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https://www.readbyqxmd.com/read/28742911/targeted-temperature-management-for-48-vs-24-hours-and-neurologic-outcome-after-out-of-hospital-cardiac-arrest-a-randomized-clinical-trial
#1
Hans Kirkegaard, Eldar Søreide, Inge de Haas, Ville Pettilä, Fabio Silvio Taccone, Urmet Arus, Christian Storm, Christian Hassager, Jørgen Feldbæk Nielsen, Christina Ankjær Sørensen, Susanne Ilkjær, Anni Nørgaard Jeppesen, Anders Morten Grejs, Christophe Henri Valdemar Duez, Jakob Hjort, Alf Inge Larsen, Valdo Toome, Marjaana Tiainen, Johanna Hästbacka, Timo Laitio, Markus B Skrifvars
Importance: International resuscitation guidelines recommend targeted temperature management (TTM) at 33°C to 36°C in unconscious patients with out-of-hospital cardiac arrest for at least 24 hours, but the optimal duration of TTM is uncertain. Objective: To determine whether TTM at 33°C for 48 hours results in better neurologic outcomes compared with currently recommended, standard, 24-hour TTM. Design, Setting, and Participants: This was an international, investigator-initiated, blinded-outcome-assessor, parallel, pragmatic, multicenter, randomized clinical superiority trial in 10 intensive care units (ICUs) at 10 university hospitals in 6 European countries...
July 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28742643/sensitive-troponin-i-and-stress-testing-in-the-emergency-department-for-the-early-management-of-chest-pain-using-2-hour-protocol
#2
Shahriar Dadkhah, Zakaria Almuwaqqat, Samian Sulaiman, Husein Husein, Quang Nguyen, Saad Ali, Tuncay Taskesen
BACKGROUND: Despite improvements in identifying high-risk patients with non-ST segment ACS (acute coronary syndrome), low risk patients presenting with atypical chest pain and non-diagnostic Electrocardiogram (ECG) continued to undergo unnecessary admissions and testing. Since 1992, our chest pain protocol included using 4-hour serial biomarkers from ED admission in combination with stress testing to evaluate these patients. Our study aimed at determining whether a new accelerated diagnostic protocol using sensitive cardiac troponin I (cTnI) 2 hours after admission to the ED followed by stress testing is safe and effective in emergency settings, allowing for appropriate triage, earlier discharge and reducing costs...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742267/profiling-the-effects-of-short-time-course-cold-ischemia-on-tumor-protein-phosphorylation-using-a-bayesian-approach
#3
You Wu, Jeremy Gaskins, Maiying Kong, Susmita Datta
Phosphorylated proteins provide insight into tumor etiology and are used as diagnostic, prognostic, and therapeutic markers of complex diseases. However, pre-analytic variations, such as freezing delay after biopsy acquisition, often occur in real hospital settings and potentially lead to inaccurate results. The objective of this work is to develop statistical methodology to assess the stability of phosphorylated proteins under short-time cold ischemia. We consider a hierarchical model to determine if phosphorylation abundance of a protein at a particular phosphorylation site remains constant or not during cold ischemia...
July 25, 2017: Biometrics
https://www.readbyqxmd.com/read/28742223/impact-and-implementation-of-a-sustainable-regional-telestroke-network
#4
Annemarei Ranta, Jeremy Lanford, Suzanne Busch, Carolyn Providence, Ivan Iniesta, Ian Rosemergy, Andrew Wilson, Pietro Cariga, Victoria Richmond, John Gommans
INTRODUCTION: Telestroke uses videoconferencing (VC) technology to allow off-site experts to provide stroke thrombolysis decision support to less experienced front line clinicians. This project aimed to assess the impact of a new telestroke service on thrombolysis rates and door-to-needle times in participating provincial hospitals and service resources to aid transition to a sustainably telestroke service. METHODS: This is a sequential comparison of 'pre' (December 2015 to May 2016) and 'postr' (June 2016 to December 2016) implementation outcomes...
