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https://www.readbyqxmd.com/read/28547563/poor-adherence-to-national-clinical-management-guidelines-a-population-based-cross-sectional-study-of-the-surgical-management-of-melanoma-in-new-south-wales-australia
#1
Alexander H R Varey, Christine M Madronio, Anne E Cust, Chris Goumas, Graham J Mann, Bruce K Armstrong, Richard A Scolyer, Austin M Curtin, John F Thompson
BACKGROUND: Standardization of the clinical management of melanoma through the formulation of national guidelines, based on interpretation of the existing evidence and consensus expert opinion, seeks to improve quality of care; however, adherence to national guidelines has not been well studied. METHODS: A population-based, cross-sectional study of the clinical management of all patients with newly notified primary melanomas in the state of New South Wales, Australia, during 2006/2007 was conducted using cancer registry identification and questionnaires completed by treating physicians...
May 25, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28544068/interstitial-fluid-pressure-a-novel-biomarker-to-monitor-photo-induced-drug-uptake-in-tumor-and-normal-tissues
#2
Sabrina Cavin, Xingyu Wang, Matthieu Zellweger, Michel Gonzalez, Michaël Bensimon, Georges Wagnières, Thorsten Krueger, Hans-Beat Ris, Fabrizio Gronchi, Jean Y Perentes
BACKGROUND: Low-dose photodynamic therapy PDT (photoinduction) can modulate tumor vessels and enhance the uptake of liposomal cisplatin (Lipoplatin®) in pleural malignancies. However, the photo-induction conditions must be tightly controlled as overtreatment shuts down tumor vessels and enhances normal tissue drug uptake. MATERIAL AND METHODS: In a pleural sarcoma and adenocarcinoma rat model (n = 12/group), we applied photoinduction (0.0625 mg/kg Visudyne®, 10 J/cm(2) ) followed by intravenous Lipoplatin® (5 mg/kg) administration...
May 22, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28543860/a-unique-case-of-bilateral-ovarian-splenosis-and-review-of-the-literature
#3
Maria Giulia Disanto, Francesca Mercalli, Andrea Palicelli, Alberto Arnulfo, Renzo Boldorini
Splenosis is an acquired anomaly related to heterotopic auto-transplantation of splenic tissue following abdominal trauma or splenectomy. We report the first definitive bilateral ovarian case in a 65-year-old woman who underwent splenectomy following a motor vehicle accident 44 years prior to presentation. We review the literature and discuss the main differential diagnoses. Gross examination revealed a 1-cm well-circumscribed dark nodule on the surface of each ovary. Paraffin-embedded, formalin-fixed blocks were sectioned and stained with hematoxylin-eosin and immunostains (CK5/6, Calretinin, WT1, Vimentin)...
May 25, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28543047/less-overdiagnosis-of-kidney-cancer-an-age-period-cohort-analysis-of-incidence-trends-in-16-populations-worldwide
#4
Ariana Znaor, Mathieu Laversanne, Freddie Bray
The increasing rates of kidney cancer incidence, reported in many populations globally, have been attributed both to increasing exposures to environmental risk factors, as well as increasing levels of incidental diagnosis due to widespread use of imaging. To better understand these trends, we examine long-term cancer registry data worldwide, focusing on the roles of birth cohort and calendar period, proxies for changes in risk factor prevalence and detection practice respectively. We used an augmented version of the Cancer Incidence in Five Continents series to analyse kidney cancer incidence rates 1978-2007 in 16 geographically representative populations worldwide by sex for ages 30-74, using age-period-cohort (APC) analysis...
May 23, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28542707/-urinary-tract-infection-requiem-for-a-heavyweight
#5
Thomas E Finucane
"Urinary tract infection" ("UTI") is an ambiguous, expansive, overused diagnosis that can lead to marked, harmful antibiotic overtreatment. "Significant bacteriuria," central to most definitions of "UTI," has little significance in identifying individuals who will benefit from treatment. "Urinary symptoms" are similarly uninformative. Neither criterion is well defined. Bacteriuria and symptoms remit and recur spontaneously. Treatment is standard for acute uncomplicated cystitis and common for asymptomatic bacteriuria, but definite benefits are few...
