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https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#1
Welmoed K van Deen, Arlen Spiro, A Burak Ozbay, Martha Skup, Adriana Centeno, Natalie E Duran, Precious N Lacey, Darius Jatulis, Eric Esrailian, Martijn G H van Oijen, Daniel W Hommes
BACKGROUND AND OBJECTIVES: Value-based healthcare (VBHC) is considered to be the solution that will improve quality and decrease costs in healthcare. Many hospitals are implementing programs on the basis of this strategy, but rigorous scientific reports are still lacking. In this pilot study, we present the first-year outcomes of a VBHC program for inflammatory bowel disease (IBD) management that focuses on highly coordinated care, task differentiation of providers, and continuous home monitoring...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27926378/automated-segmentation-of-white-matter-fiber-bundles-using-diffusion-tensor-imaging-data-and-a-new-density-based-clustering-algorithm
#2
Tahereh Kamali, Daniel Stashuk
OBJECTIVE: Robust and accurate segmentation of brain white matter (WM) fiber bundles assists in diagnosing and assessing progression or remission of neuropsychiatric diseases such as schizophrenia, autism and depression. Supervised segmentation methods are infeasible in most applications since generating gold standards is too costly. Hence, there is a growing interest in designing unsupervised methods. However, most conventional unsupervised methods require the number of clusters be known in advance which is not possible in most applications...
October 2016: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/27925480/evaluation-of-background-parenchymal-enhancement-on-breast-mri-a-systematic-review
#3
Bianca Bignotti, Alessio Signori, Francesca Valdora, Federica Rossi, Massimo Calabrese, Manuela Durando, Giovanna Mariscotti, Alberto Tagliafico
OBJECTIVES: To perform a systematic review of the methods used for background parenchymal enhancement (BPE) evaluation on breast magnetic resonance imaging (MRI). METHODS: Studies dealing with BPE assessment on breast MRI were retrieved from major medical libraries independently by four reviewers up to 6 October 2015. The keywords used for database searching are "background parenchymal enhancement', 'parenchymal enhancement', "MRI" and "breast". The studies were included if a qualitative and/or quantitative methods for BPE assessment were described...
December 7, 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27924720/n-terminal-pro-b-type-natriuretic-peptide-and-subclinical-brain-damage-in-the-general-population
#4
Hazel I Zonneveld, M Arfan Ikram, Albert Hofman, Wiro J Niessen, Aad van der Lugt, Gabriel P Krestin, Oscar H Franco, Meike W Vernooij
Purpose To investigate the association between N-terminal pro-B-type natriuretic peptide (NT-proBNP), which is a marker of heart disease, and markers of subclinical brain damage on magnetic resonance (MR) images in community-dwelling middle-aged and elderly subjects without dementia and without a clinical diagnosis of heart disease. Materials and Methods This prospective population-based cohort study was approved by a medical ethics committee overseen by the national government, and all participants gave written informed consent...
December 7, 2016: Radiology
https://www.readbyqxmd.com/read/27924366/utility-of-plain-radiographs-and-mri-in-cervical-spine-clearance-in-symptomatic-non-obtunded-pediatric-patients-without-high-impact-trauma
#5
Justin M Moore, Jonathan Hall, Michael Ditchfield, Christopher Xenos, Andrew Danks
PURPOSE: The optimal imaging modality for evaluating cervical spine trauma and optimizing management in the pediatric population is controversial. In pediatric populations, there are no well-established guidelines for cervical spine trauma evaluation and treatment. Currently, there is virtually no literature regarding imaging and management of symptomatic pediatric patients who present with cervical spine trauma without high-impact mechanism. This study aims to establish an optimal imaging strategy for this subgroup of trauma patients...
December 6, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27924218/sex-related-differences-in-the-associations-between-plasma-free-fatty-acid-levels-and-clinical-features-in-patients-with-hypertrophic-cardiomyopathy
#6
Chengzhi Yang, Changlin Zhang, Jiansong Yuan, Jingang Cui, Shengwen Liu, Fenghuan Hu, Weixian Yang, Xuanye Bi, Shubin Qiao
BACKGROUND: Previous studies have indicated that inefficient energy utilization may play a pivotal role in hypertrophic cardiomyopathy (HCM). However, whether plasma free fatty acid (FFA), a main energy substrate of heart, has an effect on HCM remains unclear. Besides, several studies have suggested sex-related differences in HCM features and FFA metabolism. Here, we aimed to explore the association between plasma FFA levels and HCM and potential effects of sex on this relation. METHODS: A total of 412 patients (age 47...
2016: Biology of Sex Differences
https://www.readbyqxmd.com/read/27923935/radiographic-mastoid-and-middle-ear-effusions-in-intensive-care-unit-subjects
#7
Phillip Huyett, Yael Raz, Barry E Hirsch, Andrew A McCall
BACKGROUND: This study was conducted to determine the incidence of and risk factors associated with the development of radiographic mastoid and middle ear effusions (ME/MEE) in ICU patients. METHODS: Head computed tomography or magnetic resonance images of 300 subjects admitted to the University of Pittsburgh Medical Center neurologic ICU from April 2013 through April 2014 were retrospectively reviewed. Images were reviewed for absent, partial, or complete opacification of the mastoid air cells and middle ear space...
