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S Chawla, J Bowman, M Gandhi, B Panizza
BACKGROUND: The skull base is a highly complex anatomical region that provides passage for important nerves and vessels as they course into and out of the cranial cavity. Key to the management of pathology in this region is a thorough understanding of the anatomy, with its variations, and the relationship of various neurovascular structures to the pathology in question. Targeted high-resolution magnetic resonance imaging on high field strength magnets can enable the skull base surgeon to understand this intricate relationship and deal with the pathology from a position of relative advantage...
October 20, 2016: Journal of Laryngology and Otology
K M Olsson, M Halank, B Egenlauf, D Fistera, H Gall, C Kaehler, K Kortmann, T Kramm, M Lichtblau, A Marra, C Nagel, A Sablotzki, H-J Seyfarth, D Schranz, S Ulrich, M M Hoeper, T J Lange
The 2015 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension are also valid for Germany. The guidelines contain detailed recommendations for the targeted treatment of pulmonary arterial hypertension (PAH). However, the practical implementation of the European Guidelines in Germany requires the consideration of several country-specific issues and already existing novel data. This requires a detailed commentary to the guidelines, and in some aspects an update already appears necessary. In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany...
October 2016: Deutsche Medizinische Wochenschrift
Li F Chen, Hsuan K Chang, Yu C Chen, Jau C Wu, Wen C Huang, Henrich Cheng, Su S Lo
BACKGROUND: This study aimed to investigate the medical expenses and outcomes of central cord syndrome (CCS), comparing patients who received surgical and non-surgical management. METHODS: Using a 14-year nationwide database in Taiwan, this study followed-up all patients of CCS at least 5 years. The incidence rates, medical expenses, permanently disabled spinal cord injury (SCI), and mortality rates were compared for patients who underwent surgery and those who were managed conservatively...
October 19, 2016: Journal of Neurosurgical Sciences
Jenny T Chen, Steven J Kempton, Venkat K Rao
: The incidence and cost of nonmelanoma skin cancers are skyrocketing. Five million cases cost $8.1 billion in 2011. The average cost of treatment per patient increased from $1000 in 2006 to $1600 in 2011. We present a study of the economics and costs of skin cancer management in Medicare patients. METHODS: We studied data released by the Centers for Medicare and Medicaid Services in 2014. Treatment modalities for the management of skin cancer were reviewed, and costs of treatment were quantified for a sample of 880,000 providers...
September 2016: Plastic and Reconstructive Surgery. Global Open
Do Young Kim, Ki Tae Yoon, Won Kim, Jung Il Lee, Sung Hwi Hong, Danbi Lee, Jeong Won Jang, Jong Won Choi, Ilsu Kim, Yong Han Paik
BACKGROUND: This study aimed to estimate the direct medical costs of managing chronic hepatitis C (CHC) and its complications based on health-care resources in South Korea. METHODS: The study design was multicenter, retrospective, non-interventional, and observational. Between September 2013 and April 2014, health-care resource data from patients chronically infected with hepatitis C virus, regardless of genotype, were collected from 8 institutions, including data related to outpatient management, emergency care, and hospitalization...
July 2016: Medicine (Baltimore)
Nicola Maurea, Paolo Spallarossa, Christian Cadeddu, Rosalinda Madonna, Donato Mele, Ines Monte, Giuseppina Novo, Pasquale Pagliaro, Alessia Pepe, Carlo G Tocchetti, Concetta Zito, Giuseppe Mercuro
The US National Cancer Institute estimates that cardiotoxicity (CTX) from target therapy refers mostly to four groups of drugs: epidermal growth factor receptor 2 inhibitors, angiogenic inhibitors, directed Abelson murine leukemia viral oncogene homolog inhibitors, and proteasome inhibitors. The main cardiotoxic side-effects related to antiepidermal growth factor receptor 2 therapy are left ventricular systolic dysfunction and heart failure. Angiogenesis inhibitors are associated with hypertension, left ventricular dysfunction/heart failure, myocardial ischemia, QT prolongation, and thrombosis...
May 2016: Journal of Cardiovascular Medicine
Paolo Spallarossa, Nicola Maurea, Christian Cadeddu, Rosalinda Madonna, Donato Mele, Ines Monte, Giuseppina Novo, Pasquale Pagliaro, Alessia Pepe, Carlo G Tocchetti, Concetta Zito, Giuseppe Mercuro
Anthracyclines are the mainstay of treatment of a variety of haematological malignancies and solid tumours. Unfortunately, the clinical use of these drugs is limited by cumulative, dose-related cardiotoxicity which may ultimately lead to a severe and irreversible form of cardiomyopathy. Thus, there is an increasing need for close cooperation among cardiologists, oncologists and haemato-oncologists. As anthracyclines save lives, the logical goal of this cooperation, besides preventing or mitigating cardiotoxicity, is to promote an acceptable balance between the potential cardiac side effects and the vital benefit of anticancer treatment...
