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https://www.readbyqxmd.com/read/29783030/venous-conduits-have-superior-patency-compared-to-prosthetic-grafts-for-femoro-femoral-bypass
#1
Khanh Nguyen, Gregory Moneta, Gregory Landry
OBJECTIVE: To compare outcomes of externally supported polytetrafluoroethylene (PTFE) grafts and femoral vein as conduits for femoro-femoral crossover grafts. METHODS: This is a retrospective review of consecutive femoro-femoral crossover grafts at our institution between January 2005 and March 2016. Patient demographics, indications, complication rates, patency rates and survival rates were compared between femoro-femoral grafts created with either PTFE or femoral vein conduits, autogenous or cryopreserved...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29783012/decisional-conflict-among-patients-considering-treatment-options-for-lumbar-herniated-disc
#2
Hwang Richard, Lambrechts Sylvia, Liu Hui, Christopher S Saigal, Kwan Lorna, Cisneros Crystal, Langston T Holly, Duru O Kenrik
BACKGROUND: Lumbar herniated disc is a "preference-sensitive" condition, in which the optimal treatment choice is crucially dependent on an informed patient's goals and values. Little is known about decisional conflict, defined as an individual's level of uncertainty regarding a decision, in patients considering treatment for lumbar herniated discs. Our work aims to identify factors associated with decisional conflict and areas for improved shared decision-making. METHODS: We prospectively surveyed patients seeking treatment for a lumbar herniated disc at L4-L5 and/or L5-S1 with a physician at the UCLA Spine Center...
May 18, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29782953/electrodermal-reactivity-to-emotional-stimuli-in-healthy-subjects-and-patients-with-disorders-of-consciousness
#3
Jacques Luauté, Anne Dubois, Lizette Heine, Chloé Guironnet, Ariane Juliat, Valérie Gaveau, Barbara Tillmann, Fabien Perrin
OBJECTIVES: After a coma, one major challenge is the detection of awareness in patients with disorders of consciousness. In some patients, the only manifestation indicative of awareness is an appropriate emotional response. Preferred music is a powerful medium to elicit emotions and auto-biographical memory. Furthermore, music has been shown to improve cognitive functions both in healthy subjects and patients with neurological impairment. We hypothesized that signs of awareness could be enhanced in some patients with disorders of consciousness under appropriate emotional stimulation such as preferred music and also probably preferred odors...
May 18, 2018: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29782661/comparable-outcomes-in-intestinal-retransplantation-single-center-cohort-study
#4
Burcin Ekser, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
BACKGROUND: Graft loss in intestinal transplantation (ITx) is close to 25% in the first year and 50% at 5-year post-transplantation. Although technically and immunologically challenging, intestinal retransplantation is now the 4th most common indication for ITx. METHODS: The aim of this study is to review and compare the outcomes of intestinal retransplantation with primary ITx, which included isolated ITx, modified multivisceral transplantation (mMVTx), and full MVTx, between 2003-2014 at Indiana University...
May 21, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29782648/patient-preferences-for-topical-treatment-of-actinic-keratoses-a-discrete-choice-experiment
#5
D Kopasker, A Kwiatkowski, R N Matin, C A Harwood, F Ismail, J T Lear, J Thomson, Z Hasan, G N Wali, A Milligan, L Crawford, I Ahmed, H Duffy, C M Proby, P F Allanson
BACKGROUND: Treatment of actinic keratoses (AK) is a potentially effective strategy for prevention of cutaneous squamous cell carcinoma (cSCC). However, the patient perspective on potential benefits of AK treatment in terms of skin cancer reduction has received little attention to date. OBJECTIVES: (1) To investigate patient preferences for AK topical treatments using a discrete choice experiment (DCE); (2) To evaluate patient willingness to trade between clinical benefit and medical burden...
May 21, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29782451/the-efficacy-of-regional-anesthesia-techniques-to-control-postoperative-pain-after-total-knee-arthroplasty
#6
Cecilia Otten, Karen S Dunn
BACKGROUND: Choosing the most effective type of anesthesia for controlling postoperative pain is paramount for improving patient outcomes and patient satisfaction. Most often, the type of anesthesia selected is dependent on the duration and type of surgical procedure and anesthesiologist/surgeon preference. Using a combination of regional anesthesia techniques, however, remains the cornerstone of multimodal analgesia for postoperative pain management after total knee arthroplasty. PURPOSE: The purpose of this study was to determine what regional anesthesia techniques and/or combinations of regional anesthesia techniques provided the best postoperative pain control in patients who had undergone a total knee arthroplasty...
