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https://www.readbyqxmd.com/read/28214497/incidence-of-pulmonary-embolism-in-patients-with-isolated-calf-deep-vein-thrombosis
#1
REVIEW
Alvin R Wu, Jonah Garry, Nicos Labropoulos
BACKGROUND: The severity of pulmonary embolism (PE) after isolated calf deep vein thrombosis (C-DVT) is controversial, which leads to inconsistent clinical decision making when treating C-DVT. This systematic review assessed PE frequency and severity in patients with C-DVT. METHODS: Database searches were completed using MEDLINE and Scopus along with cross-referencing. Two independent reviewers used using rigorous inclusion and exclusion criteria to screen the papers...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28212953/the-influence-of-genotype-information-on-psychiatrists-treatment-recommendations-more-experienced-clinicians-know-better-what-to-ignore
#2
Alan J McMichael, Marco Boeri, Jonathan J Rolison, Joe Kane, Francis A O'Neill, Ric Scarpa, Frank Kee
BACKGROUND: This study applies attribute nonattendance to medical decision making. We aimed to demonstrate how this type of analysis can be used in medical decision making to assess whether psychiatrists were influenced in their treatment recommendations by information on the genotype of a patient, despite knowing the patient's response to treatment as measured by the Positive and Negative Syndrome Scale. A patient's genetic information may be used to predict their response to therapy; such information, however, becomes redundant, and should not influence decisions, once a clinician knows the patient's actual response to treatment...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212147/monitoring-hospitalized-adult-patients-for-opioid-induced-sedation-and-respiratory-depression
#3
Carla R Jungquist, Kirsten Smith, Kelly L Wiltse Nicely, Rosemary C Polomano
: Opioid analgesics are commonly administered to hospitalized patients to treat acute pain, but these drugs put patients at risk for serious adverse events, such as unintended advancing sedation, respiratory depression, and death. Nurses play an important role in keeping patients safe by making clinical decisions about the frequency and intensity with which patients receiving IV and epidural opioids should be monitored. To make sound clinical judgments, nurses must be aware of the factors that place patients at elevated risk for adverse opioid-related effects and know how to screen and assess patients for these risks...
March 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28211229/serum-micrornas-as-predictors-for-liver-fibrosis-staging-in-hepatitis-c-virus-associated-chronic-liver-disease-patients
#4
Olfat G Shaker, Mahmoud A Senousy
Accurate staging of liver fibrosis is important for clinical decision making and personalized management. Liver fibrosis is influenced by patients' genomics, including IFNL3 genotype and microRNA expression. However, incorporating microRNAs into fibrosis prediction algorithms has not been investigated. We examined the potential of 8 selected serum microRNAs; miR-122, miR-126, miR-129, miR-199a, miR-155, miR-203a, miR-221, and miR-223 as non-invasive biomarkers to stage liver fibrosis in HCV-associated chronic liver disease (HCV-CLD)...
February 17, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28210788/surgical-management-of-degenerative-meniscus-lesions-the-2016-esska-meniscus-consensus
#5
Ph Beaufils, R Becker, S Kopf, M Englund, R Verdonk, M Ollivier, R Seil
PURPOSE: A degenerative meniscus lesion is a slowly developing process typically involving a horizontal cleavage in a middle-aged or older person. When the knee is symptomatic, arthroscopic partial meniscectomy has been practised for a long time with many case series reporting improved patient outcomes. Since 2002, several randomised clinical trials demonstrated no additional benefit of arthroscopic partial meniscectomy compared to non-operative treatment, sham surgery or sham arthroscopic partial meniscectomy...
February 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28207409/to-report-or-not-to-report-a-proposal-on-how-to-deal-with-altered-test-results-in-hemolytic-samples
#6
Janne Cadamuro, Cornelia Mrazek, Elisabeth Haschke-Becher, Sverre Sandberg
Preanalytically altered test results are a challenge every laboratory has to face. The release of such results may be to the harm of the patient by triggering wrong clinical decision making in monitoring or treatment. On the other hand, their deletion also might be to the harm of the patient by delaying the time to decision making as the exact value sometimes is not even necessary but rather an answer to the question "Is it raised or lowered". Based on this dilemma and forced to produce laboratory values without any clinical information on the respective patient, laboratories have developed their own preferred way on how to deal with preanalytically altered test results...
February 16, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28206888/evidence-based-clinical-practice-guideline-for-the-use-of-pit-and-fissure-sealants
#7
(no author information available yet)
BACKGROUND: This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits-and-fissures of occlusal surfaces...
October 15, 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/28206672/assessment-of-a-novel-point-of-care-ultrasound-curriculum-s-effect-on-competency-measures-in-family-medicine-graduate-medical-education
#8
Paul Bornemann
OBJECTIVES: Point-of-care ultrasound has been shown to decrease the use of expensive diagnostic studies and improve quality outcome measures. Currently, there is a large desire for training in family medicine residencies, but very few programs have established curricula. We sought to develop a family medicine residency curriculum and evaluate it with tools we developed. We wanted our curriculum to be easy to adopt by other residency programs, even if they did not have many well-trained ultrasound faculty...
