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Benditt David G - - 2013
Syncope is a frequent cause for presentation to emergency departments and urgent-care clinics. The physician should establish a confident causal diagnosis, assess prognostic implications, and provide appropriate advice to prevent recurrences. An organized approach is needed to the assessment of the patient with syncope, including a careful initial examination as ...
Costantino Giorgio - - 2013
The overall risk for a patient entering the emergency department (ED) because of syncope ranges between 5% and 15%, and the mortality at 1 week is approximately 1%. The primary goal for the ED physician is thus to discriminate individuals at low risk, who can be safely discharged, from patients ...
Sheldon Robert - - 2013
The articles in this issue provide a comprehensive overview of the recent advances in the management of syncope by masters in the field. There are now solid approaches to most facets of diagnosis, risk stratification, prognostication, treatment, and health services delivery. However, 5 important challenges remain, including syncope etiology, treatment, ...
Sheldon Robert - - 2013
This article summarizes the major contributions of tilt table tests and implantable loop recorders to the diagnosis of syncope and provides simple recommendations for these tests. Tilt table tests have provided important benefits in the field of neurally mediated syncope. However, they have significant limitations. Implantable loop recorders also are ...
Jardine D L - - 2013
This review deals with recent changes in understanding of physiologic mechanisms involved in vasovagal syncope. The approach is not comprehensive but attempts to integrate new findings with older studies. The major clinical presentations of the condition and recognized triggers are discussed first, followed by a summary of how new laboratory ...
Guzman Juan C - - 2013
Neurally mediated reflex syncope, more commonly known as vasovagal syncope (VVS), remains the most common cause of transient loss of consciousness and syncope in all age groups. Most evidence assessing treatment of VVS derived from randomized clinical trials is limited. Multiple modalities of both nonpharmacologic and pharmacologic strategies have been ...
Khoo Clarence - - 2013
While the overall prognosis of syncope is favorable, the identification of individuals with a potentially life-threatening cause is of paramount importance. Cardiac syncope is associated with an elevated risk of mortality, and includes both primary arrhythmic and obstructive etiologies. Identification of these individuals is contingent on careful clinical assessment and ...
Seifer Colette - - 2013
Carotid sinus hypersensitivity was first reported more than 200 years ago. Nevertheless, a complete understanding of this relatively common clinical finding in older patients has proven elusive. There is evidence to support an association between symptoms, particularly syncope, and a hypersensitive response to carotid sinus massage. However, the clinical implication ...
Moya Angel - - 2013
The current evidence for pacemaker therapy is reviewed in 2 different syncopal conditions: reflex syncope with cardioinhibitory response and syncope in patients with bundle branch block. Although recent trials support the use of pacemaker therapy in selected patients with reflex syncope in whom an asystole is documented during spontaneous syncope ...
Lobban Trudie C A - - 2013
The most common form of syncope is reflex syncope (also called vasovagal syncope and reflex anoxic seizures). Reflex syncope is common, relatively simple to diagnose, and, in most cases, should not become a significant burden for patients or their families. Yet, too many patients with treatable syncope suffer dismissal of ...
Viqar-Syed Maria - - 2013
Clinical decision making can be challenging regarding the emergency department (ED) management of patients with recent syncope. Several models of the syncope management unit are summarized in this article. Assessment of patients with recent syncope in a specialized evaluation unit, such as an emergency department-based syncope management unit, holds great ...
Nwazue Victor C VC Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, AA3228 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232-2195, - - 2013
A syncope evaluation should start by identifying potentially life-threatening causes, including valvular heart disease, cardiomyopathies, and arrhythmias. Most patients who present with syncope, however, have the more benign vasovagal (reflex) syncope. A busy syncope practice often also sees patients with neurogenic orthostatic hypotension presenting with syncope or severe recurrent presyncope. ...