May 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28540564/digital-breast-tomosynthesis-dbt-recommendations-from-the-italian-college-of-breast-radiologists-icbr-by-the-italian-society-of-medical-radiology-sirm-and-the-italian-group-for-mammography-screening-gisma
#6
Daniela Bernardi, Paolo Belli, Eva Benelli, Beniamino Brancato, Lauro Bucchi, Massimo Calabrese, Luca A Carbonaro, Francesca Caumo, Beatrice Cavallo-Marincola, Paola Clauser, Chiara Fedato, Alfonso Frigerio, Vania Galli, Livia Giordano, Paolo Giorgi Rossi, Paola Golinelli, Doralba Morrone, Giovanna Mariscotti, Laura Martincich, Stefania Montemezzi, Carlo Naldoni, Adriana Paduos, Pietro Panizza, Federica Pediconi, Fiammetta Querci, Antonio Rizzo, Gianni Saguatti, Alberto Tagliafico, Rubina M Trimboli, Marco Zappa, Chiara Zuiani, Francesco Sardanelli
This position paper, issued by ICBR/SIRM and GISMa, summarizes the evidence on DBT and provides recommendations for its use. In the screening setting, DBT in adjunct to digital mammography (DM) increased detection rate by 0.5-2.7‰ and decreased false positives by 0.8-3.6% compared to DM alone in observational and double-testing experimental studies. The reduction in recall rate could be less prominent in those screening programs which already have low recall rates with DM. The increase in radiation exposure associated with DM/DBT protocols has been solved by the introduction of synthetic mammograms (sDM) reconstructed from DBT datasets...
May 25, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28527622/genome-wide-copy-number-analysis-reveals-candidate-gene-loci-that-confer-susceptibility-to-high-grade-prostate-cancer
#7
Prevathe Poniah, Shamsul Mohd Zain, Azad Hassan Abdul Razack, Shanggar Kuppusamy, Shankar Karuppayah, Hooi Sian Eng, Zahurin Mohamed
BACKGROUND: Two key issues in prostate cancer (PCa) that demand attention currently are the need for a more precise and minimally invasive screening test owing to the inaccuracy of prostate-specific antigen and differential diagnosis to distinguish advanced vs. indolent cancers. This continues to pose a tremendous challenge in diagnosis and prognosis of PCa and could potentially lead to overdiagnosis and overtreatment complications. Copy number variations (CNVs) in the human genome have been linked to various carcinomas including PCa...
May 17, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28524246/combined-pet-ct-and-axillary-lymph-node-marking-with-radioactive-iodine-seeds-mari-procedure-for-tailored-axillary-treatment-in-node-positive-breast-cancer-after-neoadjuvant-therapy
#8
B B Koolen, M Donker, M E Straver, M E M van der Noordaa, E J T Rutgers, R A Valdés Olmos, M J T F D Vrancken Peeters
BACKGROUND: The treatment of axillary lymph node metastases after neoadjuvant systemic therapy (NST) remains debatable and axillary lymph node dissection (ALND) is still the standard of care. Marking axillary lymph nodes with radioactive iodine seeds (MARI procedure) is accurate in restaging the axilla after NST (false-negative rate 7 per cent). Here, the potential of tailored axillary treatment, determined by combining the results of PET-CT before NST with those of the MARI procedure after NST, was analysed...
May 19, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28522924/use-of-the-4kscore-test-to-predict-the-risk-of-aggressive-prostate-cancer-prior-to-prostate-biopsy-overall-cost-savings-and-improved-quality-of-care-to-the-us-healthcare-system
#9
Jeffrey D Voigt, Yan Dong, Vincent Linder, Stephen Zappala
The 4Kscore® Test (BioReference Laboratories, Elmwood Park, NJ) is a blood test that accurately determines the risk of aggressive prostate cancer and significantly reduces prostate biopsies and associated overdiagnosis and overtreatment of indolent cancer. A budget impact model was developed to test the hypothesis that the 4Kscore Test can improve quality of care and deliver cost savings for patients who are suspected of having prostate cancer and would otherwise undergo prostate biopsy under the current standard of care (SOC) in the United States...
