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https://www.readbyqxmd.com/read/28333183/machine-learning-algorithms-for-objective-remission-and-clinical-outcomes-with-thiopurines
#1
Akbar K Waljee, Kay Sauder, Anand Patel, Sandeep Segar, Boang Liu, Yiwei Zhang, Ji Zhu, Ryan W Stidham, Ulysses Balis, Peter D R Higgins
Background and Aims: Big data analytics leverage patterns in data to harvest valuable information, but are rarely implemented in clinical care. Optimising thiopurine therapy for inflammatory bowel disease [IBD] has proved difficult. Current methods using 6-thioguanine nucleotide [6-TGN] metabolites have failed in randomized controlled trials [RCTs], and have not been used to predict objective remission [OR]. Our aims were to: 1) develop machine learning algorithms [MLA] using laboratory values and age to identify patients in objective remission on thiopurines; and 2) determine whether achieving algorithm-predicted objective remission resulted in fewer clinical events per year...
March 14, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28332345/high-incidence-of-virulence-factors-among-clinical-enterococcus-faecalis-isolates-in-southwestern-iran
#2
Hamid Heidari, Somayeh Hasanpour, Hadi Sedigh Ebrahim-Saraie, Mohammad Motamedifar
BACKGROUND: Over the past two decades, enterococci have emerged as an important agent responsible for hospital acquired infection. Several virulence factors contribute to the adherence, colonization, evasion of the host immune response, and pathogenicity and severity of the infection. Enterococcus faecalis is the most common and virulent species causing infections in hospitalized patients. The aim of the present study was to examine the prevalence of genes encoding virulence factors and antimicrobial resistance patterns of E...
March 13, 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/28332154/altered-cerebrospinal-fluid-dynamics-in-neurofibromatosis-type-l-severe-arachnoid-thickening-in-patients-with-neurofibromatosis-type-1-may-cause-abnormal-csf-dynamic
#3
Young Sill Kang, Eun-Kyung Park, Yong-Oock Kim, Ju-Seong Kim, Dong-Seok Kim, U W Thomale, Kyu-Won Shim
INTRODUCTION: The object of this study is to understand abnormal dynamic of cerebrospinal fluid (CSF) in patients with neurofibromatosis type 1 (NF1), which may cause temporal lobe herniation and bulging of temporal fossa. METHODS: Four patients, three females and one male, with NF1 were studied retrospectively. They presented with a similar craniofacial deformity, which consisted of pulsatile exophthalmos, an enlarged bony orbit, dysplasia of the sphenoid wing with the presence of a herniation of the temporal lobe into the orbit, and a bulging temporal fossa...
March 22, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28332153/valve-exchange-towards-an-adjustable-differential-pressure-valve-with-gravitational-unit-clinical-outcome-of-a-single-center-study
#4
S Alavi, M Schulz, A Schaumann, K Schwarz, Ulrich W Thomale
OBJECTIVE: Overdrainage in children is a long-term problem for shunted patients which might lead to chronic anatomical changes. In order to prevent these problems, valve exchange is performed on a regular basis in patients without hydrostatic units towards a valve with both an adjustable and a gravitational unit. The clinical outcome of these patients is reported in a retrospective study. METHODS: Between 2009 and 2014, the in-house database was analyzed for patients who received a valve exchange towards an adjustable differential pressure valve with gravitational unit...
March 22, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28331772/an-automated-gravity-driven-csf-drainage-system-decreases-complications-and-lowers-costs
#5
Robert E Lieberson, Jan Eckermann, William Meyer, Tung Trang
BACKGROUND: FlowSafe(TM) (BeckerSmith Medical, Irvine, CA, USA) is a novel, robotic, external lumbar drainage (ELD) system, which was designed to control cerebrospinal fluid (CSF) drainage, reduce complications, and decrease treatment costs. METHODS:  Forty-seven consecutive neurosurgical patients requiring ELD were treated using the FlowSafe system. RESULTS: In 39 of 40 patients with traumatic and surgical dural openings, potential CSF leaks were avoided...
February 3, 2017: Curēus
https://www.readbyqxmd.com/read/28331646/conversion-of-low-flow-priapism-to-high-flow-state-using-t-shunt-with-tunneling
#6
Neil A Mistry, Nicholas N Tadros, Jason C Hedges
Introduction. The three types of priapism are stuttering, arterial (high-flow, nonischemic), and venoocclusive (low-flow, ischemic). These are usually distinct entities and rarely occur in the same patient. T-shunts and other distal shunts are frequently combined with tunneling, but a seldom recognized potential complication is conversion to a high-flow state. Case Presentation. We describe 2 cases of men who presented with low-flow priapism episodes that were treated using T-shunts with tunneling that resulted with both men having recurrent erections shortly after surgery that were found to be consistent with high-flow states...
2017: Case Reports in Urology
https://www.readbyqxmd.com/read/28331438/clinical-images-interventional-management-of-pediatric-rex-shunt-stenosis
#7
Corey Area, David Kirsch, Lena Gowharji
No abstract text is available yet for this article.
