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https://www.readbyqxmd.com/read/28736021/infectious-complications-and-multidrug-resistant-bacteria-in-patients-with-hematopoietic-stem-cell-transplantation-in-the-first-12-months-after-transplant
#1
A César-Arce, P Volkow-Fernández, L M Valero-Saldaña, B Acosta-Maldonado, D Vilar-Compte, P Cornejo-Juárez
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) has been used as treatment in different hematologic and solid malignancies. The aim of this study was to describe the frequency of infectious complications, microbiology, and outcome in patients undergoing HSCT in Mexico during the pre-engraftment period and the impact on mortality rates at 12 months. METHODS: We conducted a retrospective study of all hematologic malignancies that received HSCT from January 2009 and December 2014, at an oncology reference center...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28734773/epico-4-0-total-quality-in-the-management-of-invasive-candidiasis-in-critically-ill-patients-by-analysing-the-integrated-process
#2
Rafael Zaragoza, Ricard Ferrer, Pedro Llinares, Emilio Maseda, Alejandro Rodríguez, Santiago Grau, Guillermo Quindós
BACKGROUND: A high quality integrated process in the clinical setting of non-neutropenic critically ill patients at risk for invasive candidiasis is a necessary tool to improve the management of these patients. AIMS: To identify the key points on invasive candidiasis in order to develop a set of recommendations with a high level of consensus required for the creation of a total quality integrated process for the management of non-neutropenic critically ill patients at risk of invasive candidiasis...
July 19, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28734759/nivolumab-in-patients-with-metastatic-dna-mismatch-repair-deficient-or-microsatellite-instability-high-colorectal-cancer-checkmate-142-an-open-label-multicentre-phase-2-study
#3
Michael J Overman, Ray McDermott, Joseph L Leach, Sara Lonardi, Heinz-Josef Lenz, Michael A Morse, Jayesh Desai, Andrew Hill, Michael Axelson, Rebecca A Moss, Monica V Goldberg, Z Alexander Cao, Jean-Marie Ledeine, Gregory A Maglinte, Scott Kopetz, Thierry André
BACKGROUND: Metastatic DNA mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H) colorectal cancer has a poor prognosis after treatment with conventional chemotherapy and exhibits high levels of tumour neoantigens, tumour-infiltrating lymphocytes, and checkpoint regulators. All of these features are associated with the response to PD-1 blockade in other tumour types. Therefore, we aimed to study nivolumab, a PD-1 immune checkpoint inhibitor, in patients with dMMR/MSI-H metastatic colorectal cancer...
July 19, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28734692/respiratory-arrest-at-the-onset-of-idiopathic-childhood-occipital-epilepsy-of-gastaut
#4
Keiko Funata, Tatsuhiko Shike, Toshiki Takenouchi, Yukio Yamashita, Takao Takahashi
Occipital lobe epilepsy of childhood includes two entities: Panayiotopoulos syndrome in pre-school children, and idiopathic childhood occipital epilepsy of Gastaut (ICOEG) in school-age children. The typical initial manifestation of the former is vomiting, and that of the latter is visual hallucinations. Ictal cardiopulmonary arrest at initial presentation has been reported for Panayiotopoulos syndrome, but not for ICOEG. We document a 7-year-old previously healthy girl who experienced an acute elemental visual hallucination of seeing insects, followed by a new-onset generalized seizure...
July 19, 2017: Brain & Development
https://www.readbyqxmd.com/read/28732480/metformin-and-longevity-metal-a-window-of-opportunity-study-investigating-the-biological-effects-of-metformin-in-localised-prostate-cancer
#5
Danielle Crawley, Ashish Chandra, Massimo Loda, Cheryl Gillett, Paul Cathcart, Ben Challacombe, Gary Cook, Declan Cahill, Aida Santa Olalla, Fidelma Cahill, Gincy George, Sarah Rudman, Mieke Van Hemelrijck
BACKGROUND: Metformin is a biguanide oral hypoglycaemic agent commonly used for the treatment of type 2 diabetes mellitus. In addition to its anti-diabetic effect, metformin has also been associated with a reduced risk of cancer incidence of a number of solid tumours, including prostate cancer (PCa). However, the underlying biological mechanisms for these observations have not been fully characterised in PCa. One hypothesis is that the indirect insulin lowering effect may have an anti-neoplastic action as elevated insulin and insulin like growth factor - 1 (IGF-1) levels play a role in PCa development and progression...
