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https://www.readbyqxmd.com/read/28394022/limited-versus-full-sternotomy-for-aortic-valve-replacement
#1
REVIEW
Bilal H Kirmani, Sion G Jones, S C Malaisrie, Darryl A Chung, Richard Jnn Williams
BACKGROUND: Aortic valve disease is a common condition that is easily treatable with cardiac surgery. This is conventionally performed by opening the sternum longitudinally down the centre ("median sternotomy") and replacing the valve under cardiopulmonary bypass. Median sternotomy is generally well tolerated, but as less invasive options have become available, the efficacy of limited incisions has been called into question. In particular, the effects of reducing the visibility and surgical access has raised safety concerns with regards to the placement of cannulae, venting of the heart, epicardial wire placement, and de-airing of the heart at the end of the procedure...
April 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28381238/homozygous-germ-line-mutation-of-the-pms2-mismatch-repair-gene-a-unique-case-report-of-constitutional-mismatch-repair-deficiency-cmmrd
#2
N C Ramchander, N A J Ryan, E J Crosbie, D G Evans
BACKGROUND: Constitutional mismatch repair deficiency syndrome results from bi-allelic inheritance of mutations affecting the key DNA mismatch repair genes: MLH1, MSH2, MSH6 or PMS2. Individuals with bi-allelic mutations have a dysfunctional mismatch repair system from birth; as a result, constitutional mismatch repair deficiency syndrome is characterised by early onset malignancies. Fewer than 150 cases have been reported in the literature over the past 20 years. This is the first report of the founder PMS2 mutation - NM_000535...
April 5, 2017: BMC Medical Genetics
https://www.readbyqxmd.com/read/28377258/cavernoma-new-insights-from-an-unusual-case
#3
G Sokratous, I Ughratdar, R Selway, Safa Al-Sarraj, K Ashkan
Rapid growth in cerebral cavernous malformation is rare. We present the case of a 71 year old patient with known multiple cavernomas over many years in whom one lesion showed rapid expansion in size. Histological examination revealed co-existence of glioblastoma within the cavernoma. We review the literature for similar cases and discuss the potential mechanisms underlying this phenomenon. Review of the literature revealed four cases with known cerebral cavernous malformations that have later developed, at the same site, a high grade glioma...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28374963/mortality-caused-by-intracranial-bleeding-in-non-severe-hemophilia-a-patients
#4
Janneke I Loomans, Corien L Eckhardt, Sylvia E Reitter-Pfoertner, Margareta Holmström, Britta Laros van Gorkom, Frank W G Leebeek, Cristina Santoro, Saturnino Haya, Karina Meijer, Marten R Nijziel, Johanna G Van der Bom, Karin Fijnvandraat
INTRODUCTION: Non-severe hemophilia (factor VIII concentration (FVIII:C) 2-40 IU/dL) is characterized by a milder bleeding phenotype than severe hemophilia A. However, some patients with non-severe hemophilia A suffer from severe bleeding complications that may result in death. Data on bleeding-related causes of death, such as fatal intracranial bleeding in non-severe patients are scarce. Such data may provide new insight in areas of care that can be improved. AIMS: To describe mortality rates, risk factors and co-morbidities associated with fatal intracranial bleeding in non-severe hemophilia A patients...
April 4, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28374708/-laparoscopic-cholecystectomy-in-patients-with-liver-cirrhosis
#5
S I Gadiev, K G Sarieva, E A Abdinov
AIM: To assess efficacy and safety of laparoscopic cholecystectomy in patients with liver cirrhosis. MATERIAL AND METHODS: 46 patients with liver cirrhosis Child-Pugh class A and B underwent laparoscopic cholecystectomy for the period from August 2001 to December 2015. Indications for surgery were acute calculous cholecystitis in 21 (45.6%) patients and chronic calculous cholecystitis in 25 (54.4%) patients. RESULTS: Mean surgery time was 75 minutes...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28366835/emerging-therapeutic-uses-of-direct-acting-oral-anticoagulants-an-evidence-based-perspective
#6
REVIEW
Emanuel Raschi, Matteo Bianchin, Roberto De Ponti, Fabrizio De Ponti, Walter Ageno
Direct-acting oral anticoagulants (DOACs) were claimed to cause a potential paradigm shift in the therapeutic scenario of patients requiring short- and long-term anticoagulation, by virtue of their pharmacological properties, perceived as innovative. The evidence gathered so far (from pre-approval pivotal trials to real-world post-marketing observational data) consistently confirmed that DOACs are overall comparable to vitamin-K antagonists (VKAs) in terms of safety, efficacy and effectiveness and unequivocally documented a consistent and clinically relevant reduced risk of intracranial bleeding in the settings of non-valvular atrial fibrillation (NVAF) and venous thromboembolism (VTE)...
