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https://www.readbyqxmd.com/read/28445436/irritable-bowel-syndrome-clinical-manifestations-dietary-influences-and-management
#1
REVIEW
Ronald Ikechi, Bradford D Fischer, Joshua DeSipio, Sangita Phadtare
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is characterized by symptoms of chronic abdominal pain and altered bowel habits in the absence of an overtly identifiable cause. It is the most commonly diagnosed functional gastrointestinal disorder, accounting for about one third of gastroenterology visits. It generally presents as a complex of symptoms, including psychological dysfunction. Hypersensitivity to certain foods, especially foods that contain high amounts of fructose, plays a role in the pathophysiology of IBS...
April 26, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28445380/a-formidable-foe-is-sabotaging-your-results-what-you-should-know-about-biofilms-and-wound-healing
#2
Jenny C Barker, Ibrahim Khansa, Gayle M Gordillo
LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Describe biofilm pathogenesis as it relates to problem wounds. 2. Understand the preclinical and clinical evidence implicating biofilm in problem wounds. 3. Explain the diagnostic and treatment challenges that biofilms create for problem wounds. 4. Demonstrate a basic understanding of emerging strategies aimed at counteracting these processes. SUMMARY: Biofilm represents a protected mode of growth for bacteria, allowing them to evade standard diagnostic techniques and avoid eradication by standard therapies...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28444006/scale-up-of-collaborative-tb-hiv-activities-in-guyana
#3
Brian J Baker, Brandy Peterson, Jeetendra Mohanlall, Shanti Singh, Collene Hicks, Ruth Jacobs, Ruth Ramos, Barbara Allen, Eric Pevzner
Objective: To assess scale-up of recommended tuberculosis (TB)/HIV activities in Guyana and to identify specific strategies for further expansion. Methods: Medical records and clinic registers were reviewed at nine TB clinics and 10 HIV clinics. At TB clinics, data were collected on HIV testing and antiretroviral therapy (ART) for patients with TB/HIV; at HIV clinics, data were collected on intensified case finding (ICF), tuberculin skin test (TST) results, and provision of isoniazid preventive therapy (IPT)...
April 20, 2017: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28443817/childhood-sustained-hypercalcemia-a-diagnostic-challenge
#4
Nisa Eda Çullas İlarslan, Zeynep Şıklar, Merih Berberoğlu
OBJECTIVE: This study aimed to call attention to hypercalcemia, a rare finding in children, which carries the potential of leading serious complications without proper intervention. METHODS: Diagnosis, treatment and clinical course of children with sustained hypercalcemia between 2006-2016 were reviewed. Group 1 (PTH-dependent) consisted of patients with high/unsupressed PTH level and Group 2 (PTH-independent) included cases with normal/supressed PTH level. RESULTS: Twenty patients (11 male, 9 female) with a median age of 6,25 (0,03-17,88) years were evaluated...
April 26, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28443809/-twenty-years-of-combination-antiretroviral-therapy-for-hiv-infection-in-the-netherlands-progression-and-new-challenges
#5
K Brinkman, T S Boender, M van der Valk, A van Sighem, P Reiss, F P Kroon
Due to the introduction of combination antiretroviral therapy (cART) 20 years ago, HIV infection in the Netherlands has changed from a fatal disease to a chronic condition with a near normalized life expectancy. The average age of HIV-positive patients continues to increase, as does the prevalence of non-HIV-related comorbidity. The number of new HIV diagnoses seems to be decreasing in the Netherlands, which is partly due to increased testing, earlier diagnosis, prompt cART initiation, and achievement of high levels of viral suppression, resulting in a reduced likelihood of onward transmission...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28442848/dermatofibrosarcoma-protuberance-of-the-breast-a-diagnostic-challenge
#6
Ismail A S Burud, Ng Sze How, Gan CheeWei, Suboh Roslina
Dermatofibrosarcoma protuberans (DFSP) is an uncommon slow growing neoplasm of the dermis with tendency to invade the subcutaneous tissues. It presents during the third to fourth decade of life and is commonly seen over the trunk, extremities and head and neck. DFSP presenting as a breast lump is rare but few cases have been reported in the literature. Pre-operative diagnosis with mammography, ultrasonography and FNAC is challenging. We report a case of a DFSP of the right breast in a middle aged lady with history of recurrent breast lumps excised and diagnosed in the past as benign...
April 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28442822/effects-of-implementing-international-association-of-diabetes-and-pregnancy-study-groups-gestational-diabetes-screening-on-pregnancy-outcomes-at-a-small-community-teaching-hospital
#7
Jody M Gerome, Lucy K M Bucher, Godwin Dogbey
IN BRIEF Traditional methods of screening for and diagnosing gestational diabetes mellitus (GDM) have been challenged, leading to the development of new screening guidelines by the International Association of Diabetes and Pregnancy Study Groups (IADPSG). This study is a retrospective comparison of pregnancy outcomes based on the Carpenter and Coustan (CC) and IADPSG screening guidelines. It demonstrates that adoption of IADPSG guidelines increased the rate of GDM diagnosis and resulted in more women with diet-controlled GDM...
