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https://www.readbyqxmd.com/read/28203278/efficacy-of-granulocyte-and-monocyte-apheresis-for-antibiotic-refractory-pouchitis-after-proctocolectomy-for-ulcerative-colitis-an-open-label-prospective-multicentre-study
#1
Takayuki Yamamoto, Toshiaki Tanaka, Tadashi Yokoyama, Takahiro Shimoyama, Hiroki Ikeuchi, Motoi Uchino, Toshiaki Watanabe
BACKGROUND: Granulocyte and monocyte apheresis (GMA) has shown therapeutic efficacy in active ulcerative colitis (UC). We thought that in patients with pouchitis after proctocolectomy for UC, GMA might produce immunological effects in the intestinal mucosa, and improve clinical symptoms. This prospective study was to evaluate the efficacy of GMA for antibiotic-refractory pouchitis after proctocolectomy for UC. METHODS: A total of 13 patients with pouchitis disease activity index (PDAI) > 7 unresponsive to 2 weeks of antibiotic therapy were included...
February 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28194809/prodromal-symptoms-in-hidradenitis-suppurativa
#2
H C Ring, P Theut Riis, K Zarchi, I M Miller, D M Saunte, G B Jemec
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease, which presents as recurrent nodules and sinus tracts (tunnels) with subsequent scarring, predominantly involving the intertriginous regions. Although prodromal symptoms (i.e. various symptoms preceding the eruption of the HS lesions) are often mentioned, there have been no formal investigations into this aspect. Insight into prodromal symptoms may enable patients with HS or dermatologists in choosing a more targeted treatment at a much earlier stage, potentially increasing treatment efficacy and quality of life...
February 14, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/28194755/withdrawn-exercise-for-dysmenorrhoea
#3
REVIEW
Julie Brown, Stephen Brown
BACKGROUND: Dysmenorrhoea is characterised by cramping lower abdominal pain that may radiate to the lower back and upper thighs and is commonly associated with nausea, headache, fatigue and diarrhoea. Physical exercise has been suggested as a non-medical approach to the management of these symptoms. OBJECTIVES: To assess the evidence for the effectiveness of exercise in the treatment of dysmenorrhoea. SEARCH METHODS: A search was conducted using the methodology of the Menstrual Disorders and Subfertility Group (August 2009)...
February 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28194059/nk-t-cell-lymphoma-a-tertiary-centre-experience
#4
Neeraj Arora, Arpan Mehta, Sriram Ravichandran, Indu Arun, Rimpa Basu Achari, Anupam Chakrapani, Saurabh Jayant Bhave, Mammen Chandy, Reena Nair
Extranodal NK/T-cell lymphoma (ENKTL), nasal type, is a rare type of non-Hodgkin lymphoma that is commonly seen in East Asian countries and is associated with Epstein-Barr virus infection. This is a retrospective study where we describe nine cases of ENKTL; nasal type diagnosed and treated at our center over a period of 2 years. These cases were analyzed retrospectively for clinical presentation (age, sex, site of involvement), immunophenotype, treatment, response and toxicity profile. Sino-nasal symptoms (blocked nose, headache, epistaxis, regurgitation) were the most common presenting complaints (n = 8)...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28192568/early-performance-in-medicaid-accountable-care-organizations-a-comparison-of-oregon-and-colorado
#5
K John McConnell, Stephanie Renfro, Benjamin K S Chan, Thomas H A Meath, Aaron Mendelson, Deborah Cohen, Jeanette Waxmonsky, Dennis McCarty, Neal Wallace, Richard C Lindrooth
Importance: Several state Medicaid reforms are under way, but the relative performance of different approaches is unclear. Objective: To compare the performance of Oregon's and Colorado's Medicaid Accountable Care Organization (ACO) models. Design, Setting, and Participants: Oregon initiated its Medicaid transformation in 2012, supported by a $1.9 billion investment from the federal government, moving most Medicaid enrollees into 16 Coordinated Care Organizations, which managed care within a global budget...
February 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28192271/ventral-spontaneous-durotomy-following-vaginal-delivery
#6
Nitin Agarwal, Ahmed I Kashkoush, Arpan V Prabhu, Raymond F Sekula
INTRODUCTION: Dural breaches have a diverse etiology, including spontaneous rupture and trauma. Most cases resolve with bedrest, though in refractory cases an epidural blood patch can be placed to obstruct further leakage. Here, we discuss a unique case of a spontaneous ventral durotomy following vaginal delivery managed with injections of autologous blood through bilateral transforaminal needles. CLINICAL PRESENTATION: A previously healthy 36-year-old pregnant female presented to the inpatient maternity ward with positional occipital headaches and neck pain 24 hours following normal spontaneous vaginal delivery...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28191384/delayed-temporal-lobe-hemorrhage-after-initiation-of-acyclovir-in-an-immunocompetent-patient-with-herpes-simplex-virus-2-encephalitis-a-case-report
#7
Kyle Mueller, Joshua E Ryan, Alex Tai, Rocco A Armonda
Herpes simplex virus (HSV) is the most common cause of non-epidemic, sporadic, acute focal encephalitis in the United States. Inflammation of the vasculature makes them friable and susceptible to hemorrhage. Massive hemorrhage, though rare, can present in a delayed fashion after initiation of acyclovir and often requires surgical intervention. We report a unique case of delayed temporal lobe hemorrhage after initiation of acyclovir in an immunocompetent patient, specifically for its presentation, virology, and surgical management...
