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https://www.readbyqxmd.com/read/29346650/persistence-of-zika-virus-after-birth-clinical-virological-neuroimaging-and-neuropathological-documentation-in-a-5-month-infant-with-congenital-zika-syndrome
#1
Leila Chimelli, Sheila Moura Pone, Elyzabeth Avvad-Portari, Zilton Farias Meira Vasconcelos, Andrea Araújo Zin, Daniela Prado Cunha, Nathalia Raposo Thompson, Maria Elisabeth Lopes Moreira, Clayton A Wiley, Marcos Vinicius da Silva Pone
During the Zika epidemic in Brazil, a baby was born at term with microcephaly and arthrogryposis. The mother had Zika symptoms at 10 weeks of gestation. At 17 weeks, ultrasound showed cerebral malformation and ventriculomegaly. At 24 weeks, the amniotic fluid contained ZIKV RNA and at birth, placenta and maternal blood were also positive using RT-qPCR. At birth the baby urine contained ZIKV RNA, whereas CSF at birth and urine at 17 days did not. Seizures started at 6 days. EEG was abnormal and CT scan showed cerebral atrophy, calcifications, lissencephaly, ventriculomegaly, and cerebellar hypoplasia...
January 13, 2018: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/29346540/blood-and-lymphatic-vessels-contribute-to-the-impact-of-the-immune-microenvironment-on-clinical-outcome-in-non-small-cell-lung-cancer
#2
Giovanna Armani, Denise Madeddu, Giulia Mazzaschi, Giovanni Bocchialini, Francesco Sogni, Caterina Frati, Bruno Lorusso, Angela Falco, Costanza Annamaria Lagrasta, Stefano Cavalli, Chiara Mangiaracina, Rocchina Vilella, Gabriella Becchi, Letizia Gnetti, Emilia Corradini, Eugenio Quaini, Konrad Urbanek, Matteo Goldoni, Paolo Carbognani, Luca Ampollini, Federico Quaini
OBJECTIVES: Lymphangiogenesis plays a critical role in the immune response, tumour progression and therapy effectiveness. The aim of this study was to determine whether the interplay between the lymphatic and the blood microvasculature, tumour-infiltrating lymphocytes and the programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) immune checkpoint constitutes an immune microenvironment affecting the clinical outcome of patients with non-small-cell lung cancer. METHODS: Samples from 50 squamous cell carcinomas and 42 adenocarcinomas were subjected to immunofluorescence to detect blood and lymphatic vessels...
January 15, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29346209/the-society-of-thoracic-surgeons-the-society-of-cardiovascular-anesthesiologists-and-the-american-society-of-extracorporeal-technology-clinical-practice-guidelines-anticoagulation-during-cardiopulmonary-bypass
#3
Linda Shore-Lesserson, Robert A Baker, Victor A Ferraris, Philip E Greilich, David Fitzgerald, Philip Roman, John W Hammon
Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29346176/rapid-response-to-scan-or-not-to-scan-the-utility-of-noncontrast-ct-head-for-altered-mental-status
#4
Purujit J Thacker, Mansha Sethi, Jonathan Sternlieb, Doron Schneider, Mary Naglak, Rajeshkumar R Patel
OBJECTIVES: The aims of the study were the following: (1) to determine how often computed tomography (CT) scans of the head are obtained on rapid responses called for altered mental status (AMS), (2) to determine whether CT imaging of the head is required during all rapid responses called for AMS, (3) to determine which patients would benefit from CT scans of the head in this setting, (4) to note whether an adequate neurologic exam was documented, (5) to determine the cost of CT scans that did not change management, and (6) to examine the role of medications leading to AMS...
January 17, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29345756/clinical-intentions-of-antibiotics-prescribed-upon-discharge-to-hospice-care
#5
Sarah A Servid, Brie N Noble, Erik K Fromme, Jon P Furuno
OBJECTIVES: To better understand the clinical intentions for antibiotic prescribing upon discharge from acute care to hospice care. DESIGN: Retrospective cohort study. SETTING: Five hundred forty-four-bed academic, acute-care, tertiary referral hospital in Portland, Oregon. PARTICIPANTS: Adults (≥18) who received an outpatient prescription for antibiotics on discharge from an acute care hospital to hospice care between January 1, 2009 and December 31, 2011 (N = 149)...
