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https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#1
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28437764/the-use-of-lithium-for-the-treatment-of-bipolar-disorder-recommendations-from-clinical-practice-guidelines
#2
Gin S Malhi, Danielle Gessler, Tim Outhred
BACKGROUND: Lithium is an effective mood stabilizer that is used principally for the management of bipolar disorder (BD). Its administration is complex and often requires sophisticated management and assiduous monitoring. When considering the use of lithium therapy for bipolar disorder, clinicians are advised to refer to recommendations outlined in clinical practice guidelines (CPGs); but because of varying emphases placed by different international CPGs, recommendations addressing the practical use of lithium lack consistency...
March 27, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28437543/association-of-donor-age-and-sex-with-survival-of-patients-receiving-transfusions
#3
Gustaf Edgren, Henrik Ullum, Klaus Rostgaard, Christian Erikstrup, Ulrik Sartipy, Martin J Holzmann, Olof Nyrén, Henrik Hjalgrim
Importance: Following animal model data indicating the possible rejuvenating effects of blood from young donors, there have been at least 2 observational studies conducted with humans that have investigated whether donor age affects patient outcomes. Results, however, have been conflicting. Objective: To study the association of donor age and sex with survival of patients receiving transfusions. Design, Setting, and Participants: A retrospective cohort study based on the Scandinavian Donations and Transfusions database, with nationwide data, was conducted for all patients from Sweden and Denmark who received at least 1 red blood cell transfusion of autologous blood or blood from unknown donors between January 1, 2003, and December 31, 2012...
April 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28437375/both-positive-and-negative-fluid-balance-may-be-associated-with-reduced-long-term-survival-in-the-critically-ill
#4
Vikram Balakumar, Raghavan Murugan, Florentina E Sileanu, Paul Palevsky, Gilles Clermont, John A Kellum
OBJECTIVES: Among critically ill patients with acute kidney injury, exposure to positive fluid balance, compared with negative fluid balance, has been associated with mortality and impaired renal recovery. However, it is unclear whether positive and negative fluid balances are associated with poor outcome compared to patients with even fluid balance (euvolemia). In this study, we examined the association between exposure to positive or negative fluid balance, compared with even fluid balance, on 1-year mortality and renal recovery...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28436748/disruption-of-tetr-type-regulator-aden-by-mobile-genetic-element-confers-elevated-virulence-in-acinetobacter-baumannii
#5
Rajagopalan Saranathan, Sudhakar Pagal, Ajit R Sawant, Archana Tomar, M Madhangi, Suresh Sah, Annapurna Satti, K P Arunkumar, K Prashanth
Acinetobacter baumannii is an important human pathogen and considered as a major threat due to its extreme drug resistance. In this study, the genome of a hyper-virulent MDR strain PKAB07 of A. baumannii isolated from an Indian patient was sequenced and analysed to understand its mechanisms of virulence, resistance and evolution. Comparative genomics analysis of PKAB07 revealed virulence and resistance related genes scattered throughout the genome, instead of being organized as an island, indicating the highly mosaic nature of the genome...
April 24, 2017: Virulence
https://www.readbyqxmd.com/read/28436298/adenocarcinoma-of-the-appendix-occurring-in-a-patient-treated-with-paclitaxel-for-locally-advanced-esophageal-cancer
#6
Constantin A Dasanu, David M Hyams, Frank J Senatore
Paclitaxel has been linked with a number of immunosuppressive effects such as decreased numbers and activity of dendritic cells, NK-cells and monocytes, which may in turn lead to defective T-cell activation. In addition, this agent was shown to cause mitotic arrest resembling high-grade dysplasia throughout the gastrointestinal tract, including the appendix. We have previously documented a series of lung cancer patients who developed pre-malignant colonic polyps and/or colon cancer either during or weeks following chemotherapy with paclitaxel, suggesting a potential role of this agent in their pathogenesis...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28436256/clinical-and-economic-impact-of-hyperkalemia-in-patients-with-chronic-kidney-disease-and-heart-failure
#7
Michael Polson, Todd C Lord, Anne Kangethe, Lindsay Speicher, Carolyn Farnum, Melanie Brenner, Nina Oestreicher, Paula Alvarez
BACKGROUND: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34.6% of patients with CKD and 30.0% of patients with HF. OBJECTIVE: To evaluate the association of HK and use of RAASi therapies at optimal and suboptimal doses in patients with CKD and/or HF with health care resource utilization and overall cost of care in a diverse cohort of commercially insured patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28436130/sleep-complaints-associated-with-wish-to-die-after-a-suicide-crisis-an-exploratory-study
#8
Anca Mirsu-Paun, Isabelle Jaussent, Giovanni Komar, Philippe Courtet, Jorge Lopez-Castroman
The present study explores whether sleep concerns are associated with wish to die throughout a 1-month time interval following a suicide crisis. Sixty-eight patients admitted to the emergency department of a general or psychiatric hospital were enrolled. Sleep difficulties were assessed using the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale, self-reported satisfaction with sleep and time in bed. Suicidal ideation was assessed through the presence of a wish to die at 1 month following a suicide crisis...