May 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29782402/understanding-conflict-management-styles-in-anesthesiology-residents
#7
Terrie Vasilopoulos, Christopher R Giordano, Jack D Hagan, Brenda G Fahy
BACKGROUND: Successful conflict resolution is vital for effective teamwork and is critical for safe patient care in the operating room. Being able to appreciate the differences in training backgrounds, individual knowledge and opinions, and task interdependency necessitates skilled conflict management styles when addressing various clinical and professional scenarios. The goal of this study was to assess conflict styles in anesthesiology residents via self- and counterpart assessment during participation in simulated conflict scenarios...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782295/diagnostic-and-treatment-strategies-of-dermatologists-for-treating-morphea-in-hungary
#8
Gábor Bali, Bernadett Hidvégi
Localized scleroderma is an uncommon disease, only infrequently encountered by dermatologists in private practices or even in larger academic centers. Because of its rarity, current treatment guidelines are mostly based on low-level clinical evidence and expert opinions. The aim of this study was to evaluate treatment strategies to treat localized scleroderma. A questionnaire was developed and sent to dermatologists in Hungary. 101 returned questionnaires were eligible for evaluation. 87.12% of clinicians employed local steroids...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29782270/-tactics-of-selection-of-anticoagulant-therapy-in-patients-with-atrial-fibrillation-and-ischemic-heart-disease
#9
Y N Belenkov, G A SHakaryants, N V Khabarova
In the clinical practice a physician quite often is at a loss due to "freedom of choice" granted by availability of direct oral anticoagulants (DOAC). If a patient with nonvalvular atrial fibrillation (AF) has indications for therapy with anticoagulants which DOAC should be preferred? What are benefits for a patient with ischemic heart disease and AF when definite NOAC is chosen and what are risks inherent of this choice? Answers to such questions are given in this paper.
March 2018: Kardiologiia
https://www.readbyqxmd.com/read/29782051/the-novel-sodium-channel-modulator-gs-458967-gs967-is-an-effective-treatment-in-a-mouse-model-of-scn8a-encephalopathy
#10
Erin M Baker, Christopher H Thompson, Nicole A Hawkins, Jacy L Wagnon, Eric R Wengert, Manoj K Patel, Alfred L George, Miriam H Meisler, Jennifer A Kearney
OBJECTIVE: De novo mutations of SCN8A, encoding the voltage-gated sodium channel NaV 1.6, have been associated with a severe infant onset epileptic encephalopathy. Individuals with SCN8A encephalopathy have a mean age of seizure onset of 4-5 months, with multiple seizure types that are often refractory to treatment with available drugs. Anecdotal reports suggest that high-dose phenytoin is effective for some patients, but there are associated adverse effects and potential for toxicity...
May 21, 2018: Epilepsia
https://www.readbyqxmd.com/read/29781978/mixed-methods-evaluation-of-real-time-safety-reporting-by-hospitalized-patients-and-their-care-partners-the-mysafecare-application
#11
Sarah A Collins, Brittany Couture, Ann DeBord Smith, Esteban Gershanik, Elizabeth Lilley, Frank Chang, Cathy Yoon, Stuart Lipsitz, Aziz Sheikh, James Benneyan, David W Bates
OBJECTIVE: The aims of the study were to evaluate the amount and content of data patients and care partners reported using a real-time electronic safety tool compared with other reporting mechanisms and to understand their perspectives on safety concerns and reporting in the hospital. METHODS: This study used mixed methods including 20-month preimplementation and postimplementation trial evaluating MySafeCare, a web-based application, which allows hospitalized patients/care partners to report safety concerns in real time...
April 27, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29781853/the-use-of-pedicled-perforator-flaps-in-chest-reconstruction-a-systematic-review-of-outcomes-and-reliability
#12
Anne-Sophie Florczak, Benoit Chaput, Christian Herlin, Pascal Rousseau, Eric Watier, Nicolas Bertheuil
BACKGROUND: In recent years, pedicled perforator flaps have revolutionized plastic surgery by reducing donor site morbidity and ensuring larger and deeper reconstructions with local pedicled cutaneous flaps. The aim of the study was to make a systematic review of perforator pedicled propeller flaps (PPPFs) in chest reconstruction. METHODS: Pubmed and Cochrane databases were searched from 1989 to October 2016 for articles describing the use of PPPFs in chest reconstruction...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781846/preperitoneal-or-subcutaneous-wound-catheters-as-alternative-for-epidural-analgesia-in-abdominal-surgery-a-systematic-review-and-meta-analysis
#13
Timothy H Mungroop, Marinde J Bond, Philipp Lirk, Olivier R Busch, Markus W Hollmann, Denise P Veelo, Marc G Besselink
OBJECTIVE: To assess whether the location of wound catheters (ie, preperitoneal vs. subcutaneous) impacts outcomes, when compared with alternatives such as epidural analgesia. BACKGROUND: Continuous wound infiltration is an alternative for epidural analgesia in abdominal surgery but studies have shown conflicting results. This difference could be explained by different efficacy of preperitoneal versus subcutaneous placement of the infiltrative catheters. METHODS: A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines until April 3, 2017...
