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https://www.readbyqxmd.com/read/28101735/urethral-carcinoma-in-situ-recognition-and-management
#1
Ricardo H Berjeaut, Maliza D I Persaud, Nikolai Sopko, Arthur L Burnett
PURPOSE: Urethral carcinoma in situ (CIS) is an uncommon malignancy that is poorly described in the published literature and is often under-recognized in the clinical setting. This short case series reports some challenges associated with the recognition and management of this disease. METHODS: A retrospective chart review was done over a 12-year period of patients presenting with urethral cancer to the Johns Hopkins Hospital. Four patients were identified with CIS of the anterior urethra, and their demographic and clinical data were recorded...
January 18, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28100382/-epidemiological-pattern-of-abnormal-urinary-fluoride-rates-in-population-with-occupational-fluoride-exposure-in-shanghai
#2
M H Gu, J Su, C H Liu, Y Q Zhu, H Shen, Y H Huang, L Zhong, M H Zhang, Y H Li
Objective: To investigate the epidemiological features of abnormal urinary fluoride rates in population with occupational exposure, and its relationships with age, work years and gender in Shanghai. Methods: A questionnaire survey was conducted respectively in 4 999 exposed workers and 283 non-exposed people during 2012-2015. Their urine samples were collected in plastic bottles and the fluoride ion selective electrode method was used for urinary fluoride level analysis. Logistic regression model was used to estimate associations between the abnormal rates and demographic/socioeconomic status of the study subjects...
January 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28100148/palliative-care-in-uk-prisons
#3
Mary Turner, Marian Peacock
Despite falling crime rates in England and Wales over the past 20 years, the number of prisoners has doubled. People over the age of 50 constitute the fastest growing section of the prison population, and increasing numbers of older prisoners are dying in custody. This article discusses some of the issues raised by these changing demographics and draws on preliminary findings from a study underway in North West England. It describes the context behind the rise in the numbers of older prisoners; explores the particular needs of this growing population; and discusses some of the practical and emotional challenges for prison officers, health care staff, and fellow prisoners who are involved in caring for dying prisoners in a custodial environment...
January 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28099365/melanoma-during-pregnancy-a-report-of-60-pregnancies-complicated-by-melanoma
#4
Jorine de Haan, Christianne A Lok, Christianne J de Groot, Marianne B Crijns, Kristel Van Calsteren, Karina Dahl Steffensen, Michael J Halaska, Sevilay Altintas, Ingrid A Boere, Robert Fruscio, Wojciech Kolawa, Petronella O Witteveen, Frédéric Amant
The management of melanoma during pregnancy is challenging as maternal benefits and fetal risks need to be balanced. Here, we present an overview of the incidence, the demographic and clinical characteristics and the treatment modalities used. After analysis of obstetric, fetal and maternal outcome, recommendations for clinical practice are provided. From the 'International Network on Cancer, Infertility and Pregnancy' database, pregnant patients with melanoma were identified and analysed. Sixty pregnancies were eligible for analysis...
January 17, 2017: Melanoma Research
https://www.readbyqxmd.com/read/28099287/anesthetic-outcomes-of-children-with-arthrogryposis-syndromes-no-evidence-of-hyperthermia
#5
Stephen J Gleich, Michael Tien, Darrell R Schroeder, Andrew C Hanson, Randall Flick, Michael E Nemergut
BACKGROUND: Arthrogryposis syndromes are a heterogeneous group of disorders characterized by congenital joint contractures often requiring multiple surgeries during childhood to address skeletal and visceral abnormalities. Previous reports suggest that these children have increased perioperative risk, including hypermetabolic events discrete from malignant hyperthermia, difficult airway management, isolated hyperthermia, and difficult IV line placement. We sought to compare children with arthrogryposis multiplex congenita (AMC) versus the less severe, distal arthrogryposis syndromes (DAS) and to evaluate possible intraoperative hyperthermia of patients with AMC...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099256/diagnosis-of-chronic-pancreatitis-incorporating-endosonographic-features-demographics-and-behavioral-risk
#6
Linda S Lee, Ying P Tabak, Vivek Kadiyala, Xiaowu Sun, Shadeah Suleiman, Richard S Johannes, Peter A Banks, Darwin L Conwell
OBJECTIVES: Diagnosing chronic pancreatitis remains challenging. Endoscopic ultrasound (EUS) is utilized to evaluate pancreatic disease. Abnormal pancreas function test is considered the "nonhistologic" criterion standard for chronic pancreatitis. We derived a prediction model for abnormal endoscopic pancreatic function test (ePFT) by enriching EUS findings with patient demographic and pancreatitis behavioral risk characteristics. METHODS: Demographics, behavioral risk characteristics, EUS findings, and peak bicarbonate results were collected from patients evaluated for pancreatic disease...
