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https://www.readbyqxmd.com/read/29232669/implication-of-haemodiafiltration-flow-rate-on-amikacin-pharmacokinetic-parameters-in-critically-ill-patients
#1
Jesús Ruiz-Ramos, Esther Villarreal, Mónica Gordon, María Martin-Cerezula, Maria Jesús Broch, María Remedios Marqués, Jose Luis Poveda, Álvaro Castellanos-Ortega, Paula Ramírez
BACKGROUND: To analyse the effect of haemodiafiltration (CVVHDF) flow rate on amikacin pharmacokinetics and blood concentrations. METHODS: Prospective observational study. Patients receiving CVVHDF and amikacin treatment were included. Pharmacokinetic parameters were calculated using Bayesian analysis. Spearman correlation test was used in order to assess the influence of CVVHDF flux on amikacin minimum concentration (Cmin) and plasma clearance. RESULTS: Thirty patients undergoing CVVHDF procedures were included...
December 12, 2017: Blood Purification
https://www.readbyqxmd.com/read/29232467/immunotherapy-in-ovarian-cancer
#2
K Odunsi
Immunological destruction of tumors is a multistep, coordinated process that can be modulated or targeted at several critical points to elicit tumor rejection. These steps in the cancer immunity cycle include: (i) generation of sufficient numbers of effector T cells with high avidity recognition of tumor antigens in vivo; (ii) trafficking and infiltration into the tumor; (iii) overcoming inhibitory networks in the tumor microenvironment; (iv) direct recognition of tumor antigens and generation of an effector anti-tumor response; and (v) persistence of the anti-tumor T cells...
November 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29232422/atypical-disseminated-herpes-zoster-management-guidelines-in-immunocompromised-patients
#3
Daniel J Lewis, Megan J Schlichte, Harry Dao
Reactivation of the varicella-zoster virus (VZV) causes dermatomal herpes zoster (HZ) and more rarely severe disseminated HZ including diffuse rash, encephalitis, hepatitis, and pneumonitis. An atypical form of VZV infection, disseminated HZ has been described primarily in immunocompromised hosts. We report 2 cases of atypical disseminated HZ in immunocompromised patients presenting with diffuse, nondermatomal, vesicular eruptions. We also provide a review of the literature and summarize the current guidelines for the treatment and prophylaxis of HZ in patients with human immunodeficiency virus (HIV) infection, solid organ transplantation (SOT), and hematopoietic stem cell transplantation (HSCT)...
November 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/29232365/monitoring-compliance-with-standards-of-care-for-chronic-diseases-using-healthcare-administrative-databases-in-italy-strengths-and-limitations
#4
Rosa Gini, Martijn J Schuemie, Alessandro Pasqua, Emanuele Carlini, Francesco Profili, Iacopo Cricelli, Patrizio Dazzi, Valentina Barletta, Paolo Francesconi, Francesco Lapi, Andrea Donatini, Giulia Dal Co, Modesta Visca, Mariadonata Bellentani, Miriam Sturkenboom, Niek Klazinga
BACKGROUND: A recent comprehensive report on healthcare quality in Italy published by the Organization of Economic Co-operation and Development (OECD) recommended that regular monitoring of quality of primary care by means of compliance with standards of care for chronic diseases is performed. A previous ecological study demonstrated that compliance with standards of care could be reliably estimated on regional level using administrative databases. This study compares estimates based on administrative data with estimates based on GP records for the same persons, to understand whether ecological fallacy played a role in the results of the previous study...
2017: PloS One
https://www.readbyqxmd.com/read/29232353/improving-pediatric-preparedness-in-critical-access-hospital-emergency-departments-impact-of-a-longitudinal-in-situ-simulation-program
#5
Jessica H Katznelson, Jiangxia Wang, Martha W Stevens, William A Mills
OBJECTIVES: Critical access hospitals (CAH) see few pediatric patients. Many of these hospitals do not have access to physicians with pediatric training. We sought to evaluate the impact of an in situ pediatric simulation program in the CAH emergency department setting on care team performance during resuscitation scenarios. METHODS: Five CAHs conducted 6 high-fidelity pediatric simulations over a 12-month period. Team performance was evaluated using a validated 35-item checklist representing commonly expected resuscitation team interventions...
