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https://www.readbyqxmd.com/read/29457869/assessment-of-the-spectrum-of-hepatic-encephalopathy-a-multi-center-study
#1
Bradley Reuter, Kara Walter, Julien Bissonnette, Michael D Leise, Jennifer Lai, Puneeta Tandon, Patrick S Kamath, Scott W Biggins, Christopher F Rose, James B Wade, Jasmohan S Bajaj
Hepatic encephalopathy (HE) is a major cause of morbidity in cirrhosis. However its severity assessment is often subjective, which needs to be studied systematically. AIM: To determine how accurately trainee and non-trainee practitioners grade and manage HE patients throughout its severity. METHODS: We performed a survey study using standardized simulated patient videos at 4 US and 3 Canadian centers. Participants were trainees (gastroenterology/hepatology fellows) and non-trainees (faculty, nurse practitioners, physician assistants)...
February 19, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29457520/caregiver-reactions-to-aggressive-behaviors-in-persons-with-dementia-in-a-diverse-community-dwelling-sample
#2
Bryan R Hansen, Nancy A Hodgson, Chakra Budhathoki, Laura N Gitlin
PURPOSE: To describe caregiver challenges with and confidence managing three aggressive behavior types in persons with dementia: verbal aggression, destroying property, and threatening to hurt others. DESIGN AND METHOD: Secondary analysis of baseline data from the 2001-2004 Resources for Enhancing Alzheimer's Caregiver Health II (REACH II) initiative. RESULTS: One or more aggressive behaviors within 1 week were reported by more than a third of caregivers, with most expressing upset but fewer expressing confidence managing the behaviors...
February 1, 2018: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/29456881/multimodality-treatment-of-advanced-non-small-cell-lung-cancer-where-are-we-with-the-evidence
#3
REVIEW
Christopher M Jones, Alessandro Brunelli, Matthew E Callister, Kevin N Franks
Purpose of review: The majority of patients with non-small cell lung cancer (NSCLC) present with advanced disease and overall survival rates are poor. This article outlines the current and outstanding evidence for the use of multimodality treatment in this group of patients, including in combination with an increasing number of treatment options, such as immunotherapy and genotype-targeted small molecule inhibitors. Recent findings: Optimal therapy for surgically resectable stage III disease remains debatable and currently the choice of treatment reflects each individual patient's disease characteristics and the expertise and opinion of the thoracic multi-disciplinary team...
2018: Current Surgery Reports
https://www.readbyqxmd.com/read/29454568/the-phenotypic-heterogeneity-of-hereditary-diffuse-gastric-cancer-the-report-of-one-family-with-early-onset-disease
#4
Irene Gullo, Vitor Devezas, Manuela Baptista, Luzia Garrido, Sérgio Castedo, Rui Morais, Xiaogang Wen, Elisabete Rios, Jorge Pinheiro, Inȇs Pinto-Ribeiro, Rui M Ferreira, John Preto, João Santos-Antunes, Margarida Marques, Miquel Campos, Filipe Almeida, Maria do Céu Espinheira, Jorge Amil Dias, Céu Figueiredo, Carla Oliveira, Eunice Trindade, Fátima Carneiro
BACKGROUND AND AIMS: The time-course for the development of clinically significant hereditary diffuse gastric cancer (HDGC) is unpredictable. Little is known about the progression from pre-clinical, indolent lesions to widely invasive, aggressive phenotypes. Gastro-endoscopy often fails to detect early lesions and risk-reducing/prophylactic total gastrectomy (PTG) is the only curative approach. We present a HDGC family with early-onset disease, in which clinical and histological findings provided insight into the understanding of different HDGC phenotypes...
February 15, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29454048/new-insights-into-the-molecular-characteristics-of-pulmonary-carcinoids-and-large-cell-neuroendocrine-carcinomas-and-the-impact-on-their-clinical-management
#5
REVIEW
J L Derks, N Leblay, S Lantuejoul, A M Dingemans, E J M Speel, L Fernandez-Cuesta
Carcinoids and large-cell neuroendocrine carcinomas (LCNEC) are rare neuroendocrine lung tumors. Here we provide an overview of the most updated data on the molecular characteristics of these diseases. Recent genomic studies showed that carcinoids generally contain a low mutational burden and few recurrently mutated genes. Most of the reported mutations occur in chromatin-remodeling genes (e.g. MEN1), and few affect genes of the PI3K-AKT-mTOR pathway. Aggressive disease has been related to chromothripsis, DNA-repair gene mutations, loss of OTP/CD44, and upregulation of RET gene expression...
February 14, 2018: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/29452744/emerging-concepts-in-diagnosis-and-treatment-of-syncope-by-pacing
#6
REVIEW
Richard Sutton, Jean-Claude Deharo, Michele Brignole, Mohamed H Hamdan
Neuroendocrine syncope is a newly proposed term to embody both syncope of reflex and adenosine-related etiology. Recent publications on tilt testing have revealed the presence of a hypotensive tendency in some patients, even in the face of severe cardioinhibition. This new understanding may allow better selection of older reflex syncope patients, documented by ECG loop recorder, for successful pacing where tilt testing is ideally negative for a good result in terms of few syncope recurrences and prompts a less aggressive management policy when hypotensive medication is required...
