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https://www.readbyqxmd.com/read/29782404/evaluating-patient-centered-outcomes-in-clinical-trials-of-procedural-sedation-part-2-safety-sedation-consortium-on-endpoints-and-procedures-for-treatment-education-and-research-recommendations
#1
Denham S Ward, Mark R Williams, John W Berkenbosch, Maala Bhatt, Douglas Carlson, Phillip Chappell, Randall M Clark, Isabelle Constant, Aaron Conway, Joseph Cravero, Albert Dahan, Franklin Dexter, Raymond Dionne, Robert H Dworkin, Tong J Gan, David Gozal, Steven Green, Michael G Irwin, Suzanne Karan, Michael Kochman, Jerrold Lerman, Jenifer R Lightdale, Ronald S Litman, Keira P Mason, James Miner, Robert E O'Connor, Pratik Pandharipande, Richard R Riker, Mark G Roback, Daniel I Sessler, Anne Sexton, Joseph R Tobin, Dennis C Turk, Rebecca S Twersky, Richard D Urman, Mark Weiss, Hannah Wunsch, Anna Zhao-Wong
The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research, established by the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks, a public-private partnership with the US Food and Drug Administration, convened a second meeting of sedation experts from a variety of clinical specialties and research backgrounds to develop recommendations for procedural sedation research. The previous meeting addressed efficacy and patient- and/or family-centered outcomes...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782402/understanding-conflict-management-styles-in-anesthesiology-residents
#2
Terrie Vasilopoulos, Christopher R Giordano, Jack D Hagan, Brenda G Fahy
BACKGROUND: Successful conflict resolution is vital for effective teamwork and is critical for safe patient care in the operating room. Being able to appreciate the differences in training backgrounds, individual knowledge and opinions, and task interdependency necessitates skilled conflict management styles when addressing various clinical and professional scenarios. The goal of this study was to assess conflict styles in anesthesiology residents via self- and counterpart assessment during participation in simulated conflict scenarios...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29781109/rate-pressure-product-and-the-components-of-heart-rate-and-systolic-blood-pressure-in-hospitalized-heart-failure-patients-with-preserved-ejection-fraction-insights-from-ascend-hf
#3
Amanda K Verma, Jie-Lena Sun, Adrian Hernandez, John R Teerlink, Phillip J Schulte, Justin Ezekowitz, Adriaan Voors, Randall Starling, Paul Armstrong, Christopher M O'Conner, Robert J Mentz
BACKGROUND: Heart rate (HR) and systolic blood pressure (SBP) are prognostic markers in heart failure with reduced ejection fraction (HFrEF). Their combination in rate-pressure product (RPP) as well as their role in heart failure with preserved ejection fraction (HFpEF) remains unclear. METHODS: We performed an analysis of ASCEND-HF (clinicaltrials.gov; NCT00476852), which studied 7141 patients with acute HF. HFpEF was defined as left ventricular ejection fraction (LVEF) ≥40%...
May 20, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29780236/pharmacokinetic-comparison-of-a-fixed-dose-combination-versus-concomitant-administration-of-fimasartan-amlodipine-and-rosuvastatin-using-partial-replicated-design-in-healthy-adult-subjects
#4
Minkyung Oh, Jong-Lyul Ghim, Sung-Eun Park, Eun-Young Kim, Jae-Gook Shin
Objective: The aim of this study was to compare the pharmacokinetics (PK) and safety profiles of a fixed-dose combination (FDC) formulation of fimasartan, amlodipine, and rosuvastatin with the co-administration of the two products by using a replicated crossover study design in healthy male subjects. Results: This was an open-label, randomized, three-sequence, three-period replicated crossover study in healthy male subjects. The replicated crossover design was done because of high coefficient of variation of PK parameter for fimasartan, that is, >30%...
2018: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29779415/male-circumcision-for-hiv-prevention-female-risk-compensatory-behaviour-in-south-africa
#5
Clare Greevy, Rebecca King, Firoza Haffejee
South Africa promotes male circumcision (MC) as an HIV prevention method and implemented a national plan to scale-up MC in the country from 2012 to 2016. Literature has suggested that female risk compensatory behaviours (RCBs) are occurring in countries where these programmes have been implemented. Behaviours such as decreased condom use, concurrent sexual partners and sexual activity during the circumcision wound-healing period have the potential to jeopardise the campaigns' objectives. Literature has shown that directly providing women with MC information results in correct knowledge however, previous studies have not directly sought women's views and ideas on engagement with the information...
