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Operational medicine

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https://www.readbyqxmd.com/read/29349997/-surgical-outcome-of-percutaneous-endoscopic-technique-for-highly-migrated-disc-herniation-via-three-different-approaches
#1
Yi Jiang, Ru-Jun Zuo, Lei Wu, Cheng Huang, Yan Shi, Hua-Wei Song, Yi-Wei Wang, Bin Li
OBJECTIVE: To analyze the clinical effects of percutaneous endoscopic technique via three different approaches for highly migrated lumbar disc herniation. METHODS: The clinical data of 68 patients underwent percutaneous endoscopic technique from June 2011 to June 2014 were retrospectively analyzed. There were 43 males and 25 females, aged from 11 to 77 years old with an average of (42.29±15.92) years. The patients were divided into three groups according to different operative approaches, of them, 45 cases were by transforaminal approach (group A), 15 cases by translaminar approach (group B), and 8 cases by transpedicular approach (group C)...
February 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29349986/-observation-of-curative-effects-of-musculoskeletal-ultrasound-guided-needle-knife-on-the-degenerative-meniscus-disease
#2
Zong-Ting Shi, Qing-Fu Wang, Dong Yu, Yi Zhang, Xiao-Xia Yang, Heng-Ping Liu, Qing-Feng Zhang
OBJECTIVE: To observe the curative effect of musculoskeletal ultrasound-guided needle-knife on the degenerative meniscus disease, and to provide a new method in the treatment of degenerative meniscus disease. METHODS: Seventy-seven patients with degenerative meniscus disease treated in the Third Affiliated Hospital of Beijing University of Chinese Medicine from January 2015 to September 2015 were selected, including 30 males and 47 females, aged from 44 to 66 years old, with an average of 57...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29349584/-percutaneous-endoscopic-gastrostomy-in-geriatrics-indications-technique-and-complications
#3
Rainer Wirth
The technique of percutaneous endoscopic gastrostomy (PEG) was introduced in 1979 as a semi-invasive approach for children with the need for a gastric fistula in order to avoid an operative intervention. The suture pull-through method was rapidly established and is now omnipresent. Because scientific evidence is broadly missing, there is some uncertainty about the indications in geriatric medicine. Guidelines do not recommend the insertion of a PEG in patients with severe dementia and malnutrition. Tube feeding is mainly recommended as a temporary method for patients who cannot take oral nutrition for more than 3 days or for whom the energy intake for more than 10 days presumably covers less than 50% of their needs, assuming that the overall prognosis is reasonable...
January 18, 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29346209/the-society-of-thoracic-surgeons-the-society-of-cardiovascular-anesthesiologists-and-the-american-society-of-extracorporeal-technology-clinical-practice-guidelines-anticoagulation-during-cardiopulmonary-bypass
#4
Linda Shore-Lesserson, Robert A Baker, Victor A Ferraris, Philip E Greilich, David Fitzgerald, Philip Roman, John W Hammon
Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29344990/self-gated-golden-angle-spiral-4d-flow-mri
#5
Rene Bastkowski, Kilian Weiss, David Maintz, Daniel Giese
PURPOSE: The acquisition of 4D flow magnetic resonance imaging (MRI) in cardiovascular applications has recently made large progress toward clinical feasibility. The need for simultaneous compensation of cardiac and breathing motion still poses a challenge for widespread clinical use. Especially, breathing motion, addressed by gating approaches, can lead to unpredictable and long scan times. The current work proposes a time-efficient self-gated 4D flow sequence that exploits up to 100% of the acquired data and operates at a predictable scan time...
January 17, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29343626/engineering-precision-biomaterials-for-personalized-medicine
#6
REVIEW
Brian A Aguado, Joseph C Grim, Adrianne M Rosales, Jana J Watson-Capps, Kristi S Anseth
As the demand for precision medicine continues to rise, the "one-size-fits-all" approach to designing medical devices and therapies is becoming increasingly outdated. Biomaterials have considerable potential for transforming precision medicine, but individual patient complexity often necessitates integrating multiple functions into a single device to successfully tailor personalized therapies. Here, we introduce an engineering strategy based on unit operations to provide a unified vocabulary and contextual framework to aid the design of biomaterial-based devices and accelerate their translation...
