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https://www.readbyqxmd.com/read/28444987/platelet-count-spleen-length-and-platelet-count-to-spleen-length-ratio-for-the-diagnosis-of-oesophageal-varices-in-people-with-chronic-liver-disease-or-portal-vein-thrombosis
#1
REVIEW
Agostino Colli, Juan Cristóbal Gana, Jason Yap, Thomasin Adams-Webber, Natalie Rashkovan, Simon C Ling, Giovanni Casazza
BACKGROUND: Current guidelines recommend screening of people with oesophageal varices via oesophago-gastro-duodenoscopy at the time of diagnosis of hepatic cirrhosis. This requires that people repeatedly undergo unpleasant invasive procedures with their attendant risks, although half of these people have no identifiable oesophageal varices 10 years after the initial diagnosis of cirrhosis. Platelet count, spleen length, and platelet count-to-spleen length ratio are non-invasive tests proposed as triage tests for the diagnosis of oesophageal varices...
April 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28444285/preeclampsia-screening-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#2
Jillian T Henderson, Jamie H Thompson, Brittany U Burda, Amy Cantor
Importance: Preeclampsia is a complex disease of pregnancy with sometimes serious effects on maternal and infant morbidity and mortality. It is defined by hypertension after 20 weeks' gestation and proteinuria or other evidence of multisystem involvement. Objective: To systematically review the benefits and harms of preeclampsia screening and risk assessment for the US Preventive Services Task Force. Data Sources: MEDLINE, PubMed, and Cochrane Central Register of Controlled Trials databases from 1990 through September 1, 2015...
April 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28444213/representation-of-occupational-information-across-resources-and-validation-of-the-occupational-data-for-health-model
#3
Sripriya Rajamani, Elizabeth S Chen, Elizabeth Lindemann, Ranyah Aldekhyyel, Yan Wang, Genevieve B Melton
Reports by the National Academy of Medicine and leading public health organizations advocate including occupational information as part of an individual's social context. Given recent National Academy of Medicine recommendations on occupation-related data in the electronic health record, there is a critical need for improved representation. The National Institute for Occupational Safety and Health has developed an Occupational Data for Health (ODH) model, currently in draft format. This study aimed to validate the ODH model by mapping occupation-related elements from resources representing recommendations, standards, public health reports and surveys, and research measures, along with preliminary evaluation of associated value sets...
April 22, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28444135/prevalence-and-correlates-of-olfactory-dysfunction-in-old-age-a-population-based-study
#4
Janina Seubert, Erika J Laukka, Debora Rizzuto, Thomas Hummel, Laura Fratiglioni, Lars Bäckman, Maria Larsson
Background: Olfactory dysfunction (OD) in old age is associated with poor health outcomes. Interrelationships among different correlates of OD can offer insights into the underlying mechanisms, but to date remain understudied. Methods: Odor identification performance and self-reported olfactory functioning were studied in 2,234 people aged 60-90 years, who were free of neurodegenerative disease and enrolled in the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) study, Stockholm, Sweden...
April 21, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28441940/clinical-records-anonymisation-and-text-extraction-crate-an-open-source-software-system
#5
REVIEW
Rudolf N Cardinal
BACKGROUND: Electronic medical records contain information of value for research, but contain identifiable and often highly sensitive confidential information. Patient-identifiable information cannot in general be shared outside clinical care teams without explicit consent, but anonymisation/de-identification allows research uses of clinical data without explicit consent. RESULTS: This article presents CRATE (Clinical Records Anonymisation and Text Extraction), an open-source software system with separable functions: (1) it anonymises or de-identifies arbitrary relational databases, with sensitivity and precision similar to previous comparable systems; (2) it uses public secure cryptographic methods to map patient identifiers to research identifiers (pseudonyms); (3) it connects relational databases to external tools for natural language processing; (4) it provides a web front end for research and administrative functions; and (5) it supports a specific model through which patients may consent to be contacted about research...
