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https://www.readbyqxmd.com/read/28641169/association-between-switching-antiepileptic-drug-products-and-healthcare-utilization-a-systematic-review
#1
REVIEW
Patrick Kwan, André Palmini
AIMS: There is ongoing concern whether switching between different antiepileptic drug (AED) products may compromise patient care. We systematically reviewed changes in healthcare utilization following AED switch. METHODS: We searched MEDLINE and EMBASE databases (1980-October 2016) for studies that assessed the effect of AED switching in patients with epilepsy on outpatient visits, emergency room visits, hospitalization and hospital stay duration. RESULTS: A total of 14 articles met the inclusion criteria...
June 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28636738/impact-of-a-pediatric-anesthesiologist-on-operating-room-efficiency-during-pediatric-tonsillectomies-and-adenotonsillectomies
#2
Nicholas A Dewyer, Yoseph A Kram, Stephen Long, Marika D Russell
We conducted a retrospective case review to determine if the presence of an Accreditation Council for Graduate Medical Education (ACGME) fellowship-trained pediatric anesthesiologist improves efficiency during pediatric tonsillectomies and adenotonsillectomies in hospitals that do not have dedicated pediatric operating rooms and, if so, to determine which specific anesthesia practices might account for such a difference. We reviewed the charts of all patients aged 12 years and younger who had undergone a tonsillectomy or adenotonsillectomy from Jan...
June 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28636092/impact-of-diagnosis-of-von-willebrand-disease-on-patient-outcomes-analysis-of-medical-insurance-claims-data
#3
R F Sidonio, K M Haley, D Fallaize
The inherited bleeding disorder von Willebrand disease (VWD) is challenging to diagnose owing to disease heterogeneity, lack of a definitive laboratory test and variations in diagnostic criteria. We evaluated the impact of diagnosis and diagnostic delay on patient outcomes. The PharMetrics Plus Database was interrogated for medical claims for VWD (ICD-9 286.4) and bleeding events between 1 January 2006 and 30 June 2015. Longitudinal analysis was performed of patients newly diagnosed with VWD (≥9 months' continuous enrolment before first VWD claim) through 24 months following diagnosis...
June 21, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28634593/carcinoid-heart-disease-starting-from-heart-failure
#4
Nicole Bertin, Serena Favretto, Francesco Pelizzo, Lucio Mos, Franco Pertoldi, Olga Vriz
Carcinoid syndrome is the constellation of symptoms mediated by humoral factors produced by some carcinoid tumors. It consists primarily of vasomotor symptoms, gastrointestinal hypermotility, hypotension, and bronchospasm, due to the production and release of vasoactive substances. Carcinoid heart disease occurs in more than 50% of patients with carcinoid syndrome; in some cases, it represents the initial manifestation of the disease. We report the case of a 75-year-old woman with a metastatic neuroendocrine tumor admitted to the emergency room for fatigue and heart failure...
April 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28634084/drug-delivery-to-melanoma-brain-metastases-can-current-challenges-lead-to-new-opportunities
#5
Gautham Gampa, Shruthi Vaidhyanathan, Jann N Sarkaria, William F Elmquist
Melanoma has a high propensity to metastasize to the brain, and patients with melanoma brain metastases (MBM) have an extremely poor prognosis. The recent approval of several molecularly-targeted agents (e.g., BRAF, MEK inhibitors) and biologics (anti-CTLA-4, anti-PD-1 and anti-PD-L1 antibodies) has brought new hope to patients suffering from this formerly untreatable and lethal disease. Importantly, there have been recent reports of success in some clinical studies examining the efficacy of both targeted agents and immunotherapies that show similar response rates in both brain metastases and extracranial disease...
June 17, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28633798/case-report-irreducible-ankle-fracture-with-posterior-tibialis-tendon-and-retinaculum-deltoid-ligament-and-anteromedial-joint-capsule-entrapment
#6
Nicole M Stevens, Amy S Wasterlain, Sanjit R Konda
Irreducible ankle fractures are a relatively rare phenomenon. We present a case of a pronation abduction-type ankle fracture that was irreducible in the emergency room despite sedation. The patient was taken to the operating room, where the posterior tibialis tendon and retinaculum, deltoid ligament, and anteromedial capsule were found to be trapped within the joint. After removal of the tissue, alignment was restored. The patient did well clinically and was advanced to full weightbearing at 6 weeks. This is, to the best of our knowledge, the first report of entrapment of all 4 anatomic structures, preventing closed reduction...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28633745/carcinoma-hemorrhagiectoides-case-report-of-an-uncommon-presentation-of-cutaneous-metastatic-breast-carcinoma
#7
Roberto Cullen Aravena, Daniella Cullen Aravena, Margarita Jo Velasco, Alejandra Queirolo González, Luis Requena
In most cases, cutaneous metastases develop after the diagnosis of the primary internal malignancy has been established, but sometimes they can be discovered earlier or simultaneously. We describe a case of a 90-year-old woman who presented to the emergency room in poor general condition, with cutaneous lesions characterized by hot, infiltrated, violaceous and erythematous plaques involving the left chest wall. The clinical and histopathological findings were consistent with the recently described variant of inflammatory cutaneous metastatic carcinoma named carcinoma hemorrhagiectoides...
