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https://www.readbyqxmd.com/read/28643112/a-retrospective-study-of-antibiotic-de-escalation-in-patients-with-ventilator-associated-pneumonia-in-malaysia
#1
Rahela Ambaras Khan, Zoriah Aziz
Background Antibiotic de-escalation is an important strategy to conserve the effectiveness of broad-spectrum antibiotics. However, the outcome of this strategy for the treatment of ventilator-associated pneumonia (VAP) has not been widely studied in developing countries. Objectives To evaluate the outcome on intensive care unit (ICU) mortality, 28 days mortality, and length of ICU stay among VAP patients who receive de-escalation therapy. Setting This study was conducted in an ICU of a Malaysian public hospital...
June 22, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28641838/dual-antiplatelet-therapy-for-6-versus-18%C3%A2-months-after-biodegradable-polymer-drug-eluting-stent-implantation
#2
Masato Nakamura, Raisuke Iijima, Junya Ako, Toshiro Shinke, Hisayuki Okada, Yoshiaki Ito, Kenji Ando, Hitoshi Anzai, Hiroyuki Tanaka, Yasunori Ueda, Shin Takiuchi, Yasunori Nishida, Hiroshi Ohira, Katsuhiro Kawaguchi, Makoto Kadotani, Hiroyuki Niinuma, Kazuto Omiya, Takashi Morita, Kan Zen, Yoshinori Yasaka, Kenji Inoue, Sugao Ishiwata, Masahiko Ochiai, Toshimitsu Hamasaki, Hiroyoshi Yokoi
OBJECTIVES: The NIPPON (Nobori Dual Antiplatelet Therapy as Appropriate Duration) study was a multicenter randomized investigation of the noninferiority of short-term versus long-term dual antiplatelet therapy (DAPT) in patients with implantation of the Nobori drug-eluting stent (DES) (Terumo, Tokyo, Japan), which has a biodegradable abluminal coating. BACKGROUND: The optimum duration of DAPT for patients with a biodegradable polymer-coated DES is unclear. METHODS: The subjects were 3,773 patients with stable or acute coronary syndromes undergoing Nobori stent implantation...
June 26, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28641750/predicting-outcomes-in-congenital-diaphragmatic-hernia
#3
Oluwatomilayo Daodu, Mary E Brindle
Identification of CDH infant populations at high risk for mortality postnatally may help to develop targeted care strategies, guide discussions surrounding palliation and contribute to standardizing reporting and benchmarking, so that care strategies at different centers can be compared. Clinical prediction rules are evidence-based tools that combine multiple predictors to estimate the probability that a particular outcome in an individual patient will occur. In CDH, a suitable clinical prediction rule can stratify high- and low-risk populations and provide the ability to tailor management strategies based on severity...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28641385/development-of-an-electronic-medical-record-based-child-physical-abuse-alert-system
#4
Rachel P Berger, Richard A Saladino, Janet Fromkin, Emily Heineman, Srinivasan Suresh, Tom McGinn
Objective: Physical abuse is a leading cause of pediatric morbidity and mortality. Physicians do not consistently screen for abuse, even in high-risk situations. Alerts in the electronic medical record may help improve screening rates, resulting in early identification and improved outcomes. Methods: Triggers to identify children < 2 years old at risk for physical abuse were coded into the electronic medical record at a freestanding pediatric hospital with a level 1 trauma center...
