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https://www.readbyqxmd.com/read/29783255/management-of-the-patients-with-blunt-renal-trauma-20-years-of-clinical-experience
#1
Leonid P Sarychev, Yaroslav V Sarychev, Hanna L Pustovoyt, Sergiy A Sukhomlin, Sergiy M Suprunenko
OBJECTIVE: Introduction: Blunt renal trauma (BRT) is a dangerous medical condition. The aim: Analysis of effectiveness of conservative and expectant treatment tactics under ultrasound and CT monitoring in patients with blunt renal trauma (BRT). PATIENTS AND METHODS: Materials and methods: The results of treatment of 81 patients with BRT during 20 years (1998-2017) were analyzed. Amount of men was 58 (71.6%), women - 23 (28.4%). Grade I trauma was seen in 37.0% of cases, grade II - in 25...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29782913/statewide-collaborative-to-reduce-surgical-site-infection-results-of-the-hawaii-surgical-unit-based-safety-program
#2
Della M Lin, Kathryn A Carson, Lisa H Lubomski, Elizabeth C Wick, Julius Cuong Pham
BACKGROUND: Surgical Site Infections (SSI) after colorectal surgery are common, lead to patient harm, and are costly to the healthcare system. This study's purpose was to evaluate the effectiveness of the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Surgery in Hawaii. STUDY DESIGN: This pre-post cohort study involved 100% of 15 hospitals in Hawaii from January 2013-June 2015. The intervention was a statewide implementation of the Comprehensive-Unit-based-Safety-Program (CUSP) and individualized bundles of interventions to reduce SSI...
May 3, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29782601/patient-centered-medical-home-status-and-preparedness-to-assess-resident-milestones-a-cera-study
#3
Thad Wilkins, Wonsuk Yoo, Ralph A Gillies, Julie Dahl-Smith, Jacqueline Dubose, Joseph Hobbs, Selina Smith, Dean A Seehusen
Purpose: The patient-centered medical home (PCMH) model has been proposed as the ideal model for delivering primary care and is focused on improving patient safety and quality, reducing costs, and enhancing patient satisfaction. The mandated Accreditation Council for Graduate Medical Education educational milestones for evaluation of resident competency represent the skills graduates will utilize after graduation. Many of these skills are reflected in the PCMH model. We sought to determine if residency programs whose main family medicine (FM) practice sites have achieved PCMH recognition are therefore more prepared to evaluate milestones...
May 2018: PRiMER
https://www.readbyqxmd.com/read/29782429/early-results-of-laparoscopic-sleeve-gastrectomy-with-loop-bipartition
#4
Ergin Arslan, Mesut Sipahi, Oktay Banli
PURPOSE: We evaluated early results of this new procedure of transit loop bipartition with sleeve gastrectomy (TLB-SG), making a comparison with transit bipartition with sleeve gastrectomy. MATERIALS AND METHODS: Between January 2017 and September 2017, 22 patients have undergone transit bipartition with sleeve gastrectomy or TLB-SG surgery in our clinic. Patients' body mass index, excess body mass index loss, and HOMA-IR were calculated before and after the surgical operation...
May 18, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29782352/an-update-on-the-management-of-pancreatic-neuroendocrine-tumors
#5
Limin Gao, Nikola S Natov, Kevin P Daly, Faisal Masud, Sadia Chaudhry, Mark J Sterling, Muhammad W Saif
Pancreatic neuroendocrine tumors (PNETs) are a rare and heterogeneous group of neoplasia and differ in their clinical presentation, behavior, and prognosis based on both histological features and cancer stage at the time of diagnosis. Although small-sized tumors can be surgically resected, locally advanced and metastatic tumors confer a poor prognosis. In addition, only limited treatment options are available to the latter group of patients with PNETs, such as hormonal analogs, cytotoxic agents, and targeted therapy...
May 8, 2018: Anti-cancer Drugs
https://www.readbyqxmd.com/read/29782305/tatami-mats-a-source-of-pitted-keratolysis-in-a-martial-arts-athlete
#6
Anamaria Balić, Zrinka Bukvić Mokos, Branka Marinović, Daniela Ledić Drvar
Dear Editor, Pitted keratolysis (PK), also known as keratosis plantaris sulcatum, is a non-inflammatory, bacterial, superficial cutaneous infection, characterized by many discrete superficial crateriform ''pits'' and erosions in the thickly keratinized skin of the weight-bearing regions of the soles of the feet (1). The disease often goes unnoticed by the patient, but when it is noticed it is because of the unbearable malodor and hyperhidrosis of the feet, which are socially unacceptable and cause great anxiety to many of the patients...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29782274/-dysfunctional-high-density-lipoproteins-role-in-atherogenesis-and-potential-targets-for-phospholipid-therapy
#7
T I Torchovskaya, V A Kudinov, T S Zakharova, S S Markin
In recent years the number of articles on damages of high-density lipoproteins (HDL) properties in patients with atherosclerosis has sharply increased. First, it concerns their ability to accept cholesterol (CH) from macrophages - the basis of antiatherogenic action of HDL. This ability was assessed ex vivo - by activity of cell cholesterol (CH) efflux to HDL or into patient's serum. In many works inverse relationship was shown between CH acceptor capacity of HDL and severity of atherosclerotic disease or frequency of its exacerbations during long-term observation, independent from HDL CH concentration...
