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https://www.readbyqxmd.com/read/28655201/unplanned-reoperation-after-craniotomy-for-tumor-a-national-surgical-quality-improvement-program-analysis
#1
Hormuzdiyar H Dasenbrock, Sandra C Yan, Vamsi Chavakula, William B Gormley, Timothy R Smith, Elizabeth B Claus, Ian F Dunn
BACKGROUND: Reoperation has been increasingly utilized as a metric evaluating quality of care. OBJECTIVE: To evaluate the rate of, reasons for, and predictors of unplanned reoperation after craniotomy for tumor in a nationally accrued population. METHODS: Patients who underwent cranial tumor resection were extracted from the prospective National Surgical Quality Improvement Program registry (2012-2014). Multivariate logistic regression examined predictors of unplanned cranial reoperation...
June 26, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28655143/air-pollution-and-cardiometabolic-disease-an-update-and-call-for-clinical-trials
#2
Robert D Brook, David E Newby, Sanjay Rajagopalan
Fine particulate matter <2.5 µm (PM2.5) air pollution is a leading cause of global morbidity and mortality. The largest portion of deaths is now known to be due to cardiovascular disorders. Several air pollutants can trigger acute events (e.g., myocardial infarctions, strokes, heart failure). However, mounting evidence additionally supports that longer-term exposures pose a greater magnified risk to cardiovascular health. One explanation may be that PM2.5 has proven capable of promoting the development of chronic cardiometabolic conditions including atherosclerosis, hypertension, and diabetes mellitus...
June 24, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28652467/systolic-blood-pressure-and-biochemical-assessment-of-adherence-a-cross-sectional-analysis-in-the-emergency-department
#3
Candace D McNaughton, Nancy J Brown, Russell L Rothman, Dandan Liu, Edmond K Kabagambe, Phillip D Levy, Wesley H Self, Alan B Storrow, Sean P Collins, Christianne L Roumie
Elevated blood pressure (BP) is common in the emergency department (ED), but the relationship between antihypertensive medication adherence and BP in the ED is unclear. This cross-sectional study tested the hypothesis that higher antihypertensive adherence is associated with lower systolic BP (SBP) in the ED among adults with hypertension who sought ED care at an academic hospital from July 2012 to April 2013. Biochemical assessment of antihypertensive adherence was performed using a mass spectrometry blood assay, and the primary outcome was average ED SBP...
June 26, 2017: Hypertension
https://www.readbyqxmd.com/read/28649065/poor-adherence-with-ace-inhibitors-is-a-risk-factor-of-cva-with-oral-hypoglycemic-agents-in-diabetic-patients
#4
Muhammad Tariq Aftab, Hasnain Abbas Dharamshi, Ahmed Faraz, Saba Shakeel, Osama Shakeel
Poor adherence with medicine declines the clinical outcome of pharmacotherapy. It may carry serious sequelae especially in case of antihypertensive drugs like cerebrovascular accident (CVA). This study has been planned to find the association of poor adherence with anti-hypertensive with CVA in diabetic and non- diabetic patients. One hundred CVA patients who were admitted through Emergency in Abbasi Shaheed hospital, a tertiary care hospital in Karachi, were recruited from Jun 2013 till Dec 2013. The criteria of inclusion was, diagnosed case of CVA, with primary hypertension, availability of patient's therapeutic record, consent of the patient or legal successor/heir...
