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life saving

Si Zhang, Hexiang Zhao, Hao Li, Chao You, Xuhui Hui
OBJECTIVE Decompressive craniectomy (DC) is a life-saving treatment for severe hemorrhagic cerebral venous thrombosis (CVT). However, the correlations between the clinicoradiological features and surgical outcomes of this disease are not well established. Therefore, the authors endeavored to analyze the potential risk factors for this more severe subtype of CVT and to provide more evidence regarding the benefits of DC in patients with hemorrhagic CVT. METHODS The clinical features, radiological findings, and surgical outcomes of patients with severe hemorrhagic CVT who had undergone DC treatment in the period from January 2005 to March 2015 were retrospectively analyzed, and the risk factors for this disease were evaluated...
October 21, 2016: Journal of Neurosurgery
Annabelle South, Wendy R Parulekar, Matthew R Sydes, Bingshu E Chen, Mahesh K Parmar, Noel Clarke, Padraig Warde, Malcolm Mason
BACKGROUND: Recent trials have shown that the addition of external beam radiotherapy (EBRT) to androgen deprivation therapy (ADT) improves survival among men with locally advanced prostate cancer. OBJECTIVE: To examine the potential impact of these trials on changes in clinical practice and life-years saved. DESIGN SETTING AND PARTICIPANTS: A model was developed to examine the impact of changes in clinical practice in the UK. A survey of clinicians who treat men with prostate cancer in the UK and Canada was performed...
August 2016: European Urology Focus
Yu-Min Shen
Atypical hemolytic uremic syndrome (aHUS) is a rare genetic disorder caused by defective complement regulation resulting in thrombotic microangiopathy (TMA). Patients can present as children or adults. The syndrome consists of hemolytic anemia with schistocytosis, thrombocytopenia, significant renal damage, and/or other organ system dysfunction(s). Patients with aHUS may succumb to the complications of the disease with the very first manifestation; surviving patients often suffer from progressive organ dysfunction with significant morbidity and mortality despite plasma infusion or plasma exchange...
2016: Thrombosis Journal
Charlotte Buswell, Jason Powell, Steven Powell
Paediatric tracheostomy can be a life saving procedure, but one with many unwanted effects, including a significant effect on phonation. This can range from reduced intensity and length of phonation to aphonia. This impairment has detrimental effects on a child's ability to express themselves, communicate with those around them, and ultimately may adversely impact on their speech and language development(1) . Rates of tracheostomy in children are increasing in many countries with improved healthcare(2) . This article is protected by copyright...
October 19, 2016: Clinical Otolaryngology
Sigrid Bosteels, Michel Vandenbroeck, Geert Van Hove
New-born screening programs for congenital disorders and chronic disease are expanding worldwide and children "at risk" are identified by nationwide tracking systems at the earliest possible stage. These practices are never neutral and raise important social and ethical questions. An emergent concern is that a reflexive professionalism should interrogate the ever earlier interference in children's lives. The Flemish community of Belgium was among the first to generalize the screening for hearing loss in young children and is an interesting case to study the public justification of early interventions for families with deaf children...
October 19, 2016: Journal of Bioethical Inquiry
Mougnyan Cox, Manisha Patel, Zhenteng Li, Sarah Kamel, Sandeep Deshmukh, Christopher Roth, Laurence Needleman
Venous thromboembolism (VTE) is a serious common disorder with substantial cost and morbidity to society and can be life threatening in some cases. The majority of VTE is diagnosed on lower extremity ultrasound or CT pulmonary angiography, but some cases of deep venous thrombosis (DVT) may be occasionally diagnosed on CT of the abdomen and pelvis by the alert radiologist. The purpose of our study was to determine the fraction of new/unsuspected DVTs diagnosed on CTAP and the subsequent management and clinical course of these patients...
October 19, 2016: Emergency Radiology
Carine Bou-Abboud, Jeffry Katz, Wendy Liu
Celiac crisis, an atypical presentation of celiac disease, is characterized by acute diarrhea and severe metabolic derangements. This diagnosis is often missed in the differential of acute diarrheal illness. Our patient is a 69-year-old man who presented with ICD firing and was found to have profound metabolic derangements. Further evaluation revealed undiagnosed celiac disease and his symptoms resolved with a gluten-free diet. Celiac crisis should be considered in all patients presenting with acute diarrhea, metabolic acidosis, and severe electrolyte abnormalities as management can be life-saving...
