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https://www.readbyqxmd.com/read/28934705/vitamin-c-the-next-step-in-sepsis-management
#1
REVIEW
J Teng, A Pourmand, M Mazer-Amirshahi
Sepsis is a life-threatening medical condition, affecting approximately 26 million people worldwide every year. The disease is a continuum, marked by dysregulated inflammation and hemodynamic instability leading to shock, multi-system organ dysfunction, and death. Over the past decades, there has been a focus on the early identification and treatment of sepsis primarily with bundled and goal directed therapy. Despite these advances, morbidity and mortality has remained high, prompting investigation into novel therapies...
September 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28932974/japanese-perspective-in-surgery-for-thoracoabdominal-aortic-aneurysms
#2
Norihiko Shiiya, Naoki Washiyama, Kazumasa Tsuda, Ken Yamanaka, Daisuke Takahashi, Katsushi Yamashita, Kayoko Natsume, Yuki Takeuchi, Suguru Kubota, Yoshiro Matsui
OBJECTIVE: Operative mortality and morbidity after thoracoabdominal aortic surgery remain high. We report our strategy and outcomes, especially those of spinal cord protection. METHODS: Outcomes of 178 patients (age: 26-88 years) who underwent thoracoabdominal aortic replacement were retrospectively analyzed. 65 had aortic dissection, 14 had infected aneurysms, and 22 presented with rupture. Operations were non-elective in 24 and redo through re-thoracotomy in 21...
September 20, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28932394/feasibility-and-safety-of-single-incision-laparoscopic-cholecystectomy-in-elderly-patients-a-single-institution-retrospective-case-series
#3
Masaki Wakasugi, Masahiro Tanemura, Kenta Furukawa, Mitsuyoshi Tei, Yozo Suzuki, Toru Masuzawa, Kentaro Kishi, Hiroki Akamatsu
INTRODUCTION: To evaluate the feasibility and safety of single-incision laparoscopic cholecystectomy (SILC) for uncomplicated gallbladder in elderly patients. MATERIALS AND METHODS: A retrospective analysis of 810 patients undergoing SILC from May 2009 to October 2016 at Osaka Police Hospital was performed, and the outcomes of the patients aged < 80 years and the patients ≥ 80 years were compared. RESULTS: The median operative times of patients <80 years and patients ≥80 years were 100 min and 110 min, respectively (p = 0...
October 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28925974/if-you-build-it-they-will-come-initial-experience-with-a-multi-disciplinary-pediatric-neurocritical-care-follow-up-clinic
#4
Cydni N Williams, Aileen Kirby, Juan Piantino
Pediatric Neurocritical Care diagnoses account for a large proportion of intensive care admissions. Critical care survivors suffer high rates of long-term morbidity, including physical disability, cognitive impairment, and psychosocial dysfunction. To address these morbidities in Pediatric Neurocritical Care survivors, collaboration between Pediatric Neurology and Pediatric Critical Care created a multidisciplinary follow-up clinic providing specialized evaluations after discharge. Clinic referrals apply to all Pediatric Neurocritical Care patients regardless of admission severity of illness...
September 19, 2017: Children
https://www.readbyqxmd.com/read/28925896/allopurinol-old-drug-new-indication-in-neonates
#5
Kim V Annink, Axel R Franz, Jan B Derks, Mario Rüdiger, Frank van Bel, Manon J N L Benders
BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) is an important cause of neonatal mortality and neurological morbidity, even despite hypothermia treatment. Neuronal damage in these infants is partly caused by the production of superoxides via the xanthine-oxidase pathway and concomitant free radical formation. Allopurinol is a xanthine-oxidase inhibitor and can potentially reduce the formation of these superoxides that lead to brain damage in HIE. METHODS: The aim of this review is to provide an overview of the animal and clinical data about the neuroprotective effect of allopurinol in HIE and the relevant mechanisms leading to brain injury in HIE...
