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https://www.readbyqxmd.com/read/29652913/ventilator-associated-pneumonia-in-patients-assisted-by-veno-arterial-extracorporeal-membrane-oxygenation-support-epidemiology-and-risk-factors-of-treatment-failure
#1
Adrien Bouglé, Camille Bombled, Dimitri Margetis, Guillaume Lebreton, Charles Vidal, Marine Coroir, David Hajage, Julien Amour
INTRODUCTION: Ventilator-associated pneumonia (VAP) is frequent in Intensive Care Unit (ICU) patients. In the specific case of patients treated with Veno-Arterial Extracorporeal Membrane Oxygenation Support (VA-ECMO), VAP treatment failures (VAP-TF) have been incompletely investigated. METHODS: To investigate the risk factors of treatment failure (VAP-TF) in a large cohort of ICU patients treated with VA-ECMO, we conducted a retrospective study in a Surgical ICU about patients assisted with VA-ECMO between January 1, 2013, and December 31, 2014...
2018: PloS One
https://www.readbyqxmd.com/read/29652077/the-implications-of-cocaine-use-and-associated-behaviors-on-adverse-cv-outcomes-among-veterans-insights-from-the-va-clinical-assessment-reporting-and-tracking-cart-program
#2
Ateka Gunja, Maggie A Stanislawski, Anna E Barón, Thomas M Maddox, Steven M Bradley, Mladen I Vidovich
BACKGROUND: Cocaine use has been associated with adverse cardiovascular outcomes in patients with coronary artery disease. It is unclear if this association is due to direct effects of cocaine or other factors. METHODS: The Veterans Affairs cardiac catheterization database was used to identify Veterans undergoing coronary catheterization between 2007 and 2014. We analyzed association between cocaine use and 1-year all-cause mortality, myocardial infarction (MI), and cerebrovascular accident (CVA) among Veterans with obstructive CAD (N=122,035)...
April 13, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29651959/central-to-peripheral-arterial-stiffness-gradient-in-hemodialyzed-patients-depends-on-the-location-of-the-upper-limb-vascular-access
#3
Daniel Bia, Cintia Galli, Yanina Zocalo, Rodolfo Valtuille, Sandra Wray, Franco Pessana, Edmundo I Cabrera-Fischer
Pulse wave velocity ratio (PWV-ratio), a measure of central-to-peripheral arterial stiffness gradient, is calculated as a quotient between carotid-femoral and carotid-radial PWV (cf-PWV/cr-PWV). This new index has been reported to be significantly associated with increased mortality in hemodialyzed patients. Since several reports showed differences in arterial stiffness regarding the pathway where the vascular access (VA) is, the purpose of this research was: a) to compare arterial stiffness values obtained in the left and right sides of the body in hemodialyzed and non-hemodialyzed patients, and b) to analyze PWV-ratio values obtained in the side of the body where the VA was placed and compare them to its contralateral intact side...
April 13, 2018: Current Hypertension Reviews
https://www.readbyqxmd.com/read/29651795/variability-of-the-vertebral-artery-origin-and-transverse-foramen-entrance-level-ct-angiographic-study
#4
Siniša Vujmilović, Goran Spasojević, Saša Vujnović, Slobodan Malobabić, Zoran Vujković
Vertebral artery (VA), the main element of the posterior brain circulation, has many anatomical variations which generally were widely investigated. However, available data vary in wide ranges, reflecting very different sample sizes, lack of data about left-right or sex differences, and about possible ethnic, regionally specific or genetic differences. Certain new findings suggest possible involvement of some environmental factors in VA variations. Accurate anatomical data about VA variations in different regions of the world, including Balkans countries, are still lacking...
April 13, 2018: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29651586/revascularization-techniques-for-acute-basilar-artery-occlusion-technical-considerations-and-outcome-in-the-setting-of-severe-posterior-circulation-steno-occlusive-disease
#5
Eberhard Siebert, Georg Bohner, Sarah Zweynert, Volker Maus, Anastasios Mpotsaris, Thomas Liebig, Christoph Kabbasch
PURPOSE: To describe the clinical and radiological characteristics, frequency, technical aspects and outcome of endovascular treatment of acute basilar artery occlusion (ABO) in the setting of vertebrobasilar steno-occlusive disease. METHODS: Retrospective analysis of databases of two universitary stroke centers including all consecutive patients from January 2013 until May 2017 undergoing thrombectomy for a) acute stroke due to basilar artery occlusion and either significant basilar artery stenosis or vertebral artery stenosis/occlusion as well as b) presumed embolic basilar artery occlusions...
