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https://www.readbyqxmd.com/read/28943544/malignant-syndrome-and-serotonin-syndrome-in-a-general-hospital-setting-clinical-features-frequency-and-prognosis
#1
Akiyuki Hiraga, Satoshi Kuwabara
Objective The differences in the frequency and clinical features of malignant syndrome (MS) and serotonin syndrome (SS) in same population have only rarely been reported. To report the frequency and clinical features of MS and SS in a general hospital setting. Methods The clinical and laboratory features of patients with MS and those with SS, who were consecutively admitted to Chiba Rosai Hospital, during the past 4.5 years were reviewed. Results Of the 2005 patients admitted, MS was observed in 16 patients (0...
September 25, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28940654/video-assisted-microwave-ablation-for-the-treatment-of-a-metastatic-lung-lesion-in-a-dog-with-appendicular-osteosarcoma-and-hypertrophic-osteopathy
#2
Kaitlyn Mazzaccari, Sarah E Boston, Beau B Toskich, Kristina Bowles, J Brad Case
OBJECTIVE: To describe video-assisted microwave ablation (VAMA) for the treatment of a metastatic lung lesion secondary to right forelimb osteosarcoma in a dog. STUDY DESIGN: Case report. ANIMALS: A 10-year-old female spayed mixed breed dog with a metastatic lung lesion secondary to appendicular osteosarcoma. METHODS: An osteosarcoma of the right distal scapula and proximal humerus that was suspected to be a radiation-induced osteosarcoma was treated with limb amputation and carboplatin chemotherapy...
September 22, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28940342/physician-assisted-death-and-severe-treatment-resistant-depression
#3
Bonnie Steinbock
Should people suffering from untreatable psychiatric conditions be eligible for physician-assisted death? This is possible in Belgium and the Netherlands, where PAD for psychiatric conditions is permitted, though rare, so long as the criteria of due care are met. Those opposed to all instances of PAD point to Belgium and the Netherlands as a dark warning that once PAD is legalized, restricting it will prove impossible because safeguards, such as the requirement that a patient be terminally ill, will inevitably be eroded or discarded...
September 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28940248/can-a-left-ventricular-assist-device-in-individuals-with-advanced-systolic-heart-failure-improve-or-reverse-frailty
#4
Mathew S Maurer, Evelyn Horn, Alex Reyentovich, Victoria Vaughan Dickson, Sean Pinney, Deena Goldwater, Nathan E Goldstein, Omar Jimenez, Sergio Teruya, Jeff Goldsmith, Stephen Helmke, Melana Yuzefpolskaya, Gordon R Reeves
BACKGROUND/OBJECTIVES: Frailty, characterized by low physiological reserves, is strongly associated with vulnerability to adverse outcomes. Features of frailty overlap with those of advanced heart failure, making a distinction between them difficult. We sought to determine whether implantation of a left ventricular assist device (LVAD) would decrease frailty. DESIGN: Prospective, cohort study. SETTING: Five academic medical centers. PARTICIPANTS: Frail individuals (N = 29; mean age 70...
September 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28936821/-forensic-psychiatric-assessment-with-the-claim-of-incitement-solicitation-assistance-to-suicide-and-reinforcement-of-suicide-decision-a-case-report
#5
Altan Eşsizoğlu, Mustafa Sercan
Although the act of suicide is not considered a crime in Turkish Criminal Law, any contribution (incitement, solicitation, assistance and reinforcement of suicide decision) to the commitment of suicide is a crime according to the 84th item. However, the number of cases opened with respect to this item as well as request for forensic psychiatric expertise is very rare. In these cases, forensic psychiatric expertise depends on the psychiatric evaluation of the individual that committed suicide and the analysis of his/her relationship with the person that incited the suicide...
