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https://www.readbyqxmd.com/read/27923198/detoxification-with-titration-and-tapering-in-gamma-hydroxybutyrate-ghb-dependent-patients-the-dutch-ghb-monitor-project
#1
Boukje A G Dijkstra, Rama Kamal, Martijn S van Noorden, Hein de Haan, Anton J M Loonen, Cor A J De Jong
BACKGROUND AND AIMS: Gamma-hydroxybutyrate (GHB) detoxification procedures have been insufficiently studied for effectiveness and safety. Based on case reports, benzodiazepines are generally regarded as first-choice agents in GHB detoxification. Detoxification by titration and tapering (DeTiTap) with pharmaceutical GHB in an open-label consecutive case series of 23 GHB-dependent patients showed to be feasible, effective and safe. This study further explored the feasibility, effectiveness and safety of this detoxification procedure in a large group of patients...
November 21, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27923183/the-distal-consequences-of-physical-and-emotional-neglect-in-emerging-adults-a-person-centered-multi-wave-longitudinal-study
#2
Joseph R Cohen, Suvarna V Menon, Ryan C Shorey, Vi Donna Le, Jeff R Temple
Despite being the most prevalent form of child maltreatment, the correlates and consequences of neglect are poorly understood, particularly during early adulthood. The present multi-wave, longitudinal study sought to address this gap in this literature by examining physical and emotional neglect in emerging adults in a diverse community sample. 580 adolescents (AgeMean=18.25; AgeSD=0.59; 58.3% female; 31% Hispanic, 28.9% Caucasian; 26.2% African-American; 13.9% other) completed self-report measures for child maltreatment at baseline, and measures for depression, posttraumatic stress disorder, generalized anxiety disorder, and substance use every year for three years...
December 3, 2016: Child Abuse & Neglect
https://www.readbyqxmd.com/read/27923181/combined-oral-contraceptive-use-is-associated-with-both-improvement-and-worsening-of-mood-in-the-different-phases-of-the-treatment-cycle-a-double-blind-placebo-controlled-randomized-trial
#3
Cecilia Lundin, Kristina Gemzell Danielsson, Marie Bixo, Lena Moby, Hanna Bengtsdotter, Izabella Jawad, Lena Marions, Jan Brynhildsen, Agota Malmborg, Ingela Lindh, Inger Sundström Poromaa
OBJECTIVE: Ever since the introduction of combined oral contraception (COC), one of the major reasons for discontinuing the pill use has been mood-related side effects. Moreover, women who discontinue the pill turn to less effective methods whereby the probability of an unintended conception increases. Approximately 4-10% of COC users complain of depressed mood, irritability or increased anxiety, but drug-related causality has been difficult to prove. Given the lack of randomized controlled trials in this area, we aimed to prospectively estimate the severity of adverse mood in COC users that would be as representative of general users as possible...
November 29, 2016: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/27922990/robotically-assisted-thoracic-surgery-proposed-guidelines-for-privileging-and-credentialing
#4
Faiz Y Bhora, Adnan M Al-Ayoubi, Sadiq S Rehmani, Craig M Forleiter, Wissam N Raad, Scott G Belsley
OBJECTIVE: Increased use of robotically assisted thoracic surgery (RATS) necessitates effective credentialing guidelines to ensure safe outcomes. We provide a stepwise algorithm for granting privileges and credentials in RATS. This algorithm reflects graduated responsibility and complexity of the surgical procedures performed. Furthermore, it takes into account volume, outcomes, surgeon's competency, and appropriateness of robot usage. METHODS: We performed a literature review for available strategies to grant privileges and credentials for implementing robotic surgery...
December 5, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27922976/intraoperative-frozen-section-of-ovarian-tumors-a-6-year-review-of-performance-and-potential-pitfalls-in-an-australian-tertiary-referral-center
#5
Rhett Morton, Lyndal Anderson, Jonathan Carter, Selvan Pather, Samir A Saidi
OBJECTIVES: Intraoperative frozen section (IFS) offers a rapid test to guide the extent of surgery, which is essential for optimal treatment of ovarian cancer. This study evaluated the diagnostic performance and influence of IFS in the surgical management of ovarian tumors. METHODS: A retrospective review was conducted of IFS of adnexal lesions from 2008 to 2013, with diagnoses classified as benign, borderline, or malignant. The diagnostic performance of IFS was calculated, with a focus on primary epithelial tumors...
