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https://www.readbyqxmd.com/read/29331342/development-of-a-prognostic-score-to-predict-response-to-yttrium-90-radioembolization-for-hepatocellular-carcinoma-with-portal-vein-invasion
#1
Carlo Spreafico, Carlo Sposito, Marta Vaiani, Tommaso Cascella, Sherrie Bhoori, Carlo Morosi, Rodolfo Lanocita, Raffaele Romito, Carlo Chiesa, Marco Maccauro, Alfonso Marchianò, Vincenzo Mazzaferro
BACKGROUND & AIMS: Yttrium-90 trans-arterial radioembolization (TARE) has shown promising efficacy in the treatment of patients with hepatocellular carcinoma (HCC) associated with tumoral portal vein thrombosis (PVTT). Aim of this study is to identify prognostic factors for survival in patients with HCC and PVTT undergoing TARE, and build a prognostic classification for these patients. METHODS: This is a single Center retrospective study conducted over 6 years (2010-2015), on consecutive patients undergoing TARE...
January 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29325878/can-we-identify-futility-in-kids-an-evaluation-of-admission-parameters-predicting-100-mortality-in-1292-severely-injured-children
#2
Kyle J Kalkwarf, Shane D Jensen, Myron Allukian, Matthew T Harting, Charles S Cox, Erin E Fox, Charles E Wade, Bryan A Cotton
BACKGROUND: Objective parameters predicting futility of care in severely injured pediatric patients are lacking. While futility of care has been investigated in a limited number of studies in trauma patients, none of these studies achieves a 100% success rate in a large cohort of pediatric patients. The purpose of the current study was to identify extreme laboratory values that could be used to predict 100% mortality in severely injured children. STUDY DESIGN: Registry-based, historical cohort of all severely injured children (level 1 trauma, <16 years old), who were not dead on arrival, between January 2010 and December 2016 from a single level 1 trauma center...
January 8, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29325753/induced-hypothermia-in-patients-with-septic-shock-and-respiratory-failure-cass-a-randomised-controlled-open-label-trial
#3
Theis Skovsgaard Itenov, Maria Egede Johansen, Morten Bestle, Katrin Thormar, Lars Hein, Louise Gyldensted, Anne Lindhardt, Henrik Christensen, Stine Estrup, Henrik Planck Pedersen, Matthew Harmon, Uday Kant Soni, Silvia Perez-Protto, Nicolai Wesche, Ulrik Skram, John Asger Petersen, Thomas Mohr, Tina Waldau, Lone Musaeus Poulsen, Ditte Strange, Nicole P Juffermans, Daniel I Sessler, Else Tønnesen, Kirsten Møller, Dennis Karsten Kristensen, Alessandro Cozzi-Lepri, Jens D Lundgren, Jens-Ulrik Jensen
BACKGROUND: Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent patients with septic shock. METHODS: In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America...
January 8, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29317350/duration-of-cardiopulmonary-resuscitation-in-patients-without-prehospital-return-of-spontaneous-circulation-after-out-of-hospital-cardiac-arrest-results-from-a-severity-stratification-analysis
#4
Akira Funada, Yoshikazu Goto, Hayato Tada, Ryota Teramoto, Masaya Shimojima, Kenshi Hayashi, Masa-Aki Kawashiri, Masakazu Yamagishi
BACKGROUND: The relationship between duration of cardiopulmonary resuscitation (CPR) and post-arrest outcomes based on severity stratification in out-of-hospital cardiac arrest (OHCA) patients without prehospital return of spontaneous circulation (ROSC) remains unclear. METHODS: We analysed 420,959 adult patients without prehospital ROSC in the All-Japan OHCA registry for 4 years. Prehospital CPR duration was defined as the time from CPR initiation by emergency medical service (EMS) providers to hospital arrival...
January 6, 2018: Resuscitation
https://www.readbyqxmd.com/read/29314834/interface-mechanisms-of-catalytic-ozonation-with-amorphous-iron-silicate-for-removal-of-4-chloronitrobenzene-in-aqueous-solution
#5
Lei Yuan, Jimin Shen, Pengwei Yan, Zhonglin Chen
Iron silicate was synthesized and characterized as an efficient ozonation catalyst. Results indicated that iron silicate is a microporous material with poor crystallinity. Fe-O-Si and Fe-O bonds were observed on its surface. The Fe-O bonds belonged to α-Fe2O3. Heterogeneous catalytic ozonation test was performed in batch reaction mode, and 4-chloronitrobenzene was used as model organic compounds. Amorphous iron silicate exhibited high catalytic activity, ozone utilization efficiency, and stability in catalytic ozonation...
January 9, 2018: Environmental Science & Technology
https://www.readbyqxmd.com/read/29314425/ebus-faster-cheaper-and-most-effective-in-lung-cancer-staging
#6
REVIEW
Fotios Sampsonas, Loukas Kakoullis, Dimosthenis Lykouras, Kiriakos Karkoulias, Konstantinos Spiropoulos
The use of endobronchial ultrasound trans-bronchial needle aspiration (EBUS-TBNA) as the initial diagnostic and staging procedure in patients with suspected, non-metastatic lung cancer has gained substantial support, and is now recommended by numerous guidelines. Whereas considerable attention has been pointed to the reductions in costs achieved by EBUS-TBNA, that has not been the case for some of its more significant benefits, namely the reduction of the diagnostic work-up time and its ability to accurately assess and restage lymph nodes, which were previously stated incorrectly by CT or PET scan...
