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https://www.readbyqxmd.com/read/29681886/importance-of-collateralization-in-patients-with-large-artery-intracranial-occlusive-disease-long-term-longitudinal-assessment-of-cerebral-hemodynamic-function
#1
Larissa McKetton, Lakshmikumar Venkatraghavan, Julien Poublanc, Olivia Sobczyk, Adrian P Crawley, Casey Rosen, Frank L Silver, James Duffin, Joseph A Fisher, David J Mikulis
Patients with large artery intracranial occlusive disease (LAICOD) are at risk for both acute ischemia and chronic hypoperfusion. Collateral circulation plays an important role in prognosis, and imaging plays an essential role in diagnosis, treatment planning, and prognosis of patients with LAICOD. In addition to standard structural imaging, assessment of cerebral hemodynamic function is important to determine the adequacy of collateral supply. Among the currently available methods of assessment of cerebral hemodynamic function, measurement of cerebrovascular reactivity (CVR) using blood oxygen level-dependent (BOLD) MRI and precisely controlled CO2 has shown to be a safe, reliable, reproducible, and clinically useful method for long-term assessment of patients...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29678488/medicolegal-considerations-involving-iatrogenic-lingual-nerve-damage
#2
REVIEW
Roberto Pippi, Andrea Spota, Marcello Santoro
The aim of this review is to improve risk management strategies through analysis of the anatomic, semeiotic, and medicolegal aspects that characterize iatrogenic lingual nerve damage (LND) and its legal consequences in the case of legal proceedings for a claim for compensation. In dental practice, LND can be caused by local or general anesthesia or by mechanical, chemical, or thermal mechanisms. A certain postoperative identification of LND etiopathogenesis is often very challenging because it can be difficult to show at what time the damage occurred and which mechanism actually caused it...
March 27, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29662295/should-hot-biopsy-forceps-be-abandoned-for-polypectomy-of-diminutive-colorectal-polyps
#3
Vasileios Panteris, Antonios Vezakis, J K Triantafillidis
Standardized approach to polypectomy of diminutive colorectal polyps (DCPs) is lacking since cold biopsy forceps have been associated with high levels of recurrence, hot biopsy forceps are considered inadequate and risky and cold snaring is currently under investigation for its efficacy and safety. This has led to confusion and a gap in clinical practice. This article discusses the usefulness and contemporary practical applicability of hot biopsy forceps and provides well-intentioned criticism of the new European guidelines for the treatment of DCPs...
April 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29658049/a-simple-microfluidic-platform-for-rapid-and-efficient-production-of-the-radiotracer-18-f-fallypride
#4
Xin Zhang, Fei Liu, Karla-Anne Knapp, Michael L Nickels, H Charles Manning, Leon M Bellan
Herein, we report the development of a simple, high-throughput and efficient microfluidic system for synthesizing radioactive [18F]fallypride, a PET imaging radiotracer widely used in medical research. The microfluidic chip contains all essential modules required for the synthesis and purification of radioactive fallypride. The radiochemical yield of the tracer is sufficient for multiple animal injections for preclinical imaging studies. To produce the on-chip concentration and purification columns, we employ a simple "trapping" mechanism by inserting rows of square pillars with predefined gaps near the outlet of microchannel...
April 16, 2018: Lab on a Chip
https://www.readbyqxmd.com/read/29627916/necrotizing-fasciitis-case-series-and-review-of-the-literature-on-clinical-and-medico-legal-diagnostic-challenges
#5
Paolo Fais, Alessia Viero, Guido Viel, Renzo Giordano, Dario Raniero, Stefano Kusstatscher, Chiara Giraudo, Giovanni Cecchetto, Massimo Montisci
Necrotizing fasciitis (NF) is a life-threatening infection of soft tissues spreading along the fasciae to the surrounding musculature, subcutaneous fat and overlying skin areas that can rapidly lead to septic shock and death. Due to the pandemic increase of medical malpractice lawsuits, above all in Western countries, the forensic pathologist is frequently asked to investigate post-mortem cases of NF in order to determine the cause of death and to identify any related negligence and/or medical error. Herein, we review the medical literature dealing with cases of NF in a post-mortem setting, present a case series of seven NF fatalities and discuss the main ante-mortem and post-mortem diagnostic challenges of both clinical and forensic interests...
