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https://www.readbyqxmd.com/read/28647200/racial-disparities-after-infrainguinal-bypass-surgery-in-hemodialysis-patients
#1
Isibor Arhuidese, Sophie Wang, Satinderjit Locham, Muhammad Faateh, Besma Nejim, Mahmoud Malas
BACKGROUND: Peripheral arterial disease poses a significant burden in the hemodialysis (HD)-dependent population. Race is a known modifier of outcomes after surgical treatment of peripheral arterial disease. A comprehensive evaluation of the effect of race on infrainguinal bypass surgery (IBS) outcomes in HD patients is lacking. In this study, we evaluated the effects of race on long-term IBS outcomes in a large, nationally representative cohort of HD patients. METHODS: We studied all HD patients who underwent IBS between January 2007 and December 2011 in the United States Renal Disease System-Medicare matched database...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28644156/clinical-case-of-the-month-a-57-year-old-man-with-an-axillary-mass
#2
Palak Desai, Andrew Myers, Brian Boulmay, Fred A Lopez
A 57-year-old man presented to the surgical oncology clinic with a mildly tender mass under his right arm. Four years prior, the patient had a melanoma removed from his right shoulder along with an ipsilateral right axillary sentinel lymph sampling. Computed tomography (CT) scan was negative for metastatic disease at that time. The patient did not undergo completion axillary node dissection and was lost to follow-up. The patient was originally from Australia, did not tan but reported multiple sunburns before age 18...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28643428/mechanical-circulatory-support-in-the-treatment-of-advanced-heart-failure
#3
Amanda W Cai, Sabrina Islam, Shelley R Hankins, Wade Fischer, Howard J Eisen
According to the Centers for Disease Control (CDC), heart failure (HF) remains a pervasive condition with high morbidity and mortality, affecting 5.8 million people in the United States (US) and 23 million worldwide. For patients with refractory end-stage HF, heart transplantation is the gold standard for definitive treatment. However, the demand for heart transplantation has consistently exceeded the availability of donor hearts, with approximately 2,331 orthotopic heart transplantations performed in the US in 2015 despite an estimated 100,000 to 250,000 patients with New York Heart Association (NYHA) class IIIB or IV symptoms that are refractory to medical treatment and potential transplant candidates...
June 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28640703/integrating-evidence-based-medicine-for-treatment-of-spinal-metastases-into-a-decision-framework-neurologic-oncologic-mechanicals-stability-and-systemic-disease
#4
Ori Barzilai, Ilya Laufer, Yoshiya Yamada, Daniel S Higginson, Adam M Schmitt, Eric Lis, Mark H Bilsky
Patients with cancer are frequently affected by spinal metastases. Treatment is palliative, with the principle goals of pain relief, preservation of neurologic function, and improvement in quality of life. In the past decade, we have witnessed a dramatic change in the treatment paradigms due to the development of improved surgical strategies and systemic and radiation therapy. The most important change to these paradigms has been the integration of spinal stereotactic radiosurgery (SSRS), allowing delivery of tumoricidal radiation doses with sparing of nearby organs at risk...
June 22, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28634727/safety-and-efficacy-of-chemosaturation-in-patients-with-primary-and-secondary-liver-tumors
#5
Martha M Kirstein, Steffen Marquardt, Nils Jedicke, Silke Marhenke, Wolfgang Koppert, Michael P Manns, Frank Wacker, Arndt Vogel
BACKGROUND: Chemosaturation with percutaneous hepatic perfusion (CS-PHP; hepatic CHEMOSAT(®) delivery system; Delcath Systems Inc, USA) is a novel medical device, which delivers high doses of melphalan directly to the liver in patients with primary and secondary liver tumors while limiting systemic toxicity through hemofiltration of the hepatic venous blood. The aim of this study was to analyze the safety and efficacy of the second-generation CS-PHP after 54 treatments at Hannover Medical School, Germany...