January 18, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29344752/transforming-dermatologic-imaging-for-the-digital-era-metadata-and-standards
#6
Liam J Caffery, David Clunie, Clara Curiel-Lewandrowski, Josep Malvehy, H Peter Soyer, Allan C Halpern
Imaging is increasingly being used in dermatology for documentation, diagnosis, and management of cutaneous disease. The lack of standards for dermatologic imaging is an impediment to clinical uptake. Standardization can occur in image acquisition, terminology, interoperability, and metadata. This paper presents the International Skin Imaging Collaboration position on standardization of metadata for dermatologic imaging. Metadata is essential to ensure that dermatologic images are properly managed and interpreted...
January 17, 2018: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/29344667/clinical-evaluation-of-covered-stents-in-the-treatment-of-superficial-femoral-artery-pseudoaneurysm-in-drug-abusers
#7
Jian Xu, Zhao Zheng, Yong Yang, Wei Zhang, Hongliang Zhao, Bei E, Minwen Zheng
The present study aimed to investigate the technical feasibility and initial clinical outcomes of a covered stent for the endovascular treatment of superficial femoral artery (SFA) pseudoaneurysm in drug abusers. A total of 29 drug abuse patients with SFA pseudoaneurysm, as confirmed by color Doppler sonography, were enrolled to the present study between January 2012 and May 2014. All patients were treated percutaneously by implantation of a covered stent. Physical examination and lower extremity computed tomography angiography were performed at 1 and 9 months postoperation...
January 15, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29344620/association-of-depression-with-mortality-in-older-adults-undergoing-transcatheter-or-surgical-aortic-valve-replacement
#8
Laura M Drudi, Matthew Ades, Sena Turkdogan, Caroline Huynh, Sandra Lauck, John G Webb, Nicolo Piazza, Giuseppe Martucci, Yves Langlois, Louis P Perrault, Anita W Asgar, Marino Labinaz, Andre Lamy, Nicolas Noiseux, Mark D Peterson, Rakesh C Arora, Brian R Lindman, Melissa Bendayan, Rita Mancini, Amanda Trnkus, Dae H Kim, Jeffrey J Popma, Jonathan Afilalo
Importance: Depression is increasingly recognized as a risk factor for adverse outcomes in cardiovascular disease. However, little is known about depression in older adults undergoing transcatheter (TAVR) or surgical (SAVR) aortic valve replacement. Objective: To determine the prevalence of depression and its association with all-cause mortality in older adults undergoing TAVR or SAVR. Design, Setting, and Participants: This preplanned analysis of the Frailty Aortic Valve Replacement (FRAILTY-AVR) prospective cohort study included 14 centers in 3 countries from November 15, 2011, through April 7, 2016...
January 17, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29344576/clinical-exposure-to-transgender-medicine-improves-students-preparedness-above-levels-seen-with-didactic-teaching-alone-a-key-addition-to-the-boston-university-model-for-teaching-transgender-healthcare
#9
Jason A Park, Joshua D Safer
Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients...
2018: Transgender Health
https://www.readbyqxmd.com/read/29344457/development-and-implementation-of-module-for-medical-graduates-to-improve-socio-cultural-sensitivity-towards-people-living-with-hiv
#10
Sushanta Kumar Mishra, Somanath Dash
Background: Health professionals are documented as an important cause for stigmatizing people living with HIV (PLHIV). Since traditional teaching on HIV in India does not address cultural competencies, medical graduates lack sociocultural sensitiveness while addressing the health needs of PLHIV. Aim: The aim of this study is to develop and to implement a module for medical graduates to improve their sociocultural sensitivity toward PLHIV. Methodology: A module was designed and introduced to address the core sensitive issues in HIV among medical graduates with the help of trained faculty...
December 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/29344376/effectiveness-of-pharmacist-s-intervention-in-the-management-of-cardiovascular-diseases
#11
REVIEW
Stefano Omboni, Marina Caserini
The pharmacist may play a relevant role in primary and secondary prevention of cardiovascular diseases, mainly through patient education and counselling, drug safety management, medication review, monitoring and reconciliation, detection and control of specific cardiovascular risk factors (eg, blood pressure, blood glucose, serum lipids) and clinical outcomes. Systematic reviews of randomised controlled and observational studies have documented an improved control of hypertension, dyslipidaemia or diabetes, smoking cessation and reduced hospitalisation in patients with heart failure, following a pharmacist's intervention...
