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https://www.readbyqxmd.com/read/28644792/what-moral-distress-in-nursing-history-could-suggest-about-the-future-of-health-care
#1
Andrew Jameton
The concept of moral distress was defined in 1984 as (a) the psychological distress of (b) being in a situation in which one is constrained from acting (c) on what one knows to be right. A substantial literature on the subject has developed, primarily in nursing ethics. The aforementioned elements of distress are applied here to areas of clinical and organizational significance: (a) distress from causing intimate pain during care of the dying, (b) constraints stemming from proximate and background challenges of health care organizations, and (c) changing perspectives on therapeutic technologies derived from global environmental perspectives...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644254/sporadic-creutzfeldt-jakob-disease-with-unilateral-symptoms-in-the-setting-of-metastatic-renal-cell-carcinoma
#2
Kyle C Rossi, Christine M Stahl, Pengfei Zhang, John W Liang, Lara V Marcuse, Fred Lublin
INTRODUCTION: Although it is not rare for magnetic resonance imaging findings in Creutzfeldt-Jakob disease to be asymmetric, unilateral clinical syndromes are uncommonly reported and may confound diagnosis. In addition, neurological paraneoplastic syndromes are not common in renal cell carcinoma, though there are cases reported, often without an offending antibody isolated. CASE REPORT: A 66-year-old man was admitted with 1 month of left-sided numbness and "loss of control" of the left arm...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28644156/clinical-case-of-the-month-a-57-year-old-man-with-an-axillary-mass
#3
Palak Desai, Andrew Myers, Brian Boulmay, Fred A Lopez
A 57-year-old man presented to the surgical oncology clinic with a mildly tender mass under his right arm. Four years prior, the patient had a melanoma removed from his right shoulder along with an ipsilateral right axillary sentinel lymph sampling. Computed tomography (CT) scan was negative for metastatic disease at that time. The patient did not undergo completion axillary node dissection and was lost to follow-up. The patient was originally from Australia, did not tan but reported multiple sunburns before age 18...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28644077/leiomyosarcoma-of-the-wing-in-a-vieilott-s-fireback-pheasant-lophura-rufa
#4
Martín A Zordan, Michael M Garner, Rebecca Smedley, Dana Neelis, Carlos R Sánchez
A 15-year-old, female Vieilott's fireback pheasant (Lophura rufa) presented with a 2-day history of a drooping right wing. Examination revealed severe soft tissue swelling in the area extending from the right shoulder to the humeral-radio-ulnar joint with associated bruising and feather loss. Results of a complete blood cell count revealed marked heterophilia and lymphocytosis, and results of serum biochemical analysis showed severe increases in creatine kinase and aspartate aminotransferase activities, hypoproteinemia, and hypoalbuminemia...
June 2017: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/28641844/the-in%C3%A2-vivo-morphology-of-post-infarct-ventricular-septal-defect-and-the-implications%C3%A2-for%C3%A2-closure
#5
Mark C K Hamilton, Jonathan C L Rodrigues, Robin P Martin, Nathan E Manghat, Mark S Turner
OBJECTIVES: The aim of this study was to define the dynamic in vivo morphology of post-infarct ventricular septal defect (PIVSD), which has not been previously described in living patients. BACKGROUND: PIVSD is a devastating complication of acute myocardial infarction. METHODS: The anatomic features of PIVSD, as demonstrated by computed tomography or magnetic resonance imaging, were retrospectively reviewed. RESULTS: Thirty-two PIVSDs were assessed, 16 left coronary artery and 16 right coronary artery PIVSDs...
June 26, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28637308/three-dimensional-right-ventricular-regional-deformation-and-survival-in-pulmonary-hypertension
#6
Pamela Moceri, Nicolas Duchateau, Delphine Baudouy, Elie-Dan Schouver, Sylvie Leroy, Fabien Squara, Emile Ferrari, Maxime Sermesant
Aims: Survival in pulmonary hypertension (PH) relates to right ventricular (RV) function. However, the RV unique anatomy and structure limit 2D analysis and its regional 3D function has not been studied yet. The aim of this study was to assess the implications of global and regional 3D RV deformation on clinical condition and survival in adults with PH and healthy controls. Methods and results: We collected a prospective longitudinal cohort of 104 consecutive PH patients and 34 healthy controls between September 2014 and December 2015...
