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https://www.readbyqxmd.com/read/28324983/the-precuneus-may-encode-irrationality-in-human-gambling
#1
P Sacre, M S D Kerr, S Subramanian, K Kahn, J Gonzalez-Martinez, M A Johnson, S V Sarma, J T Gale
Humans often make irrational decisions, especially psychiatric patients who have dysfunctional cognitive and emotional circuitry. Understanding the neural basis of decision-making is therefore essential towards patient management, yet current studies suffer from several limitations. Functional magnetic resonance imaging (fMRI) studies in humans have dominated decision-making neuroscience, but have poor temporal resolution and the blood oxygenation level-dependent signal is only a proxy for neural activity. On the other hand, lesion studies in humans used to infer functionality in decision-making lack characterization of neural activity altogether...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28315499/evaluation-of-the-decision-making-process-in-the-conservative-approach-to-small-testicular-masses
#2
Andrea Benelli, Virginia Varca, Lorenzo Derchi, Andrea Gregori, Giorgio Carmignani, Alchiede Simonato
INTRODUCTION: We evaluate the clinical outcome of patients treated with conservative approach for small testicular masses (STMs). We analyzed the steps who brought to the selection of the therapeutic approach: starting from clinical presentation, through imaging and lab studies. METHODS: We considered 18 patients who underwent an organ-sparing approach for STMs from 2005 until 2014. The selection criteria were dimension of the mass and absence of clinical, laboratory and/or radiological malignancy suspicion...
March 15, 2017: Urologia
https://www.readbyqxmd.com/read/28302330/precision-surgery-for-colorectal-liver-metastases-opportunities-and-challenges-of-omics-based-decision-making
#3
REVIEW
R P Jones, K W Brudvik, J M Franklin, G J Poston
Precision surgery involves improving patient selection to ensure that surgical intervention that is proven to benefit on a population level is the optimal treatment for each individual patient. For patients with colorectal liver metastases (CRLM), existing prognostic scoring systems rely on well-recognised histopathological features such as size and number of lesions. Advances in preoperative imaging algorithms mean that increasingly low volume disease can be detected, improving assessment of these factors...
March 6, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28300284/predictors-and-variability-of-drug-eluting-vs-bare-metal-stent-selection-in-contemporary-percutaneous-coronary-intervention-insights-from-the-prism-study
#4
Ali Shafiq, Kensey Gosch, Amit P Amin, Henry H Ting, John A Spertus, Adam C Salisbury
Drug-eluting stents (DES) reduce risk of in-stent restenosis after percutaneous coronary intervention (PCI) but require dual antiplatelet therapy (DAPT) for a longer term than bare-metal stents (BMS). Few studies have examined clinical predictors of DES vs BMS, and variability in provider selection between DES and BMS in clinical practice has not been well described. These insights can inform our understanding of current practice and may identify opportunities to improve decision-making stent selection decinsion-making...
March 16, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28289516/biochemical-changes-in-the-injured-brain
#5
EDITORIAL
Seelora Sahu, Deb Sanjay Nag, Amlan Swain, Devi Prasad Samaddar
Brain metabolism is an energy intensive phenomenon involving a wide spectrum of chemical intermediaries. Various injury states have a detrimental effect on the biochemical processes involved in the homeostatic and electrophysiological properties of the brain. The biochemical markers of brain injury are a recent addition in the armamentarium of neuro-clinicians and are being increasingly used in the routine management of neuro-pathological entities such as traumatic brain injury, stroke, subarachnoid haemorrhage and intracranial space occupying lesions...
February 26, 2017: World Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28283790/a-retrospective-study-of-ultrasound-and-fna-cytology-investigation-of-thyroid-nodules-working-towards-combined-risk-stratification
#6
Zi Wei Liu, Richard Fox, Samit Unadkat, Roy Farrell
The British Thyroid Association recommended in new guidelines on thyroid cancer treatment [Kwak et al. (Korean J Radiol 14:110-117, 2013)] that ultrasound grading of thyroid nodules should be incorporated into MDT management. A retrospective study was carried out to determine that the impact of US grading has had on MDT decision making in practice. The design used in the study is a retrospective review of case notes. The study was carried out in the hub hospital for thyroid cancer in the North west London Cancer network...
