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https://www.readbyqxmd.com/read/28403094/less-invasive-management-of-deep-neck-infection-and-descending-necrotizing-mediastinitis-a-single-center-retrospective-study
#1
Dong Wei, Ling Bi, Huiyong Zhu, Jianfeng He, Huiming Wang
By a 7-year retrospective review, we reported our experience in management of descending necrotizing mediastinitis (DNM) and deep neck infection (DNI). A retrospective design was used to reveal the clinical characteristics of DNI and DNM. The clinical outcome was analyzed to validate less invasive management. We reviewed 82 patients between 2009 and 2016, 12 of which were diagnosed as DNM by clinical and computed tomography findings. A total of 35 patients had relevant systemic conditions, mainly diabetes mellitus (19 patients)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28394786/usefulness-of-the-delta-neutrophil-index-to-predict-30-day-mortality-in-patients-with-upper-gastrointestinal-bleeding
#2
Taeyoung Kong, Sangkook In, Yoo Seok Park, Hye Sun Lee, Jong Wook Lee, Je Sung You, Hyun Soo Chung, Incheol Park, Sung Phil Chung
PURPOSE: The delta neutrophil index (DNI), reflecting the fraction of circulating immature granulocytes, is associated with increased mortality in patients with systemic inflammation. It is rapidly and easily measured while performing a complete blood count. This study aimed to determine whether the DNI can predict short-term mortality in patients presenting to the emergency department (ED) with upper gastrointestinal hemorrhage (UGIH). METHODS: We retrospectively identified consecutive patients (>18 years old) with UGIH admitted to the ED from January 1, 2015 to February 28, 2016...
April 7, 2017: Shock
https://www.readbyqxmd.com/read/28320333/delta-neutrophil-index-is-an-independent-predictor-of-mortality-in-septic-acute-kidney-injury-patients-treated-with-continuous-renal-replacement-therapy
#3
In Mi Han, Chang-Yun Yoon, Dong Ho Shin, Youn Kyung Kee, Seung Gyu Han, Young Eun Kwon, Kyoung Sook Park, Mi Jung Lee, Hyung Jung Oh, Jung Tak Park, Seung Hyeok Han, Shin-Wook Kang, Tae-Hyun Yoo
BACKGROUND: Delta neutrophil index (DNI), representing an elevated fraction of circulating immature granulocytes in acute infection, has been reported as a useful marker for predicting mortality in patients with sepsis. The aim of this study was to evaluate the prognostic value of DNI in predicting mortality in septic acute kidney injury (S-AKI) patients treated with continuous renal replacement therapy (CRRT). METHOD: This is a retrospective analysis of consecutively CRRT treated patients...
March 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28319139/identification-of-cell-morphology-parameters-from-automatic-hematology-analyzers-to-predict-the-peripheral-blood-cd34-positive-cell-count-after-mobilization
#4
Saeam Shin, Sung Ran Cho, Sinyoung Kim, Jong Rak Choi, Kyung-A Lee
Optimal timing of apheresis initiation is important for maximizing the hematopoietic stem cell (HSC) yield. This study aimed to identify useful parameters from automatic hematology analyzers for predicting the peripheral blood CD34+ cell count after mobilization. We prospectively enrolled 53 healthy donors and 72 patients, and evaluated 43 cell morphology parameters from Unicel DxH800 (Beckman Coulter, USA) and Advia 2120i (Siemens Healthcare Diagnostics, USA). The correlation of each parameter with the CD34+ cell count in pre-apheresis blood samples was analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28278698/usefulness-of-the-delta-neutrophil-index-as-an-ancillary-test-in-the-emergency-department-for-the-early-diagnosis-of-suspected-acute-promyelocytic-leukemia
#5
Dong Ryul Ko, Ji Eun Jang, Sung Phil Chung, Jong Wook Lee, Hye Sun Lee, Jung Hwa Hong, Taeyoung Kong, Je Sung You, Incheol Park
The delta neutrophil index (DNI) reflects the fraction of circulating immature granulocytes. We evaluated the usefulness of DNI values in patients with acute myeloid leukemia (AML) to distinguish the acute stage of acute promyelocytic leukemia (APL). We analyzed patients retrospectively who were first diagnosed with AML upon admission to the emergency department (ED). Thirty of the 134 patients (22.4%) were diagnosed with APL on ED admission. The univariate analysis and multivariate logistic regression models revealed that DNI values differed significantly between APL and non-APL AML patients on days 0, 1 and 2...
