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https://www.readbyqxmd.com/read/29664999/randomized-clinical-trial-of-the-effect-of-a-fibrin-sealant-patch-on-pancreatic-fistula-formation-after-pancreatoduodenectomy
#1
M Schindl, R Függer, P Götzinger, F Längle, M Zitt, S Stättner, P Kornprat, K Sahora, D Hlauschek, M Gnant
BACKGROUND: The potential for a fibrin sealant patch to reduce the risk of postoperative pancreatic fistula (POPF) remains uncertain. The aim of this study was to evaluate whether a fibrin sealant patch is able to reduce POPF in patients undergoing pancreatoduodenectomy with pancreatojejunostomy. METHODS: In this multicentre trial, patients undergoing pancreatoduodenectomy were randomized to receive either a fibrin patch (patch group) or no patch (control group), and stratified by gland texture, pancreatic duct size and neoadjuvant treatment...
April 17, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29663690/cranial-pair-0-the-nervus-terminalis
#2
Angel Peña-Melian, Juan Pablo Cabello-de la Rosa, Maria Jose Gallardo-Alcañiz, Julia Vaamonde-Gamo, Fernanda Relea-Calatayud, Lucia Gonzalez-Lopez, Patricia Villanueva-Anguita, Alicia Flores-Cuadrado, Daniel Saiz-Sanchez, Alino Martinez-Marcos
Originally discovered in elasmobranchs by Fritsh in 1878, the nervus terminalis has been found in virtually all species, including humans. After more than one-century debate on its nomenclature, it is nowadays recognized as cranial pair zero. The nerve mostly originates in the olfactory placode, although neural crest contribution has been also proposed. Developmentally, the nervus terminalis is clearly observed in human embryos; subsequently, during the fetal period loses some of its ganglion cells, and it is less recognizable in adults...
April 16, 2018: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/29663669/preliminary-efficacy-and-tolerability-of-chemohormonal-therapy-in-metastatic-hormone-na%C3%A3-ve-prostate-cancer-the-first-real-life-experience-in-asia
#3
Darren M C Poon, Tim Chan, Kuen Chan, Michelle Chan, Eric K C Lee, Kitty Law, Daisy Lam
INTRODUCTION: A substantial survival benefit with chemohormonal therapy has been proven by the CHAARTED and STAMPEDE studies, and this clinical approach has emerged as the standard of care for patients with metastatic hormone-naïve prostate cancer (mHSPC). However, because its clinical efficacy and tolerability in Asian patients remains uncertain, this study aims to evaluate preliminary results of its use in Hong Kong. METHODS: The clinical records of mHSPC patients treated with chemohormonal therapy from all six public oncology centers in Hong Kong between January 2015 and July 2016 were reviewed...
April 16, 2018: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29663328/gamma-aminobutyric-acid-agonists-for-antipsychotic-induced-tardive-dyskinesia
#4
REVIEW
Samer Alabed, Youssef Latifeh, Husam Aldeen Mohammad, Hanna Bergman
BACKGROUND: Chronic antipsychotic drug treatment may cause tardive dyskinesia (TD), a long-term movement disorder. Gamma-aminobutyric acid (GABA) agonist drugs, which have intense sedative properties and may exacerbate psychotic symptoms, have been used to treat TD. OBJECTIVES: 1. Primary objectiveThe primary objective was to determine whether using non-benzodiazepine GABA agonist drugs for at least six weeks was clinically effective for the treatment of antipsychotic-induced TD in people with schizophrenia, schizoaffective disorder or other chronic mental illnesses...
April 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29663113/low-inter-examiner-agreement-of-the-friedman-staging-system-indicating-limited-value-in-patient-selection
#5
Joar Sundman, Johan Fehrm, Danielle Friberg
PURPOSE: The Friedman staging system is a clinical method for selecting patients with obstructive sleep apnoea who are likely to benefit from uvulopalatopharyngoplasty. The objective of this study was to evaluate the system by determining its inter-examiner agreement. METHODS: Twelve patients with obstructive sleep apnoea were examined by 14 doctors. The Friedman stage was derived from tonsil size and tongue position, and a Cohen's kappa analysis was performed to assess inter-examiner agreement...
