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https://www.readbyqxmd.com/read/28212219/drug-infusion-systems-technologies-performance-and-pitfalls
#1
Uoo R Kim, Robert A Peterfreund, Mark A Lovich
This review aims to broadly describe drug infusion technologies and raise subtle but important issues arising from infusion therapy that can potentially lead to patient instability and morbidity. Advantages and disadvantages of gravity-dependent drug infusion are described and compared with electromechanical approaches for precise control of medication infusion, including large-volume peristaltic and syringe pumps. This review discusses how drugs and inert carriers interact within infusion systems and outlines several complexities and potential sources of drug error...
February 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28210202/mechanisms-and-effects-of-transcranial-direct-current-stimulation
#2
James Giordano, Marom Bikson, Emily S Kappenman, Vincent P Clark, H Branch Coslett, Michael R Hamblin, Roy Hamilton, Ryan Jankord, Walter J Kozumbo, R Andrew McKinley, Michael A Nitsche, J Patrick Reilly, Jessica Richardson, Rachel Wurzman, Edward Calabrese
The US Air Force Office of Scientific Research convened a meeting of researchers in the fields of neuroscience, psychology, engineering, and medicine to discuss most pressing issues facing ongoing research in the field of transcranial direct current stimulation (tDCS) and related techniques. In this study, we present opinions prepared by participants of the meeting, focusing on the most promising areas of research, immediate and future goals for the field, and the potential for hormesis theory to inform tDCS research...
January 2017: Dose-response: a Publication of International Hormesis Society
https://www.readbyqxmd.com/read/28209623/access-to-contraception-and-sexual-and-reproductive-health-information-post-abortion-a-systematic-review-of-literature-from-low-and-middle-income-countries
#3
REVIEW
Claire Rogers, Jaya A R Dantas
AIM: This systematic literature review documented, analysed and critiqued the accessibility of contraception and sexual and reproductive health (SRH) information for women living in low- and middle-income countries who have undergone medical or surgical abortion. METHODOLOGY: This review systematically collated relevant and recent empirical evidence regarding women's access to contraception and SRH information post-abortion within low- and middle-income countries...
February 16, 2017: Journal of Family Planning and Reproductive Health Care
https://www.readbyqxmd.com/read/28167407/efficient-blood-flow-visualization-using-flowline-extraction-and-opacity-modulation-based-on-vascular-structure-analysis
#4
Ohjae Kwon, Jeongjin Lee, Bohyoung Kim, Juneseuk Shin, Yeong-Gil Shin
With the recent advances regarding the acquisition and simulation of blood flow data, blood flow visualization has been widely used in medical imaging for the diagnosis and treatment of pathological vessels. In this paper, we present a novel method for the visualization of the blood flow in vascular structures. The vessel inlet or outlet is first identified using the orthogonality metric between the normal vectors of the flow velocity and vessel surface. Then, seed points are generated on the identified inlet or outlet by Poisson disk sampling...
January 31, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28157723/integrated-care-pathway-for-rectal-cancer-treatment-health-care-resource-utilization-costs-and-outcomes
#5
Silvia T Kobayashi, Maria D P E Diz, Alessandro G Campolina, Patricia C De Soárez, Ulysses Ribeiro, Sergio C Nahas, Karina G M C Vasconcelos, Fernanda Capareli, Ivan Cecconello, Paulo M Hoff
AIM: Managed Flow C20 (MFC20) is an integrated care pathway (ICP) for rectal cancer implemented at a public teaching hospital. This study aims to quantify resource utilization and estimate direct costs and outcomes associated with the use of this ICP. METHODS: We evaluated consecutive rectal cancer patients treated with neoadjuvant chemoradiotherapy (nCRT) followed by surgery, comparing the period before the ICP implementation (Pre-MFC20 group) and after (MFC20 group)...
