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https://www.readbyqxmd.com/read/28210940/syndromic-diagnosis-in-evaluation-of-women-with-symptoms-of-vaginitis
#1
REVIEW
Theophilus Ogochukwu Nwankwo, Uzochukwu Uzoma Aniebue, Uchenna Anthony Umeh
PURPOSE OF REVIEW: This review aims to determine the effectiveness of the use of syndrome diagnosis in the evaluation of vaginitis and to make suggestions based on the review findings. RECENT FINDINGS: Vaginal discharge as the main symptom of vaginitis is unspecific. A randomized study of symptom-based diagnosis and treatment of vaginitis in the USA favored symptoms used for treatment; however, this was only a pilot study. Hence, a population-based study is necessary to validate these findings...
January 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28201871/a-targeted-contrast-agent-specific-to-an-oncoprotein-in-tumor-microenvironment-with-the-potential-for-detection-and-risk-stratification-of-prostate-cancer-with-mri
#2
Zheng Han, Yajuan Li, Sarah Roelle, Zhuxian Zhou, Yuchi Liu, Rob Sabatelle, Aidan DeSanto, Xin Yu, Hui Zhu, Cristina Magi-Galluzzi, Zheng-Rong Lu
Accurate detection and risk stratification are paramount to the clinical management of prostate cancer. Current diagnostic methods, including prostate specific antigen (PSA) screening, are unable to differentiate high-risk tumors from low-risk tumors, resulting in overdiagnosis and overtreatment of numerous patients. A peptide targeted contrast agent, ZD2-Gd(HP-DO3A), specific to an oncoprotein in tumor microenvironment, EDB-FN, was synthesized for non-invasive detection and characterization of aggressive prostate cancer...
February 16, 2017: Bioconjugate Chemistry
https://www.readbyqxmd.com/read/28194568/t1-colon-cancer-in-the-era-of-screening-risk-factors-and-treatment
#3
F Bianco, S De Franciscis, A Belli, A Falato, R Fusco, D F Altomare, A Amato, C R Asteria, A Avallone, G A Binda, L Boccia, P Buzzo, M Carvello, C Coco, P Delrio, P De Nardi, M Di Lena, A Failla, F La Torre, M La Torre, M Lemma, P Luffarelli, G Manca, I Maretto, F Marino, A Muratore, A Pascariello, S Pucciarelli, D Rega, V Ripetti, G Rizzo, A Serventi, A Spinelli, F Tatangelo, E D L Urso, G M Romano
BACKGROUND: The aim of this study was to identify risk factors for lymph node positivity in T1 colon cancer and to carry out a surgical quality assurance audit. METHODS: The sample consisted of consecutive patients treated for early-stage colon lesions in 15 colorectal referral centres between 2011 and 2014. The study investigated 38 factors grouped into four categories: demographic information, preoperative data, indications for surgery and post-operative data...
February 13, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28194354/oncoplastic-to-onco-aesthetic-surgery-a-movement-toward-overtreatment
#4
COMMENT
Mona P Tan
No abstract text is available yet for this article.
January 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28191285/autoantibodies-against-oncogenic-erg-protein-in-prostate-cancer-potential-use-in-diagnosis-and-prognosis-in-a-panel-with-c-myc-amacr-and-herv-k-gag
#5
Anshu Rastogi, Amina Ali, Shyh-Han Tan, Sreedatta Banerjee, Yongmei Chen, Jennifer Cullen, Charles P Xavier, Ahmed A Mohamed, Lakshmi Ravindranath, Jigisha Srivastav, Denise Young, Isabell A Sesterhenn, Jacob Kagan, Sudhir Srivastava, David G McLeod, Inger L Rosner, Gyorgy Petrovics, Albert Dobi, Shiv Srivastava, Alagarsamy Srinivasan
Overdiagnosis and overtreatment of prostate cancer (CaP) is attributable to widespread reliance on PSA screening in the US. This has prompted us and others to search for improved biomarkers for CaP, to facilitate early detection and disease stratification. In this regard, autoantibodies (AAbs) against tumor antigens could serve as potential candidates for diagnosis and prognosis of CaP. Towards this, our goals were: i) To investigate whether AAbs against ERG oncoprotein (overexpressed in 25-50% of Caucasian American and African American CaP) are present in the sera of CaP patients; ii) To evaluate an AAb panel to enhance CaP detection...
