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https://www.readbyqxmd.com/read/28727491/impact-of-point-of-care-xpert-mtb-rif-on-tuberculosis-treatment-initiation-a-cluster-randomised-trial
#1
Richard J Lessells, Graham S Cooke, Nuala McGrath, Mark P Nicol, Marie-Louise Newell, Peter Godfrey-Faussett
RATIONALE: Point-of-care (POC) diagnostics have potential to reduce pre-treatment loss to follow-up and delays to initiation of appropriate TB treatment. OBJECTIVE: To evaluate the effect of a POC diagnostic strategy on initiation of appropriate TB treatment. METHODS: A cluster randomised trial of adults with cough who were HIV positive and/or at high risk of drug-resistant TB. Two-week time blocks were randomised to two strategies (i) Xpert performed at district hospital laboratory (ii) POC Xpert performed at primary health care clinic...
July 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28727229/volatile-organic-compound-detection-as-a-potential-means-of-diagnosing-cutaneous-wound-infections
#2
Mohammed Ashrafi, Matt Bates, Mohamed Baguneid, Teresa Alonso-Rasgado, Riina Rautemaa-Richardson, Ardeshir Bayat
Chronic cutaneous wound infections and surgical site infections (SSIs) present a huge burden on the healthcare system and can lead to increased morbidity and mortality. Current diagnostic methods of identifying and confirming infection involve culture-based and molecular methods. Both techniques are time consuming and delays commonly lead to un-targeted empirical treatment. An ideal diagnostic method would be non-invasive and highly sensitive and detect pathogenic organisms with a high degree of accuracy in order to allow targeted treatment...
July 20, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28724392/a-prospective-study-assessing-agreement-and-reliability-of-a-geriatric-evaluation
#3
Isabella Locatelli, Stéfanie Monod, Jacques Cornuz, Christophe J Büla, Nicolas Senn
BACKGROUND: The present study takes place within a geriatric program, aiming at improving the diagnosis and management of geriatric syndromes in primary care. Within this program it was of prime importance to be able to rely on a robust and reproducible geriatric consultation to use as a gold standard for evaluating a primary care brief assessment tool. The specific objective of the present study was thus assessing the agreement and reliability of a comprehensive geriatric consultation...
July 19, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28721938/practical-clues-for-diagnosing-wwox-encephalopathy
#4
Oana Tarta-Arsene, Diana Barca, Dana Craiu, Catrinel Iliescu
The WW domain-containing oxidoreductase gene is implicated in autosomal recessive disorders of the central nervous system, expressed either as spinocerebellar ataxia or as a severe form with early-infantile epileptic encephalopathy. Here, we describe the electroclinical evolution of these disorders, adding new diagnostic clues based on a case study. The patient, a boy with early-onset epilepsy, presented with profound global developmental delay, persistent hypsarrhythmia, and epileptic spasms, associated with progressive cerebral atrophy without microcephaly...
July 19, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28721092/hemicrania-continua-clinical-review-diagnosis-and-management
#5
REVIEW
Sanjay Prakash, Payal Patel
Hemicrania continua (HC) is an indomethacin-responsive primary headache disorder which is currently classified under the heading of trigeminal autonomic cephalalgias (TACs). It is a highly misdiagnosed and underreported primary headache. The pooled mean delay of diagnosis of HC is 8.0 ± 7.2 years. It is not rare. We noted more than 1000 cases in the literature. It represents 1.7% of total headache patients attending headache or neurology clinic. Just like other TACs, it is characterized by strictly unilateral pain in the trigeminal distribution, cranial autonomic features in the same area and agitation during exacerbations/attacks...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28719593/long-term-treatment-of-eosinophilic-esophagitis-with-swallowed-topical-corticosteroids-development-and-evaluation-of-a-therapeutic-concept
#6
Thomas Greuter, Christian Bussmann, Ekaterina Safroneeva, Alain M Schoepfer, Luc Biedermann, Stephan R Vavricka, Alex Straumann
OBJECTIVES: Swallowed topical corticosteroids (STCs) are efficacious in inducing and presumably maintaining remission in patients with active eosinophilic esophagitis (EoE). Hitherto, it has not been evaluated whether long-lasting remission can be achieved, and whether treatment can be stopped once patients have achieved this remission. METHODS: Since 2007, EoE patients included into a large database at the Swiss EoE Clinics were put on STCs as induction/maintenance therapy...
