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Hasan Terzi, Pinar Solmaz Hasdemir, Alper Biler, Ahmet Kale, Fatih Sendag
OBJECTIVE: The aim of this study was to investigate whether uterine weight has a deleterious effect on the operation time, complication rates, length of hospital stay and incidence of intraoperative haemorrhage during total laparoscopic hysterectomy operation. METHODS: A total of 282 patients who underwent total laparoscopic hysterectomy for benign gynaecologic indications were retrospectively analyzed. The median operation time of 70 min was accepted as an index number, and a cut-off point of ≥300 g was calculated for uterine weight by using reciever operator characteristics (ROC) curve analysis...
October 19, 2016: International Journal of Surgery
Karen R Sepucha, Maggie Breslin, Charles Graffeo, Christopher R Carpenter, Erik P Hess
Shared decision making (SDM) has been advocated as an approach to selecting medical tests and treatments for many situations. The goal of SDM is to ensure that patients are well informed, meaningfully involved in decisions, and receive treatments that meet their goals and preferences. There is considerable evidence about the tools used to promote SDM, called patient decision aids, and many different measures have been developed to assess the impact of SDM. However, fairly little is known about the applicability of the tools and measures in the emergency department setting...
October 21, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Rosemarie Forstner, Isabelle Thomassin-Naggara, Teresa Margarida Cunha, Karen Kinkel, Gabriele Marselli, Rahel Kubik-Huch, John A Spencer, Andrea Rockall
: An update of the 2010 published ESUR recommendations of MRI of the sonographically indeterminate adnexal mass integrating functional techniques is provided. An algorithmic approach using sagittal T2 and a set of transaxial T1 and T2WI allows categorization of adnexal masses in one of the following three types according to its predominant signal characteristics. T1 'bright' masses due to fat or blood content can be simply and effectively determined using a combination of T1W, T2W and FST1W imaging...
October 21, 2016: European Radiology
Walter Pirker, Regina Katzenschlager
Human gait depends on a complex interplay of major parts of the nervous, musculoskeletal and cardiorespiratory systems. The individual gait pattern is influenced by age, personality, mood and sociocultural factors. The preferred walking speed in older adults is a sensitive marker of general health and survival. Safe walking requires intact cognition and executive control. Gait disorders lead to a loss of personal freedom, falls and injuries and result in a marked reduction in the quality of life. Acute onset of a gait disorder may indicate a cerebrovascular or other acute lesion in the nervous system but also systemic diseases or adverse effects of medication, in particular polypharmacy including sedatives...
October 21, 2016: Wiener Klinische Wochenschrift
Dennis Toddenroth, Janakan Sivagnanasundaram, Hans-Ulrich Prokosch, Thomas Ganslandt
BACKGROUND: The difficulty of managing patient recruitment and documentation for clinical trials prompts a demand for instruments for closely monitoring these critical but unpredictable processes. Increasingly adopted Electronic Data Capture (EDC) applications provide novel opportunities to reutilize stored information for an efficient management of traceable trial workflows. In related clinical and administrative settings, so-called digital dashboards that continuously visualize time-dependent parameters have recently met a growing acceptance...
October 18, 2016: Journal of Biomedical Informatics
Pei-Jung Lin, Wei-Shi Yeh, Peter J Neumann
OBJECTIVES: The current US mandatory newborn screening panel does not include spinal muscular atrophy, the most common fatal genetic disease among children. We assessed population preferences for newborn screening for spinal muscular atrophy, and how test preferences varied depending on immediate treatment implications. METHODS: We conducted an online willingness-to-pay survey of US adults (n = 982). Respondents were asked to imagine being parents of a newborn...
September 15, 2016: Pediatric Neurology
Charlotte Jensen, Gerry M Raghoebar, Wouter Kerdijk, Henny J A Meijer, Marco S Cune
OBJECTIVES: To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. METHODS: Thirty subjects with a bilateral unbounded posterior saddle received 2 PM and 2M Implants. A new RPD was placed. Implant support was provided 3 months later. Two PM implants supported the RPD. After 3 months the 2M implants were used or vice versa...
October 18, 2016: Journal of Dentistry
Jayd Lukenchuk, Laura A Sims, Jason J Shin
PURPOSE: The purpose of this study was to quantify the degree of variability in outcomes assessed after surgery for anterior shoulder instability in recent high-impact literature. METHODS: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, an extensive review of the literature during a 5-year period from January 2011 through December 2015 was performed across 6 orthopaedic journals with high impact factors to identify all studies investigating outcomes after anterior shoulder instability...
