David Sweet , Julian Marsden , Kendall Ho , Christina Krause , James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: British Columbia Medical Journal
Lori J Williams, Katherine Waller, Rachel P Chenoweth, Anne L Ersig
PURPOSE: The purpose of this study was to obtain feedback on communication, care coordination, and transitions in care for hospitalized children with medical complexity (CMC). DESIGN AND METHODS: This descriptive, mixed-methods study used online surveys with forced-choice and open-ended questions to obtain stakeholder feedback. Stakeholders included parents, healthcare providers, and nurses. Participants over 18 years of age were recruited from a Midwest children's hospital inpatient unit dedicated to care of CMC...
October 24, 2020: Journal for Specialists in Pediatric Nursing: JSPN
Ahmed I El-Sakka
BACKGROUND: The treatment of Peyronie's disease (PD) remains a dilemma since the true pathogenesis of PD remains an enigma. Consequently, new molecules and therapies continue to evolve. The safety and efficacy of conservative treatment for PD has not yet established. OBJECTIVES: To provide the available information of the status of conservative therapy for PD. METHODS: A systematic literatures search was conducted using PubMed, Embase, and the Cochrane Library for English-language journal articles between January 2000 and July 2019, using the terms "Conservative treatment for PD", "medical treatment for PD", "non-invasive therapies for PD" and "minimally invasive therapies for PD'...
October 24, 2020: Andrology
Nathan Balzer, Shelley McLeod, Chris Walsh, Keerat Grewal
OBJECTIVE: There has been increased interest in the use of low dose ketamine (LDK) as an alternative analgesic for the management of acute pain in the emergency department (ED). The objective of this systematic review was to compare the analgesic effectiveness and safety profile of LDK and morphine for acute pain management in the ED. METHODS: Electronic searches of Medline and EMBASE were conducted and reference lists were hand-searched. Randomized controlled trials (RCTs) comparing LDK to morphine for acute pain control in the ED were included...
October 24, 2020: Academic Emergency Medicine
Aduragbemi Banke-Thomas, Christian Chigozie Makwe, Mobolanle Balogun, Bosede Bukola Afolabi, Theresa Amaogechukwu Alex-Nwangwu, Charles Anawo Ameh
OBJECTIVE: To estimate utilization cost of spontaneous vaginal delivery (SVD) and caesarean delivery (CD) for pregnant women with Coronavirus Disease (COVID-19) at the largest teaching hospital in Lagos, the pandemic's epicenter in Nigeria. METHODS: We collected facility-based and household costs of all nine pregnant women with COVID-19 managed at the hospital. We compared their mean facility-based costs with those paid by pregnant women pre-COVID-19, identifying cost-drivers...
October 24, 2020: International Journal of Gynaecology and Obstetrics
Yin Yao, Cai-Ling Chen, Di Yu, Zheng Liu
Allergic diseases are characterized by overactive type 2 immune responses to allergens and immunoglobulin E (IgE)-mediated hypersensitivity. Emerging evidence suggests that follicular helper T (TFH ) cells, rather than type 2 T-helper (TH 2) cells, play a crucial role in controlling IgE production. However, follicular regulatory T (TFR ) cells, a specialized subset of regulatory T (TREG ) cells resident in B-cell follicles, restricts TFH cell-mediated help in extrafollicular antibody production, germinal center (GC) formation, immunoglobulin affinity maturation, and long-lived, high-affinity plasma and memory B-cell differentiation...
October 24, 2020: Allergy
Haoqi Sun, Aayushee Jain, Michael J Leone, Haitham S Alabsi, Laura N Brenner, Elissa Ye, Wendong Ge, Yu-Ping Shao, Christine L Boutros, Ruopeng Wang, Ryan A Tesh, Colin Magdamo, Sarah I Collens, Wolfgang Ganglberger, Ingrid V Bassett, James B Meigs, Jayashree Kalpathy-Cramer, Matthew D Li, Jacqueline T Chu, Michael L Dougan, Lawrence W Stratton, Jonathan Rosand, Bruce Fischl, Sudeshna Das, Shibani S Mukerji, Gregory K Robbins, M Brandon Westover
BACKGROUND: We sought to develop an automatable score to predict hospitalization, critical illness, or death for patients at risk for COVID-19 presenting for urgent care. METHODS: We developed the COVID-19 Acuity Score (CoVA) based on a single-center study of adult outpatients seen in respiratory illness clinics (RICs) or the emergency department (ED). Data was extracted from the Partners Enterprise Data Warehouse, and split into development (n = 9381, March 7-May 2) and prospective (n = 2205, May 3-14) cohorts...
