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Cleveland clinic review

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https://www.readbyqxmd.com/read/28818349/fifteen-year-decrease-in-general-surgery-resident-breast-operative-experience-are-we-training-proficient-breast-surgeons
#1
Kelsey E Larson, Stephen R Grobmyer, Mika A B Reschke, Stephanie A Valente
OBJECTIVE: The goal of the study was to evaluate trends in general surgery resident breast cases over the past 15 years. STUDY DESIGN: The Accreditation Council for Graduate Medical Education (ACGME) Case Logs Statistics Reports from 2000 to 2015 were reviewed for average breast-specific case numbers and trends over time. ACGME data were available for all cases and breast-specific cases including the following: excisional biopsy/lumpectomy, simple mastectomy, modified radical mastectomy, and sentinel lymph node excision...
August 14, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28777386/effect-of-mannitol-on-globe-and-orbital-volumes-in-humans
#2
Adam C Weber, Alexander D Blandford, Bryan R Costin, Julian D Perry
PURPOSE: To determine the effect of intravenous mannitol on globe and orbital volumes. METHODS: Retrospective chart review of a consecutive series of Cleveland Clinic Neurosurgical Intensive Care Unit patients who underwent computed tomographic imaging before and after intravenous mannitol administration. Volume measurements were performed according to a previously described technique by averaging axial image areas. Measurements before and after mannitol administration were compared using paired t-test...
August 2, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28701263/treatment-for-anal-fissure-is-there-a-safe-option
#3
Justin T Brady, Alison R Althans, Ruel Neupane, Eslam M G Dosokey, Murad A Jabir, Harry L Reynolds, Scott R Steele, Sharon L Stein
BACKGROUND: Surgeons often approach anal fissure with chemical denervation (Botulinum toxin, BT) instead of initial lateral internal sphincterotomy (LIS) due to concerns for long-term incontinence. We evaluated the characteristics and outcomes of patients who received BT or LIS. METHODS: We performed a retrospective chart review of patients undergoing LIS and BT for anal fissure between 2009 and 2015. In 2015, a telephone survey was performed to evaluate durability, long-term incontinence and patient satisfaction...
July 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28685224/a-retrospective-review-of-1495-patients-with-obstetric-anal-sphincter-injuries-referred-for-assessment-of-function-and-endoanal-ultrasonography
#4
G P Thomas, L E Gould, F Casunuran, D A Kumar
AIM: Obstetric anal sphincter injuries are a significant risk factor for faecal incontinence. Correct identification and successful primary repair are important. The aim of this study was to review the outcome of all patients, with an obstetric anal sphincter injury, referred to our unit. METHOD: This is a retrospective review of 1495 patients over a 12-year period. All had a third or fourth degree tear and were referred at 4-months postpartum. RESULTS: Endoanal ultrasonography demonstrated residual sphincter defect in 792 (53%) and normal sphincters, with no evidence of repair, in 661 (44%)...
July 7, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28636421/analysis-of-origins-of-admission-for-solid-tumor-oncology-inpatients-disease-severity-and-outcomes
#5
Christopher E Wee, Lindsey M Goodman, Leticia Varella, Lisa A Rybicki, Alberto J Montero, Bassam N Estfan, Carolyn H Best, James P Stevenson
PURPOSE: Hospital transfers may affect clinical outcomes. Evaluation of admission by source of transfer, time of admission, and provider type may identify opportunities to improve inpatient outcomes. METHODS: We reviewed charts of patients admitted to the solid tumor oncology service between July and December 2014 from the Cleveland Clinic Foundation (CCF) Main Campus emergency department (ED), CCF Regional EDs, outside hospital (OSH) ED, OSH inpatient services, and CCF outpatient clinics...
July 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28630049/comparison-of-electroacupuncture-and-medical-treatment-for-functional-constipation-a-systematic-review-and-meta-analysis
#6
Sheng-Li Zhou, Xiu-Lai Zhang, Jing-Hua Wang
OBJECTIVES: To assess the effectiveness of electroacupuncture (EA) relative to conventional medication in functional constipation (FC). DESIGN: Systematic review and meta-analysis SETTING: To be included, studies needed to: (1) have been randomised controlled trials; (2) have recruited adult patients diagnosed with FC according to the Rome II/III criteria or the American Gastroenterological Association guideline for chronic FC; and (3) have randomised patients to be treated with EA or anti-constipation medication...
