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[PMID]: 25596602
[Au] Autor:Jones JM; Richter LM; Alonto A; Leedahl DD
[Ad] Address:Justin M. Jones, Pharm.D., is Postgraduate Year 1 Pharmacy Resident; Lisa M. Richter, Pharm.D., BCPS, is Postgraduate Year 1 Pharmacy Residency Director; Augusto Alonto, M.D., is Infectious Disease Physician, Division of Infectious Diseases; and David D. Leedahl, Pharm.D., BCPS, is Clinical Pharmacy...
[Ti] Title:Desensitization to ceftaroline in a patient with multiple medication hypersensitivity reactions.
[So] Source:Am J Health Syst Pharm;72(3):198-202, 2015 Feb 1.
[Is] ISSN:1535-2900
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: The case of a patient with multiple medication hypersensitivity reactions and a methicillin-resistant Staphylococcus aureus (MRSA) infection who underwent desensitization to ceftaroline is reported. SUMMARY: A 32-year-old Caucasian woman with asthma, gastroesophageal reflux disease, heart murmur, and major depression was admitted for MRSA cellulitis with a subcutaneous abscess along the left sternomanubrial joint and clavicular osteomyelitis secondary to port placement after gastric bypass surgery. The patient had an extensive history of hypersensitivity reactions. Pertinent documented allergies were as follows: penicillin (anaphylaxis), daptomycin (anaphylaxis), vancomycin (hives), linezolid (hives), ertapenem (rash), ciprofloxacin (rash), and tigecycline (rash). The patient also reported previous reactions to aztreonam (unknown) and gentamicin (hives). The pharmacy was consulted to develop a desensitization protocol for ceftaroline. The desensitization protocol used three serial dilutions of ceftaroline to make 14 sequential infusions with escalating doses. Intramuscular epinephrine, i.v. diphenhydramine, and i.v. methylprednisolone were ordered as needed for the development of immediate hypersensitivity reactions during or after administration of ceftaroline. The cumulative dose (574.94 mg) was administered intravenously over 225 minutes with no breakthrough symptoms reported during or after the desensitization protocol. Ceftaroline fosamil 600 mg i.v. every 12 hours was continued for six weeks. CONCLUSION: Desensitization to ceftaroline was conducted for a patient with extensive history of hypersensitivity reactions to other drugs, including penicillin-induced anaphylaxis. Desensitization and subsequent treatment with full doses of ceftaroline were accomplished without apparent adverse effects.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.2146/ajhp140151

  2 / 1427580 MEDLINE  
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[PMID]: 25022673
[Au] Autor:Jensen-Otsu E; Ward EK; Mitchell B; Schoen JA; Rothchild K; Mitchell NS; Austin GL
[Ad] Address:Department of Medicine, University of Colorado Denver, 12631 E. 17th Ave., Room 8603, Aurora, CO, USA, elsbeth.jensen-otsu@ucdenver.edu.
[Ti] Title:The Effect of Medicaid Status on Weight Loss, Hospital Length of Stay, and 30-Day Readmission After Laparoscopic Roux-en-Y Gastric Bypass Surgery.
[So] Source:Obes Surg;25(2):295-301, 2015 Feb.
[Is] ISSN:1708-0428
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Patients with Medicaid are much less likely to undergo bariatric surgery compared to those with commercial insurance. The aims of this study were to compare outcomes after laparoscopic Roux-en-Y gastric bypass (LRYGB) for patients covered by Medicaid, other (non-Medicaid) government insurance, and commercial insurance. METHODS: This was a retrospective cohort study of all eligible patients who underwent LRYGB between July 2004 and October 2011 at a single university hospital (n = 450). Multivariable regression analysis was used to compare percent weight loss (PWL), absolute weight loss (AWL), hospital length of stay (LOS) ≥3 days, and 30-day readmission rates. Analyses were adjusted for appropriate covariates. RESULTS: There was a nonsignificant increase in PWL in Medicaid patients at 2 months (p = 0.08), 6 months (p = 0.09), and 12 months (p = 0.17) compared to commercial insurance patients. Similarly, there was a nonsignificant increase in AWL in Medicaid patients at 2 months (p = 0.054), 6 months (p = 0.08), and 12 months (p = 0.14) compared to commercial insurance patients. Medicaid patients had similar PWL and AWL compared to those with other government insurance (p ≥ 0.29 at all time points). Medicaid patients were more likely to have a hospital LOS ≥ 3 days (OR 2.03; 95 % confidence interval (CI) 1.09-3.77) and a hospital readmission within 30 days of discharge (odds ratio (OR) 2.84; 95 % CI 1.15-6.96) compared to commercial insurance patients. CONCLUSIONS: These data should be considered as states expand Medicaid and make decisions regarding treatment of severe obesity. Interventions to decrease hospital LOS and the 30-day readmission rate, particularly in Medicaid patients, should be explored.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Cu] Class update date: 150117
[Lr] Last revision date:150117
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1007/s11695-014-1367-y