December 3, 2016: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/27922974/training-and-validating-a-deep-convolutional-neural-network-for-computer-aided-detection-and-classification-of-abnormalities-on-frontal-chest-radiographs
#6
Mark Cicero, Alexander Bilbily, Errol Colak, Tim Dowdell, Bruce Gray, Kuhan Perampaladas, Joseph Barfett
OBJECTIVES: Convolutional neural networks (CNNs) are a subtype of artificial neural network that have shown strong performance in computer vision tasks including image classification. To date, there has been limited application of CNNs to chest radiographs, the most frequently performed medical imaging study. We hypothesize CNNs can learn to classify frontal chest radiographs according to common findings from a sufficiently large data set. MATERIALS AND METHODS: Our institution's research ethics board approved a single-center retrospective review of 35,038 adult posterior-anterior chest radiographs and final reports performed between 2005 and 2015 (56% men, average age of 56, patient type: 24% inpatient, 39% outpatient, 37% emergency department) with a waiver for informed consent...
December 5, 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27922948/fluoroscopic-guidance-increases-the-incidence-of-thoracic-epidural-catheter-placement-within-the-epidural-space-a-randomized-trial
#7
Michelle C Parra, Kristin Washburn, Jeremiah R Brown, Michael L Beach, Mark P Yeager, Patricia Barr, Kathy Bonham, Kathryn Lamb, Randy W Loftus
BACKGROUND AND OBJECTIVES: Thoracic epidural analgesia can reduce postoperative pain and cardiopulmonary morbidity, but it is associated with a high rate of clinical failure. Up to 50% of clinical failure is thought to be related to technical insertion. In this study, patients undergoing thoracic surgery were randomized to one of two catheter insertion techniques: fluoroscopically guided or conventional loss of resistance with saline/air. Our primary aim was to examine whether fluoroscopic guidance could increase the incidence of correct catheter placement and improve postoperative analgesia...
December 5, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27922946/patient-reported-outcome-measurement-for-patients-with-total-knee-arthroplasty
#8
Stephen Lyman, Kaitlyn L Yin
Total knee arthroplasty is a large contributor to Medicare costs. In an effort to lower costs and improve outcomes, the Centers for Medicaid and Medicare Services has implemented the Comprehensive Care for Joint Replacement model, which incentivizes surgeons to submit both general health and joint-specific patient-reported outcome measures (PROMs). However, in addition to using PROMs for reporting purposes, surgeons should also consider incorporating PROMs into clinical practice. Currently, PROMs are not widely implemented in the clinical setting despite their value in measuring factors such as patients' expectations and mental state, which impact outcomes...
December 5, 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27922921/the-effects-of-muscle-relaxation-and-therapeutic-walking-on-depression-suicidal-ideation-and-quality-of-life-in-breast-cancer-patients-receiving-chemotherapy
#9
Fan-Ko Sun, Chao-Ming Hung, YuChun Yao, Chu-Yun Lu, Chun-Ying Chiang
BACKGROUND: The suicide rate of cancer patients is high in Taiwan. Breast cancer has a high incidence rate and is the leading cause of cancer in women. There is a lack of research examining breast cancer-related depression, suicidal ideation, and quality of life. OBJECTIVES: This study evaluated the effects of muscle relaxation and therapeutic walking on depression, suicidal ideation, and quality of life in breast cancer patients receiving chemotherapy. METHODS: An experimental approach was adopted...
December 5, 2016: Cancer Nursing
https://www.readbyqxmd.com/read/27922837/safety-of-overlapping-surgery-at-a-high-volume-referral-center
#10
Joseph A Hyder, Kristine T Hanson, Curtis B Storlie, Amy Glasgow, Nageswar R Madde, Michael J Brown, Daryl J Kor, Robert R Cima, Elizabeth B Habermann
OBJECTIVE: To compare safety profiles of overlapping and nonoverlapping surgical procedures at a large tertiary-referral center where overlapping surgery is performed. BACKGROUND: Surgical procedures are frequently performed as overlapping, wherein one surgeon is responsible for 2 procedures occurring at the same time, but critical portions are not coincident. The safety of this practice has not been characterized. METHODS: Primary analyses included elective, adult, inpatient surgical procedures from January 2013 to September 2015 available through University HealthSystem Consortium...
