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https://www.readbyqxmd.com/read/28737573/investigating-the-impact-of-different-suspicion-of-infection-criteria-on-the-accuracy-of-quick-sepsis-related-organ-failure-assessment-systemic-inflammatory-response-syndrome-and-early-warning-scores
#1
Matthew M Churpek, Ashley Snyder, Sarah Sokol, Natasha N Pettit, Dana P Edelson
OBJECTIVE: Studies in sepsis are limited by heterogeneity regarding what constitutes suspicion of infection. We sought to compare potential suspicion criteria using antibiotic and culture order combinations in terms of patient characteristics and outcomes. We further sought to determine the impact of differing criteria on the accuracy of sepsis screening tools and early warning scores. DESIGN: Observational cohort study. SETTING: Academic center from November 2008 to January 2016...
July 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28736692/evaluating-the-impact-of-a-hiv-low-risk-express-care-task-shifting-program-a-case-study-of-the-targeted-learning-roadmap
#2
Linh Tran, Constantin T Yiannoutsos, Beverly S Musick, Kara K Wools-Kaloustian, Abraham Siika, Sylvester Kimaiyo, Mark J van der Laan, Maya Petersen
In conducting studies on an exposure of interest, a systematic roadmap should be applied for translating causal questions into statistical analyses and interpreting the results. In this paper we describe an application of one such roadmap applied to estimating the joint effect of both time to availability of a nurse-based triage system (low risk express care (LREC)) and individual enrollment in the program among HIV patients in East Africa. Our study population is comprised of 16,513 subjects found eligible for this task-shifting program within 15 clinics in Kenya between 2006 and 2009, with each clinic starting the LREC program between 2007 and 2008...
December 2016: Epidemiologic Methods
https://www.readbyqxmd.com/read/28736342/tfos-dews-ii-diagnostic-methodology-report
#3
REVIEW
James S Wolffsohn, Reiko Arita, Robin Chalmers, Ali Djalilian, Murat Dogru, Kathy Dumbleton, Preeya Gupta, Paul Karpecki, Sihem Lazreg, Heiko Pult, Benjamin D Sullivan, Alan Tomlinson, Louis Tong, Edoardo Villani, Kyung Chul Yoon, Lyndon Jones, Jennifer Craig
The role of the Tear Film and Ocular Surface Society (TFOS) Dry Eye Workshop (DEWS) II Diagnostic Methodology Subcommittee was 1) to identify tests used to diagnose and monitor dry eye disease (DED), 2) to identify those most appropriate to fulfil the definition of DED and its sub-classifications, 3) to propose the most appropriate order and technique to conduct these tests in a clinical setting, and 4) to provide a differential diagnosis for DED and distinguish conditions where it is a comorbidity. Symptom screening with the DEQ-5 or OSDI confirms that a patient might have DED and triggers the diagnostic tests of (ideally non-invasive) breakup time, osmolarity and ocular surface staining with fluorescein and lissamine green (observing the cornea, conjunctiva and eyelid margin)...
May 4, 2017: Ocular Surface
https://www.readbyqxmd.com/read/28731783/identification-of-sppl2a-inhibitors-by-multiparametric-analysis-of-a-high-content-ultra-high-throughput-screen
#4
Xian Zhang, Marjo Götte, Yvonne Ibig-Rehm, Ansgar Schuffenhauer, Marion Kamke, Dan Beisner, Danilo Guerini, Daniela Siebert, Ghislain M C Bonamy, Daniela Gabriel, Ursula Bodendorf
The intramembrane protease signal peptide peptidase-like 2a (SPPL2a) is a potential drug target for the treatment of autoimmune diseases due to an essential role in B cells and dendritic cells. To screen a library of 1.4 million compounds for inhibitors of SPPL2a, we developed an imaging assay detecting nuclear translocation of the proteolytically released cytosolic substrate fragment. The state-of-the-art hit calling approach based on nuclear translocation resulted in numerous false-positive hits, mainly interrupting intracellular protein trafficking...
