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https://www.readbyqxmd.com/read/28449530/quality-improvement-in-the-icu-treat-first-what-kills-first
#1
EDITORIAL
Peter H J van der Voort
Professionals in the ICU, like nurses and doctors, are constantly working on quality improvement by developing protocols and monitoring the implementation with indicators. Protocols and quality indicators are usually based on evidence. Studies on quality improvement often measure the effect of protocols after implementation but frequently cannot replicate the results of the previously performed RCTs in clinical practice. Amongst other reasons, this is due to the selection of patients that are included in RCTs...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449508/avoiding-completion-pneumonectomy-by-omentopexy-for-bronchial-dehiscence
#2
Takuro Miyazaki, Naoya Yamasaki, Tomoshi Tsuchiya, Keitaro Matsumoto, Ryotaro Kamohara, Go Hatachi, Shigekazu Hidaka, Takeshi Nagayasu
A 56-year-old man underwent right upper sleeve lobectomy with mediastinal lymph node dissection after induction chemoradiotherapy (CRT) for advanced non-small cell lung cancer (NSCLC). The patient developed anastomotic dehiscence 11 days postoperatively. A fistula measuring 10 mm in diameter was found around the transition region between cartilage and membranous portions of the bronchus. To avoid completion right pneumonectomy, omentopexy was performed to cover the bronchial dehiscence and facilitate healing...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449489/electromagnetic-navigational-bronchoscopy-with-dye-marking-for-identification-of-small-peripheral-lung-nodules-during-minimally-invasive-surgical-resection
#3
Juan A Muñoz-Largacha, Michael I Ebright, Virginia R Litle, Hiran C Fernando
BACKGROUND: Identification of small peripheral lung nodules during minimally invasive resection can be challenging. Electromagnetic navigational bronchoscopy (ENB) with injection of dye to identify nodules can be performed by the surgeon immediately prior to resection. We evaluated the effectiveness of ENB with dye marking to aid minimally invasive resection. METHODS: Patients with peripheral pulmonary nodules underwent ENB before planned thoracoscopic or robotic-assisted thoracoscopic resection...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449479/early-results-of-the-sorin-%C3%A2-perceval-s-sutureless-valve-systematic-review-and-meta-analysis
#4
Karan Sian, Sheila Li, Daneish Selvakumar, Ross Mejia
BACKGROUND: Minimally invasive aortic valve replacement (MAVR) has demonstrated a benefit with respect to increased patient satisfaction due to minimised pain and earlier recovery. Sutureless valves may benefit MAVR and conventional aortic valve replacement (AVR) by reducing operative times and blood transfusion requirements. The Perceval valve (Sorin, Salluggia, Italy) is a self-expanding prosthesis made from bovine pericardium mounted in a nitinol stent, designed to simplify the implantation of an aortic valve...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449428/a-rare-case-of-pancreas-divisum-accompanied-by-acute-pancreatitis-following-endoscopic-hemostasis-for-duodenal-ulcer-bleeding
#5
Yong Hyeok Choi, Soon Man Yoon, Eun Bee Kim, Youngmin Oh, Keunmo Kim, Jisun Lee, Seon Mee Park, Sei Jin Youn
Peptic ulcer bleeding is treated using endoscopic hemostasis using clips or bands. Pancreas divisum (PD), a congenital anomaly of the pancreas, usually has no clinical symptoms; however, pancreatitis may occur if there are disturbances in the drainage of pancreatic secretions. We report an unusual case of PD accompanied by acute pancreatitis, following endoscopic band ligation for duodenal ulcer bleeding. A 48-year-old woman was admitted to our hospital due to melena. An upper endoscopy revealed a small ulcer with oozing adjacent minor papilla...
