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Francesco Simonit, Fabio Bassan, Carlo Scorretti, Lorenzo Desinan
Complex suicides are rare and consist in the use of more than one method to induce death, representing a challenging investigation for forensic pathologists. According to the several combinations reported in literature, they have been classified into "typical" (where two common suicide methods are associated) and "atypical" (where more than two methods, or infrequent combinations of suicide methods are involved). In the case discussed here, an elderly man suffering of depression was found dead inside the tool shed of his house with a knife embedded in the abdomen and two plastic bags fastened around the neck using a twine...
August 2, 2018: Forensic Science International
Akhil Chawla, Michael H Rosenthal, Thomas E Clancy
PURPOSE: The anatomic variability of the hepatic artery has important implications in the treatment of periampullary cancers. The purpose is of this report is to describe the importance of the replaced right hepatic artery originating from the gastroduodenal artery, which is typically removed during a pancreatic head resection, and to demonstrate how this variant can markedly alter treatment planning and intraoperative decision making. MATERIALS AND METHODS: In this report, two cases of a replaced right hepatic artery originating from the gastroduodenal artery are described in the setting of a borderline-resectable pancreatic adenocarcinoma identified on preoperative CT imaging...
August 8, 2018: Clinical Imaging
John T Pierce, Prasad Kanuparthi, Brendan J Mcshane, Rachel L Welch, Paul J Marcotte, William C Welch
INTRODUCTION: Single-level open lumbar microdiscectomy surgery is one of the most straightforward and effective spinal surgeries performed by spinal surgeons today to treat disc herniation. Though a common operation, little in the literature is reported on the exact overall time, cost and effort associated with the performance of this surgery. The consistency of this operation across institutions and disciplines makes it a good starting point to accurately track the total time and effort of all phases of the surgical intervention...
August 10, 2018: World Neurosurgery
Zhang F, Tao C, Hu X, Qian J, Li X, You C, Jiang Y, Yang M
BACKGROUND: Inflammatory response plays a vital role in the pathological mechanism of intracerebral hemorrhage. It has been recently reported that neutrophil to lymphocyte ratio (NLR) could represent a novel composite inflammatory marker for predicting the prognosis of intracranial hemorrhage (ICH). However, in considering that surgical evacuation effects on the initiation of inflammatory responses. Thus, the relationship between NLR and functional outcome of ICH patients after surgical treatment is still controversial...
August 10, 2018: World Neurosurgery
Takashi Yorifuji, Shigeru Takaoka, Philippe Grandjean
Severe methylmercury poisoning occurred in Minamata and neighboring communities in Japan during the 1950s and 1960s. A considerable number of children were born with conditions resembling cerebral palsy, later known as congenital Minamata disease. Although surviving patients are now in their 50s or 60s, few assessments of functional capacities in daily living have been performed. We assessed the changes in Activities of Daily Living (ADL) status of 11 patients over a 10-year period. For assessment of ADL, we applied the Barthel Index (BI) and the Functional Independence Measure (FIM)...
August 10, 2018: Neurotoxicology and Teratology
Lena Alsabban, Felix Jose Amarista, Louis G Mercuri, Daniel Perez
PURPOSE: Idiopathic condylar resorption (ICR) is a relatively uncommon condition. Its diagnosis, etiology, and management options are controversial. Furthermore, it is difficult for 1 provider to collect a large cohort of ICR patients to develop a statistically significant study of these concerns. Therefore, the purpose of this study was to survey experienced temporomandibular joint (TMJ) surgeons who have managed ICR cases relative to these concerns, as well as review the management outcome literature...
July 19, 2018: Journal of Oral and Maxillofacial Surgery
Sebastião van Uden, Valentina Catto, Giovanni Perotto, Athanassia Athanassiou, Alberto C L Redaelli, Francesco G Greco, Stefania A Riboldi
Several attempts made so far to combine silk fibroin and polyurethane, in order to prepare scaffolds encompassing the bioactivity of the former with the elasticity of the latter, suffer from critical drawbacks concerning industrial and clinical applicability (e.g., separation of phases upon processing, use of solvents unaddressed by the European Pharmacopoeia, and use of degradable polyurethanes). Overcoming these limitations, in this study, we report the successful blending of regenerated silk fibroin with a medical-grade, non-degradable polyurethane using formic acid and dichloromethane, and the manufacturing of hybrid, semi-degradable electrospun tubular meshes with different ratios of the two materials...
