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https://www.readbyqxmd.com/read/28528478/the-diagnosis-and-management-of-a-vertebral-artery-loop-causing-cervical-radiculopathy
#1
L Wood, M Czyz, S Forster, Bronek M Boszczyk
BACKGROUND: Cervical radiculopathies are rarely caused by vertebral artery loop formation, which is estimated to be present in less than 3% of patients. It is uncertain what causes the loop formation: some propose an association with spondylotic changes or trauma, whilst others suggest hypertension and atherosclerosis may be responsible. CASE REPORT 1: A 35-year-old male patient presented with signs and symptoms of cervical radiculopathy that was not improved with anterior cervical discectomy and fusion surgery performed 2 years beforehand...
May 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28528388/fertility-sparing-for-young-patients-with-gynecologic-cancer-how-mri-can-guide-patient-selection-prior-to-conservative-management
#2
REVIEW
Sinead H McEvoy, Stephanie Nougaret, Nadeem R Abu-Rustum, Hebert Alberto Vargas, Elizabeth A Sadowski, Christine O Menias, Fuki Shitano, Shinya Fujii, Ramon E Sosa, Joanna G Escalon, Evis Sala, Yulia Lakhman
Historically, cancer treatment has emphasized measures for the "cure" regardless of the long-term consequences. Advances in cancer detection and treatment have resulted in improved outcomes bringing to the fore various quality of life considerations including future fertility. For many young cancer patients, fertility preservation is now an integral component of clinical decision-making and treatment design. Optimal fertility-sparing options for young patients with gynecologic cancer are influenced by patient age, primary cancer, treatment regimens, and patient preferences...
May 20, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28528376/isometric-handgrip-as-an-adjunct-for-blood-pressure-control-a-primer-for-clinicians
#3
REVIEW
Cheri L McGowan, David N Proctor, Ian Swaine, Robert D Brook, Elizabeth A Jackson, Phillip D Levy
Considered a global health crisis by the World Health Organization, hypertension (HTN) is the leading risk factor for death and disability. The majority of treated patients do not attain evidence-based clinical targets, which increases the risk of potentially fatal complications. HTN is the most common chronic condition seen in primary care; thus, implementing therapies that lower and maintain BP to within-target ranges is of tremendous public health importance. Isometric handgrip (IHG) training is a simple intervention endorsed by the American Heart Association as a potential adjuvant BP-lowering treatment...
June 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28528347/discriminative-accuracy-of-physician-and-nurse-predictions-for-survival-and-functional-outcomes-6-months-after-an-icu-admission
#4
Michael E Detsky, Michael O Harhay, Dominique F Bayard, Aaron M Delman, Anna E Buehler, Saida A Kent, Isabella V Ciuffetelli, Elizabeth Cooney, Nicole B Gabler, Sarah J Ratcliffe, Mark E Mikkelsen, Scott D Halpern
Importance: Predictions of long-term survival and functional outcomes influence decision making for critically ill patients, yet little is known regarding their accuracy. Objective: To determine the discriminative accuracy of intensive care unit (ICU) physicians and nurses in predicting 6-month patient mortality and morbidity, including ambulation, toileting, and cognition. Design, Setting, and Participants: Prospective cohort study conducted in 5 ICUs in 3 hospitals in Philadelphia, Pennsylvania, and enrolling patients who spent at least 3 days in the ICU from October 2013 until May 2014 and required mechanical ventilation, vasopressors, or both...
May 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28528329/the-interrater-reliability-of-the-autism-diagnostic-interview-revised-adi-r-in-clinical-settings
#5
Eric Zander, Charlotte Willfors, Steve Berggren, Christina Coco, Anette Holm, Ida Jifält, Renata Kosieradzki, Jenny Linder, Viviann Nordin, Karin Olafsdottir, Sven Bölte
BACKGROUND: The Autism Diagnostic Interview-Revised (ADI-R) is considered a first choice assessment tool in autism spectrum disorder. Nevertheless, despite its wide use in psychiatric practice and recommendations by various clinical guidelines, its interrater reliability has predominantly been confirmed in research settings by specially trained, research reliability interviewers. The reliability of ADI-R assessments among clinicians has not yet been established. Therefore, this study examined the spontaneous interrater reliability of the ADI-R in a naturalistic clinical multicenter setting...