Nwazue Victor C VC Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, AA3228 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232-2195, - - 2013
Most patients who present to a cardiologist with syncope have vasovagal (reflex) syncope. A busy syncope practice often also sees patients with postural tachycardia syndrome, often presenting with severe recurrent presyncope. Recognition of this syncope confounder might be difficult without adequate knowledge of their presentation, and this can adversely affect ...
Beliakova-Bethell Nadejda - - 2013
To assess the off-target effects of the histone deacetylase inhibitor (HDACi) suberoylanilide hydroxamic acid (SAHA) in human primary CD4 T cells. A pharmacologically relevant concentration (340 nmol/l) of SAHA was shown to significantly increase histone hyperacetylation by 24 h and this length of treatment was selected to determine its impact ...
Dickinson Sharon - - 2013
: The Agency for Healthcare Research and Quality has defined pressure ulcers (PUs) an important patient safety indicator (#3). Despite the existence of evidence-based guidelines for PU prevention and treatment from the United States Department of Health and Human Services, the sustained success in reducing the development of PUs is ...
Torretta Sara - - 2013
The management of unilateral nasal lesions can sometimes be a challenge and an ordinary bioptic assessment should be avoided in order to prevent complications due to their possible vascular or meningoencephalic origin. Narrow-band imaging (NBI) endoscopy could improve the diagnosis of vascular nasal formations by enhancing the visualisation of the ...
Cassibba Rosalinda - - 2013
The current research reports that mothers' security of attachment predicts their children's sense of God's closeness. A total of 71 mother-child dyads participated (children's M age = 7.5). Mothers' attachment organization was studied with the Adult Attachment Interview (AAI; Main, Goldwyn, & Hesse, 2003 ) and their religiosity and attachment to God ...
Vollman Kathleen M - - 2013
In today's critical care environment, we face a difficult but essential task. We must provide comprehensive, compassionate, complex, technological care without causing harm to our patients. To foster a patient-safe environment, we must examine care practices and processes to reduce the chance of error. Successful early mobilization of critically ill ...
Talley Cheryl L - - 2013
Evidence to support improved outcomes with early ambulation is strong in medical literature. Yet, critically ill continuous renal replacement therapy (CRRT) patients remain tethered to their beds by devices delivering supportive therapy. The University of Michigan Adult CRRT Committee identified this deficiency and sought to change it. There was no ...
Thompson Barry J - - 2013
Determinants of cell polarity orient the behaviour of many cell types during development. Pioneering genetic screens in yeast, worms and flies have identified key polarity determinants that are evolutionarily conserved across the animal kingdom. Recent work in these three model organisms has combined computer modelling with experimental analysis to reveal ...
Havey Renee - - 2013
The postoperative period following abdominal surgery presents many challenges to patients and clinicians as recovery progresses and discharge from the intensive care unit approaches. Physiologic changes including the release of inflammatory mediators, increased fatigue and reduction in body mass, and a decline in pulmonary function occurring after abdominal surgery are ...
Chadwell Katherine - - 2013
With the advent of the human genome project, we have never known so much about the uniqueness of individuals. Personalized medicine is poised to use this genetic and genomic information along with the impact of environment and clinical presentation to provide healthcare from an individual perspective. This offers the opportunity ...
Watanabe Junzo - - 2013
People with schizophrenia have higher rates of medical illness and mortality than the general population. Cardiovascular disease is a major contributor to premature death in patients with schizophrenia. There has been an increase literature discussing the high prevalence of dyslipidemia, which is one of risk factors for cardiovascular disease, induced ...
Bretherton Inge - - 2013
Three related hypotheses derived from attachment theory were examined in this multi-informant and multi-method study of 71 postdivorce mothers and their preschool children (40 boys, 31 girls): (1) mother-child interactions observed at home will be related to attachment-related representations by children (Attachment Story Completion Task or ASCT) and mothers (Parent ...
Fishkind William J - - 2013
The phaco machine is frequently overlooked as the crucial surgical instrument it is. Understanding how to set parameters is initiated by understanding fundamental concepts of machine function. This study analyses the critical concepts of partial occlusion phaco, occlusion phaco and pump technology. In addition, phaco energy categories as well as ...
