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https://read.qxmd.com/read/30786291/-developments-in-emergency-care-analysis-of-emergency-cases-in-in-and-outpatient-care-from-2009-to-2015-in-germany
#1
Philip Wahlster, Thomas Czihal, Bernhard Gibis, Cornelia Henschke
BACKGROUND: Increasing numbers of emergency cases, different stakeholders involved (physicians' practices vs. hospitals providing ambulatory and inpatient care) and changing patient utilization patterns lead to changes in health care needs. This study aimed at analyzing changes in patient characteristics as well as indications for in- and outpatient emergency care between 2009 and 2015 and their potential reasons. METHODS: Based on in- and outpatient routine data, we descriptively analyzed changes in emergency diagnosis, population-based emergency prevalence as well as regional differences and their changes over time...
February 20, 2019: Das Gesundheitswesen
https://read.qxmd.com/read/30786269/circular-rna-biogenesis-is-decreased-in-postmortem-cortical-gray-matter-in-schizophrenia-and-may-alter-the-bioavailability-of-associated-mirna
#2
E Mahmoudi, C Fitzsimmons, M Geaghan, C Shannon Weickert, Jr Atkins, X Wang, M J Cairns
Circular RNAs (circRNAs) are a covalently closed subclass of lncRNA molecules formed by back splicing of linear precursor RNA. These molecules are relatively stable and particularly abundant in the mammalian brain and therefore may participate in neural development and function. With the emergence of circRNAs activity in gene regulation, these molecules have been implicated in several biological processes, including synaptic plasticity, and we therefore suspect they may have a role in neurobehavioral disorders...
February 20, 2019: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://read.qxmd.com/read/30786175/histopathological-and-hematological-changes-in-recurrent-nasal-polyposis
#3
Giuseppe Brescia, Lara Alessandrini, Claudia Zanotti, Daniela Parrino, Giulia Tealdo, Miriam Torsello, Vladislav Zybine, Luciano Giacomelli, Umberto Barion, Gino Marioni
BACKGROUND: There is a dearth of information regarding the histological and hematological differences between primary and recurrent chronic rhinosinusitis with nasal polyps (CRSwNP). The present study analyzed the histological changes in recurrent CRSwNP in terms of eosinophilic infiltrate, subepithelial edema, goblet cell hyperplasia, and basement membrane thickness. Blood levels of eosinophils and basophils were also measured prior to surgery on both primary and recurrent disease. METHODS: Thirty-two consecutive adult patients with nasal polyposis treated with primary surgery who subsequently underwent revision surgery were retrospectively enrolled...
February 20, 2019: International Forum of Allergy & Rhinology
https://read.qxmd.com/read/30786109/hematopoietic-stem-cell-transplantation-in-children-with-sickle-cell-anemia-the-parents-experience
#4
Raphaël Cavadini, Elise Drain, Françoise Bernaudin, Clémence D'Autume, Davide Giannica, François Giraud, Thierry Baubet, Olivier Taïeb
Genoidentical HSCT is currently the only curative treatment for SCA, preventing further vascular complications in high-risk children. Studies on the psychological implications of HSCT for recipient, sibling donor, and the rest of the family have been limited in SCA. This study enrolled ten families and used semi-structured interviews to explore the parents' experience at three time points: first before transplantation, then 3 months later, and 1 year later. Three themes emerged from the results: (a) the presence of anxiety, experienced throughout the process, and alleviated by coping strategies (positive thinking, family support, praying); (b) the ability to remain parents to recipient and other family members, despite apprehension and feelings of helplessness, reinforced by the mobilization of important resources at the individual/family levels; (c) the ability to acknowledge the opportunity for their child to be cured of the disease, despite feelings of guilt toward families without a donor, or their own families back home...
February 20, 2019: Pediatric Transplantation
https://read.qxmd.com/read/30786031/epidemiology-and-resource-utilization-of-ludwig-angina-ed-visits-in-the-united-states-2006-2014
#5
Jamiela A McDonnough, Deawodi A Ladzekpo, Iasson Yi, William R Bond, Gezzer Ortega, Adedoyin O Kalejaiye
OBJECTIVES: Ludwig angina is a potentially lethal submandibular space infection. We aim to describe the epidemiological characteristics of Ludwig angina patients presenting to the emergency department (ED) and to examine outcomes and resource utilization to determine their burden on ED and hospitals. METHODS: Using the Nationwide Emergency Department Sample database, a nationally representative all-payer database, we retrospectively reviewed all ED visits between 2006 and 2014 for patients admitted with a primary diagnosis of Ludwig angina (International Classification of Diseases, Ninth Revision, 528...
