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https://www.readbyqxmd.com/read/28444398/plasma-transfusion-demystified-a-review-of-the-key-factors-influencing-the-response-to-plasma-transfusion
#1
Allen W Bryan, Elizabeth M Staley, Timothy Kennell, Alexander Z Feldman, Lance A Williams, Huy P Pham
Many studies have suggested that inappropriate plasma usage is common. An important factor contributing to futile plasma administration in most patients is the nonlinear relationship between coagulation-factor levels and the volume of plasma transfused. In this review, a validated mathematical model and data from the literature will be used to illuminate 3 key properties of plasma transfusion. Those properties are as follows: the effect of plasma transfusion on international normalized ratio (INR) is transient; for the same volume of transfused plasma, a greater reduction in INR is observed at higher initial INRs; and the effect of plasma transfusion on INR correction (ie, the difference between initial and final INRs) diminishes as more plasma is transfused...
April 24, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28441973/treatment-limiting-decisions-in-patients-with-severe-traumatic-brain-injury-in-a-norwegian-regional-trauma-center
#2
Annette Robertsen, Reidun Førde, Nils Oddvar Skaga, Eirik Helseth
BACKGROUND: Treatment-limiting decisions (TLD) for severe traumatic brain injury (sTBI) have been sparsely studied. This study determine prevalence, main reason for, categories and timing of TLDs in a Norwegian regional trauma setting. METHODS: A retrospective study of a 2-year cohort of 579 sTBI patients admitted to Oslo University Hospital (OUH). Prospectively collected data in the OUH Trauma Registry were combined with retrospective data from a chart review regarding TLDs...
April 26, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28435144/effects-of-stanniocalcin-1-on-glucose-flux-in-rat-brown-adipose-tissue
#3
Aline G Cozer, Márcia Trapp, Tiago L Martins, Luciano Stürmer De Fraga, Claudia Vieira Marques, Jorge Felipe A Model, Vanessa Schein, Luiz Carlos Kucharski, Roselis S M Da Silva
The present work assesses in vitro the role of human Stanniocalcin 1 (hSTC-1) in (14)C-glucose metabolism in brown adipose tissue (BAT) from fed rat. In the fed state, hSTC-1 decreases the incorporation of (14)C from glucose into lipids in the rat BAT. The data support the hypothesis that the capacity of the glycerol-3-phosphate (G3P)-generating pathway (glycolysis) from glucose is regulated by hSTC-1, decreasing the adequate supply of G3P needed for fatty acid esterification and triacylglycerol (TG) storage in BAT...
April 20, 2017: Biochimie
https://www.readbyqxmd.com/read/28432405/-extracorporeal-membrane-oxygenation-system-selection-contra-indications-and-management
#4
T Staudinger
There are a large number of extracorporeal membrane oxygenation (ECMO) systems and configurations. Thorough planning and evaluation of specific therapeutic needs are necessary to tailor ECMO therapy to the individual patient situation. Indications tend towards lowering the threshold towards respiratory ECMO. Patients with severe acute respiratory distress syndrome (ARDS) not improving to optimization of ventilation and supportive therapeutic measures potentially qualify for ECMO. Contraindications are relative and have to be considered in the light of the individual risk-benefit ratio...
April 21, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28430791/the-medically-managed-patient-with-severe-symptomatic-aortic-stenosis-in-the-tavr-era-patient-characteristics-reasons-for-medical-management-and-quality-of-shared-decision-making-at-heart-valve-treatment-centers
#5
Kumar Dharmarajan, Jill Foster, Megan Coylewright, Philip Green, John P Vavalle, Osman Faheem, Pei-Hsiu Huang, Amar Krishnaswamy, Vinod H Thourani, Lisa A McCoy, Tracy Y Wang
BACKGROUND: Little is known about patients with severe symptomatic aortic stenosis (AS) who receive medical management despite evaluation at a heart valve treatment center. OBJECTIVE: We identified patient characteristics associated with medical management, physician-reported reasons for selecting medical management, and patients' perceptions of their involvement and satisfaction with treatment selection. METHODS AND RESULTS: Of 454 patients evaluated for AS at 9 established heart valve treatment centers from December 12, 2013 to August 19, 2014, we included 407 with severe symptomatic AS...
