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https://www.readbyqxmd.com/read/28340206/monitoring-the-quality-of-cardiac-surgery-based-on-three-or-more-surgical-outcomes-using-a-new-variable-life-adjusted-display
#1
Fah Fatt Gan, Xu Tang, Yexin Zhu, Puay Weng Lim
Quality problem or issue: The traditional variable life-adjusted display (VLAD) is a graphical display of the difference between expected and actual cumulative deaths. The VLAD assumes binary outcomes: death within 30 days of an operation or survival beyond 30 days. Full recovery and bedridden for life, for example, are considered the same outcome. This binary classification results in a great loss of information. Initial assessment: Although there are many grades of survival, the binary outcomes are commonly used to classify surgical outcomes...
March 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28339332/disc-displacement-without-reduction-with-limited-opening-a-clinical-diagnostic-accuracy-study
#2
Steven Kraus, Janey Prodoehl
PURPOSE: The purpose of this study is to explore the diagnostic accuracy and clinical utility of an examination by a physical therapist using a clinical patient population for diagnosing a specific sub-type of disc displacement (DDWoR wLO) compared to the imaged disc position. METHODS: Data from 46 patients with a clinical diagnosis of DDWoR wLO (92 clinical examinations and MRI records) were collected. Clinical diagnosis was made based on predefined diagnostic criteria, and the MRI diagnosis was made based on the MRI radiology report obtained from the dental provider...
March 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28339314/an-analysis-of-ems-and-ed-detection-of-stroke
#3
Ian Medoro, David C Cone
BACKGROUND AND PURPOSE: Studies have shown a reduction in time-to-CT and improved process measures when EMS personnel notify the ED of a "stroke alert" from the field. However, there are few data on the accuracy of these EMS stroke alerts. The goal of this study was to examine diagnostic test performance of EMS and ED stroke alerts and related process measures. METHODS: The EMS and ED records of all stroke alerts in a large tertiary ED from August 2013-January 2014 were examined and data abstracted by one trained investigator, with data accuracy confirmed by a second investigator for 15% of cases...
March 24, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28336719/colon-cancer-screening-among-patients-receiving-dialysis-in-the-united-states-are-we-choosing-wisely
#4
Christopher A Carlos, Charles E McCulloch, Chi-Yuan Hsu, Barbara Grimes, Meda E Pavkov, Nilka R Burrows, Vahakn B Shahinian, Rajiv Saran, Neil R Powe, Kirsten L Johansen
The American Society of Nephrology recommends against routine cancer screening among asymptomatic patients receiving maintenance dialysis on the basis of limited survival benefit. To determine the frequency of colorectal cancer screening among patients on dialysis and the extent to which screening tests were targeted toward patients at lower risk of death and higher likelihood of receiving a kidney transplant, we performed a cohort study of 469,574 Medicare beneficiaries ages ≥50 years old who received dialysis between January 1, 2007 and September 30, 2012...
March 23, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28336000/high-intensity-cannabis-use-and-hiv-clinical-outcomes-among-hiv-positive-people-who-use-illicit-drugs-in-vancouver-canada
#5
Stephanie Lake, Thomas Kerr, Rielle Capler, Jeannie Shoveller, Julio Montaner, M-J Milloy
BACKGROUND: Reforms to the legal status of medical and non-medical cannabis are underway in many jurisdictions, including Canada, as are renewed efforts to scale-up HIV treatment-as-prevention (TasP) initiatives. It has been suggested that high-intensity cannabis use may be associated with sub-optimal HIV treatment outcomes. Thus, using data from a setting with a community-wide treatment-as-prevention (TasP) initiative coinciding with increasing access to medical cannabis, we sought to investigate the possible impact of high-intensity cannabis use on HIV clinical outcomes...
