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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/29454039/effect-of-long-term-selenium-supplementation-on-mortality-results-from-a-multiple-dose-randomised-controlled-trial
#2
REVIEW
Margaret P Rayman, Kristian Hillert Winther, Roberto Pastor-Barriuso, Frederick Cold, Marianne Thvilum, Saverio Stranges, Eliseo Guallar, Søren Cold
BACKGROUND: Selenium, an essential trace element, is incorporated into selenoproteins with a wide range of health effects. Selenoproteins may reach repletion at a plasma selenium concentration of ~125µg/L, at which point the concentration of selenoprotein P reaches a plateau; whether sustained concentrations higher than this are beneficial, or indeed detrimental, is unknown. OBJECTIVE: In a population of relatively low selenium status, we aimed to determine the effect on mortality of long-term selenium supplementation at different dose levels...
February 14, 2018: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/29454032/basal-polarization-of-the-immune-responses-to-streptococcus-agalactiae-susceptible-and-resistant-tilapia-oreochromis-niloticus
#3
Jiajie Zhu, Xi Gan, Qiuwei Ao, Xiashuang Shen, Yun Tan, Ming Chen, Yongju Luo, Hui Wang, Hesheng Jiang, Chao Li
One of the highest priority areas for improvement is the development of effective strategies for decreasing disease mortality levels in aquaculture production, a better understanding of the components of the fish immune system and their functions in the context of pathogen invasion is needed. Tilapia is the most common fish in South China, and Streptococcus agalactiae has become the most serious disease problem for tilapia industry in China. Here, we profiled gene expression differences between tilapia differing in their susceptibility to S...
February 14, 2018: Fish & Shellfish Immunology
https://www.readbyqxmd.com/read/29453891/an-investigation-of-an-open-access-model-for-scaling-up-methadone-maintenance-treatment
#4
Lynn M Madden, Scott O Farnum, Kathryn F Eggert, Andrew R Quanbeck, Robert Freeman, Samuel A Ball, Richard S Schottenfeld, Julia M Shi, Mary Ellen Savage, Declan T Barry
AIMS: To retrospectively examine patient and programmatic outcomes following the development and implementation of an "open-access" model in which prospective patients were enrolled rapidly in methadone maintenance treatment, irrespective of ability to pay, and provided real-time access to multiple voluntary treatment options. DESIGN: Medical and administrative records were abstracted to compare data for one year before and 9 years after initiating the implementation of an open-access treatment model in May 2007...
February 17, 2018: Addiction
https://www.readbyqxmd.com/read/29453412/pulmonary-antigen-encounter-regulates-the-establishment-of-tissue-resident-cd8-memory-t-cells-in-the-lung-airways-and-parenchyma
#5
Sean R McMaster, Alexander N Wein, Paul R Dunbar, Sarah L Hayward, Emily K Cartwright, Timothy L Denning, Jacob E Kohlmeier
Resident memory CD8 T (T RM ) cells in the lung parenchyma (LP) and airways provide heterologous protection against influenza virus challenge. However, scant knowledge exists regarding factors necessary to establish and maintain lung CD8 T RM . Here we demonstrate that, in contrast to mechanisms described for other tissues, airway, and LP CD8 T RM establishment requires cognate antigen recognition in the lung. Systemic effector CD8 T cells could be transiently pulled into the lung in response to localized inflammation, however these effector cells failed to establish tissue residency unless antigen was present in the pulmonary environment...
February 16, 2018: Mucosal Immunology
https://www.readbyqxmd.com/read/29453176/toxicological-interactions-induced-by-chronic-exposure-to-gold-nanoparticles-and-microplastics-mixtures-in-daphnia-magna
#6
Alexandre Pacheco, Alexandra Martins, Lúcia Guilhermino
The effects of emerging environmental contaminants on human and environmental health is of high concern, especially those potentially induced by mixtures. The main goal of the present study was to assess the chronic effects of mixtures of citrate stabilized ≈5 nm gold nanoparticles (AuNP) and 1-5μm microplastics (MP) on Daphnia magna. A 21-day bioassay was carried out. The effect criteria were parental mortality, somatic growth and several reproductive parameters. AuNP induced parental mortality, reduced the total offspring and caused immobile juveniles and aborted eggs...