2017: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/28936597/terminal-weaning-or-immediate-extubation-for-withdrawing-mechanical-ventilation-in-critically-ill-patients-the-arreve-observational-study
#6
René Robert, Amélie Le Gouge, Nancy Kentish-Barnes, Alice Cottereau, Bruno Giraudeau, Mélanie Adda, Djillali Annane, Juliette Audibert, François Barbier, Patrick Bardou, Simon Bourcier, Jeremy Bourenne, Alexandre Boyer, François Brenas, Vincent Das, Arnaud Desachy, Jérôme Devaquet, Marc Feissel, Frédérique Ganster, Maïté Garrouste-Orgeas, Guillaume Grillet, Olivier Guisset, Rebecca Hamidfar-Roy, Anne-Claire Hyacinthe, Sebastien Jochmans, Mercé Jourdain, Alexandre Lautrette, Nicolas Lerolle, Olivier Lesieur, Fabien Lion, Philippe Mateu, Bruno Megarbane, Sybille Merceron, Emmanuelle Mercier, Jonathan Messika, Paul Morin-Longuet, Bénédicte Philippon-Jouve, Jean-Pierre Quenot, Anne Renault, Xavier Repesse, Jean-Philippe Rigaud, Ségolène Robin, Antoine Roquilly, Amélie Seguin, Didier Thevenin, Patrice Tirot, Isabelle Vinatier, Elie Azoulay, Jean Reignier
PURPOSE: The relative merits of immediate extubation versus terminal weaning for mechanical ventilation withdrawal are controversial, particularly regarding the experience of patients and relatives. METHODS: This prospective observational multicentre study (ARREVE) was done in 43 French ICUs to compare terminal weaning and immediate extubation, as chosen by the ICU team. Terminal weaning was a gradual decrease in the amount of ventilatory assistance and immediate extubation was extubation without any previous decrease in ventilatory assistance...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28934837/bromocriptine-for-the-treatment-of-peripartum-cardiomyopathy-a-multicentre-randomized-study
#7
Denise Hilfiker-Kleiner, Arash Haghikia, Dominik Berliner, Jens Vogel-Claussen, Johannes Schwab, Annegret Franke, Marziel Schwarzkopf, Philipp Ehlermann, Roman Pfister, Guido Michels, Ralf Westenfeld, Verena Stangl, Ingrid Kindermann, Uwe Kühl, Christiane E Angermann, Axel Schlitt, Dieter Fischer, Edith Podewski, Michael Böhm, Karen Sliwa, Johann Bauersachs
Aims: An anti-angiogenic cleaved prolactin fragment is considered causal for peripartum cardiomyopathy (PPCM). Experimental and first clinical observations suggested beneficial effects of the prolactin release inhibitor bromocriptine in PPCM. Methods and results: In this multicentre trial, 63 PPCM patients with left ventricular ejection fraction (LVEF) ≤35% were randomly assigned to short-term (1W: bromocriptine, 2.5 mg, 7 days) or long-term bromocriptine treatment (8W: 5 mg for 2 weeks followed by 2...
September 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28929846/becoming-dead-two-solitudes
#8
Eric Wasylenko
The moral divide between proponents and opponents of medical assistance in dying is wide and can be ascribed to a number of dichotomous beliefs. This article addresses a particular and less commonly described platform for the divide: human acquiescence to physical decline and death as an important stage of life, versus presumptive human mastery over the timing and manner of some peoples' death. Practical ideas are then offered for health systems that wish to bridge the divide, to provide both robust palliative end-of-life care and medical assistance in dying programs for their patients, while keeping health workers whole...
September 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28929413/accessing-support-before-or-after-a-parent-dies-from-cancer-and-young-people-s-current-wellbeing
#9
A Varathakeyan, F E J McDonald, P Patterson, K Nicholson Perry, K R Allison
PURPOSE: To examine differences in distress and unmet needs between bereaved adolescent and young adult (AYA) offspring who accessed support before and after being bereaved by parental cancer, and to explore aspects of their cancer experience that influenced their help-seeking. METHODS: Phase 1: Surveys completed by AYAs (11-26 years) bereaved by parental cancer were subjected to analysis of covariance examining differences in distress and unmet needs between those who accessed support before (n = 159) and after (n = 212) parental bereavement...
September 19, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28925783/laparoscopic-assisted-resection-for-advanced-colorectal-cancer-in-solid-organ-transplant-recipients
#10
Ze-Nan Xia, Rui Hou, Wei Zhu, Ru Yao, Zhao Lu, Hui-Zhong Qiu, Guo-Le Lin
AIM: To evaluate the feasibility, short- and long-term outcomes, and safety of laparoscopic resection for advanced colorectal cancer (CRC) in solid organ transplant recipients. METHODS: Between September 2001 and April 2016, five patients who underwent laparoscopic-assisted resection for CRC after solid organ transplantation were included in this study. Their clinical data were retrospectively analyzed with regard to patient demographics, immunosuppressive therapy, tumor characteristics, surgical outcomes, and follow-up data...
