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https://www.readbyqxmd.com/read/28733536/do-cancer-patients-with-dementia-receive-less-aggressive-treatment-in-end-of-life-care-a-nationwide-population-based-cohort-study
#1
Huei-Kai Huang, Jyh-Gang Hsieh, Chia-Jung Hsieh, Ying-Wei Wang
Dementia is a progressive, incurable disease that can deprive patients of the ability to make decisions. This study determines whether dementia influences the medical care that a cancer patient receives at the end of life. We conducted a nationwide population-based cohort study on patients aged ≥20 with newly diagnosed cancer during 2000-2012. After matching to reduce confounders, there were 7,111 patients with and 28,444 without dementia. The adjusted odd ratios (OR) for medical interventions, including intensive care, palliative care, invasive procedures, and advanced diagnostic testing, were calculated for the final month and three months of life by a multiple logistic regression model...
June 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28729914/effects-of-mtor-on-neurological-deficits-after-transient-global-ischemia
#2
Jihong Xing, Jian Lu
Mammalian target of rapamycin (mTOR) is a serine/threonine protein kinase and activation of its signal pathway plays an important role in regulating protein growth and synthesis as well as cell proliferation and survival. In the present study, we examined the contribution of mTOR and its downstream products to brain injuries and neurological deficiencies after cardiac arrest (CA) induced-transient global ischemia. CA was induced by asphyxia followed by cardiopulmonary resuscitation (CPR) in rats. Our results showed that expression of p-mTOR, mTOR-mediated phosphorylation of 4E-binding protein 4 (4E-BP1) and p70 ribosomal S6 protein kinase 1 (S6K1) pathways were amplified in CA rats compared to their controls...
2017: Translational Neuroscience
https://www.readbyqxmd.com/read/28727184/early-warning-systems-and-rapid-response-to-the-deteriorating-patient-in-hospital-a-systematic-realist-review
#3
REVIEW
Jennifer McGaughey, Peter O'Halloran, Sam Porter, Bronagh Blackwood
AIM: To determine the Rapid Response System programme theory and investigate how the mechanisms of implementation and the characteristics of context combine to enable or constrain the implementation of Rapid Response Systems and the achievement of desired outcomes. BACKGROUND: Rapid Response Systems have been implemented internationally to improve the recognition and management of patient deterioration, reduce the need for cardiopulmonary resuscitation and improve patient outcomes...
July 20, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28724904/hypertonic-saline-infusion-suppresses-apoptosis-of-hippocampal-cells-in-a-rat-model-of-cardiopulmonary-resuscitation
#4
Xiang Zhou, Yong Liu, Yang Huang, ShuiBo Zhu, Jian Zhu, RongPing Wang
Hypertonic saline (HS) attenuates cerebral edema, improves microcirculation perfusion and alleviates inflammation. However, whether the beneficial effect of HS on neurological function after cardiopulmonary resuscitation (CPR) in rat model of asphyxial cardiac arrest (CA) is mediated via attenuating apoptosis of neurons is not known. We studied the neuroprotective effect of HS in rats after CA and CPR, and explored the likely underlying mechanisms. Animals were randomly assigned to 4 equal groups (n = 15 each) according to the different infusions administered during resuscitation: control (C), normal saline (NS), hypertonic saline (HS), and hydroxyethyl starch (HES) groups...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28723894/cysteine-protease-cathepsin-b-mediates-radiation-induced-bystander-effects
#5
Yu Peng, Man Zhang, Lingjun Zheng, Qian Liang, Hanzeng Li, Jeng-Ting Chen, Hongyan Guo, Sawako Yoshina, Yu-Zen Chen, Xiang Zhao, Xiaoqi Wu, Bin Liu, Shohei Mitani, Jau-Song Yu, Ding Xue
The radiation-induced bystander effect (RIBE) refers to a unique process in which factors released by irradiated cells or tissues exert effects on other parts of the animal not exposed to radiation, causing genomic instability, stress responses and altered apoptosis or cell proliferation. Although RIBEs have important implications for radioprotection, radiation safety and radiotherapy, the molecular identities of RIBE factors and their mechanisms of action remain poorly understood. Here we use Caenorhabditis elegans as a model in which to study RIBEs, and identify the cysteine protease CPR-4, a homologue of human cathepsin B, as the first RIBE factor in nematodes, to our knowledge...
