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https://www.readbyqxmd.com/read/28720673/challenges-with-implementation-of-a-respiratory-therapist-driven-protocol-of-spontaneous-breathing-trials-in-the-pediatric-icu
#1
Conrad Krawiec, Dale Carl, Christy Stetter, Lan Kong, Gary D Ceneviva, Neal J Thomas
BACKGROUND: Timely ventilator liberation is crucial in the pediatric ICU. In many pediatric ICUs, the decision to initiate weaning is driven by the physician, which may lead to delays in ventilator liberation. The objectives of this quality improvement project were to develop and implement a respiratory therapist (RT)-led protocol for screening for spontaneous breathing trial (SBT) readiness, to test protocol feasibility, and to evaluate its impact on SBT timing. METHODS: A retrospective chart review was performed on all intubated patients in the pediatric ICU for 18 months prior to protocol institution...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28710577/detection-of-small-bowel-tumours-with-ct-enteroclysis-using-carbon-dioxide-and-virtual-enteroscopy-a-preliminary-study
#2
Anthony Dohan, Mourad Boudiaf, Xavier Dray, Elia Samaha, Christophe Cellier, Marine Camus, Clarisse Eveno, Raphael Dautry, Philippe Soyer
PURPOSE: The aim of this prospective study was to evaluate the feasibility, tolerance and performance of virtual enteroscopy (VE) using carbon dioxide for small-bowel distension in patients with suspected small-bowel tumours (SBTs). PATIENTS AND METHODS: After IRB approval, 17 patients with suspected SBTs were prospectively included. Radiation dose was compared to 34 matched patients (2 for 1) for age, gender and body weight, who had undergone CT-enteroclysis with neutral contrast (CTE)...
July 14, 2017: European Radiology
https://www.readbyqxmd.com/read/28709881/can-primary-care-for-back-and-or-neck-pain-in-the-netherlands-benefit-from-stratification-for-risk-groups-according-to-the-start-back-tool-classification
#3
Jasper D Bier, Janneke J W Sandee-Geurts, Raymond W J G Ostelo, Bart W Koes, Arianne P Verhagen
OBJECTIVE: To evaluate whether current Dutch primary-care clinicians offer tailored treatment to patients with lower-back pain (LBP) or neck pain (NP) according to their risk stratification, based on the Keele STarT (Subgroup Targeted Treatment) Back-Screening Tool (SBT). DESIGN: Prospective cohort study with 3 month follow-up SETTING: Primary care PARTICIPANTS: General practitioners (GPs) and physiotherapists (PTs) included patients with non-specific LBP and/or NP...
July 11, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28707742/intramolecular-locked-dithioalkylbithiophene-based-semiconductors-for-high-performance-organic-field-effect-transistors
#4
Sureshraju Vegiraju, Bo-Chin Chang, Pragya Priyanka, Deng-Yi Huang, Kuan-Yi Wu, Long-Huan Li, Wei-Chieh Chang, Yi-Yo Lai, Shao-Huan Hong, Bo-Chun Yu, Chien-Lung Wang, Wen-Jung Chang, Cheng-Liang Liu, Ming-Chou Chen, Antonio Facchetti
New 3,3'-dithioalkyl-2,2'-bithiophene (SBT)-based small molecular and polymeric semiconductors are synthesized by end-capping or copolymerization with dithienothiophen-2-yl units. Single-crystal, molecular orbital computations, and optical/electrochemical data indicate that the SBT core is completely planar, likely via S(alkyl)⋯S(thiophene) intramolecular locks. Therefore, compared to semiconductors based on the conventional 3,3'-dialkyl-2,2'-bithiophene, the resulting SBT systems are planar (torsional angle <1°) and highly π-conjugated...
July 14, 2017: Advanced Materials
https://www.readbyqxmd.com/read/28704815/relaxation-rate-of-the-respiratory-muscles-and-prediction-of-extubation-outcome-in-prematurely-born-infants
#5
Theodore Dassios, Ourania Kaltsogianni, Anne Greenough
BACKGROUND: Accurate prediction of extubation outcome could result in a significant reduction of respiratory morbidity in premature neonates. OBJECTIVES: To assess whether the respiratory muscle time constant of relaxation (τ) predicted extubation outcome in mechanically ventilated, premature infants. METHODS: Forty-six mechanically ventilated infants with a median gestational age of 26 (interquartile range [IQR] 25-29) weeks were prospectively studied...
