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https://www.readbyqxmd.com/read/28107771/a-prospective-study-of-maternal-fetal-and-neonatal-outcomes-in-the-setting-of-cesarean-section-in-low-and-middle-income-countries
#1
Margo S Harrison, Omrana Pasha, Sarah Saleem, Sumera Ali, Elwyn Chomba, Waldemar A Carlo, Ana L Garces, Nancy F Krebs, K Michael Hambidge, Shivaprasad S Goudar, Bhala Kodkany, Sangappa Dhaded, Richard J Derman, Archana Patel, Patricia L Hibberd, Fabian Esamai, Edward A Liechty, Janet L Moore, Dennis Wallace, Elizabeth M McClure, Menachem Miodovnik, Marion Koso-Thomas, Jose Belizan, Robert L Goldenberg
Cesarean section (CS) rates are increasing globally with an unclear effect on pregnancy outcomes. The study objective was to quantify maternal and perinatal morbidity and mortality in low- and middle-income countries associated with CS compared to vaginal delivery (VD) both within and across sites MATERIAL AND METHODS: A prospective population-based study including home and facility births in 337,153 women with a VD and 47,308 women with a CS from 2010 to 2015 was performed in Guatemala, India, Kenya, Pakistan, Zambia, and Democratic Republic of Congo...
January 20, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28107762/thulium-laser-in-interventional-endoscopy-animal-and-human-studies
#2
Gian E Tontini, Helmut Neumann, Luca Pastorelli, Luisa Spina, Flaminia Cavallaro, Paola Soriani, Alessandro Rimondi, Barbara Bruni, Claudio Clemente, Filippo Fagnani, Pavlos Lagoussis, Luca Carmignani, Maurizio Vecchi
Background and study aims The thulium laser system (TLS) is an emerging surgical tool. The 2-μm wavelength provides a confined coagulation depth (0.2 - 0.4 mm) to reduce the potential for inadvertent injuries. For the first time ever, we assessed TLS feasibility for endoscopic hemostasis ex vivo in pigs. In addition, we performed the first in vivo hemostatic treatments in humans. Patients and methods Tissue damage induced by TLS using different settings and optical fibers was compared to that from argon plasma coagulation (APC) in established ex vivo animal models...
January 20, 2017: Endoscopy
https://www.readbyqxmd.com/read/28107761/pre-emptive-endoscopic-vacuum-therapy-for-treatment-of-anastomotic-ischemia-after-esophageal-resections
#3
Philipp-Alexander Neumann, Rudolf Mennigen, Daniel Palmes, Norbert Senninger, Thorsten Vowinkel, Mike G Laukoetter
Background and study aims Endoscopic vacuum therapy (EVT) is a promising new approach for the treatment of anastomotic leakage in the gastrointestinal tract. Here, we present the first case series demonstrating successful use of EVT for the treatment of post-esophagectomy anastomotic ischemia prior to development of leakage. Patients and methods Between 2012 and 2015, intraluminal EVT was performed in eight patients with anastomotic ischemia following esophagectomy. The primary outcome measure was successful mucosal recovery...
January 20, 2017: Endoscopy
https://www.readbyqxmd.com/read/28107662/a-simple-and-powerful-co-delivery-system-based-on-ph-responsive-metal-organic-frameworks-for-enhanced-cancer-immunotherapy
#4
Fei Duan, Xiaochen Feng, Xinjian Yang, Wentong Sun, Yi Jin, Huifang Liu, Kun Ge, Zhenhua Li, Jinchao Zhang
Tumor-associated antigens (TAAs)-loaded nanoparticles are able to be actively internalized by antigen-presenting cells (APCs) and have shown promising potential in cancer immunotherapy. However, current TAAs delivery strategy exhibits limitations of complicated synthesis process, low loading efficiency and inefficient CD8(+) cytotoxic T lymphocyte activation leading to unsatisfactory therapeutic effect. Thus, the construction of novel TAAs-delivery systems for enhanced cancer therapy is highly desirable. In this work, we fabricated a very simple yet powerful antigens-delivery system for cancer immunotherapy based-on pH-responsive metal-organic frameworks (MOFs) with size about 30 nm...
