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https://www.readbyqxmd.com/read/29763816/design-of-a-phase-3-trial-of-intracoronary-administration-of-human-adenovirus-5-encoding-human-adenylyl-cyclase-type-6-rt-100-gene-transfer-in-patients-with-heart-failure-with-reduced-left-ventricular-ejection-fraction-the-flourish-clinical-trial
#1
William F Penny, Timothy D Henry, Matthew W Watkins, Amit N Patel, H Kirk Hammond
The prognosis of patients with HFrEF remains poor despite the use of current medical and device therapies. Preclinical studies of HFrEF using IC delivery of RT-100, a replication deficient, E1/E3-deleted human adenovirus 5 encoding human AC6 was associated with favorable effects on LV function and remodeling. A recent multicenter, double-blind, placebo-controlled, phase 2 study demonstrated the safety of IC delivery of RT-100 in HFrEF patients and potential efficacy at the higher doses. This phase 2 dose finding study, which included doses not expected to be effective, identified a potential reduction in congestive heart failure admissions in the AC6-treated group one year after randomization...
April 6, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29751798/clinic-flow-for-sti-hiv-and-tb-patients-in-an-urban-infectious-disease-clinic-offering-point-of-care-testing-services-in-durban-south-africa
#2
Katrina J Stime, Nigel Garrett, Yukteshwar Sookrajh, Jienchi Dorward, Ntuthu Dlamini, Ayo Olowolagba, Monisha Sharma, Ruanne V Barnabas, Paul K Drain
BACKGROUND: Many clinics in Southern Africa have long waiting times. The implementation of point-of-care (POC) tests to accelerate diagnosis and improve clinical management in resource-limited settings may improve or worsen clinic flow and waiting times. The objective of this study was to describe clinic flow with special emphasis on the impact of POC testing at a large urban public healthcare clinic in Durban, South Africa. METHODS: We used time and motion methods to directly observe patients and practitioners...
May 11, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29746482/implementation-of-a-voluntary-deep-inspiration-breath-hold-technique-vdibh-using-brainlab-exactrac-infrared-optical-tracking-system
#3
Edy Ippolito, Michele Fiore, Alessia Di Donato, Sonia Silipigni, Carla Rinaldi, Patrizia Cornacchione, Erminia Infusino, Cristina Di Venanzio, Carlo Greco, Lucio Trodella, Sara Ramella, Rolando Maria D'Angelillo
BACKGROUND: Voluntary deep inspiration breath hold technique (vDIBH) is considered as the key to achieving the widest cardiac sparing in whole breast irradiation. Several techniques have been implemented to achieve a reproducible, fast and friendly treatment. The aim of the present study is to implement vDIBH using the ExacTrac (BrainLAB AG, Germany) monitoring system. METHODS: Women with left-sided breast cancer, younger than 50 years or with cardiac disease, underwent whole breast RT with vDIBH using the ExacTrac (BrainLAB AG, Germany) monitoring system...
2018: PloS One
https://www.readbyqxmd.com/read/29745009/a-fast-jaw-tracking-model-for-vmat-and-imrt-monte-carlo-simulations
#4
Reid Townson, Hilary Egglestone, Sergei Zavgorodni
Modern radiotherapy techniques involve routine use of volumetric arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) with jaw-tracking - dynamic motion of the secondary collimators (jaws) in tandem with multi-leaf collimators (MLCs). These modalities require accurate dose calculations for the purposes of treatment planning and dose verification. Monte Carlo (MC) methods for radiotherapy dose calculation are widely accepted as capable of achieving high accuracy. This paper presents an efficiency-enhancement method for secondary collimator modeling, presented in the context of a tool for MC-based dose second checks...
