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https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#1
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27913460/autoimmune-and-other-acquired-neutropenias
#2
Peter E Newburger
This educational review addresses the diagnostic evaluation of patients for autoimmune and other forms of acquired neutropenia, including the futility of deconstructing the overlap of chronic "autoimmune," "benign," and "idiopathic" categories. Isolated neutropenias caused by infection, drugs, and immunologic disorders are also addressed. Discussion of management options emphasizes a conservative approach, with largely supportive care for these mostly benign and self-limited disorders.
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913383/traumatic-haemopneumothorax-and-whole-body-subcutaneous-emphysema-successful-use-of-a-small-bore-chest-drain
#3
Benjamin Hardy, Nicholas Sunderland, Mevan Perera, Kathryn Channing
A 56-year-old man presented having had two falls at home. He had a background of multiple sclerosis. After his second fall, during which he had fallen onto the toilet injuring his right chest, he was brought into the emergency department reporting pleuritic chest discomfort. Immediately evident was extensive swelling from his forehead to his thighs, which on palpation was found to be subcutaneous emphysema. A chest X-ray showed a large right-sided pneumothorax for which a chest drain was inserted. A CT revealed extensive surgical emphysema, pneumomediastinum, pneumoperitoneum and gas within the spinal canal...
December 2, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27912972/fate-of-males-with-urethral-y-duplication-40-year-long-follow-up-in-8-patients
#4
Mario Lima, Francesca Destro, Neil Di Salvo, Tommaso Gargano, Giovanni Ruggeri
PURPOSE: The spectrum of male urethral duplication is heterogeneous and it includes the Y-duplication. The malformation is rare and there is only a few case series reported in the literature. The management of Y-forms remains challenging for the surgeon and the long-term follow-up is still scarcely investigated. We report our 40-year experience in the management of patients with Y-duplication. MATERIALS AND METHODS: We conducted a restrospective analysis collecting information of patients with urethral Y-duplication treated at our department from April 1975 to April 2015...
November 17, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27912016/soil-microbial-communities-influence-seedling-growth-of-a-rare-conifer-independent-of-plant-soil-feedback
#5
Jessica L Rigg, Cathy A Offord, Brajesh K Singh, Ian Anderson, Steve Clarke, Jeff R Powell
Plant-soil feedback, the reciprocal relationship between a plant and its associated microbial communities, has been proposed to be an important driver of plant populations and community dynamics. While rarely considered, understanding how plant-soil feedback contributes to plant rarity may have implications for conservation and management of rare species. Wollemi pine (Wollemia nobilis) is a critically endangered species, of which fewer than 100 trees are known to exist in the wild. Seedling survival within the first year after germination and subsequent recruitment of Wollemi pine is limited in the wild...
December 2016: Ecology
https://www.readbyqxmd.com/read/27912012/coast-wide-recruitment-dynamics-of-olympia-oysters-reveal-limited-synchrony-and-multiple-predictors-of-failure
#6
Kerstin Wasson, Brent B Hughes, John S Berriman, Andrew L Chang, Anna K Deck, Paul A Dinnel, Charlie Endris, Michael Espinoza, Sarah Dudas, Matthew C Ferner, Edwin D Grosholz, David Kimbro, Jennifer L Ruesink, Alan C Trimble, Dick Vander Schaaf, Chela J Zabin, Danielle C Zacherl
Recruitment of new propagules into a population can be a critical determinant of adult density. We examined recruitment dynamics in the Olympia oyster (Ostrea lurida), a species occurring almost entirely in estuaries. We investigated spatial scales of interannual synchrony across 37 sites in eight estuaries along 2,500 km of Pacific North American coastline, predicting that high vs. low recruitment years would coincide among neighboring estuaries due to shared exposure to regional oceanographic factors. Such synchrony in recruitment has been found for many marine species and some migratory estuarine species, but has never been examined across estuaries in a species that can complete its entire life cycle within the same estuary...
December 2016: Ecology
https://www.readbyqxmd.com/read/27912002/a-novel-application-of-multi-event-modeling-to-estimate-class-segregation-in-a-highly-migratory-oceanic-vertebrate
#7
T K Chapple, T Chambert, P E Kanive, S J Jorgensen, J J Rotella, S D Anderson, A B Carlisle, B A Block
Spatial segregation of animals by class (i.e., maturity or sex) within a population due to differential rates of temporary emigration (TE) from study sites can be an important life history feature to consider in population assessment and management. However, such rates are poorly known; new quantitative approaches to address these knowledge gaps are needed. We present a novel application of multi-event models that takes advantage of two sources of detections to differentiate temporary emigration from apparent absence to quantify class segregation within a study population of double-marked (photo-identified and tagged with coded acoustic transmitters) white sharks (Carcharodon carcharias) in central California...
