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https://www.readbyqxmd.com/read/28647926/importance-of-gold-guidelines-for-chronic-obstructive-pulmonary-disease
#1
J Sadlonova, D Osinova, E Rozborilova, O Osina, E Novakova, V Sadlonova
In December 2011, a major revision of GOLD 2011 guidelines was published based on the evidence-based medicine. The goal of GOLD 2011 is to determine the severity of the disease, its impact on the patient's health, and the risk of future events; all of which eventually guide therapy. A combined COPD assessment according to GOLD 2011 considers the patient's level of symptoms, spirometry abnormalities, risk of exacerbation, and the presence of comorbidities. GOLD 2011 stratifies patients into four basic groups labeled A, B, C, and D...
June 25, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28647705/revolution-in-acute-ischaemic-stroke-care-a-practical-guide-to-mechanical-thrombectomy
#2
REVIEW
Matthew Evans, Phil White, Peter Cowley, David Werring
Rapid, safe and effective arterial recanalisation to restore blood flow and improve functional outcome remains the primary goal of hyperacute ischaemic stroke management. The benefit of intravenous thrombolysis with recombinant tissue-type plasminogen activator for patients with severe stroke due to large artery occlusion is limited; early recanalisation is generally less than 30% for carotid, proximal middle cerebral artery or basilar artery occlusion. Since November 2014, nine positive randomised controlled trials of mechanical thrombectomy for large vessel occlusion in the anterior circulation have led to a revolution in the care of patients with acute ischaemic stroke...
June 24, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28647655/face-content-and-construct-validity-of-an-aneurysm-clipping-model-using-human-placenta
#3
Evgenii Belykh, Eric J Miller, Ting Lei, Kristina Chapple, Vadim A Byvaltsev, Robert F Spetzler, Peter Nakaji, Mark C Preul
OBJECTIVE: Proficient open surgical treatment of cerebral aneurysms requires extensive training and practice. The goal of this study was to test the validity of a human placenta aneurysm model for surgical simulation training of aneurysm clipping. METHODS: Thirty participants were divided into 3 groups (n=10 per group) according to their neurosurgical experience: low experience, intermediate experience, and attending. Subjective measures were collected using the Aneurysm Clipping Participant Survey (n=27)...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28647356/optimizing-bone-morphogenic-protein-4-mediated-human-embryonic-stem-cell-differentiation-into-trophoblast-like-cells-using-fibroblast-growth-factor-2-and-transforming-growth-factor-%C3%AE-activin-nodal-signalling-inhibition
#4
Mariann Koel, Urmo Võsa, Kaarel Krjutškov, Elisabet Einarsdottir, Juha Kere, Juha Tapanainen, Shintaro Katayama, Sulev Ingerpuu, Viljar Jaks, Ulf-Hakan Stenman, Karolina Lundin, Timo Tuuri, Andres Salumets
Several studies have demonstrated that human embryonic stem cells (hESC) can be differentiated into trophoblast-like cells if exposed to bone morphogenic protein 4 (BMP4) and/or inhibitors of fibroblast growth factor 2 (FGF2) and the transforming growth factor beta (TGF-β)/activin/nodal signalling pathways. The goal of this study was to investigate how the inhibitors of these pathways improve the efficiency of hESC differentiation when compared with basic BMP4 treatment. RNA sequencing was used to analyse the effects of all possible inhibitor combinations on the differentiation of hESC into trophoblast-like cells over 12 days...
June 12, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28647255/influence-of-coagulation-mechanisms-and-floc-formation-on-filterability
#5
Ruyuan Jiao, Rolando Fabris, Christopher W K Chow, Mary Drikas, John van Leeuwen, Dongsheng Wang, Zhizhen Xu
Minimizing particles in water is a key goal for improving drinking water quality and safety. The media filtration process, as the last step of the solid-liquid separation process, is largely influenced by the characteristics of flocs, which are formed and controlled within the coagulation process. In a laboratory-based study, the impacts of the physical characteristics of flocs formed using aluminum sulfate on the filtration treatment of two comparative water samples were investigated using a photometric dispersion analyzer and a filterability apparatus...
July 2017: Journal of Environmental Sciences (China)
https://www.readbyqxmd.com/read/28646964/global-advocacy-needed-for-sepsis-in-children
#6
Sagar Dugani, Niranjan Kissoon
Sepsis in children is a complex syndrome that develops from various infections and results in 15-30% mortality in high-income countries and up to 50% or higher in low-income countries. Worldwide, this represents an annual burden of 30 million cases resulting in 8 million deaths. Not surprisingly, there is a significantly higher burden in low-income countries with children there being 18 times more likely to die before the age of 5 years compared to high-income countries. Factors such as commercial air travel, climate change, and unchecked population growth have contributed to the growing burden of infectious diseases and ensuing sepsis...
