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https://www.readbyqxmd.com/read/28805361/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the-long-term-care-hospital-prospective-payment-system-and-policy-changes-and-fiscal-year-2018-rates-quality-reporting-requirements-for-specific-providers-medicare
#1
(no author information available yet)
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation...
August 14, 2017: Federal Register
https://www.readbyqxmd.com/read/28802955/hysterscopic-resection-of-premalignant-and-malignant-endometrial-polyps-is-it-a-safe-alternative-to-hysterectomy
#2
Osnat Elyashiv, Ron Sagiv, Ram Kerner, Ran Keidar, Joseph Menczer, Tally Levy
STUDY OBJECTIVE: The standard treatment of endometrial cancer (EC) and complex atypical hyperplasia (CAH) is hysterectomy with or without adnexectomy. In the last decade, several centers have attempted to perform hysteroscopic resection of malignant and pre-malignant polyps as an alternative to hysterectomy. In the present study, we evaluated the safety of this procedure in regard to residual uterine pathology. DESIGN: Retrospective chart review DESIGN CLASSIFICATION: Canadian Task Force classification II-2 SETTING: University hospital PATIENTS: 1766 women who underwent hysteroscopic polypectomy during the years 1998-2016 MEASUREMENTS: Patients with CAH and endometrioid type EC in the removed polyps who underwent hysterectomy were included in the study...
August 9, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28797817/biodegradable-poly-lactic-acid-cellulose-nanocrystals-cncs-composite-microcellular-foam-effect-of-nanofillers-on-foam-cellular-morphology-thermal-and-wettability-behavior
#3
Shasanka Sekhar Borkotoky, Prodyut Dhar, Vimal Katiyar
This article addresses the elegant and green approach for fabrication of bio-based poly (lactic acid) (PLA)/cellulose nanocrystal (CNCs) bionanocomposite foam (PLA/CNC) with cellular morphology and hydrophobic surface behavior. Highly porous (porosity >80%) structure is obtained with interconnected pores and the effect of CNCs in the cell density (Nf) and cell size of foams are thoroughly investigated by morphological analysis. The thermo-mechanical investigations are performed for the foam samples and almost ∼1...
August 7, 2017: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/28777882/calcium-hydride-cation-cah-stabilized-by-an-nnnn-type-macrocyclic-ligand-selective-catalyst-for-olefin-hydrogenation
#4
Jun Okuda, Thomas Spaniol, Danny Schuhknecht, Carolin Lhotzky, Laurent Maron
Reaction of dibenzyl calcium complex [Ca(Me4TACD)¬(CH2Ph)2], containing the neutral NNNN-type macrocyclic ligand Me4TACD (Me4TACD = 1,3,5,7-tetramethyl-1,3,5,7-tetraazacyclododecane), with triphenylsilane gave the cationic dinuclear calcium hydride [Ca2H2(Me4TACD)2](PhCHSiPh3)2 which was characterized by NMR spectroscopy and single crystal XRD. The cation can be regarded as the ligand-stabilized dimeric form of hypothetical [CaH]+. Hydrogenolysis of benzyl calcium cation [Ca(Me4TACD)(CH2Ph)(thf)]+ gave dicationic calcium hydrides [Ca2H2(Me4TACD)2][BAr4]2 (Ar = C6H4-4-tBu; C6H3-3,5-Me2) containing weakly coordinating anions...
August 4, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/28774854/analysis-of-the-dehydration-process-of-caffeine-using-backscattering-and-transmission-raman-spectroscopy
#5
Rina Takeshima, Yusuke Hattori, Satoshi Managaki, Makoto Otsuka
In the present study, the dehydration process of caffeine hydrate (CAH) was investigated by calibrating the moisture content in the caffeine tablet using backscattering Raman spectroscopy (BRS) and transmission Raman spectroscopy (TRS). The detectable depth of BRS is limited by its shallow laser penetration, while TRS is a powerful tool to determine the content of active pharmaceutical ingredients in a tablet. Our results suggest that the accuracy of a TRS-based calibration model falls beyond that of a BRS-based model...
