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pearls review

David K Tso, Ajay K Singh
OBJECTIVE: The purpose of this article is to review the imaging findings of necrotizing fasciitis as seen on radiograph, ultrasound, CT, and MRI, and to recognize the early findings in this potentially fatal disease. CONCLUSION: Although classically a clinical diagnosis, imaging is a powerful adjunct to facilitate early diagnosis in equivocal cases. Compared to plain radiography, US, CT and MR provide higher sensitivity and specificity for the diagnosis of necrotizing fasciitis...
March 14, 2018: British Journal of Radiology
William N Levine, Julian J Sonnenfeld, Brian Shiu
Operative treatment of the unstable shoulder historically has a high success rate. However, the complication rate has risen. This article reviews the pearls and pitfalls to attempt to elucidate the etiology for these complications and failures. Preoperative assessment of the unstable shoulder ultimately is critical to avoid complications, including history, physical examination, and key radiographic features. Intraoperative techniques include appropriate soft tissue mobilization, multiple points of fixation, avoidance of hardware-related problems, and appropriate management of the capsule and bone defects...
April 2018: Clinics in Sports Medicine
Asalim Thabet, Tyler Greenfield, Richard M Cantor, Bryan Wilson
Corticosteroids have been used for over half a century to treat various inflammatory disorders; however, their use in many pediatric conditions remains controversial. This issue reviews evidence on corticosteroid treatment in acute asthma exacerbations, croup, acute pharyngitis, anaphylaxis, acute spinal injury, and bacterial meningitis. While corticosteroids are clearly indicated for management of asthma exacerbations and croup, they are not universally recommended for potential spinal cord injury. Due to insufficient data or conflicting data, corticosteroids may be considered in children with acute pharyngitis, anaphylaxis, and bacterial meningitis...
March 1, 2018: Pediatric Emergency Medicine Practice
Diego Suárez-Estrella, Luisa Torri, Maria Ambrogina Pagani, Alessandra Marti
Awareness of the several agronomic, environmental, and health benefits of quinoa has led to a constant increase in its production and consumption not only in South America - where it is a native crop - but also in Europe and the United States. However, producing wheat or gluten-free based products enriched with quinoa alters some quality characteristics, including sensory acceptance. Several anti-nutritional factors such as saponins are concentrated in the grain pericarp. These bitter and astringent substances may interfere with the digestion and absorption of various nutrients...
February 27, 2018: Journal of the Science of Food and Agriculture
Anagha Anand Mahajani, Abhijit Shrinivas Prabhughate, Pearl Tiwari, Shubhangi Sohoni, Ajay Gajanan Phatak, Vallaree Anant Morgaonkar, Somashekhar Marutirao Nimbalkar
BACKGROUND: Community Health Workers (CHWs) play an instrumental role in promoting socio-behavioural change at the community level, which results in changed indicators of community health. While outcomes are mostly reviewed for achieving program objectives, it is pertinent to understand the process of program implementation mainly from the perception of participating CHWs. METHODS: A qualitative study to understand the perception of Sakhi's (CHWs) regarding the outcomes of their participation in Home-Based Neonatal Care (HBNC) Program implemented by a non-governmental organization (NGO)...
February 21, 2018: BMC Women's Health
J K Skelton, A M Ortega-Prieto, M Dorner
Humanized mice are increasingly appreciated as an incredibly powerful platform for infectious disease research. The often very narrow species tropism of many viral infections, coupled with the sometimes-misleading results from preclinical studies in animal models (e.g. fatal immune reactions in the PEARL study 1 ) further emphasize the need for more predictive model systems based on human cells rather than surrogates. Humanized mice represent such a model and have been greatly enhanced in regards to their immune system reconstitution as well as immune functionality in the past years, resulting in their recommendation as pre-clinical model by the US Food and Drug Administration...
February 15, 2018: Immunology
Ralph V Clayman, Roshan M Patel, Margaret S Pearle
In this review, a simplified straightforward algorithmic approach to the metabolic evaluation and treatment of the at-risk or recurrent urolithiasis patient is provided. Eight diagnoses and eight therapies are provided which cover over 95% of renal stone disease.