May 20, 2017: Psychopathology
https://www.readbyqxmd.com/read/28528239/the-experiences-of-women-midwives-and-obstetricians-when-women-decline-recommended-maternity-care-a-feminist-thematic-analysis
#6
Bec Jenkinson, Sue Kruske, Sue Kildea
BACKGROUND: pregnant women, like all competent adults, have the right to refuse medical treatment, although concerns about maternal and fetal safety can make doing so problematic. Empirical research about refusal of recommended maternity care has mostly described the attitudes of clinicians, with women's perspectives notably absent. DESIGN: feminist thematic analysis of in-depth, semi-structured interviews with women's (n=9), midwives' (n=12) and obstetricians' (n=9) about their experiences of refusal of recommended maternity care...
May 11, 2017: Midwifery
https://www.readbyqxmd.com/read/28528237/skin-deformation-during-shoulder-movements-and-upper-extremity-activities
#7
Weiqing Ge, Alison Sfara, Brittany Hians
BACKGROUND: The necessity of sternal precautions for patients following cardiac surgery with median sternotomy has been questioned by clinicians, researchers, and even patients. The primary purpose was to determine if sternal skin deformation during shoulder movements and upper extremity activities is compressive or distractive and if there are any significant differences between the skin deformation at different positions during shoulder movements and upper extremity activities. The secondary purpose was to determine if sternal skin deformation is correlated with scapular stabilizer muscle strength...
May 12, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28528047/sclerosing-aortic-and-coronary-arteritis-due-to-igg4-related-disease
#8
Mikael Barbu, Ulf Lindström, Claes Nordborg, Andreas Martinsson, Christian Dworeck, Anders Jeppsson
We present the case of a 55-year-old woman admitted for a coronary artery bypass operation because of three-vessel coronary artery disease based on angiographic findings and clinical symptoms. Unexpected intraoperative findings with diffuse tissue thickening of the ascending aorta and coronary arteries indicated an alternate pathogenesis rather than coronary artery atherosclerosis. Histopathologic findings and clinical evaluation could confirm IgG4-related disease (IgG4-RD). IgG4-RD is a newly recognized fibroinflammatory condition that can present in a variety of organs and is characterized by common histopathologic features...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527833/evaluation-of-the-sipat-instrument-to-assess-psychosocial-risk-in-heart-transplant-candidates-a-retrospective-single-center-study
#9
Elizabeth Vandenbogaart, Lynn Doering, Belinda Chen, Ann Saltzman, Tamara Chaker, Julie W Creaser, Darlene Rourke, Richard W Cheng, Gregg C Fonarow, Mario Deng
OBJECTIVES: We evaluated the reliability of the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) in heart transplant (HT) recipients and explored its usefulness in predicting post-transplant outcomes. BACKGROUND: Pre-transplant psychosocial and behavioral risk is associated with post-transplant clinical outcomes. SIPAT is a risk assessment tool created for pre-transplant psychosocial evaluation. METHODS: Via retrospective chart review, three examiners applied the SIPAT to 51 adult HT recipients...
May 17, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28527643/parental-knowledge-and-recall-of-concussion-discharge-instructions
#10
Danny George Thomas, Lia Bradley, Ashley Servi, Suzanne Reilly, Jennifer Niskala Apps, Michael McCrea, Thomas Hammeke
INTRODUCTION: Children increasingly are being seen in the emergency department for a concussion, or mild traumatic brain injury (mTBI). A key aim of the ED visit is to provide discharge advice that can help parents to identify an evolving neurosurgical crisis, facilitate recovery, and prevent reinjury. The present study examined parents' knowledge of symptoms and recall of discharge instructions after their adolescent's mTBI and the effect of supplementing written discharge instructions with verbal instruction and reinforcement...
