Read by QxMD icon Read

Complex case management

Nguefack C Tchente, G Brichant, M Nisolle
Asherman's syndrome (AS) is a partial or complete obliteration of the uterine cavity after intrauterine trauma. Approximately 90 % of severe AS cases occur after abortion curettage or postpartum curettage. Clinical signs and symptoms are abnormalities of the cycle (hypomenorrhoea or amenorrhoea) and fertility disorders. We have reviewed the recent literature on AS following the description of a typical clinical case. The management of AS is not easy. It must be done by experienced surgeons. Realization of several surgeries is sometimes mandatory, with the use of anti-adhesive devices between interventions...
October 2018: Revue Médicale de Liège
Vinicius Tieppo Francio, Brandon Barndt, Chris Towery, Travis Allen, Saeid Davani
A 34-year-old man with a history of gunshot wound (GSW) to the right upper chest developed secondary aortic valve endocarditis (AVE) and was treated with an artificial valve placement (AVP). Three months after, he presented to an outpatient pain management clinic right arm pain and was diagnosed with complex regional pain syndrome type II (CRPS II). The patient underwent a diagnostic sympathetic ganglion block, before undergoing endoscopic thoracic sympathectomy surgery. Successful outcomes revealed decreased pain, opioid utilisation and improved tolerance to therapy and activities of daily living...
October 16, 2018: BMJ Case Reports
F Vigouroux, C Choufani, A Grosset, O Barbier, S Rigal, L Mathieu
The purpose of this report was to analyze sequential management of patients with combat-related hand injuries in the Kabul International Airport Combat Support Hospital and to identify principles of hand damage control orthopedics (DCO). A retrospective study was conducted using the French Opex data system that included all the patients who received sequential treatment for combat-related hand injuries from 2009 to 2013. Demographics, mechanism, injury pattern, reasons for DCO application and surgical procedures performed during initial and definitive treatment were described...
October 14, 2018: Hand Surgery and Rehabilitation
Shabnam Sabetkish, Nastaran Sabetkish, Abdol-Mohammad Kajbafzadeh
OBJECTIVE: To introduce a practical technique for the early detection and prompt management of a probable bladder dehiscence (BD) and glanular dehiscence (GD) in patients with bladder exstrophy epispadias complex (BEEC) and hypospadias. METHOD: In this prospective study, paediatric patients with BEEC (group 1) and with proximal hypospadias (group 2) underwent body temperature measurement using a non-contact infrared radiant digital temperature measurement device in four body regions, including the surgical wound, forehead, right hand, and right foot at eight hour intervals, postoperatively...
October 2, 2018: Journal of Wound Care
Alessandro Aprato, Matteo Giachino, Paolo Bedino, Danilo Mellano, Raimondo Piana, Alessandro Massè
PURPOSE: Our study aims at the evaluation of the recently introduced Lima Promade custom-made acetabular device for the treatment of complex acetabular Paprosky 3B defects. METHODS: Between 2016 and 2018, eight patients with major acetabular osteolysis and multiple revisions history were treated with a custom-made implant in a single centre and by a single surgeon. We assessed patients' demographics, peri-operative data, and complications and a specific questionnaire was submitted to the surgeon after each procedure...
October 16, 2018: International Orthopaedics
Malcolm Pyles Chelliah, Huy M Do, Zachary Zinn, Viraat Patel, Michael Jeng, Rohit K Khosla, Mai-Thy Truong, Ann Marqueling, Joyce M C Teng
Importance: Current therapeutic options for patients with extracranial head and neck arteriovenous malformations are limited. Surgical intervention, such as sclerotherapy or resection, often result in rapid recurrence and progression of disease. Objective: To assess the efficacy and tolerability of sirolimus as an adjuvant therapy for endovascular embolization in the management of complicated extracranial head and neck arteriovenous malformations. Design, Setting, and Participants: This case series examined 6 patients with extracranial head and neck arteriovenous malformations treated from January 1, 2013, to December 31, 2017, at a multidisciplinary vascular anomalies clinic within Stanford Hospital and Clinics...
