Preliminary validation of serotransferrin and vitamin D binding protein in the gingival crevicular fluid as candidate biomarkers for pubertal growth peak in subjects with Class I and Class II malocclusion

xloma.fota13 shared this article with you from Inoreader Preliminary validation of serotransferrin and vitamin D binding protein in the gingival crevicular fluid as candidate biomarkers for pubertal growth peak in subjects with Class I and Class II malocclusion Via http://rss.sciencedirect.com/publication/science/08895406 Publication date: Available online 3 February 2021 Source: American Journal of Orthodontics and Dentofacial Orthopedics Author(s): Xi Wen, Yan Gu View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Initial Safety Trial Results Find Increased Risk of Serious Heart-Related Problems and Cancer with Xeljanz, Xeljanz XR (tofacitinib)

xloma.fota13 shared this article with you from Inoreader Initial Safety Trial Results Find Increased Risk of Serious Heart-Related Problems and Cancer with Xeljanz, Xeljanz XR (tofacitinib) Via Drugs.com - FDA MedWatch Alerts Audience: Consumer, Patient, Health Professional, Pharmacy February 4, 2021 -- The U.S. Food and Drug Administration (FDA) is alerting the public that preliminary results from a safety clinical trial show an increased risk of serious heart-related... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mīlle viae dūcunt hominēs per saecula Rōmam

xloma.fota13 shared this article with you from Inoreader Reply: Mīlle viae dūcunt hominēs per saecula Rōmam Via The Journal of Thoracic and Cardiovascular Surgery I read with great interest the author's letter based on their article reporting exemplary outcomes using bilateral internal thoracic arteries among elderly patients receiving coronary artery bypass grafting.1 "Mīlle viae dūcunt hominēs per saecula Rōmam" translated from the Latin means "a thousand roads lead men forever to Rome." This phrase likely refers to the "Millarium Aureum," a monument erected by the Emperor Caesar Augustus in central Rome. However, proverbially, it translates to the idea that there are many acceptable ways to reach the same goal. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of positive end-expiratory pressure/recruitment manoeuvres compared with zero end-expiratory pressure on atelectasis in children as tracked by ultrasound: A randomised clinical trial

xloma.fota13 shared this article with you from Inoreader Effects of positive end-expiratory pressure/recruitment manoeuvres compared with zero end-expiratory pressure on atelectasis in children as tracked by ultrasound: A randomised clinical trial Via European Journal of Anaesthesiology (EJA) - Published Ahead-of-Print BACKGROUND Atelectasis is a common postoperative complication. Peri-operative lung protection can reduce atelectasis; however, it is not clear whether this persists into the postoperative period. OBJECTIVE To evaluate to what extent lung-protective ventilation reduces peri-operative atelectasis in children undergoing nonabdominal surgery. DESIGN Randomised, controlled, double-blind study. SETTING Single tertiary hospital, 25 July 2019 to 18 January 2020. PATIENTS A total of 60 patients aged 1 to 6 years, American Society of Anesthesiologists physical status 1 or 2, planned for nonabdominal surgery under general anaesthesia (≤2 h) with mechanical ventilation. INTERVENTIONS The patients were assigned randomly into either the lung-protective or zero end-expiratory pressure with no recruitment manoeuvres (control) group. Lung protection entailed 5 cmH2O positive end-expiratory pressure and recruitment manoeuvres every 30 min. Both groups received volume-controlled ventilation with a tidal volume of 6 ml kg−1 body weight. Lung ultrasound was conducted before anaesthesia induction, immediately after induction, surgery and tracheal extubation, and 15 min, 3 h, 12 h and 24 h after extubation. MAIN OUTCOME MEASURES The difference in lung ultrasound score between groups at each interval. A higher score indicates worse lung aeration. RESULTS Patients in the lung-protective group exhibited lower median [IQR] ultrasound scores compared with the control group immediately after surgery, 4 [4 to 5] vs. 8 [4 to 6], (95% confidence interval for the difference between group values −4 to −4, Z = -6.324) and after extubation 3 [3 to 4] vs. 4 [4 to 4], 95% CI −1 to 0, Z = −3.161. This did not persist from 15 min after extubation onwards. Lung aeration returned to normal in both groups 3 h after extubation. CONCLUSIONS The reduced atelectasis provided by lung-protective ventilation does not persist from 15 min after extubation onwards. Further studies are needed to determine if it yields better results in other types of surgery. TRIAL REGISTRATION Chictr.org.cn (ChiCTR2000033469). Correspondence to Rong Wei, Department of Anaesthesiology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China. Tel: +86 13801662704; e-mail: Rongwei2014@163.com This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 © 2021 European Society of Anaesthesiology View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

