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https://www.readbyqxmd.com/read/28821197/regional-variability-in-percentage-of-breast-cancers-reported-as-positive-for-her2-in-california-implications-of-patient-demographics-on-laboratory-benchmarks
#1
Chieh-Yu Lin, Eugene E Carneal, Daphne Y Lichtensztajn, Scarlett L Gomez, Christina A Clarke, Kristin C Jensen, Allison W Kurian, Kimberly H Allison
Objectives: The expected regional variability in percent human epidermal growth factor receptor 2 (HER2)-positive breast cancers is not currently clear. Methods: Data from the 2006 to 2011 California Cancer Registry were examined by county and health service area. The influence of demographic and pathologic features was used in a multivariable logistic regression model to compare expected with observed HER2-positive percentages by region. Results: There was significant geographic variation by California counties (11...
September 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28820705/the-impact-of-introducing-malaria-rapid-diagnostic-tests-on-fever-case-management-a-synthesis-of-ten-studies-from-the-act-consortium
#2
Katia J Bruxvoort, Baptiste Leurent, Clare I R Chandler, Evelyn K Ansah, Frank Baiden, Anders Björkman, Helen E D Burchett, Sîan E Clarke, Bonnie Cundill, Debora D DiLiberto, Kristina Elfving, Catherine Goodman, Kristian S Hansen, S Patrick Kachur, Sham Lal, David G Lalloo, Toby Leslie, Pascal Magnussen, Lindsay Mangham-Jefferies, Andreas Mårtensson, Ismail Mayan, Anthony K Mbonye, Mwinyi I Msellem, Obinna E Onwujekwe, Seth Owusu-Agyei, Mark W Rowland, Delér Shakely, Sarah G Staedke, Lasse S Vestergaard, Jayne Webster, Christopher J M Whitty, Virginia L Wiseman, Shunmay Yeung, David Schellenberg, Heidi Hopkins
Since 2010, the World Health Organization has been recommending that all suspected cases of malaria be confirmed with parasite-based diagnosis before treatment. These guidelines represent a paradigm shift away from presumptive antimalarial treatment of fever. Malaria rapid diagnostic tests (mRDTs) are central to implementing this policy, intended to target artemisinin-based combination therapies (ACT) to patients with confirmed malaria and to improve management of patients with nonmalarial fevers. The ACT Consortium conducted ten linked studies, eight in sub-Saharan Africa and two in Afghanistan, to evaluate the impact of mRDT introduction on case management across settings that vary in malaria endemicity and healthcare provider type...
August 7, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28820652/decreasing-stroke-code-to-ct-time-in-patients-presenting-with-stroke-symptoms
#3
Aleksandrs Kalnins, L Jake Mickelsen, Daisha Marsh, Christoph Zorich, Stephanie Casal, Waimei Amy Tai, Nirali Vora, Gennette Olalia, Max Wintermark, David B Larson
Guided quality improvement (QI) programs present an effective means to streamline stroke code to computed tomography (CT) times in a comprehensive stroke center. Applying QI methods and a multidisciplinary team approach may decrease the stroke code to CT time in non-prenotified emergency department (ED) patients presenting with symptoms of stroke. The aim of this project was to decrease this time for non-prenotified stroke code patients from a baseline mean of 20 minutes to one less than 15 minutes during an 18-week period by applying QI methods in the context of a structured QI program...
August 18, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28820648/natural-bioactive-food-components-for-improving-enteral-tube-feeding-tolerance-in-adult-patient-populations
#4
Adam J Kuchnia, Beth Conlon, Norman Greenberg
Tube feeding (TF) is the most common form of nutrition support. In recent years, TF administration has increased among patient populations within and outside hospital settings, in part due to greater insurance coverage, reduced use of parenteral nutrition, and improved formularies suitable for sole source nutrition. With increasing life expectancy and improved access to TFs, the number of adults dependent on enteral nutrition is expected to grow. However, enteral TF intolerance (ETFI) is the most common complication of TFs, typically presenting with at least 1 adverse gastrointestinal event, including nausea, diarrhea, and constipation...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28820514/topical-opioids-and-antimicrobials-for-the-management-of-pain-infection-and-infection-related-odors-in-malignant-wounds-a-systematic-review
#5
Kathleen Finlayson, Laisa Teleni, Alexandra L McCarthy
PROBLEM IDENTIFICATION: Patients with malignant wounds report pain, distress from odor and exudate, decreased self-esteem, and poor quality of life. This systematic review explores topical opioids, antimicrobials, and odor-reducing agents for preventing or managing malignant wound pain, infection, and odor.
