Τρίτη, 23 Αυγούστου 2016

ESO Solutions names Jennifer Mabe Chief Financial Officer

AUSTIN, Texas – ESO Solutions, Inc., a leading provider of healthcare software and interoperability solutions, announced today the hiring of Jennifer Mabe, CPA, CGMA, as Chief Financial Officer (CFO). "It's an exciting time at ESO. We're growing fast and focused on scaling to meet our customers' needs," said Chris Dillie, President and CEO of ESO. "As we scale, it is ...

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Pediatric IOs: 5 things I didn’t learn in paramedic school

Pediatric IO insertion can be stressful, but it's a critical tool to have if you can't get IV access.

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In vivo bone strain in the mandibular corpus of Sapajus during a range of oral food processing behaviors

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Publication date: Available online 23 August 2016
Source:Journal of Human Evolution
Author(s): Callum F. Ross, Jose Iriarte-Diaz, David A. Reed, Thomas A. Stewart, Andrea B. Taylor
It has been hypothesized that mandibular corpus morphology of primates is related to the material properties of the foods that they chew. However, chewing foods with different material properties is accompanied by low levels of variation in mandibular strain patterns in macaques. We hypothesized that if variation in primate mandible form reflects adaptations to feeding on foods with different material and geometric properties, then this variation will be driven primarily by differences in oral food processing behavior rather than differences in chewing per se. To test this hypothesis, we recorded in vivo bone strain data from the lateral and medial surfaces of the mandibular corpus during complete feeding sequences in three adult male Sapajus as they fed on foods with a range of sizes and material properties. We assessed whether variation in mandibular corpus strain regimes is associated with variation in feeding behaviors and/or chewing on different foods, and we quantified the relative variation in mandibular corpus strain regimes associated with chewing on foods of different material properties versus a range of oral food processing behaviors (incisor, premolar, and molar biting; pulling on incisors; mastication). Feeding behavior had a significant effect on mandibular corpus strain regimes, as did chewing side and the cycle number in a feeding sequence. However, food type had weaker effects and usually only through interaction effects with chewing side and/or cycle type. Strain regimes varied most across different chew sides, then across different behaviors, and lastly between mastication cycles on different foods. Strain magnitudes associated with premolar, molar, and incisor biting were larger than those recorded during mastication. These data suggest that intra- and inter-specific variation in mandible morphology is a trade-off between performance requirements of different oral food processing behaviors and of variation in chewing side, with direct effects of food type being less important.



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A comparative study on intraoperative mitomycin-c augmented external dacryocystorhinostomy with conventional dacryocystorhinostomy

2016-08-23T08-14-23Z
Source: International Journal of Research in Medical Sciences
Bharoti Sarmah Puzari, Pramod Kumar H. N..
Background: Dacryocystorhinostomy (DCR) is a commonly done surgery performed for management of epiphora due to nasolacrimal duct obstruction. Goal of the procedure is to bypass the obstructed nasolacrimal duct allowing tear drainage into the nasal cavity directly from lacrimal sac by creating an anastomosis between the lacrimal sac and the nasal mucosa via a bony ostium. Common cause of DCR failure are attributed as an end effect of fibrous tissue growth, scarring and granulation tissue formation which obstructs the new drainage channel. Mitomycin c is an antiproliferative agent and may enhance the result of DCR by inhibiting fibrous tissue proliferation. Here we aim to evaluate the results of intraoperative mitomycin C application in dacryocystorhinostomy surgery compared with the result of conventional DCR. Methods: A prospective randomized comparative study of one year duration was done in the Department of Ophthalmology, Assam Medical College and Hospital, Dibrugarh, Assam, India. A total of 60 patients of acquired nasolacrimal duct obstruction were enrolled and divided randomly into two groups, 30 nos of patients in each group. One group had undergone conventional external DCR operation and other group was treated with DCR surgery with intraoperative mitomycin C application at the anastomotic flap and osteotomy site. Patients were reviewed after 1week, 1month, 3month and 6months postoperatively. The results of DCR surgeries were evaluated by observation of different parameters such as height of tear meniscus and patency of the nasolacrimal passage. Results: In our study we have observed that majority of cases were in 21-30 years age group with female preponderance (male vs female; 35% vs 75%). Chronic dacryocystitis was seen in majority of cases (70%) followed by mucocele (26.67%) and lacrimal fistula (3.33%). Major difficulties encountered during surgery and postoperatively were almost identical in both the groups. There was no case of abnormal mucosal bleeding, mucosal necrosis, delayed wound healing in patients which underwent DCR with mitomycin C use. Post-operative care and follow up were done identically in both the groups. It was seen that a total success rate of 80% was achieved in conventional group where as 96.67% success was achieved in MMC group at the end of 6 months. In case of scar prone conditions like lacrimal fistula mitomycin C use has shown to be efficacious in maintaining patency of the system after surgery. Conclusions: Distinctly higher success rate have been achieved in patients undergoing DCR with intra-operative MMC as compared to patients undergoing conventional DCR. Use of intraoperative mitomycin C can be considered safe and simple but very effective modification of conventional external DCR.


