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https://www.readbyqxmd.com/read/28239996/re-presentations-and-recurrent-events-following-initial-management-of-the-acute-paediatric-scrotum-a-5-year-review
#1
Shareena Lala, Neil Price, Vipul Upadhyay
BACKGROUND: Previous reviews report relatively low rates of post-operative complications for acute scrotal exploration. The aim of this study was to evaluate the re-presentation to hospital in boys with previous acute scrotal pathology, reviewing contralateral symptoms, post-operative complications, testicular torsion following fixation and failure of conservative management of testicular appendage (TA) torsion. METHODS: All boys under 16 years presenting to our unit with an acute scrotum from January 2008 to December 2012 (5-year period) were identified...
February 27, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28239760/incidence-and-outcome-of-acute-cardiorenal-syndrome-in-hospitalized-children
#2
Vivek Athwani, Maneesha Bhargava, Rahul Chanchlani, Amar Jeet Mehta
OBJECTIVES: To determine the incidence, etiology and outcome of Cardiorenal syndrome (CRS) in hospitalized children. METHODS: A prospective cohort study was carried out in 242 children between 6 mo to 18 y of age hospitalized with primary cardiac, renal or any systemic disorder at a tertiary care center in India. The primary outcome was the development of CRS. Univariate and multivariate logistic regression analysis were performed to determine the risk of mortality secondary to CRS...
February 27, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28239497/predictive-factors-for-a-long-hospital-stay-in-patients-undergoing-laparoscopic-cholecystectomy
#3
Wasana Ko-Iam, Trichak Sandhu, Sahattaya Paiboonworachat, Paisal Pongchairerks, Anon Chotirosniramit, Narain Chotirosniramit, Kamtone Chandacham, Tidarat Jirapongcharoenlap, Sunhawit Junrungsee
Background. Although the advantages of laparoscopic cholecystectomy (LC) over open cholecystectomy are immediately obvious and appreciated, several patients need a postoperative hospital stay of more than 24 hours. Thus, the predictive factors for this longer stay need to be investigated. The aim of this study was to identify the causes of a long hospital stay after LC. Methods. This is a retrospective cohort study with 500 successful elective LC patients being included in the analysis. Short hospital stay was defined as being discharged within 24 hours after the operation, whereas long hospital stay was defined as the need for a stay of more than 24 hours after the operation...
2017: International Journal of Hepatology
https://www.readbyqxmd.com/read/28239475/long-term-cognitive-outcomes-among-unselected-ventilated-and-non-ventilated-icu-patients
#4
José Raimundo A de Azevedo, Widlani Sousa Montenegro, Djane Pereira Rodrigues, Suellen C de C Souza, Vanessa F S Araujo, Margareth Pereira de Paula, Patricia H C P Prazeres, Adenilde da Luz Leitão, Adriana V N Mendonça
BACKGROUND: Cognitive dysfunction is an important long-term complication of critical illness associated with reduced quality of life, increase in healthcare costs, and institutionalization. Delirium, an acute form of brain dysfunction that is common during critical illness has been shown to be associated with long-term cognitive dysfunction. The aim of this prospective cohort study was to estimate the prevalence and severity of cognitive dysfunction in an unselected population of medical and surgical ICU patients...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28239179/unsuspected-lung-pathology-in-autopsies-of-children-with-cancer
#5
María Elena Y Furuya, Alicia Rodríguez-Velasco, María Carmen Rodríguez-Zepeda, Enrique López-Aguilar, Mario H Vargas, Martha Sciandra-Rico, Rocío Cárdenas-Navarrete, Olivia Madrigal-Muñiz, Carina Feria-Kaiser, Elba E Delgado-González, Miguel Ángel Villasís-Keeverz
BACKGROUND: Although pulmonary involvement is common in patients with cancer, its frequency and nature is seldom reported in the medical literature. OBJECTIVE: To determine the frequency and type of lung pathological conditions revealed by autopsy in children with cancer. METHODS: All reports from autopsies performed in children with cancer from 1989 to 2012 in a pediatric hospital were reviewed. RESULTS: In the analyzed period, 118 autopsies (10...
