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https://www.readbyqxmd.com/read/29025045/clinical-features-and-outcomes-in-secondary-adult-hemophagocytic-lymphohistiocytosis
#1
Meng Zhou, Li Li, Qiaolei Zhang, Shanshan Ma, Jianai Sun, Lixia Zhu, Danlei Lu, Jingjing Zhu, De Zhou, Yanlong Zheng, Xiudi Yang, Mixue Xie, Mingyu Zhu, Xiujin Ye, Wanzhuo Xie
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a rare clinical syndrome characterized by an infrequent but immune-mediated life-threatening disease, with confusing clinical manifestations, rapidly deteriorating health, high morbidity and mortality and challenging diagnosis. METHODS: To improve the recognition and understanding of this disease, we analyzed clinical and laboratory findings and prognostic factors from 205 adult patients diagnosed with HLH in a large cohort managed at a single medical center from January 2011 to December 2015...
September 15, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29022830/direct-costs-for-nonsurgical-management-of-chronic-pancreatitis-in-a-tertiary-care-teaching-hospital
#2
Nagesh Kamat, Ganesh Pai, Surulivel Rajan Mallayasamy, Asha Kamath, Rajasulochana S
BACKGROUND: Chronic pancreatitis (CP) is a leading cause of hospitalization among gastrointestinal diseases resulting in considerable financial burden to patients. However the direct costs for nonsurgical management in CP remains unexplored. METHODS: A cross sectional study was carried out (2011-14) in the Department of Gastroenterology, Kasturba Hospital, Manipal, India. Demographic and clinical data on laboratory investigations, interventions and follow up were obtained from the medical records department...
October 12, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/29022085/rare-pancreatic-tumors
#3
Jonathan Steinman, Atif Zaheer, Michael D Kluger, Helen Remotti, Elizabeth M Hecht
In this review, we will focus on rare pancreatic tumors. Most of these tumors do not have distinct characteristic appearances so the key to diagnosis requires a combination of imaging appearance, laboratory data, patient demographics, and associated medical syndromes in order to narrow the differential diagnosis. Nonetheless, imaging plays a vital role in narrowing the differential and guiding management. While there are many variant pathologic entities that cannot be encompassed by a single review, we aim to illustrate the imaging appearance of less common pancreatic tumors highlighting key distinctive diagnostic characteristics and discuss the implications for management...
October 11, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29018155/clinical-characteristics-of-138-chinese-female-patients-with-idiopathic-hypogonadotropic-hypogonadism
#4
Rui-Yi Tang, Rong Chen, Miao Ma, Shou-Qing Lin, Yi-Wen Zhang, Ya-Ping Wang
OBJECTIVE: To evaluate the clinical features of Chinese women with idiopathic hypogonadotropic hypogonadism (IHH). METHODS: We retrospectively reviewed the clinical characteristics, laboratory and imaging findings, therapeutic management, and fertility outcomes of 138 women with IHH. All patients had been treated and followed-up at an academic medical centre during 1990-2016. RESULTS: Among the 138 patients, 82 patients (59.4%) were diagnosed with normosmic IHH and 56 patients (40...
October 10, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/29017451/multiplex-pcr-point-of-care-testing-versus-routine-laboratory-based-testing-in-the-treatment-of-adults-with-respiratory-tract-infections-a-quasi-randomised-study-assessing-impact-on-length-of-stay-and-antimicrobial-use
#5
Denise Andrews, Yumela Chetty, Ben S Cooper, Manjinder Virk, Stephen K Glass, Andrew Letters, Philip A Kelly, Malur Sudhanva, Dakshika Jeyaratnam
BACKGROUND: Laboratory-based respiratory pathogen (RP) results are often available too late to influence clinical decisions such as hospitalisation or antibiotic treatment due to time delay in transport of specimens and testing schedules. Ward-based i.e. point of care (POC) testing providing rapid results may alter the clinical management pathway. METHODS: FilmArray® RP polymerase chain reaction (PCR) systems were placed in three in-patient and out-patient medical areas...
October 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28990428/retrospective-review-of-comorbid-conditions-in-a-multidisciplinary-pediatric-weight-management-clinic
#6
Christine Thang, Margaret Whitley, Nilufar Izadpanah, Daniel DeUgarte, Wendy Slusser
A retrospective medical chart review was conducted of patients enrolled in the Fit for Healthy Weight Clinic (Fit Clinic). At initial evaluation, comorbidities were identified by the patient and pediatrician. The number of comorbidities increased with age among patients. In reviewing the differences among the number of identified comorbidities among grade school age and adolescent patients, increases of 30% were observed in gastrointestinal-associated, 23% in psychiatric, 18% in endocrine, 16% in cardiovascular, and 14% in respiratory comorbidities...