2017: PloS One
https://www.readbyqxmd.com/read/28424017/computed-tomography-perfusion-based-selection-of-endovascularly-treated-acute-ischaemic-stroke-patients-are-there-lessons-to-be-learned-from-the-pre-evidence-era
#6
Marios-Nikos Psychogios, Michael Knauth, Raya Bshara, Katharina Schregel, Ioannis Tsogkas, Ismini Papageorgiou, Ilko Maier, Jan Liman, Daniel Behme
Introduction Some of the latest groundbreaking trials suggest that noncontrast cranial computed tomography and computed tomography-angiography are sufficient tools for patient selection within six hours of symptom onset. Before endovascular stroke therapy became the standard of care, patient selection was one of the most useful tools to avoid futile reperfusions. We report the outcomes of endovascularly treated stroke patients selected with a perfusion-based paradigm and discuss the implications in the current era of endovascular treatment...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28422888/18f-fdg-pet-ct-for-detection-of-the-primary-tumor-in-adults-with-extracervical-metastases-from-cancer-of-unknown-primary-a-systematic-review-and-meta-analysis
#7
Synne Alexandra Burglin, Søren Hess, Poul Flemming Høilund-Carlsen, Oke Gerke
BACKGROUND: Cancer of unknown primary (CUP) is a heterogeneous group of cancers, so called when a biopsy from a patient reveals malignancy without giving a clue to where in the body the primary tumor is located. Whole-body 18-fluorine-fluorodeoxyglucose positron-emission-tomography/computed tomography (18F-FDG PET/CT) is widely used for diagnosis and staging of most cancers. We hypothesized that 18F-FDG PET/CT-especially if used early-is suitable for the detection of the primary tumor in patients with CUP...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28419193/a-randomized-phase-ii-iii-study-of-cabazitaxel-versus-vinflunine-in-metastatic-or-locally-advanced-transitional-cell-carcinoma-of-the-urothelium-secavin
#8
J Bellmunt, J M Kerst, F Vázquez, R Morales-Barrera, E Grande, A Medina, Mªb González Graguera, G Rubio, U Anido, O Fernández Calvo, E González-Billalabeitia, Ajm Van den Eertwegh, E Pujol, J L Perez-Gracia, J L González Larriba, R Collado, M Los, S Maciá, R De Wit
BACKGROUND: Despite the advent of immunotherapy in urothelial cancer, there is still a need to find effective cytotoxic agents beyond first and second line. Vinflunine is the only treatment approved in this setting by the European Medicines Agency (EMA) and taxanes are also widely used in second line. Cabazitaxel is a taxane with activity in docetaxel-refractory cancers. A randomized study was conducted to compare its efficacy vs vinflunine. PATIENTS AND METHODS: This is a multicenter, randomized, open-label, phase II/III study, following a Simon's optimal method with stopping rules based on an interim futility analysis and a formal efficacy analysis at the end of the phase II...
April 13, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28414200/combining-53bp1-with-brca1-as-a-biomarker-to-predict-the-sensitivity-of-poly-adp-ribose-polymerase-parp-inhibitors
#9
Zhong-Min Yang, Xue-Mei Liao, Yi Chen, Yan-Yan Shen, Xin-Ying Yang, Yi Su, Yi-Ming Sun, Ying-Lei Gao, Jian Ding, Ao Zhang, Jin-Xue He, Ze-Hong Miao
Over half of patients with BRCA1-deficient cancers do not respond to treatment with poly(ADP-ribose) polymerase (PARP) inhibitors. In this study, we report that a combination of 53BP1 and BRCA1 may serve as a biomarker of PARP inhibitor sensitivity. Based on the mRNA levels of four homologous recombination repair (HR) genes and PARP inhibitor sensitivity, we selected BRCA1-deficient MDA-MB-436 cells to conduct RNA interference. Reducing expression of 53BP1, but not the other three HR genes, was found to lower simmiparib sensitivity...
