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https://www.readbyqxmd.com/read/28742427/a-comparison-of-multimodal-analgesic-approaches-in-institutional-eras-protocols-for-colorectal-surgery-pharmacological-agents
#1
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Enhanced recovery after surgery (ERAS(®)) protocols are the cornerstone of improved recovery after colorectal surgery. Their implementation leads to reduced morbidity and shorter hospital stays while attenuating the surgical stress response. Multimodal analgesia is an important part of ERAS protocols. We compared and contrasted protocols from 15 institutions to test our hypothesis that there is a fundamental consensus among them. MATERIALS AND METHODS: ERAS protocols for open and laparoscopic colorectal surgery were compared from 15 different healthcare facilities...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28730712/slow-conduction-through-an-arc-of-block-a-basis-for-arrhythmia-formation-post-myocardial-infarction
#2
Eugene Patterson, Benjamin J Scherlag, Edward J Berbari, Ralph Lazzara
INTRODUCTION: The electrophysiologic basis for characteristic rate-dependent, constant-late-coupled (390+54 msec) premature ventricular beats (PVBs) present 4-5 days following coronary artery occlusion were examined in 108 anesthetized dogs. METHODS AND RESULTS: Fractionated/double potentials were observed in injured zone bipolar and composite electrograms at prolonged sinus cycle lengths (1296 ± 396 msec). At shorter cycle lengths, conduction of the delayed potential decremented, separating from the initial electrogram by a progressively prolonged isoelectric interval...
July 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28725595/a-prospective-evaluation-of-penile-measures-and-glans-penis-sensory-changes-after-penile-prosthetic-surgery
#3
Donghua Xie, Marilin Nicholas, Victor Gheiler, Dylan Perito, Luanda Siano, Igor Kislinger, Guy M Nehrenz, Boris Klopukh, Fernando J Bianco, Paul Perito, Edward Gheiler
BACKGROUND: With better designed devices and lower infection rates, satisfaction with inflatable penile prosthesis (IPP) placement is increasingly high. However, dissatisfaction is still present and there is disagreement regarding length and sensation changes after the IPP placement. The aim of this study was to evaluate changes in penile length, girth and sensitivity after IPP placement. METHODS: From August 2012 to January 2013 all patients undergoing "de novo" IPP surgery were invited to participate in this study...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28713211/early-extubation-in-pediatric-heart-surgery-across-a-spectrum-of-case-complexity-impact-on-hospital-length-of-stay-and-chest-tube-days
#4
Staci Beamer, Sunita Ferns, Lloyd Edwards, Greer Gunther, Jennifer Nelson
Early extubation is increasingly common in congenital heart surgery, but there are limited outcomes data across the spectrum of case complexity. We performed a retrospective review of 201 pediatric operations using cardiopulmonary bypass between 2012 and 2014. Patients extubated in the operating room or immediately on arrival to the ICU were compared to those extubated by traditional protocols. In-hospital mortality, major complications, need for re-intubation, hospital length of stay, and chest-tube days were compared between groups and by Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery Congenital Heart Surgery (STAT) mortality category...
June 2017: Progress in Pediatric Cardiology
https://www.readbyqxmd.com/read/28700086/antiseptics-for-burns
#5
REVIEW
Gill Norman, Janice Christie, Zhenmi Liu, Maggie J Westby, Jayne M Jefferies, Thomas Hudson, Jacky Edwards, Devi Prasad Mohapatra, Ibrahim A Hassan, Jo C Dumville
BACKGROUND: Burn wounds cause high levels of morbidity and mortality worldwide. People with burns are particularly vulnerable to infections; over 75% of all burn deaths (after initial resuscitation) result from infection. Antiseptics are topical agents that act to prevent growth of micro-organisms. A wide range are used with the intention of preventing infection and promoting healing of burn wounds. OBJECTIVES: To assess the effects and safety of antiseptics for the treatment of burns in any care setting...
July 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28699845/development-and-implementation-of-an-alcohol-withdrawal-protocol-using-a-5-item-brief-alcohol-withdrawal-scale-baws
#6
Darius A Rastegar, Dinah Applewhite, Anika A H Alvanzo, Christopher Welsh, Timothy Niessen, Edward S Chen
BACKGROUND: The standard of care for management of alcohol withdrawal is symptom-triggered treatment using the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale. Many items of this 10-question scale rely on subjective assessments of withdrawal symptoms, making it time-consuming and cumbersome to use. Therefore, there is interest in shorter and more objective methods to assess alcohol withdrawal symptoms. METHODS: We initially piloted a 6-item withdrawal scale developed at another institution...
