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https://www.readbyqxmd.com/read/28549132/selective-impairment-of-goal-directed-decision-making-following-lesions-to-the-human-ventromedial-prefrontal-cortex
#1
Justin Reber, Justin S Feinstein, John P O'Doherty, Mimi Liljeholm, Ralph Adolphs, Daniel Tranel
HASH(0x3e76290)
June 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28543000/fine-needle-aspiration-with-selective-use-of-core-needle-biopsy-of-major-salivary-gland-tumors
#2
Erica B Romano, Jason M Wagner, Anthony M Alleman, Lichao Zhao, Rachel D Conrad, Greg A Krempl
OBJECTIVES: Preferential use of fine-needle aspiration (FNA) versus core needle biopsy (CNB) for distinguishing benign from malignant major salivary gland tumors is highly debated. The main disadvantage of FNA is lower sensitivity, whereas arguments against CNB include use of a larger bore needle and greater risk of complications. The aim of this study is to evaluate our experience performing ultrasound-guided (UG) FNA with selective use of CNB based on preliminary cytopathology, and to determine whether our preoperative diagnostic approach is more sensitive and specific than FNA alone-and at least as sensitive and specific as CNB alone...
May 23, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28541420/surgical-decompression-of-high-grade-spinal-cord-compression-from-hormone-refractory-metastatic-prostate-cancer
#3
Muhammad Omar Chohan, Sweena Kahn, Gustav Cederquist, Anne S Reiner, Joseph Schwab, Ilya Laufer, Mark Bilsky
BACKGROUND: Spine and nonspine skeletal metastases occur in more than 80% of patients with prostate cancer. OBJECTIVE: To examine the characteristics of the patient population undergoing surgery for the treatment of prostate cancer metastatic to the spine. METHODS: A retrospective chart review was performed on all patients treated at our institution from June 1993 to August 2014 for surgical management of metastatic spine disease from prostate cancer...
May 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28540208/myocardial-ct-perfusion-imaging-for-ischemia-detection
#4
REVIEW
Patricia Carrascosa, Carlos Capunay
Coronary computed tomography angiography (CCTA) plays an important role in many specific scenarios such as in symptomatic patients with intermediate pretest of coronary artery disease (CAD), as well as in the triage of patients with acute chest pain with TIMI risk ≤2. However, it cannot detect the presence of associated ischemia, which is critical for clinical decision making among patients with moderate to severe stenosis. Although functional information can be obtained with different non-invasive tools, cardiac CT is the unique modality that can perform a comprehensive evaluation of coronary anatomy plus the functional significance of lesions...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28528215/patients-criteria-determining-difficulty-of-the-laparoscopic-lateral-transperitoneal-adrenalectomy-a-retrospective-cohort-study
#5
Michał Natkaniec, Jadwiga Dworak, Michał Pędziwiatr, Magdalena Pisarska, Piotr Major, Marcin Dembiński, Marek Winiarski, Andrzej Budzyński
BACKGROUND: Identification of patients in whom adrenalectomy may be more difficult, can help in decision making in borderline and doubtful cases. The aim of the study was to determine patients criteria influencing difficulty of laparoscopic lateral transperitoneal adrenalectomy (LTA). MATERIAL AND METHODS: The study enrolled 275 patients who underwent LTA. We analyzed the impact of gender, age, history of previous abdominal surgery, body mass index, risk of anesthesia measured as ASA scale, size, localization (left/right), and histological type of the tumor on parameters reflecting the level of difficulty of the procedure: operative time, intraoperative blood loss, conversion rate and intraoperative complications rate...
May 17, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28521931/hemodynamic-measurements-for%C3%A2-the%C3%A2-selection-of-patients-with-renal%C3%A2-artery%C3%A2-stenosis-a-systematic-review
#6
REVIEW
Peter M van Brussel, Tim P van de Hoef, Robbert J de Winter, Liffert Vogt, Bert-Jan van den Born
Interventions targeting renal artery stenoses have been shown to lower blood pressure and preserve renal function. In recent studies, the efficacy of catheter-based percutaneous transluminal renal angioplasty with stent placement has been called into question. In the identification of functional coronary lesions, hyperemic measurements have earned a place in daily practice for clinical decision making, allowing discrimination between solitary coronary lesions and diffuse microvascular disease. Next to differences in clinical characteristics, the selection of renal arteries suitable for intervention is currently on the basis of anatomic grading of the stenosis by angiography rather than functional assessment under hyperemia...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28511385/intra-operative-diagnosis-of-breast-lesions-by-imprint-cytology-and-frozen-section-with-histopathological-correlation
#7
Asha Mahadevappa, Thattamparambil Gopalakrishnan Nisha, Gubbanna V Manjunath
INTRODUCTION: The most common malignant tumour among women is breast carcinoma. Early lesions of the breast including carcinoma are potentially curable if treated properly in the era of breast conservative therapy. For this purpose different diagnostic strategies are in practice. Intra operative Imprint Cytology (IC) and Frozen Section (FS) have a role in spite of the intense recognition of aspiration cytology in the following settings: inconclusive cytological/core biopsy findings; for evaluation of lumpectomy margins and intra operative nodal status...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28511066/deep-image-mining-for-diabetic-retinopathy-screening
#8
Gwenolé Quellec, Katia Charrière, Yassine Boudi, Béatrice Cochener, Mathieu Lamard
Deep learning is quickly becoming the leading methodology for medical image analysis. Given a large medical archive, where each image is associated with a diagnosis, efficient pathology detectors or classifiers can be trained with virtually no expert knowledge about the target pathologies. However, deep learning algorithms, including the popular ConvNets, are black boxes: little is known about the local patterns analyzed by ConvNets to make a decision at the image level. A solution is proposed in this paper to create heatmaps showing which pixels in images play a role in the image-level predictions...
