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“Patient safety”

J N Ma, Y Wang, Y Song, T Shao, Y Cai
Objective: To investigate the influence of corneal biomechanical properties on opaque bubble layer (OBL) in small incision lenticule extraction (SMILE). Methods: In this nested case control study, 20 patients (31 eyes) were enrolled in OBL group, while 51 patients (98 eyes) were included in non-OBL group. The parameters were obtained by Pentacam HR and Corvis ST examinations. Independent t test was used to analyze the difference of corneal biomechanical parameters between the two groups and multivariable logistics regression was applied to analysis the influence of corneal biomechanical properties on OBL...
February 11, 2019: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
L Yang, S S Diao, Y P Ding, S J Huang, T Sun, Y Lu, Q Fang, X Y Cai, Y Kong, Z Xu
Objective: To assess outcome, safety and possible mechanism of loading dose clopidogrel in patients with transient ischemic attack (TIA) and minor stroke. Methods: We reviewed patients with confirmed TIA and minor stroke admitted between July 2016 and December 2017 into the First Affiliated Hospital of Soochow University. Loss-of-function allele carriers of CYP2C19 were included and randomly divided into loading dose group (first dose of 300 mg clopidogrel) and standard dose group (first dose of 75 mg clopidogrel), 100 mg aspirin was gave at the same time, followed by aspirin 100 mg/d plus clopidogrel 75 mg/d maintaining for 20 days...
January 29, 2019: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Waseem A Abboud, Sahar Nadel, Sharon Hassin-Baer, Abigail Arad, Alex Dobriyan, Ran Yahalom
BACKGROUND: Drooling is the unintentional loss of saliva from the mouth, usually caused by poor coordination of the swallowing mechanism. It is commonly seen in patients with chronic neurologic disorders, such as Parkinson's disease, amyotrophic lateral sclerosis (ALS), cerebral palsy, and stroke, as well as in patients with cognitive impairment and dementia. OBJECTIVES: To evaluate the efficacy and safety of ultrasound-guided botulinum toxin injections into the parotid and submandibular salivary glands for the treatment of drooling...
February 2019: Israel Medical Association Journal: IMAJ
Subashnie Devkaran, Patrick N O'Farrell, Samer Ellahham, Randy Arcangel
OBJECTIVE: To evaluate whether hospital re-accreditation improves quality, patient safety and reliability over three accreditation cycles by testing the accreditation life cycle model on quality measures. DESIGN: The validity of the life cycle model was tested by calibrating interrupted time series (ITS) regression equations for 27 quality measures. The change in the variation of quality over the three accreditation cycles was evaluated using the Levene's test. SETTING: A 650-bed tertiary academic hospital in Abu Dhabi, UAE...
February 15, 2019: BMJ Open
Martin Geoffrey Thomas, Carrie Bayliss, Simon Bond, Francis Dowling, James Galea, Vipul Jairath, Christopher Lamb, Christopher Probert, Elizabeth Timperley-Preece, Alastair Watson, Lynne Whitehead, John G Williams, Miles Parkes, Arthur Kaser, Tim Raine
INTRODUCTION: Acute severe ulcerative colitis (ASUC) is a severe manifestation of ulcerative colitis (UC) that warrants hospitalisation. Despite significant advances in therapeutic options for UC and in the medical management of steroid-refractory ASUC, the initial treatment paradigm has not changed since 1955 and is based on the use of intravenous corticosteroids. This treatment is successful in approximately 50% of patients but failure of this and subsequent medical therapy still occurs, with colectomy rates of up to 40% reported...
February 15, 2019: BMJ Open
Charlotte Alexandra Woodhouse, Vishal C Patel, Simon Goldenberg, Alberto Sanchez-Fueyo, Louise China, Alastair O'Brien, Clare Flach, Abdel Douiri, Debbie Shawcross
INTRODUCTION: Patients with advanced cirrhosis have enteric bacterial dysbiosis and translocation of bacteria and their products across the gut epithelial barrier. This culminates in systemic inflammation and endotoxaemia, inducing innate immune dysfunction which predisposes to infection, and development of complications such as bleeding, sepsis and hepatic encephalopathy. This feasibility study aims to assess the safety of administering faecal microbiota transplantion to patients with cirrhosis and explore the effect of the intervention on their prognosis by achieving restoration of a healthy gut microbiome...
