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Phonthep Angsuwatcharakon, Santi Kulpatcharapong, Wiriyaporn Ridtitid, Chaloemphon Boonmee, Panida Piyachaturawat, Pradermchai Kongkam, Wattana Pareesri, Rungsun Rerknimitr
BACKGROUND:  Endoscopic papillary large-balloon dilation (EPLBD) allows for the complete removal of large common bile duct (CBD) stones without fragmentation; however, a significant proportion of very large stones and stones floating above a tapering CBD require lithotripsy. Mechanical lithotripsy and cholangioscopy-guided laser lithotripsy are both effective for stone fragmentation. This study aimed to directly compare, for the first time, the efficacy of these two techniques in terms of stone clearance rate, procedure duration, patient radiation exposure, and safety...
February 20, 2019: Endoscopy
Lisa Morrissey, Megan Lurvey, Courtney Sullivan, Julia Challinor, Peter W Forbes, Linda Abramovitz, Glenn M Afungchwi, Rachel Hollis, Sara Day
BACKGROUND: In 2014, a task force of the International Society of Paediatric Oncology (SIOP) Paediatric Oncology in Developing Countries Nursing Workgroup published six baseline standards to provide a framework for pediatric oncology nursing care in low- and lower-middle income countries (L/LMIC). We conducted an international survey in 2016-2017 to examine the association between country income level and nurses' resporting of conformity to the standards at their respective institutions...
February 20, 2019: Pediatric Blood & Cancer
Rick D Vavolizza, David F Grabski, Daniel E Levin, Jeffrey W Gander
BACKGROUND: Gastrostomy tube (GT) placement is a common pediatric surgical procedure typically indicated for oral aversion. This may develop in patients with congenital heart disease (CHD) who require an orthotopic heart transplant (OHT). The safety profile of GT placement in OHT patients who are immunosuppressed is unknown. Given the potential increased risk of wound site complications on a patient receiving immunosuppression, we sought to determine the safety profile of GT placement in pediatric patients with OHT...
February 20, 2019: Pediatric Transplantation
Eui Geum Oh, Jeong Hyun Kim, Hyun Joo Lee
AIMS AND OBJECTIVES: To examine the effects of the Patient-Oriented Safe Transition program on 30-day unplanned readmissions and emergency department visits, medical costs, caregiver burden, and patient health-related quality of life. BACKGROUND: With the success of hospitals' quality improvement efforts, the number of discharged patients has been increasing. Successful management of discharged patients is needed in order to reduce unplanned readmissions and to improve patient health outcomes...
February 20, 2019: Journal of Clinical Nursing
Jamiela A McDonnough, Deawodi A Ladzekpo, Iasson Yi, William R Bond, Gezzer Ortega, Adedoyin O Kalejaiye
OBJECTIVES: Ludwig angina is a potentially lethal submandibular space infection. We aim to describe the epidemiological characteristics of Ludwig angina patients presenting to the emergency department (ED) and to examine outcomes and resource utilization to determine their burden on ED and hospitals. METHODS: Using the Nationwide Emergency Department Sample database, a nationally representative all-payer database, we retrospectively reviewed all ED visits between 2006 and 2014 for patients admitted with a primary diagnosis of Ludwig angina (International Classification of Diseases, Ninth Revision, 528...
February 20, 2019: Laryngoscope
Martina Ventura, Valeria Belleudi, Paolo Sciattella, Riccardo Di Domenicantonio, Mirko Di Martino, Nera Agabiti, Marina Davoli, Danilo Fusco
BACKGROUND: The relationship between guideline adherence and outcomes in patients with acute myocardial infarction (AMI) has been widely investigated considering the emergency, acute, post-acute phases separately, but the effectiveness of the whole care process is not known. AIM: The study aim was to evaluate the effect of the multicomponent continuum of care on 1-year survival after AMI. METHODS: We conducted a cohort study selecting all incident cases of AMI from health information systems during 2011-2014 in the Lazio region...
2019: PloS One
Fasil Wagnew, Getiye Dejenu, Setegn Eshetie, Animut Alebel, Wubet Worku, Amanuel Alemu Abajobir
BACKGROUND: More than 29 million that is an estimated 5%, under-five children suffer from severe acute malnutrition (SAM) globally, with a nine times higher risk of mortality than that of well-nourished children. However, little is known regarding outcomes and predictors of SAM in Ethiopia. Therefore, this study aims to determine treatment cure rate and its predictors among children aged 6-59 months with SAM admitted to a stabilization center. METHODOLOGY: A retrospective record review was employed in SAM children at the University of Gondar Comprehensive Specialized Hospital (UOGCSH) from 2014 to 2016...
