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https://www.readbyqxmd.com/read/29742786/-patient-controlled-analgesia-pca-an-overview-about-methods-handling-and-new-modalities
#1
Marie Abrolat, Leopold H J Eberhart, Gerald Kalmus, Tilo Koch, Stefan Nardi-Hiebl
Patient-controlled analgesia (PCA) is one of the well established methods for the treatment of postoperative pain. A cochrane-review concluded that PCA is associated with better postoperative pain ratings and improved patient-satifaction compared to traditional way of administering opioids. Some prerequisites concerning patient selection, education of the patient and the medical staff, and supervision during PCA therapy are mandatory for a safe use of PCA. Current PCA modalities (intravenous and epidural routes of application) are expanded by newer, less invasive routes of drug administration, e...
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29731850/single-center-analysis-of-appendiceal-neoplasms
#2
Takayuki Tajima, Takuma Tajiri, Masaya Mukai, Tomoko Sugiyama, Sayuri Hasegawa, Souichirou Yamamoto, Sotaro Sadahiro, Hideo Shimada, Hiroyasu Makuuchi
The purpose of the present study was to evaluate the recent trend of diagnosing appendiceal diseases through the analysis of appendectomy materials, stressing the importance of their pathological examination. A clinicopathological assessment of patients undergoing an appendectomy was conducted, based on the pathological examination of resected appendiceal lesions. Using a pathological database of surgical specimens from patients who underwent an appendectomy between March 2002 and September 2014, a retrospective, single-center analysis was performed...
May 2018: Oncology Letters
https://www.readbyqxmd.com/read/29731024/the-potential-effects-of-new-stent-platforms-for-coronary-revascularization-in-patients-with-diabetes
#3
REVIEW
Gustavo S Guandalini, Sripal Bangalore
Coronary artery disease in patients with diabetes mellitus (DM) is characterized by extensive atherosclerosis, longer lesions, and diffuse distal disease. Consequently, these patients have worse outcomes after coronary revascularization, regardless of the modality used. Traditionally, coronary artery bypass grafting (CABG) has been regarded as more effective than percutaneous coronary intervention (PCI) in patients with DM, likely because of more complete revascularization and protection against disease progression in the bypass segment...
May 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29729855/addressing-potential-health-disparities-in-the-adoption-of-advanced-breast-imaging-technologies
#4
REVIEW
Randy C Miles, Tracy Onega, Christoph I Lee
With the advent of new screening technologies, including digital breast tomosynthesis, screening ultrasound, and breast magnetic resonance imaging, there is growing concern that existing disparities among traditionally underserved populations will worsen. These newer screening modalities purport improved cancer detection over mammography alone but are not offered at all screening facilities and often require a larger co-pay or out-of-pocket expense. Thus, the potential for worsening disparities with regard to access and appropriate utilization of supplemental screening technologies exists...
May 2018: Academic Radiology
https://www.readbyqxmd.com/read/29722568/liver-fat-imaging-a-clinical-overview-of-ultrasound-ct-and-mr-imaging
#5
Yingzhen Zhang, Kathryn J Fowler, Gavin Hamilton, Jennifer Cui, Ethan Z Sy, Michelle Balanay, Jonathan C Hooker, Nikolaus M Szeverenyi, Claude B Sirlin
Hepatic steatosis is a frequently encountered imaging finding that may indicate chronic liver disease, the most common of which is nonalcoholic fatty liver disease (NAFLD). NAFLD is implicated in the development of systemic diseases and its progressive phenotype, nonalcoholic steatohepatitis (NASH), leads to increased liver-specific morbidity and mortality. With the rising obesity epidemic and advent of novel therapeutics aimed at altering metabolism, there is a growing need to quantify and monitor liver steatosis...
May 3, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29720750/newer-regional-analgesia-interventions-fascial-plane-blocks-for-breast-surgeries-review-of-literature
#6
REVIEW
Rakesh Garg, Swati Bhan, Saurabh Vig
Surgical resection of the primary tumour with axillary dissection is one of the main modalities of breast cancer treatment. Regional blocks have been considered as one of the modalities for effective perioperative pain control. With the advent of ultrasound, newer interventions such as fascial plane blocks have been reported for perioperative analgesia in breast surgeries. Our aim is to review the literature for fascial plane blocks for analgesia in breast surgeries. The research question for initiating the review was 'What are the reported newer regional anaesthesia techniques (fascial plane blocks) for female patients undergoing breast surgery and their analgesic efficacy?...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29708928/revisiting-monovision-for-presbyopia
#7
Abdallah Mahrous, Jessica B Ciralsky, Edward C Lai
PURPOSE OF REVIEW: Presbyopia is an inevitable age-related loss of accommodation that results in spectacle dependence with common everyday near-vision tasks. Many surgical approaches to presbyopic correction have been investigated, with monovision correction being amongst the most common and attractive options. In this article, we will review the advantages and disadvantages of the new modalities of presbyopic monovision correction. RECENT FINDINGS: New methods such as mini-monovision, corneal inlays, and multifocal corneal ablation aim to maximize stereopsis and decrease the anisometropic side effects of conventional monovision...