August 2016: ACG Case Reports Journal
Dani Sarohia, Ramin Javan, Salim Aziz
We present a case in which intraocular silicone injection for complex retinal detachment resulted in migration and distribution of silicone along the intracranial visual pathway, and ultimately throughout the ventricular system. Misinterpretation of this material as intracranial hemorrhage on outside computed tomography imaging delayed emergent repair of a Type A aortic dissection until the diagnosis was made on repeat imaging. A discussion of this case and salient computed tomography and magnetic resonance imaging characteristics of silicone is provided...
August 2016: Journal of Radiology Case Reports
Adam J Mitchell, Warren D Gray, Max Schroeder, Hong Yi, Jeannette V Taylor, Rebecca S Dillard, Zunlong Ke, Elizabeth R Wright, David Stephens, John D Roback, Charles D Searles
BACKGROUND: Red blood cell (RBC) transfusions are a common, life-saving therapy for many patients, but they have also been associated with poor clinical outcomes. We identified unusual, pleomorphic structures in human RBC transfusion units by negative-stain electron microscopy that appeared identical to those previously reported to be bacteria in healthy human blood samples. The presence of viable, replicating bacteria in stored blood could explain poor outcomes in transfusion recipients and have major implications for transfusion medicine...
2016: PloS One
Rajiv Singh, Saurabh Sinha, Alan Bill, Lynne Turner-Stokes
OBJECTIVE: To identify the needs for specialised rehabilitation provision in a cohort of neurosurgical patients; to determine if these were met, and to estimate the potential cost implications and cost-benefits of meeting any unmet rehabilitation needs. METHODS: A prospective study of in-patient admissions to a regional neurosurgical ward. Assessment of needs for specialised rehabilitation (Category A or B needs) was made with the Patient Categorisation Tool. The number of patients who were referred and admitted for specialised rehabilitation was calculated...
October 19, 2016: British Journal of Neurosurgery
Laura Martelli, Laurent Peyrin-Biroulet
BACKGROUND: Anti-tumor necrosis factor (anti-TNF) monoclonal antibodies have revolutionized the treatment of inflammatory bowel diseases (IBD). However, because of their complexity, their production is expensive contributing to their high price. As the patent protection of these therapies has expired in several countries, biosimilars have been developed to reduce the healthcare costs. The aim of this article is to review the literature on the safety, efficacy and immunogenicity of biosimilars in IBD...
October 14, 2016: Current Medicinal Chemistry
Shivaram Prasad Singh, Pradeep Kumar Padhi, Jimmy Narayan, Ayaskanta Singh, Girish Kumar Pati, Preetam Nath, Prasant Kumar Parida, Sunil Mishra
AIM: The aim of this study is to estimate the socioeconomic impact of alcohol use on patients with alcoholic liver disease (ALD) and their families. METHODS: The demographic and socioeconomic data were collected from hospitalized ALD patients and attendants using a self designed non validated questionnaire and analyzed. RESULTS: Study subjects included 100 consecutive ALD patients (all males). Sixty percent were between 30 and 50 years. Most were married (96 %), literate (63 %), either businessmen (37 %) or employed (30 %) and belonged to middle socioeconomic class...
October 19, 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Madhu Bhamidipaty, Barend Mees, Timothy Wagner
While the intra-aortic balloon pump (IABP) itself has many useful and life-saving indications, it has a high complication rate, up to 30% in some studies. This report discusses the surgical removal and subsequent vascular repair in a patient with a ruptured and subsequently entrapped IABP and reviews the literature on the presentation and management of this rare but major complication.
April 2016: Aorta (Stamford, Conn.)
Larry E Miller, William G Herbert
Spinal cord injury (SCI) is a traumatic, life-disrupting event with an annual incidence of 17,000 cases in the US. SCI is characterized by progressive physical deconditioning due to limited mobility and lack of modalities to allow safe physical activity that may partially offset these deleterious physical changes. Approximately, 50% of patients with SCI report no leisure-time physical activity and 15% report leisure-time physical activity below the threshold where meaningful health benefits could be realized...
