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https://www.readbyqxmd.com/read/28427747/percutaneous-endoscopic-gastrostomy-for-aspiration-pneumonia-a-10-year-single-center-experience
#1
Hiromi Tomioka, Shyuji Yamashita, Nobuaki Mamesaya, Masahiro Kaneko
BACKGROUND: The significance of percutaneous endoscopic gastrostomy (PEG) in patients with aspiration pneumonia is unknown. The purpose of this study was to evaluate the clinical characteristics and outcomes of aspiration pneumonia patients who underwent PEG. METHODS: A retrospective cohort study of consecutive patients hospitalized with pneumonia who underwent PEG from 2005 to 2014. RESULTS: Of 2281 cases of pneumonia, 92 patients with aspiration pneumonia underwent PEG during their hospital stay...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28425762/the-evaluation-of-bulbar-dysfunction-in-amyotrophic-lateral-sclerosis-survey-of-clinical-practice-patterns-in-the-united-states
#2
Emily K Plowman, Lauren C Tabor, James Wymer, Gary Pattee
OBJECTIVE: Speech and swallowing impairments are highly prevalent in individuals with amyotrophic lateral sclerosis (ALS) and contribute to reduced quality of life, malnutrition, aspiration, pneumonia and death. Established practice parameters for bulbar dysfunction in ALS do not currently exist. The aim of this study was to identify current practice patterns for the evaluation of speech and swallowing function within participating Northeast ALS clinics in the United States. METHODS AND RESULTS: A 15-item survey was emailed to all registered NEALS centres...
April 20, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/28425182/serum-ferritin-thresholds-for-the-diagnosis-of-iron-deficiency-in-pregnancy-a-systematic-review
#3
REVIEW
J Daru, J Allotey, J P Peña-Rosas, K S Khan
The aim of this review was to understand the landscape of serum ferritin in diagnosing iron deficiency in the aetiology of anaemia in pregnancy. Iron deficiency in pregnancy is a major public health problem leading to the development of anaemia. Reducing the global prevalence of anaemia in women of reproductive age is a 2025 global nutrition target. Bone marrow aspiration is the gold standard test for iron deficiency but requires an invasive procedure; therefore, serum ferritin is the most clinically useful test...
April 20, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28404647/randomised-comparison-of-needle-aspiration-and-chest-tube-drainage-in-spontaneous-pneumothorax
#4
A Thelle, M Gjerdevik, M SueChu, O M Hagen, P Bakke
Guidelines on spontaneous pneumothorax are contradictory as to intervention between needle aspiration (NA) and chest tube drainage (CTD). Studies show poor adherence to guidelines.Three Norwegian hospitals included patients with primary (PSP) and secondary (SSP) spontaneous pneumothorax. Patients underwent NA or CTD as the primary intervention. The main outcome was duration of hospital stay. Secondary outcomes were immediate- and 1-week success rates and complications.127 patients were included, including 48 patients with SSP...
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28404017/dna-testing-of-pancreatic-cyst-fluid-is-it-ready-for-prime-time
#5
REVIEW
Aatur D Singhi, Marina N Nikiforova, Kevin McGrath
Pancreatic cysts are a clinical quandary in both diagnosis and management. Although many cysts, such as pseudocysts and serous cystadenomas, are benign and can be monitored clinically, mucinous cysts, such as intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, have the potential to progress to pancreatic cancer. Considering the poor prognosis of pancreatic cancer, the detection of a pancreatic cyst can be a source of anxiety for both the patient and physician. This diagnosis in turn can lead to expensive, invasive, and even harmful surveillance and treatment options...
