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Carlos Walter Sobrado, Lucas Faraco Sobrado
Introduction: Acute severe colitis is a potentially lethal medical emergency and, even today, its treatment remains a challenge for clinicians and surgeons. Intravenous corticoid therapy, which was introduced into the therapeutic arsenal in the 1950s, continues to be the first-line treatment and, for patients who are refractory to this, the rescue therapy may consist of clinical measures or emergency colectomy. Objective: To evaluate the indications for and results from drug rescue therapy (cyclosporine, infliximab and tacrolimus), and to suggest a practical guide for clinical approaches...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Marianne H Gillam, Nicole L Pratt, Maria C S Inacio, Elizabeth E Roughead, Sepehr Shakib, Stephen J Nicholls, Stephen E Graves
Background and purpose - It is unclear whether metal particles and ions produced by mechanical wear and corrosion of hip prostheses with metal-on-metal (MoM) bearings have systemic adverse effects on health. We compared the risk of heart failure in patients with conventional MoM total hip arthroplasty (THA) and in those with metal-on-polyethylene (MoP) THA. Patients and methods - We conducted a retrospective cohort study using data from the Australian Government Department of Veterans' Affairs health claims database on patients who received conventional THA for osteoarthritis between 2004 and 2012...
October 19, 2016: Acta Orthopaedica
Satishkumar G Patil, Imtiaz A Kotwal, Udupikrishna Joshi, Soumya Allurkar, Nitin Thakur, Aafreen Aftab
BACKGROUND AND PURPOSE: Midfacial fractures may often be associated with injuries to the orbit which may lead to notable dysfunction of the visual apparatus, if not detected early after injury. The purpose of this study is to evaluate the associated ophthalmic injuries in mid-face trauma and to emphasize the need for understanding the ophthalmic signs and symptoms by an attending maxillofacial surgeon. PATIENTS AND METHODS: A total number of 60 clinically and radiographically proven subjects with midfacial fractures were considered in the study that underwent complete ophthalmological evaluation at initial presentation...
September 2016: Journal of Maxillofacial and Oral Surgery
Julia Schellong, Franziska Epple, Kerstin Weidner, Andrea Möllering
A non-neglectable portion of people that have fled to Germany have been subjected to expulsion, violence, torture and grave human loss. In some of them, signs of secondary mental problems are obvious. In the light of the efforts at integration, these diseases must not be neglected. Outlined are the federal legal requirements and how the cost coverage, as well as the admission to health care system, is structured. Additionally, 2 exemplary regional models for psychosomatic health care are being introduced: Dresden's "Stepped Care Model for Psychologically Vulnerable Refugees" includes phased offers for prevention and treatment of acute mental crises, as well as somatoform disorders in refugees and their volunteer helpers...
October 17, 2016: Psychotherapie, Psychosomatik, Medizinische Psychologie
Yu Mi Seo, Seok Hwang-Bo, Seong Koo Kim, Seung Beom Han, Nack-Gyun Chung, Jin Han Kang
BACKGROUND: Although adenovirus (ADV) infection usually causes self-limiting respiratory disorders in immune competent children; severe and systemic ADV infection in children undergoing chemotherapy for leukemia has been continuously reported. Nevertheless, there has been no consensus on risk factors and treatment strategies for severe ADV infection in children undergoing chemotherapy. CASE SUMMARY: We report a case of a 15-year-old boy with a fatal systemic ADV infection...
October 2016: Medicine (Baltimore)
Mohammad Khassawneh, Nedaa Al-Ghazo
A 35-year-old woman with a 9-year history of Grave's disease delivered a male infant weighing 2,210 g at 32 weeks of gestation by caesarean section. The neonate developed thyrotoxicosis and, at the age of 24 h, was treated with oral carbimazole (500 µg every 8 h) and propranolol (2 mg/kg/day in two divided doses). He subsequently developed hypertension on day 4, which required therapy with amlodipine (0.1 mg once daily). Severe hypotension developed within 24 h and required discontinuation of amlodipine, with initiation of intravenous inotropic support with dopamine and dobutamine (at a rate of 20 µg/kg/min)...
December 2015: Drug Saf Case Rep
János Jakucs, Eszter Bánffy, Krisztián Oross, Vanda Voicsek, Christopher Bronk Ramsey, Elaine Dunbar, Bernd Kromer, Alex Bayliss, Daniela Hofmann, Peter Marshall, Alasdair Whittle
Perhaps nowhere in European prehistory does the idea of clearly-defined cultural boundaries remain more current than in the initial Neolithic, where the southeast-northwest trend of the spread of farming crosses what is perceived as a sharp divide between the Balkans and central Europe. This corresponds to a distinction between the Vinča culture package, named for a classic site in Serbia, with its characteristic pottery assemblage and absence of longhouses, and the Linearbandkeramik (LBK), with equally diagnostic but different pottery, and its apparently culturally-diagnostic longhouses, extending in a more northerly belt through central Europe westward to the Dutch coast...
