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https://www.readbyqxmd.com/read/28749586/patient-decisions-to-receive-secondary-pharmacogenomic-findings-and-development-of-a-multidisciplinary-practice-model-to-integrate-results-into-patient-care
#1
J Kevin Hicks, Amy Shealy, Allison Schreiber, Marissa Coleridge, Ryan Noss, Marvin Natowicz, Rocio Moran, Timothy Moss, Angelika Erwin, Charis Eng
Whole exome sequencing (WES) has the potential of identifying secondary findings that are predictive of poor pharmacotherapy outcomes. The purpose of this study was to investigate patients' wishes regarding the reporting of secondary pharmacogenomic findings. WES results (n = 106 patients) were retrospectively reviewed to determine the number of patients electing to receive secondary pharmacogenomic results. Phenotypes were assigned based on Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines...
July 27, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/28749488/trends-in-provider-initiated-versus-spontaneous-preterm-deliveries-2004-2013
#2
M L Ada, M R Hacker, T H Golen, M J Haviland, S A Shainker, H H Burris
OBJECTIVE: The objectives of this study were as follows: (i) to estimate the proportion of preterm deliveries at a tertiary perinatal center that were provider-initiated versus spontaneous before and after a 2009 policy to reduce elective early-term deliveries, and (ii)to evaluate whether shifts in type of preterm delivery varied by race/ethnicity. METHOD: We performed a retrospective cohort study of preterm deliveries over a 10-year period, 2004 to 2013, including detailed review of 929 of 5566 preterm deliveries, to designate each delivery as provider-initiated or spontaneous...
July 27, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28749231/phase-%C3%A2-study-of-concurrent-chemoradiotherapy-with-a-modified-target-volumes-delineation-method-for-inoperable-esophageal-cancer-patients
#3
Wenyi Zhang, Huifang Li, Xingxing Chen, Meng Su, Ruifang Lin, Changlin Zou
OBJECTIVE: A Phase || study was designed to test the safety and efficacy of concurrent chemoradiotherapy with a modified target volumes delineation method for inoperable esophageal cancer patients. METHODS: All eligible patients were treated with concurrent chemoradiotherapy. The method of delineating target volume was as follow: Planning gross target volume (PGTV) was defined as the primary gross tumor volume (GTV-t) plus a 3 cm margin longitudinally and a 0...
July 27, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28749026/maxillary-unicystic-ameloblastoma-in-a-6-week-old-filly-evaluated-with-computed-tomography
#4
H L Smith, A J Rosenblatt, W W Suen, H Owen, B J Ahern
CASE REPORT: A 6-week-old Thoroughbred filly was presented for evaluation of an expansile mass overlying the right nasal passage and causing respiratory stertor. On skull radiographs, there was a loculated, soft tissue-opaque mass identified dorsal to the right upper premolars and effacing the right nasal cavity. Computed tomography (CT) revealed a locally extensive mass with relatively benign characteristics located centrally on the tooth root apices of the deciduous second premolar (506)...
August 2017: Australian Veterinary Journal
https://www.readbyqxmd.com/read/28748429/admission-control-policies-for-surgery-patients
#5
Li Luo, Yong Luo, Chunrong Qin
In China, day surgery has been promoted because its operation time and post-operative hospital stay are shorter than those of elective surgery. Day surgery can speed up the turnover of beds and operation rooms. Usually, the conditions of elective surgery patients are more complicated than those of day surgery patients. The development of the discipline, which means that the hospital has improved the skills of the doctors and the ability of doctors to cope with serious diseases and has increased the overall medical level of the hospital, requires surgeons to operate in some complicated elective surgeries...
