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https://www.readbyqxmd.com/read/28106022/complicated-left-sided-infective-endocarditis-in-chronic-hemodialysis-patients-a-case-report
#1
Öykü Gülmez, Mehtap Aydın
Infective endocarditis (IE) is a serious infectious condition with high morbidity and mortality in patients with end-stage renal disease (ESRD). It has been particularly associated with recurrent bacteremia due to vascular access via lumen catheters. The most common pathogen is Staphylococcus (S.) aureus, and most affected valve is mitral valve, which frequently calcified. Two patients with ESRD who received hemodialysis treatment via tunneled catheters, aged 56 and 88 years, were admitted with fever and high troponin level...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28100994/reocclusion-after-self-expandable-metallic-stent-placement-for-relieving-malignant-colorectal-obstruction-as-a-palliative-treatment
#2
Toshikatsu Nitta, Kensuke Fujii, Yoshimasa Hirata, Tomo Tominaga, Yoshihiro Inoue, Hiroshi Kawasaki, Ken Kawakami, Takashi Ishibashi
Self-expandable metallic stent (SEMS) placement has been practiced in several hospitals in Japan, including ours, since January 2012. Here, we report the case of an 82-year-old Japanese man who presented to the hospital with a 1-week history of right hypochondrial pain. Computed tomography (CT) findings indicated colorectal cancer. The laboratory findings on admission indicated severe anemia (red blood cell count, 426 × 104/μL; hemoglobin, 7.9 g/dL). We performed SEMS placement because the patient refused to undergo surgery...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28099054/association-between-do-not-resuscitate-do-not-intubate-status-and-resident-physician-decision-making-a-national-survey
#3
Elizabeth K Stevenson, Hashim M Mehter, Allan J Walkey, Renda Soylemez Wiener
RATIONALE: Compared to their Full Code counterparts, patients with Do Not Resuscitate/Do Not Intubate (DNR/DNI) status receive fewer interventions and have higher mortality than predicted by clinical characteristics. OBJECTIVES: To assess whether internal medicine residents, the front-line providers for many hospitalized patients, would manage hypothetical patients differently based on code status. We hypothesized respondents would be less likely to provide a variety of interventions to DNR/DNI patients than Full Code patients...
January 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28097082/a-review-of-colorectal-cancer-detection-modalities-stool-dna-and-fecal-immunochemistry-testing-in-adults-over-the-age-of-50
#4
REVIEW
Tyler Janz, Karen Lu, Michael R Povlow, Brittany Urso
Colorectal cancer (CRC) is the third leading cause of cancer death in the United States. Recently, more focus has been placed on developing effective screening tools to detect the presence of both precancerous and cancerous lesions present in the colon and rectum. Colonoscopy has been well established as the gold standard of the colon and rectal cancer screening. However, not all patients are willing to undergo a colonoscopy due to the procedure's invasive nature. Non-invasive screening methods have been developed to appeal to patients who refuse colonoscopy...
December 16, 2016: Curēus
https://www.readbyqxmd.com/read/28079587/review-of-the-alternatives-to-epidural-blood-patch-for-treatment-of-postdural-puncture-headache-in-the-parturient
#5
Daniel Katz, Yaakov Beilin
Labor neuraxial anesthesia is commonly used in the parturient, and postdural puncture headache is the most common complication of the technique. Although epidural blood patch is the best treatment, there are some patients in whom this treatment is refused or contraindicated. The goal of this article is to review the efficacy of the most studied alternate modalities to treat postdural puncture headache. This will include a discussion of the various oral or intravenous therapies and the non-blood-containing epidural injections...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28069989/incomplete-diagnostic-follow-up-after-a-positive-colorectal-cancer-screening-test-a-systematic-review
#6
A R H Dalton
BACKGROUND: Colorectal cancer (CRC) screening using faecal occult blood or faecal immunological testing (FOBT/FIT) involves completion of a screening test-then if required a follow-up diagnostic test. METHODS: A systematic review, of EMBASE, MEDLINE, the Cochrane Library and Google Scholar, of studies up to 2016. Studies explored characteristics behind, reasons for and interventions to reduce incomplete diagnostic testing after a positive FOBT/FIT in CRC screening...
