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https://www.readbyqxmd.com/read/28441847/-feasibility-of-device-closure-for-multiple-atrial-septal-defects-using-3d-printing-and-ultrasound-guided-intervention-technique
#1
X Qiu, B Lü, N Xu, C W Yan, W B Ouyang, Y Liu, F W Zhang, Z Q Yue, K J Pang, X B Pan
Objective: To investigate the feasibility of trans-catheter closure of multiple atrial septal defects (ASD) monitored by trans-thoracic echocardiography (TTE) under the guidance of 3D printing heart model. Methods: Between April and August 2016, a total of 21 patients (8 male and 13 female) with multiple ASD in Fuwai Hospital of Chinese Academy of Medical Sciences underwent CT scan and 3-dimensional echocardiography for heart disease model produced by 3D printing technique. The best occlusion program was determined through the simulation test on the model...
April 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28441446/fetal-outcomes-and-associated-factors-of-adverse-outcomes-of-pregnancy-in-southern-chinese-women-with-systemic-lupus-erythematosus
#2
Zhongping Zhan, Ying Yang, Yanfeng Zhan, Dongying Chen, Liuqin Liang, Xiuyan Yang
This study aims to investigate the fetal outcomes and associated factors of adverse pregnancy outcomes (APOs) in pregnant women with systemic lupus erythematosus (SLE). Clinical data from 251 SLE patients with 263 pregnancies from 2001 to 2015 were analyzed retrospectively. APOs occurred in 70.0% of pregnancies, in which pregnancy loss occurred in 28.5%; preterm delivery occurred in 21.3%; intrauterine growth retardation occurred in 12.2%; and fetal distress occurred in 8.0%. Over time, the rate of APOs decreased from 82...
2017: PloS One
https://www.readbyqxmd.com/read/28441266/safety-of-the-inactivated-japanese-encephalitis-virus-vaccine-ixiaro%C3%A2-in-children-an-open-label-randomized-active-controlled-phase-3-study
#3
Katrin L Dubischar, Vera Kadlecek, Benjamin Sablan, Charissa Fay Borja-Tabora, Salvacion Gatchalian, Susanne Eder-Lingelbach, Zsuzsanna Mueller, Kerstin Westritschnig
BACKGROUND: Japanese encephalitis (JE) remains a serious health concern in Asian countries and has sporadically affected pediatric travelers. In the present study we monitored the safety profile of the JE virus (JEV) vaccine IXIARO in a pediatric population. METHODS: We randomized 1869 children between the age of 2 months and 17 years in an age-stratified manner to vaccination with IXIARO or one of the control vaccines, Prevnar and HAVRIX 720. Adverse events (AEs) (unsolicited and solicited local and systemic adverse events), serious AEs and medically-attended AEs were assessed up to Day 56 and Month 7 after the first dose...
April 24, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28440589/prime-movers-advanced-practice-professionals-in-the-role-of-stroke-coordinator
#4
Nicholas A Rattray, Teresa M Damush, Cherie Luckhurst, Catherine J Bauer-Martinez, Barbara J Homoya, Edward J Miech
BACKGROUND AND PURPOSE: Following a stroke quality improvement clustered randomized trial and a national acute ischemic stroke (AIS) directive in the Veterans Health Administration in 2011, this comparative case study examined the role of advanced practice professionals (APPs) in quality improvement activities among stroke teams. METHODS: Semistructured interviews were conducted at 11 Veterans Affairs medical centers annually over a 3-year period. A multidisciplinary team analyzed interviews from clinical providers through a mixed-methods, data matrix approach linking APPs (nurse practitioners and physician assistants) with Consolidated Framework for Implementation Research constructs and a group organization measure...