. LITERATURE SEARCH: MEDLINE®, EMBASE, the Cochrane Library, CINAHL®, and reference lists were searched to identify relevant studies.
. DATA EVALUATION: Eligible study designs included interventions with pre- and postintervention data...
September 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28820511/feasibility-and-acceptability-of-a-dignity-therapy-life-plan-intervention-for-patients-with-advanced-cancer
#6
Ann Marie Dose, Joleen M Hubbard, Aaron S Mansfield, Pamela J McCabe, Catherine A Krecke, Jeff A Sloan
PURPOSE/OBJECTIVES: To determine the feasibility and acceptability of a dignity therapy/life plan intervention in the outpatient oncology setting.
. RESEARCH APPROACH: Pilot descriptive study.
. SETTING: Outpatient clinic in a tertiary oncology center. 
. PARTICIPANTS: 18 patients within 12 months after diagnosis undergoing treatment for advanced pancreatic cancer or non-small cell lung cancer.
. METHODOLOGIC APPROACH: Patients received dignity therapy, consisting of a focused life review/values clarification interview session and two subsequent sessions to produce a generativity document, which they can use later as they wish...
September 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28820185/can-lester-jones-tubes-be-tolerated-for-decades
#7
R L Scawn, D H Verity, G E Rose
PurposeLester Jones described canalicular bypass tubes 50 years ago. We present a cohort of patients with Jones' tubes first placed between 1969 and 1989, and who were reviewed within the last 15 years.Patients and methodsRetrospective case-note review for living patients identified as having had Jones' tube placement prior to 1990. The duration of Jones' tube usage was noted and the number of replacements recorded.ResultsTwenty-nine patients (33 eyes) had maintenance of their Jones' tube(s) within the last 15 years, and had first tube placement before 1990...
August 18, 2017: Eye
https://www.readbyqxmd.com/read/28820041/a-report-of-7-year-experience-on-pediatric-continuous-renal-replacement-therapy
#8
Ayse Filiz Yetimakman, Selman Kesici, Murat Tanyildiz, Umut Selda Bayrakci, Benan Bayrakci
BACKGROUND: Continuous renal replacement therapies (CRRTs) either as continuous venovenous hemofiltration (CVVH) or hemodiafiltration (CVVHD) are used frequently in critically ill children. Many clinical variables and technical issues are known to affect the result. The factors that could be modified to increase the survival of renal replacement are sought. As a contribution, we present the data on 104 patients who underwent CRRT within a 7-year period. MATERIALS AND METHOD: A total of 104 patients admitted between 2009 and 2016 were included in the study...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28819895/optimal-lymphadenectomy-in-small-bowel-neuroendocrine-tumors-analysis-of-the-ncdb
#9
Benjamin M Motz, Patrick D Lorimer, Danielle Boselli, Joshua S Hill, Jonathan C Salo
BACKGROUND: Current National Comprehensive Cancer Network guidelines for resectable small bowel neuroendocrine tumors (NETs) recommend regional lymphadenectomy. However, no consensus exists on the optimal nodal harvest. METHODS: The National Cancer Database was queried for patients with resectable small bowel NETs (1998-2013). Patients with metastatic disease and missing lymph node harvest data were excluded. We performed logistic regression of factors determining nodal positivity and multivariable survival analyses...
