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[PMID]: 25374819
[Au] Autor:Esposito P; Dal Canton A
[Ad] Address:Pasquale Esposito, Antonio Dal Canton, Unit of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo and University of Pavia, 27100 Pavia, Italy.
[Ti] Title:Clinical audit, a valuable tool to improve quality of care: General methodology and applications in nephrology.
[So] Source:World J Nephrol;3(4):249-55, 2014 Nov 6.
[Is] ISSN:2220-6124
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Evaluation and improvement of quality of care provided to the patients are of crucial importance in the daily clinical practice and in the health policy planning and financing. Different tools have been developed, including incident analysis, health technology assessment and clinical audit. The clinical audit consist of measuring a clinical outcome or a process, against well-defined standards set on the principles of evidence-based medicine in order to identify the changes needed to improve the quality of care. In particular, patients suffering from chronic renal diseases, present many problems that have been set as topics for clinical audit projects, such as hypertension, anaemia and mineral metabolism management. Although the results of these studies have been encouraging, demonstrating the effectiveness of audit, overall the present evidence is not clearly in favour of clinical audit. These findings call attention to the need to further studies to validate this methodology in different operating scenarios. This review examines the principle of clinical audit, focusing on experiences performed in nephrology settings.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1411
[Da] Date of entry for processing:141106
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.5527/wjn.v3.i4.249

  2 / 1860677 MEDLINE  
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[PMID]: 25374806
[Au] Autor:Elhoufi A; Ahmadi A; Asnaashari AM; Davarpanah MA; Bidgoli BF; Moghaddam OM; Torabi-Nami M; Abbasi S; El-Sobky M; Ghaziani A; Jarrahzadeh MH; Shahrami R; Shirazian F; Soltani F; Yazdinejad H; Zand F
[Ad] Address:Ashraf Elhoufi, Department of Critical Care Medicine, Dubai Hospital, Dubai Health Authority, Dubai 7272, United Arab Emirates....
[Ti] Title:Invasive candidiasis in critical care setting, updated recommendations from "Invasive Fungal Infections-Clinical Forum", Iran.
[So] Source:World J Crit Care Med;3(4):102-12, 2014 Nov 4.
[Is] ISSN:2220-3141
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Invasive candidiasis (IC) bears a high risk of morbidity and mortality in the intensive care units (ICU). With the current advances in critical care and the use of wide-spectrum antibiotics, invasive fungal infections (IFIs) and IC in particular, have turned into a growing concern in the ICU. Further to blood cultures, some auxiliary laboratory tests and biomarkers are developed to enable an earlier detection of infection, however these test are neither consistently available nor validated in our setting. On the other hand, patients' clinical status and local epidemiology data may justify the empiric antifungal approach using the proper antifungal option. The clinical approach to the management of IC in febrile, non-neutropenic critically ill patients has been defined in available international guidelines; nevertheless such recommendations need to be customized when applied to our local practice. Over the past three years, Iranian experts from intensive care and infectious diseases disciplines have tried to draw a consensus on the management of IFI with a particular focus on IC in the ICU. The established IFI-clinical forum (IFI-CF), comprising the scientific leaders in the field, has recently come up with and updated recommendation on the same (June 2014). The purpose of this review is to put together literature insights and Iranian experts' opinion at the IFI-CF, to propose an updated practical overview on recommended approaches for the management of IC in the ICU.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1411
[Da] Date of entry for processing:141106
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.5492/wjccm.v3.i4.102