April 28, 2017: Medical Image Analysis
https://www.readbyqxmd.com/read/28503350/clinicoradiologic-profile-of-involvement-and-healing-in-tuberculosis-of-the-spine
#9
R Singh, N K Magu, R K Rohilla
BACKGROUND: There is no much information about how tuberculous lesions of the spine progress/heal; what clinical and radiological features suggest progression/healing; what is the optimal duration of antitubercular treatment; and what clinical, laboratory, and radiological investigations and their frequency should be done to monitor the disease course. AIMS: The present study aimed to evaluate what specific clinicoradiologic features suggest involvement and healing in tuberculosis of the spine...
September 2016: Annals of Medical and Health Sciences Research
https://www.readbyqxmd.com/read/28500587/insights-into-the-pathogenesis-of-pancreatic-cystic-neoplasms
#10
REVIEW
Vrishketan Sethi, Bhuwan Giri, Ashok Saluja, Vikas Dudeja
With the current epidemic of diagnosed pancreatic cystic neoplasms on the rise, a substantial amount of work has been done to unravel their biology, thus leading to implications on clinical decision making. Recent genetic profiling of resected human specimens has identified alterations in signaling pathways involving KRAS and GNAS signaling as early events in the pathogenesis of intraductal pancreatic mucinous neoplasms. Progressively, mutations in genes such as TP53, SMAD4, RNF43, and others are thought to characterize invasive and advanced lesions...
May 12, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28495358/animal-to-human-translational-paradigms-relevant-for-approach-avoidance-conflict-decision-making
#11
Namik Kirlic, Jared Young, Robin L Aupperle
Avoidance behavior in clinical anxiety disorders is often a decision made in response to approach-avoidance conflict, resulting in a sacrifice of potential rewards to avoid potential negative affective consequences. Animal research has a long history of relying on paradigms related to approach-avoidance conflict to model anxiety-relevant behavior. This approach includes punishment-based conflict, exploratory, and social interaction tasks. There has been a recent surge of interest in the translation of paradigms from animal to human, in efforts to increase generalization of findings and support the development of more effective mental health treatments...
April 24, 2017: Behaviour Research and Therapy
https://www.readbyqxmd.com/read/28488195/differences-in-clinical-features-between-subcategories-of-atypia-follicular-lesion-of-undetermined-significance
#12
Seong Dong Kim, Seung Hoon Han, Woo-Jin Jeong, Hyojin Kim, Soon Hyun Ahn
Within the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), category III (atypia or follicular lesion of undetermined significance (AUS/FLUS)) comprises specimens with heterogeneous features and the need for subcategorization has been reported. We compared the clinical features of two subgroups from within the category of AUS/FLUS to determine precise guidelines for clinicians who explain the results of fine-needle aspiration (FNA) to patients. Retrospective review was performed including data from all patients who underwent FNA with results reported as AUS/FLUS at a single tertiary hospital from January 2010 to August 2014...
May 9, 2017: Endocrine Pathology
https://www.readbyqxmd.com/read/28481705/breast-reconstruction-with-postmastectomy-radiation-choices-and-tradeoffs
#13
Matthew M Poppe, Jayant P Agarwal
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
May 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28479239/renal-mass-and-localized-renal-cancer-aua-guideline
#14
Steven Campbell, Robert G Uzzo, Mohamad E Allaf, Eric B Bass, Jeffrey A Cadeddu, Anthony Chang, Peter E Clark, Brian J Davis, Ithaar H Derweesh, Leo Giambarresi, Debra A Gervais, Susie L Hu, Brian R Lane, Bradley C Leibovich, Philip M Pierorazio
PURPOSE: This AUA Guideline focuses on evaluation/counseling and management of adult patients with clinically-localized renal masses suspicious for cancer, including solid-enhancing tumors and Bosniak 3/4 complex-cystic lesions. MATERIALS/METHODS: Systematic review utilized research from the Agency for Healthcare Research and Quality (AHRQ) and additional supplementation by the authors and consultant methodologists. Evidence-based statements were based on body of evidence strength Grade A/B/C (Strong/Moderate/Conditional Recommendations, respectively) with additional statements presented as Clinical Principles or Expert Opinions...