April 16, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29661795/machine-learning-analysis-of-left-ventricular-function-to-characterize-heart-failure-with-preserved-ejection-fraction
#6
Sergio Sanchez-Martinez, Nicolas Duchateau, Tamas Erdei, Gabor Kunszt, Svend Aakhus, Anna Degiovanni, Paolo Marino, Erberto Carluccio, Gemma Piella, Alan G Fraser, Bart H Bijnens
BACKGROUND: Current diagnosis of heart failure with preserved ejection fraction (HFpEF) is suboptimal. We tested the hypothesis that comprehensive machine learning (ML) of left ventricular function at rest and exercise objectively captures differences between HFpEF and healthy subjects. METHODS AND RESULTS: One hundred fifty-six subjects aged >60 years (72 HFpEF+33 healthy for the initial analyses; 24 hypertensive+27 breathless for independent evaluation) underwent stress echocardiography, in the MEDIA study (Metabolic Road to Diastolic Heart Failure)...
April 2018: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29660004/renal-transplant-outcomes-and-de-novo-donor-specific-anti-human-leukocyte-antigen-antibodies-a-systematic-review
#7
Ankit Sharma, Joshua R Lewis, Wai H Lim, Suetonia Palmer, Giovanni Strippoli, Jeremy R Chapman, Stephen I Alexander, Jonathan C Craig, Germaine Wong
Background: Pre-transplant donor-specific anti-human leukocyte antigen antibodies (DSAs) are known risk factors for acute rejection and reduced graft survival after kidney transplantation. DSAs may also develop de novo DSAs (dnDSAs) after transplantation but the clinical implications of these antibodies remain uncertain. Methods: We undertook a systematic review of observational studies that examined the association between dnDSAs and graft and patient outcomes (through August 2017) with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system of reporting used to assess the quality of evidence available...
April 11, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29659887/homeostasis-model-assessment-of-insulin-resistance-and-survival-in-patients-with-diabetes-and-acute-coronary-syndrome
#8
Barbara E Stähli, Anna Nozza, Ilse C Schrieks, John B Buse, Klas Malmberg, Linda Mellbin, Bruce Neal, Stephen J Nicholls, Lars Rydén, Anders Svensson, Hans Wedel, Arlette Weichert, A Michael Lincoff, Diederick E Grobbee, Jean-Claude Tardif, Gregory G Schwartz
Purpose: Insulin resistance has been linked to development and progression of atherosclerosis and is present in most patients with type 2 diabetes (T2D). Whether the degree of insulin resistance predicts adverse outcomes in patients with T2D and acute coronary syndrome (ACS) is uncertain. Methods: The AleCardio trial compared the peroxisome proliferator-activated receptor-α/γ agonist aleglitazar with placebo in patients with T2D and recent ACS. In participants not treated with insulin, we determined whether baseline homeostasis model assessment of insulin resistance (HOMA-IR, n=4303) or the change in HOMA-IR on assigned study treatment (n=3568) was related to the risk of death or major adverse cardiovascular events (MACE: cardiovascular death, myocardial infarction, and stroke) in unadjusted and adjusted models...
April 6, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29659677/targeting-the-human-epidermal-growth-factor-receptor-2-her2-oncogene-in-colorectal-cancer
#9
S Siena, A Sartore-Bianchi, S Marsoni, H I Hurwitz, S J McCall, F Penault-Llorca, S Srock, A Bardelli, L Trusolino
BACKGROUND: Human epidermal growth factor receptor 2 (HER2) is an oncogenic driver, and a well-established therapeutic target in breast and gastric cancers. Using functional and genomic analyses of patient-derived xenografts, we previously showed that a subset (approximately 5%) of metastatic colorectal cancer (CRC) tumors are driven by amplification or mutation of HER2. MATERIALS AND METHODS: This paper reviews the role of HER2 as an oncogenic driver, a prognostic and predictive biomarker, and a clinically actionable target in CRC, considering the specifics of HER2 testing in this tumor type...
April 6, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29652076/systematic-reanalysis-of-genomic-data-improves-quality-of-variant-interpretation
#10
S M Hiatt, M D Amaral, K M Bowling, C R Finnila, M L Thompson, D E Gray, J M J Lawlor, J Nicholas Cochran, E Martina Bebin, K B Brothers, K M East, W V Kelley, N E Lamb, S E Levy, E J Lose, M B Neu, C A Rich, S Simmons, R M Myers, G S Barsh, G M Cooper
As genomic sequencing expands, so does our knowledge of the link between genetic variation and disease. Deeper catalogs of variant frequencies improve identification of benign variants, while sequencing affected individuals reveals disease-associated variation. Accumulation of human genetic data thus makes reanalysis a means to maximize benefits of clinical sequencing. We implemented pipelines to systematically reassess sequencing data from 494 individuals with developmental disability. Reanalysis yielded pathogenic or likely pathogenic (P/LP) variants in six individuals who initially had no P/LP variants, a 16% increase to P/LP yield...
