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https://www.readbyqxmd.com/read/28437795/effect-of-using-the-heart-score-in-patients-with-chest-pain-in-the-emergency-department-a-stepped-wedge-cluster-randomized-trial
#1
Judith M Poldervaart, Johannes B Reitsma, Barbra E Backus, Hendrik Koffijberg, Rolf F Veldkamp, Monique E Ten Haaf, Yolande Appelman, Herman F J Mannaerts, Jan-Melle van Dantzig, Madelon van den Heuvel, Mohamed El Farissi, Bernard J W M Rensing, Nicolette M S K J Ernst, Ineke M C Dekker, Frank R den Hartog, Thomas Oosterhof, Ghizelda R Lagerweij, Eugene M Buijs, Maarten W J van Hessen, Marcel A J Landman, Roland R J van Kimmenade, Luc Cozijnsen, Jeroen J J Bucx, Clara E E van Ofwegen-Hanekamp, Maarten-Jan Cramer, A Jacob Six, Pieter A Doevendans, Arno W Hoes
Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Design: Stepped-wedge, cluster randomized trial...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28437679/nodal-recurrence-after-stereotactic-body-radiotherapy-for-early-stage-non-small-cell-lung-cancer-incidence-and-proposed-risk-factors
#2
REVIEW
Krista C J Wink, Angela van Baardwijk, Esther G C Troost, Dirk De Ruysscher
Stereotactic body radiotherapy (SBRT) is an alternative to surgery for patients with early stage non-small cell lung cancer (NSCLC) who are inoperable due to comorbid disease or who refuse surgery. SBRT results in an excellent local control rate of more than 90%, which is comparable to surgery, while short and long-term overall toxicity is low. Surgically treated patients are often more extensively staged pre-operatively, e.g. with endobronchial ultrasound and/or mediastinoscopy, and typically undergo intra-operative lymph node dissection or sampling...
April 12, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#3
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28437582/modified-frailty-index-predicts-postoperative-outcomes-in-older-gastrointestinal-cancer-patients
#4
Sarah A Vermillion, Fang-Chi Hsu, Robert D Dorrell, Perry Shen, Clancy J Clark
BACKGROUND AND OBJECTIVES: Frailty disproportionately impacts older patients with gastrointestinal cancer, rendering them at increased risk for poor outcomes. A frailty index may aid in preoperative risk stratification. We hypothesized that high modified frailty index (mFI) scores are associated with adverse outcomes after tumor resection in older, gastrointestinal cancer patients. METHODS: Patients (60-90 years old) who underwent gastrointestinal tumor resection were identified in the 2005-2012 NSQIP Participant Use File...
April 24, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28437562/no-post-copulatory-selection-against-mhc-homozygous-offspring-evidence-from-a-pedigreed-captive-rhesus-macaque-colony
#5
E H M Sterck, R E Bontrop, N de Groot, A J M de Vos-Rouweler, G G M Doxiadis
The heterozygosity status of polymorphic elements of the immune system, such as the Major Histocompatability Complex (MHC), are known to increase the potential to cope with a wider variety of pathogens. Pre- and post-copulatory processes may regulate MHC heterozygosity. In a population where mating occurs among individuals that share identical MHC-haplotypes, post-copulatory selection may disfavour homozygous offspring or ones with two MHC-haplotypes identical to its mother. We tested these ideas by determining the incidence of MHC-heterozygous and MHC-homozygous individuals in a pedigreed, partially consanguineous captive rhesus monkey colony...
