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https://www.readbyqxmd.com/read/28644589/when-do-we-think-it-is-safe-to-drive-after-hand-surgery-current-practice-and-legal-perspective
#1
S F Murphy, J D Martin-Smith, W Martin-Smith, E O'Broin, A J P Clover
Patients recovering from hand surgery frequently ask when it is safe to drive and it is unclear where the responsibility lies; the surgeon, the patient or the insurance company. An eight-question survey looking at various aspects of clinical practice was circulated to consultant and trainee plastic and orthopaedic surgeons in Ireland and the UK. Of the 89 surgeons who replied, (53%) felt the decision when to drive was the patient's compared with the insurance company (40%) and the surgeon (7%). 80% advised patients to contact their insurance company...
December 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28643050/application-of-transoral-continuous-intraoperative-neuromonitoring-in-natural-orifice-transluminal-endoscopic-surgery-for-thyroid-disease-a-preliminary-study
#2
Han-Kun Chen, Chun-Liang Chen, Kuo-Shan Wen, Yi-Feng Lin, Kai-Yuan Lin, Yih-Huei Uen
BACKGROUND: The novel concept of continuous intraoperative neuromonitoring (Cont-IONM) through stimulation of the vagal nerve has been used in thyroidectomies to prevent imminent injury of the recurrent laryngeal nerve (RLN). This article reports on this technology and the results of using transoral Cont-IONM in natural orifice transluminal endoscopic surgery for thyroid disease. METHODS: Cont-IONM of the RLN was achieved through automatic cyclical stimulation of the vagal nerve using a C2 monitor and delta stimulating electrode...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28642694/ehlers-danlos-syndrome-hypermobility-type-impact-of-somatosensory-orthoses-on-postural-control-a-pilot-study
#3
Emma G Dupuy, Pascale Leconte, Elodie Vlamynck, Audrey Sultan, Christophe Chesneau, Pierre Denise, Stéphane Besnard, Boris Bienvenu, Leslie M Decker
Elhers-Danlos syndrome (EDS) is the clinical manifestation of connective tissue disorders, and comprises several clinical forms with no specific symptoms and selective medical examinations which result in a delay in diagnosis of about 10 years. The EDS hypermobility type (hEDS) is characterized by generalized joint hypermobility, variable skin hyperextensibility and impaired proprioception. Since somatosensory processing and multisensory integration are crucial for both perception and action, we put forth the hypothesis that somatosensory deficits in hEDS patients may lead, among other clinical symptoms, to misperception of verticality and postural instability...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28641990/do-negative-emotions-expressed-during-follow-up-consultations-with-adolescent-survivors-of-childhood-cancer-reflect-late-effects
#4
Anneli V Mellblom, Ellen Ruud, Jon Håvard Loge, Hanne C Lie
OBJECTIVE: To explore whether negative emotions expressed by adolescent cancer survivors during follow-up consultations were associated with potential late effects (persisting disease or treatment-related health problems). METHODS: We video-recorded 66 follow-up consultations between 10 pediatricians and 66 adolescent survivors of leukemia, lymphoma or stem-cell transplantations. In transcripts of the recordings, we identified utterances coded as both 1) expressions of negative emotions (VR-CoDES), and 2) late effect-related discussions...
June 14, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28628665/a-chromosome-5q31-1-locus-associates-with-tuberculin-skin-test-reactivity-in-hiv-positive-individuals-from-tuberculosis-hyper-endemic-regions-in-east-africa
#5
Rafal S Sobota, Catherine M Stein, Nuri Kodaman, Isaac Maro, Wendy Wieland-Alter, Robert P Igo, Albert Magohe, LaShaunda L Malone, Keith Chervenak, Noemi B Hall, Mecky Matee, Harriet Mayanja-Kizza, Moses Joloba, Jason H Moore, William K Scott, Timothy Lahey, W Henry Boom, C Fordham von Reyn, Scott M Williams, Giorgio Sirugo
One in three people has been infected with Mycobacterium tuberculosis (MTB), and the risk for MTB infection in HIV-infected individuals is even higher. We hypothesized that HIV-positive individuals living in tuberculosis-endemic regions who do not get infected by Mycobacterium tuberculosis are genetically resistant. Using an "experiment of nature" design that proved successful in our previous work, we performed a genome-wide association study of tuberculin skin test positivity using 469 HIV-positive patients from prospective study cohorts of tuberculosis from Tanzania and Uganda to identify genetic loci associated with MTB infection in the context of HIV-infection...
