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https://www.readbyqxmd.com/read/28810024/effect-of-an-intensive-lifestyle-intervention-on-glycemic-control-in-patients-with-type-2-diabetes-a-randomized-clinical-trial
#1
Mette Yun Johansen, Christopher Scott MacDonald, Katrine Bagge Hansen, Kristian Karstoft, Robin Christensen, Maria Pedersen, Louise Seier Hansen, Morten Zacho, Anne-Sophie Wedell-Neergaard, Signe Tellerup Nielsen, Ulrik Wining Iepsen, Henning Langberg, Allan Arthur Vaag, Bente Klarlund Pedersen, Mathias Ried-Larsen
Importance: It is unclear whether a lifestyle intervention can maintain glycemic control in patients with type 2 diabetes. Objective: To test whether an intensive lifestyle intervention results in equivalent glycemic control compared with standard care and, secondarily, leads to a reduction in glucose-lowering medication in participants with type 2 diabetes. Design, Setting, and Participants: Randomized, assessor-blinded, single-center study within Region Zealand and the Capital Region of Denmark (April 2015-August 2016)...
August 15, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28808364/the-effect-of-furosemide-on-the-level-of-neutrophil-gelatinase-associated-lipocalin-in-critically-hospitalized-patients-with-acute-kidney-injury
#2
Hadi Hamishehkar, Sarvin Sanaie, Vahid Fattahi, Mehran Mesgari, Ata Mahmoodpoor
BACKGROUND AND AIMS: Oliguric acute kidney injury (AKI), commonly attributed to a more severe degree of renal injury, is associated with poorer prognosis than nonoliguric form. The aim of this study was to determine the effect of furosemide therapy on kidney function and on the level of neutrophil gelatinase-associated lipocalin (NGAL) in critically hospitalized patients in the Intensive Care Unit (ICU). MATERIALS AND METHODS: In this randomized controlled trial, 106 ICU patients with AKI were assigned into furosemide and control groups...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28807443/acute-mass%C3%A4-ve-pulmonary-embolism-assoc%C3%A4-ated-w%C3%A4-th-olanzap%C3%A4-ne-a-case-report
#3
Emine Keles, Sevinc Sarinc Ulasli, Nursel Calik Basaran, Elif Babaoglu, Deniz Koksal
Treatment with low-potency anti-psychotic agents is an important risk factor in the development of pulmonary embolism (PE). We report a case of 74years old female patient receiving olanzapine for psychotic depression admitted to the emergency service with the complaints of chest pain and shortness of breath. She had tachypnea, hypotension and tachycardia. Arterial blood gas analysis showed hypoxemia-hypocapnia and D-dimer level was high. Computed tomographic pulmonary angiography (CTPA) demonstrated pulmonary embolism in both main pulmonary arteries, through lobar and segmental branches...
July 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28806965/decreased-circulating-dihomo-gamma-linolenic-acid-levels-are-associated-with-total-mortality-in-patients-with-acute-cardiovascular-disease-and-acute-decompensated-heart-failure
#4
Shohei Ouchi, Tetsuro Miyazaki, Kazunori Shimada, Yurina Sugita, Megumi Shimizu, Azusa Murata, Takao Kato, Tatsuro Aikawa, Shoko Suda, Tomoyuki Shiozawa, Masaru Hiki, Shuhei Takahashi, Takatoshi Kasai, Katsumi Miyauchi, Hiroyuki Daida
BACKGROUND: Polyunsaturated fatty acids (PUFAs) have important roles in the pathogenesis of cardiovascular diseases. However, the clinical significance of omega-6 PUFAs in acute cardiovascular disease remains unknown. METHODS: We enrolled 417 consecutive patients with acute cardiovascular disease admitted to the cardiac intensive care unit at Juntendo University Hospital between April 2012 and October 2013. We investigated the association between serum PUFA levels and long-term mortality...
August 14, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28806821/endoscopic-submucosal-dissection-of-colitis-related-dysplasia
#5
Noriko Suzuki, Takashi Toyonaga, James E East
Background and study aims Endoscopic submucosal dissection (ESD) offers en bloc resection of lesions, allowing precise pathological assessment. Although possible in ulcerative colitis (UC) patients, the chronic inflammation may increase the procedural risks and reduce the complete resection rate. The aim of this study was to assess the feasibility of ESD for UC and to consider the factors contributing to its technical difficulty. Patients and methods Multicenter experiences of ESD for UC were retrospectively analyzed by reviewing endoscopic videos, pictures, reports, and clinical notes...
