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https://www.readbyqxmd.com/read/27909644/primary-squamous-cell-carcinoma-of-the-pancreas-as-a-cause-of-biliary-obstruction
#1
Kyle Rowe, Jeet Mehta, Fredy Nehme, William Salyers
Primary squamous cell carcinoma of the pancreas (SCCP) is a rare neoplasm, given a lack of naturally occurring squamous cells within the pancreas, accounting for only 0.2% of all pancreatic cancers. The etiology is unknown. Symptomatology is non-specific and similar to other pancreatic neoplasms. No non-invasive testing can adequately rule in SCCP, and workup should proceed similarly to any pancreatic mass. Tissue sampling is required for diagnosis and guidance of further management, most commonly by endoscopic ultrasound with fine needle aspirate...
October 31, 2016: Curēus
https://www.readbyqxmd.com/read/27909643/source-control-and-graft-preservation-using-negative-pressure-wound-therapy-with-antibiotic-instillation-a-case-report
#2
Victoria Gilbert, Timothy Kelly, Robert Grossi
Negative pressure wound therapy (NPWT) is widely used to treat many types of complex wounds, and the advent of the instillation and dwell time (NPWTi-d) technique has enhanced this system with the addition of automated treatment with topical solutions. In the field of vascular surgery, NPWT is utilized to help close wounds over underlying grafts; however keeping these wounds free of infection and avoiding large reoperation when infection occurs remains a challenge. In this case report we present a patient who required acute intervention for limb ischemia, with a large wound created in the groin for anastomosis of a prosthetic graft bypass...
October 31, 2016: Curēus
https://www.readbyqxmd.com/read/27909642/seasonal-variations-and-trends-in-hospitalization-for-peptic-ulcer-disease-in-the-united-states-a-12-year-analysis-of-the-nationwide-inpatient-sample
#3
Ritesh Kanotra, Moiz Ahmed, Nileshkumar Patel, Badal Thakkar, Shantanu Solanki, Sarah Tareen, Matthew J Fasullo, Mayurathan Kesavan, Nikhil Nalluri, Ahsan Khan, Dhaval Pau, Liliane Deeb, Jeffrey Abergel, Ananya Das
BACKGROUND: Peptic ulcer disease (PUD) is a major public health burden significantly impacting the cost of hospitalization in the United States (US). We examined the trends, characteristics, complications, cost, and seasonality of PUD-related hospitalizations from 2000 to 2011. METHODS: With the use of the Nationwide Inpatient Sample from 2000 through 2011, we identified PUD-related hospitalizations using the International Classification of Diseases (ICD-9), 9th Revision, and the Clinical Modification code 531...
October 30, 2016: Curēus
https://www.readbyqxmd.com/read/27909641/a-case-series-of-complex-recalcitrant-wounds-treated-with-epidermal-grafts-harvested-from-an-automated-device
#4
Stephen S Cai, Arvind U Gowda, Karan Chopra, Rachel Waldman, Ronald P Silverman, Yvonne M Rasko
INTRODUCTION: Epidermal grafting has several advantages over full-thickness or split-thickness grafts in the treatment of complex non-healing wounds. These include the low risk of donor site complications, minimal patient discomfort, and abstention from the operating room. Traditionally, the lack of reliable epidermal harvesting techniques has limited its clinical utilization. The development of an automated suction blister epidermal graft (SBEG) harvesting device may facilitate clinical utilization of this technique...
October 30, 2016: Curēus
https://www.readbyqxmd.com/read/27909640/treating-fasciotomy-wounds-with-negative-pressure-wound-therapy-with-instillation-and-dwell-time-npwti-d
#5
Priscilla Lee
Acute compartment syndrome (ACS) is a serious complication of lower-extremity trauma caused by accidents or post-procedure complications. ACS is characterized by increased pressure within the compartment, resulting in reduced blood flow, tissue hypoxia, and tissue necrosis. Fasciotomies to relieve pressure and debridement of necrotic tissue comprise primary treatment. My purpose is to present initial experience using negative pressure wound therapy with instillation and dwell time (NPWTi-d)* to treat fasciotomy wounds in two patients...