March 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28648651/the-impact-of-functional-status-on-the-outcomes-of-endovascular-lower-extremity-revascularization-for-critical-limb-ischemia-in-the-elderly
#5
Isidore Dinga Madou, Martin D Slade, Kristine C Orion, Timur Sarac, Cassius Iyad Ochoa Chaar
INTRODUCTION: Functional status is an important predictor of outcomes after infrainguinal bypass surgery. There is little data on the effect of functional status on the outcomes of endovascular LE interventions, especially in the elderly frail population. METHODS: This is a retrospective analysis of the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) files for the years 2011-2013 to assess the impact of functional status on outcome after endovascular intervention for critical limb ischemia...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28648615/structural-biology-and-the-design-of-new-therapeutics-from-hiv-and-cancer-to-mycobacterial-infections
#6
REVIEW
Sherine E Thomas, Vitor Mendes, So Yeon Kim, Sony Malhotra, Bernardo Ochoa-Montaño, Michal Blaszczyk, Tom L Blundell
Interest in applications of protein crystallography to medicine was evident as the first high-resolution structures emerged in the 50s and 60s. In Cambridge Max Perutz and John Kendrew sought to understand mutations in sickle cell and other genetic diseases related to haemoglobin, while in Oxford the group of Dorothy Hodgkin became interested in long-lasting zinc-insulin crystals for treatment of diabetes and later considered insulin redesign as synthetic insulins became possible. The use of protein crystallography in structure-guided drug discovery emerged as enzyme structures allowed the identification of potential inhibitor-binding sites and optimisation of interactions of hits using the structure of the target protein...
June 22, 2017: Journal of Molecular Biology
https://www.readbyqxmd.com/read/28647656/delayed-retroclival-and-cervical-spinal-subdural-hematoma-complicated-by-pre-existing-chiari-malformation-in-an-adult-trauma-patient
#7
Ha Nguyen, Hoon Choi, Shekar Kurpad, Hesham Soliman
INTRODUCTION: Traumatic spinal subdural hematoma involving the retroclival region and upper cervical spine is a rare pathology. To our knowledge, there have only been two prior cases in an adult trauma patient. We describe a patient with pre-existing Chiari 1 malformation, who recently sustained a unilateral Type 1 OCF (occipital condyle fracture) with associated disruption of the tectorial membrane and transverse ligament, that returned with a retroclival subdural hematoma extending down to C7, causing spinal cord compression and symptomatic obstructive hydrocephalus...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28646567/severe-menses-associated-hypertension-successfully-treated-with-gonadotropin-releasing-hormone-agonist
#8
Luke J Laffin, Munnam S Jafar, George L Bakris
A case of a 32-year-old nulliparous white woman referred for a 5-year history of severe hypertension, hypokalemia, and resultant systolic dysfunction is presented. She additionally had a left ventricular ejection fraction of 30% including left ventricular dilation and normal left ventricular mass index, as measured by cardiac magnetic resonance imaging when she initially presented to us. Her history revealed that her severe hypertension episodes were monthly and would occur around the catamenial (menses-associated) time...
June 23, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28643721/surgical-treatment-of-metarhizium-anisopliae-sclerokeratitis-and-endophthalmitis
#9
Dan Derhy, Arnaud Sauer, Marcela Sabou, Jonathan Letsch, Ermanno Candolfi, Valérie Letscher-Bru, Tristan Bourcier
A 55-year-old nurse was referred with a 5-month history of right eye corneal abscess. The initial injury occurred when doing lawn work. The infection worsened despite multiple antibiotic, antiviral, and steroid treatments. Visual acuity was limited to hand motion. On examination, there was keratitis, ocular hypertension, and a secondary cataract. Corneal scrapings grew a filamentous fungus, identified as Metarhizium anisopliae (MA). Despite intensive antifungal treatment with topical, intravitreous, and systemic voriconazole, purulent corneal melting and scleritis with endophthalmitis rapidly appeared...
June 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28642988/development-of-pulmonary-hypertension-during-treatment-with-diazoxide-a-case-series-and-literature-review
#10
Matthew R Timlin, Alexander B Black, Heather M Delaney, Renée I Matos, Candace S Percival
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy. The mainstay of medical management for CHI is diazoxide. Diazoxide inhibits insulin release from the pancreas, but also causes smooth muscle relaxation and fluid retention so it is typically given with chlorothiazide. In July 2015, the FDA issued a drug safety communication warning that pulmonary hypertension (PH) had been reported in 11 infants being treated with diazoxide and that the PH resolved with withdrawal of diazoxide...
