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https://www.readbyqxmd.com/read/28689230/the-extended-transnasal-transsphenoidal-approach-for-anterior-skull-base-meningioma-considerations-in-patient-selection
#1
Joseph P Castlen, David J Cote, Hasan A Zaidi, Edward R Laws
PURPOSE: In this study, we set out to define our institutional criteria for patient eligibility for transsphenoidal resection of parasellar meningiomas, and to report our experience with extended transnasal approaches for these lesions. We aimed to discuss the important considerations of patient selection and risk stratification to optimize outcomes for patients with these difficult lesions, and also include considerations that should be reviewed during surgical approach selection. METHODS: Medical records from Brigham and Women's Hospital were retrospectively reviewed for all patients who underwent transsphenoidal surgery for pituitary disease with the senior author from April 2008 to March 2017 (938 procedures)...
July 8, 2017: Pituitary
https://www.readbyqxmd.com/read/28687072/evaluating-the-feasibility-of-the-kdigo-ckd-referral-recommendations
#2
Karandeep Singh, Sushrut S Waikar, Lipika Samal
BACKGROUND: In 2012, the international nephrology organization Kidney Disease Improving Global Outcomes (KDIGO) released recommendations for nephrology referral for chronic kidney disease (CKD) patients. The feasibility of adhering to these recommendations is unknown. METHODS: We conducted a retrospective analysis of the primary care population at Brigham and Women's Hospital (BWH). We translated referral recommendations based upon serum creatinine, estimated glomerular filtration rate (eGFR), and albuminuria into a set of computable criteria in order to project referral volume if the KDIGO referral recommendations were to be implemented...
July 7, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28679813/a-systematic-intervention-to-improve-serious-illness-communication-in-primary-care
#3
Joshua R Lakin, Luca A Koritsanszky, Rebecca Cunningham, Francine L Maloney, Brandon J Neal, Joanna Paladino, Marissa C Palmor, Christine Vogeli, Timothy G Ferris, Susan D Block, Atul A Gawande, Rachelle E Bernacki
Improving communication about goals and values for patients with advancing serious illness nearing the end of life is a key opportunity to improve the value of care. The Serious Illness Care Program, implemented at primary care clinics affiliated with Brigham and Women's Hospital in Boston, Massachusetts, is a multicomponent intervention designed to support best practices in communication by clinicians to increase conversations with patients with serious illness about their goals and values. We conducted a study of the program in fourteen primary care clinics participating in a high-risk care management program based in an accountable care organization...
July 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28669499/the-impact-of-margins-on-outcomes-after-wedge-resection-for-stage-i-non-small-cell-lung-cancer
#4
Andrea S Wolf, Scott J Swanson, Rowena Yip, Bian Liu, Elizabeth S Tarras, David F Yankelevitz, Claudia I Henschke, Emanuela Taioli, Raja M Flores
BACKGROUND: The relationship between margin distance and recurrence and survival for stage I non-small cell lung carcinoma (NSCLC) less than or equal to 2 cm is not clear. METHODS: Patient clinicopathologic data were reviewed from a pooled data set of stage I NSCLC lesions less than or equal to 2 cm resected by wedge resection at Brigham and Women's Hospital (BWH) between 2000 and 2005 and the International Early Lung and Cardiac Action Program (I-ELCAP) between 1999 and 2015...
June 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28654579/detection-of-high-risk-histologic-features-and-tumor-upstaging-of-nonmelanoma-skin-cancers-on-debulk-analysis-a-quantitative-systematic-review
#5
Babu Singh, Adriana Dorelles, Nellie Konnikov, Bichchau M Nguyen
BACKGROUND: Histologic analysis of tumor debulks from Mohs micrographic surgery (MMS) or wide local excision may lead to the detection of adverse features missed on initial biopsy. OBJECTIVE: Determine the incidence of (1) high-risk features on debulk analysis compared with initial biopsy and (2) upstaging of tumors on debulk analysis according to the American Joint Committee of Cancer-7th Edition (AJCC-7) and the Brigham and Women's Alternative (BWH) staging criteria...
