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first case delays

Josie Merchant, Gemma Kitsos, Samantha Ashby, Alex Kitsos, Isobel J Hubbard
Objective. To assess whether acute stroke patients in rural hospitals receive less occupational therapy and physiotherapy than those in metropolitan hospitals. Design. Retrospective case-control study of health data in patients ≤10 days after stroke. Setting. Occupational therapy and physiotherapy services in four rural hospitals and one metropolitan hospital. Participants. Acute stroke patients admitted in one health district. Main Outcome Measures. Frequency and duration of face-to-face and indirect therapy sessions...
2016: Stroke Research and Treatment
Sandeep Kumar, Gerald Pflueger
Femoral nerve neuropathy after total hip arthroplasty is rare but catastrophic complication. Pain and quadriceps muscle weakness caused by this complication can significantly affect the functional outcome. Here we present a case report, describing delayed onset femoral nerve palsy associated with iliopsoas hematoma following pseudoaneurysm of a branch of profunda femoris artery after 3 months of primary total hip arthroplasty in an 80-year-old female patient with single kidney. Hip arthroplasty was done for painful primary osteoarthritis of left hip...
2016: Case Reports in Orthopedics
Carlos E Rodríguez-Rodríguez, Karina Madrigal-León, Mario Masís-Mora, Marta Pérez-Villanueva, Juan Salvador Chin-Pampillo
The use of fungal bioaugmentation represents a promising way to improve the performance of biomixtures for the elimination of pesticides. The ligninolyitc fungus Trametes versicolor was employed for the removal of three carbamates (aldicarb, ALD; methomyl, MTM; and methiocarb, MTC) in defined liquid medium; in this matrix ALD and MTM showed similar half-lives (14d), nonetheless MTC exhibited a faster removal, with a half-life of 6.5d. Then the fungus was employed in the bioaugmentation of an optimized biomixture to remove the aforementioned carbamates plus carbofuran (CFN)...
October 14, 2016: Ecotoxicology and Environmental Safety
Ashley S Case
Breast cancer is one of the most common malignancies affecting pregnancy. Pregnancy-associated breast cancer refers to breast cancer that is diagnosed during pregnancy or within the first postpartum year. The incidence is increasing as more women delay childbearing. Breast cancer can be safely diagnosed, staged, and treated during pregnancy while protecting the fetus and mother with excellent outcomes for both. Avoiding diagnostic delays is vital to prognosis. This article provides an overview of the diagnosis, staging, management, and prognosis of pregnancy-associated breast cancer...
October 5, 2016: Clinical Obstetrics and Gynecology
Edna Pereira Gomes Morais, Rachel Riera, Gustavo Jm Porfírio, Cristiane R Macedo, Vivian Sarmento Vasconcelos, Alexsandra de Souza Pedrosa, Maria R Torloni
BACKGROUND: Caesarean sections (CS) are the most frequent major surgery in the world. A transient impairment of bowel motility is expected after CS. Although this usually resolves spontaneously within a few days, it can cause considerable discomfort, require symptomatic medication and delay hospital discharge, thus increasing costs. Chewing gum in the immediate postoperative period is a simple intervention that may be effective in enhancing recovery of bowel function in other types of abdominal surgeries...
October 17, 2016: Cochrane Database of Systematic Reviews
Yi Wang, HongBin Liu, Peng Li, Wei Wang
A 40-year-old male who had a severe tremor, bradykinesia, and rigidity for 6 years underwent bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) at our hospital. The patient did not have any prior ischemia events or any risk factors in his medical history. Six and 9 months post-operation, this patient was admitted to the hospital twice for lower left limb involuntary twitching. Two magnetic resonance imaging (MRI) scans showed cerebral ischemia surrounding the implanted electrode. To our knowledge, this is the first case of recurrent cerebral ischemia associated with DBS...
October 15, 2016: Acta Neurochirurgica
Francesco Demaria, Franco De Crescenzo, Anna Maria Caramadre, Adele D'Amico, Antonella Diamanti, Fabiana Fattori, Maria Pia Casini, Stefano Vicari
Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare multisystemic autosomal recessive disorder mainly caused by mutations in the nuclear gene TYMP, encoding thymidine phosphorylase. It generally appears in childhood and is clinically characterized by severe gastrointestinal dysmotility, cachexia, ptosis, progressive external ophthalmoplegia, peripheral neuropathy, and diffuse leukoencephalopathy on brain magnetic resonance imaging. The disease is clinically heterogeneous with the main symptoms being gastrointestinal, with an important weight loss...
