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https://www.readbyqxmd.com/read/28813090/brazilian-consensus-on-duchenne-muscular-dystrophy-part-1-diagnosis-steroid-therapy-and-perspectives
#1
Alexandra P Q C Araujo, Alzira A S de Carvalho, Eduardo B U Cavalcanti, Jonas Alex M Saute, Elmano Carvalho, Marcondes C França, Alberto R M Martinez, Monica de M M Navarro, Anamarli Nucci, Maria Bernadete D de Resende, Marcus Vinicius M Gonçalves, Juliana Gurgel-Giannetti, Rosana H Scola, Cláudia F da R Sobreira, Umbertina C Reed, Edmar Zanoteli
Significant advances in the understanding and management of Duchenne muscular dystrophy (DMD) took place since international guidelines were published in 2010. Our objective was to provide an evidence-based national consensus statement for multidisciplinary care of DMD in Brazil. A combination of the Delphi technique with a systematic review of studies from 2010 to 2016 was employed to classify evidence levels and grade of recommendations. Our recommendations were divided in two parts. We present Part 1 here, where we describe the guideline methodology and overall disease concepts, and also provide recommendations on diagnosis, steroid therapy and new drug treatment perspectives for DMD...
August 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28813037/concomitant-bladder-cancer-and-prostate-cancer-challenges-and-controversies
#2
REVIEW
Antonio Lopez-Beltran, Liang Cheng, Francesco Montorsi, Maria Scarpelli, Maria R Raspollini, Rodolfo Montironi
Radical cystoprostatectomy (RCP) followed by bilateral pelvic lymphadenectomy and urinary diversion remains the gold-standard therapy for men with localized muscle-invasive bladder cancer (MIBC). Prostate cancer might be incidentally detected at the time of RCP with a reported prevalence of 24-51%. Typically, these patients are considered to have clinically insignificant disease, but data from emerging series challenge this assumption and suggest that some of these tumours might be aggressive, or somehow increase the aggressiveness of the associated MIBC, and can negatively influence the patient's overall survival outcomes...
August 16, 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28812959/periocular-manifestations-of-trigeminal-trophic-syndrome-a-case-series-and-literature-review
#3
Katherine A McVeigh, Morag Adams, Richard Harrad, Rebecca Ford
Trigeminal trophic syndrome (TTS) is a condition whereby persistent facial ulceration presents consequent to central or peripheral insult to the trigeminal nerve. Lesions are created by repetitive self-inflicted manipulation and trauma of dysaesthetic skin within the trigeminal dermatome. We discuss four cases with aetiologies varied from presumed microvascular compromise to resection of cerebral meningioma, cerebrovascular accident, and herpes zoster ophthalmicus. We discuss the management of the under-recognised associated periocular skin ulcerations that result from physical manipulation of dysesthic skin and prove to be persistent and challenging to treat...
August 16, 2017: Orbit
https://www.readbyqxmd.com/read/28812958/a-microcosting-study-of-establishing-a-baby-caf%C3%A3-%C3%A2-in-texas
#4
Rigoberto I Delgado, Sara L Gill
BACKGROUND: This article focuses on the costs of opening and running a Baby Café. A Baby Café is an intervention that focuses on providing peer-to-peer support for breastfeeding mothers. Research aim: This study aimed to estimate the costs of establishing and running a Baby Café. METHODS: The authors used a microcosting approach to identifying costs using the case of a Baby Café located in San Antonio, Texas, and modeled after other existing cafés in the United States...
August 1, 2017: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/28812933/use-of-bilayer-matrix-wound-dressing-in-the-exenterated-socket
#5
Leon Rafailov, Roger E Turbin, Paul D Langer
To describe the novel use of a bilayer dermal substitute to reconstruct exenterated orbits. A retrospective chart review was performed in the practices of two surgeons (RET and PDL) of all patients who had undergone orbital exenteration between April 2014 and June 2016 and whose subsequent reconstruction included lining the socket with Integra bilayer. Patient demographics, pathologic diagnoses, surgical and post-operative complications, graft integrity, and patient acceptance were recorded. The charts of 7 patients (4 men and 3 women, ages 60-87 years) were reviewed...
August 16, 2017: Orbit
https://www.readbyqxmd.com/read/28812914/retrospective-chart-review-of-the-use-of-imaging-and-biopsy-in-the-diagnosis-of-optic-nerve-sheath-meningiomas-and-intra-conal-orbital-lymphomas-at-a-single-institution
#6
Anna Parlin, Alina Dumitrescu, William T Nunery, Peter J Timoney, Jason A Sokol
Optic nerve sheath meningiomas (ONSM) and intra-conal orbital lymphomas are common entities on the differential of a retrobulbar optic nerve involving space-occupying lesion. In this study, we compare the pre-surgical diagnosis, based on clinical presentation and neuroimaging, to the surgical pathology results of intra-conal orbital lymphomas and ONSM. This is an IRB approved retrospective chart review of orbital lymphomas and optic nerve sheath meningiomas biopsied by a single surgeon over a 4-year period at a single institution...