Winkelman Chris - - 2013
Human skeletal muscles are continually remodeled to match the function required of them. Diameter, strength, and vascular supply are altered when a muscle group experiences contraction and resistance. The purpose of this article is to describe selected muscle signaling pathways that contribute to muscle remodeling. Multiple factors affect the cellular ...
Patel Hussain Y - - 2013
This review summarizes the recent literature regarding the incidence and management of cataract following glaucoma surgery. Half of the total number of phakic patients that have either trabeculectomy or tube shunt surgery will go on to develop visually significant cataract within 5 years. Phacoemulsification following trabeculectomy is significantly associated with ...
Deng Gui-Fang - - 2013
The pigmented rice has been consumed in China, Japan, and Korea for a long time. It has been used for strengthening kidney function, treating anemia, promoting blood circulation, removing blood stasis, treating diabetes, and ameliorating sight in traditional Chinese medicine. The extracts from pigmented rice are used as natural food ...
Sigurdsson M I - - 2013
The aim of this study was to assess population-based changes in incidence, treatment, and in short- and long-term survival of patients with acute respiratory distress syndrome (ARDS) over 23 years. Analysis of all patients in Iceland who fulfilled the consensus criteria for ARDS in 1988-2010. Demographic variables, Acute Physiology and ...
Anthony Tracy G - - 2013
To understand the principles of amino acid deprivation sensing in the brain and its behavioral and metabolic outcomes with an emphasis on the current literature. Sensing essential amino acid (EAA) depletion occurs in the anterior piriform cortex (APC) via general control nonderepressible 2 (GCN2) binding to deacylated tRNA and subsequent ...
Kocan Mary Jo - - 2013
Patients with neurologic illness or injury benefit from early interventions to increase physical activity and mobility, but they also have special needs related to hemodynamic stability and intracranial pressure dynamics. After brain injury, moving paralyzed limbs-even passively-helps promote neural plasticity, "rerouting" signals around the injured area and forming new connections, ...
Weed Douglas L - - 2013
The methodological quality of published reviews of nutrition and cancer (2008-2009) and of the carcinogenicity of acrylamide (1999-2009) was systematically assessed. Each review was examined with respect to four characteristics: whether the purpose of the review was explicitly stated, whether a methods section (detailing the methods used to "weigh" the ...
Finkelman Anita - - 2013
Healthcare delivery is in a crisis, requiring improvement. How to improve and who should assume more leadership are not clear. At the same time, the nursing profession struggles with a weak education system, graduating students who require major support for an extended time. There is also confusion related to nursing ...
Norton Tomás - - 2013
The design of thermal processes in the food industry has undergone great developments in the last two decades due to the availability of cheap computer power alongside advanced modelling techniques such as computational fluid dynamics (CFD). CFD uses numerical algorithms to solve the non-linear partial differential equations of fluid mechanics ...
Radtke Kimberly - - 2013
: The objective of this study was to determine if standardizing shift report improves patient satisfaction with nursing communication. : Patient surveys taken after discharge from the hospital show that patients perceive nursing communication during their stay could be improved. Standardizing bedside reporting is one step toward improving communication between ...
Riaz Qurat Ul Ain - - 2013
The importance of probiotics and their live delivery in the gastrointestinal tract has gained much importance in the recent past. Many reports have indicated that there is poor viability of probiotic bacteria in dairy based products, both fermented and non-fermented, and also in the human gastro-intestinal system is questionable. In ...
Knoblauch Diane J - - 2013
A review of the literature revealed that there was a dearth of information regarding the financial impact of implementing a mobility program in an intensive care unit. The purpose of this article was to identify and quantify costs and cost-benefit from implementing a mobility protocol. Factors to be considered when ...