July 19, 2017: Nature
https://www.readbyqxmd.com/read/28710963/2-substituted-3-7-8-trimethylnaphtho-1-2-b-furan-4-5-diones-as-specific-l-shaped-nqo1-mediated-redox-modulators-for-the-treatment-of-non-small-cell-lung-cancer
#6
Xiaojin Zhang, Jinlei Bian, Xiang Li, Xingsen Wu, Yanan Dong, Qidong You
Based on the scaffold of 3,7,8-trimethylnaphtho[1,2-b]furan-4,5-dione, a series of L-shaped derivatives with substituted side chains at the position of C2 were designed by analyzing the binding mode with NQO1. The drug-like compound 6q (named as DDO-7178) emerged as the most specific substrate of the two-electron oxidoreductase NQO1 and could hardly be reduced by one-electron oxidoreductases CPR (NQO1/CPR = 20.8). In addition, compound 6q showed much improved physicochemical properties such as water solubility than the control β-lap...
June 15, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28707059/a-prospective-cohort-study-on-the-prediction-of-fetal-distress-and-neonatal-status-with-arterial-and-venous-doppler-measurements-in-appropriately-grown-term-fetuses
#7
Ihsan Atabay, Semir Kose, Erkan Cagliyan, Bora Baysal, Ebru Yucesoy, Sabahattin Altunyurt
PURPOSE: To assess the predictive power of the cerebro-placental ratio (CPR) and the venous-arterial index (VAI) for the development of intrapartum fetal distress (FD) and neonatal intensive care unit (NICU) admission. METHODS: Fetal umbilical artery, middle cerebral artery and umbilical vein Doppler measurements were obtained before the active phase of labor in 311 singleton pregnancies at ≥37 weeks. A continuous electronic fetal monitorization was applied, and an umbilical cord blood sample was obtained for each participant...
July 13, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28691504/takotsubo-cardiomyopathy-another-form-of-cardiorenal-syndrome
#8
Verena Bill, Ibrahim El-Battrawy, Ursula Hoffmann, Darius Haghi, Jürgen Kuschyk, Martin Borggrefe, Ibrahim Akin
Takotsubo cardiomyopathy (TC) is a life-threatening syndrome with ambiguous pathophysiology. The interdependency between heart failure and kidney failure (KF) is well established, but the influence of KF on TC outcome is not known. This single-center cohort from January 2003 to September 2015 consisted of 114 consecutive patients with TC. They were divided into 2 groups according to the presence (n = 32, 29.6%) or absence (n = 76, 70.3%) of KF. The end point of this retrospective study was a composite of in-hospital events, all-cause mortality, rehospitalization due to heart failure, stroke, and recurrence of TC (mean follow-up: 5 years)...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28682838/characteristics-and-outcome-of-cancer-patients-admitted-to-the-icu-in-england-wales-and-northern-ireland-and-national-trends-between-1997-and-2013
#9
Marlies Ostermann, Paloma Ferrando-Vivas, Carmen Gore, Sarah Power, David Harrison
OBJECTIVE: To describe trends in outcomes of cancer patients with an unplanned admission to the ICU between 1997 and 2013 and to identify risk factors for mortality of those admitted between 2009 and 2013. DESIGN: Retrospective analysis. SETTING: Intensive Care National Audit & Research Centre Case Mix Programme Database including data of ICUs in England, Wales, and Northern Ireland. PATIENTS: Patients (99,590) with a solid tumor and 13,538 patients with a hematological malignancy with an unplanned ICU admission between 1997 and 2013; 39,734 solid tumor patients and 6,652 patients with a hematological malignancy who were admitted between 2009 and 2013 were analyzed in depth...
