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Diagnosis and procedures

M Aurich, D Albrecht, P Angele, C Becher, S Fickert, J Fritz, P E Müller, P Niemeyer, M Pietschmann, G Spahn, M Walther
Background: Osteochondral lesions (OCL) of the ankle are a common cause of ankle pain. Although the precise pathophysiology has not been fully elucidated, it can be assumed that a variety of factors are responsible, mainly including traumatic events such as ankle sprains. Advances in arthroscopy and imaging techniques, in particular magnetic resonance imaging (MRI), have improved the possibilities for the diagnosis of OCLs of the ankle. Moreover, these technologies aim at developing new classification systems and modern treatment strategies...
October 21, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Přemysl Frič, Jan Škrha, Aleksi Šedo, Tomaš Zima, Petr Bušek, Klára Kmochová, Martin Laclav, Bohuš Bunganič, Svatopluk Solař, Petr Hrabal, František Bělina, Pavel Záruba, Pavel Škrha, Miroslav Zavoral
High-resolution imaging methods (HRIMs) and biomarkers present the second step of pancreatic cancer (PC) diagnostics in at-risk individuals. These include patients with positive risk factors, early symptoms, nonresponders to the initial antidiabetic therapy, patients older than 50 years of age with new-onset unstable diabetes requiring insulin as well as patients with long-term insulin-non-dependent diabetes and recent (up to 6 months) failure of antidiabetic therapy. The procedures should be started without delay and the co-operation between the primary and tertiary medical centers is highly desirable...
December 2016: European Journal of Gastroenterology & Hepatology
Ana Karen Medina Lira, Argenis Jose Mayorga Soto, Pamela Frigerio
BACKGROUND: Choledochal cyst is a congenital dilatation of the biliary tree. It may affect only the extrahepatic bile duct (type I, II and III), intrahepatic (type V) or both (type IVa). Vater first described choledochal cyst in 1723. Open excision was the standard procedure made a great impact in the treatment but since 1995 Farello et al. first reported laparoscopic choledochal cyst excision and this has been used worldwide. CASE REPORT: Female, 17 years old, past medical history two years ago a laparoscopic cholecystectomy for gallbladders...
October 5, 2016: International Journal of Surgery Case Reports
Stefan Reuter, Stefanie Reiermann, Viola Malyar, Katharina Schütte-Nütgen, Renè Schmidt, Hermann Pavenstädt, Holger Reinecke, Barbara Suwelack
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death after renal transplantation with a high prevalence in dialysis patients. It is still a matter of debate how to assess the cardiovascular risk in kidney transplant candidates. Several approaches and scores exist and found their way into the guidelines. METHODS AND RESULTS: We herein assessed PROCAM, Framingham, ESC-SCORE and our own dedicated algorithm in patients applying for renal transplantation at our transplantation center between July 2006 and August 2009...
2016: PloS One
Eva Carlsson, Jeanette Fingren, Anne-Marie Hallén, Charlotta Petersén, Elisabet Lindholm
Despite advancements in the creation and care of stomas, ostomy and peristomal skin complications are common immediately following surgery as well as in the months and years thereafter. A prospective study to determine the prevalence of ostomy and peristomal skin complications and the influence of ostomy configuration on such complications was conducted 1 year after ostomy surgery among all patients at a university hospital in Sweden. All participants received regular (10 to 14 days post discharge, 6 weeks, 3 months, 6 months, and 1 year post surgery) ostomy follow-up care by a wound ostomy continence (WOC) nurse...
October 2016: Ostomy/wound Management
David E Rosow, Jamal Ahmed
Importance: Adult laryngotracheal stenosis (LTS) is typically managed surgically, but some patients fail treatment because of rapid restenosis or granulation tissue formation. The need for frequent surgery or tracheostomy reduces the quality of life in these patients and poses a significant challenge for the treating physician. New adjuvant treatments are required to reduce the surgical burden of this condition. Objective: To examine whether patients with rapidly recurrent nonvasculitic LTS who fail surgical management of their stenosis (ie, requiring dilation more frequently than every 6 months) experience longer intervals between surgical procedures when receiving adjuvant treatment with low-dose methotrexate...
