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https://www.readbyqxmd.com/read/28531959/occurrence-and-removal-of-pharmaceuticals-hormones-personal-care-products-and-endocrine-disrupters-in-a-full-scale-water-reclamation-plant
#1
Ngoc Han Tran, Karina Yew-Hoong Gin
This study provided the first comprehensive data on the occurrence and removal of twenty-five target emerging contaminants (ECs) in a full-scale water reclamation plant (WRP) in the Southeast Asian region. Nineteen out of the twenty-five ECs were ubiquitously detected in raw influent samples. Concentrations of the detected ECs in raw influent samples ranged substantially from 44.3 to 124,966ng/L, depending upon the compound and sampling date. The elimination of ECs in full-scale conventional activated sludge (CAS) and membrane bioreactor (MBR) systems at a local WRP was evaluated and compared...
May 17, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28530312/-the-second-victim-treating-the-health-care-providers
#2
REVIEW
Shimrit Shor, Orna Tal, Ron Maymon
During their professional careers, physicians and other health care providers are repeatedly exposed to emotional stress. This is usually secondary to coping with the results of a medical error or complicated medical event. Generally, in the above cases, the patient and his/her family are in the center of the medical system, being "the first victim" of such an event, while the involved caregiver, who provided the medical service, is categorized as the "second victim". "Second victims" may feel anxiety, fear, guilt or anger and experience social withdrawal, which may lead to troubling memories, depression and insomnia...
January 2017: Harefuah
https://www.readbyqxmd.com/read/28527071/cost-of-medication-overuse-headache-in-italian-patients-at-the-time-point-of-withdrawal-a-retrospective-study-based-on-real-data
#3
Domenico D'Amico, Licia Grazzi, Marcella Curone, Matilde Leonardi, Alberto Raggi
The objective was to assess the cost of Medication Overuse Headache (MOH) at the time-point of withdrawal treatment. We implemented a protocol in which both direct and indirect cost were directly gathered from patients and referred to the previous three months. Direct costs were calculated by medications for acute treatment and prophylaxis, diagnostic procedures, visits, complementary treatments, informal care. Indirect costs were referred to missed workdays and workdays with reduced productivity: we asked patients to refer their salaries and to rate the overall level of performance in days worked with reduced productivity, and we calculated indirect costs on this basis...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28524061/immediate-hypersensitivity-reaction-to-pegylated-liposomal-doxorubicin-management-and-outcome-in-four-patients
#4
Saskia Ingen-Housz-Oro, Anne Pham-Ledard, Pauline Brice, Bénédicte Lebrun-Vignes, Ouidad Zehou, Delphine Reitter, Caroline Ram-Wolff, Nicolas Dupin, Martine Bagot, Olivier Chosidow, Marie Beylot-Barry
Hypersensitivity reactions (HSR) to pegylated liposomal doxorubicin (PLD; Caelyx(®)) have been reported, and symptoms usually resolve with drug withdrawal. However, the risk of relapse of severe HSR and prevention remain poorly described. To report the management and outcome in four patients with HSR due to PLD. Patient characteristics, premedication regimen, rate of infusion, time between onset and HSR, clinical manifestations, and management were documented. A first cycle of PLD was received for cutaneous T-cell lymphoma (n = 3) and Kaposi sarcoma (n = 1)...
May 19, 2017: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/28523249/risk-factors-clinical-presentation-and-outcome-of-acinetobacter-baumannii-bacteremia
#5
Tala Ballouz, Jad Aridi, Claude Afif, Jihad Irani, Chantal Lakis, Rakan Nasreddine, Eid Azar
Infections caused by Acinetobacter baumannii (AB), an increasingly prevalent nosocomial pathogen, have been associated with high morbidity and mortality. We conducted this study to analyze the clinical features, outcomes, and factors influencing the survival of patients with AB bacteremia. We retrospectively examined the medical records of all patients developing AB bacteremia during their hospital stay at a tertiary care hospital in Beirut between 2010 and 2015. Ninety episodes of AB bacteremia were documented in eighty-five patients...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28519244/neonatal-abstinence-syndrome-update-on-diagnostic-and-therapeutic-strategies
#6
Genny Raffaeli, Giacomo Cavallaro, K Karel Allegaert, Enno Diederik Wildschut, Monica Fumagalli, Massimo Agosti, Dick Tibboel, Fabio Mosca
Substance use among pregnant women is a major public health issue. Both prescription opioid use and illicit opioid abuse have increased dramatically in recent years. Prolonged in utero drug exposure may result in neonatal abstinence syndrome (NAS), an acute multisystemic clinical entity that occurs in the first days of life. This syndrome is caused by abrupt discontinuation of fetal exposure to licit or illicit drugs chronically consumed by the mother during pregnancy and transmitted to the fetus through the placenta...
