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https://www.readbyqxmd.com/read/28742911/targeted-temperature-management-for-48-vs-24-hours-and-neurologic-outcome-after-out-of-hospital-cardiac-arrest-a-randomized-clinical-trial
#1
Hans Kirkegaard, Eldar Søreide, Inge de Haas, Ville Pettilä, Fabio Silvio Taccone, Urmet Arus, Christian Storm, Christian Hassager, Jørgen Feldbæk Nielsen, Christina Ankjær Sørensen, Susanne Ilkjær, Anni Nørgaard Jeppesen, Anders Morten Grejs, Christophe Henri Valdemar Duez, Jakob Hjort, Alf Inge Larsen, Valdo Toome, Marjaana Tiainen, Johanna Hästbacka, Timo Laitio, Markus B Skrifvars
Importance: International resuscitation guidelines recommend targeted temperature management (TTM) at 33°C to 36°C in unconscious patients with out-of-hospital cardiac arrest for at least 24 hours, but the optimal duration of TTM is uncertain. Objective: To determine whether TTM at 33°C for 48 hours results in better neurologic outcomes compared with currently recommended, standard, 24-hour TTM. Design, Setting, and Participants: This was an international, investigator-initiated, blinded-outcome-assessor, parallel, pragmatic, multicenter, randomized clinical superiority trial in 10 intensive care units (ICUs) at 10 university hospitals in 6 European countries...
July 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28742910/clinicopathological-evaluation-of-chronic-traumatic-encephalopathy-in-players-of-american-football
#2
Jesse Mez, Daniel H Daneshvar, Patrick T Kiernan, Bobak Abdolmohammadi, Victor E Alvarez, Bertrand R Huber, Michael L Alosco, Todd M Solomon, Christopher J Nowinski, Lisa McHale, Kerry A Cormier, Caroline A Kubilus, Brett M Martin, Lauren Murphy, Christine M Baugh, Phillip H Montenigro, Christine E Chaisson, Yorghos Tripodis, Neil W Kowall, Jennifer Weuve, Michael D McClean, Robert C Cantu, Lee E Goldstein, Douglas I Katz, Robert A Stern, Thor D Stein, Ann C McKee
Importance: Players of American football may be at increased risk of long-term neurological conditions, particularly chronic traumatic encephalopathy (CTE). Objective: To determine the neuropathological and clinical features of deceased football players with CTE. Design, Setting, and Participants: Case series of 202 football players whose brains were donated for research. Neuropathological evaluations and retrospective telephone clinical assessments (including head trauma history) with informants were performed blinded...
July 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28742853/leadership-and-management-training-as-a-catalyst-to-health-system-strengthening-in-low-income-settings-evidence-from-implementation-of-the-zambia-management-and-leadership-course-for-district-health-managers-in-zambia
#3
Wilbroad Mutale, Anne-Thora Vardoy-Mutale, Arthur Kachemba, Roman Mukendi, Kupela Clarke, Dennis Mulenga
BACKGROUND: Research has shown that the modes of leadership and management may influence health outcomes. However, majority of health leaders and managers in many low-income countries are promoted on account of clinical expertise. It has been recognised that these new managers are often ill-prepared for managing complex health systems. In response to this challenge, the Zambian Ministry of Health (MoH) has developed the Governance and Management Capacity Building (GMCB) Strategic Plan (2012-2016), whose overarching goal is to improve health sector governance and create an environment that is result-oriented, accountable and transparent...