October 20, 2016: JAMA Otolaryngology—Head & Neck Surgery
Michael O Childress, José A Ramos-Vara, Audrey Ruple
OBJECTIVE To determine the effect of prednisone omission from a multidrug chemotherapy protocol on outcome in dogs with peripheral nodal lymphomas. DESIGN Single-center, nonblinded, parallel-group, randomized, controlled trial. ANIMALS 40 client-owned dogs with a histopathologically confirmed diagnosis of peripheral nodal lymphoma and an expected survival time of > 4 weeks with treatment. PROCEDURES Treatment consisted of a combination of L-asparaginase, cyclophosphamide, doxorubicin, vincristine, and prednisone (L-CHOP) or an identical protocol except for the omission of prednisone (L-CHO)...
November 1, 2016: Journal of the American Veterinary Medical Association
Neige M Journy, Kieran McHugh, Richard W Harbron, Mark S Pearce, Amy Berrington de Gonzalez
OBJECTIVE: To describe medical conditions associated with the use of CT in children or young adults with no previous cancer diagnosis. METHODS: Radiologists' reports for scans performed in 1995-2008 in patients <22 years of age were collected from the Radiology Information System in 44 hospitals of Great Britain. By semantic search, an automated procedure identified 192 medical conditions within the radiologists' reports. Manual validation of a subsample by a paediatric radiologist showed a satisfactory performance of the automatic coding procedure...
October 21, 2016: British Journal of Radiology
Sachin S Dole, Gauri P Godbole, Himanshu S Pophale
BACKGROUND: Medical thoracoscopy has received interest in recent past for diagnostic as well as therapeutic uses. In this study we describe our experience with diagnostic medical thoracoscopy in pleural effusions of undiagnosed etiology. OBJECTIVE: 1.To detect diagnostic yield of medical thoracoscopy in pleural effusions of unknown etiology. 2.To find complication rate in these patients. METHODOLOGY: In a retrospective analysis of thoracoscopic procedures performed between March 2011 and December 2014, diagnostic yield and complications of thoracoscopic pleural biopsy for achieving a diagnosis in undiagnosed pleural effusions were evaluated...
October 2016: Journal of the Association of Physicians of India
Cigdem Benlice, Erman Aytac, Meagan Costedio, Hermann Kessler, Maher A Abbas, Feza H Remzi, Emre Gorgun
BACKGROUND: This study aimed to compare perioperative outcomes of patients undergoing robotic, laparoscopic, and open colectomy using a procedure-targeted database. METHODS: Retrospective review of patients undergoing elective colectomy in 2013 was conducted using the procedure-targeted database of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Robotic, laparoscopic, and open groups were matched (1:1:1) based on age, gender, body mass index, surgical procedure, diagnosis and ASA classification...
October 21, 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Shasha Yuan, Weidong Zhou, Junhui Li, Qi Wu
Epilepsy is a serious chronic neurological disorder, which affects more than 50 million people worldwide, and automatic seizure detection on EEG recordings is extremely required in the diagnosis and monitoring of epilepsy. This paper presents a novel seizure detection method using sparse representation-based Earth Mover's Distance (SR-EMD). In the proposed algorithm, wavelet decomposition is executed on the original EEG recordings with five scales, and the scales 3, 4 and 5 are selected to structure the distributions of EEG signals...
October 20, 2016: Medical & Biological Engineering & Computing
Joseph E Tanenbaum, Vincent J Alentado, Jacob A Miller, Daniel Lubelski, Edward C Benzel, Thomas E Mroz
BACKGROUND CONTEXT: Lumbar fusion is a common and costly procedure in the United States. Reimbursement for surgical procedures is increasingly tied to care quality and patient safety as part of value-based reimbursement programs. The incidence of adverse quality events among lumbar fusion patients is unknown using the definition of care quality (patient safety indicators [PSI]) utilized by the Centers for Medicare and Medicaid Services (CMS). The association between insurance status and the incidence of PSI is similarly unknown in lumbar fusion patients...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Dehong Liu, Huixia Zhou, Lifei Ma, Xiaoguang Zhou, Hualin Cao, Tian Tao, Xiaolong Luo, Shaojun Chen
OBJECTIVE: The choice of different laparoscopic approaches of laparoscopic pyeloplasty (LP) in children remains controversial. We present comparison of different approaches of LP in children and critical analysis of 11-year experiences in a single-surgeon. MATERIAL AND METHODS: Of 1750 Patients (1889 sides) who underwent LP between 2003 and 2014 were reviewed. The diagnosis and outcomes of ureteropelvic junction obstruction (UPJO) were reviewed based on clinical and imaging data...
