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https://www.readbyqxmd.com/read/29458153/eus-guided-transluminal-interventions
#1
Uzma D Siddiqui, Michael J Levy
The role of endoscopic ultrasound (EUS) has transitioned from a diagnostic to a therapeutic one over the past 40 years. With the advent of curvilinear array echoendoscopes in the 1990's with an accessory channel, multiple tools and devices have been developed and utilized for a variety of transluminal interventions. EUS provides a viable option and is becoming the procedure of choice for many interventions including bile and pancreatic duct drainage, guiding angiotherapy, pancreatic fluid collection management, gallbladder drainage, and creating a gastrojejunostomy...
February 16, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29457117/goal-directed-therapy-reduces-fluid-balance-while-maintaining-hemodynamic-stability-in-intraoperative-management-of-pancreaticoduodenectomy-a-retrospective-comparative-study
#2
Satoshi Ishihara, Takeshi Yokoyama, Katsuyuki Katayama
Background: Goal-directed therapy (GDT) is beneficial for surgical patients, especially for those undergoing high-risk surgery. However, little has been reported on the hemodynamic effects of GDT in extensive surgery. We conducted a study to determine the impact of GDT on intraoperative management of extensive surgery. Findings: We retrospectively collected data from 90 patients who underwent pancreaticoduodenectomy: 44 who received intraoperative GDT (GDT group) and 46 who received conventional hemodynamic management (control group)...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29456950/cerebrospinal-fluid-leakage-during-temporal-bone-surgery-selecting-intra-operative-dural-closure-with-a-dumbbell-shaped-muscle-graft-as-a-surgical-approach
#3
Nasrin Yazdani, Mohammad Taghi Khorsandi-Ashtiani, Hamed Tashakorinia, Mahtab Rabbani Anari, Narges Mikaniki
Cerebrospinal fluid (CSF) leakages of the temporal bone may arise during mastoid surgery. The leakages can have multiple potential etiologies, for instance, using a cutting burr near the bony tegmen or monopolar electrocautery on the surface of the dura mater. In this paper, we introduced an effective and simple technique for the management of CSF leakages of the temporal bone. In a prospective case series, 36 patients (16 males and 20 females) who have had an experience of incidental or inevitable CSF otorrhea or otorhinorrhea during temporal bone surgery were selected...
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29456933/pediatricians-lack-knowledge-for-the-diagnosis-and-management-of-functional-constipation-in-children-over-6-mo-of-age
#4
Ariani Widodo, Badriul Hegar, Yvan Vandenplas
AIM: To assess the knowledge of general pediatricians througout Indonesia about the diagnosis and treatment of childhood constipation. METHODS: A comprehensive questionnaire was distributed to general pediatricians from several teaching hospitals and government hospitals all over Indonesia. RESULTS: Data were obtained from 100 pediatricians, with a mean of 78.34 ± 18.00 mo clinical practice, from 20 cities throughout Indonesia. Suspicion of constipation in a child over 6 mo of age arises when the child presents with a decreased frequency of bowel movements (according to 87% of participants) with a mean of one bowel movement per 3...
February 8, 2018: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/29456597/insertion-rates-and-complications-of-central-lines-in-the-uk-population-a-pilot-study
#5
Adrian Vk Wong, Nitin Arora, Olusegun Olusanya, Ben Sharif, Robert M Lundin, A Dhadda, S Clarke, R Siviter, M Argent, Gavin Denton, Anna Dennis, Angela Day, Tamas Szakmany
Background: Central venous catheters are inserted ubiquitously in critical care and have roles in drug administration, fluid management and renal replacement therapy. They are also associated with numerous complications. The true number of central venous catheters inserted per year and the proportion of them associated with complications are unknown in the UK. Methods: We performed a prospective audit at five hospitals, as a feasibility pilot for a larger, nationwide audit...
