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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/28346806/active-surveillance-in-younger-men-with-prostate-cancer
#2
Michael S Leapman, Janet E Cowan, Hao G Nguyen, Katsuto K Shinohara, Nannette Perez, Matthew R Cooperberg, William J Catalona, Peter R Carroll
Purpose The suitability of younger patients with prostate cancer (PCa) for initial active surveillance (AS) has been questioned on the basis of eventual treatment necessity and concerns of safety; however, the role of age on surveillance outcomes has not been well defined. Patients and Methods We identified men managed with AS at our institution with a minimum follow-up of 6 months. The primary study objective was to examine the association of age with risk of biopsy-based Gleason score upgrade during AS. We also examined the association of age with related end points, including overall biopsy-determined progression, definitive treatment, and pathologic and biochemical outcomes after delayed radical prostatectomy (RP), using descriptive statistics, the Kaplan-Meier method, and multivariable Cox proportional hazards regression...
March 27, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28346739/a-novel-approach-to-limit-chemical-deterioration-of-gilthead-sea-bream%C3%A2-sparus-aurata-%C3%A2-fillets-coating-with-electrospun-nanofibers-as-characterized-by-molecular-thermal-and-microstructural-properties
#3
Zafer Ceylan, Gulgun F Unal Sengor, Mustafa Tahsin Yilmaz
Coating of sea bream fillets with thymol loaded chitosan based electrospun nanofibers (TLCN) and chitosan based nanafibers (CN) has been presented a novel approach to delay chemical deterioration. We assessed CN and TLCN with respect of scanting of total volatile basic nitrogen (TVBN), trimethylamine (TMA), thiobarbituric acid (TBA) deterioration during cold storage condition. Electrospinning process was applied to obtain TLCN and CN. Both of nanofibers obtained from biopolymer and bioactive material were cylindrical, smooth, beadless...
March 27, 2017: Journal of Food Science
https://www.readbyqxmd.com/read/28346702/evaluation-of-the-effects-of-time-temperature-and-specimen-storage-on-in-vitro-lactate-concentrations-in-healthy-dogs
#4
Colin F Reich, Jonathan F Bach, Julie M Walker
BACKGROUND: Lactate concentrations increase significantly under certain storage conditions, except for when glycolysis-arresting agents are used. Evaluation of time and storage conditions on heparinized whole blood lactate concentrations without glycolysis-arresting agents have not been evaluated in dogs. OBJECTIVES: The purpose of the study was to determine the effects of preanalytic storage conditions on the in vitro concentration of lactate in heparinized canine venous blood specimens...
March 27, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28346616/unilateral-amblyopia-affects-two-eyes-fellow-eye-deficits-in-amblyopia
#5
Kimberly Meier, Deborah Giaschi
Unilateral amblyopia is a visual disorder that arises after selective disruption of visual input to one eye during critical periods of development. In the clinic, amblyopia is understood as poor visual acuity in an eye that was deprived of pattern vision early in life. By its nature, however, amblyopia has an adverse effect on the development of a binocular visual system and the interactions between signals from two eyes. Visual functions aside from visual acuity are impacted, and many studies have indicated compromised sensitivity in the fellow eye even though it demonstrates normal visual acuity...
March 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28346534/spatial-and-temporal-changes-in-leaf-coloring-date-of-acer-palmatum-and-ginkgo-biloba-in-response-to-temperature-increases-in-south-korea
#6
Chang-Kyun Park, Chang-Hoi Ho, Su-Jong Jeong, Eun Ju Lee, Jinwon Kim
Understanding shifts in autumn phenology associated with climate changes is critical for preserving forest ecosystems. This study examines the changes in the leaf coloring date (LCD) of two temperate deciduous tree species, Acer palmatum (Acer) and Ginkgo biloba (Ginkgo), in response to surface air temperature (Ts) changes at 54 stations of South Korea for the period 1989-2007. The variations of Acer and Ginkgo in South Korea are very similar: they show the same mean LCD of 295th day of the year and delays of about 0...
2017: PloS One
https://www.readbyqxmd.com/read/28346311/latissimus-dorsi-flap-breast-reconstruction-a-nationwide-inpatient-sample-review
#7
Michael R DeLong, Vickram J Tandon, George H Rudkin, Andrew L Da Lio
INTRODUCTION: The latissimus dorsi (LD) myocutaneous flap has been a long term standard for breast reconstruction. The variable indications for the LD flap have not been statistically examined because of the relative infrequency of its use by any single surgeon or institution. METHODS: The Nationwide Inpatient Sample data set was queried for all patient encounters involving a LD myocutaneous flap procedure. The study population was further restricted to female patients with a history of breast cancer or previous mastectomy...
March 24, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28346286/delayed-coronary-obstruction-following-portico-in-freedom-solo-valve-in-valve-implantation
#8
Johannes Kastner, Georg Goliasch, Max-Paul Winter, Olev Luha, Martin Andreas, Irene M Lang
No abstract text is available yet for this article.
