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https://www.readbyqxmd.com/read/29156160/treating-charcot-arthropathy-is-a-challenge-explaining-why-my-treatment-algorithm-has-changed
#1
REVIEW
Lawrence DiDomenico, Zachary Flynn, Michael Reed
Charcot deformity is a challenge that foot and ankle surgeons struggle to manage successfully. Despite the advances in knowledge, technology, and treatment modalities, limb loss is still greater than 10%. This article discusses the efficacy of conservative measures and traditional surgical approaches. It proposes a multidisciplinary team approach, medical optimization, and lifestyle modification to put the patient in the best position to heal. Also discussed is the authors' staged surgical treatment protocol to enhance outcomes and decrease the rate of limb loss...
January 2018: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/29155667/use-of-a-diagonal-approach-to-health-system-strengthening-and-measles-elimination-after-a-large-nationwide-outbreak-in-mongolia
#2
José E Hagan, Ashley Greiner, Ulzii-Orshikh Luvsansharav, Jason Lake, Christopher Lee, Roberta Pastore, Yoshihiro Takashima, Amarzaya Sarankhuu, Sodbayar Demberelsuren, Rachel Smith, Benjamin Park, James L Goodson
Measles is a highly transmissible infectious disease that causes serious illness and death worldwide. Efforts to eliminate measles through achieving high immunization coverage, well-performing surveillance systems, and rapid and effective outbreak response mechanisms while strategically engaging and strengthening health systems have been termed a diagonal approach. In March 2015, a large nationwide measles epidemic occurred in Mongolia, 1 year after verification of measles elimination in this country. A multidisciplinary team conducted an outbreak investigation that included a broad health system assessment, organized around the Global Health Security Agenda framework of Prevent-Detect-Respond, to provide recommendations for evidence-based interventions to interrupt the epidemic and strengthen the overall health system to prevent future outbreaks of measles and other epidemic-prone infectious threats...
December 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29153618/advantages-of-a-prospective-multidisciplinary-approach-in-transcatheter-aortic-valve-implantation-eight-years-of-experience
#3
Cátia Costa, Rui Campante Teles, João Brito, José Pedro Neves, Henrique Mesquita Gabriel, Miguel Abecassis, Regina Ribeiras, João Abecasis, Tiago Nolasco, Maria da Conceição Furstenau, Nélson Vale, António Tralhão, Sérgio Madeira, João Mesquita, Carla Saraiva, Rita Calé, Manuel Almeida, Ana Aleixo, Miguel Mendes
INTRODUCTION: Aortic stenosis is the most prevalent type of valvular disease in Europe. Surgical aortic valve replacement (SAVR) is the standard therapy, while transcatheter aortic valve implantation (TAVI) is an alternative in patients at unacceptably high surgical risk. Assessment by a heart team is recommended by the guidelines but there is little published evidence on this subject. The purpose of this paper is to describe the experience of a multidisciplinary TAVI program that began in 2008...
November 15, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29153290/locally-advanced-pancreatic-cancer-an-emerging-entity
#4
REVIEW
Grainne M O Kane, Jennifer J Knox
Pancreatic adenocarcinoma (PDAC) remains a highly fatal disease that is increasing in incidence. PDAC can be classified according to resectability status with 3 nonmetastatic groups defined: resectable, borderline resectable, and locally advanced PDAC (LAPC). Delineating these subtypes is important with the optimal treatment approach dictated by high-quality CT imaging and multidisciplinary team discussion. Patients with LAPC are thought unresectable and are therefore rarely cured. In these patients, chemotherapy remains the mainstay of treatment...
November 16, 2017: Current Problems in Cancer
https://www.readbyqxmd.com/read/29152685/cerebral-palsy-an-overview
#5
REVIEW
Sheffali Gulati, Vishal Sondhi
Cerebral palsy (CP) is a neurodevelopmental disorder characterized by abnormalities of muscle tone, movement and motor skills, and is attributed to injury to the developing brain. The clinical features of this entity evolve over time and the specific CP syndrome may be recognizable only after 3-5 y of age; although suggestive signs and symptoms may be present at an earlier age. The management involves neurological rehabilitation (addressing muscle tonal abnormalities, and devising physical and occupational therapies) and diagnosis and management of co-morbidities (including epilepsy, impairment of cognition, vision, hearing, and disturbances of growth and gastrointestinal function)...
November 20, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29152326/development-of-a-communication-aid-for-explaining-hypertrophic-cardiomyopathy-genetic-test-results
#6
Yana Smagarinsky, Charlotte Burns, Catherine Spinks, Christopher Semsarian, Jodie Ingles
Background: Large gene panels are now commonplace for hypertrophic cardiomyopathy (HCM), increasing the yield of uncertain genetic findings. Few resources exist which aim to facilitate communication of HCM genetic test results. We sought to develop, pilot, and refine a communication aid for probands receiving HCM genetic test results. Methods: Development was a multi-step process involving expertise of a multidisciplinary team, literature review, and empirical experience...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29151714/multidisciplinary-team-based-obesity-treatment-in-patients-with-diabetes-current-practices-and-the-state-of-the-science
#7
Daniel Foster, Shakira Sanchez-Collins, Lawrence J Cheskin
IN BRIEF Rates of obesity and diabetes are growing, as are their costs. Because the two diseases share many key determinants, the paradigms for their treatment overlap. For both, optimal treatment involves a multidisciplinary team following the Chronic Care Model of health care delivery. Combined treatment programs that include 1) a low-calorie diet individualized to patients' preferences, 2) structured exercise that is also tailored to each patient, and 3) psychotherapy induce the largest weight changes in patients with diabetes...