May 9, 2018: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/29742626/delta-alert-expanding-gerotrauma-criteria-to-improve-patient-outcomes-a-2-year-study
#5
Lynn L Wiles, Mark D Day
BACKGROUND/SIGNIFICANCE: Because of their decreased physical reserve and increased risk of complications, the geriatric trauma patient (GTP) population warrants heightened awareness by clinical staff. PURPOSE: The purpose of this study is to determine whether the institution of a third-tier trauma protocol results in a change in GTP outcomes, complications, and mortality rates. METHODS: Researchers conducted a retrospective review of 2 years of data from the trauma registry, hospital quality improvement audits, and patient charts to examine what, if any, patient outcomes were impacted by the institution of the expanded GTP protocol...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29740519/repurposing-drugs-to-fast-track-therapeutic-agents-for-the-treatment-of-cryptococcosis
#6
Megan Truong, Leigh G Monahan, Dee A Carter, Ian G Charles
Many infectious diseases disproportionately affect people in the developing world. Cryptococcal meningitis is one of the most common mycoses in HIV-AIDS patients, with the highest burden of disease in sub-Saharan Africa. Current best treatment regimens still result in unacceptably high mortality rates, and more effective antifungal agents are needed urgently. Drug development is hampered by the difficulty of developing effective antifungal agents that are not also toxic to human cells, and by a reluctance among pharmaceutical companies to invest in drugs that cannot guarantee a high financial return...
2018: PeerJ
https://www.readbyqxmd.com/read/29718154/early-extubation-is-associated-with-improved-early-outcome-after-extracardiac-total-cavopulmonary-connection-independently-of-duration-of-cardiopulmonary-bypass
#7
Stanislav Ovroutski, Peter Kramer, Sarah Nordmeyer, Mi-Young Cho, Matthias Redlin, Oliver Miera, Joachim Photiadis, Felix Berger
OBJECTIVES: Strict patient selection, short cardiopulmonary bypass (CPB) time and short mechanical ventilation are well-recognized aspects of optimizing the postoperative course after total cavopulmonary connection. In this study, we evaluated the influence of our early postoperative extubation strategy in our population of Fontan patients over the past 2 decades. METHODS: Early postoperative course was evaluated retrospectively in 211 consecutive patients, who were selected for total cavopulmonary connection in our institution between 1995 and 2015...
April 27, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29701425/analgesia-management-for-mitral-valve-repair-via-minithoracotomy-a-case-report
#8
Andreia Fernandes, Clara Gaio Lima, Nelson Paulo, Catarina Celestino, Ana Fonte Boa, Fátima Lima, Manuela Vieira
INTRODUCTION: Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. Chronic pain, due to intercostal nerve injury, develops in up to 50% of postthoracotomy patients.A number of regional anaesthesia and analgesia techniques may be employed, and the anaesthesiologists play a key role in facilitating optimal outcomes after surgery. METHODS: We report a case of postoperative pain management with a local anesthetic infiltration for MICS...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29696301/-radical-cystectomy-and-urinary-diversion-what-is-important
#9
REVIEW
J Noldus, G Niegisch, A Pycha, A Karl
BACKGROUND: In Germany, radical cystectomy with urinary diversion is the primary therapeutic option for localized muscle invasive urothelial bladder cancer. Modifications in the pre-, peri-, and postoperative phase have significantly improved outcomes. OBJECTIVES: Different factors and parameters are directly associated with patients' outcome. An overview on how to best approach this procedure is provided in this article. MATERIALS AND METHODS: The data regarding preparation and the procedure for the radical cystectomy followed by urinary diversion are separately analyzed...
April 25, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29691950/adapting-evidence-based-clinical-practice-guidelines-at-university-teaching-hospitals-a-model-for-the-eastern-mediterranean-region
#10
Yasser S Amer, Hayfaa A Wahabi, Manal M Abou Elkheir, Ghada A Bawazeer, Shaikh M Iqbal, Maher A Titi, Aishah Ekhzaimy, Khalid A Alswat, Rasmieh A Alzeidan, Lubna A Al-Ansary
RATIONALE, AIMS, AND OBJECTIVES: Clinical practice guidelines (CPGs) are significant tools for evidence-based health care quality improvement. The CPG program at King Saud University was launched as a quality improvement program to fulfil the international accreditation standards. This program was a collaboration between the Research Chair for Evidence-Based Healthcare and Knowledge Translation and the Quality Management Department. This study aims to develop a fast-track method for adaptation of evidence-based CPGs and describe results of the program...
