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https://www.readbyqxmd.com/read/27936449/methotrexate-treated-ectopic-pregnancy-beta-human-chorionic-gonadotropin-serum-changes-as-a-success-predictor-using-a-mathematical-model-validation
#1
Aleksandra Kovaleva, Natalia Irishina, Augusto Pereira, Tatiana Cuesta-Guardiola, Luis Ortiz-Quintana
BACKGROUND: Surgical rescue of methotrexate-treated ectopic pregnancy is necessary when tubal rupture or medical therapy failure is detected during post-therapeutic monitoring. It is known that an increased beta human chorionic gonadotropin (β-hCG) concentration is the most important factor associated with treatment failure. Therefore, we suggested that relative changes in serum β-hCG could predict a successful result of medical treatment, leading to facilitation of the decision to forgo the prospect of possible surgical rescue...
October 27, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27935925/clinical-evaluation-of-fused-ankylosed-hip-with-severe-flexion-deformity-after-conversion-to-total-hip-arthroplasty
#2
S K Suwal, P Songming, L Gang, H Kui
INTRODUCTION: Fused or Ankylosed hip is late complication of chronic inflammatory disorder with progressive changes in and around articular as well as periarticular structures with alteration in bio-force line of body which later lead to severe flexion deformity of joint. This not only results decreased movements of hip, it's also increase pain around the hip, back and contralateral hip. METHODS: Retrospectively, all patients aged 18 years or older undergoing THA between June 2006 to June 2012 were reviewed with selection criteria...
April 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/27935890/-surgical-prevention-of-ischaemic-strokes-by-means-of-an-extraintracranial-microanastomosis-eicma-in-the-carotid-basin
#3
V V Krylov, V A Luk'yanchikov, A S Tokarev, O Yu Nakhabin, N A Polunina, I V Sen'ko, V A Dalibaldyan, E V Grigor'eva, N E Kudryashova, G K Guseinova, E V Udodov, T A Fedulova
BACKGROUND: Not less than 50% of all ischaemic strokes appear to occur resulting from pathology of extracranial arteries. Occlusions and stenoses are more commonly encountered in carotid arteries, with the incidence of occlusion of the internal carotid artery (ICA) ranging from 5 to 10% within the structure of all lesions of brachiocephalic arteries (BCA). AIM: The study was aimed at assessing the results of a surgical procedure of extra-intracranial microanastomosis (EICMA) performed in patients presenting with occlusive and stenotic lesions of BCA at the Neurosurgical Department...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27935782/wet-or-dry-a-review-of-intravenous-fluid-administration-in-anesthesia-practice
#4
Matthew D'Angelo, R Kyle Hodgen
Fluid therapy has dramatically changed since its early inception nearly 200 years ago. Administration of intravenous fluid (IVF) has evolved from a "drip" technique to the algorithmic approach of the anesthetic fluid plan, and is now moving toward Goal-Directed Fluid Therapy. As the science and culture of fluid management evolves, anesthetists must remain focused on "why" anesthetic fluid matters. The purpose of IVF administration is to support tissue perfusion and maintain euvolemia. As the evidence underlying perioperative practice matures and the science of anesthesia races to meet the evolving demands of surgery, anesthetists must align knowledge generation with the individualized needs of the patient...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27935741/barriers-to-evidence-based-physician-decision-making-at-the-point-of-care-a-narrative-literature-review
#5
Kara Contreary, Anna Collins, Eugene C Rich
We conduct a narrative literature review using four real-world cases of clinical decisions to show how barriers to the use of evidence-based medicine affect physician decision-making at the point of care, and where adjustments could be made in the healthcare system to address these barriers. Our four cases constitute decisions typical of the types physicians make on a regular basis: diagnostic testing, initial treatment and treatment monitoring. To shed light on opportunities to improve patient care while reducing costs, we focus on barriers that could be addressed through changes to policy and/or practice at a particular level of the healthcare system...
December 9, 2016: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/27935727/how-to-write-a-health-policy-brief
#6
Shale L Wong, Larry A Green, Andrew W Bazemore, Benjamin F Miller
Although many health care professionals are interested in health policy, relatively few have training in how to utilize their clinical experience and scientific knowledge to impact policy. Developing a policy brief is one approach that health professionals may use to draw attention to important evidence that relates to policy. This article offers guidance on how to write a policy brief by outlining 4 steps: (a) define the problem, (b) state the policy, (c) make your case, and (d) discuss the impact. The steps and tips offer a starting point for health care professionals interested in health policy and translating research or clinical experience to impact policy...
