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https://www.readbyqxmd.com/read/28711085/risk-factors-for-positive-or-equivocal-margins-after-wide-local-excision-of-1345-cutaneous-melanomas
#1
Christopher J Miller, Thuzar M Shin, Joseph F Sobanko, John M Sharkey, John W Grunyk, Rosalie Elenitsas, Emily Y Chu, Brian C Capell, Michael E Ming, Jeremy R Etzkorn
BACKGROUND: Positive or equivocal margins after wide local excision (WLE) complicate surgical management of cutaneous melanoma. OBJECTIVE: To identify the frequency of and risk factors for positive or equivocal margins after WLE of cutaneous melanoma. METHODS: Retrospective, single-center, cross-sectional study of 1345 consecutive melanomas treated with WLE. RESULTS: The overall frequency of positive or equivocal margins was 4...
August 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28705042/musculoskeletal-injuries-in-gastrointestinal-endoscopists-a-systematic-review
#2
Diana E Yung, Tommaso Banfi, Gastone Ciuti, Alberto Arezzo, Paolo Dario, Anastasios Koulaouzidis
INTRODUCTION: Gastrointestinal(GI) endoscopy forms a significant proportion of clinicians' workloads. However, little attention is given to the ergonomic aspects of endoscopy. This systematic review of musculoskeletal pain and/or injuries in GI endoscopists aims to better understand the types of occupational injuries resulting from endoscopic procedures and associated risk factors. Areas covered: Systematic literature search conducted for articles evaluating prevalence, risk factors and mechanism of musculoskeletal pain and/or injuries related to GI endoscopy...
July 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28704747/two-cases-of-late-medial-instability-of-the-knee-due-to-hip-disease-after-total-knee-arthroplasty
#3
Masanori Tsubosaka, Tomoyuki Matsumoto, Koji Takayama, Naoki Nakano, Ryosuke Kuroda
INTRODUCTION: There are few specific reports of late medial instability after total knee arthroplasty (TKA). We described two cases of late medial instability of the knee due to hip disease with osteoarthritis or rheumatoid arthritis after TKA, which required revision TKA. PRESENTATION OF CASES: An 82-year-old woman experienced right femoral neck fracture due to a fall that required conservative treatment at age 77 years and underwent left TKA at age 80 years. A 68-year-old woman underwent left TKA at age 54 years, right TKA at age 64 years, and left THA at age 67 years...
June 29, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28702387/reverse-shoulder-arthroplasty-clinical-results-and-quality-of-life-evaluation
#4
Arnaldo Amado Ferreira Neto, Eduardo Angeli Malavolta, Jorge Henrique Assunção, Evelinda Marramon Trindade, Mauro Emilio Conforto Gracitelli
OBJECTIVE: To evaluate the clinical and radiological results and the impact on quality of life of the reverse shoulder arthroplasty. METHODS: Retrospective case series evaluating 13 patients undergoing reverse shoulder arthroplasty with at least two years of clinical follow-up. Clinical evaluation was performed before and after surgery with the ASES and VAS scales and hand-mouth, hand-neck, and hand-head functional tests. Quality of life was measured with the SF-12 questionnaire...
May 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28695184/the-stability-of-dual-taper-modular-hip-implants-a-biomechanical-analysis-examining-the-effect-of-impact-location-on-component-stability
#5
Nicholas B Frisch, Jonathan R Lynch, Richard F Banglmaier, Craig D Silverton
BACKGROUND: The purpose of this study was to investigate the stability of dual-taper modular implants following impaction forces delivered at varying locations as measured by the distraction forces required to disassemble the components. METHODS: Distraction of the head-neck and neck-stem (NS) tapers of dual-taper modular implants with 0°, 8°, and 15° neck angles were measured utilizing a custom-made distraction fixture attached to a servohydraulic materials test machine...
June 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28691756/surgical-specimen-handover-from-the-operating-theatre-to-laboratory-can-we-improve-patient-safety-by-learning-from-aviation-and-other-high-risk-organisations
#6
Peter A Brennan, Marieke T Brands, Lucy Caldwell, Felipe Paiva Fonseca, Nic Turley, Susie Foley, Siavash Rahimi
Essential communication between healthcare staff is considered one of the key requirements for both safety and quality care when patients are handed over from one clinical area to other. This is particularly important in environments such as the operating theatre and intensive care where mistakes can be devastating. Healthcare has learned from other high-risk organisations (HRO) such aviation where the use of checklists and human factors awareness has virtually eliminated human error and mistakes. To our knowledge, little has been published around ways to improve pathology specimen handover following surgery, with pathology request forms often conveying the bare minimum of information to assist the laboratory staff...
July 10, 2017: Journal of Oral Pathology & Medicine
https://www.readbyqxmd.com/read/28690439/grasshopper-dcmd-an-undergraduate-electrophysiology-lab-for-investigating-single-unit-responses-to-behaviorally-relevant-stimuli
#7
Dieu My T Nguyen, Mark Roper, Stanislav Mircic, Robert M Olberg, Gregory J Gage
Avoiding capture from a fast-approaching predator is an important survival skill shared by many animals. Investigating the neural circuits that give rise to this escape behavior can provide a tractable demonstration of systems-level neuroscience research for undergraduate laboratories. In this paper, we describe three related hands-on exercises using the grasshopper and affordable technology to bring neurophysiology, neuroethology, and neural computation to life and enhance student understanding and interest...
