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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/28343225/clinical-trial-of-vadadustat-in-patients-with-anemia-secondary-to-stage-3-or-4-chronic-kidney-disease
#2
Edouard R Martin, Mark T Smith, Bradley J Maroni, Qing C Zuraw, Emil M deGoma
BACKGROUND: Therapeutic options for the treatment of anemia secondary to chronic kidney disease (CKD) remain limited. Vadadustat (AKB-6548) is an oral hypoxia-inducible factor prolyl-hydroxylase domain (HIF-PHD) inhibitor that is being investigated for the treatment of anemia secondary to CKD. METHODS: A phase 2a, multicenter, randomized, double-blind, placebo-controlled, dose-ranging trial (NCT01381094) was undertaken in adults with anemia secondary to CKD stage 3 or 4...
March 25, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28343221/abandoning-prophylactic-abdominal-drainage-after-hepatic-surgery-10-years-of-no-drain-policy-in-an-enhanced-recovery-after-surgery-environment
#3
Edgar M Wong-Lun-Hing, Victor van Woerden, Toine M Lodewick, Marc H A Bemelmans, Steven W M Olde Damink, Cornelis H C Dejong, Ronald M van Dam
BACKGROUND: Routine prophylactic abdominal drainage after hepatic surgery is still being debated, as it may be unnecessary, possibly harmful, and uncomfortable for patients. This study evaluated the safety of a no-drain policy after liver resection within an Enhanced Recovery after Surgery (ERAS) programme. METHODS: All hepatectomies performed without prophylactic drainage during 2005-2014 were included. Primary end points were resection-surface-related (RSR) morbidity, defined as the presence of postoperative biloma, hemorrhage or abscess, and reinterventions...
March 25, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28343177/gaps-in-obstetric-care-processes-we-can-only-improve-what-is-being-measured
#4
Charlotte Millde Luthander, Hans Järnbert Pettersson, Ulf Högberg, Sophie Berglund, Charlotta Grunewald
A multifaceted intervention at all six obstetric units in the Stockholm Health Region was performed in 2008-2011 in order to increase safety for the newborn infants. Case-controlled criterion-based reviews of care processes during labor and delivery have been used to assess factors associated with suboptimal care during labor and delivery. Categories of increased risk of adverse outcome during labor and delivery were defined. Cases with low Apgar scores and healthy controls were scrutinized and compared to data from a study with an identical design performed before the intervention...
March 27, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28343164/a-quantitative-concordance-measure-for-comparing-and-combining-treatment-selection-markers
#5
Zhiwei Zhang, Shujie Ma, Lei Nie, Guoxing Soon
Motivated by an HIV example, we consider how to compare and combine treatment selection markers, which are essential to the notion of precision medicine. The current literature on precision medicine is focused on evaluating and optimizing treatment regimes, which can be obtained by dichotomizing treatment selection markers. In practice, treatment decisions are based not only on efficacy but also on safety, cost and individual preference, making it difficult to choose a single cutoff value for all patients in all settings...
March 25, 2017: International Journal of Biostatistics
https://www.readbyqxmd.com/read/28343124/effects-of-acute-alcohol-consumption-on-measures-of-simulated-driving-a-systematic-review-and-meta-analysis
#6
Christopher Irwin, Elizaveta Iudakhina, Ben Desbrow, Danielle McCartney
Driving simulators are used in a wide range of research settings to help develop an understanding of driver behavior in complex environments. Acute alcohol impairment is an important research topic for traffic safety and a large number of studies have indicated levels of simulated driving impairment imposed by alcohol across a range of performance outcome variables. The aim of the present study was to examine the impact of acute alcohol consumption on simulated driving performance by conducting a systematic review and meta-analysis of the available evidence...
