescue Lung Injury in Severe ARDS trial of VV-ECMO for severe ARDS reported a nonsignificant, but clinically important, reduction in mortality (35 vs...
November 30, 2018: Current Opinion in Critical Care
M Garazdiuk, V Bachinskyi, O Vanchuliak, O Garazdiuk, O Nechytailo
Objective - to develop a method of two-dimensional Stokes-polarimetric spatial-frequency mapping of small-scale components of cerebrospinal fluid to improve the accuracy of post-mortem interval estimation. The object of the study was polycrystalline cerebrospinal fluid films taken from 69 corpses (the main study group) and 20 healthy volunteers (comparison group). For each sample, the coordinate distribution of the values of the complex degree of mutual polarization was determined in the optical arrangement of the Stokes polarimeter...
October 2018: Georgian Medical News
David Gøttsche, Kirill Gromov, Petra H Viborg, Elvira V Bräuner, Alma B Pedersen, Anders Troelsen
Background and purpose - Obesity is a rising issue worldwide and growing evidence supports poor outcome amongst obese patients following total knee arthroplasty (TKA). Using nationwide registries we investigated the association between bodyweight and risk of revision of primary TKA. Patients and methods - All primary TKA performed during 1997-2015, weight at time of primary TKA and subsequent TKA revisions were identified in the Danish Knee Arthroplasty Register (DKR). Data on comorbidities and a priori selected confounding variables were collected from nationwide registries...
December 5, 2018: Acta Orthopaedica
Marco Roffi, Dragana Radovanovic, Juan F Iglesias, Franz R Eberli, Philip Urban, Giovanni B Pedrazzini, Paul Erne, Hans Rickli
INTRODUCTION: Limited data are available on the impact of multisite artery disease in patients with acute coronary syndromes. In particular, it is unknown whether the outcomes of those high-risk patients have improved over time. Therefore, we addressed the multisite artery disease patient population enrolled in the Swiss nationwide prospective acute coronary syndromes cohort study AMIS Plus over two decades. METHODS: All patients enrolled from January 1999 to October 2016 were stratified according to the presence of isolated coronary artery disease or multisite artery disease, defined as coronary artery disease with known concomitant vascular disease (i...
December 5, 2018: European Heart Journal. Acute Cardiovascular Care
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