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https://www.readbyqxmd.com/read/28719890/effect-of-neoadjuvant-nab-paclitaxel-plus-gemcitabine-therapy-on-overall-survival-in-patients-with-borderline-resectable-pancreatic-cancer-a-prospective-multicenter-phase-ii-trial-nac-ga-trial
#1
Ken-Ichi Okada, Toshio Shimokawa, Seiko Hirono, Manabu Kawai, Masayuki Sho, Sohei Satoi, Ippei Matsumoto, Hidetoshi Eguchi, Yoshiaki Murakami, Suguru Yamada, Mariko Doi, Hiroki Yamaue
We conducted a prospective multicenter phase II trial of patients with borderline resectable pancreatic carcinoma to investigate the efficacy of neoadjuvant nab-paclitaxel plus gemcitabine therapy on overall survival (OS). The clinical trial primarily evaluated OS time from the first day of protocol therapy as a primary endpoint. The secondary endpoints were recurrence-free survival from the first day of protocol therapy, safety of the protocol therapy (adverse effect), morbidity based on the Clavien Dindo classification of more than III, response rate, preoperative/postoperative tumor marker (CA 19-9, CEA), rate of normalization, reduction rate of the maximum standardized uptake value on positron emission tomography-computed tomography (limited to institutions where positron emission tomography-computed tomography was available), chemotherapeutic effect grade based on Evans' classification, resection rate, R0 resection rate, surgical data (operative time, blood loss, transfusion, postoperative hospital day), overall morbidity rates (reoperation, rate of readmission, mortality), patient rate in postoperative adjuvant therapy (entry rate, completion rate), dose intensity, quality of life regarding fatigue and malaise assessed by the questionnaire of FACIT-F (Japanese version), and peripheral sensory neuropathy assessed by the questionnaire of the FACT/GOG-NTX subscale (version 4; Japanese version)...
July 19, 2017: Oncology
https://www.readbyqxmd.com/read/28719887/anesthetic-management-of-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-crs-hipec-the-importance-of-hydro-electrolytic-and-acid-basic-control
#2
Fabrício Tavares Mendonça, Marília Moreira Guimarães, Sérgio Honorato de Matos, Rúbia Garcia Dusi
JUSTIFICATION AND OBJECTIVES: Patients affected by gynecological or gastrointestinal tract neoplasms that evolve to peritoneal carcinomatosis experience a significant drop in their quality of life, high morbidity and short survival times with currently available chemotherapeutic schemes. The surgical treatment based on cytoreduction and the employment of hyperthermic intraperitoneal chemotherapy in the intra-operative period is a true challenge to anesthesiologist. CASE REPORT: A 67 years old patient diagnosed with mucinous adenocarcinoma of the Appendix associated with mucinous carcinomatosis, was submitted to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), under general anesthesia and epidural block...
July 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28719516/echocardiography-and-passive-leg-raising-in-the-postoperative-period-a-prospective-observational-study
#3
Yasser El Hadouti, Lucía Valencia, Angel Becerra, Aurelio Rodríguez-Pérez, Jean L Vincent
BACKGROUND: Signs of hypovolaemia are frequent in the postoperative period, but not all patients need or respond to fluid administration. An increase in cardiac output (CO) after passive leg raising (PLR) has been demonstrated to be useful as a volume response predictor in non-surgical, spontaneously breathing patients. OBJECTIVE: The objective of this study was to evaluate the accuracy of transthoracic echocardiography after PLR to predict fluid responsiveness in post-surgical patients...
July 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28719134/development-and-implementation-of-a-clinical-pathway-for-cardiac-surgery-in-the-intensive-care-unit-effects-on-protocol-adherence
#4
Marion van der Kolk, Mark van den Boogaard, Corine Ter Brugge-Speelman, Jeroen Hol, Luc Noyez, Kees van Laarhoven, Hans van der Hoeven, Peter Pickkers
RATIONALE, AIMS AND OBJECTIVES: Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. METHODS: This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report...
