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https://www.readbyqxmd.com/read/29183519/abdominal-trauma-revisited
#1
REVIEW
David V Feliciano
Although abdominal trauma has been described since antiquity, formal laparotomies for trauma were not performed until the 1800s. Even with the introduction of general anesthesia in the United States during the years 1842 to 1846, laparotomies for abdominal trauma were not performed during the Civil War. The first laparotomy for an abdominal gunshot wound in the United States was finally performed in New York City in 1884. An aggressive operative approach to all forms of abdominal trauma till the establishment of formal trauma centers (where data were analyzed) resulted in extraordinarily high rates of nontherapeutic laparotomies from the 1880s to the 1960s...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28918087/left-atrial-enlargement-and-anticoagulation-status-in-patients-with-acute-ischemic-stroke-and-atrial-fibrillation
#2
Katarina Dakay, Andrew D Chang, Morgan Hemendinger, Shawna Cutting, Ryan A McTaggart, Mahesh V Jayaraman, Antony Chu, Nikhil Panda, Christopher Song, Alexander Merkler, Gino Gialdini, Benjamin Kummer, Michael P Lerario, Hooman Kamel, Mitchell S V Elkind, Karen L Furie, Shadi Yaghi
BACKGROUND: Despite anticoagulation therapy, ischemic stroke risk in atrial fibrillation (AF) remains substantial. We hypothesize that left atrial enlargement (LAE) is more prevalent in AF patients admitted with ischemic stroke who are therapeutic, as opposed to nontherapeutic, on anticoagulation. METHODS: We included consecutive patients with AF admitted with ischemic stroke between April 1, 2015, and December 31, 2016. Patients were divided into two groups based on whether they were therapeutic (warfarin with an international normalized ratio ≥ 2...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28915204/laparoscopy-for-trauma-and-the-changes-in-its-use-from-1990-to-2016-a-current-systematic-review-and-meta-analysis
#3
Roberto Cirocchi, Arianna Birindelli, Kenji Inaba, Matteo Mandrioli, Alice Piccinini, Renata Tabola, Luigi Carlini, Gregorio Tugnoli, Salomone Di Saverio
BACKGROUND: The role of laparoscopy in the diagnosis and treatment of stable abdominal trauma patients is still a matter of serious debate and only incomplete data are available. MATERIALS AND METHODS: We performed a systematic review and meta-analysis of the literature between January 1990 and August 2016. RESULTS: Overall, 9817 laparoscopies were performed for abdominal trauma; only 26.2% of the cases were converted to a laparotomy. The incidence of therapeutic laparotomies showed a reduction from 69% to 47...
September 14, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28870818/-fatal-female-genital-mutilation-in-a-10-year-old-girl
#4
A Sow, G Diagne, Y Keita, O Sow, A Ndiath, A Ouattara, M-L Sarr, A Sylla, C Moreira
Female genital mutilation (FGM) comprises all procedures involving partial or total removal of the external genitalia and/or any other procedures affecting the female genitalia, for cultural or religious reasons or for nontherapeutic purposes in general. FGM is responsible for a number of short-, medium-, and long-term complications that can engage the vital and functional prognosis, especially in African countries. We report on a case in a 10-year-old girl who underwent genital mutilation, a traditional type of total excision during the neonatal period...
September 1, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28846521/nontherapeutic-circumcision-of-minors-as-an-ethically-problematic-form-of-iatrogenic-injury
#5
J Steven Svoboda
Nontherapeutic circumcision (NTC) of male infants and boys is a common but misunderstood form of iatrogenic injury that causes harm by removing functional tissue that has known erogenous, protective, and immunological properties, regardless of whether the surgery generates complications. I argue that the loss of the foreskin itself should be counted, clinically and morally, as a harm in evaluating NTC; that a comparison of benefits and risks is not ethically sufficient in an analysis of a nontherapeutic procedure performed on patients unable to provide informed consent; and that circumcision violates clinicians' imperatives to respect patients' autonomy, to do good, to do no harm, and to be just...
