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https://www.readbyqxmd.com/read/29224191/bilateral-choroiditis-as-the-only-sign-of-persistent-mycobacterium-intracellulare-infection-following-haematogenous-spread-in-an-immunocompromised-patient
#1
Alessandro Invernizzi, Davide Ricaboni, Marco Franzetti, Giovanni Staurenghi, Peter McCluskey, Fabio Franzetti
An immunocompromised patient had positive blood cultures for Mycobacterium intracellulare and no identifiable organ seeding was started on treatment. One month later, the patient was clinically well with negative blood cultures but drug-induced myelotoxicity had developed. Ocular fundus examination at this time revealed bilateral choroidal granulomas which changed patient management.
December 9, 2017: Infection
https://www.readbyqxmd.com/read/29223998/cryptococcal-meningitis-in-apparently-immunocompetent-patients-association-with-idiopathic-cd4-lymphopenia
#2
Samuel Shribman, Alastair Noyce, Sharmilee Gnanapavan, Jonathan Lambourne, Thomas Harrison, Frederick Schon
We present two cases of cryptococcal meningitis in people subsequently diagnosed with idiopathic CD4+ lymphopenia. Both presented with new onset headaches without sinister features and were sent home on multiple occasions from emergency departments. Cryptococcal meningitis in HIV-negative patients poses major diagnostic and management problems; the associated mortality is 9%-27%. We suggest performing blood and cerebrospinal fluid cryptococcal antigen tests in all people with lymphocytic meningitis.
December 9, 2017: Practical Neurology
https://www.readbyqxmd.com/read/29223720/serum-periostin-is-associated-with-body-mass-index-and-allergic-rhinitis-in-healthy-and-asthmatic-subjects
#3
Hirokazu Kimura, Satoshi Konno, Hironi Makita, Natsuko Taniguchi, Hiroki Kimura, Houman Goudarzi, Kaoruko Shimizu, Masaru Suzuki, Noriharu Shijubo, Katsunori Shigehara, Junya Ono, Kenji Izuhara, Yoichi Minagawa Ito, Masaharu Nishimura
BACKGROUND: Many studies have attempted to clarify the factors associated with serum periostin levels in asthmatic patients. However, these results were based on studies of subjects mainly characterized by high eosinophil counts, which may present as an obstacle for clarification in the identification of other factors associated with serum periostin levels. The aim of this study was to determine the factors associated with serum periostin levels in healthy subjects. We also assessed some factors in asthmatic subjects to confirm their extrapolation for management of asthma...
December 6, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/29223713/diagnostic-values-of-dce-mri-and-dsc-mri-for-differentiation-between-high-grade-and-low-grade-gliomas-a-comprehensive-meta-analysis
#4
Jianye Liang, Dexiang Liu, Peng Gao, Dong Zhang, Hanwei Chen, Changzheng Shi, Liangping Luo
RATIONALE AND OBJECTIVES: This study aimed to collect the studies on the role of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and dynamic susceptibility contrast MRI (DSC-MRI) in differentiating the grades of gliomas, and evaluate the diagnostic performances of relevant quantitative parameters in glioma grading. MATERIALS AND METHODS: We systematically searched studies on the diagnosis of gliomas with DCE-MRI or DSC-MRI in Medline, PubMed, China National Knowledge Infrastructure database, Cochrane Library, and Embase published between January 2005 and December 2016...
December 6, 2017: Academic Radiology
https://www.readbyqxmd.com/read/29223684/thromboelastometry-as-guidance-for-blood-management-in-patients-undergoing-cardiac-surgery
#5
C Sarrais Polo, A Alonso Morenza, J Rey Picazo, L Álvarez Mercadal, R Beltrao Sial, C Aguilar Lloret
OBJECTIVE: Thromboelastometry is a viscoelastometric method for haemostasis testing in a whole blood sample. The aim of this study was to assess the results of using thromboelastometry as guidance for blood management in cardiac surgery, postoperative adverse events and ICU stay. MATERIAL AND METHOD: Analytical and comparative non-randomised quasi-experimental prospective study with a retrospective control group. The inclusion criteria for the 80 patients were: patients undergoing cardiac surgery who had had prior cardiac surgery, endocarditis surgery or aortic arch surgery...
December 6, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29223308/what-we-have-lost-mastitis-resistance-in-holstein-friesians-and-in-a-local-cattle-breed
#6
Giulio Curone, Joel Filipe, Paola Cremonesi, Erminio Trevisi, Massimo Amadori, Claudia Pollera, Bianca Castiglioni, Lauretta Turin, Vittorio Tedde, Daniele Vigo, Paolo Moroni, Andrea Minuti, Valerio Bronzo, M Filippa Addis, Federica Riva
In Holstein Friesian dairy cows, selective pressure for increased milk production has led to a higher propensity to disease, including mastitis, when compared to less selected and lower producing dairy breeds. The biology underpinning the higher resistance to disease of such "local breeds" is not fully understood. With the aim of investigating the factors associated to this phenomenon, we applied a multidisciplinary approach to compare innate immune response patterns, metabolic parameters, milk protein profiles and the milk microbiota in Holstein Friesian and Rendena cows reared in the same farm and under the same management conditions...
