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https://www.readbyqxmd.com/read/28074802/goal-directed-therapy-improves-the-outcome-of-high-risk-cardiac-patients-undergoing-off-pump-coronary-artery-bypass
#1
Poonam Malhotra Kapoor, Rohan Magoon, Rajinder Singh Rawat, Yatin Mehta, Sameer Taneja, R Ravi, Milind P Hote
BACKGROUND: There has been a constant emphasis on developing management strategies to improve the outcome of high-risk cardiac patients undergoing surgical revascularization. The performance of coronary artery bypass surgery on an off-pump coronary artery bypass (OPCAB) avoids the risks associated with extra-corporeal circulation. The preliminary results of goal-directed therapy (GDT) for hemodynamic management of high-risk cardiac surgical patients are encouraging. The present study was conducted to study the outcome benefits with the combined use of GDT with OPCAB as compared to the conventional hemodynamic management...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28065470/the-rare-variant-generalized-disequilibrium-test-for-association-analysis-of-nuclear-and-extended-pedigrees-with-application-to-alzheimer-disease-wgs-data
#2
Zongxiao He, Di Zhang, Alan E Renton, Biao Li, Linhai Zhao, Gao T Wang, Alison M Goate, Richard Mayeux, Suzanne M Leal
Whole-genome and exome sequence data can be cost-effectively generated for the detection of rare-variant (RV) associations in families. Causal variants that aggregate in families usually have larger effect sizes than those found in sporadic cases, so family-based designs can be a more powerful approach than population-based designs. Moreover, some family-based designs are robust to confounding due to population admixture or substructure. We developed a RV extension of the generalized disequilibrium test (GDT) to analyze sequence data obtained from nuclear and extended families...
January 2, 2017: American Journal of Human Genetics
https://www.readbyqxmd.com/read/27999663/implementation-of-goal-directed-fluid-therapy-during-hip-revision-arthroplasty-a-matched-cohort-study
#3
Marit Habicher, Felix Balzer, Viktor Mezger, Jennifer Niclas, Michael Müller, Carsten Perka, Michael Krämer, Michael Sander
BACKGROUND: Several randomized controlled trials (RCTs) have demonstrated that intraoperative goal-directed fluid therapy (GDFT) can decrease postsurgical complications in patients undergoing major abdominal surgery. However, very few studies have demonstrated the value of goal-directed therapy (GDT) in patients undergoing orthopaedic surgery and confirmed it is as useful in real-life conditions. Therefore, we initiated a GDFT implementation programme in patients undergoing hip revision arthroplasty in order to assess its effects on postoperative complications (e...
2016: Perioperative Medicine
https://www.readbyqxmd.com/read/27938662/transient-protein-protein-interactions-perturb-e-coli-metabolome-and-cause-gene-dosage-toxicity
#4
Sanchari Bhattacharyya, Shimon Bershtein, Jin Yan, Tijda Argun, Amy I Gilson, Sunia A Trauger, Eugene I Shakhnovich
Gene dosage toxicity (GDT) is an important factor that determines optimal levels of protein abundances, yet its molecular underpinnings remain unknown. Here, we demonstrate that overexpression of DHFR in E. coli causes a toxic metabolic imbalance triggered by interactions with several functionally related enzymes. Though deleterious in the overexpression regime, surprisingly, these interactions are beneficial at physiological concentrations, implying their functional significance in vivo. Moreover, we found that overexpression of orthologous DHFR proteins had minimal effect on all levels of cellular organization - molecular, systems, and phenotypic, in sharp contrast to E...
December 10, 2016: ELife
https://www.readbyqxmd.com/read/27936959/significance-of-perioperative-goal-directed-hemodynamic-approach-in-preventing-postoperative-complications-in-patients-after-cardiac-surgery-a-meta-analysis-and-systematic-review
#5
Peng Li, Li-Ping Qu, Dong Qi, Bo Shen, Yi-Mei Wang, Jia-Rui Xu, Wu-Hua Jiang, Hao Zhang, Xiao-Qiang Ding, Jie Teng
PURPOSE: Goal-directed hemodynamic therapy (GDT) is used to prevent hypoperfusion resulting from surgery. The objective of this study was to analyze the efficacy and importance of perioperative GDT. METHODS: PUBMED, MEDLINE, CENTRAL, and Google Scholar databases were searched until June 17, 2016 using the search terms: cardiac output, cardiac surgical procedures, hemodynamics, goal-directed therapy, and intraoperative. Randomized-controlled trials with pre-emptive hemodynamic intervention for cardiac surgical population versus standard hemodynamic therapy were included...