April 24, 2017: Molecular Ecology
https://www.readbyqxmd.com/read/28437336/both-bilateral-breast-volume-discrepancy-and-asymmetric-anterior-chest-wall-shape-contribute-to-the-unsightly-breast-contour-in-female-right-thoracic-idiopathic-scoliosis
#6
Benlong Shi, Saihu Mao, Xu Sun, Leilei Xu, Feng Zhu, Zezhang Zhu, Bangping Qian, Weijun Wang, Yong Qiu
STUDY DESIGN: A retrospective radiographic study. OBJECTIVE: To evaluate the asymmetry of breast volume (BV) and shape in female adolescent idiopathic scoliosis (AIS) patients and to define their relationship with deformed components of the anterior chest wall and curved spine. SUMMARY OF BACKGROUND DATA: The higher incidence of asymmetric breast development in AIS was described by prior studies. However, the interplay between scoliosis curve magnitude and severity of breast asymmetry (BA) are unknown...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28437260/early-postoperative-neuropathic-pain-assessed-by-the-dn4-score-predicts-an-increased-risk-of-persistent-postsurgical-neuropathic-pain
#7
Helene Beloeil, Barthelemy Sion, Chloe Rousseau, Pierre Albaladejo, Mathieu Raux, Frederic Aubrun, Valeria Martinez
BACKGROUND: Acute neuropathic pain can occur in the postoperative period but any link with persistent post-surgical neuropathic pain remains unclear. OBJECTIVES: The objectives of this study were to prospectively describe the incidence of acute post-surgical neuropathic pain in a large population using the DN4 (clinician administered) questionnaire and to confirm the hypothetical link between acute and persistent neuropathic pain at 2 months after surgery in a large population using the DN2 (self administered) questionnaire...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28436728/trends-in-the-risk-of-early-and-late-onset-heart-failure-as-an-adverse-outcome-of-acute-myocardial-infarction-a-cardiovascular-disease-in-norway-project
#8
Gerhard Sulo, Jannicke Igland, Ottar Nygård, Stein E Vollset, Marta Ebbing, Charlotte Cerqueira, Grace M Egeland, Torben Jørgensen, Grethe S Tell
Aims Heart failure is a serious complication of acute myocardial infarction, leading to a poor prognosis. We explored trends in the risk of heart failure among patients hospitalised with an incident acute myocardial infarction in Norway during 2001-2009. Methods and results A total of 69,372 patients were followed for an episode of heart failure occurring either during (early-onset heart failure) or within one year of discharge from the incident acute myocardial infarction hospitalisation (late-onset heart failure)...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28436465/the-clinical-efficacy-of-fibrinogen-concentrate-in-massive-obstetric-haemorrhage-with-hypofibrinogenaemia
#9
Shigetaka Matsunaga, Yasushi Takai, Eishin Nakamura, Sumiko Era, Yoshihisa Ono, Koji Yamamoto, Hiroo Maeda, Hiroyuki Seki
Massive obstetric haemorrhage remains a major cause of maternal death attributable to hypofibrinogenaemia. Transfusion of large volumes of fresh frozen plasma (FFP) is required to normalise fibrinogen levels. We compared the efficacy of FFP (F group) with that of FFP plus fibrinogen concentrate (F + F group) in massive obstetric haemorrhage. In this retrospective study, we compared the medical charts (2004-2016) of 137 patients with <150 mg/dl fibrinogen treated with F + F (n = 47; after August 2009) or F (n = 56; before August 2009)...
April 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28436394/sarcomere-dysfunction-in-nemaline-myopathy
#10
Josine M de Winter, Coen A C Ottenheijm
Nemaline myopathy (NM) is among the most common non-dystrophic congenital myopathies (incidence 1:50.000). Hallmark features of NM are skeletal muscle weakness and the presence of nemaline bodies in the muscle fiber. The clinical phenotype of NM patients is quite diverse, ranging from neonatal death to normal lifespan with almost normal motor function. As the respiratory muscles are involved as well, severely affected patients are ventilator-dependent. The mechanisms underlying muscle weakness in NM are currently poorly understood...
