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https://www.readbyqxmd.com/read/28533807/malignant-soft-tissue-sarcoma-of-the-shoulder-treated-by-surface-mould-brachytherapy-boost-in-an-adjuvant-setting
#1
Ashutosh Mukherji, Mourougan Sinnatamby
PURPOSE: Soft tissue sarcomas of the extremities account for half of all soft tissue sarcomas. Radiotherapy and surgery have been the standard modalities in the treatment of this type of cancer. Brachytherapy can be used as the sole therapy, if the target volume is localized and easily accessible. This work reports three cases of shoulder soft tissue sarcomas with positive deep resected margins, treated with a combination of external beam radiotherapy and surface mould brachytherapy boost technique...
April 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28532896/healing-of-fracture-nonunions-treated-with-low-intensity-pulsed-ultrasound-lipus-a-systematic-review-and-meta-analysis
#2
Ross Leighton, J Tracy Watson, Peter Giannoudis, Costas Papakostidis, Andrew Harrison, R Grant Steen
INTRODUCTION: Bone fractures fail to heal and form nonunions in roughly 5% of cases, with little expectation of spontaneous healing thereafter. We present a systematic review and meta-analysis of published papers that describe nonunions treated with low-intensity pulsed ultrasound (LIPUS). METHODS: Articles in PubMed, Ovid MEDLINE, CINAHL, AMED, EMBASE, Cochrane Library, and Scopus databases were searched, using an approach recommended by the Methodological Index for Non-Randomized Studies (MINORS), with a Level of Evidence rating by two reviewers independently...
May 15, 2017: Injury
https://www.readbyqxmd.com/read/28532432/periodontitis-and-early-mortality-among-adults-treated-with-hemodialysis-a-multinational-propensity-matched-cohort-study
#3
Marinella Ruospo, Suetonia C Palmer, Germaine Wong, Jonathan C Craig, Massimo Petruzzi, Michele De Benedittis, Pauline Ford, David W Johnson, Marcello Tonelli, Patrizia Natale, Valeria Saglimbene, Fabio Pellegrini, Eduardo Celia, Ruben Gelfman, Miguel R Leal, Marietta Torok, Paul Stroumza, Anna Bednarek-Skublewska, Jan Dulawa, Luc Frantzen, Domingo Del Castillo, Staffan Schon, Amparo G Bernat, Jorgen Hegbrant, Charlotta Wollheim, Letizia Gargano, Casper P Bots, Giovanni Fm Strippoli
BACKGROUND: Periodontitis is associated with cardiovascular mortality in the general population and adults with chronic diseases. However, it is unclear whether periodontitis predicts survival in the setting of kidney failure. METHODS: ORAL-D was a propensity matched analysis in 3338 dentate adults with end-stage kidney disease treated in a hemodialysis network in Europe and South America designed to examine the association between periodontitis and all-cause and cardiovascular-related mortality in people on long-term hemodialysis...
May 22, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28532425/combined-pulmonary-and-left-ventricular-support-with-veno-pulmonary-ecmo-and-impella-5-0-for-cardiogenic-shock-after-coronary-surgery
#4
Sameh Sayed, Christoph Schimmer, Ina Shade, Rainer Leyh, Ivan Aleksic
BACKGROUND: Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery...
May 22, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28532134/assessing-the-efficacy-of-second-line-antiretroviral-treatment-for-hiv-patients-failing-first-line-antiretroviral-therapy-in-iran-a-cohort-study
#5
Mehrnaz Rasooli-Nejad, Maryam Khazaee-Pool, Ladan Abbasian, Zahra Bayat Jozani, Sara Ahsani-Nasab, Banafsheh Moradmand Badie, Afsaneh Pargar, Gholamreza Esmaeeli Djavid
There are limited documents about HIV patients switched to second-line antiretroviral therapy (ART) in resource-limited countries. We aimed to assess the efficacy of second-line ART for HIV patients following first-line ART failure. This was a cohort study of HIV/AIDS patients with first-line ART treatment failure switched to second-line ART between January 2004 and March 2014, who followed for at least 12 months after switching. Fifty of studied patients (85%) were treated with regimens containing lopinavir/ritonavir (Kaletra) and nine of them (15%) treated with other regimes...