2017: PloS One
https://www.readbyqxmd.com/read/28742817/temporal-profile-of-intracranial-pressure-and-cerebrovascular-reactivity-in-severe-traumatic-brain-injury-and-association-with-fatal-outcome-an-observational-study
#4
Hadie Adams, Joseph Donnelly, Marek Czosnyka, Angelos G Kolias, Adel Helmy, David K Menon, Peter Smielewski, Peter J Hutchinson
BACKGROUND: Both intracranial pressure (ICP) and the cerebrovascular pressure reactivity represent the dysregulation of pathways directly involved in traumatic brain injury (TBI) pathogenesis and have been used to inform clinical management. However, how these parameters evolve over time following injury and whether this evolution has any prognostic importance have not been studied. METHODS AND FINDINGS: We analysed the temporal profile of ICP and pressure reactivity index (PRx), examined their relation to TBI-specific mortality, and determined if the prognostic relevance of these parameters was affected by their temporal profile using mixed models for repeated measures of ICP and PRx for the first 240 hours from the time of injury...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742805/intra-dialytic-hypertension-is-associated-with-high-mortality-in-hemodialysis-patients
#5
Chi-Young Choi, Jae Seok Park, Kyu Tae Yoon, Hyo Wook Gil, Eun Young Lee, Sae Yong Hong
BACKGROUND: Intra-dialytic hypertension (IDH) is emerging as an important issue in hemodialysis patients. Its risk factors and clinical outcomes are unclear. METHODS: A total of 73 prevalent hemodialysis patients were enrolled. They included 14 (19.2%) patients with baseline IDH and 59 patients without IDH. Their clinical parameters, laboratory parameters, and mortality were investigated over 78 months. RESULTS: The risks factor of IDH included low serum potassium levels, low ultrafiltration, and low arm muscle area...
2017: PloS One
https://www.readbyqxmd.com/read/28742799/the-new-survivors-and-a-new-era-for-trauma-research
#6
EDITORIAL
Karim Brohi, Martin Schreiber
Karim Brohi and Martin Schreiber, Guest Editors of the Special Issue on Trauma, describe a new era in exploration of the biology of injury response and translation of new opportunities into clinical practice.
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742779/a-novel-method-of-evaluating-key-factors-for-success-in-a-multifaceted-critical-care-fellowship-using-data-envelopment-analysis
#7
Vikram Tiwari, Avinash B Kumar
BACKGROUND: The current system of summative multi-rater evaluations and standardized tests to determine readiness to graduate from critical care fellowships has limitations. We sought to pilot the use of data envelopment analysis (DEA) to assess what aspects of the fellowship program contribute the most to an individual fellow's success. DEA is a nonparametric, operations research technique that uses linear programming to determine the technical efficiency of an entity based on its relative usage of resources in producing the outcome...
July 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742762/kdigo-clinical-practice-guideline-on-the-evaluation-and-care-of-living-kidney-donors
#8
Krista L Lentine, Bertram L Kasiske, Andrew S Levey, Patricia L Adams, Josefina Alberú, Mohamed A Bakr, Lorenzo Gallon, Catherine A Garvey, Sandeep Guleria, Philip Kam-Tao Li, Dorry L Segev, Sandra J Taler, Kazunari Tanabe, Linda Wright, Martin G Zeier, Michael Cheung, Amit X Garg
The 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors is intended to assist medical professionals who evaluate living kidney donor candidates and provide care before, during and after donation. The guideline development process followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guideline recommendations are based on systematic reviews of relevant studies that included critical appraisal of the quality of the evidence and the strength of recommendations...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28742723/supraglottic-atomization-of-surfactant-in-spontaneously-breathing-lambs-receiving-continuous-positive-airway-pressure
#9
Ilaria Milesi, David G Tingay, Anna Lavizzari, Federico Bianco, Emanuela Zannin, Paolo Tagliabue, Fabio Mosca, Maria Luisa Ventura, Anushi Rajapaksa, Elizabeth J Perkins, Don Black, Marco Di Castri, Magdy Sourial, Gerhard Pohlmann, Raffaele L Dellaca'
OBJECTIVES: To determine the short-term tolerance, efficacy, and lung deposition of supraglottic atomized surfactant in spontaneously breathing lambs receiving continuous positive airway pressure. DESIGN: Prospective, randomized animal study. SETTING: Animal research laboratory. SUBJECTS: Twenty-two preterm lambs on continuous positive airway pressure (132 ± 1 d gestational age). INTERVENTIONS: Animals receiving continuous positive airway pressure via binasal prongs at 8 cm H2O were randomized to receive atomized surfactant at approximately 60-minute of life (atom; n = 15) or not (control; n = 7)...
