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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/29224251/efficacy-and-safety-of-fesoterodine-treatment-for-overactive-bladder-symptoms-in-elderly-women-with-and-without-hypertension
#2
Osamu Yokoyama, Hidetomi Yamagami, Shintaro Hiro, Shinichi Hotta, Masaki Yoshida
OBJECTIVE: To assess fesoterodine treatment in elderly women with overactive bladder with and without hypertension. METHODS: Data for 2527 elderly women with overactive bladder symptoms, including urgency urinary incontinence, were pooled from 10 double-blind, placebo-controlled fesoterodine studies. RESULTS: A total of 1523 elderly women (60.3%) had a history of hypertension, and 1004 women (39.7%) had no hypertension history. Overactive bladder symptoms, mean bodyweight and mean body mass index at baseline were significantly higher in women with overactive bladder and hypertension versus those without hypertension (P < 0...
December 10, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/29224250/multiple-autologous-bone-marrow-derived-cd271-mesenchymal-stem-cell-transplantation-overcomes-drug-resistant-epilepsy-in-children
#3
Olga Milczarek, Danuta Jarocha, Anna Starowicz-Filip, Stanislaw Kwiatkowski, Bogna Badyra, Marcin Majka
There is a need among patients suffering from drug-resistant epilepsy (DRE) for more efficient and less toxic treatments. The objective of the present study was to assess the safety, feasibility, and potential efficacy of autologous bone marrow cell transplantation in pediatric patients with DRE. Two females and two males (11 months to 6 years) were enrolled and underwent a combined therapy consisting of autologous bone marrow nucleated cells (BMNCs) transplantation (intrathecal: 0.5 × 109 ; intravenous: 0...
December 10, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/29224190/metabolic-surgery-for-the-treatment-of-type-2-diabetes-in-obese-individuals
#4
REVIEW
David E Cummings, Francesco Rubino
Several bariatric operations originally designed to promote weight loss have been found to powerfully treat type 2 diabetes, causing remission in most cases, through diverse mechanisms additional to the secondary consequences of weight loss. These observations have prompted consideration of such operations as 'metabolic surgery', used expressly to treat diabetes, including among patients who are only mildly obese or merely overweight. Large, long-term observational studies consistently demonstrate that bariatric/metabolic surgery is associated with reductions in all cardiovascular risk factors, actual cardiovascular events, microvascular diabetes complications, cancer and death...
December 9, 2017: Diabetologia
https://www.readbyqxmd.com/read/29224057/identifying-factors-associated-with-need-for-flexible-ureteroscope-repair-a-western-endourology-stone-west-research-consortium-prospective-cohort-study
#5
Kazumi Taguchi, Jonathan D Harper, Marshall L Stoller, Brian D Duty, Mathew D Sorensen, Roger L Sur, Manint Usawachintachit, David T Tzou, David L Wenzler, Dylan Isaacson, Angela Xu, Carissa Chu, Uwais B Zaid, Eric R Taylor, Krishna Ramaswamy, Thomas Chi
Maintenance of flexible ureteroscopes can involve high costs and administrative burden. Instrument fragility necessitates eventual repair, rendering scopes inaccessible during refurbishment. We conducted a multi-institutional prospective cohort study to identify perioperative factors influencing flexible ureteroscope durability. Patients undergoing flexible ureteroscopy (URS) at six United States endourology centers were enrolled between August 2014 and June 2015. Surgeon self-reported concern and satisfaction with scope performance as well as upward and downward angles of deflection for each scope tip were measured before and after each procedure...
December 9, 2017: Urolithiasis
https://www.readbyqxmd.com/read/29224030/advances-in-fractional-technology-for-skin-rejuvenation-skin-tightening-drug-delivery-and-treating-scars-and-skin-defects
#6
Deirdre Connolly, Laura Schilling, Nazanin Saedi
The development of fractional photothermolysis has revolutionized the treatment of skin scarring, rejuvenation, and tightening. By creating targeted microthermal zones and leaving surrounding tissue intact, this concept has provided the field with efficacious results, with less downtime and a better safety profile. This has started to change the paradigm of what is considered first-line treatment for scarring and rejuvenation. While originally applied to nonablative lasers, fractionation has now been employed in ablative, quality-switched, picosecond, and novel hybrid fractional lasers...
