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https://www.readbyqxmd.com/read/28647997/-endovascular-management-and-classification-of-the-dissecting-aneurysms-of-the-vertebral-artery
#1
Y Z Zang, Z G Wang, C W Wang, X Ding, X F Wang, L L Wang
Objective: To summarize the classifications and optimize endovascular treatment of the dissecting aneurysms of the vertebral artery (DAVA). Methods: The clinical information of 39 cases of DAVA treated with endovascular methods in our department between January 2007 and September 2016 were analyzed retrospectively.According to the location of the aneurysm in relation to the posterior inferior cerebellar artery (PICA), the aneurysms were classified into three types: type pre-PICA, located proximally to the PICA; type in-PICA, located at the PICA origin; and type post-PICA located distally to the PICA...
June 20, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28647947/continuous-glucose-monitoring-in-pediatrics-the-gap-between-potential-benefits-and-the-reality-of-utility
#2
Regina L Taddeo, Joanne T Moser, Pantea P Minnock
Continuous Glucose Monitoring (CGM) is rapidly becoming a standard of care in the management of Type 1 diabetes (T1D). Today's devices are nearly as accurate as home glucose meters. They provide glucose data every 5 minutes, alert to high and low blood glucose levels, and allow for remote monitoring of a user's glucose data and patterns. Use of CGM has many benefits including support for tighter glycemic control without increasing the risk for hypoglycemia. There is however emerging evidence of some negative aspects associated with using CGM, which may result in decreased utilization of the device as well as a decline in quality of life, especially in the pediatric population...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647800/safety-and-effectiveness-of-tolvaptan-for-fluid-management-after-pediatric-cardiovascular-surgery
#3
Yuzo Katayama, Tsukasa Ozawa, Noritsugu Shiono, Hiroshi Masuhara, Takeshiro Fujii, Yoshinori Watanabe
BACKGROUND: Postoperative fluid management is important after open heart surgery, because cardiopulmonary bypass evokes an abnormal inflammatory response and increases vascular permeability, especially in pediatric patients. We assessed the safety and effectiveness of tolvaptan for management of postoperative fluid retention after congenital heart surgery. METHODS AND RESULTS: This retrospective study analyzed data from 43 children with uncomplicated congenital heart disease who underwent open heart surgery between September 2013 and August 2016...
June 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28647705/revolution-in-acute-ischaemic-stroke-care-a-practical-guide-to-mechanical-thrombectomy
#4
REVIEW
Matthew Evans, Phil White, Peter Cowley, David Werring
Rapid, safe and effective arterial recanalisation to restore blood flow and improve functional outcome remains the primary goal of hyperacute ischaemic stroke management. The benefit of intravenous thrombolysis with recombinant tissue-type plasminogen activator for patients with severe stroke due to large artery occlusion is limited; early recanalisation is generally less than 30% for carotid, proximal middle cerebral artery or basilar artery occlusion. Since November 2014, nine positive randomised controlled trials of mechanical thrombectomy for large vessel occlusion in the anterior circulation have led to a revolution in the care of patients with acute ischaemic stroke...
June 24, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28647407/external-validation-of-the-simple-null-please-clinical-score-in-predicting-outcome-of-out-of-hospital-cardiac-arrest
#5
Tatjana S Potpara, Miroslav Mihajlovic, Sanja Stankovic, Tanja Jozic, Irena Jozic, Milika R Asanin, Rajai Ahmad, Gregory Y H Lip
BACKGROUND: Rapid clinical decision-making on further management of patients with out-of-hospital cardiac arrest may be challenging. Recently, a 'futility' score (NULL-PLEASE) incorporating multiple adverse resuscitation features (Non-shockable rhythm, Unwitnessed arrest, Long no-flow or Long low-flow period, blood pH <7.2, Lactate >7.0 mmol/l, End-stage chronic kidney disease on dialysis, Age ≥85 years, Still resuscitation and Extra-cardiac cause) has been proposed to help identify out-of-hospital cardiac arrest patients unlikely to survive; however, external independent score validation is lacking...
