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https://www.readbyqxmd.com/read/28820363/incidence-of-perioperative-medical-complications-and-mortality-among-elderly-patients-undergoing-surgery-for-spinal-deformity-analysis-of-3519-patients
#1
Amit Jain, Hamid Hassanzadeh, Varun Puvanesarajah, Eric O Klineberg, Daniel M Sciubba, Michael P Kelly, D Kojo Hamilton, Virginie Lafage, Aaron J Buckland, Peter G Passias, Themistocles S Protopsaltis, Renaud Lafage, Justin S Smith, Christopher I Shaffrey, Khaled M Kebaish
OBJECTIVE Using 2 complication-reporting methods, the authors investigated the incidence of major medical complications and mortality in elderly patients after surgery for adult spinal deformity (ASD) during a 2-year follow-up period. METHODS The authors queried a multicenter, prospective, surgeon-maintained database (SMD) to identify patients 65 years or older who underwent surgical correction of ASD from 2008 through 2014 and had a minimum 2 years of follow-up (n = 153). They also queried a Centers for Medicare & Medicaid Services claims database (MCD) for patients 65 years or older who underwent fusion of 8 or more vertebral levels from 2005 through 2012 (n = 3366)...
August 18, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28820309/advanced-cone-beam-ct-venous-angiographic-imaging
#2
Visish M Srinivasan, Gouthami Chintalapani, Edward A M Duckworth, Peter Kan
OBJECTIVE The evaluation of the venous neurovasculature, especially the dural venous sinuses, is most often performed using MR or CT venography. For further assessment, diagnostic cerebral angiography may be performed. Three-dimensional rotational angiography (3D-RA) can be applied to the venous system, producing 3D rotational venography (3D-RV) and cross-sectional reconstructions, which function as an adjunct to traditional 2D digital subtraction angiography. METHODS After querying the database of Baylor St...
August 18, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28820231/interventions-for-treating-persistent-pain-in-survivors-of-torture
#3
REVIEW
Emma Baird, Amanda C de C Williams, Leslie Hearn, Kirstine Amris
BACKGROUND: Persistent (chronic) pain is a frequent complaint in survivors of torture, particularly but not exclusively pain in the musculoskeletal system. Torture survivors may have no access to health care; where they do, they may not be recognised when they present, and the care available often falls short of their needs. There is a tendency in state and non-governmental organisations' services to focus on mental health, with poor understanding of persistent pain, while survivors may have many other legal, welfare, and social problems that take precedence over health care...
August 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28819998/reliability-and-validity-of-the-script-concordance-test-for-postgraduate-students-of-general-practice
#4
Julie Subra, Bruno Chicoulaa, André Stillmunkès, Pierre Mesthé, Stéphane Oustric, Marie-Eve Rougé Bugat
BACKGROUND: The script concordance test (SCT) is a validated method of examining students' clinical reasoning. Medical students' professional skills are assessed during their postgraduate years as they study for a specialist qualification in general practice. However, no specific provision is made for assessing their clinical reasoning during their postgraduate study. OBJECTIVE: The aim was to demonstrate the reliability and validity of the SCT in general practice and to determine if this tool could be used to assess medical students' progress in acquiring clinical reasoning...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/28819817/estimation-of-entrance-surface-air-kerma-due-to-diagnostic-x-ray-examinations-of-adult-patients-in-uttarakhand-india-and-establishment-of-local-diagnostic-reference-levels
#5
Satish C Uniyal, Vineet Chaturvedi, Sunil D Sharma, Shailendra Raghuvanshi
It is well established that diagnostic X-ray practices must be optimised to keep patient radiation dose as low as compatible with providing the diagnostic information required. For effective optimisation of diagnostic exposures, the International Commission on Radiological Protection (ICRP) introduced the concept of diagnostic reference levels (DRLs) in 1996. The present study aimed to carry out an extensive dose survey of diagnostic radiography installations in the Uttarakhand region of India to establish local DRL Values for the different diagnostic practices...
