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https://www.readbyqxmd.com/read/28538650/consequences-of-pediatric-undertriage-and-overtriage-in-a-statewide-trauma-system
#1
Hilary A Hewes, Mathew Christensen, Peter P Taillac, N Clay Mann, Kammy K Jacobsen, Stephen J Fenton
BACKGROUND: With increasing attention to the quality of health care delivery, evaluating trauma triage decisions in a large system of emergency care can help decision makers reduce mortality, morbidity, unnecessary transfers, and healthcare costs. OBJECTIVES: To quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system. METHODS: A statewide population-based evaluation of pediatric trauma outcomes and secondary triage (interfacility transfers) patterns from 2001-2013 among 45 hospitals in Utah's statewide trauma system...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538602/pelvic-organ-prolapse-does-hormone-therapy-use-matter
#2
Erika J Wasenda, Ixora Kamisan Atan, Nishamini Subramaniam, Hans Peter Dietz
OBJECTIVE: To determine the effect of hormone therapy (HT) use on pelvic organ support. METHODS: A retrospective observational study involving postmenopausal women with pelvic floor dysfunction attending a tertiary urogynecology center between January 2012 and March 2015. All underwent a clinical examination including International Continence Society Pelvic Organ Prolapse Quantification and 4D translabial ultrasound imaging. Information on current or former use of systemic HT and current local estrogen use was collected...
May 22, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28538044/mycobacterium-chimaera-infections-associated-with-heater-cooler-units-in-cardiac-surgery
#3
Peter W Schreiber, Hugo Sax
PURPOSE OF REVIEW: Mycobacterium chimaera infections following cardiac surgery have been reported from an increasing number of countries. These infections are characterized by a poor prognosis with a case fatality rate around 50% despite treatment. Since the first description in 2013, our understanding has grown steadily. Several outbreak investigations, case series, and experiments with heater-cooler units (HCUs) have been published. This review summarizes the current knowledge. RECENT FINDINGS: M...
May 19, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28537786/designing-a-community-based-population-health-model
#4
Christopher J Durovich, Peter W Roberts
The pace of change from volume-based to value-based payment in health care varies dramatically among markets. Regardless of the ultimate disposition of the Affordable Care Act, employers and public-private payers will continue to increase pressure on health care providers to assume financial risk for populations in the form of shared savings, bundled payments, downside risk, or even capitation. This article outlines a suggested road map and practical considerations for health systems that are building or planning to build population health capabilities to meet the needs of their local markets...
May 24, 2017: Population Health Management
https://www.readbyqxmd.com/read/28535473/length-effect-of-methoxy-poly-ethylene-oxide-b-poly-%C3%AE%C2%B5-caprolactone-g-poly-methacrylic-acid-copolymers-on-cisplatin-delivery
#5
Hsuan-Ying Chen, Yu-Lun Lo, Pei-Ling Wu, Pei-Chi Lo, Li-Fang Wang
Novel comb-shaped amphiphilic copolymers based on methoxy poly(ethylene glycol)-b-[poly(ε-caprolactone)-g-poly(methacrylic acid)] (MPCL-g-pMAA), were synthesized via ring opening polymerization (ROP) and atom transfer radical polymerization (ATRP) for drug delivery systems. MPCL-g-pMAAs with various MAA repeating units self-assemble into a core-shell structure in an aqueous solution. Critical aggregation concentrations range within 5.6×10(-3)-7.0×10(-2)mg/mL in double deionized water and 8.9×10(-3)-7.0×10(-2)mg/mL in phosphate buffered saline of pH 7...
May 12, 2017: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/28535347/preparation-and-characterization-of-protein-loaded-electrospun-fiber-mat-and-its-release-kinetics
#6
Peng Wen, Yan Wen, Xiao Huang, Minhua Zong, Hong Wu
For the enhancement of protein's bioavailability, a specific delivery system was developed by coaxial electrospinning. Bovine serum albumin (BSA) was used as protein model and the core-sheath fiber mat was fabricated using sodium alginate as shell layer and the BSA-loaded chitosan nanoparticle that prepared previously as core layer. By optimizing electrospinning parameters, uniform fibers with diameters ranging from 200 nm to 600 nm were obtained, and transmission electron microscopy and confocal laser scanning microscopy revealed its core-sheath structure...
