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https://www.readbyqxmd.com/read/28931255/initial-single-center-technical-experience-with-the-brainpath-system-for-acute-intracerebral-hemorrhage-evacuation
#1
Andrew M Bauer, Peter A Rasmussen, Mark D Bain
BACKGROUND: Surgical intervention has been proposed as a means of reducing the high morbidity and mortality associated with acute intracerebral hemorrhage (ICH), but many previously reported studies have failed to show a clinically significant benefit. Newer, minimally invasive approaches have shown some promise. OBJECTIVE: We report our early single-center technical experience with minimally invasive clot evacuation using the BrainPath system. METHODS: Prospective data were collected on patients who underwent ICH evacuation with BrainPath at the Cleveland Clinic from August 2013 to May 2015...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28930707/re-evaluating-the-ethics-of-uterine-transplantation
#2
Danish Zaidi
In February 2016, the Cleveland Clinic initiated the first attempt at cadaveric uterine transplantation (UTx) in the United States. The transplantation was ultimately unsuccessful, but it opened doors for further research on both live and cadaveric UTx. While initial strides toward successful transplantation have been made, questions persist on the ethics of UTx: whether the uterus is a vital organ, whether we should prioritize live or cadaveric options, and how the procedure should be covered by health insurance...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28928129/new-advances-and-challenges-of-targeting-cancer-stem-cells
#3
Nurmaa K Dashzeveg, Rokana Taftaf, Erika K Ramos, Luke Torre-Healy, Anastasia Chumakova, Daniel J Silver, Tyler J Alban, Maksim Sinyuk, Praveena S Thiagarajan, Awad M Jarrar, Soumya M Turaga, Caner Saygin, Erin Mulkearns-Hubert, Masahiro Hitomi, Jeremy N Rich, Stanton L Gerson, Justin D Lathia, Huiping Liu
The second International Cancer Stem Cell Conference in Cleveland, Ohio, on September 20-23, 2016, convened 330 attendees from academic, industrial, and clinical organizations. It featured a debate on the concepts and challenges of the cancer stem cells (CSC) as well as CSC-centered scientific sessions on clinical trials, genetics and epigenetics, tumor microenvironment, immune suppression, metastasis, therapeutic resistance, and emerging novel concepts. The conference hosted 35 renowned speakers, 100 posters, 20 short talks, and a preconference workshop...
September 19, 2017: Cancer Research
https://www.readbyqxmd.com/read/28927976/quality-of-life-outcomes-in-children-with-hirschsprung-disease
#4
Lucy Collins, Brennan Collis, Misel Trajanovska, Rija Khanal, John M Hutson, Warwick J Teague, Sebastian K King
BACKGROUND: Morbidity following repair of Hirschsprung disease (HD) is common. However, quality of life (QoL) results focused on HD children are contradictory. We aimed to measure QoL outcomes in HD children using validated questionnaires. METHODS: Patients with HD, managed at a large tertiary pediatric institution between 2004 and 2013, were identified. Parents completed validated questionnaires. Results were compared with published healthy population controls...
September 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28920007/towards-treatment-of-stargardt-disease-workshop-organized-and-sponsored-by-the-foundation-fighting-blindness
#5
REVIEW
Avery E Sears, Paul S Bernstein, Artur V Cideciyan, Carel Hoyng, Peter Charbel Issa, Krzysztof Palczewski, Philip J Rosenfeld, SriniVas Sadda, Ulrich Schraermeyer, Janet R Sparrow, Ilyas Washington, Hendrik P N Scholl
Accumulation of fluorescent metabolic byproducts of the visual (retinoid) cycle is associated with photoreceptor and retinal pigment epithelial cell death in both Stargardt disease and atrophic (nonneovascular) age-related macular degeneration (AMD). As a consequence of this observation, small molecular inhibitors of enzymes in the visual cycle were recently tested in clinical trials as a strategy to protect the retina and retinal pigment epithelium in patients with atrophic AMD. To address the clinical translational needs for therapies aimed at both diseases, a workshop organized by the Foundation Fighting Blindness was hosted by the Department of Pharmacology at Case Western Reserve University on February 17, 2017, at the Tinkham Veale University Center, Cleveland, OH, USA...
