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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/100001002/kdigo-2013-clinical-practice-guideline-for-lipid-management-in-chronic-kidney-disease-full-guidelines
#2
(no author information available yet)
No abstract text is available yet for this article.
2013: Kidney International Supplements
https://www.readbyqxmd.com/read/100001001/summary-of-recommendation-statements-kdigo-2013-clinical-practice-guideline-for-lipid-management-in-chronic-kidney-disease
#3
(no author information available yet)
No abstract text is available yet for this article.
2013: Kidney International Supplements
https://www.readbyqxmd.com/read/27926975/large-for-gestational-age-infants-and-adverse-outcomes-among-uncomplicated-pregnancies-at-term
#4
Hector Mendez-Figueroa, Van Thi Thanh Truong, Claudia Pedroza, Suneet P Chauhan
Background While traumatic delivery with large for gestational age (LGA; birth weight above 90%) is acknowledged, there is paucity of data regarding other morbidity and mortality associated with LGA. Our hypothesis was that compared with appropriate for gestational age (AGA), LGA have a significantly higher rate of composite neonatal morbidity (CNM). Objective Our objective was to compare the CNM among uncomplicated LGA versus AGA at term (37 weeks or more) among all available Maternal-Fetal Medicine Units (MFMU) databases...
December 7, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27926972/management-of-endometriosis-in-the-infertile-patient
#5
Edgardo Somigliana, Paola Vigano, Laura Benaglia, Andrea Busnelli, Nicola Berlanda, Paolo Vercellini
The management of endometriosis-related infertility remains debated. However, in recent years, the role of in vitro fertilization (IVF) has progressively grown. Reasons to explain this change include (1) the improvement of the effectiveness and safety of IVF, (2) the raised awareness of the modest effectiveness of surgery, (3) the inherent risks of surgery including in particular the damage to the ovarian reserve when ovarian endometriomas have to be removed, (4) the ineffectiveness of intrauterine insemination and the possible risks of endometriosis progression associated with the use of this technique...
December 7, 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27926971/management-of-endometriomas
#6
Ludovico Muzii, Chiara Di Tucci, Mara Di Feliciantonio, Giulia Galati, Ludovica Verrelli, Violante Di Donato, Claudia Marchetti, Pierluigi Benedetti Panici
Ovarian endometriomas affect 17 to 44% of women with endometriosis, and are often associated with pelvic pain and infertility. Treatment options include expectant management, medical and/or surgical treatment, and in vitro fertilization and embryo transfer (IVF-ET). The choice of treatment depends mostly on the associated symptoms. In most cases, surgery is the preferred choice, since endometriomas do not respond to medical treatment, which may only treat associated pain. In case of infertility, IVF-ET may be a suitable alternative to surgery, particularly when there is no associated pain...
December 7, 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27926970/management-of-endometriosis-involving-the-urinary-tract
#7
Mobolaji O Ajao, Jon I Einarsson
Endometriosis is a common cause of infertility and disabling pelvic pain in reproductive age women. The most widely accepted theory of its pathogenesis is the retrograde flow of menstrual products, although extra-abdominal and extrapelvic diagnoses have been made. After the pelvic peritoneum and gynecologic structures, the most commonly affected sites are the lower gastrointestinal and urinary tracts. When the urinary tract is involved, the bladder is the predominant site, followed by the ureters. The focus of this seminar will thus be these two anatomic sites...
December 7, 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27926892/do-mobile-phone-applications-improve-glycemic-control-hba1c-in-the-self-management-of-diabetes-a-systematic-review-meta-analysis-and-grade-of-14-randomized-trials
#8
REVIEW
Can Hou, Ben Carter, Jonathan Hewitt, Trevor Francisa, Sharon Mayor
OBJECTIVE: To investigate the effect of mobile phone applications (apps) on glycemic control (HbA1c) in the self-management of diabetes. RESEARCH DESIGN AND METHODS: Relevant studies that were published between 1 January 1996 and 1 June 2015 were searched from five databases: Medline, CINAHL, Cochrane Library, Web of Science, and Embase. Randomized controlled trials that evaluated diabetes apps were included. We conducted a systematic review with meta-analysis and GRADE (Grading of Recommendations Assessment, Development and Evaluation) of the evidence...
