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https://www.readbyqxmd.com/read/27920646/successful-treatment-of-small-intestinal-bleeding-in-a-crohn-s-patient-with-noncirrhotic-portal-hypertension-by-transjugular-portosystemic-shunt-placement-and-infliximab-treatment
#1
Benjamin Heimgartner, Heather Dawson, Andrea De Gottardi, Reiner Wiest, Jan Hendrik Niess
Small intestinal bleeding in Crohn's disease patients with noncirrhotic portal hypertension and partial portal and superior mesenteric vein thrombosis is a life-threatening event. Here, a case is reported in which treatment with azathioprine may have resulted in nodular regenerative hyperplasia, portal hypertension and portal vein thrombosis. The 56-year-old patient with Crohn's disease developed nodular regenerative hyperplasia under treatment with azathioprine. He was admitted with severe bleeding. Gastroscopy showed small esophageal varices without bleeding stigmata...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27919308/outbreak-of-pantoea-agglomerans-bloodstream-infections-at-an-oncology-clinic-illinois-2012-2013
#2
Brian R Yablon, Raymund Dantes, Victoria Tsai, Rachel Lim, Heather Moulton-Meissner, Matthew Arduino, Bette Jensen, Megan Toth Patel, Michael O Vernon, Yoran Grant-Greene, Demian Christiansen, Craig Conover, Alexander Kallen, Alice Y Guh
OBJECTIVE To determine the source of a healthcare-associated outbreak of Pantoea agglomerans bloodstream infections. DESIGN Epidemiologic investigation of the outbreak. SETTING Oncology clinic (clinic A). METHODS Cases were defined as Pantoea isolation from blood or catheter tip cultures of clinic A patients during July 2012-May 2013. Clinic A medical charts and laboratory records were reviewed; infection prevention practices and the facility's water system were evaluated. Environmental samples were collected for culture...
December 6, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27916363/tipping-the-scales-educating-surgeons-about-medical-malpractice
#3
Steven E Raper, Johncy Joseph, Wilda G Seymour, Patricia G Sullivan
BACKGROUND: In Pennsylvania, medical malpractice premiums are a major cost to surgeons. Yet surgeons often have little if any education in the basics of tort litigation or how to manage their risk. This work describes one approach for educating academic faculty surgeons on current concepts of medical malpractice and provide some guidance on how to "tip the scales of justice"; or minimize the risks of being named in a malpractice claim. MATERIALS AND METHODS: The course had five parts: the basics of medical malpractice, the cost of malpractice insurance, current departmental claims experience, strategies for decreasing the risk of being named in a claim, and an overview of malpractice reforms...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27915362/teaching-health-care-students-the-radial-arterial-puncture-procedure
#4
Kevin P Collins, Christopher J Russian, Joshua F Gonzales
The radial artery puncture is a frequently ordered medical procedure for patients requiring blood gas analysis. Deviating from the proper procedure increases the likelihood of error and jeopardizes patient safety. The teaching methodology for the radial artery puncture is rarely addressed in the medical literature. First-year respiratory care students enrolled in a clinical practice course participated in an expanded curriculum on arterial puncture technique. The new five-step curriculum included: 1) a face-to-face lecture, 2) radial artery localization, 3) blunt-tipped needle simulation, 4) manikin arm puncture, and 5) a peer assessment video...
2016: Journal of Allied Health
https://www.readbyqxmd.com/read/27909510/interactive-in-vitro-training-in-physics-of-radiofrequency-ablation-for-physicians-and-medical-engineering-students
#5
REVIEW
Haber T, Kleister G, Selman B, Härtig J, Melichercik J, Ismer B
Radiofrequency (RF) ablation requires a complex set of devices as well as profound electrophysiological experience and substantial knowledge of physical science basics. To establish RF ablation in-vitro teaching-system, six workstations were equipped with computer-controlled RF ablation generators. Universal connection boxes allow ablation-essays with catheters of different make and model. Special wetlabs were developed combining a basin containing isotonic saline solution with a thermostat and a pump to simulate blood flow...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908536/the-sensitivity-and-negative-predictive-value-of-a-pediatric-cervical-spine-clearance-algorithm-that-minimizes-computerized-tomography
#6
Mary Arbuthnot, David P Mooney
BACKGROUND: It is crucial to identify cervical spine injuries while minimizing ionizing radiation. This study analyzes the sensitivity and negative predictive value of a pediatric cervical spine clearance algorithm. METHODS: We performed a retrospective review of all children <21years old who were admitted following blunt trauma and underwent cervical spine clearance utilizing our institution's cervical spine clearance algorithm over a 10-year period. Age, gender, International Classification of Diseases 9th Edition diagnosis codes, presence or absence of cervical collar on arrival, Injury Severity Score, and type of cervical spine imaging obtained were extracted from the trauma registry and electronic medical record...