September 2017: Translational Vision Science & Technology
https://www.readbyqxmd.com/read/28918677/prevalence-of-anal-incontinence-in-a-working-population-within-a-healthcare-environment
#6
Carlos Cerdán Santacruz, Rocío Santos Rancaño, Marta Vigara García, Cristina Fernández Pérez, Mario Ortega López, Javier Cerdán Miguel
OBJECTIVES: Anal incontinence is a devastating affliction with several considerations that make it difficult to define in terms of epidemiology with good precision. The aim of the present work is to study the prevalence of an important disorder such as anal incontinence in a healthy working population within a sanitary environment. MATERIAL AND METHODS: A cluster of easy understanding and filling inquiry forms are distributed to 910 apparently healthy individuals at our hospital...
September 18, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28912038/proton-pump-inhibitor-use-is-associated-with-a-reduced-risk-of-infection-with-intestinal-protozoa
#7
Johnathan M Sheele
OBJECTIVE: Proton pump inhibitors (PPIs) can kill some human protozoan parasites in cell culture better than the drug metronidazole. Clinical data showing an antiprotozoal effect for PPIs are lacking. The objective of the study is to determine if PPI use is associated with a reduced risk of having intestinal parasites. METHODS: We obtained electronic medical record data for all persons who received a stool ova and parasite (O & P) examination at our tertiary care academic medical center in Cleveland, Ohio, between January 2000 and September 2014...
September 11, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28902668/functional-results-and-quality-of-life-following-magnetic-anal-sphincter-augmentation-in-severely-incontinent-patients
#8
Mia Kim, Guillaume Meurette, Ramasamy Ragu, Vincent Wyart, Paul Antoine Lehur
OBJECTIVE: Magnetic anal sphincter augmentation is a novel surgical option in the treatment of severe fecal incontinence. This study aimed to analyze functional results, quality of life, and satisfaction after implantation in the mid-term, and to identify factors associated with success of this new treatment. METHODS: All patients, who underwent magnetic anal sphincter augmentation procedure at a single center between December 2008 and January 2016, were consecutively included...
September 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28892987/a-comparison-of-the-clinico-radiological-outcomes-with-proximal-femoral-nail-pfn-and-proximal-femoral-nail-antirotation-pfna-in-fixation-of-unstable-intertrochanteric-fractures
#9
Anirudh Sharma, Anupam Mahajan, Bobby John
INTRODUCTION: Management of unstable intertrochanteric fractures poses challenges in terms of obtaining stable fixation and good postoperative outcomes. There is a paucity of clinical data comparing the commonly used Proximal Femoral Nail (PFN) and Proximal Femoral Nail Antirotation (PFNA) implants, especially in relation to osteoporosis. AIM: To assess comparative performance of PFN and PFNA in the setting of osteoporosis. MATERIALS AND METHODS: Patients presenting with unstable intertrochanteric fractures (AO 31...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28891839/the-relative-effects-of-dexmedetomidine-and-propofol-on-cerebral-blood-flow-velocity-and-regional-brain-oxygenation-a-randomised-noninferiority-trial
#10
Ehab Farag, Michael Kot, Attila Podolyak, Maged Argalious, Milind Deogaonkar, Edward J Mascha, Zekun Xu, Irene Katzan, Zeyd Ebrahim
BACKGROUND: Dexmedetomidine constricts cerebral blood vessels without a concomitant reduction in cerebral metabolic oxygen consumption. Its safety as a sedative in patients with neurological diseases thus remains uncertain. OBJECTIVE: Our primary objective was to test the hypothesis that dexmedetomidine is noninferior to propofol as regards cerebral blood flow (CBF) velocity and brain oxygenation. DESIGN: Unblinded randomised trial. SETTING: Cleveland Clinic Hospital, Cleveland, from November 2010 to July 2013...