June 21, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28641354/-acute-liver-failure-acute-on-chronic-liver-failure-hepatorenal-syndrome-hepatopulmonary-syndrome-and-portopulmonary-hypertension-artificial-liver-support-on-the-icu
#5
Uwe Lodes, David Jacob, Frank Meyer
Background Acute hepatic dysfunction in the form of acute liver failure (ALF) or acute-on-chronic liver failure (ACLF) is a disease with a high risk of mortality and requires interdisciplinary intensive care. Aim This article explains the nomenclature, pathophysiology, prognosis and possible treatment options of ALF and ACLF, including the possibilities of extracorporeal liver support therapy at the point of liver transplantation (LTx). Method Narrative review with a selective literature review and representative case studies...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28640781/hydrogen-gas-inhalation-inhibits-progression-to-the-irreversible-stage-of-shock-after-severe-hemorrhage-in-rats
#6
Tadashi Matsuoka, Masaru Suzuki, Motoaki Sano, Kei Hayashida, Tomoyoshi Tamura, Koichiro Homma, Keiichi Fukuda, Junichi Sasaki
BACKGROUND: Mortality of hemorrhagic shock primarily depends on whether or not the patients can endure the loss of circulating volume until radical treatment is applied. We investigated whether hydrogen (H2) gas inhalation would influence the tolerance to hemorrhagic shock and improve survival. METHODS: Hemorrhagic shock was achieved by withdrawing blood until the mean arterial blood pressure reached 30-35 mmHg. After 60 minutes of shock, the rats were resuscitated with a volume of normal saline equal to four times the volume of shed blood...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28640686/prevalence-of-financial-fraud-and-scams-among-older-adults-in-the-united-states-a-systematic-review-and-meta-analysis
#7
David Burnes, Charles R Henderson, Christine Sheppard, Rebecca Zhao, Karl Pillemer, Mark S Lachs
BACKGROUND: The financial exploitation of older adults was recently recognized by the Centers for Disease Control and Prevention as a serious public health problem. Knowledge of the prevalence of elder financial exploitation is mostly limited to the category of financial abuse, which occurs in relationships involving an expectation of trust. Little is known about the other major category of elder financial exploitation-elder financial fraud and scams, which is perpetrated by strangers...
June 22, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28640142/the-derivation-and-validation-of-a-simple-model-for-predicting-in-hospital-mortality-of-acutely-admitted-patients-to-internal-medicine-wards
#8
Ali Sakhnini, Walid Saliba, Naama Schwartz, Naiel Bisharat
Limited information is available about clinical predictors of in-hospital mortality in acute unselected medical admissions. Such information could assist medical decision-making.To develop a clinical model for predicting in-hospital mortality in unselected acute medical admissions and to test the impact of secondary conditions on hospital mortality.This is an analysis of the medical records of patients admitted to internal medicine wards at one university-affiliated hospital. Data obtained from the years 2013 to 2014 were used as a derivation dataset for creating a prediction model, while data from 2015 was used as a validation dataset to test the performance of the model...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28640020/extubation-success-prediction-in-a-multicentric-cohort-of-patients-with-severe-brain-injury
#9
Karim Asehnoune, Philippe Seguin, Sigismond Lasocki, Antoine Roquilly, Adrien Delater, Antoine Gros, Florian Denou, Pierre-Joachim Mahé, Nicolas Nesseler, Dominique Demeure-Dit-Latte, Yoann Launey, Karim Lakhal, Bertrand Rozec, Yannick Mallédant, Véronique Sébille, Samir Jaber, Aurélie Le Thuaut, Fanny Feuillet, Raphaël Cinotti
BACKGROUND: Patients with brain injury are at high risk of extubation failure. METHODS: We conducted a prospective observational cohort study in four intensive care units of three university hospitals. The aim of the study was to create a score that could predict extubation success in patients with brain injury. RESULTS: A total of 437 consecutive patients with brain injury were included, and 338 patients (77.3%) displayed successful extubation...
June 21, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28639569/performance-of-simplified-acute-physiology-score-3-in-predicting-hospital-mortality-in-emergency-intensive-care-unit
#10
Qing-Bian Ma, Yuan-Wei Fu, Lu Feng, Qiang-Rong Zhai, Yang Liang, Meng Wu, Ya-An Zheng
BACKGROUND: Since the 1980s, severity of illness scoring systems has gained increasing popularity in Intensive Care Units (ICUs). Physicians used them for predicting mortality and assessing illness severity in clinical trials. The objective of this study was to assess the performance of Simplified Acute Physiology Score 3 (SAPS 3) and its customized equation for Australasia (Australasia SAPS 3, SAPS 3 [AUS]) in predicting clinical prognosis and hospital mortality in emergency ICU (EICU)...
