931,394 results match your criteria failure


Fire safety and emergency evacuation guidelines for intensive care units and operating theatres: for use in the event of fire, flood, power cut, oxygen supply failure, noxious gas, structural collapse or other critical incidents: Guidelines from the Association of Anaesthetists and the Intensive Care Society.

Anaesthesia 2021 May 13. Epub 2021 May 13.

Health and Safety Executive.

The need to evacuate an ICU or operating theatre complex during a fire or other emergency is a rare event but one potentially fraught with difficulty: Not only is there a risk that patients may come to harm but also that staff may be injured and unable to work. Designing newly-built or refurbished ICUs and operating theatre suites is an opportunity to incorporate mandatory fire safety features and improve the management and outcomes of such emergencies: These include well-marked manual fire call points and oxygen shut off valves (area valve service units); the ability to isolate individual zones; multiple clear exit routes; small bays or side rooms; preference for ground floor ICU location and interconnecting routes with operating theatres; separate clinical and non-clinical areas. ICUs and operating theatre suites should have a bespoke emergency evacuation plan and route map that is readily available. Read More

View Article and Full-Text PDF

Direct reprogramming with Sendai virus vectors repaired infarct hearts at the chronic stage.

Biochem Biophys Res Commun 2021 May 10;560:87-92. Epub 2021 May 10.

Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba City, Ibaraki, 305-8575, Japan. Electronic address:

Adult hearts have limited regenerative capacity. Hence, after acute myocardial infarction (MI), dead myocardial tissues are digested by immune cells and replaced by fibrosis, leading to ventricular remodeling and heart failure at the chronic stage. Direct reprogramming of the cardiac fibroblasts (CFs) into induced cardiomyocytes (iCMs) with cardiac transcription factors, including Gata4, Mef2c, and Tbx5 (GMT), may have significant potential for cardiac repair. Read More

View Article and Full-Text PDF

Outcomes and complications following minimally invasive excision of synovial cysts of the lumbar spine: A systematic review and meta-analysis.

Clin Neurol Neurosurg 2021 May 4;206:106667. Epub 2021 May 4.

University Hospitals Cleveland Medical Centre, Case Western Reserve University School of Medicine, Cleveland, OH, USA. Electronic address:

Objective: Lumbar synovial cysts (LSC) are one of the manifestations of spinal degenerative cascade. Spinal stenosis or presence of instability in these patients can lead to various symptoms and surgery is indicated following failure of non-operative management for symptomatic synovial cysts. Surgery when performed consists of either decompression with resection of cyst with our without fusion. Read More

View Article and Full-Text PDF

Hypofractionated versus single-fraction stereotactic radiosurgery for the treatment of brain metastases: A systematic review and meta-analysis.

Clin Neurol Neurosurg 2021 Apr 20;206:106645. Epub 2021 Apr 20.

Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia. Electronic address:

Objective: This systematic review and meta-analysis aimed to synthesize the latest evidence on the hypofractionated stereotactic radiosurgery (HF-SRS) compared to single-fraction stereotactic radiosurgery (SF-SRS) for the treatment of brain metastases.

Methods: We systematically searched PubMed, Scopus, EuropePMC, ProQuest, and Cochrane Central Databases. Original research articles investigating patients with brain metastasis receiving HF-SRS or SF-SRS reporting the local control/failure and/or radionecrosis during follow-up were included. Read More

View Article and Full-Text PDF

Heart failure at the crossroads of cardiology and diabetology.

Diabetes Res Clin Pract 2021 May 10;175:108844. Epub 2021 May 10.

FoU - Tema Hjärta och Kärl, S1:02, Karolinska Universitetssjukhuset/Solna, SE-171 76 Stockholm, Sweden. Electronic address:

View Article and Full-Text PDF

A multicenter cohort study of osimertinib compared with afatinib as first-line treatment for EGFR-mutated non-small-cell lung cancer from practical dataset: CJLSG1903.

ESMO Open 2021 May 10;6(3):100115. Epub 2021 May 10.

Department of Respiratory Medicine, Matsunami General Hospital, Kasamatsu, Gifu, Japan.

