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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
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
https://www.readbyqxmd.com/read/27927009/efficacy-and-safety-of-guardcel-nasal-packing-after-endoscopic-sinus-surgery-a-prospective-single-blind-randomized-controlled-study
#2
Byungjin Kang, Jeong-Rok Kim, Jae-Min Shin, Il-Ho Park, Heung-Man Lee
Objectives: Nasal packing after endoscopic sinus surgery is frequently used to control postoperative bleeding, enhance the wound healing process, and prevent lateralization of the middle turbinate, which causes insufficient ventilation. Many biodegradable materials have been developed to reduce pain and mucosal damage during packing removal. The purpose of this study was to compare the efficacy of Guardcel (Genewel Co.) middle meatal packing with a traditional nonabsorbable middle meatal packing, Merocel (Medtronic Xomed), on wound healing and patient satisfaction...
November 17, 2016: Clinical and Experimental Otorhinolaryngology
https://www.readbyqxmd.com/read/27926987/impact-of-everolimus-on-japanese-patients-with-advanced-pancreatic-neuroendocrine-neoplasms
#3
Lingaku Lee, Tetsuhide Ito, Hisato Igarashi, Keijiro Ueda, Takashi Fujiyama, Ken Kawabe, Yoshihiro Ogawa
BACKGROUND: Although everolimus has become a key therapeutic agent in patients with advanced pancreatic neuroendocrine neoplasms (PNEN), its efficacy and safety in clinical practice remains unclear. METHODS: Forty-seven patients with advanced PNEN treated with everolimus were reviewed retrospectively. To evaluate the safety of everolimus as a long-term treatment, the patients were divided into 2 groups according to treatment duration: group A, ≤1 year (n = 21); group B, >1 year (n = 26)...
December 7, 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27926986/long-term-safety-of-icatibant-treatment-of-patients-with-angioedema-in-real-world-clinical-practice
#4
Andrea Zanichelli, Marcus Maurer, Werner Aberer, Teresa Caballero, Hilary Longhurst, Laurence Bouillet, Vincent Fabien, Irmgard Andresen
The Icatibant Outcome Survey (IOS) is an observational study monitoring safety and effectiveness of icatibant in the real-world setting. We analyzed safety data from 3025 icatibant-treated attacks in 557 patients (enrolled between July 2009 and February 2015). Icatibant was generally well tolerated. Excluding off-label use and pregnancy, 438 patients (78.6%) did not report adverse events (AEs). The remaining 119 (21.4%) patients reported 341 AEs, primarily gastrointestinal disorders (19.6%). Of these, 43 AEs in 17 patients (3...
December 7, 2016: Allergy
https://www.readbyqxmd.com/read/27926972/management-of-endometriosis-in-the-infertile-patient
#5
Edgardo Somigliana, Paola Vigano, Laura Benaglia, Andrea Busnelli, Nicola Berlanda, Paolo Vercellini
The management of endometriosis-related infertility remains debated. However, in recent years, the role of in vitro fertilization (IVF) has progressively grown. Reasons to explain this change include (1) the improvement of the effectiveness and safety of IVF, (2) the raised awareness of the modest effectiveness of surgery, (3) the inherent risks of surgery including in particular the damage to the ovarian reserve when ovarian endometriomas have to be removed, (4) the ineffectiveness of intrauterine insemination and the possible risks of endometriosis progression associated with the use of this technique...
December 7, 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27926909/dexamethasone-implant-in-chronic-diabetic-macular-edema-resistant-to-intravitreal-ranibizumab-treatment
#6
Ozlem Eski Yucel, Ertugrul Can, Hilal Eser Ozturk, Hakki Birinci, Yuksel Sullu
PURPOSE: The aim of this study was to assess the efficacy of a single intravitreal dexamethasone implant (IDI) over 6 months in eyes with chronic diabetic macular edema (DME) that were resistant to intravitreal ranibizumab (IR) treatment. METHODS: This retrospective study was conducted at the Ondokuz Mayis University Hospital, Samsun, Turkey. Efficacy outcomes were considered as the change from baseline in best corrected visual acuity (BCVA) and central macular thickness (CMT)...