November 2016: Diabetes Care
https://www.readbyqxmd.com/read/27926794/metastatic-type-a-thymoma-morphologic-and-genetic-correlation
#9
Tobias Bürger, Inga-Marie Schaefer, Stefan Küffer, Hanibal Bohnenberger, Kirsten Reuter-Jessen, John Kwok-Cheung Chan, Alexander Emmert, Marc Hinterthaner, Alexander Marx, Philipp Ströbel
INTRODUCTION: The vast majority of type A thymomas are diagnosed in tumor stage 1 or 2, and metastatic cases are exceedingly rare. The histological and genetic features of such metastatic type A thymomas have not been described in detail. METHODS: Five metastatic type A thymomas in tumor stage Masaoka IVb that had been reviewed by a panel of expert pathologists were analyzed using comparative genomic hybridization (CGH). All cases had metastasized to the lungs. RESULTS: Cases #1, 2 and 3 showed the prototypic morphology of type A thymomas with mostly solid growth patterns...
December 7, 2016: Histopathology
https://www.readbyqxmd.com/read/27926784/preoperative-characteristics-and-cytological-features-of-136-histologically-confirmed-pancreatic-mucinous-cystic-neoplasms
#10
Aristana Scourtas, Jonathan C Dudley, William R Brugge, Abdurrahman Kadayifci, Mari Mino-Kenudson, Martha B Pitman
BACKGROUND: Mucinous cystic neoplasms (MCNs) of the pancreas present a management conundrum. The majority are benign but all are resected due to their malignant potential. Recent studies have recommended nonsurgical management. In the current study, the authors analyzed the preoperative imaging, cytology, and cyst fluid characteristics of 136 histologically confirmed MCNs to assess predictors of a high-risk (HR) cyst for surgical triage. METHODS: MCNs resected at the Massachusetts General Hospital between 1990 and 2014 formed the study cohort...
December 7, 2016: Cancer
https://www.readbyqxmd.com/read/27926766/teledermatology-for-the-diagnosis-and-management-of-skin-cancer-a-systematic-review
#11
Anna Finnane, Kathy Dallest, Monika Janda, H Peter Soyer
Importance: As technology becomes more commonplace in dermatological practice, it is essential to continuously review the accuracy of teledermatology devices and services compared with in-person care. The last systematic review was conducted over 5 years ago. Objective: To synthesize and assess the quality of the evidence to address 3 research questions: (1) How accurate is teledermatology for skin cancer diagnosis compared with usual care (face-to-face [FTF] diagnosis)? (2) Does teledermatology save clinician and/or patient time, compared with usual care? (3) What are the enablers and barriers to adoption of teledermatology in clinical practice for the diagnosis of skin cancer? Evidence Review: The review protocol was registered in the PROSPERO database...
December 7, 2016: JAMA Dermatology
https://www.readbyqxmd.com/read/27926733/high-resolution-mapping-of-global-surface-water-and-its-long-term-changes
#12
Jean-François Pekel, Andrew Cottam, Noel Gorelick, Alan S Belward
The location and persistence of surface water (inland and coastal) is both affected by climate and human activity and affects climate, biological diversity and human wellbeing. Global data sets documenting surface water location and seasonality have been produced from inventories and national descriptions, statistical extrapolation of regional data and satellite imagery, but measuring long-term changes at high resolution remains a challenge. Here, using three million Landsat satellite images, we quantify changes in global surface water over the past 32 years at 30-metre resolution...
December 7, 2016: Nature
https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#13
Welmoed K van Deen, Arlen Spiro, A Burak Ozbay, Martha Skup, Adriana Centeno, Natalie E Duran, Precious N Lacey, Darius Jatulis, Eric Esrailian, Martijn G H van Oijen, Daniel W Hommes
BACKGROUND AND OBJECTIVES: Value-based healthcare (VBHC) is considered to be the solution that will improve quality and decrease costs in healthcare. Many hospitals are implementing programs on the basis of this strategy, but rigorous scientific reports are still lacking. In this pilot study, we present the first-year outcomes of a VBHC program for inflammatory bowel disease (IBD) management that focuses on highly coordinated care, task differentiation of providers, and continuous home monitoring...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27926659/macroprolactinomas-and-nonfunctioning-pituitary-adenomas-and-pregnancy-outcomes
#14
Kimberley Lambert, Kate Rees, Paul T Seed, Mandish K Dhanjal, Marian Knight, David R McCance, Catherine Williamson
OBJECTIVE: To examine the monitoring, management, and outcomes of pituitary tumors in pregnancy. METHODS: A national, prospective, observational, population-based case series study was conducted in all U.K. consultant-led obstetric units over 3 years using the U.K. Obstetric Surveillance System. To evaluate rates of adverse pregnancy outcomes, women with a macroprolactinoma (10 mm or greater) or nonfunctioning pituitary adenoma, diagnosed before or during pregnancy, were compared with two comparison groups: 1) a U...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27926655/maternal-morbidity-after-previable-prelabor-rupture-of-membranes
