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medical review

Blanka Nemeth, Elisabeth Weber, Lars Christian Huber
Syncope is defined as a transient, self-limited loss of consciousness due to insufficient cerebral blood perfusion. In a clinical setting, syncopal events usually present a diagnostic dilemma due to its broad differential diagnosis ranging from banal to potentially harmful causes. In the absence of a working hypothesis, multiple tests are ordered that result in high costs but are of questionable diagnostic and therapeutic value. This article provides a practical overview and, based on international guidelines and selected studies, proposes a standardized approach to patients with syncope...
October 2018: Deutsche Medizinische Wochenschrift
Laurent Tatu, Odile Roynette, Julien Bogousslavsky
The writer Louis Ferdinand Céline (1894-1961) developed a personal style which changed twentieth century French literature. As an enlisted soldier in 1912, he was involved in the Great War and his right arm was severely wounded. After the war, he became a medical doctor and a writer who published his first novel, Voyage au bout de la nuit (Journey to the End of the Night), in 1932. In the middle of the 1930s, he began to write anti-Semitic and racist pamphlets and turned to a collaborationist stance with Nazi Germany...
2018: Frontiers of Neurology and Neuroscience
Jan C Frich
Henrik Ibsen (1828-1906) is a Norwegian playwright and poet who is known as the father of modern drama. Ibsen was in good health when he announced at his 70th birthday celebration that he intended to continue writing. His last play, When We Dead Awaken, was published in 1899. Why did Ibsen's dramatic writing come to an end? This chapter presents a medical account of Ibsen's health condition during the last 6 years of his life. It is based on a review of a document written by one of his doctors, Edvard Bull (1845-1925), letters, biographic information, and Ibsen's death certificate...
2018: Frontiers of Neurology and Neuroscience
Luc Biedermann, Alex Straumann
Eosinophilic esophagitis (EoE) refers to a relatively new chronic inflammatory disease of the esophagus, which according to the current understanding underlies an immune-mediated pathogenesis driven by exposure to allergens. While several open questions remain regarding ethiopathogenesis as well as treatment options and their positioning, one thing has increasingly been recognized. The disease is on the rise and will increasingly be of importance in everyday's clinical practice, not only in expert physicians but also gastroenterologists with a broad clinical spectrum, allergologists and even general practitioners...
October 15, 2018: Current Opinion in Pharmacology
Ikumi Kuno, Hiroshi Yoshida, Hanako Shimizu, Takashi Uehara, Masaya Uno, Mitsuya Ishikawa, Tomoyasu Kato
OBJECTIVES: Incidentally discovered lymphangioleiomyomatosis (LAM) in sampled lymph nodes are infrequent but intractable issues for gynecologists. The aims of this study were to elucidate the prevalence of incidental nodal LAM in a consecutive cohort of gynecologic surgical specimens from Japanese patients, to document clinicopathological features of nodal LAM cases, and to investigate the association between the subsequent development of pulmonary LAM and tuberous sclerosis complex (TSC)...
October 10, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Daniel R Felbaum, Christina Maxwell, Stan Naydin, Andrew Ringer, Ricardo A Hanel, Eric Sauvageau, Amin Aghaebrahim, Pedro Aguilar-Salinas, Erol Veznedaroglu, Kenneth Liebman, Zakaria Hakma, Hirad Hedayat, Peter Kan, Visish Srinivasan, Mandy J Binning
Carotid artery stenosis is frequently diagnosed through screening tests with non-invasive imaging. Because of differences noted between the various modalities, we sought to investigate our experience comparing non-invasive imaging (ultrasound, CT angiography, MR angiography) with invasive imaging (digital subtraction angiography). In a multi-center retrospective analysis, 249 carotid vessels were reviewed based on angiography with the associated non-invasive imaging. Overall, medical or surgical decision management was changed in 43% (107/243) of cases investigated with digital subtraction angiography due to a discrepancy between the measured percentage stenosis...
October 15, 2018: World Neurosurgery
Manpreet Singh, Natasha Gautam, Zoramthara Zadeng, Manpreet Kaur, Pankaj Gupta
PURPOSE: To study the clinical findings, imaging features, and treatment outcomes in children diagnosed with traumatic orbital subperiosteal hematoma (OSpH). METHODS: The medical records of eligible OSpH children treated either via needle aspiration or open surgical drainage were reviewed retrospectively. Three anatomical factors (inferior globe displacement, superior orbital sulcus fullness, extraocular movements) and two functional parameters (visual acuity, pupillary reactions) were used to determine overall success...
