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https://www.readbyqxmd.com/read/28520106/prophylactic-sustained-inflation-is-just-one-step-to-preventing-bronchopulmonary-dysplasia
#1
G Lista, I Bresesti
I am glad to see that the Sustained Lung Inflation (SLI) trial (1) still draws a great deal of attention and I would like to clarify some aspects of the trial, in response to the comments by Gupta and Argarwal (2) in Acta Paediatrica. A meta-analysis carried out in 2016 demonstrated that starting non-invasive respiratory support from birth could reduce the incidence of bronchopulmonary dysplasia and death. However, about 50% of very low birth weight infants who are initially on nasal continuous positive airway pressure need subsequent intubation and mechanical ventilation...
May 18, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28503301/is-there-a-role-for-ischaemic-conditioning-in-cardiac-surgery
#2
REVIEW
Luciano Candilio, Derek Hausenloy
Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Coronary artery bypass graft (CABG) surgery is the revascularisation strategy of choice in patients with diabetes mellitus and complex CAD. Owing to a number of factors, including the ageing population, the increased complexity of CAD being treated, concomitant valve and aortic surgery, and multiple comorbidities, higher-risk patients are being operated on, the result of which is an increased risk of sustaining perioperative myocardial injury (PMI) and poorer clinical outcomes...
2017: F1000Research
https://www.readbyqxmd.com/read/28497180/performance-of-a-capnodynamic-method-estimating-effective-pulmonary-blood-flow-during-transient-and-sustained-hypercapnia
#3
Thorir Svavar Sigmundsson, Tomas Öhman, Magnus Hallbäck, Eider Redondo, Fernando Suarez Sipmann, Mats Wallin, Anders Oldner, Caroline Hällsjö Sander, Håkan Björne
The capnodynamic method is a minimally invasive method continuously calculating effective pulmonary blood flow (COEPBF), equivalent to cardiac output when intra pulmonary shunt flow is low. The capnodynamic equation joined with a ventilator pattern containing cyclic reoccurring expiratory holds, provides breath to breath hemodynamic monitoring in the anesthetized patient. Its performance however, might be affected by changes in the mixed venous content of carbon dioxide (CvCO2). The aim of the current study was to evaluate COEPBF during rapid measurable changes in mixed venous carbon dioxide partial pressure (PvCO2) following ischemia-reperfusion and during sustained hypercapnia in a porcine model...
May 11, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28471245/there-has-been-little-progress-in-implementing-comprehensive-alcohol-control-strategies-in-africa
#4
Nasheeta Peer
Alcohol is the most common substance of addiction and a threat not only to health but also to sustainable human development. Consequently, at least a 10% relative reduction in the harmful use of alcohol has been advocated by the World Health Organization (WHO). This perspective describes alcohol use in Africa, strategies to reduce harmful alcohol use, and the ability of African countries to meet this target. Although alcohol consumption in Africa was intermediate compared to other world regions, the total alcohol per capita among alcohol consumers was the second highest (19...
May 4, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28459798/resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-for-major-abdominal-venous-injury-in-a-porcine-hemorrhagic-shock-model
#5
Michael S Lallemand, Donald M Moe, John M McClellan, Joshua P Smith, Leo Daab, Shannon Marko, Nam Tran, Benjamin Starnes, Matthew J Martin
BACKGROUND: Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a rescue maneuver for unstable patients with non-compressible hemorrhage below the diaphragm. The efficacy of REBOA in the setting a major abdominal venous injury is unknown. Our objective was to examine the use of REBOA in a large animal model of major abdominal venous injury, and characterize any impact on the hemodynamics, rate and volume of hemorrhage, and survival. METHODS: Ten swine (35-55kg) underwent a controlled and validated hemorrhage and ischemia/reperfusion injury protocol to produce shock physiology...
April 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28436316/first-in-man-experience-of-self-expanding-nitinol-stents-combined-with-drug-coated-balloon-in-the-treatment-of-femoropopliteal-occlusive-disease
#6
Bibombe Patrice Mwipatayi, Kalpa Perera, Ali Daneshmand, Rhys Daniel, Jackie Wong, Shannon D Thomas, Sally A Burrows
Purpose The present study aimed to determine the safety and efficacy of a drug-coated balloon inflated within a thin-strut self-expanding bare-metal stent in patients with severe and complex femoropopliteal occlusive disease. Methods This prospective study used the Pulsar-self-expanding stent and Passeo-18 Lux drug-coated balloon in patients with severe and complex femoropopliteal occlusive disease. The primary endpoint was the 12-month primary patency, and the secondary endpoints included 24-month primary patency, assisted primary patency, secondary patency, and clinically associated target lesion revascularisation...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28429851/impacts-of-taxonomic-inertia-for-the-conservation-of-african-ungulate-diversity-an-overview
#7
Spartaco Gippoliti, Fenton P D Cotterill, Dietmar Zinner, Colin P Groves
We review the state of African ungulate taxonomy over the last 120 years, with an emphasis on the introduction of the polytypic species concept and the discipline's general neglect since the middle of the 20th century. We single out negative consequences of 'orthodox' taxonomy, highlighting numerous cases of neglect of threatened lineages, unsound translocations that led to lineage introgression, and cases of maladaptation to local conditions including parasitic infections. Additionally, several captive breeding programmes have been hampered by chromosome rearrangements caused by involuntary lineage mixing...
