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https://www.readbyqxmd.com/read/28325458/chronic-subdural-hematoma-icu-management
#1
REVIEW
Jeremy T Ragland, Kiwon Lee
Patients with cSDH presenting with new or worsening neurological deficits, especially if they are debilitating and adversely affecting quality of life require urgent medical and surgical attention. Neurological and neurosurgical critical care team need to stabilize the patient by reversing any underlying coagulopathy states in order to prevent further hematoma expansion.In the event of brain herniation and presumed ICP elevation and CPP compromise, step-wise ICP management should be instituted promptly.Seizure prophylaxis treatment is reasonable...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28323589/preventing-high-altitude-cerebral-edema-in-rats-with-repurposed-anti-angiogenesis-pharmacotherapy
#2
Samantha Tarshis, Joanne Maltzahn, Zoe Loomis, David C Irwin
BACKGROUND: High altitude cerebral edema (HACE) is a fulminant, deadly, and yet still unpredictable brain disease. A new prophylactic treatment for HACE and its predecessor, acute mountain sickness (AMS), needs to be developed without the contraindications or adverse effect profiles of acetazolamide and dexamethasone. Since neovascularization signals are likely key contributors to HACE/AMS, our approach was to examine already existing anti-angiogenic drugs to inhibit potential initiating HACE pathway(s)...
December 1, 2016: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28302045/complications-following-stem-cell-therapy-in-inflammatory-bowel-disease
#3
Hongyun Wei, Xiaowei Liu, Chunhui Ouyang, Jie Zhang, Shuijiao Chen, Fanggen Lu, Linlin Chen
Pharmacotherapy and surgery constitute the mainstay of treatment for inflammatory bowel disease (IBD). However, post-treatment relapsing and recurrence persist as concerns in patients with IBD. Together with a considerable economic burden, stem cell therapy (SCT) has emerged as a promising treatment strategy in IBD, including hematopoietic stem cells (HST), mensenchymal stem cells (MSCs). HSCT could restore the immune tolerance following chemotherapy-induced immune ablation, and MSCs could affect immune cells or secret trophic factors to treat IBD...
March 15, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28282556/mechanisms-involved-in-the-possible-nephroprotective-effect-of-rutin-and-low-dose-%C3%AE-irradiation-against-cisplatin-induced-nephropathy-in-rats
#4
Rasha R Radwan, Salma M Abdel Fattah
Cisplatin has demonstrated high antitumor efficacy. However, nephrotoxicity is a dose-limiting factor in its clinical use. The present study was designed to investigate the protective effect of rutin and low dose of irradiation (LDR) on cisplatin-induced nephrotoxicity in rats. Rats received rutin (200mg/kg/day, p.o) for 10 consecutive days and subjected to LDR (0.5Gy) 1day prior to cisplatin. Intraperitoneal administration of single dose of cisplatin (7.5mg/kg) was used to induce nephrotoxicity. Data showed that cisplatin caused elevation in serum creatinine and urea, disturbance in blood count, elevation in gene expression of tumor necrosis factor alpha, nuclear factor kappa B, interleukin-1β, caspase-3, mitochondrial cytochrome C and apoptosis-inducing factor in renal tissue...
