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https://www.readbyqxmd.com/read/28922781/toxicity-of-extended-adjuvant-therapy-with-aromatase-inhibitors-in-early-breast-cancer-a-systematic-review-and-meta-analysis
#1
Hadar Goldvaser, Tristan A Barnes, Boštjan Šeruga, David W Cescon, Alberto Ocaña, Domen Ribnikar, Eitan Amir
Background: A number of randomized controlled trials (RCTs) have reported improvement in breast cancer outcomes from extending treatment with aromatase inhibitors (AIs) beyond the initial five years after diagnosis. However, the toxicity profile of extended AIs is uncertain. Methods: We identified RCTs that compared extended AIs to placebo or no treatment using MEDLINE and a review of abstracts from key conferences between 2013 and 2016. Odds ratios (ORs), 95% confidence intervals (CIs), absolute risks, and the number needed to harm (NNH) were computed for prespecified safety and tolerability outcomes including cardiovascular events, bone fractures, second cancers (excluding new breast cancer), treatment discontinuation for adverse events, and death without recurrence...
January 1, 2018: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28922710/paediatric-mild-head-injury-is-routine-admission-to-a-tertiary-trauma-hospital-necessary
#2
Krishna Tallapragada, Ratna Soundarya Peddada, Mark Dexter
BACKGROUND: Previous studies have shown that children with isolated linear skull fractures have excellent clinical outcomes and low risk of surgery. We wish to identify other injury patterns within the spectrum of paediatric mild head injury, which need only conservative management. Children with low risk of evolving neurosurgical lesions could be safely managed in primary hospitals. METHODS: We retrospectively analysed all children with mild head injury (i.e. admission Glasgow coma score 13-15) and skull fracture or haematoma on a head computed tomography scan admitted to Westmead Children's Hospital, Sydney over the years 2009-2014...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28922451/low-medical-morbidity-and-mortality-after-acute-courses-of-electroconvulsive-therapy-in-a-population-based-sample
#3
D M Blumberger, D P Seitz, N Herrmann, J G Kirkham, R Ng, C Reimer, P Kurdyak, A Gruneir, M J Rapoport, Z J Daskalakis, B H Mulsant, S N Vigod
BACKGROUND: To determine event rates for specific medical events and mortality among individuals receiving electroconvulsive therapy (ECT). METHOD: Population-based cohort study using health administrative data of acute ECT treatments delivered in Ontario, Canada, from 2003 to 2011. We measured the following medical event rates, per 10 000 ECT treatments, up to 7 and 30 days post-treatment: stroke, seizure, acute myocardial infarction, arrhythmia, pneumonia, pulmonary embolus, deep vein thrombosis, gastrointestinal bleeding, falls, hip fracture, and mortality...
September 18, 2017: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/28922277/percutaneous-posterior-trans-articular-atlantoaxial-fixation-for-the-treatment-of-odontoid-fractures-in-the-elderly-a-prospective-study
#4
Mohamed Alhashash, Mootaz Shousha, Hany Gendy, Ahmed Samir Barakat, Heinrich Boehm
STUDY DESIGN: A prospective study of 20 multimorbid patients older than 65 years undergoing minimally invasive surgical treatment for odontoid fracture. OBJECTIVES: To analyze the results of percutaneous transarticular atlantoaxial screw fixation as a new minimally invasive treatment modality in this high risk group of patients. SUMMARY OF BACKGROUND DATA: Odontoid fractures are a common injury pattern in the elderly. These fractures typically present significant challenges as geriatric patients often have multiple comorbidities that may adversely affect fracture management...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28922275/indications-for-ct-angiography-of-the-vertebral-arteries-after-trauma
#5
Joseph P Drain, Douglas S Weinberg, James S Ramey, Timothy A Moore, Heather A Vallier
STUDY DESIGN: Retrospective. OBJECTIVE: The purpose of this project is to identify factors that predict vertebral artery injury (VAI) in an effort to assess risks and benefits of computed tomography angiography (CT-A) of the neck in the trauma setting. We seek to develop guidelines for practitioners to stratify patients at medium/high risk of VAI from those who are at low risk. SUMMARY OF BACKGROUND DATA: VAI and blunt carotid injury (BCI) together comprise blunt cerebrovascular injury (BCVI)...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28921820/systematic-review-and-network-meta-analysis-on-the-relative-efficacy-of-osteoporotic-medications-men-with-prostate-cancer-on-continuous-androgen-deprivation-therapy%C3%A2-to-reduce-risk-of-fragility-fractures
#6
REVIEW
Yeesha Poon, Petros Pechlivanoglou, Shabbir M H Alibhai, David Naimark, Jeffrey S Hoch, Emmanuel Papadimitropoulos, Mary-Ellen Hogan, Murray Krahn
BACKGROUND: Androgen deprivation therapy (ADT) is an effective treatment for men with advanced prostate cancer, but loss of bone mineral density (BMD) is a major risk factor for fractures. This analysis evaluated the relative effectiveness of osteoporosis treatments using BMD as a surrogate endpoint for fragility fractures in men on continuous ADT. METHOD: We included randomized controlled trials studying bisphosphonates, denosumab, toremifene, and raloxifene in patients with non-metastatic prostate cancer on ADT for review...
