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Jean-Louis Vincent, Marc Leone
Distributive shock is associated with decreased systemic vascular resistance and altered oxygen extraction. Septic shock is the most frequent form of distributive shock. In shock states, duration of hypotension is associated with poor outcomes. The speed at which treatment to restore adequate perfusion pressure is initiated is, therefore, important to improve survival. Areas covered: This review presents an overview of the literature related to the management of vasopressor-dependent distributive shock, and in particular the relationship between arterial pressure and organ perfusion and function...
October 24, 2016: Expert Review of Anti-infective Therapy
Madan M Maddali, Nishant R Arora, John Valliattu, Pranav S Kandachar, Francois Lacour-Gayet
Intraoperative transesophageal echocardiography is an established modality for confirming the preoperative diagnosis, assess adequacy of surgical repair, identify residual problems, and help improve the outcome after operation. Despite the multitude of advantages, intraoperative transesophageal echocardiography can affect the hemodynamic parameters in small neonates and children. A severe transient electromechanical dissociation caused by the anteflexion of a transesophageal echocardiography probe during a total anomalous pulmonary venous connection repair in an infant is reported...
November 2016: Annals of Thoracic Surgery
Marvin C Alkin
This discussion comments on the approximately 20years history of writings on the prescriptive theory called Empowerment Evaluation. To do so, involves examining how "Empowerment Evaluation Theory" has been defined at various points of time (particularly 1996 and now in 2015). Defining a theory is different from judging the success of a theory. This latter topic has been addressed elsewhere by Michael Scriven, Michael Patton, and Brad Cousins. I am initially guided by the work of Robin Miller (2010) who has written on the issue of how to judge the success of a theory...
October 15, 2016: Evaluation and Program Planning
Eric L Scholten, Roy Semaan, Peter Illei, Christopher Mallow, Sixto Arias, David Feller-Kopman, Karen Oakjones-Burgess, Bernice Frimpong, Ricardo Ortiz, Hans Lee, Lonny Yarmus
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of thoracic structures is a commonly performed tissue sampling technique. The usage of an inner-stylet in the EBUS needle has never been rigorously evaluated, and may be unnecessary. METHODS: In a prospective randomized single blinded controlled clinical trial, patients with a clinical indication for EBUS-TBNA underwent lymph node sampling using both with-stylet and without-stylet techniques...
October 18, 2016: Chest
Joachim Niehren, Cristian Versari, Mathias John, François Coutte, Philippe Jacques
We wish to predict changes of reaction networks with partial kinetic information that lead to target changes of their steady states. The changes may be either increases or decreases of influxes, reaction knockouts, or multiple changes of these two kinds. Our prime applications are knockout prediction tasks for metabolic and regulation networks. In a first step, we propose a formal modeling language for reaction networks with partial kinetic information. The modeling language has a graphical syntax reminiscent to Petri nets...
October 18, 2016: Bio Systems
Dirk Wildemeersch, Thomas Hasskamp, Kilian Nolte, Sohela Jandi, Ansgar Pett, Sabine Linden, Maarten van Santen, Olivier Julen
BACKGROUND: In the selection of an appropriate IUD little consideration is placed on device size or adequacy of fit. Properly fitting IUDs will likely lead to less adverse effects or patient discomfort resulting in enhanced continuation of use. METHODS: A multicenter study conducted at 7 centers in 410 nulliparous women, to measure the width of the uterine cavity using 2D and 3D ultrasound. RESULTS: Measurements of maximal fundal cavity width was performed by either 2D or 3D ultrasound by experienced sonographists...
September 21, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Marybeth Grant-Beuttler, Jenifer Jennings, Christina McCauley, Robert Dulay, Katlyn Grossnickle, Kerri Kill, John Hay
PURPOSE: To develop an electronic version of the Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity (eCSAPPA), which would allow individual administration to children younger than nine years of age. METHODS: Fifty-four, four - nine-year-old children completed the eCSAPPA and the Test of Gross Motor Development-2 (TGMD-2). Parental measures of physical activity, and body mass index were obtained. Twenty-one participants additionally completed the paper version of the CSAPPA...
