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https://www.readbyqxmd.com/read/28645203/neurosurgical-randomized-controlled-trials-distance-travelled
#1
Tej D Azad, Anand Veeravagu, Vaishali Mittal, Rogelio Esparza, Eli Johnson, John P A Ioannidis, Gerald A Grant
BACKGROUND: The evidence base for many neurosurgical procedures has been limited. We performed a comprehensive and systematic analysis of study design, quality of reporting, and trial results of neurosurgical randomized controlled trials (RCTs). OBJECTIVE: To systematically assess the design and quality characteristics of neurosurgical RCTs. METHODS: From January 1961 to June 2016, RCTs with >5 patients assessing any 1 neurosurgical procedure against another procedure, nonsurgical treatment, or no treatment were retrieved from MEDLINE, Scopus, and Cochrane Library...
June 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28645194/predictors-of-treatment-response-and-survival-outcomes-in-meningioma-recurrence-with-atypical-or-anaplastic-histology
#2
Muhammad O Chohan, Christopher T Ryan, Ranjodh Singh, Ryan M Lanning, Anne S Reiner, Marc K Rosenblum, Viviane Tabar, Philip H Gutin
BACKGROUND: Recurrence rates for atypical and anaplastic meningiomas range between 9% and 50% after gross total resection and between 36% and 83% after subtotal resection. Optimal treatment of recurrent meningiomas exhibiting atypical/anaplastic histology is complicated because they are often refractory to both surgery and radiation. OBJECTIVE: To evaluate clinical determinants of recurrence and treatment-specific outcomes in patients with recurrent meningiomas exhibiting atypical/anaplastic histology at our institution...
June 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28645105/a-three-gene-immunohistochemical-panel-serves-as-an-adjunct-to-clinical-staging-of-patients-with-head-and-neck-cancer
#3
Chin-Ann J Ong, Nicholas B Shannon, Stefan Mueller, Sze Min Lek, Xuan Qiu, Fui Teen Chong, Ke Li, Kelvin K N Koh, Gerald C A Tay, Thakshayeni Skanthakumar, Jacqueline S G Hwang, Tony Kiat Hon Lim, Mei Kim Ang, Daniel S W Tan, Ngian-Chye Tan, Hiang Khoon Tan, Khee Chee Soo, N Gopalakrishna Iyer
BACKGROUND: Current management of head and neck squamous cell carcinoma (HNSCC) depends on tumor staging. Despite refinements in clinical staging algorithms, outcomes remain unchanged for the last two decades. In this study, we set out to identify a small, clinically applicable molecular panel to aid prognostication of patients with HNSCC. MATERIALS AND METHODS: Data from The Cancer Genome Atlas (TCGA) was used to derive copy number aberrations and expression changes to identify putative prognostic genes...
June 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28645047/neurological-condition-assessed-with-the-hempel-examination-and-cognition-and-behaviour-at-4years
#4
Pamela Schendelaar, Jorien Seggers, Maas Jan Heineman, Mijna Hadders-Algra
AIM: To investigate associations between neurological condition, assessed with the Hempel examination, in terms of minor neurological dysfunction (MND) and neurological optimality, and cognition and behaviour at 4years. STUDY DESIGN: Cross-sectional analyses within a prospective, assessor-blinded follow-up study. SUBJECTS: Four-year-old singletons born to subfertile parents (n=235; 120 boys). OUTCOME MEASURES: Outcome parameters were complex minor neurological dysfunction (complex MND) and the neurological optimality score (NOS)...
June 20, 2017: Early Human Development
https://www.readbyqxmd.com/read/28644931/quadrigia-and-productivity
#5
John Ingraham
Financial productivity in academic surgery is important and deserves great emphasis, yet it is but one of many vital elements of a healthy practice. Productivity must be carefully balanced with many other vital goals such as maximizing patient safety, maintaining excellent outcomes, optimizing resident and medical student education, and earning outstanding patient feedback. The following editorial explores this elusive balance and the importance of not swaying too far in the direction of revenue.
