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https://www.readbyqxmd.com/read/28226414/methylene-blue-for-the-treatment-of-intractable-pain-associated-with-oral-mucositis
#1
Carlos J Roldan, Kent Nouri, Thomas Chai, Billy Huh
Oral mucositis is a common and often debilitating complication among cancer patients receiving radiation therapy to the head and neck or chemotherapy agents, or undergoing hematopoietic stem cell transplantation. Pain and decreased oral function associated with oral mucositis may persist long after the conclusion of therapy. Although most patients respond to conservative management, a subset of patients develop intractable pain with severe consequences. For some, the use of total parenteral nutrition with insertion of percutaneous endoscopic gastrostomy feeding tubes is the only alternative...
February 22, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28226332/responsible-safe-and-effective-prescription-of-opioids-for-chronic-non-cancer-pain-american-society-of-interventional-pain-physicians-asipp-guidelines
#2
Laxmaiah Manchikanti, Adam M Kaye, Nebojsa Nick Knezevic, Heath McAnally, Konstantin Slavin, Andrea M Trescot, Susan Blank, Vidyasagar Pampati, Salahadin Abdi, Jay S Grider, Alan D Kaye, Kavita N Manchikanti, Harold Cordner, Christopher G Gharibo, Michael E Harned, Sheri L Albers, Sairam Atluri, Steve M Aydin, Sanjay Bakshi, Robert L Barkin, Ramsin M Benyamin, Mark V Boswell, Ricardo M Buenaventura, Aaron K Calodney, David L Cedeno, Sukdeb Datta, Timothy R Deer, Bert Fellows, Vincent Galan, Vahid Grami, Hans Hansen, Standiford Helm Ii, Rafael Justiz, Dhanalakshmi Koyyalagunta, Yogesh Malla, Annu Navani, Kent H Nouri, Ramarao Pasupuleti, Nalini Sehgal, Sanford M Silverman, Thomas T Simopoulos, Vijay Singh, Daneshvari R Solanki, Peter S Staats, Ricardo Vallejo, Bradley W Wargo, Arthur Watanabe, Joshua A Hirsch
BACKGROUND: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28225544/in-defense-of-clinical-autopsy-and-its-practice-in-cuba
#3
Alfredo D Espinosa-Brito, José Hurtado de Mendoza-Amat
There has been a notable decrease in the global practice of clinical autopsy; the rate has fallen to below 10%, even in high-income countries. This is attributed to several causes, including increased costs, overreliance on modern diagnostic techniques, cultural and religious factors, the emergence of new infectious diseases and negative attitudes on the part of doctors, even pathologists. Alternative methods to autopsy in postmortem studies have been developed based on imaging, endoscopy and biopsy (all quite expensive)...
January 2017: MEDICC Review
https://www.readbyqxmd.com/read/28225315/improving-glycemic-control-safely-in-critical-care-patients-a-collaborative-systems-approach-in-nine-hospitals
#4
Gregory A Maynard, Janet Holdych, Heather Kendall, Karen Harrison, Patricia A Montgomery, Kristen Kulasa
Objective Safely improve glycemic control in the critical care units of nine hospitals. Methods Critical care adult inpatients from nine hospitals with ≥ 4 point-of-care (POC) blood glucose (BG) readings over ≥ 2 days were targeted by collaborative improvement efforts to reduce hyper- and hypo-glycemia. Balanced glucometric goals for each hospital were set targeting improvement from baseline, or goals deemed desirable from Society of Hospital Medicine (SHM) benchmarking data. Collaborative interventions included standardized insulin infusion protocols, hypoglycemia prevention bundles, audit and feedback, education, and measure-vention (coupling measurement of patients "off protocol" with concurrent interventions to correct suboptimal care)...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28224110/comparison-of-inhaled-milrinone-nitric-oxide-and-prostacyclin-in-acute-respiratory-distress-syndrome
#5
Martin Albert, Daniel Corsilli, David R Williamson, Marc Brosseau, Patrick Bellemare, Stéphane Delisle, Anne Qn Nguyen, France Varin
