keyword
MENU ▼
Read by QxMD icon Read
search

Overtreatment

keyword
https://www.readbyqxmd.com/read/28350520/genomic-classifier-augments-the-role-of-pathological-features-in-identifying-optimal-candidates-for-adjuvant-radiation-therapy-in-patients-with-prostate-cancer-development-and-internal-validation-of-a-multivariable-prognostic-model
#1
Deepansh Dalela, María Santiago-Jiménez, Kasra Yousefi, R Jeffrey Karnes, Ashley E Ross, Robert B Den, Stephen J Freedland, Edward M Schaeffer, Adam P Dicker, Mani Menon, Alberto Briganti, Elai Davicioni, Firas Abdollah
Purpose Despite documented oncologic benefit, use of postoperative adjuvant radiotherapy (aRT) in patients with prostate cancer is still limited in the United States. We aimed to develop and internally validate a risk-stratification tool incorporating the Decipher score, along with routinely available clinicopathologic features, to identify patients who would benefit the most from aRT. Patient and Methods Our cohort included 512 patients with prostate cancer treated with radical prostatectomy at one of four US academic centers between 1990 and 2010...
March 28, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28346806/active-surveillance-in-younger-men-with-prostate-cancer
#2
Michael S Leapman, Janet E Cowan, Hao G Nguyen, Katsuto K Shinohara, Nannette Perez, Matthew R Cooperberg, William J Catalona, Peter R Carroll
Purpose The suitability of younger patients with prostate cancer (PCa) for initial active surveillance (AS) has been questioned on the basis of eventual treatment necessity and concerns of safety; however, the role of age on surveillance outcomes has not been well defined. Patients and Methods We identified men managed with AS at our institution with a minimum follow-up of 6 months. The primary study objective was to examine the association of age with risk of biopsy-based Gleason score upgrade during AS. We also examined the association of age with related end points, including overall biopsy-determined progression, definitive treatment, and pathologic and biochemical outcomes after delayed radical prostatectomy (RP), using descriptive statistics, the Kaplan-Meier method, and multivariable Cox proportional hazards regression...
March 27, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28341983/-management-of-different-cardiovascular-risk-factors-with-a%C3%A2-combination-tablet-polypill
#3
REVIEW
P Bramlage, W März, D Westermann, B Weisser, J H Wirtz, U Zeymer, P Baumgart, G van Mark, U Laufs, B K Krämer, T Unger
BACKGROUND: The multifactorial origin of cardiovascular diseases has led to polypharmacy in primary and secondary prophylaxis with evidence-based medications, such as statins, antihypertensive drugs and platelet aggregation inhibitors. The number of prescribed drugs correlates inversely to adherence and can lead to treatment failure. Fixed-dose combination drugs (polypills) could increase the medication adherence of patients, reduce risks and prevent cardiovascular events. METHODS: This review is based on publications that were retrieved from Medline (via PubMed) and The Cochrane Library...
March 24, 2017: Herz
https://www.readbyqxmd.com/read/28338156/-pay-attention-to-the-selective-lateral-pelvic-lymph-node-dissection-in-mid-low-rectal-cancer
#4
Wenjian Meng, Ziqiang Wang
Lateral pelvic lymph node metastasis is an important metastatic mode and a major cause of locoregional recurrence of mid-low rectal cancer. Recently, there is an East-West discrepancy in regard to the diagnosis, clinical significance, treatment and prognosis of lateral pelvic lymph node metastasis. In the West, lateral nodal involvement may represent systemic disease and preoperative chemoradiotherapy can sterilize clinically suspected lateral nodes. Thus, in many Western countries, the standard therapy for lower rectal cancer is total mesorectal excision with chemoradiotherapy, and pelvic sidewall dissection is rarely performed...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28331841/resistance-testing-for-the-treatment-of-chronic-hepatitis-c-with-direct-acting-antivirals-when-and-for-how-long
#5
Ana Belén Pérez, Natalia Chueca, Federico García
The need to test for resistance associated substitutions (RAS) has been intensively debated in the past two years. In the absence of pangenotypic combinations, it seems reasonable that, if available, RAS testing in the NS5A gene at baseline for genotypes 1a and 3 may help to avoid overtreatment in terms of ribavirin usage and/or prolonged treatment duration. When patients fail treatment, RAS testing may also be useful to guide the selection of the new regimen, especially for those that need urgent retreatment and that have failed a combination including an NS5A inhibitor...
