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https://www.readbyqxmd.com/read/29028645/an-update-on-the-status-of-molecular-testing-for-the-indeterminate-thyroid-nodule-and-risk-stratification-of-differentiated-thyroid-cancer
#1
Kristina J Nicholson, Linwah Yip
PURPOSE OF REVIEW: Correct identification of malignancy in cytologically indeterminate thyroid nodules is a diagnostic challenge, leading to potentially unnecessary surgery in patients for whom final histology is benign. Similarly, many patients with differentiated thyroid cancer (DTC) undergo aggressive surgical management of tumors, which may ultimately have low-risk histologic features. Use of molecular testing strategies can aid in both the diagnosis of indeterminate thyroid nodules and preoperative risk stratification of DTC...
October 11, 2017: Current Opinion in Oncology
https://www.readbyqxmd.com/read/29028110/melanoma-staging-evidence-based-changes-in-the-american-joint-committee-on-cancer-eighth-edition-cancer-staging-manual
#2
Jeffrey E Gershenwald, Richard A Scolyer, Kenneth R Hess, Vernon K Sondak, Georgina V Long, Merrick I Ross, Alexander J Lazar, Mark B Faries, John M Kirkwood, Grant A McArthur, Lauren E Haydu, Alexander M M Eggermont, Keith T Flaherty, Charles M Balch, John F Thompson
Answer questions and earn CME/CNE To update the melanoma staging system of the American Joint Committee on Cancer (AJCC) a large database was assembled comprising >46,000 patients from 10 centers worldwide with stages I, II, and III melanoma diagnosed since 1998. Based on analyses of this new database, the existing seventh edition AJCC stage IV database, and contemporary clinical trial data, the AJCC Melanoma Expert Panel introduced several important changes to the Tumor, Nodes, Metastasis (TNM) classification and stage grouping criteria...
October 13, 2017: CA: a Cancer Journal for Clinicians
https://www.readbyqxmd.com/read/29025541/imaging-of-the-pericardium-a-multimodality-cardiovascular-imaging-update
#3
REVIEW
Bo Xu, Deborah H Kwon, Allan L Klein
Pericardial diseases represent diverse conditions, ranging from painful inflammatory states, such as acute pericarditis, to life-threatening tamponade and chronic heart failure due to constrictive pericarditis. Multimodality cardiovascular imaging plays important roles in diagnosis and management of pericardial conditions. This review provides a clinical update on multimodality cardiovascular imaging of the pericardium, incorporating echocardiography, multidetector computed tomography, and cardiac magnetic resonance imaging, focusing on guiding clinicians about when each cardiac imaging modality should be used in each relevant pericardial condition...
November 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/29025194/procalcitonin-to-initiate-or-discontinue-antibiotics-in-acute-respiratory-tract-infections
#4
REVIEW
Philipp Schuetz, Yannick Wirz, Ramon Sager, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Long Wei, Heiner C Bucher, Neera Bhatnagar, Djillali Annane, Konrad Reinhart, Angela Branche, Pierre Damas, Maarten Nijsten, Dylan W de Lange, Rodrigo O Deliberato, Stella Ss Lima, Vera Maravić-Stojković, Alessia Verduri, Bin Cao, Yahya Shehabi, Albertus Beishuizen, Jens-Ulrik S Jensen, Caspar Corti, Jos A Van Oers, Ann R Falsey, Evelien de Jong, Carolina F Oliveira, Bianca Beghe, Matthias Briel, Beat Mueller
BACKGROUND: Acute respiratory infections (ARIs) comprise of a large and heterogeneous group of infections including bacterial, viral, and other aetiologies. In recent years, procalcitonin (PCT), a blood marker for bacterial infections, has emerged as a promising tool to improve decisions about antibiotic therapy (PCT-guided antibiotic therapy). Several randomised controlled trials (RCTs) have demonstrated the feasibility of using procalcitonin for starting and stopping antibiotics in different patient populations with ARIs and different settings ranging from primary care settings to emergency departments, hospital wards, and intensive care units...
