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https://www.readbyqxmd.com/read/28549099/impact-of-resident-and-fellow-changeovers-on-patient-outcomes-a-nationwide-cross-sectional-study
#1
Jean-David Zeitoun, Jeanne Reboul-Marty, Jérémie H Lefèvre
Findings regarding the association of cohort changeovers with patient outcomes are mixed. We sought to examine the association of resident and fellow changeovers with a comprehensive set of indicators. We performed a cross-sectional comparative study including all French teaching and non-teaching hospitals. All-cause mortality and length of stay were assessed. Focused analysis for three medical conditions (myocardial infarction, intestinal hemorrhage, stroke) and three surgical procedures (colorectal, vascular and spine surgery) was performed regarding other quality and efficiency indicators (readmissions, intensive care unit admission, transfers)...
May 25, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28548598/associations-between-endothelin-polymorphisms-and-aneurysmal-subarachnoid-hemorrhage-clinical-vasospasm-delayed-cerebral-ischemia-and-functional-outcome
#2
Christoph J Griessenauer, Robert M Starke, Paul M Foreman, Philipp Hendrix, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Mingkuan Lin, Beverly C Walters, Jean-Francois Pittet, Mali Mathru
OBJECTIVE Endothelin-1, a potent vasoconstrictor, and its receptors may be involved in the pathogenesis of aneurysmal subarachnoid hemorrhage (aSAH), clinical vasospasm, delayed cerebral ischemia (DCI), and functional outcome following aSAH. In the present study, common endothelin single nucleotide polymorphisms (SNPs) and their relation to aSAH were evaluated. METHODS Blood samples from all patients enrolled in the Cerebral Aneurysm Renin Angiotensin System (CARAS) study were used for genetic evaluation. The CARAS study prospectively enrolled patients with aSAH at 2 academic institutions in the US from 2012 to 2015...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28548595/effect-of-treatment-modality-on-in-hospital-outcome-in-patients-with-subarachnoid-hemorrhage-a-nationwide-study-in-japan-j-aspect-study
#3
Ryota Kurogi, Akiko Kada, Kunihiro Nishimura, Satoru Kamitani, Ataru Nishimura, Tetsuro Sayama, Jyoji Nakagawara, Kazunori Toyoda, Kuniaki Ogasawara, Junichi Ono, Yoshiaki Shiokawa, Toru Aruga, Shigeru Miyachi, Izumi Nagata, Shinya Matsuda, Shinichi Yoshimura, Kazuo Okuchi, Akifumi Suzuki, Fumiaki Nakamura, Daisuke Onozuka, Akihito Hagihara, Koji Iihara
OBJECTIVE Although heterogeneity in patient outcomes following subarachnoid hemorrhage (SAH) has been observed across different centers, the relative merits of clipping and coiling for SAH remain unknown. The authors sought to compare the patient outcomes between these therapeutic modalities using a large nationwide discharge database encompassing hospitals with different comprehensive stroke center (CSC) capabilities. METHODS They analyzed data from 5214 patients with SAH (clipping 3624, coiling 1590) who had been urgently hospitalized at 393 institutions in Japan in the period from April 2012 to March 2013...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28548592/intracranial-pressure-monitoring-in-severe-blunt-head-trauma-does-the-type-of-monitoring-device-matter
#4
Alberto Aiolfi, Desmond Khor, Jayun Cho, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28548570/embolic-mycotic-encephalitis-in-a-cow-following-mortierella-wolfii-infection-of-a-surgery-site
#5
Benjamin Curtis, Charlotte Hollinger, Ailam Lim, Matti Kiupel
A 5-y-old Holstein dairy cow had surgery for a suspected displaced abomasum 10 d postpartum, developed acute neurologic signs at day 19, and was found dead 21 d postpartum. At autopsy, there was a peri-incisional intramuscular abscess that communicated with the peritoneal cavity, as well as hemorrhage and malacia involving the brain, and multiple nodules in the liver, kidneys, and lungs. Fungal hyphae were seen histologically at the surgery site, on the surface of the liver, and in lesions of severe necrotizing vasculitis in the lungs, kidneys, brain, and liver...