March 10, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28281913/rapidly-progressing-facial-leishmaniasis-effective-treatment-with-liposomal-amphotericin-b-and-a-review-of-the-management-of-old-world-cutaneous-leishmaniasis
#7
Shamim Islam
Cutaneous leishmaniasis (CL), a common condition in many parts of the world, is being increasingly encountered in non-endemic countries secondary to immigration. The clinical manifestations and course can vary substantially, with appropriate management ranging from observation for self-healing lesions to urgent treatment to prevent damaging anatomical and cosmetic sequelae. While there are now several effective medications, optimal therapy is not well defined, and decision-making can be challenged by the location of lesions and various drug issues, including availability, mode of delivery and adverse effects...
March 10, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28275900/a-simple-classification-system-the-tree-flowchart-for-breast-mri-can-reduce-the-number-of-unnecessary-biopsies-in-mri-only-lesions
#8
Ramona Woitek, Claudio Spick, Melanie Schernthaner, Margaretha Rudas, Panagiotis Kapetas, Maria Bernathova, Julia Furtner, Katja Pinker, Thomas H Helbich, Pascal A T Baltzer
OBJECTIVES: To assess whether using the Tree flowchart obviates unnecessary magnetic resonance imaging (MRI)-guided biopsies in breast lesions only visible on MRI. METHODS: This retrospective IRB-approved study evaluated consecutive suspicious (BI-RADS 4) breast lesions only visible on MRI that were referred to our institution for MRI-guided biopsy. All lesions were evaluated according to the Tree flowchart for breast MRI by experienced readers. The Tree flowchart is a decision rule that assigns levels of suspicion to specific combinations of diagnostic criteria...
March 8, 2017: European Radiology
https://www.readbyqxmd.com/read/28273332/comparison-between-model-predicted-tumor-oxygenation-dynamics-and-vascular-flow-related-doppler-indices
#9
Antonella Belfatto, Ailyn M Vidal Urbinati, Delia Ciardo, Dorella Franchi, Federica Cattani, Roberta Lazzari, Barbara A Jereczek-Fossa, Roberto Orecchia, Guido Baroni, Pietro Cerveri
PURPOSE: Mathematical modeling is a powerful and flexible method to investigate complex phenomena. It discloses the possibility of reproducing expensive as well as invasive experiments in a safe environment with limited costs. This makes it suitable to mimic tumor evolution and response to radiotherapy although the reliability of the results remains an issue. Complexity reduction is therefore a critical aspect in order to be able to compare model outcomes to clinical data. Among the factors affecting treatment efficacy, tumor oxygenation is known to play a key role in radiotherapy response...
March 8, 2017: Medical Physics
https://www.readbyqxmd.com/read/28269815/electroclinical-semiology-of-the-bilateral-asymmetric-tonic-seizures-observed-in-patients-with-supplementary-sensorimotor-area-epilepsy-confirmed-by-pre-and-post-operative-mri
#10
Guilan Cai, Jing Wang, Xi Mei, Wei Zhang, Guoming Luan, Xingzhou Liu
OBJECTIVE: To retrospectively reappraise characteristics of the electro-clinical seizure semiology of the bilateral asymmetric tonic seizure (BATS) in the patients with supplementary sensorimotor area (SSMA) epilepsy. METHODS: From the retrospective analysis of the pre- and post-operative Magnetic Resonance Imaging (MRI) data involving 386 patients who received epilepsy surgery, 123 BATS were identified meeting the clinical criteria and included in the study. For comparison in four extremities involvement, limbs were paired and comparatively evaluated between the contralateral and ipsilateral sides, proximal and distal segments, and upper and lower limbs...