January 9, 2017: Journal of Public Health
https://www.readbyqxmd.com/read/28035631/reflections-on-cultural-preferences-and-internal-medicine-the-case-of-jehovah-s-witnesses-and-the-changing-thresholds-for-blood-transfusions
#7
Iftach Sagy, Alan Jotkowitz, Leonid Barksi
Jehovah's witnesses oppose receiving blood transfusions based on religious grounds. This refusal raises complex medical, legal and ethical issues for the treating medical staff. In the past physicians attempted to force patients and children to accept transfusions when deemed medically necessary through the use of court orders. However, in recent years the threshold for blood transfusion has been gradually raised by medical experts as expressed in consensus guidelines, which means that Jehovah's witnesses' aversion to transfusion would have been partially justified medically...
December 29, 2016: Journal of Religion and Health
https://www.readbyqxmd.com/read/28017845/endoscopic-sleeve-gastroplasty-significantly-reduces-body-mass-index-and-metabolic-complications-in-obese-patients
#8
Reem Z Sharaiha, Nikhil A Kumta, Monica Saumoy, Amit P Desai, Alex M Sarkisian, Andrea Benevenuto, Amy Tyberg, Rekha Kumar, Leon Igel, Elizabeth C Verna, Robert Schwartz, Christina Frissora, Alpana Shukla, Louis J Aronne, Michel Kahaleh
BACKGROUND & AIMS: Endoscopic sleeve gastroplasty (ESG) is an incisionless, minimally invasive bariatric procedure that reduces the length and width of the gastric cavity to facilitate weight loss. We performed a prospective study to evaluate the effects of ESG on total body weight loss and obesity-related comorbidities. METHODS: We collected data from 91 consecutive patients (mean age, 43.86 ± 11.26 years; 68% female) undergoing ESG from August 2013 through March 2016...
December 22, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28002357/pediatric-sacroiliitis-clinical-and-microbiologic-differences-between-infants-and-children-adolescents
#9
Ambra Donzelli, Eleftheria Samara, Vassiliki Spyropoulou, Céline Juchler, Dimitri Ceroni
BACKGROUND: The aim of this study was to improve knowledge of pediatric pyogenic sacroiliitis (PSI) in the pediatric population based on a consecutive case series. METHOD: We conducted a single-center cross-sectional study on 16 patients admitted to the emergency department of our Hospital between January 1990 and December 2015 with a confirmed diagnosis of PSI. The patients were divided into 2 groups by age: infants (6 months - 4 years) and children-adolescents (4-16 years)...
December 19, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27998608/a-score-to-estimate-30-day-mortality-after-intensive-care-admission-after-cardiac-surgery
#10
Yoan Lamarche, Mahsa Elmi-Sarabi, Lillian Ding, James G Abel, Demetrios Sirounis, André Y Denault
OBJECTIVE: Several risk-scoring systems have been developed to predict surgical mortality and complications in cardiac surgical patients, but none of the current systems include factors related to the intraoperative period. The purpose of this study was to develop a score that incorporates both preoperative and intraoperative factors so that it could be used for patients admitted to a cardiac surgical intensive care unit (ICU) immediately after surgery. METHOD: Preoperative and intraoperative data from 30,350 patients in four hospitals were used to build a multiple logistic regression model estimating 30-day mortality after cardiac surgery...
November 23, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27993880/providing-hemostatic-and-blood-conservation-options-for-jehovah-s-witness-patients-in-a-large-medical-system
#11
Yu Bai, Brian S Castillo, Amanda Tchakarov, Miguel A Escobar, Bryan A Cotton, John B Holcomb, Robert E Brown
People of the Jehovah's Witness faith believe that they shall "abstain from blood." Because of this belief, we encounter the challenges from Jehovah's Witness patients who actively seek medical care for themselves and their children, but refuse the transfusion of blood products, which may result in increased morbidity and mortality in this patient population. With the development/availability of new hemostatic/coagulation products and the advances in medical technology, we, in collaboration with our clinical colleagues and our local Jehovah's Witness leadership, have developed a clinical guideline comprising medical protocol and surgical strategy for patients refusing blood products...
