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https://www.readbyqxmd.com/read/27913478/thrombosis-in-the-setting-of-obesity-or-inflammatory-bowel-disease
#1
Steven R Lentz
Obesity and inflammatory bowel disease (IBD) are systemic inflammatory disorders that predispose to arterial and venous thrombosis through similar prothrombotic mechanisms. Obesity and IBD are chronic risk factors that lead to a persistently elevated risk of thrombosis, although the thrombotic risk with IBD appears to wax and wane with disease severity. Because of the lack of high-quality evidence to guide management decisions, approaches to the prevention and treatment of thrombosis in patients with obesity or IBD are based on extrapolation from general guidelines for antithrombotic therapy...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27910800/routine-x-ray-of-the-chest-is-not-justified-in-staging-of-cutaneous-melanoma-patients
#2
Caroline Asirvatham Gjørup, Helle Westergren Hendel, Rita Kaae Pilegaard, Cecilie Balslev Willert, Lisbet Rosenkrantz Hölmich
INTRODUCTION: The incidence of cutaneous melanoma is increasing in Denmark and worldwide. However, the prevalence of distant metastases at the time of diagnosis has decreased to 1%. We therefore questioned the value of routine preoperative chest X-ray (CXR) for staging asymptomatic melanoma patients and hypothesised that routine CXR is not justified. METHODS: A retrospective study was conducted on patients undergoing wide local excision and sentinel lymph node biopsy for cutaneous melanoma in the period from 2010 to 2014...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27909117/when-is-the-ideal-time-to-operate-on-a-patient-with-a-fracture-of-the-hip-a-review-of-the-available-literature
#3
REVIEW
P M Lewis, J P Waddell
Fractures of the hip are common, often occurring in frail elderly patients, but also in younger fit healthy patients following trauma. They have a significant associated mortality and major social and financial implications to patients and health care providers. Many guidelines are available for the management of these patients, mostly recommending early surgery for the best outcomes. As a result, healthcare authorities now put pressure on surgical teams to 'fast track' patients with a fracture of the hip, often misquoting the available literature, which in itself can be confusing and even conflicting...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27908918/alpha-blockers-for-treatment-of-ureteric-stones-systematic-review-and-meta-analysis
#4
John M Hollingsworth, Benjamin K Canales, Mary A M Rogers, Shyam Sukumar, Phyllis Yan, Gretchen M Kuntz, Philipp Dahm
OBJECTIVE:  To investigate the efficacy and safety of alpha blockers in the treatment of patients with ureteric stones. DESIGN:  Systematic review and meta-analysis. DATA SOURCES:  Cochrane Central Register of Controlled Trials, Web of Science, Embase, LILACS, and Medline databases and scientific meeting abstracts to July 2016. REVIEW METHODS:  Randomized controlled trials of alpha blockers compared with placebo or control for treatment of ureteric stones were eligible...
December 1, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27908822/how-admission-to-a-vascular-surgery-department-improves-medical-treatment-in-patients-with-lower-extremity-peripheral-arterial-disease
#5
M Thiney, N Della Schiava, P Feugier, P Lermusiaux, J Ninet, A Millon, A Long
OBJECTIVES: All patients with lower extremity peripheral arterial disease (LE-PAD) should benefit from recommended pharmacologic therapies including antiplatelet agents, angiotensin converting enzyme (ACE) inhibitors or Angiotensin receptor blockers (ARBs), and HMG-CoA-reductase inhibitors (statins). In the present study, this triple therapy was defined as the best medical treatment. This study was designed to determine the number of patients who received best medical treatment at admission and at discharge from a vascular surgery department...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908544/inhibition-of-cartilage-degradation-and-suppression-of-pge2-and-mmps-expression-by-pomegranate-fruit-extract-in-a-model-of-posttraumatic-osteoarthritis
#6
Nahid Akhtar, Nazir M Khan, Omer S Ashruf, Tariq M Haqqi
OBJECTIVE: Osteoarthritis (OA) is characterized by cartilage degradation in the affected joints. Pomegranate fruit extract (PFE) inhibits cartilage degradation in vitro. The aim of this study was to determine whether oral consumption of PFE inhibits disease progression in rabbits with surgically induced OA. METHODS: OA was surgically induced in the tibiofemoral joints of adult New Zealand White rabbits. In one group, animals were fed PFE in water for 8 wk postsurgery...
January 2017: Nutrition
https://www.readbyqxmd.com/read/27908531/chemotherapy-delay-after-primary-debulking-surgery-for-ovarian-cancer
#7
Brandon-Luke L Seagle, Sharlay K Butler, Anna E Strohl, Wilberto Nieves-Neira, Shohreh Shahabi
OBJECTIVE: To determine the association of chemotherapy delay with overall survival (OS) and investigate predictors of delay among a population-representative American ovarian cancer cohort. METHODS: An observational retrospective cohort analysis of women with ovarian cancer who received National Comprehensive Cancer Network guideline-consistent care was performed with the 1998-2011 National Cancer Data Base. Chemotherapy delay was defined as initiation of multiagent chemotherapy >28days from primary debulking surgery...
