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https://www.readbyqxmd.com/read/29774173/role-of-interventional-radiology-in-the-management-of-peripheral-vascular-malformations-a-tertiary-care-center-experience
#1
Misbah Tahir, Muhammad Anees Mumtaz, Anum Sultan, Jawaid Iqbal, Raza Sayani
Peripheral vascular malformations (PVMs) represent a wide spectrum of vascular abnormalities occurring due to anomalous connections between arteries, veins, capillaries, and lymphatic channels at the microscopic level, in different combinations. They are rare and challenging to treat. Different operators may have different approaches based on their experience and expertise. Sclerotherapy either alone or in combination with embolization has been used as an independent method for the treatment of PVMs. Purpose The aim of this study is to assess the safety and efficacy of sclerotherapy and embolization, with or without surgery, for the treatment of peripheral vascular malformations, based on our approach...
March 16, 2018: Curēus
https://www.readbyqxmd.com/read/29773539/effectiveness-of-text-message-based-diabetes-self-management-support-programme-sms4bg-two-arm-parallel-randomised-controlled-trial
#2
Rosie Dobson, Robyn Whittaker, Yannan Jiang, Ralph Maddison, Matthew Shepherd, Catherine McNamara, Richard Cutfield, Manish Khanolkar, Rinki Murphy
OBJECTIVE: To determine the effectiveness of a theoretically based and individually tailored, text message based, diabetes self management support intervention (SMS4BG) in adults with poorly controlled diabetes. DESIGN: Nine month, two arm, parallel randomised controlled trial. SETTING: Primary and secondary healthcare services in New Zealand. PARTICIPANTS: 366 participants aged 16 years and over with poorly controlled type 1 or type 2 diabetes (HbA1c ≥65 mmol/mol or 8%) randomised between June 2015 and November 2016 (n=183 intervention, n=183 control)...
May 17, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29773516/lymphoedema-management-to-prevent-acute-dermatolymphangioadenitis-in-podoconiosis-in-northern-ethiopia-golbet-a-pragmatic-randomised-controlled-trial
#3
Henok Negussie, Meseret Molla, Moses Ngari, James A Berkley, Esther Kivaya, Patricia Njuguna, Greg Fegan, Abreham Tamiru, Abebe Kelemework, Trudie Lang, Melanie J Newport, Andy McKay, Fikre Enquoselassie, Gail Davey
BACKGROUND: Podoconiosis (also known as endemic, non-filarial elephantiasis) affects about 4 million subsistence farmers in tropical Africa. Poor awareness of the condition and inadequate evidence for the efficacy of treatment mean that no government in an endemic country yet offers lymphoedema management for patients with podoconiosis. Among patients with filarial lymphoedema, trials suggest that limb care is effective in reducing the most disabling sequelae: episodes of acute dermatolymphangioadenitis...
May 14, 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29772673/reducing-amputations-in-people-with-diabetes-rapid-evaluation-of-a-new-care-pathway
#4
Sandra MacRury, Kate Stephen, Fiona Main, Jane Gorman, Sandra Jones, David Macfarlane
People with diabetes are at increased risk of foot ulcers, which, if left untreated, can lead to infection, gangrene, and subsequent amputation. Management by a multidisciplinary diabetes foot team has been shown to reduce amputation rates; however, accessing specialist treatment is made particularly difficult when living in remote and rural locations, such as many individuals cared for within NHS Highland. The RAPID project was made up of two phases: firstly, to evaluate the technical feasibility of a new integrated care pathway using innovative technology, and secondly, to establish process enhancement of the pathway to justify a larger-scale study...
