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https://www.readbyqxmd.com/read/29053075/machine-learning-applied-to-neuroimaging-for-diagnosis-of-adult-classic-chiari-malformation-role-of-the-basion-as-a-key-morphometric-indicator
#1
Aintzane Urbizu, Bryn A Martin, Dulce Moncho, Alex Rovira, Maria A Poca, Juan Sahuquillo, Alfons Macaya, Malena I Español
OBJECTIVE The current diagnostic criterion for Chiari malformation Type I (CM-I), based on tonsillar herniation (TH), includes a diversity of patients with amygdalar descent that may be caused by a variety of factors. In contrast, patients presenting with an overcrowded posterior cranial fossa, a key characteristic of the disease, may remain misdiagnosed if they have little or no TH. The objective of the present study was to use machine-learning classification methods to identify morphometric measures that help discern patients with classic CM-I to improve diagnosis and treatment and provide insight into the etiology of the disease...
October 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29052069/robotic-single-site-versus-multiport-laparoscopic-cholecystectomy-a-case-matched-analysis-of-short-and-long-term-costs
#2
Monika E Hagen, Alexandre Balaphas, Michele Podetta, Peter Rohner, Minoa K Jung, Nicolas C Buchs, Leo Buehler, Jona M Mendoza, Philippe Morel
BACKGROUND: Multiport laparoscopy is the gold-standard approach for cholecystectomy, and single-port laparoscopy has been developed to further reduce its invasiveness. A specific robotic single-port platform (da Vinci single-site, Intuitive Surgical Inc., Sunnyvale, CA, USA) has been released in 2011, which could technically facilitate single-site cholecystectomy. Current data show its feasibility; however, detailed short- and long-term analyses of costs and comparisons relative to multiport laparoscopy are not available to date...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29052065/robotic-ventral-hernia-repair-is-not-superior-to-laparoscopic-a-national-database-review
#3
Priscila Armijo, Akshay Pratap, Yi Wang, Valerie Shostrom, Dmitry Oleynikov
BACKGROUND: Minimally invasive surgery (MIS) use for ventral hernia repair has increased over the last decade. Whether outcomes are improved by robotic assistance remains a subject of debate. The aim of this study is to evaluate outcomes (including cost, complications, length of stay (LOS), and pain medication utilization) in patients who underwent an open (OVHR), laparoscopic (LVHR), or robotic (RVHR) ventral hernia repair (VHR). METHODS: The Vizient database was queried using ICD-9 procedure and diagnosis codes for patients who underwent VHR from January 2013 to September 2015...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29052024/multimodality-imaging-in-secondary-postpartum-or-postabortion-hemorrhage-retained-products-of-conception-and-related-conditions
#4
REVIEW
Yuko Iraha, Masahiro Okada, Masafumi Toguchi, Kimei Azama, Keiko Mekaru, Tadatsugu Kinjo, Wataru Kudaka, Yoichi Aoki, Hajime Aoyama, Akiko Matsuzaki, Sadayuki Murayama
Secondary postpartum hemorrhage (PPH) and postabortion hemorrhage are rare complications. Retained products of conception (RPOC) is among the most common causes of both secondary PPH and postabortion hemorrhage. Other less common causes of secondary PPH are uterine vascular abnormalities such as arteriovenous malformations and pseudoaneurysms. These are usually related to a history of a procedure such as dilation and curettage or cesarean delivery. Subinvolution of the placental site is an idiopathic cause of secondary PPH; this condition may be underrecognized and therefore could have a higher incidence than currently reported...
October 19, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/29051869/case-of-acute-concomitant-rupture-of-anterior-cruciate-ligament-and-patellar-tendon-of-knee-surgical-decision-making-and-outcome
#5
Jithin Orville Lobo, Joe Joseph Cherian, Arnav Sahu
INTRODUCTION: Acute concomitant rupture of both anterior cruciate ligament (ACL) and patellar tendon is a rare injury. The diagnosis of either of the injuries may be missed on clinical examination in the emergency room. A high index of suspicion is necessary when active extension is absent, and necessary investigations like ultrasound or magnetic resonance imaging (MRI) should be done to confirm the diagnosis. There are no fixed treatment protocols in these injuries. The options include immediate repair of patellar tendon with either simultaneous or delayed reconstruction of ACL...
May 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29051548/gastrointestinal-hemorrhage-after-spontaneous-subarachnoid-hemorrhage-a-single-center-cohort-study
#6
Shang-Po Wang, Yu-Hua Huang
Spontaneous subarachnoid hemorrhage (SAH) is a devastating disease, and gastrointestinal hemorrhage is one of several potential complications of acute strokes. We aim to analyze its prevalence, risk factors, and association with in-hospital prognosis following SAH. A total of 1047 adult patients with a primary diagnosis of spontaneous SAH were retrospectively enrolled. We retrieved medical information from the administrative database utilizing diagnostic and procedure codes of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)...