April 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28530401/rational-design-of-mof-nanocarrier-based-co-delivery-system-of-doxorubicin-hydrochloride-verapamil-hydrochloride-for-overcoming-multidrug-resistance-with-efficient-targeted-cancer-therapy
#6
Huiyuan Zhang, Wei Jiang, Ruiling Liu, Jing Zhang, Di Zhang, Zhonghao Li, Yuxia Luan
Conventional organic and inorganic drug nanocarriers suffer from serious drawbacks, such as low drug-storage capacity and uncontrolled release. Moreover, multidrug resistance (MDR) has been one of the primary causes leading to chemotherapy failure for cancers. The main reason of MDR is the overexpressed active efflux transporters such as P-glycoprotein. Here, zeolitic imidazolate framework ZIF-8, as one of the biocompatible metal organic frameworks (MOFs), is reported for the first time as the multidrug carrier to realize the efficient co-delivery of verapamil hydrochloride (VER) as the P-glycoprotein inhibitor as well as doxorubicin hydrochloride (DOX) as an anticancer drug to overcome the MDR in addition to realizing the active targeted ability for an efficient anticancer effect...
May 22, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28529915/hemolytic-uremic-syndrome-in-adults-a-case-report
#7
Fabiel Gerardo Pérez-Cruz, Patricia Villa-Díaz, María Consuelo Pintado-Delgado, María Loreto Fernández Rodríguez, Ana Blasco-Martínez, María Pérez-Fernández
Thrombotic microangiopathies (TMA) are microvascular occlusive disorders characterized by platelet aggregation and mechanical damage to erythrocytes, clinically characterized by microangiopatic haemolytic anemia, thrombocytopenia and organ injury. We are reporting a case of a woman patient with severe hemolytic uremic syndrome associated to infectious diarrhoea caused by Shiga toxin-producing pathogen, who were admitted to our intensive care unit. The patient described developed as organ injury, neurological failure and acute renal failure, with need of haemodialysis technique...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28529867/efficacy-of-antibiotic-suppressive-therapy-in-patients-with-a-prosthetic-joint-infection
#8
Marjan Wouthuyzen-Bakker, Jasperina M Nijman, Greetje A Kampinga, Sander van Assen, Paul C Jutte
Introduction: For chronic prosthetic joint infections (PJI), complete removal of the infected prosthesis is necessary in order to cure the infection. Unfortunately, a subgroup of patients is not able to undergo a revision surgery due to high surgical risk. Alternatively, these patients can be treated with antibiotic suppressive therapy (AST) to suppress the infection. Aim: To evaluate the efficacy and tolerability of AST. Methods: We retrospectively collected data (period 2009-2015) from patients with a PJI (of hip, knee or shoulder) who were treated with AST at the University Medical Center Groningen, the Netherlands...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529117/new-markers-for-adult-onset-still-s-disease
#9
Stéphane Mitrovic, Bruno Fautrel
Adult-onset Still's disease (AOSD) is a rare systemic auto-inflammatory disorder (SAID). Although the pathogenesis of the disease is complex and far from being fully understood, recent progresses in pathophysiological knowledge have paved the way to new diagnostic approaches. Indeed, AOSD diagnosis can be a real challenge, owing to its infrequency, and to the lack of specificity of the principal clinical features (high fever, arthralgia or arthritis, skin rash) and laboratory findings (elevated acute phase reactants, hyperleukocytosis ≥ 10,000 cells/mm(3) with neutrophils ≥80%)...
May 18, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28528576/using-non-thermal-irreversible-electroporation-to-create-an-in-vivo-niche-for-exogenous-cell-engraftment
#10
Tammy T Chang, Vivian X Zhou, Boris Rubinsky
The critical shortage of donor organs has spurred investigation of alternative approaches to either generate replacement organs or implant exogenous cells for treatment of end-stage organ failure. Non-thermal irreversible electroporation (NTIRE), which uses brief high electric field pulses to induce irreversible permeabilization of cell membranes, has emerged as a technique for tumor ablation. Here, we introduce a new application for NTIRE that employs in situ cell ablation to create a niche within a solid organ for engraftment of exogenous cells in vivo...