June 20, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28623537/durability-of-silicone-airway-stents-in-the-management-of-benign-central-airway-obstruction
#6
Justin M Karush, Christopher W Seder, Anish Raman, Gary W Chmielewski, Michael J Liptay, William H Warren, Andrew T Arndt
PURPOSE: The literature is devoid of a comprehensive analysis of silicone airway stenting for benign central airway obstruction (BCAO). With the largest series in the literature to date, we aim to demonstrate the safety profile, pattern of re-intervention, and duration of silicone airway stents. METHODS: An institutional database was used to identify patients with BCAO who underwent rigid bronchoscopy with dilation and silicone stent placement between 2002 and 2015 at Rush University Medical Center...
June 16, 2017: Lung
https://www.readbyqxmd.com/read/28620970/a-coating-free-nonfouling-polymeric-elastomer
#7
Hsiang-Chieh Hung, Priyesh Jain, Peng Zhang, Fang Sun, Andrew Sinclair, Tao Bai, Bowen Li, Kan Wu, Caroline Tsao, Erik J Liu, Harihara S Sundaram, Xiaojie Lin, Payam Farahani, Timothy Fujihara, Shaoyi Jiang
Medical devices face nonspecific biofouling from proteins, cells, and microorganisms, which significantly contributes to complications and device failure. Imparting these devices with nonfouling capabilities remains a major challenge, particularly for those made from elastomeric polymers. Current strategies, including surface coating and copolymerization/physical blending, necessitate compromise among nonfouling properties, durability, and mechanical strength. Here, a new strategy is reported to achieve both high bulk mechanical strength and excellent surface nonfouling properties, which are typically contradictory, in one material...
June 16, 2017: Advanced Materials
https://www.readbyqxmd.com/read/28616109/the-management-of-mixed-urinary-incontinence-in-women
#8
REVIEW
Blayne Welk, Richard J Baverstock
Mixed urinary incontinence is a common diagnosis among women with urinary leakage and is often present in women who are unable to characterize their incontinence. Research and optimized clinical treatment of these patients is limited by the challenges in objectively defining and stratifying this population. The evaluation of these patients should follow the same general principles as any assessment of any women with incontinence; however, it is essential to define whether urge or stress incontinence is the predominant symptom...
June 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28610762/early-trifecta-valve-failure-report-of-a-cluster-of-cases-from-a-tertiary-care-referral-center
#9
Ankur Kalra, Hasan Rehman, Mahesh Ramchandani, Colin M Barker, Gerald M Lawrie, Ross M Reul, Michael J Reardon, Neal S Kleiman
BACKGROUND: The Trifecta valve (St Jude Medical, Inc, St Paul, Minn) was approved for commercial use by the US Food and Drug Administration in 2011. Several isolated cases have been reported since then, describing early structural valve deterioration. We report a case series of 8 Trifecta valve failures, describing patients' clinical substrate and management, and the pathologic characteristics of the explanted valves. METHODS: Trifecta valve failure occurred in 7 patients (8 valves) receiving 19-mm (n = 2), 21-mm (n = 3), 23-mm (n = 1), and 25-mm (n = 2) valves...
May 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28609794/-destruction-of-microsurgical-devices-by-sterilisation
#10
Raphaela Berto, Jürgen Strutz
Hospital facilities issue numerous risk announcements on corrosion, deformation or premature wearout of medical devices every year. As there is yet little data on the impact of reprocessing on the quality and durability of microsurgical instruments, this paper aims at evaluating the effects of the reprocessing on microsurgical instruments. Material and Methods 22 brand new microsurgical instruments for stapes surgery were being reprocessed 30 times without being used for surgery or other purposes in the interim time...
June 13, 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28601373/evaluating-the-association-between-adjuvant-chemotherapy-and-function-related-adverse-events-among-older-patients-with-early-stage-breast-cancer
#11
Caroline Mariano, Jennifer L Lund, Sharon Peacock Hinton, Phyo Htoo, Hyman Muss, Katherine E Reeder-Hayes
PURPOSE: The incidence of treatment-related toxicity for adjuvant chemotherapy in breast cancer is well documented in clinical trials. However, the effect of chemotherapy on functional outcomes in older patients is less well known. We identified a cohort of older women diagnosed with early stage breast cancer to examine the association between exposure to chemotherapy and a claims-based measure of function-related adverse events (FAE). METHODS: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare dataset, we identified women aged ≥66 diagnosed with stage I or II breast cancer from 2004 to 2011...