April 26, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28441939/estimation-of-the-severity-of-breathlessness-in-the-emergency-department-a-dyspnea-score
#6
Tibor Gondos, Viktor Szabó, Ágnes Sárkány, Adrienn Sárkány, Gábor Halász
BACKGROUND: Dyspnea is a frequent complaint in emergency departments (ED). It has a significant amount of subjective and affective components, therefore the dyspnea scores, based on the patients' rating, can be ambiguous. Our purpose was to develop and validate a simple scoring system to evaluate the severity of dyspnea in emergency care, based on objectively measured parameters. METHODS: We performed a double center, prospective, observational study including 350 patients who were admitted in EDs with dyspnea...
April 26, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28441696/declining-blood-pressure-and-intensification-of-blood-pressure-management-among-people-over-80-years-cohort-study-using-electronic-health-records
#7
Rathi Ravindrarajah, Alex Dregan, Nisha C Hazra, Shota Hamada, Stephen H D Jackson, Martin C Gulliford
BACKGROUND: Management of high blood pressure (BP) in people over 80 years is controversial, but there is limited information available concerning the uptake of hypertension treatment at this age. OBJECTIVE: To evaluate use of antihypertensive drugs and changes in SBP and DBP from 2001 to 2014 in men and women aged 80 years and over. METHODS: Cohort study using primary care electronic health records of 265 225 participants from the UK Clinical Practice Research Datalink...
June 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28441671/swimming-upstream-creating-a-culture-of-high-value-care
#8
Reshma Gupta, Christopher Moriates
As health system leaders strategize the best ways to encourage the transition toward value-based health care, the underlying culture-defined as a system of shared assumptions, values, beliefs, and norms existing within an environment-continues to shape clinician practice patterns. The current prevailing medical culture contributes to overtesting, overtreatment, and health care waste. Choosing Wisely lists, appropriateness criteria, and guidelines codify best practices, but academic medicine as a whole must recognize that faculty and trainees are all largely still operating within the same cultural climate...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441271/alternative-payment-models-and-urology
#9
Deborah R Kaye, David C Miller, Chad Ellimoottil
PURPOSE OF REVIEW: The Medicare Access and CHIP Reauthorization Act (MACRA) is a historic bill that was recently passed that establishes how quality measurement and practice patterns will affect physician reimbursement. Alternative payment models (APMs) are an essential component of MACRA and Medicare's vision of paying for high-value care. This review describes APMs in the context of MACRA and their impact on urology. RECENT FINDINGS: The majority of urologists will be affected by MACRA...
April 22, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28440678/involvement-of-primary-care-physicians-in-the-decision-making-and-care-of-patients-with-breast-cancer
#10
Lauren P Wallner, Paul Abrahamse, Jaspreet K Uppal, Christopher R Friese, Ann S Hamilton, Kevin C Ward, Steven J Katz, Sarah T Hawley
Purpose Collaborative care between cancer specialists and primary care providers (PCPs) may improve the delivery of high-quality cancer care. Yet, patient perspectives about how involved the PCPs were in their breast cancer care and treatment decisions remain unknown. Patients and Methods A weighted random sample of women newly diagnosed with breast cancer in 2013 to 2014, as reported to the SEER registries in Los Angeles, California, and Georgia, were sent a survey approximately 6 months after diagnosis (N = 2,279, 71% response rate)...
November 20, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28438778/the-dual-amylin-and-calcitonin-receptor-agonist-kbp-042-works-as-adjunct-to-metformin-on-fasting-hyperglycaemia-and-hba1c-in-a-rat-model-of-type-2-diabetes
#11
Sara Toftegaard Hjuler, Sofie Gydesen, Kim Vietz Andreassen, Morten Asser Karsdal, Kim Henriksen
KBP-042 is a dual amylin and calcitonin receptor agonist which increases glucose tolerance and insulin action, and reduces body weight in rat models of obesity and pre-diabetes. The objective of the present study was to 1) Evaluate KBP-042 as a treatment of late stage type 2 diabetes in a rat model and 2) Assess the value of adding KBP-042 to the standard of care, metformin, in order to consider KBP-042 as a relevant drug for treating patients with type 2 diabetes. Two studies were included: an intervention and a prevention study...
