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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/29041034/inhaled-versus-systemic-corticosteroids-for-preventing-bronchopulmonary-dysplasia-in-ventilated-very-low-birth-weight-preterm-neonates
#2
REVIEW
Sachin S Shah, Arne Ohlsson, Henry L Halliday, Vibhuti S Shah
BACKGROUND: Bronchopulmonary dysplasia (BPD) remains an important cause of mortality and morbidity in preterm infants and inflammation plays a significant role in its pathogenesis. The use of inhaled corticosteroids may modulate the inflammatory process without concomitant high systemic steroid concentrations and less risk of adverse effects. This is an update of a review published in 2012 (Shah 2012). We recently updated the related review on "Inhaled versus systemic corticosteroids for treating bronchopulmonary dysplasia in ventilated very low birth weight preterm neonates"...
October 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29041003/depression-in-the-context-of-medical-disorders-new-pharmacological-pathways-revisited
#3
Undine E Lang, Marc Walter
The depressive state has been characterised as one of elevated inflammation, changed cardiovascular parameters and a deranged metabolic situation all of which holds promise for a better understanding and handling of treatment-resistance in affective disorders as well as for future developments in treatment algorithms. In this context several biomarkers are differentially regulated by antidepressant treatment and connected to metabolic, inflammatory, cardiovascular and apoptotic components of the pathophysiology, i...
October 17, 2017: Neuro-Signals
https://www.readbyqxmd.com/read/29040995/role-of-immune-checkpoint-blockade-in-the-treatment-for-human-hepatocellular-carcinoma
#4
Naoshi Nishida, Masatoshi Kudo
With the development of molecular targeting therapy, several treatment options for advanced hepatocellular carcinoma (HCC) have become available in cases where curative and other palliative treatments, such as radiofrequency ablation, surgical resection, and transarterial chemoembolization, are not applicable. However, with the detection of a variety of mutations in cancer-related genes in a single tumor, molecular heterogeneity is commonly observed in HCC. Therefore, mutations in the major cellular signaling pathways underlie the development of resistance to molecular targeting agents...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/29040976/diagnosing-psychopathy-through-emotional-regulation-tasks-heart-rate-variability-versus-implicit-association-test
#5
Gerardo Flórez, Xosé A Vila, María J Lado, Pedro Cuesta, Ventura Ferrer, Luis S García, María R Crespo, Manuel Pérez
BACKGROUND: Nowadays, the assessment of psychopathy relies on semistructured interviews plus file reviews. In order to improve the predictive validity of psychopathy at the individual level, tools that are not based on the rating of signs and symptoms are in great need. SAMPLING AND METHODS: The present study was conducted in a representative sample of 204 Spanish sentenced inmates. These inmates have served at least 6 months of their sentence at the Pereiro de Aguiar (Ourense, Spain) penitentiary...
October 18, 2017: Psychopathology
https://www.readbyqxmd.com/read/29040973/sulforaphane-and-epigallocatechin-gallate-restore-estrogen-receptor-expression-by-modulating-epigenetic-events-in-the-breast-cancer-cell-line-mda-mb-231-a-systematic-review-and-meta-analysis
#6
Vincenza Gianfredi, Samuele Vannini, Massimo Moretti, Milena Villarini, Nicola Luigi Bragazzi, Alberto Izzotti, Daniele Nucci
BACKGROUND/AIMS: Epigenetics refers to modifications in gene activity and expression without alteration at the DNA sequence. Environment and diet could influence gene expression. Diet modifications may be meaningful in preventing and treating chronic diseases, cancer included. Dietary bioactive compounds, such as polyphenols (e.g., curcumin, resveratrol, or epigallocatechin gallate [EGCG]) or isothiocyanate (e.g., sulforaphane [SFN]), can regulate histone acetylation. The aim of this systematic review and meta-analysis was to evaluate the effect of SFN and EGCG on breast cancer (BC) cells cultured in vitro...
