51
|
Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
Collapse
|
52
|
|
53
|
SAT0319 SUBCLINICAL ATHEROSCLEROSIS IN INDIAN PATIENTS WITH SCLERODERMA – CLINICAL AND SEROLOGICAL ASSOCIATIONS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Scleroderma has been associated with increased risk of cardiovascular events, however,studies on this from India are sparse.We evaluated clinical and serological factors associated with subclinical atherosclerosis in Indian patients with scleroderma, in a cross-sectional design.Objectives:To compare carotid intima-medial thickness (CIMT, mean value of both carotids) as a measure of subclinical atherosclerosis (SCA) between patients with scleroderma (n=61) fulfilling 2013 ACR/EULAR criteria, and healthy controls (n=41).- To compare clinical (body mass index – BMI, waist-hip ratio – WHR, fasting lipid profile) and serological factors (microparticles, endothelial microparticles, inflammatory cytokines associated with increased cardiovascular risk) between patients with scleroderma and healthy controls.- To identify factors associated with SCA in scleroderma patients.Methods:Subclinical atherosclerosis(SCA) was defined by presence of carotid plaques, or increased CIMT >2 standard deviations compared with Indian reference standards for age and sex. Total microparticles (TMP) were measured of plasma after ultracentrifugation as per previously described protocol using microbeads of 3 μm size (TMP were of size 0.1-1 μm); of these, microparticles positive for CD31 and CD142 were endothelial microparticles (EMP). Serum cytokines (IL-1, IL-6, TNF-α, IL-17) were measured by ELISA using manufacturer instructions. Linear regression was used to identify the determinants of CIMT in scleroderma. Binomial logistic regression was used to identify factors associated with subclinical athersclerosis in scleroderma.VariablePatients with scleroderma (n=61)Healthy controls (n=41)p valueAge37.8 ± 11.9235.37 ± 6.690.2375Gender (M:F)11:506:350.6516Diabetes/Hypertension/Tobacco use1/2/00/0/0NSBody mass index (kg/m2)20.11 ± 3.8224.38 ± 4.45<0.0001Waist-hip ratio0.86 ± 0.110.89 ± 0.070.1251Total cholesterol (mg/dL)142.5 ± 30.7147.3 ± 39.50.4948Triglycerides (mg/dL)99.4 ± 37121.4 ± 460.0087HDL cholesterol (mg/dL)46.9 ± 4.946.1 ± 4.20.4029LDL cholesterol (mg/dL)93.6 ± 10.593.3 ± 7.50.8520VLDL cholesterol (mg/dL)19.9 ± 7.424.7 ± 9.70.0057Carotid intima-medial thickness (mm)0.68 ± 0.100.53 ± 0.03<0.0001Total microparticles (per±L)12913 ± 24936272 ± 1533<0.0001Endothelial microparticles (per±L)2623 ± 1032829 ± 439.5<0.0001Serum IL-1±(pg/mL)38.19 ± 13.4631.38 ± 18.290.0326IL-6 (pg/mL)176.6 ± 85.74128.9 ± 53.610.0020IL-17 (pg/mL)56.3 ± 20.4553.89 ± 20.510.5611TNF±(pg/mL)49.65 ± 26.7142.09 ± 30.410.1879Results:Despite lower BMI, triglycerides and VLDL cholesterol, CIMT was significantly higher in patients with scleroderma. Patients with scleroderma had significantly higher total microparticles and endothelial microparticles in plasma, and serum IL-1± and IL-6 (Table 1). On multivariable regression, age was the only significant determinant of CIMT. 28 (45.9%) patients had SCA; 13 (21.3%) had carotid plaques. Patients with SCA had higher proportion of males (9/28 in those with SCA vs 2/33 in those without SCA). Binomial logistic regression did not identify any other significant predictors of SCA.Table 1Comparison between patients with scleroderma and healthy controlsSerum IL-1± (pg/mL)38.19 ± 13.4631.38 ± 18.290.0326IL-6 (pg/mL)176.6 ± 85.74128.9 ± 53.610.0020IL-17 (pg/mL)56.3 ± 20.4553.89 ± 20.510.5611TNF± (pg/mL)49.65 ± 26.7142.09 ± 30.410.1879Conclusion:Patients with scleroderma had significant burden of subclinical atherosclerosis, which could not be explained by traditional or novel cardiovascular risk factors.References:[1]Psarras A, Soulaidopoulos S, Garyfallos A, Kitas G, Dimitroulas T. A critical view on cardiovascular risk in systemic sclerosis. Rheumatol Int. 2017 Jan; 37(1):85-95.[2]Jung C, Drummer K, Oelzner P, Figulla HR, Boettcher J, Franz M, et al. The association between endothelial microparticles and inflammation in patients with systemic sclerosis and Raynaud’s phenomenon as detected by functional imaging. Clin HemorheolMicrocirc. 2015; 61(3):549-557.Acknowledgments:Supported by IRA(Indian Rheumatology Association) Research Grant to DP Misra.Disclosure of Interests:None declared
Collapse
|
54
|
Abstract
Plant genetic resources (PGR) are the foundation of agriculture as well as food and nutritional security.
