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https://www.readbyqxmd.com/read/28343331/economic-and-public-health-consequences-of-delayed-access-to-medical-care-for-migrants-living-with-hiv-in-france
#1
Marlène Guillon, Michel Celse, Pierre-Yves Geoffard
In 2013, migrants accounted for 46% of newly diagnosed cases of HIV (human immunodeficiency virus) infection in France. These populations meet with specific obstacles leading to late diagnosis and access to medical care. Delayed access to care (ATC) for HIV-infected migrants reduces their life expectancy and quality of life. Given the reduction of infectivity under antiretroviral (ARV) treatment, delayed ATC for HIV-infected migrants may also hinder the control of the HIV epidemic. The objective of this study is to measure the public health and economic consequences of delayed ATC for migrants living with HIV in France...
March 25, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28342959/early-lance-adams-syndrome-after-cardiac-arrest-prevalence-time-to-return-to-awareness-and-outcome-in-a-large-cohort
#2
Irene Aicua Rapun, Jan Novy, Daria Solari, Mauro Oddo, Andrea O Rossetti
INTRODUCTION: Early myoclonus after Cardiac Arrest (CA) is traditionally viewed as a poor prognostic sign (status myoclonus). However, some patients may present early Lance-Adams syndrome (LAS): under appropriate treatment, they can reach a satisfactory functional outcome. Our aim was to describe their profile, focusing on pharmacologic management in the ICU, time to return of awareness, and long-term prognosis. METHODS: Adults with early LAS (defined as generalized myoclonus within 96hours, with epileptiform EEG within 48hours after CA) were retrospectively identified in our CA registry between 2006 and 2016...
March 22, 2017: Resuscitation
https://www.readbyqxmd.com/read/28342750/mutation-of-the-caspase-3-cleavage-site-in-the-astroglial-glutamate-transporter-eaat2-delays-disease-progression-and-extends-lifespan-in-the-sod1-g93a-mouse-model-of-als
#3
Lauren Taylor Rosenblum, Shashirekha Shamamandri-Markandaiah, Biswarup Ghosh, Emily Foran, Angelo C Lepore, Piera Pasinelli, Davide Trotti
Downregulation in the astroglial glutamate transporter EAAT2 in amyotrophic lateral sclerosis (ALS) patients and mutant SOD1 mouse models of ALS is believed to contribute to the death of motor neurons by excitotoxicity. We previously reported that caspase-3 cleaves EAAT2 at a unique cleavage consensus site located in its c-terminus domain, a proteolytic cleavage that also occurs in vivo in the mutant SOD1 mouse model of ALS and leads to accumulation of a sumoylated EAAT2 C-Terminus fragment (CTE-SUMO1) beginning around onset of disease...
March 22, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28342738/american-brachytherapy-society-consensus-statement-for-soft-tissue-sarcoma-brachytherapy
#4
A O Naghavi, D C Fernandez, N Mesko, A Juloori, A Martinez, J G Scott, C Shah, L B Harrison
PURPOSE: Radiation therapy represents an essential treatment option in the management of soft tissue sarcomas (STS). Brachytherapy represents an important subset of radiation therapy techniques used for STS, with evolving indications and applications. Therefore, the purpose of this guideline was to update clinicians regarding the data surrounding brachytherapy (BT) and provide recommendations for the utilization of BT in patients with STS. METHODS AND MATERIALS: Members of the American Brachytherapy Society with expertise in STS, and STS BT in particular, created an updated guideline for the use of BT in STS based on a literature review and clinical experience...