August 14, 2017: Endoscopy
https://www.readbyqxmd.com/read/28804482/risk-factors-for-intensive-care-unit-admission-in-patients-with-autoimmune-encephalitis
#6
Gayane Harutyunyan, Larissa Hauer, Martin W Dünser, Tobias Moser, Slaven Pikija, Markus Leitinger, Helmut F Novak, Wolfgang Aichhorn, Eugen Trinka, Johann Sellner
BACKGROUND: Prevention and early recognition of critical illness in patients with autoimmune encephalitis (AE) is essential to achieve better outcome. AIM OF THE STUDY: To evaluate risk factors for intensive care unit (ICU) admission and its prognostic impact in patients with AE. PATIENTS AND METHODS: A reclassification of patients hospitalized between 2011 and 2016 revealed 17 "definite" and 15 "probable" AE cases. Thirteen patients (41%) developed critical illness and required ICU admission...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28802377/an-innovative-approach-to-improve-ear-nose-and-throat-surgical-access-for-remote-living-cape-york-indigenous-children
#7
Susan P Jacups, Denise Newman, Deborah Dean, Ann Richards, Kate M McConnon
INTRODUCTION: On a background of high rates of severe otitis media (OM) with associated hearing loss, children from the Torres Strait and Cape York region requiring ear, nose and throat (ENT) surgery, faced waiting times exceeding three years. After numerous clinical safety incidents were raised, indicating a failure of the current system to deliver appropriate care, the governing Hospital and Health service opted to deliver surgical care through an alternate process. ENT surgeries were performed on 16 consented children from two remote locations via the private health care system, funded by a health provider partnership...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28801519/xor-inhibition-with-febuxostat-accelerates-pulmonary-endothelial-barrier-recovery-and-improves-survival-in-lipopolysaccharide-induced-murine-sepsis
#8
Mahendra Damarla, Laura F Johnston, Gigi Liu, Li Gao, Lan Wang, Lidenys Varela, Todd M Kolb, Bo S Kim, Rachel L Damico, Paul M Hassoun
Sepsis is a leading cause of death among patients in the intensive care unit, resulting from multi-organ failure. Activity of xanthine oxidoreductase (XOR), a reactive oxygen species (ROS) producing enzyme, is known to be elevated in nonsurvivors of sepsis compared to survivors. We have previously demonstrated that XOR is critical for ventilator-induced lung injury. Using febuxostat, a novel nonpurine inhibitor of XOR, we sought to determine the role of XOR inhibition in a murine model of sepsis-induced lung injury and mortality...
August 2017: Physiological Reports
https://www.readbyqxmd.com/read/28798876/the-criterion-validity-reliability-and-feasibility-of-an-instrument-for-assessing-the-nursing-intensity-in-perioperative-settings
#9
Satu Rauta, Sanna Salanterä, Tero Vahlberg, Kristiina Junttila
Patient classification systems generate information for staff allocation based on a patient's care needs. This study aims to test further the instrument for assessing nursing intensity (NI) in perioperative settings. Nine operating departments from five university hospitals were involved. The perioperative nurses gathered data from patients (N = 876) representing different fields of surgery. Reliability was tested by parallel classifications (n = 144). Also, the users' (n = 40) opinions were surveyed. The results support the predictive validity and interrater reliability of the instrument...
2017: Nursing Research and Practice
https://www.readbyqxmd.com/read/28797537/mortality-associated-with-less-intense-risk-factor-control-among-adults-with-diabetes-in-the-united-states
#10
Sharon H Saydah, Edward W Gregg, Henry S Kahn, Mohammed K Ali
AIMS: Determine the mortality experience among adults with diabetes in meeting and not meeting less intense control for glycated hemoglobin (HbA1c), blood pressure (BP), and cholesterol. METHODS: National Health and Nutrition Examination Survey 1999-2010 participants with self-report of diagnosed diabetes (N=3335), measured HbA1c, BP and non-HDL cholesterol were linked to the National Death Index through December 31, 2011. Proportional hazards models were used to estimate hazard ratios (HR) of meeting HbA1c<9% and BP<160/110, and non-HDL cholesterol<190mg/dL...
