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https://www.readbyqxmd.com/read/28108038/the-effect-of-endotracheal-tubes-versus-laryngeal-mask-airways-on-perioperative-respiratory-adverse-events-in-infants-a-randomised-controlled-trial
#1
Thomas F E Drake-Brockman, Anoop Ramgolam, Guicheng Zhang, Graham L Hall, Britta S von Ungern-Sternberg
BACKGROUND: Perioperative respiratory adverse events (PRAE) are the most common critical incidents in paediatric anaesthesia and occur more often in infants. Use of laryngeal mask airways (LMAs) is associated with reduced PRAE compared with endotracheal tubes in older children (>1 year). We aimed to evaluate the effect of these devices on the incidence of PRAE in infants. METHODS: We did a randomised controlled trial at the Princess Margaret Hospital for Children in Perth (WA, Australia) by recruiting infants (aged 0-12 months) undergoing general (with or without regional or local) anaesthesia with anticipated fentanyl dose 1 μg/kg or lower for minor elective surgery...
January 17, 2017: Lancet
https://www.readbyqxmd.com/read/28107234/comparison-between-acrylic-cage-and-polyetheretherketone-peek-cage-in-single-level-anterior-cervical-discectomy-and-fusion-a-randomized-clinical-trial
#2
Majid R Farrokhi, Zahra Nikoo, Mehrnaz Gholami, Khadijeh Hosseini
STUDY DESIGN: Prospective, single-blind randomized-controlled clinical study. OBJECTIVE: To compare polyetheretherketone (PEEK) cage with a novel Acrylic cage to find out which fusion cage yielded better clinical outcomes following single-level anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: ACDF is considered a standard neurosurgical treatment for degenerative diseases of cervical intervertebral disks. There are many options, including bone grafts, bone cement, and spacers made of titanium, carbon fiber, and synthetic materials, used to restore physiological disk height and enhance spinal fusion, but the ideal device, which would provide immediate structural support and subsequent osteointegration and stability, has not been identified yet...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28105356/conversion-therapy-for-pancreatic-cancer-with-peritoneal-metastases-using-intravenous-and-intraperitoneal-paclitaxel-with-s-1
#3
Hiromitsu Kitayama, Yasushi Tsuji, Tomohiro Kondo, Junko Sugiyama, Michiaki Hirayama, Kazuyuki Yamamoto, You Kawarada, Yumiko Oyamada, Satoshi Hirano
Combination chemotherapy consisting of systemic and intraperitoneal agents against peritoneal metastases from several types of cancer has shown promising results. We herein report a case in which combination therapy with intravenous and intraperitoneal paclitaxel with S-1 converted an unresectable pancreatic cancer with peritoneal metastases into a resectable one. The patient was a 65-year old woman with recurrent pancreatitis for 5 months. Endoscopic ultrasonography-guided fine-needle aspiration revealed minute epithelial masses composed of cells with irregular nuclei in the pancreatic body...
December 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28104306/midterm-and-one-year-outcome-of-amphilimus-polymer-free-drug-eluting-stent-in-patients-needing-short-dual-antiplatelet-therapy-insight-from-the-astute-registry-amphilimus-italian-multicenter-registry
#4
Cosmo Godino, Mauro Chiarito, Michael Donahue, Luca Testa, Riccardo Colantonio, Alberto Cappelletti, Alberto Monello, Valeria Magni, Diego Milazzo, Rosario Parisi, Annamaria Nicolino, Shahram Moshiri, Rossella Fattori, Gianfranco Aprigliano, Altin Palloshi, Giuseppe Caramanno, Matteo Montorfano, Francesco Bedogni, Carlo Briguori, Alberto Margonato, Antonio Colombo
BACKGROUND: To assess clinical outcomes of patients needing short dual antiplatelet therapy (S-DAPT) after PCI with Cre8 polymer-free amphilimus eluting-stent (AES). The Cre8-AES with pure i-Carbofilm coating was supposed to induce faster stent endothelialization and reduce device thrombogenicity. METHODS: We performed a sub-analysis of unrestricted consecutive patients treated with Cre8-AES between August 2011 and January 2015. Two groups were formed: 1) patients discharged with S-DAPT (≤3-month), because of high bleeding risk or attending urgent non-cardiac surgery; and 2) patients discharged with Recommended DAPT duration (R-DAPT; ≥6-month)...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28104211/balloon-post-dilation-following-implantation-of-a-self-expanding-transcatheter-aortic-valve%C3%A2-bioprosthesis
#5
J Kevin Harrison, G Chad Hughes, Michael J Reardon, Robert Stoler, Paul Grayburn, Robert Hebeler, David Liu, Yanping Chang, Jeffrey J Popma
OBJECTIVES: This study sought to explore the impact of balloon post-dilation (BPD) on outcomes in the CoreValve US Clinical Trials. BACKGROUND: BPD following transcatheter aortic valve replacement (TAVR) has been used in selected cases to optimize hemodynamic results. METHODS: Procedural details of 3,532 patients were examined to determine whether BPD was performed after self-expanding TAVR. "Best practice" guidelines recommended BPD for treatment of suboptimal intraprocedural valve function, primarily manifested by moderate or severe residual aortic regurgitation (AR)...
