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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/28644576/size-dependency-of-tree-growth-response-to-drought-among-norway-spruce-and-european-beech-individuals-in-monospecific-and-mixed-species-stands
#2
Haiyu Ding, Hans Pretzsch, Gerhard Schütze, Thomas Rötzer
Climatic anomalies have resulted in changing forest productivity, increasing tree mortality in Central and Southern Europe. This has resulted in more severe and frequent ecological disturbances to the forest stands. This study analysed the size dependency of growth response to drought years based on 384 tree individuals of Norway spruce (Picea abies [L.] Karst.) and European beech (Fagus sylvatica [L.]) in Bavaria, Germany. Samples were collected in both monospecific and mixed-species stands. To quantify the growth response of drought stress, indices including basal area increment, resistance, recovery, and resilience were calculated from tree ring measurements of increment cores...
June 23, 2017: Plant Biology
https://www.readbyqxmd.com/read/28644310/predictors-of-mortality-in-cirrhosis-inpatients-with-clostridium-difficile-infection
#3
Elliot Z Smith, Patrick G Northup, Curtis K Argo
BACKGROUND: Clostridium difficile is a bacterial pathogen associated with significant morbidity and mortality in patients with cirrhosis. GOALS: Our primary aim is to identify variables that are predictive of poor outcomes in cirrhosis patients with C. difficile infection (CDI). We also aim to further characterize the risk factors for developing CDI and risk of mortality in this patient population. STUDY: A total of 200 subjects with a diagnosis of cirrhosis and CDI were matched to 200 cirrhosis inpatients without CDI...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28644097/thirty-day-postoperative-morbidity-and-mortality-after-temporal-lobectomy-for-medically-refractory-epilepsy
#4
Panagiotis Kerezoudis, Brandon McCutcheon, Meghan E Murphy, Kenan R Rajjoub, Daniel Ubl, Elizabeth B Habermann, Gregory Worrell, Mohamad Bydon, Jamie J Van Gompel
OBJECTIVE Temporal lobectomy is a well-established treatment modality for the management of medically refractory epilepsy in appropriately selected patients. The aim of this study was to assess 30-day morbidity and mortality after temporal lobectomy in cases registered in a national database. METHODS A retrospective cohort analysis was conducted using a multiinstitutional surgical registry compiled between 2006 and 2014. The authors identified patients who underwent anterior temporal lobectomy and/or amygdalohippocampectomy for a primary diagnosis of intractable epilepsy...
June 23, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28643746/breast-cancer-screening-practices-amongst-female-tertiary-health-worker-in-nnewi
#5
Chimezie Innocent Madubogwu, Amobi Ochonma Egwuonwu, Ngozi Ukamaka Madubogwu, Ifeoma A Njelita
BACKGROUND: Breast cancer in Nigeria and other developing countries is characterized by late presentation and poor outcome due to ignorance, superstition, self-denial, fear of mastectomy, and unavailability of treatment facilities. The mortality of breast cancer in Western world is decreasing due to early detection and better management. OBJECTIVE: This study aims at accessing the knowledge, attitude, and practice of breast cancer screening among female tertiary health workers...
April 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28643378/effects-of-weight-based-ultrafiltration-rate-limits-on-intradialytic-hypotension-in-hemodialysis
#6
James L Pirkle, Mary E Comeau, Carl D Langefeld, Gregory B Russell, Somer S Balderston, Barry I Freedman, John M Burkart
INTRODUCTION: High ultrafiltration (UF) rates can result in intradialytic hypotension and are associated with increased mortality. The effects of a weight-based UF rate limit on intradialytic hypotension and the potential for unwanted fluid weight gain and hospitalizations for volume overload are unknown. METHODS: This retrospective cohort study examined 123 in-center hemodialysis patients at one facility who transitioned to 13 mL/kg/h maximum UF rates. Patients were studied for an 8 week UF rate limit exposure period and compared to the 8-week period immediately prior, during which the cohort served as its own historical control...
