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https://www.readbyqxmd.com/read/28214970/optimal-bowel-cleansing-for-colonoscopy-in-the-elderly-patient
#1
Samuel B Ho, Rita Hovsepians, Samir Gupta
Colonoscopy is an important diagnostic and screening tool for colorectal cancer detection and prevention, and adequate bowel preparation is critical for successful colonoscopy. Complications related to colonoscopy, either directly or indirectly related to the procedure, are increased in elderly patients, and the risks and benefits of colonoscopy procedures need to be carefully considered in these patients. Recent studies have shown that 4 L polyethylene glycol with a split preparation is safe and effective for elderly patients, and is the preferred preparation for patients with medical comorbidities...
February 18, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28214878/mirna-26a-contributes-to-the-acquisition-of-malignant-behaviors-of-doctaxel-resistant-lung-adenocarcinoma-cells-through-targeting-ezh2
#2
Jing Chen, Yuejuan Xu, Leilei Tao, Yan Pan, Kai Zhang, Rui Wang, Long-Bang Chen, Xiaoyuan Chu
BACKGROUND/AIMS: Accumulating evidence revealed that microRNAs (miRNAs) have been demonstrated as critical molecules in tumor development and progression. MiR-26a, located in a fragile chromosomal region associated with various human cancer, has been reported to be involved in regulating various cellular process, such as proliferation, apoptosis and invasion through targeting multiple oncogene. Docetaxel-mediated chemotherapy has been applied in improving the survival and prognosis of patients with advanced lung adenocarcinoma (LAD)...
February 3, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28214722/when-high-pressure-system-constraints-and-a-social-justice-mission-collide-a-socio-structural-analysis-of-emergency-department-social-work-services
#3
Megan Moore, Margaret Cristofalo, Danae Dotolo, Nicole Torres, Alexandra Lahdya, Leyna Ho, Mia Vogel, Mollie Forrester, Bonnie Conley, Susan Fouts
The emergency department (ED) can be a critical intervention point for many patients with multifaceted needs. Social workers have long been part of interdisciplinary ED teams. This study aimed to contribute to the limited understanding of social worker-patient interactions and factors influencing social work services in this setting. This paper reports a qualitative content analysis of social work medical record notes (N = 1509) of services provided to trauma patients in an urban, public, level 1 trauma center and an in-depth analysis of semi-structured interviews with ED social workers (N = 10)...
February 11, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28214475/hunter-and-new-england-healthpathways-a-4-year-journey-of-integrated-care
#4
Jane S Gray, Judith R Swan, Margaret A Lynch, Tracey M Tay, Marika-Jane Mackenzie, John H Wiggers, Karen A Harrison, Robert C McDonald, Ian P O'Dea, Louise M Harrigan, Sandra M Fitzgerald
Objective This paper describes the 4-year journey of Hunter and New England HealthPathways - a password-protected web-based portal designed to provide localised evidence-informed clinical and referral information to support general practice at the point of care.Methods A process evaluation was conducted in 2013, with a case study comparison performed in 2014 to assess impact of HealthPathways on patient referral and access to specialist care, followed by a review in 2016 of utilisation of the online portal to assess whether healthcare providers continued to access HealthPathways...
February 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28214431/simulation-in-undergraduate-paediatric-nursing-curriculum-evaluation-of-a-complex-ward-for-a-day-education-program
#5
Andree S Gamble
Simulation in health education has been shown to increase confidence, psychomotor and professional skills, and thus positively impact on student preparedness for clinical placement. It is recognised as a valuable tool to expose and engage students in realistic patient care encounters without the potential to cause patient harm. Although inherent challenges exist in the development and implementation of simulation, variability in clinical placement time, availability and quality dictates the need to provide students with learning opportunities they may otherwise not experience...
February 4, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28214108/cyclic-seizures-in-critically-ill-patients-clinical-correlates-dc-recordings-and-outcomes
#6
Lecio F Pinto, Emily J Gilmore, Ognen A Petroff, Adithya Sivaraju, Nishi Rampal, Lawrence J Hirsch, Nicolas Gaspard
OBJECTIVE: To describe EEG and clinical correlates, DC recordings and prognostic significance of cyclic seizures (CS). METHODS: We reviewed our prospective continuous EEG database to identify patients with CS, controls with non-cyclic status epilepticus (SE) and controls without seizure matched for age and etiology. EEG was reviewed with DC settings. RESULTS: 39/260 (15%) patients with electrographic seizures presented with CS. These patients were older (62 vs...