  3 / 1427580 MEDLINE  
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[PMID]: 25549194
[Au] Autor:Swanson KI; Clark PA; Zhang RR; Kandela IK; Farhoud M; Weichert JP; Kuo JS
[Ad] Address:*Department of Neurological Surgery, ‡Cellular and Molecular Biology Training Program, ¶Department of Radiology, ‖Department Medical Physics, and #Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; §Cellectar Biosciences, Inc, Madison, Wisconsin; **Department of Surgery, National University of Singapore, Singapore.
[Ti] Title:Fluorescent cancer-selective alkylphosphocholine analogs for intraoperative glioma detection.
[So] Source:Neurosurgery;76(2):115-24, 2015 Feb.
[Is] ISSN:1524-4040
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: 5-Aminolevulinic acid (5-ALA)-induced tumor fluorescence aids brain tumor resections but is not approved for routine use in the United States. We developed and describe testing of 2 novel fluorescent, cancer-selective alkylphosphocholine analogs, CLR1501 (green) and CLR1502 (near infrared), in a proof-of-principle study for fluorescence-guided glioma surgery. OBJECTIVE: To demonstrate that CLR1501 and CLR1502 are cancer cell-selective fluorescence agents in glioblastoma models and to compare tumor-to-normal brain (T:N) fluorescence ratios with 5-ALA. METHODS: CLR1501, CLR1502, and 5-ALA were administered to mice with magnetic resonance imaging-verified orthotopic U251 glioblastoma multiforme- and glioblastoma stem cell-derived xenografts. Harvested brains were imaged with confocal microscopy (CLR1501), the IVIS Spectrum imaging system (CLR1501, CLR1502, and 5-ALA), or the Fluobeam near-infrared fluorescence imaging system (CLR1502). Imaging and quantitative analysis of T:N fluorescence ratios were performed. RESULTS: Excitation/emission peaks are 500/517 nm for CLR1501 and 760/778 nm for CLR1502. The observed T:N ratio for CLR1502 (9.28 ± 1.08) was significantly higher (P < .01) than for CLR1501 (3.51 ± 0.44 on confocal imaging; 7.23 ± 1.63 on IVIS imaging) and 5-ALA (4.81 ± 0.92). Near-infrared Fluobeam CLR1502 imaging in a mouse xenograft model demonstrated high- contrast tumor visualization compatible with surgical applications. CONCLUSION: CLR1501 (green) and CLR1502 (near infrared) are novel tumor-selective fluorescent agents for discriminating tumor from normal brain. CLR1501 exhibits a tumor-to-brain fluorescence ratio similar to that of 5-ALA, whereas CLR1502 has a superior tumor-to-brain fluorescence ratio. This study demonstrates the potential use of CLR1501 and CLR1502 in fluorescence-guided tumor surgery. ABBREVIATIONS: APC, alkylphosphocholine5-ALA, 5-aminolevulinic acidGBM, glioblastoma multiformeGSC, glioblastoma stem cellGTR, gross total resectionHGG, high-grade gliomaPBS, phosphate-buffered solutionPpIX, protoporphyrin IXT:N, tumor to normal brain.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Cu] Class update date: 150117
[Lr] Last revision date:150117
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1227/NEU.0000000000000622