December 1, 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/27935547/flap-design-and-perfusion-are-keys-of%C3%A2-success-axial-fasciocutaneous-posterior-thigh-flaps-for-deep-small-pelvic-defect-reconstruction
#7
Andreas Kehrer, Philipp Lamby, Benjamin H Miranda, Lukas Prantl, Juergen H Dolderer
BACKGROUND AND OBJECTIVES: Radical excisions of the rectum often result in large perineal and intrapelvic defects. Compromised wound healing can delay adjuvant therapies and limit the patient's prognosis. With current treatment, integrity of the abdominal wall may be maintained. The defect geometry is unique and requires extensive volume for reconstruction. This study describes the surgical technique and reports clinical outcomes of fasciocutaneous posterior thigh flaps as preliminary data for this indication...
December 8, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27935083/endometrial-cancer-risk-prediction-including-serum-based-biomarkers-results-from-the-epic-cohort
#8
Renée T Fortner, Anika Hüsing, Tilman Kühn, Meric Konar, Kim Overvad, Anne Tjønneland, Louise Hansen, Marie-Christine Boutron-Ruault, Gianluca Severi, Agnès Fournier, Heiner Boeing, Antonia Trichopoulou, Vasiliki Benetou, Philippos Orfanos, Giovanna Masala, Claudia Agnoli, Amalia Mattiello, Rosario Tumino, Carlotta Sacerdote, H B As Bueno-de-Mesquita, Petra H M Peeters, Elisabete Weiderpass, Inger T Gram, Oxana Gavrilyuk, J Ramón Quirós, José Maria Huerta, Eva Ardanaz, Nerea Larrañaga, Leila Lujan-Barroso, Emilio Sánchez-Cantalejo, Salma Tunå Butt, Signe Borgquist, Annika Idahl, Eva Lundin, Kay-Tee Khaw, Naomi E Allen, Sabina Rinaldi, Laure Dossus, Marc Gunter, Melissa A Merritt, Ioanna Tzoulaki, Elio Riboli, Rudolf Kaaks
Endometrial cancer risk prediction models including lifestyle, anthropometric, and reproductive factors have limited discrimination. Adding biomarker data to these models may improve predictive capacity; to our knowledge, this has not been investigated for endometrial cancer. Using a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, we investigated the improvement in discrimination gained by adding serum biomarker concentrations to risk estimates derived from an existing risk prediction model based on epidemiologic factors...
December 9, 2016: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/27934566/the-legal-ethical-backbone-of-conscientious-refusal
#9
Christian Munthe, Morten Ebbe Juul Nielsen
This article analyzes the idea of a legal right to conscientious refusal for healthcare professionals from a basic legal ethical standpoint, using refusal to perform tasks related to legal abortion (in cases of voluntary employment) as a case in point. The idea of a legal right to conscientious refusal is distinguished from ideas regarding moral rights or reasons related to conscientious refusal, and none of the latter are found to support the notion of a legal right. Reasons for allowing some sort of room for conscientious refusal for healthcare professionals based on the importance of cultural identity and the fostering of a critical atmosphere might provide some support, if no countervailing factors apply...
January 2017: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/27934559/recurrent-nephrotic-syndrome-after-renal-transplant-in-children
#10
Bassam Saeed, Huda Mazloum
OBJECTIVES: Recurrent disease occurs in around 30% of children transplanted for steroid-resistant nephrotic syndrome. Its precipitating risk factors have rarely been studied in the Middle East. The aim of our study was to determine what characterizes posttransplant recurrence of nephrotic syndrome in Syrian children. MATERIALS AND METHODS: We performed a retrospective analysis of 12 nephrotic children who received 1 renal allograft at the Kidney Hospital in Damascus from 2002 to 2013...
December 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27934330/matrix-isolation-infrared-and-ab-initio-study-of-the-interaction-of-n-heterocyclic-carbene-with-water-and-methanol-a-case-study-of-a-strong-hydrogen-bond
#11
Akshay H Raut, Ginny Karir, K S Viswanathan
This study reports, for the first time, the experimental study of the hydrogen-bonded complexes of H2O and MeOH with 1,3-dimethylimidazol-2-ylidene, which is a dimethyl-substituted N-heterocyclic carbene, using matrix isolation infrared spectroscopy. The hydrogen bond was found to be established between the carbene carbon and the hydrogen in the O-H group of H2O or MeOH. The hydrogen-bonded complexes of N-heterocyclic carbenes are significantly stronger than many conventional hydrogen-bonded systems, as is evidenced by the large red shifts observed in the infrared frequencies of complexed H2O and MeOH...
