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https://www.readbyqxmd.com/read/29161702/favorable-effects-of-endoscopic-ligation-combined-with-drugs-on-rebleeding-and-mortality-in-cirrhotic-patients-a-network-meta-analysis
#1
Liang Shi, Xueping Zhang, Jianye Li, Xibo Bai
BACKGROUND: To assess the effects of combination therapies (endoscopic plus drug[s], drug combinations) on variceal/any-cause rebleeding and mortality among cirrhotic patients with one previous episode of variceal hemorrhage. SUMMARY: We searched PubMed, Embase, Cochrane Library, and Web of Science for eligible studies. We included 26 randomized controlled trials involving 2,536 adults using OR to measure the effects. Endoscopic variceal ligation (EVL) plus nadolol ranked first for reducing recurrent bleeds...
November 21, 2017: Digestive Diseases
https://www.readbyqxmd.com/read/29161385/are-we-close-to-the-ideal-intravenous-fluid
#2
N MacDonald, R M Pearse
The approach to i.v. fluid therapy for hypovolaemia may significantly influence outcomes for patients who experience a systemic inflammatory response after sepsis, trauma, or major surgery. Currently, there is no single i.v. fluid agent that meets all the criteria for the ideal treatment for hypovolaemia. The physician must choose the best available agent(s) for each patient, and then decide when and how much to administer. Findings from large randomized trials suggest that some colloid-based fluids, particularly starch-based colloids, may be harmful in some situations, but it is unclear whether they should be withdrawn from use completely...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161192/patient-preferences-in-subglottic-stenosis-treatment-a-discrete-choice-experiment
#3
Matthew R Naunheim, Margaret L Naunheim, Vinay K Rathi, Ramon A Franco, Mark G Shrime, Phillip C Song
Objectives Subglottic stenosis can be addressed with several different surgical techniques, but patient preferences for these treatment modalities are poorly understood. Economic methods are increasingly being used to understand how patients make decisions. The objective of this pilot study was to assess preferences in subglottic stenosis treatment using patient-centric stated preference techniques. Study Design Discrete choice experiment (DCE). Setting Academic research facility. Subjects and Methods A computer-based DCE was administered in a monitored setting to volunteers from the general population...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29160976/cannulation-outcomes-of-the-arteriovenous-fistula-for-hemodialysis-a-scoping-review
#4
Lori Harwood, Barbara Wilson, Maren Goodman
The arteriovenous fistula (AVF) is the recommended access for most people requiring hemodialysis. Success or failure of cannulation of the AVF greatly impacts the patient's experience. Research suggests that skill development in this area is needed. This scoping review was conducted to review current research on cannulation of the AVF to find strategies to improve successful cannulation. Results of this scoping review (n = 36)demonstrated that most studies can be categorized under the technique of cannulation, and concerns and preferences with the AVF as a consequence of cannulation...
September 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29160765/antithrombotic-treatment-in-peripheral-artery-disease
#5
Dan-Mircea Olinic, Dan Alexandru Tataru, Calin Homorodean, Mihail Spinu, Maria Olinic
This review treats antithrombotic use for peripheral arterial disease (PAD). In asymptomatic patients, there are no scientific data to support single antiplatelet therapy (SAPT) for primary prophylaxis. In symptomatic PAD, SAPT with aspirin or clopidogrel is indicated. The efficacy of aspirin is controversial. Clopidogrel may be preferred over aspirin. Ticagrelor is not superior to clopidogrel in reducing major adverse cardiovascular events and major adverse limb events, but lowers the risk of ischaemic stroke...
