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https://www.readbyqxmd.com/read/28437811/symptomatic-outcome-after-bone-only-suboccipital-decompression-in-adult-patients-with-chiari-type-i-malformations-in-the-absence-of-hydromyelia-or-hydrocephalus
#1
Nicolas Olmo Koechlin, Hazem J Abuhusain, Manuri Gunawardena, Tyler S Auschwitz, Charles Teo
Background Type I Chiari malformation presents without an associated hydromyelia in 30 to 70% of cases, yet there is no agreement regarding the optimal surgical treatment for these patients. We review our experience for treating symptomatic adult type I Chiari malformation without hydromyelia using a suboccipital bone decompression of the hindbrain and no duraplasty in 12 adult patients. Outcome was measured according to the Chicago Chiari Outcome Scale (CCOS). Results Nine of 12 patients were female; average age at surgery was 34...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28437748/rational-and-timely-haemostatic-interventions-following-cardiac-surgery-coagulation-factor-concentrates-or-blood-bank-products
#2
Mariann Tang, Christian Fenger-Eriksen, Per Wierup, Jacob Greisen, Jørgen Ingerslev, Vibeke Hjortdal, Benny Sørensen
BACKGROUND: Cardiac surgery may cause a serious coagulopathy leading to increased risk of bleeding and transfusion demands. Blood bank products are commonly first line haemostatic intervention, but has been associated with hazardous side effect. Coagulation factor concentrates may be a more efficient, predictable, and potentially a safer treatment, although prospective clinical trials are needed to further explore these hypotheses. This study investigated the haemostatic potential of ex vivo supplementation of coagulation factor concentrates versus blood bank products on blood samples drawn from patients undergoing cardiac surgery...
April 5, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28437539/safety-and-efficacy-of-antiviral-therapy-for-prevention-of-cytomegalovirus-reactivation-in-immunocompetent-critically-ill-patients-a-randomized-clinical-trial
#3
Nicholas J Cowley, Andrew Owen, Sarah C Shiels, Joanne Millar, Rebecca Woolley, Natalie Ives, Husam Osman, Paul Moss, Julian F Bion
Importance: Latent cytomegalovirus (CMV) infection is present in more than half the adult population, and a viral reactivation (ie, when the virus becomes measurable in body fluids such as blood) can occur in up to one-third of these individuals during episodes of critical illness. Objective: To determine whether antiviral therapy is safe and effective for preventing CMV reactivation in a general population of critically ill patients. Design, Setting, and Participants: A single-center, open-label, randomized, controlled clinical trial recruited 124 CMV-seropositive patients undergoing mechanical ventilation for at least 24 hours in the intensive care unit between January 1, 2012, and January 31, 2014...
April 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28437515/a-new-equation-for-predicting-evolution-of-oral-pain-in-orthodontic-treatment-a-longitudinal-prospective-cohort-study
#4
Monica Larrea, Rosario Salvador, Rosa Cibrian, Jose Luis Gandia, Vanessa Paredes-Gallardo
AIMS: To develop an equation capable of relating the evolution of oral pain to the time elapsed, measured from the moment of dental archwire fitting and identifying when pain begins, peaks, and ends; and secondly, to compare pain during orthodontic treatment in relation to archwire material (steel or nickel-titanium [Ni-Ti]) and position (maxillary or mandibular) and patient age (child, teenager, or adult) and gender (male or female). METHODS: A longitudinal prospective cohort study was conducted of 112 patients who filled in a scale to evaluate pain, noting the times when the pain occurred...