December 1, 2016: Journal of Physical Chemistry. A
https://www.readbyqxmd.com/read/27933734/improved-quality-of-life-in-asthma-patients-under-long-term-therapy-assessed-by-ahq-japan
#12
Yuji Tohda, Takashi Iwanaga, Hiroyuki Sano, Hiroaki Kume, Kazuto Hirata, Noriyuki Ohkura, Isao Tachibana, Yoshihiro Nishimura, Hisako Matsumoto, Yoshiaki Minakata, Masanori Yoshikawa, Masaki Fujimura
BACKGROUND AND OBJECTIVES: Assessment of the effects of long-term management on patient quality of life (QOL) would be extremely useful for determining asthma treatment strategies. However, no studies have evaluated QOL over an extended period of time. This study evaluated the changes in QOL, drug management and disease severity in the same asthma patients at an interval of approximately 9 years. METHODS: We re-surveyed asthma patients enrolled in a survey conducted in 2004 to evaluate the effects of approximately a decade of treatment on disease severity and QOL assessed by the Japanese Asthma Health Questionnaire (AHQ-JAPAN)...
December 9, 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/27933517/a-novel-mutation-in-the-fibrinogen-a%C3%AE-chain-gly13arg-fibrinogen-nanning-causes-congenital-dysfibrinogenemia-associated-with-defective-peptide-a-release
#13
Jie Yan, Meiling Luo, Peng Cheng, Lin Liao, Xuelian Deng, Donghong Deng, Faquan Lin
Dysfibrinogenemia is characterized by blood coagulation dysfunction induced by an abnormal molecular structure of fibrinogen. Here, we describe a new case. A 32-year-old female was suspected of having dysfibrinogenemia during routine laboratory screening, based on her decreased functional fibrinogen level, normal fibrinogen antigen level, and prolonged thrombin time. We extracted DNA and performed polymerase chain reaction and DNA sequencing to identify genetic mutation. Fibrin polymerization, the kinetics of the fibrinopeptide release, scanning electron microscopy, mass spectrometric analysis, fibrin cross-linking, sodium dodecyl sulfate polyacrylamide gel electrophoresis and western blot were conducted...
December 8, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27933209/prevalence-and-incidence-of-gout-in-southern-sweden-from-the-socioeconomic-perspective
#14
Meliha C Kapetanovic, Mohaned Hameed, Aleksandra Turkiewicz, Tuhina Neogi, Tore Saxne, Lennart Jacobsson, Martin Englund
OBJECTIVES: To estimate the prevalence and cumulative incidence of gout in southern Sweden with respect to socioeconomic status. METHODS: Among residents of Skåne region in the year 2013 (total population 1.3 million), adult persons (age 18 years +) who between 1998 and 2013 received a diagnosis of gout (International Classification of Disease 10th Edition (ICD-10) code M10) by any physician were identified using the Skåne Healthcare Register. We calculated the point prevalence by end of 2013 and annual cumulative incidence in 2013 standardised to the whole Skåne population according to sex, individual information on occupation (white collar/blue collar), income (low/middle/high) and level of education (primary school/high school/university)...
2016: RMD Open
https://www.readbyqxmd.com/read/27933172/brown-tumor-of-the-jaw-after-pregnancy-and-lactation-in-a-men1-patient
#15
Anna Casteràs, Lídia Darder, Carles Zafon, Juan Antonio Hueto, Margarita Alberola, Enric Caubet, Jordi Mesa
: Skeletal manifestations of primary hyperparathyroidism (pHPT) include brown tumors (BT), which are osteoclastic focal lesions often localized in the jaws. Brown tumors are a rare manifestation of pHTP in Europe and USA; however, they are frequent in developing countries, probably related to vitamin D deficiency and longer duration and severity of disease. In the majority of cases, the removal of the parathyroid adenoma is enough for the bone to remineralize, but other cases require surgery...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27932480/magi2-mutations-cause-congenital-nephrotic-syndrome
#16
Agnieszka Bierzynska, Katrina Soderquest, Philip Dean, Elizabeth Colby, Ruth Rollason, Caroline Jones, Carol D Inward, Hugh J McCarthy, Michael A Simpson, Graham M Lord, Maggie Williams, Gavin I Welsh, Ania B Koziell, Moin A Saleem
Steroid-resistant nephrotic syndrome (SRNS), a heterogeneous disorder of the renal glomerular filtration barrier, results in impairment of glomerular permselectivity. Inheritance of genetic SRNS may be autosomal dominant or recessive, with a subset of autosomal recessive SRNS presenting as congenital nephrotic syndrome (CNS). Mutations in 53 genes are associated with human SRNS, but these mutations explain ≤30% of patients with hereditary cases and only 20% of patients with sporadic cases. The proteins encoded by these genes are expressed in podocytes, and malfunction of these proteins leads to a universal end point of podocyte injury, glomerular filtration barrier disruption, and SRNS...
