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https://www.readbyqxmd.com/read/27922845/continued-under-recognition-of-acute-respiratory-distress-syndrome-after-the-berlin-definition-what-is-the-solution
#1
John G Laffey, Tài Pham, Giacomo Bellani
PURPOSE OF REVIEW: Timely recognition of acute respiratory distress syndrome (ARDS) may allow for more prompt management and less exacerbation of lung injury. However, the absence of a diagnostic test for ARDS means that the diagnosis of ARDS requires clinician recognition in what is usually a complicated and evolving illness. We review data concerning the extent of recognition of ARDS in the era of the Berlin definition of ARDS. RECENT FINDINGS: ARDS continues to be under-recognized - even in the era of the more recent 'Berlin' definition, and significant delay in its recognition is common...
December 5, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27917305/laboratory-diagnosis-for-outbreak-prone-infectious-diseases-after-typhoon-yolanda-haiyan-philippines
#2
Mariko Saito-Obata, Mayuko Saito, Titus C Tan, Inez Andrea P Medado, Clyde Dapat, Michiko Okamoto, Raita Tamaki, Rowena C Capistrano, Edelwisa Segubre-Mercado, Socorro P Lupisan, Hitoshi Oshitani
Typhoon Yolanda (Haiyan) hit the central part of the Philippines on November 8, 2013. To identify possible outbreaks of communicable diseases after the typhoon, nasopharyngeal swabs, stool and blood samples were collected from patients who visited the Eastern Visayas Regional Medical Center due to acute respiratory infection (ARI), acute gastroenteritis (AGE) or other febrile illness (OFI) including suspected dengue fever, between November 28, 2013 and February 5, 2014.   Methods: Samples were tested on-site for selected pathogens using rapid diagnostic tests...
October 21, 2016: PLoS Currents
https://www.readbyqxmd.com/read/27916725/prognostic-value-of-a-category-based-on-electron-microscopic-features-of-clival-chordomas
#3
Jiwei Bai, Yixuan Zhai, Shuai Wang, Hua Gao, Jiang Du, Junmei Wang, Mingxuan Li, Chuzhong Li, Songbai Gui, Cuiping Zhang, Yilin Sun, Yazhuo Zhang
OBJECTIVE: Skull base chordomas are clinically malignant because of the difficulty of total removal and the high recurrence rate. Because the disease-free survival after surgery is currently unpredictable, there is a need for new parameters obtained from histological analyses of the resection specimen that allows a risk stratification of patients with chordoma. METHODS: Electron microscopic diagnoses were introduced into the clinical practice for the diagnosis of chordoma in our department in recent years...
December 1, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27911376/rapid-and-efficient-generation-of-recombinant-human-pluripotent-stem-cells-by-recombinase-mediated-cassette-exchange-in-the-aavs1-locus
#4
Laura Ordovás, Ruben Boon, Mariaelena Pistoni, Yemiao Chen, Rangarajan Sambathkumar, Nicky Helsen, Jolien Vanhove, Pieter Berckmans, Qing Cai, Kim Vanuytsel, Susanna Raitano, Catherine M Verfaillie
Even with the revolution of gene-targeting technologies led by CRISPR-Cas9, genetic modification of human pluripotent stem cells (hPSCs) is still time consuming. Comparative studies that use recombinant lines with transgenes integrated into safe harbor loci could benefit from approaches that use site-specific targeted recombinases, like Cre or FLPe, which are more rapid and less prone to off-target effects. Such methods have been described, although they do not significantly outperform gene targeting in most aspects...
November 20, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27905116/unparalleled-replacement-of-native-mitochondrial-genes-by-foreign-homologs-in-a-holoparasitic-plant
#5
M Virginia Sanchez-Puerta, Laura E García, Josefina Wohlfeiler, Luis F Ceriotti
Horizontal gene transfer (HGT) among flowering plant mitochondria occurs frequently and, in most cases, leads to nonfunctional transgenes in the recipient genome. Parasitic plants are particularly prone to this phenomenon, but their mitochondrial genomes (mtDNA) have been largely unexplored. We undertook a large-scale mitochondrial genomic study of the holoparasitic plant Lophophytum mirabile (Balanophoraceae). Comprehensive phylogenetic analyses were performed to address the frequency, origin, and impact of HGT...
