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https://www.readbyqxmd.com/read/29145711/timing-of-antibiotics-in-the-management-of-community-acquired-sepsis-can-a-randomised-controlled-trial-of-prehospital-therapy-provide-answers
#1
Andrew A Udy, Karen Smith, Stephen Bernard
Significant tension surrounds the application of antibiotics in suspected infection. Guidelines stress the importance of early empirical broad-spectrum therapy, with select observational data suggesting inferior outcomes when this is delayed. In contrast, microbiological resistance is an ever increasing global problem, with many advocating for a more restricted, culture-driven approach to antibiotic prescription. Controlled trial data are urgently needed, although many clinicians would find withholding of antibiotic therapy unethical...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29145507/light-sensors-for-objective-light-measurement-in-ambulatory-polysomnography
#2
Rachel Schembri, Jo Spong, Allison Peters, Peter Rochford, Philip Wilksch, Fergal J O'Donoghue, Kenneth M Greenwood, Maree Barnes, Gerard A Kennedy, David J Berlowitz
Ambulatory polysomnography (PSG) does not commonly include an objective measure of light to determine the time of lights off (Loff), and thus cannot be used to calculate important indices such as sleep onset latency and sleep efficiency. This study examined the technical specifications and appropriateness of a prototype light sensor (LS) for use in ambulatory Compumedics Somte PSG.Two studies were conducted. The first examined the light measurement characteristics of the LS when used with a portable PSG device, specifically recording trace range, linearity, sensitivity, and stability...
2017: PloS One
https://www.readbyqxmd.com/read/29145323/the-effectiveness-of-2-consecutive-intra-articular-polydeoxyribonucleotide-injections-compared-with-intra-articular-triamcinolone-for-hemiplegic-shoulder-pain-a-strobe-complaint-retrospective-study
#3
Donghwi Park, Kwang Jae Yu, Ju Young Cho, Seung Beom Woo, Junu Park, Zeeihn Lee, Jong Min Kim
The aim of this study was to investigate the effects of intra-articular injection of polydeoxyribonucleotide (PDRN), compared with intraarticular triamcinolone (TA) injection, in subacute stroke patients with hemiplegic shoulder pain (HSP).Participants were subacute stroke patients with HSP who had undergone 2 consecutive intra-articular injections of TA or PDRN.Numeric rating scale (NRS) and passive range of motion (PROM) of hemiplegic shoulder were evaluated until 4 weeks after 2nd injection.In the results, there were significant improvements in all PROM measures 2 weeks after the second injection, compared with pre-injection results, in both groups (P < ...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145257/clinical-features-of-acute-acquired-comitant-esotropia-in-the-chinese-populations
#4
Tao Fu, Jing Wang, Moran Levin, Ping Xi, Dongguo Li, Junfa Li
Acute acquired comitant esotropia (AACE) is an unusual presentation of esotropia that occurs after infancy. This study was aimed to study the clinical features and the differences between children and adult patients with AACE in the Chinese populations.This was a retrospective analysis of patients diagnosed with AACE over 4 years; 69 patients (25 females and 44 males) were identified. The patients were divided into 3 groups: < 10 year-old (n = 6, 8.7%), 10-18 year-old (n = 23, 33.3%), and ≥18 year-old (n = 40, 58...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144799/parathyroid-function-after-total-thyroidectomy-a-randomized-clinical-trial-concerning-the-influence-of-the-surgical-technique
#5
Theodossis S Papavramidis, Olympia Anastasiou, Ioannis Pliakos, George Kotsovolis, Stavros Panidis, Antonios Michalopoulos
Background Thyroidectomy impairs parathyroid function, even if it does not necessarily lead to postoperative clinical hypocalcaemia. This study is prospective and evaluates the PTH function in non-clinically symptomatic patients after total thyroidectomy performed by two different techniques. Materials and Methods Prospective randomized clinical trial including 269 patients undergoing classic (group A) or harmonic scalpel (group B) total thyroidectomy. Preoperatively and at 48 hours biochemical analysis was performed...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29144716/mechanism-of-action-of-non-invasive-cervical-vagus-nerve-stimulation-for-the-treatment-of-primary-headaches
#6
Bruce Simon, Justyna Blake
Stimulation of the cervical vagus nerve with implanted vagus nerve stimulation (iVNS) has been used clinically for more than 20 years to treat patients with epilepsy. More recently, a non-invasive cervical vagus nerve stimulation (nVNS), gammaCore, was developed, which has been purported to also stimulate the vagus nerve without the cost and morbidity associated with an iVNS system. gammaCore has been used to acutely treat various types of primary headaches, including migraine and cluster headaches (CH), and for the prevention of episodic, chronic, and menstrual migraines and CH...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144490/neonatal-lung-ultrasound-exam-guidelines
#7
D Kurepa, N Zaghloul, L Watkins, J Liu
Point-of-care ultrasound (POC-US) is increasingly used especially in emergency and critical-care medicine. It is focused, quick and does not expose patients to ionizing radiation. It encompasses all organ systems and has well-defined indications. Lung ultrasound (LUS) represents one of the most exciting applications in the field of POC-US. It is particularly important to emphasize the role of LUS in neonatology due to the specific pathology inherent in lung immaturity as well as in the particular sensitivity of neonates to repeated radiation exposure...