March 3, 2017: Journal of X-ray Science and Technology
https://www.readbyqxmd.com/read/28263798/lesions-to-polar-orbital-prefrontal-cortex-selectively-impair-reasoning-about-emotional-material
#11
Vinod Goel, Elaine Lam, Kathleen W Smith, Amit Goel, Vanessa Raymont, Frank Krueger, Jordan Grafman
While it is widely accepted that lesions to orbital prefrontal cortex lead to emotion related disruptions and poor decision-making, there is very little patient data on this issue involving actual logical reasoning tasks. We tested patients with circumscribed, focal lesions largely confined to polar/orbital prefrontal cortex (BA 10 & 11) (N=17) on logical reasoning tasks involving neutral and emotional content, and compared their performance to that of an age and education-matched normal control group (N=22) and a posterior lesion control group (N=24)...
March 3, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/28262536/challenges-in-salvaging-urinary-continence-following-failed-bladder-exstrophy-repair-in-a-developing-country
#12
Moneer K Hanna, Ibrahim Bassiouny
INTRODUCTION: The management of urinary incontinence following failed bladder exstrophy repairs is not well defined, some surgeons recommend urinary diversion, others would pursue reconstructive surgery. OBJECTIVE: Herein we review our experience with various strategies for management of urinary incontinence and their outcome in 61 patients born with bladder exstrophy who failed their initial repairs. We also examine the impact of diverse factors in making the surgical decision for patients with limited resources in a developing country...
January 29, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28261901/discussing-prognosis-and-treatment-goals-with-patients-with-advanced-cancer-a-qualitative-analysis-of-oncologists-language
#13
Wen-Ying Sylvia Chou, Lauren M Hamel, Chan L Thai, David Debono, Robert A Chapman, Terrance L Albrecht, Louis A Penner, Susan Eggly
BACKGROUND: The National Academy of Medicine recommends that cancer patients be knowledgeable of their prognosis to enable them to make informed treatment decisions, but research suggests few patients receive this information. OBJECTIVE: This qualitative study describes oncologists' language during discussions of prognosis and treatment goals in clinical interactions with African American patients diagnosed with cancer. DESIGN: We analysed transcripts from video recordings of clinical interactions between patients with Stage III or IV cancer (n=26) and their oncologists (n=9)...
March 5, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28259368/practices-and-attitudes-of-canadian-cardiologists-caring-for-patients-with-trisomy-18
#14
Aisling A Young, Christy Simpson, Andrew E Warren
Trisomy 18 (T18) is a genetic disorder with cardiac lesions in up to 90% of patients. Cardiac surgery is not frequently offered because of the overall poor prognosis, although this has recently been challenged. Our study aimed to explore the practices and attitudes of Canadian pediatric cardiologists managing T18 patients. We administered a survey to pediatric cardiologists attending the Canadian Cardiovascular Congress, Canadian Pediatric Cardiology Association Business Meeting. There were 30 respondents. Most (67%) supported comfort care for affected patients with a heart lesion...
November 17, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28259011/clinical-use-of-biomarkers-in-breast-cancer-updated-guidelines-from-the-european-group-on-tumor-markers-egtm
#15
REVIEW
M J Duffy, N Harbeck, M Nap, R Molina, A Nicolini, E Senkus, F Cardoso
Biomarkers play an essential role in the management of patients with invasive breast cancer. For selecting patients likely to respond to endocrine therapy, both oestrogen receptors (ERs) and progesterone receptors (PRs) should be measured on all newly diagnosed invasive breast cancers. On the other hand, for selecting likely response to all forms of anti-HER2 therapy (trastuzumab, pertuzumab, lapatinib or ado-trastuzumab emtansine), determination of HER2 expression or gene copy number is mandatory. Where feasible, measurement of ER, PR and HER2 should be performed on recurrent lesions and the primary invasive tumour...
February 27, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28255212/competitive-coronary-flow-between-the-native-left-anterior-descending-artery-and-left-internal-mammary-artery-graft-is-it-a-surrogate-angiographic-marker-of-over-or-unnecessary-revascularization-decision-in-daily-practice
#16
Pinar Dogan, Mevlut Serdar Kuyumcu, Emine Demiryapan, Fazil Arisoy, Ozcan Ozeke
Overdiagnosis and overtreatment are often thought of as relatively recent phenomena in modern medicine, influenced by a contemporary combination of technology, specialization, payment models, marketing, and supply-related demand. Several investigators have reported discrepancies between the angiographic and functional severity of coronary angiographic stenosis. However, the visual anatomic assessment of the coronary lesion severity continues in daily practice. We evaluated the consecutive all coronary angiograms performed between January 2015 and December 2015 and examined only patients who had previous coronary artery bypass grafting (CABG) to analyze the cases with regard to presence of the competitive flow (CF) between the native left anterior descending coronary artery (LAD) and left internal mammary artery (LIMA) graft...
