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https://www.readbyqxmd.com/read/28938608/use-of-confocal-laser-endomicroscopy-with-a-fluorescently-labeled-fatty-acid-to-diagnose-colorectal-neoplasms
#1
Feihong Deng, Yuan Fang, Zhiyong Shen, Wei Gong, Tao Liu, Jing Wen, Wanling Zhang, Xianjun Zhu, Hui Zhong, Tong Wang, Fachao Zhi, Biao Nie
Endoscopic treatment for early colorectal cancer closely correlates with patient prognosis. However, endoscopic differentiation between carcinomas and non-neoplastic lesions remains difficult. Here, we topically stained colorectal neoplasms with a fatty acid analogue (BODIPY-FA) and quantified the fluorescent signals using confocal laser endomicroscopy (CLE) and fluorescence microscopy. We also analyzed protein expression in colorectal cancer tissues. We found that expression of fatty acid synthase was elevated, while the expression of fatty acid transporters was reduced in colorectal cancer...
August 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28938339/reduction-techniques-for-diaphyseal-femur-fractures
#2
Philip R Wolinsky, Justin F Lucas
Achieving and maintaining reduction in patients with a diaphyseal femur fracture may be difficult; therefore, thorough preoperative planning is required. To fully prepare for successful surgical management of diaphyseal femur fractures, surgeons must consider appropriate patient positioning and necessary tools, including surgical tables, traction devices, and instruments. Principles of acceptable reduction rely on the restoration of length, alignment, and rotation. Reduction of diaphyseal femur fractures should be attained in the least invasive manner, via percutaneous reduction techniques, if possible, to preserve fracture biology and promote successful fracture healing...
September 21, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28938303/optimizing-education-in-difficult-airway-management-meeting-the-challenge
#3
Sheila N Myatra, Rupali S Kalkundre, Jigeeshu V Divatia
PURPOSE OF REVIEW: The last 2 decades have seen a vast change in the science and technology of airway management. As a result, there is an increasing need to equip anesthesiologists with the new knowledge and skills for the safe management of a difficult airway. RECENT FINDINGS: In addition to knowledge and expertise, human factors and nontechnical skills (NTS), including situational awareness, communication and team work, play an important role during difficult airway management and contribute to the outcome...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28938298/safety-and-efficacy-of-epidural-analgesia
#4
Elke M E Bos, Markus W Hollmann, Philipp Lirk
PURPOSE OF REVIEW: Epidural analgesia remains a widely used analgesic technique. This article aims to assess the safety of epidural analgesia by balancing efficacy and complications, of epidural analgesia for acute, labor and chronic pain. RECENT FINDINGS: Main indications for epidural analgesia include major open abdominal surgery, thoracotomy and labor analgesia. Past and current literature show that epidural analgesia leads to statistically significant, but possibly clinically less meaningful, reductions in pain scores compared with intravenous analgesia...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28938107/lhermitte-duclos-disease-clinical-study-with-long-term-follow-up-in-a-single-institution
#5
Qiguang Wang, Si Zhang, Jian Cheng, Wenke Liu, Xuhui Hui
OBJECTIVE: LDD is a rare lesion, controversy about diagnosis and treatment of LDD and CS still exists. We aimed to clarify clinical and radiological characteristics, the optimal treatment timing and strategies of LDD with long-term follow-up. PATIENTS AND METHODS: From January 2004 to May 2017, 12 LDD patients were enrolled in our study. The clinical and radiological features, treatment strategies and long-term follow-up data were retrospectively analyzed. RESULTS: The mean follow-up was 89...
September 9, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28937998/selection-of-dna-aptamers-specific-for-live-pseudomonas-aeruginosa
#6
Jennifer Soundy, Darren Day
Pseudomonas aeruginosa is an opportunistic pathogen that causes significant morbidity and mortality in immunocompromised patients, particular cystic fibrosis sufferers, burns victims, diabetics and neonates. It thrives in moist places where it forms biofilms that are exceedingly difficult to eradicate on hospital surfaces, in water supplies and implanted biomaterials. Using a live cell SELEX approach we selected DNA aptamers to P. aeruginosa grown as biofilms in microfluidic cells. From a pool of aptamer candidates showing tight binding a stem-loop structure was identified as being important for binding...