December 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29232263/can-the-critically-ill-patient-generate-sufficient-energy-to-facilitate-exercise-in-the-icu
#6
Danielle E Bear, Selina M Parry, Zudin A Puthucheary
PURPOSE OF REVIEW: Trials of physical rehabilitation post critical illness have yet to deliver improved health-related quality of life in critical illness survivors. Muscle mass and strength are lost rapidly in critical illness and a proportion of patients continue to do so resulting in increased mortality and functional disability. Addressing this issue is therefore fundamental for recovery from critical illness. RECENT FINDINGS: Altered mitochondrial function occurs in the critically ill and is likely to result in decreased adenosine tri-phosphate (ATP) production...
December 9, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29232262/intermittent-versus-continuous-feeding-in-critically-ill-adults
#7
Jayshil J Patel, Martin D Rosenthal, Daren K Heyland
PURPOSE OF REVIEW: Early enteral nutrition is recommended in critically ill adult patients. The optimal method of administering enteral nutrition remains unknown. Continuous enteral nutrition administration in critically ill patients remains the most common practice worldwide; however, its practice has recently been called into question in favor of intermittent enteral nutrition administration, where volume is infused multiple times per day. This review will outline the key differences between continuous and intermittent enteral nutrition, describe the metabolic responses to continuous and intermittent enteral nutrition administration and outline recent studies comparing continuous with intermittent enteral nutrition administration on outcomes in critically ill adults...
December 11, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29232210/response-percutaneous-vascular-interventions-versus-bypass-surgeries-in-patients-with-critical-limb-ischemia
#8
Chi Shu, Jiarong Wang, Yazhou He, Jichun Zhao
No abstract text is available yet for this article.
December 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29232173/tele-pediatric-intensive-care-for-critically-ill-children-in-syria
#9
Muhammad Bakr Ghbeis, Katherine M Steffen, Elizabeth A Braunlin, Gregory J Beilman, Jay Dahman, Waseem Ostwani, Marie E Steiner
BACKGROUND: Armed conflicts can result in humanitarian crises and have major impacts on civilians, of whom children represent a significant proportion. Usual pediatric medical care is often disrupted and trauma resulting from war-related injuries is often devastating. High pediatric mortality rates are thus experienced in these ravaged medical environments. INTRODUCTION: Using simple communication technology to provide real-time management recommendations from highly trained pediatric personnel can provide substantive clinical support and have a significant impact on pediatric morbidity and mortality...
December 12, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29232021/investigation-of-diffusion-kurtosis-imaging-for-discriminating-tumors-from-inflammatory-lesions-after-treatment-for-bladder-cancer
#10
Fang Wang, Di Jin, Xiao-Lan Hua, Zi-Zhou Zhao, Lian-Ming Wu, Wei-Bo Chen, Guang-Yu Wu, Xiao-Xi Chen, Hai-Ge Chen
BACKGROUND: The bladder wall may thicken resulting from chronic inflammation after initial treatment (transurethral resection [TUR] or neoadjuvant chemotherapy), which may mimic the feature of recurrent or residual bladder tumors (RBT). Therefore, it is critical to discriminate RBT from benign lesions after initial treatment. PURPOSE: To investigate whether diffusion kurtosis imaging (DKI) could discriminate RBT from post-therapy bladder inflammatory lesions. STUDY TYPE: Retrospective...
December 12, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29231904/protective-effects-of-%C3%AF-3-pufa-in-anthracycline-induced-cardiotoxicity-a-critical-review
#11
REVIEW
Simona Serini, Renata Ottes Vasconcelos, Renata Nascimento Gomes, Gabriella Calviello
It has been demonstrated that ω-3 polyunsaturated fatty acids (ω-3 PUFA) may exert a beneficial role as adjuvants in the prevention and treatment of many disorders, including cardiovascular diseases and cancer. Particularly, several in vitro and in vivo preclinical studies have shown the antitumor activity of ω-3 PUFA in different kinds of cancers, and several human studies have shown that ω-3 PUFA are able to decrease the risk of a series of cardiovascular diseases. Several mechanisms have been proposed to explain their pleiotropic beneficial effects...