June 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28643079/similar-clinical-outcomes-with-preoperative-and-postoperative-start-of-thromboprophylaxis-in-tha-a-register-based-study
#7
Pål O Borgen, Are H Pripp, Eva Dybvik, Lilian Leistad, Ola E Dahl, Olav Reikerås
BACKGROUND: Elective THA is associated with a high risk of thromboembolic events. Although these events may be less common now than they were in the past, they can be serious, and most patients undergoing the procedure therefore still receive thromboprophylaxis. However, controversy remains regarding whether to begin thromboprophylaxis before THA or after to best balance the risks of clotting and bleeding. QUESTIONS/PURPOSES: We asked the following questions: (1) Is there a difference in bleeding events with pre- versus postoperative thromboprophylaxis? (2) Is there a difference in thromboembolic episodes after THA between the two regimens? (3) How do the two approaches of thromboprophylaxis influence mortality, readmissions, and other complications? METHODS: We used a population-based followup design with predefined data based on international health codification to assess clinical effects of LMWH prophylaxis initiated before or after THA...
June 22, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28642846/decreased-fitness-and-virulence-in-st10-escherichia-coli-harboring-blandm-5-and-mcr-1-against-a-st4981-strain-with-blandm-5
#8
Yawei Zhang, Kang Liao, Hua Gao, Qi Wang, Xiaojuan Wang, Henan Li, Ruobing Wang, Hui Wang
Although coexistence of blaNDM-5 and mcr-1 in Escherichia coli has been reported, little is known about the fitness and virulence of such strains. Three carbapenem-resistant Escherichia coli (GZ1, GZ2, and GZ3) successively isolated from one patient in 2015 were investigated for microbiological fitness and virulence. GZ1 and GZ2 were also resistant to colistin. To verify the association between plasmids and fitness, growth kinetics of the transconjugants were performed. We also analyzed genomic sequences of GZ2 and GZ3 using PacBio sequencing...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28642773/infestation-of-broad-bean-vicia-faba-by-the-green-stink-bug-nezara-viridula-decreases-shoot-abscisic-acid-contents-under-well-watered-and-drought-conditions
#9
Luisa Ederli, Cecilia Brunetti, Mauro Centritto, Stefano Colazza, Francesca Frati, Francesco Loreto, Giovanni Marino, Gianandrea Salerno, Stefania Pasqualini
The response of broad bean (Vicia faba) plants to water stress alone and in combination with green stink bug (Nezara viridula) infestation was investigated through measurement of: (1) leaf gas exchange; (2) plant hormone titres of abscisic acid (ABA) and its metabolites, and of salicylic acid (SA); and (3) hydrogen peroxide (H2O2) content. Furthermore, we evaluated the effects of experimentally water-stressed broad-bean plants on N. viridula performance in terms of adult host-plant preference, and nymph growth and survival...
2017: Frontiers in Plant Science
https://www.readbyqxmd.com/read/28642302/residual-erythropoiesis-protects-against-myocardial-hemosiderosis-in-transfusion-dependent-thalassemia-by-lowering-labile-plasma-iron-via-transient-generation-of-apotransferrin
#10
Maciej W Garbowski, Patricia Evans, Evangelia Vlachodimitropoulou, Robert Hider, John B Porter
Cardiosiderosis is a leading cause of mortality in transfusion-dependent thalassemias. Plasma non-transferrin-bound iron and its redox-active component, labile plasma iron, are key sources of iron loading in cardiosiderosis. Risk factors were identified in 73 patients with or without cardiosiderosis. Soluble transferrin receptor-1 levels were significantly lower in patients with cardiosiderosis (odds ratio 21). This risk increased when transfusion-iron loading rates exceeded the erythroid transferrin uptake rate (derived from soluble transferrin receptor-1) by >0...