February 13, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29452666/transformation-of-follicular-lymphoma-why-does-it-happen-and-can-it-be-prevented
#7
REVIEW
Brian K Link
Follicular lymphoma is a clinical disease with a multitude of presentations and behaviors. Although infrequent, transformation of follicular lymphoma to a more aggressive behaving subtype - prototypically diffuse large B-cell lymphoma - confers a substantially adverse prognosis. There is no consensus for optimal management after transformation is recognized. Historically considered a distinct clinical event, this review highlights the multiple subclinical transformational events that either variably or cumulatively result in clinical recognition of transformed follicular lymphoma...
March 2018: Best Practice & Research. Clinical Haematology
https://www.readbyqxmd.com/read/29449896/myxofibrosarcoma-primary-cultures-molecular-and-pharmacological-profile
#8
Alessandro De Vita, Federica Recine, Laura Mercatali, Giacomo Miserocchi, Chiara Liverani, Chiara Spadazzi, Roberto Casadei, Alberto Bongiovanni, Federica Pieri, Nada Riva, Dino Amadori, Toni Ibrahim
Background: Myxofibrosarcoma (MFS), formerly considered as a myxoid variant of malignant fibrous histiocytoma, is the most common sarcoma of the extremities in adults and is characterized by a high frequency of local recurrence. The clinical behavior of MFS is unpredictable and the efficacy of chemotherapy is still not well documented. Furthermore, given the relatively recent recognition of MFS as a distinct pathologic entity its cellular and molecular biology has still not been extensively studied in patient-derived preclinical models...
December 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/29448863/mental-health-literacy-sub-clinical-personality-disorders-and-job-fit
#9
Adrian Furnham, Kelly Petropoulou
BACKGROUND: This study looked at lay theories of how people with sub-clinical personality disorders experience the world of work. AIMS: The aim was to investigate the paradox that subclinical and clinical personality disorders are seen as beneficial for success, rather than a handicap in certain jobs. METHODS: In all, 230 participants read 14 vignettes derived from Oldham and Morris's book describing DSMIII personality disorders for a popular audience...
February 15, 2018: Journal of Mental Health
https://www.readbyqxmd.com/read/29447639/a-patient-case-highlighting-the-myriad-of-cutaneous-adverse-effects-of-prolonged-use-of-hydroxyurea
#10
Brett Neill, Ted Ryser, John Neill, Daniel Aires, Anand Rajpara
BACKGROUND: Hydroxyurea is an antimetabolite primarily used to treat myeloproliferative disorders, and chronic treatment is associated with many cutaneous adverse effects ranging in severity from ichthyosis to aggressive nonmelanoma skin cancer. CASE PRESENTATION: We report a 67-year-oldman with a history of polycythemia vera who was referred for management of progressively worsening dorsal hand lesions. The patient presented withhyperpigmentation, ichthyosis, plantar keratoderma, dermatomyositis-like eruptions, two squamous cell carcinomas, and actinic keratoses...
November 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29446553/children-s-moral-experiences-of-crisis-management-in-a-child-mental-health-setting
#11
Marjorie Montreuil, Catherine Thibeault, Linda McHarg, Franco A Carnevale
The experiences of children related to conflict and crisis management in child mental health settings, especially those aged 12 and below, have been rarely studied. This study examined the moral experiences of children related to conflict and crisis management and the related use of restraint and seclusion in a child mental health setting. A 5-month focused ethnography using a participatory hermeneutic framework was conducted in a day hospital programme for children with severe disruptive disorders within a mental health institute...
February 15, 2018: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/29444895/optimizing-hybrid-closed-loop-therapy-in-adolescents-and-emerging-adults-using-the-minimed-670g-system
#12
Laurel H Messer, Gregory P Forlenza, Jennifer L Sherr, R Paul Wadwa, Bruce A Buckingham, Stuart A Weinzimer, David M Maahs, Robert H Slover
OBJECTIVE: The MiniMed 670G System is the first commercial hybrid closed-loop (HCL) system for management of type 1 diabetes. Using data from adolescent and young adult participants, we compared insulin delivery patterns and time-in-range metrics in HCL (Auto Mode) and open-loop (OL). System alerts, usage profiles, and operational parameters were examined to provide suggestions for optimal clinical use of the system. RESEARCH DESIGN AND METHODS: Data from 31 adolescent and young adult participants (14-26 years old) at three clinical sites in the 670G pivotal trial were analyzed...
February 14, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29444789/giant-cell-tumour-of-the-patella-with-local-recurrence-successful-management-with-excision-curettage-and-artificial-bone-grafting
#13
Timothy Mark Morris, Zakareya Gamie, Kanishka Milton Ghosh, Kenneth Samora Rankin
Primary patellar neoplasms are rare, comprising 0.12% of primary bone tumours; thus, no standardised treatment related to staging exists. 70%-90% of primary patellar neoplasms are benign or intermediate with giant cell tumour (GCT) being the most common. GCTs are locally aggressive, have a high recurrence rate and metastasise in 1%-2%. We report the case of a 23-year-old man with histologically confirmed recurrent GCT of the patella to demonstrate that aggressive surgical management options described in the literature, such as patellectomy with or without complex reconstruction, may be excessive and cause patients undue morbidity...
