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https://www.readbyqxmd.com/read/29342440/the-critical-warning-sign-of-real-time-brainstem-auditory-evoked-potentials-during-microvascular-decompression-for-hemifacial-spasm
#1
Sang-Ku Park, Byung-Euk Joo, Seunghoon Lee, Jeong-A Lee, Jeong-Ho Hwang, Doo-Sik Kong, Dae-Won Seo, Kwan Park, Hoon-Taek Lee
OBJECTIVE: The aim of this study was to define the critical warning sign of real-time brainstem auditory evoked potential (BAEP) for predicting hearing loss (HL) after microvascular decompression (MVD) for hemifacial spasm (HFS). METHODS: Nine hundred and thirty-two patients with HFS who underwent MVD with intraoperative monitoring (IOM) of BAEP were analyzed. We used a 43.9 Hz/s stimulation rate and 400 averaging trials to obtain BAEP. To evaluate HL, pure-tone audiometry and speech discrimination scoring were performed before and one week after surgery...
January 4, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29342284/two-ways-to-kill-a-patient
#2
Ben Bronner
According to the Standard View, a doctor who withdraws life-sustaining treatment does not kill the patient but rather allows the patient to die-an important distinction, according to some. I argue that killing (and causing death) can be understood in either of two ways, and given the relevant understanding, the Standard View is insulated from typical criticisms. I conclude by noting several problems for the Standard View that remain to be fully addressed.
January 12, 2018: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29342251/kinetics-of-serological-responses-in-critically-ill-patients-hospitalized-with-influenza-a-h1n1-pdm09-virus-infection-in-canada-2009-2011
#3
Melissa A Rolfes, F Liaini Gross, Brendan Flannery, Adrienne F A Meyers, Ma Luo, Nathalie Bastien, Robert A Fowler, Jacqueline M Katz, Min Z Levine, Anand Kumar, Timothy M Uyeki
Background: The kinetics of the antibody response during severe influenza are not well documented. Methods: Critically ill patients with influenza A(H1N1)pdm09 virus infection, confirmed by RT-PCR or seroconversion (≥4-fold rise in titers), during 2009-2011 in Canada were prospectively studied. Antibody titers in serially collected sera were determined using hemagglutinin inhibition (HAI) and microneutralization assays. Average antibody curves were estimated using linear mixed effects models and compared by patient outcome, age, and corticosteroid treatment...
January 12, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29342133/a-myc-enhancer-cluster-regulates-normal-and-leukaemic-haematopoietic-stem-cell-hierarchies
#4
Carsten Bahr, Lisa von Paleske, Veli V Uslu, Silvia Remeseiro, Naoya Takayama, Stanley W Ng, Alex Murison, Katja Langenfeld, Massimo Petretich, Roberta Scognamiglio, Petra Zeisberger, Amelie S Benk, Ido Amit, Peter W Zandstra, Mathieu Lupien, John E Dick, Andreas Trumpp, François Spitz
The transcription factor Myc is essential for the regulation of haematopoietic stem cells and progenitors and has a critical function in haematopoietic malignancies. Here we show that an evolutionarily conserved region located 1.7 megabases downstream of the Myc gene that has previously been labelled as a 'super-enhancer' is essential for the regulation of Myc expression levels in both normal haematopoietic and leukaemic stem cell hierarchies in mice and humans. Deletion of this region in mice leads to a complete loss of Myc expression in haematopoietic stem cells and progenitors...