November 2016: Genes & Cancer
https://www.readbyqxmd.com/read/28188595/should-small-renal-masses-be-biopsied
#6
REVIEW
Ricardo R N Leão, Ardalan E Ahmad, Patrick O Richard
Over the last few decades, the incidence of renal cell carcinomas (RCCs) has been steadily increasing. This is primarily due to an increase in detection of small renal masses (SRMs) as a result of widespread utilization of abdominal imaging. Interestingly, up to 30% of incidentally discovered SRMs (solid lesions measuring ≤4 cm) are benign, and consequently, the definitive treatment of all SRMs is associated with a considerable risk of overtreatment. To decrease the overtreatment rate, renal tumour biopsy (RTB) has been advocated as a safe alternative to identify the pretreatment histology of these SRMs...
January 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28184356/how-trustworthy-are-clinical-examinations-and-plain-radiographs-for-diagnosis-of-scaphoid-fractures
#7
Mohammad Reza Ghane, Mohammad Saeid Rezaee-Zavareh, Mohammad Kazem Emami-Meibodi, Vahid Dehghani
BACKGROUND: Sometimes patients with a scaphoid fracture, especially in an acute phase of injury, can have normal radiographs and, therefore, initial diagnosis of the scaphoid fracture may be neglected. In this study, we determined the value in of clinical examination and a radiograph in the diagnosis of scaphoid fracture based on the results of a two-week follow-up magnetic resonance imaging (MRI). OBJECTIVES: In this study, sought to assess the value of using both a clinical examination (tenderness of scaphoid tubercle, tenderness of anatomical snuffbox, and compression test) and radiographic imaging in the diagnosis of scaphoid fractures based on the results after a two-week follow-up MRI...
November 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28170085/guarding-against-overtesting-overdiagnosis-and-overtreatment-of-older-adults-thinking-beyond-imaging-and-injuries-to-weigh-harms-and-benefits
#8
EDITORIAL
Jerome R Hoffman, Christopher R Carpenter
No abstract text is available yet for this article.
February 7, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28158883/factors-associated-with-routine-recommendation-of-mammography-for-women-aged-40-49-provider-characteristics-and-screening-influences
#9
Kathryn A Martinez, Abhishek Deshpande, Allison L Ruff, Shari D Bolen, Kathryn Teng, Michael B Rothberg
OBJECTIVES: Despite the US Preventive Services Task Force recommendation against screening mammography in women younger than 50 years, rates remain high, suggesting that screening recommendations may be motivated by other factors. The objective of this study was to understand provider-reported influences on screening recommendations for women 40 to 49 years old at average risk for breast cancer. METHODS: An online survey of primary care providers was conducted at four health centers in Cleveland, Ohio in 2015...
