keyword
https://read.qxmd.com/read/38491826/exploring-the-relation-of-active-surveillance-schedules-and-prostate-cancer-mortality
#1
JOURNAL ARTICLE
Zhenwei Yang, Eveline A M Heijnsdijk, Lisa F Newcomb, Dimitris Rizopoulos, Nicole S Erler
BACKGROUND: Active surveillance (AS), where treatment is deferred until cancer progression is detected by a biopsy, is acknowledged as a way to reduce overtreatment in prostate cancer. However, a consensus on the frequency of taking biopsies while in AS is lacking. In former studies to optimize biopsy schedules, the delay in progression detection was taken as an evaluation indicator and believed to be associated with the long-term outcome, prostate cancer mortality. Nevertheless, this relation was never investigated in empirical data...
March 2024: Cancer Medicine
https://read.qxmd.com/read/38490879/axillary-ultrasonography-for-early-stage-invasive-breast-cancer
#2
JOURNAL ARTICLE
Karen Jiang, Crystal Ma, Yuwei Yang, Elaine McKevitt, Jin-Si Pao, Rebecca Warburton, Carol Dingee, Jieun Newman- Bremang, Melina Deban, Amy Bazzarelli
BACKGROUND: Among women with early invasive breast cancer and 1-2 positive sentinel nodes, sentinel lymph node biopsy (SLNB) is non-inferior to axillary lymph node dissection (ALND).1-3 However, preoperative axillary ultrasonography (AxUS) may not be sensitive enough to discriminate burden of nodal metastasis in these patients, potentially leading to overtreatment.4-6 This study compares axillary operation rates in patients who did and did not receive preoperative AxUS, assessing its utility and risks for overtreatment...
March 8, 2024: American Journal of Surgery
https://read.qxmd.com/read/38489281/antibiotic-overuse-poor-antimicrobial-stewardship-and-low-specificity-of-syndromic-case-management-in-a-cross-section-of-men-with-urethral-discharge-syndrome-in-kampala-uganda
#3
JOURNAL ARTICLE
Matthew M Hamill, Annet Onzia, Rosalind M Parkes-Ratanshi, Peter Kyambadde, Emmanuel Mande, Vivian Nakate, Johan H Melendez, Ethan Gough, Yukari C Manabe
OBJECTIVE: High prevalence of sexually transmitted infections (STIs) combined with poor antimicrobial stewardship are drivers of STI antimicrobial resistance (AMR) especially in resource-limited settings where syndromic case management (SCM) is the norm. We characterized patterns of antibiotic use prior to clinic attendance and study enrollment in Ugandan men with urethral discharge syndrome (UDS), evaluated in-clinic prescribing, and the performance characteristics of SCM. METHODS: Participants were recruited from government clinics participating in an existing gonococcal surveillance program in Kampala, Uganda...
2024: PloS One
https://read.qxmd.com/read/38483373/patterns-of-undertreatment-and-overtreatment-in-adjuvant-radiotherapy-for-early-stage-endometrial-cancer-based-on-molecular-classification
#4
JOURNAL ARTICLE
Otilia Ciobanu, Yixuan He, Alicia R Martin, Jill S Remick, Joseph W Shelton, Tony Y Eng, David C Qian
No abstract text is available yet for this article.
March 14, 2024: JAMA Oncology
https://read.qxmd.com/read/38482582/bilirubin-measurement-and-phototherapy-use-after-the-aap-2022-newborn-hyperbilirubinemia-guideline
#5
JOURNAL ARTICLE
Leela Sarathy, Joseph H Chou, Giuseppina Romano-Clarke, Katherine A Darci, Paul H Lerou
BACKGROUND AND OBJECTIVES: Guidelines for the management of neonatal hyperbilirubinemia have helped to reduce rates of significant hyperbilirubinemia. However, recent evidence suggesting overtreatment and potential harms of phototherapy have informed the American Academy of Pediatrics clinical practice guideline revision and the accompanying increase in phototherapy thresholds. These changes are predicted to safely reduce overuse; however, to date, the exact effect of these guidelines has not been established...
March 14, 2024: Pediatrics
https://read.qxmd.com/read/38481240/lymphatic-drainage-of-sinonasal-malignancies-and-the-role-of-sentinel-node-biopsies
#6
JOURNAL ARTICLE
Fatemeh Kashani, B G Weiss, P Bartenstein, M Canis, F Haubner
BACKGROUND: Locoregional recurrence is a critical factor in the prognosis of sinonasal malignancies. Due to the rarity of these tumours, as well as the heterogeneity of histologies and anatomical subsites, there is little evidence regarding the rate and location of regional metastases in sinonasal malignancies. Elective regional lymph node dissection in the therapy of sinonasal malignancies has become controversial. On the one hand, elective regional lymph node dissection is considered to be an overtreatment in the cN0 cases...
