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https://www.readbyqxmd.com/read/28340494/postoperative-care-of-patients-with-high-grade-glioma-is-there-a-real-need-for-the-neurocritical-icu-and-early-ct-scan
#1
Roberto Altieri, Fabio Cofano, Alessandro Agnoletti, Riccardo Fornaro, Marco Ajello, Francesco Zenga, Alessandro Ducati, Diego Garbossa
Background Pressure on economic resources now requires a careful rationalization of services. For adult patients with supratentorial gliomas, there is no consensus on the real need for care in a postoperative neurocritical intensive care unit (NICU) and on the timing of a postsurgical computed tomography (CT) scan. In this retrospective nonrandomized study, we assessed if and when there is a real need for NICU and if an early CT scan could be justified in the absence of neurologic worsening. Methods Of 264 patients, 21 were admitted to the NICU after the procedure as planned before the surgery for their clinical features (Karnofsky performance status < 70, American Society of Anesthesiologists score > 2, or Charlson Comorbidity Index > 5)...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28340359/diabetic-foot-ulcer-development-risk-classifications-validation-a-multicentre-prospective-cohort-study
#2
M Monteiro-Soares, R Ribas, C Pereira da Silva, T Bral, A Mota, S Pinheiro Torres, A Morgado, R Couceiro, R Ribeiro, V Dias, M Moreira, P Mourão, M J Oliveira, M Madureira, V Paixão-Dias, M Dinis-Ribeiro
AIMS: To prospectively validate the existing classifications to stratify subjects with diabetes mellitus (DM) by their risk of diabetic foot ulcer (DFU), in high and low risk settings. METHODS: A prospective multicentre cohort study was conducted, including 446 subjects with DM without active DFU followed in the hospital or primary care setting. Demographic, clinical characterization variables, and those included in the classifications were collected at baseline...
March 9, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28340257/cd8-positive-t-cell-leukoencephalitis-with-astrocytopathy-clinically-presenting-as-neuromyelitis-optica
#3
Diana L Thomas, Jody Manners, Daniel Marker, Joseph Mettenburg, Geoffrey Murdoch, Bryan Stevens, Guoji Wang, Clayton Wiley
We describe a novel disease entity with the clinical and radiologic presentation of neuromyelitis optica (NMO) and widespread CD8-positive T-cell leukoencephalitis and astrocytopathy. The 59-year-old female patient had a complex 2-year neurological history that included early changes in cognition and memory, progressive lower extremity motor dysfunction, and multimodal sensory involvement. MRI of the spinal cord showed increased T2 signal in the central cord extending from C2 through T4. MRI of the brain showed symmetric radial enhancement in periventricular deep white matter without evidence of demyelinating lesions...
March 16, 2017: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/28340227/transplant-as-a-competing-risk-in-the-analysis-of-dialysis-patients
#4
Nan van Geloven, Saskia le Cessie, Friedo W Dekker, Hein Putter
Time-to-event analyses are frequently used in nephrology research, for instance, when recording time to death or time to peritonitis in dialysis patients. Many papers have pointed out the important issue of competing events (or competing risks) in such analyses. For example, when studying one particular cause of death it can be noted that patients also die from other causes. Such competing events preclude the event of interest from occurring and thereby complicate the statistical analysis. The Kaplan-Meier approach to calculating the cumulative probability of the event of interest yields invalid results in the presence of competing risks, thus the alternative cumulative incidence competing risk (CICR) approach has become the standard...
March 3, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28340158/maintenance-therapy-is-associated-with-better-long-term-outcomes-in-adult-patients-with-primary-angiitis-of-the-central-nervous-system
#5
Hubert de Boysson, Jean-Jacques Parienti, Caroline Arquizan, Grégoire Boulouis, Nicolas Gaillard, Alexis Régent, Antoine Néel, Olivier Detante, Emanuel Touzé, Achille Aouba, Boris Bienvenu, Loïc Guillevin, Olivier Naggara, Mathieu Zuber, Christian Pagnoux
Objective.: We aimed to analyse the effect of maintenance therapy after induction on the outcomes of adult patients with primary angiitis of the CNS (PACNS). Methods.: We analysed long-term outcomes (relapse, survival and functional status) of patients enrolled in the French multicentre PACNS cohort who achieved remission after induction treatment and with ⩾12 months' follow-up, according to whether or not they received maintenance therapy. Good outcome was defined as relapse-free survival and good functional status (modified Rankin scale ⩽ 2) at last follow-up...