October 18, 2017: Journal of Nutrigenetics and Nutrigenomics
https://www.readbyqxmd.com/read/29040894/demystifying-endoscopic-retrograde-cholangiopancreatography-ercp-during-pregnancy
#7
REVIEW
Vítor Magno-Pereira, Pedro Moutinho-Ribeiro, Guilherme Macedo
BACKGROUND: For many years, ERCP was avoided in pregnancy given the concerns regarding the adverse effects that, with special focus on radiation, could occur in the developing fetus. However, the postponement or rejection of ERCP in pregnant women, may lead to a higher risk for mother and fetus, especially when the indication is unequivocal, namely cholangitis, biliary pancreatitis and symptomatic choledocholithiasis. SUMMARY AND KEY MESSAGES: This review aims to summarize the scarce literature on the subject in order to plan ERCP in pregnancy with the highest safety...
October 8, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29040892/majority-of-flat-epithelial-atypia-diagnosed-on-biopsy-do-not-require-surgical-excision
#8
Patrick Mun Yew Chan, Niketa Chotai, Eileen Shujuan Lai, Pei Yi Sin, Juliana Chen, Sarah Qinghui Lu, Mui Heng Goh, Bee Kiang Chong, Bernard Chi Shern Ho, Ern Yu Tan
BACKGROUND: Borderline risk lesions such as flat epithelial atypia (FEA) are increasingly being diagnosed on biopsy. The need for surgery is being debated. In this study, we determined the frequency of histological upgrade following a diagnosis of FEA on biopsy and evaluated potential predictive factors. METHODS: Retrospective review was done of 194 women who underwent biopsy of indeterminate lesions (total 195 lesions) that were diagnosed as FEA. The review covered a 10-year period...
October 14, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29040883/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-for-emergency-cardiac-support
#9
Terri Sun, Andrew Guy, Amandeep Sidhu, Gordon Finlayson, Brian Grunau, Lillian Ding, Saida Harle, Leith Dewar, Richard Cook, Hussein D Kanji
PURPOSE: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may provide benefit to patients in refractory cardiac arrest and cardiogenic shock. We aim to summarize our center's 6-year experience with resuscitative VA-ECMO. MATERIALS AND METHODS: A retrospective medical record review (April 2009 to 2015) was performed on consecutive non-cardiotomy patients who were managed with VA-ECMO due to refractory in- or out-of-hospital cardiac (IHCA/OHCA) arrest (E-CPR) or refractory cardiogenic shock (E-CS) with or without preceding cardiac arrest...
October 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29040820/systematic-review-of-the-effect-of-enteral-feeding-on-gut-microbiota-in-preterm-infants
#10
Wanli Xu, Michelle Judge, Kendra Maas, Naveed Hussain, Jacqueline M McGrath, Wendy A Henderson, Xiaomei Cong
OBJECTIVE: To examine the effect of feeding type on microbial patterns among preterm infants and to identify feeding factors that promote the colonization of beneficial bacteria. DATA SOURCES: PubMed, Cochrane Database of Systematic Reviews, Scopus, and the Cummulative Index of Nursing and Allied Health Literature were thoroughly searched for articles published between January 2000 and January 2017, using the keywords gut microbiome, gut microbiota, enteral microbiome, enteral microbiota, premature infant, preterm infant, extremely low birth weight infant, ELBW infant, very low birth weight infant, feeding, breast milk, breastfeeding, formula, prebiotic, probiotic, and long chain polyunsaturated fatty acid...
October 14, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/29040815/the-role-of-folic-acid-and-selenium-against-oxidative-ethanol-damage-in-early-life-programming-a-review
#11
Mª Luisa Ojeda Murillo, Fatima Nogales Bueno, Mª Luisa Murillo Taravillo, Olimpia Carreras Sánchez
Several disorders in children, called Fetal Alcohol Spectrum Disorders (FASD), occur as result of alcohol consumption during pregnancy and lactation. They appear, at least in part, to be related to the oxidative stress that this drug generates. Ethanol metabolism generates reactive oxygen species and causes a depletion of the antioxidant molecule glutathione (GSH) leading to oxidative stress and lipid and protein damage which are related to growth retardation and neurotoxicity, increasing the incidence of FASD...
