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https://www.readbyqxmd.com/read/29351686/basilar-artery-ectasia-causing-trigeminal-neuralgia-an-evolved-technique-of-transpositional-suture-pexy
#1
Harminder Singh, Harley Brito da Silva, Mehdi Zeinalizadeh, Turki Elarjani, David Straus, Laligam N Sekhar
BACKGROUND: Microvascular decompression for patients with trigeminal neuralgia (TGN) is widely accepted as one of the modalities of treatment. The standard approach has been retrosigmoid suboccipital craniotomy with placement of a Teflon pledget to cushion the trigeminal nerve from the offending artery, or cauterize and divide the offending vein(s). However, in cases of severe compression caused by a large artery, the standard decompression technique may not be effective. OBJECTIVE: To describe a unique technique of vasculopexy of the ectatic basilar artery to the tentorium in a patient with TGN attributed to a severely ectatic and tortuous basilar artery...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29350511/a-cost-effectiveness-analysis-of-cardiology-econsults-for-medicaid-patients
#2
Daren Anderson, Victor Villagra, Emil N Coman, Ianita Zlateva, Alex Hutchinson, Jose Villagra, J Nwando Olayiwola
OBJECTIVES: To evaluate the cost-effectiveness of electronic consultations (eConsults) for cardiology compared with traditional face-to-face consults. STUDY DESIGN: Cost-effectiveness analysis for a subset of Medicaid-insured patients in a cluster-randomized trial of eConsults versus the traditional face-to-face consultation process in a statewide federally qualified health center. METHODS: A total of 369 Medicaid patients were referred for cardiology consultations by primary care providers who were randomly assigned to use either eConsults or their usual face-to-face referral process...
January 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29350454/patterns-of-internet-based-health-information-seeking-in-adult-survivors-of-childhood-cancer
#3
Mechelle D Claridy, Melissa M Hudson, Lee Caplan, Pauline A Mitby, Wendy Leisenring, Selina A Smith, Leslie L Robison, Ann C Mertens
BACKGROUND: To assess where, when, and why survivors of childhood cancer seek health information. PROCEDURE: Data from the Childhood Cancer Survivor Study (CCSS) cohort (n = 1386) and Health Information National Trends Survey (n = 2385) were analyzed to determine the health information seeking strategies of childhood cancer survivors. Descriptive frequencies, χ2 analyses, t-tests, and multivariable logistic regression models were used. RESULTS: To seek health-related information for themselves, 54% (n = 742) of the childhood survivors reported using the Internet in the past 12 months, compared to 45% of the general population (adjusted OR: 2...
January 19, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29348284/laryngeal-tuberculosis-a-rare-cause-of-critical-airway-obstruction
#4
Abigail Elizabeth Cole, Daniel Heaton, Ahmed Chekairi
Laryngeal tuberculosis (TB) is a rare condition, occurring in less than 1% of patients infected with pulmonary TB. We present a case of a 57-year-old male patient, who presented in extremis with audible stridor, increased work of breathing and cyanosis. In addition, the patient had a complex medical history, including a recent diagnosis of congenital malformation of the epiglottis. Emergency intervention was required to secure the airway, and after initial attempts at intubation were unsuccessful, an emergency tracheostomy was performed...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29348111/leveraging-social-networking-sites-for-an-autoimmune-hepatitis-genetic-repository-pilot-study-to-evaluate-feasibility
#5
Megan Comerford, Rachel Fogel, James Robert Bailey, Prianka Chilukuri, Naga Chalasani, Craig Steven Lammert
BACKGROUND: Conventional approaches to participant recruitment are often inadequate in rare disease investigation. Social networking sites such as Facebook may provide a vehicle to circumvent common research limitations and pitfalls. We report our preliminary experience with Facebook-based methodology for participant recruitment and participation into an ongoing study of autoimmune hepatitis (AIH). OBJECTIVE: The goal of our research was to conduct a pilot study to assess whether a Facebook-based methodology is capable of recruiting geographically widespread participants into AIH patient-oriented research and obtaining quality phenotypic data...
January 18, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29345325/a-new-retrograde-transillumination-technique-for-videolaryngoscopic-tracheal-intubation
#6
P Biro, E Fried, M Schlaepfer, M S Kristensen
This single-centre, prospective trial was designed to assess the efficacy of a new retrograde transillumination device called the 'Infrared Red Intubation System' (IRRIS) to aid videolaryngoscopic tracheal intubation. We included 40 adult patients, who were undergoing elective urological surgery under general anaesthesia. We assessed the ability to differentiate the transilluminated glottis from other structures and found a median (IQR [range]) larynx recognition time of 8 (5-14 [3-28]) s. The difference in laryngeal visibility on the screen between the deactivated vs...
