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https://www.readbyqxmd.com/read/29667215/a-simple-signaling-rule-for-variable-life-adjusted-display-derived-from-an-equivalent-risk-adjusted-cusum-chart
#1
Philipp Wittenberg, Fah Fatt Gan, Sven Knoth
The variable life-adjusted display (VLAD) is the first risk-adjusted graphical procedure proposed in the literature for monitoring the performance of a surgeon. It displays the cumulative sum of expected minus observed deaths. It has since become highly popular because the statistic plotted is easy to understand. But it is also easy to misinterpret a surgeon's performance by utilizing the VLAD, potentially leading to grave consequences. The problem of misinterpretation is essentially caused by the variance of the VLAD's statistic that increases with sample size...
April 17, 2018: Statistics in Medicine
https://www.readbyqxmd.com/read/29666926/segmental-reversal-of-distal-small-intestine-in-short-bowel-syndrome-a-study-on-the-influence-on-postoperative-weight-and-intestinal-topography-in-piglets
#2
Pernille Kock Grave, Sabrina Valentin Thomsen, Pia Susanne Clark, Gunvor Iben Madsen, Niels Qvist, Mark Bremholm Ellebæk
PURPOSE: The objective of the present study was to investigate the effect of segmental reversal of the distal 20 cm of the small intestine in piglets with induced SBS compared to controls with SBS alone. Primary endpoint was postoperative weight change over a period of 1 month. Secondary endpoints were the influence on cell proliferation and mucosal architecture shown by histological analysis. METHODS: Sixteen piglets underwent a 60% resection of the distal small intestine and were randomized into two groups...
April 17, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29666717/aortic-dissection-presenting-as-septic-shock-a-case-report-and-literature-review
#3
Jing Feng, Rui Liu, Sai Ma, Changkui Cao, Wei Zhang, Yang Zhao, Shinan Nie
Acute aortic dissection is a life-threatening clinical emergency, which mostly occurs in aged patients and presents with sharp chest pain. In this paper, we reported a case of acute aortic dissection, which induced septic shock in a young woman, without typical chest pain. The septic shock was possibly due to the bacterial translocation caused by aortic dissection-induced intestinal ischemia and intestinal epithelial barrier dysfunction. Our case appeared as the first case report of aortic dissection presenting as septic shock...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29665190/comparison-of-emergency-medicine-malpractice-cases-involving-residents-to-non-resident-cases
#4
Kiersten L Gurley, Shamai A Grossman, Margaret Janes, C Winnie Yu-Moe, Ellen Song, Carrie D Tibbles, Nathan I Shapiro, Carlo L Rosen
BACKGROUND: Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. OBJECTIVES: To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. METHODS: We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013...
April 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29664539/-atypical-subacute-thyroiditis-in-combination-with-grave-s-disease-diagnostic-difficulties-in-a-case-report
#5
Emmanouela Koutouridou, Tereza Planck, Erik Uddman, Mikael Lantz
Subacute thyroiditis is a common inflammatory disorder of the thyroid gland, possibly of viral etiology, that typically presents with neck pain, fever and tenderness on palpation of the thyroid gland. Graves' disease is an autoimmune thyroid disorder caused by stimulation of the thyroid gland by thyrotropin receptor antibodies (TRAb). The development of Graves´ disease and subacute thyroiditis simultaneously is an uncommon condition and only a few cases have been reported. In this article we present a case of a 46-year old woman diagnosed with Graves´ disease who was started on thiamazole and weeks later developed high fever...
April 13, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29664177/-osler-warned-was-william-osler-a-grave-robber-while-at-mcgill-or-was-he-a-victim-or-perpetrator-of-one-final-practical-joke
#6
James R Wright
Bodysnatching was an illegal way to procure cadavers for anatomical dissection before the existence of effective anatomy legislation. As knowledge of anatomy was fundamental to medical practice, many famous 19th century physicians turned a blind eye to this activity or even participated. Sir William Osler, perhaps the most revered physician of all time, received his medical degree from McGill University in 1872 and then served as pathologist at Montreal General Hospital from 1874 to 1884, where he began a career which culminated in him becoming both the first Professor of Medicine at Johns Hopkins and then Regius Professor at Oxford...