June 19, 2017: PLoS Genetics
https://www.readbyqxmd.com/read/28625424/scheduling-non-operating-room-anesthesia-cases-in-endoscopy-using-the-sandbox-analogy
#6
Mitchell H Tsai, Leah A Cipri, Stephen E O'Donnell, J Matthew Fisher, Dimitrios A Andritsos
STUDY OBJECTIVE: For many hospitals, the non-operating room anesthesia (NORA) workload continues to expand. We developed a new NORA scheduling process with shared block time - a sandbox - amongst all of the gastroenterology groups and measured the efficacy of the intervention using basic operating room management metrics. DESIGN: Prospective analysis, statistical process control. SETTING: Academic, rural hospital; endoscopy suite; postoperative recovery area...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28608984/dialysis-in-the-undocumented-the-past-the-present-and-what-lies-ahead
#7
EDITORIAL
Shruti Gupta, Andrew Z Fenves
In many states undocumented immigrants with end stage renal disease (ESRD) do not have access to regular, thrice weekly dialysis. The term "compassionate dialysis" is used to describe dialysis that is provided on an emergent basis, when patients are in extremis from symptoms of volume overload or suffer from life-threatening electrolyte abnormalities. In this editorial, one particularly poignant anecdote is presented from the experience of one of the authors (AZF) as a nephrologist in Texas, a state where undocumented immigrants have faced difficulties in accessing regular dialysis...
June 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28599483/effects-of-programmed-death-ligand-1-expression-on-ok-432-immunotherapy-following-transurethral-resection-in-non-muscle-invasive-bladder-cancer
#8
Zhi-Hua Liu, Fu-Fu Zheng, Yu-Ling Mao, Lie-Fu Ye, Jun Bian, De-Hui Lai, Yun-Lin Ye, Yu-Ping Dai
The present study aimed to investigate the effect of the negative costimulatory molecule programmed death-ligand 1 (PD-L1) on immunotherapy with OK-432, following transurethral resection of bladder tumors in non-muscle invasive bladder cancer (NMIBC), and to elucidate the underlying mechanism. PD-L1 was detected by immunohistochemical staining in tumor specimens from 55 cases of NMIBC following postoperative immunotherapy with OK-432. The PD-L1 mRNA and protein expression levels were measured in the bladder cancer T24 cell line and the human uroepithelial SV-HUC-1 cell line, following treatment with interleukin (IL)-2, interferon (IFN)-α and IFN-γ, by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blot analysis, respectively...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28595733/a-novel-cytogenetic-and-molecular-characterization-of-renal-metanephric-adenoma-identification-of-partner-genes-involved-in-translocation-t-9-15-p24-q24
#9
Aida Catic, Amina Kurtovic-Kozaric, Sarah H Johnson, George Vasmatzis, Michael R Pins, Jillene Kogan
Renal metanephric adenoma (MA) is a rare benign tumor frequently misclassified when microscopic features alone are applied. The correct classification of a renal tumor is critical for diagnostic, prognostic, and therapeutic purposes. Despite the advancements in cancer genomics, up until recently relatively few genetic alterations critical to MA development have been recognized. Recent data suggest that 90% of MA have BRAF(V600E) mutations; the genetics of the remaining 10% are unclear. To date, only one case of a chromosomal translocation, t(9;15)(p24;q24) associated with MA has been reported...