March 2, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28278168/the-delta-neutrophil-index-as-a-predictive-marker-of-histological-chorioamnionitis-in-patients-with-preterm-premature-rupture-of-membranes-a-retrospective-study
#6
Hee Young Cho, Inkyung Jung, Ja-Young Kwon, So Jung Kim, Yong Won Park, Young-Han Kim
BACKGROUND: Histological chorioamnionitis (HCA) is related to perinatal morbidity. However, there is no definite diagnostic method for detecting chorioamnionitis before delivery. METHODS: We evaluated whether the delta neutrophil index (DNI) was an effective early marker of HCA in patients with preterm premature rupture of membranes (PPROM). We retrospectively evaluated 149 women diagnosed with PPROM (gestational age, 20+0 to 36+6 weeks) at Severance Hospital from January 2013 to December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28271977/end-of-life-conversations-and-hospice-placement-association-with-less-aggressive-care-desired-in-the-nursing-home
#7
Joann P Reinhardt, Deirdre Downes, Verena Cimarolli, Patricia Bomba
Education about end-of-life care and treatment options, communication between family and health care providers, and having advance directives and medical orders in place are important for older adults with chronic, progressive decline and end-stage disease who spend their last days in the nursing home. This study used retrospective data (6 months before death) of long-stay nursing home decedents (N = 300) taken from electronic health records to capture the end-of-life experience. Findings showed for almost all decedents, Do Not Resuscitate and Do Not Intubate orders were in place, and just over one-half had Do Not Hospitalize and No Artificial Feeding orders in place...
January 2017: Journal of Social Work in End-of-life & Palliative Care
https://www.readbyqxmd.com/read/28265798/the-role-of-a-hospital-ethics-consultation-service-in-decision-making-for-unrepresented-patients
#8
Andrew M Courtwright, Joshua Abrams, Ellen M Robinson
Despite increased calls for hospital ethics committees to serve as default decision-makers about life-sustaining treatment (LST) for unrepresented patients who lack decision-making capacity or a surrogate decision-maker and whose wishes regarding medical care are not known, little is known about how committees currently function in these cases. This was a retrospective cohort study of all ethics committee consultations involving decision-making about LST for unrepresented patients at a large academic hospital from 2007 to 2013...
March 6, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28238210/delta-neutrophil-index-a-reliable-marker-to-differentiate-perforated-appendicitis-from-non-perforated-appendicitis-in-the-elderly
#9
Dong Hyuk Shin, Young Suk Cho, Yoon Sung Kim, Hee Cheol Ahn, Young Taeck Oh, Sang O Park, Moo-Ho Won, Jun Hwi Cho, Young Myeong Kim, Jeong Yeol Seo, Young Hwan Lee
BACKGROUND: Delta neutrophil index (DNI) is a new inflammatory marker and the present study aimed to evaluate the predictive value of the DNI for the presence of a perforation in elderly with acute appendicitis. METHODS: This retrospective observational study was conducted on 108 consecutive elderly patients (≥65 years old) with acute appendicitis treated over a 24-month period. RESULTS: Sixty-nine of the 108 patients (median, IQR: 72, 67-77 years) were allocated to the perforated appendicitis group (63...
February 26, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28169298/the-value-of-delta-neutrophil-index-in-young-infants-with-febrile-urinary-tract-infection
#10
Jung Won Lee, Seong Heon Kim, Se Jin Park, Keum Hwa Lee, Jae Hyon Park, Andreas Kronbichler, Michael Eisenhut, Ji Hong Kim, Jong Wook Lee, Jae Il Shin
Delta neutrophil index (DNI) is the fraction of circulating immature granulocytes, which reflects severe bacterial infections and septic condition but has not been studied in urinary tract infection (UTI). Here, we evaluated the value of DNI in predicting acute pyelonephritis (APN) or vesicoureteral reflux (VUR) using the data of 288 patients. Conventional inflammatory markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and DNI were measured. WBC, CRP, ESR and DNI were higher in APN than in lower UTI (p < 0...
