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https://www.readbyqxmd.com/read/27913485/congenital-and-acquired-bleeding-disorders-in-pregnancy
#1
Terry B Gernsheimer
Obstetrical hematology represents challenges not only for the patient, but also for her progeny. In particular, bleeding disorders, both congenital and acquired, not only present problems both for delivery and in the immediate postpartum period, but also may have significant implications for the fetus and neonate. Women with congenital bleeding disorders or who are carriers of X-linked or autosomal disorders should be counseled prior to conception so that pregnancy can be safely undertaken with careful preparation...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913475/molecular-monitoring-in-chronic-myeloid-leukemia-how-low-can-you-go
#2
Susan Branford
Molecular monitoring of BCR-ABL1 transcripts for patients with chronic myeloid leukemia (CML) is now used to assess response to tyrosine kinase inhibitors (TKIs), including treatment failure that mandates a change of therapy. Therefore, many centers have adopted the molecular technique for measuring BCR-ABL1 and rely on conversion of values to the international reporting scale for appropriate clinical interpretation. However, the technique has a degree of inherent variability despite standardized procedures, which means care should be taken by the clinician when assessing response based on BCR-ABL1 cutoff limits...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913227/assisted-partner-services-for-hiv-in-kenya-a-cluster-randomised-controlled-trial
#3
Peter Cherutich, Matthew R Golden, Beatrice Wamuti, Barbra A Richardson, Kristjana H Ásbjörnsdóttir, Felix A Otieno, Ann Ng'ang'a, Peter Maingi Mutiti, Paul Macharia, Betsy Sambai, Matt Dunbar, David Bukusi, Carey Farquhar
BACKGROUND: Assisted partner services for index patients with HIV infections involves elicitation of information about sex partners and contacting them to ensure that they test for HIV and link to care. Assisted partner services are not widely available in Africa. We aimed to establish whether or not assisted partner services increase HIV testing, diagnoses, and linkage to care among sex partners of people with HIV infections in Kenya. METHODS: In this cluster randomised controlled trial, we recruited non-pregnant adults aged at least 18 years with newly or recently diagnosed HIV without a recent history of intimate partner violence who had not yet or had only recently linked to HIV care from 18 HIV testing services clinics in Kenya...
November 29, 2016: Lancet HIV
https://www.readbyqxmd.com/read/27911959/barriers-to-timely-and-safe-blood-transfusion-for-pph-patients-evidence-from-a-qualitative-study-in-dhaka-bangladesh
#4
Sadika Akhter, Iqbal Anwar, Rashida Akter, Feroza Akhter Kumkum, Monjura Khatun Nisha, Fatema Ashraf, Ferdousi Islam, Nazneen Begum, Mahbub Elahi Chowdhury, Anne Austin, Syed Shariful Islam, Aminur Rahman
BACKGROUND AND OBJECTIVES: In Bangladesh, postpartum hemorrhage (PPH) is the leading cause of maternal mortality accounting for 31% of all blood transfusions in the country. Although safe blood transfusion is one of the 8 signal functions of Comprehensive Emergency Obstetric Care (CEmOC) strategy, most of the designated public sector CEmOC facilities do not have on-site blood storage system. Emergent blood is mainly available from external blood banks. As a result, emergent patients are to rely on an unregulated network of brokers for blood which may raise question about blood safety...