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28329461/cardiac-function-after-tetralogy-of-fallot-complete-atrioventricular-canal-repair
#8
Elizabeth H Stephens, Jennifer Tingo, Marc Najjar, Betul Yilmaz, Stéphanie Levasseur, Jeffrey D Dayton, Ralph S Mosca, Paul Chai, Jan M Quaegebeur, Emile A Bacha
BACKGROUND: Repair of complete atrioventricular canal (CAVC) with tetralogy of Fallot (TOF) is a challenging operation increasingly being performed as a complete, primary repair in infancy. Previous studies have focused on perioperative outcomes; however, midterm valve function, ventricular function, and residual obstruction have received little attention. METHODS: We retrospectively reviewed 20 patients who underwent CAVC/TOF repair (January 2005 to December 2014)...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28329375/long-term-outcome-of-patients-with-right-atrial-isomerism-after-common-atrioventricular-valve-plasty%C3%A2
#9
Kenta Imai, Masaya Murata, Yujiro Ide, Mikio Sugano, Hiroki Ito, Kazuyoshi Kanno, Motonori Ishido, Ryohei Fukuba, Kisaburo Sakamoto
OBJECTIVES: To review long-term outcomes of patients with right atrial (RA) isomerism who underwent common atrioventricular valve (CAVV) plasty. METHODS: We retrospectively analysed 59 patients with RA isomerism operated on between January 2004 and April 2016. We divided patients into those with CAVV plasty (CAVV plasty (+), 29 patients) and without CAVV plasty (CAVV plasty (-), 30), and we compared the outcome between the groups. We further divided patients into those with CAVV plasty before bidirectional cavopulmonary shunt (BCPS) operation (group before BCPS, 13 patients) or CAVV plasty with or after BCPS (group with or after BCPS, 16), and we compared the outcome between these groups...
March 13, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329193/a-successful-transdiaphragmatic-shunting-for-a-late-and-recurrent-pericardial-effusion-following-coronary-bypass
#10
Nicolas Themelin, Serge Cappeliez, Jean-Jacques Houben, Badih El Nakadi
Although pericardial effusion (PE) is common after cardiac surgery, late and recurrent cardiac tamponade that occurs more than 5-7 days after coronary artery bypass grafting is an infrequent complication. Moreover, the treatment of PE resistant to medical therapy, percutaneous drainage and pleuro-pericardial window remains a therapeutic challenge. We report the case of a recalcitrant PE with high-daily volume outflow drainage, finally treated with success, with a transdiaphragmatic pleuro-peritoneal shunting by laparoscopic approach...
February 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329191/management-of-ventriculoperitoneal-shunt-infections-in-adults-analysis-of-risk-factors-associated-with-treatment-failure
#11
Iván Pelegrín, Jaime Lora-Tamayo, Joan Gómez-Junyent, Nuria Sabé, Dolors García-Somoza, Andreu Gabarrós, Javier Ariza, Pedro Fernández Viladrich, Carmen Cabellos
Background.: Little is known regarding the optimal treatment of ventriculoperitoneal (VP) shunt infections in adults. Our aim was to assess the efficacy of treatment strategies and to identify factors that predict failure. Methods.: Retrospective, observational study of patients aged ≥12 years with VP shunt infections (1980 -2014). Therapeutic approaches were classified under 4 headings: only antibiotics (OA), one-stage shunt replacement (OSSR), two-stage shunt replacement (TSSR), and shunt removal without replacement (SR)...
March 10, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28329100/long-term-cardiovascular-changes-following-creation-of-arteriovenous-fistula-in-patients-with-end-stage-renal-disease
#12
Yogesh N V Reddy, Masaru Obokata, Patrick G Dean, Vojtech Melenovsky, Karl A Nath, Barry A Borlaug
Aims: Short-term studies have reported left ventricular (LV) dilatation following surgical creation of arteriovenous fistulas (AVF) or arteriovenous grafts (AVGs), but chronic cardiac structural and functional changes have not been examined or related to clinical outcomes following AVF/AVG. We sought to characterize the long-term changes in cardiac structure and function in patients undergoing shunt creation for haemodialysis. Methods and results: A retrospective analysis was performed of patients undergoing echocardiography before and after surgical AVF/AVG creation for the initiation of haemodialysis...
March 6, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329049/surgical-treatment-of-pulmonary-atresia-with-major-aortopulmonary-collateral-arteries-in-83-consecutive-patients%C3%A2
#13
Oleksandr D Babliak, Yaroslav B Mykychak, Oleksandra O Motrechko, Illya M Yemets
OBJECTIVES: This article reports the safety and efficacy of a morphology-based algorithm for the surgical management of pulmonary atresia and ventricular septal defect with major aortopulmonary collateral arteries. METHODS: A total of 83 patients were operated from 2007 to 2014 using 3 surgical approaches: one-stage total repair, one-stage unifocalization with central shunt and delayed total repair and multistage unifocalization with subsequent total repair. Patients were divided into 2 groups depending on the surgical strategy used to choose the surgical approach...
