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https://www.readbyqxmd.com/read/28444414/-general-diagnostic-work-up-for-benign-tumors-of-the-musculoskeletal-system
#1
REVIEW
J Panotopoulos, P Th Funovics, R Windhager
INTRODUCTION: Benign bone tumors are heterogeneous and have different biological behaviors. Treatment requires knowledge of the principle diagnosis and clinical behavior to avoid, on the one hand, overtreatment and, on the other hand, incorrect diagnosis of a potentially malignant tumor. METHODS: Bone tumors of stage I (according to Enneking) should be observed clinically and radiologically. For stage II and stage III lesions, a biopsy should be performed, based on the corresponding oncological guidelines...
April 25, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28441815/-the-interpretation-of-2015-american-thyroid-association-management-guidelines-for-adult-patients-with-thyroid-nodules-and-differentiated-thyroid-cancer
#2
X Y Li, B Zhang, Y S Lin
The prevalence of thyroid nodules, especially differentiated thyroid cancer, has increased during the past decades. With the consideration of increasing prevalence of the diseases, American Thyroid Association (ATA) updated the guidelines for adult patients with thyroid nodules and differentiated thyroid carcinoma (DTC) in 2015. The aim of the new guidelines was to minimize potential harm from overtreatment in majority of patients at low risk for diseasespecific mortality and morbidity while appropriately treat and monitor those patients at higher risk...
April 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28441671/swimming-upstream-creating-a-culture-of-high-value-care
#3
Reshma Gupta, Christopher Moriates
As health system leaders strategize the best ways to encourage the transition toward value-based health care, the underlying culture-defined as a system of shared assumptions, values, beliefs, and norms existing within an environment-continues to shape clinician practice patterns. The current prevailing medical culture contributes to overtesting, overtreatment, and health care waste. Choosing Wisely lists, appropriateness criteria, and guidelines codify best practices, but academic medicine as a whole must recognize that faculty and trainees are all largely still operating within the same cultural climate...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28436336/cardiovascular-screening-of-young-athletes-a-review-of-economic-evaluations
#4
Sophie Gerkens, Hans Van Brabandt, Anja Desomer, Christian Leonard, Mattias Neyt
OBJECTIVES: Some experts have promoted preparticipative cardiovascular screening programs for young athletes and have claimed that such programs were cost-effective without performing a critical analysis of studies supporting this statement. In this systematic review, a critical assessment of economic evaluations on these programs is performed to determine if they really provide value for money. METHODS: A systematic review of economic evaluations was performed on December 24, 2014...
April 24, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28435446/cardiovascular-risk-assessment-in-patients-with-diabetes
#5
REVIEW
Marcello Casaccia Bertoluci, Viviane Zorzanelli Rocha
Although patients with diabetes have 2 to 4 times increased risk of cardiovascular morbidity and mortality than individuals without diabetes, recent studies indicate that a significant part of patients are in a lower cardiovascular risk category. Men younger than 35 years, women younger than 45 years, patients with diabetes duration of less than 10 years without other risk factors have a much lower risk than patients who have traditional cardiovascular risk factors, and subclinical or established coronary artery disease (CAD)...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28424236/hyalinizing-trabecular-tumour-of-the-thyroid-fine-needle-aspiration-cytological-diagnosis-and-correlation-with-histology
#6
REVIEW
Chiara Saglietti, Simonetta Piana, Stefano La Rosa, Massimo Bongiovanni
Hyalinizing trabecular tumour (HTT) is a rare thyroid neoplasm of follicular cell origin characterised by a trabecular growth pattern and prominent intratrabecular and intertrabecular hyalinisation. These peculiar histological features allow the prompt recognition of this neoplasm in surgical specimens. However, cytological diagnosis of HTT remains elusive and misleading because of overlapping characteristics with other thyroid tumours, particularly papillary thyroid carcinoma (PTC), medullary thyroid carcinoma (MTC) and the newly described non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)...