November 29, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/29222997/-that-wasn-t-really-a-place-to-worry-about-diabetes-housing-access-and-diabetes-self-management-among-low-income-adults
#7
Danya E Keene, Monica Guo, Sascha Murillo
Lack of affordable housing access represents a significant and growing problem for low-income households in the United States and these housing challenges may present barriers to the management of chronic diseases such as type 2 diabetes. In this qualitative study, we examined how both housing challenges and housing resources shaped diabetes self-management behaviors. We conducted semi-structured interviews with 40 low-income residents of one US city, New Haven, Connecticut, who had a diagnosis of type 2 diabetes and either resided in or qualified for subsidized housing...
December 2, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29222972/factors-associated-with-adverse-pregnancy-outcomes-in-women-with-systematic-lupus-erythematosus
#8
Masashi Deguchi, Yoko Maesawa, Shino Kubota, Mayumi Morizane, Kenji Tanimura, Yasuhiko Ebina, Hideto Yamada
The aim of this prospective study was to determine clinical factors associated with adverse pregnancy outcomes in women with systematic lupus erythematosus (SLE). Fifty-six pregnancies from 46 women with SLE were enrolled. Risk factors for pregnancy loss, premature delivery, hypertensive disorders of pregnancy (HDP), and light-for-date neonate (LFD), were evaluated. Univariate and multivariate logistic regression analyses revealed a history of two or more pregnancy losses before 10 gestational weeks (GW) (OR 11...
November 27, 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/29222405/multiple-weekly-dalbavancin-dosing-for-the-treatment-of-native-vertebral-osteomyelitis-caused-by-methicillin-resistant-staphylococcus-aureus-a-case-report
#9
Thamer A Almangour, Valerie Fletcher, Mohammed Alessa, Abdullah A Alhifany, Deanne Tabb
BACKGROUND Native vertebral osteomyelitis (NVO) is a common form of hematogenous osteomyelitis, with Staphylococcus aureus (S. aureus) being the most commonly isolated organism. Dalbavancin is approved by the US Food and Drug Administration (FDA) for the treatment of acute bacterial skin and skin structure infections (ABSSSI) and has a sufficiently promising pharmacokinetic and pharmacodynamic profile to be considered for the treatment of vertebral osteomyelitis. We describe here what is probably the first reported case of using multiple weekly dalbavancin to treat a complicated methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and vertebral osteomyelitis...
December 9, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29222293/current-treatment-algorithm-for-the-management-of-lower-risk-mds
#10
REVIEW
Aristoteles Giagounidis
Lower risk myelodysplastic syndromes (MDS), defined as MDS with a Revised International Prognostic Scoring System score ≤3.5 points, will remain a challenging entity in 2018. Supportive care continues to be the linchpin of treatment, although the options to reduce transfusion needs are broadening. To achieve red blood cell transfusion independence in non-del(5q) patients, erythropoiesis-stimulating agents remain a mainstay of therapy as long as endogenous erythropoietin levels are <500 U/L (and preferably <200 U/L)...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222286/improving-emergency-department-based-care-of-sickle-cell-pain
#11
REVIEW
Jeffrey A Glassberg
Pain is the leading cause of emergency department (ED) visits for individuals living with sickle cell disease (SCD). The care that is delivered in the ED is often cited by patients with SCD as the area of health care in greatest need of improvement. In 2014, the National Heart, Lung, and Blood Institute released guidelines for the care of SCD, including recommendations for the management of acute sickle cell pain in the ED. These guidelines provide a framework to understand the elements of ideal emergency sickle cell pain care; however, they do not provide guidance on barriers and facilitators to achieving these ideals in the complex system of the ED...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222285/five-lessons-learned-about-long-term-pain-management-in-adults-with-sickle-cell-disease
#12
REVIEW
Joshua J Field
Chronic pain affects one-half of adults with sickle cell disease (SCD). Despite the prevalence of chronic pain, few studies have been performed to determine the best practices for this patient population. Although the pathophysiology of chronic pain in SCD may be different from other chronic pain syndromes, many of the guidelines outlined in the pain literature and elsewhere are applicable; some were consensus-adopted in the 2014 National Heart, Lung, and Blood Institute SCD Guidelines. Recommended practices, such as controlled substance agreements and monitoring of urine, may seem unnecessary or counterproductive to hematologists...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222253/new-monogenic-disorders-identify-more-pathways-to-neutropenia-from-the-clinic-to-next-generation-sequencing
#13
REVIEW
Seth J Corey, Usua Oyarbide
Neutrophils are the most common type of leukocyte in human circulating blood and constitute one of the chief mediators for innate immunity. Defined as a reduction from a normal distribution of values, neutropenia results from a number of congenital and acquired conditions. Neutropenia may be insignificant, temporary, or associated with a chronic condition with or without a vulnerability to life-threatening infections. As an inherited bone marrow failure syndrome, neutropenia may be associated with transformation to myeloid malignancy...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222034/management-of-invasive-candidiasis-and-candidemia-in-critically-ill-adults-expert-opinion-of-the-european-society-of-anaesthesia-esa-intensive-care-scientific-subcommittee
#14
REVIEW
Ruth-Aoibheann OLeary, Sharon Einav, Marc Leone, Krisztina Madách, Claude Martin, Ignacio Martin-Loeches
OBJECTIVE: The global burden of invasive fungal disease is increasing. Candida albicans remains the leading cause of fungal blood stream infections although non-albicans Candidal infections are emerging. Areas of controversy regarding diagnosis and management are hampering our ability to respond effectively to this evolving threat. The purpose of this narrative review is to address current controversies and provide recommendations to supplement guidelines. DIAGNOSIS OF INVASIVE CANDIDIASIS: Diagnosis of invasive candidiasis requires a combination of diagnostic tests and patient risk factors...