April 19, 2017: Journal of Neuromuscular Diseases
https://www.readbyqxmd.com/read/28436357/prostate-cancer-detection-following-diagnosis-of-atypical-small-acinar-proliferation
#11
Kyle J Ericson, Hannah C Wenger, Alexandre M Rosen, Kyle J Kiriluk, Glenn S Gerber, Gladell P Paner, Scott E Eggener
INTRODUCTION: To report the incidence and characteristics of cancer following a diagnosis of atypical small acinar proliferation (ASAP) and comment on current clinical practice recommendations. MATERIALS AND METHODS: We reviewed patients that underwent prostate biopsy between 2008 and 2013 at a single institution. Men with ASAP without previous cancer were included. Clinicopathologic features including prostate-specific antigen (PSA), presence of ASAP or cancer, tumor volume, number of involved cores, and Gleason score were analyzed in men that received a repeat prostate biopsy...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28436214/a-comparison-of-the-cost-of-primary-closure-or-rectus-abdominis-myocutaneous-flap-closure-of-the-perineum-after-abdominoperineal-excision
#12
John Woodfield, Michael Hulme-Moir, Jasen Ly
AIM: Perineal wound complications following abdominoperineal resection continue to be a major challenge.. The aim of this study was to compare the clinical outcomes and cost of primary closure (PC) and rectus abdominis myocutaneous flap reconstruction (RAM). METHOD: Retrospective case review of consecutive patients by one surgeon over 11 years. Patient demographics, risk factors, operative details and complications were identified. Inpatient and outpatient costs were calculated...
April 24, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28435915/impact-of-surgical-approach-on-complication-rates-after-elective-spinal-fusion-%C3%A2-3-levels-for-adult-spine-deformity
#13
Aladine A Elsamadicy, Owoicho Adogwa, Shay Behrens, Amanda Sergesketter, Angel Chen, Ankit I Mehta, Raul A Vasquez, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
BACKGROUND: While there are variations in techniques and surgical approaches to spinal fusion, there is not a defined consensus on a recommended surgical approach. The aim of this study is to determine if there was a difference in intra- and post-operative complication rates between different surgical approaches after elective spinal fusion (≥3 levels) for adult spine deformity. METHODS: The medical records of 443 adult spine deformity patients undergoing elective spinal fusion (≥3) at a major academic institution from 2005 to 2015 were reviewed...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28435401/head-and-neck-lymphomas-a-retrospective-ten-year-observation
#14
Marcelina Niemiec, Grażyna Stryjewska-Makuch, Małgorzata Janik, Bogdan Kolebacz, Grażyna Lisowska, Wojciech Ścierski
AIM OF THE STUDY: Lymphomas are a heterogeneous group of tumours of lymphoid tissue in which there is an abnormal proliferation of cells of the lymphatic system. The literature notes a gradual increase in the incidence of this type of cancer in the whole population. The aim of the study was to evaluate whether the above tendency occurs in the head and neck area. MATERIAL AND METHODS: In the years 2005-2014, at the Otolaryngology and Laryngological Oncology Department of the Upper Silesian Medical Centre in Katowice, 77 cases of lymphoma were recorded, 58 of which were analysed in terms of location, histological type, age and sex of the patient, and the presence of risk factors...