April 7, 2018: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29604509/the-role-of-the-size-and-location-of-the-tumors-and-of-the-vertebral-anatomy-in-determining-the-structural-stability-of-the-metastatically-involved-spine-a-finite-element-study
#6
Fabio Galbusera, Zhihui Qian, Gloria Casaroli, Tito Bassani, Francesco Costa, Benedikt Schlager, Hans-Joachim Wilke
Vertebral fractures associated with the loss of structural integrity of neoplastic vertebrae are common, and determined to the deterioration of the bone quality in the lesion area. The prediction of the fracture risk in metastatically involved spines can guide in deciding if preventive solutions, such as medical prophylaxis, bracing, or surgery are indicated for the patient. In this study, finite element models of 22 thoracolumbar vertebrae were built based on CT scans of three spines, covering a wide spectrum of possible clinical scenarios in terms of age, bone quality and degenerative features, taking into account the local material properties of bone tissue...
March 28, 2018: Translational Oncology
https://www.readbyqxmd.com/read/29572339/-montgomery-informed-consent-and-causation-of-harm-lessons-from-australia-or-a-uniquely-english-approach-to-patient-autonomy
#7
Malcolm K Smith, Tracey Carver
The UK Supreme Court in Montgomery v Lanarkshire Health Board adopts an approach to information disclosure in connection with clinical treatment that moves away from medical paternalism towards a more patient-centred approach. In doing so, it reinforces the protection afforded to informed consent and autonomous patient decision making under the law of negligence. However, some commentators have expressed a concern that the widening of the healthcare providers' duty of disclosure may provide impetus, in future cases, for courts to adopt a more rigorous approach to the application of causation principles...
March 23, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29531613/knowledge-and-preparedness-of-dental-practitioners-on-management-of-medical-emergencies-in-jazan-province
#8
Ghassan M Al-Iryani, Fareedi Mukram Ali, Naima H Alnami, Sahar K Almashhur, Maha A Adawi, Abrar A Tairy
Medical emergencies are one of the most stressful situations the staff in a dental practice might encounter. The duty of care toward the attending patients obligates suitable preparedness to provide the necessary care if such emergencies ensue. Unfortunately, we found that 22% of the investigated dental clinics had no emergency kit available. Only 38% of the interviewed dentists felt confident to perform CPR, and 18% had no confidence to manage any medical emergency. An MCQ test of 20 questions examining the dentists' knowledge in medical emergencies was distributed, and the level of knowledge was found to be suboptimal...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29492556/a-waveform-archiving-system-for-the-ge-solar-8000i-bedside-monitor
#9
Andrea Fanelli, Rohan Jaishankar, Aristotelis Filippidis, James Holsapple, Thomas Heldt
OBJECTIVES:  Our objective was to develop, deploy, and test a data-acquisition system for the reliable and robust archiving of high-resolution physiological waveform data from a variety of bedside monitoring devices, including the GE Solar 8000i patient monitor, and for the logging of ancillary clinical and demographic information. MATERIALS AND METHODS:  The data-acquisition system consists of a computer-based archiving unit and a GE Tram Rac 4A that connects to the GE Solar 8000i monitor...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29457203/challenges-and-opportunities-in-establishing-and-maintaining-newborn-screening-in-a-rural-area-of-andhra-pradesh-task-force-study-by-indian-council-of-medical-research
#10
A Radha Rama Devi, Y Ananthalakshmi, K Srimannarayana Rao
OBJECTIVE: The primary objective was to evaluate the feasibility of setting up newborn screening in rural areas in India. Secondary objective was to enhance the knowledge and awareness towards early detection of diseases by newborn screening, management of the affected baby and to impart genetic counseling. METHODS: Awareness programs were conducted at different mandals in the district for the medical practioners during the preparatory phase of the Task Force Project...