December 2016: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/27979847/concomitant-multiple-myeloma-gastric-adenocarcinoma-and-evan-s-syndrome-in-a-patient-presenting-with-anaemia
#12
Maged Al-Ammari, Soheir Adam
An association between multiple myeloma (MM) and solid tumours has been previously described.(1) Furthermore, autoimmune disorders can precede plasma cell dyscrasias, and the pathogenesis of MM maybe linked to chronic immune stimulation. (2) We describe a case of concomitant MM and gastric adenocarcinoma preceded by Evan's syndrome. A previously healthy woman presented to the emergency room with symptomatic anaemia. Her initial workup was compatible with autoimmune haemolytic anaemia and monoclonal gammopathy of undetermined significance...
December 15, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27968915/dynamic-contrast-enhanced-mri-to-predict-response-to-vinorelbine-cisplatin-alone-or-with-rh-endostatin-in-patients-with-non-small-cell-lung-cancer-and-bone-metastases-a-randomised-double-blind-placebo-controlled-trial
#13
Rui Zhang, Zhi-Yu Wang, Yue-Hua Li, Yao-Hong Lu, Shuai Wang, Wen-Xi Yu, Hui Zhao
BACKGROUND: Metastatic bone disease is a frequent complication of advanced non-small-cell lung cancer and causes skeletal-related events which result in a poor prognosis. A standard method to assess the therapeutic response of bone metastases does not currently exist. We used dynamic contrast-enhanced MRI to obtain quantitative measures to assess the suitability of this technique to gauge therapeutic response to vinorelbine-cisplatin plus rh-endostatinfor previously untreated non-small cell lung cancer with bone metastases...
October 2016: Lancet
https://www.readbyqxmd.com/read/27930527/feasibility-of-radiofrequency-ablation-as-an-alternative-to-surgical-intervention-in-patients-with-huge-multiloculated-pyogenic-liver-abscesses-a-retrospective-cohort-study
#14
Shan Ke, Xue-Mei Ding, Jun Gao, Shao-Hong Wang, Jian Kong, Li Xu, Wen-Bing Sun
This retrospective cohort study investigated the feasibility of radiofrequency (RF) ablation as an alternative to surgical intervention in patients with huge multiloculated pyogenic liver abscesses (PLAs).From August 2010 to April 2016, 83 patients with PLA were admitted to Beijing Chao-Yang Hospital, China. Four of these patients had huge multiloculated PLAs and underwent RF ablation plus antibiotics. The inclusion criteria for RF ablation were as follows: multiloculated PLA confirmed by computed tomography (CT) or magnetic resonance imaging (MRI), widest diameter of the PLA ≥5 cm, failure to respond to or not suitable to treatment with percutaneous drainage (PD), and patient refusal of surgery...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27893353/low-dose-erythropoietin-treatment-is-not-associated-with-clinical-benefits-in-severely-anaemic-jehovah-s-witnesses-a-plea-for-a-change
#15
Andrei M Beliaev, Sara J Allen, Paget Milsom, Parma Nand, Warren M Smith, Colleen J Bergin
BACKGROUND: Jehovah's Witnesses who refuse blood transfusion have high mortality. Erythropoietin (EPO) has been used as an alternative to blood transfusion. The optimal dosing of EPO in anaemic Jehovah's Witnesses is unknown. The aim of our study was to evaluate the clinical benefits of treatment with a low dose (<600 IU/kg/week) of epoietin beta (EPO-β). MATERIALS AND METHODS: This was an observational study, retrospectively considering a 10-year period during which 3,529 adult Jehovah's Witnesses with a total of 10,786 hospital admissions were identified from databases of four major public hospitals in New Zealand...