August 16, 2017: Orbit
https://www.readbyqxmd.com/read/28812911/isolated-orbital-mucoceles-in-the-absence-of-obstructive-sinus-disease
#7
M A Prendes, I Perszyk, D Horkey, J Sokol, P Timoney
Orbital surgeons are quite familiar with the diagnosis and management of paranasal sinus mucoceles due their frequent involvement of the orbit. These benign masses form and expand following sinus outflow obstruction secondary to various causes including trauma, inflammation and malignancy, amongst others. The authors present two cases of isolated orbital mucoceles without associated sinus outflow obstruction. There were notably no connections between the paranasal sinuses and the lesions. The mucoceles were diagnosed following orbitotomies and excisional biopsies with confirmatory histopathology...
August 16, 2017: Orbit
https://www.readbyqxmd.com/read/28812838/forced-migration-and-global-responsibility-for-health-comment-on-defining-and-acting-on-global-health-the-case-of-japan-and-the-refugee-crisis
#8
Kayvan Bozorgmehr, Oliver Razum
Forced migration has become a world-wide phenomenon in the past century, affecting increasing numbers of countries and people. It entails important challenges from a global health perspective. Leppold et al have critically discussed the Japanese interpretation of global responsibility for health in the context of forced migration. This commentary complements their analysis by outlining three priority areas of global health responsibility for European Union (EU) countries. We highlight important stages of the migration phases related to forced migration and propose three arguments...
November 5, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28812815/stakeholders-perspectives-on-the-success-drivers-in-ghana-s-national-health-insurance-scheme-identifying-policy-translation-issues
#9
Adam Fusheini, Gordon Marnoch, Ann Marie Gray
BACKGROUND: Ghana's National Health Insurance Scheme (NHIS), established by an Act of Parliament (Act 650), in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa...
October 1, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28812813/do-management-and-leadership-practices-in-the-context-of-decentralisation-influence-performance-of-community-health-fund-evidence-from-iramba-and-iringa-districts-in-tanzania
#10
Chakupewa Joseph, Stephen Oswald Maluka
BACKGROUND: In early 1990s, Tanzania like other African countries, adopted health sector reform (HSR). The most strongly held centralisation system that informed the nature of services provision including health was, thus, disintegrated giving rise to decentralisation system. It was within the realm of HSR process, user fees were introduced in the health sector. Along with user fees, various types of health insurances, including the Community Health Fund (CHF), were introduced. While the country's level of enrolment in the CHF is low, there are marked variations among districts...
September 26, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28812802/diplomacy-and-health-the-end-of-the-utilitarian-era
#11
Sebastian Kevany, Marcus Matthews
Cost-effectiveness analysis (CEA), as a system of allocative efficiency for global health programs, is an influential criterion for resource allocation in the context of diplomacy and inherent foreign policy decisions therein. This is because such programs have diplomatic benefits and costs that can be uploaded from the recipient and affect the broader foreign policy interests of the donor and the diplomacy landscape between both parties. These diplomatic implications are vital to the long-term success of both the immediate program and any subsequent programs; hence it is important to articulate them alongside program performance, in terms of how well their interrelated interventions were perceived by the communities served...
January 8, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28812737/human-exposure-and-sensitivity-to-globally-extreme-wildfire-events
#12
David M J S Bowman, Grant J Williamson, John T Abatzoglou, Crystal A Kolden, Mark A Cochrane, Alistair M S Smith
Extreme wildfires have substantial economic, social and environmental impacts, but there is uncertainty whether such events are inevitable features of the Earth's fire ecology or a legacy of poor management and planning. We identify 478 extreme wildfire events defined as the daily clusters of fire radiative power from MODIS, within a global 10 × 10 km lattice, between 2002 and 2013, which exceeded the 99.997th percentile of over 23 million cases of the ΣFRP 100 km(-2) in the MODIS record. These events are globally distributed across all flammable biomes, and are strongly associated with extreme fire weather conditions...
February 6, 2017: Nature ecology & evolution
https://www.readbyqxmd.com/read/28812464/congenital-diaphragmatic-hernia-with-liver-herniation-into-the-pericardial-sac-in-a-30-week-gestation-infant
#13
Nisha Patel, Christina Sollinger, Carl T D'Angio, Jeffrey M Vinocur, Kate G Ackerman, Philip J Katzman
Anterior diaphragmatic defects with pericardial involvement are extremely rare and diagnostically challenging entities encountered perinatally. While a majority of diaphragmatic defects occur in isolation, others are associated with multiple defects forming a complex of syndromes such as Pentalogy of Cantrell. Liver herniation into the pericardial sac poses a particular challenge and can mimic a pericardial tumor on prenatal ultrasound, yielding a different management course. The following case is an unusual presentation of a 30-week gestation female with an anterior midline diaphragmatic defect with liver herniation mimicking as a pericardial tumor, diagnosed at time of autopsy...
