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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/28449573/a-case-of-ruptured-hepatic-angiomyolipoma-in-a-young-male
#2
Sun Hwa Kim, Tae Wook Kang, Kyunghee Lim, Hyun Sung Joh, Jiseok Kang, Dong Hyun Sinn
A 31-year-old male visited a local hospital due to sudden-onset severe abdominal pain. Abdominal computed tomography revealed a solid cystic mass with a size of approximately 12 cm and exhibiting both hemorrhage and fluid collection in the pelvic cavity. Emergency angiography and embolization were performed, and a large hepatic tumor was subsequently surgically resected. The tumor cells stained positive for human melanoma black-45 and smooth-muscle actin, and the pathologic diagnosis was hepatic angiomyolipoma...
April 28, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28449532/the-future-of-hybrid-ablation-an-emerging-need-for-an-anticoagulation-protocol-for-thoracoscopic-ablation
#3
EDITORIAL
Pavel Osmancik, Petr Budera
The midterm efficacy of hybrid ablation of atrial fibrillation (AF) reported in recent papers is about 70% in terms of sinus rhythm maintenance without antiarrhythmic drugs. Bearing in mind that the majority of patients enrolled are patients with persistent and long-standing persistent AF, the reported efficacies seem to be very good. Despite the high efficacies, safety remains a critical issue in hybrid, and especially thoracoscopic ablations. The frequency of complications during thoracoscopic ablations is more than 10% in the majority of reports...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449514/left-ventricular-outflow-tract-obstruction-due-to-a-left-ventricular-myxoma-that-was-misidentified-as-an-accessory-mitral-valve-tissue
#4
Seung-Hoon Baek, Hee Young Kim, Hyae Jin Kim, Sang Wook Shin, Hye Jin Kim, Yun Mi Choi, Eun Ji Choi, Eunjung Chang, Hong-Sik Son
We report obstruction of the left ventricle outflow tract (LVOT) caused by cardiac myxoma that was misidentified as an accessory mitral valve tissue preoperatively. A 65-year-old woman presented with chest discomfort that persisted for 7 days. Transthoracic echocardiography (TTE) revealed a mobile, low-echogenic, balloon-shaped mass attached to the anterior mitral valve leaflet and papillary muscle, which was suspected to be an accessory mitral valve tissue. Because the mass caused LVOT obstruction and it could result in hemodynamic instability, emergency operation was performed...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449509/rapid-response-in-a-critical-lung-adenocarcinoma-presenting-as-large-airway-stenoses-after-receiving-stent-implantation-and-sequential-rebiopsy-guided-alk-inhibitor-therapy-a-case-report
#5
Ling Ding, Cheng Chen, Yuan-Yuan Zeng, Jian-Jie Zhu, Jian-An Huang, Ye-Han Zhu
Airway stent implantation can improve the symptoms of airway stenosis caused by a malignant tumor immediately. However, stent implantation is only a palliative therapy and disease will quickly progress without subsequent treatment. Targeted therapy can provide accurate etiological treatment for patients with critical lung cancer who cannot receive chemotherapies. In our clinic, we encountered a 50-year-old male presenting with stage IV lung adenocarcinoma. He failed both the first-line and second-line chemotherapies and suffered severe complex left and right main bronchial stenoses caused by tumor invasion...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449505/pulmonary-vein-stump-thrombosis-after-left-pneumonectomy-diagnosed-based-on-a-high-plasma-d-dimer-level-a-case-report
#6
Tomohiro Kamori, Gouji Toyokawa, Tatsuro Okamoto, Yuka Kozuma, Taichi Matsubara, Naoki Haratake, Shinkichi Takamori, Takaki Akamine, Kazuki Takada, Masakazu Katsura, Fumihiro Shoji, Yoshihiko Maehara
A 69-year-old man with locally advanced squamous cell lung cancer in the left hilum underwent left upper sleeve lobectomy following neoadjuvant chemoradiotherapy with an S-1/cisplatin regimen. On postoperative day (POD) 5, the chest X-ray findings deteriorated, and computed tomography (CT) images showed pulmonary congestion of the left residual lung. We then performed emergent left completion pneumonectomy. Although the Postoperative course after re-operation was uneventful, and the patient was scheduled to be discharged on POD 12 when the serum creatinine level and plasma D-dimer level increased to 1...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449501/transarterial-embolization-of-intralobar-pulmonary-sequestration-in-a-young-adult-with-hemoptysis
#7
Rebecca Zener, David Bottoni, Andrew Zaleski, Dalilah Fortin, Richard A Malthaner, Richard I Inculet, Amol Mujoomdar