The ICAR-NBPGR is the nodal institution at national level for management of PGR in India under the umbrella
of Indian Council of Agricultural Research (ICAR), New Delhi. India being one of the gene-rich countries faces a
unique challenge of protecting its natural heritage while evolving mutually beneficial strategies for germplasm
exchange with other countries. The Bureaus activities include PGR exploration, collection, exchange, characterization,
evaluation, conservation and documentation. It also has the responsibility to carry out quarantine of
all imported PGR including transgenics meant for research purposes. The multifarious activities are carried out
from ICAR-NBPGR headquarters and its 10 regional stations located in different agro-climatic zones of India. It
has linkages with international organizations of the Consultative Group on International Agricultural Research
(CGIAR) and national crop-based institutes to accomplish its mandated activities. NBPGR collects and acquires
germplasm from various sources, conserves it in the Genebank, characterizes and evaluates it for different traits
and provides ready material for breeders to develop varieties for farmers. ICAR-NBPGR encompasses the National
Genebank Network and at present, the National Genebank conserves more than 0.40 million accessions. NBPGR
works in service-mode for effective utilization of PGR in crop improvement programmes which depends mainly
on its systematic characterization and evaluation, and identification of potentially useful germplasm. NBPGR is
responsible for identifying trait-specific pre-adapted climate resilient genotypes, promising material with disease
resistance and quality traits which the breeders use for various crop improvement programmes. The system has
contributed immensely towards safeguarding the indigenous and introducing useful exotic PGR for enhancing
the agricultural production. Presently, our focus is on characterization of ex situ conserved germplasm and
detailed evaluation of prioritized crops for enhanced utilization; assessment of impact of on-farm conservation
practices on genetic diversity; genome-wide association mapping for identification of novel genes and alleles for
enhanced utilization of PGR; identification and deployment of germplasm/landraces using climate analog data;
validation of trait-specific introduced germplasm for enhanced utilization.
Key words: plant genetic resources; gene banks; wild relatives; biotic and abiotic stresses; marker-assisted
selection.
Collapse
|
55
|
Early and Late Pulmonary AMR Show Distinct Profiles; Clinical and Epigenetic Analyses. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
56
|
Efficacy of bioactive nanoparticles on tissue-endotoxin induced suppression of stem cell viability, migration and differentiation. Int Endod J 2020; 53:859-870. [PMID: 32068891 DOI: 10.1111/iej.13283] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 12/22/2022]
Abstract
AIM To characterize a lipopolysaccharide (LPS)-treated dentine tissue model (LPS dentine) to analyse the efficacy of polycationic chitosan nanoparticles (CSnp) and/or dexamethasone conjugate chitosan nanoparticles (Dex-CSnp) on the viability/differentiation potential of stem cells from apical papilla (SCAP) when exposed to LPS dentine. A further aim was to understand the effect of macrophage-dependent inflammation on SCAP migration in the presence of LPS dentine. METHODOLOGY A total of 88 dentine slabs were used. TOF-SIMS analysis was performed amongst the LPS-treated and untreated dentine groups (n = 2/group). The study was conducted using four dentine groups: no treatment (control); LPS treatment only; LPS treatment followed by CSnp conditioning; and LPS treatment followed by Dex-CSnp conditioning groups. SCAP adherence, viability, differentiation and biomineralization potential on dentine from different groups were studied using fluorescent and scanning electron microscopy. Inflammation by macrophages in response to LPS dentine was quantified, and effect on SCAP migration was analysed. Statistical analysis was performed using Student's t-test with a significance level of P < 0.05. RESULT TOF-SIMS analysis confirmed LPS contamination. LPS dentine affected SCAP viability but not adherence to dentine (P < 0.001). Conditioning of LPS dentine with either nanoparticles improved SCAP viability (P < 0.01) and rescued other LPS related adverse effects on SCAPs, such as F-actin disruption, decrease in differentiation/biomineralization potential. IL-6 produced by macrophages in response to LPS-treated dentine impeded SCAP migration (P < 0.001), diminished on CSnp and Dex-CSnp conditioning groups (P < 0.01). CONCLUSION This study developed an LPS-dentine model and highlighted the ability of CSnp and Dex-CSnp to promote stem cell viability, migration, differentiation potential and reduce inflammation, providing an environment conducive for tissue regeneration/repair.