July 14, 2017: Neonatology
https://www.readbyqxmd.com/read/28700429/mucosal-proliferations-in-completely-examined-fallopian-tubes-accompanying-ovarian-low-grade-serous-tumors-neoplastic-precursor-lesions-or-normal-variants-of-benign-mucosa
#6
Rebecca J Wolsky, Matt A Price, Charles J Zaloudek, Joseph T Rabban
Malignant transformation of the fallopian tube mucosa, followed by exfoliation of malignant cells onto ovarian and/or peritoneal surfaces, has been implicated as the origin of most pelvic high-grade serous carcinoma. Whether a parallel pathway exists for pelvic low-grade serous tumors [ovarian serous borderline tumor (SBT) and low-grade serous carcinoma (LGSC)] remains to be fully elucidated. The literature is challenging to interpret due to variation in the diagnostic criteria and terminology for cytologically low-grade proliferations of the fallopian tube mucosa, as well as variation in fallopian tube specimen sampling...
July 11, 2017: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/28697778/electrical-impedance-tomography-for-predicting-failure-of-spontaneous-breathing-trials-in-patients-with-prolonged-weaning
#7
Johannes Bickenbach, Michael Czaplik, Mareike Polier, Gernot Marx, Nikolaus Marx, Michael Dreher
BACKGROUND: Spontaneous breathing trials (SBTs) on a T-piece can be difficult in patients with prolonged weaning because of remaining de-recruitment phenomena and/or insufficient ventilation. There is no clinically established method existent other than experience for estimating whether an SBT is most probably beneficial. Electrical impedance tomography (EIT) is a clinical useful online monitoring technique during mechanical ventilation, particularly because it enables analysis of effects of regional ventilation distribution...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28693057/-the-value-of-the-excursion-of-diaphragm-tested-by-ultrosonography-to-predict-weaning-from-mechanical-ventilation-in-icu-patients
#8
L X Liu, D Su, Z J Hu
Objective: To evaluate the excursion of the diaphragm and analyze the value in predicting weaning from mechanical ventilation in intensive care unit patients. Methods: The patients with mechanical ventilation (>48 hours) in ICU at Hebei Forth Medical University Hospital from June 2014 to December were classified into a success group or a failure group according to the weaning outcome. T-piece spontaneous breathing (SBT), airway occlusion pressure at 0.1 sec (P(0.1)) and maximal inspiratory pressure (MIP), rapid shallow breathing index (RSBI) and P(0...
July 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28659467/motor-learning-in-a-complex-balance-task-and-associated-neuroplasticity-a-comparison-between-endurance-athletes-and-non-athletes
#9
Oliver Seidel, Daniel Carius, Rouven Kenville, Patrick Ragert
Studies suggested that motor expertise is associated with functional and structural brain alterations, which positively affect sensorimotor performance and learning capabilities. The purpose of the present study was to unravel differences in motor skill learning and associated functional neuroplasticity between endurance athletes (EA) and non-athletes (NA). For this purpose, participants had to perform a multimodal balance task (MBT) training on two sessions which were separated by one week. Before and after MBT-training, a static balance task (SBT) had to be performed...
June 28, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28651862/severe-impacts-of-brown-tides-caused-by-sargassum-spp-on-near-shore-caribbean-seagrass-communities
#10
Brigitta I van Tussenbroek, Héctor A Hernández Arana, Rosa E Rodríguez-Martínez, Julio Espinoza-Avalos, Hazel M Canizales-Flores, Carlos E González-Godoy, M Guadalupe Barba-Santos, Alejandro Vega-Zepeda, Ligia Collado-Vides
From mid-2014 until the end of 2015, the Mexican Caribbean coast experienced a massive influx of drifting Sargassum spp. that accumulated on the shores, resulting in build-up of decaying beach-cast material and near-shore murky brown waters (Sargassum-brown-tides, Sbt). The effects of Sbt on four near-shore waters included reduction in light, oxygen (hypoxia or anoxia) and pH. The monthly influx of nitrogen, and phosphorus by drifting Sargassum spp. was estimated at 6150 and 61kgkm(-1) respectively, resulting in eutrophication...