June 15, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28637096/uncovering-the-decision-making-work-of-transferring-dying-patients-home-from-critical-care-units-an-integrative-review
#7
REVIEW
Yanxia Lin, Michelle Myall, Nikki Jarrett
AIMS: To understand how decisions are made to transfer dying patients home from critical care units. BACKGROUND: Many people prefer a home death, but a high proportion die in critical care units. Transferring dying patients home is recognized to be complex but transfer decision-making itself remains unclear. DESIGN: Integrative review. DATA SOURCES: Seven bibliographic databases (origin - 2015), grey literature and reference lists were searched...
June 21, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28635683/blastic-plasmacytoid-dendritic-cell-neoplasm-with-pulmonary-involvement-and-atypical-skin-lesion
#8
Cyndi Myrelle da Silva Barros Romão, Cláudio José Dos Santos Júnior, Luiz Arthur Calheiros Leite, Maria Jordana Rocha Gomes Alves, Nathalia Silva Araújo, Anderson F L Castro, Muriel Silva Moura, Vitória Mikaelly da Silva Gomes, Arthur Moacir Costa Sampaio Batinga, João Antonio S Queiroz, Natanael Barbosa Dos Santos
BACKGROUND Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematodermic malignancy neoplasm with highly aggressive course and poor prognosis. This disease typically presents with cutaneous involvement as the first manifestation, with subsequent or simultaneous spread to bone marrow and peripheral blood.  CASE REPORT Here, we report the case of a 51-year-old woman who presented a violaceus skin lesion on the lateral region of the right thigh, weight loss, fever, and lymphadenopathies. Computed tomography (CT) displayed thoracic and abdominal lymph node and alveolar bleeding...
June 21, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28630844/multifocal-septic-arthritis-secondary-to-infective-endocarditis-a-rare-case-report
#9
Pavandeep Soor, Nikhil Sharma, Chandra Rao
INTRODUCTION: Infective endocarditis (IE) is a rare cause of septic arthritis. We report a patient who presented with multifocal septic arthritis as a result of IE, which is an extremely rare condition. CASE REPORT: This 69-year-old gentleman presented to the emergency department (ED) with a 3-day history of acute right knee pain. Initial investigations demonstrated chondrocalcinosis on knee radiographs, acute renal failure with rhabdomyolysis and a CRP of 520. After treatment with intravenous fluid rehydration and analgesia, the knee aspiration grew a Group B Streptococcus, and the patient underwent arthroscopic washout...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630388/spontaneous-liver-rupture-associated-with-anticoagulant-therapy-a-case-report
#10
Marco Clementi, Sara Colozzi, Stefano Guadagni, Beatrice Pessia, Federico Sista, Mario Schietroma, Andrea Della Penna, Gianfranco Amicucci
Spontaneous hepatic rupture without underlying liver diseases is uncommon entity. We report a rare case of spontaneous rupture of liver hematoma in patient treated with warfarin end enoxaparin sodium because of pulmonary embolism. Two day after admission the patient complained generalized abdominal pain and hemodynamic instability. The abdominal US and TC scan revealed free fluid and lesion at right liver lobe. The patient, despite intravenous fluid support and blood transfusion, was hemodinamically instable and urgent laparotomy was needed...
