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https://www.readbyqxmd.com/read/28431413/novel-oral-anticoagulants-and-trauma-the-results-of-a-prospective-american-association-for-the-surgery-of-trauma-multi-institutional-trial
#1
Leslie Kobayashi, Galinos Barmparas, Patrick Bosarge, Carlos V Brown, Marko Bukur, Matthew M Carrick, Richard D Catalano, Jan Holly-Nicolas, Kenji Inaba, Stephen Kaminski, Amanda L Klein, Tammy Kopelman, Eric J Ley, Ericca M Martinez, Forrest O Moore, Jason Murry, Raminder Nirula, Douglas Paul, Jacob Quick, Omar Rivera, Martin Schreiber, Raul Coimbra
BACKGROUND: The number of anticoagulated trauma patients is increasing. Trauma patients on warfarin have been found to have poor outcomes, particularly after intracranial hemorrhage (ICH). However, the effect of novel oral anticoagulants (NOAs) on trauma outcomes is unknown. We hypothesized that patients on NOAs would have higher rates of ICH, ICH progression, and death compared with patients on traditional anticoagulant and antiplatelet agents. METHODS: This was a prospective observational trial across 16 trauma centers...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28430999/repurposing-quantiferon-for-detection-of-neutralizing-ifn-%C3%AE-autoantibodies-in-patients-with-nontuberculous-mycobacterial-infections
#2
Isabelle Suárez, Clara Lehmann, Henning Gruell, Jessica Graeb, Matthias Kochanek, Gerd Fätkenheuer, Georg Plum, Annelies van Wengen, Esther van de Vosse, Pia Hartmann, Leif G Hanitsch, Jan Rybniker
Nontuberculous mycobacterial (NTM) infections due to autoantibodies targeting IFN-γ are an emerging medical problem. However, case finding is hampered due to highly complex diagnostic procedures not available in routine laboratories. We show that QuantiFERON assays can be exploited as a simple screening tool that may facilitate adequate and timely treatment.
April 20, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28430956/achieving-high-reliability-in-histology-%C3%A2-an-improvement-series-to-reduce-errors
#3
Yael K Heher, Yigu Chen, Sergey Pyatibrat, Edward Yoon, Jeffrey D Goldsmith, Kenneth E Sands
Objectives: Despite sweeping medical advances in other fields, histology processes have by and large remained constant over the past 175 years. Patient label identification errors are a known liability in the laboratory and can be devastating, resulting in incorrect diagnoses and inappropriate treatment. The objective of this study was to identify vulnerable steps in the histology workflow and reduce the frequency of labeling errors (LEs). Methods: In this 36-month study period, a numerical step key (SK) was developed to capture LEs...
November 1, 2016: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28430557/utilization-management-of-high-cost-imaging-in-an-outpatient-setting-in-a-large-stable-patient-and-provider-cohort-over-7-years
#4
Jeffrey B Weilburg, Christopher L Sistrom, Daniel I Rosenthal, Markus B Stout, Keith J Dreyer, Helaine R Rockett, Jason M Baron, Timothy G Ferris, James H Thrall
Purpose To quantify the effect of a comprehensive, long-term, provider-led utilization management (UM) program on high-cost imaging (computed tomography, magnetic resonance imaging, nuclear imaging, and positron emission tomography) performed on an outpatient basis. Materials and Methods This retrospective, 7-year cohort study included all patients regularly seen by primary care physicians (PCPs) at an urban academic medical center. The main outcome was the number of outpatient high-cost imaging examinations per patient per year ordered by the patient's PCP or by any specialist...
