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Patient delay

Gaby Aphram, Laurent De Kerchove, Stefano Mastrobuoni, Emiliano Navarra, Silvia Solari, Saadallah Tamer, Jerome Baert, Alain Poncelet, Jean Rubay, Parla Astarci, Philippe Noirhomme, Gebrine El Khoury
OBJECTIVES: Mitral valve (MV) repair is the gold standard for treatment of degenerative mitral regurgitation. A variety of surgical techniques allow surgeons to achieve a high rate of MV repair even with MV diseases of other aetiologies. However, a certain number of repairs fail over time. The aim of this study was to review our single-centre experience of MV re-repair and analyse the mode of repair failure, re-repair safety and efficiency in relation to the initial aetiology. METHODS: Between 1997 and 2015, 91 patients underwent redo MV re-repair...
March 14, 2018: European Journal of Cardio-thoracic Surgery
Zahraa Haidar, Nadine Jalkh, Sandra Corbani, Ali Fawaz, Eliane Chouery, André Mégarbané
Pyridoxine dependent epilepsy (PDE) is a rare autosomal recessive neurometabolic disorder. In the classical form, seizures are observed within the first month of life, while in the atypical form seizures appear later in life, sometimes as late as at the age of 3 years of life. Both types are unresponsive to conventional anticonvulsant therapy, but can be controlled with pyridoxine monotherapy. Mutations in the ALDH7A1 gene, encoding α-aminoadipic semialdehyde dehydrogenase have been reported to cause this disease in most patients...
March 10, 2018: Seizure: the Journal of the British Epilepsy Association
Barbara J Wilson, Laura J Zitella, Colleen H Erb, Jackie Foster, Mary Peterson, Sylvia K Wood
BACKGROUND: Cancer-related infections lead to increases in mortality, antibiotic use, and hospital stays. Other adverse outcomes include dose delays and reductions, which can result in suboptimal treatment outcomes. OBJECTIVES: Effective implementation of risk assessment and evidence-based interventions for the prevention and treatment of infection are essential to improve care and reduce costs related to infections in patients with cancer receiving immunosuppressive therapy...
April 1, 2018: Clinical Journal of Oncology Nursing
Meghan Mastrangelo
BACKGROUND: Cisplatin-based chemotherapy regimens are the backbone of chemotherapy for germ cell testicular cancer. Cisplatin is administered for five days, causing an overlap of acute and delayed chemotherapy-induced nausea and vomiting (CINV). Although CINV is widely researched, studies involving multiday chemotherapy regimens are limited. OBJECTIVES: This article synthesizes the research in antiemetics used in multiday cisplatin-based chemotherapy regimens and provides recommendations to optimize antiemetic therapy...
April 1, 2018: Clinical Journal of Oncology Nursing
Varun Chandra, Danielle Buck, Rahul Chakrabarti, Alan McNab
A 24-year-old woman presented with a 1-year history of gradually increasing pain on eye movements, worse on the right. She had a significant background of undergoing intracranial correction of orbital hypertelorism with internal fixation of the lateral orbital rims at the age of 6 years. Imaging was consistent with bilateral metallic foreign bodies from both lateral orbital rims protruding into the globes. The patient underwent removal of bilateral plates and screws, with a significant improvement of symptoms and ocular motility postoperatively...
March 14, 2018: Ophthalmic Plastic and Reconstructive Surgery
Vinayak Narayan, Hima Pendharkar, Bhagavatula Indira Devi, Dhananjaya I Bhat, Dhaval P Shukla
Background: The conventional medical management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is associated with uncertainty of outcome and complications. Aims and Objectives: To examine the effect of direct intra-arterial nimodipine therapy on outcome in patients with delayed cerebral ischemia (DCI). Settings and Design: The retrospective observational study was conducted at a single neurosurgical unit and interventional neuroradiolgy suite of a center managing SAH...
March 2018: Neurology India
Nishant Patel, Jeffrey Forris Beecham Chick, Joseph J Gemmete, Jordan C Castle, Narasimham Dasika, Wael E Saad, Ravi N Srinivasa
OBJECTIVE: The objective of our study was to report the technique, complications, and clinical outcomes of interventional radiology-operated cholecystoscopy with stone removal for the management of symptomatic cholelithiasis. MATERIALS AND METHODS: Ten (77%) men and three (23%) women (mean age, 65 years) with symptomatic cholelithiasis underwent cholecystostomy followed by interventional radiology-operated cholecystoscopy with stone removal. Major comorbidities precluding cholecystectomy included prior cardiac, pulmonary, or abdominal surgery; cirrhosis; sepsis with hyponatremia; seizure disorder; developmental delay; and cholecystoduodenal fistula...