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A study of birth preparedness of women in Jamnagar district

2016-08-23T07-53-46Z
Source: International Journal of Community Medicine and Public Health
Khyati A. Nimavat, Abha D. Mangal, Sumit V. Unadkat, Sudha B. Yadav.
Background: About 800 women die every day from preventable causes related to pregnancy and child birth globally. Birth-preparedness is a strategy developed by the maternal and neonatal health programme of JHPIEGO for addressing the three main delays at various stakeholder levels. Present study is an attempt to assess the level of birth preparedness of pregnant women in rural area of Jamnagar district and various factors associated with it. Methods: It was a cross-sectional study conducted during October 2011 to March 2012. Total live births in a year 2011 were 39943.90 and Taking 1% of total births ≈ 400, Adding 10% of non-response rate, total sample size was 440. Total 450 study subjects were chosen. The study-subjects were divided in 1) current pregnant women and 2) recent delivered women. A pretested semi-structured questionnaire was used to interview women, chosen for the study using multistage random sampling technique and data was analysed by Epi Info. Results: It was found that only about one third of women i.e. 32.2% were prepared for birth and 67.8% women were not prepared. Out of 450 women, it was found that 86.2% of them planned for the skilled birth attendant, 59.6% women planned for saving money, about one third of women i.e. 37.6% had planned for transportation and only 2.7% women had planned for blood donor in case of emergency. Religion Hindu, literacy of women and their husbands, higher socio-economic status, advice given during pregnancy were some positive factors associated with birth preparedness. Conclusions: The level of birth preparedness in study subjects was found very low. Sincere efforts are required to identify this gap and reducing the same.


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Knowledge and practice of universal precautions among nursing staff at a tertiary care hospital in South Gujarat, India

2016-08-23T07-53-46Z
Source: International Journal of Community Medicine and Public Health
Priti Solanky, Hinal Baria, Alka Nerulkar, Nilesh Chavda.
Background: Health care providers are at an increased risk of exposure to various infections like HIV, Hepatitis B, Hepatitis C etc. These infections are prevented if proper universal precautions are observed by health care providers consistently in their day to day clinical work. In study we have explored knowledge and practice of universal precautions among nursing staff. Methods: A cross sectional study carried out among staff nurses in December 2013. Self-administered semi structured proforma was used for data collection. Information regarding knowledge and practice of universal precautions was collected. Results: Out of 88 participants interviewed, almost all of them reported of having awareness about universal precautions and personal protective equipments. Only 44.3% nurses mentioned all the correct measures for universal precautions. 89.77% nurses were aware about health hazards of needle stick injury but only 67.05% correctly reported about how needle stick injury can be prevented. 38.64% nurses had experienced needle stick injury while working and most of them (79.41%) followed proper guidelines. Conclusions: correct knowledge regarding universal precautions among nursing staff is still not of satisfactory level and training at repeated interval needs to be given to ensure correct knowledge as well as implementation of universal precautions.