2017: PloS One
https://www.readbyqxmd.com/read/28937549/electroconvulsive-therapy-for-super-refractory-status-epilepticus
#7
Jayme Ahmed, Michael Metrick, Anne Gilbert, Anita Glasson, Ranjeet Singh, Wayne Ambrous, Lori Brown, Laura Aykroyd, Karen Bobel
OBJECTIVES: Super refractory status epilepticus (SRSE) is a stage beyond refractory status that requires general anesthesia as management. Electroconvulsive therapy (ECT) is recommended only as a potential treatment option beyond general anesthesia and after all other options have been exhausted. Its effect on aborting status has been minimally researched. We present the largest case series to our knowledge exploring the effect of ECT on SRSE. METHODS: Eight adults hospitalized for SRSE received ECT in an attempt to abort status after other treatment modalities were exhausted...
September 20, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28937468/psychogenic-low-back-pain-and-hysterical-paralysis-in-adolescence
#8
Tsukasa Kanchiku, Hidenori Suzuki, Yasuaki Imajo, Yuichiro Yoshida, Norihiro Nishida, Toshihiko Taguchi
STUDY DESIGN: A retrospective review. OBJECTIVE: The purpose of this study was to investigate the clinical outcomes in adolescents diagnosed with psychogenic low-back pain and hysterical paralysis and to evaluate the efficacy of differential diagnosis methods. SUMMARY OF BACKGROUND DATA: The incidence of low-back pain in adolescence is similar to that in adults, but the causes of low-back pain are difficult to determine in most cases. For these patients, a definitive diagnosis of psychogenic low-back pain and hysterical paralysis as well as adequate treatment are clinically important to avoid unnecessary surgical treatment...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28937457/is-a-drain-tip-culture-required-after-spinal-surgery
#9
Kazuyoshi Kobayashi, Shiro Imagama, Zenya Ito, Kei Ando, Hideki Yagi, Tetsuro Hida, Kenyu Ito, Yoshimoto Ishikawa, Mikito Tsushima, Naoki Ishiguro
STUDY DESIGN: The efficacy of use of a drain tip culture for early detection of surgical-site infection (SSI) was investigated in 329 patients after spinal surgery. OBJECTIVE: To examine the efficacy of a wound drain tip culture for detection of SSI in spinal surgery. SUMMARY OF BACKGROUND DATA: A complication of SSI after spinal surgery has high associated morbidity and mortality, and is often difficult to treat. MATERIALS AND METHODS: The subjects were patients who underwent spinal surgery at our institution between January 2010 and March 2013...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28937388/undiagnosed-senile-systemic-amyloidosis-with-mesenteric-angiopathy-leading-to-fatal-outcomes-two-case-series-with-a-review-of-literature
#10
Avneesh Gupta, Maryna Tarbunova, Anil Aggrawal, Anges E Aysola
Amyloid mesenteric angiopathy is difficult to diagnose as gastrointestinal (GI) signs are nonspecific and radiological studies rarely identify amyloid deposits with certainty. The objective of this study was to highlight the pathological findings of amyloid mesenteric angiopathy in cases of senile systemic amyloidosis. Literature review, author's research data, and practice experience were used. Systemic amyloidosis should be considered in the differential diagnoses when evaluating nonspecific and unexplained GI in patient population aged> 55 years to decrease the morbidity and fatal outcomes...
July 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28937146/associations-of-aniseikonia-with-metamorphopsia-and-retinal-displacements-after-epiretinal-membrane-surgery
#11
Y Ichikawa, Y Imamura, M Ishida
PurposeTo determine the correlation of the degree of aniseikonia with the retinal displacements and metamorphopsia in patients that have undergone successful epiretinal membrane (ERM) surgery.MethodsSubjects were 28 eyes with an ERM in 28 patients. The New Aniseikonia Test (NAT) and M-CHARTS were used to quantify the degree of preoperative and postoperative aniseikonia and metamorphopsia. We also evaluated the distance between the intersections of 2 sets of retinal vessels situated vertically or horizontally by using spectral-domain optical coherence tomography (SD-OCT) images in 28 patients...