October 17, 2016: Urology
S El Batti, F Solla, J-L Clément, O Rosello, I Oborocianu, E Chau, V Rampal
BACKGROUND: The initial treatment of congenital idiopathic clubfoot (CIC) is nonoperative. Either the French physiotherapy method or the Ponseti casting method may be used. Whether either method is superior over the other remains unclear. However, the method used initially is not the only determinant of the final outcome. OBJECTIVE: The primary objective was to identify determinants of the final outcome as evaluated based on the need for surgical treatment and on the Ghanem-Seringe score...
October 17, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Gerhard Batz, Michael Dinkel
Echocardiography as an imaging method in anaesthesia and intensive care medicine has enabled a new dimension of hemodynamic monitoring: the direct visualization of the cardiac function and its disruptions. Preconditions for a broad application in this area was the development of mobile, high-definition ultrasonic devices and the origination of focused examination techniques. A successful application of this method requires the respective know-how of the examiner, in order to take relevant decisions and avoid misdiagnoses...
October 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Christian Quinet, Guy Czaplicki, Elise Dion, Fabiana Dal Pozzo, Anke Kurz, Claude Saegerman
BACKGROUND: Infection due to bovine viral diarrhoea virus (BVDV) is endemic in most cattle-producing countries throughout the world. The key elements of a BVDV control programme are biosecurity, elimination of persistently infected animals and surveillance. Bovine viral diarrhoea (BVD) is a notifiable disease in Belgium and an official eradication programme started from January 2015, based on testing ear notches sampled during the official identification and registration of calves at birth...
2016: PloS One
Marie Louise Landry, Kirsten St George
CONTEXT: -The rapid and accurate diagnosis of Zika virus infection is an international priority. OBJECTIVE: -To review current recommendations, methods, limitations, and priorities for Zika virus testing. DATA SOURCES: -Sources include published literature, public health recommendations, laboratory procedures, and testing experience. CONCLUSIONS: -Until recently, the laboratory diagnosis of Zika infection was confined to public health or research laboratories that prepared their own reagents, and test capacity has been limited...
October 20, 2016: Archives of Pathology & Laboratory Medicine
B P C Hoppe, E de Jongh, A Griffioen-Keijzer, J M Zijlstra-Baalbergen, E P F IJzerman, F Baboe
Human metapneumovirus (hMPV) is a paramyxovirus that causes respiratory tract infections ranging from mild upper airway infection to severe pneumonia. Patients with haematological disease, especially haematopoietic stem cell transplantation (HSCT) recipients, are more likely to develop more severe infections. We describe three cases of hMPV infection in HSCT patients. The most reliable diagnostic procedure for hMPV is multiplex ligation-dependent probe amplification (MLPA) on a nasopharyngeal swab. Sensitivity and specificity of MLPA to detect hMPV is high and time to diagnosis is short...
October 2016: Netherlands Journal of Medicine
Danieli Urach Monteiro, Maria Isabel Azevedo, Carla Weiblen, Sônia DE Avila Botton, Nadine Lysyk Funk, Cristiane DE Bona DA Silva, Régis Adriel Zanette, Thiago Guilherme Schwanz, Mário Luiz DE LA Rue
Cystic echinococcosis is a zoonotic disease of difficult diagnosis and treatment. The use of protoscolicidal agents in procedures is of utmost importance for treatment success. This study was aimed at analysing the in vitro and ex vivo activity of Melaleuca alternifolia oil (tea tree oil - TTO), its nanoemulsion formulation (NE-TTO) and its major component (terpinen-4-ol) against Echinococcus ortleppi protoscoleces obtained from cattle. Concentrations of 2·5, 5 and 10 mg mL-1 of TTO, 10 mg mL-1 of NE-TTO and 1, 1·5 and 2 mg mL-1 of terpinen-4-ol were evaluated in vitro against protoscoleces at 5, 10, 15 and 30 min...
October 20, 2016: Parasitology
Jan-Willem Alffenaar, Onno W Akkerman, Richard Anthony, Simon Tiberi, Scott Heysell, M P Grobusch, Frank Cobelens, Dick van Soolingen
Success rates for treatment of extensively drug resistant tuberculosis (XDR-TB) are low due to limited treatment options, delayed diagnosis and inadequate health care infrastructure. Areas covered: This review analyses existing programmes of prevention, diagnosis and treatment of XDR-TB. Improved diagnostic procedures and rapid molecular tests help to select appropriate drugs and dosages. Drugs dosages can be further tailored to the specific conditions of the patient based on quantitative susceptibility testing of the M...
October 20, 2016: Expert Review of Anti-infective Therapy
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