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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/28088844/role-of-contrast-ct-for-the-diagnosis-and-the-prognosis-of-suspected-lvad-thrombosis
#2
Bill C Tran, Prabhjot S Nijjar
BACKGROUND: There is an urgent need for further studies evaluating the role of imaging modalities in the management of left ventricular assist device (LVAD) thrombosis. This study reviews the role of computed tomography (CT) in the diagnosis of suspected LVAD thrombosis. METHODS: All contrast chest CTs performed in patients with suspected LVAD thrombosis at the University of Minnesota between January 2008 and April 2014 were reviewed. Significant CT findings were identified, operative notes were reviewed, and patient outcomes were reported...
January 15, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28088840/evaluation-of-a-short-term-training-program-in-bedside-emergency-ultrasound-in-southwestern-tanzania
#3
Mark Shaffer, Heather A Brown, Chloé McCoy, Prosper Bashaka
OBJECTIVES: To evaluate the effect of a short-term training program in emergency ultrasound on physician skills and attitudes in southwestern Tanzania. METHODS: Eight registrar physicians at Mbeya Zonal Referral Hospital (Mbeya, Tanzania) underwent a 5-day course in bedside emergency ultrasound, focusing primarily on the focused assessment with sonography for trauma examination, including didactic sessions, practical sessions, and on-job training. The impact on ultrasound knowledge was assessed by pretest and posttest evaluations...
January 15, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28088837/disease-severity-classification-using-quantitative-magnetic-resonance-imaging-data-of-cartilage-in-femoroacetabular-impingement
#4
Lisa L Henn, John Hughes, Eleena Iisakka, Jutta Ellermann, Shabnam Mortazavi, Connor Ziegler, Mikko J Nissi, Patrick Morgan
Femoroacetabular impingement (FAI) is a condition in which subtle deformities of the femoral head and acetabulum (hip socket) result in pathological abutment during hip motion. FAI is a common cause of hip pain and can lead to acetabular cartilage damage and osteoarthritis. For some patients with FAI, surgical intervention is indicated, and it can improve quality of life and potentially delay the onset of osteoarthritis. For other patients, however, surgery is contraindicated because significant cartilage damage has already occurred...
January 15, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28088809/fibroblast-growth-factor-receptor-1-fgfr1-partly-related-to-vascular-endothelial-growth-factor-receptor-2-vegfr2-and-microvessel-density-is-an-independent-prognostic-factor-for-non-small-cell-lung-cancer
#5
Dan Pu, Jiewei Liu, Zhixi Li, Jiang Zhu, Mei Hou
BACKGROUND This study aimed to explore the correlation between FGFR1 and clinical features, including survival analysis and the promotion of angiogenesis by fibroblast growth factor receptor 1 (FGFR1) and vascular endothelial growth factor receptor 2 (VEGFR2). FGFR1 gene amplification has been found in non-small cell lung cancer (NSCLC). However, the prognostic value of FGFR1 and the correlation between FGFR1 and clinical features are still controversial. MATERIAL AND METHODS A total of 92 patients with NSCLC who underwent R0 resection between July 2006 and July 2008 were enrolled in the study...
January 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28088808/shunt-surgery-in-idiopathic-intracranial-hypertension-aided-by-electromagnetic-navigation
#6
Elvis J Hermann, Manolis Polemikos, Hans E Heissler, Joachim K Krauss
BACKGROUND: Idiopathic intracranial hypertension (IIH) is characterized by increased cerebrospinal fluid (CSF) pressure and normal or slit ventricles. Lumboperitoneal shunting had been favored by many investigators for CSF diversion in IIH for decades; however, it has been associated with various side effects. Because of the small ventricular size adequate positioning of a ventricular catheter is challenging. OBJECTIVES: Here, we investigated the usefulness of electromagnetic (EM)-guided ventricular catheter placement for ventriculoperitoneal shunting in IIH...