April 24, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28435862/financialization-impedes-climate-change-mitigation-evidence-from-the-early-american-solar-industry
#9
Max Jerneck
The article investigates how financialization impedes climate change mitigation by examining its effects on the early history of one low-carbon industry, solar photovoltaics in the United States. The industry grew rapidly in the 1970s, as large financial conglomerates acquired independent firms. While providing needed financial support, conglomerates changed the focus from existing markets in consumer applications toward a future utility market that never materialized. Concentration of the industry also left it vulnerable to the corporate restructuring of the 1980s, when the conglomerates were dismantled and solar divisions were pared back or sold off to foreign firms...
March 2017: Science Advances
https://www.readbyqxmd.com/read/28435754/establishing-successful-patient-centered-medical-homes-in-rural-hawai-i-three-strategies-to-consider
#10
Melissa Nelson Scribner, Kasey Kehoe
The challenges to healthcare delivery posed by Hawai'i's unique geography, physician shortages, and dispersed population are of particular importance in light of implementing the Affordable Care Act (ACA). This study draws on central goals laid out in the ACA - to decrease costs, increase access, and improve patient outcomes. The use of the Patient-Centered Medical Homes (PCMHs) is a care model that has the potential to meet all three goals. How to identify the most effective way to develop PCMHs in the specific context of Hawai'i is the focus of this study...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28435498/security-violent-events-and-anticipated-surge-capabilities-of-emergency-departments-in-washington-state
#11
Jonathan S Weyand, Emily Junck, Christopher S Kang, Jason D Heiner
INTRODUCTION: Over the past 15 years, violent threats and acts against hospital patients, staff, and providers have increased and escalated. The leading area for violence is the emergency department (ED) given its 24/7 operations, role in patient care, admissions gateway, and center for influxes during acute surge events. This investigation had three objectives: to assess the current security of Washington State EDs; to estimate the prevalence of and response to threats and violence in Washington State EDs; and to appraise the Washington State ED security capability to respond to acute influxes of patients, bystanders, and media during acute surge events...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435310/tropical-diseases-of-the-myocardium-a-review
#12
REVIEW
Zoe C Groom, Aristotle D Protopapas, Vasileios Zochios
Cardiovascular diseases are widely distributed throughout the world. Human parasitic infections are ubiquitous. Tropical parasites are increasingly recognized as causes of cardiovascular diseases. In this review, we address the most frequently reported parasites that directly infect the myocardium, including Trypanosoma cruzi, the protozoal causative agent of American trypanosomiasis (Chagas disease), and Taenia solium, the cestode causative agent of taeniasis and cysticercosis. We also discuss tropical endomyocardial fibrosis, trichinellosis and schistosomiasis...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28434822/current-and-potential-imaging-applications-of-ferumoxytol-for-magnetic-resonance-imaging
#13
REVIEW
Gerda B Toth, Csanad G Varallyay, Andrea Horvath, Mustafa R Bashir, Peter L Choyke, Heike E Daldrup-Link, Edit Dosa, John Paul Finn, Seymur Gahramanov, Mukesh Harisinghani, Iain Macdougall, Alexander Neuwelt, Shreyas S Vasanawala, Prakash Ambady, Ramon Barajas, Justin S Cetas, Jeremy Ciporen, Thomas J DeLoughery, Nancy D Doolittle, Rongwei Fu, John Grinstead, Alexander R Guimaraes, Bronwyn E Hamilton, Xin Li, Heather L McConnell, Leslie L Muldoon, Gary Nesbit, Joao P Netto, David Petterson, William D Rooney, Daniel Schwartz, Laszlo Szidonya, Edward A Neuwelt
Contrast-enhanced magnetic resonance imaging is a commonly used diagnostic tool. Compared with standard gadolinium-based contrast agents, ferumoxytol (Feraheme, AMAG Pharmaceuticals, Waltham, MA), used as an alternative contrast medium, is feasible in patients with impaired renal function. Other attractive imaging features of i.v. ferumoxytol include a prolonged blood pool phase and delayed intracellular uptake. With its unique pharmacologic, metabolic, and imaging properties, ferumoxytol may play a crucial role in future magnetic resonance imaging of the central nervous system, various organs outside the central nervous system, and the cardiovascular system...
