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https://www.readbyqxmd.com/read/29334338/at-home-genital-nerve-stimulation-for-individuals-with-sci-and-neurogenic-detrusor-overactivity-a-pilot-feasibility-study
#1
Dennis J Bourbeau, Kenneth J Gustafson, Steven W Brose
OBJECTIVE: Neurogenic bladder dysfunction, including neurogenic detrusor overactivity (NDO) is one of the most clinically significant problems for persons with spinal cord injury (SCI), affecting health and quality of life. Genital nerve stimulation (GNS) can acutely inhibit NDO-related reflex bladder contractions and increase bladder capacity. However, it is unknown if GNS can improve urinary continence or help meet individuals' bladder management goals during sustained use, which is required for GNS to be clinically effective...
January 15, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29321554/mutations-in-dnmt3a-u2af1-and-ezh2-identify-intermediate-risk-acute-myeloid-leukemia-patients-with-poor-outcome-after-cr1
#2
Caner Saygin, Cassandra Hirsch, Bartlomiej Przychodzen, Mikkael A Sekeres, Betty K Hamilton, Matt Kalaycio, Hetty E Carraway, Aaron T Gerds, Sudipto Mukherjee, Aziz Nazha, Ronald Sobecks, Christopher Goebel, Donna Abounader, Jaroslaw P Maciejewski, Anjali S Advani
Intermediate-risk acute myeloid leukemia (IR-AML) is a clinically heterogeneous disease, for which optimal post-remission therapy is debated. The utility of next-generation sequencing information in decision making for IR-AML has yet to be elucidated. We retrospectively studied 100 IR-AML patients, defined by European Leukemia Net classification, who had mutational information at diagnosis, received intensive chemotherapy and achieved complete remission (CR) at Cleveland Clinic (CC). The Cancer Genome Atlas (TCGA) data were used for validation...
January 10, 2018: Blood Cancer Journal
https://www.readbyqxmd.com/read/29313165/effectiveness-of-sacral-nerve-stimulation-in-fecal-incontinence-after-multimodal-oncologic-treatment-for-pelvic-malignancies-a-multicenter-study-with-2-year-follow-up
#3
M Schiano di Visconte, G A Santoro, N Cracco, G Sarzo, G Bellio, M Brunner, Z Cui, K E Matzel
BACKGROUND: To assess whether sacral nerve stimulation (SNS) is an effective treatment for severe fecal incontinence (FI) after radiotherapy (RT)/chemoRT (CRT) in combination with pelvic surgery. METHODS: A multicenter study was conducted on patients with FI that developed after multimodal therapy for pelvic tumors and was refractory to non-operative management, who were treated with SNS between November 2009 and November 2012. Data were prospectively collected and retrospectively analyzed...
January 8, 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29303890/comparative-outcomes-and-toxicities-for-ruthenium-106-versus-palladium-103-in-the-treatment-of-choroidal-melanoma
#4
Hasan Danish, Matthew J Ferris, Ehsan Balagamwala, Jeffrey M Switchenko, Kirtesh R Patel, Maria Choudhary, Caroline Craven, Pia Mendoza, John Suh, Chris Bergstrom, Hans E Grossniklaus, Thomas M Aaberg, Arun Singh, Ian R Crocker, Mohammad K Khan
For the treatment of choroidal melanoma, palladium-103 (Pd) and ruthenium-106 (Ru) plaque brachytherapy shows reduced toxicity compared with the historical standard iodine-125. No report has directly compared the clinical outcomes between Pd and Ru, and the reasons for the selection of one over the other remain purely theoretical. Patients with choroidal melanoma with apical tumor height up to 5 mm were included. Patients from Emory University were treated with Pd between 1993 and 2012. Patients from Cleveland Clinic were treated with Ru between 2005 and 2010...
January 3, 2018: Melanoma Research
https://www.readbyqxmd.com/read/29294679/childhood-trauma-social-networks-and-the-mental-health-of-adult-survivors
#5
F David Schneider, Cynthia A Loveland Cook, Joanne Salas, Jeffrey Scherrer, Ivy N Cleveland, Sandra K Burge
The purpose of this study was to investigate the relationship of childhood trauma to the quality of social networks and health outcomes later in adulthood. Data were obtained from a convenience sample of 254 adults seen in one of 10 primary care clinics in the state of Texas. Standardized measures of adverse childhood experiences (ACEs), stressful and supportive social relationships, medical conditions, anxiety, depression, and health-related quality of life were administered. Using latent class analysis, subjects were assigned to one of four ACE classes: (a) minimal childhood abuse (56%), (b) physical/verbal abuse of both child and mother with household alcohol abuse (13%), (c) verbal and physical abuse of child with household mental illness (12%), and (d) verbal abuse only (19%)...
