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https://www.readbyqxmd.com/read/27889874/decision-support-provided-by-a-temporally-oriented-health-care-assistant-an-implementation-of-computer-interpretable-guidelines
#1
Tiago Oliveira, António Silva, José Neves, Paulo Novais
The automatic interpretation of clinical recommendations is a difficult task, even more so when it involves the processing of complex temporal constraints. In order to address this issue, a web-based system is presented herein. Its underlying model provides a comprehensive representation of temporal constraints in Clinical Practice Guidelines. The expressiveness and range of the model are shown through a case study featuring a Clinical Practice Guideline for the diagnosis and management of colon cancer. The proposed model was sufficient to represent the temporal constraints in the guideline, especially those that defined periodic events and placed temporal constraints on the assessment of patient states...
January 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/27889548/impact-of-physician-adherence-to-colonoscopy-surveillance-guidelines-on-interval-colon-cancer
#2
Jennifer Nayor, John R Saltzman, Emily J Campbell, Molly L Perencevich, Kunal Jajoo, James M Richter
BACKGROUND AND AIMS: Interval colorectal cancer (iCRC) incidence is the criterion standard benchmark for measuring the effectiveness of colonoscopy. Colonoscopy surveillance guidelines are designed to minimize iCRC cases. Our aims were to (1) describe characteristics of iCRC patients; and (2) assess if development of iCRC is related to colonoscopy surveillance guideline intervals. METHODS: We performed a retrospective cohort study of post-colonoscopy iCRC cases in a large healthcare system...
November 23, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27884517/endoscopic-morphological-features-of-ulcerative-colitis-associated-dysplasia-classified-according-to-the-scenic-consensus-statement
#3
Shinya Sugimoto, Makoto Naganuma, Yasushi Iwao, Katsuyoshi Matsuoka, Masayuki Shimoda, Shuji Mikami, Shinta Mizuno, Yoshihiro Nakazato, Kosaku Nanki, Nagamu Inoue, Haruhiko Ogata, Takanori Kanai
BACKGROUND AND AIMS: Recent advances in endoscopic equipment and diagnostic techniques have made possible the detection of early dysplasia in the inflamed mucosa of ulcerative colitis (UC). The SCENIC consensus statement recommends the use of unified terminology for the morphology of dysplasia. In this study, we investigated the endoscopic features of high-grade dysplasia (HGD) in a clinical setting. METHODS: We retrospectively identified 62 patients with UC who were diagnosed with colitis-associated cancer or HGD between 1997 and 2015...
November 21, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27864808/latina-and-black-african-american-women-s-perspectives-on-cancer-screening-and-cancer-screening-reminders
#4
Susan Brandzel, Eva Chang, Leah Tuzzio, Camille Campbell, Nora Coronado, Erin J Aiello Bowles, Susan Carol Bradford, Diana S M Buist
INTRODUCTION: Racial and ethnic disparities continue to exist in cancer screening rates, especially among US Latina and Black/African American populations. We conducted six focus groups among 41 women from these communities in order to better understand their preferences about cancer screening reminders and the motivators and deterrents they face in obtaining recommended breast, cervical, and colon cancer screening. METHODS: Using self-reported patient race/ethnicity from electronic medical records of a large, integrated health care system in Seattle, we recruited women ages 30-60 to participate in one of five 2-hour focus groups...
November 18, 2016: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/27856106/surgical-management-of-colorectal-cancer-for-the-aging-population-a-survey-by-the-japanese-society-for-cancer-of-colon-and-rectum
#5
Hiroshi Matsuoka, Kotaro Maeda, Tsunekazu Hanai, Harunobu Sato, Koji Masumori, Yosikazu Koide, Hidetoshi Katsuno, Tomoyoshi Endo, Miho Shiota, Kenichi Sugihara
OBJECTIVE: The treatment policy of colorectal cancer in elderly patients is controversial due to a lack of specific guidelines. To clarify the present management of colorectal cancer for aged patients, a questionnaire survey was conducted by the Japanese Society for Cancer of the Colon and Rectum. METHODS: Questionnaire forms were sent to the 430 member institutions of the Japanese Society for Cancer of the Colon and Rectum. RESULTS: The response rate of the surgical department to the questionnaire was 39%...