April 17, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29663139/corneal-biopsy-for-diagnosis-of-recalcitrant-microbial-keratitis
#7
Dana Robaei, U-Teng Chan, Pauline Khoo, Svetlana Cherepanoff, Yi-Chiao Li, Jane Hanrahan, Stephanie Watson
PURPOSE: To document the findings of corneal biopsies for progressive microbial keratitis in a large tertiary referral institution. METHODS: A retrospective medical records review of all patients who underwent at least one corneal biopsy for the diagnosis of microbial keratitis at Sydney Eye Hospital, Australia between January 1, 2010 and December 31, 2016 was performed. RESULTS: Thirty-eight patients (18 men and 20 women) underwent a corneal biopsy for progressive microbial keratitis unresponsive to broad-spectrum topical antimicrobials...
April 16, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29659320/opioid-discussion-in-the-twittersphere
#8
Rachel L Graves, Christopher Tufts, Zachary F Meisel, Dan Polsky, Lyle Ungar, Raina M Merchant
BACKGROUND: The rise in opioid use and overdose has increased the importance of improving data collection methods for the purpose of targeting resources to high-need populations and responding rapidly to emerging trends. OBJECTIVE: To determine whether Twitter data could be used to identify geographic differences in opioid-related discussion and whether opioid topics were significantly correlated with opioid overdose death rate. METHODS: We filtered approximately 10 billion tweets for keywords related to opioids between July 2009 and October 2015...
April 16, 2018: Substance Use & Misuse
https://www.readbyqxmd.com/read/29657494/stereomicroscopic-study-on-unsectioned-extracted-teeth
#9
V Keerthi Narayan, V K Varsha, H C Girish, Sanjay Murgod
Introduction: Age has been considered as a reliable marker for establishing the identity of a person in the field of forensic medicine. Teeth are useful skeletal indicators of age at death since it can survive for decades. Nondestructive methods ensure the evident preservation of dental hard tissues that reflect age changes from the cradle to the grave. Therefore, an attempt was made for estimating the age using the nondestructive method. Aims and Objectives: The aim of this study to assess whether physiological changes of the teeth allow possible correlation for accurate age estimation and to establish a graduation standard by microscopic observation for a better age correlation...
September 2017: Journal of Forensic Dental Sciences
https://www.readbyqxmd.com/read/29657178/doctor-in-and-for-the-family-physicians-reflect-on-care-for-loved-ones
#10
John C Moskop
This commentary examines themes identified in twelve physicians' narratives recounting their experiences in caring for seriously ill family members. In these narratives, physicians describe heavy emotional burdens and other impediments to sound medical decision-making with and for their loved ones. The physicians struggled to balance their roles as physicians and as loving family members, and they employed their professional role in a variety of different ways. Several physicians became personal physicians to their family members, and others deliberately avoided that role...
2018: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/29657073/-treatment-of-severe-cutaneous-adverse-drug-reactions
#11
S Ingen-Housz-Oro, T-A Duong, N de Prost, A Colin, L Fardet, B Lebrun-Vignes, A Barbaud, O Chosidow, P Wolkenstein
No abstract text is available yet for this article.
April 13, 2018: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/29656212/myeloid-related-proteins-are-up-regulated-in-autoimmune-thyroid-diseases-and-activate-toll-like-receptor-4-and-pro-inflammatory-cytokines-in-vitro
#12
Shiqiao Peng, Xuren Sun, Xinyi Wang, Haoyu Wang, Zhongyan Shan, Weiping Teng, Chenyan Li
PURPOSE: Myeloid-related protein (MRP) family plays an important role in the promotion of cell proliferation and the production of inflammatory cytokines. We investigated the expression of MRP6, MRP8 and MRP14 in thyroid tissues, serum, and peripheral blood monocular cells (PBMCs) in patients with autoimmune thyroid diseases (AITD). METHOD: The expression of MRP6, MRP8, and MRP14 was investigated using immunohistochemical staining and quantitative real-time polymerase chain reaction in the thyroid glands of 7 patients with Graves' disease (GD), 8 with Hashimoto's thyroiditis (HT), and 7 healthy controls (HC)...
