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Uri Alkan, Yotam Shkedy, Aviram Mizrachi, Thomas Shpitzer, Aron Popovtzer, Gideon Bachar
OBJECTIVE: To determine the risk of inflammation associated with fine-needle aspiration during evaluation of Warthin's tumour. DESIGN: Retrospective case series. SETTING: Tertiary medical center. PARTICIPANTS: All patients who underwent fine-needle aspiration followed by parotidectomy between1992-2009 for the diagnosis/evaluation of a parotid gland tumour. MAIN OUTCOME MEASURE: Rate of fine-needle-aspiration-related parotitis in patients with Warthin's tumour or other parotid pathologies...
February 24, 2017: Clinical Otolaryngology
Luis N Gonzalez Castro, Jaideep H Mehta, Jordan B Brayanov, Gary J Mullen
BACKGROUND: Pre-operative administration of benzodiazepines can cause hypoventilation-a decrease in minute ventilation (MV)-commonly referred to as "respiratory compromise or respiratory depression." Respiratory depression can lead to hypercarbia and / or hypoxemia, and may heighten the risk of other respiratory complications. Current anesthesia practice often places patients at risk for respiratory complications even before surgery, as respiratory monitoring is generally postponed until the patient is in the operating room...
2017: PloS One
Benoit Visseaux, Gilles Collin, Houria Ichou, Charlotte Charpentier, Samia Bendhafer, Madalina Dumitrescu, Lahcene Allal, Bogdan Cojocaru, Luc Desfrère, Diane Descamps, Laurent Mandelbrot, Nadhira Houhou-Fidouh
BACKGROUND: To date, only influenza and RSV testing are recommended for respiratory viruses' detection in paediatric units. In this study, we described, according to seasons, ages and clinical units, the results obtained in children (<15 years old) by multiplex-PCR (mPCR) tests allowing a quick and wide range detection of all respiratory viruses. These results were also compared with RSV specific detection. METHODS: All nasopharyngeal mPCR and RSV tests requested by clinicians in our French teaching hospitals group between 2011 and 2014 were retrospectively included...
2017: PloS One
Juhye Lena Kim, Edmund F La Gamma, Todd Estabrook, Necla Kudrick, Bistra B Nankova
Recurrent hypoglycemia can occur as a major complication of insulin replacement therapy, limiting the long-term health benefits of intense glycemic control in type 1 and advanced type 2 diabetic patients. It impairs the normal counter-regulatory hormonal and behavioral responses to glucose deprivation, a phenomenon known as hypoglycemia associated autonomic failure (HAAF). The molecular mechanisms leading to defective counter-regulation are not completely understood. We hypothesized that both neuronal (excessive cholinergic signaling between the splanchnic nerve fibers and the adrenal medulla) and humoral factors contribute to the impaired epinephrine production and release in HAAF...
2017: PloS One
Sophie E R Horbach, Dirk T Ubbink, Fabienne E Stubenrouch, Mark J W Koelemay, Carine J M van der Vleuten, Bas H Verhoeven, Jim A Reekers, Leo J Schultze Kool, Chantal M A M van der Horst
BACKGROUND: In shared decision-making, clinicians and patients arrive at a joint treatment decision, by incorporating best available evidence and the patients' personal values and preferences. Little is known about the role of shared decision-making in managing patients with congenital vascular malformations, for which preference-sensitive decision-making seems obvious. The authors investigated preferences regarding decision-making and current shared decision-making behavior during physician-patient encounters...
March 2017: Plastic and Reconstructive Surgery
Russell C Dale, Mark P Gorman, Ming Lim
PURPOSE OF REVIEW: Auto-antibodies that bind to conformational extracellular epitopes of neuronal receptors or synaptic proteins have provided clinicians with essential biomarkers in acute neurology. This review summarizes the current status and challenges in the field. RECENT FINDINGS: In children, anti-N-methyl-D-aspartate receptor encephalitis remains the most identifiable autoimmune encephalitis, although many patients have a clinical syndrome of brain inflammation in which no antibodies are identified...