January 15, 2017: Curēus
https://www.readbyqxmd.com/read/28188169/cerebral-cryptococcoma-mimicking-glioblastoma
#8
Kimberly B Ulett, James W J Cockburn, Rosalind Jeffree, Marion L Woods
Cryptococcus neoformans and C. gattii cause invasive fungal disease, with meningitis being the most common manifestation of central nervous system (CNS) disease. Encapsulated cryptococcomas occur rarely, predominantly in immunocompetent hosts, usually related to C. gattii Our patient was an immunocompetent man who presented with headache and a large cystic CNS lesion thought to be glioblastoma. Biopsy of a concomitant lung lesion confirmed cryptococcoma and empiric antifungal therapy was started for presumed CNS cryptococcoma...
February 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28186393/chronic-fatigue-in-ehlers-danlos-syndrome-hypermobile-type
#9
Alan Hakim, Inge De Wandele, Chris O'Callaghan, Alan Pocinki, Peter Rowe
Chronic fatigue is an important contributor to impaired health-related quality of life in Ehlers-Danlos syndrome. There is overlap in the symptoms and findings of EDS and chronic fatigue syndrome. A proportion of those with CFS likely have EDS that has not been identified. The evaluation of chronic fatigue in EDS needs to include a careful clinical examination and laboratory testing to exclude common causes of fatigue including anemia, hypothyroidisim, and chronic infection, as well as dysfunction of major physiological or organ systems...
February 10, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28186390/pain-management-in-the-ehlers-danlos-syndromes
#10
Pradeep Chopra, Brad Tinkle, Claude Hamonet, Isabelle Brock, Anne Gompel, Antonio Bulbena, Clair Francomano
Chronic pain in the Ehlers-Danlos syndromes (EDS) is common and may be severe. According to one study, nearly 90% of patients report some form of chronic pain. Pain, which is often one of the first symptoms to occur, may be widespread or localized to one region such as an arm or a leg. Studies on treatment modalities are few and insufficient to guide management. The following is a discussion of the evidence regarding the underlying mechanisms of pain in EDS. The causes of pain in this condition are multifactorial and include joint subluxations and dislocations, previous surgery, muscle weakness, proprioceptive disorders, and vertebral instability...
February 10, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28184348/refractory-spontaneous-chronic-subdural-hematoma-a-rare-presentation-of-an-intracranial-arteriovenous-fistula
#11
El Kim
The author has encountered a 67-year-old man with dural arteriovenous fistula (AVF) presenting as a non-traumatic chronic subdural hematoma (CSDH). This previously healthy patient was hospitalized due to progressive headache with subacute onset. He underwent burr-hole surgery twice for evacuating the left CSDH that was thickest at the posterior temporal area. The operative procedure and finding was not extraordinary, but subdural hematoma slowly progressed for days following the revision surgery. After investigation by super-selective external carotid angiography, a dural AVF found near the transverse-sigmoid sinus was diagnosed...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28182123/long-term-safety-and-analgesic-efficacy-of-buprenorphine-buccal-film-in-patients-with-moderate-to-severe-chronic-pain-requiring-around-the-clock-opioids
#12
Martin Hale, Veronica Urdaneta, M Todd Kirby, Qinfang Xiang, Richard Rauck
BACKGROUND: This open-label, single-arm study was conducted to evaluate the long-term safety and efficacy of a novel buprenorphine formulation, buprenorphine buccal film, in the treatment of moderate-to-severe chronic pain requiring around-the-clock opioids. METHODS: The primary purpose of this study was to evaluate the long-term safety and tolerability of buprenorphine buccal film. Five hundred and six patients who completed previous studies with buprenorphine buccal film (n=445; rollover patients) or were recruited de novo for this study (n=61) were enrolled in this study...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28179389/homonymous-hemianopia-in-the-primary-antiphospholipid-syndrome
#13
Derek Kwun-Hong Ho, Rishi Ramessur, Mradul Gupta, John P Mathews
A woman aged 26 years was referred by her GP to the eye casualty department with sudden-onset left homonymous hemianopia and right-sided headache. Full ophthalmic examination was normal with the exception of a left homonymous hemianopia confirmed with automated perimetry. Urgent CT imaging revealed a non-haemorrhagic cerebral infarct in the right parieto-occipital region. Subsequent blood tests confirmed a diagnosis of antiphospholipid syndrome with positivity in IgG anticardiolipin antibody, IgG anti-β2-GP1 antibody and the Lupus anticoagulant screen...
