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Observation management

M Pinart, F Kunath, V Lieb, I Tsaur, B Wullich, Stefanie Schmidt
PURPOSE: Prognostic models are developed to estimate the probability of the occurrence of future outcomes incorporating multiple variables. We aimed to identify and summarize existing multivariable prognostic models developed for predicting overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC). METHODS: The protocol was prospectively registered (CRD42017064448). We systematically searched Medline and reference lists up to May 2018 and included experimental and observational studies, which developed and/or internally validated prognostic models for mCRPC patients and were further externally validated or updated...
December 15, 2018: World Journal of Urology
Victor Bouteleux, Laurent Kodjikian, Maud Mendes, Emilie Agard, Zaïnab Machkour-Bentaleb, Hussam El-Chehab, Philippe Denis, Thibaud Mathis, Corinne Dot
PURPOSE: The main objective of this study was to assess choroidal thickness (CT) changes during an exudative recurrence of age-related macular degeneration (AMD). METHODS: A real-life prospective non-interventional 9-month study was conducted in two centers in consecutive patients with exudative AMD between November 2016 and July 2017. CT was measured manually in both eyes based on enhanced-depth imaging spectral-domain optical coherence tomography at different follow-up visits scheduled in the morning...
December 16, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Satoru Yamaguchi, Kinro Sasaki, Hiroyuki Kato, Shin Fukudo, Ryuichi Iwakiri, Takeshi Kamiya, Satoshi Motoya, Kazunari Murakami, Akihito Nagahara, Hidekazu Suzuki, Toshio Watanabe, Shin'ichi Takahashi, Francis K L Chan, Ki-Baik Hahm, Udom Kachintorn, Fock Kwong Ming, Abdul Aziz Rani, Jose D Sollano, Qi Zhu
BACKGROUND/AIMS: To elucidate the current management of ulcerative colitis (UC)-associated cancer, a questionnaire-based survey was conducted to gather current opinions on colitis-associated cancer in different East Asian countries. METHODS: The questionnaire, based on physicians, contains 9 questions focused on UC management and cancer surveillance. In addition, the questionnaire based on neoplastic cases, which contains 17 questions, was collected and analyzed...
December 14, 2018: Digestion
Ben Mathews
BACKGROUND: Child sexual abuse is undisclosed for many reasons that are resistant to change. Citizens can play an important role in disclosing cases of child sexual abuse to authorities. Professionals who deal with children also play a crucial role. Office-holders in organisations have a clear responsibility to prevent cover-ups of sexual abuse. Recently, some countries have created important new legal duties for adults to disclose child sexual abuse. OBJECTIVES: This article creates a contemporary taxonomy of duties to disclose cases of child sexual abuse, and explains their nature and justification...
December 13, 2018: Child Abuse & Neglect
Christian S Marchello, Mark H Ebell, Brian McKay, Ye Shen, Eric T Harvill, Christopher C Whalen
BACKGROUND: Uncomplicated episodes of prolonged acute cough are usually viral and self-limited, but despite evidence and recommendations to the contrary, they are often treated with antibiotics. METHODS: Mixed cross-sectional and prospective observational study of adults 18 years or older presenting to two urgent care centers with a cough of 7 to 56 days as their chief complaint. Factors associated with cough duration and clinical decisions were analyzed by univariate and multivariate logistic regression...
December 6, 2018: American Journal of Emergency Medicine
Rakesh M Suri, Hoda Javadikasgari, David A Heimansohn, Neil J Weissman, Gorav Ailawadi, Niv Ad, Gabriel S Aldea, Vinod H Thourani, Wilson Y Szeto, Robert E Michler, Hector I Michelena, Reza Dabir, Gregory P Fontana, William F Kessler, Michael G Moront, Louis A Brunsting, Bartley P Griffith, Alvaro Montoya, Sreekumar Subramanian, Mark A Mostovych, Eric E Roselli
OBJECTIVES: We performed a prospective, single-arm clinical trial approved under a Food and Drug Administration Investigational Device Exemption to assess safety and efficacy of Perceval, a sutureless bovine pericardial aortic valve representing the initial US experience. METHODS: From June 2013 to January 2015, 300 patients (mean age 76.7 ± 7.7 years, 54.3% men, 37.3% ≥80 years, median Society of Thoracic Surgeons Predicted Risk of Mortality 2.8%), underwent Perceval valve implantation at 18 centers across the United States...
October 23, 2018: Journal of Thoracic and Cardiovascular Surgery
Jean-Charles Pasquier, Olivier Claris, Muriel Rabilloud, René Ecochard, Jean-Charles Picaud, Stéphanie Moret, Danielle Buch, Georges Mellier
OBJECTIVES: Preterm premature rupture of fetal membranes (PPROM) exposes the fetus to preterm birth, and optimal timing for delivery is controversial. The aim of this study was to compare intentional early delivery ("active management") with expectant management in very preterm birth (28-32 weeks). STUDY DESIGN: We conducted a prospective randomized controlled trial with intent-to-treat analysis, at 19 tertiary-care hospitals in France and 1 in Geneva, Switzerland...