April 24, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29676839/analgesic-consumption-trajectories-in-8-975-patients-1-year-after-fast-track-total-hip-or-knee-arthroplasty
#11
C C Jørgensen, M Petersen, H Kehlet, E K Aasvang
BACKGROUND: Persistent or increased long-term opioid consumption has previously been described following total hip- (THA) and knee arthroplasty (TKA). However, detailed information on postoperative analgesic consumption trajectories and risk factors associated with continued need of analgesics in fast-track THA and TKA is sparse. METHODS: Descriptive multicenter study in primary unilateral fast-track THA or TKA with prospective data on patient characteristics and information on reimbursement entitled dispensed prescriptions of paracetamol, non-steroidal anti-inflammatory drugs, opioids, anticonvulsants, and antidepressants one month preoperatively and one year postoperatively...
April 20, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29671152/predictive-simulations-of-neuromuscular-coordination-and-joint-contact-loading-in-human-gait
#12
Yi-Chung Lin, Jonathan P Walter, Marcus G Pandy
We implemented direct collocation on a full-body neuromusculoskeletal model to calculate muscle forces, ground reaction forces and knee contact loading simultaneously for one cycle of human gait. A data-tracking collocation problem was solved for walking at the normal speed to establish the practicality of incorporating a 3D model of articular contact and a model of foot-ground interaction explicitly in a dynamic optimization simulation. The data-tracking solution then was used as an initial guess to solve predictive collocation problems, where novel patterns of movement were generated for walking at slow and fast speeds, independent of experimental data...
April 18, 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29669540/predictive-values-of-upper-gastrointestinal-cancer-alarm-symptoms-in-the-general-population-a-nationwide-cohort-study
#13
Sanne Rasmussen, Peter Fentz Haastrup, Kirubakaran Balasubramaniam, René DePont Christensen, Jens Søndergaard, Dorte Ejg Jarbøl
BACKGROUND: Survival rates for upper gastrointestinal (GI) cancer are poor since many are diagnosed at advanced stages. Fast track endoscopy has been introduced to prompt diagnosis for patients with alarm symptoms that could be indicative of upper GI cancer. However, these symptoms may represent benign conditions and little is known about the predictive values of alarm symptoms of upper GI cancer in the general population. METHODS: The study is a nationwide cohort study of 60,562 individuals aged 45 years or above randomly selected from the Danish general population...
April 18, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29629201/anesthesia-and-fast-track-in-video-assisted-thoracic-surgery-vats-from-evidence-to-practice
#14
REVIEW
Marzia Umari, Stefano Falini, Matteo Segat, Michele Zuliani, Marco Crisman, Lucia Comuzzi, Francesco Pagos, Stefano Lovadina, Umberto Lucangelo
In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29618625/getting-serious-about-the-early-life-epilepsies-lessons-from-the-world-of-pediatric-oncology
#15
REVIEW
Anne T Berg, Stewart Goldman
Early-life epilepsies represent a group of many individually rare and often complex developmental brain disorders associated with lifelong devastating consequences and high risk for early mortality. The quantity and quality of evidence needed to guide the evaluation and treatment to optimize outcomes of affected children is minimal; most children are treated within an evidence-free practice zone based solely on anecdote and lore. The remarkable advances in diagnostics and therapeutics are implemented haphazardly with no systematic effort to understand their effects and value...
April 4, 2018: Neurology
https://www.readbyqxmd.com/read/29615066/a-qualitative-assessment-of-the-challenges-of-who-prequalification-for-anti-malarial-drugs-in-china
#16
Yangmu Huang, Ke Pan, Danlu Peng, Andy Stergachis
BACKGROUND: While China is a major manufacturer of artemisinin and its derivatives, it lags as a global leader in terms of the total export value of anti-malarial drugs as finished pharmaceutical products ready for marketing and use by patients. This may be due to the limited number of World Health Organization (WHO) prequalified anti-malarial drugs from China. Understanding the reasons for the slow progress of WHO prequalification (PQ) in China can help improve the current situation and may lead to greater efforts in malaria eradication by Chinese manufacturers...
