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Florentine Schreiner, Gurpreet Anand, Felix Beuschlein
Endocrine active adrenal tumors are associated with a relevant risk of complications during surgery, either due to direct hemodynamic effects of the hormone excess or due to hormone related comorbidities. Over the last decades, careful preoperative evaluation and improved peri-interventional medical management of affected patients has resulted in a significant reduction of perioperative complications. In addition, improvement in anesthesia and surgical techniques with the feasibility of laparoscopic adrenalectomy have contributed to reduce morbidity...
August 14, 2018: Experimental and Clinical Endocrinology & Diabetes
Gang Jee Ko, Connie M Rhee, Yoshitsugu Obi, Tae Ik Chang, Melissa Soohoo, Tae Woo Kim, Csaba P Kovesdy, Elani Streja, Kamyar Kalantar-Zadeh
Background: Arteriovenous fistulas (AVFs) are the preferred vascular access type in most hemodialysis patients. However, the optimal vascular access type in octogenarians and older (≥80 years) hemodialysis patients remains widely debated given their limited life expectancy and lower AVF maturation rates. Methods: Among incident hemodialysis patients receiving care in a large national dialysis organization during 2007-2011, we examined patterns of vascular access type conversion in 1 year following dialysis initiation in patients <80 versus ≥80 years of age...
August 9, 2018: Nephrology, Dialysis, Transplantation
Jung Youn Kim, Ji Eun Park, Youngheun Jo, Woo Hyun Shim, Soo Jung Nam, Jeong Hoon Kim, Roh-Eul Yoo, Seung Hong Choi, Ho Sung Kim
Background: Pseudoprogression is a diagnostic challenge in early post-treatment glioblastoma. We therefore developed and validated a radiomics model using multiparametric MRI to differentiate pseudoprogression from early tumor progression in patients with glioblastoma. Methods: The model was developed from the enlarging contrast-enhancing portions of 61 glioblastomas within 3 months after standard treatment with 6472 radiomic features being obtained from contrast-enhanced T1-weighted imaging, fluid-attenuated inversion recovery imaging, and apparent diffusion coefficient (ADC), and cerebral blood volume (CBV) maps...
August 11, 2018: Neuro-oncology
Yuko Sato, Mitsunori Miyashita, Kazuki Sato, Kenji Fujimori, Koichi Benjamin Ishikawa, Hiromasa Horiguchi, Kiyohide Fushimi, Chikashi Ishioka
Background: End-of-life (EOL) cancer care in Japanese acute care hospitals has not been well described. Methods: We aimed to assess the aggressiveness of EOL care and examine common treatments administered to cancer patients using a health administrative database. Subjects are adult cancer patients who died at acute care hospitals between April 2011 and March 2014. Data from the Japanese Diagnosis Procedure Combination database were analysed to measure the aggressiveness of care (chemotherapy, intensive care unit [ICU] admission and cardiopulmonary resuscitation [CPR]) and describe procedures and prescriptions administered in the last 14 and 30 days of life, disaggregated by hospital case volume: high, intermediate and low volumes...
August 13, 2018: Japanese Journal of Clinical Oncology
Abhilasha Karkey, Niva Joshi, Shiva Chalise, Suchita Joshi, Shrijana Shrestha, To Nguyen Thi Nguyen, Sabina Dongol, Buddha Basnyat, Stephen Baker, Christine J Boinett
Background: Human infections with Serratia spp. are generally limited to Serratia marcescens and the Serratia liquefaciens complex. There is little data regarding the infections caused by the remaining Serratia spp., as they are seldom isolated from clinical specimens. Methods: In this health care setting in Kathmandu, Nepal routine blood culture is performed on all febrile patients with a temperature >38°C or when there is clinical suspicion of bacteremia. During 2015 we atypically isolated and identified several Serratia spp...
August 11, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
Weiqing Ge, Brittany Hians, Alison Sfara
Background: Existing variation has been identified in the rehabilitation programs for patients following cardiac surgery. Sternal precautions are believed to be overly restrictive and detrimental to patient recovery both physically and psychologically. Objective: The objective of this study was to determine the deformation of sternal skin during shoulder movements and upper extremity activities using a non-contact approach. Design: This study was a cross-sectional, nonexperimental observational study...
August 13, 2018: Physical Therapy
Hanna Grol-Prokopczyk
Objectives: This study identifies sociodemographic predictors of prescription opioid use among older adults (age 65+) during the peak decade of U.S. opioid prescription, and tests whether pain level and Medicaid coverage mediate the association between low wealth and opioid use. Predictors of prescription nonsteroidal anti-inflammatory drug (NSAID) use, and of opinions of both drug classes, are also examined. Method: Regressions of opioid and NSAID use on sociodemographic characteristics, pain level, and insurance type were conducted using Health and Retirement Study 2004 core and 2005 Prescription Drug Study data (n=3,721)...
