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https://www.readbyqxmd.com/read/28340495/residents-learning-curve-of-lumbar-transforaminal-epidural-steroid-injections
#1
Holger Joswig, Sarah Roberta Haile, Gerhard Hildebrandt, Martin Nikolaus Stienen
Background and Study Aims There is a paucity of literature on beginners' training and on its connection with patient safety for transforaminal epidural steroid injections (TFESIs). This study retrospectively assessed the learning curves and associated complications of neurosurgery residents never previously exposed to TFESI and compared them with experienced board-certified faculty neurosurgeons (BCFNs). Material and Methods Procedure time in minutes, dose-area product (DAP) in cGy*cm(2), periprocedural observations, and complications in 354 TFESIs for radicular pain secondary to lumbar disk herniation or lumbar spinal stenosis were extracted from operative notes and the electronic infiltration logbook in the per-injection format...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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
#2
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/28340230/determinants-of-opioid-prescribing-for-nonmalignant-chronic-pain-in-us-outpatient-settings
#3
Rafia S Rasu, Maureen E Knell
Study Objectives.:  Identify prescribing trends for opioid use in non-malignant chronic pain (NMCP) from the National Ambulatory Medical Care Survey (NAMCS). Determine predictors of opioid use based on patient-specific factors. Design.:  This cross-sectional study analyzed NAMCS data from 2000 to 2007. Pain medications prescribed were retrieved using NAMCS drug codes. Multivariate logistic models examined determinants of opioid prescribing among NMCP patients...
March 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340223/implantation-of-cardiac-resynchronization-therapy-devices-using-three-leads-by-cephalic-vein-dissection-approach
#4
Alexios Hadjis, Riccardo Proietti, Vidal Essebag
Aims: Percutaneous subclavian, axillary, and cephalic vein access are all used in conjunction for atrial and ventricular lead implantation, though no standard approach for cardiac resynchronization therapy (CRT) device implantation has been established. We describe an effective and a safe technique for implanting three leads via cephalic vein for CRT pacemaker and/or defibrillator implantations. Methods and results: A total of 171 consecutive patients undergoing de novo implantation of CRT pacemaker or defibrillator were included...
March 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28340160/safety-of-fluoroscopy-guided-transseptal-approach-for-ablation-of-left-sided-arrhythmias
#5
Zviad Matoshvili, Hamid Bastani, Tara Bourke, Frieder Braunschweig, Nikola Drca, Kristjan Gudmundsson, Per Insulander, Anette Jemtrén, Göran Kennebäck, Ott Saluveer, Jonas Schwieler, Jari Tapanainen, Christer Wredlert, Mats Jensen-Urstad
Aims: The transseptal approach is used for left atrial access during the ablation of atrial fibrillation (AF) and other left-sided arrhythmia substrates. Transseptal puncture (TP) is commonly performed with fluoroscopic guidance, contrast injection, and pressure monitoring. In many centres, additional techniques [intracardiac echocardiography (ICE), transoesophageal echocardiography (TEE), radiofrequency needle] are used to facilitate TP but its use adds costs. In this retrospective study, we studied the safety and complication rate when TP was routinely done with fluoroscopic guidance, contrast injection, and pressure monitoring using ICE or TEE only in selected cases...
March 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28340127/do-interoceptive-sensations-provoke-fearful-responses-in-adolescents-with-chronic-headache-or-chronic-abdominal-pain-a-preliminary-experimental-study
#6
Florentina Flack, Christiane A Pané-Farré, Boris Zernikow, Luca Schaan, Tanja Hechler
Objective : To determine whether fear can be triggered when experiencing interoceptive sensations locally proximal to the primary pain region.  Two groups of adolescents (11-18 years) with chronic headache ( n  = 20) or chronic abdominal pain (CAP; n  = 20) completed three muscle tensing tasks to induce proximal versus distal sensations: (1) "frown" task (proximal for chronic headache; distal for CAP), (2) "tighten stomach" task (proximal for CAP; distal for chronic headache), and (3) safe comparison task (clench fist)...
