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https://www.readbyqxmd.com/read/28640697/current-clinical-challenges-in-childhood-ependymoma-a-focused-review
#1
Thomas E Merchant
Ependymoma is a locally aggressive tumor with metastatic potential that arises in diverse locations throughout the brain and spine in children. Tumor and treatment may result in significant morbidity. Cure remains elusive for many patients owing to diverse biology and resistance to conventional therapy. The implementation of systematic postoperative irradiation in clinical trials during the past 20 years has increased the proportion of patients achieving durable disease control with excellent results, as measured by objective functional outcome measures...
June 22, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28640692/comparison-of-gadolinium-concentrations-within-multiple-rat-organs-after-intravenous-administration-of-linear-versus-macrocyclic-gadolinium-chelates
#2
Robert J McDonald, Jennifer S McDonald, Daying Dai, Dana Schroeder, Mark E Jentoft, David L Murray, Ramanathan Kadirvel, Laurence J Eckel, David F Kallmes
Purpose To compare gadolinium tissue concentrations of multiple linear and macrocyclic chelates in a rat model to better understand the scope and extent of tissue deposition following multiple intravenous doses of gadolinium-based contrast agent (GBCA). Materials and Methods In this Institutional Animal Care and Use Committee-approved study, healthy rats received 20 intravenous injections of 2.5 mmol gadolinium per kilogram (gadolinium-exposed group) or saline (control group) over a 26-day period. Unenhanced T1 signal intensities of the dentate nucleus were measured from magnetic resonance (MR) images obtained prior to GBCA injection and 3 days after final injection...
June 19, 2017: Radiology
https://www.readbyqxmd.com/read/28635194/volitional-rehabilitative-assessments-in-patients-admitted-in-a-post-intensive-care-step-down-unit-a-feasibility-study
#3
Mara Paneroni, Francesco D' Abrosca, Georges Fokom, Laura Comini, Michele Vitacca
A high variability in functional tests and activities used during the pulmonary rehabilitation has been observed in post-intensive care unit (ICU) patients, and the best battery of tests to adopt has not been described yet. We tested in patients admitted in a post-ICU Step Down Unit the ability to perform the more frequent functional volitional tests. The relations of each single volitional test with general disability and dyspnea at discharge were also evaluated. Ten volitional tests including: bedside spirometry test (ST: FEV1%, FVC%), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), Peak Expiratory Flow during Cough (PCEF), Quadriceps Muscle Strength (QMS), latissimus Dorsi and teres Major Strength (DMS), Brachial biceps Muscle Strength (BMS), effort tolerance measured by sit-to-stand test, Takahashi test and 6-Min Walking Test (6MWT), were evaluated in post-ICU patients at entry and discharge from in-hospital rehabilitation...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28634259/effectiveness-of-an-online-support-programme-supr-for-older-hearing-aid-users-study-protocol-for-a-cluster-randomised-controlled-trial
#4
Janine Fj Meijerink, Marieke Pronk, Bernadette Paulissen, Birgit I Witte, Bregje van der Wouden, Vera Jansen, Sophia E Kramer
BACKGROUND: An educational SUpport PRogramme called SUPR has been developed for hearing aid users (HAUs) and their communication partners (CPs) offering care beyond hearing aid fitting. SUPR teaches its users communication strategies, hearing aid handling skills and personal adjustment to hearing impairment. METHODS/DESIGN: Using a cluster randomised controlled trial design, 70 Dutch hearing aid dispenser practices were randomised into hearing aid fitting (care as usual, 34 practices) and hearing aid fitting including SUPR (36 practices)...
June 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28634025/impaired-cerebral-autoregulation-in-preoperative-newborn-infants-with-congenital-heart-disease
#5
Jodie K Votava-Smith, Christopher J Statile, Michael D Taylor, Eileen C King, Jesse M Pratt, David P Nelson, Erik C Michelfelder
OBJECTIVES: To characterize cerebral autoregulation (CA) in preoperative newborn infants with congenital heart disease (CHD). METHODS: This was a prospective, pilot study of term newborns with CHD who required intensive care. Continuous mean arterial blood pressure (MAP), cerebral tissue oxygen saturation (SCTO2) via near-infrared spectroscopy, and arterial oxygen saturation (SaO2) were collected. Significant low-frequency coherence between MAP and SCTO2 was used to define impaired CA in 20-minute epochs...