January 18, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29342478/design-and-implementation-of-a-visual-analytics-electronic-antibiogram-within-an-electronic-health-record-system-at-a-tertiary-pediatric-hospital
#7
Allan F Simpao, Luis M Ahumada, Beatriz Larru Martinez, Ana M Cardenas, Talene A Metjian, Kaede V Sullivan, Jorge A Gálvez, Bimal R Desai, Mohamed A Rehman, Jeffrey S Gerber
BACKGROUND:  Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time-consuming manual process that is typically performed annually. OBJECTIVE:  We aimed to apply visual analytics software to electronic health record (EHR) data to build an automated, electronic antibiogram ("e-antibiogram") that adheres to national guidelines and contains filters for patient characteristics, thereby providing access to detailed, clinically relevant, and up-to-date antibiotic susceptibility data...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29342139/structure-and-mutagenesis-reveal-essential-capsid-protein-interactions-for-kshv-replication
#8
Xinghong Dai, Danyang Gong, Hanyoung Lim, Jonathan Jih, Ting-Ting Wu, Ren Sun, Z Hong Zhou
Kaposi's sarcoma-associated herpesvirus (KSHV) causes Kaposi's sarcoma, a cancer that commonly affects patients with AIDS and which is endemic in sub-Saharan Africa. The KSHV capsid is highly pressurized by its double-stranded DNA genome, as are the capsids of the eight other human herpesviruses. Capsid assembly and genome packaging of herpesviruses are prone to interruption and can therefore be targeted for the structure-guided development of antiviral agents. However, herpesvirus capsids-comprising nearly 3,000 proteins and over 1,300 Å in diameter-present a formidable challenge to atomic structure determination and functional mapping of molecular interactions...
January 17, 2018: Nature
https://www.readbyqxmd.com/read/29340295/usage-characteristics-and-adverse-event-rates-%C3%A2-of-the-direct-puncture-and-pull-techniques-for-percutaneous-endoscopic-gastrostomy-in-patients-with-malignant-tumors-of-the-upper-aerodigestive-tract
#9
Niels Teich, Lars Selig, Susanne Liese, Franziska Schiefke, Alexander Hemprich, Joachim Mössner, Ingolf Schiefke
Background and study aims:  Patients with malignant tumors of the upper gastrointestinal tract are at risk of weight loss. Early supportive nutrition therapy is therefore recommended and usually requires placement of a percutaneous endoscopic gastrostomy (PEG). The aim of this study was to compare adverse events and usage characteristics of the direct puncture technique with those of the traditional pull technique when used in patients with endoscopically passable tumors. The primary endpoint was the rate of inflammatory adverse events (AEs) at the gastrostomy fistula...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29337783/s1-sacrectomy-for-re-recurrent-rectal-cancer-our-experience-with-reconstruction-using-an-expandable-vertebral-body-replacement-device
#10
Daniel Jin Keat Lee, Kelvin Yafan Wang, Peter Michael Sagar, Jake Timothy
INTRODUCTION: R0 resection is achieved by high sacrectomy for local recurrence of colorectal cancer, but significant rates of perioperative complications and long-term patient morbidity are associated with this procedure. In this report, we outline our unique experience of using an expandable cage for vertebral body reconstruction following S1 sacrectomy in a 66-year-old patient with re-recurrent rectal cancer. We aim to highlight several key steps, with a view to improving postoperative outcomes...
February 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29336950/daratumumab-therapeutic-asset-biological-trap
#11
V Deneys, C Thiry, A Frelik, C Debry, B Martin, C Doyen
OBJECTIVES: Recently, daratumumab has been included in the therapeutic strategies for myeloma patients. This molecule is an antibody directed against CD38, strongly expressed on plasma cells. Nevertheless, as CD38 is also present on erythrocyte membrane, daratumumab interferes with immunohaematological tests, complicating the selection of compatible blood. METHODS: A total of 14 patients treated by daratumumab have been followed in our transfusion laboratory. Among them, 11 have been transfused...
January 11, 2018: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/29335745/-health-privacy-in-the-age-of-digital-networks
#12
REVIEW
Thilo Weichert
Digitization in the health sector embodies opportunities and risks. These consist of patient and data confidentiality. Vulnerability of data concerning integrity and availability can lead to financial losses and to damage of the health of data subjects. Those risks must be tackled by privacy or data protection law. For this purpose we have the European Data Protection Regulation as a comprehensive legal framework and a harmonizing bracket.This framework contains regulations on consent, purpose binding and data transfer, on rights of the data subject, technical and organizational measures and procedural arrangements...
January 15, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29335234/a-patient-held-smartcard-with-a-unique-identifier-and-an-mhealth-platform-to-improve-the-availability-of-prenatal-test-results-in-rural-nigeria-demonstration-study
#13
Semiu Olatunde Gbadamosi, Chuka Eze, John Olajide Olawepo, Juliet Iwelunmor, Daniel F Sarpong, Amaka Grace Ogidi, Dina Patel, John Okpanachi Oko, Chima Onoka, Echezona Edozie Ezeanolue
BACKGROUND: Community-based strategies to test for HIV, hepatitis B virus (HBV), and sickle cell disease (SCD) have expanded opportunities to increase the proportion of pregnant women who are aware of their diagnosis. In order to use this information to implement evidence-based interventions, these results have to be available to skilled health providers at the point of delivery. Most electronic health platforms are dependent on the availability of reliable Internet connectivity and, thus, have limited use in many rural and resource-limited settings...
