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https://www.readbyqxmd.com/read/28735650/prognostic-utility-of-neuroinjury-biomarkers-in-post-out-of-hospital-cardiac-arrest-ohca-patient-management
#1
S S Gul, K W Huesgen, K K Wang, K Mark, J A Tyndall
Despite aggressive intervention, patients who survive an out-of-hospital cardiac arrest (OHCA) generally have very poor prognoses, with nationwide survival rates of approximately 10-20%. Approximately 90% of survivors will have moderate to severe neurological injury ranging from moderate cognitive impairment to brain death. Currently, few early prognostic indicators are considered reliable enough to support patients' families and clinicians' in their decisions regarding medical futility. Blood biomarkers of neurological injury after OHCA may be of prognostic value in these cases...
August 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28734694/regenerative-biosensor-for-use-with-biotinylated-bait-molecules
#2
Claudia Knoglinger, Andreas Zich, Lukas Traxler, Kristýna Poslední, Gloria Friedl, Bianca Ruttmann, Anika Schorpp, Katharina Müller, Mirjam Zimmermann, Hermann J Gruber
Label-free biosensors are ideally suited for the quantitative analysis of specific interactions among biomolecules or of biomolecules with drugs, as well as for quantitation of diagnostic markers in biofluids. In contrast to the label-dependent methods, a new assay for a particular prey molecule can be set up within few minutes by immobilizing the corresponding bait molecule on the sensor surface, using one of the common immobilization procedures. Unfortunately, the extensive application of label-free biosensors is still hampered by the fact that the immobilization of the bait molecule is usually irreversible; for that reason, a new chip (which is expensive) is required for every successful or futile attempt...
July 13, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28733645/hdac3-is-a-molecular-brake-of-the-metabolic-switch-supporting-white-adipose-tissue-browning
#3
Alessandra Ferrari, Raffaella Longo, Erika Fiorino, Rui Silva, Nico Mitro, Gaia Cermenati, Federica Gilardi, Béatrice Desvergne, Annapaola Andolfo, Cinzia Magagnotti, Donatella Caruso, Emma De Fabiani, Scott W Hiebert, Maurizio Crestani
White adipose tissue (WAT) can undergo a phenotypic switch, known as browning, in response to environmental stimuli such as cold. Post-translational modifications of histones have been shown to regulate cellular energy metabolism, but their role in white adipose tissue physiology remains incompletely understood. Here we show that histone deacetylase 3 (HDAC3) regulates WAT metabolism and function. Selective ablation of Hdac3 in fat switches the metabolic signature of WAT by activating a futile cycle of de novo fatty acid synthesis and β-oxidation that potentiates WAT oxidative capacity and ultimately supports browning...
July 21, 2017: Nature Communications
https://www.readbyqxmd.com/read/28733295/the-impact-of-healthcare-professionals-personality-and-religious-beliefs-on-the-decisions-to-forego-life-sustaining-treatments-an-observational-multicentre-cross-sectional-study-in-greek-intensive-care-units
#4
Asimenia Ntantana, Dimitrios Matamis, Savvoula Savvidou, Kyriaki Marmanidou, Maria Giannakou, Μary Gouva, George Nakos, Vasilios Koulouras
OBJECTIVES: To assess the opinion of intensive care unit (ICU) personnel and the impact of their personality and religious beliefs on decisions to forego life-sustaining treatments (DFLSTs). SETTING: Cross-sectional, observational, national study in 18 multidisciplinary Greek ICUs, with >6 beds, between June and December 2015. PARTICIPANTS: 149 doctors and 320 nurses who voluntarily and anonymously answered the End-of-Life (EoL) attitudes, Personality (EPQ) and Religion (SpREUK) questionnaires...
July 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728997/sepsis-reconsidered-identifying-novel-metrics-for-behavioral-landscape-characterization-with-a-high-performance-computing-implementation-of-an-agent-based-model
#5
Chase Cockrell, Gary An
OBJECTIVES: Sepsis affects nearly 1 million people in the United States per year, has a mortality rate of 28-50% and requires more than $20 billion a year in hospital costs. Over a quarter century of research has not yielded a single reliable diagnostic test or a directed therapeutic agent for sepsis. Central to this insufficiency is the fact that sepsis remains a clinical/physiological diagnosis representing a multitude of molecularly heterogeneous pathological trajectories. Advances in computational capabilities offered by High Performance Computing (HPC) platforms call for an evolution in the investigation of sepsis to attempt to define the boundaries of traditional research (bench, clinical and computational) through the use of computational proxy models...
