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https://www.readbyqxmd.com/read/28432462/novel-esophageal-stent-for-treatment-of-cervical-anastomotic-leakage-after-esophagectomy
#1
Gang Wu, Meipan Yin, Yan Shi Zhao, Yi Fang, Gaofeng Zhao, Jia Zhao, Xinwei Han
BACKGROUND: Dedicated stents for treatment of cervical anastomotic leakage are currently unavailable. In this study, we aimed to assess the feasibility and efficacy of using custom-designed stents for treatment of cervical anastomotic leakage after esophagectomy. METHODS: The stents were designed according to the location and size of the leakage and the residual esophageal length as determined by esophagography in each case. It had a cup-shaped upper end and a globular lower end and a total height of 60-85 mm...
April 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28431914/pain-trajectories-of-nursing-home-residents-nearing-death
#2
Genevieve N Thompson, Malcolm Doupe, R Colin Reid, Jennifer Baumbusch, Carole A Estabrooks
BACKGROUND/OBJECTIVES: Although examining point in time prevalence of pain among nursing home (NH) residents has value, there is a lack of evidence describing the actual changes (ie, trajectories) in pain that take place during their last 6 months of life. The main objective of this study is to describe the major pain trajectories experienced by NH residents during their last 6 months of life. DESIGN: Secondary analysis of Resident Assessment Instrument-Minimum Data Set (MDS) 2...
April 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28431860/predictive-value-of-perfusion-defects-on-dual-energy-cta-in-the-absence-of-thromboembolic-clots
#3
Richard A P Takx, Thomas Henzler, U Joseph Schoepf, Thomas Germann, Stefan O Schoenberg, Aysel Shirinova, Ralf W Bauer, Claudia Frellesen, Long Jiang Zhang, John W Nance, Christian Fink, Paul Apfaltrer
BACKGROUND: To determine the predictive value of volumetrically measured lung perfusion defects (PDvol) and right ventricular dysfunction on dual-energy computed tomography angiography (DE-CTA) for predicting all cause mortality in patients suspected of pulmonary embolism (PE) but without evident thromboembolic clot on CTA. METHODS: 448 patients underwent DE-CTA on a 64-channel DSCT system between January 2007 and December 2012 for suspected PE, of which 115 were without detectable thromboembolic clot on CTA...
April 18, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28429542/study-of-the-wearable-cardioverter-defibrillator-in-advanced-heart-failure-patients-swift
#4
Alon Barsheshet, Valentina Kutyifa, Theodora Vamvouris, Arthur J Moss, Yitschak Biton, Leway Chen, Eugene Storozynsky, Chingping Wan, Steven J Szymkiewicz, Ilan Goldenberg
INTRODUCTION: The wearable cardioverter defibrillator (WCD) may allow stabilization until reassessment for an implantable cardioverter defibrillator (ICD) among high-risk HF patients. However, there are limited data on the WCD benefit in the acute decompensated HF setting. METHODS AND RESULTS: The Study of the Wearable Cardioverter Defibrillator in Advanced Heart-Failure Patients (SWIFT) was a prospective clinical trial carried out at two medical centers. Patients hospitalized with advanced HF symptoms and reduced left ventricular ejection function (LVEF) were enrolled and prescribed a WCD prior to discharge for a total of 3 months...
April 21, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28425123/a-5-year-follow-up-of-a-cohort-of-italian-alcoholics-hospital-admissions-and-overall-survival
#5
Gabriele Bardazzi, Ines Zanna, Marco Ceroti, Benedetta Bendinelli, Adriana Iozzi, Saverio Caini, Gabriella Nesi, Calogero Saieva
BACKGROUND: Alcohol-use disorders (AUDs), including alcohol dependence and alcohol abuse defined according to specific DSM-IV and ICD-X criteria, can be potentially lethal, since they are associated with several medical and psychiatric conditions. This study aims to describe the causes of hospitalization of a large cohort of subjects with alcohol dependence (alcoholics) enrolled in Florence (Italy) over a 5-year follow-up period and to evaluate the effect of hospitalization on overall survival...