August 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28831812/thromboembolic-and-major-bleeding-events-with-rivaroxaban-versus-warfarin-use-in-a-real-world-setting
#6
Giavanna Russo-Alvarez, Kathryn A Martinez, Megan Valente, James Bena, Bo Hu, Jennifer Luxenburg, Alexander Chaitoff, Catherine Ituarte, Andrei Brateanu, Michael B Rothberg
BACKGROUND: Although randomized trials demonstrate the noninferiority of rivaroxaban compared with warfarin in the context of nonvalvular atrial fibrillation (AF), little is known about how these drugs compare in practice. OBJECTIVE: To assess the relative effectiveness and safety of rivaroxaban versus warfarin in a large health system and to evaluate this association by time in therapeutic range (TTR). METHODS: We conducted a retrospective cohort study with propensity matching in the Cleveland Clinic Health System...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28749780/the-prevalence-of-extended-spectrum-beta-lactamase-producing-multidrug-resistant-escherichia-coli-in-poultry-chickens-and-variation-according-to-farming-practices-in-punjab-india
#7
Charles H Brower, Siddhartha Mandal, Shivdeep Hayer, Mandeep Sran, Asima Zehra, Sunny J Patel, Ravneet Kaur, Leena Chatterjee, Savita Mishra, B R Das, Parminder Singh, Randhir Singh, J P S Gill, Ramanan Laxminarayan
BACKGROUND: Agricultural use of antimicrobials in subtherapeutic concentrations is increasing in response to the rising demand for food animal products worldwide. In India, the use of antimicrobials in food animal production is unregulated. Research suggests that many clinically important antimicrobials are used indiscriminately. This is the largest study to date in India that surveys poultry production to test for antimicrobial resistance and the occurrence of extended-spectrum β-lactamases (ESBLs) modulated by farming and managerial practices...
July 20, 2017: Environmental Health Perspectives
https://www.readbyqxmd.com/read/28689604/outcomes-of-hospitalized-patients-undergoing-emergency-general-surgery-remote-from-admission
#8
COMPARATIVE STUDY
Catherine E Sharoky, Elizabeth A Bailey, Morgan M Sellers, Elinore J Kaufman, Andrew J Sinnamon, Christopher J Wirtalla, Daniel N Holena, Rachel R Kelz
BACKGROUND: Emergency general surgery during hospitalization has not been well characterized. We examined emergency operations remote from admission to identify predictors of postoperative 30-day mortality, postoperative duration of stay >30 days, and complications. METHODS: Patients >18 years in The American College of Surgeons National Surgical Quality Improvement Program (2011-2014) who had 1 of 7 emergency operations between hospital day 3-18 were included...
September 2017: Surgery
https://www.readbyqxmd.com/read/28446999/minimally-invasive-staging-of-esophageal-cancer
#9
REVIEW
Kunal Mehta, Valentino Bianco, Omar Awais, James D Luketich, Arjun Pennathur
Esophageal cancer is one of the most common malignancies in the world today and the sixth-leading cause of cancer-related mortality. Accurate preoperative staging of esophageal cancer is imperative to the selection of appropriate treatments. Patients with esophageal carcinomas typically undergo a multimodality staging process including noninvasive imaging techniques, such as computed tomography (CT) and positron emission tomography (PET), as well as endoscopic ultrasound (EUS), which is slightly more invasive...
March 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28438704/folic-acid-decorated-polyamidoamine-dendrimer-exhibits-high-tumor-uptake-and-sustained-highly-localized-retention-in-solid-tumors-its-utility-for-local-sirna-delivery
#10
Leyuan Xu, W Andrew Yeudall, Hu Yang
The utility of folic acid (FA)-decorated polyamidoamine dendrimer G4 (G4-FA) as a vector was investigated for local delivery of siRNA. In a xenograft HN12 (or HN12-YFP) tumor mouse model of head and neck squamous cell carcinomas (HNSCC), intratumorally (i.t.) injected G4-FA exhibited high tumor uptake and sustained highly localized retention in the tumors according to near infrared (NIR) imaging assessment. siRNA against vascular endothelial growth factor A (siVEGFA) was chosen as a therapeutic modality. Compared to the nontherapeutic treatment groups (PBS solution or dendrimer complexed with nontherapeutic siRNA against green fluorescent protein (siGFP)), G4-FA/siVEGFA showed tumor inhibition effects in single-dose and two-dose regimen studies...