October 18, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Simon Tarp, Daniel E Furst, Anna Dossing, Mikkel Østergaard, Tove Lorenzen, Michael S Hansen, Jasvinder A Singh, Ernest H Choy, Maarten Boers, Maria E Suarez-Almazor, Lars E Kristensen, Henning Bliddal, Robin Christensen
OBJECTIVES: To summarize and compare the benefits and harms of biological agents used as monotherapy for rheumatoid arthritis (RA) in order to inform decisions for patients who are intolerant to conventional DMARD therapy. METHODS: We searched MEDLINE, EMBASE, CENTRAL, and other sources for randomised trials that compared biological monotherapy with methotrexate, placebo, or other biological monotherapies. Primary outcomes were ACR50 and the number of patients who discontinued due to adverse events...
September 14, 2016: Seminars in Arthritis and Rheumatism
Jyh-Ming Liou, Yu-Jen Fang, Chieh-Chang Chen, Ming-Jong Bair, Chi-Yang Chang, Yi-Chia Lee, Mei-Jyh Chen, Chien-Chuan Chen, Cheng-Hao Tseng, Yao-Chun Hsu, Ji-Yuh Lee, Tsung-Hua Yang, Jiing-Chyuan Luo, Chun-Chao Chang, Chi-Yi Chen, Po-Yueh Chen, Chia-Tung Shun, Wen-Feng Hsu, Wen-Hao Hu, Yen-Nien Chen, Bor-Shyang Sheu, Jaw-Town Lin, Jeng-Yih Wu, Emad M El-Omar, Ming-Shiang Wu
BACKGROUND: Whether concomitant therapy is superior to bismuth quadruple therapy or 14-day triple therapy for the first-line treatment of Helicobacter pylori infection remains poorly understood. We aimed to compare the efficacy and safety of 10-day concomitant therapy, 10-day bismuth quadruple therapy, and 14-day triple therapy in the first-line treatment of H pylori. METHODS: In this multicentre, open-label, randomised trial, we recruited adult patients (aged >20 years) with H pylori infection from nine medical centres in Taiwan...
October 18, 2016: Lancet
Eli Kisilevsky, Luminita Tarita-Nistor, Esther G González, Mark S Mandelcorn, Michael H Brent, Samuel N Markowitz, Martin J Steinbach
OBJECTIVE: Patients with central vision loss develop preferred retinal loci (PRLs) in the eccentric retina. The characteristics of the PRLs for the better eye (BE) are well studied, but not those of the worse eye (WE). We examined the distribution of monocular PRLs in the visual field (VF), as well as visual acuity, fixation stability, and PRL eccentricity for the BE and WE of patients with central vision loss. DESIGN: Retrospective consecutive case series. PARTICIPANTS: A total of 87 BE and 50 WE of patients with central vision loss...
October 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
David J Pulford, Philipp Harter, Anne Floquet, Catherine Barrett, Dong Hoon Suh, Michael Friedlander, José Angel Arranz, Kosei Hasegawa, Hiroomi Tada, Peter Vuylsteke, Mansoor R Mirza, Nicoletta Donadello, Giovanni Scambia, Toby Johnson, Charles Cox, John K Chan, Martin Imhof, Thomas J Herzog, Paula Calvert, Pauline Wimberger, Dominique Berton-Rigaud, Myong Cheol Lim, Gabriele Elser, Chun-Fang Xu, Andreas du Bois
BACKGROUND: The focus on translational research in clinical trials has the potential to generate clinically relevant genetic data that could have importance to patients. This raises challenging questions about communicating relevant genetic research results to individual patients. METHODS: An exploratory pharmacogenetic analysis was conducted in the international ovarian cancer phase III trial, AGO-OVAR 16, which found that patients with clinically important germ-line BRCA1/2 mutations had improved progression-free survival prognosis...
October 21, 2016: BMC Medical Ethics
Zhangguo Chen, Katherine Gowan, Sonia M Leach, Sawanee S Viboolsittiseri, Ameet K Mishra, Tanya Kadoishi, Katrina Diener, Bifeng Gao, Kenneth Jones, Jing H Wang
BACKGROUND: Whole genome next generation sequencing (NGS) is increasingly employed to detect genomic rearrangements in cancer genomes, especially in lymphoid malignancies. We recently established a unique mouse model by specifically deleting a key non-homologous end-joining DNA repair gene, Xrcc4, and a cell cycle checkpoint gene, Trp53, in germinal center B cells. This mouse model spontaneously develops mature B cell lymphomas (termed G1XP lymphomas). RESULTS: Here, we attempt to employ whole genome NGS to identify novel structural rearrangements, in particular inter-chromosomal translocations (CTXs), in these G1XP lymphomas...
