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Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
Tim Mitchell, Hannah Gooding, Cathy Mews, Leon Adams, Gerry MacQuillan, George Garas, Madhur Ravikumara, Ainslie Lopez, Megan Collins, Gary Jeffrey
Transition to adult care is a vulnerable period for pediatric transplant recipients and is associated with reduced medication compliance, graft loss, and increased mortality. Psychosocial outcomes in young adults differ between pediatric transplant recipients and their healthy peers. We conducted a single-center, retrospective cohort study of all pediatric liver transplant recipients who were transitioned through our center. This study aimed to assess the outcomes of transitioned pediatric liver transplant recipients at an Australian center, including mortality, adherence, and psychosocial morbidity...
October 20, 2016: Pediatric Transplantation
Markus Hoffmann, Asita Fazel, Kai-Gerrit Mews, Petra Ambrosch
OBJECTIVES: To underline the value of the microendoscopic CO2 -Laser assisted treatment (MEDCO2 ) of Zenker's diverticulum by investigating a large patient cohort treated in a single medical center. DESIGN: Retrospective Cohort Study of consecutive patients. SETTING: Dept. of Otorhinolaryngology, Head & Neck Surgery, Christian-Albrechts-University Kiel, Germany. PARTICIPANTS: 227 patients with Zenkers' diverticulum were treated by MEDCO2 and the results were compared with those reported in the literature for the open transcervical approach (OTA) and the endoscopic staple-assisted esophagodiverticulostomy (ESED)...
October 19, 2016: Clinical Otolaryngology
Vanessa F Carvalho, Debora P de Lemos, Camila S Vieira, Amanda Migotto, Luciana B Lopes
In this study, non-aqueous microemulsions were developed because of the challenges associated with finding pharmaceutically acceptable solvents for topical delivery of drugs sparingly soluble in water. The formulation irritation potential and ability to modulate the penetration of lipophilic compounds (progesterone, α-tocopherol, and lycopene) of interest for topical treatment/prevention of skin disorders were evaluated and compared to solutions and aqueous microemulsions of similar composition. The microemulsions (ME) were developed with BRIJ, vitamin E-TPGS, and ethanol as surfactant-co-surfactant blend and tributyrin, isopropyl myristate, and oleic acid as oil phase...
October 18, 2016: AAPS PharmSciTech
Kristina Klaus, Susanne Fischer, Johanna M Doerr, Urs M Nater, Ricarda Mewes
PURPOSE: Fibromyalgia syndrome (FMS) is associated with psychological distress. The recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) raises the question of whether FMS is classifiable as "somatic symptom disorder" (SSD) and consequently as a mental disorder. To address this, the present ambulatory assessment study focuses on the everyday life occurrence of SSD symptoms in FMS and their predictive value concerning severity indicators of widespread pain...
October 18, 2016: International Journal of Behavioral Medicine
C A Arrell, J Ojeda, L Mewes, J Grilj, F Frassetto, L Poletto, F van Mourik, M Chergui
The laser-assisted photoelectric effect from liquid surfaces is reported for the first time. Photoelectrons generated by 35.6 eV radiation from a liquid microjet of water under vacuum are dressed with a ℏω=1.55  eV laser field. The subsequent redistribution of the photoelectron energies consists in the appearance of sidebands shifted by energies equivalent to ℏω, 2ℏω, and 3ℏω. The response has been modeled to the third order and combined with energy-resolved measurements. This result opens the possibility to investigate the dynamics at surfaces of liquid solutions and provide information about the electron emission process from a liquid...
September 30, 2016: Physical Review Letters
Ricarda Mewes, Lea Kowarsch, Hanna Reinacher, Urs M Nater
Introduction: The number of refugees and asylum seekers in Germany is high. Presumably, the need for psychotherapeutic care is high in this group. However, this need stands in contrast to a lack of a specialized and widespread provision of such care. Registered psychotherapists could help to partially reduce this gap. The present study aimed at learning more about the expected or experienced obstacles and opportunities of registered psychotherapists in regard to the psychotherapeutic treatment of asylum seekers in Germany...
September 2016: Psychotherapie, Psychosomatik, Medizinische Psychologie
Hannington Ssemmanda, Tonny Stone Luggya, Clare Lubulwa, Zeridah Muyinda, Pascal Kwitonda, Humphrey Wanzira, Joseph Ejoku
Background. Critical care in Uganda is a neglected speciality and deemed costly with limited funding/prioritization. We studied admission X-ray and MEWS as mortality predictors of ICU patients requiring mechanical ventilation. Materials and Methods. We did a cross-sectional study in Mulago Hospital ICU and 87 patients for mechanical ventilation were recruited with mortality as the outcome of interest. Chest X-ray results were the main independent variable and MEWS was also gotten for all patients. Results. We recruited 87 patients; most were males (60...