May 16, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29767226/evaluation-of-the-wear-and-tear-scale-for-therapeutic-footwear-results-of-a-generalizability-study
#5
Rutger Dahmen, Petra C Siemonsma, Sandra Monteiro, Geoffrey R Norman, Maarten Boers, Gustaaf J Lankhorst, Leo D Roorda
OBJECTIVE: Therapeutic footwear is often prescribed at considerable cost. Foot-care specialists normally assess the wear-and-tear of therapeutic footwear in order to monitor the adequacy of the prescribed footwear and to gain an indicator of its use. We developed a simple, rapid, easily applicable indicator of wear-and-tear of therapeutic footwear: the wear-and-tear scale. The aim of this study was to investigate the intra- and inter-rater reliability of the wear-and-tear scale. METHODS: A test set of 100 therapeutic shoes was assembled; 24 raters (6 inexperienced and 6 experienced physiatrists, and 6 inexperienced and 6 experienced orthopaedic shoe technicians) rated the degree of wear-and-tear of the shoes on the scale (range 0-100) twice on 1 day with a 4-h interval (short-term) and twice over a 4-week interval (long-term)...
May 16, 2018: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29760842/appropriateness-of-extremity-magnetic-resonance-imaging-examinations-in-an-academic-emergency-department-observation-unit
#6
McKinley Glover, Ravi V Gottumukkala, Yadiel Sanchez, Brian J Yun, Theodore I Benzer, Benjamin A White, Anand M Prabhakar, Ali S Raja
Introduction: Emergency departments (ED) and hospitals face increasing challenges related to capacity, throughput, and stewardship of limited resources while maintaining high quality. Appropriate utilization of extremity magnetic resonance imaging (MRI) examinations within the emergency setting is not well known. Therefore, this study aimed to determine indications for and appropriateness of MRI of the extremities for musculoskeletal conditions in the ED observation unit (EDOU). Methods: We conducted this institutional review board-approved, retrospective study in a large, quaternary care academic center and Level I trauma center...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29759883/minimally-invasive-plate-osteosynthesis-for-tibial-derotation-osteotomies-in-children-with-cerebral-palsy
#7
Ilker Abdullah Sarikaya, Ali Seker, Ozan Ali Erdal, Mehmet Ali Talmac, Muharrem Inan
OBJECTIVE: Tibial derotation osteotomy can be used in the treatment of rotational deformities in case of ineffective conservative management. Our aim was to evaluate the results of the patients who underwent minimal invasive plate osteosynthesis for tibial derotation osteotomies. METHODS: Total of 16 patients (17 procedures) were included in this study. Mean age was 11.5 (3-25) years. We clinically assessed the tibial torsion by measuring the thigh-foot angle (TFA)...
May 11, 2018: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29757846/increasing-diabetic-patient-engagement-and-self-reported-medication-adherence-using-a-web-based-multimedia-program
#8
Kerri Elsabrout
BACKGROUND AND PURPOSE: Evidence-based, multimedia applications to supplement clinical care can improve patient engagement and clinical outcomes. Patients with diabetes with potentially devastating complication of foot ulcers present a substantial opportunity to improve engagement. This project examines how providing an online, multimedia self-management program affects patient engagement and self-reported medication adherence scores within 4-6 weeks compared with preprogram scores. METHODS: Participants included 14 adult, diabetic outpatients receiving care at a Wound Care Center in suburban New York...
May 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29753655/are-the-u-s-territories-lagging-behind-in-diabetes-care-practices
#9
Rachel P Ogilvie, Shivani A Patel, K M Venkat Narayan, Neil K Mehta
AIMS: Although U.S. territories fall within the mandate outlined by Healthy People 2020, they remain neglected in diabetes care research. We compared the prevalence and secular trends of four recommended diabetes care practices in the U.S. territories of Guam, Puerto Rico, and the U.S. Virgin Islands to the 50 United States and D.C. ("U.S. States") in 2001-2015. METHODS: Data were from 390,268 adult participants with self-reported physician diagnosed diabetes in the Behavioral Risk Factor Surveillance System...