July 18, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28718048/joint-effects-of-gwas-snps-in-coagulation-system-confer-risk-to-hypertensive-intracerebral-hemorrhage
#5
Yanyan Cao, Min Tian, Qin Fang, Zheng Wen, Wei Wang, Hu Ding, Dao Wen Wang
Recent genome-wide association studies (GWAS) have identified numerous single nucleotide polymorphisms (SNPs) associated with coagulation system, including hemostatic factors and hematological phenotypes. However, few articles described the relationships between these SNPs and the risk of hemorrhagic stroke. The aim of our study was to evaluate the roles of these SNPs as risk factors and survival predictors for hemorrhagic stroke. Thirteen SNPs from GWAS in coagulation system were genotyped in a Chinese Han population including 1000 patients with hemorrhagic stroke (intracerebral hemorrhage, ICH = 743; subarachnoid hemorrhage, SAH = 257) and 1044 population-based controls...
July 17, 2017: Neuromolecular Medicine
https://www.readbyqxmd.com/read/28716803/psychiatric-boarding-in-the-pediatric-inpatient-medical-setting-a-retrospective-analysis
#6
Katherine A S Gallagher, I Simona Bujoreanu, Priscilla Cheung, Christine Choi, Sara Golden, Kerry Brodziak, Gabriela Andrade, Patricia Ibeziako
BACKGROUND AND OBJECTIVES: Psychiatric concerns are a common presenting problem for pediatric providers across many settings, particularly on inpatient medical services. The volume of youth requiring intensive psychiatric treatment outnumbers the availability of psychiatric placements, and as a result many youth must board on pediatric medical units while awaiting placement. As the phenomenon of boarding in the inpatient pediatric setting increases, it is important to understand trends in boarding volume and characteristics of pediatric psychiatric boarders (PBs) and understand the supports they receive while boarding...
July 17, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28716145/mortality-differences-by-surgical-volume-among-patients-with-stomach-cancer-a-threshold-for-a-favorable-volume-outcome-relationship
#7
Hyeok Choi, Seong-Yoon Yang, Hee-Seung Cho, Woorim Kim, Eun-Cheol Park, Kyu-Tae Han
BACKGROUND: Many studies have assessed the volume-outcome relationship in cancer patients, but most focused on better outcomes in higher volume groups rather than identifying a specific threshold that could assist in clinical decision-making for achieving the best outcomes. The current study suggests an optimal volume for achieving good outcome, as an extension of previous studies on the volume-outcome relationship in stomach cancer patients. METHODS: We used National Health Insurance Service (NHIS) Sampling Cohort data during 2004-2013, comprising healthcare claims for 2550 patients with newly diagnosed stomach cancer...
July 17, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28715578/adverse-pathologic-findings-for-men-electing-immediate-radical-prostatectomy-defining-a-favorable-intermediate-risk-group
#8
Hiten D Patel, Jeffrey J Tosoian, H Ballentine Carter, Jonathan I Epstein
Importance: Active surveillance is recommended for patients with very low-risk (VLR) and low-risk (LR) prostate cancer. Despite controversy, recent clinical guidelines state surveillance may be considered for men with low-volume intermediate-risk (LVIR) disease. Objective: To compare rates of adverse pathologic findings among VLR, LR, and LVIR men electing immediate radical prostatectomy and evaluate criteria to define if a favorable intermediate-risk group minimizing risk exists...
July 13, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28714229/implementing-a-protocol-to-optimize-blood-use-in-a-cardiac-surgery-service-results-of-a-pre-post-analysis-and-the-impact-of-high-volume-blood-users
#9
Juan B Grau, Jacqueline H Fortier, Cyrus Kuschner, Giovanni Ferrari, Mariano E Brizzio, Alex Zapolanski, Richard E Shaw
BACKGROUND: Blood transfusions are a common and costly intervention for cardiac surgery patients. Evidence suggests that a more restrictive transfusion strategy may reduce costs and transfusion-related complications without increasing perioperative morbidity and mortality. STUDY DESIGN AND METHODS: A transfusion-limiting protocol was developed and implemented in a cardiovascular surgery unit. Over a 5-year period, data were collected on patient characteristics, procedures, utilization of blood products, morbidity, and mortality, and these were compared before and after the protocol was implemented...
July 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28713844/epidemiology-diagnosis-and-management-of-neurogenic-orthostatic-hypotension
#10
Jose-Alberto Palma, Horacio Kaufmann
BACKGROUND: Orthostatic hypotension (OH) is a sustained fall in blood pressure on standing which can cause symptoms of organ hypoperfusion. OH is associated with increased morbidity and mortality and leads to a significant number of hospital admissions particularly in the elderly (233 per 100,000 patients over 75 years of age in the US). OH can be due to volume depletion, blood loss, large varicose veins, medications, or due to defective activation of sympathetic nerves and reduced norepinephrine release upon standing (i...