April 21, 2017: Biological Reviews of the Cambridge Philosophical Society
https://www.readbyqxmd.com/read/28388648/trends-in-medicines-procurement-by-the-brazilian-federal-government-from-2006-to-2013
#8
Tatiana Chama Borges Luz, Claudia Garcia Serpa Osorio-de-Castro, Rachel Magarinos-Torres, Bjorn Wettermark
The costs of medicines pose a growing burden on healthcare systems worldwide. A comprehensive understanding of current procurement processes provides strong support for the development of effective policies. This study examined Brazilian Federal Government pharmaceutical procurement data provided by the Integrated System for the Administration of General Services (SIASG) database, from 2006 to 2013. Medicine purchases were aggregated by volume and expenditure for each year. Data on expenditure were adjusted for inflation using the Extended National Consumer Price Index (IPCA) for December 31, 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28340927/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-control-of-noncompressible-truncal-hemorrhage-in-the-abdomen-and-pelvis
#9
Laura J Moore, Clay D Martin, John A Harvin, Charles E Wade, John B Holcomb
BACKGROUND: Noncompressible truncal hemorrhage is a leading cause of potentially preventable death in trauma and acute care surgery patients. These patients are at high risk of exsanguination before potentially life-saving surgical intervention may be performed. Temporary aortic occlusion is an effective means of augmenting systolic blood pressure and perfusion of the heart and brain in these patients. Aortic occlusion temporarily controls distal bleeding until permanent hemostasis can be achieved...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28339394/global-and-regional-assessment-of-sustained-inflation-pressure-volume-curves-in-patients-with-acute-respiratory-distress-syndrome
#10
Tobias Becher, Philipp Rostalski, Matthias Kott, Andy Adler, Dirk Schadler, Norbert Weiler, Inez Frerichs
Static or quasi-static pressure-volume (P-V) curves can be used to determine the lung mechanical properties of patients suffering from acute respiratory distress syndrome (ARDS). According to the traditional interpretation, lung recruitment occurs mainly below the lower point of maximum curvature (LPMC) of the inflation P-V curve. Although some studies have questioned this assumption, setting of positive end-expiratory pressure 2 cmH2O above the LPMC was part of a "lung-protective" ventilation strategy successfully applied in several clinical trials...
March 24, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28335801/different-challenges-different-approaches-and-related-expenditures-of-community-based-tuberculosis-activities-by-international-non-governmental-organizations-in-myanmar
#11
Wai Wai Han, Saw Saw, Petros Isaakidis, Mohammed Khogali, Anthony Reid, Nguyen Hoa, Ko Ko Zaw, Si Thu Aung
BACKGROUND: International non-governmental organizations (INGOs) have been implementing community-based tuberculosis (TB) care (CBTBC) in Myanmar since 2011. Although the National TB Programme (NTP) ultimately plans to take over CBTBC, there have been no evaluations of the models of care or of the costs of providing CBTBC in Myanmar by INGOs. METHODS: This was a descriptive study using routinely-collected programmatic and financial data from four INGOs during 2013 and 2014, adjusted for inflation...
March 24, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28328648/the-economic-and-clinical-impact-of-sustained-use-of-a-progressive-mobility-program-in-a-neuro-icu
#12
Jeannette M Hester, Peggy R Guin, Gale D Danek, Jaime R Thomas, William L Titsworth, Richard K Reed, Terrie Vasilopoulos, Brenda G Fahy
OBJECTIVE: To investigate a progressive mobility program in a neurocritical care population with the hypothesis that the benefits and outcomes of the program (e.g., decreased length of stay) would have a significant positive economic impact. DESIGN: Retrospective analysis of economic and clinical outcome data before, immediately following, and 2 years after implementation of the Progressive Upright Mobility Protocol Plus program (UF Health Shands Hospital, Gainesville, FL) involving a series of planned movements in a sequential manner with an additional six levels of rehabilitation in the neuro-ICU at UF Health Shands Hospital...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28320895/peripheral-venous-congestion-causes-time-and-dose-dependent-release-of-endothelin-1-in-humans
#13
Jeffrey Lin, Neelesh Chudasama, Yacki Hayashi, Christopher Hawk, Sahadeo D Ramnauth, Ka Yuk Wong, Ante Harxhi, Duygu Onat, Michiyori Wakabayashi, Nir Uriel, Ulrich P Jorde, Thierry H LeJemtel, Hani N Sabbah, Ryan T Demmer, Paolo C Colombo
Endothelin-1 (ET-1) is a pivotal mediator of vasoconstriction and inflammation in congestive states such as heart failure (HF) and chronic kidney disease (CKD). Whether peripheral venous congestion (VC) increases plasma ET-1 at pressures commonly seen in HF and CKD patients is unknown. We seek to characterize whether peripheral VC promotes time- and dose-dependent increases in plasma ET-1 and whether these changes are sustained after decongestion. We used a randomized, cross-over design in 20 healthy subjects (age 30 ± 7 years)...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28285473/a-modern-case-series-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-an-out-of-hospital-combat-casualty-care-setting
#14
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOA™ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28270610/eliciting-probabilistic-expectations-collaborations-between-psychologists-and-economists
#15
Wändi Bruine de Bruin, Baruch Fischhoff
We describe two collaborations in which psychologists and economists provided essential support on foundational projects in major research programs. One project involved eliciting adolescents' expectations regarding significant future life events affecting their psychological and economic development. The second project involved eliciting consumers' expectations regarding inflation, a potentially vital input to their investment, saving, and purchasing decisions. In each project, we sought questions with the precision needed for economic modeling and the simplicity needed for lay respondents...