April 25, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28440070/chiral-analysis-of-amphetamines-in-hair-by-liquid-chromatography-tandem-mass-spectrometry-compliance-monitoring-of-attention-deficit-hyperactivity-disorder-adhd-patients-under-elvanse%C3%A2-therapy-and-identification-after-controlled-low-dose-application
#5
Tina M Binz, Elena Williner, Petra Strajhar, Patrick C Dolder, Matthias E Liechti, Markus R Baumgartner, Thomas Kraemer, Andrea E Steuer
Amphetamine (AMP) is used as illicit drug but also for the treatment of attention deficit hyperactivity disorder (ADHD). Respective drugs most often contain the enantiomer (S)-AMP as active compound or (S)-AMP is formed from the prodrug lisdexamfetamine (Elvanse®) whereas the illicit drug is usually traded as racemate ((R/S)-AMP). A differentiation between the use of the medically prescribed drug and the abuse of illicit street amphetamine is of great importance e.g. in retrospective consumption monitoring by hair analysis...
April 24, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28439951/incidence-and-risk-factors-of-hypotension-after-intravenous-fosphenytoin-administration
#6
H K Kim, I G Hwang, I-S Koh, D W Kim
WHAT IS KNOWN AND OBJECTIVE: Fosphenytoin (FOS) administered intravenously offers several benefits over intravenously administered phenytoin, including a faster infusion rate, decreased pain and irritation at the infusion site, and fewer cardiovascular complications. However, some studies suggest that the intravenous administration of FOS in some patients may also induce adverse cardiovascular events. Here, we investigated the clinical characteristics of patients who experienced hypotension following an intravenous infusion of a FOS loading dose...
April 24, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28439398/a-practical-approach-to-the-pharmacological-management-of-hypertension-in-older-people
#7
REVIEW
Nikesh Parekh, Amy Page, Khalid Ali, Kevin Davies, Chakravarthi Rajkumar
Hypertension is the leading cause of cardiovascular (CV) morbidity and mortality in adults over the age of 65. The first part of this paper is an overview, summarizing the current guidelines on the pharmacological management of hypertension in older adults in Europe and the USA, and evidence from key trials that contributed to the guidelines. In the second part of the paper, we will discuss the major challenges of managing hypertension in the context of multimorbidity, including frailty, orthostatic hypotension (OH), falls and cognitive impairment that are associated with ageing...
April 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28439389/management-of-a-viable-cesarean-scar-pregnancy-a-case-report
#8
Mini Mammen Roy, Forough Radfar
The incidence of cesarean scar pregnancy (CSP), which was extremely rare till recent times, has been rising steadily. We have more of such cases being published in medical literature now. A 38-year-old woman with a past history of previous three cesarean sections presented with five weeks pregnancy and complaints of bleeding per vaginum associated with mild lower abdominal discomfort. The diagnosis of CSP with a live fetus within the gestational sac was made on a transvaginal ultrasound examination and later confirmed with a magnetic resonance imaging (MRI)...
March 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28439135/assessment-of-direct-oral-anticoagulant-prescribing-and-monitoring-pre-and-post-implementation-of-a-pharmacy-protocol-at-a-community-teaching-hospital
#9
Christina Miele, Mary Taylor, Aditi Shah
Background: Direct oral anticoagulants (DOACs) have become popular alternatives to vitamin K antagonists for the treatment and prevention of thromboembolic diseases; however, there are limited data regarding the appropriate use of DOACs in clinical practice. To ensure safety and efficacy of these medications, it is important that decisions regarding their use in patients rely on the available evidence. Objective: The purpose of this study was to evaluate the appropriateness of DOAC prescribing in adult patients before and after the implementation of a pharmacist-driven DOAC protocol...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28438728/designing-patient-centered-text-messaging-interventions-for-increasing-physical-activity-among-participants-with-type-2-diabetes-qualitative-results-from-the-text-to-move-intervention
#10
Gabrielle N Horner, Stephen Agboola, Kamal Jethwani, Aswita Tan-McGrory, Lenny Lopez
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a disease affecting approximately 29.1 million people in the United States, and an additional 86 million adults have prediabetes. Diabetes self-management education, a complex health intervention composed of 7 behaviors, is effective at improving self-care behaviors and glycemic control. Studies have employed text messages for education, reminders, and motivational messaging that can serve as "cues to action," aiming to improve glucose monitoring, self-care behaviors, appointment attendance, and medication adherence...