May 2016: Journal of Cardiovascular Medicine
Ganiyu Oboh, Omodesola O Ogunruku, Sunday I Oyeleye, Tosin A Olasehinde, Ayokunle O Ademosun, Aline Augusti Boligon
This study investigated the inhibitory effects of phenolic-rich extracts from Clerodendrum volubile leaves on cholinergic [acetylcholinesterase (AChE) and butyrylcholinesterase (BChE)] and monoaminergic [monoamine oxidase (MAO)] enzymes' activities and pro-oxidants [Fe(2+) and quinolinic acid-(QA)] induced lipid peroxidation in rats brain homogenates in vitro. Free phenolic extracts (FPE) and bound phenolic extracts (BPE) were obtained via solvent extraction, and the total phenol and flavonoid contents were evaluated...
October 18, 2016: Journal of Dietary Supplements
Timothy M Zagar, Amanda E D Van Swearingen, Orit Kaidar-Person, Matthew G Ewend, Carey K Anders
This review summarizes the most up-to-date approach to the multidisciplinary management of patients with breast cancer brain metastases. A brief overview of the epidemiology and biology of breast cancer brain metastasis is provided. The perspectives of radiation oncology, neurosurgery, and medical oncology-and landmark studies from each discipline-are all discussed. We also offer practical tips to help guide the treating physician, including data on antiseizure medications. Finally, we introduce the concept of a multidisciplinary clinic that combines input from medical and radiation oncology, neurosurgery, and support services, which we developed at the University of North Carolina as a coordinated and optimal approach to the management of patients with this complex disease...
October 15, 2016: Oncology (Williston Park, NY)
Wanhee Suk, JiEun Kim, Do-Yeon Kim, Hyunjung Lim, Ryowon Choue
Recent trial results suggest that the consumption of a low glycemic index (GI) diet is beneficial in the prevention of high blood glucose levels. Identifying active hypoglycemic substances in ordinary foods could be a significant benefit to the management of blood glucose. It has been hypothesized that noodles with Bombyx mori powder are a low GI food. We evaluated GI and changes in postprandial glucose levels following consumption of those noodles and compared them with those following consumption of plain wheat flour noodles (control) and glucose (reference) in healthy subjects...
September 2016: Preventive Nutrition and Food Science
Anil C Anand, Radha K Dhiman
Acute on chronic liver failure (ACLF) is a recently recognized syndrome and its definition has been evolving over last two decades. Currently, there is no universal consensus about the definition as kind of cases being seen in the Western world appear to be somewhat different from those that are seen in Asia Pacific region. But every one agrees that definition of ACLF should include following components. (a) The status of pre-existing liver disease, (b) defining the acute insult that leads to rapid deterioration of liver status, (c) time frame during which the acute insult can lead to rapid deterioration, (d) the quantification and definition of liver failure status after deterioration, which will determine the severity of ACLF, and (e) prediction of prognosis after analyzing first four components in the short and long terms...
September 2016: Journal of Clinical and Experimental Hepatology
K Masmoudi, M Mtaoumi, K Bouattour, M L Ben Ayeche
Congenital constriction of the limbs is usually due to amniotic band syndrome, which often causes damage to the skin and soft tissues. We report an unusual case in which a neonate had recent fractures of both leg bones with an amniotic band encircling the limb. Non-operative treatment was successful. Challenges to the management of neonatal limb constriction include the absence of a consensus about the best treatment and the high frequency of damage to vessels and nerves.
October 10, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Basil M Jan, Mohammed M Jan
Cerebral palsy (CP) is a common chronic motor disorder with associated cognitive, communicative, and seizure disorders. Children with CP have a higher risk of dental problems creating significant morbidity that can further affect their wellbeing and negatively impact their quality of life. Screening for dental disease should be part of the initial assessment of any child with CP. The objective of this article is to present an updated overview of dental health issues in children with CP and outline important preventative and practical strategies to the management of this common comorbidity...
