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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/27914184/the-potential-use-of-ultrasound-magnetic-resonance-imaging-fusion-applications-in-musculoskeletal-intervention
#2
Christopher J Burke, Jenny Bencardino, Ronald Adler
We sought to assess the potential use of an application allowing real-time ultrasound spatial registration with previously acquired magnetic resonance imaging in musculoskeletal procedures. The ultrasound fusion application was used to perform a range of outpatient procedures including piriformis, sacroiliac joint, pudendal and intercostal nerve perineurial injections, hamstring-origin calcific tendonopathy barbotage, and 2 soft tissue biopsies at our institution in 2015. The application was used in a total of 7 procedures in 7 patients, all of which were technically successful...
December 3, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27914180/burned-out-testis-tumors-in-asymptomatic-infertile-men-multiparametric-sonography-and-mri-findings
#3
Laurence Rocher, Ludivine Glas, Marie France Bellin, Sophie Ferlicot, Vincent Izard, Gerard Benoit, Laurence Albiges, Karim Fizazi, Jean-Michel Correas
Multiparametric testicular ultrasound and magnetic resonance imaging (MRI) findings were analyzed in a series of 10 infertile asymptomatic men presenting with pathologically confirmed burned-out testicular tumors. Color/power Doppler ultrasound (CDUS), shear wave elastography (SWE), contrast-enhanced ultrasonography (CEUS), and MRI were performed on 10, 5, 6, and 7 patients, respectively. All lesions appeared as a hypoechoic and hypovascular nodular area at CDUS, SWE, CEUS CDUS, and CEUS (if performed). Shear wave elastography showed a stiffer nodular area compared with the surrounding/contralateral tissues (13 versus 2 kPa); MRI revealed a well-delineated nodular area in hypointense signal on T2, a high apparent diffusion coefficient value, and a lack of enhancement...
December 3, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27914176/prophylactic-rectal-indomethacin-may-be-ineffective-for-preventing-post-ercp-pancreatitis-in-general-patients-a-meta-analysis
#4
REVIEW
Yunlu Feng, Udayakumar Navaneethan, Xiang Zhu, Shyam Varadarajulu, Ingrid Schwartz, Robert H Hawes, Muhammad K Hasan, Aiming Yang
BACKGROUND AND AIMS: The efficacy of prophylactic indomethacin for prevention of post-ERCP pancreatitis (PEP) in general patients remains controversial. To address this, we therefore conducted a meta-analysis of clinical trials specifically on rectal indomethacin in prevention of PEP in consecutive patients undergoing ERCP. METHODS: We searched MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials databases to identify randomized, double-blinded, controlled clinical trials on rectal indomethacin in prevention of PEP in consecutive patients undergoing ERCP...
December 3, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27914175/dynamic-changes-in-liver-stiffness-measured-by-transient-elastography-predict-clinical-outcomes-among-patients-with-chronic-hepatitis-b
#5
Jianyong Zeng, Shaohang Cai, Jiajun Liu, Xiulan Xue, Xiaolu Wu, Caixia Zheng
OBJECTIVES: We aimed to evaluate the validity of transient elastography in monitoring the antiviral outcomes in patients with chronic hepatitis B. METHODS: This study included 108 patients treated with nucleos(t)ide analogues and 67 patients treated with interferon (IFN). Liver biopsies were evaluated by the METAVIR score. Transient elastography was performed initially at baseline, 48 weeks, and 96 weeks. Liver tissue was obtained before and after 96 weeks of treatment...
December 3, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27914172/cryotherapy-of-renal-lesions-enhancement-on-contrast-enhanced-sonography-on-postoperative-day-1-does-not-imply-viable-tissue-persistence
#6
Michele Bertolotto, Salvatore Siracusano, Calogero Cicero, Mariano Iannelli, Tommaso Silvestri, Antonio Celia, Alessandro Guarise, Fulvio Stacul
OBJECTIVES: To investigate whether persistent enhancement detected on contrast-enhanced sonography at postoperative day 1 (early contrast-enhanced sonography) after cryoablation of renal tumors implies the presence of residual viable tumor tissue, defined as residual enhancing tissue on reference imaging (computed tomography or magnetic resonance imaging) performed 6 months after the procedure. METHODS: Seventy-four patients with percutaneous cryoablation of renal tumors had early contrast-enhanced sonography from November 2011 to August 2015...
