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David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
Harriet Mortimer, Haytham Kubba
The National Confidential Enquiry into Patient Outcome and Death recently conducted a large, robust study investigating tracheostomy care for patients in England, Wales and Northern Ireland. They found up to 31% of tracheostomy patients experience a complication at some stage in their care, many of which were serious. This study aims to explore the nature of adverse events and complications affecting tracheostomy patients across the diverse hospitals of NHS Greater Glasgow and Clyde (NHSGGC) including both adult and paediatric populations over a 6-year period between 2008 and 2014...
October 19, 2016: Clinical Otolaryngology
John J Wroblewski, Allen Y Hu
BACKGROUND AND OBJECTIVE: To evaluate the effects of squalamine (OHR-102; Ohr Pharmaceuticals, New York, NY) and ranibizumab (Lucentis; Genentech, South San Francisco, CA) on macular edema (ME) secondary to retinal vein occlusion (RVO). PATIENTS AND METHODS: Twenty consecutive, treatment-naïve patients with RVO-related ME received topical squalamine and intravitreal ranibizumab 0.5 mg for 10 weeks, followed by randomization to continue or discontinue squalamine...
October 1, 2016: Ophthalmic Surgery, Lasers & Imaging Retina
Nathan Elie Frenk, Fernando Sebastianes, Antonio Marcondes Lerario, Maria Candida Barisson Villares Fragoso, Berenice Bilharinho Mendonca, Marcos Roberto de Menezes
OBJECTIVES: To evaluate the safety and long-term efficacy of computed tomography-guided percutaneous ethanol ablation for benign primary and secondary hyperfunctioning adrenal disorders. METHOD: We retrospectively evaluated the long-term results of nine patients treated with computed tomography-guided percutaneous ethanol ablation: eight subjects who presented with primary adrenal disorders, such as pheochromocytoma, primary macronodular adrenal hyperplasia and aldosterone-producing adenoma, and one subject with Cushing disease refractory to conventional treatment...
October 1, 2016: Clinics
Roberto Hegg, André Mattar, João Nunes de Matos-Neto, José Luiz Pedrini, Sabina Bandeira Aleixo, Roberto Odebrecht Rocha, Renato Peixoto Cramer-Junior, Sylvie van-Eyll-Rocha
OBJECTIVES: To compare the efficacy and safety of two filgrastim formulations for controlling chemotherapy-induced neutropenia and to evaluate the non-inferiority of the test drug relative to the originator. METHODS: This phase III non-inferiority study had a randomized, multicenter, and open-label design. The patients were randomized at a ratio of 1:1 with a follow-up period of 6 weeks for each patient. In both study arms, filgrastim was administered subcutaneously at a daily dose of 5 mg/kg body weight...
October 1, 2016: Clinics
Lívia Falcão Lima, Bruna Cristina Cardoso Martins, Francisco Roberto Pereira de Oliveira, Rafaela Michele de Andrade Cavalcante, Vanessa Pinto Magalhães, Paulo Yuri Milen Firmino, Liana Silveira Adriano, Adriano Monteiro da Silva, Maria Jose Nascimento Flor, Eugenie Desirée Rabelo Néri
Objective: To describe and analyze the pharmaceutical orientation given at hospital discharge of transplant patients. Methods: This was a cross-sectional, descriptive and retrospective study that used records of orientation given by the clinical pharmacist in the inpatients unit of the Kidney and Liver Transplant Department, at Hospital Universitário Walter Cantídio, in the city of Fortaleza (CE), Brazil, from January to July, 2014. The following variables recorded at the Clinical Pharmacy Database were analyzed according to their significance and clinical outcomes: pharmaceutical orientation at hospital discharge, drug-related problems and negative outcomes associated with medication, and pharmaceutical interventions performed...
July 2016: Einstein
Flavia Petrini, Ida Di Giacinto, Rita Cataldo, Clelia Esposito, Vittorio Pavoni, Paolo Donato, Antonella Trolio, Guido Merli, Massimiliano Sorbello, Paolo Pelosi
Proper management of obese patients requires a team vision and appropriate behaviors by all health care providers in hospital. Specialist competencies are fundamental, as are specific clinical pathways and good clinical practices designed to deal with patients whose body mass index is ≥30 kg/m2. Standards of care for bariatric and non-bariatric surgery and for the critical care management of this population exist but are not well defined nor clearly followed in every hospital. Thus every anesthesiologist is likely to deal with this challenging population...