2016: PloS One
https://www.readbyqxmd.com/read/27911238/managing-overlapping-surgery-an-analysis-of-1018-neurosurgical-and-spine-cases
#5
Jian Guan, Andrea A Brock, Michael Karsy, William T Couldwell, Meic H Schmidt, John R W Kestle, Randy L Jensen, Andrew T Dailey, Richard H Schmidt
OBJECTIVE Overlapping surgery-the performance of parts of 2 or more surgical procedures at the same time by a single lead surgeon-has recently come under intense scrutiny, although data on the effects of overlapping procedures on patient outcomes are lacking. The authors examined the impact of overlapping surgery on complication rates in neurosurgical patients. METHODS The authors conducted a retrospective review of consecutive nonemergent neurosurgical procedures performed during the period from May 12, 2014, to May 12, 2015, by any of 5 senior neurosurgeons at a single institution who were authorized to schedule overlapping cases...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27910706/intravenous-oxygen-a-novel-method-of-oxygen-delivery-in-hypoxemic-respiratory-failure
#6
Jonathan A Gehlbach, Kyle J Rehder, Michael A Gentile, David A Turner, Daniel J Grady, Ira M Cheifetz
Hypoxemic respiratory failure is a common problem in critical care. Current management strategies, including mechanical ventilation and extracorporeal membranous oxygenation, can be efficacious but these therapies put patients at risk for toxicities associated with invasive forms of support. Areas Covered: In this manuscript, we discuss intravenous oxygen (IVO2), a novel method to improve oxygen delivery that involves intravenous administration of a physiologic solution containing dissolved oxygen at hyperbaric concentrations...
December 2, 2016: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/27910267/the-impact-of-patient-characteristics-on-nurse-practitioners-assessment-and-management-of-adolescent-concussion
#7
Janessa M Graves, Tracy A Klein
BACKGROUND AND PURPOSE: To evaluate the effect of patient sex and type of activity on concussion assessment and management recommendations. METHODS: We administered a web-based survey to all nurse practitioners (NPs) actively licensed in Washington and Oregon. Participants were randomized to view one of four standardized patient scenario videos of an adolescent seeking care for a concussion, portraying the same symptomology but differing by sex and activity (soccer/hiking)...
December 2, 2016: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/27910086/higher-vs-lower-haemoglobin-threshold-for-transfusion-in-septic-shock-subgroup-analyses-of-the-triss-trial
#8
S L Rygård, L B Holst, J Wetterslev, P I Johansson, A Perner
BACKGROUND: Using a restrictive transfusion strategy appears to be safe in sepsis, but there may be subgroups of patients who benefit from transfusion at a higher haemoglobin level. We explored if subgroups of patients with septic shock and anaemia had better outcome when transfused at a higher vs. a lower haemoglobin threshold. METHODS: In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological malignancy or metastatic cancer), in patients who had undergone surgery (elective or acute) and in patients with septic shock as defined by the new consensus definition: lactate above 2 mmol/l and the need for vasopressors to maintain a mean arterial pressure above 65 mmHg...
December 2, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27909818/presto-lift-a-facelift-that-preserves-the-retaining-ligaments-and-smas-tethering
#9
Wolfgang Funk
BACKGROUND: Producing youthful facial appearance by face-lifting often comes along with an undesired loss of patient's individual phenotype. This may result from insufficient preservation of retaining ligaments, the "guardians of facial identify," and from severance of the intersegmental connections of the superficial musculo-aponeurotic system (SMAS), which tether, structure, and compartmentalize facial soft tissue into defined, relevant anatomical zones. METHODS: The technique reported here preserves most retaining ligaments...
December 2, 2016: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27909641/a-case-series-of-complex-recalcitrant-wounds-treated-with-epidermal-grafts-harvested-from-an-automated-device
#10
Stephen S Cai, Arvind U Gowda, Karan Chopra, Rachel Waldman, Ronald P Silverman, Yvonne M Rasko
INTRODUCTION: Epidermal grafting has several advantages over full-thickness or split-thickness grafts in the treatment of complex non-healing wounds. These include the low risk of donor site complications, minimal patient discomfort, and abstention from the operating room. Traditionally, the lack of reliable epidermal harvesting techniques has limited its clinical utilization. The development of an automated suction blister epidermal graft (SBEG) harvesting device may facilitate clinical utilization of this technique...