December 3, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27914171/clinical-feasibility-of-brain-computer-interface-based-on-steady-state-visual-evoked-potential-in-patients-with-locked-in-syndrome-case-studies
#7
Han-Jeong Hwang, Chang-Hee Han, Jeong-Hwan Lim, Yong-Wook Kim, Soo-In Choi, Kwang-Ok An, Jun-Hak Lee, Ho-Seung Cha, Seung Hyun Kim, Chang-Hwan Im
Although the feasibility of brain-computer interface (BCI) systems based on steady-state visual evoked potential (SSVEP) has been extensively investigated, only a few studies have evaluated its clinical feasibility in patients with locked-in syndrome (LIS), who are the main targets of BCI technology. The main objective of this case report was to share our experiences of SSVEP-based BCI experiments involving five patients with LIS, thereby providing researchers with useful information that can potentially help them to design BCI experiments for patients with LIS...
December 3, 2016: Psychophysiology
https://www.readbyqxmd.com/read/27914166/trauma-related-dissociation-psychological-features-and-psychophysiological-responses-to-script-driven-imagery-in-borderline-personality-disorder
#8
Dana Bichescu-Burian, Jürgen Steyer, Tilman Steinert, Benjamin Grieb, Stefan Tschöke
Defense reactions to threatening situations are vital adaptations to stress that protect organisms from injury and ensure survival. We retrospectively investigated the role of peritraumatic dissociation (PD) in the occurrence of severe psychopathology and dissociative patterns of reactions in borderline personality disorder (BPD). We recruited 28 patients with a clinical diagnosis of BPD and 15 healthy controls. The BPD group was divided according to the level of PD (low vs. high): BPD and PD (n = 15) and BPD only (n = 13)...
December 3, 2016: Psychophysiology
https://www.readbyqxmd.com/read/27914159/-molecular-mechanisms-for-adhesion-and-colonization-of-human-gastric-mucosa-by-helicobacter-pylori-and-its-clinical-implications
#9
REVIEW
Elisabete Coelho, Ana Magalhães, Mário Dinis-Ribeiro, Celso A Reis
INTRODUCTION: Helicobacter pylori infection is very prevalent worldwide and is associated with the progression of the gastric carcinogenesis cascade, being one of the main risk factors for the development of gastric carcinoma. Several factors are determinant for the infection and for the development of gastric disease, including environmental factors, host genetic factors and virulence factors of the bacteria. MATERIAL AND METHODS: In this review, we present an overview of the current knowledge on the determinants of the infection and on the recently described molecular mechanisms of Helicobacter pylori adhesion to the gastric mucosa, as well as its possible future therapeutic application...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27914158/causes-of-death-in-an-acute-psychiatric-inpatient-unit-of-a-portuguese-general-hospital
#10
Sofia Barbosa, Márcia Sequeira, Sara Castro, Rita Manso, Catarina Klut Câmara, Bruno Trancas, Nuno Borja-Santos, Teresa Maia
INTRODUCTION: Psychiatric patients are at increased risk of death from a number of natural and unnatural causes. This study examines the mortality causes of all psychiatric inpatients of an acute psychiatric unit at a general hospital in Portugal for sixteen years (1998 to 2013). MATERIAL AND METHODS: Twenty-one inpatients died at the inpatient unit between 1998 and 2013 (average 1.3 per year). A retrospective study through case-file review was carried to collect demographic characteristics, medical and psychiatry diagnosis...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27914157/-prevalence-of-dental-caries-in-type-1-diabetic-patients-treated-with-insulin-pump
#11
Rosana Garcia, Ana Coelho, Anabela Paula, Manuel Marques Ferreira, Francisco Caramelo, Luísa Barros, Carla Batista, Miguel Melo, Mário Jorge Silva, Eunice Carrilho
