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https://www.readbyqxmd.com/read/29793050/small-scale-managed-marine-areas-over-time-developments-and-challenges-in-a-local-fijian-reef-fishery
#1
Elodie Fache, Annette Breckwoldt
This paper investigates the Locally Managed Marine Area (LMMA) approach through looking at developments and challenges of community-based marine resource management over time, with a particular focus on Fiji in the South Pacific region. A diachronic perspective, based on two multi-method empirical studies, is used to exemplify the social complexities of the implementation of this LMMA approach in a specific island setting. This perspective connects local stakeholders' establishment and management of a LMMA covering their entire customary fishing rights area (iqoliqoli) with the national context articulated around the Fiji Locally Managed Marine Area (FLMMA) network, as well as with regional networking and international conservation dynamics...
May 21, 2018: Journal of Environmental Management
https://www.readbyqxmd.com/read/29793015/right-atrial-anomalous-muscle-bundle-presenting-with-acute-superior-vena-cava-syndrome-and-pulmonary-embolism-surgical-management
#2
Jeko M Madjarov, Michael G Katz, Sophia Madjarova, Svetozar Madzharov, Frank R Arko, David W Miller, Francis Robicsek
BACKGROUND: An anomalous muscle bundle crossing the right atrial cavity represents a pathological finding with unproved clinical significance. This congenital anomaly may be difficult to recognize via echocardiography and could be confused with other intra-cavitary lesions. METHODS: We report a case of a 53-year-old female presented to the cardio-vascular service with acute superior vena cava syndrome and sub-massive pulmonary embolism. RESULTS: The patient underwent venography confirming superior vena cava stenosis...
May 21, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29792979/immune-checkpoint-inhibitor-toxicity-review-for-the-palliative-care-clinician
#3
Eric D Hansen, Xiao Wang, Amy A Case, Igor Puzanov, Tom Smith
Immune checkpoint inhibitors (ICI) have opened an exciting chapter in the treatment of patients with advanced cancer. For the palliative care clinician, however, ICI present several new challenges, including new ways to define treatment success, as well as treatment-related toxicities which differ in nature and timing from traditional chemotherapy. In this article, we review the mechanism of action of immune checkpoint inhibitors, as well as selected published data supporting the efficacy of ICI in patients with advanced cancer...
May 21, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29792881/the-temporal-association-of-robotic-surgical-diffusion-with-overtreatment-of-the-small-renal-mass
#4
Paras H Shah, Manaf A Alom, Bradley C Leibovich, R Houston Thompson, Robert G Uzzo, Louis R Kavoussi, Lee Richstone, Bimal Bhindi, Elizabeth B Habermann, Vidhu Joshi, Stephen A Boorjian
PURPOSE: To evaluate contemporary practice patterns in the management of small renal masses. METHODS: We identified 52,804 patients within the National Cancer Database diagnosed with a small renal mass (≤4cm) between 2010-2014. Utilization trends for active surveillance, ablation, and robotic, laparoscopic, and open surgical techniques were compared among all-comers, elderly patients (≥75 years) and individuals with competing health risks (Charlson index ≥2)...
May 21, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29792839/patient-choice-of-adjunctive-non-pharmacologic-pain-management-during-first-trimester-abortion-a-randomized-controlled-trial
#5
Mary Tschann, Jennifer Salcedo, Reni Soon, Bliss Kaneshiro
OBJECTIVE: To determine if offering patients a choice of adjunctive non-pharmacologic pain management during first-trimester aspiration abortion results in lower pain scores than seen without offering these additional measures. STUDY DESIGN: We enrolled women receiving first-trimester aspiration abortion at the University of Hawai'i. We randomized patients to standard care (control), or standard care plus a choice of non-pharmacologic pain management options (intervention)...
May 21, 2018: Contraception
https://www.readbyqxmd.com/read/29792837/total-avulsed-ear-management-with-radial-forearm-free-flap
#6
Uzair Luqman, Zahid Qayyum, Zahid Furqan, Kaleem Ullah
Avulsive injuries to the ear are extremely challenging to treat. The literature documents numerous ways to manage such injuries. This report describes a case of total auricular cartilaginous avulsion that occurred during a motor vehicle accident. The avulsed segment had an ischemia time longer than 8 hours by the time of presentation at the authors' tertiary care facility. The avulsed segment was de-epithelialized and embedded into the volar forearm. After a healing period of 6 months, a radial forearm free flap was harvested and the ear was reconstructed...
April 28, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29792785/two-cases-of-combined-patellar-tendon-avulsion-from-the-tibia-and-patella
#7
Viachaslau Bradko, William T Stoll, Lee S Haruno, Scott B Rosenfeld, Scott D McKay
Avulsion fractures of the inferior pole of the patella and proximal tibial apophysis are independently rare injuries. They occur in children due to the relative weakness of the apophyseal cartilage compared to the ligaments and tendons. The combination of these two fractures, is exceedingly rare, with only a few previously described cases in the literature. Due to the infrequent presentation of this injury, careful examination and consideration of advanced imaging is important for diagnosis and preoperative planning...
