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https://www.readbyqxmd.com/read/28212219/drug-infusion-systems-technologies-performance-and-pitfalls
#1
Uoo R Kim, Robert A Peterfreund, Mark A Lovich
This review aims to broadly describe drug infusion technologies and raise subtle but important issues arising from infusion therapy that can potentially lead to patient instability and morbidity. Advantages and disadvantages of gravity-dependent drug infusion are described and compared with electromechanical approaches for precise control of medication infusion, including large-volume peristaltic and syringe pumps. This review discusses how drugs and inert carriers interact within infusion systems and outlines several complexities and potential sources of drug error...
February 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28212175/advances-in-epilepsy-gene-discovery-and-implications-for-epilepsy-diagnosis-and-treatment
#2
Joseph D Symonds, Sameer M Zuberi, Michael R Johnson
PURPOSE OF REVIEW: Epilepsy genetics is shifting from the academic pursuit of gene discovery to a clinical discipline based on molecular diagnosis and stratified medicine. We consider the latest developments in epilepsy genetics and review how gene discovery in epilepsy is influencing the clinical classification of epilepsy and informing new therapeutic approaches and drug discovery. RECENT FINDINGS: Recent studies highlighting the importance of mutation in GABA receptors, NMDA receptors, potassium channels, G-protein coupled receptors, mammalian target of rapamycin pathway and chromatin remodeling are discussed...
February 15, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28211787/clinical-factors-influencing-the-decision-to-order-red-blood-cell-transfusions-for-a-sample-of-us-dialysis-patients%C3%A2
#3
J Mark Stephens, John P Caloyeras, John Holmen, Victoria A Kumar, Spiros Tzivelekis, Allan Pollock
AIM: To characterize the clinical context for the decision to order red blood cell (RBC) transfusions in dialysis patients. MATERIALS AND METHODS: Retrospective review of medical records from three integrated health systems serving chronic dialysis patients. Subjects were randomly selected from all patients who received at least one transfusion between January 2009 and December 2013. Data abstracted included transfusion setting, prescribing clinician type, patient demographics and hemoglobin (Hb) concentration prior to transfusion, and cataloguing and prioritizing of clinical factors for their contribution to the decision to transfuse...
February 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28211047/reasons-for-rarity-of-anal-melanocytic-naevi
#4
Eman Aljufairi, Fayek Alhilli
In the last 16 years only seven definite cases of anal melanocytic naevi have been reported in the literature. We describe three new cases, none of which were suspected clinically and were incidentally diagnosed on histological examination of haemorrhoidectomy specimens. The infrequency of these special site flexural melanocytic lesions may be related to changes in the involutionary mechanisms of the anal melanocyte proliferation. However, other factors related to the low detection rates by clinicians and pathologists need also to be considered...
February 17, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28210838/urinary-ngal-deficiency-in-recurrent-urinary-tract-infections
#5
Catherine S Forster, Kathryn Johnson, Viral Patel, Rebecca Wax, Nancy Rodig, Jonathan Barasch, Richard Bachur, Richard S Lee
INTRODUCTION: Children with recurrent urinary tract infections (rUTI) often show no identifiable cause of their infections. Neutrophil gelatinase-associated lipocalin (NGAL) is known to be upregulated within the uroepithelium and kidney of patients with UTI and exhibits a localized bacteriostatic effect through iron chelation. We hypothesize that some patients with rUTI without an identifiable cause of their recurrent infections have locally deficient NGAL production. We therefore explored whether a lack of NGAL production may be a factor in the pathogenesis of rUTI...
