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General Medical

Loes H C Nissen, Lauranne A A P Derikx, Anouk M E Jacobs, Carla M van Herpen, Wietske Kievit, Rob Verhoeven, Esther van den Broek, Elise Bekers, Tim van den Heuvel, Marieke Pierik, Janette Rahamat-Langendoen, Robert P Takes, Willem J G Melchers, Iris D Nagtegaal, Frank Hoentjen
Background: Immunosuppressed inflammatory bowel disease (IBD) patients are at increased risk to develop extra-intestinal malignancies. Immunosuppressed transplant patients show increased incidence of head and neck cancer with impaired survival. This study aims to identify risk factors for oral cavity (OCC) and pharyngeal carcinoma (PC) development in IBD, to compare clinical characteristics in IBD with the general population, and to assess the influence of immunosuppressive medication on survival...
August 16, 2018: Inflammatory Bowel Diseases
Valerie M Vaughn, Tejal Gandhi, Anna Conlon, Vineet Chopra, Anurag N Malani, Scott A Flanders
Background: Fluoroquinolones increase the risk of Clostridioides difficile infection and antibiotic resistance. Hospitals often use pre-prescription approval or prospective audit and feedback to target fluoroquinolone prescribing. Whether these strategies impact aggregate fluoroquinolone use is unknown. Methods: This study is a 48-hospital, retrospective cohort of general-care, medical patients hospitalized with pneumonia or positive urine culture between December 2015-September 2017...
February 13, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Daniela Petrić, Valentino Rački, Nadija Gačo, Ana Kaštelan, Mirjana Graovac
OBJECTIVE: The aim of this study was to explore the effectiveness and tolerability of long-acting paliperidone palmitate antipsychotic in adolescent first-episode schizophrenia patients while comparing the results with the oral antipsychotic risperidone. METHODS: This study is a retrospective, noninterventional study to assess the effectiveness and tolerability of long-acting injectable antipsychotic paliperidone palmitate in first-episode adolescent patients during the first 12 months of treatment compared with the oral antipsychotic risperidone...
February 13, 2019: Journal of Child and Adolescent Psychopharmacology
Danielle Weiss, Sarah Ostrowski-Delahanty, Jason Van Allen, Paige Seegan, Meghan L Marsac
PURPOSE: Nurses are at the forefront of children's postinjury recovery; this unique role provides an opportunity for nurses to recognize and screen for symptoms that may interfere with children's quality of life (QOL). As such, aims of the present investigation were to explore selected variables (e.g., posttraumatic stress symptoms [PTSS], hope) that have the potential to impact QOL after pediatric injury, with a larger goal of contributing to recommendations for nursing practice to support children's full (physical and emotional) recovery during the peritrauma period following injury...
February 13, 2019: Journal for Specialists in Pediatric Nursing: JSPN
Nathan Emmerich, Bert Gordijn
With few exceptions, the literature on withdrawing and withholding life-saving treatment considers the bare fact of withdrawing or withholding to lack any ethical significance. If anything, the professional guidelines on this matter are even more uniform. However, while no small degree of progress has been made toward persuading healthcare professionals to withhold treatments that are unlikely to provide significant benefit, it is clear that a certain level of ambivalence remains with regard to withdrawing treatment...
February 13, 2019: Theoretical Medicine and Bioethics
Danielle L Terry, Christopher P Terry
Behavioral health issues like anxiety and depression negatively impact numerous aspects of primary care, including medical regimen adherence, communication, physical well-being, and engagement in beneficial health behaviors. This study aimed to examine internal and family medicine residents': (1) patterns of addressing mental health concerns (e.g., frequency of referral for psychotherapy and/or medication), (2) self-perceptions of competency in assessment and treatment of specific mental health disorders, and (3) frequency of utilization of efficacious therapeutic strategies during clinical encounters...
February 13, 2019: Journal of Clinical Psychology in Medical Settings
Yusuke Watanabe, Masato Watanabe, Nobuhiro Suehara, Michiyo Saimura, Yusuke Mizuuchi, Kazuyoshi Nishihara, Toshimitsu Iwashita, Toru Nakano
BACKGROUND: Delta-shaped anastomosis is an established procedure for intracorporeal Billroth-I reconstruction (B-I). However, this procedure has several technical and economic problems. The aim of the current study was to present the technique of B-I using an overlap method (overlap B-I), which is a side-to-side intracorporeal gastroduodenostomy in laparoscopic distal gastrectomy (LDG), and to evaluate the short- and long-term outcomes of this overlap B-I procedure. METHODS: We retrospectively reviewed the medical records of 533 patients who underwent LDG with overlap B-I (n = 247) or Roux-en-Y reconstruction (R-Y) (n = 286)...
