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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/27933569/decision-making-in-clinical-practice-oral-anticoagulant-therapy-in-patients-with-non-valvular-atrial-fibrillation-and-a-single-additional-stroke-risk-factor
#2
REVIEW
Tatjana S Potpara, Nikolaos Dagres, Nebojša Mujović, Dragan Vasić, Milika Ašanin, Milan Nedeljkovic, Francisco Marin, Laurent Fauchier, Carina Blomstrom-Lundqvist, Gregory Y H Lip
Approximately 1 in 3-4 patients presenting with an ischemic stroke will also have atrial fibrillation (AF), and AF-related strokes can be effectively prevented using oral anticoagulant therapy (OAC), either with well-controlled vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs). In addition, OAC use (both VKAs and NOACs) is associated with a 26% reduction in all-cause mortality (VKAs) or an additional 10% mortality reduction with NOACs relative to VKAs. The decision to use OAC in individual AF patient is based on the estimated balance of the benefit from ischemic stroke reduction against the risk of major OAC-related bleeding [essentially intracranial hemorrhage (ICH)]...
December 8, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27933460/assessing-colorectal-cancer-screening-barriers-by-two-methods
#3
Mira L Katz, Gregory S Young, Barret J Zimmermann, Cathy M Tatum, Electra D Paskett
Colorectal cancer (CRC) is commonly diagnosed in the USA despite screening tests that have decreased CRC incidence and mortality. Finding the best method to identify patient-level screening barriers is important to improve CRC screening rates. A group-randomized trial was conducted among ten primary-care clinics. Clinics were randomized to a multi-level (clinic, provider, patient) CRC screening intervention or usual care (2007-2013). Subsequent to clinic- and provider-level interventions, a three-step, patient-level intervention was conducted...
December 8, 2016: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/27933389/high-volume-is-the-key-for-improving-in-hospital-outcomes-after-radical-prostatectomy-a-total-population-analysis-in-germany-from-2006-to-2013
#4
Christer Groeben, Rainer Koch, Martin Baunacke, Manfred P Wirth, Johannes Huber
PURPOSE: Outcomes of radical prostatectomy are prone to publication bias, because most of the data originated from highly specialized centers. We assessed in-hospital outcomes of all radical prostatectomies in Germany from 2006 to 2013 focusing on caseload volume, surgical approach, and certification status. METHODS: We analyzed the nationwide German hospital billing data covering 221,331 radical prostatectomies from 2006 to 2013. Outcomes were in-hospital mortality, surgical revision, and transfusion rates and the length of stay...
December 8, 2016: World Journal of Urology
https://www.readbyqxmd.com/read/27933286/viral-infection-in-the-development-and-progression-of-pediatric-acute-respiratory-distress-syndrome
#5
REVIEW
Steven Nye, Richard J Whitley, Michele Kong
Viral infections are an important cause of pediatric acute respiratory distress syndrome (ARDS). Numerous viruses, including respiratory syncytial virus (RSV) and influenza A (H1N1) virus, have been implicated in the progression of pneumonia to ARDS; yet the incidence of progression is unknown. Despite acute and chronic morbidity associated with respiratory viral infections, particularly in "at risk" populations, treatment options are limited. Thus, with few exceptions, care is symptomatic. In addition, mortality rates for viral-related ARDS have yet to be determined...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27933183/differential-eligibility-of-african-american-and-european-american-lung-cancer-cases-using-ldct-screening-guidelines
#6
Bríd M Ryan
INTRODUCTION: Lung cancer incidence and mortality is higher among African Americans compared with European Americans in the USA where screening guidelines are currently in place and based on age at diagnosis and smoking history. Given the different smoking patterns observed in these populations and the earlier age at which African Americans are diagnosed, it is possible that African Americans will be disproportionally excluded from screening programmes. METHODS: We assessed the capture of African American and EA lung cancer cases using the National Lung Screening Trial, US Preventive Services Task Force and Centers for Medicare and Medicaid Services eligibility guidelines in a population of lung cancer cases diagnosed between 1998 and 2014 in the Baltimore region of Maryland (n=1658)...