December 2016: Ecology
https://www.readbyqxmd.com/read/27911911/genetic-diversity-and-structure-analysis-of-percocypris-pingi-cypriniformes-cyprinidae-implications-for-conservation-and-hatchery-release-in-the-yalong-river
#8
Xiaoyan Li, Yuanping Deng, Kun Yang, Weixiong Gan, Rukui Zeng, Longjun Deng, Zhaobin Song
Percocypris pingi is a near threatened cyprinid species, which has suffered a dramatic decline due to anthropogenic factors. As one response to this decline, hatchery release for P. pingi has been conducted in the lower reaches of the Yalong River since 2012. To understand the conservation status of this species and the potential impact of the release of hatchery-reared fish, we studied the genetic diversity and population structure of wild and hatchery populations of P. pingi. Two hatchery populations (Jinping [JPH] and Ya'an [YAH]) and two wild populations (Muli [MLW] and Woluo [WLW]) of P...
2016: PloS One
https://www.readbyqxmd.com/read/27911249/international-multicenter-cohort-study-of-pediatric-brain-arteriovenous-malformations-part-2-outcomes-after-stereotactic-radiosurgery
#9
Robert M Starke, Dale Ding, Hideyuki Kano, David Mathieu, Paul P Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Pediatric patients (age < 18 years) harboring brain arteriovenous malformations (AVMs) are burdened with a considerably higher cumulative lifetime risk of hemorrhage than adults. Additionally, the pediatric population was excluded from recent prospective comparisons of intervention versus conservative management for unruptured AVMs. The aims of this multicenter, retrospective cohort study are to analyze the outcomes after stereotactic radiosurgery for unruptured and ruptured pediatric AVMs. METHODS We analyzed and pooled AVM radiosurgery data from 7 participating in the International Gamma Knife Research Foundation...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27911227/radiofrequency-ablation-of-spinal-osteoid-osteoma-a-prospective-study
#10
Joe Faddoul, Yara Faddoul, Sandra Kobaiter-Maarrawi, Ronald Moussa, Tony Rizk, Georges Nohra, Nabil Okais, Elie Samaha, Joseph Maarrawi
OBJECTIVE Surgery has been considered the standard treatment for spinal osteoid osteomas that are refractory to analgesic agents. Radiofrequency ablation (RFA) is a less invasive technique with established efficiency for the treatment of peripheral osteoid osteomas. The main objectives of this study are to evaluate the safety of RFA based on the results of a previous experimental study in rats conducted in the authors' laboratory and to identify its short- and long-term efficiency in the treatment of spinal osteoid osteomas...
December 2, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27911069/-urological-pathology-of-lymphatic-origin
#11
A Domènech, A Serrano, I Forner-Cordero, F Gómez, D Maldonado, C Domínguez
OBJECTIVES: Lymphatic disease is a rarely cause of some very unspecific genitourinary manifestations, assuming a diagnostic challenge in most cases. The aim of this paper is to warn about the possible etiology of these urological lymphatic presentations and discuss its management. METHODS: Retrospective review of clinical data in pediatric patients with urological pathology of lymphatic origin between 2008-2014. Three patients, two boys and a girl, were included...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27911066/-conservative-management-of-liver-trauma-and-its-complications-current-gold-standard
#12
R Gander, J A Molino, S Santiago, A Laín, G Guillén, C Giné, G Royo, S López, M Pérez, I Díez, S Cañadas, J Lloret, J Bueno
INTRODUCTION: The liver is the second most frequently involved organ in abdominal trauma in children. The aim of this study was to review the characteristics of liver traumas (LT) in children, its treatment and complications. MATERIAL AND METHODS: Retrospective study of patients with LT treated between 2010-2014. We analyzed data regarding diagnosis, conservative management (CM), complications and treatment. RESULTS: Twenty-four patients of LT with a mean age of 9...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27910749/role-of-toll-like-receptors-in-hepatitis-c-virus-pathogenesis-and-treatment
#13
Usman Ali Ashfaq, Muhammad Sarfaraz Iqbal, Saba Khaliq
Viral infections are rising every day, and viruses appear to be the most dangerous pathogens in the world. Hepatitis C virus (HCV) is accepted as one of the major destructive factors of promoting severe hepatic disorders by infecting more than 180 million individuals throughout the world. Chronic infection caused by HCV poses a serious global health emergency and appears to be a powerful threat to humanity. Almost 20 years have passed since the disclosure of HCV, but even now, treatment preferences remain limited...
2016: Critical Reviews in Eukaryotic Gene Expression
https://www.readbyqxmd.com/read/27909672/arthroscopic-360%C3%A2-capsular-release-for-adhesive-capsulitis-in-the-lateral-decubitus-position
#14
Gregory L Cvetanovich, Timothy Leroux, Jason T Hamamoto, John D Higgins, Anthony A Romeo, Nikhil N Verma
Idiopathic adhesive capsulitis of the shoulder is a relatively common condition that results in pain and loss of motion due to capsular thickening and fibrosis. Most cases are successfully treated with conservative management including physical therapy and intra-articular steroid injections. If conservative management fails, arthroscopic capsular release allows precise release of thickened capsular tissue with a lower risk of complications and less soft-tissue trauma than manipulation under anesthesia alone...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909631/a-nonoperative-approach-for-neurosurgical-management-of-a-sylvian-fissure-dermoid-cyst
#15
Ali S Haider, Clarence Kee, Danielle L DeBacker, Ian T Watson, Eliel N Arrey, Tijani Osumah, Dean Leonard, Chen Chen, Maryam Alam, L Gerard Toussaint Iii
The nonoperative management of sylvian fissure dermoid/epidermoid cysts presents a risk that is difficult to quantify. With rupture, potentially fatal complications such as chemical meningitis, hydrocephalus, fever, seizure, or meningeal irritation may occur. In this paper, we present an asymptomatic case of such a cyst with imaging evidence of prior rupture, and we review the literature for the likelihood of future complications. We use for illustration a case of a 68-year-old woman with imaging features of a sylvian fissure epithelial inclusion cyst who refused surgical intervention and review the literature for further investigation...