August 2017: Cancer Genetics
https://www.readbyqxmd.com/read/28587512/accuracy-of-predicted-haemoglobin-concentration-on-cardiopulmonary-bypass-in-paediatric-cardiac-surgery-effect-of-different-formulae-for-estimating-patient-blood-volume
#10
Matthias Redlin, Wolfgang Boettcher, Frank Dehmel, Mi-Young Cho, Marian Kukucka, Helmut Habazettl
INTRODUCTION: When applying a blood-conserving approach in paediatric cardiac surgery with the aim of reducing the transfusion of homologous blood products, the decision to use blood or blood-free priming of the cardiopulmonary bypass (CPB) circuit is often based on the predicted haemoglobin concentration (Hb) as derived from the pre-CPB Hb, the prime volume and the estimated blood volume. We assessed the accuracy of this approach and whether it may be improved by using more sophisticated methods of estimating the blood volume...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28561657/clinical-pathways-and-the-patient-perspective-in-the-pursuit-of-value-based-oncology-care
#11
Jennifer L Ersek, Eric Nadler, Janet Freeman-Daily, Samir Mazharuddin, Edward S Kim
The art of practicing oncology has evolved substantially in the past 5 years. As more and more diagnostic tests, biomarker-directed therapies, and immunotherapies make their way to the oncology marketplace, oncologists will find it increasingly difficult to keep up with the many therapeutic options. Additionally, the cost of cancer care seems to be increasing. Clinical pathways are a systematic way to organize and display detailed, evidence-based treatment options and assist the practitioner with best practice...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28560679/personalized-treatment-through-detection-and-monitoring-of-genetic-aberrations-in-single-circulating-tumor-cells
#12
Swee Jin Tan, Trifanny Yeo, Sarvesh Abhay Sukhatme, Say Li Kong, Wan-Teck Lim, Chwee Teck Lim
Circulating tumor cells (CTCs) present a viable alternative to access tumor materials other than primary biopsies in cancer. This disease is among the most widespread in the world and is difficult to target because of its complex nature, challenges in getting quality samples and dynamic temporal changes in response to treatment. Conventional methods of detection and monitoring the disease profile do not suffice to be able to target the heterogeneity that exists at the cellular level. CTCs have been identified as a possible substitute for tumor tissue samples, and can be used to complement current disease management...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28558001/reverse-epitope-mapping-of-the-e2-glycoprotein-in-antibody-associated-hepatitis-c-virus
#13
Amruta S Naik, Ania Owsianka, Brendan A Palmer, Ciaran J O'Halloran, Nicole Walsh, Orla Crosbie, Elizabeth Kenny-Walsh, Arvind H Patel, Liam J Fanning
The humoral immune system responds to chronic hepatitis C virus (HCV) infection by producing neutralising antibodies (nAb). In this study we generated three HCV pseudoparticles in which E1E2 glycoprotein sequence was targeted by the host humoral immune system. We used patient derived virus free Fabs (VF-Fabs) obtained from HCV genotype 1a (n = 3), genotype 1b (n = 7) and genotype 3a (n = 1) for neutralisation of HCVpp produced in this study both individually and in combination. Based on the available anti-HCV monoclonal nAb mapping information we selected amino acid region 384-619 for conformational epitope mapping...
2017: PloS One
https://www.readbyqxmd.com/read/28557723/microcystic-lymphatic-malformation-successfully-treated-with-topical-rapamycin
#14
Pablo García-Montero, Javier Del Boz, Miguel Sanchez-Martínez, Isabel María Escudero Santos, Eulalia Baselga
Microcystic lymphatic malformations (MLM) are low-flow vascular malformations composed of multiple small cysts. MLM usually affect deep-lying structures, which makes their treatment even more difficult and complex. A novel and interesting treatment is rapamycin, a mammalian target of rapamycin inhibitor that when orally administrated has offered favorable results. However, until recently, topical rapamycin had not been used in the treatment of MLM. Case 1 is a girl aged 13 years with extensive MLM affecting the muscles in the right buttock...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28555313/uneven-intervertebral-motion-sharing-is-related-to-disc-degeneration-and-is-greater-in-patients-with-chronic-non-specific-low-back-pain-an-in-vivo-cross-sectional-cohort-comparison-of-intervertebral-dynamics-using-quantitative-fluoroscopy
#15
Alan Breen, Alexander Breen
PURPOSE: Evidence of intervertebral mechanical markers in chronic, non-specific low back pain (CNSLBP) is lacking. This research used dynamic fluoroscopic studies to compare intervertebral angular motion sharing inequality and variability (MSI and MSV) during continuous lumbar motion in CNSLBP patients and controls. Passive recumbent and active standing protocols were used and the relationships of these variables to age and disc degeneration were assessed. METHODS: Twenty patients with CNSLBP and 20 matched controls received quantitative fluoroscopic lumbar spine examinations using a standardised protocol for data collection and image analysis...