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644862/high-intensity-corneal-collagen-crosslinking-with-riboflavin-and-uva-in-rat-cornea
#6
Yirui Zhu, Peter S Reinach, Hanlei Zhu, Qiufan Tan, Qinxiang Zheng, Jia Qu, Wei Chen
Corneal collagen cross-linking (CXL) halts human corneal ectasias progression by increasing stromal mechanical stiffness. Although some reports describe that this procedure is effective in dealing with some infectious and immunologic corneal thinning diseases, there is a need for more animal models whose corneal thickness more closely resemble those occurring in these patients. To meet this need, we describe here high-intensity protocols that are safe and effective for obtaining CXL in rat corneas. Initially, a range of potentially effective UVA doses were evaluated based on their effectiveness in increasing tissue enzymatic resistance to dissolution...
2017: PloS One
https://www.readbyqxmd.com/read/28644850/visceral-adiposity-index-predicts-the-conversion-of-metabolically-healthy-obesity-to-an-unhealthy-phenotype
#7
Yu Mi Kang, Chang Hee Jung, Yun Kyung Cho, Jung Eun Jang, Jenie Yoonoo Hwang, Eun Hee Kim, Woo Je Lee, Joong-Yeol Park, Hong-Kyu Kim
OBJECTIVE: Some individuals with metabolically healthy obesity (MHO) convert to metabolically unhealthy obesity (MUO) phenotype, and visceral adiposity is one of proposed mechanisms underlying such conversion. Visceral adipose index (VAI) is a novel mathematical model which estimates visceral adiposity based on anthropometric and lipid profiles. We aimed to determine the association of VAI-estimated visceral adiposity with the MHO-to-MUO conversion and the predictive value of VAI in estimating such unfavorable outcomes...
2017: PloS One
https://www.readbyqxmd.com/read/28644698/sleep-disturbance-after-hospitalization-and-critical-illness-a-systematic-review
#8
Marcus T Altman, Melissa P Knauert, Margaret A Pisani
BACKGROUND: Sleep disturbance during intensive care unit (ICU) admission is common and severe. Sleep disturbance has been observed in survivors of critical illness even after transfer out of the ICU. Not only is sleep important to overall health and well-being, but patients after critical illness are also in a physiologically vulnerable state. Understanding how sleep disturbance impacts recovery from critical illness after hospital discharge is therefore clinically meaningful. OBJECTIVE: This systematic review aimed to summarize studies that identify the prevalence of and risk factors for sleep disturbance after hospital discharge for critical illness survivors...
June 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28644693/supplemental-oxygen-in-interstitial-lung-disease-an-art-in-need-of-science
#9
Kerri A Johannson, Sachin R Pendharkar, Kirk Mathison, Charlene D Fell, Jordan A Guenette, Meena Kalluri, Martin Kolb, Christopher J Ryerson
Interstitial lung disease (ILD) comprises a large and heterogeneous group of disorders that often lead to progressive fibrosis and premature death. Oxygen supplementation is typically used in advanced lung disease patients with resting hypoxemia; however, there is a paucity of evidence guiding the use of supplemental oxygen in ILD, and significant heterogeneity in clinical practice. It remains unclear whether supplemental oxygen improves clinically meaningful outcomes, and the role of ambulatory oxygen supplementation in isolated exertional hypoxemia is particularly controversial...
June 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28644472/placing-and-shaping-liposomes-with-reconfigurable-dna-nanocages
#10
Zhao Zhang, Yang Yang, Frederic Pincet, Marc C Llaguno, Chenxiang Lin
The diverse structure and regulated deformation of lipid bilayer membranes are among a cell's most fascinating features. Artificial membrane-bound vesicles, known as liposomes, are versatile tools for modelling biological membranes and delivering foreign objects to cells. To fully mimic the complexity of cell membranes and optimize the efficiency of delivery vesicles, controlling liposome shape (both statically and dynamically) is of utmost importance. Here we report the assembly, arrangement and remodelling of liposomes with designer geometry: all of which are exquisitely controlled by a set of modular, reconfigurable DNA nanocages...