July 18, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28718262/laparoscopic-approach-to-a-rare-interstitial-incisional-hernia-following-appendectomy
#7
Kerim Erdem Ulucay, Muhammad Umar Younis
Among the complications of an open appendectomy is the presentation of an incisional hernia. An interstitial or interparietal hernia is the one in which the hernia sac is present between the muscle layers of the abdominal wall which makes the presentation of a post-operative incisional interstitial hernia quite a rarity. A 52-year-old female was admitted through the outpatient clinic presenting with the complaints of discomfort and a bulge felt in the right hypochondrium for the last 3 years. Radiological investigations were able to delineate an interstitial incisional hernia through the previous open appendectomy scar...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28718241/c-reactive-protein-an-aid-for-diagnosis-of-acute-appendicitis
#8
Nauman Ahmed
BACKGROUND: Delayed or wrong diagnosis of acute appendicitis in patients results in complications like perforation, gangrene, etc. which carries a significant amount of morbidity and mortality to the patients. Thus, timely diagnosis of acute appendicitis is crucial to prevent these complications. Recently, it was found that serum C-reactive protein (CRP) individually can be a useful marker, thus in resource limited settings (i.e., access to ultrasonography) simple laboratory investigation can be of extreme utility for the diagnosis of acute appendicitis...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28717741/patient-reported-burden-of-a-neuroendocrine-tumor-net-diagnosis-results-from-the-first-global-survey-of-patients-with-nets
#9
Simron Singh, Dan Granberg, Edward Wolin, Richard Warner, Maia Sissons, Teodora Kolarova, Grace Goldstein, Marianne Pavel, Kjell Öberg, John Leyden
PURPOSE: Despite the considerable impact of neuroendocrine tumors (NETs) on patients' daily lives, the journey of the patient with a NET has rarely been documented, with published data to date being limited to small qualitative studies. NETs are heterogeneous malignancies with nonspecific symptomology, leading to extensive health care use and diagnostic delays that affect survival. A large, international patient survey was conducted to increase understanding of the experience of the patient with a NET and identify unmet needs, with the aim of improving disease awareness and care worldwide...
February 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28717600/implementation-of-the-xpert-mtb-rif-assay-for-tuberculosis-in-mongolia-a-qualitative-exploration-of-barriers-and-enablers
#10
Nicole L Rendell, Solongo Bekhbat, Gantungalag Ganbaatar, Munkhjargal Dorjravdan, Madhukar Pai, Claudia C Dobler
OBJECTIVE: The aim of our study was to identify barriers and enablers to implementation of the Xpert MTB/RIF test within Mongolia's National Tuberculosis Program. METHODS: Twenty-foursemi-structured interviews were conducted between June and September 2015 with laboratory staff and tuberculosis physicians in Mongolia's capital Ulaanbaatar and regional towns where Xpert MTB/RIF testing had been implemented. Interviews were recorded, transcribed, translated and analysed thematically using NVIVO qualitative analysis software...
2017: PeerJ
https://www.readbyqxmd.com/read/28716575/strategic-targeting-of-multiple-bmp-receptors-prevents-trauma-induced-heterotopic-ossification
#11
Shailesh Agarwal, Shawn J Loder, Christopher Breuler, John Li, David Cholok, Cameron Brownley, Jonathan Peterson, Hsiao H Hsieh, James Drake, Kavitha Ranganathan, Yashar S Niknafs, Wenzhong Xiao, Shuli Li, Ravindra Kumar, Ronald Tompkins, Michael T Longaker, Thomas A Davis, Paul B Yu, Yuji Mishina, Benjamin Levi
Trauma-induced heterotopic ossification (tHO) is a condition of pathologic wound healing, defined by the progressive formation of ectopic bone in soft tissue following severe burns or trauma. Because previous studies have shown that genetic variants of HO, such as fibrodysplasia ossificans progressiva (FOP), are caused by hyperactivating mutations of the type I bone morphogenetic protein receptor (T1-BMPR) ACVR1/ALK2, studies evaluating therapies for HO have been directed primarily toward drugs for this specific receptor...