October 12, 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Jasper H van Lieshout, Iris Bruland, Igor Fischer, Jan F Cornelius, Marcel A Kamp, Bernd Turowski, Angelo Tortora, Hans-Jakob Steiger, Athanasios K Petridis
BACKGROUND: Time has shown to be a relevant factor in the prognosis for a multitude of clinical conditions. The current analysis aimed to establish whether delayed admission to specialized care is a risk factor for increased mortality in case of high-grade aneurysmal subarachnoid hemorrhage. MATERIAL AND METHODS: Consecutive patients with aneurysmal subarachnoid hemorrhage were enrolled retrospectively if they had a World Federation of Neurological Surgeons Grading System grade of 5...
September 30, 2016: American Journal of Emergency Medicine
Antonio Berruezo, Juan Acosta, Juan Fernández-Armenta, Alonso Pedrote, Alberto Barrera, Eduardo Arana-Rueda, Andrés Ignacio Bodegas, Ignasi Anguera, Luis Tercedor, Diego Penela, David Andreu, Rosario Jesus Perea, Susana Prat-González, Lluis Mont
BACKGROUND: First-line endoepicardial ventricular tachycardia (VT) ablation has been proposed for patients with arrhythmogenic cardiomyopathy (AC). This study reports procedural safety, outcomes, and predictors of recurrence. METHODS AND RESULTS: Forty-one consecutive patients [12 with left ventricle (LV) involvement, 7 left-dominant] underwent first-line endoepicardial VT substrate ablation. Standard bipolar and unipolar thresholds were used to define low-voltage areas (LVA)...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Maria Cecilia Gonzalez Corcia, Juan Sieira, Andrea Sarkozy, Carlo de Asmundis, Gian-Battista Chierchia, Jaime Hernandez Ojeda, Gudrun Pappaert, Pedro Brugada
AIMS: To investigate the clinical characteristics, prognoses, and presence of risk factors in young patients with Brugada syndrome (BS). METHODS AND RESULTS: A consecutive cohort of 128 young BS patients (≤25 years old at diagnosis) was analysed. Eighty-eight patients (69%) were asymptomatic, whereas 40 (31%) presented with clinical manifestations of BS. Markers of prognosis and risk were identified upon comparison of these two groups. A history of malignant syncope was strong predictors of ventricular arrhythmic events...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Charles L Francoeur, Stephan A Mayer
For patients who survive the initial bleeding event of a ruptured brain aneurysm, delayed cerebral ischemia (DCI) is one of the most important causes of mortality and poor neurological outcome. New insights in the last decade have led to an important paradigm shift in the understanding of DCI pathogenesis. Large-vessel cerebral vasospasm has been challenged as the sole causal mechanism; new hypotheses now focus on the early brain injury, microcirculatory dysfunction, impaired autoregulation, and spreading depolarization...
October 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
E Trinczek, M Heinzel-Gutenbrunner, M Haberhausen, C J Bachmann
Introduction: Early-onset schizophrenia (EOS) has a poor prognosis and is difficult to treat, which often leads to the initiation of clozapine treatment. Studies in adults have shown that the initiation of clozapine treatment is often delayed. There is a lack of studies concerning the initiation of clozapine in children and adolescents with EOS. The aim of this study was to investigate the time span from first EOS-related psychiatric hospitalization to clozapine initiation. Methods: We retrospectively studied a consecutive cohort of children and adolescents with EOS and first-time clozapine prescriptions from a tertiary care child and adolescent psychiatric center in Germany...
October 13, 2016: Pharmacopsychiatry
Philip A May, Anna-Susan Marais, Marlene M de Vries, Wendy O Kalberg, David Buckley, Julie M Hasken, Colleen M Adnams, Ronel Barnard, Belinda Joubert, Marise Cloete, Barbara Tabachnick, Luther K Robinson, Melanie A Manning, Kenneth Lyons Jones, Heidre Bezuidenhout, Soraya Seedat, Charles D H Parry, H Eugene Hoyme
BACKGROUND: The prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in a fifth sample in a South African community. METHODS: An active case ascertainment approach was employed among all first grade learners in this community (n=862). Following individual examination by clinical geneticists/dysmorphologists, cognitive/behavioral testing, and maternal interviews, final diagnoses were made in multidisciplinary case conferences...
October 6, 2016: Drug and Alcohol Dependence
Charmaine Tang, Mythily Subramaniam, Boon Tat Ng, Edimansyah Abdin, Lye Yin Poon, Swapna K Verma
OBJECTIVE: Early symptomatic response is pertinent in improving outcomes in first-episode psychosis. One of the ways in which this may be achieved is by reducing inappropriate delays in clozapine initiation. This study aimed to examine clozapine prescribing practices among clinicians by establishing the prevalence of clozapine use, identifying baseline clinical and demographic factors that were associated with clozapine use, examining outcomes in clozapine users versus nonusers, and identifying inappropriate antipsychotic prescription patterns prior to clozapine initiation...
