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https://www.readbyqxmd.com/read/29054974/laryngeal-closure-impedes-non-invasive-ventilation-at-birth
#1
Jessica R Crawshaw, Marcus J Kitchen, Corinna Binder-Heschl, Marta Thio, Megan J Wallace, Lauren T Kerr, Charles C Roehr, Katie L Lee, Genevieve A Buckley, Peter G Davis, Andreas Flemmer, Arjan B Te Pas, Stuart B Hooper
BACKGROUND: Non-invasive ventilation is sometimes unable to provide the respiratory needs of very premature infants in the delivery room. While airway obstruction is thought to be the main problem, the site of obstruction is unknown. We investigated whether closure of the larynx and epiglottis is a major site of airway obstruction. METHODS: We used phase contrast X-ray imaging to visualise laryngeal function in spontaneously breathing premature rabbits immediately after birth and at approximately 1 hour after birth...
October 20, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29050063/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives-part-1
#2
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the Society for Obstetric Anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29045653/a-quality-improvement-project-to-reduce-hypothermia-in-preterm-infants-on-admission-to-the-neonatal-intensive-care-unit
#3
Wai Yan Yip, Bin Huey Quek, Mary Choi Wan Fong, Thilagamangai, Sally Siew Gim Ong, Bee Leong Lim, Bo Chu Lo, Pratibha Agarwal
Objective: To study effectiveness of quality improvement interventions in reducing hypothermia in preterm infants on admission to neonatal intensive care unit. Design: Quality improvement methodologies including multidisciplinary planning and implementation of evidence-based interventions. Data during and post-implementation were collected. Setting and participants: In total, 84 preterm infants with birth weights ≤ 1500 g delivered during implementation period (October 2008-April 2009) were compared with 168 historical controls and 947 infants in the subsequent 4 years...
October 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29042819/distance-from-health-facility-and-mothers-perception-of-quality-related-to-skilled-delivery-service-utilization-in-northern-ethiopia
#4
Girmatsion Fisseha, Yemane Berhane, Alemayehu Worku, Wondwossen Terefe
BACKGROUND: Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. SUBJECTS AND METHODS: A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/29042802/utilization-of-fetal-fibronectin-testing-and-pregnancy-outcomes-among-women-with-symptoms-of-preterm-labor
#5
Sean C Blackwell, Erin M Sullivan, Allison A Petrilla, Xian Shen, Kathleen A Troeger, James D Byrne
OBJECTIVES: To identify pregnant health plan members triaged through the emergency department (ED), including labor and delivery (ELD) units, with symptoms of preterm labor (PTL), and evaluate the use of fetal fibronectin (fFN) testing; and to calculate the rate of hospitalization and timing of delivery in relation to the ED visit. METHODS: Retrospective cohort study using Medical Outcomes Research for Effectiveness and Economics Registry(®), a national multipayer claims database...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29039292/an-innovative-short-stay-health-care-model-for-treatment-of-uncomplicated-vaso-occlusive-crisis-in-adult-sickle-cell-disease-patients-in-canada-to-reduce-emergency-department-utilization
#6
Andrew Binding, Richard Ward, Chai Phua, Veronique Naessens, Tara O'Brien, Sacha Bhatia, Hayley Baranek, Husayn Marani, Geetha Mukerji
OBJECTIVES: Patients with sickle cell disease (SCD) with vaso-occlusive crises (VOC) often visit the emergency department (ED) for management of painful episodes. The primary objective of this pilot study was to evaluate the acceptability of a short-stay model for treatment of VOC in SCD outside of the ED in Toronto, Canada. Secondary objectives were to assess patient satisfaction of this model, barriers to its use and comparison of clinical outcomes to a historical control. METHODS: Adult SCD patients with symptoms of an uncomplicated VOC between October 2014 to July 2016 were managed according to best practice recommendations in a short-stay unit as an alternative to the local emergency room...
