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Stefan Quadlbauer, Ch Pezzei, J Jurkowitsch, R Rosenauer, A Pichler, S Schättin, T Hausner, M Leixnering
INTRODUCTION: Distal radius fractures (DRF) are the most common fractures of the upper extremities. The incidence is expected to continue rising in the next years due to the increased life expectancy. Palmar locking plate stabilizing has since become the standard treatment for dorsally displaced DRF with a complication rate of 8-39% reported in the literature. Main aim of this study was to investigate the incidence of complications after DRF stabilization using palmar angular stable locking plate...
October 19, 2018: Archives of Orthopaedic and Trauma Surgery
Merle Spriggs, Lynn Gillam
Labiaplasty is a form of genital surgery to reduce large or protruding labia minora. Internationally, the rates of this surgery among women and girls is increasing and is viewed as a worrying trend. Currently, the main clinical strategy is to reassure adolescents that they are normal by talking about the variation of labia size and appearance and showing pictures demonstrating the wide range of normal female genital appearance. For the most part, policy documents recommend against labiaplasty in adolescents, claiming that it is medically non-essential surgery...
October 19, 2018: Journal of Bioethical Inquiry
Kathleen M Aguilar, Katherine B Winfree, Catherine E Muehlenbein, Yajun Emily Zhu, Thomas Wilson, Stewart Wetmore, Eric S Nadler
INTRODUCTION: Targeted therapies, including tyrosine kinase inhibitors (TKIs) that target the sensitizing epidermal growth factor receptor (EGFR) gene are recommended for patients with non-small cell lung cancer (NSCLC). Most patients with NSCLC who test positive for the EGFR mutation and receive TKIs develop resistance to these drugs. Questions remain regarding which treatment sequence is optimal for patients with EGFR-mutant NSCLC, and few studies have evaluated patterns of TKI treatment use in NSCLC, irrespective of EGFR mutation status, in a real-world setting...
October 19, 2018: Advances in Therapy
Cristina Scavone, Maurizio Sessa, Emilio Clementi, Giovanni Corrao, Roberto Leone, Alessandro Mugelli, Francesco Rossi, Edoardo Spina, Annalisa Capuano
BACKGROUND: In recent years, several biosimilar drugs, including those of infliximab, have obtained marketing authorization from the European Medicines Agency (EMA). Given the peculiarity of the safety profile of biological medical products (originator and biosimilars), the evaluation of their tolerability represents an important component of pre-marketing and post-marketing clinical development. For example, infliximab products may cause adverse drug reactions (ADRs) including acute infusion reactions, delayed hypersensitivity reactions, and loss of efficacy, as a direct consequence of immunogenicity...
October 20, 2018: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
Cath Taylor, Andreas Xyrichis, Mary C Leamy, Ellie Reynolds, Jill Maben
OBJECTIVES: (i) To synthesise the evidence-base for Schwartz Center Rounds (Rounds) to assess any impact on healthcare staff and identify key features; (ii) to scope evidence for interventions with similar aims, and compare effectiveness and key features to Rounds. DESIGN: Systematic review of Rounds literature; scoping reviews of comparator interventions (action learning sets; after action reviews; Balint groups; caregiver support programme; clinical supervision; critical incident stress debriefing; mindfulness-based stress reduction; peer-supported storytelling; psychosocial intervention training; reflective practice groups; resilience training)...
October 18, 2018: BMJ Open
Rodney Ogwang, Ronald Anguzu, Pamela Akun, Albert Ningwa, Edward Kayongo, Kevin Marsh, Charles R J C Newton, Richard Idro
OBJECTIVE: Plasmodium falciparum is epileptogenic and in malaria endemic areas, is a leading cause of acute seizures. In these areas, asymptomatic infections are common but considered benign and so, are not treated. The effects of such infections on seizures in patients with epilepsy is unknown. This study examined the relationship between P. falciparum infection and seizure control in children with a unique epilepsy type, the nodding syndrome. DESIGN: This cross-sectional study was nested in an ongoing trial 'Doxycycline for the treatment of nodding syndrome (NCT02850913)'...
October 18, 2018: BMJ Open
Susan M Wcislak, William S King, Benjamin R Waller, Natasha Goins, Paxton V Dickson
BACKGROUND: Multifocal pheochromocytoma/paraganglioma presenting at an early age is commonly associated with a hereditary syndrome. CASE REPORT: A 29-year-old woman was referred for evaluation of multifocal pheochromocytoma/paraganglioma. Interestingly, her family history did not include pheochromocytoma/paraganglioma, and comprehensive genetic testing for the well-documented pheochromocytoma/paraganglioma susceptibility genes was negative. Of note, this patient had a history of a complex cardiac defect resulting in cyanotic congenital heart disease and had never undergone operative repair...