January 18, 2017: Pancreas
https://www.readbyqxmd.com/read/28098569/human-papillomavirus-genotyping-of-incidental-malignant-and-premalignant-lesions-on-hemorrhoidectomy-specimens
#7
Yiang Hui, M Ruhul Quddus, Jayasimha N Murthy, Dongfang Yang, C James Sung, Shaolei Lu, Murray B Resnick, Li Juan Wang
Routine histopathologic examination of hemorrhoidectomy specimens is controversial having been described as not useful and expensive with few of these common cases demonstrating incidental lesions. However, unexpected premalignant and malignant lesions have been detected on excised hemorrhoids. The high-risk human papillomavirus (HR-HPV) types associated with these incidentally identified high-grade lesions are presently unknown. We aimed to identify cases of incidental high-grade anal intraepithelial neoplasia (HG-AIN) and anal squamous cell carcinoma incidentally discovered on hemorrhoidectomy specimens, genotype HR-HPVs from these lesions, and assess p53 and p16 expression by immunohistochemistry to identify risk factors for their development...
January 16, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28098483/academic-performance-on-first-year-medical-school-exams-how-well-does-it-predict-later-performance-on-knowledge-based-and-clinical-assessments
#8
Edward Krupat, Stephen R Pelletier, Jules L Dienstag
Number of appearances in the bottom quartile of 1st-year medical school exams were used to represent the extent to which students were having academic difficulties. Medical educators have long expressed a desire to have indicators of medical student performance that have strong predictive validity. Predictors traditionally used fell into 4 general categories: demographic (e.g., gender), other background factors (e.g., college major), performance/aptitude (e.g., medical college admission test scores), and noncognitive factors (e...
January 18, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28096903/anxiety-and-depression-symptoms-among-women-attending-group-based-patient-education-courses-for-hereditary-breast-and-ovarian-cancer
#9
Wenche Listøl, Hildegunn Høberg-Vetti, Geir Egil Eide, Cathrine Bjorvatn
BACKGROUND: Women carrying BRCA-mutations are facing significant challenges, including decision making regarding surveillance and risk-reducing surgery. They often report that they are left alone with these important decisions. In order to enhance the genetic counselling session we organized a group-based patient education (GPE) course for women with BRCA-mutations. The study aims were to characterize women attending a group-based patient education (GPE) course for hereditary breast and ovarian cancer, consider the usefulness of the course, evaluate symptoms of anxiety and depression among the participants, and finally investigate whether their levels of anxiety and depression changed from before to after the course session...