March 23, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28343123/estimation-of-red-light-running-frequency-using-high-resolution-traffic-and-signal-data
#7
Peng Chen, Guizhen Yu, Xinkai Wu, Yilong Ren, Yueguang Li
Red-light-running (RLR) emerges as a major cause that may lead to intersection-related crashes and endanger intersection safety. To reduce RLR violations, it's critical to identify the influential factors associated with RLR and estimate RLR frequency. Without resorting to video camera recordings, this study investigates this important issue by utilizing high-resolution traffic and signal event data collected from loop detectors at five intersections on Trunk Highway 55, Minneapolis, MN. First, a simple method is proposed to identify RLR by fully utilizing the information obtained from stop bar detectors, downstream entrance detectors and advance detectors...
March 23, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28343112/the-impact-of-australian-legislative-changes-on-synthetic-cannabinoid-exposures-reported-to-the-new-south-wales-poisons-information-centre
#8
Rose Cairns, Jared A Brown, Naren Gunja, Nicholas A Buckley
BACKGROUND: The emergence of new psychoactive substances (NPS), including synthetic cannabinoid receptor agonists (SCRAs) poses novel challenges for drug regulation and public health. Misconceptions of safety and legality, coupled with the fact that NPS are undetectable on routine drugs screens contributes to their popularity. Concerns over the unpredictable toxicity and abuse potential of NPS has led to a variety of legislative responses worldwide. We wish to describe Australian trends in SCRA use, examining the effects of legislative changes on calls to Australia's largest poisons centre...
March 23, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28343108/the-effects-of-modified-versus-unmodified-wheat-gluten-administration-in-patients-with-celiac-disease
#9
Mariacatia Marino, Rossella Casale, Raffaele Borghini, Sara Di Nardi, Giuseppe Donato, Antonio Angeloni, Salvatore Moscaritolo, Lorenza Grasso, Giuseppe Mazzarella, Marco Di Tola, Mauro Rossi, Antonio Picarelli
Celiac disease (CD) treatment requires a gluten-free diet (GFD), although alternative approaches have been proposed. Modification of gliadin peptides using microbial transglutaminase (mTG) inhibits their ability to induce immune response in vitro. Our aim was to evaluate the safety of mTG-modified wheat flour ingestion in CD patients. Twenty-one CD patients in remission were randomized to receive mTG-modified (n=11) or unmodified (n=10) wheat flour rusks, in double-blind fashion. Monthly, patients completed a symptom questionnaire...
March 23, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28343105/photoluminescence-light-up-detection-of-zinc-ion-and-imaging-in-living-cells-based-on-the-aggregation-induced-emission-enhancement-of-glutathione-capped-copper-nanoclusters
#10
Liyun Lin, Yuefang Hu, Liangliang Zhang, Yong Huang, Shulin Zhao
In this work, we prepared glutathione (GSH)-capped copper nanoclusters (Cu NCs) with red emission by simply adjusting the pH of GSH/Cu(2+) mixture at room temperature. A photoluminescence light-up method for detecting Zn(2+) was then developed based on the aggregation induced emission enhancement of GSH-capped Cu NCs. Zn(2+) could trigger the aggregation of Cu NCs, inducing the enhancement of luminescence and the increase of absolute quantum yield from 1.3% to 6.2%. GSH-capped Cu NCs and the formed aggregates were characterized, and the possible mechanism was also discussed...
March 19, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28343051/tolerability-of-cariprazine-in-the-treatment-of-acute-bipolar-i-mania-a-pooled-post-hoc-analysis-of-3-phase-ii-iii-studies
#11
Willie Earley, Suresh Durgam, Kaifeng Lu, Marc Debelle, István Laszlovszky, Eduard Vieta, Lakshmi N Yatham
BACKGROUND: Atypical antipsychotics have broad-spectrum efficacy against core symptoms of acute mania/mixed states in bipolar disorder; however, they are associated with clinically significant adverse effects (AEs). METHODS: This post hoc analysis evaluated the safety and tolerability of the atypical antipsychotic cariprazine in the treatment of adult patients with acute manic/mixed episodes of bipolar I disorder. Data were taken from three 3-week randomized, double-blind, placebo-controlled, flexible-dose trials of cariprazine 3-12mg/d...