January 2017: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
https://www.readbyqxmd.com/read/28238711/efficacy-and-safety-of-ticagrelor-versus-aspirin-in-acute-stroke-or-transient-ischaemic-attack-of-atherosclerotic-origin-a-subgroup-analysis-of-socrates-a-randomised-double-blind-controlled-trial
#6
Pierre Amarenco, Gregory W Albers, Hans Denison, J Donald Easton, Scott R Evans, Peter Held, Michael D Hill, Jenny Jonasson, Scott E Kasner, Per Ladenvall, Kazuo Minematsu, Carlos A Molina, Yongjun Wang, K S Lawrence Wong, S Claiborne Johnston
BACKGROUND: Ticagrelor is an effective antiplatelet therapy for patients with coronary atherosclerotic disease and might be more effective than aspirin in preventing recurrent stroke and cardiovascular events in patients with acute cerebral ischaemia of atherosclerotic origin. Our aim was to test for a treatment-by-ipsilateral atherosclerotic stenosis interaction in a subgroup analysis of patients in the Acute Stroke or Transient Ischaemic Attack Treated with Aspirin or Ticagrelor and Patient Outcomes (SOCRATES) trial...
February 23, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28238693/digital-rectal-examination-reduces-hospital-admissions-endoscopies-and-medical-therapy-in-patients-with-acute-gastrointestinal-bleeding
#7
Manish P Shrestha, Mark Borgstrom, Eugene Trowers
BACKGROUND: Although digital rectal examination is an established part of physical examination in patients with acute gastrointestinal bleeding, clinicians are reluctant to perform rectal examination. We intended to assess if rectal examination affects the clinical management decision in these patients. STUDY: We performed a single-center, retrospective, cross-sectional study using data from electronic health record of patients ≥18 years old presenting to emergency with acute gastrointestinal bleeding...
February 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28238691/early-invasive-versus-initial-conservative-strategies-for-women-with-non-st-elevation-acute-coronary-syndromes-propensity-matched-analysis
#8
Islam Y Elgendy, Ahmed N Mahmoud, Hend Mansoor, Anthony A Bavry
BACKGROUND: Studies conducted largely in men have shown improved outcomes with an early invasive strategy with non-ST-elevation acute coronary syndrome. In contrast, data have been less conclusive in women, with some trials demonstrating potential harm. This study aims to assess if an early invasive strategy in women is associated with better outcomes in real world data. METHODS: Women admitted with a primary diagnosis of non-ST-elevation myocardial infarction or unstable angina were identified from the National Inpatient Sample years 2012-2013...
February 24, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28238636/-kawasaki-disease-is-more-prevalent-in-rural-areas-of-catalonia-spain
#9
Judith Sánchez-Manubens, Jordi Antón, Rosa Bou, Estibaliz Iglesias, Joan Calzada-Hernandez, Xavier Rodó, Josep-Antón Morguí
INTRODUCTION: Kawasaki disease (KD) is an acute self-limited systemic vasculitis relatively common in childhood. The etiology of KD is still unknown, although clinical, laboratory and epidemiological features suggest an infectious origin or trigger. Differences on incidence between countries have been related to specific genetic factors, ethnicity, country of birth and some other sociocultural and environmental factors. We present a population-based study on incidence of KD in Catalonia (Spain), focusing on differences between patients in rural and non-rural areas of the region...
February 23, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28238528/impact-of-insurance-precertification-on-discharge-of-stroke-patients-to-acute-rehabilitation-or-skilled-nursing-facility
#10
Andrew L Smith, Ashish Kulhari, Julie A Wolfram, Anthony Furlan
BACKGROUND AND PURPOSE: The purpose of this study is to determine if the common insurance practice of requiring precertification before a medically ready stroke patient can be discharged to a skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF) causes a delay in discharge. Eliminating delays in discharge of stroke patients is important given the increasing demands for health-care efficiency after the passage of the Affordable Health Care Act. METHODS: A retrospective chart review of 1007 patients who were admitted to our comprehensive stroke center with the primary diagnosis of stroke over a 12-month period was performed...