July 12, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28676198/treatment-of-gabapentin-toxicity-with-peritoneal-dialysis-assessment-of-gabapentin-clearance
#7
Hisham Ibrahim, Zachary Oman, Matthew Schuelke, John C Edwards
Gabapentin is almost exclusively cleared by the kidney and thus presents challenges in patients with kidney failure. Gabapentin is known to be effectively cleared by hemodialysis, but the efficiency of clearance by peritoneal dialysis (PD) has not been previously described. We report a case of gabapentin toxicity in a patient on long-term PD who was treated with continuous automated cycling PD. We find that continuous PD provides significant clearance of gabapentin. With 2-L exchanges every 2 hours, we document an apparent elimination half-life of 41...
July 1, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28675539/the-association-between-patient-activation-and-self-care-practices-a-cross-sectional-study-of-an-australian-population-with-comorbid-diabetes-and-chronic-kidney-disease
#8
Edward Zimbudzi, Clement Lo, Sanjeeva Ranasinha, Peter G Kerr, Kevan R Polkinghorne, Helena Teede, Timothy Usherwood, Rowan G Walker, Greg Johnson, Greg Fulcher, Sophia Zoungas
OBJECTIVE: This study aimed to examine the association between performance of self-care activities and patient or disease factors as well as patient activation levels in patients with diabetes and chronic kidney disease (CKD) in Australia. METHODS: A cross-sectional study was conducted among adults with diabetes and CKD (eGFR <60 mL/min/1.73m(2) ) who were recruited from renal and diabetes clinics of four tertiary hospitals in Australia. Demographic and clinical data were collected, as well as responses to the Patient Activation Measure (PAM) and the Summary of Diabetes Self-Care Activities (SDSCA) scale...
July 4, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28672140/evaluation-of-oral-and-maxillofacial-surgery-residents-operative-skills-feasibility-and-engagement-study-using-simpl-software-for-a-mobile-phone
#9
Leonard B Kaban, Alyssa Cappetta, Brian George, Edward Lahey, Jordan Bohnen, Maria J Troulis
PURPOSE: There are no universally accepted tools to evaluate operative skills of surgical residents in a timely fashion. The purpose of this study was to determine the feasibility of using a smartphone application, SIMPL (System for Improving and Measuring Procedural Learning), developed by a multi-institutional research collaborative, to achieve a high rate of timely operative evaluations and resident communication and to collect performance data. The authors hypothesized that these goals would be achieved because the process is convenient and efficient...
June 8, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28646147/whole-organ-vascular-casting-and-microct-examination-of-the-human-placental-vascular-tree-reveals-novel-alterations-associated-with-pregnancy-disease
#10
Toluwalope O Junaid, Robert S Bradley, Rohan M Lewis, John D Aplin, Edward D Johnstone
Experimental methods that allow examination of the intact vascular network of large organs, such as the human placenta are limited, preventing adequate comparison of normal and abnormal vascular development in pregnancy disease. Our aims were (i) to devise an effective technique for three-dimensional analyses of human placental vessels; (ii) demonstrate the utility of the technique in the comparison of placental vessel networks in normal and fetal growth restriction (FGR) complicated pregnancies. Radiopaque plastic vessel networks of normal and FGR placentas (n = 12/group) were created by filling the vessels with resin and corroding the surrounding tissues...
June 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28619716/ratchet-like-polypeptide-translocation-mechanism-of-the-aaa-disaggregase-hsp104
#11
Stephanie N Gates, Adam L Yokom, JiaBei Lin, Meredith E Jackrel, Alexandrea N Rizo, Nathan M Kendsersky, Courtney E Buell, Elizabeth A Sweeny, Korrie L Mack, Edward Chuang, Mariana P Torrente, Min Su, James Shorter, Daniel R Southworth
Hsp100 polypeptide translocases are conserved AAA+ machines that maintain proteostasis by unfolding aberrant and toxic proteins for refolding or proteolytic degradation. The Hsp104 disaggregase from S. cerevisiae solubilizes stress-induced amorphous aggregates and amyloid. The structural basis for substrate recognition and translocation is unknown. Using a model substrate (casein), we report cryo-EM structures at near-atomic resolution of Hsp104 in different translocation states. Substrate interactions are mediated by conserved, pore-loop tyrosines that contact an 80 Å-long unfolded polypeptide along the axial channel...