February 13, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29453133/mortality-after-emergency-abdominal-operations-in-premature-infants
#7
Sarah B Cairo, Benjamin D Tabak, Loren Berman, Sara K Berkelhamer, Guan Yu, David H Rothstein
CONTEXT/BACKGROUND: To determine risk of 30-day mortality for premature infants undergoing abdominal operations during the first 2 months of life and to identify risk factors for perioperative mortality using available demographic and clinical variables of interest. BASIC PROCEDURES: Retrospective descriptive analysis of premature infants (gestational age less than or equal to 36weeks) undergoing abdominal operations during the first 2 months of life using the American College of Surgeon's National Surgical Quality Improvement Project Pediatric (NSQIP-P, 2012-2015) database...
January 31, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29453032/impact-of-metformin-on-gastric-adenocarcinoma-survival-a-belgian-population-based-study
#8
Olivia Lacroix, Alexandra Couttenier, Evelien Vaes, Chris R Cardwell, Harlinde De Schutter, Annie Robert
BACKGROUND: Preclinical studies have shown anticancer activities of metformin in gastric cancer and a recent epidemiological study showed a decrease in recurrence and mortality of gastric cancer in metformin users. This study aimed to assess the impact of metformin on gastric cancer survival in diabetic patients at a Belgian population level. METHODS: We conducted an observational, population-based study by linking data of the Belgian Cancer Registry with medical claims data coming from the health insurance companies for patients diagnosed with stage I to III gastric adenocarcinoma between 2006 and 2012...
February 13, 2018: Cancer Epidemiology
https://www.readbyqxmd.com/read/29452832/delayed-endovascular-aortic-repair-is-associated-with-reduced-in-hospital-mortality-in-patients-with-blunt-thoracic-aortic-injury
#9
Christina L Marcaccio, Ryan P Dumas, Yanlan Huang, Wei Yang, Grace J Wang, Daniel N Holena
OBJECTIVE: The traditional approach to stable blunt thoracic aortic injury (BTAI) endorsed by the Society for Vascular Surgery is early (<24 hours) thoracic endovascular aortic repair (TEVAR). Recently, some studies have shown improved mortality in stable BTAI patients repaired in a delayed manner (≥24 hours). However, the indications for use of delayed TEVAR for BTAI are not well characterized, and its overall impact on the patient's survival remains poorly understood. We sought to determine whether delayed TEVAR is associated with a decrease in mortality compared with early TEVAR in this population...
February 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29452803/preoperative-fasting-in-children-review-of-existing-guidelines-and-recent-developments
#10
REVIEW
P Frykholm, E Schindler, R Sümpelmann, R Walker, M Weiss
The current guidelines for preoperative fasting recommend intervals of 6, 4, and 2 h (6-4-2) of fasting for solids, breast milk, and clear fluids, respectively. The objective is to minimize the risk of pulmonary aspiration of gastric contents, but also to prevent unnecessarily long fasting intervals. Pulmonary aspiration is rare and associated with nearly no mortality in paediatric anaesthesia. The incidence may have decreased during the last decades, judging from several audits published recently. However, several reports of very long fasting intervals have also been published, in spite of the implementation of the 6-4-2 fasting regimens...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452732/efficacy-of-pre-hospital-rapid-sequence-intubation-in-paediatric-traumatic-brain-injury-a-9-year-observational-study
#11
Stefan Heschl, Ben Meadley, Emily Andrew, Warwick Butt, Stephen Bernard, Karen Smith
INTRODUCTION: Prehospital airway management of the paediatric patient with traumatic brain injury (TBI) is controversial. Endotracheal intubation of children in the field requires specific skills and has potential benefits but also carries potentially serious complications. We aimed to compare mortality and functional outcomes after six months between children with TBI who either underwent prehospital rapid sequence intubation (RSI) by trained Intensive Care paramedics (ICP) or received no intubation...