December 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29223999/two-years-follow-up-of-patients-with-abnormal-uterine-bleeding-after-insertion-of-the-levonorgestrel-releasing-intrauterine-system
#7
Numan Cim, Sunullah Soysal, Sena Sayan, Begum Yildizhan, Erbil Karaman, Orkun Cetin, Harun Egemen Tolunay, Recep Yildizhan
AIM: To evaluate the efficacy and safety of levonorgestrel-releasing intrauterine system (LNG-IUS) in the long-term treatment of heavy menstrual blood loss in women unrelated to intrauterine pathology. METHODS: One hundred and six parous women aged 33-48 years with recurrent heavy menstrual bleeding (HMB) participated in this study. The women were followed up for 24 months and were assessed for intensity of bleeding both for pre- and post-insertion periods. An LNG-IUS was inserted in each patient within 7 days of the start of menstrual flow...
December 8, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/29223983/ensuring-patient-safety-and-access-in-cancer-care
#8
Katy Winckworth-Prejsnar, Elizabeth A Nardi, James McCanney, F Marc Stewart, Terry Langbaum, Bruce J Gould, C Lyn Fitzgerald, Robert W Carlson
The inability to obtain the right high-quality cancer care in a timely and safe manner can have devastating results for patients. As cancer care becomes inundated with cutting edge and novel treatments, such as personalized medicine, oral chemotherapy, biosimilars, and immunotherapy, new safety challenges are emerging at increasing speed and complexity. Moreover, shifting federal healthcare policies could have significant implications for the safety and access to high-quality and effective cancer care for millions of patients with cancer...
December 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29223967/questionnaire-based-algorithm-for-assessing-occupational-noise-exposure-of-construction-workers
#9
Kate Lewkowski, Kahlia McCausland, Jane S Heyworth, Ian W Li, Warwick Williams, Lin Fritschi
OBJECTIVES: Occupational noise exposure is a major cause of hearing loss worldwide. In order to inform preventative strategies, we need to further understand at a population level which workers are most at risk. METHODS: We have developed a new questionnaire-based algorithm that evaluates an individual worker's noise exposure. The questionnaire and supporting algorithms are embedded into the existing software platform, OccIDEAS. Based on the tasks performed by a worker during their most recent working shift and using a library of task-based noise exposure levels, OccIDEAS estimates whether a worker has exceeded the full-shift workplace noise exposure limit (LAeq,8h≥85 dBA)...
December 9, 2017: Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29223954/effect-of-pcsk9-inhibitors-on-clinical-outcomes-in-patients-with-hypercholesterolemia-a-meta-analysis-of-35-randomized-controlled-trials
#10
REVIEW
Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Bavana V Rangan, Michele K Roesle, Thomas Knickelbine, Michael D Miedema, Houman Khalili, Zahid Ahmad, Shuaib Abdullah, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: We sought to examine the efficacy and safety of 2 PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors: alirocumab and evolocumab. METHODS AND RESULTS: We performed a systematic review and meta-analysis of randomized controlled trials comparing treatment with and without PCSK9 inhibitors; 35 randomized controlled trials comprising 45 539 patients (mean follow-up: 85.5 weeks) were included. Mean age was 61.0±2.8 years, and mean baseline low-density lipoprotein cholesterol was 106±22 mg/dL...
December 9, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29223921/metabolism-and-pharmacokinetics-of-alantolactone-and-isoalantolactone-in-rats-thiol-conjugation-as-a-potential-metabolic-pathway
#11
Bailun Zhou, Ji Ye, Niao Yang, Liping Chen, Zhiguo Zhuo, Ling Mao, Qun Liu, Gongcai Lan, Jing Ning, Guangbo Ge, Ling Yang, Yunheng Shen, Shumei Wang, Weidong Zhang
Alantolactone (AL) and isoalantolactone (IAL), two major active sesquiterpene lactones isolated from Radix Inulae extract, have a wide range of pharmacological activities. The predominant metabolic pathway of AL and IAL observed was glutathione (GSH) conjugation in vitro, which could occur in the absence of metabolic enzymes. Non-enzymatic conjugation with cysteine (Cys) couldalso be observed. Four metabolites (AL-GSH, AL-Cys, IAL-GSH, IAL-Cys) were subsequently isolated and confirmed by nuclear magnetic resonance (NMR)...