#15
Sarah K Dotters-Katz, Alexis Panzer, Matthew R Grace, Marcela C Smid, J Adeolu Keku, Catherine J Vladutiu, Kim A Boggess, Tracy A Manuck
OBJECTIVE: To identify risk factors for maternal morbidity after previable prelabor rupture of membranes (PROM). METHODS: We conducted a case-control study of singleton and twin pregnancies complicated by previable PROM (14.0-22.9 weeks of gestation) at a single tertiary care referral institution, 2000-2015. Pregnancies complicated by fetal anomalies, previable PROM within 2 weeks of chorionic villus sampling or amniocentesis, and those with contraindications to expectant management (eg, chorioamnionitis) were excluded...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27926646/treatment-of-a-pregnant-patient-in-a-persistent-vegetative-state
#16
Matthew P Romagano, William E Scorza, Stephen E Lammers, Carole Dorr, John C Smulian
BACKGROUND: Brain injury leading to a persistent vegetative state during pregnancy involves difficult medical and ethical decisions. CASE: A 21-year-old multigravid woman entered a persistent vegetative state at 20 1/7 weeks of gestation after cardiac arrest with postanoxic brain injury from a suspected drug overdose. The clinical disciplines responsible for her case formed a collaborative care plan involving ventilator, nutrition, and medication support of the mother and regular fetal monitoring and ultrasound testing...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27926644/cervical-cancer-screening-guideline-adherence-before-and-after-guideline-changes-in-pennsylvania-medicaid
#17
Natasha Parekh, Julie M Donohue, Aiju Men, Jennifer Corbelli, Marian Jarlenski
OBJECTIVE: To assess changes in cervical cancer screening after the 2009 American College of Obstetricians and Gynecologists' guideline change and to determine predictors associated with underscreening and overscreening among Medicaid-enrolled women. METHODS: We performed an observational cohort study of Pennsylvania Medicaid claims from 2007 to 2013. We evaluated guideline adherence of 18- to 64-year-old continuously enrolled women before and after the 2009 guideline change...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27926641/vaginal-hysterectomy-for-treatment-of-cervical-ectopic-pregnancy
#18
Roa Alammari, Renee Thibodeau, Oz Harmanli
BACKGROUND: Cervical ectopic pregnancy can lead to catastrophic hemorrhage, and may be managed conservatively with intra-amniotic methotrexate (MTX), systemic MTX, or both; surgical evacuation with or without balloon tamponade; and uterine artery embolization. However, some patients require hysterectomy, which has traditionally been performed abdominally. CASE: A 39-year-old parous woman was diagnosed with cervical ectopic pregnancy at an estimated 7 1/7 weeks of gestation...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27926636/feasibility-and-outcomes-of-fetoscopic-tracheal-occlusion-for-severe-left-diaphragmatic-hernia
#19
Michael A Belfort, Oluyinka O Olutoye, Darrell L Cass, Olutoyin A Olutoye, Christopher I Cassady, Amy R Mehollin-Ray, Alireza A Shamshiraz, Stephanie M Cruz, Timothy C Lee, David G Mann, Jimmy E Espinoza, Stephen E Welty, Caraciolo J Fernandes, Rodrigo R Ruano
OBJECTIVE: To evaluate feasibility and initial outcomes of fetoscopic tracheal occlusion for severe diaphragmatic hernia compared with a historical cohort who had not received fetal tracheal occlusion. METHODS: Outcomes in a prospective observational cohort who underwent fetoscopic tracheal occlusion for severe fetal left diaphragmatic hernia without associated anomalies were compared with our historical nontreated cohort of matched fetuses of similar severity. Fetuses were classified using the same ultrasonography and magnetic resonance imaging methodology-prospectively in the fetoscopic tracheal occlusion group and retrospectively in the historical nontreated cohort...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27926635/the-obstetrician-gynecologist-s-role-in-detecting-preventing-and-treating-depression
#20
Amritha Bhat, Susan D Reed, Jürgen Unützer
Women are at a higher risk for depression than are men, and this risk is especially pronounced at specific reproductive periods of vulnerability: adolescence, pregnancy, postpartum, and the menopausal transition. Obstetrician-gynecologists are often the health care providers who women consult during these vulnerable periods, usually presenting with conditions or complaints other than depression or anxiety. Presenting symptoms are frequently known comorbidities with depression or are risk factors for depression...
December 2, 2016: Obstetrics and Gynecology
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