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https://www.readbyqxmd.com/read/28820967/identifying-predictors-for-bleeding-in-hospitalized-cancer-patients-a-cohort-study
#1
Rushad Patell, Alejandra Gutierrez, Lisa Rybicki, Alok A Khorana
BACKGROUND: Bleeding and thrombosis are both major complications of hospitalization in cancer patients. Concern regarding bleeding risk may reduce compliance with thromboprophylaxis. We assessed incidence of major and clinically relevant non-major bleeding (MCRNMB) and identified risk factors associated with in-hospital bleeding risk in hospitalized cancer patients. METHODS: We conducted a retrospective cohort study of consecutive adults admitted to general oncology floor at Cleveland Clinic from 11/2012-12/2014 (n=3525)...
August 12, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28818349/fifteen-year-decrease-in-general-surgery-resident-breast-operative-experience-are-we-training-proficient-breast-surgeons
#2
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/28816783/association-of-testosterone-replacement-therapy-and-the-incidence-of-a-composite-of-postoperative-in-hospital-mortality-and-cardiovascular-events-in-men-undergoing-noncardiac-surgery
#3
Maged Y Argalious, Jing You, Guangmei Mao, Daniel Ramos, Sandeep Khanna, Kamal Maheshwari, Carlos Trombetta
BACKGROUND: Whether patients on testosterone replacement therapy undergoing noncardiac surgery have an increased risk of postoperative in-hospital mortality and cardiovascular events remains unknown. We therefore sought to identify the impact of testosterone replacement on the incidence of a composite of postoperative in-hospital mortality and cardiovascular events in men undergoing noncardiac surgery. METHODS: Data from male American Society of Anesthesiologists I through IV patients 40 yr or older who underwent noncardiac surgery between May 2005 and December 2015 at the Cleveland Clinic (Cleveland, Ohio) main campus were included...
September 2017: Anesthesiology
https://www.readbyqxmd.com/read/28813218/five-year-outcomes-after-on-pump-and-off-pump-coronary-artery-bypass
#4
A Laurie Shroyer, Brack Hattler, Todd H Wagner, Joseph F Collins, Janet H Baltz, Jacquelyn A Quin, G Hossein Almassi, Elizabeth Kozora, Faisal Bakaeen, Joseph C Cleveland, Muath Bishawi, Frederick L Grover
Background Coronary-artery bypass grafting (CABG) surgery may be performed either with cardiopulmonary bypass (on pump) or without cardiopulmonary bypass (off pump). We report the 5-year clinical outcomes in patients who had been included in the Veterans Affairs trial of on-pump versus off-pump CABG. Methods From February 2002 through June 2007, we randomly assigned 2203 patients at 18 medical centers to undergo either on-pump or off-pump CABG, with 1-year assessments completed by May 2008. The two primary 5-year outcomes were death from any cause and a composite outcome of major adverse cardiovascular events, defined as death from any cause, repeat revascularization (CABG or percutaneous coronary intervention), or nonfatal myocardial infarction...
August 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28793322/stool-consistency-is-significantly-associated-with-pain-perception
#5
Yukiko Shiro, Young-Chang Arai, Tatsunori Ikemoto, Kazuhiro Hayashi
BACKGROUND: Commensal as well as pathogenic bacteria can influence a variety of gut functions, thereby leading to constipation and diarrhea in severe cases. In fact, several researchers have reported evidence supporting the association between stool consistency or constipation and the Gut microbiome (GM) composition and dysbiosis. GM influences the human health and disease via the gut-brain axis. We thus hypothesized that the pathogenic bacteria increases pain perception to some extent, which means that there could be an association between stool consistency or constipation and pain perception of healthy subjects...
2017: PloS One
https://www.readbyqxmd.com/read/28790037/a-six-year-retrospective-analysis-of-cut-out-risk-predictors-in-cephalomedullary-nailing-for-pertrochanteric-fractures-can-the-tip-apex-distance-tad-still-be-considered-the-best-parameter
#6
G Caruso, M Bonomo, G Valpiani, G Salvatori, A Gildone, V Lorusso, L Massari
OBJECTIVES: Intramedullary fixation is considered the most stable treatment for pertrochanteric fractures of the proximal femur and cut-out is one of the most frequent mechanical complications. In order to determine the role of clinical variables and radiological parameters in predicting the risk of this complication, we analysed the data pertaining to a group of patients recruited over the course of six years. METHODS: A total of 571 patients were included in this study, which analysed the incidence of cut-out in relation to several clinical variables: age; gender; the AO Foundation and Orthopaedic Trauma Association classification system (AO/OTA); type of nail; cervical-diaphyseal angle; surgical wait times; anti-osteoporotic medication; complete post-operative weight bearing; and radiological parameters (namely the lag-screw position with respect to the femoral head, the Cleveland system, the tip-apex distance (TAD), and the calcar-referenced tip-apex distance (CalTAD))...
