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https://www.readbyqxmd.com/read/29777788/modified-transanosphincteric-york-mason-repair-of-non-radiated-rectourinary-fistulae-patient-reported-fecal-continence-outcomes
#1
Maxim J McKibben, Joceline S Fuchs, Alexander T Rozanski, Jeremy M Scott, Craig Olson, Farshid Araghizadeh, Allen F Morey
OBJECTIVES: To review our experience with the modified York Mason (MYM) procedure in treatment of rectourinary fistulae (RUF), and to assess fecal continence using patient reported measures. METHODS: Retrospective review was performed for patients who underwent MYM repair of non-radiated RUF with gluteal free fat graft from 2008 to 2016 at a single institution. Success was defined as resolution of fistula without need for further surgery. The Cleveland Clinic-Florida Wexner Fecal Incontinence Score (CCFFIS) and Patient Global Impression of Improvement (PGI-I) surveys were administered by phone...
May 16, 2018: Urology
https://www.readbyqxmd.com/read/29774313/echoes-from-the-40-th-annual-san-antonio-breast-cancer-symposium-2017
#2
Bekir Kuru
The Annual San Antonio Symposium was held on 5-9, December, 2017 in San Antonio, Texas, USA (1). As expected, many new studies were presented for the first time at the sessions. The unofficial opening lecture in my point of view was given on locoregional recurrence by Monica Morrow from MSKCC, New York. As always, Morrow's lecture on "Challenges in the surgical management of locoregional recurrence" attracted great interest. The other prominent conferences were given on "Individualizing Management of the Axillary Nodes" by Tari A...
April 2018: European Journal of Breast Health
https://www.readbyqxmd.com/read/29773456/custom-air-puff-derived-biomechanical-variables-in-a-refractive-surgery-screening-setting-study-from-2-centers
#3
Vinicius S De Stefano, Ibrahim Seven, J Bradley Randleman, William J Dupps
PURPOSE: To assess the ability of air puff-derived biomechanical variables to predict surgeon-perceived candidacy for laser in situ keratomileusis (LASIK). SETTING: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, and Emory Eye Institute, Emory University, Atlanta, Georgia, USA. DESIGN: Retrospective case series. METHODS: Data were collected from refractive surgery screening examinations by 2 surgeons at 2 centers...
May 15, 2018: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29771822/pulse-oximetry-and-arterial-oxygen-saturation-during-cardiopulmonary-exercise-testing
#4
Mona Ascha, Anirban Bhattacharyya, Jose A Ramos, Adriano R Tonelli
INTRODUCTION/PURPOSE: Peripheral capillary oxygen saturation (SpO2) is used as surrogate for arterial blood oxygen saturation. We studied the degree of discrepancy between SpO2 and arterial oxygen (SaO2) and identified parameters that may explain this difference. METHODS: We included patients who underwent cardiopulmonary exercise testing (CPET) at Cleveland Clinic. Pulse oximeters with forehead probes measured SpO2 and arterial blood gas (ABG) samples provided the SaO2 both at rest and peak exercise...
April 30, 2018: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/29771227/team-development-among-physician-leaders-at-the-cleveland-clinic
#5
Tracy H Porter, James K Stoller, Scott J Allen
Purpose Since 1990, the Cleveland Clinic has trained physicians in team skills through various iterations of a program called Leading in Healthcare (LHC). In the present study, the authors utilize a case study approach to gain insight into the LHC curriculum, and more specifically, the team project. The purpose of this paper is to better understand the Cleveland Clinic's position on the issue and its approach to education - specifically among physicians. Design/methodology/approach The authors utilized a case study approach with four key program architects...