November 14, 2016: Asian Journal of Surgery
https://www.readbyqxmd.com/read/27846172/colon-cancer-surgery-a-retrospective-study-based-on-a-large-administrative-database
#6
Mario Saia, Alessandra Buja, Gino Sartor, Domenico Mantoan, Ferdinando Agresta, Vincenzo Baldo
INTRODUCTION: Laparoscopic colectomy (LC) for colon cancer is considered as safe and effective as open colectomy. It has many benefits in terms of postoperative pain, length of hospital stay, and esthetic results. There is evidence in the United States of a positive trend in the proportion of oncologic patients undergoing LC. Our aim is to confirm this trend in Europe and identify factors associated with a greater use of LC. MATERIALS AND METHODS: A retrospective cohort study based on hospital discharge records (HDR) collected from 2008 to 2013 in a north-eastern Italian region (Veneto)...
November 14, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27845412/a-comparative-analysis-and-guidance-for-individualized-chemotherapy-of-stage-ii-and-iii-colorectal-cancer-patients-based-on-pathological-markers
#7
Yang Han, Su Lu, Fudong Yu, Xisheng Liu, Huimin Sun, Jingtao Wang, Xingwu Zhu, Huijun Lu, Hao Yue, Jing Wang, Jun Lin, Chongzhi Zhou, Huamei Tang, Zhihai Peng
Adjuvant chemotherapy is considered the standard of care for patients with colorectal cancer after curative resection. Although current guidelines provide clear instructions for chemotherapy for stage II high-risk and stage III colorectal cancer, it is insufficient to individualize therapy. We analyzed the outcomes of 902 patients with colorectal cancer treated with or without chemotherapy in our hospital. We found Chinese survival benefit for chemotherapy was consistent with current guidelines. Moreover, our data added to the evidence that chemotherapy might be used for elderly patients with stage II high-risk colorectal cancer...
November 15, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27828732/economics-of-ramucirumab-for-metastatic-colorectal-cancer
#8
Simon B Zeichner, Christine G Kohn, Daniel A Goldstein
Introduction Despite its FDA approval and incorporation into the National Comprehensive Cancer Network (NCCN) treatment guidelines, ramucirumab (RAM) is associated with a drug acquisition cost that is substantially higher than other approved options. Given its substantial cost, the presence of a viable alternative treatment option, and its minimal survival improvement, the usefulness of RAM in clinical practice has been called into question. Areas covered In this paper, we outline the cost, benefits, and economic implications of RAM from a US perspective, as it is used in the treatment of mCRC...
November 9, 2016: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/27824698/hospital-variability-in-use-of-adjuvant-chemotherapy-for-patients-with-stage-2-and-3-colon-cancer
#9
Meghan C Daly, Dennis J Hanseman, Daniel E Abbott, Shimul A Shah, Ian M Paquette
BACKGROUND: Following oncologic resection, adjuvant chemotherapy is associated with decreased recurrence and improved survival in stage 3 colon cancer. However, there is controversy regarding its use in stage 2 colon cancer with high-risk features (tumor depth T4, poorly differentiated, positive margin, and/or inadequate lymph node retrieval). Consensus guidelines recommend no adjuvant chemotherapy in the absence of these high-risk features (low-risk stage 2). OBJECTIVE: This study aimed to examine hospital characteristics associated with poor risk-adjusted, stage-specific guideline compliance for the use of adjuvant chemotherapy in stage 3 and low-risk stage 2 colon cancer...
