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H Zöllner, R Jouni, S Panzer, A Khadour, L Janzen, J Wesche, M Ten Berg, S Schellong, A Heinken, A Greinacher, T Bakchoul
BACKGROUND: Protamine (PRT) is used to stabilize insulin in Neutral Protamine Hagedorn (NPH) insulin, a commonly used therapeutic agent for diabetes mellitus. Immunization against PRT/heparin-complexes is common in diabetic patients. OBJECTIVES: To investigate the impact of NPH-insulin on the interaction between anti-PRT/heparin antibodies and platelets. METHODS: The interaction between NPH-insulin and anti-PRT/heparin antibodies was tested using in-house enzyme immunoassays...
October 19, 2016: Journal of Thrombosis and Haemostasis: JTH
Zhi-Gang Chu, Bo Sheng, Meng-Qi Liu, Fa-Jin Lv, Qi Li, Yu Ouyang
OBJECTIVES: To clarify differences between solitary pulmonary inflammatory lesions and peripheral lung cancers with contrast-enhanced computed tomography. METHODS: In total, 64 and 132 patients with solitary pulmonary inflammatory masses/nodules and peripheral lung cancers, respectively, were enrolled in this study. Their computed tomographic findings were summarized and compared retrospectively. RESULTS: Compared with the peripheral lung cancers, the inflammatory lesions were located closer to the pleura (p<0...
October 1, 2016: Clinics
Patrícia Fernanda Saboya Ribeiro, Luiz Fernandao Kubrusly, Paulo Afonso Nunes Nassif, Irma Cláudia Saboya Ribeiro, Andressa de Souza Bertoldi, Venessa Caroline Batistão
Background: The Helicobacter pylori infection (HP) is related to the development of gastric lesions and lymphoma; however, it is not known if there is a relation with gastroesophageal reflux disease and reflux esophagitis. Aim: To evaluate HP's relationship with esophagitis in patients undergoing upper endoscopy. Methods: Observational, retrospective and cross-sectional study, being evaluated 9576 patients undergoing outpatient endoscopic examination during the period between January and December 2015...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Cheal Wung Huh, Sung Ill Jang, Beom Jin Lim, Hee Wook Kim, Jae Keun Kim, Jun Sung Park, Ja Kyung Kim, Se Joon Lee, Dong Ki Lee
Common bile duct (CBD) stones are generally associated with greater elevations of alkaline phosphatase and gamma-glutamyl transpeptidase levels than aspartate aminotransferase and alanine aminotransferase levels. However, some patients with CBD stones show markedly increased aminotransferase levels, sometimes leading to the misdiagnosis of liver disease. Therefore, the aim of this study was to investigate the clinicopathologic features of patients with CBD stones and high aminotransferase levels.This prospective cohort study included 882 patients diagnosed with CBD stones using endoscopic retrograde cholangiopancreatography (ERCP)...
October 2016: Medicine (Baltimore)
I-Shiang Tzeng, Su-Hsun Liu, Kuan-Fu Chen, Chin-Chieh Wu, Jih-Chang Chen
To reduce patient boarding time at the emergency department (ED) and to improve the overall quality of the emergent care system in Taiwan, the Minister of Health and Welfare of Taiwan (MOHW) piloted the Grading Responsible Hospitals for Acute Care (GRHAC) audit program in 2007-2009.The aim of the study was to evaluate the impact of the GRHAC audit program on the identification and management of acute myocardial infarction (AMI)-associated ED visits by describing and comparing the incidence of AMI-associated ED visits before (2003-2007), during (2007-2009), and after (2009-2012) the initial audit program implementation...
October 2016: Medicine (Baltimore)
Beth Wieczorek, Judith Ascenzi, Yun Kim, Hallie Lenker, Caroline Potter, Nehal J Shata, Lauren Mitchell, Catherine Haut, Ivor Berkowitz, Frank Pidcock, Jeannine Hoch, Connie Malamed, Tamara Kravitz, Sapna R Kudchadkar
OBJECTIVE: To determine the safety and feasibility of an early mobilization program in a PICU. DESIGN: Observational, pre-post design. SETTING: PICU in a tertiary academic hospital in the United States. PATIENTS: Critically ill pediatric patients admitted to the PICU. INTERVENTION: This quality improvement project involved a usual-care baseline phase, followed by a quality improvement phase that implemented a multicomponent, interdisciplinary, and tiered activity plan to promote early mobilization of critically ill children...