October 28, 2016: Curēus
https://www.readbyqxmd.com/read/27909639/factors-associated-with-the-use-of-radiation-therapy-in-patients-with-stage-iii-non-small-cell-lung-cancer-in-alberta-canada-a-population-based-study
#6
Hong-Wei Liu, Marc Kerba, Gerald Lim, Zsolt Gabos, Ivo A Olivotto, Anil Abraham Joy, Wilson Roa, Zoann Nugent, Harold Lau
BACKGROUND: Cancer care in Alberta, Canada is publicly funded and provides patients with access to health care facilities and providers. The distribution of patients and health services across Alberta presents challenges to the delivery of cancer care, especially radiation therapy. In this study, we examined the association between patient and health system factors, the use of radiation therapy and survival outcomes in patients with stage III non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: The provincial cancer registry was used to identify all patients who presented with clinical stage III NSCLC, diagnosed from 2005 to 2007, in Alberta...
October 27, 2016: Curēus
https://www.readbyqxmd.com/read/27909638/four-rod-instrumentation-for-treatment-of-charcot-spinal-arthropathy-causing-autonomic-dysreflexia-case-report-and-literature-review
#7
Stephanie Zyck, Gentian Toshkezi, John Pizzuti, Satya Marawar
Late complications of spinal cord injury can include Charcot arthropathy, in which spinal instability occurs as a result of repetitive trauma in the insensate spine. In rare cases, this can present as autonomic dysreflexia. We present the case of a 60-year-old man with longstanding C6 quadriplegia who presented with six months of hypertension, diaphoresis and dizziness. After an extensive workup, the patient's symptoms were attributed to autonomic dysreflexia in the setting of spinal instability from Charcot spinal arthropathy...
October 27, 2016: Curēus
https://www.readbyqxmd.com/read/27909637/the-impact-of-hope-and-resilience-on-multiple-factors-in-neurosurgical-patients
#8
REVIEW
Devika Duggal, Amanda Sacks-Zimmerman, Taylor Liberta
The purpose of the present article is to outline and review the impact of stable psychological characteristics on the emotional and functional outcomes of neurosurgical patients. Neurosurgical patients face adversity as inherent to their diagnoses and, consequently, experience emotional distress. Despite commonalities in diagnoses, diverse outcomes are seen post-neurosurgery, which are influenced by psychological factors. Therefore, an understanding of neurosurgical patients' behavior, thoughts, and feelings surrounding their diagnoses, informed by psychological concepts, is important for both neuropsychology and neurosurgery...
October 26, 2016: Curēus
https://www.readbyqxmd.com/read/27909636/imatinib-induced-ototoxicity-in-a-patient-with-gastrointestinal-stromal-tumor-gist
#9
Komal Wasif, Nawal Wasif, Muhammad W Saif
Imatinib (Gleevec) is a biological agent that is approved for the treatment of chronic myeloid leukemia (CML) as well as gastrointestinal stromal tumor (GIST). The most frequently seen adverse effects in patients treated with imatinib include superficial edema, muscle cramps, musculoskeletal pain, rash, fatigue, headache, abdominal pain, and joint pain. Ototoxicity has rarely been reported except in two cases. We report a case of bilateral irreversible sensorineural hearing loss (SNHL) caused by imatinib in a patient receiving this agent in the adjuvant setting...
October 26, 2016: Curēus
https://www.readbyqxmd.com/read/27909635/secondary-neuroendocrine-carcinoma-following-high-dose-radiotherapy-for-head-and-neck-cancer-report-of-two-cases
#10
Amandeep S Taggar, Roderick Simpson, Desiree Hao, Marc Webster, Moosa Khalil, John Lysack, David Skarsgard
Patients treated with radiation have an increased risk of developing second cancers, of which carcinomas, sarcomas, and hematological malignancies have most commonly been reported. Neuroendocrine carcinomas (NEC) are rarely reported in patients previously treated with radiation. Two patients, who had successfully undergone chemoradiotherapy for head and neck cancers at our institution, developed secondary NEC within the radiation field more than five years after the treatment. Both patients underwent curative-intent treatment of secondary malignancies, one with chemotherapy, radiation and surgery (Case 1) and the other with chemotherapy and surgery (Case 2)...
