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https://www.readbyqxmd.com/read/28625532/emergency-department-do-not-resuscitate-order-in-patients-with-spontaneous-intracerebral-hemorrhage
#1
Ju-Sing Fan, Hsien-Hao Huang, Yen-Chia Chen, Chorng-Kuang How, David Hung-Tsang Yen
OBJECTIVES: To explore the determinant factors and prognostic significance of emergency department do-not-resuscitate (ED-DNR) orders for patients with spontaneous intracerebral hemorrhage (SICH). METHODS: Consecutive adult SICH patients treated in our ED from January 1, 2012 to December 31, 2016 were selected as the eligible cases from our hospital's stroke database. Patients' information was comprehensively reviewed from the database and medical and nursing charts...
June 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28620153/premature-labor-and-neonatal-septicemia-caused-by-capnocytophaga-ochracea
#2
Abdullah A Alhifany, Thamer A Almangour, Deanne E Tabb, David H Levine
BACKGROUND Capnocytophaga ochracea is a gram-negative anaerobic organism commonly found in human oral flora. It is characteristically sensitive to beta-lactams and resistant to aminoglycosides. CASE REPORT A 23-year-old woman presented with lower abdominal pain and was admitted for premature labor at 24-weeks of gestation. At presentation, the cervix was closed and the membrane was intact; however, contractions continued, the membrane subsequently ruptured before receiving any steroids or magnesium, and the mother gave birth to a 540-gram female baby...
June 16, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28614079/do-not-resuscitate-with-no-surrogate-and-no-advance-directive-an-ethics-case-study
#3
Jamie Diamond, Umesh Gidwani, Rosamond Rhodes
Do-not-resuscitate (DNR) orders are typically signed by physicians in conjunction with patients or their surrogate decision makers in order to instruct healthcare providers not to perform cardiopulmonary resuscitation (CPR). Both the medical literature and CPR guidelines fail to address when it is appropriate for physicians to sign DNR orders without any knowledge of a patient's wishes. We explore the ethical issues surrounding instituting a two-physician DNR for a dying patient with multiple comorbidities and no medical record on file, no advance directives, and no surrogate decision maker...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28595818/do-not-resuscitate-orders-and-high-risk-pediatric%C3%A2-surgery-professional-nuisance-or%C3%A2-medical%C3%A2-necessity
#4
Lauren M Baumann, Kibileri Williams, Fizan Abdullah, Richard J Hendrickson, Tolulope A Oyetunji
BACKGROUND: There is a paucity of data in the literature regarding end-of-life care and do-not-resuscitate (DNR) status of the pediatric surgical patient, although invasive procedures are frequently performed in very high risk and critically ill children. Despite significant efforts in adult medicine to enhance discussions around end-of-life care, little is known about similar endeavors in the pediatric population. METHODS: A retrospective review of the National Surgical Quality Improvement Program Pediatric database was performed...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28588271/pp2a-inhibition-from-lb100-therapy-enhances-daunorubicin-cytotoxicity-in-secondary-acute-myeloid-leukemia-via-mir-181b-1-upregulation
#5
Chao Hu, Mengxia Yu, Yanling Ren, Kongfei Li, Dominic M Maggio, Chen Mei, Li Ye, Juying Wei, Jie Jin, Zhengping Zhuang, Hongyan Tong
Patients with secondary acute myeloid leukemia (sAML) arising from myelodysplastic syndromes have a poor prognosis marked by an increased resistance to chemotherapy. An urgent need exists for adjuvant treatments that can enhance or replace current therapeutic options. Here we show the potential of LB100, a small-molecule protein phosphatase 2 A (PP2A) inhibitor, as a monotherapy and chemosensitizing agent for sAML using an in-vitro and in-vivo approach. We demonstrate that LB100 decreases cell viability through caspase activation and G2/M cell-cycle arrest...
