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https://www.readbyqxmd.com/read/29166411/a-machine-learning-approach-to-triaging-patients-with-chronic-obstructive-pulmonary-disease
#1
Sumanth Swaminathan, Klajdi Qirko, Ted Smith, Ethan Corcoran, Nicholas G Wysham, Gaurav Bazaz, George Kappel, Anthony N Gerber
COPD patients are burdened with a daily risk of acute exacerbation and loss of control, which could be mitigated by effective, on-demand decision support tools. In this study, we present a machine learning-based strategy for early detection of exacerbations and subsequent triage. Our application uses physician opinion in a statistically and clinically comprehensive set of patient cases to train a supervised prediction algorithm. The accuracy of the model is assessed against a panel of physicians each triaging identical cases in a representative patient validation set...
2017: PloS One
https://www.readbyqxmd.com/read/29166203/temporal-profile-of-care-following-mild-traumatic-brain-injury-predictors-of-hospital-admission-follow-up-referral-and-six-month-outcome
#2
John K Yue, Ethan A Winkler, Sourabh Sharma, Mary J Vassar, Jonathan J Ratcliff, Frederick K Korley, Seth A Seabury, Adam R Ferguson, Hester F Lingsma, Sacha Meeuws, Opeolu M Adeoye, Jonathan W Rick, Caitlin K Robinson, Siena M Duarte, Esther L Yuh, Pratik Mukherjee, Sureyya S Dikmen, Thomas W McAllister, Ramon Diaz-Arrastia, Alex B Valadka, Wayne A Gordon, David O Okonkwo, Geoffrey T Manley
OBJECTIVE: To investigate the clinical management and medical follow-up of patients with mild traumatic brain injury (mTBI) presenting to emergency departments (EDs). METHODS: Overall, 168 adult patients with mTBI from the prospective, multicentre Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Pilot study with Glasgow Coma Scale (GCS) 13-15, no polytrauma and alive at six months were included. Predictors for hospital admission, three-month follow-up referral and six-month functional disability (Glasgow Outcome Scale-Extended (GOSE) ≤ 6) were analysed using multivariable regression...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29165005/models-of-care-in-tele-ophthalmology-a-scoping-review
#3
Liam J Caffery, Monica Taylor, Glen Gole, Anthony C Smith
The objective of this review was to identify and describe telehealth models of care for ophthalmic services. We conducted a scoping review of the literature to identify how ophthalmic care can be delivered by telehealth. We searched the PubMed database to identify relevant articles which were screened based on pre-defined inclusion criteria. For included articles, data were extracted, categorised and analysed. Synthesis of findings was performed narratively. The scoping review included 78 articles describing 62 discrete tele-ophthalmic models of care...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/29161402/fit-for-surgery-perspectives-on-preoperative-exercise-testing-and-training
#4
K Richardson, D Z H Levett, S Jack, M P W Grocott
There is a consistent relationship between physical activity, physical fitness, and health across almost all clinical contexts, including the perioperative setting. Physiological measurements obtained during physical exercise may be used to infer the risk of adverse outcome after major surgery. In particular, data obtained from perioperative cardiopulmonary exercise testing have an expanding role in perioperative care. Such information may be used to inform a variety of changes in clinical practice, including interventions that may reduce the risk of perioperative adverse events...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161279/whole-exome-sequencing-for-determination-of-tumor-mutation-load-in-liquid-biopsy-from-advanced-cancer-patients
#5
Florence Koeppel, Steven Blanchard, Cécile Jovelet, Bérengère Genin, Charles Marcaillou, Emmanuel Martin, Etienne Rouleau, Eric Solary, Jean-Charles Soria, Fabrice André, Ludovic Lacroix
Tumor mutation load (TML) has been proposed as a biomarker of patient response to immunotherapy in several studies. TML is usually determined by tumor biopsy DNA (tDNA) whole exome sequencing (WES), therefore TML evaluation is limited by informative biopsy availability. Circulating cell free DNA (cfDNA) provided by liquid biopsy is a surrogate specimen to biopsy for molecular profiling. Nevertheless performing WES on DNA from plasma is technically challenging and the ability to determine tumor mutation load from liquid biopsies remains to be demonstrated...