May 8, 2018: Leadership in Health Services
https://www.readbyqxmd.com/read/29764498/talimogene-laherparepvec-combined-with-anti-pd-1-based-immunotherapy-for-unresectable-stage-iii-iv-melanoma-a-case-series
#6
Lillian Sun, Pauline Funchain, Jung Min Song, Patricia Rayman, Charles Tannenbaum, Jennifer Ko, Michael Mcnamara, C Marcela Diaz-Montero, Brian Gastman
BACKGROUND: Talimogene Laherparepvec (T-VEC) is an oncolytic virus approved as an intratumoral therapy for treating unresectable stage IIIB-IV metastatic melanoma. The mechanisms of action for T-VEC and checkpoint inhibitor are highly complementary. Recent studies have shown that combining checkpoint inhibitor therapy with T-VEC injection can lead to improved response rates for stage IIIB-IV melanoma patients. METHODS: We reviewed 10 consecutive cases of stage IIIC to stage IVM1b melanoma patients that received T-VEC plus checkpoint inhibitor(s) therapy (pembrolizumab, ipilimumab/nivolumab, or nivolumab) treated between June 2016 and August 2017 at the Cleveland Clinic with a median follow-up of 7 months (range: 4 to 13 months)...
May 16, 2018: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/29761298/lumbar-muscle-atrophy-caused-by-harness-replacement-in-a-chronic-calf-model-of-total-artificial-heart-implantation
#7
Jamshid H Karimov, Kimberly A Such, Raymond Dessoffy, Kiyotaka Fukamachi
The postoperative care of animals implanted with mechanical circulatory support devices is complex. The standard of care requires continuous monitoring of hemodynamic parameters post implant, wound care, and maintenance of the animal's well-being, but also includes controlling the animal's biomechanics under conditions of continuous restraint and harnessing. In such studies, a harness provides secure fixation of the exteriorized device driveline and pressure lines and aids animal handling (lifting, position adjustment, and assistance with standing up)...
May 14, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29755626/the-impact-of-admission-serum-creatinine-on-major-adverse-clinical-events-in-st-segment-elevation-myocardial-infarction-patients-undergoing-primary-percutaneous-coronary-intervention
#8
Poornima Vinod, Taylor Kann, Shyam Polaconda, Alibel Bello, Mohamed Khayata, Fernando Munoz, Vinod Krishnappa, Rupesh Raina
Background: Impaired renal function has been shown in previous studies to be an independent predictor of cardiovascular adverse events amongst patients admitted for percutaneous coronary intervention (PCI) following ST-segment elevation myocardial infarction (STEMI). This study investigates the impact of admission serum creatinine (SCr) on major cardiovascular outcomes among STEMI patients undergoing PCI. Methods: A retrospective study of patients admitted for PCI following STEMI was conducted using the National Cardiovascular Database Action Registry (NCDR) at Cleveland Clinic Akron General (CCAG) Hospital...
April 2018: Cardiology Research
https://www.readbyqxmd.com/read/29750891/using-hiv-surveillance-data-to-link-people-to-hiv-medical-care-5-us-states-2012-2015
#9
John Beltrami, Odessa Dubose, Reginald Carson, Janet C Cleveland
INTRODUCTION: From 2012 through 2015, the Centers for Disease Control and Prevention (CDC) provided funding to 5 health departments for demonstration projects using HIV surveillance data to link people with newly diagnosed HIV to care. We assessed how well these health departments established linkage to care, how the demonstration projects helped them with this work, and if they sustained these activities after CDC funding ended. MATERIALS AND METHODS: We obtained quantitative and qualitative data on linkage-to-care activities from health department communications and progress reports submitted to CDC...
January 1, 2018: Public Health Reports
https://www.readbyqxmd.com/read/29736283/chronic-pulmonary-silicone-embolism-from-breast-augmentation-is-not-a-common-finding-in-explanted-lungs
#10
Jarmanjeet Singh, Hanine Inaty, Sanjay Mukhopadhyay, Atul C Mehta
Objective: Acute pulmonary silicone embolism (APSE) related to subcutaneous silicone injections is a well-known entity. Recently, a few cases of pathologically confirmed chronic pulmonary silicone embolism (CPSE) from breast implants have been reported. The prevalence of CPSE in women with breast augmentation is unknown. This study was done to determine the prevalence of CPSE in female lung transplant recipients with a history of breast augmentation and to determine whether breast augmentation plays a role in chronic lung diseases requiring lung transplantation...