April 20, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28425041/familial-amyloid-cardiomyopathy-masquerading-as-chronic-guillain-barre-syndrome-things-are-not-always-what-they-seem
#6
Die Hu, Ling Liu, Shuguang Yuan, Yuhong Yi, Daoquan Peng
Familial amyloid cardiomyopathy is a challenging condition that mimics many other diseases, particularly in patients with pronounced neurological presentations and unexplained or equivocal cardiac abnormalities. In this case, a 57-year-old man was admitted for outpatient cardiological evaluation of progressive right heart failure and limb paraesthesias. The patient presented with hypertension, chronic Guillain-Barre syndrome, and sick sinus syndrome. Transthoracic echocardiograms showed a thickened ventricular wall and enlarged atrium...
April 19, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28423478/a-qualitative-study-of-community-nurses-decision-making-around-the-anticipatory-prescribing-of-end-of-life-medications
#7
Ben Bowers, Sarah Redsell
AIMS: To explore community nurses' decision-making processes around the prescribing of anticipatory medications for people who are dying. BACKGROUND: Community nurses frequently initiate the prescribing of anticipatory medications to help control symptoms in those who are dying. However, little is known about their decision-making processes in relation to when they instigate anticipatory prescribing and their discussions with families and General Practitioners. DESIGN: A qualitative interpretive descriptive enquiry...
April 19, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28423464/high-clinical-suspicion-of-donor-derived-disease-leads-to-timely-recognition-and-early-intervention-to-treat-solid-organ-transplant-transmitted-lymphocytic-choriomeningitis-virus
#8
Gagan Mathur, Kunal Yadav, Bradley Ford, Ilana J Schafer, Shridhar V Basavaraju, Barbara Knust, Wun-Ju Shieh, Sam Hill, Garret D Locke, Patricia Quinlisk, Shelley Brown, Ardith Gibbons, Deborah Cannon, Matthew Kuehnert, Stuart T Nichol, Pierre E Rollin, Ute Ströher, Rachel Miller
Despite careful donor screening, unexpected donor-derived infections continue to occur in organ transplant recipients (OTRs). Lymphocytic choriomeningitis virus (LCMV) is one such transplant-transmitted infection that in previous reports has resulted in a high mortality among the affected OTRs. We report a LCMV case cluster that occurred 3 weeks post-transplant in three OTRs who received allografts from a common organ donor in March 2013. Following confirmation of LCMV infection at Centers for Disease Control and Prevention, immunosuppression was promptly reduced and ribavirin and/or intravenous immunoglobulin therapy were initiated in OTRs...
April 19, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28422310/adult-onset-cystic-fibrosis-liver-disease-diagnosis-and-characterization-of-an-underappreciated-entity
#9
Christopher Koh, Sasan Sakiani, Pallavi Surana, Xiongce Zhao, Jason Eccleston, David E Kleiner, David Herion, T Jake Liang, Jay H Hoofnagle, Milica Chernick, Theo Heller
BACKGROUND & AIMS: Cystic fibrosis liver disease (CFLD), a leading cause of death in cystic fibrosis (CF), is mostly described in pediatric populations. Adult-onset CFLD lacks sufficient characterization and diagnostic tools. METHODS: A cohort of CF patients without CFLD during childhood were followed for up to 38 years with serologic testing, imaging, and noninvasive fibrosis markers. Historical CFLD diagnostic criteria were compared with a newly proposed CFLD criteria...
April 19, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28422306/development-of-a-novel-frailty-index-to-predict-mortality-in-patients-with-end-stage-liver-disease
#10
Jennifer C Lai, Kenneth E Covinsky, Jennifer L Dodge, W John Boscardin, Dorry L Segev, John P Roberts, Sandy Feng
BACKGROUND: Cirrhosis is characterized by muscle wasting, malnutrition, and functional decline that confer excess mortality not well quantified by the MELDNa score. We aimed to develop a frailty index to capture these extrahepatic complications of cirrhosis and enhance mortality prediction in cirrhotics. METHODS: Consecutive outpatients listed for LT at a single transplant center without MELD exceptions were assessed with candidate frailty measures. Best subset selection analyses with Cox regression identified subsets of frailty measures that predicted waitlist mortality (=death or delisting due to sickness)...
