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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/28087295/postconditioning-induced-neuroprotection-mechanisms-and-applications-in-cerebral-ischemia
#2
REVIEW
Yan-Ying Fan, Wei-Wei Hu, Fang Nan, Zhong Chen
Ischemic postconditioning (PostC) is defined as a series of rapid intermittent interruptions of blood flow at the phase of reperfusion, which produces neuroprotection against cerebral ischemia/reperfusion injury via mobilizing the brain's own endogenous adaptive mechanisms. Now the concept of conventional ischemic PostC has been extended to limb remote ischemic PostC and chemical PostC with hypoxia, volatile anesthetic, CO2, etc. According to the different temporal profile of PostC, it is divided into rapid and delayed PostC...
January 10, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28087089/point-of-care-ultrasound-diagnosis-of-posterior-sternoclavicular-joint-dislocation
#3
Rachel R Bengtzen, Ryan C Petering
BACKGROUND: Posterior sternoclavicular dislocations can be challenging diagnostically, as traumatic force often happens to the lateral shoulder rather than directly to the sternoclavicular joint. Shoulder radiographs do not illustrate the sternoclavicular joint well, and can miss the diagnosis. This injury, however, has the potential for life-threatening complications due to proximity of mediastinal structures that might also be injured. CASE REPORT: The following case illustrates a delayed diagnosis of posterior sternoclavicular dislocation...
January 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28087054/care-pathway-of-patients-with-metastatic-pancreatic-cancer-in-daily-practice-in-france-results-from-the-repere-national-survey
#4
Pascal Hammel, Romain Coriat, Gérard Lledo, Mariella de Bausset, Marion Selosse, Stéphane Obled, Franck Bonnetain
Data in the literature regarding the care pathway of pancreatic cancer patients are limited. The objective of the REPERE survey was to identify and describe the initial stages of the care pathway of pancreatic patients in the metastatic phase. From May to October 2015, 62 oncologists (ON) or gastroenterologists specialized in digestive oncology (GESDO) and 300 general practitioners (GP) completed an electronic questionnaire on the pathway of 728 patients recently diagnosed with metastatic pancreatic adenocarcinoma...
January 10, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28086849/successful-outcome-following-pneumonectomy-in-a-teenage-boy-with-cystic-fibrosis-a-case-report
#5
Zheyi Liew, Santosh Mallikarjuna, Asif Hasan, F Kate Gould, Su Bunn, Matthew F Thomas, Jim L Lordan, Christopher O'Brien, Malcolm Brodlie
BACKGROUND: Cystic fibrosis lung disease is generally a diffuse process however rarely one lung may become particularly damaged through chronic collapse and consolidation resulting in end-stage bronchiectasis with relative sparing of the contralateral lung. This clinical situation is sometimes referred to as "destroyed lung". Lung resection surgery is seldom indicated in cystic fibrosis and the associated medical literature is relatively sparse. CASE PRESENTATION: A 14 year old boy was referred to our centre for lung transplantation assessment...
January 13, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28086766/psychoeducational-preventive-treatment-for-women-at-risk-of-postpartum-depression-study-protocol-for-a-randomized-controlled-trial-progea
#6
Amaia Ugarte Ugarte, Purificación López-Peña, Carmen Serrulla Vangeneberg, Julia Gemma Torregaray Royo, Maria Asunción Arrieta Ugarte, Maria Teresa Zabalza Compains, Maria Pilar Riaño Medrano, Nerea Muñoz Toyos, Edurne Arenaza Lamo, Maria Begoña Beneitez Dueñas, Ana González-Pinto
BACKGROUND: Postpartum depression is a disease with a prevalence of 20% that has deleterious consequences not only for the mother but also for the baby and can cause delays in physical, social and cognitive development. In this context, the European Union Committee on Public Health has declared it essential that preventative measures are taken by centres providing care for women with a multidisciplinary approach. PROGEA is a multicentre, single-blind randomized, 3-year, longitudinal clinical trial aiming to evaluate the efficacy of a psychoeducational programme in preventing postpartum depression in at-risk women, based on a range of clinical variables, and explore prognostic factors...
January 13, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28081131/-i-wasted-3-years-thinking-it-s-not-a-problem-patient-and-health-system-delays-in-diagnosis-of-leprosy-in-india-a-mixed-methods-study
#7
Thirumugam Muthuvel, Srinivas Govindarajulu, Petros Isaakidis, Hemant Deepak Shewade, Vasudev Rokade, Rajbir Singh, Sanjeev Kamble
BACKGROUND: Worldwide, leprosy is one of the major causes of preventable disability. India contributes to 60% of global leprosy burden. With increasing numbers of leprosy with grade 2 disability (visible disability) at diagnosis, we aimed to determine risk factors associated with grade 2 disability among new cases and explore patients and providers' perspectives into reasons for late presentation. METHODOLOGY/PRINCIPAL FINDINGS: This was an explanatory mixed-methods study where the quantitative component, a matched case-control design, was followed by a qualitative component...
