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Gavin Docherty, Jiyoung Hwang, Michelle Yang, Brennan Eadie, Kathryn Clapson, Jodi Siever, Simon J Warner
OBJECTIVE: This study was conducted to analyze data from emergency ophthalmology referrals after hours from different hospitals to identify the most common pathologies and compare accuracy of diagnoses. Additionally, examination findings, including visual acuity (VA), intraocular pressure (IOP), and pupils from referring service and ophthalmic examination, were compared to assess agreement. DESIGN: This was a prospective study that reviewed information collected from referring services to the emergency on-call ophthalmology service and compared it with ophthalmic examination between February 2017 and July 2017...
October 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
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
Carlo Lomonte, Carlo Basile, Sandip Mitra, Christian Combe, Adrian Covic, Andrew Davenport, Dimitrios Kirmizis, Daniel Schneditz, Frank van der Sande
Life-sustaining haemodialysis requires a durable vascular access (VA) to the circulatory system. The ideal permanent VA must provide longevity for use with minimal complication rate and supply sufficient blood flow to deliver the prescribed dialysis dosage. Arteriovenous fistulas (AVFs) have been endorsed by many professional societies as the VA of choice. However, the high prevalence of comorbidities, particularly diabetes mellitus, peripheral vascular disease and arterial hypertension in elderly people, usually make VA creation more difficult in the elderly...
October 17, 2018: Nephrology, Dialysis, Transplantation
Takuro Washio, Jennifer R Vranish, Jasdeep Kaur, Benjamin E Young, Keisho Katayama, Paul J Fadel, Shigehiko Ogoh
The mechanism(s) for the increased occurrence of a grayout or blackout, syncope, immediately after heavy resistance exercise are unclear. It is well-known that orthostatic stress increases the occurrence of postexercise syncope. In addition, previous findings have suggested that hypo-perfusion, especially in the posterior cerebral circulation rather than anterior cerebral circulation, may be associated with the occurrence of syncope. Herein, we hypothesized that the postexercise decrease in posterior, but not anterior, cerebral blood flow (CBF) would be greater during orthostatic stress...
October 2018: Physiological Reports
Aaron Legler, Megan Price, Megha Parikh, Jonathan R Nebeker, Merry C Ward, Linda Wedemeyer, Steven D Pizer
PURPOSE: To examine associations between patient perceptions that their provider was knowledgeable of their medical history and clinicians' early adoption of an application that presents providers with an integrated longitudinal view of a patient's electronic health records (EHR) from multiple healthcare systems. METHOD: This retrospective analysis utilizes provider audit logs from the Veterans Health Administration Joint Legacy Viewer (JLV) and patient responses to the Survey of Patient Healthcare Experiences Patient-Centered Medical Home (SHEP/PCMH) patient satisfaction survey (FY2016) to assess the relationship between the primary care provider being an early adopter of JLV and patient perception of the provider's knowledge of their medical history...
October 18, 2018: Journal of General Internal Medicine
Jingzhi Li, Yang Hua, Laurence Needleman, Flemming Forsberg, John R Eisenbray, Zhaojun Li, Ran Liu, Xiaojie Tian, Liqun Jiao, Ji-Bin Liu
OBJECTIVE: The study was designed to investigate if vascular occlusion in the internal carotid artery (ICA) or the contralateral vertebral artery (VA) contribute to developing in-stent restenosis (ISR) in patients with vertebral artery ostium stenosis (VAOS). METHODS: 420 consecutive patients treated with VAOS stents (from a population of 8145 patients with VAOS) from January 2013 to December 2014 were analyzed in this retrospective study; 216 with drug eluted stents and 204 with bare metal stents...
October 18, 2018: Journal of Neurointerventional Surgery
Jeremy P Moore, Kevin M Shannon, Roberto G Gallotti, Christopher J McLeod, Anca Chiriac, Edward P Walsh, Narayanswami Sreeram, Akash R Patel, Natasja M De Groot, Johannes von Alvensleben, Seshadri Balaji, David S Frankel, Christina Y Miyake, James C Perry, Kalyanam Shivkumar
OBJECTIVES: The purpose of this study was to determine the ventricular arrhythmia (VA) substrates in patients with unoperated and post-surgical Ebstein's Anomaly (EA). BACKGROUND: EA is associated with variable atrialization of the right ventricle and a propensity for VA and sudden death. There are scant data on catheter ablation for VA in this population. METHODS: This was a retrospective study involving 11 congenital heart disease centers...