Background: FLAURA, the prospective trial of osimertinib as a first-line therapy compared with first-generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), did not show superior survival benefit for osimertinib in either the subgroup of Asians or the subgroup with the L858R mutation. In addition, the superiority of osimertinib compared with second-generation EGFR-TKI is thus far unclear.

Patients And Methods: We reviewed the clinical data of all consecutive patients who were treated with osimertinib or afatinib as first-line therapy between May 2016 and October 2019 from 15 institutions in Japan. Read More

View Article and Full-Text PDF

A prediction model of risk factors for complications among SARS-CoV2 positive patients: Cases from Jordan.

J Infect Public Health 2021 Mar 6;14(6):689-695. Epub 2021 Mar 6.

Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan; Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.

Background: The number of COVID-19 infected patients has been soaring in the Middle East countries. The disease poses a significant threat, decisions about prioritizing care should be made in accordance with the proven risk factors for complications.

Objective: The present study provides the first bespoke prediction model in the Middle East to identify COVID-19 patients, who are at higher risk for complications. Read More

View Article and Full-Text PDF

Real-life experience with ceftolozane/tazobactam in Canada; results from the CLEAR (Canadian LEadership on Antimicrobial Real-life usage) registry.

J Glob Antimicrob Resist 2021 May 10. Epub 2021 May 10.

Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address:

Objectives: Ceftolozane/tazobactam is a cephalosporin/β-lactamase inhibitor combination with activity against Gram-negative bacilli. We report the use of ceftolozane/tazobactam in Canada using a national registry.

Methods: The CLEAR registry uses REDCap (Research Electronic Data Capture) (online survey, https://is. Read More

View Article and Full-Text PDF

In vivo fitness of carbapenem-resistant Acinetobacter baumannii (CRAB) strains in murine infection is associated with treatment failure in human infections.

Clin Microbiol Infect 2021 May 10. Epub 2021 May 10.

Division of Epidemiology and Preventive Medicine, Tel Aviv Sourasky Medical Center, National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Objectives: Mortality among patients with carbapenem-resistant Acinetobacter baumannii (CRAB) infections varies between studies. We examined whether in vivo fitness of CRAB strains is associated with clinical outcomes in patients with CRAB infections.

Methods: Isolates were collected from patients enrolled in the AIDA trial with hospital-acquired pneumonia, bloodstream infections, and/or urinary tract infections caused by CRAB. Read More

View Article and Full-Text PDF

Concomitant Coronary Artery Bypass in Patients with Acute Type A Aortic Dissection.

Semin Thorac Cardiovasc Surg 2021 May 10. Epub 2021 May 10.

Department of Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland. Electronic address:

Coronary Artery Bypass Grafting (CABG) is sometimes necessary in acute Type A Aortic Dissection (AAAD) repair. The aim of this study is to analyze the incidence, indications and influence in-hospital outcomes of AAAD repair requiring concomitant CABG in a high-volume single-center experience. Retrospective study of all consecutive AAAD patients. Read More

View Article and Full-Text PDF

Bacterial Infection Related Acute on Chronic Liver Failure: the standpoint matters!

J Hepatol 2021 May 10. Epub 2021 May 10.

Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor," Anesthesia and Intensive Care Department, Cluj-Napoca, Romania; University of Medicine and Pharmacy "Iuliu Hatieganu," Department of Anesthesia and Intensive Care I, Cluj-Napoca, Romania.

View Article and Full-Text PDF

Egg residue and depletion in Rhode Island Red hens (Gallus gallus domesticus) following multiple oral doses of Trimethoprim-Sulfamethoxazole.

Regul Toxicol Pharmacol 2021 May 10:104941. Epub 2021 May 10.

Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA; Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607. Electronic address:

Sulfamethoxazole-Trimethoprim residues in eggs can cause risks to human health. The most common cause of residues in eggs results from failure to meet an appropriate withdrawal interval. The aim of this study was to determine the quantity and duration of sulfamethoxazole- trimethoprim residues in eggs and evaluate the drug elimination parameters in egg components and whole egg to better estimate the withdrawal interval of sulfamethoxazole and trimethoprim following oral administration for 7 days at a purposed dosage regimen (time average 46 mg kg day for sulfamethoxazole, time average 25 mg kg day for trimethoprim). Read More

View Article and Full-Text PDF

Targeting fibrosis in the failing heart with nanoparticles.

