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https://www.readbyqxmd.com/read/29050063/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives-part-1
#1
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the Society for Obstetric Anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28988432/impact-of-flow-gradient-and-left-ventricular-function-on-outcomes-after-transcatheter-aortic-valve-replacement
#2
Edward T Carreras, Tsuyoshi Kaneko, Fernando Ramirez-Del Val, Marc P Pelletier, Piotr S Sobieszczyk, Deepak L Bhatt, Pinak B Shah
OBJECTIVES: To assess the impact of low flow with and without preserved left ventricular ejection fraction (LVEF) on outcomes after transcatheter aortic valve replacement (TAVR). BACKGROUND: Prior studies have shown that patients with low flow, AVG, and LVEF have worse outcomes after TAVR. It is unclear whether low AVG and LVEF remain prognostic after adjusting for flow, and how the outcomes of patients with low flow with and without preserved LVEF compare after TAVR...
October 8, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28975467/salvage-re-irradiation-for-recurrent-high-grade-glioma-and-comparison-to-bevacizumab-alone
#3
Nils D Arvold, Diana D Shi, Ayal A Aizer, Andrew D Norden, David A Reardon, Eudocia Q Lee, Lakshmi Nayak, Ian F Dunn, Alexandra J Golby, Mark D Johnson, Elizabeth B Claus, E Antonio Chiocca, Keith L Ligon, Patrick Y Wen, Brian M Alexander
While salvage re-irradiation is often used for recurrent high-grade glioma (HGG), there have been few comparisons between various re-radiation dose/fractionation schedules or with bevacizumab alone. We analyzed patients with recurrent HGG who received re-irradiation at Dana-Farber Cancer Institute and Brigham and Women's Hospital from 2010 to 2014 (n = 67), as well as those who received bevacizumab alone (n = 177). Cox proportional hazards modeling was used to examine factors associated with overall survival (OS)...
October 3, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28958850/catalyzing-healthcare-transformation-with-digital-health-performance-indicators-and-lessons-learned-from-a-digital-health-innovation-group
#4
Jocelyn Tseng, Sonia Samagh, Donna Fraser, Adam B Landman
Despite considerable investment in digital health (DH) companies and a growing DH ecosystem, there are multiple challenges to testing and implementing innovative solutions. Health systems have recognized the potential of DH and have formed DH innovation centers. However, limited information is available on DH innovation center processes, best practices, or outcomes. This case report describes a DH innovation center process that can be replicated across health systems and defines and benchmarks process indicators to assess DH innovation center performance...
September 25, 2017: Healthcare
https://www.readbyqxmd.com/read/28942086/validation-of-a-52-gene-risk-profile-for-outcome-prediction-in-patients-with-idiopathic-pulmonary-fibrosis-an-international-multicentre-cohort-study
#5
Jose D Herazo-Maya, Jiehuan Sun, Philip L Molyneaux, Qin Li, Julian A Villalba, Argyrios Tzouvelekis, Heather Lynn, Brenda M Juan-Guardela, Cristobal Risquez, Juan C Osorio, Xiting Yan, George Michel, Nachelle Aurelien, Kathleen O Lindell, Melinda J Klesen, Miriam F Moffatt, William O Cookson, Yingze Zhang, Joe G N Garcia, Imre Noth, Antje Prasse, Ziv Bar-Joseph, Kevin F Gibson, Hongyu Zhao, Erica L Herzog, Ivan O Rosas, Toby M Maher, Naftali Kaminski
BACKGROUND: The clinical course of idiopathic pulmonary fibrosis (IPF) is unpredictable. Clinical prediction tools are not accurate enough to predict disease outcomes. METHODS: We enrolled patients with IPF diagnosis in a six-cohort study at Yale University (New Haven, CT, USA), Imperial College London (London, UK), University of Chicago (Chicago, IL, USA), University of Pittsburgh (Pittsburgh, PA, USA), University of Freiburg (Freiburg im Breisgau, Germany), and Brigham and Women's Hospital-Harvard Medical School (Boston, MA, USA)...
