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https://www.readbyqxmd.com/read/29236280/intracranial-abscess-formation-following-sphenoid-sinus-occlusion-with-nasoseptal-flap-skull-base-reconstruction-a-cautionary-tale
#1
George S Tarasidis, Jeremiah A Alt, Richard R Orlandi
The formation of an intracranial abscess secondary to sphenoid sinus occlusion after nasoseptal flap skull base reconstruction has not been previously described. We report such a case that occurred at our institution in a 23-year-old man who underwent flap reconstruction for a cerebrospinal fluid leak. We determined that occlusion of the sphenoid sinus outflow might have played a role in this complication. The patient was treated via a combined surgical and medical approach that entailed a bur-hole craniotomy and endoscopic debridement followed by administration of an intravenous antibiotic...
December 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29236230/gene-patents-in-canada-is-there-a-new-legal-landscape
#2
Katherine L Bonter, Carmela De Luca, Christi J Guerrini
In 2016, the Children's Hospital of Eastern Ontario (CHEO) announced the settlement of its patent lawsuit against US-based Transgenomic, Inc. At issue in the case was CHEO's ability to test for gene mutations associated with long QT syndrome (LQTS) that are described in Transgenomic's patents. CHEO challenged the patents as invalid, and Transgenomic ultimately agreed to license them on a royalty-free basis to CHEO and other healthcare institutions for LQTS testing and research. While widely celebrated in the media, the ethical rhetoric surrounding the settlement has at times obscured the practical and legal context in which it was made and will operate...
December 13, 2017: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/29236110/simultaneous-monitoring-of-different-vitrification-solution-components-permeating-into-tissues
#3
Andrés Vásquez-Rivera, Kim K Sommer, Harriëtte Oldenhof, Adam Z Higgins, Kelvin G M Brockbank, Andres Hilfiker, Willem F Wolkers
Cryopreservation can be used for long-term preservation of tissues and organs. It relies on using complex mixtures of cryoprotective agents (CPAs) to reduce the damaging effects of freezing, but care should be taken to avoid toxic effects of CPAs themselves. In order to rationally design cryopreservation strategies for tissues, it is important to precisely determine permeation kinetics of the protectants that are used to ensure maximum permeation, while minimizing the exposure time and toxicity effects. This is particularly challenging with protectant solutions consisting of multiple components each with different physical properties and diffusing at a different rate...
December 13, 2017: Analyst
https://www.readbyqxmd.com/read/29235986/managing-diabetes-in-people-with-dementia-a-realist-review
#4
Frances Bunn, Claire Goodman, Peter Reece Jones, Bridget Russell, Daksha Trivedi, Alan Sinclair, Antony Bayer, Greta Rait, Jo Rycroft-Malone, Chris Burton
BACKGROUND: Dementia and diabetes mellitus are common long-term conditions that coexist in a large number of older people. People living with dementia and diabetes may be at increased risk of complications such as hypoglycaemic episodes because they are less able to manage their diabetes. OBJECTIVES: To identify the key features or mechanisms of programmes that aim to improve the management of diabetes in people with dementia and to identify areas needing further research...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29235900/treatment-and-discharge-patterns-among-patients-hospitalized-with-non-valvular-atrial-fibrillation-transitioning-from-the-inpatient-to-outpatient-setting
#5
Henry J Henk, Feng Cao, Kenneth Tuell, Kwanza Price, Prianka Singh, Jack Mardekian, Kevin Odell, Chad Patel, Wilson Tan, George H Sands, Shalabh Singhal, Jeffrey Trocio, Lien Vo
OBJECTIVE: To evaluate inpatient oral anticoagulant (OAC) treatment, discharge location, and post-discharge OAC treatment for patients hospitalized with non-valvular atrial fibrillation (NVAF). RESEARCH DESIGN AND METHODS: Retrospective study using claims data linked to hospital electronic health records (EHR). Patients (N = 2,484) were hospitalized with a primary (38%) or secondary (62%) diagnosis of AF without evidence of mitral valvular heart disease or valve replacement between January 2009 and September 2013...
