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https://www.readbyqxmd.com/read/29040639/the-medical-science-dmz-a-network-design-pattern-for-data-intensive-medical-science
#1
Sean Peisert, Eli Dart, William Barnett, Edward Balas, James Cuff, Robert L Grossman, Ari Berman, Anurag Shankar, Brian Tierney
Objective: We describe a detailed solution for maintaining high-capacity, data-intensive network flows (eg, 10, 40, 100 Gbps+) in a scientific, medical context while still adhering to security and privacy laws and regulations. Materials and Methods: High-end networking, packet-filter firewalls, network intrusion-detection systems. Results: We describe a "Medical Science DMZ" concept as an option for secure, high-volume transport of large, sensitive datasets between research institutions over national research networks, and give 3 detailed descriptions of implemented Medical Science DMZs...
October 6, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29036751/-diagnosis-and-management-of-vestibular-schwannomas-an-interdisciplinary-challenge
#2
Steffen Rosahl, Christopher Bohr, Michael Lell, Klaus Hamm, Heinrich Iro
Vestibular schwannomas expand slowly in the internal auditory canal, in the cerebellopontine angle, inside the cochlear and the labyrinth. Larger tumors can displace and compress the brainstem. With an annual incidence of 1:100 000 vestibular schwannoma represent 6-7% of all intracranial tumors. In the cerebellopontine angle they are by far the most neoplasm with 90% of all lesions located in this region. Magnetic resonance imaging (MRI), audiometry, and vestibular diagnostics are the mainstays of the clinical workup for patients harboring tumors...
April 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29035982/comparison-of-the-effect-of-5-different-treatment-options-for-managing-patellar-tendinopathy-a-secondary-analysis
#3
Dafne van Rijn, Inge van den Akker-Scheek, Mirjam Steunebrink, Ron L Diercks, Johannes Zwerver, Henk van der Worp
OBJECTIVE: Currently, no treatments exist for patellar tendinopathy (PT) that guarantee quick and full recovery. Our objective was to assess which treatment option provides the best chance of clinical improvement and to assess the influence of patient and injury characteristics on the clinical effect of these treatments. DESIGN: A secondary analysis was performed on the combined databases of 3 previously performed double-blind randomized controlled trials. PATIENTS: In total, 138 patients with PT were included in the analysis...
October 10, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29034961/a-randomized-trial-of-automated-intermittent-ropivacaine-administration-vs-continuous-infusion-in-an-interscalene-catheter
#4
J Oxlund, A H Clausen, S Venø, M D Nielsen, M Pall, T Strøm, P Toft
BACKGROUND: Ultrasound-guided interscalene nerve block with ropivacaine as local anesthetic agent given as boluses or continuous infusion is the preferred pain management after major shoulder surgery. The use of automated intermittent boluses has been shown to be superior to continuous infusion in sciatic and epidural nerve block. HYPOTHESIS: Automated intermittent boluses reduce pain after major shoulder surgery. METHODS: Seventy patients aged 18-75 years, scheduled for major shoulder surgery under general anesthesia with interscalene nerve block were included in this randomized controlled trial...
October 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29034331/extensive-core-microbiome-in-drone-captured-whale-blow-supports-a-framework-for-health-monitoring
#5
Amy Apprill, Carolyn A Miller, Michael J Moore, John W Durban, Holly Fearnbach, Lance G Barrett-Lennard
The pulmonary system is a common site for bacterial infections in cetaceans, but very little is known about their respiratory microbiome. We used a small, unmanned hexacopter to collect exhaled breath condensate (blow) from two geographically distinct populations of apparently healthy humpback whales (Megaptera novaeangliae), sampled in the Massachusetts coastal waters off Cape Cod (n = 17) and coastal waters around Vancouver Island (n = 9). Bacterial and archaeal small-subunit rRNA genes were amplified and sequenced from blow samples, including many of sparse volume, as well as seawater and other controls, to characterize the associated microbial community...