May 20, 2018: AIDS Care
https://www.readbyqxmd.com/read/29779201/clinical-acceptability-of-trimetazidine-modified-release-80-mg-once-daily-versus-trimetazidine-modified-release-35-mg-twice-daily-in-stable-angina-pectoris
#6
Yuri M Pozdnyakov
INTRODUCTION: Trimetazidine (TMZ) is an anti-ischemic metabolic agent that has been shown to be efficacious in angina treatment, both in monotherapy and in combination. A new formulation of TMZ modified-release (MR) 80 mg was developed, which is to be taken once daily (od), instead of twice daily (bid) for the currently available TMZ MR 35 mg, with the aim of simplifying the medication regimen. METHODS: The present study was an international, multicenter, randomized, double-blind, parallel-group phase III study with a 12-week treatment period...
May 19, 2018: Cardiology and Therapy
https://www.readbyqxmd.com/read/29778416/the-use-of-the-shock-index-as-a-predictor-of-active-bleeding-in-trauma-patients
#7
Andrea Campos-Serra, Sandra Montmany-Vioque, Pere Rebasa-Cladera, Heura Llaquet-Bayo, Raquel Gràcia-Roman, Anna Colom-Gordillo, Salvador Navarro-Soto
INTRODUCTION: Vital signs indicate the presence of bleeding only after large amounts of blood have been lost, with high morbidity and mortality. The Shock Index (SI) is a hemorrhage indicator with a cut-off point for the risk of bleeding at 0.9. The aim of this study is to assess whether a cut-off of≥0.8 is more sensitive for detecting occult bleeding, providing for early initiation of therapeutic maneuvers. METHODS: SI analytical validation study of severe trauma patients older than 16 years of age...
May 16, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29777009/feasibility-of-cxcr4-directed-radioligand-therapy-in-advanced-diffuse-large-b-cell-lymphoma
#8
Constantin Lapa, Heribert Hänscheid, Malte Kircher, Andreas Schirbel, Gerd Wunderlich, Rudolf Werner, Samuel Samnick, Jörg Kotzerke, Hermann Einsele, Andreas Buck, Hans-Jürgen Wester, Götz Ulrich Grigoleit
We have recently reported on our experience with C-X-C-motif chemokine receptor 4- (CXCR4-) directed radioligand therapy (RLT) in multiple myeloma and acute leukemia. Methods: Six patients with heavily pre-treated relapsed diffuse large B cell lymphoma (DLBCL) (3 males, 3 females; aged, 54±8 years) underwent CXCR4-directed RLT in combination with conditioning chemotherapy and allogeneic stem cell transplantation (SCT). In 2 patients, radioimmunotherapy (RIT) targeting CD20 or CD66 was added to enhance anti-lymphoma activity...
May 18, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/29776768/-topical-anesthesia-without-the-use-of-an-anesthesiologist-in-adult-outpatient-cataract-surgery-assessment-of-selection-criteria-on-consultation-report-of-248-cases
#9
M Pepin, E Rineau, A Caignard, S Leruez, P Gohier
INTRODUCTION: This work aims to evaluate selection criteria used during the cataract surgery scheduling visit, to choose whether or not there will be an anesthesiologist available during the surgery, depending upon the patient's comorbidities. MATERIALS AND METHODS: Retrospective study performed in 2016 in Angers university medical center. Two groups were established on the cataract surgery scheduling visit, based on patients' comorbidities and vital signs (blood pressure, heart rate)...
May 15, 2018: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29775117/intravenous-low-dose-ketamine-provides-greater-pain-control-compared-to-fentanyl-in-a-civilian-prehospital-trauma-system-a-propensity-matched-analysis
#10
E Stein Bronsky, Catherine Koola, Alessandro Orlando, Diane Redmond, Cecile D'Huyvetter, Heather Sieracki, Allen Tanner, Ray Fowler, Charles Mains, David Bar-Or
OBJECTIVE: A few studies report comparable analgesic efficacy between low-dose ketamine and opioids such as morphine or fentanyl; however, limited research has explored the safety and effectiveness of intravenous low-dose ketamine as a primary analgesic in a civilian prehospital setting. The objective of this study is to compare pain control between low-dose ketamine and fentanyl when administered intravenously (IV) for the indication of severe pain. METHODS: This was a retrospective, observational review of prehospital adult patients (≥18 years) who presented with severe pain (numeric rating scale, 7-10) and were treated solely with either low-dose ketamine IV or fentanyl IV between January 1, 2014 and December 31, 2016...