October 25, 2016: Curēus
https://www.readbyqxmd.com/read/27909634/nontuberculous-mycobacteria-lymphadenitis-a-case-report
#11
Amanda M Krantz, Meera Varnam, Cristina Fernandez
Atypical mycobacteria, also known as nontuberculous mycobacteria (NTM) includes acid-fast bacteria other than Mycobacterium tuberculosis. NTM can be isolated from a variety of environmental sources including water, food products, domestic animals, and soil; human exposure is typically from soil to the oral cavity and respiratory tract. Diagnosis of NTM is suspected in children less than five years old with subacute, unilateral, non-tender cervicofacial lymphadenitis in combination with a history of water exposure, penetrating injection, as well as negative routine cultures or response to antistaphylococcal and antistreptococcal antibiotics...
October 25, 2016: Curēus
https://www.readbyqxmd.com/read/27909633/the-hidden-curriculum-exposing-the-unintended-lessons-of-medical-education
#12
Laura Hopkins, Lana Saciragic, Joanna Kim, Glenn Posner
INTRODUCTION:  The hidden curriculum is a set of ethical, moral, and value-based teachings communicated to doctors-in-training, providing a basis for their future interactions with patients, peers, and colleagues. The aim of our study is to introduce the concept of the hidden curriculum to a cohort of third-year medical students and to subsequently evaluate their understanding. In particular, we sought to measure and benchmark the degree of hidden curriculum recognition within a Canadian medical education context...
October 25, 2016: Curēus
https://www.readbyqxmd.com/read/27909632/a-framework-for-navigating-institutional-review-board-irb-oversight-in-the-complicated-zone-of-research
#13
Gretchen E Parker
The treatment therapies and technologies currently emerging from the rapidly evolving health care industry must undergo full examination in a clinical setting if they are to be marketed to the public. All elements of clinical studies involving human subjects must undergo thorough IRB review before study activities can commence. Regulations regarding IRB oversight apply to all clinical studies-including retrospective examinations of private medical data and identifiable biological samples. It is not uncommon for researchers to be unsure whether, or on what level, IRB review and oversight are required for a particular project...
October 25, 2016: Curēus
https://www.readbyqxmd.com/read/27909631/a-nonoperative-approach-for-neurosurgical-management-of-a-sylvian-fissure-dermoid-cyst
#14
Ali S Haider, Clarence Kee, Danielle L DeBacker, Ian T Watson, Eliel N Arrey, Tijani Osumah, Dean Leonard, Chen Chen, Maryam Alam, L Gerard Toussaint Iii
The nonoperative management of sylvian fissure dermoid/epidermoid cysts presents a risk that is difficult to quantify. With rupture, potentially fatal complications such as chemical meningitis, hydrocephalus, fever, seizure, or meningeal irritation may occur. In this paper, we present an asymptomatic case of such a cyst with imaging evidence of prior rupture, and we review the literature for the likelihood of future complications. We use for illustration a case of a 68-year-old woman with imaging features of a sylvian fissure epithelial inclusion cyst who refused surgical intervention and review the literature for further investigation...
October 24, 2016: Curēus
https://www.readbyqxmd.com/read/27909630/comparison-between-closed-suction-drainage-and-no-drainage-following-total-knee-arthroplasty-in-a-tertiary-care-setting-in-pakistan
#15
Avais Raja, Hana Manzoor, Waqar M Jan, Salman Assad
BACKGROUND: Total knee arthroplasty is associated with hematoma formation and extensive blood loss up to 1.5 liters. The placement of a closed suction drain to control this complication is controversial. The purpose of this study is to determine the efficacy between total knee arthroplasty without a drain and with a closed suction drain.  Methods: A retrospective cohort study was conducted between January 2014 and December 2015 on 100 patients to assess the hemoglobin and hematocrit levels, the rate of allogeneic blood transfusion, and the length of hospital stay in patients with a closed suction drain versus no suction post-total knee arthroplasty...
