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Deteriorating patients

Ayşe Baha, Fatma Yıldırım, Nurdan Köktürk, Züleyha Galata, Nalan Akyürek, Nilgün Yılmaz Demirci, Haluk Türktaş
OBJECTIVES: Organizing pneumonia is an important disease that is associated with non-specific clinical findings and radiographic appearance. Our aim was to examine the clinical and radiological features, laboratory findings, diagnostic approach, and response to therapy in subjects with cryptogenic (COP) and secondary organizing pneumonia (SOP). MATERIALS AND METHODS: Patients' medical records were retrospectively reviewed between 2010 and 2016 in our hospital. We analyzed the symptoms, radiological features, pulmonary function tests, laboratory data, bronchoalveolar lavage findings, treatment, and prognosis...
September 13, 2018: Turkish Thoracic Journal
Rienk Dekker, Yoanna V Hristova, Juha M Hijmans, Jan H B Geertzen
BACKGROUND: Major lower-limb amputation (LLA) predisposes patients post-operatively to a significant decline in daily-life functioning. The physical condition of amputee patients prior to surgery is significantly deteriorated due to chronic peripheral vascular disease (PVD) and diabetes, which accounts for the majority of LLAs in the adult population. A common strategy called pre-rehabilitation has been used in multiple patient populations to prepare the patient for undergoing a surgical event and to improve post-operative patient outcomes...
2018: PloS One
Konstantin Kogan, Rafi Panizel, Yael Perlman
We explore how reliance on part-time medical staff affects operational and medical outcome performance in two general surgery departments Whereas prior research has indicated that operational performance is positively associated with medical performance, we find that heavier reliance on part-time practice may deteriorate operational performance but not necessarily medical-outcome performance. For so-called "complex" patients, reliance on part-time practice may even override the effect of patients' characteristics on medical-outcome performance...
October 15, 2018: Health Marketing Quarterly
Nikolaos Spathas, Panagiota Economopoulou, Myrto Cheila, Ioannis Kotsantis, Antonis Fanouriakis, Dimitra Kassara, Amanda Psyrri
Introduction: T cell checkpoint inhibitors targeting Programmed cell Death protein-1 (PD-1) have emerged as novel immunotherapy agents showing remarkable efficacy in head and neck squamous cell carcinoma (HNSCC). Despite important clinical benefits, they are associated with side effects that occur as a consequence of general immunological stimulation due to loss of T cell inhibition. Herein, we report the unusual case of inflammatory arthritis induced by anti-PD-1 agent pembrolizumab. Case report: A 55-years old male was treated with pembrolizumab at a dose of 200 mg every 3 weeks for a metastatic hypopharyngeal carcinoma...
2018: Frontiers in Oncology
Dilyara S Ismailova, Irina M Belovalova, Yaroslav O Grusha, Natalya Y Sviridenko
Orbital decompression is a surgical procedure aimed at increasing the orbital volume and/or decreasing the volume of the orbital fat. The indications for orbital decompression are determined in the course of thorough eye examination. An important objective of examination of a patient with thyroid eye disease (TED) is determination of inflammation activity and severity. Orbital decompression is a surgical procedure that can be performed in both the active and nonactive stages of the disease. However, the indications for the surgery in these cases are different...
2018: International Medical Case Reports Journal
Erika Gray, Judy Currey, Julie Considine
AIM: To describe what is currently known about nurses' assessment decisions when providing care to patients at home or in their usual place of residence. METHODS: In August 2018, an integrative literature review using a systematic approach was conducted using specific search terms to search Informit, MEDLINE and Cumulative Index of Nursing and Allied Health Literature (CINAHL). The literature search was not limited by date, and included published papers or unpublished dissertations written between 1980 and 2018...
October 13, 2018: Contemporary Nurse
Yohko Maki, Takashi Sakurai, Jiro Okochi, Haruyasu Yamaguchi, Kenji Toba
The goal of dementia treatment is to improve the quality of life for both people with dementia and their families. Rehabilitation as a non-pharmacological approach, coordinated with pharmacological treatment, aims to allow patients to live better by slowing the progression, and relieving the behavioral and psychological symptoms of dementia. In dementia, the manifestation of symptoms caused by neurological impairment is modified by various factors; thus, multidimensional assessment and approaches are effective based on the concept of the International Classification of Functioning, which emphasizes the healthy components of every person's functioning...
