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https://www.readbyqxmd.com/read/28337935/a-novel-approach-in-the-treatment-of-neonatal-gastroschisis-a-review-of-the-literature-and-a-single-center-experience
#1
Vito Briganti, Daniela Luvero, Caterina Gulia, Roberto Piergentili, Simona Zaami, Elsa Laura Buffone, Cristina Vallone, Roberto Angioli, Claudio Giorlandino, Fabrizio Signore
Gastroschisis is a congenital abdominal wall defect and its management remains an issue. We performed a review of the literature to summarize its evaluation, management and outcome and we describe a new type of surgical reduction performed in our center without anesthesia (GA), immediately after birth, in the delivery room. Between January 2002 and March 2013, we enrolled all live born infants with gastroschisis referred to the third level Division of Obstetrics and Gynecology "San Camillo" of Rome.Two groups of infants were identified: group 1 in which gastroschis reduction was performed by the traditional technique and group 2 in which reduction was immediately performed after birth in the delivery room without GA...
March 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28334688/preparation-of-poly-n-isopropylacrylamide-block-acrylic-acid-encapsulated-proteinaceous-microbubbles-for-delivery-of-doxorubicin
#2
Xiaochen Ma, Qingxia Liu
Inspired by theranostic technologies, we electrostatically loaded proteinaceous microbubbles (MBs) with a model drug, doxorubicin (Dox) to couple their utilizations in diagnostic imaging with drug loading. A temperature-sensitive polymer, poly(N-isopropylacrylamide-block-acrylic acid) (poly(NIPAM-b-AAc)) was used to encapsulate the Dox-loaded MBs to prevent premature release and to control the Dox release thermally. An LCST of 39°C, slightly higher than normal body temperatures, enables the release of Dox through a conformational change of the polymer shell upon moderate heating...
March 12, 2017: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/28332298/impact-of-maternal-obesity-on-very-preterm-infants
#3
Rubia Khalak, Asha Rijhsinghani, Sarah E McCallum
OBJECTIVE: Infants born at less than  34 weeks' gestational age are at higher risk for morbidity and mortality. Data are limited on the impact of maternal obesity on the very preterm infant. This study reviewed whether maternal obesity further increases the intensive care needs of very preterm infants of less than 34 weeks' gestation. METHODS: Maternal and neonatal data for live-born singleton births of 23 0/7 to 33 6/7 weeks' gestation delivering in upstate New York were reviewed...
March 22, 2017: Obesity
https://www.readbyqxmd.com/read/28328640/we-are-going-to-name-names-and-call-you-out-improving-the-team-in-the-academic-operating-room-environment
#4
Richard Bodor, Brian J Nguyen, Kevin Broder
INTRODUCTION: Communication failures between multidisciplinary teams can impact efficiency, performance, and morale. Academic operating rooms (ORs) often have surgical, anesthesia, and nursing teams, each teaching multiple trainees. Incorrectly identifying name and "rank" (postgraduate year [PGY]) of resident trainees can disrupt performance evaluations and team morale and even potentially impair delivery of quality care when miscommunication errors proliferate. METHODS: Our OR-based survey asked 50 participants (18 surgeons, 14 anesthesiologists, and 18 nursing members), to recall basic identification data including provider names and PGY levels from their recent collaborating OR teams...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28325723/face-presentation-in-delivery-room-what-is-strategy
#5
Giuseppe De Bernardo, Maria Svelto, Maurizio Giordano, Desiree Sordino
No abstract text is available yet for this article.
March 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28323647/clinical-complications-with-the-delivery-of-inhaled-epoprostenol-in-the-operating-room
#6
Amar M Bhatt, Erica J Stein
No abstract text is available yet for this article.
March 21, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28323086/characteristics-and-outcomes-of-very-low-birth-weight-infants-receiving-epinephrine-during-delivery-room-resuscitation
#7
Malvi Savani, Kirtikumar Upadhyay, Ajay J Talati
Background Delivery room resuscitation of very low birth weight infants can involve use of endotracheal or intravenous epinephrine. Data of the past 19 years were reviewed to identify the usage of epinephrine in delivery room and identify characteristics of these babies. METHODS: Neonates with ≤1500gm birthweight from January 1996 to August 2014 were reviewed. Infants born alive and admitted to NICU were eligible. Characteristics such as demographics, survival and outcomes were recorded...