February 15, 2019: BMJ Open
Janine Ghielen, Sezgin Cihangir, Karin Hekkert, Ine Borghans, Rudolf Bertijn Kool
OBJECTIVES: The indicator unexpectedly long length of stay (UL-LOS) is used to gain insight into quality and safety of care in hospitals. The calculation of UL-LOS takes patients' age, main diagnosis and main procedure into account. University hospitals have relatively more patients with a UL-LOS than other hospitals. Our main research question is whether the high number of patients with a UL-LOS in university hospitals is caused by differences in additional patient characteristics between university hospitals and other hospitals...
February 15, 2019: BMJ Open
Kousalya Prabahar, Teja Katikam, Saranya Punniyakotti, Praveen Devanandan
To evaluate the anti-hypertensive drugs used in pregnancy induced hypertension and to determine the safety of the anti-hypertensive drugs administered in gestational hypertensive patients. Pregnancy induced hypertension are very common in women and if unnoticed may lead to severe complications. The appropriate therapy is very much essential for the welfare of both the mother and the child. Hence this study was undertaken to identify the commonly used and safe drugs in pregnancy induced hypertension. This retrospective study was carried out in the Medical Records Department of a specialized gynecological hospital...
January 2019: Pakistan Journal of Pharmaceutical Sciences
Jian Wu, Ming Lv, Yixin Zhou
This meta-analysis aimed to confirm the efficacy and safety (side effect) of curcumin for osteoarthritis (OA). Two researchers independently searched the database of Pub Med, EMBASE and Cochrane Library updated to November 2015 to find randomized controlled trials that reported the effect of curcumin on OA. The outcomes of this meta-analysis were Visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index scale (WOMAC) and side effect. Furthermore, the quality assessment was performed with Cochrane Collaboration's tool...
January 2019: Pakistan Journal of Pharmaceutical Sciences
Christian W Keller, Isaak Quast, Marinos C Dalakas, Jan D Lünemann
Patients with acute and chronic inflammatory demyelinating neuropathies exhibit elevated serum and cerebrospinal fluid (CSF) levels of terminal complement activation products and therapeutic inhibition of complement activation is currently tested for its safety and efficacy in patients with Guillain-Barré syndrome (GBS). Here, we determined serum levels of the complement activation products C3a, C5a and the soluble terminal complement complex (sTCC) in 39 individuals with chronic inflammatory demyelinating polyneuropathy (CIDP) who participated in one of the largest ever conducted clinical trial in patients with CIDP (ICE trial) and received Intravenous Immunoglobulin (IVIG) or placebo (albumin) in 3 week intervals for up to 24 weeks...
February 10, 2019: Journal of Neuroimmunology
Kei Hosoda, Hiroaki Mieno, Akira Ema, Hideki Ushiku, Marie Washio, Ildae Song, Masahiko Watanabe, Keishi Yamashita
BACKGROUND: Conventional laparoscopic and open distal gastrectomy procedures have inherent limitations such as restricted movement of straight forceps and tremor of the tip of the devices that can potentially be overcome using robotic distal gastrectomy (RDG). This single-institutional phase II trial aimed to evaluate the safety and feasibility of RDG with lymph node dissection for clinical stage IA gastric cancer. METHODS: The study included patients with clinical stage IA gastric cancer in the lower two-thirds of the stomach considered to be curatively resected via distal gastrectomy...
