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https://www.readbyqxmd.com/read/28445186/the-hip-fracture-patient-on-warfarin-evaluating-blood-loss-and-time-to-surgery
#1
Matthew R Cohn, Ashley E Levack, Nikunj N Trivedi, Jordan C Villa, David S Wellman, John P Lyden, Dean G Lorich, Joseph M Lane
OBJECTIVES: To compare blood loss, delay of surgery, and short term adverse events in (1) patients admitted on warfarin versus non-anticoagulated controls and (2) warfarin patients with day of surgery (DOS) INR of 1.5 or greater versus below 1.5. DESIGN: Retrospective cohort. SETTING: Academic level I trauma center. PATIENTS/PARTICIPANTS: One hundred twenty four patients treated surgically for hip fractures including patients presenting on warfarin (n=62) and matched controls (n=62)...
April 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28443099/a-century-of-radiation-therapy-and-adaptive-immunity
#2
REVIEW
Dörthe Schaue
The coming of age for immunotherapy (IT) as a genuine treatment option for cancer patients through the development of new and effective agents, in particular immune checkpoint inhibitors, has led to a huge renaissance of an old idea, namely to harness the power of the immune system to that of radiation therapy (RT). It is not an overstatement to say that the combination of RT with IT has provided a new conceptual platform that has re-energized the field of radiation oncology as a whole. One only has to look at the immense rise in sessions at professional conferences and in grant applications dealing with this topic to see its emergence as a force, while the number of published reviews on the topic is staggering...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28441971/the-clinical-and-cost-effectiveness-of-stratified-care-for-patients-with-sciatica-the-scopic-randomised-controlled-trial-protocol-isrctn75449581
#3
Nadine E Foster, Kika Konstantinou, Martyn Lewis, Reuben Ogollah, Kate M Dunn, Danielle van der Windt, Ruth Beardmore, Majid Artus, Bernadette Bartlam, Jonathan C Hill, Sue Jowett, Jesse Kigozi, Christian Mallen, Benjamin Saunders, Elaine M Hay
BACKGROUND: Sciatica has a substantial impact on patients, and is associated with high healthcare and societal costs. Although there is variation in the clinical management of sciatica, the current model of care usually involves an initial period of 'wait and see' for most patients, with simple measures of advice and analgesia, followed by conservative and/or more invasive interventions if symptoms fail to resolve. A model of care is needed that does not over-treat those with a good prognosis yet identifies patients who do need more intensive treatment to help with symptoms, and return to everyday function including work...
April 26, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28441678/the-addiction-recovery-clinic-a-novel-primary-care-based-approach-to-teaching-addiction-medicine
#4
Stephen R Holt, Nora Segar, Dana A Cavallo, Jeanette M Tetrault
PROBLEM: Substance use is highly prevalent in the United States, but little time in the curriculum is devoted to training internal medicine residents in addiction medicine. APPROACH: In 2014, the authors developed and launched the Addiction Recovery Clinic (ARC) to address this educational gap while also providing outpatient clinical services to patients with substance use disorders. The ARC is embedded within the residency primary care practice and is staffed by three to four internal medicine residents, two board-certified addiction medicine specialists, one chief resident, and one psychologist...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441611/genotoxic-effect-of-pb-and-cd-on-in%C3%A2-vitro-cultures-of-sphagnum-palustre-an-evaluation-by-issr-markers
#5
Maria Cristina Sorrentino, Fiore Capozzi, Simonetta Giordano, Valeria Spagnuolo
In the present work, the genotoxic effect of cadmium and lead supplied in a laboratory trial, was investigated for the first time in the moss Sphagnum palustre, by ISSR molecular markers. A total of 169 reproducible bands were obtained with 12 primers, ten of which gave polymorphisms (i.e., appearance/disappearance of bands), indicating a clear genotoxic effect induced by the metals. Both metals induced a decrease of the genome template stability in a dose dependent manner. At concentration >10(-5) Cd also induced a general toxic effect in S...