June 19, 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/28620573/clinical-characteristics-and-outcomes-of-patients-with-ischemic-and-non-ischemic-complete-heart-block
#7
Murtaza Sundhu, Mehmet Yildiz, Mubbasher Syed, Bhavan Shah, Sajjad Gul, Omer Afzal, Lon Castle
INTRODUCTION: Third degree or complete heart block (CHB) is a medical emergency and usually requires permanent pacemaker placement. CHB can be caused by cardiac ischemia or non-ischemic conditions such as infiltrative diseases or fibrosis. The purpose of this study is to identify the baseline clinical characteristics associated with ischemic versus non-ischemic causes of complete heart block and compare their outcomes. MATERIALS AND METHODS: An institutional review broad approval was granted by the Cleveland Clinic Health System...
May 12, 2017: Curēus
https://www.readbyqxmd.com/read/28611838/endovascular-embolization-of-intracranial-infectious-aneurysms-in-patients-undergoing-open-heart-surgery-using-n-butyl-cyanoacrylate
#8
Esteban Cheng-Ching, Seby John, Mark Bain, Gabor Toth, Thomas Masaryk, Ferdinand Hui, Muhammad Shazam Hussain
INTRODUCTION: Mycotic aneurysms are a serious complication of infective endocarditis with increased risk of intracranial hemorrhage. Patients undergoing open heart surgery for valve repair or replacement are exposed to anticoagulants, increasing the risk of aneurysm bleeding. These patients may require endovascular or surgical aneurysm treatment prior to heart surgery, but data on this approach are scarce. METHODS: Retrospective review of consecutive patients with infectious endocarditis and mycotic aneurysms treated endovascularly with Trufill n-butyl cyanoacrylate (n-BCA) at the Cleveland Clinic between January 2013 and December 2015...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28556385/atenolol-versus-propranolol-for-treatment-of-infantile-hemangiomas-during-the-proliferative-phase-a-retrospective-noninferiority-study
#9
Cheryl B Bayart, Joan E Tamburro, Allison T Vidimos, Lu Wang, Alex B Golden
BACKGROUND/OBJECTIVES: The nonselective beta-blocker propranolol is the current criterion standard for treatment of infantile hemangiomas (IHs) and the first therapy that the U.S. Food and Drug Administration has approved for the condition, but concern about adverse effects, such as bronchospasm, hypoglycemia, and sleep disturbances, has sparked interest in the use of alternative agents such as the selective β1 antagonist atenolol. Our aim was to compare the efficacy and adverse effect profiles of atenolol with those of propranolol in the treatment of IHs in a retrospective noninferiority trial...
July 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28529185/care-guidelines-for-case-reports-explanation-and-elaboration-document
#10
David S Riley, Melissa S Barber, Gunver S Kienle, Jeffrey K Aronson, Tido von Schoen-Angerer, Peter Tugwell, Helmut Kiene, Mark Helfand, Douglas G Altman, Harold Sox, Paul G Werthmann, David Moher, Richard A Rison, Larissa Shamseer, Christian A Koch, Gordon H Sun, Patrick Hanaway, Nancy L Sudak, Marietta Kaszkin-Bettag, James E Carpenter, Joel J Gagnier
BACKGROUND: Well-written and transparent case reports (1) reveal early signals of potential benefits, harms, and information on the use of resources; (2) provide information for clinical research and clinical practice guidelines, and (3) inform medical education. High-quality case reports are more likely when authors follow reporting guidelines. During 2011-2012, a group of clinicians, researchers, and journal editors developed recommendations for the accurate reporting of information in case reports that resulted in the CARE (CAse REport) Statement and Checklist...