May 2017: Movement Disorders Clinical Practice
https://www.readbyqxmd.com/read/28713516/sequential-compression-pump-effect-on-hypotension-due-to-spinal-anesthesia-for-cesarean-section-a-double-blind-clinical-trial
#11
Fatemeh Javaherforoosh Zadeh, Mostafa Alqozat, Reza Akhond Zadeh
BACKGROUND: Spinal anesthesia (SA) is a standard technique for cesarean section. Hypotension presents an incident of 80-85% after SA in pregnant women. OBJECTIVE: To determine the effect of intermittent pneumatic compression of lower limbs on declining spinal anesthesia induced hypotension during cesarean section. METHODS: This double-blind clinical prospective study was conducted on 76 non-laboring parturient patients, aged 18-45 years, with the American Society of Anesthesiologist physical status I or II who were scheduled for elective cesarean section at Razi Hospital, Ahvaz, Iran from December 21, 2015 to January 20, 2016...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28713086/intensifying-approach-to-the-therapy-of-patients-with-constellation-of-the-diseases-chronic-obstructive-pulmonary-disease-and-osteoarthritis
#12
Vyacheslav N Zhdan, Maksim М Potyazhenko, Galina S Khaymenova, Nadezhda N Lyulka, Tatyana V Dubrovinskaya, Igor V Ivanitsky
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is one of 21st century. About 210 million people all over the world are suffering with COPD, and annually 3 million people die of it. Under the influence of different factors, such as smoking, air prolusion, evaporation of chemicals, poisoning effect of chemical firings, inflammation processes take place in lungs, and if it is prolonged and take place simultaneously with morphological changes in the lungs, it it provide the de4velopment of the systemic inflammation process...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28712558/catheter-ablation-of-accessory-pathway-14-year-trends-in-utilization-and-complications-in-adults-in-the-united-states
#13
Jalaj Garg, Neeraj Shah, Parasuram Krishnamoorthy, Kathan Mehta, Babak Bozorgnia, Noel G Boyle, Ronald Freudenberger, Andrea Natale
BACKGROUND: The aim of this study was to determine the temporal trends in utilization of catheter ablation of accessory pathways in the United States. METHODS: All patients from the Nationwide Inpatient Sample (NIS) ≥18years of age with a primary diagnosis of anomalous atrioventricular excitation syndrome (International Classification of Diseases, Ninth Edition, Clinical Modification [ICD-9-CM] code 426.7) were included in the study. Patients who underwent catheter ablation were identified using ICD-9-CM procedure code 37...
June 30, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28711325/improving-coronary-artery-bypass-grafting-readmission-outcomes-from-2000-to-2012-in-the-medicare-population
#14
Christian McNeely, Kathleen Kwedar, Stephen Markwell, Christina M Vassileva
OBJECTIVE: The study objective was to examine trends in 30-day readmission after coronary artery bypass grafting in the Medicare population over 13 years. METHODS: The study included isolated coronary artery bypass grafting procedures in the Medicare population from January 2000 to November 2012. Comorbidities and causes of readmission were determined using Internal Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes. RESULTS: The cohort included 1,116,991 patients...
June 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28709874/analysis-of-hospital-readmissions-after-prosthetic-urologic-surgery-in-the-united-states-nationally-representative-estimates-of-causes-costs-and-predictive-factors
#15
Filippo Pederzoli, Meera R Chappidi, Sarah Collica, Max Kates, Gregory A Joice, Nikolai A Sopko, Francesco Montorsi, Andrea Salonia, Trinity J Bivalacqua
BACKGROUND: The surgical treatment of urinary incontinence and erectile dysfunction by prosthetic devices has become part of urologic practice, although sparse data exist at a national level on readmissions and hospital costs. AIM: To assess causes and costs of early (≤30 days) and late (31-90 days) readmissions after implantation of penile prostheses (PPs), artificial urinary sphincters (AUSs), or PP + AUS. METHODS: Using the 2013 and 2014 US Nationwide Readmission Databases, sociodemographic characteristics, hospital costs, and causes of readmission were compared among PP, AUS and AUS + PP surgeries...
