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https://www.readbyqxmd.com/read/29458152/controversies-in-endoscopic-eradication-therapy-for-barrett-s-esophagus
#1
Srinadh Komanduri, V Raman Muthusamy, Sachin Wani
Advances in Endoscopic Eradication Therapy for Barrett's Esophagus associated neoplasia have resulted in a significant paradigm shift in diagnosis and management of this complex disease. A robust body of literature critically evaluating outcomes of resection and ablative strategies has allowed gastroenterologists to make quality, evidence based decisions for their patients. Despite this progress, there are still many unanswered questions and challenges that remain. Ultimately, identification of a cost-effective screening modality, biomarkers for risk stratification, and strides to eliminate post surveillance endoscopy after EET are essential to reach our long term goal for eradication of esophageal adenocarcinoma...
February 16, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29458092/ramifications-of-the-children-s-surgery-verification-program-for-patients-and-hospitals
#2
Katherine J Baxter, Bonnie F Gale, Curtis D Travers, Kurt F Heiss, Mehul V Raval
BACKGROUND: The American College of Surgeons in 2015 instituted the Children's Surgery Verification (CSV) program delineating requirements for hospitals providing pediatric surgical care. Our purpose was to examine possible effects of the CSV program by evaluating neonates undergoing high-risk operations. STUDY DESIGN: Using the Kid's Inpatient Database 2009, we identified infants undergoing surgery for five high risk neonatal conditions. We considered all children's hospitals and children's units Level I centers and considered all others Level II/III...
February 16, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29457946/the-provision-of-ambulatory-systemic-anti-cancer-therapy
#3
Susan Cooper, Kate de Lord
This article reflects on the changing nature of the provision of care and delivery of ambulatory systemic anti-cancer therapy (SACT) services. It reviews the national guidance and looks at ambulatory SACT in terms of patients being treated closer to home, i.e. ambulatory care in its truest sense. It considers the impact on quality of life for patients receiving treatments at a place of their choice. It explores the role of the nurse as an advanced practitioner while also examining the safety and delivery of complex regimens ensuring robust pathways are in place to deliver care in a safe and standardised way...
February 22, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29457935/customized-titanium-lattice-structure-in-three-dimensional-alveolar-defect-an-initial-case-letter
#4
Marcus Seiler, Peer W Kaemmerer, Michael Peetz, Amely Gundula Hartmann
The aim of this initial case report was to provide a new protocol for the clinical application of a patient-specific titanium lattice structure (Yxoss CBR®, ReOSS, Filderstadt, Germany) for customized bone regeneration. To obtain a 3-dimensional reconstruction of a posterior mandible segment in a 61-year-old woman, a patient-specific titanium customized lattice structure was used. As graft material autogenous bone tissue mixed with xenogenic alloplastic material (Bio Oss®, Geistlich Pharma, Wolhusen, Switzerland) was obtained for reconstruction...
February 19, 2018: Journal of Oral Implantology
https://www.readbyqxmd.com/read/29457878/genetic-determinants-of-heart-failure-facts-and-numbers
#5
EDITORIAL
Frauke S Czepluch, Bernd Wollnik, Gerd Hasenfuß
The relevance of gene mutations leading to heart diseases and hence heart failure has become evident. The risk for and the course of heart failure depends on genomic variants and mutations underlying the so-called genetic predisposition. Genetic contribution to heart failure is highly heterogenous and complex. For any patient with a likely inherited heart failure syndrome, genetic counselling is recommended and important. In the last few years, novel sequencing technologies (named next-generation sequencing - NGS) have dramatically improved the availability of molecular testing, the efficiency of genetic analyses, and moreover reduced the cost for genetic testing...
February 19, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29457852/successful-management-of-living-donor-liver-transplantation-for-biliary-atresia-with-single-ventricle-physiology-from-peri-transplant-through-total-cavopulmonary-connection-a-case-report
#6
Yohei Yamada, Ken Hoshino, Takayuki Oyanagi, Ryohei Gatayama, Jun Maeda, Nobuyuki Katori, Yasushi Fuchimoto, Taizo Hibi, Masahiro Shinoda, Kentaro Matsubara, Hideaki Obara, Ryo Aeba, Yuko Kitagawa, Hiroyuki Yamagishi, Tatsuo Kuroda
Children with single ventricle physiology have complete mixing of the pulmonary and systemic circulations, requiring staged procedures to achieve a separation of these circulations, or Fontan circulation. The single ventricle physiology significantly increases the risk of mortality in children undergoing non-cardiac surgery. As liver transplantation for patients with single ventricle physiology is particularly challenging, only a few reports have been published. We herein report a case of successful LDLTx for an 8-month-old pediatric patient with biliary atresia, heterotaxy, and complex heart disease of single ventricle physiology...
