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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/28734130/right-lobe-living-donors-ages-55-and-older-in-liver-transplantation
#2
Seong Hoon Kim, Eung Chang Lee, Jae Ryong Shim, Sang Jae Park
Insufficient is the evidence for safe use of elderly donors in adult-to-adult living donor liver transplantation (LDLT). The aim of this study was to evaluate the outcomes of right lobe LDLT by donor age (≥55 vs. <55 years). All living donors who underwent right hepatectomy at the authors' institution between March 2008 and December 2015 were divided into 2 groups: group A with an age ≥ 55 and group B with an age < 55. The selection criteria for elderly donor were preservation of middle hepatic vein, remnant liver volume ≥30%, and no or mild fatty liver...
July 22, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28732391/a-new-intraductal-radiofrequency-ablation-device-for-inoperable-biliopancreatic-tumors-complicated-by-obstructive-jaundice-the-ignite-1-study
#3
Wim Laleman, Schalk van der Merwe, Len Verbeke, Dirk Vanbeckevoort, Raymond Aerts, Hans Prenen, Eric Van Cutsem, Chris Verslype
Background and study aims Biliary stenting of unresectable malignant bile duct obstruction is generally accepted as the standard of care but it can be hampered by tumor ingrowth and stent dysfunction. We aimed to test the feasibility, safety, and biliary patency rate of a new endoscopically applied intraductal radiofrequency ablation (RFA) device. Patients and methods Eighteen patients with inoperable malignant biliary obstruction underwent endoscopic retrograde cholangiopancreatography (ERCP)-directed RFA and stenting...
July 21, 2017: Endoscopy
https://www.readbyqxmd.com/read/28732390/a-novel-hitch-and-ride-deep-biliary-cannulation-method-during-rendezvous-endoscopic-ultrasound-guided-ercp-technique
#4
Yousuke Nakai, Hiroyuki Isayama, Saburo Matsubara, Hirofumi Kogure, Suguru Mizuno, Tsuyoshi Hamada, Naminatsu Takahara, Tomoka Nakamura, Tatsuya Sato, Tsuyoshi Takeda, Ryunosuke Hakuta, Kazunaga Ishigaki, Kei Saito, Minoru Tada, Kazuhiko Koike
Background and study aim Endoscopic ultrasound-guided rendezvous (EUS-RV) is increasingly reported as a treatment option after failed endoscopic retrograde cholangiopancreatography. We developed a novel "hitch-and-ride" catheter for biliary cannulation to reduce the risk of guidewire loss during EUS-RV. Patients and methods We retrospectively evaluated safety and technical success of EUS-RV between June 2011 and May 2016. Biliary cannulation during EUS-RV using three methods - over-the-wire, along-the-wire, and hitch-and-ride - were compared...
July 21, 2017: Endoscopy
https://www.readbyqxmd.com/read/28732386/a-phase-i-trial-of-nk-92-cells-for-refractory-hematological-malignancies-relapsing-after-autologous-hematopoietic-cell-transplantation-shows-safety-and-evidence-of-efficacy
#5
Brent A Williams, Arjun Datt Law, Bertrand Routy, Neal denHollander, Vikas Gupta, Xing-Hua Wang, Amélie Chaboureau, Sowmya Viswanathan, Armand Keating
BACKGROUND: Autologous NK cell therapy can treat a variety of malignancies, but is limited by patient-specific variations in potency and cell number expansion. In contrast, allogeneic NK cell lines can overcome many of these limitations. Cells from the permanent NK-92 line are constitutively activated, lack inhibitory receptors and appear to be safe based on two prior phase I trials. MATERIALS AND METHODS: We conducted a single-center, non-randomized, non-blinded, open-label, Phase I dose-escalation trial of irradiated NK-92 cells in adults with refractory hematological malignancies who relapsed after autologous hematopoietic cell transplantation (AHCT)...