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The effect of different bleaching materials on the solubility of enamel

2016-08-23T07-15-36Z
Source: Medicine Science | International Medical Journal
Hatice Akinci Cansunar, Yegane Guven, Ferda Dogan.
In this research, the effect of three bleaching materials, 20% carbamide peroxide, 35% carbamide peroxide and 38% hydrogen peroxide on the solubility of enamel is examined. For this study, 30 premolar teeth extracted for orthodontic purpose were used. They were divided into three groups 10 teeth in each Crowns of the teeth were divided into 2 pieces longitudinally. One part of the tooth crown was used as control and the other part was used as experimental group. 20 percent carbamide peroxide was applied at 370 C during 6 hours for 8 days to the first test group (at-home bleaching), 35 percent carbamide peroxide was applied at 37 0C for 30 minutes for 8 days to the second test group (at-home bleaching) and 38 percent hydrogen peroxide was used 4 times for 15 minutes making a total 60 minutes on the remaining ten specimen (in-office bleaching). The solubility of the enamel was calculated by the determination of inorganic phosphorus using a spectrophotometer. Comparative analysis of the depths in the groups was carried out and its relation with mineral loss was evaluated. Paired t-test was used to compare the differences between the groups. A statistically significant difference was found between the control and the study groups for the 38% hydrogen peroxide. There was no statistically significant difference between the control and experimental groups in the other two groups. It is concluded that of these three bleaching materials, 38% hydrogen peroxide has the greatest effect on mineral loss from the enamel.


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Profiling of 6 mini STR loci (D1S1677,D2S441,D4S2364, D10S1248, D14S1434, D22S1045) on blood spots waited on various surfaces [Çeşitli yüzeyler üzerindeki kan lekelerinde 6 mini str lokusunun (D1S1677, D2S441, D4S2364, D10S1248, D14S1434, D22S1045) profillendirilmesi]

2016-08-23T05-17-30Z
Source: Medicine Science | International Medical Journal
Tugba Unsal, Gonul Filoglu, Havva Altuncul, Kadir Dastan, Ozlem Bulbul.
Conventional STR loci are insufficient for successful analysis of DNA specimens from mass disasters or forensic evidence. In order to solve this problem, The National Institute of Standards and Technology (NIST) developed 26 new STR loci. The PCR products of these loci are less than 150 bp in size. Especially the PCR products of 6 loci (D1S1677,D2S441,D4S2364,D10S1248,D14S1434,D22S1045) are less than 125 bp in size. In this study, blood was dripped on various surfaces that may be found in crime scenes (jean, t-shirt, couch upholstery, towel, knife hilt, laminate parquet, door lock iron and grouting between tiles) and they were kept waiting for 1 week, 1 month, 3 months and 6 months. For the mentioned loci, the PCR conditions previously determined in the optimization and validation process were applied. At the end of this study, it was determined that the minimum DNA quantity of 6 mini SRT loci can be 0.1 ng/μl for identification of blood spots.


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Examining the Prevalence Rates of Preexisting Maternal Medical Conditions and Pregnancy Complications by Source: Evidence to Inform Maternal and Child Research

Abstract

Objectives We sought to examine whether there are systematic differences in ascertainment of preexisting maternal medical conditions and pregnancy complications from three common data sources used in epidemiologic research. Methods Diabetes mellitus, chronic hypertension, gestational diabetes mellitus (GDM), gestational hypertensive disorders (GHD), placental abruption and premature rupture of membranes (PROM) among 4821 pregnancies were identified via birth certificates, maternal self-report at approximately 4 months postpartum and by discharge codes from the Statewide Planning and Research Cooperative System (SPARCS), a mandatory New York State hospital reporting system. The kappa statistic (k) was estimated to ascertain beyond chance agreement of outcomes between birth certificates with either maternal self-report or SPARCS. Results GHD was under-ascertained on birth certificates (5.7 %) and more frequently indicated by maternal report (11 %) and discharge data (8.2 %). PROM was indicated more on birth certificates (7.4 %) than maternal report (4.5 %) or discharge data (5.7 %). Confirmation across data sources for some outcomes varied by maternal age, race/ethnicity, prenatal care utilization, preterm delivery, parity, mode of delivery, infant sex, use of infertility treatment and for multiple births. Agreement between maternal report and discharge data with birth certificates was generally poor (kappa < 0.4) to moderate (0.4 ≤ kappa < 0.75) but was excellent between discharge data and birth certificates for GDM among women who underwent infertility treatment (kappa = 0.79, 95 % CI 0.74, 0.85). Conclusions for Practice Prevalence and agreement of conditions varied across sources. Condition-specific variations in reporting should be considered when designing studies that investigate associations between preexisting maternal medical and pregnancy-related conditions with health outcomes over the life-course.