December 8, 2016: Ophthalmic Research
https://www.readbyqxmd.com/read/27926908/community-perceptions-of-biobanking-participation-a-qualitative-study-among-mexican-americans-in-three-texas-cities
#7
Natalia I Heredia, Sarah Krasny, Larkin L Strong, Laura Von Hatten, Lynne Nguyen, Belinda M Reininger, Lorna H McNeill, María E Fernández
BACKGROUND: Most biospecimens in the US are collected from non-Hispanic Whites, limiting the generalizability of findings. There is a need to increase participation in biobanking among ethnic and racial minorities. The purpose of this study was to use qualitative methods to identify factors that may influence Mexican-American individuals' willingness to participate in biobanking. METHODS: We conducted 15 focus groups in three Texas cities with Mexican-American individuals, in both Spanish and English...
December 8, 2016: Public Health Genomics
https://www.readbyqxmd.com/read/27926906/long-term-real-life-efficacy-and-safety-of-repeated-ozurdex%C3%A2-injections-and-factors-associated-with-macular-edema-resolution-after-retinal-vein-occlusion-the-remido-2-study
#8
Stéphan Pommier, Franck Meyer, Sébastien Guigou, Tony Barthelemy, Fréderic Gobert, Christian Hajjar, Pierre-Yves Merite, Eric Parrat, Hervé Rouhette, Fréderic Matonti
PURPOSE: The objective was to study long-term real-life efficacy and safety of repeated Ozurdex® injections and factors associated with macular edema (ME) resolution after retinal vein occlusion. METHODS: Patients with ME after retinal vein occlusion, receiving Ozurdex®, were included to assess the following endpoints: visual acuity and central retinal thickness, retreatment, number of injections, side effects and ME resolution. ME resolution was defined as permanent discontinuation of intravitreal injections (IVTs) for at least 6 months after the last IVT...
December 8, 2016: Ophthalmologica. Journal International D'ophtalmologie
https://www.readbyqxmd.com/read/27926826/potential-of-a-bpv1-l1-vlp-vaccine-to-prevent-bpv1-or-bpv2-induced-pseudo-sarcoid-formation-and-safety-and-immunogenicity-of-ecpv2-l1-vlps-in-the-horse
#9
Edmund K Hainisch, Hans Abel-Reichwald, Saeed Shafti-Keramat, Barbara Pratscher, Annunziata Corteggio, Giuseppe Borzacchiello, Maria Wetzig, Christoph Jindra, Alexander Tichy, Reinhard Kirnbauer, Sabine Brandt
We have previously shown that immunization of horses with BPV1 L1 virus-like particles (VLP) is safe and highly immunogenic, and that bovine papillomavirus types 1 and 2 (BPV1, BPV2) are closely related serotypes. Here we evaluated the protective potential of a BPV1 L1 VLP vaccine against experimental BPV1 and BPV2 challenge, and studied the safety and immunogenicity of a bivalent EcPV2/BPV1 L1 VLP vaccine. Fourteen healthy horses were immunized with BPV1 L1 VLPs (100 µg/injection) plus adjuvant on days 0 and 28, whilst seven remained unvaccinated...
December 7, 2016: Journal of General Virology
https://www.readbyqxmd.com/read/27926810/analysis-of-changes-in-cancer-health-care-system-in-poland-since-the-socio-economic-transformation-in-1989
#10
Dorota Dudek-Godeau, Anna Kieszkowska-Grudny, Katarzyna Kwiatkowska, Joanna Bogusz, Mirosław J Wysocki, Magdalena Bielska-Lasota
Background: The transformation period in Poland is associated with a set of factors seen as ‘socio-economic stress’, which unfavourably influenced cancer treatment and slowed down the progress of the Polish cancer care in the 90’s. These outcomes in many aspects of cancer care may be experienced till today. The results of the international EUROCARE and CONCORD studies based on European data prove evidence that there is a substantial potential for improvement of low 5-year survival rates in Poland...
