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https://www.readbyqxmd.com/read/28544836/aortic-valve-replacement-with-the-labcor-tlpb-supra%C3%A2-porcine-bioprosthesis-intermediate-clinical-and-echocardiographic-outcomes
#1
Markus Schlömicher, Zulfugar Taghiyev, Yazan Al-Jabery, Peter Lukas Haldenwang, Leif Markthaler, Vadim Moustafine, Axel Maria Laczkovics, Justus Thomas Strauch, Matthias Bechtel
BACKGROUND: The Labcor TBLP Supra™ prosthesis is a second-generation tissue valve that has evolved from the Labcor TBLP™ prosthesis, first introduced in 1984. The Supra prosthesis is a triple-composite porcine valve, with no specific anticalcification treatment being used in its production other than standard tissue fixation with 0.4% glutaraldehyde. To date, more than 100,000 Supra valves have been implanted, mainly in South America. Despite this remarkably high number of implants, only marginal data exist concerning durability and safety issues...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544274/antithrombotic-therapy-in-end-stage-renal-disease
#2
REVIEW
Svetha Chunduri, Jon E Folstad, Tushar J Vachharajani
The delicate balance of risk vs. benefit of using antiplatelet and antithrombotic agents in the general population is well established. The decision to use these agents in the end stage renal disease (ESRD) population remains complex and difficult. The concomitant association of a prothombotic state with high risk of bleeding in the ESRD population requires individualization and careful clinical judgment before implementing such therapy. There remains a paucity of clinical trials and lack of substantial evidence in literature for safe and effective use of antithrombotic drugs in patients with advanced chronic kidney disease...
May 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28544168/presurgical-language-fmri-mapping-of-six-critical-regions
#3
Christopher F Benjamin, Patricia D Walshaw, Kayleigh Hale, William D Gaillard, Leslie C Baxter, Madison M Berl, Monika Polczynska, Stephanie Noble, Rafeed Alkawadri, Lawrence J Hirsch, Todd C Constable, Susan Y Bookheimer
Language mapping is a key goal in neurosurgical planning. fMRI mapping typically proceeds with a focus on Broca's and Wernicke's areas, although multiple other language-critical areas are now well-known. We evaluated whether clinicians could use a novel approach, including clinician-driven individualized thresholding, to reliably identify six language regions, including Broca's Area, Wernicke's Area (inferior, superior), Exner's Area, Supplementary Speech Area, Angular Gyrus, and Basal Temporal Language Area...
May 23, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28541917/an-unobtrusive-computerized-assessment-framework-for-unilateral-peripheral-facial-paralysis
#4
Zhe-Xiao Guo, Guo Dan, Jianghuai Xiang, Jun Wang, Wanzhang Yang, Huijun Ding, Oliver Deussen, Yongjin Zhou
Unilateral peripheral facial paralysis (UPFP) is a form of facial nerve paralysis and clinically classified according to conditions of facial symmetry. Prompt and precise assessment is crucial to neural rehabilitation of UPFP. The prevalent House-Brackmann (HB) grading system relies on subjective judgments with significant inter-observation variation. Therefore to explore an objective method for UPFP assessment, clinical image sequences are captured using a web camera setup while 5 healthy and 27 UPFP subjects performing a group of pre-defined actions, including keeping expressionless, raising brows, closing eyes, bulging cheek and showing teeth in turn...
May 24, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28541499/hypertension-and-cardiac-arrhythmias-executive-summary-of-a-consensus-document-from-the-european-heart-rhythm-association-ehra-and-esc-council-on-hypertension-endorsed-by-the-heart-rhythm-society-hrs-asia-pacific-heart-rhythm-society-aphrs-and-sociedad-latinoamericana
#5
Gregory Y H Lip, Antonio Coca, Thomas Kahan, Giuseppe Boriani, Antonis S Manolis, Michael Hecht Olsen, Ali Oto, Tatjana S Potpara, Jan Steffel, Francisco Marín, Márcio Jansen de Oliveira Figueiredo, Giovanni de Simone, Wendy S Tzou, Chern En Chiang, Bryan Williams
Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in HTN patients, especially in those with left ventricular hypertrophy (LVH), CAD or HF. In addition, high doses of thiazide diuretics commonly used to treat hypertension, may result in electrolyte abnormalities (eg...
May 25, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28533183/dedicated-research-time-during-surgery-residency-leads-to-a-significant-decline-in-self-assessed-clinical-aptitude-and-surgical-skills
#6
Monica M Grova, Anthony D Yang, Misty D Humphries, Joseph M Galante, Edgardo S Salcedo
OBJECTIVE: The surgical community commonly perceives a decline in surgical and patient care skills among residents who take dedicated time away from clinical activity to engage in research. We hypothesize that residents perceive a decline in their skills because of dedicated research time. SETTING: UC Davis Medical Center, Sacramento, CA, an institutional tertiary care center. PARTICIPANTS: General surgery residents and graduates from UC Davis general surgery residency training program, who had completed at least 1 year of research during their training...