March 22, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28342701/predictive-subtle-or-overlooked-initial-head-ct-findings-in-patients-who-develop-delayed-chronic-subdural-hematoma
#5
William C Olivero, Huan Wang, Arash Farahvar, Thomas A Kim, Fei Wang
With the aging population, the incidence of chronic subdural hematoma (CSDH) is expected to rise. Once symptomatic the morbidity from CSDH is not insignificant. We studied patients who had a minor head injury and CT brain scan prior to developing CSDH to determine if there were any predictors on these scans for subsequent development of a CSDH. A retrospective review was performed on all patients operated for CSDH over a 3-year period and a review performed on those who had imaging studies at the time of a preceding minor head injury...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28342581/neurodevelopmental-outcomes-in-infants-undergoing-general-anesthesia
#6
Kelsey A Nestor, Michelle Zeidan, Erin Boncore, Aaron Richardson, Gijo Alex, Michael Weiss, Saleem Islam
PURPOSE: Preclinical data strongly suggest that all agents used for general anesthesia (GA) have detrimental effects on the developing brain. However, clinical data are unclear. The purpose of this study was to use a cohort of infants who underwent GA and understand their neurodevelopmental outcomes. METHODS: A cohort of infants who underwent GA was selected between 2010 and 2011, and a control group was created. Data regarding GA, procedures, and outcomes were collected in 2015...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28342574/ultrasound-findings-in-tension-pneumothorax-a-case-report
#7
Maxine Inocencio, Jeannine Childs, Mikaela L Chilstrom, Kristin Berona
BACKGROUND: Delayed recognition of tension pneumothorax can lead to a mortality of 31% to 91%. However, the classic physical examination findings of tracheal deviation and distended neck veins are poorly sensitive in the diagnosis of tension pneumothorax. Point-of-care ultrasound is accurate in identifying the presence of pneumothorax, but sonographic findings of tension pneumothorax are less well described. CASE REPORT: We report the case of a 21-year-old man with sudden-onset left-sided chest pain...
March 22, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28342436/-vulnerations-of-human-dignity-at-the-end-of-life
#8
Roberto Germán Zurriaráin
Death is constitutive of human nature and therefore it must happen naturally. But there are mainly two ways that falsify it: euthanasia and therapeutic obstinacy. Two wrong choices that do not accept the human reality of death (the first, anticipates death and the second, delays it). From the philosophical and ethical point of view, both options are rejected, because they are against human dignity at the end of life. Aside from these, this article also rejects the different names which are given to refer to euthanasia, that also go against human nature at the end of life...
January 2017: Cuadernos de Bioética: Revista Oficial de la Asociación Española de Bioética y Ética Médica
https://www.readbyqxmd.com/read/28342390/lidocaine-gel-versus-plain-lubricating-gel-for-pain-reduction-during-transrectal-sonography-lips-a-randomized-controlled-trial
#9
Su Hyun Nam, Kye Hyun Kim, Chahien Choi, Se Hyun Nam, Taejong Song, Kyo Won Lee
OBJECTIVE: To compare the efficacy and safety of lidocaine gel and plain lubricating gel in relieving pain during transrectal sonography (TRS) in patients with gynecologic problems. METHODS: A randomized controlled trial was conducted in 80 participants who were scheduled to undergo TRS. The participants were allocated into the lidocaine gel group and the aqueous gel group at a 1:1 ratio. The intensity of pain during TRS based on the visual analogue scale (0-10 points) and the adverse events were assessed and compared between the two groups...
March 11, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28342378/elevated-triglyceride-levels-are-associated-with-cognitive-impairments-among-patients-with-major-depressive-disorder
#10
Tian Nan Shao, Guang Zhong Yin, Xiao Li Yin, Jing Qin Wu, Xiang Dong Du, Hong Liang Zhu, Jia Hong Liu, Xiao Qiong Wang, Dong Wu Xu, Wen Jie Tang, Li Hui
BACKGROUND: Cognitive deficits have been identified as one of core clinical symptoms of major depressive disorder (MDD). Accumulating evidence indicated that triglycerides (TG) might be associated with MDD and cognitive decline. OBJECTIVE: This study examined whether patients with MDD had poorer cognitive functions than healthy controls, and further investigate whether TG levels were involved in MDD, and its cognitive impairments in a Han Chinese population. METHOD: 115 patients with MDD and 119 healthy controls were enrolled...
