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https://www.readbyqxmd.com/read/28437329/metastatic-spinal-cord-compression-and-steroid-treatment-a-systematic-review
#1
Abhishek Kumar, Michael H Weber, Ziya Gokaslan, Jean-Paul Wolinsky, Meic Schmidt, Laurence Rhines, Michael G Fehlings, Ilya Laufer, Daniel M Sciubba, Michelle J Clarke, Narayan Sundaresan, Jorrit-Jan Verlaan, Arjun Sahgal, Dean Chou, Charles G Fisher
STUDY DESIGN: Systematic review. OBJECTIVES: We conducted a systematic review of the literature to answer the following questions regarding the use of steroid therapy in metastatic spinal cord compression (MSCC): 1. In cases of MSCC, what is the effect of steroid administration before definitive radiotherapy or surgery on ambulatory status, bowel and bladder function and survival? 2. What steroid dosing regimens are associated with the best outcomes concerning neurological symptoms and complication prevention in cases of MSCC? SUMMARY OF BACKGROUND DATA: Currently, there is significant variation in the initial bolus dose, daily maintenance dose and duration of treatment when steroids are used as a bridge to definitive therapy for MSCC...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28435323/ambulatory-thyroidectomy-an-anesthesiologist-s-perspective
#2
REVIEW
Benjamin Murray, Sankalap Tandon, Ged Dempsey
Thyroidectomy has been performed on an inpatient basis because of concerns regarding postoperative complications. These include cervical hematoma, bilateral recurrent laryngeal nerve injury and symptomatic hypocalcemia. We have reviewed the current available evidence and aimed to collate published data to generate incidence of the important complications. We performed a literature search of Medline, EMBASE and the Cochrane database of randomized trials. One hundred sixty papers were included. Twenty-one papers fulfilled inclusion criteria...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28428160/simulated-conversations-with-virtual-humans-to-improve-patient-provider-communication-and-reduce-unnecessary-prescriptions-for-antibiotics-a-repeated-measure-pilot-study
#3
Antoinette Schoenthaler, Glenn Albright, Judith Hibbard, Ron Goldman
BACKGROUND: Despite clear evidence that antibiotics do not cure viral infections, the problem of unnecessary prescribing of antibiotics in ambulatory care persists, and in some cases, prescribing patterns have increased. The overuse of antibiotics for treating viral infections has created numerous economic and clinical consequences including increased medical costs due to unnecessary hospitalizations, antibiotic resistance, disruption of gut bacteria, and obesity. Recent research has underscored the importance of collaborative patient-provider communication as a means to reduce the high rates of unnecessary prescriptions for antibiotics...
April 19, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28424275/outcomes-after-intracerebral-hemorrhage-from-arteriovenous-malformations
#4
Santosh B Murthy, Alexander E Merkler, Setareh Salehi Omran, Gino Gialdini, Aaron Gusdon, Benjamin Hartley, David Roh, Halinder S Mangat, Costantino Iadecola, Babak B Navi, Hooman Kamel
OBJECTIVE: To compare outcomes after intracerebral hemorrhage (ICH) from cerebral arteriovenous malformation (AVM) rupture and other causes of ICH. METHODS: We performed a retrospective population-based study using data from the Nationwide Inpatient Sample. We used standard diagnosis codes to identify ICH cases from 2002 to 2011. Our predictor variable was cerebral AVM. Our primary outcomes were inpatient mortality and home discharge. We used logistic regression to compare outcomes between patients with ICH with and without AVM while adjusting for demographics, comorbidities, and hospital characteristics...
April 19, 2017: Neurology
https://www.readbyqxmd.com/read/28419020/education-in-the-waiting-room-description-of-a-pediatric-emergency-department-educational-initiative
#5
Sarah Reid, Gina Neto, Sandy Tse, Ken J Farion, Ariyan Marvizi, Lauren Smith, Chantalle Clarkin, Kristina Rohde, Katherine Moreau
OBJECTIVE: The aim of this study was to understand parents' awareness of and reactions to a slide presentation based waiting-room educational initiative. METHODS: This was a prospective observational study at a Canadian tertiary-care pediatric emergency department (ED) with an annual census of 68,000 visits. An anonymous parental survey was developed de novo, and parents were asked to complete the survey during their low-acuity ED visit over a 2-week study period...