January 20, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28629852/bioelectronic-block-of-paravertebral-sympathetic-nerves-mitigates-post-myocardial-infarction-ventricular-arrhythmias
#11
Ray W Chui, Una Buckley, Pradeep S Rajendran, Tina Vrabec, Kalyanam Shivkumar, Jeffrey L Ardell
BACKGROUND: Autonomic dysfunction contributes to induction of ventricular tachyarrhythmia (VT). OBJECTIVE: To determine the efficacy of charge-balanced direct current (CBDC), applied to the T1-T2 segment of the paravertebral sympathetic chain, on VT inducibility post-myocardial infarction (MI). METHODS: In a porcine model, CBDC was applied in acute animals (n=7) to optimize stimulation parameters for sympathetic blockade and in chronic MI animals (n=7) to evaluate the potential for VTs...
June 16, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28627763/suspected-methadone-toxicity-from-hospital-to-autopsy-bed
#12
Jaber Gharehdaghi, Asieh Takalloo-Bakhtiari, Hossein Hassanian-Moghaddam, Nasim Zamani, Mohammad-Javad Hedayatshode
High mortality rates have been reported for methadone in both adults and children. We aimed to determine the pattern of toxicity, possible underlying diseases and treatment challenges in patients referred to our center with early diagnosis of methadone toxicity and who later died. Medical files of all methadone-poisoned patients who had been admitted to a referral center of toxicology between March 2011 and March 2016, died during the hospital stay and sent for autopsy to Legal Medicine Organization were retrospectively evaluated...
June 19, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28626853/conjunctival-melanoma-in-southwestern-nigeria-a-case-series-and-review-of-literature
#13
Oluyemi Fasina, Olayiwola A Oluwasola
PURPOSE: Conjunctival melanoma is a rare tumor worldwide and is extremely rare among black population. This study aims to report the demographics, clinical presentation, treatment, and outcome of patients seen in an indigenous black population in Southwestern Nigeria. METHODS: All patients histologically diagnosed with conjunctival melanoma and managed in the facility were reviewed. Their demographics, clinical presentation, treatment received, outcome of treatment, and histopathological features were analyzed...
June 19, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28626581/carcinosarcoma-of-the-maxillary-sinus-a-rare-case-report
#14
Jawad Hasnaoui, Said Anajar, Mohammed Tatari, Reda Abada, Sami Rouadi, Mohammed Roubal, Mohammed Mahtar
INTRODUCTION: Carcinosarcoma is a highly malignant tumor characterized by dual malignant histologic differentiation of epithelial and mesenchymal components. The tumor is extremely rare in the sinonasal tract, with only 13 cases reported since 1957 in the literature. PRESENTATION OF CASE: We report a case of a 55-year-old man with right-sided face pain revealed a mass in the right maxillary sinus and nasal cavity. A large incisional biopsy from the nasal cavity concluded the diagnosis of carcinosarcoma...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28626373/biliary-pleural-fistula-following-portal-vein-embolization-for-perihilar-cholangiocarcinoma
#15
Mujtaba Mohammed, Katsuhiro Kobayashi, Mohammed Jawed
Biliary-pleural fistula (BPF), an abnormal communication between the biliary tract and pleural space, is a rare but potentially life-threatening complication following percutaneous biliary intervention. We report a case of BPF following portal vein embolization (PVE) in a 79-year-old woman with obstructive jaundice secondary to perihilar cholangiocarcinoma. The patient successfully underwent right-sided PVE; however, the patient developed a symptomatic right-sided bilious pleural effusion the following day...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28624411/incremental-prognostic-utility-of-left-ventricular-global-longitudinal-strain-in-asymptomatic-patients-with-significant-chronic-aortic-regurgitation-and-preserved-left-ventricular-ejection-fraction
#16
Alaa Alashi, Amgad Mentias, Amjad Abdallah, Ke Feng, A Marc Gillinov, L Leonardo Rodriguez, Douglas R Johnston, Lars G Svensson, Zoran B Popovic, Brian P Griffin, Milind Y Desai