February 16, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28210556/are-breast-cancer-stem-cells-the-key-to-resolving-clinical-issues-in-breast-cancer-therapy
#6
REVIEW
Hidetaka Shima, Akimitsu Yamada, Takashi Ishikawa, Itaru Endo
Despite the dramatic advances in breast cancer treatment over the past two decades, it is still the most common malignancies in women. One of the reasons patients succumb to breast cancer is treatment resistance leading to metastasis and recurrence. Recently, cancer stem cells (CSCs) have been suggested as a cause of metastasis and recurrence in several cancers because of their unique characteristics, including self-renewal, pluripotency, and high proliferative ability. Increasing evidence has implicated breast cancer stem cells (BCSCs) as essential for tumor development, progression, recurrence, and treatment resistance...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28210235/clinical-case-studies-in-psychoanalytic-and-psychodynamic-treatment
#7
REVIEW
Jochem Willemsen, Elena Della Rosa, Sue Kegerreis
This manuscript provides a review of the clinical case study within the field of psychoanalytic and psychodynamic treatment. The method has been contested for methodological reasons and because it would contribute to theoretical pluralism in the field. We summarize how the case study method is being applied in different schools of psychoanalysis, and we clarify the unique strengths of this method and areas for improvement. Finally, based on the literature and on our own experience with case study research, we come to formulate nine guidelines for future case study authors: (1) basic information to include, (2) clarification of the motivation to select a particular patient, (3) information about informed consent and disguise, (4) patient background and context of referral or self-referral, (5) patient's narrative, therapist's observations and interpretations, (6) interpretative heuristics, (7) reflexivity and counter-transference, (8) leaving room for interpretation, and (9) answering the research question, and comparison with other cases...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28210230/acute-mental-discomfort-associated-with-suicide-behavior-in-a-clinical-sample-of-patients-with-affective-disorders-ascertaining-critical-variables-using-artificial-intelligence-tools
#8
Susana Morales, Jorge Barros, Orietta Echávarri, Fabián García, Alex Osses, Claudia Moya, María Paz Maino, Ronit Fischman, Catalina Núñez, Tita Szmulewicz, Alemka Tomicic
AIM: In efforts to develop reliable methods to detect the likelihood of impending suicidal behaviors, we have proposed the following. OBJECTIVE: To gain a deeper understanding of the state of suicide risk by determining the combination of variables that distinguishes between groups with and without suicide risk. METHOD: A study involving 707 patients consulting for mental health issues in three health centers in Greater Santiago, Chile. Using 345 variables, an analysis was carried out with artificial intelligence tools, Cross Industry Standard Process for Data Mining processes, and decision tree techniques...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28209745/platinum-fluoropyrimidine-and-paclitaxel-based-chemotherapy-in-the-treatment-of-advanced-anal-cancer-patients
#9
Francesco Sclafani, Federica Morano, David Cunningham, Chiara Baratelli, Eleftheria Kalaitzaki, David Watkins, Naureen Starling, Ian Chau, Sheela Rao
BACKGROUND: Although treatment of localized anal cancer (AC) is well established, very little evidence is available to inform the management of advanced tumors, and the prognosis of these patients remains poor. We have analyzed treatment pathways and outcomes of a single-institution series of advanced AC patients in order to provide insight into the management of this rare condition. MATERIALS AND METHODS: Inclusion criteria included epidermoid histology, inoperable locally recurrent or metastatic disease, and availability of full medical records...
February 16, 2017: Oncologist
https://www.readbyqxmd.com/read/28209456/the-role-of-stereotactic-ablative-body-radiotherapy-in-gynaecological-cancers-a-systematic-review
#10
L C Mendez, E Leung, P Cheung, L Barbera
AIMS: To summarise and evaluate the current literature in gynaecological tumours treated with stereotactic ablative body radiotherapy (SABR) through a systematic review using the Preferred Reported Items for Systematic Reviews and Meta-analysis (PRISMA) guideline. MATERIALS AND METHODS: A literature search through Medline, EMBASE and Cochrane databases resulted in 22 pertinent manuscripts. Selected studies evaluated the locoregional role of SABR in gynaecological tumours, regardless of SABR clinical indication...