October 17, 2017: CJEM
https://www.readbyqxmd.com/read/29037941/pre-clinical-assessment-of-the-lovo-device-for-dimethyl-sulfoxide-removal-and-cell-concentration-in-thawed-hematopoietic-progenitor-cell-grafts
#7
Bechara Mfarrej, Guillaume Bouchet, Jérôme Couquiaud, Lionel Regimbaud, Steven Binninger, Mathieu Mercier, Claude Lemarié, Pascal Houzé, Christian Chabannon, Boris Calmels
BACKGROUND: Cryopreserved hematopoietic progenitor cell (HPC) grafts are widely infused to patients with malignant and nonmalignant conditions. Despite reduction of immediate side effects linked to dimethyl sulfoxide (DMSO), cell debris-containing grafts and comparable hematopoietic engraftment between washed and unwashed cryopreserved products, bedside infusion of thawed HPC grafts is still preferred. Introduction of automated devices is important for standardization and consistency of graft manipulation...
October 13, 2017: Cytotherapy
https://www.readbyqxmd.com/read/29036647/investigation-of-secondary-mixed-radiation-field-around-a-medical-linear-accelerator
#8
Piotr Tulik, Monika Tulik, Maciej Maciak, Natalia Golnik, Damian Kabat, Tomasz Byrski, Jan Lesiak
The aim of this study is to investigate secondary mixed radiation field around linac, as the first part of an overall assessment of out-of-field contribution of neutron dose for new advanced radiation dose delivery techniques. All measurements were performed around Varian Clinic 2300 C/D accelerator at Maria Sklodowska-Curie Memorial, Cancer Center and Institute of Oncology, Krakow Branch. Recombination chambers REM-2 and GW2 were used for recombination index of radiation quality Q4 determination (as an estimate of quality factor Q), measurement of total tissue dose Dt and calculation of gamma and neutron components to Dt...
September 29, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29036444/the-elephant-in-the-room-toward-a-more-ethical-approach-with-accountability-toward-intended-beneficiaries-in-humanitarian-aid
#9
Ramin Asgary, Ronald J Waldman
There is considerable tension between the concept of accountability to beneficiaries and its practice in humanitarian aid. The beneficiaries live in a relationship that is asymmetric; upward or horizontal accountability within the aid system alone-even with the best of intentions-might be short-sighted. Could beneficiaries be effectively involved in programing, priority setting or allocation of resources? Is there space for a rights-based approach in aid delivery and operations? The mind-set, governance and structure of operations in aid agencies may need significant institutional reform to share the process of decision-making, and to transform the current dynamic from connecting resources to brokering better governance, true collaboration and co-operation among all stakeholders...
September 28, 2017: International Health
https://www.readbyqxmd.com/read/29034997/everything-you-always-wanted-to-know-about-poly-l-lysine-dendrigrafts-but-were-afraid-to-ask
#10
Jean-Patrick Francoia, Laurent Vial
Less than a decade ago, dendrigrafts of poly-L-lysine (DGLs) joined the family of polycationic dendritic macromolecules. Resulting from the iterative polycondensation of a N-carboxyanhydride in water, four generations of the dendrigraft can be obtained on a multi-gram scale and without chromatographic purification. DGLs share features with both dendrimers and hyperbranched polymers, but turned out to have unique biophysical and bioactive properties. The macromolecules - in their native form or functionalized - have been extensively characterized by various analytical and computational methods, and already found numerous applications in the biomedical field such as drug and gene delivery, biomaterials, tissue engineering, bioimaging, and biosensing...
October 16, 2017: Chemistry: a European Journal
https://www.readbyqxmd.com/read/29030677/safe-surgery-for-all-early-lessons-from-implementing-a-national-government-driven-surgical-plan-in-ethiopia
#11
Daniel Burssa, Atlibachew Teshome, Katherine Iverson, Olivia Ahearn, Tigistu Ashengo, David Barash, Erin Barringer, Isabelle Citron, Kaya Garringer, Victoria McKitrick, John Meara, Abraham Mengistu, Swagoto Mukhopadhyay, Cheri Reynolds, Mark Shrime, Asha Varghese, Samson Esseye, Abebe Bekele
Recognizing the unmet need for surgical care in Ethiopia, the Federal Ministry of Health (FMOH) has pioneered innovative methodologies for surgical system development with Saving Lives through Safe Surgery (SaLTS). SaLTS is a national flagship initiative designed to improve access to safe, essential and emergency surgical and anaesthesia care across all levels of the healthcare system. Sustained commitment from the FMOH and their recruitment of implementing partners has led to notable accomplishments across the breadth of the surgical system, including but not limited to: (1) Leadership, management and governance-a nationally scaled surgical leadership and mentorship programme, (2) Infrastructure-operating room construction and oxygen delivery plan, (3) Supplies and logistics-a national essential surgical procedure and equipment list, (4) Human resource development-a Surgical Workforce Expansion Plan and Anaesthesia National Roadmap, (5) Advocacy and partnership-strong FMOH partnership with international organizations, including GE Foundation's SafeSurgery2020 initiative, (6) Innovation-facility-driven identification of problems and solutions, (7) Quality of surgical and anaesthesia care service delivery-a national peri-operative guideline and WHO Surgical Safety Checklist implementation, and (8) Monitoring and evaluation-a comprehensive plan for short-term and long-term assessment of surgical quality and capacity...