December 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29235781/addressing-the-social-determinants-of-health-through-medicaid-managed-care
#6
David Machledt
Issue: With its emphasis on coordinated care and prevention, managed care should be tailor-made to tackle social determinants of health. But various challenges discourage Medicaid health plans and providers from assisting beneficiaries with nonmedical concerns such as housing insecurity or parenting skills that are integral to improving health outcomes and lowering costs. To better address these social factors, the Centers for Medicare and Medicaid Services (CMS) updated its Medicaid managed care rule in early 2016...
November 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29235737/long-term-survival-of-discharged-patients-admitted-to-intensive-coronary-care-unit-after-out-of-hospital-cardiac-arrest
#7
Dante Antonelli, Ofir Koren, Menachem Nahir, Ehud Rozner, Nahum A Freedberg, Yoav Turgeman
BACKGROUND: Survival of patients who were discharged from the hospital following out-of-hospital cardiac arrest (OHCA) has not been well defined. OBJECTIVES: To verify predictor variables for prognosis of patients following OHCA who survived hospitalization. METHODS: We retrospectively reviewed clinical, demographic, and outcome data of consecutive patients who were hospitalized from January 1, 2009, through December 31, 2014, into the intensive coronary care unit (ICCU) after aborted OHCA and discharged alive...
December 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29234709/repeating-platinum-bevacizumab-in-recurrent-or-progressive-cervical-cancer-yields-marginal-survival-benefits
#8
Abigail S Zamorano, Leping Wan, Matthew A Powell, L Stewart Massad
Our objective was to assess overall survival of cervical cancer patients following prior platinum/bevacizumab chemotherapy, comparing retreatment with platinum/bevacizumab with alternative therapies. A retrospective analysis was performed of women who received platinum/bevacizumab (PB) chemotherapy for cervical cancer at Washington University between July 1, 2005 and December 31, 2015. Wilcoxon rank-sum exact test and Fisher's exact test were used to compare the treatment groups, and Kaplan Meier curves were generated...
November 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/29234512/new-models-of-care-a-liaison-psychiatry-service-for-medically-unexplained-symptoms-and-frequent-attenders-in-primary-care
#9
Janine Bestall, Najma Siddiqi, Suzanne Heywood-Everett, Charlotte Freeman, Paul Carder, Mick James, Brendan Kennedy, Angela Moulson, Allan House
Aims and method This paper describes the process of setting up and the early results from a new liaison psychiatry service in primary care for people identified as frequent general practice attenders with long-term conditions or medically unexplained symptoms. Using a rapid evidence synthesis, we identified existing service models, mechanisms to identify and refer patients, and outcomes for the service. Considering this evidence, with local contingencies we defined options and resources. We agreed a model to set up a service in three diverse general practices...
December 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/29234507/implementation-of-a-novel-primary-care-pathway-for-patients-with-severe-and-enduring-mental-illness
#10
Frank Röhricht, Gopal Krishan Waddon, Paul Binfield, Rhiannon England, Richard Fradgley, Lise Hertel, Paul James, Judith Littlejohns, David Maher, Matthew Oppong
Aims and method New collaborative care models with an emphasis on primary care are required for long-term management of patients with severe and enduring mental illness (SMI). We conducted a descriptive evaluation of clinical outcomes of the first 3 years of a novel enhanced primary care (EPC) service. Data from 2818 patients and staff survey results were analysed. Results 2310 patients were discharged to EPC (508 not assessed as clinically suitable or patients/general practitioners declined the transfer); mean length of stay with secondary care service of the cohort was 9...