2017: Journal of Undergraduate Neuroscience Education: JUNE: a Publication of FUN, Faculty for Undergraduate Neuroscience
https://www.readbyqxmd.com/read/28688694/nutritional-changes-in-patients-with-locally-advanced-head-and-neck-cancer-during-treatment
#8
L Arribas, L Hurtós, M Taberna, I Peiró, E Vilajosana, A Lozano, S Vazquez, R Mesia, N Virgili
OBJECTIVE: The purpose of the study is to evaluate changes in body composition and nutritional status that occur throughout the oncological treatment in head and neck cancer patients. METHODS: A prospective cohort observational study in patients diagnosed with head and neck squamous cell carcinoma (HNSCC) that underwent treatment with induction chemotherapy (iCT) followed by chemoradiotherapy or bioradiotherapy were invited to participate. All patients had dietetic counseling from the diagnosis and a close monitoring throughout the treatment implementing nutritional support as needed...
August 2017: Oral Oncology
https://www.readbyqxmd.com/read/28681148/effects-of-denosumab-treatment-on-bone-mineral-density-and-joint-destruction-in-patients-with-rheumatoid-arthritis
#9
Takeshi Mochizuki, Koichiro Yano, Katsunori Ikari, Kosei Kawakami, Ryo Hiroshima, Naoko Koenuma, Mina Ishibashi, Shigeki Momohara
We aimed to investigate the efficacy of denosumab for rheumatoid arthritis (RA). This study enrolled 70 RA patients who received denosumab 60 mg subcutaneous injection at baseline and at 6 months. Bone mineral densities (BMD) of the lumbar spine, total hip, femoral neck, and hand were measured by dual energy X-ray absorptiometry. Changes in total modified Sharp score (mTSS), erosion (EN) score, and joint space narrowing score at baseline from 12 months before and at 12 months from baseline. The mean values of BMD of the lumbar spine, total hip, femoral neck, and hand significantly increased by 7...
July 5, 2017: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/28673655/peak-inspiratory-flow-as-predictor-for-tracheotomy
#10
M Lesnik, J J Sanchez-Guerrero, O De Crouy Chanel, C Hervé, J Guerlain, S Périé
OBJECTIVES: Quantitative evaluation of upper airway obstruction cannot be commonly performed under acute dyspnea, especially in head and neck cancer (HNC); the decision whether or not to perform airway control surgery may be difficult to reach. Peak inspiratory flow (PIF) has been previously demonstrated to be a useful tool to decide on decannulation after HNC surgery. The aim of the present study was to assess the role of PIF as a standardized non-invasive tool in quantifying severe inspiratory dyspnea requiring emergency tracheostomy...
June 30, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28670248/allergic-contact-dermatitis-pattern-in-kuwait-nickel-leads-the-pack-in-depth-analysis-of-nickel-allergy-based-on-the-results-from-a-large-prospective-patch-test-series-report
#11
Nawaf Almutairi, Fahad Almutawa
INTRODUCTION: Contact dermatitis is a relatively common dermatosis reported among several population groups from all around the globe. However, the data from Kuwait is unavailable. Patch tests are essential for the diagnosis of contact sensitization. AIM: To determine a relative frequency and pattern of sensitizers to different allergens in patients of suspected contact dermatitis in Kuwait and, also to study the role of the commonest sensitizer in detail. MATERIAL AND METHODS: Patch tests were performed in 2461 consecutive patients with a clinical diagnosis of contact dermatitis seen at our hospital between September 1, 2014 and August 31, 2015...
June 2017: Postȩpy Dermatologii i Alergologii
https://www.readbyqxmd.com/read/28670091/metastatic-calcinosis-cutis-in-end-stage-renal-disease
#12
Victoria A Jaeger, Megan G Newman, Curtis R Mirkes
Alterations in calcium and phosphorus levels and joint pain are a common occurrence in end-stage renal disease patients. However, metastatic calcinosis cutis is a rare diagnosis that often combines these two findings, with extensive soft tissue calcification surrounding a large joint being the hallmark of this disease. The exact mechanism behind this clinical entity is unknown. The treatment and complications can be severe and disabling. Here, we discuss the case of a 26-year-old man presenting with unusually advanced skin and joint calcification of the shoulders, neck, hand, and penis...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28662849/use-of-an-in-house-monte-carlo-platform-to-assess-the-clinical-impact-of-algorithm-related-dose-differences-on-dvh-constraints
#13
A Wagner, F Crop, X Mirabel, C Tailly, N Reynaert
PURPOSE: The aim of the present work is to evaluate a semi-automatic prescription and validation system of treatment plans for complex delivery techniques, integrated in a Monte Carlo platform, and to investigate the clinical impact of dose differences due to the calculation algorithms, by assessing the changes in DVH constraints. METHODS: A new prescription module was implemented into the Moderato system, an in-house Monte Carlo platform, with corresponding dose constraints generated depending on the anatomical region and fractionation scheme considered...
