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https://www.readbyqxmd.com/read/28936682/early-versus-delayed-source-control-in-open-abdomen-management-for-severe-intra-abdominal-infections-a-retrospective-analysis-on-111-cases
#1
Stefano Rausei, Vincenzo Pappalardo, Laura Ruspi, Antonio Colella, Simone Giudici, Vincenzo Ardita, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi
BACKGROUND: Time to source control plays a determinant prognostic role in patients having severe intra-abdominal infections (IAIs). Open abdomen (OA) management became an effective treatment option for peritonitis. Aim of this study was to analyze the correlation between time to source control and outcome in patients presenting with abdominal sepsis and treated by OA. METHODS: We retrospectively analyzed 111 patients affected by abdominal sepsis and treated with OA from May 2007 to May 2015...
September 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28935330/acute-delayed-tension-pneumopericardium-the-first-reported-case-after-elective-lobectomy
#2
Salvatore Torre, Jennifer Lee, Stephen O'Connor, Sarah A Early, Ronan Ryan
Pneumopericardium is an overall rare condition caused by increased intrathoracic positive pressure. Different mechanisms can contribute to its development. It can be observed in both pediatric and adult populations. Only a small percentage of patients have cardiac tamponade. We describe the first case of delayed tension pneumopericardium after elective lobectomy. Sudden symptom onset and clinical management are discussed. Only an accurate and quick patient assessment allowed diagnosing this condition and, hence, its correct treatment...
October 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28934498/widespread-intra-dependencies-in-the-removal-of-introns-from-human-transcripts
#3
Seong Won Kim, Allison J Taggart, Claire Heintzelman, Kamil J Cygan, Caitlin G Hull, Jing Wang, Barsha Shrestha, William G Fairbrother
Research into the problem of splice site selection has followed a reductionist approach focused on how individual splice sites are recognized. Early applications of information theory uncovered an inconsistency. Human splice signals do not contain enough information to explain the observed fidelity of splicing. Here, we conclude that introns do not necessarily contain 'missing' information but rather may require definition from neighboring processing events. For example, there are known cases where an intronic mutation disrupts the splicing of not only the local intron but also adjacent introns...
September 19, 2017: Nucleic Acids Research
https://www.readbyqxmd.com/read/28932296/genetic-diagnosis-of-chromosomal-congenital-anomalies-in-albanian-pediatric-patients-by-array-cgh
#4
Anila Babameto-Laku, Dorina Roko, Gentian Vyshka
AIM: The aim of our study was to identify chromosomal imbalances by whole-genome microarray-based comparative genomic hybridization (array CGH) in DNA samples of children in which karyotype results cannot be obtained. The present paper describes the first Albanian experience of an array CGH application. MATERIAL AND METHODS: The cohort included seven children with developmental delay or intellectual disability, facial dysmorphism and congenital anomalies according to clinical criteria, suggestive of chromosomal anomalies...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28931645/comorbidity-in-multiple-sclerosis-is-associated-with-diagnostic-delays-and-increased-mortality
#5
Anja Thormann, Per Soelberg Sørensen, Nils Koch-Henriksen, Bjarne Laursen, Melinda Magyari
OBJECTIVE: To investigate the effect of chronic comorbidity on the time of diagnosis of multiple sclerosis (MS) and on mortality in MS. METHODS: We conducted a population-based, nationwide cohort study including all incident MS cases in Denmark with first MS symptom between 1980 and 2005. To investigate the time of diagnosis, we compared individuals with and without chronic comorbidity using multinomial logistic regression. To investigate mortality, we used Cox regression with time-dependent covariates, following study participants from clinical MS onset until endpoint (death) or to the end of the study, censuring at emigration...