August 17, 2017: Australasian Physical & Engineering Sciences in Medicine
https://www.readbyqxmd.com/read/28819204/prognostic-factors-and-outcomes-of-unplanned-extubation
#6
Chien-Ming Chao, Mei-I Sung, Kuo-Chen Cheng, Chih-Cheng Lai, Khee-Siang Chan, Ai-Chin Cheng, Shu-Chen Hsing, Chin-Ming Chen
This study investigated the prognostic factors and outcomes of unplanned extubation (UE) in patients in a medical center's 6 intensive care units (ICUs) and calculated their mortality risk. We retrospectively reviewed the medical records of all adult patients in Chi Mei Medical Center who underwent UE between 2009 and 2015. During the study period, there were 305 episodes of UE in 295 ICU patients (men: 199 [67.5%]; mean age: 65.7 years; age range: 18-94 years). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 16...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28818315/screening-for-familial-cancer-risk-focus-on-breast-cancer
#7
REVIEW
Christine Rousset-Jablonski, Anne Gompel
A breast or an ovarian cancer occurring at a young age and/or in a family where other cases preexist suggests that those patients should be candidates for screening for mutations. Despite decades of medical research, less than 30% of cases with a suggestive personal and/or family history of hereditary breast cancer have an identified causative gene mutation. The vast majority of these cases are due to a mutation in one of the highly penetrant breast cancer genes (BRCA1, BRCA2, PTEN, TP53, CDH1, and STK11) and various guidelines direct the management of these patients...
August 7, 2017: Maturitas
https://www.readbyqxmd.com/read/28818305/treatment-of-the-ventral-intermediate-nucleus-for-medically-refractory-tremor-a-cost-analysis-of-stereotactic-radiosurgery-versus-deep-brain-stimulation
#8
Shearwood McClelland, Jerry J Jaboin
INTRODUCTION: Medically refractory tremor treatment has evolved over the past half-century from intraoperative thalamotomy to deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus (VIM). Within the past 15years, unilateral radiosurgical VIM thalamotomy has emerged as a comparably efficacious treatment modality. METHODS: An extensive literature search of VIM DBS series was performed; the total cost of VIM DBS was calculated from hospitals geographically representative of the entire United States using current procedural terminology and work relative value unit (RVU) codes...
August 14, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28818223/impact-of-an-inferior-vena-cava-filter-retrieval-algorithm-on-filter-retrieval-rates-in-a-cancer-population
#9
Robert J Litwin, Steven Y Huang, Sharjeel H Sabir, Quoc B Hoang, Kamran Ahrar, Judy Ahrar, Alda L Tam, Armeen Mahvash, Joe E Ensor, Michael Kroll, Sanjay Gupta
OBJECTIVE: Our primary purpose was to assess the impact of an inferior vena cava filter retrieval algorithm in a cancer population. Because cancer patients are at persistently elevated risk for development of venous thromboembolism (VTE), our secondary purpose was to assess the incidence of recurrent VTE in patients who underwent filter retrieval. METHODS: Patients with malignant disease who had retrievable filters placed at a tertiary care cancer hospital from August 2010 to July 2014 were retrospectively studied...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28817940/-confirming-the-utility-of-raisus-antifungal-susceptibility-testing-by-new-software
#10
Tomoko Ono, Hiroyuki Suematsu, Haruki Sawamura, Yuka Yamagishi, Hiroshige Mikamo
Clinical and Laboratory Standards Institute (CLSI) methods for susceptibility tests of yeast are used in Japan. On the other hand, the methods have some disadvantage; 1) reading at 24 and 48 h, 2) using unclear scale, approximately 50% inhibition, to determine MICs, 3) calculating trailing growth and paradoxical effects. These makes it difficult to test the susuceptibility for yeasts. Old software of RAISUS, Ver. 6.0 series, resolved problem 1) and 2) but did not resolve problem 3). Recently, new software of RAISUS, Ver...
