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https://www.readbyqxmd.com/read/29792018/predictive-factors-of-a-poor-outcome-following-revascularization-for-critical-limb-ischemia-implications-for-practice
#1
Mireia Martínez, Claudia Sosa, Alina Velescu, Carme Llort, Roberto Elosua, Albert Clarà
BACKGROUND/OBJECTIVE: Advancements in open and endovascular techniques have brought a widespread indication of revascularization in the majority of patients with critical limb ischemia (CLI). However, some cases still have a dismal short-term outcome. Identifying preoperative variables that characterize these patients could be important to prevent futile decisions. The aim of this study was to define predictive risk factors of mortality and/or major amputation after revascularization for CLI...
May 23, 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29791943/the-growing-reality-of-the-neurological-complications-of-global-stem-cell-tourism
#2
Katie Julian, Nick Yuhasz, Ethan Hollingsworth, Jaime Imitola
"Stem cell tourism" is defined as the unethical practice of offering unproven cellular preparations to patients suffering from various medical conditions. This phenomenon is rising in the field of neurology as patients are requesting information and opportunities for treatment with stem cells for incurable conditions such as multiple sclerosis and amyotrophic lateral sclerosis, despite their clinical research and experimental designation. Here, we review the recent trends in "stem cell tourism" in both the United States and abroad, and discuss the recent reports of neurological complications from these activities...
April 2018: Seminars in Neurology
https://www.readbyqxmd.com/read/29791762/ethical-dilemmas-in-nursing-an-integrative-review
#3
REVIEW
Jennifer Rainer, Joanne Kraenzle Schneider, Rebecca A Lorenz
AIMS: The purpose of this integrative review was to identify themes and gaps in the literature to stimulate researchers to develop strategies to guide decision-making among clinical nurses faced with ethical dilemmas. BACKGROUND: The concept of ethical dilemmas has been well explored in nursing because of the frequency of ethical dilemmas in practice and the toll these dilemmas can take on nurses. Although ethical dilemmas are prevalent in nursing practice, frequently leading to moral distress, there is little guidance in the literature to help nurses resolve them...
May 23, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29790655/maximising-yield-of-peripheral-blood-flow-cytometry-for-chronic-lymphoproliferative-disorders
#4
H Y Lim, F S Hong
INTRODUCTION: Flow cytometry is used in the diagnosis of haematological diseases including chronic lymphoproliferative disorders. This audit aims to ascertain the real-world indications for peripheral blood (PB) flow cytometry and which of these are associated with higher diagnostic yields. METHODS: All PB flow cytometry requests for chronic lymphoproliferative disorders from 1 January 2014 to 31 December 2014 were identified using the laboratory information system...
May 23, 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29787472/a-randomised-placebo-controlled-clinical-trial-with-the-%C3%AE-2-3-5-subunit-selective-gabaa-positive-allosteric-modulator-pf-06372865-in-patients-with-chronic-low-back-pain
#5
Rachel Gurrell, Pinky Dua, Gang Feng, Maria Sudworth, Mark Whitlock, David S Reynolds, Richard P Butt
The effect of PF-06372865, a subtype selective positive allosteric modulator (PAM) of the γ-aminobutyric acid type A (GABAA) receptor, on chronic low back pain was investigated in a randomised, placebo and active-controlled Phase 2 clinical trial. The parallel treatment group trial consisted of a 1 week single-blind placebo run in phase, followed by 4 weeks double-blind treatment. Patients were randomised to receive either PF-06372865, naproxen or placebo BID for 4 weeks. The primary endpoint was the numerical rating score (NRS) of low back pain intensity (LBPI) after 4 weeks of active treatment...
May 21, 2018: Pain
https://www.readbyqxmd.com/read/29785716/randomised-italian-sonography-for-occiput-position-trial-ante-vacuum-r-i-s-pos-t-a
#6
Tullio Ghi, Andrea Dall'Asta, Bianca Masturzo, Beatrice Tassis, Monica Martinelli, Nicola Volpe, Federico Prefumo, Giuseppe Rizzo, Gianluigi Pilu, Luisa Cariello, Lorenzo Sabbioni, Antonio Morselli-Labate, Tullia Todros, Tiziana Frusca
OBJECTIVE: To assess whether the ultrasound diagnosis of fetal head position reduces the risk of failed vacuum delivery and improves labor outcomes. METHODS: R.I.S.POS.T.A. (Randomised Italian Sonography for Occiput POSition Trial Ante Vacuum) was a randomised controlled trial conducted from April 2014 to June 2017 and involving thirteen Italian maternity hospitals. Singleton term pregnancies with cephalic presentation where a decision for instrumental delivery by vacuum extractor was made were included...