November 21, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29160622/mechanical-colon-cleansing-for-screening-colonoscopy-a-randomized-controlled-trial
#6
Kamran Ayub, Gyanprakash Ketwaroo, Suhaib Abudayyeh, Abeer Ibrahim, Rhonda A Cole, Rosetta Brumfield-Brown, Waqar A Qureshi, Linda Rabeneck, David Y Graham
AIMS: Effective screening colonoscopy depends on the quality of colon preparation. To compare pulsed irrigation evacuation (PIE), polyethylene glycol (PEG) and sodium phosphate colon preps. METHODS: Outpatients at a VA hospital were randomized using sealed envelopes. Preparations consisted of: 4 liters Golytely; 90 mL of Fleet sodium phosphate with 4-6 glasses water b.i.d., and 296 mL of Mg citrate in the evening with PIE prior to colonoscopy. Colon cleansing was assessed blindly using a 5-point scale: 0 = very poor to 4 = excellent...
November 21, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/29160473/tracheal-cuff-pressure-change-before-and-after-the-performance-of-nursing-care
#7
Lúcia Marinilza Beccaria, Thays Marley Antonio Doimo, Nádia Aparecida Antonia Polletti, Tais Pagliuco Barbosa, Daniele Cristiny da Silva, Alexandre Lins Werneck
OBJECTIVE: Verify the changes of endotracheal cuff pressure before and after oral hygiene, head-of-bed elevation at 0º, 30º, and 60º, change in body position, aspiration of the endotracheal tube, and in-bed bathing. METHOD: The study sample was composed of 88 patients. We performed 3,696 checks from July to September 2014. RESULTS: Pressure values were analyzed in seven nursing care in the morning. Six of them were significantly altered before and after nursing procedure...
November 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29160327/imbalance-in-amino-acid-and-purine-metabolisms-at-the-hypothalamus-in-inflammation-associated-depression-by-gc-ms
#8
Yu Wu, Yonghong Li, Yanjuan Jia, Chaojun Wei, Hui Xu, Rui Guo, Yuanting Li, Jing Jia, Xiaoming Qi, Xiaoling Gao
Hypothalamic dysfunction is a key factor in depression; increasing evidence highlights neuroinflammation abnormalities as well as imbalances in neurotransmitters and the purinergic system in the pathophysiology of depression. However, little is known about the metabolomic changes in the hypothalamus of depressed patients with neuroinflammation. Herein, taking advantage of the well-established lipopolysaccharide (LPS)-induced depression mouse model, we measured metabolic changes in the hypothalamus using gas chromatography-mass spectrometry (GC-MS)...
November 21, 2017: Molecular BioSystems
https://www.readbyqxmd.com/read/29159851/comparison-of-three-fixation-methods-in-treatment-of-tibial-fracture-in-adolescents
#9
REVIEW
Lixiang Lin, Yang Liu, Chuanlu Lin, Yifei Zhou, Yongzeng Feng, Xiaolong Shui, Kehe Yu, Xiaolang Lu, Jianjun Hong, Yang Yu
BACKGROUND: Tibial fractures are the most common musculoskeletal injury in adolescents. The optimal management of tibial fractures in adolescents is controversial. In this study, we compared the outcomes including complications of three fixation methods in tibial fractures of adolescents and explored the factors associated with the complications. METHODS: A retrospective cohort study about 83 diaphyseal tibial fractures in 79 children and adolescents, who were treated with plate fixation (PF), elastic stable intramedullary nail fixation (ESINF), or external fixation (EF), was conducted...
November 21, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29159776/non-pharmacological-interventions-in-patients-with-spinal-cord-compression-a-systematic-review
#10
REVIEW
María Paniagua-Collado, Omar Cauli
Spinal cord compression is a complex and challenging condition that greatly affects the quality of life. Non-pharmacological techniques have only been studied to a very lesser extent; although they are evidence to be beneficial. We performed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) analysis of the scientific literature in several databases (Medline, Cochrane, Scopus, Cuiden, Pubmed, Lilacs and Embase); using the following keywords: spinal cord compression, spine compression, mobilization, positioning, brace and bracing...