March 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28321299/successful-emergency-department-interventions-that-reduce-time-to-antibiotics-in-febrile-pediatric-cancer-patients
#8
Sandra Spencer, MIchele Nypaver, Katherine Hebert, Christopher Benner, Rachel Stanley, Daniel Cohen, Alexander Rogers, Jason Goldstick, Prashant Mahajan
Children with cancer and fever are at high risk for sepsis related death. Rapid antibiotic delivery (< 60 minutes) has been shown to reduce mortality. We compared patient outcomes and describe interventions from three separate quality improvement (QI) projects conducted in three United States (US) tertiary care pediatric emergency departments (EDs) with the shared aim to reduce time to antibiotic (TTA) to < 60 minutes in febrile pediatric oncology patients (Temperature > 38.0 C). A secondary objective was to identify interventions amenable to translation to other centers...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28321296/improving-surgical-and-anaesthesia-practice-review-of-the-use-of-the-who-safe-surgery-checklist-in-felege-hiwot-referral-hospital-ethiopia
#9
Ryan Ellis, Ahmad Izzuddin Mohamad Nor, Iona Pimentil, Zebenaye Bitew, Jolene Moore
Development of surgical and anaesthetic care globally has been consistently reported as being inadequate. The Lancet Commission on Global Surgery highlights the need for action to address this deficit. One such action to improve global surgical safety is the introduction of the WHO Surgical Checklist to Operating Rooms (OR) around the world. The checklist has a growing body of evidence supporting its ability to assist in the delivery of safe anaesthesia and surgical care. Here we report the introduction of the Checklist to a major Ethiopian referral hospital and low-resource setting and highlight the success and challenges of its implementation over a one year period...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28319990/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#10
Renata Konrad, Sarah Ficarra, Catherine Danko, Rachel Wallace, Cliona Archambeault
The patient-centered medical home (PCMH) has been proposed as a viable and medically effective model of primary care delivery. The fundamental principles of a PCMH address increased access and offer new ways to organize a practice. Creating provider schedules able to satisfy the operational and organizational constraints imposed by this type of delivery model is a challenging, complex, and time-consuming task.This article presents a two-step approach for scheduling providers and prospectively assessing the consequences of various schedules on patient throughput without experimenting on the real-world system...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28319487/videolaryngoscopy-in-neonates-infants-and-children
#11
Onur Balaban, Joseph D Tobias
Airway management is vital during anesthetic care and during resuscitative efforts in the PICU, the emergency department, and the delivery room. Given specific anatomic and physiologic differences, neonates and infants may be more prone to complications during airway management. Videolaryngoscopy may offer an alternative to or advantages over direct laryngoscopy in specific clinical scenarios. The following article reviews some of the basic types of videolaryngoscopy and discusses their potential applications in the pediatric population...
March 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28302696/achievement-of-saturation-targets-in-preterm-infants-32%C3%A2-weeks-gestational-age-in-the-delivery-room
#12
Lani Nui White, Marta Thio, Louise S Owen, C Omar Kamlin, Samantha Sloss, Stuart B Hooper, Peter G Davis, Jennifer A Dawson
BACKGROUND: To reduce the risks of hypoxia and hyperoxia in preterm infants in the delivery room; national and international guidelines recommend titrating supplemental oxygen delivery to achieve specific oxygen saturation (SpO2) targets. Our aim was to measure the proportion of time infants <32 weeks' gestation spent within and outside prescribed SpO2 targets during the first 10 min after birth. METHOD: Prospective observational study using data from a preductal SpO2 sensor and oxygen analyser measuring fraction of inspired oxygen (FiO2) in the inspiratory limb of the respiratory circuit...
March 16, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28302396/supercritical-antisolvent-co-precipitation-of-rifampicin-and-ethyl-cellulose
#13
Rania Djerafi, Andri Swanepoel, Christelle Crampon, Lonji Kalombo, Philip Labuschagne, Elisabeth Badens, Yasmine Masmoudi
Rifampicin-loaded submicron-sized particles were prepared through supercritical anti-solvent process using ethyl cellulose as polymeric encapsulating excipient. Ethyl acetate and a mixture of ethyl acetate/dimethyl sulfoxide (70/30 and 85/15) were used as solvents for both drug and polymeric excipient. When ethyl acetate was used, rifampicin was crystallized separately without being embedded within the ethyl cellulose matrix while by using the ethyl acetate/dimethyl sulfoxide mixture, reduced crystallinity of the active ingredient was observed and a simultaneous precipitation of ethyl cellulose and drug was achieved...
March 14, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28302085/adaptation-of-non-technical-skills-behavioural-markers-for-delivery-room-simulation
#14
Fabrizio Bracco, Michele Masini, Gabriele De Tonetti, Francesca Brogioni, Arianna Amidani, Sara Monichino, Alessandra Maltoni, Andrea Dato, Claudia Grattarola, Massimo Cordone, Giancarlo Torre, Claudio Launo, Carlo Chiorri, Danilo Celleno
BACKGROUND: Simulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations. However, the observation, assessment and feedback on these skills is particularly complex, because the process needs expert observers and the feedback is often provided in judgmental and ineffective ways...
March 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28300477/evaluation-of-intracameral-pentablock-copolymer-thermosensitive-gel-for-sustained-drug-delivery-to-the-anterior-chamber-of-the-eye
#15
Elizabeth Schaefer, Sara M Smith, Jacklyn Salmon, Santhi Abbaraju, Rasidul Amin, Sidney Weiss, Ulrich Grau, Poonam Velagaleti, Brian Gilger
PURPOSE: To investigate PTSgels (Pentablock copolymers) as an injectable formulation technology for sustained ocular drug delivery. Drug release profile, tolerability, and polymer degradation for one of the thermosensitive, biodegradable, and biocompatible compositions were investigated through intracameral (IC) injection in rabbits. METHODS: New Zealand White rabbit eyes were injected IC (50 μL) with 100 μg near-infrared-immunoglobulin G (NIR-IgG) in balanced salt solution (BSS) or 20% PTSgel; or with PTSgel or BSS alone...