October 30, 2016: Curēus
https://www.readbyqxmd.com/read/27909629/stereotactic-body-radiotherapy-for-hepatocellular-carcinoma-resulting-in-a-durable-relapse-free-survival-a-case-report
#11
Samual Francis, Ned Williams, Christopher J Anker, Akram Shaaban, Robin Kim, Dennis Shrieve, Jonathan Tward
The standard of care for localized hepatocellular carcinoma (HCC) is surgical resection. For patients who decline or who are unfit for surgery, stereotactic body radiotherapy (SBRT) is emerging as a viable treatment approach. We present a case of a 77-year-old female in whom an early stage HCC was incidentally discovered. Given her religious edicts as a devout Jehovah's Witness and her subsequent desire to avoid a blood transfusion, she declined surgical resection or transplant due to the risk of hemorrhage...
October 24, 2016: Curēus
https://www.readbyqxmd.com/read/27908676/effect-of-selective-dorsal-rhizotomy-on-daily-care-and-comfort-in-non-walking-children-and-adolescents-with-severe-spasticity
#12
A I Buizer, P E M van Schie, E A M Bolster, W J van Ouwerkerk, R L Strijers, L A van de Pol, A Stadhouder, J G Becher, R J Vermeulen
BACKGROUND: In non-walking children with severe spasticity, daily care can be difficult and many patients suffer from pain. Selective dorsal rhizotomy (SDR) reduces spasticity in the legs, and therefore has the potential to improve daily care and comfort. AIM: To examine effects of SDR on daily care and comfort in non-walking children with severe spasticity due to different underlying neurological conditions. METHODS: Medical history, changes in daily care and comfort and satisfaction with outcome were assessed retrospectively in non-walking children who underwent SDR in our center, with a mean follow-up of 1y 7m (range 11m-4y 3m)...
October 22, 2016: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/27906939/a-new-radiofrequency-ablation-procedure-to-treat-sacroiliac-joint-pain
#13
Jianguo Cheng, See Loong Chen, Nicole Zimmerman, Jarrod E Dalton, Garret LaSalle, Richard Rosenquist
BACKGROUND: Low back pain may arise from disorders of the sacroiliac joint in up to 30% of patients. Radiofrequency ablation (RFA) of the nerves innervating the sacroiliac joint has been shown to be a safe and efficacious strategy. OBJECTIVES: We aimed to develop a new RFA technique to relieve low back pain secondary to sacroiliac joint disorders. STUDY DESIGN: Methodology development with validation through prospective observational non-randomized trial (PONRT)...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906935/long-term-prednisolone-in-post-stroke-complex-regional-pain-syndrome
#14
Jayantee Kalita, Usha Misra, Ajit Kumar, Sanjeev K Bhoi
BACKGROUND: There is no study on the long-term use of prednisolone in post-stroke complex regional pain syndrome-1 (CRPS1). OBJECTIVE: To evaluate the efficacy and safety of long-term low dose prednisolone in post-stroke CRPS-I. STUDY DESIGN: Open-labeled randomized controlled trial. SETTING: Tertiary care teaching institute. METHODS: Seventy-seven out of 396 (19.4%) patients with stroke had CRPS-1 and 58 met the inclusion criteria...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906741/halo-vest-immobilization-in-elderly-odontoid-fracture-patients-evolution-in-treatment-modality-and-in-hospital-outcomes
#15
J Mason DePasse, Mark A Palumbo, Abdul-Kareem Ahmed, Charles A Adams, Alan H Daniels
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To evaluate the utilization and effectiveness of halo-vest (HV) immobilization for type II odontoid fractures from 2004 to 2014. SUMMARY OF BACKGROUND DATA: Controversy persists regarding the optimal treatment method for odontoid fractures in the elderly. Management options include immobilization in a cervical orthosis, HV immobilization, and operative intervention. Over the past decade, high mortality and morbidity rates have been reported following HV immobilization in this patient population...