April 13, 2018: Clinical Genetics
https://www.readbyqxmd.com/read/29651777/cost-effectiveness-of-genome-and-exome-sequencing-in-children-diagnosed-with-autism-spectrum-disorder
#11
Tracy Yuen, Melissa T Carter, Peter Szatmari, Wendy J Ungar
BACKGROUND: Genome (GS) and exome sequencing (ES) could potentially identify pathogenic variants with greater sensitivity than chromosomal microarray (CMA) in autism spectrum disorder (ASD) but are costlier and result interpretation can be uncertain. Study objective was to compare the costs and outcomes of four genetic testing strategies in children with ASD. METHODS: A microsimulation model estimated the outcomes and costs (in societal and public payer perspectives in Ontario, Canada) of four genetic testing strategies: CMA for all, CMA for all followed by ES for those with negative CMA and syndromic features (CMA+ES), ES or GS for all...
April 12, 2018: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29651500/outcome-of-endovascular-treatment-for-acute-basilar-artery-occlusion-in-the-modern-era-a-single-institution-experience
#12
Chuanhui Li, Wenbo Zhao, Chuanjie Wu, Shuyi Shang, Jian Chen, Ming Ren, Jiangang Duan, Qingfeng Ma, Guilin Li, Yunzhou Zhang, Hongqi Zhang, Liqun Jiao, Xunming Ji
PURPOSE: The beneficial effect of endovascular treatment (EVT) for patients with acute basilar artery occlusion (ABAO) remains uncertain. The purpose of the present study was to evaluate clinical outcome of EVT for patients with ABAO and analyze prognostic factors of good outcome. METHODS: From our prospectively established database, we reviewed all patients with ABAO receiving EVT during January 2014 to December 2016. Baseline characteristics and outcomes were evaluated...
April 12, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29650415/pulmonary-vein-stenosis-in-infants-a-systematic-review-meta-analysis-and-meta-regression
#13
Carl H Backes, Erin Nealon, Aimee K Armstrong, Clifford L Cua, Courtney Mitchell, Usha Krishnan, Rachel D Vanderlaan, Mi Kyoung Song, Nicola Viola, Charles V Smith, Patrick I McConnell, Brian K Rivera, Jeffrey Bridge
OBJECTIVE: To quantify outcomes of infants (<1 year of age) diagnosed with pulmonary vein stenosis (PVS). STUDY DESIGN: MEDLINE (PubMed), Scopus, and Web of Science were searched through February 1, 2017, with no language restrictions. Publications including infants diagnosed with primary PVS, defined as the absence of preceding intervention(s), were considered. The study was performed according to Meta-analysis of Observational Studies in Epidemiology guidelines, the Systematic Reviews, and Meta-Analysis checklist, and registered prospectively...
April 9, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29649800/is-there-enough-evidence-to-prove-that-hemodiafiltration-is-superior
#14
Hideki Kawanishi
The evidence concerning online hemodiafiltration (HDF) includes the following: (1) the increase of removal of uremic toxin, (2) the prevention of dialysis rerated hypotension, (3) the recovery of survival, and (4) the recovery of dialysis related uncertain symptoms. Although clinical evidence has been noted, the hypothesis of the efficacy of HDF are still indefinite and require further precise research.
April 12, 2018: Blood Purification
https://www.readbyqxmd.com/read/29649004/atypical-hepatocellular-neoplasms-review-of-clinical-morphologic-immunohistochemical-molecular-and-cytogenetic-features
#15
Won-Tak Choi, Sanjay Kakar
The distinction of hepatocellular adenoma from well-differentiated hepatocellular carcinoma (HCC) can be difficult in some cases, especially on biopsy specimens. These borderline cases often occur in men or older patients and may have β-catenin activation or focal atypical morphologic features (such as small cell change, prominent pseudoacinar formation, cytologic atypia, focally thick plates, and/or focal reticulin loss) that are insufficient for an unequivocal diagnosis of HCC. The term "atypical hepatocellular neoplasm" has been advocated for these tumors, but a number of other terms, including "atypical adenoma," "hepatocellular neoplasm of uncertain malignant potential," and "well-differentiated hepatocellular neoplasm with atypical or borderline features" have also been proposed...