2017: PloS One
https://www.readbyqxmd.com/read/29160154/staging-neck-dissection-and-transoral-robotic-surgery-treatment-algorithm-in-palatine-tonsil-cancer
#6
Joseph Spellman, Ryan Sload, Paul Kim, Peter Martin, Gabriel Calzada
Objective This study introduces a treatment algorithm based on staging neck dissection to identify patients with palatine tonsil squamous cell carcinoma who can be effectively treated with single-modality transoral robotic surgery while maintaining quality of life. Study Design Retrospective case series. Setting Kaiser Permanente Southern California Medical Group from 2012 to 2017. Subjects and Methods Patients with early-stage (T1/2) palatine tonsil squamous cell carcinoma with clinically and radiographically N0 necks underwent staging neck dissection...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29156402/effect-of-initiating-drug-treatment-on-the-risk-of-drug-related-poisoning-death-and-acquisitive-crime-among-offending-heroin-users
#7
Matthias Pierce, Sheila M Bird, Matthew Hickman, John Marsden, Graham Dunn, Toby Seddon, Tim Millar
BACKGROUND: A recent Cochrane review of randomised trials identified a lack of evidence for interventions provided to drug-using offenders. We use routine data to address whether contact with treatment services reduces heroin users' likelihood of a future acquisitive offence or drug-related poisoning (DRP) death. METHODS: Heroin-users were identified from probation assessments and linked to drug-treatment, mortality and offending records. The study cohort was selected to ensure that the subject was not: in prison, in treatment or had recently left treatment...
November 17, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29154810/multiple-performance-measures-are-needed-to-evaluate-triage-systems-in-the-emergency-department
#8
Joany M Zachariasse, Daan Nieboer, Rianne Oostenbrink, Henriëtte A Moll, Ewout W Steyerberg
OBJECTIVE: Emergency department triage systems can be considered prediction rules with an ordinal outcome, where different directions of misclassification have different clinical consequences. We evaluated strategies to compare the performance of triage systems and aim to propose a set of performance measures that should be used in future studies. STUDY DESIGN AND SETTING: We identified performance measures based on literature review and expert knowledge. Their properties are illustrated in a case study evaluating two triage modifications in a cohort of 14,485 pediatric emergency department visits...
November 14, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29153541/screening-for-cervical-cancer-among-hiv-positive-and-hiv-negative-women-in-cameroon-using-simultaneous-co-testing-with-carehpv-dna-testing-and-visual-inspection-enhanced-by-digital-cervicography-findings-of-initial-screening-and-one-year-follow-up
#9
Preetam Cholli, Leslie Bradford, Simon Manga, Kathleen Nulah, Edith Kiyang, Florence Manjuh, Geneva DeGregorio, Rebecca K Ogembo, Enow Orock, Yuxin Liu, Richard G Wamai, Lisa Kennedy Sheldon, Philimon N Gona, Zacharie Sando, Thomas Welty, Edith Welty, Javier Gordon Ogembo
OBJECTIVE: The World Health Organization (WHO)'s cervical cancer screening guidelines for limited-resource settings recommend sequential screening followed by same-day treatment under a "screen-and-treat" approach. We aimed to (1) assess feasibility and clinical outcomes of screening HIV-positive and HIV-negative Cameroonian women by pairing visual inspection with acetic acid and Lugol's iodine enhanced by digital cervicography (VIA/VILI-DC) with careHPV, a high-risk human papillomavirus (HR-HPV) nucleic acid test designed for low-resource settings; and (2) determine persistence of HR-HPV infection after one-year follow-up to inform optimal screening, treatment, and follow-up algorithms...
November 15, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29151402/difference-in-first-aid-activity-during-mass-casualty-training-based-on-having-taken-an-educational-course
#10
Youichi Yanagawa, Kazuhiko Omori, Kouhei Ishikawa, Ikuto Takeuchi, Kei Jitsuiki, Toshihiko Yoshizawa, Jun Sato, Hideyuki Matsumoto, Masaru Tsuchiya, Hiromichi Osaka
BACKGROUND: The Japanese Association for Disaster Medicine developed a mass casualty life support (MCLS) course to improve cooperation among medical practitioners during a disaster, which is essential for reducing the rates of preventable disaster death. We investigated whether there was difference in first aid activity among members of the ambulance service during mass casualty training based on having taken the MCLS course. METHODS: Mass casualty training was held at the fire department of Numazu City...