June 28, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28639314/determinants-of-red-blood-cell-alloantibody-detection-duration-analysis-of-multiply-alloimmunized-patients-supports-peritransfusion-factors
#6
Lorette Noiret, Amy Slater, John M Higgins
BACKGROUND: Alloimmunization to red blood cells (RBCs) can cause serious transfusion reactions and complicate the search for compatible blood products. Alloantibodies can be detected for periods ranging from a few days to several years, yet the mechanisms controlling the duration of detectability remain unknown. We studied the detection durations in patients forming multiple antibodies to investigate whether the duration is more strongly determined by conditions present at the time of each transfusion (peritransfusion factors) or by more stable patient-specific factors likely to persist across transfusions...
June 21, 2017: Transfusion
https://www.readbyqxmd.com/read/28603435/an-active-learning-curriculum-improves-fellows-knowledge-and-faculty-teaching-skills
#7
Jennifer A Inra, Stephen Pelletier, Navin L Kumar, Edward L Barnes, Helen M Shields
OBJECTIVES: Traditional didactic lectures are the mainstay of teaching for graduate medical education, although this method may not be the most effective way to transmit information. We created an active learning curriculum for Brigham and Women's Hospital (BWH) gastroenterology fellows to maximize learning. We evaluated whether this new curriculum improved perceived knowledge acquisition and knowledge base. In addition, our study assessed whether coaching faculty members in specific methods to enhance active learning improved their perceived teaching and presentation skills...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28585909/agreement-analysis-comparing-ipad-lcva-and-sloan-testing-in-multiple-sclerosis-patients
#8
Neda Sattarnezhad, Samantha Farrow, Dorlan Kimbrough, Bonnie Glanz, Brian Healy, Tanuja Chitnis
BACKGROUND: Visual symptoms are common in multiple sclerosis (MS). Low-contrast visual acuity (LCVA) testing using Sloan charts has demonstrated increased sensitivity for visual deficits compared to high-contrast acuity testing. Computerized testing of visual acuity may facilitate use in the clinic setting. OBJECTIVES: To evaluate the agreement between an iPad-based and Sloan testing of LCVA in a cohort of MS patients. METHODS: A total of 38 patients with relapsing-remitting MS were enrolled after providing informed written consent at Partners MS Center, Brigham and Women's hospital...
June 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28577841/aortic-atheroma-increases-the-risk-of-long-term-mortality-in-20-000-patients
#9
Carolyn Goldberg Butler, Jamahal Maeng Ho Luxford, Chuan-Chin Huang, Julius I Ejiofor, James D Rawn, Kerry Wilusz, John A Fox, Stanton K Shernan, Jochen Daniel Muehlschlegel
BACKGROUND: The association between long-term survival and aortic atheroma in cardiac surgical patients has not been comprehensively investigated. In this study we determine the relation between grade of atheroma and the risk of long-term mortality in a retrospective cohort of more than 20,000 patients undergoing cardiac operation during a 20-year period. METHODS: We included 22,304 consecutive intraoperative transesophageal and epiaortic ultrasound examinations performed at Brigham and Women's Hospital between 1995 and 2014, with long-term follow-up...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28544102/a-multicenter-retrospective-case-cohort-study-of-the-epidemiology-and-risk-factors-for-clostridium-difficile-infection-among-cord-blood-transplant-recipients
#10
Carolyn D Alonso, David A Braun, Ishan Patel, Mona Akbari, Daniel Jungmyung Oh, Tomi Jun, Malgorzata McMasters, Sarah P Hammond, Brett Glotzbecker, Corey Cutler, Daniel A Leffler, Karen K Ballen, Ciarán P Kelly
BACKGROUND: Clostridium difficile infection (CDI) is the leading cause of health-care associated infectious diarrhea. The aim of this study was to evaluate the epidemiology and risk factors for CDI in the 100 days following umbilical cord blood transplantation (UCBT) at three Boston hospitals. METHODS: We performed a multicenter, retrospective, case-cohort study of 226 UCBT recipients at Beth Israel Deaconess Medical Center, Massachusetts General Hospital, and Dana Farber/Brigham and Women's Cancer Center from 2003 to 2012...