October 19, 2016: Minerva Anestesiologica
Mengjing Wang, Jason Chou, Yongen Chang, Wei L Lau, Uttam Reddy, Connie M Rhee, Jing Chen, Chuanming Hao, Kamyar Kalantar-Zadeh
In the management of patients with chronic kidney diseases (CKD), a low-protein diet usually refers to a diet with protein intake of 0.6 to 0.8 grams per kilogram of body weight per day (g/kg/day) and should include at least 50% high-biologic-value protein. It may be supplemented with essential acids or nitrogen- free ketoanalogues if <0.6 g/kg/d. Low-protein diet can reduce proteinuria especially in non-diabetic CKD patients. In hypoalbuminemic patients it may lead to an increase in serum albumin level...
October 19, 2016: Panminerva Medica
Takahisa Hiramitsu, Manabu Okada, Kenta Futamura, Takayuki Yamamoto, Makoto Tsujita, Norihiko Goto, Shunji Narumi, Yoshihiko Watarai
This study aimed to investigate the impact of grafting using thin upper pole artery ligation for living-donor adult kidney transplantation. Few reports have examined the safety of thin upper pole artery ligation.Between January 2008 and May 2015, 613 consecutive living-donor adult kidney transplantations were performed. We excluded 21 recipients who experienced graft loss due to factors that were unrelated to surgical complications and 3 recipients with grafts treated with arterial reconstruction and thin upper pole artery ligation for 3 arteries...
October 2016: Medicine (Baltimore)
Ping Wei, Jia-Wei Yang, Hai-Wen Lu, Bei Mao, Wen-Lan Yang, Jin-Fu Xu
BACKGROUND AND OBJECTIVE: There is presently no clear evidence on the effect of combined treatment for non-cystic fibrosis (non-CF) bronchiectasis with inhaled corticosteroid (ICS) and long-acting β2-adrenergic agonist (LABA). The objective of this study is to assess the efficacy and safety of salmeterol-fluticasone combined inhaled therapy for non-CF bronchiectasis with airflow limitation. METHODS: An observational study was performed in 120 non-CF bronchiectasis patients diagnosed by high-resolution computed tomography (HRCT) scanning of the chest...
October 2016: Medicine (Baltimore)
Julian C Harnoss, Isabelle Zelienka, Pascal Probst, Kathrin Grummich, Catharina Müller-Lantzsch, Jonathan M Harnoss, Alexis Ulrich, Markus W Büchler, Markus K Diener
OBJECTIVE: The aim was to investigate available evidence regarding effectiveness and safety of surgical versus conservative treatment of acute appendicitis. SUMMARY OF BACKGROUND DATA: There is ongoing debate on the merits of surgical and conservative treatment for acute appendicitis. METHODS: A systematic literature search (Cochrane Library, Medline, Embase) and hand search of retrieved reference lists up to January 2016 was conducted to identify randomized and nonrandomized studies...
October 17, 2016: Annals of Surgery
Homero Rivas, Ignacio Robles, Francisco Riquelme, Marcelo Vivanco, Julio Jiménez, Boris Marinkovic, Mario Uribe
OBJECTIVE: To evaluate a new magnetic surgical system during reduced-port laparoscopic cholecystectomy in a prospective, multicenter clinical trial. BACKGROUND: Laparoscopic instrumentation coupled by magnetic fields may enhance surgeon performance by allowing for shaft-less retraction and mobilization. The movements can be performed under direct visualization, generating different angles of traction and reducing the number of trocars to perform the procedure. This may reduce well-known associated complications of trocars, including incisional pain, scarring, infection, bowel, and vascular injuries, among others...
October 17, 2016: Annals of Surgery
Kathleen Rice Simpson
No abstract text is available yet for this article.
November 2016: MCN. the American Journal of Maternal Child Nursing
Diane VonBehren, Molly M Killion, Carol Burke, Betsy Finkelmeier, Brigit Zamora
Three teams of perinatal expert nurses participated in planning and designing a new maternity unit, operationalizing the move to the new space, and evaluating care processes and workflows after the move. The hospitals involved were University of California, San Francisco Benioff Children's Hospital, Prentice Women's Hospital of Northwestern Memorial Healthcare in Chicago, IL, and Florida Hospital Orlando, Florida Hospital for Women. Although each team discussed specific details and lessons learned, there is remarkable consistency among the experiences of these teams and with the discussion of the process by the team at Mercy Hospital St...