May 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28516851/intimate-partner-abuse-and-attachment-a-comparison-between-abused-and-nonabused-women
#7
M Meghan Davidson, Michael S Butchko, Janice E Castro, Krista Robbins
The purpose of this study was to examine intimate partner abuse (IPA), parental attachment, and romantic attachment among college women. More specifically, IPA was examined such that women who had experienced abuse and those who had not were compared with respect to parental and romantic attachment using the lens of attachment theory. Undergraduate women (N = 502) completed an online survey assessing their experiences of IPA as well as their parental and romantic attachment styles. Bivariate correlations demonstrated that IPA was significantly associated with all study variables (i...
May 17, 2017: Violence and Victims
https://www.readbyqxmd.com/read/28512418/cushing-s-syndrome-cortisol-and-cognitive-competency-a-case-report
#8
Neil Oronsky, Bennett Thilagar, Carolyn M Ray, Scott Caroen, Michelle M C Lybeck, Lindsey Ferry, Ronald A Voves, Bryan Oronsky
Glucocorticoids are associated with immunosuppression and neuropsychiatric complications. We describe the case of a carcinoid patient with Cushing's syndrome (CS) and neurocognitive impairment due to ectopic ACTH production who developed sepsis and died because of his family's decision to withdraw antibiotic treatment. This report is presented to illustrate the importance of advanced-care planning in patients with CS.
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28506865/protocol-driven-neurological-prognostication-and-withdrawal-of-life-sustaining-therapy-after-cardiac-arrest-and-targeted-temperature-management
#9
Irina Dragancea, Matthew P Wise, Nawaf Al-Subaie, Julius Cranshaw, Hans Friberg, Guy Glover, Tommaso Pellis, Rebecca Rylance, Andrew Walden, Niklas Nielsen, Tobias Cronberg
BACKGROUND: Brain injury is reportedly the main cause of death for patients resuscitated after out-of-hospital cardiac arrest (OHCA). However, the majority may actually die following withdrawal of life-sustaining therapy (WLST) with a presumption of poor neurological recovery. We investigated how the protocol for neurological prognostication was used and how related treatment recommendations might have affected WLST decision-making and outcome after OHCA in the Targeted Temperature Management (TTM) trial...
May 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28506439/clinical-review-loperamide-toxicity
#10
REVIEW
Peter E Wu, David N Juurlink
Loperamide is a nonprescription opioid widely used for the treatment of diarrhea. Although it is relatively safe at therapeutic doses, increasing reports describe its misuse and abuse at very high doses either for euphoric effects or to attenuate symptoms of opioid withdrawal. Life-threatening loperamide toxicity can result from the relatively new clinical syndrome of loperamide-induced cardiac toxicity. These patients are often young and may present in cardiac arrest or with unheralded, recurrent syncope in conjunction with ECG abnormalities, including marked QT-interval prolongation, QRS-interval widening, and ventricular dysrhythmias...
May 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28506244/early-eeg-for-outcome-prediction-of-postanoxic-coma-prospective-cohort-study-with-cost-minimization-analysis
#11
Lotte Sondag, Barry J Ruijter, Marleen C Tjepkema-Cloostermans, Albertus Beishuizen, Frank H Bosch, Janine A van Til, Michel J A M van Putten, Jeannette Hofmeijer
BACKGROUND: We recently showed that electroencephalography (EEG) patterns within the first 24 hours robustly contribute to multimodal prediction of poor or good neurological outcome of comatose patients after cardiac arrest. Here, we confirm these results and present a cost-minimization analysis. Early prognosis contributes to communication between doctors and family, and may prevent inappropriate treatment. METHODS: A prospective cohort study including 430 subsequent comatose patients after cardiac arrest was conducted at intensive care units of two teaching hospitals...
