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2023
| Keywords | Text ; ddc:610 |
|---|---|
| Language | English |
| Publishing country | de |
| Document type | Book ; Audio / Video ; Online |
| Database | BASE - Bielefeld Academic Search Engine (life sciences selection) |
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The Journal of laryngology and otology
2023 Volume 137, Issue 12, Page(s) 1409–1412
Abstract: Objective: Transsphenoidal pituitary surgery is commonly performed via a direct transostial approach with a posterior septectomy. However, a technique via an endoscopic transseptal route has been described that avoids a posterior septectomy, but it ... ...
| Abstract | Objective: Transsphenoidal pituitary surgery is commonly performed via a direct transostial approach with a posterior septectomy. However, a technique via an endoscopic transseptal route has been described that avoids a posterior septectomy, but it comes with its own disadvantages. Methods: This paper describes a modification, and discusses its pros and cons. Results: The initial incision in the mucosa is placed level with the anterior middle turbinate. The mucoperichondrial flap is raised ipsilaterally until the sphenoid sinus ostium. An incision is made at the osseocartilaginous junction, and the contralateral mucoperichondrial flap is raised. The bony septum and posterior aspect of this flap is excised. The size and position of this window can be adapted. At the end of the operation, the lateralised intact mucoperichondrial flap is moved back to the midline. Conclusion: Excision or deflection of the cartilaginous septum is not required. It maintains an intact septal mucosa on one side and avoids a septal perforation. |
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| MeSH term(s) | Humans ; Nasal Septum/surgery ; Endoscopy/methods ; Surgical Flaps ; Turbinates ; Pituitary Neoplasms/surgery ; Sphenoid Sinus/surgery |
| Language | English |
| Publishing date | 2023-02-17 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 218299-3 |
| ISSN | 1748-5460 ; 0022-2151 |
| ISSN (online) | 1748-5460 |
| ISSN | 0022-2151 |
| DOI | 10.1017/S0022215123000221 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
| Ul II Zs.64: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG) |
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.
2023 Volume 76, Issue 2, Page(s) 2158–2161
Abstract: Adenoid cystic carcinoma (ACC) of the lacrimal gland is the most common malignant epithelial tumor of the lacrimal gland. The biological behavior of these tumors is characterized by a slow growth with frequent nerve invasion but rare invasion of the neck ...
| Abstract | Adenoid cystic carcinoma (ACC) of the lacrimal gland is the most common malignant epithelial tumor of the lacrimal gland. The biological behavior of these tumors is characterized by a slow growth with frequent nerve invasion but rare invasion of the neck nodes. Local extension intracranially with bone erosions is seen in locally advanced tumors. Distant metastasis to lungs bone and liver are commonly reported. Treatments using surgery and radiotherapy are generally preferred for adequate tumor control. However there is still no consensus on the best treatment approach. Supplementary information: The online version contains supplementary material available at 10.1007/s12070-023-04426-5. |
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| Language | English |
| Publishing date | 2023-12-21 |
| Publishing country | India |
| Document type | Journal Article |
| ZDB-ID | 1471137-0 |
| ISSN | 0973-7707 ; 2231-3796 ; 0019-5421 |
| ISSN (online) | 0973-7707 |
| ISSN | 2231-3796 ; 0019-5421 |
| DOI | 10.1007/s12070-023-04426-5 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
| Zs.A 5300: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG) |
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Journal of research in nursing : JRN
2024 Volume 29, Issue 1, Page(s) 6–18
Abstract: Background: Peripheral intravenous catheter placement is one of the most common invasive procedures that nurses will perform, especially in emergency departments.: Aims: This early analysis aimed to quantify the economic burden associated with ... ...