December 2016: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27813103/utilization-of-pre-operative-imaging-for-colon-cancer-a-population-based-study
#10
Matthew D F McInnes, Sulaiman Nanji, William J Mackillop, Jennifer A Flemming, Xuejiao Wei, D Blair Macdonald, Nicola Scheida, Christopher M Booth
OBJECTIVE: To assess the use of pre-operative imaging for colon cancer and to identify factors associated with utilization in routine clinical practice. METHODS: This population-based, retrospective cohort study used a random sample of 25% of colon cancer patients treated with surgery in the province of Ontario (2002-2008). Pre-operative imaging (<16 weeks from surgery) of the chest, abdomen-pelvis was identified. Modified poisson regression was used to analyze factors associated with practice patterns...
November 4, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27807574/vertebral-metastasis-as-the-initial-manifestation-of-colon-cancer
#11
Tushina Jain, Renee Williams, Benjamin Liechty, Lea Ann Chen
Oncology guidelines currently recommend against performing colonoscopies in the workup of adenocarcinoma of unknown primary unless colonic malignancy is otherwise suggested by clinical signs or symptoms. We present 2 cases of metastatic colonic adenocarcinoma that presented only with neurologic symptoms from vertebral metastasis. Although bony metastases are a rare presentation of colon cancer and colonoscopy is not warranted in the initial workup of adenocarcinoma of unknown primary, we describe these cases as a reminder that bony metastases do not rule out a colon cancer diagnosis...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27785421/lynch-syndrome-and-exposure-to-aristolochic-acid-in-upper-tract-urothelial-carcinoma-its-clinical-impact
#12
REVIEW
Pierre Colin, Thomas Seisen, Romain Mathieu, Sharohkh F Shariat, Morgan Rouprêt
The purpose of the current review was to describe the clinical risk for Lynch syndrome (LS) after exposure to aristolochic acid (AA) in cases of upper urinary-tract urothelial carcinoma (UTUC). A systematic review of the scientific literature was performed using the Medline database (National Library of Medicine, PubMed) using the following keywords: epidemiology, risk factor, AA, Balkan nephropathy (BNe), LS, hereditary cancer, hereditary non-polyposis colorectal cancer (HNPCC), mismatch repair genes, urothelial carcinomas, upper urinary tract, renal pelvis, ureter, Amsterdam criteria, genetic counselling, mismatch repair genes, genetic instability, microsatellite, and Bethesda guidelines...
October 2016: Translational Andrology and Urology
https://www.readbyqxmd.com/read/27778444/using-graphical-representations-to-enhance-the-quality-of-care-for-colorectal-cancer-patients
#13
T-W Chien, Y Chang, K-S Wen, Y-H Uen
The study was to enhance adherence to quality-of-care guidelines for colorectal cancer (CRC) patients through plotting graphical representations. Rasch analysis was performed to examine the unidimensional measurement of the 13 core indicators. An author-made Excel module was applied to plot the so-called Wright map and KIDMAP in education field to report physicians' adherence to the quality-of-life guidelines. We found that the scale of the quality-of-care guidelines for patients with colon cancer is unidimensional...
October 24, 2016: European Journal of Cancer Care
https://www.readbyqxmd.com/read/27686516/the-association-between-location-age-and-advanced-colorectal-adenoma-characteristics-a-propensity-matched-analysis
#14
Hans-Christian Pommergaard, Jakob Burcharth, Jacob Rosenberg, Hans Raskov
PURPOSE: Evidence supports an association between certain colorectal adenoma characteristics and predisposition to cancer. The association between anatomical location of colorectal adenoma, age and advanced adenomas needs attention. The objective of this study was to evaluate the possible association between occurrence of sporadic advanced adenomas with location and age. MATERIALS AND METHODS: A cross-sectional study using baseline data from index colonoscopy from a randomized controlled trial evaluating chemopreventive treatment against recurrence of colorectal adenomas was performed...
August 16, 2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27683963/the-effect-of-right-colon-retroflexion-on-adenoma-detection-a-systematic-review-and-meta-analysis
#15
Jonah Cohen, Douglas Grunwald, Laurie B Grossberg, Mandeep S Sawhney
BACKGROUND: Although colonoscopy with polypectomy can prevent up to 80% of colorectal cancers, a significant adenoma miss rate still exists, particularly in the right colon. Previous studies addressing right colon retroflexion have revealed discordant evidence regarding the benefit of this maneuver on adenoma detection with concomitant concerns about safety and rates of maneuver success. In this meta-analysis, we sought to determine the effect of right colon retroflexion on improving adenoma detection compared with conventional colonoscopy without retroflexion, as well as determine the rates of retroflexion maneuver success and adverse events...