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Quality Control of a Laser Additive Manufactured Medical Implant by X-Ray Tomography

3D Printing and Additive Manufacturing , Vol. 0, No. 0.


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Advanced Manufactured Fused Filament Fabrication 3D Printed Osseointegrated Prosthesis for a Transhumeral Amputation Using Taulman 680 FDA

3D Printing and Additive Manufacturing , Vol. 0, No. 0.


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Somatic AKT1 mutations cause meningiomas colocalizing with a characteristic pattern of cranial hyperostosis

Somatic genetic mutations in meningiomas are associated with histologic subtypes, anatomical location, and grade. Concomitant hyperostosis occurs with some meningiomas and the pathogenesis is not well understood. Cranial hyperostosis and meningiomas are common in patients with Proteus syndrome, which is caused by a somatic activating mutation in AKT1 c.49G>A. This same mutation has also been found in 6–9% of sporadic non-syndromic meningiomas. Sixty-one patients with Proteus syndrome meeting clinical diagnostic criteria were evaluated at the NIH from 1997 to 2014. Of these 61, 52 had a somatic activating mutation (c.49G>A, p.Glu17Lys) in AKT1 confirmed from affected tissue samples. Photographs, physical examination and/or autopsy, X-rays, CT, and/or MRI scan of the head were reviewed in 29/52 patients. Of the 29 patients, the most common intracranial tumor was meningioma, all co-localizing with cranial hyperostosis, and diagnosed at younger ages than typical for isolated, non-syndromic meningiomas. These patients had progressive cranial overgrowth that consisted primarily of diploic space expansion, and was characterized by unilateral, parasagittal, and frontal bone involvement. We hypothesize that sporadic meningothelial and transitional subtype meningiomas are a forme fruste or microform of Proteus syndrome, and activation of the AKT/PI3K pathway drives hyperostosis in both non-syndromic, and Proteus-related meningiomas. © 2016 The Authors. American Journal of Medical Genetics Part A Published by Wiley Periodicals, Inc.



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Concomitant 11p15.4-p15.5 duplication and terminal 22q13.33 deletion in a patient with features of Beckwith–Wiedemann syndrome



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Diagnostic conundrums in antenatal presentation of a skeletal dysplasia with description of a heterozygous C-propeptide mutation in COL1A1 associated with a severe presentation of osteogenesis imperfecta

Prompt and accurate diagnosis of skeletal dysplasias can play a crucial role in ensuring appropriate counseling and management (both antenatal and postnatal). When a skeletal dysplasia is detected during the antenatal period, especially early in the pregnancy, it can be associated with a poor prognosis. It is important to make a diagnosis in antenatal presentation of skeletal dysplasias to inform diagnosis, predict prognosis, provide accurate recurrence risks, and options for prenatal genetic testing in future pregnancies. Prenatal ultrasound scanning is a useful tool to detect several skeletal dysplasias and sonographic measurements serve as reliable indicators of lethality. The lethality depends on various factors including gestational age at which features are identified, size of the chest and progression of malformations. Although, it is important to type the skeletal presentation as accurately as possible, this is not always possible in an antenatal presentation and it is important to acknowledge this uncertainty. In the case of a live birth, it is always important to reassess the infant. Osteogenesis imperfecta (OI) is a heterogeneous group of disorders characterized by fragile bones. Here, we report an infant with severe OI born following a twin pregnancy in whom the bone disease is caused by a heterozygous pathogenic mutation, c.4160C >T, p.(Ala1387Val) located in the C-propeptide region of COL1A1. An assumption of lethality antenatally complicated his management in early life. We discuss this patient with particular emphasis on the neonatal presentation of a severe skeletal dysplasia and the lessons that may be learned in such situations. © 2016 Wiley Periodicals, Inc.