April 19, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28419665/lettuce-produced-hepatitis-c-virus-e1e2-heterodimer-triggers-immune-responses-in-mice-and-antibody-production-after-oral-vaccination
#11
Jihong Liu Clarke, Lisa Paruch, Mihaela-Olivia Dobrica, Iuliana Caras, Catalin Tucureanu, Adrian Onu, Sonya Ciulean, Crina Stavaru, Andre Eerde, Yanliang Wang, Hege Steen, Sissel Haugslien, Catalina Petrareanu, Catalin Lazar, Ioan Popescu, Ralph Bock, Jean Dubuisson, Norica Branza-Nichita
The hepatitis C virus (HCV) is a major etiologic agent for severe liver diseases (e.g., cirrhosis, fibrosis and hepatocellular carcinoma). Approximately 140 million people have chronic HCV infections and about 500,000 die yearly from HCV-related liver pathologies. To date, there is no licenced vaccine available to prevent HCV infection and production of an HCV vaccine remains a major challenge. Here we report the successful production of the HCV E1E2 heterodimer, an important vaccine candidate, in an edible crop (lettuce, Lactuca sativa) using Agrobacterium-mediated transient expression technology...
April 17, 2017: Plant Biotechnology Journal
https://www.readbyqxmd.com/read/28419552/feasibility-and-utility-of-portable-ultrasound-during-retrieval-of-sick-preterm-infants
#12
Kathryn Browning Carmo, Tracey Lutz, Mark Greenhalgh, Andrew Berry, Martin Kluckow, Nick Evans
AIM: Document the incidence of haemodynamic pathology in critically ill preterm newborns requiring transport. METHOD: A transport neonatologist performed cardiac and cerebral ultrasound before and after transportation of infants born ≤ 30 weeks gestation. RESULTS: 44 newborns were studied 2008 - 2015, 21 transported by road, 19 by helicopter and 4 by fixed wing. Median birth weight 1130g (680-1960g), median gestation 27 weeks (23-30) and 30/44 were male...
April 17, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28419505/assisted-dying-disability
#13
Christopher A Riddle
This article explores at least two dominant critiques of assisted dying from a disability rights perspective. In spite of these critiques, I conclude that assisted dying ought to be permissible. I arrive at the conclusion that if we respect and value people with disabilities, we ought to permit assisted dying. I do so in the following manner. First, I examine recent changes in legislation that have occurred since the Royal Society of Canada Expert Panel on End-of-Life Decision-Making report, published in this journal...
April 17, 2017: Bioethics
https://www.readbyqxmd.com/read/28419418/does-surgery-for-deep-infiltrating-bowel-endometriosis-improve-fertility-a-review
#14
Maja Lundegaard Iversen, Mikkel Seyer-Hansen, Axel Forman
INTRODUCTION: Reduced fertility is a major concern in women with endometriosis. The influence of surgery of deep infiltrating endometriosis (DIE) affecting the bowel wall on fertility is controversial and the literature on this field is heterogenous. In this review we addressed if surgery for bowel DIE improves spontaneous pregnancy rate and results of in vitro fertilization (IVF), and the potential risk of such surgery. MATERIAL AND METHODS: We conducted a literature search including the terms "deep", "deep infiltrating", "bowel", rectovaginal", "endometriosis", "fertility", "infertility" and "IVF" in Pubmed...