May 18, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28485495/locoregional-recurrence-following-maxillectomy-implications-for-microvascular-reconstruction
#11
Ilya Likhterov, Michael A Fritz, Ivan H El-Sayed, Rahul Seth, Hani M Rayess, P Daniel Knott
OBJECTIVE: Reconstruction of maxillectomy defects offers potential quality-of-life improvement, although cavity coverage may impact surveillance of recurrent malignancy. We describe the pattern of postmaxillectomy locoregional recurrence. STUDY DESIGN: Retrospective review. METHODS: Patients from 2001 to 2011 at the University of California, San Francisco and the Cleveland Clinic. RESULTS: Among 75 patients with malignancy resulting in partial or total maxillectomy, 57 were treated with obturators and 18 underwent reconstructive surgery...
May 9, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28477435/sacral-nerve-stimulation-can-be-an-effective-treatment-for-low-anterior-resection-syndrome
#12
Saleh M Eftaiha, Banujan Balachandran, Slawomir J Marecik, Anders Mellgren, Johan Nordenstam, George Melich, Leela M Prasad, John J Park
AIM: Sacral nerve stimulation has become a preferred method for the treatment of faecal incontinence in patients who fail conservative (non-operative) therapy. In previous small studies, sacral nerve stimulation has demonstrated improvement of faecal incontinence and quality of life in a majority of patients with low anterior resection syndrome. We evaluated the efficacy of sacral nerve stimulation in the treatment of low anterior resection syndrome, using a recently developed and validated low anterior resection syndrome instrument to quantify symptoms...
May 6, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28466562/subsequent-pulse-generator-replacement-surgery-does-not-increase-the-infection-rate-in-patients-with-deep-brain-stimulator-systems-a-review-of-1537-unique-implants-at-a-single-center
#13
Leonardo A Frizon, Olivia Hogue, Connor Wathen, Erin Yamamoto, Navin C Sabharwal, Jaes Jones, Josephine Volovetz, Andres L Maldonado-Naranjo, Darlene A Lobel, Andre G Machado, Sean J Nagel
INTRODUCTION: Deep brain stimulation (DBS) is a well-recognized treatment for patients with movement disorders and other neurological diseases. The implantable pulse generator (IPG) is a fundamental component of the DBS system. Although IPG implantation and replacement surgeries are comparatively minor procedures relative to the brain lead insertion, patients often require multiple IPG replacements during their lifetime with each operation carrying a small but possibly cumulative risk of complications...
May 3, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28421812/the-frequency-of-incidental-findings-and-subsequent-evaluation-in-low-dose-ct-scans-for-lung-cancer-screening
#14
Lillie Morgan, Humberto Choi, Michal Reid, Ali Khawaja, Peter J Mazzone
RATIONALE: The USPSTF recommends lung cancer screening with low-dose chest CT scans (LDCT) for a well-defined high-risk population. Data on the frequency and impact of incidental findings on LDCT scans performed within a centralized lung cancer screening program has not been reported. OBJECTIVES: Previous studies have reported IFs in the setting of clinical trials. We present our findings in a real clinical setting where the decision to manage these findings may depend on factors that are not captured in a research trial such as disclosing IFs, patient preferences, severity of comorbidities, and physician expertise...
April 19, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28421723/clinical-outcomes-of-proton-beam-therapy-for-choroidal-melanoma-at-a-single-institute-in-korea
#15
Tae Wan Kim, Euncheol Choi, Jeonghoon Park, Dong-Ho Shin, Su Kyung Jung, Susie Seok, Kwan Ho Cho, Joo-Young Kim, Dae Yong Kim, Tae Hyun Kim, Yang Kwon Suh, Yeon Joo Kim, Sung Ho Moon
Purpose: This study retrospectively evaluated the clinical outcomes and complications of proton beam therapy (PBT) in a single institution in Korea and quantitatively analyzed the change in tumor volume after PBT using magnetic resonance imaging (MRI). Materials and Methods: Twenty-four treatment-naïve patients who underwent PBT for choroidal melanoma between 2009 and 2015 were reviewed. Dose fractionation was 60-70 CGE over 5 fractions. Orbital MRIs were taken at baseline and 3, 6, and 12 months after PBT and annually thereafter...