2017: Reviews in Urology
https://www.readbyqxmd.com/read/28522188/an-update-on-myofibromas-and-myofibromatosis-affecting-the-oral-regions-with-report-of-24-new-cases
#10
Molly Housley Smith, John D Reith, Donald M Cohen, Nadim M Islam, Kimberly T Sibille, Indraneel Bhattacharyya
OBJECTIVES: Myofibromas are uncommon soft tissue tumors exhibiting considerable histopathologic overlap with other benign and malignant entities. The treatment of lesions arising in the oral cavity is controversial. Here, we present 24 new cases and review the literature. STUDY DESIGN: A search for oral myofibromas was performed within the archives of the University of Florida Oral Pathology and Surgical Pathology Services (1994-2015). Demographic information and immunohistochemical results were recorded...
April 5, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28520680/acute-pediatric-monteggia-fractures-a-conservative-approach-to-stabilization
#11
Ian Foran, Vidyadhar V Upasani, Charles D Wallace, Elise Britt, Tracey P Bastrom, James D Bomar, Andrew T Pennock
BACKGROUND: In 2015, a multicenter study group proposed a treatment algorithm for pediatric Monteggia fractures based upon the ulnar fracture pattern. This strategy recommends surgical stabilization for all complete ulna fractures. The purpose of this study was to evaluate whether an initial nonoperative approach to pediatric Monteggia fractures resulted in poorer outcomes and a higher rate of complications. METHODS: This institutional review board approved retrospective study evaluated all Monteggia fractures presenting to a level 1 pediatric trauma center between 2008 and 2014...
May 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28513865/diagnosis-of-tuberculosis-in-hiv-co-infected-individuals-current-status-challenges-and-opportunities-for-the-future
#12
REVIEW
P Méndez-Samperio
Tuberculosis (TB) remains one of the most important causes of death amongst people co-infected with human immunodeficiency virus (HIV). The diagnosis of TB remains challenging in HIV co-infected individuals, due to a high frequency of smear-negative disease and high rates of extrapulmonary TB. Accurate, ease of use, and rapid diagnosis of active TB is critical to the World Health Organization (WHO) End TB Strategy by 2050. Traditional laboratory techniques do not provide rapid and accurate results to effectively manage HIV co-infected patients...
May 17, 2017: Scandinavian Journal of Immunology
https://www.readbyqxmd.com/read/28498634/older-people-with-type-2-diabetes-including-those-with-chronic-kidney-disease-or-dementia-are-commonly-overtreated-with-sulfonylurea-or-insulin-therapies
#13
C E Hambling, Samuel Seidu, M J Davies, K Khunti
AIM: To evaluate potential overtreatment with sulfonylurea and insulin therapies amongst older people with Type 2 diabetes, including those with chronic kidney disease or dementia. METHODS: Using the ECLIPSE Live software tool, we developed a search to examine data on older people (age ≥ 70 years) with Type 2 diabetes, who were prescribed sulfonylurea or insulin therapies over the previous 90 days. Sixteen Norfolk general practices participated, representing a population of 24 661 older people, including 3862 (15...
May 12, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28493044/postoperative-upgrading-of-prostate-cancer-in-men-%C3%A2-75%C3%A2-years-a-propensity-score-matched-analysis
#14
Annika Herlemann, Alexander Buchner, Alexander Kretschmer, Maria Apfelbeck, Christian G Stief, Christian Gratzke, Stefan Tritschler
PURPOSE: Gleason score upgrading should be considered when indicating surgery in prostate cancer (PCa) patients. In elderly patients, definitive treatment of low-risk PCa must be weighed with the risks of overtreatment. Our aim was to evaluate rates of Gleason score upgrading in patients ≥75 years undergoing radical prostatectomy (RP) for localized PCa and to identify predictors associated with upgrading. METHODS: 3296 patients undergoing RP were retrospectively evaluated and categorized into age groups: <70 years (n = 2971) vs...
May 10, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28492993/-choosing-wisely-at-the-end-of-life-recommendations-of-the-german-society-for-palliative-medicine-dgp
#15
REVIEW
B Alt-Epping
In addition to an overuse of unnecessary or no longer indicated diagnostic or therapeutic procedures at the end of life in the sense of overtreatment, there is often also a lack of therapeutic awareness in terms of a healthcare deficit, for example concerning the recognition and treatment of symptoms and complex burden of the disease. Sticking closely to the methodology of the German S3 "Palliative Medicine" guideline, the Choosing wisely recommendations of the German Society for Palliative Medicine address various examples of over- and underuse of healthcare services and treatment at the end of life, and thus also mirror basic principles of palliative medical care...
