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https://www.readbyqxmd.com/read/29331086/current-management-of-small-bowel-obstruction-in-the-uk-results-from-the-national-audit-of-small-bowel-obstruction-clinical-practice-survey
#1
Matthew J Lee, Adele E Sayers, Timothy R Wilson, Austin G Acheson, Iain D Anderson, Nicola S Fearnhead
AIM: Small bowel obstruction (SBO) is associated with high rates of morbidity and mortality. The National Audit of Small Bowel Obstruction (NASBO) is a collaboration between trainees and specialty associations to improve the care of patients with SBO through national clinical audit. The aim of this study was to define current Consultant practice preferences in the management of small bowel obstruction in the UK. METHOD: A survey was designed to assess practice preferences of consultant surgeons...
January 13, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29324374/ileal-gist-presenting-with-bacteremia-and-liver-abscess-a-case-report-and-review-of-literature
#2
Marina Gorelik, Braulio Sabates, Adel Elkbuli, Tony Dunne
INTRODUCTION: Small intestine gastrointestinal stromal tumors can infrequently present with intra-abdominal abscess, perforation, obstruction or fistula. Tumor-small intestine fistula is a rare phenomenon and occurs as a result of GISTs' propensity to cause mucosal ulceration. This allows bacteria from the gut to gain access to the systemic circulation and predisposes the patient to bacteremia and pyogenic liver abscess. PRESENTATION OF CASE: We present a case of a 63-year-old female whose initial symptoms included fever, nausea, vomiting and right upper quadrant pain...
December 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29306977/acute-appendicitis-in-childhood-oral-contrast-does-not-improve-ct-diagnosis
#3
Crystal R Farrell, Adam D Bezinque, Jared M Tucker, Erica A Michiels, Bradford W Betz
INTRODUCTION: We compared the diagnostic accuracy of CT performed without and with oral contrast for suspected appendicitis in children. METHODS: In this retrospective cohort study, we reviewed abdomen/pelvis CT scans with IV contrast performed between 2011 and 2015 for suspected appendicitis. Oral contrast was used routinely before August 2013 and eliminated from the CT protocol thereafter. Diagnostic accuracy of CT was compared with operative/pathology reports, and included a 30-day follow-up period for non-surgical patients...
January 6, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29250759/orbital-cellulitis-presenting-as-giant-cell-arteritis-a-case-report
#4
Yu-Wei Hsu, Fu-Chi Yang, Jiunn-Tay Lee, Hung-Wen Kao, Chia-Kuang Tsai
PURPOSE: To present a case of orbital cellulitis initially mimicking giant cell arteritis. CASE REPORT: An 80-year-old man with a history of hypertension and type 2 diabetes mellitus was referred with a prominent progressive headache over the right temporal and periorbital areas. Non-contrast brain CT results were normal, but ESR was elevated. Giant cell arteritis was suspected initially. However, the symptoms progressed under oral corticosteroid therapy. The subsequent brain MRI with contrast revealed extensive contrast enhancement along the right optic nerve and optic canal with a rim-enhancing lesion in the posterior aspect of the optic nerve...
June 15, 2017: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/29249008/secondary-imaging-for-suspected-appendicitis-after-equivocal-ultrasound-time-to-disposition-of-mri-compared-to-ct
#5
James F Martin, David J Mathison, Paul C Mullan, Hansel J Otero
PURPOSE: The purpose of this study was to compare MRI to CT as a secondary imaging modality for children age 5 years and older with suspected appendicitis after an equivocal abdominal ultrasound in terms of (1) the time to ED disposition decision, (2) surgery consultation rate, and (3) imaging test accuracy. METHODS: We retrospectively studied children with suspected appendicitis and equivocal ultrasound results who underwent MR or CT as secondary imaging in a pediatric emergency department over two-consecutive 9-month periods...