February 20, 2019: Laryngoscope
https://read.qxmd.com/read/30785928/high-quality-process-of-care-increases-one-year-survival-after-acute-myocardial-infarction-ami-a-cohort-study-in-italy
#6
Martina Ventura, Valeria Belleudi, Paolo Sciattella, Riccardo Di Domenicantonio, Mirko Di Martino, Nera Agabiti, Marina Davoli, Danilo Fusco
BACKGROUND: The relationship between guideline adherence and outcomes in patients with acute myocardial infarction (AMI) has been widely investigated considering the emergency, acute, post-acute phases separately, but the effectiveness of the whole care process is not known. AIM: The study aim was to evaluate the effect of the multicomponent continuum of care on 1-year survival after AMI. METHODS: We conducted a cohort study selecting all incident cases of AMI from health information systems during 2011-2014 in the Lazio region...
2019: PloS One
https://read.qxmd.com/read/30785905/averting-wheat-blast-by-implementing-a-wheat-holiday-in-search-of-alternative-crops-in-west-bengal-india
#7
Khondoker A Mottaleb, Pawan K Singh, Kai Sonder, Gideon Kruseman, Olaf Erenstein
The emergence of wheat-blast in Bangladesh in the 2015-16 wheat (Triticum aestivum L.) crop threatens the food security of South Asia. A potential spread of the disease from Bangladesh to India could have devastating impacts on India's overall food security as wheat is its second most important staple food crop. West Bengal state in eastern India shares a 2,217 km-long border with Bangladesh and has a similar agro-ecology, enhancing the prospects of the disease entering India via West Bengal. The present study explores the possibility of a 'wheat holiday' policy in the nine border districts of West Bengal...
2019: PloS One
https://read.qxmd.com/read/30785873/secondary-contact-between-diverged-host-lineages-entails-ecological-speciation-in-a-european-hantavirus
#8
Moritz Saxenhofer, Sabrina Schmidt, Rainer G Ulrich, Gerald Heckel
The diversity of viruses probably exceeds biodiversity of eukaryotes, but little is known about the origin and emergence of novel virus species. Experimentation and disease outbreak investigations have allowed the characterization of rapid molecular virus adaptation. However, the processes leading to the establishment of functionally distinct virus taxa in nature remain obscure. Here, we demonstrate that incipient speciation in a natural host species has generated distinct ecological niches leading to adaptive isolation in an RNA virus...
February 2019: PLoS Biology
https://read.qxmd.com/read/30785860/virtual-reality-assisted-pain-anxiety-and-anger-management-in-the-emergency-department
#9
Neal Sikka, Liqi Shu, Brandon Ritchie, Richard L Amdur, Ali Pourmand
STUDY OBJECTIVE: Pain management in emergency department (ED) patients is challenging. Although both pharmacological and nonpharmacological therapies exist, they are often suboptimal. Immersive virtual reality (VR) uses distraction and possible other methods to reduce perceptions of pain. The purpose of the study is to evaluate the usability and acceptability of VR applications in ED patients by assessing patient-reported changes in pain, anger, and anxiety levels. METHODS: This is a prospective cohort study at a single academic urban tertiary care center among ED patients with a pain score ≥3 on a numeric rating scale (0-10 integers) for any reason...
February 20, 2019: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://read.qxmd.com/read/30785787/dermatologic-urgencies-and-emergencies-what-every-pathologist-should-know
#10
Mallory S Abate, Laura R Battle, Ashley N Emerson, Jerad M Gardner, Sara C Shalin
CONTEXT.—: Fatal dermatologic diseases and ones with high morbidity can occur in the inpatient setting. In such cases, prompt and accurate assessment of a bedside skin biopsy is required. This may be challenging for many pathologists who are not familiar with the complexity of skin pathology and skin terminology within the fields of dermatopathology and dermatology. OBJECTIVE.—: To provide the pathologist with a practical, up-to-date, and "must-know" reference guide on dermatologic urgencies and emergencies from a real-world perspective, highlighting diagnostic pearls, diagnostic pitfalls, and commonly encountered practice gaps...