Intralobar pulmonary sequestration is a rare congenital malformation characterized by the presence of dysplastic lung that does not communicate with the tracheobronchial tree, and has aberrant systemic arterial supply. While most are asymptomatic, they rarely can present with hemoptysis, which has been traditionally managed with surgical resection of the sequestration. We report a case of an 18-year-old male who presented with acute large-volume hemoptysis on a background of recurrent minor episodes of hemoptysis, due to intralobar sequestration...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449467/clinical-analysis-on-113-patients-with-lung-cancer-treated-by-percutaneous-ct-guided-microwave-ablation
#8
Lou Zhong, Siyuan Sun, Jiahai Shi, Fei Cao, Xiao Han, Xueping Bao, Qingsheng You
BACKGROUND: Lung Cancer is a primary tumor with poor prognosis. For early stage lung cancer, treatment options include surgical resection and microwave techniques. Percutaneous ablative techniques emerged as best therapeutic options for nonsurgical patients. METHODS: The aim of this study was to retrospectively analyze the clinical effect of CT-guided microwave ablation (MWA) treatment for patients with lung cancer who were not eligible for surgical resection. MWA was used to treat the tumor lesion of 113 patients with lung cancer who were in our hospital from Jan, 2013 to Jun, 2015...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449390/partial-tibial-nerve-transfer-to-tibialis-anterior-for-traumatic-peroneal-nerve-palsy
#9
Scott Ferris, Simon J Maciburko
BACKGROUND: Partial tibial nerve transfer to the motor branches of tibialis anterior is an emerging reconstructive technique for the treatment of traumatic common peroneal nerve (CPN) injury; however, few papers in the literature describe clinical outcomes. METHODS: A prospective single-surgeon series of nine consecutive patients who underwent partial tibial nerve transfers to the motor branches of tibialis anterior for traumatic CPN injuries between 2008 and 2014...
April 27, 2017: Microsurgery
https://www.readbyqxmd.com/read/28449366/moving-forward-with-the-neuromuscular-junction
#10
REVIEW
Claire Legay, Lin Mei
The neuromuscular junction (NMJ) is indispensable for survival. This synapse between motoneurons and skeletal muscle fibers allows posture, movement and respiration. Therefore, its dysfunction creates pathologies than can be lethal. The molecular mechanisms of NMJ development and maintenance are the subject of intensive studies. This mini-review focuses on some of the most recent discoveries. An unexpected role for a protein, rapsyn, which has been known for 40 years to aggregate acetylcholine receptors has emerged...
April 27, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/28449321/a-review-of-associated-controversies-surrounding-glucocorticoid-use-in-veterinary-emergency-and-critical-care
#11
Maya A Aharon, Jennifer E Prittie, Kate Buriko
OBJECTIVE: To review the literature in human and veterinary medicine regarding the indications for, efficacy of, and controversies surrounding glucocorticoid (GC) administration in the emergency and critical care (ECC) setting, and to provide an overview of the most commonly used synthetic GC formulations. MEDICATIONS: Synthetic GCs vary in GC and mineralocorticoid potency, hypothalamic pituitary axis suppression, duration of action, route of administration, and clinical indication for use...
April 27, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28449293/a-novel-approach-to-study-medical-decision-making-in-the-clinical-setting-the-own-point-of-view-perspective
#12
Thierry Pelaccia, Jacques Tardif, Emmanuel Triby, Bernard Charlin
BACKGROUND: Making diagnostic and therapeutic decisions is a critical activity among physicians. It relies on the ability of physicians to use cognitive processes and specific knowledge in the context of a clinical reasoning. This ability is a core competency in physicians, especially in the field of emergency medicine where the rate of diagnostic errors is high. Studies that explore medical decision-making in an authentic setting are increasing significantly. They are based on the use of qualitative methods which are applied at two separate times: 1) a video recording of the subject's actual activity in an authentic setting and 2) an interview with the subject, supported by the video recording...
April 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28449273/systematic-review-the-safety-of-vedolizumab-for-the-treatment-of-inflammatory-bowel-disease
#13
REVIEW
W A Bye, V Jairath, S P L Travis
BACKGROUND: Vedolizumab specifically recognises the α4β7 integrin and selectively blocks gut lymphocyte trafficking: potentially, it offers gut-specific immunosuppression. AIM: To review the safety of vedolizumab and summarise post-marketing data to assess if any safety concerns that differ from registration trials have emerged. METHOD: A systematic bibliographic search identified six registration trials and nine cohort studies. RESULTS: Integrated data from registration trials included 2830 vedolizumab-exposed patients (4811 person-years exposure [PYs]) and 513 placebo patients...