May 21, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29779997/variations-in-time-to-benefit-among-clinical-trials-of-cholesterol-lowering-drugs
#7
Philip J Barter, David D Waters
BACKGROUND: Time to benefit (TTB) in clinical trials of cholesterol-lowering drugs is important because it may provide a clue as to the potential mechanism of action of the drug, it is helpful in determining when to stop a trial for futility, and it may inform treatment decisions in subjects with reduced life expectancy. OBJECTIVE: To compare TTB among clinical trials of cholesterol-lowering drugs. METHODS: We examined TTB in 24 trials of cholesterol-lowering drugs with positive outcomes...
April 21, 2018: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29778857/development-of-a-risk-score-based-on-aortic-calcification-to-predict-1-year-mortality-after-transcatheter-aortic-valve-replacement
#8
Pierre Lantelme, Hélène Eltchaninoff, Muriel Rabilloud, Géraud Souteyrand, Marion Dupré, Marco Spaziano, Marc Bonnet, Clément Becle, Benjamin Riche, Eric Durand, Erik Bouvier, Jean-Nicolas Dacher, Pierre-Yves Courand, Lucie Cassagnes, Eduardo E Dávila Serrano, Pascal Motreff, Loic Boussel, Thierry Lefèvre, Brahim Harbaoui
OBJECTIVES: The aim of this study was to develop a new scoring system based on thoracic aortic calcification (TAC) to predict 1-year cardiovascular and all-cause mortality. BACKGROUND: A calcified aorta is often associated with poor prognosis after transcatheter aortic valve replacement (TAVR). A risk score encompassing aortic calcification may be valuable in identifying poor TAVR responders. METHODS: The C4 CAPRI (4 Cities for Assessing CAlcification PRognostic Impact) multicenter study included a training cohort (1,425 patients treated using TAVR between 2010 and 2014) and a contemporary test cohort (311 patients treated in 2015)...
May 11, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29776804/hemicraniectomy-for-malignant-middle-cerebral-artery-syndrome-a-review-of-functional-outcomes-in-two-high-volume-stroke-centers
#9
Abhi Pandhi, Georgios Tsivgoulis, Nitin Goyal, Muhammad F Ishfaq, Shailesh Male, Efstathios Boviatsis, Jason J Chang, Ramin Zand, Konstantinos Voumvourakis, Lucas Elijovich, Anne W Alexandrov, Marc D Malkoff, Daniel Hoit, Adam S Arthur, Andrei V Alexandrov
BACKGROUND AND PURPOSE: Despite recent landmark randomized controlled trials showing significant benefits for hemicraniectomy (HCT) compared with medical therapy (MT) in patients with malignant middle cerebral artery infarction (MMCAI), HCT rates have not substantially increased in the United States. We sought to evaluate early outcomes in patients with MMCAI who were treated with HCT (cases) in comparison to patients treated with MT due to the perception of procedural futility by families (controls)...
May 15, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29774044/identification-and-functional-characterization-of-sugarcane-invertase-inhibitor-shinh1-a-potential-candidate-for-reducing-pre-and-post-harvest-loss-of-sucrose-in-sugarcane
#10
Suresha G Shivalingamurthy, Raveendra Anangi, Sundaravelpandian Kalaipandian, Donna Glassop, Glenn F King, Anne L Rae
In sugarcane, invertase enzymes play a key role in sucrose accumulation and are also involved in futile reactions where sucrose is continuously degraded during the pre- and post-harvest period, thereby reducing sugar yield and recovery. Invertase inhibitor (INVINH) proteins play a key role in post-translation regulation of plant invertases through which sucrose hydrolysis is controlled. INVINH proteins are small (18 kDa) members of the pectin methylesterase inhibitor superfamily and they are moderately conserved across plants...