August 13, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Kornelia Kreiser, Isabell Gröber, Claus Zimmer, Katharina Storck
BACKGROUND: Carotid blowout syndrome due to tumor infiltration, fistulas, and therapy-related necrosis can occur as late as years after the treatment. Reporting our experiences with preventive and acute treatment with stent grafts and discussing different ways of antiplatelet therapy. METHODS: We reviewed all patients between 2010 and 2016 who underwent stent graft placement and analyzed outcome, complications, and antiplatelet regime. RESULTS: Seventeen patients were treated in 24 sessions (n = 7 threatened, n = 5 imminent, and n = 12 acute bleeding)...
August 13, 2018: Head & Neck
Susan M Peterson, Cathi A Harbertson, James J Scheulen, Gabor D Kelen
OBJECTIVES: To meet the unique comparative data needs of academic emergency departments, we describe the recent five-year national and regional trends for adult emergency patients' characteristics and operational parameters at academic emergency medical centers. METHODS: Data collected from the recent five-year period academic year (AY) 2012 through AY 2016 of the Academy of Administrators in Academic Emergency Medicine (AAAEM) and the Association of Academic Chairs of Emergency Medicine (AACEM) Academic Emergency Medicine Benchmarking Survey were analyzed for trends in 1) ED volumes and modes of arrival 2) triage acuity level 3) trends in ED professional fee billing and 4) disposition patterns of ED patients including admission rates and walkouts...
August 13, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Da Young Lee, Eun-Jung Rhee, Jung Hwan Cho, Hyemi Kwon, Se Eun Park, Yang-Hyun Kim, Kyungdo Han, Yong-Kyu Park, Soon Jib Yoo, Won-Young Lee
PURPOSE: This study aimed at investigating whether there is a continuous dose-response relationship between the amount of physical activity (PA) and longevity benefit. METHODS: We evaluated the records of 23,257,723 Koreans aged ≥20 years who had undergone one biennial medical evaluation by the National Health Insurance Corporation. Participants with ≥20 minutes of vigorous or ≥30 minutes of moderate PA or walking were stratified into four groups: 0 days/week; 1-3 days/week; 4-5 days/week; and 6-7 days/week...
August 10, 2018: Medicine and Science in Sports and Exercise
Moaaz Soliman, Fatima Neemuchwala, Amanda Sankar, Rama Jasty, Raja Rabah, Antonia P Popova, Erika A Newman
A 14-year-old male patient presented with a nonproductive cough, weight loss, fatigue, and malaise. A chest radiograph showed large bilateral cavitary lung lesions in both upper and lower lobes that failed to improve with antibiotics and anti-inflammatory medications. Infectious and rheumatologic work-ups were negative. Thoracoscopic lung biopsies were diagnostic for nodular lymphocyte predominant Hodgkin lymphoma (NLPHL). The patient received combination chemotherapy and immunotherapy based on current treatment standards with an excellent clinical response...
August 10, 2018: Journal of Pediatric Hematology/oncology
Elizabeth K Potter, Luke Hodgson, Ben Creagh-Brown, Lui G Forni
BACKGROUND: Sepsis is life-threatening organ dysfunction due to a dysregulated host response to infection. Disturbed microvascular blood flow is associated with excess mortality and is a potential future target for interventions. This review addresses the evidence for pharmacological manipulation of the microcirculation in sepsis assessed by techniques that evaluate the sublingual microvasculature. METHODS: Systematic review using a published protocol. Eligibility criteria were studies of septic patients published from Jan 2000 - February 2018...
August 10, 2018: Shock
Mitchell L Schubert
PURPOSE OF REVIEW: The present review summarizes the past year's literature, both clinical and basic science, regarding potential adverse effects of proton pump inhibitors. RECENT FINDINGS: Proton pump inhibitors are amongst the most widely prescribed and overprescribed medications worldwide. Although generally considered well tolerated, epidemiologic studies mining large databases have reported a panoply of purported serious adverse effects associated with proton pump inhibitors, including chronic kidney disease, cognitive decline, myocardial infarction, stroke, bone fracture and even death...
August 9, 2018: Current Opinion in Gastroenterology
Caner Alparslan, Elif Perihan Öncel, Sinem Akbay, Demet Alaygut, Fatma Mutlubaş, Mansur Tatlı, Martin Konrad, Önder Yavaşcan, Belde Kasap-Demir
Alparslan C, Öncel EP, Akbay S, Alaygut D, Mutlubaş F, Tatlı M, Konrad M, Yavaşcan Ö, Kasap-Demir B. A novel homozygous W99G mutation in CLDN-16 gene causing familial hypomagnesemic hypercalciuric nephrocalcinosis in Turkish siblings. Turk J Pediatr 2018; 60: 76-80. Familial hypomagnesemic hypercalciuric nephrocalcinosis (FHHNC) (OMIM: 248250) is characterized by hypomagnesemia, hypercalciuria and nephrocalcinosis. FHHNC inevitably progresses to end-stage renal disease in decades. Mutations in CLDN-16 and CLDN-19 genes are associated with disrupted magnesium handling in the thick ascending limp of Henle`s loop...