October 24, 2020: Journal of Infectious Diseases
Elrazi Ali, Mohamed Badawi, Elabbass Abdelmahmuod, Samah Kohla, Mohamed A Yassin
BACKGROUND COVID-19 is a newly emerging disease that is not yet fully understood. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel virus that is easily transmitted from human to human through the respiratory route. Usually, it presents with fever, headache, fatigue accompanied by respiratory symptoms like cough and dyspnea, and other systemic involvements. Chronic lymphocytic leukemia (CLL) is a common lymphoproliferative neoplasm characterized by absolute lymphocytosis and demonstration of clonality unlike other causes of lymphocytosis...
October 24, 2020: American Journal of Case Reports
Jahanavi M Ramakrishna, Claudia R Libertin, Jason Siegel, Matthew J Binnicker, Dana Harris, Gautam V Matcha, Thomas Caulfield, W D Freeman
The COVID-19 pandemic continues to overwhelm global healthcare systems. While the disease primarily causes pulmonary complications, reports of central nervous system (CNS) involvement have recently emerged ranging from encephalopathy to stroke. This raises a practical dilemma for clinicians as to when to pursue neuroimaging and lumbar tap with cerebrospinal fluid (CSF) analysis in COVID-19 patients with neurological symptoms. We present a case of an encephalopathic patient infected with SARS-CoV-2 with no pulmonary symptoms...
October 23, 2020: Romanian Journal of Internal Medicine
Victoria Bitsadze, Jamilya Khizroeva, Ismail Elalamy, Makatsariya Alexander
Objectives Assess all risk factors of venous thromboembolism (VTE) in pregnancy and puerperium. Methods Different guidelines for VTE prevention have been analyzed. Results Various recommendations have appeared for practitioners during the last 10-15 years on the basis of the risk factors analysis in order to prevent VTE in pregnant women more effectively. Nevertheless, none of these recommendations can yet take into account all risk factors, although convenient scoring systems have emerged for risk assessment and clear recommendations on anti-thrombotic prophylaxis regimens in risk groups in recent years...
October 26, 2020: Journal of Perinatal Medicine
Jitendra Kumar, Rakesh Verma, Chandana Haldar
BPS has detrimental effects on human reproductive health and emerged as an environmental contaminant for global health concern. This study deals with the adverse impact of BPS exposure on testicular oxidative stress, inflammation and apoptosis in adult male golden hamster, Mesocricetus auratus and its amelioration by melatonin. BPS (75 mg/kg BW/day) exposure caused testicular impairment as evident by histological degenerative changes, declined sperm quality (viability and motility), serum levels of testosterone and melatonin with a concomitant decrease in testicular androgen receptor (AR) and melatonin receptor (MT1) expression...
October 24, 2020: Environmental Toxicology
Christopher Bond, Justin Morgenstern, Corey Heitz, William K Milne
Epigastric pain and dyspepsia are common presenting complaints to the emergency department and are typically treated with a variety of antacids, antihistamines, proton pump inhibitors, or anticholinergics. Prior studies have shown mixed results for acute dyspepsia management, which raises the question as to the optimal analgesic therapy. This study compares antacid monotherapy with two combinations of lidocaine with antacid in the treatment of dyspepsia.
October 24, 2020: Academic Emergency Medicine
Manoj Kumar, Rishi Kumar Jaiswal, Pramod K Yadava, Rana P Singh
Poly (ADP-ribose) polymerase (PARP) is a superfamily of 18 proteins characterized by the PARP homology domain, the catalytic domain. This catalytic domain helps in the ADP-ribosylation of various acceptor proteins using nicotinamide adenine dinucleotide (NAD+) as a donor for ADP-ribose. PARP-1 and PARP-2 carry out 80% of poly-ADP-ribosylation of cellular protein. Hence, their combined knockout results in embryonic lethality of mice. PARP-1 consists of three major domains, namely, DNA binding domain, automodification domain, and a catalytic domain...