July 17, 2017: Journal of Theoretical Biology
https://www.readbyqxmd.com/read/28718858/donationsutredningen-%C3%A3-ppnar-f%C3%A3-r-nya-organdonatorer-kr%C3%A3-ver-reflexion-om-m%C3%A3-nniskov%C3%A3-rdesprincipen-och-samtycke
#6
Stellan Welin
Swedish white paper on donation can give more donors without compromising ethics The White Paper on organ donation (SOU 2015:84) proposes new regulations for organ donation. In particular it spells out that it is permissible to take medical steps to preserve organs while the patient is still alive. It is proposed that this should be allowed after the medical team has declared that the continuation of life sustaining treatment is futile. The white paper opens up for donation after cardiac death. There has been some critique of the white paper for lack of deeper ethical discussions...
July 14, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28715945/methodological-issues-associated-with-clinical-trials-in-epilepsy
#7
Edoardo Ferlazzo, Chiara Sueri, Sara Gasparini, Emilio Russo, Vittoria Cianci, Michele Ascoli, Giovambattista De Sarro, Umberto Aguglia
despite methodological advances in epilepsy clinical trials, the proportion of patients reaching seizure-freedom has not substantially changed over the years. We review the main methodological limitations of current trials, the possible strategies to overcome these limits, and the issues that need to be addressed in next future. Area covered: references were identified by PubMed search until March 2017 and unpublished literature was searched on ClinicalTrials.gov. Add-on trials mainly involve refractory epilepsy subjects, reducing overall response to the investigational drug...
July 18, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28714544/otolaryngology-externships-and-the-match-productive-or-futile
#8
Carissa M Thomas, Cristina Cabrera-Muffly
OBJECTIVES/HYPOTHESIS: The objectives of this study were to summarize externship experiences among recent graduates and current residents in otolaryngology residency programs and determine whether externships affect the match process. STUDY DESIGN: Cross-sectional survey. METHODS: A survey was distributed to otolaryngology residents in allopathic US residency programs and otolaryngology graduates from the past 5 years (2011-2015). There were 2,141 surveys distributed...
July 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28713042/implementation-of-the-universal-bls-termination-of-resuscitation-rule-in-a-rural-ems-system
#9
Matthew R Jordan, Michael F O'Keefe, David Weiss, C Wes Cubberley, Charles D MacLean, Daniel L Wolfson
BACKGROUND: Emergency Medical Services (EMS) are often the first medical providers to begin resuscitation of out-of-hospital cardiac arrest (OHCA) victims. The universal Basic Life Support Termination of Resuscitation (BLS-TOR) rule is a validated clinical prediction tool used to identify patients in which continued resuscitation efforts are futile. OBJECTIVE: The primary aim is to compare the rate of transport of OHCA cases before and after the implementation of a BLS-TOR protocol and to determine the compliance rate of EMS personnel with the new protocol in a largely volunteer, rural system...
July 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/28711629/randomized-comparison-of-3-high-level-disinfection-and-sterilization-procedures-for-duodenoscopes
#10
Graham M Snyder, Sharon B Wright, Anne Smithey, Meir Mizrahi, Michelle Sheppard, Elizabeth B Hirsch, Ram Chuttani, Riley Heroux, David S Yassa, Lovisa B Olafsdottir, Roger B Davis, Anastasiou Jiannis, Vijay Bapat, Kiran Bidari, Douglas K Pleskow, Daniel Leffler, Benjamin Lane, Alice Chen, Howard S Gold, Anthony Bartley, Aleah D King, Mandeep S Sawhney
BACKGROUND AND AIMS: Duodenoscopes have been implicated in the transmission of multi-drug resistant bacteria (MDRO). We compared the frequency of duodenoscope contamination with MDRO or any other bacteria after disinfection or sterilization by 3 different methods. METHODS: We performed a single-center prospective randomized study in which duodenoscopes were randomly reprocessed by standard high-level disinfection (sHLD), double high-level disinfection (dHLD), or standard high-level disinfection followed by ethylene oxide gas sterilization (HLD/ETO)...