June 23, 2017: Marine Pollution Bulletin
https://www.readbyqxmd.com/read/28645964/the-predictive-value-of-serial-changes-in-diaphragm-function-during-the-spontaneous-breathing-trial-for-weaning-outcome-a-study-protocol
#11
Pengmin Zhou, Zhongheng Zhang, Yucai Hong, Huabo Cai, Hui Zhao, Peifeng Xu, Yiming Zhao, Shengping Lin, Xuchang Qin, JiaWei Guo, Yun Pan, Junru Dai
INTRODUCTION: There is a variety of tools being used in clinical practice for the prediction of weaning success from mechanical ventilation. However, their diagnostic performances are less than satisfactory. The purpose of this study is to investigate the value of serial changes in diaphragm function measured by ultrasound during the spontaneous breathing trial (SBT) as a weaning predictor. METHODS AND ANALYSIS: This is a prospective observational study conducted in a 10-bed medical emergency intensive care unit (EICU) in a university-affiliated hospital...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28644962/validity-and-reproducibility-of-the-modified-start-back-tool-dutch-version-for-patients-with-neck-pain-in-primary-care
#12
Jasper D Bier, Raymond W J G Ostelo, Bart W Koes, Arianne P Verhagen
OBJECTIVE: To evaluate the reliability and validity of the Dutch version of the STarT Back screening Tool (SBT), for patients with neck pain. METHODS: We modified the SBT to fit patients with neck pain. General practitioners and physiotherapists included patients who completed both a baseline and a follow-up questionnaire at 3 days and 3 months, respectively. The construct validity was assessed using Pearson's correlation between the SBT and the reference questionnaires...
June 15, 2017: Musculoskeletal Science & Practice
https://www.readbyqxmd.com/read/28642919/correlation-between-antioxidant-activity-and-bonding-strength-on-bleached-enamel
#13
Hellen Caroliny De Carvalho, Ricardo Danil Guiraldo, Regina Célia Poli-Frederico, Sandra Mara Maciel, Sandra Kiss Moura, Murilo Baena Lopes, Sandrine Bittencourt Berger
Objective: This study used the 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) method to evaluate the percentage of antioxidant activity (%AA) of green tea (GT) and sodium ascorbate (SA) gel in three concentrations (10%, 20% and 30%), and the influence of these concentrations on the microshear bond strength (μ-SBT) values of bleached enamel, using 10% carbamide peroxide (CP). Materials and methods: Eighty intact third molars were selected to perform the μ-SBT test, and were randomly divided into eight experimental groups: G1: positive control - no treatment; G2: negative control - bleached with CP; G3: PC +10% GT; G4: PC +20% GT; G5: PC +30% GT; G6: PC +10% SA; G7: PC +20% SA and G8: PC +30% SA...
December 2016: Acta Biomaterialia Odontologica Scandinavica
https://www.readbyqxmd.com/read/28640202/evaluation-of-legionella-air-contamination-in-healthcare-facilities-by-different-sampling-methods-an-italian-multicenter-study
#14
Maria Teresa Montagna, Osvalda De Giglio, Maria Luisa Cristina, Christian Napoli, Claudia Pacifico, Antonella Agodi, Tatjana Baldovin, Beatrice Casini, Maria Anna Coniglio, Marcello Mario D'Errico, Santi Antonino Delia, Maria Grazia Deriu, Marco Guida, Pasqualina Laganà, Giorgio Liguori, Matteo Moro, Ida Mura, Francesca Pennino, Gaetano Privitera, Vincenzo Romano Spica, Silvia Sembeni, Anna Maria Spagnolo, Stefano Tardivo, Ida Torre, Federica Valeriani, Roberto Albertini, Cesira Pasquarella
Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurring after inhalation of contaminated aerosols. In general, the control of water is preferred to that of air because, to date, there are no standardized sampling protocols. Legionella air contamination was investigated in the bathrooms of 11 HF by active sampling (Surface Air System and Coriolis(®)μ) and passive sampling using settling plates. During the 8-hour sampling, hot tap water was sampled three times. All air samples were evaluated using culture-based methods, whereas liquid samples collected using the Coriolis(®)μ were also analyzed by real-time PCR...
June 22, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28629606/evidence-for-a-higher-resolution-of-hla-genotyping-by-a-new-ngs-based-approach
#15
M Alizadeh, A Walencik, C Frassati, P Moskovtchenko, X Lafarge, F Verite, G Semana
With more than 16,000 alleles identified, the human leucocyte antigen (HLA) system is one of the most polymorphic regions of the human genome. Regarding the crucial role of HLA compatibility in transplantation and especially in Hematopoietic Stem Cell Transplantation, identification of HLA polymorphisms at a high-resolution level is of major interest. Recently, NGS technology has been proposed which appears to be simpler and more informative than the classical molecular methods such as SSP, SSOr and SBT. In the present report, a new set of NGS reagents and the appropriate associated software for sequence analysis are described...
