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Early Goal Direct Therapy

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https://www.readbyqxmd.com/read/28771656/transfusion-practice-in-trauma-resuscitation
#1
Ashley M Eckel, John R Hess
Recognition of the acute coagulopathy of trauma and the limits of reconstituting whole blood with conventional blood components has led to a radical change in the way trauma patients with severe injuries are resuscitated. Massive transfusion protocols (MTP) have evolved toward the administration of conventional blood components in fixed ratios. Administration of a 1:1:1 unit ratio of fresh frozen plasma to whole-blood-derived platelets to packed red blood cells is now the most common strategy and the stated goal of directors of >80% of the level I trauma centers in the United States...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28757155/antibody-drug-conjugates-for-treatment-of-breast-cancer-novel-targets-and-diverse-approaches-in-adc-design
#2
REVIEW
Pamela A Trail, Gene M Dubowchik, Timothy Lowinger
Breast cancer is a heterogeneous group of malignancies with a spectrum of molecular subtypes, pathologies and outcomes that together comprise the most common non-cutaneous cancer in women. Currently, over 80% of breast cancer patients are diagnosed at relatively early stages of disease where there are encouraging data on outcomes and long term survival. However, there is currently no curative option for those patients with metastatic disease and there is a substantial medical need to identify effective and safe treatment options for these patients...
July 27, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28756405/the-recognition-and-management-of-sepsis-and-septic-shock-a-guide-for-non-intensivists
#3
REVIEW
Alexander Keeley, Paul Hine, Emmanuel Nsutebu
Sepsis is common, often fatal and requires rapid interventions to improve outcomes. While the optimal management of sepsis in the intensive care setting is the focus of extensive research interest, the mainstay of the recognition and initial management of sepsis will occur outside the intensive care setting. Therefore, it is key that institutions and clinicians remain well informed of the current updates in sepsis management and continue to use them to deliver appropriate and timely interventions to enhance patient survival...
July 29, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28749096/early-goal-directed-therapy-by-continuous-non-invasive-hemodynamic-monitoring-still-elusive
#4
Ole Broch, Matthias Gruenewald, Arne Carstens, Jochen Renner
No abstract text is available yet for this article.
July 26, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28724540/targeting-bcl-2-in-b-cell-lymphomas
#5
Matthew S Davids
The B-cell leukemia/lymphoma-2 (BCL-2) family of proteins governs the intrinsic pathway of mitochondrial apoptosis. Dysregulation of BCL-2 has long been known to be a crucial part of the pathophysiology of B-cell lymphomas, yet several early attempts to target this pathway therapeutically were unsuccessful due to toxicity, lack of efficacy, or both. Recently, a highly potent and selective oral BCL-2 antagonist, venetoclax, was approved in chronic lymphocytic leukemia (CLL), where it has proven to be highly active, even in patients with high risk del(17p) disease...
July 19, 2017: Blood
https://www.readbyqxmd.com/read/28715828/pooled-rcts-early-goal-directed-therapy-does-not-reduce-mortality-more-than-usual-care-in-early-septic-shock
#6
Brian M Fuller, Christopher R Carpenter
No abstract text is available yet for this article.
July 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28712609/is-early-goal-directed-therapy-or-standard-therapy-more-effective-in-decreasing-mortality-among-patients-with-sepsis
#7
EDITORIAL
Melinda J Morton Hamer, Sara K Faught
No abstract text is available yet for this article.
July 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28711120/from-efficacy-to-global-impact-lessons-learned-about-what-not-to-do-in-translating-our-research-to-reach
#8
Carolyn B Becker
Although members of the Association for Behavioral and Cognitive Therapies have made significant strides toward the collective goals outlined in our mission statement, we routinely acknowledge that our ability to develop empirically supported treatments exceeds our success in improving dissemination and implementation of said interventions. Further, as noted by Kazdin and Blase (2011), even if we succeeded in having every clinician worldwide administer our best treatments with excellent competency, we still would be unsuccessful in markedly impacting the worldwide burden of mental illness because most treatments require intensive labor by expensive providers...
September 2017: Behavior Therapy
https://www.readbyqxmd.com/read/28708676/is-early-goal-directed-therapy-harmful-to-patients-with-sepsis-and-high-disease-severity
#9
Andre C Kalil, John A Kellum
No abstract text is available yet for this article.
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28653282/therapeutic-targets-for-multiple-sclerosis-current-treatment-goals-and-future-directions
#10
REVIEW
Andrew L Smith, Jeffrey A Cohen, Le H Hua
Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system, and the most common cause of nontraumatic disability in young adults. Most patients have a relapsing-remitting course, and roughly half of them will eventually enter a degenerative progressive phase, marked by gradual accrual of disability over time in the absence of relapses. Early initiation of treatment has delayed the onset of disability progression. Thus, there is increased interest in treating to target in MS, particularly targeting no evidence of disease activity...
June 26, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/28653134/goal-directed-therapy-hit-early-and-personalize
#11
EDITORIAL
Bernd Saugel, Frederic Michard, Thomas W L Scheeren
No abstract text is available yet for this article.
June 26, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28629462/treatment-decisions-for-older-adults-with-advanced-chronic-kidney-disease
#12
REVIEW
Steven J Rosansky, Jane Schell, Joseph Shega, Jennifer Scherer, Laurie Jacobs, Cecile Couchoud, Deidra Crews, Matthew McNabney
Dialysis initiation rates among older adults, aged 75 years or greater, are increasing at a faster rate than for younger age groups. Older adults with advanced CKD (eGFR < 30 ml/min/1.73 m(2)) typically lose renal function slowly, often suffer from significant comorbidity and thus may die from associated comorbidities before they require dialysis.A patient's pattern of renal function loss over time in relation to their underlying comorbidities can serve as a guide to the probability of a future dialysis requirement...