December 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/29233742/how-to-approach-a-hodgkin-lymphoma-patient-with-relapse-after-autologous-sct-allogeneic-sct
#11
REVIEW
Matthew Mei, Robert Chen
Hodgkin lymphoma (HL) is a highly curable B-cell lymphoma, and ∼90% of patients who present with early-stage (stage I-II) disease and 70% of patients who present with late-stage disease will be cured with standard frontline treatment. For patients with relapsed or refractory (r/r) disease after initial therapy, the standard of care is salvage chemotherapy, followed by autologous transplantation (autoSCT). Although this approach will cure a significant proportion of patients, upto 50% of patients will experience disease progression after autoSCT, and this population has historically had a very poor prognosis...
December 9, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/29233607/the-concept-of-frailty-in-intensive-care
#12
Fakhri Athari, Ken M Hillman, Steven A Frost
Our population is ageing and this is also reflected in the ageing of the hospital and intensive care population. Along with ageing, there is also an increase in age-related chronic health conditions or co-morbidities, which in turn affects the patient's functional state. There is an increasing need to describe a patient's clinical condition in terms of their functional capacity, such as frailty. Frailty is an age-related syndrome which reduces physiological and cognitive reserves. As a result, frailty increases people's vulnerability to insults such as infection and trauma...
December 9, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29233574/the-principles-and-practice-of-re-irradiation-in-clinical-oncology-an-overview
#13
W Dörr, D Gabryś
Long-term cancer survivors are at risk of the development of recurrence or a new primary cancer that requires a second (or third) radio-oncological treatment. Publications on re-irradiation have been followed and are summarised in this overview. Information from clinical and experimental animal studies suggests that specific normal tissues can tolerate a considerable retreatment radiation dose. However, the risk of normal tissue damage and the impact on the quality of life must be considered. If a second course of radiotherapy needs to be administered, this should be done with maximum care and accuracy...
December 9, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29233461/long-term-safety-of-subcutaneous-immunotherapy-with-to-204-in-japanese-patients-with-house-dust-mite-induced-allergic-rhinitis-and-allergic-bronchial-asthma-multicenter-open-label-clinical-trial
#14
Takao Fujisawa, Terufumi Shimoda, Keisuke Masuyama, Kimihiro Okubo, Kohei Honda, Mitsuhiro Okano, Toshio Katsunuma, Atsuo Urisu, Yasuto Kondo, Hiroshi Odajima, Kazuyuki Kurihara, Makoto Nagata, Masami Taniguchi, Shoichiro Taniuchi, Satoru Doi, Tomoshige Matsumoto, Shoji Hashimoto, Akihiko Tanaka, Kensuke Natsui, Nahoko Abe, Hideki Ozaki
BACKGROUND: To evaluate the long-term safety of subcutaneous immunotherapy with TO-204, a standardized house dust mite (HDM) allergen extracts, we conducted a multicenter, open label clinical trial. METHODS: Japanese patients aged 5-65 years were eligible for the study, if they had HDM-induced allergic rhinitis (AR), allergic bronchial asthma (BA), or both. TO-204 was administered in a dose titration scheme, and the maintenance dose was determined according to the predefined criteria...
December 7, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/29233276/comparison-of-long-term-knowledge-retention-in-lecture-based-versus-flipped-team-based-learning-course-delivery
#15
Catherine Taglieri, David Schnee, Lana Dvorkin Camiel, Kathy Zaiken, Amee Mistry, Stefanie Nigro, Gary Tataronis, Dhiren Patel, Susan Jacobson, Jennifer Goldman
OBJECTIVES: To determine whether team based learning (TBL) is superior to traditional lecture -based learning in confidence and knowledge retention one year later. DESIGN: A survey was administered 17 months after a completion of a required over-the-counter /self-care (OTC) course to two different cohorts of students. The survey assessed confidence and knowledge related to OTC topics. The lecture group had a traditional lecture based classroom experience; the intervention group experienced a TBL format throughout the entire course...