February 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28156499/palliative-treatment-directives-for-bone-metastases-a-quality-directed-approach-to-guiding-institutional-practice
#10
Lucille Lee, Petrina Zuvic, Isabella Bingchan Zhang, Louis Potters, Beatrice Bloom
: 188 Background: The efficacy of single fraction (fx) radiation treatment (RT) has proven to have equipoise for palliation of bone metastases when compared to courses of 10 fx or more. Despite these data, there has been a slow adoption of this practice in the US and worldwide. Examination of our multicenter practice from 2004 - 2016 showed that single fx RT utilization has remained at 17% and hypofractionationed (HFX) courses (1 or 5 fx) have remained at 71% since 2009. We hypothesized that evidence-based, treatment-guiding directives could improve HFX utilization in this population...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152879/contralateral-prophylactic-mastectomy-decision-making-in-the-population-based-icancare-study-of-early-stage-breast-cancer-patients
#11
Sarah T Hawley, Kent A Griffith, Nancy K Janz, Allison W Kurian, Kevin C Ward, Ann S Hamilton, Steven J Katz, Monica Morrow
: 177 Background: Contralateral prophylactic mastectomy (CPM) use is increasing in women who are not at increased risk of contralateral cancer development and will experience no survival benefit from the more morbid procedure. Little is known about treatment decision-making or provider interactions. METHODS: We surveyed a weighted random sample of newly diagnosed patients with early-stage breast cancer who were treated in 2013-14, identified through the population-based SEER registries of Los Angeles and Georgia about 3 months after surgical treatment, and merged with SEER data (N=2632, RR=70%), to determine receipt of diagnostic tests and factors related to the decision about surgery (including knowledge and perceived physician recommendation)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152660/diagnosis-and-treatment-of-adhd-in-the-united-states
#12
Kathleen A Fairman, Alyssa M Peckham, David A Sclar
OBJECTIVE: The aim of this article is to update ADHD diagnosis/treatment trends by age, gender, and race. METHOD: National Ambulatory Medical Care Survey data were obtained for 2008-2009 to 2012-2013. Physician office visits including ADHD diagnosis and pharmacotherapy were measured per 1,000 population and per 1,000 office visits overall, and by demographic group. Logistic regression models controlled for demographics, psychiatric comorbidities, insurance type, and time period...
February 1, 2017: Journal of Attention Disorders
https://www.readbyqxmd.com/read/28143614/mir-193b-promoter-methylation-accurately-detects-prostate-cancer-in-urine-sediments-and-mir-34b-c-or-mir-129-2-promoter-methylation-define-subsets-of-clinically-aggressive-tumors
#13
Jorge Torres-Ferreira, João Ramalho-Carvalho, Antonio Gomez, Francisco Duarte Menezes, Rui Freitas, Jorge Oliveira, Luís Antunes, Maria José Bento, Manel Esteller, Rui Henrique, Carmen Jerónimo
BACKGROUND: Contemporary challenges of prostate cancer (PCa) include overdiagnosis and overtreatment, entailing the need for novel clinical tools to improve risk stratification and therapy selection. PCa diagnosis and prognostication might be perfected using epigenetic biomarkers, among which aberrant DNA methylation of microRNA promoters has not been systematically explored. Herein, we identified aberrantly methylated microRNAs promoters in PCa and assessed its diagnostic and prognostic biomarker potential...
January 31, 2017: Molecular Cancer
https://www.readbyqxmd.com/read/28141702/antibiotic-therapy-in-critically-ill-patients-expert-opinion-of-the-european-society-of-anaesthesia-intensive-care-scientific-subcommittee-a-narrative-review
#14
Ignacio Martin-Loeches, Marc Leone, Krisztina Madách, Claude Martin, Sharon Einav
Antimicrobial treatment is the cornerstone of infection treatment, and the selection of appropriate antibiotic treatment for critically ill patients is challenging. Clinicians working with critically ill patients usually feel a greater obligation towards their patient than towards maintenance of the delicate ecological balance of prevalent microbiological threats and their resistance patterns. Although antibiotic overtreatment is a frequent phenomenon, patient outcomes need not be compromised when antibiotic treatment is driven by informed decision-making...
January 30, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28137495/the-impact-of-dysfunctional-breathing-on-the-assessment-of-asthma-control
#15
Sandra Veidal, Maria Jeppegaard, Asger Sverrild, Vibeke Backer, Celeste Porsbjerg
BACKGROUND AND OBJECTIVE: Dysfunctional breathing (DB) is a respiratory disorder, which involves a pattern of breathing too deeply, too superficially and/or too rapidly. In asthma patients, DB may lead to an overestimation of the severity of asthma symptoms, and hence potentially to overtreatment. However, it is not known to which degree DB may affect estimates of asthma control, in a specialist clinical setting. METHODS: The MAPOut-study examined all patients referred consecutively over a 12-months period for specialist assessment of asthma at the Respiratory Outpatient Clinic at Bispebjerg Hospital in Copenhagen...