October 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Amit Odelia, Joffe Erel, Perry Chava, Herishanu Yair, Sarid Nadav, Lishner Michael, Avivi Irit
INTRODUCTION: Due to the rarity of lymphoma during pregnancy, management guidelines are based upon evidence from retrospective studies and case reports. Here, we review the major dilemmas in the field and examine the approach of hemato-oncologists in Israel to the management of lymphoma in pregnancy. METHODOLOGY: We performed a literature search on the PubMed database using keywords for all papers on the subject from 1990-2014. The papers were reviewed by an expert panel who devised a questionnaire covering the main dilemmas...
October 14, 2016: International Journal of Clinical Oncology
Pierluca Vitale, Noemi Arena, Fabrizio Di Gregorio, Umberto Arena
The study investigates the potential environmental impacts related to the end-of-life phase of a residential building, identified in a multifamily dwelling of three levels, constructed in the South of Italy by utilizing conventional materials and up-to-date procedures. An attributional life cycle assessment has been utilised to quantify the contributions of each stage of the end-of-life phase, with a particular attention to the management of the demolition waste. The investigation takes into account the selective demolition, preliminary sorting and collection of main components of the building, together with the processes of sorting, recycling and/or disposal of main fractions of the demolition waste...
October 11, 2016: Waste Management
Satoru Koyanagi, Naoki Kusunose, Marie Taniguchi, Takahiro Akamine, Yuki Kanado, Yui Ozono, Takahiro Masuda, Yuta Kohro, Naoya Matsunaga, Makoto Tsuda, Michael W Salter, Kazuhide Inoue, Shigehiro Ohdo
Diurnal variations in pain hypersensitivity are common in chronic pain disorders, but the underlying mechanisms are enigmatic. Here, we report that mechanical pain hypersensitivity in sciatic nerve-injured mice shows pronounced diurnal alterations, which critically depend on diurnal variations in glucocorticoids from the adrenal glands. Diurnal enhancement of pain hypersensitivity is mediated by glucocorticoid-induced enhancement of the extracellular release of ATP in the spinal cord, which stimulates purinergic receptors on microglia in the dorsal horn...
October 14, 2016: Nature Communications
I O Shchederkina, N N Zavadenko, I E Koltunov
AIM: To optimize a system of medical care, introduction of treatment and diagnostic guidelines, including secondary stroke prevention and rehabilitation measures, by implementation of pediatric stroke registry. MATERIAL AND METHODS: Fifty-seven patients, aged from 1 year to 17 years 11 months, included into the Moscow city registry of pediatric stroke were examined. Forty-two patients suffered ischemic stroke and 15 hemorrhagic stroke. RESULTS AND CONCLUSION: The diagnostic search for the causes of pediatric stroke is difficult due to the wide variety of etiologic factors and high frequency of their combinations...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
John R Benson, Ismail Jatoi, Masakazu Toi
The heterogeneous nature of ductal carcinoma in situ has been emphasised by data for breast-cancer screening that show substantial increases in the detection of early-stage non-invasive breast cancer but no noteworthy change in the incidence of invasive and distant metastatic disease. Indolent non-progressive forms of ductal carcinoma in situ are managed according to similar surgical strategies as high-risk disease, with extent of resection dictated by radiological and pathological estimates of tumour dimensions...
October 2016: Lancet Oncology
Leslie Citrome, Joseph P McEvoy, Stephen R Saklad
Clozapine is a highly effective antipsychotic medication, which provides a range of significant benefits for patients with schizophrenia, and is the standard of care for treatment-resistant schizophrenia as well as for reducing the risk of suicidal behaviors in schizophrenia and schizoaffective disorder. However, clozapine is widely underutilized, largely because prescribing clinicians lack experience in prescribing it and managing its adverse events (AEs). Clozapine is associated with three uncommon but immediately dangerous AEs-agranulocytosis, myocarditis/cardiomyopathy, and seizures-as well as AEs that may become dangerous if neglected, including weight gain, metabolic syndrome and constipation, and others that are annoying or distressing such as sedation, nighttime enuresis and hypersalivation...
2016: Clinical Schizophrenia & related Psychoses
S A Braun, P A Gerber
actinic field cancerization (AFC) is a frequent neoplastic skin disease with a high prevalence in the elderly population. AFC is defined as a condition with at least six actinic keratosis (AKs) in one body region or field of chronically sun-damaged skin.(1) With regard to the management of AFC a superior efficacy has been demonstrated for field-directed treatments, such as 5-fluorouracil, imiquimod, ingenol mebutate or photodynamic therapy (PDT), as compared to lesion-directed measures, such as cryotherapy...
October 12, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
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