2016: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/27933180/serum-levels-of-immunoglobulins-and-severity-of-community-acquired-pneumonia
#7
Mari C de la Torre, Pere Torán, Mateu Serra-Prat, Elisabet Palomera, Estel Güell, Ester Vendrell, Joan Carles Yébenes, Antoni Torres, Jordi Almirall
INSTRUCTION: There is evidence of a relationship between severity of infection and inflammatory response of the immune system. The objective is to assess serum levels of immunoglobulins and to establish its relationship with severity of community-acquired pneumonia (CAP) and clinical outcome. METHODS: This was an observational and cross-sectional study in which 3 groups of patients diagnosed with CAP were compared: patients treated in the outpatient setting (n=54), patients requiring in-patient care (hospital ward) (n=173), and patients requiring admission to the intensive care unit (ICU) (n=191)...
2016: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/27932069/quercetin-attenuates-vascular-calcification-by-inhibiting-oxidative-stress-and-mitochondrial-fission
#8
Lei Cui, Zhong Li, Xueying Chang, Guangting Cong, Lirong Hao
Vascular calcification is a strong independent predictor of increased cardiovascular morbidity and mortality and has a high prevalence among patients with chronic kidney disease. The present study investigated the effects of quercetin on vascular calcification caused by oxidative stress and abnormal mitochondrial dynamics both in vitro and in vivo. Calcifying vascular smooth muscle cells (VSMCs) treated with inorganic phosphate (Pi) exhibited mitochondrial dysfunction, as demonstrated by decreased mitochondrial potential and ATP production...
December 5, 2016: Vascular Pharmacology
https://www.readbyqxmd.com/read/27932054/changes-in-physical-activity-sedentary-time-and-risk-of-falling-the-women-s-health-initiative-observational-study
#9
Jennifer W Bea, Cynthia A Thomson, Robert B Wallace, Chunyuan Wu, Rebecca A Seguin, Scott B Going, Andrea LaCroix, Charles Eaton, Judith K Ockene, Michael J LaMonte, Rebecca Jackson, W Jerry Mysiw, Jean Wactawski-Wende
Falling significantly affects quality of life, morbidity, and mortality among older adults. We sought to evaluate the prospective association between sedentary time, physical activity, and falling among post-menopausal women aged 50-79 y recruited to the Women's Health Initiative Observational Study between 1993 and 1998 from 40 clinical centers across the United States. Baseline (B) and change in each of the following were evaluated at year 3 (Y3) and year 6 (Y6; baseline n=93,676; Y3 n=76,598; Y6 n=75,428): recreational physical activity (MET-h/wk), sitting, sleeping (min/d), and lean body mass by dual energy X-ray absorptiometry (subset N=6,475)...
December 5, 2016: Preventive Medicine
https://www.readbyqxmd.com/read/27931829/primary-immunodeficiencies-associated-with-ebv-induced-lymphoproliferative-disorders
#10
REVIEW
Mahsima Shabani, Kim E Nichols, Nima Rezaei
Primary immunodeficiency diseases (PIDs) are a subgroup of inherited immunological disorders that increase susceptibility to viral infections. Among the range of viral pathogens involved, EBV remains a major threat because of its high prevalence of infection among the adult population and its tendency to progress to life-threatening lymphoproliferative disorders (LPDs) and/or malignancy. The high mortality in immunodeficient patients with EBV-driven LPDs, despite institution of diverse and often intensive treatments, prompts the need to better study these PIDs to identify and understand the affected molecular pathways that increase susceptibility to EBV infection and progression...
December 2016: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/27931818/evaluation-of-the-pigret-assay-as-a-short-term-test-using-a-single-dose-of-diethylnitrosamine
#11
Kunio Wada, Risako Nishino, Tomoki Fukuyama, Kyomu Matsumoto
The PIGRET assay, which was developed as the Pig-a assay in reticulocytes, can detect mutagenicity of compounds earlier than the Pig-a assay in total red blood cells (RBC; RBC Pig-a assay). The usefulness of the PIGRET assay as a short-term test has been confirmed in a collaborative study in Japan with 24 chemicals. One of these chemicals, diethylnitrosamine (DEN), which mainly induces liver tumors in both sexes of rats, was tested. To determine the appropriate doses, DEN was dissolved in physiological saline and administered orally with a single dose to male 8-week-old Sprague-Dawley rats in a preliminary dose-range finding study...