July 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28732369/efficacy-and-safety-of-accelerated-partial-breast-irradiation-a-meta-analysis-of-published-randomized-studies
#6
Gengchun Liu, Zhongyi Dong, Baqun Huang, Yuelong Liu, Yan Tang, Qing Li, Yihui Zhu
BACKGROUND AND PURPOSE: Accelerated partial breast irradiation (APBI) technology has theoretical advantages in comparison with traditional adjuvant radiation therapy (whole-breast irradiation; WBI) after breast-conserving surgery. However, published randomized controlled trials have shown inconsistent outcomes. Therefore, a comprehensive assessment of the effectiveness and safety of APBI technology is needed. RESULTS: A total of 7 studies of 7452 patients were included in this analysis...
July 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28732349/intracoronary-administration-of-tirofiban-during-percutaneous-coronary-intervention-facilitates-patients-with-acute-coronary-syndrome
#7
Helei Jia, Changqing Lu, Panli Sun
We assessed the efficacy and safety of tirofiban intracoronary versus intravenous administration during percutaneous coronary intervention for patients with acute coronary syndrome. The databases of PubMed, Web of Science, China National Knowledge Infrastructure, and WanFang Database were retrieved. A total of 437 articles were found, according to inclusive and exclusive criteria, 13 of which were finally included. Compared with subjects with intravenous administration, those with intracoronary administration were more likely to reach thrombolysis in myocardial infarction trial grade 3 flow (relative risk = 1...
July 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28732252/update-on-medical-treatment-of-uterine-fibroids
#8
REVIEW
Fátima Faustino, Margarida Martinho, José Reis, Fernanda Águas
OBJECTIVES: In this review paper, the pros and cons of the available pharmacological options for the treatment of uterine fibroids are explored, including oral progestogens, levonorgestrel intra-uterine device, gonadotropin-releasing hormone analogs and progesterone receptor modulators with an emphasis on ulipristal acetate. STUDY DESIGN: The choice of the appropriate therapeutic approach for uterine fibroids depends on several factors, including women's age, parity, childbearing aspirations and wish to preserve fertility, extent and severity of symptoms, size, number and location of myomas, risk of malignancy and proximity to menopause...
July 8, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28732161/an-elegant-ph-responsive-nanovehicle-for-drug-delivery-based-on-triazine-dendrimer-modified-magnetic-nanoparticles
#9
Amir Landarani-Isfahani, Majid Moghadam, Shima Mohammadi, Maryam Royvaran, Naimeh Moshtael-Arani, Saghar Rezaei, Shahram Tangestaninejad, Valiollah Mirkhani, Iraj Mohammadpoor-Baltork
Owing to properties of magnetic nanoparticles and elegant three-dimensional macromolecule architectural features, dendrimeric structures have been investigated as nanoscale drug delivery systems. In this paper, a novel magnetic nanocarrier, generation two (G2) triazine dendrimer modified Fe3O4@SiO2 magnetic nanoparticles (MNP-G2), was designed, fabricated and characterized by Fourier transform infrared (FT-IR), thermal gravimetric analysis (TGA), vibrating sample magnetometer (VSM), field emission scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM) and dynamic light scattering (DLS)...
July 21, 2017: Langmuir: the ACS Journal of Surfaces and Colloids
https://www.readbyqxmd.com/read/28732152/secukinumab-in-the-treatment-of-psoriasis-and-psoriatic-arthritis-a-review-of-the-literature
#10
M Abrouk, J Gandy, M Nakamura, K Lee, M Brodsky, R Singh, H Zhu, B Farahnik, T Bhutani, J Koo
While there are several commercially available treatment options for psoriasis and psoriatic arthritis, there remains a large number of individuals who are refractory to current modalities. In the recent past, there has been increasing evidence that interleukin (IL)-17 plays a vital role in the pathophysiology of psoriasis. Preclinical, phase II, and phase III studies of secukinumab (Cosentyx®) targeting IL-17 and its receptor have thus far proved to be promising. We reviewed the results of phase II and phase III clinical trials for secukinumab in the treatment of psoriasis and psoriatic arthritis...
