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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/29352662/distinct-progression-patterns-of-brain-disease-in-infantile-and-juvenile-gangliosidoses-volumetric-quantitative-mri-study
#2
Igor Nestrasil, Alia Ahmed, Josephine M Utz, Kyle Rudser, Chester B Whitley, Jeanine R Jarnes-Utz
BACKGROUND: GM1-gangliosidosis and GM2-gangliosidosis (Tay-Sachs disease and Sandhoff disease) are unrelenting heritable neurodegenerative conditions of lysosomal ganglioside accumulation. Although progressive brain atrophy is characteristic, longitudinal quantification of specific brain structures has not been systematically studied. OBJECTIVES: The goal of this longitudinal study has been to quantify and track brain MRI volume changes, including specific structure volume changes, at different times in disease progression of childhood gangliosidoses, and to explore quantitative brain MRI volumetry (qMRI) as a non-invasive marker of disease progression for future treatment trials...
December 20, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/29352368/endocrine-therapy-and-related-issues-in-hormone-receptor-positive-early-breast-cancer-a-roundtable-discussion-by-the-breast-cancer-therapy-expert-group-bcteg
#3
REVIEW
Jame Abraham, Humberto Caldera, Robert Coleman, Anthony Elias, Matthew P Goetz, Muaiad Kittaneh, Elyse Lower, Reshma Mahtani, E Terry Mamounas, Mark Pegram, Hope Rugo, Lee Schwartzberg, Tiffany Traina, Chuck Vogel
PURPOSE: Management of breast cancer is a rapidly evolving field, and, although evidence-based guidelines are available for clinicians to provide direction on critical issues in patient care, clinicians often left to address these issues in the context of community practice situations with their patients. These include the patient's comorbid conditions, actual versus perceived benefit of treatments, patient's compliance as well as financial/reimbursement issues, and long-term tolerability of therapy...
January 19, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29351889/disentangling-the-effects-of-low-ph-and-metal-mixture-toxicity-on-macroinvertebrate-diversity
#4
Riccardo Fornaroli, Alessio Ippolito, Mari J Tolkkinen, Heikki Mykrä, Timo Muotka, Laurie S Balistrieri, Travis S Schmidt
One of the primary goals of biological assessment of streams is to identify which of a suite of chemical stressors is limiting their ecological potential. Elevated metal concentrations in streams are often associated with low pH, yet the effects of these two potentially limiting factors of freshwater biodiversity are rarely considered to interact beyond the effects of pH on metal speciation. Using a dataset from two continents, a biogeochemical model of the toxicity of metal mixtures (Al, Cd, Cu, Pb, Zn) and quantile regression, we addressed the relative importance of both pH and metals as limiting factors for macroinvertebrate communities...
January 16, 2018: Environmental Pollution
https://www.readbyqxmd.com/read/29351795/malaria-knowledge-and-bed-net-use-in-three-transmission-settings-in-southern-africa
#5
Mufaro Kanyangarara, Harry Hamapumbu, Edmore Mamini, James Lupiya, Jennifer C Stevenson, Sungano Mharakurwa, Mike Chaponda, Philip E Thuma, Lovemore Gwanzura, Shungu Munyati, Modest Mulenga, Douglas E Norris, William J Moss
BACKGROUND: Insecticide-treated nets (ITNs) reduce malaria morbidity and mortality in endemic areas. Despite increasing availability, the use of ITNs remains limited in some settings. Poor malaria knowledge is a barrier to the widespread use of ITNs. The goal of this study was to assess the levels of malaria knowledge and evaluate factors associated with bed net use among individuals residing in three regions of southern Africa with different levels of malaria transmission and control...