February 2, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28152973/multidisciplinary-process-improvement-to-optimize-oral-chemotherapy-safety
#6
Kerin B Adelson, Monica Fradkin, Renee Havriliak, Michelle Renee Harrison, Osama Abdelghany, Stephanie Kregling, Jessica Wright, Bret Morrow, Roberta Sterling, Mandeep Smith, Frank Esposito, Martha Stutsky, LeeAnn Miller, Rogerio Lilenbaum, Catherine A Lyons, Anne C Chiang, Howard Cohen
: 134 Background: The rapid development of oral chemotherapy agents brings unique challenges. These drugs must be treated with the same vigilance as parenteral chemotherapy. The oral chemotherapy system is not optimized or integrated across our hospital. A quality assessment survey identified the need for a better means to monitor and improve oral chemotherapy patient outcomes. METHODS: Patient and staff satisfaction with the current process was measured. A chartered multidisciplinary task force reviewed existing practice and developed a program to identify patients, ensure drug access, standardize prescription and consent, ensure on-going clinical support including patient education, regimen specific adherence monitoring, toxicity assessment and address patient concerns...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152900/hardwiring-advance-directives-into-an-electronic-medical-record
#7
Tyler Buckley, Andrew Badke, Amy Horyna, Julie Howell, Lisa Gren, Anna Catherine Beck
: 146 Background: Patient preference at the end of life has been extensively researched and documented. Advance Directives (AD) have been shown to make a difference for patients in the areas of quality, cost, and patient satisfaction. Organizations struggle with meeting federal laws and accreditation expectations due to our complex systems. Literature supports "hardwiring" AD documentation into the EMR and providing "one click" accessibility to AD's. Changing EMR vendors provides a unique opportunity to optimize access to AD's, both through patient education /endorsement, review of providers' role, and engagement of IT...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28129889/sarcopenia-but-not-excess-weight-or-increased-caloric-intake-is-associated-with-coronary-subclinical-atherosclerosis-in-the-very-elderly
#8
Alessandra M Campos, Filipe A Moura, Simone N Santos, Wladimir M Freitas, Andrei C Sposito
BACKGROUND AND AIMS: Excess weight is a widespread condition related to increased risk of coronary heart disease (CHD). Sarcopenia is a catabolic pathway common of the aging process and also associated with CHD. In the elderly, both changes occur concurrently and it remains unclear the relative contribution on CHD risk. We aimed to investigate whether sarcopenia, excess weight, or both are associated with subclinical atherosclerosis and/or endothelial dysfunction in very elderly individuals...
January 18, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28125930/from-coastal-to-global-the-transnational-flow-of-ayurveda-and-its-relevance-for-indo-african-linkages
#9
Caroline Meier Zu Biesen
Driven by long-standing ties with India, and intertwined with global market interests, a growing influx of materia medica from South Asia is currently emerging in East Africa. To compete at a global level and framed within the language of 'South-South cooperation for mutual benefit', India presents itself as an appropriate exporter of medical products suitable for African clientele. The expansion of India's medical sector into Africa is particularly relevant for Ayurvedic pharmaceuticals. Ayurveda's diaspora into Africa exemplifies the emergence of new health interventions and medical assemblages in a transnationally interconnected world and implies innovative coalitions involved in the complex promotion of local/Global Health industries...
January 26, 2017: Global Public Health
https://www.readbyqxmd.com/read/28118144/development-of-x-ray-micro-focus-computed-tomography-to-image-and-quantify-biofilms-in-central-venous-catheter-models-in-vitro
#10
Wilmari L Niehaus, Robert P Howlin, David A Johnston, Daniel J Bull, Gareth L Jones, Elizabeth Calton, Mark N Mavrogordato, Stuart C Clarke, Philipp J Thurner, Saul N Faust, Paul Stoodley
Bacterial infections of central venous catheters (CVCs) cause much morbidity and mortality, and are usually diagnosed by concordant culture of blood and catheter tip. However, studies suggest that culture often fails to detect biofilm bacteria. This study optimizes X-ray micro-focus computed tomography (X-ray µCT) for the quantification and determination of distribution and heterogeneity of biofilms in in vitro CVC model systems. Bacterial culture and scanning electron microscopy (SEM) were used to detect Staphylococcus epidermidis ATCC 35984 biofilms grown on catheters in vitro in both flow and static biofilm models...
