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https://www.readbyqxmd.com/read/28438026/intramuscular-lorazepam-for-status-epilepticus-in-children-with-complex-medical-and-physical-disabilities
#1
Peter N Johnson, Anna Nguyen, Stephen B Neely, Michael Johnson
BACKGROUND: A protocol was developed to achieve status epilepticus (SE) resolution: step 1, intramuscular (IM) lorazepam; step 2, repeat IM lorazepam; step 3, rectal diazepam. OBJECTIVE: The primary objective was to identify the number of patients with SE resolution after step 1. Secondary objectives included categorization of mean number of IM doses per episode and patient factors associated with SE resolution. METHODS: This was a retrospective study of patients <21 years old with complex medical and physical disabilities admitted over 5 years...
April 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28418346/extra-gastrointestinal-stromal-tumor-of-prostate
#2
Demet Etit, Haldun Kar, Neşe Ekinci, Ahmet Emre Yenipazar, Fulya Çakalağaoğlu
BACKGROUND: Extra-gastrointestinal stromal tumor is defined as a mesenchymal neoplasm arising from soft tissues outside the gastrointestinal tract. Prostatic extra-gastrointestinal stromal tumor has rarely been noted. CASE REPORT: A 56 year-old man presented with pain in the anal region. A digital rectal examination revealed that the prostate was markedly enlarged with a smooth, bulging surface. Computerized tomography images showed a 6 cm heterogeneous, infiltrative tumor within the prostate gland extending to the trigon of the bladder, left seminal vesicle and rectum...
April 5, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28414670/diulafoy-s-lesion-an-uncanny-etiology-of-gastrointestinal-bleed
#3
V Gasia, O Lamendola
INTRODUCTION: Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2 percent of acute gastrointestinal (GI); bleeding. CASE: A 99-year-old woman was initially admitted due to left lower extremity cellulitis related to chronic venous stasis ulcer and was receiving broad-spectrum IV antibiotics. Upon admission to the medical floor, she had an episode of hematemesis and multiple bowel movements with black-tarry stools...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413306/urogenital-management-in-cloaca-an-alternative-approach
#4
Harshjeet Singh Bal, Sudipta Sen, Cenita Sam, Jacob Chacko, John Mathai, S R Regunandan
INTRODUCTION: In the management of cloaca, there is concern that dissection of the urogenital sinus in early childhood with the aim of total anatomical correction is hazardous. Avoiding such mobilization and providing mitrofanoff channel, when needed, till peripubertal period reduces complications and is technically easier. MATERIALS AND METHODS: Forty-three cases of cloaca were managed in the period 2004-2016. Case records and radiology were reviewed retrospectively...
April 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28403899/hepato-bronchial-fistula-secondary-to-perforated-sigmoid-diverticulitis-a-case-report
#5
Jun Sunny Yin, Shaylan Govind, Daniele Wiseman, Richard Inculet, Raymond Kao
BACKGROUND: Patients with diverticulitis are predisposed to hepatic abscesses via seeding through the portal circulation. Hepatic abscesses are well-documented sequelae of diverticulitis, however instances of progression to hepato-bronchial fistulization are rare. We present a case of diverticulitis associated with hepatic abscess leading to hepato-bronchial fistulization, which represents a novel disease course not yet reported in the literature. CASE PRESENTATION: A 61-year-old Caucasian man presented with a history of unintentional weight loss and dyspnea both at rest and with exertion...
April 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28374259/anorectal-complications-after-robotic-intersphincteric-resection-for-low-rectal-cancer
#6
Li-Jen Kuo, James Chi-Yong Ngu, Yan-Jiun Huang, Yen-Kuang Lin, Chia-Che Chen, Yiu-Shun Tong, Szu-Chia Huang, Chia-Chen Hu, Shu-Hwa Tan
BACKGROUND: Robotic intersphincteric resection (ISR) has been introduced for sphincter-preservation in the treatment of low rectal cancer. However, many patients experience anorectal symptoms and defecatory dysfunction after ISR. This study aims to evaluate the anorectal complications that develop after ISR. METHODS: The medical records of 108 patients who underwent robotic ISR at Taipei Medical University Hospital, Taipei, Taiwan between December 2011 and June 2016 were retrospectively reviewed...
April 3, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28371010/laparoscopic-ventral-rectopexy-for-rectal-prolapse-and-rectal-intussusception-using-a-biological-mesh
#7
Sinan Albayati, Matthew J Morgan, Catherine E Turner
AIM: Laparoscopic ventral rectopexy (LVR) is a nerve sparing technique for the treatment of rectal prolapse. Concerns about the use of synthetic meshes in the pelvis and the associated risk of erosion have led to the recent use of biological meshes in some colorectal units. This retrospective study aims to assess the outcomes of patients undergoing LVR using a non-cross-linked non-dermal biological mesh. METHODS: Medical notes of all patients who underwent LVR between December 2011 and May 2014 were reviewed...