March 2, 2017: Journal of Photochemistry and Photobiology. B, Biology
https://www.readbyqxmd.com/read/28275224/aggressive-versus-conservative-antibiotic-use-to-prevent-and-treat-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-comparison-of-two-case-series
#5
Arturo Chieregato, Paolo Malacarne, Francesco Cocciolo, Maurizio Ravaldini, Emanuele Russo, Bruno Viaggi, Michele Giardino, Carlotta Rossi, Bruno Simini, Guido Bertolini
BACKGROUND: In patients with traumatic brain injury (TBI), ventilator-associated pneumonia (VAP) is considered a dangerous complication, prompting early aggressive antibiotic treatment and prophylaxis. While this approach increases the selection of multidrug-resistant bacteria (MDR), its clinical benefit has not been demonstrated. METHODS: One-year incidence of VAP in severe TBI patients (ICU stay >48 hours, with either Glasgow Coma Scale 8 or receiving intracranial pressure monitoring, or having undergone emergency surgery) and the prevalence of MDR among those who eventually developed it, were compared in two Italian intensive care units (ICUs) adopting different antibiotic approaches...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28270852/effects-of-honey-on-oral-mucositis-among-pediatric-cancer-patients-undergoing-chemo-radiotherapy-treatment-at-king-abdulaziz-university-hospital-in-jeddah-kingdom-of-saudi-arabia
#6
Soad K Al Jaouni, Mohammad S Al Muhayawi, Abear Hussein, Iman Elfiki, Rajaa Al-Raddadi, Saad M Al Muhayawi, Saad Almasaudi, Mohammad Amjad Kamal, Steve Harakeh
One of the most common complications of cancer chemotherapy is oral mucositis. This study evaluates the therapeutic effects of honey with the focus on grade III and IV oral mucositis, reduction of bacterial and fungal infections, duration of episodes of oral mucositis, and body weight in pediatric leukemic patients undergoing chemo/radiotherapy. This is an open labeled randomized controlled study conducted at our hospital on 40 pediatric cancer patients undergoing chemo/radiotherapy. All the 40 patients included in this study experienced a sum total of 390 episodes of fever and neutropenia associated with oral mucositis...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28270114/violation-of-prophylactic-vancomycin-administration-timing-is-a-potential-risk-factor-for-rate-of-surgical-site-infections-in-cardiac-surgery-patients-a-prospective-cohort-study
#7
Paolo Cotogni, Cristina Barbero, Roberto Passera, Lucina Fossati, Giorgio Olivero, Mauro Rinaldi
BACKGROUND: Intensivists and cardiothoracic surgeons are commonly worried about surgical site infections (SSIs) due to increasing length of stay (LOS), costs and mortality. The antimicrobial prophylaxis is one of the most important tools in the prevention of SSIs. The objective of this study was to investigate the relationship between the timing of antimicrobial prophylaxis administration and the rate of SSIs. METHODS: A prospective cohort study was carried out over 1-year period in all consecutive adult patients undergoing elective cardiac surgery...
March 8, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28265016/embolic-stroke-of-undetermined-source-a-systematic-review-and-clinical-update
#8
Robert G Hart, Luciana Catanese, Kanjana S Perera, George Ntaios, Stuart J Connolly
BACKGROUND AND PURPOSE: Embolic stroke of undetermined source (ESUS) designates patients with nonlacunar cryptogenic ischemic strokes in whom embolism is the likely stroke mechanism. It has been hypothesized that anticoagulation is more efficacious than antiplatelet therapy for secondary stroke prevention in ESUS patients. We review available information about ESUS. METHODS: Systematic literature review to assess the frequency of ESUS, patient features, and prognosis using PubMed from 2014 to present, unrestricted by language...
March 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28262045/recurrent-urinary-tract-infections-in-women-risk-factors-etiology-pathogenesis-and-prophylaxis
#9
Antonio Guglietta
Urinary tract infections (UTIs) are one of the most common bacterial infections in women, often as a recurrent disease. Uropathogenic Escherichia coli (UPEC) is the most common pathotype of extraintestinal pathogenic E. coli (ExPEC) found among patients with UTI. The human intestinal can act as a reservoir of UPEC, with the female urethra being infected by fecal material containing UPEC. Adhesion of bacteria to the epithelial cells of urogenital mucosa is an important mechanism in the pathogenesis of UTI. Alternative nonantibiotic based approaches, such as mechanical barrier protection of the intestinal mucosa have been proposed to reduce bacterial adherence to intestinal epithelium, bacteria proliferation and decrease of the load of UPEC in the intestinal lumen and in the fecal material...