January 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28104069/outcomes-among-older-patients-receiving-implantable-cardioverter-defibrillators-for-secondary-prevention-from-the-ncdr-icd-registry
#6
Jarrod K Betz, David F Katz, Pamela N Peterson, Ryan T Borne, Sana M Al-Khatib, Yongfei Wang, Carolina Malta Hansen, David D McManus, Jehu S Mathew, Frederick A Masoudi
BACKGROUND: Clinical trials of implantable cardioverter-defibrillators (ICDs) for secondary prevention of sudden cardiac death were conducted nearly 2 decades ago and enrolled few older patients. OBJECTIVES: This study assessed morbidity and mortality of older patients receiving ICDs for secondary prevention in contemporary clinical practice. METHODS: We identified 12,420 Medicare beneficiaries from the National Cardiovascular Data Registry ICD Registry undergoing first-time secondary prevention ICD implantation between 2006 and 2009 in 956 U...
January 24, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28103628/treatment-of-a-vulvar-paget-s-disease-by-photodynamic-therapy-with-a-new-light-emitting-fabric-based-device
#7
Claire Vicentini, Olivier Carpentier, Fabienne Lecomte, Elise Thecua, Laurent Mortier, Serge R Mordon
INTRODUCTION: The non-invasive vulvar Paget's disease is an intra-epidermal carcinoma with glandular characteristics. It appears like an erythematous plaque. The main symptoms are pruritus and pain. The standard treatment is surgical excision in depth. This treatment is complicated with a severe morbidity and photodynamic therapy can be an alternative choice. However, the pain experienced during the photodynamic treatment of vulvar lesion is intense and leads to a premature interruption of the treatment...
January 19, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28102899/b-type-natriuretic-peptide-guided-treatment-for-heart-failure
#8
REVIEW
Julie McLellan, Carl J Heneghan, Rafael Perera, Alison M Clements, Paul P Glasziou, Karen E Kearley, Nicola Pidduck, Nia W Roberts, Sally Tyndel, F Lucy Wright, Clare Bankhead
BACKGROUND: Heart failure is a condition in which the heart does not pump enough blood to meet all the needs of the body. Symptoms of heart failure include breathlessness, fatigue and fluid retention. Outcomes for patients with heart failure are highly variable; however on average, these patients have a poor prognosis. Prognosis can be improved with early diagnosis and appropriate use of medical treatment, use of devices and transplantation. Patients with heart failure are high users of healthcare resources, not only due to drug and device treatments, but due to high costs of hospitalisation care...
December 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28102448/development-of-a-new-assessment-tool-for-cervical-myelopathy-using-hand-tracking-sensor-part-1-validity-and-reliability
#9
M Abdulhadi Alagha, Mahmoud A Alagha, Eleanor Dunstan, Olaf Sperwer, Kate A Timmins, Bronek M Boszczyk
PURPOSE: To assess the reliability and validity of a hand motion sensor, Leap Motion Controller (LMC), in the 15-s hand grip-and-release test, as compared against human inspection of an external digital camera recording. METHODS: Fifty healthy participants were asked to fully grip-and-release their dominant hand as rapidly as possible for two trials with a 10-min rest in-between, while wearing a non-metal wrist splint. Each test lasted for 15 s, and a digital camera was used to film the anterolateral side of the hand on the first test...