Collapse
|
57
|
Structural, optical, thermal and conducting properties of V 2-xLi xO 5-δ (0.15 ≤ x ≤ 0.30) systems. Sci Rep 2020; 10:1089. [PMID: 31974466 PMCID: PMC6978346 DOI: 10.1038/s41598-020-57836-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 11/15/2019] [Indexed: 12/04/2022] Open
Abstract
Lithium-doped vanadates (V2−xLixO5−δ (0.15 ≤ x ≤ 0.30)) are synthesized by melt-quench method. The physical, structural, optical, thermal and conducting properties of as-quenched samples are investigated using various experimental techniques to study their suitability for electrolyte in battery/solid oxide fuel cell application. X-ray diffraction (XRD) patterns confirm the formation of three different crystalline phases. FTIR and Raman spectra indicate that the doping of Li2O into V2O5 leads to a transition from VO5 into VO4 structural unit. The optical diffused reflectance spectra revealed that the optical band gap (Eg) decreases from 2.2 to 2.08 eV while Urbach energy (EU) increases (0.31–0.41 eV) with the addition of Li2O content in place of vanadium. The thermal stability is studied by thermogravimetric analyser (TGA). The DC conductivity of the present samples is increased from 0.08 to 0.12 Scm−1 at 450 °C with Li2O doping. These materials can be used as electrolyte for battery/solid oxide fuel cell due to their good conductivity (~0.12 Scm−1) at 450 °C.
Collapse
|
58
|
891 Systematic Review and Meta-Analysis of Spontaneous Coronary Artery Dissection Recurrence. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
59
|
496 Geographical Variation in the Statin Trials: Does It Exist? Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
60
|
462 Comparing the Impact of Transradial and Transfemoral Coronary Angiography on the Radiation Dose, Contrast Volume and Fluoroscopy Time in Patients With Varying BMI. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
61
|
793 Association of BMI and Radiation Exposure in Coronary Angiography. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
62
|
889 Stretching the Limits of Transcatheter Aortic Valve Replacement (TAVR): Emergency TAVR Deployment Using Leaflet Calcification for Neo-Annulus Construction in an Extremely Large Aortic Annulus. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
63
|
Introduction of a national program for HbA1c testing in Guyana South America and initial results. Diabetes Res Clin Pract 2019; 158:107929. [PMID: 31738996 DOI: 10.1016/j.diabres.2019.107929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 10/08/2019] [Accepted: 11/13/2019] [Indexed: 11/15/2022]
Abstract
Diabetes is an increasing challenge for low- and middle-income countries (LMIC) and access to HbA1c testing is limited. HbA1c, a measure of glycaemic control averaged over 3 months, provides both clinicians and policymakers with a tool to identify the risk of long-term diabetes comorbidity. We describe the steps used to implement standardised testing in Guyana South America and the initial results according to a locally developed protocol as part of a country-wide project to improve the care of people with all forms of diabetes The steps identified include: a standardised method traceable to a recognized international reference standard, participation in a quality control cycle with an international reference laboratory, a clinical pathway for testing to reduce inappropriate use and minimize resource wastage, training of technicians in operation and maintenance of equipment, identification of a suitable space with constant power supply, a reliable procurement system, education of healthcare professionals on interpretation and follow-up of results and feedback of programme results to improve clinical practice. Some steps for implementation of the national HbA1c testing program were initiated better than others. Initial unreliability of the service undermined confidence in the system. Failure to follow the testing protocol led to some patients being tested too soon and others too late. Cost of reagents was about 5.60 USD/test. We trained 340 people in diabetes care and knowledge was improved but were unable to assess whether it was appropriately applied. Over one third of people tested in the 30-70 age group had an HbA1c over 9% (75 mmol/mol) and this did not improve over the 5 years of testing. Despite the difficulties we think our unique experience of implementation of a nationwide HbA1c testing programme has important lessons for other LMICs.
Collapse
|
64
|
Association of body mass index and upper arm body composition with depressive symptoms in old age home and family based elderly. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2019; 70:155-162. [PMID: 31486826 DOI: 10.1127/homo/2019/1054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 04/19/2019] [Accepted: 04/24/2019] [Indexed: 11/05/2022]
Abstract
The following study was designed to find out the association of the mid-upper arm body composition and body mass index (BMI) with depressive symptoms among the old age home based (group 1) and family based elderly (group 2) subjects. In group 1 elderly males, 51.5% were showing mild depressive symptoms and 17% were showing moderate to severe depressive symptoms. On the other hand, among group 2 elderly males, prevalence of mild depressive symptoms was in 27% and moderate to severe depressive symptoms was in 4.5% of the subjects. Among elderly with and without depressive symptoms, BMI, waist-hip ratio (WHR), arm muscle circumference (AMC), arm muscle area (AMA), arm fat area (AFA), fat mass (FM), muscle mass and bone mass were significantly (p < 0.01) lesser among group 1 as compared to group 2. Among group 1, the AFA (R2 change = 0.178), AMC (R2 change = 0.035), AMA (R2 change = 0.032), FM (R2 change = 0.022) and muscle mass (R2 change = 0.019) have highest contribution to the variance of depressive symptoms. On the other hand, BMI (R2 change = 0.04) and WHR (R2 change = 0.03) had the highest, though small, contribution to the variance of depressive symptoms among group 2. The upper arm body composition indices were better indicator of depressive symptoms in group 1, and BMI and WHR were better indicators of depressive symptoms in group 2. Therefore, among group 1 subjects, the upper arm body composition indices prove to be better regular health monitoring indices as compared to traditionally used BMI and WHR.