February 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29457843/the-tumour-stroma-ratio-in-colon-cancer-the-biological-role-and-its-prognostic-impact
#7
REVIEW
Gabi W van Pelt, Tessa P Sandberg, Hans Morreau, Hans Gelderblom, J Han J M van Krieken, Rob A E M Tollenaar, Wilma E Mesker
The tumour microenvironment consists of a complex mixture of non-neoplastic cells including fibroblasts, immune cells and endothelial cells embedded in the proteins of the extracellular matrix. The tumour microenvironment plays an active role in tumour behaviour. By interacting with cancer cells, it influences disease progression and the metastatic capacity of the tumour. Tumours with a high amount of stroma correspond to poor patient prognosis. The tumour-stroma ratio (TSR) is a strong independent prognostic tool in colon cancer and provides additional value to the current clinically used TNM classification...
February 19, 2018: Histopathology
https://www.readbyqxmd.com/read/29457836/deptor-suppresses-lipogenesis-and-ameliorates-hepatic-steatosis-and-acute-on-chronic-liver-injury-in-alcoholic-liver-disease
#8
Hanqing Chen, Feng Shen, Alex Sherban, Allison Nocon, Yu Li, Hua Wang, Ming-Jiang Xu, Xianliang Rui, Jinyan Han, Bingbing Jiang, Donghwan Lee, Na Li, Farnaz Keyhani-Nejad, Jian-Gao Fan, Feng Liu, Amrita Kamat, Nicolas Musi, Leonard Guarente, Pal Pacher, Bin Gao, Mengwei Zang
Alcoholic liver disease (ALD) is characterized by lipid accumulation and liver injury. However, how chronic alcohol consumption causes hepatic lipid accumulation remains elusive. The present study demonstrates that activation of the mechanistic target of rapamycin complex 1 (mTORC1) plays a causal role in alcoholic steatosis, inflammation and liver injury. Chronic-plus-binge ethanol feeding led to hyperactivation of mTORC1, as evidenced by increased phosphorylation of mTOR and its downstream kinase S6K1 in hepatocytes...
February 19, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29457743/a-framework-for-complexity-in-palliative-care-a-qualitative-study-with-patients-family-carers-and-professionals
#9
Sophie Pask, Cathryn Pinto, Katherine Bristowe, Liesbeth van Vliet, Caroline Nicholson, Catherine J Evans, Rob George, Katharine Bailey, Joanna M Davies, Ping Guo, Barbara A Daveson, Irene J Higginson, Fliss Em Murtagh
BACKGROUND: Palliative care patients are often described as complex but evidence on complexity is limited. We need to understand complexity, including at individual patient-level, to define specialist palliative care, characterise palliative care populations and meaningfully compare interventions/outcomes. AIM: To explore palliative care stakeholders' views on what makes a patient more or less complex and insights on capturing complexity at patient-level. DESIGN: In-depth qualitative interviews, analysed using Framework analysis...
February 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29457589/short-term-efficacy-of-pipeline-embolization-device-for-treating-complex-intracranial-aneurysms
#10
NiZaMiDingJiang ReXiaTi, ReXiDan AiKeReMu, KaHeErMan KaDeEr, Yan-Dong Fan, Zhao-Hai Feng, Kai Wang, TeWuErBaTi SuErTanNiYa, Tao-Tao Dou, Hai-Qiang Wu, MaiMaiTiLi AiSha, Xiao-Jiang Cheng
OBJECTIVE: To observe the short-term efficacy of Pipeline embolization divice (PED) for the treatment of complex intracranial aneurysms. METHODS: The clinical data of 29 consecutive patients with 32 intracranial aneurysms treated with PED between April 2015 to September 2016 were analyzed retrospectively. There were 3 small aneurysm, 15 large aneurysms, 8 giant aneurysms, 5 fusiform ayneurysms and 1 recidivation. The vessels include 25 anterior circulation and 4 posterior circulation...