February 13, 2019: Surgical Endoscopy
Carlos Federico Davrieux, Mariano Palermo, Edgardo Serra, Eduardo Javier Houghton, Pablo Agustín Acquafresca, Caetano Finger, Mariano Eduardo Giménez
BACKGROUND: The aeronautical industry is one of the disciplines that most use control systems. Its purpose is to avoid accidents and return safer flights. The flight of an airplane, from its takeoff to its landing is a process divided into stages under strict control. A surgical procedure has the same characteristics. We try to identify and develop the stages of the surgical process using the experience of the aviation industry in order to optimize the results and reduce surgical complications...
February 7, 2019: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Burcin Atak, Gulali Aktas, Tuba T Duman, Edip Erkus, M Zahid Kocak, Haluk Savli
OBJECTIVE: Association between type 2 diabetes mellitus and inflammation is well-established. We aimed to study platelet-to-lymphocyte ratio (PLR), a novel inflammatory index derived from hemogram, in diabetic patients in comparison to those in healthy volunteers. METHODS: Medical data of type 2 diabetics that showed up in general outpatient medical clinics of our institution between February 2017 and August 2017 were recorded and analyzed. RESULTS: Median PLR of type 2 diabetic patients was significantly higher than the PLR of healthy controls (p=0...
January 2019: Revista da Associação Médica Brasileira
Timothy A Durso, Bart O Iddins, Nathanial R Miletta
Shortly after completing residency or fellowship, army dermatologists routinely deploy to combat zones as field surgeons. The US Army generally does not deploy dermatologists for their expertise in diagnosing and managing cutaneous diseases; rather, as field surgeons they provide routine, emergency, and trauma care for active-duty soldiers and coalition forces. In this article, we review the various functions of the deployed dermatologist and highlight the importance of maintaining basic emergency medical skills that could be generalized to the civilian population in case of local or national emergencies...
January 2019: Cutis; Cutaneous Medicine for the Practitioner
Scott A Davis, Delesha Carpenter, Charles Lee, Nacire Garcia, Daniel S Reuland, Gail Tudor, Ceila E Loughlin, Betsy Sleath
BACKGROUND: Many adolescents do not obtain the maximum benefit from their asthma medications. Improving patient-provider communication may improve adolescents' asthma knowledge, adherence, and clinical outcomes. OBJECTIVE: To determine how a question prompt list and educational video intervention affect youth- and caregiver-reported medication adherence and self-reported medication problems. METHODS: Adolescents with persistent asthma (n = 359; 56...
February 13, 2019: Annals of Pharmacotherapy
Fulvio Fiorini, Antonio Granata, Yuri Battaglia, Michele A A Karaboue
The ability to communicate is central to all professional activities and therefore being able to communicate effectively with mass media is essential. The medical doctor often needs to communicate not with a single patient or with a group of family members, but with "an important number of patients" through a microphone, a newspaper, a radio or a television. In this case it is not necessary to provide specific information on a single clinical case, but to provide simple, general information on a single pathology or a group of diseases to an interviewer or journalist, who will probably elaborate it at his own discretion making it usable to a diverse and unspecified audience...
February 2019: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Jiaqian Li, Yuxin Song, Huanxi Zheng, Shile Feng, Wanghai Xu, Zuankai Wang
Just as the innovation of electronic diodes that allow the current to flow in one direction provides a foundation for the development of digital technologies, the engineering of surfaces or devices that allow the directional and spontaneous transport of fluids, termed liquid diodes, is highly desired in a wide spectrum of applications ranging from medical microfluidics, advanced printing, heat management and water collection to oil-water separation. Recent advances in manufacturing, visualization techniques, and biomimetics have led to exciting progress in the design of various liquid diodes...
