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https://www.readbyqxmd.com/read/28822398/variability-in-perioperative-fasting-practices-negatively-impacts-nutritional-support-of-critically-ill-intubated-patients
#1
Molly J Douglas, David Ciraulo
The aim of the study was to quantify nutritional losses related to pre- and postoperative fasts in critically ill intubated patients and to explore whether shorter fasts are safe and appropriate in this population. A retrospective review of mechanically ventilated adults undergoing surgery more than 24 hours after admission to a Level I trauma center over 15 months was done, which yielded 132 procedures and 81 unique patients. Ninety per cent of preoperative periods and 43 per cent of postoperative periods were affected by nonmedical barriers to feeding...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28797607/trends-and-clinical-outcomes-in-patients-undergoing-primary-percutaneous-revascularisation-for-st-elevation-myocardial-infarction-a-single-centre-experience
#2
Luke P Dawson, Josephine Warren, Juan Mundisugih, Viveka Nainani, William Chan, Dion Stub, Archer Broughton, Andrew J Taylor, Antony Walton, Stephen J Duffy, James A Shaw
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is the preferred therapy for patients presenting with ST-elevation myocardial infarction (STEMI). We reviewed patients undergoing PCI for STEMI over a six-year period to evaluate changes in procedural characteristics and clinical outcomes given recent changes to STEMI guidelines. METHODS: All patients presenting to the Alfred Hospital, a tertiary referral hospital, between 1 January 2010 and 31 December 2015 undergoing PCI for STEMI were identified...
July 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28772003/case-of-chondroid-syringoma-mimicking-as-nodular-hidradenoma-a-diagnostic-pitfall-on-cytopathology
#3
Bahadur Shalini, Katyal Akshi, Nargotra Namrata, Soni Shilpi, Nain Manupriya
Limited literature is available on the use of fine needle aspiration (FNA) for skin tumors. Awareness of cytological features of these lesions is important to prevent misdiagnosis. A 45-year-old male, presented with slowly growing swelling over the thigh since 4 years. FNA from multiple sites yielded highly cellular smears with a dual cell population consisting of cells with small round nucleus scanty cytoplasm and polygonal cells with moderate to abundant cytoplasm. Extracellular basement membrane like material was also noted...
August 3, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28770404/validation-of-the-american-gastroenterological-association-guidelines-on-management-of-intraductal-papillary-mucinous-neoplasms-more-than-5%C3%A2-years-of-follow-up
#4
Koh Imbe, Naoyoshi Nagata, Yuya Hisada, Yusuke Takasaki, Katsunori Sekine, Saori Mishima, Akihito Kawazoe, Tsuyoshi Tajima, Takuro Shimbo, Mikio Yanase, Junichi Akiyama, Kazuma Fujimoto, Naomi Uemura
OBJECTIVES: Recent guidelines suggest that imaging surveillance be conducted for 5 years for patients with at most one high-risk feature. If there were no significant changes, surveillance is stopped. We sought to validate this follow-up strategy. METHODS: In study 1, data were analysed for 392 patients with intraductal papillary mucinous neoplasms (IPMNs) and at most one high-risk feature who were periodically followed up for more than 1 year with imaging tests...
August 2, 2017: European Radiology
https://www.readbyqxmd.com/read/28762228/-a-systematic-review-and-meta-analysis-of-the-pros-and-cons-of-consuming-liquids-preoperatively
#5
Fang-Tzu Lin, Tsai-Rung Lin, Chia-Wei Liao, Shu-Hui Chen
BACKGROUND: Preoperative anesthesia long time fasting, may increase patient hemodynamic instability during surgery and may affect the patient's post-surgery electrolyte balance. No meta-analysis has been conducted to explore the effects of preoperative liquid intake amount on gastric fluid PH, gastric fluid volume, surgery inhalation of pulmonary complications, and patient self-perceptions quality of care systematic review and meta-analysis of the literature. PURPOSE: To assess the pros and cons of preoperative liquid intake using a systematic review of the literature...