National outcomes and characteristics of patients admitted to Swedish intensive care units for COVID-19: A registry-based cohort study

xloma.fota13 shared this article with you from Inoreader National outcomes and characteristics of patients admitted to Swedish intensive care units for COVID-19: A registry-based cohort study Via European Journal of Anaesthesiology (EJA) - Published Ahead-of-Print BACKGROUND Mortality among patients admitted to intensive care units (ICUs) with COVID-19 is unclear due to variable follow-up periods. Few nationwide data are available to compare risk factors, treatment and outcomes of COVID-19 patients after ICU admission. OBJECTIVE To evaluate baseline characteristics, treatments and 30-day outcomes of patients admitted to Swedish ICUs with COVID-19. DESIGN Registry-based cohort study with prospective data collection. SETTING Admissions to Swedish ICUs from 6 March to 6 May 2020 with laboratory confirmed COVID-19 disease. PARTICIPANTS Adult patients admitted to Swedish ICUs. EXPOSURES Baseline characteristics, intensive care treatments and organ failures. MAIN OUTCOMES AND MEASURES The primary outcome was 30-day all-cause mortality. A multivariable model was used to determine the independent association between potential predictor variables and death. RESULTS We identified 1563 patients with complete 30-day follow-up. The 30-day all-cause mortality was 26.7%. Median age was 61 [52 to 69], Simplified Acute Physiology Score III (SAPS III) was 53 [46 to 59] and 62.5% had at least one comorbidity. Median PaO2/FiO2 on admission was 97.5 [75.0 to 140.6] mmHg, 74.7% suffered from moderate-to-severe acute respiratory failure. Age, male sex [adjusted odds ratio (aOR) 1.5 (1.1 to 2.2)], SAPS III score [aOR 1.3 (1.2 to 1.4)], severe respiratory failure [aOR 3.0 (2.0 to 4.7)], specific COVID-19 pharmacotherapy [aOR 1.4 (1.0 to 1.9)] and continuous renal replacement therapy [aOR 2.1 (1.5 to 3.0)] were associated with increased mortality. Except for chronic lung disease, the presence of comorbidities was not independently associated with mortality. CONCLUSIONS Thirty-day mortality rate in COVID-19 patients admitted to Swedish ICUs is generally lower than previously reported despite a severe degree of hypoxaemia on admission. Mortality was driven by age, baseline disease severity, the presence and degree of organ failure, rather than pre-existing comorbidities. TRIAL REGISTRATION NO NCT04462393 Correspondence to Michelle S. Chew, Departments of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Linköping University Hospital, Linköping S-58185, Sweden. Tel: +46 13 282452; e-mail: michelle.chew@liu.se Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com). © 2021 European Society of Anaesthesiology View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Physostigmine for prevention of postoperative delirium and long-term cognitive dysfunction in liver surgery: A double-blinded randomised controlled trial