August 17, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28819771/the-impact-of-bridging-lrt-on-survival-in-patients-listed-for-liver-transplantation
#10
Peiman Habibollahi, Stephen Hunt, Terence Gade, Mandeep S Dagli, Jeffrey I Mondschein, Deepak Sudheendra, S William Stavropoulos, Michael Soulen, Nadolski Gregory
PURPOSE: Locoregional therapy (LRT) is recommended for certain groups of patients with hepatocellular carcinoma (HCC) listed for orthotopic liver transplantation (OLT) with expected wait times greater than 6 months. A retrospective single-center study was performed to evaluate the effect of LRT on the outcomes of patients with HCC listed for OLT. METHODS: Institutional database was reviewed to identify the patients listed for OLT with HCC (March 1998-December 2010)...
August 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28819597/case-report-oblique-fracture-of-the-ulnar-sesamoid-bone-of-the-metacarpophalangeal-joint-a-rare-pathology
#11
Dauwe Jan, Van der Cruyssen Fréderic, De Smet Luc
INTRODUCTION: Fractures of the sesamoid bones of the metacarpophalangeal joint (MCPJ) are a rare pathology in hand trauma. Only a few case reports and case series were found in literature. The diagnosis of an ulnar sesamoid bone fracture of the MCPJ is difficult and can pose a differential diagnostic problem with Stener lesions or ulnar collateral ligament (UCL) instability. This pathology is frequently missed with subsequent poor functional outcomes. Correct and early diagnosis is important as this will allow for correct treatment with full recovery of function without sequelae...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28819541/mortality-among-5-17-year-old-children-in-kenya
#12
Bonface Ombaba Osano, Fred Were, Shanaaz Mathews
INTRODUCTION: Global mortality trends have changed over time and are expected to continue changing with a reduction in communicable diseases and an increase of non-communicable disease. Increased survival of children beyond five years may change mortality patterns for these children. There are few studies in Africa that explore the causes of mortality in children over five years. The objective of this study was to determine the mortality rate and clinical profiles of children aged 5-17 years who died in six Kenyan hospitals in 2013...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28819075/-advances-in-neurological-therapeutics-for-friedreich-ataxia-and-machado-joseph-disease
#13
Ichiro Yabe, Hidenao Sasaki
We reviewed advances in therapeutics for both Friedreich ataxia and Machado-Joseph disease. Various clinical trials have been carried out, mainly for Friedreich ataxia; however, the therapeutic reports from these trials have not provided much evidence for success. Some interesting clinical trials have been reported, and further developments are expected. Regenerative therapy using umbilical cord mesenchymal stem cells and a therapeutic study investigating a new pathomechanism in animal and/or cell culture studies were reported...
August 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28819017/adrenocortical-carcinoma-and-succinate-dehydrogenase-gene-mutations
#14
Tobias Else, Antonio Marcondes Lerario, Jessica Everett, Lori Haymon, Deborah Wham, Michael Mullane, Tremika LeShan Wilson, Irene Rainville, Huma Rana, Andrew J Worth, Nathaniel W Snyder, Ian A Blair, Rana McKay, Kerry Kilbridge, Gary D Hammer, Justine Barletta, Anand Vaiyda
OBJECTIVE: Germline loss-of-function mutations in succinate dehydrogenase (SDHx) genes results in rare tumor syndromes that include pheochromocytoma, paraganglioma, and others. Here we report a case series of patients with adrenocortical carcinoma (ACC) that harbor SDHx germline mutations. PATIENTS AND RESULTS: We report four unrelated patients with ACC and SDHx mutations. All cases presented with Cushing syndrome and large adrenal masses that were confirmed to be ACC on pathology...
August 17, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28818700/vascularized-jejunal-mesenteric-lymph-node-transfer-a-novel-surgical-treatment-for-extremity-lymphedema
#15
Michelle Coriddi, Corrine Wee, Joseph Meyerson, Daniel Eiferman, Roman Skoracki
BACKGROUND: Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema. Multiple donor sites have been described and each has significant disadvantages. We propose the jejunal mesentery as a novel donor site for VLNT. METHODS: Cadaveric anatomic study analyzing jejunal lymph nodes (LNs) and description of outcomes from the first patients who received jejunal mesenteric VLNT for treatment of lymphedema. RESULTS: In 5 cadavers, the average number of total LNs and peripheral LNs were identified in the proximal, middle and distal segments of jejunum...