December 16, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29218226/hamman-s-syndrome-in-diabetic-ketoacidosis
#6
Alexandra Rose Pain, Josh Pomroy, Andrea Benjamin
Hamman's syndrome (spontaneous subcutaneous emphysema and pneumomediastinum) is a rare complication of diabetic ketoacidosis (DKA), with a multifactorial etiology. Awareness of this syndrome is important: it is likely underdiagnosed as the main symptom of shortness of breath is often attributed to Kussmaul's breathing and the findings on chest radiograph can be subtle and easily missed. It is also important to be aware of and consider Boerhaave's syndrome as a differential diagnosis, a more serious condition with a 40% mortality rate when diagnosis is delayed...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29195844/leaflet-thrombosis-following-transcatheter-aortic-valve-implantation
#7
M Marwan, N Mekkhala, M Göller, J Röther, D Bittner, A Schuhbaeck, M Hell, G Muschiol, J Kolwelter, R Feyrer, C Schlundt, S Achenbach, M Arnold
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is increasingly being offered to high-risk patients with symptomatic aortic valve stenosis. Recent reports have suggested a high incidence of subclinical leaflet thrombosis following bioprosthestic aortic valve replacement. We report the frequency and clinical presentation of leaflet thrombosis identified by cardiac CT in patients referred for follow-up contrast enhanced CT angiography following TAVI. METHODS: 91 consecutive patients referred for follow-up contrast-enhanced CT angiography following TAVI were screened for inclusion in this analysis...
November 9, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29180930/examination-of-anastomotic-leak-with-aqueous-contrast-swallow-after-total-gastrectomy-should-it-be-carried-out-routinely
#8
Ulaş Aday, Ebubekir Gündeş, Hüseyin Çiyiltepe, Durmuş A Çetin, Selçuk Gülmez, Aziz S Senger, Kamuran C Değer, Mustafa Duman
Aim of the study: Examination of esophagojejunal (EJ) anastomosis with aqueous contrast swallow after total gastrectomy is still routinely conducted by many centres. The present study aimed to answer the question: Is it necessary to evaluate EJ anastomosis in terms of leakage by having every patient drink oral contrast agent before initiation of oral food intake after total gastrectomy (TG) performed due to gastric cancer? Material and methods: Clinical and radiological results of patients on whom total gastrectomy was performed due to gastric cancer between January 2013 and December 2016 were retrospectively reviewed...
2017: Contemporary Oncology Współczesna Onkologia
https://www.readbyqxmd.com/read/29175803/review-nanopreparations-for-better-drug-delivery
#9
Muhammad Imran Qadir
Nanomedicines are a recent development to face medical and pharmaceutical challenges because nanoparticles have unique properties. They are very small in size and are easy to handle. One more advantage is that they are not harmful for the human body. Poorly soluble drugs have serious problems with their delivery and dosage forms. Formulation strategies by means of nanocarrier systems, such as polymeric micelles, can resolve the trouble. Micelles from PEG-diacyllipids, e.g. PEG-PE, are of special attention. On the other hand, the layer-by-layer (LbL) technique can be useful to set up stable nanocolloids of low solubility...
November 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29166132/imaging-of-iatrogenic-esophageal-injuries-using-optimized-ct-esophageal-leak-protocol-pearls-and-pitfalls
#10
Rachna Madan, Olga Laur, Breland Crudup, Latia Peavy, Brett W Carter
Iatrogenic injury to the esophagus is a serious complication which is increasingly seen in clinical practice secondary to expansion and greater acceptability of surgical and endoscopic esophageal procedures. Morbidity and mortality following such injury is high. This is mostly due to an inflammatory response to gastric contents in the mediastinum, and the negative intra-thoracic pressures that may further draw out esophageal contents into the mediastinum leading to mediastinitis. Subsequently, pulmonary complications such as pneumonia or abscess may ensue leading to rapid clinical deterioration...