September 20, 2017: Neurology
https://www.readbyqxmd.com/read/28931125/patients-with-mental-problems-the-most-defenseless-travellers
#6
Peter Felkai, Tamas Kurimay
Background: Severe mental illness occurring abroad is a difficult situation for patients, their families, and for the local medical community. Patients with mental problem are doublely stigmatized due to their mental illness and because they are foreigners in an unfamiliar country. The appropriate treatment is often delayed, while patients are often dealt with in a manner that violates their human rights. Moreover, repatriation - which is vital in this case - is often delayed due to the lack of international protocols for the transportation and treatment of mentally ill travelers...
September 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28930777/endoscopic-delayed-breast-reconstruction-with-expanders-and-implants-via-the-axillary-incision-made-for-sentinel-lymph-node-biopsy-or-lymphadenectomy
#7
José Maria Serra-Mestre, Randolfo Fernandez Peñuela, Francesco DʼAndrea, Joan Maria Viñals, José Maria Serra-Renom
BACKGROUND: Classic techniques of delayed prosthetic breast reconstruction use the mastectomy scar as an access route. As a result, the filling of the expander must be postponed until the wounds have healed. This creates an asymmetry between the breasts with the volume changes caused by the filling of the expander, which may occur over several weeks and cause considerable discomfort. METHODS: Delayed breast reconstruction was performed via the axillary incision made for sentinel lymph node biopsy or lymphadenectomy with endoscopic assistance and detachment of the pectoralis major muscle...
September 19, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28928953/treatment-of-femoral-shaft-fractures-with-monoaxial-external-fixation-in-polytrauma-patients
#8
Gianluca Testa, Domenico Aloj, Alessandro Ghirri, Eraclite Petruccelli, Vito Pavone, Alessandro Massé
Background: Femoral shaft fractures, typical in younger people, are often associated with polytrauma followed by traumatic shock. In these situations, despite intramedullary nailing being the treatment of choice, external fixation could be used as the definitive treatment. The aim of this study is to report evidence regarding definitive treatment of femoral shaft fractures with monoaxial external fixation. Methods: Between January 2006 and December 2015, 83 patients with 87 fractures were treated at the Department of Orthopaedics and Traumatology CTO of Turin, with a monoaxial external fixation device...
2017: F1000Research
https://www.readbyqxmd.com/read/28928326/a-delayed-acute-complication-of-bariatric-surgery-gastric-remnant-haemorrhagic-ulcer-after-roux-en-y-gastric-bypass
#9
Stefan Patrascu, Carmen Balague Ponz, Sonia Fernandez Ananin, Eduardo M Targarona Soler
Acute gastric remnant bleeding is an exceptionally rare complication when it occurs long after bariatric surgery. We present the case of a patient with a bleeding ulcer of the excluded stomach (i.e., the remnant), occurring 7 years after Roux-en-Y gastric bypass (RYGB) for morbid obesity. A computed tomography scan managed to locate the active bleeding source in the gastric remnant. During emergency laparotomy, a bleeding ulcer of the fundic region of the excluded stomach was identified. Total resection of the remnant was performed, with good post-operative recovery...
September 20, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28925344/prehospital-response-time-delays-for-emergency-patients-in-events-of-concurrent-mass-casualty-incidents
#10
Jungeun Kim, Chu Hyun Kim, Sang Do Shin, Ju Ok Park
OBJECTIVE: We investigated the extent of delays in the response time of emergency medical services (EMS) as an impact of mass casualty incidences (MCIs) in the same area. METHODS: We defined an MCI case as an event that resulted in 6 or more patients being transported by EMS, and prehospital response time as the time from the call to arrival at the scene. We matched patients before and after MCIs by dividing them into categories of 3 hours before, 0-1 hour after, 1-2 hours after, and 2-3 hours after the MCIs...
