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Viola Andresen, Peter Layer
The irritable bowel syndrome (IBS) counts among the most prevalent chronic diseases. Clinically, the IBS is characterized by abdominal symptoms combined with irregular defecation, which are not explained by routine diagnostic tests. IBS is often triggered by enteric bacterial infections, and its pathogenesis involves disturbed enteric, gut-brain, and cerebral mechanisms. Diagnostic work-up must aim to establish a positive IBS diagnosis, and to exclude serious underlying differential diagnoses (such as neoplasia, inflammatory bowel disease, celiac disease and others)...
March 2018: Deutsche Medizinische Wochenschrift
Gesine Meyer, Klaus Badenhoop
An adrenal crisis (Addisonian crisis) is an acute life-threatening complication of adrenal insufficiency. It occurs when hydrocortisone demand is not met by supplementation in the context of an infection - often gastrointestinal, fever, trauma, acute psychological or physical stress. Symptoms of weakness, nausea, muscle/joint pain and drowsiness may develop out of robust health within few hours. If overlooked, treated too late, with insufficient dose or route of application, there exists a considerable risk of mortality...
March 2018: Deutsche Medizinische Wochenschrift
Stephanie Elyse Ambrose, Julina Ongkasuwan, Kavita Dedhia, Gillian Ruth Diercks, Samantha Anne, Subhadra Shashidharan, Nikhila Raol
Importance: Vocal fold motion impairment (VFMI) is a known risk factor following congenital heart surgery (CHS). The impact of this diagnosis on utilization and outcomes is unknown. Objective: To evaluate the cost, postprocedure length of stay (PPLOS), and outcomes for neonates with VFMI after CHS. Design, Setting, and Participants: A cross-sectional analysis of the 2012 Kids' Inpatient Database (KID) of neonates who underwent CHS was carried out...
March 15, 2018: JAMA Otolaryngology—Head & Neck Surgery
Bruno Tochetto Primo, Leonardo Marcos Mezzari, Luís Carlos da Fontoura Frasca, Raquel Linderman, Elken Gomes Rivaldo
PURPOSE: To evaluate and compare the clinical and radiographic outcomes of mandibular rehabilitation with fixed prostheses on three implants with immediate versus delayed loading. MATERIALS AND METHODS: The sample comprised 21 patients who underwent treatment with immediate loading and 23 who received delayed loading. All had worn their prostheses for at least 18 months. Radiographic evaluation of bone loss was carried out in Adobe Photoshop CS5 by a single calibrated examiner using digitized panoramic radiographs...
March 15, 2018: International Journal of Oral & Maxillofacial Implants
Aleksandra Augusciak-Duma, Joanna Witecka, Aleksander L Sieron, Magdalena Janeczko, Jacek J Pietrzyk, Karolina Ochman, Anna Galicka, Maria K Borszewska-Kornacka, Jacek Pilch, Elzbieta Jakubowska-Pietkiewicz
Although over 85% of osteogenesis imperfecta (OI) cases are associated with mutations in the procollagen type I genes (COL1A1 or COL1A2), no hot spots for the mutations were associated with particular clinical phenotypes. Eight patients that were studied here, diagnosed with OI by clinical standards, are from the Polish population with no ethnic background indicated. Previously unpublished mutations were found in six out of those eight patients. Genotypes for polymorphisms (Sp1 - rs1800012 and PvuII - rs412777), linked to bone formation and metabolism were determined...
March 15, 2018: Acta Biochimica Polonica
Zengli Zhang, Huiqian Wang, Qifeng Ding, Yufei Xing, Zhonghua Xu, Chun Lu, Dongdong Luo, Longjiang Xu, Wei Xia, Caicun Zhou, Minhua Shi
The prognosis of advanced non-small cell lung cancer (NSCLC) patients is poor. One of the reasons for this hampered progress has been a lack of in vitro models that would faithfully recapitulate the heterogeneity of tumors and response to treatment. In this study, surgically resected tumors were obtained from patients with stage I/II NSCLC during curative-intent surgery. Using a 3D patient-derived tumor spheroids culture system, our results demonstrate successful long-term expansion of primary NSCLC cells in vitro (> 120 days)...
2018: PloS One
I-Ting Kuo, Kuang-Yi Chang, De-Fong Juan, Steen J Hsu, Chia-Tai Chan, Mei-Yung Tsou
Pain relief always plays the essential part of perioperative care and an important role of medical quality improvement. Patient-controlled analgesia (PCA) is a method that allows a patient to self-administer small boluses of analgesic to relieve the subjective pain. PCA logs from the infusion pump consisted of a lot of text messages which record all events during the therapies. The dosage information can be extracted from PCA logs to provide easily understanding features. The analysis of dosage information with time has great help to figure out the variance of a patient's pain relief condition...