June 16, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28623885/monitoring-the-electric-activity-of-the-diaphragm-during-noninvasive-positive-pressure-ventilation-a-case-report
#16
Fabia Diniz-Silva, Anna Miethke-Morais, Adriano M Alencar, Henrique T Moriya, Pedro Caruso, Eduardo L V Costa, Juliana C Ferreira
BACKGROUND: In patients with post-extubation respiratory distress, delayed reintubation may worsen clinical outcomes. Objective measures of extubation failure at the bedside are lacking, therefore clinical parameters are currently used to guide the need of reintubation. Electrical activity of the diaphragm (EAdi) provides clinicians with valuable, objective information about respiratory drive and could be used to monitor respiratory effort. CASE PRESENTATION: We describe the case of a patient with Chronic Obstructive Pulmonary Disease (COPD), from whom we recorded EAdi during four different ventilatory conditions: 1) invasive mechanical ventilation, 2) spontaneous breathing trial (SBT), 3) unassisted spontaneous breathing, and 4) Noninvasive Positive Pressure Ventilation (NPPV)...
June 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28598701/a-double-blind-randomized-pilot-trial-comparing-computerized-cognitive-exercises-to-tetris-in-adolescents-with-attention-deficit-hyperactivity-disorder
#17
Aida Bikic, Torben Østergaard Christensen, James F Leckman, Niels Bilenberg, Søren Dalsgaard
BACKGROUND: The purpose of this trial was to examine the feasibility and efficacy of computerized cognitive exercises from Scientific Brain Training (SBT), compared to the computer game Tetris as an active placebo, in a pilot study of adolescents with attention-deficit/hyperactivity disorder (ADHD). METHOD: Eighteen adolescents with ADHD were randomized to treatment or control intervention for 7 weeks. Outcome measures were cognitive test, symptom, and motivation questionnaires...
June 9, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28589693/antipsychotic-prescription-and-mortality-in-hospitalized-older-persons
#18
Deborah Chiesa, Alessandra Marengoni, Alessandro Nobili, Mauro Tettamanti, Luca Pasina, Carlotta Franchi, Codjo D Djade, Salvatore Corrao, Francesco Salerno, Maura Marcucci, Giuseppe Romanelli, Pier Mannuccio Mannucci
BACKGROUND: Recent scientific reports have shown that older persons treated with antipsychotics for dementia-related behavioural symptoms have increased mortality. However, the impact of these drugs prescribed during hospitalization has rarely been assessed. We aimed to investigate whether antipsychotics are associated with an increased risk of mortality during hospitalization and at 3-month follow-up in elderly inpatients. METHODS: We analyzed data gathered during two waves (2010 and 2012) by the REPOSI (Registro Politerapie Società Italiana Medicina Interna)...
June 6, 2017: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://www.readbyqxmd.com/read/28588895/evaluation-of-cough-peak-expiratory-flow-as-a-predictor-of-successful-mechanical-ventilation-discontinuation-a-narrative-review-of-the-literature
#19
REVIEW
Chuan Jiang, Antonio Esquinas, Bushra Mina
A crucial step in the transition from mechanical ventilation to extubation is the successful performance of a spontaneous breathing trial (SBT). The American College of Chest Physicians (ACCP) Guidelines recommend removal of the endotracheal tube upon successful completion of a SBT. However, this does not guarantee successful extubation as there remains a risk of re-intubation. Guidelines have outlined ventilator liberation protocols, selected use of non-invasive ventilation on extubation, early mobilization, and dynamic ventilator metrics to prevent and better predict extubation failure...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28586526/weaning-attempts-cough-strength-and-albumin-are-independent-risk-factors-of-reintubation-in-medical-patients
#20
Meiling Xiao, Jun Duan
BACKGROUND: Reintubation is associated with increased hospital mortality. It is necessary to identify risk factors associated with reintubation. METHODS: A prospective observational study was performed in a respiratory intensive care unit. Medical patients who successfully completed a spontaneous breathing trial (SBT) were enrolled. Before extubation, age, gender, vital signs, acute physiology and chronic health evaluation II (APACHE II) score, SBT attempts, cough peak flow, arterial blood gas tests, and albumin were recorded...
June 6, 2017: Clinical Respiratory Journal
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