April 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28449427/trichuris-trichiura-infection-in-north-korean-defector-resulted-in-chronic-abdominal-pain-and-growth-retardation
#6
Jong Bin Kim, Kwang Il Seo, Won Moon
Trichuris trichiura infection is a common helminth infection, which is transmitted via soil, with worldwide distribution, especially in rural areas of developing countries. Occasionally, sporadic cases occur in non-endemic, developed areas due to the widespread of immigration. We experienced a case of Trichuris dysentery syndrome in a young North Korean defector, who had been suffering from chronic abdominal pain for 10 years. He is relatively short and thin compared with his older brother. Unexpectedly, the diagnosis, made by a colonoscopy, revealed numerous, small, white, and gently moving worms at the cecum and ascending colon...
April 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28449332/behavioural-disinhibition-in-the-general-population-during-the-antiretroviral-therapy-roll-out-in-sub-saharan-africa-systematic-review-and-meta-analysis
#7
REVIEW
Eva M Legemate, Jan A C Hontelez, Caspar W N Looman, Sake J De Vlas
OBJECTIVES: Improved life expectancy and reduced transmission probabilities due to ART may result in behavioural disinhibition - i.e. an increase in sexual risk behaviour in response to a perceived lower risk of HIV. We examined trends in sexual risk behaviour in the general population of sub-Saharan African countries 1999 - 2015. METHODS: We systematically reviewed scientific literature of sexual behaviour, and reviewed trends in Demographic and Health Surveys...
April 27, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28449316/does-my-high-blood-pressure-improve-your-survival-overall-and-subgroup-learning-curves-in-health
#8
Raf Van Gestel, Tobias Müller, Johan Bosmans
Learning curves in health are of interest for a wide range of medical disciplines, healthcare providers, and policy makers. In this paper, we distinguish between three types of learning when identifying overall learning curves: economies of scale, learning from cumulative experience, and human capital depreciation. In addition, we approach the question of how treating more patients with specific characteristics predicts provider performance. To soften collinearity problems, we explore the use of least absolute shrinkage and selection operator regression as a variable selection method and Theil-Goldberger mixed estimation to augment the available information...
April 27, 2017: Health Economics
https://www.readbyqxmd.com/read/28449276/the-efficacy-of-thrombolysis-in-lacunar-stroke-evidence-from-the-austrian-stroke-unit-registry
#9
C C J Eggers, C Bocksrucker, L Seyfang
BACKGROUND AND PURPOSE: Intravenous thrombolysis (ivT) with recombinant tissue plasminogen activator is established in acute ischaemic stroke. Little is known, however, about its efficacy in different stroke subtypes. METHODS: A retrospective analysis of 128 733 patients from the Austrian Stroke Unit Registry was performed. Patients were classified as lacunar (LacS) or non-lacunar ischaemic stroke (nonLacS) by use of the clinical syndrome and technical findings...
April 27, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28449258/improve-toolmarks-impressions-in-soft-wax
#10
Nir Finkelstein, Nikolai Volkov, Tsadok Tsach
When the forensic toolmarks laboratory receives for examination and comparison a tool that is suspected of having been involved in a crime, the expert performs tests designed to determine whether or not the specific tool generates the same toolmarks as those found at the crime scene. This is performed by testing tool striation on a piece of soft metal, such as lead, and examining the marks left by the tool. Studies have shown that wax may be an optimal material for this purpose. This study examines the use of wax at different temperatures and shows that quality of results is better when the wax is cooled (recommended temperature is -18°C)...
May 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28449217/job-satisfaction-and-intention-to-stay-within-community-and-residential-aged-care-employees
#11
Katrina Radford, Ellen Meissner
OBJECTIVE: This study investigated the different facets of job satisfaction that influence community care and residential care employees' intention to stay in the aged care workforce. METHODS: A survey of four organisations in Australia was undertaken. t-Tests were conducted to analyse differences between groups. Regression analyses were performed to examine the factors influencing intentions to stay in the workforce. RESULTS: Community care workers were more satisfied with various facets of job satisfaction including work on their present job, supervision, people in their present job and the job in general...
