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https://www.readbyqxmd.com/read/28732098/variability-of-the-pressure-measurements-exerted-by-the-tip-of-laryngoscope-during-laryngeal-sensory-testing-a-clinical-demonstration
#1
Asako Kaneoka, Jessica M Pisegna, Gintas P Krisciunas, Takaharu Nito, Michael P LaValley, Cara E Stepp, Susan E Langmore
Purpose: Clinicians often test laryngeal sensation by touching the laryngeal mucosa with the tip of a flexible laryngoscope. However, the pressure applied to the larynx by using this touch method is unknown, and the expected responses elicited by this method are uncertain. The variability in pressure delivered by clinicians using the touch method was investigated, and the subject responses to the touches were also reported. Methods: A fiberoptic pressure sensor passed through the working channel of a laryngoscope, with its tip positioned at the distal port of the channel...
July 21, 2017: American Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28730950/statistical-analysis-plan-for-the-head-position-in-stroke-trial-headpost-an-international-cluster-cross-over-randomized-trial
#2
Laurent Billot, Mark Woodward, Hisatomi Arima, Maree L Hackett, Paula Muñoz Venturelli, Pablo M Lavados, Alejandro Brunser, Bin Peng, Liying Cui, Lily Song, Stephane Heritier, Stephen Jan, Sandy Middleton, Verónica V Olavarría, Joyce Lim, Thompson Robinson, Octavio Pontes-Neto, Caroline Watkins, Craig S Anderson
Background There is evidence to indicate that the lying flat head position increases cerebral blood flow and oxygenation in patients with acute ischemic stroke, but how these physiological effects translate into clinical outcomes is uncertain. The Head Position in Stroke Trial aims to determine the comparative effectiveness of lying flat (0°) compared to sitting up (≥30°) head positioning, initiated within 24 h of hospital admission for patients with acute stroke. Design An international, pragmatic, cluster-randomized, crossover, open, blinded outcome assessed clinical trial...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28730853/dengue-in-the-elderly-a-review
#3
Ray Junhao Lin, Tau Hong Lee, Yee Sin Leo
Changing dengue epidemiological trends have resulted in a shift in the disease burden to the adult population. Older adults suffer from poorer outcomes as compared to their younger counterparts, making clinical management of this sub-population particularly challenging. Areas covered: We present a review of the current literature on the changing epidemiology of dengue in the elderly, the atypical features of the clinical disease in this population with emphasis on severe disease presentations and challenges in the current management strategies...
July 21, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28730738/the-effects-of-aspirated-thickened-water-on-survival-and-pulmonary-injury-in-a-rabbit-model
#4
Nogah Nativ-Zeltzer, Maggie A Kuhn, Denise M Imai, Ryan P Traslavina, Amanda S Domer, Juliana K Litts, Brett Adams, Peter C Belafsky
OBJECTIVES/HYPOTHESIS: Liquid thickeners are one of the most frequently utilized treatment strategies for persons with oropharyngeal swallowing dysfunction. The effect of commercially available thickeners on lung injury is uncertain. The purpose of this study was to compare the effects of aspiration of water alone, xanthan gum (XG)-thickened water, and cornstarch (CS)-thickened water on survival and lung morphology in a rabbit model. STUDY DESIGN: Animal model. Prospective small animal clinical trial...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28730457/efficacy-safety-and-clinical-outcome-of-modern-mechanical-thrombectomy-in-elderly-patients-with-acute-ischemic-stroke
#5
Seungnam Son, Dong-Hun Kang, Yang-Ha Hwang, Yong-Sun Kim, Yong-Won Kim
BACKGROUND: The average life expectancy is increasing worldwide, surpassing 80 years in some countries. Recently, mechanical thrombectomy (MT) using modern devices and techniques has led to improved clinical outcomes following acute ischemic stroke. However, thus far, it remains uncertain whether MT is effective in elderly patients aged over 80 years. METHODS: Between July 2013 and June 2016, 207 patients with acute ischemic stroke in the anterior circulation received MT at our center...