July 1, 2017: SLAS Discovery
https://www.readbyqxmd.com/read/28731050/genomic-abnormalities-in-invasive-endocervical-adenocarcinoma-correlate-with-pattern-of-invasion-biologic-and-clinical-implications
#5
Anjelica Hodgson, Yutaka Amemiya, Arun Seth, Matthew Cesari, Bojana Djordjevic, Carlos Parra-Herran
The pattern-based classification system for HPV-related endocervical adenocarcinoma, which classifies tumors based on the destructiveness of stromal invasion, is predictive of the risk of nodal metastases and adverse outcome. Previous studies have demonstrated clinically important molecular alterations in endocervical adenocarcinoma, including KRAS and PIK3CA mutations; however, correlation between the molecular landscape and pathological variables including pattern of invasion has not been thoroughly explored...
July 21, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28730987/evaluation-of-an-advanced-practice-physiotherapist-in-triaging-patients-with-lumbar-spine-pain-surgeon-physiotherapist-level-of-agreement-and-patient-satisfaction
#6
Susan Robarts, Paul Stratford, Deborah Kennedy, Barry Malcolm, Joel Finkelstein
BACKGROUND: Surgery for lumbar spine pain is indicated for specific etiologies. Given the majority of individuals referred to spine surgeons are not surgical candidates, care delivery is inefficient, with consultations being of limited value for most. Using specially trained physiotherapists in triage is a human resource strategy that may optimize surgeons' time and the patient experience. METHODS: An advanced-practice physiotherapist (APP) and a surgeon assessed consecutive patients with lumbar spine pain presenting at an academic health centre's spine surgery clinic...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28730227/hpv-genotyping-and-p16%C3%A3-ki-67-dual-staining-in-the-detection-of-high-grade-cervical-lesion-in-patients-with-lsil-on-pap-smear
#7
Lavinia Cristina Moleriu, Ioan Sas, Adrian Claudiu RaŢiu, Mădălin Marius Margan, Cristina Anamaria Secoşan, Răzvan Ştefan Ilina, Florin George Horhat, Loredana Gabriela Stana, Dorin Grigoraş, LaurenŢiu Cornel Pirtea
p16÷Ki-67 dual-stained cytology, either alone or combined with human papillomavirus (HPV) 16÷18 genotyping, could be a useful tool for triage for colposcopy of HPV-positive patients. Based on this background, we aimed at comparing the diagnostic performance of the p16÷Ki-67 dual staining test, and high-risk HPV test for the detection of high-risk cervical intraepithelial neoplasia (CIN2÷3) in patients diagnosed with low-grade squamous intraepithelial lesion (LSIL) on Pap smear. We performed a retrospective study including 184 patients with LSIL cytology on Pap smear, of which 64 were referred for biopsy after colposcopy...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28729322/feasibility-of-a-uk-community-based-etherapy-mental-health-service-in-greater-manchester-repeated-measures-and-between-groups-study-of-living-life-to-the-full-interactive-sleepio-and-breaking-free-online-at-self-help-services
#8
Sarah Elison, Jonathan Ward, Chris Williams, Colin Espie, Glyn Davies, Stephanie Dugdale, Kathryn Ragan, Leanne Chisnall, Nicky Lidbetter, Keith Smith
OBJECTIVES: There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services. Therefore, this service evaluation reports on feasibility and outcomes from an eTherapy mental health service. SETTING: 'Self Help Services', an Increasing Access to Psychological Therapies (IAPT) eTherapy service in Greater Manchester. PARTICIPANTS: 1068 service users referred to the service for secondary care for their mental health difficulties...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728604/target-d-a-stratified-individually-randomized-controlled-trial-of-the-diamond-clinical-prediction-tool-to-triage-and-target-treatment-for-depressive-symptoms-in-general-practice-study-protocol-for-a-randomized-controlled-trial
#9
Jane Gunn, Caroline Wachtler, Susan Fletcher, Sandra Davidson, Cathrine Mihalopoulos, Victoria Palmer, Kelsey Hegarty, Amy Coe, Elizabeth Murray, Christopher Dowrick, Gavin Andrews, Patty Chondros
BACKGROUND: Depression is a highly prevalent and costly disorder. Effective treatments are available but are not always delivered to the right person at the right time, with both under- and over-treatment a problem. Up to half the patients presenting to general practice report symptoms of depression, but general practitioners have no systematic way of efficiently identifying level of need and allocating treatment accordingly. Therefore, our team developed a new clinical prediction tool (CPT) to assist with this task...
