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https://www.readbyqxmd.com/read/28644345/yield-of-endoscopy-in-pediatric-gastroparesis
#1
Tara A Altepeter, Stephen Shaffer
OBJECTIVES: The aim of the study was to quantify the diagnostic yield of upper endoscopy in children with gastroparesis and to develop a clinical model for gastroparesis using common symptoms and screening blood tests. METHODS: We retrospectively reviewed charts of 196 patients of age 4 to 18 years evaluated for gastroparesis between 2009 and 2013. All patients completed a standard solid-phase gastric emptying scan and upper endoscopy within a 12-month period. We analyzed gross and histologic endoscopy findings...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28641055/long-term-safety-evaluation-of-natalizumab-for-the-treatment-of-multiple-sclerosis
#2
Marinella Clerico, Carlo Alberto Artusi, Alessandra Di Liberto, Simona Rolla, Valentina Bardina, Pierangelo Barbero, Stefania Federica De Mercanti, Luca Durelli
Introduction Natalizumab is a humanized monoclonal antibody highly effective in relapsing-remitting multiple sclerosis (MS). Important concerns about its safety have been pointed out because of the risk of progressive multifocal leukoencephalopathy (PML), caused by the opportunistic John-Cunningham virus (JCV). Areas covered This review analyzes all the safety aspects related to the use of natalizumab in MS patients. Fatigue and allergic reactions are not-severe adverse events (AEs) occurring more frequently than placebo and no differences in serious AEs (SAE) have been observed comparing to interferon-β1a during clinical trials...
June 22, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28637110/guidelines-for-cauda-equina-syndrome-red-flags-and-white-flags-systematic-review-and-implications-for-triage
#3
Nicholas V Todd
INTRODUCTION: Patients with cauda equina syndrome (CES) are frequently referred late when neurological damage cannot be reversed. National Guidelines for emergency referral, imaging and treatment of CES contain symptoms and/or signs that are those of late often, irreversible CES. Referral at this stage may be too late for that patient. METHODS: Seven sources were reviewed. Advice re emergency referral/imaging/treatment were reviewed. Symptoms/signs were compared with a standard classification of CES...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28631045/-headaches
#4
REVIEW
M Michl, G M Michl
Headaches can be so severe that patients and doctors often fear life-threatening underlying cerebral pathologies. The spectrum of causes of headache is very heterogeneous and ranges from harmless situations to severe diseases, so that it is very difficult to consider all differential diagnoses simultaneously; however, a few targeted questions and physical examinations are sufficient to be able to make a better classification of the leading symptom headache. The following article serves as a quick guide for identification of patients at risk...
June 19, 2017: Der Internist
https://www.readbyqxmd.com/read/28625338/acute-diplopia-in-the-pediatric-emergency-department-a-cohort-multicenter-italian-study
#5
Umberto Raucci, Pasquale Parisi, Nicola Vanacore, Francesco La Penna, Valentina Ferro, Lucia Calistri, Claudia Bondone, Fabio Midulla, Agnese Suppiej, Raffaele Falsaperla, Duccio Maria Cordelli, Antonella Palmieri, Alberto Verrotti, Sabrina Becciani, Sonia Aguzzi, Mario Mastrangelo, Federica Pelizza, Filippo Greco, Giulia Carbonari, Ramona Tallone, Gabriella Bottone, Italo Trenta, Stefano Masi, Maria Pia Villa, Antonino Reale
BACKGROUND: Acute diplopia (AD) is an uncommon and distressing symptom of numerous ocular and neurological conditions, with potentially serious sequelaes. No data are present in pediatrics on the presentation and management of AD. AIM: This study investigated characteristics, etiology and health care utilization of the pediatric population with AD accessed to pediatric Emergency Departments (ED), trying to identify "red flags" associated with potentially life-threatening (LT) conditions...
