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Operational medicine

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https://www.readbyqxmd.com/read/29149145/endoscopic-epidural-laser-decompression-versus-transforaminal-epiduroscopic-laser-annuloplasty-for-lumbar-disc-herniation-a-prospective-randomized-trial
#1
Chang Hong Park, Sang Ho Lee
BACKGROUND: Lumbar radicular pain often results from lumbar disc herniation, spinal stenosis, or degenerative spondylolisthesis. Minimally invasive disc decompression procedures, such as nucleo-annuloplasty or epiduroscopic neural decompression by laser, have been devised to treat such pain. OBJECTIVE: The short-term outcomes of disc decompression by endoscopic epidural laser decompression (EELD) or transforaminal epiduroscopic laser annuloplasty (TELA) were compared in patients with lumbar radicular pain due to disc herniation...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29146439/risk-stratification-after-paracetamol-overdose-using-mechanistic-biomarkers-results-from-two-prospective-cohort-studies
#2
James W Dear, Joanna I Clarke, Ben Francis, Lowri Allen, Jonathan Wraight, Jasmine Shen, Paul I Dargan, David Wood, Jamie Cooper, Simon H L Thomas, Andrea L Jorgensen, Munir Pirmohamed, B Kevin Park, Daniel J Antoine
BACKGROUND: Paracetamol overdose is common but patient stratification is suboptimal. We investigated the usefulness of new biomarkers that have either enhanced liver specificity (microRNA-122 [miR-122]) or provide mechanistic insights (keratin-18 [K18], high mobility group box-1 [HMGB1], and glutamate dehydrogenase [GLDH]). The use of these biomarkers could help stratify patients for their risk of liver injury at hospital presentation. METHODS: Using data from two prospective cohort studies, we assessed the potential for biomarkers to stratify patients who overdose with paracetamol...
November 13, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29145330/pathologic-femoral-fracture-due-to-tenofovir-induced-fanconi-syndrome-in-patient-with-chronic-hepatitis-b-a-case-report
#3
You-Sung Suh, Dong-Il Chun, Sung-Woo Choi, Hwan-Woong Lee, Jae-Hwi Nho, Soon-Hyo Kwon, Jae-Ho Cho, Sung Hun Won
RATIONALE: We report a case of a hepatitis B virus (HBV)-positive patient with preexisting bone disease who developed tenofovir-induced Fanconi syndrome and subsequently sustained pathologic fracture. To our best knowledge, this is the first report in the English literature about pathologic femoral fracture due to tenofovir-induced Fanconi syndrome in patient with chronic hepatitis B (CHB). The present report describes detailed our experience with the diagnosis of pathologic femoral fracture due to tenofovir-induced Fanconi syndrome and treatment...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29142543/career-choices-of-medical-doctors-at-graduate-level-a-multicenter-study
#4
Sadaf Zia, Maisam Abbas, Mehreen Sulaiman, Salman Matiullah Sheikh
Objective: To find out the specialty choices being taken by Final year Medical students and graduate Doctors. Method: This is a cross sectional survey study which was conducted over two months from 1(st) November to 31(st) December 2016. Final year students and house job doctors were asked for the filling of Performa, after filling the consent form. A self-developed, anonymous questionnaire was used to conduct the study using close ended type of questions. This was a multi-center study conducted at Dow International Medical College and Jinnah Medical and Dental College...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29142479/medication-beliefs-predict-medication-adherence-in-ambulatory-patients-with-decompensated-cirrhosis
#5
Kelly L Hayward, Patricia C Valery, Jennifer H Martin, Antara Karmakar, Preya J Patel, Leigh U Horsfall, Caroline J Tallis, Katherine A Stuart, Penny L Wright, David D Smith, Katharine M Irvine, Elizabeth E Powell, W Neil Cottrell
AIM: To investigate the impact of medication beliefs, illness perceptions and quality of life on medication adherence in people with decompensated cirrhosis. METHODS: One hundred adults with decompensated cirrhosis completed a structured questionnaire when they attended for routine outpatient hepatology review. Measures of self-reported medication adherence (Morisky Medication Adherence Scale), beliefs surrounding medications (Beliefs about Medicines Questionnaire), perceptions of illness and medicines (Brief Illness Perception Questionnaire), and quality of life (Chronic Liver Disease Questionnaire) were examined...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29142477/modified-model-for-end-stage-liver-disease-improves-short-term-prognosis-of-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#6
Wei Chen, Jia You, Jing Chen, Qi Zheng, Jia-Ji Jiang, Yue-Yong Zhu
AIM: To investigate whether the short-term prognosis of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) could be improved by using a modified model for end-stage liver disease (MELD) including serum lactate. METHODS: This clinical study was conducted at the First Affiliated Hospital, Fujian Medicine University, China. From 2009 to 2015, 236 patients diagnosed with HBV-related ACLF at our center were recruited for this 3-month follow-up study...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29142343/calculating-gamma-camera-uniformity-parameters-beyond-the-vendor-specific-protocol
#7
Anil Kumar Pandey, Param Dev Sharma, Jay Prakash Kumar, Kartik Saroha, Chetan Patel, Chandra Sekhar Bal, Rakesh Kumar
Objectives: The aim of this study was to develop and verify a personal computer-based software tool for calculating uniformity indices of gamma camera. Materials and Methods: The program was developed in MATLAB R2013b under Microsoft Windows operating system. Noise-less digital phantoms with known uniformity parameters were used to verify the accuracy of the program. Two hundred and forty-four Co-57 flood source images were acquired on Symbia T6 and Discovery nuclear medicine/computed tomography 670...