February 14, 2019: Journal of Surgical Research
Christopher F Janowak, Suresh K Agarwal, Ben L Zarzaur
BACKGROUND: We previously demonstrated that unidentified aliased patients, John Doe's (DOEs), are one of the highest risk and most medically fragile populations of injured patients. Aliasing can result in misplaced information and confusion that must be overcome by health care professionals. DOE alias use is institutionally dependent and not uniform, which may lead to significant variation in perception of confusion and error. We sought to determine if health care practitioners experience confusion that may result in compromised care when caring for injured DOE patients...
February 14, 2019: Journal of Surgical Research
I G Papanikolaou, D Haidopoulos, M Paschopoulos, I Chatzipapas, D Loutradis, N F Vlahos
The traditional method of acquiring surgical skills by observing and assisting in surgical procedures involving human beings has been challenged during the past several years. Lessons obtained from aviation suggested that the use of simulators is related to reduced costs, increased efficiency in performing certain tasks and above all safety. A shift in paradigm is also required in modern surgical training. The development of endoscopic surgery allowed for the incorporation of medical simulators into training programmes...
January 22, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Gregory M T Guilcher, Dania A Monagel, Alberto Nettel-Aguirre, Tony H Truong, Sunil J Desai, Aisha Bruce, Ravi M Shah, Michael T Leaker, Victor A Lewis
Sickle cell disease (SCD) is a potentially debilitating hemoglobinopathy associated with early mortality. The only established curative therapy is hematopoietic cell transplantation (HCT)with a matched sibling donor (MSD). The National Institutes of Health (NIH) nonmyeloablative regimen of alemtuzumab/300 cGy total body irradiation and prolonged sirolimus exposure for graft-versus-host disease (GVHD) prophylaxis was administered to 16 children and adolescents. Infused products were unmanipulated G-CSF mobilized peripheral blood stem cells...
February 14, 2019: Biology of Blood and Marrow Transplantation
Timothy Craig, Bruce Zuraw, Hilary Longhurst, Marco Cicardi, Konrad Bork, Clive Grattan, Constance Katelaris, Gordon Sussman, Paul K Keith, William Yang, Jacques Hébert, Jana Hanzlikova, Petra Staubach-Renz, Inmaculada Martinez-Saguer, Markus Magerl, Emel Aygören-Pürsün, Henriette Farkas, Avner Reshef, Shmuel Kivity, Sergio Neri, Ioana Crisan, Teresa Caballero, Maria L Baeza, Maria Dolores Hernandez, Henry Li, William Lumry, Jonathan A Bernstein, Iftikar Hussain, John Anderson, Lawrence B Schwartz, Joshua Jacobs, Michael Manning, Donald Levy, Marc Riedl, Sandra Christiansen, Henrike Feuersenger, Ingo Pragst, Sarah Mycroft, Dipti Pawaskar, Iris Jacobs
BACKGROUND: For the prevention of attacks of hereditary angioedema (HAE), the efficacy and safety of subcutaneous human C1-esterase inhibitor (C1-INH[SC]; HAEGARDA® , CSL Behring) was established in the 16-week COMPACT trial. OBJECTIVE: To assess the long-term safety, occurrence of angioedema attacks, and use of rescue medication with C1-INH(SC). METHODS: Open-label, randomised, parallel-arm extension of COMPACT across 11 countries. Patients with frequent angioedema attacks, either study treatment-naïve or who had completed the COMPACT trial, were randomly assigned (1:1) to 40 IU/kg or 60 IU/kg C1-INH(SC) twice per week, with conditional up-titration to optimise prophylaxis...
February 14, 2019: Journal of Allergy and Clinical Immunology in Practice
Fabrizio Sallustio, Caterina Motta, Stefano Merolla, Giacomo Koch, Francesco Mori, Fana Alemseged, Daniele Morosetti, Valerio Ros Da, Roberto Gandini, Marina Diomedi
BACKGROUND AND PURPOSE: the effect of intravenous heparin during mechanical thrombectomy for acute ischemic stroke is not clear. We aimed to study efficacy and safety of heparin use during endovascular stroke treatment in a real-world setting. MATERIALS AND METHODS: patients with anterior circulation stroke were divided, based on the use of intraprocedural heparin, in those treated and those untreated. Main outcomes were successful reperfusion defined as a TICI score ≥ 2b, 3-month functional independence defined as a modified Rankin Scale ≤ 2, symptomatic intracranial hemorrhage (sICH) and mortality...