May 23, 2017: Journal of Agricultural and Food Chemistry
https://www.readbyqxmd.com/read/28535343/tuning-adsorption-duration-to-control-the-diffusion-of-a-nanoparticle-in-adsorbing-polymers
#7
Xuezheng Cao, Holger Merlitz, Chen-Xu Wu
Controlling the nanoparticle (NP) diffusion in polymers is a prerequisite to obtain polymer nanocomposites (PNCs) with desired dynamical and rheological properties, and to achieve targeted delivery of nanomedicine in biological systems. Here we determinate the suppression mechanism of direct NP-polymer attraction to hamper the NP mobility in adsorbing polymers, and then quantify the dependence of the effective viscosity \eta_{eff} felt by the NP on the adsorption duration \tau_{ads} of polymers on the NP, using scaling theory analysis and molecular dynamics (MD) simulations...
May 23, 2017: Journal of Physical Chemistry Letters
https://www.readbyqxmd.com/read/28535026/tetanus-%C3%A2-n%C3%A3-stan-bortgl%C3%A3-md-men-allvarlig-sjukdom-%C3%A3-ldre-kvinnor-%C3%A3-r-en-riskgrupp-diagnosen-kan-vara-en-utmaning
#8
Bernhard Hozgraefe, Akad Koria, Victoria Sem, Joak Johansson
Tetanus, an almost forgotten but serious disease Tetanus is the systemic consequence of a local infection with Clostridium tetani, that produces toxin which spreads in the systemic circulation. In developed countries, it is extremely rare. Women born before 1950 are a group at risk due to lower prevalence of immunisation. This report describes a case of tetanus. The patient is a previously healthy 82-year-old woman. She presented to primary care with a complaint of stiffness in the neck and jaw. A physical exam and basic laboratory tests were normal apart from a slightly increased blood pressure...
May 22, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28534875/dose-dependent-social-cognitive-effects-of-intranasal-oxytocin-delivered-with-novel-breath-powered-device-in-adults-with-autism-spectrum-disorder-a-randomized-placebo-controlled-double-blind-crossover-trial
#9
D S Quintana, L T Westlye, S Hope, T Nærland, T Elvsåshagen, E Dørum, Ø Rustan, M Valstad, L Rezvaya, H Lishaugen, E Stensønes, S Yaqub, K T Smerud, R A Mahmoud, P G Djupesland, O A Andreassen
The neuropeptide oxytocin has shown promise as a treatment for symptoms of autism spectrum disorders (ASD). However, clinical research progress has been hampered by a poor understanding of oxytocin's dose-response and sub-optimal intranasal delivery methods. We examined two doses of oxytocin delivered using a novel Breath Powered intranasal delivery device designed to improve direct nose-to-brain activity in a double-blind, crossover, randomized, placebo-controlled trial. In a randomized sequence of single-dose sessions, 17 male adults with ASD received 8 international units (IU) oxytocin, 24IU oxytocin or placebo followed by four social-cognitive tasks...
May 23, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28534827/optimizing-prednisolone-loading-into-distiller-s-dried-grain-kafirin-microparticles-and-in-vitro-release-for-oral-delivery
#10
Esther T L Lau, Stuart K Johnson, Barbara A Williams, Deirdre Mikkelsen, Elizabeth McCourt, Roger A Stanley, Ram Mereddy, Peter J Halley, Kathryn J Steadman
Kafirin microparticles have potential as colon-targeted delivery systems because of their ability to protect encapsulated material from digestive processes of the upper gastrointestinal tract (GIT). The aim was to optimize prednisolone loading into kafirin microparticles, and investigate their potential as an oral delivery system. Response surface methodology (RSM) was used to predict the optimal formulation of prednisolone loaded microparticles. Prednisolone release from the microparticles was measured in simulated conditions of the GIT...