March 2017: Future Microbiology
https://www.readbyqxmd.com/read/28261425/intermittent-pneumatic-compression-for-the-prevention-of-venous-thromboembolism-after-total-hip-arthroplasty
#10
Hong Suk Kwak, Jai Ho Cho, Jung Taek Kim, Jeong Joon Yoo, Hee Joong Kim
BACKGROUND: Venous thromboembolism (VTE) is a relatively common and potentially life threatening complication after major hip surgery. There are two main types of prophylaxis: chemical and mechanical. Chemical prophylaxis is very effective but causes bleeding complications in surgical wounds and remote organs. On the other hand, mechanical methods are free of hemorrhagic complications but are less effective. We hypothesized that mechanical prophylaxis is effective enough for Asians in whom VTE occurs less frequently...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28255256/postcesarean-wound-infection-prevalence-impact-prevention-and-management-challenges
#11
REVIEW
Sivan Zuarez-Easton, Noah Zafran, Gali Garmi, Raed Salim
Surgical site infection (SSI) is one of the most common complications following cesarean section, and has an incidence of 3%-15%. It places physical and emotional burdens on the mother herself and a significant financial burden on the health care system. Moreover, SSI is associated with a maternal mortality rate of up to 3%. With the global increase in cesarean section rate, it is expected that the occurrence of SSI will increase in parallel, hence its clinical significance. Given its substantial implications, recognizing the consequences and developing strategies to diagnose, prevent, and treat SSI are essential for reducing postcesarean morbidity and mortality...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28254373/dosing-antibiotic-prophylaxis-during-cardiopulmonary-bypass-a-higher-level-of-complexity-a-structured-review
#12
REVIEW
Fathima Paruk, Fekade B Sime, Jeffrey Lipman, Jason A Roberts
In highly invasive procedures such as open heart surgery, the risk of post-operative infection is particularly high due to exposure of the surgical field to multiple foreign devices. Adequate antibiotic prophylaxis is an essential intervention to minimise post-operative morbidity and mortality. However, there is a lack of clear understanding on the adequacy of traditional prophylactic dosing regimens, which are rarely supported by data. The aim of this structured review is to describe the relevant pharmacokinetic/pharmacodynamic (PK/PD) considerations for optimal antibiotic prophylaxis for major cardiac surgery including cardiopulmonary bypass (CPB)...
February 27, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28245707/standardized-extract-of-lactuca-sativa-linn-and-its-fractions-abrogates-scopolamine-induced-amnesia-in-mice-a-possible-cholinergic-and-antioxidant-mechanism
#13
Jai Malik, Jagpreet Kaur, Sunayna Choudhary
OBJECTIVES: The present study was designed to evaluate the efficacy of Lactuca sativa (LS) Linn. (Asteraceae) against scopolamine- induced amnesia and to validate its traditional claim as memory enhancer. METHODS: Ethanol extract of fresh LS leaves (LSEE), standardized on the basis of quercetin content, was successively partitioned using various solvents viz., hexane, ethyl acetate, and n-butanol in increasing order of polarity. LSEE (50, 100, and 200 mg/kg) and its various fractions (at a dose equivalent to dose of LSEE exhibiting maximum activity), administered orally for 14 days, were evaluated for their memory enhancing effect against scopolamine-induced (1 mg/kg, i...
February 28, 2017: Nutritional Neuroscience
https://www.readbyqxmd.com/read/28243008/a-descriptive-study-of-hand-injuries-presenting-to-the-adult-emergency-department-of-a-tertiary-care-center-in-urban-india
#14
Murtuza N Ghiya, Shakuntala Murty, Naren Shetty, Rodney D'Cunha
BACKGROUND: Despite having a dedicated Plastic Surgery Unit, emergency physicians (EPs) manage many of the acute, traumatic hand injuries. Further very minimal information exists about the extent to which tetanus recommendations as per Advisory Committee on Immunization Practices are followed in emergency departments (EDs). Furthermore, the management of pain is often neglected. OBJECTIVES: To provide a clinical description of hand injuries with etiology and mechanism; and describe the trends of ED management, including analgesia and tetanus prophylaxis...
January 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28240046/-fusion-and-binding-inhibition-key-target-for-hiv-1-treatment-and-pre-exposure-prophylaxis-targets-drug-delivery-and-nanotechnology-approaches
#15
REVIEW
Tanushree Malik, Gaurav Chauhan, Goutam Rath, R S R Murthy, Amit K Goyal
More than 35 million people are living with HIV worldwide with approximately 2.3 million new infections per year. Cascade of events (cell entry, virus replication, assembly and release of newly formed virions) is involved in the HIV-1 transmission process. Every single step offers a potential therapeutic strategy to halt this progression and HIV fusion into the human host cell is one such stage. Controlling the initial event of HIV-1 transmission is the best way to control its dissemination especially when prophylaxis is concerned...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28238119/use-of-pre-exposure-prophylaxis-prep-in-young-men-who-have-sex-with-men-is-associated-with-race-sexual-risk-behavior-and-peer-network-size
#16
Lisa M Kuhns, Anna L Hotton, John Schneider, Robert Garofalo, Kayo Fujimoto
Pre-exposure prophylaxis (PrEP) is efficacious to prevent HIV infection, however, uptake among young men who have sex with men (YMSM) is relatively low. The purpose of this study was to describe PrEP use and related factors in a representative sample of YMSM in two cities, Chicago and Houston. YMSM, ages 16-29, were recruited via respondent-driven sampling (RDS) from 2014 to 2016. Correlates of PrEP uptake were assessed in weighted multivariable logistic regression models. A total of 12.2% of participants (of 394) reported ever taking PrEP; Black YMSM had the lowest rates of uptake (4...