January 19, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29351769/protocol-to-disseminate-a-hospital-site-controlled-intervention-using-audit-and-feedback-to-implement-guidelines-concerning-inappropriate-treatment-of-asymptomatic-bacteriuria
#6
Barbara W Trautner, Pooja Prasad, Larissa Grigoryan, Sylvia J Hysong, Jennifer R Kramer, Suja Rajan, Nancy J Petersen, Tracey Rosen, Dimitri M Drekonja, Christopher Graber, Payal Patel, Paola Lichtenberger, Timothy P Gauthier, Steve Wiseman, Makoto Jones, Anne Sales, Sarah Krein, Aanand Dinkar Naik
BACKGROUND: Antimicrobial stewardship to combat the spread of antibiotic-resistant bacteria has become a national priority. This project focuses on reducing inappropriate use of antimicrobials for asymptomatic bacteriuria (ASB), a very common condition that leads to antimicrobial overuse in acute and long-term care. We previously conducted a successful intervention, entitled "Kicking Catheter Associated Urinary Tract Infection (CAUTI): the No Knee-Jerk Antibiotics Campaign," to decrease guideline-discordant ordering of urine cultures and antibiotics for ASB...
January 19, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29351495/implementing-prehospital-evidence-based-guidelines-a-systematic-literature-review
#7
Jennifer N Fishe, Remle P Crowe, Rebecca E Cash, Nikiah G Nudell, Christian Martin-Gill, Christopher T Richards
OBJECTIVE: As prehospital research advances, more evidence-based guidelines (EBGs) are implemented into emergency medical services (EMS) practice. However, incomplete or suboptimal prehospital EBG implementation may hinder improvement in patient outcomes. To inform future efforts, this study's objective was to review existing evidence pertaining to prehospital EBG implementation methods. METHODS: This study was a systematic literature review and evaluation following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology...
January 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29350974/use-of-simulation-based-training-to-aid-in-implementing-complex-health-technology
#8
Veffa Devers
Clinicians are adult learners in a complex environment that historically does not invest in training in a way that is conducive to these types of learners. Adult learners are independent, self-directed, and goal oriented. In today's fast-paced clinical setting, a practical need exists for nurses and clinicians to master the technology they use on a daily basis, especially as medical devices have become more interconnected and complex. As hospitals look to embrace new technologies, medical device companies must provide clinical end-user training...
January 2018: Biomedical Instrumentation & Technology
https://www.readbyqxmd.com/read/29350695/prechemotherapy-education-reducing-patient-anxiety-through-nurse-led-teaching-sessions%C3%A2
#9
Emmanuel Apor, Nathan T Connell, Katherine Faricy-Anderson, Peter Barth, Rouba Youssef, Mary Fenton, William M Sikov, Anthony Thomas, Kayla Rosati, Andrew Schumacher, Alise Lombardo, Susan Korber, Humera Khurshid, Howard Safran, Anthony Mega
BACKGROUND: Patients with cancer experience stress surrounding diagnosis and treatment. Many cancer centers employ a nurse-led education session to alleviate patient anxiety and confusion.
. OBJECTIVES: The goal was to evaluate the effect of a nurse-led chemotherapy teaching session on patients' knowledge, anxiety, and preparedness for 
cancer-directed therapy.
. METHODS: After discussing treatment with their oncologist, participants completed a survey assessing their perceived understanding of various treatment topics...
February 1, 2018: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29349298/direct-measurements-of-doco-isomers-in-the-kinetics-of-od-co
#10
Thinh Q Bui, Bryce J Bjork, P Bryan Changala, Thanh L Nguyen, John F Stanton, Mitchio Okumura, Jun Ye
Quantitative and mechanistically detailed kinetics of the reaction of hydroxyl radical (OH) with carbon monoxide (CO) have been a longstanding goal of contemporary chemical kinetics. This fundamental prototype reaction plays an important role in atmospheric and combustion chemistry, motivating studies for accurate determination of the reaction rate coefficient and its pressure and temperature dependence at thermal reaction conditions. This intricate dependence can be traced directly to details of the underlying dynamics (formation, isomerization, and dissociation) involving the reactive intermediates cis- and trans-HOCO, which can only be observed transiently...