May 1, 2017: BioTechniques
https://www.readbyqxmd.com/read/28528561/angiotensin-ii-for-the-treatment-of-vasodilatory-shock
#11
Ashish Khanna, Shane W English, Xueyuan S Wang, Kealy Ham, James Tumlin, Harold Szerlip, Laurence W Busse, Laith Altaweel, Timothy E Albertson, Caleb Mackey, Michael T McCurdy, David W Boldt, Stefan Chock, Paul J Young, Kenneth Krell, Richard G Wunderink, Marlies Ostermann, Raghavan Murugan, Michelle N Gong, Rakshit Panwar, Johanna Hästbacka, Raphael Favory, Balasubramanian Venkatesh, B Taylor Thompson, Rinaldo Bellomo, Jeffrey Jensen, Stew Kroll, Lakhmir S Chawla, George F Tidmarsh, Adam M Deane
Background Vasodilatory shock that does not respond to high-dose vasopressors is associated with high mortality. We investigated the effectiveness of angiotensin II for the treatment of patients with this condition. Methods We randomly assigned patients with vasodilatory shock who were receiving more than 0.2 μg of norepinephrine per kilogram of body weight per minute or the equivalent dose of another vasopressor to receive infusions of either angiotensin II or placebo. The primary end point was a response with respect to mean arterial pressure at hour 3 after the start of infusion, with response defined as an increase from baseline of at least 10 mm Hg or an increase to at least 75 mm Hg, without an increase in the dose of background vasopressors...
May 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28527983/when-a-death-apparently-associated-to-sexual-assault-is-instead-a-natural-death-due-to-idiopathic-hypereosinophilic-syndrome-the-importance-of-gamma-hydroxybutyric-acid-analysis-in-vitreous-humor
#12
Francesco Paolo Busardò, Francesca Portelli, Angelo Montana, Maria Concetta Rotolo, Simona Pichini, Emiliano Maresi
We here report a case involving a 21-year-old female, found dead in a central square of a city in the south of Italy. Initial evidences and circumstances were suggestive of a death associated with a sexual assault. Two peripheral blood and two vitreous humor samples were collected for the purpose of gamma-hydroxybutyric acid (GHB) testing from the dead body at two different post-mortem intervals (PMIs): approximately 2 (t0) and 36 (t1) hours. The obtained results showed that, between t0 and t1, there was an increase of GHB concentrations in peripheral blood and vitreous humor of 66...
April 11, 2017: Legal Medicine
https://www.readbyqxmd.com/read/28527886/immuno-pcr-a-new-technique-for-the-serodiagnosis-of-tuberculosis
#13
REVIEW
Promod K Mehta, Bhawna Dahiya, Suman Sharma, Netrapal Singh, Renu Dharra, Zoozeal Thakur, Neeru Mehta, Krishna B Gupta, Mahesh C Gupta, Dhruva Chaudhary
Rapid and accurate diagnosis of tuberculosis (TB) is essential to control the disease. The conventional microbiological tests have limitations and there is an urgent need to devise a simple, rapid and reliable point-of-care (POC) test. The failure of TB diagnostic tests based on antibody detection due to inconsistent and imprecise results has stimulated renewed interest in the development of rapid antigen detection methods. However, the World Health Organization (WHO) has emphasized to continue research for designing new antibody-based detection tests with improved accuracy...
May 17, 2017: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/28526675/iterative-user-interface-design-for-automated-sequential-organ-failure-assessment-score-calculator-in-sepsis-detection
#14
Christopher Ansel Aakre, Jaben E Kitson, Man Li, Vitaly Herasevich
BACKGROUND: The new sepsis definition has increased the need for frequent sequential organ failure assessment (SOFA) score recalculation and the clerical burden of information retrieval makes this score ideal for automated calculation. OBJECTIVE: The aim of this study was to (1) estimate the clerical workload of manual SOFA score calculation through a time-motion analysis and (2) describe a user-centered design process for an electronic medical record (EMR) integrated, automated SOFA score calculator with subsequent usability evaluation study...