2018: Turkish Journal of Pediatrics
Jeffrey Kaye, Christina Reynolds, Molly Bowman, Nicole Sharma, Thomas Riley, Ona Golonka, Jonathan Lee, Charlie Quinn, Zachary Beattie, Johanna Austin, Adriana Seelye, Katherine Wild, Nora Mattek
An end-to-end suite of technologies has been established for the unobtrusive and continuous monitoring of health and activity changes occurring in the daily life of older adults over extended periods of time. The technology is aggregated into a system that incorporates the principles of being minimally obtrusive, while generating secure, privacy protected, continuous objective data in real-world (home-based) settings for months to years. The system includes passive infrared presence sensors placed throughout the home, door contact sensors installed on exterior doors, connected physiological monitoring devices (such as scales), medication boxes, and wearable actigraphs...
July 27, 2018: Journal of Visualized Experiments: JoVE
Madison A Niermeyer, Rosemary E Ziemnik, Emilie I Franchow, Casey A Barron, Yana Suchy
OBJECTIVES: Unusually high engagement in expressive suppression (i.e., purposeful regulation of overt affect) has been associated with poorer performance on executive functioning (EF) and motor-sequence learning tasks. As such, expressive suppression represents one possible source of fluctuations in executive test performance. However, the relationship between expressive suppression and EF and motor performance has not yet been examined in older adults, who are more prone to EF and motor fluctuations than are younger adults...
August 13, 2018: Journal of Clinical and Experimental Neuropsychology
Dorice Hankemeier, Sarah A Manspeaker
CONTEXT:   The ability to engage in interprofessional and collaborative practice (IPCP) has been identified as one of the Institute of Medicine's core competencies required of all health care professionals. OBJECTIVE:   To determine the perceptions of athletic trainers (ATs) in the collegiate setting regarding IPCP and current practice patterns. DESIGN:   Cross-sectional study. PATIENTS OR OTHER PARTICIPANTS:   Of 6313 ATs in the collegiate setting, 739 (340 men, 397 women, 2 preferred not to answer; clinical experience = 10...
August 13, 2018: Journal of Athletic Training
Dana J Caldwell, Kaelyn E Petras, Brandi L Mattison, Raegan J Wells, Victoria L Heffelman
OBJECTIVE: To describe the clinical presentation of a dog with spontaneous hemoperitoneum associated with anaphylactic shock from Hymenoptera envenomation. CASE SUMMARY: An 8-year-old female neutered Beagle presented as an emergency for acute onset of collapse, hematemesis, and hematochezia. The dog was tachycardic, tachypneic, and hypotensive. Initial assessment revealed a hemoperitoneum with documentation of a nonclotting sanguineous peritoneal effusion with PCV 81% and total protein concentration 65 g/L (6...
August 13, 2018: Journal of Veterinary Emergency and Critical Care
Yuki Matsumoto, Haeru Hayashi, Koichiro Tahara, Takuya Yasuda, Shoko Tsubouchi, Yusuke Yamamoto, Takahiro Mizuuchi, Hiroaki Mori, Tetsuji Sawada
Gastric antral vascular ectasia (GAVE) is a rare cause of chronic gastric hemorrhaging and iron deficiency anemia and is characterized by a distinctive endoscopic appearance. The main treatment of GAVE is endoscopic; however, medication is necessary in refractory cases. We herein report a 69-year-old woman with systemic sclerosis (SSc) who developed recurrent severe anemia after endoscopic treatment of GAVE that was successfully managed using intravenous cyclophosphamide (IVCY). The recurrence of GAVE after discontinuation of IVCY was successfully managed using a combination of IVCY and endoscopic treatment, without blood transfusion...
August 10, 2018: Internal Medicine
Toshiyuki Koya, Takashi Hasegawa, Junko Takasawa, Fumitoshi Yoshimine, Takuro Sakagami, Masachika Hayashi, Eiichi Suzuki, Toshiaki Kikuchi
Objective High adherence to medications and accurate handling of inhaler devices are important for asthma management. However, few reports to date have simultaneously evaluated adherence and handling errors. We therefore investigated the adherence to inhaled corticosteroid (ICS) and inhaler handling errors in the same patients in cooperation with pharmacists. Methods Data were derived from a survey of physicians and pharmacists treating asthma patients who visited participating hospitals and pharmacies from July 2012 to January 2013...
August 10, 2018: Internal Medicine
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