January 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28101624/the-safety-and-efficacy-of-cardiac-contractility-modulation-in-heart-failure-a%C3%A2-meta-analysis-of-clinical-trials
#10
X Liu, H J Yang, H Q Ping, S Qiu, S Shi, B Yang
BACKGROUND: Cardiac contractility modulation (CCM) has developed as a promising treatment device for heart failure (HF). This meta-analysis aimed at systematically reviewing the latest available published trials to provide evidence on the safety and efficacy of CCM in patients with HF. METHODS: We searched the Cochrane Central Resister of Controlled Trials, PubMed, and EMBASE in May 2016 to identify eligible clinical trials comparing CCM with sham treatment or with usual care...
January 18, 2017: Herz
https://www.readbyqxmd.com/read/28098809/the-clinical-benefits-and-accuracy-of-continuous-glucose-monitoring-systems-in-critically-ill-patients-a-systematic-scoping-review
#11
REVIEW
Sigrid C J van Steen, Saskia Rijkenberg, Jacqueline Limpens, Peter H J van der Voort, Jeroen Hermanides, J Hans DeVries
Continuous Glucose Monitoring (CGM) systems could improve glycemic control in critically ill patients. We aimed to identify the evidence on the clinical benefits and accuracy of CGM systems in these patients. For this, we performed a systematic search in Ovid MEDLINE, from inception to 26 July 2016. Outcomes were efficacy, accuracy, safety, workload and costs. Our search retrieved 356 articles, of which 37 were included. Randomized controlled trials on efficacy were scarce (n = 5) and show methodological limitations...
January 14, 2017: Sensors
https://www.readbyqxmd.com/read/28097334/the-role-of-cardiovascular-implantable-electronic-devices-in-the-detection-and-treatment-of-subclinical-atrial-fibrillation-a-review
#12
Paul L Hess, Jeff S Healey, Christopher B Granger, Stuart J Connolly, Paul D Ziegler, John H Alexander, Peter R Kowey, Christian T Ruff, Greg Flaker, Jonathan L Halperin, Robert G Hart, Renato D Lopes
Importance: Subclinical atrial fibrillation (AF) is associated with an increased risk for stroke. Observations: Subclinical AF is asymptomatic, short in duration, and usually detected with long-term, continuous monitoring. Most prior studies have explored its consequences using cardiovascular implantable electronic devices (CIEDs). Although current prevalence estimates are derived from study populations with prior CIEDs, 3 trials will assess the time to a first AF diagnosis among patients receiving a CIED for purposes of AF detection...
January 11, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28097332/effect-of-incentive-spirometry-on-postoperative-hypoxemia-and-pulmonary-complications-after-bariatric-surgery-a-randomized-clinical-trial
#13
Haddon Pantel, John Hwang, David Brams, Thomas Schnelldorfer, Dmitry Nepomnayshy
Importance: The combination of obesity and foregut surgery puts patients undergoing bariatric surgery at high risk for postoperative pulmonary complications. Postoperative incentive spirometry (IS) is a ubiquitous practice; however, little evidence exists on its effectiveness. Objective: To determine the effect of postoperative IS on hypoxemia, arterial oxygen saturation (Sao2) level, and pulmonary complications after bariatric surgery. Design, Setting, and Participants: A randomized noninferiority clinical trial enrolled patients undergoing bariatric surgery from May 1, 2015, to June 30, 2016...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28096585/comparison-of-three-insertion-techniques-of-proseal-laryngeal-mask-airway-a-randomized-clinical-trial
#14
Kadirehally Bheemanna Nalini, Shivanna Shivakumar, Shivashankar Archana, Doddagavanahalli Channaiah Sandhya Rani, Chadalavada Venkata Rama Mohan
BACKGROUND AND AIMS: We aimed to compare three techniques for insertion of ProSeal laryngeal mask airway (PLMA). MATERIAL AND METHODS: Two hundred ten patients (American Society of Anaethesiologists I-II, aged 18-60 years) undergoing general anesthesia using the PLMA as an airway management device were randomly allocated to digital (D), rotational (R), or pharyngoscopic (P) techniques. In the D group (n = 70), the PLMA insertion was performed by using digital manipulation...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28095918/anti-staphylococcal-activity-resulting-from-epithelial-lining-fluid-elf-concentrations-of-amikacin-inhale-administered-via-the-pulmonary-drug-delivery-system
#15
Islam M Ghazi, Mordechai Grupper, David P Nicolau
BACKGROUND: Amikacin inhale (BAY41-6551), a unique drug-device combination of a specially formulated drug solution and a pulmonary drug delivery system device (AMK-I) is currently under phase III study as an adjunctive therapy to IV antibiotics for the treatment of Gram-negative pneumonia in mechanically ventilated patients. While the epidemiology of nosocomial pneumonia is predominated by Gram-negative pathogens such as Pseudomonas aeruginosa and the Enterobacteriaceae, Staphylococcus aureus is increasingly recognized as a pathogen of concern for these pulmonary based infections...