2016: ClinicoEconomics and Outcomes Research: CEOR
Tomaž Nerat, Igor Locatelli, Mitja Kos
INTRODUCTION: Type 2 diabetes is a major burden for the payer, however, with proper medication adherence, diet and exercise regime, complication occurrence rates, and consequently costs can be altered. AIMS: The aim of this study was to conduct a cost-effectiveness analysis on real patient data and evaluate which medication adherence or lifestyle intervention is less cost demanding for the payer. METHODS: Medline was searched systematically for published type 2 diabetes interventions regarding medication adherence and lifestyle in order to determine their efficacies, that were then used in the cost-effectiveness analysis...
2016: Patient Preference and Adherence
Kirsi Kautiainen, Heikki Ekroos, Mikko Puhakka, Helena Liira, Juha Laine, Kari Linden, Jarmo Hahl
OBJECTIVE: One quit attempt with varenicline has been found to be a cost-effective smoking cessation intervention. The purpose of this study was to analyze varenicline's cost-effectiveness in patients who relapse during or after the first treatment. A comparison was made between retreatment schema with varenicline and retreatment schema with bupropion, NRT and unaided cessation, and treatment once with varenicline in a Finnish context. METHODS: The two-quit version of BENESCO Markov model was used to follow a cohort of smokers making up to two quit attempts over a lifetime...
October 18, 2016: Journal of Medical Economics
Mustafa Arici
Middle East and Eastern Mediterranean Region (EMR) is a transcontinental region centered on Western Asia, east of the Mediterranean Sea and the Egypt. The whole area has almost 20 countries with an approximate population of 400 million with different ethnicities. The whole area has basically a hot and dry climate. In some parts of the Middle East, there is a desert climate.Cardiovascular diseases were the leading causes of death in the Middle East, similar to the many other territories of the World. Beyond that, the World Health Organization (WHO) has recognized this region as a hotspot for cardiovascular disease, where disease projections will exceed those of other regions...
September 2016: Journal of Hypertension
Dae-Hee Choi, Youn-Jung Kim, Seung Mok Ryoo, Chang Hwan Sohn, Shin Ahn, Dong-Woo Seo, Ju Yong Lim, Won Young Kim
OBJECTIVE: Extracorporeal cardiopulmonary resuscitation (ECPR) may be considered as a rescue therapy for patients with refractory cardiac arrest. Identifying patients who might benefit from this potential life-saving procedure is crucial for implementation of ECPR. The objective of this study was to estimate the number of patients who fulfilled a hypothetical set of ECPR criteria and to evaluate the outcome of ECPR candidates treated with conventional cardiopulmonary resuscitation. METHODS: We performed an observational study using data from a prospective registry of consecutive adults (≥18 years) with non-traumatic out-of-hospital cardiac arrest in a tertiary hospital between January 2011 and December 2015...
September 2016: Clin Exp Emerg Med
Fatma Nur Korkmaz, Gulsen Ozen, Ali Uğur Ünal, Pınar Kahraman Koytak, Nese Tuncer, Haner Direskeneli
Abstract/ Resumo Behcet's disease (BD) is a multisystem inflammatory disorder characterized by recurrent oral and genital ulcers, skin lesions and uveitis. The nervous system involvement of BD, neuro-Behcet's disease (NBD), is one of the important causes of mortality of the disease. Herein, we present a 29-year-old male with parenchymal NBD who has progressed rapidly and was managed with an uncommon aggressive immunosuppresive combination therapy. The patient first presented six years ago with vertigo and difficulty in talking and walking...
September 28, 2016: Acta Reumatológica Portuguesa
Alladi Mohan, G Sivaram Naik, J Harikrishna, D Prabath Kumar, M H Rao, Kvs Sarma, K K Guntupalli
BACKGROUND & OBJECTIVES: Ingestion of Cleistanthus collinus causes hypokalemia and cardiac arrhythmias leading to mortality in most cases. We undertook this retrospective study to evaluate the clinical presentation and predictors of outcome in critically ill patients admitted with C. collinus poisoning. METHODS: The case records of 56 patients admitted to the medical intensive care unit (MICU) of a tertiary care teaching hospital in south India (2000-2014) with C...
June 2016: Indian Journal of Medical Research
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