July 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28732052/protein-asparagine-deamidation-prediction-based-on-structures-with-machine-learning-methods
#11
Lei Jia, Yaxiong Sun
Chemical stability is a major concern in the development of protein therapeutics due to its impact on both efficacy and safety. Protein "hotspots" are amino acid residues that are subject to various chemical modifications, including deamidation, isomerization, glycosylation, oxidation etc. A more accurate prediction method for potential hotspot residues would allow their elimination or reduction as early as possible in the drug discovery process. In this work, we focus on prediction models for asparagine (Asn) deamidation...
2017: PloS One
https://www.readbyqxmd.com/read/28732050/a-heckman-selection-model-for-the-safety-analysis-of-signalized-intersections
#12
Xuecai Xu, S C Wong, Feng Zhu, Xin Pei, Helai Huang, Youjun Liu
PURPOSE: The objective of this paper is to provide a new method for estimating crash rate and severity simultaneously. METHODS: This study explores a Heckman selection model of the crash rate and severity simultaneously at different levels and a two-step procedure is used to investigate the crash rate and severity levels. The first step uses a probit regression model to determine the sample selection process, and the second step develops a multiple regression model to simultaneously evaluate the crash rate and severity for slight injury/kill or serious injury (KSI), respectively...
2017: PloS One
https://www.readbyqxmd.com/read/28732031/breast-tissue-ablation-with-irreversible-electroporation-in-rabbits-a-safety-and-feasibility-study
#13
Wenlong Zhang, Wanning Wang, Wei Chai, Xiaomei Luo, Jiannan Li, Jian Shi, Liqi Bi, Lizhi Niu
BACKGROUND AND AIM: Irreversible electroporation (IRE) was confirmed to control several solid tumors effectively in vivo. Our preclinical study aimed to assess the feasibility and safety of IRE in the breast of rabbit. METHODS: Thirty New Zealand white rabbits were randomly divided into 3 groups of 10 rabbits (control group, IRE group A, and B). Two mono-electrode needles were inserted into the breast tissue by percutaneous puncture. Electrocardiogram and vital signs were monitored before, during, and after ablation...
2017: PloS One
https://www.readbyqxmd.com/read/28732018/carboplatin-with-intravenous-and-subsequent-oral-administration-of-vinorelbine-in-resected-non-small-cell-lung-cancer-in-real-world-set-up
#14
Vítězslav Kolek, Ivona Grygárková, Leona Koubková, Jana Skřičková, Jiřina Švecová, Dimka Sixtová, Jiří Bartoš, Aleš Tichopád
OBJECTIVES: Adjuvant cisplatin-based chemotherapy is recommended for routine use in patients with Stage IIA, IIB or IIIA non-small cell lung cancer (NSCLC) after complete resection. Results obtained for Stage IB were not conclusive. While vinorelbine plus cisplatin is the preferred choice after resection, combining vinorelbine with carboplatin promises improved compliance and delivery of drugs due to lower toxicity. We evaluated the impact of this option on treatment compliance and survival under real-world conditions...
2017: PloS One
https://www.readbyqxmd.com/read/28731977/interventions-for-neuropathic-pain-an-overview-of-systematic-reviews
#15
Svjetlana Dosenovic, Antonia Jelicic Kadic, Maja Miljanovic, Marina Biocic, Krste Boric, Marija Cavar, Nikolina Markovina, Katarina Vucic, Livia Puljak
Numerous interventions for neuropathic pain (NeuP) are available, but its treatment remains unsatisfactory. We systematically summarized evidence from systematic reviews (SRs) of randomized controlled trials on interventions for NeuP. Five electronic databases were searched up to March 2015. Study quality was analyzed using A Measurement Tool to Assess Systematic Reviews. The most common interventions in 97 included SRs were pharmacologic (59%) and surgical (15%). The majority of analyzed SRs were of medium quality...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28731932/investing-in-physicians-is-investing-in-patients-enhancing-patient-safety-through-physician-health-and-well-being-research
#16
Elizabeth Brooks, Doris C Gundersen, Michael H Gendel
Keeping medical practitioners healthy is an important consideration for workforce satisfaction and retention, as well as public safety. However, there is limited evidence demonstrating how to best care for this group. The absence of data is related to the lack of available funding in this area of research. Supporting investigations that examine physician health often "fall through the cracks" of traditional funding opportunities, landing somewhere between patient safety and workforce development priorities...