August 13, 2018: Journals of Gerontology. Series B, Psychological Sciences and Social Sciences
Arek J Wiktor, Laura Madsen, Heather Carmichael, Tyler Smith, Shana Zanyk, Hamed Amani, Anne Lambert Wagner
Technology and telehealth have the potential to optimize burn care in areas limited by lack of expertise and geographic distance from a Burn Center. This study reports a multicenter, multiregional experience using a mobile phone app to facilitate triage of patients by allowing referring providers to send encrypted photos, thus enhancing the telephone consultation process. A retrospective review was conducted on referrals from August 2016 to July 2017 at three regional Burn Centers that utilize the same mobile phone app...
August 10, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Lindsay D Oliver, John D Haltigan, James M Gold, George Foussias, Pamela DeRosse, Robert W Buchanan, Anil K Malhotra, Aristotle N Voineskos
Background: Schizophrenia spectrum disorders (SSDs) often feature social cognitive deficits. However, little work has focused on the factor structure of social cognition, and results have been inconsistent in schizophrenia. This study aimed to elucidate the factor structure of social cognition across people with SSDs and healthy controls. It was hypothesized that a 2-factor model, including lower-level "simulation" and higher-level "mentalizing" factors, would demonstrate the best fit across participants...
August 10, 2018: Schizophrenia Bulletin
Fausto Caruana, Marzio Gerbella, Pietro Avanzini, Francesca Gozzo, Veronica Pelliccia, Roberto Mai, Rouhollah O Abdollahi, Francesco Cardinale, Ivana Sartori, Giorgio Lo Russo, Giacomo Rizzolatti
The cingulate cortex is a mosaic of different anatomical fields, whose functional characterization is still a matter of debate. In humans, one method that may provide useful insights on the role of the different cingulate regions, and to tackle the issue of the functional differences between its anterior, middle and posterior subsectors, is intracortical electrical stimulation. While previous reports showed that a variety of integrated behaviours could be elicited by stimulating the midcingulate cortex, little is known about the effects of the electrical stimulation of anterior and posterior cingulate regions...
August 13, 2018: Brain: a Journal of Neurology
Gianfranco Frojo, Aaron Dotson, Kara Christopher, Sumesh Kaswan, Herluf Lund
Background: Anesthesia for elective ambulatory procedures must provide appropriate pain control while minimizing perioperative risk. Local anesthesia in combination with oral sedation provides a safe office-based method of anesthesia for rhytidectomy. Objectives: The purpose of this analysis was to identify the incidence of traditional outcome parameters in ambulatory rhytidectomy performed with local anesthesia and oral sedation. Methods: A retrospective chart review was performed on all patients who underwent office-based rhytidectomy under local anesthesia with oral sedation from February 2011 to May 2017...
August 13, 2018: Aesthetic Surgery Journal
Sarah J Gutman, Benedict T Costello, Stavroula Papapostolou, Aleksandr Voskoboinik, Leah Iles, Johnson Ja, James L Hare, Andris Ellims, Peter M Kistler, Thomas H Marwick, Andrew J Taylor
Aims: In patients with non-ischaemic cardiomyopathy (NICM), the mortality benefit of a primary prevention implantable cardioverter-defibrillator (ICD) has been challenged. Left ventricular (LV) scar identified by cardiac magnetic resonance (CMR) imaging is associated with a high risk of malignant arrhythmia in NICM. We aimed to determine the impact of LV scar on the mortality benefit from a primary prevention ICD in NICM. Methods and results: We recruited 452 consecutive heart failure patients [New York Heart Association (NYHA) Class II/III] with NICM and LV ejection fraction ≤35% from a state-wide CMR service...
August 10, 2018: European Heart Journal
Hari Padmanabhan, Keith Siau, Alan M Nevill, Ian Morgan, James Cotton, Alex Ng, Matthew J Brookes, Heyman Luckraz
OBJECTIVES: Preoperative anaemia is a strong predictor of blood transfusion requirements and must be assessed for appropriate optimization before elective surgery. Iron therapy is a transfusion-sparing approach effective for increasing haemoglobin concentrations. However, its role in elective cardiac surgery and the optimal route of administration remain unknown. This single-centre, non-blinded, randomized, controlled trial compared the effectiveness of intravenous ferric carboxymaltose therapy with oral iron for anaemic patients undergoing elective cardiac surgery...