April 11, 2018: Advances in Anatomic Pathology
https://www.readbyqxmd.com/read/29642451/should-we-prescribe-more-protein-to-critically-ill-patients
#16
Daren K Heyland, Renee Stapleton, Charlene Compher
In the context of critical illness, evidence suggests that exogenous protein/amino acid supplementation has the potential to favorably impact whole-body protein balance. Whether this translates into retention of muscle, greater muscle strength, and improved survival and physical recovery of critically ill patients remains uncertain. The purpose of this brief commentary is to provide an overview of the clinical evidence for and against increasing protein doses and to introduce two new trials that will add considerably to our evolving understanding of protein requirements in the critically ill adult patient...
April 7, 2018: Nutrients
https://www.readbyqxmd.com/read/29630150/a-possible-role-for-dupilumab-dupixent-in-the-management-of-idiopathic-chronic-eczematous-eruption-of-aging
#17
Grace C Brummer, Lawrence T Wang, Richard D Sontheimer
Aging individuals can develop generalized, exquisitely-pruritic, eczematous eruptions of uncertain etiology that can be therapeutically-refractory and life-altering. Limited information exists in the literature to guide clinicians in the diagnosis and management of such patients. It is suggested that in approximately 40% of such patients a known cause for their chronic pruritic eruptions cannot be identified. In this report we will refer to this subgroup of patients as having idiopathic chronic eczematous eruption of aging (CEEA)...
February 15, 2018: Dermatology Online Journal
https://www.readbyqxmd.com/read/29629983/impact-of-icu-structure-and-processes-of-care-on-outcomes-after-severe-traumatic-brain-injury-a-multicenter-cohort-study
#18
Victoria A McCredie, Aziz S Alali, Damon C Scales, Gordon D Rubenfeld, Brian H Cuthbertson, Avery B Nathens
OBJECTIVES: It is uncertain whether dedicated neurocritical care units are associated with improved outcomes for critically ill neurologically injured patients in the era of collaborative protocol-driven care. We examined the association between dedicated neurocritical care units and mortality and the effects of standardized management protocols for severe traumatic brain injury. DESIGN: We surveyed trauma medical directors from centers participating in the American College of Surgeons Trauma Quality Improvement Program to obtain information about ICU structure and processes of care...
April 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29629294/validity-of-yin-yang-temperament-in-sasang-personality-questionnaire
#19
Bo Kyung Hwang, Yeo-Jin Yoon, Sang Yun Han, Soo Jin Lee, Han Chae
Background: The Yin-Yang is a pivotal concept of traditional East-Asian medicine, however the stability of Yin-Yang temperament in Sasang Personality Questionnaire (SPQ) over time has not been extensively studied. The purpose of this study was to examine the test-retest validity of SPQ with a large number of participants. Methods: SPQ test was conducted two times with three months interval in 247 Korean university students. The structural validity of first SPQ data was examined with Factor analysis and Cronbach's alpha, and the correlation between first and second measure of SPQ was attested with Pearson's correlation...
March 2018: Integrative Medicine Research
https://www.readbyqxmd.com/read/29627950/molecular-based-diagnosis-of-clostridium-difficile-infection-is-associated-with-reduced-mortality
#20
Tomer Avni, Tanya Babich, Haim Ben-Zvi, Alaa Atamna, Dafna Yahav, Daniel Shepshelovich, Yaara Leibovici-Weissman, Jihad Bishara
Polymerase chain reaction (PCR) for the diagnosis of Clostridium difficile infection (CDI) might result in overdiagnosis. The clinical outcomes of symptomatic CDI patients diagnosed by PCR remain uncertain. We aimed to determine whether patients whose diagnosis of CDI was based on PCR had different characteristics and clinical outcomes than those diagnosed by toxin immunoassay. Consecutive CDI patients, hospitalized at Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel, between January 2013 and January 2016, were identified retrospectively and included in the study...
April 7, 2018: European Journal of Clinical Microbiology & Infectious Diseases
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