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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/28549366/-conservative-treatment-of-a-chronic-rupture-of-achilles-tendon-case-report
#2
M González-Murillo, A Rodrigo-Alonso, H Figueiredo-González, A M Salgado-Rodrigo, S M Mota-Blanco
We report a case of a 64 years-old-female patient with ruptured left Achilles tendon within two months of evolution that has gone unnoticed. By the application of a conservative treatment recovered complete and symmetrical functionality in five months time after the injury.
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28549365/-giant-tumor-from-the-nerve-sheath
#3
L M Díaz-Rojas, A Lorente-Gómez, R Lorente-Moreno
A schwannoma is a benign nerve sheath tumor derived from Schwann cells. They are usually small and solitary tumors more frequently localized in cranial nerves and the spinal cord and rarely in the limbs. Some cases have been reported involving extremities (mainly the upper ones) but with a small size. Cases of big size schwannomas unrelated to a neurofibromatosis are very rare. We report the case of a 25 year old patient, with a giant schwannoma which invaded the ischiatic region reaching the triceps surae.
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28549364/-an-option-to-restore-ulnar-intrinsic-muscles-when-the-anterior-interosseus-nerve-is-not-available
#4
G A González-Trevizo
BACKGROUND: The peripheral nerve injuries are devastating for the patient; the classic reconstructive options are the Nerve Graft and Tendon Transfers. Lately the Nerve Transfers are being used more and more broadly. They are an excellent option on early injuries and when the motor plate is still alive. The advantages are numerous, because the functional recovery is much better. METHODS AND RESULTS: We report the case of a patient who sustained and injury on the median and ulnar nerve, so the EDQ and ECU branches were used to restore the Ulnar Intrinsic Function...
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28549363/-thoracic-inestability-fixed-with-bioabsorbable-screws-and-plates
#5
A L Nolasco-de la Rosa, R Mosiñoz-Montes, J Matehuala-García, A A Cuautle-Ramírez, E Román-Guzmán, A L Reyes-Miranda, F Quero-Sandoval
BACKGROUND: Flail chest is managed with mechanical ventilation or inhaloteraphy and analgesia. Little has been published on the use of bioabsorbable material and its evolution in flail chest fixation. METHODS: This is a descriptive study of patients with unstable chest undergoing fixation with bioabsorbable plates and screws in a period from February 2009 to December 2011. RESULTS: We report 18 cases, aged 33-74 years (mean 53), three with bilateral involvement; rib fixation was performed between 1-21 days of the accident (mean 1...
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28549362/-iliotibial-band-friction-syndrome-due-to-bioabsorbable-pins-in-acl-reconstruction
#6
F Cruz-López, A Mallen-Trejo, C Pascual-Vidriales, A Almazán-Díaz, J C Ibarra-Ponce de León
Injuries of the anterior cruciate ligament are currently treated primarily with the use of hamstring graft with a wide range of different techniques and fixation systems for anterior cruciate ligament in reducing patient morbidity. We report the case of a female patient aged 42 that suffered an anterior cruciate ligament rupture and was treated with anterior cruciate ligament reconstruction with hamstring autograft with femoral fixation with bio-absorbable cross-pin and tibial fixation with bio-absorbable screw...
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28549361/-leukocyte-esterase-as-a-diagnostic-tool-for-an-infectious-disease-of-the-knee
#7
S U Ceja-Picazo, S Fuentes-Figueroa, A H Rivera-Villa, A R Hernández-Salgado, R Torres-González, A M Pérez, J A Hernández-García, J M Pérez-Atanasio
BACKGROUND: Articular infection is an orthopedic challenge due to its difficult diagnosis and devastating results. Various diagnostic studies exist: culture, ESR, CRP, count of leukocytes, among others, but none is specific, they all take more than 30 minutes to complete, and require complex infrastructure. In this study, we determine the sensitivity and specificity of the leukocyte esterase for detection of an infectious process joint in Mexican population. MATERIAL AND METHODS: During November 2015 to April 2016, we obtained synovial fluid from two groups of patients: one with a diagnosis of synovial joint infection with or without implant, and the control group, without infection but with degenerative pathology of the knee...
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28549360/-intercarpal-fusion-as-a-salvage-procedure-in-kienb%C3%A3-ck-disease
#8
M Puig-Zentella, J A Rivas-Montero, E Hernández-Méndez-Villamil, A J Espinosa-Gutiérrez
INTRODUCTION: Functional results of four surgical techniques to resolve the IIIB-IV Litchman's stage of the Kienböck disease were analyzed. We observed the evolution from 2000 to 2015. MATERIAL AND METHODS: Transversal retrospective study of 33 patients treated with different surgical techniques and evaluated with Quick-DASH scale, dynamometer and EVA. RESULTS: Less functional limitation was found in the patients who underwent the intercarpal fusion with or without neurotomy of the posterior interosseous...