February 12, 2018: Injury
https://www.readbyqxmd.com/read/29452729/postoperative-pneumonia-among-patients-with-and-without-copd-in-spain-from-2001-to-2015
#12
Javier de Miguel-Díez, Ana López-de-Andrés, Valentín Hernández-Barrera, Isabel Jiménez-Trujillo, Manuel Méndez-Bailón, José María de Miguel-Yanes, Rodrigo Jiménez-García
BACKGROUND: To describe and compare incidence, characteristics and outcomes of postoperative pneumonia among patients with or without COPD. METHODS: We included hospitalized patients aged ≥40 years whose medical diagnosis included pneumonia and ventilator-associated pneumonia in the secondary's diagnosis field and who were discharged from Spanish hospitals from 2001 to 2015. Irrespectively of the position at the procedures coding list, we retrieved data about the type of surgical procedures using the enhanced ICD-9-CM codes...
February 13, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29452460/outcomes-after-surgical-pulmonary-embolectomy-for-acute-submassive-and-massive-pulmonary-embolism-a-single-center-experience
#13
Chetan Pasrija, Anthony Kronfli, Michael Rouse, Maxwell Raithel, Gregory J Bittle, Sheelagh Pousatis, Mehrdad Ghoreishi, James S Gammie, Bartley P Griffith, Pablo G Sanchez, Zachary N Kon
OBJECTIVES: Ideal treatment strategies for submassive and massive pulmonary embolism remain unclear. Recent reports of surgical pulmonary embolectomy have demonstrated improved outcomes, but surgical technique and postoperative outcomes continue to be refined. The aim of this study is to describe in-hospital survival and right ventricular function after surgical pulmonary embolectomy for submassive and massive pulmonary embolism with excessive predicted mortality (≥5%). METHODS: All patients undergoing surgical pulmonary embolectomy (2011-2015) were retrospectively reviewed...
March 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29452361/iui-review-and-systematic-assessment-of-the-evidence-that-supports-global-recommendations
#14
Ben Cohlen, Aartjan Bijkerk, Sheryl Van der Poel, Willem Ombelet
BACKGROUND: IUI with or without ovarian stimulation (OS) has become a first-line treatment option for many infertile couples, worldwide. The appropriate treatment modality for couples and their clinical management through IUI or IUI/OS cycles must consider maternal and perinatal outcomes, most notably the clinical complication of higher-order multiple pregnancies associated with IUI-OS. With a current global emphasis to continue to decrease maternal and perinatal mortality and morbidity, the World Health Organization (WHO) had established a multi-year project to review the evidence for the establishment of normative guidance for the implementation of IUI as a treatment to address fertility problems, and to consider its cost-effectiveness for lower resource settings...
February 14, 2018: Human Reproduction Update
https://www.readbyqxmd.com/read/29452335/change-in-cardiometabolic-risk-among-blacks-whites-and-hispanics-findings-from-the-health-and-retirement-study
#15
Uchechi A Mitchell, Jennifer A Ailshire, Eileen M Crimmins
Background: Blacks experience greater multi-system physiological dysregulation, or cumulative biological risk, which is associated with poor cardiometabolic health and mortality. In this study, we assess race differences in change in risk over four years among older whites, blacks and Hispanics. Method: We examined race differences in 4-year change in individual biomarkers and a cumulative measure of risk-cardiometabolic risk (CMR)-using data for each respondent from two waves of the Health and Retirement Study's biomarker assessment (n=5,512)...
