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https://www.readbyqxmd.com/read/28647951/complexities-of-care-in-klinefelter-syndrome-an-aprn-perspective
#1
Sharron Close, Amy Talboy, Ilene Fennoy
47,XXY (Klinefelter Syndrome) is associated with a spectrum of complex clinical needs that are associated with variable physical, neurocognitive and psychosocial aspects. For patients and families affected by this sex chromosome trisomy, navigation of health care services is difficult due to lack of 47,XXY awareness among many health care providers and little evidence to support endocrine and additional treatment plans. While endocrine management of androgen deficiency has been the mainstay of treatment for patients from puberty through adulthood, testosterone replacement, alone, fails to mitigate many symptoms and issues...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647949/the-key-to-adrenal-insufficiency-education-repetition-repetition-repetition
#2
Margaret F Keil, Carol Van Ryzin
Described more than 150 years ago by Thomas Addison, adrenal gland dysfunction, while treatable, remains a clinically significant and potentially fatal disease. Vague and non-specific symptomatology can delay diagnosis of adrenal insufficiency and lead to adrenal crisis. Affected individuals may delay self-management due to knowledge deficits or lack of required therapies. Advanced practice nurses must remain vigilant for signs and symptoms of adrenal insufficiency and prevention of crisis. Education of patients and their caregivers/family members must emphasize early intervention with regards to adrenal insufficiency in order to prevent adrenal crisis...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647947/continuous-glucose-monitoring-in-pediatrics-the-gap-between-potential-benefits-and-the-reality-of-utility
#3
Regina L Taddeo, Joanne T Moser, Pantea P Minnock
Continuous Glucose Monitoring (CGM) is rapidly becoming a standard of care in the management of Type 1 diabetes (T1D). Today's devices are nearly as accurate as home glucose meters. They provide glucose data every 5 minutes, alert to high and low blood glucose levels, and allow for remote monitoring of a user's glucose data and patterns. Use of CGM has many benefits including support for tighter glycemic control without increasing the risk for hypoglycemia. There is however emerging evidence of some negative aspects associated with using CGM, which may result in decreased utilization of the device as well as a decline in quality of life, especially in the pediatric population...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647946/current-strategies-in-nutrition-education-to-optimize-glycemic-management-for-children-with-diabetes
#4
Francesca Annan
Recent developments in the understanding of the impact of dietary quality and meal composition are driving changes in the education provided to children and young people about nutrition and lifestyle management of Type 1 Diabetes (T1D). Nutrition education is moving beyond carbohydrate counting and insulin adjustment to acknowledging the influence of whole food choices on glycemic outcomes.
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647944/management-of-type-1-diabetes-in-children-in-the-first-5-years-of-life
#5
Melissa Rearson, Susan Sullivan-Bolyai
A significant increase in children <6 years of age being diagnosed with type 1 diabetes (T1D) is occurring. The parents (caregivers) of these children have full responsibility for the complex and individualized management while having to deal with the emotional stress of caring for a child with a chronic condition. This article will provide a summary of the diagnosis and recommended medical treatment for this special age group of children. Also presented will be common day-to-day family management issues for health care providers to consider as they provide care for this most common endocrine chronic condition...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647909/organic-matter-export-to-the-seafloor-in-the-baltic-sea-drivers-of-change-and-future-projections
#6
Tobias Tamelander, Kristian Spilling, Monica Winder
The impact of environmental change and anthropogenic stressors on coastal marine systems will strongly depend on changes in the magnitude and composition of organic matter exported from the water column to the seafloor. Knowledge of vertical export in the Baltic Sea is synthesised to illustrate how organic matter deposition will respond to climate warming, climate-related changes in freshwater runoff, and ocean acidification. Pelagic heterotrophic processes are suggested to become more important in a future warmer climate, with negative feedbacks to organic matter deposition to the seafloor...
June 24, 2017: Ambio
https://www.readbyqxmd.com/read/28647851/a-questionnaire-survey-of-radiological-diagnosis-and-management-of-renal-dysplasia-in-children
#7
Giovanni Montini, Marco Busutti, Fatos Yalcinkaya, Adrian S Woolf, Stefanie Weber
BACKGROUND: The condition called renal dysplasia is considered to be a frequent cause of chronic kidney disease in children. Formally, it is defined by histological parameters. In current nephrology practice, however, the appearance of the kidneys on ultrasound scanning is often used as a basis for the diagnosis. METHODS: The European Society for Pediatric Nephrology Working Group on Congenital Anomalies of the Kidney and Urinary Tract hypothesized that the current diagnostic approach with regard to renal dysplasia was not homogeneous...
