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https://www.readbyqxmd.com/read/27933591/charcoal-hemoperfusion-in-the-treatment-of-medically-refractory-pruritus-in-cholestatic-liver-disease
#1
Wonngarm Kittanamongkolchai, Ziad M El-Zoghby, J Eileen Hay, Russell H Wiesner, Patrick S Kamath, Nicholas F LaRusso, Kymberly D Watt, Carl H Cramer, Nelson Leung
BACKGROUND: Pruritus is a distressing symptom in a considerable proportion of cholestatic patients and a few of them do not respond to conventional treatment. Charcoal hemoperfusion (CH) is an extracorporeal technique that is effective in eliminating protein-bound substances which may have accumulated during cholestasis. Several case reports have shown significant reduction of bilirubin in mechanical jaundice and neonatal hemolytic jaundice. However, the published data of CH for the treatment of refractory pruritus in cholestatic patients are scarce...
December 8, 2016: Hepatology International
https://www.readbyqxmd.com/read/27933569/decision-making-in-clinical-practice-oral-anticoagulant-therapy-in-patients-with-non-valvular-atrial-fibrillation-and-a-single-additional-stroke-risk-factor
#2
REVIEW
Tatjana S Potpara, Nikolaos Dagres, Nebojša Mujović, Dragan Vasić, Milika Ašanin, Milan Nedeljkovic, Francisco Marin, Laurent Fauchier, Carina Blomstrom-Lundqvist, Gregory Y H Lip
Approximately 1 in 3-4 patients presenting with an ischemic stroke will also have atrial fibrillation (AF), and AF-related strokes can be effectively prevented using oral anticoagulant therapy (OAC), either with well-controlled vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs). In addition, OAC use (both VKAs and NOACs) is associated with a 26% reduction in all-cause mortality (VKAs) or an additional 10% mortality reduction with NOACs relative to VKAs. The decision to use OAC in individual AF patient is based on the estimated balance of the benefit from ischemic stroke reduction against the risk of major OAC-related bleeding [essentially intracranial hemorrhage (ICH)]...
December 8, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27933479/-bunch-of-grapes-in-complete-hydatidiform-mole
#3
REVIEW
Eduardo Kaiser Ururahy Nunes Fonseca, Marina Athaniel Silva Rodrigues, Fernando Ide Yamauchi, Ronaldo Hueb Baroni
Complete hydatidiform mole is a common cause of gestational bleeding of the first trimester, commonly assessed by ultrasound. It represents an abnormal proliferation of trophoblastic tissue, with no fetal formation, just hydropic villi. These abnormal villi seen in ultrasound are compared to a "bunch of grapes," a classic description of this disease.
December 8, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27933396/totally-laparoscopic-total-gastrectomy-using-the-overlap-method-early-outcomes-of-50-consecutive-cases
#4
Tae-Gyun Lee, In-Seob Lee, Jeong-Hwan Yook, Byung-Sik Kim
BACKGROUND: Construction of an esophagojejunostomy is still a challenging procedure in totally laparoscopic total gastrectomy (TLTG), and there is no standard anastomosing method. The aims of this study were to describe our TLTG with the overlap method using a linear stapler and report surgical outcomes. METHODS: From January 2015 to April 2016, 50 patients underwent TLTG using the overlap method for gastric cancer. The procedures were performed by a single surgeon, and the patients' medical records were reviewed...
December 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27933350/endoscopic-ear-surgery%C3%A2-a%C3%A2-complement-to-microscopic-ear-surgery
#5
S Preyer
Wullstein, the founder of modern microscopic ear surgery, already used an oto-endoscope intraoperatively. However, it is only after the recent development of modern video-endoscopy with high-definition, 4K, and 3‑dimensional imaging that endoscopically guided surgery of the middle ear is gaining some importance. Key ventilation routes like the isthmus tympani and the epitympanic diaphragm can be visualized far better using an endoscope than with a microscope. Going through the external meatus, surgery of middle ear pathologies is possible without external incision...
December 8, 2016: HNO
https://www.readbyqxmd.com/read/27932871/efficacy-and-safety-outcomes-of-fractional-flow-reserve-in-guiding-clinical-therapy-of-non-st-segment-elevation-myocardial-infarction-compared-with-angiography-alone-in-elderly-chinese-patients
#6
Zhao Zhang, Ke Li, Jinwen Tian
OBJECTIVE: Fractional flow reserve (FFR) is an innovative method for evaluating the physiological significance of a coronary stenosis, but its validity is less certain in patients with non-ST-segment elevation myocardial infarction (NSTEMI). It is important to assess whether FFR is effective and safe in patients, especially elderly Chinese patients, with NSTEMI. As the first one in China, the purpose of this study was to establish the efficacy and safety outcomes of FFR in guiding clinical therapy of NSTEMI compared with angiography alone in elderly Chinese patients...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27932844/what-factors-influence-patient-compliance-with-supportive-periodontal-therapy-in-a-general-practice-setting
#7
C Perrell-Jones, R S Ireland
Background The importance of supportive periodontal therapy following active treatment has been well documented but numerous studies have shown patient compliance to be poor. The aim of this study was to ascertain which factors affect patient compliance and whether this included routinely recorded periodontal indices.Methodology This was a five-year retrospective service evaluation study set within a private general dental practice. It utilised demographic and periodontal data from patients who attended the practice for chronic periodontal treatment in 2009 and ascertained whether there were links between this data and compliance with the supportive phase of periodontal treatment...
