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https://www.readbyqxmd.com/read/28723900/the-natural-history-of-acute-ebola-virus-disease-among-patients-managed-in-five-ebola-treatment-units-in-west-africa-a-retrospective-cohort-study
#1
Kelly Skrable, Reshma Roshania, Michaela Mallow, Vanessa Wolfman, Matthew Siakor, Adam C Levine
INTRODUCTION: Previous studies of Ebola Virus Disease (EVD) have focused on clinical symptoms and Ebola virus (EBOV) cycle threshold (CT) values recorded at patient triage. Our study explores EVD symptoms and EBOV CT values from onset of illness to recovery or death in a diverse population of patients. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed clinical care data from EBOV positive patients admitted to five Ebola treatment units in West Africa from 2014-2015. Prevalence of clinical signs/symptoms and CT values were explored using descriptive statistics...
July 19, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28723783/novel-surgical-management-of-cyclodialysis-cleft-via-anterior-chamber-perfusion-case-report
#2
Jinfei Tang, Ergang Du, Jie Wang
RATIONALE: Cyclodialysis cleft is a relatively rare but severe condition with persistent ocular hypotony, which can cause morphologic changes and visual loss. Here we report a case of a traumatic cyclodialysis cleft that was successfully managed with direct cyclopexy via anterior chamber perfusion. During the operation, if there is aqueous humor flowing out of the deep scleral incision, the cleft is not closed, and surgery should continue until there is no aqueous outflow. PATIENT CONCERNS: A 66-year-old man was treated for severe blunt ocular trauma of the left eye and a resultant cyclodialysis cleft, lens subluxation, choroidal detachment and a cataract...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723767/return-of-the-cadaver-key-role-of-anatomic-dissection-for-plastic-surgery-resident-training
#3
Swenn Maxence Krähenbühl, Paul Čvančara, Thomas Stieglitz, Raphaël Bonvin, Murielle Michetti, Marjorie Flahaut, Sébastien Durand, Lina Deghayli, Lee Ann Applegate, Wassim Raffoul
Successful Plastic Surgery Residency training is subjected to evolving society pressure of lower hourly work weeks imposed by external committees, labor laws, and increased public awareness of patient care quality. Although innovative measures for simulation training of surgery are appearing, there is also the realization that basic anatomy training should be re-enforced and cadaver dissection is of utmost importance for surgical techniques.In the development of new technology for implantable neurostimulatory electrodes for the management of phantom limb pain in amputee patients, a design of a cadaveric model has been developed with detailed steps for innovative transfascicular insertion of electrodes...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#4
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723703/management-of-chest-pain-in-the-french-emergency-healthcare-system-the-prospective-observational-epidoultho-study
#5
Sandrine Charpentier, Sebastien Beaune, Luc Marie Joly, Abdo Khoury, François-Xavier Duchateau, Raphael Briot, Bertrand Renaud, François-Xavier Ageron
OBJECTIVE: The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). PATIENTS AND METHODS: All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013...
July 18, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28723495/surgical-management-and-oncologic-outcomes-of-recurrent-venous-tumor-thrombus-after-prior-nephrectomy-for-renal-cell-carcinoma
#6
William P Parker, Stephen A Boorjian, Harras B Zaid, John C Cheville, Bradley C Leibovich, R Houston Thompson
BACKGROUND: While the management of a venous tumor thrombus in renal cell carcinoma is well described, there is a paucity of evidence to guide care in patients who recur within the vena cava. OBJECTIVE: To report our experience with patients presenting with recurrent venous tumor thrombi after prior radical nephrectomy. DESIGN, SETTING, AND PARTICIPANTS: A retrospective review of 16 patients from 1970 to 2013 with a history of renal cell carcinoma treated surgically for a recurrent tumor thrombus unrelated to a new renal tumor...
December 15, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28723369/evaluation-and-classification-of-stress-urinary-incontinence-current-concepts-and-future-directions
#7
REVIEW
Nadir I Osman, Vincenzo Li Marzi, Jean N Cornu, Marcus J Drake
CONTEXT: Stress urinary incontinence (SUI) is a common and bothersome problem that frequently requires operative management. Over the past two decades, novel techniques have been introduced into clinical practice. With the greater variety of surgical options now available, there is an increasing focus on selecting the appropriate procedure for the individual patient based on the likely underlying pathophysiologic mechanism. OBJECTIVE: To review the methods used in the evaluation of SUI and the proposed classification systems...
