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Martin Jakobs, Erenik Krasniqi, Manja Kloß, Jan-Oliver Neumann, Benito Campos, Andreas W Unterberg, Karl L Kiening
OBJECTIVES: Implantation of deep brain stimulation (DBS) electrodes requires stereotactic imaging. Stereotactic magnetic resonance imaging (MRI) for DBS surgery has become more popular and intraoperative MRI scanners have become more available. We report on our cohort of movement disorder patients who underwent intraoperative stereotactic MRI-only DBS electrode implantation. METHODS: A review of our DBS database for eligible patients over a study period of 8 years was performed...
August 7, 2018: World Neurosurgery
U Herbers, C Trautwein, F Tacke, A Koch
Acute pancreatitis is a potentially life-threatening disease, which is morphologically classified into interstitial edematous or necrotizing pancreatitis. According to the revised Atlanta classification, mild, moderate and severe clinical courses are differentiated regarding local and systemic complications as well as concomitant organ failure. In the initial disease phase, the therapeutic measures are focused on (aggressive) volume replacement, early enteral nutrition and adequate analgesia. Characteristic in the course of severe acute pancreatitis are abdominal necroses, which require individualized and interdisciplinary treatment with antibiotic therapy, drainage and definitive necrosectomy...
August 9, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Rebecca E Sadun, Melissa A Wells, Stephen J Balevic, Victoria Lackey, Erica J Aldridge, Nicholas Holdgagte, Samya Mohammad, Lisa G Criscione-Schreiber, Megan E B Clowse, Mamata Yanamadala
Teratogenic medications are often prescribed to women of childbearing age with autoimmune diseases. Literature suggests that appropriate use of contraception among these women is low, potentially resulting in high-risk unintended pregnancies. Preliminary review in our clinic showed suboptimal documentation of women's contraceptive use. We therefore designed a quality improvement initiative to target three process measures: documentation of contraception usage and type, contraception counselling and provider action after counselling...
2018: BMJ Open Quality
Patricio Rosa, Ihor Pidhorecky
Our patient is a 44 years old woman who underwent exploratory laparotomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy by GYN Oncology for a suspected malignancy. The diagnosis of intravenous leiomyomatosis (IVL) was made instead. She was followed by GYN and remained asymptomatic until two years later when she complained to the GYN of leg heaviness, and two months later also complained of palpitations. She was treated with a short course of megestrol without any clinical response. She was then referred to Vascular Surgery...
August 6, 2018: Annals of Vascular Surgery
Rebecca O'Hara, Heather Rowe, Louise Roufeil, Jane Fisher
Objective The aim of this study was to determine whether endometriosis meets the definition for chronic disease in Australian policy documents. Methods A qualitative case study approach was used to thematically analyse the definitions contained in Australian chronic disease policy documents and technical reports. The key themes were then compared with descriptions of endometriosis in peer-reviewed literature, clinical practice guidelines and expert consensus statements. Results The search yielded 18 chronic disease documents that provided a definition or characteristics of chronic disease...
August 10, 2018: Australian Health Review: a Publication of the Australian Hospital Association
Douglas S Hawkins, Yueh-Yun Chi, James R Anderson, Jing Tian, Carola A S Arndt, Lisa Bomgaars, Sarah S Donaldson, Andrea Hayes-Jordan, Leo Mascarenhas, Mary Beth McCarville, Jeannine S McCune, Geoff McCowage, Lynn Million, Carol D Morris, David M Parham, David A Rodeberg, Erin R Rudzinski, Margarett Shnorhavorian, Sheri L Spunt, Stephen X Skapek, Lisa A Teot, Suzanne Wolden, Torunn I Yock, William H Meyer
Purpose Intermediate-risk rhabdomyosarcoma (RMS) includes patients with either nonmetastatic, unresected embryonal RMS (ERMS) with an unfavorable primary site or nonmetastatic alveolar RMS (ARMS). The primary aim of this study was to improve the outcome of patients with intermediate-risk RMS by substituting vincristine and irinotecan (VI) for half of vincristine, dactinomycin, and cyclophosphamide (VAC) courses. All patients received a lower dose of cyclophosphamide and earlier radiation therapy than in previous trials...
August 9, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Karl-Dietrich Sievert, Jörg Hennenlotter, Thomas Dillenburg, Patricia Toomey, J Wöllner, P Zweers, J Pannek, Karl-Erik Andersson, Bastian Amend
OBJECTIVE: To perform descriptive microscopic study of prostatectomy specimens from 19 patients which anatomically characterizes distributions of periprostatic nerves qualities and visualize them using diffusion tensor imaging (DTI). METHODS AND MATERIALS: Serial whole-mounted sections were stained for cholinergic(nNOS), adrenergic(TH), and sensory(CGRP) nerves. Extracapsular stained nerves were counted by prostate surface sector and classified by diameter. Stain-related relative density was calculated and distribution patterns were evaluated...