February 14, 2019: Journal of Neuroradiology. Journal de Neuroradiologie
Jorge L Alió, Jorge L Alió Del Barrio, Mona El Zarif, Albert Azaar, Nehman Makdissy, Charbel Khalil, Walid Harb, Ibrahim El Achkar, Ziad Abdul Jawad, María P de Miguel
PURPOSE: To evaluate the one-year safety and efficacy of the cellular therapy of the corneal stroma by implanting autologous adipose derived adult stem cells (ADASc) with or without sheets of decellularized donor human corneal stroma within the stroma of patients with advanced keratoconus. METHODS: Prospective interventional non-randomized series of cases. Fourteen consecutive patients were selected and distributed into 3 experimental groups: A) Implantation of autologous ADASc alone (3x 106 /1mL ) (n:5); B) Decellularized donor 120 μm thick corneal stroma lamina alone (n:5); C) Recellularized donor lamina with 1x106 autologous ADASc+ another 1x106 /1mL cells at the time of the surgery (n:4)...
February 14, 2019: American Journal of Ophthalmology
Pavel Overtchouk, Thierry Folliguet, Frédéric Pinaud, Oliver Fouquet, Mathieu Pernot, Guillaume Bonnet, Maxime Hubert, Joël Lapeze, Jean Philippe Claudel, Said Ghostine, Alexandre Azmoun, Christophe Caussin, Konstantinos Zannis, Majid Harmouche, Jean-Philippe Verhoye, Antoine Lafont, Chekrallah Chamandi, Vito Giovanni Ruggieri, Alessandro Di Cesare, Florence Leclercq, Thomas Gandet, Thomas Modine
OBJECTIVES: This study sought to describe the procedural and clinical outcomes of patients undergoing transcarotid (TC) transcatheter aortic valve replacement (TAVR) with the Edwards Sapien 3 device. BACKGROUND: The TC approach for TAVR holds the potential to become the optimal alternative to the transfemoral gold standard. Limited data exist regarding safety and efficacy of TC-TAVR using the Edwards Sapien 3 device. METHODS: The French Transcarotid TAVR prospective multicenter registry included patients between 2014 and 2018...
February 7, 2019: JACC. Cardiovascular Interventions
Vishal Gupta, Saket Kumar, Vivek Gupta, Pradeep Joshi, Rahul Rahul, Rakesh Kumar Yadav, Amit Dangi, Abhijit Chandra
BACKGROUND: Blumgart's pancreaticojejunostomy (PJ) has been described with low pancreatic leak rates. This study aimed to evaluate our experience with this technique regarding the pancreatic leak and other perioperative outcomes. METHODS: We performed a single-center retrospective analysis of a cohort of 81 patients who underwent pancreaticoduodenectomy in our department from January 2011 to February 2018. The primary endpoint was the occurrence of a clinically relevant postoperative pancreatic fistula (CR-POPF) and analysis of its risk factors...
January 31, 2019: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Kristen A Lee, Andrew Taylor, Brittany Bartolome, Nicholas Fidelman, K Pallav Kolli, Maureen Kohi, Ryan Kohlbrenner, Jeanne Laberge, Evan Lehrman, Robert Kerlan
PURPOSE: To evaluate efficacy and safety of transjugular liver biopsy (TJLB) via the left hepatic vein in patients with left lobe-only liver transplants (LLOTs). MATERIALS AND METHODS: Retrospective review revealed 43 TJLBs performed in 26 patients with LLOTs (mean age 51.3 y; range, 18-73 y) between January 2009 and June 2016 at a single institution. A comparison group of 44 randomly selected TJLBs performed in 37 orthotopic whole liver transplant (OWLT) recipients (mean age 57...
February 13, 2019: Journal of Vascular and Interventional Radiology: JVIR
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