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https://www.readbyqxmd.com/read/28343240/childhood-angular-kyphosis-a-plea-for-involvement-of-the-pediatric-neurosurgeon
#1
E Cornips, S Koudijs, J Vles, L van Rhijn
INTRODUCTION: Childhood angular kyphosis is rare, as most children are affected by a mixed kyphotic and scoliotic deformity. Published series involving a mix of kyphosis and kyphoscoliosis, pediatric and adult, congenital and acquired cases are almost exclusively authored by orthopedic surgeons, suggesting that (pediatric) neurosurgeons are not involved. CASE SERIES: We present five cases that illustrate the spectrum of angular kyphosis, and these were treated by a multidisciplinary team including child neurologist, orthopedic surgeon, and pediatric neurosurgeon as complementary partners...
March 25, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28343178/fetal-cardiac-tumors-clinical-features-management-and-prognosis
#2
Shi-Min Yuan
Fetal cardiac tumors are rare and usually benign. While echocardiography is a reliable technique for diagnosing fetal cardiac tumors, their definitive diagnosis relies on pathological examination. The strategies used to manage fetal cardiac tumors are challenging. A good clinical result is their complete regression during pregnancy or shortly after birth, as often occurs with cardiac rhabdomyomas. Moreover, the fetal prognosis depends on the nature of the tumors, namely, their location, size, number and associated complications...
March 27, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28343177/gaps-in-obstetric-care-processes-we-can-only-improve-what-is-being-measured
#3
Charlotte Millde Luthander, Hans Järnbert Pettersson, Ulf Högberg, Sophie Berglund, Charlotta Grunewald
A multifaceted intervention at all six obstetric units in the Stockholm Health Region was performed in 2008-2011 in order to increase safety for the newborn infants. Case-controlled criterion-based reviews of care processes during labor and delivery have been used to assess factors associated with suboptimal care during labor and delivery. Categories of increased risk of adverse outcome during labor and delivery were defined. Cases with low Apgar scores and healthy controls were scrutinized and compared to data from a study with an identical design performed before the intervention...
March 27, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28343155/more-than-just-muscle-spasms-a-rare-presentation-of-aortic-dissection
#4
Ebisa Bekele, Deepthi Chaitanya Kagolanu, Martin Kim, Kent Stephenson
Acute aortic dissection is associated with significant morbidity and mortality, often from complications including aortic regurgitation, cardiac tamponade and myocardial infarction. Typical clinical presentation includes a sudden onset of severe chest pain, although this is not always consistent. Clinical signs and symptoms are diverse with an estimated 38% of cases being missed on initial evaluation. Primary neurological symptoms at presentation are rare but have been reported often to coexist with chest pain...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28343153/de-garengeot-s-hernia-an-unusual-case-on-call
#5
Madeline Moore, Bassem Amr
De Garengeot's hernia is defined as a femoral hernia that contains the appendix. Owing to the extreme rarity of de Garengeot's hernia, it could represent a diagnostic challenge; however, it should remain in the differential diagnosis, particularly in this patient demographic. A female patient aged 96 years, who presented as an emergency with acute right iliac fossa pain, was found to have de Garengeot's hernia. The diagnosis was made intraoperatively, where she was treated with an appendicectomy and repair of the hernia defect...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28342973/effects-of-a-sustained-release-formulation-of-1-25-dihydroxyvitamin-d3-glycosides-for-milk-fever-prevention-on-serum-1-25-dihydroxyvitamin-d3-calcium-and-phosphorus-in-dairy-cows
#6
Heinrich Bachmann, Michael Lanz, Susanne Kehrle, Wolfgang Bittner, Annick Toggenburger, Georg A Mathis, Walter Rambeck
Milk fever (MF) is a metabolic disease in dairy cows around parturition. The clinical lead sign is muscular paresis leading in severe cases to paralysis of the affected animal. Multiparturient animals of high performing dairy breeds are most likely to be affected and have a high probability of recurrence. An acute drop in blood calcium levels causes the disease when the demand for calcium at the onset of lactation exceeds the ability to replete blood calcium levels through mobilization from bone and intestinal uptake...
March 22, 2017: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/28342841/use-of-a-parallel-stiff-wire-to-facilitate-percutaneous-impella-rp-ventricular-assist-device-positioning
#7
Francesco Giannini, Matteo Montorfano, Richard J Jabbour, Azeem Latib, Neil Ruparelia, Lorenzo Azzalini, Valeria Magni, Vittorio Romano, Michele De Bonis, Federico Pappalardo, Antonio Colombo
Despite optimal medical management, some patients with severe right ventricular failure fail to respond and may benefit from additional support with the implantation of a RV assist device. Experience to date with Impella RP is limited. We report a case of percutaneous Impella RP implantation, using a parallel stiff wire to reduce anatomical tortuosity by acting as a buddy-wire to facilitate device implantation and reduce the risk of tricuspid ring damage in a patient recently treated with tricuspid ring annuloplasty...