May 29, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28554697/orthostatic-hypertension-in-normotensive-type-2-diabetics-what-characteristics
#16
W N Nibouche-Hattab, N Lanasri, F Zeraoulia, A Chibane, A Biad
AIM OF THE STUDY: We aimed to determine the prevalence of orthostatic hypertension (OHT) in normotensive, newly diagnosed type 2 diabetics, to assess clinical, biological characteristics of those patients and evaluate the evolution of their blood pressure, after one year of follow-up. MATERIALS AND METHODS: It is an observational, prospective, cohort study, on 108 normotensive, newly diagnosed diabetics, 40 men and 68 women aged from 40 to 70 ans. OHT was defined as an increase of systolic blood pressure (SBP) ≥20mmHg and/or diastolic blood pressure (DBP) ≥10mmHg, after 1 and 2min of standing from supine position...
May 26, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28540634/simplifying-contrast-induced-acute-kidney-injury-prediction-after-primary-percutaneous-coronary-intervention-the-age-creatinine-and-ejection-fraction-score
#17
Gustavo N Araujo, Fernando Pivatto Junior, Bruno Fuhr, Elvis P Cassol, Guilherme P Machado, Felipe H Valle, Luiz C Bergoli, Rodrigo V Wainstein, Carisi A Polanczyk, Marco V Wainstein
Contrast-induced acute kidney injury (CI-AKI) is a common event after percutaneous coronary intervention (PCI). Presently, the main strategy to avoid CI-AKI lies in saline hydration, since to date none pharmacologic prophylaxis proved beneficial. Our aim was to determine if a low complexity mortality risk model is able to predict CI-AKI in patients undergoing PCI after ST elevation myocardial infarction (STEMI). We have included patients with STEMI submitted to primary PCI in a tertiary hospital. The definition of CI-AKI was a raise of 0...
May 24, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28535563/the-effectiveness-and-safety-of-selective-lumbar-decompression-in-diagnostic-doubt-patients-a-retrospective-control-study
#18
Li Xiaochuan, Cheng-Fan Zhong, Jian-Hua Tang, Rong-Wei Liang, Shao-Jian Luo, Chun-Ming Huang
BACKGROUND: Our previous study demonstrated that selective nerve root block (SNRB) can influence decision-making in lumbar surgery by guiding the selection of nerve roots targeted for decompression in diagnostic doubt patients (DDPs). However, further studies were needed to determine whether this selective decompression (SD) procedure would result in similar clinical outcomes and reduce the perioperative parameters and postoperative complications as compared to the non-selective decompression (NSD) procedure...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28525479/outcome-of-bilateral-c1-laminar-hooks-combined-with-c2-pedicle-screw-fixation-for-the-treatment-of-c1-c2-instability-a-report-of-18-cases-from-a-single-chinese-center
#19
Lifeng Lao, Guibin Zhong, Qianyi Li, Xinfeng Li, Bin Chen, Lie Qian, Zude Liu
STUDY DESIGN: A retrospective technical report. OBJECTIVE: To assess the effect of bilateral C1 laminar hooks combined with C2 pedicle screw fixation for the treatment of C1-C2 instability. SUMMARY OF BACKGROUND DATA: Various posterior atlantoaxial fixations for C1-C2 instability have been developed. However, due to anatomic anomalies of the vertebral artery, the smallness of the pedicle, trajectories of broken screws, or a lack of surgical experience, a simple atlantoaxial fixation technique with good safety and effectiveness is urgently needed...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28517982/data-sharing-and-the-idea-of-ownership
#20
Jonathan Montgomery
Ideas about ownership are sometimes used in discussions of data sharing in personalised medicine. Personal health data are thought by many to be 'theirs'. Paradoxically, personalised medicine (at least in the context of genomics) relies on the aggregation of private data into a dataset that is held as a form of knowledge commons. When the notions of private and common property that lie behind this discourse are made explicit we can use thinking about the justifications and jurisprudence of property both to clarify the persuasiveness and limits of such claims, and also how they differ from other principles that are at stake in the interplay between individual and collective goods in the delivery of personalised medicine...
April 2017: New Bioethics: a Multidisciplinary Journal of Biotechnology and the Body
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