May 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28527499/it-is-from-mars-and-physicians-from-venus-bridging-the-gap
#11
REVIEW
Mark E Huang
With increasing adoption of electronic health records (EHRs) and legislative mandates for its use within the United States, collaboration between physicians and information technology (IT) staff is essential. Current challenges that physicians face include addressing EHR usability, system performance, adequate training, issue resolution, regulatory compliance, and lack of awareness of IT roles. These challenges lead to gaps in communication between clinicians and IT staff. Strategies to improve collaboration between physicians and IT staff include increasing physician involvement with health information technology software development, involvement with legislative regulations and standards, IT project implementation, as well as system stabilization and optimization...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28527263/-racemose-neurocysticercosis-neuroimaging-guides-the-diagnosis
#12
Carlos Hugo Zapata, Sergio Alberto Vargas, Carlos Santiago Uribe
Neurocysticercosis is the leading cause of parasitosis of the central nervous system and acquired epilepsy in developing countries. The clinical manifestations of neurocysticercosis, especially its racemose variant, are pleomorphic and unspecific, characteristics that hinder the diagnosis and make it a challenge for the clinician.The objective of this report was to describe two cases of racemose neurocysticercosis in which neuroimaging led to the definitive diagnosis. The first case involved a patient with persistent headache and focal neurological signs...
April 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28527069/clinical-and-psychosocial-features-of-frequent-relapsers-fr-among-patients-with-chronic-migraine-and-medication-overuse
#13
Alberto Raggi, Licia Grazzi, Roberta Ayadi, Matilde Leonardi, Alberto Proietti, Silvia Schiavolin, Chiara Scaratti, Susanna Usai, Domenico D'Amico
The objective was to characterize frequent relapsers (FR)-i.e. those requiring two or more withdrawals in a 3-year period-in a sample of 188 patients with chronic migraine with medication overuse (CM-MO). We tested differences between FR and non-FR for age, gender, employment status, days with headache, headache severity, type of overused medication, BDI-II, WHODAS 2.0 and MSQ. 30.8% of participants were FR: they were more frequently treated as inpatients and living alone, had a lower education, higher disability and lower QoL, higher frequency and intensity of headaches, and higher depression scores...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28526915/dietary-behaviors-in-psoriasis-patient-reported-outcomes-from-a-u-s-national-survey
#14
Ladan Afifi, Melissa J Danesh, Kristina M Lee, Kevin Beroukhim, Benjamin Farahnik, Richard S Ahn, Di Yan, Rasnik K Singh, Mio Nakamura, John Koo, Wilson Liao
INTRODUCTION: Psoriasis patients demonstrate high interest in the role of diet on their skin condition. However, data are lacking to describe dietary interventions among psoriasis patients and associated outcomes. This study aims to identify common dietary habits, interventions and perceptions among patients with psoriasis, and to examine patient-reported skin outcomes in response to these interventions. METHODS: We administered a 61-question survey to the National Psoriasis Foundation membership asking psoriasis patients about dietary habits, modifications, skin responses, and perceptions...
May 19, 2017: Dermatology and Therapy
https://www.readbyqxmd.com/read/28526719/management-of-treatment-related-adverse-events-with-agents-targeting-the-mapk-pathway-in-patients-with-metastatic-melanoma
#15
Adil Daud, Katy Tsai
Tremendous progress has been made in the clinical landscape of advanced-stage BRAF V600-mutant melanoma treatment over the past 5 years. Targeted therapies that inhibit specific steps of the mitogen-activated protein kinase pathway have been shown to provide significant overall treatment benefit in patients with this difficult-to-treat disease. Combination therapy with BRAF and MEK inhibitors (dabrafenib plus trametinib or vemurafenib plus cobimetinib, respectively) has become standard of care. These agents are administered until disease progression or unacceptable toxicity occurs; thus, some patients may remain on maintenance therapy for an extended period of time, while toxicities may result in early discontinuation in other patients...
