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Filippo Montevecchi, Alberto Caranti, Giovanni Cammaroto, Giuseppe Meccariello, Claudio Vicini
Eagle syndrome is a rare and poorly understood clinical condition caused by an elongated or disfigured styloid process. The possible managements of Eagle syndrome include conservative medical treatment or surgical intervention. The surgical removal of the elongated styloid process may be efficiently achieved either by an intraoral or a transcervical approach. An effective styloidectomy may be either total or partial, provided the bony residue's length is within the range of normality. Here, we report our experience with a bilateral robotic-assisted styloidectomy in a young female patient...
December 11, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Thomas Bøker Lund, John Brodersen, Peter Sandøe
OBJECTIVES: The study investigated whether treatment options for episodic tension-type headache vary among general practitioners (GPs) in Denmark depending on the patients' weight status and gender, and whether these decisions can be explained by the GPs' own anti-fat bias and lifestyle. METHODS: A cross-sectional questionnaire study with responses from 240 GPs on measures of anti-fat bias, healthiness of GPs' lifestyles, and reported patient treatment decisions...
December 11, 2018: Obesity Facts
Jitka Vanderpol, Leon Jonker
OBJECTIVE: Greater occipital nerve (GON) block is a treatment option applied for a variety of primary headache disorders. Although a patient's body position is known to have an impact on the effect of local anaesthetics, this has not before been investigated for patients undergoing GON block. Therefore, the clinical effectiveness of either a sitting or supine position was assessed. PATIENTS AND METHODS: This evaluative prospective study took place in a single neurology department in the UK...
December 3, 2018: Clinical Neurology and Neurosurgery
Leonard J Keller, Vincent J Alentado, Joseph E Tanenbaum, Bryan S Lee, Amy S Nowacki, Edward C Benzel, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: A spinal epidural abscess (SEA) is a serious condition that may be managed with antibiotics alone or with decompressive surgery combined with antibiotics. PURPOSE: The objectives of this study were to assess the clinical outcomes of SEA after surgical management and to identify the patient-level factors that are associated with outcomes following surgical decompression and removal of SEA. STUDY DESIGN/SETTING: Retrospective chart review analysis...
December 8, 2018: Spine Journal: Official Journal of the North American Spine Society
Mitsuru Yagi, Naobumi Hosogane, Nobuyuki Fujita, Eijiro Okada, Satoshi Suzuki, Osahiko Tsuji, Narihito Nagoshi, Takashi Asazuma, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
BACKGROUND CONTEXT: Corrective surgery for adult spinal deformity (ASD) improves health-related quality of life but has high complication rates. Predicting a patient's risk of perioperative and late postoperative complications is difficult, although several potential risk factors have been reported. PURPOSE: To establish an accurate, ASD-specific model for predicting the risk of postoperative complications, based on baseline demographic, radiographic, and surgical invasiveness data in a retrospective case series...
December 8, 2018: Spine Journal: Official Journal of the North American Spine Society
Sofa D Alfian, Ivan S Pradipta, Eelko Hak, Petra Denig
OBJECTIVES: We reviewed measures used to estimate adherence and persistence to multiple cardiometabolic medications from prescription data, particularly for blood pressure-lowering, lipid-lowering, and/or glucose-lowering medication, and give guidance on which measures to choose. STUDY DESIGN AND SETTING: A literature search of Medline, Embase, and PsycINFO databases was conducted to identify studies assessing medication adherence and/or persistence for patients using multiple cardiometabolic medications...
December 8, 2018: Journal of Clinical Epidemiology
King Cp, Kives S
BACKGROUND: The Mirena levonorgestrel intrauterine system (IUS) is frequently used for menstrual suppression in adolescents with special needs. However, the presence of a uterine anomaly is generally considered a contraindication to IUS insertion, thereby excluding a potentially highly effective option for this patient population. CASE: A Mirena IUS was utilized in a medically and surgically complex special needs 14-year-old adolescent with a didelphys uterus and obstructed hemivagina...
December 8, 2018: Journal of Pediatric and Adolescent Gynecology
Daniel B Chastain, Anthony Davis
Osteomyelitis remains difficult to treat, typically requiring a prolonged course of intravenous (IV) antibiotics. The optimal route and duration of antibiotics remains ill-defined due to limited prospective clinical trials. Oritavancin is a long acting, semisynthetic, lipoglycopeptide antibiotic with rapid, concentration-dependent bactericidal activity against many Gram-positive organisms. Favorable pharmacokinetics makes oritavancin an appealing alternative for currently available antibiotics requiring daily infusions to decrease the risk of vascular access complications associated with outpatient antimicrobial therapy...