October 24, 2016: Curēus
https://www.readbyqxmd.com/read/27909629/stereotactic-body-radiotherapy-for-hepatocellular-carcinoma-resulting-in-a-durable-relapse-free-survival-a-case-report
#16
Samual Francis, Ned Williams, Christopher J Anker, Akram Shaaban, Robin Kim, Dennis Shrieve, Jonathan Tward
The standard of care for localized hepatocellular carcinoma (HCC) is surgical resection. For patients who decline or who are unfit for surgery, stereotactic body radiotherapy (SBRT) is emerging as a viable treatment approach. We present a case of a 77-year-old female in whom an early stage HCC was incidentally discovered. Given her religious edicts as a devout Jehovah's Witness and her subsequent desire to avoid a blood transfusion, she declined surgical resection or transplant due to the risk of hemorrhage...
October 24, 2016: Curēus
https://www.readbyqxmd.com/read/27909628/deep-brain-stimulation-salvages-a-flourishing-dental-practice-a-dentist-with-essential-tremor-recounts-his-experience
#17
EDITORIAL
Guy Giacopuzzi, Melanie Lising, Casey H Halpern
In recounting his experience with deep brain stimulation (DBS), a practicing dentist challenged with long-standing bilateral essential tremor of the hands shares insights into his diagnosis, treatments, and ultimately successful DBS surgery at Stanford University Medical Center, CA, USA. Now nearly one year after his surgery, his practice continues to flourish and he encourages others in his profession to consider the possibility of DBS as a definitive treatment for tremors of the hand, which may salvage their practice...
October 22, 2016: Curēus
https://www.readbyqxmd.com/read/27900232/vanishing-pituitary-macroadenoma-a-case-report
#18
Emily P Sieg, Hayk Stepanyan, Russell Payne, Tao Ouyang, Brad E Zacharia
Pituitary macroadenomas are the most common suprasellar lesions in adults and are typically managed surgically through transsphenoidal resection when symptomatic. Due to their close proximity to the optic chiasm, pituitary macroadenomas often present with signs of bitemporal hemianopsia. Alternatively, these tumors can cause mass effect, thus presenting with signs of elevated intracranial pressure or can present with signs and symptoms of endocrine dysfunction. Here, we discuss a 55-year-old male diagnosed with a non-functioning pituitary macroadenoma (NFPA) based on cranial imaging, ophthalmologic exam, and endocrine evaluation...
October 20, 2016: Curēus
https://www.readbyqxmd.com/read/27904817/transitional-vertebra-and-spina-bifida-occulta-related-with-chronic-low-back-pain-in-a-young-patient
#19
Maryam Kundi, Maham Habib, Sumbal Babar, Asif K Kundi, Salman Assad, Amjad Sheikh
Bertolotti's syndrome (BS) must be considered as a differential diagnosis in a young patient presenting with low back pain (LBP). We present a case of a 26-year-old male complaining of mild chronic LBP for six years, radiating to his left thigh for the past six months. He has been taking non-steroidal anti-inflammatory drugs (NSAIDs) with skeletal muscle relaxants for pain relief. The X-ray and computed tomography (CT) imagings showed congenital enlargement of the left transverse process of the fifth lumbar (L5) vertebra forming pseudo-articulation with the sacrum and unilateral pars interarticularis defect at the L4 level on the left side, respectively...
October 19, 2016: Curēus
https://www.readbyqxmd.com/read/27900231/efficacy-and-safety-of-direct-oral-anticoagulants-compared-to-warfarin-in-prevention-of-thromboembolic-events-among-elderly-patients-with-atrial-fibrillation
#20
REVIEW
Shilpa D Kailas, Sirisha Reddy Thambuluru
Direct oral anticoagulants (DOACs), previously also known as novel oral anticoagulants (NOACs), have increased the therapeutic options for stroke prevention in atrial fibrillation (AF). Previous studies comparing their relative efficacy and safety do not address age-related differences, such as comorbidities and physical and social boundaries. This review aimed to summarize and compare the clinical and safety outcomes of DOACs and warfarin for stroke prevention in AF in the elderly population (≥ 65 years)...
October 18, 2016: Curēus
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