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https://www.readbyqxmd.com/read/28812833/evaluating-the-implementation-and-feasibility-of-a-web-based-tool-to-support-timely-identification-and-care-for-the-frail-population-in-primary-healthcare-settings
#1
Beverley Lawson, Tara Sampalli, Stephanie Wood, Grace Warner, Paige Moorhouse, Rick Gibson, Laurie Mallery, Fred Burge, Lisa G Bedford
BACKGROUND: Understanding and addressing the needs of frail persons is an emerging health priority for Nova Scotia and internationally. Primary healthcare (PHC) providers regularly encounter frail persons in their daily clinical work. However, routine identification and measurement of frailty is not standard practice and, in general, there is a lack of awareness about how to identify and respond to frailty. A web-based tool called the Frailty Portal was developed to aid in identifying, screening, and providing care for frail patients in PHC settings...
March 7, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28811930/improved-ct-detection-of-acute-bowel-ischemia-using-frequency-selective-non-linear-image-blending
#2
Sven Schneeweiss, Michael Esser, Wolfgang Thaiss, Hans Boesmueller, Hendrik Ditt, Konstantin Nikolau, Marius Horger
BACKGROUND: Computed tomography (CT) as a fast and reliable diagnostic technique is the imaging modality of choice for acute bowel ischemia. However, diagnostic is often difficult mainly due to low attenuation differences between ischemic and perfused segments. PURPOSE: To compare the diagnostic efficacy of a new post-processing tool based on frequency selective non-linear blending with that of conventional linear contrast-enhanced CT (CECT) image blending for the detection of bowel ischemia...
July 2017: Acta Radiologica Open
https://www.readbyqxmd.com/read/28810886/factors-affecting-survival-after-concurrent-chemoradiation-therapy-for-advanced-hepatocellular-carcinoma-a-retrospective-study
#3
Ja Kyung Kim, Jun Won Kim, Ik Jae Lee, Seung-Moon Joo, Kwang-Hun Lee, Eun-Suk Cho, Jeong-Sik Yu, Tae Joo Jeon, Yonsoo Kim, Jung Il Lee, Kwan Sik Lee
BACKGROUND: Concurrent chemoradiation therapy (CCRT) followed by hepatic arterial infusional chemotherapy (HAIC) was reported to be effective for advanced hepatocellular carcinoma (HCC) with portal vein thrombosis. However, transarterial chemoembolization (TACE) is not preferred in this setting. The aim of this study was to assess the factors affecting survival after CCRT, including additional TACE during repeated HAIC. METHODS: Thirty-eight patients who underwent CCRT as the initial treatment for Barcelona Clinic Liver Cancer stage C HCC with vascular invasion between 2009 and 2016 were reviewed retrospectively...
August 15, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28809736/monosegmental-alpps-after-bilateral-hepatectomy
#4
Klaus Steinbru Ck, Marcelo D'Oliveira, Renato Cano, Marcelo Enne
Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) has emerged as an alternative for patients with bilobar colorectal liver metastasis and a small future liver remnant (FLR). In cases of extensive disease, ALPPS can be performed, leaving only one segment of the liver as FLR. We describe a case of monosegmental ALPPS using segment 4 as FLR. In conclusion, ALPPS should be reserved for a selected group of patients. Monosegmental ALPPS is feasible, but should be performed by hepatobiliary surgeons in specialized centers...
August 8, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28809446/deferasirox-for-managing-iron-overload-in-people-with-thalassaemia
#5
REVIEW
Claudia Bollig, Lisa K Schell, Gerta Rücker, Roman Allert, Edith Motschall, Charlotte M Niemeyer, Dirk Bassler, Joerg J Meerpohl
BACKGROUND: Thalassaemia is a hereditary anaemia due to ineffective erythropoiesis. In particular, people with thalassaemia major develop secondary iron overload resulting from regular red blood cell transfusions. Iron chelation therapy is needed to prevent long-term complications.Both deferoxamine and deferiprone are effective; however, a review of the effectiveness and safety of the newer oral chelator deferasirox in people with thalassaemia is needed. OBJECTIVES: To assess the effectiveness and safety of oral deferasirox in people with thalassaemia and iron overload...
