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https://www.readbyqxmd.com/read/28191381/spontaneous-unilateral-adrenal-hemorrhage-in-pregnancy
#1
Salam Kadhem, Rawaa Ebrahem, Cyrus Munguti, Rami Mortada
Spontaneous adrenal hemorrhage (SAH) is a serious medical condition associated with variable clinical presentation depending on the extent of the hemorrhage. Pregnancy-induced adrenal hemorrhage is poorly understood. A low cortisol level in the peripartum period with radiological findings is sufficient to establish the diagnosis. Prompt hormone replacement and supportive care to ensure good clinical outcomes is crucial. Due to the potentially life-threatening complications, physicians should have a high suspicion for adrenal hemorrhage when they evaluate patients with hypotension, fatigue, and abdominal pain during the peripartum period...
January 13, 2017: Curēus
https://www.readbyqxmd.com/read/28186630/cascade-convolutional-neural-networks-for-automatic-detection-of-thyroid-nodules-in-ultrasound-images
#2
Jinlian Ma, Fa Wu, Tian'an Jiang, Jiang Zhu, Dexing Kong
PURPOSE: It is very important for calculation of clinical indices and diagnosis to detect thyroid nodules from ultrasound images. However, this task is a challenge mainly due to heterogeneous thyroid nodules with distinct components are similar to background in ultrasound images. In this study, we employ cascade deep convolutional neural networks (CNNs) to develop and evaluate a fully automatic detection of thyroid nodules from 2D ultrasound images. METHODS: Our cascade CNNs are a type of hybrid model, consisting of two different CNNs and a new splitting method...
February 10, 2017: Medical Physics
https://www.readbyqxmd.com/read/28185891/feasibility-of-a-telehealth-educational-program-on-self-management-of-pain-and-fatigue-in-adult-cancer-patients
#3
Gabrielle B Rocque, Karina I Halilova, Allyson L Varley, Courtney P Williams, Richard A Taylor, David G Masom, William J Wright, Edward E Partridge, Elizabeth A Kvale
BACKGROUND: Pain and fatigue are common symptoms among cancer patients and often lead to substantial distress. Innovative self-management programs for pain and fatigue are needed. OBJECTIVES: The primary objective was to assess the feasibility of a telehealth pain and fatigue self-management program among adult cancer patients. Secondary objectives included assessment of differences in patient characteristics, recruitment and retention of patients based on 2 screening strategies: (1) navigator-collected, patient-reported pain or fatigue and (2) in-clinic, physician-identified pain or fatigue...
February 6, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28181278/hematology-patient-reported-symptom-screen-to-assess-quality-of-life-for-al-amyloidosis
#4
Rahma Warsame, Shaji K Kumar, Morie A Gertz, Martha Q Lacy, Francis K Buadi, Suzanne R Hayman, Nelson Leung, David Dingli, John A Lust, Yi Lin, Stephen Russell, Prashant Kapoor, Ronald S Go, Taxiarchis Kourelis, Wilson Gonsalves, Steven R Zeldenrust, Robert A Kyle, S Vincent Rajkumar, Tyler Zemla, Jeffrey Sloan, Angela Dispenzieri
Patients with light chain amyloidosis (AL) often have delayed diagnosis and present with significant symptomatology; this may result in decreased quality of life (QOL). We prospectively employ a "Hematology Patient Reported Symptom Screen" (HPRSS) which is three questions about fatigue, pain and QOL, scored 0-10. The aim of this study is to better understand QOL and determine if HPRSS parameters predict for clinical outcomes. From 2009-2014, 302 newly diagnosed AL patients were included. Baseline median scores [interquartile range] for fatigue, pain, and QOL were 6 [3,7], 2 [0,5], 5 [3,8], respectively...