March 14, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28339818/refining-success-of-cardiac-resynchronization-therapy-using-a-simple-score-predicting-the-amount-of-reverse-ventricular-remodelling-results-from-the-markers-and-response-to-crt-marc-study
#11
Alexander H Maass, Kevin Vernooy, Sofieke C Wijers, Jetske van 't Sant, Maarten J Cramer, Mathias Meine, Cornelis P Allaart, Frederik J De Lange, Frits W Prinzen, Bart Gerritse, Erna Erdtsieck, Coert O S Scheerder, Michael R S Hill, Marcoen Scholten, Mariëlle Kloosterman, Iris A H Ter Horst, Adriaan A Voors, Marc A Vos, Michiel Rienstra, Isabelle C Van Gelder
Aims: Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in systolic heart failure patients with ventricular conduction delay. Variability of individual response to CRT warrants improved patient selection. The Markers and Response to CRT (MARC) study was designed to investigate markers related to response to CRT. Methods and results: We prospectively studied the ability of 11 clinical, 11 electrocardiographic, 4 echocardiographic, and 16 blood biomarkers to predict CRT response in 240 patients...
February 27, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339771/implementing-patient-reported-outcome-surveys-as-part-of-routine-care-lessons-from-an-academic-radiation-oncology-department
#12
Lisa S Rotenstein, Ankit Agarwal, Kelly O'Neil, Andrea Kelly, Maureen Keaty, Colleen Whitehouse, Barbara Kalinowski, Peter F Orio, Neil Wagle, Neil E Martin
Patient reported outcomes (PROs) are reports of health conditions that come directly from patients. Use of PROs has been associated with improved patient outcomes, enhanced quality of life, and reduced end-of-life spending. Yet there are still outstanding questions regarding the process of implementing PRO collection in routine practice. In this article, we describe the experience of selecting and implementing PROs in a multisite, multidisease academic medical center-based radiation oncology practice and demonstrate that such large-scale rollout is feasible...
March 2, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339663/cardiac-involvement-in-granulomatosis-with-polyangiitis-a-magnetic-resonance-imaging-study-of-31-consecutive-patients
#13
Grégory Pugnet, Hervé Gouya, Xavier Puéchal, Benjamin Terrier, André Kahan, Paul Legmann, Loïc Guillevin, Olivier Vignaux
Objectives.: Specific cardiac involvement in granulomatosis with polyangiitis (GPA) is probably underestimated since many of these conditions are subclinical. The objective of this study was to assess the prevalence and patterns of cardiac abnormalities detected by cardiac MRI (CMRI) in patients with GPA. Methods.: Thirty-one consecutive patients with newly diagnosed or relapsing GPA underwent CMRI to assess morphological, functional, perfusion at rest and delayed enhancement abnormalities...
February 16, 2017: Rheumatology
https://www.readbyqxmd.com/read/28339449/reversal-of-progressive-conscious-disturbance-with-epidural-blood-patch-for-cerebrospinal-fluid-leakage-at-c2-level
#14
Yi-Chen Lai, Yuan-Yi Chia, Wei-Hung Lien
Intracranial hypotension syndrome (IHS) is generally caused by cerebrospinal fluid (CSF) leakage. Complications include bilateral subdural hygroma or haematoma and herniation of the cerebellar tonsils. Epidural blood patch (EBP) therapy is indicated if conservative treatment is ineffective. We reported the case of a 46-year-old man with a history of postural headache and dizziness. The patient was treated with bed rest and daily hydration with 2000 mL of fluid for 2 weeks. However, dizziness and headache did not resolve, and he became drowsy and disoriented with incomprehensible speech...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339403/dopamine-transporter-imaging-has-no-impact-on-functional-outcomes-in-de-novo-probable-parkinson-s-disease
#15
Patrick T Hickey, Maragatha Kuchibhatla, Burton Scott, Lisa Gauger, Mark A Stacy
BACKGROUND: Parkinson's disease (PD) is among the most prevalent neurodegenerative conditions. While motor and non-motor aspects of this disease have been well characterized, no objective biomarker exists to support an accurate clinical diagnosis. However, newer imaging techniques, including [123I]-FP-CIT (DaTSCAN), have demonstrated utility in differentiating between PD and non-neurodegenerative tremor disorders. OBJECTIVE: DaTSCAN has been primarily investigated in situations where diagnostic confusion exists, and in these instances has been shown to significantly impact clinical management...