2018: SICOT-J
https://www.readbyqxmd.com/read/29792540/cerebral-amyloid-angiopathy-diagnosis-and-potential-therapies
#8
Stewart A Weber, Ranish K Patel, Helmi L Lutsep
Cerebral amyloid angiopathy (CAA) is characterized by the pathologic deposition of amyloid-beta within cortical and leptomeningeal arteries, arterioles, capillaries and, in rare cases, the venules of the brain. It is often associated with the development of lobar intracerebral hemorrhages but may cause other neurologic symptoms or be asymptomatic. Magnetic resonance imaging characteristics, such as lobar microbleeds, support a diagnosis of CAA and assist with hemorrhage risk assessments. Immunosuppressants are used to treat rarer inflammatory forms of CAA...
May 24, 2018: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/29792263/an-update-on-the-use-of-immunohistochemistry-and-molecular-pathology-in-the-diagnosis-of-pre-invasive-and-malignant-lesions-in-gynecological-oncology
#9
REVIEW
Emmanouil Kalampokas, Fiona Payne, Mahalakshmi Gurumurthy
OBJECTIVE: One of the most common challenges in everyday clinical practice of gynecological oncology is to identify the type and the primary origin of a tumor. This is a crucial step in the management, treatment, prognosis, and survival of patients suffering from a gynecological malignancy. Immunohistochemistry has been widely adopted over the last three decades in pathology laboratories all over the world. Recent advances in our understanding of the differentiation of gynecological tumors based on immunohistochemical expression have resulted in use of immunohistochemistry as a major diagnostic tool in gynecology, for precise tumor classification...
May 21, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29792228/field-evaluation-of-an-immunochromatographic-test-for-diagnosis-of-cystic-and-alveolar-echinococcosis
#10
Chun-Hua Gao, Jun-Yun Wang, Feng Shi, Dietmar Steverding, Xia Wang, Yue-Tao Yang, Xiao-Nong Zhou
BACKGROUND: The larval stages of the tapeworms Echinocoocus granulosus and Echinococcus multilocularis are the causative agents of human cystic echinococcosis (CE) and human alveolar echinococcosis (AE), respectively. Both CE and AE are chronic diseases characterised by long asymptomatic periods of many years. However, early diagnosis of the disease is important if treatment and management of echinococcosis patients are to be successful. METHODS: A previously developed rapid diagnostic test (RDT) for the differential detection of CE and AE was evaluated under field conditions with finger prick blood samples taken from 1502 people living in the Ganzi Tibetan Autonomous Prefecture, China, a region with a high prevalence for both forms of human echinococcosis...
May 23, 2018: Parasites & Vectors
https://www.readbyqxmd.com/read/29792218/sudden-cardiac-arrest-under-spinal-anesthesia-in-a-mission-hospital-a-case-report-and-review-of-the-literature
#11
Bamidele Johnson Alegbeleye
BACKGROUND: Sudden cardiac arrest following spinal anesthesia is relatively uncommon and a matter of grave concern for any anesthesiologist as well as clinicians in general. There have been, however, several reports of such cases in the literature. Careful patient selection, appropriate dosing of the local anesthetic, volume loading, close monitoring, and prompt intervention at the first sign of cardiovascular instability should improve outcomes. The rarity of occurrence and clinical curiosity of this entity suggest reporting of this unusual and possibly avoidable clinical event...
May 24, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29792178/anti-ganglioside-complex-antibody-profiles-in-a-recurrent-complicated-case-of-gq1b-seronegative-miller-fisher-syndrome-and-bickerstaff-brainstem-encephalitis-a-case-report
#12
Hiroto Ito, Yuki Hatanaka, Yuki Fukami, Yumiko Harada, Rei Kobayashi, Hisashi Okada, Ayumi Uchibori, Atsuro Chiba, Satoshi Okuda
BACKGROUND: Guillain-Barré syndrome (GBS), Miller Fisher syndrome (MFS) and Bickerstaff brainstem encephalitis (BBE) are a group of autoimmune neurological disorders (GBS spectrum disorder) that rarely recur. Recently, anti-ganglioside complex antibodies (GSC-Abs) were identified in patients with GBS spectrum disorder. However, there has been no case report describing GSC-Abs profiles in a recurrent case showing different phenotypes. CASE PRESENTATION: We report the case of a 33-year-old male patient with GQ1b-seronegative BBE-GBS after two prior episodes of MFS-GBS...
May 23, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29792165/molecular-characterization-and-differential-expression-suggested-diverse-functions-of-p-type-ii-ca-2-atpases-in-triticum-aestivum-l
#13
Mehak Taneja, Santosh Kumar Upadhyay
BACKGROUND: Plant P-type II Ca2+ ATPases are formed by two distinct groups of proteins (ACAs and ECAs) that perform pumping of Ca2+ outside the cytoplasm during homeostasis, and play vital functions during development and stress management. In the present study, we have performed identification and characterisation of P-type II Ca 2+ ATPase gene family in an important crop plant Triticum aestivum. RESULTS: Herein, a total of 33 TaACA and 9 TaECA proteins were identified from the various chromosomes and sub-genomes of Triticum aestivum...