October 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28988402/nutritional-markers-may-identify-patients-with-greater-risk-of-re-admission-after-geriatric-hip-fractures
#7
Austin V Stone, Alexander Jinnah, Brian J Wells, Hal Atkinson, Anna N Miller, Wendell M Futrell, Kristin Lenoir, Cynthia L Emory
PURPOSE: Osteoporotic hip fractures are increasing in prevalence with the growing elderly population. Morbidity and mortality remain high following osteoporotic hip fractures despite advances in medical and surgical treatments. The associated costs and medical burdens are increased with a re-admission following hip fracture treatment. This study sought to identify demographic and clinical values that may be a predictive model for 30-day re-admission risk following operative management of an isolated hip fracture...
October 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28987448/fungal-keratitis
#8
REVIEW
T Bourcier, A Sauer, A Dory, J Denis, M Sabou
Fungal keratitis, or keratomycoses, are corneal infections which must be considered in cases of corneal trauma, prior corneal surgery, chronic ocular surface disease, topical corticosteroids or contact lens wear. Filamentous fungi or yeasts may be involved. Presenting clinical features such as corneal infiltrates with feathery edges and/or raised surface, intact epithelium with deep stromal involvement, satellite lesions, endothelial plaques, lack of improvement with antibiotics and worsening with steroids are suggestive of fungal keratitis...
October 4, 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/28984672/cholangitis-lenta-a-clinicopathologic-study-of-28-cases
#9
Vanda F Torous, A Laura De La Cruz, Bita V Naini, Hanlin L Wang
Cholangitis lenta, also known as ductular cholestasis, cholangiolar cholestasis, or subacute nonsuppurative cholangitis, is an uncommon type of cholangitis characterized by ductular reaction with inspissated bile in dilated ductules. The literature on this unique entity has been limited to only a few studies based on a very limited number of cases, which importantly suggest an association with sepsis and/or intra-abdominal infection. The clinical, laboratory, and histologic features of 28 cases of cholangitis lenta are herein investigated...
October 3, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28975014/the-relative-burden-of-menopausal-and-postmenopausal-symptoms-versus-other-major-conditions-a-retrospective-analysis-of-the-medical-expenditure-panel-survey-data
#10
Annlouise R Assaf, Andrew G Bushmakin, Nina Joyce, Michael J Louie, Michael Flores, Margaret Moffatt
BACKGROUND: The direct costs associated with menopausal and postmenopausal symptoms (hereafter "menopausal symptoms") may include the costs of physician and emergency department visits, medications, laboratory testing, and the management of side effects. However, much remains unknown about the costs related to menopausal symptoms, including how they compare with the costs of other diseases that are common among menopausal women. OBJECTIVE: To compare the economic burden of menopausal symptoms with other select prevalent chronic conditions among a nationally representative sample of US menopausal women aged 45 to 65 years...
September 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28972988/orbital-complications-of-paranasal-sinusitis-in-taiwan-1988-through-2015-acute-ophthalmological-manifestations-diagnosis-and-management
#11
Yi-Sheng Chang, Po-Lin Chen, Jia-Horung Hung, Hsiao-Yen Chen, Chun-Chieh Lai, Chun-Yen Ou, Chia-Ming Chang, Chien-Kuo Wang, Hon-Chun Cheng, Sung-Huei Tseng
PURPOSE: Paranasal sinusitis is widespread and can lead to orbital complications, blindness, and death. However, the correlation between ophthalmological findings and disease staging remains unclear. This study aimed to investigate the staging, acute ophthalmological manifestations, diagnosis, management, and outcomes of orbital complications of paranasal sinusitis during a 27-year period. METHODS: We retrospectively reviewed the medical records of all patients with orbital complications of paranasal sinusitis hospitalized at the National Cheng Kung University Hospital, a medical center in Taiwan during 1988-2015...
2017: PloS One
https://www.readbyqxmd.com/read/28970189/impact-of-a-telehealth-program-with-voice-recognition-technology-in-patients-with-chronic-heart-failure-feasibility-study
#12
Heesun Lee, Jun-Bean Park, Sae Won Choi, Yeonyee E Yoon, Hyo Eun Park, Sang Eun Lee, Seung-Pyo Lee, Hyung-Kwan Kim, Hyun-Jai Cho, Su-Yeon Choi, Hae-Young Lee, Jonghyuk Choi, Young-Joon Lee, Yong-Jin Kim, Goo-Yeong Cho, Jinwook Choi, Dae-Won Sohn
BACKGROUND: Despite the advances in the diagnosis and treatment of heart failure (HF), the current hospital-oriented framework for HF management does not appear to be sufficient to maintain the stability of HF patients in the long term. The importance of self-care management is increasingly being emphasized as a promising long-term treatment strategy for patients with chronic HF. OBJECTIVE: The objective of this study was to evaluate whether a new information communication technology (ICT)-based telehealth program with voice recognition technology could improve clinical or laboratory outcomes in HF patients...
October 2, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28967605/-22q11-2%C3%A2-microdeletion-syndrome-analysis-of-the-care-pathway-before-the-genetic-diagnosis
#13
T Ingrao, L Lambert, M Valduga, G Bosser, E Albuisson, B Leheup
BACKGROUND: 22q11.2 deletion syndrome (22q11.2DS) is a very broad phenotypic spectrum disorder. It can affect many organs or systems. 22q11.2DS is the most common microdeletion syndrome in humans, with a prevalence ranging from one in every 2000 to one in 4000 newborns. It seems to be more prevalent than reported and under-recognized or undiagnosed because of its inherent clinical variability and heterogeneity. In France, 15,000 patients may be affected by this disease, more than half without knowing it...