April 19, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28417238/bilateral-mastectomy-as-overtreatment-for-breast-cancer-in-women-age-forty-years-and-younger-with-unilateral-operable-invasive-breast-cancer
#7
Cory A Donovan, Jean Bao, Alexandra Gangi, Farin Amersi, Xiao Zhang, Armando E Giuliano, Alice P Chung
BACKGROUND: Young women with breast cancer (BC) have an increased risk of contralateral breast cancer (CBC) compared with older women. This may contribute to the rising rates of bilateral mastectomy (BM), but it is unclear if BM leads to improved outcomes. METHODS: A prospectively maintained database was reviewed. Patient and tumor characteristics, survival, and rate of CBC were compared in women age ≤40 years treated for unilateral Stage 1-3 BC from January 2000 through December 2013...
April 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28417143/impact-of-high-age-and-comorbidity-on-management-decisions-and-adherence-to-guidelines-in-patients-with-keratinocyte-skin-cancer
#8
Satish F K Lubeek, Celia A J Michielsens, Rinke J Borgonjen, Ewald M Bronkhorst, Peter C M van de Kerkhof, Marie-Jeanne P Gerritsen
Appropriate medical decision-making in patients with keratinocyte skin cancer (KSC) can be challenging, especially in those with a limited life expectancy (LEx). Treatment should be beneficial for the individual patient, the risk of both over- and under-treatment should be carefully considered, and deviation from guideline recommendations may be necessary. In this study retrospective analysis was performed to determine the influence of age and comorbidity, both factors strongly related to limited LEx, on KSC management in daily practice...
April 18, 2017: Acta Dermato-venereologica
https://www.readbyqxmd.com/read/28413897/fibroadenoma-with-pleomorphic-stromal-giant-cells-it-s-not-as-bad-as-it-looks
#9
Jonathan Wawire, Kamaljeet Singh, Margaret M Steinhoff
Clinically relevant histological categorization of fibroepithelial lesions can be a daunting task, especially in a core needle biopsy. Assessment of stromal nuclear atypia, including nuclear pleomorphism and mitotic activity, is a key morphological feature employed to classify fibroepithelial lesions. We describe a case of fibroadenoma with markedly atypical nuclear features in the stromal cells that led to misclassification as phyllodes tumor in the core needle biopsy. Excision showed a fibroadenoma containing pleomorphic stromal giant cells, with occasional mitotic figures, including atypical forms...
April 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28410180/rotterdam-prostate-cancer-risk-calculator-development-and-usability-testing-of-the-mobile-phone-app
#10
Nuno Pereira-Azevedo, Luís Osório, Avelino Fraga, Monique J Roobol
BACKGROUND: The use of prostate cancer screening tools that take into account relevant prebiopsy information (ie, risk calculators) is recommended as a way of determining the risk of cancer and the subsequent need for a prostate biopsy. This has the potential to limit prostate cancer overdiagnosis and subsequent overtreatment. mHealth apps are gaining traction in urological practice and are used by both practitioners and patients for a variety of purposes. OBJECTIVE: The impetus of the study was to design, develop, and assess a smartphone app for prostate cancer screening, based on the Rotterdam Prostate Cancer Risk Calculator (RPCRC)...
January 6, 2017: JMIR Cancer
https://www.readbyqxmd.com/read/28408987/saving-from-unnecessary-pancreaticoduodenectomy-brunner-s-gland-hamartoma-case-report-on-a-rare-duodenal-lesion-and-exhaustive-literature-review
#11
Andrea Peloso, Jacopo Viganò, Alessandro Vanoli, Tommaso Dominioni, Sandro Zonta, Dario Bugada, Carlo Maria Bianchi, Francesco Calabrese, Ilaria Benzoni, Marcello Maestri, Paolo Dionigi, Lorenzo Cobianchi
INTRODUCTION: Brunner's gland hamartoma (BGH) is an infrequently encountered, benign, polypoid proliferation of Brunner's glands. Usually these lesions are asymptomatic, just only occasionally presenting with duodenal obstruction or bleeding signs and mimicking a tumoral lesion. CASE PRESENTATION: A 72-year-old male, referred for recurrent vomiting and epigastralgia, was investigated and all preoperative findings were suggestive of a tumour of the duodenum. During the scheduled pancreaticoduodenectomy a mass, resultant to a polyp, was palpatory felt inside the duodenum and then successfully and completely resected through a duodenotomy avoiding surgical overtreatment and connected postoperative morbidities...