February 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29456216/the-cardiovascular-risk-factor-profiles-among-end-stage-renal-failure-patients-treated-with-continuous-ambulatory-peritoneal-dialysis-and-intermittent-hemodialysis
#6
S A K Sharifah Zamiah, Che Rosle Draman, Mohd Ramli Seman, A Fariz Safhan, R Rozalina, N I Nik Ruzni
Cardiovascular (CV) event is the most common cause of death in dialysis patients. Both traditional and nontraditional CV risk factors related to malnutrition, inflammation, and anemia are commonly found in this population. This study was conducted to evaluate the burden factors of CV risk factors and its management in our regularly dialyzed patients. It was a single-center, cross-sectional analysis of prevalent intermittent hemodialysis (IHD) and continuous ambulatory peritoneal dialysis (CAPD) patients followed up in our hospital...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29456197/clinical-usefulness-and-accuracy-of-polymerase-chain-reaction-in-the-detection-of-bacterial-meningitis-agents-in-pediatric-cerebrospinal-fluid
#7
M Nour, A Alaidarous
Bacterial meningitis poses enormous healthcare challenges due to a high mortality, morbidity and sequelae. Neisseria (N.) meningitidis, Haemophilus (H.) influenzae, Streptococcus (S.) pneumoniae and S. agalactiae remain among the most prevalent infectious agents that cause bacterial meningitis in children. The objective of this study was the simultaneous detection of these pathogens in suspected cerebrospinal fluid (CSF) by using multiplex polymerase chain reaction (mPCR) and compare PCR results with standard diagnostics currently used in clinical practice...
February 15, 2018: Current Research in Translational Medicine
https://www.readbyqxmd.com/read/29455690/effect-of-cerebral-perfusion-pressure-on-acute-respiratory-distress-syndrome
#8
Sonny Thiara, Donald E Griesdale, William R Henderson, Mypinder S Sekhon
BACKGROUND: Increased cerebral perfusion pressure (CPP)>70 mmHg has been associated with acute respiratory distress syndrome (ARDS) after traumatic brain injury (TBI). Since this reported association, significant changes in ventilation strategies and fluid management have been accepted as routine critical care. Recently, individualized perfusion targets using autoregulation monitoring suggest CPP titration>70 mmHg. Given these clinical advances, the association between ARDS and increased CPP requires further delineation...
February 19, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29455408/frequency-and-treatment-of-hydrocephalus-prior-to-and-after-posterior-fossa-tumor-surgery-in-adult-patients
#9
Sascha Marx, Maresa Reinfelder, Marc Matthes, Henry W S Schroeder, Joerg Baldauf
BACKGROUND: There is paucity of information about the frequency of hydrocephalus prior to and after posterior fossa tumor surgery in adult patients and about the best way it should be managed. The present study was conducted to determine the frequency of hydrocephalus prior to and after posterior fossa tumor surgery in adult patients as well as the value of an endoscopic third ventriculostomy (ETV) prior to posterior fossa tumor surgery with regard to the rate of perioperative complications and persistent hydrocephalus...
February 17, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29455228/numeracy-health-literacy-cognition-and-30-day-readmissions-among-patients-with-heart-failure
#10
Madeline R Sterling, Monika M Safford, Kathryn Goggins, Sam K Nwosu, Jonathan S Schildcrout, Kenneth A Wallston, Amanda S Mixon, Russell L Rothman, Sunil Kripalani
BACKGROUND: Numeracy, health literacy, and cognition are important for chronic disease management. Prior studies have found them to be associated with poorer selfcare and worse clinical outcomes, but limited data exists in the context of heart failure (HF), a condition that requires patients to monitor their weight, fluid intake, and dietary salt, especially in the posthospitalization period. OBJECTIVE: To examine the relationship between numeracy, health literacy, and cognition with 30-day readmissions among patients hospitalized for acute decompensated HF (ADHF)...