November 30, 2016: New Phytologist
https://www.readbyqxmd.com/read/27902964/variations-of-different-dissolved-and-particulate-phosphorus-classes-during-an-algae-bloom-in-a-eutrophic-lake-by-31-p-nmr-spectroscopy
#6
Xiuling Bai, Jinhua Sun, Yunkai Zhou, Lei Gu, Hongyan Zhao, Jiehua Wang
Characterization of phosphorus (P) pools is vital to understanding the contribution of P to water eutrophication. In this study, dissolved and particulate P classes during an algae bloom in Lake Taihu, as well as their relationships with the main environmental factors, were analyzed based on solution (31)P NMR. The results showed that dissolved P was dominated by orthophosphate (Ortho-P) in heavily polluted regions and by orthophosphate monoester (Mono-P) and orthophosphate diester (Diester-P) in lightly polluted regions, indicating that the main dissolved P classes varied with the degree of lake pollution...
November 27, 2016: Chemosphere
https://www.readbyqxmd.com/read/27902481/association-of-smoking-status-with-prognosis-in-bladder-cancer-a-meta-analysis
#7
Lina Hou, Xuwei Hong, Meng Dai, Pengliang Chen, Hongfan Zhao, Qiang Wei, Fei Li, Wanlong Tan
There is considerable controversy regarding the association between smoking and prognosis in surgically treated bladder cancer. The present meta-analysis was performed to quantify the role of smoking status in bladder cancer recurrence, progression and patient survival by pooling the available previous data. Pubmed, Embase and the Cochrane Library databases were searched for eligible studies published prior to April 2016. Random and fixed effects models were used to calculate the summary relative risk estimates (SRRE)...
November 25, 2016: Oncotarget
https://www.readbyqxmd.com/read/27900922/-extracorporeal-life-support-for-legionella-pneumonia
#8
W A C Koekkoek, C Savelkoul, P R Wijnandts, M Platenkamp, D W Donker, D H T Tjan
BACKGROUND: Legionella species cause 5% of all community acquired pneumonias. However, Legionella pneumonia results relatively often in admission to the intensive care unit (ICU). A significant complication is the development of acute respiratory distress syndrome (ARDS). The ICU mortality rate for Legionella pneumonia is > 30% with conventional treatments. CASE DESCRIPTION: A 64-year-old male was admitted to the ICU with respiratory failure due to Legionella pneumonia complicated by ARDS...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27899151/lung-ultrasound-can-be-used-to-predict-the-potential-of-prone-positioning-and-assess-prognosis-in-patients-with-acute-respiratory-distress-syndrome
#9
Xiao-Ting Wang, Xin Ding, Hong-Min Zhang, Huan Chen, Long-Xiang Su, Da-Wei Liu
BACKGROUND: It is very important to assess the effectiveness of prone positioning (PP) in patients with severe acute respiratory distress syndrome (ARDS). However, it is difficult to identify patients who may benefit from PP. The purpose of this study was to investigate whether prone positioning potential (PPP) can be predicted by lung ultrasound in patients with ARDS. METHODS: In this prospective study, 45 patients with ARDS were included for the assessment of PPP...
November 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27898709/individual-differences-in-emotion-regulation-childhood-trauma-and-proneness-to-shame-and-guilt-in-adolescence
#10
Aurora Szentágotai-Tătar, Andrei C Miu
Dispositional shame and guilt have been associated with psychopathology and an increasing number of studies have traced this relation back to adolescence. This developmental period is thought to be characterized by maturational changes in emotion regulation, which also play an important role in vulnerability to psychopathology, but little is known about the links between emotion regulation and dispositional shame and guilt. The current study investigated the relations between individual differences in the habitual use of a wide range of emotion regulation strategies and proneness to shame and guilt in a large sample of adolescents (N = 706), aged 13 to 17 years...