July 20, 2017: Trials
https://www.readbyqxmd.com/read/28728306/-interpretation-of-guidance-for-establishing-the-performance-characteristics-of-in-vitro-diagnostic-devices-for-the-detection-or-detection-and-differentiation-of-high-risk-human-papillomaviruses-issued-by-food-and-drug-administration-of-united-states-and-china
#10
R M Feng, W Chen, Y L Qiao
To establish the standardization of clinical verification designs for in vitro diagnostic devices(IVDs) of human papillomavirus, China Food and Drug Administration (CFDA) and United States Food and Drug Administration (FDA) issued guidelines of detailed study designs and effectiveness evaluation for accuracy validation and clinical performance of nucleic acid detection, respectively, including triage of a typical squamous cells of undetermined significance(ASC-US) patients and validation of combined screening and preliminary screening...
July 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28728222/-application-of-p16-ki-67-immunocytochemistry-in-triage-of-patients-with-atypical-squamous-cells-of-undetermined-significance
#11
R R Jin, H W Ma, T Y Chen, R Rong, Y Wu, S L Li, Z H Zhang
Objective: To investigate the clinical value of p16/Ki-67 immunocytochemistry in patients with atypical squamous cells of undetermined significance(ASC-US). Methods: One hundred and seventy-one cases of thin-prep cytology test (TCT) diagnosed as ASC-US underwent p16/Ki-67 immunocytochemistry. All patients had colposcopy and biopsy from March 2015 to January 2016. Ninety of the 171 cases underwent high-risk HPV test at the same time. Results: p16/Ki-67 immunocytochemistry was positive in 43.9% (75/171) of the 171 cytology samples; the sensitivity and specificity of p16/Ki-67 immunocytochemistry were 77...
July 8, 2017: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
https://www.readbyqxmd.com/read/28727521/ethical-guidance-for-disaster-response-specifically-around-crisis-standards-of-care-a-systematic-review
#12
Jonathon P Leider, Debra DeBruin, Nicole Reynolds, Angelica Koch, Judy Seaberg
BACKGROUND: Terrorism, disease outbreaks, and other natural disasters and mass casualty events have pushed health care and public health systems to identify and refine emergency preparedness protocols for disaster response. Ethical guidance, alongside legal and medical frameworks, are increasingly common components of disaster response plans. OBJECTIVES: To systematically review the prevalence and content of ethical guidance offered for disaster response, specifically around crisis standards of care (CSCs)...
July 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28727502/triage-in-psychiatric-emergency-services-in-copenhagen-results-from-a-descriptive-1-year-evaluation-study
#13
Ditte Sæbye, Erica Bernt Høegh, Joachim Knop
Inspired by the Australasian triage system, a regional psychiatric triage system was introduced in the psychiatric emergency units (PEUs) in Copenhagen in 2011. Our aim of the study is to determine the characteristics of the patient according to the defined triage criteria and check if this is in accordance with recommendations. A random 10% data sample was obtained throughout 2012 in three PEUs of Copenhagen. Triage category, demographic, social and clinically relevant variables were collected. A total of 929 contacts were registered...