Adv Drug Deliv Rev 2021 May 10. Epub 2021 May 10.

Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy; Interdepartmental Center for Nanotechnology Research-NanoBem, University of Molise, Campobasso, Italy. Electronic address:

Heart failure (HF) is a clinical syndrome characterized by typical symptoms and signs caused by a structural and/or functional cardiac abnormality, resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress. Due to increasing incidence, prevalence and, most importantly mortality, HF is a healthcare burden worldwide, despite the improvement of treatment options and effectiveness. Acute and chronic cardiac injuries trigger the activation of neurohormonal, inflammatory, and mechanical pathways ultimately leading to fibrosis, which plays a key role in the development of cardiac dysfunction and HF. Read More

View Article and Full-Text PDF

Kidney-Related Research in the United States: A Position Statement From the National Kidney Foundation and the American Society of Nephrology.

Am J Kidney Dis 2021 May 10. Epub 2021 May 10.

Department of Medicine, Division of Nephrology and Hypertension, Beth Israel Deaconess Medical Center, Boston MA,; Departments of Public Health Science and Medicine, Loyola University Chicago, Maywood, IL and Edward Hines VA Medical Center, Hines, IL. Electronic address:

Kidney disease is an important U.S. public health problem because it affects over 37 million Americans, and Medicare expenditures for patients with chronic kidney disease now alone exceed 130 billion dollars annually. Read More

View Article and Full-Text PDF

The dilemma of choosing obstetrics and anesthesia techniques in a patient with cerebral cavernomatosis: a case report.

Braz J Anesthesiol 2021 May 10. Epub 2021 May 10.

Hospital Universitario 12 de Octubre, Madrid, Spain.

This report describes the case of a pregnant woman who arrived for pre-anesthetic assessment of External Cephalic Version (ECV) for fetus in breech presentation and cesarean section in case of ECV failure. Although the technique seems simple, attempts to rotate the fetus can result in elevated intracranial pressure, which might cause malformation bleeding. The most appropriate anesthetic technique in cases of arteriovenous malformations during C-sections has not been determined. Read More

View Article and Full-Text PDF

Days Alive Out of Hospital in Heart Failure: Insights from the PARADIGM-HF and CHARM Trials.

Am Heart J 2021 May 10. Epub 2021 May 10.

Director, Division of Cardiology and Nephrology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration.

Background: An endpoint that has received some attention in recent cardiovascular trials is 'days alive and out of hospital' (DAOH). Percent DAOH is a natural extension of DAOH that adjusts for differences in length of follow-up. This endpoint measure incorporates mortality and morbidity together in a way that has the potential to give more insight regarding treatment effects compared to conventional time-to-event endpoints. Read More

View Article and Full-Text PDF

Advanced Heart Failure Patients Supported with Ambulatory Inotropic Therapy: What Defines Success of Therapy?

Am Heart J 2021 May 10. Epub 2021 May 10.

Department of Medicine, Columbia University Irving Medical Center, New York, NY. Electronic address:

Objective: The objective of this study was to describe the profiles and outcomes of a cohort of advanced heart failure patients on ambulatory inotropic therapy (AIT).

Background: With the growing burden of patients with end-stage heart failure, AIT is an increasingly common short or long-term option, for use as bridge to heart transplant (BTT), bridge to ventricular assist device (BTVAD), bridge to decision regarding advanced therapies (BTD) or as palliative care. AIT may be preferred by some patients and physicians to facilitate hospital discharge. Read More

View Article and Full-Text PDF

Rationale and Design of the Comparison of Outcomes and Access to Care for Heart Failure (COACH) Trial: A Stepped Wedge Cluster Randomized Trial.

Am Heart J 2021 May 10. Epub 2021 May 10.