January 17, 2018: Nature
https://www.readbyqxmd.com/read/29342070/an-evaluation-of-industry-relationships-among-contributors-to-aaos-clinical-practice-guidelines-and-appropriate-use-criteria
#5
Jake X Checketts, Courtney Cook, Matt Vassar
BACKGROUND: A long-standing relationship between orthopaedic surgeons and industry has made financial conflicts of interest a concerning issue. Research supports that financial conflicts of interest can influence both medical research and clinical practice. Financial conflicts of interest may also influence clinical practice guideline recommendations and their corresponding appropriate use criteria. Because of the influential nature of these guidelines, it is imperative that care be taken to minimize bias during guideline development...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29342057/audiologic-natural-history-of-small-volume-cochleovestibular-schwannomas-in-neurofibromatosis-type-2
#6
Alvin T deTorres, Carmen C Brewer, Chris K Zalewski, Kelly A King, Robert Walker, Gretchen C Scott, Ashok R Asthagiri, Prashant Chittiboina, Hung Jeffrey Kim
OBJECTIVE: To characterize the audiometric natural progression in patient-ears with small volume (<1,000 mm), treatment-naïve cochleovestibular schwannomas (CVSs) in Neurofibromatosis Type 2 (NF2). STUDY DESIGN: Prospective, longitudinal cohort study. SETTING: Quaternary medical research institute. PATIENTS: One hundred eleven ears in 71 NF2 patients with small, treatment-naïve CVSs observed from July 2006 to July 2016...
January 16, 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29342009/how-academic-health-systems-can-achieve-population-health-in-vulnerable-populations-through-value-based-care-the-critical-importance-of-establishing-trusted-agency
#7
Donald E Wesson, Heather E Kitzman
Improving population health may require health systems to proactively engage patient populations as partners in the implementation of healthy behaviors as a shared value using strategies that incentivize healthy outcomes for the population as a whole. The current reactive health care model, which focuses on restoring the health of individuals after it has been lost, will not achieve the goal of improved population health. To achieve this goal, health systems must proactively engage in partnerships with the populations they serve...
January 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29341985/dexmedetomidine-as-single-continuous-sedative-during-noninvasive-ventilation-typical-usage-hemodynamic-effects-and-withdrawal
#8
Brittany L Shutes, Samantha W Gee, Cheryl L Sargel, Kelsey A Fink, Joseph D Tobias
OBJECTIVES: Dexmedetomidine use in pediatric critical care is increasing. Its prolonged effects as a single continuous agent for sedation are not well described. The aim of the current study was to describe prolonged dexmedetomidine therapy without other continuous sedation, specifically the hemodynamic effects, discontinuation strategies, and risk factors for withdrawal. DESIGN: Retrospective chart review. SETTING: Large, single-center, quaternary care pediatric academic institution...
January 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29341970/does-the-use-of-indirect-calorimetry-change-outcome-in-the-icu-yes-it-does
#9
Elisabeth De Waele, Patrick M Honoré, Manu L N G Malbrain
PURPOSE OF REVIEW: To review the recent findings on metabolic monitoring and possible beneficial effects of an adequate nutrition therapy, based on indirect calorimetry as the golden standard to predict energy expenditure. RECENT FINDINGS: in the last decades, major steps are taken in the field of metabolism and nutrition, evolving from nutrition as a baseline support to a therapeutic intervention. The aspect of energy expenditure is of cardinal importance, and technical possibilities have impressively improved: from the first 'calorimetre' in 1789 to the new generation, clinical applicable indirect calorimeters and the high accuracy and easy use model reaching high technology readiness level [Oshima et al...
