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https://www.readbyqxmd.com/read/30545480/pre-hospital-transport-times-and-outcomes-after-different-reperfusion-strategies-for-st-elevation-myocardial-infarction
#1
Hedvig B Andersson, Milan Seth, Hitinder S Gurm, Eric R Bates
This study evaluated prehospital transport times and clinical outcomes after different reperfusion strategies for ST-elevation myocardial infarction in a real-world setting. We consecutively enrolled 27,205 patients who underwent percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction in Michigan from 2010 to 2016. Primary PCI was performed in 25,927 patients (95%), whereas 1,278 (5%) were treated with a pharmacoinvasive strategy. The overall use of a pharmacoinvasive strategy decreased during the study period (p <0...
October 21, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/30541326/afatinib-in-the-treatment-of-advanced-non-small-cell-lung-cancer-with-rare-egfr-in-exon-18-t179x-mutation-a-case-report
#2
Čoupková Helena, Vyzula Rostislav
INTRODUCTION: Exon 18-T719X EGFR mutation in non-small cell lung cancer is rare, only 1-5% of all EGFR mutations. The efficacy of EGFR tyrosin kinase inhibitors in tumours with uncommon mutations is still unclear and the prediction of response of such tumours to therapy remains unexplored. CASE: A 71-year-old woman with no previous smoking history with disseminated lung adenocarcinoma with exon 18-T719X EGFR mutation was treated with afatinib. A partial response was achieved in 2 months, progression-free survival was 19 months...
2018: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/30541325/solid-pseudopapillary-tumor-of-the-pancreas-rare-neoplastic-disease-in-20-year-old-woman
#3
Fichtl Jakub, Skalický Tomáš, Vodička Josef, Třeška Vladislav, Tupý Radek, Hes Ondřej
INTRODUCTION: Benign cystic tumors represent only 2% of all pancreatic tumors (pancreatic cancer - PC). In contrast to malignant cystic tumors, these tumors occur typically in young women. A solid pseudopapillary tumor is a relatively rare affliction representing less than 4% of cystic PC. Although the tumor is considered benign, metastasis, especially to the spleen, has been reported in approximately 0.5-4% patients. Despite R0 resection, vascular and perineural invasion is monitored in 20% of cases...
2018: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/30541322/assessment-of-incidence-and-character-of-neurologic-neuropsychiatric-complications-in-a-group-of-patients-with-malignant-melanoma-treated-with-adjuvant-high-dose-interferon
#4
Prošvicová Jarmila, Grim Jiří, Kopecký Jindřich, Priester Peter, Priester Iva, Trojanová Petronela, Jílková Věra, Paulík Adam, Lukešová Šárka, Filip
BACKGROUND: Authors describe the incidence and character of neurologic and neuropsychiatric complications - particularly depression and parkinsonism - during adjuvant treatment of malignant melanoma (MM) with high dose interferon (HDI). Among the most frequently observed side effects are fatigue, hematotoxicity, and hepatotoxicity. Most research has been directed at depression and parkinsonism because of the lack of literature concerning these complications. Interferon induced parkinsonism has only been described rarely and only in case reports...
2018: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/30541320/psychoneuroimmunology-of-cancer-recent-findings-and-perspectives
#5
Mravec Boris, Tibenský Miroslav, Horváthová Ľubica
BACKGROUND: Gallen observed that psychosocial factors influence tumor incidence. Findings of the last decades have enabled us to understand the mechanisms and pathways responsible for this influence. Ader, Solomon, Besedovsky, and other pioneers of psychoneuroimmunology demonstrated that the nervous system can regulate the activity of immune cells. Based on their findings, the mechanisms via which psychosocial stressors potentiate tumor growth indirectly through inhibition of anti-tumor immune cells have been reported...
2018: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/30541319/the-significance-of-brafv600e-mutation-in-thyroid-cancer-in-terms-of-novel-targeted-therapies-overview-of-current-knowledge-and-studies
#6
Jakubíková Iva, Gabalec Filip, Beránek Martin, Žák Pavel, Čáp Jan
BACKGROUND: About 50% of papillary thyroid cancers, the most common type of all thyroid malignancies, harbor the BRAFV600E mutation. The prognostic value of this mutation is still under debate, but according to many studies, the BRAF mutation significantly downregulates genes involved in the iodine metabolism of tumor follicular cells. This mutation can be also found in some dedifferentiated and anaplastic thyroid cancers, which raises the issue of the selective advantage of novel targeted therapies...
2018: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/30541317/pregnancy-and-ovarian-stimulation-in-the-patients-with-breast-cancer
#7
Dostálek Lukáš, Pavlišta David, Mašata Jaromír
BACKGROUND: Total 19% of patients diagnosed with breast cancer are younger than 50 years. Many of these patients will have postponed pregnancy into later life and many clinicians, who take care of these patients with mutations in tumor-suppressor genes, such as BRCA2, BRCA1, CHEK2, and others, recommend that it is better not to have a child than take the risk of developing a relapse. However, this recommendation can significantly reduce quality of life. AIM: The purpose of this article was to answer the most common questions that clinicians are confronted with when dealing with breast cancer patients who express a desire to have a child later in life...