June 24, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28647829/extra-central-nervous-system-metastases-from-glioblastoma-a-new-possible-trigger-event
#8
G Simonetti, A Silvani, L Fariselli, A F Hottinger, G A Pesce, F Prada, P Gaviani
Extra-cranial metastases of glioblastoma (GBM) represent a rare event, and the biological-genetic mechanisms involved in the pathogenesis have not yet been determined. We report the case of a young patient with multiple visceral and osseous metastases occurred after 4 years after first diagnosis of GBM. The strangeness as well as the rarity of this event does not allow to identify an effective treatment for GBM metastases, making the management of this ominous tumor an even greater challenge.
June 24, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28647800/safety-and-effectiveness-of-tolvaptan-for-fluid-management-after-pediatric-cardiovascular-surgery
#9
Yuzo Katayama, Tsukasa Ozawa, Noritsugu Shiono, Hiroshi Masuhara, Takeshiro Fujii, Yoshinori Watanabe
BACKGROUND: Postoperative fluid management is important after open heart surgery, because cardiopulmonary bypass evokes an abnormal inflammatory response and increases vascular permeability, especially in pediatric patients. We assessed the safety and effectiveness of tolvaptan for management of postoperative fluid retention after congenital heart surgery. METHODS AND RESULTS: This retrospective study analyzed data from 43 children with uncomplicated congenital heart disease who underwent open heart surgery between September 2013 and August 2016...
June 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28647737/trends-in-the-management-of-acute-appendicitis-in-a-single-center-quality-register-cohort-of-5-614-patients
#10
Martin J A Dahlberg, Emil H A Pieniowski, Lennart Å S Boström
Acute appendicitis is one of the most common reasons for emergency surgery. At Stockholm South General Hospital, information on all patients - 15 years or older - undergoing surgery for acute appendicitis is included in a quality register. Data on surgical method, preoperative imaging, hospital stay, intraoperative findings, and 30-day complications were recorded for each patient. From January 2004 to December 2014, 5,614 consecutive patients were registered. The percentage of patients examined with preoperative imaging increased from 30% in 2004 to 93% in 2014...
June 24, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28647693/recognition-investigation-and-management-of-mitochondrial-disease
#11
REVIEW
James E Davison, Shamima Rahman
Mitochondria are dynamic organelles present in virtually all human cells that are needed for a multitude of cellular functions, including energy production, control of cell apoptosis and numerous biochemical catabolic and synthetic pathways that are critical for cellular health. Primary mitochondrial disorders are a group of greater than 200 single gene defects arising from two genomes (nuclear and mitochondrial) leading to mitochondrial dysfunction, and are associated with extremely heterogeneous phenotypes...
June 24, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28647663/management-of-residual-tumor-after-limited-subtotal-resection-of-large-vestibular-schwannomas-lessons-learned-and-a-rationale-for-specialized-care
#12
William R Copeland, Matthew L Carlson, Brian A Neff, Colin L W Driscoll, Michael J Link
BACKGROUND: In an era where subtotal resection (STR) is increasingly utilized, we have encountered a growing number of patients referred to our institution with limited resection of large vestibular schwannomas (VS), at times associated with grave complications. OBJECTIVE: We highlight lessons learned in the management of large VS and provide a rationale for specialized care. METHODS: A prospectively maintained database of over 2,000 patients with VS evaluated at our institution between 2000 and 2016 was reviewed...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28647660/novel-oral-anticoagulants-in-patients-undergoing-cranial-surgery
#13
Davide Marco Croci, Maria Kamenova, Raphael Guzman, Luigi Mariani, Jehuda Soleman
BACKGROUND: The number of patients treated with NOACS is increasing. Despite growing clinical relevance, guidelines on the perioperative management of neurosurgical patients treated with NOACS are still lacking. OBJECTIVES: The aim of this study was to analyze the occurrence of postoperative bleeding events and factors which might influence bleeding rates of these patients. METHODS: Out of 1353 consecutive patients undergoing cranial neurosurgical procedures 30 patients (2...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28647639/flow-reduction-aided-thrombin-injection-for-complex-femoral-pseudoaneurysms-case-series-and-review-of-the-literature
#14
Nandakumar Menon, Charles B Drucker, Abhishek Bhardwaj, Richa Kalsi, Robert S Crawford, Rajabrata Sarkar, Shahab Toursavadkohi
We describe a series of 4 patients with complex femoral pseudoaneuryms including short, wide necks that were successfully managed with a combination of proximal endovascular balloon occlusion and percutaneous thrombin injection. Contralateral femoral access was used to place an occlusion balloon proximal to or across the lesion and thrombin was injected directly into the pseudoaneurysm under ultrasound guidance. All patients recovered from their procedures without incident and are free from recurrence at follow-up...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647638/evolution-of-practices-in-carotid-surgery-observational-study-in-france-from-2006-to-2015
#15
Lucie Salomon du Mont, Stefan Olteanu, Eric Steinmetz, Benjamin Kretz
INTRODUCTION: The principal objective of this study was to determine the evolution of the surgical management of stenosis of the carotid bifurcation over a period of 10 years in France. The secondary objective was to ascertain the impact of recommendations and of the literature on the evolution of these practices. MATERIALS AND METHODS: From the registry of the 'Agence Technique de l'Information sur l'Hospitalisation (ATIH)', we collected all of the data for carotid surgery procedures carried out in French healthcare establishments between 2006 and 2015...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647592/liposphere-mediated-topical-delivery-of-thymoquinone-in-the-treatment-of-psoriasis
#16
Anjali Jain, P Venkatesh, Upendra Bulbake, Sindhu Doppalapudi, Towseef Amin Rafeeqi, Chandraiah Godugu, Wahid Khan
Thymoquinone (TMQ) is reported with good anti-psoriatic activity however, the hydrophobicity, poor aqueous solubility, light and pH sensitive nature of TMQ hinder its delivery to target site. To address these delivery challenges of TMQ, lipospheres were explored. The topical use of lipospheres offer an effective mean of penetration along with stability and scalability. TMQ lipospheres of particle size below 70nm were prepared and evaluated. These lipospheres resulted in deeper skin penetration, slow release and skin compatibility...