2018: PloS One
Plansky Hoang, Jason Wang, Bruce R Conklin, Kevin E Healy, Zhen Ma
The creation of human induced pluripotent stem cells (hiPSCs) has provided an unprecedented opportunity to study tissue morphogenesis and organ development through 'organogenesis-in-a-dish'. Current approaches to cardiac organoid engineering rely on either direct cardiac differentiation from embryoid bodies (EBs) or generation of aligned cardiac tissues from predifferentiated cardiomyocytes from monolayer hiPSCs. To experimentally model early cardiac organogenesis in vitro, our protocol combines biomaterials-based cell patterning with stem cell organoid engineering...
April 2018: Nature Protocols
Jaime Fernández-Sarmiento, Joseph A Carcillo, Claudia M Salinas, Edgar F Galvis, Paula A López, Andrés Jagua-Gualdrón
OBJECTIVES: To evaluate adherence to the sepsis bundle before and after an educational strategy and its impact on hospital stay. DESIGN: A prospective, analytic, before-and-after study of children with severe sepsis and septic shock who presented to the emergency department. SETTING: Carried out from January to December 2014 in the emergency department of a quaternary care hospital. PATIENTS: Of a total of 19,836 children who presented to the emergency department, 4,383 had an infectious pathology, with 203 of these showing severe sepsis and septic shock (124 pre intervention, and 79 post intervention)...
March 14, 2018: Pediatric Critical Care Medicine
Sheng Yan, Hangyan Shi, Da Chen, Jincai Guo, Yi Sun, Sufan Wu
The reconstruction of large full-thickness scalp defects remains a surgical challenge, especially when the skull is exposed completely without periosteum. Surgical technique options for wound coverage have included tissue expansion, skin grafting, local or regional flaps, and microvascular free tissue transfer. In recent years, some authors have reported to use biological material as an alternative for repairing complex wounds. The authors report the successful reconstruction of a large defect with bare skull in bilateral temporal regions of a 3-year-old child...
March 14, 2018: Journal of Craniofacial Surgery
Hannah C Levy, Amber L Billingsley, Kristen S Springer, Scott Hannan, Akanksha Das, David F Tolin
OBJECTIVE: The Outcome Questionnaire-45.2 (OQ-45) is a self-report measure of general psychological distress. Although intended to be transdiagnostic, the OQ-45 may be best conceptualized as a measure of depression; as such, its utility in assessing other symptoms such as anxiety is unclear. METHOD: We examined scores on the OQ-45 in a sample of 329 patients with anxiety and related disorders, half of whom had co-occurring depression. RESULTS: Eighty-two percent of patients scored above the OQ-45 cutoff, whereas 18% were incorrectly screened out...
March 15, 2018: Journal of Clinical Psychology
Khalid A Awartani, Maryam S Al Shabibi
OBJECTIVES: To determine the prevalence of chromosomal abnormalities in couples with recurrent pregnancy loss (RPL), to determine other factors that may be associated with the chromosomal abnormalities, and to assess the outcomes of couples who had undergone multidisciplinary interventions according to associated etiological factors. METHODS: This retrospective cohort study involved 1074 couples who attended RPL clinic during an 11-year period from January 2006 to December 2016 at a single center, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia...
March 2018: Saudi Medical Journal
Orazio Valsecchi, Angelina Vassileva, Alberto Francesco Cereda, Paolo Canova, Keisuke Satogami, Luigi Fiocca, Giulio Guagliumi
BACKGROUND: Distal transradial access in the anatomical snuffbox has advantages over standard access in terms of patient and operator comfort levels and risk of ischemia. Radial artery preservation could be a relevant issue in patients requiring multiple radial artery procedures and coronary bypass with the use of a radial graft. One relevant drawback is the challenging puncture of a small and weak artery, with a steeper learning curve. AIM: The study was aimed at proving feasibility and safety of right and left transradial access in the anatomical snuffbox...
March 15, 2018: Journal of Invasive Cardiology
Sarah Ackerman
The ethical underpinnings of writing about patients are explored, the question of how best to undertake the writing of case reports being subordinated to a more general question about the ethics of choosing how or whether to write. An unsolvable paradox is encountered here: that we need to write or speak about our clinical work in order to conceptualize and understand the work we are doing, but that in the very gesture of doing so, we are breaking a fundamental bond with the patient. This conundrum is viewed from a number of vantage points...
