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Amara Krag, Gregory L Holmes
Infantile spasms, one of the catastrophic epilepsies, can be a diagnostic challenge since the clinical manifestations may be subtle and may mimic benign conditions. Because of the rarity of the condition, primary care physicians and pediatricians may never see a case of infantile spasms during their career and may be unfamiliar with the seizure semiology. This is a serious issue since there is evidence that early diagnosis and treatment may improve outcome. Patients and families are increasingly using the internet more than their physician as a source of medical information about epilepsy...
October 17, 2016: Epilepsy & Behavior: E&B
Takehiro Matsumura, Yoshihiro Takamura, Takeshi Tomomatsu, Shogo Arimura, Makoto Gozawa, Akira Kobori, Masaru Inatani
PURPOSE: To evaluate the efficacy of the inverted internal limiting membrane (ILM) flap technique in vitrectomy for macular hole (MH) with retinal detachment (RD) compared with vitrectomy using ILM peeling. METHODS: A retrospective case series study was performed. Twenty-two eyes of 22 patients who underwent vitrectomy for MH with RD and followed-up more than 12 months after the surgery were included in this study. We retrospectively reviewed the medical records of patients who underwent vitrectomy with inverted ILM flap technique or vitrectomy with ILM peeling...
2016: PloS One
Danielle Bloch, Nicole M Roth, Elba V Caraballo, Jorge Muñoz-Jordan, Elizabeth Hunsperger, Aidsa Rivera, Janice Pérez-Padilla, Brenda Rivera Garcia, Tyler M Sharp
BACKGROUND: Chikungunya virus (CHIKV) is transmitted by Aedes species mosquitoes and is the cause of an acute febrile illness characterized by potentially debilitating arthralgia. After emerging in the Caribbean in late 2013, the first locally-acquired case reported to public health authorities in Puerto Rico occurred in May 2014. During June-August 2014, household-based cluster investigations were conducted to identify factors associated with infection, development of disease, and case reporting...
October 2016: PLoS Neglected Tropical Diseases
Gianna Sepede, Giuseppe Di Iorio, Maria Chiara Spano, Marco Lorusso, Fabiola Sarchione, Rita Santacroce, Rosa Maria Salerno, Massimo Di Giannantonio
BACKGROUND: Treatment-resistant schizophrenia (TRS) is a condition characterized by intense symptom severity and poor response to different antipsychotic agents. The first therapeutic option in TRS is clozapine, but often high/medium doses are not tolerated. Adding an oral antipsychotic to low doses of clozapine is a promising strategy in the management of TRS. On the contrary, there are few data on combined clozapine/long-acting injectable (LAI) medications, and none on clozapine/LAI-aripiprazole...
October 18, 2016: Clinical Neuropharmacology
Anand Pandey, Vipin Gupta, Shailendra P Singh, Vijendra Kumar, Rajesh Verma
A trophic ulcer is a pressure ulcer caused by external trauma to a part of the body that is compromised due to disease, vascular insufficiency, or loss of afferent nerve fibers. Spinal dysraphism (ie, neural tube defects [NTD]) such as meningomyelocele is a risk factor for developing these ulcers in adults and pediatric patients. Information regarding the occurrence of trophic ulcers in pediatric patients with NTD is lacking. A review of the English-language literature on skin/neuropathic ulcers in patients with NTDs, irrespective of study design, published between 1975 and 2014, was undertaken using the PubMed database...
December 2015: Ostomy/wound Management
Carey L Medin, Alan L Rothman
Once obscure, Zika virus (ZIKV) has attracted significant medical and scientific attention in the past year because of large outbreaks associated with the recent introduction of this virus into the Western hemisphere. In particular, the occurrence of severe congenital infections and cases of Guillain-Barré syndrome has placed this virus squarely in the eyes of clinical and anatomic pathologists. This review article provides a basic introduction to ZIKV, its genetics, its structural characteristics, and its biology...
October 20, 2016: Archives of Pathology & Laboratory Medicine
David A Siegel, Reda Wilson, Edward J Wilkinson, Julia W Gargano, Meg Watson, Brenda Y Hernandez, Marc T Goodman, Charles F Lynch, Elizabeth R Unger, Mona Saraiya
CONTEXT: -Knowing the subtype of vulvar cancer histology is important for estimating human papillomavirus-related cancer etiology. Surveillance of human papillomavirus-related vulvar cancers informs public health decisions related to vaccination against human papillomavirus. OBJECTIVE: -To assess the accuracy of registry classifications of vulvar cancer and determine the histologic classification of cases reported as not otherwise specified. DESIGN: -Pathology specimens were collected from Florida, Iowa, and Hawaii cancer registries...