October 15, 2018: Geriatrics & Gerontology International
Robert J Barry, Ulises Zanetto, Sai Kolli, Rupal Morjaria
A 38-year-old woman presented to casualty with bilateral red eyes associated with a recent upper respiratory tract infection. This was initially diagnosed as conjunctivitis, however systemic review revealed an erythematous facial and skin rash, mildly swollen lips and mild swallowing difficulties. The patient was referred for an urgent medical assessment, by which time she was found to have erythema affecting 54% of her body surface area and diagnosed with suspected toxic epidermal necrolysis (TEN). She rapidly deteriorated over 24 hours with a spreading blistering skin rash and airway compromise requiring urgent intubation and admission to the intensive treatment unit (ITU)...
October 12, 2018: BMJ Case Reports
Y-L Chang, Y-T Cheng, T-C Chen, Y-S Chien, W-C Lee, Y-C Shen
This study evaluates the incidence of BK polyomavirus (BKV) and prognosis of BKV infection in kidney transplant recipients (KTRs) who received transplantation in our hospital before and after regular BKV nucleic acid test (NAT) was implemented. METHODS: The study included 74 KTRs who received a single kidney either from standard- or expanded-criteria deceased donor between March 2011 and March 2017. BKV NATs were regularly checked in 26 patients (group 1) in the first posttransplant year in accordance with current guidelines since NAT was implemented in our laboratory in 2014...
October 2018: Transplantation Proceedings
S Sekito, K Nishikawa, S Masui, Y Hasegawa, H Kanda, K Arima, Y Sugimura
BACKGROUND: The frequency of renal transplants from elderly living donors has increased because of a shortage of donors. However, the results of renal transplantation using aged kidney grafts have yet to be determined conclusively. METHODS: We evaluated 45 patients who underwent living donor kidney transplantation at our institution. The patients were categorized according to donor age at the time of the transplant: ≥ 60 years (elderly donor group, n = 21) and <60 years (young donor group, n = 24)...
October 2018: Transplantation Proceedings
Monika Dybicz, Konrad Perkowski, Aleksandra Sędzikowska, Wanda Baltaza, Lidia Chomicz
Trichomonas tenax, cosmopolitan flagellate inhabiting human oral cavity, is the etiological agent of oral trichomonosis associated with gingival and periodontium deterioration. Purpose of this studies was to investigate the prevalence of infection with Trichomonas tenax identified by molecular techniques amplifying the region of ITS1-5.8S rRNA-ITS2 specific for T. tenax. The study included 498 persons: diabetic, renal transplant, rheumatoid arthritis patients and the control group. Prevalence of T. tenax in oral cavity was 10...
2018: Annals of Parasitology
Sharon R Lewis, Michael W Pritchard, Oliver J Schofield-Robinson, David Jw Evans, Phil Alderson, Andrew F Smith
BACKGROUND: During intensive care unit (ICU) admission, patients and their carers experience physical and psychological stressors that may result in psychological conditions including anxiety, depression, and post-traumatic stress disorder (PTSD). Improving communication between healthcare professionals, patients, and their carers may alleviate these disorders. Communication may include information or educational interventions, in different formats, aiming to improve knowledge of the prognosis, treatment, or anticipated challenges after ICU discharge...
October 13, 2018: Cochrane Database of Systematic Reviews
Lazar Tosic, Dominik Baschera, Bastian Jentsch, Thomas Feuerstein, Alex Alfieri
Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms commonly involving visceral or parietal pleura. We present the first report of tumor-to-tumor metastasis involving a pulmonary adenocarcinoma donor and an intradural SFT recipient. The patient presented with a 1 year history of diffuse back pain. A spinal intradural contrast-enhancing mass at the T9/10 level and a tumor of the lung were diagnosed radiologically. Bronchoscopic biopsy confirmed pulmonary adenocarcinoma in the right upper lung lobe...
October 13, 2018: Acta Neurochirurgica
Tilak Shah, Elliot B Tapper
Acute-on-chronic-liver-failure (ACLF) describes acute deterioration of liver function in patients with decompensated cirrhosis resulting in organ failure, and can occur as a procedural complication. In the current issue, Leal et al found that, compared to in-patients with cirrhosis who did not undergo interventions, ACLF was significantly more common among undergoing ERCP, but not more so than other non-ERCP interventions. ACLF risk increased significantly, however, if an ERCP-related AE occurred. ACLF can be a consequence of both the indication for and a complication of ERCP...