October 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29023881/review-article-the-role-of-the-microcirculation-in-liver-cirrhosis
#5
REVIEW
T Davies, S Wythe, J O'Beirne, D Martin, E Gilbert-Kawai
BACKGROUND: Intrahepatic microvascular derangements and microcirculatory dysfunction are key in the development of liver cirrhosis and its associated complications. While much has been documented relating to cirrhosis and the dysfunction of the microcirculation in the liver parenchyma, far less is known about the state of the extrahepatic microcirculation and the role this may have in the pathogenesis of multiple organ failure in end stage liver cirrhosis. AIM: To provide an update on the role of the microcirculation in the pathophysiology of cirrhosis and its associated complications and briefly discuss some of the imaging techniques which may be used to directly investigate the microcirculation...
November 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29023316/septic-shock-resuscitation-in-the-first-hour
#6
Nicholas Simpson, Francois Lamontagne, Manu Shankar-Hari
PURPOSE OF REVIEW: We reviewed the recent advances in the initial approach to resuscitation of sepsis and septic shock patients. RECENT FINDINGS: Sepsis and septic shock are life-threatening emergencies. Two key interventions in the first hour include timely antibiotic therapy and resuscitation. Before any laboratory results, the need for resuscitation is considered if a patient with suspected infection has low blood pressure (BP) or impaired peripheral circulation found at clinical examination...
October 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29020853/blood-based-protein-biomarkers-for-the-management-of-traumatic-brain-injuries-in-adults-presenting-with-mild-head-injury-to-emergency-departments-a-living-systematic-review-and-meta-analysis
#7
Stefania Mondello, Abayomi Sorinola, Endre Czeiter, Zoltán Vámos, Krisztina Amrein, Anneliese Synnot, Emma L Donoghue, János Sándor, Kevin K W Wang, Ramon Diaz-Arrastia, Ewout W Steyerberg, David Menon, Andrew Maas, Andras Buki
Accurate diagnosis of traumatic brain injury (TBI) is critical to effective management and intervention, but can be challenging in patients with mild TBI. A substantial number of studies have reported the use of circulating biomarkers as signatures for TBI, capable of improving diagnostic accuracy and clinical decision-making beyond current practice standards. We performed a systematic review and meta-analysis to comprehensively and critically evaluate the existing body of evidence for the use of blood protein biomarkers (S100B, GFAP, NSE, UCH-L1, Tau and Neurofilament proteins) for diagnosis of intracranial lesions on CT following mild TBI...
October 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29020819/update-on-relapsed-ovarian-cancer-treatment-from-new-consensus-to-daily-clinical-practice
#8
Antonio González-Martín
The outcome of the 5th Ovarian Cancer Consensus Conference (OCCC) held in November 2015 in Tokyo, Japan, was the development of new and revised consensus statements to guide clinical investigations in ovarian cancer. The OCCC statements may also have direct application to daily clinical practice. This review examines the consensus statements for recurrent ovarian cancer and their impact on treatment paradigms. Importantly, patients are no longer to be categorized by the platinum-free interval (with its arbitrary 6-month cut-off points) but according to the question: 'is platinum still an option for the patient?' Another important change since the 4th OCCC in 2010 is the inclusion of BRCA mutation status when defining patient subgroups for entry into clinical trials...
October 11, 2017: Future Oncology
https://www.readbyqxmd.com/read/29017160/role-of-molecular-biology-in-diagnosis-and-characterization-of-vulvo-vaginitis-in-clinical-practice
#9
Gilbert G G Donders, Jacques Ravel, Beatrice Vitali, Mihai G Netea, Andres Salumets, Magnus Unemo
The diagnosis of vulvo-vaginal complaints has always been enigmatic in obstetrics and gynecology. Patients with clear, pathognomonic symptoms end up with a proper diagnosis and treatment most of the time, but unfortunately we are now living in a world where women reach out to the Internet and readily get all information as to which disease their symptoms correspond to and also find the appropriate treatment "over-the-counter." Because of this trend, we as specialists are increasingly confronted with patients with complex and combined conditions...
October 10, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28993302/user-participation-and-engagement-with-the-see-me-smoke-free-mhealth-app-prospective-feasibility-trial
#10
Chris A Schmidt, James K Romine, Melanie L Bell, Julie Armin, Judith S Gordon
BACKGROUND: The See Me Smoke-Free (SMSF) mobile health (mHealth) app was developed to help women quit smoking by targeting concerns about body weight, body image, and self-efficacy through cognitive behavioral techniques and guided imagery audio files addressing smoking, diet, and physical activity. A feasibility trial found associations between SMSF usage and positive treatment outcomes. This paper reports a detailed exploration of program use among eligible individuals consenting to study participation and completing the baseline survey (participants) and ineligible or nonconsenting app installers (nonparticipants), as well as the relationship between program use and treatment outcomes...