April 17, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28418617/improved-survival-of-patients-with-hepatocellular-carcinoma-and-compensated-hcv-related-cirrhosis-who-attained-svr
#15
Savino Bruno, Vito Di Marco, Massimo Iavarone, Luigi Roffi, Vincenzo Boccaccio, Andrea Crosignani, Giuseppe Cabibbo, Sonia Rossi, Vincenza Calvaruso, Alessio Aghemo, Luca Giacomelli, Antonio Craxì, Massimo Colombo, Patrick Maisonneuve
BACKGROUND: Few studies examined the outcome of patients with HCV-related cirrhosis who developed hepatocellular carcinoma (HCC). The relative weight as determinant of death for cancer versus end-stage-liver-disease (ESLD) and the benefit of HCV eradication remain undefined. This multicenter, retrospective analysis evaluates overall survival (OS), rate of decompensation and tumor recurrence in compensated HCC patients treated with IFN according to HCV status since HCC diagnosis. METHODS: Two groups of patients with HCV-related cirrhosis and HCC were followed since HCC diagnosis: (i) compensated cirrhotics with prior sustained virologic response (SVR) on IFN-based regimens (N=19); (ii) compensated cirrhotics without SVR (viremic) (N=156)...
April 18, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28418365/-surgical-strategy-for-locally-advanced-right-sided-colonic-cancer
#16
M I Davydov, Yu I Patyutko, A O Rasulov, A G Kotel'nikov, I A Fainshtein, M G Abgaryan, V A Aliev, N E Kudashkin
AIM: To present early and remote surgical outcomes in patients with locally-advanced right-sided colonic cancer, invasion of pancreatic head and/or duodenal wall. MATERIAL AND METHODS: Early and remote surgical outcomes were analyzed in 27 patients who underwent gastropancreatoduodenectomy combined with right-sided hemicolectomy (ileotransversostomy extirpation) for locally-advanced right-sided colonic cancer. RESULTS: Mean time of surgery was 300 (240-460) minutes, intraoperative blood loss - 2000 (500-7200) ml...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28414849/-the-rights-of-the-dying-the-refusal-of-medical-treatments-in-argentine-courts
#17
Juan Pedro Alonso
This paper addresses the judicialization of end of life medical decision-making, as part of the advance of the justice system in the regulation of medical practice and the rise of recognition of patient autonomy. The article analyzes, from a sociological standpoint, legal decisions regarding treatment refusal at the end of life produced by the Argentine courts between 1975 and 2015. Based on a qualitative design, 38 sentences collected from jurisprudential databases using key terms were analyzed. First, judicialized cases during the period are described; these are characterized by a high proportion of claims presented by health institutions, a pro-treatment bias in the legal actions requested, and a high percentage of unnecessary litigation in the absence of conflicts or in situations that do not require court intervention...
July 2016: Salud Colectiva
https://www.readbyqxmd.com/read/28414673/purulent-pericarditis-due-to-an-infected-pacemaker-lead
#18
Teresa Backes
INTRODUCTION: Intravenous drug users have a substantially increased risk of infective endocarditis, especially in the setting of implanted cardiac devices. Purulent pericarditis is a rare occurrence that can occur iatrogenically or through direct or hematogenous spread. CASE DESCRIPTION: A 75 year old man with a past medical history significant for hepatitis C, IV drug abuse, and sick sinus syndrome status post pacemaker was brought in by EMS with a chief complaint of diaphoresis and chest pain...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414666/just-a-puff-of-smoke
#19
A Leonard
CASE: A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. On exam the patient was afebrile, normotensive with mild tachycardia to 110...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412038/surgical-treatment-of-postintubation-tracheal-stenosis-a-retrospective-22-patient-series-from-a-single-center
#20
Ahmet Ulusan, Maruf Sanli, Ahmet Feridun Isik, İlknur Aytekin Celik, Bulent Tuncozgur, Levent Elbeyli
BACKGROUND/OBJECTIVE: We aimed to present cases of postintubation tracheal stenosis (PITS), all due to long-term intubation and treated surgically in a university hospital, and to discuss them in light of the literature. METHODS: In this retrospective study, 22 patients who were treated with tracheal resection and reconstruction due to PITS were included. Demographics, intubation characteristics, localization of stenosis, surgical technique and material, postoperative complications, and survival of patients were recorded...
April 12, 2017: Asian Journal of Surgery
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