April 24, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28438712/empirical-consideration-of-the-effects-of-acquisition-parameters-and-analysis-model-on-clinically-feasible-q-ball-imaging
#12
Kurt Schilling, Vishwesh Nath, Justin A Blaber, Prasanna Parvathaneni, Adam W Anderson, Bennett A Landman
Q-ball imaging (QBI) is a popular high angular resolution diffusion imaging (HARDI) technique used to study brain architecture in vivo. Simulation and phantom-based studies suggest that QBI results are affected by the b-value, the number of diffusion weighting directions, and the signal-to-noise ratio (SNR). However, optimal acquisition schemes for QBI in clinical settings are largely undetermined given empirical (observed) imaging considerations. In this study, we acquire a HARDI dataset at five b-values with 11 repetitions on a single subject to investigate the effects of acquisition scheme and subsequent analysis models on the accuracy and precision of measures of tissue composition and fiber orientation derived from clinically feasible QBI at 3T...
April 21, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28437207/persistent-delirium-in-chronic-critical-illness-as-a-prodrome-syndrome-before-death
#13
Anna DeForest, Craig D Blinderman
BACKGROUND: Chronic critical illness (CCI) patients have poor functional outcomes, high risk of mortality, and significant sequelae, including delirium and cognitive dysfunction. The prognostic significance of persistent delirium in patients with CCI has not been well described. OBJECTIVE: We report a case of a patient with CCI following major cardiac surgery who was hemodynamically stable following a long course in the cardiothoracic intensive care unit (CTICU), but had persistent and unremitting delirium...
February 21, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28436344/inattention-tests-for-delirium
#14
Paul Regal
Voyer and colleagues (2016) report an interesting and important comparison of ten attention/concentration tests for DSM-5 delirium. I have a number of questions and comments as follows: (1) What training did the research assistants have? DSM-5 diagnosis is generally regarded as a decision by medical specialists. When the person has prior dementia, identifying delirium is a high-level medical skill. Behavioral and psychological symptoms of dementia can closely mimic delirium unless the examiner focuses on behavioral triggers and the speed of cognitive decline...
April 24, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28435765/chronic-nephropathy-from-dietary-hyperoxaluria-sustained-improvement-of-renal-function-after-dietary-intervention
#15
Yijuan Sun, Bruce L Horowitz, Karen S Servilla, Joanna R Fair, Darlene Vigil, Kavitha Ganta, Larry Massie, Antonios H Tzamaloukas
A 56-year-old man with stable chronic kidney disease (CKD) for two years following a single episode of calcium oxalate urolithiasis developed progressive elevation of his serum creatinine concentration. Urinalysis revealed pyuria and white cell casts, a few red blood cells, minimal proteinuria, and no crystals. Urine culture was sterile. Gallium scintigraphy was consistent with interstitial nephritis. Proton pump inhibitor intake was discontinued, and a short course of oral corticosteroids was initiated. Percutaneous kidney biopsy, performed because of the continued deterioration of renal function to a minimum estimated glomerular filtration rate (eGFR) value of 15 mL/min per 1...