July 31, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28771930/parental-management-of-adrenal-crisis-in-children-with-congenital-adrenal-hyperplasia
#6
Louise Fleming, Kathleen Knafl, George Knafl, Marcia Van Riper
PURPOSE: Congenital adrenal hyperplasia (CAH) requires parents to inject their child with hydrocortisone intramuscularly during times of illness and adrenal crisis. The purpose of this study was to describe circumstances surrounding adrenal crisis events in children with CAH; to explore parents' perceptions of the consequences of having a child with a life-threatening condition; and to examine a relationship between parents' perceived management ability and the impact CAH has on the family...
August 3, 2017: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/28771762/cognitive-impairment-in-adolescents-and-adults-with-congenital-adrenal-hyperplasia
#7
Leif Karlsson, Anton Gezelius, Anna Nordenström, Tatja Hirvikoski, Svetlana Lajic
OBJECTIVE: Impaired cognition has been reported in patients with congenital adrenal hyperplasia (CAH), although the findings have been conflicting. It has been hypothesized that the major causes of the deficits are prenatal hormonal imbalances and/or excessive glucocorticoid treatment. DESIGN, PATIENTS AND SETTING: This was an observational study comparing cognition in CAH patients (n=55) to control subjects from the general population (n=58), aged 16-33 years. Nine CAH subjects had been treated prenatally with dexamethasone...
August 3, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28759182/intima-media-thickness-of-common-carotids-and-abdominal-aorta-in-children-and-adolescents-with-congenital-adrenal-hyperplasia-due-to-21-hydroxylase-deficiency-in-relation-to-their-genotypes
#8
Dominika Janus, Malgorzata Wojcik, Katarzyna Tyrawa, Magdalena Janeczko, Mirosław Bik-Multanowski, Jerzy B Starzyk
BACKGROUND: Patients with congenital adrenal hyperplasia (CAH) are at risk of vascular and metabolic complications due to steroid therapy and increased adrenal androgens exposure. OBJECTIVE: of the study was to evaluate the relation between patient's genotype and (1) intima media thickness of abdominal aorta (AIMT) and common carotid arteries (CIMT) and (2) metabolic profile. MATERIAL AND METHODS: In 71 patients (27 boys) aged from 1.5 to 17...
July 2, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28731843/telemedicine-use-decreases-rural-emergency-department-length-of-stay-for-transferred-north-dakota-trauma-patients
#9
Nicholas M Mohr, J Priyanka Vakkalanka, Karisa K Harland, Amanda Bell, Brian Skow, Dan M Shane, Marcia M Ward
BACKGROUND: Telemedicine has been proposed as one strategy to improve local trauma care and decrease disparities between rural and urban trauma outcomes. OBJECTIVES: This study was conducted to describe the effect of telemedicine on management and clinical outcomes for trauma patients in North Dakota. METHODS: Cohort study of adult (age ≥18 years) trauma patients treated in North Dakota Critical Access Hospital (CAH) Emergency Departments (EDs) from 2008 to 2014...
July 21, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28720594/impact-of-transition-on-quality-of-life-in-patients-with-congenital-adrenal-hyperplasia-diagnosed-during-childhood
#10
Anne Bachelot, Magaly Vialon, Amandine Baptiste, Isabelle Tejedor, Caroline Elie, Michel Polak, Philippe Touraine
BACKGROUND: Health-related quality of life (QoL) in adult patients with congenital adrenal hyperplasia (CAH) has been variously reported. However, there is no study evaluating the impact of transition on quality of life. METHODS: Adult patients with classic or non-classic CAH diagnosed during childhood CAH, born between 1970 and 1990, were recruited from the registers of Pediatric departments belonging to the French reference center for endocrine rare disease. Primary end point was the quality of life (WHOQoL -BREF)...
July 18, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28710552/the-african-froghopper-ptyelus-flavescens-suborder-cicadomorpha-contains-two-novel-and-one-known-peptides-of-the-adipokinetic-hormone%C3%A2-akh-family-structure-function-and-comparison-with-aphid-akh-suborder-sternorrhyncha
#11
Gerd Gäde, Petr Šimek, Heather G Marco
The rationale of "green pesticides" in food security is to use information about endogenous hormones of pest insects to make peptide mimetics that will act against the pest insects to alter their behaviour or physiology, while taking care not to harm beneficial insects or other organisms in the food chain. Such "green" insecticides are designed thus, on the basis of neuropeptide ligand-receptor interaction and it is of paramount interest to have finally a mimetic at hand that is harmful only to pest insects...