September 18, 2017: BJU International
https://www.readbyqxmd.com/read/28921041/stabilization-of-scaphoid-type-b2-fractures-with-one-or-two-headless-compression-screws
#7
S Quadlbauer, T Beer, Ch Pezzei, J Jurkowitsch, A Tichy, T Hausner, M Leixnering
INTRODUCTION: Fractures of the scaphoid account for the most commonly injured carpal bone. Minimally displaced fractures of the waist will heal in 85-90% when using a below elbow cast. However, fractures with displacement have a higher risk for nonunion. Therefore, open reduction and fixation with headless compression screws (HCS) have become the preferred method of treatment. The aim of this study was to compare the radiological and clinical outcome of unstable scaphoid B2 type fractures, stabilized using one or two headless compression screws...
September 18, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28921003/mortality-and-cardiorespiratory-complications-in-trochanteric-femoral-fractures-a-ten-year-retrospective-analysis
#8
Juliane Carow, John Bennet Carow, Mark Coburn, Bong-Sung Kim, Benjamin Bücking, Christopher Bliemel, Leo Cornelius Bollheimer, Cornelius Johannes Werner, Jan Philipp Bach, Matthias Knobe
PURPOSE: Despite intense research and innovations in peri-operative management, a high mortality rate and frequent systemic complications in trochanteric femoral fractures persist. The aim of the present study was to identify predictive factors for mortality and cardio-respiratory complications after different treatment methods in a ten year period at a level I trauma centre. METHODS: Retrospectively, all patients above 60 years of age with trochanteric femoral fracture between January 2000 and May 2011 were analyzed at a level I trauma centre...
September 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28920780/use-of-composite-materials-as-a-component-of-tusk-fracture-management-in-an-asian-elephant-elephas-maximus-and-an-african-elephant-loxodonta-africana
#9
Richard R Sim, Elizabeth Stringer, Dennis Donovan, Rachael Chappell, Pat Flora, Jon Hall, Selvum Pillay, Benjamin G Willis, Stephanie McCain
Tusk fractures in Asian (Elephas maximus) and African elephants (Loxodonta africana) can result in damage to the distal end or to longitudinal cracks, potentially progressing to pulpitis. With pulp exposure, endodontic therapy is the treatment of choice, but conservative therapy has sufficed for some elephants. This manuscript describes the use of composite materials as a component of tusk fracture management. A 7-yr-old male Asian elephant fractured the distal end of both tusks with pulp exposure in one. Capping of each tusk with a Kevlar/fiberglass composite prevented further damage, and a modification allowed care of the exposed pulp tissue...
September 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28919186/non-surgical-treatment-of-delayed-onset-brachial-plexopathy-due-to-hypertrophic-clavicular-callus-a-case-report
#10
REVIEW
Benjamin M Carpenter, David R Pettersson, Adam J Mirarchi, Drew Groshong, Hans L Carlson
Clavicular fractures are common injuries which are traditionally managed non-surgically without clinically significant sequelae. However, they may develop hypertrophic callus formation that compresses the brachial plexus. These cases may present months to years after initial injury with varying degrees of pain, paresthesia and weakness on the affected side, and are usually treated by surgical resection of the hypertrophic callus. We present a case of brachial plexopathy due to hypertrophic clavicular callus causing weakness and paresthesia...