June 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28647104/-french-haemovigilance-from-1994-to-nowadays-evolution-and-prospects
#6
B Lassale, G Daurat, M Besse-Moreau, J-P Aullen
Born in France in 1993, haemovigilance aims at monitoring the blood transfusion chain from the donor to the recipient, receiving labile blood products. It differs from the other vigilances due to its organization and its completeness dealing with the collected information. Prior to the European directive, the French agency created a new gravity level: grade 0, aiming at reporting and analyzing the blood transfusion chain dysfunction. Thus, haemovigilance gradually integrates the management of the risks and is given new missions in hospitals and private hospitals...
June 21, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28646804/pilot-investigation-of-2-nondiet-approaches-to-improve-weight-and-health
#7
Kelly H Webber, Laurel Mellin, Lindsey Mayes, Igor Mitrovic, Matt Saulnier
Context • Weight loss and maintenance are associated with many health benefits, but long-term maintenance of weight loss remains elusive for many people. Overweight individuals are at higher risk than normal-weight individuals for stress-induced overeating. The use of stress-management tools in a weight loss program might decrease the physiological stress that fuels overeating and improve posttreatment maintenance of weight loss Objective • The study intended to compare the differences in outcomes between 2 approaches to achieving weight loss and changes in health-stress reduction and intuitive eating (IE)-during a 14-wk period...
June 23, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28646744/systematic-biobanking-novel-imaging-techniques-and-advanced-molecular-analysis-for-precise-tumor-diagnosis-and-therapy-the-polish-mobit-project
#8
Jacek Niklinski, Adam Kretowski, Marcin Moniuszko, Joanna Reszec, Anna Michalska-Falkowska, Magdalena Niemira, Michal Ciborowski, Radoslaw Charkiewicz, Dorota Jurgilewicz, Miroslaw Kozlowski, Rodryg Ramlau, Cezary Piwkowski, Miroslaw Kwasniewski, Monika Kaczmarek, Andrzej Ciereszko, Tomasz Wasniewski, Robert Mroz, Wojciech Naumnik, Ewa Sierko, Magdalena Paczkowska, Joanna Kisluk, Anetta Sulewska, Adam Cybulski, Zenon Mariak, Boguslaw Kedra, Jacek Szamatowicz, Paweł Kurzawa, Lukasz Minarowski, Angelika Edyta Charkiewicz, Barbara Mroczko, Jolanta Malyszko, Christian Manegold, Lothar Pilz, Heike Allgayer, Mohammed L Abba, Hartmut Juhl, Frauke Koch
Personalized and precision medicine is gaining recognition due to the limitations by standard diagnosis and treatment; many areas of medicine, from cancer to psychiatry, are moving towards tailored and individualized treatment for patients based on their clinical characteristics and genetic signatures as well as novel imaging techniques. Advances in whole genome sequencing have led to identification of genes involved in a variety of diseases. Moreover, biomarkers indicating severity of disease or susceptibility to treatment are increasingly being characterized...
June 21, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28646478/newborn-screening-for-fabry-disease-in-the-north-west-of-spain
#9
Cristobal Colon, Saida Ortolano, Cristina Melcon-Crespo, Jose V Alvarez, Olalla E Lopez-Suarez, Maria L Couce, José R Fernández-Lorenzo
Fabry disease is an X-linked lysosomal storage disorder caused by the impairment of α-galactosidase A. Enzyme replacement therapy is available to treat patients, who often experience delayed diagnosis. A newborn screening for Fabry disease was performed to study the prevalence of the pathology and to evaluate the possibility to implement the test in systematic screenings. We collected 14,600 dried blood spot samples (7575 males and 7025 females) and carried out a diagnostic study by fluorometric measurement of α-galactosidase A enzymatic activity and GLA gene sequencing...