October 15, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Prajitha N, Athira Ss, Mohanan Pv
Fever is one of the cardinal symptoms of onset of an infection or inflammation and is the common clinical indicator for medical consultation in mammalian host worldwide. Simply, fever manifested with elevation of body temperature from normal physiological range represents adaptive response of immune system on challenge with an infectious and non-infectious circumstance. Fever usually initiated in the periphery as a result of interaction of immune cells with exogenous or endogenous pyrogens. Peripheral pyrogenic signals gain access to the central nervous system via humoral and neural route...
October 15, 2018: Immunology Letters
Seema D Shah, Linda Prine, Eve Waltermaurer, Susan E Rubin
OBJECTIVE: To assess the feasibility of an intervention introducing family planning services screening clinical decision support to improve provision of contraception and/or preconception services for women of reproductive age in our primary care Federally Qualified Health Center (FQHC) network. STUDY DESIGN: We implemented a family planning services screening prompt for support staff to ask women 13-44years at non-obstetric visits at specified time intervals. The response displayed in the electronic medical record for the provider to review, linked to a documentation tool...
October 15, 2018: Contraception
B Cameron Webb, Dayna Bowen Matthew
"Medicalization" has been a contentious notion since its introduction centuries ago. While some scholars lamented a medical overreach into social domains, others hailed its promise for social justice advocacy. Against the backdrop of a growing commitment to health equity across the nation, this article reviews historical interpretations of medicalization, offers an application of the term to non-biologic risk factors for disease, and presents the case of housing the demonstrate the great potential of medicalizing poverty...
September 2018: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
Cananzi Mara, Vajro Pietro, Rela Mohamed, Dhawan Anil
BACKGROUND: NAFLD has now become a common cause of chronic liver disease in children, however unlike adults liver transplantation is rarely required as treatment. It is important that in children presenting with NAFLD, secondary causes of fatty liver particularly inherited metabolic defects should be excluded. METHODS: A pediatric working group comprised of 3 hepatologists and a liver transplant surgeon was tasked with a set of questions to address the current state of evidence and knowledge about NAFLD in children with particular focus on liver transplantation...
October 16, 2018: Transplantation
Michael R Charlton, Edward J Gane, Akash Shukla, Bekhbold Dashtseren, Davaadorj Duger, David H Muljono, Diana A Payawal, Ganbolor Jargalsaikhan, Hery D Purnomo, Ian H Cua, Irsan Hasan, Jose Sollano, Khin Maung Win, Laurentius A Lesmana, Mohammad Salih, Pham Thi Thu Thuy, Ravi Shankar, Vivek A Saraswat
BACKGROUND: The population of Asia exceeds 4.4 billion people. Chronic hepatitis C virus (HCV) infection in Asia is characterized by specific distribution of genotypes, lack of access to specific therapeutic agents, relatively high cost of treatment, and lack of experienced healthcare providers. Clear consensus on the diagnosis, management, and monitoring of HCV infection specific to the Asian region is a major unmet need. The consensus guidelines documents that have been published to date by major medical societies presume access to an array of direct acting antiviral agents and diagnostic tests that are not broadly applicable to resource limited settings, including Asia...
October 17, 2018: Transplantation
T Tyler Patterson, Susannah Nicholson, David Wallace, Gregory W J Hawryluk, Ramesh Grandhi
Traumatic brain injury (TBI) contributes to nearly one in three injury-related deaths in the United States and accounts for a substantial public health burden and cost. The current literature reports that physiologic responses in the gastrointestinal system after TBI include, but are not limited to, epithelial barrier dysfunction, microbiota changes, and immunologic transformations. Recent evidence suggests gut alterations after TBI modify the homeostasis of the bidirectional gut-microbiota-brain axis, resulting in altered immune responses in the periphery and the brain...
October 17, 2018: Shock
Salmaan Keshavjee, Farhana Amanullah, Adithya Cattamanchi, Richard Chaisson, Karen M Dobos, Gregory J Fox, Howard E Gendelman, Richard Gordon, Anneke Hesseling, Le Van Hoi, Beate Kampmann, Bavesh Kana, Gopal Khuller, David M Lewinsohn, Deborah A Lewinsohn, Philiana Ling Lin, Lenette Lin Lu, Gary Maartens, Andrew Owen, Marina Protopopova, Jyothi Rengarajan, Eric Rubin, Padmini Salgame, Erwin Schurr, James A Seddon, Susan Swindells, David M Tobin, Zarir Udwadia, Gerhard Walzl, Sudha Srinivasan, Roxana Rustomjee, Payam Nahid
Tuberculosis (TB) has surpassed HIV to become the leading infectious killer of adults globally, causing almost 2 million deaths annually. Although this airborne disease has been treatable since 1948, global rates of TB have dropped less than two percent per year; an estimated 10 million incident cases continue to occur annually, including one million in children. While transmission of active disease is an important driver of the epidemic, the seedbed that feeds the epidemic is the more than two billion people estimated to have TB infection, five to ten percent of whom will progress to active disease during their lifetime...