February 23, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28238522/endovascular-thrombectomy-and-medical-therapy-versus-medical-therapy-alone-in-acute-stroke-a-randomized-care-trial
#11
Naim N Khoury, Tim E Darsaut, Jimmy Ghostine, Yan Deschaintre, Nicole Daneault, André Durocher, Sylvain Lanthier, Alexandre Y Pope, Céline Odier, Louise-Hélène Lebrun, François Guilbert, Jean-Christophe Gentric, André Batista, Alain Weill, Daniel Roy, Serge Bracard, Jean Raymond
BACKGROUND: Until recently, the benefits of endovascular treatment in stroke were not proven. Care trials have been designed to simultaneously offer yet-to-be validated interventions and verify treatment outcomes. Our aim was to implement a care trial for patients with acute ischemic stroke. METHODS: The study was offered to all patients considered for endovascular management of acute ischemic stroke in one Canadian hospital. Inclusion criteria were broad: onset of symptoms≤5h or at any time in the presence of clinical-imaging mismatch and suspected or demonstrated proximal large vessel occlusion...
February 23, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28238331/prognostic-value-of-blood-glucose-in-emergency-room-and-glycosylated-hemoglobin-in-patients-who-have-suffered-an-acute-cerebro-vascular-event
#12
Ander Ernaga Lorea, María Cecilia Hernández Morhain, María Dolores Ollero García-Agulló, Juan Pablo Martínez de Esteban, Ana Iriarte Beroiz, Jaime Gállego Culleré
BACKGROUND AND OBJECTIVE: Stress hyperglycemia has been associated with a worse prognosis in patients hospitalized in critical care units. The aim of this study is to evaluate the impact of blood glucose and glycosylated hemoglobin (HbA1c) levels on the mortality of patients suffering a acute cerebro-vascular event, and to determine if this relationship depends on the presence of diabetes. MATERIAL AND METHODS: A retrospective analysis of 255 patients admitted to the ER for stroke was performed...
February 18, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28238221/acquisition-of-involuntary-spinal-locomotion-spinal-walking-in-dogs-with-irreversible-thoracolumbar-spinal-cord-lesion-81-dogs
#13
A Gallucci, L Dragone, M Menchetti, T Gagliardo, M Pietra, M Cardinali, G Gandini
BACKGROUND: Spinal walking (SW) is described as the acquisition of an involuntary motor function in paraplegic dogs and cats without pain perception affected by a thoracolumbar lesion. Whereas spinal locomotion is well described in cats that underwent training trials after experimental spinal cord resection, less consistent information is available for dogs. HYPOTHESIS: Paraplegic dogs affected by a thoracolumbar complete spinal cord lesion undergoing intensive physical rehabilitation could acquire an autonomous SW gait under field conditions...
February 26, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28238158/acute-kidney-injury-during-a-pediatric-sickle-cell-vaso-occlusive-pain-crisis
#14
Sujatha Baddam, Inmaculada Aban, Lee Hilliard, Thomas Howard, David Askenazi, Jeffrey D Lebensburger
BACKGROUND: Patients who develop sickle cell disease (SCD) nephropathy are at a high risk for mortality. The pathophysiology of vaso-occlusive pain crisis may contribute to acute kidney injury (AKI). Non-steroidal anti-inflammatory drugs, known inducers of AKI, are used to treat pain crises. Multiple gaps exist in the knowledge about the impact of AKI in SCD. METHODS: We conducted a 2-year retrospective review of AKI events in patients admitted for vaso-occlusive crisis...
February 25, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28238002/risk-factors-for-worsening-of-acute-pancreatitis-in-patients-admitted-with-mild-acute-pancreatitis
#15
Zhouxiang Jin, Lubai Xu, Xiangyu Wang, Dinghua Yang
BACKGROUND The aim of the present study was to investigate risk factors for developing more severe pancreatitis, including moderately severe (MSAP) and severe acute pancreatitis (SAP), in patients admitted with mild acute pancreatitis (MAP). MATERIAL AND METHODS Patients admitted with MAP to our hospital from March 2013 to May 2016 were included and prospectively evaluated. Possible risk factors for developing MSAP or SAP were age, blood glucose level on admission, etiology, sex, Ranson score, amylase level, Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores, C-reactive protein (CRP) level, serum calcium level, visceral fat area (VFA), body mass index (BMI), whether this was the first episode of AP, and method of administration of octreotide...