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28549359/-bristow-latarjet-technique-for-anterior-glenohumeral-instability
#9
I Jiménez, A Marcos-García, J Medina, G Muratore-Moreno, J Caballero-Martel
BACKGROUND: In treatment of anterior shoulder instability, many surgical techniques have been described, all of them with advantages and disadvantages. Our goal is to study the half term results on patients that underwent open Bristow-Latarjet surgery considering the preoperative ISIS value. MATERIAL AND METHODS: This is a retrospective study of 33 patients which underwent open Bristow-Latarjet surgery in our center between 2005 and 2012. Average age of 33.2 years and follow up of 75 months...
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28549358/-complication-analysis-in-lisfranc-fracture-dislocation
#10
R J García-Renedo, A Carranza-Bencano, R Leal-Gómez, F Cámara-Arrigunaga
OBJECTIVE: To value the complications and sequels for patients with Lisfrancs fracture-luxation (FLL). MATERIAL AND METHODS: A transverse ambispective study of cohorts was realized of 83 patients by diagnosis of Lisfrancs fracture-luxation. There was in use a protocol of withdrawal of information with variables related to the injury, clinical, therapeutic parameters, complications and scales of clinical valuation. RESULTS: 66 patients (79...
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28549357/-hip-osteosynthesis-with-im-nail-lateral-decubitus-without-fracture-table
#11
V H Aguirre-Rodríguez, G Inzunza-Enríquez, O Bibiano-Escalante, F J Martínez-Ruiz, F S Valero-González
BACKGROUND: Hip fractures have increased in the last decades, mainly in elderly patients with osteoporosis. The incidence becomes in some countries up to 250 thousand new cases per year, generating millions for health systems costs, so it should be considered a public health problem. They are treated in supine position, with a fracture table, through a lateral approach. However, it is important to know that there are other techniques, which can dispense a table of fractures and in a different position...
November 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28549349/synchronous-splenectomy-and-hepatectomy-for-patients-with-small-hepatocellular-carcinoma-and-pathological-spleen-neutrophil-to-lymphocyte-ratio-changes-can-predict-the-prognosis
#12
Xiaoyun Zhang, Chuan Li, Tianfu Wen, Wei Peng, Lunan Yan, Bo Li, Jiayin Yang, Wentao Wang, Mingqing Xu, Yong Zeng
BACKGROUND: Treatments about small hepatocellular carcinoma (HCC) and hypersplenism associated with good hepatic reserve are not well established. The aim of this study was to investigate the outcome of synchronous hepatectomy and splenectomy for those patients. STUDY DESIGN: Splenomegaly and hypersplenism were defined as a pathological spleen. Seven hundred fifty-six patients with small HCC (381 with a pathological spleen, 375 without a pathological spleen) were divided into three groups...
May 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/28549348/ocular-toxicities-associated-with-targeted-anticancer-agents-an-analysis-of-clinical-data-with-management-suggestions
#13
Chen Fu, Dan S Gombos, Jared Lee, Goldy C George, Kenneth Hess, Andrew Whyte, David S Hong
Ocular toxicities are among the most common adverse events resulting from targeted anticancer agents and are becoming increasingly relevant in the management of patients on these agents. The purpose of this study is to provide a framework for management of these challenging toxicities based on objective data from FDA labels and from analysis of the literature. All oncologic drugs approved by the FDA up to March 14, 2015, were screened for inclusion. A total of 16 drugs (12 small-molecule drugs and 4 monoclonal antibodies) were analyzed for ocular toxicity profiles based on evidence of ocular toxicity...
May 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28549346/functional-heterogeneity-in-tumor-derived-human-pancreatic-stellate-cells-differential-expression-of-hgf-and-implications-for-mitogenic-signaling-and-migration-in-pancreatic-cancer-cells
#14
Vegard Tjomsland, Monica Aasrum, Thoralf Christoffersen, Ivar P Gladhaug
The pancreatic stellate cell (PSC) is the principal cell type of the desmoplastic stroma of pancreatic ductal adenocarcinoma (PDAC). PSCs interact with cancer cells and influence the progression of the disease through a complex network of signaling molecules including hepatocyte growth factor (HGF). Functional heterogeneity of PSCs within a tumor might conceivably influence tumor progression. We investigated PSC populations isolated from different human PDACs and examined the effects of PSC-conditioned medium on BxPC-3 and AsPC-1 pancreatic cancer cells...