  3 / 1860677 MEDLINE  
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[PMID]: 25374805
[Au] Autor:Andersen C; Afshari A
[Ad] Address:Cheme Andersen, Arash Afshari, Department of Anaesthesiology, Juliane Marie Centre, Rigshospitalet, 2100 Copenhagen, Denmark.
[Ti] Title:Impact of perioperative hyponatremia in children: A narrative review.
[So] Source:World J Crit Care Med;3(4):95-101, 2014 Nov 4.
[Is] ISSN:2220-3141
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:For more than 50 years, hypotonic fluids (crystalloids) have been the standard for maintenance fluid used in children. In the last decade, several studies have evaluated the risk of hyponatremia associated with the use of hypotonic vs isotonic fluids, which has lead to an intense debate. Children undergoing surgery have several stimuli for release of antidiuretic hormone, which controls renal water handling, including pain, nausea, vomiting, narcotic use and blood loss. The body's primary defense against the development of hyponatremia is the ability of the kidneys to excrete free water and dilute urine. Increased levels of antidiuretic hormone can result in hyponatremia, defined as a plasma sodium level < 136 mmol/L, which causes cells to draw in excess water and swell. This manifests as central nervous system symptoms such as lethargy, irritability and seizures. The risk for symptomatic hyponatremia is higher in children than in adults. It represents an emergency condition, and early diagnosis, prompt treatment and close monitoring are essential to reduce morbidity and mortality. The widespread use of hypotonic fluids in children undergoing surgery is a matter of concern and more focus on this topic is urgently needed. In this paper, we review the literature and describe the impact of perioperative hyponatremia in children.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1411
[Da] Date of entry for processing:141106
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.5492/wjccm.v3.i4.95

  4 / 1860677 MEDLINE  
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[PMID]: 25374804
[Au] Autor:Cotogni P; Pittiruti M
[Ad] Address:Paolo Cotogni, Anesthesiology and Intensive Care, Department of Medicine, S. Giovanni Battista Hospital, University of Turin, 10123 Turin, Italy.
[Ti] Title:Focus on peripherally inserted central catheters in critically ill patients.
[So] Source:World J Crit Care Med;3(4):80-94, 2014 Nov 4.
[Is] ISSN:2220-3141
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Venous access devices are of pivotal importance for an increasing number of critically ill patients in a variety of disease states and in a variety of clinical settings (emergency, intensive care, surgery) and for different purposes (fluids or drugs infusions, parenteral nutrition, antibiotic therapy, hemodynamic monitoring, procedures of dialysis/apheresis). However, healthcare professionals are commonly worried about the possible consequences that may result using a central venous access device (CVAD) (mainly, bloodstream infections and thrombosis), both peripherally inserted central catheters (PICCs) and centrally inserted central catheters (CICCs). This review aims to discuss indications, insertion techniques, and care of PICCs in critically ill patients. PICCs have many advantages over standard CICCs. First of all, their insertion is easy and safe -due to their placement into peripheral veins of the arm- and the advantage of a central location of catheter tip suitable for all osmolarity and pH solutions. Using the ultrasound-guidance for the PICC insertion, the risk of hemothorax and pneumothorax can be avoided, as well as the possibility of primary malposition is very low. PICC placement is also appropriate to avoid post-procedural hemorrhage in patients with an abnormal coagulative state who need a CVAD. Some limits previously ascribed to PICCs (i.e., low flow rates, difficult central venous pressure monitoring, lack of safety for radio-diagnostic procedures, single-lumen) have delayed their start up in the intensive care units as common practice. Though, the recent development of power-injectable PICCs overcomes these technical limitations and PICCs have started to spread in critical care settings. Two important take-home messages may be drawn from this review. First, the incidence of complications varies depending on venous accesses and healthcare professionals should be aware of the different clinical performance as well as of the different risks associated with each type of CVAD (CICCs or PICCs). Second, an inappropriate CVAD choice and, particularly, an inadequate insertion technique are relevant-and often not recognized-potential risk factors for complications in critically ill patients. We strongly believe that all healthcare professionals involved in the choice, insertion or management of CVADs in critically ill patients should know all potential risk factors of complications. This knowledge may minimize complications and guarantee longevity to the CVAD optimizing the risk/benefit ratio of CVAD insertion and use. Proper management of CVADs in critical care saves lines and lives. Much evidence from the medical literature and from the clinical practice supports our belief that, compared to CICCs, the so-called power-injectable peripherally inserted central catheters are a good alternative choice in critical care.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1411
[Da] Date of entry for processing:141106
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.5492/wjccm.v3.i4.80

