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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/28351083/how-to-escape-from-primary-aldosteronism-news-and-views-on-an-adrenal-disorder-of-salt-retention
#2
Holger S Willenberg
The last years have seen substantial progress in primary aldosteronism (PA), which is the most common cause of secondary hypertension. Many programs have been established around the world to meet the needs in healthcare and the management of patients with PA according to published guidelines and clinical protocols. Systematic analysis of emerging data and meticulous scientific work have informed us on the molecular basis of the disease and helped to characterize hereditary forms of PA. Techniques have been developed to better diagnose PA and to establish genotype-phenotype relationships and their impact on hypertension...
March 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28351067/do-medical-students-narrative-representations-of-the-good-doctor-change-over-time-comparing-humanism-essays-from-a-national-contest-in-1999-and-2013
#3
Pooja C Rutberg, Brandy King, Elizabeth Gaufberg, Pamela Brett-MacLean, Perry Dinardo, Richard M Frankel
PURPOSE: To explore medical students' conceptions of "the good doctor" at two points in time separated by 14 years. METHOD: The authors conducted qualitative analysis of narrative-based essays. Following a constant comparative method, an emergent relational coding scheme was developed which the authors used to characterize 110 essays submitted to the Arnold P. Gold Foundation Humanism in Medicine Essay Contest in 1999 (n = 50) and 2013 (n = 60) in response to the prompt, "Who is the good doctor?" RESULTS: The authors identified five relational themes as guiding the day-to-day work and lives of physicians: doctor-patient, doctor-self, doctor-learner, doctor-colleague, and doctor-system/society/profession...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28351066/bringing-rounds-back-to-the-patient-a-one-year-evaluation-of-the-chiefs-service-model-for-inpatient-teaching
#4
Nadia L Bennett, Judd D Flesch, Peter Cronholm, James B Reilly, Jack Ende
PURPOSE: The Chiefs' Service (CS), a structured approach to inpatient teaching rounds, focuses on resident education and patient-centered care without disrupting patient census sizes or admitting cycles. It has five key elements: morning huddles; bedside rounds; diagnostic "time-outs"; day-of-discharge rounds; and postdischarge follow-up rounds. The authors hypothesized the CS model would be well received by residents and considered more effective than more-traditional rounds. METHOD: The CS was implemented on Penn Presbyterian Medical Center's general medicine inpatient service using a quasi-experimental design...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28351062/using-national-health-care-databases-and-problem-based-practice-analysis-to-inform-integrated-curriculum-development
#5
Amy J Baker, Mark R Raymond, Steven A Haist, John R Boulet
One challenge when implementing case-based learning, and other approaches to contextualized learning, is determining which clinical problems to include. This article illustrates how health care utilization data, readily available from the National Center for Health Statistics (NCHS), can be incorporated into an educational needs assessment to identify medical problems physicians are likely to encounter in clinical practice. The NCHS survey data summarize patient demographics, diagnoses, and interventions for tens of thousands of patients seen in various settings, including emergency departments (EDs), clinics, and hospitals...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28351056/comparison-of-umbilical-serum-copeptin-relative-to-erythropoietin-and-s100b-as-asphyxia-biomarkers-at-birth
#6
Milla Summanen, Laura Seikku, Petri Rahkonen, Vedran Stefanovic, Kari Teramo, Sture Andersson, Kai Kaila, Leena Rahkonen
BACKGROUND: Birth asphyxia, estimated to account for a million neonatal deaths annually, can cause a wide variety of neurodevelopmental impairments. There is a need to develop new, swift methods to identify those neonates who would benefit from neuroprotective treatments such as hypothermia. OBJECTIVES: To examine the utility of cord serum copeptin, a stable byproduct of arginine vasopressin release, as a biomarker of birth asphyxia based on a comparison with 2 biomarkers of hypoxia and brain trauma: erythropoietin and S100B...
March 29, 2017: Neonatology
https://www.readbyqxmd.com/read/28351012/a-comprehensive-overview-on-electro-active-biofilms-role-of-exo-electrogens-and-their-microbial-niches-in-microbial-fuel-cells-mfcs
#7
Ganesh Dattatraya Saratale, Rijuta Ganesh Saratale, Muhammad Kashif Shahid, Guangyin Zhen, Gopalakrishnan Kumar, Han-Seung Shin, Young-Gyun Choi, Sang-Hyoun Kim
Microbial fuel cells (MFCs) are biocatalyzed systems which can drive electrical energy by directly converting chemical energy using microbial biocatalyst and are considered as one of the important propitious technologies for sustainable energy production. Much research on MFCs experiments is under way with great potential to become an alternative to produce clean energy from renewable waste. MFCs have been one of the most promising technologies for generating clean energy industry in the future. This article summarizes the important findings in electro-active biofilm formation and the role of exo-electrogens in electron transfer in MFCs...