December 8, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27932458/the-impact-of-recent-improvements-in-cryo-electron-microscopy-technology-on-the-understanding-of-bacterial-ribosome-assembly
#17
Aida Razi, Robert A Britton, Joaquin Ortega
Cryo-electron microscopy (cryo-EM) had played a central role in the study of ribosome structure and the process of translation in bacteria since the development of this technique in the mid 1980s. Until recently cryo-EM structures were limited to ∼10 Å in the best cases. However, the recent advent of direct electron detectors has greatly improved the resolution of cryo-EM structures to the point where atomic resolution is now achievable. This improved resolution will allow cryo-EM to make groundbreaking contributions in essential aspects of ribosome biology, including the assembly process...
December 8, 2016: Nucleic Acids Research
https://www.readbyqxmd.com/read/27932353/ezetimibe-in-combination-with-statins-ameliorates-endothelial-dysfunction-in-coronary-arteries-after-stenting-the-cuvic-trial-effect-of-cholesterol-absorption-inhibitor-usage-on-target-vessel-dysfunction-after-coronary-stenting-a-multicenter-randomized-controlled
#18
Susumu Takase, Tetsuya Matoba, Soichi Nakashiro, Yasushi Mukai, Shujiro Inoue, Keiji Oi, Taiki Higo, Shunsuke Katsuki, Masao Takemoto, Nobuhiro Suematsu, Kenichi Eshima, Kenji Miyata, Mitsutaka Yamamoto, Makoto Usui, Kenji Sadamatsu, Shinji Satoh, Toshiaki Kadokami, Kiyoshi Hironaga, Ikuyo Ichi, Koji Todaka, Junji Kishimoto, Kensuke Egashira, Kenji Sunagawa
OBJECTIVES: We sought to investigate whether treatment with ezetimibe in combination with statins improves coronary endothelial function in target vessels in coronary artery disease patients after coronary stenting. APPROACH AND RESULTS: We conducted a multicenter, prospective, randomized, open-label, blinded-end point trial among 11 cardiovascular treatment centers. From 2011 to 2013, 260 coronary artery disease patients who underwent coronary stenting were randomly allocated to 2 arms (statin monotherapy (S) versus ezetimibe [10 mg/d]+statin combinational therapy [E+S])...
December 8, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/27932029/implementing-a-resident-acute-care-surgery-service-improving-resident-education-and-patient-care
#19
Olga Kantor, Andrew B Schneider, Marko Rojnica, Andrew J Benjamin, Nancy Schindler, Mitchell C Posner, Jeffrey B Matthews, Kevin K Roggin
BACKGROUND: To simulate the duties and responsibilities of an attending surgeon and allow senior residents more intraoperative and perioperative autonomy, our program created a new resident acute care surgery consult service. METHODS: We structured resident acute care surgery as a new admitting and inpatient consult service managed by chief and senior residents with attending supervision. When appropriate, the chief resident served as a teaching assistant in the operation...
December 5, 2016: Surgery
https://www.readbyqxmd.com/read/27931316/exhaust-air-dust-monitoring-is-superior-to-soiled-bedding-sentinels-for-the-detection-of-pasteurella-pneumotropica-in-individually-ventilated-cage-systems
#20
Manuel Miller, Brbel Ritter, Julia Zorn, Markus Brielmeier
Reliable detection of unwanted organisms is essential for meaningful health monitoring in experimental animal facilities. Currently, most rodents are housed in IVC systems, which prevent the aerogenic transmission of pathogens between cages. Typically soiled-bedding sentinels (SBS) exposed to soiled bedding collected from a population of animals within an IVC rack are tested as representatives, but infectious agents often go undetected due to inefficient transmission. Pasteurellaceae are among the most prevalent bacterial pathogens isolated from experimental mice, and the failure of SBS to detect these bacteria is well established...
November 2016: Journal of the American Association for Laboratory Animal Science: JAALAS
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