June 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28625299/managing-major-obstetric-haemorrhage-pharmacotherapy-and-transfusion
#13
REVIEW
Rachel Collis, Emilia Guasch
Major obstetric haemorrhage is a leading cause of maternal mortality. A prescriptive approach to early recognition and management is critical to improving outcomes. Uterine atony is the primary cause of post-partum haemorrhage. First-line prevention and treatment include the administration of uterine tonic agents; other conservative measures include uterine cavity tamponade and uterine compression sutures. Interventional radiology procedures have been used for both prophylaxis and treatment, but a hysterectomy may be necessary if conservative measures fail...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28625234/-effect-of-global-end-diastolic-volume-index-guidance-fluid-resuscitation-in-elderly-patients-with-septic-shock
#14
Shuang Ma, Rumin Zhang, Shifu Wang, Meiling Zhao, Lei Wang, Yun Zhang
OBJECTIVE: To evaluate the effect of global end diastolic volume index (GEDVI) on fluid resuscitation in elderly patients with septic shock. METHODS: A prospective randomized controlled trial (RCT) was conducted. Septic shock patients over 65 years admitted to intensive care unit (ICU) of Shandong Province, Zibo Central Hospital from January 2013 to December 2015 were enrolled. The patients were randomly divided into control group and observation group, 20 cases in each group...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28601273/potential-impact-of-the-2016-consensus-definitions-of-sepsis-and-septic-shock-on-future-sepsis-research
#15
Sandra L Peake, Anthony Delaney, Michael Bailey, Rinaldo Bellomo
STUDY OBJECTIVE: The influence of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) on the conduct of future sepsis research is unknown. We seek to examine the potential effect of the new definitions on the identification and outcomes of patients enrolled in a sepsis trial. METHODS: This was a post hoc analysis of the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial of early goal-directed therapy that recruited 1,591 adult patients presenting to the emergency department (ED) with early septic shock diagnosed by greater than or equal to 2 systemic inflammatory response syndrome criteria and either refractory hypotension or hyperlactatemia...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28591964/-new-concept-for-surviving-sepsis-from-phenomenon-to-essence
#16
REVIEW
Xue-Lian Liao, Zhi-Chao Xie, Yan Kang
Sepsis is a critical clinical syndrome which keep puzzling the medical profession for many years. Recently, the results from several large-scale trials challenged the necessity of early goal directed therapy (EGDT) in surviving sepsis bundle, These trials were not opposed to EGDT but bring new concept that it is essential to utilize therapy with multiple monitoring measures in order to minimize injury while guarantee the safety . Deeper understanding in the pathogenesis of sepsis gives rise to the update of its definition based on vital organ dysfunction...
July 2016: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28580261/all-arthroscopic-coracoclavicular-ligament-reconstruction-surgical-technique-using-a-semitendinosus-allograft-and-tenodesis-screws
#17
Xinning Li, Anand Padmanabha, Justin Koh, Antonio Cusano
Acromioclavicular joint injuries account for 9% of shoulder girdle injuries and are most often associated with direct blows to the shoulder or axially directed forces onto the ipsilateral extremity. Type IV, V, and VI injuries are generally managed surgically, whereas type I and II injuries are treated with sling immobilization, early shoulder range of motion, and physical therapy. Type III injuries are more controversial but are generally managed surgically in the active and high-demand patient. When surgical treatment is indicated, the primary goal of a coracoclavicular (CC) ligament reconstruction is to restore anatomic reduction of the acromioclavicular joint and reconstruct the biomechanical forces of the CC ligaments...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28572520/clinical-management-of-sepsis
#18
S M Lam, A Cw Lau, R Pk Lam, W W Yan
Sepsis is a common cause of hospital admission worldwide and contributes significantly to morbidity and mortality. The definition of sepsis has evolved from the 1991 American College of Chest Physicians/Society of Critical Care Medicine definition based on the criteria of systemic inflammatory response syndrome, to the 2016 Sepsis-3 definition that incorporates the Sequential Organ Failure Assessment score. The landmark trial on protocolised early goal-directed therapy was published in 2001, but three subsequent multicentre randomised controlled trials (ProCESS, ARISE, and ProMISe) in 2014-2015 did not confirm a survival benefit with protocolised care...
June 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28484927/ethical-and-legal-considerations-in-the-management-of-an-unbefriended-patient-in-a-vegetative-state
#19
Alexandra Lloyd-Smith Sequeira, Ariane Lewis
BACKGROUND: Patients without surrogates are referred to as "unbefriended." Because these patients do not have representatives to assist with medical decision-making, patient autonomy and self-determination, fundamental concepts of American healthcare, are jeopardized. METHODS: We present a case of an unbefriended patient in a vegetative state and discuss the ethical and legal complications associated with management of unbefriended patients. RESULTS: An unbefriended patient was admitted to our hospital with a cardiac arrest in the setting of an intracerebral hemorrhage...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28477393/directiveness-in-psychotherapy-a-phenomenological-narrative-study-of-therapist-attitudes
#20
Erik Rautalinko
OBJECTIVES: This study of directiveness draws on the literature on patient-therapist matching, neutrality, and resistance. Our aim was to investigate how psychotherapists conceptualize directiveness as an attitude, with a focus on pantheoretical aspects of directiveness. DESIGN AND METHODS: Our data are narratives from 18 interviews with psychotherapists of different theoretical orientations (cognitive-behavioural, family-systems, humanistic-experiential, and psychodynamic), and from focus-group discussions with six other psychotherapists...
May 6, 2017: Psychology and Psychotherapy
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