April 19, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28410361/rates-of-intraocular-pressure-elevation-and-use-of-topical-antihypertensive-medication-after-descemet-stripping-automated-endothelial-keratoplasty
#16
Mona Kaleem, Faisal Ridha, Zryan Shwani, Bonnielin Swenor, Jeffrey Goshe, Annapurna Singh
PURPOSE: To investigate intraocular pressure (IOP) elevation and medication augmentation after Descemet stripping automated endothelial keratoplasty (DSAEK) in those with and without glaucoma. METHODS: The records of 379 patients who underwent DSAEK at the Cleveland Clinic Foundation between January 2009 and 2014 were retrospectively reviewed. Postoperative IOP elevations were considered significant if IOP was ≥22 mm Hg on at least 1 follow-up visit or if it increased by ≥10 mm Hg from baseline...
June 2017: Cornea
https://www.readbyqxmd.com/read/28398932/brachial-arterial-pressure-monitoring-during-cardiac-surgery-rarely-causes-complications
#17
Asha Singh, Bobby Bahadorani, Brett J Wakefield, Natalya Makarova, Priya A Kumar, Michael Zhen-Yu Tong, Daniel I Sessler, Andra E Duncan
BACKGROUND: Brachial arterial catheters better estimate aortic pressure than radial arterial catheters but are used infrequently because complications in a major artery without collateral flow are potentially serious. However, the extent to which brachial artery cannulation promotes complications remains unknown. The authors thus evaluated a large cohort of cardiac surgical patients to estimate the incidence of related serious complications. METHODS: The institutional Society of Thoracic Surgeons Adult Cardiac Surgery Database and Perioperative Health Documentation System Registry of the Cleveland Clinic were used to identify patients who had brachial artery cannulation between 2007 and 2015...
June 2017: Anesthesiology
https://www.readbyqxmd.com/read/28391967/physicians-talking-about-sex-sexuality-and-protection-with-adolescents
#18
REVIEW
Lindsay Fuzzell, Cleveland G Shields, Stewart C Alexander, J Dennis Fortenberry
Adolescent-physician communication about sexual behaviors, sexuality, and protective behaviors is vital for the support of sexual minorities and the prevention of sexually transmitted infections and unintended pregnancies. The objective of this review is to identify sexual topics that physicians and adolescents discuss during medical encounters and examine the quantity and quality of that communication. We performed a systematic literature review of major databases through May 2016. We identified 33 papers that focused on adolescent-physician communication about three major sexual health topics: coital or noncoital sexual behaviors, sexual orientation or attractions, and sexually protective or preventative behaviors...
July 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28370509/multimodal-imaging-of-suspicious-choroidal-neoplasms-in-a-primary-eye-care-clinic
#19
REVIEW
Gurpinderjeet Kaur, Scott A Anthony
Small suspicious choroidal neoplasms commonly present a diagnostic challenge in primary eye-care clinics, where they are most likely to present. Differentiating benign from malignant choroidal neoplasms is essential for facilitating early diagnosis and treatment, potentially decreasing the risk of metastasis and vision loss in some cases. The purpose of this review is to describe the clinical, spectral-domain optical coherence tomography and fundus autofluorescence features of suspicious choroidal neoplasms in a case series of patients presenting to a primary eye-care clinic at the Veterans Health Administration, Cleveland, Ohio, USA...
March 28, 2017: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/28318820/sarcoidosis-associated-small-fiber-neuropathy-in-a-large-cohort-clinical-aspects-and-response-to-ivig-and-anti-tnf-alpha-treatment
#20
Jinny O Tavee, Karen Karwa, Zubair Ahmed, Nicolas Thompson, Joseph Parambil, Daniel A Culver
OBJECTIVE: Small fiber neuropathy commonly affects patients with sarcoidosis and is often refractory to standard immunosuppressive therapies used for systemic disease. The clinical features of sarcoidosis-associated small fiber neuropathy (SSFN) and its response to medical therapy have not been described in a large population. METHODS: We performed a retrospective review of patients with SSFN seen at the Cleveland Clinic over a 4-year period. RESULTS: SSFN was identified in 143 individuals although other causes of neuropathy were found in 28 cases...
May 2017: Respiratory Medicine
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