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https://www.readbyqxmd.com/read/29054949/metachronous-solitary-plasmacytoma
#1
Robin Khosa, Shishir Seth, Sapna Nangia
Solitary plasmacytoma is a rare disorder comprising 5%-10% of all plasma cell neoplasms. Progression to multiple myeloma is the most common pattern of relapse. Appearance of new lesions without any systemic disease is the most unusual pattern of relapse seen in <2% cases. We present a case of a 46-year-old female who presented with features of third and seventh cranial nerve palsy, diagnosed with solitary plasmacytoma, with no evidence of any systemic disease. As per standard recommendations, the patient received radiotherapy to the local site...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29054942/primary-hepatic-hemangioendothelioma-in-a-patient-with-budd-chiari-syndrome
#2
Preet Mukesh Shah, Vijay Waman Dhakre, Aabha Nagral
A 36-year-old woman was diagnosed with compensated cirrhosis of liver secondary to Budd-Chiari syndrome (BCS) and had undergone stenting of a thrombosed left hepatic vein. Eight months later, she presented with jaundice and right upper quadrant pain. CT revealed multiple focal lesions in the liver, which on biopsy proved to be hepatic hemangioendothelioma (HHE). Her liver disease and ascites progressively increased. Four months later, magnetic resonance cholangiopancreatography showed an advanced stage of HHE with infiltration of the common bile duct and vascular invasion with a blocked stent, with metastasis to the spleen and dorsolumbar vertebrae...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29054908/strange-case-of-dimorphic-skin-rash-in-a-patient-with-cirrhosis-atypical-herpes-simplex-and-sweet-s-syndrome
#3
Cyriac Abby Philips, Rajaguru Paramaguru, Philip Augustine
A middle-aged man with decompensated cirrhosis and a dimorphic multisite skin rash is diagnosed with rare atypical herpes simplex infection, manifesting Sweet's syndrome (SS) in the absence of other described associations. SS, an acute febrile neutrophilic dermatosis, has three common forms-classical or idiopathic, malignancy associated and drug induced. Systemic autoimmune, connective tissue diseases and infections are also strong associations. The latter is commonly described in Gram-positive bacteria, salmonellosis and Yersinia Herpes infections are a rare cause of SS, reported only thrice in literature, one with concomitant lupus, the second with associated mycobacterial infection and third, in metastatic breast disease in contrast to our patient...
October 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29054815/whole-brain-radiotherapy-or-autologous-stem-cell-transplantation-as-consolidation-strategies-after-high-dose-methotrexate-based-chemoimmunotherapy-in-patients-with-primary-cns-lymphoma-results-of-the-second-randomisation-of-the-international-extranodal-lymphoma
#4
Andrés J M Ferreri, Kate Cwynarski, Elisa Pulczynski, Christopher P Fox, Elisabeth Schorb, Paul La Rosée, Mascha Binder, Alberto Fabbri, Valter Torri, Eleonora Minacapelli, Monica Falautano, Fiorella Ilariucci, Achille Ambrosetti, Alexander Roth, Claire Hemmaway, Peter Johnson, Kim M Linton, Tobias Pukrop, Jette Sønderskov Gørløv, Monica Balzarotti, Georg Hess, Ulrich Keller, Stephan Stilgenbauer, Jens Panse, Alessandra Tucci, Lorella Orsucci, Francesco Pisani, Alessandro Levis, Stefan W Krause, Hans J Schmoll, Bernd Hertenstein, Mathias Rummel, Jeffery Smith, Michael Pfreundschuh, Giuseppina Cabras, Francesco Angrilli, Maurilio Ponzoni, Martina Deckert, Letterio S Politi, Jürgen Finke, Michele Reni, Franco Cavalli, Emanuele Zucca, Gerald Illerhaus
BACKGROUND: The International Extranodal Lymphoma Study Group-32 (IELSG32) trial is an international randomised phase 2 study that addresses two key clinical questions in the treatment of patients with newly diagnosed primary CNS lymphoma. Results of the first randomisation have demonstrated that methotrexate, cytarabine, thiotepa, and rituximab (called the MATRix regimen) is the induction combination associated with significantly better outcome compared with the other induction combinations tested...