May 19, 2017: Pharmaceutics
https://www.readbyqxmd.com/read/28534813/synthesis-and-characterization-of-dual-sensitive-fluorescent-nanogels-for-enhancing-drug-delivery-and-tracking-intracellular-drug-delivery
#11
Szu-Yuan Wu, Tilahun Ayane Debele, Yu-Chih Kao, Hsieh-Chih Tsai
Here, dual-sensitive fluorescent branched alginate-polyethyleneimine copolymer (bAPSC) nanogels were synthesized from thiolated alginate and stearoyl-derivatized branched polyethyleneimine. The formation of bAPSC conjugates was confirmed through proton nuclear magnetic resonance and Fourier transform infrared spectroscopy, whereas dynamic light scattering was used to measure the particle size and ζ potential of the nanogels. The fluorescent properties of the nanogels were confirmed through fluorescent spectroscopy and microscopy...
May 19, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28534298/formulation-and-in-vitro-characterization-of-bioactive-mesoporous-silica-with-doxorubicin-and-metronidazole-intended-for-bone-treatment-and-regeneration
#12
Katarzyna Czarnobaj, Magdalena Prokopowicz, Wiesław Sawicki
The purpose of this study was to evaluate the surface mineralization activity and in vitro drug behavior potential of two forms of mesoporous silica: powder and granulate. Ordered mesoporous SiO2 powder was synthesized by surfactant-assisted sol-gel process using tetraethoxysilane as a silica precursor and hexadecyltrimethylammonium bromide as the structure-directing agent. The granulate was prepared using silica powder and ethyl cellulose as a binding agent. Metronidazole (MT)-an anti-inflammatory substance and doxorubicin hydrochloride (ChD)-an anti-cancer drug were chosen as drug models for delivery studies...
May 22, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28534287/loading-with-vancomycin-does-not-decrease-gentamicin-elution-in-gentamicin-premixed-bone-cement
#13
Sebastian P Boelch, Martin C Jordan, Joerg Arnholdt, Maximilian Rudert, Martin Luedemann, Andre F Steinert
Antibiotic loaded bone cements are used as drug delivery systems for the treatment of periprosthetic joint infections. They can be loaded with antibiotics during industrial component production (premixing) and during cement preparation (manually blending). Although double premixed antibiotic loaded bone cements are available, manually blending of a gentamicin premixed antibiotic loaded bone cement with vancomycin is still popular. We compared in vitro antibiotic elution and compressive strength of 0.5 g gentamicin premixed bone cement (PALACOS® R + G), 0...
July 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28534285/development-of-self-forming-doxorubicin-loaded-polymeric-depots-as-an-injectable-drug-delivery-system-for-liver-cancer-chemotherapy
#14
Pinunta Nittayacharn, Norased Nasongkla
The objective of this work was to develop self-forming doxorubicin-loaded polymeric depots as an injectable drug delivery system for liver cancer chemotherapy and studied the release profiles of doxorubicin (Dox) from different depot formulations. Tri-block copolymers of poly(ε-caprolactone), poly(D,L-lactide) and poly(ethylene glycol) named PLECs were successfully used as a biodegradable material to encapsulate Dox as the injectable local drug delivery system. Depot formation and encapsulation efficiency of these depots were evaluated...
July 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28534199/leveraging-the-u-s-criminal-justice-system-to-access-women-for-hiv-interventions
#15
REVIEW
Jaimie P Meyer, Dharushana Muthulingam, Nabila El-Bassel, Frederick L Altice
The criminal justice (CJ) system can be leveraged to access women for HIV prevention and treatment programs. Research is lacking on effective implementation strategies tailored to the specific needs of CJ-involved women. We conducted a scoping review of published studies in English from the United States that described HIV interventions, involved women or girls, and used the CJ system as an access point for sampling or intervention delivery. We identified 350 studies and synthesized data from 42 unique interventions, based in closed (n = 26), community (n = 7), or multiple/other CJ settings (n = 9)...