January 15, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29341963/role-of-the-anesthesiologist-intensivist-outside-the-icu-opportunity-to-add-value-for-the-hospital-or-an-unnecessary-distraction
#10
Suzanne Bennett, Erin Grawe, Courtney Jones, Sean A Josephs, Maggie Mechlin, William E Hurford
PURPOSE OF REVIEW: Given the extremely expensive nature of critical care medicine, it seems logical that intensivists should play an active role in designing efficient systems of care. The true value of intensivists, however, is not well defined. RECENT FINDINGS: Anesthesiologists have taken key roles in improving patient safety in the operating room. Anesthesia-related mortality rates have decreased from 20 deaths per 100 000 anesthetics in the early 1980s to less than one death per 100 000 currently...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29341468/downregulation-of-barh-like-homeobox-2-promotes-cell-proliferation-migration-and-aerobic-glycolysis-through-wnt-%C3%AE-catenin-signaling-and-predicts-a-poor-prognosis-in-non-small-cell-lung-carcinoma
#11
Hao Chen, Maowei Zhang, Wenhui Zhang, Yuanqin Li, Jiechen Zhu, Xiaojiao Zhang, Li Zhao, Shuyang Zhu, Bi Chen
BACKGROUND: Human BarH-like homeobox 2 (Barx2), a homeodomain factor of the Bar family, plays a critical role in cell adhesion and cytoskeleton remodeling, and has been reported in an increasing array of tumor types except non-small cell lung carcinoma (NSCLC). The purpose of the current study was to characterize the expression of Barx2 and assess the clinical significance of Barx2 in NSCLC. METHODS: Quantitative real-time polymerase chain reaction, immunohistochemistry and western blot analysis were used to examine mRNA and protein expression, respectively...
January 17, 2018: Thoracic Cancer
https://www.readbyqxmd.com/read/29341331/the-relationship-between-thalamic-gaba-content-and-resting-cortical-rhythm-in-neuropathic-pain
#12
Flavia Di Pietro, Paul M Macey, Caroline D Rae, Zeynab Alshelh, Vaughan G Macefield, E Russell Vickers, Luke A Henderson
Recurrent thalamocortical connections are integral to the generation of brain rhythms and it is thought that the inhibitory action of the thalamic reticular nucleus is critical in setting these rhythms. Our work and others' has suggested that chronic pain that develops following nerve injury, that is, neuropathic pain, results from altered thalamocortical rhythm, although whether this dysrhythmia is associated with thalamic inhibitory function remains unknown. In this investigation, we used electroencephalography and magnetic resonance spectroscopy to investigate cortical power and thalamic GABAergic concentration in 20 patients with neuropathic pain and 20 pain-free controls...
January 17, 2018: Human Brain Mapping
https://www.readbyqxmd.com/read/29341039/covert-hepatic-encephalopathy-leads-to-distinct-alterations-in-the-emotional-state-independently-of-meld-score
#13
Robin Greinert, Cristina Ripoll, Alexander Zipprich
BACKGROUND AND AIMS:  Covert hepatic encephalopathy impairs many aspects of quality of life, although its impact on the emotional state has not been evaluated. This study aims to evaluate the impact of covert hepatic encephalopathy on the emotional state and which factors are associated with changes in the emotional state in patients with cirrhosis. METHODS:  This single-center study included all patients with cirrhosis who underwent the portosystemic encephalopathy syndrome (PSE) test, critical flicker frequency, and emotional state assessment with the Eigenschaftswörterliste 60-S in 2011...
January 16, 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29340992/prospective-comparative-study-of-laparoscopic-narrow-band-imaging-nbi-versus-standard-imaging-in-gynecologic-oncology
#14
Alessia Aloisi, Yukio Sonoda, Ginger J Gardner, Kay J Park, Sarah L Elliott, Qin C Zhou, Alexia Iasonos, Nadeem R Abu-Rustum
BACKGROUND: Narrow band imaging (NBI) is an optic filtration enhancement for endoscopy that uses two wavelengths of light (415 and 540 nm) to highlight superficial microvascular patterns. It has been successfully utilized to improve identification of lesions with abnormal vasculature, which is associated with endometriosis and endometrial cancer. Case studies suggest it may also facilitate surgical staging of gynecologic cancer, which is critical in determining appropriate adjuvant therapies...