April 17, 2017: Chemosphere
https://www.readbyqxmd.com/read/28440211/a-cluster-randomised-trial-cost-effectiveness-analysis-and-psychosocial-evaluation-of-insulin-pump-therapy-compared-with-multiple-injections-during-flexible-intensive-insulin-therapy-for-type-1-diabetes-the-repose-trial
#6
Simon Heller, David White, Ellen Lee, Julia Lawton, Daniel Pollard, Norman Waugh, Stephanie Amiel, Katharine Barnard, Anita Beckwith, Alan Brennan, Michael Campbell, Cindy Cooper, Munyaradzi Dimairo, Simon Dixon, Jackie Elliott, Mark Evans, Fiona Green, Gemma Hackney, Peter Hammond, Nina Hallowell, Alan Jaap, Brian Kennon, Jackie Kirkham, Robert Lindsay, Peter Mansell, Diana Papaioannou, David Rankin, Pamela Royle, W Henry Smithson, Carolin Taylor
BACKGROUND: Insulin is generally administered to people with type 1 diabetes mellitus (T1DM) using multiple daily injections (MDIs), but can also be delivered using infusion pumps. In the UK, pumps are recommended for patients with the greatest need and adult use is less than in comparable countries. Previous trials have been small, of short duration and have failed to control for training in insulin adjustment. OBJECTIVE: To assess the clinical effectiveness and cost-effectiveness of pump therapy compared with MDI for adults with T1DM, with both groups receiving equivalent structured training in flexible insulin therapy...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28439797/desmoid-type-fibromatosis-who-when-and-how-to-treat
#7
REVIEW
Javier Martínez Trufero, Isabel Pajares Bernad, Irene Torres Ramón, Jorge Hernando Cubero, Roberto Pazo Cid
Desmoid-type fibromatosis is a sarcoma subtype that gathers some singular characteristics, making it a difficult challenge to face in clinical practice. Despite its excellent survival prognosis, these tumors may be unpredictable, ranging from an asymptomatic indolent course to persistent, local, and extended recurrences that significantly impair quality of life. Although surgery was initially considered the first elective treatment, collected published data during the past few years are now pointing to the "wait and see" approach as a reasonable initial strategy because many patients can live a long life with the disease without having symptoms...
May 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28438653/the-fate-of-side-branches-covered-by-flow-diverters-results-from-140-patients
#8
P Bhogal, O Ganslandt, H Bäzner, H Henkes, M Aguilar Perez
BACKGROUND: Flow diverter stents (FDS) are a recognised treatment option for intracranial aneurysms. There remain on-going concerns regarding the safety of FDS especially when it comes to the fate of covered side branches. We sought to report on the patency of side branches covered by FDS. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated with FDS for an unruptured saccular aneurysm of the clinoid, ophthalmic, and terminating segments of the internal carotid artery between September 2009 and July 2016...
April 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28436622/congenital-intestinal-fibrosarcoma-with-rapid-recurrence-requiring-adjuvant-chemotherapy
#9
Wing Shan Queenie See, Daniel Ka Leung Cheuk, Ka Fai To, Philip Pun Ching Ip, Alan Kwok Shing Chiang, Shau Yin Ha, Godfrey Chi Fung Chan
A total of 16 cases of congenital fibrosarcoma have been reported from 1975 to March 2015. Five of the 16 had abnormal fusion between erythroblast transformation specific translocation variant 6 and neurotrophin recptor gene neurotrophic tyrosine kinase, receptor, type 3 (ETV6-NTRK3); in another five out of 16 this was absent, and six were not tested. All were managed by surgical resection but none involved metastasis. Herein we report the case of a newborn baby girl with congenital fibrosarcoma negative for ETV6-NTRK3 gene fusion, who presented with ileal perforation and positive resection margin...
April 24, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28435487/randomized-trial-of-adding-parenteral-acetaminophen-to-prochlorperazine-and-diphenhydramine-to-treat-headache-in-the-emergency-department
#10
Stefan H Meyering, Ryan W Stringer, Matthew K Hysell
INTRODUCTION: Headaches represent over three million emergency department (ED) visits per year, comprising 2.4% of all ED visits. There are many proposed methods and clinical guidelines of treating acute headache presentations. However, data on intravenous acetaminophen usage in these settings are lacking. In this study, we sought to determine the efficacy of intravenous (IV) acetaminophen as an adjunct to a standard therapy for the treatment of patients who present to the ED with a chief complaint of "headache...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431409/outcomes-of-hemiarthroplasty-and-total-hip-arthroplasty-for-femoral-neck-fracture-a-medicare-cohort-study
#11
Zhong Wang, Timothy Bhattacharyya
OBJECTIVES: For patients with femoral neck fractures, total hip arthroplasty (THA) demonstrates superior outcomes compared with hemiarthroplasty. However, hemiarthroplasty remains a common treatment for femoral neck fractures and the conversion rates are unknown. We compared the results of the 2 procedures using a Medicare database. METHODS: We assembled a cohort of 70,242 patients 65 to 90 years of age with an ICD9 diagnosis and matching Current Procedure Terminology code for femoral neck fracture between 2008 and 2012...