June 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28583331/a-novel-immunoliposome-mediated-by-cd123-antibody-targeting-to-acute-myeloid-leukemia-cells
#6
Yin Wang, Furong Liu, Qiantao Wang, Honglin Xiang, Hui Jin, Hui Li, Shengjun Mao
The application of the tumor targeting antibody-mediated immunoliposomes (ILP) provides us a potential effective strategy for treating malignancies, such as acute myeloid leukemia (AML). CD123, which is specifically overexpressed on AML cells, plays an important role in cell cycling and enhances the cell resistance to the apoptotic stimuli. Given such a unique role of CD123 in AML cells, we aim to develop a novel drug targeting delivery system using CD123 monoclonal antibody (mAb) in this study. On the basis of the daunorubicin (DNR) loaded PEGylated liposomes (DNR-LP), a post-insertion method was applied to covalently attach the anti-CD123 mAb onto the surface of the liposomes to obtain the anti-CD123 mAb modified immunoliposomes (CD123-ILP)...
June 2, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28574300/anti-cd123-antibody-modified-niosomes-for-targeted-delivery-of-daunorubicin-against-acute-myeloid-leukemia
#7
Fu-Rong Liu, Hui Jin, Yin Wang, Chen Chen, Ming Li, Sheng-Jun Mao, Qiantao Wang, Hui Li
A novel niosomal delivery system was designed and investigated for the targeted delivery of daunorubicin (DNR) against acute myeloid leukemia (AML). Anti-CD123 antibodies conjugated to Mal-PEG2000-DSPE were incorporated into normal niosomes (NS) via a post insertion method to afford antibody-modified niosomes (CD123-NS). Next, NS was modified with varying densities of antibody (0.5 or 2%, antibody/Span 80, molar ratio), thus providing L-CD123-NS and H-CD123-NS. We studied the effect of antibody density on the uptake efficiency of niosomes in NB4 and THP-1 cells, on which CD123 express differently...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28566684/quantitative-refractive-index-distribution-of-single-cell-by-combining-phase-shifting-interferometry-and-afm-imaging
#8
Qinnan Zhang, Liyun Zhong, Ping Tang, Yingjie Yuan, Shengde Liu, Jindong Tian, Xiaoxu Lu
Cell refractive index, an intrinsic optical parameter, is closely correlated with the intracellular mass and concentration. By combining optical phase-shifting interferometry (PSI) and atomic force microscope (AFM) imaging, we constructed a label free, non-invasive and quantitative refractive index of single cell measurement system, in which the accurate phase map of single cell was retrieved with PSI technique and the cell morphology with nanoscale resolution was achieved with AFM imaging. Based on the proposed AFM/PSI system, we achieved quantitative refractive index distributions of single red blood cell and Jurkat cell, respectively...
May 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28557015/palestinian-community-perceptions-of-do-not-resuscitation-order-for-terminally-ill-patients-a-qualitative-study
#9
Intima Alrimawi, Ahmad Rajeh Saifan, Raghad Abdelkader, Abdul-Monim Batiha
AIM AND OBJECTIVES: This study aims to illustrate the Palestinian community's views, opinions and stances about the concept of do not resuscitate (DNR) for terminally ill patients. BACKGROUND: DNR orders are practiced in many countries worldwide, but there is no consensus on their practice in the Middle East. DNR orders may be applied for terminally ill pediatric patients. Some studies have been conducted describing people's experiences with these DNR orders. However, few studies have considered community perspectives on DNR orders for terminally ill patients in Palestine...
May 30, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28540112/comparison-of-postoperative-outcomes-in-elderly-patients-with-a-do-not-resuscitate-order-undergoing-elective-and-nonelective-hip-surgery
#10
Anair Beverly, Ethan Y Brovman, Richard D Urman
PURPOSE: Emergency hip surgery generally has worse outcomes than elective hip surgery, even when adjusted for patient and surgical factors. Do-not-resuscitate (DNR) status patients are typically at higher perioperative risk and undergo a narrow range of surgical procedures. We aimed to compare the outcomes after hip surgery of differing degrees of urgency in this cohort. MATERIALS AND METHODS: Using National Surgical Quality Improvement Program (NSQIP) data, we conducted univariate and multivariate analyses comparing outcomes of DNR status patients after emergency and nonemergency hip surgery (2007-2013)...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28523117/evaluation-of-pediatric-residents-attitudes-toward-ethical-conflict-a-cross-sectional-study-in-tehran-iran
#11
Maliheh Kadivar, Marjan Mardani-Hamooleh, Shiva Shayestefar
Ethical conflicts are recognized as critical aspects in assessing competence in clinical communication. Moreover, pediatrics residents may face more problems, compared to other disciplines; due to the specific characteristics of the age group receiving services as well as the presence of their families. This study has been conducted with the aim of determining the attitude and perspective of pediatric residents toward ethical conflicts in the field of pediatrics. This descriptive, cross-sectional study was carried out on all residents of Tehran University of Medical Sciences (90 residents), selected through census method, in 2014...