May 24, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28527078/our-headache-fellowship-a-10-year-history
#11
Paul Rizzoli
There has been a clear trend in American medical education after World War II toward training specialization and subspecialization. After some early specialization efforts by the American Board of Psychiatry and Neurology, further efforts were undertaken by the United Council for Neurologic Subspecialties (UCNS), leading to the introduction of the neurologic subspecialty of Headache Medicine in March, 2005. The training program at our center at the Brigham and Women's Hospital Department of Neurology, Harvard Medical School, in Boston, Massachusetts, was accredited in 2008 and has graduated 14 trainees since its inception...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28520927/preoperative-stratification-of-transsphenoidal-pituitary-surgery-patients-based-on-surgical-urgency
#12
Hasan A Zaidi, Amy J Wang, David J Cote, Timothy R Smith, Daniel Prevedello, Domenico Solari, Paolo Cappabianca, Monica Quiroga, Edward R Laws
BACKGROUND: Currently, there is no prioritization scale available to distinguish those patients with pituitary tumors who require urgent surgical intervention from those who are candidates for elective treatment. OBJECTIVE: To develop a classification system that can help primary care physicians, endocrinologists, neurosurgeons, ancillary support staff, and hospital administrators identify high-priority surgical candidates. METHODS: An expert international panel of clinicians consisting of endocrinologists and neurosurgeons who are involved in the diagnosis and management of sellar disease was convened...
May 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28486603/clinical-identification-of-oncogenic-drivers-and-copy-number-alterations-in-pituitary-tumors
#13
Wenya Linda Bi, Noah F Greenwald, Shakti H Ramkissoon, Malak Abedalthagafi, Shannon M Coy, Keith L Ligon, Yu Mei, Laura MacConaill, Matt Ducar, Le Min, Sandro Santagata, Ursula B Kaiser, Rameen Beroukhim, Edward R Laws, Ian F Dunn
Pituitary tumors are the second most common adult primary brain tumor, with a variable clinical course. Recent work has identified a number of genetic determinants of pituitary tumor subtypes, which may augment classic histopathologic classification schemes. We sought to determine whether pituitary tumors could be stratified based on objective molecular characteristics using a clinical genomics assay. We profiled pituitary tumors using OncoPanel, a clinical multiplexed next-generation sequencing assay and retrospectively collected the clinical information and sequencing results for 127 patients from 2012-2016 at the Brigham and Women's Hospital...
May 8, 2017: Endocrinology
https://www.readbyqxmd.com/read/28486371/trends-in-mode-of-hysterectomy-after-the-u-s-food-and-drug-administration-power-morcellation-advisory
#14
Helga Ottarsdottir, Sarah L Cohen, Mary Cox, Allison Vitonis, Jon I Einarsson
OBJECTIVE: To evaluate the trends in mode of surgery for benign hysterectomy after the 2014 U.S. Food and Drug Administration (FDA) morcellation guidelines. METHODS: This is a retrospective review of all patients who underwent a hysterectomy for benign indications, specifically for leiomyomas, at Brigham and Women's Hospital from 2013 to 2015. The rates of abdominal, vaginal, laparoscopic, and robotic-assisted laparoscopic hysterectomy as well as the perioperative outcomes were compared over the study period...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28447007/minimally-invasive-esophagectomy-the-brigham-and-women-s-hospital-experience
#15
REVIEW
Jon O Wee, Raphael Bueno, Scott J Swanson
No abstract text is available yet for this article.