March 18, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28340095/non-laser-percutaneous-extraction-of-pacemaker-and-defibrillation-leads-a-decade-of-progress
#7
Giulia Domenichini, Hanney Gonna, Rajan Sharma, Sergio Conti, Lorenzo Fiorista, Sue Jones, Maria Arthur, Shaumik Adhya, Marjan Jahangiri, Edward Rowland, Mark M Gallagher
Aims: Non-laser-based methods are safe in lead extraction but in the past have been less effective than laser methods. In the past decade, new equipment has been introduced including the Evolution® Mechanical Dilator Sheath and the Evolution® RL. We sought to determine the impact of new equipment on outcome in mechanical lead extraction. Methods and results: We considered 288 consecutive patients (age 66 ± 18 years) who underwent transvenous lead extraction (TLE) of 522 leads in the decade to the end of 2014...
March 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28340078/image-integration-into-3-dimensional-electro-anatomical-mapping-system-facilitates-safe-ablation-of-ventricular-arrhythmias-originating-from-the-aortic-root-and-its-vicinity
#8
Mario Jularic, Ruken Özge Akbulak, Benjamin Schäffer, Julia Moser, Jana Nuehrich, Christian Meyer, Christian Eickholt, Stephan Willems, Boris A Hoffmann
Aims: During ablation in the vicinity of the coronary arteries establishing a safe distance from the catheter tip to the relevant vessels is mandatory and usually assessed by fluoroscopy alone. The aim of the study was to investigate the feasibility of an image integration module (IIM) for continuous monitoring of the distance of the ablation catheter tip to the main coronary arteries during ablation of ventricular arrhythmias (VA) originating in the sinus of valsalva (SOV) and the left ventricular summit part of which can be reached via the great cardiac vein (GCV)...
March 7, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28340063/conventional-simplicity-iii-and-cooled-sinergy-radiofrequency-for-sacroiliac-joint-denervation-one-year-retrospective-study-comparing-two-devices
#9
Andrea Tinnirello, Sandra Barbieri, Manuel Todeschini, Maurizio Marchesini
Objective. : To compare two radiofrequency (RF) devices, Simplicity III (conventional RF), and SInergy (cooled RF), which are specifically designed to denervate the sacroiliac joint (SIJ). Design. : Retrospective observational study. Setting. : Italian National Health Service Public Hospital. Subjects.:  Forty-three patients with SIJ-derived pain refractory to conservative treatment; 21 and 22 patients, respectively, received Simplicity III or SInergy to denervate the SIJ...
March 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340043/very-long-term-outcome-following-transcatheter-ablation-of-atrial-fibrillation-are-results-maintained-after-10-years-of-follow-up
#10
Fiorenzo Gaita, Marco Scaglione, Alberto Battaglia, Mario Matta, Cristina Gallo, Michela Galatà, Domenico Caponi, Paolo Di Donna, Matteo Anselmino
Aims: Atrial fibrillation (AF) transcatheter ablation is a safe and effective procedure. However, outcome over 10 years of follow-up has never been reported. The aim of this study is to assess outcome, describe predictors of recurrences, and report on quality of life (QoL) the decade after an AF ablation. Methods and results: Patients referred for AF ablation in a single high volume centre from June 2004 to June 2006 were enrolled and followed in a prospective fashion by yearly clinical assessment and Holter monitoring...
February 28, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339995/long-term-flecainide-therapy-in-type-3-long-qt-syndrome
#11
Ehud Chorin, Rivki Taub, Aron Medina, Nir Flint, Sami Viskin, Jesaia Benhorin
Aims: Type 3 long QT syndrome (LQT3) is caused by gain-of-function mutations in the cardiac sodium channel gene (SCN5A). Previous reports on the long-term use of sodium channel blockers in LQT3 are sparse. The objective of the current study was to evaluate the long-term safety and efficacy of flecainide therapy in patients with LQT3 who carry the D1790G SCN5A mutation. Methods and results: The study population comprised 30 D1790G carriers who were treated with flecainide and followed for 1-215 months (mean 145 ± 54 months, median 140 months)...