December 12, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29231793/acute-rerupture-after-coil-embolization-of-ruptured-intracranial-saccular-aneurysms-a-literature-review
#12
Kailing Li, Yunbao Guo, Ying Zhao, Baofeng Xu, Kan Xu, Jinlu Yu
Acute rerupture after coil embolization is defined as rerupture within three days after treatment; its prognosis is worse than that of rebleeding at other time periods. However, to date, little is known about complications during the acute phase. Therefore, we used the PubMed database to perform a review of acute rerupture after coil embolization of ruptured intracranial saccular aneurysms and increase our understanding. After reviewing the complications, we found that the cause of acute rerupture is unclear, but the following risk factors are involved: incomplete occlusion of the initial aneurysm, the presence of a hematoma adjacent to a ruptured aneurysm, an aneurysmal outpouching, poor Hunt-Hess grade at the time of treatment, and the location of the aneurysm in an anterior communicating artery...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29231189/the-liver-frailty-index-improves-mortality-prediction-of-the-subjective-clinician-assessment-in-patients-with-cirrhosis
#13
Jennifer C Lai, Kenneth E Covinsky, Charles E McCulloch, Sandy Feng
OBJECTIVES: Frailty, a critical determinant of health outcomes, is most commonly assessed in patients with cirrhosis by general clinician assessment that is limited by its subjectivity. We aimed to compare the objective Liver Frailty Index (LFI), consisting of three performance-based tests (grip, chair stands, balance), with a subjective hepatologist assessment. METHODS: Outpatients with cirrhosis awaiting liver transplantation (LT) underwent: (1) objective measurement using the LFI and (2) subjective clinician assessment...
December 12, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29230556/liver-directed-therapy-for-hepatocellular-carcinoma
#14
Kazim H Narsinh, David P Duncan, Isabel G Newton, Jeet Minocha, Steven C Rose
Liver-directed therapy is a critical component of treatment strategies for hepatocellular carcinoma. These therapies included percutaneous image-guided ablation, transarterial chemoembolization, and transarterial radioembolization, and are administered by interventional radiologists. Depending on the stage of disease, a particular treatment modality, or a combination thereof, is expected to be most efficacious in achieving the goals of treatment for a particular patient. This article seeks to review the various liver-directed treatment modalities for treatment of hepatocellular carcinoma, with attention to their efficacy and patient selection criteria...
December 11, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29230521/correction-to-efficacy-and-safety-of-stress-ulcer-prophylaxis-in-critically-ill-patients-a-network-meta-analysis-of-randomized-trials
#15
Waleed Alhazzani, Fayez Alshamsi, Emilie Belley-Cote, Diane Heels-Ansdell, Romina Brignardello-Petersen, Mustafa Alquraini, Anders Perner, Morten Hylander Møller, Mette Krag, Saleh Almenawer, Bram Rochwerg, Joanna Dionne, Roman Jaeschke, Mohammed Alshahrani, Adam Deane, Dan Perri, Lehana Thebane, Awad Al-Omari, Simon Finfer, Deborah Cook, Gordon Guyatt
Owing to an oversight by the authors, all the figures in the last column of Table 2 (upper section: Number needed to treat; lower section: Number needed to harm) in this article were given without the final digit 0 and are thus 10 times too small.