June 22, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28642328/leukocyte-diversity-in-resolving-and-nonresolving-mechanisms-of-cardiac-remodeling
#11
REVIEW
Bochra Tourki, Ganesh Halade
In response to myocardial infarction (MI), time-dependent leukocyte infiltration is critical to program the acute inflammatory response. Post-MI leukocyte density, residence time in the infarcted area, and exit from the infarcted injury predict resolving or nonresolving inflammation. Overactive or unresolved inflammation is the primary determinant in heart failure pathology post-MI. Here, our review describes supporting evidence that the acute inflammatory response also guides the generation of healing and regenerative mediators after cardiac damage...
June 22, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28642065/severe-and-resistant-hypertension-in-an-older-woman-with-claudication
#12
Puneet Gupta, Robert Hagberg, Electra Kaloudis, Anika Lucas, Parth Shah, William B White
Coarctation of the aorta is an uncommon cause of treatment-resistant hypertension in adults. It is typically detected and treated in infancy or childhood with surgical or endovascular procedures. Most cases of recurrence of coarctation after repair occur in childhood or early adulthood; recurrence in older persons (>70 years) has rarely been reported. A 73-year-old woman was referred to us for the management of treatment-resistant hypertension accompanied by symptoms of claudication and headaches, which had resulted in multiple emergency room visits...
June 1, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28641752/congenital-diaphragmatic-hernia-associated-pulmonary-hypertension
#13
Matthew T Harting
Congenital diaphragmatic hernia (CDH) is a complex entity wherein a diaphragmatic defect allows intrathoracic herniation of intra-abdominal contents and both pulmonary parenchymal and vascular development are stifled. Pulmonary pathology and pathophysiology, including pulmonary hypoplasia and pulmonary hypertension, are hallmarks of CDH and are associated with disease severity. Pulmonary hypertension (PH) is sustained, supranormal pulmonary arterial pressure, and among patients with CDH (CDH-PH), is driven by hypoplastic pulmonary vasculature, including alterations at the molecular, cellular, and tissue levels, along with pathophysiologic pulmonary vasoreactivity...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28638577/a-rare-case-of-apical-hypertrophic-cardiomyopathy-ahcm
#14
Seyed Abbas Mirabbasi, Koroush Khalighi, Suresh Mukkamala, Archana Kodali
Apical hypertrophic cardiomyopathy is a rare form of hypertrophic cardiomyopathy that involves thickening of the distal portion of the left ventricular wall. Most commonly seen in the Japan, with a prevalence rate of about 15% of all HCM patient, its incidence in the USA is approximately 3% of HCM cases. We report a case of a 46-year-old woman with history of hypertension who presented to emergency department with worsening dyspnea and orthopnea with features of left ventricular hypertrophy (LVH) and diffuse large T-wave inversions in the lateral leads on a 12-lead ECG...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28637781/detecting-optic-nerve-head-swelling-on-ultrasound-and-optical-coherence-tomography-in-children-and-young-people-an-observational-study
#15
Annegret Hella Dahlmann-Noor, Gillian W Adams, Moritz Claudius Daniel, Alison Davis, Joanne Hancox, Melanie Hingorani, Patricia Ibanez, Becky McPhee, Himanshu Patel, Marie Restori, Clare Roberts, Maria Theodorou, James Acheson
BACKGROUND: Following high-profile cases, referrals for evaluation of 'suspicious optic discs' to eye clinics in the UK have sharply increased, asking ophthalmologists to reliably distinguish between true and pseudopapilloedema. Optic nerve sheath dilatation (ONSD) on ocular ultrasound (US) is considered a reliable sign of true papilloedema, but this test is not widely available. Recently, anterior bowing of Bruch's membrane (BM) and increased retinal nerve fibre layer thickness on optical coherence tomography (OCT) have emerged as indicators of intracranial hypertension, and OCT is widely available...