July 20, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28726539/rethinking-transitions-of-care-an-interprofessional-transfer-triage-protocol-in-post-acute-care
#14
Radha V Patel, Lauri Wright, Brittany Hay
Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28725580/pre-biopsy-mri-as-an-adjunct-for-cancer-detection-in-men-with-elevated-psa-and-no-previous-biopsy
#15
REVIEW
Facundo Uriburu-Pizarro, Veeru Kasivisvanathan, Philippe Puech, Arnauld Villers
The role of magnetic resonance imaging (MRI) prior to biopsy in the diagnosis of prostate cancer in biopsy-naïve patients has been strengthened by recent developments such as the PIRADS V2 criteria, which cover acquisition, interpretation, and reporting for clinical practice and data collection for research. Important questions on the role of prostate MRI remain: can MRI be used as a triage test before first biopsy series? Can it be used to avoid the use of systematic biopsies (SB) and instead use only targeted biopsies (TB) to MRI-suspicious lesions? Studies to evaluate image guided TB compared to SB have started to accumulate...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28723900/the-natural-history-of-acute-ebola-virus-disease-among-patients-managed-in-five-ebola-treatment-units-in-west-africa-a-retrospective-cohort-study
#16
Kelly Skrable, Reshma Roshania, Michaela Mallow, Vanessa Wolfman, Matthew Siakor, Adam C Levine
INTRODUCTION: Previous studies of Ebola Virus Disease (EVD) have focused on clinical symptoms and Ebola virus (EBOV) cycle threshold (CT) values recorded at patient triage. Our study explores EVD symptoms and EBOV CT values from onset of illness to recovery or death in a diverse population of patients. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed clinical care data from EBOV positive patients admitted to five Ebola treatment units in West Africa from 2014-2015. Prevalence of clinical signs/symptoms and CT values were explored using descriptive statistics...
July 19, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28721933/transient-lesions-of-the-splenium-of-the-corpus-callosum-following-rapid-withdrawal-of-levetiracetam
#17
Ryo Sawagashira, Hisashi Narita, Naoki Hashimoto, Tsugiko Kurita, Shin Nakagawa, Takuya Saitoh, Ichiro Kusumi
Transient lesions of the splenium of the corpus callosum are characterized by MRI findings. The lesions are very rare, but significant from a clinical standpoint as differential diagnoses include serious conditions such as encephalitis, meningitis, and neuroleptic malignant syndrome. In addition, it is reported that some are attributed to the withdrawal of antiepileptic drugs. Here, we present a case of transient lesions of the splenium of the corpus callosum following rapid withdrawal of levetiracetam alone...
July 19, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28720723/profile-and-outcomes-of-critically-ill-children-in-a-lower-middle-income-country
#18
Muhammad Irfan Habib, Khalid Mehmood A Khan
OBJECTIVE: To determine the clinical profile and outcome of critically ill children presenting to a paediatric ED in a lower middle-income country. METHODS: We performed a retrospective analysis of children (<14 years) presenting to the ED of the National Institute of Child Health, Karachi, between January and December 2014 who were assigned to acuity 1 (requiring immediate life-saving interventions) according to the Emergency Severity Index. Data included demographic variables, presenting complaints, interventions and outcomes in the ED...
July 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28720720/comparison-of-prehospital-triage-and-five-level-triage-system-at-the-emergency-department
#19
Li-Heng Tsai, Chien-Hsiung Huang, Yi-Chia Su, Yi-Ming Weng, Chung-Hsien Chaou, Wen-Cheng Li, Chan-Wei Kuo, Chip-Jin Ng
OBJECTIVE: There is lack of scientific evidence regarding the effectiveness of prehospital triage systems. This study compared the two-level Taiwan Prehospital Triage System (TPTS) with the five-level Taiwan Triage and Acuity Scale (TTAS) at ED arrival regarding the prediction of patient outcomes and the utilisation of medical resources. DESIGN: This was a retrospective cohort study. Adult patients transported via the emergency medical service (EMS), who arrived at the ED of a medical centre in northern Taiwan during the study period were enrolled...
July 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28720454/comparative-accuracy-of-pap-smear-and-hpv-screening-in-ubon-ratchathani-in-thailand
#20
Suleeporn Sangrajrang, Piyawat Laowahutanont, Metee Wongsena, Richard Muwonge, Anant Karalak, Weerawut Imsamran, Virginia Senkomago, Rengaswamy Sankaranarayanan
We evaluate the potential for using high-risk human papillomavirus (hr-HPV) testing-based screening for cervical intraepithelial neoplasia (CIN) in routine health services in Thailand; its accuracy in comparison to that of conventional cytology (CC); and the utility of HPV16/18 positive results and liquid-based cytology (LBC) triage for HPV-positive women in the detection of high-grade CIN. Women aged 30-60 years in Ubon Ratchathani province, Thailand were screened with CC and hr-HPV testing and those abnormal on either tests were referred for colposcopy and/or directed biopsies...
June 2017: Papillomavirus Research
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