November 15, 2016: Mutation Research
https://www.readbyqxmd.com/read/27931585/resveratrol-ameliorated-vascular-calcification-by-regulating-sirt-1-and-nrf2
#12
P Zhang, Y Li, Y Du, G Li, L Wang, F Zhou
Pathologic vascular calcification is a significant reason for mortality and morbidity in patients who suffer from end-stage renal disease (ESRD). Resveratrol, a scavenger for many free radicals, is a crucial compound for biomedicine. However, the role and mechanism of resveratrol in vascular calcification is still unknown. In this study, to mimic vascular calcification in ESRD, we used β-glyceophosphate to stimulate the rat vascular smooth muscle cells (RASMCs). We investigate the therapeutic role of resveratrol pretreatment in vascular calcification...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931574/effects-of-the-hypnotic-agent-on-primary-graft-dysfunction-after-liver-transplantation
#13
L Gajate Martín, C González, I Ruiz Torres, C Fernández Martín, A Martín Grande, E Elías Martín, D Parise Roux, J M Del Rey Sánchez
BACKGROUND: Morbidity and mortality rates in orthotopic liver transplantation have decreased in the past few years. Risk factors related to severe postoperative complications, such as primary graft dysfunction, still need to be analyzed. We evaluated the influence of the hypnotic agent used during anesthesia on primary graft dysfunction. METHODS: We performed a retrospective analysis of 419 consecutive patients who received a liver transplant between 2005 and 2013 in a single center...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931548/percutaneous-transvenous-mitral-commissurotomy-in-mitral-stenosis-and-left-atrial-appendage-clot-patients-in-special-conditions-hospital-based-study
#14
Rajib Rajbhandari, Rabi Malla, Arun Maskey, Yadav Bhatta, Yubraj Limbu, Ranjit Sharma, Satish Singh, Chandramani Adhikari, Sundeep Mishra
BACKGROUND: The percutaneous transvenous mitral commissurotomy is an important procedure for the treatment of mitral stenosis. A lot of mitral stenosis cases have left atrial appendage clot which precludes the patient from the benefit of this procedure. The aim of the study was to study the feasibility and safety of the procedure in a patient with appendage clot in the setup of certain urgent conditions. METHOD: All cases of mitral stenosis with significant dyspnea and mitral valve area <1...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27931546/maternal-and-fetal-outcomes-in-pregnant-women-undergoing-balloon-mitral-valvotomy-for-rheumatic-mitral-stenosis
#15
Desabandhu Vinayakumar, G V Vinod, Suresh Madhavan, Mangalath Narayanan Krishnan
BACKGROUND: Rheumatic mitral stenosis constitutes a major cause of acquired heart disease complicating pregnancy in India. In the present study, we have studied the fetal and maternal outcomes of women undergoing balloon mitral valvotomy during pregnancy. METHODS AND RESULTS: 49 pregnant ladies were included in this study in whom balloon mitral valvotomy was performed. The mean age of these patients was 25.7±3.1 years. The mean gestational age was 23.5±5.2 weeks (12-36 weeks)...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27931259/abdominal-septic-shock-endotoxin-adsorption-treatment-asset-endotoxin-removal-in-abdominal-and-urogenital-septic-shock-with-the-alteco%C3%A2-lps-adsorber-study-protocol-for-a-double-blinded-randomized-placebo-controlled-trial
#16
Miklos Lipcsey, Jyrki Tenhunen, Jan Sjölin, Robert Frithiof, Stepani Bendel, Hans Flaatten, Rafael Kawati, Anne Kuitunen, Tor Inge Tønnessen, Sten Rubertsson
BACKGROUND: Severe sepsis and septic shock are common in intensive care and carry high mortality rates. In patients with Gram-negative infections, early and extensive removal of endotoxin may limit the inflammatory response that characterizes septic shock. The Alteco® LPS Adsorber (hereafter referred to cited as the lipopolysaccharide (LPS) Adsorber) can be used for endotoxin removal and attenuate the deleterious inflammatory and clinical responses seen in septic shock. METHODS/DESIGN: The Abdominal Septic Shock - Endotoxin Adsorption Treatment (ASSET) trial is a pilot study investigating the feasibility and safety of LPS Adsorber therapy...