March 13, 2024: Orphanet Journal of Rare Diseases
https://read.qxmd.com/read/38479427/refining-risk-stratification-in-paediatric-b-acute-lymphoblastic-leukaemia-combining-ikzf1-plus-and-day-15-mrd-positivity
#7
JOURNAL ARTICLE
Hsi-Che Liu, Ying-Jung Huang, Tang-Her Jaing, Kang-Hsi Wu, Shih-Hsiang Chen, Shih-Chung Wang, Ting-Chi Yeh, Chih-Cheng Hsiao, Te-Kau Chang, Hsiu-Ju Yen, Fang-Liang Huang, Pei-Chin Lin, Jen-Yin Hou, Jiunn-Ming Sheen, Yu-Mei Liao, Tsung-Yen Chang, Yu-Chieh Chen, Shyh-Shin Chiou, Chao-Ping Yang, Ching-Hon Pui, Der-Cherng Liang, Lee-Yung Shih
This study investigates the potential utility of IKZF1 deletion as an additional high-risk marker for paediatric acute lymphoblastic leukaemia (ALL). The prognostic impact of IKZF1 status, in conjunction with minimal/measurable residual disease (MRD), was evaluated within the MRD-guided TPOG-ALL-2013 protocol using 412 newly diagnosed B-ALL patients aged 1-18. IKZF1 status was determined using multiplex ligation-dependent probe amplification. IKZF1 deletions, when co-occurring with CDKN2A, CDKN2B, PAX5 or PAR1 region deletions in the absence of ERG deletions, were termed IKZF1plus ...
March 13, 2024: British Journal of Haematology
https://read.qxmd.com/read/38473287/association-of-lymphovascular-invasion-with-lymph-node-metastases-in-prostate-cancer-lateralization-concept
#8
JOURNAL ARTICLE
Jakub Karwacki, Adam Gurwin, Arkadiusz Jaworski, Michał Jarocki, Marcel Stodolak, Andrzej Dłubak, Przemysław Szuba, Artur Lemiński, Krystian Kaczmarek, Agnieszka Hałoń, Tomasz Szydełko, Bartosz Małkiewicz
BACKGROUND: Lymphovascular invasion (LVI) is a vital but often overlooked prognostic factor in prostate cancer. As debates on lymphadenectomy's overtreatment emerge, understanding LVI laterality gains importance. This study pioneers the investigation into PCa, aiming to uncover patterns that could influence tailored surgical strategies in the future. METHODS: Data from 96 patients with both LVI and lymph node invasion (LNI) were retrospectively analyzed. All participants underwent radical prostatectomy (RP) with modified-extended pelvic lymph node dissection (mePLND)...
February 25, 2024: Cancers
https://read.qxmd.com/read/38472998/accuracy-of-treatment-recommendations-by-pragmatic-evidence-search-and-artificial-intelligence-an-exploratory-study
#9
JOURNAL ARTICLE
Zunaira Baig, Daniel Lawrence, Mahen Ganhewa, Nicola Cirillo
There is extensive literature emerging in the field of dentistry with the aim to optimize clinical practice. Evidence-based guidelines (EBGs) are designed to collate diagnostic criteria and clinical treatment for a range of conditions based on high-quality evidence. Recently, advancements in Artificial Intelligence (AI) have instigated further queries into its applicability and integration into dentistry. Hence, the aim of this study was to develop a model that can be used to assess the accuracy of treatment recommendations for dental conditions generated by individual clinicians and the outcomes of AI outputs...
March 1, 2024: Diagnostics
https://read.qxmd.com/read/38472210/deep-learning-radiomics-based-prediction-of-axillary-lymph-node-metastasis-in-breast-cancer
#10
JOURNAL ARTICLE
Han Liu, Liwen Zou, Nan Xu, Haiyun Shen, Yu Zhang, Peng Wan, Baojie Wen, Xiaojing Zhang, Yuhong He, Luying Gui, Wentao Kong
This study aimed to develop and validate a deep learning radiomics nomogram (DLRN) for the preoperative evaluation of axillary lymph node (ALN) metastasis status in patients with a newly diagnosed unifocal breast cancer. A total of 883 eligible patients with breast cancer who underwent preoperative breast and axillary ultrasound were retrospectively enrolled between April 1, 2016, and June 30, 2022. The training cohort comprised 621 patients from Hospital I; the external validation cohorts comprised 112, 87, and 63 patients from Hospitals II, III, and IV, respectively...