March 2017: Germs
https://www.readbyqxmd.com/read/28326347/the-insufficiencies-of-risk-analysis-of-impending-pathological-fractures-in-patients-with-femoral-metastases-a-literature-review
#6
Emir Benca, Janina M Patsch, Winfried Mayr, Dieter H Pahr, Reinhard Windhager
PURPOSE: Pathologic fractures in patients with bone metastases are a common problem in clinical orthopaedic routine. On one hand recognition of metastatic lesions, which are at a high risk of fracture, is essential for timely prophylactic fixation, while on the other hand patients with a low risk of pathologic fractures should be spared from overtreatment. The purpose of this review is to identify all methods for fracture risk evaluation in patients with femoral metastases in the literature and to evaluate their predictive values in clinical applications...
December 2016: Bone Reports
https://www.readbyqxmd.com/read/28325799/a-proposal-for-an-out-of-range-glycemic-population-health-safety-measure-for-older-adults-with-diabetes
#7
Leonard Pogach, Chin-Lin Tseng, Orysya Soroka, Miriam Maney, David Aron
OBJECTIVE: To evaluate patient-level glycemic control and facility variation of a proposed out-of-range (OOR) measure (overtreatment [OT] [HbA1c <7% (53 mmol/mol)] or undertreatment [UT] [>9% (75 mmol/mol)]) compared with the standard measure (SM) (HbA1c <8% [64 mmol/mol]) in high-risk older adults. RESEARCH DESIGN AND METHODS: Veterans Health Administration patients ≥65 years of age in 2012 who were taking antihyperglycemic agents in 2013 were identified...
April 2017: Diabetes Care
https://www.readbyqxmd.com/read/28324216/new-classification-for-the-treatment-of-pyogenic-spondylodiscitis-validation-study-on-a-population-of-250-patients-with-a-follow-up-of-2%C3%A2-years
#8
Enrico Pola, G Autore, V M Formica, V Pambianco, D Colangelo, R Cauda, M Fantoni
PURPOSE: Pyogenic spondylodiscitis (PS) is still burdened by a high rate of orthopedic and neurological complications. Despite the rising incidence, the choice of a proper orthopedic treatment is often delayed by the lack of clinical data. The aim of this study was to propose a clinical-radiological classification of pyogenic spondylodiscitis to define a standard treatment algorithm. METHODS: Based on data from 250 patients treated from 2008 to 2015, a clinical-radiological classification of pyogenic spondylodiscitis was developed...
March 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28322617/clinicians-views-on-management-and-terminology-for-papillary-thyroid-microcarcinoma-a-qualitative-study
#9
Brooke Nickel, Juan P Brito, Alexandra Barratt, Susan Jordan, Ray Moynihan, Kirsten McCaffery
BACKGROUND: There is growing acceptance that the increase in thyroid cancer incidence is in part a result of overdiagnosis of small low-risk papillary microcarcinomas (PMCs) with indolent clinical course. Although surgery is the cornerstone treatment for patients with PMCs, recent management guidelines are shifting toward inclusion of more conservative treatments such as active surveillance. There is little evidence on clinicians' experience in managing PMC patients and their attitudes toward treatment options, including their willingness to accept a nonsurgical option...