August 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28808803/a-prototype-educational-model-for-hepatobiliary-interventions-unveiling-the-role-of-graphic-designers-in-medical-3d-printing
#6
Ramin Javan, Merissa N Zeman
In the context of medical three-dimensional (3D) printing, in addition to 3D reconstruction from cross-sectional imaging, graphic design plays a role in developing and/or enhancing 3D-printed models. A custom prototype modular 3D model of the liver was graphically designed depicting segmental anatomy of the parenchyma containing color-coded hepatic vasculature and biliary tree. Subsequently, 3D printing was performed using transparent resin for the surface of the liver and polyamide material to develop hollow internal structures that allow for passage of catheters and wires...
August 14, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28808782/thromboembolic-events-following-splenectomy-risk-factors-prevention-management-and-outcomes
#7
Amihai Rottenstreich, Geffen Kleinstern, Galia Spectre, Nael Da'as, Esther Ziv, Yosef Kalish
BACKGROUND: Thromboembolic events following splenectomy are not uncommon. However, the role of thromboprophylaxis and risk factors for thrombosis, as well as the clinical course and outcomes, are not well characterized. METHODS: A retrospective review of individuals who underwent splenectomy between January 2006 and December 2015 in two university hospitals. RESULTS: Overall, 297 patients underwent splenectomy [open splenectomy (n = 199), laparoscopic splenectomy (n = 98)]...
August 14, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28807977/can-secure-patient-provider-messaging-improve-diabetes-care
#8
Sukyung Chung, Laura Panattoni, Jeffrey Chi, Latha Palaniappan
OBJECTIVE: Internet-based secure messaging between patients and providers through a patient portal is now common in the practice of modern medicine. There is limited evidence on how messaging is associated with use and clinical quality measures among patients with type 2 diabetes. We examine whether messaging with physicians for medical advice is associated with fewer face-to-face visits and better diabetes management. RESEARCH DESIGN AND METHODS: Patients with diabetes who were enrolled in an online portal of an outpatient health care organization in 2011-2014 were studied (N = 37,762 patient-years)...
August 14, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28807245/portal-vein-ligation-versus-portal-vein-embolization-for-induction-of-hypertrophy-of-the-future-liver-remnant-a-systematic-review-and-meta-analysis
#9
REVIEW
C J Isfordink, M Samim, M N G J A Braat, A M Almalki, J Hagendoorn, I H M Borel Rinkes, I Q Molenaar
An important risk of major hepatic resection is postoperative liver failure, which is directly related to insufficient future liver remnant (FLR). Portal vein embolization (PVE) and portal vein ligation (PVL) can minimize this risk by inducing hypertrophy of the FLR. The aim of this systematic review and meta-analysis was to compare the efficacy and safety of PVE and PVL for FLR hypertrophy. A systematic search was conducted on the17(th) of January 2017. The methodological quality of the studies was assessed using the Oxford Critical Appraisal Skills Program for cohort studies...
September 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28807040/management-of-upper-gastrointestinal-bleeding-in-emergency-departments-from-bleeding-symptoms-to-diagnosis-a-prospective-multicenter-observational-study
#10
Pierre-Clément Thiebaud, Youri Yordanov, Jacques-Emmanuel Galimard, Pierre-Alexis Raynal, Sébastien Beaune, Laurent Jacquin, François-Xavier Ageron, Dominique Pateron
BACKGROUND: Upper gastrointestinal bleeding (UGB) is common in emergency departments (EDs) and can be caused by many eso-gastro-duodenal lesions. Most available epidemiological data and data on the management of UGB comes from specialized departments (intensive care units or gastroenterology departments), but little is known from the ED perspective. We aimed to determine the distribution of symptoms revealing UGB in EDs and the hemorrhagic lesions identified by endoscopy. We also describe the characteristics of patients consulting for UGB, UGB management in the ED and patients outcomes...