August 14, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28818479/a-structured-assessment-of-motor-function-behavior-and-communication-in-patients-with-wolf-hirschhorn-syndrome
#16
Heidi E Nag, David K Bergsaker, Bente S Hunn, Susanne Schmidt, Lise B Hoxmark
The present study aimed to increase the knowledge about Wolf-Hirschhorn syndrome (WHS), especially concerning motor function, autism spectrum disorders (ASD), and adapted behavior, but also regarding clinical symptoms in general. Motor function was evaluated via systematic observation. Standardized assessments such as the Vineland Adapted Behavior Scales II (VABS II), the Social Communication Questionnaire (SCQ), and the Child Behavior Checklist (CBCL) or Adult Behavior Checklist (ABCL) were used for the behavioral assessment...
August 14, 2017: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/28818359/environment-of-care-is-it-time-to-reassess-microbial-contamination-of-the-operating-room-air-as-a-risk-factor-for-surgical-site-infection-in-total-joint-arthroplasty
#17
REVIEW
Javad Parvizi, Sue Barnes, Noam Shohat, Charles E Edmiston
In the modern operating room (OR), traditional surgical mask, frequent air exchanges, and architectural barriers are viewed as effective in reducing airborne microbial populations. Intraoperative sampling of airborne particulates is rarely performed in the OR because of technical difficulties associated with sampling methodologies and a common belief that airborne contamination is infrequently associated with surgical site infections (SSIs). Recent studies suggest that viable airborne particulates are readily disseminated throughout the OR, placing patients at risk for postoperative SSI...
August 14, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28818324/the-treatment-of-segmental-tibial-fractures-does-patient-preference-differ-from-surgeon-choice
#18
Z Little, T O Smith, S E McMahon, C Cooper, A Trompeter, M Pearse, S Britten, B Rogers, H Sharma, B Narayan, M Costa, D J Beard, C B Hing
INTRODUCTION: Segmental tibial fractures are complex injuries with a prolonged recovery time. Current definitive treatment options include intramedullary fixation or a circular external fixator. However, there is uncertainty as to which surgical option is preferable and there are no sufficiently rigorous multi-centre trials that have answered this question. The objective of this study was to determine whether patient and surgeon opinion was permissive for a randomised controlled trial (RCT) comparing intramedullary nailing to the application of a circular external fixator...
August 9, 2017: Injury
https://www.readbyqxmd.com/read/28818268/-metformin-resistant-folic-acid-producing-probiotics-or-folic-acid-against-metformin-s-adverse-effects-like-diarrhea
#19
Abdullah Olgun
Metformin, first line medication in the treatment of type2 diabetes by millions of patients worldwide, causes gastrointestinal adverse effects (i.e. diarrhea) in approximately 30% of patients, frequently leading to discontinuation. Interestingly, metformin was reported to increase life span in a microscopic worm, Caenorhabditis elegans, by decreasing folate and methionine production of bacteria that this worm uses as a food source. Metformin can be expected to have a similar effect on some microorganisms of human gut microbiota...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28818261/contemporary-medical-therapies-of-atherosclerotic-carotid-artery-disease
#20
Suk F Cheng, Martin M Brown
Contemporary medical therapy consists of identification and treatment of all patient-modifiable vascular risk factors. Specific atherosclerotic disease therapies are designed to reduce the risk of thrombosis, and the disease progression in order to reduce the risk of future cardiovascular events. Contemporary medical management emphasizes the need to support the patient in achieving lifestyle modifications and to adjust medication to achieve individualized target values for specific quantifiable risk factors...
March 2017: Seminars in Vascular Surgery
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