April 12, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29651467/outcomes-of-intraoperative-oct-assisted-epiretinal-membrane-surgery-from-the-pioneer-study
#6
Justis P Ehlers, Mehnaz Khan, Daniel Petkovsek, Laura Stiegel, Peter K Kaiser, Rishi P Singh, Jamie L Reese, Sunil K Srivastava
Purpose: To assess the retinal architecture changes which occur during epiretinal membrane (ERM) surgery, utilizing intraoperative optical coherence tomography ( i OCT). Design: Prospective multi-surgeon single center study. Subjects/Participants: Subjects from the PIONEER i OCT study who underwent surgical intervention for management of ERM. Methods: All subjects underwent vitrectomy with ERM peeling with optional internal limiting membrane (ILM) peeling...
April 2018: Ophthalmology Retina
https://www.readbyqxmd.com/read/29651345/subthreshold-photocoagulation-using-endpoint-management-in-the-pascal%C3%A2-system-for-diffuse-diabetic-macular-edema
#7
Masafumi Hamada, Kishiko Ohkoshi, Keiji Inagaki, Nobuyuki Ebihara, Akira Murakami
We evaluated subthreshold photocoagulation using endpoint management (EPM) for the treatment of diabetic macular edema (DME). The study enrolled 10 eyes from 10 patients (6 men and 4 women) with DME. The entry criteria included central macular thickness (CMT) ≥ 300  μ m and decimal visual acuity (VA) ≤ 0.5. The primary endpoints were VA (logMAR) and CMT at 6 months follow-up. Secondary endpoints included fundus autofluorescence, macular volume (MV), and macular sensitivity (MS). We used the PASCAL Streamline Yellow® (wavelength, 577 nm) system to perform grid pattern laser photocoagulation at 50% of the threshold (size, 100  μ m; duration, 0...
2018: Journal of Ophthalmology
https://www.readbyqxmd.com/read/29648520/transfer-coefficients-kco-better-reflect-emphysematous-changes-than-carbon-monoxide-diffusing-capacity-dlco-in-obstructive-lung-diseases
#8
Kaoruko Shimizu, Satoshi Konno, Hironi Makita, Hirokazu Kimura, Hiroki Kimura, Masaru Suzuki, Masaharu Nishimura
The overlap between asthma and chronic obstructive pulmonary disease (COPD) has attracted the interest of pulmonary physicians; thus, measurement of carbon monoxide diffusion capacity (DLco) and/or transfer coefficients (Kco, DLco/VA) may become valuable in clinical settings. How these parameters behave in chronic obstructive lung diseases is poorly understood. We predicted that Kco might more accurately reflect emphysematous changes in the lungs, than DLco. We examined DLco and Kco in non-smokers and smokers with asthma and investigated their relationships with forced expiratory volume in 1 s (%FEV1 ) by group...
April 12, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29645319/it-saved-my-life
#9
Nancy Lutwak
After being appointed the Women's Health Emergency Department Champion at our Veterans Administration (VA) Hospital, I became aware of the large number of veterans who experienced military sexual trauma (MST). I realized coming to our medical center for care could be daunting for many women. The expansive main lobby is a bustling place where many male veterans congregate speaking in loud voices causing them to seem frightening and aggressive. The men may sometimes approach women to chat, but I have been told by female veterans this act, although seemingly benign, causes anxiety and discomfort...
April 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29644241/striped-circle-visual-acuity-chart-a-novel-visual-acuity-chart-based-on-the-landolt-c-chart
#10
Mohammad Reza Pishnamaz, Hadi Ostadimoghaddam
Measurement of Visual Acuity (VA) has been used for eye examinations under various clinical conditions. In addition, because of changes in VA with a range of eye diseases, its measurement is used to screen, diagnose, and evaluate response to treatment in numerous eye diseases and predict the patient's visual function. VA and the likelihood of astigmatism could be evaluated simultaneously using a newly designed Stripped Circle (SC) VA chart. This chart has been developed based on the standard VA measurement scale chart, and the Landolt-C (LC) VA chart and all the standards for a VA chart design were implemented during its development...