January 11, 2017: Biomaterials
https://www.readbyqxmd.com/read/28107603/desmopressin-octostim%C3%A2-before-a-native-kidney-biopsy-can-reduce-the-risk-for-biopsy-complications-in-patients-with-impaired-renal-function-a-pilot-study
#5
Björn Peters, Henrik Hadimeri, Johan Mölne, Salmir Nasic, Gert Jensen, Bernd Stegmayr
AIM: To evaluate if the administration of desmopressin alters the risk for renal biopsy complications. METHODS: A multicenter registry containing 576 native kidney biopsies (NKb) with a serum creatinine above 150 µmol/L in 527 patients (372 men and 155 women, median age 61 years) was used. Most of the data were prospective. At one of the hospitals all biopsies with creatinine above 150 µmol/L received desmopressin before biopsies (NKb 204). These were compared to outcome of biopsy complications against other centres where desmopressin was not given (NKb 372)...
January 20, 2017: Nephrology
https://www.readbyqxmd.com/read/28107594/weighing-the-evidence-from-surgical-trials
#6
Quoc-Dien Trinh, Alexander P Cole, Prokar Dasgupta
With growing calls to improve value in health care, the assessment of surgical outcomes has moved to the spotlight. Public awareness of medical errors has spurred initiatives like the ProPublica "Surgeon Scorecard" to measure and report complications (h t t p s : //projects. propublica. org/surgeons/). High-tech and expensive innovations such as robot-assisted surgery must be measured against traditional approaches. This article is protected by copyright. All rights reserved.
January 20, 2017: BJU International
https://www.readbyqxmd.com/read/28107554/inclusion-of-a-variable-rbe-into-proton-and-photon-plan-comparison-for-various-fractionation-schedules-in-prostate-radiation-therapy
#7
Jakob Ödén, Kjell Eriksson, Iuliana Toma-Dasu
PURPOSE: A constant relative biological effectiveness (RBE) of 1.1 is currently used in proton radiation therapy to account for the increased biological effectiveness compared to photon therapy. However, there is increasing evidence that proton RBE vary with the linear energy transfer (LET), the dose per fraction and the type of the tissue. Therefore, this study aims to evaluate the impact of disregarding variations in RBE when comparing proton and photon dose plans for prostate treatments for various fractionation schedules using published RBE models and several α/β assumptions...
January 20, 2017: Medical Physics
https://www.readbyqxmd.com/read/28107510/effect-of-the-crystal-environment-on-side-chain-conformational-dynamics-in-cyanovirin-n-investigated-through-crystal-and-solution-molecular-dynamics-simulations
#8
Logan S Ahlstrom, Ivan I Vorontsov, Jun Shi, Osamu Miyashita
Side chains in protein crystal structures are essential for understanding biochemical processes such as catalysis and molecular recognition. However, crystal packing could influence side-chain conformation and dynamics, thus complicating functional interpretations of available experimental structures. Here we investigate the effect of crystal packing on side-chain conformational dynamics with crystal and solution molecular dynamics simulations using Cyanovirin-N as a model system. Side-chain ensembles for solvent-exposed residues obtained from simulation largely reflect the conformations observed in the X-ray structure...
2017: PloS One
https://www.readbyqxmd.com/read/28107485/better-visual-outcome-by-intraocular-lens-ejection-in-geriatric-patients-with-ruptured-ocular-injuries
#9
Hiroki Kaneko, Tetsu Asami, Tadasu Sugita, Taichi Tsunekawa, Toshiyuki Matsuura, Kei Takayama, Kentaro Yamamoto, Shu Kachi, Yasuki Ito, Shinji Ueno, Norie Nonobe, Keiko Kataoka, Ayana Suzumura, Takeshi Iwase, Hiroko Terasaki
Ocular trauma is one of the leading causes of visual impairment worldwide. Because of the popularity of cataract surgeries, aged individuals with ocular trauma commonly have a surgical wound in their eyes. The purpose of this study was to evaluate the visual outcome of cases that were coincident with intraocular lens (IOL) ejection in the eyes with ruptured open-globe ocular injuries. Consecutive patients with open-globe ocular injuries were first reviewed. Patients' characteristics, corrected distance visual acuities (CDVAs) over 3 years after the trauma, causes of injuries, traumatic wound patterns, and coexistence of retinal detachment were examined...