July 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28639031/opioid-use-among-female-breast-cancer-patients-using-different-adjuvant-endocrine-therapy-regimens
#11
Xi Tan, Tareq Fabian Camacho, Virginia T LeBaron, Leslie J Blackhall, Rajesh Balkrishnan
PURPOSE: To explore differences in opioid use across different adjuvant endocrine therapy (AET) regimens, factors associated with opioid use, and the impact of opioid use on overall survival in female breast cancer patients treated with AET. METHODS: This retrospective study analyzed 2006-2012 SEER-Medicare datasets, following patients for at least two years from the index date, defined as the first date they filled an AET prescription. The study included adult women with incident, primary, hormone-receptor-positive, stage I-III breast cancer...
June 21, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28638127/the-relevance-of-arieti-s-work-in-the-age-of-medication
#12
Francisco Balbuena Rivera
This paper looks at the relevance of psychoanalysis as a treatment option for psychotic individuals at a time when psychosis is invariably considered to be a biologically-based brain disease, for which the preferred course of treatment is psychotropic medication. In recent years, the use of psychoanalysis has declined noticeably in favor of evidenced-based biomedical approaches, which rely heavily upon statistical probabilities for ameliorating specific psychotic symptoms. Well-publicized biological approaches have proliferated, often to the detriment of the psychotic individual's general health, emotional recovery, and long-term rehabilitation...
September 2016: American Journal of Psychoanalysis
https://www.readbyqxmd.com/read/28637897/heritability-of-resting-heart-rate-and-association-with-mortality-in-middle-aged-and-elderly-twins
#13
Magnus T Jensen, Mette Wod, Søren Galatius, Jacob B Hjelmborg, Gorm B Jensen, Kaare Christensen
OBJECTIVE: Resting heart rate (RHR) possibly has a hereditary component and is associated with longevity. We used the classical biometric twin study design to investigate the heritability of RHR in a population of middle-aged and elderly twins and, furthermore, studied the association between RHR and mortality. METHODS: In total, 4282 twins without cardiovascular disease were included from the Danish Twin Registry, hereof 1233 twin pairs and 1816 'single twins' (twins with a non-participating co-twin); mean age 61...
June 21, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28637401/relationship-between-ambulatory-arterial-stiffness-index-aasi-and-night-day-blood-pressure-ratio-in-essential-hypertensives
#14
Domenico Di Raimondo, Alessandra Casuccio, Rosangela Di Liberti, Gaia Musiari, Valentina Zappulla, Alessandra D'angelo, Antonio Pinto
BACKGROUND: Ambulatory Arterial Stiffness Index (AASI) has been proposed as an indirect and simpler method to estimate the Arterial Stiffness (AS). AASI, calculated from a set of data collected during a 24-hours ambulatory blood pressure monitoring (ABPM), is defined as 1 minus the regression slope of diastolic on systolic blood pressure (BP) values. For a given increase in diastolic BP, the increase in systolic BP is smaller in a compliant compared to a stiff artery; the stiffer the arterial tree, the closer AASI is to 1...
June 21, 2017: Current Hypertension Reviews
https://www.readbyqxmd.com/read/28635344/trajectories-of-remission-and-mortality-over-13-years-after-intake-to-substance-use-treatment
#15
Andrea H Kline-Simon, Felicia W Chi, Jennifer R Mertens, Constance Weisner
BACKGROUND: Little is known about the relationships between long-term patterns of substance use and mortality risk among substance use disorder (SUD) patients. OBJECTIVE: To determine distinct patterns of remission and relapse of SUD over time and examine their relationship with mortality. METHODS: The study site was Kaiser Permanente of Northern California. Data for 997 adults who entered substance use treatment between 1994 and 1996 and 4,241 non-SUD patients with similar demographic distributions (35% women in both groups) were analyzed...