March 29, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28347333/a-phase-ii-study-of-preoperative-chemoradiation-with-tegafur-uracil-plus-leucovorin-for-locally-advanced-rectal-cancer-with-pharmacogenetic-analysis
#8
Sun Young Kim, Ji Yeon Baek, Jae Hwan Oh, Sung Chan Park, Dae Kyung Sohn, Min Ju Kim, Hee Jin Chang, Sun-Young Kong, Dae Yong Kim
BACKGROUND: This study aimed to evaluate the efficacy of a high dose of oral tegafur-uracil (400 mg/m(2)) plus leucovorin with preoperative chemoradiation of locally advanced rectal cancer and to explore the impact of polymorphisms of cytochrome P 2A6 (CYP2A6), uridine monophosphate synthetase (UMPS), and ATP-binding cassette B1 (ABCB1) on clinical outcome. METHODS: Patients with cT3 or cT4 rectal cancer were enrolled and were given tegafur-uracil 400 mg/m(2)/day and leucovorin 90 mg/m(2)/day for 7 days a week during preoperative chemoradiation (50...
March 27, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28339103/iterative-dataset-optimization-in-automated-planning-implementation-for-breast-and-rectal-cancer-radiotherapy
#9
Jiawei Fan, Jiazhou Wang, Zhen Zhang, Weigang Hu
PURPOSE: To develop a new automated treatment planning solution for breast and rectal cancer radiotherapy. METHODS: The automated treatment planning solution developed in this study includes selection of the iterative optimized training dataset, dose volume histogram (DVH) prediction for the organs at risk (OARs), and automatic generation of clinically acceptable treatment plans. The iterative optimized training dataset is selected by an iterative optimization from 40 treatment plans for left-breast and rectal cancer patients who received radiation therapy...
March 24, 2017: Medical Physics
https://www.readbyqxmd.com/read/28289572/human-listeriosis-presenting-as-breast-abscess-report-of-a-rare-case
#10
Venkataramana Kandi
An abscess is defined as a collection of pus in various tissues of the body including skin and other organs. Abscesses most commonly are formed on the skin under the armpits, groin areas, and rectal areas. Most abscesses involve microbial infections with few remaining sterile. The treatment of abscesses includes both medical and surgical intervention. In the era of multidrug resistance, isolation and identification of the causative microbe and testing for antimicrobial susceptible patterns assume greater significance for the better management of patients, thereby reducing the resultant morbidity and mortality...
February 1, 2017: Curēus
https://www.readbyqxmd.com/read/28288297/early-rehabilitation-of-incisors-with-dentinogenesis-imperfecta-type-ii-case-report
#11
Ana Paula Ca Beltrame, Maíra Mery Rosa, Ricardo At Noschang, Izabel Cs Almeida
Dentinogenesis imperfecta is an phenotypic alteration in the formation of the organic matrix. It causes the rapid and progressive wear of tooth structure, which may compromise tooth function and aesthetics. This is a case of a 1y, 8m-old child with dentinogenesis imperfecta. All teeth presented with an opalescent appearance and grayish color hue. Compromised structural integrity was noted as excessive wear and fracturing of the enamel from the dentin layer. With low doses of midazolam (oral) and chloral hydrate (rectal) administration, in a hospital environment, sedation was used to aid full mouth rehabilitation...
2017: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28285396/pelvic-organ-support-several-years-after-a-first-birth
#12
Caroline W S Ferreira, Ixora K Atan, Andrew Martin, Ka Lai Shek, Hans Peter Dietz
INTRODUCTION AND HYPOTHESIS: Female pelvic organ prolapse is highly prevalent and childbirth has been shown to be an important risk factor. The study was carried out to observe if pelvic organ support deteriorates over time following a first birth. METHODS: This is a retrospective review using archived data sets of women seen in the context of two prospective perinatal imaging studies. All subjects had undergone a standardised interview, a clinical examination and 4D translabial ultrasound, 3 months and 2-5 years post-partum...
March 11, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28277472/transvaginal-repair-of-complex-rectovaginal-fistulas-using-the-porcine-urinary-bladder-matrix-as-an-augmenting-graft
#13
Hemikaa Devakumar, Neeraja Chandrasekaran, Alexandriah Alas, Laura Martin, G Willy Davila, Eric Hurtado
BACKGROUND: After the US Food and Drug Administration issued a safety warning concerning vaginal mesh implants in 2008, their use in correction of pelvic floor defects have decreased in the United States (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm479732.htm). However, we are still treating patients who have had complications associated with their use, rectovaginal fistulas (RVFs) being one of them. Rectovaginal fistulas are considered complex if greater than 2.5 cm, recurrent, associated with inflammatory bowel disease, or if they are proximal in location...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28258628/intracorporeal-anastomoses-in-emergency-laparoscopic-colorectal-surgery-from-a-series-of-59-cases-where-and-how-to-do-it-a-technical-note
#14
Salomone Di Saverio, Arianna Birindelli, Matteo Mandrioli, Mauro Podda, Gian Andrea Binda
BACKGROUND: Laparoscopy offers the benefits of minimally invasive surgery and faster recovery. Acute surgical patients may potentially benefit from the greatest advantages of emergency laparoscopy, even more clinically relevant in acute rather than elective patients. Fashioning a laparoscopic intra-corporeal anastomosis (ICA) after emergent colorectal resection, whenever technically feasible and non-contraindicated for the patients' general and hemodynamic condition, represents the most challenging technical skill to be learned...
