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https://www.readbyqxmd.com/read/28096296/a-critical-asthma-standardized-clinical-and-management-plan-reduces-duration-of-critical-asthma-therapy
#1
Jackson Wong, Michael S D Agus, Dionne A Graham, Elliot Melendez
BACKGROUND AND OBJECTIVE: Reduction of critical asthma management time can reduce intensive care utilization. The goal of this study was to determine whether a Critical Asthma Standardized Clinical Assessment and Management Plan (SCAMP) can decrease length of critical asthma management time. METHODS: This retrospective study compared critical asthma management times in children managed before and after implementation of a Critical Asthma SCAMP. The SCAMP used an asthma severity score management scheme to guide stepwise escalation and weaning of therapies...
January 17, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28092204/impact-of-combination-therapy-and-early-de-escalation-on-outcome-of-ventilator-associated-pneumonia-caused-by-pseudomonas-aeruginosa
#2
Laurène Deconinck, Agnès Meybeck, Pierre Patoz, Nicolas Van Grunderbeeck, Nicolas Boussekey, Arnaud Chiche, Pierre-Yves Delannoy, Hugues Georges, Olivier Leroy
BACKGROUND: Pseudomonas aeruginosa is a common cause of ventilator-associated pneumonia (VAP). Guidelines recommend dual coverage of P. aeruginosa, but the beneficial effect of combination therapy is controversial. We described antibiotic prescriptions and evaluated the clinical impact of initial combination antibiotic therapy and de-escalation strategy in patients with VAP caused by P. aeruginosa. METHODS: Between 1994 and 2014, all 100 patients with VAP caused by P...
January 16, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28086870/a-pilot-study-of-a-community-health-agent-led-type-2-diabetes-self-management-program-using-motivational-interviewing-based-approaches-in-a-public-primary-care-center-in-s%C3%A3-o-paulo-brazil
#3
Thais Moura Ribeiro do Valle Nascimento, Ken Resnicow, Marcia Nery, Alexandra Brentani, Elizabeth Kaselitz, Pooja Agrawal, Simanjit Mand, Michele Heisler
BACKGROUND: Rates of noncommunicable diseases (NCDs) such as type 2 diabetes are escalating in low and middle-income countries such as Brazil. Scalable primary care-based interventions are needed to improve self-management and clinical outcomes of adults with diabetes. This pilot study examines the feasibility, acceptability, and outcomes of training community health agents (CHAs) in Motivational Interviewing (MI)-based counseling for patients with poorly controlled diabetes in a primary care center in São Paulo, Brazil...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28079601/infliximab-optimization-based-on-therapeutic-drug-monitoring-in-pediatric-ibd
#4
Tatyana Hofmekler, Madeline Bertha, Courtney McCracken, Benadette Martineau, Elizabeth McKinnon, Bess T Schoen, Barbara O McElhanon, Gayathri Tenjarla, Subra Kugathasan, Cary Sauer
BACKGROUND: Infliximab (IFX) is an effective treatment for the management of moderate to severe inflammatory bowel disease (IBD). Low serum IFX levels are associated with the development of antibodies to IFX (ATI) which subsequently associated with clinical relapse and increased morbidity. The purpose of this study is to examine the relationship between dose and interval to IFX level. Secondary goal is to evaluate the relationship between IFX level and ATI in a pediatric IBD population...
June 21, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28077144/intraoperative-radiation-therapy-for-colon-and-rectal-cancers-a-clinical-review
#5
REVIEW
Michael G Haddock
Although there have been significant advances in the adjuvant therapy of colorectal cancer, results for patients have historically been poor when complete resection is unlikely or not possible. Similarly, locally recurrent colorectal cancer patients often experience significant tumor related morbidity and disease control and long term survival have historically been poor with standard therapies. Intraoperative radiation therapy (IORT) has been proposed as a possible tool for dose escalation in patients with locally advanced colorectal cancer...
January 11, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28073650/the-utilisation-of-one-district-hospital-emergency-department-by-people-with-parkinson-s-disease
#6
Marion Harris, Margaret Fry
BACKGROUND: Parkinson's disease (PD) is the second most common neurodegenerative disorder in Australia and the economic burden is more than $8.3 billion a year and predicted to escalate. However, little is known of the trends and characteristics of people with Parkinson's disease presenting to emergency departments (ED). METHOD: The study design was a 12 month retrospective medical record audit. The study was conducted in one metropolitan 300 bed district hospital in an outer suburb of Sydney...