April 17, 2017: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/28402747/randomized-phase-ii-study-investigating-pazopanib-versus-weekly-paclitaxel-in-relapsed-or-progressive-urothelial-cancer
#10
Robert J Jones, Syed A Hussain, Andrew S Protheroe, Alison Birtle, Prabir Chakraborti, Robert A Huddart, Satinder Jagdev, Amit Bahl, Andrew Stockdale, Santhanam Sundar, Simon J Crabb, Judith Dixon-Hughes, Laura Alexander, Anna Morris, Caroline Kelly, Jon Stobo, James Paul, Thomas Powles
Purpose Two previous single-arm trials have drawn conflicting conclusions regarding the activity of pazopanib in urothelial cancers after failure of platinum-based chemotherapy. Patients and Methods This randomized (1:1) open-label phase II trial compared the efficacy of pazopanib 800 mg orally with paclitaxel (80 mg/m(2) days 1, 8, and 15 every 28 days) in the second-line setting. The primary end point was overall survival (OS). Results Between August 2012 and October 2014, 131 patients, out of 140 planned, were randomly assigned...
April 12, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28401943/signal-coverage-approach-to-the-detection-probability-of-hypothetical-extraterrestrial-emitters-in-the-milky-way
#11
Claudio Grimaldi
The lack of evidence for the existence of extraterrestrial life, even the simplest forms of animal life, makes it is difficult to decide whether the search for extraterrestrial intelligence (SETI) is more a high-risk, high-payoff endeavor than a futile attempt. Here we insist that even if extraterrestrial civilizations do exist and communicate, the likelihood of detecting their signals crucially depends on whether the Earth lies within a region of the galaxy covered by such signals. By considering possible populations of independent emitters in the galaxy, we build a statistical model of the domain covered by hypothetical extraterrestrial signals to derive the detection probability that the Earth is within such a domain...
April 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28401622/predicting-mortality-in-the-emergency-department-external-validation-and-derivation-of-a-clinical-prediction-tool
#12
Rajat N Moman, Caitlin Loprinzi Brauer, Katherine M Kelsey, Rachel D Havyer, Christine M Lohse, M Fernanda Bellolio
BACKGROUND: he Choosing Wisely campaign has called for better engagement of palliative and hospice care services for patients in the emergency department (ED). PREDICT is a clinical prediction tool that was derived in an Australian ED cohort. It assesses a patient's risk of mortality at one year to select those who would benefit from advanced care planning. Such goals of care discussion can improve patients' ability to communicate what they want out of their healthcare and, in cases of end-of-life, potentially reduce the number of futile interventions...
April 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28399755/nmc-ruling-could-encourage-futile-cpr
#13
Alison Moore
What would you do if you found a patient had died in the night while under your care? Most nurses would inform their superiors and probably play a part in contacting relatives with the bad news. Their actions would be aimed at protecting the dignity of the person who had died and showing respect for them and their bereaved family.
April 12, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28398846/anthracyclines-in-early-breast-cancer-the-abc-trials-usor-06-090-nsabp-b-46-i-usor-07132-and-nsabp-b-49-nrg-oncology
#14
Joanne L Blum, Patrick J Flynn, Greg Yothers, Lina Asmar, Charles E Geyer, Samuel A Jacobs, Nicholas J Robert, Judith O Hopkins, Joyce A O'Shaughnessy, Chau T Dang, Henry Leonidas Gómez, Louis Fehrenbacher, Svetislava J Vukelja, Alan P Lyss, Devchand Paul, Adam M Brufsky, Jong-Hyeon Jeong, Linda H Colangelo, Sandra M Swain, Eleftherios P Mamounas, Stephen E Jones, Norman Wolmark
Purpose Docetaxel and cyclophosphamide (TC) was superior to doxorubicin and cyclophosphamide (AC) in a trial in early breast cancer. However, activity of TC relative to AC regimens with a taxane (TaxAC) is unknown. Methods In a series of three adjuvant trials, women were randomly assigned to TC for six cycles (TC6) or to a standard TaxAC regimen. US Oncology Research (USOR) 06-090 compared TC6 with docetaxel, doxorubicin, and cyclophosphamide (TAC6). National Surgical Adjuvant Breast and Bowel Project (NSABP) B-46-I/USOR 07132 compared TC6, TAC6, or TC6 plus bevacizumab...
April 11, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28398319/a-futile-cycle-in-cell-therapy
#15
EDITORIAL
(no author information available yet)
No abstract text is available yet for this article.