2018: Bio-medical Materials and Engineering
https://www.readbyqxmd.com/read/29457554/complexity-of-articulation-planning-in-apraxia-of-speech-the-limits-of-phoneme-based-approaches
#11
Wolfram Ziegler
This report presents evidence suggesting that the phoneme-based approach taken by Romani, Galuzzi, Guariglia, and Goslin (Comparing phoneme frequency, age of acquisition, and loss in aphasia: Implications for phonological universals. Cognitive Neuropsychology, this issue) falls short of capturing the complexity of articulation planning in patients with apraxia of speech. Empirical and modelling data are reported to demonstrate that the apraxic pathomechanism resides in the hierarchical architecture of phonological words rather than in the context-independent properties of phonemes...
October 2017: Cognitive Neuropsychology
https://www.readbyqxmd.com/read/29457409/-analysis-of-risk-factors-of-infection-for-complex-tibial-plateau-fractures-after-operation
#12
Ju-Lei Ma, Yun-Qin Xu, Tu-Gang Shen, Qiang Li
OBJECTIVE: To analyze the risk factor of infection for complex tibial plateau fractures after operation. METHODS: Totally clinical data of 293 patients with complex tibial plateau fractures underwent open reduction and internal fixation were retrospectively analyzed from September 2010 to March 2015, including 199 males and 94 females, ranging in age from 17 to 80 years old with an average of 47.3 years old. The possible risk factors such as gender, age, smoking, diabetes, type of fracture(open/closed), classification of open fracture(Gustilo-Anderson classification), classification of soft tissue injury in closed fracture (Tscherne-Gotzen classification), fracture classification(Schatzker V/VI), osteofascial compartment syndrome, ASA score, anesthesia, timing of surgery, operative time(<=150 min/>150 min), surgical approach, combined approach or not, internal fixation site were studied...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29457402/-clinical-study-on-negative-pressure-closed-drainage-combined-with-vancomycin-loaded-calcium-sulfate-and-autogenous-bone-in-the-treatment-of-chronic-osteomyelitis
#13
Qiang Li, Shi-Feng Song, Wei Zhang, Guo-Zhi Wu, Li-Zhu Liu
OBJECTIVE: To study the clinical effects of negative pressure closed drainage combined with vancomycin loaded calcium sulfate and autogenous bone in the treatment of chronic osteomyelitis. METHODS: From June 2013 to December 2016, there were 35 cases of chronic osteomyelitis patients in our department, including 23 males and 12 females, ranging in age from 11 to 65 years old, with an average of 34 years old. The course of disease ranged from 8 to 46 months, with an average of 26 months...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29457390/-diagnosis-and-treatment-for-posterolateral-rotatory-instability-of-the-elbow
#14
Hui Kang, Wei Wang, Hong-Chuan Li, Jian Li
OBJECTIVE: To study the effects of surgical reconstruction of the lateral ligament complex for posterolateral rotatory instability (PLRI) of the elbow joint. METHODS: From January 2013 to January 2015, 20 patients with posterolateral rotatory instability of elbow joint were treated in our department. There were 12 males and 8 females whose age ranged from 30 to 60 years old, with an average age of 45.5 years old. Sixteen patients had injuries on the right side and 4 patients had injuries on the left side...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29457362/a-multinational-observational-investigation-of-illness-perceptions-and-quality-of-life-among-patients-with-a-fontan-circulation
#15
Christina E Holbein, Nicholas D Fogleman, Kevin Hommel, Silke Apers, Jessica Rassart, Philip Moons, Koen Luyckx, Maayke A Sluman, Junko Enomoto, Bengt Johansson, Hsiao-Ling Yang, Mikael Dellborg, Raghavan Subramanyan, Jamie L Jackson, Werner Budts, Adrienne H Kovacs, Stacey Morrison, Martha Tomlin, Kathy Gosney, Alexandra Soufi, Katrine Eriksen, Corina Thomet, Malin Berghammer, Luis Alday, Edward Callus, Susan M Fernandes, Maryanne Caruana, Samuel Menahem, Stephen C Cook, Gwen R Rempel, Kamila White, Paul Khairy, Shelby Kutty, Gruschen Veldtman
OBJECTIVE: First, to compare QOL and illness perceptions between patients with a Fontan circulation and patients with anatomically simple defects (ie, atrial septal defects [ASD] or ventricular septal defects [VSD]). Second, to explore illness perceptions as a mediator of the association between congenital heart disease (CHD) diagnosis and QOL. DESIGN: Cross-sectional observational study. SETTING: Twenty-four cardiology centers from 15 countries across five continents...