March 2018: Kardiologiia
https://www.readbyqxmd.com/read/29782209/practical-assessment-and-management-of-vulnerabilities-in-older-patients-receiving-chemotherapy-asco-guideline-for-geriatric-oncology
#8
Supriya G Mohile, William Dale, Mark R Somerfield, Mara A Schonberg, Cynthia M Boyd, Peggy S Burhenn, Beverly Canin, Harvey Jay Cohen, Holly M Holmes, Judith O Hopkins, Michelle C Janelsins, Alok A Khorana, Heidi D Klepin, Stuart M Lichtman, Karen M Mustian, William P Tew, Arti Hurria
Purpose To provide guidance regarding the practical assessment and management of vulnerabilities in older patients undergoing chemotherapy. Methods An Expert Panel was convened to develop clinical practice guideline recommendations based on a systematic review of the medical literature. Results A total of 68 studies met eligibility criteria and form the evidentiary basis for the recommendations. Recommendations In patients ≥ 65 years receiving chemotherapy, geriatric assessment (GA) should be used to identify vulnerabilities that are not routinely captured in oncology assessments...
May 21, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29781402/life-expectancy-and-comorbidities-in-patients-with-hereditary-hemorrhagic-telangiectasia
#9
Freya Droege, Kruthika Thangavelu, Boris A Stuck, Andreas Stang, Stephan Lang, Urban Geisthoff
There are only a few published studies that demonstrate associations between life expectancy, severe comorbidities, and their complications in patients with hereditary hemorrhagic telangiectasia (HHT). Relatives of 73 deceased patients with suspected HHT completed a questionnaire about causes of death, and symptoms and comorbidities that the patients had developed. We compared the data for 55 cases where HHT had been clinically confirmed with the general population. Patients suffering from HHT lost, on average, 19 years (SD 11 years) of potential life compared to the general population...
May 1, 2018: Vascular Medicine
https://www.readbyqxmd.com/read/29781384/how-to-uncover-sources-of-unwarranted-practice-variation-a-case-study-in-emergency-medicine
#10
Markus A Feufel
Forty years of statistical database analyses have demonstrated the existence of unwarranted practice variation in care delivery, that is, variations independent of medical need, evidence, or patient preference. Alas, little is known about the underlying mechanisms and thus finding interventions to reduce unwarranted variations remains difficult, hampering quality, equity, and efficiency of care. Whereas statistical analyses describe deviations from ideal patterns, ethnographically inspired analyses aim at understanding when, how, and why variations occur in practice...
May 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29781322/the-impact-of-chronic-kidney-disease-on-medication-choice-and-pharmacologic-management-in-patients-with-heart-failure
#11
Syed Raza Shah, David E Winchester
In the past few years, medical community, including doctors, have become increasingly aware of the fact that chronic kidney disease (CK) and heart failure (HF) have common risk factors which impacts one another in terms of choice of therapy. Areas covered: Management of these two diseases has been a challenge for physicians. The treatment goals for HF patients in CK are very important. They serve as the end-point in using a specific treatment for management and treatment of CK patients hence, decreasing mortality rates...
May 21, 2018: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29781145/core-outcome-set-for-gene-therapy-in-haemophilia-results-of-the-corehem-multistakeholder-project
#12
A Iorio, M W Skinner, E Clearfield, D Messner, G F Pierce, M Witkop, S Tunis
BACKGROUND: Gene therapy trial results show potential to cure haemophilia A and haemophilia B. Securing broad access to a cure for a lifelong chronic disease is anticipated to face barriers at the individual and healthcare system levels, which can be partly mitigated by harmonized planning of clinical research studies. The aim of the coreHEM project was to determine the set of outcome measures required to evaluate efficacy, safety, comparative effectiveness and value of gene therapy for haemophilia...
May 20, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29781074/identifying-risk-factors-for-cesarean-scar-pregnancy-a-retrospective-study-of-79-cases
#13
Min Shi, Hui Zhang, Sha-Sha Qi, Wen-Hui Liu, Ming Liu, Xing-Bo Zhao, Yu-Lan Mu
OBJECTIVES: To explore the possible risk factors for cesarean scar pregnancy (CSP), the incidence of which is increasing rapidly in China. MATERIAL AND METHODS: 79 patients with CSP and 69 non-CSP expectant mothers with at least 1 previous cesarean section were employed in the study. The obstetric histories of the participants were collected and analyzed using Chi square test. RESULTS: We found that 77.2% CSP patients had ≥ 3 pregnancies and only 36...
2018: Ginekologia Polska
https://www.readbyqxmd.com/read/29780743/detection-of-ostecalcin-in-gingival-crevicular-fluid-in-a-group-of-orthodontic-patients
#14
Najwa Adeeb Nassrawin
Aim: To detect osteocalcin (OC) in gingival crevicular fluid (GCF) and to monitor the concentration of OC at what stage inflammation and bone resorption reaches their maximum following orthodontic activation. Materials and Methods: GCF samples were collected from six adult orthodontic patients (mean age = 22.3, range 20-24 years) on 3, 7, 10, 14, 21, 28, and 35 days after activation of orthodontic appliance, from the tooth surface where bone resorption was expected to occur...