February 16, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28205339/doing-it-hard-in-the-bush-aligning-what-gets-measured-with-what-matters
#9
Malcolm I McDonald, Kenny D Lawson
What gets measured gets managed. Funding of health services is substantially determined by operational activity and specific outcome indicators. In day-to-day clinical decision-making, surrogate markers, such as glycosylated haemoglobin and blood pressure, are commonly used to modify risks of 'hard' outcomes that include kidney failure, ischaemic cardiac events, stroke and all-cause mortality. In many settings, surrogates are all we have to go on. As a consequence, current health funding models heavily rely on surrogate-based key performance indicators [KPIs]...
February 16, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28199897/real-world-utility-of-whole-exome-sequencing-with-targeted-gene-analysis-for-focal-epilepsy
#10
Piero Perucca, Ingrid E Scheffer, A Simon Harvey, Paul A James, Sebastian Lunke, Natalie Thorne, Clara Gaff, Brigid M Regan, John A Damiano, Michael S Hildebrand, Samuel F Berkovic, Terence J O'Brien, Patrick Kwan
OBJECTIVE: Driven by advances in genomic technology and reduction in costs, next-generation sequencing (NGS) is venturing into routine clinical care. The 'real-world' clinical utility of NGS remains to be determined in focal epilepsies, which account for 60% of all epilepsies and for which the importance of genetic factors is just beginning to emerge. We investigated the diagnostic yield and management implications of whole exome sequencing (WES)-based screening of selected genes in the routine care of common focal epilepsies suspected to have a genetic basis...
February 7, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28199360/systematic-review-of-statistically-derived-models-of-immunological-response-in-hiv-infected-adults-on-antiretroviral-therapy-in-sub-saharan-africa
#11
Joseph B Sempa, Eva L Ujeneza, Martin Nieuwoudt
INTRODUCTION: In Sub-Saharan African (SSA) resource limited settings, Cluster of Differentiation 4 (CD4) counts continue to be used for clinical decision making in antiretroviral therapy (ART). Here, HIV-infected people often remain with CD4 counts <350 cells/μL even after 5 years of viral load suppression. Ongoing immunological monitoring is necessary. Due to varying statistical modeling methods comparing immune response to ART across different cohorts is difficult. We systematically review such models and detail the similarities, differences and problems...
2017: PloS One
https://www.readbyqxmd.com/read/28198966/computerized-nursing-process-in-the-intensive-care-unit-ergonomics-and-usability
#12
Sônia Regina Wagner de Almeida, Grace Teresinha Marcon Dal Sasso, Daniela Couto Carvalho Barra
OBJECTIVE: Analyzing the ergonomics and usability criteria of the Computerized Nursing Process based on the International Classification for Nursing Practice in the Intensive Care Unit according to International Organization for Standardization(ISO). METHOD: A quantitative, quasi-experimental, before-and-after study with a sample of 16 participants performed in an Intensive Care Unit. Data collection was performed through the application of five simulated clinical cases and an evaluation instrument...
November 2016: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28197310/novel-18-f-labeled-1-hydroxyanthraquinone-derivatives-for-necrotic-myocardium-imaging
#13
Ai-Yan Ji, Qiao-Mei Jin, Dong-Jian Zhang, Hua Zhu, Chang Su, Xing-Hua Duan, Li Bian, Zi-Ping Sun, Yi-Cheng Ni, Jian Zhang, Zhi Yang, Zhi-Qi Yin
Rapid detection and precise evaluation of myocardial viability is necessary to aid in clinical decision making whether to recommend revascularization for patients with myocardial infarction (MI). Three novel (18)F-labeled 1-hydroxyanthraquinone derivatives were synthesized, characterized, and evaluated as potential necrosis avid imaging agents for assessment of myocardial viability. Among these tracers, [(18)F]FA3OP emerged as the most promising compound with best stability and highest targetability. Clear PET images of [(18)F]FA3OP were obtained in rat model of myocardial infarction and reperfusion at 1 h after injection...
February 9, 2017: ACS Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28196632/procedure-selection-and-patient-positioning-influence-spine-kinematics-during-high-velocity-low-amplitude-spinal-manipulation-applied-to-the-low-back
#14
Spencer Bell, Kevin D'Angelo, Gregory N Kawchuk, John J Triano, Samuel J Howarth
OBJECTIVES: This investigation compared indirect 3-dimensional angular kinematics (position, velocity, and acceleration) of the lumbar spine for 2 different high-velocity, low-amplitude (HVLA) spinal manipulation procedures (lumbar spinous pull or push), and altered initial patient lower limb posture. METHODS: Twenty-four participants underwent 6 HVLA procedures directed toward the presumed L4 vertebra, reflecting each combination of 2 variants of a spinal manipulation application technique (spinous pull and push) and 3 initial hip flexion angles (0°, 45°, and 90°) applied using a right lateral recumbent patient position...
