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https://www.readbyqxmd.com/read/28110392/tarsal-navicular-stress-fractures
#1
REVIEW
Rachel J Shakked, Emily E Walters, Martin J O'Malley
PURPOSE OF REVIEW: Navicular stress fractures are common in athletes and management is debated. This article will review the evaluation and management of navicular stress fractures. RECENT FINDINGS: Various operative and non-operative adjunctive treatment modalities are reviewed including the relevance of vitamin D levels, use of shock wave therapy and bone marrow aspirate concentrate (BMAC), and administration of teriparatide. Surgical treatment may be associated with earlier return to sports...
January 21, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28110383/risk-factors-for-recurrence-after-acute-colonic-diverticulitis-a-systematic-review
#2
REVIEW
Line Hupfeld, Jakob Burcharth, Hans-Christian Pommergaard, Jacob Rosenberg
PURPOSE: Several factors may influence the risk of recurrence after an episode of acute colonic diverticulitis. Until now, a comprehensive systematic overview and evaluation of relevant risk factors have not been presented. This review aimed at assembling and evaluating current evidence on risk factors for recurrence after conservatively treated acute colonic diverticulitis. METHODS: PubMed, Embase, and Cochrane databases were searched for studies evaluating risk factors for recurrence after acute diverticulitis treated non-surgically defined as antibiotic treatment, percutaneous abscess drainage, or by observation...
January 22, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28110382/economic-evaluations-alongside-efficient-study-designs-using-large-observational-datasets-the-pleasant-trial-case-study
#3
Matthew Franklin, Sarah Davis, Michelle Horspool, Wei Sun Kua, Steven Julious
BACKGROUND: Large observational datasets such as Clinical Practice Research Datalink (CPRD) provide opportunities to conduct clinical studies and economic evaluations with efficient designs. OBJECTIVES: Our objectives were to report the economic evaluation methodology for a cluster randomised controlled trial (RCT) of a UK NHS-delivered public health intervention for children with asthma that was evaluated using CPRD and describe the impact of this methodology on results...
January 21, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28110364/repair-of-sternoclavicular-joint-dislocations-with-fiberwire-%C3%A2
#4
Stefan Adamcik, Markus Ahler, Konstantinos Gioutsos, Ralph A Schmid, Gregor J Kocher
PURPOSE: Up to 50% of traumatic sternoclavicular joint (SCJ) dislocations need open reduction and fixation to prevent long-term complications and complaints. We present our preferred surgical approach for acute as well as chronic SCJ dislocations, including their outcome. METHODS: Five consecutive male patients with a median age of 27 (range 20-49) were treated for traumatic anterior (n = 2) or posterior (n = 3) SCJ dislocation. Open reduction and surgical fixation were achieved by a modified figure-of-eight sutures using Fiberwire(®)...
January 21, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28110056/current-knowledge-and-management-of-hypersensitivity-reactions-to-monoclonal-antibodies
#5
Matthieu Picard, Violeta Régnier Galvão
Hypersensitivity reactions (HSRs) to monoclonal antibodies (mAbs) are increasingly frequent as this class of therapeutic agents is rapidly expanding. Immediate and nonimmediate HSRs have been reported with mAbs. Immediate HSRs can be explained by 3 main mechanisms: cytokine release syndrome, IgE-mediated, and IgG-mediated reactions. Importantly, IgE-mediated reactions can occur on first exposure due to preformed specific IgEs, as shown for cetuximab. Almost all patients with an immediate HSR can be safely re-exposed either through desensitization or challenge depending on the severity and mechanism of the initial reaction...
January 18, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28109638/myasthenia-triggered-by-immune-checkpoint-inhibitors-new-case-and-literature-review
#6
Natalia L Gonzalez, Araya Puwanant, Angela Lu, Stanley M Marks, Saša A Živković
Immune checkpoint molecules are potent regulators of immunologic homeostasis that prevent the development of autoimmunity while maintaining self-tolerance. Inhibitors of immune checkpoint molecules are used as immunotherapy in the treatment of melanoma and different types of refractory cancer, and can trigger various autoimmune complications including myositis and myasthenia gravis. We describe a case of generalized myasthenia gravis induced by pembrolizumab and review 11 other cases. Five patients also had elevated serum CK levels ranging from 1200 to 8729 IU/L, and biopsy showed myositis in one...
January 6, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28109628/preoperative-bathing-of-the-surgical-site-with-chlorhexidine-for-infection-prevention-systematic-review-with-meta-analysis
#7
Lúcia Maciel de Castro Franco, Gláucia Fernandes Cota, Tatiana Saraiva Pinto, Flávia Falci Ercole
BACKGROUND: Preoperative bathing with 4% chlorhexidine is recommended as a measure to prevent surgical site infection (SSI) despite uncertainty regarding the effectiveness of the intervention. This review aimed to assess the effect of bathing with 4% chlorhexidine on the prevention of SSIs in clean surgeries compared with bathing with placebo solution or soap. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews and the Cochrane manual were followed...