April 27, 2018: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/29706252/gadolinium-based-contrast-agents-in-kidney-disease-comprehensive-review-and-clinical-practice-guideline-issued-by-the-canadian-association-of-radiologists
#8
REVIEW
Nicola Schieda, Jason I Blaichman, Andreu F Costa, Rafael Glikstein, Casey Hurrell, Matthew James, Pejman Jabehdar Maralani, Wael Shabana, An Tang, Anne Tsampalieros, Christian van der Pol, Swapnil Hiremath
Use of gadolinium-based contrast agents (GBCAs) in renal impairment is controversial, with physician and patient apprehension in acute kidney injury (AKI), chronic kidney disease (CKD), and dialysis because of concerns regarding nephrogenic systemic fibrosis (NSF). The position that GBCAs are absolutely contraindicated in AKI, CKD stage 4 or 5 (estimated glomerular filtration rate [eGFR] <30 mL/min/1.73 m2 ) and dialysis-dependent patients is outdated, and may limit access to clinically necessary contrast-enhanced MRI examinations...
May 2018: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
https://www.readbyqxmd.com/read/29704019/role-of-minimal-residual-disease-in-the-management-of-acute-myeloid-leukemia-a-case-based-discussion
#9
REVIEW
A Coltoff, J Houldsworth, A Keyzner, A S Renteria, John Mascarenhas
AML is stratified into risk-categories based on cytogenetic and molecular features that prognosticate survival and facilitate treatment algorithms, though there is still significant heterogeneity within risk groupings with regard to risk of relapse and prognosis. The ambiguity regarding prognosis is due in large part to the relatively outdated criteria used to determine response to therapy. Whereas risk assessment has evolved to adopt cytogenetic and molecular profiling, response criteria are still largely determined by bone marrow morphologic assessment and peripheral cell count recovery...
April 27, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29692352/respiratory-care-in-neuromuscular-diseases
#10
REVIEW
Ashima S Sahni, Lisa Wolfe
Caring for patients with neuromuscular disease (NMD) is challenging. Respiratory care is of the utmost importance because it is a major determinant of quality of life and survival. Noninvasive ventilation (NIV) is one of the few modalities that has shown survival benefit in the NMD patient population. Newer modes with smart technologies are being developed to assist in better ventilation. Some noninvasive methods have shown success in the management of sialorrhea, which is of paramount importance in the initiation of NIV...
April 24, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29684256/reirradiation-of-head-and-neck-cancer-using-modern-highly-conformal-techniques
#11
REVIEW
Jennifer C Ho, Jack Phan
Locoregional disease recurrence or development of a second primary cancer after definitive radiotherapy for head and neck cancers remains a treatment challenge. Reirradiation utilizing traditional techniques has been limited by concern for serious toxicity. With the advent of newer, more precise radiotherapy techniques, such as intensity-modulated radiotherapy (IMRT), proton radiotherapy, and stereotactic body radiotherapy (SBRT), there has been renewed interest in curative-intent head and neck reirradiation...
April 23, 2018: Head & Neck
https://www.readbyqxmd.com/read/29657376/smoke-inhalation-injury-etiopathogenesis-diagnosis-and-management
#12
REVIEW
Kapil Gupta, Mayank Mehrotra, Parul Kumar, Anoop Raj Gogia, Arun Prasad, Joseph Arnold Fisher
Smoke inhalation injury is a major determinant of morbidity and mortality in fire victims. It is a complex multifaceted injury affecting initially the airway; however, in short time, it can become a complex life-threatening systemic disease affecting every organ in the body. In this review, we provide a summary of the underlying pathophysiology of organ dysfunction and provide an up-to-date survey of the various critical care modalities that have been found beneficial in caring for these patients. Major pathophysiological change is development of edema in the respiratory tract...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29657369/factors-affecting-the-effective-management-of-acute-stroke-a-prospective-observational-study
#13
C V Nagendra, T S Srinath Kumar, Vikram Bohra, Viju Wilben, Vivek Karan, Vikram Huded
Background: Stroke, characterized by sudden loss of cerebral function, is among one of the leading cause of death and disability world over. The newer treatment modalities have changed the landscape of stroke treatment but are very much time bound. Aim: To characterize pre-hospital and in-hospital factors affecting acute stroke management thus defining lacunae in stroke management. Subjects and Methods: A prospective observational study, conducted at the emergency department of a tertiary care center in southern India from August 2015 to July 2016...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29627865/advances-in-treatment-of-cardiac-amyloid
#14
REVIEW
Cherie N Dahm, R Frank Cornell, Daniel J Lenihan
Systemic amyloidosis represents a complex group of diseases with a common feature characterized by misfolded autologous proteins depositing into tissues or organs throughout the body. Light chain amyloidosis (AL) and transthyretin (TTR) amyloid are the two most prevalent forms of this disease that commonly results in cardiac amyloidosis. In both of these conditions, the myocardium is a frequent site of infiltration and end-organ involvement often with devastating consequences. With cardiac amyloidosis becoming an increasingly identified disease that has previously been under-recognized, the purpose of this comprehensive review is to focus on the diagnosis and treatment of these two types of cardiac amyloidosis including a contemporary update on currently available therapies being investigated in clinical trials...