February 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28137327/urine-culture-testing-in-community-nursing-homes-gateway-to-antibiotic-overprescribing
#16
Philip D Sloane, Christine E Kistler, David Reed, David J Weber, Kimberly Ward, Sheryl Zimmerman
OBJECTIVE To describe current practice around urine testing and identify factors leading to overtreatment of asymptomatic bacteriuria in community nursing homes (NHs) DESIGN Observational study of a stratified random sample of NH patients who had urine cultures ordered in NHs within a 1-month study period SETTING 31 NHs in North Carolina PARTICIPANTS 254 NH residents who had a urine culture ordered within the 1-month study period METHODS We conducted an NH record audit of clinical and laboratory information during the 2 days before and 7 days after a urine culture was ordered...
January 31, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28136139/outcome-of-large-noninvasive-follicular-thyroid-neoplasm-with-papillary-like-nuclear-features-niftp
#17
Bin Xu, Giovanni Tallini, Theresa Scognamiglio, Benjamin R Roman, R Michael Tuttle, Ronald Ghossein
BACKGROUND: In 2016, encapsulated papillary thyroid carcinoma, follicular variant without invasion was renamed noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) in order to reduce overtreatment of this indolent tumor. However, many endocrinologists remain uneasy about managing large (≥ 4 cm) NIFTP conservatively without radioactive iodine (RAI) therapy. The objectives of this study are to characterize the clinicopathologic characteristics and outcome of large NIFTP in order to assist therapeutic decision making...
January 30, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28134678/what-is-new-in-the-management-of-skin-and-soft-tissue-infections-in-2016
#18
Garyphallia Poulakou, Efthymia Giannitsioti, Sotirios Tsiodras
PURPOSE OF REVIEW: Skin and soft tissue infections (SSTIs) are the most frequent infectious cause of referrals to emergency departments and hospital admissions in developed world, contributing to significant morbidity and healthcare expenditures. We sought to review recent literature covering epidemiology and management of SSTIs. RECENT FINDINGS: Incidence trends of SSTIs were increasing worldwide with Staphylococcus aureus and streptococci predominating and methicillin-resistant S...
January 27, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28131024/-too-much-medicine-insights-and-explanations-from-economic-theory-and-research
#19
Martin Hensher, John Tisdell, Craig Zimitat
Increasing attention has been paid in recent years to the problem of "too much medicine", whereby patients receive unnecessary investigations and treatments providing them with little or no benefit, but which expose them to risks of harm. Despite this phenomenon potentially constituting an inefficient use of health care resources, it has received limited direct attention from health economists. This paper considers "too much medicine" as a form of overconsumption, drawing on research from health economics, behavioural economics and ecological economics to identify possible explanations for and drivers of overconsumption...
January 18, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28130940/false-positive-cytopathology-results-for-papillary-thyroid-carcinoma-a-trap-for-thyroid-surgeons
#20
Keun Ik Yi, Sangjeong Ahn, Do Youn Park, Jin-Choon Lee, Byung-Joo Lee, Soo-Geun Wang, Wonjae Cha
OBJECTIVES: Current preoperative diagnosis of thyroid nodules remains imperfect despite recent advances in cytopathology and molecular diagnostics. False-positivity in preoperative fine needle aspiration cytology (FNAC) may lead to overtreatment of patients, including total thyroidectomy, and sometimes to lawsuits for misdiagnosis and malpractice. In this study, we analyzed clinical characteristics and pathologic findings in patients with false-positivity for papillary thyroid carcinoma (PTC) in FNAC...
January 28, 2017: Clinical Otolaryngology
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