January 14, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28088807/posterior-versus-anterior-circulation-stroke-in-young-adults-a-comparative-study-of-stroke-aetiologies-and-risk-factors-in-stroke-among-young-fabry-patients-sifap1
#7
Bettina von Sarnowski, Ulf Schminke, Ulrike Grittner, Christian Tanislav, Tobias Böttcher, Michael G Hennerici, Turgut Tatlisumak, Jukka Putaala, Manfred Kaps, Franz Fazekas, Christian Enzinger, Arndt Rolfs, Christof Kessler
BACKGROUND: Although 20-30% of all strokes occur in the posterior circulation, few studies have explored the characteristics of patients with strokes in the posterior compared to the anterior circulation so far. Especially data on young patients is missing. METHODS: In this secondary analysis of data of the prospective multi-centre European sifap1 study that investigated stroke and transient ischemic attack (TIA) patients aged 18-55 years, we compared vascular risk factors, stroke aetiology, presence of white matter hyperintensities (WMH) and cerebral microbleeds (CMB) between patients with ischaemic posterior circulation stroke (PCS) and those having suffered from anterior circulation stroke (ACS) based on cerebral MRI...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28088805/a-retrospective-analysis-of-stereoelectroencephalography-and-subdural-electroencephalography-for-preoperative-evaluation-of-intractable-epilepsy
#8
Meihua Yang, Yuanshi Ma, Wei Li, Xianjun Shi, Zhi Hou, Ning An, Chunqing Zhang, Lihong Liu, Hui Yang, Dong Zhang, Shiyong Liu
BACKGROUND: Different methods for intracranial electrode recording have various advantages and disadvantages, and controversy exists regarding the complications of stereoelectroencephalography (SEEG) and subdural EEG. OBJECTIVE: The purpose of this study was to determine the efficacy and safety of SEEG by comparing it with subdural EEG. METHODS: Data from 100 patients who underwent SEEG (n = 48) and subdural EEG (n = 52) to evaluate the epileptogenic zone were collected from June 2011 to June 2015...
January 14, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28088804/monitoring-noninvasive-ventilation-in-patients-with-obesity-hypoventilation-syndrome-comparison-between-ventilator-built-in-software-and-respiratory-polygraphy
#9
Ramon Fernandez Alvarez, Claudio Rabec, Gemma Rubinos Cuadrado, Juan Alejandro Cascon Hernandez, Patricia Rodriguez, Marjolaine Georges, Pere Casan
BACKGROUND: Polygraphy (PG) remains the standard method of assessing noninvasive ventilation (NIV) effectiveness. Built-in software (BIS) of recent NIV equipment provides estimates of some ventilator parameters, but their usefulness is unclear. OBJECTIVES: To assess the reliability of BIS compared with PG in a cohort of obesity hypoventilation syndrome (OHS) patients on NIV. METHODS: Thirty stable OHS patients on NIV were evaluated in an outpatient setting with simultaneous PG and BIS recordings...
January 14, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28088803/small-versus-large-ruptured-intracranial-aneurysm-concerns-with-the-site-of-aneurysm
#10
Bum Joon Kim, Hyun Goo Kang, Byeong-Duk Kwun, Jae-Sung Ahn, Jisung Lee, Sung Ho Lee, Dong-Wha Kang, Jong S Kim, Sun U Kwon
BACKGROUND: Although size is one of the strongest predictors, small aneurysms often rupture. We compared the characteristics of small and large ruptured intracranial aneurysms (RIAs) according to their location to find the factors associated with small RIAs in each location. METHODS: Patients with subarachnoid hemorrhage due to saccular RIAs were consecutively enrolled. The sizes were dichotomized as small (<5 mm) or large, and the location was classified as paraclinoid-distal internal carotid artery, sidewalls of anterior or middle cerebral artery (MCA; sidewall), MCA-bifurcation, anterior or posterior communicating artery (Acom or Pcom, respectively), and posterior circulation RIAs...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28088801/natural-history-of-untreated-hemifacial-spasm-a-study-of-104-consecutive-patients-over-5-years
#11
Jeong-A Lee, Kyung-Hee Kim, Kwan Park
BACKGROUND: The natural history without treatment of a large series of hemifacial spasm (HFS) patients has not been well-documented. OBJECTIVE: The purpose of this study was to characterize the natural history and clinical outcome in patients with HFS. METHODS: The initial visits of all 2,155 patients and the diagnosis of HFS took place between 2001 and 2010. In 1,775 of the patients, compressing vessels were identified on magnetic resonance imaging...