June 3, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28618040/optimising-implementation-of-a-patient-assessment-framework-for-emergency-nurses-a-mixed-method-study
#6
Belinda Munroe, Kate Curtis, Thomas Buckley, Melinda Lewis, Lou Atkins
AIMS AND OBJECTIVES: To determine potential facilitators and barriers and tailor interventions to optimise future implementation of a patient-assessment framework into emergency nursing practice. BACKGROUND: An evidence-informed patient-assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) improves the quality of patient assessments performed by emergency nurses. Facilitators and barriers must be understood and tailored interventions selected to optimise implementation...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28605309/disordered-eating-the-young-male-side
#7
Sabine Ammann, André Berchtold, Yara Barrense-Dias, Christina Akre, Joan-Carles Surís
Disordered eating (DE) is known to predominate among girls, and historically studies have focused primarily on them. This cross-sectional study aimed to investigate the characteristics of adolescent and young adult males at risk of DE. Participants (N=2269; 15-24 years) in a study assessing their lifestyle were divided into two groups based on the SCOFF five-question screening tool: a SCOFF[+] group for participants at risk of disordered eating, and a SCOFF[-] group for everyone else. SCOFF[+] participants were more likely to be overweight and obese; have a lower socio-economic status and non-Swiss parents; experience weight issues; and report a chronic condition, poorer emotional well-being and a less positive attitude towards life...
June 12, 2017: Behavioral Medicine
https://www.readbyqxmd.com/read/28603516/iodine-123-meta-iodobenzylguanidine-myocardial-scintigraphy-in-isolated-autonomic-failure-potential-red-flag-for-future-multiple-system-atrophy
#8
Francesca Baschieri, Giovanna Calandra-Buonaura, Annagrazia Cecere, Giorgio Barletta, Manuela Contin, Piero Parchi, Pietro Cortelli
Pure autonomic failure is challenging as it can be the presenting feature of a central nervous system syncleinopathy such as Parkinson's disease (PD) or multiple system atrophy (MSA). Because the prognosis of MSA and PD is so different, predictive features for a possible conversion can be extremely valuable. In this paper, we report three cases (two with autopsy-proven diagnosis) that had isolated AF for many years before converting to MSA or PD. Of all the tests that were performed during the premotor stage, Iodine-123-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy was predictive of the conversion to MSA...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28599362/determination-of-phytoplankton-abundances-chlorophyll-a-in-the-optically-complex-inland-water-the-baltic-sea
#9
Daoxi Zhang, Samantha Lavender, Jan-Peter Muller, David Walton, Bengt Karlson, Johan Kronsell
A novel approach, termed Summed Positive Peaks (SPP), is proposed for determining phytoplankton abundances (Chlorophyll-a or Chl-a) and surface phytoplankton bloom extent in the optically complex Baltic Sea. The SPP approach is established on the basis of a baseline subtraction method using Rayleigh corrected top-of-atmosphere data from the Medium Resolution Imaging Spectrometer (MERIS) measurements. It calculates the reflectance differences between phytoplankton related signals observed in the MERIS red and near infrared (NIR) bands, such as sun-induced chlorophyll fluorescence (SICF) and the backscattering at 709nm, and considers the summation of the positive line heights for estimating Chl-a concentrations...
June 4, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28598686/how-your-ears-can-tell-what-is-hidden-in-your-heart-wild-type-transthyretin-amyloidosis-as-potential-cause-of-sensorineural-hearing-loss-inelderly-amylodeafness-pilot-study
#10
Emilie Béquignon, Aziz Guellich, Sophie Barthier, Marc Raynal, Virginie Prulière-Escabasse, Florence Canouï-Poitrine, André Coste, Thibaud Damy
BACKGROUND: Wild-type transthyretin amyloidosis (ATTRwt) is an age-related life-threatening condition. Prognosis is mainly dependent on cardiac involvement. Other organs and tissues may be affected. Their early recognition may increase awareness of physicians and positively affects the prognosis. Presbycusis is another age-related disorder. Whether this disease is associated to ATTRwt amyloidosis is unknown. METHODS: Sixteen consecutive patients with confirmed diagnosis of ATTRwt amyloidosis at the Mondor Amyloidosis Network, France, underwent otoscopy and audiological tests including pure tone audiometry, speech reception threshold and speech discrimination score...