2017: PloS One
https://www.readbyqxmd.com/read/28107484/resveratrol-co-treatment-attenuates-the-effects-of-hiv-protease-inhibitors-on-rat-body-weight-and-enhances-cardiac-mitochondrial-respiration
#10
Burger Symington, Rudo F Mapanga, Gavin R Norton, M Faadiel Essop
Since the early 1990s human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) emerged as a global health pandemic, with sub-Saharan Africa the hardest hit. While the successful roll-out of antiretroviral (ARV) therapy provided significant relief to HIV-positive individuals, such treatment can also elicit damaging side-effects. Here especially HIV protease inhibitors (PIs) are implicated in the onset of cardio-metabolic complications such as type-2 diabetes and coronary heart disease. As there is a paucity of data regarding suitable co-treatments within this context, this preclinical study investigated whether resveratrol (RSV), aspirin (ASP) or vitamin C (VitC) co-treatment is able to blunt side-effects in a rat model of chronic PI exposure (Lopinavir/Ritonavir treatment for 4 months)...
2017: PloS One
https://www.readbyqxmd.com/read/28107430/discontinuation-from-antiretroviral-therapy-a-continuing-challenge-among-adults-in-hiv-care-in-ethiopia-a-systematic-review-and-meta-analysis
#11
Hailay Abrha Gesesew, Paul Ward, Kifle Woldemichael Hajito, Garumma Tolu Feyissa, Leila Mohammadi, Lillian Mwanri
BACKGROUND: Discontinuation of antiretroviral therapy (ART) reduces the immunological benefit of treatment and increases complications related to human immune-deficiency virus (HIV). However, the risk factors for ART discontinuation are poorly understood in developing countries particularly in Ethiopia. This review aimed to assess the best available evidence regarding risk factors for ART discontinuation in Ethiopia. METHODS: Quantitative studies conducted in Ethiopia between 2002 and 2015 that evaluated factors associated with ART discontinuation were sought across six major databases...
2017: PloS One
https://www.readbyqxmd.com/read/28107388/factors-moderating-the-relationship-between-childhood-trauma-and-premorbid-adjustment-in-first-episode-schizophrenia
#12
S Kilian, J K Burns, S Seedat, L Asmal, B Chiliza, S Du Plessis, M R Olivier, M Kidd, R Emsley
Childhood trauma is a recognised risk factor for schizophrenia. It has been proposed that childhood trauma interferes with normal neurodevelopment, thereby establishing a biological vulnerability to schizophrenia. Poor premorbid adjustment is frequently a precursor to schizophrenia, and may be a manifestation of neurodevelopmental compromise. We investigated the relationship between childhood trauma and premorbid adjustment in 77 patients with first-episode schizophrenia spectrum disorders. We also investigated possible mediating roles for other selected risk factors in the relationship...
2017: PloS One
https://www.readbyqxmd.com/read/28107373/dexmedetomidine-versus-midazolam-in-procedural-sedation-a-systematic-review-of-efficacy-and-safety
#13
Clemens R M Barends, Anthony Absalom, Baucke van Minnen, Arjan Vissink, Anita Visser
OBJECTIVES: To systematically review the literature comparing the efficacy and safety of dexmedetomidine and midazolam when used for procedural sedation. MATERIALS AND METHODS: We searched MEDLINE, EMBASE and COCHRANE for clinical trials comparing dexmedetomidine and midazolam for procedural sedation up to June 20, 2016. Inclusion criteria: clinical trial, human subjects, adult subjects (≥18 years), article written in English, German, French or Dutch, use of study medication for conscious sedation and at least one group receiving dexmedetomidine and one group receiving midazolam...
2017: PloS One
https://www.readbyqxmd.com/read/28107366/comparative-analysis-of-direct-hospital-care-costs-between-aseptic-and-two-stage-septic-knee-revision
#14
Richard Kasch, Sebastian Merk, Grit Assmann, Andreas Lahm, Matthias Napp, Harry Merk, Steffen Flessa
BACKGROUND: The most common intermediate and long-term complications of total knee arthroplasty (TKA) include aseptic and septic failure of prosthetic joints. These complications cause suffering, and their management is expensive. In the future the number of revision TKA will increase, which involves a greater financial burden. Little concrete data about direct costs for aseptic and two-stage septic knee revisions with an in depth-analysis of septic explantation and implantation is available...