November 22, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29131024/evaluation-of-anastomotic-leak-after-esophagectomy-for-esophageal-cancer-typical-time-point-of-occurrence-mode-of-diagnosis-value-of-routine-radiocontrast-agent-studies-and-therapeutic-options
#11
Benjamin Struecker, Andreas Andreou, Sascha Chopra, Ann-Christin Heilmann, Johanna Spenke, Christian Denecke, Igor Maximilian Sauer, Marcus Bahra, Johann Pratschke, Matthias Biebl
BACKGROUND: Data on the typical time point of occurrence of anastomotic leak (AL) after esophagectomy for esophageal cancer are currently scarce. Therefore, the usefulness of routine radiocontrast agent studies (RRCS) for testing proper healing of the anastomosis after esophagectomy remains unclear. Furthermore, preferred available tools to diagnose postoperative AL and therapeutic options are still under debate. METHODS: We present a retrospective analysis of 328 consecutive patients who underwent esophagectomy for esophageal cancer between 2005 and 2015...
November 7, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29123884/a-case-of-cerebral-tuberculoma-mimicking-neurocysticercosis
#12
Hiroko Yuzawa, Yousuke Hirose, Tomonori Kimura, Sho Kimura, Hisanori Sugawara, Asako Yanagisawa, Sono Toi, Takashi Ohashi, Tomohito Sadahiro
Case: A 42-year-old Peruvian woman residing in Japan for 11 years with a family history of neurocysticercosis presented to our intensive care unit with fever and intense headache.Computed tomography indicated multiple micronodular lesions in the brain parenchyma, and cerebral tuberculoma and neurocysticercosis were considered in the differential diagnosis. Neurocysticercosis was initially suspected, and oral praziquantel was initiated. However, because of a high adenosine deaminase level in the cerebrospinal fluid and positive peripheral blood interferon gamma release test result, cerebral tuberculoma was subsequently considered...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29116626/unclassified-hepatocellular-adenoma-in-a-middle-aged-woman-with-glucose-intolerance
#13
Kumi Ozaki, Kenichi Harada, Toru Yamamoto, Hiroyuki Aoyagi, Yasuharu Kaizaki, Jun Yoshikawa
The patient was a 43-year-old woman with obesity (body mass index: 29.1) and glucose intolerance who was not taking oral contraceptives. An ultrasound showed a hypoechoic hepatic mass. Dynamic contrast-enhanced computed tomography revealed a lesion in segment 6 that showed homogeneous and slight-to-moderate enhancement in the arterial phase with persistent enhancement during the portal and equilibrium phases. On magnetic resonance (MR) imaging, the lesion demonstrated hyperintensity on T2- and diffusion-weighted images and hypointensity in the hepatobiliary phase of gadoxetic-acid-enhanced MR imaging...
November 7, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29106877/role-of-imaging-in-the-diagnosis-of-parotid-infantile-hemangiomas
#14
Fabiola C Weber, Arin K Greene, Denise M Adams, Marilyn G Liang, Mohammed H Alomari, Stephan D Voss, Gulraiz Chaudry
OBJECTIVES: To review the clinical presentation, imaging and follow-up of parotid infantile hemangiomas (IH). METHODS: Over a 15-year period, all patients with a clinical diagnosis of parotid IH were evaluated. Imaging was available in 35. The medical records, photographs, and radiology studies of these patients were reviewed. RESULTS: All patients presented at less than 4 months of age (M:F, 13:21). 19 (55)% of tumors were on the left and were bilateral in 2 patients...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29093341/effects-of-the-antiepileptic-drugs-phenytoin-gabapentin-and-levetiracetam-on-bone-strength-bone-mass-and-bone-turnover-in-rats
#15
Junkichi Kanda, Nobuo Izumo, Yoshiko Kobayashi, Kenji Onodera, Taketoshi Shimakura, Noriaki Yamamoto, Hideaki E Takahashi, Hiroyuki Wakabayashi
Long-term treatment with antiepileptic drugs (AEDs) is accompanied by reduced bone mass that is associated with an increased risk of bone fractures. Although phenytoin has been reported to adversely influence bone metabolism, little is known pertaining to more recent AEDs. The aim of this study was to evaluate the effects of gabapentin or levetiracetam on bone strength, bone mass, and bone turnover in rats. Male Sprague-Dawley rats were orally administered phenytoin (20 mg/kg), gabapentin (30 or 150 mg/kg), or levetiracetam (50 or 200 mg/kg) daily for 12 weeks...