October 21, 2016: Pediatric Exercise Science
Sonia Duarte de Azevedo Bittencourt, Rosa Maria Soares Madeira Domingues, Lenice Gnocchi da Costa Reis, Márcia Melo Ramos, Maria do Carmo Leal
BACKGROUND: In Brazil, hospital childbirth care is available to all, but differences in access and quality of care result in inequalities of maternal health. The objective of this study is to assess the infrastructure and staffing of publicly financed labor and birth care in Brazil and its adequacy according to clinical and obstetric conditions potentially associated with obstetric emergencies. METHODS: Nationwide cross-sectional hospital-based study "Birth in Brazil: national survey into labor and birth" conducted in 2011-2012...
October 17, 2016: Reproductive Health
Julie Dare, Celia Wilkinson, Michael Garlepp, Johnny Lo, Steve Allsop
OBJECTIVES: This qualitative study explored the barriers and enablers influencing Western Australian (WA) community pharmacists' knowledge, confidence, willingness and practice in engaging older clients (>60 years) in alcohol-related health discussions. METHODS: Two focus groups were conducted with a total of 14 community pharmacists who had previously completed a formative quantitative survey (n = 63), and indicated willingness to participate in a follow-up focus group...
October 20, 2016: International Journal of Pharmacy Practice
James Tattersall
Current guidelines focus on conventional dialysis defined as 3-5 hours, three times per week, and suggest that longer or more frequent dialysis be considered. This paper presents the case for considering that shorter or less frequent dialysis should also be considered. More frequent and/or longer dialysis facilitates control of fluid overload, blood pressure, and phosphate levels. These benefits will require time to translate into probable hard outcome improvement. Patients are unlikely to participate in productive or pleasurable activities while undergoing dialysis in center or traveling to treatment...
October 20, 2016: Seminars in Dialysis
I Fusier, O Parent de Curzon, S Touratier, L Escaut, M Lafaurie, S Fournier, M Sinègre, P Lechat, D Vittecoq
OBJECTIVE: We aimed to document amoxicillin-clavulanic acid prescription to improve the proper use of antibiotics in hospital settings. We used three criteria: quality of medical charts, adequacy of indications, and adequacy of treatment duration. METHOD: This study was designed as a one-day point prevalence survey carried out by antibiotic lead specialists. RESULTS: We included 387 prescriptions from 32 hospitals. Immunodeficiency was recorded as a risk factor in 30% of patients...
October 17, 2016: Médecine et Maladies Infectieuses
Anuj Gupta, Robert W Yeh, Jacqueline E Tamis-Holland, Shalin H Patel, Robert A Guyton, Lloyd W Klein, Tanveer Rab, Ajay J Kirtane
Assessment of clinical outcomes such as 30-day mortality following coronary revascularization procedures has historically been used to spur quality improvement programs. Public reporting of risk-adjusted outcomes is already mandated in several states, and proposals to further expand public reporting have been put forward as a means of increasing transparency and potentially incentivizing high quality care. However, for public reporting of outcomes to be considered a useful surrogate of procedural quality of care, several prerequisites must be met...
October 24, 2016: JACC. Cardiovascular Interventions
Ann F Minnick, Linda D Norman, Beth Donaghey
BACKGROUND: Concerns about U.S. nursing research workforce preparation and success in the research arena require information about support mechanisms and readiness because the first research position is key to researcher retention and success. PURPOSE: The purpose was to describe the state of junior nursing research faculty recruitment terms, nursing programs' support during the first 2 years of employment, and administrators' views about strengths and weaknesses of the junior nursing research faculty pool and adequacy of the support provided...
September 21, 2016: Nursing Outlook
Vijayalakshmi Padmanabhan, Heather B Steinmetz, Elizabeth J Rizzo, Amber J Erskine, Tamara L Fairbank, Francine B de Abreu, Gregory J Tsongalis, Laura J Tafe
CONTEXT: -At our medical center, cytopathologists perform rapid on-site evaluation for specimen adequacy of fine-needle aspiration and touch imprint of needle core biopsy lung cancer samples. Two years ago the molecular diagnostics laboratory at our institution changed to next-generation sequencing using the Ion Torrent PGM and the 50-gene AmpliSeq Cancer Hotspot Panel v2 for analyzing mutations in a 50-gene cancer hot spot panel. This was associated with in a dramatic fall in adequacy rate (68%)...