February 13, 2019: Soft Matter
Marie Beauséjour, Lise Goulet, Marjolaine Roy-Beaudry, Guy Grimard, Hubert Labelle
In absence of school scoliosis screening programs (SSSP) in Canada, this study examined the relationships between the lay person's perception of morbidity and the appropriateness of referral in orthopaedics. A cross-sectional study was conducted with all children consecutively referred in orthopaedics for suspected scoliosis. The 831 participants were classified as Appropriate, Late or Inappropriate referrals for the orthopaedic setting. Perceived morbidity was operationalized by: the scoliosis detection originator, the perceptions of the seriousness of the condition and urgency to consult a physician, the perception of the general health, as well as Visible Back Deformity, Self-image and Pain...
February 12, 2019: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Han-Tao Li, Chih-Hong Lee, Tony Wu, Mei-Yun Cheng, Wei-En Johnny Tseng, Chun-Wei Chang, Hsiang-Yao Hsieh, Hsing-I Chiang, Chih-Yin Lin, Bao-Luen Chang, Wey-Ran Lin, Siew-Na Lim
BACKGROUND: The incidence of cefepime-induced neurotoxicity (CIN) has been previously underestimated, and there have only been sporadic reports from critical neurological settings. The present study aimed to investigate the potential factors associated with disease development, electroencephalography (EEG) sub-classification, and outcome measures. METHODS: The 10-year medical records of patients who underwent EEG between 2007 and 2016 at a tertiary medical center in Taiwan, and developed encephalopathy after cefepime therapy were retrospectively reviewed...
February 12, 2019: Neurocritical Care
Andrew M Hersh, Robert J Walter, Scott K Abberegg
BACKGROUND: Noninferiority trials are becoming more common. Their design often requires investigators to "trade" a secondary benefit for efficacy. Use of mortality as an outcome of interest leads to important ethical conflicts whereby researchers must establish a minimal clinically important difference for mortality, a process which has the potential to result in problematic conclusions. OBJECTIVE: We sought to investigate the frequency of the use of mortality as an outcome in noninferiority trials, as well as to determine the average pre-specified noninferiority ("delta") values...
February 12, 2019: Journal of General Internal Medicine
Douglas Redd, Yijun Shao, Yan Cheng, Qing Zeng-Treitler
Medical treatments change over time for multiple reasons, including introduction of new treatments, availability of new scientific evidence, change in institutional guidelines, and market efforts by pharmaceutical and medical device companies. Monitoring and analyzing these secular trends will also inform the evaluation of evidence based practice as well as outcome research. Using a large national clinical dataset from the United States Veterans Health Administration (VHA), we measured the change in prevalence of all diseases, medications, and procedures by year from 2001 to 2014...
February 12, 2019: Journal of Medical Systems
Niels van der Naald, Diederik P J Smeeing, Roderick M Houwert, Falco Hietbrink, Geertje A M Govaert, Detlef van der Velde
Introduction: Brodie's abscess is a form of osteomyelitis. Since its first appearance in the medical literature in 1832, numerous cases have been described. The aim of this article is to provide the first comprehensive overview of published cases of Brodie's abscess, and to describe diagnostic methods, therapeutic consequences and outcomes. Methods: According to PRISMA guidelines a systematic review of the literature was performed. All published data in English or Dutch were considered for inclusion with no limitations on publication date...
2019: Journal of Bone and Joint Infection
M K Khan, M N Islam, J Ferdous, M M Alam
Tuberculosis (TB) is a progressive granulomatous infectious disease caused by the gram positive, acid fast bacilli classified under the genus Mycobacterium. Tuberculosis in human is mostly by Mycobacterium tuberculosis and primarily affects lungs causing pulmonary tuberculosis. It can also affect intestine, meninges, bones, joints, lymph nodes, skin and other tissues of the body causing extra-pulmonary tuberculosis. Human TB is transmitted mainly through droplet infection and droplet nuclei. Infection of human with M...
January 2019: Mymensingh Medical Journal: MMJ
S Yesmin, M Sanyal, M J Hasan
Breast cancer in male is rare which accounts about 1% of all malignant breast neoplasm cases. Since paraneoplastic syndrome is unusual with male breast cancer, very few reported cases are found. A72- year-old gentleman presented with proximal myopathy in all four limbs was referred to Dr. Sirajul Islam Medical College and Hospital in April 2017. He had generalized wasting with reduced tone and reflexes. Planter responses were normal with intact sensory. There were typical Heliotrope rash bilaterally. In background, he had history of radical mastectomy due to stage IIA ductal carcinoma of left breast 7 years back...
January 2019: Mymensingh Medical Journal: MMJ
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