October 24, 2020: BioFactors
Erin E Gorsich, Colleen T Webb, Andrew A Merton, Jennifer A Hoeting, Ryan S Miller, Matthew L Farnsworth, Seth R Swafford, Thomas J DeLiberto, Kerri Pedersen, Alan B Franklin, Robert G McLean, Kenneth R Wilson, Paul F Doherty
Emerging diseases of wildlife origin are increasingly spilling over into humans and domestic animals. Surveillance and risk assessments for transmission between these populations are informed by a mechanistic understanding of the pathogens in wildlife reservoirs. For avian influenza viruses (AIV), much observational and experimental work in wildlife has been conducted at local scales, yet fully understanding their spread and distribution requires assessing the mechanisms acting at both local, (e.g., intrinsic epidemic dynamics), and continental scales, (e...
October 24, 2020: Ecological Applications
José Alberto Ramírez-Valiente, Aida Solé-Medina, Tanja Pyhäjärvi, Outi Savolainen, Sandra Cervantes, Robert Kesälahti, Sonja T Kujala, Timo Kumpula, Katrin Heer, Lars Opgenoorth, Jan Siebertz, Darius Danusevicius, Eduardo Notivol, Raquel Benavides, Juan José Robledo-Arnuncio
Understanding the dynamics of selection is key to predict the response of tree species to new environmental conditions in the current context of climate change. However, selection patterns acting on early recruitment stages and its climatic drivers remain largely unknown in most tree species, despite being a critical period of their life cycle. We measured phenotypic selection on Pinus sylvestris seed mass, emergence time and early growth rate over two years in four common garden experiments established along the latitudinal gradient of the species in Europe...
October 24, 2020: New Phytologist
Geurts Jan Ap, Vugt Tom Ag, Arts Jacobus Jc
Chronic osteomyelitis has always been a therapeutic challenge for patient and surgeon due to the specific problems related with bone infection and bacterial biofilm eradication. Other than being the cause of infection or facilitating spread or persistence of infection, biomaterials are also becoming a tool in the treatment of infection. Certain novel biomaterials have unique and ideal properties that render them perfectly suited to combat infection and are therefore used more and more in the treatment of chronic bone infections...
October 24, 2020: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Christina Scharmer, Kimberly Martinez, Sasha Gorrell, Erin E Reilly, Joseph M Donahue, Drew A Anderson
OBJECTIVE: COVID-19 has led to disruptions in daily living and increased uncertainty about physical, financial, social, and psychological consequences, which may contribute to anxiety, eating disorder (ED) pathology, and compulsive exercise. Individual factors, such as intolerance of uncertainty, may impact risk for ED pathology and CE in response to COVID-19 anxiety. The current study examined associations between COVID-19 anxiety, trait intolerance of uncertainty, and COVID-19 intolerance of uncertainty and ED pathology and compulsive exercise...
October 24, 2020: International Journal of Eating Disorders
Silvia Bloise, Vanessa Martucci, Alessia Marcellino, Saverio Mallardo, Riccardo Lubrano
No abstract text is available yet for this article.
October 24, 2020: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Cindy Cy Law, Conor Bell, Deborah Koh, Yueyang Bao, Vipul Jairath, Neeraj Narula
BACKGROUND: Medications used to treat inflammatory bowel disease (IBD) have significantly improved patient outcomes and delayed time to surgery. However, some of these therapies are recognized to increase the general risk of infection and have an unclear impact on postoperative infection risk. OBJECTIVES: To assess the impact of perioperative IBD medications on the risk of postoperative infections within 30 days of surgery. SEARCH METHODS: We searched the Cochrane IBD Group's Specialized Register (29 October 2019), MEDLINE (January 1966 to October 2019), Embase (January 1985 to October 2019), the Cochrane Library, ClinicalTrials...
October 24, 2020: Cochrane Database of Systematic Reviews
Daniela Di Martino, Francesca Chiaffarino, Luisa Patanè, Federico Prefumo, Patrizia Vergani, Sara Ornaghi, Valeria Savasi, Arsenio Spinillo, Antonella Cromi, Francesco D'Ambrosi, Beatrice Tassis, Enrico Iurlaro, Fabio Parazzini, Enrico Ferrazzi
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global health emergency [1, 2], with Lombardy being the epicenter of this outbreak in Italy [3].
October 24, 2020: International Journal of Gynaecology and Obstetrics
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