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Scott Shannon, Janet Opila-Lehman
INTRODUCTION: Anxiety and sleep disorders are often the result of posttraumatic stress disorder and can contribute to an impaired ability to focus and to demonstration of oppositional behaviors. CASE PRESENTATION: These symptoms were present in our patient, a ten-year-old girl who was sexually abused and had minimal parental supervision as a young child under the age of five. Pharmaceutical medications provided partial relief, but results were not long-lasting, and there were major side effects...
October 12, 2016: Permanente Journal
Cheryl L Cox, M Robyn Andersen, Aimee K Santucci, Les L Robison, Melissa M Hudson
PURPOSE/OBJECTIVES: To document the per survivor and per additional survivor screening costs of a mailed survivorship care plan (SCP) with advanced practice nurse (APN) telephone counseling (SCP+C) or without APN telephone counseling (SCP).
. DESIGN: Randomized, longitudinal clinical trial.
. SETTING: St. Jude Children's Research Hospital in Memphis, Tennessee.
. SAMPLE: 411 at-risk pediatric cancer survivors (aged 26-59 years), stratified by age (younger than 30 years versus 30 years or older), recommended screening frequency (every one, two, or five years), gender, and cancer diagnosis (hematologic versus solid tumor)...
November 1, 2016: Oncology Nursing Forum
Vina Tresa, Afshan Yaseen, Ali Asghar Lanewala, Seema Hashmi, Sabeeta Khatri, Irshad Ali, Muhammed Mubarak
BACKGROUND: The reported prevalence rates and etiologies of acute kidney injury (AKI) are quite variable in different regions of the world. The current study was planned to determine the etiology, clinical profile, and short-term outcome of pediatric AKI at our hospital. METHODS: A prospective, observational study was carried out from April 2014 to March 2015. All pediatric patients (1 month to ≤15 years) diagnosed as AKI using modified pRIFLE criteria were studied and followed for 3 months to document short-term outcome...
October 21, 2016: Renal Failure
Margaret L Salisbury, David A Lynch, Edwin J R van Beek, Ella A Kazerooni, Junfeng Guo, Meng Xia, Susan Murray, Kevin J Anstrom, Eric Yow, Fernando J Martinez, Eric A Hoffman, Kevin R Flaherty
RATIONALE: Adaptive Multiple Features Method (AMFM) lung texture analysis software recognizes high-resolution computed tomography (HRCT) patterns. OBJECTIVES: We evaluated AMFM and visual quantification of HRCT patterns and their relationship with disease progression in Idiopathic Pulmonary Fibrosis. METHODS: IPF patients in a clinical trial of prednisone, azathioprine, and N-acetylcysteine underwent HRCT at study start and finish. Proportion of lung occupied by ground glass, ground glass-reticular (GGR), honeycombing, emphysema, and normal were measured by AMFM and 3 radiologists, documenting baseline disease extent and post-baseline change...
October 21, 2016: American Journal of Respiratory and Critical Care Medicine
Audrey Mirand, François Vié le Sage, Bruno Pereira, Robert Cohen, Corinne Levy, Christine Archimbaud, Hélène Peigue-Lafeuille, Jean-Luc Bailly, Cécile Henquell
The clinical impact of enteroviruses associated with hand, foot and mouth disease (HFMD) is unknown outside Asia, and the prevalence of enterovirus A71 (EV-A71) in particular might be underestimated. To investigate the prevalence of enterovirus serotypes and the clinical presentations associated with HFMD in France, we conducted prospective ambulatory clinic-based surveillance of children during April 2014-March 2015. Throat or buccal swabs were collected from children with HFMD and tested for the enterovirus genome...
November 2016: Emerging Infectious Diseases
Inimary T Toby, Mikhail K Levin, Edward A Salinas, Scott Christley, Sanchita Bhattacharya, Felix Breden, Adam Buntzman, Brian Corrie, John Fonner, Namita T Gupta, Uri Hershberg, Nishanth Marthandan, Aaron Rosenfeld, William Rounds, Florian Rubelt, Walter Scarborough, Jamie K Scott, Mohamed Uduman, Jason A Vander Heiden, Richard H Scheuermann, Nancy Monson, Steven H Kleinstein, Lindsay G Cowell
BACKGROUND: The genes that produce antibodies and the immune receptors expressed on lymphocytes are not germline encoded; rather, they are somatically generated in each developing lymphocyte by a process called V(D)J recombination, which assembles specific, independent gene segments into mature composite genes. The full set of composite genes in an individual at a single point in time is referred to as the immune repertoire. V(D)J recombination is the distinguishing feature of adaptive immunity and enables effective immune responses against an essentially infinite array of antigens...