2016: Roczniki Państwowego Zakładu Higieny
https://www.readbyqxmd.com/read/27926661/the-effect-of-intraoperative-and-6-h-postoperative-intravenous-administration-of-low-dose-prostacyclin-on-the-endothelium-hemostasis-and-hemodynamics-in-patients-undergoing-a-pancreaticoduodenoctemy-a-randomized-controlled-pilot-study
#11
Pär I Johansson, Christian R Mortensen, Tatiana Nielsen, Carsten Tollund, Jakob Stensballe, Carsten P Hansen, Hans J Frederiksen, Sisse R Ostrowski
BACKGROUND: Capillary leakage, secondary to endothelial breakdown, is common in patients undergoing major surgical procedures with extensive tissue injury and this is associated with increased morbidity and mortality. Prostacyclin has been ascribed cytoprotective properties together with its vasodilatory and antiplatelet effects. The present pilot study investigated the safety and endothelial protective effects of low-dose prostacyclin infusion. PATIENTS AND METHODS: A randomized placebo-controlled pilot study evaluating the effect of prostacyclin (iloprost) infusion (1...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27926652/hysteroscopic-sterilization-with-essure-summary-of-the-u-s-food-and-drug-administration-actions-and-policy-implications-for-postmarketing-surveillance
#12
Jessica R Walter, Comeron W Ghobadi, Emily Hayman, Shuai Xu
In September 2015, the U.S. Food and Drug Administration (FDA) convened a meeting of the Obstetrics and Gynecology Advisory Board Committee to address the sudden increase of patient-reported adverse events surrounding Essure, a Class III device offering a less invasive method for permanent female sterilization. After a review of the premarketing and postmarketing data and existing scientific literature, the FDA concluded there was insufficient evidence to remove the device from the market. However, the FDA did release a new guidance document requiring a black box warning for the device and ordered a new postmarketing study comparing Essure's safety and efficacy with laparoscopic tubal sterilization...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27926634/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#13
Joseph E Pellegrini, Paloma Toledo, David E Soper, William C Bradford, Deborah A Cruz, Barbara S Levy, Lauren A Lemieux
Surgical site infections are the most common complication of surgery in the United States. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effort to reduce the incidence of surgical site infection...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27926632/a-pooled-analysis-of-robotic-versus-laparoscopic-surgery-for-colon-cancer
#14
Bo-Shi Duan, Guo-Hua Zhao, Helen Yang, Yue Wang
OBJECTIVE: An increasing number of studies have been reported since the "Da Vinci" Robotic System was used in gastrointestinal disease. Thus, we conducted this meta-analysis to evaluate the safety and efficacy of robotic colectomy (RC) compared with laparoscopic colectomy (LC) in the treatment of colon cancer. METHOD: A systematic search of Medline, Embase databases, and the Cochrane Library was performed to identify studies that compared RC and LC and were published up to February 2015...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27926620/tapping-magnet%C3%A2-s-culture-of-innovation-to-improve-the-patient-experience
#15
Jennifer Rainer
As incentives grow for healthcare organizations to improve the patient experience, an increasing number choose to add consumers directly into their leadership structures. In this final installment about the value of patient and family advisory councils, the senior director of quality at a large, Magnet®-recognized Texas hospital explains how tapping into a well-established Magnet culture helped the organization adopt innovative approaches that produced positive change. Based on an interview with the author, she notes that seeing basic issues through patients' eyes challenged long-held beliefs and led to improvements in a wide variety of areas...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27926587/anti-programmed-cell-death-protein-1-tolerance-and-efficacy-after-ipilimumab-immunotherapy-observational-study-of-39-patients
#16
Reyhan Amode, Barouyr Baroudjian, Anita Kowal, Majdi Jebali, Clara Allayous, Martine Bagot, Nika Madjlessi, Jennifer Roux, Manuelle Viguier, Nicole Basset Seguin, Raphaël Porcher, Cécile Pagès, Céleste Lebbé
In patients with ipilimumab (IPI)-refractory melanoma, the anti-programmed cell death proteins 1 (PD1s) nivolumab (NIV) and pembrolizumab (PEM) are considered to be a new standard of treatment. Few data are available on anti-PD1 safety in patients who develop IPI-related severe adverse events (AEs) (grade≥3). The aim of this study was to compare the anti-PD1 safety and efficacy in patients with previous severe toxicity to IPI versus in those showing moderate and no previous IPI-related AEs. This single institution-based observational study included all patients treated with anti-PD1 (PEM or NIV) and previously treated with IPI for unresectable stage III or IV melanoma...