May 1, 2017: Journal of Veterinary Diagnostic Investigation
https://www.readbyqxmd.com/read/28547982/clinicopathological-study-of-5-cases-of-renal-cell-carcinoma-with-t-6-11-p21-q12
#6
Naoto Kuroda, Kenji Yorita, Naomi Sasaki, Akira Ishihara, Keiko Matsuura, Tsutomu Daa, Shintaro Mori, Aya Sasaki, Shuji Mikami, Kazuto Shigematsu, Yoji Nagashima
Renal cell carcinoma (RCC) with t(6;11)(p21;q12) has been incorporated into the recent WHO classification. We performed a clinicopathological study of 5 cases with such a tumor. The patients consisted of 4 males and 1 female. The age of patients ranged from 17 to 57 years with a mean age of 38.6 years. Tumor sizes ranged from 2.8 to 11 cm with a mean value of 6.5 cm. Despite immunotherapy and molecular-targeted therapy, one patient died of the disease 28 months after the surgery. Grossly, the cut surface of this tumor showed grayish white color in at least the focal area of all tumors...
2017: Polish Journal of Pathology: Official Journal of the Polish Society of Pathologists
https://www.readbyqxmd.com/read/28547880/the-possible-role-of-ccr5%C3%AE-32-mutation-in-crimean-congo-hemorrhagic-fever-infection
#7
Aydin Rustemoglu, Duygu Ekinci, Ayşe Feyda Nursal, Sener Barut, Fazilet Duygu, Özgür Günal
Crimean-Congo hemorrhagic fever infection (CCHF) is a viral zoonosis. The pathogenesis of this disease has not been established so far, however cytokines account for its progression and outcome. The aim of the present study is to investigate the association between chemokine receptor 5 (CCR5) gene Δ32 mutation and pathogenity, severity, and mortality of CCHF. This case-control study included 133 CCHF patients diagnosed by detection of CCHV RNA positivity and 97 healthy control subjects. CCR5 gene Δ32 mutation analyzed by polymerase chain reaction (PCR) method...
May 26, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/28547840/performance-of-norwegian-civilian-emts-and-army-medics-in-penetrating-trauma-a-controlled-simulation-based-assessment
#8
S W Blix, J Melau, I Lund-Kordahl
BACKGROUND: Penetrating trauma kills rapidly. Thorough and efficient examination and aggressive hemorrhage control is important to save lives. The aim of this study was to assess the skills of civilian Emergency Medical Technicians (EMTs) in bleeding examination and control compared to Army Medics. Our hypothesis was that civilian pre-hospital systems perform at a lower level compared to an expert group, and did not have sufficient focus on education and training in examination and treatment of penetrating injuries...
May 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28547808/cytokine-response-in-crimean-congo-hemorrhagic-fever-virus-infection
#9
Önder Ergönül, Ceren Şeref, Şebnem Eren, Aysel Çelikbaş, Nurcan Baykam, Başak Dokuzoğuz, Mehmet Gönen, Füsun Can
BACKGROUND: We described the predictive role of cytokines in fatality of Crimean Congo Hemorrhagic Fever Virus (CCHFV) infection by using daily clinical sera samples. METHODS: Consequent serum samples of the selected patients in different severity groups and healthy controls were examined by using human cytokine 17-plex assay. RESULTS: We included 12(23%) mild, 30(58%) moderate, 10(19%) severe patients, and 10 healthy volunteers. The mean age of the patients was 52 (sd 15), 52% were female...