April 2017: Clinical Diabetes: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/28442772/discriminative-and-distinct-phenotyping-by-constrained-tensor-factorization
#8
Yejin Kim, Robert El-Kareh, Jimeng Sun, Hwanjo Yu, Xiaoqian Jiang
Adoption of Electronic Health Record (EHR) systems has led to collection of massive healthcare data, which creates oppor- tunities and challenges to study them. Computational phenotyping offers a promising way to convert the sparse and complex data into meaningful concepts that are interpretable to healthcare givers to make use of them. We propose a novel su- pervised nonnegative tensor factorization methodology that derives discriminative and distinct phenotypes. We represented co-occurrence of diagnoses and prescriptions in EHRs as a third-order tensor, and decomposed it using the CP algorithm...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28442467/recognition-and-assessment-of-atypical-and-ambiguous-genitalia-in-the-newborn
#9
REVIEW
Justin H Davies, Timothy Cheetham
The baby with atypical or ambiguous genitalia is usually born in secondary care. For most clinicians, this is an unfamiliar and challenging scenario with the potential for life-long ramifications arising from a consultation led by an unprepared clinician. Language needs to be used carefully with particular clarity when liaising with parents, local health professionals and the specialist multidisciplinary team. Confidence in the recognition and assessment of atypical or ambiguous genitalia in a newborn will guide the local clinician when deciding on the initial investigations required and is a foundation for subsequent management...
April 25, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28442194/a-child-abuse-research-network-now-what
#10
Daniel M Lindberg, Philip V Scribano
As foundational work in preparation for a sustainable, multi-center network devoted to child abuse medical research, we recently used a combination of survey and modified Delphi methodologies to determine research priorities for future multi-center studies. Avoiding missed diagnoses, and improving selected/indicated prevention were the topics rated most highly in terms of research priority. Several constructive commentaries in this issue identify the key challenges which must be overcome to ensure a successful network...
April 22, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28441952/management-of-suspected-primary-toxoplasma-gondii-infection-in-pregnant-women-in-norway-twenty-years-of-experience-of-amniocentesis-in-a-low-prevalence-population
#11
Gry Findal, Anne Helbig, Guttorm Haugen, Pål A Jenum, Babill Stray-Pedersen
BACKGROUND: Primary infection with Toxoplasma gondii during pregnancy may pose a threat to the fetus. Women infected prior to conception are unlikely to transmit the parasite to the fetus. If maternal serology indicates a possible primary infection, amniocentesis for toxoplasma PCR analysis is performed and antiparasitic treatment given. However, discriminating between primary and latent infection is challenging and unnecessary amniocenteses may occur. Procedure-related fetal loss after amniocentesis is of concern...
April 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28441668/evaluation-and-management-of-orofacial-pain
#12
Stephanie Joseph Gilkey, Francisco Plaza-Villegas
Challenging to diagnose and manage, orofacial pain is a common and costly problem with a profound effect on quality of life. Delayed diagnosis and management can lead to prolonged patient suffering and disability. This article describes the background, assessment, differential diagnosis, management, and referral of patients with orofacial pain.
May 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28440972/a-comparison-between-the-diagnostic-accuracy-of-frozen-section-and-permanent-section-analyses-in-central-nervous-system
#13
Razie Amraei, Afshin Moradi, Hanieh Zham, Mahsa Ahadi, Maryam Baikpour, Azadeh Rakhshan
Objective: Using diagnostic pathological methods during surgery is a valuable means of determining the appropriate management for patients. Application of Frozen Section in CNS surgeries might face challenges due to friability of brain tissue and its relative inaccessibility. Various studies have evaluated the diagnostic acuity of frozen section compared to gold standard but results have been quite inconsistent. We conducted the present study to evaluate the accuracy of cryostat in diagnosing central nervous system tumors compared to the Gold Standard method...
March 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28440262/risk-of-complications-and-urinary-incontinence-following-cytoreductive-prostatectomy-a-multi-institutional-study
#14
Dae Keun Kim, Jaspreet Singh Parihar, Young Suk Kwon, Sinae Kim, Brian Shinder, Nara Lee, Nicholas Farber, Thomas Ahlering, Douglas Skarecky, Bertram Yuh, Nora Ruel, Wun-Jae Kim, Koon Ho Rha, Isaac Yi Kim
Emerging evidence has suggested that cytoreductive prostatectomy (CRP) allows superior oncologic control when compared to current standard of care androgen deprivation therapy alone. However, the safety and benefit of cytoreduction in metastatic prostate cancer (mPCa) has not been proven. Therefore, we evaluated the incidence of complications following CRP in men newly diagnosed with mPCa. A total of 68 patients who underwent CRP from 2006 to 2014 at four tertiary surgical centers were compared to 598 men who underwent radical prostatectomy for clinically localized prostate cancer (PCa)...