March 1, 2017: Journal of Interpersonal Violence
https://www.readbyqxmd.com/read/29289106/tracking-kidney-stones-in-a-homogeneous-medium-using-a-trilateration-approach
#6
Kya Shoar, Benjamin W Turney, Robin O Cleveland
Shock wave lithotripsy is a non-invasive procedure by which kidney stones are fragmented by thousands of shock waves. Currently, many shock waves are delivered to the body that do not impact the stone, but do result in tissue trauma. This motivates developing a monitoring system to locate kidney stones, with the goal of gating shock waves not aligned with the stone, and hence, reducing renal trauma during lithotripsy. The system consists of a circular array housing twenty-two 0.5 MHz transducers that can be mounted on a clinical lithotripter...
December 2017: Journal of the Acoustical Society of America
https://www.readbyqxmd.com/read/29281610/aortic-replacement-in-cardiac-surgery
#7
REVIEW
Eric E Roselli
The number of aorta procedures performed annually in the United States has grown substantially during the past decade. Cleveland Clinic is a leader in research on the risk of aortic dissection in patients with a bicuspid or tricuspid aortic valve and associated aneurysm, which has led to changes in the recommendations of when to operate. Safety and efficacy data support more proactive treatment for most patients with thoracic aortic aneurysm and/or dissection with a growing emphasis on the need to provide life-long care to patients with aortic conditions...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29281609/improving-the-safety-and-efficacy-of-robotically-assisted-mitral-valve-surgery
#8
REVIEW
Stephanie Mick
To improve outcomes with robotically assisted mitral valve surgery, Cleveland Clinic conducted a study evaluating outcomes in 1,000 consecutive cases. Primary areas of interest were to determine whether increased surgical experience with robotic techniques improved outcomes and to identify opportunities that could improve procedural processes. Results showed that these surgeries were effective and safe in terms of improvements in procedure time, transfusion rates, stroke risk, number of mitral valve replacements, and number of conversions to sternotomy...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29280117/-long-term-efficacy-of-stapled-transanal-rectal-resection-for-obstructed-defecation-syndrome
#9
Yonghong Yu, Bin Zhang, Jianhua Ding, Guangzuan Zhuo, Guowei Ni, Jun Zhu, Ke Zhao
OBJECTIVE: To evaluate the long-term efficacy of stapled transanal rectal resection (STARR) in treating obstructed defecation syndrome(ODS). METHODS: Clinical data of 95 female patients with ODS undergoing STARR at Department of Colorectal Surgery, Rocket Army General Hospital from February 2010 to August 2012 were analyzed retrospectively. The Cleveland constipation scoring system (CSS), Longo ODS scoring system and severe symptoms score(SSS) were used to evaluate the degree and intensity of clinical symptoms...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29277461/intra-cranial-granulomatous-disease-in-common-variable-immunodeficiency-case-series-and-review-of-the-literature
#10
REVIEW
Catherine E Najem, Jason Springer, Richard Prayson, Daniel A Culver, James Fernandez, Jinny Tavee, Rula A Hajj-Ali
BACKGROUND/PURPOSE: Common variable immunodeficiency (CVID) is typically characterized by hypogammaglobulinemia and often but not always recurrent infections. Paradoxically, 8-22% of patients with CVID develop granulomatous disease. Granulomata have been described in many organs including the lungs, skin, liver, spleen, kidneys, eyes, lymph nodes, and intestines. Data about central nervous system (CNS) involvement in CVID are extremely rare. We aim to describe a case series and include an extensive literature review of CNS involvement in CVID to understand the different features and patterns of the disease...
October 20, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29196813/sense-encoded-poly-gr-dipeptide-repeat-proteins-correlate-to-neurodegeneration-and-uniquely-co-localize-with-tdp-43-in-dendrites-of-repeat-expanded-c9orf72-amyotrophic-lateral-sclerosis
#11
Shahram Saberi, Jennifer E Stauffer, Jie Jiang, Sandra Diaz Garcia, Amy E Taylor, Derek Schulte, Takuya Ohkubo, Cheyenne L Schloffman, Marcus Maldonado, Michael Baughn, Maria J Rodriguez, Don Pizzo, Don Cleveland, John Ravits
Hexanucleotide repeat expansions in C9orf72 are the most common genetic cause of amyotrophic lateral sclerosis (C9 ALS). The main hypothesized pathogenic mechanisms are C9orf72 haploinsufficiency and/or toxicity from one or more of bi-directionally transcribed repeat RNAs and their dipeptide repeat proteins (DPRs) poly-GP, poly-GA, poly-GR, poly-PR and poly-PA. Recently, nuclear import and/or export defects especially caused by arginine-containing poly-GR or poly-PR have been proposed as significant contributors to pathogenesis based on disease models...