May 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28404198/molecular-fluorescence-guided-surgery-of-peritoneal-carcinomatosis-of-colorectal-origin-a-single-centre-feasibility-study
#12
Niels J Harlaar, Marjory Koller, Steven J de Jongh, Barbara L van Leeuwen, Patrick H Hemmer, Schelto Kruijff, Robert J van Ginkel, Lukas B Been, Johannes S de Jong, Gursah Kats-Ugurlu, Matthijs D Linssen, Annelies Jorritsma-Smit, Marleen van Oosten, Wouter B Nagengast, Vasilis Ntziachristos, Gooitzen M van Dam
BACKGROUND: Optimum cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is essential for the curative treatment of peritoneal carcinomatosis of colorectal origin. At present, surgeons depend on visual inspection and palpation for tumour detection. Improved detection of tumour tissue using molecular fluorescence-guided surgery could not only help attain a complete cytoreduction of metastatic lesions, but might also prevent overtreatment by avoiding resection of benign lesions...
December 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404010/risk-stratification-of-barrett-s-oesophagus-using-a-non-endoscopic-sampling-method-coupled-with-a-biomarker-panel-a-cohort-study
#13
Caryn S Ross-Innes, Hamza Chettouh, Achilleas Achilleos, Nuria Galeano-Dalmau, Irene Debiram-Beecham, Shona MacRae, Petros Fessas, Elaine Walker, Sibu Varghese, Theodore Evan, Pierre S Lao-Sirieix, Maria O'Donovan, Shalini Malhotra, Marco Novelli, Babett Disep, Phillip V Kaye, Laurence B Lovat, Rehan Haidry, Michael Griffin, Krish Ragunath, Pradeep Bhandari, Adam Haycock, Danielle Morris, Stephen Attwood, Anjan Dhar, Colin Rees, Matt D Rutter, Richard Ostler, Benoit Aigret, Peter D Sasieni, Rebecca C Fitzgerald
BACKGROUND: Barrett's oesophagus predisposes to adenocarcinoma. However, most patients with Barrett's oesophagus will not progress and endoscopic surveillance is invasive, expensive, and fraught by issues of sampling bias and the subjective assessment of dysplasia. We investigated whether a non-endoscopic device, the Cytosponge, could be coupled with clinical and molecular biomarkers to identify a group of patients with low risk of progression suitable for non-endoscopic follow-up. METHODS: In this multicentre cohort study (BEST2), patients with Barrett's oesophagus underwent the Cytosponge test before their surveillance endoscopy...
January 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28393719/a-case-of-tracheal-leiomyoma-misdiagnosed-as-asthma
#14
Ayperi Öztürk, Zafer Aktaş, Aydın Yılmaz, Havva Yeşildağlı, Leyla Memiş
Primary benign tumors of trachea are rare. Of them, tracheal leiomyoma, constitutes only 1% of all benign lower respiratory tract tumors. Here, we present a case of tracheal leiomyoma who has been receiving high doses of inhaled corticosteroids and bronchodilators for a year with a misdiagnosis of asthma. As the symptoms did not resolve with an overtreatment, she has been undergone radiologic study to find a possible alternative diagnosis. The chest roentgenogram revealed an opacity in the upper mediastinum...
December 2016: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/28390650/garlic-burn-of-the-oral-mucosa-a-case-report-and-review-of-self-treatment-chemical-burns
#15
Richard J Vargo, Blake M Warner, Anitha Potluri, Joanne L Prasad
BACKGROUND AND OVERVIEW: Inappropriate self-treatment with topically applied therapeutic or nontherapeutic agents frequently results in mucosal burns. Although such chemical burns typically are associated with misuse of analgesics, investigators also have reported them in conjunction with topical application of a variety of other agents. CASE DESCRIPTION: The authors report an unusual case of a 49-year-old man seeking care for maxillary tooth pain who had an oral mucosal burn of the maxillary vestibule caused by topical application of crushed raw garlic...