March 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28328860/ventilation-during-cardiopulmonary-bypass-for-prevention-of-respiratory-insufficiency-a-meta-analysis-of-randomized-controlled-trials
#14
Dongmei Chi, Chan Chen, Yu Shi, Wanyu Wang, Ye Ma, Ronghua Zhou, Hai Yu, Bin Liu
BACKGROUND: Cardiopulmonary bypass (CPB) is necessary for most cardiac surgery, which may lead to postoperative lung injury. The objective of this paper is to systematically evaluate whether ventilation during CPB would benefit patients undergoing cardiac surgery. METHODS: We searched randomized controlled trials (RCTs) through PubMed, Embase, and Cochrane Library from inception to October 2016. Eligible studies compared clinical outcomes of ventilation versus nonventilation during CPB in patients undergoing cardiac surgery...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328008/commentary-postural-headache-associated-with-ventriculo-peritoneal-shunt-overdrainage-what-are-our-options
#15
Anthony Alvarado, Jacqueline Boyle, Derek Martinez, Anthony M Avellino, Julian Lin
No abstract text is available yet for this article.
March 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28326451/application-of-endoscopic-third-ventriculostomy-for-treating-hydrocephalus-correlated-chiari-type-i-malformation-in-a-single-chinese-neurosurgery-centre
#16
Yiping Wu, Chuzhong Li, Xuyi Zong, Xinsheng Wang, Songbai Gui, Caiping Gu, Yazhuo Zhang
The correlation between hydrocephalus and Chiari type I malformation (CIM) has been debated since Chiari's first descriptions of CIM but some studies have shown that CIM and hydrocephalus (HCP) could cause symptoms/disease of each other or vice versa. Recent research has found that treatment focused on hydrocephalus with ventricle enlargement also provides alleviation of CIM and even of syringomyelia. However, the lack of consensus among previous studies left unanswered the question of how endoscopic third ventriculostomy (ETV) addresses CIM and why it fails...
March 22, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28325462/management-of-recurrent-subdural-hematomas
#17
REVIEW
Virendra R Desai, Robert A Scranton, Gavin W Britz
Subdural hematomas commonly recur after surgical evacuation, at a rate of 2% to 37%. Risk factors for recurrence can be patient related, radiologic, or surgical. Patient-related risk factors include alcoholism, seizure disorders, coagulopathy, and history of ventriculoperitoneal shunt. Radiologic factors include poor brain reexpansion postoperatively, significant subdural air, greater midline shift, heterogeneous hematomas (layered or multi-loculated), and higher-density hematomas. Surgical factors include lack of or poor postoperative drainage...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28324193/hemodynamic-characterization-of-peripheral-arterio-venous-malformations
#18
Sabrina Frey, A Haine, R Kammer, H von Tengg-Kobligk, D Obrist, I Baumgartner
Peripheral arterio-venous malformations (pAVMs) are congenital vascular anomalies that require treatment, due to their severe clinical consequences. The complexity of lesions often leads to misdiagnosis and ill-planned treatments. To improve disease management, we developed a computational model to quantify the hemodynamic effects of key angioarchitectural features of pAVMs. Hemodynamic results were used to predict the transport of contrast agent (CA), which allowed us to compare our findings to digital subtraction angiography (DSA) recordings of patients...
March 21, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28324187/frontal-burr-hole-approach-for-neuroendoscopic-resection-of-craniopharyngioma-with-the-nico-myriad-device-report-of-two-cases
#19
Reilin J Moore, Andrea Scherer, Daniel H Fulkerson
OBJECTIVE: Craniopharyngiomas are challenging tumors to resect due to their deep location and proximity to vital structures. The perceived benefit of gross total resection may be tempered by the possibility of permanent disability. Minimally invasive techniques may reduce surgical morbidity while still allowing effective resection. The authors describe their initial experience with a neuroendoscopic transcortical, transventricular approach to two craniopharyngiomas. The surgeries were performed through a right frontal burr hole using the NICO Myriad, a side-cutting, aspiration device that fits through the working channel of a standard neuroendoscope...
March 21, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28323231/carotid-endarterectomy-in-the-southern-california-vascular-outcomes-improvement-collaborative
#20
Kaelan Chan, Ahmed Abouzamzam, Karen Woo
OBJECTIVE: The objective of this study is to examine the variation in practice patterns and associated outcomes for carotid endarterectomy (CEA) within the Southern California Vascular Outcomes Improvement Collaborative (So Cal VOICe), a regional quality group of the Vascular Quality Initiative (VQI). METHODS: All cases entered in the CEA registry by the So Cal VOICe were included in the study. RESULTS: From September 2010 through September 2015, 1110 CEA cases were entered by nine centers in the So Cal VOICe...
March 17, 2017: Annals of Vascular Surgery
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