October 20, 2016: Archives of Pathology & Laboratory Medicine
Ronald E Domen, Kristen Johnson, Richard Michael Conran, Robert D Hoffman, Miriam D Post, Jacob J Steinberg, Mark D Brissette, Dita A Gratzinger, Cindy B McCloskey, Patricia M Raciti, Cory Anthony Roberts, Amyn M Rojiani, Suzanne Zein-Eldin Powell
CONTEXT: -Professionalism issues in residency training can be difficult to assess and manage. Generational or role-based differences may also exist between faculty and residents as to what constitutes unprofessional behavior and how to manage it. OBJECTIVE: -To examine and compare how faculty and residents would approach the same 5 case scenarios detailing various aspects of unprofessional behavior. DESIGN: -Five case scenarios highlighting various unprofessional behaviors were presented in a workshop at an annual meeting of pathology department chairs, residency program directors, and undergraduate pathology medical educators (ie, pathologists involved in medical student pathology education)...
October 20, 2016: Archives of Pathology & Laboratory Medicine
Christopher Rowe, Eric Vittinghoff, Glenn-Milo Santos, Emily Behar, Caitlin Turner, Phillip Coffin
OBJECTIVES: Opioid overdose mortality has tripled in the USA since 2000 and opioids are responsible for more than half of all drug overdose deaths, which reached an all-time high in 2014. Opioid overdoses resulting in death, however, represent only a small fraction of all opioid overdose events and efforts to improve surveillance of this public health problem should include tracking nonfatal overdose events. International Classification of Disease (ICD) diagnosis codes, increasingly used for the surveillance of nonfatal drug overdose events, have not been rigorously assessed for validity in capturing overdose events...
October 20, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Paul L Schneider, Zhaoping Li
OBJECTIVE: To provide a thorough analysis of the range of ethical concerns that may present in relation to the care of the morbidly obese inpatient over the course of several years of care. METHODS: A narrative of the patient's complex medical care is given, with particular attention to the recommendations of three separate ethics committee consultations that were sought by his health care providers. An ethical analysis of the relevant issues is given within the Principles of Biomedical Ethics framework, highlighting the principles of autonomy, beneficence, non-maleficence, and justice...
2016: Narrative Inquiry in Bioethics
Eric Klingelhoefer, Hendrik Bergert, Stephan Kersting, Stefan Ludwig, Norbert Weiss, Frank Schönleben, Robert Grützmann, Gabor Gäbel
BACKGROUND: Peripheral arterial disease (PAD) is one of the most underestimated diseases because of its high prevalence and unfavorable prognosis. Many PAD patients without suitable autologous veins or options for endovascular treatment receive prosthetic above-knee femoropopliteal bypass (PAKB). Until now predictors of prosthetic bypass failure and of increased amputation risk remain indistinct. This study aimed to identify predictive factors associated with better bypass patency and limb salvage to achieve a more favorable outcome after PAKB reconstruction...
August 2016: Journal of Vascular Surgery
A E Cullen, L Bowers, M Khondoker, S Pettit, E Achilla, L Koeser, L Moylan, J Baker, A Quirk, F Sethi, D Stewart, P McCrone, A D Tulloch
AIMS: Within acute psychiatric inpatient services, patients exhibiting severely disturbed behaviour can be transferred to a psychiatric intensive care unit (PICU) and/or secluded in order to manage the risks posed to the patient and others. However, whether specific patient groups are more likely to be subjected to these coercive measures is unclear. Using robust methodological and statistical techniques, we aimed to determine the demographic, clinical and behavioural predictors of both PICU and seclusion...
October 20, 2016: Epidemiology and Psychiatric Sciences
Parthopratim Dutta Majumder, Avirupa Ghose, Meenakshi Chidambaram, Sudha K Ganesh, Jyotirmay Biswas
PURPOSE: To report the clinical profile of a series of necrotizing scleritis in an Indian population. METHODS: A retrospective medical record review of 27 consecutive patients with necrotizing scleritis. Patient demographics, ocular and systemic findings, treatment modalities, and visual outcome were recorded. RESULTS: There were 19 males and 8 females (31 eyes) with mean age at presentation of 49.5 years (range: 30-84 years). Underlying immunologically induced disorders was present in 37%...