February 22, 2017: Current Opinion in Neurology
Ellen T Kurtzman, Burt S Barnow
BACKGROUND: Under the Affordable Care Act, the number and capacity of community health centers (HCs) is growing. Although the majority of HC care is provided by primary care physicians (PCMDs), a growing proportion is delivered by nurse practitioners (NPs) and physician assistants (PAs); yet, little is known about how these clinicians' care compares in this setting. OBJECTIVES: To compare the quality of care and practice patterns of NPs, PAs, and PCMDs in HCs. RESEARCH DESIGN: Using 5 years of data (2006-2010) from the HC subsample of the National Ambulatory Medical Care Survey and multivariate regression analysis, we estimated the impact of receiving NP-delivered or PA-delivered care versus PCMD-delivered care...
February 23, 2017: Medical Care
Kimberley J Haines, Phillipa Kelly, Peter Fitzgerald, Elizabeth H Skinner, Theodore J Iwashyna
OBJECTIVE: There is growing interest in patient and family participation in critical care-not just as part of the bedside, but as part of educational and management organization and infrastructure. This offers tremendous opportunities for change but carries risk to patients, families, and the institution. The objective is to provide a concise definitive review of patient and family organizational participation in critical care as a high-risk population and other vulnerable groups. A pragmatic, codesigned model for critical care is offered as a suggested approach for clinicians, researchers, and policy-makers...
February 23, 2017: Critical Care Medicine
Miriam Ting, Matthew S Tenaglia, Gary H Jones, Jon B Suzuki
OBJECTIVES: The objective of this systematic review was to perform a comprehensive overview of systematic reviews and meta-analyses of surgical and patient factors affecting marginal bone loss around osseointegrated dental implants in humans. MATERIAL AND METHODS: Electronic databases were searched for systematic reviews and meta-analyses published up to November 2015. RESULTS: Of the 41 articles selected, 11 evaluated implant factors, 10 evaluated patient factors, 19 evaluated surgical protocol-related factors, and one evaluated all three factors...
February 23, 2017: Implant Dentistry
Elaine Chang, Anita L Sabichi, Yvonne H Sada
Checkpoint inhibitors have become standard therapy for multiple cancers, and their use will increase in the next year as regulatory approvals for additional indications are expected. It is essential for clinicians to be aware of the potential for rare immune-related adverse effects. Here, we report the case of a new diagnosis of myasthenia gravis (MG) after the use of nivolumab for squamous cell carcinoma of the bladder. A review the literature identified 10 cases of MG diagnosed after programmed cell death protein 1 inhibitor therapy...
February 23, 2017: Journal of Immunotherapy
John Torous, Joseph Firth, Nora Mueller, J P Onnela, Justin T Baker
The increasing prevalence of mobile devices among patients of all demographic groups has the potential to transform the ways we diagnose, monitor, treat, and study mental illness. As new tools and technologies emerge, clinicians and researchers are confronted with an increasing array of options both for clinical assessment, through digital capture of the essential behavioral elements of a condition, and for intervention, through formalized treatments, coaching, and other technology-assisted means of patient communication...
February 23, 2017: Harvard Review of Psychiatry
Siu W Tang, Wayne H Tang, Brian E Leonard
Polypharmacy is common in psychiatry. Usage of cognitive enhancers is increasing in the psychiatric population. Many clinicians are not familiar with these new psychoactive compounds. This paper reviews the potential drug-drug interactions when these cognitive enhancers are used together with psychotropic drugs and their confounding effects on diagnosis and clinical management.
February 23, 2017: International Clinical Psychopharmacology
Laura Churchill, Samuel J Malian, Bert M Chesworth, Dianne Bryant, Steven J MacDonald, Jacquelyn D Marsh, J Robert Giffin
BACKGROUND: In previous studies, 50%-70% of patients referred to orthopedic surgeons for total knee replacement (TKR) were not surgical candidates at the time of initial assessment. The purpose of our study was to identify and cross-validate patient self-reported predictors of suitability for TKR and to determine the clinical utility of a predictive model to guide the timing and appropriateness of referral to a surgeon. METHODS: We assessed pre-consultation patient data as well as the surgeon's findings and post-consultation recommendations...
December 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Gail L McGlothlen, Lori Rodriguez
OBJECTIVES: This study describes the training, experience with pocket fills, and life-long learning behaviors in a national sample of health care professionals who perform the reservoir refill procedure and compares results with intraspinal drug delivery morbidity and mortality clinical practice guidelines to demonstrate the need for standardized training. METHODS: Using a cross-sectional, descriptive design and a 23-item questionnaire administered via social media, 65 health care professionals who performed the reservoir refill procedure within the last year were surveyed...