August 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28759584/a-safety-rule-approach-to-surveillance-and-eradication-of-biological-invasions
#6
Denys Yemshanov, Robert G Haight, Frank H Koch, Robert Venette, Kala Studens, Ronald E Fournier, Tom Swystun, Jean J Turgeon
Uncertainty about future spread of invasive organisms hinders planning of effective response measures. We present a two-stage scenario optimization model that accounts for uncertainty about the spread of an invader, and determines survey and eradication strategies that minimize the expected program cost subject to a safety rule for eradication success. The safety rule includes a risk standard for the desired probability of eradication in each invasion scenario. Because the risk standard may not be attainable in every scenario, the safety rule defines a minimum proportion of scenarios with successful eradication...
2017: PloS One
https://www.readbyqxmd.com/read/28751516/the-use-and-utility-of-aspiration-thrombectomy-in-acute-ischemic-stroke-a-systematic-review-and-meta-analysis
#7
D Wei, J R Mascitelli, D A Nistal, C P Kellner, J T Fifi, J D Mocco, R A De Leacy
BACKGROUND: Thrombectomy trials are often specifically interpreted as evidence for the effectiveness of stent retrievers. The effectiveness of other thrombectomy techniques such as aspiration thrombectomy should be validated through further investigation and review. PURPOSE: To evaluate published treatment times and clinical outcomes in patients treated with aspiration thrombectomy or ADAPT (A Direct Aspiration, First Pass Technique) for acute ischemic stroke. DATA SOURCES: A systematic literature review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
July 27, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28748505/comparison-of-consecutive-results-from-fine-needle-aspiration-and-core-needle-biopsy-in-thyroid-nodules
#8
Soon-Hyun Ahn, So-Yeon Park, Sang Il Choi
There are papers suggesting the complementary role of core needle biopsy (CNB) in the diagnosis of thyroid nodules. By comparing the result of CNB and fine needle aspiration (FNA) cytology performed in consecutive cases of thyroid nodules, the role of CNB was evaluated. Retrospective reviews of 2131 FNA and 275 CNB which were performed as first-line biopsy for 2406 thyroid nodules in 2187 patients were performed. The ultrasound (US) feature of thyroid nodule was classified following the risk of malignancy suggested by American Thyroid Association (ATA) guideline...
July 26, 2017: Endocrine Pathology
https://www.readbyqxmd.com/read/28738608/a-fast-bioanalytical-method-based-on-microextraction-by-packed-sorbent-and-uplc-ms-ms-for-determining-new-psychoactive-substances-in-oral-fluid
#9
A M Ares, P Fernández, M Regenjo, A M Fernández, A M Carro, R A Lorenzo
The emergence in recent years of potentially dangerous new psychoactive substances (NPS) that are not under international control has led to the development of multi-analyte procedures for their unequivocal quantification. A fast ultra-performance liquid chromatography-tandem mass spectrometry method (UPLC-MS/MS), in combination with a sample pretreatment based on microextraction by packed sorbent (MEPS), was for the first time used in this work for the simultaneous determination of NPS in oral fluid. This matrix is an effective alternative to typical biological samples for drug control in substitution therapy programs, and also for the prevention and reduction of traffic accidents...
November 1, 2017: Talanta
https://www.readbyqxmd.com/read/28731350/gastric-and-duodenal-ethanol-concentrations-after-intake-of-alcoholic-beverages-in-postprandial-conditions
#10
Jari Rubbens, Danny Riethorst, Joachim Brouwers, Kris Wolfs, Erwin Adams, Jan Tack, Patrick Augustijns
INTRODUCTION: This study determined intraluminal ethanol concentrations (stomach and duodenum) in fed healthy volunteers after the consumption of common alcoholic beverages (beer, wine and whisky). The results of this study were compared with a previous study in fasted volunteers. MATERIALS AND METHODS: Five healthy volunteers were recruited in a cross-over study. The fed state was simulated by ingestion of 250 mL of Nutridrink Compact® Neutral. Volunteers subsequently consumed two standard units of beer (Stella Artois®, 500 mL, 5...