2016: Journal of World Prehistory
I G Murphy, M J Graves, S Reid, A J Patterson, I Patterson, A N Priest, D J Lomas
PURPOSE: Hepatic magnetic resonance elastography (MRE) is currently a breath-hold imaging technique. Patients with chronic liver disease can have comorbidities that limit their ability to breath-hold (BH) for the required acquisition time. Our aim was to evaluate whether stiffness measurements obtained from a navigator-triggered MRE acquisition are comparable to standard expiratory breath-hold, inspiratory breath-hold or free-breathing in healthy participants. MATERIALS AND METHODS: Twelve healthy participants were imaged using the four methods on a clinical 1...
October 13, 2016: Magnetic Resonance Imaging
Hugh Stephen Leff, Clifton M Chow, Stephen C Graves
OBJECTIVE: A random-effects meta-analysis of studies that used Markov transition probabilities (TPs) to describe outcomes for mental health service systems of differing quality for persons with serious mental illness was implemented to improve the scientific understanding of systems performance, to use in planning simulations to project service system costs and outcomes over time, and to test a theory of how outcomes for systems varying in quality differ. METHODS: Nineteen systems described in 12 studies were coded as basic (B), maintenance (M), and recovery oriented (R) on the basis of descriptions of services provided...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Alfredo Campennì, Salvatore Giovinazzo, Salvatore Antonio Pignata, Francesca Di Mauro, Domenico Santoro, Lorenzo Curtò, Francesco Trimarchi, Rosaria Maddalena Ruggeri, Sergio Baldari
Parathyroid carcinoma is a rare malignancy, which usually occurs as a sporadic disease, and less frequently in the setting of genetic syndromes. Despite the association of parathyroid and thyroid disorders being quite common, the coexistence of parathyroid carcinoma and thyroid disease is rare. We reviewed the pertinent literature. The terms "parathyroid carcinoma" and "thyroid disease, hyperthyroidism, thyrotoxicosis, hypothyroidism, thyroid nodule(s), Graves' disease, autonomously functioning thyroid nodules" were used both separately and in reciprocal conjunction to search MEDLINE for articles published from January 2007 to March 2016...
October 15, 2016: Endocrine
Joseph L Graves, Chris Reiber, Anna Thanukos, Magdalena Hurtado, Terry Wolpaw
Evolutionary science is indispensable for understanding biological processes. Effective medical treatment must be anchored in sound biology. However, currently the insights available from evolutionary science are not adequately incorporated in either pre-medical or medical school curricula. To illuminate how evolution may be helpful in these areas, examples in which the insights of evolutionary science are already improving medical treatment and ways in which evolutionary reasoning can be practiced in the context of medicine are provided...
October 15, 2016: Evolution, Medicine, and Public Health
Andrew O'Keefe, Ann Clarke, Yvan St Pierre, Jennifer Mill, Yuka Asai, Harley Eisman, Sebastien La Vieille, Reza Alizadehfar, Lawrence Joseph, Judy Morris, Jocelyn Graveli, Moshe Ben-Shoshan
OBJECTIVES: To determine the recurrence rate of anaphylaxis in children medically attended in an emergency department (ED), we performed a prospective cohort study to evaluate prehospital and ED management of children with recurrent anaphylaxis and to assess factors associated with recurrent anaphylaxis. STUDY DESIGN: As part of the Cross-Canada Anaphylaxis Registry, parents of children with anaphylaxis identified prospectively in 3 EDs and through an emergency medical response service were contacted annually after presentation and queried on subsequent reactions...
October 12, 2016: Journal of Pediatrics
Imran M Paruk, Yasmeen Ganie, Sureka Maharaj, Fraser J Pirie, Vasudevan G Naidoo, Ntombifikile M Nkwanyana, Hilary L Dinnematin, Pratistadevi K Ramdial, Ayesha A Motala
OBJECTIVE: Data on the prevalence of autoimmune thyroid disease (AITD) and gastric autoimmunity in type 1 diabetes mellitus (T1DM) in Africa are limited. The aim of this study was to assess the prevalence of antithyroid peroxidase (TPO-A) and antiparietal cell antibody (PCA) in patients with T1DM at a tertiary diabetes clinic in Durban, South Africa. RESEARCH DESIGN AND METHODS: This was a cross-sectional observational study among subjects attending the adult T1DM clinic at Inkosi Albert Luthuli Hospital...
