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https://www.readbyqxmd.com/read/28108685/a-tablet-based-multimedia-education-tool-improves-provider-and-subject-knowledge-of-inhaler-use-techniques
#1
Aaron M Mulhall, Muhammad A Zafar, Samantha Record, Herman Channell, Ralph J Panos
BACKGROUND: Although inhaled medications are effective therapies for COPD, many patients and providers use them incorrectly. METHODS: We recruited providers who prescribe inhalers or teach inhaler technique and assessed their use of metered-dose inhalers (MDIs), various dry powder inhalers (DPIs), and Respimat using predefined checklists. Then they watched tablet-based multimedia educational videos that demonstrated correct inhaler technique by a clinical pharmacist with teach-back from a patient and were re-evaluated...
February 2017: Respiratory Care
https://www.readbyqxmd.com/read/28067715/incidence-risk-factors-clinical-impact-and-management-of-bioprosthesis-structural-valve-degeneration
#2
Nancy Côté, Philippe Pibarot, Marie-Annick Clavel
PURPOSE OF REVIEW: Structural valve deterioration is the major cause of bioprosthesis failure and is increasing over time. We present an overview of incidence, mechanisms, predictors, clinical impact, and management of bioprosthetic valve structural degeneration. RECENT FINDINGS: Early degeneration caused by calcification and destruction of connective tissue of the prosthesis is controlled by multiple mechanisms, from mechanical stress to infiltration of lipids and inflammatory cells, and activation of the immune system...
January 6, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28067196/management-of-st-elevation-myocardial-infarction-in-young-patients-by-limiting-implantation-of-durable-intracoronary-devices-and-guided-by-optical-frequency-domain-imaging-proof-of-concept-study
#3
Nicolas Combaret, Géraud Souteyrand, Nicolas Barber-Chamoux, Guilhem Malcles, Aimé Amonchot, Bruno Pereira, Louis Le Bivic, Romain Eschalier, Romain Trésorier, Pascal Motreff
AIMS: To demonstrate the feasibility and safety of ST-elevation myocardial infarction (STEMI) management in young patients by limiting implantation of durable intracoronary devices (using bioresorbable stent or medical treatment alone). METHODS AND RESULTS: Patients <50 years admitted for STEMI with single vessel disease received a two-stage management strategy. During a second coronary angiography performed between day 2 and day 7, optical frequency domain imaging (OFDI) enabled to guide therapeutic management: i) in the case of a stenosis greater that 70% or plaque prolapse, implantation of a BVS; ii) in the other cases, continuation of medical management alone without stenting...
January 10, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28065736/long-term-outcomes-of-bariatric-surgery-in-adolescents-with-severe-obesity-fabs-5-a-prospective-follow-up-analysis
#4
Thomas H Inge, Todd M Jenkins, Stavra A Xanthakos, John B Dixon, Stephen R Daniels, Meg H Zeller, Michael A Helmrath
BACKGROUND: Little is known about the long-term outcomes of bariatric surgery for severe adolescent obesity, raising questions about the durability of early responses to surgery. We aimed to analyse long-term (>5 years) outcomes of Roux-en-Y gastric bypass in a cohort of young adults who had undergone the operation during adolescence, in the Follow-up of Adolescent Bariatric Surgery at 5 Plus Years (FABS-5+) extension study. METHODS: A cohort of young people aged 13-21 years underwent Roux-en-Y gastric bypass for clinically severe obesity at a paediatric academic medical centre in the USA...
January 5, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28063126/a-retrospective-study-of-neurocombing-for-the-treatment-of-trigeminal-neuralgia-without-neurovascular-compression
#5
X Liang, X Dong, S Zhao, X Ying, Y Du, W Yu
BACKGROUND: Microvascular decompression (MVD) is the most effective and non-ablative treatment for trigeminal neuralgia (TN). However, it is not possible when neurovascular compression (NVC) is absent. Neurocombing is a possible treatment option for TN patients without NVC. AIM: To evaluate and describe the clinical outcome of neurocombing for the treatment of TN when NVC was absent. METHODS: We retrospectively reviewed the clinical data of the 37 patients of Type 1 TN without NVC who underwent neurocombing in our department between January 2013 and November 2014...