January 3, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29313791/dilemmas-in-dual-disease-complexity-and-futility-in-prosthetic-valve-endocarditis-and-substance-use-disorder
#7
James N Kirkpatrick, Jason W Smith
No abstract text is available yet for this article.
January 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29304789/fractionated-palliative-thoracic-radiotherapy-in-non-small-cell-lung-cancer-futile-or-worth-while
#8
Malene Støchkel Frank, Dorte Schou Nørøxe, Lotte Nygård, Gitte Fredberg Persson
BACKGROUND: Palliative thoracic radiotherapy (PTR) can relieve symptoms originating from intra-thoracic disease. The optimal timing and fractionation of PTR is unknown. Time to effect is 2 months. The primary aim of this retrospective study was to investigate survival after PTR, hypothesizing that a significant number of patients received futile fractionated PTR. The secondary aim was to find prognostic factors to guide treatment decisions. METHODS: Patients with non-small-cell lung cancer (NSCLC) planned for PTR in the period of 2010-2011 at the University Hospital of Copenhagen were included...
January 5, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29290493/interhospital-vascular-surgery-transfers-to-a-tertiary-care-hospital
#9
Sheena K Harris, Dale G Wilson, Enjae Jung, Amir-Farzin Azarbal, Gregory J Landry, Timothy K Liem, Gregory L Moneta, Erica L Mitchell
OBJECTIVE: Interhospital transfers (IHTs) to tertiary care centers are linked to lower operative mortality in vascular surgery patients. However, IHT incurs great health care costs, and some transfers may be unnecessary or futile. In this study, we characterize the patterns of IHT at a tertiary care center to examine appropriateness of transfer for vascular surgery care. METHODS: A retrospective review was performed of all IHT requests made to our institution from July 2014 to October 2015...
December 28, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29288291/transfusion-of-blood-products-in-the-neurocritical-care-unit-an-exploration-of-rationing-and-futility
#10
Deepa P Malaiyandi, Galen V Henderson, Michael A Rubin
Rationing is the allocation of scarce resources, which in healthcare necessarily requires withholding potentially beneficial treatments from some individuals. While it often entails a negative connotation, rationing is unavoidable because need is limitless and resources are not. How rationing occurs is important, because it not only affects individual lives, but also reflects society's most important values. At the core of any rationing, decision is how much a limited resource may benefit a patient, which can be particularly difficult to determine in the practice of neurocritical care, as prognosis is often uncertain...
December 29, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29288287/a-contemporary-paradigm-integrating-spirituality-in-advance-care-planning
#11
Katie Lutz, Stefan R Rowniak, Prabjot Sandhu
In the 25 years since advance care planning first drew the attention of the national healthcare and legal systems, gains in the rate of advance care directive completion have been negligible despite the effort of researchers, ethicists, and lawmakers. With the benefit of sophisticated healthcare technology, patients are living longer. Despite the benefits of increased longevity, it is widely acknowledged that enough has not been done to adequately address end-of-life care decisions at the crossroads between medical futility and quality of life...
December 29, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/29287807/validation-of-an-algorithm-to-predict-the-likelihood-of-an-8-8-hla-matched-unrelated-donor-at-search-initiation
#12
Eric Davis, Sean Devlin, Candice Cooper, Melissa Nhaissi, Jennifer Paulson, Deborah Wells, Andromachi Scaradavou, Sergio Giralt, Esperanza Papadopoulos, Nancy A Kernan, Courtney Byam, Juliet N Barker
A strategy to rapidly determine if a matched unrelated donor (URD) can be secured for allograft recipients is needed. We sought to validate the accuracy of 1) HapLogic™ match predictions, and, 2) a resultant novel Search Prognosis (SP) patient categorization that could predict 8/8 HLA-matched URD(s) likelihood at search initiation. Patient prognosis categories at search initiation were correlated with URD confirmatory typing results. HapLogic™-based SP categorizations accurately predicted the likelihood of an 8/8 HLA-match in 830 patients (1,530 donors tested)...
December 26, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29277618/cost-effectiveness-of-new-biomarkers-for-colorectal-cancer-screening-futility-or-call-for-innovation
#13
EDITORIAL
Thomas F Imperiale, Charles J Kahi
No abstract text is available yet for this article.
December 19, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29277163/criterion-validity-and-inter-rater-reliability-of-a-palliative-care-screening-tool-for-patients-admitted-to-an-emergency-department-intensive-care-unit
#14
Sabrina Corrêa da Costa Ribeiro, Ricardo Tavares de Carvalho, Juraci Aparecida Rocha, Roger Daglius Dias
OBJECTIVE: The use of palliative care (PC) screening criteria to trigger PC consultations may optimize the utilization of PC services, improve patient comfort, and reduce invasive and futile end-of-life care. The aim of the present study was to assess the criterion validity and inter-rater reliability of a PC screening tool for patients admitted to an emergency department intensive care unit (ED-ICU). METHOD: Observational retrospective study evaluating PC screening criteria based on the presence of advanced diagnosis and the use of two "surprise questions" (traditional and modified)...