May 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28430721/outcomes-of-reverse-total-shoulder-arthroplasty-for-proximal-humeral-fractures-primary-arthroplasty-versus-secondary-arthroplasty-following-failed-proximal-humeral-locking-plate-fixation
#12
Emilio Sebastia-Forcada, Alejandro Lizaur-Utrilla, Román Cebrian-Gomez, Francisco A Miralles-Muñoz, Fernando A Lopez-Prats
OBJECTIVE: To compare the outcomes of reverse shoulder arthroplasty (RSA) between patients with failed proximal humeral locking plate (PHLP) fixation and those with acute fractures. DESIGN: Matched case-control study. SETTING: University hospital, level I trauma center. PATIENTS: 30 consecutive patients with fracture sequelae due to failed PHLP fixation (mean age 73) were age- and gender-matched to 30 patients with acute fracture (mean age 75)...
April 6, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28421906/the-role-of-para-aortic-lymphadenectomy-in-stage-iiic-endometrial-cancer-a-single-institute-study
#13
Akira Kikuchi, Toru Yanase, Motoi Sasagawa, Shigeru Honma
The therapeutic value of para-aortic lymphadenectomy (PAL) in women with endometrial cancer (EC) remains uncertain. We retrospectively analysed 25 patients with stage IIIc EC (17 stage IIIC1; 8 IIIC2) who were treated in our institution. All subjects had undergone pelvic lymphadenectomies in which para-aortic nodes were sampled, or removed only when these nodes were enlarged. Sampling of para-aortic nodes or PAL was performed in all patients with stage IIIC2 disease and one of 17 with stage IIIC1 disease. Para-aortic lymph nodes were the most frequent site of recurrence in stage IIIC1 patients, but no such recurrences occurred in stage IIIC2 patients...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28420670/confirmed-early-myocardial-rupture-in-a-patient-with-pulseless-electrical-activity-pea-following-late-presentation-of-st-elevation-myocardial-infarction
#14
Baskar Sekar, Joe Martins, Sanjiv Petkar
A 69 year old male, an ex-smoker, was admitted with ongoing chest pain of 11 hours duration. Past medical history included treated hypertension and gastro-oesophageal reflux disease. He delayed seeking medical attention as he assumed the pain to be due to indigestion and kept taking antacids without much symptomatic relief. Clinical examination on arrival was unremarkable. Admission 12 lead electrocardiogram (ECG) was diagnostic of a recent anterolateral myocardial infarction (MI) (Figure 1a). Bedside trans-thoracic echocardiogram (TTE) confirmed an established anterolateral MI (Video 1, Figure 1b)...
April 18, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28419031/prognostic-factors-affecting-union-after-ulnar-shortening-osteotomy-in-ulnar-impaction-syndrome-a-retrospective-case-control-study
#15
Soo Min Cha, Hyun Dae Shin, Ki Jun Ahn
BACKGROUND: Ulnar shortening osteotomy (USO) is a widely adopted procedure with excellent outcomes. However, delayed union or nonunion has occasionally been observed. The purpose of this retrospective case-control study was to identify variables affecting osseous consolidation after USO in patients with ulnar impaction syndrome. METHODS: The study included 325 patients who had undergone USO between March 2008 and March 2014. We evaluated the association between union and basic demographic factors as well as preoperative pain (assessed on a visual analog scale [VAS]), range of wrist motion, grip strength, and modified Mayo wrist score...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28415795/renal-sympathetic-denervation-guided-by-renal-nerve-stimulation-to-treat-ventricular-arrhythmia-in-ckd-patients-with-icd
#16
Márcio Galindo Kiuchi, Shaojie Chen, Luis Marcelo Rodrigues Paz, Helmut Pürerfellner
Chronic kidney disease (CKD) patients on stage 4 present greater risk rates for malignant ventricular arrhythmia events. This study examined patients with CKD in stages 1, 2, 3 and 4, left ventricular dysfunction and automatic implantable cardioverter-defibrillator (ICD). Our goal was to record the appropriate therapies, "Anti-tachycardia Therapy Pacing" (ATP) and shock events during the 18 months of follow-up and compare the incidence and severity of these at different stages of CKD, mainly in patients with CKD stage 4 underwent renal sympathetic denervation (RSD) guided by renal nerve stimulation (RNS)...