2016: Critical Care Research and Practice
Barbara DeVoe, Anita Roth, Gregory Maurer, Michal Tamuz, Martin Lesser, Renee Pekmezaris, Amgad N Makaryus, Alan Hartman, Paola DiMarzio
BACKGROUND: The Modified Early Warning Score (MEWS) helps identify patients experiencing a decline in physiological parameters that indicate risk for cardiac arrest (CA). OBJECTIVES: To assess the association between MEWS values and patient survival following in-hospital CA. METHODS: Retrospective cohort study of patients who experienced in-hospital CA. The relationship between CA survival and MEWS values as well as other risk factors such as age, gender and type of electrographic cardiac rhythms was analyzed using logistic regression...
October 1, 2016: Heart & Lung: the Journal of Critical Care
Thomas Desautels, Jacob Calvert, Jana Hoffman, Melissa Jay, Yaniv Kerem, Lisa Shieh, David Shimabukuro, Uli Chettipally, Mitchell D Feldman, Chris Barton, David J Wales, Ritankar Das
BACKGROUND: Sepsis is one of the leading causes of mortality in hospitalized patients. Despite this fact, a reliable means of predicting sepsis onset remains elusive. Early and accurate sepsis onset predictions could allow more aggressive and targeted therapy while maintaining antimicrobial stewardship. Existing detection methods suffer from low performance and often require time-consuming laboratory test results. OBJECTIVE: To study and validate a sepsis prediction method, InSight, for the new Sepsis-3 definitions in retrospective data, make predictions using a minimal set of variables from within the electronic health record data, compare the performance of this approach with existing scoring systems, and investigate the effects of data sparsity on InSight performance...
September 30, 2016: JMIR Medical Informatics
Tobias Kiefer, Torsten Diekhoff, Sandra Hermann, Andrea Stroux, Jürgen Mews, Jörg Blobel, Bernd Hamm, Kay-Geert A Hermann
OBJECTIVES: To investigate the diagnostic value of single-source dual-energy computed tomography (SDECT) in gouty arthritis and to compare its capability to detect urate depositions with digital radiography (DR) and conventional computed tomography (CT). METHODS: Forty-four patients who underwent SDECT volume scans of the feet for suspected gouty arthritis were retrospectively analyzed. SDECT, CT (both n=44) and DR (n=36) were scored by three blinded readers for presence of osteoarthritis, erosions, and tophi...
October 2016: European Journal of Radiology
Matthew M Churpek, Ashley Snyder, Xuan Han, Sarah Sokol, Natasha Pettit, Michael D Howell, Dana P Edelson
RATIONALE: The 2016 definitions of sepsis included the quick Sepsis-related Organ Failure Assessment (qSOFA) score to identify high-risk patients outside the intensive care unit (ICU). OBJECTIVE: We sought to compare qSOFA to other commonly used early warning scores. METHODS: All admitted patients first meeting criteria for suspicion of infection in the emergency department (ED) or hospital wards from November 2008 until January 2016 were included...
September 20, 2016: American Journal of Respiratory and Critical Care Medicine
André Mewes, Bennet Hensen, Frank Wacker, Christian Hansen
PURPOSE: In this article, we systematically examine the current state of research of systems that focus on touchless human-computer interaction in operating rooms and interventional radiology suites. We further discuss the drawbacks of current solutions and underline promising technologies for future development. METHODS: A systematic literature search of scientific papers that deal with touchless control of medical software in the immediate environment of the operation room and interventional radiology suite was performed...
September 19, 2016: International Journal of Computer Assisted Radiology and Surgery
Qin Qin, Yiqin Xia, Yu Cao
OBJECTIVE: Shock, the most common severe emergency syndrome, has a complicated etiopathogenesis, is difficult to identify, progresses quickly, and is dangerous. Early identification and intervention play determining roles in the final outcomes of shock patients, but no specific scoring system for shock has been established to date. METHODS: We collected 292 shock patients and analyzed the correlation between 28-day prognosis and the Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II), Modified Early Warning System (MEWS), and Sequential Organ Failure Assessment scoring systems...