November 20, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29151009/risk-stratification-triage-and-implementation-of-an-expedited-hip-fracture-treatment-protocol-is-it-safe-and-effective
#11
William Zelenty, Richard Yoon, Lorraine Hutzler, Nirmal Tejwani, Joseph Bosco
INTRODUCTION: The population of patients in the USA over the age of 65 is expected to significantly increase over the next 40 years. These patients are at increased risk for hip fractures and will pose a burden to providers in the near future. In order to provide high value care, providers will need to maintain positive outcomes, mitigate complications, and reduce overall cost burdens. This study was designed to investigate the safety and efficacy of a patient transfer protocol between a large academic medical center and a single specialty orthopaedic institution...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29150972/patient-level-factors-and-the-quality-of-care-delivered-in-pediatric-emergency-departments
#12
James P Marcin, Patrick S Romano, Parul Dayal, Madan Dharmar, James M Chamberlain, Nanette Dudley, Charles G Macias, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Meridith Sonnett, Leah Tzimenatos, Elizabeth R Alpern, Rebecca Andrews-Dickert, Dominic A Borgialli, Erika Sidney, T Charles Casper, J Michael Dean, Nathan Kuppermann
OBJECTIVE: Quality of care delivered to adult patients in the emergency department (ED) is often associated with demographic and clinical factors such as a patient's race/ethnicity and insurance status. We sought to determine whether the quality of care delivered to children in the ED was associated with a variety of patient-level factors. METHODS: This was a retrospective, observational cohort study. Pediatric patients (<18 years) who received care between January 2011 and December 2011 at one of twelve EDs participating in the Pediatric Emergency Care Applied Research Network (PECARN) were included...
November 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29149903/improving-access-to-school-health-services-as-perceived-by-school-professionals
#13
Janine Bezem, Debbie Heinen, Ria Reis, Simone E Buitendijk, Mattijs E Numans, Paul L Kocken
BACKGROUND: The organisation of health assessments by preventive health services focusing on children's health and educational performance needs to be improved due to evolving health priorities such as mental health problems, reduced budgets and shortages of physicians and nurses. We studied the impact on the school professionals' perception of access to school health services (SHS) when a triage approach was used for population-based health assessments in primary schools. The triage approach involves pre-assessments by SHS assistants, with only those children in need of follow-up being assessed by a physician or nurse...
November 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29149873/health-care-workers-knowledge-attitudes-and-practices-on-tuberculosis-infection-control-nepal
#14
Anita Shrestha, Dipesh Bhattarai, Barsha Thapa, Prem Basel, Rajendra Raj Wagle
BACKGROUND: Infection control remains a key challenge for Tuberculosis (TB) control program with an increased risk of TB transmission among health care workers (HCWs), especially in settings with inadequate TB infection control measures. Poor knowledge among HCWs and inadequate infection control practices may lead to the increased risk of nosocomial TB transmission. METHODS: An institution-based cross-sectional survey was conducted in 28 health facilities providing TB services in the Kathmandu Valley, Nepal...
November 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29149359/-preclinical-and-intrahospital-management-of-mass-casualties-and-terrorist-incidents
#15
REVIEW
A Franke, D Bieler, B Friemert, E Kollig, S Flohe
Due to the recent terrorist attacks in Paris, Brussels, Ansbach, Munich, Berlin and more recently Manchester and London, terrorism is realized as a present threat to our society and social life, as well as a challenge for the health care system. Without fueling anxiety, there is a need for sensitization to this subject and to familiarize all concerned with the special kind of terrorist attack-related injuries, the operational priorities and tactics and the individual basic principles of preclinical and hospital care...