June 23, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28646129/microscope-enhanced-the-efficacy-and-safety-of-anterior-cervical-surgery-for-managing-cervical-ossification-of-the-posterior-longitudinal-ligament
#10
Mingxiao Sun, Lili Kong, Zhaofu Jiang, Liming Li, Bing Lu
BACKGROUND We aimed to compare microscope-assisted anterior cervical surgery with traditional open-base surgery for treating cervical ossification of the posterior longitudinal ligament (OPLL). MATERIAL AND METHODS Patients were grouped into microscope-assisted anterior cervical surgery group (case group, n=30) and conventional anterior cervical surgery group (control group, n=30). Baseline characteristics, intraoperative and post-operative indexes including operation time, blood loss amount, duration of hospitalization, visual analogue scale (VAS), and complication rate were recorded...
June 24, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28645995/mepolizumab-for-the-treatment-of-severe-eosinophilic-asthma
#11
REVIEW
Mara N Poulakos, Shawna M Cargill, Melissa F Waineo, Allen L Wolford
PURPOSE: Published data on the pharmacology, pharmacokinetics and pharmacodynamics, and clinical efficacy and safety of the interleukin-5 antagonist mepolizumab are reviewed. SUMMARY: Asthma of the eosinophilic phenotype is characterized by persistent eosinophilic airway inflammation promoted primarily by T-helper type 2 cytokines, the key regulator of eosinophils. Patients with severe eosinophilic asthma are burdened by the need to administer high doses of corticosteroids to help manage their symptoms...
July 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28645890/tailored-communication-within-mobile-apps-for-diabetes-self-management-a-systematic-review
#12
Heidi Holmen, Astrid Klopstad Wahl, Milada Cvancarova Småstuen, Lis Ribu
BACKGROUND: The prevalence of diabetes is increasing and with the requirements for self-management and risk of late complications, it remains a challenge for the individual and society. Patients can benefit from support from health care personnel in their self-management, and the traditional communication between patients and health care personnel is changing. Smartphones and apps offer a unique platform for communication, but apps with integrated health care personnel communication based on patient data are yet to be investigated to provide evidence of possible effects...
June 23, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28645696/exercise-training-improves-functional-status-in-hypertensive-older-adults-under-angiotensin-converting-enzymes-inhibitors-medication
#13
Liliana C Baptista, Aristides M Machado-Rodrigues, Manuel Teixeira Veríssimo, Raul A Martins
BACKGROUND: The study aims to analyze the effect of three types of treatment on functional status, and cardiovascular risk outcomes in hypertensive older adults with comorbidities. METHODS: Participants (n=418) underwent one of the following 3 conditions: i) multicomponent exercise training 3times/week (MEX; n=116); ii) angiotensin converting enzyme inhibitors used mono-dose daily (ACEi; n=70); iii) combined exercise and ACEi drugs (ACEiMEX; n=232). The trial was completed by 82% of the participants (n=342): MEX (n=90); ACEi (n=66); ACEiMEX (n=186)...
June 20, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28645227/diabetic-and-obese-patient-clinical-outcomes-improve-during-a-care-management-implementation-in-primary-care
#14
Jodi Summers Holtrop, Zhehui Luo, Gretchen Piatt, Lee A Green, Qiaoling Chen, John Piette
BACKGROUND: To address the increasing burden of chronic disease, many primary care practices are turning to care management and the hiring of care managers to help patients coordinate their care and self-manage their conditions. Care management is often, but not always, proving effective at improving patient outcomes, but more evidence is needed. METHODS: In this pair-matched cluster randomized trial, 5 practices implemented care management and were compared with 5 comparison practices within the same practice organization...
June 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28645074/relationship-between-inter-arm-blood-pressure-difference-and-severity-of-coronary-atherosclerosis
#15
Se-Jun Park, Jung-Woo Son, Sang-Min Park, Hyun-Hee Choi, Kyung-Soon Hong
BACKGROUND AND AIMS: A greater inter-arm blood pressure difference (IABPD) is associated with atherosclerosis, but its association with coronary artery disease is unknown. We investigated the relationship between IABPD and coronary atherosclerosis. METHODS: We retrospectively reviewed blood pressure (BP) data that was measured simultaneously in both arms of patients who underwent initial coronary angiography. Coronary atherosclerosis was assessed using the Gensini score, based on quantitative coronary angiography findings...