June 19, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28891032/the-need-for-unique-risk-adjustment-for-surgical-site-infections-at-a-high-volume-tertiary-care-center-with-inherent-high-risk-colorectal-procedures
#11
E Gorgun, C Benlice, J Hammel, T Hull, L Stocchi
BACKGROUND: The aim of the present study was to create a unique risk adjustment model for surgical site infection (SSI) in patients who underwent colorectal surgery (CRS) at the Cleveland Clinic (CC) with inherent high risk factors by using a nationwide database. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried to identify patients who underwent CRS between 2005 and 2010. Initially, CC cases were identified from all NSQIP data according to case identifier and separated from the other NSQIP centers...
September 11, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28887350/institutional-care-paths-development-implementation-and-evaluation
#12
Mandy C Leonard, Seth R Bauer, Christine Ahrens, Anita Reddy, Irene Katzan
PURPOSE: The Cleveland Clinic experience with care paths, including their creation and implementation, challenges overcome during development and testing, and outcomes of selected care path evaluations, is described. SUMMARY: Care paths are tools to assist healthcare professionals in practicing evidence-based medicine. The Cleveland Clinic health system has implemented or is developing approximately 100 care paths, including care paths designed to optimize management of sepsis and septic shock and to promote timely use of i...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28884212/routine-sildenafil-does-not-improve-clinical-outcomes-after-fontan-operation
#13
J Leslie Gaddis Collins, Mark A Law, Santiago Borasino, W Clinton Erwin, David C Cleveland, Jeffrey A Alten
Fontan operation can be complicated by persistent chest tube output (CTO) leading to prolonged hospital length of stay (LOS). Postoperative sildenafil administration has been shown to improve clinical outcomes in selected patients after Fontan. We initiated a practice change utilizing intravenous (IV) sildenafil in early postoperative period in all patients undergoing Fontan operation with aim to decrease LOS and CTO. Nineteen patients (February 2014-May 2016) received 0.35 mg/kg sildenafil IV (three doses) followed by enteral, 1 mg/kg every eight hours until hospital discharge...
September 7, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28883698/hypothesized-summative-anal-physiology-score-correlates-but-poorly-predicts-incontinence-severity
#14
Christopher J Young, Assad Zahid, Cherry E Koh, Jane M Young
AIM: To explore the relationship between such a construct and an existing continence score. METHODS: A retrospective study of incontinent patients who underwent anal physiology (AP) was performed. AP results and Cleveland Clinic Continence Scores (CCCS) were extracted. An anal physiology score (APS) was developed using maximum resting pressures (MRP), anal canal length (ACL), internal and external sphincter defects and pudendal terminal motor latency. Univariate associations between each variable, APS and CCCS were assessed...
August 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28875731/outpatient-palliative-cardiology-service-embedded-within-a-heart-failure-clinic-experiences-with-an-emerging-model-of-care
#15
Benjamin Gandesbery, Krista Dobbie, Eiran Z Gorodeski
BACKGROUND: The role of palliative care consultation in the outpatient treatment of patients with symptomatic heart failure (HF) is poorly studied. In August 2015, we created an outpatient palliative care service embedded within the HF clinic at Cleveland Clinic main campus. AIM: To characterize patients cared for by our novel outpatient palliative cardiology service, including their degree of HF, symptoms, comorbidities, topics addressed in clinic, palliative treatments prescribed, advanced directives status, and mortality...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28859706/outcomes-of-sinonasal-squamous-cell-carcinoma-with-and-without-association-of-inverted-papilloma-a-multi-institutional-analysis
#16
Brian C Lobo, Brian D'Anza, Janice L Farlow, Dennis Tang, Troy D Woodard, Jonathan Y Ting, Raj Sindwani
INTRODUCTION: Sinonasal squamous cell carcinoma (SCC) accounts for <1% of all malignancies but represents 70% of sinonasal cancer. Up to 10% of SCCs are associated with inverted papilloma (IPSCC). Studies that compare patients, treatment, and outcomes of SCC and IPSCC are absent in the literature. METHODS: A retrospective review of patients with SCC and those with IPSCC at Cleveland Clinic and Indiana University from 1995 to 2015. The records were analyzed for demographics, tumor characteristics, treatment, and outcomes...