April 25, 2017: Asian Journal of Andrology
https://www.readbyqxmd.com/read/28439883/an-update-for-richter-syndrome-new-directions-and-developments
#15
REVIEW
Toby A Eyre, Anna Schuh
High-grade transformation of chronic lymphocytic leukaemia [Richter syndrome (RS)] is rare and represents a unique and uncommon clinical challenge. Clonally related diffuse large B cell type RS is a chemotherapy-resistant and devastating disease. Patients are typically elderly, immunosuppressed and present with a rapidly deteriorating performance status. Historical outcomes suggest a median overall survival of approximately 8 months. RS remains is an area of high unmet clinical need. The molecular profile and treatment needs of patients are likely to change over time with the advent of novel B cell receptor inhibitors, monoclonal antibodies and BH3 mimetics...
April 25, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28439217/pediatric-metabolic-syndrome-pathophysiology-and-laboratory-assessment
#16
Victoria Higgins, Khosrow Adeli
Pediatric overweight and obesity is an emerging public health priority as rates have rapidly increased worldwide. Obesity is often clustered with other metabolic abnormalities including hypertension, dyslipidemia, and insulin resistance, leading to increased risk of cardiovascular disease. This cluster of risk factors, termed the metabolic syndrome, has traditionally been reported in adults. However, with the increased prevalence of pediatric obesity, the metabolic syndrome is now evident in children and adolescents...
March 2017: EJIFCC
https://www.readbyqxmd.com/read/28439048/faecal-volatile-organic-compounds-analysis-using-field-asymmetric-ion-mobility-spectrometry-non-invasive-diagnostics-in-paediatric-inflammatory-bowel-disease
#17
Nora van Gaal, Rozanne Lakenman, James Covington, Richard Savage, Evelien de Groot, Marije Bomers, Marc Benninga, Chris Mulder, Nanne de Boer, Tim de Meij
Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), remains challenging to diagnose. Diagnostic work up carries a high burden, especially in paediatric patients, due to invasive endoscopic procedures. IBD is associated with alterations in intestinal microbiota composition. Faecal volatile organic compounds (VOCs) reflect gut microbiota composition. Aim of this study was to assess the diagnostic accuracy of faecal VOC profiling as non-invasive diagnostic biomarker for paediatric IBD...
April 25, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28438129/severe-type-1-upgrading-leprosy-reaction-in-a-renal-transplant-recipient-a-paradoxical-manifestation-associated-with-deficiency-of-antigen-specific-regulatory-t-cells
#18
Ana Paula Vieira, Maria Angela Bianconcini Trindade, Flávio Jota de Paula, Neusa Yurico Sakai-Valente, Alberto José da Silva Duarte, Francine Brambate Carvalhinho Lemos, Gil Benard
BACKGROUND: Due to its chronic subclinical course and large spectrum of manifestations, leprosy often represents a diagnostic challenge. Even with proper anti-mycobacteria treatment, leprosy follow up remains challenging: almost half of leprosy patients may develop reaction episodes. Leprosy is an infrequent complication of solid organ transplant recipients. This case report illustrates the challenges in diagnosing and managing leprosy and its reactional states in a transplant recipient...
April 24, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28437628/advanced-biomaterials-and-microengineering-technologies-to-recapitulate-the-stepwise-process-of-cancer-metastasis
#19
REVIEW
Nitish Peela, Danh Truong, Harpinder Saini, Hunghao Chu, Samaneh Mashaghi, Stephanie L Ham, Sunil Singh, Hossein Tavana, Bobak Mosadegh, Mehdi Nikkhah
Cancer is one of the leading causes of death globally according to the World Health Organization. Although improved treatments and early diagnoses have reduced cancer related mortalities, metastatic disease remains a major clinical challenge. The local tumor microenvironment plays a significant role in cancer metastasis, where tumor cells respond and adapt to a plethora of biochemical and biophysical signals from stromal cells and extracellular matrix (ECM) proteins. Due to these complexities, there is a critical need to understand molecular mechanisms underlying cancer metastasis to facilitate the discovery of more effective therapies...
April 21, 2017: Biomaterials
https://www.readbyqxmd.com/read/28437579/mosaic-trisomy-1q-a-recurring-chromosome-anomaly-that-is-a-diagnostic-challenge-and-is-associated-with-a-fryns-like-phenotype
#20
Kathleen M Bone, Judy E Chernos, Renee Perrier, A Micheil Innes, Francois P Bernier, Ross McLeod, Mary Ann Thomas
OBJECTIVE: Trisomy of the long arm of chromosome 1 is a very rare cytogenetic anomaly that is difficult to diagnose due to tissue-limited mosaicism. This study aimed to further characterize the prenatal and postnatal findings associated with this anomaly, including the first reported chromosomal microarray finding. METHOD: This is a retrospective study of 6 cases of mos 46,X,der(Y)t(Y;1)(q12;q21)/46,XY diagnosed both pre- and postnatally. Detailed clinical features and pregnancy outcome were documented...
April 24, 2017: Prenatal Diagnosis
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