xloma.fota13 shared this article with you from Inoreader Physostigmine for prevention of postoperative delirium and long-term cognitive dysfunction in liver surgery: A double-blinded randomised controlled trial Via European Journal of Anaesthesiology (EJA) - Published Ahead-of-Print BACKGROUND Anecdotally, cholinergic stimulation has been used to treat delirium and reduce cognitive dysfunction. OBJECTIVE The aim of this investigation was to evaluate whether physostigmine reduced the incidence of postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) in patients undergoing liver resection. DESIGN This was a double-blind, randomised, placebo-controlled trial. Between 11 August 2009 and 3 March 2016, patients were recruited at the Charité – Universitätsmedizin Berlin in Germany. Follow-ups took place at 1 week (T1), 90 days (T2) and 365 days (T3) after surgery. SETTING This single-centre study was conducted at an academic medical centre. PARTICIPANTS In total, 261 participants aged at least 18 years scheduled for elective liver surgery were randomised. The protocol also included 45 nonsurgical matched controls to provide normative data for POCD and neurocognitive deficit (NCD). INTERVENTION Participants were allocated to receive either intravenous physostigmine, as a bolus of 0.02 mg kg−1 body weight followed by 0.01 mg kg−1 body weight per hour (n = 130), or placebo (n = 131), for 24 h after induction of anaesthesia. MAIN OUTCOMES AND MEASURES Primary outcomes were POD, assessed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-4-TR) twice daily up to day 7 after surgery, and POCD assessed via the CANTAB neuropsychological test battery, and two paper pencil tests on the day before surgery, and on postoperative days 7, 90 and 365. RESULTS In total, 261 patients were randomised, 130 to the physostigmine and 131 to the placebo group. The incidence of POD did not differ significantly between the physostigmine and placebo groups (20 versus 15%; P = 0.334). Preoperative cognitive impairment and POCD frequencies did not differ significantly between the physostigmine and placebo groups at any time. Lower mortality rates were found in the physostigmine group compared with placebo at 3 months [2% (95% confidence interval (CI), 0 to 4) versus 11% (95% CI, 6 to 16), P = 0.002], and 6 months [7% (95% CI, 3 to 12) versus 16% (95% CI, 10 to 23), P = 0.012] after surgery. CONCLUSION Physostigmine had no effect on POD and POCD when applied after induction of anaesthesia up to 24 h. TRIAL REGISTRATION DOI 10.1186/ISRCTN18978802, EudraCT 2008-007237-47, Ethics approval ZS EK 11 618/08 (15 January 2009). Correspondence to Claudia D. Spies, MD, PhD, Full Professor of Anaesthesiology and Intensive Care Medicine, Department of Anaesthesiology and Intensive Care Medicine (CCM, CVK), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, D-13353 Berlin, Germany. Tel: +49 30 450 551 102; fax: +49 30 450 551 909; e-mail: claudia.spies@charite.de Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.ejanaesthesiology.com). © 2021 European Society of Anaesthesiology View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Discontinuation of Transmission Precautions for COVID-19 Patients: Polymerase Chain Reaction Diagnostics, Patient Delays, and Cycle Threshold Values

xloma.fota13 shared this article with you from Inoreader Discontinuation of Transmission Precautions for COVID-19 Patients: Polymerase Chain Reaction Diagnostics, Patient Delays, and Cycle Threshold Values Via Infectious Diseases in Clinical Practice - Published Ahead-of-Print Background The decision of when it is safe to discontinue transmission-based precautions for SARS-CoV-2 coronavirus disease-2019 (COVID-19) hospitalized patients has been controversial. The Centers for Disease Control and Prevention offered reverse transcriptase polymerase chain reaction (PCR) diagnostic test- or symptom-based guidelines. Methods A retrospective chart review of Vidant Health system, Eastern North Carolina, was conducted. Length of stay, days in isolation unit, and date appropriate for discharge or isolation discontinuation based on the symptom-based strategy were recorded. Results Of 196 COVID hospitalized patients, 34 had repeated COVID PCR tests 3 or more days from their first positive test result. Half of these patients experienced delays in release from transmission-based precautions because of repeated positive PCR test results and use of the test-based approach. This resulted in an additional 166 days of hospitalization, costing an estimated $415,000. Furthermore, 2 subjects had a combined 16-day delay in necessary medical procedures. Most of the COVID PCR platforms yield quantitative results in the form of cycle threshold (Ct) values, the number of cycles needed to detect the genome. These values have also been used to assess whether patients are likely to remain contagious. None of our patients who met the criteria for symptom-based strategy for transmission-based precaution discontinuation had positive PCR test results with Ct values lower than 25, but 4 had Ct values lower than 30. Conclusions Concerns surround immunocompromised patients and those treated with steroids who might be delayed or incapable of stopping viral replication and thus remain contagious. Our results suggest that clinicians use all available data including Ct values to evaluate the safety of discontinuation of transmission precautions. Correspondence to: Rahim A. Jiwani, MD, 600 Moye Blvd, Vidant Medical Center MA-350, Greenville, NC 27834. E-mail: jiwanir19@ecu.edu. The authors have no funding or conflicts of interest to disclose. This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.