August 9, 2018: BJU International
Matthew S Briggs, Katherine K Rethman, Matthew T Lopez
Background and Purpose: Differentiating between cervical nerve root and peripheral nerve injuries can be challenging. A phenomenon known as double crush syndrome may increase the susceptibility to injury and symptoms at other locations along the course of the nerve. The purpose of this case report is to describe the physical therapy differential diagnosis and management of a cyclist with upper extremity pain, weakness, and paresthesia. Case Description: The subject was referred to physical therapy with a diagnosis of cervical disc disease...
April 2018: International Journal of Sports Physical Therapy
Matevž Pintar, Janez Langus, Ibrahim Edhemović, Erik Brecelj, Matej Kranjc, Gregor Sersa, Tomaž Šuštar, Tomaž Rodič, Damijan Miklavčič, Tadej Kotnik, Bor Kos
Electrochemotherapy and irreversible electroporation are gaining importance in clinical practice for the treatment of solid tumors. For successful treatment, it is extremely important that the coverage and exposure time of the treated tumor to the electric field are within the specified range. In order to ensure successful coverage of the entire target volume with sufficiently strong electric fields, numerical treatment planning has been proposed and its use has also been demonstrated in practice. Most of numerical models in treatment planning are based on charge conservation equation and are not able to provide time course of electric current, electrical conductivity, or electric field distribution changes established in the tissue during pulse delivery...
January 1, 2018: Technology in Cancer Research & Treatment
Andrea Mari, David D'Andrea, Shoji Kimura, Irene Resch, Shahrokh F Shariat, Tobias Klatte
PURPOSE: We hypothesized sarcopenia as predictive factor as a response to upfront chemotherapy of muscle-invasive urothelial bladder cancer (MIBC). METHODS: We retrospectively studied 30 patients who received upfront cisplatin-based chemotherapy for MIBC (pT2-4 N0/+ M0) before planned radical cystectomy. Skeletal muscle index (SMI) was calculated by CT at study baseline and following completion of chemotherapy. Patients were stratified according to the presence of sarcopenia...
August 8, 2018: Urologia Internationalis
Saionara Nunes de Oliveira, Aline Massaroli, Jussara Gue Martini, Jeferson Rodrigues
OBJECTIVE: To report the experience of the operationalization of clinical simulation as a pedagogical strategy in a subject of an undergraduate course in Nursing. METHOD: Clinical simulation cycles were carried out following the steps of action research, such as: planning, action, observation and reflection, from March 2014 to July 2015 with 10 professors and 44 students from a Primary Care and Mental Health subject of an undergraduate course in Nursing. RESULTS: Five cycles of clinical simulation were performed, at the end of each cycle modifications were suggested by students and professors and the operation was adjusted to meet the needs of the subject...
2018: Revista Brasileira de Enfermagem
Hideto Ueki, Takuya Fujimoto, Masato Okuno, Yuji Kusuda, Isao Taguchi, Yasushi Itou, Sawami Kiyonaka, Gaku Kawabata
Background: CT-guided marking technique is rarely used in abdominal or urologic surgery. We developed and performed a marking technique for a small tumor, undetectable by ultrasound, using CT guidance before laparoscopic resection of the tumor. Case Presentation: A 73-year-old woman with a history of breast cancer underwent right colectomy with D3 lymph node dissection for ascending colon cancer. Five years after the operation, a solitary tumor was found in the right pararenal region of the retroperitoneal space on enhanced abdominal CT...
2018: Journal of Endourology Case Reports
Stefan Leger, Alex Zwanenburg, Karoline Pilz, Sebastian Zschaeck, Klaus Zöphel, Jörg Kotzerke, Andreas Schreiber, Daniel Zips, Mechthild Krause, Michael Baumann, Esther G C Troost, Christian Richter, Steffen Löck
BACKGROUND AND PURPOSE: The development of radiomic risk models to predict clinical outcome is usually based on pre-treatment imaging, such as computed tomography (CT) scans used for radiation treatment planning. Imaging data acquired during the course of treatment may improve their prognostic performance. We compared the performance of radiomic risk models based on the pre-treatment CT and CT scans acquired in the second week of therapy. MATERIAL AND METHODS: Treatment planning and second week CT scans of 78 head and neck squamous cell carcinoma patients treated with primary radiochemotherapy were collected...