Collapse
|
65
|
P11. Abstract Title: Investigating the resistance of ADAMTS13 towards Alpha 2-Macroglobulin. Thromb Res 2019. [DOI: 10.1016/j.thromres.2019.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
66
|
P13. Abstract Title: Deep Mutational Scan of VWF to Define Mutations that Enhance or Impair Secretion. Thromb Res 2019. [DOI: 10.1016/j.thromres.2019.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
67
|
Review on titanium and titanium based alloys as biomaterials for orthopaedic applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 102:844-862. [PMID: 31147056 DOI: 10.1016/j.msec.2019.04.064] [Citation(s) in RCA: 356] [Impact Index Per Article: 71.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/20/2019] [Accepted: 04/20/2019] [Indexed: 02/07/2023]
Abstract
Variety of implant materials have been employed in various disciplines of medical science depending on the requirement of a particular application. Metals, alloys, ceramics, and polymers are the commonly used biomaterials. The main focus of this study is to review the various structural and microstructural properties of titanium and titanium based alloys used as orthopaedic implants. Orthopaedic implants need to possess certain important qualities to ensure their safe and effective use. These properties like the biocompatibility, relevant mechanical properties, high corrosion and wear resistance and osseointegration are summarized in this review. Various attempts to improve upon these properties like different processing routes, surface modifications have also been inculcated in the paper to provide an insight into the extent of research and effort that has been put into developing a highly superior titanium orthopaedic implant.
Collapse
|
68
|
A field study of a roof bolter canopy air curtain (2nd generation) for respirable coal mine dust control. INTERNATIONAL JOURNAL OF MINING SCIENCE AND TECHNOLOGY 2019; 29:711-720. [PMID: 31850153 PMCID: PMC6917209 DOI: 10.1016/j.ijmst.2019.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A 2nd generation roof bolter canopy air curtain (CAC) design was tested by National Institute for Occupational Safety and Health (NIOSH) at a Midwestern underground coal mine. During the study, the roof bolter never operated downwind of the continuous miner. Using a combination of personal Data Rams (pDR) and gravimetric samplers, the dust control efficiency of the roof bolter CAC was ascertained. Performance evaluation was determined using three methods: (1) comparing roof bolter operator concentrations underneath the CAC to roof bolter concentrations outside the CAC, (2) comparing roof bolter operator concentrations underneath the CAC to the concentrations at the rear of the bolter, and finally, (3) using the gravimetric data directly underneath the CAC to correct roof bolter operator concentrations underneath the CAC and comparing them to the concentrations at the rear of the bolter. Method 1 dust control efficiencies ranged from -53.9% to 60.4%. Method 2 efficiencies ranged from -150.5% to 52.2%, and Method 3 efficiencies ranged from 40.7% to 91%. Reasons for negative and low dust control efficiencies are provided in this paper and include: incorrect sampling locations, large distance between CAC and operator, and contamination of intake air from line curtain. Low dust concentrations encountered during the testing made it difficult to discern whether differences in concentrations were due to the CAC or due to variances inherent in experimental dust measurement. However, the analyses, especially the Method 3 analysis, show that the CAC can be an effective dust control device.
Collapse
|
69
|
367 Apremilast Switches Pro-Inflammatory M1 Macrophages to Anti-Inflammatory M2 Macrophages – Transcription Factors Beyond CREB. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
70
|
Field investigation to measure airflow velocities of a ram dump car using circular routing at a Midwestern underground coal mine: a case study. ENVIRONMENTAL MONITORING AND ASSESSMENT 2019; 191:515. [PMID: 31346812 PMCID: PMC6697381 DOI: 10.1007/s10661-019-7624-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Abstract
Due to the successful application of roof bolter canopy air curtains (CACs) to protect roof bolter operators from high levels of coal mine respirable dust, a shuttle car CAC is currently being developed. Since a shuttle car consistently trams from the continuous miner to the feeder and back at a speed up to 9.66 kph (6 mph) or 2.68 m/s (528 fpm), it is thought that the shuttle car may encounter very high air velocities (mine ventilation air velocity + max shuttle speed (2.68 m/s (528 fpm)). Past research and preliminary lab testing showed that CAC protection in high interference air velocities is difficult to achieve. Therefore, testing was conducted at a Midwestern US coal mine to determine the air velocities their shuttle car actually encounters. This mine used ram dump cars as their shuttle cars. Results showed that coal mine dust exposure is generally very low at the feeder and when tramming. Elevated concentrations are encountered at the ram dump car operator position when the car is being loaded by the continuous miner. Recorded air velocities while tramming did not reach the max air velocity of mine ventilation air velocity + 2.68 m/s (528 fpm) calculated as 3.32 m/s (653 fpm). High velocities, while encountered, were of low frequency and associated with low respirable coal mine dust concentrations. Therefore, using this new information, designing the shuttle car CAC for maximum interference air velocity may not be as important as previously thought.