July 21, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28729942/problems-related-to-levodopa-carbidopa-intestinal-gel-treatment-in-advanced-parkinson-s-disease
#6
Marianne Udd, Jukka Lyytinen, Johanna Eerola-Rautio, Anu Kenttämies, Outi Lindström, Leena Kylänpää, Eero Pekkonen
BACKGROUND: Continuous levodopa-carbidopa intestinal gel (LCIG) diminishes daily "off" time and dyskinesia in patients with advanced Parkinson's disease (PD). Complications are common with percutaneous endoscopic gastrostomy with a jejunal extension tube (PEG-J). AIM OF THE STUDY: To report the clinical outcome of LCIG in patients with advanced PD in the years 2006-2014 at Helsinki University Hospital. PATIENTS AND METHODS: Levodopa-carbidopa intestinal gel treatment started following PEG-J placement in patients with advanced PD after successful in-hospital LCIG trial with a nasojejunal tube...
July 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28729319/accelerated-enhanced-recovery-following-minimally-invasive-colorectal-cancer-surgery-recovermi-a-study-protocol-for-a-novel-randomised-controlled-trial
#7
Brandee A Price, Brian K Bednarski, Y Nancy You, Meryna Manandhar, E Michelle Dean, Zeinab M Alawadi, B Bryce Speer, Vijaya Gottumukkala, Marla Weldon, Robert L Massey, Xuemei Wang, Wei Qiao, George J Chang
INTRODUCTION: Definitive treatment of localised colorectal cancer involves surgical resection of the primary tumour. Short-stay colectomies (eg, 23-hours) would have important implications for optimising the efficiency of inpatient care with reduced resource utilisation while improving the overall recovery experience with earlier return to normalcy. It could permit surgical treatment of colorectal cancer in a wider variety of settings, including hospital-based ambulatory surgery environments...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729311/a-review-of-rate-control-in-atrial-fibrillation-and-the-rationale-and-protocol-for-the-rate-af-trial
#8
Dipak Kotecha, Melanie Calvert, Jonathan J Deeks, Michael Griffith, Paulus Kirchhof, Gregory Yh Lip, Samir Mehta, Gemma Slinn, Mary Stanbury, Richard P Steeds, Jonathan N Townend
BACKGROUND AND OBJECTIVE: Atrial fibrillation (AF) is common and causes impaired quality of life, an increased risk of stroke and death as well as frequent hospital admissions. The majority of patients with AF require control of heart rate. In this article , we summarise the limited evidence from clinical trials that guides prescription, and present the rationale and protocol for a new randomised trial. As rate control has not yet been shown to reduce mortality, there is a clear need to compare the impact of therapy on quality of life, cardiac function and exercise capacity...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28727714/3d-morphometric-analysis-of-normal-sacroiliac-joints-a-new-classification-of-surface-shape-variation-and-the-potential-implications-in-pain-syndromes
#9
Mary Kristen Jesse, Christopher Kleck, Adam Williams, Brian Petersen, Deborah Glueck, Kimberly Lind, Vikas Patel
BACKGROUND: Normal sacroiliac (SI) joints vary widely in shape, and it is unclear whether SI joint morphology plays a role in the development of pain. To answer this question, we used 3D-CT surface rendering to image healthy study participants and used the resulting images to develop a classification system for SI joint morphology. In a case-control study comparing health research participants to patients with SI pain, we assessed whether the classification of SI joint morphology was associated with pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727491/impact-of-point-of-care-xpert-mtb-rif-on-tuberculosis-treatment-initiation-a-cluster-randomised-trial
#10
Richard J Lessells, Graham S Cooke, Nuala McGrath, Mark P Nicol, Marie-Louise Newell, Peter Godfrey-Faussett
RATIONALE: Point-of-care (POC) diagnostics have potential to reduce pre-treatment loss to follow-up and delays to initiation of appropriate TB treatment. OBJECTIVE: To evaluate the effect of a POC diagnostic strategy on initiation of appropriate TB treatment. METHODS: A cluster randomised trial of adults with cough who were HIV positive and/or at high risk of drug-resistant TB. Two-week time blocks were randomised to two strategies (i) Xpert performed at district hospital laboratory (ii) POC Xpert performed at primary health care clinic...