July 15, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28712734/combined-direct-and-indirect-traumatic-carotid-cavernous-fistula-ccf-case-report-and-review-of-the-literature
#12
Isaac Josh Abecassis, Ryan P Morton, Louis J Kim, Basavaraj V Ghodke, Michael R Levitt
BACKGROUND: Within the current Barrow classification system, there are no categorical descriptions or reports in the literature of cavernous carotid fistulas (CCFs) with both a direct component (type A) and separate indirect contribution (type B, C, or D). We report the first definitive case of a combined simultaneous traumatic direct and indirect CCF, and review the literature on the similar existing entity of traumatic indirect CCFs presenting delayed and subsequent to the treatment of traumatic, direct CCFs...
July 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28712694/imaging-pearls-of-pediatric-beh%C3%A3-et-s-disease
#13
REVIEW
Osman Melih Topcuoglu, Elif Dilara Topcuoglu, Cetin Murat Altay, Sinan Genc
OBJECTIVE: To emphasize the diverse diagnostic imaging findings of pediatric Behçet's disease and to define the fundamental imaging clues for pulmonary, vascular, gastrointestinal and central nervous system involvements of Behçet's disease in pediatric age group. We also aim to list the major imaging differences of Behçet's disease in childhood and adulthood. CONCLUSION: The diagnosis of pediatric Behçet's disease is challenging. Imaging can narrow the differential diagnosis by using some substantial clues and prevent diagnostic delays...
June 28, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28712662/enteropathogen-detection-in-children-with-diarrhoea-or-vomiting-or-both-comparing-rectal-flocked-swabs-with-stool-specimens-an-outpatient-cohort-study
#14
Stephen B Freedman, Jianling Xie, Alberto Nettel-Aguirre, Bonita Lee, Linda Chui, Xiao-Li Pang, Ran Zhuo, Brendon Parsons, James A Dickinson, Otto G Vanderkooi, Samina Ali, Lara Osterreicher, Karen Lowerison, Phillip I Tarr
BACKGROUND: Enteropathogen detection traditionally relies on diarrhoeal stool samples, but these are inconvenient to collect if they are not immediately available, leading to suboptimum return rates of samples and delayed or missed diagnostic opportunities. We sought to compare the enteropathogen yields of rectal swabs and stool specimens in children with diarrhoea or vomiting, or both. METHODS: The Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE) did a study in three outpatient cohorts in Calgary and Edmonton (AB, Canada)-children enrolled in the Pediatric Emergency Research Canada emergency departments, children receiving routine vaccinations at a Calgary health clinic, and symptomatic children who met criteria for treatment at home...
July 13, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28712645/comparison-of-qsofa-score-and-sirs-criteria-as-screening-mechanisms-for-emergency-department-sepsis
#15
Samir Haydar, Matthew Spanier, Patricia Weems, Samantha Wood, Tania Strout
OBJECTIVES: The Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score has been shown to accurately predict mortality in septic patients and is part of recently proposed diagnostic criteria for sepsis. We sought to ascertain the sensitive of the score in diagnosing sepsis, as well as the diagnostic timeliness of the score when compared to traditional systemic inflammatory response syndrome (SIRS) criteria in a population of emergency department (ED) patients treated in the ED, admitted, and subsequently discharged with a diagnosis of sepsis...