2016: PloS One
https://www.readbyqxmd.com/read/27898601/fontan-fenestration-closure-prior-to-posterior-spinal-fusion-in-patients-with-single-ventricle-heart-disease
#11
Matthew C Schwartz, David Nykanen, Craig Fleishman, Hamish M Munro, Jonathan Phillips, Raymond D Knapp, Donald Felix
STUDY DESIGN: Case series. OBJECTIVE: To describe transcatheter closure of the Fontan fenestration prior to posterior spinal fusion in two children to prevent paradoxical venous air embolism during the operation. SUMMARY OF BACKGROUND DATA: Scoliosis is common among patients with single-ventricle congenital heart disease who have undergone Fontan operation and spinal surgery can offer physiologic benefits. Venous air embolism is a rare, but important reported complication during spinal surgery performed in the prone position...
December 1, 2016: Spine
https://www.readbyqxmd.com/read/27898439/limiting-sedation-for-patients-with-acute-respiratory-distress-syndrome-time-to-wake-up
#12
Faraaz Ali Shah, Timothy D Girard, Sachin Yende
PURPOSE OF REVIEW: Critically ill patients with acute respiratory distress syndrome (ARDS) may require sedation in their clinical care. The goals of sedation in ARDS patients are to improve patient comfort and tolerance of supportive and therapeutic measures without contributing to adverse outcomes. This review discusses the current evidence for sedation management in patients with ARDS. RECENT FINDINGS: Deep sedation strategies should be avoided in the care of patients with ARDS because deep sedation has been associated with increased time on mechanical ventilation, longer ICU and hospital length of stay, and higher mortality in critically ill patients...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27898438/rescue-therapies-for-acute-respiratory-distress-syndrome-what-to-try-first
#13
Onnen Moerer, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Severe respiratory failure due to the acute respiratory distress syndrome (ARDS) might require rescue therapy measures beyond even extended standard care to ensure adequate oxygenation and survival. This review provides a summary and assessment of treatment options that can be beneficial when the standard approach fails. RECENT FINDINGS: 'Life-threatening' conditions or refractory hypoxemia during mechanical ventilation are more a matter of personal rating than an objective diagnosis based on defined and/or unanimously agreed thresholds that would mandate the use of rescue therapies...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27898429/dosimetric-improvements-with-a-novel-breast-stereotactic-radiotherapy-device-for-delivery-of-preoperative-partial-breast-irradiation
#14
James W Snider Iii, Yildirim Mutaf, Elizabeth Nichols, Andrea Hall, Patrick Vadnais, William F Regine, Steven J Feigenberg
OBJECTIVE: Partial-breast irradiation (PBI) with external-beam radiotherapy has produced higher than expected rates of fair-to-poor cosmesis. Worsened outcomes have been correlated with larger volumes of breast tissue exposed to radiation. A novel breast-specific stereotactic radiotherapy (BSRT) device (BSRTD) has been developed at our institution and has shown promise in delivering highly conformal dose distributions. We compared normal tissue sparing with this device with that achieved with intensity-modulated radiation therapy (IMRT)-PBI...
November 30, 2016: Oncology
https://www.readbyqxmd.com/read/27897108/diagnostic-validity-and-clinical-utility-of-hba1c-tests-for-type-2-diabetes-mellitus
#15
Arthur Hamie Owora
Individual and population level inference about risk and burden of diabetes is often made using diagnostic tests that are imperfect and prone to misclassification error (i.e. false positives and negatives). These errors or biases are rarely accounted for and could lead to inappropriate clinical decisions, inefficient allocation of scarce resources, and poor planning of disease prevention and treatment interventions. The objective of this article is to describe how misclassification error due to imperfect diagnostic tests affects individual and population level inference, particularly involving the role of hemoglobin HbA1c in diagnosing Type 2 diabetes mellitus...