August 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28782277/long-term-outcome-of-intractable-constipation-treated-by-sacral-neuromodulation-a-comparison-between-children-and-adults
#7
Paul T J Janssen, Yannick M Meyer, Sander M J Van Kuijk, Marc A Benninga, Laurents P S Stassen, Nicole D Bouvy, Jarno Melenhorst, Stephanie O Breukink
AIM: Sacral neuromodulation (SNM) is a minimal invasive therapy for functional-constipation (FC) and is most often used to treat adults. Recent studies suggest that SNM may also beneficial in children. However, comparative data regarding preferred age of SNM for FC are lacking. Therefore, long-term results of SNM for FC were compared between children and adults. METHOD: All patients treated with SNM for FC between 2004 and 2015 were evaluated. Outcomes of children (age 10-18 years) were compared with adults (≥18 years)...
August 7, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28777386/effect-of-mannitol-on-globe-and-orbital-volumes-in-humans
#8
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/28776956/first-follow-up-radiographic-response-is-one-of-the-predictors-of-local-tumor-progression-and-radiation-necrosis-after-stereotactic-radiosurgery-for-brain-metastases
#9
Mayur Sharma, Xuefei Jia, Manmeet Ahluwalia, Gene H Barnett, Michael A Vogelbaum, Samuel T Chao, John H Suh, Erin S Murphy, Jennifer S Yu, Lilyana Angelov, Alireza M Mohammadi
Local progression (LP) and radiation necrosis (RN) occur in >20% of cases following stereotactic radiosurgery (SRS) for brain metastases (BM). Expected outcomes following SRS for BM include tumor control/shrinkage, local progression and radiation necrosis. 1427 patients with 4283 BM lesions were treated using SRS at Cleveland Clinic from 2000 to 2012. Clinical, imaging and radiosurgery data were collected from the database. Local tumor progression and RN were the primary end points and correlated with patient and tumor-related variables...
August 4, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28768314/low-dose-naltrexone-treatment-of-familial-benign-pemphigus-hailey-hailey-disease
#10
Omer Ibrahim, Sara R Hogan, Alok Vij, Anthony P Fernandez
Importance: Familial benign pemphigus, or Hailey-Hailey disease (HHD), is a rare and debilitating genetic dermatosis characterized by chronic, recurrent vesicles, erosions, and maceration in flexural areas. Despite the reported therapeutic modalities, such as topical and systemic corticosteroids, systemic immunomodulators, topical and systemic retinoids, and laser, HHD can still be markedly difficult to control. Objective: To assess low-dose naltrexone hydrochloride in the treatment of recalcitrant HHD...
August 2, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28767361/full-modelling-of-high-intensity-focused-ultrasound-and-thermal-heating-in-the-kidney-using-realistic-patient-models
#11
Visa Suomi, Jiri Jaros, Bradley Treeby, Robin Cleveland
OBJECTIVE: High-intensity focused ultrasound (HIFU) therapy can be used for non-invasive treatment of kidney (renal) cancer, but the clinical outcomes have been variable. In this study, the efficacy of renal HIFU therapy was studied using nonlinear acoustic and thermal simulations in three patients. METHODS: The acoustic simulations were conducted with and without refraction in order to investigate its effect on the shape, size and pressure distribution at the focus...
July 28, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28765496/impact-of-a-post-discharge-integrated-disease-management-program-on-copd-hospital-readmissions
#12
Ashlee N Russo, Gayathri Sathiyamoorthy, Chris Lau, Didem Saygin, Xiaozhen Han, Xiao-Feng Wang, Richard Rice, Loutfi S Aboussouan, James K Stoller, Umur Hatipoğlu
BACKGROUND: Readmission following a hospitalization for COPD is associated with significant health-care expenditure. METHODS: A multicomponent COPD post-discharge integrated disease management program was implemented at the Cleveland Clinic to improve the care of patients with COPD and reduce readmissions. This retrospective study reports our experience with the program. Groups of subjects who were exposed to different components of the program were compared regarding their readmission rates...
August 1, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28761992/novel-technique-for-airless-connection-of-artificial-heart-to-vascular-conduits
#13
Jamshid H Karimov, Shengqiang Gao, Raymond Dessoffy, Gengo Sunagawa, Martin Sinkewich, Patrick Grady, Shiva Sale, Nader Moazami, Kiyotaka Fukamachi
Successful implantation of a total artificial heart relies on multiple standardized procedures, primarily the resection of the native heart, and exacting preparation of the atrial and vascular conduits for pump implant and activation. Achieving secure pump connections to inflow/outflow conduits is critical to a successful outcome. During the connection process, however, air may be introduced into the circulation, traveling to the brain and multiple organs. Such air emboli block blood flow to these areas and are detrimental to long-term survival...