October 21, 2016: BMC Genomics
Xiao Zheng, Zhi Yuan Bo, Wei Wan, Ye Chen Wu, Tian Tian Wang, Jun Wu, Dao Jian Gao, Bing Hu
AIM: Endoscopic biliary radiofrequency ablation (RFA) has been increasingly used for unresectable malignant biliary obstruction (MBO). However, its efficacy and safety remain unclear. METHODS: A comprehensive search of Cochrane Library, PubMed and EMBASE was conducted to collect studies to evaluate endoscopic biliary RFA in the management of MBO. Meta-analysis was performed by extracting the data from included studies with regards to the technical effectiveness, overall survival, adverse events and mortality of endoscopic RFA...
October 21, 2016: Journal of Digestive Diseases
Kimberly DiGioia, Mohit Nair, Morgan Shields, Vikas Saini
With the aim of better understanding what the public (as opposed to "patients") wants from health care, this study asked people on the street, "What does the right health care mean to you?" Responses ranged from "Caring about me more than just in the appointment" to "That everyone should see exactly what medical treatment costs." A qualitative analysis revealed that all responses fell into 2 overarching categories: health care at the interpersonal level and health care at the system level. Approximately 66...
October 20, 2016: Journal of Patient Safety
Dnyaneshwar D Athavale, Robin Jones, Brett A O'Donnell, Martin Forer, Nigel Biggs
PURPOSE: To describe the non-exenteration management of sino-orbital fungal infection, a life-threatening condition for which orbital exenteration is generally considered a first-line treatment. METHODS: A retrospective case series is presented of 7 orbits in 6 consecutive patients admitted and treated at 2 major metropolitan tertiary teaching hospitals in Sydney, New South Wales, Australia. RESULTS: Seven orbits in 6 consecutive patients with sino-orbital fungal infection were treated conservatively with surgical debridement and intravenous antifungal agents...
October 20, 2016: Ophthalmic Plastic and Reconstructive Surgery
Stephen Matthew Quinnan
Obtaining optimal results in the treatment of extraarticular distal tibia fractures can be challenging. Plate and screw and intramedullary fixation have proven to be effective treatments, but are associated with significant complication rates when used for open fractures and patient with severe medical comorbidities. External fixation is a third alternative that is less often employed, but provides a very effective means of treatment. Circular external fixation offers great flexibility in obtaining anatomic alignment and stable fixation for even the most challenging distal tibia fractures...
November 2016: Journal of Orthopaedic Trauma
Ersin Özaslan, Halit Karaca, Sinan Koca, Alper Sevinç, Bekir Hacioğlu, Metin Özkan, Melike Özçelik, Ayşe O Duran, İlhan Hacibekiroğlu, Yaşar Yildiz, Özgür Tanriverdi, Serkan Menekşe, Asude Aksoy, Oktay Bozkurt, Semiha Urvay, Mükremin Uysal, Hacer Demir, Aydin Çiltaş, Faysal Dane
The objectives of this study were to compare progression-free survival (PFS) with somatostatin analog (SSA) versus chemotherapy (CTx) in first-line therapy and to determine the patient group in which these treatments were more effective in neuroendocrine tumors (NETs) with a Ki-67 index of 20% or less. Patients who received SSA or CTx and had unresectable locally advanced and metastatic NETs with a Ki-67 index of 20% or less were retrospectively selected from 13 centers in the Turkish database between 2000 and 2015...
October 20, 2016: Anti-cancer Drugs
Helen Cullington, Padraig Kitterick, Lisa DeBold, Mark Weal, Nicholas Clarke, Eva Newberry, Lisa Aubert
Purpose: This research note describes a planned project to design, implement, and evaluate remote care for adults using cochlear implants and compare their outcomes with those of individuals following the standard care pathway. Method: Sixty people with cochlear implants will be recruited and randomized to either the remote care group or a control group. The remote care group will use new tools for 6 months: remote and self-monitoring, self-adjustment of device, and a personalized online support tool...
October 1, 2016: American Journal of Audiology
Michael D Cusimano, Iryna Pshonyak, Michael Y Lee, Gabriela Ilie
OBJECTIVE The 30-day readmission rate has emerged as an important marker of the quality of in-hospital care in several fields of medicine. This review aims to summarize available research reporting readmission rates after cranial procedures and to establish an association with demographic, clinical, and system-related factors and clinical outcomes. METHODS The authors conducted a systematic review of several databases; a manual search of the Journal of Neurosurgery, Neurosurgery, Acta Neurochirurgica, Canadian Journal of Neurological Sciences; and the cited references of the selected articles...
October 21, 2016: Journal of Neurosurgery
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