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Braddock–Carey syndrome: A 21q22 contiguous gene syndrome encompassing RUNX1

In 1994, Braddock and Carey first reported two unrelated girls with a new multiple malformation syndrome. The primary features included Pierre Robin sequence, persistent neonatal-onset thrombocytopenia, agenesis of the corpus callosum, a distinctive facies, enamel hypoplasia, and severe developmental delay. Since that time, there have been multiple other reported patients with a similar phenotype. In addition, several reports of thrombocytopenia and developmental delay have been documented in association with deletions in the Down syndrome critical region at 21q22. The similarity of the reported cases with deletions involving 21q22 with the clinical presentation of the two patients with Braddock–Carey syndrome resulted in a reinvestigation of the genetic etiology of these two patients 20 years after the original study. This investigation provides evidence that the etiology of this and other "Fanconi-like" disorders represent a newly recognized contiguous gene deletion syndrome involving 21q22 and specifically, the RUNX1 gene. © 2016 Wiley Periodicals, Inc.



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Top 100 Cited Articles in Recent Tobacco Research

2016-08-23T03-10-12Z
Source: Journal of Behavioral Health
E. Melinda Mahabee-Gittens, Judith S. Gordon, Katie F. Melink, Ashley L. Merianos.
Background: The total citations that a peer-reviewed manuscript has is often used to measure the impact that a publication has in its respective field of study. Both the citation count and total number of publications are often used as measures of academic productivity and success. This issue has been previously investigated in the field of tobacco control research. Given the changing landscape in the field of tobacco research since 2004, we sought to re-examine this issue. The study purpose was to identify the 100 top-cited tobacco-related articles published since 2005, and to categorize and describe the fields of study represented in these articles. Methods: We searched the Scopus library database to determine the citations of the top 100 tobacco-related articles. Information was gathered on: title, number of authors, publication year, journal name and impact factor, country of origin, article type and subject category. Articles were selected and analyzed by two independent investigators. Results: We identified the 100 top-cited articles published in 58 journals, led by The New England Journal of Medicine (8) and Lancet (6), between 2005 and 2014. The United States was the most common country of origin for the highly-cited articles. The top article types were observation (27%), basic science (26%), and review articles (24%). The most common article subject area was medicine (74%). A statistically significant association was found between the journal impact factor and the number of top 100 cited articles (p = 0.03). Conclusions: This review may be helpful to identify articles that may be contributing to the conduct of current and future tobacco research. The analysis can be used as a reference to review and evaluate the publications that are making a high impact in the field of tobacco research.


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Socio-Economic Covariates of Micronutrients Supplementation and Deworming among Children in Ghana

2016-08-23T03-10-12Z
Source: Journal of Behavioral Health
Mustapha Immurana, Arabi U..
Objective: To investigate the Socio-Economic covariates of Vitamin A and Iron Supplementation as well as deworming among children in Ghana. Methods: The 2014 Ghana Demographic and Health Survey (GDHS) which was a cross-sectional survey carried out from early September to Mid-December, 2014 was the source of data for the study whiles the binary probit regression model was the empirical model of estimation. Results: The study among other findings revealed that Children from the Greater Accra, Northern and Western regions were less likely to have received Vitamin A supplements (VAS). Employed mothers were also revealed to be more likely to utilise VAS and dewormer for their children relative to unemployed mothers. Also mothers with secondary education, primary education and educated mothers respectively were more likely to utilise VAS, Iron supplements and Dewormer for their children relative to the uneducated mothers. Further, mothers with health insurance were more probable to utilise VAS for their children relative to uninsured mothers. Also children from the Guan, Ewe, Mole-Dagbani, Gurma and Grusi ethnic backgrounds were found to be less likely to have received iron supplements. Conclusion: Given the above, the study concludes that women empowerment through education and employment, maternal health insurance, regional and ethnic Behaviour Change Communication (BCC) could be effective tools in ensuring child health utilisation (VAS, Iron supplements and deworming).