August 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28806321/liver-imaging-reporting-and-data-system-discordance-between-computed-tomography-and-gadoxetate-enhanced-magnetic-resonance-imaging-for-detection-of-hepatocellular-carcinoma-major-features
#11
Victoria Chernyak, Milana Flusberg, Amy Law, Mariya Kobi, Viktoriya Paroder, Alla M Rozenblit
PURPOSE: The goal of this study was to compare agreement between computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of the major Liver Imaging Reporting and Data System (LI-RADS) features used in assessment of hepatocellular carcinoma: arterial phase hyperenhancement (APHE), portal venous phase washout (WO), capsule appearance (capsule), and largest diameter (diameter). METHODS: Patients with liver protocol CT and gadoxetate-enhanced MRI within 1 month of each other and at least 1 discrete untreated liver lesion were included...
August 12, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28806301/risk-adjustment-in-alpps-is-associated-with-a-dramatic-decrease-in-early-mortality-and-morbidity
#12
Michael Linecker, Bergthor Björnsson, Gregor A Stavrou, Karl J Oldhafer, Georg Lurje, Ulf Neumann, René Adam, Francois-René Pruvot, Stefan A Topp, Jun Li, Ivan Capobianco, Silvio Nadalin, Marcel Autran Machado, Sergey Voskanyan, Deniz Balci, Roberto Hernandez-Alejandro, Fernando A Alvarez, Eduardo De Santibañes, Ricardo Robles-Campos, Massimo Malagó, Michelle L de Oliveira, Mickael Lesurtel, Pierre-Alain Clavien, Henrik Petrowsky
OBJECTIVE: To longitudinally assess whether risk adjustment in Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) occurred over time and is associated with postoperative outcome. BACKGROUND: ALPPS is a novel 2-stage hepatectomy enabling resection of extensive hepatic tumors. ALPPS has been criticized for its high mortality, which is reported beyond accepted standards in liver surgery. Therefore, adjustments in patient selection and technique have been performed but have not yet been studied over time in relation to outcome...
August 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28805258/impact-of-beta-blockers-on-cardiopulmonary-exercise-testing-in-patients-with-advanced-liver-disease
#13
M P Wallen, A Hall, K A Dias, J S Ramos, S E Keating, A J Woodward, T L Skinner, G A Macdonald, R Arena, J S Coombes
BACKGROUND: Patients with advanced liver disease may develop portal hypertension that can result in variceal haemorrhage. Beta-blockers reduce portal pressure and minimise haemorrhage risk. These medications may attenuate measures of cardiopulmonary performance, such as the ventilatory threshold and peak oxygen uptake measured via cardiopulmonary exercise testing. AIM: To determine the effect of beta-blockers on cardiopulmonary exercise testing variables in patients with advanced liver disease...
August 14, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28801510/therapeutic-options-for-bleeding-oesophageal-varices-cyanoacrylate-and-balloon-occluded-retrograde-obliteration-brto
#14
Helena L Frischtak, Jessica P Davis, Neeral L Shah
A 56-year-old male with cirrhosis presented with acute bleeding from cardiofundal gastroesophageal varices (GOV) and was treated with endoscopic cyanoacrylate glue. Glue therapy achieved stabilisation of the patient in the emergent setting. Three months later, the patient suffered rebleeding. At that time, he underwent retreatment with balloon-occluded retrograde obliteration (BRTO), with no recurrence at a follow-up of 14 months.Available treatments for bleeding GOV include methods to (a) directly obstruct the varices (endoscopic variceal ligation , sclerotherapy and cyanoacrylate glue, BRTO) or to (b) decrease portal pressure (surgical portacaval shunts; transportal intrahepatic portosystemic shunt)...
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28799842/midterm-safety-and-efficacy-of-irreversible-electroporation-of-malignant-liver-tumors-located-close-to-major-portal-or-hepatic-veins
#15
Martina Distelmaier, Alexandra Barabasch, Philipp Heil, Nils A Kraemer, Peter Isfort, Sebastian Keil, Christiane K Kuhl, Philipp Bruners
Purpose To investigate the efficacy and safety of irreversible electroporation (IRE) in the treatment of hepatic tumors not suitable for thermal ablation (radiofrequency ablation [RFA] or microwave ablation). Materials and Methods This was an institutional review board-approved prospective study in 29 patients (15 men, 14 women; mean age, 63 years ± 12 [standard deviation]) with 43 primary (n = 8) or secondary (n = 35) malignant liver tumors who underwent computed tomography (CT)-guided IRE. All target tumors were located immediately adjacent to major hepatic veins, portal veins, or both; thus, they were not considered suitable for RFA or microwave ablation...