January 6, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28061421/low-cost-and-facile-fabrication-of-a-paper-based-capillary-electrophoresis-microdevice-for-pathogen-detection
#6
Jee Won Lee, Dohwan Lee, Yong Tae Kim, Eun Yeol Lee, Do Hyun Kim, Tae Seok Seo
This paper describes the development of a novel paper-based capillary electrophoresis (pCE) microdevice using mineral paper, which is durable, oil and tear resistant, and waterproof. The pCE device is inexpensive (~$1.6 per device for materials), simple to fabricate, lightweight, and disposable, so it is more adequate for point-of-care (POC) pathogen diagnostics than a conventional CE device made of glass, quartz, silicon or polymer. In addition, the entire fabrication process can be completed within 1h without using expensive clean room facilities and cumbersome photolithography procedures...
December 28, 2016: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28058615/complete-remission-in-metastatic-breast-cancer-expecting-the-unexpected-results-of-a-cross-sectional-study
#7
Giulia Galli, Anna Tessari, Luca Porcu, Giacomo Bregni, Biagio Paolini, Maria Luisa Carcangiu, Massimiliano Gennaro, Maria Carmen De Santis, Laura Lozza, Filippo de Braud, Serena Di Cosimo
BACKGROUND: Complete response (CR) in metastatic breast cancer (MBC) is rare. This study aims at analyzing the characteristics and outcome of MBC patients achieving CR. METHODS: We performed a cross-sectional analysis of clinical data from a consecutive series of MBC patients admitted at the Division of Medical Oncology of Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, achieving CR following treatment for systemic disease and with at least 2 years of follow-up...
January 5, 2017: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/28058556/surgical-treatment-of-malignant-pheochromocytoma-and-paraganglioma-retrospective-case-series
#8
Veljko Strajina, Benzon M Dy, David R Farley, Melanie L Richards, Travis J McKenzie, Keith C Bible, Florencia G Que, David M Nagorney, William F Young, Geoffrey B Thompson
INTRODUCTION: Pheochromocytoma and paraganglioma (PPGL) are rare neoplasms; about 10% are malignant. Literature regarding possible benefit from resection is extremely limited. METHODS: A 20 year review of all patients undergoing surgery for malignant PPGL at the Mayo Clinic Rochester Campus between 1994 and June 2014 was performed. RESULTS: We identified 34 patients undergoing surgery for malignant PPGL. Median follow up was 6 and 5 years survival was 90% (median 11 years)...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28042725/stepwise-illustration-of-teeth-fixation-semi-constrained-cervical-disc-arthroplasty
#9
Chih-Chang Chang, Jau-Ching Wu, Peng-Yuan Chang, Mei-Yin Yeh, Yi-Hsuan Kuo, Li-Yu Fay, Tsung-Hsi Tu, Wen-Cheng Huang, Henrich Cheng
There are many kinds of artificial discs available for cervical disc arthroplasty (CDA), with various designs of fixation and articulation mechanisms. Each of these designs has different features and theoretically fits most optimally in selected types of patients. However, there has been insufficient literature to guide individualized selection among these CDA devices. Since CDA aims to restore the joint function rather than arthrodesis, tailor-made size, shape, and mechanical properties should be taken into account for each candidate's target disc...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28035319/the-role-of-transurethral-resection-in%C3%A2-trimodal-therapy-for-muscle-invasive-bladder-cancer
#10
REVIEW
Christopher M Russell, Amir H Lebastchi, Tudor Borza, Daniel E Spratt, Todd M Morgan
While radical cystectomy (RC) with pelvic lymph node dissection (PLND) represents the accepted gold standard for the treatment of muscle-invasive bladder cancer, this treatment approach is associated with significant morbidity. As such, bladder preservation strategies are often utilized in patients who are either deemed medically unfit due to significant comorbidities or whom decline management with RC and PLND secondary to its associated morbidity. In a select group of patients, meeting strict criteria, bladder preservation approaches may be employed with curative intent...