January 17, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28092200/the-challenges-surrounding-preclinical-testing-in-transcatheter-device-development-and-the-implications-on-the-clinic
#16
Ralf Holzer, Jake Goble, Ziyad Hijazi
Transcatheter devices have contributed significantly to the advances achieved in treating many cardiovascular conditions over the last few decades. Sophisticated and detailed preclinical testing is not only a regulatory requirement to support an investigational device exemption (IDE) application, but more crucially its success and accuracy is needed to safeguard patients during the subsequent clinical testing stages. Areas Covered: This article covers the regulatory background as well as specific considerations related to pre-clinical testing of transcatheter devices...
January 16, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28092092/domains-of-daily-physical-activity-in-children-with-mitochondrial-disease-a-3d-accelerometry-approach
#17
Saskia Koene, Ilse Dirks, Esmee van Mierlo, Pascal R de Vries, Anjo J W M Janssen, Jan A M Smeitink, Arjen Bergsma, Hans Essers, Kenneth Meijer, Imelda J M de Groot
Feasible, sensitive and clinically relevant outcome measures are of extreme importance when designing clinical trials. For paediatric mitochondrial disease, no robust end point has been described to date. The aim of this study was to select the domains of daily physical activity, which can be measured by 3D accelerometry, that could serve as sensitive end points in future clinical trials in children with mitochondrial disorders.In this exploratory observational study, 17 patients with mitochondrial disease and 16 age- and sex-matched controls wore 3D accelerometers at the upper leg, upper arm, lower arm and chest during one weekend...
January 17, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28089562/sequential-multiple-assignment-randomized-trials-an-opportunity-for-improved-design-of-stroke-reperfusion-trials
#18
William J Meurer, Nicholas J Seewald, Kelley Kidwell
BACKGROUND: Modern clinical trials in stroke reperfusion fall into 2 categories: alternative systemic pharmacological regimens to alteplase and "rescue" endovascular approaches using targeted thrombectomy devices and/or medications delivered directly for persistently occluded vessels. Clinical trials in stroke have not evaluated how initial pharmacological thrombolytic management might influence subsequent rescue strategy. A sequential multiple assignment randomized trial (SMART) is a novel trial design that can test these dynamic treatment regimens and lead to treatment guidelines that more closely mimic practice...
January 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28088893/intervention-for-cardiac-repair-a-clinical-perspective
#19
Hui Na Tan, Zhe Yuan Tay, Boon Seng Soh
Cardiovascular disease remains the leading cause of death worldwide. Damage to the heart resulting from cardiovascular disease leads to gradual loss of function and reduced quality of life. Cardiac injury is particularly debilitating, more so than injury to any other organ given our current inability to either generate new and functional cardiac tissue or to mimic the actions of the heart using external devices. Advances in the field of stem cells and genetics have paved the way for the development of a variety of novel therapies...
January 12, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28088498/vaginal-misoprostol-prior-to-intrauterine-device-insertion-in-women-delivered-only-by-elective-cesarean-section-a-randomized-double-blind-clinical-trial
#20
Mohamed S Abdellah, Ahmed M Abbas, Aml M Hegazy, Ihab M El-Nashar
OBJECTIVE: The current study aims to evaluate if vaginal misoprostol (400 mcg) administered prior to intrauterine device (IUD) insertion increase the ease and success of insertion among women who had delivered only by elective Cesarean delivery (CD). STUDY DESIGN: The current study was a randomized, double-blind, placebo-controlled trial, conducted in Assiut Women's Health Hospital, Egypt between the 1st of April 2015 and the 31st of March 2016 included women delivered only by elective CD...
January 11, 2017: Contraception
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