September 19, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28916295/utilization-of-hospice-services-in-a-population-of-patients-with-huntington-s-disease
#11
Margaret O Johnson, Samuel Frank, Matthew Mendlik, David Casarett
CONTEXT: Although the early and middle stages of Huntington's Disease (HD) and its complications have been well described, less is known about the course of late-stage illness. In particular, little is known about the population of patients who enroll in hospice. OBJECTIVES: Our goal is to describe the characteristics of patients with HD who enrolled in hospice. METHODS: Retrospective cohort study of electronic medical record data from 12 not-for-profit hospices in the United States from 2008 to 2012...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28915211/minimally-invasive-laparoscopic-dissected-deep-inferior-epigastric-artery-perforator-flap-mild-diep-an-anatomic-feasibility-study-and-a-first-clinical-case
#12
Mikael Hivelin, Antoine Soprani, Nathaniel Schaffer, Stéphane Hans, Laurent Lantieri
The deep inferior epigastric perforator (DIEP) flap is a workhorse of breast reconstruction. Risks of herniation derive from violation of the rectus abdominis muscle anterior rectus sheath (ARS) and might be reduced by Minimally Invasive Laparoscopic Dissection (MILD) of the deep inferior epigastric vessels. We performed a feasibility study on five anatomical subjects and performed a secondary right breast reconstruction on a 67 year-old woman. A 30° laparoscope was used with laparoscopy ports inset to preserve the flap...
September 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28915075/responding-to-patient-requests-for-hastened-death-physician-aid-in-dying-and-the-clinical-oncologist
#13
Rebecca A Spence, Charles D Blanke, Thomas J Keating, Lynne P Taylor
Physician aid in dying (PAD) or assisted suicide is becoming legal in more US jurisdictions. Meanwhile, the needs of terminally ill patients with cancer are receiving greater attention, including the integration of palliative care into oncology practice. This article highlights a case vignette of a patient with advanced cancer who requests PAD from her oncologist, as a backdrop to help the practicing oncologist examine his or her moral stance regarding participation in aid in dying. The article concludes by offering a framework within which the practicing oncologist can receive and process a patient's request for PAD...
September 15, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28910138/hsp90-inhibition-and-cellular-stress-elicits-phenotypic-plasticity-in-hematopoietic-differentiation
#14
Abdalla A Lawag, Jennifer M Napper, Caroline A Hunter, Nickolas A Bacon, Seth Deskins, Manaf El-Hamdani, Sarah-Leigh Govender, Emine C Koc, Vincent E Sollars
Cancer cells exist in a state of Darwinian selection using mechanisms that produce changes in gene expression through genetic and epigenetic alteration to facilitate their survival. Cellular plasticity, or the ability to alter cellular phenotype, can assist in survival of premalignant cells as they progress to full malignancy by providing another mechanism of adaptation. The connection between cellular stress and the progression of cancer has been established, although the details of the mechanisms have yet to be fully elucidated...
September 14, 2017: Cellular Reprogramming
https://www.readbyqxmd.com/read/28905470/outcomes-of-berlin-heart-excor-%C3%A2-pediatric-ventricular-assist-device-support-in-patients-with-restrictive-and-hypertrophic-cardiomyopathy
#15
Jennifer A Su, Jondavid Menteer
The outcomes of pediatric ventricular assist device support in patients with diastolic heart failure have not been well described. This study reviews the North American experience with Berlin Heart EXCOR(®) ventricular assist device implants in children with such physiology. The Berlin Heart clinical database was reviewed. Patients with primary diastolic dysfunction are included in this study. Twenty pediatric patients with restrictive cardiomyopathy (n = 13), hypertrophic cardiomyopathy (n = 3), or congenital heart disease with restrictive physiology (n = 4) who were supported with EXCOR(®) were identified...
