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https://www.readbyqxmd.com/read/28103266/adherence-to-prophylaxis-in-adolescents-and-young-adults-with-severe-haemophilia-a-quantitative-study-with-patients
#1
Sandra B van Os, Nick A Troop, Keith R Sullivan, Daniel P Hart
INTRODUCTION: haemophilia is an inherited bleeding disorder caused by a deficiency in one of the blood coagulation factors. For people affected by severe haemophilia, the deficiency can cause spontaneous internal bleeding. Most young people with severe haemophilia in the UK follow a preventative treatment regimen (prophylaxis) consisting of several intravenous injections of factor concentrate each week. There is good evidence that prophylaxis reduces bleeds whilst also improving quality of life...
2017: PloS One
https://www.readbyqxmd.com/read/28103165/burn-wound-healing-present-concepts-treatment-strategies-and-future-directions
#2
A Oryan, E Alemzadeh, A Moshiri
Burns are the most extensive forms of soft tissue injuries occasionally resulting in extensive and deep wounds and death. Burns can lead to severe mental and emotional distress, because of excessive scarring and skin contractures. Treatment of burns has always been a difficult medical problem and many different methods have been used to treat such injuries, locally. Biofilms are a collection of microorganisms that delay wound healing. One of the new methods of prevention and treatment of burn wound infections is application of antimicrobials, which act on biofilms and prevent the wound infection...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28102155/surgical-treatment-of-radial-head-fractures-outcomes-and-complications
#3
Bartosz Chwedczuk, Piotr Piekarczyk, Krzysztof Kwiatkowski, Krzysztof Piątkowski
BACKGROUND: Appropriate treatment of radial head fractures remains an area of disputes and controversy. The present paper aims to assess the outcomes of surgical fixation of these injuries and identify the most common complications. MATERIAL AND METHODS: The medical records of 63 patients (25 women and 38 men) treated in 2011 -2014 were analysed retrospectively. The treatment outcomes were assessed according to the Broberg and Morrey rating system and the QuickDASH score...
October 28, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28101968/defined-daily-doses-ddd-do-not-accurately-reflect-opioid-doses-used-in-contemporary-chronic-pain-treatment
#4
Suzanne Nielsen, Natasa Gisev, Raimondo Bruno, Wayne Hall, Milton Cohen, Briony Larance, Gabrielle Campbell, Marian Shanahan, Fiona Blyth, Nicholas Lintzeris, Sallie Pearson, Richard Mattick, Louisa Degenhardt
OBJECTIVE: To assess how well the defined daily dose (DDD) metric reflects opioid utilisation among chronic non-cancer pain patients. DESIGN: Descriptive, cross-sectional study, utilising a 7-day medication diary. SETTING: Community-based treatment settings, Australia. SUBJECTS: A sample of 1101 people prescribed opioids for chronic non-cancer pain. METHODS: Opioid dose data was collected via a self-completed 7-day medication diary capturing names, strengths and doses of each medication taken in the past week...
January 19, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28101629/treatment-of-ribbing-disease-with-5-year-follow-up-and-literature-review
#5
L L Zhang, W M Jiang, H L Yang, Z-P Luo
Ribbing disease, or multiple diaphyseal sclerosis, is a rare diaphyseal sclerosis of unknown etiology. Patients with this pathology usually present with asymmetric pain limited to the lower extremities. Though all efforts are made to relieve the progressive pain associated with Ribbing disease, no medical or surgical treatments have been established yet. In this case report, we followed up a Ribbing case with sclerotic bone fenestration for 5 years. The radiological changes and the clinical effects are described, and the different Ribbing treatments are then briefly reviewed...
January 18, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28101559/cannabis-use-in-persons-with-traumatic-spinal-cord-injury-in-denmark
#6
Sven R Andresen, Fin Biering-Sørensen, Ellen Merete Hagen, Jørgen F Nielsen, Flemming W Bach, Nanna B Finnerup
OBJECTIVE: To evaluate recreational and medical cannabis use in individuals with traumatic spinal cord injury, including reasons and predictors for use, perceived benefits and negative consequences. DESIGN: Cross-sectional survey in Denmark. METHODS: A 35-item questionnaire was sent to 1,101 patients with spinal cord injury who had been in contact with a rehabilitation centre between 1990 and 2012. RESULTS: A total of 537 participants completed the questionnaire...
January 18, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28101047/acute-anterior-uveitis-in-a-patient-taking-fingolimod-fty720-for-multiple-sclerosis
#7
Heather Gwen Mack, Melissa Chih-Hui Tien, Owen Bruce White
Fingolimod is an oral sphingosine-1-phosphate (S1P) receptor modulator and the first oral therapy for relapsing-remitting multiple sclerosis. Its use has been complicated by a low rate of cystoid macular edema usually in the first 3 months after commencement of the medication. We report the case of a 34-year-old male with relapsing-remitting multiple sclerosis, who developed acute anterior uveitis on day 5 of fingolimod treatment. He responded to appropriate treatment and cessation of drug, but developed low-grade chronic anterior uveitis without cystoid macular edema...
