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https://www.readbyqxmd.com/read/28424230/a-quiet-revolution-in-organ-transplant-ethics
#1
Arthur Caplan, Duncan Purves
A quiet revolution is occurring in the field of transplantation. Traditionally, transplants have involved solid organs such as the kidney, heart and liver which are transplanted to prevent recipients from dying. Now transplants are being done of the face, hand, uterus, penis and larynx that aim at improving a recipient's quality of life. The shift away from saving lives to seeking to make them better requires a shift in the ethical thinking that has long formed the foundation of organ transplantation. The addition of new forms of transplants requires doctors, patients, regulators and the public to rethink the risk and benefit ratio represented by trade-offs between saving life, extending life and risking the loss of life to achieve improvements in the quality of life...
April 19, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28421296/metabolite-signatures-of-doxorubicin-induced-toxicity-in-human-induced-pluripotent-stem-cell-derived-cardiomyocytes
#2
Umesh Chaudhari, James K Ellis, Vilas Wagh, Harshal Nemade, Jürgen Hescheler, Hector C Keun, Agapios Sachinidis
Drug-induced off-target cardiotoxicity, particularly following anti-cancer therapy, is a major concern in new drug discovery and development. To ensure patient safety and efficient pharmaceutical drug development, there is an urgent need to develop more predictive cell model systems and distinct toxicity signatures. In this study, we applied our previously proposed repeated exposure toxicity methodology and performed (1)H NMR spectroscopy-based extracellular metabolic profiling in culture medium of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) exposed to doxorubicin (DOX), an anti-cancer agent...
April 18, 2017: Amino Acids
https://www.readbyqxmd.com/read/28409519/off-line-analysis-of-electro-anatomical-mapping-in-ventricular-arrhythmias
#3
Daniele Muser, Jackson J Liang, Pasquale Santangeli
Sudden cardiac death due to ventricular tachycardia (VT) is a major health issue in patients with structural heart disease and depressed ejection fraction. If from one side, implantable cardioverter defibrillator (ICD) therapy has significantly improved survival of these patients, on the other hand, it has led to frequent ICD shocks as an emerging problem, being associated with poor quality of life, frequent hospitalizations and increased mortality. Scar-related reentry due to the coexistence of surviving myocardial fibers within fibrotic tissue is the most common mechanism subtending VT both in ischemic and non-ischemic cardiomyopathies...
April 12, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28392154/sunitinib-4-2-versus-2-1-schedule-for-patients-with-metastatic-renal-cell-carcinoma-tertiary-care-hospital-experience
#4
Mai Ezz El Din
BACKGROUND: Sunitinib first-line treatment is one of the standards of care in metastatic renal cell carcinoma (mRCC). However, the adverse events associated with its use can hinder adequate dosing and hence have detrimental effects on treatment outcome. Alternative schedules, such as 2-weeks-on treatment and 1-week-off treatment (2/1 schedule), might solve this dilemma. Therefore, an analysis was performed to compare both schedules in terms of toxicity and efficacy. PATIENTS AND METHODS: Data regarding first-line sunitinib treatment of mRCC patients using the 4/2 and 2/1 schedules were collected...
January 4, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28389132/the-reliability-and-measurement-error-of-protractor-based-goniometry-of-the-fingers-a-systematic-review
#5
Yara E van Kooij, Alexandra Fink, Maria W Nijhuis-van der Sanden, Caroline M Speksnijder
STUDY DESIGN: Systematic review PURPOSE OF THE STUDY: The purpose was to review the available literature for evidence on the reliability and measurement error of protractor-based goniometry assessment of the finger joints. METHODS: Databases were searched for articles with key words "hand," "goniometry," "reliability," and derivatives of these terms. Assessment of the methodological quality was carried out using the Consensus-Based Standards for the Selection of Health Measurement Instruments checklist...