AIM: To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome (ARDS). METHODS: Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of iNO (20 ppm) or nebulized epoprostenol (10 μg/mL) was done in all patients...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224103/management-of-parenteral-nutrition-in-critically-ill-patients
#6
REVIEW
Paolo Cotogni
Artificial nutrition (AN) is necessary to meet the nutritional requirements of critically ill patients at nutrition risk because undernutrition determines a poorer prognosis in these patients. There is debate over which route of delivery of AN provides better outcomes and lesser complications. This review describes the management of parenteral nutrition (PN) in critically ill patients. The first aim is to discuss what should be done in order that the PN is safe. The second aim is to dispel "myths" about PN-related complications and show how prevention and monitoring are able to reach the goal of "near zero" PN complications...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224093/pediatric-asthma-severity-score-is-associated-with-critical-care-interventions
#7
Danielle K Maue, Nadia Krupp, Courtney M Rowan
AIM: To determine if a standardized asthma severity scoring system (PASS) was associated with the time spent on continuous albuterol and length of stay in the pediatric intensive care unit (PICU). METHODS: This is a single center, retrospective chart review study at a major children's hospital in an urban location. To qualify for this study, participants must have been admitted to the PICU with a diagnosis of status asthmaticus. There were a total of 188 participants between the ages of two and nineteen, excluding patients receiving antibiotics for pneumonia...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28223874/towards-safety-of-oral-anti-cancer-agents-the-need-to-educate-our-pharmacists
#8
Sanaa Saeed Mekdad, Adher Dhaya AlSayed
Introduction: The global prevalence of cancer is rising. Use of oral anticancer medications has expanded exponentially. Knowledge about these medications as well as safe handling guidelines has not kept abreast with the rapidity these medications are applied in clinical practice. They pose serious hazards on all personal involved in handling these medications as well as on patients and their caregivers. We addressed the gaps in knowledge and safe handling of oral anticancer agents among pharmacists in institutional based cancer care...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28223864/clinical-pharmacist-interventions-in-refill-clinic-at-tertiary-care-eye-specialist-hospital
#9
Sitah N Alzuman, Abdullah S Al-Humaidan
Objective: To describe the role of Clinical Pharmacists in the Medication Refill Clinic area as a part of a multidisciplinary team in which he/she can provide education to patients and caregivers on the safe and appropriate use of medications, counsel on medication compliance, monitor and manage medication side effects, as well as screen for dangerous drug interactions. Methods: The data of this prospective, single-centered, chart review based study have been collected since the clinic launched in June 2011 till December 2013 in King Khalid Eye Specialist Hospital which is a Tertiary Hospital in KSA...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28223040/red-blood-cell-exchange-as-an-approach-for-treating-a-case-of-severe-tacrolimus-overexposure
#10
Valentina Spallanzani, Lucia Bindi, Irene Bianco, Arianna Precisi, Paolo DeSimone, Alessandro Mazzoni, Gianni Biancofiore
Immunosuppressive medication dosing errors are not unfrequent and may present a number of challenges to transplant clinicians. Tacrolimus (TAC) is a widely used immunosuppressant with a narrow therapeutic index and potential severe side effects, including neurotoxicity and kidney injury. We herein report a case of 60-year-old woman who underwent deceased-donor liver transplantation at our center and due to inadvertent TAC overexposure was admitted to the Intensive Care Unit because of severe neurologic impairment, kidney injury and arterial hypotension...