January 2018: Science Advances
https://www.readbyqxmd.com/read/29348321/lower-limbic-metabotropic-glutamate-receptor-5-availability-in-alcohol-dependence
#11
Gil Leurquin-Sterk, Jenny Ceccarini, Cleo L Crunelle, Bart de Laat, Jef Verbeek, Stephanie Deman, Hugo Neels, Guy Bormans, Hendrik Peuskens, Koen Van Laere
Animal studies suggest an important role for the metabotropic glutamate receptor subtype 5 (mGlu5) in the pathophysiology of alcohol dependence, but direct human evidence is lacking. The goal of this study was to investigate cerebral mGlu5 availability in alcohol-dependent patients versus controls using 18F-FPEB positron emission tomography. Methods: Dynamic 90 minute 18F-FPEB scans combined with arterial blood sampling were acquired in 16 recently abstinent alcohol-dependent patients and 32 age-matched controls...
January 18, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/29348292/morbid-jealousy-reactivated-by-mood-episodes
#12
Ruziana Masiran, Nik Shaliza Hussin
A middle-aged man who has been enduring financial constraint experienced a period of irritability, increased goal-directed activities and insomnia occurring along with extreme jealousy with his current wife. The episode was followed by depressed mood and non-prominent auditory hallucination. His previous history revealed a forensic psychiatry case of a murder he committed 20 years ago.
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29348166/clinical-evaluation-of-a-blood-assay-to-diagnose-paucibacillary-tuberculosis-via-bacterial-antigens
#13
Chang Liu, Christopher J Lyon, Yang Bu, Zaian Deng, Elisabetta Walters, Yan Li, Liqun Zhang, Anneke C Hesseling, Edward A Graviss, Ye Hu
BACKGROUND: The diagnosis of active tuberculosis (TB)10 cases primarily relies on methods that detect Mycobacterium tuberculosis (Mtb) bacilli or their DNA in patient samples (e.g., mycobacterial culture and Xpert MTB/RIF assays), but these tests have low clinical sensitivity for patients with paucibacillary TB disease. Our goal was to evaluate the clinical performance of a newly developed assay that can rapidly diagnose active TB cases by direct detection of Mtb-derived antigens in patients' blood samples...
January 18, 2018: Clinical Chemistry
https://www.readbyqxmd.com/read/29347942/infant-and-child-mortality-in-relation-to-malaria-transmission-in-kemri-cdc-hdss-western-kenya-validation-of-verbal-autopsy
#14
Nyaguara O Amek, Annemieke Van Eijk, Kim A Lindblade, Mary Hamel, Nabie Bayoh, John Gimnig, Kayla F Laserson, Laurence Slutsker, Thomas Smith, Penelope Vounatsou
BACKGROUND: Malaria transmission reduction is a goal of many malaria control programmes. Little is known of how much mortality can be reduced by specific reductions in transmission. Verbal autopsy (VA) is widely used for estimating malaria specific mortality rates, but does not reliably distinguish malaria from other febrile illnesses. Overall malaria attributable mortality includes both direct and indirect deaths. It is unclear what proportion of the deaths averted by reducing malaria transmission are classified as malaria in VA...
January 18, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29347124/controllability-of-flow-conservation-networks
#15
Chen Zhao, An Zeng, Rui Jiang, Zhengzhong Yuan, Wen-Xu Wang
The ultimate goal of exploring complex networks is to control them. As such, controllability of complex networks has been intensively investigated. Despite recent advances in studying the impact of a network's topology on its controllability, a comprehensive understanding of the synergistic impact of network topology and dynamics on controllability is still lacking. Here, we explore the controllability of flow-conservation networks, trying to identify the minimal number of driver nodes that can guide the network to any desirable state...