January 16, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29340811/a-word-of-caution-never-use-tacks-for-mesh-fixation-to-the-diaphragm
#15
F Köckerling, C Schug-Pass, R Bittner
BACKGROUND: The mesh fixation technique used in repair of hiatal hernias and subxiphoid ventral and incisional hernias must meet strenuous requirements. In the literature, there are reports of life-threatening complications with cardiac tamponade and a high mortality rate on using tacks. The continuing practice of tack deployment for mesh fixation to the diaphragm and esophageal hiatus should be critically reviewed. METHODS: In a systematic search of the available literature in May 2017, 23 cases of severe penetrating cardiac complications were identified...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340720/correction-to-polymyxin-b-immobilized-hemoperfusion-and-mortality-in-critically-ill-adult-patients-with-sepsis-septic-shock-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#16
Tomoko Fujii, Riki Ganeko, Yuki Kataoka, Toshi A Furukawa, Robin Featherstone, Kent Doi, Jean-Louis Vincent, Daniela Pasero, René Robert, Claudio Ronco, Sean M Bagshaw
Owing to an oversight by the authors, Figure 2 in this article was not the version intended for publication. The correct Figure 2, reproduced here, features footnote symbols and Figure 2b includes three studies as described in the main text.
January 16, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29340547/quality-of-life-after-vertical-gastrectomy-evaluated-by-the-baros-questionnaire
#17
Guilherme Pedroso Vargas, Giselle Abigail Mendes, Rinaldo Danesi Pinto
BACKGROUND: The satisfactory outcome in the surgical treatment of obesity must include, in addition to weight loss, a significant change in the pre-existing comorbidities and in the quality of life of the patients. AIM: To evaluate the quality of life in the late postoperative period in patients that underwent videolaparoscopic sleeve gastrectomy. METHODS: Was applied the questionnaire "Bariatric Analysis and Reporting Outcome System" (BAROS) in patients that underwent videolaparoscopic sleeve gastrectomy...
October 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/29340541/safety-criteria-to-start-early-mobilization-in-intensive-care-units-systematic-review
#18
Thais Martins Albanaz da Conceição, Ana Inês Gonzáles, Fernanda Cabral Xavier Sarmento de Figueiredo, Danielle Soares Rocha Vieira, Daiana Cristine Bündchen
Mobilization of critically ill patients admitted to intensive care units should be performed based on safety criteria. The aim of the present review was to establish which safety criteria are most often used to start early mobilization for patients under mechanical ventilation admitted to intensive care units. Articles were searched in the PubMed, PEDro, LILACS, Cochrane and CINAHL databases; randomized and quasi-randomized clinical trials, cohort studies, comparative studies with or without simultaneous controls, case series with 10 or more consecutive cases and descriptive studies were included...
October 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29340540/toxic-epidermal-necrolysis-a-paradigm-of-critical-illness
#19
Alfonso Estrella-Alonso, José Antonio Aramburu, Mercedes Yolanda González-Ruiz, Lucía Cachafeiro, Manuel Sánchez Sánchez, José A Lorente
Toxic epidermal necrolysis is an adverse immunological skin reaction secondary in most cases to the administration of a drug. Toxic epidermal necrolysis, Stevens-Johnson syndrome, and multiform exudative erythema are part of the same disease spectrum. The mortality rate from toxic epidermal necrolysis is approximately 30%. The pathophysiology of toxic epidermal necrolysis is similar in many respects to that of superficial skin burns. Mucosal involvement of the ocular and genital epithelium is associated with serious sequelae if the condition is not treated early...
October 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29340538/autonomic-nervous-system-monitoring-in-intensive-care-as-a-prognostic-tool-systematic-review
#20
Luis Bento, Rui Fonseca-Pinto, Pedro Póvoa
OBJECTIVE: To present a systematic review of the use of autonomic nervous system monitoring as a prognostic tool in intensive care units by assessing heart rate variability. METHODS: Literature review of studies published until July 2016 listed in PubMed/Medline and conducted in intensive care units, on autonomic nervous system monitoring, via analysis of heart rate variability as a prognostic tool (mortality study). The following English terms were entered in the search field: ("autonomic nervous system" OR "heart rate variability") AND ("intensive care" OR "critical care" OR "emergency care" OR "ICU") AND ("prognosis" OR "prognoses" OR "mortality")...
October 2017: Revista Brasileira de Terapia Intensiva
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