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Incidence of back pain among women of child bearing age and its management during pregnancy

2016-08-23T03-10-12Z
Source: Journal of Behavioral Health
Olusola Ayanniyi, Arinola Olasumbo Sanya, Samuel Olusegun Ogunlade.
OBJECTIVE: There is a dearth of studies on history of back pain (BP) among women of child bearing age in Nigeria. The aims of this study were to investigate the history of incidence of BP among women of child bearing age and how pregnancy-related BP is being managed among this population. METHODS: A survey of 2,187 pregnant women attending ante-natal clinics in selected Medical facilities in Ibadan and Ogbomoso, Nigeria was carried out over a period of 2 years and 3 months using pre-tested close-ended questionnaire. Data obtained was analyzed using both descriptive and inferential statistics. RESULTS: One thousand and eight (52.5%) of the 1919 respondents had back pain during their current pregnancy. The mean age of those with and without back pain was 26.8 ± 5.3 and 27.1 ± 5.4 years respectively. Mean number of pregnancy was higher among respondents with back pain 2.6 ±1.50 than those without back pain 2.4±1.40. Incidence of BP was highest during current pregnancy 52.5%, during menses 341(17.8%) and it was least post-delivery 69(3.6%). Analgesics (50 .4%) and physical approaches (49. 6%) were nearly equally utilized in managing BP among the studied population. Side lying (78.2%) was the most preferred therapeutic position for relieving BP and supine lying was the least favored (22.6 %,) among the respondents in relieving BP. Standing up and walking around was found useful to relieve BP induced or aggravated by prolonged sitting or maintenance of static posture. CONCLUSIONS: Back pain is most prevalent during pregnancy and also troublesome during menses among women of child bearing age. Analgesic and postural modifications were the two major interventions utilised in managing BP among the pregnant women in this study. More treatment options needs to be promoted for holistic management of pregnancy-related back pain. KEYWORDS: Incidence, back pain, pregnancy, management.


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Comprehensive review of the duplication 3q syndrome and report of a patient with Currarino syndrome and de novo duplication 3q26.32-q27.2

Abstract

Partial duplications of the long arm of chromosome 3, dup(3q), are a rare but well-described condition, sharing features of Cornelia de Lange syndrome. Around two thirds of cases are derived from unbalanced translocations, whereas pure dup(3q) have rarely been reported.

Here, we provide an extensive review of the literature on dup(3q). This search revealed several patients with caudal malformations and anomalies, suggesting that caudal malformations or anomalies represent an inherent phenotypic feature of dup(3q). In this context, we report a patient with a pure de novo duplication 3q26.32-q27.2. The patient had the clinical diagnosis of Currarino syndrome (characterized by the triad of sacral anomalies, anorectal malformations and a presacral mass) and additional features, frequently detected in patients with a dup(3q). Mutations within the MNX1 gene were found to be causative in Currarino syndrome but no MNX1 mutation could be detected in our patient. Around two thirds of cases are derived from unbalanced translocations, whereas pure dup(3q) have rarely been reported. Our comprehensive search for candidate genes located in the critical region of the duplication 3q syndrome, 3q26.3-q27, revealed a so far neglected phenotypic overlap of dup(3q) and the Pierpont syndrome, associated with a mutation of the TBL1XR1 gene on 3q26.32.

Thumbnail image of graphical abstract

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Caudal analgesia and cardiothoracic surgery: a look at postoperative pain scores in a pediatric population

Summary

Aim

Caudal epidural anesthesia has been shown to reduce stress response and shorten the time to extubation in children after cardiac surgery. Combined with general anesthesia, regional anesthesia has been proven to be safe and efficacious in the pediatric population. It is not known, however, whether the use of caudal anesthesia actually reduces postoperative pain scores and decreases postoperative opioid use.

Methods

We retrospectively analyzed the charts of 199 children who underwent repair for atrial septal defect (ASD), ventricular septal defect (VSD), and Tetralogy of Fallot (TOF) at a major academic children's hospital between 2010 and 2013.