May 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28632972/non-randomised-interventional-study-showed-that-early-aggressive-nutrition-was-effective-in-reducing-postnatal-growth-restriction-in-preterm-infants
#6
Giulia Genoni, Marco Binotti, Alice Monzani, Elena Bernascone, Ilaria Stasi, Gianni Bona, Federica Ferrero
AIM: This study evaluated whether an early aggressive nutrition (EAN) strategy could limit extrauterine growth restriction (EUGR) in a cohort of preterm infants. METHODS: This prospective non-randomised interventional study was carried out in the neonatal intensive care unit of an Italian hospital from January 2013 to December 2015. The prevalence of EUGR was assessed in 100 infants with a gestational age of ≤34 weeks, 50 after the introduction of an EAN regimen in October 2014 and 50 before...
June 20, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28632666/change-in-calcaneal-bone-strength-in-long-term-care-residents-treated-with-low-intensity-pulsed-ultrasound
#7
Hiroyasu Okuizumi, Kiyoshi Koyano, Kazuya Kurosawa, Naoto Kamide, Ayako Soyano
OBJECTIVE: We examined the effect of low-intensity pulsed ultrasound (LIPUS) on bone strength in osteoporotic elderly residents. MATERIALS AND METHODS: This was a randomized controlled trial. Elderly residents with osteoporosis in a long-term care facility were treated with LIPUS (oscillation frequency 100 KHz) that involved treatment of the heel bone for 2 minutes a day. The selection of the treated heel was decided randomly with a personal computer. The heel bone mineral density before and after treatment was measured by calcaneal quantitative ultrasound (GE-1000 Express)...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28631639/prevalence-of-clostridium-difficile-infection-among-the-patients-attending-a-tertiary-care-teaching-hospital
#8
Lavanya Segar, Joshy M Easow, Sreenivasan Srirangaraj, Mohammad Hanifah, Noyal M Joseph, K S Seetha
BACKGROUND: Clostridium difficile, a most important nosocomial enteric pathogen, is recognized globally as responsible for antibiotic-associated diarrhea and colitis. It is associated with considerable morbidity and mortality due to widespread use of antibiotics. AIMS: The study was done to determine the prevalence of C. difficile infection (CDI) among the patients attending a tertiary care teaching hospital in Puducherry. SETTINGS AND DESIGN: We performed a prospective cohort study in Mahatma Gandhi Medical College and Research Institute...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28631532/measuring-sleep-in-the-intensive-care-unit-a-critical-appraisal-of-the-use-of-subjective-methods
#9
Emma L Jeffs, Julie L Darbyshire
OBJECTIVES: To collate and appraise the use of subjective measures to assess sleep in the intensive care unit (ICU). DESIGN: A systematic search and critical review of the published literature. DATA SOURCES: Medline, Scopus, and Cumulative Index to Nursing and Allied Health Literature were searched using combinations of the key words "Sleep," "Critical Care," "Intensive Care," and "Sleep Disorders," and this was complemented by hand searching the most recent systematic reviews on related topics...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28631452/the-impact-of-the-anaesthetic-conserving-device-on-occupational-exposure-to-isoflurane-among-intensive-care-healthcare-professionals
#10
Jennifer Herzog-Niescery, Heike Vogelsang, Philipp Gude, Hans-Martin Seipp, Horst Bartz, Waldemar Uhl, Thomas P Weber, Martin Bellgardt
BACKGROUND: Use of Anesthetic Conserving Devices (ACD) for inhalational isoflurane sedation in intensive care units (ICU) has grown in recent years, and healthcare professionals are concerned about isoflurane pollution and exposure-related health risks. Real-time measurements to determine isoflurane exposure in ICU personnel during short-term patient care procedures and ACD handling have not yet been performed. METHODS: Isoflurane concentrations in the breathing zones of ICU staff (25 cm around the nose and mouth) were measured, by photoacoustic gas monitoring, during daily practice including tracheal suctioning, oral hygiene, body care, and patient positioning...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28630772/severe-rhabdomyolysis-due-to-presumed-drug-interactions-between-atorvastatin-with-amlodipine-and-ticagrelor