August 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28748422/safety-and-feasibility-of-umbilical-diverting-loop-ileostomy-for-patients-with-rectal-tumor
#6
Masaaki Miyo, Ichiro Takemasa, Taishi Hata, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori
BACKGROUND: Fashioning an ileostomy in the umbilicus and combining the trauma from extraction of colorectum with that from ileostomy should be less invasive and lead to improved cosmetic outcomes. However, there are only a few reports regarding umbilical ileostomy. METHODS: We retrospectively collected data for 121 consecutive patients with rectal tumor who underwent elective laparoscopic rectal resection with diverting loop ileostomy between 2010 and 2015 at Osaka University Hospital, Japan...
July 26, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28747942/complex-corrective-procedure-in-surgical-treatment-of-asymmetrical-pectus-excavatum
#7
Krystian Pawlak, Łuksasz Gąsiorowski, Wojciech Dyszkiewicz
AIM: In this study we analysed the early and late results of surgical treatment of asymmetrical pectus excavatum using complex surgery combining the Ravitch procedure and the Nuss procedure in the same general anaesthesia. MATERIAL AND METHODS: Eighty out of 938 patients with pectus excavatum operated on between 2002 and 2013, 67 males and 13 females aged 11 to 49 years (mean: 19.2), underwent a complex surgical procedure. During surgery the Nuss procedure was usually performed first (one corrective bar was implanted in 35 patients and two bars were inserted in 45 patients)...
June 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28746233/preoperative-thromboelastometry-for-the-prediction-of-increased-chest-tube-output-in-cardiac-surgery-a-retrospective-study
#8
Waldemar Gozdzik, Barbara Adamik, Grzegorz Wysoczanski, Anna Gozdzik, Maciej Rachwalik, Tomasz Skalec, Andrzej Kübler
Bleeding following cardiac surgery is a serious event with potentially life-threatening consequences. Preoperative recognition of coagulation abnormalities and detection of cardiopulmonary bypass (CPB) related coagulopathy could aid in the start of preventive treatment strategies that minimize perioperative blood loss. Most algorithms that analyze thromboelastometry coagulation tests in elective cardiac surgery do not include test results performed before surgery. We evaluated preoperative rotational thromboelastometry test results for their ability to predict blood loss during and after cardiac surgery...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28746173/ultrasonographic-diagnosis-and-minimally-invasive-treatment-of-a-patent-urachus-associated-with-a-patent-omphalomesenteric-duct-in-a-newborn-a-case-report
#9
Mirko Bertozzi, Nicola Recchia, Giuseppe Di Cara, Sara Riccioni, Victoria Elisa Rinaldi, Susanna Esposito, Antonino Appignani
RATIONAL: Patent urachus (PU) is due to an incomplete obliteration of the urachus, whereas patent omphalomesenteric duct (POMD) is due to an incomplete obliteration of the vitelline duct. These anomalies are very rarely associated with one another. We describe a case of a newborn with a PU associated with a POMD, who was diagnosed by an abdominal ultrasound (US) and laparoscopy, and managed with a minimally invasive excision. PATIENT CONCERN: A 28-day-old male neonate was referred to our hospital to investigate a delay in umbilical healing, with blood-mucinous material spillage for 3 weeks prior to the referral...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28746156/textbook-outcome-a-composite-measure-for-quality-of-elective-aneurysm-surgery
#10
Eleonora G Karthaus, Niki Lijftogt, Linde A D Busweiler, Bernard H P Elsman, Michel W J M Wouters, Anco C Vahl, Jaap F Hamming
OBJECTIVE: To investigate a new composite quality measurement, which comprises a desirable outcome for elective aneurysm surgery, called "Textbook Outcome" (TO). BACKGROUND: Single-quality indicators in vascular surgery are often not distinctive and insufficiently reflect the quality of care. METHODS: All patients undergoing elective abdominal aortic aneurysm repair, registered in the Dutch Surgical Aneurysm Audit between 2014 and 2015 were included...