October 2018: JACC. Clinical Electrophysiology
Yung-Ho Hsu, Yu-Chun Yen, Yi-Chun Lin, Li-Chin Sung
BACKGROUND: In this study, we evaluated the effects of various medications on the patency of vascular access (VA) for hemodialysis. METHODS: We analyzed data from the Longitudinal Health Insurance Database of Taiwan. We adopted a case-control study design within a cohort of patients who had received regular hemodialysis between 2002 and 2012; 34,354 patients with first VA failure were identified, and the duration from VA creation date to the first VA failure date was calculated...
2018: PloS One
Joshua D Niznik, Song Zhang, Maria K Mor, Xinhua Zhao, Mary Ersek, Sherrie L Aspinall, Walid F Gellad, Joshua M Thorpe, Joseph T Hanlon, Loren J Schleiden, Sydney Springer, Carolyn T Thorpe
OBJECTIVES: To evaluate the predictive validity of an adapted version of the Minimum Data Set (MDS) Mortality Risk Index-Revised (MMRI-R) based on MDS version 3.0 assessment items (MMRI-v3) and to compare the predictive validity of the MMRI-v3 with that of a single MDS item indicating limited life expectancy (LLE). DESIGN: Retrospective, cross-sectional study of MDS assessments. Other data sources included the Veterans Affairs (VA) Residential History File and Vital Status File...
October 18, 2018: Journal of the American Geriatrics Society
Tuan Anh Nguyen, Huong Nguyen, Thang Pham, Trong Hung Nguyen, Ladson Hinton
BACKGROUND: Resources for Enhancing All Caregivers Health in the Department of Veterans Affairs (REACH VA) is an evidence-based intervention supporting family dementia caregivers that has been shown to improve caregiver outcomes for culturally diverse populations in the United States. However, this model has not been tested in low- and middle-income countries (LMICs) including Vietnam, where community-based psychosocial interventions are urgently needed. The objectives of this study are to assess the feasibility and preliminary effectiveness of a culturally adapted version of the Resources for Enhancing All Caregivers Health in Vietnam (REACH VN)...
October 2018: Medicine (Baltimore)
Ming Wei, Yuxiang Ma, Long Yin
INTRODUCTION: The endovascular treatment of intracranial atherosclerotic stenosis has become a common intervention. However, few reports are available regarding stenting performed for hypoplastic vertebral artery (HVA) with multiple atherosclerotic lesions. Combining multiple neuroendovascular devices provides more possibilities for technical success. We describe a stenting technique using a distal intracranial catheter (Navien) for providing an approach to an HVA with multiple existing atherosclerotic lesions...
October 2018: Medicine (Baltimore)
Wasawat Vutthikraivit, Pattara Rattanawong, Jakrin Kewcharoen, Chanavuth Kanitsoraphan, Pavida Pachariyanon, Sakolwan Suchartlikitwong, Saranapoom Klomjit, Pakpoom Tantrachoti
BACKGROUND: Recent studies suggested that chronic total occlusion of the coronary artery increased risk of ventricular arrhythmia (VA) and all-cause mortality in ischaemic cardiomyopathy (ICM) patient who underwent implantable cardiac defibrillator (ICD) implantation. We aim to demonstrate an association between a presence of CTO and poor cardiovascular outcome in ICD implanted ICM patients. OBJECTIVE: To examine the association between the presence of CTO and all-cause mortality in ICM with ICD implantation Methods: We comprehensively searched the databases of MEDLINE and EMBASE from inception to February 2018...
October 17, 2018: Acta Cardiologica
Carolyn T Thorpe, Walid F Gellad, Maria K Mor, John P Cashy, John R Pleis, Courtney H Van Houtven, Loren J Schleiden, Joseph T Hanlon, Joshua D Niznik, Ronald L Carico, Chester B Good, Joshua M Thorpe
OBJECTIVE: To evaluate the effect of dual use of VA/Medicare Part D drug benefits on antihypertensive medication supply in older Veterans with dementia. DATA SOURCES/STUDY SETTING: National, linked 2007-2010 Veterans Affairs (VA) and Medicare utilization and prescription records for 50,763 dementia patients with hypertension. STUDY DESIGN: We used inverse probability of treatment (IPT)-weighted multinomial logistic regression to examine the association of dual prescription use with undersupply and oversupply of antihypertensives...