2019: PloS One
Tracey Bleakley, Heather Richardson, Shaun O'Leary, Caroline Scates, Karen Harrison Dening, Kerry Harrison
Foreword Hospice UK's annual conference is the national hospice and palliative care charity's flagship event, bringing together everyone involved in leading hospice, palliative and end-of-life care for adults, children and young people. In 2018, the conference spanned two days and was held at the International Centre in Telford, Shropshire. Its theme was Transforming Palliative Care and it provided a unique forum for delegates to discuss current and forthcoming issues facing the hospice and palliative care community, and to discover new ways of thinking from outside of the sector...
February 2, 2019: International Journal of Palliative Nursing
Marcos Tobias-Machado, Cristiano Linck Pazeto, Eliney Ferreira Faria, Breno Dauster, William Enrique Pertuz Genes, Ricardo Hissashi Nishimoto
To describe a technical modifi cation for robotic-assisted simple prostatectomy (RASP) using three-steps reconstructive technique to achieve a 360 trigonization of the bladder mucosa. Through fi ve-trocars transperitoneal access, we perform a longitudinal incision of the bladder wall and prostate capsule. Our technique of RASP is very similar to the standard operative technique described during laparoscopic and robotic removal of adenoma, however, for reconstruction, we propose the Tunnel-Shaped Trigonization (TST)...
February 10, 2019: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Fei Li, HongFan Zhao, Lina Hou, Fengsheng Ling, Yue Zhang, WanLong Tan
OBJECTIVE: To investigate the relationship between vitamin D status, using circulating 25-hydroxyvitamin D [25 (OH) D], and renal cell carcinoma (RCC) risk in a case-control study, because the association between the two is unclear in China. MATERIALS AND METHODS: A total of 135 incident RCC cases were matched with 135 controls by age and sex. The blood samples were collected on the first day of hospitalization before surgery to measure plasma 25 (OH) D. Logistic regression analyses were used to calculate odds ratios (ORs) and 95% confi dence intervals (95% CIs) with adjustment for several confounders (e...
February 10, 2019: International Braz J Urol: Official Journal of the Brazilian Society of Urology
T Scott Stroup, Tobias Gerhard, Stephen Crystal, Cecilia Huang, Zhiqiang Tan, Melanie M Wall, Chacku Mathai, Mark Olfson
Importance: People with schizophrenia are commonly treated with psychotropic medications in addition to antipsychotics, but there is little evidence about the comparative effectiveness of these adjunctive treatment strategies. Objective: To study the comparative real-world effectiveness of adjunctive psychotropic treatments for patients with schizophrenia. Design, Setting, and Participants: This comparative effectiveness study used US national Medicaid data from January 1, 2001, to December 31, 2010, to examine the outcomes of initiating treatment with an antidepressant, a benzodiazepine, a mood stabilizer, or another antipsychotic among adult outpatients (aged 18-64 years) diagnosed with schizophrenia who were stably treated with a single antipsychotic...
February 20, 2019: JAMA Psychiatry
Jari Tiihonen, Heidi Taipale, Juha Mehtälä, Pia Vattulainen, Christoph U Correll, Antti Tanskanen
Importance: The effectiveness of antipsychotic polypharmacy in schizophrenia relapse prevention is controversial, and use of multiple agents is generally believed to impair physical well-being. Objective: To study the association of specific antipsychotic combinations with psychiatric rehospitalization. Design, Setting, and Participants: In this nationwide cohort study, the risk of psychiatric rehospitalization was used as a marker for relapse among 62 250 patients with schizophrenia during the use of 29 different antipsychotic monotherapy and polypharmacy types between January 1, 1996, and December 31, 2015, in a comprehensive, nationwide cohort in Finland...
February 20, 2019: JAMA Psychiatry
Gabriel Carmona Fernandes, Guilherme Viotto Rodrigues da Silva, Luiz Fernando Caneo, Carla Tanamati, Aida Luiza Ribeiro Turquetto, Marcelo Biscegli Jatene
BACKGROUND: The Fontan-Kreutzer procedure (FK) was widely performed in the past, but in the long-term generated many complications resulting in univentricular circulation failure. The conversion to total cavopulmonary connection (TCPC) is one of the options for treatment. OBJECTIVE: To evaluate the results of conversion from FK to TCPC. METHODS: A retrospective review of medical records for patients who underwent the conversion of FK to TCPC in the period of 1985 to 2016...
February 2019: Arquivos Brasileiros de Cardiologia
Gabriela Beatriz Sia, Pedro França da Costa Soares, Martinho Antonio Gestic, Elinton Adami Chaim, Francisco Callejas-Neto, Everton Cazzo
BACKGROUND: Cystic lesions of the pancreas represent a group of pancreatic diseases with great histological heterogeneity, varying from benign lesions, some of them with malignant potential, to overt malignant lesions. OBJECTIVE: To describe the cases of cystic lesions of the pancreas which underwent surgical intervention at a tertiary university hospital. METHODS: This is a retrospective population-based study (historical cohort) which was carried out enrolling individuals attended at the Outpatient service of Pancreas Surgery of the Hospital de Clínicas of Unicamp...