September 14, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28898867/cerebral-fat-embolism-clinical-presentation-diagnostic-steps-and-long-term-follow-up
#16
Juliane Dunkel, Christian Roth, Frank Erbguth, Wenke Dietrich, Monika Hügens-Penzel, Andreas Ferbert
OBJECTIVE: Symptomatic cerebral fat embolism (CFE) is a rare complication that occurs after a traumatic injury or orthopaedic surgery and is diagnostically challenging. No data is currently available concerning long-term follow-up. METHODS: We identified from medical records 9 patients with CFE and revised the clinical signs and the diagnostic process. We then analysed long-term follow-up data, targeting clinical course after discharge, neurological impairment, and current quality of life, using the Barthel index and the modified Rankin Scale...
2017: European Neurology
https://www.readbyqxmd.com/read/28895175/the-use-of-case-management-for-community-dwelling-older-people-the-effects-on-loneliness-symptoms-of-depression-and-life-satisfaction-in-a-randomised-controlled-trial
#17
Elin Taube, Jimmie Kristensson, Patrik Midlöv, Ulf Jakobsson
AIM: To investigate the effects of a case management intervention for community-dwelling frail older people, with functional dependency and repeated contacts with the healthcare services, focusing on loneliness, depressive symptoms and life satisfaction. DESIGN: A two-armed, nonblinded, randomised control trial with repeated follow-ups, of N = 153 participants at baseline allocated to an intervention (n = 80) and control (n = 73) group. METHOD: Inclusion criteria were the following: ≥65 years of age, living in ordinary housing, in need of assistance in two or more self-reported activities of daily living, having at least two hospital admissions or at least four visits in outpatient care 12 months prior to enrolment...
September 12, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28893830/assessment-of-paravalvular-leakage-after-transcatheter-aortic-valve-implantation-add-clinical-signs-to-echocardiographic-data
#18
Corstiaan A den Uil, Mihai Strachinaru, Ben van der Hoven, J Han J Meeder
A 62-year old male with pulmonary fibrosis and aortic valve stenosis underwent TAVI (Corevalve Evolut XL 34 mm) in the build-up for lung transplantation (LuTx). Following post-dilation for a large annular perimeter, moderate paravalvular aortic regurgitation (AR) was observed. After 6 weeks, he was admitted to the ICU with respiratory failure(A). TTE demonstrated residual mild AR (based on a small excentric paravalvular AR jet, <10% circumferential extent, pressure half-time was not reliably measured) and together with borderline elevated NT-pro-BNP, the consultant cardiologist authorized LuTx listing...
September 11, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28892278/reflection-on-stroke-deaths-and-end-of-life-stroke-care
#19
Syed Zujajuddin Quadri, Thang Huynh, Cecilia Cappelen-Smith, Nirupama Wijesuriya, Abul Mamun, Roy Beran, Alan Mcdougall, Dennis Cordato
BACKGROUND: The benefit of palliative care referral for severe stroke patients on end-of-life care pathways (EOLCP) is increasingly recognised. Palliative care provides assistance with symptom management and transition to end-of-life care. Advance care planning (ACP) may help accommodate patient/family expectations and guide management. METHOD: Retrospective study of all stroke deaths (2014-2015) at Liverpool Hospital, Sydney, Australia. Data examined included age, co-morbidities, living arrangements, pre-existing ACP, palliative care referral rates and 'survival time'...
September 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28887708/long-term-clinical-results-of-acute-myocardial-infarction-at-the-left-main-trunk-requiring-percutaneous-cardiopulmonary-support
#20
Takashi Yamauchi, Takafumi Masai, Kenji Fujii, Yoshiki Sawa, Shinya Shirai, Mitsunori Kamigaki, Naofumi Itou
The clinical results of patients with acute myocardial infarction (AMI) at the left main trunk (LMT) remain unclear, especially in cases requiring percutaneous cardiopulmonary support (PCPS). Twenty seven cases of AMI at the LMT requiring emergent PCPS were retrospectively investigated. These 27 patients were aged 44-83 years (65.6 ± 8.6 years) and 20 (81.5%) were men. Peak creatine kinase (CK) leakage ranged from 538 to 34,010 IU/l (13,553 ± 7656 IU/l). Eight (29.6%) patients were discharged without mechanical support...
September 8, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
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