April 4, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28388956/diagnostic-value-of-a-3-day-course-of-prednisolone-in-patients-with-possible-rheumatoid-arthritis-the-trycort-study
#6
Uta Kiltz, Christine von Zabern, Xenofon Baraliakos, Frank Heldmann, Bernd Mintrop, Michael Sarholz, Dietmar Krause, Friedrich Dybowski, Ludwig Kalthoff, Jürgen Braun
BACKGROUND: In patients with tender and swollen finger joints, the differential diagnosis between rheumatoid arthritis (RA) and osteoarthritis (OA) of the hands can be initially difficult. This prospective study (the TryCort study) was performed to study the diagnostic value of prednisolone in differentiating between RA and hand OA. We present the results of this potentially diagnostic test in patients with possible RA in daily clinical practice by demonstrating the results of a pilot and a validation part of this 'prednisolone test' (pred-test)...
April 7, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28384926/trus-biopsy-yield-in-indian-population-a-retrospective-analysis
#7
Sunil Raghunath Patil, Prakash Wamanrao Pawar, Ajit Somaji Sawant, Akshay Vijay Patil, Sayalee Suryabhan Narwade, Shankar Tanaji Mundhe, Abhishek Jaysukhbhai Savalia, Ashwin Sunil Tamhankar
INTRODUCTION: The reported cancer detection rate of Trans-Rectal Ultrasonography (TRUS) biopsies (TRUS biopsy yield) has been around 30 percent in western countries. However it is much lower in Asian countries, including India. Hence a larger proportion of patients in India undergo unnecessary biopsies. AIMS: To find out the cancer detection rate of TRUS biopsy (TRUS biopsy yield) in contemporary Indian population. Also, to study the positive predictive values at different serum Prostate-Specific Antigen (PSA)/PSA Density (PSAD) cut off levels and suspicious Digital Rectal Examination (DRE) findings...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28376986/transition-hand-off-from-inpatient-to-outpatient-treatment-of-acute-pyelonephritis-in-an-elderly-male
#8
Patricia L Orlando, Laura Shane-McWhorter
Pyelonephritis is the progression of a urinary tract infection (UTI) to the kidney. In younger patients the infection may not be as severe and may even be treated with oral antibiotics. However, in elderly males pyelonephritis can be more complex and may require hospitalization and treatment with intravenous antibiotics. In the United States UTIs are responsible for frequent visits to emergency departments by elderly individuals. Current literature suggests that pyelonephritis in elderly males is a serious infection that may result in significant morbidity and mortality...
April 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28364655/real-life-experience-with-brivaracetam-in-101-patients-with-difficult-to-treat-epilepsy-a-monocenter-survey
#9
Bernhard J Steinhoff, Matthias Bacher, Iancu Bucurenciu, Barbara Hillenbrand, Tassanai Intravooth, Reinhold Kornmeier, Christoph Kurth, Jakob Stockinger, Anke M Staack
PURPOSE: To assess the efficiency of brivaracetam under real-world conditions in a tertiary referral epilepsy center. METHODS: We consecutively collected patients treated at our center with brivaracetam (BRV). After a minimum observation period of six months we retrospectively analyzed the efficiency of BRV. RESULTS: Data of 101 patients (mean age 42 years, range 18-81 years, 54 females,) were analyzed. The median number of antiepileptic drugs (AEDs) used prior to BRV was 10 (range 2-18)...
March 18, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28352162/determinants-of-initiation-implementation-and-discontinuation-of-amoxicillin-by-adults-with-acute-cough-in-primary-care
#10
David Gillespie, Daniel Farewell, Lucy Brookes-Howell, Christopher C Butler, Samuel Coenen, Nick A Francis, Paul Little, Beth Stuart, Theo Verheij, Kerenza Hood
AIM: To investigate the determinants of adherence to amoxicillin in patients with acute lower respiratory tract infection. MATERIALS AND METHODS: Three European data sets were used. Adherence data were collected using self-reported diaries. Candidate determinants included factors relating to patient, condition, therapy, health care system/provider, and the study in which the patient participated. Logistic and Cox regression models were used to investigate the determinants of initiation, implementation, and discontinuation of amoxicillin...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28343870/cd15-focus-score-infection-diagnosis-and-stratification-into-low-virulence-and-high-virulence-microbial-pathogens-in-periprosthetic-joint-infection
#11
V T Krenn, M Liebisch, B Kölbel, N Renz, T Gehrke, M Huber, M G Krukemeyer, A Trampuz, H Resch, V Krenn
INTRODUCTION: The aim of the work was to validate the CD15 focus score for the infection pathology of periprosthetic joint infection in a large group and to clarify whether a stratification into low-virulence and high-virulence microbial pathogens is possible by means of the CD15 focus score (quantification of CD15 positive granulocytes). METHODS: The histopathology of 275 synovial tissue samples taken intraoperatively during revision operations (n=127 hip, n=141 knee, n=2 shoulder, n=5 ankle) was evaluated according to the SLIM consensus classification (SLIM=synovial-like interface membrane)...