| Abstract | Background: Peripheral intravenous catheter placement is one of the most common invasive procedures that nurses will perform, especially in emergency departments. Aims: This early analysis aimed to quantify the economic burden associated with intravenous therapy in patients presenting in emergency departments with difficult intravenous access, receiving traditional peripheral intravenous catheters. This may inform the opportunity for improvement for investment in nursing tools and services regarding difficult venous access burden reduction. Methods: Model parameter data were obtained from published literature where possible via a targeted literature review for the terms including relative variations of 'Difficult Venous Access', 'burden', and 'costs', or elicited from expert clinical opinion. A simple decision tree model was developed in Microsoft® Excel 2016. Results included number of insertion attempts, number of patients requiring escalation, catheter failures due to complications, healthcare professional (e.g. nurse) time, and total costs (including/excluding health care professional time). Sensitivity analyses were performed. Results: The model considers 64,000 individuals presenting in the emergency department annually, of which 75% (48,000) require a peripheral intravenous catheter; of these 22% (10,560) are estimated to have difficult venous access. The total cost burden of difficult venous access is estimated to be $890,095 per year/$84.29 per patient with difficult venous access, including the cost of clinician time. Key total cost drivers include the population size treated in the emergency department annually, the proportion of midlines placed by a specialist IV (intravenous access) nurse and the percentage of patients with difficult venous access. Conclusion: This is the first formal analysis estimating the significant economic burden of difficult venous access in emergency departments via peripheral intravenous catheter placement, a task frequently performed by nurses. Further studies are needed to evaluate nursing-centric strategies for reducing this burden. Additionally, adoption of a concise definition is needed, as is routine use of reliable assessment tools so that future cost analyses can be better contextualised. |
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| Language | English |
| Publishing date | 2024-01-16 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 2173772-1 |
| ISSN | 1744-988X ; 1744-9871 |
| ISSN (online) | 1744-988X |
| ISSN | 1744-9871 |
| DOI | 10.1177/17449871231213025 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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2024 Volume 19, Issue 3, Page(s) e0299692
Abstract: Objective: This study aimed to analyze the prevalence, risk factors, and clinical implications of hemolyzed laboratory samples in the pediatric emergency department (ED), a subject on which existing data remains scarce.: Methods: We conducted a multi- ...
| Abstract | Objective: This study aimed to analyze the prevalence, risk factors, and clinical implications of hemolyzed laboratory samples in the pediatric emergency department (ED), a subject on which existing data remains scarce. Methods: We conducted a multi-site observational cohort analysis of pediatric ED encounters in Metro Detroit, Michigan, United States. The study included participants below 18 years of age who had undergone peripheral intravenous catheter (PIVC) placement and laboratory testing. The primary outcome was the presence of hemolysis, and secondary outcomes included identifying risk factors for hemolysis and assessing the impact of hemolysis on PIVC failure. Results: Between January 2021 and May 2022, 10,462 ED encounters met inclusion criteria, of which 14.0% showed laboratory evidence of hemolysis. The highest proportion of hemolysis occurred in the infant (age 0-1) population (20.1%). Multivariable regression analysis indicated higher odds of hemolysis for PIVCs placed in the hand/wrist in the toddler (age 2-5) and child (age 6-11) subgroups. PIVCs placed in the hand/wrist also demonstrated higher odds of failure in infants. Conclusions: Hemolysis in the pediatric ED population is a frequent complication that occurs at similar rates as in adults. PIVCs placed in the hand/wrist were associated with higher odds of hemolysis compared to those placed in the antecubital fossa. Clinicians should consider alternative locations for PIVC placement if clinically appropriate. Further research is needed to better understand the clinical implications of pediatric hemolysis. |
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| MeSH term(s) | Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Catheterization, Peripheral/adverse effects ; Emergency Service, Hospital ; Hemolysis ; Prevalence ; Risk Factors |
| Language | English |
| Publishing date | 2024-03-21 |
| Publishing country | United States |
| Document type | Journal Article ; Multicenter Study ; Observational Study |
| ZDB-ID | 2267670-3 |
| ISSN | 1932-6203 ; 1932-6203 |
| ISSN (online) | 1932-6203 |
| ISSN | 1932-6203 |
| DOI | 10.1371/journal.pone.0299692 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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2023 Volume 34, Page(s) 101698
Abstract: Prostate cancer (PCa) is one of the leading causes of cancer-related deaths in men. Localised PCa can be treated effectively, but most patients relapse/progress to more aggressive disease. One possible mechanism underlying this progression is alternative ...
| Abstract | Prostate cancer (PCa) is one of the leading causes of cancer-related deaths in men. Localised PCa can be treated effectively, but most patients relapse/progress to more aggressive disease. One possible mechanism underlying this progression is alternative splicing of the androgen receptor, with AR variant 7(ARV7) considered to play a major role. Using viability assays, we confirmed that ARV7-positive PCa cells were less sensitive to treatment with cabazitaxel and an anti-androgen-enzalutamide. Also, using live-holographic imaging, we showed that PCa cells with ARV7 exhibited an increased rate of cell division, proliferation, and motility, which could potentially contribute to a more aggressive phenotype. Furthermore, protein analysis demonstrated that ARV7 knock-down was associated with a decrease in insulin-like growth factor-2 (IGFBP-2) and forkhead box protein A1(FOXA1). This correlation was confirmed in-vivo using PCa tissue samples. Spearman rank correlation analysis showed significant positive associations between ARV7 and IGFBP-2 or FOXA1 in tissue from patients with PCa. This association was not present with the AR. These data suggest an interplay of FOXA1 and IGFBP-2 with ARV7-mediated acquisition of an aggressive prostate cancer phenotype. |
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| Language | English |
| Publishing date | 2023-06-10 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 2443840-6 |
| ISSN | 1936-5233 |
| ISSN | 1936-5233 |
| DOI | 10.1016/j.tranon.2023.101698 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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The journal of vascular access
2024 , Page(s) 11297298231222060
Abstract: Objective: Comprehensive education and training programs are urgently needed to improve vascular access outcomes in the emergency department (ED). This study aimed to demonstrate the success of a formalized vascular access program in developing ... ...