January 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28079720/%C3%A2-s%C3%A3-lo-se-vive-una-vez-you-only-live-once-a-pilot-evaluation-of-individually-tailored-video-modules-aiming-to-increase-hiv-testing-among-foreign-born-latino-men
#8
Suzanne M Dolwick Grieb, Alejandra Flores-Miller, Kathleen R Page
BACKGROUND: Although Latinos living in the United States are disproportionately affected by HIV, the development, implementation, and evaluation of HIV prevention, testing, and linkage to care interventions lag behind efforts occurring in other communities. To address sociocultural barriers to testing, we developed a multilevel intervention. This study is a pilot evaluation of the individual-level component of the intervention-animated video modules that address specific barriers to HIV testing common among foreign-born Latino men...
February 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28079591/point-of-care-diagnostics-extending-the-laboratory-network-to-reach-the-last-mile
#9
Paul K Drain, Christine Rousseau
PURPOSE OF REVIEW: More point-of-care (POC) diagnostic tests are becoming available for HIV diagnosis and treatment in resource-limited settings. These novel technologies have the potential to foster decentralized HIV care and treatment for the benefit of clinical laboratories, HIV clinics, and HIV-infected patients. There continue to be many business, technological, and operational challenges that limit product development and regulatory approval, which limits products available for the required operational and cost-effectiveness studies and delays policy adoption and implementation...
January 11, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28078464/outcome-of-stent-grafting-for-esophageal-perforations-single-center-experience
#10
Fausto Biancari, Tuomas Tauriainen, Tatu Ylikotila, Misa Kokkonen, Jukka Rintala, Elisa Mäkäräinen-Uhlbäck, Vesa Koivukangas, Juha Saarnio
BACKGROUND: Recent studies showed that stent grafting is a promising technique for treatment of esophageal perforation. However, the evidence of its benefits is still scarce. METHODS: Forty-three consecutive patients underwent stent grafting for esophageal perforation at the Oulu University Hospital, Finland. The main endpoints of this study were early and mid-term mortality. Secondary outcome endpoints were the need of esophagectomy and additional surgical procedures on the esophagus and extraesophageal structures...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28078459/endotherapy-in-case-of-relapse-of-neoplastic-barrett-s-esophagus-after-successful-initial-endoscopic-resection
#11
Sébastien Godat, Fabrice Caillol, Aurélie Autret, Erwan Bories, Christian Pesenti, Jean Philippe Ratone, Chiara De Cassan, Flora Poizat, Marc Giovannini
BACKGROUND: Endotherapy in cases of neoplastic Barrett esophagus (BE) relapse after successful initial endoscopic management is commonly accepted, but few studies analyze this topic and also take into account the metachronous lesions. AIMS: To evaluate the efficiency of endotherapy in the case of neoplastic BE relapse after successful complete endoscopic eradication of neoplastic BE and metaplastic BE. METHODS: Retrospective review of medical records was collected in a computerized and prospective manner between 2000 and 2015, in a single tertiary care center...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28077385/impact-of-sex-and-contact-to-device-time-on-clinical-outcomes-in-acute-st-segment-elevation-myocardial-infarction-findings-from-the-national-cardiovascular-data-registry
#12
Robert O Roswell, Jordan Kunkes, Anita Y Chen, Karen Chiswell, Sohah Iqbal, Matthew T Roe, Sripal Bangalore
BACKGROUND: Emergent myocardial reperfusion via primary percutaneous coronary intervention is optimal care for patients presenting with ST-segment elevation myocardial infarction (STEMI). Delays in such interventions are associated with increases in mortality. With the shift in focus to contact-to-device (C2D) time as a new perfusion metric, this study was designed to examine how sex affects C2D time and mortality in STEMI patients. METHODS AND RESULTS: Clinical data on male and female STEMI patients were extracted and analyzed from the National Cardiovascular Data Registry from July 1, 2008 to December 31, 2014...
January 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28077135/comorbidity-study-of-borderline-personality-disorder-applying-association-rule-mining-to-the-taiwan-national-health-insurance-research-database
#13
Cheng-Che Shen, Li-Yu Hu, Ya-Han Hu
BACKGROUND: Borderline personality disorder (BPD) is a complex clinical state with highly polymorphic symptoms and signs. Studies have demonstrated that people with a BPD diagnosis are likely to have numerous co-occurring psychiatric disorders and physical comorbidities. The aim of our study was to obtain further insight about the associations among comorbidities of BPD and to demonstrate the practicality of using association rule mining (ARM) technique in clinical databases. METHODS: A retrospective case-control study was conducted on information of 1460 patients (292 BPD patients and 1168 control patients) selected from the Taiwan National Health Insurance Research Database...