January 7, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28060367/applications-of-molecular-testing-in-surgical-pathology-of-the-head-and-neck
#7
Jennifer L Hunt
Molecular testing in routine surgical pathology is becoming an important component of the workup of many different types of tumors. In fact, in some organ systems, guidelines now suggest that the standard of care is to obtain specific molecular panels for tumor classification and/or therapeutic planning. In the head and neck, clinically applicable molecular tests are not as abundant as in other organ systems. Most current head and neck biomarkers are utilized for diagnosis rather than as companion diagnostic tests to predict therapeutic response...
January 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28053969/pneumococcal-urinary-antigen-test-use-in-diagnosis-and-treatment-of-pneumonia-in-seven-utah-hospitals
#8
Devin M West, Lindsay M McCauley, Jeffrey S Sorensen, Al R Jephson, Nathan C Dean
The pneumocococcal urine antigen test increases specific microbiological diagnosis over conventional culture methods in pneumonia patients. Data are limited regarding its yield and effect on antibiotic prescribing among patients with community-onset pneumonia in clinical practice. We performed a secondary analysis of 2837 emergency department patients admitted to seven Utah hospitals over 2 years with international diagnostic codes version 9 codes and radiographic evidence of pneumonia. Mean age was 64.2 years, 47...
October 2016: ERJ Open Research
https://www.readbyqxmd.com/read/28053514/clinical-outcome-and-predictors-of-adverse-events-of-an-enhanced-older-adult-psychiatric-liaison-service-rapid-assessment-interface-and-discharge-newport
#9
Inderpal Singh, Priya Fernando, Jane Griffin, Chris Edwards, Kathryn Williamson, Patrick Chance
BACKGROUND: Hospitals are currently admitting an increasing number of older people, and more than one-third could have an underlying mental health problem. The existing Older Adult Mental Health (OAMH) liaison service was increasingly unable to meet the escalating needs of older and frail patients. Therefore, the service was modernized and enhanced on an "invest-to-save" principle to provide a prompt holistic assessment for older adults with mental health problems. The objective of this study was a service evaluation to appraise clinical outcome, minimize the length of stay, and measure the predictors of adverse outcomes to streamline this enhanced service...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28049359/iranian-low-dose-escalating-prophylaxis-regimen-in-children-with-severe-hemophilia-a-and-b
#10
Peyman Eshghi, Elham Sadeghi, S Zahra Tara, Behnaz Habibpanah, Razieh Hantooshzadeh
Establishing an appropriate prophylaxis regimen for children with hemophilia is a critical challenge in developing countries. Barriers including availability and affordability, catheter-related complications, and inhibitor development risks have led to the introduction of new tailored prophylaxis regimens in different countries. This study emphasizes on the benefits of the Iranian low-dose escalating prophylaxis regimen in a Hemophilia Comprehensive Care Center in Iran. Referred patients with hemophilia less than 15 years of age, who were subject to prophylaxis regimen, are studied retrospectively...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28041323/impact-of-cervicothoracic-region-stereotactic-spine-radiosurgery-on-adjacent-organs-at-risk
#11
Mayur Sharma, Elizabeth E Bennett, Gazanfar Rahmathulla, Samuel T Chao, Hilary K Koech, Stephanie N Gregory, Todd Emch, Anthony Magnelli, Antonio Meola, John H Suh, Lilyana Angelov
OBJECTIVE Stereotactic radiosurgery (SRS) of the spine is a conformal method of delivering a high radiation dose to a target in a single or few (usually ≤ 5) fractions with a sharp fall-off outside the target volume. Although efforts have been focused on evaluating spinal cord tolerance when treating spinal column metastases, no study has formally evaluated toxicity to the surrounding organs at risk (OAR), such as the brachial plexus or the oropharynx, when performing SRS in the cervicothoracic region. The aim of this study was to evaluate the radiation dosimetry and the acute and delayed toxicities of SRS on OAR in such patients...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28033032/dynamic-and-personalized-risk-forecast-in-step-down-units-implications-for-monitoring-paradigms
#12
Lujie Chen, Ogundele Olufunmilayo, Gilles Clermont, Marilyn Hravnak, Michael R Pinsky, Artur W Dubrawski
RATIONALE: Cardiorespiratory insufficiency (CRI) is a term applied to the manifestations of loss of normal cardiorespiratory reserve and portends a bad outcome. CRI occurs commonly in hospitalized patients, but its risk escalation patterns are unexplored. OBJECTIVES: To describe the dynamic and personal character of CRI risk evolution observed through continuous vital sign monitoring of individual Step-Down Unit patients. METHODS: Using a machine learning model, we estimated risk trends for CRI (defined as exceedance of vital sign stability thresholds) for each of 1,971 admissions (1,880 unique patients) to a 24-bed adult surgical-trauma step-down unit at an urban teaching hospital in Pittsburgh, Pennsylvania using continuously-recorded vital signs from standard bedside monitors...