October 16, 2018: Surgery
Christopher R McLaughlin, Michelle Biehl, Brian J Chan, Sarah J Mullen, Lily Zhao, Laura Donaldson, Nirojini Sivachandran, Prima Moinul, Joshua Barbosa, Varun Chaudhary
OBJECTIVE: To characterize emergency optometrist referrals triaged at a tertiary ophthalmology care centre by physical examination findings and provisional diagnosis accuracy. DESIGN: Prospective case review. PARTICIPANTS: Consecutive patients referred to a tertiary eye care clinic for an after-hours ocular consult. METHODS: Variables extracted from the patient charts included date of referral, age, sex, eye(s) under examination, referral visual acuity (VA), referral intraocular pressure (IOP), the referring optometrist's provisional diagnosis, VA at the time of the ophthalmologist consultation, IOP at the time of the ophthalmologist consultation, number of days between referral and ophthalmic consultation, and the ophthalmologist's diagnosis...
October 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Biao Chen, Liaobin Chen, Haitao Chen, Xu Yang, Kai Tie, Hua Wang
BACKGROUND: It is often technically demanding to find and remove loose bodies in several difficult locations like the popliteus hiatus and posterior compartment arthroscopically. We aim to present the technical aspects of establishing some special accessory portals to achieve arthroscopic removal of the loose bodies in these locations. METHODS: From September 2010 to July 2017, 76 patients underwent removal of loose bodies in the popliteus hiatus and posterior compartment arthroscopically using some special accessory portal techniques...
October 19, 2018: Journal of Orthopaedic Surgery and Research
Natascha Platz Batista da Silva, Matthias Hornung, Lukas P Beyer, Christina Hackl, Stefan Brunner, Hans Jürgen Schlitt, Philipp Wiggermann, Ernst Michael Jung
PURPOSE:  Assessment of intraoperative quantitative shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) for the characterization of focal liver lesions (FLLs) during liver surgery using postoperative histopathological results as the gold standard. MATERIALS AND METHODS:  US data of 79 consecutive patients with 98 FLLs who underwent liver surgery between 08/2015 - 06/2017 were prospectively acquired and retrospectively analyzed. Multifrequency linear/T-shaped probes (6 - 9 MHz) were used to store cine loops of at least 5 s and images of B-mode, SWE and CEUS...
October 19, 2018: Ultraschall in der Medizin
Dirk Domagk, Kofi W Oppong, Lars Aabakken, Laszlo Czakó, Tibor Gyökeres, Gianpiero Manes, Peter Meier, Jan-Werner Poley, Thierry Ponchon, Andrea Tringali, Cristina Bellisario, Silvia Minozzi, Carlo Senore, Cathy Bennett, Michael Bretthauer, Cesare Hassan, Michal F Kaminski, Mario Dinis-Ribeiro, Colin J Rees, Cristiano Spada, Roland Valori, Raf Bisschops, Matthew D Rutter
The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). We recommend that endoscopy services across Europe adopt the following seven key and one minor performance measures for EUS and ERCP, for measurement and evaluation in daily practice at center and endoscopist level: 1: Adequate antibiotic prophylaxis before ERCP (key performance measure, at least 90 %); 2: Antibiotic prophylaxis before EUS-guided puncture of cystic lesions (key performance measure, at least 95 %); 3: Bile duct cannulation rate (key performance measure, at least 90 %); 4: Tissue sampling during EUS (key performance measure, at least 85 %); 5: Appropriate stent placement in patients with biliary obstruction below the hilum (key performance measure, at least 95 %); 6: Bile duct stone extraction (key performance measure, at least 90 %); 7: Post-ERCP pancreatitis (key performance measure, less than 10 %)...
October 19, 2018: Endoscopy
Michael D Sgroi, Graeme McFarland, Nathan Itoga, Ehab Sorial, Manuel Garcia-Toca
OBJECTIVE: Limited reports have documented the effect cardiac implantable electronic devices (CIED) have on arteriovenous access patency. Current recommendations suggest placing the access on the contralateral side of the CIED, as there is concern for increased central venous stenosis and access failure. The goal of this study is to review our single center AV access patency rates for dialysis patients with an ipsilateral or contralateral side CIED. METHODS: A retrospective review was performed from 2008-2016 at a single institution identifying all patients who have received a CIED and the diagnosis of ESRD...