February 13, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28208174/feasibility-assessment-of-patient-reporting-of-symptomatic-adverse-events-in-multicenter-cancer-clinical-trials
#11
Ethan Basch, Amylou C Dueck, Lauren J Rogak, Lori M Minasian, William Kevin Kelly, Ann M O'Mara, Andrea M Denicoff, Drew Seisler, Pamela J Atherton, Electra Paskett, Lisa Carey, Maura Dickler, Rebecca S Heist, Andrew Himelstein, Hope S Rugo, William M Sikov, Mark A Socinski, Alan P Venook, Douglas J Weckstein, Diana E Lake, David D Biggs, Rachel A Freedman, Charles Kuzma, Jeffrey J Kirshner, Deborah Schrag
Importance: In cancer clinical trials, symptomatic adverse events (AEs), such as nausea, are reported by investigators rather than by patients. There is increasing interest to collect symptomatic AE data via patient-reported outcome (PRO) questionnaires, but it is unclear whether it is feasible to implement this approach in multicenter trials. Objective: To examine whether patients are willing and able to report their symptomatic AEs in multicenter trials. Design, Setting, and Participants: A total of 361 consecutive patients enrolled in any 1 of 9 US multicenter cancer treatment trials were invited to self-report 13 common symptomatic AEs using a PRO adaptation of the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) via tablet computers at 5 successive clinic visits...
February 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28207996/the-use-of-a-contextual-modal-and-psychological-classification-of-medication-errors-in-the-emergency-department-a-retrospective-descriptive-study
#12
C J Cabilan, J A Hughes, C Shannon
BACKGROUND: The causes of medication errors are unique in every clinical setting; hence error minimisation strategies are not always effective. For this reason, it is fundamental to understand the causes specific to the emergency department so that targeted strategies can be implemented. OBJECTIVES: To describe the contextual, modal, and psychological classification of medication errors in the emergency department to know the factors associated with the reported medication errors...
February 16, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28207824/evaluation-of-surgical-anti-adhesion-products-to-reduce-postsurgical-intra-abdominal-adhesion-formation-in-a-rat-model
#13
Long-Xiang Lin, Fang Yuan, Hui-Hui Zhang, Ni-Na Liao, Jing-Wan Luo, Yu-Long Sun
BACKGROUND: Adhesions frequently occur after abdominal surgery. Many anti-adhesion products have been used in clinic. However, the evidences are short for surgeons to reasonably choose the suitable anti-adhesion produces in clinical practice. This study provided such evidence by comparing the efficiency of five products to prevent abdominal adhesion formation in a rat model. METHODS: Fifty-six Sprague-Dawley rats were randomly divided into seven groups: sham-operation group, adhesion group, and five product groups (n = 8)...
2017: PloS One
https://www.readbyqxmd.com/read/28207721/clinical-anatomy-e-cases-a-five-year-follow-up-of-learning-analytics
#14
Geoffrey Braatvedt, Amelia Tekiteki, Holly Britton, John Wallace, Manish Khanolkar
AIMS: To examine the length of stay and need for intensive care of people admitted with diabetic ketoacidosis (DKA) to a single centre between 1988 and 2011. METHODS: Patients aged ≥15 years admitted for the first time with DKA (plasma glucose ≥ 10mmol/L and a bicarbonate concentration ≤15mmol/L and a pH <7.35, and raised plasma or urine ketones or anion gap) to Auckland City Hospital from 1988-2011 were identified retrospectively. The patients were divided into four cohorts (1988-1996; 1997-2001; 2002-2006; 2007-2011)...
February 17, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28206964/association-of-15-hydroxyprostaglandin-dehydrogenate-and-poor-prognosis-of-obese-breast-cancer-patients
#15
Ruxing Wu, Tao Liu, Peiwen Yang, Xiyou Liu, Fei Liu, Ya Wang, Huihua Xiong, Shiying Yu, Xiaoyuan Huang, Liang Zhuang
In order to explore the new mechanism that obesity worsens the prognosis of breast cancer, we reanalyzed the data about gene expression of normal, overweight, and obese breast cancer patients to explore potential genes and validate its function by clinical and experimental data. The fold change of 15-hydroxyprostaglandin dehydrogenate (HPGD) gene which displayed declining trend with BMI increase was 0.46 in obese versus normal weight patients. HPGD protein was highest expressed in normal weight group and lowest expressed in obese group...