May 19, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28532614/evidence-based-medicine-was-bound-to-fail-a-report-to-alvan-feinstein
#7
Giovanni A Fava
John Ioannidis has provided a lucid account, in the form of a report to David Sackett, of how evidence-based medicine (EBM) was hijacked to serve vested interests: major randomized controlled trials are largely done by and for the benefit of the industry; meta-analyses and guidelines are flooded with conflicts of interest; national and federal research funds are unable to address basic clinical questions. Nonetheless, EBM would remain a worthwhile goal. In this paper, in the form of a report to Alvan Feinstein, it is argued that current developments were largely predictable...
April 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28532613/the-practice-of-evidence-based-medicine-involves-the-care-of-whole-persons
#8
W Scott Richardson
In this issue of the Journal, Dr. Fava posits that evidence-based medicine (EBM) was bound to fail. I share some of the concerns he expresses, yet I see more reasons for optimism. Having been on rounds with both Drs. Engel and Sackett, I reckon they would have agreed more than they disagreed. Their central teaching was the compassionate and well-informed care of sick persons. The model that emerged from these rounds was that patient care could be both person-centered and evidence-based, that clinical judgment was essential to both, and the decisions could and should be shared...
April 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28530343/-sexuality-in-psychiatric-hospitalization-reality-versus-policy
#9
Anat Shalev, Gabriel Weil, Ludmila Rubinstein
Psychiatric hospitalization might be a necessity for certain groups of patients with mental illness, involving acute symptoms and substantial disability which do not allow independent living in the community. In such situations, it is crucial to enable inpatients to enjoy the best possible quality of life, including the right for sexual autonomy as a basic human right. Satisfying sexual life is part of meaningful life and plays an important role in personal and social recovery. On the other hand, sexual relations in psychiatric wards raise many dilemmas, including the need to protect inpatients from sexual abuse and victimization, particularly when mental illness involves judgment deficits and decreased ability to express autonomous will...
December 2016: Harefuah
https://www.readbyqxmd.com/read/28521598/malnutrition-critical-illness-survivors-and-postdischarge-outcomes-a-cohort-study
#10
Kris M Mogensen, Clare M Horkan, Steven W Purtle, Takuhiro Moromizato, James D Rawn, Malcolm K Robinson, Kenneth B Christopher
BACKGROUND: We hypothesized that preexisting malnutrition in patients who survived critical care would be associated with adverse outcomes following hospital discharge. METHODS: We performed an observational cohort study in 1 academic medical center in Boston. We studied 23,575 patients, aged ≥18 years, who received critical care between 2004 and 2011 and survived hospitalization. RESULTS: The exposure of interest was malnutrition determined at intensive care unit (ICU) admission by a registered dietitian using clinical judgment and on data related to unintentional weight loss, inadequate nutrient intake, and wasting of muscle mass and/or subcutaneous fat...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28521401/mri-features-of-intracranial-anaplastic-hemangiopericytoma
#11
Liang-Cai Bai, Tian-You Luo, Hao Zhu, Rui Xu
Magnetic resonance imaging (MRI) features of intracranial anaplastic hemangiopericytoma (AHPC) were analyzed. The pathological examination showed that there was a great number of irregularly arranged tumor cells with nuclear atypia, and mitotic properties were commonly seen providing support for clinical staging, therapy and prognosis judgment. Eighteen cases of intracranial AHPC proved by operation and pathology were analyzed retrospectively. Both plain and enhanced MR scans were performed and the results were compared with pathology in all cases...
May 2017: Oncology Letters
https://www.readbyqxmd.com/read/28513820/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-acute-pancreatitis-hepato-pancreato-biliary-operations-and-liver-transplantation
#12
Alexsander K Bressan, Chad G Ball
Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target...
May 17, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28512732/decision-making-in-the-surgical-management-of-invasive-breast-cancer-part-1-lumpectomy-mastectomy-and-contralateral-prophylactic-mastectomy
#13
REVIEW
Lisa A Newman
Several prospective randomized clinical trials conducted internationally have proven the safety and survival equivalence of breast-conserving surgery compared with mastectomy. Adjuvant radiation is routinely recommended following lumpectomy surgery to minimize the risk of local recurrence. Comprehensive breast imaging (including bilateral mammography with diagnostic views and ultrasound evaluation), in addition to clinical examination, is essential to rule out potential contralateral pathology and to optimally characterize the extent of disease...
