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https://www.readbyqxmd.com/read/28803232/digestive-system-mixed-neuroendocrine-non-neuroendocrine-neoplasms
#1
Louis de Mestier, Jérôme Cros, Cindy Neuzillet, Olivia Hentic, Axel Egal, Nelly Muller, Olivier Bouché, Guillaume Cadiot, Philippe Ruszniewski, Anne Couvelard, Pascal Hammel
Mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) are a heterogeneous subgroup of rare neoplasms that represent about a third of all poorly differentiated neuroendocrine carcinomas (PDNEC). MiNEN combine a neuroendocrine component, usually a PDNEC, and a non-neuroendocrine component, generally an adenocarcinoma, both accounting for at least 30% of the neoplasm. MiNEN are classified as high-, intermediate-, or low-grade malignancies depending on the metastatic potential of the tumour components. High-grade malignant component should be considered even if it represents <30% of the tumour...
August 12, 2017: Neuroendocrinology
https://www.readbyqxmd.com/read/28758605/rescue-extracorporeal-membrane-oxygenation-therapy-in-methamphetamine-toxicity
#2
Laura K Morrison, J Kromm, J Gaudet, D Zuege, B Button, F Warshawski, S N Lucyk
Complications related to methamphetamine use and abuse are common presentations seen in the emergency department. Standard management focuses on addressing the central nervous system and cardiovascular effects with the use of sedation and hemodynamic support. We describe a case report of a patient with methamphetamine toxicity and subsequent severe cardiomyopathy refractory to conventional management that responded to cardiovascular support with extracorporeal membrane oxygenation therapy (ECMO). A 22-year-old female was admitted in severe cardiogenic shock following intravenous administration of methamphetamine and oral fentanyl use...
July 31, 2017: CJEM
https://www.readbyqxmd.com/read/28756639/diagnosis-and-treatment-of-community-acquired-pneumonia-in-adults-2016-clinical-practice-guidelines-by-the-chinese-thoracic-society-chinese-medical-association
#3
REVIEW
Bin Cao, Yi Huang, Dan-Yang She, Qi-Jian Cheng, Fan Hong, Xin-Lun Tian, Jin-Fu Xu, Jing Zhang, Yu Chen, Ning Shen, Hui Wang, Mei Jiang, Xiang-Yan Zhang, Yi Shi, Bei He, Li-Xian He, You-Ning Liu, Jie-Ming Qu
Community-acquired pneumonia (CAP) in adults is an infectious disease with high morbidity in China and the rest of the world. With the changing pattern in the etiological profile of CAP and advances in medical techniques in diagnosis and treatment over time, Chinese Thoracic Society of Chinese Medical Association updated its CAP guideline in 2016 to address the standard management of CAP in Chinese adults. Extensive and comprehensive literature search was made to collect the data and evidence for experts to review and evaluate the level of evidence...
July 29, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28749037/transfusion-for-sickle-cell-disease-in-pregnancy-a-single-centre-survey
#4
J Sharif, L Byrd, K Stevenson, J Raddats, E Morsman, K Ryan
INTRODUCTION: Sickle cell disease in pregnancy carries a high risk of maternal and fetal adverse outcomes. The use of prophylactic transfusions to reduce the risk of sickle complications is controversial. Current UK standards do not recommend the routine use of transfusion for sickle pregnancy. We examined transfusion episodes during sickle pregnancies in a single centre over an 11-year period. METHODS: We conducted a retrospective observational study of all pregnancies in patients with sickle cell disease who attended the joint obstetric/haematology clinic over an 11-year period...
July 27, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28734951/emergency-department-management-of-diabetic-ketoacidosis-and-hyperosmolar-hyperglycemic-state-national-survey-of-attitudes-and-practice
#5
Alexandra L Hamelin, Justin W Yan, Ian G Stiell
OBJECTIVES: In 2013, the Association, now Diabetes Canada, published national clinical practice guidelines for the effective management of diabetic ketoacidosis and hyperosmolar hyperglycemic states in adults. We sought to determine emergency physician compliance rates and attitudes toward these guidelines and to identify potential barriers to their use in Canadian emergency departments. METHODS: An online survey consisting of questions related to the awareness and use of the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada was distributed to 500 randomly selected members of the Canadian Association of Emergency Physicians...
