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Clinical outcome research initiative

Avinash Chandra, George Dervenoulas, Marios Politis
Research utilizing magnetic resonance imaging (MRI) has been crucial to the understanding of the neuropathological mechanisms behind and clinical identification of Alzheimer's disease (AD) and mild cognitive impairment (MCI). MRI modalities show patterns of brain damage that discriminate AD from other brain illnesses and brain abnormalities that are associated with risk of conversion to AD from MCI and other behavioural outcomes. This review discusses the application of various MRI techniques to and their clinical usefulness in AD and MCI...
August 17, 2018: Journal of Neurology
Rustam Al-Shahi Salman, Joseph Frantzias, Robert J Lee, Patrick D Lyden, Thomas W K Battey, Alison M Ayres, Joshua N Goldstein, Stephan A Mayer, Thorsten Steiner, Xia Wang, Hisatomi Arima, Hitoshi Hasegawa, Makoto Oishi, Daniel A Godoy, Luca Masotti, Dar Dowlatshahi, David Rodriguez-Luna, Carlos A Molina, Dong-Kyu Jang, Antonio Davalos, José Castillo, Xiaoying Yao, Jan Claassen, Bastian Volbers, Seiji Kazui, Yasushi Okada, Shigeru Fujimoto, Kazunori Toyoda, Qi Li, Jane Khoury, Pilar Delgado, José Álvarez Sabín, Mar Hernández-Guillamon, Luis Prats-Sánchez, Chunyan Cai, Mahesh P Kate, Rebecca McCourt, Chitra Venkatasubramanian, Michael N Diringer, Yukio Ikeda, Hans Worthmann, Wendy C Ziai, Christopher D d'Esterre, Richard I Aviv, Peter Raab, Yasuo Murai, Allyson R Zazulia, Kenneth S Butcher, Seyed Mohammad Seyedsaadat, James C Grotta, Joan Martí-Fàbregas, Joan Montaner, Joseph Broderick, Haruko Yamamoto, Dimitre Staykov, E Sander Connolly, Magdy Selim, Rogelio Leira, Byung Hoo Moon, Andrew M Demchuk, Mario Di Napoli, Yukihiko Fujii, Craig S Anderson, Jonathan Rosand
BACKGROUND: Intracerebral haemorrhage growth is associated with poor clinical outcome and is a therapeutic target for improving outcome. We aimed to determine the absolute risk and predictors of intracerebral haemorrhage growth, develop and validate prediction models, and evaluate the added value of CT angiography. METHODS: In a systematic review of OVID MEDLINE-with additional hand-searching of relevant studies' bibliographies- from Jan 1, 1970, to Dec 31, 2015, we identified observational cohorts and randomised trials with repeat scanning protocols that included at least ten patients with acute intracerebral haemorrhage...
August 14, 2018: Lancet Neurology
Jenny Carter, Rachel M Tribe, Jane Sandall, Andrew H Shennan
BACKGROUND: Despite much research effort, there is a paucity of conclusive evidence in the field of preterm birth prediction and prevention. The methods of monitoring and prevention strategies offered to women at risk vary considerably around the UK and depend on local maternity care provision. It is becoming increasingly recognised that this experience and knowledge, if captured on a larger scale, could be a utilized as a valuable source of evidence for others. The UK Preterm Clinical Network (UKPCN) was established with the aim of improving care and outcomes for women at risk of preterm birth through the sharing of a wealth of experience and knowledge, as well as the building of clinical and research collaboration...
August 17, 2018: BMC Pregnancy and Childbirth
Steven M Falowski, David A Provenzano, Ying Xia, Alissa H Doth
OBJECTIVE: Surgical site infections can cause negative clinical and economic outcomes. A recent international survey on Spinal Cord Stimulation (SCS) infection control practices demonstrated low compliance with evidence-based guidelines. This study defines infection rate for SCS implants and identifies infection risk factors. MATERIALS AND METHODS: A retrospective analysis of the MarketScan® Databases identified patients with SCS implant (2009-2014) and continuous health plan enrollment for ≥12-months (12 m) preimplant...
August 17, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Antoine Thiery-Vuillemin, Mads Hvid Poulsen, Edouard Lagneau, Guillaume Ploussard, Alison Birtle, Louis-Marie Dourthe, Dominique Beal-Ardisson, Elias Pintus, Redas Trepiakas, Laurent Antoni, Martin Lukac, Suzy Van Sanden, Geneviève Pissart, Alison Reid
Introduction: Abiraterone acetate plus prednisone (AAP) and enzalutamide (ENZ) are commonly prescribed for metastatic castration-resistant prostate cancer (mCRPC). Data comparing their effects on patient-reported outcomes (PROs) from routine clinical practice are limited. Methods: AQUARiUS (NCT02813408) is an ongoing, two-cohort, prospective, observational, non-randomised, multicentre, phase IV European study assessing the effects of AAP and ENZ on PROs in 211 patients with mCRPC over 12 months...