May 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28505041/the-potential-return-on-public-investment-in-detecting-adverse-drug-effects
#12
Krista F Huybrechts, Rishi J Desai, Moa Park, Joshua J Gagne, Mehdi Najafzadeh, Jerry Avorn
BACKGROUND: Many countries lack fully functional pharmacovigilance programs, and public budgets allocated to pharmacovigilance in industrialized countries remain low due to resource constraints and competing priorities. OBJECTIVE: Using 3 case examples, we sought to estimate the public health and economic benefits resulting from public investment in active pharmacovigilance programs to detect adverse drug effects. RESEARCH DESIGN: We assessed 3 examples in which early signals of safety hazards were not adequately recognized, resulting in continued exposure of a large number of patients to these drugs when safer and effective alternative treatments were available...
June 2017: Medical Care
https://www.readbyqxmd.com/read/28504892/palliative-care-interventions-before-left-ventricular-assist-device-implantation-in-both-bridge-to-transplant-and-destination-therapy
#13
Shunichi Nakagawa, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Craig D Blinderman
BACKGROUND: The optimal level of palliative care (PC) involvement in left ventricular assist device (LVAD) therapy has yet to be determined. OBJECTIVE: Describe the feasibility of PC intervention to elucidate patients' goals and values in LVAD therapy in both destination therapy (DT) and bridge to transplant (BTT). DESIGN: Single center, prospective, single-arm study. SETTING/SUBJECTS: All patients who received mandatory PC consultation, using a semistructured script, before LVAD implantation (PreVAD evaluation)...
May 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28501140/alectinib-versus-crizotinib-in-patients-with-alk-positive-non-small-cell-lung-cancer-j-alex-an-open-label-randomised-phase-3-trial
#14
Toyoaki Hida, Hiroshi Nokihara, Masashi Kondo, Young Hak Kim, Koichi Azuma, Takashi Seto, Yuichi Takiguchi, Makoto Nishio, Hiroshige Yoshioka, Fumio Imamura, Katsuyuki Hotta, Satoshi Watanabe, Koichi Goto, Miyako Satouchi, Toshiyuki Kozuki, Takehito Shukuya, Kazuhiko Nakagawa, Tetsuya Mitsudomi, Nobuyuki Yamamoto, Takashi Asakawa, Ryoichi Asabe, Tomohiro Tanaka, Tomohide Tamura
BACKGROUND: Alectinib, a potent, highly selective, CNS-active inhibitor of anaplastic lymphoma kinase (ALK), showed promising efficacy and tolerability in the single-arm phase 1/2 AF-001JP trial in Japanese patients with ALK-positive non-small-cell lung cancer. Given those promising results, we did a phase 3 trial to directly compare the efficacy and safety of alectinib and crizotinib. METHODS: J-ALEX was a randomised, open-label, phase 3 trial that recruited ALK inhibitor-naive Japanese patients with ALK-positive non-small-cell lung cancer, who were chemotherapy-naive or had received one previous chemotherapy regimen, from 41 study sites in Japan...
May 10, 2017: Lancet
https://www.readbyqxmd.com/read/28499730/effects-of-withdrawing-alpha-1-blocker-from-the-combination-therapy-with-alpha-1-blocker-and-5-alpha-reductase-inhibitor-in-patients-with-lower-urinary-tract-symptoms-suggestive-of-benign-prostatic-hyperplasia-a-prospective-and-comparative-trial-using-urodynamics
#15
Yoshihisa Matsukawa, Shun Takai, Yasuhito Funahashi, Tsuyoshi Majima, Masashi Kato, Tokunori Yamamoto, Momokazu Gotoh
PURPOSE: To compare the effects on lower urinary tract symptoms (LUTS) and bladder outlet obstruction between combination therapy with α1 blocker and 5α-reductase inhibitor and a switch to 5α-reductase inhibitor monotherapy, and determine the factors influencing changes in LUTS after α1 blocker withdrawal. MATERIALS AND METHODS: One-hundred and forty outpatients with LUTS suggestive of benign prostatic hyperplasia received combination therapy with silodosin 8 mg/day and dutasteride 0...