September 2017: MSystems
https://www.readbyqxmd.com/read/29034081/renal-impairment-in-stroke-patients-a-comparison-between-the-haemorrhagic-and-ischemic-variants
#6
Pratyush Shrestha, Shalima Thapa, Shikher Shrestha, Subash Lohani, Suresh Bk, Oscar MacCormac, Lekhjung Thapa, Upendra Prasad Devkota
Background: Renal impairment is regularly seen in hospitalized stroke patients, affecting the outcome of patients, as well as causing difficulties in their management. A prospective cohort study was conducted to assess the trend of renal function in hospitalized ischemic and haemorrhagic stroke patients. The incidence of renal impairment in these subgroups, the contributing factors and the need for renal replacement in renal impaired patients was evaluated. Methods: Alternate day renal function testing was performed in hospitalized stroke patients...
2017: F1000Research
https://www.readbyqxmd.com/read/29032886/prevalence-and-risk-factors-for-paroxysmal-atrial-fibrillation-and-flutter-detection-after-cryptogenic-ischemic-stroke
#7
Claire Carrazco, Daniel Golyan, Michael Kahen, Karen Black, Richard B Libman, Jeffrey M Katz
INTRODUCTION: Long-term cardiac monitoring with implantable loop recorders (ILRs) has revealed occult paroxysmal atrial fibrillation and flutter (PAF) in a substantial minority of cryptogenic ischemic stroke (CIS) patients. Herein, we aim to define the prevalence, clinical relevance, and risk factors for PAF detection following early poststroke ILR implantation. MATERIALS AND METHODS: A retrospective study of CIS patients (n = 100, mean age 65.8 years; 52.5% female) who underwent ILR insertion during, or soon after, index stroke admission...
October 9, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29032824/the-impact-on-survival-of-two-different-staging-strategies-in-apparent-early-stage-endometrial-cancer-comparing-sentinel-lymph-nodes-mapping-algorithm-and-selective-lymphadenectomy-an-italian-retrospective-analysis-of-two-reference-centers
#8
Alessandro Buda, Giampaolo Di Martino, Stefano Restaino, Elena De Ponti, Giorgia Monterossi, Daniela Giuliani, Alfredo Ercoli, Federica Dell'Orto, Giorgia Dinoi, Tommaso Grassi, Giovanni Scambia, Francesco Fanfani
OBJECTIVE: The role of lymphadenectomy in endometrial cancer is still uncertain. We aimed to evaluate the survival outcomes of two different strategies in apparent uterine confined disease by comparing sentinel lymph node (SLN) mapping and selective lymphadenectomy (LD). METHODS: We retrospectively reviewed women with preoperative stage I endometrial cancer underwent surgical staging with either SLN mapping, or LD in two Italian centers. RESULTS: Eight hundred and two women underwent surgical staging for preoperative stage I endometrial cancer were revised (145 Monza; 657 Rome)...
October 9, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29032716/prediction-of-coronary-plaque-progression-using-biomechanical-factors-and-vascular-characteristics-based-on-computed-tomography-angiography
#9
Xiujian Liu, Guanghui Wu, Chuangye Xu, Yuna He, Lixia Shu, Yuyang Liu, Nan Zhang, Changyan Lin
OBJECTIVES: Coronary atherosclerotic plaques progress in a highly individual manner. Accurately predicting plaque progression will promote clinical management of atherosclerosis. The purpose of this study was to investigate the role of local biomechanics factors and vascular characteristics in coronary plaque progression and arterial remodeling. METHODS: Computed tomography angiography-based three-dimensional reconstruction of the native right coronary artery was performed in vivo in twelve patients with acute coronary syndrome at baseline and 12-month follow-up...
October 16, 2017: Computer Assisted Surgery (Abingdon, England)
https://www.readbyqxmd.com/read/29031916/image-guided-adaptive-external-beam-radiation-therapy-for-cervix-cancer-evaluation-of-a-clinically-implemented-plan-of-the-day-technique
#10
Martin Buschmann, Katarina Majercakova, Alina Sturdza, Stephanie Smet, Dina Najjari, Michaela Daniel, Richard Pötter, Dietmar Georg, Yvette Seppenwoolde
BACKGROUND: Radiotherapy for cervix cancer is challenging in patients exhibiting large daily changes in the pelvic anatomy, therefore adaptive treatments (ART) have been proposed. The aim of this study was the clinical implementation and subsequent evaluation of plan-of-the-day (POTD)-ART for cervix cancer in supine positioning. The described workflow was based on standard commercial equipment and current quality assurance (QA) methods. MATERIALS AND METHODS: A POTD strategy, which employs a VMAT plan library consisting of an empty bladder plan, a full bladder plan and a motion robust backup plan, was developed...