February 9, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28173737/failure-of-a-systemic-lupus-erythematosus-response-index-developed-from-clinical-trial-data-lessons-examined-and-learned
#5
L J Forbess, C Bresee, D J Wallace, M H Weisman
Background Our primary goal was to create an outcome change score index similar to a standard rheumatoid arthritis (RA) model utilizing real-world data in systemic lupus erythematosus (SLE) patients that occurred during their phase 3 trials with a Food and Drug Administration-approved drug. Methods We utilized raw data from trials of belimumab for the treatment of SLE. Data were split 80/20 into training/validation sets. Index variables present in a majority of patients and with face validity were selected...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28163299/a-rare-case-of-acute-phlegmonous-esophagogastritis-complicated-with-hypopharyngeal-abscess-and-esophageal-perforation
#6
Yuan-Chun Huang, Ching-Yuan Cheng, Chiung-Ying Liao, Ching Hsueh, Yeu-Sheng Tyan, Shang-Yun Ho
BACKGROUND Acute phlegmonous esophagogastritis is a life-threatening disease that may be combined with serious complications. We present the classical radiological and endoscopic features and treatment strategy of a middle-aged female patient suffering from acute phlegmonous esophagogastritis complicated with hypopharyngeal abscess, esophageal perforation, mediastinitis, and empyema. CASE REPORT A 60-year-old Taiwanese female presented at our hospital due to fever, fatigue, painful swallowing, and vague chest pain for 5 days...
February 6, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28156596/impact-of-support-group-participation-in-women-with-gynecologic-cancer
#7
Adam Pyrzak, Fengjiao Hu, Ramses F Sadek, Donna Wheatley, Bunja Jane Rungruang, Sharad A Ghamande
: 252 Background: Unlike breast cancer support group literature, there is no data in women with gynecologic cancer who have different perspectives about their disease and therapy. We have a well-established, grass root level support group unique to women with gynecologic cancers that meets monthly. Our goal was to investigate perceived benefits of support group participation. METHODS: We developed an original questionnaire to evaluate the CSRA Gynecologic Oncology Support Group (CGOSG) participant's perceived effects of attending the group on their side effects and disease status which was distributed to patients attending CGOSG meetings...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156583/developing-a-supportive-oncology-program-in-a-cancer-institute-needs-assessment
#8
Tara Liberman, James D'Olimpio, Maria Carney
: 141 Background: Cancer patients experience significant symptom and psychosocial burden (Temel JS, et. al. N Engl J Med. 2010 Aug 19; 363(8):733-42. Early palliative care for patients with metastatic non-small-cell lung cancer.). Integration of supportive oncology programs within cancer centers has developed since the findings of Temel and Jackson. Addressing a growing need to manage patients comprehensively, the Northwell Health Divisions of Geriatric and Palliative Medicine and Hematology and Oncology partnered to initiate a community-based supportive oncology program...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156532/experience-of-patient-death-and-subsequent-bereavement-by-members-of-the-oncology-team-in-the-outpatient-setting
#9
(no author information available yet)
: 244 Background: Working with cancer patients is considered inherently stressful with high levels of burnout reported. There is limited research that focuses on the multidisciplinary team as a whole; research to date tends to focus on patient death from the perspective of the bedside oncology nurse, the physician or social worker. With the focus on those disciplines individually, thereby ignoring the centrality of the multidisciplinary nature of oncology care and excluding fundamental team members who provide care and are potentially impacted by the death of the patient...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28148697/updating-the-psoriatic-arthritis-psa-core-domain-set-a-report-from-the-psa-workshop-at-omeract-2016
#10
Ana-Maria Orbai, Maarten de Wit, Philip J Mease, Kristina Callis Duffin, Musaab Elmamoun, William Tillett, Willemina Campbell, Oliver FitzGerald, Dafna D Gladman, Niti Goel, Laure Gossec, Pil Hoejgaard, Ying Ying Leung, Chris Lindsay, Vibeke Strand, Désirée M van der Heijde, Bev Shea, Robin Christensen, Laura Coates, Lihi Eder, Neil McHugh, Umut Kalyoncu, Ingrid Steinkoenig, Alexis Ogdie
OBJECTIVE: To include the patient perspective in accordance with the Outcome Measures in Rheumatology (OMERACT) Filter 2.0 in the updated Psoriatic Arthritis (PsA) Core Domain Set for randomized controlled trials (RCT) and longitudinal observational studies (LOS). METHODS: At OMERACT 2016, research conducted to update the PsA Core Domain Set was presented and discussed in breakout groups. The updated PsA Core Domain Set was voted on and endorsed by OMERACT participants...