March 20, 2017: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/28338851/do-not-resuscitate-orders-and-early-mortality-in-hip-fracture-patients
#16
Anouk E Simons, Julian Karres, Leontien M G Nijland, Jan M Ultee, Gino M M J Kerkhoffs, Bart C Vrouenraets
Background: factors affecting mortality after hip fracture surgery have been studied extensively. It has been suggested that do-not-resuscitate (DNR) orders are associated with higher mortality in surgical patients due to less aggressive treatment. However, the effect of DNR orders on mortality in hip fracture patients is unknown. The objective of this study was to investigate the effect of DNR orders on early mortality after hip fracture surgery. Methods: all patients undergoing hip fracture surgery between 2004 and 2015 were included in this retrospective study...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28338788/hypertension-and-atrial-fibrillation-an-intimate-association-of-epidemiology-pathophysiology-and-outcomes
#17
Mikhail S Dzeshka, Farhan Shahid, Alena Shantsila, Gregory Y H Lip
Atrial fibrillation (AF) is the most prevalent sustained arrhythmia found in clinical practice. AF rarely exists as a single entity but rather as part of a diverse clinical spectrum of cardiovascular diseases, related to structural and electrical remodeling within the left atrium, leading to AF onset, perpetuation, and progression. Due to the high overall prevalence within the AF population arterial hypertension plays a significant role in the pathogenesis of AF and its complications. Fibroblast proliferation, apoptosis of cardiomyocytes, gap junction remodeling, accumulation of collagen both in atrial and ventricular myocardium all accompany ageing-related structural remodeling with impact on electrical activity...
February 18, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28338592/open-abdomen-with-vacuum-assisted-wound-closure-and-mesh-mediated-fascial-traction-in-patients-with-complicated-diffuse-secondary-peritonitis-a-single-center-8-year-experience
#18
Matti Tolonen, Panu Mentula, Ville Sallinen, Suvi Rasilainen, Minna Bäcklund, Ari Leppäniemi
BACKGROUND: Open abdomen (OA) treatment in patients with peritonitis is increasing worldwide. Various temporary abdominal closure devices are being used. This study included patients with complicated diffuse secondary peritonitis, OA, and vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM). The aim of this study was to describe mortality and major morbidity in terms of delayed primary fascial closure (DPFC) and enteroatmospheric fistula rates. METHODS: This was a single academic center retrospective study of consecutive patients with diffuse peritonitis, OA, and VAWCM between years 2008-2016...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28338567/bevacizumab-therapy-for-pilomyxoid-astrocytoma
#19
Ryan D Metts, Walter Bartynski, Cynthia T Welsh, Stephen Kinsman, Amy-Lee Bredlau
Pilomyxoid astrocytoma is a rare tumor of the central nervous system generally found in young children near the hypothalamus. Herein, we report a 19-month-old female infant with a pilomyxoid astrocytoma, who underwent surgery as well as carboplatin and vincristine chemotherapy in an attempt to delay radiation therapy to the brain. Magnetic resonance imaging revealed that the tumor had increased in tumor volume on therapy. Chemotherapy with carboplatin and vincristine was stopped and bevacizumab therapy (10 mg/kg every other week) was initiated...
March 23, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28338553/consequences-of-hybrid-procedure-addition-to-robotic-assisted-direct-coronary-artery-bypass
#20
Feras Khaliel, Vincenzo Giambruno, Michael W A Chu, Kumar Sridhar, Patrick Teefy, Bob B Kiaii
OBJECTIVE: Patients postcoronary artery revascularization surgery often receives blood product transfusion, which could delay their intensive care unit and hospital discharge. We investigated our robotic-assisted direct coronary artery bypass (RADCAB) transfusion rate to determine whether performing the minimal invasive coronary surgery with percutaneous coronary intervention in one stage would increase the incidence of blood transfusion, morbidity, and length of stay. METHODS: Between November 2003 and November 2015, 483 consecutive patients underwent RADCAB surgery...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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