September 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28812458/congenital-cystic-lung-lesions-evolution-from-in-utero-detection-to-pathology-diagnosis-a-multidisciplinary-approach
#14
Steven Hardee, Lea Tuzovic, Cicero T Silva, Robert A Cowles, Joshua Copel, Raffaella A Morotti
Congenital cystic lung lesions are a group of rare pathologies that are usually diagnosed in the prenatal period. The majority of these lesions are diagnosed at pathology examination as congenital pulmonary airway malformations (CPAM) and bronchopulmonary sequestration (BPS). These lesions are typically managed by surgical intervention within the first year of life and have an excellent prognosis. We examined the evolution of imaging appearances from prenatal diagnosis to postnatal work-up of these lesions and correlate imaging and pathological findings...
September 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28812406/types-of-orbital-osteoma-a-descriptive-analysis
#15
Tayyab Afghani, Hassan Mansoor
AIMS: This study describes different types of orbital osteoma based on clinical per-operative morphology and radiological findings to facilitate communication between ophthalmologists and surgical management for a better patient outcome. MATERIALS AND METHODS: The study was conducted in the Orbit and Oculoplastics Department of Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan, from July 1, 2001 to June 30, 2014. A retrospective analysis of 520 diagnosed orbital tumours who presented to us was carried out and the prevalence of orbital osteoma was determined...
August 16, 2017: Orbit
https://www.readbyqxmd.com/read/28812381/retrospective-review-of-sglt2-inhibitor-exposures-reported-to-13-poison-centers
#16
Scott E Schaeffer, Carol DesLauriers, Henry A Spiller, Alfred Aleguas, Salvador Baeza, Mark L Ryan
BACKGROUND: SGLT2 inhibitors are a new class of oral antidiabetics prescribed in the United States since 2013. They act by inhibiting reabsorption of glucose in the proximal convoluted tubule of the kidney, allowing excess glucose to be excreted. Little has been reported regarding effects of non-therapeutic exposure to this class of medication. METHODS: Retrospective records from 13 poison centers were examined for human exposures to SGLT2 inhibitors between 1st January 2013 and 31st December 2016...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28812302/management-of-sleep-wake-disturbances-comorbid-with-cancer
#17
Ann M Berger Aprn, Ellyn E Matthews Cbsm, Ashley M Kenkel
It is critical that clinicians and healthcare systems adopt routine screening and affordable interventions to reduce chronic insomnia and improve the quality of life in cancer patients and survivors. We provide expert clinical advice on how to manage sleep-wake disturbances that occur comorbidly with cancer. Our discussion focuses on the etiology, screening, and assessment of sleep-wake disturbances, and on both nonpharmacologic and pharmacologic interventions to manage sleep disturbances, insomnia, and sleep-related breathing disorders...
August 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28812283/hydrodynamic-rupture-of-liver-in-combat-patient-a-case-of-successful-application-of-damage-control-tactic-in-area-of-the-hybrid-war-in-east-ukraine
#18
Igor Khomenko, Vitalii Shapovalov, Ievgen Tsema, Georgii Makarov, Roman Palytsia, Ievgen Zavodovskyi, Ivan Ishchenko, Andrii Dinets, Vladimir Mishalov
BACKGROUND: The hybrid war of Russia against Ukraine has been started in certain districts of Donetsk and Luhansk oblasts within the Donbas area in 2014. CASE PRESENTATION: We report a clinical case of a combat patient who was injured after the multiple launcher rocket system "Grad" shelling, diagnosed with hydrodynamic liver rupture followed by medical management with application of damage control (DC) tactic in conditions of hybrid war. The patient underwent relaparatomy, liver resection, endoscopic papillosphincterotomy, endoscopic retrograde cholecystopancreatography, stenting of the common bile duct, and VAC-therapy...
August 15, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28812151/high-clinical-impact-and-diagnostic-accuracy-of-eus-guided-biopsy-sampling-of-subepithelial-lesions-a-prospective-comparative-study
#19
Per Hedenström, Hanns-Ulrich Marschall, Bengt Nilsson, Akif Demir, Björn Lindkvist, Ola Nilsson, Riadh Sadik
BACKGROUND: In a tertiary center setting we aimed to study the diagnostic accuracy and clinical impact of EUS-guided biopsy sampling (EUS-FNB) with a reverse bevel needle compared with that of fine needle aspiration (EUS-FNA) in the work-up of subepithelial lesions (SEL). METHODS: All patients presenting with SELs referred for EUS-guided sampling were prospectively included in 2012-2015. After randomization of the first pass modality, dual sampling with both EUS-FNB and EUS-FNA was performed in each lesion...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28812032/nonoperative-management-of-osteochondritis-dissecans-of-the-knee-progression-to-osteoarthritis-and-arthroplasty-at-mean-13-year-follow-up
#20
Thomas L Sanders, Ayoosh Pareek, Nick R Johnson, James L Carey, Travis G Maak, Michael J Stuart, Aaron J Krych
BACKGROUND: Osteochondritis dissecans (OCD) is a disorder of subchondral bone that commonly affects the knee. PURPOSE: To (1) evaluate the rate of arthritis and knee arthroplasty in a population-based cohort of patients with OCD lesions treated nonoperatively and (2) evaluate factors that may predispose patients to knee osteoarthritis and arthroplasty. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Eighty-six patients (mean age, 21...
July 2017: Orthopaedic Journal of Sports Medicine
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