May 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28549339/typical-and-atypical-presenting-symptoms-of-breast-cancer-and-their-associations-with-diagnostic-intervals-evidence-from-a-national-audit-of-cancer-diagnosis
#15
Minjoung Monica Koo, Christian von Wagner, Gary A Abel, Sean McPhail, Greg P Rubin, Georgios Lyratzopoulos
INTRODUCTION: Most symptomatic women with breast cancer have relatively short diagnostic intervals but a substantial minority experience prolonged journeys to diagnosis. Atypical presentations (with symptoms other than breast lump) may be responsible. METHODS: We examined the presenting symptoms of breast cancer in women using data from a national audit initiative (n=2316). Symptoms were categorised topographically. We investigated variation in the length of the patient interval (time from symptom onset to presentation) and the primary care interval (time from presentation to specialist referral) across symptom groups using descriptive analyses and quantile regression...
May 23, 2017: Cancer Epidemiology
https://www.readbyqxmd.com/read/28549337/the-relation-of-childhood-trauma-to-suicide-ideation-in-patients-suffering-from-obsessive-compulsive-disorder-with-lifetime-suicide-attempts
#16
Vahid Khosravani, Zoleikha Kamali, Razieh Jamaati Ardakani, Mehdi Samimi Ardestani
The aim of this study was to evaluate the relations of childhood trauma (CT) and obsessive-compulsive (OC) symptom dimensions to suicide ideation in patients with obsessive-compulsive disorder (OCD). Seventy OCD outpatients with lifetime suicide attempts and 60 controls were included. Participants completed the Scale for Suicide Ideation (SSI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21)...
May 20, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28549336/evaluation-of-a-new-random-access-hbv-dna-molecular-assay-the-veris-hbv-assay
#17
Slim Fourati, Dominique Challine, Jean-Dominique Poveda, Syria Laperche, Sandrine Rallier, Jean-Michel Pawlotsky, Stéphane Chevaliez
BACKGROUND: Detection and quantification of HBV DNA are essential to diagnose chronic HBV infection, monitor the virological response to treatment and the possible selection of resistant viruses in order to tailor therapy. The VERIS/MDx System HBV Assay is a random-access system that quantifies HBV DNA in clinical samples using unique single sample and reagent access during the workflow process without the need to reload other tests and delivers results within 1.2h following sampling...
May 17, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28549335/microstructural-alterations-of-white-matter-in-juvenile-myoclonic-epilepsy
#18
Jinnan Gong, Xuebin Chang, Sisi Jiang, Benjamin Klugah-Brown, Song Tan, Dezhong Yao, Cheng Luo
Juvenile myoclonic epilepsy (JME) is a common type of idiopathic generalized epilepsy that is characterized by myoclonic jerks of the upper limbs and generalized tonic-clonic seizures. Frontal cognitive dysfunctions and abnormal coupling of the thalamocortical system have been found in neuropsychological and neuroimaging studies. This study intended to explore white matter (WM) measurement changes in JME using MRI. Twenty-six patients with JME and 25 healthy controls (HC) were recruited for the acquisition of diffusion MRI and structural MRI data...
April 4, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28549330/impact-of-post-traumatic-stress-disorder-on-oral-health
#19
Ana Cristina de Oliveira Solis, Álvaro Cabral Araújo, Felipe Corchs, Marcio Bernik, Érica Panzani Duran, Cláudio Silva, Francisco Lotufo-Neto
BACKGROUND: The stress experienced as an intense and traumatic event can increase the odds of orofacial pain, affect the biomechanics of masticatory system and compromise the periodontal health. This study was conducted to investigate the impact of post-traumatic stress disorder (PTSD) on oral health. METHODS: A case-control study with a convenience sample was designed. Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing, and plaque were recorded at 6 sites per tooth...
May 20, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28549329/abnormal-small-world-brain-functional-networks-in-obsessive-compulsive-disorder-patients-with-poor-insight
#20
Hui Lei, Yan Cui, Jie Fan, Xiaocui Zhang, Mingtian Zhong, Jinyao Yi, Lin Cai, Dezhong Yao, Xiongzhao Zhu
BACKGROUND: There are limited data on neurobiological correlates of poor insight in obsessive-compulsive disorder (OCD). This study explored whether specific changes occur in small-world network (SWN) properties in the brain functional network of OCD patients with poor insight. METHOD: Resting-state electroencephalograms (EEGs) were recorded for 12 medication-free OCD patients with poor insight, 50 medication-free OCD patients with good insight, and 36 healthy controls...
May 20, 2017: Journal of Affective Disorders
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