February 19, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29424474/a-critical-review-of-the-application-of-polymer-of-low-concern-and-regulatory-criteria-to-fluoropolymers
#11
Barbara J Henry, Joseph P Carlin, Jon A Hammerschmidt, Robert C Buck, L William Buxton, Heidelore Fiedler, Jennifer Seed, Oscar Hernandez
Per- and polyfluoroalkyl substances (PFAS) are a group of fluorinated substances that are in the focus of researchers and regulators due to widespread presence in the environment and biota, including humans, of perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). Fluoropolymers, high molecular weight polymers, have unique properties that constitute a distinct class within the PFAS group. Fluoropolymers have thermal, chemical, photochemical, hydrolytic, oxidative, and biological stability. They have negligible residual monomer and oligomer content and low to no leachables...
February 9, 2018: Integrated Environmental Assessment and Management
https://www.readbyqxmd.com/read/29413639/biotin-and-acetazolamide-for-treatment-of-an-unusual-child-with-autism-plus-lack-of-nail-and-hair-growth
#12
Paul J Benke, Michael Duchowny, Dianalee McKnight
BACKGROUND: Patients with autism spectrum disorder and developmental delay or encephalopathy rarely demonstrate no or negligible hair and nail growth, suggesting a biotin-responsive clinical disorder. METHODS: A ten-year-old girl presented with features of autism spectrum disorder, isolated headaches, and episodes of headaches and limb shaking. Her medical history revealed that her hair and nails did not grow. Administration of biotin restored her nail and hair growth and improved intellectual ability and school performance...
February 2018: Pediatric Neurology
https://www.readbyqxmd.com/read/29390862/financial-incentives-for-chronic-disease-management-results-and-limitations-of-2-randomized-clinical-trials-with-new-york-medicaid-patients
#13
Eric M VanEpps, Andrea B Troxel, Elizabeth Villamil, Kathryn A Saulsgiver, Jingsan Zhu, Jo-Yu Chin, Jacqueline Matson, Joseph Anarella, Patrick Roohan, Foster Gesten, Kevin G Volpp
PURPOSE: To identify whether financial incentives promote improved disease management in Medicaid recipients diagnosed with hypertension or diabetes, respectively. DESIGN: Four-group, multicenter, randomized clinical trials. SETTING AND PARTICIPANTS: Between 2013 and 2016, New York State Medicaid managed care members diagnosed with hypertension (N = 920) or with diabetes (N = 959). INTERVENTION: Participants in each 6-month trial were randomly assigned to 1 of 4 arms: (1) process incentives-earned by attending primary care visits and/or receiving prescription medication refills, (2) outcome incentives-earned by reducing systolic blood pressure (hypertension) or hemoglobin A1c (HbA1c ; diabetes) levels, (3) combined process and outcome incentives, and (4) control (no incentives)...
January 1, 2018: American Journal of Health Promotion: AJHP
https://www.readbyqxmd.com/read/29379382/indicators-for-medical-mistrust-in-healthcare-a-review-and-standpoint-from-southeast-asia
#14
REVIEW
Hew Hei Choy, Aniza Ismail
The relationship based on trust is exceptionally important in healthcare, where life or death and quality of health are major concerns. Relational crack jeopardises the provision of quality healthcare when trust is taken for granted. Trust is believed to be the vital key to minimise medical negligence, lawsuits and patient complaints towards healthcare providers while acting as an empowering agent to significant clinical outcomes. Trust is indispensable to healthcare. However, to identify its deterioration is not a simple feature...
December 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29361180/prevalence-of-burnout-among-pain-medicine-physicians-and-its-potential-effect-upon-clinical-outcomes-in-patients-with-oncologic-pain-or-chronic-pain-of-nononcologic-origin
#15
Irene Riquelme, José-Ignacio Chacón, Alba-Violeta Gándara, Inmaculada Muro, Susana Traseira, Vicente Monsalve, José-Francisco Soriano
Objective: To evaluate the prevalence of burnout among physicians treating patients with chronic pain and to assess the potential relationships between the presence of burnout and patients' clinical outcomes such as pain relief, satisfaction with pain control, and quality of life. Design: An observational, prospective, and noncomparative study. Setting: Pain medicine clinics. Subjects: Physicians from medical departments involved in the management of chronic pain...