October 9, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28991149/decisional-informatics-for-psychosocial-rehabilitation-a-feasibility-pilot-on-tailored-and-fluid-treatment-algorithms-for-serious-mental-illness
#11
Jimmy Choi, Paul H Lysaker, Morris D Bell, Lisa Dixon, Paul Margolies, Matthew Gold, Elizabeth Golden-Roose, Warren Thime, Lawrence C Haber, Michael J Dewberry, Michael Stevens, Godfrey D Pearlson, Joanna M Fiszdon
This study introduces a computerized clinical decision-support tool, the Fluid Outpatient Rehabilitation Treatment (FORT), that incorporates individual and ever-evolving patient needs to guide clinicians in developing and updating treatment decisions in real-time. In this proof-of-concept feasibility pilot, FORT was compared against traditional treatment planning using similar behavioral therapies in 52 adults with severe mental illness attending community-based day treatment. At posttreatment and follow-up, group differences and moderate-to-large effect sizes favoring FORT were detected in social function, work readiness, self-esteem, working memory, processing speed, and mental flexibility...
October 4, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28988959/decision-making-frameworks-and-considerations-for-informing-coverage-decisions-for-healthcare-interventions-a-critical-interpretive-synthesis
#12
Rebecca L Morgan, Leah Kelley, Gordon Guyatt, Ana Johnson, John N Lavis
OBJECTIVE: To guide decision-making about whether or not to pay for a new healthcare intervention, a number of existing frameworks systematically weigh scientific evidence, cost, and social and ethical values. Each framework has strengths and limitations. This study aims to review and summarize available frameworks, and generate an integrated framework, if and where applicable, highlighting particular issues faced with expensive but effective and desirable healthcare interventions. STUDY DESIGN AND SETTING: We conducted a critical interpretive synthesis to inform decision-making about healthcare interventions...
October 5, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28983873/updates-in-lupus-genetics
#13
REVIEW
Yun Deng, Betty P Tsao
PURPOSE OF REVIEW: Our understanding on genetic basis of SLE has been advanced through genome-wide association studies. We review recent progress in lupus genetics with a focus on SLE-associated loci that have been functionally characterized, and discuss the potential for clinical translation of genetics data. RECENT FINDINGS: Over 100 loci have been confirmed to show robust association with SLE and many share with other immune-mediated diseases. Although causative variants captured at these established loci are limited, they guide biological studies of gene targets for functional characterization which highlight the importance of aberrant recognition of self-nucleic acid, type I interferon overproduction, and defective immune cell signaling underlying the pathogenesis of SLE...
October 5, 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28982848/lipofilling-outcomes-mimicking-breast-cancer-recurrence-case-report-and-update-of-the-literature
#14
REVIEW
Silvia Gigli, Maria Ida Amabile, Francesca DI Pastena, Alessandro DE Luca, Caterina Gulia, Lucia Manganaro, Massimo Monti, Laura Ballesio
Breast lipofilling uses autologous fat grafting to correct breast defects after radical or conservative surgery. After early concerns regarding its application in reconstruction after breast cancer (BC), in 2009 the American Society of Plastic Surgeons formed a task force to assess the indications, safety and efficacy of autologous fat grafting. We report the case of a woman who came to our attention for a painful swelling of the left breast. She had undergone breast-conserving therapy for BC, followed by lipofilling...
October 2017: Anticancer Research
https://www.readbyqxmd.com/read/28982021/a-data-driven-synthesis-of-research-evidence-for-domains-of-hearing-loss-as-reported-by-adults-with-hearing-loss-and-their-communication-partners
#15
Venessa Vas, Michael A Akeroyd, Deborah A Hall
A number of assessment tools exist to evaluate the impact of hearing loss, with little consensus among researchers as to either preference or psychometric adequacy. The item content of hearing loss assessment tools should seek to capture the impact of hearing loss on everyday life, but to date no one has synthesized the range of hearing loss complaints from the perspectives of the person with hearing loss and their communication partner. The current review aims to synthesize the evidence on person with hearing loss- and communication partner-reported complaints of hearing loss...