February 18, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29457330/modeling-suicide-in-bipolar-disorders
#16
REVIEW
Gin S Malhi, Tim Outhred, Pritha Das, Grace Morris, Amber Hamilton, Zola Mannie
INTRODUCTION: Suicide is a multicausal human behavior, with devastating and immensely distressing consequences. Its prevalence is estimated to be 20-30 times greater in patients with bipolar disorders than in the general population. The burden of suicide and its high prevalence in bipolar disorders make it imperative that our current understanding be improved to facilitate prediction of suicide and its prevention. In this review, we provide a new perspective on the process of suicide in bipolar disorder, in the form of a novel integrated model that is derived from extant knowledge and recent evidence...
February 19, 2018: Bipolar Disorders
https://www.readbyqxmd.com/read/29457248/duty-hours-restriction-for-our-surgical-trainees-an-ethical-obligation-or-a-bad-idea
#17
REVIEW
Christopher A Adin, Callie A Fogle, Steven L Marks
To ensure patient safety and protect the well-being of interns and residents, the Accreditation Council for Graduate Medical Education (ACGME) issued guidelines in 2003 limiting the working hours of physician trainees. Although many supported the goals of the ACGME, institutions struggled to restructure their programs and hire staff required by this unfunded mandate. Numerous studies have analyzed the effects of duty hours restrictions on patient outcomes and physician training over the past 15 years. Most agree that duty hours restrictions improved well-being of house officers, but these improvements came at the expense of continuity, and patient hand-offs led to medical errors...
February 19, 2018: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29456981/prevalence-of-ctx-m-and-tem-%C3%AE-lactamases-in-klebsiella-pneumoniae-isolates-from-patients-with-urinary-tract-infection-al-zahra-hospital-isfahan-iran
#18
Nafiseh Maleki, Zahra Tahanasab, Sina Mobasherizadeh, Aliakbar Rezaei, Jamshid Faghri
Background: Extended-spectrum β-lactamase (ESBL)-producing is a significant resistant mechanism to β-lactams in Enterobacteriaceae , especially in Klebsiella pneumoniae . The main objectives of this study were to genetically characterize urinary clinical isolates of K. pneumoniae through the investigating of blaTEM , blaCTX-M and using molecular typing by Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) method. We also determined the frequency of antibiotic resistance of K...
2018: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29456940/mrmc-neo-surgical-ventilating-port-and-neo-attic-malleo-incudal-complex-in-endoscopic-management-of-limited-attico-antral-cholesteatoma
#19
C B Nandyal, Mithun Sutrave, Vinayak Kurle, Pallavi A Harsoor
To study functional outcome of the endoscopic management of limited attico-antral cholesteatoma in terms of visualization of sac, cholesteatoma disease clearance, ABG closure improvement, preservation of residual anatomy and recurrence of disease. It is a prospective study done during Feb 2016 to March 2017 done on 20 pts with limited attico-antral cholesteatoma with CT confirmation. Endoscopic management of limited attico-antral cholesteatoma with complete removal of sac, infected discharge and granulations along with creation of MRMC Neo surgical ventilating port (joining Anterior & posterior isthmuses) done in cases where residual attic anatomy was present to establish physiological attic ventilation and drainage...
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29456870/a-psychosocial-intervention-for-the-management-of-functional-dysphonia-complex-intervention-development-and-pilot-randomised-trial
#20
Vincent Deary, Elaine McColl, Paul Carding, Tracy Miller, Janet Wilson
Background: Medically unexplained loss or alteration of voice-functional dysphonia-is the commonest presentation to speech and language therapists (SLTs). Besides the impact on personal and work life, functional dysphonia is also associated with increased levels of anxiety and depression and poor general health. Voice therapy delivered by SLTs improves voice but not these associated symptoms. The aims of this research were the systematic development of a complex intervention to improve the treatment of functional dysphonia, and the trialling of this intervention for feasibility and acceptability to SLTs and patients in a randomised pilot study...
2018: Pilot and Feasibility Studies
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