May 17, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29781688/-he-should-feel-your-pain-patient-insights-on-patient-provider-communication-in-rwanda
#14
Vincent K Cubaka, Michael Schriver, Janvier B Kayitare, Phil Cotton, Helle T Maindal, Laetitia Nyirazinyoye, Per Kallestrup
BACKGROUND:  Patient-provider communication is an interpersonal interaction between a patient and a health care provider. OBJECTIVE:  This study explored patients' communication preferences and perceptions on what factors influence the patient-provider communication in primary health care settings in Rwanda. METHODS:  In-depth semi-structured interviews with 15 individuals including 8 with limited literacy. A thematic inductive analysis was used...
April 16, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29781384/how-to-uncover-sources-of-unwarranted-practice-variation-a-case-study-in-emergency-medicine
#15
Markus A Feufel
Forty years of statistical database analyses have demonstrated the existence of unwarranted practice variation in care delivery, that is, variations independent of medical need, evidence, or patient preference. Alas, little is known about the underlying mechanisms and thus finding interventions to reduce unwarranted variations remains difficult, hampering quality, equity, and efficiency of care. Whereas statistical analyses describe deviations from ideal patterns, ethnographically inspired analyses aim at understanding when, how, and why variations occur in practice...
May 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29781353/clinical-trials-with-multiple-endpoints-can-establish-a-correlation-but-not-yet-causality-between-dietary-supplementation-with-omega-3-fatty-acids-and-keratoconjunctivitis-sicca
#16
Roger Lee Mendoza
AIM: We review clinical evidence of therapeutic efficacy and effectiveness of omega-3 fatty acids (omega-3s) in keratoconjunctivitis sicca, colloquially known as dry eye disease. In doing so, we identify relevant literature to address the following questions: 1) What definitive guidance can clinical evidence offer eye physicians and their patients? 2) What aspects of omega-3 supplementation lack definitive evidence, and how might economic assessments help? METHODS: A targeted and systematic search strategy based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was designed in this study for refereed clinical trials of omega-3s in dry eye treatment...
May 21, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29781336/advances-in-the-treatment-of-severe-alcoholic-hepatitis
#17
Wenjun Wang, Ying Xu, Chang Jiang, Yanhang Gao
Severe alcoholic hepatitis (SAH) is a costly and worldwide public health issue with high morbidity and mortality. Specific effective treatments for SAH have yet to be established. The aim of the present article is to review the current knowledge of the pathogenesis, assessment, and treatment options in patients with SAH. To date, alcohol abstinence and enteral nutrition are the recommended first-line treatments. Although corticosteroids remain the preferred therapy for certain patients with a modified Maddrey discriminant function level greater than 54, they only improve short-term survival rates...
May 21, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29781208/a-useful-alternative-surgical-technique-to-reconstructing-large-defects-following-excision-of-recurrent-pilonidal-sinus-disease-in-the-intergluteal-region-an-operative-approach-for-the-transverse-lumbar-artery-perforator-flap
#18
Alethea My Tan, Zeeshan Ahmad, Charles Yy Loh, Sonya Gardiner, Bhagwat Mathur
The reconstruction of defects in the intergluteal region following pilonidal sinus excision is challenging due to its anatomical location, close proximity to the anus, and being a high-tension area prone to wound-healing problems. Excision and primary closure is known to carry a higher risk of recurrence and subsequent complications compared with using nearby local healthy tissue, such as a flap, to reconstruct defect. Extra due diligence should be given to patient selection and flap choice when deciding the reconstruction of a defect...
May 21, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29781184/pre-operative-dobutamine-stress-echocardiography-in-patients-undergoing-orthotopic-liver-transplantation
#19
Krishna K Patel, Laura Young, William Carey, Kathryn A Kohn, Richard A Grimm, L Leonardo Rodriguez, Brian P Griffin, Milind Y Desai
BACKGROUND: Coronary artery disease (CAD) is associated with increased mortality in patients that undergo orthotopic liver transplantation (OLT). Due to chronic vasodilatory state and poor exercise tolerance in patients with end stage liver disease, dobutamine stress echocardiography (DSE) is preferred for preoperative evaluation of CAD prior to OLT. We sought to a) study the incidence of positive DSE results and b) test whether there is an association between DSE results and perioperative and longer-term events...
May 20, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29780847/community-acquired-respiratory-paramyxovirus-infection-after-allogeneic-hematopoietic-cell-transplantation-a-single-center-experience
#20
Yasmin Spahr, Sarah Tschudin-Sutter, Veronika Baettig, Francesca Compagno, Michael Tamm, Jörg Halter, Sabine Gerull, Jakob Passweg, Hans H Hirsch, Nina Khanna
Background: Paramyxoviruses include respiratory syncytial virus (RSV), parainfluenza virus (PIV), and human metapneumovirus (MPV), which may cause significant respiratory tract infectious disease (RTID) and mortality after allogeneic hematopoietic cell transplantation (HCT). However, clinical data regarding frequency and outcome are scarce. Methods: We identified all paramyxovirus RTIDs in allogeneic HCT recipients diagnosed by multiplex polymerase chain reaction between 2010 and 2014...
May 2018: Open Forum Infectious Diseases
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