February 2, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28222678/tracheal-extubation-in-deeply-anesthetized-pediatric-patients-after-tonsillectomy-a-comparison-of-high-concentration-sevoflurane-alone-and-low-concentration-sevoflurane-in-combination-with-dexmedetomidine-pre-medication
#11
Meiqin Di, Yuan Han, Zhuqing Yang, Huacheng Liu, Xuefei Ye, Hongyan Lai, Jun Li, Wangning ShangGuan, Qingquan Lian
BACKGROUND: Dexmedetomidine can facilitate a smooth extubation process and reduce the requirement of sevoflurane and emergence agitation when administrated perioperatively. We aimed to observe the extubation process and the recovery characteristics in pediatric patients undergoing tonsillectomy while anesthetized with either high-concentration sevoflurane alone or low-concentration sevoflurane combined with pre-medication of single dose of intravenous dexmedetomidine. METHODS: Seventy-five patients (ASA I or II, aged 3-7 years) undergoing tonsillectomy were randomized into three equal groups: to receive intravenous saline (Group D0), dexmedetomidine 1 μg/kg (Group D1), or dexmedetomidine 2 μg/kg (Group D2) approximately 10 min before anesthesia...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28222473/telemedizin-%C3%A2-tempis%C3%A2-netzwerk-f%C3%A3-r-schlaganfallbehandlung-in-der-regelversorgung
#12
Nicolas Völkel, Gordian J Hubert, Roman L Haberl
Despite all efforts that have been made stroke is a burden and remains one of the most devastating neurological diseases. Treatment of patients on a Stroke Unit improves stroke prognosis and is recommended for all patients with acute stroke. In rural areas population-wide implementation of Stroke Units is extremely challenging. Therefore the Telemedical Project for integrated Stroke Care (TEMPiS) was established in 2003 as a TeleStroke network to overcome this barrier in Southeast Bavaria/Germany. TEMPiS was one of the very early telemedical stroke networks worldwide and was evaluated intensively during its implementation phase between February 2003 and December 2005...
February 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28221178/non-neuraxial-labor-analgesia-options
#13
John C Markley, Mark D Rollins
Although it is the most effective method to treat labor pain, neuraxial analgesia may be undesired, contraindicated, unsuccessful, or unavailable. Providing safe choices for labor pain relief is a central goal of health care providers alike. Consequently, knowledge of the efficacy, clinical implementation, and side effects of various non-neuraxial strategies is needed to provide appropriate options for laboring patients. In addition to nonpharmacologic alternatives, inhaled nitrous oxide and systemic opioids represent two broad classes of non-neuraxial pharmacologic labor analgesia most commonly available...
February 17, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28220628/the-role-of-nicotinamide-in-acne-treatment
#14
REVIEW
Frances M Walocko, Ariel E Eber, Jonette E Keri, Mana A Al-Harbi, Keyvan Nouri
Safe and effective treatment options for acne vulgaris are needed to address side effects and increasing rates of antibiotic resistance from current treatments. Nicotinamide is a vitamin with potent anti-inflammatory properties that could offer a potential treatment option. We aim to summarize the relevant literature on the role of nicotinamide in acne vulgaris and discuss the next steps necessary to move this approach into clinical practice. We searched PubMed for clinical studies using nicotinamide for treatment of acne vulgaris...
February 21, 2017: Dermatologic Therapy
https://www.readbyqxmd.com/read/28219597/combined-heart-and-kidney-transplantation-a-23-year-experience
#15
M Awad, L S C Czer, F Esmailian, S Jordan, M A De Robertis, J Mirocha, J Patel, D H Chang, M Kittleson, D Ramzy, F Arabia, J S Chung, J L Cohen, A Trento, J A Kobashigawa
BACKGROUND: We report clinical experience with combined heart and kidney transplantation (HKTx) over a 23-year time period. METHODS: From June 1992 to August 2015, we performed 83 combined HKTx procedures at our institution. We compared the more recent cohort of 53 HKTx recipients (group 2, March 2009 to August 2015) with the initial 30 previously reported HKTx recipients (group 1, June 1992 to February 2009). Pre-operative patient characteristics, peri-operative factors, and post-operative outcomes including survival were examined...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28219392/meaning-and-barriers-to-quality-care-service-provision-in-child-and-adolescent-mental-health-services-qualitative-study-of-stakeholder-perspectives
#16
Nadzeya Svirydzenka, Pablo Ronzoni, Nisha Dogra
BACKGROUND: Defining quality in health presents many challenges. The Institute of Medicine (IOM) defined quality clinical care as care that is equitable, timely, safe, efficient, effective and patient centred. However, it is not clear how different stakeholders within a child and adolescent mental health service (CAMHS) understand and/or apply this framework. This project aims to identify key stakeholders" understanding of the meaning of quality in the context of CAMHS. METHOD: The study sample comprised of three groups: (i) patients and carers, (ii) CAMHS clinical staff, and (iii) commissioners (Total N = 24)...