2018: ESMO Open
Cristiano Pagnini, Spyros I Siakavellas, Giorgos Bamias
Background and Aim: Crohn's disease (CD) is a chronic inflammatory condition of the gastrointestinal tract with the potential to progress to a severe debilitating state. Treatment with biological agents is highly efficient, improving both short-term outcomes and long-term prognosis. Nonetheless, up to 60% of patients receiving biological therapy will exhibit nonresponse at some point. The optimal management of such patients is not clearly defined. Besides traditional anti-TNF agents (infliximab, adalimumab, and certolizumab), alternative biological therapies (natalizumab, vedolizumab, and ustekinumab) are currently available for the treatment of CD...
2018: Gastroenterology Research and Practice
Philippe Lachapelle, Juan Cascon, Sushmita Pamidi, R John Kimoff
PURPOSE: Type 3 home study (HS) monitors do not detect cortical arousal-related hypopneas and may therefore underestimate the polysomnography (PSG)-based apnea-hypopnea index (AHI). Our aim was to test the hypothesis that scoring hypopneas using heart rate accelerations as a surrogate marker for cortical arousal (autonomic hypopnea; AnH) improves the accuracy of HS for OSA diagnosis, using PSG AHI as the diagnostic gold standard. METHODS: We retrospectively identified patients referred for OSA who underwent complete PSG following an initial inconclusive HS...
August 15, 2018: Sleep & Breathing, Schlaf & Atmung
Getinet Ayano, Melat Solomon, Mebratu Abraha
BACKGROUND: Depression is the most prevalent psychiatric disorder among people living with HIV (PLWHIV) and is associated with poor quality of life, additional comorbidities, disability, unemployment, poorer therapeutic outcomes and risky behaviors. The present systematic review and meta-analysis aims to systematically summarize empirical evidence and to formulate recommendations for future research. METHODS: We searched PubMed, EMBASE, SCOPUS, and relevant literature for possible studies to include...
August 15, 2018: BMC Psychiatry
Joanne Blair, Andrew McKay, Colin Ridyard, Keith Thornborough, Emma Bedson, Matthew Peak, Mohammed Didi, Francesca Annan, John W Gregory, Dyfrig Hughes, Carrol Gamble
BACKGROUND: The risk of developing long-term complications of type 1 diabetes (T1D) is related to glycaemic control and is reduced by the use of intensive insulin treatment regimens: multiple daily injections (MDI) (≥ 4) and continuous subcutaneous insulin infusion (CSII). Despite a lack of evidence that the more expensive treatment with CSII is superior to MDI, both treatments are used widely within the NHS. OBJECTIVES: (1) To compare glycaemic control during treatment with CSII and MDI and (2) to determine safety and cost-effectiveness of the treatment, and quality of life (QoL) of the patients...
August 2018: Health Technology Assessment: HTA
Robert W Gerlach, Paul A Sagel
PURPOSE: Health-related outcomes from three randomized controlled trials represented the initial research on the feasibility of novel, sequential oral hygiene with a stannous fluoride (SnF₂) dentifrice then hydrogen peroxide (H₂O₂) whitening gel. METHODS: One crossover and two parallel clinical trials were conducted independently. Objectives varied, with individual studies assessing short, intermediate or longer-term outcomes from breath, dental plaque or gingivitis, respectively...
July 2018: American Journal of Dentistry
Tanya Smit, Natalia Peraza, Lorra Garey, Kirsten J Langdon, Joseph W Ditre, Andrew H Rogers, Kara Manning, Michael J Zvolensky
Scientific evidence suggests that pain-related anxiety may contribute to the maintenance of tobacco addiction among smokers with varying levels of pain. Yet, no work has investigated the relation between pain-related anxiety and cognitive-based smoking processes within an indirect effect model. Dysphoria may explain the relation between pain-related anxiety and cigarette smoking, as it is a construct that relates to both pain and smoking outcomes. Thus, the current cross-sectional study examined the indirect effect of pain-related anxiety and three clinically significant smoking processes: perceived barriers to cessation, negative affect reduction motives, and negative mood abstinence expectancies via dysphoria...
August 10, 2018: Addictive Behaviors
Melina A Throuvala, Mark D Griffiths, Mike Rennoldson, Daria J Kuss
Adolescents' media use represents a normative need for information, communication, recreation and functionality, yet problematic Internet use has increased. Given the arguably alarming prevalence rates worldwide and the increasingly problematic use of gaming and social media, the need for an integration of prevention efforts appears to be timely. The aim of this systematic literature review is (i) to identify school-based prevention programmes or protocols for Internet Addiction targeting adolescents within the school context and to examine the programmes' effectiveness, and (ii) to highlight strengths, limitations, and best practices to inform the design of new initiatives, by capitalizing on these studies' recommendations...