June 23, 2017: Nature Chemistry
https://www.readbyqxmd.com/read/28644188/surgical-techniques-for-total-knee-arthroplasty-measured-resection-gap-balancing-and-hybrid
#11
Neil P Sheth, Adeel Husain, Charles Lenwood Nelson
Total knee arthroplasty (TKA) is effective in managing end-stage degenerative joint disease. Achieving favorable clinical outcomes is predicated on proper implant alignment, sizing, and rotation as well as adequate soft-tissue balancing. Modern TKA implants are designed to address the fundamental needs of attaining stability in both flexion and extension and of optimizing patellar tracking. Measured resection and gap balancing are the two different techniques used to implant the TKA components used today. Both techniques have been validated as durable and successful, and each has unique advantages and disadvantages...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28644187/perioperative-blood-management-in-pediatric-spine-surgery
#12
Matthew E Oetgen, Jody Litrenta
Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28644179/improving-heart-failure-patient-outcomes-utilizing-guideline-directed-therapy
#13
Beth Towery Davidson, Terri Lynn Allison
Heart failure (HF) prevalence continues to rise and remains a significant burden to patients, caregivers, providers, and the healthcare system. Guideline-directed medical therapy with standard neurohormonal blockade has been the cornerstone of medical management for many years. Despite aggressive utilization of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and aldosterone antagonists, HF hospitalizations and readmissions are common and residual mortality remains high...
July 21, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28644135/evaluation-of-thromboelastometry-parameters-as-predictive-markers-for-sinusoidal-obstruction-syndrome-in-patients-undergoing-allogeneic-stem-cell-transplantation-for-acute-leukaemia
#14
Joanna Rupa-Matysek, Lidia Gil, Ewelina Wojtasińska, Zuzanna Kanduła, Adam Nowicki, Magdalena Matuszak, Mieczysław Komarnicki
Hepatic sinusoidal obstruction syndrome (previously named veno-occlusive disease, SOS/VOD) is a serious complication of allogeneic stem cell transplantation (HSCT). Early identification of patients at risk of SOS/VOD may possibly improve the outcome and reduce mortality. Rotation thromboelastometry (ROTEM) is global assay allowing for the precise assessment of both bleeding and thrombotic conditions, however, its usefulness in patients undergoing HSCT for acute leukaemia has not been studied.We evaluated the thromboelastometry parameters in patients undergoing allogeneic HSCT for acute leukaemia to identify candidate biomarkers of SOS/VOD occurrence...
June 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28644075/spine-stereotactic-radiosurgery-for-metastatic-sarcoma-patterns-of-failure-and-radiation-treatment-volume-considerations
#15
Andrew J Bishop, Randa Tao, B Ashleigh Guadagnolo, Pamela K Allen, Neal C Rebueno, Xin A Wang, Behrang Amini, Claudio E Tatsui, Laurence D Rhines, Jing Li, Eric L Chang, Paul D Brown, Amol J Ghia
OBJECTIVE Given the relatively lower radiosensitivity of sarcomas and the locally infiltrative patterns of spread, the authors sought to investigate spine stereotactic radiosurgery (SSRS) outcomes for metastatic sarcomas and to analyze patterns of failure. METHODS The records of 48 patients with 66 sarcoma spinal metastases consecutively treated with SSRS between 2002 and 2013 were reviewed. The Kaplan-Meier method was used to estimate rates of overall survival (OS) and local control (LC). Local recurrences were categorized as occurring infield (within the 95% isodose line [IDL]), marginally (between the 20% and 95% IDLs), or out of field...