Chow Tam-Lin - - 2013
Parotidectomy is usually carried out under general anesthesia. We reported our early experience of performing parotidectomy under local anesthesia. Case series reviewed. Head and neck services of a regional hospital. PATIENTS, INTERVENTION, AND RESULTS: Seven patients underwent parotidectomy under local anesthesia. The indications were high risk for general anesthesia due ...
Pasha Imran - - 2013
In the era of nutrition, much focus has been remunerated to functional and nutraceutical foodstuffs. The health endorsing potential of such provisions is attributed to affluent phytochemistry. These dynamic constituents have functional possessions that are imperative for cereal industry. The functional and nutraceutical significance of variety of foods is often ...
Pascuzzo Katherine - - 2013
Attachment security towards parents and peers in adolescence, and romantic attachment styles and emotion regulation strategies in young adulthood, were evaluated using an eight-year longitudinal design. Fifty-six young adults completed the Inventory of Parent and Peer Attachment (IPPA) at age 14, and then, at age 22, the Experience in Close ...
Dammeyer Jennifer - - 2013
Professional experience and wisdom have taught us that immobility is a risk factor for various adverse outcomes, such as deep vein thrombosis, joint contractures, pulmonary dysfunction, and bone demineralization to name a few. Balancing bed rest and mobility may improve both short- and long-term outcomes for our patients. Moreover, early, ...
Rukstele Christina D - - 2013
As advances in research and technology expand our ability to optimize the short-term outcomes in critical illness, survivors are often left with long-term functional impairments. The complications of bed rest can be nearly as devastating as the illness itself. Prolonged periods of immobility during the acute phase of illness have ...
Freeman Regi - - 2013
Historically, intensive care cardiac surgery patients remained on bed rest for several days postoperatively to prevent complications and promote rest and healing. Over time, the cardiac surgery discipline has acknowledged the benefits of early mobility, including reduced risk of venous thromboembolism and pulmonary emboli, improved pulmonary toilet, prevention of pneumonia, ...
Zeng Tao - - 2013
Garlic has long been the focus of experimental and clinical attentions due to its promising lipid-lowering effects. Numerous animal studies as well as in vitro ones have demonstrated the hypolipidemic effects of garlic, while clinical trials are highly inconsistent. Based on some double-blind, randomized, placebo-controlled clinical trials which denied the ...
Mason Alison Rich - - 2013
A learning healthcare system has emerged as a means of addressing the need to move evidence to the bedside in a manner that is meaningful and efficacious. The advent of electronic healthcare records has translated to massive quantities of clinical data; a learning healthcare system coupled with locally derived clinical ...
Taylor Sarah - - 2013
Mobilizing patients with burns can be challenging due to their unique characteristics. Many times, common practice is to elevate and immobilize the burned extremity after debridement and grafting. On the contrary, mobility is imperative for patients with burns, as patients can lose function and flexibility quickly. The objective of this ...
Borensztejn Antoine - - 2013
During development, specific cells are eliminated by apoptosis to ensure that the correct number of cells is integrated in a given tissue or structure. How the apoptosis machinery is activated selectively in vivo in the context of a developing tissue is still poorly understood. In the Drosophila ovary, specialised follicle ...
Brenet O - - 2013
An increasing number of immediate hypersensitivity reactions (HSR) have been reported after the use of Patent Blue V (PBV) for breast cancer surgery. This is the first study to publish prospective data with systematic allergological assessment. We conducted a multicentre study in 10 French cancer centres for over 6 months. ...
Dammeyer Jennifer A - - 2013
The safety and efficacy of mobility programs for the ventilated patient and the ability to improve outcomes related to immobility of the critically ill are well documented in the literature. Early mobility programs have been proven safe and effective in study. However, a lack of literature describing application of the ...
Cherry-Bukowiec Jill R - - 2013
Critically ill patients are at high risk of malnutrition and lean body mass loss. Screening for malnutrition and performing detailed assessment of energy needs should be routine for patients admitted to intensive care units. Providing adequate calorie and protein provisions can attenuate muscle loss in many at-risk patients. Enteral nutrition ...
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