March 16, 2017: Journal of Ocular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28300169/double-flow-focused-liquid-injector-for-efficient-serial-femtosecond-crystallography
#16
Dominik Oberthuer, Juraj Knoška, Max O Wiedorn, Kenneth R Beyerlein, David A Bushnell, Elena G Kovaleva, Michael Heymann, Lars Gumprecht, Richard A Kirian, Anton Barty, Valerio Mariani, Aleksandra Tolstikova, Luigi Adriano, Salah Awel, Miriam Barthelmess, Katerina Dörner, P Lourdu Xavier, Oleksandr Yefanov, Daniel R James, Garrett Nelson, Dingjie Wang, George Calvey, Yujie Chen, Andrea Schmidt, Michael Szczepek, Stefan Frielingsdorf, Oliver Lenz, Edward Snell, Philip J Robinson, Božidar Šarler, Grega Belšak, Marjan Maček, Fabian Wilde, Andrew Aquila, Sébastien Boutet, Mengning Liang, Mark S Hunter, Patrick Scheerer, John D Lipscomb, Uwe Weierstall, Roger D Kornberg, John C H Spence, Lois Pollack, Henry N Chapman, Saša Bajt
Serial femtosecond crystallography requires reliable and efficient delivery of fresh crystals across the beam of an X-ray free-electron laser over the course of an experiment. We introduce a double-flow focusing nozzle to meet this challenge, with significantly reduced sample consumption, while improving jet stability over previous generations of nozzles. We demonstrate its use to determine the first room-temperature structure of RNA polymerase II at high resolution, revealing new structural details. Moreover, the double flow-focusing nozzles were successfully tested with three other protein samples and the first room temperature structure of an extradiol ring-cleaving dioxygenase was solved by utilizing the improved operation and characteristics of these devices...
March 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28298660/hyperlactatemia-and-cardiac-surgery
#17
REVIEW
Jonathon Minton, David A Sidebotham
The normal blood lactate level is 0-2 mmol/L, and a value above 3-5 mmol/L is variably used to define hyperlactatemia. In cardiac surgical patients, hyperlactatemia can arise from both hypoxic and non-hypoxic mechanisms. The major non-hypoxic mechanism is likely stress-induced accelerated aerobic metabolism, in which elevated lactate results from a mass effect on the lactate/pyruvate equilibrium. The lactate/pyruvate ratio is normal (<20) in this circumstance. Hyperlactatemia can also result from impaired global or regional oxygen delivery, in which case the lactate/pyruvate ratio is typically elevated (>20)...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28296670/intraoperative-feeding-improves-calorie-and-protein-delivery-in-acute-burn-patients
#18
David E Varon, Gil Freitas, Neha Goel, Jennifer Wall, Deepak Bharadia, Erin Sisk, Joshua C Vacanti, Bohdan Pomahac, Indranil Sinha, Vihas M Patel
Enteral nutrition support is a critical component of modern burn care for severely burned patients. However, tube feeds are frequently withheld during the perioperative period because of aspiration concerns. As a result, patients requiring multiple operative procedures risk accumulating significant protein-calorie deficits. The objective of this study was to describe our American Burn Association-certified burn center's experience implementing an intraoperative feeding protocol in severely burned patients defined as a cutaneous burn ≥20% TBSA...
March 6, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28292333/location-and-content-of-counselling-and-acceptance-of-postpartum-iud-in-sri-lanka
#19
Mahesh Karra, David Canning, Sorcha Foster, Iqbal H Shah, Hemantha Senanayake, U D P Ratnasiri, Ramya Priyanwada Pathiraja
BACKGROUND: The immediate postpartum IUD (PPIUD) is a long-acting, reversible method of contraception that can be used safely and effectively following a birth. To appropriately facilitate the immediate postpartum insertion of IUDs, women must be informed of the method's availability and must be counselled on its benefits and risks prior to entering the delivery room. We examine the relationship between the location and quality of antenatal counselling and women's acceptance of immediate postpartum IUD (PPIUD) in four hospitals in Sri Lanka...
March 14, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28290954/improving-surgical-complications-and-patient-safety-at-the-nation-s-largest-military-hospital-an-analysis-of-national-surgical-quality-improvement-program-data
#20
Steve Maturo, Charlotte Hughes, George Kallingal, Stephen Silvey, A J Johnson, Douglas Soderdahl, Evan Renz, Joseph Brennan
INTRODUCTION: The U.S. Military Health System cares for over 9 million patients and encompasses 63 hospitals and 413 clinics worldwide. Military medicine balances the simultaneous tasks of caring for those patients wounded in military engagements, treating large numbers of families of service men and women, and training the next generation of health care providers and ancillary staff. Similar to civilian health care delivery in the United States, military medicine has also seen increased scrutiny in the areas of cost and quality...
March 2017: Military Medicine
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