November 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29143944/one-thousand-seventy-eight-autologous-ivf-cycles-in-women-45%C3%A2-years-and-older-the-largest-single-center-cohort-to-date
#8
Vinay Gunnala, Mohamad Irani, Alexis Melnick, Zev Rosenwaks, Steven Spandorfer
PURPOSE: The purpose of this study was to determine IVF outcomes in women 45 years and older using autologous oocytes. METHODS: This is a retrospective cohort study reviewing all IVF cycles in women ≥ 45 years old from January 1995 to June 2015 that were conducted at one academic medical center. One thousand seventy-eight fresh, autologous IVF cycles met inclusion criteria. PGD/S, natural IVF, and donor egg cycles were excluded. Outcomes were analyzed for the different age groups (age 45, n = 773; age 46, n = 221; age 47, n = 57; age 48, n = 22; age 49, n = 5)...
November 16, 2017: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/29143444/the-subversion-of-mill-and-the-ultimate-aim-of-nursing
#9
Paul C Snelling
This is lightly edited and referenced version of a presentation given at the 20th International Philosophy of Nursing conference in Quebec on 23rd August 2016. Philosophical texts are not given the same prominence in nurse education as their more valued younger sibling, primary research evidence, but they can influence practice through guidelines, codes and espoused values. John Stuart Mill's harm principle, found in On Liberty, is not a universal law, and only a thoroughgoing libertarian would defend it as such, though it, or its remnants, can be seen can be seen in policy documents...
November 15, 2017: Nursing Philosophy: An International Journal for Healthcare Professionals
https://www.readbyqxmd.com/read/29143140/impact-of-conventional-medical-therapy-on-bone-mineral-density-and-bone-turnover-in-adult-patients-with-x-linked-hypophosphatemia-a-6-year-prospective-cohort-study
#10
Vikram Vinod Shanbhogue, Stinus Hansen, Niklas Rye Jørgensen, Signe Sparre Beck-Nielsen
X-linked hypophosphatemia (XLH) is a rare, inheritable disorder manifesting as rickets in children and osteomalacia in adults. While conventional medical treatment with oral phosphate and alfacalcidol is recommended in childhood, it is undecided whether adults should continue therapy. The aim of this 6-year prospective study was to determine the impact of conventional medical treatment on areal bone mineral density (aBMD), bone turnover markers (BTMs) and measures of calcium homeostasis in 27 adult patients with XLH, 11 of whom received medical treatment...
November 15, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/29143065/-complex-joint-reconstruction-and-joint-transplantation-with-the-flocsat-concept-planning-and-surgical-implementation
#11
REVIEW
C Krettek, J-D Clausen, C Neunaber
Cartilage defects in adult patients are so far incurable. Fresh osteochondral allograft (OCA) transplantation is based on the insertion of mature, living, mechanically sound hyaline cartilage into an osteochondral defect where it undergoes osseointegration. Intact hyaline cartilage of OCA does not cause immune reactions in the recipient. Many reports show that small OCA have good osseointegration and show good long-term results. These observations have been incorporated into the development of the fresh large (> 10 cm(2)) osteochondral shell allograft transplantation (FLOCSAT) concept, which is based on the following principles: 1) the thickness of the osseous layer should be kept as thin as possible (target < 6-8 mm) so that the transplant remains stable and fixable...
November 15, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29142849/the-application-of-drains-in-thyroid-surgery
#12
REVIEW
Mattia Portinari, Paolo Carcoforo
It has been shown that the use of drain in thyroid surgery does not reduce the reoperation rate for hemorrhage. The aim of this systematic review was to update the knowledge of the role of drain in thyroid surgery in term of postoperative complications, pain and hospital length of stay (LOS). A systematic search was performed in the PubMed and Embase database to identify all randomized controlled trials (RCTs) comparing clinical outcomes in patients who underwent thyroidectomy or lobectomy with or without drainage...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142079/laboratory-diagnosis-of-parasites-from-the-gastrointestinal-tract
#13
REVIEW
Lynne S Garcia, Michael Arrowood, Evelyne Kokoskin, Graeme P Paltridge, Dylan R Pillai, Gary W Procop, Norbert Ryan, Robyn Y Shimizu, Govinda Visvesvara
This Practical Guidance for Clinical Microbiology document on the laboratory diagnosis of parasites from the gastrointestinal tract provides practical information for the recovery and identification of relevant human parasites. The document is based on a comprehensive literature review and expert consensus on relevant diagnostic methods. However, it does not include didactic information on human parasite life cycles, organism morphology, clinical disease, pathogenesis, treatment, or epidemiology and prevention...