February 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28178090/management-of-a-ventral-cerebrospinal-fluid-leak-with-a-lumbar-transforaminal-epidural-blood-patch-in-a-child-with-persistent-postdural-puncture-headache-a-case-report
#14
Genevieve Dʼsouza, F Glen Seidel, Elliot J Krane
OBJECTIVE: Postdural puncture headache (PDPH) is an uncommon sequel of lumbar puncture in children. When conservative treatment with bed rest, hydration, and caffeine are ineffective, epidural blood patches are recommended and are generally effective. The purpose of this report was to highlight that when lumbar epidural blood patches fail to eliminate PDPH, diagnostic evaluation should be performed and alternative treatment sought. CASE REPORT: An unusual case is described of an 11-year-old boy with PDPH, which was successfully managed with a ventral (anterior) epidural blood patch and epidural saline infusion after headache and other symptoms failed to resolve after conservative treatment and conventionally performed blood patches...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28165827/clinical-characteristics-treatment-and-outcome-of-trochleitis
#15
Elena Jarrín, Ángel García-García, Francisco J Hurtado-Ceña, José M Rodríguez-Sánchez
BACKGROUND AND PURPOSE: To study the clinical characteristics, treatment options, and outcome of patients with trochleitis in our population. METHODS: Retrospective review of 59 patients diagnosed with trochleitis in the Ramon y Cajal Hospital Emergency Service between 2003 and 2010. Demographic data and trochleitis features were described. The relationship between outcome and treatment options was analyzed by SPSS. RESULTS: The estimated prevalence rate of trochleitis in our area was 12 per 100,000...
February 6, 2017: Strabismus
https://www.readbyqxmd.com/read/28163938/evaluating-complications-of-chronic-sinusitis
#16
Phillip Hong, Charles A Pereyra, Uta Guo, Adam Breslin, Laura Melville
Chronic sinusitis is a relatively common diagnosis throughout the US. In patients with an otherwise unremarkable medical history the treatment is typically supportive, requiring only clinical evaluation. We present the case of a 25-year-old male with a history of chronic sinusitis that was brought to our emergency department with new-onset seizure. Three days before he had presented to his usual care facility with two days of headache and fever and was discharged stating headache, subjective fever, and neck stiffness...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28162097/is-age-associated-with-the-severity-of-post-mild-traumatic-brain-injury-symptoms
#17
Tina Hu, Cindy Hunt, Donna Ouchterlony
BACKGROUND: Mild traumatic brain injury (mTBI) is a significant public health concern. Research has shown that mTBI is associated with persistent physical, cognitive, and behavioural symptoms, leading to significant direct and indirect medical costs. Our objective was to determine if age impacts the type and severity of post-mTBI symptoms experienced. METHODS: Retrospective analysis of prospectively collected data at a level 1 tertiary care outpatient head injury clinic...
February 6, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28159879/symptomatic-intracranial-hypertension-during-recovery-from-the-syndrome-of-headache-with-neurologic-deficits-and-cerebrospinal-fluid-lymphocytosis-handl
#18
Eoin Mulroy, Joel Yap, Helen Danesh-Meyer, Neil Anderson
The syndrome of headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HANDL) is rare; it comprises migrainous headaches (generally in headache-naïve people), fluctuating neurological symptoms and cerebrospinal fluid (CSF) lymphocytosis. The syndrome generally runs a benign, self-limiting course over weeks. A small proportion of patients develop intracranial hypertension as a consequence of the illness. Recurrence of headaches or development of visual symptoms following apparent recovery from HANDL should prompt urgent re-evaluation for elevated intracranial pressure...
February 3, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28157058/fibromuscular-dysplasia-results-of-a-multicentre-study-in-flanders
#19
Marie De Groote, Patricia Van der Niepen, Dimitri Hemelsoet, Bert Callewaert, Frank Vermassen, Jean-Marie Billiouw, An De Vriese, Jan Donck, Tine De Backer
BACKGROUND: Fibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory, non-atherosclerotic vascular disease, resulting in focal narrowing of small and medium-sized arteries. Systematic recording of clinical data in central databases as in the US and France provided new insights into FMD. The main objectives of this multicentre study were to explore the epidemiology, pattern of vascular involvement, clinical manifestations, and management of FMD patients in Flanders. PATIENTS AND METHODS: Multicentre, retrospective registry of patients diagnosed with FMD based on medical imaging...
February 3, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28156637/complications-of-intrathecal-pump-therapy-in-malignancy-related-pain
#20
Egidio Del Fabbro
: 102 Background: Intrathecal pumps (ITP) are used to manage severe malignancy related pain by delivering analgesics directly into the cerebrospinal fluid, in theory allowing for a reduced opioid dose and fewer complications. Although there is literature to support efficacy in patients with cancer, including improved survival, this mode of drug delivery also carries a risk of serious complications. Reports of complications in non-malignant pain suggest the risks and mortality related to ITP may be under-appreciated and that injury and liability occur with both ITP placement and ITP maintenance...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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