December 5, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27922809/impact-of-coronary-artery-disease-on-postoperative-outcomes-in-patients-undergoing-transcatheter-aortic-valve-replacement-tavr-is-preoperative-coronary-revascularization-necessary
#11
Dhaval Chauhan, Mohammad Thawabi, Nicky Haik, Bruce J Haik, Chunguang Chen, Marc Cohen, Mark Russo
BACKGROUND: There remains much controversy on impact of preoperative coronary artery disease (CAD) and necessity of preoperative coronary revascularization on postoperative outcomes in patients undergoing transcatheter aortic valve replacement (TAVR). METHODS: Data were collected retrospectively for 364 consecutive patients undergoing TAVR at Newark Beth Israel Medical Center, New Jersey, from May 15, 2012 to September 17, 2015. Preoperative CAD burden was calculated by three different measures of CAD: SYNTAX score, Duke Myocardial Jeopardy score (DMJS), and number of diseased coronary arteries...
December 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27922769/see-test-treat-a-5-year-experience-of-pathologists-driving-cervical-and-breast-cancer-screening-to-underserved-and-underinsured-populations
#12
Barbarajean Magnani, Beth Harubin, Judith F Katz, Andrea L Zuckerman, William C Strohsnitter
CONTEXT: - See, Test & Treat is a pathologist-driven program to provide cervical and breast cancer screening to underserved and underinsured patient populations. This program is largely funded by the CAP Foundation (College of American Pathologists, Northfield, Illinois) and is a collaborative effort among several medical specialties united to address gaps in the current health care system. OBJECTIVE: - To provide an outline for administering a See, Test & Treat program, using an academic medical center as a model for providing care and collating the results of 5 years of data on the See, Test & Treat program's findings...
December 2016: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/27922764/comparison-of-abuse-suspected-suicidal-intent-and-fatalities-related-to-the-7-day-buprenorphine-transdermal-patch-versus-other-opioid-analgesics-in-the-national-poison-data-system
#13
Paul M Coplan, Nelson E Sessler, Venkatesh Harikrishnan, Richa Singh, Charles Perkel
OBJECTIVE: Prescription opioid related abuse, suicide and death are significant public health problems. This study compares rates of poison center calls categorized as intentional abuse, suspected suicidal intent or fatality for the 7-day buprenorphine transdermal system/patch (BTDS) with other extended-release and long-acting (ER/LA) opioids indicated for chronic pain. DESIGN: Retrospective 24-month cohort study using National Poison Data System data from July 2012 through June 2014...
December 6, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27922624/association-of-pain-social-support-and-socioeconomic-indicators-in-patients-with-spinal-cord-injury-in-iran
#14
Z Khazaeipour, E Ahmadipour, V Rahimi-Movaghar, F Ahmadipour, A R Vaccaro, B Babakhani
STUDY DESIGN: Descriptive cross-sectional study. OBJECTIVES: Pain is a prevalent complication of individuals with spinal cord injury (SCI). Our objective was to examine the association between social support, socioeconomic factors and psychosocial factors and pain to develop more effective management strategies. SETTING: Brain and Spinal Cord Injury Research (BASIR) Center, Tehran University of Medical Sciences, Tehran, Iran. METHODS: The Persian version of the Brief Pain Inventory was used to measure the pain, and the Multidimensional Scale of Perceived Social Support was used to measure social support through structured face-to-face interviews in SCI individuals...
December 6, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27922580/comparative-analysis-of-peri-operative-outcomes-using-nationally-derived-hospital-discharge-data-relative-to-a-prospective-multi-center-surgical-database-of-adult-spinal-deformity-surgery
#15
Gregory W Poorman, Peter G Passias, Aaron J Buckland, Cyrus M Jalai, Michael Kelly, Daniel M Sciubba, Brian J Neuman, D Kojo Hamilton, Amit Jain, Bassel Diebo, Virginie Lafage, Shay Bess, Eric O Klineberg
STUDY DESIGN: Retrospective analysis of three prospectively collected databases. OBJECTIVE: compare peri-operative outcomes in Adult Spinal Deformity (ASD) surgeries in a surgeon-run (SR-ASD) and two national databases: the Nationwide Inpatient Sample (NIS) and the National Surgical Quality Improvement Program (NSQIP). SUMMARY OF BACKGROUND DATA: has been learned on the treatment of ASD in the last decade with prospective multicenter collaborative research focusing on this specific condition...