May 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29232992/cleft-lip-and-palate-in-context-learning-from-and-adding-to-the-sociological-literature-on-long-term-conditions
#16
Raed Abualfaraj, Blanaid Daly, Fraser McDonald, Sasha Scambler
Cleft lip and palate is a common congenital anomaly affecting males and females. While there is psychological research on cleft lip and palate, there is relatively little research exploring the social context of cleft lip and palate and the experiences of living with the condition on a daily basis. Drawing on common themes emerging from sociological work which have explored the experiences of people living with long-term conditions (uncertainty, social relations, self-esteem and self-image and biomedical concerns), we argue that these themes can be used to help elucidate the experiences of people living with cleft lip and palate...
January 1, 2017: Health (London)
https://www.readbyqxmd.com/read/29232940/no-benefit-of-hypomethylating-agents-compared-to-supportive-care-for-higher-risk-myelodysplastic-syndrome
#17
Sang Kyun Sohn, Joon Ho Moon, In Hee Lee, Jae Sook Ahn, Hyeoung Joon Kim, Joo Seop Chung, Ho Jin Shin, Sung Woo Park, Won Sik Lee, Sang Min Lee, Hawk Kim, Ho Sup Lee, Yang Soo Kim, Yoon Young Cho, Sung Hwa Bae, Ji Hyun Lee, Sung Hyun Kim, Ik Chan Song, Ji Hyun Kwon, Yoo Jin Lee
Background/Aims: This study evaluated the role of hypomethylating agents (HMA) compared to best supportive care (BSC) for patients with high or very-high (H/VH) risk myelodysplastic syndrome (MDS) according to the Revised International Prognostic Scoring System. Methods: A total of 279 H/VH risk MDS patients registered in the Korean MDS Working Party database were retrospectively analyzed. Results: HMA therapy was administered to 205 patients (73...
December 15, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29232736/-left-ventricular-assist-device-therapy-ways-to-improve-the-ambulatory-care
#18
Caspar Burkhard-Meier, Michiel Morshuis
The use of left-ventricular assist device therapy (LVAD) in terminal heart failure patients is increasing. Many patients are receiving LVAD-therapy as final solution (destination therapy). After discharge from the implanting heart center patient-centered care has to be implemented on an outpatient basis. A responsible ambulatory treatment of this severe heart failure population requires knowledge about LVAD specific problems (general medical care, long term complications, device management). The referring cardiologist as well as the private practitioner should be more involved in the care of patients with LVAD...
December 12, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29232680/is-outpatient-control-of-long-term-non-invasive-ventilation-feasible-in-chronic-obstructive-pulmonary-disease-patients
#19
Sarah Bettina Schwarz, Jens Callegari, Christine Hamm, Wolfram Windisch, Friederike Sophie Magnet
BACKGROUND: Long-term non-invasive ventilation (NIV) is an established and increasingly used treatment option for patients with chronic hypercapnic chronic obstructive pulmonary disease (COPD). Following inpatient NIV establishment, inpatient control visits regularly occur thereafter. However, it remains unclear whether such control visits can also be performed in an outpatient setting, which, in turn, would reduce costs, patient burden and the complications related to hospitalization...
December 12, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29232474/is-intraperitoneal-chemotherapy-still-an-acceptable-option-in-primary-adjuvant-chemotherapy-for-advanced-ovarian-cancer
#20
B J Monk, J K Chan
The role of intraperitoneal (i.p.) chemotherapy in treating newly diagnosed advanced epithelial ovarian cancer (EOC) has been the subject of controversy for almost three decades. Three large intergroup phase III trials (GOG 104, 114, 172) have demonstrated a survival benefit associated with i.p. over intravenous (i.v.) therapy in advanced, low-volume EOC. Despite the positive clinical trial results and a subsequent National Cancer Institute alert in 2006, i.p. treatment has not been widely accepted as the standard of care in the United States and is infrequently used in Europe...
November 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
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