December 29, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28026911/managing-glycaemia-in-older-people-with-type-2-diabetes-a-retrospective-primary-care-based-cohort-study-with-economic-assessment-of-patient-outcomes
#13
Jason Gordon, Phil McEwan, Marc Evans, Jorge Puelles, Alan Sinclair
AIMS: To describe the relative health and economic outcomes associated with different therapeutic approaches to managing older patients with type 2 diabetes failing metformin (M) monotherapy and escalated to second-line treatment. METHODS: The Clinical Practice Research Datalink (CPRD) database was used to inform a retrospective observational cohort study of patients with type 2 diabetes treated with M monotherapy requiring escalation (addition or switch) to a second-line oral regimen from 01-01-2008 to 31-12-2014...
December 27, 2016: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28019065/pregnancy-outcomes-in-women-with-mechanical-prosthetic-heart-valves-a-prospective-descriptive-population-based-study-using-the-united-kingdom-obstetric-surveillance-system-ukoss-data-collection-system
#14
S Vause, B Clarke, C L Tower, Crm Hay, M Knight
OBJECTIVE: To describe the incidence of mechanical prosthetic heart valves (MPHV) in pregnancy in the UK; rates of maternal and fetal complications in this group of women, and whether these vary with the anticoagulation used during pregnancy. DESIGN: Prospective descriptive population-based study. SETTING: All consultant-led maternity units in the UK. POPULATION: All women with an MPHV who were pregnant between 1 February 2013 and 31 January 2015...
December 26, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28009421/phase-ii-multi-institutional-clinical-trial-on-a-new-mixed-beam-rt-scheme-of-imrt-on-pelvis-combined-with-a-carbon-ion-boost-for-high-risk-prostate-cancer-patients
#15
Giulia Marvaso, Barbara A Jereczek-Fossa, Barbara Vischioni, Delia Ciardo, Tommaso Giandini, Azusa Hasegawa, Federica Cattani, Mauro Carrara, Mario Ciocca, Nice Bedini, Sergio Villa, Sara Morlino, Stefania Russo, Dario Zerini, Sarah Pia Colangione, Costanza Maria Vittoria Panaino, Cristiana Fodor, Luigi Santoro, Emanuele Pignoli, Francesca Valvo, Riccardo Valdagni, Ottavio De Cobelli, Roberto Orecchia
PURPOSE: Definition of the optimal treatment schedule for high-risk prostate cancer is under debate. A combination of photon intensity modulated radiotherapy (IMRT) on pelvis with a carbon ion boost might be the optimal treatment scheme to escalate the dose on prostate and deliver curative dose with respect to normal tissue and quality of dose distributions. In fact, carbon ion beams offer the advantage to deliver hypofractionated radiotherapy (RT) using a significantly smaller number of fractions compared to conventional RT without increasing risks of late effects...
December 2, 2016: Tumori
https://www.readbyqxmd.com/read/28003505/bortezomib-for-treatment-of-therapy-refractory-anti-nmda-receptor-encephalitis
#16
Franziska Scheibe, Harald Prüss, Annerose M Mengel, Siegfried Kohler, Astrid Nümann, Martin Köhnlein, Klemens Ruprecht, Tobias Alexander, Falk Hiepe, Andreas Meisel
OBJECTIVE: We assessed the therapeutic potential of the plasma-cell-depleting proteasome inhibitor bortezomib in severe and therapy-refractory cases of anti-NMDA receptor (anti-NMDAR) encephalitis. METHODS: Five severely affected patients with anti-NMDAR encephalitis with delayed treatment response or resistance to standard immunosuppressive and B-cell-depleting drugs (corticosteroids, IV immunoglobulins, plasma exchange, immunoadsorption, rituximab, cyclophosphamide) who required medical treatment and artificial ventilation on intensive care units were treated with 1-6 cycles of 1...