March 20, 2017: Curēus
https://www.readbyqxmd.com/read/28435491/agreement-between-serum-assays-performed-in-ed-point-of-care-and-hospital-central-laboratories
#16
Meir Dashevsky, Steven L Bernstein, Carol L Barsky, Richard A Taylor
INTRODUCTION: Point-of-care (POC) testing allows for more time-sensitive diagnosis and treatment in the emergency department (ED) than sending blood samples to the hospital central laboratory (CL). However, many ED patients have blood sent to both, either out of clinical custom, or because clinicians do not trust the POC values. The objective of this study was to examine the level of agreement between POC and CL values in a large cohort of ED patients. METHODS: In an urban, Level I ED that sees approximately 120,000 patients/year, all patients seen between March 1, 2013, and October 1, 2014, who had blood sent to POC and CL labs had levels of agreement measured between serum sodium, potassium, blood urea nitrogen (BUN), creatinine, and hematocrit...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434270/what-is-stable-pain-control-a-prospective-longitudinal-study-to-assess-the-clinical-value-of-a-personalized-pain-goal
#17
Robin Fainsinger, Cheryl Nekolaichuk, Lara Fainsinger, Viki Muller, Lisa Fainsinger, Pablo Amigo, Amanda Brisebois, Sarah Burton-Macleod, Sunita Ghosh, Rebekah Gilbert, Yoko Tarumi, Vincent Thai, Gary Wolch
BACKGROUND: A universal consensus regarding standardized pain outcomes does not exist. The personalized pain goal has been suggested as a clinically relevant outcome measure. AIM: To assess the feasibility of obtaining a personalized pain goal and to compare a clinically based personalized pain goal definition versus a research-based study definition for stable pain. DESIGN: Prospective longitudinal descriptive study. MEASURES: The attending physician completed routine assessments, including a personalized pain goal and the Edmonton Classification System for Cancer Pain, and followed patients daily until stable pain control, death, or discharge...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28433624/temporal-slice-registration-and-robust-diffusion-tensor-reconstruction-for-improved-fetal-brain-structural-connectivity-analysis
#18
Bahram Marami, Seyed Sadegh Mohseni Salehi, Onur Afacan, Benoit Scherrer, Caitlin K Rollins, Edward Yang, Judy A Estroff, Simon K Warfield, Ali Gholipour
Diffusion weighted magnetic resonance imaging, or DWI, is one of the most promising tools for the analysis of neural microstructure and the structural connectome of the human brain. The application of DWI to map early development of the human connectome in-utero, however, is challenged by intermittent fetal and maternal motion that disrupts the spatial correspondence of data acquired in the relatively long DWI acquisitions. Fetuses move continuously during DWI scans. Reliable and accurate analysis of the fetal brain structural connectome requires careful compensation of motion effects and robust reconstruction to avoid introducing bias based on the degree of fetal motion...
April 19, 2017: NeuroImage
https://www.readbyqxmd.com/read/28432878/in-vitro-susceptibility-of-methicillin-resistant-staphylococcus-aureus-isolates-from-skin-and-soft-tissue-infections-to-vancomycin-daptomycin-linezolid-and-tedizolid
#19
Johanna Marcela Vanegas Múnera, Ana María Ocampo Ríos, Daniela Montoya Urrego, Judy Natalia Jiménez Quiceno
INTRODUCTION: Treatment of multidrug-resistant Gram-positive infections caused by Staphylococcus aureus remains as a clinical challenge due to emergence of new resistance mechanisms. Tedizolid is a next-generation oxazolidinone, recently approved for skin and soft tissues infections. We conducted a study to determine in vitro susceptibility to vancomycin, daptomycin, linezolid, and tedizolid in MRSA clinical isolates from adult patients with skin and soft tissue infections. MATERIAL AND METHODS: Methicillin-resistant S...
April 19, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28432698/quantitative-evaluation-of-metal-artifacts-using-different-cbct-devices-high-density-materials-and-field-of-views
#20
Marina Codari, Karla de Faria Vasconcelos, Laura Ferreira Pinheiro Nicolielo, Francisco Haiter Neto, Reinhilde Jacobs
OBJECTIVE: To objectively compare the influence of different cone-beam computed tomography (CBCT) devices, high-density materials and field of views (FOVs) on metal artifact expression. MATERIAL AND METHODS: For this in vitro study, three customized acrylic resin phantoms containing high-density materials cylinders: titanium, copper-aluminum alloy and amalgam were scanned on three CBCT devices using high-resolution protocols, same voxel size (0.2 mm) and different FOVs...
April 22, 2017: Clinical Oral Implants Research
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