October 17, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/29054568/genetic-epidemiology-of-ovarian-cancer-and-prospects-for-polygenic-risk-prediction
#5
REVIEW
Michelle R Jones, Daniella Kamara, Beth Y Karlan, Paul D P Pharoah, Simon A Gayther
Epithelial ovarian cancer (EOC) is a heterogeneous disease with a major heritable component. The different histotypes of invasive disease - high grade serous, clear cell, endometrioid and mucinous - are associated with different underlying genetic susceptibility and epidemiological and lifestyle risk factors, all of which contribute to the different biology and clinical characteristics of each histotype. A combination of familial and population based sequencing studies, and genome wide association studies (GWAS) have identified a range of genetic susceptibility alleles for EOC comprising rare but highly penetrant genes (e...
October 17, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29054250/using-anchors-from-free-text-in-electronic-health-records-to-diagnose-postoperative-delirium
#6
Karl Øyvind Mikalsen, Cristina Soguero-Ruiz, Kasper Jensen, Kristian Hindberg, Mads Gran, Arthur Revhaug, Rolv-Ole Lindsetmo, Stein Olav Skrøvseth, Fred Godtliebsen, Robert Jenssen
OBJECTIVES: Postoperative delirium is a common complication after major surgery among the elderly. Despite its potentially serious consequences, the complication often goes undetected and undiagnosed. In order to provide diagnosis support one could potentially exploit the information hidden in free text documents from electronic health records using data-driven clinical decision support tools. However, these tools depend on labeled training data and can be both time consuming and expensive to create...
December 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29054184/under-utilization-of-pacemaker-therapy-for-sinus-node-dysfunction-real-world-data-from-south-asia
#7
C Narasimhan, J Sanyal, R Sethi, Y Kothari, F T N Malik, U Pandurangi, N Khan, S Sahu, J Lande, H Sachanandani, A Naik
OBJECTIVE: Chronic symptomatic sinus node dysfunction (SND), the most common bradyarrhythmia, can be effectively managed by permanent cardiac pacing. Yet the care pathway and barriers to adoption of pacing therapy are not well understood - particularly in low volume implanting countries. The IMPROVE Brady study is a quality improvement initiative being conducted at centers in South Asia, Latin America, and Russia. We assessed the rates of SND diagnosis and pacemaker treatment for SND in the South Asia cohort...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29054018/isolated-aphasia-in-the-emergency-department-the-likelihood-of-ischemia-is-low
#8
Gabriel Casella, Rafael H Llinas, Elisabeth B Marsh
OBJECTIVE: Aphasia is a common presentation of ischemic stroke, often diagnosed in the acute setting using tools such as the NIH Stroke Scale (NIHSS). Due to the vascular distribution of the middle cerebral artery, it is often accompanied by other symptoms such as weakness, sensory loss, or visual changes. Isolated aphasia due to ischemia is possible, but language problems mimicking aphasia syndromes can also be seen with other diagnoses such as metabolic abnormalities or dementia. In this study, we determine the incidence of aphasia-only strokes using the NIHSS, and factors associated with a higher likelihood of ischemia...
October 16, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29053976/longitudinal-association-between-mental-disorders-in-childhood-and-subsequent-depression-a-nationwide-prospective-cohort-study
#9
Louise Krarup Gundel, Carsten Bøcker Pedersen, Trine Munk-Olsen, Søren Dalsgaard
BACKGROUND: Depression ranges among the most impairing mental disorders worldwide, and early detection is a global health priority. Little is known about the association between non-affective mental disorders in childhood/adolescence and later depression. METHODS: Nationwide register-based prospective cohort study, estimating cumulative incidences and incidence rate ratios (IRR) for later depression in individuals with and without non-affective mental disorders in early life...
October 7, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29053882/electrodiagnostic-studies-in-the-intensive-care-unit-a-comparison-study-two-decades-later
#10
Ajitesh Ojha, Sasha A Zivkovic, David Lacomis
INTRODUCTION: Since the late 1980s, critical illness myopathy (CIM) and polyneuropathy (CIP) have been increasingly recognized in the intensive care unit (ICU). We explored whether these causes of ICU weakness were now more likely to lead to electrodiagnostic studies (EDX) at our institution than they were 19-20 years earlier. METHODS: We reviewed 100 consecutive ICU patients who underwent EDX from 2009-2015 and compared them to a previously reported study population from 1990-1995...