October 2018: Arquivos de Gastroenterologia
Laté Mawuli Lawson-Ananissoh, Oumboma Bouglouga, Aklesso Bagny, Rafiou El-Hadji Yakoubou, Laconi Kaaga, Datouda Redah
BACKGROUND: The digestive pathologies are frequent in the elderly and often have a latent and atypical symptomatology. OBJECTIVE: To assess the epidemiological and evolutionary current data on digestive diseases in the elderly, and look for factors associated with length of hospital stay. METHODS: Retrospective study of 10 years, including patients aged 60 and over hospitalized for digestive diseases in the Gastroenterology Department of the Campus Teaching Hospital of Lome, Togo...
October 2018: Arquivos de Gastroenterologia
Alan R Schroeder, Brian P Lucas, Matthew D Garber, Russell J McCulloh, Ashley A Joshi-Patel, Eric A Biondi
The role of the urinalysis (UA) in the management of young, febrile infants is controversial. To assess how frequently infants are treated for urinary tract infection (UTI) despite having normal UA values and to compare the characteristics of infants treated for UTI who have positive versus negative UAs, we reviewed 20,570 wellappearing febrile infants 7-60 days of age evaluated at 124 hospitals in the United States who were included in a national quality improvement project. Of 19,922 infants without bacteremia and meningitis, 2,407 (12...
February 2019: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Seung Tae Kim, Jung Hun Kang, Jeeyun Lee, Hyun Woo Lee, Sung Young Oh, Joung Soon Jang, Myung Ah Lee, Byeong Seok Sohn, So Young Yoon, Hye Jin Choi, Ji Hyong Hong, Min-Ji Kim, Seonwoo Kim, Young Suk Park, Joon Oh Park, Ho Yeong Lim
BACKGROUND: Capecitabine plus oxaliplatin (XELOX) has shown modest activity and tolerable toxicity in a phase two trial for biliary tract cancers (BTCs). Meanwhile, gemcitabine plus oxaliplatin (GEMOX) has been the reference arm in recent phase two and three trials for BTCs. We aimed to investigate the efficacy of XELOX versus GEMOX as first-line therapy for advanced BCTs. PATIENTS AND METHODS: In this open-label, randomized, phase three, non-inferiority trial, we randomly selected patients with metastatic BCTs to receive GEMOX (gemcitabine 1000 mg/m2 on days 1 and 8, and oxaliplatin 100 mg/m2 on day 1) or XELOX (capecitabine 1000 mg/m2, twice daily, on days 1-14 and oxaliplatin 130 mg/m2 on day 1) as first-line treatment, given every 3 weeks, totaling 8 cycles...
February 20, 2019: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Alan Villavicencio, E Lee Nelson, Sharad Rajpal, Niketna Vivek, Sigita Burneikiene
OBJECTIVE: Obesity affects not only the health of an individual but society as a whole and especially the healthcare system. Healthcare providers are faced with challenges to deliver adequate care in this resource-limited environment, assure safety, and accommodate the increasing population of overweight patients. The effects of increased body mass index (BMI) on clinical outcomes, complications, health care resource utilization, effectiveness of minimally invasive approaches, and perioperative parameters in spine surgeries have all been previously studied, but the majority of these findings are conflicting rather than conclusive...
February 11, 2019: Clinical Neurology and Neurosurgery
Ryan Kipp, Mariam Askari, Jun Fan, Michael E Field, Mintu P Turakhia
OBJECTIVES: In this study the authors investigated effectiveness and safety of an initial treatment strategy with class IC or class III antiarrhythmic drugs (AAD) for newly diagnosed atrial fibrillation (AF) or atrial flutter (AFL). BACKGROUND: There is limited evidence to guide optimal AAD selection for rhythm control in newly diagnosed AF/AFL. METHODS: Using data from TREAT-AF (The Retrospective Evaluation and Assessment of Therapies in AF), the authors performed a retrospective cohort study of patients with AF/AFL from 2004 to 2014 and class IC or class III AAD prescription within 90 days following diagnosis...
February 2019: JACC. Clinical Electrophysiology
Akira Ogawa, Kazunori Toyoda, Kazuo Kitagawa, Takanari Kitazono, Takehiko Nagao, Hiroshi Yamagami, Shinichiro Uchiyama, Norio Tanahashi, Masayasu Matsumoto, Kazuo Minematsu, Izumi Nagata, Masakatsu Nishikawa, Shinsuke Nanto, Kenji Abe, Yasuo Ikeda
BACKGROUND: The effect of prasugrel in terms of the prevention of recurrence of ischaemic stroke is unknown. We investigated the non-inferiority of prasugrel to clopidogrel for prevention of ischaemic stroke, myocardial infarction, and death from other vascular causes in Japanese patients with non-cardioembolic stroke. METHODS: In this phase 3 randomised, double-blind, non-inferiority trial, patients aged 20-74 years who had had a non-cardioembolic stroke in the previous 1-26 weeks were recruited from 224 hospitals in Japan...
March 2019: Lancet Neurology
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