September 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28857610/fast-track-to-accreditation-an-implementation-review-of-college-of-american-pathologists-and-international-organization-for-standardization-15189-accreditation
#17
Laila O AbdelWareth, Fasila Pallinalakam, Faisal Ibrahim, Peter Anderson, Muneezeh Liaqat, Bryson Palmer, Jonathan Harris, Saber Bashir, Adnan Alatoom, Manuel Algora, Ahmad Alduaij, Imran Mirza
CONTEXT: - This review examines challenges and opportunities in preparing laboratories in a startup phase for accreditation by both College of American Pathologists (CAP) and International Organization for Standardization (ISO) 15189 in an international setting as it relates to our experience at Cleveland Clinic Abu Dhabi Laboratory. It also discusses some of the strategies used in executing those projects and the added advantages in perusing both types of accreditations. OBJECTIVES: - To share our experience with CAP and ISO 15189 accreditations in a startup international operation in relation to the challenges encountered and implementation strategy success factors...
August 31, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28855857/a-health-information-system-for-scalable-and-comprehensive-assessment-of-well-being-a-multidisciplinary-team-solution
#18
Leming Zhou, Valerie Watzlaf, Paul Abernathy, Mervat Abdelhak
To improve the health and well-being of the medically underserved in a free clinic in Pittsburgh, Pennsylvania, a multidisciplinary team representing several health information management and information technology (IT) professionals, including faculty, students, researchers, and clinicians, created a novel IT system called imHealthy. The imHealthy system includes four critical components: a multidomain well-being questionnaire, a mobile app for data collection and tracking, a customization of an open-source electronic health record (EHR), and a data integration and well-being evaluation program leading to recommendations for personalized interventions to caregivers serving the medically underserved...
2017: Perspectives in Health Information Management
https://www.readbyqxmd.com/read/28854716/livebirth-and-utero-placental-insufficiency-in-papio-hamadryas-baboons-with-uterus-angiosome-perfused-by-bilateral-utero-ovarian-microsurgical-anastomoses-alone
#19
B Beran, K Arnolds, M Shockley, K Rivas, M Medina, P F Escobar, A Tzakis, T Falcone, M L Sprague, S Zimberg
STUDY QUESTION: Can the baboon uterus support a gestation to livebirth with an angiosome using microsurgically anastomosed utero-ovarian vessels and lacking uterine arteries and veins? SUMMARY ANSWER: Our angiosome model allows healthy livebirth albeit with risk of fetal growth restriction and stillbirth. WHAT IS KNOWN ALREADY: Uterine transplant can provide livebirth in humans, but requires a living donor to undergo a prolonged laparotomy for hysterectomy...
September 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28852526/identification-of-the-distinguishing-features-of-crohn-s-disease-and-ischemic-colitis-using-computed-tomographic-enterography
#20
Min Chen, Erick M Remer, Xiuli Liu, Rocio Lopez, Bo Shen
Background and aims: The differential diagnosis between Crohn's disease (CD) and ischemic colitis (ISC) is important as their clinical management is different. ISC can easily be misdiagnosed as CD, especially in elderly populations. The distinctive radiographic features of the two disease entities have not been investigated. The aim of this study is to assess the utility of computed tomographic enterography (CTE) in the differential diagnosis between CD and ISC. Methods: Patients with confirmed CD and ISC were identified through an electronic medical record search of the Cleveland Clinic Foundation...
August 2017: Gastroenterology Report
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