January 14, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28088799/use-of-spinal-cord-diffusion-tensor-imaging-to-quantify-neural-ablation-and-evaluate-outcome-after-percutaneous-cordotomy-for-intractable-cancer-pain
#12
Aditya Vedantam, Ping Hou, T Linda Chi, Patrick M Dougherty, Kenneth R Hess, Ashwin Viswanathan
BACKGROUND: Up to 20% of patients experience only partial pain relief after percutaneous cordotomy for cancer pain. OBJECTIVE: To determine whether diffusion tensor imaging (DTI) can quantify neural ablation and help evaluate early postoperative outcomes after cordotomy. METHODS: Patients undergoing percutaneous CT-guided cordotomy for intractable cancer pain were prospectively studied. Pre- and postoperative assessment was made using the visual analog scale (VAS) on pain and the pain severity scores of the Brief Pain Inventory Short Form...
January 14, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28088798/the-intracranial-b2leed3s-score-and-the-risk-of-intracranial-hemorrhage-in-ischemic-stroke-patients-under-antiplatelet-treatment
#13
Pierre Amarenco, Leila Sissani, Julien Labreuche, Eric Vicaut, Marie Germaine Bousser, Angel Chamorro, Marc Fisher, Ian Ford, Kim M Fox, Michael G Hennerici, Heinrich Mattle, Peter M Rothwell, Philippe Gabriel Steg, Hans-Christoph Diener, Ralph L Sacco, Jacoba P Greving, Ale Algra
BACKGROUND: Chronic antiplatelet therapy in the post-acute phase of non-cardioembolic ischemic stroke is limited by the risk of intracranial hemorrhage (ICH) complications. METHODS: We developed an ICH risk score based on the PERFORM trial cohort (n = 19,100), which included patients with a non-cardioembolic ischemic stroke or transient ischemic attack, and externally validated this score in one contemporary trial of very similar size and inclusion criteria, the PRoFESS trial (n = 20,332 patients)...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28088795/influence-of-intracranial-air-on-electrode-position-and-clinical-outcomes-following-deep-brain-stimulation-for-parkinson-s-disease
#14
J Nicole Bentley, Zhe Guan, Karen S Cummings, Kelvin L Chou, Parag G Patil
BACKGROUND: The introduction of intracranial air during deep brain stimulation (DBS) surgery is believed to negatively impact targeting accuracy and clinical outcomes. OBJECTIVE: To quantify the relationship between intracranial air (ICA) volumes, targeting accuracy, and clinical outcomes in patients undergoing subthalamic nucleus (STN) DBS for Parkinson's disease. METHODS: ICA in 73 consecutive STN DBS cases (146 leads) was measured by high-resolution CT and correlated with proximal lead bowing, electrode displacement, targeting accuracy, and clinical outcomes at 6 and 12 months...
January 14, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28088793/hnrnp-l-mediates-bladder-cancer-progression-by-inhibiting-apoptotic-signaling-and-enhancing-mapk-signaling-pathways
#15
Daojun Lv, Huayan Wu, Rongwei Xing, Fangpeng Shu, Bin Lei, Chengyong Lei, Xumin Zhou, Bo Wan, Yu Yang, Liren Zhong, Xiangming Mao, Yaguang Zou
Heterogeneous nuclear ribonucleoprotein L (hnRNP-L) is a promoter of various kinds of cancers, but its actions in bladder cancer (BC) are unclear. In this study, we investigated the function and the underlying mechanism of hnRNP-L in bladder carcinogenesis. Our results demonstrated that enhanced hnRNP-L expression in BC tissues was associated with poor overall survival of BC patients. Depletion of hnRNP-L significantly suppressed cell proliferation in vitro and inhibited xenograft tumor growth in vivo. Furthermore, downregulation of hnRNP-L resulted in G1-phase cell cycle arrest and enhanced apoptosis accompanied by inhibition of EMT and cell migration...
January 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28088792/impact-of-nudt15-polymorphisms-on-thiopurines-induced-myelotoxicity-and-thiopurines-tolerance-dose
#16
Dandan Yin, Xuyang Xia, Junlong Zhang, Shouyue Zhang, Fei Liao, Ge Zhang, Yan Zhang, Qianqian Hou, Xue Yang, Hong Wang, Zhigui Ma, Heyao Wang, Yiping Zhu, Wei Zhang, Yuelan Wang, Bo Liu, Lanlan Wang, Heng Xu, Yang Shu
Thiopurines are widely used as anticancer and immunosuppressive agents. However, life-threatening myelotoxicity has been noticed and largely explained by genetic variations, including NUDT15 polymorphisms (e.g., rs116855232). In this study, we conduct a meta-analysis to investigate the impact of rs116855232 on thiopurines-induced myelotoxicity susceptibility (1752 patients from 7 independent cohorts), as well as on thiopurines intolerance dose (2745 patients from 13 cohorts). Variant allele of rs116855232 contributes 7...