July 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28711593/clinical-evaluation-of-sepsis-1-and-sepsis-3-in-the-intensive-care-unit
#16
Xueling Fang, Zhenzhen Wang, Jun Yang, Hongliu Cai, Zhengjie Yao, Kun Li, Qiang Fang
BACKGROUND: There has been considerable controversy between sepsis-1 and sepsis-3 criteria. METHODS: Patients with infection meeting SIRS ≥ 2 criteria (sepsis-1) or a SOFA score ≥ 2 (sepsis-3) on the first day after ICU admission were selected from the MIMIC-III database, and their outcomes were compared using all-cause death as the endpoint. Subgroup analysis was also performed based on prior chronic organ dysfunction. RESULTS: 21,491 infected patients were included...
July 12, 2017: Chest
https://www.readbyqxmd.com/read/28711565/new-aspects-of-molecular-imaging-in-prostate-cancer
#17
Francesco Ceci, Paolo Castellucci, Juliano J Cerci, Stefano Fanti
Nowadays several new imaging modalities are available for investigating prostate cancer (PCa) such as magnet resonance imaging (MRI) in the form of whole body MRI and pelvic multiparametric MRI and positron emission tomography (PET) using choline as radiotracers. Nevertheless, these modalities proved sub-optimal accuracy for detecting PCa metastases, particularly in the recurrence setting. A new molecular probe targeting the prostate specific membrane antigen (PSMA) has been recently developed for PET imaging...
July 12, 2017: Methods: a Companion to Methods in Enzymology
https://www.readbyqxmd.com/read/28710882/mid-trimester-preterm-premature-rupture-of-membranes-pprom-etiology-diagnosis-classification-international-recommendations-of-treatment-options-and-outcome
#18
REVIEW
Michael Tchirikov, Natalia Schlabritz-Loutsevitch, James Maher, Jörg Buchmann, Yuri Naberezhnev, Andreas S Winarno, Gregor Seliger
Mid-trimester preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes prior to 28 weeks of gestation, complicates approximately 0.4%-0.7% of all pregnancies. This condition is associated with a very high neonatal mortality rate as well as an increased risk of long- and short-term severe neonatal morbidity. The causes of the mid-trimester PPROM are multifactorial. Altered membrane morphology including marked swelling and disruption of the collagen network which is seen with PPROM can be triggered by bacterial products or/and pro-inflammatory cytokines...
July 15, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28709918/unroofed-coronary-sinus-syndrome-an-easily-corrected-congenital-anomaly-but-more-diagnostic-suspicions-are-needed
#19
Changcheng Chen, Lili Xu, Yi Xu, Ping Li, Shuo Liu, Bin You
BACKGROUND: Unroofed coronary sinus syndrome (URCSS) is a spectrum of cardiac anomalies in which part (partial type) or the entire common wall (complete type) between the coronary sinus (CS) and left atrium is absent. It is commonly associated with a persistent left superior vena cava (PLSVC). The PLSVC can even anomalously connect to the left atrium in complete type anomaly. URCSS has been reported to be associated with delayed diagnosis and life-threatening cerebral injury. The purpose of the present study was to review our experience with surgical correction of this often-concealed malformation and discuss methods for reducing diagnostic omission...
June 22, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28709694/early-clinical-manifestations-of-s%C3%A3-zary-syndrome-a-multicenter-retrospective-cohort-study
#20
Aaron R Mangold, Agnieszka K Thompson, Mark D Davis, Ieva Saulite, Antonio Cozzio, Emmanuella Guenova, Emmilia Hodak, Iris Amitay-Laish, Ramon M Pujol, Mark R Pittelkow, Robert Gniadecki
BACKGROUND: Classic Sézary syndrome (SS) is defined by erythroderma, generalized lymphadenopathy, and leukemic blood involvement. Clinical observations suggest that SS begins as a nonerythrodermic disease. OBJECTIVE: To describe the early clinical characteristics of patients with SS. METHODS: A retrospective, multicenter chart review was performed for 263 confirmed cases of SS diagnosed during 1976-2015. RESULTS: Erythroderma was the earliest recorded skin sign of SS in only 25...
July 11, 2017: Journal of the American Academy of Dermatology
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