May 18, 2017: Oncologist
https://www.readbyqxmd.com/read/28526675/iterative-user-interface-design-for-automated-sequential-organ-failure-assessment-score-calculator-in-sepsis-detection
#16
Christopher Ansel Aakre, Jaben E Kitson, Man Li, Vitaly Herasevich
BACKGROUND: The new sepsis definition has increased the need for frequent sequential organ failure assessment (SOFA) score recalculation and the clerical burden of information retrieval makes this score ideal for automated calculation. OBJECTIVE: The aim of this study was to (1) estimate the clerical workload of manual SOFA score calculation through a time-motion analysis and (2) describe a user-centered design process for an electronic medical record (EMR) integrated, automated SOFA score calculator with subsequent usability evaluation study...
May 18, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28526667/patient-centered-decision-support-formative-usability-evaluation-of-integrated-clinical-decision-support-with-a-patient-decision-aid-for-minor-head-injury-in-the-emergency-department
#17
Edward R Melnick, Erik P Hess, George Guo, Maggie Breslin, Kevin Lopez, Anthony J Pavlo, Fuad Abujarad, Seth M Powsner, Lori A Post
BACKGROUND: The Canadian Computed Tomography (CT) Head Rule, a clinical decision rule designed to safely reduce imaging in minor head injury, has been rigorously validated and implemented, and yet expected decreases in CT were unsuccessful. Recent work has identified empathic care as a key component in decreasing CT overuse. Health information technology can hinder the clinician-patient relationship. Patient-centered decision tools to support the clinician-patient relationship are needed to promote evidence-based decisions...
May 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28526631/mating-strategies-and-sexual-functioning-in-personality-disorders-a%C3%A2-comprehensive-review-of-literature
#18
REVIEW
Alberto Collazzoni, Giacomo Ciocca, Erika Limoncin, Carmela Marucci, Daniele Mollaioli, Stefania Di Sante, Giorgio Di Lorenzo, Cinzia Niolu, Alberto Siracusano, Mario Maggi, Giovanni Castellini, Alessandro Rossi, Emmanuele A Jannini
INTRODUCTION: Personality disorders impair several aspects of intrapsychic and interpersonal life. In particular, mating strategies and sexual functioning could manifest in different and/or dysfunctional ways in people with personality disorders. AIM: To describe, through a comprehensive review of the literature, the mating strategies and sexual functioning in patients with personality disorders. METHODS: We listed and discussed the principal studies on the relation between mating strategies and sexual functioning in personality disorders...
May 16, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28526598/breathe-easy-5-steps-to-better-breathing-with-your-metered-dose-inhaler-mdi
#19
Evan H Allie, Ellen B O'Kelley, Katie H Fischesser, Lawrence B Stack, Donald H Arnold
Proper use of the metered-dose inhaler (MDI) is essential for medications to prevent and treat acute asthma exacerbations. This training video teaches children and clinicians correct technique for MDI use.
May 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28526452/gestational-age-at-initiation-of-17-alpha-hydroxyprogesterone-caproate-and-recurrent-preterm-birth
#20
Angela Ning, Catherine J Vladutiu, Sarah K Dotters-Katz, William H Goodnight, Tracy A Manuck
BACKGROUND: Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality in non-anomalous neonates in the US. Women with a previous early spontaneous PTB are at highest risk for recurrence. Weekly intramuscular 17-alpha hydroxyprogesterone caproate (17-OHPC) reduces the risk of recurrent prematurity. Though current guidelines recommend 17-OHPC initiation between 16-20 weeks', in clinical practice, 17-OHPC is started across a spectrum of gestational ages. OBJECTIVE: To examine the relationship between the gestational age at 17-OHPC initiation and recurrent PTB among women a prior spontaneous PTB 16-28 weeks' gestation...
May 16, 2017: American Journal of Obstetrics and Gynecology
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