December 5, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Perrine Capmas, Anina Lobersztajn, Laura Duminil, Tiphaine Barral, Anne-Gaëlle Pourcelot, Hervé Fernandez
Retained product of conception complicates nearly 1% of pregnancies and can lead to synechiae and compromise ulterior fertility. The aim of this study is to evaluate efficiency of operative hysteroscopy in management of retained products of conception (RPOC). Secondary objectives are assessments of intra-uterine adhesions rate and later fertility. This unicentric retrospective study includes women who undertook an operative hysteroscopy for retained products of conception between January 2012 and March 2014...
December 12, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Angélica Aponte, R Patricia Penilla, Américo D Rodríguez, Clara B Ocampo
In Colombia Aedes (Stegomyia) aegypti is the main vector of urban arboviruses such as dengue, chikungunya and Zika. This urban mosquito has a well-established capacity to develop insecticide resistance to different types of insecticides (pyrethroids, organochlorides, organophosphates), using multiple resistance mechanisms. An understanding of ongoing resistance mechanisms is critical to determining the activities of vector control programs. In order to identify the biochemical and molecular mechanisms associated with pyrethroid resistance in Colombia, three laboratory-selected strains resistant to DDT, Propoxur and lambdacyhalothrin, and 7 field-collected strains were evaluated...
December 12, 2018: Acta Tropica
G Gatt, N Attard
AIM: To determine the influence of erosive tooth wear in the primary dentition on parental perceptions of oral health. METHODS: This cross-sectional study involved a standardised clinical examination of 775 preschool aged children and a parent-administered questionnaire. Erosive tooth wear was measured using the Basic Erosive Wear Examination Index. RESULTS: 71% and 81% of 3 (n = 256) and 5 year-old children (n = 337) respectively exhibited signs of erosive tooth wear...
December 14, 2018: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
Wen-Chi Chou, Jen-Shi Chen, Chia-Yen Hung, Chang-Hsien Lu, Yu-Yun Shao, Tzeon-Jye Chiou, Yung-Chuan Sung, Kun-Ming Rau, Chia-Jui Yen, Su-Peng Yeh, Ta-Chih Liu, Ming-Fang Wu, Ming-Yang Lee, Ming-Sun Yu, Wen-Li Hwang, Pang-Yu Lai, Cheng-Shyong Chang, Ruey-Kuen Hsieh
PURPOSE: Poor adherence to analgesic drugs is one of the most common barriers to adequate pain management. This prospective, cross-sectional, patient-oriented observational study aimed to explore the adherence rate, clinical factors, and impact of adherence to analgesic drugs on the quality of life (QoL) among cancer outpatients in Taiwan. METHODS: Eight hundred ninety-seven consecutive adult outpatients with cancer who had reported tumor pain and received regular analgesic drug treatment were enrolled from 16 medical centers across Taiwan...
December 14, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Chul Hwan Bang, Jae Woong Yoon, Hyun Ji Lee, Jun Young Lee, Young Min Park, Suk Jun Lee, Ji Hyun Lee
Onychomycosis (OM) is a common nail disease. Although controversial, vascular diseases are considered independent predictors of OM and vice versa. Sequential pattern mining (SPM) has not been previously used for statistical analysis in dermatology, but it is an efficient method for identifying frequent association rules in multiple sequential data sets. The aim of our study was to identify the relationship between OM and vascular diseases in the real world through a population-based study using SPM. We obtained population-based data recorded from 2002 to 2013 by the Health Insurance Research and Assessment Agency...
December 14, 2018: Scientific Reports
Shobi Sivathamboo, Sarah Farrand, Zhibin Chen, Elise J White, Andrew Andreas Pattichis, Callum Hollis, John Carino, Caitlin J Roberts, Thomas Minogue, Nigel C Jones, Raju Yerra, Christopher French, Piero Perucca, Patrick Kwan, Dennis Velakoulis, Terence J O'Brien, Jeremy Goldin
OBJECTIVE: To examine the prevalence and risk factors of sleep-disordered breathing (SDB) in individuals with epilepsy and psychogenic nonepileptic seizures (PNES). METHODS: We conducted a cross-sectional study of consecutive patients admitted for inpatient video-EEG monitoring at The Royal Melbourne Hospital, Australia, between December 1, 2011, and July 31, 2017. Participants underwent routine clinical investigations during their monitoring period including polysomnography, neurocognitive testing, and screening instruments of daytime somnolence, sleep quality, and quality of life...
December 14, 2018: Neurology
Julie Woodfield, Ingrid Hoeritzauer, Aimun A B Jamjoom, Savva Pronin, Nisaharan Srikandarajah, Michael Poon, Holly Roy, Andreas K Demetriades, Philip Sell, Niall Eames, Patrick F X Statham
INTRODUCTION: Cauda equina syndrome (CES) is a potentially devastating condition caused by compression of the cauda equina nerve roots. This can result in bowel, bladder and sexual dysfunction plus lower limb weakness, numbness and pain. CES occurs infrequently, but has serious potential morbidity and medicolegal consequences. This study aims to identify and describe the presentation and management of patients with CES in the UK. METHODS AND ANALYSIS: Understanding Cauda Equina Syndrome (UCES) is a prospective and collaborative multicentre cohort study of adult patients with confirmed CES managed at specialist spinal centres in the UK...
