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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/29787035/hair-toe-tourniquets-a-review-of-two-case-studies
#2
Julia Booth, Tim Morse
Digit hair tourniquets are relatively uncommon. There are reports in the literature of hair tourniquets involving other appendages, such as the penis and uvula, however the phenomenon is not widely recognised and is often overlooked by healthcare professionals. This article discusses two case studies in which hair was responsible for creating a tourniquet around a digit. The article explores possible causes and management options for patients, with reference to the case studies. Midwives and health visitors are central to minimising the risk of injury to children as they can educate expectant mothers about this potential problem...
May 22, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29786976/multiple-acquired-pigmented-lesions-in-a-patient-affected-by-melanoma
#3
Francesco Savoia, Michela Tabanelli, Antonio Ascari Raccagni, Emilia Crisanti, Ignazio Stanganelli, Domenico Piccolo
No abstract text is available yet for this article.
May 22, 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/29786975/a-comparison-of-one-stage-vs-two-stage-individual-patient-data-meta-analysis-methods-a-simulation-study
#4
Evangelos Kontopantelis
BACKGROUND: Individual patient data (IPD) meta-analysis allows for the exploration of heterogeneity and can identify subgroups that most benefit from an intervention (or exposure), much more successfully than meta-analysis of aggregate data. One-stage or two-stage IPD meta-analysis is possible, with the former using mixed-effects regression models and the latter obtaining study-estimates through simpler regression models before aggregating using standard meta-analysis methodology. However, a comprehensive comparison of the two methods, in practice, is lacking...
May 22, 2018: Research Synthesis Methods
https://www.readbyqxmd.com/read/29786958/variability-in-student-perceptions-of-mistreatment
#5
Samantha Ellis, Joel Purkiss, Emily Abdoler, Amanda Opaskar, Rajesh S Mangrulkar, Joseph C Kolars, Sally A Santen
BACKGROUND: As medical schools strive to improve the learning environment, it is important to understand medical students' perceptions of mistreatment. The purpose of this study was to explore student interpretations of previously reported mistreatment incidents to better understand how they conceptualise the interactions. METHODS: Medical students were presented with case scenarios of previously reported instances of mistreatment and asked to indicate their agreement as to whether the scenarios demonstrated mistreatment, using a five-point Likert scale (1, strongly disagree; 5, strongly agree)...
May 22, 2018: Clinical Teacher
https://www.readbyqxmd.com/read/29786957/statistical-approaches-to-adjusting-weights-for-dependent-arms-in-network-meta-analysis
#6
Yu-Xuan Su, Yu-Kang Tu
Network meta-analysis compares multiple treatments in terms of their efficacy and harm by including evidence from randomized controlled trials. Most clinical trials use parallel design, where patients are randomly allocated to different treatments and receive only one treatment. However, some trials use within person designs such as split-body, split-mouth and cross-over designs, where each patient may receive more than one treatment. Data from treatment arms within these trials are no longer independent, so the correlations between dependent arms need to be accounted for within the statistical analyses...
May 22, 2018: Research Synthesis Methods
https://www.readbyqxmd.com/read/29786953/iatrogenic-botulism-outbreak-in-egypt-due-to-a-counterfeit-botulinum-toxin-a-preparation-a-descriptive-series-of-patient-features-and-outcome
#7
Eman Abdel Monaem Abdel Rashid, Nashwa Mohamed El-Mahdy, Huda Shehata Kharoub, Ahmed Salah Gouda, Naglaa Ahmed ElNabarawy, Bruno Mégarbane
Iatrogenic botulism resulting from the substantial increase in use of botulinum neurotoxin type-A (BoNT-A) treatment is rarely reported. We aimed to describe a large iatrogenic botulism outbreak in Egypt in June-July 2017. Nine patients developed botulism after receiving intramuscular injections of BoNT-A (dose: 200-300 IU) to treat cerebral palsy (N=7), spastic dystonia (N=1), and hyperhidrosis (N=1). Detailed findings were available in 5/9 cases. Patients were admitted to the hospital 5-10 days after the BoNT-A injection...
May 22, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29786949/the-qsofa-score-a-simple-and-accurate-predictor-of-outcomes-in-patients-with-glyphosate-herbicide-poisoning
#8
Yongsoo Cho, Byeongjo Chun, Jeongmi Moon
This study aimed to investigate whether the quick Sequential Organ Failure Assessment (qSOFA) score at emergency department (ED) presentation can help improve the risk assessment of glyphosate-surfactant herbicide (GlySH) poisoning complications. A total of 150 patients presenting with acute glyphosate herbicide ingestion were enrolled in this retrospective observational study. The qSOFA scores at presentation, ΔqSOFA (calculated by subtracting the worst qSOFA score from 1 hr after admission from the qSOFA score at presentation), baseline characteristics, clinical courses and outcomes were collected and analysed...