November 20, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29159744/treatment-and-outcome-of-synchronous-colorectal-carcinomas-a-nationwide-study
#11
A C R K Bos, R A Matthijsen, F N van Erning, M G H van Oijen, H J T Rutten, V E P P Lemmens
BACKGROUND: Synchronous colorectal carcinomas (CRC) occur in 1-8% of patients diagnosed with CRC. This study evaluated treatment patterns and patient outcomes in synchronous CRCs compared with solitary CRC patients. METHODS: All patients diagnosed with primary CRC between 2008 and 2013, who underwent elective surgery, were selected from the Netherlands Cancer Registry. Using multivariable regressions, the effects of synchronous CRC were assessed for both short-term outcomes (prolonged postoperative hospital admission, anastomotic leakage, postoperative 30-day mortality, administration of neoadjuvant or adjuvant treatment), and 5-year relative survival (RS)...
November 20, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29159605/outcomes-of-emergency-laparotomy-el-care-protocol-at-tertiary-care-center-from-low-middle-income-country-lmic
#12
Nitin Vashistha, Dinesh Singhal, Sandeep Budhiraja, Bharat Aggarwal, Raj Tobin, Kamal Fotedar
BACKGROUND: Emergency laparotomy mortality ranges between 10 and 20% in best of Western healthcare systems and is currently a major focus for quality improvement programs. In contrast, emergency surgery scenario in LMIC is largely undefined, often neglected and complex (large burden of diseases but only limited capacity for adequate treatment). We evaluated the efficacy of 'EL care protocol' aimed at cost-effective optimal utilization of best available local expertise and infrastructure...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29159479/operative-treatment-of-pelvic-apophyseal-avulsions-in-adolescent-and-young-adult-athletes-a-follow-up-study
#13
Juha-Jaakko Sinikumpu, Iftach Hetsroni, Ernest Schilders, Lasse Lempainen, Willy Serlo, Sakari Orava
INTRODUCTION: Pelvic apophyseal avulsion can limit young athletes' performance for months and may result in permanent disability. Nonoperative treatment is most commonly preferred, while surgical management with reduction and fixation is reserved for selected cases. Our aim was to evaluate outcomes of operative management of pelvic apophyseal avulsions in a series of adolescents and young adult athletes. MATERIALS AND METHODS: Operative room registries and medical records were reviewed to identify patients who received surgical treatment for pelvic apophyseal avulsions who were younger than 24 years and with a minimum of 12 month follow-up...
November 20, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29159371/care-planning-for-inpatients-referred-for-palliative-care-consultation
#14
Kara Bischoff, David L O'Riordan, Angela K Marks, Rebecca Sudore, Steven Z Pantilat
Importance: Care planning is a critical function of palliative care teams, but the impact of advance care planning and goals of care discussions by palliative care teams has not been well characterized. Objective: To describe the population of patients referred to inpatient palliative care consultation teams for care planning, the needs identified by palliative care clinicians, the care planning activities that occur, and the results of these activities. Design, Setting, and Participants: This was a prospective cohort study conducted between January 1, 2013, and December 31, 2016...
November 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29159311/the-response-of-the-menstrual-cycle-to-initiation-of-hormonal-therapy-in-transgender-men
#15
Shazia Ahmad, Matthew Leinung
Purpose: Transition from female to male gender after initiation of hormonal therapy involves both phenotypic and physiological changes. The response to treatment can vary widely from person to person. In this study, we looked at the response of the menstrual cycle after the initiation of testosterone therapy and we wished to determine the time period and dose of testosterone leading to the cessation of menses in transgender men. Methods: A retrospective chart review of 114 transgender men (individuals assigned female gender at birth but later identify themselves as males) seen for hormonal therapy in our transgender clinic from 2006 through 2016...