October 24, 2016: Curēus
https://www.readbyqxmd.com/read/27909114/conservative-treatment-of-chronic-subdural-hematoma-in-hiv-associated-thrombocytopenia-with-tranexamic-acid
#16
Raja K Kutty, Anil Kumar Peethambaran, Sunilkumar, M Anilkumar
Chronic subdural hematomas (CSDHs) and its management comprise a majority work in a neurosurgical specialty. The effectiveness of surgery is beyond doubt and sometimes even lifesaving in severe cases. However, the straightforward surgery is sometimes complicated by the associated comorbidities of the patient. Comorbidities in the form of coagulopathies secondary to chronic liver diseases, drugs (warfarin, ecosprin, clopidogrel), thrombocytopenia secondary to systemic illness are always a challenge to deal with in patients with CSDH...
December 1, 2016: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/27908918/alpha-blockers-for-treatment-of-ureteric-stones-systematic-review-and-meta-analysis
#17
John M Hollingsworth, Benjamin K Canales, Mary A M Rogers, Shyam Sukumar, Phyllis Yan, Gretchen M Kuntz, Philipp Dahm
OBJECTIVE:  To investigate the efficacy and safety of alpha blockers in the treatment of patients with ureteric stones. DESIGN:  Systematic review and meta-analysis. DATA SOURCES:  Cochrane Central Register of Controlled Trials, Web of Science, Embase, LILACS, and Medline databases and scientific meeting abstracts to July 2016. REVIEW METHODS:  Randomized controlled trials of alpha blockers compared with placebo or control for treatment of ureteric stones were eligible...
December 1, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27908586/standard-wide-local-excision-or-bilateral-reduction-mammoplasty-in-large-breasted-women-with-small-tumours-surgical-and-patient-reported-outcomes
#18
R Di Micco, R L O'Connell, P A Barry, N Roche, F A MacNeill, J E Rusby
INTRODUCTION: Oncoplastic breast surgery is used to extend the role of breast-conserving surgery (BCS) to women with an unfavourable tumour to breast volume ratio. However, large-breasted women with a relatively small breast cancer may be offered bilateral reduction mammoplasty (BRM) despite being suitable for standard BCS as the more complex surgery may have advantages in terms of patient satisfaction and reduced adverse effects of radiotherapy. PATIENT AND METHODS: This retrospective study evaluated surgical and patient-reported outcome measures (PROMs) in large-breasted women with early (<3 cm) breast cancer, who have undergone unilateral standard BCS or BRM...
November 17, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27908583/should-lower-limb-fractures-be-treated-surgically-in-patients-with-chronic-spinal-injuries-experience-in-a-reference-centre
#19
S Barrera-Ochoa, S Haddad, S Rodríguez-Alabau, J Teixidor, J Tomás, V Molero
OBJECTIVE: To report the outcomes of surgical treatment of lower limb fractures in patients with chronic spinal cord injuries. MATERIAL AND METHOD: A total of 37 lower limb fractures were treated from 2003 to 2010, of which 25 fractures were treated surgically and 12 orthopaedically. RESULTS: Patients of the surgical group had better clinical results, range of motion, bone consolidation, and less pressure ulcers and radiological misalignment...
November 28, 2016: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/27908292/conservatively-treated-congenital-hyperinsulinism-chi-due-to-k-atp-channel-gene-mutations-reducing-severity-over-time
#20
Maria Salomon-Estebanez, Sarah E Flanagan, Sian Ellard, Lindsey Rigby, Louise Bowden, Zainab Mohamed, Jacqueline Nicholson, Mars Skae, Caroline Hall, Ross Craigie, Raja Padidela, Nuala Murphy, Tabitha Randell, Karen E Cosgrove, Mark J Dunne, Indraneel Banerjee
BACKGROUND: Patients with Congenital Hyperinsulinism (CHI) due to mutations in K-ATP channel genes (K-ATP CHI) are increasingly treated by conservative medical therapy without pancreatic surgery. However, the natural history of medically treated K-ATP CHI has not been described; it is unclear if the severity of recessively and dominantly inherited K-ATP CHI reduces over time. We aimed to review variation in severity and outcomes in patients with K-ATP CHI treated by medical therapy. METHODS: Twenty-one consecutively presenting patients with K-ATP CHI with dominantly and recessively inherited mutations in ABCC8/KCNJ11 were selected in a specialised CHI treatment centre to review treatment outcomes...
December 1, 2016: Orphanet Journal of Rare Diseases
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