March 17, 2017: Rheumatology
https://www.readbyqxmd.com/read/28340112/long-term-mortality-of-patients-with-an-alcohol-related-wernicke-korsakoff-syndrome
#6
Arantza Sanvisens, Paola Zuluaga, Daniel Fuster, Inmaculada Rivas, Jordi Tor, Miguel Marcos, Antonio J Chamorro, Roberto Muga
Aims: To characterize a series of contemporary patients with alcohol-related Wernicke's encephalopathy (WE) or Korsakoff's syndrome (KS) and to update the current prognosis of disease. Methods: Retrospective and prospective study of patients diagnosed with an alcohol-related WE or KS between 2002 and 2011 in a tertiary hospital. Socio-demographic, alcohol use characteristics, signs and symptoms, co-morbidity and blood parameters were obtained at admission. Patients were followed up until 2013 and causes of death were ascertained through the review of charts...
March 10, 2017: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/28340060/physician-dispensing-of-oxycodone-and-other-commonly-used-opioids-2000-2015-united-states
#7
Karin Ann Mack, Christopher McCall Jones, Roderick John McClure
Objective.:  An average of 91 people in the United States die every day from an opioid-related overdose (including prescription opioids and heroin). The direct dispensing of opioids from health care practitioner offices has been linked to opioid-related harms. The objective of this study is to describe the changing nature of the volume of this type of prescribing at the state level. Methods.:  This descriptive study examines the distribution of opioids by practitioners using 1999-2015 Automation of Reports and Consolidated Orders System data...
March 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340014/association-between-right-ventricular-lead-position-and-clinical-outcomes-in-patients-with-cardiac-resynchronization-therapy
#8
Mads Brix Kronborg, Jens Brock Johansen, Sam Riahi, Helen Hoegh Petersen, Jens Haarbo, Ole Dan Jørgensen, Jens Cosedis Nielsen
Aims: To evaluate the association between an apical vs. non-apical right ventricular lead position (RV-LP) and clinical outcome in a large nationwide cohort of patients treated with cardiac resynchronization therapy (CRT). Methods and results: We included consecutive Danish patients receiving a CRT device from 2008 to 2012, identified from the Danish Pacemaker and ICD Register. Endpoints were mortality, mortality or hospitalization for heart failure (HF), and clinical response (improvement ≥1 New York Heart Association class at follow-up)...
March 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339910/rituximab-and-hepatitis-b-reactivation-in-hbsag-negative-anti-hbc-positive-kidney-transplant-recipients
#9
Juhan Lee, Jun Yong Park, Kyu Ha Huh, Beom Seok Kim, Myoung Soo Kim, Soon Il Kim, Hoon Sang Ahn, Yu Seun Kim
Background.: Hepatitis B virus (HBV) reactivation is a well-known complication of immunosuppressive therapy. Although rituximab is increasingly used for desensitization of ABO-incompatible or positive crossmatch kidney transplantation, the risk of HBV reactivation in hepatitis B surface antigen (HBsAg)-negative/hepatitis B core antibody (anti-HBc)-positive kidney transplant patients receiving rituximab desensitization remains undetermined. Methods.: We analysed 172 resolved HBV patients who underwent living donor kidney transplantation between 2008 and 2014...
February 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339886/optimal-method-of-measuring-the-t-peak-to-t-end-interval-for-risk-stratification-in-primary-prevention
#10
Todd M Rosenthal, Daniel Masvidal, Freddy M Abi Samra, Michael L Bernard, Sammy Khatib, Glenn M Polin, Paul A Rogers, Joel Q Xue, Daniel P Morin
Aims: Several published investigations demonstrated that a longer T-peak to T-end interval (Tpe) implies increased risk for ventricular tachyarrhythmia (VT/VF) and mortality. Tpe has been measured using diverse methods. We aimed to determine the optimal Tpe measurement method for screening purposes. Methods and results: We evaluated 305 patients with LVEF ≤ 35% and an implantable cardioverter-defibrillator implanted for primary prevention. Tpe was measured using seven different methods described in the literature, including six manual methods and the automated algorithm '12SL', and was corrected for heart rate...