December 14, 2018: BMJ Open
Xiang-Dong Wu, Meng-Meng Liu, Ya-Ying Sun, Zhi-Hu Zhao, Quan Zhou, Joey S W Kwong, Wei Xu, Mian Tian, Yao He, Wei Huang
INTRODUCTION: Joint arthroplasty is a particularly complex orthopaedic surgical procedure performed on joints, including the hip, knee, shoulder, ankle, elbow, wrist and even digit joints. Increasing evidence from volume-outcomes research supports the finding that patients undergoing joint arthroplasty in high-volume hospitals or by high-volume surgeons achieve better outcomes, and minimum case load requirements have been established in some areas. However, the relationships between hospital/surgeon volume and outcomes in patients undergoing arthroplasty are not fully understood...
December 14, 2018: BMJ Open
Grace Joshy, Emily Banks, Anthony Lowe, Rory Wolfe, Leonie Tickle, Bruce Armstrong, Mark Clements
OBJECTIVES: To develop and validate a prediction model for short-term mortality in Australian men aged ≥45years, using age and self-reported health variables, for use when implementing the Australian Clinical Practice Guidelines for Prostate-Specific Antigen (PSA) Testing and Early Management of Test-Detected Prostate Cancer. Implementation of one of the Guideline recommendations requires an estimate of 7-year mortality. DESIGN: Prospective cohort study using questionnaire data linked to mortality data...
December 14, 2018: BMJ Open
Nina-Sophie Schmidt-Hegemann, Eze Chukwuka, Li Minglun, Paul Rogowski, Christian Schaefer, Christian Stief, Alexander Buchner, Constantinos Zamboglou, Wolfgang P Fendler, Ute Ganswindt, Clemens Cyran, Peter Bartenstein, Claus Belka, Harun Ilhan
68 Gallium-prostate-specific membrane antigen positron emission tomography/computed tomography (68 Ga-PSMA PET/CT) offers unprecedented accuracy for staging of primary, persistent or recurrent prostate cancer. Thus, we hypothesized that PSMA PET/CT prior to radiotherapy significantly impacts the radiotherapeutic approach in comparison to the current standard of CT based approach. Methods: Between February 2014 and December 2017, a total of 172 patients received PSMA PET/CT before radiotherapy and were included in this retrospective analysis...
December 14, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Helena C Lyson, Sara Ackerman, Courtney Lyles, Dean Schillinger, Pamela Williams, Gato Gourley, Reena Gupta, Margaret Handley, Urmimala Sarkar
BACKGROUND: Team-based care is an innovative approach to primary care in which groups of health care professionals work collaboratively to manage care for groups of patients. Safety-net organizations face specific barriers to implementing health care innovations. More research is needed that documents the dynamics that inform implementation and sustainment of innovative practices in the safety net. METHODS: We conducted qualitative fieldwork, including purposeful observation and semi-structured and informal interviews, to explore the implementation of care teams in safety-net clinics in California...
December 11, 2018: Healthcare
Cleveland G Shields, Lindsay N Fuzzell, Sharon L Christ, Marianne S Matthias
OBJECTIVE: Our objective is to examine the relationship of patient and provider characteristics and communication with chronic non-cancer pain and opioid management in primary care. METHOD: We conducted an observational study using audio-recorded primary care appointments (up to 3/patient) and self-reported assessments of primary care providers (PCPs) and patients. We coded visit transcripts for 1) opioid and pain management talk and 2) mental health and opioid safety talk...
December 3, 2018: Patient Education and Counseling
Valentina Fanotto, Lorenzo Fornaro, Roberto Bordonaro, Gerardo Rosati, Lorenza Rimassa, Samantha Di Donato, Daniele Santini, Gianluca Tomasello, Francesco Leone, Nicola Silvestris, Silvia Stragliotto, Mario Scartozzi, Riccardo Giampieri, Federico Nichetti, Lorenzo Antonuzzo, Saverio Cinieri, Antonio Avallone, Antonio Pellegrino, Davide Melisi, Enrico Vasile, Lorenzo Gerratana, Giuseppe Aprile
OBJECTIVES: Although gastric cancer (GC) incidence rises with age, older patients are poorly represented in clinical trials, whose results are therefore difficult to translate into standard management of older patients. Purpose of this study was to compare clinico-pathological features and survival outcomes between older and non-older patients with advanced GC treated with at least two chemotherapy lines. MATERIALS AND METHODS: Clinico-pathological characteristics, basal values, and treatment data of older (≥70 years at second-line start) and non-older patients were compared using chi-square test or 2-tailed Fisher exact test...
December 11, 2018: Journal of Geriatric Oncology
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