September 28, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27663601/adjuvant-chemotherapy-for-stage-ii-colon-cancer-practice-patterns-and-effectiveness-in-the-general-population
#16
C M Booth, S Nanji, X Wei, Y Peng, J J Biagi, T P Hanna, M K Krzyzanowska, W J Mackillop
AIMS: Although guidelines do not recommend adjuvant chemotherapy (ACT) for stage II colon cancer, many state that ACT may be considered in high-risk disease. Here we describe practice patterns and outcomes associated with ACT in the general population. MATERIALS AND METHODS: All cases of colon cancer diagnosed in Ontario 2002-2008 were identified using the Ontario Cancer Registry, which was linked to electronic treatment records. Pathology reports were obtained for a 25% random sample of cases...
September 20, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/27645221/endoscopic-tattooing-to-aid-tumour-localisation-in-colon-cancer-the-need-for-standardisation
#17
I S Reynolds, M H Majeed, I Soric, M Whelan, J Deasy, D A McNamara
BACKGROUND/AIMS: An increasing number of colon and rectal tumours are being resected using laparoscopic techniques. Identifying these tumours intraoperatively can be difficult. The use of tattooing can facilitate an easier resection; however, the lack of standardised guidelines can potentially lead to errors intraoperatively and potentially result in worse outcomes for patients. The aim of this study was to identify the most reliable method of preoperative tumour localisation from the available literature to date...
September 19, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27624582/perineural-invasion-is-a-major-prognostic-and-predictive-factor-of-response-to-adjuvant-chemotherapy-in-stage-i-ii-colon-cancer
#18
J A Cienfuegos, P Martínez, J Baixauli, C Beorlegui, S Rosenstone, J J Sola, J Rodríguez, J L Hernández-Lizoáin
BACKGROUND: Perineural invasion (PNI) in colon cancer (CC) has been associated with poorer prognosis even in stage II disease (T3-4 N0 M0). The aim of this study is to analyze prognostic histopathologic factors in stage II colon cancer in patients treated with curative surgery as established in National Comprehensive Cancer Network guidelines. METHODS: From a prospective database of CC cases, 507 patients with stage I-II disease who had undergone curative resection from January 2000 and December 2012 were identified...
September 13, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27589804/imaging-in-colorectal-cancer-progress-and-challenges-for-the-clinicians
#19
REVIEW
Eric Van Cutsem, Henk M W Verheul, Patrik Flamen, Philippe Rougier, Regina Beets-Tan, Rob Glynne-Jones, Thomas Seufferlein
The use of imaging in colorectal cancer (CRC) has significantly evolved over the last twenty years, establishing important roles in surveillance, diagnosis, staging, treatment selection and follow up. The range of modalities has broadened with the development of novel tracer and contrast agents, and the fusion of technologies such as positron emission tomography (PET) and computed tomography (CT). Traditionally, the most widely used modality for assessing treatment response in metastasised colon and rectal tumours is CT, combined with use of the RECIST guidelines...
August 31, 2016: Cancers
https://www.readbyqxmd.com/read/27580697/contribution-of-extended-family-history-in-assessment-of-risk-for-breast-and-colon-cancer
#20
Benjamin L Solomon, Todd Whitman, Marie E Wood
BACKGROUND: Family history is important for identifying candidates for high risk cancer screening and referral for genetic counseling. We sought to determine the percentage of individuals who would be eligible for high risk cancer screening or genetic referral and testing if family history includes an extended (vs limited) family history. METHODS: Family histories were obtained from 626 women at UVMMC associated mammography centers from 2001 to 2002. ACS guidelines were used to determine eligibility for high risk breast or colon cancer screening...
2016: BMC Family Practice
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