November 29, 2016: Current Diabetes Reviews
https://www.readbyqxmd.com/read/27895621/immune-modulatory-effects-of-human-chorionic-gonadotropin-on-dendritic-cells-supporting-fetal-survival-in-murine-pregnancy
#16
Dominique Dauven, Stefanie Ehrentraut, Stefanie Langwisch, Ana Claudia Zenclussen, Anne Schumacher
Dendritic cells (DCs) are critically involved in the determination of immunity vs. tolerance. Hence, DCs are key regulators of immune responses either favoring or disfavoring fetal survival. Several factors were proposed to modulate DC phenotype and function during pregnancy. Here, we studied whether the pregnancy hormone human chorionic gonadotropin (hCG) is involved in DC regulation. In vitro, bone marrow-derived DCs (BMDCs) were stimulated in the presence or absence of urine-purified or recombinant hCG (rhCG) preparations...
2016: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/27894277/human-limb-skeletal-muscle-wasting-and-architectural-remodeling-during-five-to-ten-days-intubation-and-ventilation-in-critical-care-an-observational-study-using-ultrasound
#17
Peter Turton, Richard Hay, Jonathon Taylor, Jamie McPhee, Ingeborg Welters
BACKGROUND: Critically ill patients frequently suffer muscle weakness whilst in critical care. Ultrasound can reliably track loss of muscle size, but also quantifies the arrangement of the muscle fascicles, known as the muscle architecture. We sought to measure both pennation angle and fascicle length, as well as tracking changes in muscle thickness in a population of critically ill patients. METHODS: On days 1, 5 and 10 after admission to critical care, muscle thickness was measured in ventilated critically ill patients using bedside ultrasound...
November 29, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27891744/inducing-speech-errors-in-dysarthria-using-tongue-twisters
#18
Heather Kember, Kathryn Connaghan, Rupal Patel
Although tongue twisters have been widely use to study speech production in healthy speakers, few studies have employed this methodology for individuals with speech impairment. The present study compared tongue twister errors produced by adults with dysarthria and age-matched healthy controls. Eight speakers (four female, four male; mean age = 54.5 years) with spastic (mixed-spastic) dysarthria of varying aetiology (cerebral palsy, multiple sclerosis, multiple system atrophy) and eight controls (four female, four male; mean age = 56...
November 27, 2016: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/27890095/an-unexpected-death-due-to-massive-ascites-and-a-giant-mucinous-ovarian-cystadenoma
#19
Masayuki Kashiwagi, Mio Takayama, Tomoko Sugimura, Aya Matsusue, Kenji Hara, Brian Waters, Shin-Ichi Kubo
A female in her thirties fell face down in her room. She was motionless when her sister found her. She was transported to the hospital by ambulance and was in a state of cardiopulmonary arrest on admission. She did not respond to resuscitation. Her abdomen had started to swell 3years before her death. An autopsy was performed to clarify the decedent's cause of death. She was 172cm tall and weighed 146kg. Her maximum abdominal girth was 172.1cm. A subcutaneous hemorrhage measuring 4.5cm in diameter was observed in the epigastric region...
November 2016: Legal Medicine
https://www.readbyqxmd.com/read/27889866/management-and-outcomes-of-obstructive-sleep-apnea-in-children-with-robin-sequence-a-cross-sectional-study
#20
Manouk J S van Lieshout, Koen F M Joosten, Maarten J Koudstaal, Marc P van der Schroeff, Karolijn Dulfer, Irene M J Mathijssen, Eppo B Wolvius
OBJECTIVE: The objective of this cross-sectional study is to assess the prevalence, course, and management of obstructive sleep apnea (OSA) in children with Robin sequence (RS) aged 1-18 years. MATERIALS AND METHODS: A cross-sectional study was conducted in 63 children aged 1 to18 years with RS. Patient data were collected on baseline characteristics and management. OSA was evaluated by polysomnography. RESULTS: Sixty-three children with RS were included (median age 8...
November 26, 2016: Clinical Oral Investigations
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