December 1, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/29174460/long-term-outcomes-of-transforaminal-lumbar-interbody-fusion-in-patients-with-spinal-stenosis-and-degenerative-scoliosis
#12
Swamy Kurra, William F Lavelle, Michael P Silverstein, Jason W Savage, R Douglas Orr
BACKGROUND CONTEXT: Spinal deformity patients may present with complaints related to either the deformity itself or to the manifestations of the coexisting spinal stenosis. There are reports of successful management of lumbar pathology in the absence of global sagittal or coronal imbalance, with limited decompression and fusion, addressing only the symptomatic segment. PURPOSE: Our study examined the long-term outcomes of transforaminal lumbar interbody fusion (TLIF), a less extensive procedure, based on the experience of the senior author over the past ten years...
November 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29169582/history-of-cervical-insufficiency-increases-the-risk-of-pelvic-organ-prolapse-and-stress-urinary-incontinence-in-parous-women
#13
David Sheyn, Kateena L Addae-Konaedu, Alison M Bauer, Konyinsola I Dawodu, David N Hackney, Sherif A El-Nashar
OBJECTIVE: A likely contributor to pelvic floor disorders is injury and degradation of connective tissue components such as collagen and elastin, leading to weakening of the pelvic floor. Prior studies have found similar connective tissue component changes in women with cervical insufficiency (CI). However, the connection between pelvic floor disorders and cervical insufficiency has not previously been evaluated. Our objective was to determine whether a history of cervical insufficiency is associated with an increased risk of pelvic organ prolapse and stress urinary incontinence after controlling for confounders...
January 2018: Maturitas
https://www.readbyqxmd.com/read/29154154/transitioning-from-intravenous-to-subcutaneous-insulin-in-the-medical-intensive-care-unit
#14
Keren Zhou, Mia F Williams, Mary Angelynne Esquivel, Anne Song, Farah Rahman, James Bena, Simon W Lam, Deborah A Rathz, M Cecilia Lansang
BACKGROUND: There is a paucity of studies on transitions from IV insulin infusion (IVII) to subcutaneous (SC) insulin in the medical ICU (MICU). METHODS: We conducted a retrospective study of patients admitted to the Cleveland Clinic MICU from June 2013 to January 2014 who received IVII. We compared blood glucose (BG) control between 3 cohorts based on timing of basal insulin dose: (1) NB (no basal), (2) IB (incorrect basal), (3) CB (correct basal) at 5 time points post-IVII discontinuation (1, 4, 8, 12, and 24h)...
December 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29154131/impact-of-age-sex-therapeutic-intent-race-and-severity-of-advanced-heart-failure-on-short-term-principal-outcomes-in-the-momentum-3-trial
#15
Daniel J Goldstein, Mandeep R Mehra, Yoshifumi Naka, Christopher Salerno, Nir Uriel, David Dean, Akinobu Itoh, Francis D Pagani, Eric R Skipper, Geetha Bhat, Nirav Raval, Brian A Bruckner, Jerry D Estep, Rebecca Cogswell, Carmelo Milano, Lahn Fendelander, John B O'Connell, Joseph Cleveland
BACKGROUND: Primary outcomes analysis of the Multicenter Study of MagLev Technology in Patients Undergoing MCS Therapy With HeartMate 3 (MOMENTUM 3) trial short-term cohort demonstrated a higher survival rate free of debilitating stroke and reoperation to replace/remove the device (primary end-point) in patients receiving the HeartMate 3 (HM3) compared with the HeartMate (HMII). In this study we sought to evaluate the individual and interactive effects of pre-specified patient subgroups (age, sex, race, therapeutic intent [bridge to transplant/bridge to candidacy/destination therapy] and severity of illness) on primary end-point outcomes in MOMENTUM 3 patients implanted with HM3 and HMII devices...