August 11, 2017: Radiology
https://www.readbyqxmd.com/read/28799827/laparoscopic-splenectomy-for-massive-splenomegaly-does-size-matter
#16
Levan Tsamalaidze, John A Stauffer, Samantha L Permenter, Horacio J Asbun
BACKGROUND: Laparoscopic splenectomy (LS) has become the most common approach for elective splenectomy, but use of LS for patients with massive splenomegaly (MS) remains controversial. By the 2008 European guidelines, LS for MS (spleen size >20 cm) is generally not recommended. METHODS: We performed a retrospective analysis of 229 consecutive patients undergoing LS, hand-assist (HALS), and open splenectomy (OS) at our institution from January 1, 1995 to December 2016...
August 11, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28799151/contrast-enhanced-ultrasound-features-of-hepatocellular-carcinoma-not-detected-during-the-screening-procedure
#17
Yi Dong, Wen-Ping Wang, Feng Mao, Christoph Dietrich
Aim The aim of this retrospective study is to report on the characteristics of contrast-enhanced ultrasound (CEUS) of primarily not detected hepatocellular carcinoma (HCC) during the screening procedure of patients at risk. Methods Sixty-four patients with a finally solitary and histologically proven HCC not detected HCC during the screening procedure were retrospectively analyzed. Most of HCC lesions (90.6 %, 58/64) measured < 20 mm in diameter. All HCC lesions were not detected during the initial screening procedure but suspected using contrast-enhanced magnetic resonance imaging...
August 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28798996/operative-results-and-oncologic-outcomes-of-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-versus-two-stage-hepatectomy-tsh-in-patients-with-unresectable-colorectal-liver-metastases-a-systematic-review-and-meta-analysis
#18
REVIEW
Dimitrios Moris, Sean Ronnekleiv-Kelly, Ioannis D Kostakis, Diamantis I Tsilimigras, Eliza W Beal, Alexandros Papalampros, Dimitrios Dimitroulis, Evangelos Felekouras, Timothy M Pawlik
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently emerged as a treatment choice for patients with colorectal liver metastases (CLM) and inadequate future liver remnant (FLR). The aim of this study was to define the results of ALPPS compared with two-stage hepatectomy (TSH) for patients with CLM. MATERIALS AND METHODS: A meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines...
August 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28798939/orphan-nuclear-receptor-tr3-nur77-is-a-specific-therapeutic-target-for-hepatic-cancers
#19
Yingling Zeng, Xiaoguang Ye, Degui Liao, Shizhang Huang, Huinan Mao, Dezheng Zhao, Huiyan Zeng
OBJECTIVE: Although great success has been achieved in cancer treatment, current cancer therapies, including anti-tumorigenesis and anti-angiogenesis, still face the problems of insufficient efficacy, resistance and intrinsic refractoriness, in addition to their toxic side effects. There is a demand to identify additional targets that can be blocked to turn off the downstream effects of most, if not all, pathways. Our previous studies suggest that orphan nuclear receptor TR3 (human) / Nur77 (mouse) is such a target...
June 2017: Journal of Clinical & Experimental Oncology
https://www.readbyqxmd.com/read/28798013/an-electronic-health-record-based-strategy-to-systematically-assess-medication-use-among-primary-care-patients-with-multidrug-regimens-feasibility-study
#20
Stacy Cooper Bailey, Christine U Oramasionwu, Alexandra C Infanzon, Emily R Pfaff, Izabela E Annis, Daniel S Reuland
BACKGROUND: Medication nonadherence and misuse are public health and patient safety concerns. With the increased adoption of electronic health records (EHRs), greater opportunities exist to communicate directly with, and collect data from, patients through secure portals linked to EHRs. OBJECTIVE: The study objectives were to develop and pilot test a method of monitoring patient medication use in outpatient settings and determine the feasibility and acceptability of this approach...
August 10, 2017: JMIR Research Protocols
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