December 11, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29230392/non-invasive-monitoring-of-cardiac-output-in-critical-care-medicine
#16
REVIEW
Lee S Nguyen, Pierre Squara
Critically ill patients require close hemodynamic monitoring to titrate treatment on a regular basis. It allows administering fluid with parsimony and adjusting inotropes and vasoactive drugs when necessary. Although invasive monitoring is considered as the reference method, non-invasive monitoring presents the obvious advantage of being associated with fewer complications, at the expanse of accuracy, precision, and step-response change. A great many methods and devices are now used over the world, and this article focuses on several of them, providing with a brief review of related underlying physical principles and validation articles analysis...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29230210/checkpoint-blockade-toxicity-and-immune-homeostasis-in-the-gastrointestinal-tract
#17
REVIEW
Michael Dougan
Monoclonal antibodies targeting the regulatory immune "checkpoint" receptors CTLA-4, PD-1, and PD-L1 are now standard therapy for diverse malignancies including melanoma, lung cancer, and renal cell carcinoma. Although effective in many patients and able to induce cures in some, targeting these regulatory pathways has led to a new class of immune-related adverse events. In many respects, these immune toxicities resemble idiopathic autoimmune diseases, such as inflammatory bowel disease, autoimmune hepatitis, rheumatoid arthritis, and vitiligo...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29229993/therapeutic-relevance-of-the-pp2a-b55-inhibitory-kinase-mastl-greatwall-in-breast-cancer
#18
Mónica Álvarez-Fernández, María Sanz-Flores, Belén Sanz-Castillo, María Salazar-Roa, David Partida, Elisabet Zapatero-Solana, H Raza Ali, Eusebio Manchado, Scott Lowe, Todd VanArsdale, David Shields, Carlos Caldas, Miguel Quintela-Fandino, Marcos Malumbres
PP2A is a major tumor suppressor whose inactivation is frequently found in a wide spectrum of human tumors. In particular, deletion or epigenetic silencing of genes encoding the B55 family of PP2A regulatory subunits is a common feature of breast cancer cells. A key player in the regulation of PP2A/B55 phosphatase complexes is the cell cycle kinase MASTL (also known as Greatwall). During cell division, inhibition of PP2A-B55 by MASTL is required to maintain the mitotic state, whereas inactivation of MASTL and PP2A reactivation is required for mitotic exit...
December 11, 2017: Cell Death and Differentiation
https://www.readbyqxmd.com/read/29229756/decoding-the-molecular-switches-of-natriuretic-peptides-which-differentiate-its-vascular-and-renal-functions
#19
Sindhuja Sridharan, R Manjunatha Kini
Heart failure (HF) is associated with high morbidity and mortality. Dysfunction of blood pressure and/or volume homeostatic processes result in lower perfusion and/or congestion. Treatment strategies exerting differential effects on pressure and volume mechanisms are critical in handling patients with HF. Atrial natriuretic peptides (ANP) is a key hormone in maintaining circulation. It binds to NP receptor-A (NPR-A) on vasculature, kidneys and nervous system to lowers blood pressure and volume. It exerts a concentration-dependent pharmacological activity; only increased renal excretion of water and sodium at low doses and vasodilation along with renal effects at slightly higher doses...
December 11, 2017: Biochemical Journal
https://www.readbyqxmd.com/read/29229678/epitope-mapping-of-serca2a-identifies-an-antigenic-determinant-that-induces-mainly-atrial-myocarditis-in-a-j-mice
#20
Bharathi Krishnan, Chandirasegaran Massilamany, Rakesh H Basavalingappa, Arunakumar Gangaplara, Rajkumar A Rajasekaran, Muhammad Z Afzal, Vahid Khalilzad-Sharghi, You Zhou, Jean-Jack Riethoven, Shyam S Nandi, Paras K Mishra, Raymond A Sobel, Jennifer L Strande, David Steffen, Jay Reddy
Sarcoplasmic/endoplasmic reticulum Ca2+ adenosine triphosphatase (SERCA)2a, a critical regulator of calcium homeostasis, is known to be decreased in heart failure. Patients with myocarditis or dilated cardiomyopathy develop autoantibodies to SERCA2a suggesting that they may have pathogenetic significance. In this report, we describe epitope mapping analysis of SERCA2a in A/J mice that leads us to make five observations: 1) SERCA2a contains multiple T cell epitopes that induce varying degrees of myocarditis...
December 11, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
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