February 20, 2019: Archives of Pathology & Laboratory Medicine
https://read.qxmd.com/read/30785374/modeling-epidemics-in-seed-systems-and-landscapes-to-guide-management-strategies-the-case-of-sweetpotato-in-northern-uganda
#11
Kelsey F Andersen, Christopher Buddenhagen, Paul Rachkara, Richard Gibson, Stephen Kalule, David Phillips, Karen A Garrett
Seed systems are critical for deployment of improved varieties, but also can serve as major conduits for the spread of seed-borne pathogens. As in many other epidemic systems, epidemic risk in seed systems often depends on the structure of networks of trade, social interactions, and landscape connectivity. In a case study, we evaluated the structure of an informal sweetpotato seed system in the Gulu Region of Northern Uganda, for its vulnerability to the spread of emerging epidemics, and its utility for disseminating improved varieties...
February 20, 2019: Phytopathology
https://read.qxmd.com/read/30785333/current-and-emerging-pharmacotherapy-for-the-treatment-of-infections-following-open-heart-surgery
#12
Daniele Roberto Giacobbe, Silvia Corcione, Antonio Salsano, Filippo Del Puente, Simone Mornese Pinna, Francesco Giuseppe De Rosa, Malgorzata Mikulska, Francesco Santini, Claudio Viscoli
Patients undergoing open-heart surgery may suffer from postoperative complications, including severe infections. Antimicrobials to treat infectious complications in this population should be selected thoughtfully, taking into account three different and fundamental issues: (i) the site of infection; (ii) the suspected or proven causative agent and its susceptibility pattern; and (iii) the risk of suboptimal pharmacokinetic characteristics and potential toxicity of the chosen drug/s. Areas covered: The present narrative review summarizes the current and future antimicrobial options for the treatment of infections developing after open-heart surgery...
February 20, 2019: Expert Opinion on Pharmacotherapy
https://read.qxmd.com/read/30785074/potential-mechanisms-of-action-related-to-the-efficacy-and-safety-of-cladribine
#13
REVIEW
David Baker, Gareth Pryce, Samuel S Herrod, Klaus Schmierer
Oral cladribine is a novel treatment for relapsing multiple sclerosis (MS). This appears to be a semi-selective immune-reconstitution therapy that induces long-term therapy from short treatment cycles. It has a relatively good safety profile that currently does not require extensive monitoring associated with some continuous immunosuppressive and relatively non-selective immune reconstitution therapies. The efficacy and safety of cladribine relates to its particular physicochemical properties, the function of the lymphocyte subsets that are selectively targeted by the drug and the repopulation kinetics of these subsets...
February 14, 2019: Multiple Sclerosis and related Disorders
https://read.qxmd.com/read/30785027/treatment-patterns-clinical-outcomes-health-resource-utilization-and-cost-in-patients-with-brca-mutated-metastatic-breast-cancer-treated-in-community-oncology-settings
#14
Arthur C Houts, Tope Olufade, Rahul Shenolikar, Mark S Walker, Lee S Schwartzberg
PURPOSE: This retrospective study of community oncology patients with breast cancer gene (BRCA)-mutated metastatic breast cancer (MBC) examined treatment outcomes and health resource utilization (HRU) and costs for a sample of patients with human epidermal growth factor receptor 2 (HER2)-negative disease who were either hormone receptor positive (HR+) or triple negative breast cancer (TNBC). METHODS: Evidence from the Vector Oncology Data Warehouse, a repository of electronic medical records/billing data and provider notes, was analyzed...
February 6, 2019: Cancer Treatment and Research Communications
https://read.qxmd.com/read/30784983/adherence-to-fluid-resuscitation-guidelines-and-outcomes-in-patients-with-septic-shock-reassessing-the-one-size-fits-all-approach
#15
Tuyet-Trinh N Truong, Andrew S Dunn, Ken McCardle, Allison Glasser, Shirish Huprikar, Hooman Poor, Beth Raucher, Jashvant Poeran
OBJECTIVE: The Surviving Sepsis Campaign and Centers for Medicare and Medicaid Services (CMS) Severe Sepsis and Septic Shock Management Bundle (SEP-1) recommend rapid crystalloid infusion (≥30 mL/kg) for patients with sepsis-induced hypoperfusion or septic shock. We aimed to assess compliance with this recommendation, factors associated with non-compliance, and how compliance relates to mortality. DESIGN: Retrospective, observational study. SETTING: 1136-bed academic and 235-bed community hospital (January 2015-June 2016)...