  5 / 1860677 MEDLINE  
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[PMID]: 25374803
[Au] Autor:Timmers TK; Verhofstad MH; Moons KG; Leenen LP
[Ad] Address:Tim K Timmers, Luke PH Leenen, Department of Surgery, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands....
[Ti] Title:Intensive care performance: How should we monitor performance in the future?
[So] Source:World J Crit Care Med;3(4):74-9, 2014 Nov 4.
[Is] ISSN:2220-3141
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Intensive care faces economic challenges. Therefore, evidence proving both effectiveness and efficiency, i.e., cost-effectiveness, of delivered care is needed. Today, the quality of care is an important issue in the health care debate. How do we measure quality of care and how accurate and representative is this measurement? In the following report, several topics which are used for the evaluation of intensive care unit (ICU) performance are discussed: (1) The use of general outcome prediction models to determine the risk of patients who are admitted to ICUs in an increasing variety of case mix for the different intensive care units, together with three major limitations; (2) As critical care outcomes research becomes a more established entity, mortality is now only one of many endpoints that are relevant. Mortality is a limited outcome when assessing critical care performance, while patient interest in quality of life outcomes is relevant; and (3) The Quality Indicators Committee of the Society of Critical Care Medicine recommended that short-term readmission is a major performance indicator of the quality of intensive care medicine.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Da] Date of entry for processing:141106
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.5492/wjccm.v3.i4.74

  6 / 1860677 MEDLINE  
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[PMID]: 25372082
[Au] Autor:Sayin E; Baran ET; Hasirci V
[Ad] Address:METU, Department of Biotechnology, Ankara, Turkey.
[Ti] Title:Protein-based materials in load-bearing tissue-engineering applications.
[So] Source:Regen Med;9(5):687-701, 2014 Sep.
[Is] ISSN:1746-076X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Proteins such as collagen and elastin are robust molecules that constitute nanocomponents in the hierarchically organized ultrastructures of bone and tendon as well as in some of the soft tissues that have load-bearing functions. In the present paper, the macromolecular structure and function of the proteins are reviewed and the potential of mammalian and non-mammalian proteins in the engineering of load-bearing tissue substitutes are discussed. Chimeric proteins have become an important structural biomaterial source and their potential in tissue engineering is highlighted. Processing of proteins challenge investigators and in this review rapid prototyping and microfabrication are proposed as methods for obtaining precisely defined custom-built tissue engineered structures with intrinsic microarchitecture.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.2217/rme.14.52

  7 / 1860677 MEDLINE  
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[PMID]: 25372081
[Au] Autor:Smith RK; Garvican ER; Fortier LA
[Ad] Address:Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, UK.
[Ti] Title:The current 'state of play' of regenerative medicine in horses: what the horse can tell the human.
[So] Source:Regen Med;9(5):673-85, 2014 Sep.
[Is] ISSN:1746-076X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:The horse is an attractive model for many human age-related degenerative diseases of the musculoskeletal system because it is a large animal species that both ages and exercises, and develops naturally occurring injuries with many similarities to the human counterpart. It therefore represents an ideal species to use as a 'proving ground' for new therapies, most notably regenerative medicine. Regenerative techniques using cell-based therapies for the treatment of equine musculoskeletal disease have been in use for over a decade. This review article provides a summary overview of the sources, current challenges and problems surrounding the use of stem cell and non-cell-based therapy in regenerative medicine in horses and is based on presentations from a recent Havemeyer symposium on equine regenerative medicine where speakers are selected from leading authorities in both equine and human regenerative medicine fields from 10 different countries.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.2217/rme.14.42