2018: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/30537555/assessment-of-postoperative-outcomes-in-spinal-epidural-abscess-following-surgical-decompression
#8
Leonard J Keller, Vincent J Alentado, Joseph E Tanenbaum, Bryan S Lee, Amy S Nowacki, Edward C Benzel, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: A spinal epidural abscess (SEA) is a serious condition that may be managed with antibiotics alone or with decompressive surgery combined with antibiotics. PURPOSE: The objectives of this study were to assess the clinical outcomes of SEA after surgical management and to identify the patient-level factors that are associated with outcomes following surgical decompression and removal of SEA. STUDY DESIGN/SETTING: Retrospective chart review analysis...
December 8, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/30531332/-management-of-duodenal-trauma-a-retrospective-review-from-the-pan-american-trauma-society
#9
Paula Ferrada, Luke Wolfe, Juan Duchesne, Gustavo P Fraga, Elizabeth Benjamin, Agustin Alvarez, Andre Campbell, Christopher Wybourn, Alberto García, Carlos Morales, Julieta Correa, Bruno M Pereira, Marcelo Ribeiro, Martha Quiodettis, Gregory Peck, Juan C Salamea, Vitor F Kruger, Rao Ivatury, Thomas Scalea
INTRODUCTION: The operative management of duodenal trauma remains controversial. Our hypothesis is that a simplified operative approach could lead to better outcomes. METHODS: We conducted an international multicenter study, involving thirteen centers. We performed a retrospective review from January 2007 to December of 2016. Data on demographics, mechanism of trauma, blood loss, operative time, and associated injured organs were collected. Outcomes included post-operative intra-abdominal sepsis, leak, need for unplanned surgery, length of stay, renal failure and mortality...
December 6, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/30529786/paraspinal-muscle-cross-sectional-area-predicts-low-back-disability-but-not-pain-intensity
#10
Tom A Ranger, Flavia M Cicuttini, Tue Secher Jensen, Stephane Heritier, Donna M Urquhart
BACKGROUND AND CONTEXT: The lumbar paraspinal muscles, including the erector spinae and multifidus, play an important role in movement and control of the spine. However, our understanding of their contribution to low back pain and disability is unclear. Systematic reviews have reported conflicting evidence for an association between paraspinal muscle size and low back pain, and a paucity of data examining muscle cross-sectional area and low back disability. PURPOSE: To investigate the relationship between paraspinal muscle cross-sectional area and both low back pain intensity and disability...
December 7, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/30526039/the-meanings-of-pediatric-drug-development
#11
Klaus Rose, Jane M Grant-Kels
Pediatric drug development (PDD) became an industry goal when the Food and Drug Administration (FDA) granted patent extensions. This was later expanded to obligations for pediatric studies and to the European Medicines Agency's (EMA's) strict pediatric investigation plans (PIPs). Industry now sponsors many often international studies in young patients that are difficult or impossible to recruit. PDD's intellectual foundations characterize children as "therapeutic orphans," allegedly discriminated in drug treatment and development...
December 9, 2018: Therapeutic Innovation & Regulatory Science
https://www.readbyqxmd.com/read/30521983/reasonable-expectations-of-privacy-in-non-disclosure-of-familial-genetic-risk-what-is-it-reasonable-to-expect
#12
Victoria Chico
Where there is conflict between a patient's interests in non-disclosure of their genetic information to relatives and the relative's interest in knowing the information because it indicates their genetic risk, clinicians have customarily been able to protect themselves against legal action by maintaining confidence even if, professionally, they did not consider this to be the right thing to do. In ABC v St Georges Healthcare NHS Trust ([2017] EWCA Civ 336) the healthcare team recorded their concern about the wisdom of the patient's decision to withhold genetic risk information from his relative, but chose to respect what they considered to be an unwise choice...
December 3, 2018: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/30517719/fresh-transfer-of-day-5-slow-growing-embryos-versus-deferred-transfer-of-vitrified-fully-expanded-day-6-blastocysts-which-is-the-optimal-approach
#13
Samer Tannus, Yoni Cohen, Sara Henderson, Na'ama Al Ma'mari, Tal Shavit, Weon-Young Son, Michael H Dahan
STUDY QUESTION: In IVF cycles in which the entire embryo cohort is slow growing, is it optimal to perform fresh transfer in Day 5 or to extend the culture and transfer in subsequent vitrified-warmed cycles? SUMMARY ANSWER: The outcomes depend on the degree of embryo development on Day 5. WHAT IS KNOWN ALREADY: Slow-growing blastocysts have lower implantation potential when transferred in fresh cycles. It has been suggested that embryo-endometrial asynchrony could explain this finding...