July 2017: Physical Review. E
https://www.readbyqxmd.com/read/29346245/diagnostic-yield-and-safety-of-bronchoscopist-directed-moderate-sedation-with-a-bolus-dose-administration-of-propofol-during-endobronchial-ultrasound-bronchoscopy
#16
Danai Khemasuwan, Krittika Teerapuncharoen, David C Griffin
BACKGROUND: The propofol use for moderate sedation (MS) during endobronchial ultrasound (EBUS) bronchoscopy is primarily restricted for use by an anesthesiologist because of safety concerns. The goals of this study were to demonstrate the safety and the diagnostic yield of the use of propofol by bronchoscopists and trained endoscopy nurses during EBUS bronchoscopy without intubation. METHODS: We tested a bolus propofol administration protocol targeting MS for EBUS bronchoscopy...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29345985/cyp3a-activity-and-rivaroxaban-serum-concentrations-in-russian-patients-with-deep-vein-thrombosis
#17
Dmitriy Alexeyevich Sychev, Arshak Vardanyan, Aleksandr Rozhkov, Edita Hachatryan, Ani Badanyan, Valery Smirnov, Anna Ananichuk, Natalya Denisenko
BACKGROUND: Rivaroxaban is metabolized in the liver via CYP3A4, the cytochrome involved in the metabolism of nearly 50% of all medications. Thus, its effective concentration depends on multiple pharmacologic parameters. METHODS: The primary goal of our research was to study the correlation between the CYP3A family activity and the safety and efficacy of anticoagulant therapy with rivaroxaban in patients with deep vein thrombosis (DVT). Thirty one patients with DVT aged 21-83 years, 18 men and 13 women, received rivaroxaban (Xarelto) 30 mg/day for 21 days after diagnosis and 20 mg/day for the follow-up period of 6 months...
January 2018: Genetic Testing and Molecular Biomarkers
https://www.readbyqxmd.com/read/29345588/the-role-of-percutaneous-coronary-intervention-in-the-treatment-of-chronic-total-occlusions-rationale-and-review-of-the-literature
#18
Harsh Agrawal, Richard Lange, Ruben Montanez, Soma Wali, Khan Omar Mohammad, Subrata Kar, Mohamed Teleb, Debabrata Mukherjee
BACKGROUND: Chronic total occlusion (CTO) of a coronary artery is defined as an occluded segment with no antegrade flow and a known or estimated duration of at least 12 weeks. OBJECTIVE: We considered the current literature describing the indications and clinical outcomes for de-novo CTO- percutaneous coronary intervention (PCI), and discuss the role of CTO-PCI and future directions for this procedure. METHOD: Databases (PubMed, the Cochrane Library, Embase, EBSCO, Web of Science, and CINAHL were searched and relevant studies of CTO-PCI were selected for review...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29344982/experience-with-pharmacologic-leeching-with-bivalirudin-for-adjunct-treatment-of-venous-congestion-of-head-and-neck-reconstructive-flaps
#19
Aisha Harun, Rachel M Kruer, Andrew Lee, Kofi Boahene, Patrick J Byrne, Jeremy D Richmon
OBJECTIVES: The goal of this study was to review the feasibility of local bivalirudin injection for adjunct treatment of venous congestion of head and neck reconstructive flaps. METHODS: A retrospective chart review of patients who underwent bivalirudin treatment for venous congestion of head and neck reconstructive flaps in a single institution from September 1, 2012 to September 1, 2015 was undertaken. Individuals were treated with variable number of intradermal injections directly into the flap followed by a small skin incision to allow extended passive bleeding...
January 18, 2018: Microsurgery
https://www.readbyqxmd.com/read/29344522/intraductal-papillary-mucinous-neoplasms-of-the-pancreas-strategic-considerations
#20
Vicente Morales-Oyarvide, Zhi Ven Fong, Carlos Fernández-Del Castillo, Andrew L Warshaw
Intraductal papillary mucinous neoplasms (IPMN) are cystic neoplasms with the potential for progression to pancreatic cancer. Recognized by the global medical community just over two decades ago, IPMN have gained great epidemiological and clinical relevance thanks to the widespread use of cross-sectional abdominal imaging, which has led to a surge in the number of incidental pancreatic cysts being diagnosed. As our understanding of this disease has improved, we now know that some IPMN have a very elevated risk of cancer and require surgical resection, while others are low-risk lesions and can be followed...
December 2017: Visceral Medicine
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