December 2, 2016: Spine
https://www.readbyqxmd.com/read/27922578/facet-joint-violation-during-percutaneous-pedicle-screw-placement-a-comparison-of-two-techniques
#16
Oliver Tannous, Ehsan Jazini, Tristan B Weir, Kelley E Banagan, Eugene Y Koh, D Greg Anderson, Daniel E Gelb, Steven C Ludwig
STUDY DESIGN: A comparative study of facet joint violation (FJV) using two percutaneous surgical techniques. OBJECTIVE: To compare the rate of iatrogenic FJV and medial pedicle wall breach between two methods of percutaneous pedicle screw instrumentation in the thoracic and lumbar spine. SUMMARY OF BACKGROUND DATA: Variable iatrogenic damage to the facet joints has been reported to occur with percutaneous pedicle screw techniques, compared with the open approach, which has been associated with adjacent segment disease...
December 2, 2016: Spine
https://www.readbyqxmd.com/read/27922568/sex-differences-in-the-relationship-between-depressive-symptoms-and-actigraphic-assessments-of-sleep-and-rest-activity-rhythms-in-a-population-based-sample
#17
Kaitlin Hanley White, Meredith E Rumble, Ruth M Benca
OBJECTIVE: Depression is often associated with disruptions in sleep and circadian rhythms. We aimed to confirm these relationships via actigraphic assessment in a large, population-based sample, and test whether sex moderates these relationships. METHODS: 418 participants (age 35-85, mean 57.04, SD = 11.47) completed questionnaires and one week of actigraphy, used to calculate sleep and rest-activity statistics including mesor (mean activity level), amplitude (height of rhythm), and acrophase (time of day that rhythm peaks)...
December 2, 2016: Psychosomatic Medicine
https://www.readbyqxmd.com/read/27922562/operation-smile-and-the-guwahati-comprehensive-cleft-care-center-multidisciplinary-global-activism-in-plastic-surgery
#18
Chad Allen Purnell
Participation in a medical mission in an underserved area is both a challenging and deeply satisfying experience. The global burden of cleft lip and palate is significant, and as plastic surgery providers we are all empowered to help these patients. Surgery for cleft lip and palate is life changing for patients, and the privilege of participating in a mission can be life altering for the providers as well. The Comprehensive Cleft Care Center in Guwahati, India, is a prime example of multidisciplinary collaboration resulting in excellent care in the developing world...
October 2016: Plastic Surgical Nursing
https://www.readbyqxmd.com/read/27922559/botulinum-toxin-type-a-bont-a-injections-of-the-corrugator-muscles-for-aesthetics-and-depression
#19
Connie Brennan
The treatment of glabellar lines with botulinum toxin type-A (BoNT-A) is a staple for aesthetic providers who specialize in facial rejuvenation. Clinical efforts are currently underway to substantiate upper facial injections (the corrugator muscles are the target muscles) of BoNT-A as an antidepression therapy. This article describes the origin of "facial feedback" by Charles Darwin nearly 150 years ago, as well as "emotional proprioception"-2 neuroanatomical concepts that help provide the scientific rationale behind the general influence facial muscles have on the emotional centers of the brain, and, specifically, how the corrugator muscles-involved with frowning-promote a gloomy mood...
October 2016: Plastic Surgical Nursing
https://www.readbyqxmd.com/read/27922538/the-role-of-68ga-dota-noc-pet-ct-in-evaluating-neuroendocrine-tumors-real-world-experience-from-two-large-neuroendocrine-tumor-centers
#20
Mohamad Haidar, Ali Shamseddine, Emmanouil Panagiotidis, Mario Jreige, Deborah Mukherji, Rita Assi, Rayan Abousaid, Toni Ibrahim, Marwan M Haddad, Sobhan Vinjamuri
OBJECTIVE: Our aim was to assess the role of Ga-DOTA-NOC PET/CT as a tool for the management of neuroendocrine tumors (NETs), evaluating the clinical impact on patients from two large NET centers in different geopolitical settings. PATIENTS AND METHODS: This is a retrospective study of patients with NETs who underwent Ga-DOTA-NOC PET/CT at Royal Liverpool University Hospital (UK) and at Mount Lebanon Hospital (Lebanon). Indications for imaging and findings of the PET/CT along with demographic and clinical outcome data were recorded and evaluated...
December 2, 2016: Nuclear Medicine Communications
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