October 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27898454/transvaginal-pelvic-floor-muscle-injection-technique-a-cadaver-study
#7
Priyanka Gupta, Michael Ehlert, Larry T Sirls, Kenneth Peters
INTRODUCTION: Women with pelvic floor dysfunction can have tender areas on vaginal examination, which can be treated with trigger-point injections. There are no publications to evaluate the accuracy of pelvic floor muscle injections. METHODS: Trigger-point injections were performed on 2 fresh cadaveric pelvises using a curved nasal cannula guide and 7-in spinal needle. This was performed using our standard template of 2 sets of injections at the 1-, 3-, and 5-o'clock positions distally and proximally...
November 28, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27894853/concurrent-carpal-tunnel-syndrome-and-pronator-syndrome-a-retrospective-study-of-21-cases
#8
Chih-Wei Hsiao, Jui-Tein Shih, Sheng-Tsai Hung
PURPOSE: Concurrent carpal tunnel syndrome and pronator syndrome are rarely considered and the proximal compression sites are easily overlooked. We retrospectively studied 21 concurrent cases in our series from 2009 to 2015 and report the results. PATIENTS AND METHODS: The typical symptoms were pain, tingling, and numbness of the radial 3½ digits. If paresthesia involved the thenar eminence and proximal forearm pain was noted in cases of carpal tunnel syndrome, carpal tunnel syndrome combined with pronator syndrome was considered...
November 25, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27894388/-analysis-of-distribution-and-drug-resistance-of-pathogens-isolated-from-541-hospitalized-children-with-burn-infection
#9
J X Dai, L Li, L Xu, Z H Chen, X Y Li, M Liu, Y Q Wen, X D Chen
Objective: To investigate the distribution and drug resistance of pathogens isolated from hospitalized children with burn infection. Methods: Totally 541 patients were hospitalized in Fujian Medical University Union Hospital, the 180th Hospital of Chinese People's Liberation Army(PLA), the 92th Hospital of PLA, and Longyan First Hospital from January 2013 to December 2015. Totally 848 clinical specimens (blood, catheter tip attachments, wound exudate, etc.) were collected for pathogen detection. After being identified by an automatic microbiological identification system, drug resistance of pathogens to 41 commonly-used antibiotics in clinic including gentamicin, aztreonam, erythromycin, clindamycin, etc...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27891327/analysis-of-fetal-palate-to-assist-pre-natal-ultrasound
#10
Anjali Shastry, Yogitha Ravindranath, Roopa Ravindranath
INTRODUCTION: Cleft palate is one of the major facial congenital malformation in newborns. Pre-natal detection of this malformation is limited to detection of clefting of hard palate but isolated soft palate clefting still remains challenge for sonologists. As Indian literature is limited present study was attempted to provide dimensions and position of fetal palate by digitized images. AIM: To study dimensions, position and differences in parameters between second and third trimester fetuses...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27884494/consensus-conference-on-tips-management-techniques-indications-contraindications
#11
Stefano Fagiuoli, Raffaele Bruno, Wilma Debernardi Venon, Filippo Schepis, Francesco Vizzutti, Pierluigi Toniutto, Marco Senzolo, Paolo Caraceni, Francesco Salerno, Paolo Angeli, Roberto Cioni, Alessandro Vitale, Maurizio Grosso, Andrea De Gasperi, Gennaro D'Amico, Alfredo Marzano
The trans jugular intrahepatic Porto systemic shunt (TIPS) is no longer viewed as a salvage therapy or a bridge to liver transplantation and is currently indicated for a number of conditions related to portal hypertension with positive results in survival. Moreover, the availability of self-expandable polytetrafluoroethylene (PTFE)-covered endoprostheses has dramatically improved the long-term patency of TIPS. However, since the last updated International guidelines have been published (year 2009) new evidence have come, which have open the field to new indications and solved areas of uncertainty...