March 31, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28355985/cessation-of-oral-anticoagulants-in-antiphospholipid-syndrome
#7
C Comarmond, P Jego, C Veyssier-Belot, I Marie, A Mekinian, A Elmaleh-Sachs, G Leroux, D Saadoun, E Oziol, T Fraisse, H Hyvernat, M-F Thiercein-Legrand, F Sarrot-Reynauld, N Ferreira-Maldent, M de Menthon, C Goujard, D Khau, Y Nguen, S Monnier, A Michon, B Castel, O Decaux, J-C Piette, P Cacoub
Objective To study the outcome of patients with antiphospholipid syndrome (APS) after oral anticoagulant treatment cessation. Methods We performed a retrospective study of patients with APS experiencing cessation of oral anticoagulant and enrolled in a French multicentre observational cohort between January 2014 and January 2016. The main outcome was the occurrence of recurrent thrombotic event after oral anticoagulation cessation. Results Forty four APS patients interrupted oral anticoagulation. The median age was 43 (27-56) years...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28335035/a-novel-cisd2-mutation-associated-with-a-classical-wolfram-syndrome-phenotype-alters-ca2-homeostasis-and-er-mitochondria-interactions
#8
Cécile Rouzier, David Moore, Cécile Delorme, Sandra Lacas-Gervais, Samira Ait-El-Mkadem, Konstantina Fragaki, Florence Burté, Valérie Serre, Sylvie Bannwarth, Annabelle Chaussenot, Martin Catala, Patrick Yu-Wai-Man, Véronique Paquis-Flucklinger
Wolfram syndrome (WS) is progressive neurodegenerative disease characterized by early-onset optic atrophy and diabetes mellitus, which can be associated with more extensive central nervous system and endocrine complications. The majority of patients harbour pathogenic WFS1 mutations, but recessive mutations in a second gene, CISD2, have been described in a small number of families with Wolfram syndrome type 2 (WFS2). The defining diagnostic criteria for WFS2 also consist of optic atrophy and diabetes mellitus, but unlike WFS1, this phenotypic subgroup has been associated with peptic ulcer disease and an increased bleeding tendency...
March 6, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28323734/radial-probe-ultrasound-guided-cryobiopsy
#9
Ilya G Berim, Ali I Saeed, Ahmed Awab, Adam Highley, Agnes Colanta, Fawad Chaudry
Fluoroscopy-guided transbronchial forceps biopsy has a low diagnostic yield in patients with radiographic suspicion of interstitial lung disease. Cryobiopsy has a higher diagnostic yield likely due to preserved lung architecture and larger biopsies; however, there is an increased risk of major airway bleeding and pneumothorax. Simultaneous use of endobronchial balloon blocker allows for containment of bleeding after cryobiopsy to the affected lobe. In the current article we describe use of radial ultrasound in identification of a target lung parenchyma without a major blood vessel adjacent to distal bronchi...
April 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28303867/-organization-and-results-of-surgical-care-for-ulcerative-gastroduodenal-bleeding-in-the-hospitals-of-central-federal-district
#10
V A Kubyshkin, V P Sazhin, A V Fedorov, G A Krivtsov, I V Sazhin
AIM: To present treatment of 52 149 patients with ulcerative gastroduodenal bleeding (UGDB) who were treated in different regions of Central Federal District (CFD) for the period 2011-2014. It is noted that UGDB incidence per 100 thousands is increased proportionally from 32.9 to 77.8 according to population less than 20 and over 100 thousands, respectively. In hospitals of small and medium settlements the number of UGDB patients without surgery reaches 81.6 and 81.1%, the number of operated patients - 18...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28293746/long-standing-crohn-s-disease-and-its-implication-on-anal-squamous-cell-cancer-management
#11
Amy L Lightner, Sara B Moncrief, Thomas C Smyrk, John H Pemberton, Michael G Haddock, David W Larson, Eric J Dozois, Kellie L Mathis
BACKGROUND: Anal squamous cell carcinoma (ASCC) is rare, accounting for only 1% of gastrointestinal malignancies. We sought to better understand management strategies for ASCC in the setting of Crohn's disease (CD). METHODS: A retrospective chart review from 2001 to 2016 was conducted using ICD-9/10 codes for CD (555.9/K50) and ASCC (154.3/C44.520). Adult patients with a diagnosis of CD at the time of ASCC diagnosis were included. RESULTS: Seven patients (five female) were included with a median age of 50 years...
May 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28288056/ottawa-criteria-for-appropriate-transfusions-in-hepatectomy-using-the-rand-ucla-appropriateness-method
#12
Sean Bennett, Alan Tinmouth, Daniel I McIsaac, Shane English, Paul C Hébert, Paul J Karanicolas, Alexis F Turgeon, Jeffrey Barkun, Timothy M Pawlik, Dean Fergusson, Guillaume Martel
OBJECTIVE: Create practice guidelines for the appropriate use of red blood cell transfusions in hepatectomy. BACKGROUND: Hepatectomy is associated with a high prevalence of transfusions. A transfusion can be life-saving, but can be associated with important adverse effects. Given the prevalence, the potential for benefit and harm, and the difficulty in conducting clinical trials, transfusion in hepatectomy is well-suited for a study of appropriateness. METHODS: Using the RAND/UCLA appropriateness method, an international, multidisciplinary expert panel in hepatobiliary surgery, anesthesia, transfusion medicine, and critical care rated a series of 468 perioperative scenarios for transfusion appropriateness...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28282004/five-year-retrospective-review-of-blunt-renal-injuries-at-a-level-i-trauma-center
#13
Jessica Burns, Megan Brown, Zakaria I Assi, Eric J Ferguson
We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28271517/effect-of-storage-time-of-platelet-products-on-clinical-outcomes-after-transfusion-a-systematic-review-and-meta-analyses
#14
REVIEW
A L Kreuger, C Caram-Deelder, J Jacobse, J-L Kerkhoffs, J G van der Bom, R A Middelburg
BACKGROUND: Prolonged storage improves availability of platelet products but could also influence safety and efficacy. This systematic review and meta-analyses summarize and quantify the evidence of the effect of storage time of transfused platelets on clinical outcomes. METHODS: A systematic search in seven databases was performed up to February 2016. All studies reporting storage time of platelet products and clinical outcomes were included. To quantify heterogeneity, I² was calculated, and to assess publication bias, funnel plots were constructed...