January 29, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28214097/impact-of-an-enhanced-recovery-after-surgery-programme-in-radical-cystectomy-a-cohort-comparative-study
#7
R Casans-Francés, A T Roberto-Alcácer, A C García-Lecina, M L Ferrer-Ferrer, J Subirá-Ríos, J Guillén-Antón
OBJECTIVE: To evaluate the results of the implementation of an enhanced recovery program (ERAS) for open approach radical cystectomy compared to the historical cohort of the same hospital. MATERIAL AND METHODS: A retrospective analysis of 138 consecutive patients who underwent radical cystectomy with Bricker or Studer ileal derivation (97 historical vs. 41 ERAS). Overall complication rate, Clavien-Dindo stage>2 complications, mortality, hospital and critical care length of stay and readmission rates, as well as need for reoperation, nasogastric intubation, transfusion or parenteral nutrition were compared...
February 14, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#8
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28213648/-state-of-the-art-in-fluid-and-volume-therapy-a%C3%A2-user-friendly-staged-concept
#9
M Rehm, N Hulde, T Kammerer, A S Meidert, K Hofmann-Kiefer
Adequate fluid therapy is highly important for the perioperative outcome of our patients. Both, hypovolemia and hypervolemia can lead to an increase in perioperative complications and can impair the outcome. Therefore, perioperative infusion therapy should be target-oriented. The main target is to maintain the patient's preoperative normovolemia by using a sophisticated, rational infusion strategy.Perioperative fluid losses should be discriminated from volume losses (surgical blood loss or interstitial volume losses containing protein)...
February 17, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28213611/transthyretin-amyloidosis-an-under-recognized-neuropathy-and-cardiomyopathy
#10
REVIEW
Natalie J Galant, Per Westermark, Jeffrey N Higaki, Avijit Chakrabartty
Transthyretin (TTR) amyloidosis (ATTR amyloidosis) is an underdiagnosed and important type of cardiomyopathy and/or polyneuropathy that requires increased awareness within the medical community. Raising awareness among clinicians about this type of neuropathy and lethal form of heart disease is critical for improving earlier diagnosis and the identification of patients for treatment. The following review summarizes current criteria used to diagnose both hereditary and wild-type ATTR (ATTRwt) amyloidosis, tools available to clinicians to improve diagnostic accuracy, available and newly developing therapeutics, as well as a brief biochemical and biophysical background of TTR amyloidogenesis...
March 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28213517/the-p53-binding-protein-1-tudor-interacting-repair-regulator-complex-participates-in-the-dna-damage-response
#11
Aili Zhang, Bo Peng, Ping Huang, Junjie Chen, Zihua Gong
The 53BP1-dependent end-joining pathway plays a critical role in DSB repair and is uniquely responsible for cellular sensitivity to PARPi in BRCA1-deficient cancers. We and others have investigated the downstream effectors of 53BP1, including replication timing regulatory factor 1 (RIF1) and Pax transactivation domain-interacting protein (PTIP), in the past few years to elucidate how loss of the 53BP1-dependent repair pathway results in PARPi resistance in BRCA1 patients. However, questions regarding the upstream regulation of the 53BP1 pathway remain unanswered...
February 17, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28213493/development-of-the-critical-care-pharmacotherapy-trials-network
#12
Seth R Bauer, Prasad E Abraham, Jeffrey F Barletta, Gretchen M Brophy, Brian L Erstad, Jeffrey P Gonzales, Curtis E Haas, Robert MacLaren, Eric W Mueller, Keith M Olsen, Ishaq Lat
PURPOSE: The development of the Critical Care Pharmacotherapy Trials Network (CCPTN) as a model for practice-based pharmacotherapy research is described. SUMMARY: The CCPTN was formed in 2010 as a collaborative research network dedicated to scientific investigation in the field of critical care pharmacotherapy. The CCPTN organizational structure is consistent with many professional pharmacy and interdisciplinary organizations and organized into 3 primary domains: executive committee, working committees, and network membership...
March 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28213437/%C3%AE-synuclein-multiple-system-atrophy-prions
#13
Amanda L Woerman, Joel C Watts, Atsushi Aoyagi, Kurt Giles, Lefkos T Middleton, Stanley B Prusiner
Multiple system atrophy (MSA) is a rapidly progressive neurodegenerative disease arising from the misfolding and accumulation of the protein α-synuclein in oligodendrocytes, where it forms glial cytoplasmic inclusions (GCIs). Several years of studying synthetic α-synuclein fibrils has provided critical insight into the ability of α-synuclein to template endogenous protein misfolding, giving rise to fibrillar structures capable of propagating from cell to cell. However, more recent studies with MSA-derived α-synuclein aggregates have shown that they have a similar ability to undergo template-directed propagation, like PrP prions...