October 29, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27867343/park2-microduplication-clinical-and-molecular-characterization-of-a-further-case-and-review-of-the-literature
#12
Orazio Palumbo, Pietro Palumbo, Maria P Leone, Raffaella Stallone, Teresa Palladino, Marcella Vendemiale, Stefano Palladino, Francesco Papadia, Massimo Carella, Rira Fischetto
We report on a patient with psychomotor deficits, language delay, dyspraxia, skeletal anomalies, and facial dysmorphisms (hirsutism, right palpebral ptosis, a bulbous nasal tip with enlarged and anteverted nares, and a mild prominent antihelix stem). Using high-resolution SNP array analysis, we identified a 0.49-Mb microduplication in chromosome 6q26 inherited from the mother involving the PARK2 gene: arr[hg19] 6q26(162,672,821-163,163,143)×3 mat. To the best of our knowledge, this is the third patient to date described in whom a 6q26 microduplication encompassing only the PARK2 gene has been reported in medical literature...
October 2016: Molecular Syndromology
https://www.readbyqxmd.com/read/27864929/temporal-lobe-epilepsy-and-focal-cortical-dysplasia-in-children-a-tip-to-find-the-abnormality
#13
Luca Bartolini, Matthew T Whitehead, Cheng-Ying Ho, Leigh N Sepeta, Chima O Oluigbo, Kathryn Havens, Emily R Freilich, John M Schreiber, William D Gaillard
OBJECTIVE: To demonstrate an association between magnetic resonance imaging (MRI) findings and pathologic characteristics in children who had surgery for medically refractory epilepsy due to focal cortical dysplasia (FCD). METHODS: We retrospectively studied 110 children who had epilepsy surgery. Twenty-seven patients with FCD were included. Thirteen had temporal lobe epilepsy (TLE) and 14 had extra-temporal lobe epilepsy (ETLE). Three patients had associated mesial temporal sclerosis...
November 16, 2016: Epilepsia
https://www.readbyqxmd.com/read/27864615/the-effects-of-active-mobilisation-and-rehabilitation-in-icu-on-mortality-and-function-a-systematic-review
#14
REVIEW
Claire J Tipping, Meg Harrold, Anne Holland, Lorena Romero, Travis Nisbet, Carol L Hodgson
PURPOSE: Early active mobilisation and rehabilitation in the intensive care unit (ICU) is being used to prevent the long-term functional consequences of critical illness. This review aimed to determine the effect of active mobilisation and rehabilitation in the ICU on mortality, function, mobility, muscle strength, quality of life, days alive and out of hospital to 180 days, ICU and hospital lengths of stay, duration of mechanical ventilation and discharge destination, linking outcomes with the World Health Organization International Classification of Function Framework...
November 18, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27858520/fundoplication-for-gastroesophageal-reflux-disease-tips-for-success
#15
Marco G Patti, Francisco Schlottmann, Timothy M Farrell
Gastroesophageal reflux disease affects almost 20% of the population in the United States. Today, proton pump inhibitors are the most frequently prescribed drugs, with an estimated cost of 10 billion dollars per year. Although these medications control heartburn in the majority of patients, other symptoms such as regurgitation and respiratory symptoms often are not controlled, particularly in patients with large hiatal hernias. In these patients a properly performed laparoscopic fundoplication controls esophageal and extraesophageal symptoms and avoids life-long medical therapy...