August 2016: European Urology Focus
https://www.readbyqxmd.com/read/28722563/the-west-african-experience-in-establishing-steering-committees-for-better-collaboration-between-researchers-and-decision-makers-to-increase-the-use-of-health-research-findings
#8
Namoudou Keita, Virgil Lokossou, Abdramane Berthe, Issiaka Sombie, Ermel Johnson, Kofi Busia
BACKGROUND: Aware of the advantages of a project steering committee (SC) in terms of influencing the development of evidence-based health policies, the West African Health Organisation (WAHO) encouraged and supported the creation of such SCs around four research projects in four countries (Burkina Faso, Nigeria, Senegal and Sierra Leone). This study was conducted to describe the process that was used to establish these committees and its findings aim to assist other stakeholders in initiating this type of process...
July 12, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28722516/pre-operative-obesity-does-not-predict-poorer-symptom-control-and-quality-of-life-after-lumbar-disc-surgery
#9
Paul M Brennan, James J M Loan, Neil Watson, Pragnesh M Bhatt, Peter Alwyn Bodkin
PURPOSE: We aimed to determine whether there was a difference in post-operative symptomatic control and quality of life (QoL) between patients who were obese (BMI >30) and non-obese (BMI <30) pre-operatively. This information may inform the decision making of Physicians and patients whether to proceed to surgery for management of symptomatic lumbar disc prolapse. METHODS: We conducted a prospective questionnaire-based study of QoL and symptom control in 120 patients with postal follow-up at 3 and 12 months after lumbar disc surgery...
July 19, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28722339/structured-pain-management-reduces-patient-discomfort-after-catheter-ablation-and-rhythm-device-surgery
#10
M Dörschner, A Bollmann, B Dinov, S Richter, M Döring, A Arya, A Müssigbrodt, S Kircher, N Dagres, P Sommer, G Hindricks, K Bode
BACKGROUND: The goal was to test the effectiveness of a structured pain management programme after invasive electrophysiological interventions in cardiology including ablation of atrial fibrillation (AF) or ventricular tachycardia (VT) and implantation, or explantation, of pacemakers or implantable cardioverter defibrillators. METHODS: This was a prospective study with a pre-/post-design where a post-intervention group (116 consecutive patients) was compared to a pre-intervention group (102 consecutive patients) after implementation of a structured pain-management programme using the numeric rating scale (NRS 0-10) and classified as moderate-to-severe if NRS > 3...
July 18, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28722089/-how-to-carry-out-high-quality-clinical-trial
#11
Lai Xu, Yi Xiao
Evidence-based medicine derived from large-scale clinical trials has been widely accepted by clinicians, which strongly motivates the clinicians in medical institutions to conduct or participate in clinical trials. However, how to improve the clinical trial quality and management to achieve worldwide acceptance still remains challenging. By analyzing the difficulties faced by the majority of large Chinese clinical institutions and the opportunities during the evolvement of research modes, this paper proposes to improve the quality of clinical trial by closely following the domain development, raising clinical research thinking, ensuring rigorous research design, standardizing the steps and details of each operational session, as well as establishing a collaborative and well-communicated team...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28722084/-postoperative-complications-after-rectal-cancer-surgery-and-management
#12
Jin Gu, Qingkun Gao
Although neoadjuvant treatment such as radiotherapy, even chemoradiotherapy has already widely used in middle-low rectal cancer, surgery remains the mainstay of therapy for patients with rectal cancer. Because neoadjuvant chemoradiotherapy combined with surgery was adopted for the locally advanced rectal cancer as a standard treatment based on guidelines, postoperative complications of rectal cancer surgery caused surgeons attention and concern gradually. Some severe complications should seriously affect patient's quality of life, even patient's survival...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28722080/-a-surgery-oriented-classification-in-conversion-therapy-of-gastric-cancer
#13
Ziyu Li, Kan Xue, Jiafu Ji
Clinical practice showed that some advanced gastric cancer (AGC) patients achieved long-term survival after surgery, whereas some benefited from non-surgical treatment. In recent years, with the emergence of new drugs, diversity of treatment and development of multi-disciplinary team, the concept of conversion therapy comes into attention. Owing to diverse phenotypes with scattered cases, publications are mainly case reports or small sample studies from single centers, which makes it hard to acquire high-level evidence...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28721796/managing-patients-anxiety-about-planned-medical-interventions
#14
Bob Price
Patients are often anxious about planned medical interventions, and those experiencing anxiety are less likely to have the confidence to collaborate with healthcare professionals on their plan of care, and make decisions about consent. They may also find it challenging to follow rehabilitation guidelines, which can affect their long-term recovery. As part of their professional duty, nurses are required to recognise when people are anxious or in distress and respond compassionately, and while acquiring valid consent for any planned medical intervention requires the nurse to explain any risks, they should also attempt to reassure patients...