March 7, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28255911/solitary-rectal-ulcer-syndrome-in-children-a-case-series-study
#15
K Kowalska-Duplaga, I Lazowska-Przeorek, K Karolewska-Bochenek, M Woynarowski, G Czaja-Bulsa, A Stawarski, S Pieczarkowski, E Hapyn, J Jozefczuk, B Korczowski, A Szaflarska-Poplawska, A Banaszkiewicz
Information on solitary rectal ulcer syndrome (SRUS) in children is limited and based on case reports only. This study was undertaken with the objective of describing the clinical history, symptoms, diagnostic work-up, and treatment of a large case series of pediatric patients with SRUS. The study was multi-center and retrospective. All pediatric endoscopists in Poland were invited to participate in the study and were asked to look through their endoscopic databases to identify SRUS cases from the last 10 years...
March 3, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28251541/profile-of-pediatric-idiopathic-inflammatory-myopathies-from-a-tertiary-care-center-of-eastern-india
#16
Sumantra Sarkar, Tanushree Mondal, Arpan Saha, Rakesh Mondal, Supratim Datta
OBJECTIVES: To report data on Idiopathic inflammatory myopathies (IIM) from eastern India. METHODS: All IIM patients diagnosed over the last 5 y (2011-2016) were included through a retrospective review of records from the hospital and specialty clinic at Institute of Postgraduate Medical Education & Research (I.P.G.M.E.&R.), Kolkata. RESULTS: Out of the 11 IIM patients, 9 had Juvenile dermatomyositis (JDM) and 2 had overlap myositis (OM) [with systemic lupus erythematosus (SLE) and scleroderma]...
March 2, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28248060/-using-laser-radiation-in-partial-nephrectomy-for-renal-tumors
#17
A M Dymov, P V Glybochko, Yu G Alyaev, A Z Vinarov, E V Shpot, N I Sorokin, D V Enikeev, A V Koshkarev, E A Shmeleva, M V Yurova
In recent years, the number of organ-sparing operations for renal tumors has been increasing steadily due to comparable oncological outcomes and the desire to preserve functioning renal parenchyma. Another technique, which is becoming increasingly popular, is so-called zero ischemia partial nephrectomy, which allows bleeding to be controlled during the operation without clamping the renal artery, thus avoiding renal ischemic injury. One of the most interesting and promising instruments for partial nephrectomy is a laser radiation...
December 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28248054/-age-related-androgen-deficiency-and-benign-prostatic-hyperplasia-how-to-improve-the-rehabilitation-of-patients-after-transurethral-surgery
#18
A G Martov, D V Ergakov
RELEVANCE: Age-related androgen deficiency often coexists with benign prostatic hyperplasia (BPH), which requires surgical treatment. At the same time, severe lower urinary tract symptoms secondary to BPH are considered a relative contraindication to testosterone replacement therapy. The aim of this study was to evaluate the importance of correcting age-related androgen deficiency in patients with benign prostatic hyperplasia after transurethral operations. MATERIALS AND METHODS: The study comprised 60 patients with androgen deficiency (plasma testosterone levels below12...
December 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28244463/pediatric-nasopharyngeal-carcinoma-experience-from-a-tertiary-cancer-center-in-india
#19
V Radhakrishnan, P Kumar, S Totadri, P Ganesan, G Selvaluxmy, T Ganesan, M Dhanushkodi, T Sagar
BACKGROUND: Pediatric nasopharyngeal carcinomas (NPCs) are rare tumors. There is paucity of data on outcomes in pediatric NPC from developing countries. AIM: The present study was conducted to ascertain the outcomes of children with NPC at our center. SETTINGS AND DESIGN: A retrospective analysis of case records of pediatric NPC patients treated at our hospital was performed. PATIENTS AND METHODS: We analyzed the outcomes of 37 consecutive patients <18 years of age with pediatric NPC treated between 2000 and 2015...
July 2016: Indian Journal of Cancer
https://www.readbyqxmd.com/read/28228201/five-year-retrospective-review-of-blunt-renal-injuries-at-a-level-i-trauma-center
#20
Jessica Burns, Megan Brown, Zakaria I Assi, Eric J Ferguson
We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality...
February 1, 2017: American Surgeon
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