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https://www.readbyqxmd.com/read/28550787/apocrine-sweat-gland-adenocarcinoma-a-rare-case-report-and-review
#1
Arthur Paredes Gatti, Luiza Tonello, William Pfaffenzeller, Fernando Oliveira Savóia, Diego Inácio Goergen, Rodrigo De Pieri Coan, Uirá Fernandes Teixeira, Fábio Luiz Waechter, Paulo Roberto Ott Fontes
INTRODUCTION: Primary apocrine sweat gland carcinoma (PASGC) is an extremely rare neoplasia whose management and treatment are still evolving. The only curative therapy is wide local excision. Many patients have metastasis at the time of the diagnosis, mainly because this neoplasm has been misdiagnosed as some benign skin lesions. PRESENTATION OF CASE: We herein report a case of a 72-year-old-man with PASGC affecting the axilla and regional lymph nodes that underwent surgical resection and lymphadenectomy at our Institution...
May 18, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28550767/antibiotics-and-mania-a-systematic-review
#2
REVIEW
Simon Lambrichts, Lukas Van Oudenhove, Pascal Sienaert
OBJECTIVES: Mania can occur secondary to a medical condition and can be elicited by various pharmacological treatments, both in patients with or without a history of affective disorder. Antibiotic-induced mania or antibiomania is suggested to be a rare phenomenon. We reviewed the literature in order to collect published reports of antibiomania and to summarize new insights about its mechanism and management. METHODS: We performed a MEDLINE-search and used manual cross-referencing for reports of antibiotic-induced mania and included cases in which a (hypo)manic episode was diagnosed in close temporal relationship with the prescription of an antibiotic...
May 20, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28550756/reduction-of-medical-hospitalizations-in-veterans-with-schizophrenia-using-home-telehealth
#3
Leah R Flaherty, Karin Daniels, Jim Luther, Gretchen L Haas, John Kasckow
This study tested the hypothesis that addition of telehealth to Intensive Case Monitoring (ICM) would reduce hospital admissions in Veterans with schizophrenia or schizoaffective disorder admitted for psychiatric care in response to suicidal behavior. Participants (n =51) were randomized to ICM or ICM plus telehealth monitoring. Telehealth participants responded to daily electronic queries about depression, suicidality, and medication adherence. Comparisons revealed that participants in the telehealth group had significantly less medical hospitalizations than the control group...
May 16, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28550480/characteristics-associated-with-quality-of-life-among-people-with-drug-resistant-epilepsy
#4
Leone Ridsdale, Gabriella Wojewodka, Emily Robinson, Sabine Landau, Adam Noble, Stephanie Taylor, Mark Richardson, Gus Baker, Laura H Goldstein
Quality of Life (QoL) is the preferred outcome in non-pharmacological trials, but there is little UK population evidence of QoL in epilepsy. In advance of evaluating an epilepsy self-management course we aimed to describe, among UK participants, what clinical and psycho-social characteristics are associated with QoL. We recruited 404 adults attending specialist clinics, with at least two seizures in the prior year and measured their self-reported seizure frequency, co-morbidity, psychological distress, social characteristics, including self-mastery and stigma, and epilepsy-specific QoL (QOLIE-31-P)...
May 26, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28550374/performance-of-an-artificial-multi-observer-deep-neural-network-for-fully-automated-segmentation-of-polycystic-kidneys
#5
Timothy L Kline, Panagiotis Korfiatis, Marie E Edwards, Jaime D Blais, Frank S Czerwiec, Peter C Harris, Bernard F King, Vicente E Torres, Bradley J Erickson
Deep learning techniques are being rapidly applied to medical imaging tasks-from organ and lesion segmentation to tissue and tumor classification. These techniques are becoming the leading algorithmic approaches to solve inherently difficult image processing tasks. Currently, the most critical requirement for successful implementation lies in the need for relatively large datasets that can be used for training the deep learning networks. Based on our initial studies of MR imaging examinations of the kidneys of patients affected by polycystic kidney disease (PKD), we have generated a unique database of imaging data and corresponding reference standard segmentations of polycystic kidneys...