July 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28742685/recurrence-patterns-and-long-term-results-after-induction-chemotherapy-chemoradiotherapy-and-curative-surgery-in-patients-with-locally-advanced-esophageal-cancer
#10
Thomas Steffen, Daniel Dietrich, Annelies Schnider, Christoph Kettelhack, Olivier Huber, Walter R Marti, Markus Furrer, Beat Gloor, Marc Schiesser, Sandra Thierstein, Peter Brauchli, Thomas Ruhstaller
OBJECTIVE: The long-term follow up data of 2 prospective phase II trials is reported (NCT00072033, NCT00445861), which investigated neoadjuvant chemoradiation followed by surgery in patients with esophageal carcinoma. Postoperative complications as well as prognostic factors and patterns of relapse during long-term observation are shown. SUMMARY OF BACKGROUND DATA: Long-term follow-up is often missing in the complex setting of multimodal treatments of esophageal carcinoma; this leads to rather undifferentiated follow-up guidelines for this tumor entity...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742612/short-sleep-and-adolescents-performance-on-a-concussion-assessment-battery-an-experimental-sleep-manipulation-study
#11
Dean W Beebe, Scott W Powers, Eric W Slattery, Paul J Gubanich
OBJECTIVE: Correlational studies have linked short sleep to adolescents' report of postconcussion symptoms and cognitive performance during concussion assessments. This study tested whether those are cause-effect relationships. DESIGN: Three-week randomly counterbalanced, within-subjects, crossover experiment. SETTING: Adolescents slept at home with weekly visits to an outpatient clinic for sleep monitor uploads and outcome assessments. PARTICIPANTS: Twenty-four healthy 14- to 17...
July 21, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28742609/the-efficacy-of-dynamic-contract-relax-stretching-on-delayed-onset-muscle-soreness-among-healthy-individuals-a-randomized-clinical-trial
#12
Yanfei Xie, Beibei Feng, Kedi Chen, Lars L Andersen, Phil Page, Yuling Wang
OBJECTIVE: To evaluate the efficacy of dynamic contract-relax stretching on delayed-onset muscle soreness (DOMS) in the calf muscle of healthy individuals. DESIGN: Randomized clinical trial. SETTING: Research laboratory. PARTICIPANTS: Three groups of 16 healthy participants (n = 48) were recruited by convenience sampling. INTERVENTIONS: Three sets of resisted bilateral heel-raising exercises until exhaustion were conducted to initiate DOMS...
July 21, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28742462/a-novel-iris-transillumination-grading-scale-allowing-flexible-assessment-with-quantitative-image-analysis-and-visual-matching
#13
Chen Wang, Flavia Brancusi, Zaheer M Valivullah, Michael G Anderson, Denise Cunningham, Adam Hedberg-Buenz, Bradley Power, Dimitre Simeonov, William A Gahl, Wadih M Zein, David R Adams, Brian Brooks
PURPOSE: To develop a sensitive scale of iris transillumination suitable for clinical and research use, with the capability of either quantitative analysis or visual matching of images. METHODS: Iris transillumination photographic images were used from 70 study subjects with ocular or oculocutaneous albinism. Subjects represented a broad range of ocular pigmentation. A subset of images was subjected to image analysis and ranking by both expert and nonexpert reviewers...
July 25, 2017: Ophthalmic Genetics
https://www.readbyqxmd.com/read/28742438/effect-of-low-level-laser-therapy-on-bone-regeneration-during-osseointegration-and-bone-graft
#14
Randa Zein, Wayne Selting, Stefano Benedicenti
BACKGROUND: The effect of low-level laser therapy (LLLT) on bone regeneration during osseointegration and bone graft is very controversial. Despite many positive reports of in vitro and in vivo studies and more than 50 randomized clinical trials claiming a positive effect of photobiomodulation (PBM), many reports found no significant effect of lasers. OBJECTIVE: The aim of this study was to evaluate studies correlating PBM and bone regeneration and to assesses parameters that produce positive results based on dose and output power used...