August 7, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28797270/implementing-the-teen-marijuana-check-up-in-schools-a-study-protocol
#11
Bryan Hartzler, Aaron R Lyon, Denise D Walker, Lauren Matthews, Kevin M King, Kathryn E McCollister
BACKGROUND: Substance misuse is now encountered in settings beyond addiction specialty care, with schools a point-of-contact for student access to behavioral health services. Marijuana is a leading impetus for adolescent treatment admissions despite declining risk perception, for which the Teen Marijuana Check-Up (TMCU)-a tailored adaptation of motivational enhancement therapy-offers an efficacious service option. To bridge the knowledge gap concerning effective and affordable technical assistance strategies for implementing empirically supported services, the described trial will test such a strategy to facilitate school-based TMCU implementation...
August 10, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28797053/the-epidemiology-of-medically-attended-respiratory-syncytial-virus-in-older-adults-in-the-united-states-a-systematic-review
#12
Ann D Colosia, Jin Yang, Eric Hillson, Josephine Mauskopf, Catherine Copley-Merriman, Vivek Shinde, Jeffrey Stoddard
OBJECTIVE: This review was undertaken to assess the historical evidence of the disease incidence and burden of laboratory-confirmed respiratory syncytial virus (RSV) in medically attended older adults. DESIGN: A qualitative systematic literature review was performed; no statistical synthesis of the data was planned, in anticipation of expected heterogeneity across studies in this population. METHODS: A literature search of PubMed, Embase, and the Cochrane Library was conducted for studies of medically attended RSV in older adults (≥ 50 years) published in the last 15 years...
2017: PloS One
https://www.readbyqxmd.com/read/28795662/-evaluation-value-of-the-levels-of-peripheral-blood-cd20-cd24-hi-cd38-hi-regulatory-b-cells-on-the-prognosis-of-elderly-patients-with-sepsis
#13
Chunmei Wang, Lunxian Tang, Huihui Xu, Xiaoming Zhang, Jianwen Bai
OBJECTIVE: To explore the predicting value of peripheral blood CD20(+) CD24(hi) CD38(hi) regulatory B cells (Bregs) on the prognosis of elderly patients with sepsis. METHODS: A prospective study was conducted. Septic patients aged > 65 years old, compliance with diagnostic criteria for Sepsis-3, admitted to emergency and emergency intensive care unit (ICU) of Shanghai East Hospital of Tongji University from April 2016 to February 2017 were enrolled. Procalcitonin (PCT), C-reaction protein (CRP) and lactate (Lac) were routinely measured...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28793935/utilization-of-electronic-health-record-events-to-conduct-a-tuberculosis-contact-investigation-in-a-high-risk-oncology-unit
#14
Shauna C Usiak, Fabian A Romero, Patrice Schwegman, Violet Fitzpatrick, MaryAnn Connor, Janet Eagan, Arthur E Brown, Mini Kamboj
OBJECTIVE To describe the utilization of electronic medical data resources, including health records and nursing scheduling resources, to conduct a tuberculosis (TB) exposure investigation in a high-risk oncology unit. SETTING A 42-bed inpatient unit with a mix of surgical and medical patients at a large tertiary-care cancer center in New York City. PARTICIPANTS High-risk subjects and coworkers exposed to a healthcare worker (HCW) with cavitary smear positive lung TB. RESULTS During the 3-month exposure period, 270 patients were admitted to the unit; 137 of these (50...
August 10, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28793903/latent-class-analysis-derived-subgroups-of-low-back-pain-patients-do-they-have-prognostic-capacity
#15
Anne Molgaard Nielsen, Lise Hestbaek, Werner Vach, Peter Kent, Alice Kongsted
BACKGROUND: Heterogeneity in patients with low back pain is well recognised and different approaches to subgrouping have been proposed. One statistical technique that is increasingly being used is Latent Class Analysis as it performs subgrouping based on pattern recognition with high accuracy. Previously, we developed two novel suggestions for subgrouping patients with low back pain based on Latent Class Analysis of patient baseline characteristics (patient history and physical examination), which resulted in 7 subgroups when using a single-stage analysis, and 9 subgroups when using a two-stage approach...