July 20, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28731912/assessing-infant-and-maternal-readiness-for-newborn-discharge
#17
Ling Jing, Casidhe-Nicole Bethancourt, Thomas McDonagh
PURPOSE OF REVIEW: The review highlights the shift from prescribed length of stay (LOS) to mother-infant dyad readiness as the basis for making discharge decisions for healthy term newborns. We describe the components of readiness that should be considered in making the decision, focusing on infant clinical readiness, and maternal and familial readiness. RECENT FINDINGS: Although the Newborns' and Mothers' Health Protection Act of 1996 aimed to protect infants and mothers by establishing a minimum LOS, the American Academy of Pediatrics 2015 policy on newborn discharge acknowledges the shift from LOS-based to readiness-based discharge decision-making...
July 20, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28731889/stent-thrombosis-with-bioabsorbable-polymer-drug-eluting-stents-insights-from-the-food-and-drug-administration-database
#18
Abdur R Khan, Avnish Tripathi, Talha A Farid, Bilal Abaid, Deepak L Bhatt, Jon R Resar, Michael P Flaherty
BACKGROUND: SYNERGY, a bioabsorbable polymer-based, everolimus-eluting stent (BP-DES), recently received regulatory approval in the USA for use in percutaneous coronary interventions. Yet, information on the safety of BP-DES in routine clinical practice is limited. Our aim was to compare the safety of the recently approved BP-DES with current durable polymer drug-eluting stents (DP-DES) by analyzing adverse events, namely, stent thrombosis (ST), reported to the Manufacturer and User Facility Device Experience (MAUDE) database...
July 20, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28731833/the-dishwater-menace-and-the-compromising-solution-healthy-drinking-spaces-and-the-public-good-in-post-prohibition-ontario
#19
Dan Malleck
This paper examines inter-bureaucracy tension, negotiation, and resolution in the case of the oversight of beverage room sanitation in Ontario in the 1930s and 1940s. Both the Liquor Control Board of Ontario (LCBO) and various public health authorities claimed authority over the health status of public drinking spaces. But the LCBO had legislative priority. The ensuing debates regarding health and cleanliness linked issues of beverage room glass sanitation to a biopolitical approach to public drinking. Developing a more scientifically sophisticated approach to beverage glass cleaning required a balancing of administrative priorities...
July 21, 2017: Canadian Bulletin of Medical History, Bulletin Canadien D'histoire de la Médecine
https://www.readbyqxmd.com/read/28731823/maternal-fetal-outcomes-in-34-pregnant-women-with-type-1-diabetes-in-sensor-augmented-insulin-pump-therapy
#20
Ana María Gómez, Lisseth Fernanda Marín Carrillo, Carol M Arévalo Correa, Oscar Mauricio Muñoz Velandia, Martín Alonso Rondón Sepúlveda, Jaime Luis Silva Herrera, Diana Cristina Henao Carrillo
BACKGROUND: Pregnancy in women with type 1 diabetes (T1D) is associated with increased risk of maternal complications and neonatal morbidity and mortality. Optimizing glycemic control improves these outcomes. OBJECTIVE: To describe the experience of using sensor-augmented insulin pump therapy (SAPT) and SAPT + low-glucose suspension (LGS) on pregnant women with T1D, including neonatal and maternal outcomes. METHODS: A prospective observational study was conducted in women with T1D who started SAPT and SAPT + LGS before or during pregnancy at the San Ignacio University Hospital Diabetes Center in Bogotá, Colombia...
July 2017: Diabetes Technology & Therapeutics
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