July 20, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28729407/long-term-stroke-risk-prediction-in-patients-with-atrial-fibrillation-comparison-of-the-abc-stroke-and-cha2ds2-vasc-scores
#6
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Gregory Y H Lip, Francisco Marín
BACKGROUND: The ABC-stroke score (age, biomarkers [N-terminal fragment B-type natriuretic peptide, high-sensitivity troponin], and clinical history [prior stroke/transient ischemic attack]) was proposed to predict stroke in atrial fibrillation (AF). This score was derived/validated in 2 clinical trial cohorts in which patients with AF were highly selected and carefully followed-up. However, the median follow-up was 1.9 years in the trial cohort; therefore, its long-term predictive performance remains uncertain...
July 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28728744/serial-heart-rates-guideline-directed-beta-blocker-use-and-outcomes-in-patients-with-chronic-heart-failure-with-reduced-ejection-fraction
#7
Nasrien E Ibrahim, James L Januzzi, Dustin J Rabideau, Parul U Gandhi, Hanna K Gaggin
A single heart rate (HR) measurement may inform future prognosis in chronic heart failure with reduced ejection fraction (HFrEF). The importance of elevated HR across serial assessment is uncertain, particularly with well-applied guideline-directed medical therapy (GDMT) with beta blockers (BBs). In this post hoc analysis of 129 patients with chronic HFrEF in sinus rhythm, who had aggressive medication titration over 10.6 months, HR and BB use were assessed at each visit (average of 6 visits per patient). All-cause mortality was assessed...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28728623/veterans-affairs-primary-care-provider-perceptions-of-insomnia-treatment
#8
Christi S Ulmer, Hayden B Bosworth, Jean C Beckham, Anne Germain, Amy S Jeffreys, David Edelman, Stephanie Macy, Angela Kirby, Corrine I Voils
STUDY OBJECTIVES: Insomnia is a widespread issue among United States adults and rates of insomnia among veterans are even higher than the general population. Prior research examining primary care provider (PCP) perspectives on insomnia treatment found that: sleep hygiene and pharmacotherapy are the primary treatments offered; PCPs tend to focus on perceived causes of insomnia rather than the insomnia itself; and neither patients nor providers are satisfied with insomnia treatment options...
July 14, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28728605/surrogate-endpoints-in-oncology-when-are-they-acceptable-for-regulatory-and-clinical-decisions-and-are-they-currently-overused
#9
Robert Kemp, Vinay Prasad
BACKGROUND: Surrogate outcomes are not intrinsically beneficial to patients, but are designed to be easier and faster to measure than clinically meaningful outcomes. The use of surrogates as an endpoint in clinical trials and basis for regulatory approval is common, and frequently exceeds the guidance given by regulatory bodies. DISCUSSION: In this article, we demonstrate that the use of surrogates in oncology is widespread and increasing. At the same time, the strength of association between the surrogates used and clinically meaningful outcomes is often unknown or weak...
July 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28728581/a-gestational-choriocarcinoma-of-the-ovary-diagnosed-by-dna-polymorphic-analysis-a-case-report-and-systematic-review-of-the-literature
#10
Nan Jia, Yan Chen, Xiang Tao, Enzhi Ou, Xin Lu, Weiwei Feng
BACKGROUND: Choriocarcinoma of the ovary is rare. This tumor can arise from gestational tissue or pure germ cells of the ovary, the former results in gestational choriocarcinoma. The clinical characteristics and histology of both tumor types are identical, differentiation of these tumors is necessary for effective treatment. One strategy for the differentiation of these tumors types is to identify the presence of paternal DNA by DNA polymorphic analysis. CASE PRESENTATION: In the present case, a 27-year-old patient with a history of amenorrhea, lower abdominal pain and vaginal bleeding received a laparoscopic dissection of cystic mass of the right ovary according to an initial diagnosis of ectopic pregnancy...