May 22, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29786937/the-effect-of-the-weekend-upon-admissions-to-general-medicine
#9
Tessa Potezny, Chris Horwood, Paul Hakendorf, Campbell Thompson
RATIONALE, AIMS, AND OBJECTIVES: A reduction in the provision of hospital services on the weekend probably explains higher mortality for patients who are either admitted to hospital or undergo procedures on the weekend. The aim was to examine the effect of the day of the week of admission (DOWOA) upon the efficiency and quality of care for a cohort of General Medical inpatients. METHODS: Electronic records were selected for unplanned adult admissions to 2 large public hospitals in Adelaide, South Australia, July 2012 to June 2017...
May 22, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29786928/evaluation-of-medication-dose-omissions-amongst-inpatients-in-a-hospital-using-an-electronic-medication-management-system
#10
Katherine V Hunt, Andrew M Harding, Simone E Taylor, Colin Curtain
RATIONALE, AIMS, AND OBJECTIVES: Whilst many dose omissions cause no patient harm, inappropriate dose omissions have been associated with increased length of hospital stay, risk of sepsis, and mortality. This study aimed to comprehensively describe the prevalence and nature of omitted doses overall and of high risk medication dose omissions in an organization using an electronic Medication Management System. METHODS: A retrospective cross-sectional study was undertaken in an Australian tertiary referral health service...
May 22, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29786927/the-exhaled-nitric-oxide-and-mannitol-test-to-predict-exercise-induced-bronchoconstriction
#11
Kyubo Kim, Hong Je Cho, Jung Won Yoon, Sun Hee Choi, Youn Ho Sheen, ManYong Han, Heysung Baek
BACKGROUND: Exercise-induced bronchoconstriction (EIB) is diagnosed via exercise challenge on a treadmill. However, such testing requires complex equipment and sufficient healthcare resources. The fraction of exhaled nitric oxide (FeNO) test and mannitol bronchial provocation test (BPT) may serve as a surrogate of exercise testing. METHODS: We compared the diagnostic utilities of the FeNO test and mannitol BPT in predicting EIB in asthmatic children. We retrospectively analysed data from 60 asthmatic children aged 6-16 years...
May 22, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29786922/finding-factors-that-predict-treatment-resistant-depression-results-of-a-cohort-study
#12
M Soledad Cepeda, Jenna Reps, Patrick Ryan
BACKGROUND: Treatment for depressive disorders often requires subsequent interventions. Patients who do not respond to antidepressants have treatment-resistant depression (TRD). Predicting who will develop TRD may help healthcare providers make more effective treatment decisions. We sought to identify factors that predict TRD in a real-world setting using claims databases. METHODS: A retrospective cohort study was conducted in a US claims database of adult subjects with newly diagnosed and treated depression with no mania, dementia, and psychosis...
May 22, 2018: Depression and Anxiety
https://www.readbyqxmd.com/read/29786916/herbal-medicine-as-a-promising-therapeutic-approach-for-the-management-of-vascular-dementia-a-systematic-literature-review
#13
REVIEW
Adel Ghorani-Azam, Samaneh Sepahi, Elham Khodaverdi, Seyed Ahmad Mohajeri
Vascular dementia (VaD) generally refers to memory deficits and cognitive abnormalities that are resulted from vascular disease. In this study, we aimed to systematically review the literature wherein therapeutic effects of medicinal plants have been studied on VaD. A systematic literature search was performed in the PubMed, Scopus, Web of Science, Google Scholar, and other databases using VaD, and medicinal plants as key terms. No strict inclusion criteria were defined, and almost all clinical studies were included...
May 22, 2018: Phytotherapy Research: PTR
https://www.readbyqxmd.com/read/29786897/targeted-next-generation-sequencing-for-the-diagnosis-of-patients-with-rare-congenital-anemias
#14
Noa Shefer Averbuch, Orna Steinberg-Shemer, Orly Dgany, Tanya Krasnov, Sharon Noy-Lotan, Joanne Yacobovich, Amir A Kuperman, Antonis Kattamis, Ayelet Ben Barak, Batia Roth-Jelinek, Evgeni Chubar, Evelyn Shabad, Gustavo Dufort, Martin Ellis, Ofir Wolach, Idit Pazgal, Abed Abu Quider, Hagit Miskin, Hannah Tamary
BACKGROUND: Most patients with anemia are diagnosed through clinical phenotype and basic laboratory testing. Nonetheless, in cases of rare congenital anemias, some patients remain undiagnosed despite undergoing an exhaustive workup. Genetic testing is complicated by the large number of genes involved in rare anemias and the similarities in the clinical presentation of the different syndromes. OBJECTIVE: We aimed to enhance the diagnosis of patients with congenital anemias by using targeted next-generation sequencing...
May 22, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29786896/diagnostic-accuracy-of-bioelectrical-impedance-analysis-parameters-for-the-evaluation-of-malnutrition-in-patients-receiving-hemodialysis
#15
Angela Teodósio da Silva, Daniela Barbieri Hauschild, Yara Maria Franco Moreno, João Luiz Dornelles Bastos, Elisabeth Wazlawik
BACKGROUND: In the absence of a gold standard technique for assessing nutrition status in patients receiving hemodialysis (HD), we aimed to determine the diagnostic accuracy of single-frequency (50 kHz) bioelectrical impedance analysis parameters, resistance/height (R/H), reactance/height (Xc/H), and impedance/height (Z/H), and their cutoff points for malnutrition. METHODS: The reference standards, Subjective Global Assessment (SGA), Malnutrition Inflammation Score, and Nutritional Risk Screening 2002, were performed at baseline and then once a year for 2 years...
