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https://www.readbyqxmd.com/read/28230644/expanding-the-donor-pool-through-intensive-care-to-facilitate-organ-donation-results-of-a-spanish-multicenter-study
#1
Beatriz Domínguez-Gil, Elisabeth Coll, José Elizalde, Jaime E Herrero, Teresa Pont, Brígida Quindós, Bella Marcelo, María A Bodí, Adolfo Martínez, Agustín Nebra, Francisco Guerrero, José M Manciño, Juan Galán, Miguel Lebrón, Eduardo Miñambres, Rafael Matesanz
BACKGROUND: Intensive Care to facilitate Organ Donation (ICOD) may help to increase the donor pool. We describe the Spanish experience with ICOD. METHODS: ACCORD-Spain consisted of an audit of the donation pathway from patients dead as a result of a devastating brain injury (possible donors) in 68 hospitals during 11/1/2014-4/30/2015. We focused on possible donors whose family was interviewed to discuss organ donation once intensive care with a therapeutic purpose was deemed futile and brain death (BD) was a likely outcome...
February 23, 2017: Transplantation
https://www.readbyqxmd.com/read/28228578/proof-of-concept-randomized-trial-of-the-monoclonal-antibody-gsk249320-versus-placebo-in-stroke-patients
#2
Steven C Cramer, Lori A Enney, Colleen K Russell, Monica Simeoni, Thomas R Thompson
BACKGROUND AND PURPOSE: One class of poststroke restorative therapy focuses on promoting axon outgrowth by blocking myelin-based inhibitory proteins such as myelin-associated glycoprotein. The purpose of the current study was to extend preclinical and clinical findings of GSK249320, a humanized monoclonal antibody to myelin-associated glycoprotein with disabled Fc region, to explore effects on motor outcomes post-stroke. METHODS: In this phase IIb double-blind, randomized, placebo-controlled study, patients at 30 centers with ischemic stroke 24 to 72 hours prior and gait deficits were randomized to 2 IV infusions of GSK249320 or placebo...
February 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28225696/what-to-do-when-there-aren-t-enough-beds-in-the-picu
#3
Michael A Rubin, Robert D Truog
The concepts of medical futility and rationing are often misunderstood and lead to significant consternation when resources are stretched and pediatric intensive care unit (PICU) beds are unavailable. While the two concepts overlap, each has its own distinct application and moral justification. Most importantly, we should avoid using one to justify the other. Bioethics professionals should assist critical care clinicians in clarifying when each rubric should be applied as well as how to develop policies to standardize the approach...
February 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28223532/identification-of-productive-and-futile-encounters-in-an-electron-transfer-protein-complex
#4
Witold Andrałojć, Yoshitaka Hiruma, Wei-Min Liu, Enrico Ravera, Masaki Nojiri, Giacomo Parigi, Claudio Luchinat, Marcellus Ubbink
Well-defined, stereospecific states in protein complexes are often in exchange with an ensemble of more dynamic orientations: the encounter states. The structure of the stereospecific complex between cytochrome P450cam and putidaredoxin was solved recently by X-ray diffraction as well as paramagnetic NMR spectroscopy. Other than the stereospecific complex, the NMR data clearly show the presence of additional states in the complex in solution. In these encounter states, populated for a small percentage of the time, putidaredoxin assumes multiple orientations and samples a large part of the surface of cytochrome P450cam...