August 15, 2017: JARMAM: Journal of the Association for Rapid Method and Automation in Microbiology
https://www.readbyqxmd.com/read/28816837/individualizing-thresholds-of-cerebral-perfusion-pressure-using-estimated-limits-of-autoregulation
#11
Joseph Donnelly, Marek Czosnyka, Hadie Adams, Chiara Robba, Luzius A Steiner, Danilo Cardim, Brenno Cabella, Xiuyun Liu, Ari Ercole, Peter John Hutchinson, David Krishna Menon, Marcel J H Aries, Peter Smielewski
OBJECTIVES: In severe traumatic brain injury, cerebral perfusion pressure management based on cerebrovascular pressure reactivity index has the potential to provide a personalized treatment target to improve patient outcomes. So far, the methods have focused on identifying "one" autoregulation-guided cerebral perfusion pressure target-called "cerebral perfusion pressure optimal". We investigated whether a cerebral perfusion pressure autoregulation range-which uses a continuous estimation of the "lower" and "upper" cerebral perfusion pressure limits of cerebrovascular pressure autoregulation (assessed with pressure reactivity index)-has prognostic value...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28816542/the-fate-of-asymptomatic-severe-carotid-stenosis-in-the-era-of-best-medical-therapy
#12
Rodolfo Pini, Gianluca Faggioli, Andrea Vacirca, Laura Maria Cacioppa, Enrico Gallitto, Mauro Gargiulo, Andrea Stella
BACKGROUND: Medical therapy for asymptomatic carotid artery stenosis (ACAS) may obviate the carotid revascularization, according to recent literature reports, but many studies also considered moderate carotid artery stenosis (50-69% NASCET). This study reviews the most recent series of ACAS focusing on ipsilateral transient ischemic attack (TIA) stroke and annual risk of stroke in patients with ACAS ≥70%, thereby also evaluating the adherence to best medical therapy (BMT). METHODS: A systematic review consisting of all the series of patients with ACAS being treated medically was performed, which was published after 2005...
August 17, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28816346/homocysteine-lowering-interventions-for-preventing-cardiovascular-events
#13
REVIEW
Arturo J Martí-Carvajal, Ivan Solà, Dimitrios Lathyris, Mark Dayer
BACKGROUND: Cardiovascular disease, which includes coronary artery disease, stroke and peripheral vascular disease, is a leading cause of death worldwide. Homocysteine is an amino acid with biological functions in methionine metabolism. A postulated risk factor for cardiovascular disease is an elevated circulating total homocysteine level. The impact of homocysteine-lowering interventions, given to patients in the form of vitamins B6, B9 or B12 supplements, on cardiovascular events has been investigated...
August 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28816338/prediction-of-emergency-department-hospital-admission-based-on-natural-language-processing-and-neural-networks
#14
Xingyu Zhang, Joyce Kim, Rachel E Patzer, Stephen R Pitts, Aaron Patzer, Justin D Schrager
OBJECTIVE: To describe and compare logistic regression and neural network modeling strategies to predict hospital admission or transfer following initial presentation to Emergency Department (ED) triage with and without the addition of natural language processing elements. METHODS: Using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), a cross-sectional probability sample of United States EDs from 2012 and 2013 survey years, we developed several predictive models with the outcome being admission to the hospital or transfer vs...
August 16, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28815835/patient-education-materials-assessment-tool-for-laryngectomy-health-information
#15
Kevin Wong, Amir Gilad, Michael B Cohen, Diana N Kirke, Scharukh M Jalisi
BACKGROUND: The decision to undergo laryngectomy carries medical, social, and emotional consequences. This study evaluates the understandability and actionability of current laryngectomy information. METHODS: Laryngectomy-related educational materials from an online search were evaluated using the validated Patient Education Materials Assessment Tool (PEMAT). Reading difficulty was calculated using the Flesch-Kincaid Level, Flesch Reading Ease, Gunning-Fog Index (GFI), Coleman-Liau Index, Automated Readability Index, and Simple Measure of Gobbledygook (SMOG) score...