July 21, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28729309/the-role-of-a-decision-support-smartphone-application-in-enhancing-community-health-volunteers-effectiveness-to-improve-maternal-and-newborn-outcomes-in-nairobi-kenya-quasi-experimental-research-protocol
#11
Pauline Bakibinga, Eva Kamande, Milka Omuya, Abdhalah K Ziraba, Catherine Kyobutungi
INTRODUCTION: Improving maternal and newborn survival remains major aspirations for many countries in the Global South. Slum settlements, a result of rapid urbanisation in many developing countries including Kenya, exhibit high levels of maternal and neonatal mortality. There are limited referral mechanisms for sick neonates and their mothers from the community to healthcare facilities with ability to provide adequate care. In this study, we specifically plan to develop and assess the added value of having community health volunteers (CHVs) use smartphones to identify and track mothers and children in a bid to reduce pregnancy-related complications and newborn deaths in the urban slums of Kamukunji subcounty in Nairobi, Kenya...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728311/clinical-approach-to-incidental-pancreatic-cystic-neoplasm-in-outpatient-clinics
#12
REVIEW
Young Sik Woo, Kyu Taek Lee
Cystic lesions of the pancreas are increasingly observed due to increased use of abdominal images. The malignant rate of pancreas cystic lesion varies widely between various types. Identification of malignant or high-risk lesions is important when determining the appropriate course of management. Using these image findings, including cyst size, presence of solid components, and pancreatic duct involvement, the 2012 International Association of Pancreatology (IAP) and the 2015 American Gastroenterological Association (AGA) guidelines provide a rationale in identifying higher risk patients requiring further workups using an endoscopic ultrasound (EUS)...
July 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28721972/ultrasound-imaging-features-of-isolated-pancreatic-tuberculosis
#13
Yi Dong, Christian Jürgensen, Rajesh Puri, Mirko D'Onofrio, Michael Hocke, Wen-Ping Wang, Nathan Atkinson, Malay Sharma, Christoph F Dietrich
BACKGROUND AND OBJECTIVES: Isolated pancreatic tuberculosis (PTB) is extremely rare worldwide. The purpose of this multicenter retrospective study is to analyze imaging features of histologically confirmed isolated PTB in order to determine the diagnostic features of the new methods contrast enhanced ultrasound (CEUS), ultrasound elastography and contrast enhanced endoscopic ultrasound (CE-EUS). PATIENTS AND METHODS: We report on a retrospective data collection of 12 cases of PTB confirmed by histology or cytology...
July 19, 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28719972/risk-stratification-of-thyroid-nodules-with-atypia-of-undetermined-significance-follicular-lesion-of-undetermined-significance-aus-flus-cytology-using-ultrasonography-patterns-defined-by-the-2015-ata-guidelines
#14
Ji Hye Lee, Kyunghwa Han, Eun-Kyung Kim, Hee Jung Moon, Jung Hyun Yoon, Vivian Y Park, Jin Young Kwak
PURPOSE: The purpose of this study was to evaluate the predictive value of ultrasonography (US) patterns based on the 2015 American Thyroid Association (ATA) guidelines for malignancy in atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) nodules. METHODS: From January 2014 to August 2015, 133 thyroid nodules that were initially diagnosed as AUS/FLUS on fine needle aspiration (FNA) were included in this study. Each nodule was assigned a category with US patterns defined by the ATA guidelines...
September 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28715529/changes-in-peak-airflow-measurement-during-maximal-cough-after-vocal-fold-augmentation-in-patients-with-glottic-insufficiency
#15
Gregory R Dion, Efstratios Achlatis, Stephanie Teng, Yixin Fang, Michael Persky, Ryan C Branski, Milan R Amin
Importance: Compromised cough effectiveness is correlated with dysphagia and aspiration. Glottic insufficiency likely yields decreased cough strength and effectiveness. Although vocal fold augmentation favorably affects voice and likely improves cough strength, few data exist to support this hypothesis. Objective: To assess whether vocal fold augmentation improves peak airflow measurements during maximal-effort cough following augmentation. Setting, Design, Participants: This case series study was conducted in a tertiary, academic laryngology clinic...