May 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29774628/efficacy-and-safety-of-brexpiprazole-for-the-treatment-of-acute-schizophrenia-in-japan-a-6-week-randomized-double-blind-placebo-controlled-study
#11
Jun Ishigooka, Shuichi Iwashita, Yoshihiro Tadori
AIMS: This study aimed to evaluate the efficacy, safety, and tolerability of brexpiprazole compared to placebo in Japanese patients with acute schizophrenia. METHODS: We conducted a 6-week, multicenter, double-blind, placebo-controlled, phase 2/3 study in Japan. Patients with acute schizophrenia were randomized (1:1:1:1) to receive brexpiprazole 1, 2, or 4 mg or placebo once a day. The primary endpoint was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total scores...
May 18, 2018: Psychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/29774167/complete-hypokalemic-quadriparesis-as-a-first-presentation-of-sj%C3%A3-gren-syndrome
#12
Jason An, Branko Braam
Rationale: We hope to increase awareness that hypokalemic paralysis may be the first presentation of Sjögren syndrome, for which potassium-sparing diuretics can be an effective adjunct to potassium replenishment. Presenting concerns: A 73-year-old female presented to a peripheral hospital with quadriparesis and a critically low serum potassium of 1.6 mmol/L with U waves on the electrocardiogram (ECG). The initial arterial blood gas showed a pH of 7.19, bicarbonate of 13 mEq/L, and a CO2 of 35 mm Hg...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29769018/informative-graphing-of-continuous-safety-variables-relative-to-normal-reference-limits
#13
Christopher D Breder
BACKGROUND: Interpreting graphs of continuous safety variables can be complicated because differences in age, gender, and testing site methodologies data may give rise to multiple reference limits. Furthermore, data below the lower limit of normal are compressed relative to those points above the upper limit of normal. The objective of this study is to develop a graphing technique that addresses these issues and is visually intuitive. METHODS: A mock dataset with multiple reference ranges is initially used to develop the graphing technique...
May 16, 2018: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29768414/adipose-derived-mesenchymal-stem-cells-admsc-for-the-treatment-of-secondary-progressive-multiple-sclerosis-a-triple-blinded-placebo-controlled-randomized-phase-i-ii-safety-and-feasibility-study
#14
Oscar Fernández, Guillermo Izquierdo, Victoria Fernández, Laura Leyva, Virginia Reyes, Miguel Guerrero, Antonio León, Carlos Arnaiz, Guillermo Navarro, Maria Dolores Páramo, Antonio De la Cuesta, Bernat Soria, Abdelkrim Hmadcha, David Pozo, Rafael Fernandez-Montesinos, Maria Leal, Itziar Ochotorena, Patricia Gálvez, Maria Angeles Geniz, Francisco Javier Barón, Rosario Mata, Cristina Medina, Carlos Caparrós-Escudero, Ana Cardesa, Natividad Cuende
BACKGROUND: Currently available treatments for secondary progressive multiple sclerosis(SPMS) have limited efficacy and/or safety concerns. Adipose-mesenchymal derived stem cells(AdMSCs) represent a promising option and can be readily obtained using minimally invasive procedures. PATIENTS AND METHODS: In this triple-blind, placebo-controlled study, cell samples were obtained from consenting patients by lipectomy and subsequently expanded. Patients were randomized to a single infusion of placebo, low-dose(1x106cells/kg) or high-dose(4x106cells/kg) autologous AdMSC product and followed for 12 months...