July 15, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28390650/garlic-burn-of-the-oral-mucosa-a-case-report-and-review-of-self-treatment-chemical-burns
#11
Richard J Vargo, Blake M Warner, Anitha Potluri, Joanne L Prasad
BACKGROUND AND OVERVIEW: Inappropriate self-treatment with topically applied therapeutic or nontherapeutic agents frequently results in mucosal burns. Although such chemical burns typically are associated with misuse of analgesics, investigators also have reported them in conjunction with topical application of a variety of other agents. CASE DESCRIPTION: The authors report an unusual case of a 49-year-old man seeking care for maxillary tooth pain who had an oral mucosal burn of the maxillary vestibule caused by topical application of crushed raw garlic...
April 5, 2017: Journal of the American Dental Association
https://www.readbyqxmd.com/read/28382255/angioembolization-is-necessary-with-any-volume-of-contrast-extravasation-in-blunt-trauma
#12
Ankur Bhakta, David S Magee, Matthew S Peterson, Michael Shay O'Mara
INTRODUCTION: Reduction of nonessential angiogram and embolization for patients sustaining blunt abdominal and pelvic trauma would allow improved utilization and decreased morbidity related to nontherapeutic embolization. We hypothesized that the nature of intravenous contrast extravasation (IVCE) on computed tomography (CT) would be directly related to the finding of extravasation on angiogram and need for embolization. METHODS: A 5-year retrospective evaluation of trauma patients with IVCE on CT...
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28376159/burdensome-research-procedures-in-trials-why-less-is-more
#13
Jonathan Kimmelman, David B Resnik, Jeffrey Peppercorn, Mark J Ratain
A large volume of trials involve invasive, nontherapeutic research procedures, like organ biopsy or sham surgeries, that can pose risks comparable with the experimental treatment itself but that have no direct benefit for volunteers. Though such procedures can enhance the value of clinical investigations, recent studies suggest that many studies involving invasive, nontherapeutic research procedures are not well planned and reported; some studies suggest that their results are often not utilized in the planning of new investigations...
April 1, 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28353490/accuracy-of-clinician-assessments-of-medication-status-in-the-emergency-setting-a-comparison-of-clinician-assessment-of-antipsychotic-usage-and-plasma-level-determination
#14
COMPARATIVE STUDY
Leonardo V Lopez, Atef Shaikh, Jonathan Merson, Jessica Greenberg, Raymond F Suckow, John M Kane
PURPOSE: The present study aimed to assess the level of agreement between clinicians' routine assessments of medication status and plasma levels of commonly prescribed antipsychotic medications in patients presenting to an emergency room with an exacerbation of psychosis. METHODS: We studied 105 patients presenting to an emergency room and admitted to an inpatient psychiatric unit with a diagnosis of schizophrenia, schizoaffective disorder, bipolar I disorder, or psychotic disorder not otherwise specified and a prior outpatient medication regimen including risperidone, olanzapine, quetiapine, aripiprazole, or paliperidone...
June 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28287001/transplacental-passage-of-vancomycin
#15
Craig V Towers, Beth Weitz
OBJECTIVE: To evaluate a larger number of patients receiving a vancomycin-dosing regimen of 20 mg/kg IV every 8 h for Group B streptococcus (GBS) chemoprophylaxis and analyze maternal and neonatal cord blood levels at delivery. METHODS: We prospectively enrolled every mother that entered labor with a positive GBS culture and a high-risk penicillin allergy with resistance to clindamycin or unknown sensitivity. Maternal and cord blood vancomycin levels were obtained at delivery...