2018: Medical Hypothesis, Discovery and Innovation in Ophthalmology
https://www.readbyqxmd.com/read/29644151/trans-cranial-doppler-as-an-ancillary-study-supporting-irreversible-brain-injury-in-a-post-cardiac-arrest-patient-on-extracorporeal-membrane-oxygenation
#11
Naresh Mullaguri, Aarti Sarwal, Nakul Katyal, Premkumar Nattanamai, Pravin George, Christopher R Newey
Obtaining neuroimaging in patients on cardiopulmonary support devices such as extracorporeal membrane oxygenation (ECMO) can be challenging, given the complexities in monitoring, instrumentation, and associated hemodynamic lability. Transcranial Doppler (TCD) is used as an ancillary test for the assessment of cerebral circulatory arrest, but its use in non-pulsatile blood flow in venoarterial (VA) ECMO is not well described. We report the use of TCD in a patient on VA ECMO post-cardiac arrest for evaluation of death by neurological criteria...
February 6, 2018: Curēus
https://www.readbyqxmd.com/read/29643883/comparison-of-volume-and-frequency-advancement-feeding-protocols-in-very-low-birth-weight-neonates
#12
Afaq Hussain, Abdur Rehman, Nazia Fatima
Objective: To determine the outcomes in very low birth weight (VLBW) neonates receiving volume advancement versus frequency advancement feeding protocols. Methods: This controlled clinical trial was conducted in Children Hospital Multan within duration of 6 months from February 2017 to August 2017. VLBW neonates having weight < 1500 g at the time of birth were included. The protocol for frequency advancement (FA) group was to give 1 ml/kg human or pre-formula milk after every 8 hours and in volume advancement (VA) group after every 3 hours initially...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29643781/two-cases-of-rhegmatogenous-retinal-detachment-associated-with-asteroid-hyalosis
#13
Yoshitaka Okuda, Keigo Kakurai, Takaki Sato, Seita Morishita, Masanori Fukumoto, Ryohsuke Kohmoto, Mai Takagi, Takatoshi Kobayashi, Teruyo Kida, Tsunehiko Ikeda
Background: To report two cases of rhegmatogenous retinal detachment (RRD) associated with asteroid hyalosis (AH). Case Presentation: Two patients presented with RRD originating from a flap tear. Case 1 involved a 62-year-old male who was found to have bullous RRD in his left eye originating from a flap tear. During vitreous surgery, a thick vitreous cortex was found to have strongly adhered to the entire retinal surface, from the center to the periphery. A bimanual method was then used in conjunction with the vitrectomy to create an artificial posterior vitreous detachment...
January 2018: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/29643777/a-case-of-retinal-detachment-with-unique-optical-coherence-tomography-findings-after-gamma-knife%C3%A2-radiosurgery-treatment-for-choroidal-melanoma
#14
Daisaku Kimura, Teruyo Kida, Takaki Sato, Masanori Fukumoto, Ryohsuke Kohmoto, Shota Kojima, Hiroshi Mizuno, Hitoshi Sakaguchi, Jun Sugasawa, Tsunehiko Ikeda
Purpose: To report a case of retinal detachment with unique optical coherence tomography (OCT) findings after Gamma Knife® (GK; Elekta Instrument AB, Stockholm, Sweden) treatment for choroidal melanoma (CM). Case Report: A 48-year-old woman underwent GK therapy for CM in her right eye from the macula to the temporal side. While the tumor subsequently shrank, the patient developed radiation retinopathy, which was treated with laser photocoagulation. The tumor lesions later subsided; however, her visual acuity (VA) decreased 8 years after the initial treatment...
January 2018: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/29628471/a-case-of-a-cardiac-resynchronization-therapy-defibrillator-exhibiting-a-lower-and-alternately-variable-basic-rate
#15
Keigo Iwazaki, Toshiya Kojima, Takahide Murasawa, Jun Yokota, Hikaru Tanimoto, Jun Matsuda, Nobuaki Fukuma, Takumi Matsubara, Yu Shimizu, Gaku Oguri, Eriko Hasumi, Hitoshi Kubo, Kyungho Chang, Katsuhito Fujiu, Issei Komuro
A cardiac resynchronization therapy defibrillator (CRT-D) (Medtronic Inc. Protecta XT) was implanted in a 67-year-old man who had cardiac sarcoidosis with extremely low cardiac function. He had ventricular tachycardia which was controlled by catheter ablation, medication and pacing. The programmed mode was DDI, lower rate was 90 beats/minute, paced AV delay was 150 ms, and the noncompetitive atrial pacing (NCAP) function was programmed as 300 ms.After his admission for pneumonia and heart failure, we changed his DDI mode to a DDD mode because he had atrial tachycardia, which led to inadequate bi-ventricular pacing...