March 15, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28342811/myeloid-sarcoma-presentation-diagnosis-and-treatment
#8
REVIEW
L Max Almond, Maria Charalampakis, Samuel J Ford, David Gourevitch, Anant Desai
Myeloid sarcoma is an extramedullary tumor of immature granulocytic cells. It is a rare condition, most often associated with acute myeloid leukemia (AML), although in some rare cases it may present in nonleukemic patients. It should therefore be considered as a differential diagnosis of any atypical cellular infiltrate. It may occur at any site, leading to very varied clinical presentations. Diagnosis is challenging and relies on a high index of suspicion as well as radiology, histology, immunophenotyping, and molecular analyses, which also are essential for risk stratification and treatment planning...
March 7, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28342738/american-brachytherapy-society-consensus-statement-for-soft-tissue-sarcoma-brachytherapy
#9
A O Naghavi, D C Fernandez, N Mesko, A Juloori, A Martinez, J G Scott, C Shah, L B Harrison
PURPOSE: Radiation therapy represents an essential treatment option in the management of soft tissue sarcomas (STS). Brachytherapy represents an important subset of radiation therapy techniques used for STS, with evolving indications and applications. Therefore, the purpose of this guideline was to update clinicians regarding the data surrounding brachytherapy (BT) and provide recommendations for the utilization of BT in patients with STS. METHODS AND MATERIALS: Members of the American Brachytherapy Society with expertise in STS, and STS BT in particular, created an updated guideline for the use of BT in STS based on a literature review and clinical experience...
March 22, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28342704/trends-in-the-presentation-surgical-treatment-and-outcomes-of-tethered-cord-syndrome-a-nationwide-study-from-2001-to-2010
#10
Cyrus M Jalai, Charles Wang, Bryan J Marascalchi, Samantha R Horn, Gregory W Poorman, Olivia J Bono, Anthony K Frempong-Boadu, Peter G Passias
OBJECTIVE: This is a nationwide query into surgical management techniques for tethered cord syndrome, focusing on patient demographic, hospital characteristics, and treatment outcomes. Our hypothesis is that detethering vs. fusion for TCS results in different in-hospital complications. MATERIALS AND METHODS: Retrospective review of the Nationwide Inpatient Sample 2001-2010. Inclusion: TCS discharges undergoing detethering or fusion. Sub-analysis compared TCS cases by age (pediatric [≤9years] vs...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28342655/tacrolimus-induced-reversible-cerebral-vasoconstriction-syndrome-with-delayed-multi-segmental-vasoconstriction
#11
Satoshi Kodama, Tatsuo Mano, Akihiro Masuzawa, Yasutaka Hirata, Yuki Nagasako, Kagari Koshi Mano, Masashi Hamada, Yasuo Terao, Toshihiro Hayashi, Minoru Ono, Shoji Tsuji
Reversible cerebral vasoconstriction syndrome (RCVS) is a cerebrovascular syndrome characterized by multi-segmental constrictions of the cerebral arteries that resolves spontaneously within 3 months. Although RCVS is considered to be due to transient dysregulation of vascular tone, the exact pathomechanism remains unclear. We describe the case of a 15-year-old girl with RCVS induced by tacrolimus, who developed generalized seizure during the postoperative course of orthotropic heart transplantation. Magnetic resonance imaging at symptom onset showed a few vasoconstrictions accompanying brain edema and convexity subarachnoid hemorrhage...
March 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28342580/evidence-based-management-of-chylothorax-in-infants
#12
Joseph T Church, Alexis G Antunez, Ashley Dean, Niki Matusko, Kristopher B Deatrick, Mohammad A Attar, Samir K Gadepalli
PURPOSE: Management guidelines for infants with chylothorax lack substantial evidence. We sought to identify variables that impact outcomes in these patients in order to develop an evidence-based management algorithm. METHODS: We retrospectively reviewed the medical records of all infants diagnosed with chylothorax from June 2005 to December 2014 at our institution. Data collected included demographics, chest tube output (CTO), medical and dietary interventions, surgical procedures, and absolute lymphocyte count (ALC)...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28342443/incidental-metastatic-mediastinal-atypical-carcinoid-in-a-patient-with-parathyroid-adenoma-a-case-report
#13
Zareen Kiran, Asma Ahmed, Owais Rashid, Saira Fatima, Faizan Malik, Saulat Fatimi, Mubassher Ikram
BACKGROUND: Atypical carcinoid arising from the mediastinal tissue is a rare neuroendocrine tumor and an association with parathyroid adenoma is very unusual. We report an unusual case of atypical carcinoid of mediastinum with metastasis in a patient presenting with parathyroid adenoma, which is the first case to be reported from Pakistan. CASE PRESENTATION: A 51-year-old Pakistani man was seen in postoperative intensive care after right parathyroidectomy and mediastinal mass resection for the management of postoperative hypocalcaemia...