May 9, 2018: Primary Care Diabetes
https://www.readbyqxmd.com/read/29752218/elevated-international-normalized-ratio-is-not-associated-with-increased-perioperative-morbidity-in-podiatric-limb-salvage-surgery-a-retrospective-analysis
#10
Nalini Vadivelu, Alice M Kai, Feng Dai, Hosni Mikhael, Rima Aouad, Peter Blume
The risk of hemorrhage always exists in anticoagulated patients with an elevated international normalized ratio (INR), a risk that must be measured against the necessity for surgical procedures. The objective of the present retrospective medical record study was to assess the safety with which limb salvage procedures can be conducted in patients with an INR >1.4. The medical records of 231 patients who had undergone limb salvage procedures by 1 surgeon at the Yale New Haven Health System from November 2008 through July 2014 were reviewed...
May 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29750744/experience-and-prognosis-of-systemic-neonatal-thrombosis-at-a-level-iii-nicu
#11
Sevim Unal, Deniz Gönülal, Betül Siyah Bilgin, Vildan Koşan Çulha, Neşe Yarali
OBJECTIVE: The objective of this article was to evaluate neonates diagnosed systemic thrombosis and their outcomes. METHODS: We retrospectively evaluated data of neonatal systemic thrombosis between January 2011 and December 2016. RESULTS: Among 4376 hospitalized, 30 neonates (0.69%) were diagnosed systemic thrombosis. Their mean birth weight was 2422±1152 g (680 to 4750 g), gestational age was 35±5.4 weeks (25 to 41 wk). There were 25 neonates (83...
May 10, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29746363/lower-extremity-fractures-in-hospitalized-pediatric-patients-following-road-traffic-accidents
#12
Shay Tenenbaum, Jason T Bariteau, Ofir Chechik, Adi Givon, Kobi Peleg, Ran Thein
Lower extremity fractures (LEFs) caused by road traffic accidents (RTAs) can result in significant morbidity and account for a substantial part of nonfatal injuries requiring hospitalization. This study investigated the epidemiology of RTA-associated LEFs in the pediatric population. Based on the National Trauma Registry, data of 28,924 RTA hospitalized pediatric patients were reviewed. Data were analyzed according to LEF mechanism of injury, age distribution, fracture types, associated injuries, surgical treatment, and their interrelations...
May 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29746280/the-impact-of-microbial-communities-on-wound-healing-a-review
#13
Zhenzhen Xu, Henry C Hsia
Chronic, nonhealing wounds place an enormous burden on both the health care system and patients, with no definitive treatments available. There has been increasing evidence that the microbial composition of wounds may play an important role in wound healing. Culture-independent methods for bacterial detection and analysis have revealed the wound microbiome to be much more diverse and complex than culture alone. Such methods primarily rely on targeted amplification and sequencing of various hypervariable regions of the bacterial 16S rRNA for phylogenetic analysis...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29742663/a-simulator-for-breech-extraction-of-the-second-twin
#14
Meredith L Birsner
BACKGROUND: Breech extraction of a second twin is a skill useful for any health care provider planning on undertaking vaginal delivery of twins. However, training opportunities in this skill may be limited. METHOD: Using readily available supplies, a reusable model neoprene uterus can be constructed, as can a balloon model to simulate a fetus in the amniotic cavity. EXPERIENCE: The model allowed demonstration of skills expected of trainees and is easy to construct...
May 7, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29738857/the-effect-of-tumour-neovasculature-on-fmri-bold-activation
#15
Layla Gould, Chelsea Ekstrand, Daryl R Fourney, Marla J S Mickleborough, Tasha Ellchuk, Ron Borowsky
We report a 40-year-old patient with a large, WHO grade III oligodendroglioma in the left parietal lobe. Presurgical planning included fMRI localization of language, motor, and somatosensory processing. The fMRI results for the motor and somatosensory tasks revealed activation in peri-lesional regions near the surgical resection, as well as deactivation in the tumour for the sensory task, suggesting that there is decreased autoregulation in the region due to the glioma. The fMRI results showed left hemisphere dominance for language, as well as activation in peri-lesional regions for all three speech tasks (i...