August 9, 2018: Interactive Cardiovascular and Thoracic Surgery
Maya Gopalakrishnan, Kolar Vishwanath Vinod, Tarun Kumar Dutta, Kusha Kumar Shaha, Magadi Gopalakrishna Sridhar, Suman Saurabh
Background: Viper envenomation contributes to nearly 50% of snake-bite deaths in India, chiefly due to circulatory shock. The mechanisms leading to circulatory shock include bleeding, capillary leak syndrome (CLS) and myocardial depression. Pituitary-adrenal axis involvement in circulatory shock, though described, has not been fully elucidated. Aims: To identify predictors of circulatory shock and mortality in viper envenomation and explore the role of pituitary-adrenal axis in circulatory shock...
August 13, 2018: QJM: Monthly Journal of the Association of Physicians
Amanda Ricciuto, Jasbir Dhaliwal, Thomas D Walters, Anne M Griffiths, Peter C Church
Background and aims: We undertook a systematic review and meta-analysis examining the effectiveness of therapeutic drug monitoring (TDM) to improve clinical outcomes in anti-TNF-treated IBD patients. Methods: We searched MEDLINE, Epub Ahead of Print, EMBASE and Cochrane through October 2017 for randomized trials (RCTs) and cohort studies comparing proactive or reactive TDM to each other or empiric care. Outcomes included clinical remission (primary), clinical relapse, endoscopic remission, anti-TNF response durability, cost and adverse events (secondary)...
August 10, 2018: Journal of Crohn's & Colitis
Richard E Nelson, Martin E Evans, Loretta Simbartl, Makoto Jones, Matthew H Samore, Stephen M Kralovic, Gary A Roselle, Michael A Rubin
Background: The Department of Veterans Affairs implemented an active surveillance program for methicillin-resistant Staphylococcus aureus (MRSA) in 2007 in which acute care inpatients are tested for MRSA carriage on admission, unit-to-unit transfer, and discharge. Using these data, we followed patients longitudinally to estimate the difference in infection rates for those who were not colonized, those who were colonized on admission (importers), and those who acquired MRSA during their stay...
August 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Süleyman Tas
Background: The cephalic trimming of the lower lateral cartilage (LLC) is an attempt to reduce tip bulbosity; unfortunately, it has the potential to cause a pinched nose deformity and valve collapse. Objectives: To use the superior-based transposition (ST) flap to reshape, relocalize, and reinforce the LLC as a support material for both internal and external valves with aesthetic corrections, leaving the scroll area untouched. Methods: A total of 367 patients (female, 215; male, 152) were operated with the presented technique...
August 10, 2018: Aesthetic Surgery Journal
Lydia Giannitrapani, Walter Granà, Anna Licata, Cosima Schiavone, Giuseppe Montalto, Maurizio Soresi
OBJECTIVE: Non-selective β-blockers (NSBBs) are used in liver cirrhosis (LC) to prevent variceal bleeding because they decrease portal pressure. A main risk factor for the development of portal vein thrombosis (PVT) in LC is decreased portal vein inflow velocity. The aim of our study was to examine retrospectively the incidence of PVT and its correlation with the use of β-blockers in a cohort of LC patients. SUBJECTS AND METHODS: Data from 230 LC patients (90% Child-Pugh class A), who had been followed up for at least 5 years, were reviewed...
August 14, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Hisao Imai, Yutaka Yamada, Tomohide Sugiyama, Hiroyuki Minemura, Kyoichi Kaira, Kenya Kanazawa, Takashi Kasai, Takayuki Kaburagi, Koichi Minato
BACKGROUND/AIMS: More than 50% of patients with lung cancer are aged > 65 years, and non-small-cell lung cancer (NSCLC) accounts for 85% of all cases of lung cancer among both elderly and adult patients. Subsequent therapies confound the capability to discern the effect of first-line chemotherapy on overall survival (OS). Therefore, using individual-level data, our study aimed to determine the relationships of progression-free survival (PFS) and post-progression survival (PPS) with OS after first-line epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment in elderly patients with NSCLC harboring sensitive EGFR mutations...
August 14, 2018: Chemotherapy
Jung Hoon Kim, Joonho Chung, Seung Kon Huh, Keun Young Park, Dong Joon Kim, Byung Moon Kim, Jae Whan Lee
OBJECTIVES: Therapeutic strategies for residual or recurrent aneurysm (RRA) after microsurgical clipping have not been well established. The purpose of this study was to report our retreatment experiences with previously clipped aneurysms and to demonstrate retreatment strategies for these RRAs. PATIENTS AND METHODS: From 1996-2016, we treated 68 RRAs after previous clipping. Among them, 34 patients underwent microsurgical retreatment, and the other 34 underwent endovascular retreatment...
August 6, 2018: Clinical Neurology and Neurosurgery
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