February 14, 2018: Journal of Endourology
Gustavo Guimarães Moreira Balbi, Francinne Machado-Ribeiro, Cláudia D L Marques, Flávio Signorelli, Roger Abramino Levy
PURPOSE OF REVIEW: Tuberculosis (TB) is a millenarian chronic infection and, yet, remains a major global health problem. The interaction between systemic lupus erythematosus (SLE) and TB is complex, as one seems to be a risk factor for the development of the other. SLE patients are more likely to develop TB, that is more frequently extrapulmonary, with more extensive pulmonary involvement, and with a higher relapse rate. RECENT FINDINGS: Different studies suggest that TB is more prevalent in SLE patients and that TB may actually be a risk factor for the development of the disease...
February 12, 2018: Current Opinion in Rheumatology
France W Fung, Mark H Libenson, Jeffrey Bolton, Phillip L Pearl, Kush Kapur, Candice Marti, Ann Paris, Ann M Bergin, Chellamani Harini
BACKGROUND: Presurgical evaluation with antiseizure medication tapering in patients with refractory epilepsy places them at risk for seizure clustering or prolonged seizures. We looked at the occurrence of seizure clustering (3 or more seizures within 24h) and prolonged seizures and the factors that influence seizure clustering and affect length of stay (LOS) in pediatric patients during presurgical monitoring. METHODS: We retrospectively reviewed the medical records of all consecutive admissions to the epilepsy monitoring unit (EMU) and included patients undergoing noninvasive presurgical evaluation...
February 1, 2018: Epilepsy & Behavior: E&B
Charles R Marshall, Chris J D Hardy, Anna Volkmer, Lucy L Russell, Rebecca L Bond, Phillip D Fletcher, Camilla N Clark, Catherine J Mummery, Jonathan M Schott, Martin N Rossor, Nick C Fox, Sebastian J Crutch, Jonathan D Rohrer, Jason D Warren
The primary progressive aphasias are a heterogeneous group of focal 'language-led' dementias that pose substantial challenges for diagnosis and management. Here we present a clinical approach to the progressive aphasias, based on our experience of these disorders and directed at non-specialists. We first outline a framework for assessing language, tailored to the common presentations of progressive aphasia. We then consider the defining features of the canonical progressive nonfluent, semantic and logopenic aphasic syndromes, including 'clinical pearls' that we have found diagnostically useful and neuroanatomical and other key associations of each syndrome...
February 1, 2018: Journal of Neurology
Juliana Tolles, Nachi Gupta, Jeffrey Nusbaum
Thermal burn injuries are a significant cause of morbidity and mortality worldwide. In addition to treatment of the burns, emergency clinicians must assess for inhalation injury, exposure to toxic gases, and related traumatic injuries. Priorities for emergency resuscitation include stabilization of airway and breathing, intravenous fluid administration, pain control, and local wound care. Special populations, including children and pregnant women, require additional treatment considerations. Referral to specialized burn care for select patients is necessary to improve long-term outcomes...
February 1, 2018: Emergency Medicine Practice
KeriAnne Brady, Kathryn H Pade
Although most cases of acute gastroenteritis require minimal medical intervention, severe dehydration and hypoglycemia may develop in cases of prolonged vomiting and diarrhea. The mainstay of treatment for mild-to-moderately dehydrated patients with acute gastroenteritis should be oral rehydration solution. Antiemetics allow for improved tolerance of oral rehydration solution, and, when used appropriately, can decrease the need for intravenous fluids and hospitalization. This issue reviews the common etiologies of acute gastroenteritis, discusses more-severe conditions that should be considered in the differential diagnosis, and provides evidence-based recommendations for management of acute gastroenteritis in patients with mild-to-moderate dehydration, severe dehydration, and hypoglycemia...