May 23, 2018: BMC Genomics
https://www.readbyqxmd.com/read/29792146/use-of-bipolar-radiofrequency-catheter-ablation-in-treatment-of-cardiac-arrhythmias
#14
Filip Soucek, Zdenek Starek
Background Arrhythmia management is a complex process involving both pharmacological and non-pharmacological approaches. Radiofrequency ablation is the pillar of non-pharmacological arrhythmia treatment. Unipolar ablation is considered to be the gold standard in the treatment of the majority of arrhythmias; however, its efficacy is limited to specific cases. In particular, the creation of deep or transmural lesions to eliminate intramurally originating arrhythmias remains inadequate. Bipolar ablation is proposed as an alternative to overcome unipolar ablation boundaries...
May 23, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29792122/drug-cost-avoidance-in-clinical-trials-of-breast-cancer
#15
M Mañes-Sevilla, R Romero-Jiménez, A Herranz-Alonso, M Sánchez-Fresneda, E Gonzalez-Haba, R Collado-Borrel, J Benedi-González, M Sanjurjo-Sáez
Background The objectives of this study were to determine if clinical trials in breast cancer, with an investigational drug, created direct drug cost savings for the healthcare system related to cost avoidance of the best standard of care treatments used in these studies. The aim was to quantify this potential drug cost avoidance. Methods We conducted a retrospective observational study of the drug cost avoidance during the study period (2014-2016). We included clinical trials with investigational drug, managed by pharmacy department and provided by the sponsor...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29792095/what-is-the-effect-of-intertwin-delivery-interval-on-the-outcome-of-the-second-twin-delivered-vaginally
#16
Paola Algeri, Clelia Callegari, Salvatore Andrea Mastrolia, Letizia Brienza, Isadora Vaglio Tessitore, Giuseppe Paterlini, Maddalena Incerti, Sabrina Cozzolino, PatriziaVergani
OBJECTIVE: Optimal management of twin deliveries is controversial. We aimed to assess if intertwin delivery interval, after vaginal delivery of the first twin, may have an influence on adverse neonatal outcomes of the second twin Study design: This is a retrospective observational study including diamniotic twin pregnancies with vaginal delivery of the first twin, between January 2000 and July 2017. Inclusion criteria were diamniotic pregnancies and vaginal delivery of the first twin...
May 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29791988/-liver-abscess-secondary-to-perforation-after-duodenal-endoscopic-resection
#17
Seung Ho Choi, Su Jin Kim, Dae Hwan Kang, Hyung Wook Kim, Cheol Woong Choi, Tae Un Kim, Jeong Seok Lee, Ji Hwan Ko
Duodenal perforation is a complication of endoscopic mucosal resection. Liver abscess secondary to iatrogenic perforation is extremely rare. A 43-year-old female visited the hospital to remove a sub-epithelial tumor on the duodenal bulb. After endoscopic mucosal resection with band ligation, duodenal perforation occurred. Endoscopic closure was performed successfully using a clipping device to manage duodenal perforation. After 4 weeks, the patient visited our outpatient clinic due to abdominal pain and fever...
May 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29791985/-management-of-acute-cholecystitis
#18
REVIEW
Seung Ok Lee, Sung Kyun Yim
Acute cholecystitis is a common serious complication of gallstones. The reported mortality of acute cholecystitis is approximately 3%, but the rate increases with age or comorbidity of the patient. If appropriate treatment is delayed, complications can develop as a consequence with a grave prognosis. The current standard of care in acute cholecystitis is an early laparoscopic cholecystectomy with the appropriate administration of fluid, electrolyte, and antibiotics. On the other hand, the severity of the disease and patient's operational risk must be considered...
May 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29791982/-management-of-intrahepatic-duct-stone
#19
REVIEW
Sang Woo Cha
Intrahepatic duct (IHD) stone is the presence of calculi within the intrahepatic bile duct specifically located proximal to the confluence of the left and right hepatic ducts. This stone is characterized by its intractable nature and frequent recurrence, requiring multiple therapeutic interventions. Without proper treatment, biliary strictures and retained stones can lead to repeated episodes of cholangitis, liver abscesses, secondary biliary cirrhosis, portal hypertension, and death from sepsis or hepatic failure...
May 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29791966/outcomes-of-bethesda-categories-iii-and-iv-thyroid-nodules-over-5-years-and-performance-of-the-afirma-gene-expression-classifier-a-single-institution-study
#20
Kelsi E Deaver, Bryan R Haugen, Nikita Pozdeyev, Carrie B Marshall
OBJECTIVE: The second edition Bethesda System for Reporting Thyroid Cytology estimates 6-18% malignancy rate of category III (B3) and 10-40% for category IV (B4) nodules; however, reported malignancy rates have considerable variability among institutions. Use of molecular classifiers (including Afirma Gene Expression Classifier, GEC) can be utilized in management of thyroid nodules. Our objective was to analyze malignancy rates of B3 and B4 nodules and determine clinical outcomes of GEC Benign nodules...
May 23, 2018: Clinical Endocrinology
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