August 16, 2017: Head & Neck
https://www.readbyqxmd.com/read/28815611/the-value-of-frontal-sinusotomy-for-chronic-rhinosinusitis-with-nasal-polyps-a-cost-utility-analysis
#16
George A Scangas, Ashton E Lehmann, Aaron K Remenschneider, Brooke M Su, Mark G Shrime, Ralph Metson
OBJECTIVES/HYPOTHESIS: The number of surgical procedures performed for frontal sinusitis and the associated costs have increased dramatically over the past decade. The purpose of this study was to evaluate the cost-effectiveness of endoscopic frontal sinusotomy (EFS) in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). STUDY DESIGN: Cohort-style Markov decision-tree economic model with a 36-year time horizon. METHODS: Matched cohorts of CRSwNP patients who underwent endoscopic sinus surgery (ESS) with (n = 139) and without (n = 49) EFS were compared to each other and to patients (n = 139) from the Medical Expenditures Survey Panel database who underwent medical management for chronic rhinosinusitis...
August 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28815546/clusters-of-week-specific-maternal-gestational-weight-gain-pattern-and-their-association-with-birthweight-an-observational-cohort-study
#17
Huan Liang, Chuanmin Yin, Xinran Dong, Ganesh Acharya, Xiaotian Li
INTRODUCTION: Gestational weight gain (GWG) varies widely among different populations, and an inappropriate GWG is associated with adverse pregnancy outcomes. We aimed to investigate week-specific serial changes in GWG in an urban Chinese population to derive clusters of GWG pattern and explore the impact of GWG patterns on birthweight. MATERIAL AND METHODS: This was an observational cohort study of 6130 women delivered at a university hospital in Shanghai, China...
August 16, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28815515/assessing-communication-skills-in-real-medical-encounters-in-oncology-development-and-validation-of-the-comon-coaching-rating-scales
#18
Marcelo Niglio de Figueiredo, Lorena Krippeit, Johanna Freund, Gabriele Ihorst, Andreas Joos, Juergen Bengel, Alexander Wuensch
One of the challenges in research on teaching physician-patient communication is how to assess communication, necessary for evaluating training, the learning process, and for feedback. Few instruments have been validated for real physician-patient consultations. Real consultations involve unique contexts, different persons, and topics, and are difficult to compare. The aim of this study is to develop and validate a rating scale for assessment of such consultations. For the evaluation study of a communication skills training for physicians in oncology, real consultations were recorded in three assessment points...
August 16, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28815425/methodological-study-of-vancomycin-dosing-in-elderly-patients-using-actual-serum-creatinine-versus-rounded-serum-creatinine
#19
Tramaine Young, Matt Daniel, Stephanie Baumhover, Duke Eidson, Jane Green
PURPOSE: The practice of intentional rounding up of serum creatinine (SCr) in elderly patients with low measured values can lead to an underestimation of creatinine clearance and subsequent inaccurate dosing of medications. Thus, the purpose of this study was to evaluate the accuracy of vancomycin dose calculations for patients aged ≥65 years using an SCr rounded up to 1 mg/dL versus actual SCr. METHODS: This study compared the difference between measured steady-state vancomycin trough concentrations with predicted trough concentrations that have been calculated using rounded SCr and actual SCr...
August 16, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28815008/evaluation-of-medication-adherence-in-chronic-disease-at-a-federally-qualified-health-center
#20
Alvin B Oung, Emily Kosirog, Benjamin Chavez, Jason Brunner, Joseph J Saseen
BACKGROUND: While medication adherence in chronic disease has been evaluated in the general population, limited data are available among Medicaid recipients, especially within federally qualified health centers (FQHCs). This study determined baseline medication adherence for Medicaid recipients receiving care in an FQHC for first-line medications used in hypertension, hyperlipidemia, and diabetes. Secondary outcomes included baseline adherence for individual patient factors. METHODS: Patients from the Salud Family Health Centers, an FQHC with a large percentage of both Spanish-speaking patients and providers, were included in this study...
August 2017: Therapeutic Advances in Chronic Disease
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