September 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28921422/high-incidence-of-secondary-hyperparathyroidism-in-bariatric-patients-comparing-different-procedures
#6
Jih-Hua Wei, Wei-Jei Lee, Keong Chong, Yi-Chih Lee, Shu-Chun Chen, Po-Hsun Huang, Shing-Jong Lin
BACKGROUND: Bariatric surgery is an effective therapy for morbid obesity but may reduce calcium absorption and significantly decrease the bone mineral density. This study examined the prevalence of secondary hyperparathyroidism (SHPT) in obese subjects during follow-up after different bariatric surgeries. We investigated predictors of SHPT. METHODS: We enrolled 1470 obese subjects undergoing bariatric/metabolic surgery with at least 1-year follow-up, including 322 patients undergoing Roux-en-Y gastric bypass (RYGB), 695 undergoing single anastomosis (mini-) gastric bypass (SAGB), 93 undergoing laparoscopic adjustable gastric banding (LAGB), and 360 undergoing sleeve gastrectomy (SG)...
September 18, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28921419/sentinel-lymph-node-biopsy-in-endometrial-cancer-a-new-standard-of-care
#7
REVIEW
Stephanie A Sullivan, Emma C Rossi
Lymph node status is one of the most important factors in determining prognosis and the need for adjuvant treatment in endometrial cancer (EMCA). Unfortunately, full lymphadenectomy bears significant surgical and postoperative risks. The majority of patients with clinical stage I disease will not have metastatic disease; thus, a full lymphadenectomy only increases morbidity in this population of patients. The use of the sentinel lymph node (SLN) biopsy has emerged as an alternative to complete lymphadenectomy in EMCA...
September 18, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28921168/chromosomal-abnormalities-affect-the-surgical-outcome-in-infants-with-hypoplastic-left-heart-syndrome-a-large-cohort-analysis
#8
Dala Zakaria, Xinyu Tang, Rupal Bhakta, Nahed O ElHassan, Parthak Prodhan
Patients with hypoplastic left heart syndrome (HLHS) can have associated genetic abnormalities. This study evaluated the incidence of genetic abnormalities among infants with HLHS and the short-term outcomes of this population during the first hospitalization. This is a retrospective analysis of the multi-center Pediatric Heath Information System database of infants with HLHS who underwent Stage I Norwood, Hybrid, or heart transplant during their first hospitalization from 2004 through 2013. We compared clinical data between infants with and without genetic abnormality, among the three most common chromosomal abnormalities, and between survivors and non-survivors...
September 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28920559/functional-mechanics-of-a-pectin-based-pleural-sealant-after-lung-injury
#9
Andrew B Servais, Cristian D Valenzuela, Arne Kienzle, Alexandra B Ysasi, Willi L Wagner, Akira Tsuda, Maximilian Ackermann, Steven J Mentzer
Pleural injury and associated air leaks are a major influence on patient morbidity and health care costs after lung surgery. Pectin, a plant-derived heteropolysaccharide, has recently demonstrated potential as an adhesive binding to the glycocalyx of visceral mesothelium. Since bioadhesion is a process likely involving the interpenetration of the pectin-based polymer with the glycocalyx, we predicted that the pectin-based polymer may also be an effective sealant for pleural injury. To explore the potential role of an equal weight % mixture of high-methoxyl pectin and carboxymethylcellulose as a pleural sealant, we compared the yield strength of the pectin-based polymer to commonly available surgical products...
September 16, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28919609/psychiatric-disorders-in-drop-out-from-educational-attainment-attending-mental-health-facilities-a-descriptive-cross-sectional-study
#10
M S Islam, M H Rashid, M N Uddin, R K Singha, M A Rahman, M A Haque, C K Saha, M F Abedin
Studies of the impact of mental disorders on educational attainment are rare. Mental disorders, those beginning in childhood or adolescence may increase the risk of early drop out from education. The latter has been shown to have adverse life-course consequences on individuals such as greater demand on social welfare entitlements. A descriptive cross sectional study was carried out at the department of Psychiatry, Comilla Medical College, Comilla, Bangladesh. All cases were selected from patients attending at Comilla Medical College Hospital and Private Mental Health Facilities in Comilla City from March 2015 to February 2016...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28918848/a-multi-institutional-analysis-of-intraoperative-radiotherapy-for-early-breast-cancer-does-age-matter
#11
A M Abbott, S A Valente, L Loftus, R D Tendulkar, J M Greif, K P Bethke, E D Donnelly, C Lottich, D L Ross, N B Friedman, C G Bedi, J E Joh, P Kelemen, R A Hoefer, S K Kang, J Ruffer, A Police, A Fyles, G M Graves, S C Willey, E A Tousimis, W Small, J Lyons, S Grobmyer, C Laronga
BACKGROUND: Single-session intraoperative radiation therapy (IORT) minimizes treatment demands associated with traditional whole breast radiation therapy (WBRT) but outcomes on local disease control and morbidity among the elderly is limited. METHODS: A multi-institutional retrospective registry was established from 19 centers utilizing IORT from 2007 to 2013. Patient, tumor, and treatment variables were analyzed for ages <70 and ≥70. RESULTS: We evaluated 686 patients (<70 = 424; ≥70 = 262) who were margin and lymph node negative...