February 25, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28236873/perianesthetic-refractory-anaphylactic-shock-with-cefuroxime-in-a-patient-with-history-of-penicillin-allergy-on-multiple-antihypertensive-medications
#17
Deb Sanjay Nag, Devi Prasad Samaddar, Shashi Kant, Pratap Rudra Mahanty
We report a case of perianesthetic refractory anaphylactic shock with cefuroxime in a patient with history of penicillin allergy on regular therapy with atenolol, losartan, prazosin and nicardipine. Severe anaphylactic shock was only transiently responsive to 10mL of (1:10,000) epinephrine and needed norepinephrine and dopamine infusion. Supportive therapy with vasopressors and inotropes along with mechanical ventilation for the next 24hours resulted in complete recovery. She was successfully operated upon 2 weeks later with the same anesthetic drugs but intravenous ciprofloxacin as the alternative antibiotic for perioperative prophylaxis...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28235999/concise-review-of-the-management-of-iatrogenic-emesis-using-cannabinoids-emphasis-on-nabilone-for-chemotherapy-induced-nausea-and-vomiting
#18
REVIEW
Joseph V Pergolizzi, Robert Taylor, Jo Ann LeQuang, Gianpietro Zampogna, Robert B Raffa
Chemotherapy-induced nausea and vomiting (CINV) is a prevalent, distressing, and burdensome side effect of cancer chemotherapy. It is estimated to affect the majority of patients receiving certain anti-cancer drug regimens and can be treatment-limiting, even for life-saving medications. Despite seemingly numerous options, such as antimuscarinic anticholinergics, antihistamines, 5-HT3 receptor antagonists, dopamine receptor antagonists, and neurokinin-1 receptor antagonists, preventative therapies are often inadequately effective, particularly for "delayed CINV"-leaving an important unmet clinical need...
March 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28214184/-systemic-lupus-erythematosus-and-lymphopenia-clinical-and-pathophysiological-features
#19
M Martin, A Guffroy, X Argemi, T Martin
Lymphopenia is frequent in systemic lupus erythematosus (SLE) and profound (<500/mm(3)) in 10% of cases. T lymphocytes, especially CD4+, are more affected than B cells. The pathophysiological mechanisms are complex, involving lymphocytotoxic antibodies, excess of apoptosis, increased susceptibility of T cells to complement mediated cytolysis, as well as lymphopoiesis impairment and lymphocyte sequestration. Lymphopenia in SLE is independent from other cytopenia and immunosuppressive drug regiments, and associated with disease activity, risk of flare and damage scores...
February 14, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28203409/practice-patterns-in-venous-thromboembolism-vte-prophylaxis-in-thoracic-surgery-a-comprehensive-canadian-delphi-survey
#20
John Agzarian, Lori-Ann Linkins, Laura Schneider, Waël C Hanna, Christian J Finley, Colin Schieman, Marc De Perrot, Mark Crowther, James Douketis, Yaron Shargall
BACKGROUND: The incidence of venous thromboembolic events (VTE) after resection of thoracic malignancies can reach 15%, but prophylaxis guidelines are yet to be established. We aimed to survey Canadian practitioners regarding perioperative risk factors for VTE, impact of those factors on extended prophylaxis selection, type of preferred prophylaxis, and timing of initiation and duration of thromboprophylaxis. METHODS: A modified Delphi survey was undertaken over three rounds with thoracic surgeons, thoracic anesthesiologists and thrombosis experts across Canada...
January 2017: Journal of Thoracic Disease
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