January 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28402167/multiinstitutional-analysis-of-thyroid-nodule-risk-stratification-using-the-american-college-of-radiology-thyroid-imaging-reporting-and-data-system
#6
William D Middleton, Sharlene A Teefey, Carl C Reading, Jill E Langer, Michael D Beland, Margaret M Szabunio, Terry S Desser
OBJECTIVE: Guidelines for managing thyroid nodules are highly dependent on risk stratification based on sonographic findings. The purpose of this study is to evaluate the risk stratification system used by the American College of Radiology Thyroid Imaging Reporting and Data System (TIRADS). MATERIALS AND METHODS: Patients with thyroid nodules who underwent sonography and fine-needle aspiration were enrolled in a multiinstitutional study. The sonographic nodule features evaluated in the study were composition, echogenicity, margins, and echogenic foci...
April 12, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28397856/1-5-2%C3%A2-cm-tumor-size-was-not-associated-with-distant-metastasis-and-mortality-in-small-thyroid-cancer-a-population-based-study
#7
Kyunghwa Han, Eun-Kyung Kim, Jin Young Kwak
Most guidelines for the diagnosis and management of thyroid nodules have suggested fine-needle aspiration as a diagnostic tool, with some of these previously published guidelines suggesting a cutoff size of 1.5 cm. In thyroid cancers (1-2 cm), we hypothesized that tumors 1.5 cm or larger had more unfavorable clinical outcomes than ones smaller than 1.5 cm nodules. Using the Surveillance, Epidemiology, and End Results database, we identified 14,117 patients diagnosed with only primary thyroid cancer between 1988 and 2007...
April 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28384788/neurologic-evaluation-in-children-with-laryngeal-cleft
#8
Ryan D Walker, Alexandria L Irace, Margaret A Kenna, David K Urion, Reza Rahbar
Importance: Referral to a neurologist and imaging play important roles in the management of laryngeal cleft. Swallowing involves a complex series of neuromuscular interactions, and aspiration can result from anatomical causes (eg, laryngeal cleft), neuromuscular disorders, or some combination thereof. To date, no protocols or guidelines exist to identify which patients with laryngeal cleft should undergo neuroimaging studies and/or consultation with a neurologist. Objective: To establish guidelines for neurologic evaluation and imaging techniques to identify or rule out neuromuscular dysfunction in children with laryngeal cleft...
April 6, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28371480/percutaneous-and-endoscopic-gallbladder-drainage-for-the-acute-cholecystitis-international-multicenter-comparative-study-by-a-propensity-score-matched-analysis
#9
Takao Itoi, Tadahiro Takada, Tsann-Long Hwang, Itaru Endo, Kohei Akazawa, Fumihiko Miura, Miin-Fu Chen, Yi-Yin Jan, Chen-Guo Ker, Hsiu-Po Wang, Harumi Gomi, Masamichi Yokoe, Seiki Kiriyama, Hiroki Yamaue, Masaru Miyazaki, Masakazu Yamamoto
BACKGROUND: Tokyo Guideline 2013 (TG13) proposed three drainage technique for the treatment of acute cholecystitis. We evaluated the clinical efficacy and adverse events between percutaneous transhepatic intervention (PTGBI) including percutaneous transhepatic drainage (PTGBD) and percutaneous transhepatic aspiration (PTGBA) and endoscopic transpapillary gallbladder drainage (EGBD). METHODS: A cohort study was performed using propensity score matching to reduce treatment selection bias...
March 29, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28370782/preoperative-evaluation-and-surgical-planning-of-submandibular-gland-tumors
#10
Timo Atula, Juha Panigrahi, Jussi Tarkkanen, Antti Mäkitie, Katri Aro
BACKGROUND: Roughly half of submandibular gland neoplasms are malignant. Because preoperative information on the nature of these tumors remains limited, both preoperative evaluation and assessment of the extent of primary surgery warrant guidelines that are more accurate. METHODS: We evaluated the preoperative examinations and management of all submandibular gland neoplasms treated surgically at the Helsinki University Hospital between 2000 and 2010. RESULTS: Of the 83 tumors, 58 (70%) were benign and 25 (30%) were malignant...