2017: Journal of Medical Ethics and History of Medicine
https://www.readbyqxmd.com/read/28513885/biomechanical-function-of-a-balloon-nucleus-pulposus-replacement-system-a-human-cadaveric-spine-study
#12
Taekyeong Lee, Tae-Hong Lim, Sang-Heon Lee, Joo-Han Kim, Junghwa Hong
With recent advances in motion-sparing techniques in spine surgery, disc nucleus replacement (DNR) has been introduced as a viable method to restore the biomechanical functions of the spine. Several methods of DNR have been proposed in the literature. However, the risk of device migration or extrusion is a major issue that should be addressed for a successful DNR. DNR using a balloon nucleus (BN) filled with pressurized fluid may be capable of reducing such risks while preserving the advantages of DNR. The objective of this study was to investigate the biomechanical functionalities of the human cadaveric lumbar motion segments with a custom made BN filled with saline at internal fluid pressure of 0...
May 17, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28508956/doctors-attitudes-towards-the-introduction-and-clinical-operation-of-do-not-resuscitate-orders-dnrs-in-ireland
#13
M O'Reilly, C M P O'Tuathaigh, K Doran
BACKGROUND: Do not resuscitate orders (DNRs) are documents which state that should a patient suffer from cardiopulmonary failure, resuscitation should not be attempted. Internationally, DNRs are often misunderstood and used inappropriately in a clinical setting. AIMS: The aim of this paper was to determine the current understanding of DNRs and their clinical operation among hospital doctors in Ireland. METHODS: A cross-sectional, questionnaire-based study was conducted involving doctors from the Cork teaching hospitals...
May 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28505160/role-of-nf-e2-related-factor-2-nrf2-on-chemotherapy-resistance-in-acute-myeloid-leukemia-aml-and-the-effect-of-pharmacological-inhibition-of-nrf2
#14
Sreeja Karathedath, Bharathi M Rajamani, Syed Mohammed Musheer Aalam, Ajay Abraham, Savitha Varatharajan, Partha Krishnamurthy, Vikram Mathews, Shaji Ramachandran Velayudhan, Poonkuzhali Balasubramanian
Cytarabine (Ara-C) and Daunorubicin (Dnr) forms the backbone of acute myeloid leukemia (AML) therapy. Drug resistance and toxic side effects pose a major threat to treatment success and hence alternate less toxic therapies are warranted. NF-E2 related factor-2 (Nrf2), a master regulator of antioxidant response is implicated in chemoresistance in solid tumors. However, little is known about the role of Nrf2 in AML chemoresistance and the effect of pharmacological inhibitor brusatol in modulating this resistance...