December 9, 2016: British Dental Journal
https://www.readbyqxmd.com/read/27932811/a-pilot-study-of-the-gingival-response-when-smokers-switch-from-smoking-to-vaping
#8
R Wadia, V Booth, H F Yap, D L Moyes
Introduction Tobacco smoking is one of the most important risk factors for periodontitis as it alters the host response to plaque. Although the prevalence of tobacco smoking has declined in recent years, the use of electronic-cigarettes (vaping) has increased. The effect of vaping on the gingiva is unknown and an evidence-base needs to be established before providing dental advice about the use of these products.Objective To compare the gingival health of a group of established smokers before and after substituting vaping for smoking tobacco...
December 9, 2016: British Dental Journal
https://www.readbyqxmd.com/read/27932769/-correction-of-posttraumatic-thoracolumbar-kyphosis-with-modified-pedicle-subtraction-osteotomy
#9
Fei Chen, Yijun Kang, Bin Zhou, Zhehao Dai
To evaluate the efficacy and safety of modified pedicle subtraction osteotomy for treatment of thoracolumbar old fracture with kyphosis.
 Methods: From January 2003 to January 2013, 58 patients of thoracolumbar kyphosis, who underwent modified pedicle subtraction osteotomy, were reviewed. Among them, 45 cases underwent initial operation and 13 cases underwent revision surgery. Preoperative and postoperative kyphotic Cobb's angle, score of back pain, as well as the incidence of complication were accessed by using visual analogue scale (VAS) and Oswestry disability index (ODI)...
November 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/27932749/-hemorrhage-from-an-angiographically-obliterated-arteriovenous-malformation-after-gamma-knife-radiosurgery-an-immunohistochemistry-study
#10
Saori Hamada, Daina Kashiwazaki, Tetsuhiro Kamo, Takahiro Tomita, Naoki Akioka, Naoya Kuwayama, Satoshi Kuroda
A 24-year-old woman was diagnosed with a cerebral arteriovenous malformation(AVM)in the right parietal lobe(Spetzler-Martin grade I). The AVM was treated with stereotactic radiosurgery and was observed to have completely disappeared 3 years after radiosurgery. At the age of 35 years, the patient complained of a headache, and was referred to our hospital. A plain CT scan demonstrated a large cyst with niveau formation in the right parietal lobe. Cerebral angiography identified no recurrence of AVM. However, contrast MRI revealed an enhanced lesion on the surface of the cyst...
December 2016: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/27932439/management-of-splenic-ectopic-pregnancy-presenting-with-massive-haemoperitoneum
#11
Alissa Greenbaum, Richard Miskimins, Brittany Coffman, Jasmeet Paul
Abdominal ectopic pregnancy (EP) accounts for only 1.3% of EPs and occurs when a fertilised ovum implants in an extrapelvic peritoneal location. Primary splenic pregnancy is a rare type of abdominal EP, with only 16 cases previously reported in the literature. Early diagnosis is essential as delay in treatment carries significant potential for morbidity and mortality. We present the case of a 27-year-old woman presenting with left upper quadrant abdominal pain, elevated human chorionic gonadotropin levels, absence of intrauterine gestational sac and massive haemoperitoneum on transvaginal ultrasound...
December 8, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27932176/intrahepatic-artery-pseudoaneurysm-induced-hemobilia-caused-by-a-plastic-biliary-stent-after-abo-incompatible-living-donor-liver-transplantation-a-case-report
#12
J M Chun, H T Ha, Y Y Choi, Y J Hwang, J Heo, H K Ryeom, Y S Han
Bile leakage after duct-to-duct anastomosis in living-donor liver transplantation (LDLT) can mostly be managed by therapeutic endoscopic retrograde cholangiopancreatography. Following this, various complications such as biliary infection, pancreatitis, perforation, and bleeding can occur, and endoscopic sphincterotomy is primarily associated with post- endoscopic retrograde cholangiopancreatography bleeding; other causes have been published in case reports. In the present case, a plastic biliary stent used for treating liver abscesses and leakage at the bile duct anastomosis site after ABO-incompatible LDLT resulted in an intrahepatic artery pseudoaneurysm and hemobilia, which were managed by angiography and coil embolization...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931726/meta-analysis-of-impact-of-diabetes-mellitus-on-outcomes-after-transcatheter-aortic-valve-implantation
#13
Yinghao Sun, Xianbao Liu, Yuxin He, Mengyao Tang, Qifeng Zhu, Xiaobin Xu, Dongyu Guo, Keda Shi, Po Hu, Lihan Wang, Huijia Kong, Jubo Jiang, Xiaoping Lin, Qiyuan Xu, Feng Gao, Jian'an Wang
To date, the impact of diabetes mellitus (DM) on prognosis after transcatheter aortic valve implantation (TAVI) is still contradictory and thus merits further investigation. The purpose of this meta-analysis was to evaluate the impact of DM on outcomes after TAVI. A systematic search of the PubMed database was performed. Primary end points were 30-day and 1-year all-cause mortality after TAVI. Risk ratios (RRs) and 95% CIs were calculated using the random-effect or fixed-effect model, depending on heterogeneity between studies, and p values <0...