February 1, 2018: Pediatric Emergency Medicine Practice
Chouhan Devendra Kumar, John Rakesh, Bansal Tungish, Dhillon Mandeep Singh
Background: Multiple reports of congenitally absent long head of biceps tendon (LHBT) have been reported in the literature. However, there is no consensus on the clinical implications of this relatively rare entity. Study Purpose: To systematically review and analyze all studies which have reported absence of LHBT. Methods: PubMed and EMBASE databases were searched. Also, a secondary search was performed by pearling the bibliography of all the full-text articles obtained...
July 2017: Muscles, Ligaments and Tendons Journal
Pearl Anna McElfish, Britni L Ayers, Rachel S Purvis, Christopher R Long, Ka'imi Sinclair, Monica Esquivel, Susan C Steelman
INTRODUCTION: Community-based participatory research is a partnership approach to research that seeks to equally involve community members, organisational representatives and academic partners throughout the research process in a coequal and mutually beneficial partnership. To date, no published article has synthesised the best practices for community-based participatory research practices with Pacific Islanders. METHODS AND ANALYSIS: The reviewers will examine studies' titles, abstracts and full text, comparing eligibility to address discrepancies...
January 24, 2018: BMJ Open
Pearl Pugh, Pippa Hemingway, Martin Christian, Gina Higginbottom
BACKGROUND: Chronic disease of childhood may be delayed by early dietary intervention. The purpose of this systematic review is to provide decision-makers with a perspective on the role of early dietary intervention, as a form of self-management, to delay disease progression in children with early chronic disease, as described by children, parents and other stakeholders. METHODS: The study will systematically review empirical research (qualitative, quantitative and mixed method designs), including grey literature, using a narrative synthesis...
January 25, 2018: Systematic Reviews
Vera Feuer, Joshua Rocker, Babar M Saggu, Jason M Andrus, Molly Wormley
Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies...
January 22, 2018: Pediatric Emergency Medicine Practice
David Wacker, Michael T McCurdy, Jeffrey Nusbaum, Nachi Gupta
As the prevalence of cancer continues to increase in the general population and improvements in cancer treatment prolong survival, the incidence of patients presenting to the emergency department with oncologic complications will, similarly, continue to rise. This issue reviews 3 of the more common presentations of oncology patients to the emergency department: metastatic spinal cord compression, tumor lysis syndrome, and febrile neutropenia. Signs and symptoms of these conditions can be varied and nonspecific, and may be related to the malignancy itself or to an adverse effect of the cancer treatment...
January 22, 2018: Emergency Medicine Practice
Robert Guthrie
Review of: Marso S, Daniels G, Brown-Frandsen K, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2016; 375: 311-322. Mann J, Orsted D, Brown-Frandsen K, et al. Liraglutide and Renal Outcomes in Type 2 Diabetes. N Engl J Med 2017; 377: 839-848. This comprehensive research project, LEADER, led to two reports, one focusing on the effect of liraglutide on cardiovascular events, and the second one reporting on the renal effects on the same study population. The study group included 9340 patients with type 2 diabetes...
January 19, 2018: Postgraduate Medicine
H Atil Atilla, T David Luo, Allston J Stubbs
Microfracture of hip chondral lesions has been performed for more than a decade with modified treatment principles and techniques from knee arthroscopy. This note and accompanying video review the pertinent techniques, pearls, and pitfalls of the microfracture procedure in the treatment of hip chondral lesions. After debridement of damaged chondral tissue, the size of the lesion is approximated to determine the number of microfracture holes to create. The working portal may be adjusted based on the site of the lesion...
December 2017: Arthroscopy Techniques
Swati Pradeep, Jonathan H Smith
PURPOSE OF REVIEW: The purpose of this review is to summarize recent updates and distill practical points from the literature which can be applied to the care of patients with suspected and confirmed giant cell arteritis (GCA). RECENT FINDINGS: Contemporary thinking implicates a fundamental failure of T regulatory cell function in GCA pathophysiology, representing opportunity for novel therapeutic avenues. Tocilizumab has become the first Food and Drug Administration-approved treatment for GCA following demonstration of efficacy and safety in a phase 3 clinical trial...
January 17, 2018: Current Pain and Headache Reports
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