January 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28109573/the-optimal-procedure-for-retransplantation-after-single-lung%C3%A2-transplantation
#8
Zachary N Kon, Gregory J Bittle, Chetan Pasrija, Pablo G Sanchez, Bartley P Griffith, Richard N Pierson
BACKGROUND: Retransplantation has emerged as a therapeutic option for patients experiencing respiratory failure after single lung transplantation. However, outcomes associated with the surgical option (ipsilateral, contralateral, or bilateral lung retransplantation) has not been well evaluated. METHODS: The Organ Procurement and Transplantation Network database (1994 to 2012) was queried for all lung transplant procedures performed after an initial single lung transplantation...
January 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28109549/time-kill-determination-of-the-bactericidal-activity-of-telavancin-and-vancomycin-against-clinical-methicillin-resistant-staphylococcus-aureus-isolates-from-cancer-patients
#9
Kenneth Vi Rolston, Weiqun Wang, Lior Nesher, Jordan R Smith, Michael J Rybak, Randall A Prince
The bactericidal activity of vancomycin and telavancin was compared against 4 clinical methicillin-resistant Staphylococcus aureus isolates recently recovered from cancer patients, using minimum bactericidal concentration (MBC):MIC ratios and time-kill studies. All 4 isolates were susceptible to both agents based on individual MIC values. The 2 methodologies for assessing bactericidal activity produced variable results. Telavancin appeared to have somewhat better bactericidal activity than vancomycin based on narrower MBC:MIC ratios...
December 16, 2016: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28109544/cost-effectiveness-of-prophylactic-cranial-irradiation-with-hippocampal-avoidance-in-limited-stage-small-cell-lung-cancer
#10
Xuanlu M Qu, Mark V Mishra, Glenn S Bauman, Ben Slotman, Minesh Mehta, Vinai Gondi, Alexander V Louie
BACKGROUND AND PURPOSE: Prophylactic cranial irradiation (PCI) in limited stage small cell lung cancer (LS-SCLC) prevents brain metastases and improves survival, with the potential for neurocognitive toxicity. RTOG0933 demonstrated that hippocampal avoidance (HA) during whole brain radiotherapy preserves neurocognition. This study's objective was to evaluate the cost-effectiveness of HA-PCI in LS-SCLC through decision analysis. MATERIALS AND METHODS: A Markov model was developed to simulate the clinical course of LS-SCLC who received HA-PCI or conventional PCI (C-PCI)...
January 18, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28109474/-hidden-scar-submandibular-gland-excision-using-an-endoscope-assisted-hairline-approach
#11
Seung Hoon Woo, Jung Je Park, MinSu Kwon, Jin Pyeong Kim
OBJECTIVES: Endoscope-assisted surgery is becoming the standard and most frequently preferred technique in a number of surgical disciplines because of its advantages of leaving a minimal or concealed postoperative scar compared with the conventional approaches. However, such operations are not yet standard in submandibular gland (SMG) surgery due to the anatomic complexity of this region. MATERIALS AND METHODS: We conducted a prospective comparative analysis of the clinical outcome of patients who underwent SMG resection using the hairline approach versus the conventional transcervical approach...
February 2017: Oral Oncology
https://www.readbyqxmd.com/read/28108966/breast-reconstruction-and-postmastectomy-radiotherapy-complications-by-type-and-timing-and-other-problems-in-radiation-oncology
#12
Kenji Sekiguchi, Jiro Kawamori, Hideko Yamauchi
Breast reconstruction (BR) represents a suitable option for women who are not expected to require postmastectomy radiotherapy (PMRT). As recent evidence has led to an extension of the indications for PMRT, this has also appeared to increase the incidence of reconstructive complications. Nevertheless, in the USA at least, trends towards BR are changing. The frequency of immediate reconstruction continues to increase, even in the setting of PMRT. In immediate implant-based reconstruction, a staged approach is preferred...
January 20, 2017: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/28108833/soft-tissue-substitutes-in-non-root-coverage-procedures-a-systematic-review-and-meta-analysis
#13
REVIEW
Kristina Bertl, Maximilian Melchard, Nikolaos Pandis, Michael Müller-Kern, Andreas Stavropoulos
OBJECTIVES: The present systematic review compared the effectiveness of soft tissue substitutes (STSs) and autogenous free gingival grafts (FGGs) in non-root-coverage procedures to increase keratinized tissue (KT) width around teeth. MATERIALS AND METHODS: Included studies fulfilled the following main eligibility criteria: (a) preclinical in vivo or human controlled trials using FGG as control, (b) non-root-coverage procedures, and (c) assessment of KT width. Meta-analysis was performed on the gain in KT width (primary outcome variable) and several secondary variables...
January 20, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28108750/-titanium-or-steel-as-osteosynthesis-material-systematic-literature-search-for-clinical-evidence
#14
Alexander Joeris, Sabine Goldhahn, Elke Rometsch, Dankward Höntzsch
BACKGROUND: The selection of the appropriate implant material, stainless steel or titanium, is still the decision of the surgeon and/or the affiliated institution. Additionally, remarkable international differences can be found between the different markets, which cannot really be explained. OBJECTIVE: A systematic literature search was performed to verify whether there is clinical evidence for the preference of one material over the other. MATERIAL AND METHODS: The systematic literature search was performed utilizing the internet databases PubMed, Cochrane and Web of Science...
