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Clinical protocols

Saar van T Hof, Alexander R Delaney, Hilâl Tekatli, Jos Twisk, Ben J Slotman, Suresh Senan, Max Dahele, Wilko Far Verbakel
PURPOSE: Stereotactic ablative body radiotherapy (SABR) for lung tumors ≥5cm, can be associated with more toxicity. We investigated the relationship between dosimetry and toxicity and used a knowledge-based planning solution to retrospectively perform individualized treatment plan quality assurance (QA) with the aim of identifying where planning could have been improved. MATERIAL AND METHODS: Prior retrospective analysis of 53 patients with primary or recurrent non-small cell lung cancer ≥5cm, treated with 5 or 8-fraction volumetric modulated arc therapy SABR, between 2008-2014, showed 30% ≥grade (G) 3 toxicity...
August 13, 2018: International Journal of Radiation Oncology, Biology, Physics
Giuseppe Paglia, M Fabiola Del Greco, Baldur B Sigurdsson, Johannes Rainer, Chiara Volani, Andrew A Hicks, Peter P Pramstaller, Sigurdur V Smarason
BACKGROUND: Plasma and serum are the most widely used matrices in clinical studies. However, some variability in absolute concentrations of metabolites are likely to be observed in these collection tubes matrices. METHODS: We analyzed 189 metabolites using the same protocol for quantitative targeted metabolomics (LC-MS/MS AbsoluteIDQ p180 Kit Biocrates) in three types of samples, serum, plasma EDTA and citrate, of 80 subjects from the Cooperative Health Research In South Tyrol cohort (40 healthy elderly and 40 healthy young)...
August 13, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Andrew J Sinnamon, Jason K C Tong, Elizabeth A Bailey, Caitlin Brown, Latesha Colbert, Shannon Murray, Benjamin M Jackson, Robert E Roses
BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE) remains a major cause of perioperative morbidity and mortality despite implementation of prophylaxis guidelines. We sought to identify risk factors for occult deep venous thrombosis (DVT) following abdominal surgery for cancer and measure the clinical impact of a prospectively implemented standardized postoperative DVT screening protocol. METHODS: Patients undergoing abdominal surgery for malignant indication were screened with early postoperative lower extremity duplex to identify DVT...
August 16, 2018: Journal of Surgical Oncology
Lenneke Minjon, Els van den Ban, Emma de Jong, Toine C G Egberts, Eibert R Heerdink
BACKGROUND: It is unclear how youth treated with antipsychotics are monitored. The purpose of this study was to assess monitoring of metabolic, cardiac, and endocrine indicators in youth (<18 years old) treated with antipsychotics as reported by health care professionals in the Netherlands. METHODS: A questionnaire was designed to collect information from health care professionals regarding the monitoring of youth treated with antipsychotics. Data were collected at a national conference...
August 15, 2018: Journal of Clinical Psychopharmacology
Ferenc Kálovits, Márton Tompa, Ádám Nagy, Bernadette Kálmán
Background and purpose: Oncogenesis is related to a sequential accumulation of somatic mutations. Comprehensive characterizations of the genomic landscapes have been completed recently for several tumors, glioblastoma being among the first ones. Our own translational research studies have been focused on defining molecular subtypes of glioblastoma in the clinical setting because of an expected prognostic and therapeutic utility of the information. Somatic mutations in genes of the isocitrate dehydrogenase (IDH) enzyme family appear to be among the best-defined biomarkers that also influence tumor behavior and confer clinical utility...
July 30, 2018: Ideggyógyászati Szemle
M Daix, P Dillies, A Gueuning, L Watkins-Masters, F Gielen
The primary vaginal melanoma is a rare aggressive tumour with a poor prognosis. The average age at diagnosis is 60, and there are no known risk factors. The establishment of a classification system and treatment protocols are made difficult because there are so few cases. The 5-year survival rate is estimated at no more than ten per cent. We report a case of an inoperable primary vaginal melanoma in a 58-year old woman. There were metastatic lymph nodes in the lumbo-aortic region, but no extension to bone or viscera...
July 2018: Revue Médicale de Liège
K M Gallagher, E Christopher, A J Cameron, S Little, A Innes, G Davis, J Keanie, P Bollina, S A McNeill
OBJECTIVES: This study aimed to report outcomes from a multi-parametric MRI (MP-MRI) based active surveillance programme that did not perform protocol biopsies after the first confirmatory biopsy. PATIENTS AND METHODS: All patients diagnosed with Gleason 3+3 prostate cancer because of a raised PSA who had MP-MRI scan after diagnosis were included. Patients were recorded in a prospective clinical database and followed up with PSA monitoring and repeat MRI scans. In patients who remained on active surveillance after the first MRI +/- confirmatory biopsy we investigated PSA dynamics for association with subsequent progression...