July 13, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28707827/cat-scratch-disease-u-s-clinicians-experience-and-knowledge
#16
C A Nelson, A R Moore, A E Perea, P S Mead
Cat scratch disease (CSD) is a zoonotic infection caused primarily by the bacterium Bartonella henselae. An estimated 12,000 outpatients and 500 inpatients are diagnosed with CSD annually, yet little is known regarding clinician experience with and treatment of CSD in the United States. Questions assessing clinical burden, treatment and prevention of CSD were posed to 3,011 primary care providers (family practitioners, internists, paediatricians and nurse practitioners) during 2014-2015 as part of the annual nationwide DocStyles survey...
July 14, 2017: Zoonoses and Public Health
https://www.readbyqxmd.com/read/28681751/assessment-of-surgical-risk-factors-in-the-development-of-ventilator-associated-pneumonia-in-neurosurgical-intensive-care-unit-patients-alarming-observations
#17
Deepashu Sachdeva, Daljit Singh, Poonam Loomba, Amandeep Kaur, Monica Tandon, Ishu Bishnoi
BACKGROUND: Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in patients receiving mechanical ventilation (MV) and contributes to a longer intensive care unit (ICU) stay, duration of MV, and a high morbidity and mortality. OBJECTIVE: The purpose of study was to determine the incidence of VAP in neurosurgery ICU patients and to assess the probable contributing neurosurgical risk factors like the site and nature of the lesion in the brain, the duration of surgery, blood loss during surgery, and infection elsewhere in the body, in the development of VAP...
July 2017: Neurology India
https://www.readbyqxmd.com/read/28677255/anaerobic-antibiotic-usage-for-pneumonia-in-the-medical-intensive-care-unit
#18
Mutsumi J Kioka, Bruno DiGiovine, Mohamed Rezik, Jeffrey H Jennings
BACKGROUND AND OBJECTIVE: Pneumonia is a common admitting diagnosis in the intensive care unit (ICU). When aspiration is suspected, antibiotics to cover anaerobes are frequently used, but in the absence of clear risk factors, current guidelines have questioned their role. It is unknown how frequently these guidelines are followed. METHODS: We conducted a single-centre observational study on practice patterns of anaerobic antibiotic use in consecutive patients admitted to the ICU with aspiration pneumonia (Asp), community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP)...
July 4, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28675504/ultrasound-assessment-of-gastric-emptying-after-breakfast-in-healthy-preschool-children
#19
Anne E Sümpelmann, Robert Sümpelmann, Michael Lorenz, Ilona Eberwien, Nils Dennhardt, Dietmar Boethig, Sebastian G Russo
BACKGROUND: In current guidelines, 6 hours of fasting is recommended for solids to limit the risk of pulmonary aspiration during anesthesia in children. Ultrasonography has recently been introduced to evaluate gastric volumes in children in the context of preanesthetic fasting. Therefore, in this study, we firstly evaluated the precision of ultrasound assessment of gastric volume in an experimental setting and secondly studied gastric emptying times after a normal breakfast in healthy preschool children using ultrasound...
July 4, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28666656/reasons-for-and-experiences-with-surgical-interventions-for-female-genital-mutilation-cutting-fgm-c-a-systematic-review
#20
REVIEW
Rigmor C Berg, Sølvi Taraldsen, Maryan A Said, Ingvil Krarup Sørbye, Siri Vangen
BACKGROUND: Because female genital mutilation/cutting (FGM/C) leads to changes in normal genital anatomy and functionality, women are increasingly seeking surgical interventions for their FGM/C-related concerns. AIM: To conduct a systematic review of empirical quantitative and qualitative research on interventions for women with FGM/C-related complications. METHODS: We conducted systematic searches up to May 2016 in 16 databases to obtain references from different disciplines...
June 27, 2017: Journal of Sexual Medicine
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