January 12, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28340234/detection-of-severe-digital-vasculopathy-in-systemic-sclerosis-by-colour-doppler-sonography-is-associated-with-digital-ulcers
#12
Susanne Lüders, Stefanie Friedrich, Sarah Ohrndorf, Anne-Marie Glimm, Gerd-Rüdiger Burmester, Gabriela Riemekasten, Marina Backhaus
Objective.: Colour Doppler ultrasonography (CDUS) is very important in general vascular diagnostic procedures. Its role in determining the extent of vasculopathy in Systemic Sclerosis (SSc) needs further investigation. The aim of this study was to compare the presence of altered arteries with nailfold capillaroscopy and clinical signs of ischaemia, that is, digital ulcers or pitting scars (DU/PS). A feasible CDUS protocol is provided. Methods.: Two thousand five hundred and twenty-eight arteries of the fingers, palms and wrists from 79 SSc patients (32 arteries per patient) were examined using CDUS...
March 17, 2017: Rheumatology
https://www.readbyqxmd.com/read/28337810/electronic-stic-improves-four-dimensional-fetal-echocardiography
#13
F Guasina, F Bellussi, G Morganelli, G Salsi, G Pilu, G Simonazzi
OBJECTIVES: To compare the efficiency of electronic Spatio-Temporal Image Correlation (eSTIC) with conventional STIC to acquire fetal cardiac four-dimensional (4D) volumes of diagnostic quality METHODS: This was a randomized controlled trial of 100 patients at midgestation with normal sonograms. In half of the cases, STIC of the fetal heart were obtained with a conventional mechanical 4D probe, in the remaining eSTIC were obtained with an electronic 4D probe. Examinations were kept within the time frame allotted for a standard examination of fetal anatomy, with a maximum of 2 attempts at obtaining a 4D cardiac volume...
March 24, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28334591/crossing-the-communication-chasm-challenges-and-opportunities-in-transitions-of-care-from-the-hospital-to-the-primary-care-clinic
#14
Nicholas A Rattray, Jason J Sico, LeeAnn M Cox, Alissa L Russ, Marianne S Matthias, Richard M Frankel
BACKGROUND: Transitions of care from specialty and acute settings to primary care abound. Compared to the continuity in end-of-shift handoffs, care transitions involve provider communication between practices and facilities with their own cultures and bureaucracies. Using the transition from acute care to outpatient primary care for stroke/transient ischemic attack (TIA) patients as a case study, this qualitative research explored communication practices and institutional arrangements among clinical providers responsible for longitudinal management of hypertension...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28329874/long-term-health-related-quality-of-life-outcomes-in-digital-replantation-versus-revision-amputation
#15
Oren Tessler, Matthew J Bartow, Marie P Tremblay-Champagne, Alex M Lin, Geneviève Landes, Sarah Sebbag, Andreas Nikolis
Background Earlier, digit viability judged the success of digital replantation. Now, utility health-related quality of life (HRQOL) measures can better assess the impact of digital replantation. Methods Overall, 264 digital injury patients were sent a regimen of utility measures: Disabilities of the Arm, Shoulder and Hand (DASH) score, European Quality of Life 5 Dimensions, visual analog scale (VAS), time trade-off (TTO), and standard gamble (SG). Overall, 51 patients responded completely to all of these-36 replantation patients and 15 revision amputation patients...