October 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29141086/use-of-entrustable-professional-activities-in-the-assessment-of-surgical-resident-competency
#8
Justin P Wagner, Catherine E Lewis, Areti Tillou, Vatche G Agopian, Chi Quach, Timothy R Donahue, O Joe Hines
Importance: Competency-based assessments of surgical resident performance require metrics of entrustable autonomy. Objectives: To designate entrustable professional activities (EPAs) in global performance and in specific operations, and to identify differences in perceived capability, autonomy, and expectations between surgical faculty and residents. Design, Setting, and Participants: This survey study was conducted from August 9, 2016, through August 24, 2016, in the Department of Surgery at the UCLA David Geffen School of Medicine...
November 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29139057/cadaveric-simulation-a-review-of-reviews
#9
REVIEW
M Yiasemidou, E Gkaragkani, D Glassman, C S Biyani
BACKGROUND: Traditional surgical training, largely based on the Halstedian model "see one, do one, teach one" is not as effective in the era of working time restrictions and elaborate shift-patterns. As a result, contemporary surgeons turned to educational methods outside the operating theatre such as simulation. Cadavers are high fidelity models but their use has ethical and cost implications and their availability may be limited. In this review, we explore the role of cadaveric simulation in modern surgical education...
November 14, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29134686/selective-proton-observed-carbon-edited-selpoce-mrs-method-for-measurement-of-glutamate-and-glutamine-13-c-labeling-in-the-human-frontal-cortex
#10
Henk M De Feyter, Raimund I Herzog, Bart R Steensma, Dennis W J Klomp, Peter B Brown, Graeme F Mason, Douglas L Rothman, Robin A de Graaf
PURPOSE: (13) C magnetic resonance spectroscopy (MRS) in combination with infusion of (13) C-labeled substrates has led to unique insights into human brain metabolism and neurotransmitter cycling. However, the low sensitivity of direct (13) C MRS and high radiofrequency power requirements has limited (13) C MRS studies to predominantly data acquisition in large volumes of the occipital cortex. The purpose of this study is to develop an MRS technique for localized detection of (13) C-labeling of glutamate and glutamine in the human frontal lobe...
November 13, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29133818/searching-for-prostate-cancer-by-fully-automated-magnetic-resonance-imaging-classification-deep-learning-versus-non-deep-learning
#11
Xinggang Wang, Wei Yang, Jeffrey Weinreb, Juan Han, Qiubai Li, Xiangchuang Kong, Yongluan Yan, Zan Ke, Bo Luo, Tao Liu, Liang Wang
Prostate cancer (PCa) is a major cause of death since ancient time documented in Egyptian Ptolemaic mummy imaging. PCa detection is critical to personalized medicine and varies considerably under an MRI scan. 172 patients with 2,602 morphologic images (axial 2D T2-weighted imaging) of the prostate were obtained. A deep learning with deep convolutional neural network (DCNN) and a non-deep learning with SIFT image feature and bag-of-word (BoW), a representative method for image recognition and analysis, were used to distinguish pathologically confirmed PCa patients from prostate benign conditions (BCs) patients with prostatitis or prostate benign hyperplasia (BPH)...
November 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29132624/the-value-of-ehr-based-assessment-of-physician-competency-an-investigative-effort-with-internal-medicine-physicians
#12
Kimberly Venta, Erin Baker, Cali Fidopiastis, Kay Stanney
OBJECTIVE: The purpose of this study was to investigate the potential of developing an EHR-based model of physician competency, named the Skill Deficiency Evaluation Toolkit for Eliminating Competency-loss Trends (Skill-DETECT), which presents the opportunity to use EHR-based models to inform selection of Continued Medical Education (CME) opportunities specifically targeted at maintaining proficiency. METHODS: The IBM Explorys platform provided outpatient Electronic Health Records (EHRs) representing 76 physicians with over 5000 patients combined...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29132573/critical-decisions-in-the-management-of-thoracic-trauma
#13
REVIEW
Morgan Schellenberg, Kenji Inaba
Traumatic injuries to the thorax are common after both blunt and penetrating trauma. Emergency medicine physicians must be able to manage the initial resuscitation and diagnostic workup of these patients. This involves familiarity with a range of radiologic investigations and invasive bedside procedures, including resuscitative thoracotomy. This knowledge is critical to allow for rapid decision making when life-threatening injuries are encountered. This article explores the initial resuscitation and assessment of patients after thoracic trauma, discusses available imaging modalities, reviews frequently performed procedures, and provides an overview of the indications for operative intervention, while emphasizing the critical decision making throughout...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132408/using-semantics-for-representing-experimental-protocols
#14
Olga Giraldo, Alexander García, Federico López, Oscar Corcho
BACKGROUND: An experimental protocol is a sequence of tasks and operations executed to perform experimental research in biological and biomedical areas, e.g. biology, genetics, immunology, neurosciences, virology. Protocols often include references to equipment, reagents, descriptions of critical steps, troubleshooting and tips, as well as any other information that researchers deem important for facilitating the reusability of the protocol. Although experimental protocols are central to reproducibility, the descriptions are often cursory...