June 22, 2017: Haematologica
https://www.readbyqxmd.com/read/28642260/cigarette-smoke-disrupts-monolayer-integrity-by-altering-epithelial-cell-cell-adhesion-and-cortical-tension
#11
Kristine Nishida, Kieran A Brune, Nirupama Putcha, Pooja Mandke, Wanda K O'Neal, Danny Shade, Vasudha Srivastava, Menghen Wang, Hong Lam, Steven S An, M Bradley Drummond, Nadia N Hansel, Douglas N Robinson, Venkataramana K Sidhaye
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Cigarette smoke (CS) drives disease development and progression. The epithelial barrier is damaged by CS with increased monolayer permeability. However, the molecular changes that cause this barrier disruption and the interaction between adhesion proteins and the cytoskeleton are not well defined. We hypothesized that CS alters monolayer integrity by increasing cell contractility and decreasing cell adhesion in epithelia...
June 22, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28642182/the-effect-of-morbid-obesity-on-subarachnoid-hemorrhage-prognosis-in-the-united-states
#12
Ross-Jordon S Elliott, Daniel Agustin Godoy, Joel E Michalek, Réza Behrouz, Marwah A Elsehety, Shaheryar Hafeez, Denise Rios, Ali Seifi
BACKGROUND: The association between obesity and non-traumatic subarachnoid hemorrhage (SAH) patient outcome is unclear. AIMS: Determine the impact of morbid obesity (body mass index ≥40 kg/m(2)) on non-traumatic SAH outcomes. METHODS: Using the Nationwide Inpatient Sample, we identified hospitalized, non-traumatic SAH patients diagnosed from 2008 to 2013 and tested the effect of obesity on their mortality and clinical outcomes. Odds ratios were estimated with a mixed effects linear logistic model with adjustment for hospital clustering...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28641862/perioperative-beta-blockers-and-statins-for-noncardiac-surgery-patients-with-coronary-stents
#13
Joshua S Richman, Laura A Graham, Aerin DeRussy, Thomas M Maddox, Kamal M F Itani, Mary T Hawn
IMPORTANCE: Recent publications report that perioperative initiation of statin therapy is associated with improved outcomes particularly among patients with increased cardiac risk. However, findings on associations with beta blocker (BB) initiation are mixed. OBJECTIVE: This study examines associations between perioperative statin and BB use in a national sample of patients with cardiac stents. DESIGN: Retrospective cohort study. SETTING: VA Medical Centers nationwide...
May 31, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28641796/cardiac-sympathetic-denervation-for-refractory-ventricular-arrhythmias
#14
Marmar Vaseghi, Parag Barwad, Federico J Malavassi Corrales, Harikrishna Tandri, Nilesh Mathuria, Rushil Shah, Julie M Sorg, Jean Gima, Kaushik Mandal, Luis C Sàenz Morales, Yash Lokhandwala, Kalyanam Shivkumar
BACKGROUND: Cardiac sympathetic denervation (CSD) has been shown to reduce the burden of implantable cardioverter-defibrillator (ICD) shocks in small series of patients with structural heart disease (SHD) and recurrent ventricular tachyarrhythmias (VT). OBJECTIVES: This study assessed the value of CSD and the characteristics associated with outcomes in this population. METHODS: Patients with SHD who underwent CSD for refractory VT or VT storm at 5 international centers were analyzed by the International Cardiac Sympathetic Denervation Collaborative Group...
June 27, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28641790/ideal-cardiovascular-health-mortality-and%C3%A2-vascular-events-in-elderly-subjects-the%C3%A2-three-city%C3%A2-study
#15
Bamba Gaye, Marianne Canonico, Marie-Cécile Perier, Cecilia Samieri, Claudine Berr, Jean-François Dartigues, Christophe Tzourio, Alexis Elbaz, Jean-Philippe Empana
BACKGROUND: The benefit of ideal cardiovascular health (CVH) on health-related outcomes in middle-aged patients is firmly established. In the growing elderly population, the high prevalence of comorbidities and medications for chronic diseases may offset such benefit. OBJECTIVES: This study analyzed the association of ideal CVH with mortality, incident coronary heart disease, and stroke events in elderly individuals from the community. METHODS: Between 1999 and 2001, 9,294 men and women, noninstitutionalized and aged 65 years and over were examined, and thereafter followed up for the occurrence of vascular events and mortality within the Three-City Study...