March 20, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28335775/evaluation-of-biomarker-canine-prostate-specific-arginine-esterase-cpse-for-the-diagnosis-of-benign-prostatic-hyperplasia
#6
Dora Pinheiro, João Machado, Carlos Viegas, Cláudia Baptista, Estela Bastos, Joana Magalhães, Maria A Pires, Luís Cardoso, Ana Martins-Bessa
BACKGROUND: Benign prostatic hyperplasia (BPH) is the most common canine prostatic disorder. Although most or even all intact male dogs may develop BPH by 5-8 years of age, many show no clinical signs. Taking into account the non-specific character of clinical and ultrasonographic findings, a new diagnostic approach has recently been proposed based on the augmentation of blood canine prostate-specific arginine esterase (CPSE) in hyperplasic dogs. The aim of the present study was to verify CPSE levels in negative controls and hyperplasic dogs, considering cytological findings as the reference method and taking into account the fact that controls were middle-aged intact dogs (median of 5...
March 23, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28334212/sequential-sampling-plan-of-anthonomus-grandis-coleoptera-curculionidae-in-cotton-plants
#7
J F J Grigolli, L A Souza, T A Mota, M G Fernandes, A C Busoli
The boll weevil, Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae), is one of the most important pests of cotton production worldwide. The objective of this work was to develop a sequential sampling plan for the boll weevil. The studies were conducted in Maracaju, MS, Brazil, in two seasons with cotton cultivar FM 993. A 10,000-m2 area of cotton was subdivided into 100 of 10- by 10-m plots, and five plants per plot were evaluated weekly, recording the number of squares with feeding + oviposition punctures of A...
March 2, 2017: Journal of Economic Entomology
https://www.readbyqxmd.com/read/28333950/drug-resistant-hiv-behaviors-and-characteristics-among-los-angeles-men-who-have-sex-with-men-with-new-hiv-diagnosis
#8
Pamina M Gorbach, Marjan Javanbakht, Lorelei Bornfleth, Robert K Bolan, Martha Lewis Blum
Epidemiology of drug resistant HIV has focused on trends and less attention has been given to identification of factors, especially behaviors including substance use, in acquisition of drug-resistant HIV. From 2009 to 2012 The Metromates Study enrolled and followed for one year men who have sex with men (MSM) seeking testing for HIV in a community clinic in Los Angeles assessing those testing positive for acute and recent HIV infection. Behavioral data were collected via Computer-Assisted Self-Interview from 125 classified as newly HIV infected and 91 as chronically infected (newly HIV-diagnosed); specimens were available and viable for resistance testing for 154 of the 216 HIV positives with new diagnoses...
2017: PloS One
https://www.readbyqxmd.com/read/28333918/21-gene-recurrence-score-testing-among-medicare-beneficiaries-with-breast-cancer-in-2010-2013
#9
Julie A Lynch, Brygida Berse, Nicole Coomer, John Kautter
PURPOSE: We evaluated national patient-level utilization of the 21-gene recurrence score (21-gene RS) test among Medicare beneficiaries with breast cancer. We analyzed clinical, demographic, and regional factors that predict testing. METHODS: Using 2010-2013 Medicare claims, we conducted a retrospective study of breast cancer patients. The outcome variable was whether the patient underwent testing. Independent variables expected to predict testing were age, gender, race, Medicaid status, clinical characteristics, and hospital referral region (HRR)...
March 23, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28330887/usefulness-of-two-aspergillus-pcr-assays-and-aspergillus-galactomannan-and-%C3%AE-d-glucan-testing-of-bronchoalveolar-lavage-fluid-for-diagnosis-of-chronic-pulmonary-aspergillosis
#10
Naohisa Urabe, Susumu Sakamoto, Go Sano, Junko Suzuki, Akira Hebisawa, Yasuhiko Nakamura, Kazuya Koyama, Yoshikazu Ishii, Kazuhiro Tateda, Sakae Homma
We evaluated the usefulness of an Aspergillus galactomannan (GM) test, a β-D-glucan (βDG) test, and two different Aspergillus polymerase chain reaction (PCR) assays of bronchoalveolar lavage fluid (BALF) samples for diagnosis of chronic pulmonary aspergillosis (CPA). BALF samples from 28 patients with and 120 patients without CPA were collected. We calculated the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for each test individually and in combination with other tests...