October 11, 2017: Zeitschrift Für Medizinische Physik
https://www.readbyqxmd.com/read/29030642/saline-is-as-effective-as-nitrogen-scavengers-for-treatment-of-hyperammonemia
#11
G van Straten, M G M de Sain-van der Velden, I M van Geijlswijk, R P Favier, S J Mesu, N E Holwerda-Loof, M van der Ham, H Fieten, J Rothuizen, B Spee, N M Verhoeven-Duif
Urea cycle enzyme deficiency (UCED) patients with hyperammonemia are treated with sodium benzoate (SB) and sodium phenylacetate (SPA) to induce alternative pathways of nitrogen excretion. The suggested guidelines supporting their use in the management of hyperammonemia are primarily based on non-analytic studies such as case reports and case series. Canine congenital portosystemic shunting (CPSS) is a naturally occurring model for hyperammonemia. Here, we performed cross-over, randomized, placebo-controlled studies in healthy dogs to assess safety and pharmacokinetics of SB and SPA (phase I)...
October 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29030279/posterior-cranial-vault-distraction-osteogenesis-in-craniofacial-surgery-technical-note
#12
Q de Kerangal, A Paré, A Joly, N Travers, D Goga, B Laure
INTRODUCTION: Posterior cranial vault distraction is a treatment for intracranial hypertension in certain cases of craniosynostosis and faciocraniosynostosis. It allows the harmonisation of the skull back and prevents turricephaly. This study presents the surgical technique. TECHNICAL NOTE: Posterior cranial vault distraction osteogenesis consists of a circular osteotomy of the skull back. Four distractors are placed on the cranial flap without detachment of the dura mater...
October 10, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29030065/diuretics-versus-volume-expansion-in-acute-submassive-pulmonary-embolism
#13
Elie Dan Schouver, Olivier Chiche, Priscille Bouvier, Denis Doyen, Pierre Cerboni, Pamela Moceri, Emile Ferrari
BACKGROUND: The benefit of volume expansion (VE) in submassive pulmonary embolism (PE) with right ventricular (RV) dysfunction is unclear. AIM: To compare the effects of diuretic treatment versus VE in patients hospitalized for PE with RV dysfunction. METHODS: We prospectively included 46 consecutive patients with submassive PE treated on admission with a 40mg bolus of furosemide (D group, n=24) or 500mL of saline infusion (VE group, n=22)...
October 10, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29029586/use-and-misuse-of-opioids-in-chronic-pain
#14
Nora Volkow, Helene Benveniste, A Thomas McLellan
The prescribing of opioid analgesics for pain management-particularly for management of chronic noncancer pain (CNCP)-has increased more than fourfold in the United States since the mid-1990s. Yet there is mounting evidence that opioids have only limited effectiveness in the management of CNCP, and the increased availability of prescribed opioids has contributed to upsurges in opioid-related addiction cases and overdose deaths. These concerns have led to critical revisiting and modification of prior pain management practices (e...
October 13, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/29029357/a-pilot-retrospective-study-to-evaluate-two-multi-layer-foam-dressings-for-the-management-of-moderately-exudative-pressure-injuries
#15
Kevin Woo, Jennifer Kasaboski
Prevention and treatment of pressure injuries (PI) is a standard benchmark for quality of care, performance, risk reduction, and patient safety. Foam dressings are designed to wick away a large volume of exudate with minimal lateral movement to prevent periwound skin maceration; this renders foam dressings a popular choice for the treatment of chronic wounds with high to moderate amounts of exudate. In addition, multi-layer foam dressings may have added benefits to alleviate pressure and minimize shear as the dressing materials slide against each other...