July 25, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28742094/epidemiology-clinical-features-and-risk-factors-for-human-rabies-and-animal-bites-during-an-outbreak-of-rabies-in-maputo-and-matola-cities-mozambique-2014-implications-for-public-health-interventions-for-rabies-control
#5
Cristolde Salomão, Amílcar Nacima, Lutero Cuamba, Lorna Gujral, Olga Amiel, Cynthia Baltazar, Julie Cliff, Eduardo Samo Gudo
BACKGROUND: In Mozambique, the majority of rabies outbreaks are unreported and data on the epidemiological features of human rabies and animal bites are scarce. An outbreak of human rabies in adjacent Maputo and Matola cities in 2014 prompted us to investigate the epidemiology, clinical features and risk factors of human rabies and animal bites in the two cities. METHODOLOGY/PRINCIPAL FINDINGS: We reviewed cases of human rabies and animal bites from April to July 2014, and carried out a community investigation in July and August in the neighborhoods where cases of human rabies resided...
July 24, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28742014/results-and-limitations-of-outpatient-and-overnight-stay-laminectomies-for-lumbar-spinal-stenosis
#6
David Yen, Abdu Albargi
BACKGROUND: At our centre, laminectomies have been traditionally performed as inpatient surgery. A gradual change in practice occurred between 2010 and 2013 to try to do these procedures as outpatient or overnight stay surgery. METHODS: We conducted a retrospective cohort study of consecutive patients having laminectomies over 2 18-month periods: before the change in practice and after full implementation of the outpatient/overnight stay protocol. We collected information on patient characteristics (age, sex, American Society of Anesthesiologists [ASA] classification, home address, number of laminectomy levels, estimated blood loss) and patient outcome (complications, hospital length of stay, 30-day readmissions)...
August 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28741872/breast-disease-in-men-in-metropolitan-s%C3%A3-o-paulo-brazil
#7
Renata Thaís de Almeida Barbosa, Maria Auxiliadora F Vertamatti, Claudia Arab, Tânia Brusque Crocetta, Ricardo Lencioni Mazzei, Ivo Carelli Filho, Ricardo Faure, Izabella Brandão Mendes, Luiz Carlos de Abreu
Although rare, breast cancer in males represents 1% of all cancer in men, and has shown increasing incidence in 25 years. To analyze age, gender, type of procedure performed and diagnosis of all cases of breast diseases in a public hospital in Sao Paulo, Brazil, with special focus on men. Cross-sectional study of breast surgery in 2010-2014 at Hospital Municipal Universitario de Sao Bernardo do Campo, Brazil. In the period 999 breast surgery were carried out. Patients with benign diseases were about 30 years old and patients with malignant diseases were over 50...
July 25, 2017: Breast Journal
https://www.readbyqxmd.com/read/28741406/balanced-endoscopic-medial-and-transcutaneous-lateral-orbital-decompression-in-graves-orbitopathy
#8
Estefanía Hernández-García, J Javier San-Román, Ramón González, Araceli Nogueira, Ignacio Genol, Bazil Stoica, Nicolás Toledano, Guillermo Plaza
BACKGROUND: To determine the clinical outcomes and morbidity of endoscopic medial wall combined with transcutaneous lateral orbital wall decompression in Graves' orbitopathy. METHODOLOGY: A retrospective noncomparative case series of patients who underwent surgical decompression for Graves' orbitopathy at Hospital Universitario de Fuenlabrada between 2004 and 2014 was performed. We reviewed the patients' charts and analyzed before and after the decompression, the visual acuity (Snellen chart), optic nerve compression (fundoscopy and optic coherence tomography), exophthalmometry (Hertel measurement), ocular motility, diplopia, eyelid surgery needed after decompression and its possible complications...