July 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28721624/on-the-successful-use-of-a-simplified-model-to-simulate-the-succession-of-toxic-cyanobacteria-in-a-hypereutrophic-reservoir-with-a-highly-fluctuating-water-level
#15
Ali Fadel, Bruno J Lemaire, Brigitte Vinçon-Leite, Ali Atoui, Kamal Slim, Bruno Tassin
Many freshwater bodies worldwide that suffer from harmful algal blooms would benefit for their management from a simple ecological model that requires few field data, e.g. for early warning systems. Beyond a certain degree, adding processes to ecological models can reduce model predictive capabilities. In this work, we assess whether a simple ecological model without nutrients is able to describe the succession of cyanobacterial blooms of different species in a hypereutrophic reservoir and help understand the factors that determine these blooms...
July 18, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28721569/management-of-enterocutaneous-fistula-outcomes-in-276-patients
#16
Martha Quinn, Stuart Falconer, Ruth F McKee
OBJECTIVE: To assess the outcomes of patients with type II intestinal failure due to enterocutaneous fistulae in a tertiary referral centre over a 15 year period. Intestinal failure secondary to enterocutaneous fistula (ECF) requires multidisciplinary management at significant cost. Mortality and morbidity are high. METHODS: Patients were identified from a prospectively collected database of patients requiring inpatient parenteral nutrition (1998-2013). Data collected included: demographics, mode of admission, pathological grouping and outcome...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28721567/modified-double-layer-anastomosis-for-minimally-invasive-esophagectomy-an-effective-way-to-prevent-leakage-and-stricture
#17
Yong Yuan, Xiao-Xi Zeng, Yong-Fan Zhao, Long-Qi Chen
BACKGROUND: Anastomotic leakage and stricture contribute to a large number of mortality and morbidity after esophagectomy. The aim of this work is to evaluate the outcome of modified double-layer hand-sewn esophagogastric anastomosis during minimally invasive esophagectomy for esophageal cancer. METHODS: The clinicopathological data of 176 consecutive esophageal cancer patients who underwent cervical esophagogastric anastomosis using modified double-layer hand-sewn technique after radical esophagectomy were retrospectively reviewed...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28721463/exstrophy-bladder-reconstruction-or-diversion-for-the-underprivileged
#18
REVIEW
Yogesh Kumar Sarin, Virender Sekhon
The surgical techniques for management of bladder exstrophy epispadias complex have evolved from staged reconstruction, complete primary repair to radical mobilization. Post-operative complications add to the multiplicity of surgical procedures at each step. The end results are variable with many achieving continence rates of 85-89% only after bladder augmentation and clean intermittent catheterization. The situation is further complicated in resource-poor settings, where illiteracy and poverty are the driving factors for choosing a single operative procedure for creation of low pressure reservoir aiming at upper tract preservation and good primary continence...
July 18, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28721286/open-stone-surgery-a-still-in-use-approach-for-complex-stone-burden
#19
Özer Ural Çakici, Kemal Ener, Murat Keske, Serkan Altinova, Abdullah Erdem Canda, Mustafa Aldemir, Arslan Ardicoglu
INTRODUCTION: Urinary stone disease is a major urological condition. Endourologic techniques have influenced the clinical approach and outcomes. Open surgery holds a historic importance in the management of most conditions. However, complex kidney stone burden may be amenable to successful results with open stone surgery. In this article, we report our eighteen cases of complex urinary stone disease who underwent open stone removal. MATERIAL AND METHODS: A total of 1701 patients have undergone surgical treatment for urinary stone disease in our clinic between July 2012 and July 2016, comprising eighteen patients who underwent open stone surgery...
June 30, 2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28721190/a-case-of-fatal-internal-jugular-vein-perforation-during-nasogastric-tube-insertion
#20
Katherine A Smith, Jeffrey P Fleming, Robert D Bennett, Andrew A Taitano
Nasogastric tube (NGT) insertion is a routine procedure in the management of surgical patients. We report the second case of internal jugular vein perforation during NGT insertion. A 79-year-old man presented with diffuse abdominal pain secondary to a perforated viscus. Abdominal CT revealed pneumoperitoneum, necessitating emergent exploratory laparotomy. On post-operative Day 7, the patient developed mild abdominal distension and subjective nausea for which NGT placement was ordered for decompression. Tube placement was confirmed by insufflation of air without aspiration of gastric contents...
July 2017: Journal of Surgical Case Reports
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