Collapse
|
71
|
|
72
|
1REGULAR MONITORING WITH STOOL CHART PREVENTS CONSTIPATION, URINARY RETENSION AND DELIRIUM IN ELDERLY PATIENTS: AN AUDIT LEADING TO CLINICAL EFFECTIVENESS, EFFICIENCY AND PATIENT CENTREDNESS. Age Ageing 2019. [DOI: 10.1093/ageing/afz055.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
73
|
Performance evaluation of the ADVIA Centaur Zika Test. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
74
|
Effect of Time from Cardiogenic Shock to Initiation of Complete Cardiovascular Support on Survival: “Shock to Support Time”. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
75
|
Cellular immunological changes in patients with LADA are a mixture of those seen in patients with type 1 and type 2 diabetes. Clin Exp Immunol 2019; 197:64-73. [PMID: 30843600 PMCID: PMC6591143 DOI: 10.1111/cei.13289] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2019] [Indexed: 12/19/2022] Open
Abstract
There is currently scarce knowledge of the immunological profile of patients with latent autoimmune diabetes mellitus in the adult (LADA) when compared with healthy controls (HC) and patients with classical type 1 diabetes (T1D) and type 2 diabetes (T2D). The objective of this study was to investigate the cellular immunological profile of LADA patients and compare to HC and patients with T1D and T2D. All patients and age‐matched HC were recruited from Uppsala County. Peripheral blood mononuclear cells were isolated from freshly collected blood to determine the proportions of immune cells by flow cytometry. Plasma concentrations of the cytokine interleukin (IL)‐35 were measured by enzyme‐linked immunosorbent assay (ELISA). The proportion of CD11c+CD123– antigen‐presenting cells (APCs) was lower, while the proportions of CD11c+CD123+ APCs and IL‐35+ tolerogenic APCs were higher in LADA patients than in T1D patients. The proportion of CD3–CD56highCD16+ natural killer (NK) cells was higher in LADA patients than in both HC and T2D patients. The frequency of IL‐35+ regulatory T cells and plasma IL‐35 concentrations in LADA patients were similar to those in T1D and T2D patients, but lower than in HC. The proportion of regulatory B cells in LADA patients was higher than in healthy controls, T1D and T2D patients, and the frequency of IL‐35+ regulatory B cells was higher than in T1D patients. LADA presents a mixed cellular immunological pattern with features overlapping with both T1D and T2D.
Collapse
|
76
|
A134 HIGH ADHERENCE TO SURVEILLANCE GUIDELINES IN IBD RESULTS IN LOW CRC AND DYSPLASIA RATES, WHILE RATES OF DYSPLASIA AND CANCER ARE LOW BEFORE THE SUGGESTED START OF SURVEILLANCE. RESULTS FROM A TERTIARY IBD CENTER. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
77
|
A76 HIGH ADHERENCE TO SURVEILLANCE GUIDELINES IN IBD RESULTS IN LOW CRC AND DYSPLASIA RATES, WHILE RATES OF DYSPLASIA AND CANCER ARE LOW BEFORE THE SUGGESTED START OF SURVEILLANCE. RESULTS FROM A TERTIARY IBD CENTER. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
78
|
A105 HIGH ADHERENCE TO SURVEILLANCE GUIDELINES IN IBD RESULTS IN LOW CRC AND DYSPLASIA RATES, WHILE RATES OF DYSPLASIA AND CANCER ARE LOW BEFORE THE SUGGESTED START OF SURVEILLANCE. RESULTS FROM A TERTIARY IBD CENTER. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
79
|
Effect of Ni substitution on the structural and optical properties of SrZr1-xNixO3 (0.05≤x≤0.20) perovskites. J Mol Struct 2019. [DOI: 10.1016/j.molstruc.2018.12.051] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
80
|
Abstract P3-14-04: Prevention of lymphedema in patients undergoing axillary dissection for breast cancer by benzathine penicillin: A non-inferiority randomised controlled trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-14-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Axillary lymph node dissection (ALND) is performed for axillary lymph nodal metastasis. Major complication of ALND is lymphedema. Lymphedema is a morbid condition associated with impaired activities of daily life and deterioration in quality of life (QOL). Olszewski et al (Lymphology. 2005 Jun;38(2):66–80) have shown that low-grade staphylococcal infection is a risk factor for lymphedema. Hence, we embarked upon a randomised controlled trial with non-inferiority hypothesis to evaluate efficacy of injection Benzathine penicillin in preventing breast cancer related lymphedema.