February 21, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28223052/lung-transplant-mortality-is-improving-in-recipients-with-a-lung-allocation-score-in-the-upper-quartile
#5
Todd C Crawford, Joshua C Grimm, J Trent Magruder, Jinny Ha, Christopher M Sciortino, Bo S Kim, Errol L Bush, John V Conte, Robert S Higgins, Ashish S Shah, Christian A Merlo
BACKGROUND: Since the introduction of the Lung Allocation Score (LAS), the mean LAS has risen. Still, it remains uncertain whether mortality has improved in the most severely ill lung transplant recipients over this time period. METHODS: Using the United Network for Organ Sharing database, we identified 3,548 adult lung transplant recipients from May 4, 2005, to March 31, 2014, with a match-time LAS in the upper quartile (>75th%ile). We divided this population across three eras: 1 = May 4, 2005, to December 31, 2008 (n = 1,280); 2 = January 1, 2009, to December 31, 2011 (n = 1,266); and 3 = January 1, 2012, to March 31, 2014 (n = 1,002)...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28220732/should-doctors-provide-futile-medical-treatment-if-patients-or-their-proxies-are-prepared-to-pay-for-it
#6
D J McQuoid-Mason
Ethically and legally doctors are not obliged to provide futile treatment to patients, even if the patient or their proxies are prepared to pay for it. However, it may be justified where such treatment is harmless and has a placebo effect. In deciding about a request for futile treatment, doctors should be guided by the ethical principles of patient autonomy, beneficence, non-maleficence and justice. Guidelines are provided to assist doctors in making such decisions. Where futile treatment is withdrawn or refused, palliative care must always be offered...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28219013/changes-in-smoking-drinking-overweight-and-physical-inactivity-in-young-australian-women-1996-2013
#7
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...
February 20, 2017: Health Promotion Journal of Australia
https://www.readbyqxmd.com/read/28217015/the-pearl-of-fdg-pet-ct-in-preoperative-assessment-of-patients-with-potentially-operable-non-small-cell-lung-cancer-and-its-clinical-impact
#8
Boom Ting Kung, Ting Kun Au Yong, Cheuk Man Tong
The aim of this retrospective study is to evaluate the clinical impact and efficacy of fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) on management decisions for patients suffering from clinically operable non-small-cell lung cancer (NSCLC). A retrospective review of 186 potentially operable NSCLC patients who underwent whole-body PET/CT examination in 2012 was performed. The patients were further analyzed via the electronic patient record (ePR) system for relevant findings...
January 2017: World Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/28216281/clinicians-perspectives-on-advance-care-planning-for-patients-with-ckd-in-australia-an-interview-study
#9
Marcus Sellars, Allison Tong, Tim Luckett, Rachael L Morton, Carol A Pollock, Lucy Spencer, William Silvester, Josephine M Clayton
BACKGROUND: Advance care planning (ACP) empowers patients to consider and communicate their current and future treatment goals. However, ACP is not widely implemented in chronic kidney disease (CKD) care settings. This study aims to describe clinicians' beliefs, challenges, and perspectives of ACP in patients with CKD. STUDY DESIGN: Qualitative study. SETTING & PARTICIPANTS: Nephrologists (n=20), nurses (n=7), and social workers (n=4) with a range of experience in facilitating ACP for patients with CKD across Australia...
February 16, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28212189/wnt-signaling-in-the-vessel-wall
#10
Lina Badimon, Maria Borrell-Pages
PURPOSE OF REVIEW: Wnt signaling plays a crucial role during embryogenesis. In an adult, Wnt is mainly associated to cellular proliferation and differentiation mechanisms. Recent data suggest that Wnt signaling is involved in the pathophysiology of atherosclerosis. However, the roles of Wnt signaling pathways in the vessel wall are poorly understood. This review outlines recent discoveries in understanding the role of Wnt pathways in healthy and atherosclerotic vessels. RECENT FINDINGS: In the last years, the involvement of both canonical and noncanonical Wnt pathways in the development of atherosclerotic lesions has been recognized...
February 16, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28212133/potential-uselessness-and-futility-of-left-atrial-appendage-occlusion-and-patent-foramen-ovale-closure-in-cardioembolic-stroke
#11
Gian L Nicolosi
International guidelines indicate that interventional closure of left atrial appendage and patent foramen ovale may be considered in selected patients for stroke prevention. These procedures appear, however, from the published literature, at high risk of uselessness and futility in the single case, if not even capable to induce harm and adverse events. In fact, all reported systematic reviews and meta-analyses have not shown in a convincing manner the superiority of these procedures in stroke prevention, taking into account the occurrence of possible complications also, as compared with alternative medical treatment...