| Abstract | Objective: Comprehensive education and training programs are urgently needed to improve vascular access outcomes in the emergency department (ED). This study aimed to demonstrate the success of a formalized vascular access program in developing competent ED clinicians in traditional and ultrasound-guided insertion methods. Methods: This was a retrospective observational study exploring the success of trainees in obtaining competency in peripheral vascular access at an academic suburban ED with 120,000 annual visits. Eligible participants included healthcare workers that enrolled in the Operation STICK vascular access program and perform vascular access procedures as an aspect of their clinical practice. Competency in vascular access included both traditional and ultrasound-guided (US) peripheral intravenous catheter (PIVC) insertions. Competency was defined as demonstration of successful insertion of one traditional and one US PIVC in compliance with checklist. The primary objective was competency. Secondary objectives included trainee time to competency, trainee number of line encounters, and changes in program competency achievements over time. Results: From October 15, 2021, to April 15, 2023, 141 clinicians participated in peripheral vascular access training via the Operation STICK model, which included 72 (51.1%) nurses, 52 (36.9%) ED technicians, and 17 (12.0%) healthcare personnel with other medical training. Clinicians overall reported an average of 5.6 years of experience inserting peripheral intravenous catheters (PIVCs) and 23 (16.3%) had experience with using ultrasound. About 122 (86.5%) clinicians successfully completed the program and demonstrated competency in traditional and ultrasound-guided techniques. Time to competency varied over time, with a median of 124 days in the early phase, 32.5 days middle phase, and 10.6 h over 9.5 days in the later phase of the program ( Conclusions: Achieving competency in PIVC insertion necessitates a focused effort on refining and systematizing education and training approaches. Recognizing the inherent challenges present in ED settings, it is feasible to effectively and efficiently train emergency clinicians to be expert in both basic and advanced PIVC placement techniques through participation in a well-organized vascular access training program. |
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| Language | English |
| Publishing date | 2024-01-12 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 2252820-9 |
| ISSN | 1724-6032 ; 1129-7298 |
| ISSN (online) | 1724-6032 |
| ISSN | 1129-7298 |
| DOI | 10.1177/11297298231222060 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
| Zs.A 6414: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG) |
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2024
Abstract: Background: Implantable cardioverter defibrillators (ICD) are often used as primary prevention strategy for sudden cardiac death (SCD) in young individuals. This study analyzed appropriate therapies, complications and inappropriate shocks in the real- ... ...
| Abstract | Background: Implantable cardioverter defibrillators (ICD) are often used as primary prevention strategy for sudden cardiac death (SCD) in young individuals. This study analyzed appropriate therapies, complications and inappropriate shocks in the real-world Indian population. Methods: All patients in the cardiomyopathy cohort under follow up who had ICD implanted as a primary prevention strategy were studied. The objective was to assess the incidence of appropriate ICD therapies, inappropriate therapies and complications. ICD was interrogated and stored electrograms analyzed. Underlying arrhythmia or conditions resulting in appropriate or inappropriate ICD therapy were studied. Correlation and regression studies was done to assess for the predictors of appropriate therapy. Results: Fifty patients were followed up for a mean follow-up duration of 4.4 ± 3.1 years with total follow up of 220.2 patient years. Appropriate ICD therapy was delivered in 16 out of 50 (32%) patients, with 65 appropriate therapies (median 2 per patient, range: 0-20). Inappropriate therapy delivered in 7 of the 50 (14%) patients, with 44 inappropriate therapies (median 5 per patient, range: 0-20). Complications occurred in 8 of the 50 (16%) patients. Overall, the rate of appropriate therapy was 29.5 per 100 patient years, that of inappropriate therapy was 19.9 per 100 patient years and the rate of complications was 3.6 per 100 patient years. Conclusions: When implanted for primary prevention in patients with cardiomyopathies over a mean period of 4.4 ± 3.1 years, appropriate ICD therapy was delivered in 32% patients. However, inappropriate therapy (14% patients) and complications (16% patients) were also common. |
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| Language | English |
| Publishing date | 2024-03-22 |
| Publishing country | India |
| Document type | Journal Article |
| ZDB-ID | 604366-5 |
| ISSN | 2213-3763 ; 0019-4832 |
| ISSN (online) | 2213-3763 |
| ISSN | 0019-4832 |
| DOI | 10.1016/j.ihj.2024.03.005 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
| Zs.A 616: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
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Journal of infection prevention
2024 Volume 25, Issue 3, Page(s) 73–81
Abstract: Background: Unscheduled dressing changes for central venous lines (CVLs) have been shown to increase the risk of bloodstream infections.: Objective: The objective of this study is to determine if the use of an innovative dressing change kit reduces ... ...