December 8, 2016: Trials
https://www.readbyqxmd.com/read/27931232/retention-in-georgia-opioid-substitution-therapy-program-and-associated-factors
#17
Ekaterine Ruadze, Khatuna Todadze
BACKGROUND: Substance abuse has been considered as a growing challenge in Georgia that is closely linked with human immune deficiency virus (HIV) and hepatitis C transmission due to unsafe injection and other uncontrolled behaviors. Methadone maintenance therapy is one of the major treatment options for opioid-dependent individuals. It has proven efficacy in decreasing illegal opioid consumption and criminal behavior as well as reducing the level of HIV infection, mortality, HCV infection, and increasing social functioning...
December 8, 2016: Harm Reduction Journal
https://www.readbyqxmd.com/read/27930876/pioglitazone-on-improves-whole-body-aerobic-capacity-and-skeletal-muscle-energy-metabolism-in-patients-with-metabolic-syndrome
#18
Takashi Yokota, Shintaro Kinugawa, Kagami Hirabayashi, Tadashi Suga, Shingo Takada, Masashi Omokawa, Tomoyasu Kadoguchi, Masashige Takahashi, Arata Fukushima, Shouji Matsushima, Mayumi Yamato, Koichi Okita, Hiroyuki Tsutsui
AIMS/INTRODUCTION: Low aerobic capacity is a strong and independent predictor of all-cause mortality in patients with metabolic syndrome (MetS). Here, we investigated the effects of pioglitazone treatment on whole-body aerobic capacity and skeletal muscle energy metabolism in MetS patients. MATERIALS AND METHODS: Fourteen male patients with MetS received oral 15 mg/day pioglitazone for 4 months. To assess whole-body aerobic capacity, exercise testing with a bicycle ergometer was performed before and after pioglitazone treatment...
December 8, 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/27930829/diabetes-hepatocellular-carcinoma-and-mortality-in-hepatitis-c-infected-patients-a-population-based-cohort-study
#19
Ting-Shuo Huang, Chih-Lang Lin, Yu-Chiau Shyu, Chau-Ting Yeh, Kung-Hao Liang, Chi-Chin Sun, Mu-Jie Lu, Rong-Nan Chien
BACKGROUND AND AIM: The effect of diabetes mellitus (DM) on the development of hepatocellular carcinoma (HCC) and all-cause mortality after HCC development in chronic hepatitis C virus (HCV) infected patients remains inconclusive. This cohort study aimed to investigate these issues using the Taiwanese National Health Insurance Research Database. METHODS: We retrieved and enrolled newly diagnosed DM patients with HCV from the Longitudinal Cohort of Diabetes Patients database...
December 8, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27930821/assessment-of-asymmetrical-dimethylarginine-metabolism-in-patients-with-critical-illness
#20
Rawia A Ghashut, Scott Blackwell, Sylvia Ryan, Laura Willox, Donald C McMillan, John Kinsella, Dinesh Talwar
BACKGROUND: Critically ill patients experience metabolic disorders including hypercatabolic state and hyperglycaemia and these are associated with poor outcome. Hyperglycaemia and asymmetric dimethylarginine (ADMA) are reported to have significant influences on endothelial dysfunction. The aim of the present study was to examine the relationship between plasma asymmetric dimethylarginine (ADMA) and related arginine metabolism in patients with critical illness. MATERIALS AND METHODS: Two venous blood samples (EDTA) (104 patients), on admission and follow up sample in the last day in ICU (died or discharge sample median 7, IQR 6-8, range 5-15)...
December 8, 2016: European Journal of Clinical Investigation
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