2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/29078749/endocrine-and-exocrine-pancreatic-insufficiency-after-acute-pancreatitis-long-term-follow-up-study
#16
Jianfeng Tu, Jingzhu Zhang, Lu Ke, Yue Yang, Qi Yang, Guotao Lu, Baiqiang Li, Zhihui Tong, Weiqin Li, Jieshou Li
BACKGROUND: Patients could develop endocrine and exocrine pancreatic insufficiency after acute pancreatitis (AP), but the morbidity, risk factors and outcome remain unclear. The aim of the present study was to evaluate the incidence of endocrine and exocrine pancreatic insufficiency after AP and the risk factors of endocrine pancreatic insufficiency through a long-term follow-up investigation. METHODS: Follow-up assessment of the endocrine and exocrine function was conducted for the discharged patients with AP episodes...
October 27, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29058839/-cone-beam-ct-new-tool-in-diagnostic-imaging
#17
M De Marneffe, M Milicevic, M Milicevic
The goal of this article is to show the advantages of the Cone Beam Computerized Tomography (CBCT) compared to classical Computerized Tomography (CT) and to describe several clinical applications of interest with this rather new technology. Invented practically for dentistry, in particular in implantology, the CBCT found major indications in paranasal sinus imaging, in maxillofacial and oral surgery, in periodontology, endodontics and orthodontics. CBCT is very useful to characterize various lesions of jaws with a reserve concerning the study of soft tissues (in that case, an MRI or CT with contrast injection should be preferred)...
October 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29033437/acute-anorectal-thrombophlebitis-caused-by-a-protein-c-deficiency
#18
Yuji Eso, Satoshi Yoshiji, Yuto Nakakubo, Minoru Matsuura, Hiroshi Seno
A 46-year-old man visited the emergency department of our hospital with a 3-day history of anal pain, hemorrhaging, and a slight fever. He had previously been diagnosed with protein C deficiency and was prescribed dabigatran, a direct oral anticoagulant. Contrast-enhanced computed tomography showed severe rectal wall thickening with partial defect of enhancement. In addition, sigmoidoscopy revealed a dusky purplish swollen anorectal mucosa just above the dentate line. He was diagnosed with acute anorectal thrombophlebitis, and anticoagulant therapy with heparin was initiated...
October 16, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29026839/missing-the-benefit-of-metformin-in-acute-myeloid-leukemia-a-problem-of-contrast
#19
Alice C Ceacareanu, George K Nimako, Zachary A P Wintrob
OBJECTIVE: To evaluate whether metformin's cancer-related benefits reported in patients with solid tumors (ST) are also present in acute myeloid leukemia (AML) patients. METHODS: Baseline demographic and clinical history for all diabetes mellitus patients newly diagnosed with AML or cancer of the breast, ovary, prostate, gastrointestinal tract, lung, or kidney at Roswell Park Cancer Institute in Buffalo, NY (January 2003-December 2010, n = 924) was collected. Overall survival (OS) and disease-free survival (DFS) were assessed by Kaplan-Meier (KM) analysis and Cox proportional hazards regression (hazard ratio [HR])...
July 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/29026632/salmonella-oranienburg-haemorrhagic-cystitis-in-an-immunocompetent-young-male
#20
Jiasian Teh, Mark Quinlan, Damien Bolton
Introduction. Non-typhoidal salmonella (NTS) bacteriuria is extremely rare. Haemorrhagic cystitis is defined by urinary symptoms including haematuria, frequency, urgency and dysuria. Reports of haemorrhagic cystitis caused by NTS are exceptionally uncommon, especially in immunocompetent, young, male patients. Case presentation. A 27-year-old male with no past medical history presented to the Emergency Department with a 24 h history of visible haematuria having returned five days earlier from a five month trip across South America...
August 2017: JMM Case Reports
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