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https://www.readbyqxmd.com/read/29916985/impact-of-the-current-versus-the-previous-diagnostic-threshold-on-the-outcome-of-patients-with-borderline-changes-suspicious-for-t-cell-mediated-rejection-diagnosed-on-indication-biopsies
#1
Michael McRae, François Bouchard-Boivin, Stéphanie Béland, Réal Noël, Isabelle Côté, Isabelle Lapointe, Julie Lesage, Eva Latulippe, Julie Riopel, Dominick Santoriello, Syed A Husain, Olivier Désy, Isabelle Houde, Ibrahim Batal, Sacha A De Serres
BACKGROUND: Since the borderline changes suspicious for acute T-cell-mediated rejection (BL) category was broadened, there has been a debate regarding the right threshold for tubulitis (t) and interstitial inflammation (i) scores. METHODS: We studied a first cohort of 111 patients with BL found on an indication biopsy between 2006 and 2016 and compared those with scores of t1i0 (BLt1i0) to those with higher scores (BL≥t1i1). A second cohort of 56 patients with BL was used for external validation...
June 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29916581/-immunological-mechanisms-of-allergic-diseases
#2
Enrico Maggi
OBJECTIVES: In the last decades the knowledge on pathogenetic mechanisms of allergic diseases extraordinarily improved with relevant clinical outputs. From the '90yrs we know that Th2 cells are essential for allergic inflammation, since they produce type 2 cytokines, recognise allergens, induce IgE switch on B cells and recruit mastcells and eosinophils into tissues for maintaining the flogosis. METHODS: Recently a new subset of innate immunity (ILC2) have been shown to amplify the allergic inflammation...
November 2017: Giornale Italiano di Medicina del Lavoro Ed Ergonomia
https://www.readbyqxmd.com/read/29913434/factors-influencing-child-protection-professionals-decision-making-and-multidisciplinary-collaboration-in-suspected-abusive-head-trauma-cases-a-qualitative-study
#3
Laura E Cowley, Sabine Maguire, Daniel M Farewell, Harriet D Quinn-Scoggins, Matthew O Flynn, Alison M Kemp
Clinicians face unique challenges when assessing suspected child abuse cases. The majority of the literature exploring diagnostic decision-making in this field is anecdotal or survey-based and there is a lack of studies exploring decision-making around suspected abusive head trauma (AHT). We aimed to determine factors influencing decision-making and multidisciplinary collaboration in suspected AHT cases, amongst 56 child protection professionals. Semi-structured interviews were conducted with clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom...
June 15, 2018: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29912983/efficacy-of-melatonin-with-behavioural-sleep-wake-scheduling-for-delayed-sleep-wake-phase-disorder-a-double-blind-randomised-clinical-trial
#4
Tracey L Sletten, Michelle Magee, Jade M Murray, Christopher J Gordon, Nicole Lovato, David J Kennaway, Stella M Gwini, Delwyn J Bartlett, Steven W Lockley, Leon C Lack, Ronald R Grunstein, Shantha M W Rajaratnam
BACKGROUND: Delayed Sleep-Wake Phase Disorder (DSWPD) is characterised by sleep initiation insomnia when attempting sleep at conventional times and difficulty waking at the required time for daytime commitments. Although there are published therapeutic guidelines for the administration of melatonin for DSWPD, to our knowledge, randomised controlled trials are lacking. This trial tested the efficacy of 0.5 mg melatonin, combined with behavioural sleep-wake scheduling, for improving sleep initiation in clinically diagnosed DSWPD patients with a delayed endogenous melatonin rhythm relative to patient-desired (or -required) bedtime (DBT)...
June 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29911521/integrated-perinatal-mental-health-care-a-national-model-of-perinatal-primary-care-in-vulnerable-populations
#5
Kimberly C Lomonaco-Haycraft, Jennifer Hyer, Britney Tibbits, Jennifer Grote, Kelly Stainback-Tracy, Claire Ulrickson, Alison Lieberman, Lies van Bekkum, M Camille Hoffman
IntroductionPerinatal mood and anxiety disorders (PMADs) are the most common complication of pregnancy and have been found to have long-term implications for both mother and child. In vulnerable patient populations such as those served at Denver Health, a federally qualified health center the prevalence of PMADs is nearly double the nationally reported rate of 15-20%. Nearly 17% of women will be diagnosed with major depression at some point in their lives and those numbers are twice as high in women who live in poverty...