Results

Eighty-six patients underwent preoperative placement of caudal anesthesia (bupivacaine 0.25% 1 ml·kg−1 up to 20 ml + clonidine 2mcg·kg−1 + Duramorph 40 mcg·kg−1 up to 2.5 mg) and 113 patients did not have a caudal block. Postoperative cardiac intensive care pain scores were analyzed according to standard nurse-recorded patient-appropriate pain scales ranging from 0 to 10 (CRIES for neonates and FLACC for 2 months–7 years). There was no statistical difference between caudal and noncaudal groups with respect to postoperative pain scores or with postoperative opioid requirements. There was a statistical significance with regard to intraoperative opioid use as noncaudal patients invariably received more opioid during the procedure.

Conclusion

Although regional anesthesia reduced intraoperative opioid usage, there was no difference in postoperative opioid usage or pain scores.

Thumbnail image of graphical abstract

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The European Board of Anaesthesiology recommendations for safe medication practice: First update.

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These European Board of Anaesthesiology (EBA) recommendations for well tolerated medication practice replace the first edition of the EBA recommendations published in 2011. They were updated because evidence from critical incident reporting systems continues to show that medication errors remain a major safety issue in anaesthesia, intensive care, emergency medicine and pain medicine, and there is an ongoing need for relevant up-to-date clinical guidance for practising anaesthesiologists. The recommendations are based on evidence wherever possible, with a focus on patient safety, and are primarily aimed at anaesthesiologists practising in Europe, although many will be applicable elsewhere. They emphasise the importance of correct labelling practice and the value of incident reporting so that lessons can be learned, risks reduced and a safety culture developed. (C) 2016 European Society of Anaesthesiology

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Increased long noncoding RNA SNHG20 predicts poor prognosis in colorectal cancer

BMC Cancer

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Tenofovir disoproxil fumarate (TDF) versus TDF/emtricitabine (FTC) in lamivudine-resistant hepatitis B: a 5-year randomized study

Journal of Hepatology

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Radiation recall gastritis secondary to combination of gemcitabine and erlotinib in pancreatic cancer and response to PPI - a case report

BMC Cancer

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The use of conventional and complementary health services and self-prescribed treatments amongst young women with constipation: A national cohort study

Digestive and Liver Diseases

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Diagnosis and management of oesophageal cancer in bariatric surgical patients

Journal of Gastrointestinal Surgery

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Arsenic trioxide intravenous infusion combined with transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with pulmonary metastasis: Long-term outcome analysis

Journal of Gastroenterology and Hepatology

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Health economic analysis of laparoscopic lavage versus Hartmanns procedure for diverticulitis in the randomized DILALA trial

British Journal of Surgery

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Increased serum interleukin-6, not minimal hepatic encephalopathy, predicts poor sleep quality in nonalcoholic cirrhotic patients

Alimentary Pharmacology and Therapeutics

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Anterior perineal plane for ultra-low anterior resection of the rectum (APPEAR) technique: A systematic review

International Journal of Surgery

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Ondansetron in acute food protein-induced enterocolitis syndrome, a retrospective case-control study

Allergy

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Change in Dietary Patterns and Change in Waist Circumference and DXA Trunk Fat Among Postmenopausal Women

Obesity

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Hepatitis C genotype distribution in patient and blood donor samples in South Africa for the period 2008-2012

Journal of Viral Hepatitis

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Outcomes and post-operative complications following colectomy for ulcerative colitis

Alimentary Pharmacology and Therapeutics

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Financial incentives for promoting colorectal cancer screening: A randomized, comparative effectiveness trial

The American Journal of Gastroenterology

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MicroRNA-21 promotes proliferation, migration, and invasion of colorectal cancer, and tumor growth associated with down-regulation of sec23a expression

BMC Cancer

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Risk factors for reintervention after surgery for perforated gastroduodenal ulcer

British Journal of Surgery

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Impact of donor-recipient genetic relationship on outcome of living donor liver transplantation

Liver Transplantation

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Meta-analysis of closure of the fascial defect during laparoscopic incisional and ventral hernia repair

British Journal of Surgery

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Relationships between time use and obesity in a representative sample of Americans

Obesity

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Differences in erect sitting and natural sitting spinal alignment – insights into a new paradigm and implications in deformity correction

Sitting spinal alignment is increasingly recognized as a factor influencing strategy for deformity correction. Considering that most individuals sit for longer hours in a 'slumped' rather than erect posture, greater understanding of the natural sitting posture is warranted.