March 2018: Journal of International Society of Preventive & Community Dentistry
https://www.readbyqxmd.com/read/29780358/sex-and-gender-differences-in-prevention-of-type-2-diabetes
#15
REVIEW
Jürgen Harreiter, Alexandra Kautzky-Willer
Lifestyle intervention programs are effective in the prevention of type 2 diabetes mellitus (T2DM) in high risk populations. However, most studies only give limited information about the influence of sex and/or gender effectiveness of these interventions. So far, similar outcome was reported for diabetes progression and weight loss. Nevertheless, long-term data on cardiovascular outcome are sparse but favoring women regarding all-cause and cardiovascular mortality. In both men and women, sex hormone imbalances and reproductive disorders are associated with a higher risk of T2DM development...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29780223/surgical-outcomes-and-predictors-of-complication-in-elderly-patients-with-meningiomas
#16
Ayman E Galhom, A A Madawi, M M Ellabban
Background: Surgical management of symptomatic meningioma in elderly is still a high-risk surgery due to increased incidence of complication rate. Many scoring systems have been proposed to expect the surgical risk and the outcome.The study tries to assess cranial meningioma surgery in elderly using the Ibañez grade for complication rate and the Geriatric Scoring System (GSS) for the surgical outcome (GSS). Methods: A clinical and radiological data were studied retrospectively in 42 patients with a primary intracranial meningioma at or above the age of 65...
2018: Egypt J Neurol Psychiatr Neurosurg
https://www.readbyqxmd.com/read/29780158/evaluation-of-the-factors-affecting-concerns-and-expectations-of-patients-undergoing-total-knee-arthroplasty-in-china
#17
Yang Li, Hong Cai, Hua Tian, Ke Zhang
BACKGROUND The aim of this study was to assess the level of concern and expectations of patients and their families of total knee arthroplasty (TKA), peri-operative procedures, postoperative rehabilitation, and outcome in a Chinese population. MATERIAL AND METHODS The study recruited 133 patients with osteoarthritis, scheduled to undergo primary elective TKA. Before surgery, the surgeon completed the Hospital for Special Surgery (HSS) Knee Score questionnaire on pain, function, range of motion (ROM), and muscle strength...
May 21, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29780046/-study-of-dose-recalculation-method-on-overriding-lung-density-using-cbct-image-in-the-thorax
#18
Hiroshi Watanabe, Shuichi Ozawa, Atsuyuki Ohashi, Koji Ikenaga, Kentaro Miki, Akito Saito, Teiji Nishio, Yuji Murakami, Yasushi Nagata
It is a useful method for the adaptive radiotherapy (ART) to calculate absorbed dose accurately on the image set taken by on-board cone beam computed tomography (CBCT) attached to linac for image-guided radiation therapy (IGRT). For this purpose, a simple and accurate calculation method is necessary. Several papers report that it is possible to calculate easily and accurately by using several methods of researches in the neck and prostate, but the lung density varies greatly depending on patient thorax condition...
2018: Nihon Hoshasen Gijutsu Gakkai Zasshi
https://www.readbyqxmd.com/read/29779962/implementation-of-drug-eluting-stents-for-the-treatment-of-femoropopliteal-disease-provides-significant-cost-to-system-savings-in-a-single-state-outpatient-simulation
#19
Natalie Domenick Sridharan, Nathan Liang, Darve Robinson, Efthymios Avgerinos, Edith Tzeng, Michel S Makaroun, Rabih A Chaer, Mohammad H Eslami
OBJECTIVES: Initial data on drug-eluting stents (DES) shows that they may increase the durability of endovascular treatment of superficial femoral artery disease compared with traditional bare metal stents (BMS). Observed decreased target lesion revascularization (TLR) rates have potential for cost savings despite an increased initial cost. The purpose of this study was to run a simulation model of progressive transition from BMS to DES over 5 years evaluating the overall cost impact of that transition...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29779842/a-cost-effectiveness-modeling-study-of-robot-assisted-rarc-versus-open-radical-cystectomy-orc-for-bladder-cancer-to-inform-future-research
#20
Charlotte T J Michels, Carl J Wijburg, Erik Leijte, J Alfred Witjes, Maroeska M Rovers, Janneke P C Grutters
BACKGROUND: Open radical cystectomy (ORC) is regarded the standard treatment for muscle-invasive bladder cancer, but robot-assisted radical cystectomy (RARC) is increasingly used in practice. However, it is unclear whether RARC provides value for money. OBJECTIVE: To identify the main evidence gaps and main drivers of cost-effectiveness, comparing RARC to ORC. DESIGN, SETTING, AND PARTICIPANTS: A decision analytical model was developed to study the 30d and 90d postoperative complications with RARC versus ORC and their related cost in bladder cancer patients...
May 18, 2018: European Urology Focus
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