April 21, 2017: Radiology
https://www.readbyqxmd.com/read/28429690/-our-experience-in-the-diagnosis-and-treatment-of-postural-orthostatic-tachycardia-syndrome-vasovagal-syncope-and-inappropriate-sinus-tachycardia-in-children
#5
Sezen Ugan Atik, Reyhan Dedeoğlu, Aida Koka, Funda Öztunç
OBJECTIVES: The aim of this study was to share our experience in the diagnosis and treatment of patients who presented at our clinic with syncope, pre-syncope, dizziness, and palpitations. STUDY DESIGN: Patients who were treated at pediatric cardiology clinic for complaints of syncope, dizziness, and palpitations between 2014 and 2016 were enrolled in the study. Detailed history of the patients, physical examination findings, laboratory and electrocardiogram results were recorded...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28429198/managing-the-perioperative-patient-on-direct-oral-anticoagulants
#6
Jordan Leitch, Janet van Vlymen
PURPOSE: Patients are increasingly treated with direct oral anticoagulants (DOACs) for the prevention of stroke due to non-valvular atrial fibrillation and for the treatment of venous thromboembolism. When these patients present for urgent or emergent surgical procedures, they present a challenge to the anesthesiologist who must manage perioperative risk due to anticoagulation. The purpose of this module is to review the literature surrounding the perioperative management of DOACs. Timing, laboratory monitoring, and availability of reversal agents are important considerations to optimize patients being treated with DOACs who require emergent surgery...
April 20, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28429077/-implementation-of-the-german-s3-guidelines-on-dementia-in-clinical-practice-wish-or-reality
#7
H Lohmann, F Kulessa, H Holling, A Johnen, S Reul, G Lueg, T Duning
BACKGROUND: Published in 2009, the German S3 guidelines on dementia define a milestone in quality improvement of the diagnostics and treatment of dementia. In clinical practice patients suffering from dementia are primarily treated by physicians in private practice; therefore, this study examined how the guidelines are implemented in outpatient clinical settings. Furthermore, it aimed at the identification of behavioral determinants that govern the actual diagnostic and therapeutic approach in clinical practice...
April 20, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28427801/-multimodality-imaging-in-the-cardiac-catheterization-laboratory
#8
Karine Warin-Fresse, Sébastien Hascoet, Patrice Guérin
Cardiac catheterization has greatly contributed to the progress made in the management of congenital heart diseases (CHD). Initially used in diagnosis, it allowed the understanding of heart diseases, their anatomy and hemodynamics. Gradually, the development of interventional cardiology has played a major role in the management of these malformations (Patent ductus arteriosus [PDA] and atrial septal defect [ASD] closure, pulmonary dilatation, percutaneous pulmonary valve implantation…). The development of such technology was made possible through the concomitant development of imaging techniques: fluoroscopy, ultrasound, MRI and CT...
April 17, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28425752/use-of-standard-laboratory-methods-to-obviate-routine-dithiothreitol-treatment-of-blood-samples-with-daratumumab-interference
#9
Nicholas J Lintel, Debra K Brown, Diane T Schafer, Farai M Tsimba-Chitsva, Scott A Koepsell, Sara M Shunkwiler
Daratumumab is an antibody currently used in the treatment of patients with refractory multiple myeloma. Blood samples from patients being treated with daratumumab may show panreactivity during pre-transfusion testing. To facilitate the provision of blood components for such patients, it is recommended that a baseline phenotype or genotype be established prior to starting treatment with daratumumab. If patient red blood cells (RBCs) require phenotyping after the start of daratumumab treatment, dithiothreitol (DTT) treatment of the patient's RBCs should be performed...
January 2017: Immunohematology
https://www.readbyqxmd.com/read/28425390/sterility-and-stability-of-diluted-carprofen-in-a-multidose-vial-in-the-laboratory-animal-setting
#10
Gregory D Simonek Gwendolyne G Alarcio And Laurie L Brignolo
Using compounded multidose vials (cMDV) is a common practice in the laboratory animal setting, where medications oftenare diluted to provide appropriate doses to rodents. However, bacterial contamination of MDV has been well establishedin both the human and veterinary medical literature. For this study, we created 14 cMDV by diluting carprofen into sterilewater (dilution, 1:10) and stored 6 cMDV each at 5 and 24 °C. The stoppers of the cMDV were not cleaned with alcohol, andall were punctured twice daily for 28 d...