February 17, 2017: Cold Spring Harbor Perspectives in Medicine
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#14
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28213266/noninvasivepositive-pressure-ventilation-vsinvasive-mechanical-ventilation-as-first-line-therapy-for-acute-hypoxemic-respiratory-failure-in-cancer-patients
#15
Nisha K Rathi, Sajid A Haque, Ron Nates, Alyssa Kosturakis, Hao Wang, Wenli Dong, Lei Feng, Rose J Erfe, Christina Guajardo, Laura Withers, Clarence Finch, Kristen J Price, Joseph L Nates
PURPOSE: The objective was to describe the characteristics and outcomes of critically ill cancer patients who received noninvasive positive pressure ventilation (NIPPV) vs invasive mechanical ventilation as first-line therapy for acute hypoxemic respiratory failure. MATERIAL AND METHODS: A retrospective cohort study of consecutive adult intensive care unit (ICU) cancer patients who received either conventional invasive mechanical ventilation or NIPPV as first-line therapy for hypoxemic respiratory failure...
January 20, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28213050/reduced-frequency-of-two-activating-kir-genes-in-patients-with-sepsis
#16
Luciana M Oliveira, Pamela Portela, Joice Merzoni, Juliana D Lindenau, Fernando S Dias, Jaqueline Beppler, Pietra Graebin, Clarice S Alho, Gilberto Schwartsmann, Felipe Dal-Pizzol, Luiz Fernando Jobim, Mariana Jobim, Rafael Roesler
Natural killer (NK) cell activity is regulated by activating and inhibitory signals transduced by killer cell immunoglobulin-like receptors (KIR). Diversity in KIR gene repertoire among individuals may affect disease outcome. Sepsis development and severity may be influenced by genetic factors affecting the immune response. Here, we examined sixteen KIR genes and their human leucocyte antigen (HLA) class I ligands in critical patients, aiming to identify patterns that could be associated with sepsis. Male and female patients (ages ranging between 14 and 94 years-old) were included...
February 14, 2017: Human Immunology
https://www.readbyqxmd.com/read/28212968/-what-goes-around-comes-around-lessons-learned-from-economic-evaluations-of-personalized-medicine-applied-to-digital-medicine
#17
Kathryn A Phillips, Michael P Douglas, Julia R Trosman, Deborah A Marshall
BACKGROUND: The growth of "big data" and the emphasis on patient-centered health care have led to the increasing use of two key technologies: personalized medicine and digital medicine. For these technologies to move into mainstream health care and be reimbursed by insurers, it will be essential to have evidence that their benefits provide reasonable value relative to their costs. These technologies, however, have complex characteristics that present challenges to the assessment of their economic value...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212842/pathophysiological-consequences-of-receptor-mistraffic-tales-from-the-platelet-p2y12-receptor
#18
Margaret R Cunningham, Riyaad Aungraheeta, Stuart J Mundell
Genetic variations in G protein-coupled receptor (GPCR) genes can disrupt receptor function in a wide variety of human genetic diseases, including platelet bleeding disorders. Platelets are critical for haemostasis with inappropriate platelet activation leading to the development of arterial thrombosis, which can result in heart attack and stroke whilst decreased platelet activity is associated with an increased risk of bleeding. GPCRs expressed on the surface of platelets play key roles in regulating platelet activity and therefore function...
February 14, 2017: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/28212647/an-interpretive-review-of-consensus-statements-on-clinical-guideline-development-and-their-application-in-the-field-of-traditional-and-complementary-medicine
#19
Jennifer Hunter, Matthew Leach, Lesley Braun, Alan Bensoussan
BACKGROUND: Despite ongoing consumer demand and an emerging scientific evidence-base for traditional and complementary medicine (T&CM), there remains a paucity of reliable information in standard clinical guidelines about their use. Often T&CM interventions are not mentioned, or the recommendations arising from these guidelines are unhelpful to end-users (i.e. patients, practitioners and policy makers). Insufficient evidence of efficacy may be a contributing factor; however, often informative recommendations could still be made by drawing on relevant information from other avenues...
February 17, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28212470/-prediabetes-as-a-riskmarker-for-stress-induced-hyperglycemia-in-critically-ill-adults
#20
Diego Jesús García-Gallegos, Eliseo Luis-López
BACKGROUND: It is not known if patients with prediabetes, a subgroup of non-diabetic patients that usually present hyperinsulinemia, have higher risk to present stress-induced hyperglycemia. The objective was to determine if prediabetes is a risk marker to present stress-induced hyperglycemia. METHODS: Analytic, observational, prospective cohort study of non-diabetic critically ill patients of a third level hospital. We determined plasmatic glucose and glycated hemoglobin (HbA1c) at admission to diagnose stress-induced hyperglycemia (glucose ≥ 140 mg/dL) and prediabetes (HbA1c between 5...
2017: Revista Médica del Instituto Mexicano del Seguro Social
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