April 27, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28449194/center-of-pressure-profiles-in-unilateral-compared-to-bilateral-end-stage-ankle-osteoarthritis-patients
#12
Jonathan R Gladish, Douglas W Powell, Lindsey E Allison, Robin M Queen
Ankle osteoarthritis compromises ankle joint stability in regards to static balance. Unilateral and bilateral osteoarthritis patients often exhibit different limb-loading patterns during static balance tasks. Symmetrical loading has been posited to improve balance performance. Therefore, the purpose of this study was to quantify balance performance in both ankle osteoarthritis patient groups. Twenty-two unilateral and twenty-one bilateral ankle osteoarthritis patients performed three 10-second quiet standing trials with their feet together...
April 27, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28449182/validation-of-a-nomogram-for-selecting-patients-for-chemotherapy-after-d2-gastrectomy-for-cancer
#13
Z-X Wang, G-X Li, Z-W Zhou, Z-P Huang, F Wang, R-H Xu
BACKGROUND: According to some guidelines for the management of gastric cancer, adjuvant chemotherapy is recommended for patients with pT3-4 or node-positive disease. The aim of this study was to define low- and high-risk groups in terms of survival, and to predict the benefit of adjuvant fluoropyrimidine plus oxaliplatin (F-OX) chemotherapy. METHODS: Patients with pT3-4 or node-positive gastric cancer after gastrectomy with D2 lymphadenectomy between 2000 and 2013 were included...
April 27, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28449113/development-of-a-new-clinical-severity-staging-system-for-patients-with-nonmetastatic-papillary-thyroid-carcinoma
#14
Omar A Karadaghy, Dorina Kallogjeri, Jay F Piccirillo
Importance: The inclusion of patient features in addition to tumor morphology provides a more holistic staging system. Objective: To identify prognostically important variables in papillary thyroid carcinoma (PTC) to incorporate into a comprehensive functional severity staging system (FSSS) and clinical severity staging system (CSSS) and to validate the model using a multi-institutional database. Design, Setting, and Participants: Retrospective cohort study of adults 18 years or older newly diagnosed or treated for nonmetastatic PTC at the Siteman Cancer Center from 1995 through 2012...
April 27, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28449050/cardioscape-mapping-the-cardiovascular-funding-landscape-in-europe
#15
Axel Radlach Pries, Anastasia Naoum, Helmut Habazettl, Mathias Dunkel, Robert Preissner, Caroline J Coats, Ana Tornada, Francesco Orso, Frans Van de Werf, David A Wood
Aims: The burden of cardiovascular disease is increasing worldwide, which has to be reflected by cardiovascular (CV) research in Europe. CardioScape, a FP7 funded project initiated by the European Society of Cardiology (ESC), identified where CV research is performed, how it is funded and by whom. It could be transformed into an on-line and up-to-date resource of great relevance for researchers, funding bodies and policymakers and could be a role model for mapping CV research funding in Europe and beyond...
April 25, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28449027/lipoprotein-a-and-the-risk-of-cardiovascular-disease-in-the-european-population-results-from-the-biomarcare-consortium
#16
Christoph Waldeyer, Nataliya Makarova, Tanja Zeller, Renate B Schnabel, Fabian J Brunner, Torben Jørgensen, Allan Linneberg, Teemu Niiranen, Veikko Salomaa, Pekka Jousilahti, John Yarnell, Marco M Ferrario, Giovanni Veronesi, Paolo Brambilla, Stefano G Signorini, Licia Iacoviello, Simona Costanzo, Simona Giampaoli, Luigi Palmieri, Christa Meisinger, Barbara Thorand, Frank Kee, Wolfgang Koenig, Francisco Ojeda, Jukka Kontto, Ulf Landmesser, Kari Kuulasmaa, Stefan Blankenberg
Aims: As promising compounds to lower Lipoprotein(a) (Lp(a)) are emerging, the need for a precise characterization and comparability of the Lp(a)-associated cardiovascular risk is increasing. Therefore, we aimed to evaluate the distribution of Lp(a) concentrations across the European population, to characterize the association with cardiovascular outcomes and to provide high comparability of the Lp(a)-associated cardiovascular risk by use of centrally determined Lp(a) concentrations. Methods and results: Based on the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE)-project, we analysed data of 56 804 participants from 7 prospective population-based cohorts across Europe with a maximum follow-up of 24 years...