December 30, 2016: Microbiology
https://www.readbyqxmd.com/read/28112951/molecular-tuning-of-the-vibrational-thermal-transport-mechanisms-in-fullerene-derivative-solutions
#11
Chester J Szwejkowski, Ashutosh Giri, Ronald Warzoha, Brian F Donovan, Bryan Kaehr, Patrick E Hopkins
Control over the thermal conductance from excited molecules into an external environment is essential for the development of customized photothermal therapies and chemical processes. This control could be achieved through molecule tuning of the chemical moieties in fullerene derivatives. For example, the thermal transport properties in the fullerene derivatives indene-C60 monoadduct (ICMA), indene-C60 bisadduct (ICBA), [6,6]-phenyl C61 butyric acid methyl ester (PCBM), [6,6]-phenyl C61 butyric acid butyl ester (PCBB), and [6,6]-phenyl C61 butyric acid octyl ester (PCBO) could be tuned by choosing a functional group such that its intrinsic vibrational density of states bridge that of the parent molecule and a liquid...
February 1, 2017: ACS Nano
https://www.readbyqxmd.com/read/28089455/comparison-of-transcatheter-aortic-valve-implantation-with-the-newest-generation-sapien-3-vs-direct-flow-medical-valve-in-a-single-center-cohort
#12
Eberhard Schulz, Alexander Jabs, Alexander Tamm, Patrick Herz, Andreas Schulz, Tommaso Gori, Stephan von Bardeleben, Walter Kasper-König, Ulrich Hink, Christian-Friedrich Vahl, Thomas Münzel
BACKGROUND: The latest generation transcatheter heart valves including Edwards Sapien 3 (ES3) and Direct Flow Medical (DFM) were designed to allow precise implantation at the intended position and to minimize prosthesis dysfunction as well as procedural complications. Our aim was to compare short-term functional and clinical outcomes of these 2 transcatheter aortic valve systems. METHODS: Of 174 patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) at our institution between August 2013 and June 2015, 113 were treated with ES3 and 61 with DFM...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28088428/aortic-floating-thrombus-detected-by-computed-tomography-angiography-incidentally-five-cases-and-a-literature-review
#13
Shuyi Yang, Jie Yu, Wenjuan Zeng, Liang Yang, Lin Teng, Yue Cui, Heshui Shi
OBJECTIVE: To analyze the findings of aortic floating thrombus (AFT) on computed tomography angiography (CTA) for a definitive, timely diagnosis and to select a reasonable management course to improve prognosis. METHOD: We retrospectively analyzed imaging findings of 5 patients with AFT detected by CTA, including location, morphology, size, involved aortic segment, concomitant embolism, stent, and dynamic changes during the follow-up. RESULTS: Seven lesions were detected in the initial CTA studies of the 5 patients: 5 aortic intraluminal floating thrombi (3 patients) and 2 aortic in-stents floating thrombi (ASFTs; 2 patients)...
December 22, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28079561/-single-checked-patient-group-directions-during-initial-nurse-assessment-within-paediatric-emergency-departments-of-the-uk-and-ireland
#14
Chris K Bird, Anthony G Sinclair, Stuart Hartshorn
OBJECTIVE: Double checking medications at initial assessment within paediatric emergency departments (EDs) has the potential to delay patient flow, and doubt has been cast on the efficacy of double checking in all but high-risk medications. We aimed to benchmark current practice for the use of Patient Group Direction (PGD) medications at initial assessment in EDs within the Paediatric Emergency Research UK and Ireland (PERUKI) network, with a focus on the use of 'single-checker' PGDs...
January 10, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28063683/diphasic-dyskinesias-during-levodopa-carbidopa-intestinal-gel-lcig-infusion-in-parkinson-s-disease
#15
Meloni Mario, Solla Paolo, Mascia Mario Marcello, Marrosu Francesco, Cannas Antonino
OBJECTIVES: Levodopa-carbidopa intestinal gel infusion (LCIG) is indicated in patients with advanced levodopa-responsive Parkinson's disease (PD) for the treatment of motor fluctuations and dyskinesias. Here we describe 4 PD patients who developed disabling diphasic dyskinesias after LCIG initiation. METHODS: The clinical data of 33 PD patients consecutively treated with LCIG therapy were obtained through direct clinical observation and detailed review of medical records...