| Abstract | Background: Unscheduled dressing changes for central venous lines (CVLs) have been shown to increase the risk of bloodstream infections. Objective: The objective of this study is to determine if the use of an innovative dressing change kit reduces the rate of unscheduled dressing changes. Methods: This pre-post interventional study took place at a large, academic, tertiary care center in metro Detroit, Michigan, the United States. We assessed the impact of the interventional dressing change procedure kit on the rate of unscheduled dressing changes for adult patients who underwent placement of a CVL inclusive of a central catheter, peripherally inserted central catheter, or hemodialysis catheter. Data was collected for the pre-intervention cohort through electronic health records (EHRs), while data for the post-intervention cohort were collected by direct observation by trained research staff in combination with EHR data. The primary outcome was the rate of unscheduled dressing changes. Secondary outcomes included rate of unscheduled dressing changes based on admission floor type, etiology of unscheduled dressing changes, and central line-associated bloodstream infections (CLABSIs). Results: The study included a convenience sample of 1548 CVLs placed between May 2018 and June 2022 with a matched analysis including 488 catheters in each of the pre- and post-intervention groups. The results showed that the unadjusted rate of unscheduled dressing evaluations was significantly reduced from the pre-intervention group (0.21 per day) to the post-intervention group (0.13 per day) ( Discussion: Procedural kits for central line dressing changes are effective in reducing unscheduled dressing changes and may have a role in reducing CLABSI. Further studies assessing the impact of dressing change kits on cost, procedural compliance, and the precise impact on CLABSI are needed. |
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| Language | English |
| Publishing date | 2024-02-08 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 2595000-9 |
| ISSN | 1757-1782 ; 1757-1774 |
| ISSN (online) | 1757-1782 |
| ISSN | 1757-1774 |
| DOI | 10.1177/17571774241232063 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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2023 Volume 61, Issue Suppl 3, Page(s) 51–56
Abstract: Anti-androgen therapy continues to be a basic pilar of treatment for both localized and metastatic prostate cancer. The advent of new generation of androgen receptor targeted agents (ARTA) transformed the care of patients with advanced disease. After ... ...
| Abstract | Anti-androgen therapy continues to be a basic pilar of treatment for both localized and metastatic prostate cancer. The advent of new generation of androgen receptor targeted agents (ARTA) transformed the care of patients with advanced disease. After such a success, the steps were taken to incorporate a new generation of ARTAs into the treatment landscape of localized prostate cancer. High-risk prostate cancer represents the most aggressive form of localized disease with significant metastatic potential and poor outcome. Here, the impact of novel therapies will likely be profound and transforming. This clinical space has already been a showcase for multidisciplinary treatment where the combination of local therapies with systemic treatment gradually improved patient outcomes and the chances of cure. The most recent step in redefining the treatment of localized disease is the adoption of novel ARTAs moving forward the multidisciplinary platform. In this narrative review, we discuss current clinical evidence supporting the use of novel ARTAs in patients with localized high-risk prostate cancer and cover recent developments in biomarker-driven strategies for treatment individualization in this clinical context. |
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| MeSH term(s) | Male ; Humans ; Receptors, Androgen/therapeutic use ; Prostatic Neoplasms, Castration-Resistant/drug therapy ; Prostatic Neoplasms, Castration-Resistant/pathology ; Androgen Antagonists/therapeutic use ; Antineoplastic Agents ; Prostatic Neoplasms/drug therapy ; Prostatic Neoplasms/pathology |
| Chemical Substances | Receptors, Androgen ; Androgen Antagonists ; Antineoplastic Agents |
| Language | English |
| Publishing date | 2023-02-17 |
| Publishing country | Croatia |
| Document type | Journal Article ; Review |
| ZDB-ID | 1478635-7 |
| ISSN | 1333-9451 ; 0353-9466 |
| ISSN (online) | 1333-9451 |
| ISSN | 0353-9466 |
| DOI | 10.20471/acc.2022.61.s3.7 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
| Zs.A 5057: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG) |
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