October 27, 2016: Bladder Cancer
https://www.readbyqxmd.com/read/28029573/mechanical-circulatory-support-and-heart-transplantation-in-the-asia-pacific-region
#11
EDITORIAL
Cumaraswamy Sivathasan, Choon Pin Lim, Ka Lee Kerk, David K L Sim, Mandeep R Mehra
Globalization has resulted in epidemiologic transition in developing countries from infectious disease and nutritional deficiencies to non-communicable diseases. Epidemiologic data on heart failure (HF), particularly advanced HF therapy, in Asia are increasingly becoming available, although they remain sparse. Heart transplantation for advanced stage HF remains very low in Asia-approximately 0.075 heart transplants per 1 million population. North America, which comprises 7.5% of the world population, accounted for 55...
September 29, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28027016/opioid-overdose-prevention-training-with-naloxone-an-adjunct-to-basic-life-support-training-for-first-year-medical-students
#12
Noah Berland, Aaron Fox, Babak Tofighi, Kathleen Hanley
BACKGROUND: Opioid overdose deaths have reached epidemic proportions in the United States. This problem stems from both licit and illicit opioid use. Physicians play a role in prescribing opioids, recognizing risky use, and initiating prevention, including Opioid Overdose Prevention Training (OOPT). The American Heart Association (AHA) modified their basic life support (BLS) algorithms to consider naloxone in high risk populations and when a pulse is appreciated; however, the AHA did not provide OOPT...
December 27, 2016: Substance Abuse
https://www.readbyqxmd.com/read/28024389/tribotronic-transistor-array-as-an-active-tactile-sensing-system
#13
Zhi Wei Yang, Yaokun Pang, Limin Zhang, Cunxin Lu, Jian Chen, Tao Zhou, Chi Zhang, Zhong Lin Wang
Large-scale tactile sensor arrays are of great importance in flexible electronics, human-robot interaction, and medical monitoring. In this paper, a flexible 10 × 10 tribotronic transistor array (TTA) is developed as an active tactile sensing system by incorporating field-effect transistor units and triboelectric nanogenerators into a polyimide substrate. The drain-source current of each tribotronic transistor can be individually modulated by the corresponding external contact, which has induced a local electrostatic potential to act as the conventional gate voltage...
December 27, 2016: ACS Nano
https://www.readbyqxmd.com/read/28017223/parent-vessel-occlusion-for-treatment-of-cerebral-aneurysms-is-there-still-an-indication-a-series-of-17-patients
#14
Nishant Ganesh Kumar, Travis R Ladner, Imad S Kahn, Scott L Zuckerman, Christopher B Baker, Marybess Skaletsky, Deborah Cushing, Matthew R Sanborn, J Mocco, Robert D Ecker
INTRODUCTION/PURPOSE: Flow diversion has allowed cerebrovascular neurosurgeons and neurointerventionalists to treat complex, large aneurysms, previously treated with trapping, bypass, and/or parent vessel sacrifice. However, a minority of aneurysms remain that cannot be treated endovascularly, and microsurgical treatment is too dangerous. However, balloon test occlusion (macro and micro), micro WADA testing, ICG, intra-angiography and intra-operative monitoring are all available to clinically test the hypothesis that vessel sacrifice is safe...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28006876/health-related-quality-of-life-after-pediatric-liver-transplantation-a-systematic-review
#15
REVIEW
Arpita Parmar, Shannon Marie Vandriel, Vicky Lee Ng
With improved survival rates after pediatric liver transplantation (LT), attention is targeting improving the health-related quality of life (HRQOL) as an outcome metric. We conducted a systematic review of the literature to examine HRQOL after pediatric LT, focusing on assessment tools, and factors associated with HRQOL.A literature search was conducted through PubMed, Web of Science, OVID, and Google Scholar for all studies matching the eligibility criteria between January 2004 and September 2016. Titles and abstracts were screened independently by two authors and consensus for included studies was achieved through discussion...