June 9, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28644516/hemostatic-efficiency-of-modern-topical-sealants-comparative-evaluation-after-liver-resection-and-splenic-laceration-in-a-swine-model
#16
Hamidreza Fonouni, Arash Kashfi, Ali Majlesara, Oliver Stahlheber, Lukas Konstantinidis, Negin Gharabaghi, Thomas W Kraus, Arianeb Mehrabi, Hani Oweira
Parenchymal transection during hepatobiliary surgery can disrupt small vasculature or bile ducts, which could be managed difficultly. Sealants are helpful tools to achieve better hemostasis. The aim of this study is to analyze the hemostatic efficiency of four modern sealants in a porcine model. In this study, 40 landrace pigs were assigned equally to the control (without sealant) and four sealant groups. Standardized liver resection and splenic lesions were performed and left without using sealant (control) or treated with one of the following sealants: TachoSil(®) , Tissucol Duo(®) , Coseal(®) , and FloSeal(®) ...
June 23, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28644255/periodic-paralysis-and-encephalopathy-as-initial-manifestations-of-graves-disease-case-report-and-review-of-the-literature
#17
Theocharis Tsironis, Athanasios Tychalas, Dimitrios Kiourtidis, Jannis Kountouras, Georgia Xiromerisiou, Jobst Rudolf, Georgia Deretzi
BACKGROUND: Thyrotoxic periodic paralysis (TPP) is an uncommon complication of Graves' disease, characterized by the triad of acute hypokalemia without total body potassium deficit, episodic muscle paralysis, and thyrotoxicosis. Graves' encephalopathy is an extremely rare form of encephalopathy associated with autoimmune thyroid disease (EAATD), characterized by neuropsychiatric symptoms, increased antithyroid antibodies and cerebrospinal fluid protein concentration, nonspecific electroencephalogram abnormalities, and cortico-responsiveness...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28644187/perioperative-blood-management-in-pediatric-spine-surgery
#18
Matthew E Oetgen, Jody Litrenta
Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28644154/acute-promyelocytic-leukemia-and-chronic-lymphocytic-leukemia-concomitant-presentation-of-two-molecularly-distinct-entities
#19
Jingdong Su, Diana Veillon, Rodney Shackelford, James Cotelingam, Hazem El-Osta, Glenn Mills, Reinhold Munker, Srinivas Devarakonda
Acute myeloid leukemia (AML) developing in patients with chronic lymphocytic leukemia (CLL) is very uncommon and usually associated with prior treatment. Acute promyelocytic leukemia (APL) accounts for a very small proportion of treatment-associated AML. So far, there has been only one reported case of APL occurring post radiation for prostate cancer in a patient with CLL. We report herein the first case of APL and CLL presenting concomitantly in an untreated patient. Evaluation of peripheral blood and bone marrow aspirate with immunohistochemistry, flow cytometry, and FISH to confirm two morphologically, molecularly and genetically distinct leukemic populations characteristic of APL and CLL is required...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28644101/safety-and-cost-efficiency-of-a-restrictive-transfusion-protocol-in-patients-with-traumatic-brain-injury
#20
Laura B Ngwenya, Catherine G Suen, Phiroz E Tarapore, Geoffrey T Manley, Michael C Huang
OBJECTIVE Blood loss and moderate anemia are common in patients with traumatic brain injury (TBI). However, despite evidence of the ill effects and expense of the transfusion of packed red blood cells, restrictive transfusion practices have not been universally adopted for patients with TBI. At a Level I trauma center, the authors compared patients with TBI who were managed with a restrictive (target hemoglobin level > 7 g/dl) versus a liberal (target hemoglobin level > 10 g/dl) transfusion protocol. This study evaluated the safety and cost-efficiency of a hospital-wide change to a restrictive transfusion protocol...
June 23, 2017: Journal of Neurosurgery
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