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https://www.readbyqxmd.com/read/28523117/evaluation-of-pediatric-residents-attitudes-toward-ethical-conflict-a-cross-sectional-study-in-tehran-iran
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28441794/reciprocal-interactions-of-leukemic-cells-with-bone-marrow-stromal-cells-promote-enrichment-of-leukemic-stell-cell-compartments-in-response-to-curcumin-and-daunorubicin
#11
Saeed Mohammadi, Mohsen Nikbakht, Seyed Mehdi Sajjadi, Fariba Rad, Bahram Chahardouli, Javid Sabour Takanlu, Shahrbano Rostami, Kamran Alimoghaddam, Ardeshir Ghavamzadeh, Seyed H Ghaffari
A predominant challenge in developing curative leukemia therapy is interactions of leukemic cells with the bone marrow stromal microenvironment. We aimed to investigate the role of stromal cells, such as bone marrow mesenchymal stromal cells (BMSCs) and osteoblasts (OBs), in curcumin (CUR) and daunorubicin (DNR) induced apoptosis of acute myeloid leukemia (AML) cells. We used KG1 and U937 as leukemia cell line models and treated them with CUR and DNR. The cells were then co-cultured with BMSCs or a combination of BMSCs and OBs as feeders...
March 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28440407/effects-of-cytochrome-p450-family-3-subfamily-a-member%C3%A2-5-gene-polymorphisms-on-daunorubicin-metabolism-and-adverse-reactions-in-patients-with-acute-leukemia
#12
Zhen Huang, Juxiang Wang, Jiangchao Qian, Yuan Li, Zhisheng Xu, Min Chen, Hongfei Tong
The present study aimed to investigate the association between the genetic polymorphism of cytochrome P450 family 3 subfamily A member 5 (CYP3A5) and the activity of CYP3A and plasma concentrations of daunorubicin (DNR) in patients with acute leukemia. A total of 36 children with newly diagnosed acute lymphoblastic leukemia were enrolled in the study. Polymerase chain reaction (PCR)‑restriction fragment length polymorphism and PCR product sequencing were used to detect the genotype of CYP3A5*3. PCR was then used to express the mRNA expression of CYP3A5...
June 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28409378/percutaneous-cholecystostomy-prognostic-factors-and-comparison-to-cholecystectomy
#13
Tyler J Loftus, Elisha M Collins, Camille G Dessaigne, Amber N Himmler, Alicia M Mohr, Ryan M Thomas, Charles E Hobson, George A Sarosi, William J Zingarelli
BACKGROUND: Data regarding long-term outcomes following percutaneous cholecystostomy (PC) are limited, and comparisons to cholecystectomy (CCY) are lacking. We hypothesized that chronic disease burden would predict 1-year mortality following PC, and that outcomes following PC and CCY would be similar when controlling for preprocedural risk factors. METHODS: We performed a 10-year retrospective cohort analysis of patients with acute cholecystitis managed by PC (n = 114) or CCY (n = 234)...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28399031/the-advance-care-planning-readiness-scale-development-and-validation-of-a-measure-of-willingness-to-discuss-and-acceptance-of-end-of-life-care-in-gynecologic-cancer-patients
#14
Alaina J Brown, Megan Johnson Shen, Diana Urbauer, Jolyn Taylor, Patricia A Parker, Cindy Carmack, Lauren Prescott, Carly Rosemore, Elizabeth Kolawole, Charlotte Sun, Lois Ramondetta, Diane C Bodurka
OBJECTIVE: The objective of this article was to develop and validate a scale that assesses the readiness of gynecologic oncology patients to engage in advance care planning. METHODS: The Advance Care Planning Readiness Scale (ACPRS) was validated across 3 independent samples of gynecologic oncology patients. In step I, patients underwent cognitive interviewing to determine if the scale items were comprehensible and applicable to patients. Based on this, modifications to the scale (addition, removal, and merger of items) were completed...