March 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28426563/routine-inclusion-of-long-term-functional-and-patient-reported-outcomes-into-trauma-registries-the-forte-project
#16
Arturo J Rios-Diaz, Juan P Herrera-Escobar, Elizabeth J Lilley, Jessica R Appelson, Belinda Gabbe, Karen Brasel, Terri deRoon-Cassini, Eric B Schneider, George Kasotakis, Haytham Kaafarani, George Velmahos, Ali Salim, Adil H Haider
BACKGROUND: The National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) recently recommended inclusion of postdischarge health-related quality of life (HRQoL) and patient-reported outcomes (PROs) metrics to benchmark the quality of trauma care. Currently, these measures are not routinely collected at most trauma centers. We sought to determine the feasibility and value of adding such long-term outcome measures to trauma registries. METHODS: As part of the FORTE (Functional Outcomes and Recovery after Trauma Emergencies) project, we included patients with an Injury Severity Score of 9 or greater, admitted to the Brigham and Women's Hospital in Boston, MA, who were identified retrospectively using the institutional trauma registry and contacted 6 or 12 months after injury to participate in a telephone survey evaluating HRQoL (Short Form 12 [SF-12]), PROs (Trauma Quality of Life), posttraumatic stress disorder, return to work, residential status, and health care utilization...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28378409/diffusion-of-digital-breast-tomosynthesis-among-women-in-primary-care-associations-with-insurance-type
#17
Cheryl R Clark, Tor D Tosteson, Anna N A Tosteson, Tracy Onega, Julie E Weiss, Kimberly A Harris, Jennifer S Haas
Digital breast tomosynthesis (DBT) has shown potential to improve breast cancer screening and diagnosis compared to digital mammography (DM). The FDA approved DBT use in conjunction with conventional DM in 2011, but coverage was approved by CMS recently in 2015. Given changes in coverage policies, it is important to monitor diffusion of DBT by insurance type. This study examined DBT trends and estimated associations with insurance type. From June 2011 to September 2014, DBT use in 22 primary care centers in the Dartmouth -Brigham and Women's Hospital Population-based Research Optimizing Screening through Personalized Regimens research center (PROSPR) was examined among women aged 40-89...
May 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28377941/proof-of-concept-for-a-novel-curriculum-learning-a-second-language-during-anesthesiology-residency
#18
Kate Mitchell Cohen, Alvaro Andres Macias, Robert Lekowski, Mercedes Concepcion, Jose Zeballos
This article describes a novel curriculum for anesthesiology residents matriculating through Brigham and Women's Department of Anesthesiology. It is offered electively and provides physician residents with time to acquire language skills through a medically-focused immersion program abroad. It is designed for them to learn or improve a second language and then to speak it while practicing perioperative medicine. Ultimately, the elective curriculum will equip future anesthesiologists with the communication tools to deliver professional and compassionate patient care both within the United States and internationally...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28347447/user-requirements-for-a-chronic-kidney-disease-clinical-decision-support-tool-to-promote-timely-referral
#19
Joy Gulla, Pamela M Neri, David W Bates, Lipika Samal
BACKGROUND: Timely referral of patients with CKD has been associated with cost and mortality benefits, but referrals are often done too late in the course of the disease. Clinical decision support (CDS) offers a potential solution, but interventions have failed because they were not designed to support the physician workflow. We sought to identify user requirements for a chronic kidney disease (CKD) CDS system to promote timely referral. METHODS: We interviewed primary care physicians (PCPs) to identify data needs for a CKD CDS system that would encourage timely referral and also gathered information about workflow to assess risk factors for progression of CKD...
May 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28345442/predicting-1-year-statin-adherence-among-prevalent-users-a-retrospective-cohort-study
#20
Alexis A Krumme, Jessica M Franklin, Danielle L Isaman, Olga S Matlin, Angela Y Tong, Claire M Spettell, Troyen A Brennan, William H Shrank, Niteesh K Choudhry
BACKGROUND: Attempts to predict who is at risk of future nonadherence have largely focused on predictions at the time of therapy initiation; however, these users are only a small proportion of all patients on therapy at any point in time. Methods to predict nonadherence for established medication users, which have not been previously described in the literature, would be helpful to guide efforts to enhance the use of evidence-based therapies. OBJECTIVE: To test approaches for adherence prediction among prevalent statin users, namely the use of short-term filling behavior, investigator-specified predictors from medical and pharmacy administrative claims, and the empirical selection of potential predictors using the high-dimensional propensity score variable selection algorithm...
April 2017: Journal of Managed Care & Specialty Pharmacy
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