April 24, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28437601/maternal-hemodynamics-in-normal-pregnancies-reference-ranges-and-the-role-of-maternal-characteristics
#11
Dimuthu Vinayagam, Baskaran Thilaganathan, Oliver Stirrup, Elena Mantovani, Asma Khalil
OBJECTIVES: The main aim of this study was to construct reference ranges of the maternal central hemodynamic parameters during pregnancy. The second aim was to determine the maternal and pregnancy characteristics, which influence these hemodynamic parameters. METHODS: This was a prospective cohort study of low-risk pregnant women attending for routine antenatal care at St George's Hospital, London. The exclusion criteria included any medical disorder present at the time of study recruitment, or development of hypertension or intrauterine fetal growth restriction following study recruitment...
April 24, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28437376/organizational-issues-structure-and-processes-of-care-in-257-icus-in-latin-america-a-study-from-the-latin-america-intensive-care-network
#12
Elisa Estenssoro, Leyla Alegría, Gastón Murias, Gilberto Friedman, Ricardo Castro, Nicolas Nin Vaeza, Cecilia Loudet, Alejandro Bruhn, Manuel Jibaja, Gustavo Ospina-Tascon, Fernando Ríos, Flavia R Machado, Alexandre Biasi Cavalcanti, Arnaldo Dubin, F Javier Hurtado, Arturo Briva, Carlos Romero, Guillermo Bugedo, Jan Bakker, Maurizio Cecconi, Luciano Azevedo, Glenn Hernandez
OBJECTIVE: Latin America bears an important burden of critical care disease, yet the information about it is scarce. Our objective was to describe structure, organization, processes of care, and research activities in Latin-American ICUs. DESIGN: Web-based survey submitted to ICU directors. SETTINGS: ICUs located in nine Latin-American countries. SUBJECTS: Individual ICUs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred fifty-seven of 498 (52%) of submitted surveys responded: 51% from Brazil, 17% Chile, 13% Argentina, 6% Ecuador, 5% Uruguay, 3% Colombia, and 5% between Mexico, Peru, and Paraguay...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437259/utility-of-esophageal-mucosal-impedance-as-a-diagnostic-test-for-esophageal-disease
#13
Dhyanesh A Patel, Michael F Vaezi
PURPOSE OF REVIEW: The aim of this review is to summarize the use of direct mucosal impedance (MI) for the evaluation and management of esophageal diseases. RECENT FINDINGS: Esophageal multichannel intraluminal impedance with pH (MII-pH) monitoring has been considered the most sensitive test for gastroesophageal reflux disease (GERD), but recent studies have failed to establish impedance parameters that reliably predict treatment response to medical and surgical GERD therapies...
April 21, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28437153/diabetic-ketoacidosis-in-patients-with-type-2-diabetes-recently-commenced-on-sglt-2-inhibitors-an-ongoing-concern
#14
Mohamed Ahmed, Malachi J McKenna, Rachel K Crowley
OBJECTIVE: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are increasingly used as an adjunctive treatment for type 2 diabetes. We report the occurrence of diabetic ketoacidosis (DKA) in 3 patients with type 2 diabetes recently commenced on SGLT-2 inhibitors. METHODS: Clinical presentation, laboratory data, and treatment outcomes of all 3 cases are described. RESULTS: All 3 patients had documented history of longstanding type 2 diabetes...
April 2, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28436977/provision-of-long-term-monitoring-and-late-effects-services-following-adult-allogeneic-haematopoietic-stem-cell-transplant-a-survey-of-uk-nhs-based-programmes
#15
A Hamblin, D M Greenfield, M Gilleece, N Salooja, M Kenyon, E Morris, N Glover, P Miller, H Braund, A Peniket, B E Shaw, J A Snowden
Despite international guidelines, optimal delivery models of late effects (LE) services for HSCT patients are unclear from the clinical, organizational and economic viewpoints. To scope current LE service delivery models within the UK NHS (National Health Service), in 2014, we surveyed the 27 adult allogeneic HSCT centres using a 30-question online tool, achieving a 100% response rate. Most LE services were led and delivered by senior physicians (>80% centres). Follow-up was usually provided in a dedicated allograft or LE clinic for the first year (>90% centres), but thereafter attrition meant that only ~50% of patients were followed after 5 years...