February 10, 2017: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/28196074/clinical-applicability-and-cost-of-a-46-gene-panel-for-genomic-analysis-of-solid-tumours-retrospective-validation-and-prospective-audit-in-the-uk-national-health-service
#15
Angela Hamblin, Sarah Wordsworth, Jilles M Fermont, Suzanne Page, Kulvinder Kaur, Carme Camps, Pamela Kaisaki, Avinash Gupta, Denis Talbot, Mark Middleton, Shirley Henderson, Anthony Cutts, Dimitrios V Vavoulis, Nick Housby, Ian Tomlinson, Jenny C Taylor, Anna Schuh
BACKGROUND: Single gene tests to predict whether cancers respond to specific targeted therapies are performed increasingly often. Advances in sequencing technology, collectively referred to as next generation sequencing (NGS), mean the entire cancer genome or parts of it can now be sequenced at speed with increased depth and sensitivity. However, translation of NGS into routine cancer care has been slow. Healthcare stakeholders are unclear about the clinical utility of NGS and are concerned it could be an expensive addition to cancer diagnostics, rather than an affordable alternative to single gene testing...
February 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28195606/use-of-articulating-spacer-technique-in-revision-total-knee-arthroplasty-complicated-by-sepsis-a-systematic-meta-analysis
#16
John C Spivey, George N Guild, Giles R Scuderi
Periprosthetic infection after total knee arthroplasty is a devastating complication, and 2-stage exchange is the standard of care in North America. Articulating spacers are effective in treating periprosthetic joint infections, but the optimal articulating spacer construct has yet to be identified. The authors performed a systematic review using MEDLINE, MEDLINE In-Process, EMBASE, BIOSIS, ClinicalTrials.gov, and Cochrane Database of Systematic Reviews. They identified 34 articles meeting inclusion criteria, producing 1016 spacers for comparison...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28193245/early-disease-progression-of-hurler-syndrome
#17
Bridget T Kiely, Jennifer L Kohler, Hannah Y Coletti, Michele D Poe, Maria L Escolar
BACKGROUND: Newborn screening for mucopolysaccharidosis type I (MPS I) shows promise to improve outcomes by facilitating early diagnosis and treatment. However, diagnostic tests for MPS I are of limited value in predicting whether a child will develop severe central nervous system disease associated with Hurler syndrome, or minimal or no central nervous system involvement associated with the attenuated phenotypes (Hurler-Scheie and Scheie syndromes). Given that the optimal treatment differs between Hurler syndrome and the attenuated MPS I phenotypes, the absence of a reliable prognostic biomarker complicates clinical decision making for infants diagnosed through newborn screening...
February 14, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28192533/improving-medication-safety-development-and-impact-of-a-multivariate-model-based-strategy-to-target-high-risk-patients
#18
Tri-Long Nguyen, Géraldine Leguelinel-Blache, Jean-Marie Kinowski, Clarisse Roux-Marson, Marion Rougier, Jessica Spence, Yannick Le Manach, Paul Landais
BACKGROUND: Preventive strategies to reduce clinically significant medication errors (MEs), such as medication review, are often limited by human resources. Identifying high-risk patients to allow for appropriate resource allocation is of the utmost importance. To this end, we developed a predictive model to identify high-risk patients and assessed its impact on clinical decision-making. METHODS: From March 1st to April 31st 2014, we conducted a prospective cohort study on adult inpatients of a 1,644-bed University Hospital Centre...
2017: PloS One
https://www.readbyqxmd.com/read/28191294/complete-remission-of-locally-advanced-penile-squamous-cell-carcinoma-after-multimodality-treatment
#19
Yifan Meng, Helen Levey Bernie, Tzu-Hua Weng, Dean-An Ling, Edward M Messing, Elizabeth Guancial
Treatment of locally advanced penile squamous cell carcinoma (pSCC) remains highly controversial secondary to disease rarity and lack of prospective randomized controlled trials. The current mainstays of care are multi-modality treatment with neoadjuvant chemotherapy and surgery. However, clinicians often have difficulty making recommendations for patients unable to tolerate chemotherapy or surgery due to scarcity of data to guide clinical decision-making. We report two cases of locally advanced pSCC that achieved complete remission after treatment with cisplatin-based neoadjuvant chemotherapy and surgery in one case, and concurrent cisplatin chemoradiation in a second, supporting the use of chemotherapy as part of first-line multimodal therapy...
November 17, 2016: Rare Tumors
https://www.readbyqxmd.com/read/28190666/design-of-a-framework-for-the-deployment-of-collaborative-independent-rare-disease-centric-registries-gaucher-disease-registry-model
#20
Matthew I Bellgard, Kathryn R Napier, Alan H Bittles, Jeffrey Szer, Sue Fletcher, Nikolajs Zeps, Adam A Hunter, Jack Goldblatt
Orphan drug clinical trials often are adversely affected by a lack of high quality treatment efficacy data that can be reliably compared across large patient cohorts derived from multiple governmental and country jurisdictions. It is critical that these patient data be captured with limited corporate involvement. For some time, there have been calls to develop collaborative, non-proprietary, patient-centric registries for post-market surveillance of aspects related to orphan drug efficacy. There is an urgent need for the development and sustainable deployment of these 'independent' registries that can capture comprehensive clinical, genetic and therapeutic information on patients with rare diseases...
January 27, 2017: Blood Cells, Molecules & Diseases
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