May 26, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/28547269/effect-of-intermittent-versus-continuous-bladder-catheterization-on-duration-of-the-second-stage-of-labor-among-nulliparous-women-with-an-epidural-a-randomized-controlled-trial
#10
Abeer Suleiman, Sobhiya Mruwat-Rabah, Gali Garmi, Dorit Dagilayske, Tair Zelichover, Raed Salim
INTRODUCTION AND HYPOTHESIS: Catheterization type among women laboring with epidural analgesia who develop bladder retention has been reported to affect labor duration and mode of delivery. We aimed to compare the effect of continuous bladder catheterization (CC) with that of intermittent bladder catheterization (IC) on the duration of the second stage of labor. METHODS: In a randomized trial, term nulliparous women with singleton gestation who requested epidural analgesia and were unable to void spontaneously were eligible and randomized to either CC or IC...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28547098/obstetrical-and-perinatal-morbidity-and-mortality-among-in-vitro-fertilization-pregnancies-a-population-based-study
#11
Hussein Sabban, Andrew Zakhari, Valerie Patenaude, Togas Tulandi, Haim A Abenhaim
PURPOSE: To compare patient characteristics and obstetrical/neonatal outcomes of in-vitro fertilization (IVF) and spontaneously conceived pregnancies. METHODS: Using the Nationwide Inpatient Sample, we conducted a retrospective cohort study from 2008 to 2011 comparing IVF conceptions to spontaneous ones. Patient characteristics were descriptively compared, and after adjusting for baseline characteristics with logistic regression, obstetrical/neonatal outcomes were also compared...
May 25, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28546860/predictors-of-intracranial-hemorrhage-in-adult-patients-on-extracorporeal-membrane-oxygenation-an-observational-cohort-study
#12
Alexander Fletcher Sandersjöö, Jiri Bartek, Eric Peter Thelin, Anders Eriksson, Adrian Elmi-Terander, Mikael Broman, Bo-Michael Bellander
BACKGROUND: Intracranial hemorrhage (ICH) is a recognized complication of adults treated with extracorporeal membrane oxygenation (ECMO) and is associated with increased morbidity and mortality. However, the predictors of ICH in this patient category are poorly understood. The purpose of this study was to identify predictors of ICH in ECMO-treated adult patients. METHODS: We conducted a retrospective review of adult patients (≥18 years) treated with ECMO at the Karolinska University Hospital (Stockholm, Sweden) between September 2005 and June 2016, excluding patients with ICH upon admission or those who were treated with ECMO for less than 12 h...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28546755/pediatric-ventricular-assist-devices-current-challenges-and-future-prospects
#13
REVIEW
Sarah Burki, Iki Adachi
The field of mechanical circulatory support has made great strides in the preceding 2 decades. Although pediatric mechanical circulatory support has lagged behind that of adults, the gap between them is expected to close soon. The only device currently approved by the US Food and Drug Administration for use in children is the Berlin Heart EXCOR ventricular assist device (VAD). The prospective Berlin Heart Investigational Device Exemption Trial demonstrated good outcomes, such as bridge to transplantation or recovery, in ~90% of children supported with this device...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28546695/retinal-vascular-occlusion-secondary-to-retrobulbar-injection-case-report-and-literature-review
#14
Dhaivat Vasavada, Prabu Baskaran, Seema Ramakrishnan
Retrobulbar injection has been widely practiced as a technique of ocular anesthesia for many decades. Nevertheless, the technique is not free from complications. Vascular occlusion secondary to retrobulbar injection is rare but can be vision threatening. We report a case series of two such patients who presented with poor vision following retrobulbar injection. Fundus showed pale retina with cherry red spot suggestive of central retinal artery occlusion in case 1 and pale disc with sclerosed vessels and multiple superficial hemorrhages suggestive of a combined occlusion of retinal artery and vein in case 2...
January 2017: Middle East African Journal of Ophthalmology
https://www.readbyqxmd.com/read/28546694/cannula-associated-ocular-injuries-during-cataract-surgery-a-preventable-intraoperative-complication
#15
Darren Shu Jeng Ting, Chrisjan Dees, Christine Ellerton
Although rare, inadvertently dislodged cannula can occur during cataract surgery. We report two cases of cannula-associated ocular injury during stromal hydration of the main corneal incision despite the use of Luer-lock syringes. Case 1 suffered from an initially occult intraocular injury which led to a delayed presentation of vitreous prolapsing into the anterior chamber, presumed posterior capsular rupture, vitreous hemorrhage, and multiple retinal tears, which required a three-port pars plana vitrectomy and cryotherapy...