February 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28156564/advance-care-planning-and-specialty-palliative-care-utilization-for-patients-with-hematologic-malignancies-who-undergo-allogeneic-hematopoietic-cell-transplant
#11
Lisa M McNey, Erik Eckhert, Derek Galligan, Gabriel N Mannis
18 Background: Unlike most metastatic solid tumors, many advanced hematologic malignancies are treated with curative intent. Accordingly, aggressive interventions often continue until late in the disease course because it can be difficult to discern when cure is no longer possible. This is particularly true for recipients of allogeneic hematopoietic cell transplant (alloHCT). We hypothesized that alloHCT recipients and their providers would be less likely to utilize specialty Palliative Care (PC) services or to engage in early communication regarding advance care planning...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156485/palliative-care-interventions-and-end-of-life-care-outcomes-for-hepatocellular-patients-pts-at-two-veterans-affairs-va-medical-centers
#12
Sarah Lee, Sejal Kothadia, Yucai Wang, Victor Tsu-Shih Chang, Yeun-Hee Anna Park, Ellen Olson, David Klein, Fengming Zhong
164 Background: Palliative care interventions and their effect on EOL outcomes for liver cancer pts have not been described. We investigated the association between palliative care intervention and EOL care outcomes. METHODS: We reviewed the charts of pts with hepatocellular carcinoma and who were seen by palliative care at 2 VA medical centers from 2006 to 2012. We investigated the association between EOL outcomes (number of ER visits, ICU visits, chemotherapy, place of death, number of hospitalizations during their last 30 days), and interventions such as early referral (within 30 days of diagnosis), defined goals of care, holding a family meeting, and symptom assessment and management...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156477/a-comparison-of-patients-with-liver-cancer-receiving-palliative-care-at-two-veterans-affairs-va-medical-centers
#13
Zhen Wang, Sejal Kothadia, Yucai Wang, Ellen Olson, Yeun-Hee Anna Park, David Klein, Fengming Zhong, Victor Tsu-Shih Chang
75 Background: Liver cancer is a leading cause of death. Lack of data exists on palliative care in this group, and care varies by location. We aim to determine if there are differences in palliative care for patients (pts) with liver cancer by VA site. METHODS: In an IRB approved protocol, we reviewed medical records of pts at 2 VA medical centers (S1, S2) with liver cancer, who were seen by Palliative Care between 2006 and 2012. Veterans were compared by 1) demographics: Karnofsky performance status > 50 (KPS), marital status, DNR/DNI, 2) palliative intervention: goals of care discussion, referrals to psychology and PT/OT, and 3) outcomes: ED visit within 1 month (mo) of death, ED visit within 6 mo of death, ICU within 30 days of death, and hospice as site of death, time from diagnosis to palliative care, and time from DNR to death...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28142306/noninvasive-ventilation-in-patients-with-hematologic-malignancy
#14
Jiajia Liu, Conor Bell, Vagia Campbell, Julian DeBacker, Erik Tamberg, Christie Lee, Sangeeta Mehta
INTRODUCTION: Noninvasive ventilation (NIV) is commonly used as first-line therapy for immunocompromised patients with acute respiratory failure. However, it may not be appropriate for all patients, as failure of NIV and delayed endotracheal intubation (ETI) may increase mortality. We report our center's experience and outcomes for patients with active hematologic malignancy (HM) treated with NIV. METHODS: We conducted a retrospective study of consecutive patients with HM who were admitted to the intensive care unit (ICU) of Mount Sinai Hospital for acute respiratory failure between January 1, 2010, and May 31, 2015, and were initially treated with NIV...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28115599/delta-neutrophil-index-contributes-to-the-differential-diagnosis-between-acute-gout-attack-and-cellulitis-within-24-hours-after-hospitalization
#15
Jung Yoon Pyo, You-Jung Ha, Jason Jungsik Song, Yong-Beom Park, Soo-Kon Lee, Sang-Won Lee
OBJECTIVE: An acute gout attack is often misdiagnosed as cellulitis. Differentiating these two diseases is crucial when deciding treatment strategies. Delta neutrophil index (DNI) represents the difference between leucocyte subfractions that corresponds to the fraction of immature granulocytes and can predict the bacterial infection burden. The aim of this study was to evaluate the potential of DNI as a predictive marker for differentiating an acute gout attack and cellulitis. METHODS: We reviewed medical records of 184 patients with an acute gout attack and 183 patients with lower limb cellulitis...
January 23, 2017: Rheumatology
https://www.readbyqxmd.com/read/28099054/association-between-do-not-resuscitate-do-not-intubate-status-and-resident-physician-decision-making-a-national-survey
#16
Elizabeth K Stevenson, Hashim M Mehter, Allan J Walkey, Renda Soylemez Wiener
RATIONALE: Compared with their Full Code counterparts, patients with do not resuscitate/do not intubate (DNR/DNI) status receive fewer interventions and have higher mortality than predicted by clinical characteristics. OBJECTIVES: To assess whether internal medicine residents, the front-line providers for many hospitalized patients, would manage hypothetical patients differently based on code status. We hypothesized respondents would be less likely to provide a variety of interventions to DNR/DNI patients than to Full Code patients...