March 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28252517/transanal-minimally-invasive-surgery-for-local-excision-of-benign-and-malignant-rectal-neoplasia-outcomes-from-200-consecutive-cases-with-midterm-follow-up
#15
Lawrence Lee, John P Burke, Teresa deBeche-Adams, George Nassif, Beatriz Martin-Perez, John R T Monson, Matthew R Albert, Sam B Atallah
OBJECTIVE: This study describes the outcomes for 200 consecutive transanal minimally invasive surgery (TAMIS) local excision (LE) for rectal neoplasia. BACKGROUND: TAMIS is an advanced transanal platform that can result in high quality LE of rectal neoplasia. METHODS: Consecutive patients from July 1, 2009 to December 31, 2015 from a prospective institutional registry were analyzed. Indication for TAMIS LE was endoscopically unresectable benign lesions or histologically favorable early rectal cancers...
March 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28216517/simultaneous-resection-for-colorectal-cancer-with-synchronous-liver-metastases-is-a-safe-procedure-outcomes-at-a-single-center-in-turkey
#16
Ender Dulundu, Wafi Attaallah, Metin Tilki, Cumhur Yegen, Safak Coskun, Mumin Coskun, Aylin Erdim, Eda Tanrikulu, Samet Yardimci, Omer Gunal
The optimal surgical strategy for treating colorectal cancer with synchronous liver metastases is subject to debate. The current study sought to evaluate the outcomes of simultaneous colorectal cancer and liver metastases resection in a single center. Prospectively collected data on all patients with synchronous colorectal liver metastases who underwent simultaneous resection with curative intent were analyzed retrospectively. Patient outcomes were compared depending on the primary tumor location and type of liver resection (major or minor)...
February 17, 2017: Bioscience Trends
https://www.readbyqxmd.com/read/28213843/effect-of-biofeedback-therapy-on-anorectal-physiological-parameters-among-patients-with-fecal-evacuation-disorder
#17
Abhai Verma, Asha Misra, Uday C Ghoshal
BACKGROUND: Though biofeedback therapy is often effective in patients with fecal evacuation disorder (FED), a common cause of chronic constipation (CC) in tertiary practice, data on anorectal physiological parameters following it are scanty. METHODS: Consecutive patients with FED with CC diagnosed by abnormalities in at least two of the three tests (anorectal manometry, defecography, and balloon expulsion test [BET]) undergoing biofeedback (two sessions per day, 30 min each, for 2 weeks) during a 3-year period were analyzed...
February 18, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28194176/clinicopathological-features-and-prognostic-factors-of-colorectal-neuroendocrine-neoplasms
#18
Mengjie Jiang, Yinuo Tan, Xiaofen Li, Jianfei Fu, Hanguang Hu, Xianyun Ye, Ying Cao, Jinghong Xu, Ying Yuan
Background. Limited research is available regarding colorectal NENs and the prognostic factors remain controversial. Materials and Methods. A total of 68 patients with colorectal NENs were studied retrospectively. Clinical characteristics and prognosis between colonic and rectal NENs were compared. The Cox regression models were used to evaluate the predictive capacity. Results. Of the 68 colorectal NENs patients, 43 (63.2%) had rectal NENs, and 25 (36.8%) had colonic NENs. Compared with rectal NENs, colonic NENs more frequently exhibited larger tumor size (P < 0...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28156538/variation-in-utilization-of-palliative-surgery-in-patients-with-metastatic-colorectal-cancer
#19
Hari Nathan, Scott E Regenbogen, Samantha Hendren, Arden M Morris, Pasithorn Amy Suwanabol
120 Background: Twenty-five percent of patients with colorectal cancer will present with unresectable disease. Palliative surgery has been shown to improve symptom control and improve patient satisfaction as well as demonstrate improved cost and decreased healthcare utilization. However, it is unclear what factors influence use. We sought to determine patient and hospital factors associated with palliative surgery use in advanced colorectal cancers. METHODS: Using the National Cancer Data Base (NCDB) Participant User File from 2006 to 2012, 162,967 patients with metastatic colorectal cancer were identified...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152894/engaging-managing-physicians-in-clinical-staging-prior-to-the-initiation-of-cancer-treatment
#20
Carol Huibregtse, Marija Bjegovich-Weidman, James L Weese
143 Background: Managing physicians (medical oncologist, radiation oncologist, surgeons) have a responsibility to clinically stage patients prior to the initiation of cancer treatment. Clinical staging not only directs the treatment plan, but identifies appropriate clinical trials and estimates prognosis. We sought to determine whether engagement of managing physicians would result in increased clinical staging for various types of cancer. METHODS: Baseline data on clinical staging for breast, colorectal (colon, rectal, anal, rectosigmoid junction)*, thoracic (lung esophageal)†, genitourinary (prostate, penis, testes)‡, and pancreatic primary cancers were obtained...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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