  4 / 1427580 MEDLINE  
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[PMID]: 25271380
[Au] Autor:Hoover DB; Ozment TR; Wondergem R; Li C; Williams DL
[Ad] Address:*Department of Biomedical Sciences, †Department of Surgery, and ‡Center for Inflammation, Infectious Disease and Immunity, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee.
[Ti] Title:Impaired heart rate regulation and depression of cardiac chronotropic and dromotropic function in polymicrobial sepsis.
[So] Source:Shock;43(2):185-91, 2015 Feb.
[Is] ISSN:1540-0514
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The scope of cardiac pathophysiology in sepsis has not been fully defined. Accordingly, we evaluated the effects of sepsis on heart rate (HR), HR variability, and conduction parameters in a murine model of sepsis. Electrocardiograms were recorded noninvasively from conscious mice before and after cecal ligation and puncture (CLP) or sham surgery. Responses of isolated atria to tyramine and isoproterenol were quantified to assess the functional state of sympathetic nerves and postjunctional sensitivity to adrenergic stimulation. Cecal ligation and puncture mice had lower HR compared with sham at 16 to 18 h postsurgery (sham, 741 ± 7 beats/min; CLP, 557 ± 31 beats/min; n = 6/group; P < 0.001), and there was significant prolongation of the PR, QRS, and QTc intervals. Slowing of HR and conduction developed within 4 to 6 h after CLP and were preceded by a decrease in HR variability. Treatment of CLP mice with isoproterenol (5 mg/kg, intraperitoneally) at 25 h after surgery failed to increase HR or decrease conduction intervals. The lack of in vivo response to isoproterenol cannot be attributed to hypothermia because robust chronotropic and inotropic responses to isoproterenol were evoked from isolated atria at 25°C and 30°C. These findings demonstrate that impaired regulation of HR (i.e., reduced HR variability) develops before the onset of overt cardiac rate and conduction changes in septic mice. Subsequent time-dependent decreases in HR and cardiac conduction can be attributed to hypothermia and would contribute to decreased cardiac output and organ perfusion. Because isolated atria from septic mice showed normal responsiveness to adrenergic stimulation, we conclude that impaired effectiveness of isoproterenol in vivo can be attributed to reversible effects of systemic factors on adrenergic receptors and/or postreceptor signaling.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Cu] Class update date: 150117
[Lr] Last revision date:150117
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1097/SHK.0000000000000272

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[PMID]: 25589900
[Au] Autor:Liu HT; Liang CC; Rau CS; Hsu SY; Hsieh CH
[Ad] Address:Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Ta-Pei Road, Niao-Song District, Kaohsiung City, 833 Taiwan....
[Ti] Title:Alcohol-related hospitalizations of adult motorcycle riders.
[So] Source:World J Emerg Surg;10(1):2, 2015.
[Is] ISSN:1749-7922
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To provide an overview of the demographic characteristics of adult motorcycle riders with alcohol-related hospitalizations. METHODS: Data obtained from the Trauma Registry System were retrospectively reviewed for trauma admissions at a level I trauma center between January 1, 2009 and December 31, 2013. Out of 16,548 registered patients, detailed information was retrieved regarding 1,430 (8.64%) adult motorcycle riders who underwent a blood alcohol concentration (BAC) test. A BAC level of 50 mg/dL was defined as the cut-off value for alcohol intoxication. RESULTS: In this study, alcohol consumption was more frequently noted among male motorcycle riders, those aged 30-49 years, those who had arrived at the hospital in the evening or during the night, and those who did not wear a helmet. Alcohol consumption was associated with a lower percentage of sustained severe injury (injury severity score ≥25) and lower frequencies of specific body injuries, including cerebral contusion (0.6; 95% confidence interval [CI] = 0.42-0.80), lung contusion (0.5; 95% CI = 0.24-0.90), lumbar vertebral fracture (0.1; 95% CI = 0.01-0.80), humeral fracture (0.5; 95% CI = 0.27-0.90), and radial fracture (0.6; 95% CI = 0.40-0.89). In addition, alcohol-intoxicated motorcycle riders who wore helmets had significantly lower frequencies of cranial fracture (0.4; 95% CI = 0.29-0.67), epidural hematoma (0.5; 95% CI = 0.29-0.79), subdural hematoma (0.4; 95% CI = 0.28-0.64), subarachnoid hemorrhage (0.5; 95% CI = 0.32-0.72), and cerebral contusion (0.4; 95% CI = 0.25-0.78). CONCLUSIONS: Motorcycle riders who consumed alcohol presented different characteristics and bodily injury patterns relative to sober patients, suggesting the importance of helmet use to decrease head injuries in alcohol-intoxicated riders.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Cu] Class update date: 150117
[Lr] Last revision date:150117
[Da] Date of entry for processing:150115
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1186/1749-7922-10-2