March 21, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28320219/monitoring-of-argatroban-and-lepirudin
#10
Holger Seidel, Hans-Jürgen Kolde
Monitoring of direct thrombin inhibitors (DTIs) in patients with heparin-induced thrombocytopenia (HIT) is primarily performed using the activated partial thromboplastin time (aPTT). This assay is poorly standardized, reagent dependent, and not DTI specific. We compared aPTT, thrombin time (TT), and prothrombin time (PT) to drug levels obtained by the ecarin chromogenic assay (ECA). We analyzed 495 samples of patients with confirmed or suspected HIT on treatment with either argatroban (n = 37) or lepirudin (n = 80)...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28315873/clear-lens-extraction-for-early-angle-closure-glaucoma-revolution-or-overtreatment
#11
Ke Shi, Zhipeng You, Changyun Wang
<br><br>To discuss the EAGLE study initiated by Dr. Azuara - Blanco which is published in The Lancet to investigate whether clear-lens extraction(CLE) could be a useful initial treatment.<br><br>Materials (Subjects) and Methods<br><br>Guideline and textbook reference<br><br>Results: <br><br>This conclusion has challenged European guidelines for glaucoma, in which indicated that peripheral iridectomy can deepen anterior chamber(AC) angle of primary angle closure combined with plateau iris...
March 16, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28301338/lymph-node-metastasis-in-patients-with-endometrioid-endometrial-cancer-overtreatment-is-the-main-issue
#12
Alper Karalok, Taner Turan, Derman Basaran, Osman Turkmen, Gunsu Comert Kimyon, Gokhan Tulunay, Tolga Tasci
OBJECTIVE: The aim of this study was to evaluate the effectiveness of histological grade, depth of myometrial invasion, and tumor size to identify lymph node metastasis (LNM) in patients with endometrioid endometrial cancer (EC). METHODS: A retrospective computerized database search was performed to identify patients who underwent comprehensive surgical staging for EC between January 1993 and December 2015. The inclusion criterion was endometrioid type EC limited to the uterine corpus...
March 15, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28299948/how-to-conduct-research-on-overdiagnosis-a-keynote-paper-from-the-egprn-may-2016-tel-aviv
#13
John Brodersen
Overdiagnosis is a growing problem worldwide. Overdiagnosis is the diagnosis of deviations, abnormalities, risk factors, and pathologies that in themselves would never cause symptoms (this applies only to risk factors and pathology), would never lead to morbidity, and would never be the cause of death. Overdiagnosis is often misinterpreted as overutilization or overtreatment. Overutilization, overtreatment, and overdiagnosis are interrelated but three distinct topics. Overutilization (establishment of standard practice that does not provide net benefit) does not have to lead to overdiagnosis or overtreatment, but the risk exists...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/28295933/high-concordance-of-findings-obtained-from-in-gantry-transgluteal-mri-and-trus-guided-biopsy-as-compared-to-prostatectomy-specimens
#14
Stefan Steurer, Sebastian Dwertmann Rico, Ronald Simon, Sarah Minner, Maria Christina Tsourlakis, Till Krech, Christina Koop, Markus Graefen, Hans Heinzer, Meike Adam, Hartwig Huland, Thorsten Schlomm, Guido Sauter, Agron Lumiani
OBJECTIVES: To determine the utility of our transgluteal MRI-guided prostate biopsy approach. PATIENTS AND METHODS: 960 biopsy series taken within the period of one year were evaluated including 301 MRI-guided and 659 TRUS-guided biopsies. RESULTS: The positivity rate and the fraction of high-grade cancers were significantly higher in MRI-guided than in TRUS biopsies. 65.4% of 301 MRI-guided and 57.2% of 659 TRUS biopsies contained cancer (p=0...