December 2, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/29223904/spatiotemporal-variations-of-hydrogeochemistry-and-its-controlling-factors-in-the-gandaki-river-basin-central-himalaya-nepal
#12
Ramesh Raj Pant, Fan Zhang, Faizan Ur Rehman, Guanxing Wang, Ming Ye, Chen Zeng, Handuo Tang
The characterization and assessment of water quality in the head water region of Himalaya is necessary, given the immense importance of this region in sustaining livelihoods of people and maintaining ecological balance. A total of 165 water samples were collected from 55 sites during pre-monsoon, monsoon and post-monsoon seasons in 2016 from the Gandaki River Basin of the Central Himalaya, Nepal. The pH, EC values and TDS concentrations were measured in-situ and the concentrations of major ions (Ca2+, Mg2+, K+, Na+, Cl-, SO42-, NO3-) and Si were analyzed in laboratory...
December 7, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29223767/evaluation-of-a-national-pediatric-subinternship-curriculum-implemented-through-individual-learning-plans
#13
Linda R Tewksbury, Cristina Carter, Lyuba Konopasek, Sandra M Sanguino, Janice L Hanson
OBJECTIVE: The Council on Medical Student Education in Pediatrics and Association of Pediatric Program Directors developed a Pediatric Subinternship (CAPS) Curriculum for use with an individualized learning plan (ILP). The authors determined which learning objectives (LOs) pediatric subinterns selected when provided the CAPS Curriculum, summarized students' self-reported progress, and determined feasibility of ILPs in subinternship. METHODS: Students from 10 medical schools completed a standardized ILP during pediatric subinternship...
December 6, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/29223760/down-the-local-a-qualitative-case-study-of-daytime-drinking-spaces-in-the-london-borough-of-islington
#14
Claire Thompson, Sarah Milton, Matt Egan, Karen Lock
BACKGROUND: Recognising the lack of research on daytime drinking practices in areas with managed night-time economies (NTEs), this qualitative study explores the phenomena in the London Borough of Islington; a rapidly gentrifying area with a highly regulated night-time economy (NTE). The objectives were to (i) Characterise the daytime drinking spaces of the local alcohol environment and (ii) Theorise the ways in which these spaces, and the practices and performativities within them, are situated within broader social and economic trends...
December 7, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29223745/buparlisib-plus-fulvestrant-in-postmenopausal-women-with-hormone-receptor-positive-her2-negative-advanced-breast-cancer-progressing-on-or-after-mtor-inhibition-belle-3-a-randomised-double-blind-placebo-controlled-phase-3-trial
#15
Angelo Di Leo, Stephen Johnston, Keun Seok Lee, Eva Ciruelos, Per E Lønning, Wolfgang Janni, Ruth O'Regan, Marie-Ange Mouret-Reynier, Dimitar Kalev, Daniel Egle, Tibor Csőszi, Roberto Bordonaro, Thomas Decker, Vivianne C G Tjan-Heijnen, Sibel Blau, Alessio Schirone, Denis Weber, Mona El-Hashimy, Bharani Dharan, Dalila Sellami, Thomas Bachelot
BACKGROUND: Activation of the PI3K/AKT/mTOR pathway occurs frequently in breast cancer that is resistant to endocrine therapy. Approved mTOR inhibitors effectively inhibit cell growth and proliferation but elicit AKT phosphorylation via a feedback activation pathway, potentially leading to resistance to mTOR inhibitors. We evaluated the efficacy and safety of buparlisib plus fulvestrant in patients with advanced breast cancer who were pretreated with endocrine therapy and mTOR inhibitors...
December 6, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/29223706/cross-over-clinical-trial-for-evaluating-the-safety-of-camel-s-milk-intake-in-patients-who-are-allergic-to-cow-s-milk-protein
#16
E M Navarrete-Rodríguez, L A Ríos-Villalobos, C R Alcocer-Arreguín, B E Del-Rio-Navarro, J M Del Rio-Chivardi, O J Saucedo-Ramírez, J J L Sienra-Monge, R V Frias
BACKGROUND: Cow's milk protein allergy (CMPA) affects between 0.6 and 0.9% of the general population, and its treatment implies the total elimination of the intake of this protein. Camel's milk has been suggested as an alternative for patients over one year of age who suffer from CMPA due to the difference in the amino acid sequence from that of cow's milk. The objective of this study was to evaluate the safety and tolerability of camel's milk in children with CMPA. METHODS: Crossed clinical trial for the use of camel's milk vs...