October 20, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/29053860/clinicopathological-correlations-in-behavioural-variant-frontotemporal-dementia
#11
David C Perry, Jesse A Brown, Katherine L Possin, Samir Datta, Andrew Trujillo, Anneliese Radke, Anna Karydas, John Kornak, Ana C Sias, Gil D Rabinovici, Maria Luisa Gorno-Tempini, Adam L Boxer, Mary De May, Katherine P Rankin, Virginia E Sturm, Suzee E Lee, Brandy R Matthews, Aimee W Kao, Keith A Vossel, Maria Carmela Tartaglia, Zachary A Miller, Sang Won Seo, Manu Sidhu, Stephanie E Gaus, Alissa L Nana, Jose Norberto S Vargas, Ji-Hye L Hwang, Rik Ossenkoppele, Alainna B Brown, Eric J Huang, Giovanni Coppola, Howard J Rosen, Daniel Geschwind, John Q Trojanowski, Lea T Grinberg, Joel H Kramer, Bruce L Miller, William W Seeley
Accurately predicting the underlying neuropathological diagnosis in patients with behavioural variant frontotemporal dementia (bvFTD) poses a daunting challenge for clinicians but will be critical for the success of disease-modifying therapies. We sought to improve pathological prediction by exploring clinicopathological correlations in a large bvFTD cohort. Among 438 patients in whom bvFTD was either the top or an alternative possible clinical diagnosis, 117 had available autopsy data, including 98 with a primary pathological diagnosis of frontotemporal lobar degeneration (FTLD), 15 with Alzheimer's disease, and four with amyotrophic lateral sclerosis who lacked neurodegenerative disease-related pathology outside of the motor system...
October 6, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29053649/oral-and-oropharyngeal-squamous-cell-carcinoma-in-young-adults-a-retrospective-study-in-granada-university-hospital
#12
P Cariati, A Cabello-Serrano, M Perez-de Perceval-Tara, F Monsalve-Iglesias
BACKGROUND: This study aims to evaluate and analyze the clinical features and outcomes of oral and oropharyngeal squamous cell carcinoma (SCC) in patients < 45-years old in our center. MATERIAL AND METHODS: A retrospective analysis was conducted using the records of patients diagnosed with oral and oropharyngeal SCC between 1998 and 2011 in the University Hospital of Granada (Spain). The analysis identified 33 patients with oral and oropharyngeal SCC with an age of <45 years...
October 20, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/29053497/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-phalangeal-fracture-pearls-and-pitfalls
#13
Joshua M Abzug, Charles T Mehlman
Pediatric phalangeal fractures are extremely common, especially among toddlers and older children/adolescents involved in sporting activities. The physical examination must include an assessment for deviation and malrotation. In addition, concomitant injuries must be assessed for such as tendon and/or neurovascular injuries. Plain radiographs are typically sufficient to make the diagnosis and determine the treatment. The majority of pediatric and adolescent phalangeal fractures can be treated with immobilization...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053493/induction-of-desmoplastic-trichoepithelioma-in-a-dermatofibroma
#14
Mihaela Georgescu, Norbert Blödorn-Schlicht, Almut Böer-Auer
Induction of follicular germinative structures above a dermatofibroma (DF) is a common finding. Rarely, induction of a trichoblastoma in a DF has been observed. Here, we report the case of a desmoplastic trichoepithelioma induced by a DF. The lesion with clinical and histological appearance of a DF situated on the left dorsal foot showed an associated adnexal proliferation that fulfilled histopathological criteria of desmoplastic trichoepithelioma. Immunohistochemistry (Ber-EP4, Bcl-2, CK17, CK20, CK7, EMA, and Ki67) helped to confirm the diagnosis and to exclude possible differential diagnoses...