July 31, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28758558/acute-debakey-type-i-dissection-repair-using-frozen-elephant-trunk-the-cleveland-clinic-technique
#14
Muhammad Aftab, Ryan Plichta, Eric E Roselli
Over the past 3 decades, the standard surgical management for acute DeBakey type I aortic dissection has not significantly changed. Most patients undergo ascending aortic replacement with an interposition graft under hypothermic circulatory arrest with selective root replacement. Nevertheless, with the improvement in overall patient care, acute surgical outcomes continue to improve. The frozen elephant trunk (FET) technique was introduced as a modification to conventional elephant trunk to treat extensive degenerative and chronic dissecting aneurysms involving the aortic arch and the proximal descending aorta...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28756053/-patients-with-ulcerative-colitis-and-primary-sclerosing-cholangitis-frequently-have-subclinical-inflammation-in-the-proximal-colon
#15
Noa Krugliak Cleveland, David T Rubin, John Hart, Christopher R Weber, Katherine Meckel, Anthony L Tran, Arthur S Aelvoet, Isabella Pan, Alex Gonsalves, John Nick Gaetano, Kelli Williams, Kristen Wroblewski, Bana Jabri, Joel Pekow
BACKGROUND AND AIMS: Primary sclerosing cholangitis (PSC) patients with ulcerative colitis (UC) have a high risk of colonic neoplasia. As histologic inflammation is an independent risk factor for the development of neoplasia, we hypothesized that patients with UC and PSC have more subclinical disease activity than patients with UC alone. METHODS: We performed a retrospective evaluation of patients with ulcerative pancolitis who were in clinical remission and compared endoscopic and histologic activity between those with and without PSC...
July 26, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28739031/comparison-of-outcomes-of-pericardiocentesis-versus-surgical-pericardial-window-in-patients-requiring-drainage-of-pericardial-effusions
#16
Samuel E Horr, Amgad Mentias, Penny L Houghtaling, Andrew J Toth, Eugene H Blackstone, Douglas R Johnston, Allan L Klein
Comparative outcomes of patients undergoing pericardiocentesis or pericardial window are limited. Development of pericardial effusion after cardiac surgery is common but no data exist to guide best management. Procedural billing codes and Cleveland Clinic surgical registries were used to identify 1,281 patients who underwent either pericardiocentesis or surgical pericardial window between January 2000 and December 2012. The 656 patients undergoing an intervention for a pericardial effusion secondary to cardiac surgery were also compared...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28735139/cumulative-intracranial-tumor-volume-and-number-of-brain-metastasis-as-predictors-of-developing-new-lesions-after-stereotactic-radiosurgery-for-brain-metastasis
#17
Mayur Sharma, Xuefei Jia, Manmeet Ahluwalia, Gene H Barnett, Michael A Vogelbaum, Samuel T Chao, John H Suh, Erin S Murphy, Jennifer S Yu, Lilyana Angelov, Alireza M Mohammadi
INTRODUCTION: The aim of our study was to identify risk factors associated with early distant radiographic progression in patients undergoing stereotactic radiosurgery (SRS) for brain metastases (BM). METHODS: Following IRB approval, data of 1427 patients (4283 BM lesions) who were treated using SRS at Cleveland Clinic from 2000-2012 were collected. Local tumor progression (LTP), distant tumor progression (DTP) and radiographic radiation necrosis (RN) were the primary end points...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28725862/what-s-in-a-word-my-journey-toward-empathy-education-and-practice-at-the-cleveland-clinic
#18
Rachel M Taliercio
No abstract text is available yet for this article.
June 2017: Journal of patient experience
https://www.readbyqxmd.com/read/28725326/comparison-of-clopidogrel-with-prasugrel-and-ticagrelor-in-patients-with-acute-coronary-syndrome-clinical-outcomes-from-the-national-cardiovascular-database-action-registry
#19
Mohamed Khayata, Joseph N Gabra, M Farhan Nasser, George I Litman, Shyam Bhakta, Rupesh Raina
BACKGROUND: We aimed to compare the clinical outcomes of clopidogrel, prasugrel, and ticagrelor in clinical practice using the National Cardiovascular Database ACTION Registry(®). Treatment guidelines for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention recommend dual antiplatelet therapy (DAPT) for 12 months. Few clinical trials have compared the safety and efficacy of clopidogrel with that of newer antiplatelet therapies. METHODS: A retrospective study of patients hospitalized for ACS at Cleveland Clinic Akron General was conducted...
June 2017: Cardiology Research
https://www.readbyqxmd.com/read/28719316/high-mortality-and-coinfection-in-a-prospective-cohort-of-human-immunodeficiency-virus-acquired-immune-deficiency-syndrome-patients-with-histoplasmosis-in-guatemala
#20
Blanca Samayoa, Monika Roy, Angela Ahlquist Cleveland, Narda Medina, Dalia Lau-Bonilla, Christina M Scheel, Beatriz L Gomez, Tom Chiller, Eduardo Arathoon
Histoplasmosis is one of the most common and deadly opportunistic infections among persons living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome in Latin America, but due to limited diagnostic capacity in this region, few data on the burden and clinical characteristics of this disease exist. Between 2005 and 2009, we enrolled patients ≥ 18 years of age with suspected histoplasmosis at a hospital-based HIV clinic in Guatemala City. A case of suspected histoplasmosis was defined as a person presenting with at least three of five clinical or radiologic criteria...
July 2017: American Journal of Tropical Medicine and Hygiene
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