June 23, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28644056/plasmonic-photothermal-therapy-of-atherosclerosis-with-nanoparticles-long-term-outcomes-and-safety-in-nanom-fim-trial
#16
Alexander N Kharlamov, John A Feinstein, John A Cramer, John A Boothroyd, Ekaterina V Shishkina, Vladimir Shur
AIM: The safety options in nanomedicine raise an issue of the optimal niche at the real-world clinical practice. METHODS: This is an observational prospective cohort analysis of the 5-year clinical outcomes at the intention-to-treat population (nano vs ferro vs stenting; n = 180) of NANOM first-in-man trial (NCT01270139). RESULTS: Mortality (6 vs 9 vs 10 cases of cardiac death in groups, p < 0.05), major adverse cardiovascular events (14...
June 23, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28644049/the-standard-treatment-protocol-for-paracetamol-poisoning-may-be-inadequate-following-overdose-with-modified-release-formulation-a-pharmacokinetic-and-clinical-analysis-of-53-cases
#17
Heléne Salmonson, Gunilla Sjöberg, Jacob Brogren
OBJECTIVE: The use of the standard procedure for managing overdoses with immediate release (IR) paracetamol is questionable when applied to overdoses with modified release (MR) formulations. This study describes the pharmacokinetics of paracetamol and the clinical outcomes following overdoses with a MR formulation. METHODS: Medical records including laboratory analyses concerning overdoses of MR paracetamol from 2009 to 2015 were collected retrospectively. Inclusion criteria were ingestion of a toxic dose, known time of intake and documented measurements of serum paracetamol and liver function tests...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28643998/survey-in-expert-clinicians-on-validity-of-automated-calculation-of-optimal-cerebral-perfusion-pressure
#18
Romy Steijn, Roy Stewart, Marek Czosnyka, Joseph Donnelly, Ari Ercole, Antony Absalom, Jan W Elting, Christina Haubrich, Peter Smielewski, Marcel Aries
BACKGROUND: Optimal cerebral perfusion pressure (CPPopt) targeting in traumatic brain injury (TBI) patients constitutes an active and controversial area of research. It has been suggested that an autoregulation guided CPP therapy may improve TBI outcome. Prerequisites of a CPPopt intervention study would be objective criteria for the CPPopt detection.. This study compared the agreement between automated and visual CPPopt detection. METHODS: Twenty-five clinicians from 18 centres worldwide, familiar with brain monitoring and using dedicated software, reviewed ten 4-hour CPPopt screenshots at 48 hrs after ictus in selected TBI patients...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28643884/learning-climate-and-feedback-as-predictors-of-dental-students-self-determined-motivation-the-mediating-role-of-basic-psychological-needs-satisfaction
#19
C Orsini, V Binnie, S Wilson, M J Villegas
AIM: The aim of this study was to test the mediating role of the satisfaction of dental students' basic psychological needs of autonomy, competence and relatedness on the association between learning climate, feedback and student motivation. The latter was based on the self-determination theory's concepts of differentiation of autonomous motivation, controlled motivation and amotivation. METHODS: A cross-sectional correlational study was conducted where 924 students completed self-reported questionnaires measuring motivation, perception of the learning climate, feedback and basic psychological needs satisfaction...
June 23, 2017: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
https://www.readbyqxmd.com/read/28643852/therapeutic-d2-3-receptor-occupancies-and-response-with-low-amisulpride-blood-concentrations-in-very-late-onset-schizophrenia-like-psychosis-vloslp
#20
Suzanne Reeves, Kate Eggleston, Elizabeth Cort, Emma McLachlan, Stuart Brownings, Akshay Nair, Suki Greaves, Alan Smith, Joel Dunn, Paul Marsden, Robert Kessler, David Taylor, Julie Bertrand, Robert Howard
OBJECTIVE: Antipsychotic drug sensitivity in very late-onset schizophrenia-like psychosis (VLOSLP) is well documented, but poorly understood. This study aimed to investigate blood drug concentration, D2/3 receptor occupancy and outcome in VLOSLP during open amisulpride prescribing, and compare this with Alzheimer's disease (AD). METHODS: Blood drug concentration, prolactin, symptoms and extrapyramidal side-effects (EPS) were serially assessed during dose titration...
June 23, 2017: International Journal of Geriatric Psychiatry
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