May 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29738299/perception-of-diabetic-foot-ulcers-among-general-practitioners-in-four-european-countries-knowledge-skills-and-urgency
#16
José Luis Garcia-Klepzig, Juan Pedro Sánchez-Ríos, Chris Manu, Raju Ahluwalia, Claas Lüdemann, Marco Meloni, Elisabetta Lacopi, Víctor Rodriguez-Saenz De Buruaga, Benjamin Bouillet, Julien Vouillarmet, Jose Luis Lazaro Martinez, Kristien Van Acker
OBJECTIVE: Diabetic foot ulcers (DFU) have the potential to deteriorate rapidly, in the absence of prompt assessment and treatment. The aim of this study was to analyse the awareness and perception of DFU among general practitioners (GPs) from four European countries, and to find possible differences between these countries in terms of management. METHOD: A two-part, quantitative, online questionnaire was distributed to GPs across four countries in Europe-the UK, France, Germany and Spain...
May 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29738296/microcurrent-as-an-adjunct-therapy-to-accelerate-chronic-wound-healing-and-reduce-patient-pain
#17
Harikrishna K R Nair
OBJECTIVE: The primary aim is to assess the efficacy of microcurrent, a form of electrical stimulation, as an adjunct therapy in accelerating healing in chronic wounds by reducing wound size and pain level. The secondary aim is to assess the qualitative changes in these parameters: inflammatory symptoms, vasodilation, sleep quality, gait and frequency of bowel movement. METHOD: Eligible patients with chronic wounds were enrolled between March and June 2016, from the Wound Care Unit, Hospital Kuala Lumpur in this consecutive case series...
May 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29733454/severe-pain-during-wound-care-procedures-a-cross-sectional-study-protocol
#18
Catherine A Fiala, Linda I Abbott, Cheryl D Carter, Stephen L Hillis, Jessica S Wolf, Meghan Schuster, Rachel Dulski, Elizabeth A Grice, Barbara A Rakel, Sue E Gardner
AIM: The aim of this study is to: 1) develop and evaluate a model to predict severe pain during wound care procedures so that high-risk patients can be targeted for specialised dressings and preventive pain control; and 2) identify biological factors associated with severe pain during wound care procedures so that novel pain control strategies can be developed. BACKGROUND: Wound care procedures such as dressing changes can cause moderate to severe pain in 74% of patients, with nearly half (36%) of all patients experiencing severe pain (rated as 8-10 on a 10-point numeric rating scale) during dressing change...
May 7, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29731336/empowerment-of-type-2-diabetic-patients-visiting-fuladshahr-diabetes-clinics-for-prevention-of-diabetic-foot
#19
Farbod Ebadi Fardazar, Farzaneh Tahari, Mahnaz Solhi
AIMS: Diabetic foot is one of the most serious and costly complications of diabetes. Empowerment is an important indicator in promoting foot care behaviors that helps patients to use their maximum abilities. This study was carried out with the aim of empowering patients with type 2 diabetes to prevent diabetic foot in the city of Fuladshahr, Isfahan, Iran. METHODS: This is a quasi-experimental study. 104 eligible patients were randomly assigned to two groups: intervention group and control group...
April 26, 2018: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29725557/clinico-microbiological-profile-of-septic-diabetic-foot-with-special-reference-to-anaerobic-infection
#20
K Sasikumar, Chellappa Vijayakumar, Sadasivan Jagdish, Dharanipragada Kadambari, Nagarajan Raj Kumar, Rakhi Biswas, Subhash Chandra Parija
Introduction Diabetic foot infections are a major cause of non-traumatic amputations. The role of anaerobes in the prognosis of these infections is particularly unclear. This study was conducted with the aim of correlating microbiological profiles with clinical outcomes in these diabetic foot ulcer patients. Methodology This prospective observational study was done in a tertiary care centre in South India. All patients admitted with diabetic foot ulcers for two years were included in the study. Tissue biopsies were collected from the ulcer for aerobic and anaerobic cultures...
March 1, 2018: Curēus
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