March 9, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28343022/stakeholder-evaluation-of-an-online-program-to-promote-physical-activity-and-workplace-safety-for-individuals-with-disability
#12
Mara Nery-Hurwit, Laurel Kincl, Simon Driver, Brittany Heller
Individuals with disabilities face increasing health and employment disparities, including increased risk of morbidity and mortality and decreased earnings, occupational roles, and greater risk of injury at work. Thus, there is a need to improve workplace safety and health promotion efforts for people with disability. The purpose of this study was to obtain stakeholder feedback about an online program, Be Active, Work Safe, which was developed to increase the physical activity and workplace safety practices of individuals with disability...
March 11, 2017: Evaluation and Program Planning
https://www.readbyqxmd.com/read/28343014/natural-lipids-enriched-self-nano-emulsifying-systems-for-effective-co-delivery-of-tamoxifen-and-naringenin-systematic-approach-for-improved-breast-cancer-therapeutics
#13
Premjeet Singh Sandhu, Rajendra Kumar, Sarwar Beg, Sanyog Jain, Varun Kushwah, O P Katare, Bhupinder Singh
The nano-miceller drug delivery carriers of tamoxifen (TMX) having natural ingredients like polyunsaturated fatty acid (PUFA) with self-nano-emulsifying properties was developed with naringenin (NG) in a synergistic manner i.e. TMX-NG-SNEDDS. The optimized nano-formulation revealed complete drug release in 30min and >80% permeation in 45min. Superior cellular uptake potential (4.6 to 6.5-fold) of the TMX-NG-SNEDDS using Caco-2 cells while cytotoxicity study on MCF-7 cells indicated significant results (P<0...
March 23, 2017: Nanomedicine: Nanotechnology, Biology, and Medicine
https://www.readbyqxmd.com/read/28342949/use-of-thiopurines-during-conception-and-pregnancy-not-associated-with-adverse-pregancy-outcomes-or-health-of-infants-at-1-year-in-a-prospective-study
#14
Shannon L Kanis, Alison de Lima-Karagiannis, Nanne K H de Boer, C Janneke van der Woude
BACKGROUND & AIMS: Most data on the safety of thiopurine therapy for inflammatory bowel disease (IBD) during pregnancy come from retrospective studies, making it difficult to adjust for confounding factors. We performed a prospective cohort study to determine whether thiopurine use affects pregnancy outcomes or health outcomes of children. METHODS: We performed a prospective study of all women who visited the IBD preconception outpatient clinic at our tertiary health center in The Netherlands from December 2008 through May 2016...
March 22, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28342880/-for-a-targeted-use-of-aspirin
#15
H Madar, S Brun, F Coatleven, A Nithart, C Lecoq, M Gleyze, B Merlot, L Sentilhes
The use of low-dose aspirin in pregnancy should remain a highly targeted indication since its long-term safety has not been established and should be restricted to women at high risk of vascular complications. Indications for which the benefit of aspirin has been shown are women with a history of preeclampsia responsible for a premature birth before 34 weeks, those having at least two history of preeclampsia, those with an antiphospholipid syndrome and those with lupus associated with positive antiphospholipid antibodies or renal failure...
March 22, 2017: Gynecol Obstet Fertil Senol
https://www.readbyqxmd.com/read/28342837/-malignant-cutaneous-adnexal-neoplasms-of-the-face-and-scalp-diagnostic-and-therapeutic-update
#16
M Romeu, J M Foletti, C Chossegros, J P Dales, P Berbis, B Cribier, L Guyot
INTRODUCTION: Malignant cutaneous adnexal neoplasms are rare and have been characterized only recently. They can occur at any age but preferentially in elderly. There are 3 of them: trichoblastic carcinoma, trichilemmal carcinoma and malignant pilomatricoma. The aim of our study was to make a diagnostic and therapeutic update about these tumors when located at the face or at the scalp. MATERIALS AND METHODS: A bibliographic research was made on PubMed using following keywords: appendage skin carcinoma AND pathology AND/OR therapeutic...