OBJECTIVES: We sought to examine the prognostic utility of left ventricular (LV) global longitudinal strain (GLS) in asymptomatic patients with ≥III+ aortic regurgitation (AR), an indexed LV end-systolic dimension of <2.5 cm/m(2), and preserved left ventricular ejection fraction (LVEF). BACKGROUND: Management of asymptomatic patients with severe chronic AR and preserved LVEF is challenging and is typically based on LV dimensions. METHODS: We studied 1,063 such patients (53 ± 16 years; 77% men) seen between 2003 and 2010 (excluding those with symptoms, obstructive coronary artery disease, acute AR/dissection, aortic/mitral stenosis, more than moderate mitral regurgitation, and previous cardiac surgery)...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28621295/efficacy-and-safety-in-case-of-technical-success-of-endoscopic-ultrasound-guided-transhepatic-antegrade-biliary-drainage-a-report-of-a-monocentric-study
#17
Sébastien Godat, Erwan Bories, Fabrice Caillol, Christian Pesenti, Jean Philippe Ratone, Chiara de Cassan, Marc Giovannini
BACKGROUND AND OBJECTIVES: Endoscopic ultrasound (EUS)-guided biliary drainage techniques are alternative procedures in cases of obstructive jaundice with altered anatomy or failed ERCP. Complications related to EUS-guided antegrade drainage (EUS-AD) are still present in up to 10% of cases, and combination of procedures is sometimes suggested to avoid adverse events. The purpose of our study is to evaluate the efficacy and safety of EUS-AD with transhepatic access in case of technical success...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28620573/clinical-characteristics-and-outcomes-of-patients-with-ischemic-and-non-ischemic-complete-heart-block
#18
Murtaza Sundhu, Mehmet Yildiz, Mubbasher Syed, Bhavan Shah, Sajjad Gul, Omer Afzal, Lon Castle
INTRODUCTION: Third degree or complete heart block (CHB) is a medical emergency and usually requires permanent pacemaker placement. CHB can be caused by cardiac ischemia or non-ischemic conditions such as infiltrative diseases or fibrosis. The purpose of this study is to identify the baseline clinical characteristics associated with ischemic versus non-ischemic causes of complete heart block and compare their outcomes. MATERIALS AND METHODS: An institutional review broad approval was granted by the Cleveland Clinic Health System...
May 12, 2017: Curēus
https://www.readbyqxmd.com/read/28618165/herpes-simplex-virus-2-transmission-following-solid-organ-transplantation-donor-derived-infection-and-transplantation-from-prior-organ-recipients
#19
Nenad Macesic, Ian J Abbott, Matthew Kaye, Julian Druce, Allan R Glanville, Paul J Gow, Peter D Hughes, Tony M Korman, William R Mulley, Phillip J O'Connell, Helen Opdam, Miranda Paraskeva, Matthew C Pitman, Stella Setyapranata, William D Rawlinson, Paul D R Johnson
BACKGROUND: Owing to limited availability of donor organs, previous solid organ transplant (SOT) recipients are increasingly considered as potential organ donors. We report donor-derived transmission of herpes simplex virus type-2 (HSV-2) to two clusters of SOT recipients with transmission from the original donor and an HSV-2-infected recipient who subsequently became a donor. METHODS: We reviewed medical records of the donors and recipients in both clusters. Pre-transplant serology and virological features of HSV-2 were characterized...
June 15, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28614860/primary-fetal-lung-hypoplasia-pflh-imaging-and-clinical-characteristics
#20
Reuven Achiron, Yinon Gilboa, Yishay Salem, Yizhak Jacobson, Lisa Raviv-Zilka, Andreea Cioca, Debora Kidron, Zvi Kivilevitch
Purpose To describe in utero and postnatal imaging and clinical characteristics of primary fetal lung hypoplasia (PFLH). Methods A retrospective review of fetuses and neonates diagnosed in one academic tertiary center during an eleven-year period. Results 12 cases of PFLH were identified. 4 were bilateral and 8 had unilateral involvement. Prenatal sonographic characteristics, postnatal magnetic resonance imaging (MRI), computerized tomographic angiography (CTA), and histologic findings are described...
June 2017: Ultraschall in der Medizin
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