August 4, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Jason R Vickress, Jerry Battista, Rob Barnett, Slav Yartsev
BACKGROUND: Head and neck cancers are commonly treated with radiation therapy, but due to possible volume changes, plan adaptation may be required during the course of treatment. Currently, plan adaptations consume significant clinical resources. Existing methods to evaluate the need for plan adaptation requires deformable image registration (DIR) to a new CT simulation or daily cone beam CT (CBCT) images and the recalculation of the dose distribution. In this study, we explore a tool to assist the decision for plan adaptation using a CBCT without re-computation of dose, allowing for rapid online assessment...
August 7, 2018: Journal of Applied Clinical Medical Physics
Rachel Wells, Macy L Stockdill, J Nicholas Dionne-Odom, Deborah Ejem, Kathryn L Burgio, Raegan W Durant, Sally Engler, Andres Azuero, Salpy V Pamboukian, Jose Tallaj, Keith M Swetz, Elizabeth Kvale, Rodney O Tucker, Marie Bakitas
BACKGROUND: Palliative care is specialized medical care for people with serious illness that is focused on providing relief from symptoms and stress and improving the quality of life (QOL) for patients and their families. To help the 6.5 million U.S. adults and families affected by heart failure manage the high symptom burden, complex decision-making, and risk of exacerbation and death, the early integration of palliative care is critical and has been recommended by numerous professional organizations...
August 6, 2018: Trials
Waheeb Nasr Naser, Huda Ba Saleem
BACKGROUND: Medical professionals together with other first responder teams are the first to attend an emergency or disaster. Knowledge and training in emergency and disaster preparedness are important in responding effectively. This study aims to assess the current knowledge, attitude and training in emergency and disaster preparedness among Yemeni health professionals. METHOD: A descriptive, cross-sectional, non-probability based study was conducted in Yemen using self-reported on-line and paper surveys in 2017...
August 6, 2018: BMC Emergency Medicine
Florian Labhart, Rutger Engels, Emmanuel Kuntsche
OBJECTIVE: Young people often drink more alcohol than intended over the course of a night. This study investigates individual and night-specific factors predicting young people's acknowledgment of having drunk more than intended. METHOD: Using the Youth@Night smartphone application, 176 people aged 16-25 documented 757 Friday and Saturday nights. Participants recorded their drinking intentions at the beginning of the night, the composition of the social and physical environment over the course of the night, and, the next morning, the previous night's total consumption and whether they had drunk more than intended or experienced other alcohol-related consequences...
July 2018: Journal of Studies on Alcohol and Drugs
Karishma R Kulkarni, Preethi V Reddy, Abhishek Purty, Shyam Sundar Arumugham, Kesavan Muralidharan, Yc Janardhan Reddy, Lakshmi Yatham, Sanjeev Jain
BACKGROUND: An understanding of the early course of Bipolar Disorder (BD) can contribute towards developing timely interventions. First episode mania (FEM) determines a diagnosis of bipolarity, and therefore, onset of BD-I. We investigated the course of BD-I over a five-year period after FEM by retrospective chart review. METHODS: Charts of patients diagnosed with FEM in 2008 (n = 108) were reviewed. Data was extracted about FEM and subsequent course up to 5 years, for those who came for follow-up during this period...
July 24, 2018: Journal of Affective Disorders
Yohan Jang, Khoa Nguyen, Saenz Rocky
Vascular injury to the popliteal artery during knee surgery is uncommon, but it has significant consequences not only for the patient but also to the surgeon since it poses the threat of malpractice litigation. The vascular anatomy of the lower extremity is variable especially when it involves both the popliteal artery and its branches. An aberrant vascular course may increase the risk of iatrogenic vascular injury during surgery. Careful preoperative planning with advanced imaging can decrease the risk of a devastating vascular injury...
July 2018: American Journal of Orthopedics
Vinod Dasa, Sooyeol Lim, Peter Heeckt
Osteoarthritis (OA) of the knee is a top cause of disability among the elderly. Total knee replacement (TKR) has been available as an effective and definite surgical method to treat severe OA of the knee. However, TKR is a significant procedure with potential risk for serious complications and high costs. Alternative lower risk therapies that can delay or obviate TKR are valuable to those who are poor candidates for surgery or wish to avoid TKR as long as possible. Given the chondroprotective effects of hyaluronic acid (HA) injections, they are a safe and effective treatment to improve pain, function, and longevity of the knee...
July 2018: American Journal of Orthopedics
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