March 22, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28329167/repeated-vaccination-does-not-appear-to-impact-on-influenza-vaccine-effectiveness-against-hospitalisation-with-confirmed-influenza
#11
Allen C Cheng, Kristine K Macartney, Grant W Waterer, Tom Kotsimbos, Paul M Kelly, Christopher C Blyth
Background: Annual influenza vaccine is recommended for those at greatest risk of severe influenza infection. Recent reports of a negative impact of serial influenza vaccination on vaccine effectiveness raises concerns about the recommendation for annual influenza vaccines, particularly in those at greatest risk. Methods: The Influenza Complications Alert Network (FluCAN) is an Australian hospital-based sentinel surveillance program. In this observational study, cases were defined as subjects >9 years admitted with influenza confirmed by PCR...
March 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28329058/improved-long-term-outcomes-in-double-inlet-left-ventricle-and-tricuspid-atresia-with-transposed-great-arteries-systemic-outflow-tract-obstruction-present-at-birth-defines-long-term-outcome
#12
Lotte C Franken, Manouk Admiraal, Charlotte E Verrall, Diana Zannino, Julian G Ayer, Ajay J Iyengar, Andrew D Cole, Gary F Sholler, Yves D'Udekem, David S Winlaw
OBJECTIVES: In 2 subtypes of functional single ventricle, double inlet left ventricle (DILV) and tricuspid atresia with transposed great arteries (TA-TGA), systemic output passes through an outflow chamber before entering the aorta. Intracardiac obstruction to this pathway causing systemic outflow tract obstruction (SOTO) may be present at birth or develop over time. Long-term survival after Fontan has not been defined. We defined outcomes utilizing records from 2 centres that were cross-checked with data from a bi-national Fontan Registry for completeness and accuracy...
March 4, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28328043/csf-tau-and-the-csf-tau-abeta-ratio-for-the-diagnosis-of-alzheimer-s-disease-dementia-and-other-dementias-in-people-with-mild-cognitive-impairment-mci
#13
REVIEW
Craig Ritchie, Nadja Smailagic, Anna H Noel-Storr, Obioha Ukoumunne, Emma C Ladds, Steven Martin
BACKGROUND: Research suggests that measurable change in cerebrospinal fluid (CSF) biomarkers occurs years in advance of the onset of clinical symptoms (Beckett 2010). In this review, we aimed to assess the ability of CSF tau biomarkers (t-tau and p-tau) and the CSF tau (t-tau or p-tau)/ABeta ratio to enable the detection of Alzheimer's disease pathology in patients with mild cognitive impairment (MCI). These biomarkers have been proposed as important in new criteria for Alzheimer's disease dementia that incorporate biomarker abnormalities...
March 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28327433/sonographic-prediction-of-outcome-of-vacuum-deliveries-a-multicenter-prospective-cohort-study
#14
Birgitte H Kahrs, Sana Usman, Tullio Ghi, Aly Youssef, Erik A Torkildsen, Elsa Lindtjørn, Tilde B Østborg, Sigurlaug Benediktsdottir, Lis Brooks, Lotte Harmsen, Pål R Romundstad, Kjell Å Salvesen, Christoph C Lees, Torbjørn M Eggebø
BACKGROUND: Safe management of the second stage of labor is of great importance. Unnecessary interventions should be avoided and correct timing of interventions focused. Ultrasound assessment of fetal position and station has a potential to improve the precision in diagnosing and managing prolonged or arrested labors. The decision to perform vacuum delivery is traditionally based on subjective assessment by digital vaginal examination and clinical expertise and there is currently no method of objectively quantifying the likelihood of successful delivery...
March 18, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28326534/smell-loss-predicts-mortality-risk-regardless-of-dementia-conversion
#15
Ingrid Ekström, Sara Sjölund, Steven Nordin, Annelie Nordin Adolfsson, Rolf Adolfsson, Lars-Göran Nilsson, Maria Larsson, Jonas K Olofsson
OBJECTIVES: To determine whether dementia could explain the association between poor olfactory performance and mortality risk within a decade-long follow-up period. DESIGN: Prospective cohort study. SETTING: Betula Study, Umeå, Sweden. PARTICIPANTS: A population-based sample of adult participants without dementia at baseline aged 40 to 90 (N = 1,774). MEASUREMENTS: Olfactory performance using the Scandinavian Odor-Identification Test (SOIT) and self-reported olfactory function; several social, cognitive, and medical risk factors at baseline; and incident dementia during the following decade...