April 5, 2017: Journal of the American Dental Association
https://www.readbyqxmd.com/read/28385463/clinical-and-social-barriers-to-antimicrobial-stewardship-in-pulmonary-medicine-a-qualitative-study
#16
Jennifer K Broom, Alex F Broom, Emma R Kirby, Alexandra F Gibson, Jeffrey J Post
BACKGROUND: The treatment of pulmonary infections is one of the largest indications for antibiotics in human health care, offering significant potential for antibiotic optimization internationally. This study explores the perspectives of pulmonary clinicians on antibiotic use in hospital pulmonary infections. METHODS: Twenty-eight pulmonary doctors and nurses from 2 hospitals participated in semi-structured interviews focusing on their experiences of antibiotic use...
April 3, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28372570/malaria-over-diagnosis-in-cameroon-diagnostic-accuracy-of-fluorescence-and-staining-technologies-fast-malaria-stain-and-led-microscopy-versus-giemsa-and-bright-field-microscopy-validated-by-polymerase-chain-reaction
#17
Sean M Parsel, Steven A Gustafson, Edward Friedlander, Alexander A Shnyra, Aderosoye J Adegbulu, Ying Liu, Nicole M Parrish, Syed A Jamal, Eve Lofthus, Leo Ayuk, Charles Awasom, Carolyn J Henry, Carole P McArthur
BACKGROUND: Malaria is a major world health issue and its continued burden is due, in part, to difficulties in the diagnosis of the illness. The World Health Organization recommends confirmatory testing using microscopy-based techniques or rapid diagnostic tests (RDT) for all cases of suspected malaria. In regions where Plasmodium species are indigenous, there are multiple etiologies of fever leading to misdiagnoses, especially in populations where HIV is prevalent and children. To determine the frequency of malaria infection in febrile patients over an 8-month period at the Regional Hospital in Bamenda, Cameroon, we evaluated the clinical efficacy of the Flourescence and Staining Technology (FAST) Malaria stain and ParaLens Advance(TM) microscopy system (FM) and compared it with conventional bright field microscopy and Giemsa stain (GS)...
April 4, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28372534/panel-7-otitis-media-treatment-and-complications
#18
Anne G M Schilder, Tal Marom, Mahmood F Bhutta, Margaretha L Casselbrant, Harvey Coates, Marie Gisselsson-Solén, Amanda J Hall, Paola Marchisio, Aino Ruohola, Roderick P Venekamp, Ellen M Mandel
Objective We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice. Data Sources PubMed, Ovid Medline, the Cochrane Library, and Clinical Evidence (BMJ Publishing). Review Methods All types of articles related to otitis media treatment and complications between June 2011 and March 2015 were identified...
April 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28370948/cost-effectiveness-of-a-new-urinary-biomarker-based-risk-score-compared-to-standard-of-care-in-prostate-cancer-diagnostics-a-decision-analytical-model
#19
Siebren Dijkstra, Tim M Govers, Rianne J Hendriks, Jack A Schalken, Wim Van Criekinge, Leander Van Neste, Janneke P C Grutters, J P Michiel Sedelaar, Inge M van Oort
OBJECTIVE: To assess the cost-effectiveness of a new urinary biomarker-based risk score (SelectMDx) to identify patients for transrectal ultrasound-guided biopsy (TRUSGB) and to compare this with the current standard of care (SOC), using only prostate-specific antigen (PSA) to select for TRUSGB. MATERIALS AND METHODS: A decision tree and Markov model were developed to evaluate the cost-effectiveness of SelectMDx as a reflex test versus SOC in men with a PSA >3 ng/ml...
March 29, 2017: BJU International
https://www.readbyqxmd.com/read/28366700/eau-and-aua-suo-guidelines-on-risk-categories-for-non-muscle-invasive-bladder-cancer-may-lead-to-overtreatment-for-low-grade-ta-bladder-tumors
#20
Zachary Klaassen, Mark S Soloway
No abstract text is available yet for this article.
March 30, 2017: Urology
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