February 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28206951/missed-lung-cancer-when-where-and-why
#16
Annemilia Del Ciello, Paola Franchi, Andrea Contegiacomo, Giuseppe Cicchetti, Lorenzo Bonomo, Anna Rita Larici
Missed lung cancer is a source of concern among radiologists and an important medicolegal challenge. In 90% of the cases, errors in diagnosis of lung cancer occur on chest radiographs. It may be challenging for radiologists to distinguish a lung lesion from bones, pulmonary vessels, mediastinal structures, and other complex anatomical structures on chest radiographs. Nevertheless, lung cancer can also be overlooked on computed tomography (CT) scans, regardless of the context, either if a clinical or radiological suspect exists or for other reasons...
February 16, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28205460/complaints-against-health-care-professionals-providing-police-custodial-and-forensic-medical-health-care-services-and-sexual-offence-examiner-services-in-england-wales-and-northern-ireland
#17
Kieran M Kennedy, Peter G Green, J Jason Payne-James
Complaints management is an integral component of good clinical governance and an essential contributor to patient safety. Little is known about complaints against health-care professionals (HCPs) in police custodial settings and sexual assault referral centres. This study explored the frequency with which complaints are made against such HCPs working in England, Wales and Northern Ireland. It explored the nature of those complaints and the procedures by which they are investigated. Relevant information was requested from all police services in England, Wales and Northern Ireland; professional regulatory bodies; and the Independent Police Complaints Commission under the Freedom of Information Act (FOIA)...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/28205339/doing-it-hard-in-the-bush-aligning-what-gets-measured-with-what-matters
#18
Malcolm I McDonald, Kenny D Lawson
What gets measured gets managed. Funding of health services is substantially determined by operational activity and specific outcome indicators. In day-to-day clinical decision-making, surrogate markers, such as glycosylated haemoglobin and blood pressure, are commonly used to modify risks of 'hard' outcomes that include kidney failure, ischaemic cardiac events, stroke and all-cause mortality. In many settings, surrogates are all we have to go on. As a consequence, current health funding models heavily rely on surrogate-based key performance indicators [KPIs]...
February 16, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28205080/assessment-of-cu-zn-edta-parenteral-toxicity-in-calves
#19
Luis Emilio Fazzio, Diana Esther Rosa, Sebastian Julio Picco, Guillermo Alberto Mattioli
Copper (Cu) parenteral administration is used in a beef cow-calf operations to prevent or correct Cu deficiency in bovines. At present, Zinc (Zn) salts have been incorporated to complement Cu antioxidant effect. A risk of hepatotoxicity generated by overdose is a negative consequence of injectable Cu application. Cu-Zn EDTA appears as an alternative; however, data about its toxicity is unknown. The aim of this study was to assess toxicity risk of different doses of Cu-Zn EDTA in calves. Thirty two Aberdeen Angus calves of 162 (±20) kg BW were assigned to 4 groups (n = 8), homogeneous in weight, sex, and age...
February 15, 2017: Biological Trace Element Research
https://www.readbyqxmd.com/read/28204878/unusual-onset-of-adult-still-s-disease-due-to-a%C3%A2-systemic-reaction-to-artificial-breast-implants
#20
A Wehr, G Grieb, C Trautwein, K Streetz
In this manuscript, we report an exceptional observation study of a young woman suffering from an autoimmune syndrome induced by adjuvants (ASIA). Until today only seven cases of adult-onset Still's disease (AOSD) induced by breast implants have been published. This may be due to the fact that this illness itself is very rare; however, the reason might also be that the community is not sensitized to the case-specific symptoms. Within this article, we show for the first time highly detailed diagnostic test procedures such as PET-CT scans and specific histological staining of the breast tissue, displaying proinflammatory macrophages that are a well-known activator and booster of autoimmune diseases...
February 15, 2017: Zeitschrift Für Rheumatologie
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