March 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28415589/gabaergic-neurons-in-nucleus-accumbens-are-correlated-to-resilience-and-vulnerability-to-chronic-stress-for-major-depression
#17
Zhaoming Zhu, Guangyan Wang, Ke Ma, Shan Cui, Jin-Hui Wang
BACKGROUND: Major depression, persistent low mood, is one of common psychiatric diseases. Chronic stressful life is believed to be a major risk factor that leads to dysfunctions of the limbic system. However, a large number of the individuals with experiencing chronic stress do not suffer from major depression, called as resilience. Endogenous mechanisms underlying neuronal invulnerability to chronic stress versus major depression are largely unknown. As GABAergic neurons are vulnerable to chronic stress and their impairments is associated with major depression, we have examined whether the invulnerability of GABAergic neurons in the limbic system is involved in resilience...
March 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/28414678/what-the-eyes-don-t-see-the-heart-does-grieve-over
#18
M Sciaudone, M Dery
INTRODUCTION: A 71 year old Peruvian woman presented with blurry vision and bilateral eye pain and had evidence of bilateral endophthalmitis on eye examination. Her past medical history was notable for multiple abdominal surgeries within the preceding months, including an incarcerated inguinal hernia repair which required an ileostomy placement, and cholecystitis requiring cholecystostomy tube placement. Over her multiple long hospitalizations, she developed bacteremia and fungemia on several occasions, with organisms including Enterobacter cloacae, Klebsiella pneumoniae, Bacteroides fragilis, Pseudomonas aeruginosa, Enterococcus faecium, and Candida albicans...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28409743/pet-neck-a-multicentre-randomised-phase-iii-non-inferiority-trial-comparing-a-positron-emission-tomography-computerised-tomography-guided-watch-and-wait-policy-with-planned-neck-dissection-in-the-management-of-locally-advanced-n2-n3-nodal-metastases-in-patients
#19
Hisham Mehanna, Chris C McConkey, Joy K Rahman, Wai-Lup Wong, Alison F Smith, Chris Nutting, Andrew Gj Hartley, Peter Hall, Claire Hulme, Dharmesh K Patel, Sandra Ventorin von Zeidler, Max Robinson, Bal Sanghera, Lydia Fresco, Janet A Dunn
BACKGROUND: Planned neck dissection (ND) after radical chemoradiotherapy (CRT) for locally advanced nodal metastases in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Thirty per cent of ND specimens show histological evidence of tumour. Consequently, a significant proportion of clinicians still practise planned ND. Fludeoxyglucose positron emission tomography (PET)-computerised tomography (CT) scanning demonstrated high negative predictive values for persistent nodal disease, providing a possible alternative paradigm to ND...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28409441/isolated-rectal-cancer-surgery-a-2007-2014-population-study-based-on-a-large-administrative-database
#20
Mario Saia, Alessandra Buja, Domenico Mantoan, Gino Sartor, Ferdinando Agresta, Vincenzo Baldo
Rectal resection is technically one of the most demanding laparoscopic procedures, requiring additional training and expertise of both surgeons and institutions. The literature has shown that laparoscopic procedures can be appropriate for the treatment of rectal cancer (RC), in terms of safety, outcome and efficiency, but results may not always be directly transferable to the general population. This study aimed to investigate the use of laparoscopic rectal cancer resections in a north-eastern Italian region (the Veneto) and to see how the characteristics of patients and hospitals are associated with the use of laparoscopy...
April 13, 2017: Updates in Surgery
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