May 18, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28526593/cardiac-tamponade-as-an-initial-presentation-for-systemic-lupus-erythematosus
#15
William Li, Thomas Frohwein, Kenneth Ong
Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease which follows a relapsing and remitting course that can manifest in any organ system. While classic manifestations consist of arthralgia, myalgia, frank arthritis, a malar rash and renal failure to name a few, cardiac tamponade, however, is a far less common and far more dangerous presentation. We highlight the case of a 61year-old male with complaints of acute onset shortness of breath and generalized body aches associated with a fever and chills in the ER...
April 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28525674/continuous-hemoadsorption-with-a-cytokine-adsorber-during-sepsis-a-review-of-the-literature
#16
Khosrow S Houschyar, Malcolm N Pyles, Susanne Rein, Ina Nietzschmann, Dominik Duscher, Zeshaan N Maan, Kristian Weissenberg, Hubertus M Philipps, Catharina Strauss, Beate Reichelt, Frank Siemers
Sepsis is a well-recognized healthcare issue worldwide, ultimately resulting in significant mortality, morbidity and resource utilization during and after critical illness. In its most severe form, sepsis causes multi-organ dysfunction that produces a state of critical illness characterized by severe immune dysfunction and catabolism. Sepsis induces the activation of complement factor via 3 pathways and the release of inflammatory cytokines such as tumor necrosis factor alpha (TNF-α) and interleukin-1beta (IL-1β), resulting in a systemic inflammatory response...
May 19, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28525508/analysis-of-hypo-and-hyperphosphatemia-in-an-intensive-care-unit-cohort
#17
Marcus Broman, Amanda M J Wilsson, Fredrik Hansson, Bengt Klarin
BACKGROUND: Blood phosphate levels are vulnerable to fluctuations and changes in phosphate levels are often neglected. The aim of this study was to evaluate whether deviations in phosphate levels correlate to higher 180-day overall mortality or morbidity. METHODS: Four thousand six hundred fifty-six patients with 19,467 phosphate values treated at the adult intensive care unit at Skåne University Hospital, Lund, Sweden during 2006-2014 were retrospectively divided into a control group and 3 study groups: hypophosphatemia, hyperphosphatemia, and a mixed group showing both hypo/hyperphosphatemia...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28524831/a-case-series-of-liver-abscess-formation-after-transcatheter-arterial-chemoembolization-for-hepatic-tumors
#18
Wei Sun, Fei Xu, Xiao Li, Chen-Rui Li
BACKGROUND: Liver abscess is a serious complication following transcatheter arterial chemoembolization (TACE). Much attention has been paid to this condition as it may interfere with the treatment process and result in a poor prognosis of the patient. This study aimed to analyze the causes of liver abscess, a complication, after TACE for hepatic tumors and to summarize management approaches. METHODS: From June 2012 to June 2014, of 1480 consecutive patients who underwent TACE at our hospital, five patients developed liver abscess after TACE procedures for hepatic tumors...
June 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28523364/-structured-patient-handovers-in-perioperative-medicine-rationale-and-implementation-in-clinical-practice
#19
M J Merkel, V von Dossow, B Zwißler
Clear and consistent communication is pivotal for well-functioning teamwork, in operating theatres as well as intensive care units. However, patient handovers significantly vary between specialties and locations. If communication is not well structured, it might increase the risk for mishaps and malpractice. Therefore, implementing structured handover protocols is pivotal. The perioperative setting is a high-risk environment that is prone to communication failures due to operational design (frequent change of shift due to working time restrictions) and a high work load and multitasking (operating room management, short surgery times, concurrent emergencies)...
May 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28522775/purpura-fulminans-mimicking-toxic-epidermal-necrolysis-additional-value-of-16s-rrna-sequencing-and-skin-biopsy
#20
K H W Dautzenberg, F N Polderman, R J van Suylen, M A M Moviat
Both purpura fulminans and toxic epidermal necrolysis (TEN) are rare and life-threatening disorders with a high mortality. We present a case of suspected rapidly progressive, severe pneumococcal sepsis-induced purpura fulminans complicated by multiple organ failure, severe epidermolysis and cutaneous necrosis. We show the diagnostic challenge to differentiate between purpura fulminans and TEN, as the extensive epidermolysis in purpura fulminans may mimic TEN and we highlight the additional value of repeated skin biopsies and 16S rRNA gene sequencing...
May 2017: Netherlands Journal of Medicine
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