July 14, 2017: Amino Acids
https://www.readbyqxmd.com/read/28644547/a-genetic-epidemiology-study-of-congenital-adrenal-hyperplasia-in-italy
#12
Alessandro Gialluisi, Soara Menabò, Lilia Baldazzi, Letizia Casula, Antonella Meloni, Maria Carla Farci, Stefano Mariotti, Luisa Balestrino, Rita Ortolano, Stefania Murru, Carlo Carcassi, Sandro Loche, Antonio Balsamo, Giovanni Romeo
Congenital Adrenal Hyperplasia due to 21-hydroxylase deficiency (21OHD-CAH) is an autosomal recessive disorder affecting steroidogenesis, due to mutations in CYP21A2 (6p21.3). 21OHD-CAH neonatal screening is based on 17-hydroxyprogesterone (17OHP) serum levels, showing high type I error rate and low sensitivity to mild CAH forms. Here, we used an epidemiological approach, which estimates the allelic frequency (q) of an autosomal recessive disorder using the proportion of homozygous patients, the mutational spectrum and the inbreeding coefficient in a sample of affected individuals...
June 23, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/28640966/linking-the-degree-of-virilization-in-females-with-congenital-adrenal-hyperplasia-to-genotype
#13
Semyon Gurgov, Kerlly J Bernabé, John Stites, Christopher M Cunniff, Karen Lin-Su, Diane Felsen, Maria I New, Dix P Poppas
Mutations of CYP21A2 variably decrease 21-hydroxylase activity and result in a spectrum of disease expressions in patients with congenital adrenal hyperplasia (CAH). We examined the association between CYP21A2 mutations and virilization (Prader score) in females with CAH. The study population included 187 CAH females with fully characterized CYP21A2 mutations. One hundred fifty-eight patients were sorted into groups by expected enzyme activity (percent of normal activity) of the less severely affected allele: (A) null, 0%; (B) I2G, 1%; (C) I172N, 2%; and (D) V281L, >2%...
June 22, 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28639595/prenatal-diagnosis-of-steroid-21-hydroxylase-deficient-congenital-adrenal-hyperplasia-experience-from-a-tertiary-care-centre-in-india
#14
Sudhisha Dubey, Veronique Tardy, Madhumita Roy Chowdhury, Neerja Gupta, Vandana Jain, Deepika Deka, Pankaj Sharma, Yves Morel, Madhulika Kabra
BACKGROUND & OBJECTIVES: Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder with a wide range of clinical manifestations. The disease is attributed to mutations in CYP21A2 gene encoding 21-hydroxylase enzyme. In view of severe phenotype in salt-losing cases, issues related to genital ambiguity in girls and precocity in boys, most families opt for prenatal testing and termination of affected foetus. CAH can be diagnosed in utero through direct molecular analysis of CYP21A2 gene, using DNA extracted from foetal tissues or cells obtained from chorionic villus sampling or amniocentesis...
February 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28638668/severe-short-stature-in-an-adolescent-male-with-prader-willi-syndrome-and-congenital-adrenal-hyperplasia-a-therapeutic-conundrum
#15
Meredith Wasserman, Erin M Mulvihill, Angela Ganan-Soto, Serife Uysal, Jose Bernardo Quintos
Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency results in excess androgen production which can lead to early epiphyseal fusion and short stature. Prader-Willi syndrome (PWS) is a genetic disorder resulting from a defect on chromosome 15 due to paternal deletion, maternal uniparental disomy, or imprinting defect. Ninety percent of patients with PWS have short stature. In this article we report a patient with simple-virilizing CAH and PWS who was overtreated with glucocorticoids for CAH and not supplemented with growth hormone for PWS, resulting in a significantly short adult height...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28637490/lipoid-congenital-adrenal-hyperplasia-by-steroidogenic-acute-regulatory-protein-star-gene-mutation-in-an-italian-infant-an-uncommon-cause-of-adrenal-insufficiency
#16
Carla Bizzarri, Elisa Pisaneschi, Mafalda Mucciolo, Stefania Pedicelli, Daniela Galeazzi, Antonio Novelli, Marco Cappa
BACKGROUND: Lipoid congenital adrenal hyperplasia (CAH) (OMIM n. 201710) is the most severe form of congenital adrenal hyperplasia. It is characterized by severe adrenal and gonadal steroidogenesis impairment due to a defect in the conversion of cholesterol to pregnenolone. Affected infants experience salt loss, but glucocorticoid and mineralocorticoid replacement therapy enables long-term survival. Classic lipoid congenital adrenal hyperplasia is relatively common in Japan and Korea but extremely rare in Caucasian populations...