September 20, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28934718/urinary-bpa-and-phthalate-metabolite-concentrations-and-plasma-vitamin-d-levels-in-pregnant-women-a-repeated-measures-analysis
#6
Lauren E Johns, Kelly K Ferguson, David E Cantonwine, Thomas F McElrath, Bhramar Mukherjee, John D Meeker
BACKGROUND: In addition to its well-established role in maintaining skeletal health, vitamin D has essential regulatory functions in female reproductive and pregnancy outcomes. Phthalates and bisphenol A (BPA) are endocrine disruptors, and previous research has suggested that these chemical agents may disrupt circulating levels of total 25(OH)D in adults. OBJECTIVES: We investigated the relationships between repeated measures of urinary phthalate metabolites and BPA and circulating total 25(OH)D in a prospective cohort of pregnant women...
August 31, 2017: Environmental Health Perspectives
https://www.readbyqxmd.com/read/28902465/a-modified-reporting-approach-for-thyroid-fna-in-the-niftp-era-a-1-year-institutional-experience
#7
Jeffrey K Mito, Erik K Alexander, Trevor E Angell, Justine A Barletta, Matthew A Nehs, Edmund S Cibas, Jeffrey F Krane
BACKGROUND: The reclassification of noninvasive follicular variant of papillary thyroid carcinoma as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) has created diagnostic and management issues for thyroid fine-needle aspiration (FNA). In response to these challenges, the authors' laboratory adopted a NIFTP policy including 1) stringent criteria (requiring pseudo-inclusions, papillae, and/or psammoma bodies) for a malignant diagnosis of papillary carcinoma to limit false-positive results due to NIFTP and 2) the use of explanatory notes in cases with cytomorphologic features suggestive of possible NIFTP to encourage lobectomy over thyroidectomy...
September 13, 2017: Cancer
https://www.readbyqxmd.com/read/28895835/massachusetts-what-universal-coverage-could-look-like
#8
Joseph Burns
The lowest rate of uninsured, but costs are a concern. That's due, in part, to the clout of the state's large prestigious health care systems, especially Partners Healthcare in Boston, which includes Harvard-affiliated Massachusetts General Hospital, and Brigham and Women's hospitals.
July 2017: Managed Care
https://www.readbyqxmd.com/read/28855408/association-of-intracranial-aneurysm-rupture-with-smoking-duration-intensity-and-cessation
#9
Anil Can, Victor M Castro, Yildirim H Ozdemir, Sarajune Dagen, Sheng Yu, Dmitriy Dligach, Sean Finan, Vivian Gainer, Nancy A Shadick, Shawn Murphy, Tianxi Cai, Guergana Savova, Ruben Dammers, Scott T Weiss, Rose Du
OBJECTIVE: Although smoking is a known risk factor for intracranial aneurysm (IA) rupture, the exact relationship between IA rupture and smoking intensity and duration, as well as duration of smoking cessation, remains unknown. METHODS: In this case-control study, we analyzed 4,701 patients with 6,411 IAs diagnosed at the Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016. We divided individuals into patients with ruptured aneurysms and controls with unruptured aneurysms...
September 26, 2017: Neurology
https://www.readbyqxmd.com/read/28821194/primary-benign-and-malignant-thyroid-neoplasms-with-signet-ring-cells-cytologic-histologic-and-molecular-features
#10
Nada A Farhat, Ayse M Onenerk, Jeffrey F Krane, Dora Dias-Santagata, Peter M Sadow, William C Faquin
Objectives: Signet ring cells (SRCs) can be seen in a variety of thyroid tumors and can pose a diagnostic pitfall on cytology. This study describes the cytologic, histomorphologic, and molecular aspects of a cohort of primary thyroid tumors with SRCs. Methods: A search was performed of the Massachusetts General Hospital and Brigham and Women's Hospital (Boston, MA) pathology archives for the keywords thyroid, signet, and signet ring features between 2000 and 2014...
September 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28806102/effects-of-alcohol-consumption-on-blood-pressure-in-hypertensive-women
#11
Naomi Deirdre Lakshmi Fisher, Endel John Orav, Grace Chang
BACKGROUND: Problem drinking carries significant health burdens, including an increased risk of hypertension. The effect of chronic alcohol intake on blood pressure (BP) in women is understudied and poorly understood. OBJECTIVES: We sought to examine the relationships between drinking habits and BP in hypertensive women. METHODS: We analyzed drinking habits in 113 women followed in the Brigham and Women's Hospital Hypertension Clinic for at least one year...