September 19, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28924974/incidence-and-predictive-score-for-delayed-hemolytic-transfusion-reaction-in-adult-patients-with-sickle-cell-disease
#11
David Narbey, Anoosha Habibi, Philippe Chadebech, Armand Mekontso-Dessap, Mehdi Khellaf, Jean-Daniel Lelièvre, Bertrand Godeau, Marc Michel, Frédéric Galactéros, Rachid Djoudi, Pablo Bartolucci, France Pirenne
Delayed hemolytic transfusion reaction (DHTR) is a life-threatening complication of transfusion in sickle cell disease (SCD). The frequency of DHTR is underestimated because its symptoms mimic those of vaso-occlusive crisis and antibodies (Abs) are often not detectable. No predictive factors for identifying patients likely to develop DHTR have yet been defined. We conducted a prospective single-center observational study over 30 months in adult sickle cell patients. We included 694 transfusion episodes (TEs) in 311 patients, divided into occasional TEs (OTEs: 360) and chronic transfusion program (CTEs: 334)...
September 19, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28924435/aggressive-posterior-retinopathy-of-prematurity-in-a-premature-male-infant
#12
Jun Zhou, Zheng Liu, Hai-Yan Ying, Tao Liu
A premature male infant was born at 30 weeks' gestation with a birth weight of 1,700 g in a rural hospital. He was diagnosed with respiratory distress syndrome and received continuous positive airway pressure treatment for 26 days. At 26 days after birth, the patient was transferred to our hospital for further evaluation and management. A comprehensive eye examination revealed a stage 3 retinopathy of prematurity (ROP) involving zone 2 in both eyes. The patient was recommended to a provincial-level eye hospital for emergency laser therapy...
May 2017: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28924419/surprises-during-intravitreal-drug-delivery-a-report-of-three-cases
#13
Pradeep Venkatesh, Rohan Chawla, Bhavin Shah, Sat Pal Garg
We describe 3 cases with unusual events during and after intravitreal injection of dexamethasone intravitreal implants and bevacizumab. In case 1, delayed release of the safety stop of a dexamethasone intravitreal implant injector led to impaction and retinal break formation. Timely recognition and laser treatment prevented further retinal complications. In case 2, reinjection of a second dexamethasone intravitreal implant from the same site as the first injection was noted to dislodge the remnant of the previous implant from the vitreous base...
2017: Digital Journal of Ophthalmology: DJO
https://www.readbyqxmd.com/read/28924292/hemimegalencephaly-with-intractable-epilepsy-a-case-report
#14
Prem Chand, Muhammad Faraz Raghib, Muhammad Sohail Salat, Fazal Manzoor Arain
Isolated Hemimegalencephaly (iHME) is a rare form of congenital malformation of cortical development.It is characterized by enlargement of all or part of one cerebral hemisphere. It typically presents with intractable seizures, mental retardation, developmental delay, contralateral hemiparesis and hemianopia. The patient was a five and half month's old baby girl who presented first with focal seizures at 10th day of life. No other physical or behavioral abnormality was noted. However, Initial EEG showed excessive sharp EEG transients more over the right hemisphere, repeated EEG showed spikes, polyspikes, sharps and slow wave discharges predominately over right hemisphere...
September 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28924115/neurological-complications-in-eosinophilic-granulomatosis-with-polyangiitis-egpa-the-roles-of-history-and-the-results-of-physical-examinations-in-the-diagnosis-of-egpa
#15
Hiroshi Oiwa, Sho Mokuda, Tomoyasu Matsubara, Masamoto Funaki, Ikuko Takeda, Takemori Yamawaki, Kazuhiko Kumagai, Eiji Sugiyama
Objective To investigate the clinical symptoms, the physical and neurological findings, and the clinical course of neurological complications in eosinophilic granulomatosis with polyangiitis (EGPA). Methods A retrospective chart review of EGPA cases managed by two referral hospitals was performed, with a focus on the neurological findings. The study analyzed the symptoms at the onset of EGPA and investigated their chronological relationship. The patient delay (the delay between the onset of symptoms and the initial consultation), and the physician delay (the delay from consultation to the initiation of therapy) were determined and compared...