September 19, 2018: JAMA Dermatology
Giuseppe Esposito, Sandra Fernandes Dias, Jan-Karl Burkhardt, Jorn Fierstra, Carlo Serra, Oliver Bozinov, Luca Regli
BACKGROUND: /Objective: The lateral supraorbital (LS) and minipterional (MP) approaches have been reported for treating intracranial aneurysms as alternative to the pterional approach. We present our decision-making for selecting the mini-craniotomy, LS vs. MP, for managing non-complex aneurysms of the middle cerebral artery (MCA), based on the depth of the aneurysm within the Sylvian fissure. METHODS: We report on a consecutive case-series of 50 patients who received clipping of 54 ruptured/unruptured MCA-aneurysms by means of LS or MP craniotomies...
October 13, 2018: World Neurosurgery
Alfred Andama, Akos Somoskovi, Brinnon Mandel, David Bell, Cristina Gutierrez
Tuberculosis (TB) recently surpassed HIV/AIDS as the deadliest infectious disease. Despite some advancements in technologies and programs, TB remains a global health epidemic that, without significant gains in better diagnostic and management, will not abate. This review describes the molecular diagnostic gaps, needs, and potential solutions for improving access to diagnosis and management of patients with drug susceptible and drug resistant TB. The ultimate goal is to improve laboratory diagnostics and better individualized managementof detected TB, and make an important contribution toward eliminating this global epidemic...
October 13, 2018: Infection, Genetics and Evolution
Vincenzo Piscopo, Stefano Di Luca, Michele Dimasi, Francesca Lotti
Sustainable use of groundwater in the hydrothermal area of Viterbo (Central Italy) was analyzed. In this area, multi-purposes utilization of groundwater coexists: several thermal springs and wells supply spas and public pools, cold and fresh water is used for irrigation and drinking-water. Starting from theoretical concepts, a management plan has been developed to ensure groundwater sustainability in response to the increased demand of withdrawal from thermal wells, by integrating previous hydrogeological studies, new investigations and a new finite-difference model...
October 16, 2018: Ground Water
Anja Silge, Thomas Bocklitz, Bjoern Becker, Walter Matheis, Juergen Popp, Isabelle Bekeredjian-Ding
Vaccines are complex biomedicines. Manufacturing is time consuming and requires a high level of quality control (QC) to guarantee consistent safety and potency. An increasing global demand has led to the need to reduce time and cost of manufacturing. The evolving concepts for QC and the upcoming threat of falsification of biomedicines define a new need for methods that allow the fast and reliable identification of vaccines. Raman spectroscopy is a non-destructive technology already established in QC of classical medicines...
2018: NPJ Vaccines
Takeshi Teshigawara, Akira Meguro, Kazuro Yabuki, Seiichiro Hata, Nobuhisa Mizuki
At present, only one design is available for trifocal intraocular lens (IOL); unfortunately, this particular design is not suitable for implantation in the sulcus with optic capture when posterior capsule rupture (PCR) occurs. Although three-piece bifocal IOLs can be implanted in the sulcus, this form of IOL can be vulnerable to tilt and decentration, thus causing aberration and photopic phenomena, such as halos and glares. However, visual axis centered optic capture using femtosecond laser-assisted cataract surgery (FLACS) is able to manage such complex operations...
2018: International Medical Case Reports Journal
David N Dado, Benjamin Huang, Daniel V Foster, Jamison S Nielsen, Jennifer M Gurney, Benjamin D Morrow, Kumar Sharma, Kevin K Chung, Craig R Ainsworth
Calciphylaxis is a rare, necrotizing skin disorder usually associated with kidney disease, but also caused by many other systemic illnesses. This disease is associated with mortality rates as high as 80% at 1year. We present the demographic and clinical data of nine patients with calciphylaxis treated at our burn center over a 10year period. We review the literature on the clinical presentation, pathophysiology, diagnosis and treatment of this rare disease. We propose that these patients be treated similar to patients with thermal burn injury; meaning intensive wound care, surgical management, critical care and physical therapy...
October 12, 2018: Burns: Journal of the International Society for Burn Injuries
Niccolò Tempini, Sabina Leonelli
This paper analyses the role of information security (IS) in shaping the dissemination and re-use of biomedical data, as well as the embedding of such data in material, social and regulatory landscapes of research. We consider data management practices adopted by two UK-based data linkage infrastructures: the Secure Anonymised Information Linkage, a Welsh databank that facilitates appropriate re-use of health data derived from research and routine medical practice in the region, and the Medical and Environmental Data Mash-up Infrastructure, a project bringing together researchers to link and analyse complex meteorological, environmental and epidemiological data...