January 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28088790/intraperitoneal-immunotherapy-with-t-cells-stably-and-transiently-expressing-anti-epcam-car-in-xenograft-models-of-peritoneal-carcinomatosis
#17
Wei Xia Ang, Zhendong Li, Zhixia Chi, Shou-Hui Du, Can Chen, Johan C K Tay, Han Chong Toh, John E Connolly, Xue Hu Xu, Shu Wang
The epithelial cell adhesion molecule (EpCAM) is overexpressed in a wide variety of tumor types, including peritoneal carcinomatosis (PC) from gastrointestinal and gynecological malignancies. To develop a chimeric antigen receptor T (CART) cell therapy approach to treat patients with end-stage PC, we constructed third generation CARs specific to EpCAM using the 4D5MOC-B single chain variable fragment. CART cells were generated with lentiviral transduction and exhibited specific in vitro killing activity against EpCAM-positive human ovarian and colorectal cancer cells...
January 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/28088789/gprc5a-knockout-mouse-lung-epithelial-cells-predicts-ceruloplasmin-lipocalin-2-and-periostin-as-potential-biomarkers-at-early-stages-of-lung-tumorigenesis
#18
Beibei Sun, Wenzheng Guo, Song Hu, Feng Yao, Keke Yu, Jie Xing, Ronghua Wang, Hongyong Song, Yueling Liao, Tong Wang, Pengfei Jiang, Baohui Han, Jiong Deng
Lung cancer is the leading cause of cancer death. As most of lung cancer patients were diagnosed with the advanced stage, early detection is considered as the most effective strategy to reduce high mortality. Thus, it is desirable to identify specific biomarkers at early stages of lung tumorigenesis. GPRC5A is a lung tumor suppressor gene. GPRC5A deficiency is linked to lung cancer development. We hyposthesized that, dysregulated gene expression that results from Gprc5a deficiency may provide potential biomarkers at early stages of lung tumorigenesis...
January 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/28088788/dual-syk-jak-inhibition-overcomes-ibrutinib-resistance-in-chronic-lymphocytic-leukemia-cerdulatinib-but-not-ibrutinib-induces-apoptosis-of-tumor-cells-protected-by-the-microenvironment
#19
Ailin Guo, Pin Lu, Greg Coffey, Pamela Conley, Anjali Pandey, Y Lynn Wang
Ibrutinib (BTK inhibitor) has generated remarkable responses in CLL. However, the drug, to a large extent, does not cause cell death directly and does not eradicate CLL malignant clones. Inability to eradicate CLL has fostered resistance generation. Once patients become resistant, they do poorly with a median survival of 3-4 months. Novel therapeutic strategies are needed to prevent resistance, improve treatment outcome and ultimately cure the disease. Herein, we explore dual targeting of the BCR and JAK-STAT pathways with a novel single agent, cerdulatinib, which selectively inhibits both SYK (a BCR component) and JAK kinases...
January 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/28088786/ezh2-inhibition-suppresses-endometrial-cancer-progression-via-mir-361-twist-axis
#20
Kei Ihira, Peixin Dong, Ying Xiong, Hidemichi Watari, Yosuke Konno, Sharon Jb Hanley, Masayuki Noguchi, Noriyuki Hirata, Futoshi Suizu, Takahiro Yamada, Masataka Kudo, Noriaki Sakuragi
EZH2 inhibition and reactivation of tumor suppressor microRNAs (miRNAs) represent attractive anti-cancer therapeutic strategies. We found that EZH2-suppressed let 7b and miR-361, two likely tumor suppressors, inhibited endometrial cancer (EC) cell proliferation and invasion, and abrogated cancer stem cell-like properties. In EC cells, EZH2 induced and functioned together with YY1 to epigenetically suppress miR-361, which upregulated Twist, a direct target of miR-361. Treating EC cells with GSK343, a specific EZH2 inhibitor, mimicked the effects of siRNA-mediated EZH2 knockdown, upregulating miR-361 and downregulating Twist expression...
January 10, 2017: Oncotarget
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