March 16, 2018: AJR. American Journal of Roentgenology
L B Amsden, P T Davidson, H B Fevrier, R Goldfien, L J Herrinton
Purpose To better understand diagnostic delay and doctor-patient communication during the diagnosis of systemic lupus erythematous in patients without malar rash, we conducted a qualitative study of primary care providers' perceptions. Methods We conducted in-depth interviews with a purposive sample of eight primary care physicians in Kaiser Permanente Northern California. Telephone interviews were recorded, transcribed, reviewed, and coded for domains and themes. Results We identified five domains related to diagnosis: initial assessment and tests, initial diagnosis and empiric treatment, timeliness of diagnosis, communicating with the patient, and opportunities for improvement...
January 1, 2018: Lupus
Ye Seul Yang, Min Hyuk Lim, Seong Ok Lee, Eun Roh, Chang Ho Ahn, Soo Heon Kwak, Young Min Cho, Sungwan Kim, Andrea Mari, Kyong Soo Park, Hye Seung Jung
AIMS: Angiotensin receptor blockers (ARB) are anti-hypertensive drugs with renal protective effect. Additionally, they have been associated with the delayed onset of type 2 diabetes in high-risk populations, and some ARB were reported to increase insulin secretion and sensitivity in patients with prediabetes. Therefore, we studied the effects of ARB on insulin secretion in hypertensive patients with type 2 diabetes. MATERIALS AND METHODS: Forty-one patients were enrolled in this open-labeled, active comparator-controlled and crossover study...
March 15, 2018: Diabetes, Obesity & Metabolism
Sonam Puri, Kelly A Hyland, Kristine Crowe Weiss, Gillian C Bell, Jhanelle E Gray, Richard Kim, Hui-Yi Lin, Aasha I Hoogland, Brian D Gonzalez, Ashley M Nelson, Anita Y Kinney, Stacy M Fischer, Daneng Li, Paul B Jacobsen, Howard L McLeod, Heather S L Jim
PURPOSE: Chemotherapy-induced nausea and vomiting (CINV) is common among cancer patients. Early identification of patients at risk for CINV may help to personalize anti-emetic therapies. To date, few studies have examined the combined contributions of patient-reported and genetic risk factors to CINV. The goal of this study was to evaluate these risk factors. METHODS: Prior to their first chemotherapy infusion, participants completed demographic and risk factor questionnaires and provided a blood sample to measure genetic variants in ABCB1 (rs1045642) and HTR3B (rs45460698) as well as CYP2D6 activity score...
March 15, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Taran S Sangari, Timothy W Martin
No abstract text is available yet for this article.
March 12, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
M Irani, N Zaninovic, C Canon, C O'Neill, V Gunnala, Q Zhan, G Palermo, D Reichman, Z Rosenwaks
STUDY QUESTION: Is there a benefit to assessing ploidy in delayed embryos reaching the morula stage on Day 6 of development? SUMMARY ANSWER: Day-6 morulae should be considered for biopsy in women <40 years old undergoing preimplantation genetic testing for aneuploidy (PGT-A) because they are associated with acceptable, albeit reduced, euploidy and implantation rates (IRs). WHAT IS KNOWN ALREADY: Embryo development and morphology have been shown to correlate with aneuploidy and pregnancy rates...
March 13, 2018: Human Reproduction
Fatimah Alnafisah, Shaimaa K Dawa, Sherif Alalfy
Cutaneous endometriosis is one of the rare gynecological conditions. Endometriosis is defined as the presence of endometrial glands and stroma outside the endometrial cavity. It commonly occurs in pelvic sites, such as the ovaries, cul-de-sac, bowel, or pelvic peritoneum. Endometriosis at the incisional scar is difficult to diagnose because of nonspecific symptoms. Usually, patients complain of pain at the site of the incision during menstruation. The main causes in most of the reported cases are obstetrical and gynecological surgeries...
January 13, 2018: Curēus
Aldo Berti, Michelle Granville, Robert E Jacobson
A case of an extremely healthy, active, 96-year-old patient, nonsmoker, is reviewed. He was initially treated for left V1, V2, and V3 trigeminal neuralgia in 2001, at age 80, with stereotactic radiosurgery (SRS) with a dose of 80 Gy to the left retrogasserian trigeminal nerve. He remained asymptomatic for nine years until his trigeminal pain recurred in 2010. He was first treated medically but was intolerant to increasing doses of carbamazepine and gabapentin. He underwent a second SRS in 2012 with a dose of 65...