September 26, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28965748/the-effectiveness-of-pharmacist-interventions-on-cardiovascular-risk-in-adult-patients-with-type-2-diabetes-the-multicentre-randomized-controlled-rxeach-trial
#14
Yazid N Al Hamarneh, Brenda R Hemmelgarn, Imran Hassan, Charlotte A Jones, Ross T Tsuyuki
Cardiovascular disease (CVD) is the leading cause of death among patients with diabetes. Management and control of CV risk factors in those with diabetes are generally poor. Pharmacists are frontline primary healthcare providers who see patients with chronic diseases frequently. As such, they are in a prime position to systematically identify patients with diabetes, assess their CV risk and assist in their disease management and preventive measures. OBJECTIVE: to evaluate the effect of pharmacist case finding and intervention program on estimated CV risk in patients with diabetes...
September 28, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28965637/aspirin-and-nonsteroidal-antiinflammatory-drugs-hypersensitivity-and-management
#15
REVIEW
Brian Modena, Andrew A White, Katharine M Woessner
Aspirin and nonsteroidal antiinflammatory drugs (NSAIDs) are widely used in the United States and throughout the world for a variety of indications. Several unique hypersensitivity syndromes exist to this class of medications, making them one of the common reasons for consultation to the allergist. The lack of any laboratory-based diagnostic studies to assist in identifying the culprits in these reactions make evaluation of aspirin and NSAID hypersensitivity challenging. Identifying patients appropriate for oral challenge and/or desensitization protocols is the standard pragmatic approach to this issue when it arises...
November 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/28958963/lean-management-and-medical-laboratory-application-in-transfusionnal-immuno-hematology
#16
Jean-Baptiste Thibert, Françoise Le Vacon, Bruno Danic
Despite a common use in industrial applications, only a few studies describe the lean management methods in medical laboratory. These tools have been evaluated in analysis laboratory of blood donors, especially in immuno-hematology sector. The aim was to optimize the organization and maintain team cohesion and strong staff involvement in a restructuring context. The tools used and the results obtained are presented in this study.
October 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28949250/the-challenges-of-implementing-pharmacogenomic-testing-in-the-clinic
#17
Ann M Moyer, Pedro J Caraballo
Pharmacogenomic testing has the potential to greatly benefit patients by enabling personalization of medication management, ensuring better efficacy and decreasing the risk of side effects. However, to fully realize the potential of pharmacogenomic testing, there are several important issues that must be addressed. Areas covered: In this expert review we discuss current challenges impacting the implementation of pharmacogenomic testing in the clinical practice. We emphasize issues related to testing methods, reporting of the results, test selection, clinical interpretation of the results, cost-effectiveness, and the long-term use of pharmacogenomic results in clinical practice...
October 3, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28949092/profiling-arthritis-pain-with-decision-tree
#18
Man Hung, Jerry Bounsanga, Fangzhou Liu, Maren W Voss
BACKGROUND: Arthritis is the leading cause of work disability and contributes to lost productivity. Previous studies showed that various factors predict pain but they were limited in sample size and scope from a data analytics perspective. OBJECTIVES: The current study applied machine learning algorithms to identify predictors of pain associated with arthritis in a large national sample. METHODS: Using data from the 2011-2012 Medical Expenditure Panel Survey, data mining was performed to develop algorithms to identify factors and patterns that contribute to risk of pain...
September 26, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28947321/causes-consequences-and-management-of-sample-hemolysis-in-the-clinical-laboratory
#19
REVIEW
Laura Heireman, Pieter Van Geel, Lorenz Musger, Evelien Heylen, Wim Uyttenbroeck, Boris Mahieu
Preanalytical hemolysis of blood samples is a common problem in medical practice, especially in emergency departments. Several potential influences on sample hemolysis have been investigated, including sampling techniques, centrifugation and sample transport. In particular, the use of intravenous catheters and the vacuum sampling technique have often been demonstrated to provoke hemolysis. Other factors playing a role include the use of inappropriate puncture sites, complicated blood sampling, prolonged tourniquet application, underfilling of tubes and excessive shaking of specimens...
September 22, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28944123/preventing-cushing-iatrogenic-cushing-syndrome-due-to-ritonavir-fluticasone-interaction
#20
Fasil Tiruneh, Ahmad Awan, Abiot Didana, Saumil Doshi
Ritonavir is commonly used in low doses to boost plasma levels of protease inhibitors in patients with human immunodeficiency virus (HIV) infections. It is also a potent inhibitor of cytochrome P450. We present a 50-year-old African American male with past medical history of HIV on highly active antiretroviral therapy (HAART), which also included ritonavir and long standing asthma that has been treated with inhaled fluticasone, who presented with back pain. He had central obesity, prominent abdominal striae and wasted extremities on physical examination...
July 17, 2017: Curēus
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