April 12, 2018: International Immunopharmacology
https://www.readbyqxmd.com/read/29655646/5-g-wireless-telecommunications-expansion-public-health-and-environmental-implications
#13
Cindy L Russell
The popularity, widespread use and increasing dependency on wireless technologies has spawned a telecommunications industrial revolution with increasing public exposure to broader and higher frequencies of the electromagnetic spectrum to transmit data through a variety of devices and infrastructure. On the horizon, a new generation of even shorter high frequency 5G wavelengths is being proposed to power the Internet of Things (IoT). The IoT promises us convenient and easy lifestyles with a massive 5G interconnected telecommunications network, however, the expansion of broadband with shorter wavelength radiofrequency radiation highlights the concern that health and safety issues remain unknown...
April 11, 2018: Environmental Research
https://www.readbyqxmd.com/read/29653437/early-infectious-exposures-are-not-associated-with-increased-risk-of-pediatric-onset-multiple-sclerosis
#14
Leena Suleiman, Emmanuelle Waubant, Gregory Aaen, Anita Belman, Leslie Benson, Meghan Candee, Tanuja Chitnis, Mark Gorman, Manu Goyal, Benjamin Greenberg, Yolanda Harris, Janace Hart, Ilana Kahn, Lauren Krupp, Timothy Lotze, Soe Mar, Manikum Moodley, Jayne Ness, Bardia Nourbakhsh, Mary Rensel, Moses Rodriguez, John Rose, Jennifer Rubin, Teri Schreiner, Jan-Mendelt Tillema, Amy Waldman, Bianca Weinstock-Guttman, T Charles Casper, Michael Waltz, Jennifer S Graves
OBJECTIVE: We sought to determine if early infectious exposures such as daycare, early use of antibiotics, vaccinations and other germ exposures including pacifier use and playing on grass are associated with multiple sclerosis (MS) risk in children. METHODS: This was a case-control study of children with MS or clinically isolated syndrome (CIS) and healthy controls enrolled at sixteen clinics participating in the US Network of Pediatric MS Centers. Parents completed a comprehensive environmental questionnaire that captured early infectious exposures, habits, and illnesses in the first five years of life...
March 26, 2018: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29652204/low-dose-rituximab-for-active-moderate-to-severe-graves-orbitopathy-resistant-to-conventional-treatment
#15
Laurence Du Pasquier-Fediaevsky, Stefan Andrei, Michel Berche, Laurence Leenhardt, Emmanuel Héron, Sébastien Rivière
PURPOSE: To report low-dose rituximab effect in Graves' orbitopathy (GO) resistant to conventional treatment. METHODS: Retrospective analysis of medical records, filled in according to the European Group on Graves' Orbitopathy (EUGOGO) standards, of patients with active moderate-to-severe GO who received low-dose rituximab after failure of conventional treatment. Efficacy was defined by a decrease of the clinical activity score of 2 points or <4/10. RESULTS: Among 219 patients treated between 2012 and 2016 by pulse methylprednisolone, possibly followed by oral steroids and/or orbital radiotherapy, 15 (6...
April 13, 2018: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/29651523/simple-and-inexpensive-micromachined-aluminum-microfluidic-devices-for-acoustic-focusing-of-particles-and-cells
#16
Gayatri P Gautam, Tobias Burger, Andrew Wilcox, Michael J Cumbo, Steven W Graves, Menake E Piyasena
We introduce a new method to construct microfluidic devices especially useful for bulk acoustic wave (BAW)-based manipulation of cells and microparticles. To obtain efficient acoustic focusing, BAW devices require materials that have high acoustic impedance mismatch relative to the medium in which the cells/microparticles are suspended and materials with a high-quality factor. To date, silicon and glass have been the materials of choice for BAW-based acoustofluidic channel fabrication. Silicon- and glass-based fabrication is typically performed in clean room facilities, generates hazardous waste, and can take several hours to complete the microfabrication...
