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Alexander D Jobrack, Suman Goel, Alvin M Cotlar
Introduction: Granular cell tumors (GCTs) are of neuroectodermal origin and account for 0.5% of soft tissue tumors. They are most prevalent in African-Americans in the fourth to sixth decades, with a predilection for the head and neck regions. GCTs usually resemble more common lesions and hence are difficult to diagnose preoperatively. The tumor is readily identified on needle biopsy. Although usually benign with a malignancy rate of only 2-3%, the malignant form has a reported 3-yr mortality of 60%...
March 14, 2018: Military Medicine
Tristan Pascart, Frédéric Lioté
This review article summarizes the relevant English literature on gout from 2010 through April 2017. It emphasizes that the current epidemiology of gout indicates a rising prevalence worldwide, not only in Western countries but also in Southeast Asia, in close relationship with the obesity and metabolic syndrome epidemics. New pathogenic mechanisms of chronic hyperuricaemia focus on the gut (microbiota, ABCG2 expression) after the kidney. Cardiovascular and renal comorbidities are the key points to consider in terms of management...
March 13, 2018: Rheumatology
Enrico Gugliandolo, Roberta Fusco, Giovanna Ginestra, Ramona D'amico, Carlo Bisignano, Giuseppina Mandalari, Salvatore Cuzzocrea, Rosanna Di Paola
BACKGROUND: Colonization with Pseudomonas aeruginosa (PA), the most common pathogen isolated mainly in patients with cystic fibrosis, is particularly difficult to eradicate and is associated with acceleration of decline in lung function and with poorer prognosis. PA LPS is recognized by toll like receptors 4 (TLR4) and has been shown to induce lung inflammation in vivo. In addition, regulation of this process is essential for proper pathogen clearance and to prevent excessive inflammatory response resulting in tissue damage...
March 15, 2018: Shock
Kerim Sariyilmaz, Ilker Eren, Okan Ozkunt, Mustafa Sungur, Onder I Kilicoglu, Fatih Dikici
BACKGROUND: Gout is a purine metabolism disease. Tophaceous gout may cause joint destruction and other systemic problems and sometimes may be complicated by infection. Infection and sinus with discharge associated with tophaceous gout are serious complications, and treatment is difficult. We present a patient with tophaceous gout complicated by infection and discharging sinus treated by bilateral amputation at the level of the first metatarsus. METHODS: A 43-year-old man previously diagnosed as having gout, and noncompliant with treatment, presented with tophaceous gout associated with discharging sinus and infection on his left first metatarsophalangeal joint...
January 2018: Journal of the American Podiatric Medical Association
Antony T Vincent, Steve J Charette, Jean Barbeau
The Gram-negative bacterium Pseudomonas aeruginosa is found in several habitats, both natural and human-made, and is particularly known for its recurrent presence as a pathogen in the lungs of patients suffering from cystic fibrosis, a genetic disease. Given its clinical importance, several major studies have investigated the genomic adaptation of P. aeruginosa in lungs and its transition as acute infections become chronic. However, our knowledge about the diversity and adaptation of the P. aeruginosa genome to non-clinical environments is still fragmentary, in part due to the lack of accurate reference genomes of strains from the numerous environments colonized by the bacterium...
March 16, 2018: Genome Génome / Conseil National de Recherches Canada
Giancarlo Giupponi, Gloria Giordano, Ignazio Maniscalco, Denise Erbuto, Isabella Berardelli, Andreas Conca, David Lester, Paolo Girardi, Maurizio Pompili
BACKGROUND: ADHD (Attention-deficit/hyperactivity disorder) is a common neurodevelopmental disorder that manifests itself during childhood with various combinations of symptoms, including inattention, hyperactivity and impulsivity. Research has shown that psychiatric comorbidities play an important role in the development of suicidal behavior and, recently, there has been a growing interest in a possible association between ADHD and suicide during both childhood and adulthood. Furthermore, some authors have shown a relationship between pharmacological treatments and suicide in patients affected by ADHD...
March 2018: Psychiatria Danubina
Nora Stünkel-Grees, Jens Clausen, Alexander Wünsch
Outpatient Psychotherapy for Children and Adolescents with Intellectual Disability The psychiatric morbidity risk for people with intellectual disability is considerably increased. Psychotherapy is considered as one possible treatment. Among experts the caresituation is described as substantial insufficient. This study investigated the perspective of psychotherapists for children and adolescents in the German state North Rhine-Westphalia regarding the care situation of outpatient psychotherapy for children and adolescents with intellectual disability...
