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https://www.readbyqxmd.com/read/27922024/improvements-in-the-long-term-outcome-of-crohn-s-disease-over-the-past-two-decades-and-the-relation-to-changes-in-medical-management-results-from-the-population-based-ibdsl-cohort
#1
Steven F G Jeuring, Tim R A van den Heuvel, Limmie Y L Liu, Maurice P Zeegers, Wim H Hameeteman, Mariëlle J L Romberg-Camps, Liekele E Oostenbrug, Ad A M Masclee, Daisy M A E Jonkers, Marieke J Pierik
OBJECTIVES: Medical treatment options and strategies for Crohn's disease (CD) have changed over the past decades. To assess its impact, we studied the evolution of the long-term disease outcome in the Dutch Inflammatory Bowel Disease South Limburg (IBDSL) cohort. METHODS: In total, 1,162 CD patients were included. Three eras were distinguished: 1991-1998 (n=316), 1999-2005 (n=387), and 2006-2011 (n=459), and patients were followed until 2014. Medication exposure and the rates of hospitalization, surgery, and phenotype progression were estimated using Kaplan-Meier survival analyses and compared between eras by multivariable Cox regression models...
December 6, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27921992/the-hubble-trial-haemorrhoidal-artery-ligation-hal-versus-rubber-band-ligation-rbl-for-symptomatic-second-and-third-degree-haemorrhoids-a-multicentre-randomised-controlled-trial-and-health-economic-evaluation
#2
Steven Brown, Jim Tiernan, Katie Biggs, Daniel Hind, Neil Shephard, Mike Bradburn, Allan Wailoo, Abualbishr Alshreef, Lizzie Swaby, Angus Watson, Simon Radley, Oliver Jones, Paul Skaife, Anil Agarwal, Pasquale Giordano, Marc Lamah, Mark Cartmell, Justin Davies, Omar Faiz, Karen Nugent, Andrew Clarke, Angus MacDonald, Phillip Conaghan, Paul Ziprin, Rohit Makhija
BACKGROUND: Optimal surgical intervention for low-grade haemorrhoids is unknown. Rubber band ligation (RBL) is probably the most common intervention. Haemorrhoidal artery ligation (HAL) is a novel alternative that may be more efficacious. OBJECTIVE: The comparison of HAL with RBL for the treatment of grade II/III haemorrhoids. DESIGN: A multicentre, parallel-group randomised controlled trial. PERSPECTIVE: UK NHS and Personal Social Services...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27921252/opioid-induced-bowel-dysfunction-in-patients-undergoing-spine-surgery-comparison-of-oxycodone-and-oxycodone-naloxone-treatment
#3
Merja Kokki, Moona Kuronen, Toivo Naaranlahti, Timo Nyyssönen, Ira Pikkarainen, Sakari Savolainen, Hannu Kokki
INTRODUCTION: Opioids are needed for postoperative pain in spine surgery patients, but opioid-induced constipation is a harmful adverse event. The aim of this clinical trial was to compare the use of a controlled-release oxycodone-naloxone combination product with oxycodone controlled-release tablets in these patients. The main outcome measure was the prevalence of constipation at 7 days postoperatively assessed with a Bowel Function Index questionnaire. A follow-up assessment at 21 days after surgery was also included...
December 5, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27921214/external-validity-of-the-chiari-severity-index-and-outcomes-among-pediatric-chiari-i-patients-treated-with-intra-or-extra-dural-decompression
#4
Jared M Pisapia, Maxwell B Merkow, Danielle Brewington, Rosemary E Henn, Leslie N Sutton, Phillip B Storm, Gregory G Heuer
INTRODUCTION: Chiari malformation type-1 (CM-1) may be treated by intradural (ID) or extradural (ED) posterior fossa decompression, although the optimal approach is debated. The Chiari Severity Index (CSI) is a pre-operative metric to predict patient-defined improvement after CM-1 surgery. In this study, we evaluate the results of ID versus ED decompression and assess the external validity of the CSI. METHODS: We performed a retrospective cohort study of pediatric CM-1 patients undergoing decompression at a single academic children's hospital...