April 24, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28436628/-monitoring-time-of-interictal-epileptiform-discharges-by-long-term-video-eeg-in-patients-with-epilepsy
#16
Han Wu, Zhongjin Wang, Wenjie Ming, Shuang Wang, Meiping Ding
Objective: To optimize the monitoring time of interictal epileptiform discharges (IED) in patients with epilepsy by long-term video electroencephalogram (VEEG). Methods: The cumulative percentages of IED detected by VEEG in 346 epilepsy patients (349 times) with different purposes, different waking sleep states and different MRI findings were retrospectively analyzed. According to the purposes, there were 164 patients (165 times) for clarifying diagnosis, 124 patients (124 times) for preoperative evaluation and 58 patients (60 times) for adjustment of medications...
January 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/28436599/metformin-as-targeted-treatment-in-fragile-x-syndrome
#17
Angel Belle C Dy, Flora Tassone, Marwa Eldeeb, María J Salcedo-Arellano, Nicole Tartaglia, Randi Hagerman
Individuals with Fragile X Syndrome (FXS) may be affected by several comorbid conditions, both behavioral and medical. Growth findings suggest that they are at an increased risk for obesity and overeating. The Prader-Willi phenotype (PWP) of FXS occurs in less than 10% of patients but it is associated with severe hyperphagia, lack of satiation and morbid obesity. Metformin is a drug used in individuals with high risk for diabetes type 2, obesity or impaired glucose tolerance. It has had a strong safety profile in children and adults with type 2 diabetes and obesity...
April 24, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/28436558/adverse-effects-of-pegaspargase-in-pediatric-patients-receiving-doses-greater-than-3-750%C3%A2-iu
#18
Rachel Lebovic, Natalie Pearce, Laura Lacey, James Xenakis, Cassidy B Faircloth, Patrick Thompson
BACKGROUND: Increased toxicities have been identified with higher doses of pegaspargase (PEG-ASP) in adults. This has led to routine use of a dose cap of 3,750 IU for adult acute lymphoblastic leukemia (ALL) patients in most institutions. In pediatric ALL patients, PEG-ASP is not capped. There is concern at our institution that larger doses may result in increased rates of adverse effects and that increased monitoring may be warranted in pediatric patients receiving doses greater than 3,750 IU...
April 24, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28436158/collaborating-on-medication-errors-in-nursing
#19
Marketa Marvanova, Paul J Henkel
BACKGROUND: Nurse educators are faced with changing roles and expanding responsibilities for medication administration and monitoring in pursuit of improved patient safety. The aims of this study were to develop, implement and evaluate clinical simulation experiences that included, along with nursing faculty members, a pharmacist educator for the teaching of preventable medication errors in undergraduate nursing education. METHODS: Four clinical simulation scenarios using high-fidelity patient simulators were developed focusing on select medication problems in nursing practice...
April 24, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28436156/faculty-development-effects-on-clerkship-grades
#20
Benjamin Griffeth, Michael Wiederman
BACKGROUND: Faculty member assessment of clerkship students' clinical performance has been noted as a consistently problematic issue within most medical student clerkships, and thus a worthy target of faculty development. One of the primary challenges in such faculty development is creating a change that improves the clinical assessment of students in a meaningful way. METHOD: In the current study we evaluated the effects of a pair of brief interventions designed to facilitate greater use of the 'Not observed' option in faculty member assessments of clerkship students (as opposed to use of 'Meets expectations' for skills actually not observed by the rater) within a psychiatry rotation for third-year medical students in the USA...
April 24, 2017: Clinical Teacher
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