June 7, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28593165/minimally-invasive-surgical-therapies-for-benign-prostatic-hypertrophy-the-rise-in-minimally-invasive-surgical-therapies
#12
REVIEW
Daniel Christidis, Shannon McGrath, Marlon Perera, Todd Manning, Damien Bolton, Nathan Lawrentschuk
The prevalence of benign prostatic hypertrophy (BPH) causing bothersome lower urinary tract symptoms increases with our ageing population. Treatment of BPH traditionally begins with medical therapy and surgical intervention is then considered for those whose symptoms progress despite treatment. Minimally invasive surgical therapies have been developed as an intermediary in the treatment of BPH with the aim of decreasing the invasiveness of interventions. These therapies also aim to reduce morbidity and dysfunction related to invasive surgical procedures...
June 2017: Prostate International
https://www.readbyqxmd.com/read/28593148/endovascular-repair-in-acute-complicated-type-b-aortic-dissection-3-year-results-from-the-valiant-us-investigational-device-exemption-study
#13
REVIEW
Chang Young Lim
Acute complicated type B aortic dissection (TBAD) is a potentially catastrophic, life-threatening condition. If left untreated, there is a high risk of aortic rupture, irreversible organ or limb damage, or death. Several risk factors have been associated with acute complicated TBAD, including age and refractory hypertension. In the acute phase, even uncomplicated patients are more prone to develop complications if hypertension and pain are left medically untreated. Innovations in stent graft technologies have incrementally improved outcomes since their first use for this condition in 1999, though improvement is needed in mitigating periprocedural complications, adverse events, and mortality...
June 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28589157/return-to-preoperative-function-after-autologous-cartilage-implantation-of-the-knee-in-active-military-servicemembers
#14
Nicholas J Zarkadis, Nicholas A Kusnezov, EStephan J Garcia, Mark P Pallis, Brian R Waterman
BACKGROUND: Autologous chondrocyte implantation (ACI) has been shown to provide adequate durability, pain relief, and improved long-term functional outcomes in the average patient, but proof of its efficacy in individuals with greater than average physical demands is scarce. Further knowledge is required to understand which patients may benefit from ACI and to identify which risk factors are associated with failure to return to the preinjury activity level. PURPOSE: To determine the occupational outcomes, rates of reoperation, and variables predictive of suboptimal outcomes after ACI...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28573819/use-of-eltrombopag-for-secondary-immune-thrombocytopenia-in-clinical-practice
#15
Tomás J González-López, María T Alvarez-Román, Cristina Pascual, Blanca Sánchez-González, Fernando Fernández-Fuentes, Gloria Pérez-Rus, José A Hernández-Rivas, Silvia Bernat, José M Bastida, María P Martínez-Badas, Violeta Martínez-Robles, Inmaculada Soto, Pavel Olivera, Estefanía Bolaños, Rafael Alonso, Laura Entrena, Marta Gómez-Nuñez, Arancha Alonso, María Yera Cobo, Isabel Caparrós, María Tenorio, Esther Arrieta-Cerdán, Elsa Lopez-Ansoar, Javier García-Frade, José R González-Porras
Eltrombopag is a second-line treatment in primary immune thrombocytopenia (ITP). However, its role in secondary ITP is unknown. We evaluated the efficacy and safety of eltrombopag in secondary ITP in daily clinical practice. Eighty-seven secondary ITP patients (46 with ITP secondary to autoimmune syndromes, 23 with ITP secondary to a neoplastic disease subtype: lymphoproliferative disorders [LPDs] and 18 with ITP secondary to viral infections) who had been treated with eltrombopag were retrospectively evaluated...