July 20, 2017: Journal of Ovarian Research
https://www.readbyqxmd.com/read/28727896/proseal-versus-classic-laryngeal-mask-airway-lma-for-positive-pressure-ventilation-in-adults-undergoing-elective-surgery
#11
REVIEW
Muhammad Qamarul Hoda, Khalid Samad, Hameed Ullah
BACKGROUND: The development of supraglottic airway devices has revolutionized airway management during general anaesthesia. Two devices are widely used in clinical practice to facilitate positive pressure ventilation: the ProSeal laryngeal mask airway (pLMA) and the Classic laryngeal mask airway (cLMA). It is not clear whether these devices have important clinical differences in terms of efficacy or complications. OBJECTIVES: To compare the effectiveness of the ProSeal laryngeal mask airway (pLMA) and the Classic LMA (cLMA) for positive pressure ventilation in adults undergoing elective surgery...
July 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28726144/anastomotic-stricture-after-ultralow-anterior-resection-or-intersphincteric-resection-for-very-low-lying-rectal-cancer
#12
Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim
BACKGROUND: Anastomotic stricture following colorectal cancer surgery is not a rare complication, but proper management of anastomotic stricture located close to the anal verge is uncertain. This study aimed to investigate risk factors and management strategies for anastomotic stricture after ultralow anterior resection (ULAR). METHODS: We retrospectively reviewed a database of patients with rectal cancer who underwent surgery between January 2007 and June 2015, and included patients with an anastomosis within 4 cm from the anal verge...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726052/transcranial-sonography-image-characteristics-in-different-parkinson-s-disease-subtypes
#13
Ai Yan Sheng, Ying Chun Zhang, Yu Jing Sheng, Cai Shan Wang, Ying Zhang, Hua Hu, Wei Feng Luo, CHun-Feng LIu
Recently, Parkinson's disease (PD) has been classified into three subtypes: postural instability gait difficulty (PIGD), tremor dominate (TD), and indeterminate PD. Transcranial sonography (TCS) is considered to be an important tool to diagnose PD. However, it is uncertain that whether there are differences in TCS image characteristics in different PD subtypes, so 373 idiopathic PD (188 PIGD, 108 TD, 77 indeterminate PD) were registered and received TCS in our investigation; also, the association between clinical characteristics and TCS results in different PD subtypes was analyzed...
July 19, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28725289/amnestic-mci-patients-perspectives-toward-disclosure-of-amyloid-pet-results-in-a-research-context
#14
Gwendolien Vanderschaeghe, Jolien Schaeverbeke, Rik Vandenberghe, Kris Dierickx
BACKGROUND: Researchers currently are not obligated to share individual research results (IRR) with participants. This non-disclosure policy has been challenged on the basis of participants' rights to be aware and in control of their personal medical information. Here, we determined how patients view disclosure of research PET results of brain amyloid and why they believe it is advantageous or disadvantageous to disclose. METHOD: As a part of a larger diagnostic trial, we conducted semi-structured interviews with patients with amnestic Mild Cognitive Impairment (aMCI)...
2017: Neuroethics
https://www.readbyqxmd.com/read/28724320/statins-and-venous-thromboembolism-do-they-represent-a-viable-therapeutic-agent
#15
Setor K Kunutsor, Michael R Whitehouse, Ashley W Blom, Jari A Laukkanen
Venous thromboembolism (VTE) is an important cause of preventable morbidity and mortality. Though anticoagulants are effective in preventing VTE, they are associated with major bleeding risk. The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (known as statins), are well established for the primary and secondary prevention of cardiovascular disease via their lipid-lowering properties. Emerging evidence suggests that statins may play a role in the prevention of VTE, but the evidence has been uncertain...
