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Matthew J Klebanoff, Jagpreet Chhatwal, Jacob D Nudel, Kathleen E Corey, Lee M Kaplan, Chin Hur
Importance: Severe obesity affects 4% to 6% of US youth and is increasing in prevalence. Bariatric surgery for the treatment of adolescents with severe obesity is becoming more common, but data on cost-effectiveness are limited. Objective: To assess the cost-effectiveness of bariatric surgery for adolescents with obesity using recently published results from the Teen-Longitudinal Assessment of Bariatric Surgery study. Design, Setting, and Patients: A state-transition model was constructed to compare 2 strategies: no surgery and bariatric surgery...
October 26, 2016: JAMA Surgery
Cecilia G Ethun, Lauren M Postlewait, Nina Le, Timothy M Pawlik, Stefan Buettner, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Linda X Jin, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, David A Kooby, Shishir K Maithel
Importance: The current recommendation is to perform re-resection for select patients with incidentally discovered gallbladder cancer. The optimal time interval for re-resection for both patient selection and long-term survival is not known. Objective: To assess the association of time interval from the initial cholecystectomy to reoperation with overall survival. Design, Setting, and Participants: This cohort study was conducted from January 1, 2000, to December 31, 2014 at 10 US academic institutions...
October 26, 2016: JAMA Surgery
Helen L MacLaughlin, Iain C Macdougall, Wendy L Hall, Tracy Dew, Konstantinos Mantzoukis, Jude A Oben
BACKGROUND: The outcomes of intragastric balloon (IGB) placement to achieve weight loss in obese patients with chronic kidney disease (CKD) have not been reported to date. This study aimed to assess the safety and efficacy of the IGB as a weight-loss treatment among this patient population. METHODS: A prospective, single-arm, 'first in CKD' interventional study was conducted in patients with a body mass index >35 kg/m2 and CKD stages 3-4, referred for weight loss...
October 27, 2016: American Journal of Nephrology
Savino Occhionorelli, Lucia Morganti, Lorenzo Cappellari, Rocco Stano, Dario Andreotti, Giorgio Vasquez
INTRODUCTION: Arterial pseudoaneurysm is a rare and life-threatening complication of pancreatitis, seen more often in chronic than in acute pancreatitis. It involves mostly the splenic artery, while only in 10% of the case it appears in pancreaticoduodenal and gastric artery. This case report described an asymptomatic pseudoaneurysm of the posterior superior pancreaticoduodenal artery and of the right gastric artery, which occurred after 13days from the episode of acute pancreatitis and, then it was treated with vascular angioembolization...
October 18, 2016: International Journal of Surgery Case Reports
Mukovhe Chad Phanguphangu
OBJECTIVE: To determine the prevalence of outer and middle ear pathologies in paediatrics in Limpopo, South Africa. DESIGN: Cross-sectional retrospective review of otoscopy results obtained during a school health screening campaign conducted between March and June 2015. Descriptive statistics through percentages and frequency tables were used to analyse the data. Logistic regression was used to determine associations between age, gender and pathologies observed...
October 26, 2016: International Journal of Audiology
Kwangwoo Nam, Jun-Ho Choi
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas runs along a large spectrum from benign adenoma to invasive carcinoma.(1) Fistulas between the pancreas and adjacent organs, such as the duodenum, bile duct, and stomach, have been reported,(2-4) but benign pancreaticogastric fistulas have rarely been reported.(5) Herein, we report a patient who was diagnosed with main duct type pancreatic IPMN complicated with spontaneous pancreaticogastric fistula formation. This article is protected by copyright...
October 26, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Alexander P Decilveo, Bartlomiej W Szczech, Jacob Topfer, James C Wittig
Expandable endoprostheses have become an acceptable modality to address the issue of limb-length inequality in limb-sparing procedures for skeletally immature patients afflicted with lower extremity bone sarcomas. This study retrospectively analyzed postoperative outcomes and complications for 7 patients (8 limbs) who underwent minimally invasive or noninvasive reconstruction during a 12-year period. Musculoskeletal Tumor Society (MSTS) scores and complication rates were reported. Mean functional outcome (MSTS scores) at final follow-up was 93...