December 5, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27921213/pediatric-intracranial-primary-anaplastic-ganglioglioma
#5
Wolf Lüdemann, Rouzbeh Banan, Christian Hartmann, Helmut Bertalanffy, Concezio Di Rocco
BACKGROUND: Primary intracranial anaplastic gangliogliomas are rare tumors in the pediatric patient group. Most of them present with symptoms of elevated pressure or symptomatic epilepsy. Extraaxial location is far more common than axial location. On MRI examination, they mimic pilocytic astrocytomas. The outcome after surgery depends mainly on the possible amount of surgical resection, and oncological therapy is necessary to prevent recurrence of the disease. CASE REPORT: An 11-year-old boy presented with headache and double vision due to obstructive hydrocephalus...
December 5, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27921203/treatment-of-uncomplicated-type-b-aortic-dissection
#6
REVIEW
Hitoshi Matsuda
Hospital mortality after the replacement of chronic type B aortic dissection is around 8-10% and adverse outcomes include paraplegia and stroke. However, the level of evidence for indication of thoracic endovascular aortic repair (TEVAR) for type B chronic aortic dissection is Class IIa. Results of the INSTEAD-XL trial have verified that preemptive TEVAR for uncomplicated type B aortic dissection improves prognosis. The indication for this procedure is reportedly a maximum aortic diameter >40 mm during the acute phase and a patent primary entry site in the thoracic aorta, while the optimal timing for TEVAR would be the subacute phase, from 2 weeks to 3-6 months after onset...
December 5, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27921193/an-isoperistaltic-jejunum-later-cut-overlap-method-for-esophagojejunostomy-anastomosis-after-totally-laparoscopic-total-gastrectomy-a-safe-and-feasible-technique
#7
Chang-Ming Huang, Ze-Ning Huang, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Jun Lu, Qi-Yue Chen, Long-Long Cao, Mi Lin, Ru-Hong Tu
BACKGROUND: Intracorporeal anastomosis after totally laparoscopic total gastrectomy (TLTG) has been increasingly applied. (1-7) We assessed the intracorporeal isoperistaltic jejunum-later-cut overlap method (IJOM) for esophagojejunostomy anastomosis (EA). METHODS: From January to June 2014, a total of 19 patients with resectable gastric cancer (cT1-T4aNOM0) underwent TLTG. IJOM was performed by creating side-to-side stapled anastomosis through enterotomies proximal to the left esophageal resection margin and on the antimesenteric jejunal border, 30 cm distal to the Trietz ligament...
December 5, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27921183/conversion-in-laparoscopic-colorectal-surgery-are-short-term-outcomes-worse-than-with-open-surgery
#8
E Gorgun, C Benlice, M A Abbas, L Stocchi, F H Remzi
BACKGROUND: The aim of the present study was to compare the perioperative outcomes in patients who underwent planned open colectomy to those who were converted to an open. METHODS: All patients who underwent elective colectomy were identified from the American College of Surgeons National Surgical Quality Improvement Program using procedure-targeted database (2012-2014). Patients were divided into two groups: open (planned) versus converted. Perioperative outcomes were compared...
December 5, 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27921162/multicentre-randomized-trial-of-the-ajust%C3%A2-single-incision-sling-compared-to-the-align%C3%A2-transobturator-tape-sling
#9
Jordi Sabadell, Marta Palau-Gené, Eva Huguet, Anabel Montero-Armengol, Sabina Salicrú, Jose L Poza
INTRODUCTION AND HYPOTHESIS: Tension-free suburethral tapes have become the first-line surgical treatment for female stress urinary incontinence. Single-incision midurethral slings (SIMS) were introduced with the aim of offering similar efficacy with reduced morbidity, particularly postoperative pain. The objective of this study was to compare the effectiveness and complications of the Ajust™ SIMS and the Align™ transobturator tape sling. METHODS: We performed a randomized controlled trial with a noninferiority design...
December 5, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27921130/-does-the-certification-according-to-endocert-lead-to-a%C3%A2-better-quality-of-treatment
#10
P Weber, A C Paulus, D Hallmen, A Steinbrück, F Schmidutz, V Jansson
BACKGROUND: Certification according to EndoCert in the field of arthroplasty in Germany aims at standardization of treatment and with this optimization of its quality. However, huge capital investment and efforts are necessary. There are currently more than 400 certified centres in Germany. Our Department of Orthopaedics at a German medical school was certified in the pilot phase. The aim of this study was to analyse whether there was a difference in the quality in the year after the certification...