October 17, 2017: Biochemistry and Cell Biology, Biochimie et Biologie Cellulaire
https://www.readbyqxmd.com/read/29040800/ocriplasmin-for-symptomatic-vitreomacular-adhesion
#12
REVIEW
James E Neffendorf, Varo Kirthi, Edward Pringle, Timothy L Jackson
BACKGROUND: Symptomatic vitreomacular adhesion (sVMA) is a recognised cause of visual loss and by tradition has been managed by pars plana vitrectomy (PPV). A less invasive alternative to surgery in some people is enzymatic vitreolysis, using an intravitreal injection of ocriplasmin. OBJECTIVES: To assess the efficacy and safety of ocriplasmin compared to no treatment, sham or placebo for the treatment of sVMA. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 1), MEDLINE Ovid (1946 to 24 February 2017), Embase Ovid (1947 to 24 February 2017), PubMed (1946 to 24 February 2017), the ISRCTN registry (www...
October 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29040789/a-review-of-natural-radionuclides-in-canadian-drinking-water-1975-16
#13
Jing Chen, Michael W Cooke, Jean-Francois Mercier
Historical results of natural radioactivity in drinking water were reviewed for a total of 21 communities across Canada from 1975 to 2016. Analyses for 226Ra, 210Pb and total uranium were carried out on monthly composite samples of drinking water from selected Canadian municipalities. Generally speaking, levels of 226Ra, 210Pb and total uranium were found to be low compared to national and international standards for drinking water quality. Because levels were low, federal monitoring programs were discontinued in most communities in 1986 except for Regina, Elliot Lake and Port Hope...
October 13, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29040782/egfr-heterogeneity-and-implications-for-therapeutic-intervention-in-glioblastoma
#14
Eskil Eskilsson, Gro V Røsland, Gergely Solecki, Qianghu Wang, Patrick N Harter, Grazia Graziani, Roel G W Verhaak, Frank Winkler, Rolf Bjerkvig, Hrvoje Miletic
Patients with glioblastoma (GBM) have a universally poor prognosis and are in urgent need of effective treatment strategies. Recent advances in sequencing techniques unraveled the complete genomic landscape of GBMs and revealed profound heterogeneity of individual tumors even at the single cell level. Genomic profiling has detected epidermal growth factor receptor (EGFR) gene alterations in more than half of GBMs. Major genetic events include amplification and mutation of EGFR. Yet, treatment strategies targeting EGFR have thus far failed in clinical trials...
October 10, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/29040778/multimodality-management-of-recurrent-skull-base-chordomas-factors-impacting-tumor-control-and-disease-specific-survival
#15
Shaan M Raza, Diana Bell, Jacob L Freeman, David R Grosshans, Gregory N Fuller, Franco DeMonte
BACKGROUND: Limited data exist to guide the management of recurrent chordomas arising in the skull base. OBJECTIVE: To determine factors affecting tumor control rates and disease-specific survival (DSS) in recurrent disease. METHODS: A retrospective review was performed of 29 patients with 55 recurrences treated at our institution. Tumor and treatment factors were assessed for impact on freedom from progression (FFP; primary outcome) and DSS (secondary outcome)...