November 13, 2017: Journal of Biomedical Semantics
https://www.readbyqxmd.com/read/29132361/the-impacts-of-implementation-of-national-essential-medicines-policies-on-primary-healthcare-institutions-a-cross-sectional-study-in-china
#15
Zhigang Guo, Xiaodong Guan, Luwen Shi
BACKGROUND: In 2009, China implemented the National Essential Medicines Policies (NEMPs) as part of a new round of medical system reforms. This study aims to evaluate the impacts of the NEMPs on primary healthcare institutions and discuss the roles of the policies in the new healthcare reforms of China. METHODS: The study selected a total of six representative provinces of China, generating a sample of 261 primary healthcare institutions from August to December in 2010...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29130347/editorial-comment-on-end-2017-0641-ra-r1
#16
Joel Gustavo Gómez-Núñez
The manuscript by Matlaga et al titled "Ureteroscopic Laser Lithotripsy: A Review of Dusting Versus Fragmentation With Extraction" was first intended for a meta-analysis publication, but because limited data published, it became an interesting review article focused in the current debate about which of the so described laser urinary lithotripsy "Fragmentation with Extraction" and "Dusting" techniques is better. Authors do an effort to homologize terminology and nomenclature and list the most efficient energy settings used in clinical scenario on the "Fragmentation with Extraction" [(Frequency 12-15 Hz (< 30 watt laser) >50Hz (100/120 watt laser) / Energy 0...
November 12, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29129119/periodontal-inflamed-surface-area-and-periodontal-case-definition-classification
#17
Yago Leira, Pablo Martín-Lancharro, Juan Blanco
OBJECTIVE: To assess whether a higher periodontal inflamed surface area (PISA) may reflect more severe periodontitis, and if so, to calculate which cut-off point should be used to classify a patient as suffering from periodontitis. MATERIAL AND METHODS: Eighty subjects were selected based on their periodontal status and were divided into 4 groups of 20 each; periodontally healthy, mild periodontitis, moderate periodontitis and severe periodontitis. In addition, demographic data, smoking status and socioeconomic status were also recorded...
November 11, 2017: Acta Odontologica Scandinavica
https://www.readbyqxmd.com/read/29126964/simple-and-robust-two-step-ex-vivo-whole-blood-stimulation-assay-suitable-for-investigating-il-17-pathway-in-a-clinical-laboratory-setting
#18
Muir Russell, Abraham Mellkvist-Roos, John Mo, Rabia Hidi
We describe a simple and robust tube-based ex vivo whole blood stimulation procedure suitable for use in clinical laboratories by multiple operators on repeated occasions to study cytokine production in phase 1 human trials of investigational medicines, developed by the authors specifically to study IL-17A expression in man. The stimulation procedure is further proposed as a useful tool for biomarker assay development and validation, for example to prepare quality control samples without reliance on recombinant materials for spiking...
November 7, 2017: Journal of Immunological Methods
https://www.readbyqxmd.com/read/29124379/use-of-the-breast-q%C3%A2-survey-in-the-prospective-evaluation-of-reduction-mammaplasty-outcomes
#19
Isaias Vieira Cabral, Edgard da Silva Garcia, Rebecca Neponucena Sobrinho, Natália Lana Larcher Pinto, Yara Juliano, Joel Veiga-Filho, Lydia Masako Ferreira, Daniela Francescato Veiga
INTRODUCTION: BREAST-Q™ is a patient-reported outcomes survey instrument with a specific module that evaluates breast reduction surgery. It allows assessment of patient's satisfaction with received treatment and evaluates the impact of surgery on different aspects of the patient's quality of life. This article aims to assess the satisfaction and quality of life of patients who underwent reduction mammaplasty. MATERIALS AND METHODS: Women aged between 18 and 60 years, with a body mass index ranging from 19 to 30 kg/m(2), who were already scheduled for reduction mammaplasty, were included in the study...
November 9, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29124373/-the-chignon-mastopexy-a-double-glandular-suspended-flaps-for-an-auto-augmentation-effect
#20
Bouraoui Kotti
BACKGROUND: Many mastopexy techniques have been described in the literature focusing on the new nipple areolar complex position and the breast deflation treatment, but only few of them detailed the glandular volume redistribution to avoid the use of implants. We describe a mastopexy procedure that brings the maximum of the volume to the central part of the breast. We compare the procedure to a "chignon" hair style way to vulgarize the technique and simplify its comprehension. METHODS: Breast volume is reshaped by the use of a vertical mastopexy and two deepithelized glandular flaps sutured for the first one to the pectoralis major fascia and for the second one to the contralateral flap...
November 9, 2017: Aesthetic Plastic Surgery
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