December 5, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27921127/pre-authorization-processes-have-no-effect-on-patients-undergoing-knee-mri-in-a-pediatric-setting-when-evaluated-by-specialists
#11
Drew Pierce, J Herman Kan, Megan May, George S Bisset
OBJECTIVE: Pre-authorization processes are often used by medical insurance companies to reduce costs by managing the utilization of advanced diagnostic imaging, and their impact on patient care is unclear. The purpose of our study is to determine if a pre-authorization process increases the rate of surgically significant abnormal knee MRI and surgical referrals compared with patients referred from pediatric orthopedic specialists who do not undergo a pre-authorization process. MATERIALS AND METHODS: A retrospective study was performed; 124 patients were identified who were referred for knee MRI by a pediatric orthopedist...
December 5, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27921126/successful-ct-guided-cryoablation-of-phosphaturic-mesenchymal-tumor-in-the-soft-tissues-causing-tumor-induced-osteomalacia-a-case-report
#12
Sophie Cowan, Santiago A Lozano-Calderon, Raul N Uppot, Dipti Sajed, Ambrose J Huang
We report the case of a 25-year-old male patient with tumor-induced osteomalacia from a 1.8-cm phosphaturic mesenchymal tumor in the right distal thigh, who was treated at our institution with a single session of CT-guided cryoablation in December 2015, which resulted in biochemical and clinical resolution. We present the clinical history, physical examination, biochemistry, functional imaging, anatomic characterization, and follow-up for clinical outcome. The response to treatment was documented in terms of normalization of serum fibroblastic growth factor 23 (FGF23) and phosphorous levels, symptomatic improvement, as well as normalization of bone mineralization on femur radiographs 3 months after the procedure...
December 5, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27921123/local-control-and-intermediate-term-cosmetic-outcome-following-imrt-for-nasal-tumors-an-update
#13
Yuki Mukai, Stefan Janssen, Christoph Glanzmann, David Holzmann, Gabriela Studer
OBJECTIVE: This study aims to evaluate local control and intermediate-term cosmetic outcome in patients with cancer of the nose treated with intensity-modulated radiotherapy (IMRT). METHODS: From June 2008 to September 2015, 36 consecutive patients presenting with nasal cavity, ala of the nose, or nasal vestibule tumors were treated at the Department of Radiation Oncology, University Hospital Zurich either postoperatively (n = 14; 3/14 with nasal ablation) or with definitive IMRT (n = 22)...
December 5, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/27921039/clinical-manifestation-and-management-of-adpkd-in-western-countries
#14
REVIEW
Claudia Sommerer, Martin Zeier
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease in Western countries. The prevalence is between 2.4/10,000 and 3.9/10,000. ADPKD represents a systemic disease resulting in deterioration in renal function. Until now, mutations in two genes (PKD1 and PKD2) have been identified. Recently, the European Medicines Agency (EMA) approved the use of the vasopressin V2 receptor antagonist tolvaptan to slow the progression of cyst development and renal insufficiency connected with ADPKD in adult patients with chronic kidney disease stages 1-3 at initiation of treatment with evidence of rapidly progressing disease...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27921038/the-clinical-manifestation-and-management-of-autosomal-dominant-polycystic-kidney-disease-in-china
#15
REVIEW
Cheng Xue, Chen-Chen Zhou, Ming Wu, Chang-Lin Mei
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common monogenic hereditary kidney disease characterized by progressive enlargement of renal cysts. The incidence is 1-2‰ worldwide. Mutations in two genes (PKD1 and PKD2) cause ADPKD. Currently, there is no pharmaceutical treatment available for ADPKD patients in China. Summary: This review focused on advances in clinical manifestation, gene diagnosis, risk factors, and management of ADPKD in China. There is an age-dependent increase in total kidney volume (TKV) and decrease in renal function in Chinese ADPKD patients...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27920951/risk-factors-for-in-hospital-mortality-after-coronary-artery-bypass-grafting-in-patients-80%C3%A2-years-old-or-older-a-retrospective-case-series-study
#16
Jacek Piątek, Anna Kędziora, Janusz Konstanty-Kalandyk, Grzegorz Kiełbasa, Marta Olszewska, Bryan HyoChan Song, Karol Wierzbicki, Irena Milaniak, Tomasz Darocha, Dorota Sobczyk, Bogusław Kapelak
BACKGROUND: Age remains a significant and unmodifiable risk factor for cardiovascular diseases, and an increasing number of patients older than 80 years of age undergo Coronary Artery Bypass Grafting (CABG). Old age is also an independent risk factor for postoperative complications. The aim of this study is to describe the population of patients 80 years of age or older who underwent CABG procedure and to assess the mortality rate and risk factors for in-hospital mortality. METHODS: A retrospective case-series study analyzing 388 consecutive patients aged 80 years of age or older who underwent isolated CABG procedure between 2010 and 2014 in the Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow...