November 2017: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29151230/intentional-placental-removal-on-suspicious-placenta-accreta-spectrum-still-prohibited
#8
Shigeki Matsubara, Hironori Takahashi
INTRODUCTION: Intentional placental removal for abnormally invasive placenta (AIP) is fundamentally abandoned at planned surgery for it. Whether this holds true even after recent introduction of various hemostatic procedures is unclear. MATERIALS AND METHODS: We discussed on this issue based on our own experiences and also on the recent reports on various hemostatic procedures. RESULTS: Studies directly answering this question have been lacking...
November 18, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29150237/-maternal-deaths-due-to-amniotic-fluid-embolism-results-from-the-french-confidential-enquiry-into-maternal-deaths-2010-2012
#9
E Morau, A Proust, J-C Ducloy
Amniotic fluid embolism (AFE) is an unpredictable, dreadful complication of pregnancy or childbirth. EA typically includes in the same lapse of time respiratory, haemodynamic, neurological and hemorrhagic symptoms (from early and severe coagulopathy). Immediate supportive treatment by a multidisciplinary team is the cornerstone of the management. Between 2010 an 2012 in France, 24 deaths were related to AFE giving a maternal mortality ratio of 1/100,000 live births (CI 95% 0.6-1.4). AFE ranks as the second leading cause of direct maternal death...
November 14, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29150163/the-management-of-diagnosed-heart-failure-in-older-people-in-primary-care
#10
REVIEW
Nicholas R Jones, F D Richard Hobbs, Clare J Taylor
Heart failure (HF) is a common condition affecting predominantly older people. Symptoms include breathlessness and fatigue, and can significantly reduce quality of life. HF rarely occurs in isolation, with most patients having several co-existing diseases requiring multiple medications. There is a large evidence base for treatment of HF with reduced ejection fraction, or HFrEF; however, many of the trials did not include older people with multimorbidity so their findings should be applied to this group with some caution...
December 2017: Maturitas
https://www.readbyqxmd.com/read/29149872/process-quality-of-decision-making-in-multidisciplinary-cancer-team-meetings-a-structured-observational-study
#11
Pola Hahlweg, Sarah Didi, Levente Kriston, Martin Härter, Yvonne Nestoriuc, Isabelle Scholl
BACKGROUND: The quality of decision-making in multidisciplinary team meetings (MDTMs) depends on the quality of information presented and the quality of team processes. Few studies have examined these factors using a standardized approach. The aim of this study was to objectively document the processes involved in decision-making in MDTMs, document the outcomes in terms of whether a treatment recommendation was given (none vs. singular vs. multiple), and to identify factors related to type of treatment recommendation...
November 17, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29147965/primary-squamous-cell-carcinoma-of-the-breast-in-association-with-zuska-s-disease
#12
A M Huws, L Semkin, A Moalla, S Udayasankar, S D H Holt, Y M Sharaiha
Breast cancer is the most common malignancy in women in the UK with well-defined algorithms of management in place in the western world. Squamous cell carcinoma of the breast is a rare entity and as such knowledge about the pathophysiology, treatment and prognosis are still uncertain. The report describes an unusual case of squamous cell carcinoma arising in an area of Zuska's disease of the breast. It illustrates the heterogeneity of the imaging findings with review of the literature. Decisions on management should be taken on an individual basis with full discussion in the multidisciplinary team meetings where all facets of the case are considered...
November 17, 2017: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/29143892/update-in-the-therapy-of-advanced-neuroendocrine-tumors
#13
REVIEW
Inbal Uri, Shani Avniel-Polak, David J Gross, Simona Grozinsky-Glasberg
Neuroendocrine tumors (NETs) are rare neoplasms, with an estimated annual incidence of ~ 6.9/100,000. NETs arise throughout the body from cells of the diffuse endocrine system. More than half originate from endocrine cells of the gastrointestinal tract and the pancreas, thus being referred to as gastroenteropancreatic NETs (GEP-NETs). The only treatment that offers a cure is surgery; however, most patients are diagnosed with metastatic disease, and curative surgery is usually not an option. These patients can be offered long-term systemic treatment, for both symptomatic relief and tumor growth suppression...