December 8, 2018: International Journal of Antimicrobial Agents
Anjali V Desai, Virginia M Klimek, Kimberly Chow, Andrew S Epstein, Camila Bernal, Kelly Anderson, Molly Okpako, Robin Rawlins-Duell, Dana Kramer, Danielle Romano, Jessica I Goldberg, Judith E Nelson
BACKGROUND: Prior work to integrate early palliative care in oncology has focused on patients with advanced cancer and primarily on palliative care consultation. We developed this outpatient clinic initiative for newly diagnosed patients at any stage, emphasizing primary (nonspecialist) palliative care by oncology teams, with enhanced access to palliative care specialists. METHODS: We piloted the project in two medical oncology specialty clinics (for patients with myelodysplastic syndrome and GI cancer, respectively) to establish feasibility...
December 2018: Journal of Oncology Practice
Jessica A Zerillo, Victoria Carballo, Carole K Tremonti, Orinta Kalibatas, Brian M Cummings, Joseph O Jacobson
PURPOSE: Training clinical and supportive staff in quality improvement (QI) theory and use of QI tools has the potential to improve oncology care delivery. We report our combined experience of providing training to oncologists in a variety of local settings and assess the effect of the training on individual participants and for institutions. METHODS: Multidisciplinary oncology teams at a comprehensive cancer center, an academic medical center, and community practices were led through experiential QI training that spanned several months...
December 2018: Journal of Oncology Practice
Kilian Fröhlich, Ralf A Linker, Tobias Engelhorn, Arnd Dörfler, De-Hyung Lee, Konstantin Huhn, Stefan Schwab, Max J Hilz, Frank Seifert, Klemens Winder
BACKGROUND AND PURPOSE: Bowel incontinence in multiple sclerosis might be associated with specific lesion sites. This study intended to determine associations between bowel incontinence and cerebral multiple sclerosis lesions using a voxel-wise lesion symptom mapping analysis. METHODS: We conducted a retrospective study of multiple sclerosis patients with self-reported bowel incontinence and matched controls. Lesions were manually outlined on T2-weighted MRI scans and transformed into stereotaxic space...
December 11, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Susan Dorr Goold, C Daniel Myers, Marion Danis, Julia Abelson, Steve Barnett, Karen Calhoun, Eric G Campbell, Lynette LaHAHNN, Adnan Hammad, René Pérez Rosenbaum, Hyungjin Myra Kim, Cengiz Salman, Lisa Szymecko, Zachary E Rowe
Policy Points Engaging and involving underrepresented communities when setting research priorities could make the scientific research agenda more equitable, more just, and more responsive to their needs and values. Groups and individuals from minority and underserved communities strongly prioritized child health and mental health research, often choosing to invest at the highest possible level. Groups consisting of predominantly Native American or Arab American participants invested in culture and beliefs research at the highest level, while many groups did not select it at all...
December 2018: Milbank Quarterly
James M Szymanski, Cathy Conry-Cantilena, Kamille A West
Idiopathic membranous nephropathy is the most common cause of nephrotic syndrome in nondiabetic adults. The antibody most often implicated is the M-type phospholipase A2 receptor (PLA2R) antibody, found in >70% of primary membranous nephropathy cases. First-line therapy is immunosuppressive in nature, but for patients who are treatment-resistant there is a significant risk of end-stage renal disease and mortality. Hypercholesterolemia is not only a side effect of nephrotic syndrome, but also its presence may worsen renal function...
December 10, 2018: Journal of Clinical Apheresis
David S Shulman, Preeti Mehrotra, Traci M Blonquist, Andrew Capraro, Leslie E Lehmann, Lewis B Silverman, Neeraj K Surana, Andrew E Place
BACKGROUND: Bacillus species are known to cause severe infection in immunocompromised hosts. The incidence of Bacillus bloodstream infections and characteristics of infection among children with cancer or indication for hematopoietic cell transplant (HCT) is unknown. METHODS: We performed a retrospective medical record review of all cases of Bacillus bacteremia between January 1, 2005, and December 31, 2014, at Boston Children's Hospital. We report average incidences from 2012 to 2014...