April 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28414702/minimally-invasive-treatment-for-appendiceal-mass-formed-after-acute-perforated-appendicitis
#6
Enver Zerem, Suad Kunosić, Almin Handanagić, Dženan Jahić, Dina Zerem, Omar Zerem
The optimal treatment for appendiceal mass formed after appendiceal rupture due to acute appendicitis is surrounded with controversy. The treatment strategy ranges from open surgery (emergency or interval appendectomy), laparoscopic appendectomy, and image-guided drainage, to conservative treatment with or without antibiotics. Nonsurgical treatment (including conservative and drainage treatment), followed by interval appendectomy to prevent recurrence, is the traditional management of these patients. The need for interval appendectomy after a successful conservative or/and image-guided drainage treatment, has recently been questioned as the risk of recurrence is relatively small...
April 14, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28411456/urinary-bladder-injury-during-cesarean-delivery-maternal-outcome-from-a-contemporary-large-case-series
#7
Lina Salman, Shachar Aharony, Anat Shmueli, Arnon Wiznitzer, Rony Chen, Rinat Gabbay-Benziv
BACKGROUND: Urinary bladder injury is a rare complication during cesarean delivery. Little is known on maternal outcome following this injury. OBJECTIVE: To evaluate short and long-term maternal outcome following bladder injury during cesarean delivery. STUDY DESIGN: A retrospective case series of all pregnancies complicated by full-thickness bladder injury during cesarean delivery in a single university affiliated tertiary medical center (August 2007-June 2016)...
April 5, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28410366/brief-educational-interventions-to-improve-performance-on-novel-quality-metrics-in-ambulatory-settings-in-kenya-a-multi-site-pre-post-effectiveness-trial
#8
Robert Ryan Korom, Stephanie Onguka, Peter Halestrap, Maureen McAlhaney, Mary Adam
BACKGROUND: The quality of primary care delivered in resource-limited settings is low. While some progress has been made using educational interventions, it is not yet clear how to sustainably improve care for common acute illnesses in the outpatient setting. Management of urinary tract infection is particularly important in resource-limited settings, where it is commonly diagnosed and associated with high levels of antimicrobial resistance. We describe an educational programme targeting non-physician health care providers and its effects on various clinical quality metrics for urinary tract infection...
2017: PloS One
https://www.readbyqxmd.com/read/28406861/clinical-presentation-microbiologic-profile-and-factors-predicting-outcomes-in-bacillus-endophthalmitis
#9
Vivek P Dave, Avinash Pathengay, Ina Budhiraja, Savitri Sharma, Rajeev R Pappuru, Mudit Tyagi, Raja Narayanan, Subhadra Jalali, Jay Chhablani, Taraprasad Das
PURPOSE: To describe the clinical presentation, microbiologic profile, and factors predicting outcomes in Bacillus endophthalmitis. METHODS: Retrospective interventional case series. Eighty-six patients with culture-proven Bacillus endophthalmitis, from January 2001 to December 2015, underwent vitrectomy/vitreous biopsy and intravitreal antibiotic with or without steroid as appropriate. The undiluted vitreous biopsy was subjected to microbiologic evaluation. The duration of symptoms, presenting visual acuity, organisms isolated, influence of intravitreal dexamethasone with intravitreal antibiotics, and type of initial intervention were examined for any clinical and statistical correlation in terms of odds ratio with the final visual outcome...
April 11, 2017: Retina
https://www.readbyqxmd.com/read/28405824/redo-renal-denervation-using-a%C3%A2-multi-electrode-radiofrequency-system-in-patients-with-persistent-therapy-resistant-hypertension
#10
J Daemen, L Feyz, L Van Zandvoort, N M Van Mieghem
OBJECTIVES: Renal sympathetic denervation has been studied as a potential therapeutic option for patients with therapy-resistant hypertension; however, a significant proportion of patients do not show a significant reduction in blood pressure and are classified as non-responders. The objective of the present study was to assess whether a redo renal denervation procedure increases response rates. METHODS: We present a case series of three consecutive renal denervation non-responders treated with the multi-electrode radiofrequency St...