October 25, 2016: Orthopedics
Hui-Kuang Huang, Jung-Pan Wang, Chin-Jung Lin, Yi-Chao Huang, Tung-Fu Huang, Ming-Chau Chang
Good outcomes have been reported after both open and percutaneous surgery to release trigger thumb. This study evaluated short-term and long-term outcomes after treatment of trigger thumb with open or percutaneous release. A total of 126 trigger thumbs in 107 patients were reviewed from 2009 to 2012. Short-term (3 months) and long-term results (2 years) and complications of open release (58 digits) and percutaneous release (68 digits) were recorded and compared. Short-term complications included pain occurring in 9 digits (15...
October 25, 2016: Orthopedics
Nicholas B Frisch, Andrew M Pepper, Edward Rooney, Craig Silverton
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common and successful orthopedic procedures, and as their frequency continues to increase substantially, the focus on limiting perioperative complications heightens. Intraoperative normothermia is recommended to minimize additional complications, but limited evidence exists regarding the effect of hypothermia on orthopedic patients. The purpose of this retrospective study was to determine the incidence of perioperative hypothermia in the setting of TKA and THA, and to evaluate its impact on complications and outcomes...
October 25, 2016: Orthopedics
Chieko Kadoma, Masatoshi Takahara, Masahiro Maruyama, Hiroshi Satake, Michiaki Takagi
Rupture of the flexor pollicis longus tendon is a major complication after volar locking plate fixation of distal radius fracture. This study used ultrasonography to assess the flexor pollicis longus tendon and intermediate tissue. The study assessed 27 patients (28 wrists) who underwent removal of the volar locking plate. Before plate removal, radiography and ultrasonography were performed to assess the relation between the flexor pollicis longus tendon and the volar locking plate. Intraoperatively, the authors evaluated the intermediate tissues between the flexor pollicis longus tendon and the distal volar margin of the plate...
October 25, 2016: Orthopedics
Shoji Nishio, Shigeo Fukunishi, Shinichi Yoshiya, David C Sing, Erik N Hansen, Thomas P Vail
The aim of this study was to examine the clinical characteristics of patients who required revision and the rate of early complications after revision for metal-on-metal total hip arthroplasty (MOM THA) and metal-on-polyethylene total hip arthroplasty (MOP THA). Matched cohorts were selected by retrospective review from a single-center database of revision THAs for failed MOM and MOP THAs from 2010 to 2014. A total of 140 hips in 140 patients comprised the study population; 39 revisions were performed for failed MOM THAs (MOM group), and 101 revisions were performed for failed MOP THAs (MOP group)...
October 25, 2016: Orthopedics
Ryan A Durfee, Scott A Sabo, G Douglas Letson, Odion Binitie, David Cheong
Metastatic lesions of the acetabulum can be painful and debilitating. First-line treatment is multimodal and consists of disease-specific chemotherapy, osteoclastic inhibitors, analgesics, and radiation therapy. When these therapies fail, surgical intervention usually is indicated and varies from regional defect stabilization to large periacetabular reconstructions that are demanding procedures with high rates of complications. Percutaneous cement augmentation (acetabuloplasty) of lesions in selected patients has been explored as a less invasive method of lesional control...
October 25, 2016: Orthopedics
Solimar Figueroa, Julie Gardner, Jose Irizarry, Tanya Cohn
BACKGROUND: The transition to practice for new graduate nurses poses distinct challenges at the point of care. The complicated work environment necessitates a preceptorship model that maintains safety at all times. METHOD: This study used survey, focus groups, and interviews to assess the effects of the married state preceptorship model (MSPM) on the experiences and perceptions of the new nurses and preceptors in a hospital setting. RESULTS: The result validated the original findings from the new nurses' survey, indicating all (N = 28, 100%) of the new nurses found the MSPM to be beneficial, promote safety, and lessen anxiety, and 27 (96%) thought it helped them to assume a full patient load...
November 1, 2016: Journal of Continuing Education in Nursing
Maysa Ferreira Martins Ribeiro, Luc Vandenberghe, Cejane Oliveira Martins Prudente, Vanessa da Silva Carvalho Vila, Celmo Celeno Porto
The aim of the study was to comprehend how the age group and the severity of the motor impairment of children with cerebral palsy modify the mothers' experiences of stress and to understand the coping strategies they use. A qualitative approach was used, with the method framed on Grounded Theory Analysis. Nineteen mothers of children and adolescents with different degrees of motor impairment participated in individual semi-structured interviews. A lack of support and increased time and effort invested in parenting, at the cost of other areas of life threaten participants' physical and emotional health...