October 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29028506/sodium-deoxycholate-mediated-enhanced-solubilization-and-stability-of-hydrophobic-drug-clozapine-in-pluronic-micelles
#12
Pankaj Singla, Onkar Singh, Shruti Chabba, V K Aswal, Rakesh Kumar Mahajan
In this report, the solubilization behaviour of a hydrophobic drug Clozapine (CLZ) in micellar suspensions of pluronics having different hydrophilic lipophilic balance (HLB) ratios viz. P84, F127 and F108 in the absence and presence of bile salt sodium deoxycholate (SDC) has been studied. UV-Vis spectroscopy has been exploited to determine the solubilization capacity of the investigated micellar systems in terms of drug loading efficiency, average number of drug molecules solubilized per micelle (ns), partition coefficient (P) and standard free energy of solubilization (∆G(°))...
October 7, 2017: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
https://www.readbyqxmd.com/read/29026065/urethral-diverticulum-presenting-as-a-large-vaginal-mass-complicating-pregnancy-and-delivery
#13
Everett F Magann, Lisa S Newton, Susan A Barr
BACKGROUND A case report of urethral diverticulum complicating pregnancy is presented. The diagnosis and management are challenging because of the rare nature of this condition, the varied presentations and differential diagnoses, and the possibility of misdiagnosis. CASE REPORT A 25-year-old primigravida with scheduled induction of labor at 39 weeks gestation due to gestational diabetes mellitus presented for a routine antenatal appointment at 38 weeks and four days. On digital cervical examination, she was found to have a large semi-solid anterior vaginal mass, shown by trans-vaginal ultrasound to have a nearly solid appearance of a 5×7 cm mass with septation...
October 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29024788/thermostability-of-the-coating-antigen-and-immunostimulator-in-an-adjuvanted-oral-capsule-vaccine-formulation
#14
Stephanie Longet, Vincenzo Aversa, Daire O'Donnell, Joshua Tobias, Monica Rosa, Jan Holmgren, Ivan S Coulter, Ed C Lavelle
Oral vaccines present an attractive alternative to injectable vaccines for enteric diseases due to ease of delivery and the induction of intestinal immunity at the site of infection. However, susceptibility to gastrointestinal proteolysis, limited transepithelial uptake and a lack of clinically acceptable adjuvants present significant challenges. A further challenge to mass vaccination in developing countries is the very expensive requirement to maintain the cold chain. We recently described the effectiveness of a Single Multiple Pill(®) (SmPill(®)) adjuvanted capsule approach to enhance the effectiveness of a candidate enterotoxigenic Escherichia coli (ETEC) oral vaccine...
October 9, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29022404/the-significance-of-breastfeeding-on-sleep-patterns-during-the-first-48%C3%A2-hours-postpartum-for-first-time-mothers
#15
O Hughes, M M Mohamad, P Doyle, G Burke
Postpartum women sleep less during the early days following delivery. Long-term sleep disturbance and fatigue can have significant implications for physical and mental health, relationships, employment and parental competence. Most studies focus on the quality and quantity of maternal sleep between weeks one and six postpartum. We explored sleep patterns and reasons for wakefulness of first-time mothers immediately following delivery. Thirty first-time mothers completed a postnatal sleep questionnaire, detailing their total sleep time (TST), the reasons for being awake and their level of fatigue...