Peter Munk Cardiac Centre of the University Health Network, Toronto, Canada; Ted Rogers Centre for Heart Research, Toronto, Canada; University of Toronto, Toronto, Canada.

Background: Heart failure (HF) is an ambulatory care sensitive condition and a leading reason for emergency department (ED) visits and hospitalizations. Improved decision-making and care may enhance safety and efficiency for patients presenting to the ED with acute HF.

Objectives: We will evaluate an intervention comprised of two complementary components: i) the Emergency Heart Failure Mortality Risk Grade simultaneous 7- and 30-day (EHMRG30-ST) risk scores, which will inform admission-discharge decisions, and ii) a rapid outpatient follow-up (RAPID-HF) clinic for low-to-intermediate risk patients on cardiovascular readmissions or death. Read More

View Article and Full-Text PDF

Ouabain worsens diastolic sarcomere length in myocytes from a cardiomyopathy mouse model.

Eur J Pharmacol 2021 May 10:174170. Epub 2021 May 10.

Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Germany. Electronic address:

Diastolic dysfunction is a major feature of hypertrophic cardiomyopathy (HCM). Data from patient tissue and animal models associate increased Ca sensitivity of myofilaments with altered Na and Ca ion homeostasis in cardiomyocytes with diastolic dysfunction. In this study, we tested the acute effects of ouabain on ventricular myocytes of an HCM mouse model. Read More

View Article and Full-Text PDF

An investment case for the prevention and management of rheumatic heart disease in the African Union 2021-30: a modelling study.

Lancet Glob Health 2021 May 10. Epub 2021 May 10.

Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA; Program in Global Noncommunicable Disease and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Partners In Health, Boston, MA, USA. Electronic address:

Background: Despite declines in deaths from rheumatic heart disease (RHD) in Africa over the past 30 years, it remains a major cause of cardiovascular morbidity and mortality on the continent. We present an investment case for interventions to prevent and manage RHD in the African Union (AU).

Methods: We created a cohort state-transition model to estimate key outcomes in the disease process, including cases of pharyngitis from group A streptococcus, episodes of acute rheumatic fever (ARF), cases of RHD, heart failure, and deaths. Read More

View Article and Full-Text PDF

Natural gene therapy by reverse mosaicism leads to improved hematology in Fanconi anemia patients.

Am J Hematol 2021 May 13. Epub 2021 May 13.

Genomic Instability and DNA repair Syndromes group and Joint Research Unit on Genomic Medicine UAB-Sant Pau Biomedical Research Institute (IIB Sant Pau), Institut de Recerca Hospital de la Santa Creu i Sant Pau-IIB Sant Pau, Barcelona, Spain.

Fanconi anemia (FA) is characterized by chromosome fragility, bone marrow failure (BMF) and predisposition to cancer. As reverse genetic mosaicism has been described as "natural gene therapy" in patients with FA, we sought to evaluate the clinical course of a cohort of FA mosaic patients followed at referral centers in Spain over a 30-year period. This cohort includes patients with a majority of T-cells without chromosomal aberrations in the DEB-chromosomal breakage test. Read More

View Article and Full-Text PDF

Reactor-based boron neutron capture therapy for 44 cases of recurrent and refractory high-grade meningiomas with long-term follow-up.

Neuro Oncol 2021 May 13. Epub 2021 May 13.

Department of Neurosurgery, Osaka Medical College, Takatsuki, Osaka, Japan.

Background: High-grade meningioma (HGM) is difficult to treat, and recurrent HGM after radiotherapy has an especially poor prognosis. We retrospectively analyzed the cases of 44 consecutive patients with recurrent and refractory HGM who were treated by reactor-based boron neutron capture therapy (BNCT).

Methods: In 2005-2019, we treated 44 recurrent and refractory HGMs by reactor-based BNCT. Read More

View Article and Full-Text PDF

COVID-19 Pneumonia or Hypereosinophilic Syndrome?

J Med Cases 2020 Dec 21;11(12):400-402. Epub 2020 Oct 21.

Deparment of Internal Medicine and Hematology, Liv Hospital ULUS, Istanbul, Turkey.