March 28, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28257433/a-comparison-of-nonlinear-mixed-models-and-response-to-selection-of-tick-infestation-on-lambs
#16
Panya Sae-Lim, Lise Grøva, Ingrid Olesen, Luis Varona
Tick-borne fever (TBF) is stated as one of the main disease challenges in Norwegian sheep farming during the grazing season. TBF is caused by the bacterium Anaplasma phagocytophilum that is transmitted by the tick Ixodes ricinus. A sustainable strategy to control tick-infestation is to breed for genetically robust animals. In order to use selection to genetically improve traits we need reliable estimates of genetic parameters. The standard procedures for estimating variance components assume a Gaussian distribution of the data...
2017: PloS One
https://www.readbyqxmd.com/read/28241826/the-cost-of-free-health-care-for-all-kenyans-assessing-the-financial-sustainability-of-contributory-and-non-contributory-financing-mechanisms
#17
Vincent Okungu, Jane Chuma, Di McIntyre
BACKGROUND: The need to provide quality and equitable health services and protect populations from impoverishing health care costs has pushed universal health coverage (UHC) to the top of global health policy agenda. In many developing countries where the majority of the population works in the informal sector, there are critical debates over the best financing mechanisms to progress towards UHC. In Kenya, government health policy has prioritized contributory financing strategy (social health insurance) as the main financing mechanism for UHC...
February 27, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28220735/sustained-reduction-in-antibiotic-consumption-in-a-south-african-public-sector-hospital-four-year-outcomes-from-the-groote-schuur-hospital-antibiotic-stewardship-program
#18
T H Boyles, V Naicker, N Rawoot, P J Raubenheimer, B Eick, M Mendelson
BACKGROUND: Overuse of antibiotics has driven global bacterial resistance to the extent that we have entered a post-antibiotic era, where infections that were once easily treatable are now becoming untreatable. Efforts to control consumption have focused on antibiotic stewardship programmes (ASPs), aimed at optimising use. OBJECTIVE: To report antibiotic consumption and cost over 4 years from a public hospital ASP in South Africa (SA). METHODS: A comprehensive ASP comprising online education, a dedicated antibiotic prescription chart and weekly dedicated ward rounds was introduced at Groote Schuur Hospital, Cape Town, in 2012...
January 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28193783/remote-ischemic-preconditioning-triggers-changes-in-autonomic-nervous-system-activity-implications-for-cardioprotection
#19
Safa Abdul-Ghani, Arnold N Fleishman, Igor Khaliulin, Marco Meloni, Gianni D Angelini, M-Saadeh Suleiman
Cardioprotective efficacy of remote ischemic preconditioning (RIPC) remains controversial. Experimental studies investigating RIPC have largely monitored cardiovascular changes during index ischemia and reperfusion with little work investigating changes during RIPC application. This work aims to identify cardiovascular changes associated with autonomic nervous system (ANS) activity during RIPC and prior to index ischemia. RIPC was induced in anesthetized male C57/Bl6 mice by four cycles of 5 min of hindlimb ischemia using inflated cuff (200 mmHg) followed by 5 min reperfusion...
February 2017: Physiological Reports
https://www.readbyqxmd.com/read/28127145/an-approach-for-safe-conversion-of-an-oral-endotracheal-tube-to-a-nasal-endotracheal-tube
#20
Michael Hofkamp, Zhiying Diao
We present an approach for safe management of a patient with an oral endotracheal tube who required conversion to a nasal endotracheal tube. A 35-year-old man presented for mandibular fracture repair after multiple injuries sustained in a motor vehicle accident. The patient already had an oral endotracheal tube, and the surgical team requested a nasal endotracheal tube to facilitate surgical exposure and postoperative airway management in anticipation of a wired jaw. A nasal endotracheal tube was inserted through the naris and a video laryngoscope was used to visualize the glottis...
January 2017: Proceedings of the Baylor University Medical Center
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