April 3, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29614895/heart-rate-reducing-therapy-with-add-on-ivabradine-and-bisoprolol-before-coronary-computed-tomographic-angiography-in-a-fast-track-ambulatory-setting
#17
Viktoria Muster, Markus Wallner, Albrecht Schmidt, Martin Kapl, Friederike von Lewinski, Peter Rainer, Pia Reittner, Manfred Tillich, Peter Brader, Dieter Hm Szolar, Dirk von Lewinski
Objective This study was performed to determine whether add-on oral ivabradine in patients treated with beta blockers 1 hour before coronary computed tomographic angiography (CCTA) is effective in lowering the heart rate and thus improving CCTA quality. Methods In this single-center cohort study, the data of 294 patients referred for ambulant CCTA were retrospectively screened. Patients with an initial heart rate of ≥75 bpm (n = 112) were pretreated with either a combination of bisoprolol and ivabradine or with bisoprolol alone...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29608170/multiplexed-isothermal-amplification-based-diagnostic-platform-to-detect-zika-chikungunya-and-dengue-1
#18
Ozlem Yaren, Barry W Alto, Kevin M Bradley, Patricia Moussatche, Lyudmyla Glushakova, Steven A Benner
Zika, dengue, and chikungunya viruses are transmitted by mosquitoes, causing diseases with similar patient symptoms. However, they have different downstream patient-to-patient transmission potentials, and require very different patient treatments. Thus, recent Zika outbreaks make it urgent to develop tools that rapidly discriminate these viruses in patients and trapped mosquitoes, to select the correct patient treatment, and to understand and manage their epidemiology in real time. Unfortunately, current diagnostic tests, including those receiving 2016 emergency use authorizations and fast-track status, detect viral RNA by reverse transcription polymerase chain reaction (RT-PCR), which requires instrumentation, trained users, and considerable sample preparation...
March 13, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29603321/incremental-value-of-the-tissue-motion-of-annular-displacement-derived-from-speckle-tracking-echocardiography-for-differentiating-chronic-constrictive-pericarditis-from-restrictive-cardiomyopathy
#19
Shuang Liu, Weidong Ren, Jing Zhang, Chunyan Ma, Jun Yang, Yan Zhang, Zhengyu Guan
OBJECTIVES: The tissue motion of annular displacement provides an accurate and rapid assessment of left ventricular (LV) systolic function. However, it has rarely been used in patients with chronic constrictive pericarditis and restrictive cardiomyopathy. This study aimed to assess the differences in LV systolic function in patients with constrictive pericarditis and restrictive cardiomyopathy using tissue motion of annular displacement derived from speckle-tracking echocardiography. METHODS: Twenty-four patients with constrictive pericarditis, 24 with restrictive cardiomyopathy, and 25 healthy volunteers (controls) were enrolled...
March 30, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29596123/fast-track-recovery-program-after-major-liver-resection-a-randomized-prospective-study
#20
Maria Kapritsou, Dimitrios P Korkolis, Margarita Giannakopoulou, Ioannis Kaklamanos, Maria Konstantinou, Theodoros Katsoulas, Panagiotis Kiekkas, Evangelos A Konstantinou
The objective of this study was to compare fast-track (FT) recovery protocol with the conventional one in patients treated with major liver resection by evaluating perioperative morbidity, length of hospitalization, and readmission rate. Sixty-two patients suffering from malignant liver tumors were surgically treated from May 2012 to April 2014. After randomization, they were prospectively divided into two groups: Group A patients (n = 32) followed FT recovery protocol and Group B patients (n = 30) were treated with the conventional (CON) protocol...
March 2018: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
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