September 12, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28918661/comparable-postoperative-pain-levels-using-2-different-nerve-blocks-in-the-operative-treatment-of-displaced-intra-articular-calcaneal-fractures
#11
Siem A Dingemans, Kristian J de Ruiter, Merel F N Birnie, J Carel Goslings, Gan van Samkar, Tim Schepers
BACKGROUND: The aim of this study was to compare the postoperative pain levels in patients undergoing osteosynthesis of the calcaneus with either a popliteal nerve block or an ankle block. METHODS: A retrospective analysis of all consecutive patients undergoing operative fixation of a calcaneal fracture via a sinus tarsi approach between August 2012 and April 2017 in a single foot/ankle specialized center was performed. Single-shot popliteal blocks were placed using ultrasound guidance by an anesthesiologist while ankle blocks were placed by a foot/ankle specialized surgeon...
September 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28917548/volar-capsular-release-after-distal-radius%C3%A2-fractures
#12
Robin N Kamal, David S Ruch
PURPOSE: Loss of full wrist range of motion is common after treatment of distal radius fractures. Loss of wrist extension limiting functional activities, although uncommon, can occur after volar plating of distal radius fractures. Unlike other joints in which capsular release is a common form of treatment for stiffness, this has been approached with caution in the wrist owing to concerns for carpal instability. We tested the null hypothesis that hardware removal and open volar capsular release would not lead to improved upper extremity-specific patient-reported outcome (Disabilities of the Arm, Shoulder, and Hand [DASH] questionnaire)...
September 14, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28917544/effects-on-the-incidence-of-cardiovascular-events-of-the-addition-of-pioglitazone-versus-sulfonylureas-in-patients-with-type-2-diabetes-inadequately-controlled-with-metformin-tosca-it-a-randomised-multicentre-trial
#13
Olga Vaccaro, Maria Masulli, Antonio Nicolucci, Enzo Bonora, Stefano Del Prato, Aldo P Maggioni, Angela A Rivellese, Sebastiano Squatrito, Carlo B Giorda, Giorgio Sesti, Paolo Mocarelli, Giuseppe Lucisano, Michele Sacco, Stefano Signorini, Fabrizio Cappellini, Gabriele Perriello, Anna Carla Babini, Annunziata Lapolla, Giovanna Gregori, Carla Giordano, Laura Corsi, Raffaella Buzzetti, Gennaro Clemente, Graziano Di Cianni, Rossella Iannarelli, Renzo Cordera, Olga La Macchia, Chiara Zamboni, Cristiana Scaranna, Massimo Boemi, Ciro Iovine, Davide Lauro, Sergio Leotta, Elisabetta Dall'Aglio, Emanuela Cannarsa, Laura Tonutti, Giuseppe Pugliese, Antonio C Bossi, Roberto Anichini, Francesco Dotta, Antonino Di Benedetto, Giuseppe Citro, Daniela Antenucci, Lucia Ricci, Francesco Giorgino, Costanza Santini, Agostino Gnasso, Salvatore De Cosmo, Donatella Zavaroni, Monica Vedovato, Agostino Consoli, Maria Calabrese, Paolo di Bartolo, Paolo Fornengo, Gabriele Riccardi
BACKGROUND: The best treatment option for patients with type 2 diabetes in whom treatment with metformin alone fails to achieve adequate glycaemic control is debated. We aimed to compare the long-term effects of pioglitazone versus sulfonylureas, given in addition to metformin, on cardiovascular events in patients with type 2 diabetes. METHODS: TOSCA.IT was a multicentre, randomised, pragmatic clinical trial, in which patients aged 50-75 years with type 2 diabetes inadequately controlled with metformin monotherapy (2-3 g per day) were recruited from 57 diabetes clinics in Italy...
September 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28917388/improvised-hand-injury-treatment-using-traditional-veterinary-medicine-in-ethiopia
#14
Raf Aerts, Eva J J November, Maissa Rayyan
In remote wilderness environments, local people with traditional knowledge of medicinal plants are potentially important first-line health care providers. We present a case of a 31-year-old man who fell off a horse while trekking through a remote mountain landscape in Ethiopia and sustained blunt force trauma to the hand. A local mountain hut keeper examined the patient's hand and used heated leaves of the succulent plant Kalanchoe petitiana to treat a suspected metacarpal fracture. As first responder in a low-resource setting, the hut keeper relied on his traditional knowledge of ethnoveterinary medicine to improvise a treatment for a human injury in a remote mountain environment...
September 13, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28916557/study-of-fall-risk-increasing-drugs-in-elderly-patients-before-and-after-a-bone-fracture
#15
Mónica Beunza-Sola, Ángel M Hidalgo-Ovejero, Jon Martí-Ayerdi, José Germán Sánchez-Hernández, Miguel Menéndez-García, Serafín García-Mata
BACKGROUND: Accidental falls have a significant economic and human impact. The use of certain drugs is one of the modifiable risk factors associated with these events. OBJECTIVE: The aim of this study was to determine the prevalence of use and to explore changes in treatment with fall-related drugs in patients over 65 years of age admitted as a result of a fall-related fracture. METHODS: Observational and prospective study performed in a tertiary level hospital...