Hypereosinophilic syndromes (HESs) are a group of disorders characterized by pathological proliferation of eosinophils. Diagnostic criteria include eosinophil count of 1,500/mm or higher, presence of organ involvement and exclusion of other causes of eosinophilia for at least 6 months. A 69-year-old male patient was referred to the pandemic clinic with a preliminary diagnosis of coronavirus disease 2019 (COVID-19) with fever and dyspnea. Read More

View Article and Full-Text PDF
December 2020

A Case of COVID-19 Complicated by Venous Thromboembolism Despite Being on Prophylactic Anticoagulation.

J Med Cases 2020 Jul 18;11(7):189-191. Epub 2020 Jun 18.

Department of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.

The coronavirus disease 2019 (COVID-19) presents with variable clinical syndromes, from asymptomatic disease to acute respiratory failure. Complications such as acute respiratory distress syndrome (ARDS), secondary infection, acute cardiac injury, liver failure, renal failure, coagulable disorders and in many cases, death have been recognized. Venous thromboembolism (VTE) was found to be present in up to one-third of critically ill COVID-19 patients. Read More

View Article and Full-Text PDF

A Potential Complication of COVID-19: A Case of Non-Traumatic Rhabdomyolisis.

J Med Cases 2020 Sep 6;11(9):296-298. Epub 2020 Aug 6.

MCPHS University, Boston, MA, USA.

Rhabdomyolysis can present as a clinical challenge due to broad etiological spectrum, non-specific symptomatology and numerous systemic complications including acute kidney injury. Emerging evidence suggests that rhabdomyolysis may be an associated early or late complication of coronavirus disease 2019 (COVID-19) infection. We present a case of a 55-year-old woman with recent COVID-19 pneumonia who was later found to have non-traumatic rhabdomyolysis incidentally captured on COVID-19 screening labs. Read More

View Article and Full-Text PDF
September 2020

Phenome-wide association of 1809 phenotypes and COVID-19 disease progression in the Veterans Health Administration Million Veteran Program.

PLoS One 2021 13;16(5):e0251651. Epub 2021 May 13.

Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, United States of America.

Background: The risk factors associated with the stages of Coronavirus Disease-2019 (COVID-19) disease progression are not well known. We aim to identify risk factors specific to each state of COVID-19 progression from SARS-CoV-2 infection through death.

Methods And Results: We included 648,202 participants from the Veteran Affairs Million Veteran Program (2011-). Read More

View Article and Full-Text PDF

Antiviral kinetics of tenofovir alafenamide and tenofovir disoproxil fumarate over 24 weeks in women of childbearing potential with chronic HBV.

PLoS One 2021 13;16(5):e0251552. Epub 2021 May 13.

New Zealand Liver Transplant Unit, Auckland Clinical Studies, Auckland, New Zealand.

Background/purpose: Use of tenofovir disoproxil fumarate (TDF) improves patient outcomes in preventing mother-to-child transmission (pMTCT) of the hepatitis B virus (HBV) in mothers with chronic HBV and high viral loads. Given the lack of data for tenofovir alafenamide (TAF) in pMTCT, rates of early viral suppression with TAF and TDF were evaluated in women of childbearing potential (WOCBP) participating in 2 randomized, double-blind, Phase 3 studies in chronic HBV.

Methods: In a patient subset meeting WOCBP criteria and with baseline HBV DNA >200,000 IU/mL, rates of viral suppression with TAF or TDF in achieving the target of HBV DNA <200,000 IU/mL at weeks 12 and 24 were assessed. Read More

View Article and Full-Text PDF

Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon.

PLoS One 2021 13;16(5):e0229550. Epub 2021 May 13.

Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon.

Background: HIV management remains concerning and even more challenging in the frame of comorbidities like malnutrition that favors disease progression and mortality in resource-limited settings (RLS).

Objective: To describe the nutritional parameters of antiretroviral therapy (ART) recipients (without nutritional support) with respect to CD4 count and virological failure.

Methods: A cross-sectional study was conducted from October to December 2018 among 146 consenting participants enrolled in two health facilities of the East-Region of Cameroon. Read More

View Article and Full-Text PDF