December 31, 2016: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28047932/tu-h-campus-iep3-02-neurovascular-4d-parametric-imaging-using-co-registration-of-biplane-dsa-sequences-with-3d-vascular-geometry-obtained-from-cone-beam-ct
#16
A Balasubramoniam, D Bednarek, S Rudin, C Ionita
PURPOSE: To create 4D parametric images using biplane Digital Subtraction Angiography (DSA) sequences co-registered with the 3D vascular geometry obtained from Cone Beam-CT (CBCT). METHODS: We investigated a method to derive multiple 4D Parametric Imaging (PI) maps using only one CBCT acquisition. During this procedure a 3D-DSA geometry is stored and used subsequently for all 4D images. Each time a biplane DSA is acquired, we calculate 2D parametric maps of Bolus Arrival Time (BAT), Mean Transit Time (MTT) and Time to Peak (TTP)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047187/tu-h-campus-iep2-03-development-of-3d-printed-coronary-phantoms-for-in-vitro-ct-ffr-validation-using-data-from-320-detector-row-coronary-ct-angiography
#17
C Ionita, E Angel, D Mitsouras, S Rudin, D Bednarek, S Zaid, M Wilson, F Rybicki
PURPOSE: To validate Computed Tomography Fractional Flow Reserve (CT-FFR) measurements with accurate 3D printed coronary phantoms. METHODS: DICOM data from four phases in two patients imaged with a standard 320 × 0.5mm coronary CT acquisition (70-80% cardiac cycle) underwent semi-automated segmentation using a research workstation. Both patients had a >50% stenosis from the clinical image interpretation. Each volume was saved as a Stereo Lithographic (STL) file with 250 micron resolution...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28033272/intraoperative-dexmedetomidine-and-postoperative-cerebral-hyperperfusion-syndrome-in-patients-who-underwent-superficial-temporal-artery-middle-cerebral-artery-anastomosis-for-moyamoya-disease-a-retrospective-observational-study
#18
Hyungseok Seo, Ho-Geol Ryu, Je Do Son, Jeong-Soo Kim, Eun Jin Ha, Jeong-Eun Kim, Hee-Pyoung Park
Dexmedetomidine, a selective α2-agonist, reduces cerebral blood flow and has neuroprotective effects against cerebral ischemia/reperfusion injury in experimental animals. We examined whether intraoperative dexmedetomidine would reduce the incidence of postoperative cerebral hyperperfusion syndrome (CHS) after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with moyamoya disease.The electronic medical records of 117 moyamoya patients who underwent STA-MCA anastomosis were reviewed retrospectively...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28025231/cardiac-resynchronization-therapy-by-multipoint-pacing-improves-response-of-left-ventricular-mechanics-and-fluid-dynamics-a-three-dimensional-and-particle-image-velocimetry-echo-study
#19
Mariachiara Siciliano, Federico Migliore, Luigi Badano, Emanuele Bertaglia, Gianni Pedrizzetti, Stefano Cavedon, Alessandro Zorzi, Domenico Corrado, Sabino Iliceto, Denisa Muraru
AIMS: To characterize the effect of multipoint pacing (MPP) compared to biventricular pacing (BiV) on left ventricle (LV) mechanics and intraventricular fluid dynamics by three-dimensional echocardiography (3DE) and echocardiographic particle imaging velocimetry (Echo-PIV). METHODS AND RESULTS: In 11 consecutive patients [8 men; median age 65 years (57-75)] receiving cardiac resynchronization therapy (CRT) with a quadripolar LV lead (Quartet,St.Jude Medical,Inc...
December 26, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27992529/exposure-of-bacterial-biofilms-to-electrical-current-leads-to-cell-death-mediated-in-part-by-reactive-oxygen-species
#20
Cassandra L Brinkman, Suzannah M Schmidt-Malan, Melissa J Karau, Kerryl Greenwood-Quaintance, Daniel J Hassett, Jayawant N Mandrekar, Robin Patel
Bacterial biofilms may form on indwelling medical devices such as prosthetic joints, heart valves and catheters, causing challenging-to-treat infections. We have previously described the 'electricidal effect', in which bacterial biofilms are decreased following exposure to direct electrical current. Herein, we sought to determine if the decreased bacterial quantities are due to detachment of biofilms or cell death and to investigate the role that reactive oxygen species (ROS) play in the observed effect. Using confocal and electron microscopy and flow cytometry, we found that direct current (DC) leads to cell death and changes in the architecture of biofilms formed by Gram-positive and Gram-negative bacteria...
2016: PloS One
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