July 12, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28709452/influence-of-the-patient-practitioner-interaction-context-on-acupuncture-outcomes-in-functional-dyspepsia-study-protocol-for-a-multicenter-randomized-controlled-trial
#16
Seok-Jae Ko, Jae-Woo Park, Jungtae Leem, Ted J Kaptchuk, Vitaly Napadow, Braden Kuo, Jessica Gerber, Laurie Dimisko, Inkwon Yeo, Junhee Lee, Jinsung Kim
BACKGROUND: In the treatment of functional dyspepsia, the placebo effect has been reported to be high, and the influence of the patient-practitioner relationship may be a major component of this effect. The specific and non-specific effects of acupuncture cannot be easily distinguished, and the patient-practitioner relationship may influence the total therapeutic effect in clinical practice. There have been no studies that investigate the influence of patient-practitioner relationship on acupuncture treatment for patients with functional dyspepsia...
July 14, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28709178/inflammatory-reaction-found-in-prostate-specific-material-method-standardization-and-proposed-optimal-cut-off-points
#17
P Korrovits, O Poolamets, R Mändar, M Punab
Prostatitis classification as well as treatment decisions are primarily based on differentiation of the inflammatory status in prostate-specific material. At the same time, methods used for detection of inflammation are semi-quantitative and not finally standardized. The main aim of this study was to suggest more precise methods for detection of prostate inflammatory status. Additional aims were to define optimal cut-off points of various tests in order to discriminate between inflammatory and non-inflammatory condition and to analyze the prevalence of inflammatory prostatitis in the groups of symptomatic prostatitis, lower urinary tract symptoms and control subjects...
July 14, 2017: Andrology
https://www.readbyqxmd.com/read/28708679/transpulmonary-pressure-describes-lung-morphology-during-decremental-positive-end-expiratory-pressure-trials-in-obesity
#18
Jacopo Fumagalli, Lorenzo Berra, Changsheng Zhang, Massimiliano Pirrone, Roberta R De Santis Santiago, Susimeire Gomes, Federico Magni, Glaucia A B Dos Santos, Desmond Bennett, Vinicius Torsani, Daniel Fisher, Caio Morais, Marcelo B P Amato, Robert M Kacmarek
OBJECTIVES: Atelectasis develops in critically ill obese patients when undergoing mechanical ventilation due to increased pleural pressure. The current study aimed to determine the relationship between transpulmonary pressure, lung mechanics, and lung morphology and to quantify the benefits of a decremental positive end-expiratory pressure trial preceded by a recruitment maneuver. DESIGN: Prospective, crossover, nonrandomized interventional study. SETTING: Medical and Surgical Intensive Care Units at Massachusetts General Hospital (Boston, MA) and University Animal Research Laboratory (São Paulo, Brazil)...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28707987/neonatal-caffeine-treatment-and-respiratory-function-at-11-years-in-children-1251-g-birth-weight
#19
Lex W Doyle, Sarath Ranganathan, Jeanie L Y Cheong
RATIONALE: Caffeine in the newborn period shortens the duration of assisted ventilation and reduces the incidence of bronchopulmonary dysplasia, but its effects on respiratory function in later childhood are unknown. OBJECTIVES: To determine if children born <1251 g birthweight who were treated with neonatal caffeine had improved respiratory function at 11 years of age compared with children treated with placebo. METHODS: Children enrolled in the Caffeine for Apnea of Prematurity randomized controlled trial and assessed at the Royal Women's Hospital in Melbourne at 11 years of age had expiratory flow rates measured according to the standards of the American Thoracic Society...
July 14, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28707488/efficacy-of-oxytocin-vs-carbetocin-in-prevention-of-postpartum-hemorrhage-after-cesarean-section-under-general-anesthesia-a-prospective-randomized-clinical-trial
#20
Robabeh Taheripanah, Amal Shoman, Mohammad Ali Karimzadeh, Marzieh Zamaniyan, Narges Malih
OBJECTIVE: To compare the use of carbetocin and oxytocin in prevention of postpartum hemorrhage after cesarean section. METHODS: The present study was a prospective double-blind randomized controlled clinical trial performed in two university based hospitals in Tehran, Iran. Two hundred twenty women with the gestational age of more than 37 weeks, who needed cesarean operation, participated in the study. Patients were assigned to receive either a single 100 µg IV dose of carbetocin or a standard 30-international unit IV infusion of oxytocin during 2 hours after delivery of placenta...
July 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
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