December 6, 2017: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/29223694/atraumatic-versus-conventional-lumbar-puncture-needles-a-systematic-review-and-meta-analysis
#17
Siddharth Nath, Alex Koziarz, Jetan H Badhiwala, Waleed Alhazzani, Roman Jaeschke, Sunjay Sharma, Laura Banfield, Ashkan Shoamanesh, Sheila Singh, Farshad Nassiri, Wieslaw Oczkowski, Emilie Belley-Côté, Ray Truant, Kesava Reddy, Maureen O Meade, Forough Farrokhyar, Malgorzata M Bala, Fayez Alshamsi, Mette Krag, Itziar Etxeandia-Ikobaltzeta, Regina Kunz, Osamu Nishida, Charles Matouk, Magdy Selim, Andrew Rhodes, Gregory Hawryluk, Saleh A Almenawer
BACKGROUND: Atraumatic needles have been proposed to lower complication rates after lumbar puncture. However, several surveys indicate that clinical adoption of these needles remains poor. We did a systematic review and meta-analysis to compare patient outcomes after lumbar puncture with atraumatic needles and conventional needles. METHODS: In this systematic review and meta-analysis, we independently searched 13 databases with no language restrictions from inception to Aug 15, 2017, for randomised controlled trials comparing the use of atraumatic needles and conventional needles for any lumbar puncture indication...
December 6, 2017: Lancet
https://www.readbyqxmd.com/read/29223668/transumbilical-extracorporeal-laparoscopic-assisted-appendectomy
#18
Lindsey Perea, William H Peranteau, Pablo Laje
AIM OF THE STUDY: The perfect balance between safety, cosmesis, and cost effectiveness in a world with ever growing healthcare costs has yet to be found for nonperforated appendicitis. The aim is to present our data regarding safety and cost effectiveness of the transumbilical extracorporeal laparoscopic-assisted appendectomy technique. METHODS: A retrospective review was performed for all laparoscopic appendectomies for acute appendicitis from October 2014 to October 2016...
November 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29223665/guidelines-and-checklists-for-short-term-missions-in-global-pediatric-surgery-recommendations-from-the-american-academy-of-pediatrics-delivery-of-surgical-care-global-health-subcommittee-american-pediatric-surgical-association-global-pediatric-surgery-committee
#19
REVIEW
Marilyn Butler, Elizabeth Drum, Faye M Evans, Tamara Fitzgerald, Jason Fraser, Ai-Xuan Holterman, Howard Jen, J Matthew Kynes, Jenny Kreiss, Craig D McClain, Mark Newton, Benedict Nwomeh, James O'Neill, Doruk Ozgediz, George Politis, Henry Rice, David Rothstein, Julie Sanchez, Mark Singleton, Francine S Yudkowitz
INTRODUCTION: Pediatric surgeons, anesthesia providers, and nurses from North America and other high-income countries (HICs) are increasingly engaged in resource-limited areas, with short-term missions (STMs) as the most common form of involvement. However, consensus recommendations currently do not exist for STMs in pediatric general surgery and associated perioperative care. METHODS: The American Academy of Pediatrics (AAP) Delivery of Surgical Care Subcommittee and American Pediatric Surgical Association (APSA) Global Pediatric Surgery Committee, with the American Pediatric Surgical Nurses Association, Inc...
November 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29223646/exploring-the-effects-of-dpp-4-inhibitors-on-the-kidney-from-the-bench-to-clinical-trials
#20
REVIEW
Giuseppe Coppolino, Christian Leporini, Laura Rivoli, Francesco Ursini, Eugenio Donato di Paola, Valeria Cernaro, Franco Arturi, Davide Bolignano, Emilio Russo, Giovambattista De Sarro, Michele Andreucci
Dipeptidyl-peptidase-4 (DPP-4) inhibitors are a relatively new class of non-insulin glucose-lowering agents, belonging to the incretin family, which are able to improve glycemic control with a favorable safety profile, since they are associated with a low risk of hypoglycemia, no weight gain, and good tolerability in patients with chronic renal failure. Some experimental and clinical studies suggest that these drugs may exert significant pleiotropic effects, in particular on chronic kidney disease (CKD) progression, but data from clinical trials are still controversial...
December 6, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
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