November 2016: MCN. the American Journal of Maternal Child Nursing
Beth Wieczorek, Judith Ascenzi, Yun Kim, Hallie Lenker, Caroline Potter, Nehal J Shata, Lauren Mitchell, Catherine Haut, Ivor Berkowitz, Frank Pidcock, Jeannine Hoch, Connie Malamed, Tamara Kravitz, Sapna R Kudchadkar
OBJECTIVE: To determine the safety and feasibility of an early mobilization program in a PICU. DESIGN: Observational, pre-post design. SETTING: PICU in a tertiary academic hospital in the United States. PATIENTS: Critically ill pediatric patients admitted to the PICU. INTERVENTION: This quality improvement project involved a usual-care baseline phase, followed by a quality improvement phase that implemented a multicomponent, interdisciplinary, and tiered activity plan to promote early mobilization of critically ill children...
October 10, 2016: Pediatric Critical Care Medicine
Elizabeth A Atchison, Ahmed F Omar, Raymond Iezzi, Andrew J Barkmeier, Sophie J Bakri
PURPOSE: To examine the safety outcomes of an intravitreal injection-only clinic where patients needing long-term anti-vascular endothelial growth factor therapy are treated with injections at a predetermined interval for a set number of injections without an accompanying clinic visit. METHODS: This is a retrospective chart review of all patients with exudative macular degeneration treated in an intravitreal injection clinic over a 4-year period. Data on the outcome measures of interest were gathered from electronic medical records...
October 18, 2016: Retina
Justin C Chia, P Régine Mydlarski
PURPOSE: Omalizumab is a recombinant humanized monoclonal antibody that inhibits the binding of IgE to the high-affinity IgE receptor (FceRI) on the surface of mast cells and basophils. Omalizumab has been approved for use in asthma, and new reports show promise in a variety of dermatologic diseases. Herein, we review the literature on omalizumab in dermatology and discuss the safety, efficacy and mechanisms of action for this emerging therapy. MATERIALS AND METHODS: PubMED, MEDLINE, and Embase databases were searched for the period January 1, 1990, to September 1, 2016...
October 19, 2016: Journal of Dermatological Treatment
V E Radzinskii, I V Kuznetsova, Y B Uspenskaya, N B Repina, Y K Gusak, O M Zubova, D I Burchakov, A A Osmakova
Peri- and postmenopausal women commonly suffer from climacteric symptoms. We evaluated the effectiveness and safety of dietary supplement Amberen to relieve vasomotor and psychosomatic symptoms during the course of a 3-month, randomized, double-blind, placebo-controlled study. General clinical assessment, evaluation using the Greene climacteric test and Spielberger-Hanin test, determination of plasma levels of gonadotropins, estradiol, leptin and apolipoproteins were used to evaluate 42-60-year-old women with vasomotor and psychosomatic menopausal symptoms...
October 2016: Gynecological Endocrinology
V R Badhwar, S Ganapathy, P P Prabhudesai, N K Tulara, A Y Varaiya, D Vyas
In community and family practice, infections are a common OPD presentation. In the management of common bacterial infections seen in community especially RTI, UTI, SSTI; cefuroxime a second generation cephalosporin with a broad spectrum of activity can be used for empirical treatment. To know current place of cefuroxime in the management of infections, physicians, surgeons, microbiologist, chest physician, gynecologist and pediatrician came together to discuss and debate their experience with cefuroxime and its place in today's world...
July 2016: Journal of the Association of Physicians of India
Barbara A Morrongiello, Amanda Cox
In most industrialized countries, injuries are the leading cause of death for children 1 through 18 years of age. For infants, many injuries occur in the home when they are acquiring new motor milestones. Thus, as infants' motor competencies change with development, creating increasing opportunities for them to interact with hazards, parent safety strategies need to adapt in synchrony in order to sustain a safe ecological niche and prevent injuries. The present study examined parent safety practices when infants were pre-mobile (i...
November 2016: Developmental Psychobiology
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