June 2017: Journal of Infection
https://www.readbyqxmd.com/read/28646869/long-term-outcomes-after-combined-arthroscopic-medial-reefing-and-lateral-release-in-patients-with-recurrent-patellar-instability-a-retrospective-analysis
#7
Dominik Schorn, Sera Yang-Strathoff, Georg Gosheger, Tim Vogler, Sebastian Klingebiel, Carolin Rickert, Dimosthenis Andreou, Dennis Liem
BACKGROUND: There is currently no consensus regarding the optimal surgical treatment method for patients with recurrent patella instability. Our goal was to evaluate the long-term results of combined arthroscopic medial reefing and lateral release, to identify possible risk factors for recurrent dislocations and residual complaints after surgical treatment and to assess functional outcome. METHODS: We performed a retrospective study of 38 patients (43 knees) treated with all-inside technique between 2001 and 2010...
June 24, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28646742/image-analysis-for-tsh-mrna-in-situ-hybridization-in-pituitary-glands-from-rats-with-thyroid-follicular-cell-hypertrophy-after-treatment-with-three-different-test-compounds
#8
Juergen Funk, Martin Ebeling, Thomas Singer, Christian Landes
The goal of this in situ hybridization and image analysis technique is to study the effects of new pharmacological/chemical entities on the thyroid and pituitary gland in rats, reveal the pathogenesis of thyroid follicular cell hypertrophy and to retrospectively exclude the risk of thyroid tumor development in humans. In the present study, we describe the increase of thyroid-stimulating hormone- (TSH-) beta subunit mRNA in the pars distalis of the pituitary gland and the quantitative measurement of TSH mRNA positive cells from rats of three 4-week toxicity studies treated with three different test compounds inducing thyroid follicular cell and hepatocellular hypertrophy in rats...
June 11, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/28646558/neurology-concepts-young-women-and-ischemic-stroke-evaluation-and-management-in-the-emergency-department
#9
Bernard P Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen
OBJECTIVE: Ischemic stroke is a leading cause of morbidity and mortality worldwide. While the incidence of ischemic stroke is highest in older populations, incidence of ischemic stroke in adults has been rising particularly rapidly among young (e.g. premenopausal) women. The evaluation and timely diagnosis of ischemic stroke in young women presents a challenging situation in the emergency department, due to a range of sex-specific risk factors and to broad differentials. The goals of this concepts paper are to summarize existing knowledge regarding the evaluation and management of young women with ischemic stroke in the acute setting...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28646411/achievement-of-glycated-hemoglobin-goals-in-the-us-remains-unchanged-through-2014
#10
Ginger Carls, Johnny Huynh, Edward Tuttle, John Yee, Steven V Edelman
INTRODUCTION: Previous research has found that the percentage of US adults with diabetes achieving a glycated hemoglobin (HbA1c) target of <7.0% with currently available treatments has been fairly constant from 2003 to 2010, remaining at just over 50% [1]. The objective of this study was to compare the most recent data (2011-2014) with earlier data to track progress on HbA1c target achievement, for both the general target of <7.0% and inferred individualized targets based on age and the presence of complications...
June 23, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28646272/rhesus-cochlear-and-vestibular-functions-are-preserved-after-inner-ear-injection-of-saline-volume-sufficient-for-gene-therapy-delivery
#11
Chenkai Dai, Mohamed Lehar, Daniel Q Sun, Lani Swarthout Rvt, John P Carey, Tim MacLachlan, Doug Brough, Hinrich Staecker, Alexandra M Della Santina, Timothy E Hullar, Charles C Della Santina
Sensorineural losses of hearing and vestibular sensation due to hair cell dysfunction are among the most common disabilities. Recent preclinical research demonstrates that treatment of the inner ear with a variety of compounds, including gene therapy agents, may elicit regeneration and/or repair of hair cells in animals exposed to ototoxic medications or other insults to the inner ear. Delivery of gene therapy may also offer a means for treatment of hereditary hearing loss. However, injection of a fluid volume sufficient to deliver an adequate dose of a pharmacologic agent could, in theory, cause inner ear trauma that compromises functional outcome...
June 23, 2017: Journal of the Association for Research in Otolaryngology: JARO
https://www.readbyqxmd.com/read/28645996/treatment-of-suspected-pulmonary-embolism-in-a-morbidly-obese-patient
#12
Viviene Heitlage, Mary Beth Borgstadt, Lisa Carlson
PURPOSE: A case highlighting challenges with enoxaparin dosage and monitoring in obese patients is presented. SUMMARY: A morbidly obese 22-year-old Caucasian female (height, 168 cm; weight, 322 kg; body mass index [BMI], 114 kg/m(2)) who presented to the emergency department with acute-onset dyspnea and hypoxia was empirically initiated on enoxaparin for suspected pulmonary embolism at the institution's standard maximum dosage (160 mg subcutaneously every 12 hours)...
July 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28645679/percutaneous-management-of-benign-biliary-disorders-in-children
#13
G Kahriman, N Ozcan, S B Gorkem
PURPOSE: The goal of this study was to analyze the outcomes of percutaneous transhepatic management of benign biliary disorders in pediatric patients. MATERIALS AND METHODS: This study included 11 pediatric patients who underwent percutaneous transhepatic biliary interventional procedures between September 2007 and December 2016. There were 3 males and 8 females with a mean age of 9.6±5.4 (SD)years (range: 2-17years). Technical details, complications and outcome of the procedures were evaluated...