October 2, 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/29053115/-syndrome-of-rapid-eye-movement-sleep-behavior-disorder-and-nocturia-in-parkinson-s-disease
#15
M R Nodel, Yu V Ukraintseva, N N Yakhno
AIM: Parasomnia, a syndrome of rapid eye movement sleep behavior disorder (RBD), is a common non-motor impairment in patients with Parkinson's disease (PD). The relationship between RBD with other symptoms of PD affecting night sleep, in particular, nocturia, is understudied. An aim of the study was to determine the symptoms related to night sleep disturbances in PD patients with RBD and assess the dynamics of these disturbances with the disease progression taking into account RBD onset...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29053033/hyaluronidase-allergy-mimicking-orbital-cellulitis
#16
Nirav D Raichura, Md Shahid Alam, V V Jaichandran, Saurabh Mistry, Bipasha Mukherjee
PURPOSE: Hyaluronidase enzyme is a common additive with local anesthetic agent to facilitate faster permeation of the anesthetic in periocular tissues during ophthalmic surgery. We report a series of five subjects presenting with clinical features mimicking orbital cellulitis following peribulbar anesthesia and consequently diagnosed with hyaluronidase hypersensitivity. SETTING: The study was conducted at a tertiary eye care center in Southern India. DESIGN: It was a retrospective interventional case series...
October 20, 2017: Orbit
https://www.readbyqxmd.com/read/29052741/-regional-differences-of-adhd-diagnosis-rates-in-health-insurance-data-from-2005-to-2015-methodological-considerations-and-results
#17
REVIEW
Thomas G Grobe
BACKGROUND AND OBJECTIVES: Attention deficit hyperactivity disorders (ADHD) are among the most common mental disorders in children and adolescents. For a number of years there has been evidence of regional differences in Germany. This article provides current results on the frequency of diagnosis and treatment and also discusses methodological aspects. MATERIALS AND METHODS: The analysis is based on routine data of a statutory health insurance company including annual diagnoses and drug prescriptions from 2005 to 2015 of at least 1...
October 20, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29052351/analysis-of-the-clinical-features-of-invasive-bronchopulmonary-aspergillosis
#18
Yueqin Cao, Changzhou Shao, Yuanlin Song
INTRODUCTION: Early diagnosis of invasive bronchopulmonary aspergillosis (IBPA) is difficult, so the mortality rate is high. OBJECTIVE: To discuss the clinical features of IBPA. METHODS: We retrospectively analyzed the clinical features, imaging findings, laboratory test, diagnosis, and treatment of 115 patients with IBPA diagnosed from October 2004 to June 2013 in Zhongshan Hospital, Fudan University. RESULTS: The main clinical manifestations were cough in 58 patients (50...
October 20, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29052109/assessments-of-opportunities-to-improve-antibiotic-prescribing-in-an-emergency-department-a-period-prevalence-survey
#19
Tristan T Timbrook, Aisling R Caffrey, Anais Ovalle, Maya Beganovic, William Curioso, Melissa Gaitanis, Kerry L LaPlante
INTRODUCTION: Approximately 30% of all outpatient antimicrobials are inappropriately prescribed. Currently, antimicrobial prescribing patterns in emergency departments (ED) are not well described. Determining inappropriate antimicrobial prescribing patterns and opportunities for interventions by antimicrobial stewardship programs (ASP) are needed. METHODS: A retrospective chart review was performed among a random sample of non-admitted, adult patients who received an antimicrobial prescription in the ED from January 1 to December 31, 2015...
October 19, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29051905/evaluation-of-the-trends-concomitant-procedures-and-complications-with-open-and-arthroscopic-rotator-cuff-repairs-in-the-medicare-population
#20
Andrew R Jensen, Peter S Cha, Sai K Devana, Chad Ishmael, Theo Di Pauli von Treuheim, Anthony D'Oro, Jeffrey C Wang, David R McAllister, Frank A Petrigliano
BACKGROUND: Medicare insures the largest population of patients at risk for rotator cuff tears in the United States. PURPOSE: To evaluate the trends in incidence, concomitant procedures, and complications with open and arthroscopic rotator cuff repairs in Medicare patients. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: All Medicare patients who had undergone open or arthroscopic rotator cuff repair from 2005 through 2011 were identified with a claims database...
October 2017: Orthopaedic Journal of Sports Medicine
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