June 21, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28637455/mental-disorders-and-the-use-of-primary-health-care-services-among-homeless-shelter-users-in-the-helsinki-metropolitan-area-finland
#16
Agnes Stenius-Ayoade, Peija Haaramo, Elisabet Erkkilä, Niko Marola, Kirsi Nousiainen, Kristian Wahlbeck, Johan G Eriksson
BACKGROUND: Homelessness is associated with increased morbidity, mortality and health care use. The aim of this study was to examine the role of mental disorders in relation to the use of 1) daytime primary health care services and 2) after hours primary health care emergency room (PHER) services among homeless shelter users in the Helsinki Metropolitan Area, Finland. METHODS: The study cohort consists of all 158 homeless persons using the four shelters operating in the study area during two selected nights...
June 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28632767/how-is-indonesia-coping-with-its-epidemic-of-chronic-noncommunicable-diseases-a-systematic-review-with-meta-analysis
#17
Julia Schröders, Stig Wall, Mohammad Hakimi, Fatwa Sari Tetra Dewi, Lars Weinehall, Mark Nichter, Maria Nilsson, Hari Kusnanto, Ekowati Rahajeng, Nawi Ng
BACKGROUND: Chronic noncommunicable diseases (NCDs) have emerged as a huge global health problem in low- and middle-income countries. The magnitude of the rise of NCDs is particularly visible in Southeast Asia where limited resources have been used to address this rising epidemic, as in the case of Indonesia. Robust evidence to measure growing NCD-related burdens at national and local levels and to aid national discussion on social determinants of health and intra-country inequalities is needed...
2017: PloS One
https://www.readbyqxmd.com/read/28632299/simningsorsakat-lung%C3%A3-dem-vid-svenska-f%C3%A3-rh%C3%A3-llanden-otillr%C3%A3-ckligt-studerat-erfarenheter-fr%C3%A3-n-vansbrosimningen-2016
#18
Annika Braman Eriksson, Martin Annsberg, Maria Hårdstedt
Swimming-induced pulmonary edema (SIPE) has been described in sports and military medicine during strenuous swimming in open water. Symptoms include dyspnea, cough, frothy mucus and hemoptysis. Hypertension, a tight wetsuit, overhydration and previous episodes of SIPE are suggested risk factors. Immediate interruption of swimming prevents more serious symptoms. In the open water race at Vansbro 2016, 69 swimmers (of 13,878 in total) were treated for symptoms suspected for SIPE. Continuous positive airway pressure (CPAP) was successfully used to treat suspected SIPE in 46 patients in the on-site emergency care center...
June 20, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28631455/the-prognostic-importance-of-chronic-end-stage-diseases-in-geriatric-patients-admitted-to-163-italian-icus
#19
Daniele Poole, Stefano Finazzi, Giovanni Nattino, Danilo Radrizzani, Giuseppe Gristina, Paolo Malacarne, Sergio Livigni, Guido Bertolini
BACKGROUND: The number of elderly patients undergoing major surgical interventions and then needing admission to intensive care unit (ICU) grows steadily. We investigated this issue in a cohort of 232,278 patients admitted in 5 years (2011-2015) to 163 Italian general ICUs. METHODS: Surgical patients older than 75 registered in the GiViTI MargheritaPROSAFE project were analysed. The impact on hospital mortality of important chronic conditions (severe COPD, NYHA class IV, dementia, end-stage renal disease, cirrhosis with portal hypertension) was investigated with two prognostic models developed yearly on patients staying in the ICU less or more than 24 hours...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28630565/efficacy-of-various-scoring-systems-for-predicting-the-28-day-survival-rate-among-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-requiring-emergency-intensive-care
#20
Zhihong Feng, Tao Wang, Ping Liu, Sipeng Chen, Han Xiao, Ning Xia, Zhiming Luo, Bing Wei, Xiuhong Nie
We aimed to investigate the efficacy of four severity-of-disease scoring systems in predicting the 28-day survival rate among patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) requiring emergency care. Clinical data of patients with AECOPD who required emergency care were recorded over 2 years. APACHE II, SAPS II, SOFA, and MEDS scores were calculated from severity-of-disease indicators recorded at admission and compared between patients who died within 28 days of admission (death group; 46 patients) and those who did not (survival group; 336 patients)...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
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