March 12, 2024: NPJ Breast Cancer
https://read.qxmd.com/read/38469728/evolution-of-european-prostate-cancer-screening-protocols-and-summary-of-ongoing-trials
#11
REVIEW
Meike J van Harten, Monique J Roobol, Pim J van Leeuwen, Peter-Paul M Willemse, Roderick C N van den Bergh
Population-based organised repeated screening for prostate cancer has been found to reduce disease-specific mortality, but with substantial overdiagnosis leading to overtreatment. Although only very few countries have implemented a screening programme on a national level, individual prostate-specific antigen (PSA) testing is common. This opportunistic testing may have little favourable impact, while stressing the side-effects. The classic early detection protocols as were state-of-the-art in the 1990s applied a PSA and digital rectal examination threshold for sextant systematic prostate biopsy, with a fixed interval for re-testing, and limited indication for expectant management...
March 12, 2024: BJU International
https://read.qxmd.com/read/38468499/intermediate-stage-hepatocellular-carcinoma-refining-substaging-or-shifting-paradigm
#12
JOURNAL ARTICLE
Bernardo Stefanini, Luca Ielasi, Dante Pio Pallotta, Sofia Penazza, Mariarosaria Marseglia, Fabio Piscaglia
This review explores the evolution of cancer staging, focusing on intermediate hepatocellular carcinoma (HCC), and the challenges faced by physicians. The Barcelona Clinic Liver Cancer (BCLC) staging system, introduced in 1999, was designed to address the limitations associated with providing accurate prognostic information for HCC and allocating specific treatments, to avoid overtreatment. However, criticism has emerged, particularly regarding the intermediate stage of HCC (BCLC-B) and its heterogeneous patient population...
March 12, 2024: Journal of liver cancer
https://read.qxmd.com/read/38467246/diagnostic-value-of-maternal-cord-blood-and-neonatal-biomarkers-for-early-onset-sepsis-a-systematic-review-and-meta-analysis
#13
REVIEW
Lisanne M van Leeuwen, Elandri Fourie, Gerrie van den Brink, Vincent Bekker, Marlies A van Houten
BACKGROUND: An accurate diagnosis of early onset sepsis (EOS) is challenging due to subtle symptoms and the lack of a good diagnostic tool, resulting in considerable antibiotic overtreatment. A biomarker, discriminating between infected and non-infected newborns early in the disease, could improve EOS prediction. Numerous biomarkers have been tested, but have never been compared directly. OBJECTIVE: We aimed to provide a comprehensive overview of early biomarkers and their diagnostic value in maternal samples, umbilical cord blood and neonatal serum...
March 9, 2024: Clinical Microbiology and Infection
https://read.qxmd.com/read/38462646/prediction-of-neovascular-age-related-macular-degeneration-recurrence-using-optical-coherence-tomography-images-with-a-deep-neural-network
#14
JOURNAL ARTICLE
Juho Jung, Jinyoung Han, Jeong Mo Han, Junseo Ko, Jeewoo Yoon, Joon Seo Hwang, Ji In Park, Gyudeok Hwang, Jae Ho Jung, Daniel Duck-Jin Hwang
Neovascular age-related macular degeneration (nAMD) can result in blindness if left untreated, and patients often require repeated anti-vascular endothelial growth factor injections. Although, the treat-and-extend method is becoming popular to reduce vision loss attributed to recurrence, it may pose a risk of overtreatment. This study aimed to develop a deep learning model based on DenseNet201 to predict nAMD recurrence within 3 months after confirming dry-up 1 month following three loading injections in treatment-naïve patients...
March 11, 2024: Scientific Reports
https://read.qxmd.com/read/38462410/the-overtreatment-of-papillary-thyroid-microcarcinoma-in-the-community
#15
JOURNAL ARTICLE
Peter J Abraham, Christopher Wu, Rongzhi Wang, Brendon Herring, Polina Zmijewski, Andrea Gillis, Jessica Fazendin, Brenessa Lindeman, Herbert Chen
INTRODUCTION: Total thyroidectomy is the traditional primary approach for papillary thyroid cancer. However, recent evidence supports conservative management for low-risk tumors like papillary thyroid microcarcinomas (PTMCs). This study explores the adoption of these practices in our community, using a cancer database to analyze treatment strategies. METHODS: A retrospective review of a 1433-patient institutional database identified 258 ​PTMC cases. Outcomes, including 30-day mortality, reoperation rate, postoperative hypocalcemia, and recurrent laryngeal nerve (RLN) injury, were assessed...