October 12, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29016494/maternal-and-neonatal-outcomes-in-indicated-preterm-births-based-on-the-intended-mode-of-delivery
#16
Spencer G Kuper, Rachel A Sievert, Robin Steele, Joseph R Biggio, Alan T Tita, Lorie M Harper
OBJECTIVE: To compare maternal and neonatal outcomes in women who underwent induction of labor or planned cesarean delivery in indicated preterm births before 34 weeks of gestation. METHODS: We conducted a retrospective cohort study of all indicated singleton preterm births (23-34 weeks of gestation) in a tertiary center from 2011 to 2014. The primary maternal outcome was a composite of early postpartum hemorrhage, blood transfusion, operative complications, postpartum complications, and clinical chorioamnionitis...
October 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28992154/the-patient-centered-medical-home-a-reality-for-hiv-care-in-nigeria
#17
Aima A Ahonkhai, Ifeyinwa Onwuatuelo, Susan Regan, Abdulkabir Adegoke, Elena Losina, Bolanle Banigbe, Juliet Adeola, Timothy G Ferris, Prosper Okonkwo, Kenneth A Freedberg
Objective: HIV care delivery in resource-limited settings (RLS) may serve as a paradigm for chronic disease care, but comprehensive measurement frameworks are lacking. Our objective was to adapt the patient-centered medical home (PCMH) framework for use in RLS, and evaluate the performance of HIV treatment programs within this framework. Design and setting: Cross-sectional survey administered within the AIDS Prevention Initiative in Nigeria (APIN) network. Participants: Medical directors at APIN clinics...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28988159/chest-compression-during-sustained-inflation-versus-3-1-chest-compression-ventilation-ratio-during-neonatal-cardiopulmonary-resuscitation-a-randomised-feasibility-trial
#18
Georg M Schmölzer, Megan O Reilly, Caroline Fray, Sylvia van Os, Po-Yin Cheung
BACKGROUND: Current neonatal resuscitation guidelines recommend 3:1 compression:ventilation (C:V) ratio. Recently, animal studies reported that continuous chest compressions (CC) during a sustained inflation (SI) significantly improved return of spontaneous circulation (ROSC). The approach of CC during SI (CC+SI) has not been examined in the delivery room during neonatal resuscitation. HYPOTHESIS: It is a feasibility study to compare CC+SI versus 3:1 C:V ratio during neonatal resuscitation in the delivery room...
October 7, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28988158/outcomes-of-oxygen-saturation-targeting-during-delivery-room-stabilisation-of-preterm-infants
#19
Ju Lee Oei, Neil N Finer, Ola Didrik Saugstad, Ian M Wright, Yacov Rabi, William Tarnow-Mordi, Wade Rich, Vishal Kapadia, Denise Rook, John P Smyth, Kei Lui, Maximo Vento
OBJECTIVE: To determine the association between SpO2 at 5 min and preterm infant outcomes. DESIGN: Data from 768 infants <32 weeks gestation from 8 randomised controlled trials (RCTs) of lower (≤0.3) versus higher (≥0.6) initial inspiratory fractions of oxygen (FiO2) for resuscitation, were examined. SETTING: Individual patient analysis of 8 RCTs INTERVENTIONS: Lower (≤0.3) versus higher (≥0.6) oxygen resuscitation strategies targeted to specific predefined SpO2 before 10 min of age...
October 7, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28988124/in-vitro-and-in-vivo-evaluation-of-targeting-tumor-with-folate-based-amphiphilic-multifunctional-stabilizer-for-resveratrol-nanosuspensions
#20
Lulu Wang, Yangyang Liu, Juan Zhao, Chunpeng Li, Yuqi Zhou, Juan Du, Yancai Wang
Resveratrol (RSV) nanosuspensions, with long term stability and targeting delivery ability, were designed and demonstrated by in vitro and in vivo model. The folate modified distearoylphosphatidyl ethanolamine-polyethylene glycol (DSPE-PEG-FA), as target delivery carrier, was synthesized and confirmed by FTIR and (1)H NMR. D-α-tocopherol polyethylene glycol 1000 succinate (TPGS) and DSPE-PEG-FA used as stabilizers formed two RSV nanosuspensions (RSV-NA and RSV-NB), which were prepared by anti-solvent precipitation method and optimized by central composite design-response surface model (CCD-RSM)...
September 28, 2017: Colloids and Surfaces. B, Biointerfaces
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