INTRODUCTION: Type 1 diabetes mellitus and oral health are strictly related on a reciprocal basis, and an increased susceptibility to a wide variety of oral diseases is recognised in these patients. The aim of the present study was to establish a relationship between the prevalence of dental caries in Type 1 diabetic patients treated with insulin pump and that of non-diabetic patients. MATERIAL AND METHODS: An observational clinical study of analytical and cross-sectional nature was conducted...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27914156/-intratechal-chemotherapy-treatment-through-an-ommaya-reservoir-catheter-for-meningeal-carcinomatosis-a-single-centre-experience
#12
José Pedro Lavrador, Nuno Simas, Edson Oliveira, Manuel Herculano Carvalho
INTRODUCTION: Meningeal carcinomatosis is defined as tumour cells infiltration of leptomeninges and subarachnoid space. It is normally related with poor survival (2 - 5 months). The best multidisciplinary treatment for this condition is a matter of discussion. Patient's condition and the natural history of the disease should be considered in the decision making process. MATERIAL AND METHODS: Retrospective cohort analysis of patients submitted to Ommaya Reservoir placement due to systemic solid tumour meningeal carcinomatosis between 2006 and 2014...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27914155/-main-causes-of-occupational-allergic-contact-dermatitis-a-three-year-study-in-the-center-of-portugal
#13
Catarina Pestana, Raquel Gomes, Vítor Pinheiro, Miguel Gouveia, Isabel Antunes, Margarida Gonçalo
INTRODUCTION: Allergic contact dermatitis, along with irritant contact dermatitis and immediate contact reactions, contact urticarial, are the most frequent dermatological occupational disease, but seldom reported to the National authorities. MATERIAL AND METHODS: We performed a 3-year retrospective study at the allergology section in the Dermatology Clinic of the University Hospital of Coimbra to evaluate the main occupations diagnosed as occupational allergic contact dermatitis, most common allergens and the effect of the modification of the work station in the evolution of the disease...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27914154/short-and-long-term-efficacy-of-laparoscopic-ovarian-diathermy-in-women-with-polycystic-ovary-syndrome
#14
Rita Luz, Joana Barros, Ana Aguiar, Cátia Rodrigues, Ana Paula Soares, Joaquim Nunes, Sandra Sousa, Carlos Calhaz-Jorge
INTRODUCTION: Polycystic ovary syndrome is the most frequent cause of anovulatory infertility and management involves a multistep approach. Laparoscopic ovarian diathermy is accepted as a second-line treatment of patients who failed to respond to clomiphene citrate. The aims of this study were to determine the efficacy of this technique at short and long-term and to perform an analysis of predictive factors of spontaneous pregnancy. MATERIAL AND METHODS: This retrospective study involved 76 women who underwent laparoscopic ovarian diathermy between 2004 and 2013 in a university hospital...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27914153/-pulmonary-embolism-in-portugal-epidemiology-and-in-hospital-mortality
#15
Miguel Gouveia, Luís Pinheiro, João Costa, Margarida Borges
INTRODUCTION: In Portugal, the epidemiology of acute pulmonary embolism is poorly understood. In this study, we sought to characterize the pulmonary embolism from the hospital data and evaluate its in-hospital mortality and respective prognostic factors. MATERIAL AND METHODS: The study used diagnostic related groups data from National Health System hospitals from 2003 to 2013 and National Statistics Institute population data to establish the evolution of admissions with the diagnosis of pulmonary embolism, their inhospital mortality rates and the population incidence rates...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27914152/pediatric-multiple-sclerosis-in-portugal-a-multicentre-study
#16
Ana Sofia Correia, Luís Augusto, Joana Meireles, Joana Pinto, Ana Paula Sousa