February 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28211504/novel-preoperative-nomogram-for-prediction-of-futile-resection-in-patients-undergoing-exploration-for-potentially-resectable-intrahepatic-cholangiocarcinoma
#12
Kwangwoo Nam, Dae Wook Hwang, Ju Hyun Shim, Tae Jun Song, Sang Soo Lee, Dong-Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Ki-Hun Kim, Shin Hwang, Kwang-Min Park, Young-Joo Lee, Minkyu Han, Do Hyun Park
Surgical resection is the treatment of choice for intrahepatic cholangiocarcinoma (IHCC). However, discrepancies between preoperative workup and intraoperative findings can occur, resulting in unexpected and unfavorable surgical outcomes. The aim of this study was to develop a feasible preoperative nomogram to predict futile resection of IHCC. A total of 718 patients who underwent curative-intent surgery for IHCC between January 2005 and December 2014 were included. The patients were divided into a training cohort (2005-2010, n = 377) and validation cohort (2011-2014, n = 341)...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28202420/out-of-hospital-cardiac-arrest-ohca-attended-by-mobile-emergency-teams-with-a-physician-on-board-results-of-the-spanish-ohca-registry-oshcar
#13
Fernando Rosell-Ortiz, José M Navalpotro-Pascual, Patricia Fernández Del Valle, Luis Sánchez-Santos, Xavier Escalada-Roig, Alfredo Echarri-Sucunza, José M Adsuar-Quesada, Isabel Ceniceros-Rozalén, José I Ruiz-Azpiazu, Karlos Ibarguren-Olalde, Nuria López-Cabeza, María V Mier-Ruiz, Enrique Martín-Sánchez, Marta Martínez Del Valle, Guadalupe Inza-Muñoz, Juan A Cordero Torres, María J García-Ochoa, José A Cortés-Ramas, Raúl Canabal-Berlanga, Rafael Zoyo López-Navarro, Juan B López-Messa, Javier García Del Águila, Daniel Alonso-Moreno, Carmen Pozo-Pérez, José Bravo-Castello, Natividad Ramos-García, Ignacio Gómez-Larrosa, Francisco J Mellado-Vergel
: Most survival outcomes in out-of-hospital cardiac arrest (OHCA) are provided by emergency medical services (EMS) without a doctor on board. Our objective was to determine such outcomes in a whole country with public physician-led EMS. METHODS: We analyzed data from a nationwide prospective registry of OHCA cases attended by emergency medical teams (EMS) of 19 Public EMS in Spain, covering the period from 1 October, 2013 to 30-October, 2014 (13 months). RESULTS: Advanced life support (ALS) was initiated in 9347 cases (incidence of 18...
February 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/28197545/active-nerve-regeneration-with-failed-target-reinnervation-drives-persistent-neuropathic-pain
#14
Wenrui Xie, Judith A Strong, Jun-Ming Zhang
Peripheral nerves can regenerate and, when injured, may cause neuropathic pain. We propose that the active regeneration process plays a pivotal role in the maintenance of neuropathic pain. In one commonly used rodent neuropathic pain model, pronounced pain behaviors follow ligation and cutting of the L5 spinal nerve. We found that the injured nerve regenerates into the sciatic nerve and functionally reinnervates target tissues: the regenerated nerve conducts electrical signals, mechanical responses, and tracers between the leg/hindpaw and axotomized sensory ganglion...
January 2017: ENeuro
https://www.readbyqxmd.com/read/28196063/long-term-results-and-recurrence-patterns-from-scope-1-a-phase-ii-iii-randomised-trial-of-definitive-chemoradiotherapy-cetuximab-in-oesophageal-cancer
#15
T Crosby, C N Hurt, S Falk, S Gollins, J Staffurth, R Ray, J A Bridgewater, J I Geh, D Cunningham, J Blazeby, R Roy, T Maughan, G Griffiths, S Mukherjee
BACKGROUND: The SCOPE-1 study tested the role of adding cetuximab to conventional definitive chemoradiotherapy (dCRT), and demonstrated greater toxicity and worse survival outcomes. We present the long-term outcomes and patterns of recurrence. METHODS: SCOPE-1 was a phase II/III trial in which patients were randomised to cisplatin 60 mg m(-2) (day 1) and capecitabine 625 mg m(-2) bd (days 1-21) for four cycles +/- cetuximab 400 mg m(-2) day 1 then by 250 mg m(-2) weekly...