May 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28507876/prediction-of-skin-necrosis-after-mastectomy-for-breast-cancer-using-indocyanine-green-angiography-imaging
#14
Katsuya Gorai, Keita Inoue, Noriko Saegusa, Ryo Shimamoto, Meisei Takeishi, Mutsumi Okazaki, Masahiro Nakagawa
BACKGROUND: In immediate tissue expander reconstruction following total mastectomy for breast cancer, indocyanine green angiography (ICGA)-guided skin trimming is useful for the prevention of complications. However, instances of unclear ICGA contrast can occur with this method, which are difficult to judge as to whether preventive trimming is warranted. To further improve the mastectomy flap necrosis rate, more accurate objective parameters are necessary. METHODS: The degree of clinical improvement was compared between 81 patients trimmed according to the surgeon's judgment (non-ICGA group) and 100 patients with ICGA-guided trimming (ICGA group)...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28506923/core-social-and-moral-disgust-are-bounded-a-review-on-cognitive-and-neural-bases-of-repugnance-in-clinical-disorders
#15
REVIEW
Carmelo M Vicario, Robert D Rafal, Davide Martino, Alessio Avenanti
Disgust is a multifaceted experience that might affect several aspects of life. Here, we reviewed research on neurological and psychiatric disorders that are characterized by abnormal disgust processing to test the hypothesis of a shared neurocognitive architecture in the representation of three disgust domains: i) personal experience of 'core disgust'; ii) social disgust, i.e., motor and vocal expressions of disgust; iii) moral disgust, i.e., sensitivity to ethical violations. Our analysis provides some support to the shared neurocognitive hypothesis and suggests that the insula might be the "hub" structure linking the three domains of disgust sensitivity, while other brain regions may subserve specific facets of the multidimensional experience...
May 12, 2017: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/28506369/autoimmune-hepatitis-overlap-syndromes-and-liver-pathology
#16
REVIEW
Albert J Czaja, Herschel A Carpenter
Autoimmune hepatitis (AIH) may have an atypical serum alkaline phosphatase elevation, antimitochondrial antibodies, histologic features of bile duct injury/loss, or cholangiographic findings of focal biliary strictures and dilations. These manifestations characterize the overlap syndromes. Patients can be classified as having AIH with features of primary biliary cholangitis, primary sclerosing cholangitis, or a cholestatic syndrome. The gold standard of diagnosis is clinical judgment. Histologic evaluation is a major diagnostic component...
June 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28504043/insight-in-psychosis-standards-science-ethics-and-value-judgment
#17
K S Jacob
BACKGROUND: The clinical assessment of insight solely employs biomedical perspectives and criteria to the complete exclusion of context and culture and to the disregard of values and value judgments. AIM: The aim of this discussion article is to examine recent research from India on insight and explanatory models in psychosis and re-examine the framework of assessment, diagnosis and management of insight and explanatory models. METHODS: Recent research from India on insight in psychosis and explanatory models is reviewed...
June 2017: International Journal of Social Psychiatry
https://www.readbyqxmd.com/read/28500927/comparison-of-electromagnetic-neuronavigation-system-and-free-hand-method-for-ventricular-catheter-placement-in-internal-shunt
#18
Vianney Gilard, Nicolas Magne, Emmanuel Gerardin, Sophie Curey, Valérie Pelletier, Pierre Hannequin, Stéphane Derrey
OBJECTIVE: Optimal ventricular catheter positioning is able to reduce the risk of catheter dysfunction, and subsequently the risk of multiple revision surgery. The objective of our study was to compare the proportion of optimal ventricular catheter placements in a cohort of patients operated for ventriculoperitoneal (VP) shunt between a free-hand group and a neuronavigated group. PATIENTS AND METHODS: Twenty patients with hydrocephalus requiring VP shunt were prospectively included in this study...
May 8, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28499508/new-approach-to-establish-an-object-reference-frame-for-dental-arch-in-computer-aided-surgical-simulation
#19
J Li, P Yuan, C-M Chang, D C-Y Ho, Y-F Lo, S Shen, D Kim, J F Teichgraeber, D M Alfi, J Gateno, J J Xia
The purpose of this study was to develop a principal component analysis-based adaptive minimum Euclidean distances (PAMED) approach to establish an optimal object reference frame for symmetrical alignment of the dental arch during computer-aided surgical simulation (CASS). It was compared with our triangular methods and the standard principal component analysis (PCA) method. Thirty sets of maxillary digital models were used. Midsagittal and occlusal planes were ranked by three experienced evaluators based on their clinical judgment...
May 9, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28499407/early-neurosyphilis-presenting-with-facial-palsy-and-an-oral-ulcer-in-a-patient-who-is-human-immunodeficiency-virus-positive-a-case-report
#20
Evangeline Njiru, Jamil Abdulkadir, Zipporah Kamuren, Gabriel Kigen
BACKGROUND: Neurosyphilis is the tertiary stage of Treponema pallidum infection that involves the central nervous system, which occurs within days or weeks after an initial syphilis infection, especially in immunocompromised patients. The diagnosis of neurosyphilis is quite challenging as it is uncommon and often presents with obscure symptoms since any organ system may be involved. CASE PRESENTATION: We describe a case of a 40-year-old African man who is human immunodeficiency virus positive with early neurosyphilis who presented with a stiff neck, headache, confusion, restlessness, and a left-sided chest pain; he did not respond to an empiric treatment of ceftriaxone and fluconazole for meningitis, and tramadol for headache...
May 13, 2017: Journal of Medical Case Reports
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