August 16, 2018: BJU International
Flavio Dell'Acqua, J-Donald Tournier
Since the realization that diffusion MRI can probe the microstructural organization and orientation of biological tissue in vivo and non-invasively, a multitude of diffusion imaging methods have been developed and applied to study the living human brain. Diffusion tensor imaging was the first model to be widely adopted in clinical and neuroscience research, but it was also clear from the beginning that it suffered from limitations when mapping complex configurations, such as crossing fibres. In this review, we highlight the main steps that have led the field of diffusion imaging to move from the tensor model to the adoption of diffusion and fibre orientation density functions as a more effective way to describe the complexity of white matter organization within each brain voxel...
August 16, 2018: NMR in Biomedicine
Nabil M Elkassabany, Anthony Wang, Jason Ochroch, Matthew Mattera, Jiabin Liu, Andrew Kuntz
Objectives: Pain control after shoulder arthroscopy can be challenging, often relying on opioids. The study aims to measure the quality of recovery (QoR) before and after implementation of a "Multimodal Perioperative Pain Protocol" (MP3) in patients undergoing ambulatory shoulder arthroscopy. Design: Prospective cohort study. Setting: Free-standing ambulatory surgery facility of a tertiary care academic center. Subjects: Patients undergoing ambulatory shoulder arthroscopy...
August 3, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Michael Nganga, Lucylynn Lizarondo, Jegan Krishnan, Matthew Stephenson
The objective of this review is to synthesize the best available evidence on the effectiveness of non-surgical and surgical treatment on the clinical and functional outcomes of elderly patients with full thickness rotator cuff tear.
August 2018: JBI Database of Systematic Reviews and Implementation Reports
Terra Watkins, Shelia Keller
The objectives of this scoping review are: to explore existing literature related to discharge criteria, guidelines and protocols from hospitals or clinics that are being implemented for home oxygen therapy (HOT) in the management of hypoxia in pediatric patients with acute bronchiolitis, examine and conceptually map the evidence, and identify any gaps in the literature.The question of this review is: what discharge criteria, guidelines, and protocols are used for HOT in the management of hypoxia in pediatric patients with acute bronchiolitis?...
August 2018: JBI Database of Systematic Reviews and Implementation Reports
Jin Seok Seo, Hee Seung Yang, Suk Jung, Chang Soon Kang, Sunghun Jang, Dae Hyun Kim
BACKGROUND: An assist-as-needed robot-assisted gait training protocol was recently developed. It allows active movement during training, but its exact criteria remain unknown. Asymmetric step length is a common abnormal gait pattern in hemiplegic stroke patients. We compared the effects of assist-as-needed robot-assisted gait training on the unaffected and affected limbs of hemiplegic stroke patients. METHOD: Twenty-four chronic stroke patients with asymmetric step lengths were randomly assigned to 1 of 2 groups...
August 2018: Medicine (Baltimore)
Rosicley S da Silva, Italla M P Bezerra, Carlos B M Monteiro, Fernando Adami, Hugo M F Souza, Luiz C de Abreu
To analyze the performance of nurses in the implementation of nursing care systematization (NCS). This study is a descriptive research developed from a qualitative approach. The content analysis (CA) must be developed through 3 chronological poles allowing the researcher to construct an analysis structure that corresponds to the needs of the research and the objectives of the proposed research; The chronological poles of CA are described as: Phase 1-preanalysis, phase 2-exploration of the material: phase 3-treatment of the results obtained and interpretation...
August 2018: Medicine (Baltimore)
Olubukola O Nafiu, Aleda Thompson, S Devi Chiravuri, Benjamin Cloyd, Paul I Reynolds
BACKGROUND: Many children recovering from anesthesia experience pain that is severe enough to warrant intravenous (IV) opioid treatment within moments of admission to the postanesthesia care unit (PACU). Postoperative pain has several negative consequences; therefore, preventing significant PACU pain in children is both a major clinical goal and a moral/ethical imperative. This requires identifying patient-level and perioperative factors that may be used to predict PACU IV opioid requirement...
August 14, 2018: Anesthesia and Analgesia
Doaa Taha, Sebastian Spintzyk, Ahmed Sabet, Marwa Wahsh, Tarek Salah
OBJECTIVE: This in vitro study was conducted to assess the marginal adaptation and fracture resistance of computer aided design/computer aided manufacturer (CAD-CAM) fabricated endocrowns restoring endodontically treated molars using different machinable blocks with thermomechanical loading protocols. MATERIALS AND METHODS: Devitalized mandibular molars were prepared in a standardized way and divided into 4 groups (n = 10) to receive CAD/CAM fabricated endocrowns using four materials (Lithium disilicate ceramics, polymer infiltrated ceramics, zirconia-reinforced lithium silicate ceramics and resin nanoceramics...