June 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28633152/state-of-pelvic-and-acetabular-surgery-in-the-developing-world-a-global-survey-of-orthopaedic-surgeons-at-surgical-implant-generation-network-sign-hospitals
#8
Paul S Whiting, Duane R Anderson, Daniel D Galat, Lewis G Zirkle, Douglas W Lundy, Hassan R Mir
OBJECTIVES: To document the current state of pelvic and acetabular surgery in the developing world and to identify critical areas for improvement in the treatment of these complex injuries. DESIGN: A 50-question online survey. SETTING: International, multicenter. PATIENTS/PARTICIPANTS: One hundred eighty-one orthopaedic surgeons at Surgical Implant Generation Network (SIGN) hospitals, which represent a cross-section of institutions in low- and middle-income countries that treat high-energy musculoskeletal trauma...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28632827/-occult-bacteremia-in-s%C3%A3-tero-del-r%C3%A3-o-hospital-experience-after-pneumococcal-conjugated-vaccine
#9
Isolda Budnik, Alejandra Sandoval, Alejandra Prado, Marcela Labbé, Anamaría Peña, Tamara Viviani
BACKGROUND: Occult bacteremia (OB) is one of the possible diagnoses of children younger than 3 years with fever without source in the emergency room. OBJECTIVE: describe OB in the era after introduction of pneumococcal vaccine in Chile. PATIENTS AND METHODS: Prospective descriptive review of data of children with possible OB diagnosis, referred from the emergency department between 2010-2013. RESULTS: Possible OB was diagnosed on 391 patients...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28632654/an-overview-of-cardiac-computed-tomography-in-adults-with-congenital-heart-disease
#10
Pal Suranyi, Akos Varga-Szemes, Anthony M Hlavacek
Familiarity with congenital heart disease (CHD) and its manifestations in adults is becoming increasingly important for the practicing cardiothoracic imager. The use of computed tomographic angiography is becoming commonplace not only in adults with a history and subsequent interventions for CHD as a child but also in de novo detection of-typically-milder, survivable forms of CHD, which are clinically suspected because of declining cardiac performance, cardiac events, or murmurs. Occasionally, adult CHD (ACHD) is found incidentally on scans performed for other indications (eg, trauma or neoplasm staging) because of improvements in computed tomographic technology and advanced visualization...
July 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28632149/association-between-air-pollution-and-emergency-room-visits-for-atrial-fibrillation
#11
Angelo G Solimini, Matteo Renzi
Despite the large prevalence in the population, possible factors responsible for the induction of atrial fibrillation (AF) events in susceptible individuals remain incompletely understood. We investigated the association between air pollution levels and emergency department admissions for AF in Rome. We conducted a 14 years' time-series study to evaluate the association between the daily levels of air pollution (particulate matter, PM10 and PM2.5, and nitrogen dioxide, NO₂) and the daily count of emergency accesses for AF (ICD-9 code: 427...
June 20, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28629401/odontogenic-orbital-cellulitis-associated-with-cavernous-sinus-thrombosis-and-pulmonary-embolism-a-case-report
#12
D Allegrini, S Reposi, E Nocerino, A Pece
BACKGROUND: This case illustrates the importance of prompt assessment and treatment of orbital cellulitis. In fact the ocular signs and symptoms may be associated with systemic complications which should be investigated and identified as soon as possible to avoid a poor prognosis. CASE PRESENTATION: A 46-year-old white woman presented to our emergency room with proptosis, ophthalmoplegia, and conjunctival chemosis of her left eye. An ophthalmologist, having diagnosed orbital cellulitis in her left eye, suspected a cavernous sinus thrombosis...
June 20, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28629290/functional-foods-how-functional-are-they-a-case-report-of-supplement-induced-psychosis
#13
Priyanka Yadav, Kyle Stigall, Hannah E Johnson, Abner O Rayapati, Nitin Chopra
There is rising evidence of patients' use of alternative and complementary medicine. The percentage of the U.S. population who used at least one dietary supplement increased from 42% in 1988-1994 to 53% in 2003-2006. We present a case of an Asian female in her 40s, with no previous psychiatric illness, who presented to the emergency room following a brief psychotic episode, during which she self-amputated the tips of her fingers, after using multivitamins and herbal supplements including ginseng, gui yuan rou (Chinese herb), astaxanthin, goji (Chinese fruit), selenium, saw palmetto, grape seed extract, citrus bioflavanoid, lutein (zeaxantin), resvexatrol, sun chlorella, spirulina powder, phytoceramides, phytoestrogen, glucosatrin, bromelain plus, and American bee pollen...