October 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29148755/novel-anti-tubercular-6-dialkylaminopyrimidine-carboxamides-from-phenotypic-whole-cell-high-throughput-screening-of-a-softfocus-library-structure-activity-relationship-and-target-identification-studies
#16
Colin R Wilson, Richard K Gessner, Atica Moosa, Ronnett Seldon, Digby F Warner, Valerie Mizrahi, Candice Soares de Melo, Sandile B Simelane, Aloysius T Nchinda, Efrem Abay, Dale Taylor, Mathew Njoroge, Christel Brunschwig, Nina Lawrence, Helena I M Boshoff, Clifton E Barry, Frederick A Sirgel, Paul van Helden, C John Harris, Richard Gordon, Sonja Ghidelli-Disse, Hannah Pflaumer, Markus Boesche, Gerard Drewes, Olalla Sanz, Gracia Santos, Maria José Rebollo-Lopez, Beatriz Urones, Carolyn Selenski, Maria Jose Lafuente-Monasterio, Matthew Axtman, Joël Lelièvre, Lluis Ballell, Rudolf Mueller, Leslie J Street, Sandeep R Ghorpade, Kelly Chibale
A BioFocus DPI SoftFocus library of ~35,000 compounds was screened against Mycobacterium tuberculosis (Mtb) in order to identify novel hits with anti-tubercular activity. The hits were evaluated in biology triage assays to exclude compounds suggested to function via frequently encountered promiscuous mechanisms of action including inhibition of the QcrB subunit of the cytochrome bc1 complex, disruption of cell-wall homeostasis, and DNA damage. Among the hits which passed this screening cascade, a 6-dialkylaminopyrimidine carboxamide series was prioritized for hit to lead optimization...
November 17, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29148638/factors-associated-with-treatment-outcome-of-pediatric-cancerpatients-admitted-with-febrile-neutropenia-in-tikuranbessa-specialized-teaching-hospital-addis-ababa-ethiopia
#17
Selamawit Assefa, Tinsae Alemayehu, Workeabeba Abebe
Background: Cancer treatment is associated with variable degrees of myelosupression. Infection is often a life-threatening complication of chemotherapy-induced neutropenia, and it is also considered an oncologic emergency. Febrile neutropenia is a common, costly and potentially fatal complication in oncology. Objective: To assess factors affecting treatment outcome of cancer patients with chemotherapy induced febrile neutropenia. Method: We conducted a review of records of pediatric patients hospitalized and treated for chemotherapy-induced febrile neutropenia from January 1, 2013 to December 31, 2013 and met the selection criteria...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29146385/cross-cultural-adaptation-and-implementation-of-good-life-with-osteoarthritis-in-denmark-gla-d-tm-group-education-and-exercise-for-hip-and-knee-osteoarthritis-is-feasible-in-canada
#18
Aileen M Davis, Deborah Kennedy, Rosalind Wong, Susan Robarts, Søren T Skou, Rhona McGlasson, Linda C Li, Ewa Roos
OBJECTIVE: Adapt and evaluate the feasibility of implementing Good Life with osteoArthritis in Denmark (GLA:D(TM)) in Canada for people with mild to severe hip/knee osteoarthritis. METHODS: Patients triaged to non-surgical management participated in two education sessions and 12 supervised, neuromuscular exercise classes. We used the RE-AIM implementation framework evaluating outcomes of Reach, Effectiveness/Efficacy, Adoption, Implementation and Maintenance. Patients completed surveys pre-program and at 3 months follow-up...
November 13, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29143448/prospective-observational-study-of-predicted-usage-of-intravenous-cannulas-inserted-in-a-tertiary-paediatric-emergency-department
#19
William Hollaway, Carsten Broeze, Meredith L Borland
OBJECTIVES: To determine the proportion of unused peripheral intravenous cannulas (PIVCs) inserted in a paediatric emergency department (PED) and to assess clinicians' abilities to predict future usage of PIVC. METHODS: Prospective concealed observational study in a tertiary PED. Healthcare workers (HCWs) completed questionnaires upon insertion and removal of PIVC with review of patient notes if required. The primary outcome was the number of unused, unnecessary PIVCs...
November 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29143102/diagnostic-performance-of-hpv-e6-e7-mrna-assay-for-detection-of-cervical-high-grade-intraepithelial-neoplasia-and-cancer-among-women-with-ascus-papanicolaou-smears
#20
Chenchen Ren, Yuanhang Zhu, Li Yang, Xiaoan Zhang, Ling Liu, Chunying Ren
PURPOSE: The aim of this study was to investigate the clinical performance of high risk (HR) HPV E6/E7 mRNA assay in detecting cervical high-grade intraepithelial neoplasia and cancer among women with atypical squamous cells of undetermined significance (ASCUS) Papanicolaou (Pap) smears. METHODS: A total of 160 patients with ASCUS who underwent HR-HPV DNA assay, HR-HPV E6/E7 mRNA assay and colposcopy biopsy at Third Affiliated Hospital of Zhengzhou University, China, from December 2015 to March 2017, were enrolled...
November 15, 2017: Archives of Gynecology and Obstetrics
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