February 28, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339945/single-site-ventricular-pacing-via-the-coronary-sinus-in-patients-with-tricuspid-valve-disease
#12
Amit Noheria, Martin van Zyl, Luis R Scott, Komandoor Srivathsan, Malini Madhavan, Samuel J Asirvatham, Christopher J McLeod
Aims: To evaluate coronary sinus single-site (CSSS) left ventricular pacing in adult patients with normal left ventricular ejection fraction (LVEF) when traditional right ventricular lead implantation is not feasible or is contraindicated. Methods and results: We performed a retrospective analysis of 23 patients with tricuspid valve surgery/disease who received a CSSS ventricular pacing lead to avoid crossing the tricuspid valve. Two matched control populations were obtained from patients receiving (i) conventional right ventricular single-site (RVSS) leads and (ii) coronary sinus leads for cardiac resynchronization therapy (CSCRT)...
March 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339918/can-clinically-relevant-dose-errors-in-patient-anatomy-be-detected-by-gamma-passing-rate-or-modulation-complexity-score-in-volumetric-modulated-arc-therapy-for-intracranial-tumors
#13
Shingo Ohira, Yoshihiro Ueda, Masaru Isono, Akira Masaoka, Misaki Hashimoto, Masayoshi Miyazaki, Masaaki Takashina, Masahiko Koizumi, Teruki Teshima
We investigated whether methods conventionally used to evaluate patient-specific QA in volumetric-modulated arc therapy (VMAT) for intracranial tumors detect clinically relevant dosimetric errors. VMAT plans with coplanar arcs were designed for 37 intracranial tumors. Dosimetric accuracy was validated by using a 3D array detector. Dose deviations between the measured and planned doses were evaluated by gamma analysis. In addition, modulation complexity score for VMAT (MCSv) for each plan was calculated. Three-dimensional dose distributions in patient anatomy were reconstructed using 3DVH software, and clinical deviations in dosimetric parameters between the 3DVH doses and planned doses were calculated...
March 3, 2017: Journal of Radiation Research
https://www.readbyqxmd.com/read/28339841/nutritive-value-and-the-maximum-inclusion-level-of-pennycress-meal-for-broiler-chickens
#14
R A Alhotan, R L Wang, R A Holser, G M Pesti
Two experiments were conducted to evaluate the nutritive value and maximum safe level (MSL) of pennycress meal (PM) for broiler chicks. In experiment 1, a total of 480 chicks was fed either mash or crumbled diets containing zero, 5, 10, or 15% PM for 18 d (8 diets; 6 replications per diet). In experiment 2, a total of 660 chicks was fed mash diets containing zero, 3, 6, 9, 12, or 15% of either PM or canola meal (CM; a comparative reference) for 14 d (11 diets; 6 replications per diet). Analytical results show that PM is a good source of protein (∼31% CP) and it is very comparable to CM (∼36% CP)...
February 23, 2017: Poultry Science
https://www.readbyqxmd.com/read/28339831/safety-of-intravenous-ferric-carboxymaltose-versus-oral-iron-in-patients-with-nondialysis-dependent-ckd-an-analysis-of-the-1-year-find-ckd-trial
#15
Simon D Roger, Carlo A Gaillard, Andreas H Bock, Fernando Carrera, Kai-Uwe Eckardt, David B Van Wyck, Maureen Cronin, Yvonne Meier, Sylvain Larroque, Iain C Macdougall
Background: The evidence base regarding the safety of intravenous (IV) iron therapy in patients with chronic kidney disease (CKD) is incomplete and largely based on small studies of relatively short duration. Methods: FIND-CKD (ClinicalTrials.gov number NCT00994318) was a 1-year, open-label, multicenter, prospective study of patients with nondialysis-dependent CKD, anemia and iron deficiency randomized (1:1:2) to IV ferric carboxymaltose (FCM), targeting higher (400-600 µg/L) or lower (100-200 µg/L) ferritin, or oral iron...