April 11, 2017: Nature Biotechnology
https://www.readbyqxmd.com/read/28389221/welfare-law-and-ethics-in-the-veterinary-intensive-care-unit-a-discussion-of-the-different-types-of-suffering-that-patients-may-endure-in-the-veterinary-intensive-care-unit-the-legal-limits-to-that-suffering-and-the-ethics-underpinning-at-what-point-that-suffering
#16
REVIEW
Peter S Fordyce
OBJECTIVES: In UK law, allowing an animal protected under the Animal Welfare Act 2006 (AWA 2006) (as devolved) to suffer 'unnecessarily' may render the person responsible for it to prosecution. The act does not define suffering, although 'case law' suggests that suffering encompasses more than pain. Clinicians responsible for animals under their care in the intensive care unit (ICU) are likely to also be responsible in law for the welfare of those animals, and may be called upon to justify why any suffering was necessary, or more likely, why they did not act to end any suffering when it became 'unnecessary'...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28385592/genome-scale-metabolic-modelling-common-cofactors-metabolism-in-microorganisms
#17
Nan Xu, Chao Ye, Xiulai Chen, Jia Liu, Liming Liu
The common cofactors ATP/ADP, NAD(P)(H), and acetyl-CoA/CoA are indispensable participants in biochemical reactions in industrial microbes. To systematically explore the effects of these cofactors on cell growth and metabolic phenotypes, the first genome-scale cofactor metabolic model, icmNX6434, including 6434 genes, 1782 metabolites, and 6877 reactions, was constructed from 14 genome-scale metabolic models of 14 industrial strains. The origin, consumption, and interactions of these common cofactors in microbial cells were elucidated by the icmNX6434 model, and they played important roles in cell growth...
April 4, 2017: Journal of Biotechnology
https://www.readbyqxmd.com/read/28380374/mitochondrial-patch-clamp-of-beige-adipocytes-reveals-ucp1-positive-and-ucp1-negative-cells-both-exhibiting-futile-creatine-cycling
#18
Ambre M Bertholet, Lawrence Kazak, Edward T Chouchani, Marta G Bogaczyńska, Ishan Paranjpe, Gabrielle L Wainwright, Alexandre Bétourné, Shingo Kajimura, Bruce M Spiegelman, Yuriy Kirichok
Cold and other environmental factors induce "browning" of white fat depots-development of beige adipocytes with morphological and functional resemblance to brown fat. Similar to brown fat, beige adipocytes are assumed to express mitochondrial uncoupling protein 1 (UCP1) and are thermogenic due to the UCP1-mediated H(+) leak across the inner mitochondrial membrane. However, this assumption has never been tested directly. Herein we patch clamped the inner mitochondrial membrane of beige and brown fat to provide a direct comparison of their thermogenic H(+) leak (IH)...
April 4, 2017: Cell Metabolism
https://www.readbyqxmd.com/read/28377999/catastrophic-failure-of-an-acetabular-total-hip-arthroplasty-component-mimicking-a-posterior-dislocation
#19
Christopher Joyce, Jared L Harwood, Andrew H Glassman
In our case study, we examine a case of catastrophic failure of a total hip arthroplasty acetabular component leading to complete central wear by the ceramic femoral head, requiring revision total hip arthroplasty. Despite subtle clinical findings, initial orthopaedic evaluation and treatment yielded a diagnosis of total hip arthroplasty dislocation. While a much more common phenomenon, the diagnosis led to futile initial attempts at closed reduction. Our index of suspicion must remain high to pick up on subtle, less common diagnoses we will encounter...
March 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28377807/sectioning-on-the-street-futility-or-utility
#20
Philip Timms, Jennifer Perry
Aims and method A service evaluation was undertaken to examine outcomes in patients who were street homeless ('rough sleepers') and who were compulsorily admitted to hospital under the Mental Health Act 1983. The data were collected from the patients' case notes. Results At 1-year follow-up, patients had positive outcomes in areas such as accommodation status, registration with a general practitioner and engagement with the clinical team. Clinical implications The study shows that the intervention of a Mental Health Act assessment and compulsory hospital admission in homeless people on the street is associated with positive outcomes at 1 year...
December 2016: BJPsych Bulletin
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