2018: Frontiers in Plant Science
https://www.readbyqxmd.com/read/29773715/embolus-retriever-with-interlinked-cages-versus-other-stent-retrievers-in-acute-ischemic-stroke-an-observational-comparative-study
#11
Philipp Gruber, Salome Zeller, Carlos Garcia-Esperon, Jatta Berberat, Javier Anon, Michael Diepers, Krassen Nedeltchev, Fabian Flottmann, Jens Fiehler, Luca Remonda, Timo Kahles
BACKGROUND AND PURPOSE: Given the promising performance of the new Embolus Retriever with Interlinked Cages (ERIC) in smaller case series, we sought to assess the efficacy and safety of mechanical thrombectomy (MT) with ERIC compared with other stent retrievers (SRs) in acute ischemic stroke due to large vessel occlusion (LVO). METHODS: We reviewed the databases of two comprehensive stroke centers in in Germany and Switzerland for MT due to LVO in the anterior circulation with either ERIC or another SR as a first device...
May 17, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29768067/the-development-of-fluorescence-guided-surgery-for-pancreatic-cancer-from-bench-to-clinic
#12
Thinzar M Lwin, Robert M Hoffman, Michael Bouvet
Surgeons face major challenges in achieving curative R0 resection for pancreatic cancers. When the lesion is localized, they must appropriately visualize the tumor, determine appropriate resection margins, and ensure complete tumor clearance. Real-time surgical navigation using fluorescence-guidance has enhanced the ability of surgeons to see the tumor and has the potential to assist in achieving more oncologically-complete resections. When there is metastatic disease, fluorescence enhancement can help detect these lesions and prevent unnecessary and futile surgeries...
May 16, 2018: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/29767728/andecaliximab-anti-matrix-metalloproteinase-9-induction-therapy-for-ulcerative-colitis-a-randomised-double-blind-placebo-controlled-phase-2-3-study-in-patients-with-moderate-to-severe-disease
#13
William J Sandborn, Bal R Bhandari, Charles Randall, Ziad H Younes, Tomasz Romanczyk, Yan Xin, Emily Wendt, Hao Chai, Matt McKevitt, Sally Zhao, John S Sundy, Satish Keshav, Silvio Danese
Background and Aims: Matrix metalloproteinase-9 [MMP9] is implicated in the pathogenesis of ulcerative colitis [UC] via disruption of intestinal barrier integrity and function. A phase 2/3 combined trial was designed to examine the efficacy, safety, and pharmacokinetics of the anti-MMP9 antibody, andecaliximab [formerly GS-5745], in patients with moderately to severely active UC. Methods: Patients were randomised [1:1:1] to receive placebo, 150 mg andecaliximab every 2 weeks [Q2W], or 150 mg andecaliximab weekly [QW], via subcutaneous administration...
May 14, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29766728/-euthanasia-legal-comparison-in-selected-european-countries
#14
Adam Doležal
This article deals with the subject of euthanasia (all its forms) and other end-of-life decisions, such as assisted suicide, withdrawing and whithholding life-sustaining treatments. Among other things, the article will also deal with the issue of the offense of Homicide by the Victims Request. Based on an empirical historical method, the article compares the various selected legal orders. From this analysis, it draws some conclusions that have an impact on ethical discourse. First of all, the terminology is defined in the article, which is very important in this area...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29765754/synthesis-and-crystal-structures-of-2-bromo-1-3-di-methyl-imidazolium-iodides
#15
Martin Lampl, Gerhard Laus, Volker Kahlenberg, Klaus Wurst, Hubert Huppertz, Herwig Schottenberger
Attempts at direct bromination of 1,3-di-methyl-imidazolium salts were futile. The title compounds, 2-bromo-1,3-di-methyl-imidazolium iodide chloro-form 0.33-solvate, C5 H8 BrN2 + ·I- ·0.33CHCl3 , 2-bromo-1,3-di-methyl-imidazolium iodide di-chloro-methane hemisolvate, C5 H8 BrN2 + ·I- ·0.5CH2 Cl2 , and 2-bromo-1,3-di-methyl-imidazolium iodide hemi(diiodide), C5 H8 BrN2 + ·I- ·0.5I2 , were obtained by methyl-ation of 2-bromo-1-methyl-imidazole. They crystallized as CHCl3 , CH2 Cl2 or I2 solvates/adducts...