February 27, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339758/safety-and-efficacy-of-the-new-bidirectional-rotational-evolution%C3%A2-mechanical-lead-extraction-sheath-results-from-a-multicentre-italian-registry
#16
Patrizio Mazzone, Federico Migliore, Emanuele Bertaglia, Domenico Facchin, Elisabetta Daleffe, Vittorio Calzolari, Martino Crosato, Francesco Melillo, Francesco Peruzza, Alessandra Marzi, Nicoleta Sora, Paolo Della Bella
Aims: The aim of this prospective multicentre study is to evaluate safety and efficacy of the new bidirectional rotational mechanical lead extraction (LE) sheath (Evolution RL, Cook Medical, USA) in chronically implanted leads (>1-year-old leads). Methods and results: Between September 2013 and June 2016, a total of 238 leads in 124 consecutive patients were removed by using the new Evolution RL rotational mechanical sheath. Indications for LE were cardiac device infection in 63 (50...
February 23, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339697/are-informed-policies-in-place-to-promote-safe-and-usable-ehrs-a-cross-industry-comparison
#17
Erica L Savage, Rollin J Fairbanks, Raj M Ratwani
Objective: Despite federal policies put in place by the Office of the National Coordinator (ONC) to promote safe and usable electronic health record (EHR) products, the usability of EHRs continues to frustrate providers and have patient safety implications. This study sought to compare government policies on usability and safety, and methods of examining compliance to those policies, across 3 federal agencies: the ONC and EHRs, the Federal Aviation Administration (FAA) and avionics, and the Food and Drug Administration (FDA) and medical devices...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339578/safe-automatic-one-lead-electrocardiogram-analysis-in-screening-for-atrial-fibrillation
#18
Emma Svennberg, Martin Stridh, Johan Engdahl, Faris Al-Khalili, Leif Friberg, Viveka Frykman, Mårten Rosenqvist
Aims: Screening for atrial fibrillation (AF) using intermittent electrocardiogram (ECG) recordings can identify individuals at risk of AF-related morbidity in particular stroke. We aimed to validate the performance of an AF screening algorithm compared with manual ECG analysis by specially trained nurses and physicians (gold standard) in 30 s intermittent one-lead ECG recordings. Methods: The STROKESTOP study is a mass-screening study for AF using intermittent ECG recordings...
October 6, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339554/efficacy-and-safety-of-antazoline-in-the-rapid-cardioversion-of-paroxysmal-atrial-fibrillation-the-anpaf-study
#19
Aleksander Maciag, Michal M Farkowski, Tomasz Chwyczko, Maciej Beckowski, Pawel Syska, Ilona Kowalik, Mariusz Pytkowski, Jacek Wozniak, Rafal Dabrowski, Hanna Szwed
Aims: The aim of the study was to assess the clinical efficacy of antazoline, a first-generation anti-histaminic agent, in the rapid conversion of paroxysmal non-valvular atrial fibrillation (AF) to sinus rhythm in patients without heart failure. Methods and results: This study was a single center, randomized, double blind, placebo-controlled, superiority clinical trial. We enrolled patients with an AF episode lasting less than 43 h, in stable cardiopulmonary condition...
December 22, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339500/detecting-congenital-malformations-lessons-learned-from-the-mpepu-study-botswana
#20
Gbolahan Ajibola, Rebecca Zash, Roger L Shapiro, Oganne Batlang, Kerapetse Botebele, Kara Bennett, Florence Chilisa, Erik von Widenfelt, Joseph Makhema, Shahin Lockman, Lewis B Holmes, Kathleen M Powis
INTRODUCTION: A large and increasing number of HIV-infected women are conceiving on antiretroviral treatment (ART). While most antiretrovirals are considered safe in pregnancy, monitoring for rare pregnancy and infant adverse outcomes is warranted. METHODS: We conducted a retrospective secondary analysis nested within a clinical trial of infant cotrimoxazole vs. placebo prophylaxis in Botswana (the Mpepu Study). Infants were examined at birth, and at least every 3 months through 18 months of age...
2017: PloS One
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