2017: Transgender Health
https://www.readbyqxmd.com/read/29158676/role-of-3-monthly-long-acting-injectable-paliperidone-in-the-maintenance-of-schizophrenia
#16
REVIEW
Claudio Brasso, Silvio Bellino, Paola Bozzatello, Cristiana Montemagni, Paola Rocca
Aims: Paliperidone palmitate 3-month (PP3M) represents a new long-acting injectable antipsychotic therapeutic option. This review aims: 1) to summarize available data relating to efficacy, safety, tolerability and costs of PP3M; 2) to describe hospitalization rate, occupational status, treatment preference, satisfaction, adherence and caregiver burden of patients with schizophrenia who participate in PP3M clinical trials; 3) to examine ethical implications, pros and cons of PP3M use and 4) to propose study designs to further assess PP3M...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29158371/perception-of-curability-among-advanced-cancer-patients-an-international-collaborative-study
#17
Sriram Yennurajalingam, Luis Fernando Rodrigues, Omar Shamieh, Colombe Tricou, Marilène Filbet, Kyaw Naing, Akhileshwaran Ramaswamy, Pedro Emilio Perez-Cruz, Mary Jocelyn S Bautista, Sofia Bunge, Mary Ann Muckaden, Vikash Sewram, Sarah Fakrooden, Antonio Tejedor Noguera, Shobha S Rao, Diane Liu, Minjeong Park, Janet L Williams, Zhanni Lu, Hilda Cantu, David Hui, Suresh K Reddy, Eduardo Bruera
BACKGROUND: There are limited data on illness understanding and perception of cure among advanced cancer patients around the world. The aim of the study was to determine the frequency and factors associated with inaccurate perception of curability among advanced cancer patients receiving palliative care across the globe. MATERIALS AND METHODS: Secondary analysis of a study to understand the core concepts in end-of-life care among advanced cancer patients receiving palliative care from 11 countries across the world...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29158366/therapeutic-anticoagulation-in-patients-with-primary-brain-tumors-or-secondary-brain-metastasis
#18
REVIEW
Richard J Lin, David L Green, Gunjan L Shah
Patients with primary or metastatic brain tumors are at increased risk of developing venous thromboses. However, the potential benefit of therapeutic anticoagulation in these patients must be weighed against the deadly complication of intracranial hemorrhage. In this review, we summarize available evidence and recent studies of intracranial bleeding risks in primary and metastatic tumors and the impact of therapeutic anticoagulation. We find that for the majority of primary and treated metastatic brain tumors, the risk of spontaneous bleeding is acceptable and not further increased by careful therapeutic anticoagulation with low molecular weight heparin or direct oral anticoagulants, although thrombocytopenia (platelet count less than 50,000/μL) and other coagulopathies are relative contraindications...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29158215/risk-stratification-in-arrhythmogenic-right-ventricular-cardiomyopathy
#19
REVIEW
Hugh Calkins, Domenico Corrado, Frank Marcus
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy characterized by ventricular arrhythmias and an increased risk of sudden cardiac death. Although structural abnormalities of the right ventricle predominate, it is well recognized that left ventricular involvement is common, particularly in advanced disease, and that left-dominant forms occur. The pathological characteristic of ARVC is myocyte loss with fibrofatty replacement. Since the first detailed clinical description of the disorder in 1982, significant advances have been made in understanding this disease...
November 21, 2017: Circulation
https://www.readbyqxmd.com/read/29158209/shaping-an-effective-health-information-website-on-rare-diseases-using-a-group-decision-making-tool-inclusion-of-the-perspectives-of-patients-their-family-members-and-physicians
#20
Ana Babac, Svenja Litzkendorf, Katharina Schmidt, Frédéric Pauer, Kathrin Damm, Martin Frank, Johann-Matthias Graf von der Schulenburg
BACKGROUND: Despite diverging definitions on rare conditions, people suffering from rare diseases share similar difficulties. A lack of experience by health professionals, a long wait from first symptoms to diagnosis, scarce medical and scientific knowledge, and unsatisfactory treatment options all trigger the search for health information by patients, family members, and physicians. Examining and systematically integrating stakeholder needs can help design information platforms that effectively support this search...
November 20, 2017: Interactive Journal of Medical Research
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