December 12, 2016: Annals of Medicine
https://www.readbyqxmd.com/read/27931648/haemodynamic-coherence-in-perioperative-setting
#6
REVIEW
Andrea Carsetti, Ximena Watson, Maurizio Cecconi
Over the last decade, there has been an increased interest in the use of goal-directed therapy (GDT) in patients undergoing high-risk surgery, and various haemodynamic monitoring tools have been developed to guide perioperative care. Both the complexity of the patient and surgical procedure need to be considered when deciding whether GDT will be beneficial. Ensuring optimum tissue perfusion is paramount in the perioperative period and relies on the coherence between both macrovascular and microvascular circulations...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27925584/topological-analysis-and-gaussian-decision-tree-effective-representation-and-classification-of-biosignals-of-small-sample-size
#7
Zhifei Zhang, Yang Song, Haochen Cui, Jayne Wu, Fernando Schwartz, Hairong Qi
GOAL: Bucking the trend of big data, in microdevice engineering, small sample size is common, especially when the device is still at the proof-of-concept stage. The small sample size, small inter-class variation, and large intra-class variation, have brought biosignal analysis new challenges. Novel representation and classification approaches need to be developed to effectively recognize targets of interests with the absence of a large training set. METHODS: Moving away from the traditional signal analysis in the spatiotemporal domain, we exploit the biosignal representation in the topological domain that would reveal the intrinsic structure of point clouds generated from the biosignal...
December 2, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27885514/speech-evoked-auditory-brainstem-response-and-gap-detection-threshold-in-middle-aged-individual
#8
Himanshu Kumar Sanju, Vaishnavi Bohra, Sujeet Kumar Sinha
This study aimed at characterizing the gap detection threshold (GDT) and speech evoked ABR (SABR) in younger and middle-aged individuals. Two groups of subjects were participated in the study which includes 15 young adults in the age range of 15-25 years and 15 middle-aged individuals in the age range of 40-60 years. SABR with stimulus/da/of 40 ms and GDT were investigated on both groups. For SABR, Mann-Whitney U test revealed that ageing has significantly adverse effect on the encoding of F1 and F2 at brainstem level...
November 24, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27849333/fibrates-for-primary-prevention-of-cardiovascular-disease-events
#9
REVIEW
Tobias Jakob, Alain J Nordmann, Stefan Schandelmaier, Ignacio Ferreira-González, Matthias Briel
BACKGROUND: Fibrates are effective for modifying atherogenic dyslipidaemia, and particularly for lowering serum triglycerides. However, evidence that fibrates reduce mortality and morbidity associated with cardiovascular disease (CVD), or overall mortality and morbidity, in the primary prevention of CVD is lacking. OBJECTIVES: This Cochrane Review and meta-analysis aimed to evaluate the clinical benefits and harms of fibrates versus placebo or usual care or fibrates plus other lipid-modifying drugs versus other lipid-modifying drugs alone for the primary prevention of cardiovascular disease (CVD) morbidity and mortality...
16, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27749055/use-of-restraints-from-consensus-fragments-of-multiple-server-models-to-enhance-protein-structure-prediction-capability-of-the-unres-force-field
#10
Magdalena A Mozolewska, Paweł Krupa, Bartłomiej Zaborowski, Adam Liwo, Jooyoung Lee, Keehyoung Joo, Cezary Czaplewski
Recently, we developed a new approach to protein-structure prediction, which combines template-based modeling with the physics-based coarse-grained UNited RESidue (UNRES) force field. In this approach, restrained multiplexed replica exchange molecular dynamics simulations with UNRES, with the C(α)-distance and virtual-bond-dihedral-angle restraints derived from knowledge-based models are carried out. In this work, we report a test of this approach in the 11th Community Wide Experiment on the Critical Assessment of Techniques for Protein Structure Prediction (CASP11), in which we used the template-based models from early-stage predictions by the LEE group CASP11 server (group 038, called "nns"), and further improvement of the method...