June 1, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28569053/pathology-of-balloon-expandable-transcatheter-aortic-valves
#16
Kazuyuki Yahagi, Elena Ladich, Robert Kutys, Hiroyoshi Mori, Lars G Svensson, Michael J Mack, Howard C Herrmann, Craig R Smith, Martin B Leon, Renu Virmani, Aloke V Finn
BACKGROUND: The Placement of AoRtic TraNscathetER Valves trials (PARTNER) showed favorable safety and efficacy versus medical or surgical therapy in inoperable, high, and intermediate surgical risk patients with severe aortic stenosis. However, the biological responses to transcatheter aortic valves have not been well characterized. OBJECTIVES: The aim of this study was to perform pathologic assessment of Edwards SAPIEN transcatheter aortic valves removed either at autopsy or surgically during the PARTNER I and II clinical trials...
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28564663/current-treatment-of-metastatic-spine-tumors-surgery-and-stereotactic-radiosurgery
#17
Jared S Fridley, Jaroslaw T Hepel, Adetokunbo A Oyelese
There has been significant progress and innovation in the treatment of patients with metastatic spinal tumors over the last two to three decades that has impacted our ability to provide individualized care that improves a patient's quality of life and degree of neurologic impairment. Advances in surgical techniques and radiation delivery modalities have dramatically improved our ability to decrease local tumor recurrence rates, improve pain control, and provide more durable spinal stability. Modern day spine tumor resection and reconstruction techniques have been shown to improve and prolong patients' ability to ambulate, maintain continence, and reduce the need for pain medications...
June 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28562401/using-a-standardized-patient-to-improve-collaboration-and-problem-solving-skills-with-cpap-usage-in-the-home
#18
Margaret G Williams, Joan Ruhs
A review of literature revealed a lack of research pertaining to nurses' or student nurses' knowledge of continuous positive airway pressure (CPAP) and the ability to troubleshoot CPAP malfunction. This study sought to answer the following questions: What are associate degree nursing (ADN) students' knowledge, interdisciplinary communication, and problem-solving skills regarding patients' home use of CPAP? Is there a change after participation in a simulation with a patient on CPAP in home setting? Twenty-one ADN students enrolled in small Midwest college participated...
June 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/28559412/complete-responses-to-mitotane-in-metastatic-adrenocortical-carcinoma-a-new-look-at-an-old-drug
#19
Diane L Reidy-Lagunes, Betty Lung, Brian R Untch, Nitya Raj, Anastasia Hrabovsky, Ciara Kelly, Scott Gerst, Seth Katz, Lewis Kampel, Joanne Chou, Anu Gopalan, Leonard B Saltz
PURPOSE: Based largely on reports that predate modern reporting standards, mitotane has been considered a systemic treatment option for both hormone control and antitumor control of metastatic adrenocortical cancer (ACC), although the therapeutic window is narrow. METHODS: We searched electronic medical records to identify patients with metastatic ACC treated and prescribed single agent mitotane at Memorial Sloan Kettering Cancer Center from March 15, 1989-September 18, 2015...
May 30, 2017: Oncologist
https://www.readbyqxmd.com/read/28559176/results-from-multiple-prospective-single-center-clinical-trials-of-the-off-the-shelf-p-branch-fenestrated-stent-graft
#20
Mark A Farber, Matthew J Eagleton, Tara M Mastracci, James F McKinsey, Raghuveer Vallabhaneni, Björn Sonesson, Nuno Dias, Timothy Resch
OBJECTIVE: The purpose of this study was to report prospective data of an off-the-shelf fenestrated endograft (Zenith p-Branch; Cook Medical, Bloomington, Ind) from four centers for the treatment of patients with pararenal abdominal aortic aneurysms. METHODS: Data were combined from four single-center investigational studies conducted in the United States and Europe. The p-Branch endograft consists of a proximal off-the-shelf component incorporating a scallop for the celiac artery, a superior mesenteric artery fenestration, and two conical pivot fenestrations to preserve flow to the renal vessels...
May 27, 2017: Journal of Vascular Surgery
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