October 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28918190/autophagy-inflammation-and-immune-dysfunction-in-the-pathogenesis-of-pancreatitis
#12
REVIEW
Anna S Gukovskaya, Ilya Gukovsky, Hana Algül, Aida Habtezion
Pancreatitis is a common disorder with significant morbidity and mortality, yet little is known about its pathogenesis and there is no specific or effective treatment. Its development involves dysregulated autophagy and unresolved inflammation, demonstrated by studies in genetic and experimental mouse models. Disease severity depends on whether the inflammatory response resolves or amplifies, leading to multi-organ failure. Dysregulated autophagy might promote the inflammatory response in the pancreas. We discuss the roles of autophagy and inflammation in pancreatitis, mechanisms of deregulation, and connections among disordered pathways...
September 13, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28914274/influenza-season-hospitalization-trends-in-israel-a-multi-year-comparative-analysis-2005-2006-through-2012-2013
#13
Aharona Glatman-Freedman, Zalman Kaufman, Yaniv Stein, Hanna Sefty, Hilla Zadka, Barak Gordon, Jill Meron, Ethel-Sherry Gordon, Rita Dichtiar, Ziona Haklai, Arnon Afek, Tamy Shohat
BACKGROUND: Influenza-related morbidity impacts healthcare systems, including hospitals. OBJECTIVE: To obtain a quantitative assessment of hospitalization burden in pediatric and internal medicine departments during influenza seasons compared with the summer months in Israel. METHODS: Data on pediatric and internal medicine hospitalized patients in general hospitals in Israel during the influenza seasons between 2005 and 2013 were analyzed for rate of hospitalizations, rate of hospitalization days, hospital length of stay (LOS), and bed occupancy and compared with the summer months...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28914088/multi-morbidity-a-patient-perspective-on-navigating-the-health-care-system-and-everyday-life
#14
Lisbeth Ørtenblad, Lucette Meillier, Alexandra R Jønsson
Objective The importance of everyday life when managing the burden of treatment is rarely studied. This article explores the burden of treatment among people with multi-morbidity by investigating the tension between everyday life and the health care system. Method This was an ethnographic study using individual interviews and participant-observations. An inductive analytical approach was applied, moving from observations and results to broader generalisations. Results People with multi-morbidity experience dilemmas related to their individual priorities in everyday life and the management of their treatment burdens...
January 1, 2017: Chronic Illness
https://www.readbyqxmd.com/read/28914069/the-role-of-a%C3%A2-hospital-pharmacist-in-the-management-of-asthma-in-great-britain
#15
Inka Sembol, Božena Macešková
The role of the pharmacist in the asthma management is well established. However, there is still a considerable number of patients with suboptimal asthma control affecting patients quality of life and resulting in poor outcomes, morbidity and mortality. The aim was to identify patients factors, explore the hospital pharmacists role in the asthma management and identify any areas for improvement in Great Britain. Qualitative data collection was selected. Patients case studies and semi-structured open interviews with the hospital multi-disciplinary team (MDT) were applied...
2017: Ceská a Slovenská Farmacie
https://www.readbyqxmd.com/read/28913712/surgical-site-infection-is-associated-with-tumor-recurrence-in-patients-with-extrahepatic-biliary-malignancies
#16
Stefan Buettner, Cecilia G Ethun, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Matthew Weiss, Ryan C Fields, Bradley Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Bas Groot Koerkamp, Shishir K Maithel, Timothy M Pawlik
BACKGROUND: Surgical site infections (SSI) are one of the most common complications after hepato-pancreato-biliary surgery. Infectious complications may lead to an associated immune-modulatory effect that inhibits the body's response to cancer surveillance. We sought to define the impact of SSI on long-term prognosis of patients undergoing surgical resection of extrahepatic biliary malignancies (EHBM). METHODS: Patients undergoing surgery for EHBM between 2000 and 2014 were identified using a large, multi-center, national cohort dataset...