March 25, 2017: Chemosphere
https://www.readbyqxmd.com/read/28350977/small-bowel-obstruction-caused-by-anisakis-and-meckel-s-diverticulum-a-rare-case
#8
G Carbotta, R Laforgia, Michele Milella, M G Sederino, M Minafra, F Fortarezza, D Piscitelli, N Palasciano
INTRODUCTION: Anisakiasis is a parasitic infection caused by the ingestion of raw fish contaminated by larval nematodes of Anisakis species. Intestinal or extraintestinal manifestations are rated to > 4% and >1% respectively. PRESENTATION OF CASE: A 61-year old patient was admitted to our General Surgical and Emergency Unit because of sudden abdominal pain, vomit and constipation. He had eaten raw fish 3 days before admission. Laboratory data showed high levels of WBC and PCR...
November 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28350966/cationic-phosphorus-dendrimer-enhances-photodynamic-activity-of-rose-bengal-against-basal-cell-carcinoma-cell-lines
#9
Monika Dabrzalska, Anna Janaszewska, Maria Zablocka, Serge Mignani, Jean Pierre Majoral, Barbara Klajnert-Maculewicz
In the last couple of decades, photodynamic therapy emerged as a useful tool in the treatment of basal cell carcinoma. However, it still meets limitations due to unfavorable properties of photosensitizers, such as poor solubility or lack of selectivity. Dendrimers - polymers widely studied in biomedical field - may play a role as photosensitizer carriers and improve the efficacy of photodynamic treatment. Here, we describe the evaluation of an electrostatic complex of cationic phosphorus dendrimer and rose bengal in such aspects as singlet oxygen production, cellular uptake and phototoxicity against three basal cell carcinoma cell lines...
March 28, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28350959/mapping-of-drug-like-chemical-universe-with-reduced-complexity-molecular-frameworks
#10
Aleksejs Kontijevskis
The emergence of DNA-encoded chemical libraries (DEL) field in past decade has attracted attention of pharmaceutical industry as a powerful mechanism for the discovery of novel drug-like hits for various biological targets. Nuevolution Chemetics technology enables DNA encoded synthesis of billions of chemically diverse drug-like small molecule compounds, and the efficient screening and optimization of these, facilitating effective identification of drug candidates at an unprecedented speed and scale. Although many approaches have been developed by the cheminformatics community for the analysis and visualization of drug-like chemical space, most of them are restricted to the analysis of maximum few millions of compounds and cannot handle collections of 10(8)-10(12) compounds typical for DELs...
March 28, 2017: Journal of Chemical Information and Modeling
https://www.readbyqxmd.com/read/28350952/future-advances-in-spine-surgery-the-aospine-north-america-perspective
#11
Michael G Fehlings, Christopher S Ahuja, Thomas Mroz, Wellington Hsu, James Harrop
This focus issue highlights state-of-the-art techniques, equipment, and practices in the modern era of spine surgery while providing a glimpse into the next generation of patient care. A broad range of topics are presented to cover the full spectrum of the field. Degenerative diseases are discussed in a series of 3 articles on (1) pathophysiology, management, and surgical approaches to degenerative cervical myelopathy; (2) novel approaches to degenerative thoracolumbar disease (eg, interspinous process spacers, minimally invasive/endoscopic approaches); and (3) animal models and emerging therapeutics in degenerative disk disease...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350950/spine-oncology-metastatic-spine-tumors
#12
David Choi, Mark Bilsky, Michael Fehlings, Charles Fisher, Ziya Gokaslan
Surgery for spinal metastases remains the mainstay treatment for pain, instability, and neurological deterioration due to tumor infiltration of the spine. However, several new therapies are emerging which may improve outcomes further, and in some cases even replace the need for surgery. We now have a better understanding of which factors influence survival and quality of life after surgery, and this underpins the development and application of new treatments, and assessment of outcome.Depending on genetic subtyping of tumors, novel immunotherapies and chemotherapies may be very effective in prolonging quality of life...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350946/emerging-techniques-in-degenerative-thoracolumbar-surgery
#13
Theodore J Choma, Thomas E Mroz, Christina L Goldstein, Paul Arnold, Mohammed F Shamji
There continue to be incremental advances in thoracolumbar spine surgery techniques in attempts to achieve more predictable outcomes, minimize risk of complications, speed recovery, and minimize the costs of these interventions. This paper reviews recent literature with regard to emerging techniques of interest in the surgical treatment of lumbar spinal stenosis, fusion fixation and graft material, degenerative lumbar spondylolisthesis, and thoracolumbar deformity and sacroiliac joint degeneration. There continue to be advances in minimal access options in these areas, although robust outcome data are heterogeneous in its support...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350943/controversies-in-spinal-trauma-and-evolution-of-care
#14
James S Harrop, George N Rymarczuk, Alexander R Vaccaro, Michael P Steinmetz, Lindsay A Tetreault, Michael G Fehlings