April 24, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28448998/efficacy-safety-and-tolerability-of-armodafinil-therapy-for-hypersomnia-associated-with-dementia-with-lewy-bodies-a-pilot-study
#17
Maria I Lapid, Karen M Kuntz, Sara S Mason, Jeremiah A Aakre, Emily S Lundt, Walter Kremers, Laura A Allen, Daniel A Drubach, Bradley F Boeve
BACKGROUND/AIMS: Hypersomnia is common in dementia with Lewy bodies (DLB). We assessed the efficacy, safety, and tolerability of armodafinil for hypersomnia associated with DLB. METHODS: We performed a 12-week pilot trial of armodafinil therapy (125-250 mg orally daily) in DLB outpatients with hypersomnia. The patients underwent neurologic examinations, a neuropsychological battery, laboratory testing, electrocardiography, and polysomnography. Efficacy was assessed at 2, 4, 8, and 12 weeks...
April 28, 2017: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/28448960/utility-of-genomic-analysis-in-differentiating-synchronous-and-metachronous-lung-adenocarcinomas-from-primary-adenocarcinomas-with-intrapulmonary-metastasis
#18
Jad Saab, Hamid Zia, Susan Mathew, Michael Kluk, Navneet Narula, Helen Fernandes
Distinguishing synchronous and metachronous primary lung adenocarcinomas from adenocarcinomas with intrapulmonary metastasis is essential for optimal patient management. In this study, multiple lung adenocarcinomas occurring in the same patient were evaluated using comprehensive histopathologic evaluation supplemented with molecular analysis. The cohort included 18 patients with a total of 52 lung adenocarcinomas. Eleven patients had a new diagnosis of multiple adenocarcinomas in the same lobe (n=5) or different lobe (n=6)...
April 24, 2017: Translational Oncology
https://www.readbyqxmd.com/read/28448938/choice-modeling-of-system-wide-or-large-scale-environmental-change-in-a-developing-country-context-lessons-from-the-para%C3%A3-ba-do-sul-river
#19
James R Kahn, William F Vásquez, Carlos Eduardo de Rezende
The Rio Paraiba do Sul is a highly polluted river in south central Brazil, that is contaminated by industrial, agricultural and municipal wastes, as well as being impacted by dams, water withdrawals and deforestation in the watershed. Since only very intensive and farreaching environmental policies could result in water quality improvements, valuing the restoration of the river presents many unique challenges. We develop a choice-modeling approach to valuation of the restoration of this river, with general tightening of environmental policy as the policy, and an increase in prices as the payment vehicle...
April 24, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28448817/automated-detection-of-pathologic-white-matter-alterations-in-alzheimer-s-disease-using-combined-diffusivity-and-kurtosis-method
#20
Yuanyuan Chen, Miao Sha, Xin Zhao, Jianguo Ma, Hongyan Ni, Wei Gao, Dong Ming
Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) are important diffusion MRI techniques for detecting microstructure abnormities in diseases such as Alzheimer's. The advantages of DKI over DTI have been reported generally; however, the indistinct relationship between diffusivity and kurtosis has not been clearly revealed in clinical settings. In this study, we hypothesize that the combination of diffusivity and kurtosis in DKI improves the capacity of DKI to detect Alzheimer's disease compared with diffusivity or kurtosis alone...
April 12, 2017: Psychiatry Research
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