October 6, 2016: BMC Bioinformatics
Elfrida Hartveit Kvarstein, Ola Nordviste, Lone Dragland, Theresa Wilberg
OBJECTIVES: Outpatient group psychotherapy is frequent within specialist services, recruits a mixed population, but effects are poorly documented. This study investigates long-term outcomes for patients with personality disorder (PD) treated in outpatient, psychodynamic groups within secondary mental health service. METHODS: A naturalistic study (N = 103) with repeated assessments of process and clinical outcomes. Longitudinal statistics are linear mixed models...
October 21, 2016: Personality and Mental Health
Demet Dingoyan, Mike Mösko, Yadigar Imamoğlu, Alessa von Wolff, Jens Strehle, Hans-Ulrich Wittchen, Holger Schulz, Uwe Koch-Gromus, Andreas Heinz, Ulrike Kluge
The Composite International Diagnostic Interview (CIDI), which has been widely applied in epidemiological research, is a standardized, clinically structured interview that enables the diagnosis of mental disorders based on DSM and ICD criteria. The computerized DIA-X CIDI Version 2.8 investigated in this study is an adaptation of the German DIA-X/Munich CIDI, which was translated in a multi-step process into Turkish and used to survey the prevalence of mental disorders in individuals with Turkish migration backgrounds in Germany (N = 662)...
October 21, 2016: International Journal of Methods in Psychiatric Research
Raliat Onatade, Gavin Miller, Inderjit Sanghera
Background Several clinical pharmacy activities are common to UK hospitals. It is not clear whether these are provided at similar levels, and whether they take similar amounts of time to carry out. Objective To quantify and compare clinical pharmacist ward activities between different UK hospitals. Setting Seven acute hospitals in the Greater London area (UK). Methods A list of common ward activities was developed. On five consecutive days, pharmacists visiting hospital wards documented total time spent and how many of each activity they undertook...
October 20, 2016: International Journal of Clinical Pharmacy
Falco Hietbrink, Lonneke G Bode, Louis Riddez, Luke P H Leenen, Marijke R van Dijk
BACKGROUND: Necrotizing fasciitis is an uncommon, rapidly progressive and potential lethal condition. Over the last decade time to surgery decreased and outcome improved, most likely due to increased awareness and more timely referral. Early recognition is key to improve mortality and morbidity. However, early referral frequently makes it a challenge to recognize this heterogeneous disease in its initial stages. Signs and symptoms might be misleading or absent, while the most prominent skin marks might be in discrepancy with the position of the fascial necrosis...
2016: World Journal of Emergency Surgery: WJES
Ming-Ching Shen, Ming Chen, Gwo-Chin Ma, Shun-Ping Chang, Ching-Yeh Lin, Bo-Do Lin, Han-Ni Hsieh
BACKGROUND: Von Willebrand disease (VWD) is not uncommon in Taiwan. In type 2 or type 3 VWD hemorrhagic symptoms are severer and laboratory data relatively more distinctive. De novo mutation and somatic mosaicism of type 2 VWD gene were rarely reported. Therefore clinical, laboratory and genetic studies of only type 2A, 2B and 2M VWD will be presented and issues of de novo mutation and somatic mosaicism will be explored. METHODS: Fifty-four patients belonging to 23 unrelated families from all around the country in whom type 2 VWD exclusive of type 2N has been diagnosed not only by clinical and routine laboratory studies but also by genetic confirmation during 1990-2015 were investigated...
2016: Thrombosis Journal
Alistair E W Johnson, Mohammad M Ghassemi, Shamim Nemati, Katherine E Niehaus, David A Clifton, Gari D Clifford
Clinical data management systems typically provide caregiver teams with useful information, derived from large, sometimes highly heterogeneous, data sources that are often changing dynamically. Over the last decade there has been a significant surge in interest in using these data sources, from simply re-using the standard clinical databases for event prediction or decision support, to including dynamic and patient-specific information into clinical monitoring and prediction problems. However, in most cases, commercial clinical databases have been designed to document clinical activity for reporting, liability and billing reasons, rather than for developing new algorithms...
February 2016: Proceedings of the IEEE
Sandra Bouma
The publication of the landmark paper "Defining Pediatric Malnutrition: A Paradigm Shift Toward Etiology-Related Definitions" launched a new era in diagnosing pediatric malnutrition. This work introduced the paradigm shift of etiology-related definitions-nonillness and illness related-and the use of anthropometric z scores to help identify and describe children with malnutrition (undernutrition) in the developed world. Putting the new definition into practice resulted in some interesting observations: (1) Etiology-related definitions result in etiology-related interventions...