March 24, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28346158/delayed-high-school-start-times-later-than-8-30am-and-impact-on-graduation-rates-and-attendance-rates
#9
Pamela Malaspina McKeever, Linda Clark
OBJECTIVES: The first purpose of this study was to investigate changes in high school graduation rates with a delayed school start time of later than 8:30am. The second aim of the study was to analyze the association between a delayed high school start time later than 8:30am and attendance rates. DESIGN: In the current study, a pre-post design using a repeated-measures analysis of variance was used to examine changes in attendance and graduation rates 2 years after a delayed start was implemented...
April 2017: Sleep Health
https://www.readbyqxmd.com/read/28346125/canine-neutrophil-extracellular-traps-enhance-clot-formation-and-delay-lysis
#10
Unity Jeffery, Dana N LeVine
Autoimmune diseases increase the risk of thrombosis. Neutrophil extracellular traps (NETs) are webs of DNA and protein that may mediate thrombosis in autoimmune diseases. Human and murine studies show NET-releasing neutrophils within a thrombus promote its growth, but it is unclear to what extent NET fragments released into circulation during inflammation are prothrombotic. This study hypothesized that canine NETs promote clot formation and impair lysis even in the absence of neutrophils. NETs were prepared from PMA-stimulated neutrophils and added to fibrinogen and thrombin or to recalcified pooled canine platelet-poor plasma, tissue factor, and tissue plasminogen activator...
January 1, 2017: Veterinary Pathology
https://www.readbyqxmd.com/read/28345998/pharmacokinetics-of-a-single-dose-of-voriconazole-administered-orally-with-and-without-food-to-red-tailed-hawks-buteo-jamaicensus
#11
Ruth A Parsley, Lisa A Tell, Ronette Gehring
OBJECTIVE To determine the pharmacokinetics of voriconazole administered PO with or without food to red-tailed hawks (Buteo jamaicensus) and whether any observed variability could be explained by measured covariates to inform dose adjustments. ANIMALS 7 adult red-tailed hawks. PROCEDURES In a crossover study design, hawks were randomly assigned to first receive voriconazole (15 mg/kg, PO) injected into a dead mouse (n = 3; fed birds) or without food (4; unfed birds). Sixteen days later, treatments were reversed...
April 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28345986/children-and-young-people-with-diabetes-recognition-and-management
#12
Hamish Hamilton, Grace Knudsen, Camelia Laura Vaina, Michelle Smith, Siba Prosad Paul
Diabetes mellitus (type 1) is an autoimmune condition leading to absolute insulin deficiency resulting in hyperglycaemia and its associated manifestations. It is the most common type of diabetes seen in children, characterised by the 4Ts (toilet, thinner, thirsty, tired). The signs and symptoms can sometimes be non-specific and a delay or missed diagnosis may be catastrophic to the health of the child. Children with an established diagnosis of diabetes often present to the health service with issues such as hypoglycaemia, hyperglycaemia, or diabetic ketoacidosis...
March 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28345977/spinal-cord-injuries-overcoming-barriers-to-seamless-care-for-patients
#13
Lorraine Donovan, Lee Francis, Paula Muter, Sheila Nevin, Rebecca Warren
Patients with spinal cord injuries (SCIs) often have complex needs that require multidisciplinary support in specialist centres. Optimal management depends on seamless transitions between service providers. Delays at any point potentially compromise clinical outcomes and efficient resource utilisation. The Spinal Advisory Working Group aims to develop and implement practical initiatives to improve SCI care, initially focusing on admission and discharge. A literature review identified few relevant papers. In addition, the generalisability of the findings of these papers to SCI centres in the UK is unclear...
March 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28345953/reperfusion-ventricular-arrhythmia-bursts-identify-larger-infarct-size-in-spite-of-optimal-epicardial-and-microvascular-reperfusion-using-cardiac-magnetic-resonance-imaging
#14
Kirian van der Weg, Wichert J Kuijt, Sebastiaan Cam Bekkers, Jan Gp Tijssen, Cynthia L Green, Miguel E Lemmert, Mitchell W Krucoff, Anton Pm Gorgels
AIMS: Ventricular arrhythmia (VA) bursts following recanalisation in acute ST-elevation myocardial infarction (STEMI) are related to larger infarct size (IS). Inadequate microvascular reperfusion, as determined by microvascular obstruction (MVO) using cardiac magnetic resonance imaging (CMR), is also known to be associated with larger IS. This study aimed to test the hypothesis that VA bursts identify larger infarct size in spite of optimal microvascular reperfusion. METHODS: All 65 STEMI patients from the Maastricht ST elevation (MAST) study with brisk epicardial flow (TIMI 3), complete ST recovery post-percutaneous coronary intervention and early CMR were included...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28345952/the-timing-of-early-antibiotics-and-hospital-mortality-in-sepsis
#15
Vincent X Liu, Vikram Fielding-Singh, John D Greene, Jennifer M Baker, Theodore J Iwashyna, Jay Bhattacharya, Gabriel J Escobar
RATIONALE: Prior sepsis studies evaluating antibiotic timing have shown mixed results. OBJECTIVE: To evaluate the association between antibiotic timing and mortality among sepsis patients receiving antibiotics within 6 hours of emergency department registration. METHODS AND MEASUREMENTS: Retrospective study of 35,000 randomly selected sepsis inpatients treated at 21 emergency departments between 2010 and 2013 in Northern California. The primary exposure was antibiotics given within six hours of emergency department registration...