June 18, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29909229/functional-evaluation-of-bilateral-subtalar-arthroereisis-for-the-correction-of-flexible-flatfoot-in-children-1-year-follow-up
#6
Paolo Caravaggi, Giada Lullini, Lisa Berti, Sandro Giannini, Alberto Leardini
BACKGROUND: Flexible flatfoot (FFF) is a common alteration of the foot diagnosed in the pediatric population causing pain and decreased quality of life. Surgical treatment via arthroereisis of the subtalar joint can be recommended when non-invasive options do not result in sufficient pain relief. While clinical outcome of subtalar joint arthroereisis is generally positive, no functional evaluation has thus far been reported following surgery. RESEARCH QUESTION: The aim of this study was to assess the effects of two arthroereisis implants for the correction of bilateral FFF on foot and lower limb biomechanics during gait...
June 11, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29903012/projection-of-the-future-diabetes-burden-in-the-united-states-through-2060
#7
Ji Lin, Theodore J Thompson, Yiling J Cheng, Xiaohui Zhuo, Ping Zhang, Edward Gregg, Deborah B Rolka
BACKGROUND: In the United States, diabetes has increased rapidly, exceeding prior predictions. Projections of the future diabetes burden need to reflect changes in incidence, mortality, and demographics. We applied the most recent data available to develop an updated projection through 2060. METHODS: A dynamic Markov model was used to project prevalence of diagnosed diabetes among US adults by age, sex, and race (white, black, other). Incidence and current prevalence were from the National Health Interview Survey (NHIS) 1985-2014...
June 15, 2018: Population Health Metrics
https://www.readbyqxmd.com/read/29901646/transient-ischemic-attack-characterized-by-external-strabismus-of-the-left-eye-a-case-report
#8
Xue Wang, Yang Yu, Wenxia Zhang, Hongmei Meng
RATIONALE: Patients rarely display eye movement dysfunctions as the primary symptom in transient ischemic attack. PATIENT CONCERNS: A 58-year-old patient with a history of hypertension and smoking presented with a 1-month history of paroxysmal exotropia of the left eye and double vision. No obvious abnormality was found in imaging examination and the patient ignored his symptoms. Eleven days later, the symptoms worsened and brain imaging provided an abnormal signal involving the left cerebellar hemisphere and the bilateral occipital lobe...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29900802/dementia-and-cognitive-impairment-among-u-s-veterans-with-a-history-of-mdd-or-ptsd-a-retrospective-cohort-study-based-on-sex-and-race
#9
Jagriti Jackie Bhattarai, Mary E Oehlert, Karen D Multon, Scott W Sumerall
OBJECTIVE: The aim of this study was to examine major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) diagnosed at age < 55 as predictors, and sex and race as potential moderators, of dementia and other forms of cognitive impairment. METHOD: Veterans ( N = 4,800) aged ⩾ 56 years were grouped by psychiatric history, sex, and race. Hierarchical and stepwise regression were employed to determine significant predictors. RESULTS: MDD and PTSD were associated with almost double the risk for developing dementia or cognitive impairment at age ⩾ 56...
June 1, 2018: Journal of Aging and Health
https://www.readbyqxmd.com/read/29900517/mesenchymal-stem-cells-in-osteotomy-repair-after-tibial-tuberosity-advancement-in-dogs-with-cranial-cruciate-ligament-injury
#10
Clarissa Rocha Dos Santos, Richard da Rocha Filgueiras, Patrícia Furtado Malard, Andre Rodrigues da Cunha Barreto-Vianna, Kaique Nogueira, Carolina da Silva Leite, Eduardo Maurício Mendes de Lima
BACKGROUND: The cranial cruciate ligament rupture (CCLR) is the most commonly encountered orthopedic condition in dogs. Among the various techniques to treat this condition, tibial tuberosity advancement (TTA) has been used to obtain rapid recovery of the affected knee. The objective of this study was to evaluate the viability of the use of mesenchymal stem cells (MSC) implanted in the osteotomy site obtained by TTA in nine dogs diagnosed with CCLR. METHODS: The MSC were isolated from the adipose tissue of the dogs and cultured for eight days, the animals were divided into two groups...