April 12, 2018: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/29650691/predictive-score-for-the-development-or-progression-of-graves-orbitopathy-in-patients-with-newly-diagnosed-graves-hyperthyroidism
#17
Wilmar M Wiersinga, Miloš Žarković, Luigi Bartalena, Simone Donati, Petros Perros, Onyebuchi Okosieme, Daniel Morris, Nicole Fichter, Juerg Lareida, Georg von Arx, Chantal Daumerie, Maria-Cristina Burlacu, George J Kahaly, Susanne Pitz, Biljana Beleslin, Jasmina Ćirić, Goksun Ayvaz, Onur Konuk, Fusun Balos Toruner, Mario Salvi, Danila Covelli, Nicola Currò, Laszlo Hegedüs, Thomas Heiberg Brix
Objective: To construct a predictive score for the development or progression of Graves' orbitopathy (GO) in Graves' hyperthyroidism (GH). Design: Prospective observational study in patients with newly diagnosed GH, treated with antithyroid drugs (ATD) for 18 months at ten participating centers from EUGOGO in 8 European countries. Methods: 348 patients were included with untreated GH but without obvious GO. Mixeded effects logistic regression was used to determine best predictors. A predictive score (called PREDIGO) was constructed...
April 12, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29649314/randomly-auditing-research-labs-could-be-an-affordable-way-to-improve-research-quality-a-simulation-study
#18
Adrian G Barnett, Pauline Zardo, Nicholas Graves
The "publish or perish" incentive drives many researchers to increase the quantity of their papers at the cost of quality. Lowering quality increases the number of false positive errors which is a key cause of the reproducibility crisis. We adapted a previously published simulation of the research world where labs that produce many papers are more likely to have "child" labs that inherit their characteristics. This selection creates a competitive spiral that favours quantity over quality...
2018: PloS One
https://www.readbyqxmd.com/read/29649049/a-comparison-of-repeatability-and-usability-of-semi-automated-volume-segmentation-tools-for-measurement-of-vestibular-schwannomas
#19
Samuel A C MacKeith, Tilak Das, Martin Graves, Andrew Patterson, Neil Donnelly, Richard Mannion, Patrick Axon, James Tysome
OBJECTIVE: Semi-automated volume segmentation tools (SAVST) offer a less time consuming technique compared with manual volume segmentation method. No data exists to suggest which of the available applications are optimal for use with vestibular schwannomas (VS). This study aims to compare repeatability and usability of three different SAVST for measurement of VS. STUDY DESIGN: Experimental comparison of three SAVST. SETTING: Tertiary skull base unit...
April 11, 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29648895/functional-polymorphisms-of-the-type-1-and-type-2-iodothyronine-deiodinase-genes-in-autoimmune-thyroid-diseases
#20
Naoya Inoue, Mikio Watanabe, Yuka Katsumata, Naoko Ishido, Yoh Hidaka, Yoshinori Iwatani
Graves' disease (GD) and Hashimoto's disease (HD) are major autoimmune thyroid diseases (AITDs), and their pathological conditions vary among patients. Type 1 iodothyronine deiodinase (D1) and type 2 iodothyronine deiodinase (D2) convert from thyroxine (T4) to triiodothyronine (T3). However, few findings have been described concerning the association between polymorphisms in D1 and D2 genes and AITD. Therefore, we genotyped D1 rs11206244, D2 rs225014, and rs12885300 polymorphisms in 134 GD patients, including 54 patients with intractable GD and 44 patients with GD in remission and 132 HD patients, including 57 patients with severe HD, 45 patients with mild HD, and 84 healthy controls using PCR-RFLP...
April 12, 2018: Immunological Investigations
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