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https://www.readbyqxmd.com/read/28643745/adjuvant-hypofractionated-radiation-in-carcinoma-breast-photon-versus-electron-comparison-of-treatment-outcome
#1
G Prameela Chelakkot, Rahul Ravind, K Sruthi, Namrata Chigurupati, Sanketh Kotne, Raghavendra Holla, Ram Madhavan, M Dinesh
BACKGROUND: Breast cancer tissue is sensitive to hypofractionation. This is an analysis of patients treated with hypofractionated protocols since 2009, at our tertiary cancer center. METHODS: Details of breast cancer patients treated with adjuvant hypofractionated external beam radiation therapy (EBRT) from January 2009 to December 2014 were retrieved and analyzed. RESULTS: One thousand seven hundred and eighty patients received adjuvant EBRT during this period...
April 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28643112/a-retrospective-study-of-antibiotic-de-escalation-in-patients-with-ventilator-associated-pneumonia-in-malaysia
#2
Rahela Ambaras Khan, Zoriah Aziz
Background Antibiotic de-escalation is an important strategy to conserve the effectiveness of broad-spectrum antibiotics. However, the outcome of this strategy for the treatment of ventilator-associated pneumonia (VAP) has not been widely studied in developing countries. Objectives To evaluate the outcome on intensive care unit (ICU) mortality, 28 days mortality, and length of ICU stay among VAP patients who receive de-escalation therapy. Setting This study was conducted in an ICU of a Malaysian public hospital...
June 22, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28642188/costal-graft-as-a-support-for-bone-regeneration-after-mandibular-juvenile-ossifying-fibroma-resection-an-unusual-case-report
#3
F Fauvel, R Pace, F Grimaud, F Marion, P Corre, B Piot
Spontaneous regeneration of bone tissue after mandibular resection is rare in adults, although it does often take place in children. Periosteum conservation appears to play a major role in this healing process. We here report regarding a 5-year-old boy who exhibited a large mandibular trabecular juvenile ossifying fibroma. The lesion was treated by mandibulectomy, with careful preservation of the periosteal layer and immediate reconstruction with a costal graft by an intra-oral approach. Monitoring over the course of a year revealed spontaneous mandibular regeneration, and it allowed for a series of measurements of the graft to be made...
June 19, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28642047/erectile-dysfunction-in-young-men-a-review-of-the-prevalence-and-risk-factors
#4
REVIEW
Hoang Minh Tue Nguyen, Andrew T Gabrielson, Wayne J G Hellstrom
INTRODUCTION: Erectile dysfunction (ED) is an important health concern that can significantly affect a man's psychosocial well-being. ED has traditionally been considered a disease of old age; however, contemporary evidence suggests a growing incidence of ED in men younger than 40 years. The process of achieving an erection is multifaceted; there are many potential mechanisms that can be disrupted. It is critical to identify the specific causes of ED before proceeding with potentially costly and invasive therapeutic options...
June 19, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28641445/subcutaneous-botulinum-toxin-injection-for-post-thoracotomy-pain-syndrome-in-palliative-care-a-case-report
#5
Saima Rashid, Amanda R Fields, Steven J Baumrucker
Post-thoracotomy pain syndrome (PTPS) is a traumatic neuropathy that can affect as many as 50% of patients undergoing thoracotomy. Patients are often refractory to conservative management and may require multiple analgesics for adequate pain control. Botulinum toxin, derived from Clostridium botulinum, has many uses in treating conditions involving spasticity, dystonia, chronic migraine, and a variety of pain disorders including neuropathies. Botulinum toxin type A injections may provide an alternative or adjunct to improve symptom management in patients with PTPS...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28639551/facet-joint-injections-for-people-with-persistent-non-specific-low-back-pain-facet-injection-study-a-feasibility-study-for-a-randomised-controlled-trial
#6
David R Ellard, Martin Underwood, Felix Achana, James Hl Antrobus, Shyam Balasubramanian, Sally Brown, Melinda Cairns, James Griffin, Frances Griffiths, Kirstie Haywood, Charles Hutchinson, Ranjit Lall, Stavros Petrou, Nigel Stallard, Colin Tysall, David A Walsh, Harbinder Sandhu
BACKGROUND: The National Institute for Health and Care Excellence (NICE) 2009 guidelines for persistent low back pain (LBP) do not recommend the injection of therapeutic substances into the back as a treatment for LBP because of the absence of evidence for their effectiveness. This feasibility study aimed to provide a stable platform that could be used to evaluate a randomised controlled trial (RCT) on the clinical effectiveness and cost-effectiveness of intra-articular facet joint injections (FJIs) when added to normal care...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28639041/long-term-outcomes-and-quality-of-life-after-surgical-or-conservative-treatment-of-benign-simple-liver-cysts
#7
Philip de Reuver, Izak van der Walt, Maria Albania, Jaswinder S Samra, Thomas J Hugh
BACKGROUND: Benign liver cysts are common and are often detected incidentally. Most patients do not require intervention. Occasionally, large dominant or multifocal small cysts cause symptoms as a result of rapid growth, secondary infection, intra-cystic bleeding or compression of adjacent organs. AIM: To compare presenting symptoms and outcomes of a consecutive series of patients with benign liver cysts treated either conservatively or by surgical intervention...