July 12, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28707460/the-effect-of-hospice-consultation-on-aggressive-treatment-of-lung-cancer
#11
Shin Hye Yoo, Bhumsuk Keam, Miso Kim, Tae Min Kim, Dong-Wan Kim, Dae Seog Heo
Purpose: The aims of this study were to investigate trends of aggressive treatment of non-small cell lung cancer (NSCLC) patients at the end-of-life (EOL) during the recent five years and examine the relationship between hospice consultation (HC) and aggressive care. Materials and Methods: The medical records of 789 patients with stage IIIB-IV NSCLC at SNUH who received palliative chemotherapy and died from 2010 to 2014 were retrospectively reviewed. Indicators of aggressive treatment were evaluated, and the association of HC with these indicators was analyzed...
July 14, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28707266/6-ohda-lesioned-adult-zebrafish-as-a-useful-parkinson-s-disease-model-for-dopaminergic-neuroregeneration
#12
Yuganthini Vijayanathan, Fei Tieng Lim, Siong Meng Lim, Chiau Ming Long, Maw Pin Tan, Abu Bakar Abdul Majeed, Kalavathy Ramasamy
Conventional mammalian models of neurodegeneration are often limited by futile axonogenesis with minimal functional recuperation of severed neurons. The emergence of zebrafish, a non-mammalian model with excellent neuroregenerative properties, may address these limitations. This study aimed to establish an adult zebrafish-based, neurotoxin-induced Parkinson's disease (PD) model and subsequently validate the regenerative capability of dopaminergic neurons (DpN). The DpN of adult male zebrafish (Danio rerio) were lesioned by microinjecting 6-hydroxydopamine (6-OHDA) neurotoxin (6...
July 13, 2017: Neurotoxicity Research
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#13
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation following cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28702772/a-phase-ii-trial-of-erlotinib-monotherapy-in-advanced-pancreatic-cancer-as-a-first-or-second-line-agent
#14
Christos Fountzilas, Ravi Chhatrala, Nikhil Khushalani, Wei Tan, Charles LeVea, Alan Hutson, Chris Tucker, Wen Wee Ma, Graham Warren, Patrick Boland, Renuka Iyer
INTRODUCTION: Pancreatic adenocarcinoma carries a grim prognosis. In 2007, gemcitabine with erlotinib emerged as an appropriate treatment option for patients with advanced inoperable or metastatic disease (APC). In this phase II trial we sought to evaluate the efficacy of erlotinib monotherapy in patients with APC who had disease refractory to or ineligibility for gemcitabine-based therapy. METHODS: Eligible patients who had received 0 or 1 non-EGFR inhibitor containing gemcitabine-based chemotherapy for APC were recruited prospectively and treated with erlotinib 150 mg orally daily until unacceptable toxicity or disease progression...
July 12, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28702329/metformin-causes-a-futile-intestinal-hepatic-cycle-which-increases-energy-expenditure-and-slows-down-development-of-a-type-2-diabetes-like-state
#15
Philipp Schommers, Anna Thurau, Insa Bultmann-Mellin, Maria Guschlbauer, Andreas R Klatt, Jan Rozman, Martin Klingenspor, Martin Hrabe de Angelis, Jens Alber, Dirk Gründemann, Anja Sterner-Kock, Rudolf J Wiesner
OBJECTIVE: Metformin, the first line drug for treatment of type 2 diabetes, suppresses hepatic gluconeogenesis and reduces body weight in patients, the latter by an unknown mechanism. METHODS: Mice on a high fat diet were continuously fed metformin in a therapeutically relevant dose, mimicking a retarded formulation. RESULTS: Feeding metformin in pharmacologically relevant doses to mice on a high fat diet normalized HbA1c levels and ameliorated glucose tolerance, as expected, but also considerably slowed down weight gain...