November 16, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27931700/pediatric-tonsillectomy-and-ketorolac
#14
Lesley D Phillips-Reed, Paul N Austin, Ricardo E Rodriguez
BACKGROUND: The use of ketorolac in children undergoing tonsillectomy remains limited because of the concern about postoperative bleeding. METHODS: A search was performed addressing the question: For patients undergoing a surgical tonsillectomy, does a weight-appropriate single dose of intravenous ketorolac affect the incidence of postoperative hemorrhage? RESULTS: Five systematic reviews met the inclusion criteria. A Cochrane Review included 15 studies with 1,101 pediatric subjects and focused on perioperative bleeding requiring intervention...
December 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/27931652/red-blood-cell-transfusion-and-its-effect-on-microvascular-dysfunction-in-shock-states
#15
REVIEW
Jordan A Weinberg, Rakesh P Patel
Among critically ill patients, red blood cell (RBC) transfusion is often prescribed for anemia in the absence of active or recent bleeding. The failure of RBC transfusion to improve physiological parameters and clinical outcomes in this setting may be explained by current understanding of the relationship between the RBCs and the microcirculation. It is now evident that the circulating RBCs contribute to microcirculatory hypoxic vasodilation by regulated nitric oxide (NO)-dependent vasodilation, thereby facilitating delivery of oxygen to oxygen-deprived tissue...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931646/haemodynamic-coherence-in-haemorrhagic-shock
#16
REVIEW
Nicolas Libert, Anatole Harrois, Jacques Duranteau
In case of haemorrhage, a combination of low volume fluid resuscitation and permissive hypotension is used to avoid the adverse effects of early aggressive fluid resuscitation. During this phase, occult microvascular hypoperfusion can possibly develop over time. After controlling the bleeding, it is expected that optimization of macrocirculation will result in an improvement in microcirculation. However, this is the case only without alterations in microcirculation regulation. Haemodynamic coherence must be maintained to expect the restoration of microcirculation through systemic haemodynamic-driven resuscitation...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931640/the-role-of-surgery-in-the-treatment-of-endoscopic-complications
#17
REVIEW
Peter Dixon, Gopal C Kowdley, Steven Clark Cunningham
As the number, diversity, and complexity of endoscopic complications has increased, so too has the number, diversity, and complexity of operative interventions required to treat them. The most common complications of endoscopy in general are bleeding and perforation, but each endoscopic modality has specific nuances of these and other complications. Accordingly, this review considers the surgical complications of endoscopy by location within the gastrointestinal tract, as opposed to by complication types, since there are many complication types that are specific for only one or few locations, such as buried-bumper syndrome after percutaneous endoscopic gastrostomy and pancreatitis after endoscopic retrograde cholangiopancreatography, and since the management of a given complication, such as perforation, may be vastly different in one area than in another area, such as perforations of the esophagus versus the retroperitoneal duodenum versus the intraperitoneal duodenum...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931638/complications-of-diagnostic-and-therapeutic-endoscopic-ultrasound
#18
REVIEW
Sundeep Lakhtakia
Endoscopic Ultrasound (EUS) provides the unique opportunity to visualize, interrogate and intervene gastrointestinal (GI) luminal, mural or peri-luminal structures and pathology with negligible adverse effects. Diagnostic, upper GI and rectal EUS is feasible, extremely safe, and efficacious. Most EUS guided interventions are safe, effective and minimally invasive, compared to peers in the percutaneous radiological or surgical procedures. As with any endoscopic procedure, EUS and its guided interventions may be accompanied by adverse events...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931637/complications-of-ercp
#19
REVIEW
Rupjyoti Talukdar
Even though considered safe, endoscopic retrograde cholangiopancreatography (ERCP) is among the endoscopic procedures associated with the highest rate of complications. Post ERCP pancreatitis (PEP) is the most common complication of ERCP. Several independent risk factors have been associated with PEP. Prophylactic PD stenting has been shown to be highly effective in preventing PEP. More recent studies have suggested that NSAIDs, especially rectal indomethacin, could by itself be effective in preventing PEP...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931636/complications-of-submucosal-endoscopy
#20
REVIEW
Jean-Michel Gonzalez, Alban Benezech, Marc Barthet
Submucosal endoscopy essentially regroups peroral endoscopic esophageal myotomy (POEM) and, more recently, pyloromyotomy and tunnel tumor resections. The complication rate of POEM is between 5% and 10%. Complications include gas-related complications, mucosal tears, and bleeding, and are usually managed conservatively or with non-surgical procedures. Only one case of death has been reported. The most commonly identified risk factors for complicated procedures in POEM are short experience with the technique and sigmoid-type esophagus...
October 2016: Best Practice & Research. Clinical Gastroenterology
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