February 12, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29455221/perioperative-lumbar-drain-utilization-in-transsphenoidal-pituitary-resection
#11
Shatha Alharbi, Griffith Harsh, Abdulrazag Ajlan
OBJECTIVE: To evaluate lumbar drain (LD) efficacy in transnasal resection of pituitary macroadenomas in preventing postoperative cerebrospinal fluid (CSF) leak, technique safety, and effect on length of hospital stay. METHODS: We conducted a retrospective data review of pituitary tumor patients in our institution who underwent surgery between December 2006 and January 2013. All patients were operated on for complete surgical resection of pituitary macroadenoma tumors...
January 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/29455120/amyand-s-hernia-with-acute-gangrenous-appendicitis-and-cecal-perforation-a-case-report-and-review-of-the-literature
#12
William Kromka, Aline S Rau, Charles J Fox
INTRODUCTION: An Amyand's hernia is a heterogeneous clinical condition defined by the presence of the vermiform appendix within an inguinal hernia sac, which may or may not contain other abdominal contents or pathologic inflammatory changes. Herein we present an exceptionally rare case of an Amyand's hernia containing acute appendicitis and a perforated cecum. PRESENTATION OF CASE: A 46-year-old male with a right inguinal hernia of 2-3 year duration presented to our Emergency Department complaining of acute onset abdominal and groin pain...
February 14, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29452771/radiation-therapy-as-an-effective-salvage-strategy-for-secondary-cns-lymphoma
#13
Sarah A Milgrom, Chelsea C Pinnix, T Linda Chi, Thinh H Vu, Jillian R Gunther, Tommy Sheu, Nathan Fowler, Jason R Westin, Loretta J Nastoupil, Yasuhiro Oki, Luis E Fayad, Sattva Neelapu, Maria Alma Rodriguez, Frederick B Hagemeister, Michelle A Fanale, Hun J Lee, Chitra Hosing, Sairah Ahmed, Yago Nieto, Elizabeth J Shpall, Bouthaina S Dabaja
PURPOSE: We assessed the efficacy of radiation therapy (RT) in the management of secondary central nervous system (CNS) lymphoma. METHODS AND MATERIALS: The cohort comprised 44 patients with systemic diffuse large B-cell lymphoma (DLBCL) secondarily involving the brain and/or leptomeninges at initial diagnosis or relapse that was treated with RT. RESULTS: Of these patients, 29 (66%) were in systemic remission when CNS disease was diagnosed...
January 6, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29451938/the-management-of-cerebrospinal-fluid-leak-after-anterior-cervical-decompression-surgery
#14
Jiliang Zhai, Ripul R Panchal, Ye Tian, Shujie Wang, Lijuan Zhao
Cerebrospinal fluid (CSF) leak is a rare but potentially troublesome and occasionally catastrophic complication after anterior cervical decompression surgery. There is limited literature describing this complication, and the management of CSF leak varies. The aim of this study was to retrospectively review the treatment of cases with CSF leak and develop a management algorithm. A series of 14 patients with CSF leak from January 2011 to May 2016 were included in this study. Their characteristics, management of CSF leak, and outcomes were documented...
February 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29451509/-diagnosis-and-treatment-of-blood-volume-changes-in-acute-heart-failure-a-brief-practical-guide
#15
Paola Ciancetta, Salvatore M Maggiore, Flavia Petrini, Raffaele De Caterina
The correct management of acute heart failure continues to pose diagnostic and therapeutic challenges. In particular, administering the right type and dose of fluids and drugs, thus avoiding fluid overload while establishing organ perfusion, is of key importance in stabilizing critical patients and improving prognosis. A correct estimate of the fluid volume status, however, may be difficult, as the invasive evaluation of cardiac filling pressures by cardiac catheterization is limited in routine medical practice, and there is no universal consensus on the best tools for its non-invasive evaluation...