June 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28638663/acute-abdominal-compartment-syndrome-following-extraperitoneal-bladder-perforation
#8
Ana Licina
Extraperitoneal bladder perforation is a known complication of a commonly performed rigid cystoscopy. If unrecognized, this complication can lead to continuous intra-abdominal fluid leakage with consequent organ function impairment and symptoms. This is the first case report in literature of a transurethral bladder perforation causing an acute abdominal compartment syndrome, which was subsequently managed conservatively with supportive management only. Case Presentation. We describe a clinical course of a 73-year-old Caucasian female whose initial acute presentation involved urinary symptoms...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28633984/herbal-medicinal-products-in-pregnancy-which-data-are-available
#9
REVIEW
Jacqueline Wiesner, Werner Knöss
This review aims to highlight recent approaches concerning usage of (traditional) herbal medicinal products in pregnancy and to discuss appropriate strategies to handle limited information. Therefore, published monographs of the Committee on Herbal Medicinal products (HMPC) and selected publicly funded webpages, medicinal handbooks, publications and industry and health care organisations webpages were evaluated. While within the monographs of the HMPC a rather conservative approach could be found (mainly because of lacking nonclinical and/or clinical studies), all other sources display a wide variety of information or assessments, thereby often giving contradictory recommendations...
June 17, 2017: Reproductive Toxicology
https://www.readbyqxmd.com/read/28633147/tranexamic-acid-safely-reduced-blood-loss-in-hemi-and-total-hip-arthroplasty-for-acute-femoral-neck-fracture-a-randomized-clinical-trial
#10
Chad D Watts, Matthew T Houdek, S Andrew Sems, William W Cross, Mark W Pagnano
OBJECTIVES: We aimed to determine whether (1) tranexamic acid (TXA) reduces the incidence of transfusion (2) TXA reduces the calculated blood loss, and (3) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture (FNF). DESIGN: Prospective, double-blinded, randomized controlled trial. SETTING: Level 1 Academic Trauma Center. PATIENTS/PARTICIPANTS: One hundred thirty-eight patients who presented with a low-energy, isolated, FNF (AO 31B) treated with either hemi- or total hip arthroplasty within 72 hours of injury were randomized to either the TXA group (69 patients) or placebo group (69 patients)...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28631452/the-impact-of-the-anaesthetic-conserving-device-on-occupational-exposure-to-isoflurane-among-intensive-care-healthcare-professionals
#11
Jennifer Herzog-Niescery, Heike Vogelsang, Philipp Gude, Hans-Martin Seipp, Horst Bartz, Waldemar Uhl, Thomas P Weber, Martin Bellgardt
BACKGROUND: Use of Anesthetic Conserving Devices (ACD) for inhalational isoflurane sedation in intensive care units (ICU) has grown in recent years, and healthcare professionals are concerned about isoflurane pollution and exposure-related health risks. Real-time measurements to determine isoflurane exposure in ICU personnel during short-term patient care procedures and ACD handling have not yet been performed. METHODS: Isoflurane concentrations in the breathing zones of ICU staff (25 cm around the nose and mouth) were measured, by photoacoustic gas monitoring, during daily practice including tracheal suctioning, oral hygiene, body care, and patient positioning...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28630759/the-adult-cavus-foot
#12
Carlos Maynou, Christophe Szymanski, Alexis Thiounn
Cavovarus deformity can be classified by the severity of malalignment ranging from a subtle and flexible to a severe and fixed cavovarus deformity of the foot.In the mild cavovarus foot, careful clinical assessment is required to identify the deformity.Weight-bearing radiographs are necessary to indicate the apex of the deformity and quantify the correction required.Surgery is performed when conservative measures fail and various surgical procedures have been described, including a combination of soft-tissue releases, tendon transfers and osteotomies, all with the aim of achieving a plantigrade and balanced foot...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28630224/successful-conservative-treatment-of-severe-frostbite-lesions-in-a-greenlandic-inuit
#13
Martin Ekdahl, Luit Penninga
Frostbite may cause lesions. The severity ranges from superficial wounds to severe cases with loss of limbs and tissue. Hence, proper treatment is of utmost importance. We present a case of an 18-year-old man from Arctic Greenland who was admitted with severe frostbite lesions involving both hands. The patient had fallen asleep outside during extreme temperatures. He was treated conservatively with proper wound care, antibiotics and intensive physical therapy. The patient made a full recovery without sequelae...