August 14, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28796462/malformations-surveillance-comparison-between-findings-at-birth-and-age-1-year
#12
Emma G Thomas, Cathleen Higgins, Marie-Noel Westgate, Angela E Lin, Marlene Anderka, Lewis B Holmes
BACKGROUND: Malformations surveillance programs among newborn infants are used to determine the prevalence of congenital anomalies. A comparison in the same group of infants between the malformations detected at birth and those detected at 1 year of age will identify errors in the surveillance process and, also, the abnormalities more likely not to be detected at birth, but later in the first year of life. METHODS: The malformations identified at birth by Brigham and Women's Hospital (BWH) in the years 2000 and 2005 have been compared with the abnormalities detected in the same infants up to age 1 year by the Massachusetts Birth Defects Monitoring Program...
August 10, 2017: Birth defects research
https://www.readbyqxmd.com/read/28776576/gnas-mutations-in-primary-mucinous-and-non-mucinous-lung-adenocarcinomas
#13
Lauren L Ritterhouse, Marina Vivero, Mari Mino-Kenudson, Lynette M Sholl, A John Iafrate, Valentina Nardi, Fei Dong
GNAS mutations have been described in mucinous and non-mucinous epithelial neoplasms of the appendix, pancreas, and colon, with hotspot GNAS mutations found in up to two-thirds of pancreatic intraductal papillary mucinous neoplasms. Additionally, many GNAS-mutated tumors have concurrent mutations in the Ras/Raf pathway. The clinicopathologic features of GNAS-mutated lung carcinomas, however, have not yet been characterized. Primary lung carcinomas from Brigham and Women's Hospital (n=1282) or Massachusetts General Hospital (n=1070) were genotyped on a targeted massively parallel sequencing panel of oncogenes and tumor suppressor genes including GNAS...
August 4, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28752411/alcohol-consumption-and-aneurysmal-subarachnoid-hemorrhage
#14
Anil Can, Victor M Castro, Yildirim H Ozdemir, Sarajune Dagen, Dmitriy Dligach, Sean Finan, Sheng Yu, Vivian Gainer, Nancy A Shadick, Guergana Savova, Shawn Murphy, Tianxi Cai, Scott T Weiss, Rose Du
Alcohol consumption may be a modifiable risk factor for rupture of intracranial aneurysms. Our aim is to evaluate the association between ruptured aneurysms and alcohol consumption, intensity, and cessation. The medical records of 4701 patients with 6411 radiographically confirmed intracranial aneurysms diagnosed at the Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016 were reviewed. Individuals were divided into cases with ruptured aneurysms and controls with unruptured aneurysms...
July 27, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28738986/pilot-testing-fall-tips-tailoring-interventions-for-patient-safety-a-patient-centered-fall-prevention-toolkit
#15
Patricia C Dykes, Megan Duckworth, Stephanie Cunningham, Sasha Dubois, Melissa Driscoll, Zinnia Feliciano, Michael Ferrazzi, Farah E Fevrin, Stephanie Lyons, Mary Ellen Lindros, Allison Monahan, Matthew M Paley, Saby Jean-Pierre, Maureen Scanlan
BACKGROUND: Patient falls during an acute hospitalization cause injury, reduced mobility, and increased costs. The laminated paper Fall TIPS Toolkit (Fall TIPS) provides clinical decision support at the bedside by linking each patient's fall risk assessment with evidence-based interventions. Strategies were needed to integrate this evidence into clinical practice. METHODS: The Institute for Healthcare Improvement's Framework for Spread is the conceptual model for pilot implementation of Fall TIPS at Brigham and Women's Hospital (BWH; Boston) and Montefiore Medical Center (MMC; Bronx, New York)...
August 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28689230/the-extended-transnasal-transsphenoidal-approach-for-anterior-skull-base-meningioma-considerations-in-patient-selection
#16
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
#17
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
#18
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
#19
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...
October 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
#20
REVIEW
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...
August 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
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