February 24, 2017: Neuromodulation: Journal of the International Neuromodulation Society
Jasmeet P Hayes, Mark W Logue, Andrew Reagan, David Salat, Erika J Wolf, Naomi Sadeh, Jeffrey M Spielberg, Emily Sperbeck, Scott M Hayes, Regina E McGlinchey, William P Milberg, Mieke Verfaellie, Annjanette Stone, Steven A Schichman, Mark W Miller
BACKGROUND: Memory-based alterations are among the hallmark symptoms of posttraumatic stress disorder (PTSD) and may be associated with the integrity of the hippocampus. However, neuroimaging studies of hippocampal volume in individuals with PTSD have yielded inconsistent results, raising the possibility that various moderators, such as genetic factors, may influence this association. We examined whether the catechol-O-methyltransferase (COMT) Val158Met polymorphism, which has previously been shown to be associated with hippocampal volume in healthy individuals, moderates the association between PTSD and hippocampal volume...
January 31, 2017: Journal of Psychiatry & Neuroscience: JPN
Jon Harrison, Michael J Pucci, Scott W Cowan, Charles J Yeo
The life and work of Dr. Lyon Henry Appleby, M.D., portrays the essence of a devoted clinician committed to scholarly excellence. Born in Deseronto, Ontario, in 1895 and passing in 1970, Dr. Appleby influenced all areas of general surgery, most notably popularizing a procedure that bears his name today. After a tour in World War I, he quickly proved himself to be a dedicated clinician with roots in academia, which translated into excellence within the Department of Surgery at St. Paul's Hospital in Vancouver, Canada...
December 1, 2016: American Surgeon
Oshri Wasserzug, Israel Kaffe, Towy Sorel Lazarovici, Tal Weissman, Ran Yahalom, Dan M Fliss, Noam Yarom
BACKGROUND: The use of bisphosphonates is very common among patients with osteoporosis and multiple myeloma as well as those with bone metastases from various malignancies. The benefits of bisphosphonates are well recognized, but it became evident during the past decade that these medications portend the major adverse effect of osteonecrosis of the jaw, known as bisphosphonate-related osteonecrosis of the jaw. OBJECTIVE: Our aim was to evaluate the specific manifestations of bisphosphonate use on the maxillary sinus in patients with documented bisphosphonate-related osteonecrosis of the jaw...
January 1, 2017: American Journal of Rhinology & Allergy
Ahmed Sharata, Tracy L Kelly, Yelena Rozenfeld, Chet W Hammill, Earl Schuman, James R Carlisle, Shaghayegh Aliabadi-Wahle
The failure to follow national guidelines in management of various diseases has been previously established. We sought to quantify primary care providers' familiarity with primary hyperparathyroidism as it affects adherence to the 2009 National Institute of Health (NIH) consensus recommendations in treatment of primary hyperparathyroidism. A large primary care group was surveyed to determine their familiarity with the 2009 NIH consensus recommendations for management of primary hyperparathyroidism (PHPT). Retrospective review of the group's records (2009-2011) was performed to verify compliance...
January 1, 2017: American Surgeon
Gretchen A Voge, William A Carey, Euijung Ryu, Katherine S King, Chung-Il Wi, Young J Juhn
BACKGROUND: Although results of many studies have indicated an increased risk of asthma in former late preterm (LPT) infants, most of these studies did not fully address covariate imbalance. OBJECTIVE: To compare the cumulative frequency of asthma in a population-based cohort of former LPT infants to that of matched term infants in their early childhood, when accounting for covariate imbalance. METHODS: From a population-based birth cohort of children born 2002-2006 in Olmsted County, Minnesota, we assessed a random sample of LPT (34 to 36 6/7 weeks) and frequency-matched term (37 to 40 6/7 weeks) infants...
March 1, 2017: Allergy and Asthma Proceedings:
Nilamben Patel, Linda Herbert, Todd D Green
BACKGROUND: As the prevalence of food allergy has risen among children and young adults, both in the United States and around the world, investigators have become increasingly aware of the daily emotional toll on patients and their families of living with food allergy. OBJECTIVE: To review the literature regarding the emotional, social, and financial impact of food allergy on pediatric patients and their families, and to provide evidence-based suggestions for clinicians on how to most effectively address these issues...
March 1, 2017: Allergy and Asthma Proceedings:
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