January 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29451166/molecular-analysis-of-pancreatic-cyst-fluid-changes-clinical-management
#16
David M Arner, Brooke E Corning, Ali M Ahmed, Henry C Ho, Bradley J Weinbaum, Uzma Siddiqui, Harry Aslanian, Reid B Adams, Todd W Bauer, Andrew Y Wang, Vanessa M Shami, Bryan G Sauer
Background and Objectives: DNA molecular analysis has been suggested as a tool to evaluate pancreatic cysts. This study assesses whether the addition of DNA molecular analysis alters clinical management. Methods: This is a retrospective review of 46 consecutive patients who underwent EUS-FNA of pancreatic cysts with DNA molecular analysis at two major academic institutions. Cases were presented to two pancreaticobiliary surgeons first without and then with DNA molecular analysis data...
January 2018: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/29448987/the-refeeding-syndrome-importance-of-phosphorus
#17
REVIEW
Marta Araujo Castro, Clotilde Vázquez Martínez
Refeeding syndrome (RS) is a complex disease that occurs when nutritional support is initiated after a period of starvation. The hallmark feature is the hypophosphataemia, however other biochemical abnormalities like hypokalaemia, hypomagnesaemia, thiamine deficiency and disorder of sodium and fluid balance are common. The incidence of RS is unknown as no universally accepted definition exists, but it is frequently underdiagnosed. RS is a potentially fatal, but preventable, disorder. The identification of patients at risk is crucial to improve their management...
February 12, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/29446682/fetal-urinary-tract-anomalies-review-of-pathophysiology-imaging-and-management
#18
Achille Mileto, Malak Itani, Douglas S Katz, Joseph R Siebert, Manjiri K Dighe, Theodore J Dubinsky, Mariam Moshiri
OBJECTIVE: Common fetal anomalies of the kidneys and urinary tract encompass a complex spectrum of abnormalities that can be detected prenatally by ultrasound. Common fetal anomalies of the kidneys and urinary tract can affect amniotic fluid volume production with the development of oligohydramnios or anhydramnios, resulting in fetal pulmonary hypoplasia and, potentially, abnormal development of other fetal structures. CONCLUSION: We provide an overview of common fetal anomalies of the kidneys and urinary tract with an emphasis on sonographic patterns as well as pathologic and postnatal correlation, along with brief recommendations for postnatal management...
February 15, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29446646/accuracy-of-flash-glucose-monitoring-and-continuous-glucose-monitoring-technologies-implications-for-clinical-practice
#19
Ramzi A Ajjan, Michael H Cummings, Peter Jennings, Lalantha Leelarathna, Gerry Rayman, Emma G Wilmot
Continuous glucose monitoring and flash glucose monitoring technologies measure glucose in the interstitial fluid and are increasingly used in diabetes care. Their accuracy, key to effective glycaemic management, is usually measured using the mean absolute relative difference of the interstitial fluid sensor compared to reference blood glucose readings. However, mean absolute relative difference is not standardised and has limitations. This review aims to provide a consensus opinion on assessing accuracy of interstitial fluid glucose sensing technologies...
February 1, 2018: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/29444764/clinical-radiological-pathological-correlation-in-an-unusual-case-of-refractory-epilepsy-a-two-year-journey-of-whodunit
#20
Deepak Menon, Ramshekhar N Menon, Chandrasekharan Kesavadas, Anita Mahadevan, Ashalatha Radhakrishnan, Sudheeran Kannoth, Pradeep P Nair, Mathew Abraham, Bejoy Thomas, Sanjeev V Thomas
New-onset refractory focal epilepsy poses significant challenges to the clinician in the absence of specific diagnostic biomarkers. Differential diagnoses based on imaging may be expanded by a veritable spectrum of peri-ictal imaging findings that may mask the underlying substrate. We report a 13-year-old girl who presented with refractory focal seizures of left parieto-occipital origin with cytotoxic gyral oedema noted over the same region on imaging. Despite an initial negative autoantibody profile, the patient was treated with immunosuppression, followed by serial relapses requiring immune-modulation...
February 14, 2018: Epileptic Disorders: International Epilepsy Journal with Videotape
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