Methods: In this 2 group, open label, parallel design randomized controlled trial; patients undergoing ALND for breast cancer were included. Patients were randomized using block randomization to either injection Benzathine penicillin group or in control group. Patients in the penicillin group received injection Benzathine penicillin 1.2 million units as deep intramuscular injection after antibiotic sensitivity testing at intervals of 3 weeks. Primary endpoint was development of lymphedema at 6 months follow up. Analyses were done on an intention to treat basis. Lymphedema was defined as increase in >200ml of volume on water displacement method and or increase in arm circumference of >2cm from pre surgery values (Lancet Oncol. 2013 May 1;14(6):500–15).
Findings: Between July 2016 and December 2017, 83 ladies were randomly allocated, 40 in the penicillin group and 43 in control group. At 6 months follow up; a total of 15 (18.07%) patients had lymphedema. Out of them 5 patients were in penicillin group and 10 in the control group. Cellulitis was seen in 2/3rd of patients (10 out of 15) having lymphedema. The relative risk of cellulitis in penicillin group was 0.119 with 95% CI of (0.016-0.901) and prevented fraction of 0.881. Other factors like radiotherapy, type of surgery for primary tumor, extent of axillary dissection and type of chemotherapy were comparable in both groups. None of the patients receiving penicillin have any adverse effect or allergic reaction to the drug during the study period.
Comparison of lymphedema and cellulitis in two groupsOutcome Penicillin groupControl groupRR ( 95% CI)PFLymphedemaPresent05100.538 (0.201-1.437)0.462 Absent3533 CellulitisPresent01090.119 (0.016-0.901)0.881 Absent3934 RR: Relative risk, PF: Prevented fraction, CI: Confidence interval
Conclusion: Penicillin administration in patients undergoing axillary lymph node dissection is safe and significantly reduces risk of lymphedema and cellulitis.
Novelty: This is the first randomised trial demonstrating the benefit of long term administration of penicillin in reducing lymphedema and cellulitis.
Citation Format: Singh K, Dhar A, Srivastava A, Ranjan P, Kataria K, Gour KS. Prevention of lymphedema in patients undergoing axillary dissection for breast cancer by benzathine penicillin: A non-inferiority randomised controlled trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-14-04.
Collapse
|
81
|
The results of treatment with high-dose chemotherapy and peripheral blood stem cell support for gestational trophoblastic neoplasia. Eur J Cancer 2019; 109:162-171. [PMID: 30731277 DOI: 10.1016/j.ejca.2018.12.033] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/13/2018] [Accepted: 12/23/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The objective of the study was to evaluate the effect of high-dose chemotherapy (HDC) with peripheral blood stem cell support (PBSCS) on survival of patients with gestational trophoblastic neoplasia (GTN) with either refractory choriocarcinomas or a poor-prognosis placental site/epithelioid trophoblastic tumours (PSTT/ETTs). METHODS Databases of two referral centres for gestational trophoblastic disease were searched, and 32 patients treated with HDC between 1994 and 2015 were identified. Tissue samples were retrieved for genetic evaluation. Cox regression analyses were performed to identify possible predictors of overall survival (OS). RESULTS HDC induced a sustained complete response in 7 patients. Overall, 41% (13/32) of the patients remained disease free after HDC with or without additional treatment. Patients who survived had much lower human chorionic gonadotropin (hCG) values (all ≤12 IU/L) before and after HDC than those who died of disease. Univariable Cox regression analysis demonstrated that hCG >12 IU/L before or after HDC, International Federation of Gynaecology and Obstetrics (FIGO) stage II-IV and presence of metastases at the time of diagnosis were significantly associated with adverse OS. However, only hCG values before HDC remained significant in a multivariable model (p < 0.001). Five of 11 (45%) patients with PSTT/ETT presenting ≥48 months after antecedent pregnancy and 6 of 14 (43%) patients with refractory choriocarcinoma were in remission. Three treatment-related deaths occurred. CONCLUSIONS Despite 3 treatment-induced deaths, HDC with PBSCS appears to be active in salvaging selected patients with poor-prognosis PSTT/ETTs and refractory choriocarcinomas. Low hCG values before HDC seems a beneficial predictor of OS and may suggest that HDC acts more like a consolidation therapy.