April 2017: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/28437329/metastatic-spinal-cord-compression-and-steroid-treatment-a-systematic-review
#5
Abhishek Kumar, Michael H Weber, Ziya Gokaslan, Jean-Paul Wolinsky, Meic Schmidt, Laurence Rhines, Michael G Fehlings, Ilya Laufer, Daniel M Sciubba, Michelle J Clarke, Narayan Sundaresan, Jorrit-Jan Verlaan, Arjun Sahgal, Dean Chou, Charles G Fisher
STUDY DESIGN: Systematic review. OBJECTIVES: We conducted a systematic review of the literature to answer the following questions regarding the use of steroid therapy in metastatic spinal cord compression (MSCC): 1. In cases of MSCC, what is the effect of steroid administration before definitive radiotherapy or surgery on ambulatory status, bowel and bladder function and survival? 2. What steroid dosing regimens are associated with the best outcomes concerning neurological symptoms and complication prevention in cases of MSCC? SUMMARY OF BACKGROUND DATA: Currently, there is significant variation in the initial bolus dose, daily maintenance dose and duration of treatment when steroids are used as a bridge to definitive therapy for MSCC...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28437319/quality-of-antiepileptic-treatment-among-older-medicare-beneficiaries-with-epilepsy-a-retrospective-claims-data-analysis
#6
Maria Pisu, Joshua Richman, Kendra Piper, Roy Martin, Ellen Funkhouser, Chen Dai, Lucia Juarez, Jerzy P Szaflarski, Edward Faught
BACKGROUND: Enzyme-inducing antiepileptic drugs (EI-AEDs) are not recommended for older adults with epilepsy. Quality Indicator for Epilepsy Treatment 9 (QUIET-9) states that new patients should not receive EI-AEDs as first line of treatment. In light of reported racial/ethnic disparities in epilepsy care, we investigated EI-AED use and QUIET-9 concordance across major racial/ethnic groups of Medicare beneficiaries. RESEARCH DESIGN: Retrospective analyses of 2008-2010 Medicare claims for a 5% random sample of beneficiaries 67 years old and above in 2009 augmented for minority representation...
April 21, 2017: Medical Care
https://www.readbyqxmd.com/read/28437150/cost-of-cancer-related-neutropenia-or-fever-hospitalizations-united-states-2012
#7
Eric Tai, Gery P Guy, Angela Dunbar, Lisa C Richardson
PURPOSE: Neutropenia and subsequent infections are life-threatening treatment-related toxicities of chemotherapy. Among patients with cancer, hospitalizations related to neutropenic complications result in substantial medical costs, morbidity, and mortality. Previous estimates for the cost of cancer-related neutropenia hospitalizations are based on older and limited data. This study provides nationally representative estimates of the cost of cancer-related neutropenia hospitalizations...
April 24, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28436606/early-and-late-adverse-effects-of-radioiodine-for-pediatric-differentiated-thyroid-cancer
#8
Domenico Albano, Francesco Bertagna, Maria Beatrice Panarotto, Raffaele Giubbini
BACKGROUND: Radioiodine-131 (I131) therapy for differentiated thyroid cancer (DTC) is generally a safe and effective treatment, but it has some potential side effects, which have been well described in adults but less analyzed in children. Our aim was to describe early and late adverse events of radioactive I131 in pediatric patients. METHODS: All consecutive patients ≤18 years treated for DTC in the period 1980-2015 were retrospectively analyzed for early and late side effects of radioiodine...
April 24, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28436583/physical-activity-and-exercise-for-chronic-pain-in-adults-an-overview-of-cochrane-reviews
#9
REVIEW
Louise J Geneen, R Andrew Moore, Clare Clarke, Denis Martin, Lesley A Colvin, Blair H Smith
BACKGROUND: Chronic pain is defined as pain lasting beyond normal tissue healing time, generally taken to be 12 weeks. It contributes to disability, anxiety, depression, sleep disturbances, poor quality of life, and healthcare costs. Chronic pain has a weighted mean prevalence in adults of 20%.For many years, the treatment choice for chronic pain included recommendations for rest and inactivity. However, exercise may have specific benefits in reducing the severity of chronic pain, as well as more general benefits associated with improved overall physical and mental health, and physical functioning...
April 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28436098/lecrk-v-an-l-type-lectin-receptor-kinase-in-haynaldia-villosa-plays-positive-role-in-resistance-to-wheat-powdery-mildew
#10
Zongkuan Wang, Jiangyue Cheng, Anqi Fan, Jia Zhao, Zhongyu Yu, Yingbo Li, Heng Zhang, Jin Xiao, Faheem Mohammad, Haiyan Wang, Aizhong Cao, Liping Xing, Xiue Wang
Plant sense potential microbial pathogen by using pattern recognition receptors (PRRs) to recognize pathogen associated molecular patterns (PAMPs). The Lectin receptor like kinase genes (LecRKs) are involved in various cellular processes mediated by signal transduction pathways. In the present study, an L-type lectin receptor kinase gene LecRK-V was cloned from Haynaldia villosa, a diploid wheat relative which is highly resistant to powdery mildew. The expression of LecRK-V was rapidly up-regulated by Bgt inoculation and chitin treatment...