March 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28277439/role-of-laparoscopy-in-patients-with-abdominal-trauma-at-level-i-trauma-center
#16
Purushottam Parajuli, Subodh Kumar, Amit Gupta, Virinder Kumar Bansal, Sushma Sagar, Biplab Mishra, Maneesh Singhal, Atin Kumar, Shivanand Gamangatti, Babita Gupta, Chhavi Sawhney, Mahesh C Misra
INTRODUCTION: Abdominal trauma is one of the preventable causes of death in polytrauma patients. Decision and timing of laparotomy is a major challenge. Rate of nontherapeutic laparotomy is still high. Laparoscopy can avoid nontherapeutic laparotomy and also provide a reliable and accurate diagnosis of injury. MATERIALS AND METHODS: This ambispective observational study was conducted in the division of Trauma Surgery and Critical Care, JPN Apex Trauma Centre, All India Institute Medical Sciences, New Delhi...
March 8, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28274562/biopsy-first-lessons-learned-from-cancer-and-leukemia-group-b-calgb-140503
#17
Leslie J Kohman, Lin Gu, Nasser Altorki, Ernest Scalzetti, Linda J Veit, Jason M Wallen, Xiaofei Wang
OBJECTIVE: Cancer and Leukemia Group B 140503 is an ongoing, multicenter randomized trial assessing whether sublobar resection is equivalent to lobectomy for the treatment of stage I A non-small cell lung cancer (NSCLC) ≤2 cm in diameter. The objective of this report is to determine the reasons precluding intraoperative randomization. METHODS: From June 15, 2007, to March 22, 2013, 637 patients were preregistered to the trial. Three hundred eighty-nine were randomized successfully (61%), and 248 patients were not randomized (39%)...
June 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28182115/organ-donation-and-elective-ventilation-a-necessary-strategy
#18
REVIEW
Dolores Escudero, Jesus Otero, Begoña Menéndez de León, Marcos Perez-Basterrechea
Organ transplantation is the sole treatment to improve or save the life of patients with final-stage organ failure. The shortage of available organs for transplantation constitutes a universal problem, estimating that 10% of patients on waiting lists die. Brain death is an undesirable result; nevertheless, it has beneficial side-effects since it is the most frequent source of organs for transplantation. However, this phenomenon is relatively uncommon and has a limited potential. One of the options that focuses on increasing organ donation is to admit patients with catastrophic brain injuries (with a high probability of brain death and nontreatable) to the Intensive Care Unit, with the only purpose of donation...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28025228/sex-reassignment-surgery-and-enhancement
#19
Tomislav Bracanović
Sex reassignment surgery is a therapy for gender dysphoria (gender identity disorder) standardly provided only upon a psychiatric authorization. Transgender scholars criticize this practice as unjustified medicalization and stigmatization of transsexual people. By demanding that sex reassignment surgery is not classified as therapy, they imply it should be classified as some kind of a biomedical enhancement. It is argued in this article that this reclassification is empirically and morally implausible because sex reassignment surgery is incompatible with two major views of enhancement...
February 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/27884330/factors-associated-with-adverse-events-after-emergency-laparotomy-in-cape-town-south-africa-identifying-opportunities-for-quality-improvement
#20
MULTICENTER STUDY
Richard Trafford Spence, Mark Hampton, Kent Pluke, Miriam Kahn, Nkhabe Chinyepi, Mohamed Elmusbahi, Tirsa van Wyngaard, Eugenio Panieri
BACKGROUND: Surgical outcomes research is limited in areas of the world with the greatest unmet surgical need and likely greatest variation in outcomes. Measurement alone may improve outcomes-the so-called Hawthorne effect. The purpose of this multicenter cohort study was to identify factors that are both feasible to collect and are associated with a major adverse event following a targeted procedure in Cape Town, South Africa. METHODS: A collaborative of four acute care surgical units was formed to develop a data set with minimal data burden describing outcomes after an emergency exploratory laparotomy during a 3-mo period (February-April 2015)...
December 2016: Journal of Surgical Research
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