September 2016: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28100958/routine-dyspnea-assessment-and-documentation-nurses-experience-yields-wide-acceptance
#8
Kathy M Baker, Susan DeSanto-Madeya, Robert B Banzett
BACKGROUND: Dyspnea (breathing discomfort) is a common and distressing symptom. Routine assessment and documentation can improve management and relieve suffering. A major barrier to routine dyspnea documentation is the concern that it will have a deleterious effect on nursing workflow and that it will not be readily accepted by nurses. Nurses at our institution recently began to assess and document dyspnea on all medical-surgical patients upon admission and once per shift throughout their hospitalization...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28100561/investigation-of-the-degree-of-organisational-influence-on-patient-experience-scores-in-acute-medical-admission-units-in-all-acute-hospitals-in-england-using-multilevel-hierarchical-regression-modelling
#9
Paul Sullivan, Derek Bell
OBJECTIVES: Previous studies found that hospital and specialty have limited influence on patient experience scores, and patient level factors are more important. This could be due to heterogeneity of experience delivery across subunits within organisations. We aimed to determine whether organisation level factors have greater impact if scores for the same subspecialty microsystem are analysed in each hospital. SETTING: Acute medical admission units in all NHS Acute Trusts in England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28100519/paravertebral-block-in-paediatric-abdominal-surgery-a-systematic-review-and-meta-analysis-of-randomized-trials
#10
E A Page, K L Taylor
The increased popularity of paravertebral block (PVB) can be attributed to its relative safety and comparable efficacy when compared with epidural analgesia. It has thus been recommended for open cholecystectomy and other less painful surgeries such as inguinal herniorraphy and appendectomy. We performed a systematic review of PVB in paediatric abdominal conditions to assess its clinical efficacy and side effects compared with other analgesic therapies.A search of Medline, Embase, and Web of Science and hand-searching references from inception date to May 2016 was done...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100420/osteoarthritis-year-in-review-2016-mechanics
#11
REVIEW
D J Saxby, D G Lloyd
Inappropriate biomechanics, namely wear-and-tear, has been long believed to be a main cause of osteoarthritis (OA). However, this view is now being re-evaluated, especially when examined alongside mechanobiology and new biomechanical studies. These are multiscale experimental and computational studies focussing on cell- and tissue-level mechanobiology through to organ- and whole-body-level biomechanics, which focuses on the biomechanical and biochemical environment of the joint tissues. This review examined papers from April 2015 to April 2016, with a focus on multiscale experimental and computational biomechanical studies of OA...
December 16, 2016: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28100253/minimally-invasive-percutaneous-osteosynthesis-versus-orif-for-sanders-type-ii-and-iii-calcaneal-fractures-a-prospective-randomized-intervention-trial
#12
Cong Jin, Dong Weng, Wanlei Yang, Wei He, Wengqing Liang, Yu Qian
BACKGROUND: This randomized controlled trial compared the clinical outcomes and complications of a novel minimally invasive percutaneous osteosynthesis (MIPO) with those of conventional treatment via an extended L-shaped lateral approach for calcaneal fractures. METHODS: Sixty-four patients with displaced intraarticular calcaneal fractures were enrolled. The patients were randomly allocated to receive either MIPO (29 patients) or open reduction and internal fixation via an extended L-shaped lateral approach (35 patients)...
January 18, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28100057/wilkie%C3%A2-s-syndrome
#13
Carlos Oliva-Fonte, Cristina Fernández Rey, Javier Pereda Rodríguez, Ana María González-Fernández
We report the case of a 14 year-old woman, who presents epigastric abdominal pain, abundant vomits and an important abdominal distension. Previously, she presented similar episodes. She has not any significant prior medical history. CT is performed and the imaging findings are consistent with Wilkie´s syndrome. Wilkie´s syndrome is a rare condition, that results from a intestinal obstruction caused by third portion duodenal compression between the abdominal aorta and the superior mesenteric artery. When the angle between both structures diminishes and the distance between the SMA and the aorta decreases (the most diagnostic value), duodenal obstruction occurs...
January 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28099791/mitigating-the-prescription-drug-abuse-epidemic
#14
Mike Midgley
Focused attention on the prescription drug abuse epidemic needs to include evidence-based training for clinicians who manage patients with pain to facilitate accurate screening with consideration of comorbid conditions, diagnosis, selection of the appropriate treatment regimen, and focused monitoring of adherence to the established course of therapy. DEA licensure requirements need to be amended to mandate targeted training focused on pain medication upon initial application and renewal of license. A nationwide mandated real-time dispenser database that requires verification every time a clinician prescribes opioids and other key controlled substances should be a top priority...