February 27, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339838/the-clinical-epidemiology-of-young-adults-starting-renal-replacement-therapy-in-the-uk-presentation-management-and-survival-using-15-years-of-uk-renal-registry-data
#11
Alexander J Hamilton, Anna Casula, Yoav Ben-Shlomo, Fergus J Caskey, Carol D Inward
Background: Clinical epidemiology data for young adults on renal replacement therapy (RRT) are lacking. While mostly transplanted, they have an increased risk of graft loss during young adulthood. Methods: We combined the UK Renal Registry paediatric and adult databases to describe patient characteristics, transplantation and survival for young adults. We grouped patients 11-30 years of age starting RRT from 1999 to 2008 by age band and examined their course during 5 years of follow-up...
February 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339763/long-term-care-is-increasingly-concentrated-in-the-last-years-of-life-a-change-from-2000-to-2011
#12
Leena Forma, Mari Aaltonen, Jutta Pulkki, Jani Raitanen, Pekka Rissanen, Marja Jylhä
The use of long-term care (LTC) is common in very old age and in the last years of life. It is not known how the use pattern is changing as death is being postponed to increasingly old age. The aim is to analyze the association between the use of LTC and approaching death among old people and the change in this association from 2000 to 2011. The data were derived from national registers. The study population consists of 315 458 case-control pairs. Cases (decedents) were those who died between 2000 and 2011 at the age of 70 years or over in Finland...
February 23, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28339702/subclinical-chronic-left-ventricular-systolic-dysfunction-resulting-from-phosphine-poisoning
#13
E Szymczyk, M Wiszniewska, J Walusiak-Skorupa, J D Kasprzak, P Lipiec
We present a case of a 32-year-old male crew member of a cargo ship, accidentally exposed to phosphine, a fumigating substance. He and other crew members developed increasing fatigue and digestive disorders 24 h later; two died from acute pulmonary oedema. The patient was admitted to hospital, where bilateral pneumonia, acute nephritis, hepatopathy, electrolyte imbalance and leucopenia were diagnosed. He was discharged from hospital 3 weeks later. He was examined 4 months later for possible chronic consequences of acute phosphine poisoning, which included echocardiography showing normal heart size and cardiac function...
February 21, 2017: Occupational Medicine
https://www.readbyqxmd.com/read/28339633/osmotic-indices-and-kidney-concentrating-activity-population-based-data-on-correlates-and-prognostic-power
#14
Massimo Cirillo, Giancarlo Bilancio, Cinzia Lombardi, Pierpaolo Cavallo, Oscar Terradura Vagnarelli, Alberto Zanchetti, Martino Laurenzi
Background.: Research data are limited on indices of osmotic equilibrium and of kidney concentrating activity (KCA). This study investigated correlates and prognostic power of these indices in a sample of the general population. Methods.: Urine osmolality (U-osm), plasma osmolality (P-osm), plasma creatinine and other variables were measured by the Gubbio Study for the 1988-92 exam (baseline). Plasma creatinine and other variables were re-measured in the 2001-07 exam (follow-up)...
February 4, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339474/a-decrease-in-intact-parathyroid-hormone-ipth-levels-is-associated-with-higher-mortality-in-prevalent-hemodialysis-patients
#15
Ricardo Villa-Bellosta, Laura Rodriguez-Osorio, Sebastian Mas, Younes Abadi, Mercedes Rubert, Concepción de la Piedra, Carolina Gracia-Iguacel, Ignacio Mahillo, Alberto Ortiz, Jesús Egido, Emilio González-Parra
BACKGROUND: The mortality of dialysis patients is 10- to 100-fold higher than in the general population. Baseline serum PTH levels, and more recently, changes in serum PTH levels (ΔPTH) over time, have been associated to mortality in dialysis patients. METHODS: We explored the relationship between ΔPTH over 1 year with mortality over the next year in a prospective cohort of 115 prevalent hemodialysis patients from a single center that had median baseline iPTH levels within guideline recommendations...