2018: PloS One
https://www.readbyqxmd.com/read/29768359/case-report-of-gastric-distension-due-to-superior-mesenteric-artery-syndrome-mimicking-hollow-viscus-perforation-considerations-in-critical-care-ultrasound
#15
Yan-Mei Feng, Dong Wan, Rui Guo
RATIONALE: Critical care ultrasound identifies the signs of free intraperitoneal air and echogenic free fluid always indicates hollow viscus perforation (HVP) and needs immediate surgical interventions. However, in rare cases, these classic signs may also mislead proper clinical decisions. We report perforated viscus associated large peritoneal effusion with initial critical care ultrasound findings, whereas computed tomography (CT) examination confirmed a giant stomach due to superior mesenteric artery syndrome (SMAS)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29768328/efficacy-and-safety-of-etomidate-midazolam-for-screening-colonoscopy-in-the-elderly-a-prospective-double-blinded-randomized-controlled-study
#16
Jung Min Lee, Geeho Min, Jae Min Lee, Seung Han Kim, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yoon Tae Jeen, Hoon Jai Chun, Hong Sik Lee, Chang Duck Kim, Jong-Jae Park, Beom Jae Lee, Seong Ji Choi, Woojung Kim
BACKGROUND AND AIMS: Recent studies have shown that etomidate is associated with fewer serious adverse events than propofol and has a noninferior sedative effect. We investigated whether etomidate-midazolam is associated with fewer cardiopulmonary adverse events and has noninferior efficacy compared to propofol-midazolam for screening colonoscopy in the elderly. METHODS: A prospective, single-center, double-blinded, randomized controlled trial was performed. Patients aged over 65 years who were scheduled to undergo screening colonoscopy were randomized to receive either etomidate or propofol based on midazolam...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29768291/quality-of-the-triage-of-children-with-anaphylaxis-at-the-emergency-department
#17
Esozia Arroabarren, Jorge Alvarez-Garcia, Marta Anda, Montserrat de Prada, Maria Carmen Ponce, Miriam Palacios
OBJECTIVE: Early recognition of symptoms is essential in anaphylaxis management. The Canadian Paediatric Emergency Triage and Acuity Scale prioritizes anaphylaxis to level I or II (resuscitation or emergency). We analyzed the accuracy of pediatric anaphylaxis triage. METHODS: This was a retrospective review of the triage charts (adaptation of the Canadian Paediatric Emergency Triage and Acuity Scale) of 137 children attended for anaphylaxis at our pediatric emergency department...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29768283/cerebral-oxygenation-as-a-monitoring-parameter-for-mortality-during-venoarterial-extracorporeal-membrane-oxygenation
#18
Hyoung Soo Kim, Sang Ook Ha, Kyung-Ho Yu, Mi Sun Oh, Sunghoon Park, Sun Hee Lee, Sang Jin Han, Hyun-Sook Kim, In Bok Chang, Jun Hyong Ahn
There are no recommended guidelines for monitoring parameters during venoarterial extracorporeal membrane oxygenation (VA-ECMO). We evaluated whether regional cerebral oxygen saturation (rScO2) could be a monitoring parameter for mortality during VA-ECMO. We retrospectively searched our database for adult patients who underwent VA-ECMO between April 2015 and October 2016 and identified 21 patients with rScO2 data. Their baseline and clinical characteristics during the first 7 days (vital signs, arterial blood gas results, ECMO variables, rScO2, Swan-Ganz catheter parameters, transthoracic echocardiography parameters, and outcomes) were collected and evaluated for associations with 28 day mortality...
May 15, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29767825/-palliative-sedation-development-and-consensus-of-a-german-language-documentation-template
#19
C Klein, C Wittmann, K N Wendt, C Ostgathe, S Stiel
BACKGROUND: Palliative sedation (PS) serves as a therapeutic option in cases of otherwise intractable suffering. As the use of sedative and hypnotic medication in many diverse situations is a core competency of anesthesiology, anesthesiologists are confronted with questions of sedative therapy at the end of life in institutions for specialized palliative care, in intensive care units and intermediate care wards. In recent years a number of guidelines have been published internationally but so far no official guidelines exist in Germany...
May 16, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29766124/routine-repeat-head-ct-may-not-be-necessary-for-patients-with-mild-tbi
#20
Claire B Rosen, Diego D Luy, Molly R Deane, Thomas M Scalea, Deborah M Stein
Background: Routine repeat cranial CT (RHCT) is standard of care for CT-verified traumatic brain injury (TBI). Despite mixed evidence, those with mild TBI are subject to radiation and expense from serial CT scans. Thus, we investigated the necessity and utility of RHCT for patients with mild TBI. We hypothesized that repeat head CT in these patients would not alter patient care or outcomes. Methods: We retrospectively studied patients suffering from mild TBI (Glasgow Coma Scale (GCS) score 13-15) and treated at the R Adams Cowley Shock Trauma Center from November 2014 through January 2015...
2018: Trauma surgery & acute care open
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