March 2018: Praxis der Kinderpsychologie und Kinderpsychiatrie
Stefanie J Schmidt, Ayla Behar, Frauke Schultze-Lutter
Asperger Syndrome and/or Clinical High Risk of Psychosis? A Differential Diagnostic Challenge This case-study deals with the often difficult differential diagnosis of Asperger syndrome and a clinical high risk state of psychosis, in particular as indicated by attenuated psychotic symptoms, as well as with its therapeutic implications. The presented case is a 10-year old girl, who has not been diagnosed with an autism spectrum disorder before being referred to a specialized center for early detection of psychosis due to possible hallucinatory experiences and delusional ideas...
March 2018: Praxis der Kinderpsychologie und Kinderpsychiatrie
Alexandros Mallios, William Jennings, Benoit Boura, Alessandro Costanzo, Myriam Combes
Skin necrosis overlying an arteriovenous fistula at the cannulation site is a common and potentially life-threatening problem, often associated with underlying aneurysm formation. Arteriovenous fistula-skin necrosis generally requires resection of surrounding skin margins and the underlying aneurysmal vessel wall, allowing repair with healthy tissue of the arteriovenous fistula in addition to closure of soft tissue and skin. In patients with insufficient fistula length, salvage of these arteriovenous fistulas may result in difficult or insurmountable cannulation issues leading to attempts at one-needle cannulation dialysis or, most often, catheter placement...
March 1, 2018: Journal of Vascular Access
L B Amsden, P T Davidson, H B Fevrier, R Goldfien, L J Herrinton
Purpose To better understand diagnostic delay and doctor-patient communication during the diagnosis of systemic lupus erythematous in patients without malar rash, we conducted a qualitative study of primary care providers' perceptions. Methods We conducted in-depth interviews with a purposive sample of eight primary care physicians in Kaiser Permanente Northern California. Telephone interviews were recorded, transcribed, reviewed, and coded for domains and themes. Results We identified five domains related to diagnosis: initial assessment and tests, initial diagnosis and empiric treatment, timeliness of diagnosis, communicating with the patient, and opportunities for improvement...
January 1, 2018: Lupus
Cristina Aurigemma, Francesco Burzotta, Giulio Russo, Leonardo Previ, Carlo Trani
The Completeness of Revascularization in patients with multivessel coronary artery disease (CAD) remains an unanswered question. Despite 20 years of investigation there are still major doubts in this topic, reaching as far as to the lack of a standardized definition. The employment of different definition and the multiplicity of confounding variables that in general favor patients who receive a complete revascularization (CR) are the reason of difficult comparisons between studies. The complexity of coronary anatomy diseases and the clinical features play important role in the revascularization strategy...
March 15, 2018: Minerva Cardioangiologica
Ben Lertsakdadet, Bruce Y Yang, Cody E Dunn, Adrien Ponticorvo, Christian Crouzet, Nicole Bernal, Anthony J Durkin, Bernard Choi
Laser speckle imaging (LSI) is a wide-field optical technique that enables superficial blood flow quantification. LSI is normally performed in a mounted configuration to decrease the likelihood of motion artifact. However, mounted LSI systems are cumbersome and difficult to transport quickly in a clinical setting for which portability is essential in providing bedside patient care. To address this issue, we created a handheld LSI device using scientific grade components. To account for motion artifact of the LSI device used in a handheld setup, we incorporated a fiducial marker (FM) into our imaging protocol and determined the difference between highest and lowest speckle contrast values for the FM within each data set (Kbest and Kworst)...
March 2018: Journal of Biomedical Optics
E Duchalais, N Machairas, S R Kelley, R G Landmann, A Merchea, D T Colibaseanu, K L Mathis, E J Dozois, D W Larson
BACKGROUND: Several studies have shown a correlation between longer operative times and higher rates of postoperative morbidity for open and laparoscopic surgery for rectal cancer. The aim of the study was to determine the impact of prolonged operative time on early postoperative morbidity in patients undergoing robotic-assisted rectal cancer resection. METHODS: The study was a retrospective review of a prospectively maintained database conducted in two centers of the same institution...