June 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28629462/treatment-decisions-for-older-adults-with-advanced-chronic-kidney-disease
#14
REVIEW
Steven J Rosansky, Jane Schell, Joseph Shega, Jennifer Scherer, Laurie Jacobs, Cecile Couchoud, Deidra Crews, Matthew McNabney
Dialysis initiation rates among older adults, aged 75 years or greater, are increasing at a faster rate than for younger age groups. Older adults with advanced CKD (eGFR < 30 ml/min/1.73 m(2)) typically lose renal function slowly, often suffer from significant comorbidity and thus may die from associated comorbidities before they require dialysis.A patient's pattern of renal function loss over time in relation to their underlying comorbidities can serve as a guide to the probability of a future dialysis requirement...
June 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28627321/diabetes-knowledge-management-and-prevention-among-haitian-immigrants-in-philadelphia
#15
Rhoda K Moise, Donaldson F Conserve, Bilikisu Elewonibi, Lori A Francis, Rhonda BeLue
Purpose Guided by the PEN-3 Cultural Model, the purpose of this study is to generate culturally framed insight into diabetes knowledge, management, and prevention among Haitians. Despite the disproportionate distribution of type II diabetes mellitus among US minorities, limited research explores outcomes within racial ethnic groups. It is particularly important to disaggregate the large racial-ethnic groups of black given the population growth among foreign-born blacks, such as Haitians, whose population has more than quadrupled in recent decades...
June 1, 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28626382/a-symptomatic-coffee-bean-acute-sigmoid-volvulus
#16
Michael Scharl, Luc Biedermann
An acute sigmoid volvulus is due to the torsion of the sigmoid colon around its mesenteric axis. It mainly occurs in elderly patients and represents an abdominal emergency requiring urgent treatment. A 53-year-old male patient with severe craniocerebral injury and traumatic subarachnoidal bleeding 3 weeks prior presented on the ward with distended abdomen without abdominal pain, muscular defense, or resistances. He featured large volume diarrhea within the last few hours without signs of bleeding. A plain abdominal X-ray demonstrated a coffee bean sign indicating a sigmoid volvulus...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28625299/managing-major-obstetric-haemorrhage-pharmacotherapy-and-transfusion
#17
REVIEW
Rachel Collis, Emilia Guasch
Major obstetric haemorrhage is a leading cause of maternal mortality. A prescriptive approach to early recognition and management is critical to improving outcomes. Uterine atony is the primary cause of post-partum haemorrhage. First-line prevention and treatment include the administration of uterine tonic agents; other conservative measures include uterine cavity tamponade and uterine compression sutures. Interventional radiology procedures have been used for both prophylaxis and treatment, but a hysterectomy may be necessary if conservative measures fail...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28625141/bedaquiline-a-new-hope-for-shorter-and-better-anti-tuberculosis-regimens
#18
Niccolò Riccardi, Filippo Del Puente, Federica Magnè, Lucia Taramasso, Antonio Di Biagio
In 2014, an estimated 1.8 million people died from Mycobacterium tuberculosis (MTB); moreover, 680,000 people developed multidrug-resistant TB (MDR-TB). Currently available anti-MDR and XDR regimens are long-lasting and expensive, need high adherence and are undermined by a high frequency of adverse drug events, thus leading to a low success rate; moreover, in the last 50 years only two new molecules, bedaquiline (BDQ) and delamanid, have been approved and released for treatment of MDR-TB. BDQ is a diarylquinoline anti-mycobacterial drug, active regardless the state of MTB; in fact, its efficacy is conserved against replicating and non-replicating bacilli, despite extracellular or intracellular location...
June 19, 2017: Recent Patents on Anti-infective Drug Discovery
https://www.readbyqxmd.com/read/28624330/minimally-invasive-mitral-valve-annuloplasty-confers-a-long-term-survival-benefit-compared-with-state-of-the-art-treatment-in-heart-failure-with-functional-mitral-regurgitation
#19
Martin Penicka, Martin Kotrc, Tomas Ondrus, Yujing Mo, Filip Casselman, Marc Vanderheyden, Guy Van Camp, Frank Van Praet, Jozef Bartunek
BACKGROUND: Clinical impact of the minimally invasive surgical mitral valve annuloplasty (MVA) of functional mitral regurgitation (FMR) in systolic heart failure on top of the state-of-the-art standards of care remains controversial. Therefore, we aimed to compare clinical outcomes of isolated MVA using the mini-invasive videothoracoscopic approach versus the state-of-the-art (CON=conservative) treatment in patients with chronic systolic heart failure and symptomatic FMR. METHODS: The study population consisted of 379 patients (age 68...
June 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28623468/-intracranial-pressure-monitoring-in-polytrauma-patients-with-traumatic-brain-injury
#20
REVIEW
T Neubauer, W Buchinger, E Höflinger, J Brand
BACKGROUND: The monitoring of intracranial pressure (ICP) represents a cornerstone in the intensive care of patients with traumatic brain injury (TBI) and the industry provides various technical solutions to this end. Decompressive craniectomy can be an option if conservative measures fail to reduce excessive ICP. OBJECTIVE: To examine the pathophysiology of ICP in trauma, the management of polytrauma involving TBI, and the indications for decompressive craniectomy; and to compare the different monitoring systems and their complications...
June 16, 2017: Der Unfallchirurg
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