November 3, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29154041/patient-characteristics-treatment-patterns-and-prognostic-factors-in-squamous-cell-bladder-cancer
#16
Haris Zahoor, Paul Elson, Andrew Stephenson, Georges-Pascal Haber, Jihad Kaouk, Amr Fergany, Byron Lee, Vadim Koshkin, Moshe Ornstein, Timothy Gilligan, Jorge A Garcia, Brian Rini, Petros Grivas
BACKGROUND: Squamous cell carcinoma (SCC) is an uncommon histologic subtype of bladder cancer with limited data on treatment patterns, outcomes, and prognostic factors. "Real world" information might inform decision-making, prognostic estimates, and clinical trial designs. PATIENTS AND METHODS: A retrospective review of patients with tissue-confirmed bladder SCC treated at Cleveland Clinic from 2007 to 2016 was performed. Data on patient characteristics, treatment patterns, and clinical follow-up were extracted...
October 17, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/29150468/prevalence-and-recognition-of-obesity-and-its-associated-comorbidities-cross-sectional-analysis-of-electronic-health-record-data-from-a-large-us-integrated-health-system
#17
Kevin M Pantalone, Todd M Hobbs, Kevin M Chagin, Sheldon X Kong, Brian J Wells, Michael W Kattan, Jonathan Bouchard, Brian Sakurada, Alex Milinovich, Wayne Weng, Janine Bauman, Anita D Misra-Hebert, Robert S Zimmerman, Bartolome Burguera
OBJECTIVE: To determine the prevalence of obesity and its related comorbidities among patients being actively managed at a US academic medical centre, and to examine the frequency of a formal diagnosis of obesity, via International Classification of Diseases, Ninth Revision (ICD-9) documentation among patients with body mass index (BMI) ≥30 kg/m(2). DESIGN: The electronic health record system at Cleveland Clinic was used to create a cross-sectional summary of actively managed patients meeting minimum primary care physician visit frequency requirements...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29143416/plasma-renin-activity-response-to-aliskiren-and-clinical-outcomes-in-patients-hospitalized-for-heart-failure-the-astronaut-trial
#18
Muthiah Vaduganathan, Baljash Cheema, Erin Cleveland, Kamya Sankar, Haris Subacius, Gregg C Fonarow, Scott D Solomon, Eldrin F Lewis, Stephen J Greene, Aldo P Maggioni, Michael Böhm, Faiez Zannad, Javed Butler, Mihai Gheorghiade
AIMS: The direct renin inhibitor, aliskiren, is known to reduce plasma renin activity (PRA), but whether the efficacy of aliskiren varies based on an individual's baseline PRA in patients hospitalized for heart failure (HF) is presently unknown. We characterized the prognostic value of PRA and determined if this risk is modifiable with use of aliskiren. METHODS AND RESULTS: This pre-specified neurohormonal substudy of ASTRONAUT analysed all patients hospitalized for HF with ejection fraction (EF) ≤40% with available baseline PRA data (n = 1306, 80...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29142955/improving-the-prediction-of-cardiac-surgery-associated-acute-kidney-injury
#19
Jordan Crosina, Jordyn Lerner, Julie Ho, Navdeep Tangri, Paul Komenda, Brett Hiebert, Nora Choi, Rakesh C Arora, Claudio Rigatto
Introduction: Acute kidney injury (AKI) is a potentially fatal complication of cardiac surgery. The inability to predict cardiac surgery-associated AKI is a major barrier to prevention and early treatment. Current clinical risk models for the prediction of cardiac surgery-associated AKI are insufficient, particularly in patients with preexisting kidney dysfunction. Methods: To identify intraoperative variables that might improve the performance of a validated clinical risk score (Cleveland Clinic Score, CCS) for the prediction of cardiac surgery-associated AKI, we conducted a prospective cohort study in 289 consecutive elective cardiac surgery patients at a tertiary care center...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29136649/discordance-between-actual-and-scheduled-check-in-times-at-a-heart-failure-clinic
#20
Eiran Z Gorodeski, Emer Joyce, Benjamin T Gandesbery, Eugene H Blackstone, David O Taylor, W H Wilson Tang, Randall C Starling, Rory Hachamovitch
INTRODUCTION: A 2015 Institute Of Medicine statement "Transforming Health Care Scheduling and Access: Getting to Now", has increased concerns regarding patient wait times. Although waiting times have been widely studied, little attention has been paid to the role of patient arrival times as a component of this phenomenon. To this end, we investigated patterns of patient arrival at scheduled ambulatory heart failure (HF) clinic appointments and studied its predictors. We hypothesized that patients are more likely to arrive later than scheduled, with progressively later arrivals later in the day...
2017: PloS One
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