Management of spinal trauma is a complex and rapidly evolving field. To optimize patient treatment algorithms, an understanding of and appreciation for current controversies and advancing technologies in the field of spinal trauma is necessary. Therefore, members of the AOSpine Knowledge Forum Trauma initiative used a modified Delphi method to compile a list of controversial issues and emerging technologies in the field of spinal trauma, and a list of the 14 most relevant topics was generated. A total of 45 440 manuscripts covering the breadth of spine and spinal trauma were initially identified...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350941/spine-oncology-primary-spine-tumors
#15
Nicolas Dea, Ziya Gokaslan, David Choi, Charles Fisher
Primary tumors originating from the spine are very complex and challenging entities to treat. Due to their rarity, a multicenter collaborative network is essential to shepherd the best research and contribute to the dissemination of the best evidence possible. Over the last few years, several advances have occurred in many different fields. Surgery is still the cornerstone of treatment in most cases. The occasional suboptimal outcomes and high morbidity of surgical treatment have however encouraged professionals caring for these patients to explore safer treatment options and alternatives or adjuncts to surgical treatment...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350940/recent-and-emerging-advances-in-spinal-deformity
#16
Justin S Smith, Christopher I Shaffrey, Shay Bess, Mohammed F Shamji, Darrel Brodke, Lawrence G Lenke, Michael G Fehlings, Virginie Lafage, Frank Schwab, Alexander R Vaccaro, Christopher P Ames
BACKGROUND: Over the last several decades, significant advances have occurred in the assessment and management of spinal deformity. OBJECTIVE: The primary focus of this narrative review is on recent advances in adult thoracic, thoracolumbar, and lumbar deformities, with additional discussions of advances in cervical deformity and pediatric deformity. METHODS: A review of recent literature was conducted. RESULTS: Advances in adult thoracic, thoracolumbar, and lumbar deformities reviewed include the growing applications of stereoradiography, development of new radiographic measures and improved understanding of radiographic alignment objectives, increasingly sophisticated tools for radiographic analysis, strategies to reduce the occurrence of common complications, and advances in minimally invasive techniques...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350903/advancing-diagnostics-to-address-antibacterial-resistance-the-diagnostics-and-devices-committee-of-the-antibacterial-resistance-leadership-group
#17
Ephraim L Tsalik, Elizabeth Petzold, Barry N Kreiswirth, Robert A Bonomo, Ritu Banerjee, Ebbing Lautenbach, Scott R Evans, Kimberly E Hanson, Jeffrey D Klausner, Robin Patel
Diagnostics are a cornerstone of the practice of infectious diseases. However, various limitations frequently lead to unmet clinical needs. In most other domains, diagnostics focus on narrowly defined questions, provide readily interpretable answers, and use true gold standards for development. In contrast, infectious diseases diagnostics must contend with scores of potential pathogens, dozens of clinical syndromes, emerging pathogens, rapid evolution of existing pathogens and their associated resistance mechanisms, and the absence of gold standards in many situations...
March 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28350890/quantification-of-motor-network-dynamics-in-parkinson-s-disease-by-means-of-landscape-and-flux-theory
#18
Han Yan, Jin Wang
The basal ganglia neural circuit plays an important role in motor control. Despite the significant efforts, the understanding of the principles and underlying mechanisms of this modulatory circuit and the emergence of abnormal synchronized oscillations in movement disorders is still challenging. Dopamine loss has been proved to be responsible for Parkinson's disease. We quantitatively described the dynamics of the basal ganglia-thalamo-cortical circuit in Parkinson's disease in terms of the emergence of both abnormal firing rates and firing patterns in the circuit...
2017: PloS One
https://www.readbyqxmd.com/read/28350857/differentiating-anxiety-forms-and-their-role-in-academic-performance-from-primary-to-secondary-school
#19
Emma Carey, Amy Devine, Francesca Hill, Dénes Szűcs
INTRODUCTION: Individuals with high levels of mathematics anxiety are more likely to have other forms of anxiety, such as general anxiety and test anxiety, and tend to have some math performance decrement compared to those with low math anxiety. However, it is unclear how the anxiety forms cluster in individuals, or how the presence of other anxiety forms influences the relationship between math anxiety and math performance. METHOD: We measured math anxiety, test anxiety, general anxiety and mathematics and reading performance in 1720 UK students (year 4, aged 8-9, and years 7 and 8, aged 11-13)...
2017: PloS One
https://www.readbyqxmd.com/read/28350847/biophysical-characterization-of-the-b-hlh-lz-of-%C3%AE-max-an-alternatively-spliced-isoform-of-max-found-in-tumor-cells-towards-the-validation-of-a-tumor-suppressor-role-for-the-max-homodimers
#20
Loïka Maltais, Martin Montagne, Mikaël Bédard, Cynthia Tremblay, Laura Soucek, Pierre Lavigne
It is classically recognized that the physiological and oncogenic functions of Myc proteins depend on specific DNA binding enabled by the dimerization of its C-terminal basic-region-Helix-Loop-Helix-Leucine Zipper (b-HLH-LZ) domain with that of Max. However, a new paradigm is emerging, where the binding of the c-Myc/Max heterodimer to non-specific sequences in enhancers and promoters drives the transcription of genes involved in diverse oncogenic programs. Importantly, Max can form a stable homodimer even in the presence of c-Myc and bind DNA (specific and non-specific) with comparable affinity to the c-Myc/Max heterodimer...
2017: PloS One
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