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Simon J Mitchell, Michael H Bennett, Phillip Bryson, Frank K Butler, David J Doolette, James R Holm, Jacek Kot, Pierre Lafère
Guidelines for the pre-hospital management of decompression illness (DCI) had not been formally revised since the 2004 Divers Alert Network/Undersea and Hyperbaric Medical Society workshop held in Sydney, entitled "Management of mild or marginal decompression illness in remote locations". A contemporary review was initiated by the Diver's Alert Network and undertaken by a multinational committee with members from Australasia, the USA and Europe. The process began with literature reviews by designated committee members on: the diagnosis of DCI; first aid strategies for DCI; remote triage of possible DCI victims by diving medicine experts; evacuation of DCI victims; effect of delay to recompression in DCI; pitfalls in management when DCI victims present at hospitals without diving medicine expertise and in-water recompression...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Adrian L Lopresti, Hemant Gupta, Stephen J Smith
BACKGROUND: To evaluate the efficacy and tolerability of a poly-herbal formulation, Herbagut, for the treatment of gastrointestinal symptoms and its effect on quality of life parameters in patients presenting with self-reported, unsatisfactory bowel habits. METHODS: This was a randomised, double-blind, placebo-controlled trial. Fifty adults with self-reported unsatisfactory bowel habits, primarily characterised by chronic constipation were randomly allocated to take Herbagut or a matching placebo for 28 days...
March 20, 2018: BMC Complementary and Alternative Medicine
Simon D Griffiths, Philip Chappell, Jane A Entwistle, Frank J Kelly, Michael E Deary
Public exposure to significantly elevated levels of particulate matter (PM) as a result of major fires at industrial sites is a worldwide problem. Our paper describes how the United Kingdom developed its Air Quality in Major Incidents (AQinMI) service to provide fire emission plume concentration data for use by managers at the time of the incident and to allow an informed public health response. It is one of the first civilian services of its type anywhere in the world. Based on the involvement of several of the authors in the AQinMI service, we describe the service's function, detail the nature of fires covered by the service, and report for the first time on the concentration ranges of PM to which populations may be exposed in major incident fires...
March 16, 2018: Environment International
Rajiv N Srinivasa, Jeffrey Forris Beecham Chick, Nishant Patel, Joseph J Gemmete, Ravi N Srinivasa
Postoperative lymphoceles may occur after abdominal or pelvic surgery secondary to disruption of lymphatic channels. First-line therapy includes conservative therapy with medical management and dietary restriction. Despite these measures, some patients may have persistent high-output lymphoceles requiring percutaneous aspiration, drainage, or sclerosis. Rarely, surgical evacuation is required. Management of intrathoracic chyle leak by thoracic duct embolization has been well described. Recently, interstitial (intranodal) lymphatic embolization for the treatment of plastic bronchitis has been performed...
March 15, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Raimund Lechner, Thomas Küpper, Markus Tannheimer
INTRODUCTION: History is full of examples of the influence of the mountain environment on warfare. The aim of this article is to identify the main environmental hazards and summarize countermeasures to mitigate the impact of this unique environment. METHODS: A selective PubMed and Internet search was conducted. Additionally, we searched bibliographies for useful supplemental literature and included the recommendations of the leading mountain medicine and wilderness medicine societies...
March 15, 2018: Wilderness & Environmental Medicine
Vadim V Chumak, Sergiy V Klymenko, Horst Zitzelsberger, Christina Wilke, Lyudmila A Rybchenko, Elena V Bakhanova
The Chernobyl reactor accident in 1986 has caused significant exposure to ionizing radiation of the Ukrainian population, in particular clean-up workers and evacuees from the exclusion zones. A study aiming at the discovery of radiation markers of the breast cancer was conducted from 2008 to 2015 within a collaborative project by HZM, LMU, and NRCRM. In this study, post-Chernobyl breast cancer cases both in radiation-exposed female patients diagnosed at age less than 60 from 1992 to 2014 and in non-exposed controls matched for residency, tumor type, age at diagnosis, TNM classification as well as tumor grading were investigated for molecular changes with special emphasis to copy number alterations and miRNA profiles...
March 17, 2018: Radiation and Environmental Biophysics
Philippe De Vloo, Stefaan Nijs, Sandra Verelst, Johannes van Loon, Bart Depreitere
OBJECTIVE: According to level 2 evidence, earlier evacuation of acute subdural or epidural hematomas necessitating surgery is associated with better outcome. Hence, guidelines recommend performing these procedures "immediately". Literature on extent and causes of pre- and intra-hospital intervals in trauma patients requiring emergent craniotomies is almost completely lacking. Studies delineating and refining the interval before thrombolytic agent administration in ischemic stroke have dramatically reduced the "door-to-needle time"...