October 12, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29029178/expansion-of-viral-load-testing-and-the-potential-impact-on-human-immunodeficiency-virus-drug-resistance
#16
Helen M Chun, Yaa F Obeng-Aduasare, Laura N Broyles, Dennis Ellenberger
Increasing the volume, strengthening the quality, and proactively using data of human immunodeficiency virus (HIV) load testing are pivotal to limiting the threat of HIV drug resistance (HIVDR) accumulation,and allow for optimal case-based HIVDR surveillance. Triangulation of viral load (VL) and HIVDR testing data could be pursued to answer key questions and translate data and results for program and public policy. Identification of virologic failure and early management mitigates the greater risk of HIVDR...
October 5, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29029074/multimodality-imaging-evaluation-of-chagas-disease-an-expert-consensus-of-brazilian-cardiovascular-imaging-department-dic-and-the-european-association-of-cardiovascular-imaging-eacvi
#17
Maria Carmo P Nunes, Luigi Paolo Badano, J Antonio Marin-Neto, Thor Edvardsen, Covadonga Fernández-Golfín, Chiara Bucciarelli-Ducci, Bogdan A Popescu, Richard Underwood, Gilbert Habib, Jose Luis Zamorano, Roberto Magalhães Saraiva, Ester Cerdeira Sabino, Fernando A Botoni, Márcia Melo Barbosa, Marcio Vinicius L Barros, Eduardo Falqueto, Marcus Vinicius Simões, André Schmidt, Carlos Eduardo Rochitte, Manoel Otávio Costa Rocha, Antonio Luiz Pinho Ribeiro, Patrizio Lancellotti
Aims: To develop a document by Brazilian Cardiovascular Imaging Department (DIC) and the European Association of Cardiovascular Imaging (EACVI) to review and summarize the most recent evidences about the non-invasive assessment of patients with Chagas disease, with the intent to set up a framework for standardized cardiovascular imaging to assess cardiovascular morphologic and functional disturbances, as well as to guide the subsequent process of clinical decision-making. Methods and results: Chagas disease remains one of the most prevalent infectious diseases in Latin America, and has become a health problem in non-endemic countries...
September 25, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29027774/rational-approach-to-transfusion-in-liver-transplantation
#18
Fuat H Saner, Lasitha Abeysundara, Matthias Hartmann, Susan V Mallett
For over 50 years patients with liver cirrhosis were considered to be at markedly increased risk of bleeding. This dogma was seemingly supported by abnormalities in standard laboratory tests (SLTs), such as the prothrombin time, that were interpreted as indicating a bleeding diathesis. However, publications from the last decade have revealed SLTs to be poor predictors of bleeding and it is now understood that stable patients with cirrhosis have a rebalanced haemostatic system and preserved thrombin generation...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29026937/-minimally-invasive-and-robotic-assisted-surgical-management-of-upper-gastrointestinal-cancer
#19
REVIEW
P P Grimminger, H F Fuchs
Total minimally invasive upper gastrointestinal resections are currently mainly performed in centers. The advantages include reduction of operative trauma, magnified enlargement of the operation field and the resulting improvement in operative precision. Robotic-assisted minimally invasive esophagectomy (RAMIE) and laparoscopic/thoracoscopic minimally invasive esophagectomy (MIE) are currently the most commonly performed strategies for esophageal cancer. Laparoscopic (MIG) and robotic-assisted gastrectomy (RAG) are the equivalent procedures for gastric cancer...
October 12, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29026928/-current-treatment-concepts-in-intracerebral-hemorrhage
#20
REVIEW
H B Huttner, J B Kuramatsu
BACKGROUND AND OBJECTIVE: In recent years, various important studies investigating the management of intracerebral hemorrhage (ICH) have been published. However, these have not entered guideline recommendations yet. Therefore, essential results are summarized here and the findings are integrated into current treatment concepts. MATERIALS AND METHODS: Based on a dedicated literature review and the authors' experience, up-to-date and high-quality investigations were identified...
October 12, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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