September 2, 2016: Journal of Critical Care
Roman Romero-Ortuno, Stephen Wallis, Richard Biram, Victoria Keevil
AIM: Frail individuals may be at higher risk of death from a given acute illness severity (AIS), but this relationship has not been studied in an English National Health Service (NHS) acute hospital setting. METHODS: This was a retrospective observational study in a large university NHS hospital in England. We analyzed all first non-elective inpatient episodes of people aged ≥75years (all specialties) between October 2014 and October 2015. Pre-admission frailty was assessed with the Clinical Frailty Scale (CFS) of the Canadian Study on Health & Aging, and AIS in the Emergency Department was measured with a Modified Early Warning Score (ED-MEWS<4 was considered as low acuity, and ED-MEWS≥4 as high acuity)...
September 2, 2016: European Journal of Internal Medicine
Louise S van Galen, Patricia W Struik, Babiche E J M Driesen, Hanneke Merten, Jeroen Ludikhuize, Johannes I van der Spoel, Mark H H Kramer, Prabath W B Nanayakkara
BACKGROUND: An unplanned ICU admission of an inpatient is a serious adverse event (SAE). So far, no in depth-study has been performed to systematically analyse the root causes of unplanned ICU-admissions. The primary aim of this study was to identify the healthcare worker-, organisational-, technical,- disease- and patient- related causes that contribute to acute unplanned ICU admissions from general wards using a Root-Cause Analysis Tool called PRISMA-medical. Although a Track and Trigger System (MEWS) was introduced in our hospital a few years ago, it was implemented without a clear protocol...
2016: PloS One
Felix Husslik, Jasmin Nürnberg, Christian Seutter von Loetzen, Timo Mews, Barbara K Ballmer-Weber, Jörg Kleine-Tebbe, Regina Treudler, Jan-Christoph Simon, Stefanie Randow, Elke Völker, Andreas Reuter, Paul Rösch, Stefan Vieths, Thomas Holzhauser, Dirk Schiller
BACKGROUND: Birch pollen-related soy allergy is mediated by Gly m 4. Conformational IgE epitopes of Gly m 4 are unknown. OBJECTIVE: To identify the IgE epitope profile of Gly m 4 in subjects with birch pollen-related soy allergy utilizing an epitope library presented by Gly m 4-type model proteins. METHODS: Sera from patients with (n = 26) and without (n = 19) allergy to soy as determined by oral provocation tests were studied...
August 17, 2016: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Kim Hinkelmann, Julian Hellmann-Regen, Katja Wingenfeld, Linn K Kuehl, Marie Mews, Juliane Fleischer, Isabella Heuser, Christian Otte
BACKGROUND: Many studies have shown disturbed glucocorticoid receptor (GR) in depressed patients. In contrast, only few studies targeted mineralocorticoid receptor (MR) function with inconclusive results. We examined the effects of the MR antagonist spironolactone on cortisol secretion in depressed patients and healthy individuals. METHODS: Forty-eight unmedicated depressed patients (mean age 41.6years) and 45 age- and sex-matched healthy participants (40.7years) received the MR antagonist spironolactone (300mg) or placebo with three days apart in a randomized, double-blind, within-subject cross-over design...
November 3, 2016: Progress in Neuro-psychopharmacology & Biological Psychiatry
Arun Singh, Klaus Mewes, Robert E Gross, Mahlon R DeLong, José A Obeso, Stella M Papa
Circuitry models of Parkinson's disease (PD) are based on striatal dopamine loss and aberrant striatal inputs into the basal ganglia network. However, extrastriatal mechanisms have increasingly been the focus of attention, whereas the status of striatal discharges in the parkinsonian human brain remains conjectural. We now report the activity pattern of striatal projection neurons (SPNs) in patients with PD undergoing deep brain stimulation surgery, compared with patients with essential tremor (ET) and isolated dystonia (ID)...
August 23, 2016: Proceedings of the National Academy of Sciences of the United States of America
Louise S van Galen, Casper C Dijkstra, Jeroen Ludikhuize, Mark H H Kramer, Prabath W B Nanayakkara
BACKGROUND: The Modified Early Warning Score (MEWS) was developed to timely recognise clinically deteriorating hospitalised patients. However, the ability of the MEWS in predicting serious adverse events (SAEs) in a general hospital population has not been examined prospectively. The aims were to (1) analyse protocol adherence to a MEWS protocol in a real-life setting and (2) to determine the predictive value of protocolised daily MEWS measurement on SAEs: death, cardiac arrests, ICU-admissions and readmissions...
2016: PloS One
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