July 2017: Molecular Metabolism
https://www.readbyqxmd.com/read/28701493/the-crest-e-study-of-creatine-for-huntington-disease-a-randomized-controlled-trial
#16
Steven M Hersch, Giovanni Schifitto, David Oakes, Amy-Lee Bredlau, Catherine M Meyers, Richard Nahin, Herminia Diana Rosas
OBJECTIVE: To investigate whether creatine administration could slow progressive functional decline in adults with early symptoms of Huntington disease. METHODS: We conducted a multicenter, randomized, double-blind, placebo-controlled study of up to 40 g daily of creatine monohydrate in participants with stage I and II HD treated for up to 48 months. The primary outcome measure was the rate of change in total functional capacity (TFC) between baseline and end of follow-up...
July 12, 2017: Neurology
https://www.readbyqxmd.com/read/28699370/adc-quantification-in-basilar-artery-occlusion-as-an-indicator-of-clinical-outcome-after-endovascular-treatment
#17
Daniela Pereira, Isabel Fragata, José Amorim, João Reis
Background Acute ischemic stroke due to basilar artery occlusion (BAO) is associated with a dismal prognosis and, even though endovascular treatment (EVT) contributed to an improvement in clinical outcomes, patient selection is difficult and frequently results in futile recanalization. We investigated the prognostic value of baseline ADC quantification in patients with BAO undergoing EVT. Methods We retrospectively evaluated MRI at admission in 11 patients with BAO undergoing EVT. Ischemic lesions were defined on baseline DWI and minimum ADC (minADC), ADC ratio and total area were quantified...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28695689/patterns-of-health-services-utilization-in-the-last-two-weeks-of-life-among-cancer-patients-experience-in-an-australian-academic-cancer-center
#18
Wee Loon Ong, Richard Khor, Mathias Bressel, Phillip Tran, Jo Tedesco, Keen Hun Tai, David Ball, Gillian Duchesne, Farshad Foroudi
AIM: To report the trend in end-of-life health services (HS) utilization among cancer patients treated in a large Australian academic cancer center over a 12-year period. METHODS: This is a retrospective study of cancer patients treated at the Peter MacCallum Cancer Centre (PMCC), who had documented death between January 2002 and December 2013. Using administrative and billing database, we report on the utilization of different categories of HS within two weeks of death: diagnostic investigations (pathology and radiology), inpatient and outpatient services, and potentially futile interventions (PFI, which include radiotherapy, chemotherapy and surgery)...
July 11, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28691054/use-of-warm-carbon-dioxide-insufflators-does-not-affect-intra-colonic-gas-temperature-and-has-no-effect-on-polyp-detection-rate-during-colonoscopy-a-randomized-controlled-trial
#19
Akash M Patel, Jordan Green, Fahd Jowhari, Lawrence Hookey
BACKGROUND AND STUDY AIMS : Methods to improve polyp detection during colonoscopy have been investigated, with conflicting results for warm water irrigation. Carbon Dioxide (CO 2) warmed to 37 °C may have similar or more pronounced effects on bowel motility. This study aimed to assess whether warmed CO 2 would improve polyp detection compared to room temperature air insufflation. PATIENTS AND METHODS:  This was a double-blind, randomized controlled trial that enrolled 204 patients undergoing screening or surveillance outpatient colonoscopy...
July 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28687641/immediate-vascular-imaging-needed-for-efficient-triage-of-patients-with-acute-ischemic-stroke-initially-admitted-to-nonthrombectomy-centers
#20
Gregoire Boulouis, Khawja-Ahmeruddin Siddiqui, Arne Lauer, Andreas Charidimou, Robert W Regenhardt, Anand Viswanathan, Thabele M Leslie-Mazwi, Natalia Rost, Lee H Schwamm
BACKGROUND AND PURPOSE: Current guidelines for endovascular thrombectomy (EVT) used to select patients for transfer to thrombectomy-capable stroke centers (TSC) may result in unnecessary transfers. We sought to determine the impact of simulated baseline vascular imaging on reducing unnecessary transfers and clinical-imaging factors associated with receiving EVT after transfer. METHODS: We identified patients with stroke transferred for EVT from 30 referring hospitals between 2010 and 2016 who had a referring hospitals brain computed tomography and repeat imaging on TSC arrival available for review...
July 7, 2017: Stroke; a Journal of Cerebral Circulation
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