2017: Contemporary Oncology Współczesna Onkologia
https://www.readbyqxmd.com/read/28435326/the-association-between-thyroid-disorders-and-incident-gout-population-based-case-control-study
#15
Saskia G Bruderer, Christoph R Meier, Susan S Jick, Michael Bodmer
CONTEXT: Thyroid hormones influence kidney function and thereby might alter serum urate levels, a major risk factor for gouty arthritis. OBJECTIVE: To assess the risk of developing incident gout in association with hypothyroidism or hyperthyroidism. DESIGN: Retrospective population-based case-control analysis. SETTING: UK-based Clinical Practice Research Datalink, a primary care research database. PATIENTS: We identified adult patients with a diagnosis of incident gout between 1990 and 2014...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28435222/effects-of-intrathecal-dexmedetomidine-on-shivering-after-spinal-anesthesia-for-cesarean-section-a-double-blind-randomized-clinical-trial
#16
Karim Nasseri, Negin Ghadami, Bijan Nouri
BACKGROUND: Shivering is among the common troublesome complications of spinal anesthesia (SA), and causes discomfort and discontentment in parturients undergoing cesarean sections (CSs). The aim of this study was to investigate the effects of intrathecal dexmedetomidine in the prevention of shivering in those who underwent CS under SA. SUBJECTS AND METHODS: Fifty parturients planned for elective CSs under SA were enrolled in this prospective, double-blinded, controlled study and randomly divided into two equal groups...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28434744/a-prospective-cohort-study-of-digital-cushion-and-corium-thickness-part-1-associations-with-body-condition-lesion-incidence-and-proximity-to-calving
#17
R F Newsome, M J Green, N J Bell, N J Bollard, C S Mason, H R Whay, J N Huxley
Claw horn disruption lesions (CHDL) are a major cause of lameness in dairy cattle and are likely a result of excessive forces being applied to the germinal epithelium that produces the claw horn. The digital cushion is a connective tissue structure, containing depots of adipose tissue, that sits beneath the distal phalanx and has been shown to be thicker in fatter cows. Body condition score (BCS) loss is a risk factor for CHDL, and one possible explanation is that fat is mobilized from the digital cushion during negative energy balance, causing the digital cushion to thin and lose force-dissipating capacity, leading to disruption of claw horn growth...
April 20, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28434700/incidence-etiology-and-management-of-type-iii-endoleak-after-endovascular-aortic-repair
#18
Geert Maleux, Lien Poorteman, Annouschka Laenen, Bertrand Saint-Lèbes, Sabrina Houthoofd, Inge Fourneau, Hervé Rousseau
OBJECTIVE: The objective of this study was to retrospectively assess the incidence, etiology, and management of type III endoleaks in a large cohort of patients treated with endovascular aneurysm repair (EVAR) in two European university centers. METHODS: From 1995 until 2014, 965 EVAR procedures were performed with use of first- and second-generation (n = 79) or third-generation (n = 886) endografts. Radiologic follow-up was performed with computed tomography and abdominal plain film examinations in accordance with the European Collaborators on Stent/graft Techniques for aortic Aneurysm Repair (EUROSTAR) scheme...
April 20, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28434582/effectiveness-between-early-and-late-temporary-ileostomy-closure-in-patients-with-rectal-cancer-a-prospective-study
#19
Li Zhen, Yanan Wang, Ze Zhang, Tongwei Wu, Ruoyan Liu, Tingting Li, Liying Zhao, Haijun Deng, Xiaolong Qi, Guoxin Li
A temporary stoma is often used in rectal cancer surgery to protect a distal anastomosis, which remains a major concern after rectal cancer surgery, particularly after low anterior resection. The temporary stoma is scheduled for closure. However, the optimal time of closure of the protecting stoma remains unclear because of sparse studies and data. We aimed to detect the efficacy between early and late temporary ileostomy closure in patients with rectal cancer during or after neoadjuvant chemoradiotherapy. We conducted a prospective, 2-group design between early and late ileostomy closure group in patients after rectal cancer surgery with temporary stoma...
March 2, 2017: Current Problems in Cancer
https://www.readbyqxmd.com/read/28434558/resistance-profiles-and-risk-factors-of-resistant-microorganisms-in-bacteraemia-of-abdominal-origin
#20
J Martín Jaramago, R Armero Ibáñez, J J Camarena Miñana, M Morales Suárez-Varela
OBJECTIVE: The presence of resistant microorganisms is a major cause of failure in initial empirical antimicrobial therapy. The objectives of this study are to determine the resistance profile of microorganisms that cause bacteraemia of abdominal origin and to identify whether the previous use of antibiotics and the place of acquisition of bacteraemia are risk factors associated with the presence of resistant organisms. MATERIAL AND METHODS: A clinical, observational, epidemiological, retrospective cohort study was conducted with all the adult patients admitted to a university hospital from 2011-2013...
April 20, 2017: Revista Española de Anestesiología y Reanimación
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