July 25, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28741199/radioactive-iodine-ablation-decrease-recurrences-in-papillary-thyroid-microcarcinoma-with-lateral-lymph-node-metastasis-in-chinese-patients
#9
Shuai Xue, Peisong Wang, Jia Liu, Guang Chen
INTRODUCTION: We aimed to carry out a retrospective study from a single institution to determine whether radioactive iodine (RAI) ablation decreases the risk of recurrence of papillary thyroid microcarcinoma (PTMC) patients that presented with lateral lymph node metastasis (LLNM). METHODS: We retrospectively analyzed a total of 6361 consecutive PTMC patients who initially underwent surgery for the treatment of thyroid carcinoma at the First Hospital of Jilin University, between January 2005 and February 2015...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28741196/how-safe-is-performing-cholecystectomy-in-the-oldest-old-a-15-year-retrospective-study-from-a-single-institution
#10
Matteo Novello, Davide Gori, Salomone Di Saverio, Matteo Bianchin, Lorenzo Maestri, Francesco Vito Mandarino, Giuseppe Cavallari, Bruno Nardo
BACKGROUND: Globally, the number of people aged 80 years or over, the "oldest old," is the fastest growing population group. Because of the strong association between age and gallstone disease, both prevalence and incidence of this disease are increasing. The feasibility of the cholecystectomy in octogenarians has been evaluated in several studies that confirmed the safety of the operation. However, the safety of this procedure in nonagenarians is still controversial. The aim of this study was to evaluate the safety of cholecystectomies in nonagenarians and identify related predictors for postoperative hospital length of stay (LOS) and in-hospital mortality up to 30 days postoperatively...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28741126/an-increase-in-dietary-supplement-exposures-reported-to-us-poison-control-centers
#11
Nisha Rao, Henry A Spiller, Nichole L Hodges, Thiphalak Chounthirath, Marcel J Casavant, Amrit K Kamboj, Gary A Smith
INTRODUCTION: The objective of this study was to investigate the epidemiology of dietary supplement exposures in the USA. METHODS: A retrospective analysis was conducted of out-of-hospital dietary supplement exposures reported to the National Poison Data System from 2000 through 2012. RESULTS: There were 274,998 dietary supplement exposures from 2000 through 2012. The annual rate of dietary supplement exposures per 100,000 population increased by 46...
July 24, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28741013/prompt-use-of-mechanical-cardiopulmonary-resuscitation-in-out-of-hospital-cardiac-arrest-the-mecca-study-report
#12
Venkataraman Anantharaman, Boon Lui Benjamin Ng, Shiang Hu Ang, Chun Yue Francis Lee, Siew Hon Benjamin Leong, Marcus Eng Hock Ong, Siang Jin Terrance Chua, Antony Charles Rabind, Nagaraj Baglody Anjali, Ying Hao
INTRODUCTION: Early use of mechanical cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) may improve survival outcomes. Current evidence for such devices uses outcomes from an intention-to-treat (ITT) perspective. We aimed to determine whether early use of mechanical CPR using a LUCAS 2 device results in better outcomes. METHODS: A prospective, randomised, multicentre study was conducted over one year with LUCAS 2 devices in 14 ambulances and manual CPR in 32 ambulances to manage OHCA...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741009/the-role-of-dispatch-in-resuscitation
#13
Yih Yng Ng, Siew Hon Benjamin Leong, Marcus Eng Hock Ong
The role of the dispatch centre has increasingly become a focus of attention in cardiac arrest resuscitation. The dispatch centre is part of the first link in the chain of survival because without the initiation of early access, the rest of the chain is irrelevant. The influence of dispatch can also extend to the initiation of bystander cardiopulmonary resuscitation, early defibrillation and the rapid dispatch of emergency ambulances. The new International Liaison Committee on Resuscitation, the American Heart Association and, especially, the European Resuscitation Council 2015 guidelines have been increasing their emphasis on dispatch as the key to improving out-of-hospital cardiac arrest survival...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741005/the-pan-asian-resuscitation-outcomes-study-paros-clinical-research-network-what-where-why-and-how
#14
Nausheen Edwin Doctor, Nur Shahidah Binte Ahmad, Pin Pin Pek, Susan Yap, Marcus Eng Hock Ong
Out-of-hospital cardiac arrest (OHCA) is a global health concern with an incidence rate of 50-60 per 100,000 person-years. To improve OHCA survival rates, several cardiac arrest registries have been set up in North America and Europe, such as the Resuscitation Outcomes Consortium, Cardiac Arrest Registry to Enhance Survival, Ontario Prehospital Advanced Life Support and European Registry of Cardiac Arrest. In Asia, however, there was previously no concerted effort in prehospital emergency care research owing to differences in prehospital emergency medical services systems, data collection methods and outcome reporting between countries...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740959/idiopathic-granulomatous-mastitis-an-institutional-experience
#15
Seetharam Prasad, Padmapriya Jaiprakash, Aniket Dave, Deepti Pai
OBJECTIVE: To study idiopathic granulomatous mastitis with respect to its various clinical features, etiologic factors, treatment modalities and complications. MATERIAL AND METHODS: Retrospective study of all patients who were diagnosed with idiopathic granulomatous mastitis from 1(st) January 2006 to 31(st) December 2014 at Kasturba Hospital, Manipal, India (a tertiary care referral centre). The research was performed according to the World Medical Association Declaration of Helsinki...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28740525/the-use-of-cholecalciferol-in-patients-with-hip-fracture
#16
Luisella Cianferotti, Simone Parri, Giorgio Gronchi, Roberto Civinini, Maria Luisa Brandi
INTRODUCTION: Major osteoporotic fractures are steadily increasing due to population aging. Programs of secondary prevention against refracture are essential to decrease morbidity and mortality and the cost for individuals and the society. Vitamin D supplementation and optimization of calcium intake are of a pivotal importance to start specific osteoporosis treatment and for its safety and efficacy. Cholecalciferol is the most widely employed drug for vitamin D supplementation. PURPOSE: Aim of this study was to assess the trends in the use of vitamin D supplements containing cholecalciferol in the population of hip fracture patients older than 65 years, resident in the region of Tuscany (Italy) in the years 2011-2015 and to describe vitamin D status in a subgroup of this individuals directly referred to a bone clinic for further evaluation after hip osteoporotic fracture...