January 17, 2018: Science Translational Medicine
https://www.readbyqxmd.com/read/29341963/role-of-the-anesthesiologist-intensivist-outside-the-icu-opportunity-to-add-value-for-the-hospital-or-an-unnecessary-distraction
#7
Suzanne Bennett, Erin Grawe, Courtney Jones, Sean A Josephs, Maggie Mechlin, William E Hurford
PURPOSE OF REVIEW: Given the extremely expensive nature of critical care medicine, it seems logical that intensivists should play an active role in designing efficient systems of care. The true value of intensivists, however, is not well defined. RECENT FINDINGS: Anesthesiologists have taken key roles in improving patient safety in the operating room. Anesthesia-related mortality rates have decreased from 20 deaths per 100 000 anesthetics in the early 1980s to less than one death per 100 000 currently...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29341944/nuclear-medicine-methods-for-evaluation-of-abnormal-parathyroid-glands-in-patients-with-primary-and-secondary-hyperparathyroidism
#8
Albena D Botushanova, Nikolay P Botushanov, Marianna P Yaneva
Considered rare disease in the past, primary hyperparathyroidism (PHPT) has dramatically increased in incidence over the past thirty years with the introduction of routine calcium measurements; it is now approximately 42 per 100 000 persons. By far, the most common lesion found in patients with PHPT is the solitary parathyroid adenoma, occurring in 85%-90% of patients, while in the rest 10%- 15% primary hyperplasia of the parathyroid glands is present. Currently, the most widely used surgical approach is minimally invasive parathyroidectomy which is associated with less post-surgery complications and shorter operation time...
December 20, 2017: Folia Medica
https://www.readbyqxmd.com/read/29340750/a-pilot-study-evaluating-the-efficacy-and-safety-of-artiss-human-fibrin-sealant-in-external-rhinoplasty
#9
Steven H Dayan, Jonathan T Bacos, Thuy-Van Ho, Nimit Gandhi, Selika Gutierrez-Borst
BACKGROUND: Fibrin sealant application in rhytidectomy has previously demonstrated a reduction in adverse events and drainage volume. Fibrin sealant offers multiple potential benefits including decreasing downtime, reducing complication rates, and improving patient satisfaction. In this study, we evaluated the efficacy and safety of ARTISS [fibrin sealant (human)] in external rhinoplasty. METHODS: Nine healthy participants between the ages of 18 and 50 seeking external rhinoplasty completed this study...
January 16, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29340321/randomized-clinical-trial-design-to-assess-abatacept-in-resistant-nephrotic-syndrome
#10
Howard Trachtman, Debbie S Gipson, Michael Somers, Cathie Spino, Sharon Adler, Lawrence Holzman, Jeffrey B Kopp, John Sedor, Sandra Overfield, Ayanbola Elegbe, Michael Maldonado, Anna Greka
Introduction: Treatment-resistant nephrotic syndrome is a rare form of glomerular disease that occurs in children and adults. No Food and Drug Administration-approved treatments consistently achieve remission of proteinuria and preservation of kidney function. CD80 (B7-1) can be expressed on injured podocytes, and administration of abatacept (modified CTLA4-Ig based on a natural ligand to CD80) has been associated with sustained normalization of urinary protein excretion and maintenance of glomerular filtration rate in experimental and clinical settings...
January 2018: KI Reports
https://www.readbyqxmd.com/read/29337447/-geriatric-medicine
#11
Gabriel Gold, Christophe Büla, Pierre Olivier Lang, Philippe Chassagne
2017 highlights benefits of prevention. Better control of cardiovascular risk reduces the incidence of dementia and monthly high-dose vitamin D the incidence of respiratory infections in nursing home. Pre-operative geriatric assessment lowers by 20% the rate of delirium after hip-fracture surgery and complications in vascular surgery. Deleterious effects are also reported. High-dose vitamin D triples the rate of falls in supplemented residents and doesn't improve gait speed in sedentary men. Widely used in cardiovascular prevention, antithrombotic therapy is associated with an astonishing risk of subdural bleeding that further increases with the number of drugs combined together...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29333119/phytotherapeutics-oridonin-and-ponicidin-show-additive-effects-combined-with-irradiation-in-pancreatic-cancer-in-vitro
#12
Jakob Liermann, Patrick Naumann, Franco Fortunato, Thomas E Schmid, Klaus-Josef Weber, Jürgen Debus, Stephanie E Combs
Background: Chemoradiation of locally advanced non-metastatic pancreatic cancer can lead to secondary operability by tumor mass reduction. Here, we analyzed radiomodulating effects of oridonin and ponicidin in pancreatic cancer in vitro. Both agents are ent-kaurane diterpenoids, extracted from Isodon rubescens, a plant that is well known in Traditional Chinese Medicine. Cytotoxic effects have recently been shown in different tumor entities for both agents. Materials and methods: Pancreatic cancer cell lines AsPC-1, BxPC-3, Panc-1 and MIA PaCa-2 were pretreated with oridonin or ponicidin and irradiated with 2 Gy to 6 Gy...
December 2017: Radiology and Oncology
https://www.readbyqxmd.com/read/29331519/understanding-and-misunderstanding-randomized-controlled-trials
#13
Angus Deaton, Nancy Cartwright
Randomized Controlled Trials (RCTs) are increasingly popular in the social sciences, not only in medicine. We argue that the lay public, and sometimes researchers, put too much trust in RCTs over other methods of investigation. Contrary to frequent claims in the applied literature, randomization does not equalize everything other than the treatment in the treatment and control groups, it does not automatically deliver a precise estimate of the average treatment effect (ATE), and it does not relieve us of the need to think about (observed or unobserved) covariates...