October 12, 2018: American Journal of Gastroenterology
Alipio Pinto, Clara Berdasco, David Arenas-Mosquera, Adriana Cangelosi, Patricia A Geoghegan, Myriam C Nuñez, Jorge Goldstein
Infections by Enterohemorrhagic Escherichia coli may cause in addition to hemolytic uremic syndrome neurological disorders which may lead to fatal outcomes in patients. The brain striatum is usually affected during this outcome. The aim of this study was to determine in this area the role of the microglia in pro-inflammatory events that may occur during Shiga toxin 2 intoxication and consequently to this, whether oligodendrocytes were being affected. In the present paper we demonstrated that anti-inflammatory treatments reduced deleterious effects in brain striatal cells exposed to Shiga toxin 2 and LPS...
October 4, 2018: International Journal of Medical Microbiology: IJMM
Miguel Oliveira Santos, Teresinha Evangelista, Isabel Conceição
Clinical data regarding the use of enzyme replacement therapy (ERT) during pregnancy in late-onset Pompe disease (LOPD) is still scarce. We present the clinical case of a 32-year-old female patient with LOPD, on enzyme replacement therapy (ERT) since the age of 29 years old, who had treatment interrupted after her second week of pregnancy with subsequent deterioration of her muscle condition. ERT was resumed by week 20 with clear clinical improvement. The pregnancy and delivery was otherwise uneventful and there were no problems during the neonatal period...
August 10, 2018: Neuromuscular Disorders: NMD
Alexander Barié, Michael Köpf, Ayham Jaber, Babak Moradi, Holger Schmitt, Jürgen Huber, Nikolaus Alexander Streich
BACKGROUND: The use of a quadriceps tendon-patellar bone (QTPB) autograft provides an alternative procedure in primary reconstruction of the anterior cruciate ligament (ACL). Using the press-fit technique for femoral fixation and knotting over a bone bridge as well as additional spongiosa filling for tibial fixation can completely eliminate the need for fixation implants. The objective of this study was to evaluate the long-term clinical, functional and radiological results of this operating method...
October 12, 2018: BMC Musculoskeletal Disorders
Liye Xu, Jin Cheng Song, Xiu Hua Sun, Zi Fen Gao, Li Lv, Jie Zhu
RATIONALE: Central nervous system (CNS) infiltration of Richter's syndrome (RS) is rare and only a few cases were discussed. Of these published cases, either they were accompanied with lymph node involvement or with a history of chronic lymphocytic leukemia (CLL). To our knowledge, this is the first published case of RS of the brain and meninges diagnosed concurrently with CLL in the absence of any evidence of lymphoma outside of the CNS. PATIENT CONCERNS: A 67-year-old female presented with slurred speech, headache, and left-sided hemiparesis...
October 2018: Medicine (Baltimore)
Zhimin Li, Jun Gao, Tianyu Wang, Yongning Li
To investigate effects of microvascular decompression (MVD) surgical treatment on hemifacial spasm.A retrospective analysis of 320 adult patients (95 male cases, 29.7% and 225 female cases, 70.3%) with hemifacial spasm treated by surgery was conducted between February 2007 to June 2016, with an average age of 49.3 years and average disease course of 4.9 years. All the 320 cases of patients received MVD. After surgery, all patients were followed up for an average of 2.3 years. Surgical effects were evaluated based on the patients' symptoms and signs...
October 2018: Medicine (Baltimore)
Arnav Kumar, Kimi Sato, Kinjal Banerjee, Jyoti Narayanswami, Jorge Betancor, Vivek Menon, Divyanshu Mohananey, Anil Kumar Anumandla, Abhishek C Sawant, Amar Krishnaswamy, E Murat Tuzcu, Wael Jaber, Stephanie Mick, Lars G Svensson, Zoran B Popović, Eugene H Blackstone, Samir R Kapadia
OBJECTIVES: We investigated the hemodynamic durability of the transcatheter aortic valves (TAVs) using the updated Valve Academic Research Consortium-2 (VARC-2) criteria. BACKGROUND: The updated VARC-2 consensus criteria combine flow-dependent and flow-independent echocardiographic parameters for hemodynamic assessment of TAVR. Data on the hemodynamic durability of TAV and clinical risk factors associated with valve hemodynamic deterioration (VHD) are lacking. METHODS: All patients (n = 276) who received TAV between 2006 and 2012 and had ≥2 follow-up echocardiograms were studied...
October 12, 2018: Catheterization and Cardiovascular Interventions
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