  8 / 1860677 MEDLINE  
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[PMID]: 25372080
[Au] Autor:Buzhor E; Leshansky L; Blumenthal J; Barash H; Warshawsky D; Mazor Y; Shtrichman R
[Ad] Address:LifeMap Sciences Ltd, Tel Aviv, Israel.
[Ti] Title:Cell-based therapy approaches: the hope for incurable diseases.
[So] Source:Regen Med;9(5):649-72, 2014 Sep.
[Is] ISSN:1746-076X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Cell therapies aim to repair the mechanisms underlying disease initiation and progression, achieved through trophic effect or by cell replacement. Multiple cell types can be utilized in such therapies, including stem, progenitor or primary cells. This review covers the current state of cell therapies designed for the prominent disorders, including cardiovascular, neurological (Parkinson's disease, amyotrophic lateral sclerosis, stroke, spinal cord injury), autoimmune (Type 1 diabetes, multiple sclerosis, Crohn's disease), ophthalmologic, renal, liver and skeletal (osteoarthritis) diseases. Various cell therapies have reached advanced clinical trial phases with potential marketing approvals in the near future, many of which are based on mesenchymal stem cells. Advances in pluripotent stem cell research hold great promise for regenerative medicine. The information presented in this review is based on the analysis of the cell therapy collection detailed in LifeMap Discovery(®) (LifeMap Sciences Inc., USA) the database of embryonic development, stem cell research and regenerative medicine.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.2217/rme.14.35

  9 / 1860677 MEDLINE  
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[PMID]: 25372079
[Au] Autor:Allers C; Jones JA; Lasala GP; Minguell JJ
[Ad] Address:TCA Cellular Therapy, LLC, 101 Judge Tanner Blvd, Suite 502, Covington, LA 70433, USA.
[Ti] Title:Mesenchymal stem cell therapy for the treatment of amyotrophic lateral sclerosis: signals for hope?
[So] Source:Regen Med;9(5):637-47, 2014 Sep.
[Is] ISSN:1746-076X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Based on the distinctive cellular, molecular and immunomodulatory traits of mesenchymal stem cells (MSC), it has been postulated that these cells may play a critical role in regenerative medicine. In addition to the participation of MSC in the repair of mesodermal-derived tissues (bone, cartilage), robust data have suggested that MSC may also play a reparative role in conditions involving damage of cells of ectodermal origin. The above content has been supported by the capability of MSC to differentiate into neuron-like cells as well as by a competence to generate a 'neuroprotective' environment. In turn, several preclinical studies have put forward the concept that MSC therapy may represent an option for the treatment of several neurological disorders and injuries, including amyotrophic lateral sclerosis. We expect that the above foundations, which have inspired this review, may result in the founding of an effective and/or palliative therapy for amyotrophic lateral sclerosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.2217/rme.14.30

  10 / 1860677 MEDLINE  
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[PMID]: 25372078
[Au] Autor:Vanacker J; Dolmans MM; Luyckx V; Donnez J; Amorim CA
[Ad] Address:Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1200 Brussels, Belgium.
[Ti] Title:First transplantation of isolated murine follicles in alginate.
[So] Source:Regen Med;9(5):609-19, 2014 Sep.
[Is] ISSN:1746-076X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:AIM: Our aim is to develop an artificial ovary allowing survival and growth of isolated follicles and ovarian cells, to restore fertility in women diagnosed with pathologies at high risk of ovarian involvement. MATERIALS & METHODS: For this, alginate beads containing isolated preantral follicles and ovarian cells were autografted to immunocompetent mice. One week after grafting, the beads were invaded by proliferating murine cells (12.1%) and capillaries. RESULTS: The recovery rate of follicles per graft ranged from 0% to 35.5%. Of the analyzed follicles, 77% were Ki67-positive and 81%, TUNEL-negative. Three antral follicles were also identified, evidencing their ability to grow in the matrix. CONCLUSION: Our results suggest that an artificial ovary is now conceivable, opening new perspectives to restore fertility in women.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1411
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.2217/rme.14.33


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