October 14, 2016: Postgraduate Medical Journal
Olumide Abiodun, Kamil Alausa, Olanrewaju Olasehinde
BACKGROUND: An emerging pattern of increasing median age at first birth among women has been well documented in Western countries. A similar but less remarkable trend is being experienced in sub-Saharan Africa. There is a paucity of information in Sub-Saharan Africa about awareness of age-related fertility decline. The aim of this study was to assess the perception of fertility, childbirth intentions and parenting attitudes among university students. MATERIALS AND METHODS: A cross-sectional survey of 231 female and 158 male students randomly selected university undergraduates in Nigeria using a self-reported questionnaire...
October 14, 2016: International Journal of Adolescent Medicine and Health
Murlidhar, Rishab Sharma, Sanjiv Maheshwari, Rajesh Jain, Rekha Porwal
Gas under the diaphragm or pneumoperitoneum, is often a sign of grave intra-abdominal pathology. It can be due to either of surgical or non-surgical etiology. Here we present a case of gas under right dome of diaphragm caused by a non-surgical cause i.e. secondary to aspiration of liver abscess.
June 2016: Journal of the Association of Physicians of India
Rafael Coimbra Ferreira Beltrame, Maurício Friderichs, Bárbara Rayanne Fior, Pedro Guilherme Schaefer, Gustavo Gomes Thomé, Dirceu Reis da Silva, Elvino José Guardão Barros, Renato Seligman, Francisco Veríssimo Veronese
The IgG4-related disease has a wide clinical spectrum where multiple organs can be affected, and the diagnosis depends on typical histopathological findings and an elevated IgG4 expression in plasma cells in the affected tissue. We describe the clinical presentation and evolution of a patient with acute tubulointerstitial nephritis, severe kidney failure and systemic manifestations such as lymphadenomegaly and chronic pancreatitis. The diagnosis was confirmed by the clinical picture and kidney and lymph node histopathology, in which immunohistochemistry of the lymphoid tissue showed policlonality and increased expression of IgG4, with a IgG4/total IgG ratio > 80%...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Ana Rita Francisco, Inês Gonçalves, Fátima Veiga, Mónica Mendes Pedro, Fausto J Pinto, Dulce Brito
Severe hypertriglyceridemia has been consistently associated with an increased risk of cardiovascular disease and other complications, namely acute pancreatitis. We report a case of a 64 year-old woman with hypertrophic cardiomyopathy and metabolic syndrome with triglyceride level of 3260 mg/dL. Plasma exchange was performed with simultaneous medical treatment to achieve a rapid and effective lowering of triglycerides in order to prevent clinical complications. After three plasmapheresis sessions a marked reduction in triglyceride and total cholesterol levels was observed...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Bruno Caldin da Silva, Adriano Sanjuan, Valéria Costa-Hong, Luciene Dos Reis, Fabiana Graciolli, Fernanda Consolim-Colombo, Luiz Aparecido Bortolotto, Rosa Maria Affonso Moyses, Rosilene Motta Elias
Introduction: Bone metabolism disorder (BMD) and vascular dysfunction contribute to excess cardiovascular mortality observed in hemodialysis patients. Vascular dysfunction, a new marker of atherosclerosis, can play a role in this risk. Even though associated with higher mortality in the general population, such vascular evaluation in patients on hemodialysis has not been extensively studied. Methods: In this cross-sectional study, hemodialysis patients were submitted to flow-mediated dilation, subendocardial viability ratio (SEVR) and ejection duration index assessment, in order to estimate the impact of BMD markers on vascular dysfunction...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Inés Olaizola, Hena Caorsi, Laura Fajardo, Alejandro Ferreiro, Nieves Campistrus, Deyanira Dolinsky, Alicia Petraglia, Pablo Ambrosoni
Introduction: The mineral bone disorder, particularly secondary hyperparathyroidism, in chronic kidney disease (CKD) has a systemic impact affecting not only bone metabolism. Therefore its correction is important to prevent cardiovascular, inflammatory and immune diseases. Objective: To assess the effectiveness and safety of intravenous paricalcitol administered over a 6 month period for the treatment of secondary hyperparathyroidism (SHPT) in patients undergoing conventional hemodialysis, with close follow-up of treatment response...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
S Sellari-Franceschini, I Dallan, A Bajraktari, G Fiacchini, M Nardi, R Rocchi, C Marcocci, M Marinò, A P Casani
The objective of this study is to analyse the complications of orbital decompression in Graves' orbitopathy. The clinical records of 946 patients who had been operated on with orbital decompression for Graves' orbitopathy were reviewed and the intra- and post-operative complications with minimum follow-up of six months were analysed. An extensive review of the literature was carried out to compare results. In the case-series reported here the most frequent complications were: wasting of the temporal region (100%) in patients operated on using a coronal approach; permanent hypoesthesia of V2 (13%) and V1 (8%) in patients operated on with an upper eyelid incision...
August 2016: Acta Otorhinolaryngologica Italica
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