May 22, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28533751/docetaxel-loaded-nanoparticles-assembled-from-%C3%AE-cyclodextrin-calixarene-giant-surfactants-physicochemical-properties-and-cytotoxic-effect-in-prostate-cancer-and-glioblastoma-cells
#16
Laura Gallego-Yerga, Inmaculada Posadas, Cristina de la Torre, Jesús Ruiz-Almansa, Francesco Sansone, Carmen Ortiz Mellet, Alessandro Casnati, José M García Fernández, Valentín Ceña
Giant amphiphiles encompassing a hydrophilic β-cyclodextrin (βCD) component and a hydrophobic calix[4]arene (CA4) module undergo self-assembly in aqueous media to afford core-shell nanospheres or nanocapsules, depending on the nanoprecipitation protocol, with high docetaxel (DTX) loading capacity. The blank and loaded nanoparticles have been fully characterized by dynamic light scattering (DLS), ζ-potential measurements and cryo-transmission electron microscopy (cryo-TEM). The data are compatible with the distribution of the drug between the nanoparticle core and the shell, where it is probably anchored by inclusion of the DTX aromatic moieties in βCD cavities...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28533698/use-of-the-medicare-database-in-epidemiologic-and-health-services-research-a-valuable-source-of-real-world-evidence-on-the-older-and-disabled-populations-in-the-us
#17
REVIEW
Katherine E Mues, Alexander Liede, Jiannong Liu, James B Wetmore, Rebecca Zaha, Brian D Bradbury, Allan J Collins, David T Gilbertson
Medicare is the federal health insurance program for individuals in the US who are aged ≥65 years, select individuals with disabilities aged <65 years, and individuals with end-stage renal disease. The Centers for Medicare and Medicaid Services grants researchers access to Medicare administrative claims databases for epidemiologic and health outcomes research. The data cover beneficiaries' encounters with the health care system and receipt of therapeutic interventions, including medications, procedures, and services...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28533314/exercise-metabolism-fuels-for-the-fire
#18
Mark Hargreaves, Lawrence L Spriet
During exercise, the supply of adenosine triphosphate (ATP) is essential for the energy-dependent processes that underpin ongoing contractile activity. These pathways involve both substrate-level phosphorylation, without any need for oxygen, and oxidative phosphorylation that is critically dependent on oxygen delivery to contracting skeletal muscle by the respiratory and cardiovascular systems and on the supply of reducing equivalents from the degradation of carbohydrate, fat, and, to a limited extent, protein fuel stores...
May 22, 2017: Cold Spring Harbor Perspectives in Medicine
https://www.readbyqxmd.com/read/28533126/sonodynamic-therapy-combined-with-novel-anti-cancer-agents-sanguinarine-and-ginger-root-extract-synergistic-increase-in-toxicity-in-the-presence-of-panc-1-cells-in-vitro
#19
Matthew Prescott, James Mitchell, Stella Totti, Judy Lee, Eirini Velliou, Madeleine Bussemaker
The presence of ultrasound-induced cavitation in sonodynamic therapy (SDT) treatments has previously enhanced the activity and delivery of certain sonosensitisers in biological systems. The purpose of this work was to investigate the potential for two novel anti-cancer agents from natural derivatives, sanguinarine and ginger root extract (GRE), as sonosensitisers in an SDT treatment with in vitro PANC-1 cells. Both anti-cancer compounds had a dose-dependent cytotoxicity in the presence of PANC-1 cells. A range of six discreet ultrasound power-frequency configurations were tested and it was found that the cell death caused directly by ultrasound was likely due to the sonomechanical effects of cavitation...
May 13, 2017: Ultrasonics Sonochemistry
https://www.readbyqxmd.com/read/28532943/evaluation-of-preloaded-intraocular-lens-injection-systems-ex%C3%A2-vivo-study
#20
Mayank A Nanavaty, Magdalena Kubrak-Kisza
PURPOSE: To compare preloaded intraocular lens (IOL) injection systems. SETTING: Sussex Eye Hospital, Brighton, United Kingdom. DESIGN: Experimental study. METHODS: In 30 porcine eyes, 5 preloaded +22.0 diopters IOLs were implanted from each of the following preloaded IOL systems: Ultrasert (U), iTec (iT), Eyecee (E), iSert (iS), Rayone (R), and CT Lucia (CT). External and internal wound size was measured. Nozzle damage was assessed using digital photography...
April 2017: Journal of Cataract and Refractive Surgery
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