January 15, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29335153/-the-sitting-position-during-peripheral-venipunctures-in-young-children-a-practice-to-develop
#14
REVIEW
Anne Dario-Meyer, Sylvie Sangare, Anne Dumas Laussinotte
The children's nurse has several missions including that of caring for the child in a holistic approach, ensuring their physical safety and psychological security. When performing peripheral venipunctures in young children, caregivers must implement strategies to relieve pain and prevent psychological traumas which may generate stress for subsequent care procedures. In a paediatric unit, their observations and analysis have improved children's experience of this invasive procedure, with a need for less restraint...
January 2018: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/29334569/assessment-of-prehospital-hemorrhage-and-airway-care-using-a-simulation-model
#15
Mariya E Skube, Seth Witthuhn, Kristine Mulier, Bonnie Boucher, Elizabeth Lusczek, Greg J Beilman
BACKGROUND: The quality of prehospital care impacts patient outcomes. Military efforts have focused on training revision and the creation of high fidelity simulation models to address potentially survivable injuries. We sought to investigate the applicability of models emphasizing hemorrhage control and airway management to a civilian population. METHODS: Prehospital healthcare providers (PHPs) undergoing their annual training were enrolled. A trauma scenario was simulated with two modules: hemorrhage control and airway management...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29334487/a-novel-hinged-scleral-patch-graft-for-the-repair-of-overfiltration-and-bleb-leaks
#16
Pierre G Mardelli, Marc E Mardelli, Zeina Bakkour
INTRODUCTION: The repair of the scleral flap is often needed in cases of severe hypotony or bleb leaks with over filtration. We present a simple novel technique to restore the hinged flap using a scleral patch graft. MATERIALS AND METHODS: We present 4 eyes of 4 patients that present with hypotony (IOP <6▒mm Hg) from overfiltration secondary to loose scleral flap (2 eyes) and bleb leak (2 eyes). A scleral patch from human donor preserved in 95% ehtanol is cut in a trapezoidal shape and placed over the area of filtration after a conjunctival peritomy...
January 12, 2018: Journal of Glaucoma
https://www.readbyqxmd.com/read/29333495/integrating-prevention-and-health-promotion-in-a-london-prison
#17
Adam John Finnie
Many people enter prison with poor health from a background of deprivation and with unhealthy lifestyle habits, yet spending time in prisons is often actively detrimental to health. There is therefore a clear value in providing high-quality health promotion services in prisons that are effective at reaching those who need support to improve their lifestyle. The health promotion service at HMP Brixton provides a health trainers clinic to address lifestyle issues but found that it was sometimes challenging to identify appropriate patients and that the service was inefficient as a result...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29332116/applying-preventive-measures-leading-to-significant-reduction-of-catheter-associated-urinary-tract-infections-in-adult-intensive-care-unit
#18
Fahad M Al-Hameed, Gulam R Ahmed, Asim A AlSaedi, Muhammad J Bhutta, Faisal F Al-Hameed, Majid M AlShamrani
To determine the impact of applying the best available clinical evidence on the preventive measures to reduce the rate of catheter-associated urinary tract infections (CAUTI) in adult intensive care units (ICU).     Methods:  Data were collected from adult ICUs (28 beds) from 2008 to 2016. The proper use of silicon catheter, aseptic insertion technique, emptying bag three-fourth via close circuit, the use of appropriate size catheter, securing the draining tube on the thigh to keep catheter bag below patient's bladder level and removal of the catheter as early as possible were ensured in all patients...
January 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29331965/right-iliac-fossa-pain-treatment-rift-study-protocol-for-an-international-multicentre-prospective-observational-study
#19
Dmitri Nepogodiev
INTRODUCTION: Patients presenting with right iliac fossa (RIF) pain are a common challenge for acute general surgical services. Given the range of potential pathologies, RIF pain creates diagnostic uncertainty and there is subsequent variation in investigation and management. Appendicitis is a diagnosis which must be considered in all patients with RIF pain; however, over a fifth of patients undergoing appendicectomy, in the UK, have been proven to have a histologically normal appendix (negative appendicectomy)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331474/clinical-databases-for-chest-physicians
#20
REVIEW
Andrew M Courtwright, Peter E Gabriel
A clinical database is a repository of patient medical and sociodemographic information focused on one or more specific health condition or exposure. Although clinical databases may be used for research purposes, their primary goal is to collect and track patient data for quality improvement, quality assurance, and/or actual clinical management. This article aims to provide an introduction and practical advice on the development of small-scale clinical databases for Chest physicians and practice groups. Through example projects we discuss the pros and cons of available technical platforms, including Microsoft Excel and Access, relational database management systems such as Oracle and PostgreSQL, and REDCap...
January 10, 2018: Chest
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