2017: Hereditary Cancer in Clinical Practice
https://www.readbyqxmd.com/read/28096006/immunizations-challenge-healthcare-personnel-and-affects-immunization-rates
#10
Pamela K Strohfus, Susan C Kim, Sara Palma, Russell A Duke, Richard Remington, Caleb Roberts
PURPOSE: This study measured 1. medical office immunization rates and 2. health care personnel competency in managing vaccine practices before and after evidence-based immunization education was provided. METHOD: This descriptive study compared 32 family medicine and pediatric offices and 178 medical assistants, licensed practical nurses, registered nurses, nurse practitioners, and physicians in knowledge-based testing pre-education, post-education, and 12-months post-education...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28095475/the-influence-of-community-health-resources-on-effectiveness-and-sustainability-of-community-and-lay-health-worker-programs-in-lower-income-countries-a-systematic-review
#11
Daniel H de Vries, Robert Pool
BACKGROUND: Despite the availability of practical knowledge and effective interventions required to reduce priority health problems in low-income countries, poor and vulnerable populations are often not reached. One possible solution to this problem is the use of Community or Lay Health Workers (CLHWs). So far, however, the development of sustainability in CLHW programs has failed and high attrition rates continue to pose a challenge. We propose that the roles and interests which support community health work should emerge directly from the way in which health is organized at community level...
2017: PloS One
https://www.readbyqxmd.com/read/28093988/adherence-to-secondary-prophylaxis-for-acute-rheumatic-fever-and-rheumatic-heart-disease-a-systematic-review
#12
Priya Minaxi Kevat, Benjamin M Reeves, Alan R Ruben, Ronny Gunnarsson
BACKGROUND: Optimal delivery of regular benzathine penicillin G (BPG) injections prescribed as secondary prophylaxis for acute rheumatic fever (ARF) and rheumatic heart disease (RHD) is vital to preventing disease morbidity and cardiac sequelae in affected pediatric and young adult populations. However, poor uptake of secondary prophylaxis remains a significant challenge to ARF/RHD control programs. OBJECTIVE: In order to facilitate better understanding of this challenge and thereby identify means to improve service delivery, this systematic literature review explored rates of adherence and factors associated with adherence to secondary prophylaxis for ARF and RHD worldwide...
January 16, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28093434/forty-years-of-shunt-surgery-at-rigshospitalet-denmark-a-retrospective-study-comparing-past-and-present-rates-and-causes-of-revision-and-infection
#13
Philip Kofoed Månsson, Sofia Johansson, Morten Ziebell, Marianne Juhler
OBJECTIVE: The objective of this study is to review our experience of shunt surgery by investigating 40 years of development in terms of rates of revision and infection, shunt survival and risk factors. DESIGN AND PARTICIPANTS: Medical records and operative reports were reviewed retrospectively for all patients who underwent primary shunt surgery at our department in the years 2010 to 2012. All results were compared with a previous study from our department. A mixed population consisting of 434 patients was included...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28093312/palliative-medicine-and-preparedness-planning-for-patients-receiving-left-ventricular-assist-device-as-destination-therapy-challenges-to-measuring-impact-and-change-in-institutional-culture
#14
Brandon P Verdoorn, Angela J Luckhardt, Sara E Wordingham, Shannon M Dunlay, Keith M Swetz
CONTEXT: While left ventricular assist devices as destination therapy (DT-LVAD) can improve survival, quality of life, and functional capacity in well-selected patients with advanced heart failure, there remain unique challenges to providing quality end-of-life care in this population. Palliative care involvement is universally recommended, but how to best operationalize this care and measure success is unknown. OBJECTIVES: To characterize the process of preparedness planning (PP) for patients receiving DT-LVAD at our institution and better understand opportunities for quality improvement or procedural transferability...
January 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28092838/development-and-validation-of-the-stigma-scale-for-epilepsy-in-turkey
#15
Sevim Baybaş, Zerrin Yıldırım, Harika Ertem Özhan, Ayten Dirican, Ahmet Dirican
OBJECTIVE: Epilepsy is a chronic disease with an increased risk of stigma. The aim of this study was to investigate the efficacy of a scale developed by the authors to determine the level of stigma in Turkish patients with epilepsy and their relatives. METHODS: In this pilot study, two scales were developed, one consisting of 32 questions for the patients and one of 20 questions for the patients' relatives. Initially, a total of 30 patients with epilepsy and 30 relatives of the patients were included...