September 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28912907/long-term-follow-up-of-autonomic-and-enteric-measures-in-patients-undergoing-vertical-banded-gastroplasty-for-morbid-obesity
#17
Neil E Crittenden, Hani Rashed, William D Johnson, George Cowan, David Tichansky, Atul Madan, Naeem Aslam, Teresa Cutts, Thomas L Abell
BACKGROUND: A multi-component model of autonomic and enteric factors may correlate with ultimate weight loss or gain after restrictive obesity surgery. This study aimed to determine relevant parameters to predict successful long-term weight loss. METHODS: Thirty-nine patients (four males and 35 females) with a mean age of 37.2 years were followed for over 15 years after vertical banded gastroplasty. Baseline adrenergic: postural adjustment ratio (PAR) and vasoconstriction (VC); cholinergic: electrocardiogram R-to-R interval (RRI) and enteric measure: electrogastrogram (EGG) were utilized by a discriminant function analysis to classify patients as a long-term loser or gainer...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912369/customized-viral-immunotherapy-for-hpv-associated-cancer
#18
Matthew J Atherton, Kyle B Stephenson, Jonathan Pol, Fuan Wang, Charles Lefebvre, David F Stojdl, Jake K Nikota, Anna Dvorkin-Gheva, Andrew Nguyen, Lan Chen, Stephanie Johnson-Obaseki, Patrick J Villeneuve, Jean-Simon Diallo, Jim Dimitroulakos, Yonghong Wan, Brian D Lichty
The viral transforming proteins E6 and E7 make human papilloma virus positive (HPV+) malignancies an attractive target for cancer immunotherapy. However, therapeutic vaccination exerts limited efficacy in the setting of advanced disease. We designed a strategy to induce substantial specific immune responses against multiple epitopes of E6 and E7 proteins based on an attenuated transgene from HPV serotypes 16 and 18 that is incorporated into MG1-Maraba virotherapy (MG1-E6E7). Mutations introduced to the transgene abrogate the ability of E6 and E7 to perturb p53 and retinoblastoma, respectively, while maintaining the ability to invoke tumor-specific, multi-functional CD8+ T-cell responses...
September 14, 2017: Cancer Immunology Research
https://www.readbyqxmd.com/read/28910979/crispr-cas9-based-efficient-genome-editing-in-staphylococcus-aureus
#19
Qi Liu, Yu Jiang, Lei Shao, Ping Yang, Bingbing Sun, Sheng Yang, Daijie Chen
Staphylococcus aureus is an important pathogenic bacterium prevalent in nosocomial infections and associated with high morbidity and mortality rates, which arise from the significant pathogenicity and multi-drug resistance. However, the typical genetic manipulation tools used to explore the relevant molecular mechanisms of S. aureus have multiple limitations: leaving a scar in the genome, comparatively low gene-editing efficiency, and prolonged experimental period. Here, we present a single-plasmid based on the clustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR-associated (Cas) system which allows rapid and efficient chromosomal manipulation in S...
September 1, 2017: Acta Biochimica et Biophysica Sinica
https://www.readbyqxmd.com/read/28905331/antibiotic-distribution-into-cerebrospinal-fluid-can-dosing-safely-account-for-drug-and-disease-factors-in-the-treatment-of-ventriculostomy-associated-infections
#20
Nilesh Kumta, Jason A Roberts, Jeffrey Lipman, Menino Osbert Cotta
Ventriculostomy-associated infections, or ventriculitis, in critically ill patients are associated with considerable morbidity. Efficacious antibiotic dosing for the treatment of these infections may be complicated by altered antibiotic concentrations in the cerebrospinal fluid due to variable meningeal inflammation and antibiotic properties. Therefore, doses used to treat infections with a higher degree of meningeal inflammation (such as meningitis) may often fail to achieve equivalent exposures in patients with ventriculostomy-associated infections such as ventriculitis...
September 13, 2017: Clinical Pharmacokinetics
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