2018: Pulmonary Medicine
https://www.readbyqxmd.com/read/29726593/surgical-management-of-neck-pain-and-headache-associated-with-pediatric-hashimoto-s-thyroiditis
#11
Paul Krakovitz, Christine Cairns, Bahareh Michelle Schweiger, Brian Burkey
OBJECTIVES/HYPOTHESIS: Case reports of a painful variant of Hashimoto's thyroiditis exist in the literature; however, these cases have only been documented in adult patients and there are no standard treatment guidelines. The aim of this study was to describe an alternative management for Hashimoto's thyroiditis associated with medically intractable head and neck pain in the pediatric population. STUDY DESIGN: Case series with chart review. METHODS: The study was conducted in the Section of Pediatric Otolaryngology at the Cleveland Clinic...
May 4, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29724872/diet-and-lifestyle-recommendations-for-the-treatment-of-chronic-cough-and-chronic-disease
#12
Nathaniel Bergman, David S Riley, Michelle Beidelschies
Chronic cough, possibly due to toxicant exposure, may be improved by using a low-risk nutrition-centred strategy. A 71-year-old man experiencing chronic cough for the past 25 years presented to the Cleveland Clinic. In recent years, the patient's cough had increased in frequency and intensity despite pulmonary interventions. The patient's social history revealed exposures as a foundry worker to dimethylethylamine and triethylamine two known respiratory irritants. The patient was placed on a nutrition programme (nutrient dense, low glycaemic index and anti-inflammatory), encouraged to use a sauna each day and placed on nutraceutical supplementation that supports liver detoxification, digestive health and inflammation reduction...
May 2, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29719037/provider-variation-in-antibiotic-prescribing-and-outcomes-of-respiratory-tract-infections
#13
Mahesh Manne, Abhishek Deshpande, Bo Hu, Aditi Patel, Glen B Taksler, Anita D Misra-Hebert, Stacey E Jolly, Andrei Brateanu, Robert W Bales, Michael B Rothberg
OBJECTIVES: Inappropriate antibiotic use for respiratory tract infection (RTI) is an ongoing problem linked to the emergence of drug resistance and other adverse effects. Less is known about the prescribing practices of individual physicians or the impact of physician prescribing habits on patient outcomes. We studied the prescribing practices of providers for acute RTIs in an integrated health system, identified patient factors associated with receipt of an antibiotic and assessed the relation between providers' adjusted prescribing rates and a number of patient outcomes...
April 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29710329/chronic-meningitis-investigated-via-metagenomic-next-generation-sequencing
#14
Michael R Wilson, Brian D O'Donovan, Jeffrey M Gelfand, Hannah A Sample, Felicia C Chow, John P Betjemann, Maulik P Shah, Megan B Richie, Mark P Gorman, Rula A Hajj-Ali, Leonard H Calabrese, Kelsey C Zorn, Eric D Chow, John E Greenlee, Jonathan H Blum, Gary Green, Lillian M Khan, Debarko Banerji, Charles Langelier, Chloe Bryson-Cahn, Whitney Harrington, Jairam R Lingappa, Niraj M Shanbhag, Ari J Green, Bruce J Brew, Ariane Soldatos, Luke Strnad, Sarah B Doernberg, Cheryl A Jay, Vanja Douglas, S Andrew Josephson, Joseph L DeRisi
Importance: Identifying infectious causes of subacute or chronic meningitis can be challenging. Enhanced, unbiased diagnostic approaches are needed. Objective: To present a case series of patients with diagnostically challenging subacute or chronic meningitis using metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) supported by a statistical framework generated from mNGS of control samples from the environment and from patients who were noninfectious...
April 16, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29705060/the-use-of-vessel-sealing-devices-during-vaginal-hysterectomy
#15
Emily R W Davidson, Rosanne Kho
STUDY OBJECTIVE: To demonstrate the proper use of vessel sealing devices during vaginal hysterectomy DESIGN: An educational video reviewing the principles of vessel sealing devices and techniques for appropriate use SETTING: A university hospital; Cleveland Clinic Foundation, Cleveland, Ohio INTERVENTION: The video reviews the principles on the use of energy in minimally-invasive surgery. We focus on how vessel sealing devices function and the benefits of their use in difficult vaginal hysterectomy...