December 25, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29331040/jun-gal-cd74-and-c1qb-as-potential-indicator-for-neuropathic-pain
#14
Ji-An Yang, Jun-Min He, Jing-Min Lu, Li-Juan Ji
Neuropathic pain is a kind of pain caused by primary or secondary impairment or dysfunction of peripheral or central nervous system. Patients with neuropathic pain were often with poor clinical outcome. We screened the differentially expressed genes between sciatic nerve injury and dorsal root ganglion gene in the sham operation model. Microarray and the spared nerve injury module were used to explore the molecular mechanism of neuropathic pain by injuries and the differentially expressed genes (DEGs) were identified out...
January 13, 2018: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#15
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29330239/one-year-of-family-physicians-observations-on-working-with-medical-scribes
#16
Amelia Sattler, Tracy Rydel, Cathina Nguyen, Steven Lin
PURPOSE: The immense clerical burden felt by physicians is one of the leading causes of burnout. Scribes are increasingly being used to help alleviate this burden, yet few published studies investigate how scribes affect physicians' daily work, attitudes and behaviors, and relationships with patients and the workplace. METHODS: Using a longitudinal observational design, data were collected, over 1 year, from 4 physicians working with 2 scribes at a single academic family medicine practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329471/diagnosing-meniscal-pathology-and-understanding-how-to-evaluate-a-postoperative-meniscus-based-on-the-operative-procedure
#17
Monica Tafur, Linda Probyn, Jaskarndip Chahal, Lawrence M White
Magnetic resonance imaging (MRI) represents the preferred noninvasive imaging technique to diagnose meniscal pathology in the pre- and postoperative setting. Furthermore, characterization of meniscal tissue MR properties has been possible by the development of advanced MRI techniques. Suspected meniscal tears are a frequent indication for MRI and the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification system has been developed to facilitate accurate and uniform reporting of such meniscal tears...
January 12, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29328927/alzheimer-s-disease-biomarker-guided-diagnostic-workflow-using-the-added-value-of-six-combined-cerebrospinal-fluid-candidates-a%C3%AE-1-42-total-tau-phosphorylated-tau-nfl-neurogranin-and-ykl-40
#18
Harald Hampel, Nicola Toschi, Filippo Baldacci, Henrik Zetterberg, Kaj Blennow, Ingo Kilimann, Stefan J Teipel, Enrica Cavedo, Antonio Melo Dos Santos, Stéphane Epelbaum, Foudil Lamari, Remy Genthon, Bruno Dubois, Roberto Floris, Francesco Garaci, Simone Lista
INTRODUCTION: The diagnostic and classificatory performances of all combinations of three core (amyloid β peptide [i.e., Aβ1-42], total tau [t-tau], and phosphorylated tau) and three novel (neurofilament light chain protein, neurogranin, and YKL-40) cerebrospinal fluid biomarkers of neurodegeneration were compared among individuals with mild cognitive impairment (n = 41), Alzheimer's disease dementia (ADD; n = 35), frontotemporal dementia (FTD; n = 9), and cognitively healthy controls (HC; n = 21), using 10-fold cross-validation...
January 9, 2018: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/29326331/predicting-response-to-oxygen-therapy-in-obstructive-sleep-apnoea-patients-using-a-10-minute-daytime-test
#19
David Wang, Keith K Wong, Luke Rowsell, Garrick W Don, Brendon J Yee, Ronald R Grunstein
There is no satisfactory treatment for obstructive sleep apnoea (OSA). Supplemental low-flow oxygen therapy (LFO2) has been shown to reduce hypoxaemia and is well tolerated by patients with OSA. However, oxygen therapy may be beneficial only to certain subsets of patients with OSA. In this study, we evaluated a 10-min awake ventilatory chemoreflex test in predicting individual OSA response to 2 months of LFO2 therapy.At baseline, patients with OSA underwent ventilatory chemoreflex testing in the afternoon, prior to the overnight polysomnography...
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29325707/successful-creation-of-pancreatic-cancer-organoids-by-means-of-eus-guided-fine-needle-biopsy-for-personalized-cancer-treatment
#20
Herve Tiriac, Juan Carlos Bucobo, Demetrios Tzimas, Suman Grewel, Joseph F Lacomb, Leahana M Rowehl, Satish Nagula, Maoxin Wu, Joseph Kim, Aaron Sasson, Shivakumar Vignesh, Laura Martello, Maria Munoz-Sagastibelza, Jonathan Somma, David A Tuveson, Ellen Li, Jonathan M Buscaglia
BACKGROUND AND AIMS: Pancreatic cancer organoids are tumor models of individualized human pancreatic ductal adenocarcinoma (PDA), created from surgical specimens and used for personalized treatment strategies. Unfortunately the vast majority of patients with PDA are not operative candidates. Creation of human PDA organoids at the time of initial tumor diagnosis is therefore critical. Our aim was to assess the feasibility of creating human PDA organoids by EUS fine-needle biopsy (EUS-FNB) in patients with PDA...
January 8, 2018: Gastrointestinal Endoscopy
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