April 19, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28425249/prediction-of-atopy-via-total-immunoglobulin-e-levels-andskin-prick-tests-in-patients-with-psoriasis
#11
Emine Sümeyye Ünal, Ülker Gül, Adile Berna Dursun, Ferda Öner Erkekol
BACKGROUND/AIM: Although the etiopathogeneses of psoriasis and atopy appear to be different, psoriasis has been found to be associated with atopy and atopic dermatitis. In this study, we aimed to determine the role of atopy by examining the medical history and clinical and laboratory findings of patients with psoriasis. MATERIALS AND METHODS: Patients with psoriasis, asthma patients, and healthy volunteers were included in the study. Serum total immunoglobulin E (IgE) levels were obtained, and prick tests were administered to all groups...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#12
M Braun, C J Ploner, T Lindner, M Möckel, W U Schmidt
Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO...
April 19, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28424016/acute-brain-injury-following-illicit-drug-abuse-in-adolescent-and-young-adult-patients-spectrum-of-neuroimaging-findings
#13
Shai Shrot, Andrea Poretti, Elizabeth W Tucker, Bruno P Soares, Thierry Agm Huisman
The use of illicit drugs is currently a major medical problem among adolescents. Several illicit drugs have a high abuse potential and can be neurotoxic causing high morbidity and mortality. The clinical manifestation of adolescents with acute drug-induced neurotoxicity is often characterized by non-specific symptoms and findings. Early diagnosis is important to prevent death and permanent long-term neurological impairments. We report on clinical and neuroimaging findings in five adolescents with acute brain imaging following illicit drug intoxication to highlight the role of neuroimaging findings in the diagnostic work-up of pediatric acute drug-induced neurotoxicity...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28423232/a-psychometric-evaluation-of-the-anatomy-learning-experiences-questionnaire-and-correlations-with-learning-outcomes
#14
Derek L Choi-Lundberg, Anne-Marie M Williams, Craig Zimitat
The Anatomy Learning Experiences Questionnaire (ALEQ) was designed by Smith and Mathias to explore students' perceptions and experiences of learning anatomy. In this study, the psychometric properties of a slightly altered 34-item ALEQ (ALEQ-34) were evaluated, and correlations with learning outcomes investigated, by surveying first- and second-year undergraduate medical students; 181 usable responses were obtained (75% response rate). Psychometric analysis demonstrated overall good reliability (Cronbach's alpha of 0...
April 17, 2017: Anatomical Sciences Education
https://www.readbyqxmd.com/read/28422977/defining-the-complex-phenotype-of-severe-systemic-loxoscelism-using-a-large-electronic-health-record-cohort
#15
Jamie R Robinson, Vanessa E Kennedy, Youssef Doss, Lisa Bastarache, Joshua Denny, Jeremy L Warner
OBJECTIVE: Systemic loxoscelism is a rare illness resulting from the bite of the recluse spider and, in its most severe form, can lead to widespread hemolysis, coagulopathy, and death. We aim to describe the clinical features and outcomes of the largest known cohort of individuals with moderate to severe loxoscelism. METHODS: We performed a retrospective, cross sectional study from January 1, 1995, to December 31, 2015, at a tertiary-care academic medical center, to determine individuals with clinical records consistent with moderate to severe loxoscelism...
2017: PloS One
https://www.readbyqxmd.com/read/28422588/alterations-in-redox-homeostasis-during-recovery-from-unexplained-underperformance-syndrome-in-an-elite-international-rower
#16
Nathan A Lewis, Ann Redgrave, Mark Homer, Richard Burden, Wendy Martinson, Brian Moore, Charles R Pedlar
PURPOSE: This case study of an international rower examines a diagnosis of Unexplained Under Performance Syndrome (UUPS or Overtraining Syndrome) describing a full recovery and return to elite competition the same year. METHODS: On diagnosis and 4 and 14 months post-diagnosis, detailed assessments including physiological, nutritional, and biomarkers were made. RESULTS: Clinical examination and laboratory results for haematology, biochemistry, thyroid function, immunology, vitamins and minerals were unremarkable and did not explain the presentation and diagnosis...