November 16, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/29143500/-pulmonary-hypertension-and-pregnancy
#14
Eleni Diamanti, David Baud, John-David Aubert, Laurent P Nicod
Pregnancy in the context of pulmonary hypertension is characterised by high mortality for the mother and the foetus and is therefore strongly discouraged ; contraception has to be prescribed to patients in reproductive age. Women who decide to continue their pregnancy should be followed by multidisciplinary teams in specialised centres. A specific treatment should be defined with no delay. In case of clinical deterioration, the early, intravenous administration of prostacyclin should be considered. The ideal time and method of delivery are still disputed...
November 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29142817/an-unusual-case-of-aortic-right-atrium-fistula-a-diagnostic-and-therapeutic-challenge
#15
Maria Chiara Todaro, Alessandro Aprile, Adriana Ravera, Gaetano Senatore
An aorta-to-right atrium (RA) fistula is an anomalous communication between the ascending or descending thoracic aorta and the RA. In this report, we describe a case of an idiopathic aortic root-to-RA fistula occasionally found during a coronary angiography performed in a young patient admitted for acute chest pain with evidence of multivessel coronary artery disease. The anatomical peculiarity of this fistulous communication is that it gave origin to collateral vessels furnishing the inferolateral wall of the left ventricle...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29142784/the-value-of-implementing-multidisciplinary-perinatal-care-conference-in-the-private-practice-setting
#16
Robert C Johnston, Sina Haeri, Richard T Hale, William Lindsley, Annette McCormick, Eric Su
Objective  The objective of this study was to estimate the impact of multidisciplinary (Multi-D) perinatal care conference (PCC) implementation in the private practice setting. Methods  After the initial 12-month period following implementation of the monthly PCC by private maternal-fetal medicine and neonatology practitioners, conference attendees were asked to completed a modified version of the Attitudes Toward Health Care Teams Scale, involving 19 questions assessing their attitudes and opinions toward Multi-D team care on a five-point Likert's scale...
October 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29140732/a-rare-form-of-ankyloblepharon-filiforme-adnatum-associated-with-the-hay-wells-syndrome-and-a-c-1709t-c-mutation-on-the-tp63-gene
#17
Michal Koubek, Kristýna Strakošová, Juraj Timkovič, Dagmar Grečmalová, Aneta Orlíková, Hana Burčková, Hana Wiedermannová, Petr Mašek
INTRODUCTION: Ankyloblepharon filiforme adnatum associated with Hay-Wells syndrome is a rare congenital disease caused by mutations in TP63 gene on the 3q27 chromosome. Here, we report a case of a new-born suffering from this syndrome in whom we detected a mutation c.1709T>C not previously included in the Ensemble database. CASE DESCRIPTION: A girl delivered in the 34th week of gestation from a physiological pregnancy was born with extensive burn-like skin defects, ankyloblepharon filiforme adnatum, palate cleft, onychodystrophy of all limbs and syndactyly of toes...
November 15, 2017: Ophthalmic Genetics
https://www.readbyqxmd.com/read/29139162/epidemiology-of-therapeutic-apheresis-with-a-multidisciplinary-approach-at-a-high-volume-pediatric-center
#18
Rachel M Sirignano, Matthew L Paden, Ross Fasano, Erin K Meyer
INTRODUCTION: Therapeutic apheresis (TA) is used inconsistently in pediatric populations. We seek to define our multidisciplinary institutional practice. METHODS: We conducted a retrospective chart review of patients receiving TA from January 1, 2012 through October 31, 2015. Data collected included demographics, American Society of Apheresis (ASFA) indication, complications, and mortality. RESULTS: Over 46 months, 1198 TA procedures were conducted on 289 patients ranging in age from 5 months to 21 years with weights ranging from 4...
November 15, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29138217/effectiveness-of-interprofessional-education-in-renal-physiology-curricula-for-health-sciences-graduate-students
#19
Lisa M Harrison-Bernard, Mihran V Naljayan, Jane M Eason, Donald E Mercante, Tina P Gunaldo
The primary purpose of conducting an interprofessional education (IPE) experience during the renal physiology block of a graduate-level course was to provide basic science, physical therapy, and physician assistant graduate students with an opportunity to work as a team in the diagnosis, treatment, and collaborative care of a patient with acute kidney injury. The secondary purpose was to enhance the understanding of basic renal physiology principles with a patient case presentation of renal pathophysiology...
December 1, 2017: Advances in Physiology Education
https://www.readbyqxmd.com/read/29137508/health-professional-education-and-universal-health-coverage-a-summary-of-challenges-and-selected-case-studies
#20
Arthika Sripathy, Joachim Marti, Hannah Patel, Javaid I Sheikh, Ara W Darzi
Low- and middle-income countries are experiencing serious shortages in meeting health workforce requirements for universal health coverage. We examine how national-level policies can address these deficiencies and support the development of an appropriately skilled health workforce in line with population needs. We discuss three innovative, government-led solutions that are designed to align health workforce training with the demands of universal health coverage. Specifically, we discuss two initiatives to train and retain doctors in rural areas of Thailand, the large-scale training of community health workers within multidisciplinary primary health care teams in Brazil, and the introduction of a postgraduate diploma program in primary care for nurses in India...
November 2017: Health Affairs
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