July 4, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28657909/life-threatening-and-suspicious-lesions-caused-by-mechanical-cardiopulmonary-resuscitation
#10
Louise Milling, Peter Mygind Leth, Birgitte Schmidt Astrup
Chest compression devices for mechanical cardiopulmonary resuscitation (CPR) have become more common. Here, we report the case of a young woman who attempted resuscitated with LUCAS™2 after she was found unconscious at home. At autopsy, we found extensive intramuscular hemorrhages in posterior neck, between the scapulae, and in the lumbar region. Investigation of internal organs showed injuries to the lung, spleen, and kidney. The extension of the injuries gave rise to suspicion of homicide by smothering, which police investigation subsequently did not support...
June 27, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28637497/influence-of-low-flow-time-on-survival-after-extracorporeal-cardiopulmonary-resuscitation-ecpr
#11
Tobias Wengenmayer, Stephan Rombach, Florian Ramshorn, Paul Biever, Christoph Bode, Daniel Duerschmied, Dawid L Staudacher
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) support under extracorporeal cardiopulmonary resuscitation (eCPR) is the last option and may be offered to selected patients. Several factors predict outcome in these patients, including initial heart rhythm, comorbidities, and bystander cardiopulmonary resuscitation (CPR). We evaluated outcomes of all VA-ECMO patients treated within the last 5 years at our center in respect to low-flow duration during CPR. METHODS: We report retrospective registry data on all patients with eCPR treated at a university hospital between October 2010 and May 2016...
June 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28632581/multicenter-retrospective-study-of-noncompressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#12
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
BACKGROUND: Rational development of technology for rapid control of noncompressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. METHODS: This is a retrospective study of adult trauma patients with NCTH admitted to four urban Level I trauma centers in the Houston and San Antonio metropolitan areas in 2008 to 2012...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28625243/-experimental-study-on-effect-of-airway-pressure-on-cardiopulmonary-resuscitation
#13
Dingyu Tan, Feng Sun, Yangyang Fu, Shihuan Shao, Yazhi Zhang, Yingying Hu, Jun Xu, Huadong Zhu, Xuezhong Yu
OBJECTIVE: To observe the effect of different airway pressure on ventilation, organ perfusion and return of spontaneous circulation (ROSC) of cardiac arrest (CA) pigs during cardiopulmonary resuscitation (CPR), and to explore the possible beneficial mechanism of positive airway pressure during CPR. METHODS: Twenty healthy landrace pigs of clean grade were divided into low airway pressure group (LP group, n = 10) and high airway pressure group (HP group, n = 10) with random number table...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28620978/comparison-of-healthcare-utilization-and-life-sustaining-interventions-between-elderly-patients-with-dementia-and-those-with-cancer-near-the-end-of-life-a-nationwide-population-based-study-in-taiwan
#14
Yu-Han Chen, Chung-Han Ho, Chien-Cheng Huang, Ya-Wen Hsu, Yueh-Chun Chen, Ping-Jen Chen, Guan-Ting Chen, Jhi-Joung Wang
AIM: Little is known about the pattern of healthcare services for end-of-life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancer patients in their last year of life in Taiwan. METHODS: Taiwan's National Health Insurance Research Database was applied for this case-control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life-sustaining interventions during the last year of life between the two groups were compared...
June 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28615115/circulatory-collapse-in-a-parturient-undergoing-cesarean-delivery-a-diagnostic-dilemma
#15
M M Tawfik, M E Taman, A I Tarbay, M Sayed, K A Awad
Embolic events including thromboembolism, air embolism, and amniotic fluid embolism can cause cardiovascular collapse during cesarean delivery. Differentiation between the three conditions is challenging because they share many of the initial clinical and echocardiographic findings, but an accurate, definitive diagnosis allows the administration of specific therapy that may help in saving the life of the mother and/or the fetus. We report a case of cardiovascular collapse during cesarean delivery under general anesthesia; massive pulmonary thromboembolism was suspected and unfractionated heparin was administered...