February 16, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28634519/prevalence-and-risk-factors-of-heart-failure-in-the-usa-nhanes-2013-2014-epidemiological-follow-up-study
#16
Saketram Komanduri, Yogesh Jadhao, Sai S Guduru, Pramil Cheriyath, Yijin Wert
Background: Heart Failure (HF) is a progressive epidemic associated with considerable morbidity and mortality. Self-reported data from the National Health and Nutrition Examination Survey (NHANES) provides a unique representation of individuals suffering from HF. The purpose of this study is to analyze updated NHANES 2013-2014 data to identify any changes in the prevalence and current risk factors of HF, especially given the novel lifestyles and increased medical awareness of current generations. Methods: NHANES uses a multistage probability sampling design under the Centers for Disease Control and Prevention (CDC)...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28632138/monitoring-lung-contusion-in-a-porcine-polytrauma-model-using-eit-an-application-study
#17
Susana Aguiar Santos, Carlos Castelar Wembers, Klemens Horst, Roman Pfeifer, Tim-Philipp Simon, Hans-Christoph Pape, Frank Hildebrand, Michael Czaplik, Steffen Leonhardt, Daniel Teichmann
Lung contusion is the most common lung injury following blunt chest trauma which, in turn, is associated with high mortality rates (Gavelli et al., 2002). Lung contusion is characterized by hemorrhage and edema with consecutively reduced compliance. In this study, unilateral lung contusion and other traumata were induced in 12 pigs by using a bolt gun machine. To investigate the pathophysiological consequences of lung contusion, information on clinical parameters was collected and monitored regularly while animals were additionally monitored with electrical impedance tomography (EIT) before trauma, and at 4, 24, 48 and 72 h after polytrauma...
June 20, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28631307/interventions-for-the-prevention-of-recurrent-erysipelas-and-cellulitis
#18
REVIEW
Adam Dalal, Marina Eskin-Schwartz, Daniel Mimouni, Sujoy Ray, Walford Days, Emmilia Hodak, Leonard Leibovici, Mical Paul
BACKGROUND: Erysipelas and cellulitis (hereafter referred to as 'cellulitis') are common bacterial skin infections usually affecting the lower extremities. Despite their burden of morbidity, the evidence for different prevention strategies is unclear. OBJECTIVES: To assess the beneficial and adverse effects of antibiotic prophylaxis or other prophylactic interventions for the prevention of recurrent episodes of cellulitis in adults aged over 16. SEARCH METHODS: We searched the following databases up to June 2016: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and LILACS...
June 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28630921/increasing-probability-of-mortality-during-indian-heat-waves
#19
Omid Mazdiyasni, Amir AghaKouchak, Steven J Davis, Shahrbanou Madadgar, Ali Mehran, Elisa Ragno, Mojtaba Sadegh, Ashmita Sengupta, Subimal Ghosh, C T Dhanya, Mohsen Niknejad
Rising global temperatures are causing increases in the frequency and severity of extreme climatic events, such as floods, droughts, and heat waves. We analyze changes in summer temperatures, the frequency, severity, and duration of heat waves, and heat-related mortality in India between 1960 and 2009 using data from the India Meteorological Department. Mean temperatures across India have risen by more than 0.5°C over this period, with statistically significant increases in heat waves. Using a novel probabilistic model, we further show that the increase in summer mean temperatures in India over this period corresponds to a 146% increase in the probability of heat-related mortality events of more than 100 people...
June 2017: Science Advances
https://www.readbyqxmd.com/read/28629213/la-sopravvivenza-dei-pazienti-oncologici-in-italia
#20
Vincenzo Coviello, Carlotta Buzzoni, Mario Fusco, Alessandro Barchielli, Francesco Cuccaro, Roberta De Angelis, Adriano Giacomin, Stefano Luminari, Giorgia Randi, Lucia Mangone
OBJECTIVES: Population-based survival statistics are fundamental to assess the efficacy of services offered to improve cancer patients' prognosis. This study aims to update cancer survival estimates for the Italian population, as well as provide new measures, such as the crude probability of death, which takes into account the possibility of dying from causes other than cancer, and the change in life expectancy after a cancer diagnosis, to properly address various questions. RESULTS: The study includes 1,932,450 cancer cases detected by the Network of Italian Cancer Registries (AIRTUM) from 1994 to 2011 and provides estimates for 38 cancer sites and for allsites cancer...
March 2017: Epidemiologia e Prevenzione
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