October 16, 2018: Annals of Vascular Surgery
Debra S Kovacevich, Mandy Corrigan, Vicki M Ross, Liam McKeever, Amber M Hall, Carol Braunschweig
This document represents the American Society for Parenteral and Enteral Nutrition (ASPEN) clinical guidelines to describe best practices in the selection and care of central venous access devices (CVADs) for the infusion of home parenteral nutrition (HPN) admixtures in adult patients. The guidelines targeted adults >18 years of age in which the intervention or exposure had to include HPN that was administered via a CVAD. Case studies, non-English studies, or studies of CVAD no longer available in the United States were excluded...
October 19, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Eleni E Magira, Ying Jiang, Dimitrios P Kontoyiannis
It is unclear whether differences exist in baseline serum galactomannan (sGM) in patients with hematologic malignancies and invasive pulmonary aspergillosis (IPA) caused by non-fumigatus Aspergillus species vs Aspergillus fumigatus. We found no differences in baseline sGM positivity rates, median sGM levels, and 42-day mortality in 72 such patients (Aspergillus fumigatus in 43 and non-fumigatus Aspergillus in 29).
October 19, 2018: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Carolina Abarca, Cecilia Gheza, Constanza Coda, Bernardita Elicer
According to the World Health Organization, suicide has become a public health problem of global dimensions. Forty-five percent of suicide fatalities had consulted with a primary care doctor in the month preceding the event, but no suicide risk assessment had been conducted. Although suicide is an avoidable event, there is no standardized scale for assessment of suicide risk in the primary health care setting, where mental health care competencies vary and decisions are often guided by clinical judgment. A search and review of the best available evidence was carried out to identify scales for assessment of suicide risk for the nonspecialist doctor (i...
September 20, 2018: Medwave
Jessica Clements
The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education, and professional practice of medical physics. The AAPM has more than 8000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States...
October 19, 2018: Journal of Applied Clinical Medical Physics
Sean Z Wu, Sophie Wang, Rubina Ratnaparkhi, Wilma F Bergfeld
BACKGROUND/OBJECTIVES: Data on treatment options in pediatric alopecia areata are limited. Topical anthralin has been demonstrated to be an effective treatment option in adults and has minimal systemic toxicity. Prior results on its efficacy in children with alopecia areata have been mixed. METHODS: Medical records of 37 patients with alopecia areata who were started on topical anthralin before age 17 were reviewed for efficacy and safety data. Scalp regrowth was quantified by serial photography if available or by medical record documentation if photographs were unavailable...
October 18, 2018: Pediatric Dermatology
Alberto A Uribe, Fernando L Arbona, David C Flanigan, Christopher C Kaeding, Marilly Palettas, Sergio D Bergese
Introduction: Acute postoperative pain following knee arthroscopy is common in orthopedic surgeries. Managing pain postoperatively combines usage of opioids and non-steroidal anti-inflammatory drugs. The aim of this clinical study was to assess the efficacy of two different analgesic treatment regimens: intravenous (IV) ibuprofen and IV ketorolac for the treatment of postoperative pain pertaining to arthroscopic knee surgery. Methods: This was a single center, randomized, double-blind, parallel, active comparator clinical pilot study...
2018: Frontiers in Surgery
Lynn Bar-On, Barbara M Kalkman, Francesco Cenni, Simon-Henri Schless, Guy Molenaers, Constantinos N Maganaris, Alfie Bass, Gill Holmes, Gabor J Barton, Thomas D O'Brien, Kaat Desloovere
Stretch reflex hyperactivity in the gastrocnemius of children with spastic cerebral palsy (CP) is commonly evaluated by passively rotating the ankle joint into dorsiflexion at different velocities, such as applied in conventional clinical spasticity assessments. However, surface electromyography (sEMG) collected from the medial gastrocnemius (MG) during such examination reveals unexplained heterogeneity in muscle activation between patients. Recent literature also highlights altered muscle tensile behavior in children with spastic CP...
2018: Frontiers in Pediatrics
Alan Kawarai Lefor
Simulation has become an important teaching tool, in part because of changes mandated by restrictions in resident work hours. Simulation models include life-like mannequins, ex vivo tissue, cadavers, and live animal models. The Advanced Trauma Operative Management (ATOM) course teaches a standard approach for the treatment of traumatic injuries. The 1-day course includes six lectures in the morning and a live animal surgery laboratory in the afternoon. The animal laboratory includes five standard injury scenarios...
October 2018: Acute Medicine & Surgery
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