April 26, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29688032/setting-up-an-epathology-service-at-cleveland-clinic-abu-dhabi-joint-collaboration-with-cleveland-clinic-united-states
#16
Ayoub Nahal, Crystal Mildred O Batac, Renee J Slaw, Thomas W Bauer
CONTEXT: - The production of whole slide images is the most advanced form of digital pathology, in which a high-resolution digital scanner is used to rapidly scan glass microscope slides and produce a computer-generated whole slide image that can be saved, stored in a network-attached storage device, and accessed through slide management software within the hospital domain and remotely by authorized users. Digital transformation of glass slides has revolutionized the practice of anatomic pathology by facilitating and expediting consultative services, improving clinical workflow, and becoming an indispensable tool in education and research...
April 24, 2018: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/29685397/outcomes-of-outpatient-parenteral-antimicrobial-therapy-in-patients-with-injection-drug-use
#17
Mohsen Vazirian, Jason M Jerry, Nabin K Shrestha, Steven M Gordon
BACKGROUND: Historically, there has been a restrictive approach toward outpatient parenteral antimicrobial therapy (OPAT) in patients with injection drug use (IDU) due to the fear that they might utilize the intravenous catheter to inject illicit substances. OBJECTIVE: We tested the hypothesis that patients with current IDU on OPAT would have less favorable treatment outcomes compared to those without current IDU. METHODS: In this retrospective cohort chart review study of Cleveland Clinic OPAT registry, we identified patients with current IDU by both electronic and manual review...
March 3, 2018: Psychosomatics
https://www.readbyqxmd.com/read/29684172/emergency-department-visits-during-outpatient-parenteral-antimicrobial-therapy-a-retrospective-cohort-study
#18
Nabin K Shrestha, So Lim Kim, Susan J Rehm, Angela Everett, Steven M Gordon
Objectives: Patients receiving outpatient parenteral antimicrobial therapy (OPAT) may require emergency department (ED) visits to manage complications. This study's purpose was to identify risk factors for ED visits during OPAT and risk factors for hospitalization among patients with ED visits. Methods: All OPAT courses initiated between 1 January 2013 and 1 January 2017 at Cleveland Clinic were identified. The first OPAT course per patient was included. For these, ED visits within 30 days were identified...
April 18, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29679151/comparisons-of-the-surgical-outcomes-and-medical-costs-between-transferred-and-directly-admitted-patients-diagnosed-with-intestinal-obstruction-in-an-american-tertiary-referral-center
#19
Xian Hua Gao, Hanumant Chouhan, Emre Gorgun, Luca Stocchi, Gokhan Ozuner
PURPOSE: Intestinal obstruction is a leading cause of patient mortality and the most common reason for emergent operation in colorectal surgery. The influence of inter-hospital transfer on patients' outcomes varies greatly in different diseases. We aimed to compare the surgical outcomes and medical costs between transferred and directly admitted patients diagnosed with intestinal obstruction in an American tertiary referral center. METHODS: All intestinal obstruction patients operated in Cleveland Clinic from Jan 2012 to Dec 2016 were collected from a prospectively maintained database...
April 20, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29675660/rates-of-prevalent-colorectal-cancer-occurrence-in-persons-75-years-of-age-and-older-a-population-based-national-study
#20
Vijit Chouhan, Emad Mansoor, Sravanthi Parasa, Gregory S Cooper
BACKGROUND/AIMS: There is a lack of studies describing the epidemiology of colorectal cancer (CRC) in patients aged 75 years and older (elderly). Current guidelines recommend against routine screening colonoscopies in this population. We sought to describe the epidemiology of CRC in the elderly, utilizing a large, population-based database as this may impact screening guidelines in this population. METHODS: Utilizing a commercial database (Explorys Inc, Cleveland, OH), we identified a cohort of patients with a first-ever diagnosis of CRC between 2012 and 2017 based on the Systematized Nomenclature of Medicine-Clinical Terms...
April 19, 2018: Digestive Diseases and Sciences
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