September 22, 2017: Eye
https://www.readbyqxmd.com/read/28936963/-application-of-self-made-guidance-for-difficult-gastric-tube-placement-in-patients-with-artificial-airway
#12
Xiaojie Chen, Jinchao Zhang, Wenxiu Li, Yiqing Jiang, Lingzhi Lin
OBJECTIVE: To use evidence-based nursing on patients with artificial airway to the practice of stomach tube, and to evaluate the self made guidance for difficult gastric tube placement in patients with artificial airway. METHODS: Forty patients with artificial airway and were difficult to put the tube, and admitted to Department of Critical Care Medicine of Harrison International Peace Hospital Affiliated to Hebei Medical University from April to December in 2016 were enrolled as observation group...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936588/technical-details-and-results-of-a-modified-end-to-side-technique-of-pancreatojejunostomy-a-personal-series-of-100-patients
#13
Luca Morelli, Gregorio Di Franco, Simone Guadagni, Matteo Palmeri, Niccolò Furbetta, Desirée Gianardi, Marco Del Chiaro, Giulio Di Candio, Franco Mosca
BACKGROUND: The treatment of pancreatic stump is a critical step of pancreatoduodenectomy (PD) because leaks from this anastomosis incur major morbidity and mortality. We describe the technical details of a modified end-to-side pancreatojejunostomy (mPJ), and report on the outcome of the first 100 patients. METHODS: From October 2008 to June 2017, 424 pancreatic resections were performed, of which 203 were PD. The mPJ was introduced in November 2010 and used in 100 consecutive patients, by a single surgeon...
September 21, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28936495/the-accuracy-of-nurses-predictions-for-clinical-outcomes-in-the-chronically-critically-ill
#14
Amy R Lipson, Sarah J Miano, Barbara J Daly, Sara L Douglas
BACKGROUND: Accurately predicting survivorship of patients in the intensive care unit is known to be difficult. Previous research has shown that nurses are more likely to recognize futile medical care than other disciplines. The purpose of this study was to describe the accuracy of nurse's predictions for survival of patients who are chronically critically ill (CCI). METHODS: Using a secondary data analysis from a longitudinal, descriptive study, we evaluated nurses' predictions for survival at admission and until ICU discharge or patient death...
September 2017: Research & Reviews: Journal of Nursing and Health Sciences
https://www.readbyqxmd.com/read/28935510/intraoperative-computed-tomography-navigation-during-thoracoscopic-segmentectomy-for-small-sized-lung-tumors
#15
Sung Soo Chang, Taku Okamoto, Yoshimasa Tokunaga, Takayuki Nakano
Performance of thoracoscopic pulmonary segmentectomy for primary lung cancer or pulmonary metastases has recently increased. In patients with emphysema, identification of the intersegmental line is often difficult. For nonpalpable lesions, securing a sufficient surgical margin is more likely to be uncertain. The purpose of this study was to evaluate the efficacy of intraoperative computed tomography (CT) scan during video-assisted thoracoscopic surgery (VATS) pulmonary segmentectomy. This study included 12 patients who underwent intraoperative CT-assisted VATS segmentectomy between January 2015 and August 2016...
August 24, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28935453/intraoperative-real-time-tissue-elastography-during-laparoscopic-hepatectomy
#16
Yuta Kobayashi, Kiyohiko Omichi, Yoshikuni Kawaguchi, Junichi Arita, Nobuhisa Akamatsu, Junichi Kaneko, Yoshihiro Sakamoto, Kiyoshi Hasegawa, Norihiro Kokudo
BACKGROUND: Real-time tissue elastography during open hepatectomy facilitates the differential diagnosis of liver tumors by providing information on elasticity. This study investigated the utility of intraoperative real-time tissue elastography (IORTE) during laparoscopic hepatectomy (LH). METHODS: Between 2012 and 2014, IORTE was performed during LH for 21 hepatocellular carcinomas (HCCs), 16 adenocarcinomas and 5 other tumors in 32 patients. The elasticity images were classified into six categories according to the modified criteria on the elasticity type of liver tumors, in which type 1 tumors show more strain than the surrounding liver and type 6 tumors no strain...