2017: PloS One
https://www.readbyqxmd.com/read/28339402/outcomes-of-hospitalised-muscular-dystrophy-patients
#16
Ghilas Boussaid, Hélène Prigent, Gilbert Caranhac, Djillali Annane, Christian Devaux, David Orlikowski, Frédéric Lofaso
BACKGROUND: In France, referral centres in teaching hospitals were created 10 years ago to provide MD patients with treatments and follow-up designed to prevent complications and improve outcomes. Respiratory failure is a major cause of death among subjects with MD, and its prevention and treatment can serve as a touchstone for assessing the effectiveness of MD care pathways. OBJECTIVE: We report data from a preliminary study of admissions of MD patients in France and of factors associated with mortality, with special emphasis on respiratory failure [RF]...
March 20, 2017: Journal of Neuromuscular Diseases
https://www.readbyqxmd.com/read/28339346/the-caregiver-and-her-friends
#17
Elana Dykewomon
This article is a personal essay about the lesbian friendship networks called upon when a dyke has to take on caregiving responsibilities for her dying mother and, especially, her partner who develops dementia and dies. The primary areas of concern are how friendships form a community's ethical base, the navigation of overlapping friendship networks, the different ways women come through, and the role our institutions play in creating "friendliness." Underpinning these concerns is the way that lesbians create informal groups to investigate, inform, and affirm difficult decisions...
March 24, 2017: Journal of Lesbian Studies
https://www.readbyqxmd.com/read/28338978/isotope-signals-and-anatomical-features-in-tree-rings-suggest-a-role-for-hydraulic-strategies-in-diffuse-drought-induced-die-back-of-pinus-nigra
#18
Laura Petrucco, Andrea Nardini, Georg von Arx, Matthias Saurer, Paolo Cherubini
The 2003 and 2012 summer seasons were among the warmest and driest of the last 200 years over southeastern Europe, and in particular in the Karst region (northeastern Italy). Starting from winter-spring 2013, several black pines (Pinus nigra J.F. Arnold) suffered crown die-back. Declining trees occurred nearby individuals with no signs of die-back, raising hypotheses about the occurrence of individual-specific hydraulic strategies underlying different responses to extreme drought. We investigated possible processes driving black pine decline by dendrochronological and wood anatomical measurements, coupled with analysis of tree-ring carbon (δ13C) and oxygen (δ18O) isotopic composition in healthy trees (H) and trees suffering die-back (D)...
March 17, 2017: Tree Physiology
https://www.readbyqxmd.com/read/28338808/the-relationship-between-cognitive-impairment-mortality-and-discharge-characteristics-in-a-large-cohort-of-older-adults-with-unscheduled-admissions-to-an-acute-hospital-a-retrospective-observational-study
#19
Carole Fogg, Paul Meredith, Jackie Bridges, Gill P Gould, Peter Griffiths
Background: older people with dementia admitted to hospital for acute illness have higher mortality and longer hospital stays compared to those without dementia. Cognitive impairment (CI) is common in older people, and they may also be at increased risk of poor outcomes. Methods: retrospective observational study of unscheduled admissions aged ≥75 years. Admission characteristics, mortality rates and discharge outcomes were compared between three groups: (i) known dementia diagnosis (DD), (ii) CI but no diagnosis of dementia and (iii) no CI...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28338652/3q26-2-evi1-rearrangement-is-associated-with-poor-prognosis-in-classical-philadelphia-chromosome-negative-myeloproliferative-neoplasms
#20
Zhihong Hu, L Jeffrey Medeiros, Wei Wang, Zi Chen, Guilin Tang, Parsa Hodjat, Su Yang, Lianghua Fang, Yan Li, Srdan Verstovsek, Shimin Hu
Classical Philadelphia chromosome-negative myeloproliferative neoplasms are a group of closely related myeloid disorders with different histologic features and clinical presentations at an early stage, but all later develop into a similar fibrotic stage with variable risk of acute transformation. The significance of 3q26.2/EVI1 rearrangement has been well recognized in acute myeloid leukemia, myelodysplastic syndrome, and chronic myeloid leukemia. However, the clinical importance of 3q26.2/EVI1 rearrangement in classical Philadelphia chromosome-negative myeloproliferative neoplasms is unknown...
March 24, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
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