October 10, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29040777/efficient-imaging-examining-the-value-of-ultrasound-in-the-diagnosis-of-traumatic-adult-brachial-plexus-injuries-a-systematic-review
#16
Brian Chin, Maleka Ramji, Forough Farrokhyar, James R Bain
INTRODUCTION: Traumatic brachial plexus injury (BPI) can result in debilitating sequelae of the upper extremity. Presently, therapeutic decisions are based on the mechanism of injury, serial physical examination, electromyography, nerve conduction, and imaging studies. While magnetic resonance imaging is the current imaging modality of choice for BPI, ultrasound is a promising newcomer that is inexpensive, accessible, and available at point of care. OBJECTIVE: To evaluate ultrasound as a diagnostic tool in the assessment of traumatic adult BPI through a systematic review...
October 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29040759/cervical-alignment-changes-in-patients-developing-proximal-junctional-kyphosis-following-surgical-correction-of-adult-spinal-deformity
#17
Peter G Passias, Samantha R Horn, Cyrus M Jalai, Subaraman Ramchandran, Gregory W Poorman, Han Jo Kim, Justin S Smith, Daniel Sciubba, Alexandra Soroceanu, Christopher P Ames, D Kojo Hamilton, Robert Eastlack, Douglas Burton, Munish Gupta, Shay Bess, Virginie Lafage, Frank Schwab
BACKGROUND: Proximal junctional kyphosis (PJK) following adult spinal deformity (ASD) surgery is a well-documented complication, but associations between radiographic PJK and cervical malalignment onset remain unexplored. OBJECTIVE: To study cervical malalignment in ASD surgical patients that develop PJK. METHODS: Retrospective review of prospective multicenter database. Inclusion: primary ASD patients (≥5 levels fused, upper instrumented vertebra [UIV] at T2 or above, and 1-yr minimum follow-up) without baseline cervical deformity (CD), defined as ≥2 of the following criteria: T1 slope minus cervical lordosis < 20°, cervical sagittal vertical axis < 4 cm, C2-C7 cervical lordosis < 10°...
October 12, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29040722/head-and-neck-skull-base-imaging
#18
Patricia A Hudgins, Kristen L Baugnon
There are a myriad of head and neck pathologies that extend from the extracranial to the intracranial compartment, traversing the skull base, and knowledge of the imaging appearance of this pathology is critical to practicing neurosurgeons. This article reviews some of the important inflammatory or acquired head and neck pathology along the skull base, neoplastic skull base lesions, and the intracranial extension of head and neck malignancy. Focus will be on the relevant anatomy, appropriate imaging protocols to evaluate these processes, as well as the differentiating imaging findings on computed tomography and magnetic resonance imaging...
October 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29040716/dietary-carbohydrates-components-of-energy-balance-and-associated-health-outcomes
#19
Harry A Smith, Javier T Gonzalez, Dylan Thompson, James A Betts
The role of dietary carbohydrates in the development of obesity and associated metabolic dysfunction has recently been questioned. Within the last decade, the Scientific Advisory Committee on Nutrition carried out a comprehensive evaluation of the role of dietary carbohydrates in human health. The current review aims to complement and extend this report by providing specific consideration of the effects of the component parts of energy balance, their interactions, and their culmination on energy storage and health...
October 5, 2017: Nutrition Reviews
https://www.readbyqxmd.com/read/29040711/diagnosis-and-outcome-of-biopsies-of-indeterminate-lesions-of-the-cavernous-sinus-and-meckel-s-cave-a-retrospective-case-series-in-85-patients
#20
Joshua D Hughes, Joseph Kapurch, Jamie J Van Gompel, Fredric B Meyer, Bruce E Pollock, John Atkinson, Michael J Link
BACKGROUND: When clinical presentation, laboratory studies, or imaging cannot diagnose cavernous sinus (CS) and/or Meckel's cave (MC) lesions, biopsy may be necessary. OBJECTIVE: To review our institutional series of biopsies of indeterminate CS and MC lesions. METHODS: Records from January 1994 to June 2016 were searched for biopsied indeterminate CS and MC lesions. We defined indeterminate as having an atypical imaging appearance or a broad differential and the need for tissue for definitive diagnosis...
October 11, 2017: Neurosurgery
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