March 28, 2017: Head & Neck
https://www.readbyqxmd.com/read/28367882/severe-acute-respiratory-infection-sari-surveillance-for-hospitalized-patients-in-northern-vietnam-2011-2014
#11
Hang Khanh Le Nguyen, Son Vu Nguyen, Anh Phuong Nguyen, Phuong Mai Vu Hoang, Thanh Thi Le, Thach Co Nguyen, Huong Thu Hoang, Cuong Duc Vuong, Loan Thi Thanh Tran, Le Quynh Mai
Worldwide Severe Acute Respiratory Infections (SARI) are leading causes of hospitalization, morbidity and mortality in children. The aim of this study was to identify viral pathogens responsible for SARI in northern Vietnam from 2011 to 2014. METHODS: Throat swabs and tracheal aspirates were collected from SARI patients according to WHO Guidelines. Thirteen different viral pathogens (Influenza A(H1N)pdm09; A/H3N2; A/H5; A/H7 and B; Para influenza 1,2,3; RSV; HMPV; Adeno; SARS-CoV and Rhino) were tested by conventional/ real-time RT-PCR...
March 28, 2017: Japanese Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28347199/the-use-of-cellular-and-molecular-biomarkers-to-manage-copd-exacerbations
#12
Terence Ho, Angira Dasgupta, Frederick E Hargreave, Parameswaran Nair
Chronic obstructive pulmonary disease (COPD) exacerbations are a common cause of respiratory morbidity and mortality, and have various etiologies. Multiple cellular and molecular biomarkers have been associated with exacerbations. Quantitative sputum cell counts are able to identify the presence and type of bronchitis, which is an important contributor to exacerbations. Their utility to monitor bronchitis and to help treat exacerbations has been evaluated, yet they are not used in routine clinical practice...
May 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28317015/evaluation-of-the-2015-aga-guidelines-on-pancreatic-cystic-neoplasms-in-a-large-surgically-confirmed-multicenter-cohort
#13
Phillip S Ge, V Raman Muthusamy, Srinivas Gaddam, Diana-Marie Jaiyeola, Stephen Kim, Alireza Sedarat, Timothy R Donahue, Lindsay Hosford, Robert H Wilson, David P Grande, Rajesh N Keswani, Vladimir M Kushnir, Daniel Mullady, Steven A Edmundowicz, Dayna S Early, Srinadh Komanduri, Sachin Wani, Rabindra R Watson
Background and study aims The American Gastroenterological Association (AGA) recently published guidelines for the management of asymptomatic pancreatic cystic neoplasms (PCNs). We aimed to evaluate the diagnostic characteristics of the AGA guidelines in appropriately recommending surgery for malignant PCNs. Patients and methods A retrospective multicenter study was performed of patients who underwent endoscopic ultrasound (EUS) for evaluation of PCNs who ultimately underwent surgical resection from 2004 - 2014...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28288860/epidemiology-of-multidrug-resistant-gram-negative-pathogens-isolated-from-ventilator-associated-pneumonia-in-icu-patients
#14
Richa Gupta, Abida Malik, Meher Rizvi, Moied Ahmed, Anuradha Singh
OBJECTIVES: Antibiotic resistance among Gram-negative pathogens isolated from ventilator-associated pneumonia (VAP) poses a grave threat in intensive care unit (ICU) patients. The aim of this study was to assess the prevalence of pathogens in ICU patients and their drug resistance profile. The prevalence of extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases and metallo-β-lactamases (MBLs) was also assessed. METHODS: Tracheal aspirates were collected aseptically from 87 ICU patients between May 2012 and January 2014...
April 10, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28285385/real-time-elastography-in-autonomously-functioning-thyroid-nodules-relationship-with-tsh-levels-scintigraphy-and-ultrasound-patterns
#15
Pierpaolo Trimboli, Gaetano Paone, Maria Chiara Zatelli, Luca Ceriani, Luca Giovanella
BACKGROUND: Real-time elastography has been proposed to increase the sensitivity of ultrasound and improve the detection of thyroid nodules at risk of malignancy. To date sparse data on real-time elastography assessment of autonomously functioning thyroid nodules exist. Here, we investigated the potential role of real-time elastography in autonomously functioning thyroid nodule assessment. Specifically, the correlation between serum hormones and real-time elastography score, as well as other clinical and ultrasound features, was analyzed...