November 28, 2016: Journal of Chemical Information and Modeling
https://www.readbyqxmd.com/read/27746835/auditory-temporal-resolution-in-individuals-with-diabetes-mellitus-type-2
#11
Rajkishor Mishra, Himanshu Kumar Sanju, Prawin Kumar
Introduction "Diabetes mellitus is a group of metabolic disorders characterized by elevated blood sugar and abnormalities in insulin secretion and action" (American Diabetes Association). Previous literature has reported connection between diabetes mellitus and hearing impairment. There is a dearth of literature on auditory temporal resolution ability in individuals with diabetes mellitus type 2. Objective The main objective of the present study was to assess auditory temporal resolution ability through GDT (Gap Detection Threshold) in individuals with diabetes mellitus type 2 with high frequency hearing loss...
October 2016: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/27718347/behavioral-measures-of-temporal-processing-and-speech-perception-in-cochlear-implant-users
#12
Chelsea Blankenship, Fawen Zhang, Robert Keith
BACKGROUND: Although most cochlear implant (CI) users achieve improvements in speech perception, there is still a wide variability in speech perception outcomes. There is a growing body of literature that supports the relationship between individual differences in temporal processing and speech perception performance in CI users. Previous psychophysical studies have emphasized the importance of temporal acuity for overall speech perception performance. Measurement of gap detection thresholds (GDTs) is the most common measure currently used to assess temporal resolution...
October 2016: Journal of the American Academy of Audiology
https://www.readbyqxmd.com/read/27716694/perioperative-utility-of-goal-directed-therapy-in-high-risk-cardiac-patients-undergoing-coronary-artery-bypass-grafting-a-clinical-outcome-and-biomarker-based-study
#13
Poonam Malhotra Kapoor, Rohan Magoon, Rajinder Rawat, Yatin Mehta
Goal-directed therapy (GDT) encompasses guidance of intravenous (IV) fluid and vasopressor/inotropic therapy by cardiac output or similar parameters to help in early recognition and management of high-risk cardiac surgical patients. With the aim of establishing the utility of perioperative GDT using robust clinical and biochemical outcomes, we conducted the present study. This multicenter randomized controlled study included 130 patients of either sex, with European system for cardiac operative risk evaluation ≥3 undergoing coronary artery bypass grafting on cardiopulmonary bypass...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27568887/risky-decision-making-under-risk-in-schizophrenia-a-deliberate-choice
#14
Anya Pedersen, Robert Göder, Samuel Tomczyk, Patricia Ohrmann
BACKGROUND AND OBJECTIVES: Patients with schizophrenia reveal impaired decision-making strategies causing social, financial and health care problems. The extent to which deficits in decision-making reflect intentional risky choices in schizophrenia is still under debate. Based on previous studies we expected patients with schizophrenia to reveal a riskier performance on the GDT and to make more disadvantageous decisions on the IGT. METHODS: In the present study, we investigated 38 patients with schizophrenia and 38 matched healthy control subjects with two competing paradigms regarding feedback: (1) The Game of Dice Task (GDT), in which the probabilities of winning or losing are stable and explicitly disclosed to the subject, to assess decision-making under risk and (2) the Iowa Gambling Task (IGT), which requires subjects to infer the probabilities of winning or losing from feedback, to investigate decision-making under ambiguity...
August 7, 2016: Journal of Behavior Therapy and Experimental Psychiatry
https://www.readbyqxmd.com/read/27568347/the-use-of-the-oesophageal-doppler-in-perioperative-medicine-new-opportunities-in-research-and-clinical-practice
#15
Bernardo Bollen Pinto, Glen Atlas, Bart F Geerts, Karim Bendjelid
The oesophageal Doppler (OD) is a minimally invasive haemodynamic monitor used in the surgical theatre and the ICU. Using the OD, goal-directed therapy (GDT) has been shown to reduce perioperative complications in high-risk surgical patients. However, most GDT protocols currently in use are limited to stroke volume optimisation. In the present manuscript, we examine the conceptual models behind new OD-based measurements. These would provide the clinician with a comprehensive view of haemodynamic pathophysiology; including pre-load, contractility, and afterload...