May 9, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28495642/feasibility-of-lenalidomide-therapy-for-persistent-chronic-lymphocytic-leukemia-after-allogeneic-transplantation
#16
Maria R Khouri, Elias J Jabbour, Alison M Gulbis, Francesco Turturro, Celina Ledesma, Martin Korbling, Barry I Samuels, Sairah Ahmed, Amin M Alousi, Stefan O Ciurea, David Marin, Krina K Patel, Uday R Popat, Carlos E Bueso-Ramos, Roland L Bassett, Issa F Khouri
In patients with chronic lymphocytic leukemia (CLL), persistence of disease after allogeneic stem cell transplantation (alloSCT) can result in poor outcomes. In an effort to improve these outcomes, patients with persistent CLL who were 90-100 days post alloSCT with no evidence of graft-versus-host-disease (GVHD) were randomized to receive lenalidomide or standard care (withdrawal of immunosuppression followed by donor lymphocyte infusion). Lenalidomide was initiated at 5 mg every other day and increased to 10 mg daily if tolerated in each patient...
May 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28492463/impact-of-an-alcohol-withdrawal-treatment-pathway-on-hospital-length-of-stay-a-retrospective-observational-study-comparing-pre-and-post-pathway-implementation
#17
Andrew J Muzyk, Rachel E Rogers, Gary Dighe, Jessica Hartung, Robert C Musser, Mary J Stillwagon, Sarah Rivelli
OBJECTIVE: To determine if the implementation of a hospital-specific alcohol withdrawal treatment pathway used in a medical-surgical patient population decreased hospital length of stay (LOS) compared with the standard of care. METHODS: This retrospective observational study, conducted in a large academic tertiary care hospital, involved 582 subjects who met criteria for study inclusion, with 275 subjects in the 2010 cohort and 307 in the 2012 cohort. The Alcohol Withdrawal Project Team was formed with the goal of creating a standardized approach to the recognition and treatment of alcohol withdrawal at Duke University Hospital...
May 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28490416/development-and-assessment-of-an-e-learning-course-on-pediatric-cardiology-basics
#18
Ana Cristina Oliveira, Sandra Mattos, Miguel Coimbra
BACKGROUND: Early detection of congenital heart disease is a worldwide problem. This is more critical in developing countries, where shortage of professional specialists and structural health care problems are a constant. E-learning has the potential to improve capacity, by overcoming distance barriers and by its ability to adapt to the reduced time of health professionals. OBJECTIVE: The study aimed to develop an e-learning pediatric cardiology basics course and evaluate its pedagogical impact and user satisfaction...
May 10, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28488610/pregabalin-and-lamotrigine-in-central-poststroke-pain-a-pilot-study
#19
Jayantee Kalita, Satish Chandra, Usha Kant Misra
BACKGROUND: Comparative study of Class I drugs in central poststroke pain (CPSP) is lacking. OBJECTIVE: To evaluate the safety and efficacy of pregabalin and lamotrigine in patients with CPSP. SETTING: Tertiary care teaching referral hospital. METHODS: We included consecutive patients with CPSP having ≥50 mm score on Visual Analog Scale (VAS) and randomized them to receive either oral pregabalin or oral lamotrigine...
May 2017: Neurology India
https://www.readbyqxmd.com/read/28483610/decision-making-on-withholding-or-withdrawing-life-support-in-the-icu-a-worldwide-perspective
#20
Suzana M Lobo, Flávio Henrique Barros de Simoni, Stephan M Jakob, Angel Estella, Sonali Vadi, Andreas Bluethgen, Ignacio Martin-Loeches, Yasser Sakr, Jean-Louis Vincent
BACKGROUND: Many critically ill patients who die will do so after a decision has been made to withhold/withdraw life-sustaining therapy. Our objective was to document the characteristics of intensive care unit (ICU) patients with a decision to withhold/withdraw life-sustaining treatment, including the types of supportive treatments used, patterns of organ dysfunction, and international differences, including gross national income (GNI). METHODS: In this observational cohort study conducted in 730 ICUs in 84 countries, all adult patients admitted between May 8 and May 18, 2012, except admissions for routine postoperative surveillance, were included...
May 5, 2017: Chest
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