#11
Iouri Banakh, Kavi Haji, Ross Kung, Sachin Gupta, Ravindranath Tiruvoipati
Atorvastatin and ticagrelor combination is a widely accepted therapy for secondary prevention of ischaemic heart disease. However, rhabdomyolysis is a well-known rare side effect of statins which should be considered when treatments are combined with cytochrome P450 3A4 enzyme inhibitors. We report a case of atorvastatin and ticagrelor associated severe rhabdomyolysis that progressed to multiorgan failure requiring renal replacement therapy, inotropes, intubation, and mechanical ventilation. Despite withdrawal of the precipitating cause and the supportive measures including renal replacement therapy, creatinine kinase increased due to ongoing rhabdomyolysis rapidly progressing to upper and lower limbs weakness...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28628847/the-importance-of-declining-insulin-requirements-during-pregnancy-in-patients-with-pre-gestational-gestational-diabetes-mellitus
#12
Maya Ram, Larissa Feinmesser, Shiri Shinar, Sharon Maslovitz
OBJECTIVE: In patients with pre-gestational and gestational diabetes mellitus (GDM), insulin requirements often increase during the third trimester of pregnancy in order to maintain proper glycemic control. However, a fraction of patients demonstrate a significant decrease in insulin requirements in late gestation. We aimed to evaluate the clinical significance of decreasing insulin requirements in patients with pre-gestational diabetes and GDM with respect to fetal wellbeing and pregnancy outcome...
June 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28628566/immediate-impact-of-centralization-on-abdominal-aortic-aneurysm-repair-outcomes-for-a-vascular-network-in-the-south-west-of-england-a-retrospective-cohort-study
#13
Philippa Leighton, Matthew Doe, Samir Pathak, Abdullah AlDuwaisan, Marcus Brooks
OBJECTIVE: Our aim was to assess the short-term impact of centralization on the outcomes of patients undergoing abdominal aortic aneurysm repair in a vascular network in the South West of England. BACKGROUND: The centralization of vascular services has been implemented nationally across the National Health Service to improve patient outcomes. The full impact of these major changes has not yet been fully analyzed. METHODS: A retrospective cohort study examining outcomes of patients undergoing abdominal aortic aneurysm repair, based on prospectively entered National Vascular Registry data, pre and post centralization in the South West of England...
June 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28626088/secondary-prevention-of-cardiovascular-disease-in-patients-with-type-2-diabetes-international-insights-from-the-tecos-trial
#14
Neha J Pagidipati, Ann Marie Navar, Karen S Pieper, Jennifer B Green, M Angelyn Bethel, Paul W Armstrong, Robert G Josse, Darren K McGuire, Yuliya Lokhnygina, Jan H Cornel, Sigrun Halvorsen, Timo E Strandberg, Tuncay Delibasi, Rury R Holman, Eric D Peterson
Background -Intensive risk factor modification significantly improves outcomes for patients with diabetes and cardiovascular disease (CVD). However, the degree to which secondary prevention treatment goals are achieved in international clinical practice is unknown. Methods -Attainment of 5 secondary prevention parameters-aspirin use, lipid control (low-density lipoprotein cholesterol <70 mg/dL or statin therapy), blood pressure control (<140 mmHg systolic, <90 mmHg diastolic), angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, and non-smoking status-was evaluated among 13,616 patients from 38 countries with diabetes and known CVD at entry into TECOS...