April 19, 2017: International Journal of Sports Physiology and Performance
https://www.readbyqxmd.com/read/28421731/intraoperative-dexmedetomidine-sedation-reduces-the-postoperative-agitated-behaviour-in-elderly-patients-undergoing-orthopaedic-surgery-compared-to-the-propofol-sedation-a-retrospective-analysis-of-855-patients
#17
Hyun-Jung Shin, Bon-Wook Koo, Seung-Uk Bang, Jin-Hee Kim, Jung-Won Hwang, Sang-Hwan DO, Hyo-Seok Na
BACKGROUND: Postoperative agitation or confusion is one of the symptoms of hyperactive delirium in elderly patients. We retrospectively evaluated the incidence of postoperative abnormal psychomotor behaviour in elderly surgical patients according to the use of different intraoperative sedative agents: dexmedetomidine vs. propofol. METHODS: The medical records of 855 elderly patients, who underwent orthopaedic surgery with regional anaesthesia between July 2012 and September 2015, were divided into two groups-the dexmedetomidine group (n=263) and the propofol group (n=592)-and evaluated...
April 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28421251/defining-the-ultrasound-longitudinal-natural-history-of-newly-diagnosed-pediatric-small-bowel-crohn-disease-treated-with-infliximab-and-infliximab-azathioprine-combination-therapy
#18
Jonathan R Dillman, Soudabeh Fazeli Dehkordy, Ethan A Smith, Michael A DiPietro, Ramon Sanchez, Vera DeMatos-Maillard, Jeremy Adler, Bin Zhang, Andrew T Trout
BACKGROUND: Little is known about changes in the imaging appearances of the bowel and mesentery over time in either pediatric or adult patients with newly diagnosed small bowel Crohn disease treated with anti-tumor necrosis factor-alpha (anti-TNF-α) therapy. OBJECTIVE: To define how bowel ultrasound findings change over time and correlate with laboratory inflammatory markers in children who have been newly diagnosed with pediatric small bowel Crohn disease and treated with infliximab...
April 18, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28420670/confirmed-early-myocardial-rupture-in-a-patient-with-pulseless-electrical-activity-pea-following-late-presentation-of-st-elevation-myocardial-infarction
#19
Baskar Sekar, Joe Martins, Sanjiv Petkar
A 69 year old male, an ex-smoker, was admitted with ongoing chest pain of 11 hours duration. Past medical history included treated hypertension and gastro-oesophageal reflux disease. He delayed seeking medical attention as he assumed the pain to be due to indigestion and kept taking antacids without much symptomatic relief. Clinical examination on arrival was unremarkable. Admission 12 lead electrocardiogram (ECG) was diagnostic of a recent anterolateral myocardial infarction (MI) (Figure 1a). Bedside trans-thoracic echocardiogram (TTE) confirmed an established anterolateral MI (Video 1, Figure 1b)...
April 18, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28420329/contrast-enhanced-us-with-perfluorobutane-sonazoid-used-as-a-surveillance-test-for-hepatocellular-carcinoma-hcc-in-cirrhosis-scan-an-exploratory-cross-sectional-study-for-a-diagnostic-trial
#20
Ji Hoon Park, Mi-Suk Park, So Jung Lee, Woo Kyoung Jeong, Jae Young Lee, Min Jung Park, Kyunghwa Han, Chung Mo Nam, Seong Ho Park, Kyoung Ho Lee
BACKGROUND: Ultrasonography (US) is widely used as a standard surveillance tool for patients who are at a high risk of having hepatocellular carcinoma (HCC); however, conventional B-mode US appears to be insufficient in order to ensure the early detection of HCC. Perfluorobutane allows very stable Kupffer phase imaging for at least 60 min, which is tolerable for examinations of the entire liver. The purpose of our study is to evaluate the added value of contrast-enhanced US using perfluorobutane to that of conventional B-mode US as an HCC surveillance tool for patients with liver cirrhosis...
April 18, 2017: BMC Cancer
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