February 26, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28237986/relationship-among-mortality-of-patients-with-acute-kidney-injury-after-cardiac-surgery-fluid-balance-and-ultrafiltration-of-renal-replacement-therapy-an-observational-study
#16
Buyun Wu, Jian Sun, Si Liu, Xiangbao Yu, Yamei Zhu, Huijuan Mao, Changying Xing
BACKGROUND/AIMS: The study aimed to investigate the relationship among mortality of patients with cardiac surgery-associated acute kidney injury (CSA-AKI), fluid balance, and ultrafiltration of renal replacement therapy (RRT). METHODS: From January 2009 to October 2015, hospitalized patients with CSA-AKI receiving continuous or prolonged intermittent RRT were screened. The effects of fluid balance and ultrafiltration of RRT on clinical outcome were analyzed. RESULTS: The 30-day mortality of all the 63 patients in the study was 58...
February 25, 2017: Blood Purification
https://www.readbyqxmd.com/read/28237737/data-from-the-german-chest-pain-unit-registry-the-well-known-gap-between-knowledge-and-practice
#17
EDITORIAL
Daniel Fernández-Bergés
In-hospital mortality of acute myocardial infarction with ST segment elevation remains high and is influenced by many factors, some of which are modifiable such as time to treatment initiation and modality of treatment. It is well established that reperfusion therapy is the gold-standard in the management of ST-elevation acute myocardial infarction. Despite recent developments and clear, comprehensible guidelines recommendations, it remains difficult to disseminate this knowledge to medical practitioners. The German Chest Pain Unit shows that the best door-to-balloon time is reached when patients contact the Emergency Medical Systems (EMS) directly, rather than when referred by the general practitioner (GP), or are transferred from another hospital, or present as a self-referral...
February 13, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28237735/emergency-medical-dispatch-priority-in-chest-pain-patients-due-to-life-threatening-conditions-a-cohort-study-examining-circadian-variations-and-impact-of-the-education
#18
Araz Rawshani, Nina Rawshani, Carita Gelang, Jan-Otto Andersson, Anna Larsson, Angela Bång, Johan Herlitz, Martin Gellerstedt
BACKGROUND AND AIMS: We examined the accuracy in assessments of emergency dispatchers according to their education and time of the day. We examined this in chest pain patients who were diagnosed with a potentially life-threatening condition (LTC) or died within 30days. METHODS: Among 2205 persons, 482 died, 1631 experienced an acute coronary syndrome (ACS), 1914 had a LTC. Multivariable logistic regression was used to study how time of the call and the dispatcher's education were associated with the risk of missing to give priority 1 (the highest)...
February 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28237549/il-37-increased-in-patients-with-acute-coronary-syndrome-and-associated-with-a-worse-clinical-outcome-after-st-segment-elevation-acute-myocardial-infarction
#19
Kun Liu, Qiang Tang, Xinyuan Zhu, Xinchun Yang
BACKGROUND: IL-37 emerges as a natural suppressor of inflammatory responses. The potential role of IL-37 in the pathology of atherosclerosis is unclear. The purpose of this study was to assess IL-37 profile in acute coronary syndrome (ACS) and the prognostic role of this cytokine in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS: In a case-control study, we prospectively enrolled 216 patients undergoing the first coronary angiography, which consisted of 5 groups: normal (n=57), stable angina (SAP, n=36), unstable angina (UAP, n=42), non-STEMI (n=36), STEMI (n=45)...
February 22, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28237385/ketamine-as-a-first-line-treatment-for-severely-agitated-emergency-department-patients
#20
Jeff Riddell, Alexander Tran, Rimon Bengiamin, Gregory W Hendey, Patil Armenian
OBJECTIVE: Emergency physicians often need to control agitated patients who present a danger to themselves and hospital personnel. Commonly used medications have limitations. Our primary objective was to compare the time to a defined reduction in agitation scores for ketamine versus benzodiazepines and haloperidol, alone or in combination. Our secondary objectives were to compare rates of medication redosing, vital sign changes, and adverse events in the different treatment groups. METHODS: We conducted a single-center, prospective, observational study examining agitation levels in acutely agitated emergency department patients between the ages of 18 and 65 who required sedation medication for acute agitation...
February 13, 2017: American Journal of Emergency Medicine
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