March 26, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28340503/risk-factors-for-lymph-node-metastases-in-women-with-endometrial-cancer-a-population-based-nation-wide-register-study-on-behalf-of-the-swedish-gynecological-cancer-group-swegcg
#14
K Stålberg, P Kjølhede, M Bjurberg, C Borgfeldt, P Dahm-Kähler, H Falconer, E Holmberg, C Staf, B Tholander, E Åvall-Lundqvist, P Rosenberg, T Högberg
The role of lymphadenectomy in the management of early endometrial cancer is still controversial. In the recent ESMO-ESGO-ESTRO guidelines, lymphadenectomy is recommended for patients with endometrioid adenocarcinoma grade 3 with deep myometrial invasion, but complete agreement was not achieved. In Sweden, DNA aneuploidy has been included as a high-risk factor. The aim of our study was to evaluate the impact of tumor histology, FIGO grade, DNA ploidy and myometrial invasion (MI) on occurrence of lymph node metastasis (LNM) in patients with endometrial cancer...
March 24, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28340389/minilaparotomy-without-general-anesthesia-for-the-treatment-of-sigmoid-volvulus-in-high-risk-patients-a-case-series-of-4-patients
#15
Ernesto L Enrique, Kareem A Hamdy
BACKGROUND: Sigmoid volvulus (SV) is a common cause of large bowel obstruction worldwide. Presenting symptoms can be nonspecific and varied amongst the elderly population, making medical and surgical management challenging. This population is at markedly increase risk of complications and mortality with surgery under general anesthesia. In this case series, we describe 4 cases of sigmoid volvulus in octogenarians. GOALS: To demonstrate that sigmoid colectomy under local anesthesia, with or without intravenous conscious sedation, is feasible and can be done safely and with a low rate of converting to a general anesthetic...
March 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28340312/a-preliminary-investigation-on-the-effect-of-extracorporeal-shock-wave-therapy-as-a-treatment-for-neurogenic-heterotopic-ossification-following-traumatic-brain-injury-part-ii-effects-on-function
#16
J E Reznik, E Biros, Y Sacher, O Kibrik, S Milanese, S Gordon, M P Galea
INTRODUCTION: Neurogenic heterotopic ossification (NHO) occurs as a complication of traumatic brain injury (TBI). Management of clinically significant NHO remains variable. Complications of mature NHO include limitation of mobility. The effect of the extracorporeal shock wave therapy (ESWT) on range of motion at hip and knee, and function in patients with TBI with chronic NHO was investigated. METHODS: A series of single-case studies applying ESWT to chronic NHO at the hip or knee of 11 patients with TBI were undertaken at a rehabilitation hospital...
March 24, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28340247/usability-testing-of-the-iphone-app-to-improve-pain-assessment-for-older-adults-with-cognitive-impairment-prehospital-setting-a-qualitative-study
#17
Rachael E Docking, Matthew Lane, Pat A Schofield
Objectives. : Pain assessment in older adults with cognitive impairment is often challenging, and paramedics are not given sufficient tools/training to assess pain. The development of a mobile app may improve pain assessment and management in this vulnerable population. We conducted usability testing of a newly developed iPhone pain assessment application with potential users, in this case as a tool for clinical paramedic practice to improve pain assessment of older adults with cognitive impairment...
March 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340193/addressing-structural-barriers-to-hiv-care-among-triply-diagnosed-adults-project-bridge-oakland
#18
Christina Powers, Megan Comfort, Andrea M Lopez, Alex H Kral, Owen Murdoch, Jennifer Lorvick
People who are "triply diagnosed" with HIV, mental health issues, and substance-related disorders face tremendous barriers connecting to and remaining in HIV care. Authors of this article implemented Project Bridge Oakland (PBO), an intervention based on harm reduction and trauma-informed care, to help maintain continuity of care for triply diagnosed adults through cycles of criminal justice involvement. From August 2011 to December 2014, a clinical social worker and an HIV physician provided intensive case management for 19 clients living in Oakland, California...
March 14, 2017: Health & Social Work
https://www.readbyqxmd.com/read/28340143/protecting-pain-patients-the-evaluation-of-a-chronic-pain-educational-intervention
#19
Simon Holliday, Chris Hayes, Adrian Dunlop, Simon Morgan, Amanda Tapley, Kim Henderson, Briony Larance, Parker Magin
Introduction. : Advocacy and commercially funded education successfully reduced barriers to the provision of long-term opioid analgesia. The subsequent escalation of opioid prescribing for chronic noncancer pain has seen increasing harms without improved pain outcomes. Methods. : This was a one-group pretest-posttest design study. A multidisciplinary team developed a chronic pain educational package for general practitioner trainees emphasizing limitations, risk-mitigation, and deprescribing of opioids with transition to active self-care...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340123/rapid-ascent-from-zero-quality-to-international-organization-for-standardization-accreditation%C3%A2-a-case-study-of-hai-duong-preventive-medicine-center-in-vietnam-2012-2013
#20
Cuong Ngoc Duong, Kyle B Bond, Humberto Carvalho, Hien Bui Thi Thu, Thuong Nguyen, Thomas Rush
Objectives: In 2012, the Vietnam Ministry of Health sought to improve the quality of health laboratories by introducing international quality standards. Methods: Strengthening Laboratory Management Toward Accreditation (SLMTA), a year-long, structured, quality improvement curriculum (including projects and mentorship) was piloted in 12 laboratories. Progress was measured using a standardized audit tool (Stepwise Laboratory Quality Improvement Process Towards Accreditation)...
March 15, 2017: American Journal of Clinical Pathology
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