April 24, 2017: Plant Biotechnology Journal
https://www.readbyqxmd.com/read/28436001/gait-instability-in-valproate-treated-patients-call-to-measure-ammonia-levels
#11
S Kipervasser, C E Elger, A D Korczyn, R D Nass, C M Quesada, M Y Neufeld
OBJECTIVE: Hyperammonemia induced by valproate (VPA) treatment may lead to several neurological and systemic symptoms as well as to seizure exacerbation. Gait instability and recurrent falls are rarely mentioned as symptoms, especially not as predominant ones. METHODS: We report five adult patients with frontal lobe epilepsy (FLE) who were treated with VPA and in whom a primary adverse effect was unstable gait and falls. RESULTS: There were four males and one female patients with FLE, 25-42-year-old, three following epilepsy surgery...
April 23, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28435973/acclimatization-to-middle-altitude-hypoxia-protects-against-developmental-and-cognitive-deficits-caused-by-acute-fetal-hypoxia-in-mice
#12
Hui-Lang Liu, Yong-Mei Sun, Chuan-Yu Li, Hai-Chen Niu, Min Su, Jing-Kun Wang
Acute fetal hypoxia (AFH) can elicit postnatal motor deficits and cognitive impairments. To test whether lifelong acclimatization to middle altitude (MA) hypoxia has protective effects on the impairments caused by AFH, ICR mice bred at 1 900 m altitude for 6-7 generations were evaluated under AFH. On gestation day 9 (GD 9), 13 (GD 13) or 17 (GD 17), pregnant mice received a single exposure to acute hypoxia (7% O2, 6 h). Physiological and neurodevelopmental behaviors, motor function (open field), spatial learning and memory (Morris water maze), and anxiety level (elevated plus maze) were examined in the offspring from neonate to adulthood...
April 25, 2017: Sheng Li Xue Bao: [Acta Physiologica Sinica]
https://www.readbyqxmd.com/read/28435896/association-between-persistent-tachycardia-and-tachypnea-and-in-hospital-mortality-among-non-hypotensive-emergency-department-patients-admitted-to-the-hospital
#13
Michael A Puskarich, Utsav Nandi, Ben G Long, Alan E Jones
OBJECTIVE: Vital sign trends are used in clinical practice to assess treatment response and aid in disposition, yet quantitative data to support this practice are lacking. This study aimed to determine the prognostic value of vital sign normalization. METHODS: Secondary analysis of a prospective cohort of adult emergency department (ED) patients admitted a single urban tertiary care hospital. A random sample of 182 days was chosen, and a manual review of all admissions was undertaken...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28435493/prehospital-care-for-the-adult-and-pediatric-seizure-patient-current-evidence-based-recommendations
#14
Eric C Silverman, Karl A Sporer, Justin M Lemieux, John F Brown, Kristi L Koenig, Marianne Gausche-Hill, Eric M Rudnick, Angelo A Salvucci, Greg H Gilbert
INTRODUCTION: We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of adult and pediatric patients with a seizure and to compare these recommendations against the current protocol used by the 33 emergency medical services (EMS) agencies in California. METHODS: We performed a review of the evidence in the prehospital treatment of patients with a seizure, and then compared the seizure protocols of each of the 33 EMS agencies for consistency with these recommendations...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435481/a-patient-centered-emergency-department-management-strategy-for-sickle-cell-disease-super-utilizers
#15
Grant G Simpson, Hallie R Hahn, Alex A Powel, Robert R Leverence, Linda A Morris, Lara G Thompson, Marc S Zumberg, Deepa J Borde, Joseph A Tyndall, Jonathan J Shuster, Donald M Yealy, Brandon R Allen
INTRODUCTION: A subpopulation of sickle-cell disease patients, termed super-utilizers, presents frequently to emergency departments (EDs) for vaso-occlusive events and may consume disproportionate resources without broader health benefit. To address the healthcare needs of this vulnerable patient population, we piloted a multidisciplinary intervention seeking to create and use individualized patient care plans that alter utilization through coordinated care. Our goals were to assess feasibility primarily, and to assess resource use secondarily...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435337/treatment-strategies-for-the-female-athlete-triad-in-the-adolescent-athlete-current-perspectives
#16
REVIEW
Jill Thein-Nissenbaum, Erin Hammer
Since the passage of Title IX in 1972, female sports participation has dramatically increased. The benefits of physical activity, including decreased risk for heart disease and diabetes as well as improved body image and self-esteem, far outweigh the risks. However, a select population of adolescent and young adult females may experience symptoms related to the female athlete triad (Triad), which refers to the interrelatedness of energy availability, menstrual function, and bone mineral density (BMD). These conditions often manifest clinically as disordered eating behaviors, menstrual irregularity, and stress fractures; an individual may suffer from 1 or all of the Triad components simultaneously...