July 21, 2017: Photomedicine and Laser Surgery
https://www.readbyqxmd.com/read/28742416/comparisons-of-alcohol-and-drug-dependence-in-terms-of-attachments-and-clinical-issues
#15
Dana Zeid, Joshua Carter, Marc A Lindberg
BACKGROUND: Alcohol and drug dependencies are associated with different social stigmas, and some studies suggest they might exhibit different clinical presentations. Further, the treatments for each vary considerably. Alcohol versus drug use problems were compared in terms of attachment patterns and related clinical treatment issues in two interlocking studies using converging logic and designs. METHODS: In Study 1, alcohol versus drug dependence was defined in terms of a known groups design...
July 25, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28742403/lpxc-inhibitors-a-patent-review-2010-2016
#16
Dmitrii V Kalinin, Ralph Holl
The Zn(2+)-dependent deacetylase LpxC is an essential enzyme of lipid A biosynthesis in Gram-negative bacteria and a promising target for the development of antibiotics selectively combating Gram-negative pathogens. Researchers from industry and academia have synthesized structurally diverse LpxC inhibitors, exhibiting different LpxC inhibitory and antibacterial activities. Areas covered: A brief introduction into the structure and function of LpxC, showing its suitability as antibacterial target, along with the structures of several reported LpxC inhibitors, is given...
July 25, 2017: Expert Opinion on Therapeutic Patents
https://www.readbyqxmd.com/read/28742399/nutrition-and-cancer-an-historical-perspective-the-past-present-and-future-of-nutrition-and-cancer-part-2-misunderstanding-and-ignoring-nutrition
#17
T Colin Campbell
The role that nutrition plays in cancer development and treatment has received considerable attention in recent decades, but it still engenders considerable controversy. Within the cancer research and especially the clinical community, for example, nutritional factors are considered to play, at best, a secondary role. The role of nutrition in cancer development was noted by authorities as far back as the early 1800s, generally under the theory that cancer is "constitutional" in its origin, implying a complex, multifactorial, multistage etiology...
July 25, 2017: Nutrition and Cancer
https://www.readbyqxmd.com/read/28742398/construct-validity-of-the-ucsd-performance-based-skills-assessment-brief-version-upsa-b-in-hiv-disease
#18
David P Sheppard, Steven Paul Woods, Marizela Verduzco
Among individuals living with HIV disease, approximately 60% experience problems with everyday functioning. The present study investigated the utility of the UCSD Performance-based Skills Assessment-Brief Version (UPSA-B) as a measure of functional capacity in HIV. We utilized a cross-sectional three-group design comparing individuals with HIV- associated neurocognitive disorder (HAND) (HIV + HAND+; n = 27), HIV+ neurocognitively normal individuals (HIV + HAND-; n = 51), and an HIV- comparison group (HIV-; n = 28) with broadly comparable demographics and non-HIV comorbidities...
July 25, 2017: Applied Neuropsychology. Adult
https://www.readbyqxmd.com/read/28742289/tai-chi-exercise-for-the-quality-of-life-in-a-perimenopausal-women-organization-a-systematic-review
#19
Ying Wang, Weichao Shan, Qing Li, Na Yang, Weiying Shan
BACKGROUND: Improvement of the quality of life in perimenopausal women has recently become an important global health issue. Extensive research reports provide evidence of Tai Chi for the quality of life, but no systematic review has individually investigated Tai Chi as a main intervention on the quality of life in perimenopausal women. OBJECTIVE: To assess clinical evidence of Tai Chi for the quality of life in perimenopausal women. METHODS: Studies related to the effect of Tai Chi on the quality of life in perimenopausal women in the databases of China and abroad were searched...
August 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28742270/malignancy-screening-in-autoimmune-myositis-amongst-australian-rheumatologists
#20
Katherine Dutton, Muriel Soden
BACKGROUND: The international literature advocates for cancer screening in newly diagnosed patients with autoimmune myositis; however there is no widely-accepted consensus or guideline to outline the optimal cancer screening strategy and the evidence is currently insufficient to support any recommendation. AIMS: Our study aimed to establish the current trends in practice in malignancy screening in autoimmune myositis amongst Australian Rheumatologists. METHODS: All Rheumatologists who were full members of the Australian Rheumatology Association in 2016 (386) were invited to complete an online questionnaire...
July 25, 2017: Internal Medicine Journal
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