April 12, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28405254/risk-of-falls-associated-with-antiepileptic-drug-use-in-ambulatory-elderly-populations-a-systematic-review
#11
REVIEW
Mira Maximos, Feng Chang, Tejal Patel
BACKGROUND: Falls are a major cause of morbidity and mortality in older adults. About a third of those aged 65 years or older fall at least once each year, which can result in hospitalizations, hip fractures and nursing home admissions that incur high costs to individuals, families and society. The objective of this clinical review was to assess the risk of falls in ambulatory older adults who take antiepileptic drugs, medications that can increase fall risk and decrease bone density...
March 2017: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/28405091/ambulatory-extracorporeal-membrane-oxygenation-with-subclavian-venoarterial-cannulation-to-increase-mobility-and-recovery-in-a-patient-awaiting-cardiac-transplantation
#12
Samuel Jacob, Juan C MacHannaford, Themistokles Chamogeorgakis, Gonzalo V Gonzalez-Stawinski, Joost Felius, Aldo E Rafael, Rajasekhar S Malyala, Brian Lima
Venoarterial extracorporeal membrane oxygenation (ECMO) can provide temporary cardiopulmonary support for patients in hemodynamic extremis or refractory heart failure until more durable therapies-such as cardiac transplantation or a left ventricular assist device-can be safely implemented. Conventional ECMO cannulation strategies commonly employ the femoral artery and vein, constraining the patients to the supine position for the duration of ECMO support. We have recently adopted a modified cannulation approach to promote patient mobility, rehabilitation, and faster recovery and to mitigate complications associated with femoral arterial cannulation, such as limb ischemia and compartment syndrome...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28399251/association-of-spinal-manipulative-therapy-with-clinical-benefit-and-harm-for-acute-low-back-pain-systematic-review-and-meta-analysis
#13
Neil M Paige, Isomi M Miake-Lye, Marika Suttorp Booth, Jessica M Beroes, Aram S Mardian, Paul Dougherty, Richard Branson, Baron Tang, Sally C Morton, Paul G Shekelle
Importance: Acute low back pain is common and spinal manipulative therapy (SMT) is a treatment option. Randomized clinical trials (RCTs) and meta-analyses have reported different conclusions about the effectiveness of SMT. Objective: To systematically review studies of the effectiveness and harms of SMT for acute (≤6 weeks) low back pain. Data Sources: Search of MEDLINE, Cochrane Database of Systematic Reviews, EMBASE, and Current Nursing and Allied Health Literature from January 1, 2011, through February 6, 2017, as well as identified systematic reviews and RCTs, for RCTs of adults with low back pain treated in ambulatory settings with SMT compared with sham or alternative treatments, and that measured pain or function outcomes for up to 6 weeks...
April 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28396719/case-of-hepatocellular-carcinoma-in-a-patient-with-hereditary-tyrosinemia-in-the-post-newborn-screening-era
#14
Essam M Imseis, John S Bynon, Chad Thornhill
Hereditary tyrosinemia type 1 (HT-1) is a metabolic disorder caused by a defect in tyrosine degradation. Without treatment, symptoms of hepatomegaly, renal tubular dysfunction, growth failure, neurologic crises resembling porphyrias, rickets and possible hepatocellular carcinoma can develop. The use of 2-(2-nitro-4-trifluoromethylbenzoyl)-1,3-cyclohexanedione and early diagnosis through newborn screening initiatives have resulted in a sharp decline in morbidity and mortality associated with this disease. We present a case report of a 7-year-old patient with HT-1 who was born prior to the addition of tyrosinemia to the newborn screening in her birth area...