February 2018: Journal of the American Psychoanalytic Association
Basmah Safdar, Gail D'Onofrio, James Dziura, Raymond R Russell, Caitlin Johnson, Albert J Sinusas
AIMS: Coronary microvascular dysfunction (CMD) is common in patients with non-obstructive coronary arteries but has not been described in low-risk symptomatic patients. We therefore assessed the prevalence and characteristics of CMD in low to moderate risk patients with chest pain in an emergency department. METHODS AND RESULTS: We used three-dimensional Rb82 cardiac positron emission tomography/computed tomography to diagnose coronary artery disease (known or new regional defect, any coronary calcification) and CMD (low coronary flow reserve without coronary artery disease) in chest pain patients after being ruled out for acute myocardial infarction...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
H F Dale, J G Hatlebakk, N Hovdenak, S O Ystad, G A Lied
BACKGROUND: Non-coeliac gluten-sensitivity (NCGS) has been proposed as a new entity with unknown prevalence and mechanisms, and there is a need for a standardized procedure to confirm the diagnosis. The objective of this study was to characterize the response to an oral gluten-challenge in patients with a symptom-relief when following a gluten free-diet (GFD). METHODS: Twenty patients (14F/6M, age range: 21-62 years) with suspected NCGS, without coeliac disease and wheat-allergy, were included while on a gluten-free diet...
March 15, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Rania Nabil, Elsemieke Plasmeijer, Remco van Doorn, Wilma Bergman, Nicole A Kukutsch
Approximately 10% of all melanomas occur in subjects with a family history of melanoma. This retrospective follow-up study investigated the characteristics of patients with familial melanoma who made unscheduled visits to our pigmented lesions clinic, and the diagnosis of excised lesions. A total of 110 out of 1,267 (9%) patients made at least one unscheduled visit between May 2011 and February 2016. Histopathology was taken from 59 patients. Thirty-four naevi, 7 melanomas and 3 basal cell carcinomas were detected...
March 15, 2018: Acta Dermato-venereologica
Albert Boada, Mariona Pons-Vigués, Jordi Real, Elisabet Grezner, Bonventura Bolíbar, Carl Llor
INTRODUCTION: Commensal flora of healthy people is becoming an important reservoir of resistant bacteria. OBJECTIVES: To evaluate the relationship of previous antibiotic-dispensed and resistance pattern of strains of Staphylococcus aureus in primary care patients. METHODS: A cross-sectional study was carried out in seven primary care centres in Catalonia, Spain, from October 2010 to May 2011, as part of the APRES (The appropriateness of prescribing antibiotics in primary care in Europe concerning antibiotic resistance) study...
December 2018: European Journal of General Practice
Bei Jia, Weihua Wu, Rui Huang, Guiyang Wang, Peixin Song, Yang Li, Yong Liu, Yali Xiong, Xiaomin Yan, Yingying Hao, Juan Xia, Zhaoping Zhang, Yuxin Chen, Chao Wu
BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is a life-threatening infectious disease identified in 2009. SFTS is mainly transmitted by contact with ticks or animals; however, sporadic reports suggested that SFTS could be transmitted among humans. OBJECTIVES: We aimed to comprehensively characterize clinical features and disease progression of SFTS acquired by human-to-human transmission. STUDY DESIGN: A retrospective study of 90 SFTS patients was performed in a tertiary hospital of Nanjing, China, from October 2010 to October 2016...
March 15, 2018: Infectious Diseases
Renata Valle Pedroso, José Maria Cancela, Carlos Ayán, Angelica Miki Stein, Gilson Fuzaro, José Luiz Riani Costa, Francisco J Fraga, Ruth Ferreira Santos-Galduróz
BACKGROUND: Evidence regarding the benefits of physical activity on the mental processing information of patients with Alzheimer's disease assessed objectively is scarce and can be observed through event-related potentials, such as the P300. The aim of the study was to identify the effects of physical exercises on mental processing information in the elderly with Alzheimer's disease through neurophysiological measures (P300 amplitude and latency) and reaction time. METHODS: A total of 31 patients with Alzheimer's disease participated in this study: 14 in functional exercise (FE) group and 17 in social gathering (SG) group who carried out three 1-hour sessions per week of FE and SG activities, respectively, for a 12-week period...
March 15, 2018: Journal of Physical Activity & Health
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