December 5, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29221978/influence-of-6-hydroxyethyl-starch-130-0-4-versus-crystalloid-solution-on-structural-renal-damage-markers-after-coronary-artery-bypass-grafting-a-post-hoc-subgroup-analysis-of-a-prospective-trial
#15
Thomas Datzmann, Markus Hoenicka, Helmut Reinelt, Andreas Liebold, Hagen Gorki
OBJECTIVE: The restriction of hydroxyethyl starch (HES) has mandated changes in volume management based on data of critically ill patients. Reliable data of structural renal damage after HES treatment in cardiac surgical patients are lacking. The influence of 6% HES 130/0.4 was investigated in this study. DESIGN: An exploratory post hoc subgroup analysis of a prospective trial was performed. SETTING: The study was carried out at a university hospital...
May 25, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29221921/ethanol-embolotherapy-for-the-management-of-refractory-chronic-skin-ulcers-caused-by%C3%A2-arteriovenous-malformations
#16
YunBo Jin, Xi Yang, Chen Hua, XiaoXi Lin, Hui Chen, Gang Ma, TianYou Wang, WenXin Yu
PURPOSE: To describe the clinical features and treatment outcomes of ethanol embolotherapy in refractory chronic skin ulcers caused by arteriovenous malformations (AVMs). MATERIALS AND METHODS: From October 2011 to October 2015, 12 patients (5 male; mean age, 26.2 y) with refractory chronic skin ulcers caused by AVMs were treated at a single institution. Ethanol embolotherapy was performed by direct puncture techniques. Needles were directly inserted toward the nidus of the lesion based on imaging analysis...
December 5, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#17
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29221766/screening-for-fetal-growth-restriction-and-placental-insufficiency
#18
REVIEW
Melanie C Audette, John C Kingdom
Fetal growth restriction (FGR) continues to be a leading cause of preventable stillbirth and poor neurodevelopmental outcomes in offspring, and furthermore is strongly associated with the obstetrical complications of iatrogenic preterm birth and pre-eclampsia. The terms small for gestational age (SGA) and FGR have, for too long, been considered equivalent and therefore used interchangeably. However, the delivery of improved clinical outcomes requires that clinicians effectively distinguish fetuses that are pathologically growth-restricted from those that are constitutively small...
December 5, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29221736/differential-effects-of-operative-complications-on-survival-after-surgery-for-primary-lung-cancer
#19
Felix G Fernandez, Andrzej S Kosinski, Anthony P Furnary, Mark Onaitis, Sunghee Kim, Robert H Habib, Betty C Tong, Patricia Cowper, Daniel Boffa, Jeffrey P Jacobs, Cameron D Wright, Joe B Putnam
OBJECTIVE: Complications adversely affect survival after lung cancer surgery. We tested the hypothesis that effects of complications after lung cancer surgery on survival vary substantially across the spectrum of postoperative complications. METHODS: The Society of Thoracic Surgeons General Thoracic Surgery Database was linked to Medicare data for lung cancer resections from 2002 through 2013. Linkage was achieved for 29,899 patients. A survival model was created that included operative complications as explanatory variables and adjusted for relevant baseline covariates...
November 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29221543/community-health-workers-in-diabetes-prevention-and-management-in-developing-countries
#20
REVIEW
Halimatou Alaofè, Ibitola Asaolu, Jennifer Ehiri, Hayley Moretz, Chisom Asuzu, Mobolanle Balogun, Olayinka Abosede, John Ehiri
BACKGROUND: There is limited evidence regarding the effect of community health worker (CHW) interventions for prevention and management of the burgeoning epidemic of noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs). The objective of this review was to critically appraise evidence regarding the effectiveness of CHW interventions for prevention and management of type 2 diabetes mellitus (T2DM) in LMICs. METHODS: To identify studies that reported the effect of CHW interventions for prevention and management of T2DM in LMICs, Medline/PubMed, EMBASE, Web of Science (Science and Social Science Citation Indices), EBSCO (PsycINFO and CINAHL), POPLINE, the Cochrane Metabolic and Endocrine Disorders Group's Specialized Register, the Cochrane Central Register of Controlled Trials, the Grey literature (Google, Google Scholar), and reference lists of identified articles were searched from inception to May 31, 2017...
May 2017: Annals of Global Health
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