2017: PloS One
https://www.readbyqxmd.com/read/28489813/implementing-a-novel-model-for-hospice-and-palliative-care-in-the-emergency-department-an-experience-from-a-tertiary-medical-center-in-taiwan
#15
Tzu-Chieh Weng, Ya-Chun Yang, Ping-Jen Chen, Wen-Fu Kuo, Wei-Lin Wang, Ya-Ting Ke, Chien-Chin Hsu, Kao-Chang Lin, Chien-Cheng Huang, Hung-Jung Lin
Hospice and palliative care has been recognized as an essential part of emergency medicine; however, there is no consensus on the optimal model for the delivery of hospice and palliative care in the emergency department (ED). Therefore, we conducted a novel implementation in a tertiary medical center in Taiwan. In the preintervention period, we recruited a specialist for hospice and palliative medicine in the ED to lead our intervention. In the early stage of the intervention, starting on July 1, 2014, we encouraged and funded ED physicians and nurses to receive training for hospice and palliative medicine and residents of emergency medicine to rotate to the hospice ward...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28486318/asking-a-better-question-development-and-evaluation-of-the-need-for-trauma-intervention-nfti-metric-as-a-novel-indicator-of-major-trauma
#16
Jacob W Roden-Foreman, Nakia R Rapier, Luanna Yelverton, Michael L Foreman
Many existing metrics, such as Injury Severity Score (ISS), cannot fully describe many trauma patients because of comorbidities. This study developed and evaluated the Need For Trauma Intervention (NFTI) metric as a novel indicator of major trauma. The NFTI metric was developed from an analysis of 2,396 trauma patients at a Level I trauma center. Six commonly recorded registry variables were found to be indicative of major trauma and comprised the NFTI criteria: receiving packed red blood cells within 4 hr; discharge from the emergency department (ED) to the operating room within 90 min; discharge from the ED to interventional radiology; discharge from the ED to the intensive care unit (ICU) with an ICU length of stay (LOS) of 3 or more days; mechanical ventilation outside of procedural anesthesia within 3 days; or death within 60 hr...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28480800/combined-chemotherapy-for-acute-promyelocytic-leukemia-a-meta-analysis
#17
Xueliang Li, Chao Wang, Guanglong Chen, Buqiang Ji, Yongchang Xu
BACKGROUND: This study evaluates the efficacy of combined chemotherapy for the management of acute promyelocytic leukemia (APL). METHOD: Literature search was carried out in several electronic databases. Meta-analyses were performed to achieve weighted effect sizes of overall survival (OS), disease-free survival (DFS), complete remission (CR) rate, and relapse rate. Metaregression analyses were performed to evaluate the factors affecting CR and relapse rates. RESULTS: Data from 37 studies (7566 patients) were used for meta-analysis...
May 7, 2017: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/28473807/fnrl-and-three-dnr-regulators-are-used-for-the-metabolic-adaptation-to-low-oxygen-tension-in-dinoroseobacter-shibae
#18
Matthias Ebert, Sebastian Laaß, Andrea Thürmer, Louisa Roselius, Denitsa Eckweiler, Rolf Daniel, Elisabeth Härtig, Dieter Jahn
The heterotrophic marine bacterium Dinoroseobacter shibae utilizes aerobic respiration and anaerobic denitrification supplemented with aerobic anoxygenic photosynthesis for energy generation. The aerobic to anaerobic transition is controlled by four Fnr/Crp family regulators in a unique cascade-type regulatory network. FnrL is utilizing an oxygen-sensitive Fe-S cluster for oxygen sensing. Active FnrL is inducing most operons encoding the denitrification machinery and the corresponding heme biosynthesis. Activation of gene expression of the high oxygen affinity cbb3-type and repression of the low affinity aa3-type cytochrome c oxidase is mediated by FnrL...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28467581/can-we-make-an-early-do-not-resuscitate-decision-in-severe-burn-patients
#19
Yücel Yüce, Hakan Ahmet Acar, Kutlu Hakan Erkal, Erhan Tuncay
BACKGROUND: The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders. METHODS: Between January 2009 and December 2014, 29 patients (3...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28446279/-effect-of-stromal-cell-co-culture-on-drug-resistance-of-acute-myeloid-leukemia-cells-and-its-mechanism
#20
Han Yue, Li-Ying Liu, Xiao-Qian Wang
OBJECTIVE: To study the effect of co-culture of stromal cells and acute myeloid leukemia(AML) cells on drug resistance of AML cells and its mechanism. METHODS: Stromal cells were co-cultured with acute myeloid leukemia cell HL-60 and then were treated with DNR, HHT and Ara-C for observing the sensitivity of HL-60 cells to drugs after incubation with HS-5. At the same time, the the inhibitor LY294002 of PI3K/AKT signaling pathway was used to treat the cells, so as to explore whether the changes of HL-60 sensitivity is associated with the activation of PI3K/AKT signal pathway after co-culture of cells...
April 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
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