March 13, 2018: World Neurosurgery
Xiaowei Li, Jingze Li, Xuehui Yang, Zhaosheng Sun, Jinrong Zhang, Wangmiao Zhao, Shuzhi Dong, Cong Li, Yanqiao Ye, Jianchao Chen, Yongqian Li, Yi Xiang, Jianhui Mao, Guangjie Li, Hong Guo, Wenchao Zhang, Hao Guo, Yazhao Zhang, Mingzhe Zhang, Wanzeng Zhang, Zhanyi Xu, Baoshuai Zhao, Jianhui Wei, Gengshui Zhao, Ronghua Ma, Xiuzhi Shen, Chunyan Ge, Cunling Zheng, Shang Li, Yan Wang
BACKGROUND: Prognosis of spontaneous intracerebral hemorrhage (ICH) remains poor worldwide. AIMS OF THE STUDY: To investigate the effect and optimal protocol for hyperbaric-oxygen therapy (HBOT), and reduce incidence of upper gastrointestinal bleeding (UGIB) in ICH. METHODS: This prospective, randomized, controlled trial included 565 patients with acute severe ICH. Participants were randomly assigned to a sham-control group (Group A) and four intervention groups: Groups B and C with 2...
March 13, 2018: Archives of Medical Research
Melissa Palmer, Lee Jennings, Debra G Silberg, Caleb Bliss, Patrick Martin
BACKGROUND: Accumulation of toxic free cholesterol in hepatocytes may cause hepatic inflammation and fibrosis. Volixibat inhibits bile acid reuptake via the apical sodium bile acid transporter located on the luminal surface of the ileum. The resulting increase in bile acid synthesis from cholesterol could be beneficial in patients with non-alcoholic steatohepatitis. This adaptive dose-finding study investigated the safety, tolerability, pharmacodynamics, and pharmacokinetics of volixibat...
March 16, 2018: BMC Pharmacology & Toxicology
Laurent Mathieu, Michel Levadoux, Emmanuel Soucany de Landevoisin, Tarun J McBride Windsor, Sylvain Rigal
INTRODUCTION: Noncombat-related hand injuries are common in current theatres of operations. Crushing is one of the most frequent mechanisms that may cause traumatic amputations of digits. In the military setting, management of these digital amputations is challenging regarding limitation in microsurgical means in medical treatment facilities and aeromedical evacuation delays out of the combat zone. METHODS: Two cases of digital replantation performed in French forward surgical units are described...
2018: SICOT-J
Jeroen G V Habets, Roel H L Haeren, Suen A N Lie, Noel J C Bauer, Jim T A Dings
BACKGROUND: We present a case of orbital compartment syndrome (OCS) leading to monocular irreversible blindness following a pterional craniotomy for clipping of an anterior communicating artery (ACoA) aneurysm. OCS is an uncommon but vision-threatening entity requiring urgent decompression to reduce the risk of permanent visual loss. Iatrogenic orbital roof defects are a common finding following pterional craniotomies. However, complications related to these defects are rarely reported...
March 12, 2018: World Neurosurgery
I A Filatova
By improving the existing surgical technologies for dacryocystitis, one enhances the effectiveness of patient rehabilitation. AIM: To evaluate the effectiveness of radio-wave surgery in the treatment of dacryocystitis and lacrimal sac abscesses. MATERIAL AND METHODS: The clinical group consisted of 207 patients ranging in age from 7 to 89 years (the mean age of 41±7.3 years). For 39% of patients this was a repeated treatment, while 9.3% had undergone 4-5 surgical interventions...
2018: Vestnik Oftalmologii
Ti-Yuan Yang, Marcelo Chen, Wun-Rong Lin, Chung-Yi Li, Wei-Kung Tsai, Allen W Chiu, Ming-Chung Ko
OBJECTIVES: To assess the associations between preoperative treatment with 5-alpha reductase inhibitors and the risks of blood transfusion during transurethral resection of the prostate and blood clot evacuation or emergency department visits for hematuria within 1 month after surgery. METHODS: We used data from the Taiwan National Health Insurance Research Database in this population-based cohort study. A total of 3,126 patients who underwent first-time transurethral resection of the prostate from 2004 to 2013 were identified...