December 4, 2018: Human Reproduction
https://www.readbyqxmd.com/read/30517678/what-was-the-fate-of-human-embryos-following-long-term-cryopreservation-%C3%A2-12-years-and-frozen-embryo-transfer
#14
Yuan Yuan, Qingyun Mai, Jiaxuan Ma, Mingfen Deng, Yanwen Xu, Guanglun Zhuang, Canquan Zhou
STUDY QUESTION: Do human embryos survive long-term cryopreservation (CP) (≥12 years) and implant after frozen embryo transfer (ET)? SUMMARY ANSWER: Human embryos remain usable after long-term CP. WHAT IS KNOWN ALREADY: Several cohort studies have reported the live birth rate or neonatal outcomes of human embryos after CP for up to 5 years. Only a few case reports have described successful live births from human embryos after long-term CP up to 12 years...
December 4, 2018: Human Reproduction
https://www.readbyqxmd.com/read/30514304/varying-viewpoints-of-belgian-stakeholders-on-models-of-interhospital-collaboration
#15
Melissa De Regge, Kaat De Pourcq, Paul Gemmel, Carine Van de Voorde, Koen Van den Heede, Kristof Eeckloo
BACKGROUND: Hospitals are increasingly parts of larger care collaborations, rather than individual entities. Organizing and operating these collaborations is challenging; a significant number do not succeed, as it is difficult to align the goals of the partners. However, little research has focused on stakeholders' views regarding hospital collaboration models or on whether these views are aligned with those of hospital management. This study explores Belgian hospital stakeholders' views on the factors affecting hospital collaborations and their perspectives on different models for Belgian interhospital collaboration...
December 4, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/30511634/basic-open-surgical-training-course
#16
John Brochorst Christensen, Erika Nodin, Diana Zetner Bach, Anja Fabrin, Ebbe Thingaard
INTRODUCTION: Fewer open surgical procedures are performed, and thus a need to learn open surgical techniques outside the operating room has emerged. Simulation training offers the possibility to train in a safe environment before operating on patients. The purpose of this study is to evaluate the effect of a simulation-based course in basic open surgical skills and to describe its pedagogical foundation, content and organisation. METHODS: Surgical trainees at the beginning of their surgical career participated in a basic open surgical skills course and were assessed before the course, after the course and during a one-day course operating on live sedated pigs using the Objective Structures Assessment of Technical Skills (OSATS) instrument...
December 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/30509386/the-immunobiology-of-female-predominance-in-primary-biliary-cholangitis
#17
REVIEW
Alessio Gerussi, Laura Cristoferi, Marco Carbone, Rosanna Asselta, Pietro Invernizzi
Primary biliary cholangitis (PBC) is an autoimmune liver disease with a striking female preponderance. The mechanisms behind this predominance are still to be elucidated, although multiple theories have been postulated and investigated. Among the proposed involved factors, sex hormones have been the first to be studied, but unfortunately data have been inconclusive or conflicting. Similarly, fetal microchimerism has received a huge attention in the past, but data in PBC have been unsatisfactory especially if compared to other autoimmune diseases like systemic lupus erythematosus...
December 2018: Journal of Autoimmunity
https://www.readbyqxmd.com/read/30505754/saphenous-vein-as-a-composite-graft-from-the-internal-thoracic-artery
#18
EDITORIAL
Ho Young Hwang, Ki-Bong Kim
The saphenous vein (SV) has been used as an aortocoronary bypass graft for coronary artery bypass grafting (CABG) for the past 50 years. However, CABG using the aortocoronary SV has shown disadvantages of lower long-term graft patency rates and subsequently worse clinical outcomes, compared with CABG using the internal thoracic artery (ITA). The advantages of CABG using the ITA prompted interest in total arterial revascularization, using the bilateral ITAs and other arterial conduits as composite graft configurations in patients exhibiting multi-vessel disease...
September 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/30500464/a-web-based-platform-to-accommodate-symptoms-of-anxiety-and-depression-by-featuring-social-interaction-and-animated-information-in-patients-undergoing-lumbar-spine-fusion-a-randomized-clinical-trial
#19
Janni Strøm, Claus Vinther Nielsen, Lene Bastrup Jørgensen, Niels Trolle Andersen, Malene Laursen
BACKGROUND: Approximately one-third of patients undergoing spine surgery have symptoms of anxiety and depression that correlate with pain, disability, and lower health-related quality of life. The use of web-based informative strategies before surgery and principles from cognitive behavioral therapy, have been applied in other patient groups, facilitating mobility and encouraging beneficial coping behavior. PURPOSE: To examine the effect of a web-based Spine Platform featuring Interaction and Information by Animation (w-SPIINA) on symptoms of anxiety and depression, pain, disability, and health-related quality of life...
November 27, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/30499435/how-should-clinicians-engage-with-online-health-information
#20
Dónal P O'Mathúna
Many adults, physicians, and medical students search the internet for health information. Open access has many benefits, but the variable quality of internet health information-ranging from evidence based to false-raises ethical concerns. Using Wikipedia as a case study, this article argues that everyone engaging with internet health information has ethical responsibilities. Those hosting and writing for health websites should ensure that information is evidence based, accurate, up to date, and readable and be transparent about conflicts of interest...
November 1, 2018: AMA Journal of Ethics
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