April 6, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29627134/delivering-a-new-deal-of-kidney-health-opportunities-to-improve-outcomes-within-the-veterans-health-administration
#16
Susan T Crowley, Katherine Murphy
Just as the "New Deal" aimed to elevate the "forgotten man" of the Great Depression through governmental relief and reform, so does the Department of Veterans Affairs (VA) health care system aim to improve the health of veterans with the invisible illness of chronic kidney disease through a concerted series of health care delivery reforms. Augmenting its primary care platform with advances in informatics and health service delivery initiatives targeting kidney disease, the VA is changing how nephrology care is provided to veterans with the goal of optimized population kidney health...
April 4, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29626164/neighborhood-child-opportunity-and-individual-level-pediatric-acute-care-use-and-diagnoses
#17
Ellen E Kersten, Nancy E Adler, Laura Gottlieb, Douglas P Jutte, Sarah Robinson, Katrina Roundfield, Kaja Z LeWinn
: media-1vid110.1542/5751513300001PEDS-VA_2017-2309 Video Abstract OBJECTIVES: Although health care providers and systems are increasingly interested in patients' nonmedical needs as a means to improve health, little is known about neighborhood conditions that contribute to child health problems. We sought to determine if a novel, publicly available measure of neighborhood context, the Child Opportunity Index, was associated with pediatric acute care visit frequency and diagnoses. METHODS: This cross-sectional study included San Francisco residents <18 years of age with an emergency department and/or urgent care visit to any of 3 medical systems ( N = 47 175) between 2007 and 2011...
April 6, 2018: Pediatrics
https://www.readbyqxmd.com/read/29625195/idiopathic-premature-ventricular-complexes-originating-from-the-distal-great-cardiac-vein-clinical-cardiac-and-electrophysiological-characteristics-and-catheter-ablation-outcome
#18
Wenkui Lv, Xianhui Zhou, Gulinuer Yiming, Ling Zhang, Qina Zhou, Yaodong Li, Qiang Xing, Jianghua Zhang, Yanmei Lu, Hongli Wang, Guiqiu Cao, Baopeng Tang
AIMS: Although catheter ablation for idiopathic ventricular arrhythmia (VA) has been generally well-established, VA originating from the great cardiac vein (GCV) may be clinically challenging due to its epicardial origin, proximity to coronary arteries and limited accessibility. The purpose of this study was to explore its electrophysiological characteristics and identify effective mapping/ablation strategies for idiopathic premature ventricular complexes (PVCs) originating from the GCV...
April 3, 2018: Life Sciences
https://www.readbyqxmd.com/read/29624620/clinical-risk-factors-of-extracorporeal-membrane-oxygenation-support-in-older-adults
#19
Te-Chun Yeh, Hsiao-Huang Chang, Luo-Ping Ger, Ju-O Wang, Senyeong Kao, Shung-Tai Ho
BACKGROUND: The ageing population and the expected increase in the number of elderly patients make an evidence-based assessment of Extracorporeal Membrane Oxygenation (ECMO) therapy in old patients progressively more important. Veno-arterial (VA) ECMO results for patient aged <65 years is well known. However, the risk profile and in-hospital prognosis of advanced age patients with ECMO still need more investigation. The aim of this study was to identify risk factors that predicted the outcomes for elderly patients who received VA-ECMO...
2018: PloS One
https://www.readbyqxmd.com/read/29624539/tinnitus-depression-anxiety-and-suicide-in-recent-veterans-a-retrospective-analysis
#20
Erin Martz, Chennettée Jelleberg, Deborah D Dougherty, Charles Wolters, Aaron Schneiderman
OBJECTIVES: The purpose of this project was to investigate whether there is an association between tinnitus diagnosis and suicide and whether depression and anxiety strengthen that association. Given that tinnitus is the top service-connected disability among U.S. Veterans (Veterans Benefits Administration, 2016) and that suicide among Veterans has been occurring at a higher frequency as compared with community suicide rates (Hoffmire et al., 2015), the possible associations between tinnitus and suicide will be explored...
April 5, 2018: Ear and Hearing
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