July 21, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28723776/a-case-of-idiopathic-hypertrophic-pachymeningitis-presenting-with-chronic-headache-and-multiple-cranial-nerve-palsies-a-case-report
#16
Yuanyuan Huang, Jun Chen, Li Gui
RATIONALE: Idiopathic hypertrophic pachymeningitis (IHP) is a rare condition, characterized by a chronic fibrosing inflammatory process usually involving either the intracranial or spinal dura mater, but rarely both. Here, we report a rare case of IHP affecting both the intracranial and spinal dura mater. We also discussed the diagnosis, management, and outcome of IHP. PATIENT CONCERNS: We reviewed the case of a 60-year-old woman presenting with chronic headache, multiple cranial nerve palsies and gait disturbance...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28721650/prediction-of-pulmonary-metastasis-in-pulmonary-nodules-%C3%A2-10%C3%A2-mm-detected-in-patients-with-primary-extrapulmonary-malignancy-at-thin-section-staging-ct
#17
Qiuxia Yang, Yiqi Wang, Xiaohua Ban, Jing Wu, Dailin Rong, Qianqian Zhao, Chuanmiao Xie, Rong Zhang
PURPOSE: To investigate the predictive clinical and imaging factors associated with pulmonary metastasis in pulmonary nodules (PNs) ≤10 mm in patients with primary extrapulmonary malignancy (PEPM) on initial CT as well as the inter-nodular imaging features in the non-solitary PNs patients, to make a more reliable diagnosis and appropriate management of the PNs at an earlier stage after detection. MATERIALS AND METHODS: 161 patients with PNs ≤10 mm were reviewed from April 2013 to December 2013...
July 18, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28721139/vitamin-d-deficiency-and-non-lipid-biomarkers-of-cardiovascular-risk
#18
Kamil F Faridi, Joshua R Lupton, Seth S Martin, Maciej Banach, Renato Quispe, Krishnaji Kulkarni, Steven R Jones, Erin D Michos
INTRODUCTION: Deficient 25-hydroxyvitamin D (25(OH)D) levels have been associated with dyslipidemia and cardiovascular diseases, though the underlying mechanism of these associations is uncertain. We analyzed associations between vitamin D and other non-lipid biomarkers of cardiovascular risk to better elucidate possible relationships between deficient 25(OH)D and cardiovascular disease. MATERIAL AND METHODS: We performed a cross-sectional analysis of 4,591 adults included in a clinical laboratory database from 2009 to 2011 with available measurements for 25(OH)D and the following biomarkers: homocysteine (Hcy), high-sensitivity C-reactive protein (hs-CRP), cystatin-C, creatinine, γ-glutamyltransferase (GGT), uric acid, and hemoglobin A1c (HbA1c)...
June 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28721067/phase-i-dose-escalation-study-of-long-acting-pasireotide-in-patients-with-neuroendocrine-tumors
#19
James C Yao, Jennifer A Chan, Alain C Mita, Madan G Kundu, Karina Hermosillo Reséndiz, Ke Hu, Shoba Ravichandran, Jonathan R Strosberg, Edward M Wolin
This phase I study aimed at determining the maximum tolerated dose (MTD) and characterizing the safety, tolerability, pharmacokinetics (PKs), and efficacy of pasireotide in patients with advanced neuroendocrine tumors (NETs). Patients were enrolled in two phases: dose-escalation phase (to determine the MTD) at a starting dose of 80 mg pasireotide long-acting release (LAR) i.m. followed by a dose-expansion phase (to evaluate safety and prelimi-nary efficacy). Associations between PK/pharmacodynamic parameters and clinical outcomes were evaluated using linear regression analysis...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28719548/forearm-pronation-osteotomy-for-supination-contracture-secondary-to-obstetrical-brachial-plexus-palsy-a-retrospective-cohort-study
#20
Aharon Z Gladstein, Brant Sachleben, Emily S Ho, Alison Anthony, Howard M Clarke, Sevan Hopyan
BACKGROUND: Obstetrical brachial plexus palsy can lead to fixed forearm supination contracture. Fixed supination may lead to functional deficits as the affected hand cannot be positioned optimally for activities on a desk such as writing and typing, or for using tools including utensils, which require a neutral or pronated forearm. Forearm pronation osteotomy has been used to address this problem, although the functional benefit over nonoperative management has not been clearly defined...
July 17, 2017: Journal of Pediatric Orthopedics
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