September 18, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28935452/3d-image-guidance-assisted-identification-of-colorectal-cancer-liver-metastases-not-seen-on-intraoperative-ultrasound-results-from-a-prospective-trial
#17
T Peter Kingham, Linda M Pak, Amber L Simpson, Universe Leung, Alexandre Doussot, Michael I D'Angelica, Ronald P DeMatteo, Peter J Allen, William R Jarnagin
BACKGROUND: Neoadjuvant treatment of colorectal liver metastases has become increasingly common, and while effective, often renders small metastases difficult to visualize on intraoperative US. The objective of this study was to determine the utility of a 3D image-guidance system in patients with intraoperative sonographically-occult CRLM. METHODS: 50 patients with at least one CRLM ≤ 1.5 cm were enrolled in this prospective trial of an FDA-approved Explorer image-guidance system...
September 18, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28934914/new-concept-of-3d-printed-bone-clip-polylactic-acid-hydroxyapatite-silk-composite-for-internal-fixation-of-bone-fractures
#18
Yeung Kyu Yeon, Hae Sang Park, Jung Min Lee, Ji Seung Lee, Young Jin Lee, Md Tipu Sultan, Ye Bin Seo, Ok Joo Lee, Soon Hee Kim, Chan Hum Park
Open reduction with internal fixation is commonly used for the treatment of bone fractures. However, postoperative infection associated with internal fixation devices (intramedullary nails, plates, and screws) remains a significant complication, and it is technically difficult to fix multiple fragmented bony fractures using internal fixation devices. In addition, drilling in the bone to install devices can lead to secondary fracture, bone necrosis associated with postoperative infection. In this study, we developed bone clip type internal fixation device using three- dimensional (3D) printing technology...
September 22, 2017: Journal of Biomaterials Science. Polymer Edition
https://www.readbyqxmd.com/read/28934874/radiographic-shape-of-foot-with-second-metatarsophalangeal-joint-dislocation-associated-with-hallux-valgus
#19
Tetsuro Kokubo, Takeshi Hashimoto, Yasunori Suda, Akeo Waseda, Hiroko Ikezawa
BACKGROUND: Second metatarsophalangeal (MTP) joint dislocation is associated with hallux valgus, and the treatment of complete dislocation can be difficult. The purpose of this study was to radiographically clarify the characteristic foot shape in the presence of second MTP joint dislocation. METHODS: Weight-bearing foot radiographs of the 268 patients (358 feet) with hallux valgus were examined. They were divided into 2 groups: those with second MTP joint dislocation (study group = 179 feet) and those without dislocation (control group = 179 feet)...
September 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28934633/association-of-low-back-pain-with-muscle-stiffness-and-muscle-mass-of-the-lumbar-back-muscles-and-sagittal-spinal-alignment-in-young-and-middle-aged-medical-workers
#20
Mitsuhiro Masaki, Tomoki Aoyama, Takashi Murakami, Ko Yanase, Xiang Ji, Hiroshige Tateuchi, Noriaki Ichihashi
BACKGROUND: Muscle stiffness of the lumbar back muscles in low back pain (LBP) patients has not been clearly elucidated because quantitative assessment of the stiffness of individual muscles was conventionally difficult. This study aimed to examine the association of LBP with muscle stiffness assessed using ultrasonic shear wave elastography (SWE) and muscle mass of the lumbar back muscle, and spinal alignment in young and middle-aged medical workers. METHODS: The study comprised 23 asymptomatic medical workers [control (CTR) group] and 9 medical workers with LBP (LBP group)...
September 14, 2017: Clinical Biomechanics
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