October 16, 2018: Health Services Research
Irwin M Feuerstein, Marjorie R Jenkins, Susan G Kornstein, Michael S Lauer, Pamela E Scott, Tonse N K Raju, Tamara Johnson, Stephanie Devaney, Milena Lolic, Marsha Henderson, Janine Austin Clayton
Historically, women have been underrepresented in clinical research, requiring physicians to extrapolate medical recommendations for women from clinical research done in cohorts consisting predominantly of male participants. While government-funded clinical research has achieved gender parity in phase-3 clinical trials across many biomedical disciplines, improvements are still needed in several facets of women's health research, such as the inclusion of women in early-phase clinical trials, the inclusion of pregnant women and women with physical and intellectual disabilities, the consideration of sex as a biological variable in preclinical research, and the analysis and reporting of sex and gender differences across the full biomedical research continuum...
October 2018: Journal of Women's Health
Bonnielin K Swenor, Xinxing Guo, Michael V Boland, Judith E Goldstein
PURPOSE: To use electronic health record (EHR) data to estimate the prevalence and characteristics of low-vision (LV) patients. METHODS: EHR data were obtained for all patients at the nine clinical locations of the Wilmer Eye Institute in 2014. LV status at each visit was defined as visual acuity (VA) worse than 20/40 in the better-seeing eye. Prevalence and incidence estimates were determined over a 12-month period. Demographic and clinical data were used to compare the characteristics of patients with and without LV...
October 16, 2018: Ophthalmic Epidemiology
Gianni Virgili, Mariacristina Parravano, Jennifer R Evans, Iris Gordon, Ersilia Lucenteforte
BACKGROUND: Diabetic macular oedema (DMO) is a common complication of diabetic retinopathy. Antiangiogenic therapy with anti-vascular endothelial growth factor (anti-VEGF) can reduce oedema, improve vision and prevent further visual loss. These drugs have replaced laser photocoagulation as the standard of care for people with DMO. OBJECTIVES: The 2014 update of this review found high-quality evidence of benefit with anti-VEGF modalities, compared to laser photocoagulation, for the treatment of DMO...
October 16, 2018: Cochrane Database of Systematic Reviews
Valentine Millien, Daniel Rosen, Jason Hou, Rajesh Shah
BACKGROUND: Microscopic colitis (MC), a subtype of inflammatory bowel disease, is a chronic condition of unknown etiology. Recent evidence has linked MC with intriguing changes in the stool microbiota, which may be linked to disease pathogenesis. The composition of the mucosal microbiome in patients with MC remains unclear. METHODS: We performed a cross-sectional study comparing colonic tissue samples from patients with MC to those of healthy controls at the Michael E...
October 15, 2018: Digestive Diseases and Sciences
L F Rose, E J Wolf, T Brindle, A Cernich, W K Dean, C L Dearth, M Grimm, A Kusiak, R Nitkin, K Potter, B J Randolph, F Wang, D Yamaguchi
Regenerative rehabilitation is the synergistic integration of principles and approaches from the regenerative medicine and rehabilitation fields, with the goal of optimizing form and function as well as patient independence. Regenerative medicine approaches for repairing or replacing damaged tissue or whole organs vary from utilizing cells (e.g., stem cells), to biologics (e.g., growth factors), to approaches using biomaterials and scaffolds, to any combination of these. While regenerative medicine offers tremendous clinical promise, regenerative rehabilitation offers the opportunity to positively influence regenerative medicine by inclusion of principles from rehabilitation sciences...
2018: NPJ Regenerative Medicine
Luca Rosignoli, Stephen Myles Potter, Andres Gonzalez, Sarina Amin, Syed G Khurshid
We report a case of central serous chorioretinopathy (CSC) that developed 1 month after an intralesional injection of triamcinolone acetonide that was administered during removal of a chalazion. The subretinal fluid and ipsilateral visual acuity (VA) worsened with initial observation. The edema resolved with verteporfin photodynamic therapy (PDT) 1 month after diagnosis, but VA did not improve during short-term follow-up. We conclude that CSC can occur as a complication of low-dose intrapalpebral corticosteroid administration and provide another example of the therapeutic role of PDT in the management of this disease...
September 2018: Case Reports in Ophthalmology
Linda Ewing-Cobbs, Charles S Cox, Amy E Clark, Richard Holubkov, Heather T Keenan
: media-1vid110.1542/5828371885001PEDS-VA_2018-0939 Video Abstract OBJECTIVES: We examined whether preinjury, demographic, and family factors influenced vulnerability to postconcussion symptoms (PCSs) persisting the year after mild traumatic brain injury (mTBI). METHODS: Children with mTBI ( n = 119), complicated mild traumatic brain injury (cmTBI) ( n = 110), or orthopedic injury (OI) ( n = 118), recruited from emergency departments, were enrolled in a prospective, longitudinal cohort study...
October 15, 2018: Pediatrics
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