March 12, 2018: Clinics
Tomohiro Morita, Shuhei Nomura, Tomoyuki Furutani, Claire Leppold, Masaharu Tsubokura, Akihiko Ozaki, Sae Ochi, Masahiro Kami, Shigeaki Kato, Tomoyoshi Oikawa
INTRODUCTION: Demographic changes as a result of evacuation in the acute phase of the 2011 Fukushima nuclear disaster are not well evaluated. We estimated post-disaster demographic transitions in Minamisoma City-located 14-38 km north of the nuclear plant-in the first month of the disaster; and identified demographic factors associated with the population remaining in the affected areas. MATERIALS AND METHODS: We extracted data from the evacuation behavior survey administered to participants in the city between July 11, 2011 and April 30, 2013...
2018: PloS One
Norikazu Watanabe, Masataka Suzuki, Yoshitake Yamaguchi, Yukari Egashira
It is well known that dietary fiber helps to relieve and prevent constipation, and there are a number of scientific papers, including systematic reviews and meta-analyses on the effects of naturally derived dietary fiber on bowel movements. In recent years, there has been an increase in the manufacture of dietary fiber ingredients obtained from food raw materials, and these are now commonly available in the market. Resistant maltodextrin (RMD), a soluble dietary fiber, is manufactured from starch, and industrially produced soluble dietary fiber is used worldwide...
2018: Clinical and Experimental Gastroenterology
Shunta Hori, Mitsuru Tomizawa, Fumisato Maesaka, Takuya Owari, Yosuke Morizawa, Yasushi Nakai, Makito Miyake, Tatsuo Yoneda, Nobumichi Tanaka, Katsunori Yoshida, Kiyohide Fujimoto
BACKGROUND: Page kidney phenomenon is caused by strong renal parenchymal compression and leads to renal hypoperfusion and microvascular ischemia, resulting in renal dysfunction and hypertension. Although the development of Page kidney phenomenon in allograft is rare, most of its cases are induced by allograft biopsy or trauma. We observed a case of Page kidney phenomenon that was induced by unusual causes immediately after kidney transplantation. CASE PRESENTATION: A 66-year-old man, whose wife donated a kidney, underwent ABO-compatible living kidney transplantation...
March 13, 2018: BMC Nephrology
M H Zou, L Ma, Y S Xia, S C Yang, W D Chen, F Cao, X X Chen
Objective: To review the early and mid-term results of end-to-side anastomosis technique for interrupted aortic arch in neonates and infants. Methods: Clinic data of 46 patients were diagnosed as interrupted aortic arch in Department of Cardiac Surgery, Guangzhou Women and Children's Medical Center between January 2010 and December 2016 were analyzed retrospectively. Twenty-six cases were neonates. The median age underwent surgery was 23 days (range: 2 days to 8 years). Anatomical subtypes included 36 cases of type A and 10 cases of type B...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Makoto Fujiu, Yuma Morisaki, Junichi Takayama, Kiyoko Yanagihara, Tatsuya Nishino, Masahiko Sagae, Kohei Hirako
The 2013 Partial Amendment of the Disaster Countermeasures Basic Law mandated that a roster of vulnerable persons during disasters be created, and further development of evacuation support is expected. In this study, the number of vulnerable people living in target analytical areas are identified in terms of neighborhood units by using the National Health Insurance Database to create a realistic and efficient evacuation support plan. Later, after considering the "vulnerability" of an area to earthquake disaster damage, a quantitative evaluation of the state of the disaster is performed using a principle component analysis that further divided the analytical target areas into neighborhood units to make a detailed determination of the number of disaster-vulnerable persons, the severity of the disaster, etc...
March 13, 2018: International Journal of Environmental Research and Public Health
Sophia M Schermerhorn, Paul J Auchincloss, Kyle Kraft, Kenneth J Nelson, Jeremy C Pamplin
Review the management of a patient with acute patella fracture supported by telemedical consultation. Clinical Context: Regionally Aligned Forces (RAF) supporting US Army Africa/Southern European Task Force (USARAF/ SETAF) in Africa Command area of responsibility. Care was provided by a Role I facility on the compound. Organic Expertise: Three 68W combat medics; one Special Operations Combat Medic (SOCM). Closest Medical Support: Organic battalion physician assistant (PA) located in the United States; USARAF PA located in a European country; French Role II located in nearby West African country; telemedical consults via e-mail, phone, or videoteleconsultation...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Meagan Tyler, Peter Fairbrother
This paper considers the impact of gendered norms on decision-making for wildfire preparation and response at the household level. Focusing on Australia, it provides a theoretical thematic analysis of data acquired in 107 interviews with residents of nine different localities. It builds on existing research on gender and disaster, as well as on decision-making and wildfires, and analyses the narratives that centre on 'split' households plans (where a male partner plans to stay and a female partner plans to evacuate) and disagreements within heterosexual couples as to an appropriate wildfire safety plan...
March 13, 2018: Disasters
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