October 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29051476/independent-factors-predicting-postoperative-30-day-mortality-in-101-infants-following-liver-transplantation
#7
Chan Woo Cho, Sanghoon Lee, Jong Man Kim, Gyu-Seong Choi, Choon Hyuck David Kwon, Jae-Won Joh, Suk-Koo Lee
BACKGROUND Liver transplantation (LT) in infants is a challenging procedure. This study was designed to identify risk factors of 30-day mortality of infant LT recipients. MATERIAL AND METHODS A total of 101 infants treated between May 1997 and March 2015 were assigned to one of two groups, a deceased infant group (n=9) or a live infant group (n=92), according to their mortality status at 30 days after LT. RESULTS Patient characteristics of height, weight, preoperative total bilirubin, creatinine clearance, primary diagnosis, and graft-to-recipient weight ratio (GRWR) were significantly different between the two groups...
October 20, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29050714/when-does-intraoperative-blood-loss-occur-during-pediatric-scoliosis-correction
#8
Sean Wahlquist, Montri Wongworawat, Scott Nelson
BACKGROUND: The purpose of our study was to assess the relationship between amount of blood loss and surgical stage in pediatric patients undergoing posterior spinal fusion for deformity correction to determine: (1) when the highest rate of blood loss occurred; (2) what percentage of total blood loss occurred during deformity correction and closure; and (3) how to predict remaining blood loss during a procedure. Blood loss following exposure and placement of the final pedicle screw is often underestimated, which may result in lack of sufficient blood product availability...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29050711/prevalence-of-vitamin-d-deficiency-in-pediatric-patients-with-scoliosis-preparing-for-spinal-surgery
#9
Theresa Mayes, Jennifer M Anadio, Peter F Sturm
BACKGROUND: Establishing prevalence of vitamin D deficiency in elective scoliosis surgery may impact clinical outcomes. The objectives of this study were to document vitamin D status of patients with scoliosis preparing for surgical intervention in order to establish frequency of deficiency and determine characteristics influencing levels. METHODS: Records were queried for patients with scoliosis diagnosis who underwent posterior spinal fusion or initial growing rod placement and had serum vitamin 25 hydroxyvitamin D (D25) recorded in the preoperative period...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29050505/late-onset-adhd-reconsidered-with-comprehensive-repeated-assessments-between-ages-10-and-25
#10
Margaret H Sibley, Luis A Rohde, James M Swanson, Lily T Hechtman, Brooke S G Molina, John T Mitchell, L Eugene Arnold, Arthur Caye, Traci M Kennedy, Arunima Roy, Annamarie Stehli
OBJECTIVE: Adolescents and young adults without childhood attention deficit hyperactivity disorder (ADHD) often present to clinics seeking stimulant medication for late-onset ADHD symptoms. Recent birth-cohort studies support the notion of late-onset ADHD, but these investigations are limited by relying on screening instruments to assess ADHD, not considering alternative causes of symptoms, or failing to obtain complete psychiatric histories. The authors address these limitations by examining psychiatric assessments administered longitudinally to the local normative comparison group of the Multimodal Treatment Study of ADHD...
October 20, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/29050190/-current-research-of-sympathetic-ophthalmia
#11
Y Di, J J Ye
Sympathetic ophthalmia (SO) is a rare, bilateral, non-necrotizing, granulomatous uveitis that usually occurs after open ocular injury or intraocular surgery. The pathophysiology is not clearly understood, but generally SO is an immediate hypersensitivity mediated by T lymphocytes which are related to ocular tissue antigens. The main histopathological features are granulation tissues composed of lymphocytes, macrophages and multinucleated giant cells. The clinical manifestations are different from person to person, which might be mild or severe...
October 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/29050186/-influent-factors-for-treating-procedure-of-cytomegalovirus-retinitis-after-allogeneic-bone-marrow-hematopoietic-stem-cell-transplantation
#12
H Miao, J Hou
Objective: To explore clinical and laboratory factors that influencing treating procedure of cytomegalovirus retinitis (CMVR) after allogeneic bone marrow hematopoietic stem cell transplantation (HSCT). Methods: This is a retrospective case series study. A total of 9 CMVR patients (15 eyes) between January 2016 and March 2017 were included in this study. All patients received intravenous or oral ganciclovir, together with intravitreous injection of ganciclovir alone or combined with foscanet sodium. One day before the first injection, aqueous humor samples from the affected eyes were collected, and CMV-DNA and interleukin-8 (IL-8) level were examined...
October 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/29050182/-research-progress-on-andersson-lesion-in-ankylosing-spondylitis
#13
H F Wang, C Bi, Z Q Chen
Andersson lesion is a destructive vertebral or disco-vertebral lesion that occurs in the late stage of the ankylosing spondylitis. According to the etiology, these lesions are usually classified into localized lesions and extensive lesions. The history of ankylosing spondylitis and characteristic imaging is the key to the diagnosis of Andersson lesion. Conservative treatment may be effective for localized lesions. However, surgical intervention is often required for the failure of conservative treatment and extensive lesions...