September 15, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28916133/a-modified-deltoid-splitting-approach-with-axillary-nerve-bundle-mobilization-for-proximal-humeral-fracture-fixation
#16
Young Ho Shin, Young Ho Lee, Ho Sung Choi, Min Bom Kim, Sung Hee Pyo, Goo Hyun Baek
INTRODUCTION: The deltopectoral and the deltoid splitting approach are commonly used for the treatment of proximal humeral fractures. While the deltopectoral approach requires massive soft tissue devascularization, the deltoid splitting approach needs an additional skipped incision to avoid axillary nerve injury. The purpose of this study was to describe a modified anterolateral deltoid splitting approach with axillary nerve bundle mobilization in the treatment of proximal humeral fractures and to assess its radiologic and clinical outcomes...
September 8, 2017: Injury
https://www.readbyqxmd.com/read/28915647/necroptosis-as-a-potential-therapeutic-target-in-multiple-organ-dysfunction-syndrome
#17
Yao-Li Cui, Li-Hua Qiu, Shi-Yong Zhou, Lan-Fang Li, Zheng-Zi Qian, Xian-Ming Liu, Hui-Lai Zhang, Xiu-Bao Ren, Yong-Qiang Wang
PURPOSE: To investigate how necroptosisis, i.e. programmed necrosis, is involved in MODS, and to examine whether Nec-1, a specific necroptosis inhibitor, ameliorates multiorgan injury in MODS. EXPERIMENTAL DESIGN: A model of MODS was established in six-week old SD rats using fracture trauma followed by hemorrhage. Control animals received sham surgery. Cell death form and necrosome formation were measured by fluorescence-activated cell sorting and western blotting...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28915457/tracking-oil-and-gas-wastewater-derived-organic-matter-in-a-hybrid-biofilter-membrane-treatment-system-a-multi-analytical-approach
#18
Stephanie M Riley, Danika C Ahoor, Julia Regnery, Tzahi Y Cath
Dissolved organic matter (DOM) present in oil and gas (O&G) produced water and fracturing flowback was characterized and quantified by multiple analytical techniques throughout a hybrid biological-physical treatment process. Quantitative and qualitative analysis of DOM by liquid chromatography - organic carbon detection (LC-OCD), liquid chromatography-high-resolution mass spectrometry (LC-HRMS), gas chromatography-mass spectrometry (GC-MS), and 3D fluorescence spectroscopy, demonstrated increasing removal of all groups of DOM throughout the treatment train, with most removal occurring during biological pretreatment and some subsequent removal achieved during membrane treatment...
September 12, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28915360/risk-factors-for-reoperation-and-performance-based-outcomes-after-operative-fixation-of-foot-fractures-in-the-professional-athlete-a-cross-sport-analysis
#19
Sameer Singh, Kevin Larkin, Anish Kadakia, Wellington Hsu
BACKGROUND: Professional athletes are predisposed to fractures of the foot due to large stresses placed on the lower extremity. These players are concerned with efficiently returning to play at a high level. Return-to-play rates after operative treatment have been previously reported, yet performance outcomes after such treatment are generally unknown in this population. HYPOTHESIS: Overall, professional athletes sustaining a foot fracture would return to play at high rates with little impact on post-operative performance or league participation...
September 1, 2017: Sports Health
https://www.readbyqxmd.com/read/28914349/reverse-total-shoulder-arthroplasty-for-type-i-fracture-sequelae-after-internal-fixation-of-proximal-humerus-fractures
#20
Benedikt Schliemann, Christina Theisen, Clemens Kösters, Michael J Raschke, Andre Weimann
INTRODUCTION: Complications after internal fixation of proximal humerus fracture are common and may require surgical revision. Reverse total shoulder arthroplasty (RTSA) is frequently performed in such cases. The aim of the present study was to evaluate the functional results and complications after RTSA for the treatment of type I fracture sequelae after internal fixation of proximal humerus fractures. MATERIALS AND METHODS: 26 patients (18 female, 8 male) underwent surgical revision of type I fracture sequelae of the proximal humerus after locking plate (n = 22) or intramedullary nail (n = 4) fixation...
September 15, 2017: Archives of Orthopaedic and Trauma Surgery
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