November 30, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27906730/understanding-interrater-reliability-and-validity-of-risk-assessment-tools-used-to-predict-adverse-clinical-events
#16
Sandra L Siedlecki, Nancy M Albert
PURPOSE: This article will describe how to assess interrater reliability and validity of risk assessment tools, using easy-to-follow formulas, and to provide calculations that demonstrate principles discussed. DESCRIPTION: Clinical nurse specialists should be able to identify risk assessment tools that provide high-quality interrater reliability and the highest validity for predicting true events of importance to clinical settings. Making best practice recommendations for assessment tool use is critical to high-quality patient care and safe practices that impact patient outcomes and nursing resources...
January 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/27905336/retropupillary-fixation-of-iris-claw-lens-in-visual-rehabilitation-of-aphakic-eyes
#17
G Jayamadhury, Sudhakar Potti, K Vinaya Kumar, R Madhu Kumar, K C Divyansh Mishra, Srinivasa Rao Nambula
CONTEXT: Surgical outcome of retropupillary fixation of iris claw lens. AIMS: To evaluate the various indications, intra and post-operative complications, and visual outcome of retropupillary fixation of iris claw lens in aphakic eyes. SETTINGS AND DESIGN: The study design is a retrospective study at a tertiary eye care center. METHODS: Review of medical records of 61 aphakic eyes of 61 patients, who were rehabilitated with retropupillary fixation of an iris claw lens, with a follow-up duration of at least 1 year...
October 2016: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/27905306/introduction-of-day-care-thyroid-surgery-in-a-dutch-non-academic-hospital
#18
R R Dulfer, K S de Valk, F Gilissen, T M van Ginhoven, P C Smit
OBJECTIVE: Hemithyroidectomy is the most common endocrine surgical procedure and is performed with low complication rates. Multiple international reports indicate that thyroid surgery in the day care setting is feasible and safe. Despite these results, day care thyroid surgery has not yet been implemented in the Netherlands. The objective of this study is to assess the safety of thyroid surgery in our institution and, when deemed safe, implement day care thyroid surgery. METHODS: All patients who underwent hemithyroidectomy in our institution between January 2010 and December 2014 were included in the retrospective analysis...
November 2016: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/27905017/an-evaluation-of-preparedness-delivery-and-impact-of-surgical-and-anesthesia-care-in-madagascar-a-framework-for-a-national-surgical-plan
#19
Emily Bruno, Michelle C White, Linden S Baxter, Vaonandianina Agnès Ravelojaona, Hasiniaina Narindria Rakotoarison, Hery Harimanitra Andriamanjato, Kristin L Close, Alison Herbert, Nakul Raykar, Saurabh Saluja, Mark G Shrime
BACKGROUND: The Lancet Commission on Global Surgery (LCoGS) described the lack of access to safe, affordable, timely surgical, and anesthesia care. It proposed a series of 6 indicators to measure surgery, accompanied by time-bound targets and a template for national surgical planning. To date, no sub-Saharan African country has completed and published a nationwide evaluation of its surgical system within this framework. METHOD: Mercy Ships, in partnership with Harvard Medical School and the Madagascar Ministry of Health, collected data on the 6 indicators from 22 referral hospitals in 16 out of 22 regions of Madagascar...
November 30, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27904850/the-safety-and-risk-factors-of-major-hepatobiliary-pancreatic-surgery-in-patients-older-than-80-years
#20
Jong Hun Kim, Seog Ki Min, Huisong Lee, Geun Hong, Hyeon Kook Lee
PURPOSE: Recently, the number of elderly patients has increased due to a longer life expectancy. Among these elderly patients, more octogenarians will be diagnosed with major hepatobiliary pancreatic (HBP) diseases. Therefore, we need to evaluate the safety and risk factors of major HBP surgery in patients older than 80 years. METHODS: From January 2000 to April 2015, patients who underwent major HBP surgery were identified. The patients were divided into 2 groups according to their age at the time of surgery: Group O (≥80 years) and group Y (<80 years)...
December 2016: Annals of Surgical Treatment and Research
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