INTRODUCTION: Multiple sclerosis is most often diagnosed among young adults but less frequently it may present during childhood or adolescence. In Portugal, there has been only one previous single-center, pediatric multiple sclerosis study. The main objective was the evaluation of the demographic, clinical, laboratorial and neuroradiological characteristics of patients with pediatric-onset multiple sclerosis in Portugal. The secondary objectives were to compare the characteristics of childhood-onset multiple sclerosis and adolescent-onset multiple sclerosis and to characterize the treatments prescribed...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27914146/pregnancy-and-delivery-in-a-generalized-dystonia-patient-treated-with-internal-globus-pallidal-deep-brain-stimulation-a-case-report
#17
Hye Ran Park, Jae Meen Lee, Hyeyoung Park, Chae Won Shin, Han Joon Kim, Hee Pyoung Park, Dong Gyu Kim, Beom Seok Jeon, Sun Ha Paek
Internal globus pallidus (GPi) deep brain stimulation (DBS) has been widely accepted as an effective treatment modality of medically refractory dystonia. However, there have been few studies regarding the safety issue of pregnancy and childbirth related with DBS. This report describes a female patient who was pregnant and delivered a baby after GPi DBS surgery. A 33-year-old female patient with acquired generalized dystonia underwent bilateral GPi DBS implantation. She obtained considerable improvement in both movement and disability after DBS implantation...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27914145/differential-cell-count-and-crp-level-in-blood-as-predictors-for-middle-east-respiratory-syndrome-coronavirus-infection-in-acute-febrile-patients-during-nosocomial-outbreak
#18
Ga Eun Park, Cheol In Kang, Jae Hoon Ko, Sun Young Cho, Young Eun Ha, Yae Jean Kim, Kyong Ran Peck, Jae Hoon Song, Doo Ryeon Chung
A case-control study was performed to identify clinical predictors for Middle East respiratory syndrome coronavirus (MERS-CoV) infection among patients with acute febrile illness during the nosocomial outbreak. Patients with MERS-CoV were more likely to have monocytosis with normal white blood cell (WBC) count and lower C-reactive protein (CRP) level. Simple laboratory data such as complete blood counts (CBC) with differential count could be a useful marker for the prediction of MERS and triage at the initial presentation of acute febrile patients in outbreak setting...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27914141/unfavorable-course-of-subclinical-hypothyroidism-in-children-with-hashimoto-s-thyroiditis-compared-to-those-with-isolated-non-autoimmune-hyperthyrotropinemia
#19
Yun Jeong Lee, So Yoon Jung, Hae Woon Jung, So Youn Kim, Young Ah Lee, Seong Yong Lee, Choong Ho Shin, Sei Won Yang
Subclinical hypothyroidism (SCH) is a common problem in pediatric population, and the natural history of SCH varies depending on its etiology. Whether Hashimoto's thyroiditis (HT) negatively affects the natural course of SCH was investigated in pediatric patients without concomitant diseases. Predictors for levothyroxine medication were also evaluated. Medical records of 109 children with SCH (91 girls, 5?18 years) diagnosed between 2005 and 2014 were retrospectively reviewed. Patients were classified into HT (n = 37) and isolated non-autoimmune hyperthyrotropinemia (iso-NAHT, n = 72)...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27914139/genetic-variations-of-the-kiss1r-gene-in-korean-girls-with-central-precocious-puberty
#20
Yeon Joung Oh, Young Jun Rhie, Hyo Kyoung Nam, Hye Ryun Kim, Kee Hyoung Lee
The timing of puberty onset varies greatly among individuals, and much of this variation is modulated by genetic factors. This study aimed to identify the kisspeptin receptor (KISS1R) gene variations and to investigate the associations between these variations and central precocious puberty (CPP). Korean girls with CPP (n = 194) and their healthy controls (n = 99) were included in this study. The entire coding region and the exon-intron boundaries (exon 1 through 5) of the KISS1R gene were directly sequenced...
January 2017: Journal of Korean Medical Science
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