2018: Open Heart
https://www.readbyqxmd.com/read/29344270/lenvatinib-in-advanced-radioiodine-refractory-thyroid-cancer-a-retrospective-analysis-of-the-swiss-lenvatinib-named-patient-program
#12
Catharina Balmelli, Nikola Railic, Marco Siano, Kristin Feuerlein, Richard Cathomas, Valerie Cristina, Christiane Güthner, Stefan Zimmermann, Sabine Weidner, Miklos Pless, Frank Stenner, Sacha I Rothschild
Purpose: Differentiated thyroid cancer (DTC) accounts for approximately 95% of thyroid carcinomas. In the metastatic RAI-refractory disease, chemotherapy has very limited efficacy and is associated with substantial toxicity. With increasing knowledge of the molecular pathogenesis of DTC, novel targeted therapies have been developed. Lenvatinib is a tyrosine kinase inhibitor (TKI) with promising clinical activity based on the randomized phase III SELECT trial. In Switzerland, a Named Patient Program (NPP) was installed to bridge the time gap to Swissmedic approval...
2018: Journal of Cancer
https://www.readbyqxmd.com/read/29344082/implementing-guidelines-on-physical-health-in-the-acute-mental-health-setting-a-quality-improvement-approach
#13
Stuart Green, Ed Beveridge, Liz Evans, Jenny Trite, Sandra Jayacodi, Rachel Evered, Caroline Parker, Luca Polledri, Emily Tabb, John Green, Anton Manickam, Joanna Williams, Rebecca Deere, Bill Tiplady
Background: In the UK, life expectancy for people living with a serious mental illness, such as schizophrenia and bipolar disorder, is reduced by 15-20 years compared with the general population. In recent years, evidence based guidelines/policies designed to improve their physical health have been published, yet a gap remains between recommendations and practice. This case study describes how guidelines to support physical health were implemented using a quality improvement approach...
2018: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/29343970/a-retrospective-examination-of-the-us-food-and-drug-administration-s-clinical-pharmacology-reviews-of-oncology-biologics-for-potential-use-of-therapeutic-drug-monitoring
#14
Brett Fleisher, Sihem Ait-Oudhia
Background: Biologics have gained traction for use in oncology, but have demonstrate clinical variability for efficacy and safety. Therapeutic drug monitoring (TDM) can benefit patients' outcomes from a biologic therapy when the latter has a defined therapeutic window. A clinically relevant therapeutic window may exist for biologics with established exposure-response (E-R) relationships for efficacy and/or safety and a documented maximum tolerated dose (MTD). Additionally, the inter-individual variability (IIV) on the clearance (CL) parameter could determine risks for patients falling outside the proposed therapeutic window...
2018: OncoTargets and Therapy
https://www.readbyqxmd.com/read/29343542/clinical-validation-of-the-sensitest%C3%A2-colistin-a-broth-microdilution-based-method-to-evaluate-colistin-mics
#15
Edoardo Carretto, Flavia Brovarone, Giuseppe Russello, Paola Nardini, Maisra El-Bouseary, Ali Aboklaish, Timothy R Walsh, Jonathan M Tyrrell
The global spread of multi-drug resistant Gram negative has led to the return of colistin for treating severe infections. Recently, different plasmid-mediated genes conferring resistance to this drug were described and reported worldwide. International committees (EUCAST/CLSI) re-evaluated inconsistencies surrounding colistin antimicrobial susceptibility testing (AST), concluding that broth microdilution (BMD) should serve as the reference method for AST. The development of an accurate, reproducible commercial test based on BMD is therefore highly desirable...