April 7, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29619627/new-advances-in-acute-postoperative-pain-management
#15
REVIEW
Sukanya Mitra, Daniel Carlyle, Gopal Kodumudi, Vijay Kodumudi, Nalini Vadivelu
PURPOSE OF REVIEW: Postoperative pain remains one of the most common challenges following inpatient and outpatient surgeries. With our advances in modern medicine, pain following surgical procedures still remains a challenge, though significant accomplishments have been made over the past few decades. This article highlights some of the promising new advances and approaches in postoperative pain management. RECENT FINDINGS: Over the last decade, Enhanced Recovery after Surgery (ERAS) pathways and protocols are becoming the benchmark standards for enhancing postoperative recovery...
April 4, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29619107/unusual-presentation-of-differentiated-thyroid-cancer-metastasis
#16
Haissan Iftikhar, Mubasher Ikram, Adnan Yar Muhammad, Karim Rizwan Nathani
Introduction  The rates of thyroid cancers are on a rise, especially well-differentiated thyroid cancers. This could be partly due to newer diagnostic modalities, like high-resolution ultrasound, that can pick up smaller lesions. Differentiated thyroid cancers with distant metastases are not common, and even rarer is the initial presentation with complaints not related to the neck. Objectives  The objective of this series was to study and report the unusual cases of patients with differentiated thyroid cancer with distant metastasis...
April 2018: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29604391/macular-corneal-dystrophy-a-review
#17
REVIEW
Shruti Aggarwal, Travis Peck, Jeffrey Golen, Zeynel A Karcioglu
Macular corneal dystrophy (MCD) is a corneal stromal dystrophy which leads to progressive vision loss. MCD is an autosomal recessive condition in which there is abnormality of proteoglycan synthesis. Mutations in the carbohydrate sulphotransferase gene (CHST6) prevent normal sulfation of corneal keratan. Different immunophenotypes have been described depending on the presence of keratan sulfate in cornea and or serum. The deposition of abnormal proteoglycans leads to loss of corneal transparency and decreased vision...
March 28, 2018: Survey of Ophthalmology
https://www.readbyqxmd.com/read/29590157/hyperopic-refractive-correction-by-lasik-smile-or-lenticule-reimplantation-in-a-non-human-primate-model
#18
Geraint P Williams, Benjamin Wu, Yu Chi Liu, Ericia Teo, Chan L Nyein, Gary Peh, Donald T Tan, Jodhbir S Mehta
Hyperopia is a common refractive error, apparent in 25% of Europeans. Treatments include spectacles, contact lenses, laser interventions and surgery including implantable contact lenses and lens extraction. Laser treatment offers an expedient and reliable means of correcting ametropia. LASIK is well-established however SMILE (small-incision lenticule extraction) or lenticule implantation (derived from myopic laser-correction) are newer options. In this study we compared the outcomes of hyperopic LASIK, SMILE and lenticule re-implantation in a primate model at +2D/+4D treatment...
2018: PloS One
https://www.readbyqxmd.com/read/29556832/spinal-cord-stimulation-mild-procedure-and-regenerative-medicine-novel-interventional-nonopioid-therapies-in-chronic-pain
#19
REVIEW
Ken P Ehrhardt, Susan M Mothersele, Andrew J Brunk, Jeremy B Green, Mark R Jones, Craig B Billeaud, Alan David Kaye
PURPOSE OF REVIEW: Chronic pain is a highly prevalent condition affecting millions of individuals. RECENT FINDINGS: In recent years, newer treatments have emerged that are changing the way clinicians treat pain pathogenesis, including novel nonopioid strategies. In this regard, spinal cord stimulation, the MILD procedure, and regenerative medicine have shown promise. This review summarizes recent literature on these three emerging treatment strategies. The results of this review suggest that under certain conditions, spinal cord stimulation, the MILD procedure, and regenerative medicine can be effective treatment modalities...
March 19, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29546472/transcatheter-pulmonary-valve-replacement-current-state-of-art
#20
REVIEW
Wail Alkashkari, Amani Alsubei, Ziyad M Hijazi
PURPOSE OF REVIEW: The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital heart disease (CHD). Percutaneous valve interventions are now a cornerstone of not just the congenital cardiologist treating patients with congenital heart disease, but also-and numerically more importantly-for adult interventional cardiologists treating patients with acquired heart valve disease. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction...
March 15, 2018: Current Cardiology Reports
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