January 2017: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28739808/experiences-of-hiv-postexposure-prophylaxis-pep-among-highly-exposed-men-who-have-sex-with-men-msm
#17
Romain Palich, Guillaume Martin-Blondel, Lise Cuzin, Jean-Yves Le Talec, Pierre Boyer, Patrice Massip, Pierre Delobel
OBJECTIVES: HIV postexposure prophylaxis (PEP) is indicated after sexual exposure with high risk of transmission. Men who have sex with men (MSM) are the main target of PEP. The aim of our study was to investigate the experience and shortcomings of PEP among people with a high risk of HIV exposure. DESIGN AND METHODS: Subjects with ongoing follow-up for HIV infection and PEP history were selected for the qualitative study. Semistructured interviews were conducted at the patients' homes...
July 24, 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28739788/systematic-therapeutic-drug-monitoring-for-linezolid-variability-and-clinical-impact
#18
Alicia Galar, Maricela Valerio, Patricia Muñoz, Luis Alcalá, Xandra García-González, Almudena Burillo, Maria Sanjurjo, Santiago Grau, Emilio Bouza
Linezolid serum trough (Cmin) and peak levels were determined prospectively in 90 patients. Adequate exposure was defined as a Cmin of 2-8 mg/L. Therapy was empirical (73.3%) or targeted (26.7%). Wide interindividual variability in linezolid trough levels was recorded (0.1-25.2 μg/mL). Overall 65.5% of the patients had out of range trough levels, 41.1% subtherapeutic and 24.4% supratherapeutic.We did not find a correlation between abnormal levels and adverse events, in-hospital mortality, or overall poor outcome...
July 24, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28739748/application-of-localization-and-needle-placement-guided-by-mammographic-ultrasound-and-fiberoptic-ductoscopy-for-resection-of-non-palpable-breast-lesions
#19
Zhu Yuan, Xiang Qu, Zhong-Tao Zhang, Wen G Jiang
AIM: To evaluate the usefulness of localization needles under mammographic, ultrasound or fiberoptic ductoscopy guidance for non-palpable breast lesions. PATIENTS AND METHODS: Eighty-three patients undergoing needle localization and biopsy of non-palpable breast lesions under mammographic, ultrasound or fiberoptic ductoscopy guidance from June 2013 to December 2014 in Beijing Friendship Hospital were included in the study. The preoperative imaging assessment, application of localization needles, surgical operation and pathological examination were recorded and analyzed retrospectively...
August 2017: Anticancer Research
https://www.readbyqxmd.com/read/28739741/clinical-correlation-between-wisp2-and-%C3%AE-catenin-in-gastric-cancer
#20
Liting Li, Yuxin Cui, Jia F Ji, Wen G Jiang
BACKGROUND: Evidence indicates that wingless-type MMTV integration site family, member 1 (WNT1)-inducible signaling pathway protein 2 (WISP2) may play an important role in the development of gastric cancer (GC) by regulating the WNT/β-catenin signaling pathway. In the present study, we investigated whether there is correlation between WISP2 and β-catenin proteins, and their association with clinicopathological features in GC. MATERIALS AND METHODS: Immunohistochemical staining was carried out on 119 paraffin-embedded gastric cancer tissues and 99 adjacent normal gastric tissues collected from patients with GC at the Beijing Cancer Hospital...
August 2017: Anticancer Research
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