November 15, 2016: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/27890467/use-of-hyperbaric-oxygen-therapy-and-pegylated-carboxyhemoglobin-bovine-in-a-jehovah-s-witness-with-life-threatening-anemia-following-postpartum-hemorrhage
#16
K Thenuwara, J Thomas, M Ibsen, U Ituk, K Choi, E Nickel, M J Goodheart
We present a case of a Jehovah's Witness patient who refused blood products, with the exception of albumin and clotting factors, and underwent cesarean section under spinal anesthesia complicated by postpartum hemorrhage. She was fluid resuscitated and treated with multiple uterotonics and internal iliac artery embolization. Because of agitation she required emergency tracheal intubation. Her hemoglobin concentration dropped from a preoperative value of 12mg/dL to 3mg/dL on postoperative day one. She was acidotic, requiring vasopressors for hemodynamic stability and remained ventilated and sedated...
October 24, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27881832/hematogenous-calcaneal-osteomyelitis-in-children-a-systematic-review-of-the-literature
#17
REVIEW
Megan L Mooney, Kirk Haidet, Jiayong Liu, Nabil A Ebraheim
: Osteomyelitis in children commonly affects long bones such as the femur, tibia, and humerus. There have been relatively few documented studies of osteomyelitis at unusual locations, such as the calcaneus. The objective of this study is to systematically review information on the diagnostic and treatment methods of calcaneal osteomyelitis as well as associated complications. Methods included research database searches using primarily PubMed and EMBASE databases. Results of the review show no clear approach to diagnosis and treatment of calcaneal osteomyelitis in children...
November 23, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27873493/decitabine-as-a-first-line-treatment-for-older-adults-newly-diagnosed-with-acute-myeloid-leukemia
#18
Hyunsung Park, Haerim Chung, Jungyeon Lee, Jieun Jang, Yundeok Kim, Soo Jeong Kim, Jin Seok Kim, Yoo Hong Min, June Won Cheong
PURPOSE: Decitabine, a DNA hypomethylating agent, was recently approved for use in Korea for older adults with acute myeloid leukemia (AML) who are not candidates for standard chemotherapy. This study aimed to evaluate the role of decitabine as a first-line treatment for older adults with AML. MATERIALS AND METHODS: Twenty-four patients with AML who received at least one course of decitabine (20 mg/m²/d intravenously for 5 days every 4 weeks) as a first-line therapy at Severance Hospital were evaluated retrospectively...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27871571/spine-tumor-resection-among-patients-who-refuse-blood-product-transfusion-a-retrospective-case-series
#19
Alexandra E Kisilevsky, Liam Stobart, Kristine Roland, Alana M Flexman
STUDY OBJECTIVE: To describe the perioperative blood conservation strategies and postoperative outcomes in patients who undergo complex spinal surgery for tumor resection and who also refuse blood product transfusion. DESIGN: A retrospective case series. SETTING: A single-center, tertiary care and academic teaching hospital in Canada. PATIENTS: All adult patients undergoing elective major spine tumor resection and refusing blood product transfusion who were referred to our institutional Blood Utilization Program between June 1, 2004, and May 9, 2014...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27844227/a-novel-use-of-the-spine-tango-registry-to-evaluate-selection-bias-in-patient-recruitment-into-clinical-studies-an-analysis-of-patients-participating-in-the-lumbar-spinal-stenosis-outcome-study-lsos
#20
H-J Becker, S Nauer, F Porchet, F S Kleinstück, D Haschtmann, T F Fekete, J Steurer, A F Mannion
PURPOSE: Patients enrolled in clinical studies typically represent a sub-set of all who are eligible, and selection bias may compromise the generalizability of the findings. Using Registry data, we evaluated whether surgical patients recruited by one of the referring centres into the Lumbar Spinal Stenosis Outcome Study (LSOS; a large-scale, multicentre prospective observational study to determine the probability of clinical benefit after surgery) differed in any significant way from those who were eligible but not enrolled...
November 14, 2016: European Spine Journal
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