March 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28251612/diagnosis-of-deep-pelvic-masses-on-a-gynaecology-service-trans-vaginal-ultrasound-guided-needle-aspiration-of-pelvic-solid-and-cystic-lesions
#17
Ram Eitan, Yoav Peled, Gad Sabah, Haim Krissi, Avi Ben Haroush, Israel Meizner, David Danon, Ron Bardin, Ariella Jakobson-Setton, Liat Salzer, Reuven Mashiach
OBJECTIVES: Women with undiagnosed pelvic lesions are often referred for evaluation and treatment. Transvaginal ultrasound-guided fine needle aspiration (TVUS-FNA) biopsy can assist in making management decisions. We describe our experience with this modality. METHODS: We performed a retrospective chart review of all women who had a TVUS-FNA biopsy between January 2004 and December 2014. Charts were reviewed for clinicopathologic information. The pathologic results of the TVUS-FNA were compared with the final diagnosis...
March 2, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28247214/accuracy-of-computer-aided-diagnosis-based-on-narrow-band-imaging-endocytoscopy-for-diagnosing-colorectal-lesions-comparison-with-experts
#18
Masashi Misawa, Shin-Ei Kudo, Yuichi Mori, Kenichi Takeda, Yasuharu Maeda, Shinichi Kataoka, Hiroki Nakamura, Toyoki Kudo, Kunihiko Wakamura, Takemasa Hayashi, Atsushi Katagiri, Toshiyuki Baba, Fumio Ishida, Haruhiro Inoue, Yukitaka Nimura, Msahiro Oda, Kensaku Mori
PURPOSE: Real-time characterization of colorectal lesions during colonoscopy is important for reducing medical costs, given that the need for a pathological diagnosis can be omitted if the accuracy of the diagnostic modality is sufficiently high. However, it is sometimes difficult for community-based gastroenterologists to achieve the required level of diagnostic accuracy. In this regard, we developed a computer-aided diagnosis (CAD) system based on endocytoscopy (EC) to evaluate cellular, glandular, and vessel structure atypia in vivo...
February 28, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28243488/-twin-lesions-which-one-is-the-bad-one-improvement-of-clinical-diagnosis-with-reflectance-confocal-microscopy
#19
Secil Saral, Daniela Hartmann, Valerie Letulè, Thomas Ruzicka, Cristel Ruini, Tanja von Braunmühl
BACKGROUND: In vivo reflectance confocal microscopy (RCM) is a novel non-invasive diagnostic tool, which is used to differentiate skin lesions. Even in lesions with similar dermatoscopic images, RCM may improve diagnostic accuracy. METHODS: Three sets of false "twin lesions" with similar macroscopic and dermatoscopic images are matched. All lesions are evaluated with RCM and lesions are excised for further evaluation. Corresponding features in confocal images, dermatoscopy and histopathology are discussed...
January 2017: Dermatology Practical & Conceptual
https://www.readbyqxmd.com/read/28243338/the-bony-bankart-lesion-how-to-measure-the-glenoid-bone-loss
#20
REVIEW
Jarosław Skupiński, Małgorzata Zofia Piechota, Wojciech Wawrzynek, Jarosław Maczuch, Anna Babińska
An osseous Bankart lesion is commonly seen in patients with an anterior shoulder dislocation. It is defined as a detachment of the anteroinferior labrum associated with a glenoid rim fracture. Radiological studies are crucial not only for detecting glenoid bone defects but also for measuring the amount of bone loss. The precise quantification of the bony defect is crucial for the therapeutic desicion-making and clinical outcomes. Although we know that major glenoid bone loss requires surgical intervention, none of the studies performed so far answered the question what size of the defect should be an indication for open surgery procedures...
2017: Polish Journal of Radiology
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