June 15, 2017: Science
https://www.readbyqxmd.com/read/28614995/ease-of-use-of-tobramycin-inhalation-powder-compared-with-nebulized-tobramycin-and-colistimethate-sodium-a-crossover-study-in-cystic-fibrosis-patients-with-pulmonary-pseudomonas-aeruginosa-infection
#12
James Greenwood, Carsten Schwarz, Urte Sommerwerck, Edward F Nash, Michael Tamm, Weihua Cao, Paul Mastoridis, Laurie Debonnett, Kamal Hamed
BACKGROUND: This study assessed the ease of use of tobramycin inhalation powder (TIP) administered via T-326 inhaler versus tobramycin inhalation solution (TIS) and colistimethate sodium (COLI), both administered via nebulizers, for the treatment of chronic pulmonary Pseudomonas aeruginosa infection in patients with cystic fibrosis (CF). METHODS: A real-world, open-label, crossover, interventional phase IV study was conducted in CF patients aged ⩾6 years with forced expiratory volume in 1 second (FEV1) ⩾25% to ⩽90% predicted...
July 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28607610/remote-magnetic-catheter-navigation-versus-conventional-ablation-in-atrial-fibrillation-ablation-fluoroscopy-reduction
#13
Paul Chun Yih Lim, Joseph Jia Hong Toh, Julian Kenrick Xing Yuan Loh, Edward Chun Yi Lee, Daniel Thuan Tee Chong, Boon Yew Tan, Kah Leng Ho, Chi Keong Ching, Wee Siong Teo
BACKGROUND: Percutaneous transcatheter radiofrequency ablation of atrial fibrillation with remote controlled magnetic navigation (RMN) has been shown to reduce radiation exposure to patients and physicians compared with conventional manual (MAN) ablation techniques. METHODS: Catheter ablation for atrial fibrillation was performed utilizing RMN in 214 consecutive patients and MAN ablation techniques in 229 patients. We compared the fluoroscopy and procedural times between RMN and MAN catheter ablation of atrial fibrillation...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28582580/transaortic-transcatheter-aortic-valve-implantation-using-sapien-xt-or-sapien-3-valves-in-the-route-registry%C3%A2
#14
Mauro Romano, Derk Frank, Riccardo Cocchieri, Dariusz Jagielak, Nikolaos Bonaros, Marco Aiello, Joel Lapeze, Mika Laine, Sidney Chocron, Douglas Muir, Walter Eichinger, Matthias Thielmann, Louis Labrousse, Kjell Arne Rein, Jean-Philippe Verhoye, Gino Gerosa, Hardy Baumbach, Cornelia Deutsch, Peter Bramlage, Martin Thoenes, Vinayak Bapat
OBJECTIVES: Transaortic (TAo) access for transcatheter aortic valve implantation (TAVI) is an alternative to the conventional transfemoral or transapical routes. Data comparing the characteristics and outcomes of TAo-TAVI using the SAPIEN XT and SAPIEN 3 heart valves are scarce. The objective of the current analysis was to provide such information. METHODS: ROUTE is an international, prospective, observational registry. Patients with severe calcific aortic stenosis scheduled for TAo-TAVI with an Edwards SAPIEN XT or a SAPIEN 3 heart valve were consecutively enrolled at 22 centres across Europe between February 2013 and February 2015...
June 5, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28553559/next-generation-perg-method-expanding-the-response-dynamic-range-and-capturing-response-adaptation
#15
Pedro Monsalve, Giacinto Triolo, Jonathon Toft-Nielsen, Jorge Bohorquez, Amanda D Henderson, Rafael Delgado, Edward Miskiel, Ozcan Ozdamar, William J Feuer, Vittorio Porciatti
PURPOSE: To compare a new method for steady-state pattern electroretinogram (PERGx) with a validated method (PERGLA) in normal controls and in patients with optic neuropathy. METHODS: PERGx and PERGLA were recorded in a mixed population (n = 33, 66 eyes) of younger controls (C1; n = 10, age 38 ± 8.3 years), older controls (C2; n = 11, 57.9 ± 8.09 years), patients with early manifest glaucoma (G; n = 7, 65.7 ±11.6 years), and patients with nonarteritic ischemic optic neuropathy (N; n = 5, mean age 59...