August 13, 2018: Current Neuropharmacology
Ishaq Lat, Mitchell J Daley, Anand Shewale, Mark H Pangrazzi, Drayton Hammond, Keith M Olsen
OBJECTIVE: This study was conducted to describe the prevalence, epidemiology, and clinical outcomes of multidrug resistant (MDR) organism (MDRO) pneumonia in critically ill patients. METHODS: A multicenter, prospective, observational study of patients admitted to 60 intensive care units (ICUs), from 34 hospitals, in the United States from November-December 2016. Adults (>18 years) receiving antimicrobial therapy at least 5 days for pneumonia were included. Patients were classified into 2 categories, with or without MDRO, and subcategorized by pneumonia type...
August 12, 2018: Pharmacotherapy
Phillip Staibano, Iris Perelman, Julia Lombardi, Alexandra Davis, Alan Tinmouth, Marc Carrier, Ciara Stevenson, Elianna Saidenberg
Anemia is a frequently diagnosed condition that may be a symptom of or complication of many illnesses affecting patients of all demographics. Anemia can lead to both worsened clinical outcomes and reduced quality of life. Patient-reported outcome measures (PROMs) are methodological tools used to capture the impact of disease on patient well-being. Use of PROMs in medical research is becoming more common as it is increasingly recognized that disease outcomes of interest to researchers and clinicians are not always consistent with patients' greatest concerns related to their diseases...
July 12, 2018: Transfusion Medicine Reviews
Nadiya Sunderji, Allyson Ion, Dan Huynh, Paul Benassi, Abbas Ghavam-Rassoul, Adriana Carvalhal
OBJECTIVE: Integrated or collaborative care is a well-evidenced and widely practiced approach to improve access to high-quality mental health care in primary care and other settings. Psychiatrists require preparation for this emerging type of practice, and such training is now mandatory for Canadian psychiatry residents. However, it is not known how best to mount such training, and in the absence of such knowledge, the quality of training across Canada has suffered. To guide integrated care education nationally, we conducted a systematic review of published and unpublished training programs...
August 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Jennifer K Sun, Adam R Glassman, Wesley T Beaulieu, Cynthia R Stockdale, Neil M Bressler, Christina Flaxel, Jeffrey G Gross, Michel Shami, Lee M Jampol
OBJECTIVE: Present rationale, guidelines, and results of ranibizumab treatment for proliferative diabetic retinopathy (PDR) in Diabetic Retinopathy Clinical Research Network ( Protocol S. DESIGN: Post hoc analyses from a randomized clinical trial. PARTICIPANTS: Three hundred and five participants with 394 study eyes having PDR without prior PRP. INTERVENTION: Post hoc analyses from a randomized clinical trial of 0...
August 7, 2018: Ophthalmology
Dimitrios Kloukos, Piotr Fudalej, Patrick Sequeira-Byron, Christos Katsaros
BACKGROUND: Cleft lip and palate is one of the most common birth defects and can cause difficulties with feeding, speech and hearing, as well as psychosocial problems. Treatment of orofacial clefts is prolonged; it typically commences after birth and lasts until the child reaches adulthood or even into adulthood. Residual deformities, functional disturbances, or both, are frequently seen in adults with a repaired cleft. Conventional orthognathic surgery, such as Le Fort I osteotomy, is often performed for the correction of maxillary hypoplasia...
August 10, 2018: Cochrane Database of Systematic Reviews
Aygun Babayeva, Elena Ioana Braicu, Jacek P Grabowski, Khayal Gasimli, Rolf Richter, Mustafa Zelal Muallem, Jalid Sehouli
OBJECTIVE: The aim of this study was to estimate surgical outcome and survival benefit after completion surgery. METHODS: We evaluated 164 patients with epithelial ovarian cancer who underwent incomplete primary cytoreductive surgery or rather received only staging procedures from January 2000 to December 2014 in outside institutions. Patient-related data were registered in prospective database of Tumor Bank Ovarian Cancer. The outcome analyses were performed for early and advanced stages of ovarian cancer separately...
August 7, 2018: International Journal of Gynecological Cancer
Jessica M Goehringer, Michele A Bonhag, Laney K Jones, Tara Schmidlen, Marci Schwartz, Alanna Kulchak Rahm, Janet L Williams, Marc S Williams
Context: Communication of genetic laboratory results to patients and providers is impeded by the complexity of results and reports. This can lead to misinterpretation of results, causing inappropriate care. Patients often do not receive a copy of the report leading to possible miscommunication. To address these problems, we conducted patient-centered research to inform design of interpretive reports. Here we describe the development and deployment of a specific patient-centered clinical decision support (CDS) tool, a multi-use patient-centered genomic test report (PGR) that interfaces with an electronic health record (EHR)...
June 26, 2018: EGEMS
Martin G Seneviratne, Tina Seto, Douglas W Blayney, James D Brooks, Tina Hernandez-Boussard
Background: Electronic health record (EHR) based research in oncology can be limited by missing data and a lack of structured data elements. Clinical research data warehouses for specific cancer types can enable the creation of more robust research cohorts. Methods: We linked data from the Stanford University EHR with the Stanford Cancer Institute Research Database (SCIRDB) and the California Cancer Registry (CCR) to create a research data warehouse for prostate cancer...
June 1, 2018: EGEMS
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