Collapse
|
82
|
Network Meta-Analysis of Antiplatelet Therapy Following Coronary Artery Bypass Grafting: None Versus One Versus Two Antiplatelet Agents. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
83
|
Incidence, Clinical Characteristics and In-Hospital Outcomes of MINOCA Patients: A Combined Analysis from 2 Large Registry Datasets. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
84
|
Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
Collapse
|
85
|
Cardiovascular Outcomes of Transradial Versus Transfemoral Access Cardiac Catheterization: Insights From the CADOSA Registry. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
86
|
Clinical Benefits of Prolonged DAPT Following Complex Percutaneous Coronary Intervention. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
87
|
Acceptability of a decision-support electronic health record system and its impact on diabetes care goals in South Asia: a mixed-methods evaluation of the CARRS trial. Diabet Med 2018; 35:1644-1654. [PMID: 30142228 DOI: 10.1111/dme.13804] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2018] [Indexed: 02/03/2023]
Abstract
AIMS To describe physicians' acceptance of decision-support electronic health record system and its impact on diabetes care goals among people with Type 2 diabetes. METHODS We analysed data from participants in the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) trial, who received the study intervention (care coordinators and use of a decision-support electronic health record system; n=575) using generalized estimating equations to estimate the association between acceptance/rejection of decision-support system prompts and outcomes (mean changes in HbA1c , blood pressure and LDL cholesterol) considering repeated measures across all time points available. We conducted in-depth interviews with physicians to understand the benefits, challenges and value of the decision-support electronic health record system and analysed physicians' interviews using Rogers' diffusion of innovation theory. RESULTS At end-of-trial, participants with diabetes for whom glycaemic, systolic blood pressure, diastolic blood pressure and LDL cholesterol decision-support electronic health record prompts were accepted vs rejected, experienced no reduction in HbA1c [mean difference: -0.05 mmol/mol (95% CI -0.22, 0.13); P=0.599], but statistically significant improvements were observed for systolic blood pressure [mean difference: -11.6 mmHg (95% CI -13.9, -9.3); P ≤ 0.001], diastolic blood pressure [mean difference: -5.2 mmHg (95% CI -6.5, -3.8); P ≤ 0.001] and LDL cholesterol [mean difference: -0.7 mmol/l (95% CI -0.6, -0.8); P ≤0.001], respectively. The relative advantages and compatibility of the decision-support electronic health record system with existing clinic set-ups influenced physicians' acceptance of it. Software complexities and data entry challenges could be overcome by task-sharing. CONCLUSION Wider adherence to decision-support electronic health record prompts could potentially improve diabetes goal achievement, particularly when accompanied by assistance from a non-physician health worker.
Collapse
|
88
|
MS02.9 Association of Body Mass Index and Other Cardiovascular Risk Factors With Diabetic Retinopathy Among People With Poorly-Controlled Type 2 Diabetes Mellitus In South Asia: The CARRS Trial. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
89
|
PO137 Gender Differences In Physiological and Behavioral Risk Factors Among Patients With Acute Myocardial Infarction: Findings From the Yoga-Care Trial. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
90
|
PO531 Primary and Secondary Prevention of Cardiovascular Diseases In Three South Asian Metropolitan Cities: Analysis of Self-Reported Medication Use In Community-Based CARRS Study. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
91
|
A PHASE 1/1B STUDY OF AN INHALED FORMULATION OF ITRACONAZOLE IN HEALTHY VOLUNTEERS AND ASTHMATICS. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
92
|
P01.142 Comparing Outcomes in Glioblastoma Multiforme patients undergoing Photodynamic Therapy with a Second-Generation Photosensitiser vs 5-Aminolevulinic Acid - A Single Site Retrospective Analysis. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
93
|
The NICE classification for 'Ultra-radical (extensive) surgery for advanced ovarian cancer' guidance does not meaningfully predict postoperative complications: a cohort study. BJOG 2018; 126:96-104. [PMID: 30092615 DOI: 10.1111/1471-0528.15423] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine which descriptors of cytoreductive surgical extent in advanced ovarian cancer (AOC) best predict postoperative morbidity. DESIGN Retrospective notes review. SETTING A gynaecological cancer centre in the UK. POPULATION Six hundred and eight women operated on for AOC over a period of 114 months at a tertiary cancer centre, between 16 August 2007 and 16 February 2017. METHODS Outcome data were analysed by six approaches to classify the extent of surgery: standard/ultra-radical surgery; standard/radical/supra-radical surgery; presence/absence of gastrointestinal resections; low/intermediate/high surgical complexity score (SCS); presence of bowel anastomoses and/or diaphragmatic surgery; and the presence/absence of multiple bowel resections. MAIN OUTCOME MEASURES Major (grades 3-5) postoperative morbidity and mortality. RESULTS Forty-three (7.1%) patients experienced major complications. Grade-5 complications occurred in six patients (1.0%). Patients who underwent multiple bowel resections had a relative risk (RR) of 7.73 (95% confidence interval, 95% CI 3.92-15.26), patients with a high SCS had an RR of 6.12 (95% CI 3.25-11.52), patients with diaphragmatic surgery and gastrointestinal anastomosis had an RR of 5.57 (95% CI 2.65-11.72), patients with 'any gastrointestinal resection' had an RR of 4.69 (95% CI 2.66-8.24), patients with ultra-radical surgery had an RR of 4.65 (95% CI 2.26-8.79), and patients with supra-radical surgery had an RR of 4.20 (95% CI 2.35-7.51) of grades 3-5 morbidity, compared with patients undergoing standard surgery as defined by the National Institute for Health and Care Excellence (NICE) in the UK. No significant difference was seen in the rate of major morbidity between standard (6/59, 10.2%) and ultra-radical (9/81, 11.1%) surgery within the cohort who had intermediate complex surgery (P > 0.05). CONCLUSIONS The numbers of procedures performed significantly correlate with major morbidity. The number of procedures performed better predicted major postoperative morbidity than the performance of certain 'high risk' procedures. We recommend using SCS to define a higher risk operation. NICE should re-evaluate the use of the term 'ultra-radical' surgery. TWEETABLE ABSTRACT Multiple bowel resection is the best predictor of morbidity and is more predictive than 'ultra-radical surgery'.