May 26, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28549980/trends-in-malpractice-claims-for-obstetric-and-gynecologic-procedures-2005-2014
#6
Laura M Glaser, Farah A Alvi, Magdy P Milad
BACKGROUND: Interest in medical malpractice and areas of medico-legal vulnerability for practicing obstetricians and gynecologists has grown substantially, and many providers report changing surgical practice out of fear of litigation. Furthermore, education on medical malpractice and risk management is lacking for obstetrics and gynecology trainees. Recent obstetric and gynecologic malpractice claims data is lacking. We report on recent trends in malpractice claims for obstetrics and gynecology procedures, and compare these trends to those of other medical specialties...
May 23, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28549916/utility-of-carotid-ultrasonography-in-management-of-an-atypical-high-vascular-risk-patient-with-recurrent-calcified-cerebral-embolic-stroke
#7
John W Liang, Jesse Weinberger, Aaron Tansy
OBJECTIVE: To describe a case of recurrent calcified cerebral emboli (CCE)-related acute ischemic stroke (AIS) and the diagnostic utility of plaque morphology characterization on carotid ultrasound. BACKGROUND: CCE are a rare cause of AIS. CCE-related AIS has been previously reported only in high vascular-risk patients such as those with severe carotid stenosis, widespread atheromatous disease, or cardiac valvular disease. CCE-related AIS from a carotid origin has not been reported in patients without carotid stenosis...
May 23, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28549711/symptomatic-lumbar-facet-synovial-cysts-clinical-outcomes-following-percutaneous-ct-guided-cyst-rupture-with-intraarticular-steroid-injection
#8
Steffen J Haider, Nu R Na, Clifford J Eskey, Jessica G Fried, Natalie Y Ring, Mike H Bao, David A Pastel
PURPOSE: To evaluate clinical outcomes following percutaneous rupture of symptomatic lumbar facet synovial cysts (LFSCs) with intraarticular steroid injection. MATERIALS AND METHODS: In this retrospective review, 44 consecutive patients with symptomatic LFSCs received primary treatment with CT-guided synovial cyst rupture with intraarticular steroid injection. Outcomes questionnaires were obtained before and 1, 4, 26, and 52 weeks after LFSC rupture. Assessment included pain medication use and numeric rating scale (NRS), Oswestry Disability Index (ODI), and 12-item short form health survey (SF-12) physical and mental composite scores (PCS and MCS)...
May 24, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28549580/hyperkalemia-and-cardiac-arrest-associated-with-glucose-replacement-in-a-patient-on-spironolactone
#9
Ryan Offman, Amanda Paden, Adam Gwizdala, James Fletcher Reeves
We present a case of hypoglycemia, which after intravenous glucose replacement, led to cardiac arrest secondary to a profound extracellular potassium shift. The patient was on spironolactone therapy which is known to cause aldosterone resistance (which inhibits the body's ability to prevent potassium shifts) [1]. Physicians typically review medications that cause hypoglycemia, but other medications may interfere with potassium homeostasis with administration of glucose. Knowledge of this case may prompt further monitoring, repeat lab testing, and careful medication reconciliation before discharging a patient with risk for aldosterone resistance...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28549543/paternity-testing-at-the-department-of-forensic-medicine-of-wroclaw-medical-university-poland
#10
Anna Karpiewska, Elżbieta Kowalczyk, Tadeusz Dobosz
Evidentiary materials in court cases comprise the testimony of all relevant parties and witnesses, physical and biological evidence, and the stage of child's development at the moment of birth. In this study, an analysis was made of results obtained between 1966 and 2014 from paternity testing capable of providing biological evidence for court cases. During this time, 16,508 opinions were released, with exclusion of paternity in 4182 cases. The analysis of the total percentage of exclusions in individual years over the entire period of 49years turned out to be very interesting...