January 2018: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/29141854/a-p53-deficiency-gene-signature-predicts-recurrence-risk-of-patients-with-early-stage-lung-adenocarcinoma
#14
Yanding Zhao, Frederick S Varn, Guoshuai Cai, Feifei Xiao, Christopher I Amos, Chao Cheng
BACKGROUND: Lung cancer is associated with the highest mortality rate of all cancer types, and the most common histological subtype of lung cancer is adenocarcinoma. In order to apply more effective therapeutic treatment, molecular markers that are able to predict the recurrence risk of patients with adenocarcinoma are critically needed. Mutations in TP53 tumor suppressor gene have been found in approximately 50% of lung adenocarcinoma cases, but the presence of a TP53 mutation does not always associate with increased mortality...
November 15, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/29141770/outcomes-following-changing-from-a-two-tiered-to-a-three-tiered-hospital-rapid-response-system
#15
Winston Cheung
Objectives The aim of the present study was to determine whether changing a hospital rapid response system (RRS) from a two-tiered to a three-tiered model can reduce disruption to normal hospital routines while maintaining the same overall patient outcomes.Methods Staff at an Australian teaching hospital attending medical emergency team and cardiac arrest (MET/CA) calls were interviewed after the RRS was changed from a two-tiered to three-tiered model, and the results were compared with a study using the same methods conducted before the change...
November 16, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29141589/reconstructing-cancer-karyotypes-from-short-read-data-the-half-empty-and-half-full-glass
#16
Rami Eitan, Ron Shamir
BACKGROUND: During cancer progression genomes undergo point mutations as well as larger segmental changes. The latter include, among others, segmental deletions duplications, translocations and inversions.The result is a highly complex, patient-specific cancer karyotype. Using high-throughput technologies of deep sequencing and microarrays it is possible to interrogate a cancer genome and produce chromosomal copy number profiles and a list of breakpoints ("jumps") relative to the normal genome...
November 15, 2017: BMC Bioinformatics
https://www.readbyqxmd.com/read/29141515/mri-powered-biomedical-devices
#17
Sierra Hovet, Hongliang Ren, Sheng Xu, Bradford Wood, Junichi Tokuda, Zion Tsz Ho Tse
Magnetic resonance imaging (MRI) is beneficial for imaging-guided procedures because it provides higher resolution images and better soft tissue contrast than computed tomography (CT), ultrasound, and X-ray. MRI can be used to streamline diagnostics and treatment because it does not require patients to be repositioned between scans of different areas of the body. It is even possible to use MRI to visualize, power, and control medical devices inside the human body to access remote locations and perform minimally invasive procedures...
November 16, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/29140943/antibodies-toward-vedolizumab-appear-from-the-first-infusion-onward-and-disappear-over-time
#18
Sumin Bian, Erwin Dreesen, Ho Tsun Tang, Griet Compernolle, Miet Peeters, Gert Van Assche, Marc Ferrante, Séverine Vermeire, Ann Gils
BACKGROUND: Vedolizumab (VDZ) has been approved for the treatment of patients with moderate-to-severe Crohn's disease and ulcerative colitis. The GEMINI trials reported a low prevalence of anti-VDZ antibodies (AVA). However, the AVA assays used in GEMINI were drug sensitive, resulting in a possible underestimation of the rate of AVA formation. This study aimed to monitor immunogenicity of VDZ in a real-life cohort using a drug-resistant AVA assay. METHODS: Using a combination of VDZ/AVA complex precipitation and acid dissociation, a drug-resistant assay for AVA detection in the presence of high VDZ concentrations has been developed and analytically validated...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29140887/inconsistencies-between-two-cross-cultural-adaptations-of-the-hospital-survey-on-patient-safety-culture-into-french
#19
Bastien Boussat, Patrice François, Gérald Gandon, Joris Giai, Arnaud Seigneurin, Thomas Perneger, José Labarère
OBJECTIVES: Two cross-cultural adaptations of the 12-dimension Hospital Survey on Patient Safety Culture (HSOPSC) into French coexist: the Occelli and Vlayen versions. The objective of this study was to assess the psychometric properties of the Occelli version in comparison with those reported for the Vlayen and the original US versions of this instrument. METHODS: Using the original data from a cross-sectional study of 5,064 employees at a single university hospital in France, we examined the acceptability, internal consistency, factorial structure, and construct validity of the Occelli version of the HSOPSC...
November 15, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29140581/comparison-of-long-term-outcomes-between-pull-through-resection-and-mandibular-lip-split-surgery-for-t4a-tongue-floor-of-mouth-cancers
#20
Shih-Jung Cheng, Hui-Hsin Ko, Jang-Jaer Lee, Sang-Heng Kok
BACKGROUND: The purpose of this study was to determine whether the pull-through resection is better than the mandibular lip-split for advanced tongue/floor of mouth (FOM) cancers, which remains inconclusive. METHODS: A retrospective cohort study was performed on 91 patients with T4a tongue/FOM cancers from 2009 to 2014. Cases with mandibular resection were excluded. The pull-through resection was used when the mouth opening was ≥15 mm; otherwise the mandibular lip-split was used...
November 15, 2017: Head & Neck
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