June 26, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28662704/thrombocytopenia-induced-by-dabigatran-two-case-reports
#14
Hyun Goo Kang, Seung Jae Lee, Ji Yeon Chung, Jin Sung Cheong
BACKGROUND: Vitamin K inhibitors (e.g. warfarin) and indirect thrombin inhibitors (e.g. heparin) are widely used to prevent thromboembolic disorders (e.g. myocardial infarction, venous thromboembolism, and stroke). These agents have been mainstays of anticoagulation for people older than 60 years. However, their administration is associated with a risk of bleeding and requires careful monitoring of patients. Novel oral anticoagulants (NOACs), such as dabigatran, are significantly safer in preventing thromboembolism than warfarin and heparin (sporadically causes thrombocytopenia) and are more specific for their target protein, thrombin...
June 29, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28659974/esophageal-cancer-metastases-to-unexpected-sites-a-systematic-review
#15
REVIEW
Osama Shaheen, Abdulaziz Ghibour, Bayan Alsaid
The most common pattern of esophageal cancer metastases (ECM) is to the lymph nodes, lung, liver, bones, adrenal glands, and brain. On the other hand, unexpected metastasis (UM) spread to uncommon sites has increasingly reported and consequently affected the pathway of diagnosis, staging, and management. Using the PubMed database, a systematic search of the following headings "Esophageal" and "Metastasis" or "Metastases" was performed, 10049 articles were identified, and the articles were included if they demonstrated unexpected ECM...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28659368/giant-lipoma-of-the-hand-causing-median-nerve-compression
#16
Kevin Clesham, John Gerard Galbraith, Ashok Ramasamy, Ahmed Karkuri
Lipomas are benign neoplasms derived from adipose tissue composed of mature adipocytes. They account for almost 50% of all soft-tissue neoplasms and occur in up to 2% of the population. They usually present asymptomatically as solitary discrete mobile lumps found most commonly on the neck, upper back, proximal limbs and chest. In less than 1% of cases, they can be found in the distal extremities.We discuss the case of a 65-year-old man who presented with a 2-year history of a slowly enlarging left palm swelling, with recent-onset numbness and loss of power in the distribution of the median nerve...
June 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28659054/self-reducing-proximal-humerus-fractures
#17
Christopher Fang, Ernest Beng Kee Kwek
BACKGROUND: Proximal humeral fractures are common in the elderly and can present with multiple fracture configurations. Our case series describes a three-part valgus-impacted fracture pattern of the proximal humerus that underwent spontaneous reduction by nonsurgical management with good functional outcomes. METHODS: Seven patients who sustained low-energy three-part valgus-impacted fractures of the proximal humerus were studied. We retrospectively reviewed serial anteroposterior radiographs of each patient taken as part of routine follow-up...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28658086/muscle-strength-is-protective-against-osteoporosis-in-an-ethnically-diverse-sample-of-adults
#18
Ryan P McGrath, William J Kraemer, Brenda M Vincent, O Trent Hall, Mark D Peterson
The odds for developing osteoporosis may be impacted by modifiable and non-modifiable factors such as muscle strength and ethnicity. This study sought to 1) determine if increased muscle strength was associated with decreased odds for osteoporosis and 2) identify whether the odds for osteoporosis differed by ethnicity. Data from the 2013-2014 National Health and Nutrition Examination Survey were analyzed. Muscle strength was measured with a hand-held dynamometer and duel-energy x-ray absorptiometry was used to assess femoral neck bone mineral density...
June 22, 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28654138/a-prospective-cohort-study-of-awake-fibreoptic-intubation-practice-at-a-tertiary-centre
#19
K El-Boghdadly, D N Onwochei, J Cuddihy, I Ahmad
Contemporary data are lacking for procedural practice, training provision and outcomes for awake fibreoptic intubation in the UK. We performed a prospective cohort study of awake fibreoptic intubations at a tertiary centre to assess current practice. Data from 600 elective or emergency awake fibreoptic intubations were collected to include information on patient and operator demographics, technical performance and complications. This comprised 1.71% of patients presenting for surgery requiring a general anaesthetic, with the majority occurring in patients presenting for head and neck surgery...
June 2017: Anaesthesia
https://www.readbyqxmd.com/read/28652119/a-uk-confirmed-case-of-hirayama-s-disease-in-a-young-caucasian-male-presenting-with-hand-weakness
#20
Daniel Lewis, Ankur Saxena, Amit Herwadker, John Leach
BACKGROUND: Here we present the first reported case of Hirayama's disease in the UK. An included literature review on Hirayama's disease in the Western literature shows that this case is unique in being the first such case in the UK, and constituting one of only a few cases in Europe with supporting MR imaging and reported treatment outcome. CASE REPORT: Our patient is a young Caucasian male who presented with progressive bilateral hand weakness, had confirmatory MR imaging findings of Hirayama's disease, and experienced improvement of symptoms with cervical collar immobilisation...
June 23, 2017: World Neurosurgery
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