December 22, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/28005410/results-of-a-medicare-bundled-payments-for-care-improvement-initiative-for-copd-readmissions
#16
Surya P Bhatt, J Michael Wells, Anand S Iyer, deNay P Kirkpatrick, Trisha M Parekh, Lauren T Leach, Erica M Anderson, J Greg Sanders, Jessica K Nichols, Cindy C Blackburn, Mark T Dransfield
RATIONALE: Approximately 20% of Medicare beneficiaries hospitalized for acute exacerbations of COPD are readmitted within 30 days of discharge. In addition to implementing penalties for excess readmissions, the United States Centers for Medicare & Medicaid Services (CMS) has developed Bundled Payments for Care Improvement (BPCI) initiatives to improve outcomes and control costs. OBJECTIVES: To evaluate whether a comprehensive COPD multidisciplinary intervention focusing on inpatient, transitional and outpatient care as part of our institution's BPCI participation initiative would reduce 30-day all-cause readmission rates for COPD exacerbations and reduce overall costs...
December 22, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27992525/the-combined-effect-of-high-ambient-temperature-and-antihypertensive-treatment-on-renal-function-in-hospitalized-elderly-patients
#17
Iftach Sagy, Alina Vodonos, Victor Novack, Boris Rogachev, Yosef S Haviv, Leonid Barski
BACKGROUND: The aging kidney manifests structural, functional as well as pharmacological changes, rendering elderly patients more susceptible to adverse environmental influences on their health, dehydration in particular. HYPOTHESIS: Higher temperature is associated with renal function impairment in patients 65 years and older who routinely take thiazide and/or ACE-inhibitors/ARBs. METHODS: We obtained health data of patients older than 65 who were admitted to a large tertiary center during the years 2006-2011, with a previous diagnosis of hypertension, and treated with thiazide, ACE-inhibitors/ARBs or both...
2016: PloS One
https://www.readbyqxmd.com/read/27991534/efficacy-and-safety-of-thrombopoietin-receptor-agonists-in-patients-with-primary-immune-thrombocytopenia-a-systematic-review-and-meta-analysis
#18
Li Wang, Zhe Gao, Xiao-Ping Chen, Hai-Yan Zhang, Nan Yang, Fei-Yan Wang, Li-Xun Guan, Zhen-Yang Gu, Sha-Sha Zhao, Lan Luo, Hua-Ping Wei, Chun-Ji Gao
Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased platelet destruction and impaired platelet production. In this study, we conducted a systematic review and meta-analysis to determine the efficacy and safety of thrombopoietin receptor agonists (TPO-RAs) in primary ITP patients. Thirteen randomized controlled trials were included in this study, the pooled results of which demonstrated that TPO-RAs significantly increased platelet response (R) and durable response (DR) rates [risk ratio (RR): 2...
December 19, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27989074/excellence-and-durability-a-normally-functioning-bj%C3%A3-%C3%A2-rk-shiley-flat-disc-prosthesis-42-years-post-implantation
#19
Armaan Shaikh, A Jamil Tajik
Mechanical heart valves have been used worldwide for more than 60 years. While the composition and design of the valves, and the surgical techniques employed to implant them, have changed and advanced over that time, some of the earlier mechanical heart valves showed such great durability that they are still functioning in patients today. One of the most often-used and long-lasting mechanical prostheses was the Björk-Shiley heart valve. While many versions of this valve were used during its 25 years of production, the most durable was the Björk-Shiley flat-disc valve...
March 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27986679/prevention-and-infection-management-in-mechanical-circulatory-support-device-recipients
#20
Shimon Kusne, Linda Staley, Francisco Arabia
There are currently no guidelines for the management of infection and its prevention in mechanical circulatory support (MCS) device recipients. The International Society of Heart and Lung Transplantation (ISHLT) has initiated a multidisciplinary collaboration for the creation of a consensus document to guide clinicians in infection prevention and management in MCS patients. Most medical centers use local protocols that are based on expert opinion. MCS recipients are debilitated and have some immunological dysfunction...
November 9, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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