January 17, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29343532/clinical-laboratory-practice-recommendations-for-the-use-of-cardiac-troponin-in-acute-coronary-syndrome-expert-opinion-from-the-academy-of-the-american-association-for-clinical-chemistry-and-the-task-force-on-clinical-applications-of-cardiac-bio-markers-of
#16
Alan H B Wu, Robert H Christenson, Dina N Greene, Allan S Jaffe, Peter A Kavsak, Jordi Ordonez-Llanos, Fred S Apple
This document is an essential companion to the third iteration of the National Academy of Clinical Biochemistry [NACB,8 now the American Association for Clinical Chemistry (AACC) Academy] Laboratory Medicine Practice Guidelines (LMPG) on cardiac markers. The expert consensus recommendations were drafted in collaboration with the International Federation of Clinical Chemistry and Laboratory Medicine Task Force on Clinical Applications of Bio-Markers (IFCC TF-CB). We determined that there is sufficient clinical guidance on the use of cardiac troponin (cTn) testing from clinical practice groups...
January 17, 2018: Clinical Chemistry
https://www.readbyqxmd.com/read/29343190/factors-affecting-effective-ventilation-during-newborn-resuscitation-a-qualitative-study-among-midwives-in-rural-tanzania
#17
R Moshiro, H L Ersdal, P Mdoe, H L Kidanto, C Mbekenga
BACKGROUND: Intrapartum-related hypoxia accounts for 30% of neonatal deaths in Tanzania. This has led to the introduction and scaling-up of the Helping Babies Breathe (HBB) programme, which is a simulation-based learning programme in newborn resuscitation skills. Studies have documented ineffective ventilation of non-breathing newborns and the inability to follow the HBB algorithm among providers. OBJECTIVE: This study aimed at exploring barriers and facilitators to effective bag mask ventilation, an essential component of the HBB algorithm, during actual newborn resuscitation in rural Tanzania...
2018: Global Health Action
https://www.readbyqxmd.com/read/29342449/increased-use-of-adrenaline-in-the-management-of-childhood-anaphylaxis-over-the-last-decade
#18
Kristina Rueter, Brennan Ta, Natasha Bear, Michaela Lucas, Meredith L Borland, Susan L Prescott
BACKGROUND: We recently determined that allergy training programs have improved physician recognition and diagnosis of pediatric anaphylaxis in the last decade. OBJECTIVE: To investigate for changes in management, in particular the appropriate use of adrenaline for the treatment of anaphylaxis in a tertiary pediatric emergency department (PED). METHODS: We conducted a retrospective case note study including children aged 0 to 16 years coded and verified for anaphylaxis comparing cases in years 2003/2004 with 2012...
January 13, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29342435/the-2016-american-academy-of-ophthalmology-iris%C3%A2-registry-intelligent-research-in-sight-database-characteristics-and-methods
#19
Michael F Chiang, Alfred Sommer, William L Rich, Flora Lum, David W Parke
PURPOSE: To describe the characteristics of the patient population included in the 2016 IRIS® Registry (Intelligent Research in Sight) database for analytic aims. DESIGN: Description of a clinical data registry. PARTICIPANTS: The 2016 IRIS Registry database consists of 17 363 018 unique patients from 7200 United States-based ophthalmologists in the United States. METHODS: Electronic health record (EHR) data were extracted from the participating practices and placed into a clinical database...
January 13, 2018: Ophthalmology
https://www.readbyqxmd.com/read/29341932/synthetic-extracellular-matrix-mimic-hydrogel-improves-efficacy-of-mesenchymal-stromal-cell-therapy-for-ischemic-cardiomyopathy
#20
Maria Chiara Ciuffreda, Giuseppe Malpasso, Cindy Chokoza, Deon Bezuidenhout, Kyle P Goetsch, Manuela Mura, Federica Pisano, Neil H Davies, Massimiliano Gnecchi
BACKGROUND: Mesenchymal stromal cells (MSC) repair infarcted hearts mainly through paracrine mechanisms. Low cell engraftment limits the release of soluble paracrine factors (SF) over time and, consequently, MSC efficacy. We tested whether a synthetic extracellular matrix mimic, a hydrogel containing heparin (H-HG), could ameliorate MSC engraftment and binding/release of SF, thus improving MSC therapy efficacy. METHODS AND RESULTS: In vitro, rat bone-marrow MSC (rBM-MSC) were seeded and grown into H-HG...
January 13, 2018: Acta Biomaterialia
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