January 12, 2018: Curēus
Maria Sunseri, Tania Ahuja, Tanya Wilcox, David Green
Unfractionated heparin and low-molecular-weight heparins are commonly used as thromboprophylaxis for hospitalized patients. Though generally considered safe at prophylactic doses, cases of catastrophic hemorrhage have been reported. The proposed mechanism involves bioaccumulation of heparin through saturation of the rapid-elimination pathway in its metabolism. We present an unusual case of an average-weight man with metastatic melanoma who suffered hemorrhage with syncope and end-organ damage while on prophylactic three times daily unfractionated heparin...
2018: Case Reports in Hematology
Barbara Pascucci, Alessandra Fragale, Veronica Marabitti, Giuseppe Leuzzi, Angelo Salvatore Calcagnile, Eleonora Parlanti, Annapaola Franchitto, Eugenia Dogliotti, Mariarosaria D'Errico
CS proteins have been involved in the repair of a wide variety of DNA lesions. Here, we analyse the role of CS proteins in DNA break repair by studying histone H2AX phosphorylation in different cell cycle phases and DNA break repair by comet assay in CS-A and CS-B primary and transformed cells. Following methyl methane sulphate treatment a significant accumulation of unrepaired single strand breaks was detected in CS cells as compared to normal cells, leading to accumulation of double strand breaks in S and G2 phases...
February 20, 2018: Oncotarget
Lu Xie, Wei Guo, Yi Yang, Tao Ji, Jie Xu
5,10-Methylenetrahydrofolate reductase (MTHFR), a key enzyme for folate metabolism, catalyses the irreversible conversion of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate, which is located at the end of the short arm (1p36.3). Two common non-synonymous variants, the C677T (Ala222Val) and A1298C (Glu429Ala), were mainly described with decreased enzymatic activity and an alteration of intracellular folate distribution. Osteosarcomas are currently treated with high dose of methotrexate (MTX). The decreased enzyme activity of MTHFR theoretically could increase the drug action of MTX and at the same time increase toxic and side effect...
February 20, 2018: Oncotarget
Christelle Retière, Catherine Willem, Thierry Guillaume, Henri Vié, Laetitia Gautreau-Rolland, Emmanuel Scotet, Xavier Saulquin, Katia Gagne, Marie C Béné, Berthe-Marie Imbert, Beatrice Clemenceau, Pierre Peterlin, Alice Garnier, Patrice Chevallier
We have compared prospectively the outcome and immune reconstitution of patients receiving either post-transplant cyclophosphamide (PTCY) ( n = 30) or anti-thymocyte globulin ATG ( n = 15) as Graft-versus-host disease (GVHD) prophylaxis after reduced-intensity conditioning (RIC) allogeneic peripheral blood stem cell (PBSC) transplantation (allo-SCT). The outcome and immune reconstitution of patients receiving either of these two regimens were compared prospectively. This study allowed also to investigate the impact of PTCY between haplo-identical vs matched donors and of clofarabine as part of the RIC regimen...
February 20, 2018: Oncotarget
Dexin Zou, Junlin Zhou, Xiaobing Jiang
Tuberculosis combined with brucellosis is a very rare condition. Overlapping clinical presentation and laboratory parameters of tuberculosis and brucellosis may lead to misdiagnosis or delayed diagnosis of the condition. The current study presents the case of a 45-year-old male with symptoms of lower back pain, non-tender swelling in the right flank, intermittent hyperpyrexia, sweating, body aches and numbness and weakness of right lower limb. A lumbar computed tomograph (CT) scan and magnetic resonance imaging indicated vertebral destruction and the formation of sequestra and thecal sac compression...
April 2018: Experimental and Therapeutic Medicine
Jaime S Rosa, Van B Vuong, Orly Haskin, Anne Y Liu
Background: Recombinant human erythropoietin, such as epoetin alfa and darbepoetin alfa, is an important therapy for anemia due to chronic renal failure. Allergy to recombinant human erythropoietin and the need for desensitization are rare. Case presentation: We report here a novel epoetin alfa outpatient desensitization protocol in a girl who developed delayed cutaneous hypersensitivity to subcutaneous epoetin alfa and intravenous darbepoetin alfa. An initial attempt at traditional epoetin alfa desensitization failed, so we created a slower 17-day outpatient desensitization that succeeded and allowed treatment continuation...
2018: Allergy, Asthma, and Clinical Immunology
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