May 22, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29786895/deep-brain-stimulation-treated-dystonia-trajectory-via-status-dystonicus
#16
Elodie Nerrant, Victoria Gonzalez, Christophe Milesi, Xavier Vasques, Diane Ruge, Thomas Roujeau, Isabel De Antonio Rubio, Fabienne Cyprien, Emilie Chan Seng, Diane Demailly, Agathe Roubertie, Alain Boularan, Fréderic Greco, Pierre-François Perrigault, Gilles Cambonie, Philippe Coubes, Laura Cif
BACKGROUND: Status dystonicus (SD) is a life-threatening condition. OBJECTIVE AND METHODS: In a dystonia cohort who developed status dystonicus, we analyzed demographics, background dystonia phenomenology and complexity, trajectory previous to-, via status dystonicus episodes, and evolution following them. RESULTS: Over 20 years, 40 of 328 dystonia patients who were receiving DBS developed 58 status dystonicus episodes. Dystonia was of pediatric onset (95%), frequently complex, and had additional cognitive and pyramidal impairment (62%) and MRI alterations (82...
May 22, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29786894/the-prognostic-role-of-phase-angle-in-advanced-cancer-patients-a-systematic-review
#17
REVIEW
Mayane Marinho Esteves Pereira, Mariana Dos Santos Campello Queiroz, Nathália Masiero Cavalcanti de Albuquerque, Juliana Rodrigues, Emanuelly Varea Maria Wiegert, Larissa Calixto-Lima, Livia Costa de Oliveira
Phase angle (PA) is a ratio between the reactance and resistance obtained by bioelectric impedance analysis and has been interpreted as a cell membrane integrity indicator and a predictor of total body cell mass. A low PA may suggest deterioration of the cell membrane, which in advanced cancer patients may result in a reduced overall survival (OS). This systematic review sought to investigate the current evidence regarding whether there is an association between PA and OS in patients with advanced cancer (ie, metastatic disease)...
May 22, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29786888/injectable-bioresponsive-gel-depot-for-enhanced-immune-checkpoint-blockade
#18
Shuangjiang Yu, Chao Wang, Jicheng Yu, Jinqiang Wang, Yue Lu, Yuqi Zhang, Xudong Zhang, Quanyin Hu, Wujin Sun, Chaoliang He, Xuesi Chen, Zhen Gu
Although cancer immunotherapy based on immune checkpoint inhibitors holds great promise toward many types of cancers, several challenges still remain, associated with low objective response of patient rate as well as systemic side effects. Here, a combination immunotherapy strategy is developed based on a thermogelling reactive oxygen species (ROS)-responsive polypeptide gel for sustained release of anti-programmed cell death-ligand 1 antibody and dextro-1-methyl tryptophan, inhibitor of indoleamine-2,3-dioxygenase with leveraging the ROS level in the tumor microenvironment...
May 22, 2018: Advanced Materials
https://www.readbyqxmd.com/read/29786883/left-ventricular-aneurysms-in-hypertrophic-cardiomyopathy-with-midventricular-obstruction-a-systematic-review-of-literature
#19
Moustafa O Elsheshtawy, Ahmed N Mahmoud, Mahmoud Abdelghany, Ida H Suen, Adnan Sadiq, Jacob Shani
BACKGROUND: Hypertrophic cardiomyopathy (HCM) with or without left ventricular apical aneurysm (LVA) had been studied in the past. Midventricular obstruction associated with HCM and LVA is a unique entity that has not been distinguished previously as a separate phenotypic disease in HCM patients. METHODS: A systematic review of Pubmed and Google Scholar was conducted from inception until September 2017 for all observational studies conducted on HCM with midventricular obstruction and LVA...
May 22, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29786882/feasibility-of-assessing-prognostic-nutrition-index-in-patients-with-rectal-cancer-who-receive-preoperative-chemoradiotherapy
#20
Yoshinaga Okugawa, Yuji Toiyama, Satoshi Oki, Shozo Ide, Akira Yamamoto, Takashi Ichikawa, Takahito Kitajima, Hiroyuki Fujikawa, Hiromi Yasuda, Susumu Saigusa, Junichiro Hiro, Shigeyuki Yoshiyama, Minako Kobayashi, Toshimitsu Araki, Masato Kusunoki
BACKGROUND: Malnutrition can adversely affect treatment responses and oncological outcomes in cancer patients. However, among patients with rectal cancer who undergo chemoradiotherapy (CRT), the significance of peri-treatment nutrition assessment as a predictor of treatment response and outcome remains unclear. OBJECTIVE: The aim of this study was to determine whether the Prognostic Nutrition Index (PNI) based on peri-treatment serum can be used as a predictor of treatment response and outcome in patients with rectal cancer who undergo CRT...
January 7, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
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