October 2018: Social Studies of Science
Dimosthenis A Sarigiannis, Spyros P Karakitsios
BACKGROUND: this paper is based upon work from COST Action ICSHNet. Assessment of the health impacts related to industrially contaminated sites (ICSs) is a major scientific challenge with multiple societal implications. Most studies related to associations between ICSs and public health do not provide established mechanistic links between environmental exposure and disease burden, potentially resulting in suboptimal risk management measures. OBJECTIVES: to assess the potential of the exposome paradigm to overhaul ICS risk assessment and management leading to precision prevention and targeted interventions...
September 2018: Epidemiologia e Prevenzione
Amir Mokhtari, Jane M Van Doren
We used an agent-based modeling (ABM) framework and developed a mathematical model to explain the complex dynamics of microbial persistence and spread within a food facility and to aid risk managers in identifying effective mitigation options. The model explicitly considered personal hygiene practices by food handlers as well as their activities and simulated a spatially explicit dynamic system representing complex interaction patterns among food handlers, facility environment, and foods. To demonstrate the utility of the model in a decision-making context, we created a hypothetical case study and used it to compare different risk mitigation strategies for reducing contamination and spread of Listeria monocytogenes in a food facility...
October 15, 2018: Risk Analysis: An Official Publication of the Society for Risk Analysis
Brenna B Maddox, Christina D Kang-Yi, Edward S Brodkin, David S Mandell
Background: While a growing body of research suggests that talk therapies can reduce anxiety and depression in adults with autism spectrum disorder (ASD), we know little about what community treatment for these disorders looks like for them. The present study investigated whether treatment utilization differs between adults with and without ASD who have anxiety or depression. Method: Using Pennsylvania Medicaid claims data, adults aged 18-65 years diagnosed with ASD and depression or anxiety (n = 268) were matched 1:4 to adults with depression or anxiety disorder without ASD (n = 1,072)...
July 2018: Research in Autism Spectrum Disorders
Elham Mofid-Nakhaee, Farnaz Barzinpour
Municipal solid waste collection is an increasingly difficult task and has the highest operation cost in the solid waste management process; thus, finding the optimal routes for the waste collection is a most tactically significant decision that should be focused on due to the population growth. This research investigated the multi-compartment capacitated arc routing problem with intermediate facilities (MCCARPIF) in the context of solid waste collection. This problem has been researched rarely in the past in the real world...
October 15, 2018: Waste Management & Research
Barry Ting Sheen Kweh, Chengde Pham, Catriona McLean, Jin Wee Tee
Hemangiopericytomas are rare mesenchymal tumors with propensity to recur locally and metastasize. We report the unique case of a fifty-five-year-old male with recurrence of a previously resected craniocervical hemangiopericytoma presenting with obstructive hydrocephalus secondary to new metastatic cerebellar deposits. Emergent surgical resection of the cerebellar hemangiopericytomas was performed prior to adjuvant radiotherapy. Hemangiopericytomas are rare but important differentials for craniocervical junction lesions...
October 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Hosam E Matar, Paula Stritch, Nicholas Emms
Interprosthetic femur fractures between total hip and total knee replacements are challenging injuries with rising incidence. Stability of the either implants, quality, and quantity of remaining bone as well as patients' comorbidities play an important role in operative management. Open reduction and internal fixation, advanced revision arthroplasty techniques, and megaprostheses are available options. In more complex cases, custom-made implants maybe necessary to achieve immediate weight-bearing and restore function...
2018: Journal of Long-term Effects of Medical Implants
Kisa Hyde Congo, António Tomás, Álvaro Laranjeira, Daniela Afonso, José Fragata
We report the case of 67-year old male patient who was admitted with a 2-week history of progressively worsening chest pain and dyspnea. Diagnostic investigation showed a type B aortic dissection with a retrograde intramural hematoma and bilateral pulmonary embolism. These simultaneous findings highly complicated patient management. Patient was started on anticoagulation therapy with partial resolution of pulmonary embolism after which surgical correction was performed. The patient was successfully submitted to a modified Frozen Elephant Trunk technique with a 3-branched customized Dacron tube and aortic arch replacement with E-Vita Open Plus...
January 2018: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"