March 15, 2018: Surgical Endoscopy
Adel Abdel-Moneim, Alaa Aboud, Mohamed Abdel-Gabbar, Mohamed Zanaty, Mohamed Ramadan
BACKGROUND: The current standard of care for patients with chronic hepatitis C virus (HCV) infection is a combination of direct-acting antiviral agents (DAAs). However, rare clinical trials have been reported on the combination regimen of sofosbuvir (SOF) with ombitasvir, paritaprevir, and ritonavir (OBV/PTV/r) plus ribavirin (RBV) for treated patients with HCV genotype 4 (GT4) infection. AIMS: To clarify the retreatment efficacy and safety of the recent regimen, SOF with OBV/PTV/r + RBV, for chronic HCV GT4-experienced patients who failed treatment with DAA-based regimens...
March 15, 2018: Digestive Diseases and Sciences
Mаhmoud Youns, Abeer ElKhoely, Rehab Kamel
Pancreatic cancer, the fourth most common cause of cancer-related deaths, is one of the most aggressive and devastating human malignancies with increasing incidence worldwide. To date, surgical resection is the only potentially curative therapy available for pancreatic cancer patients. Early diagnosis of pancreatic tumors is difficult, and hence, nearly 80% of patients cannot receive surgical resection. Natural products have always been a vital source for novel compounds for cancer treatment. The naturally occurring prenylated xanthone, gambogic acid, has been previously shown to exert potent anticancer, anti-inflammatory, apoptotic, antiangiogenic, and antioxidant activities...
March 15, 2018: Naunyn-Schmiedeberg's Archives of Pharmacology
Li Zhang, Jiasheng Chen, Chunming Gao, Chuanmiao Liu, Kuihua Xu
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide. The early diagnosis of HCC is greatly helpful to achieve long-term disease-free survival. However, HCC is usually difficult to be diagnosed at an early stage. The aim of this study was to create the prediction model to diagnose HCC based on gene expression programming (GEP). GEP is an evolutionary algorithm and a domain-independent problem-solving technique. Clinical data show that six serum biomarkers, including gamma-glutamyl transferase, C-reaction protein, carcinoembryonic antigen, alpha-fetoprotein, carbohydrate antigen 153, and carbohydrate antigen 199, are related to HCC characteristics...
March 16, 2018: Medical & Biological Engineering & Computing
Fatimah Alnafisah, Shaimaa K Dawa, Sherif Alalfy
Cutaneous endometriosis is one of the rare gynecological conditions. Endometriosis is defined as the presence of endometrial glands and stroma outside the endometrial cavity. It commonly occurs in pelvic sites, such as the ovaries, cul-de-sac, bowel, or pelvic peritoneum. Endometriosis at the incisional scar is difficult to diagnose because of nonspecific symptoms. Usually, patients complain of pain at the site of the incision during menstruation. The main causes in most of the reported cases are obstetrical and gynecological surgeries...
January 13, 2018: Curēus
Adilia Warris
The newly recognised and emerging fungal species, Candida auris , has caused worldwide invasive infections and has been implicated in difficult to control hospital outbreaks. Challenges are encountered in the correct identification of this fungus as commonly used phenotypic and biochemical methods fail to differentiate C. auris from other Candida species. Its resistance profile, over 90% of isolates are fluconazole resistant and 35% are resistant to amphotericin, confronts clinicians with the restricted arsenal of antifungals and concerns about optimal treatment...
March 15, 2018: Archives of Disease in Childhood
(no author information available yet)
Over recent years, drug names have become more complex and difficult to pronounce (e.g. axicabtagene ciloleucel, ▼rurioctocog alfa pegol, ▼riociguat ).1,2 Although some rules underpin drug nomenclature, there are several examples of drugs with similar sounding names that are easily confused. In addition, the different levels of nomenclature (chemical, generic and brand names) may cause confusion for patients. Here, we provide an overview of how drugs get their names, the patterns that can be seen in naming conventions and highlight the risk associated with drugs with similar looking or similar sounding names...
March 2018: Drug and Therapeutics Bulletin
S A Amukotuwa, M P Marks, G Zaharchuk, F Calamante, R Bammer, N Fischbein
BACKGROUND AND PURPOSE: Intracranial dural arteriovenous fistulas carry a risk of substantial neurologic complications but can be difficult to detect on structural MR imaging and TOF-MRA. The purpose of this study was to assess the accuracy and added value of 3D pseudocontinuous arterial spin-labeling MR imaging for the detection of these lesions. MATERIALS AND METHODS: This retrospective study included 39 patients with a dural arteriovenous fistula and 117 controls who had undergone both DSA and MR imaging with pseudocontinuous arterial spin-labeling...
March 15, 2018: AJNR. American Journal of Neuroradiology
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