July 19, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28728522/striking-decrease-in-blood-loss-with-a-urologist-assisted-standardized-multidisciplinary-approach-in-the-management-of-abnormally-invasive-placenta
#6
Zeljka Lekic, Ehab Ahmed, Ralph Peeker, Tommy Sporrong, Ove Karlsson
OBJECTIVE: The aim of this study was to investigate the outcome of a standardized multidisciplinary approach using a modified surgical technique in the management of abnormally invasive placenta (AIP), with special reference to blood loss and the need for transfusion. MATERIALS AND METHODS: Data were collected retrospectively in women managed with a recently adopted multidisciplinary strategy using a modified surgical approach, involving a urologist (study group: 10 patients)...
July 21, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28724200/effect-of-memantine-on-serum-levels-of-neuron-specific-enolase-and-on-the-glasgow-coma-scale-in-patients-with-moderate-traumatic-brain-injury
#7
Majid Mokhtari, Hossein Nayeb-Aghaei, Mehran Kouchek, Mir Mohammad Miri, Reza Goharani, Arash Amoozandeh, Sina Akhavan Salamat, Mohammad Sistanizad
Traumatic brain injury (TBI) is a major cause of disability and death globally. Despite significant progress in neuromonitoring and neuroprotection, pharmacological interventions have failed to generate favorable results. We examined the effect of memantine on serum levels of neuron-specific enolase (NSE), a marker of neuronal damage, and the Glasgow Coma Scale (GCS) in patients with moderate TBI. Patients were randomly assigned to the control group (who received standard TBI management) and the treatment group (who, alongside their standard management, received enteral memantine 30 mg twice daily for 7 days)...
July 19, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28711384/radical-treatment-of-stage-ii-non-small-cell-lung-cancer-with-nonsurgical-approaches-a-multi-institution-report-of-outcomes
#8
Shaan Dudani, Xiaofu Zhu, Daniel W Yokom, Andrew Yamada, Cheryl Ho, Jason R Pantarotto, Natasha B Leighl, Tinghua Zhang, Paul Wheatley-Price
INTRODUCTION: Standard management of stage II non-small-cell lung cancer (NSCLC) is surgery, often followed by adjuvant chemotherapy. However, some patients do not undergo surgery for various reasons. We examined outcomes in this defined patient group. METHODS: We reviewed the records of patients with stage II NSCLC treated nonsurgically with curative intent from 2002 to 2012 across 3 academic cancer centers. Data collected included demographics, comorbidities, staging, treatments, and survival...
June 21, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28691141/vinpocetine-inhibits-nf-%C3%AE%C2%BAb-dependent-inflammation-in-acute-ischemic-stroke-patients
#9
Fang Zhang, Chen Yan, Changjuan Wei, Yang Yao, Xiaofeng Ma, Zhongying Gong, Shoufeng Liu, Dawei Zang, Jieli Chen, Fu-Dong Shi, Junwei Hao
Immunity and inflammation play critical roles in the pathogenesis of acute ischemic stroke. Therefore, immune intervention, as a new therapeutic strategy, is worthy of exploration. Here, we tested the inflammation modulator, vinpocetine, for its effect on the outcomes of stroke. For this multi-center study, we recruited 60 patients with anterior cerebral circulation occlusion and onset of stroke that had exceeded 4.5 h but lasted less than 48 h. These patients, after random division into two groups, received either standard management alone (controls) or standard management plus vinpocetine (30 mg per day intravenously for 14 consecutive days, Gedeon Richter Plc...
July 9, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28671402/laceration-repair-a-practical-approach
#10
REVIEW
Randall T Forsch, Sahoko H Little, Christa Williams
The goals of laceration repair are to achieve hemostasis and optimal cosmetic results without increasing the risk of infection. Many aspects of laceration repair have not changed over the years, but there is evidence to support some updates to standard management. Studies have been unable to define a "golden period" for which a wound can safely be repaired without increasing risk of infection. Depending on the type of wound, it may be reasonable to close even 18 or more hours after injury. The use of nonsterile gloves during laceration repair does not increase the risk of wound infection compared with sterile gloves...