April 27, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28449263/multi-dice-r-package-for-comparative-population-genomic-inference-under-hierarchical-co-demographic-models-of-independent-single-population-size-changes
#14
Alexander T Xue, Michael J Hickerson
Population genetic data from multiple taxa can address comparative phylogeographic questions about community-scale response to environmental shifts, and a useful strategy to this end is to employ hierarchical co-demographic models that directly test multi-taxa hypotheses within a single, unified analysis while benefiting in statistical power from aggregating datasets. This approach has been applied to classical phylogeographic datasets such as mitochondrial barcodes as well as reduced-genome polymorphism datasets that can yield 10,000s of SNPs, produced by emergent technologies such as RAD-seq and GBS...
April 27, 2017: Molecular Ecology Resources
https://www.readbyqxmd.com/read/28449247/informant-discrepancy-defines-discrete-clinically-useful-autism-spectrum-disorder-subgroups
#15
Matthew D Lerner, Andres De Los Reyes, Deborah A G Drabick, Alan H Gerber, Kenneth D Gadow
BACKGROUND: Discrepancy between informants (parents and teachers) in severity ratings of core symptoms commonly arise when assessing autism spectrum disorder (ASD). Whether such discrepancy yields unique information about the ASD phenotype and its clinical correlates has not been examined. We examined whether degree of discrepancy between parent and teacher ASD symptom ratings defines discrete, clinically meaningful subgroups of youth with ASD using an efficient, cost-effective procedure...
April 27, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28449116/the-iconography-of-mourning-and-its-neural-correlates-a-functional-neuroimaging-study
#16
Karin Labek, Samantha Berger, Anna Buchheim, Julia Bosch, Jennifer Spohrs, Lisa Dommes, Petra Beschoner, Julia C Stingl, Roberto Viviani
The present functional neuroimaging study focuses on the iconography of mourning. A culture-specific pattern of body postures of mourning individuals, mostly suggesting withdrawal, emerged from a survey of visual material. When used in different combinations in stylized drawings in our neuroimaging study, this material activated cortical areas commonly seen in studies of social cognition (temporo-parietal junction, superior temporal gyrus, and inferior temporal lobe), empathy for pain (somatosensory cortex), and loss (precuneus, middle/posterior cingular gyrus)...
April 25, 2017: Social Cognitive and Affective Neuroscience
https://www.readbyqxmd.com/read/28449108/poly-a-clickseq-click-chemistry-for-next-generation-3%C3%AE-end-sequencing-without-rna-enrichment-or-fragmentation
#17
Andrew Routh, Ping Ji, Elizabeth Jaworski, Zheng Xia, Wei Li, Eric J Wagner
The recent emergence of alternative polyadenylation (APA) as an engine driving transcriptomic diversity has stimulated the development of sequencing methodologies designed to assess genome-wide polyadenylation events. The goal of these approaches is to enrich, partition, capture and ultimately sequence poly(A) site junctions. However, these methods often require poly(A) enrichment, 3΄ linker ligation steps, and RNA fragmentation, which can necessitate higher levels of starting RNA, increase experimental error and potentially introduce bias...
April 26, 2017: Nucleic Acids Research
https://www.readbyqxmd.com/read/28449068/development-of-a-novel-human-recellularized-endometrium-that-responds-to-a-28-day-hormone-treatment
#18
Susan A Olalekan, Joanna E Burdette, Spiro Getsios, Teresa K Woodruff, J Julie Kim
Three dimensional (3D) in vitro models have been established to study the physiology and pathophysiology of the endometrium. With emerging evidence that the native extracellular matrix (ECM) provides appropriate cues and growth factors essential for tissue homeostasis, we describe, a novel 3D endometrium in vitro model developed from decellularized human endometrial tissue repopulated with primary endometrial cells. Analysis of the decellularized endometrium using mass spectrometry analysis revealed an enrichment of cell adhesion molecules, cytoskeletal proteins and ECM proteins such as Collagen IV and Laminin...
April 25, 2017: Biology of Reproduction
https://www.readbyqxmd.com/read/28449027/lipoprotein-a-and-the-risk-of-cardiovascular-disease-in-the-european-population-results-from-the-biomarcare-consortium
#19
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/28449025/reltime-rates-collapses-to-a-strict-clock-when-estimating-the-timeline-of-animal-diversification
#20
Jesus Lozano-Fernandez, Mario Dos Reis, Philip C J Donoghue, Davide Pisani
Establishing an accurate timescale for the history of life is crucial to understand evolutionary processes. To this scope, relaxed molecular clock models implemented in a Bayesian MCMC framework are generally used. However, these methods are time consuming. RelTime, a non-Bayesian method implementing a fast, ad hoc, algorithm for relative dating, was developed to overcome the computational inefficiencies of Bayesian software. RelTime was recently used to investigate the origin of animals, and found results consistent with outdated studies from the 1980es and 1990es that recovered metazoans to have a Mesoproterozoic origin (originating approximately 1...
April 25, 2017: Genome Biology and Evolution
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