May 10, 2017: Der Internist
https://www.readbyqxmd.com/read/28492905/screening-for-thyroid-cancer-us-preventive-services-task-force-recommendation-statement
#16
Kirsten Bibbins-Domingo, David C Grossman, Susan J Curry, Michael J Barry, Karina W Davidson, Chyke A Doubeni, John W Epling, Alex R Kemper, Alex H Krist, Ann E Kurth, C Seth Landefeld, Carol M Mangione, Maureen G Phipps, Michael Silverstein, Melissa A Simon, Albert L Siu, Chien-Wen Tseng
Importance: The incidence of thyroid cancer detection has increased by 4.5% per year over the last 10 years, faster than for any other cancer, but without a corresponding change in the mortality rate. In 2013, the incidence rate of thyroid cancer in the United States was 15.3 cases per 100 000 persons. Most cases of thyroid cancer have a good prognosis; the 5-year survival rate for thyroid cancer overall is 98.1%. Objective: To update the US Preventive Services Task Force (USPSTF) recommendation on screening for thyroid cancer...
May 9, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28489299/gp-patient-communication-about-possible-cancer-in-primary-care-re-evaluating-gp-as-gatekeeper
#17
L A Brindle
As possibilities for the early detection of indolent cancers, and precursors to cancer, multiply, GPs will increasingly be involved in discussions with patients about risks and benefits of early diagnosis and treatment. Over time, improvements in evidence may decrease uncertainty about outcomes for patients and clinicians. However, where survival benefits are small, or uncertain, or risks are unacceptable to patients, grounds for preference-sensitive decision-making will remain. How risks and benefits of early detection, and the significance of indolent or low risk cancers, are communicated, will be key, if overtreatment and overdiagnosis are to be avoided...
May 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28476493/promoting-appropriate-urine-culture-management-to-improve-health-care-outcomes-and-the-accuracy-of-catheter-associated-urinary-tract-infections
#18
REVIEW
Robert Garcia, Eric D Spitzer
Published literature indicates that the unjustified ordering or improper collection of urine for urinalysis or culture from either catheterized patients or those without indwelling devices, or misinterpretation of positive results, often leads to adverse health care events, including increased financial burdens, overreporting of mandated catheter-associated urinary tract infection events, overtreatment of patients with antimicrobial agents, selection of multidrug-resistant organisms, and Clostridium difficile infection...
May 2, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28476133/improving-practice-guidelines-for-the-treatment-of-denture-related-erythematous-stomatitis-a-study-protocol-for-a-randomized-controlled-trial
#19
Raphael F de Souza, Muhammad Faheem Khiyani, Carolina A L Chaves, Jocelyne Feine, Jean Barbeau, Ramón Fuentes, Eduardo Borie, Luciana C Crizostomo, Claudia H Silva-Lovato, Pierre Rompre, Elham Emami
BACKGROUND: Denture-related erythematous stomatitis (DES) is a chronic biofilm-mediated disease, affecting one in every three complete denture wearers. Antifungals are the treatment most commonly prescribed by oral health professionals, based on the belief that colonization by Candida spp. is the main cause of DES. However, high recurrence rates and adverse effects are commonly observed, prompting the need for practice guidelines regarding treatment. Results from our pilot study demonstrate that palatal brushing can reduce the palatal inflammation and potentially associated Candida carriage without any need for antifungal therapy...
May 5, 2017: Trials
https://www.readbyqxmd.com/read/28474262/multivariate-model-to-identify-women-at-low-risk-of-cancer-upgrade-after-a-core-needle-biopsy-diagnosis-of-atypical-ductal-hyperplasia
#20
REVIEW
Alvaro Peña, Sejal S Shah, Robert T Fazzio, Tanya L Hoskin, Rushin D Brahmbhatt, Tina J Hieken, James W Jakub, Judy C Boughey, Daniel W Visscher, Amy C Degnim
PURPOSE: Atypical ductal hyperplasia (ADH) identified on percutaneous breast biopsy represents a high-risk lesion, upgrading to cancer with surgical excision in ~7-45.8% of cases. Routine excision is questioned due to potential overtreatment and cost. This study evaluates clinical, imaging, and histologic features to predict the risk of upgrade. METHODS: With IRB approval, a single-institution retrospective review was performed of patients who underwent surgical excision of ADH diagnosed by core biopsy from June 2005 to June 2013...
May 4, 2017: Breast Cancer Research and Treatment
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