June 27, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28641721/effective-self-management-interventions-for-patients-with-lupus-potential-impact-of-peer-mentoring
#16
REVIEW
Edith M Williams, Leonard Egede, Trevor Faith, James Oates
Systemic lupus erythematosus (SLE) is associated with significant mortality, morbidity and cost for the individual patient and society. In the United States, African Americans (AAs) have 3-4 times greater prevalence of lupus, risk of developing lupus at an earlier age and lupus-related disease activity, organ damage and mortality compared with whites. Evidence-based self-management interventions that incorporate both social support and health education have reduced pain, improved function and delayed disability among patients with lupus...
June 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28641096/hematopoietic-stem-cell-transplantation-for-sickle-cell-anemia-the-changing-landscape
#17
REVIEW
Adetola A Kassim, Deva Sharma
Allogeneic hematopoietic stem cell transplantation (HSCT) remains the only curative therapy for sickle cell disease (SCD); however, its use is limited by lack of suitable human leukocyte antigen (HLA)-matched donors and decreased application in older patients with significant morbidity. Myeloablative, HLA-identical sibling transplantation in children with SCD offers excellent long-term survival, with overall and event-free survival rates of 95% and 92%, respectively. However, the risk of graft-versus-host-disease, infections, infertility, and other long-term transplant complications, further limits its widespread use...
June 15, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28640930/orotracheal-intubation-in-infants-performed-with-a-stylet-versus-without-a-stylet
#18
REVIEW
Joyce E O'Shea, Jennifer O'Gorman, Aakriti Gupta, Sanjay Sinhal, Jann P Foster, Liam Af O'Connell, C Omar F Kamlin, Peter G Davis
BACKGROUND: Neonatal endotracheal intubation is a common and potentially life-saving intervention. It is a mandatory skill for neonatal trainees, but one that is difficult to master and maintain. Intubation opportunities for trainees are decreasing and success rates are subsequently falling. Use of a stylet may aid intubation and improve success. However, the potential for associated harm must be considered. OBJECTIVES: To compare the benefits and harms of neonatal orotracheal intubation with a stylet versus neonatal orotracheal intubation without a stylet...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28640797/rural-and-urban-differences-in-air-quality-2008-2012-and-community-drinking-water-quality-2010-2015-united-states
#19
Heather Strosnider, Caitlin Kennedy, Michele Monti, Fuyuen Yip
PROBLEM/CONDITION: The places in which persons live, work, and play can contribute to the development of adverse health outcomes. Understanding the differences in risk factors in various environments can help to explain differences in the occurrence of these outcomes and can be used to develop public health programs, interventions, and policies. Efforts to characterize urban and rural differences have largely focused on social and demographic characteristics. A paucity of national standardized environmental data has hindered efforts to characterize differences in the physical aspects of urban and rural areas, such as air and water quality...
June 23, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28640782/perioperative-venous-thromboembolism-a-review
#20
Ronald J Gordon, Frederick W Lombard
Venous thromboembolism (VTE) is a significant problem in the perioperative period, increasing patient morbidity, mortality, and health care costs. It is also considered the most preventable of the major postoperative complications. Despite widespread adoption of prophylaxis guidelines, it appears that morbidity from the disease has not substantially changed within the past 2 decades. It is becoming clear that current prophylaxis efforts are not sufficient. Using more potent anticoagulants may decrease the incidence of VTE, but increase the risk for bleeding and infection...
June 20, 2017: Anesthesia and Analgesia
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