June 16, 2017: Circulation
https://www.readbyqxmd.com/read/28625266/-risk-factors-of-deep-venous-thrombosis-associated-with-peripherally-inserted-central-venous-catheter-in-upper-extremity-in-icu
#15
Ning Zhao, Jiale Zhang, Ting Jiang, Xia Chen, Jianning Wang, Chengzhi Ding, Fen Liu, Kejian Qian, Rong Jiang
OBJECTIVE: To analyze the incidence and its risk factors of peripherally inserted central venous catheter related upper extremity deep venous thrombosis (PICC-UEDVT) in intensive care unit (ICU). METHODS: Clinical data of the patients received PICCs in ICU of the First Affiliated Hospital of Nanchang University from August 2013 to August 2016 were retrospectively analysed. The inclusion criteria in the study included: the age > 18 years old, catheter indwelling time > 1 week and the complete relevant information...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625255/-effect-of-vitamin-d3-on-the-severity-and-prognosis-of-patients-with-sepsis-a-prospective-randomized-double-blind-placebo-study
#16
Fulai Ding, Bin Zang, Jiahong Fu, Kaiqiang Ji
OBJECTIVE: To observe the relationship between vitamin D3 and the severity as well as prognosis in patients with sepsis, and to explore whether exogenous vitamin D3 can improve the prognosis in patients with sepsis. METHODS: A prospective randomized double-blind placebo study was conducted. Fifty-seven patients with sepsis admitted to intensive care unit (ICU) of Shengjing Hospital Affiliated to China Medical University from March to November in 2015 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625165/transpulmonary-thermodilution-advantages-and-limits
#17
REVIEW
Xavier Monnet, Jean-Louis Teboul
BACKGROUND: For complex patients in the intensive care unit or in the operating room, many questions regarding their haemodynamic management cannot be answered with simple clinical examination. In particular, arterial pressure allows only a rough estimation of cardiac output. Transpulmonary thermodilution is a technique that provides a full haemodynamic assessment through cardiac output and other indices. MAIN BODY: Through the analysis of the thermodilution curve recorded at the tip of an arterial catheter after the injection of a cold bolus in the venous circulation, transpulmonary thermodilution intermittently measures cardiac output...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28625084/objectively-assessed-physical-activity-and-associated-factors-of-sedentary-behavior-among-survivors-of-stroke-living-in-cape-town-south-africa
#18
Conran Joseph, David Conradsson, Maria Hagströmer, Isa Lawal, Anthea Rhoda
PURPOSE: To investigate objectively measured physical activity in stroke survivors living in low-income areas of Cape Town, South Africa, specifically to: (a) describe the volume of daily physical activity and time spent in different intensity levels and (b) investigate the association of factors covering the International Classification of Functioning, Disability and Health with sedentary behavior. MATERIALS AND METHODS: A cross-sectional design was used, where forty-five ambulatory community-dwelling stroke survivors participated...
June 18, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28624038/impact-of-blood-products-on-platelet-function-in-patients-with-traumatic-injuries-a-translational-study
#19
Hanne Hee Henriksen, Alexandra G Grand, Sandra Viggers, Lisa A Baer, Sacha Solbeck, Bryan A Cotton, Nena Matijevic, Sisse R Ostrowski, Jakob Stensballe, Erin E Fox, Tzu-An Chen, John B Holcomb, Pär I Johansson, Jessica C Cardenas, Charles E Wade
BACKGROUND: Reductions in platelet (PLT) count and function are associated with poor outcomes in trauma patients. We proposed to determine if patients expected to receive blood products have a decrease in PLT function higher than expected based on the reduction in PLT count, and if the reduction in function could be associated with the donor plasma/supernatant received. METHODS: PLT count and function were measured on admission to the emergency department and intensive care unit in severely injured patients expected to receive a transfusion...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28623891/systolic-blood-pressure-variability-in-patients-with-early-severe-sepsis-or-septic-shock-a-prospective-cohort-study
#20
Yi Tang, Jeff Sorenson, Michael Lanspa, Colin K Grissom, V J Mathews, Samuel M Brown
BACKGROUND: Severe sepsis and septic shock are often lethal syndromes, in which the autonomic nervous system may fail to maintain adequate blood pressure. Heart rate variability has been associated with outcomes in sepsis. Whether systolic blood pressure (SBP) variability is associated with clinical outcomes in septic patients is unknown. The propose of this study is to determine whether variability in SBP correlates with vasopressor independence and mortality among septic patients. METHODS: We prospectively studied patients with severe sepsis or septic shock, admitted to an intensive care unit (ICU) with an arterial catheter...
June 17, 2017: BMC Anesthesiology
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