November 28, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27907814/platelet-function-one-and-three-months-after-coronary-bypass-surgery-in-relation-to-once-or-twice-daily-dosing-of-acetylsalicylic-acid
#8
Torbjörn Ivert, Magnus Dalén, Charlotte Ander, Ragnhild Stålesen, Per Näsman, Marie Lordkipanidzé, Paul Hjemdahl
INTRODUCTION: Current guidelines recommend acetylsalicylic acid (ASA) treatment after coronary artery bypass grafting (CABG) to reduce thrombotic vein graft occlusion. The optimal dosage of ASA is not known. MATERIALS AND METHODS: Forty-two patients undergoing elective CABG were randomized to receive either ASA 75mg or 160mg once daily (OD) or 75mg twice daily (BID) after the operation. Platelet function testing was performed before, and one and three months after the operation...
November 21, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27906834/successful-continuation-of-hcv-treatment-following-liver-transplantation
#9
Carlos Fernández Carrillo, Gonzalo Crespo, Juan de la Revilla, Lluís Castells, Maria Buti, José Luis Montero, Emilio Fábrega, Inmaculada Fernández, Cristina Serrano-Millán, Victoria Hernández, José Luis Calleja, María-Carlota Londoño
BACKGROUND: Guidelines recommend that patients with hepatitis C virus (HCV)-related liver disease be treated for HCV before liver transplant (LT) to eliminate the virus prior to surgery. However, the unpredictability of donor organ availability may limit treatment duration. Interruption of HCV treatment with resumption post-LT is one potential solution which has not been investigated widely. METHODS: Patients from 5 clinical centres included in the large, national, noninterventional Hepa-C registry who started treatment with direct-acting antiviral agents (DAAs) while awaiting LT were identified retrospectively and followed up prospectively...
December 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27906777/asymptomatic-bacteriuria-to-screen-or-not-to-screen-and-when-to-treat
#10
Tommaso Cai, Bela Koves, Truls E Bjerklund Johansen
PURPOSE OF REVIEW: Asymptomatic bacteriuria (ABU) is a common clinical condition that often leads to unnecessary treatment. The purpose of this review is to outline and evaluate the most recent literature on the management of ABU. RECENT FINDINGS: The role of ABU management has been evaluated in several patient subgroups: healthy patients without identified risk factors, pregnant women, postmenopausal women, women with recurrent UTI, patients with diabetes, elderly institutionalized patients, patients with renal transplants, patients with indwelling catheters and prior to surgery...
November 30, 2016: Current Opinion in Urology
https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#11
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27906601/association-between-pre-operative-cefazolin-dose-and-surgical-site-infection-in-obese-patients
#12
William J Peppard, David G Eberle, Nathan W Kugler, Danielle M Mabrey, John A Weigelt
BACKGROUND: A fixed dose of cefazolin results in serum concentrations that decrease as body mass increases. Current national guidelines suggest a pre-operative cefazolin dose of two grams may be insufficient for patients ≥120 kg; thus a three gram dose is recommended. These recommendations, however, are based on pharmacokinetic rather than outcome data. We evaluate the efficacy of pre-operative cefazolin two gram and three gram doses as measured by the rate of surgical site infection (SSI)...
December 1, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27905182/optimizing-combination-dabrafenib-and-trametinib-therapy-in-braf-mutation-positive-advanced-melanoma-patients-guidelines-from-australian-melanoma-medical-oncologists
#13
Victoria Atkinson, Georgina V Long, Alexander M Menzies, Grant McArthur, Matteo S Carlino, Michael Millward, Rachel Roberts-Thomson, Benjamin Brady, Richard Kefford, Andrew Haydon, Jonathan Cebon
BRAF mutations occur commonly in metastatic melanomas and inhibition of mutant BRAF and the downstream kinase MEK results in rapid tumor regression and prolonged survival in patients. Combined therapy with BRAF and MEK inhibition improves response rate, progression free survival and overall survival compared with single agent BRAF inhibition, and reduces the skin toxicity that is seen with BRAF inhibitor monotherapy. However, this combination is associated with an increase in other toxicities, particularly drug-related pyrexia, which affects approximately 50% of patients treated with dabrafenib and trametinib (CombiDT)...
December 2016: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27905053/seom-clinical-guideline-of-localized-rectal-cancer-2016
#14
E González-Flores, F Losa, C Pericay, E Polo, S Roselló, M J Safont, R Vera, J Aparicio, M T Cano, C Fernández-Martos
Localized rectal adenocarcinoma is a heterogeneous disease and current treatment recommendations are based on a preoperative multidisciplinary evaluation. High-resolution magnetic resonance imaging and endoscopic ultrasound are complementary to do a locoregional accurate staging. Surgery remains the mainstay of treatment and preoperative therapies with chemoradiation (CRT) or short-course radiation (SCRT) must be considered in more locally advanced cases. Novel strategies with induction chemotherapy alone or preceding or after CRT (SCRT) and surgery are in development...