March 4, 2024: American Journal of Surgery
https://read.qxmd.com/read/38461117/avoiding-locoregional-overtreatment-in-older-adults-with-early-stage-breast-cancer
#16
REVIEW
Eliza H Lorentzen, Christina A Minami
Advances in the treatment of older women with early-stage breast cancer, particularly opportunities for de-escalation of therapy, have afforded patients and providers opportunity to individualize care. As the majority of women ≥65 have estrogen receptor-positive, HER2-negative disease, locoregional therapy (surgery and/or radiation) may be tailored based on a patient's physiologic age to avoid either over- or undertreatment. To determine who would derive benefit from more or less intensive therapy, an accurate assessment of an older patient's physiologic age and incorporation of patient-specific values are paramount...
February 13, 2024: Clinical Breast Cancer
https://read.qxmd.com/read/38460827/three-dimensional-volume-rendering-ultrasound-for-assessing-placenta-accreta-spectrum-severity-and-discriminating-it-from-simple-scar-dehiscence
#17
JOURNAL ARTICLE
Theophilus K Adu-Bredu, Robert Ridwan, Aditiawarman Aditiawarman, Grace Ariani, Sally L Collins, Rozi A Aryananda
BACKGROUND: Prenatal ultrasound discrimination between Placenta Accreta Spectrum (PAS) and scar dehiscence with underlying non-adherent placenta is challenging both prenatally and intraoperatively which often leads to overtreatment. Also, accurate prenatal prediction of surgical difficulty and morbidity in PAS is difficult which precludes appropriate multidisciplinary planning. The advent of advanced three-dimensional volume rendering and contrast enhancement techniques in modern ultrasound systems provides a comprehensive prenatal assessment, revealing details that are not discernible in traditional 2D imaging...
March 7, 2024: American journal of obstetrics & gynecology MFM
https://read.qxmd.com/read/38455393/over-investigation-and-overtreatment-in-pediatrics-a-survey-from-the-european-academy-of-paediatrics-and-japan-pediatric-society
#18
JOURNAL ARTICLE
Lina Jankauskaite, Corinne Wyder, Stefano Del Torso, Marina Mamenko, Sandra Trapani, Zachi Grossman, Adamos Hadjipanayis, Karin Geitmann, Hikoro Matsui, Akihiko Saitoh, Tetsuya Isayama, Nora Karara, Alessandra Montemaggi, Farhan Saleem Ud Din, Ketil Størdal
INTRODUCTION: Avoiding over-investigation and overtreatment in health care is a challenge for clinicians across the world, prompting the international Choosing Wisely campaign. Lists of recommendations regarding medical overactivity are helpful tools to guide clinicians and quality improvement initiatives. We aimed to identify the most frequent and important clinical challenges related to pediatric medical overactivity in Europe and Japan. Based on the results, we aim to establish a (European) list of Choosing Wisely recommendations...
2024: Frontiers in Pediatrics
https://read.qxmd.com/read/38451967/what-do-people-know-and-think-about-medical-overuse-an-online-questionnaire-study-in-germany
#19
JOURNAL ARTICLE
Carolin Nürnberger, Thomas Kühlein, Susann Hueber
BACKGROUND: Medical overuse is defined as health care services that exceed the individual needs of patients and when the potential harms of medical interventions exceed their benefits. It has impacts on patients as well as on health care resources. To address medical overuse, it is important to understand the knowledge and experiences of overuse on the side of patients. RESEARCH QUESTIONS: What is the citizens' understanding of overuse? How do they assess its relevance, causes, consequences and potential solutions? METHODS: A quantitative online survey was conducted...
2024: PloS One
https://read.qxmd.com/read/38443090/remission-definitions-guiding-immunosuppressive-therapy-in-rheumatoid-arthritis-which-is-best-fitted-for-the-purpose
#20
JOURNAL ARTICLE
Catia Duarte, Ricardo J O Ferreira, Paco M J Welsing, Johannes W G Jacobs, Laure Gossec, Pedro M Machado, Désirée van der Heijde, Jose Antonio Pereira da Silva
OBJECTIVE: To assess which definition of remission best predicts good radiographic outcome (GRO) and good functional outcome (GFO) in rheumatoid arthritis, focusing the updated American College of Rheumatology/European Alliance of Associations for Rheumatology criteria. MATERIAL AND METHODS: Meta-analyses of individual patient data (IPD) from randomised controlled trials (RCTs). Six definitions of remission were considered: (1) Boolean with Patient Global Assessment (PGA)≤1 (Boolean); (2) Simplified Disease Activity Index (SDAI)≤3...
March 4, 2024: RMD Open
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