October 2016: Ciência & Saúde Coletiva
Jin Qi, Peng Zhang, Yanan Wang, Hao Chen, Yumin Li
BACKGROUND/AIMS: Total gastrectomy (TG) has shown to be superior regarding low risk of recurrence and readmission to distal subtotal gastrectomy (DG) for treatment of distal stomach cancer, but the incidence of postoperative morbidity and mortality in TG cannot be ignored. Therefore, we performed a meta-analysis to compare the effectiveness between TG and DG for distal stomach cancer. METHODOLOGY: A search in PubMed, EMBASE, the Cochrane Library, Web of Science, Chinese Biomedical Database through January 2016 was performed...
2016: PloS One
Andrew D Haddow, Farooq Nasar, Hilda Guzman, Alongkot Ponlawat, Richard G Jarman, Robert B Tesh, Scott C Weaver
BACKGROUND: Zika virus (ZIKV) has extended its known geographic distribution to the New World and is now responsible for severe clinical complications in a subset of patients. While substantial genetic and vector susceptibility data exist for ZIKV, less is known for the closest related flavivirus, Spondweni virus (SPONV). Both ZIKV and SPONV have been known to circulate in Africa since the mid-1900s, but neither has been genetically characterized by gene and compared in parallel. Furthermore, the susceptibility of peridomestic mosquito species incriminated or suspected in the transmission of ZIKV to SPONV was unknown...
October 2016: PLoS Neglected Tropical Diseases
Eva Wiberg-Itzel, Andrea B Pembe, Hans Järnbert-Pettersson, Margareta Norman, Anna-Carin Wihlbäck, Irene Hoesli, Monya Todesco Bernasconi, Elie Azria, Helena Åkerud, Elisabet Darj
BACKGROUND: One of the major complications related to delivery is labor dystocia, or an arrested labor progress. Many dystocic deliveries end vaginally after administration of oxytocin, but a large numbers of women with labor dystocia will undergo a long and unsafe parturition. As a result of the exertion required in labor, the uterus produces lactate. The uterine production of lactate is mirrored by the level of lactate in amniotic fluid (AFL). OBJECTIVES: To evaluate whether the level of AFL, analysed in a sample of amniotic fluid collected vaginally at arrested labor when oxytocin was needed, could predict labor outcome in nulliparous deliveries...
2016: PloS One
Patrizia Belfiore, Davide Di Palma, Francesca Gallé, Valeria Di Onofrio, Alessandro Scaletti, Giorgio Liguori
Type II diabetes has a high prevalence rate worldwide, especially in industrialized countries. By requiring increasing health expenditures and resources, the disease and its complications generate a considerable economic burden. Since many years several institutions promote awareness and information programs regarding the most effective strategies to prevent and control diabetes. By reducing the severity of the disease and its complications, Adapted Exercise therapy (AE) represents an ideal instrument to remodulate the Therapeutic Healthcare Management Protocol (THMP) of patients with type II diabetes and may be defined as a new health technology...
July 2016: Igiene e Sanità Pubblica
Samuel Stolpe, Michel A Kroes, Neil Webb, Tami Wisniewski
BACKGROUND: Diabetes care is associated with a considerable burden to the health care system in the United States, and measuring the quality of health care is an important development goal of the Department of Health and Human Services and the Centers for Medicare & Medicaid Services. Diabetes is a priority disease within the National Quality Strategy and should therefore remain a focus in the measurement of health care quality. Despite the importance of measuring quality in diabetes care management, no quality measure is currently associated with adherence to insulin treatment, and measuring adherence to insulin is known to be complicated...
November 2016: Journal of Managed Care & Specialty Pharmacy
Yongmin Zhang, Shuang Guo, Wentao Wu, Zhirong Qin, Xuefeng Liu
Herein, we describe a strategy of fabricating CO2-triggered oil-in-water Pickering emulsion based on silica nanoparticles func-tionalized in situ by a trace amount of conventional CO2-switchable surfactant, N-(3-(dimethylamino)propyl)alkyl amide (CnPMA). By alternately bubbling CO2 and N2 at a moderate conditions (30 oC, 80 mL·min-1), silica nanoparticles reversibly switch between amphipathic and hydrophilic as a result of the adsorption of ammonium (CO2) and the desorption of ter-tiary amine (N2). The emulsion can then be smart switched "on (stable)" and "off (unstable)," along with homogenization, without needing cooling and heating...
October 26, 2016: Langmuir: the ACS Journal of Surfaces and Colloids
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