March 22, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28328569/mid-term-follow-up-of-minimally-invasive-multivessel-coronary-artery-bypass-grafting-is-the-early-learning-phase-detrimental
#16
Maria Lorena Rodriguez, Harry R Lapierre, Benjamin Sohmer, David Glineur, Marc Ruel
OBJECTIVE: Minimally invasive coronary artery bypass grafting (MICS CABG) through a small left thoracotomy is a novel technique for surgical coronary revascularization, which is increasingly being adopted around the world. This study aimed to describe the characteristics and mid-term outcomes of a series of MICS CABG to identify areas for improvement. METHODS: A prospective longitudinal study was performed on the 306 MICS CABG patients operated on by a single surgeon from 2005 to 2015...
March 22, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28327152/trim8-restores-p53-tumour-suppressor-function-by-blunting-n-myc-activity-in-chemo-resistant-tumours
#17
Francesca Mastropasqua, Flaviana Marzano, Alessio Valletti, Italia Aiello, Giuseppe Di Tullio, Annalisa Morgano, Sabino Liuni, Elena Ranieri, Luisa Guerrini, Giuseppe Gasparre, Elisabetta Sbisà, Graziano Pesole, Antonio Moschetta, Mariano Francesco Caratozzolo, Apollonia Tullo
BACKGROUND: TRIM8 plays a key role in controlling the p53 molecular switch that sustains the transcriptional activation of cell cycle arrest genes and response to chemotherapeutic drugs. The mechanisms that regulate TRIM8, especially in cancers like clear cell Renal Cell Carcinoma (ccRCC) and colorectal cancer (CRC) where it is low expressed, are still unknown. However, recent studies suggest the potential involvement of some microRNAs belonging to miR-17-92 and its paralogous clusters, which could include TRIM8 in a more complex pathway...
March 21, 2017: Molecular Cancer
https://www.readbyqxmd.com/read/28325433/reliability-of-the-grip-strength-coefficient-of-variation-for-detecting-sincerity-in-normal-and-blocked-median-nerve-in-healthy-adults
#18
N J Wachter, M Mentzel, R Hütz, J Gülke
In the assessment of hand and upper limb function, detecting sincerity of effort (SOE) for grip strength is of major importance to identifying feigned loss of strength. Measuring maximal grip strength with a dynamometer is very common, often combined with calculating the coefficient of variation (CV), a measure of the variation over the three grip strength trials. Little data is available about the relevance of these measurements in patients with median nerve impairment due to the heterogeneity of patient groups...
April 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28316216/-correlation-between-the-ct-features-and-malignancy-risk-of-small-%C3%A2-5-cm-gastric-stromal-tumors
#19
J Wang, J L Xu, H J Hu
Objective: To evaluate the correlation between computed tomography (CT) features and malignancy risk category of small (≤5 cm) gastric stromal tumors (GST), in order to provide an image reference for preoperative assessment and intraoperative pathological diagnosis. Methods: Eighty-three patients with surgically and pathologically proven GST (≤5 cm) between January 2011 and November 2015 were recruited, and their clinical, pathological and CT data were retrospectively analyzed. According to the pathological results and malignancy risk category, the patients were divided into 2 groups, the benign biological behavior group (very low and low risk) and malignant biological behavior group (intermediate and high risk)...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28314974/health-related-quality-of-life-prospectively-evaluated-by-the-8-item-short-form-after-endovascular-repair-versus-open-surgery-for-abdominal-aortic-aneurysms
#20
Takayoshi Kato, Mototsugu Tamaki, Tomohiro Tsunekawa, Yusuke Motoji, Akihiro Hirakawa, Yasuhide Okawa, Shinji Tomita
Open repair for infra-renal abdominal aortic and iliac artery aneurysms (AAAs) is a robust treatment. On the other hand, endovascular aneurysm repair (EVAR) has been widespread because of its less invasiveness. However, patients after EVAR frequently require postoperative radiographic examinations and may feel anxiety for their endoleaks. We prospectively evaluated Health-related Quality of Life of the patients with these two fashions using the 8-item Short Form (SF-8). From 2011 to 2013, 89 consecutive elective cases of AAAs were treated...
March 17, 2017: Heart and Vessels
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