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[PMID]: 25589949
[Au] Autor:Kim J; Park HS; Cho SY; Baik HJ; Kim JH
[Ad] Address:Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea....
[Ti] Title:The effect of stellate ganglion block on intractable lymphedema after breast cancer surgery.
[So] Source:Korean J Pain;28(1):61-3, 2015 Jan.
[Is] ISSN:2005-9159
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:Lymphedema of the upper limb after breast cancer surgery is a disease that carries a life-long risk and is difficult to cure once it occurs despite the various treatments which have been developed. Two patients were referred from general surgery department for intractable lymphedema. They were treated with stellate ganglion blocks (SGBs), and the circumferences of the mid-point of their each upper and lower arms were measured on every visit to the pain clinic. A decrease of the circumference in each patient was observed starting after the second injection. A series of blocks were established to maintain a prolonged effect. Both patients were satisfied with less swelling and pain. This case demonstrates the benefits of an SGB for intractable upper limb lymphedema.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Cu] Class update date: 150117
[Lr] Last revision date:150117
[Da] Date of entry for processing:150115
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.3344/kjp.2015.28.1.61

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[PMID]: 25589946
[Au] Autor:Park SK; Choi YS; Choi SW; Song SW
[Ad] Address:Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju, Korea....
[Ti] Title:A comparison of three methods for postoperative pain control in patients undergoing arthroscopic shoulder surgery.
[So] Source:Korean J Pain;28(1):45-51, 2015 Jan.
[Is] ISSN:2005-9159
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:BACKGROUND: Arthroscopic shoulder operations (ASS) are often associated with severe postoperative pain. Nerve blocks have been studied for pain in shoulder surgeries. Interscalene brachial plexus blocks (ISB) and an intra-articular injection (IA) have been reported in many studies. The aim of the present study is to evaluate the effect of ISB, a continuous cervical epidural block (CCE) and IA as a means of postoperative pain control and to study the influence of these procedures on postoperative analgesic consumption and after ASS. METHODS: Fifty seven patients who underwent ASS under general anesthesia were randomly assigned to one of three groups: the ISB group (n = 19), the CCE group (n = 19), and the IA group (n = 19). Patients in each group were evaluated on a postoperative numerical rating scale (NRS), their rescue opioid dosage (ROD), and side effects. RESULTS: Postoperative NRSs were found to be higher in the IA group than in the ISB and CCE groups both at rest and on movement. The ROD were 1.6 ± 2.3, 3.0 ± 4.9 and 7.1 ± 7.9 mg morphine equivalent dose in groups CCE, ISB, and IA groups (P = 0.001), respectively, and statistically significant differences were noted between the CCE and IA groups (P = 0.01) but not in between the ISB and CCE groups. CONCLUSIONS: This prospective, randomized study demonstrated that ISB is as effective analgesic technique as a CCE for postoperative pain control in patients undergoing ASS.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Cu] Class update date: 150117
[Lr] Last revision date:150117
[Da] Date of entry for processing:150115
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.3344/kjp.2015.28.1.45