April 14, 2017: Kidney International
https://www.readbyqxmd.com/read/28434455/creating-a-pediatric-joint-council-to-promote-patient-safety-and-quality-governance-and-accountability-across-johns-hopkins-medicine
#14
Michael Rosen, Brigitta U Mueller, Aaron M Milstone, Denise R Remus, Renee Demski, Peter J Pronovost, Marlene R Miller
BACKGROUND: Large multihospital health systems with multiple children's hospitals are relatively few in number. With a paucity of national pediatric measures for quality and patient safety, there are unique challenges to ensuring consistent levels of care across diverse health care delivery settings. At Johns Hopkins Medicine, a Pediatric Joint Council was created to help ensure high-quality and safe care across a health system encompassing two full-service children's hospitals and two community hospitals with significant pediatric volumes across two states...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28434449/electrical-superior-vena-cava-isolation-using-a-novel-pace-and-ablate-technique-under-diaphragmatic-electromyography-monitoring
#15
Shinsuke Miyazaki, Shigeki Kusa, Hitoshi Hachiya, Hiroshi Taniguchi, Takayuki Niida, Sadamitsu Ichijo, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: Diaphragmatic compound motor action potential (CMAP) amplitude monitoring is a standard technique to anticipate phrenic nerve injury during cryoballoon ablation. OBJECTIVE: The purpose of this study was to evaluate the feasibility of a novel superior vena cava isolation (SVCI) technique using simultaneous pacing and ablation through the tip of a single mapping/ablation catheter. METHODS: Fifty-four patients with atrial fibrillation were included...
May 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28434254/association-of-gstt1-null-xpd-751%C3%A2-cc-and-xpc-939%C3%A2-cc-genotypes-with-increased-levels-of-genomic-damage-among-hospital-pathologists
#16
Alfredo Santovito, Marta Delsoglio, Eleonora Manitta, Giulia Picco, Giulia Meschiati, Michela Chiarizio, Claudio Gendusa, Piero Cervella
CONTEXT: Hospital workers are at risk for genotoxic damage following occupationally exposure to xenobiotics. Pathologists are exposed to chemicals during their use in health care environments, particularly throughout inhalation of airborne agents, absorption through skin or contact with the patient's body fluids. OBJECTIVE: We evaluated the level of genomic damage in a sample of 61 hospital pathologists (occupationally exposed to antineoplastic drugs and sterilizing agents) and 60 control subjects...
April 24, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/28433338/morbidity-of-endovascular-abdominal-aortic-aneurysm-repair-is-directly-related-to-diameter
#17
Douglas M Overbey, Natalia O Glebova, Brandon C Chapman, Patrick W Hosokawa, John C Eun, Mark R Nehler
OBJECTIVE: Previous randomized controlled trials have defined specific size thresholds to guide surgical decision-making in patients presenting with an abdominal aortic aneurysm (AAA). With recent advances in endovascular techniques, the anatomic considerations of AAA repair are rapidly changing. Our specific aims were to evaluate the most recent national population data to compare anatomic differences and perioperative outcomes in patients with AAA. METHODS: The American College of Surgeons National Surgical Quality Improvement Program was queried from 2011 to 2015 using the targeted vascular public use file...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28433327/replacing-antibodies-with-modified-dna-aptamers-in-vaccine-potency-assays
#18
Jeremiah J Trausch, Mary Shank-Retzlaff, Thorsten Verch
Vaccine in vitro potency assays are vital regulatory tests that are used to confirm the presence and concentration of an antigen of interest in a form that directly or indirectly relates to protective activity in patients. Current assays come in many forms, but they almost exclusively use antibody reagents for selective detection of the target antigen. Antibodies provide specific recognition of vaccine antigens but also exhibit drawbacks such as stability limitations, cost, and lot-to-lot variation, which can make it challenging to maintain the reagent throughout the lifetime of the vaccine...
April 19, 2017: Vaccine
https://www.readbyqxmd.com/read/28432924/bringing-a-novel-to-practice-an-interpretive-study-of-reading-a-novel-in-an-undergraduate-nursing-practicum-course
#19
Graham McCaffrey, Lorraine Venturato, J David Patterson, Jennifer Langille, Roberta Jackson, Tom Rosenal
Novels are one humanities resource available to educators in health disciplines to support student reflection on their own professional practice and therapeutic relationships with patients. An interdisciplinary team, including nurses, a physician, and an English instructor, carried out an interpretive study of the use of a novel by clinical nursing instructors in an undergraduate practicum course. Students placed in assisted living or long term care facilities for the elderly were expected to read a contemporary work, Exit Lines, by Joan Barfoot, which is set in a comparable facility...
April 4, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28432612/evaluation-of-the-analgesia-nociception-index-ani-in-healthy-awake-volunteers
#20
Rami Issa, Marco Julien, Elizabeth Décary, Olivier Verdonck, Louis-Philippe Fortier, Pierre Drolet, Philippe Richebé
BACKGROUND: Analgesia might be evaluated with simple changes in vital signs, a non-specific and non-sensitive method. Heart rate variability (HRV) correlates with autonomous nervous system activity and can be used to evaluate painful stimuli. Heart rate variability is then transformed into a numeric scale called the analgesia nociception index (ANI), where higher values represent predominant parasympathetic tone, thus low nociception. Under general anesthesia, the ANI decreases following painful stimuli and increases after administration of analgesia, but significant interindividual variability is present...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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