February 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28144977/changing-landscape-for-peritoneal-dialysis-optimizing-utilization
#11
Martin J Schreiber
The future growth of peritoneal dialysis (PD) will be directly linked to the shift in US healthcare to a value-based payment model due to PD's lower yearly cost, early survival advantage over in-center hemodialysis, and improved quality of life for patients treating their kidney disease in the home. Under this model, nephrology practices will need an increased focus on managing the transition from chronic kidney disease to end-stage renal disease (ESRD), providing patient education with the aim of accomplishing modality selection and access placement ahead of dialysis initiation...
February 1, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28134037/destiny-rides-again-the-reappearance-of-silicone-gel-filled-breast-implant-toxicity
#12
A E Brawer
Background Twenty-five years ago attorneys representing ailing women in class action litigation against silicone breast implant manufacturers made the procedural error of defining silicone-induced toxicity in the courtroom before it was properly studied in the exam room. This aberrant methodology perverted the proper research process, rendered verification of any real disease elusive, and cemented the groundwork for a repeat public health crisis potentially affecting two million women in the USA who possess new silicone gel devices inserted over the past 10 years...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28132703/drug-safety-and-adverse-drug-reaction-reporting-behavior-related-to-outpatient-opioid-replacement-therapy-results-from-a-survey-among-physicians
#13
Maximilian Gahr, Jonas Eller, Maurice Cabanis, Christoph Hiemke, Roland W Freudenmann, Bernhard J Connemann, Dirk Lang, Carlos Schönfeldt-Lecuona
To study drug safety and the reporting behavior of adverse drug reactions (ADR) related to agents used for opioid replacement therapy (ORT) we conducted a cross-sectional questionnaire-based telephone survey among physicians who provide outpatient ORT in Germany (n=176; response rate=55.7%). Most respondents (n=97/55.1%) reported that they observe ADR related to buprenorphine, (dihydro)codeine, and (levo)methdone rarely (n=38/21.6%), very rarely (n=39/22.2%) or never (n=20/11.4%). Methadone was reported to be most frequently associated with the occurrence of ADR (n=82/46...
March 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28129956/-medically-unexplained-symptoms-care-in-internal-medicine-a-paradigm-of-doctor-patient-relationship-in-situation-of-uncertainty
#14
B Ranque, O Nardon
Medically unexplained symptoms (MUS) are extremely common in general practice as in all medical specialties, but their designation is not unambiguous and the approaches to take care of the patients differ from conventional therapeutic approaches. The difficulty is not to confirm the diagnosis, which is rapidly obvious with some experience, but to establish a genuinely human therapeutic relationship, without any technical help, which pushes the doctor to the edge of his empathy and communication skills. The discomfort or even distress regularly encountered by physicians in front of a patient with MUS shows that the foundations of the doctor-patient relationship under uncertainty are poorly mastered...
January 24, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28114984/professionalism-professionalization-expertise-and-compassion-a-qualitative-study-of-medical-residents
#15
Susan P Phillips, Nancy Dalgarno
BACKGROUND: Formal and informal medical curricula convey expectations about professionalization, that is, the development of physician identity, and also about professionalism. This study examined whether, in general, junior residents experienced any dissonance between these roles and focused particularly on how they negotiated conflicts between compassion, self-care, duty and medical expertise. METHODS: In 2015, purposive sampling was used to select 21 first-year residents at a Canadian medical school...