February 5, 2019: Journal of Critical Care
https://read.qxmd.com/read/30784957/t-bet-b-cells-a-common-denominator-in-protective-and-autoreactive-antibody-responses
#16
REVIEW
Arpita Myles, Ignacio Sanz, Michael P Cancro
T-bet+ B cells have emerged as a key component of the humoral immune response in both infections and autoimmune disorders, with many of their phenotypic and functional attributes conserved between mice and humans. They are protective (infections) and pathogenic (autoimmunity), although the associated commonalities and differences remain unclear. Heterogeneity within this pool, in terms of origin, fate and function may underlie these divergent roles. Their significance is context-dependent- they may constitute a persistent effector memory cell pool, or products of recent primary responses...
February 19, 2019: Current Opinion in Immunology
https://read.qxmd.com/read/30784662/novel-elisa-for-thrombospondin-type-1-domain-containing-7a-autoantibodies-in-membranous-nephropathy
#17
Christelle Zaghrini, Barbara Seitz-Polski, Joana Justino, Guillaume Dolla, Christine Payré, Noémie Jourde-Chiche, Anne-Els Van de Logt, Caroline Booth, Emma Rigby, Jennie Lonnbro-Widgren, Jenny Nystrom, Christophe Mariat, Zhao Cui, Jack F M Wetzels, GianMarco Ghiggeri, Laurence H Beck, Pierre Ronco, Hanna Debiec, Gérard Lambeau
Autoantibodies against phospholipase A2 receptor 1 (PLA2R1) and thrombospondin type 1 domain-containing 7A (THSD7A) are emerging as biomarkers to classify membranous nephropathy (MN) and to predict outcome or response to treatment. Anti-THSD7A autoantibodies are detected by Western blot and indirect immunofluorescence test (IIFT). Here, we developed a sensitive enzyme-linked immunosorbent assay (ELISA) optimized for quantitative detection of anti-THSD7A autoantibodies. Among 1012 biopsy-proven MN patients from 6 cohorts, 28 THSD7A-positive patients were identified by ELISA, indicating a prevalence of 2...
March 2019: Kidney International
https://read.qxmd.com/read/30784347/value-based-pricing-for-emerging-gene-therapies-the-economic-case-for-a-higher-cost-effectiveness-threshold
#18
Louis P Garrison, Tristen Jackson, Douglas Paul, Mike Kenston
While one-time gene replacement therapies may offer transformative innovation for the management of ultrarare, health-catastrophic diseases, they also pose challenges to the current U.S. health care system. Historically, the United States and other countries have demonstrated a willingness to support higher prices for health gains in rare diseases. However, payers may be ill-prepared to address reimbursement based on single administrations associated with gene therapies. As yet, there is no consensus on how to appropriately reward gene therapy innovation...
February 20, 2019: Journal of Managed Care & Specialty Pharmacy
https://read.qxmd.com/read/30784044/lymphoma-diagnostics-getting-more-from-less
#19
REVIEW
Paul J Galardy, Tibor Bedekovics, Elizabeth Macintyre, Rodney R Miles
In the modern era, clinicians and pathologists increasingly make challenging diagnoses in patients with suspected lymphoma using minimal amounts of diagnostic material. The increase in utilization of minimally invasive procedures, such as fine needle aspiration or needle core biopsies, lead to challenges in our ability to make accurate histopathological assessments of disease, including the integration of new diagnostic and prognostic testing, with smaller amounts of material. The trend towards minimally invasive diagnostics is also often in conflicting interest with researchers seeking to study tissue specimens to better understand the biology and genetics of these diseases to move the field forward...
February 19, 2019: British Journal of Haematology
https://read.qxmd.com/read/30783983/aav-vectors-for-efficient-gene-delivery-to-rodent-hearts
#20
Estrella Lopez-Gordo, Erik Kohlbrenner, Michael G Katz, Thomas Weber
Currently, gene therapy is one of the most promising fields in biomedicine, with great therapeutic potential for an array of inherited and acquired diseases. Adeno-associated viral (AAV) vectors have emerged as promising tools to deliver selectively a therapeutic payload to target organs, including the heart. In this chapter, we describe the production and quality control of recombinant AAV (rAAV) vectors of the serotype 9, the most cardiotropic AAV serotype when delivered systemically in rodents. We also describe the systemic administration of rAAV vectors and the local delivery of rAAV vectors by direct intramyocardial injection...
2019: Methods in Molecular Biology
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