February 14, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29451695/decreased-early-mortality-associated-with-the-treatment-of-acute-myeloid-leukemia-at-national-cancer-institute-designated-cancer-centers-in-california
#16
Gwendolyn Ho, Ted Wun, Lori Muffly, Qian Li, Ann Brunson, Aaron S Rosenberg, Brian A Jonas, Theresa H M Keegan
BACKGROUND: To the authors' knowledge, few population-based studies to date have evaluated the association between location of care, complications with induction therapy, and early mortality in patients with acute myeloid leukemia (AML). METHODS: Using linked data from the California Cancer Registry and Patient Discharge Dataset (1999-2014), the authors identified adult (aged ≥18 years) patients with AML who received inpatient treatment within 30 days of diagnosis...
February 16, 2018: Cancer
https://www.readbyqxmd.com/read/29451406/cancer-costs-and-outcomes-for-common-cancer-sites-in-the-finnish-population-between-2009-2014
#17
Paulus Torkki, Riikka-Leena Leskelä, Miika Linna, Suvi Mäklin, Jukka-Pekka Mecklin, Petri Bono, Vesa Kataja, Sakari Karjalainen
BACKGROUND: The cost of cancer and outcomes of cancer care have been discussed a lot since cancer represents 3-6% of total healthcare costs and cost estimations have indicated growing costs. There are studies considering the cost of all cancers, but studies focusing on the cost of disease and outcomes in most common cancer sites are limited. The objective of this study was to analyze the development of the costs and outcomes in Finland between 2009 and 2014 per cancer site. METHODS: The National cost, episode and outcomes data were obtained from the National register databases based on International Statistical Classification of Diseases (ICD)-10 diagnosis codes...
February 16, 2018: Acta Oncologica
https://www.readbyqxmd.com/read/29451081/permethrin-treated-clothing-to-protect-outdoor-workers-evaluation-of-different-methods-for-mosquito-exposure-against-populations-with-differing-resistance-status
#18
Stephanie L Richards, Nwanne Agada, Jo Anne G Balanay, Avian V White
Minimizing arthropod exposure (e.g. mosquito and tick bites) is vital to protect health of outdoor workers. Personal protective measures can help protect against exposure. Here, the quantity of permethrin was evaluated for different fabric types after washing. Cone and petri dish exposure assays were used to investigate the knockdown/mortality of permethrin-susceptible and permethrin-resistant populations of mosquitoes. Permethrin-treated clothing was effective against the tested mosquito population that was susceptible to permethrin but not a permethrin-resistant population...
February 16, 2018: Pathogens and Global Health
https://www.readbyqxmd.com/read/29450852/major-pancreatic-resections-normal-postoperative-findings-and-complications
#19
Marco Chincarini, Giulia A Zamboni, Roberto Pozzi Mucelli
OBJECTIVES: (1) To illustrate and describe the main types of pancreatic surgery; (2) to discuss the normal findings after pancreatic surgery; (3) to review the main complications and their radiological findings. BACKGROUND: Despite the decreased postoperative mortality, morbidity still remains high resulting in longer hospitalisations and greater costs. Imaging findings following major pancreatic resections can be broadly divided into "normal postoperative alterations" and real complications...
February 15, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29450825/unplanned-robotic-assisted-conversion-to-open-colorectal-surgery-is-associated-with-adverse-outcomes
#20
Yongjin F Lee, Jeremy Albright, Warqaa M Akram, Juan Wu, Jane Ferraro, Robert K Cleary
BACKGROUND: Laparoscopic conversion-to-open colorectal surgery is associated with worse outcomes when compared to operations completed without conversion. Consequences of robotic conversion have not yet been determined. The purpose of this study is to compare short-term outcomes of converted robotic colorectal cases with those that are completed without conversion, as well as with cases done by the open approach. METHODS: The ACS-NSQIP database was queried for patients who underwent robotic completed, robotic converted-to-open, and open colorectal resection between 2012 and 2015...
February 15, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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