March 13, 2017: BJU International
https://www.readbyqxmd.com/read/28290961/kcnq1-gene-variants-in-large-asymptomatic-populations-considerations-for-genomic-screening-of-military-cohorts
#15
Paul Kruszka, Karin Weiss, Donald W Hadley
INTRODUCTION: The advances in genomic technology of large populations make the potential for genomic screening of military cohorts and recruits feasible, affording the potential to identify at-risk individuals before occurrence of potentially life-threatening events. Exploring sudden cardiac death, known to cause significant morbidity and mortality in young military service members, we focused on the most common gene associated with long QT syndrome (LQTS), KCNQ1. MATERIALS AND METHODS: Using the publicly available database Exome Aggregation Consortium as a surrogate for a military population, variants in KCNQ1 were filtered on the basis of population prevalence, classification as a disease mutation in the Human Gene Mutation database, and classification as pathogenic or likely pathogenic in the ClinVar database...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28289110/thirty-minute-office-blood-pressure-monitoring-in-primary-care
#16
Michiel J Bos, Sylvia Buis
PURPOSE: Automated office blood pressure monitoring during 30 minutes (OBP30) may reduce overtreatment of patients with white-coat hypertension in primary health care. OBP30 results approximate those of ambulatory blood pressure monitoring, but OBP30 is much more convenient. In this study, we compared OBP30 with routine office blood pressure (OBP) readings for different indications in primary care and evaluated how OBP30 influenced the medication prescribing of family physicians. METHODS: All consecutive patients who underwent OBP30 for medical reasons over a 6-month period in a single primary health care center in the Netherlands were enrolled...
March 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28286071/bosniak-classification-for-complex-renal-cysts-re-evaluated-a-systematic-review
#17
REVIEW
Ivo G Schoots, Keren Zaccai, Myriam G Hunink, Paul C M S Verhagen
OBJECTIVE: To systematically evaluate the Bosniak classification, with malignancy rates of each Bosniak category, and to assess the effectiveness related to surgical treatment and oncological outcome, based on recurrence and/or metastasis. METHODS: A systematic review (according to the PRISMA statement and the QUADAS-2 criteria) selected 39 publications for inclusion in this analysis and categorised into: 1) "surgical" cohorts- all cysts underwent surgery, and 2) "radiological" cohorts- cysts underwent either surgical treatment or radiological follow-up...
March 9, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28284262/respiratory-medication-use-in-primary-care-among-copd-subjects-in-four-latin-american-countries
#18
J R Jardim, R Stirbulov, D Moreno, G Zabert, M V Lopez-Varela, M Montes de Oca
OBJECTIVES: To assess respiratory medications used, factors predicting treatment and patterns of corticosteroid (CS) use in primary care in Latin America among chronic obstructive pulmonary disease (COPD) patients. METHODS: COPD was defined as post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) < 0.70 or previous medical diagnosis. To determine factors associated with respiratory medication use, crude and adjusted Poisson regression models were performed...
April 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28275803/-chinese-expert-consensus-on-the-use-of-topical-timolol-maleate-treatment-of-infantile-hemangiomas
#19
Jia-Wei Zheng, Xu-Kai Wang, Cheng-Hong Jiang, Zhong-Ping Qin, Xin-Dong Fan, Yao-Wu Yang, Ran Huo, Shao-Hua Liu, Ji-Hong Zhao, Xiao-Yong Wang, De-Kai Zhou, Shao-Rong Lei
Non-selective β-blocker propranolol has been proved by FDA as the first-line agent for infantile hemangioma (IH) with dramatic response. To reduce the side effects caused by systemic administration of propranolol, timolol maleate treatment has been increasingly used as an alternative to systemic β-blockers and watchful waiting for many IH patients in recent years. However, the appropriate indications, drug dosage, dosing regimen, time for initiation, optimal duration, monitoring for side effects still remains controversial...
December 2016: Shanghai Kou Qiang Yi Xue, Shanghai Journal of Stomatology
https://www.readbyqxmd.com/read/28266306/inpatient-overtreatment
#20
Hans-Michael Steffen
No abstract text is available yet for this article.
February 10, 2017: Deutsches Ärzteblatt International
keyword
keyword
12150
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"