March 22, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28325613/head-to-head-comparison-of-the-diagnostic-performance-of-coronary-computed-tomography-angiography-and-dobutamine-stress-echocardiography-in-the-evaluation-of-acute-chest-pain-with-normal-ecg-findings-and-negative-troponin-tests-a-prospective-multicenter-study
#16
Eric Durand, Fabrice Bauer, Nicolas Mansencal, Arshid Azarine, Benoit Diebold, Albert Hagege, Ludivine Perdrix, Martine Gilard, Yannick Jobic, Hélène Eltchaninoff, Mourad Bensalah, Benjamin Dubourg, Jérôme Caudron, Ralph Niarra, Gilles Chatellier, Jean-Nicolas Dacher, Elie Mousseaux
OBJECTIVE: To perform a head-to-head comparison of coronary CT angiography (CCTA) and dobutamine-stress echocardiography (DSE) in patients presenting recent chest pain when troponin and ECG are negative. METHODS: Two hundred seventeen patients with recent chest pain, normal ECG findings, and negative troponin were prospectively included in this multicenter study and were scheduled for CCTA and DSE. Invasive coronary angiography (ICA), was performed in patients when either DSE or CCTA was considered positive or when both were non-contributive or in case of recurrent chest pain during 6month follow-up...
March 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28320074/diagnostic-performance-of-clinical-examination-measures-and-pain-presentation-to-identify-patellofemoral-joint-osteoarthritis
#17
J J Stefanik, R Duncan, D T Felson, G Peat
OBJECTIVE: Test the diagnostic performance of a comprehensive set of tests and measures to discriminate patellofemoral (PF) from tibiofemoral (TF) osteoarthritis (OA). METHODS: The Clinical Assessment of the Knee Study is a study of knee pain in the general population. The presence of PF crepitus and pain with PF compression were assessed. Anterior knee pain (AKP) was determined from a knee pain map. Pain with stairs and walking on level ground were assessed with the WOMAC...
March 20, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28318420/bayesian-penalized-log-likelihood-ratio-approach-for-dose-response-clinical-trial-studies
#18
Yuanyuan Tang, Chunyan Cai, Liangrui Sun, Jianghua He
In literature, there are a few unified approaches to test proof of concept and estimate a target dose, including the multiple comparison procedure using modeling approach, and the permutation approach proposed by Klingenberg. We discuss and compare the operating characteristics of these unified approaches and further develop an alternative approach in a Bayesian framework based on the posterior distribution of a penalized log-likelihood ratio test statistic. Our Bayesian approach is much more flexible to handle linear or nonlinear dose-response relationships and is more efficient than the permutation approach...
February 13, 2017: Journal of Biopharmaceutical Statistics
https://www.readbyqxmd.com/read/28317171/combination-of-change-in-hematological-parameters-with-exercise-stress-test-to-predict-coronary-artery-disease
#19
Ahmet Korkmaz, Abdulkadir Yıldız, Pınar Türker Duyuler, Serkan Duyuler, Samet Yılmaz, Funda Basyigit, Ozgul Ucar Elalmis, Umit Guray, Mehmet Ileri
OBJECTIVE: Treadmill exercise stress testing for identifying patients with a higher likelihood of coronary artery disease (CAD) before elective coronary angiography is recommended in the current guidelines. In this study, we aimed to evaluate the changes in the hematological parameters before and after exercise stress test in relation with the presence of CAD. METHODS: A total of 113 patients with chest pain who underwent treadmill exercise testing and coronary angiography were included in this study...
March 20, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28314238/paternity-testing-and-other-inference-about-relationships-from-dna-mixtures
#20
Peter J Green, Julia Mortera
We present methods for inference about relationships between contributors to a DNA mixture and other individuals of known genotype: a basic example would be testing whether a contributor to a mixture is the father of a child of known genotype. The evidence for such a relationship is evaluated as the likelihood ratio for the specified relationship versus the alternative that there is no relationship. We analyse real casework examples from a criminal case and a disputed paternity case; in both examples part of the evidence was from a DNA mixture...
February 16, 2017: Forensic Science International. Genetics
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