January 2017: Middle East African Journal of Ophthalmology
https://www.readbyqxmd.com/read/28546552/melatonin-mediated-mitophagy-protects-against-early-brain-injury-after-subarachnoid-hemorrhage-through-inhibition-of-nlrp3-inflammasome-activation
#16
Shenglong Cao, Sudeep Shrestha, Jianru Li, Xiaobo Yu, Jingyin Chen, Feng Yan, Guangyu Ying, Chi Gu, Lin Wang, Gao Chen
The NLRP3 inflammasome is activated in the early period following subarachnoid hemorrhage(SAH), resulting in inflammatory responses. Recent studies have shown that activation of NLRP3 inflammasome is suppressed by autophagy, but the potential mechanism is unclear. In this study, we examined whether mitophagy was involved in the beneficial effect of melatonin and its relationship with NLRP3 inflammasome activation after SAH. In total, 130 adult-male SD rats were randomly divided into four groups: sham group, SAH + vehicle group, SAH + melatonin group, and SAH + 3-methyladenine (3-MA) + melatonin group...
May 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28546377/respiratory-care-considerations-in-the-childhood-cancer-patient
#17
Lama Elbahlawan, K Jason Rains, Dennis C Stokes
This article reviews the common pulmonary complications seen in the pediatric oncology population and our approach to diagnosis, management, and therapy considerations in this specialized population, including patients receiving chemotherapy, radiation, and hematopoietic stem cell transplantation. Although infections cause the most significant complications in this population, non-infectious complications, including acute lung injury from chemotherapy or radiation, idiopathic interstitial pneumonia, diffuse alveolar hemorrhage, bronchiolitis obliterans, and cryptogenic organizing pneumonia, also occur commonly...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546325/reciprocal-interaction-of-24-hour-blood-pressure-variability-and-systolic-blood-pressure-on-outcome-in-stroke-thrombolysis
#18
Lars Kellert, Christian Hametner, Niaz Ahmed, Geraldine Rauch, Mary J MacLeod, Francesco Perini, Kennedy R Lees, Peter A Ringleb
BACKGROUND AND PURPOSE: Significance and management of blood pressure (BP) changes in acute stroke care are unclear. Here, we aimed to investigate the impact of 24-hour BP variability (BPV) on outcome in patients with acute ischemic stroke treated with intravenous thrombolysis. METHODS: From the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis registry, 28 976 patients with documented pre-treatment systolic BP at 2 and 24 hours were analyzed...
May 25, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28546252/acute-basilar-artery-occlusion-differences-in-characteristics-and-outcomes-after-endovascular-therapy-between-patients-with-and-without-underlying-severe-atherosclerotic-stenosis
#19
Y Y Lee, W Yoon, S K Kim, B H Baek, G S Kim, J T Kim, M S Park
BACKGROUND AND PURPOSE: Prediction of underlying intracranial atherosclerotic stenosis before endovascular therapy might be helpful for appropriate therapeutic planning in patients with acute ischemic stroke. This study aimed to compare the characteristics and treatment outcomes in patients with acute basilar artery occlusion relative to the existence or nonexistence of underlying intracranial atherosclerotic stenosis. MATERIALS AND METHODS: Sixty-two patients with acute basilar artery occlusion underwent multimodal endovascular therapy...
May 25, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28545622/warfarin-and-the-risk-of-stroke-and-bleeding-in-patients-with-atrial-fibrillation-receiving-dialysis-a-systematic-review-and-meta-analysis
#20
REVIEW
Ziv Harel, Glenn M Chertow, Prakesh S Shah, Shai Harel, Paul Dorian, Andrew T Yan, Gustavo Saposnik, Manish M Sood, Amber O Molnar, Jeffrey Perl, Rachel M Wald, Sam Silver, Ron Wald
BACKGROUND: Patients with atrial fibrillation who receive dialysis are at a high risk of ischemic stroke. The role of warfarin in mitigating this risk in patients with atrial fibrillation who receive dialysis is uncertain. Our objective was to examine the safety and efficacy of warfarin in patients who have atrial fibrillation and receive dialysis. METHODS: We used MedLine, Embase, and the Cochrane Library to conduct a systematic review and meta-analysis of published and unpublished observational and interventional studies related to the use of warfarin in patients with atrial fibrillation who receive dialysis, and provided data on the risk of stroke and/or bleeding outcomes relative to placebo or no anticoagulation therapy...
June 2017: Canadian Journal of Cardiology
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