August 16, 2018: Journal of Esthetic and Restorative Dentistry
Shishir Keekana Rao, Advait Mahulikar, Mohammad Ibrahim, Aashit Shah, Navid Seraji-Bozorgzad, Wazim Mohamed
Status epilepticus (SE) is defined as ongoing seizures lasting longer than five minutes or multiple seizures without recovery. Benzodiazepines (BZDs) are first-line agents for the management of SE. Our objective was to evaluate BZD dosing in SE patients and its effects on clinical/electrographic outcomes. A retrospective analysis was conducted from a prospective database of SE patients admitted to a university-based neurocritical care unit. The initial presentation and progression to refractory SE (RSE) and non-convulsive SE (NCSE) with coma was evaluated...
August 1, 2018: Epileptic Disorders: International Epilepsy Journal with Videotape
Douglas John Matthews, Mateen Arastu, Maggie Uden, John Paul Sullivan, Kristina Bolsakova, Kingsley Robinson, Sellaiah Sooriakumaran, David Ward
BACKGROUND: Amputation of a limb impacts on patients' self-perception and quality of life. Prostheses directly anchored to the skeleton are being investigated, aiming to avoid soft tissue complications. OBJECTIVES: We report outcome data for the UK trial of the Osseointegrated Prosthesis for the Rehabilitation of Amputees Implant System with a minimum of 9-year follow-up. METHODS: Eighteen transfemoral amputees received unilateral implants between 1997 and 2008...
August 16, 2018: Prosthetics and Orthotics International
Jingjing Zhang, Svetlana Markova, Alejandro Garcia, Kirk Huang, Xingyu Nie, Wookjin Choi, Wei Lu, Abraham Wu, Andreas Rimner, Guang Li
PURPOSE: The purpose of this study was to evaluate the quality of automatically propagated contours of organs at risk (OARs) based on respiratory-correlated navigator-triggered four-dimensional magnetic resonance imaging (RC-4DMRI) for calculation of internal organ-at-risk volume (IRV) to account for intra-fractional OAR motion. METHODS AND MATERIALS: T2-weighted RC-4DMRI images were of 10 volunteers acquired and reconstructed using an internal navigator-echo surrogate and concurrent external bellows under an IRB-approved protocol...
August 15, 2018: Journal of Applied Clinical Medical Physics
Yoshito Takeuchi, Yasuaki Arai, Miyuki Sone, Shunsuke Sugawara, Takeshi Aramaki, Rui Sato, Kimihiko Kichikawa, Toshihiro Tanaka, Hiroyuki Morishita, Takaaki Ito, Koichiro Yamakado, Yasutaka Baba, Takeshi Kobayashi
PURPOSE: Vena cava syndrome (VCS) from stenosis of the superior vena cava or inferior vena cava caused by compression from a malignant tumor is one of the typical clinical conditions in patients with advanced stage malignant disease. VCS is difficult to manage and painful, reducing patients' quality of life. Although several reports have investigated stent placement for VCS, this treatment has never been established as the standard because of the lack of evidence of the safety and efficacy...
August 15, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Robertino Dilena, Jacopo C DiFrancesco, Maria Virginia Soldovieri, Antonella Giacobbe, Paolo Ambrosino, Ilaria Mosca, Maria Albina Galli, Sophie Guez, Monica Fumagalli, Francesco Miceli, Dario Cattaneo, Francesca Darra, Elena Gennaro, Federico Zara, Pasquale Striano, Barbara Castellotti, Cinzia Gellera, Costanza Varesio, Pierangelo Veggiotti, Maurizio Taglialatela
Epilepsy of infancy with migrating focal seizures (EIMFS) is a rare early-onset developmental epileptic encephalopathy resistant to anti-epileptic drugs. The most common cause for EIMFS is a gain-of-function mutation in the KCNT1 potassium channel gene, and treatment with the KCNT1 blocker quinidine has been suggested as a rational approach for seizure control in EIMFS patients. However, variable results on the clinical efficacy of quinidine have been reported. In the present study, we provide a detailed description of the clinical, genetic, in vitro, and in vivo electrophysiological profile and pharmacological responses to quinidine of 2 EIMFS unrelated patients with a heterozygous de novo KCNT1 mutation: c...
August 15, 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
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