March 27, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28345786/a-de-novo-nonsense-mutation-in-zbtb18-plus-a-de-novo-15q13-3-microdeletion-in-a-6-year-old-female
#16
Nadja Ehmke, Sylvio Karge, Johannes Buchmann, Dirk Korinth, Denise Horn, Olaf Reis, Frank Häßler
ZBTB18 has been proposed as candidate gene for microcephaly and abnormalities of the corpus callosum based on overlapping microdeletions of 1q43q44. More recently, de novo mutations of ZBTB18 have been identified in patients with syndromic and non-syndromic intellectual disability. Heterozygous microdeletions of 15q13.3 encompassing the candidate gene CHRNA7 are associated with developmental delay or intellectual disability with speech problems, hypotonia, and seizures. They are characterized by significant variability and reduced penetrance...
March 27, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28345745/in-vitro-and-in-vivo-assessment-of-the-abuse-potential-of-pf614-a-novel-bio-md%C3%A2-prodrug-of-oxycodone
#17
D Lynn Kirkpatrick, William K Schmidt, Ricardo Morales, John Cremin, Julie Seroogy, Craig Husfeld, Thomas Jenkins
OBJECTIVE: The need for pain medication which will not lead to abuse is well recognized. Ensysce has designed prodrug analogs of the commonly used pain medications including hydromorphone, oxycodone (OC), hydrocodone, and morphine that limit their use to oral delivery, two of which are in clinical development. This study was undertaken to demonstrate that PF614, an extended-release prodrug of OC, allows the release of OC as designed when delivered orally, yet it resists ex vivo extraction with household chemicals and is pharmacologically inactive when administered by nonoral routes (nasal and parenteral), thereby substantially reducing its intravenous (IV) and intranasal abuse potential...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28345698/ethylcellulose-oleogels-for-lipophilic-bioactive-delivery-effect-of-oleogelation-on-in-vitro-bioaccessibility-and-stability-of-beta-carotene
#18
Chloe M O Sullivan, Maya Davidovich-Pinhas, Amanda J Wright, Shai Barbut, Alejandro G Marangoni
The in vitro lipolysis and β-carotene (BC) transfer from oil to aqueous phase of canola oil ethylcellulose (EC) oleogels were measured using a static monocompartmental model simulating oral, gastric, and duodenal digestive stages. The effects of EC oleogelation on gel in vitro digestibility were examined, using un-structured canola oil as a control. The physicochemical properties of oleogels containing BC were also measured. It was found that oleogels made with 10% 10 cP and 10% 20 cP did not differ significantly in their extent of lipolysis or BC transfer compared to canola oil; however 10% 45 cP and 15...
March 27, 2017: Food & Function
https://www.readbyqxmd.com/read/28345624/the-effects-of-self-selected-light-dark-cycles-and-social-constraints-on-human-sleep-and-circadian-timing-a-modeling-approach
#19
Anne C Skeldon, Andrew J K Phillips, Derk-Jan Dijk
Why do we go to sleep late and struggle to wake up on time? Historically, light-dark cycles were dictated by the solar day, but now humans can extend light exposure by switching on artificial lights. We use a mathematical model incorporating effects of light, circadian rhythmicity and sleep homeostasis to provide a quantitative theoretical framework to understand effects of modern patterns of light consumption on the human circadian system. The model shows that without artificial light humans wakeup at dawn...
March 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28345420/peroneal-perforator-pedicle-propeller-flap-for-lower-leg-soft-tissue-defect-reconstruction-clinical-applications-and-treatment-of-venous-congestion
#20
Lifeng Shen, Yiyang Liu, Chun Zhang, Qiaofeng Guo, Wenhua Huang, Kelvin Kian Loong Wong, Shimin Chang
Objective To describe the characteristics of the perforator vessel in the peroneal artery of the lower leg and to explore the use of perforator pedicle propeller flaps to repair soft tissue defects in the lower leg, heel and foot. Methods This retrospective study enrolled patients with soft tissue defects of the distal lower leg, heel and foot who underwent surgery using peroneal perforator-based propeller flaps. The peroneal artery perforators were identified preoperatively by colour duplex Doppler ultrasound...
January 1, 2017: Journal of International Medical Research
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