January 11, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28077058/imaging-investigations-before-referral-to-a-sarcoma-center-delay-the-final-diagnosis-of-musculoskeletal-sarcoma
#14
Heidi Buvarp Dyrop, Peter Vedsted, Mathias Rædkjær, Akmal Safwat, Johnny Keller
Background and purpose - The use of point-of-care or local investigations before referral to specialist sarcoma centers as part of a fast-track diagnostic pathway varies, and may affect the time to diagnosis. We wanted to investigate differences in time intervals and proportion of malignancy in patients who were referred after initial diagnostic investigations were performed locally and in patients who were referred without these investigations. Patients and methods - We included 545 consecutive patients who were referred to Aarhus Sarcoma Center for suspected musculoskeletal sarcoma...
January 12, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28077020/relationship-between-18-f-flutemetamol-uptake-and-rbans-performance-in-non-demented-community-dwelling-older-adults
#15
Dustin B Hammers, Taylor J Atkinson, Bonnie C A Dalley, Kayla R Suhrie, Britney E Beardmore, Lance D Burrell, Kevin P Horn, Kelli M Rasmussen, Norman L Foster, Kevin Duff, John M Hoffman
OBJECTIVE: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been used extensively for clinical care and in research for patients with mild cognitive impairment and Alzheimer's disease (AD); however, relatively few studies have evaluated the relationship between RBANS performance and AD imaging biomarkers. The purpose of the current study was to evaluate the association between a relatively new amyloid positron emission tomography imaging biomarker and performance on the RBANS...
January 12, 2017: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/28076996/a-serious-case-of-anthrax-associated-with-compartment-syndrome
#16
Seyran Kılınç, Mehmet Vakıf Keskinbıçkı, Murat Şengül, Semra Nergiz, Abdurrahman Örtücü, Okay Bulut
Compartment syndrome linked to skin anthrax is a rare complication that may develop and it should be noted that the disease may progress in spite of medical drug treatment. Our case was a farmer who was exposed after slaughtering a dead animal, a time delay for treatment hided this history and then developed compartment syndrome. In anthrax cases with delayed treatment and aggressive progression, circulation in the extremities should be carefully noted. We believe that the cases with compartment syndrome progressing in spite of medical drug treatment may be assessed for fasciotomy as a treatment approach...
January 11, 2017: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/28076671/a-randomized-trial-of-collaborative-care-for-perinatal-depression-in-socioeconomically-disadvantaged-women-the-impact-of-comorbid-posttraumatic-stress-disorder
#17
Nancy K Grote, Wayne J Katon, Joan E Russo, Mary Jane Lohr, Mary Curran, Erin Galvin, Kathy Carson
OBJECTIVE: The comorbidity of posttraumatic stress disorder (PTSD) with antenatal depression poses increased risks for postpartum depression and may delay or diminish response to evidence-based depression care. In a secondary analysis of an 18-month study of collaborative care for perinatal depression, the authors hypothesized that pregnant, depressed, socioeconomically disadvantaged women with comorbid PTSD would show more improvement in the MOMCare intervention providing Brief Interpersonal Psychotherapy and/or antidepressants, compared to intensive public health Maternity Support Services (MSS-Plus)...
November 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28076637/a-five-year-review-of-vertical-hiv-transmission-in-a-specialized-service-cross-sectional-study
#18
Izabel Cristina Hoffmann, Wendel Mombaque Dos Santos, Stela Maris de Mello Padoin, Sonia Maria Oliveira de Barros
CONTEXT AND OBJECTIVE: Healthcare professionals need to instill the process of prevention, control and treatment of people infected with HIV into care practice. Through maintaining preventive treatment among HIV-infected pregnant women, it has been demonstrated that prophylactic antiretroviral therapy, scheduled cesarean section and the prohibition of breastfeeding significantly reduce vertical HIV transmission. This study aimed to assess the rates of vertical HIV transmission in a specialized service and identify the factors associated with it...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28076542/-dental-decay-in-5-year-old-children-sociodemographic-factors-monitoring-points-and-parental-attitudes
#19
Vinícius Humberto Nunes, Gimol Benzaquen Perosa
Dental decay affects many children, especially those from the lower socioeconomic classes. In this cross-sectional study designed to investigate the role played by sociodemographic factors, parental attitudes, and monitoring points, which are an indicator of personal perception of what controls individual health, on the prevalence of tooth decay among 5-year-old pre-school children living in a midsized city in São Paulo, Brazil. The ceo-d index of 426 children was assessed; the parents reported sociodemographic characteristics and completed two questionnaires concerning monitoring points and parental attitudes...
January 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28076265/nonbacterial-causes-of-lymphangitis-with-streaking
#20
Brandon E Cohen, Arielle R Nagler, Miriam Keltz Pomeranz
BACKGROUND: Lymphangitic streaking, characterized by linear erythema on the skin, is most commonly observed in the setting of bacterial infection. However, a number of nonbacterial causes can result in lymphangitic streaking. We sought to elucidate the nonbacterial causes of lymphangitic streaking that may mimic bacterial infection to broaden clinicians' differential diagnosis for patients presenting with lymphangitic streaking. METHODS: We performed a review of the literature, including all available reports pertaining to nonbacterial causes of lymphangitic streaking...
November 2016: Journal of the American Board of Family Medicine: JABFM
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