August 27, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27543527/baroreflex-impairment-and-morbidity-after-major-surgery
#16
A Toner, N Jenkins, G L Ackland
BACKGROUND: Baroreflex dysfunction is a common feature of established cardiometabolic diseases that are most frequently associated with the development of critical illness. Laboratory models show that baroreflex dysfunction impairs cardiac contractility and cardiovascular performance, thereby increasing the risk of morbidity after trauma and sepsis. We hypothesized that baroreflex dysfunction contributes to excess postoperative morbidity after major surgery as a consequence of the inability to achieve adequate perioperative tissue oxygen delivery...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27460484/a-multidimensional-approach-to-impulsivity-in-parkinson-s-disease-measurement-and-structural-invariance-of-the-upps-impulsive-behaviour-scale
#17
S Bayard, E Joly, P Ghisletta, A Rossignol, Y Herades, C Geny, M-C Gély-Nargeot, L Rochat
BACKGROUND: Poor impulse control is a common feature in patients with Parkinson's disease (PD). However, before testing whether patients with PD and controls differ in impulsivity, one must assess whether impulsivity measures are invariant across groups. Consequently, we examined (a) the measurement and structural invariance of a scale assessing changes in four dimensions of impulsivity (urgency, lack of premeditation, lack of perseverance and sensation seeking) among patients with PD and controls; and (b) whether the four impulsivity traits relate differentially to risky decisions by patients...
October 2016: Psychological Medicine
https://www.readbyqxmd.com/read/27434283/implementation-and-effects-of-pulse-contour-automated-svv-ci-guided-goal-directed-fluid-therapy-algorithm-for-the-routine-management-of-pancreatic-surgery-patients
#18
Thomas Kratz, Christina Simon, Volker Fendrich, Ralph Schneider, Hinnerk Wulf, Caroline Kratz, Turgay Efe, Karl F Schüttler, Martin Zoremba
BACKGROUND: Goal directed fluid management in major abdominal surgery has shown to reduce perioperative complications. The approach aims to optimize the intravascular fluid volume by use of minimally invasive devices which calculate flow-directed variables such as stroke volume (SV) and stroke volume variation (SVV). OBJECTIVE: We aimed to show the feasibility of routinely implementing this type of hemodynamic monitoring during pancreatic surgery, and to evaluate its effects in terms of perioperative fluid management and postoperative outcomes...
November 14, 2016: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/27401660/protocol-based-resuscitation-for-septic-shock-a-meta-analysis-of-randomized-trials-and-observational-studies
#19
Woo Kyung Lee, Ha Yeon Kim, Jinae Lee, Shin Ok Koh, Jeong Min Kim, Sungwon Na
PURPOSE: Owing to the recommendations of the Surviving Sepsis Campaign guidelines, protocol-based resuscitation or goal-directed therapy (GDT) is broadly advocated for the treatment of septic shock. However, the most recently published trials showed no survival benefit from protocol-based resuscitation in septic shock patients. Hence, we aimed to assess the effect of GDT on clinical outcomes in such patients. MATERIALS AND METHODS: We performed a systematic review that included a meta-analysis...
September 2016: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27393349/antitumor-effects-of-minodronate-a-third-generation-nitrogen-containing-bisphosphonate-in-synergy-with-%C3%AE-%C3%AE-t-cells-in-human-glioblastoma-in-vitro-and-in-vivo
#20
Tsutomu Nakazawa, Mitsutoshi Nakamura, Ryosuke Matsuda, Fumihiko Nishimura, Young Soo Park, Yasushi Motoyama, Yasuo Hironaka, Ichiro Nakagawa, Hiroshi Yokota, Shuichi Yamada, Kentaro Tamura, Yasuhiro Takeshima, Kouji Omoto, Yoshitaka Tanaka, Yukiteru Ouji, Masahide Yoshikawa, Takahiro Tsujimura, Hiroyuki Nakase
Nitrogen-containing bisphosphonates (N-BPs), which prevent bone resorption, exert direct and γδT cell (GDT)-mediated antitumor effects against several tumor cell types, including glioblastoma (GBM). However, limited information is available regarding the antitumor effects of N-BPs in GBM. Specifically, the antitumor effects of minodronate (MDA), a third-generation N-BP, in GBM are yet unclear. This study aimed to investigate the antitumor effects of MDA in GBM in vitro and in vivo. We performed growth inhibition and apoptosis detection assays using the GBM cell lines U87MG and U138MG...
September 2016: Journal of Neuro-oncology
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