April 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27976888/magnetic-properties-of-a-dinuclear-nickel-ii-complex-with-2-6-bis-2-hydroxyethyl-methylaminomethyl-4-methylphenolate
#17
Hiroshi Sakiyama, Yukako Chiba, Katsuya Tone, Mikio Yamasaki, Masahiro Mikuriya, J Krzystek, Andrew Ozarowski
Magnetic properties of dinuclear nickel(II) complex [Ni2(sym-hmp)2](BPh4)2·3.5DMF·0.5(2-PrOH) (1), where (sym-hmp)(-) is 2,6-bis[(2-hydroxyethyl)methylaminomethyl]-4-methylphenolate anion and DMF indicates dimethylformamide, were investigated using high-frequency and -field electron paramagnetic resonance (HFEPR). To magnetically characterize the mononuclear nickel(II) species forming the dimer, its two dinuclear zinc(II) analogues, [Zn2(sym-hmp)2](BPh4)2·3.5DMF·0.5(2-PrOH) (2) and [Zn2(sym-hmp)2](BPh4)2·2acetone·2H2O (2'), were prepared...
January 3, 2017: Inorganic Chemistry
https://www.readbyqxmd.com/read/27930331/concentrator-photovoltaic-module-architectures-with-capabilities-for-capture-and-conversion-of-full-global-solar-radiation
#18
Kyu-Tae Lee, Yuan Yao, Junwen He, Brent Fisher, Xing Sheng, Matthew Lumb, Lu Xu, Mikayla A Anderson, David Scheiman, Seungyong Han, Yongseon Kang, Abdurrahman Gumus, Rabab R Bahabry, Jung Woo Lee, Ungyu Paik, Noah D Bronstein, A Paul Alivisatos, Matthew Meitl, Scott Burroughs, Muhammad Mustafa Hussain, Jeong Chul Lee, Ralph G Nuzzo, John A Rogers
Emerging classes of concentrator photovoltaic (CPV) modules reach efficiencies that are far greater than those of even the highest performance flat-plate PV technologies, with architectures that have the potential to provide the lowest cost of energy in locations with high direct normal irradiance (DNI). A disadvantage is their inability to effectively use diffuse sunlight, thereby constraining widespread geographic deployment and limiting performance even under the most favorable DNI conditions. This study introduces a module design that integrates capabilities in flat-plate PV directly with the most sophisticated CPV technologies, for capture of both direct and diffuse sunlight, thereby achieving efficiency in PV conversion of the global solar radiation...
December 20, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27902604/the-use-of-delta-neutrophil-index-and-myeloperoxidase-index-as-diagnostic-predictors-of-strangulated-mechanical-bowel-obstruction-in-the-emergency-department
#19
Yong Sung Cha, Kang Hyun Lee, Jong Wook Lee, Eun Hee Choi, Hyung Il Kim, Oh Hyun Kim, Kyoung Chul Cha, Hyun Kim, Sung Oh Hwang
Early detection of bowel strangulation is difficult in patients with mechanical bowel obstruction (MBO). There have been no previous reports of predicting strangulation in MBO cases using the delta neutrophil index (DNI), which is a measure of the proportion of circulating immature granulocytes, or the myeloperoxidase index (MPXI), which is a measure of serum myeloperoxidase level. Therefore, we evaluated differences in initial DNI and MPXI upon presentation at the emergency department (ED) according to strangulation presence in MBO patients...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27858578/severe-cerebral-edema-following-nivolumab-treatment-for-pediatric-glioblastoma-case-report
#20
Xiao Zhu, Michael M McDowell, William C Newman, Gary E Mason, Stephanie Greene, Mandeep S Tamber
Nivolumab is an immune checkpoint inhibitor (ICI) currently undergoing Phase III clinical trials for the treatment of glioblastoma. The authors present the case of a 10-year-old girl with glioblastoma treated with nivolumab under compassionate-use guidelines. After the first dose of nivolumab the patient developed hemiparesis, cerebral edema, and significant midline shift due to severe tumor necrosis. She was managed using intravenous dexamethasone and discharged on a dexamethasone taper. The patient's condition rapidly deteriorated after the second dose of nivolumab, demonstrating hemiplegia, seizures, and eventually unresponsiveness with a fixed and dilated left pupil...
February 2017: Journal of Neurosurgery. Pediatrics
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