December 6, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27923496/neural-correlates-of-rdoc-reward-constructs-in-adolescents-with-diverse-psychiatric-symptoms-a-reward-flanker-task-pilot-study
#8
Kailyn A L Bradley, Julia A C Case, Rachel D Freed, Emily R Stern, Vilma Gabbay
BACKGROUND: There has been growing interest under the Research Domain Criteria initiative to investigate behavioral constructs and their underlying neural circuitry. Abnormalities in reward processes are salient across psychiatric conditions and may precede future psychopathology in youth. However, the neural circuitry underlying such deficits has not been well defined. Therefore, in this pilot, we studied youth with diverse psychiatric symptoms and examined the neural underpinnings of reward anticipation, attainment, and positive prediction error (PPE, unexpected reward gain)...
December 1, 2016: Journal of Affective Disorders
https://www.readbyqxmd.com/read/27922974/training-and-validating-a-deep-convolutional-neural-network-for-computer-aided-detection-and-classification-of-abnormalities-on-frontal-chest-radiographs
#9
Mark Cicero, Alexander Bilbily, Errol Colak, Tim Dowdell, Bruce Gray, Kuhan Perampaladas, Joseph Barfett
OBJECTIVES: Convolutional neural networks (CNNs) are a subtype of artificial neural network that have shown strong performance in computer vision tasks including image classification. To date, there has been limited application of CNNs to chest radiographs, the most frequently performed medical imaging study. We hypothesize CNNs can learn to classify frontal chest radiographs according to common findings from a sufficiently large data set. MATERIALS AND METHODS: Our institution's research ethics board approved a single-center retrospective review of 35,038 adult posterior-anterior chest radiographs and final reports performed between 2005 and 2015 (56% men, average age of 56, patient type: 24% inpatient, 39% outpatient, 37% emergency department) with a waiver for informed consent...
December 5, 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27922579/srs-22r-scores-in-non-operated-adolescent-idiopathic-scoliosis-patients-with-curves-greater-than-forty-degrees
#10
W Timothy Ward, Nicole A Friel, Tanya S Kenkre, Maria M Brooks, Joanne A Londino, James W Roach
STUDY DESIGN: Case control comparative series OBJECTIVE.: Describe surgical range adolescent idiopathic scoliosis (AIS) patients electing to forgo surgery and compare health related quality of life outcomes to a similar cohort of operated AIS patients by the same single surgeon. SUMMARY OF BACKGROUND DATA: No data have been published either documenting SRS-22r scores of non-operated patients with curves ≥ 40° or comparing these scores to a demographically similar operated cohort...
December 2, 2016: Spine
https://www.readbyqxmd.com/read/27922502/the-limb-girdle-muscular-dystrophies-and-the-dystrophinopathies
#11
Stanley Jones P Iyadurai, John T Kissel
PURPOSE OF REVIEW: The classic approach to identifying and accurately diagnosing limb-girdle muscular dystrophies (LGMDs) relied heavily on phenotypic characterization and ancillary studies including muscle biopsy. Because of rapid advances in genetic sequencing methodologies, several additional LGMDs have been molecularly characterized, and the diagnostic approach to these disorders has been simplified. This article summarizes the epidemiology, clinical features, and genetic defects underlying the LGMDs...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27921154/peripheral-stent-thrombosis-leading-to-acute-limb-ischemia-and-major-amputation-incidence-and-risk-factors-in-the-aortoiliac-and-femoropopliteal-arteries
#12
Konstantinos Katsanos, Said A M Al-Lamki, Aneeta Parthipun, Stavros Spiliopoulos, Sanjay Dhanji Patel, Ioannis Paraskevopoulos, Hany Zayed, Athanasios Diamantopoulos
PURPOSE: To report the real-world incidence and risk factors of stent thrombosis in the aortoiliac and femoropopliteal arteries in case of bare nitinol stent (BNS) or covered nitinol stent (CNS) placement from a single-centre retrospective audit. MATERIALS AND METHODS: Medical records of consecutive patients treated with peripheral stent placement for claudication or critical limb ischemia were audited for definite stent thrombosis defined as imaging confirmed stent thrombosis that presented as acute limb-threatening ischemia...
December 5, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27921127/pre-authorization-processes-have-no-effect-on-patients-undergoing-knee-mri-in-a-pediatric-setting-when-evaluated-by-specialists
#13
Drew Pierce, J Herman Kan, Megan May, George S Bisset
OBJECTIVE: Pre-authorization processes are often used by medical insurance companies to reduce costs by managing the utilization of advanced diagnostic imaging, and their impact on patient care is unclear. The purpose of our study is to determine if a pre-authorization process increases the rate of surgically significant abnormal knee MRI and surgical referrals compared with patients referred from pediatric orthopedic specialists who do not undergo a pre-authorization process. MATERIALS AND METHODS: A retrospective study was performed; 124 patients were identified who were referred for knee MRI by a pediatric orthopedist...