2017: Open Access Journal of Sports Medicine
https://www.readbyqxmd.com/read/28435324/symptomatic-central-nervous-system-involvement-in-adult-patients-with-acute-myeloid-leukemia
#17
Nael Alakel, Friedrich Stölzel, Brigitte Mohr, Michael Kramer, Uta Oelschlägel, Christoph Röllig, Martin Bornhäuser, Gerhard Ehninger, Markus Schaich
INTRODUCTION: Acute myeloid leukemia (AML) rarely involves the central nervous system (CNS). Little is known about the clinical course in adult AML patients since most studies examined pediatric patients. Therefore, this study analyzed the data of patients treated in three prospective trials of the "Study Alliance Leukemia" (SAL) study group for CNS involvement. METHODS: In all, 3,261 AML patients included in the prospective AML96, AML2003, and AML60+ trials of the SAL study group were analyzed...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28435272/quetiapine-monotherapy-versus-placebo-in-the-treatment-of-children-and-adolescents-with-bipolar-depression-a-systematic-review-and-meta-analysis
#18
REVIEW
Benchalak Maneeton, Suwannee Putthisri, Narong Maneeton, Pakapan Woottiluk, Sirijit Suttajit, Chawanun Charnsil, Manit Srisurapanont
BACKGROUND: Some studies have indicated the efficacy of quetiapine in the treatment of bipolar depression in adult patients. However, its efficacy has been not shown in child and adolescent patients. OBJECTIVE: This systematic review purposefully determined the efficacy and acceptability of quetiapine in the treatment of children and adolescents with bipolar depression. DATA SOURCES: A database search of EMBASE, PubMed, CINAHL, and Cochrane Controlled Trials Register was carried out in March 2016...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28434548/ex%C3%A2-vivo-lung-perfusion-rehabilitates-sepsis-induced-lung-injury
#19
J Hunter Mehaffey, Eric J Charles, Ashish K Sharma, Morgan Salmon, Dustin Money, Sarah Schubert, Mark H Stoler, Curtis G Tribble, Victor E Laubach, Mark E Roeser, Irving L Kron
BACKGROUND: Sepsis is the number one cause of lung injury in adults. Ex vivo lung perfusion (EVLP) is gaining clinical acceptance for donor lung evaluation and rehabilitation and may expand the use of marginal organs for transplantation. We hypothesized that 4 hours of normothermic EVLP would improve compliance and oxygenation in a porcine model of sepsis-induced lung injury. METHODS: We used intravenous lipopolysaccharide (LPS) to induce a systemic inflammatory response in a porcine model of lung injury...
April 20, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28434507/motor-neuropathies-and-lower-motor-neuron-syndromes
#20
REVIEW
A Verschueren
Motor or motor-predominant neuropathies may arise from disease processes affecting the motor axon and/or its surrounding myelin. Lower motor neuron syndrome (LMNS) arises from a disease process affecting the spinal motor neuron itself. The term LMNS is more generally used, rather than motor neuronopathy, although both entities are clinically similar. Common features are muscle weakness (distal or proximal) with atrophy and hyporeflexia, but no sensory involvement. They can be acquired or hereditary. Immune-mediated neuropathies (multifocal motor neuropathy, motor-predominant chronic inflammatory demyelinating polyneuropathy) are important to identify, as effective treatments are available...
April 20, 2017: Revue Neurologique
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