December 11, 2018: Pediatric Blood & Cancer
Mohamad El Moheb, Johny Nicolas, Assem M Khamis, Ghida Iskandarani, Elie A Akl, Marwan Refaat
BACKGROUND: There is evidence that implantable cardioverter-defibrillator (ICD) for primary prevention in people with an ischaemic cardiomyopathy improves survival rate. The evidence supporting this intervention in people with non-ischaemic cardiomyopathy is not as definitive, with the recently published DANISH trial finding no improvement in survival rate. A systematic review of all eligible studies was needed to evaluate the benefits and harms of using ICDs for primary prevention in people with non-ischaemic cardiomyopathy...
December 8, 2018: Cochrane Database of Systematic Reviews
Cristiane da Mata, Patrick Finbar Allen, Gerald John McKenna, Martina Hayes, Ali Kashan
OBJECTIVE: To assess the oral-health-related quality of life (OHRQoL) in a cohort of Irish older patients and explore associations with overall health status. BACKGROUND: The impact of oral health conditions on older individuals' quality of life may be influenced by patients' general health status. MATERIALS AND METHODS: This paper reports a cross-sectional study, which analysed baseline data from patients aged over 60 years. Patients were recruited from two different environments, namely Cork University Dental Hospital and St...
December 7, 2018: Gerodontology
Ivy Timmermans, Mathias Meine, Istvan Szendey, Johannes Aring, Javier Romero Roldán, Lieselotte van Erven, Philipp Kahlert, Edgar Zitron, Philippe Mabo, Johan Denollet, Henneke Versteeg
BACKGROUND: Patient satisfaction with remote patient monitoring (RPM) of implantable cardioverter defibrillators (ICDs) seems to be high, yet knowledge on long-term patient experiences is limited. The European REMOTE-CIED study explored patient experiences with RPM, examined patient preferences for ICD follow-up, and identified determinants of patient preferences in the first two years post-implantation. METHODS: European heart failure patients (N = 300; median age = 66 years (IQR = 59-73), and 22% female) with a first-time ICD received a Boston Scientific LATITUDE® RPM system and had scheduled in-clinic follow-ups once a year...
December 10, 2018: Pacing and Clinical Electrophysiology: PACE
A Michael Donoghue, James C Wesdock
BACKGROUND: Lobar pneumonia is an occupational disease of welders. This is the first report of global deployment of a pneumococcal vaccination program for welders within a multi-national corporation. METHODS: Global webinars were conducted to introduce the program. Communication packages translated into all location languages were deployed. All employee welders who had not previously been vaccinated were offered a free single dose of pneumococcal polysaccharide vaccine (PPV23) by on-site location medical centers during normal working hours...
December 10, 2018: American Journal of Industrial Medicine
Shu-Yi Hsu, Wen-Shih Huang, Shu-Hui Lee, Tsui-Ping Chu, Yung-Chang Lin, Chang-Hsien Lu, Randal D Beaton, Sui-Whi Jane
The purpose of this study was to evaluate the longitudinal incidence, severity, pattern of changes or predictors of oxaliplatin-induced peripheral neuropathy (OXAIPN) in Taiwanese patients with colorectal cancer. A longitudinal repeated measures study design was employed, and 77 participants were recruited from the colorectal and oncology departments of two teaching medical centres in Taiwan. Physical examinations were performed, and self-reports regarding adverse impacts of OXAIPN and quality of life were obtained at five time points throughout 12 cycles of chemotherapy (C/T)...
December 10, 2018: European Journal of Cancer Care
Sanjay Kumar Yadav, Neeraj Saraf, Narendra S Choudhary, Jayant Kumar Saha, Sujeet Kumar Saha, Amit Rastogi, Prashanth Bhangui, Arvinder Singh Soin
INTRODUCTION: Acute-on-chronic liver failure (ACLF) is a syndrome characterized by acute decompensation of previously diagnosed or undiagnosed liver disease with organ failure(s) with high short-term mortality. This study was conducted to report the outcomes of LDLT in ACLF and assess the survival benefit of liver transplantation in these patients. MATERIALS AND METHODS: It was a retrospective study of 218 ACLF patients (based on EASL-CLIF criteria) from January 2014 through November 2017...
December 8, 2018: Liver Transplantation
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