October 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29050061/-perioperative-anaphylaxia-on-drugs
#14
Wolfgang Pfützner, Hinnerk Wulf
The diagnostic evaluation of perioperative anaphylaxia is of great importance for the medical care of the affected persons in the context of renewed interventions in general anesthesia. The most frequent triggers include muscle relaxants, antibiotics, latex and analgesics of the type of the cyclooxygenase inhibitors, but other perioperatively administered drugs such as opioids, anesthetics, benzodiazepines, dyes, disinfectants and even corticosteroids or drug additives may also be the cause in rare cases. The most important aim is therefore the identification of the responsible drug, for which a near-time allergological diagnosis should be carried out within the first 4 weeks to 6 months after the reaction...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29049672/high-mortality-in-patients-with-tracheoarterial-fistulas-clinical-experience-and-treatment-recommendations
#15
Brigitte Reger, Reiner Neu, Hans-Stefan Hofmann, Michael Ried
OBJECTIVES: A tracheoarterial fistula (TAF) is an uncommon but a critical complication of tracheostomy and represents a surgical emergency. Surgical therapy with ligation of the brachiocephalic trunk can be considered as the first choice of treatment to control massive and life-threatening haemorrhage. METHODS: We describe 3 cases of TAF in patients who had long-term placement of a tracheostomy tube and the occurrence of a severe massive haemorrhage caused by an injured brachiocephalic trunk...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049611/association-of-a-prophylactic-surgical-approach-to-stage-iv-small-intestinal-neuroendocrine-tumors-with-survival
#16
Kosmas Daskalakis, Andreas Karakatsanis, Ola Hessman, Heather C Stuart, Staffan Welin, Eva Tiensuu Janson, Kjell Öberg, Per Hellman, Olov Norlén, Peter Stålberg
Importance: Primary tumor resection and mesenteric lymph node dissection in asymptomatic patients with stage IV small intestinal neuroendocrine tumors (SI-NETs) are controversial. Objective: To determine the association of locoregional surgery (LRS) performed at diagnosis with outcomes in patients with asymptomatic SI-NETs and distant metastases. Design, Setting, and Participants: This cohort study included asymptomatic patients with stage IV SI-NETs diagnosed from January 1, 1985, through December 31, 2015, and identified using the prospective database of SI-NETs from Uppsala University Hospital, Uppsala, Sweden...
October 19, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29049182/endovascular-treatment-of-brucella-infected-abdominal-aortic-aneurysm-a-case-report
#17
Tao Zhang, Donghua Ji, Feng Wang
RATIONALE: In very rare cases, a primary infected abdominal aortic aneurysm (IAAA) is caused by a species of Brucella. In this report, we report such a case that was successfully treated with a novel approach. To the best of our knowledge, this was the first case occurring in China, in which an infection of the abdominal aortic aneurysm was caused by a Brucella species. PATIENT CONCERNS: The clinical findings included high fever, fatigue, and abdominal pain. DIAGNOSES: The diagnosis was confirmed by computed tomography angiography and by bacteriologic isolation from the patient's blood culture...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29048403/prenatal-factors-associated-with-neonatal-survival-of-infants-with-congenital-chylothorax
#18
M Dorsi, A Giuseppi, F Lesage, J Stirnemann, L De Saint Blanquat, M Nicloux, Z Assaf, N Khen Dunlop, E Kermorvant-Duchemin, J-F Magny, Y Ville, A Lapillonne
OBJECTIVES: Congenital chylothorax is a rare disease and prognostic factors are key element in properly informing parents. This study aimed at determining the prenatal factors associated with neonatal survival in a cohort of liveborn infants with congenital chylothorax. STUDY DESIGN: Observational monocentric cohort study including all liveborn neonates consecutively admitted for congenital chylothorax. RESULTS: Neonatal mortality was 32% (16/50)...
October 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29045952/-progress-in-diagnosis-and-management-of-syncope-in-children
#19
W R Xu, Y Liao, H F Jin, Q Y Zhang, C S Tang, J B DU
Syncope is a common emergency of children and adolescents, which has serious influence on the quality of life. Neurally-mediated syncope, including postural tachycardia syndrome, vasovagal syncope, orthostatic hypotension and orthostatic hypertension, is the main cause of syncope in children and adolescents. The main manifestations of neurally-mediated syncope are diverse, such as dizziness, headache, chest tightness, chest pain, pale complexion, fatigue, pre-syncope and syncope. Although the clinical manifestations are similar, each subtype of syncope has its hemodynamic feature and optimal treatment option...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29045348/choice-of-endoscopic-procedure-in-children-with-clinically-suspected-gastrointestinal-graft-versus-host-disease
#20
Thomas Mårtensson, Attila Szakos, Karin Mellgren, Jacek Toporski, Johan Arvidson, Thomas H Casswall, Britt Gustafsson
OBJECTIVES: Gastrointestinal graft-versus-host disease (GI-GVHD) is a potentially life-threatening complication after hematopoietic stem cell transplantation. Symptoms indicating GI-GVHD motivates endoscopy with biopsy sampling and histopathological confirmation. However, optimal extent of endoscopy in children is presently unknown. Therefore, we aimed to evaluate if biopsies from the rectosigmoid area versus the rest of the colon/ileocolon with or without biopsies from simultaneous upper endoscopy, were equally reliable for detection of GI-GVHD and relevant differential diagnoses...
October 17, 2017: Journal of Pediatric Gastroenterology and Nutrition
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