October 18, 2018: American Journal of Respiratory and Critical Care Medicine
Hana Brath, Nishila Mehta, Rachel D Savage, Sudeep S Gill, Wei Wu, Susan E Bronskill, Lynn Zhu, Jerry H Gurwitz, Paula A Rochon
OBJECTIVES: To systematically describe the resources available on preventing, detecting, and reversing prescribing cascades using a scoping review methodology. MEASUREMENTS: We searched Medline, EMBASE, PsychINFO, CINAHL, Cochrane Library, and Sociological Abstracts from inception until July 2017. Other searches (Google Scholar, hand searches) and expert consultations were performed for resources examining how to prevent, detect, or reverse prescribing cascades...
October 18, 2018: Journal of the American Geriatrics Society
Georgios A Maragkos, Georgios Geropoulos, Konstantinos Kechagias, Ioannis A Ziogas, Konstantinos S Mylonas
BACKGROUND: Pediatric epilepsy surgery is a treatment modality appropriate for select patients with debilitating medication-resistant seizures. Previous publications have studied seizure freedom as the main outcome of epilepsy surgery. However, there has been no systematic assessment of the postoperative life quality for these children. OBJECTIVE: To estimate the quality of life (QOL) long-term outcomes after surgery for intractable epilepsy in pediatric patients...
October 17, 2018: Neurosurgery
Ashutosh Kumar, Sanjib K Ghosh, Muneeb A Faiq, Vishwajit R Deshmukh, Chiman Kumari, Vikas Pareek
In the last few years, a cluster of anatomical discoveries has been reported which overturned the long existing dogmas about the structure and function of human body. First to come was the discovery that established the existence of a lymphatic system pertaining to the central nervous system (CNS). CNS was believed to be anatomically immune privileged owing to the absence of any lymphatics and presence of the blood-brain barrier around it, but latest research has established beyond any reasonable doubt that true lymphatic channels carry immune cells in meninges thus challenging the existing theory...
October 18, 2018: QJM: Monthly Journal of the Association of Physicians
Merel E Stellingwerf, Marlou A de Koning, Thomas Pinkney, Willem A Bemelman, Geert R D'Haens, Christianne J Buskens
Background: Appendectomy decreases the risk of developing ulcerative colitis (UC), and is suggested to have a beneficial effect on the clinical course of established UC. However, recent studies showed no significantly decreased colectomy rate, and moreover an apparently increased risk of colorectal cancer (CRC). We aimed to investigate the suggested correlation in a meta-analysis, and analyze possible confounding factors. Methods: A systematic review and meta-analysis were performed using MEDLINE, EMBASE and the Cochrane library...
October 18, 2018: Journal of Crohn's & Colitis
Daniel Stuart, Robin Christian, Hartmut Uschmann, Michelle Palokas
OBJECTIVE: The objective of this review was to determine the effectiveness of intrathecal nicardipine compared to usual care on cerebral vasospasm and its impact on the following outcome measures: mean flow velocities, angiographic and/or clinical vasospasm, and infection rates. INTRODUCTION: The results of non-traumatic (aneurysmal) subarachnoid hemorrhage can have devastating effects on patients in terms of functional outcomes. Although other medications have been and continue to be used, Nimodipine is the only Food and Drug Administration-approved medication for treating and improving outcomes following non-traumatic subarachnoid hemorrhage, which may be caused by aneurysmal rupture or arteriovenous malformation...
October 2018: JBI Database of Systematic Reviews and Implementation Reports
Weipeng Sun, Minying Li, Tong Lin, Zhizhong Sun, Yizi Xie, Shuliang Ji, Jietao Lin, Lin Wang, Chao Jia, Liang Zheng, Wei Wu, Danghan Xu
BACKGROUND: Vascular dementia (VD) is a commonly-seen disease in the elderly. What is more, "Acupuncture at 3-points for intelligence" is one of the most important components of "Jin's three-needle therapy" created by Rui Jin, a professor of Guangzhou University of Chinese Medicine, which can be used in the VD patients. In this article, researchers will assess the clinical efficacy and safety of acupuncture at 3-points for intelligence in the treatment of VD. METHODS: A systematic literature search for articles up to September 2018 will be conducted using 9 databases: PubMed, Cochrane Library, Embase, CNKI, CBM, VIP, Wanfang database, OASIS, and CiNii...
October 2018: Medicine (Baltimore)
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