May 2017: Legal Medicine
https://www.readbyqxmd.com/read/28549461/the-effect-of-white-coats-and-gender-on-medical-students-perceptions-of-physicians
#11
Malika Ladha, Aleem Bharwani, Kevin McLaughlin, Henry T Stelfox, Adam Bass
BACKGROUND: Despite the fact that medical schools spend a considerable effort to rate clinical instructors, there is limited evidence regarding the effect of physical characteristics on instructor ratings. White coats have been shown to alter patients' perceptions of physicians although it has not been determined if preceptors who wear white coats are rated differently than their colleagues. METHODS: Second year medical students were administered a questionnaire with four clinical scenarios depicting medical errors accompanied by a picture of a physician of different sexes and ethnicities...
May 26, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28549405/twelve-tips-for-the-implementation-of-epas-for-assessment-and-entrustment-decisions
#12
Harm Peters, Ylva Holzhausen, Christy Boscardin, Olle Ten Cate, H Carrie Chen
The concept of entrustable professional activities (EPAs) reframes the approach to assessment in competency-based medical education. Key to this concept is the linking of assessment to decision making about entrusting learners with clinical responsibilities. Based on recent literature and the authors' experiences with implementing EPAs, this article provides practical recommendations for how to implement EPAs for assessment and entrustment decisions in the workplace. Tips for supervising clinicians include talking to learners about trust, using EPA descriptions to guide learning and teaching, providing learners with greater ad hoc responsibilities, using EPAs to identify/create opportunities for assessment and feedback, including case-based discussions and acknowledging gut feelings about learner readiness for more autonomy...
May 26, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28549099/impact-of-resident-and-fellow-changeovers-on-patient-outcomes-a-nationwide-cross-sectional-study
#13
Jean-David Zeitoun, Jeanne Reboul-Marty, Jérémie H Lefèvre
Findings regarding the association of cohort changeovers with patient outcomes are mixed. We sought to examine the association of resident and fellow changeovers with a comprehensive set of indicators. We performed a cross-sectional comparative study including all French teaching and non-teaching hospitals. All-cause mortality and length of stay were assessed. Focused analysis for three medical conditions (myocardial infarction, intestinal hemorrhage, stroke) and three surgical procedures (colorectal, vascular and spine surgery) was performed regarding other quality and efficiency indicators (readmissions, intensive care unit admission, transfers)...
May 25, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28549063/food-addiction-and-obesity-unnecessary-medicalization-of-hedonic-overeating
#14
REVIEW
Graham Finlayson
The concept of addiction is loaded with connotations and is often used for its political as much as its medical utility. The scientific case for 'food addiction' as a clinical phenotype currently rests on its association with generic diagnostic criteria for substance-related disorders being applied to everyday foods and eating-related problems. This has fused the concept of obesity with addiction regardless of whether it fits the definition. The hedonic, or reward, system can account for the ingestion of foods and drugs, confirming that they share neural substrates that differentiate liking and wanting...
May 26, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28549011/use-of-elderly-donors-in-liver-transplantation-a-paired-match-analysis-at-a-single-center
#15
Davide Ghinolfi, Quirino Lai, Daniele Pezzati, Paolo De Simone, Erion Rreka, Franco Filipponi
OBJECTIVE: To evaluate the use of elderly donors in liver transplantation (LT) and identify risk factors associated with a worse outcome. SUMMARY BACKGROUND DATA: Use of livers from very old donors could expand the donor pool but is not universally implemented. METHODS: This is a retrospective, single-center medical record review. From January 2001 to December 2014, 1354 LTs were performed. After exclusion of donors <18 years, ABO-incompatible LT, re-LT and UNOS 1 status patients, LT recipients were stratified into 2 groups based on donor age: 18-69 (n=692) vs...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28548647/acute-endophthalmitis-after-cataract-surgery-164-consecutive-cases-treated-at-a-referral-center-in-south-korea
#16
S H Jeong, H J Cho, H S Kim, J I Han, D W Lee, C G Kim, J W Kim
PurposeTo identify prognostic factors in patients referred with endophthalmitis after cataract surgery, and to evaluate the efficacy of primary vitrectomy as an initial management.MethodsOver an eight-year study period, we retrospectively reviewed the medical records of 164 patients who were referred with endophthalmitis following cataract surgery. Treatment generally conformed to standard guidelines, although primary vitrectomy was performed in several eyes with a visual acuity of hand motion or better, depending on the patient's status...