January 2017: Trends in Hearing
https://www.readbyqxmd.com/read/28981972/standard-versus-biofilm-antimicrobial-susceptibility-testing-to-guide-antibiotic-therapy-in-cystic-fibrosis
#16
REVIEW
Valerie Waters, Felix Ratjen
BACKGROUND: The antibiotics used to treat pulmonary infections in people with cystic fibrosis are typically chosen based on the results of antimicrobial susceptibility testing performed on bacteria traditionally grown in a planktonic mode (grown in a liquid). However, there is considerable evidence to suggest that Pseudomonas aeruginosa actually grows in a biofilm (or slime layer) in the airways of people with cystic fibrosis with chronic pulmonary infections. Therefore, choosing antibiotics based on biofilm rather than conventional antimicrobial susceptibility testing could potentially improve response to treatment of Pseudomonas aeruginosa in people with cystic fibrosis...
October 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28981957/the-role-of-high-frequency-oscillations-in-epilepsy-surgery-planning
#17
REVIEW
David Gloss, Sarah J Nevitt, Richard Staba
BACKGROUND: Epilepsy is a serious brain disorder characterized by recurrent unprovoked seizures. Approximately two-thirds of seizures can be controlled with antiepileptic medications (Kwan 2000). For some of the others, surgery can completely eliminate or significantly reduce the occurrence of disabling seizures. Localization of epileptogenic areas for resective surgery is far from perfect, and new tools are being investigated to more accurately localize the epileptogenic zone (the zone of the brain where the seizures begin) and improve the likelihood of freedom from postsurgical seizures...
October 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28980386/fractional-flow-reserve-versus-angiography-guided-percutaneous-coronary-intervention-an-updated-systematic-review
#18
Tariq Enezate, Jad Omran, Ashraf S Al-Dadah, Martin Alpert, Christopher J White, Mazen Abu-Fadel, Herbert Aronow, Mauricio Cohen, Frank Aguirre, Mitul Patel, Ehtisham Mahmud
OBJECTIVES: To compare outcomes of fractional flow reserve (FFR) to angiography (ANGIO) guided percutaneous coronary intervention (PCI). BACKGROUND: The results of a recent randomized controlled trial reported unfavorable effects of routine measurement of FFR, thereby questioning its validity in improving clinical outcomes. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were queried from January, 2000 through December, 2016 and studies comparing FFR and ANGIO guided PCI were included...
October 5, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28975031/procalcitonin-for-the-diagnosis-of-invasive-candidiasis-what-is-the-evidence
#19
Santi Maurizio Raineri, Andrea Cortegiani, Filippo Vitale, Pasquale Iozzo, Antonino Giarratano
Procalcitonin is a widely used marker for the evaluation of infection and sepsis and to guide antibiotic therapy. During the last decade, several studies evaluated its role and diagnostic performance as a surrogate marker for the identification of Candida spp. in suspected invasive candidiasis. A low serum level and a favorable negative predictive value are the main findings for procalcitonin in this setting. The aim of this report is to provide an updated brief summary of the evidence supporting the use of PCT for the management of invasive candidiasis...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28974331/major-publications-in-the-critical-care-pharmacotherapy-literature-january-december-2016
#20
REVIEW
Deanna Horner, Diana Altshuler, Chris Droege, Joel Feih, Kevin Ferguson, Mallory Fiorenza, Kasey Greathouse, Leslie Hamilton, Caitlin Pfaff, Lauren Roller, Joanna Stollings, Adrian Wong
PURPOSE: To summarize select critical care pharmacotherapy guidelines and studies published in 2016. SUMMARY: The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 31 journals monthly for relevant pharmacotherapy articles and selected 107 articles for review over the course of 2016. Of those included in the monthly CCPLU, three guidelines and seven primary literature studies are reviewed here. The guideline updates included are as follows: hospital-acquired pneumonia and ventilator-associated pneumonia management, sustained neuromuscular blocking agent use, and reversal of antithrombotics in intracranial hemorrhage (ICH)...
September 22, 2017: Journal of Critical Care
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