January 20, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28108743/hormonal-therapy-followed-by-chemotherapy-or-the-reverse-sequence-as-first-line-treatment-of-hormone-responsive-human-epidermal-growth-factor-receptor-2-negative-metastatic-breast-cancer-patients-results-of-an-observational-study
#15
Claudia Bighin, Beatrice Dozin, Francesca Poggio, Marcello Ceppi, Paolo Bruzzi, Alessia D'Alonzo, Alessia Levaggi, Sara Giraudi, Matteo Lambertini, Loredana Miglietta, Marina Vaglica, Vincenzo Fontana, Giuseppina Iacono, Paolo Pronzato, Lucia Del Mastro
Introduction Although hormonal-therapy is the preferred first-line treatment for hormone-responsive, HER2 negative metastatic breast cancer, no data from clinical trials support the choice between hormonal-therapy and chemotherapy.Methods Patients were divided into two groups according to the treatment: chemotherapy or hormonal-therapy. Outcomes in terms of clinical benefit and median overall survival (OS) were retrospectively evaluated in the two groups. To calculate the time spent in chemotherapy with respect to OS in the two groups, the proportion of patients in chemotherapy relative to those present in either group was computed at every day from the start of therapy...
January 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28108613/when-clinical-trials-compete-prioritising-study-recruitment
#16
Luke Gelinas, Holly Fernandez Lynch, Barbara E Bierer, I Glenn Cohen
It is not uncommon for multiple clinical trials at the same institution to recruit concurrently from the same patient population. When the relevant pool of patients is limited, as it often is, trials essentially compete for participants. There is evidence that such a competition is a predictor of low study accrual, with increased competition tied to increased recruitment shortfalls. But there is no consensus on what steps, if any, institutions should take to approach this issue. In this article, we argue that an institutional policy that prioritises some trials for recruitment ahead of others is ethically permissible and indeed prima facie preferable to alternative means of addressing recruitment competition...
January 20, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28108429/toward-patient-centered-telerehabilitation-design-understanding-chronic-pain-patients-preferences-for-web-based-exercise-telerehabilitation-using-a-discrete-choice-experiment
#17
Karlijn Cranen, Catharina Gm Groothuis-Oudshoorn, Miriam Mr Vollenbroek-Hutten, Maarten J IJzerman
BACKGROUND: Patient-centered design that addresses patients' preferences and needs is considered an important aim for improving health care systems. At present, within the field of pain rehabilitation, patients' preferences regarding telerehabilitation remain scarcely explored and little is known about the optimal combination between human and electronic contact from the patients' perspective. In addition, limited evidence is available about the best way to explore patients' preferences...
January 20, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28108241/levator-alae-nasi-muscle-v-y-island-flap-for-nasal-tip-reconstruction
#18
Simone La Padula, Vincenzo Abbate, Gianluca Di Monta, Fabrizio Schonauer
Nasal tip reconstruction can be very challenging. It requires close attention to skin texture, colour and thickness matching, with the respect of the nasal aesthetic units and symmetry. Flaps are usually preferred to skin grafts where possible. Based on different donor areas, various flaps have been described for reconstruction of this region. Here we present a new V-Y myocutaneous island flap based on the levator alae nasi muscle (LAN muscle) blood supply. This flap may represent an alternative to the nasalis myocutaneous sliding V-Y flap previously described by Rybka...
December 21, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28108166/predictive-performance-of-different-kidney-function-estimation-equations-in-lung-transplant-patients
#19
Dov A Degen, Jyotsna Janardan, Katherine A Barraclough, Hans G Schneider, Thomas Barber, Howard Barton, Gregory Snell, Bronwyn Levvey, Rowan G Walker
BACKGROUND: There has been limited examination of the performance of glomerular filtration rate estimation (eGFR) equations in lung transplant populations. This study aimed to compare the performance of serum creatinine and cystatin C based eGFR equations with Tc-99m diethylenetriaminepentaacetic acid (DTPA) GFR measurements in individuals with end-stage lung disease, either prior to, or following, lung transplantation. METHODS: In this prospective observational study, participants underwent GFR measurements with Tc-99m Pentetate...
January 17, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28107737/contrast-enhanced-spectral-mammography-cesm-versus-mri-in-the-high-risk-screening-setting-patient-preferences-and-attitudes
#20
Jordana Phillips, Matthew M Miller, Tejas S Mehta, Valerie Fein-Zachary, Audrey Nathanson, Wendy Hori, Rita Monahan-Earley, Priscilla J Slanetz
PURPOSE: Our study evaluates patient preferences toward screening CESM versus MRI. MATERIALS AND METHODS: As part of a prospective study, high-risk patients had breast MRI and CESM. Patients completed an anonymous survey to evaluate preferences regarding the two modalities. RESULTS: 88% of participants completed the survey. 79% preferred CESM over MRI if the exams had equal sensitivity. 89% would be comfortable receiving contrast as part of an annual screening test...
December 28, 2016: Clinical Imaging
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