May 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28666184/pregnancy-outcome-in-women-with-epilepsy-in-western-china-a-prospective-hospital-based-study
#11
Shixu He, Huili Zhu, Xiangmiao Qiu, Xi Zhu, Anjiao Peng, Jianan Duan, Lei Chen
OBJECTIVE: Gaps exist in the diagnosis and treatment of women with epilepsy (WWE) between China and Euro-American countries. We aim to find out and share our experience of the multidisciplinary integrated treatment for WWE. METHODS: We prospectively registered WWE who were diagnosed by both epileptologists and obstetrician in our green way system for the past 5years (2009-2015). Registration information include years of education, epilepsy history, seizure type and frequency, pregnancy and delivery complications, delivery mode, and Apgar score of newborn...
June 27, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28664463/therapeutic-potential-of-helminths-in-autoimmune-diseases-helminth-derived-immune-regulators-and-immune-balance
#12
REVIEW
Meng Wang, Linxiang Wu, Rennan Weng, Weihong Zheng, Zhongdao Wu, Zhiyue Lv
Helminths have accompanied human throughout history by releasing immune-evasion molecules that could counteract an aberrant immune response within the host. In the past decades, helminth infections are becoming less prevalent possibly due to the developed sanitation. Meanwhile, the incidence of autoimmune diseases is increasing, which cannot be exclusively explained by the changes of susceptibility genes. While the hygiene hypothesis casts light on the problem. The infections of helminths are believed to interact with and regulate human immunity with the byproduct of suppressing the autoimmune diseases...
August 2017: Parasitology Research
https://www.readbyqxmd.com/read/28664237/surgical-and-minimally-invasive-therapies-for-the-management-of-the-small-renal-mass
#13
REVIEW
John Withington, Joana B Neves, Ravi Barod
PURPOSE OF REVIEW: This article aims to summarise recent developments in surgical and minimally invasive therapies in the management of small renal masses (SRMs). RECENT FINDINGS: The incidence of the small renal mass is increasing. Standard management of the SRM is partial nephrectomy. More recently, use of ablative techniques to manage the SRM has been increasing and an exciting array of technical advances is currently being made in the field. Nephron-sparing surgery looks set to become more financially viable with the advent of newer robotic platforms and, potentially, even less invasive with the evaluation of single-port access...
August 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28656118/pediatric-ovarian-growing-teratoma-syndrome
#14
Rebecca M Rentea, Aaron Varghese, Atif Ahmed, Alexander Kats, Michelle Manalang, Tazim Dowlut-McElroy, Richard J Hendrickson
Ovarian immature teratoma is a germ cell tumor that comprises less than 1% of ovarian cancers and is treated with surgical debulking and chemotherapy depending on stage. Growing teratoma syndrome (GTS) is the phenomenon of the growth of mature teratoma elements with normal tumor markers during or following chemotherapy for treatment of a malignant germ cell tumor. These tumors are associated with significant morbidity and mortality due to invasive and compressive growth as well as potential for malignant transformation...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28647058/-management-of-multiple-valve-disease
#15
Z Raissuni, A Abourazzak, L Hara, J Zarzur, M Cherti
Polyvalvular disease is not a rare condition, the lack of specific data for each situation does not allow perfoming standardized management and guidelines. We want to present by this review available data on the management of polyvalvular disease, taking into account different possible associations between the valve lesions.
June 21, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28639717/a-prospective-study-on-transvaginal-ultrasound-of-cervical-length-cl-in-the-first-and-second-trimester-in-a-low-risk-population
#16
C B Wulff, L Rode, S Rosthøj, E Hoseth, O B Petersen, A Tabor
OBJECTIVES: To assess cervical length (CL) longitudinally in the first and second trimester and to determine the proportion of women with a short CL. Further, to assess if women with a short CL at 19-24 weeks could be identified at the combined first-trimester screening (cFTS) at 11-14 weeks in relation to a potential implementation of CL screening in the Danish population. METHODS: We recruited singleton pregnant women attending the combined first-trimester screening from 1 November 2013 to 1 December 2014 to a longitudinal prospective study at three University Hospitals in Denmark...