November 30, 2016: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/27905051/seom-clinical-guideline-of-management-of-soft-tissue-sarcoma-2016
#15
A López-Pousa, J Martin Broto, J Martinez Trufero, I Sevilla, C Valverde, R Alvarez, J A Carrasco Alvarez, J Cruz Jurado, N Hindi, X Garcia Del Muro
Soft-tissue sarcomas are uncommon and heterogeneous tumors of mesenchymal origin. A soft-tissue mass that is increasing in size, greater than 5 cm, or located under deep fascia are criteria for suspicion of sarcoma. Diagnosis, treatment, and management should preferably be performed by a multidisciplinary team in reference centers. MRI and lung CT scan are mandatory for local and distant assessment. A biopsy indicating histological type and grade is needed previous to the treatment. Wide surgical resection with tumor-free tissue margin is the primary treatment for localized disease...
November 29, 2016: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/27903151/how-to-manage-the-obese-patient-with-cancer
#16
Andrew G Renehan, Michelle Harvie, Ramsey I Cutress, Michael Leitzmann, Tobias Pischon, Sacha Howell, Anthony Howell
Purpose Obesity (body mass index [BMI] ≥ 30 kg/m(2)) is common among patients with cancer. We reviewed management issues in the obese patient with cancer, focusing on how obesity influences treatment selection (including chemotherapy dosing), affects chemotherapy toxicity and surgical complications, and might be a treatment effect modifier. Methods The majority of evidence is drawn from observational studies and secondary analyses of trial data, typically analyzed in N × 3 BMI categories (normal weight, overweight, and obese) matrix structures...
December 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27903122/management-and-outcome-of-recurrent-adult-craniopharyngiomas-an-analysis-of-42-cases-with-long-term-follow-up
#17
Mazda K Turel, Georgios Tsermoulas, Lior Gonen, George Klironomos, Joao Paulo Almeida, Gelareh Zadeh, Fred Gentili
OBJECTIVE The treatment of recurrent and residual craniopharyngiomas is challenging. In this study the authors describe their experience with these tumors and make recommendations on their management. METHODS The authors performed an observational study of adult patients (≥ 18 years) with recurrent or residual craniopharyngiomas that were managed at their tertiary center. Retrospective data were collected on demographics and clinical, imaging, and treatment characteristics from patients who had a minimum 2-year follow-up...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27901596/magnetic-resonance-imaging-in-the-pre-surgical-staging-of-breast-cancer-our-experience
#18
Paola Rabasco, Rocchina Caivano, Giuseppina Dinardo, Matilde Gioioso, Antonella Lotumolo, Giancarlo Iannelli, Antonio Villonio, Giuseppe La Torre, Stefano D'Errico, Luca Macarini, Giuseppe Guglielmi, Aldo Cammarota
PURPOSE: To investigate the clinical impact of magnetic resonance imaging (MRI) in the detection of multifocal-multicentric breast cancers, already identified by mammography and ultrasound, and analyzed histologically, to evaluate its role in preoperative staging. MATERIALS AND METHODS: From January 2012 to February 2014, 188 patients, aged 28 to 74 years, newly diagnosed with breast cancer on conventional imaging (mammography and ultrasound) were enrolled. They underwent preoperative contrast-enhanced 3T MRI...
November 30, 2016: Cancer Investigation
https://www.readbyqxmd.com/read/27901326/tuberculuma-sellae-meningiomas-a-systematic-review-of-transcranial-approaches-in-the-endoscopic-era
#19
Mazda Turel, Georgios Tsermoulas, Abdulmounem Yasssin-Kassab, Deven Reddy, Hugo Andrade-Barazarte, Lior Gonen, Gelareh Zadeh, Fred Gentili
INTRODUCTION: With the advent of skull base endoscopy, tuberculum sellae meningiomas (TSMs) are currently operated both from the traditional transcranial (TC) route as well as the extended endonasal endoscopic trasnssphenoidal approach (EETS). The aim of this study was to conduct a systematic review of TSMs excised via the TC route in the modern era when the EETS excision is gaining popularity. EVIDENCE ACQUISITION: We performed a systematic review in the medical literature following the PRISMA guidelines...
November 30, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27900768/is-nonabsorbable-nasal-packing-after-septoplasty-essential-a-meta-analysis
#20
Jong Seung Kim, Sam Hyun Kwon
OBJECTIVES: Septoplasty is one of the most frequently performed rhinologic surgeries. Complications include nasal bleeding, pain, headache, septal hematoma, synechia, infection, residual septal deviation, and septal perforation. In this study, we aimed to compare complication rates among patients according to packing method. METHODS: We performed a literature search using PubMed, Embase, and the Cochrane Library through August 2016. Our systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines...
November 30, 2016: Laryngoscope
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