February 14, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28194075/futility-of-performing-bone-marrow-cultures-in-pyrexia-of-unknown-origin
#16
Anupama Arya, Rahul Naithani
No abstract text is available yet for this article.
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28193700/the-nuclear-transport-receptor-importin-11-is-a-tumor-suppressor-that-maintains-pten-protein
#17
Muhan Chen, Dawid G Nowak, Navneet Narula, Brian Robinson, Kaitlin Watrud, Alexandra Ambrico, Tali M Herzka, Martha E Zeeman, Matthias Minderer, Wu Zheng, Saya H Ebbesen, Kendra S Plafker, Carlos Stahlhut, Victoria M Y Wang, Lorna Wills, Abu Nasar, Mireia Castillo-Martin, Carlos Cordon-Cardo, John E Wilkinson, Scott Powers, Raffaella Sordella, Nasser K Altorki, Vivek Mittal, Brendon M Stiles, Scott M Plafker, Lloyd C Trotman
Phosphatase and tensin homologue (PTEN) protein levels are critical for tumor suppression. However, the search for a recurrent cancer-associated gene alteration that causes PTEN degradation has remained futile. In this study, we show that Importin-11 (Ipo11) is a transport receptor for PTEN that is required to physically separate PTEN from elements of the PTEN degradation machinery. Mechanistically, we find that the E2 ubiquitin-conjugating enzyme and IPO11 cargo, UBE2E1, are limiting factors for PTEN degradation...
February 13, 2017: Journal of Cell Biology
https://www.readbyqxmd.com/read/28188407/phase-ii-study-of-the-antibody-drug-conjugate-tak-264-mln0264-in-patients-with-metastatic-or-recurrent-adenocarcinoma-of-the-stomach-or-gastroesophageal-junction-expressing-guanylyl-cyclase-c
#18
Khaldoun Almhanna, Maria Luisa Limon Miron, David Wright, Antonio Cubillo Gracian, Richard A Hubner, Jean-Luc Van Laethem, Carolina Muriel López, Maria Alsina, Frederico Longo Muñoz, Johanna Bendell, Irfan Firdaus, Wells Messersmith, Zhan Ye, Adedigbo A Fasanmade, Hadi Danaee, Thea Kalebic
Background The first-in-class antibody-drug conjugate TAK-264 (formerly MLN0264) consists of an antibody targeting guanylyl cyclase C (GCC) conjugated to monomethyl auristatin E (MMAE) via a peptide linker. This phase II study evaluated the efficacy and safety of TAK-264 in patients with adenocarcinoma of the stomach or gastroesophageal junction expressing GCC, who had progressed on ≥1 line of prior therapy. Methods This study used a two-stage design, with an interim analysis conducted after stage I to determine whether to continue to stage II or discontinue on the grounds of futility...
February 11, 2017: Investigational New Drugs
https://www.readbyqxmd.com/read/28186039/integration-of-health-information-systems-using-hl7-a-case-study
#19
Jessica Wan-Yi Kuo, Alex Mu-Hsing Kuo
Interoperability is a prerequisite for health information systems (HIS) that will reduce waste of unnecessary costs, errors, delays, and futile repetition. Many previous studies had proposed different approaches in the attempt to solve interoperability challenges. In this paper, we report our experiences in using Health Level 7 (HL7) standard and adopting the Common Gateway Model for exchanging heath data. The benefits and challenges of using standards for data interoperability are also described.
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28184431/statistical-controversies-in-clinical-research-futility-analyses-in-oncology-lessons-on-potential-pitfalls-from-a-randomised-controlled-trial
#20
E Lesaffre, M J Edelman, N H Hanna, K Park, N Thatcher, S Willemsen, B Gaschler-Markefski, R Kaiser, C Manegold
No abstract text is available yet for this article.
February 9, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
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