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[PMID]: 25589945
[Au] Autor:Lee MJ; Lee KC; Kim HY; Lee WS; Seo WJ; Lee C
[Ad] Address:Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Chungju, Korea....
[Ti] Title:Comparison of ramosetron plus dexamethasone with ramosetron alone on postoperative nausea, vomiting, shivering and pain after thyroid surgery.
[So] Source:Korean J Pain;28(1):39-44, 2015 Jan.
[Is] ISSN:2005-9159
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:BACKGROUND: Postoperative nausea and vomiting (PONV), postanesthetic shivering and pain are common postoperative patient complaints that can result in adverse physical and psychological outcomes. Some antiemetics are reported to be effective in the management of postoperative pain and shivering, as well as PONV. We evaluated the efficacy of dexamethasone added to ramosetron on PONV, shivering and pain after thyroid surgery. METHODS: One hundred and eight patients scheduled for thyroid surgery were randomly allocated to three different groups: the control group (group C, n = 36), the ramosetron group (group R, n = 36), or the ramosetron plus dexamethasone group (group RD, n = 36). The patients were treated intravenously with 1 and 2 ml of 0.9% NaCl (group C); or 2 ml of 0.15 mg/ml ramosetron plus 1 ml of 0.9% NaCl (group R); or 2 ml of 0.15 mg/ml ramosetron plus 1 ml of 5 mg/ml dexamethasone (group RD) immediately after anesthesia. RESULTS: Incidence of nausea and the need for rescue antiemetics, verbal rating scale (VRS) 1 hour pain value, ketorolac consumption, and incidence of shivering were significantly lower in group R and group RD, than in group C (P < 0.05). Moreover, these parameters were significantly lower in group RD than in group R (P < 0.05). CONCLUSIONS: Combination of ramosetron and dexamethasone significantly reduced not only the incidence of nausea and need for rescue antiemetics, but also the VRS 1 hour pain value, ketorolac consumption, and the incidence of shivering compared to ramosetron alone in patients undergoing thyroid surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Cu] Class update date: 150117
[Lr] Last revision date:150117
[Da] Date of entry for processing:150115
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.3344/kjp.2015.28.1.39

  9 / 1427580 MEDLINE  
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[PMID]: 25590011
[Au] Autor:Tang J; Cao M; Qian L; Fu Y; Tang J; Zhao X
[Ad] Address:1 Department of Thoracic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China ; 2 Center for Lung Cancer, Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China....
[Ti] Title:The pure distal left main bronchial sleeve resection with total lung parenchymal preservation: report of two cases and literature review.
[So] Source:J Thorac Dis;6(12):E294-8, 2014 Dec.
[Is] ISSN:2072-1439
[Cp] Country of publication:China
[La] Language:eng
[Ab] Abstract:Pure bronchial sleeve resection and reconstruction is a type of rare thoracic surgery, especially for the second carina reconstruction on the left side, needs more exquisite surgical techniques, and patient selection to such surgery often requires rigorous screening. We present two cases of left main bronchial adenoid cystic carcinoma with the second carina reconstruction. The purpose of this paper is to recommend a useful supplement to conventional surgery for some very selected patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Cu] Class update date: 150117
[Lr] Last revision date:150117
[Da] Date of entry for processing:150115
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.3978/j.issn.2072-1439.2014.12.14

  10 / 1427580 MEDLINE  
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[PMID]: 25590005
[Au] Autor:Pan D; Cufari ME; Lim E
[Ad] Address:Imperial College and Academic Division of Thoracic Surgery, London, UK.
[Ti] Title:Beware of arteria lusoria during lymph node dissection of the right paratracheal fossa for lung cancer surgery.
[So] Source:J Thorac Dis;6(12):E264-6, 2014 Dec.
[Is] ISSN:2072-1439
[Cp] Country of publication:China
[La] Language:eng
[Ab] Abstract:An asymptomatic elderly woman presented with a solitary right upper lobe mass revealed to be non-small cell lung cancer following routine surveillance post mastectomy. Upon review of CT with contrast in preparation for rigid bronchoscopy and right upper lobectomy, we noticed that the patient had a rare case of arteria lusoria. This is the presence of an aberrant right subclavian artery extending from the left side of the aortic arch, crossing posteriorly across the midline to supply the upper limb. We suggest that with a documented 100% diagnostic sensitivity on 64 multislice computed tomography, the presence of arteria lusoria within the posterior paratracheal fossa may cause life-threatening complications in the unaware during systematic lymph node dissection for non-small cell lung cancer (NSCLC).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1501
[Cu] Class update date: 150117
[Lr] Last revision date:150117
[Da] Date of entry for processing:150115
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.3978/j.issn.2072-1439.2014.11.12


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