October 10, 2016: Pediatric Critical Care Medicine
D B Kadam, Sonali Salvi, Ajay Chandanwale
The World Health Organization (WHO) has coined the term expanded dengue to describe cases which do not fall into either dengue shock syndrome or dengue hemorrhagic fever. This has incorporated several atypical findings of dengue. Dengue virus has not been enlisted as a common etiological agent in several conditions like encephalitis, Guillain Barre syndrome. Moreover it is a great mimic of co-existing epidemics like Malaria, Chikungunya and Zika virus disease, which are also mosquito-borne diseases. The atypical manifestations noted in dengue can be mutisystemic and multifacetal...
July 2016: Journal of the Association of Physicians of India
Francesca Taylor, Jennifer Hare, Gill Combes
BACKGROUND: Many patients with end-stage kidney disease (ESKD) have significant psychosocial needs as a consequence of their illness and treatment. Unmet needs can impact negatively on their health and well-being. Patients want improved psychosocial support particularly in relation to coping and adjustment. Little is known about the relevance and applicability to patients of intervention approaches to support their psychosocial needs. OBJECTIVES: To explore patients' attitudes to different intervention approaches that could be developed to help them cope with the psychosocial stressors of ESKD, and to assess the potential acceptability of these approaches...
October 18, 2016: Journal of Renal Care
Nelson Trieu, Ryan Xia, Robert Loneragan, Lloyd Ridley, Joseph Trieu
INTRODUCTION: We report a series of patients who had computed tomography (CT) of their brains which showed an uncommon artefact caused by excess air bubbles in the cooling oil around the X-ray tube. METHODS: In November and December 2015, it was recognised that artefacts appearing on CT brain images acquired at our department were caused by a scanner fault. The test images were reviewed and the service engineer for the CT scanner was questioned about the artefact cause...
October 18, 2016: Journal of Medical Imaging and Radiation Oncology
Chenguang Wang, Daniel O Scharfstein, Elizabeth Colantuoni, Timothy D Girard, Ying Yan
In randomized studies involving severely ill patients, functional outcomes are often unobserved due to missed clinic visits, premature withdrawal, or death. It is well known that if these unobserved functional outcomes are not handled properly, biased treatment comparisons can be produced. In this article, we propose a procedure for comparing treatments that is based on a composite endpoint that combines information on both the functional outcome and survival. We further propose a missing data imputation scheme and sensitivity analysis strategy to handle the unobserved functional outcomes not due to death...
October 17, 2016: Biometrics
Elena Trujillo-Arribas, Hada C Macher, Pilar Jiménez-Arriscado, Fernando de la Portilla, Patrocinio Molinero, Juan M Guerrero, Amalia Rubio
Genomic characterization of cell-free circulating tumour DNA (ctDNA) may offer an opportunity to assess clonal dynamics throughout the course of a patient's illness. The existence of KRAS driver mutations in colon cancer patients is determinant to decide their treatment and to predict their outcome. DNA is extracted automatically from 400 μL of serum using the MagNa Pure Compact with the Nucleic Acid Isolation Kit I. DNA amplification, COLD-PCR and HRM were performed in the same run in the Light Cycler 480...
2016: Advances in Experimental Medicine and Biology
Iris K Minichmayr, André Schaeftlein, Joseph L Kuti, Markus Zeitlinger, Charlotte Kloft
OBJECTIVES: We aimed to assess linezolid pharmacokinetics in the plasma and interstitial space fluid (ISF) of patients with sepsis, diabetic foot infections or cystic fibrosis and healthy volunteers. The impacts of joint characteristics and disease on plasma and target-site exposure were to be identified together with the benefit of dose intensification in critically ill patients. METHODS: Rich plasma (n = 1598) and ISF concentrations in subcutaneous adipose (n = 1430) and muscle tissue (n = 1089) measured by microdialysis were pooled from three clinical trials with 51 individuals receiving 600 mg of intravenous and oral linezolid...
October 17, 2016: Clinical Pharmacokinetics
Kim Tran, Chaim Bell, Nathan Stall, George Tomlinson, Allison McGeer, Andrew Morris, Michael Gardam, Howard B Abrams
BACKGROUND: Isolation precautions have negative effects on patient safety, psychological well-being, and healthcare worker contact. However, it is not known whether isolation precautions affect certain hospital-related outcomes. OBJECTIVE: To examine the effect of isolation precautions on hospital-related outcomes and cost of care. DESIGN: Retrospective, propensity-score matched cohort study of inpatients admitted to general internal medicine (GIM) services at three academic hospitals in Toronto, Ontario, Canada between January 2010 and December 2012...