July 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28746136/using-organizational-philosophy-to-create-a-self-sustaining-compensation-plan-without-harming-academic-missions
#11
Robert Leverence, Richard Nuttall, Rachel Palmer, Mark Segal, Alicia Wood, Fay Yancey, Jonathon Shuster, Mark Brantly, Robert Hromas
PROBLEM: Academic physician reimbursement has moved to productivity-based compensation plans. To be sustainable, such plans must be self-funding. Additionally, unless research and education are appropriately valued, faculty involved in these efforts will become disillusioned, yet revenue generation in these activities is less robust than for clinical care activities. APPROACH: Faculty at the Department of Medicine, University of Florida Health, elected a committee of junior and senior faculty and division chiefs to restructure the compensation plan in fiscal year (FY) 2011...
August 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28746028/the-kaiser-permanente-northern-california-enhanced-recovery-after-surgery-program-design-development-and-implementation
#12
Vincent X Liu, Efren Rosas, Judith C Hwang, Eric Cain, Anne Foss-Durant, Molly Clopp, Mengfei Huang, Alexander Mustille, Vivian M Reyes, Shirley S Paulson, Michelle Caughey, Stephen Parodi
Complications are common after surgery, highlighting the need for innovations that reduce postsurgical morbidity and mortality. In this report, we describe the design, development, and implementation of an Enhanced Recovery After Surgery program in the Kaiser Permanente Northern California integrated health care delivery system. This program was implemented and disseminated in 2014, targeting patients who underwent elective colorectal resection and those who underwent emergent hip fracture repair across 20 Medical Centers...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746022/mortality-after-total-knee-and-total-hip-arthroplasty-in-a-large-integrated-health-care-system
#13
Maria C S Inacio, Mark T Dillon, Alex Miric, Ronald A Navarro, Elizabeth W Paxton
CONTEXT: The number of excess deaths associated with elective total joint arthroplasty in the US is not well understood. OBJECTIVE: To evaluate one-year postoperative mortality among patients with elective primary and revision arthroplasty procedures of the hip and knee. DESIGN: A retrospective analysis was conducted of hip and knee arthroplasties performed in 2010. Procedure type, procedure volume, patient age and sex, and mortality were obtained from an institutional total joint replacement registry...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28745576/association-of-cyp2c19-2-polymorphism-with-clopidogrel-response-and-1-year-major-adverse-cardiovascular-events-in-a-multiethnic-population-with-drug-eluting-stents
#14
Shirley Siang Ning Tan, Alan Yean Yip Fong, Melissa Mejin, Jerry Gerunsin, Khai Liy Kong, Felicia Yien Yin Chin, Lee Len Tiong, Melissa Siaw Han Lim, Asri Said, Ning Zan Khiew, Chi Yen Voon, Nor Hanim Mohd Amin, Yee Ling Cham, Keng Tat Koh, Yen Yee Oon, Tiong Kiam Ong
BACKGROUND: Patients undergoing elective percutaneous coronary intervention (PCI) with drug-eluting stents (DES) who have impaired clopidogrel response, have a higher risk of subsequent major adverse cardiovascular events (MACE). AIM OF THE STUDY: To establish the relationship between CYP2C19 genotype, clopidogrel responsiveness and 1-year MACE. MATERIALS & METHODS: Aspirin/clopidogrel responses were assessed with Multiplate Analyzer and CYP2C19*2 allele by SpartanRx...
July 26, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28745403/sex-differences-in-mortality-after-abdominal-aortic-aneurysm-repair-in-the-uk
#15
D A Sidloff, A Saratzis, M J Sweeting, J Michaels, J T Powell, S G Thompson, M J Bown
BACKGROUND: The UK abdominal aortic aneurysm (AAA) screening programmes currently invite only men for screening because the benefit in women is uncertain. Perioperative risk is critical in determining the effectiveness of screening, and contemporary estimates of these risks in women are lacking. The aim of this study was to compare mortality following AAA repair between women and men in the UK. METHODS: Anonymized data from the UK National Vascular Registry (NVR) for patients undergoing AAA repair (January 2010 to December 2014) were analysed...