June 20, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28617154/two-kidney-one-clip-is-a-pertinent-approach-to-integrate-arterial-hypertension-in-animal-models-of-stroke-serial-magnetic-resonance-imaging-studies-of-brain-lesions-before-and-during-cerebral-ischemia
#17
Benjamin Ménard, Laurent Chazalviel, Simon Roussel, Myriam Bernaudin, Omar Touzani
Although chronic arterial hypertension (CAH) represents the major comorbid factor in stroke, it is rarely integrated in preclinical studies of stroke. The majority of those investigations employ spontaneously hypertensive rats (SHR) which display a susceptibility to ischemic damage independent of hypertension. Here, we used a renovascular model of hypertension (RH) to examine, with magnetic resonance imaging (MRI), brain alterations during the development of hypertension and after brain ischemia. We also examined whether MRI-derived parameters predict the extent of ischemia-induced brain damage...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28613048/is-the-second-to-fourth-digit-ratio-2d-4d-a-biomarker-of-sex-steroids-activity
#18
Vincenzo de Sanctis, Ashraf T Soliman, Heba Elsedfy, Nada Soliman, Rania Elalaily, Salvatore Di Maio
The second-to-fourth digit ratio (2D:4D) has been used as an indirect method to investigate the putative effects of prenatal exposure to androgens, and has been reported to be smaller in males than in females. This gender difference in digit length ratios has been linked with the in utero balance of androgens to oestrogen. This sexual dimorphism in 2D:4D ratios is apparent by 2 years of age and seems to be established early in life, possibly by the 14th week of gestation. Digits in females attain their maximum length at about 2...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28609197/the-glu331del-mutation-in-the-cyp17a1-gene-causes-atypical-congenital-adrenal-hyperplasia-in-a-46-xx-female
#19
Giulia Lanzolla, Giuseppe Vancieri, Silvia Lanciotti, Federica Sangiuolo, Elisa Menegatti, Luca Federici, Costanzo Moretti, Francesco Brancati
17α-Hydroxylase deficiency is an uncommon type of congenital adrenal hyperplasia (CAH) caused by mutations in the CYP17A1 gene encoding both 17α-hydroxylase and 17,20-lyase, essential for sex steroids production. Main clinical features include lack of pubertal development, hypertension, and hypokalemia. We report the first case of a 46,XX female homozygote for the p.Glu331del mutation in the CYP17A1 gene showing an atypical clinical presentation. She was evaluated the first time for primary amenorrhea and delayed puberty in the presence of low levels of androgens, 17β-estradiol, serum cortisol, and high levels of progesterone and gonadotropins...
June 13, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28599884/comparing-single-site-and-multiport-robotic-hysterectomy-with-sentinel-lymph-node-mapping-for-endometrial-cancer-surgical-outcomes-and-cost-analysis
#20
Lea A Moukarzel, Abdulrahman K Sinno, Amanda N Fader, Edward J Tanner
STUDY OBJECTIVE: To compare operative times, surgical outcomes, and costs of robotic laparoendoscopic single-site (R-LESS) vs multiport robotic (MPR) total laparoscopic hysterectomy (TLH) with sentinel lymph node (SLN) mapping for low-risk endometrial cancer. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Academic university hospital. PATIENTS: Patients with a biopsy-proven diagnosis of complex atypical hyperplasia (CAH) or low-grade (1 or 2) endometrial cancer with body mass index <30 kg/m(2) and undergoing robotic TLH and SLN mapping between 2012 and 2016 were included...
June 7, 2017: Journal of Minimally Invasive Gynecology
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