October 11, 2016: Journal of Clinical Psychiatry
A R Alpysova, Yu V Subbota, A K Adambekova, N T Telembetov, M Maratkyzy
AIM: To analyze the management of patients with associated complications from hypertension to improve prehospital therapeutic and diagnostic care. MATERIAL AND METHODS: The accounts and records (125,905 calling cards over 2012-2014) of the Statistics Division, Karaganda Regional First Aid Station, were used. The methods of clinical and mathematical analysis were applied. RESULTS: There was an annual increase in the number of calls for all cases of hypertension complications in relation to the higher rate of hospitalization by 2014...
2016: Terapevticheskiĭ Arkhiv
Abebayehu Bitew Aniley, Tadesse Awoke Ayele, Ejigu Gebeye Zeleke, Assefa Andargie Kassa
BACKGROUND: Early HIV diagnosis and access to treatment is one of the most effective ways to prevent its further spread and to protect the health of those living with the virus. However, delay in diagnosis is the major risk factor for uptake of and response to antiretroviral therapy. METHODS: Institution-based unmatched case-control study design was used in the study. The study was conducted in Debre-Markos and Finote-Selam Hospitals, Northwest Ethiopia. Cases were people living with HIV who had CD4 count <350cells/mm(3) or WHO clinical stage III and IV regardless of the CD4 count at first presentation and controls were those who had CD4 count ≥350cells/mm(3) or WHO clinical stage I and II...
October 12, 2016: BMC Public Health
Menglan Zhou, Peng Wang, Sharon Chen, Bin Du, Jinlong Du, Fengdan Wang, Meng Xiao, Fanrong Kong, Yingchun Xu
BACKGROUND: Mycoplasma hominis, a well known cause of neonatal infection, has been reported as a pathogen in urogenital infections in adults; however, central nervous system (CNS) infections are rare. We report here the first case of M. hominis meningitis in China, post neurosurgical treatment for an intracerebral haemorrhage in a 71-year-old male. CASE PRESENTATION: We describe a 71-year-old man who developed M. hominis meningitis after neurosurgical treatment and was successfully treated with combined azithromycin and minocycline therapy of 2 weeks duration, despite delayed treatment because the Gram stain of cerebrospinal fluid (CSF) yielded no visible organisms...
October 12, 2016: BMC Infectious Diseases
Soichiro Morisaki, Jun'ichi Yokoyama, Kazunari Eda, Yousuke Itoh
We introduce a new analysis method to deal with stationary non-Gaussian noises in gravitational wave detectors in terms of the independent component analysis. First, we consider the simplest case where the detector outputs are linear combinations of the inputs, consisting of signals and various noises, and show that this method may be helpful to increase the signal-to-noise ratio. Next, we take into account the time delay between the inputs and the outputs. Finally, we extend our method to nonlinearly correlated noises and show that our method can identify the coupling coefficients and remove non-Gaussian noises...
2016: Proceedings of the Japan Academy. Series B, Physical and Biological Sciences
R Solomons, M Grantham, B J Marais, R van Toorn
BACKGROUND: The diagnosis of tuberculous meningitis (TBM) in children is often delayed, with disastrous consequences. The Integrated Management of Childhood Illness (IMCI) strategy aims to ensure the accurate assessment of ill children using simple yet reliable clinical signs. METHODS: We conducted a retrospective observational study of 30 consecutive children aged 3 months to 5 years diagnosed with TBM at Tygerberg Hospital, Cape Town, South Africa. Clinical records were reviewed to assess diagnostic delay and identify IMCI indicators that were present at the time of initial presentation...
October 2016: International Journal of Tuberculosis and Lung Disease
Jennifer Forshaw, Stephanie Raybould, Emilie Lewis, Mark Muyingo, Andrew Weeks, Kate Reed, Logan Manikam, Josaphat Byamugisha
BACKGROUND: Mulago National Referral Hospital has the largest maternity unit in sub-Saharan Africa. It is situated in Uganda, where the maternal mortality ratio is 310 per 100,000 live births. In 2010 a 'Traffic Light System' was set up to rapidly triage the vast number of patients who present to the hospital every day. The aim of this study was to evaluate the effectiveness of the obstetric department's triage system at Mulago Hospital with regard to time spent in admissions and to identify urgent cases and factors adversely affecting the system...
October 10, 2016: BMC Pregnancy and Childbirth
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