June 9, 2017: Amyloid: the International Journal of Experimental and Clinical Investigation
https://www.readbyqxmd.com/read/28594620/abdominal-pain-related-functional-gastrointestinal-disorders-in-children
#11
Jagrati Chopra, Neal Patel, Dharamveer Basude, Elena Gil-Zaragozano, Siba Prosad Paul
Recurrent abdominal pain is a common presentation in children and mostly non-organic in origin. Nearly one-fifth of the childhood population are known to suffer from it worldwide, although only 50% of these may seek consultation with a health professional. Non-organic recurrent abdominal pain encompasses four main conditions broadly labelled as abdominal pain-related functional gastrointestinal disorders (FGIDs). These are diagnosed following exclusion of organic pathologies and by symptom concordance with defined parameters, published as the Rome IV criteria for FGIDs...
June 8, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28594619/managing-acute-respiratory-tract-infections-in-children
#12
Bruce C Schuster, Clare Hoare, Atanu Mukherjee, Siba Prosad Paul
Respiratory tract infections (RTIs), including community-acquired pneumonia (CAP), bronchiolitis, viral-induced wheeze and croup, account for more primary care consultations than any other illness group and are the most likely reason for a parent or carer to contact a health professional. The majority of RTIs in fully immunised children are usually self-limiting. However, in a small percentage of children RTIs may become life threatening and it is crucial that all front-line health professionals are able to recognise and identify these children who are at risk of deterioration...
June 8, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28578606/community-health-workers-and-use-of-mhealth-improving-identification-of-pregnancy-complications-and-access-to-care-in-the-dominican-republic
#13
Susan Bonnell, Anne Griggs, Gloria Avila, Jonathan Mack, Ruth A Bush, Julie Vignato, Cynthia D Connelly
This article presents the feasibility and acceptability of using mobile health technology by community health workers (CHWs) in San Juan Province, Dominican Republic, to improve identification of pregnancy complications and access to care for pregnant women. Although most women in the Dominican Republic receive four antenatal care visits, poor women and adolescents in remote areas are more likely to have only one initial prenatal visit to verify the pregnancy. This community-based research began when community leaders raised concern about the numbers of their mothers who died in childbirth annually; San Juan's maternal mortality rate is 144/100,000 compared to the Caribbean rate of 85/100,000...
June 1, 2017: Health Promotion Practice
https://www.readbyqxmd.com/read/28576916/fabry-heterozygote-mimicking-multiple-sclerosis
#14
Wai Yan Yau, Marzena J Fabis-Pedrini, Allan G Kermode
Fabry's disease (FD) is a recognised mimic of multiple sclerosis (MS). It is an X-linked storage lysosomal disorder with deficiency of α-galactosidase A and enzyme replacement therapy is available. Patients with FD may satisfy modified McDonald criteria if the diagnosis of FD has not been pursued. We present a case of FD in a 65-year-old woman masquerading as benign MS for 40 years. She has recurrent posterior circulation stroke-like symptoms, hearing loss and acroparaesthesia, but typical radiological features of MS on MRI brain...
June 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28576235/negligent-and-inflicted-burns-in-children
#15
REVIEW
Zachary J Collier, Michelle C Roughton, Lawrence J Gottlieb
One in 4 American children have been abused and up to 5 children die per day from abuse. Children are vulnerable and error or lag in diagnosis may lead to further injury or death. In contrast, misdiagnosis of abuse is also unacceptable. Burns are a leading cause of abuse-related fatality and determination of cause can be difficult. It is critical that clinicians distinguish between burns of abuse (inflicted) and neglect and those received accidentally (noninflicted). Discordant narratives, use of alcohol and illicit substances, characteristics of the burn wound, and concomitant injury are all red flags for inflicted and negligent burns...