January 19, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29359673/non-traditional-cardiovascular-risk-markers-in-the-era-of-established-major-risk-factors-and-multiple-guidelines
#16
Thomas F Whayne
The non-traditional cardiovascular (CV) risk factors that appear to be of most clinical interest include: apolipoprotein A (ApoA), apolipoprotein B (ApoB), high-sensitivity C-Reactive protein (hsCRP), homocysteine, interleukin 1 (IL1), lipoprotein (a) [Lp(a)], the density of low-density lipoprotein (LDL) particles, the LDL particle number, tissue/tumor necrosis factor-α (TNF-α) and uric acid. These non-traditional risk factors may be of value in adding further confirmation and attention to suspected significant CV risk...
January 22, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29343085/a-lack-of-systemic-absorption-following-the-repeated-application-of-topical-quetiapine-in-healthy-adults
#17
Bryce Kayhart, Maria I Lapid, Sarah Nelson, Julie L Cunningham, Virginia H Thompson, Jonathan G Leung
In the absence of suitable oral or intravenous access for medication administration and when the intramuscular medications are undesirable, alternative routes for drug delivery may be considered. Antipsychotics administered via an inhaled, intranasal, rectal, or topical route have been described in the literature. Topically administered antipsychotics have been previously reported to produce negligible systemic absorption despite being used in clinical practice for nausea and behavioral symptoms associated with dementia...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29290546/characteristics-of-claims-in-the-management-of-septic-arthritis-in-japan-retrospective-analyses-of-judicial-precedents-and-closed-claims
#18
Yasuhiro Otaki, Makiko Ishida DaSilva, Yuichi Saito, Yasuaki Oyama, Giichiro Oiso, Tomohiko Yoshida, Masakazu Fukuhara, Mitsuru Moriyama
BACKGROUND: Septic arthritis (SA) cases can result in claims or litigation because of poor prognosis even if it is unavoidable. Although these claims or litigation are useful for understanding causes and background factors of medical errors, the characteristics of malpractice claims associated with SA remain undetermined in Japan. This study aimed to increase our understanding of malpractice claims in the clinical management of SA. METHODS: We analyzed 6 civil precedents and 16 closed claims of SA from 8530 malpractice claims processed between July 2004 and June 2014 by the Tokyo office of Sompo Japan Nipponkoa Insurance, Incorporated...
March 2018: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29241615/provision-of-medical-supply-kits-to-improve-quality-of-antenatal-care-in-mozambique-a-stepped-wedge-cluster-randomised-trial
#19
RANDOMIZED CONTROLLED TRIAL
Ana Pilar Betrán, Eduardo Bergel, Sally Griffin, Armando Melo, My Huong Nguyen, Alicia Carbonell, Santos Mondlane, Mario Merialdi, Marleen Temmerman, A Metin Gülmezoglu
BACKGROUND: High levels of maternal and newborn mortality and morbidity remain a daunting reality in many low-income countries. Several interventions delivered during antenatal care have been shown to improve maternal and newborn outcomes, but stockouts of medical supplies at point of care can prevent implementation of these services. We aimed to evaluate whether a supply chain strategy based on the provision of kits could improve quality of care. METHODS: We did a pragmatic, stepped-wedge, cluster-randomised controlled trial at ten antenatal care clinics in Mozambique...
January 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29196112/long-term-outcomes-and-prognostic-factors-in-patients-with-mild-hemoptysis
#20
Joonsung Choi, Jun Hyun Baik, Chi Hong Kim, So Hyang Song, Sung Kyung Kim, Myeongjong Kim, Sungeun Yun
OBJECTIVE: The aim of this retrospective study was to observe the long-term outcomes of conservative treatment and bronchial artery embolization (BAE) in patients with mild hemoptysis and to analyze the risk factors associated with hemoptysis recurrence. METHODS: Patients with mild hemoptysis from January 2005 to January 2016 were enrolled in this study. The patients' medical records, including smoking history, etiologic diseases, bronchoscopic findings, mortality, BAE information, and follow-up data of recurrent hemoptysis, were reviewed and analyzed...
November 27, 2017: American Journal of Emergency Medicine
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