July 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28727328/-how-to-use-microbiological-diagnostic-tests-in-a-hospital-setting
#11
Romain Martischang, Mohamed Abbas, Stephan Harbarth, Benedikt Huttner, Jacques Schrenzel
Microbiological cultures provide essential information to guide the antibiotic therapy. However, their results might be misleading for physicians and drive useless treatment, sometimes harmful for patients. Recommendations highlight the importance of clinical signs in order to take into account the pre-test probability when interpreting the results. This combination will improve the predictive value of microbiological tests. The sampling strategy is also important to avoid an overuse of these tests but also misleading results through a reduction of contaminants...
April 12, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28726590/a-method-of-managing-severe-traumatic-brain-injury-in-the-absence-of-intracranial-pressure-monitoring-the-ice-protocol
#12
Randall Chesnut, Nancy Temkin, Sureyya Dikmen, Carlos Rondina, Walter Videtta, Gustavo Petroni, Silvia Lujan, Victor Alanis, Antonio Luis Eiras Falcao, Gustavo La Fuente, Luis Gonzalez, Manuel Jibaja, Arturo Lavendez, Freddy Sandi Lora, Roberto Merida, Ricardo Romero, James Pridgeon, Jason Barber, Joan Machamer, Kelley Chaddock
Purpose - The imaging- and clinical-examination (ICE) algorithm used in the BEST TRIP ICP randomized controlled trial is the only prospectively investigated clinical protocol for TBI management without ICP monitoring. As the default literature standard, it warrants careful evaluation. Methods - We present the ICE protocol in detail and analyse the demographics, outcome, treatment intensity, frequency of intervention usage, and related adverse events in the ICE-protocol cohort. Results - The 167 ICE protocol patients were young (median 29 years) with a median Glasgow Coma Scale motor score of 4 but with anisocoria or abnormal pupillary reactivity in 40%...
July 20, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28725500/volar-plate-fixation-in-patients-older-than-70-years-with-ao-type-c-distal-radial-fractures-clinical-and-radiologic-outcomes
#13
Nicolas S Piuzzi, Ezequiel E Zaidenberg, Matias Pereira Duarte, Jorge G Boretto, Agustin Donndorff, Gerardo Gallucci, Pablo De Carli
Introduction  Treatment of unstable distal radial fractures (DRFs) in elderly patients is controversial, and considering the increasing life expectancy, their appropriate treatment is of growing importance. Our aim was to analyze the clinical and radiologic outcomes in the elderly patients with AO type C DRF treated with volar locking plate (VLP). Materials and Methods  Between 2007 and 2011, 572 DRFs were operated on in our hospital with open reduction and internal fixation with VLP. Of these, only 64 patients (66 DRFs) met the selection criteria (AO type C DRF, age > 70 years, minimum 12-month follow-up)...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28724050/higher-meld-score-increases-the-overall-cost-on-the-waiting-list-for-liver-transplantation-a-micro-costing-analysis-based-study
#14
Jose Antonio Orellana Turri, Tassia Cristina Decimoni, Leandro Augusto Ferreira, Marcio Augusto Diniz, Luciana Bertocco de Paiva Haddad, Alessandro Gonçalves Campolina
BACKGROUND: The pre-transplant period is complex and includes lots of procedures. The severity of liver disease predisposes to a high number of hospitalizations and high costs procedures. Economic evaluation studies are important tools to handle costs on the waiting list for liver transplantation. OBJECTIVE: The objective of the present study was to evaluate the total cost of the patient on the waiting list for liver transplantation and the main resources related to higher costs...