August 9, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28793902/30-year-experience-of-fontan-surgery-single-centre-s-data
#16
Laurynas Bezuska, Virgilijus Lebetkevicius, Rita Sudikiene, Daina Liekiene, Virgilijus Tarutis
BACKGROUND: The Fontan procedure has been modified several times since it was introduced into practice in 1968. As many patients now survive to adulthood, attention is directed towards their clinical status and late morbidity. We report our surgical experience of 30 years in Fontan procedures. METHODS: From January 1985 to January 2015, 80 patients underwent Fontan surgery. Twenty-one patients received an atrio-pulmonary Fontan (Group I), four patients underwent total cavopulmonary connection (TCPC) with an intra-atrial lateral tunnel (Group II), six patients received extra-cardiac TCPC with an aortic homograft (group III) and 49 patients received extra-cardiac TCPC with an expanded polytetrafluoroethylene conduit...
August 9, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28793300/the-burden-of-malignancy-in-a-tertiary-hospital-intensive-cardiovascular-care-unit
#17
Israel Mazin, Shlomi Matetzky, Linor Shemer, Dana Fourey, Paul Fefer, Amit Segev, Arsalan Abu-Much, Roy Beigel, Elad Asher
OBJECTIVES: During the past decade, the most common causes of mortality and morbidity were cardiovascular diseases and malignancies. The aim of the current study was to describe the incidence, course of admission, and short-term (30-day) prognosis of patients with and without malignancy, admitted to a tertiary center intensive cardiovascular care unit (ICCU). METHODS: A prospective observational study of 2,259 patients admitted to the ICCU was conducted between January 2014 and December 2015...
August 10, 2017: Cardiology
https://www.readbyqxmd.com/read/28792355/factors-related-to-parent-attendance-at-a-follow-up-meeting-with-an-intensivist-after-a-child-s-death-in-the-pediatric-intensive-care-unit
#18
Markita L Suttle, Cynthia A Gerhardt, Marci Z Fults
Parents who experience the death of a child are at high risk for psychopathology. Because a large percentage of pediatric deaths occur in the pediatric intensive care unit each year, a follow-up meeting between bereaved parents and intensivists could provide essential emotional support, although some parents may not attend. The aim of this study was to explore demographic and medical factors that may distinguish between bereaved parents who attend a follow-up meeting with their child's pediatric intensivist and those who do not...
January 1, 2017: Omega
https://www.readbyqxmd.com/read/28780504/intensive-versus-standard-physical-rehabilitation-therapy-in-the-critically-ill-epicc-a-multicentre-parallel-group-randomised-controlled-trial
#19
Stephen E Wright, Kirsty Thomas, Gillian Watson, Catherine Baker, Andrew Bryant, Thomas J Chadwick, Jing Shen, Ruth Wood, Jennifer Wilkinson, Leigh Mansfield, Victoria Stafford, Clare Wade, Julie Furneval, Andrea Henderson, Keith Hugill, Philip Howard, Alistair Roy, Stephen Bonner, Simon Baudouin
BACKGROUND: Early physical rehabilitation in the intensive care unit (ICU) has been shown to improve short-term clinical outcomes but long-term benefit has not been proven and the optimum intensity of rehabilitation is not known. METHODS: We conducted a randomised, parallel-group, allocation-concealed, assessor-blinded, controlled trial in patients who had received at least 48 hours of invasive or non-invasive ventilation. Participants were randomised in a 1:1 ratio, stratified by admitting ICU, admission type and level of independence...
August 5, 2017: Thorax
https://www.readbyqxmd.com/read/28780362/predictors-of-prolonged-mechanical-ventilation-in-adults-after-acute-type-a-aortic-dissection-repair
#20
Mu Jin, Wei-Guo Ma, Shiyao Liu, Junming Zhu, Lizhong Sun, Jiakai Lu, Weiping Cheng
OBJECTIVES: Prolonged mechanical ventilation (PMV) after surgical repair of acute type-A aortic dissection (ATAAD) is associated with an increased risk for mortality and morbidity. The goal of this study was to evaluate the influence of PMV on early and late outcomes and to identify the risk factors for PMV after ATAAD repair. DESIGN, SETTING, AND PARTICIPANTS: This study was a retrospective analysis of prospectively collected data, which resulted from a prior clinical trial...
March 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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