2016: PeerJ
https://www.readbyqxmd.com/read/27920717/cataract-surgery-with-a-new-fluidics-control-phacoemulsification-system-in-nanophthalmic-eyes
#17
John S M Chang, Jack C M Ng, Vincent K C Chan, Antony K P Law
PURPOSE: To report visual outcomes and complications after cataract surgery in nanophthalmic eyes with a phacoemulsification system using the active fluidics control strategy. METHODS: This is a retrospective case series. All eyes with an axial length of less than 20 mm that underwent cataract surgery or refractive lens exchange using the Centurion Vision System (Alcon Laboratories Inc.) in Hong Kong Sanatorium and Hospital were evaluated. The visual acuity and intraoperative and postoperative complications were reported...
September 2016: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/27920705/heterotopic-ossification-in-rectal-carcinoma-report-of-a-case-and-review-of-the-literature
#18
Jiro Shimazaki, Akira Takemura, Kiyotaka Nishida, Hideki Kajiyama, Mitsugi Shimoda, Shuji Suzuki
Heterotopic ossification in colorectal carcinoma is extremely rare. This report presents the case of a 57-year-old male who had undergone a low anterior resection following a diagnosis of rectal carcinoma. Histological examination showed heterotopic ossification in the tumor. The patient was referred to Ibaraki Medical Center, Tokyo Medical University, with a diagnosis of rectal carcinoma by a local physician. Abdominal computed tomography revealed thickening of the rectal wall with calcified deposits, and virtual colonoscopy showed stenosis with a mass in the rectum...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27920628/local-recurrence-after-breast-conserving-surgery-and-mastectomy-following-neoadjuvant-chemotherapy-for-locally-advanced-breast-cancer-a-meta-analysis
#19
REVIEW
Xiaodong Zhou, Yujie Li
BACKGROUND: Breast-conserving surgery (BCS) in patients with large tumors shrunk by neoadjuvant chemotherapy (NCT) remains controversial. We conducted a meta-analysis to evaluate the local recurrence rates in locally advanced breast cancer (LABC) patients receiving NCT comparing BCS with mastectomy. METHODS: Pubmed, Web of Knowledge, and Ovid's database were searched for studies concerning treatment for LABC from January 2000 to June 2015. A meta-analysis was performed to compare the recurrence rates of patients receiving BCS versus mastectomy following NCT...
October 2016: Breast Care
https://www.readbyqxmd.com/read/27920573/femoral-nerve-blockade-using-various-concentrations-of-local-anesthetic-for-knee-arthroscopy-in-the-pediatric-population
#20
Giorgio Veneziano, Jennifer Tripi, Dmitry Tumin, Mumin Hakim, David Martin, Ralph Beltran, Kevin Klingele, Tarun Bhalla, Joseph D Tobias
BACKGROUND: Femoral nerve blockade (FNB) provides effective postoperative analgesia in children undergoing arthroscopic knee surgery as evidenced by their opioid-sparing effects and decreased postoperative pain scores. Increasing the local anesthetic concentration in peripheral nerve blockade for adults undergoing orthopedic surgery has been shown to be beneficial, increasing block success rate, and providing a longer duration of analgesia. The effect of increasing the concentration of local anesthetic in extremity blocks in children remains largely unexplored...
2016: Journal of Pain Research
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