2017: PloS One
https://www.readbyqxmd.com/read/28107340/association-of-diabetes-related-complications-with-heart-rate-variability-among-a-diabetic-population-in-the-uae
#15
Ahsan H Khandoker, Haitham M Al-Angari, Kinda Khalaf, Sungmun Lee, Wael Almahmeed, Habiba S Al Safar, Herbert F Jelinek
Microvascular, macrovascular and neurological complications are the key causes of morbidity and mortality among type II diabetes mellitus (T2DM) patients. The aim of this study was to investigate the alterations of cardiac autonomic function of diabetic patients in relation to three types of diabetes-related complications. ECG recordings were collected and analyzed from 169 T2DM patients in supine position who were diagnosed with nephropathy (n = 55), peripheral neuropathy (n = 64) and retinopathy (n = 106) at two hospitals in the UAE...
2017: PloS One
https://www.readbyqxmd.com/read/28107317/photography-in-telemedicine-improving-diagnosis-of-chronic-graft-versus-host-disease%C3%A2
#16
Brianna Busby, Shannon Campbell, Rachel Cole, Charisse DeVries, Kamille Dobbins, Mary Beth Trimble, Mihkaila Wickline
BACKGROUND: The long-term follow-up (LTFU) team at the Seattle Cancer Care Alliance uses telemedicine to diagnose and treat post-transplantation complications in hematopoietic cell transplantation (HCT) survivors. Photos are often requested via the telemedicine service to aid in diagnosis, but they are typically of poor quality, making them unusable.
. OBJECTIVES: This project offered bachelor of science in nursing students, partnered with a comprehensive cancer center, the opportunity to participate in an evidence-based practice project to improve detection and management of chronic graft-versus-host disease (cGVHD) in patients after HCT...
February 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28107309/-delay-to-operating-room-fails-to-identify-adverse-outcomes-at-a-level-i-trauma-center
#17
Paul R Lewis, Jayraan Badiee, Michael J Sise, Richard Y Calvo, Jason B Brill, James D Wallace, Steven R Shackford, Casey E Dunne, Vishal Bansal, C Beth Sise
BACKGROUND: The American College of Surgeons Committee on Trauma devised process audit filters to identify opportunities for improvement (OFI), prevent adverse outcomes, and improve quality. Delay to the operating room for primary trauma laparotomy is a process audit filter that has not been definitively associated with improved outcomes. We sought to evaluate the effectiveness of delay to the operating room of greater than 2 hours (DOR) to independently identify an adverse outcome or an OFI at our Level I trauma center...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28107272/perimembranous-ventricular-septal-defect-complicated-by-aorto-right-ventricular-fistula-the-role-of-multimodal-echocardiography
#18
Lachlan F Miles, Daniel Banyasz, Shoane Ip, George Matalanis
No abstract text is available yet for this article.
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28107267/the-prevalence-of-the-complications-and-their-associated-factors-in-humeral-lengthening-for-achondroplasia-retrospective-study-of-54-cases
#19
Natsuko Nakano-Matsuoka, Kenichi Fukiage, Yuki Harada, Naoya Kashiwagi, Tohru Futami
The aim of this study is to evaluate the complications of humeral lengthening and their associated factors. Fifty-four achondroplastic patients were treated by bilateral humeral lengthening. Our original shoulder sling was sufficient to prevent shoulder dislocation. Pre-existing radial head dislocation was observed in 18 patients. Lengthening was accomplished in all cases without a decrease in the elbow function. Seven humeri fractured after the fixator removal. The risk factors for postoperative fracture were a waiting period of less than 5 days, a healing index less than 25, and the concave shape of the callus...
January 19, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28107243/robotic-guidance-for-s2-alar-iliac-screws-in-spinal-deformity-correction
#20
S Samuel Bederman, Peter Hahn, Vincent Colin, P Douglas Kiester, Nitin N Bhatia
STUDY DESIGN: A retrospective cohort study of patients who underwent S2-alar-iliac (S2AI) screw insertion using robotic guidance in long constructs for spinal deformity correction extending to the sacrum performed at a single institution. OBJECTIVE: To assess and evaluate the feasibility and accuracy of robotic guidance for S2AI screw insertion. SUMMARY OF BACKGROUND DATA: Pelvic fixation has become a common adjunct to long fusions extending to the sacrum...
February 2017: Clinical Spine Surgery
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