December 6, 2016: Melanoma Research
https://www.readbyqxmd.com/read/27926565/oncologic-outcomes-following-laparoscopic-versus-open-resection-of-pt4-colon-cancer-a-systematic-review-and-meta-analysis
#17
Adina E Feinberg, Tyler R Chesney, Sergio A Acuna, Tarik Sammour, Fayez A Quereshy
BACKGROUND: Locally advanced colon cancer is considered a relative contraindication for laparoscopic resection, and clinical trials addressing the oncologic safety are lacking. OBJECTIVE: The aim of this study was to synthesize the oncologic outcomes associated with laparoscopic versus conventional open surgery for locally advanced colon cancers. DATA SOURCES: We systematically searched Medline, Embase, Central, and ClinicalTrials.gov. STUDY SELECTION: Two reviewers independently screened the literature for controlled trials or observational studies comparing curative-intent laparoscopic and open surgery for colon cancer...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27926563/truth-in-reporting-how-data-capture-methods-obfuscate-actual-surgical-site-infection-rates-within-a-health-care-network-system
#18
Liliana Bordeianou, Christy E Cauley, Donna Antonelli, Sarah Bird, David Rattner, Matthew Hutter, Sadiqa Mahmood, Deborah Schnipper, Marc Rubin, Ronald Bleday, Pardon Kenney, David Berger
BACKGROUND: Two systems measure surgical site infection rates following colorectal surgeries: the American College of Surgeons National Surgical Quality Improvement Program and the Centers for Disease Control and Prevention National Healthcare Safety Network. The Centers for Medicare & Medicaid Services pay-for-performance initiatives use National Healthcare Safety Network data for hospital comparisons. OBJECTIVE: This study aimed to compare database concordance...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27926562/long-term-experience-of-magnetic-anal-sphincter-augmentation-in-patients-with-fecal-incontinence
#19
Jeremy Sugrue, Paul-Antoine Lehur, Robert D Madoff, Shane McNevin, Steen Buntzen, Søren Laurberg, Anders Mellgren
BACKGROUND: Magnetic anal sphincter augmentation is a novel technique for the treatment of patients with fecal incontinence. OBJECTIVE: The current study reports the long-term effectiveness and safety of this new treatment modality. DESIGN: This was a prospective multicenter pilot study. SETTINGS: The study was performed at 4 clinical sites in Europe and the United States. PATIENTS: The cohort included patients with severe fecal incontinence for ≥6 months who had previously failed conservative therapy and were implanted with a magnetic anal sphincter device between 2008 and 2011...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27926556/natural-orifice-specimen-extraction-with-single-stapling-colorectal-anastomosis-for-laparoscopic-anterior-resection-feasibility-outcomes-and-technical-considerations
#20
Bansal Saurabh, Sheng-Chi Chang, Tao-Wei Ke, Yu-Chun Huang, Takashi Kato, Hwei-Ming Wang, William Tzu-Liang Chen, Abe Fingerhut
BACKGROUND: Double and triple stapling techniques to close the rectal stump in laparoscopic anterior resection are fraught with technical drawbacks that could possibly be avoided with the use of the single stapling technique. However, little is known of its safety in laparoscopic surgery or outcomes when combined with natural orifice specimen extraction. OBJECTIVE: This study aims to analyze the feasibility and the operative and immediate postoperative outcomes of single-stapled anastomosis and natural orifice specimen extraction with conventional techniques...
January 2017: Diseases of the Colon and Rectum
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