May 4, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28478711/ct-angiography-of-peripheral-arterial-disease-by-256-slice-scanner-accuracy-advantages-and-disadvantages-compared-to-digital-subtraction-angiography
#15
Atul Mishra, Narendra Jain, Anand Bhagwat
BACKGROUND: Peripheral arterial occlusive disease (PAOD) may cause disabling claudication or critical limb ischemia. Multidetector computed tomography (CT) technology has evolved to the level of 256-slice CT scanners which has significantly improved the spatial and temporal resolution of the images. This has provided the capability of chasing the contrast bolus at a fast speed enabling angiographic imaging of long segments of the body. These images can be reconstructed in various planes and various modes for detailed analysis of the peripheral vascular diseases which helps in making treatment decision...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28475383/fractional-flow-reserve-in-2017-current-data-and-everyday-practice
#16
J J Coughlan, Colin MacDonnell, Samer Arnous, Thomas J Kiernan
Fractional Flow Reserve (FFR) is an objective physiological index utilized in coronary angiography. It expresses the blood flow in the presence of a coronary artery stenosis as a fraction of the normal blood flow and gives information regarding the functional significance of the lesion. FFR guided percutaneous coronary intervention (PCI) has been shown to be superior to angiography guided PCI in several trials and registries. In addition, it appears that the use of FFR may also be preferable from an economic perspective...
May 5, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28471149/clinical-imaging-in-patients-with-fever-and-suspected-endocarditis
#17
Benedetta DE Chiara, Antonella Moreo
Echocardiography remains the cornerstone of the diagnostic of anatomic lesions and consequences on cardiac function caused by infective endocarditis (IE). There is now evidence that other imaging techniques are useful in reducing the number of non-conclusive diagnoses, in particular when IE is suspected on prosthetic material or devices. Besides diagnosis, cardiac imaging strongly contributes to prognostic assessment, indications for early surgery and patient follow-up. It is required a specific expertise for implementing and interpreting all imaging techniques and the complexity of decision-making highlights the need for a multidisciplinary management of difficult cases in specialized endocarditis teams...
May 3, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28463669/pancreatic-cystic-lesions-diagnostic-management-and-indications-for-operation-part-i
#18
Ferdinand Bauer
We notice an increasing frequency in the detection and evaluation of pancreatic cystic lesions (PCLs) over the last three decades. They show awide spectrum of imaging and clinical features. The diagnosis and discrimination of these lesions are very important because of the risk for concurrent or later development of malignancy. The main reason is the increased awareness of these lesions and the extensive use of cross-sectional imaging, an always improving technique (1). Commonly, PCLs are diagnosed incidentally during investigation for often unrelated and nonspecific abdominal complaints using state-of-the art abdominal imaging (CT, MRT)...
March 2017: Chirurgia
https://www.readbyqxmd.com/read/28457932/the-role-of-conventional-myelography-in-the-diagnosis-and-treatment-of-degenerative-spine-diseases-in-low-income-communities-a-prospective-study
#19
David Kitya, Maria Punchak, Francis Bajunirwe
INTRODUCTION: Chronic back pain is a common problem and imaging is crucial for effective diagnosis and treatment. In low-resource settings conventional myelography is a cheap alternative to MRI and CT. This study was conducted to re-examine the diagnostic reliability, effectiveness for surgical decision making and safety of conventional myelography. METHODS: The study was conducted at Tenwek Mission Hospital during June 2009 and March 2010. New patients who presented with features of radiculopathy and/or myelopathy were eligible...
April 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28445126/clinical-features-and-surgical-treatment-of-sacral-schwannomas
#20
Weibo Pan, Zhan Wang, Nong Lin, Xin Huang, Meng Liu, Xiaobo Yan, Zhaoming Ye
BACKGROUND: Sacral schwannoma is relatively rare and both the early diagnosis and appropriate treatment of sacral schwannomas are equally very challenging. METHODS: 11 sacral schwannoma cases operated at the Second Affiliated Hospital, School of Medicine, Zhejiang University, from 2012 to 2016, were investigated retrospectively and 10 were followed up. All patients were assessed with X-ray, CT and MRI, and underwent an intralesional excision. RESULTS: One patient was male, nine were female and the average age was 48 (ranging between 31 and 63)...
April 8, 2017: Oncotarget
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