December 26, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29277132/a-second-order-confirmatory-factor-analysis-of-the-moral-distress-scale-revised-for-nurses
#15
Hamid Sharif Nia, Vida Shafipour, Kelly-Ann Allen, Mohammad Reza Heidari, Jamshid Yazdani-Charati, Armin Zareiyan
BACKGROUND: Moral distress is a growing problem for healthcare professionals that may lead to dissatisfaction, resignation, or occupational burnout if left unattended, and nurses experience different levels of this phenomenon. OBJECTIVES: This study aims to investigate the factor structure of the Persian version of the Moral Distress Scale-Revised in intensive care and general nurses. RESEARCH DESIGN: This methodological research was conducted with 771 nurses from eight hospitals in the Mazandaran Province of Iran in 2017...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/29273461/evolution-of-survival-in-cardiac-arrest-with-age-in-elderly-patients-is-resuscitation-a-dead-end
#16
Nicolas Segal, Christophe di Pompéo, Joséphine Escutnaire, Eric Wiel, Cyrielle Dumont, Laurent Castra, Karim Tazarourte, Carlos El Khoury, Pierre-Yves Gueugniaud, Hervé Hubert
BACKGROUND: Even if age is not considered the key prognostic factor for survival in cardiac arrest (CA), some studies question whether cardiopulmonary resuscitation (CPR) in the elderly could be futile. OBJECTIVE: The aim of this study was to describe differences in out-of-hospital CA survival rates according to age stratification based on the French National CA registry (RéAC). The second objective was to analyze the differences in resuscitation interventions according to age...
December 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29272933/parallel-replica-dynamics-method-for-bistable-stochastic-reaction-networks-simulation-and-sensitivity-analysis
#17
Ting Wang, Petr Plecháč
Stochastic reaction networks that exhibit bistable behavior are common in systems biology, materials science, and catalysis. Sampling of stationary distributions is crucial for understanding and characterizing the long-time dynamics of bistable stochastic dynamical systems. However, simulations are often hindered by the insufficient sampling of rare transitions between the two metastable regions. In this paper, we apply the parallel replica method for a continuous time Markov chain in order to improve sampling of the stationary distribution in bistable stochastic reaction networks...
December 21, 2017: Journal of Chemical Physics
https://www.readbyqxmd.com/read/29261818/update-in-hospital-palliative-care-symptom-management-communication-caregiver-outcomes-and-moral-distress
#18
Rachel D Havyer, Daniel H Pomerantz, Robert L Jayes, Patricia F Harris, Stephanie M Harman, Aziz A Ansari
BACKGROUND: Updated knowledge of the palliative care (PC) literature is needed to maintain competency and best address the PC needs of hospitalized patients. We critiqued the recent PC literature with the highest potential to impact hospital practice. METHODS: We reviewed articles published between January 2016 and December 2016, which were identified through a handsearch of leading journals and a MEDLINE search. The final 9 articles selected were determined by consensus based on scientific rigor, relevance to hospital medicine, and impact on practice...
December 20, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29259073/phase-ii-study-of-panitumumab-in-ras-wild-type-metastatic-adenocarcinoma-of-small-bowel-or-ampulla-of-vater
#19
Pat Gulhati, Kanwal Raghav, Rachna Shroff, Gauri Varadhachary, Milind Javle, Wei Qiao, Huamin Wang, Jeffrey Morris, Robert Wolff, Michael J Overman
LESSONS LEARNED: Panitumumab has no clinical activity in metastatic RAS wild-type small bowel adenocarcinoma (SBA) and ampullary adenocarcinoma (AAC), possibly due to the foregut and midgut derivation of small bowel and ampulla.These results, along with findings from genomic characterization of SBA, suggest that SBA represents a unique intestinal malignancy and treatments should not be habitually extrapolated from colorectal cancer.Further studies evaluating the benefit of targeted therapies exclusively in SBA and AAC are warranted...
December 19, 2017: Oncologist
https://www.readbyqxmd.com/read/29248049/corrigendum-to-changes-in-smoking-drinking-overweight-and-physical-inactivity-in-young-australian-women-1996-2013
#20
Jennifer R Powers, Deborah Loxton, Amy E Anderson, Annette J Dobson, Gita D Mishra, Richard Hockey, Wendy J Brown
Issue addressed: Smoking, risky drinking, overweight and obesity, and physical inactivity are health-risk factors (HRFs) that contribute significantly to morbidity worldwide. Several initiatives have been introduced over the past two decades to reduce these HRFs. This paper examines changes in the prevalence of HRFs in young women (aged 18-23 years) between 1996 and 2013, overall and within demographic groups.Methods: Data from two cohorts of the Australian Longitudinal Study on Women's Health, born in 1973-78 (n=14247) and 1989-95 (n=17012) were weighted to provide national estimates...
December 2017: Health Promotion Journal of Australia
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