March 22, 2017: J Stomatol Oral Maxillofac Surg
https://www.readbyqxmd.com/read/28342824/development-of-car-t-cells-designed-to-improve-antitumor-efficacy-and-safety
#17
REVIEW
Janneke E Jaspers, Renier J Brentjens
Chimeric antigen receptor (CAR) T cell therapy has shown promising efficacy against hematologic malignancies. Antitumor activity of CAR T cells, however, needs to be improved to increase therapeutic efficacy in both hematologic and solid cancers. Limitations to overcome are 'on-target, off-tumor' toxicity, antigen escape, short CAR T cell persistence, little expansion, trafficking to the tumor and inhibition of T cell activity by an inhibitory tumor microenvironment. Here we will discuss how optimizing the design of CAR T cells through genetic engineering addresses these limitations and improves the antitumor efficacy of CAR T cell therapy in pre-clinical models...
March 22, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28342700/nicotine-replacement-therapy-in-patients-with-aneurysmal-subarachnoid-hemorrhage-systematic-review-of-the-literature-and-survey-of-canadian-practice
#18
REVIEW
Ricky D Turgeon, Stephano J Chang, Charlotte Dandurand, Peter A Gooderham, Camille Hunt
Tobacco smoke increases the risk of aneurysmal subarachnoid hemorrhage (SAH), as well as complications such as vasospasm. Most patients presenting with aneurysmal SAH smoke, and many survivors continue to smoke after discharge. Neurosurgeons often hesitate to use nicotine replacement therapy (NRT) during hospitalization of patients with SAH due to concerns of inducing vasospasm. We aimed to evaluate the safety and efficacy, and patterns of use of NRT in smokers hospitalized for SAH. We performed a systematic review of MEDLINE, CENTRAL, Embase, and unpublished sources of literature to October 2016 for randomized and observational studies comparing exposure to non-exposure of smoking cessation products in the acute phase of aneurysmal SAH...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28342695/in%C3%A2-vivo-serum-concentration-of-vancomycin-in-antibiotic-loaded-acrylic-cement-for-the-treatment-and-prevention-of-periprosthetic-hip-infection
#19
Kenichi Oe, Hirokazu Iida, Narumi Ueda, Tomohisa Nakamura, Naofumi Okamoto, Yusuke Ueda
BACKGROUND: Although antibiotic-loaded acrylic cement (ALAC) is used to prevent and treat periprosthetic hip infection, it is unknown how much antibiotic is deposited in the body in vivo, how high the serum concentration rises, or how long its effects last. The aim of this study was firstly to determine the amount of vancomycin (VCM) deposited as ALAC in the body, and secondly to assess the safety and drug elution profile of VCM in ALAC. METHODS: We administered VCM to prevent infection after total hip arthroplasty (THA) or to treat patients with methicillin-resistant Staphylococcus aureus...
March 22, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28342650/subtotal-cholecystectomy-for-the-hostile-gallbladder-failure-to-control-the-cystic-duct-results-in-significant-morbidity
#20
Michael E Lidsky, Paul J Speicher, Brian Ezekian, Edwin W Holt, Daniel P Nussbaum, Anthony W Castleberry, Alexander Perez, Theodore N Pappas
BACKGROUND: Outcomes following the inability to control the cystic duct due to a hostile triangle of Calot during cholecystectomy remain unknown. The purpose of this study was to analyze the safety and efficacy of subtotal cholecystectomy, with attention to the necessity for secondary interventions. METHODS: Sixteen thousand five hundred ninety six cholecystectomies from January 2002 to August 2014 were reviewed, identifying patients managed with subtotal cholecystectomy, defined as the inability to isolate/transect the cystic duct...
March 22, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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