May 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28344598/radiation-dose-to-the-left-anterior-descending-coronary-artery-during-interstitial-pulsed-dose-rate-brachytherapy-used-as-a-boost-in-breast-cancer-patients-undergoing-organ-sparing-treatment
#15
Marcin Sinacki, Krystyna Serkies, Rafał Dziadziuszko, Magdalena Narkowicz, Joanna Kamińska, Joanna Lipniewicz
PURPOSE: To assess dose received by the left anterior descending (LAD) coronary artery during interstitial pulsed-dose-rate brachytherapy (PDR-BT) boost for left-sided breast cancer patients undergoing organ-sparing treatment. MATERIAL AND METHODS: Thirty consecutive pT1-3N0-1M0 breast cancer patients boosted between 2014 and 2015 with 10 Gy/10 pulses/hour PDR-BT following a computed tomography (CT) simulation with the multi-catheter implant were included. The most common localization of primary tumor were upper quadrants...
February 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28343206/-euthanasia-an-attempt-to-organize-issue
#16
Tomasz Kirmes, Mateusz Wilk, Czesław Chowaniec
This article is an attempt to complete and holistically discuss problem of euthanasia, especially its ethical and legal aspects, comparing to Polish law. The subject of euthanasia arouse interest of the society because it touches one of the most important aspects of life, which is the death. Even bigger emotions are aroused amongst physicians. They are forced to put on the line the life as biggest value on the one side and autonomy of human being on the other. It also touches the empathy for suffering. The euthanasia was divided into three forms: active euthanasia, passive euthanasia and assisted suicide...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28338851/do-not-resuscitate-orders-and-early-mortality-in-hip-fracture-patients
#17
Anouk E Simons, Julian Karres, Leontien M G Nijland, Jan M Ultee, Gino M M J Kerkhoffs, Bart C Vrouenraets
Background: factors affecting mortality after hip fracture surgery have been studied extensively. It has been suggested that do-not-resuscitate (DNR) orders are associated with higher mortality in surgical patients due to less aggressive treatment. However, the effect of DNR orders on mortality in hip fracture patients is unknown. The objective of this study was to investigate the effect of DNR orders on early mortality after hip fracture surgery. Methods: all patients undergoing hip fracture surgery between 2004 and 2015 were included in this retrospective study...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28323839/on-dna-numerical-representations-for-genomic-similarity-computation
#18
Gerardo Mendizabal-Ruiz, Israel Román-Godínez, Sulema Torres-Ramos, Ricardo A Salido-Ruiz, J Alejandro Morales
Genomic signal processing (GSP) refers to the use of signal processing for the analysis of genomic data. GSP methods require the transformation or mapping of the genomic data to a numeric representation. To date, several DNA numeric representations (DNR) have been proposed; however, it is not clear what the properties of each DNR are and how the selection of one will affect the results when using a signal processing technique to analyze them. In this paper, we present an experimental study of the characteristics of nine of the most frequently-used DNR...
2017: PloS One
https://www.readbyqxmd.com/read/28319514/do-not-resuscitate-status-is-associated-with-increased-mortality-but-not-morbidity
#19
Elisa C Walsh, Ethan Y Brovman, Angela M Bader, Richard D Urman
BACKGROUND: Do-not-resuscitate (DNR) orders instruct medical personnel to forego cardiopulmonary resuscitation in the event of cardiopulmonary arrest, but they do not preclude surgical management. Several studies have reported that DNR status is an independent predictor of 30-day mortality; however, the etiology of increased mortality remains unclear. We hypothesized that DNR patients would demonstrate increased postoperative mortality, but not morbidity, relative to non-DNR patients undergoing the same procedures...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28296534/trends-of-do-not-resuscitate-orders-hospice-care-utilization-and-late-referral-to-hospice-care-among-cancer-decedents-in-a-tertiary-hospital-in-taiwan-between-2008-and-2014-a-hospital-based-observational-study
#20
Tzu-Chien Shih, Hsiao-Ting Chang, Ming-Hwai Lin, Chun-Ku Chen, Tzeng-Ji Chen, Shinn-Jang Hwang
BACKGROUND: Out of respect for terminal patients' dignity and to decrease end-of-life suffering, patients in Taiwan can choose to sign do-not-resuscitate (DNR) orders and use hospice care when they are in a terminal condition. OBJECTIVES: To explore the trends and characteristics of hospice care utilization and DNR status among terminal cancer patients. Design and Setting/Subjects: A secondary data analysis was conducted to examine the rate of DNR orders, hospice care utilization, the survival time after DNR order, the duration of survival (DOS) after hospice care enrollment, and the rate of late referral to hospice care among patients who died from malignant cancers in a tertiary hospital in Taiwan between 2008 and 2014...
March 15, 2017: Journal of Palliative Medicine
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