May 2017: Translational Vision Science & Technology
https://www.readbyqxmd.com/read/28536813/long-term-outcomes-of-heller-s-myotomy-and-balloon-dilatation-in-childhood-achalasia
#16
Efstratios Saliakellis, Nikhil Thapar, Derek Roebuck, Fernanda Cristofori, Kate Cross, Edward Kiely, Joseph Curry, Keith Lindley, Osvaldo Borrelli
Achalasia is a rare esophageal motility disorder: its optimal treatment in children is still a matter of debate. Records of children treated for achalasia, over an 18-year period, were reviewed.Forty-eight children (median age at diagnosis 10 years; range 3-17 years) were identified. Twenty-eight patients were initially treated with Heller's myotomy (HM) and 20 with balloon dilatation (BD). At last follow-up (median 3 years; range 1-5.5 years), 43.8% (21/48) of children were symptom free. The number of asymptomatic children was significantly higher among those treated initially with HM compared to BD (HM 15/28, 53...
May 23, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28511707/rapid-deployment-valve-system-shortens-operative-times-for-aortic-valve-replacement-through-right-anterior-minithoracotomy
#17
Constanze Bening, Khaled Hamouda, Mehmet Oezkur, Christoph Schimmer, Ina Schade, Armin Gorski, Ivan Aleksic, Rainer Leyh
BACKGROUND: There is growing evidence from the literature that right anterior minithoracotomy aortic valve replacement (RAT-AVR) improves clinical outcome. However, increased cross clamp time is the strongest argument for surgeons not performing RAT-AVR. Rapid deployment aortic valve systems have the potential to decrease cross-clamp time and ease this procedure. We assessed clinical outcome of rapid deployment and conventional valves through RAT. METHODS: Sixty-eight patients (mean age 76 ± 6 years, 32% females) underwent RAT-AVR between 9/2013 and 7/2015...
May 16, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28508052/miocene-flooding-events-of-western-amazonia
#18
Carlos Jaramillo, Ingrid Romero, Carlos D'Apolito, German Bayona, Edward Duarte, Stephen Louwye, Jaime Escobar, Javier Luque, Jorge D Carrillo-Briceño, Vladimir Zapata, Alejandro Mora, Stefan Schouten, Michael Zavada, Guy Harrington, John Ortiz, Frank P Wesselingh
There is a considerable controversy about whether western Amazonia was ever covered by marine waters during the Miocene [23 to 5 Ma (million years ago)]. We investigated the possible occurrence of Miocene marine incursions in the Llanos and Amazonas/Solimões basins, using sedimentological and palynological data from two sediment cores taken in eastern Colombia and northwestern Brazil together with seismic information. We observed two distinct marine intervals in the Llanos Basin, an early Miocene that lasted ~0...
May 2017: Science Advances
https://www.readbyqxmd.com/read/28489476/benefits-of-thoracic-epidural-analgesia-in-patients-undergoing-an-open-posterior-component-separation-for-abdominal-herniorrhaphy
#19
Daryl S Henshaw, Christopher J Edwards, Austin R Sellers, Gregory B Russell, Robert S Weller
An open posterior component separation (PCS) is a commonly utilized surgical approach for repair of complex abdominal wall defects and hernias. Although this approach may improve surgical outcomes, significant postoperative pain can be expected given the required laparotomy and extensive abdominal wall manipulation. Both systemic opioids and thoracic epidural analgesia (TEA) are viable postoperative analgesic options, and both are commonly utilized. Although the benefits of TEA have been investigated following a variety of surgeries, there is a paucity of literature related to its efficacy for this particular surgery...
May 10, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28488830/match-outcome-and-sprinting-activities-in-match-play-by-elite-german-soccer-players
#20
Marcin Andrzejewski, Paweł Chmura, Marek Konefał, Edward Kowalczuk, Jan Chmura
PURPOSE: The aim of the study was to examine the ways playing positions and match outcome (i.e. win, draw, loss) affect the sprint distance covered and the number of sprints performed by German Bundesliga soccer players. METHODS: Match performance data were collected from 350 soccer players competing in the German Bundesliga during the 2014/2015 domestic season. A total of 4393 individual match observations were undertaken on outfield players. The analysis was carried using the Impire AG motion analysis system with records of all movements of players in all the 306 matches...
May 9, 2017: Journal of Sports Medicine and Physical Fitness
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