October 20, 2016: Archives of Pathology & Laboratory Medicine
Stefano Avanzini, Maria Grazia Faticato, Alessandro Crocoli, Calogero Virgone, Camilla Viglio, Elisa Severi, Anna Maria Fagnani, Giovanni Cecchetto, Giovanna Riccipetitoni, Bruno Noccioli, Ernesto Leva, Angela Rita Sementa, Girolamo Mattioli, Alessandro Inserra
BACKGROUND: Peripheral neuroblastic tumors are the most common extracranial solid neoplasms in children. Early and adequate tissue sampling may speed up the diagnostic process and ensure a prompt start of optimal treatment whenever needed. Different biopsy techniques have been described. The purpose of this multi-center study is to evaluate the accuracy and safety of the various examined techniques and to determine whether a preferential procedure exists. METHODS: All children who underwent a biopsy, from January 2010 to December 2014, as a result of being diagnosed with a peripheral neuroblastic tumor, were retrospectively reviewed...
October 20, 2016: Pediatric Blood & Cancer
Ahmad S Azhar
OBJECTIVES: To assess the safety and effectiveness of transthoracic echocardiography (TTE) in monitoring transcatheter closure of atrial septal defect (ASD), in comparison with conventional technique using transesophageal echocardiography (TEE).  Methods: A retrospective review of all cases of transcatheter closure of isolated ostium secundum ASDs operated from 2005 to 2015, at the Pediatric Interventional Cardiology Department, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia...
November 2016: Saudi Medical Journal
Ronaldo Sousa Oliveira Filho, Lia Mara Kauchi Ribeiro, Lucia Caruso, Patricia Azevedo Lima, Náglia Raquel Teixeira Damasceno, Francisco García Soriano
INTRODUCTION: Quality Indicators for Nutritional Therapy (QINT) allow a practical assessment of nutritional therapy (NT) quality. OBJECTIVE: To apply and monitor QINT for critically ill patients at nutritional risk. METHODS: Cross sectional study including critically ill patients > 18 years old, at nutritional risk, on exclusive enteral (ENT) or parenteral nutritional therapy (PNT) for > 72 hours. After three consecutive years, 9 QINT were applied and monitored...
September 20, 2016: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Frederico Rosário, Marcin Wojnar, Cristina Ribeiro
BACKGROUND: The effectiveness of interventions to increase general practitioners' management of alcohol problems is affected by their attitudes toward at-risk drinkers. Tailoring training programs to general practitioners' attitudes may be useful in increasing alcohol screening and brief advice. OBJECTIVES: to determine whether general practitioners could be divided into distinct groups based on their attitudes toward at-risk drinkers. Another aim of this study was to develop and validate a model for classifying general practitioners into distinct groups...
October 19, 2016: Substance Use & Misuse
Barjinder Pal Kaur, P Srinivasa Rao
This study aims to investigate the effect of high-pressure processing on the quality of black tiger shrimp using response surface methodology. A central composite rotatable design was applied to evaluate the effects of three processing parameters, namely pressure (300-600 MPa), temperature (30-50 ℃), and time (0-15 min), on the inactivation rate of Staphylococcus aureus and physical properties (color and texture) of shrimp and to optimize the process conditions to achieve maximum bacterial inactivation with minimal changes in quality attributes...
October 6, 2016: Food Science and Technology International, Ciencia y Tecnología de Los Alimentos Internacional
Paul Roux, Christine Passerieux, Marie-Josée Fleury
BACKGROUND: Needs and service performance assessment are key components in improving recovery among individuals with mental disorders. AIMS: To test the role of service performance as a mediating factor between severity of patients' needs and outcomes. METHOD: A total of 339 adults with mental disorders were interviewed. A mediation analysis between severity of needs, service performance (adequacy of help, continuity of care and recovery orientation of services) and outcomes (personal recovery and quality of life) was carried out using structural equation modelling...
October 6, 2016: British Journal of Psychiatry: the Journal of Mental Science
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