November 18, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27843092/rmnd1-related-leukoencephalopathy-with-temporal-lobe-cysts-and-hearing-loss-another-mendelian-mimicker-of-congenital-cytomegalovirus-infection
#16
Nicole Ulrick, Amy Goldstein, Cas Simons, Ryan J Taft, Guy Helman, Amy Pizzino, Miriam Bloom, Julie Vogt, Karen Pysden, Daria Diodato, Diego Martinelli, Ahmad Monavari, Daniela Buhas, Clara D M van Karnebeek, Imen Dorboz, Odile Boespflug-Tanguy, Diana Rodriguez, Martine Tétreault, Jacek Majewski, Genevieve Bernard, Yi Shiau Ng, Robert McFarland, Adeline Vanderver
BACKGROUND: Leukoencephalopathy with temporal lobe cysts may be associated with monogenetic conditions such as Aicardi-Goutières syndrome or RNASET2 mutations and with congenital infections such as cytomegalovirus. In view of the fact that congenital cytomegalovirus is difficult to confirm outside the neonatal period, excluding a Mendelian disorder is extremely relevant, changing family planning and medical management in affected families. We performed diagnostic testing in individuals with leukoencephalopathy with temporal lobe cysts without a definitive diagnosis of congenital cytomegalovirus infection...
September 13, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27832725/twelve-tips-for-turning-quality-assurance-data-into-undergraduate-teaching-awards-a-quality-improvement-and-student-engagement-initiative
#17
Kate Newton, Helen Lewis, Mark Pugh, Madhavi Paladugu, Alexander Woywodt
Data on teaching awards in undergraduate medical education are sparse. The benefits of an awards system may seem obvious at first glance. However, there are also potential problems relating to fairness, avoidance of bias, and alignment of the awards system with a wider strategy for quality improvement and curriculum development. Here, we report five- year single center experience with establishing undergraduate teaching awards in a large academic teaching hospital. Due to lack of additional funding we based our awards not on peer review but mainly on existing and very comprehensive quality assurance (QA) data...
November 10, 2016: Medical Teacher
https://www.readbyqxmd.com/read/27831998/hemodynamic-performance-of-a-novel-right-ventricular-assist-device-perkat%C3%A2
#18
Daniel Kretzschmar, P Christian Schulze, Markus W Ferrari
Acute right ventricular failure (RVF) is an increasingly clinical problem and a life-threatening condition. Right ventricular assist devices (RVADs) represent a reasonable treatment option for patients with refractory RVF. We here present a novel percutaneously implantable device for RV support.The PERKAT device is based on a nitinol stent cage which is covered with valve- carrying foils. A flexible outlet trunk with a pigtail tip is connected to the distal part. The device is driven by an IABP drive unit which inflates/deflates a standard IABP balloon placed within in the stent cage...
November 9, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27830140/failed-septal-extension-graft-in-a-patient-with-a-history-of-radiotherapy
#19
Il Gyu Kang, Seon Tae Kim, Seok Ho Lee, Min Kwan Baek
BACKGROUND: This report describes the authors' experience of "melting" septal cartilage after placement of a septal extension graft in a nasopharyngeal cancer patient that had been previously undergone radiation therapy, and provides a review of the literature. METHODS: Electronic medical records were used to obtain details of the patient's clinical history. RESULTS: A 32-year-old woman, who had previously undergone radiotherapy for nasopharyngeal cancer, visited our department to for rhinoplasty...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27825568/osteoarticular-manifestations-of-celiac-disease-and-non-celiac-gluten-hypersensitivity
#20
Stéphanie Dos Santos, Frédéric Lioté
Celiac disease is a chronic inflammatory autoimmune enteropathy based disorder that is triggered by the ingestion of gluten in genetically susceptible individuals. The global prevalence of 1% to 2% represents only the tip of the iceberg. The diagnosis is confirmed by positive specific antibody, anti-transglutaminase or anti-endomysium, specific lesions of the small intestine and a response to strict gluten-free diet. The diagnosis is difficult and often delayed because the clinical variability is very large, ranging from digestive clinical presentation "classic" to "atypical" symptoms, often extra-intestinal, that are sometimes attributed to a concomitant disease or a complication...
November 4, 2016: Joint, Bone, Spine: Revue du Rhumatisme
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