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28571563/the-design-and-development-of-a-complex-multifactorial-falls-assessment-intervention-for-falls-prevention-the-prevention-of-falls-injury-trial-prefit
#16
Julie Bruce, Shvaita Ralhan, Ray Sheridan, Katharine Westacott, Emma Withers, Susanne Finnegan, John Davison, Finbarr C Martin, Sarah E Lamb
BACKGROUND: This paper describes the design and development of a complex multifactorial falls prevention (MFFP) intervention for implementation and testing within the framework of a large UK-based falls prevention randomised controlled trial (RCT). METHODS: A complex intervention was developed for inclusion within the Prevention of Falls Injury Trial (PreFIT), a multicentre pragmatic RCT. PreFIT aims to compare the clinical and cost-effectiveness of three alternative primary care falls prevention interventions (advice, exercise and MFFP), on outcomes of fractures and falls...
June 1, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28562077/medical-student-perceptions-of-clinical-neurosurgery-teaching-in-an-undergraduate-medical-school-curriculum
#17
James Knight, Lauren Stroud, Thomas Geyton, Anthony Stead, Hannah R Cock
AIM: The aim of this study was to evaluate undergraduate medical student perceptions as to the value of different types of neurosurgical teaching to their general neuroscience education, delivered in the penultimate year of a U.K medical school. METHODS: We surveyed penultimate-year medical students at St George's Hospital Medical School, University of London (SGUL), who were undertaking their clinical neuroscience attachment from August 2014 to July 2015. A questionnaire comprising closed Likert scale questions and an open question inviting participants to comment freely was used to assess student perception about the value of Neurosurgical sessions within their overall neuroscience education...
May 31, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28560120/efficacy-evaluation-of-save-for-the-diagnosis-of-superficial-neoplastic-lesion
#18
Farah Deeba, Shahed K Mohammed, Francis Minhthang Bui, Khan A Wahid
The detection of non-polypoid superficial neoplastic lesions using current standard of white light endoscopy surveillance and random biopsy is associated with high miss rate. The subtle changes in mucosa caused by the flat and depressed neoplasms often go undetected and do not qualify for further investigation, e.g., biopsy and resection, thus increasing the risk of cancer advancement. This paper presents a screening tool named the saliency-aided visual enhancement (SAVE) method, with an objective of highlighting abnormalities in endoscopic images to detect early lesions...
2017: IEEE Journal of Translational Engineering in Health and Medicine
https://www.readbyqxmd.com/read/28558098/complex-and-dynamic-chromosomal-rearrangements-in-a-family-with-seemingly-non-mendelian-inheritance-of-dopa-responsive-dystonia
#19
Katja Lohmann, Claire Redin, Holger Tönnies, Susan B Bressman, Jose Ignacio Martin Subero, Karin Wiegers, Frauke Hinrichs, Yorck Hellenbroich, Aleksandar Rakovic, Deborah Raymond, Laurie J Ozelius, Eberhard Schwinger, Reiner Siebert, Michael E Talkowski, Rachel Saunders-Pullman, Christine Klein
Importance: Chromosomal rearrangements are increasingly recognized to underlie neurologic disorders and are often accompanied by additional clinical signs beyond the gene-specific phenotypic spectrum. Objective: To elucidate the causal genetic variant in a large US family with co-occurrence of dopa-responsive dystonia as well as skeletal and eye abnormalities (ie, ptosis, myopia, and retina detachment). Design, Setting, and Participants: We examined 10 members of a family, including 5 patients with dopa-responsive dystonia and skeletal and/or eye abnormalities, from a US tertiary referral center for neurological diseases using multiple conventional molecular methods, including fluorescence in situ hybridization and array comparative genomic hybridization as well as large-insert whole-genome sequencing to survey multiple classes of genomic variations...
May 30, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#20
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
May 18, 2017: Journal of the American College of Surgeons
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