March 11, 2017: Endocrine
https://www.readbyqxmd.com/read/28283790/a-retrospective-study-of-ultrasound-and-fna-cytology-investigation-of-thyroid-nodules-working-towards-combined-risk-stratification
#16
Zi Wei Liu, Richard Fox, Samit Unadkat, Roy Farrell
The British Thyroid Association recommended in new guidelines on thyroid cancer treatment [Kwak et al. (Korean J Radiol 14:110-117, 2013)] that ultrasound grading of thyroid nodules should be incorporated into MDT management. A retrospective study was carried out to determine that the impact of US grading has had on MDT decision making in practice. The design used in the study is a retrospective review of case notes. The study was carried out in the hub hospital for thyroid cancer in the North west London Cancer network...
March 10, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28270944/ischaemic-priapism-a-clinical-review
#17
REVIEW
Joanne Ridgley, Nicholas Raison, M Iqbal Sheikh, Prokar Dasgupta, M Shamim Khan, Kamran Ahmed
OBJECTIVE: Ischaemic priapism is a rare condition characterised by little or no cavernosal blood flow, pain and rigidity of the penis. Immediate intervention is required to restore blood flow, prevent necrosis and erectile dysfunction. This review was conducted to determine the best course of treatment and identify areas in current guidelines to which improvements could be made. MATERIAL AND METHODS: PubMed, Ovid, MEDLINE (1946-December 2016) and the Cochrane Library were searched as sources for literature...
March 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28259883/measurement-of-oxygen-desaturation-is-not-useful-for-the-detection-of-aspiration-in-dysphagic-stroke-patients
#18
Thomas Marian, Jens Schröder, Paul Muhle, Inga Claus, Stephan Oelenberg, Christina Hamacher, Tobias Warnecke, Sonja Suntrup-Krüger, Rainer Dziewas
BACKGROUND: Dysphagia is one of the most dangerous symptoms of acute stroke. Various screening tools have been suggested for the early detection of this condition. In spite of conflicting results, measurement of oxygen saturation (SpO2) during clinical swallowing assessment is still recommended by different national guidelines as a screening tool with a decline in SpO2 ≥2% usually being regarded as a marker of aspiration. This paper assesses the sensitivity of SpO2 measurements for the evaluation of aspiration risk in acute stroke patients...
March 4, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#19
Ivor S Douglas
PURPOSE OF REVIEW: Diagnosis of pulmonary infection, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in the critically ill patient remains a common and therapeutically challenging diagnosis with significant attributable morbidity, mortality, and cost. Current clinical approaches to surveillance, early detection and, conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of HAP and VAP and the impact of these novel approaches on rational antimicrobial selection and stewardship are the focus of recent studies reviewed here...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28255971/guideline-compliance-in-surgery-for-thyroid-nodules-a-retrospective-study
#20
A Reinisch, P Malkomes, N Habbe, J Bojunga, F Grünwald, K Badenhoop, W O Bechstein, K Holzer
Diagnostic guidelines for thyroid nodules focus on malignancy risk assessment to avoid unnecessary diagnostic operations. These guidelines recommend a combination of tests in form of a diagnostic algorithm. The present study analyzed the recommended algorithm and its implementation by different medical professionals. Preoperative diagnostic procedures, laboratory tests and histopathological findings of patients who underwent thyroid surgery between 2006 and 2013 were analyzed. The results were stratified by the assignation by specialized endocrinologists (ENP), general practitioners (GP) or Goethe-University Hospital Frankfurt (UKF)...
March 2, 2017: Experimental and Clinical Endocrinology & Diabetes
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