October 20, 2016: Ocular Immunology and Inflammation
Daniel López López, Paula Torreiro Pazo, Marta E Losa Iglesias, Ricardo Becerro de Bengoa Vallejo
We sought to explore the relationship between the podiatric medical student and the patient as it relates to the act of gift-giving as a sign of gratefulness for the services provided. This article presents the clinical case of a man who visited a podiatric medical student because of pain in his feet and subsequently presented the student with several gifts. Philanthropy, empathy, a positive attitude, treatment instructions, and the time devoted to the patient are some of the reasons why patients offer gifts to podiatric medical students...
September 2, 2016: Journal of the American Podiatric Medical Association
David P Seamans, Boshra F Louka, F David Fortuin, Bhavesh M Patel, John P Sweeney, Louis A Lanza, Patrick A DeValeria, Kim M Ezrre, Harish Ramakrishna
BACKGROUND: The surgical and procedural specialties are continually evolving their methods to include more complex and technically difficult cases. These cases can be longer and incorporate multiple teams in a different model of operating room synergy. Patients are frequently older, with comorbidities adding to the complexity of these cases. Recording of this environment has become more feasible recently with advancement in video and audio capture systems often used in the simulation realm...
October 2016: Annals of Cardiac Anaesthesia
Kavita Krishna, Madhu Pankaj, Ankit Tuteja, Varsha Jagtap
Thyrotoxic crisis is a life threatening medical condition that requires urgent diagnosis and treatment. Because of the wide variety of presenting symptoms, its diagnosis can be difficult in some cases and a high index of suspicion is required for diagnosis. We present a case of 53 year old patient who presented with fever, jaundice and passage of loose stools. Upon investigations other etiologies for hepatic injury were ruled out and she was found to be in thyrotoxic crisis causing liver injury.
August 2016: Journal of the Association of Physicians of India
Prakash Chandra Pandey, Sarita Bajaj, Anubha Srivastava
OBJECTIVE: Snake bite in India is a common medical emergency and an occupational hazard for majority of Indian population especially farmers. Epidemiological data on snake bite from the North India is sparse. Hence we conducted this study to find clinico-epidemiological profile of neuroparalytic snake bite. METHODS: This is a record-based, descriptive study carried out at the Department of Medicine, M.L.N. Medical College and associated Swaroop Rani Nehru Hospital, Allahabad, U...
August 2016: Journal of the Association of Physicians of India
Hasan Emre Koçak, Ayşe Şermin Filiz Acıpayam, Harun Acıpayam, Bilgen Çakıl Erdoğan, Wesam M E Alakhras, Mehmet Nurettin Kıral, Mehmet Keskin, Fatma Tülin Kayhan
OBJECTIVE: The aim of our study is to investigate whether systemic microvascular function affects the development and prognosis of sudden idiopathic hearing loss (SHL). TYPE OF STUDY: A prospective case-control study. MATERIALS-METHOD: 50 patients diagnosed with SHL at our hospital between September 2015 and May 2016 were included as the SHL group, and 50 healthy volunteers who came to the hospital for medical screening were included in the control group...
October 19, 2016: Clinical Otolaryngology
Felix Meincke, Tobias Spangenberg, Felix Kreidel, Christian Frerker, Renu Virmani, Elena Ladich, Karl-Heinz Kuck, Alexander Ghanem
AIMS: Aims of this case-series were to assess the feasibility of cerebral protection devices in interventional left atrial appendage occlusion (iLAAO) procedures and to yield insight into the pathomorphological correlate of early, procedural cerebral embolization during iLAAO. METHODS AND RESULTS: Five consecutive patients underwent iLLO flanked by the Sentinel CPS® (Claret Medical, Inc., Santa Rosa, CA) cerebral protection system. Placement and recapture of the Sentinel(®) device as well as the iLAAO were successful and safe in all cases...
October 20, 2016: Catheterization and Cardiovascular Interventions
Markus Hoffmann, Asita Fazel, Kai-Gerrit Mews, Petra Ambrosch
OBJECTIVES: To underline the value of the microendoscopic CO2 -Laser assisted treatment (MEDCO2 ) of Zenker's diverticulum by investigating a large patient cohort treated in a single medical center. DESIGN: Retrospective Cohort Study of consecutive patients. SETTING: Dept. of Otorhinolaryngology, Head & Neck Surgery, Christian-Albrechts-University Kiel, Germany. PARTICIPANTS: 227 patients with Zenkers' diverticulum were treated by MEDCO2 and the results were compared with those reported in the literature for the open transcervical approach (OTA) and the endoscopic staple-assisted esophagodiverticulostomy (ESED)...
October 19, 2016: Clinical Otolaryngology
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