August 2016: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28629042/functionalization-of-zno-nanoparticles-by-3-mercaptopropionic-acid-for-aqueous-curcumin-delivery-synthesis-characterization-and-anticancer-assessment
#14
Seyed-Behnam Ghaffari, Mohammad-Hossein Sarrafzadeh, Zahra Fakhroueian, Shadab Shahriari, M Reza Khorramizadeh
Inherent biocompatibility and stability of zinc oxide nanoparticles (ZnO-NPs) and their biomedical potentials make them an emerging candidate for drug delivery. The aim of this study was to develop and assess a simple procedure for surface functionalization of ZnO-NPs by 3-mercaptopropionic acid (MPA) for water-soluble curcumin delivery. Carboxyl-terminated ZnO nanoparticles were successfully made using ZnCl2 and NaOH in the presence of MPA. The functional groups were activated by 1,1'-carbonyldiimidazole (CDI) and the curcumin bonding was carried out at room temperature for 24h...
October 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28628487/do-toddler-s-fractures-of-the-tibia-require-evaluation-and-management-by-an-orthopaedic-surgeon-routinely
#15
John S Adamich, Mark W Camp
OBJECTIVE: The majority of uncomplicated toddler fractures of the tibia (toddler's fractures) do not need an orthopaedic surgeon's intervention or follow-up. However, inexperienced emergency room physicians, general practitioners and orthopaedic trainees and surgeons understandably defer to a cautious approach of referral and subsequent frequent clinical and radiographic follow-up. An evidence-based pathway can help prevent this overtreatment, reduce unnecessary radiation exposure and decrease the financial burden on families and the healthcare system...
June 16, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28627854/swiss-and-tropical-snakebites-the-clinical-management
#16
Laurence Rochat, Gabriel Alcoba
With increasing trips to tropical areas, as well as a high number of venomous snake holders in the country, the frequency of snake bites is likely to increase. Even if in 50 % of cases, the bites do not lead to clinical envenoming, rapid and effective management is essential to successful treatment, which includes supply with the polyvalent or specific antivenom and recognition of the signs and symptoms justifying its administration. We will deal here mainly with local and tropical snake envenoming that Swiss practitioners could encounter in their offices or the emergency rooms and propose scenarios according to the syndromes...
May 3, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28627750/emergent-low-symmetry-phases-and-large-property-enhancements-in-ferroelectric-knbo3-bulk-crystals
#17
Tom T A Lummen, J Leung, Amit Kumar, X Wu, Y Ren, Brian K VanLeeuwen, Ryan C Haislmaier, Martin Holt, Keji Lai, Sergei V Kalinin, Venkatraman Gopalan
The design of new or enhanced functionality in materials is traditionally viewed as requiring the discovery of new chemical compositions through synthesis. Large property enhancements may however also be hidden within already well-known materials, when their structural symmetry is deviated from equilibrium through a small local strain or field. Here, the discovery of enhanced material properties associated with a new metastable phase of monoclinic symmetry within bulk KNbO3 is reported. This phase is found to coexist with the nominal orthorhombic phase at room temperature, and is both induced by and stabilized with local strains generated by a network of ferroelectric domain walls...
June 19, 2017: Advanced Materials
https://www.readbyqxmd.com/read/28624764/recommended-core-items-to-assess-e-cigarette-use-in-population-based-surveys
#18
Jennifer L Pearson, Sara C Hitchman, Leonie S Brose, Linda Bauld, Allison M Glasser, Andrea C Villanti, Ann McNeill, David B Abrams, Joanna E Cohen
A consistent approach using standardised items to assess e-cigarette use in both youth and adult populations will aid cross-survey and cross-national comparisons of the effect of e-cigarette (and tobacco) policies and improve our understanding of the population health impact of e-cigarette use. Focusing on adult behaviour, we propose a set of e-cigarette use items, discuss their utility and potential adaptation, and highlight e-cigarette constructs that researchers should avoid without further item development...
June 17, 2017: Tobacco Control
https://www.readbyqxmd.com/read/28624174/the-performance-gap-for-residents-in-transfer-of-intracorporeal-suturing-skills-from-box-trainer-to-operating-room
#19
Patrice Crochet, Aubert Agostini, Sophie Knight, Noémie Resseguier, Stéphane Berdah, Rajesh Aggarwal
OBJECTIVE: Training on laparoscopic box trainer (BT) improves suturing skills in the operating room (OR). Optimal laboratory training should provide trainees with an adequate level of skills that can be transferred to the OR with no decline in performances. This study aimed to compare OR intracorporeal suturing performances of residents who trained with a fundamentals of laparoscopic surgery (FLS) BT vs. those of experienced laparoscopists. DESIGN: This was a prospective observational study...
June 14, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28623838/economic-analysis-of-an-epilepsy-outreach-model-of-care-in-a-university-hospital-setting
#20
Eimer Maloney, Ronan N McGinty, Daniel J Costello
The prevalence of epilepsy in people with intellectual disability is higher than in the general population and prevalence rates increase with increasing levels of disability. Prevalence rates of epilepsy are highest among those living in residential care. The healthcare needs of people with intellectual disability and epilepsy are complex and deserve special consideration in terms of healthcare provision and access to specialist epilepsy clinics, which are usually held in acute hospital campuses. This patient population is at risk of suboptimal care because of significant difficulties accessing specialist epilepsy care which is typically delivered in the environs of acute hospitals...
June 14, 2017: Epilepsy & Behavior: E&B
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