March 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28396027/risk-factors-for-community-associated-clostridium-difficile-infection-in-children
#15
Daniel J Adams, Matthew D Eberly, Michael Rajnik, Cade M Nylund
OBJECTIVE: To characterize the medication and other exposures associated with pediatric community-associated Clostridium difficile infections (CA-CDIs). STUDY DESIGN: We performed a case-control study using billing records from the US military health system database. CA-CDI cases included children 1-18 years of age with an outpatient International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic code for Clostridium difficile infection (CDI) from 2001 to 2013...
April 7, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28395347/burden-of-occupationally-acquired-pulmonary-tuberculosis-among-healthcare-workers-in-the-usa-a-risk-analysis
#16
Rachael M Jones
Pulmonary tuberculosis (TB) infection remains an occupational health burden among healthcare workers (HCWs), but current surveillance data do not allow for attribution of pulmonary TB disease to occupational or community exposures. The objectives of this study were to estimate the annual number of occupationally acquired pulmonary TB infections among HCW in acute care settings (ambulatory care, emergency departments (EDs), and hospitals) in the USA, and to estimate the impact of increased compliance with respiratory protection...
March 1, 2017: Annals of Work Exposures and Health
https://www.readbyqxmd.com/read/28393505/-intussusception-hospital-admission-for-risk-of-recurrence-or-early-discharge
#17
M Dore Reyes, P Triana Junco, C de la Torre, J M Gómez Cervantes, J Jiménez Gómez, A Sánchez Galán, M Romo Muñoz, V Amesty Morello, L Martínez Martínez, M López Santamaría
INTRODUCTION/PURPOSE: There is current debate about the need of hospitalization of patients with enema-reduced intussusception. The purpose of this study is to describe intussusception recurrence in a tertiary care children's hospital in order to evaluate the feasibility of ambulatory treatment. PATIENTS AND METHODS: Retrospective review of children diagnosed with intussusception from January 2009 to December 2013, identifying early recurrences as those that occurred between 12-72 hours after successful enema reduction and comparing the results with current literature...
July 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28385164/diffuse-idiopathic-pulmonary-neuroendocrine-cell-hyperplasia-diagnosed-by-transbronchial-lung-cryobiopsy-a-case-report
#18
R Sauer, S Griff, A Blau, A Franke, T Mairinger, C Grah
BACKGROUND: Micronodular lesions are common findings in lung imaging. As an important differential diagnosis, we describe a case of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia; it is notable that the diagnosis of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia is often delayed. This case provides supporting evidence to establish lung biopsy by cryotechnique as the option of first choice when considering a diagnostic strategy for micronodular lung lesions...
April 7, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28376442/prevalence-of-atypical-pathogens-in-patients-with-cough-and-community-acquired-pneumonia-a-meta-analysis
#19
REVIEW
Christian Marchello, Ariella Perry Dale, Thuy Nhu Thai, Duk Soo Han, Mark H Ebell
PURPOSE: Community-acquired pneumonia (CAP), acute cough, bronchitis, and lower respiratory tract infections (LRTI) are often caused by infections with viruses or Streptococcus pneumoniae. The prevalence of atypical pathogens Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila, and Bordetella pertussis among patients with these illnesses in the ambulatory setting has not been previously summarized. We set out to derive prevalence information from the existing literature...
November 2016: Annals of Family Medicine
https://www.readbyqxmd.com/read/28369293/report-on-mortality-from-gluteal-fat-grafting-recommendations-from-the-aserf-task-force
#20
M Mark Mofid, Steven Teitelbaum, Daniel Suissa, Arturo Ramirez-Montañana, Denis C Astarita, Constantino Mendieta, Robert Singer
Background: Gluteal fat grafting is among the fastest growing aesthetic procedures in the United States and around the world. Given numerous anecdotal and published reports of fatal and nonfatal pulmonary fat embolism resulting from this procedure, the Aesthetic Surgery Education and Research Foundation (ASERF) formed a Task Force to study this complication. Objectives: To determine the incidence of fatal and nonfatal pulmonary fat embolism associated with gluteal fat grafting and provide recommendations to decrease the risks of the procedure...
March 21, 2017: Aesthetic Surgery Journal
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