October 17, 2016: Journal of General Internal Medicine
Christopher Baethge, Michaela Jänner, Wolfgang Gaebel, Jaroslav Malevani
Hallucinations are at the core of the diagnosis of schizophrenia and schizoaffective disorders, and many neuroscience studies focus on hallucinations. However, there is a lack of data on prevalence, subtyping, and clinical correlates of hallucinations as well as on the comparison of hallucinating schizophrenia versus hallucinating schizoaffective patients. Analysis of all psychopathology evaluations is based on the AMDP scale in a German psychiatric university hospital between 2007 and 2013 regarding patients with schizophrenia or schizoaffective disorder (diagnosed according to ICD-10)...
October 17, 2016: European Archives of Psychiatry and Clinical Neuroscience
Ki Hyuk Joo, In Sool Yoo, Jinwoong Lee, Seung Whan Kim, Seung Ryu, Yeon Ho You, Yong Chul Cho, Woon Jun Jeong, Byung Jun Ahn, Sung Uk Cho
OBJECTIVE: Critically ill patients sometimes require transport to another location. Longer intra-hospital transport time increases the risk of hemodynamic instability and associated complications. Therefore, reducing intra-hospital transport time is critical. Our objective was to evaluate whether or not a new device the easy tube arrange device (ETAD) has the potential to reduce intra-hospital transport time of critically ill patients. METHODS: We enrolled volunteers for this prospective randomized controlled study...
June 2016: Clin Exp Emerg Med
Prasan K Panda, Siddharth Jain, Rita Sood, Rajni Yadav, Naval K Vikram
Histoplasmosis is caused by a dimorphic fungus Histoplasma capsulatum in endemic areas, mainly America, Africa, and Asia. In India, it is being reported from most states; however, it is endemic along the Ganges belt. We report a case of an apparently immunocompetent male who presented with 3-month history of fever, cough, and weight loss with recent onset odynophagia and had hepatosplenomegaly and mucocutaneous lesions over the face. The differential diagnosis of leishmaniasis, tuberculosis, leprosy, fungal infection, lymphoproliferative malignancy, and other granulomatous disorders was considered, but he succumbed to his illness...
2016: Case Reports in Infectious Diseases
Vibeke Strand, Eun Bong Lee, Roy Fleischmann, Rieke E Alten, Tamas Koncz, Samuel H Zwillich, David Gruben, Bethanie Wilkinson, Sriram Krishnaswami, Gene Wallenstein
OBJECTIVES: To compare patient-reported outcomes (PROs) in methotrexate (MTX)-naive patients (defined as no prior treatment or ≤3 doses) receiving tofacitinib versus MTX. METHODS: In the 24-month, phase III, randomised, controlled, ORAL Start trial (NCT01039688), patients were randomised 2:2:1 to receive tofacitinib 5 mg two times per day (n=373), tofacitinib 10 mg two times per day (n=397) or MTX (n=186). PROs assessed included Patient Global Assessment of disease (PtGA), pain, Health Assessment Questionnaire-Disability Index (HAQ-DI), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and health-related quality of life (Short Form-36 [SF-36])...
2016: RMD Open
Jo Kidd, Sue Ziebland
Online health information is increasingly popular and may bring both benefits and potential harm to users with mental health problems. The encouragement of harmful behaviour among this population is a particular concern. The website provides the benefits of shared experience by publishing excerpts from rigorous research interviews with patients, contextualised with medical information. This article sets out evidence for the positive and negative effects of online mental health information and describes the methodology behind healthtalk...
October 2016: BJPsych Bulletin
Venu Duddu, Abdulhakim Rhouma, Masood Qureshi, Imran Bashir Chaudhry, Terry Drake, Altaf Sumra, Nusrat Husain
Aims and method The need for an age-appropriate in-patient service for 16- to 17-year-olds led to the development of a 6-bed acute admissions unit in a non-metropolitan county in the UK. We provide a descriptive evaluation of the first 2 years of its operation. All admissions from April 2010 to March 2012 were reviewed, clinical details systematically recorded and descriptively analysed. Results Ninety-seven young people were admitted during this period (a third were compulsorily detained under the Mental Health Act 1983)...
October 2016: BJPsych Bulletin
Camilla Lauritzen, Charlotte Reedtz
BACKGROUND: Children who have parents with mental health problems are a vulnerable group. Intervening early to support parents with a mental illness can contribute to improve outcomes for children. Rigging the adult mental health system in such a manner that child responsible personnel are designated in wards is a strategy to systematically address the needs of families. It has since 2010 been mandatory for Norwegian hospitals to appoint such personnel in all hospital wards. The current study aimed to investigate the appointment of child responsible personnel in the adult mental health services in a regional hospital with local clinics...
2016: International Journal of Mental Health Systems
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