February 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29441165/propylthiouracil-induced-anca-negative-cutaneous-small-vessel-vasculitis
#14
Aliaksandr Trusau, Michael L Brit
Propylthiouracil (PTU) is a commonly used medication for the treatment of hyperthyroidism. PTU is known to cause different adverse reactions including autoimmune syndromes. PTU-induced autoimmune syndromes can be classified into drug-induced lupus or drug-induced vasculitis. Differential diagnoses could be very challenging. PTU-induced vasculitis is more common than PTU-induced lupus, and has a higher risk of morbidity and mortality. Usually it is limited to the skin in a form of cutaneous leukocytoclastic vasculitis, but may also affect organs including kidneys and lungs...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29440828/clinical-presentation-management-and-postnatal-outcomes-of-fetal-tachyarrhythmias-a-10-year-single-center-experience
#15
Balaganesh Karmegeraj, Sushmita Namdeo, Abish Sudhakar, Vivek Krishnan, Radhamany Kunjukutty, Balu Vaidyanathan
Background: Limited information is available regarding the prevalence and outcomes of fetal tachyarrhythmias from the developing countries. Aims: This study aims to report referral patterns, management protocols, and pregnancy outcomes of fetuses with tachyarrhythmias reporting to a single center in South India. Methods: All fetuses with documented sustained fetal tachyarrhythmia during the study period (2008-2017) were included. Arrhythmia characterization and hemodynamic evaluation were done using fetal echocardiography...
January 2018: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/29439906/dermoid-cysts-of-the-conus-medullaris-clinical-review-case-series-and-management-strategies
#16
Salah G Aoun, Mary Ashley Liu, Megan Still, Tarek Y El Ahmadieh, Mazin Al Tamimi, Wayne Gluf
BACKGROUND: The management of dermoid cysts can be tedious as they have a tendency to recur, and respond poorly to chemotherapy and radiation. Management is especially difficult for tumors involving highly eloquent areas such as the conus medullaris. OBJECTIVE: We aim to provide a summary of the pathology, clinical presentation, and operative management strategies of dermoid cysts involving the conus medullaris. METHODS: Two clinical cases of dermoid cysts of the conus are presented, as well as a commented surgical video...
February 10, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29439334/what-do-we-know-about-behavioral-crises-in-dementia-a-systematic-review
#17
Tamara Backhouse, Julieta Camino, Eneida Mioshi
BACKGROUND: Behavioral crises in dementia are represented by a wide variety of symptoms, regularly require external intervention from professionals, and are reported as a risk factor for hospital admission. Little is known about the factors that are associated with them. OBJECTIVE: To determine the factors associated with dementia-related behavioral crises. METHODS: We searched MEDLINE, CINAHL, PsycINFO, EMBASE, and AMED databases. An additional lateral search including reference lists was conducted...
2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29439058/autoimmune-necrotising-myopathy-and-hmgcr-antibodies
#18
Kushan Karunaratne, Dimitri Amiras, Matthew C Pickering, Monika Hofer, Stuart Viegas
Statins lower serum cholesterol concentrations by inhibiting the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR). Muscle side effects are relatively common and include asymptomatic elevation of serum creatine kinase (CK), myalgia, proximal muscle weakness and rhabdomyolysis. More recently, a subset of cases of immune-mediated necrotising myopathy has been found to have antibodies against HMGCR. It is often an aggressive and debilitating myopathy and has a complex pathogenesis characterised by fibre necrosis, usually with minimal associated inflammation...
February 8, 2018: Practical Neurology
https://www.readbyqxmd.com/read/29438815/new-onset-squamous-cell-carcinoma-in-previous-split-thickness-skin-graft-donor-site
#19
Vincent J Noori, Kanika Trehan, Alisa Savetamal, Damien W Carter
INTRODUCTION: Marjolin' s ulcer, an aggressive ulcerating squamous cell carcinoma, is a well-known phenomenon that occurs in chronically inflamed or scarred tissue; however, squamous cell carcinoma arising in the acute setting after tissue trauma - specifically autograft donor harvest sites for burns - is a rare, but notable event. METHODS: This case series describes three instances of squamous cell carcinoma diagnosed in split-thickness skin graft donor sites in the immediate post-operative period...
February 10, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29438791/necessity-of-repeat-ct-imaging-in-isolated-mild-traumatic-subarachnoid-hemorrhage
#20
Ashwath Kumar, Anthony Alvarado, Kushal Shah, Paul M Arnold
BACKGROUND: The standard of care for isolated mild traumatic subarachnoid hemorrhage (itSAH) involves serial head CT examinations at dedicated time-intervals to monitor neurologic status and hemorrhagic progression. Considering recent evidence questioning such an aggressive monitoring protocol, this study aimed to assess the necessity of repeat head CT imaging in managing itSAH. METHODS: All patients who presented to our academic institution with mild traumatic brain injury were evaluated...
February 10, 2018: World Neurosurgery
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