June 22, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28631720/contemporary-management-of-men-with-high-risk-localized-prostate-cancer-in-the-united-states
#17
A B Weiner, R S Matulewicz, E M Schaeffer, S L Liauw, J M Feinglass, S E Eggener
BACKGROUND: Surgery and radiation-based therapies are standard management options for men with clinically localized high-risk prostate cancer (PCa). Contemporary patterns of care are unknown. We hypothesize the use of surgery has steadily increased in more recent years. METHODS: Using the National Cancer Data Base for 2004-2013, all men diagnosed with high-risk localized PCa were identified using National Comprehensive Cancer Network criteria. Temporal trends in initial management were assessed...
June 20, 2017: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/28612680/benefits-of-stroke-treatment-delivered-using-a-mobile-stroke-unit-trial
#18
Jose-Miguel Yamal, Suja S Rajan, Stephanie A Parker, Asha P Jacob, Michael O Gonzalez, Nicole R Gonzales, Ritvij Bowry, Andrew D Barreto, Tzu-Ching Wu, David R Lairson, David Persse, Barbara C Tilley, David Chiu, Jose I Suarez, William J Jones, Andrei Alexandrov, James C Grotta
Rationale Mobile stroke units speed treatment for acute ischemic stroke, thereby possibly improving outcomes. Aim To compare mobile stroke unit and standard management clinical outcomes, healthcare utilization, and cost-effectiveness in tissue plasminogen activator-eligible acute ischemic stroke patients calling 911. Sample size 693. Eighty percent power with 0.05 type I error rate to detect a difference of 0.09 in mean utility-weighted modified Rankin scale between groups. Design Phase III, multicenter, prospective cluster-randomized (mobile stroke unit versus standard management weeks) comparative effectiveness study in tissue plasminogen activator-eligible patients...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28612228/pleomorphic-lobular-carcinoma-in-situ-of-the-breast-a-single-institution-experience-with-clinical-follow-up-and-centralized-pathology-review
#19
Marina De Brot, Starr Koslow Mautner, Shirin Muhsen, Victor P Andrade, Anita Mamtani, Melissa Murray, Dilip Giri, Rita A Sakr, Edi Brogi, Tari A King
PURPOSE: The natural history of pleomorphic lobular carcinoma in situ (PLCIS) remains largely unknown. METHODS: A pathology database search (1995-2012) was performed to identify patients diagnosed with an LCIS variant. Patients with synchronous breast cancer and/or no evidence of pleomorphism were excluded. Original slides were re-evaluated by three pathologists to identify a consensus cohort of PLCIS. Borderline lesions with focal atypia were classified as LCIS with pleomorphic features (LCIS-PF)...
June 13, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28591509/-double-pneumotorax-secondary-to-single-proyectile-weapon-one-case-report-and-review-of-literature
#20
Mario Quintero-Amaya, Francisco Flores-Orozco, José Herrera-Maldonado, Jorge Miño-Bernal, Edna López-Morales, Abigail Juárez-Ugalde, Marisol Flores-Gonzaga, Débora Aguilar-Sánchez
BACKGROUND: The 25% of traumatic deaths are due to chest trauma with a mortality of 28%, and closed trauma is the most common mechanism of injury. The use of firearms increases the relative risk of death. The five more frequent specific chest injuries are lung contusion (31.8%), hemothorax/pneumothorax (19.4%), rib fractures (13.2%), and diaphragmatic injury (7.5%). CLINICAL CASE: Patient of 25 years with a single firearm projectile wound in the chest who assisted to the emergency room (ER) with significant respiratory distress and meriting surgical emergency airway, documenting double pneumothorax, aortic laceration and rupture of the trachea, which required management in the ER with bilateral chest tube placement and subsequent surgical repair...
July 2017: Revista Médica del Instituto Mexicano del Seguro Social
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