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Pediatric Gastrojejunostomy Tube Replacement: Effects of Communication on the Need for After-Hours Procedures

imageObjectives: The aim of the study was to determine whether embedding into the radiology report a patient-specific plan in the event of gastrojejunostomy (GJ) tube dysfunction reduces the need for after-hours utilization of pediatric interventional radiology resources for the replacement of GJ tubes. Materials and Methods: This is a Health Insurance Portability and Accountability Act compliant, institutional review board–approved retrospective repeated cross-sectional study of patients requiring after-hours (5 PM–7 AM) or weekend (Saturday and Sunday) GJ tube replacement at a dedicated children's hospital, before and after the inclusion of a patient-specific plan in the radiology report as part of the electronic medical record. Results: During a 6-month period before the inclusion of a patient-specific plan, there were 242 total GJ tube changes performed by the pediatric interventional radiology service under image guidance. Twenty-six (10.7%) of these procedures were performed outside of standard operating hours at the request of the emergency department (ED) (6/26), inpatient service (8/26), or patient/caregiver (12/26). Of the 8 inpatients, 3 were admitted from the ED for the sole purpose of tube replacement. Data were again collected for 6 months following inclusion of a patient-specific plan during the same seasonal period of the following year. During this period, 240 total image-guided changes were performed. Fifteen (6.2%) were performed outside of standard operating hours at the request of the ED (2/15), inpatient service (4/15), or patient/caregiver (9/15). No patients were admitted for GJ tube replacement procedures following implementation of the enhanced reporting policy. These data indicate a trend toward reduced after-hours resource utilization for GJ tube replacement requests by the ED (23.1%–13.3%), inpatient service (30.8%–26.7%), and all patients (14.7%–11%). Fewer after-hours GJ tube changes reduced cost by proportionately reducing hourly compensation for interventional radiology nurses and technicians. Conclusions: Our single-center data suggest that the inclusion of patient-specific recommendations at the end of each radiology GJ tube procedure note, generated in collaboration with the feeding service or primary medical provider, reduces off-hour resource utilization in patients who could otherwise have their tubes replaced during standard operating hours with image guidance. Avoidance of tube-related admissions is likely the greatest source of cost savings, followed by lower radiology technical support costs. Cost savings related to improved ED workflow and reduced patient/family anxiety are difficult to quantify, but likely significant. Future studies should be designed to quantify these savings and to assess the effect of this intervention on patient/caregiver satisfaction.

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Recent advances in epilepsy management.

Purpose of review: Recent advances in our understanding of seizure generation have resulted in modified recommendations for when seizure treatment should be initiated, revisions to our definition of status epilepticus, and new pharmacological and neuromodulatory therapies. The goal of this review is to provide the anesthesiologist with an overview of the advancements they are most likely to encounter while providing clinical care. Recent findings: There have been recent modifications to seizure definitions and treatment recommendations. These include the idea that treatment with antiepileptic therapy should be initiated after the first unprovoked seizure in individuals who are at high risk for another seizure, and that the idea that status epilepticus should be thought of as a two-phase process, related to an initial phase after which intervention should be started, and a second phase after which time risk of long-term sequelae is increased. Additionally, several new therapies have become available that have novel mechanisms of action, which are more efficacious and have fewer side-effects. Summary: As knowledge about mechanisms of seizure generation has improved, there has been a concurrent evolution in our thinking about seizure-related definitions, and indications for initiation of treatment. Several next generation drug therapies with more specific targets have also become available. Taken together, there have been significant improvements in care options. Copyright (C) 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Medial branch nerve block and ablation as a novel approach to pain related to vertebral compression fracture.

Purpose of review: This review offers a critical examination of the biomechanical model that posits the posterior elements as a substantial contributor to pain in vertebral fracture. Further, the review assesses the treatment of posterior-element-associated pain in the setting of vertebral compression fracture in relation to vertebral augmentation. Recent findings: In 2015, the only prospective randomized trial comparing percutaneous vertebroplasty with facet blockade was published in which authors found that percutaneous vertebroplasty produced better pain relief and function based on Oswestry Disability Index, Roland Morris Disability Questionnaire, and visual analog scale in the short term (

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