May 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28583859/detection-and-quantification-of-gasping-during-resuscitation-for-out-of-hospital-cardiac-arrest
#16
Martha Wolfskeil, Maxim Vanwulpen, Christophe Duchatelet, Koenraad G Monsieurs, Said Hachimi-Idrissi
AIM: To detect and quantify gasping during cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA) patients and to investigate whether gasping is associated with increased return of spontaneous circulation (ROSC). MATERIALS AND METHODS: A prospective observational study in patients resuscitated and mechanically or manually ventilated for OHCA by emergency physicians of Ghent University Hospital. After intubation, pressure catheters were inserted in the endotracheal tube (ETT) and pressures were measured at the proximal and distal ends of the ETT...
June 3, 2017: Resuscitation
https://www.readbyqxmd.com/read/28578468/penetrating-cardiac-injuries-predictive-model-for-outcomes-based-on-2016-patients-from-the-national-trauma-data-bank
#17
J A Asensio, O A Ogun, P Petrone, A J Perez-Alonso, M Wagner, R Bertellotti, B Phillips, D L Cornell, A O Udekwu
BACKGROUND: Penetrating cardiac injuries are uncommon and lethal. The objectives of this study are to examine the national profile of cardiac injuries, identify independent predictors of outcome, generate, compare and validate previous predictive models for outcomes. We hypothesized that National Trauma Data Bank (NTDB) given its large number of patients, would validate these models. METHODS: The NTDB was queried for data on cardiac injuries, using survival as the main outcome measure...
June 3, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28567320/pneumoperitoneum-without-intestinal-perforation-in-a-neonate-case-report-and-literature-review
#18
Prabhavathi Gummalla, Gratias Mundakel, Maksim Agaronov, Haesoon Lee
Pneumoperitoneum in a preterm neonate usually indicates perforation of the intestine and is considered a surgical emergency. However, there are cases of pneumoperitoneum with no evidence of rupture of the intestine reported in the literature. We report a case of pneumoperitoneum with no intestinal perforation in a preterm neonate with respiratory distress syndrome who was on high frequency oscillatory ventilation (HFOV). He developed bilateral pulmonary interstitial emphysema with localized cystic lesion, likely localized pulmonary interstitial emphysema, and recurrent pneumothoraces...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28562481/extracorporeal-life-support-increases-survival-after-prolonged-ventricular-fibrillation-cardiac-arrest-in-the-rat
#19
Ingrid Anna Maria Magnet, Florian Ettl, Andreas Schober, Alexandra-Maria Warenits, Daniel Grassmann, Michael Wagner, Christoph Schriefl, Christian Clodi, Ursula Teubenbacher, Sandra Högler, Wolfgang Weihs, Fritz Sterz, Andreas Janata
BACKGROUND: Extracorporeal life support (ECLS) for cardiopulmonary resuscitation (CPR) may increase end organ perfusion and thus survival when conventional CPR fails. The aim was to investigate, if after ventricular fibrillation cardiac arrest in rodents ECLS improves outcome compared to conventional CPR. METHODS: In 24 adult male Sprague-Dawley rats (460 to 510 g) resuscitation was started after 10 min of no-flow with ECLS (consisting of an open reservoir, roller pump and membrane oxygenator, connected to a cannulas in the jugular vein and femoral artery, n = 8) or CPR (mechanical chest compressions plus ventilations, n = 8) and compared to a sham group (n = 8)...
May 29, 2017: Shock
https://www.readbyqxmd.com/read/28559304/the-transcription-regulation-mechanism-of-the-syntaxin-1a-gene-via-protein-kinase-a
#20
Takahiro Nakayama, Kimio Akagawa
Syntaxin 1A ( Stx1a ) is primarily involved in the docking of synaptic vesicles at active zones in neurons. Its gene is a TATA-less gene with several transcription initiation sites, which is activated by the binding of Sp1 and acetylated histone H3 (H3) in the core promoter region (CPR) through the derepression of class1-histone deacetylase (HDAC). In the present study, to clarify the factor characterizing Stx1a gene expression via the protein kinase A (PKA) pathway inducing the Stx1a mRNA, we investigated if the epigenetic process is involved in the Stx1a gene transcription induced by PKA signalling...
May 30, 2017: Biochemical Journal
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