July 13, 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28722167/assisted-autogenic-drainage-in-infants-and-young-children-hospitalized-with-uncomplicated-pneumonia-a-pilot-study
#15
Lieselotte Corten, Jennifer Jelsma, Anri Human, Sameer Rahim, Brenda M Morrow
BACKGROUND AND PURPOSE: Pneumonia is the most important respiratory problem in low-to-middle income countries. Airway clearance therapy continues to be used in children with pneumonia and secretion retention; however, there is lack of evidence to support or reject this treatment. This study aimed to investigate the feasibility of a randomized controlled trial (RCT) on the efficacy and safety of assisted autogenic drainage (AAD) compared to standard nursing care in children hospitalized with uncomplicated pneumonia...
July 19, 2017: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
https://www.readbyqxmd.com/read/28721591/secondary-femur-shaft-fracture-following-treatment-with-cephalomedullary-nail-a-retrospective-single-center-experience
#16
Nikolaus W Lang, J Joestl, S Payr, P Platzer, K Sarahrudi
AIM: Secondary femur fracture subsequent to treatment of trochanteric fractures with cephalomedullary nailing (i.e., a periprosthetic fracture related to the cephalomedullary nail) is a rare but very severe complication. As such, the aim of this study was to assess the impact of revision surgery and general state of health on mortality and functional outcomes in patients suffering femur fractures following treatment with cephalomedullary nails. MATERIALS AND METHODS: Between 2000 and 2015, 3549 patients presenting with OTA/AO 31A1-3 femur fractures were admitted to our department and subsequently treated with either a Gamma(®) Nail or PFNA(®)...
July 18, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28719887/anesthetic-management-of-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-crs-hipec-the-importance-of-hydro-electrolytic-and-acid-basic-control
#17
Fabrício Tavares Mendonça, Marília Moreira Guimarães, Sérgio Honorato de Matos, Rúbia Garcia Dusi
JUSTIFICATION AND OBJECTIVES: Patients affected by gynecological or gastrointestinal tract neoplasms that evolve to peritoneal carcinomatosis experience a significant drop in their quality of life, high morbidity and short survival times with currently available chemotherapeutic schemes. The surgical treatment based on cytoreduction and the employment of hyperthermic intraperitoneal chemotherapy in the intra-operative period is a true challenge to anesthesiologist. CASE REPORT: A 67 years old patient diagnosed with mucinous adenocarcinoma of the Appendix associated with mucinous carcinomatosis, was submitted to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), under general anesthesia and epidural block...
July 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28719134/development-and-implementation-of-a-clinical-pathway-for-cardiac-surgery-in-the-intensive-care-unit-effects-on-protocol-adherence
#18
Marion van der Kolk, Mark van den Boogaard, Corine Ter Brugge-Speelman, Jeroen Hol, Luc Noyez, Kees van Laarhoven, Hans van der Hoeven, Peter Pickkers
RATIONALE, AIMS AND OBJECTIVES: Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. METHODS: This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report...
July 18, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28718864/-cognitive-behavioral-group-therapy-addressing-fear-of-progression-in-cancer-out-patients
#19
Bärbel Rudolph, Alexander Wünsch, Peter Herschbach, Andreas Dinkel
Fear of progression (FoP) is an appropriate, rational response to the real threat of cancer and its treatments. However, patients experiencing elevated, dysfunctional levels of FoP often feel severely distressed and are in need of treatment. We previously conducted a (partly-)randomized controlled study with cancer patients undergoing in-patient rehabilitation and showed that a brief, four-session cognitive-behavioral group therapy significantly reduced dysfunctional FoP. In this report, we describe the adaption of the cognitive-behavioral group therapy program for use with cancer out-patients...
June 29, 2017: Psychotherapie, Psychosomatik, Medizinische Psychologie
https://www.readbyqxmd.com/read/28717904/a-description-of-deaths-following-emergency-abdominal-surgery
#20
Henrik Wolsted, Ann Merete Møller, Mai-Britt Tolstrup, Morten Vester-Andersen
OBJECTIVE: Emergency major abdominal surgery carries a high mortality rate. The aim of this present study was to characterize a population of deceased abdominal surgical patients, to examine how many died unexpectedly and how many were subject to treatment limitations. MATERIALS AND METHODS: We included adult emergency abdominal surgical patients who died within 30 days postoperatively. We collected data from January 1, 2013, to December 31, 2014, in a Danish tertiary care hospital (Herlev)...
July 17, 2017: World Journal of Surgery
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