February 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28218465/compliance-with-national-guidelines-on-isotretinoin-where-are-we-2-years-since-the-last-audit-results-of-the-national-isotretinoin-re-audit-2014
#17
L S Exton, S T Cheung, A G Brain, M F Mohd Mustapa, D A R de Berker
BACKGROUND: In 2010, the British Association of Dermatologists (BAD) published clinical guidelines for the safe introduction and continued use of isotretinoin in patients with acne in the UK. The BAD provides UK dermatologists with a facility for national audit, and it undertook an audit on compliance with these guidelines in 2012. AIM: To determine current clinical practices relating to use of isotretinoin among dermatologists in the UK (including geographical variations) as measured against BAD standards, and to ascertain any improvement since the 2012 audit...
February 20, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/28218333/effects-of-exercise-therapy-on-polymyositis-complicated-by-post-myocarditis-cardiomyopathy-a-case-report
#18
Hidetoshi Yanagi, Naohisa Shindo
BACKGROUND: A 42-year-old woman with chronic polymyositis complicated by post-myocarditis cardiomyopathy underwent supervised and unsupervised exercise therapy with staged increases in intensity. METHODS: Supervised exercise therapy, which included adopted standards for patients with heart failure, was performed for 6 months. After one month, unsupervised exercise therapy was commenced, in the form of 15 min walking, the duration of which was increased to 30 min after 2 months...
February 16, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28217891/a-comprehensive-behavioral-and-exercise-intervention-improves-physical-function-and-activity-participation-after-total-knee-replacement-a-pilot-randomized-study
#19
Sara R Piva, Gustavo J Almeida, Alexandra B Gil, Anthony M DiGioia, Diane L Helsel, Gwendolyn A Sowa
OBJECTIVE: To test the feasibility of a comprehensive behavioral intervention (CBI) program that combines intense exercises with an education program to be implemented at a later stage (3 months) post total knee replacement (TKR), and to get a first impression of the effects of the CBI as compared to a standard of care exercise (SCE) program on the outcomes of physical function and physical activity. METHODS: 44 subjects participated in a 3-month program of either CBI or SCE followed by 3 months of home exercise program...
February 19, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28217523/safe-and-pragmatic-use-of-sodium-glucose-co-transporter-2-inhibitors-in-type-2-diabetes-mellitus-south-asian-federation-of-endocrine-societies-consensus-statement
#20
REVIEW
Sanjay Kalra, Sujoy Ghosh, A H Aamir, Md Tofail Ahmed, Mohammod Feroz Amin, Sarita Bajaj, Manash P Baruah, Uditha Bulugahapitiya, A K Das, Mimi Giri, Sonali Gunatilake, Saeed A Mahar, Md Faruque Pathan, Nazmul Kabir Qureshi, S Abbas Raza, Rakesh Sahay, Santosh Shakya, Dina Shreshta, Noel Somasundaram, Manilka Sumanatilleke, A G Unnikrishnan, Achini Madushani Wijesinghe
Diabetes prevalence shows a continuous increasing trend in South Asia. Although well-established treatment modalities exist for type 2 diabetes mellitus (T2DM) management, they are limited by their side effect profile. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) with their novel insulin-independent renal action provide improved glycemic control, supplemented by reduction in weight and blood pressure, and cardiovascular safety. Based on the clinical outcomes with SGLT2i in patients with T2DM, treatment strategies that make a "good clinical sense" are desirable...
January 2017: Indian Journal of Endocrinology and Metabolism
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