January 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28099638/risk-factors-for-agitation-in-critically-ill-patients
#15
Thiago Miranda Lopes de Almeida, Luciano Cesar Pontes de Azevedo, Paulo Maurício Garcia Nosé, Flavio Geraldo Resende de Freitas, Flávia Ribeiro Machado
Objective: To evaluate the incidence of agitation in the first 7 days after intensive care unit admission, its risk factors and its associations with clinical outcomes. Methods: This single-center prospective cohort study included all patients older than 18 years with a predicted stay > 48 hours within the first 24 hours of intensive care unit admission. Agitation was defined as a Richmond Agitation Sedation Scale score ≥ +2, an episode of agitation or the use of a specific medication recorded in patient charts...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099128/bone-health-assessment-of-food-allergic-children-on-restrictive-diets-a-practical-guide
#16
Artemis E Doulgeraki, Emmanouel M Manousakis, Nikolaos G Papadopoulos
BACKGROUND: Food allergy in childhood is on the rise globally and is managed with avoidance diets; recent case reports of food allergic children with nutritional rickets in the literature highlight the importance of close monitoring of bone health in this population. METHODS: There is no consensus as yet with regard to bone health evaluation in food allergic children; therefore, extensive literature search was performed and the existing evidence is presented, along with a relevant algorithm...
January 18, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28099107/case-238-spontaneous-pneumothorax-secondary-to-intrapulmonary-necrobiotic-rheumatoid-nodule
#17
Ammar A Chaudhry, Maryam Gul, Abbas A Chaudhry, William Moore
History A 54-year-old white woman with a history of rheumatoid arthritis who was taking glucocorticoids and methotrexate presented to the emergency department in December with worsening shortness of breath and chest heaviness for 1 week. She reported additional symptoms of weakness, headache, and arthralgia primarily involving her bilateral hands, wrist, ankles, and feet. She denied experiencing fevers, syncope or presyncope, focal neurologic deficits, chest pain, nausea, vomiting, unintentional weight loss, or recent trauma...
February 2017: Radiology
https://www.readbyqxmd.com/read/28098766/single-electrode-deep-brain-stimulation-with-dual-targeting-at-dual-frequency-for-the-treatment-of-chronic-pain-a-case-series-and-review-of-the-literature
#18
REVIEW
Milo Hollingworth, Hugh P Sims-Williams, Anthony E Pickering, Neil Barua, Nikunj K Patel
Deep Brain Stimulation (DBS) has been used to target many deep brain structures for the treatment of chronic pain. The periaqueductal grey and periventricular grey (PAG/PVG) is an effective target but results are variable, sometimes short-lived or subject to tolerance. The centromedian intra-laminar parafascicular complex (CMPf) modulates medial pain pathways and CMPf DBS may address the affective aspects of pain perception. Stimulation of multiple deep brain targets may offer a strategy to optimize management of patients with complex pain symptomatology...
January 13, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28098590/analgesia-and-sedation-requirements-in-mechanically-ventilated-trauma-patients-with-acute-preinjury-use-of-cocaine-and-or-amphetamines
#19
Bridgette Kram, Shawn J Kram, Michelle L Sharpe, Michael L James, Maragatha Kuchibhatla, Mark L Shapiro
BACKGROUND: The purpose of this study was to determine whether mechanically ventilated trauma patients with a positive urine drug screen (UDS) for cocaine and/or amphetamines have different opioid analgesic and sedative requirements compared with similar patients with a negative drug screen for these stimulants. METHODS: This retrospective, single-center cohort study at a tertiary care, academic medical and level 1 trauma center in the United States included patients ≥16 years of age who were admitted to an adult intensive care unit with a diagnosis of trauma between 2009 and 2013 with a UDS documented within 24 hours of admission, and were mechanically ventilated for >24 hours...
January 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28098413/dermatomal-spread-following-posterior-transversus-abdominis-plane-block-in-pediatric-patients-our-initial-experience
#20
Maria A Hernandez, Tricia Vecchione, Karen Boretsky
INTRODUCTION: Several techniques for the transversus abdominis plane (TAP) block have been described. The extent of sensory changes using an ultrasound-guided posterior TAP block (pTAP) remains unclear in pediatric patients. The primary aim of this study was to report the extent of sensory changes achieved with pTAP; specifically the highest thoracic dermatome anesthetized. Secondary outcomes were pain scores (PS), opioid consumption, and complications. METHODS: We retrospectively reviewed the medical records of patients less than 21 years of age undergoing abdominal surgery with a unilateral or bilateral pTAP(s) for postoperative analgesia...
January 18, 2017: Paediatric Anaesthesia
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