December 21, 2016: Neurology
https://www.readbyqxmd.com/read/28000563/metabolomics-as-a-functional-tool-in-screening-gastro-intestinal-diseases-where-are-we-in-high-throughput-screening
#17
Rohit Gundamaraju, Ravichandra Vemuri, Rajaraman Eri, Hamilton M Ishiki, Ericsson Coy-Barrera, Nagendra Sastry Yarla, Sócrates Golzio Dos Santos, Mateus Feitosa Alves, José Maria Barbosa Filho, Margareth F F M Diniz, Marcus T Scotti, Luciana Scotti
Identifying novel bio markers in gastro intestinal disease is a promising method where a comprehensive analysis of the metabolome is performed. Metabolomics has evolved enormously in the past decade, paving a path in gastro intestinal disease research, especially diseases which lead to high morbidity and mortality. Metabolomics involves identifying metabolites such as anti-oxidants, and amino acids etc., which are screened in the urine, feces and tissue samples. Certain cases employ advanced tools like GC-MS, 1HNMR and GC-MS/SPME which reveal valuable information concerning disease severity and differentiation...
December 20, 2016: Combinatorial Chemistry & High Throughput Screening
https://www.readbyqxmd.com/read/27995636/managing-the-rising-costs-and-high-drug-expenditures-in-critical-care-pharmacy-practice
#18
Alexander H Flannery, Komal Pandya, Melanie E Laine, Philip J Almeter, Jeremy D Flynn
Pharmaceutical costs for patients in the intensive care unit (ICU) constitute a large portion of hospital drug budgets. Unfortunately, prices for medications commonly used in the ICU are on the rise for a variety of reasons. In particular, the U.S. Food and Drug Administration's Unapproved Drugs Initiative, generic manufacturers cornering the marketplace, drug shortages, and regulatory device changes are major drivers of pharmaceutical price escalation affecting costs in the ICU. Furthermore, traditional high acquisition cost items still pose challenges to controlling costs...
January 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/27990643/phase-1-randomized-double-blind-placebo-controlled-study-to-determine-the-safety-tolerability-and-pharmacokinetics-of-a-single-escalating-dose-and-repeated-doses-of-cn-105-in-healthy-adult-subjects
#19
Jeffrey T Guptill, Shruti M Raja, Felix Boakye-Agyeman, Robert Noveck, Sarah Ramey, Tian Ming Tu, Daniel T Laskowitz
Spontaneous intracranial hemorrhage (ICH) remains a devastating stroke subtype, affecting as many as 80,000 people annually in the United States and associated with extremely high mortality. In the absence of any pharmacological interventions demonstrated to improve outcome, care for patients with ICH remains largely supportive. Thus, despite advances in the understanding of ICH and brain injury, there remains an unmet need for interventions that improve neurologic recovery and outcomes. Recent research suggesting inflammation and APOE genotype play a role in modifying neurologic outcome after brain injury has led to the development of an APOE-derived peptide agent (CN-105)...
December 19, 2016: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27984382/diagnostic-yield-and-complications-of-ebus-tbna-performed-under-bronchoscopist-directed-conscious-sedation-single-center-experience-of-1004-subjects
#20
Sahajal Dhooria, Inderpaul S Sehgal, Nalini Gupta, Ashutosh N Aggarwal, Digambar Behera, Ritesh Agarwal
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can be performed under either conscious sedation or general anesthesia. Herein, we describe the diagnostic yield and complications of EBUS-TBNA performed under bronchoscopist-directed conscious sedation. METHODS: This is a retrospective analysis of data collected in the bronchoscopy suite of this center on EBUS-TBNA or endoscopic ultrasound with a bronchoscope-guided fine needle aspiration (EUS-B-FNA) procedures performed between July 2011 and January 2016...
January 2017: Journal of Bronchology & Interventional Pulmonology
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