May 26, 2017: Eye
https://www.readbyqxmd.com/read/28548593/bilateral-deep-brain-stimulation-of-the-subthalamic-nucleus-in-primary-meige-syndrome
#17
Shikun Zhan, Fafa Sun, Yixin Pan, Wei Liu, Peng Huang, Chunyan Cao, Jing Zhang, Dianyou Li, Bomin Sun
OBJECTIVE Subthalamic nucleus deep brain stimulation has been shown to be effective in reducing symptoms of primary Meige syndrome. However, assessments of its efficacy and safety have been limited to several case reports and small studies. METHODS The authors performed a retrospective study to assess the efficacy and safety of bilateral subthalamic nucleus stimulation in 15 patients with primary Meige syndrome who responded poorly to medical treatments or botulinum toxin injections. Using the movement and disability subscores of the Burke-Fahn-Marsden Dystonia Rating Scale, the authors evaluated the severity of patients' dystonia and related before surgery and at final follow-up during neurostimulation...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28548544/neuropsychological-impairment-in-hashimoto-s-encephalopathy-a-case-report-and-literature-review
#18
Liorah Sabbah-Talasazan, Irene Piryatinsky
Hashimoto's encephalopathy (HE) is a rare neurological syndrome characterized by the presence of positive serum antithyroid antibodies, altered mental status, and clinical response to glucocorticoid therapy. Although HE has been documented in the literature from a medical standpoint, reports on the neuropsychological presentation of this syndrome are scarce. This article presents a literature review of cognitive deficits reported in HE cases. In addition, we describe the case of a 76-year-old Russian speaking woman diagnosed with HE in May 2012...
May 26, 2017: Applied Neuropsychology. Adult
https://www.readbyqxmd.com/read/28548233/robotic-longitudinal-pancreaticojejunostomy-for-chronic-pancreatitis-comparison-of-clinical-outcomes-and-cost-to-the-open-approach
#19
Russell C Kirks, Patrick D Lorimer, Michael Fruscione, Allyson Cochran, Erin H Baker, David A Iannitti, Dionisios Vrochides, John B Martinie
BACKGROUND: This study compares clinical and cost outcomes of robot-assisted laparoscopic (RAL) and open longitudinal pancreaticojejunostomy (LPJ) for chronic pancreatitis. METHODS: Clinical and cost data were retrospectively compared between open and RAL LPJ performed at a single center from 2008-2015. RESULTS: Twenty-six patients underwent LPJ: 19 open and 7 RAL. Two robot-assisted cases converted to open were included in the open group for analysis...
May 26, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28548199/-acute-small-bowel-diverticulitis-in-a-patient-with-crohn%C3%A2-s-disease
#20
Macarena Hevia, Rodrigo Quera, Leonardo Soto, Tomás Regueira, Andrés O'Brien, Andrés Larach, Udo Kronberg
Diverticular disease of the small intestine is rare, especially when it is located in the jejunum. It is generally asymptomatic, but in some patients it may have complications such as acute diverticulitis with peritonitis, gastrointestinal bleeding or obstruction. In such cases, the recommended treatment is surgery. We report a 77-year-old patient with ileal Crohn’s disease with a long-standing inflammatory phenotype, who developed acute diverticulitis of the jejunum presenting a severe septic shock and secondary multiple-organ failure...
March 2017: Revista Médica de Chile
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