Collapse
|
94
|
P2772A novel approach for uric acid crystal detection in human coronary arteries with polarization-sensitive micro-OCT. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
95
|
P5525A meta-analysis of randomised controlled trials to compare safety and efficacy of everolimus/sirolimus bioabsorbable polymer with second-generation durable-polymer drug eluting stents. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
96
|
Sex determination by stapes. J ANAT SOC INDIA 2018. [DOI: 10.1016/j.jasi.2018.06.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
97
|
P5529A five-year follow-up of randomised studies comparing outcomes between bioabsorbable-polymer and durable-polymer drug-eluting stents: systematic review and meta-analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
98
|
Venous thromboembolism in cancer patients - magnitude of problem, approach, and management. Indian J Cancer 2018; 54:308-312. [PMID: 29199711 DOI: 10.4103/ijc.ijc_101_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Cancer is hypercoagulable state. Patients with cancer are at high risk to develop venous thromboembolism (VTE). Relative risk of developing VTE is approximately seven times higher in patients with active cancer. The incidence of occult malignancy is 7%-12% in patients with idiopathic deep vein thrombosis (DVT). However, little research has been focused on cancer with thromboembolism. Lowmolecularweight heparin most frequently used pharmacologic agents as recommended by established guidelines. The aim was to evaluate the magnitude of problem in cancer patients and treatment option as per established guidelines. EMBASE, MEDLINE, and PubMed search of the literature were done to evaluate the association of DVT with various malignancy, magnitude of problem, approach, and various guidelines for the management of DVT. References of all publication were also searched to enrich this article for recent update. Thromboprophylaxis in cancer patient is gray zone area. This need lot of investigational work to find highrisk patients who would benefit from primary thromboprophylaxis.
Collapse
|
99
|
Routine pre-operative group and save in minimally invasive laparoscopic surgery: A misuse of healthcare resources or a preventive measure? Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
100
|
Medical education in difficult circumstances: analysis of the experience of clinical medical students following the new innovative medical curriculum in Aksum, rural Ethiopia. BMC MEDICAL EDUCATION 2018; 18:119. [PMID: 29855298 PMCID: PMC5984342 DOI: 10.1186/s12909-018-1199-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 04/20/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND In 2012, 12 medical schools were opened in Ethiopia to tackle the significant shortage of doctors. This included Aksum School of Medicine situated in Aksum, a rural town in Northern Ethiopia. The new Innovative Medical Curriculum (NIMC) is a four-year programme designed by the Ethiopian Federal Ministries of Health and Education. The curriculum is designed to train biomedical science graduates to become doctors in 4 years, with a focus on the healthcare needs of rural people living in poverty. METHODS This research was conducted at Aksum School of Medicine and included two hospitals (Aksum Referral Hospital and St Mary's District Hospital). This study focused on medical students during their clinical years across multiple specialities (61 Clerkship 1 students and 13 Clerkship 2 students). We used primarily qualitative research methods supplemented with quantitative measures. There were 3 stages of data collection over a 1 month period, this included qualitative group interviews, direct observation of students in a clinical setting and direct observation of skills sessions followed by a questionnaire on the sessions. We analysed the data by reconstructing the student experience and comparing it with the NIMC. RESULTS The proposed typical week set out in the NIMC tended to differ from the real clinical experience of these students. Through qualitative group interview and direct observation of teaching, the main theme that was consistent throughout was the lack of doctors with specialist postgraduate training. Clinical need often took priority over education. However, students enjoyed taking early responsibility and gaining practical experience. Through direct observation of skills sessions and short questionnaires, these sessions were highly valuable to the students and they felt confident in carrying out the taught procedures in the future. CONCLUSIONS The combination of poorly resourced hospitals and lack of specialist doctors provides a challenging environment for medical students to learn. However, it is a unique clinical experience that is rarely seen in developed countries and facilitates the acquirement of skills from an early stage. Supervision and specialist input is fundamental in enabling students to learn and this is a key area that was lacking in the students' clinical experience.
Collapse
|