September 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28924066/-factors-contributing-to-surgical-intervention-for-subacute-subdural-hematoma-enlargement-in-patients-with-mild-head-injuries
#16
Yosuke Akamatsu, Tohru Sasaki, Masayuki Kanamori, Shinsuke Suzuki, Hiroshi Uenohara, Teiji Tominaga
Delayed neurological deterioration following mild head injury(MHI)usually occurs within 24 hours. However, some cases require delayed surgical evacuation of an acute subdural hematoma(ASDH), owing to subacute progressive hematoma enlargement. This study aimed to determine radiological or clinical parameters associated with surgical intervention in ASDH cases in which surgery was not initially considered necessary. From 2010 to 2015, 64 patients were non-surgically treated for ASDH following MHI. We evaluated the various outcomes of eventual surgical ASDH evacuation after the first 48 hours following injury, due to hematoma enlargement and clinical deterioration...
September 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28921481/negative-magnetic-resonance-imaging-in-three-cases-of-anterior-tibial-cortex-stress-fractures
#17
Ralph Smith, M Moghal, J L Newton, N Jones, J Teh
Anterior mid-tibial cortex stress fractures (ATCSF) are uncommon and notoriously challenging to treat. They are termed high risk due to their predilection to prolonged recovery, nonunion and complete fracture. Early diagnosis is essential to avoid progression and reduce fracture complications. Imaging plays a key role in confirming the diagnosis. Magnetic resonance imaging (MRI) is accepted as the gold standard modality due to its high accuracy and nonionizing properties. This report describes three cases of ATCSFs in recreational athletes who had positive radiographic findings with no significant MRI changes...
September 18, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28917829/a-chinese-boy-with-geleophysic-dysplasia-caused-by-compound-heterozygous-mutations-in-adamtsl2
#18
Li Dongxiao, Dong Hui, Zheng Hong, Song Jinqing, Li Xiyuan, Jin Ying, Liu Yupeng, Yang Yanling
Geleophysic dysplasia, belonging to the group of acromelic dysplasia, is a rare genetic disease. Two genes, FBN1 and ADAMTSL2, were known to be linked to this disorder. The disorder presents as extreme short stature, short limbs, small hands and feet, stubby fingers and toes, joint stiffness, toe walking, skin thickening, progressive cardiac valvular thickening and characteristic facial features, including a round face with full cheeks. Here, we report the first Chinese case with geleophysic dysplasia type 1 based on clinical and genetic features...
September 13, 2017: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/28913339/ulcerative-gastritis-and-esophagitis-in-two-children-with-sarcina-ventriculi-infection
#19
Tim G J de Meij, Michiel P van Wijk, Aart Mookhoek, Andries E Budding
Sarcina ventriculi is a Gram-positive, obligate anaerobic coccus, with a characteristic morphology. Only 22 cases of human infections by this microorganism, including 7 in children, have been reported in literature so far. Affected subjects usually present with abdominal pain, nausea, vomiting, and delayed gastric emptying. However, life-threatening complications, like emphysematous gastritis and gastric perforation have also been described. Gastroparesis and gastric outlet obstruction have been considered as a potential etiologic factor...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28911353/persistently-high-early-mortality-despite-rapid-diagnostics-for-drug-resistant-tuberculosis-cases-in-south-africa
#20
K Schnippel, C Firnhaber, N Ndjeka, F Conradie, L Page-Shipp, R Berhanu, E Sinanovic
OBJECTIVE: To describe the timing and predictors of mortality among multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB) patients reported in the South African electronic drug-resistant TB register (EDRweb), 2012-2014. DESIGN: We present time-to-event survival analysis and Cox proportional hazards regression. Identity numbers were matched to the National Vital Statistics Register. RESULTS: Of the 20 653 patients included in the analysis (median age 35 years, interquartile range 28-43), over half were male (n = 10 944, 53...
October 1, 2017: International Journal of Tuberculosis and Lung Disease
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