October 20, 2016: Nutrition in Clinical Practice
Gabriel Bsteh, Julia Feige, Rainer Ehling, Michael Auer, Harald Hegen, Franziska Di Pauli, Florian Deisenhammer, Markus Reindl, Thomas Berger
BACKGROUND: Stable disease course may prompt consideration of disease-modifying treatment (DMT) discontinuation in relapsing-remitting multiple sclerosis (RRMS). OBJECTIVE: To investigate the clinical outcome after DMT discontinuation and to identify predictive factors supporting decision-making. METHODS: We included 221 RRMS patients, who discontinued DMT after ⩾12 months and had documented follow-up ⩾2 years after discontinuation...
October 20, 2016: Multiple Sclerosis: Clinical and Laboratory Research
Stepana Boukalova, Jan Stursa, Lukas Werner, Zuzana Ezrova, Jiri Cerny, Ayenachew Bezawork-Geleta, Alena Pecinova, Lanfeng Dong, Zdenek Drahota, Jiri Neuzil
Pancreatic cancer is one of the hardest-to-treat types of neoplastic diseases. Metformin, a widely prescribed drug against type 2 diabetes mellitus, is being trialed as an agent against pancreatic cancer, although its efficacy is low. With the idea of delivering metformin to its molecular target, the mitochondrial complex I (CI), we tagged the agent with the mitochondrial vector, triphenylphosphonium group. Mitochondrially targeted metformin (MitoMet) was found to kill a panel of pancreatic cancer cells 3-4 orders of magnitude more efficiently than found for the parental compound...
October 7, 2016: Molecular Cancer Therapeutics
Kathryn F Flack, Jay Desai, Jennifer M Kolb, Prapti Chatterjee, Lars C Wallentin, Michael Ezekowitz, Salim Yusuf, Stuart Connolly, Paul Reilly, Martina Brueckmann, John Ilgenfritz, James Aisenberg
BACKGROUND & AIMS: Gastrointestinal (GI) bleeding in patients receiving anticoagulation agents can be caused by occult malignancies. We investigated the proportions and features of major GI bleeding (MGIB) events related to occult GI cancers in patients receiving anticoagulation therapy. METHODS: We analyzed data from the Randomized Evaluation of Long Term Anticoagulant Therapy study (conducted between December 2005 and March 2009 in 951 clinical centers in 44 countries worldwide), which compared the abilities of dabigatran vs warfarin to prevent stroke and systemic embolism in 18,113 patients with atrial fibrillation...
October 17, 2016: Clinical Gastroenterology and Hepatology
Risha L Moskalewicz, Leidy L Isenalumhe, Cindy Luu, Choo Phei Wee, Alan L Nager
OBJECTIVE: To examine clinical characteristics associated with bacteremia in febrile nonneutropenic pediatric oncology patients with central venous catheters (CVCs) in the emergency department (ED). BACKGROUND: Fever is the primary reason pediatric oncology patients present to the ED. The literature states that 0.9% to 39% of febrile nonneutropenic oncology patients are bacteremic, yet few studies have investigated infectious risk factors in this population. METHODS: This was a retrospective cohort study in a pediatric ED, reviewing medical records from 2002 to 2014...
September 17, 2016: American Journal of Emergency Medicine
Nathalie L Maitre, Olena Chorna, Domenico M Romeo, Andrea Guzzetta
BACKGROUND: High-risk infant follow-up programs provide early identification and referral for treatment of neurodevelopmental delays and impairments. In these programs, a standardized neurological examination is a critical component of evaluation for clinical and research purposes. METHODS: To address primary challenges of provider educational diversity and standardized documentation, we designed an approach to training and implementation of the Hammersmith Infant Neurological Examination with precourse materials, a workshop model, and adaptation of the electronic medical record...
September 21, 2016: Pediatric Neurology
Kuang-Wei Hsu, Yu-Fu Shen, Pein-Chi Wei
STATEMENT OF PROBLEM: In addition to the original abutments provided by implant companies, compatible computer-aided design and computer-aided manufacturing (CAD-CAM) abutments are also available from different manufacturers. However, the combination of abutments and implant systems from different manufacturers may lead to mechanical problems between components. Little has been reported on the clinical performance of this treatment option. PURPOSE: The purpose of this retrospective case series was to evaluate the outcome of compatible CAD-CAM titanium abutments (TiAs) for posterior single-implant tooth replacement (PSITR) up to 6 years after insertion...
October 17, 2016: Journal of Prosthetic Dentistry
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Abby M Howenstein, Erik N Kubiak, Michael Suk, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to evaluate the role and the necessity of radiographs and office visits obtained during follow-up of intertrochanteric hip injuries. DESIGN: Retrospective study SETTING:: Two level I trauma centers. PATIENTS: 465 elderly patients who were surgically treated for an intertrochanteric fracture of the femur at two level I trauma centers between January 2009 and August 2014 were retrospectively identified from orthopaedic trauma databases...
August 16, 2016: Journal of Orthopaedic Trauma
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