April 1, 2018: Acta Crystallographica. Section E, Crystallographic Communications
https://www.readbyqxmd.com/read/29758944/the-conundrum-of-gsk3-inhibitors-is-it-the-dawn-of-a-new-beginning
#16
Ratan V Bhat, Ulf Andersson, Shalini Andersson, Laurent Knerr, Udo Bauer, Anna Sundgren Andersson
Spanning over three decades of extensive drug discovery research, the efforts to develop a potent and selective GSK3 inhibitor as a therapeutic for the treatment of type 2 diabetes, Alzheimer's disease (AD), bipolar disorders and cancer have been futile. Since its initial discovery in 1980 and subsequent decades of research, one cannot underscore the importance of the target and the promise of a game changing disease modifier. Several pharmaceutical companies, biotech companies, and academic institutions raged in a quest to unravel the biology and discover potent and selective GSK3 inhibitors, some of which went through clinical trials...
May 11, 2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29752484/surveillance-mri-for-the-detection-of-locally-recurrent-ewing-sarcoma-seems-futile
#17
Ömer Kasalak, Amelie Dammann, Hugo J A Adams, Jelle Overbosch, Rudi A J O Dierckx, Paul C Jutte, Thomas C Kwee
PURPOSE: To determine the frequency of locally recurrent Ewing sarcoma on surveillance MRI and the outcome of these patients. MATERIALS AND METHODS: This retrospective single-center study included all patients with newly diagnosed Ewing sarcoma who underwent surveillance MRI of the primary tumor location after primary treatment between 1997 and 2016. RESULTS: Thirty-two patients underwent a total of 176 local surveillance MRI scans, yielding an average of 5...
May 11, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29750396/a-phase-1-2-dose-finding-safety-and-activity-study-of-cabazitaxel-in-pediatric-patients-with-refractory-solid-tumors-including-tumors-of-the-central-nervous-system
#18
Peter E Manley, Tanya Trippett, Amy A Smith, Margaret E Macy, Sarah E S Leary, Jessica Boklan, Kenneth J Cohen, Stewart Goldman, Lindsay B Kilburn, Girish Dhall, Jeanne Devin, Cynthia E Herzog, Sonia Partap, Floris Fauchet, Emmy Badreddine, John P Bernard, Susan N Chi
BACKGROUND: This phase 1/2 study (NCT01751308) evaluated cabazitaxel in pediatric patients. Phase 1 determined the maximum tolerated dose (MTD) in patients with recurrent/refractory solid tumors, including central nervous system (CNS) tumors. Phase 2 evaluated activity in pediatric recurrent high-grade glioma (HGG) or diffuse intrinsic pontine glioma (DIPG). PROCEDURE: In phase 1, a 3 + 3 dose-escalation study design was followed. Cabazitaxel was administered at a starting dose of 20 mg/m2 ...
May 11, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29748717/ethical-challenges-in-resuscitation
#19
REVIEW
Spyros D Mentzelopoulos, Anne-Marie Slowther, Zoe Fritz, Claudio Sandroni, Theodoros Xanthos, Clifton Callaway, Gavin D Perkins, Craig Newgard, Eleni Ischaki, Robert Greif, Erwin Kompanje, Leo Bossaert
PURPOSE: A rapidly evolving resuscitation science provides more effective treatments to an aging population with multiple comorbidites. Concurrently, emergency care has become patient-centered. This review aims to describe challenges associated with the application of key principles of bioethics in resuscitation and post-resuscitation care; propose actions to address these challenges; and highlight the need for evidence-based ethics and consensus on ethical principles interpretation. METHODS: Following agreement on the article's outline, subgroups of 2-3 authors provided narrative reviews of ethical issues concerning autonomy and honesty, beneficence/nonmaleficence and dignity, justice, specific practices/circumstances such as family presence during resuscitation, and emergency research...
May 10, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29746987/age-and-benefit-of-early-coronary-angiography-after-out-of-hospital-cardiac-arrest-in-patients-presenting-with-shockable-rhythm-insights-from-the-sudden-death-expertise-center-registry
#20
Nadia Aissaoui, Wulfran Bougouin, Florence Dumas, Franckie Beganton, Richard Chocron, Olivier Varenne, Christian Spaulding, Nicole Karam, Gilles Montalescot, Pierre Aubry, Georges Sideris, Eloi Marijon, Xavier Jouven, Alain Cariou
BACKGROUND: Little is known about the association between provision of post-resuscitation care and prognosis of out-of-hospital cardiac arrest(OHCA) in elderly patients. Previous studies have suggested futility after 65 years of age. OBJECTIVES: We aimed to evaluate the association of early coronary angiogram(CAG) followed if necessary by percutaneous coronary intervention(PCI), with favorable outcome after OHCA among elderly patients, compared to younger patients...
May 7, 2018: Resuscitation
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