June 14, 2018: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29897832/serum-25-hydroxyvitamin-d-and-risk-of-self-reported-bacterial-vaginosis-in-a-prospective-cohort-study-of-young-african-american-women
#11
Kristen R Moore, Quaker E Harmon, Donna D Baird
BACKGROUND: Bacterial vaginosis (BV), the leading cause of vaginal discharge, is associated with multiple adverse health outcomes; however, its etiology is unknown. BV treatment is not very effective, thus prevention approaches are needed. Studies investigating the impact of vitamin D on the risk of BV have had mixed findings, including two studies reporting increased risk of recurrent BV for women with higher vitamin D. MATERIALS AND METHODS: Participants were nonpregnant women in a prospective fibroid study of African Americans (ages 23-34 years) from the Detroit area...
June 13, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29897589/efficacy-of-lubiprostone-for-the-treatment-of-opioid-induced-constipation-analyzed-by-opioid-class
#12
Lynn R Webster, Randall P Brewer, Peter Lichtlen, Taryn Losch-Beridon, Shadreck Mareya, Martin Wang
Objectives: To examine the efficacy and safety of lubiprostone for the treatment of opioid-induced constipation (OIC) in patients by opioid class received. Design: Data were pooled from three phase III, randomized, double-blind, placebo-controlled studies. Subjects/Setting: Adults with chronic noncancer pain receiving opioid therapy for 30 or more days and diagnosed with OIC. Methods: Overall mean change from baseline in spontaneous bowel movement (SBM) frequency, overall treatment response (≥1 SBM/week improvement over baseline SBM frequency in all treatment weeks with available data and ≥3 SBMs/week for ≥9 of the 12 weeks of treatment), and OIC-related symptoms were examined in patients taking opioids...
June 1, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29896022/incidence-management-and-outcome-assessment-of-post-operative-infection-following-single-bundle-and-double-bundle-acl-reconstruction
#13
Pallav Mishra, Ajay Lal, Mukul Mohindra, Nitin Mehta, Deepak Joshi, Deepak Chaudhary
Introduction: Post-operative infection is a dreadful complication of ACL reconstruction with gray zone over management guidelines. We aimed to establish commonest etiology, assess incidence of infection and effect on outcome, individually for single and double bundle ACL reconstruction techniques, so as to formulate appropriate management guidelines. Methods: Our prospective study involved 1152 patients operated for ACL reconstruction (437- DBACL, 715- SBACL) from 2010-2013...
April 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29890356/laparoscopic-resection-of-cesarean-scar-ectopic-pregnancy-after-unsuccessful-systemic-methotrexate-treatment
#14
L Pirtea, O Balint, C Secosan, D Grigoras, R Ilina
STUDY OBJECTIVE: To present a case of a cesarean scar ectopic pregnancy treated by laparoscopic resection followed by isthmocele repair. DESIGN: Case report SETTINGS: University Gynecology Clinic of the Emergency Clinical City Hospital Timișoara, România. BACKGROUND: Cesarean scar pregnancy is a rare form of ectopic pregnancy. In the last years its prevalence has risen due to the increasing number of cesarean section. An early diagnosis can lead to an early management decreasing the risk of life-threatening complication such as uterine rupture and massive haemorrhage...
June 8, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29881720/screening-diagnosis-and-management-of-patients-with-alcohol-use-disorders-at-bwindi-community-hospital-uganda
#15
Yusufu Kuule, Andrew E Dobson, Anthony D Harries, Birungi Mutahunga, Alex G Stewart, Ewan Wilkinson
Introduction: The harmful use of alcohol is a growing global public health concern, with Sub-Saharan Africa at particular risk. A large proportion of adults in Uganda consume alcohol and the country has a high prevalence of alcohol use disorders (AUD), almost double that for the African region as a whole. Bwindi Community Hospital, in rural western Uganda, recently introduced a program of screening, diagnosis and management of AUD and we assessed how this worked. Methods: This was a cross-sectional study in three departments (out-patients, adult in-patients and sexual & reproductive health) of Bwindi Community Hospital assessing numbers of patients screened, diagnosed and treated with AUD between January 2014 and June 2017...