June 21, 2017: Nanomedicine: Nanotechnology, Biology, and Medicine
https://www.readbyqxmd.com/read/28647576/robotic-assisted-excision-of-a-urachal-diverticulum
#17
Pamela Frazzini Padilla, Soo Kwon
OBJECTIVE: To demonstrate a combined robotic assisted laparoscopic technique with concomitant cystoscopy use for excision of a urachal diverticulum, to ensure complete resection of diverticulum and bladder cuff. DESIGN: Step-by-step demonstration and explanation of the procedure using video illustration. IRB/Ethics Committee ruled that approval was not required for this case report, however patient consent was obtained. SETTING: Vesicourachal diverticula account for approximately 3-5% of congenital urachal anomalies...
June 21, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28647435/dietary-habits-in-parkinson-s-disease-adherence-to-mediterranean-diet
#18
Erica Cassani, Michela Barichella, Valentina Ferri, Giovanna Pinelli, Laura Iorio, Carlotta Bolliri, Serena Caronni, Samanta A Faierman, Antonia Mottolese, Chiara Pusani, Fatemeh Monajemi, Marianna Pasqua, Alessandro Lubisco, Emanuele Cereda, Gianni Pezzoli
INTRODUCTION: Our objective is to describe the dietary habits, food preferences and adherence to Mediterranean diet (MeDi) of a large sample of Italian Parkinson's Disease (PD) patients compared to a group of controls. METHODS: Dietary habits of 600 PD patients from throughout Italy and 600 controls matched by gender, age, education, physical activity level and geographical residence, were collected using the ON-GP Food Frequency Questionnaire. Then, we compared patients by disease duration and the presence of swallowing disturbances...
June 15, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28647407/external-validation-of-the-simple-null-please-clinical-score-in-predicting-outcome-of-out-of-hospital-cardiac-arrest
#19
Tatjana S Potpara, Miroslav Mihajlovic, Sanja Stankovic, Tanja Jozic, Irena Jozic, Milika R Asanin, Rajai Ahmad, Gregory Y H Lip
BACKGROUND: Rapid clinical decision-making on further management of patients with out-of-hospital cardiac arrest may be challenging. Recently, a 'futility' score (NULL-PLEASE) incorporating multiple adverse resuscitation features (Non-shockable rhythm, Unwitnessed arrest, Long no-flow or Long low-flow period, blood pH <7.2, Lactate >7.0 mmol/l, End-stage chronic kidney disease on dialysis, Age ≥85 years, Still resuscitation and Extra-cardiac cause) has been proposed to help identify out-of-hospital cardiac arrest patients unlikely to survive; however, external independent score validation is lacking...
June 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28647406/unstable-angina-in-the-era-of-cardiac-troponin-assays-with-improved-sensitivity-a-clinical-dilemma
#20
K M Eggers, T Jernberg, B Lindahl
INTRODUCTION: There is an expectation that with the adoption of more sensitive cardiac troponin (cTn) assays, unstable angina would become a rarity. However, recent data from the SWEDEHEART registry demonstrated that 15% of patients admitted with non ST-elevation acute coronary syndrome (NSTE-ACS) still were regarded having unstable angina. We aimed to further investigate the clinical characteristics and outcome of these patients. METHODS: Retrospective registry-based analysis (SWEDEHEART) including 3204 unstable patients, 18,194 non ST-elevation myocardial infarction (NSTEMI) patients and 977 controls without acute cardiovascular disease...
June 21, 2017: American Journal of Medicine
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