July 26, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28745025/nonalcoholic-steatohepatitis-is-associated-with-cardiac-remodeling-and-dysfunction
#16
Tracey G Simon, Daniel G Bamira, Raymond T Chung, Rory B Weiner, Kathleen E Corey
OBJECTIVE: Preliminary data suggest that nonalcoholic fatty liver disease is associated with early heart failure (HF). However, whether nonalcoholic steatohepatitis (NASH) is directly associated with echocardiographic changes in cardiac structure or function remains unknown. METHODS: A retrospective cohort was identified of individuals (N = 65) without known heart disease, undergoing elective bariatric surgery with perioperative liver biopsy, and available recent transthoracic echocardiography (TTE)...
August 2017: Obesity
https://www.readbyqxmd.com/read/28744896/elective-repeat-caesarean-section-versus-induction-of-labour-for-women-with-a-previous-caesarean-birth
#17
REVIEW
Jodie M Dodd, Caroline A Crowther, Rosalie M Grivell, Andrea R Deussen
BACKGROUND: When a woman has had a previous caesarean birth and requires induction of labour for a subsequent pregnancy, two options are available for her care: an elective repeat caesarean and planned induction of labour. Although risks and benefits are associated with both elective repeat caesarean birth and planned induction of labour, current sources of information are limited to non-randomised cohort studies, and studies designed in this way have significant potential for bias. Consequently, any conclusions based on results of these studies are limited in their reliability and should be interpreted with caution...
July 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28744857/the-effect-of-pre-operative-methylprednisolone-on-early-endothelial-damage-after-total-knee-arthroplasty-a-randomised-double-blind-placebo-controlled-trial
#18
V Lindberg-Larsen, S R Ostrowski, M Lindberg-Larsen, M L Rovsing, P I Johansson, H Kehlet
We wished to evaluate whether inhibition of the systemic inflammatory response by a single pre-operative dose of methylprednisolone reduced markers of early endothelial damage after fast-track total knee arthroplasty. We randomly allocated 70 patients undergoing elective unilateral total knee arthroplasty (1:1) to receive either pre-operative intravenous methylprednisolone 125 mg (methylprednisolone group) or isotonic saline (control group). All procedures were performed under spinal anaesthesia without a tourniquet, using a standardised multimodal analgesic regime...
July 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28743822/bronchial-microdialysis-monitoring-of-inflammatory-response-in-open-abdominal-aortic-aneurysm-repair-an-observational-study
#19
Stig S Tyvold, Torbjørn Dahl, Stein Dragsund, Sigurd Gunnes, Oddveig Lyng, Jan K Damås, Petter Aadahl, Erik Solligård
Aortic surgery results in ischemia-reperfusion injury that induces an inflammatory response and frequent complications. The magnitude of the inflammatory response in blood and bronchi may be associated with the risk of immediate complications. The purpose of the study was to evaluate bronchial microdialysis as a continuous monitoring of cytokines in bronchial epithelial lining fluid (ELF) and to determine whether bronchial ELF cytokine levels reflect the ischemia-reperfusion injury and risk for complications during open abdominal aortic aneurysm (AAA) repair...
July 2017: Physiological Reports
https://www.readbyqxmd.com/read/28743691/understanding-factors-affecting-participation-in-online-formative-quizzes-an-interview-study
#20
Ancil J Abney, Sarina Amin, Jonathan D Kibble
A positive correlation between performance and participation in formative quizzes and final summative examinations has been reported many times. The goal of the present interview study was to construct a model to explain why students may elect not to engage with formative assessment opportunities. Our medical school's preclinical curriculum has an established policy of offering weekly online quizzes in all courses during the first 2 yr. Quizzes do not count for credit. Semistructured interviews were recorded and transcribed verbatim, and a formal thematic analysis was applied...
September 1, 2017: Advances in Physiology Education
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