2018: Frontiers in Public Health
https://www.readbyqxmd.com/read/29881617/microbiology-and-antibiotic-susceptibility-patterns-in-spontaneous-bacterial-peritonitis-a-study-of-two-dutch-cohorts-at-a-10-year-interval
#16
Rosalie C Oey, Robert A de Man, Nicole S Erler, Annelies Verbon, Henk R van Buuren
Background: Recent investigations suggest an increasing prevalence of Gram-positive and antibiotic-resistant bacteria causing spontaneous bacterial peritonitis (SBP), probably related to changes in antibiotic prescription patterns, in particular more widespread and long-term use of antibiotic prophylaxis with quinolones. Objective: The primary objective of this study was to assess potential changes in the microbiology of SBP in two patient cohorts studied at a 10-year interval...
May 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29881523/changes-in-corneal-thickness-and-corneal-endothelial-cell-density-after-phacoemulsification-cataract-surgery-a-double-blind-randomized-trial
#17
Shahram Bamdad, Alireza Bolkheir, Mohammad Reza Sedaghat, Mahsa Motamed
Background: Age-related cataract is a leading cause of visual impairment, considered a global health burden, it is responsible for over 47% of blindness worldwide. Surgical intervention is usually the treatment of choice and phacoemulsification cataract surgery with implantation of an intraocular lens is the most common procedure, which may have several complications. Objectives: To determine the effects of phacoemulsification surgery on corneal endothelial cell density and corneal thickness in patients undergoing cataract surgery...
April 2018: Electronic Physician
https://www.readbyqxmd.com/read/29880377/lung-transplantation-in-pulmonary-hypertension-a-multidisciplinary-unit-s-management-experience
#18
C A Quezada-Loaiza, A de Pablo Gafas, V Pérez, R Alonso, L Juarros, M I Real, E López, M Cortes, J C Meneses, I H González, V Díaz-Hellín Gude, P E Subías, P Gámez
BACKGROUND: Prognosis assessment of pulmonary hypertension (PH) is multifactorial and placement of patients on the lung transplantation (LT) waiting list requires the weighing of a complex set of criteria. The aim of this retrospective cohort study was to analyze a series of patients treated in our unit at the moment of their inclusion on the LT waiting list and long-term survival after LT. MATERIAL AND METHODS: Baseline characteristics, LT outcomes, and survival were evaluated in all patients diagnosed with pulmonary arterial hypertension (PAH) and pulmonary veno-occlusive disease (PVOD) who were included on the LT waiting list in 2011-2016...
June 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29877940/early-onset-scoliosis-contemporary-decision-making-and-treatment-options
#19
Carol C Hasler
Early-onset scoliosis (EOS) describes a wide array of diagnoses and deformities exposed to growth. This potentially life-threatening condition is still 1 of the biggest challenges in pediatric orthopaedics. The enlightenment of Bob Campbell's thoracic insufficiency syndrome concept and the negative impact of the earlier short and straight spine fusion approach on respiratory function and survival have fueled the evolution of EOS care. Despite all the progress made, growth-friendly spine surgery remains to be a burden to patients and caregivers...
July 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29877233/-durable-remission-attained-with-plasmapheresis-and-intravenous-immunoglobulin-therapy-in-a-patient-with-acute-exacerbation-of-gvhd-related-myasthenia-gravis
#20
Jun Nakashima, Hidehiro Itonaga, Machiko Fujioka, Masahiko Chiwata, Yasushi Sawayama, Shunsuke Yoshimura, Hiroshi Iwanaga, Jun Taguchi, Shinichiro Yoshida, Yasushi Miyazaki
A 17-year-old male underwent a second bone marrow transplantation using a 6/8 allele HLA-matched unrelated donor. On day 100 after transplantation, steroid treatment for chronic graft-versus-host disease (GVHD) was started. On day 766, the patient experienced general fatigue, followed by double vision, ptosis, and dysphagia on day 810. Based on the positivity of the acetylcholine receptor antibody and a waning electromyography pattern, he was diagnosed with GVHD-related myasthenia gravis (MG). On day 861, we initiated plasmapheresis (PE), followed by the administration of intravenous immunoglobulin (IVIg) ; this treatment attenuated the bulbar symptoms of MG...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
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