January 13, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28092120/pediatric-peritonsillar-abscess-outcomes-and-cost-savings-from-using-transcervical-ultrasound
#16
Zhen Huang, William Vintzileos, Heather Gordish-Dressman, Anjum Bandarkar, Brian K Reilly
OBJECTIVES: 1) To analyze clinical outcomes of children stratified by ultrasound into three diagnoses: acute tonsillitis, peritonsillar phlegmon, and abscess; and 2) To compare clinical outcomes and financial impact between children who underwent ultrasound protocol to those who did not. STUDY DESIGN: Retrospective analysis between two cohorts: ultrasound protocol group and control group. METHODS: Children with peritonsillar abscess (PTA) diagnosed in the emergency department (ED) were enrolled during a 2-year period for transcervical ultrasound evaluation of bilateral tonsillar fossae...
January 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28091770/relevance-of-surgery-in-patients-with-non-variceal-upper-gastrointestinal-bleeding
#17
S Dango, T Beißbarth, E Weiss, A Seif Amir Hosseini, D Raddatz, V Ellenrieder, J Lotz, B M Ghadimi, A Beham
INTRODUCTION: Upper GI bleeding remains one of the most common emergencies with a substantial overall mortality rate of up to 30%. In severe ill patients, death does not occur due to failure of hemostasis, either medical or surgical, but mainly from comorbidities, treatment complications, and decreased tolerated blood loss. Management strategies have changed dramatically over the last two decades and include primarily endoscopic intervention in combination with acid-suppressive therapy and decrease in surgical intervention...
January 14, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28090687/prevalence-of-psychotropic-medication-use-and-association-with-challenging-behaviour-in-adults-with-an-intellectual-disability-a-total-population-study
#18
D L Bowring, V Totsika, R P Hastings, S Toogood, M McMahon
BACKGROUND: There is a high prevalence of psychotropic medication use in adults with Intellectual Disabilities (ID), often in the absence of psychiatric disorder, also associated with challenging behaviour. Previous research has focused on specific sample frames or data from primary care providers. There is also a lack of consistency in the definition of challenging behaviour used. METHODS: We adopted a total population sampling method. Medication data on 265 adults with ID were classified according to the Anatomical Therapeutic Chemical classification system...
January 16, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/28089764/promoting-weight-maintenance-with-electronic-health-record-tools-in-a-primary-care-setting-baseline-results-from-the-maintain-pc-trial
#19
Molly B Conroy, Cindy L Bryce, Kathleen M McTigue, Dana Tudorascu, Bethany Barone Gibbs, Diane Comer, Rachel Hess, Kimberly Huber, Laurey R Simkin-Silverman, Gary S Fischer
Maintaining weight loss is a significant challenge in combating obesity. The goal of Maintaining Activity and Nutrition through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) is to evaluate the use of tools delivered through an electronic health record (EHR) and patient portal, with or without health coach support, to help primary care patients maintain weight loss. EHR tools include flowsheets, standardized surveys, and secure patient messaging. Inclusion criteria were age 18-75years, voluntary 5% weight loss in the past 2years with prior BMI≥25kg/m(2), and no bariatric procedures in past 5years...
January 12, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28089265/gender-differences-in-parkinson-s-disease-depression
#20
Andrew J Perrin, Ekaterina Nosova, Kim Co, Adam Book, Oscar Iu, Vanessa Silva, Christina Thompson, Martin J McKeown, A Jon Stoessl, Matthew J Farrer, Silke Appel-Cresswell
INTRODUCTION: 30-40% of patients with Parkinson's disease (PD) experience depression during their illness; identifying subtypes of depression and groups at risk remains a challenge in routine clinical care. One avenue that remains underexplored is the gender-specific profiles manifested in PD depression. We sought to explore this in a large sample of clinical PD patients. METHODS: 307 patient records at a tertiary referral centre were reviewed for clinical and demographic factors...
December 29, 2016: Parkinsonism & related Disorders
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