June 20, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28645549/staged-treatment-of-infected-tibiotalar-fusion-using-a-combination-antibiotic-spacer-and-antibiotic-coated-intramedullary-nail
#14
Justin Miller, Victor Hoang, Richard S Yoon, Frank A Liporace
Pilon fractures are notoriously difficult injuries to treat. The current published data on salvage procedures after failed pilon fractures includes both total ankle arthroplasty (TAA) and tibiotalar fusion, each with its own specific indications. However, no acceptable treatment algorithm addressing the complications of these limb salvage procedures is available. We present the case of a 23-year-old patient, who sustained a complex pilon fracture after a motor vehicle accident. The patient was referred to our institution after an initial fixation attempt, followed by subsequent failed TAA, which was complicated by an infected fusion attempt...
June 20, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28645453/choice-of-knee-cartilage-thickness-change-metric-for-different-treatment-goals-in-efficacy-studies
#15
Robert J Buck, Marie-Pierre Hellio Le Graverand, Wolfgang Wirth, Felix Eckstein
INTRODUCTION: In knee osteoarthritis, local increase and decrease in cartilage thickness has been observed over short time intervals. Hence, averaging cartilage change across large regions may not capture the complexity of structural alterations in disease progression. This study aims to examine the relative performance of different metrics of cartilage thickness change for different clinical studies scenarios. MATERIALS AND METHODS: Metrics for assessing cartilage thickness change were characterized by conventional measures of change versus absolute values (the magnitude) of change, and by different methods of summarizing change over (sub-) regions...
May 30, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28644740/efficacy-of-guided-self-help-behavioural-activation-and-physical-activity-for-depression-a-randomized-controlled-trial
#16
Isabelle Soucy, Martin Provencher, Michelle Fortier, Taylor McFadden
Behavioural activation and physical activity have received empirical support that highlight their efficacy in reducing depression. Even though both behavioural activation and physical activity share the common goal of reactivating the individual, limited research has directly compared these interventions, and more research is required to evaluate their efficacy when offered in low-intensity formats. The present study involves a randomized controlled clinical trial comparing the efficacy of two guided self-help interventions for the treatment of depression: behavioural activation and physical activity...
June 23, 2017: Cognitive Behaviour Therapy
https://www.readbyqxmd.com/read/28644338/committee-opinion-no-706-sexual-health
#17
(no author information available yet)
Sexuality involves a broad range of expressions of intimacy and is fundamental to self-dentification, with strong cultural, biologic, and psychologic components. Obstetrician-gynecologists often are consulted by patients about sexual health and are in a unique position to open a dialogue on sexual health issues. Several obstacles to frank conversations with patients about sexual health exist, including a lack of adequate training and confidence in the topic, a perception that there are few treatment options, a lack of adequate clinical time to obtain a sexual history, patients' reluctance to initiate the conversation, and the underestimation of the prevalence of sexual dysfunction...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28644331/committee-opinion-no-706-summary-sexual-health
#18
(no author information available yet)
Sexuality involves a broad range of expressions of intimacy and is fundamental to self-dentification, with strong cultural, biologic, and psychologic components. Obstetrician-gynecologists often are consulted by patients about sexual health and are in a unique position to open a dialogue on sexual health issues. Several obstacles to frank conversations with patients about sexual health exist, including a lack of adequate training and confidence in the topic, a perception that there are few treatment options, a lack of adequate clinical time to obtain a sexual history, patients' reluctance to initiate the conversation, and the underestimation of the prevalence of sexual dysfunction...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28644315/management-of-eosinophilic-esophagitis-based-on-pathophysiological-evidence
#19
Bram D van Rhijn, Albert J Bredenoord
Over the past decades eosinophilic esophagitis (EoE) has been increasingly diagnosed, and significant progress has been made in our understanding of its pathophysiology. As EoE cannot be cured yet, treatment goals are suppression of disease activity and symptoms as well as the prevention of progression to a more severe disease phenotype. Disease-modifying treatment options can be divided into dietary therapy and immunosuppressive medications, of which topical steroids have been most investigated, yet are still prescribed off-label...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28644180/mucosal-healing-in-clinical-practice-a-single-center-pediatric-ibd-experience
#20
Savini L Santha, Prabhu R Shankar, Anqi Pan, Bess Schoen, Subra Kugathasan, Cary G Sauer
BACKGROUND: Mucosal healing (MH) is associated with improved clinical outcomes in patients with Crohn's disease (CD) and ulcerative colitis (UC). MH as a target for treatment has been suggested, although there is little pediatric data. The goal of this study was to evaluate MH in clinical practice in pediatric patients with inflammatory bowel disease in clinical remission. METHODS: A retrospective review of electronic health record data was performed on all patients with CD or UC who underwent at least 2 colonoscopies from 2010 through 2016...
June 20, 2017: Inflammatory Bowel Diseases
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