January 23, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28099277/benefits-of-comprehensive-rehabilitation-therapy-in-thymectomy-for-myasthenia-gravis-a-propensity-score-matching-analysis
#16
Vincenzo Ambrogi, Tommaso Claudio Mineo
OBJECTIVE: To demonstrate the effectiveness of a comprehensive program of rehabilitation therapy in patients undergoing thymectomy for myasthenia gravis (MG). DESIGN: From 2005 to 2010, 46 consecutive patients affected by MG underwent a rehabilitation program both before and after thymectomy. We matched each patient with a "control patient" who underwent thymectomy within the period 1999 to 2004 with no preoperative rehabilitation, who had the closest propensity score matching...
February 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28095796/a-severe-case-of-visceral-leishmaniasis-and-liposomal-amphotericin-b-treatment-failure-in-an-immunosuppressed-patient-15%C3%A2-years-after-exposure
#17
Anna Eichenberger, Annina E Buechi, Andreas Neumayr, Chistroph Hatz, Andri Rauch, Marc Huguenot, Eva Diamantis-Karamitopoulou, Cornelia Staehelin
BACKGROUND: Visceral leishmaniasis (VL) is a protozoan disease, which is responsible for 200.000-400.000 yearly infections worldwide. If left untreated, the fatality rate can be as high as 100% within 2 years. 90% of cases occur in just six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. It is thus a disease rarely seen by physicians in Europe or North America. We report on the fatal case of VL in an 80-year-old immunosuppressed patient who presented with a latency of over 15 years after having visited an endemic region...
January 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28095555/megasessions-for-robotic-hair-restoration
#18
Joa O Carlos Pereira, Joa O Carlos Pereira Filho, Joa O Pedro Cabrera Pereira
A robotic system can select and remove individual hair follicles from the donor area with great precision and without fatigue. This report describes the use of the robotic system in a megasession for hair restoration. Patients were instructed to cut their hair to 1.0 to 1.2 mm before surgery. The robot selected and removed 600 to 800 grafts per hour so the follicular units (FU)s could be transplanted manually to recipient sites. The robot arm consists of a sharp inner punch and a blunt outer punch which together separate FUs from the sur- rounding tissue...
November 1, 2016: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28087054/care-pathway-of-patients-with-metastatic-pancreatic-cancer-in-daily-practice-in-france-results-from-the-repere-national-survey
#19
Pascal Hammel, Romain Coriat, Gérard Lledo, Mariella de Bausset, Marion Selosse, Stéphane Obled, Franck Bonnetain
Data in the literature regarding the care pathway of pancreatic cancer patients are limited. The objective of the REPERE survey was to identify and describe the initial stages of the care pathway of pancreatic patients in the metastatic phase. From May to October 2015, 62 oncologists (ON) or gastroenterologists specialized in digestive oncology (GESDO) and 300 general practitioners (GP) completed an electronic questionnaire on the pathway of 728 patients recently diagnosed with metastatic pancreatic adenocarcinoma...
January 10, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28075425/management-of-fibromyalgia-practical-guides-from-recent-evidence-based-guidelines
#20
Winfried Häuser, Jacob Ablin, Serge Perrot, Mary-Ann Fitzcharles
Fibromyalgia (FM) is a prevalent and costly condition worldwide, affecting approximately 2% of the general population. Recent evidence- and consensus‑based guidelines from Canada, Germany, Israel, and the European League Against Rheumatism aim to support physicians in achieving a comprehensive diagnostic workup of patients with chronic widespread (generalized) pain (CWP) and to assist patients and physicians in shared decision making on treament options. Every patient with CWP requires, at the first medical evaluation, a complete history, medical examination, and some laboratory tests (complete blood count, measurement of C‑reactive protein, serum calcium, creatine phosphokinase, thyroid‑stimulating hormone, and 25‑hydroxyvitamin D levels) to screen for metabolic or inflammatory causes of CWP...
January 4, 2017: Polskie Archiwum Medycyny Wewnętrznej
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