December 5, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27921072/anatomy-based-algorithm-for-automatic-segmentation-of-human-diaphragm-in-noncontrast-computed-tomography-images
#14
Elham Karami, Yong Wang, Stewart Gaede, Ting-Yim Lee, Abbas Samani
In-depth understanding of the diaphragm's anatomy and physiology has been of great interest to the medical community, as it is the most important muscle of the respiratory system. While noncontrast four-dimensional (4-D) computed tomography (CT) imaging provides an interesting opportunity for effective acquisition of anatomical and/or functional information from a single modality, segmenting the diaphragm in such images is very challenging not only because of the diaphragm's lack of image contrast with its surrounding organs but also because of respiration-induced motion artifacts in 4-D CT images...
October 2016: Journal of Medical Imaging
https://www.readbyqxmd.com/read/27920974/a-case-report-of-malignant-obesity-hypoventilation-syndrome-a-weighty-problem-in-our-icus
#15
Michael Tatusov, Joshua J Joseph, Brian M Cuneo
INTRODUCTION: The obesity epidemic is reflected by increasing numbers of morbidly obese patients being admitted to intensive care units (ICUs). These are complicated patients whose care involves many diagnostic and treatment challenges. We are presenting a fatal case of super obesity, hypoventilation, and multi-organ failure known as malignant obesity hypoventilation syndrome (MOHS). CASE PRESENTATION: 35 year old African American gentleman with a body mass index (BMI) of 115 kg/m(2) presented to the hospital with respiratory distress...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27920870/pyle-disease-metaphyseal-dysplasia-presenting-in-two-adult-sisters
#16
Diego Ximenes Soares, Amália Mapurunga Almeida, André Rodrigues Façanha Barreto, Ilze Jucá Alencar E Silva, José Daniel Vieira de Castro, Francisco José Magalhães Pinto, Daniel Aguiar Dias, Lindenberg Barbosa Aguiar
Pyle's disease is an extremely rare skeletal disorder characterized by a benign course and an autosomal recessive genetic pattern of inheritance. Its causal mutation is still unknown. In the medical literature, fewer than 30 cases have been described to date. We report the case of two female siblings, daughters of consanguineous parents, referred to the radiology department complaining of genu valgum. Laboratory tests showed no other relevant findings. Conventional radiography plain films revealed Erlenmeyer flask deformity in bilateral femorotibial metaphyses, metaphyseal flaring of long bones, and mild sclerosis of the skull base...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920850/choledochoduodenal-fistula-in-the-setting-of-crohn-s-disease
#17
Shane Knipping, Ravi Rajpoot, Roozbeh Houshyar
Of all the spontaneous fistulas that occur between the extrahepatic biliary system and the intestine, a choledochoduodenal fistula is rarely seen. When it does occur, it is most often secondary to a perforated duodenal ulcer, choledocholithiasis, or cholelithiasis. It may also be seen following complications related to iatrogenic injury or tuberculosis. Generally, choledochoduodenal fistulas are asymptomatic, but may present with vague abdominal pain, fever, and other symptoms related to cholangitis. As a result, they can be difficult to diagnose clinically before imaging is obtained...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920849/subcapsular-hepatic-endometriosis-case-report-and-review-of-the-literature
#18
Ahmed Monier Sherif, Eman Rashid Musa, Rajendra Kedar, Liying Fu
Hepatic endometriosis is a very rare medical condition characterized by the implantation of ectopic endometrial tissue within the hepatic parenchyma. Preoperative diagnosis is difficult via cross-sectional imaging and histopathologic evaluation remains the gold standard for diagnosis. We report a case of hepatic endometrioma in a 44-year-old woman with history of endometriosis. The literature is reviewed, and magnetic resonance imaging findings together with differential diagnosis of hepatic endometriosis are highlighted...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920843/multimodality-imaging-of-a-cardiac-paraganglioma
#19
Alexandre Semionov, Karl Sayegh
Paragangliomas are rare neuroendocrine tumors arising from the ganglia of the sympathetic or parasympathetic nervous system. Less than 160 cases of intrapericardial or intracardiac paragangliomas have been reported in the English language peer-reviewed medical literature. Here, we report a case of intrapericardial paraganglioma, which illustrates some typical multimodality imaging features of this rare entity.
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920713/late-onset-langerhans-cell-histiocytosis-with-cerebellar-ataxia-as-an-initial-symptom
#20
Jung-Min Pyun, Hyeyoung Park, Kyung Chul Moon, Beomseok Jeon
Late-onset progressive cerebellar ataxia is a diagnostic challenge because of a poor correlation between genotype and phenotype, and a broad range of secondary causes that extend beyond the neurological field. We report the case of a 45-year-old woman admitted after 2 years of slowly progressing cerebellar ataxia, dysarthria, and emotional instability. Notably, she was diagnosed with diabetes insipidus at the age of 35. As 'idiopathic cerebellar ataxia' was suspected, diagnostic tests, including genetic testing as well as serum and cerebrospinal fluid analyses, and brain magnetic resonance imaging (MRI) were performed...
September 2016: Case Reports in Neurology
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