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https://www.readbyqxmd.com/read/28641094/emerging-concepts-in-cytomegalovirus-infection-following-hematopoietic-stem-cell-transplantation
#1
REVIEW
Jose F Camargo, Krishna V Komanduri
Despite the refinements in molecular methods for the detection of cytomegalovirus (CMV) and the advent of highly effective preemptive strategies, CMV remains a leading cause of morbidity and mortality in hematopoietic cell transplant (HCT) recipients. CMV can cause tissue-invasive disease including pneumonia, hepatitis, colitis, retinitis, and encephalitis. Mortality in HCT recipients with CMV disease can be as high as 60%. CMV infection has been associated with increased risk of secondary bacterial and fungal infections, increased risk of graft-versus-host disease, and high rates of nonrelapse mortality following HCT...
June 14, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28640720/fungating-wounds-management-and-treatment-options
#2
Suzanne Tandler, Jackie Stephen-Haynes
This article defines fungating wounds and considers the underlying cause, location and presentation. The clinical challenges presented by fungating wounds are discussed, with reference to evidence-based care delivery. This includes wound assessment, cleansing, debridement and management of malodour, infection, bleeding and exudate. Guidance on the use of wound management dressings is considered in relation to symptom management. The importance of clinical decision-making and educational preparation in the delivery of evidenced-based care for those with fungating wounds is emphasised...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28636312/combining-protein-and-mirna-quantification-for-bladder-cancer-analysis
#3
Ruixue Duan, Zhenyu Zhang, Fuxin Zheng, Longwang Wang, Ju Guo, Tianchi Zhang, Xiaomeng Dai, Shengwei Zhang, Dong Yang, Renrui Kuang, Gongxian Wang, Chaohong He, Abdul Hakeem, Chang Shu, Ping Yin, Xiaoding Lou, Fuqing Zeng, Huageng Liang, Fan Xia
We combine the telomerase extension reaction and microRNA (miRNA)-induced rolling circle amplification, followed by graphene oxide (GO) and nicking enzyme assisted signal amplification, to analyze telomerase and miRNA 21 in urine samples with following merits. Firstly, it is a binary assay and can simultaneously output double signals which corresponds to the quantities of telomerase and miRNA, respectively. Secondly, telomerase activity is firstly enhanced by using DNA molecular beacon probe to inhibit the formation of G-quadruplex...
June 21, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28636173/patient-reported-outcome-measures-in-amblyopia-and-strabismus-a-systematic-review
#4
REVIEW
Sheela E Kumaran, Jyoti Khadka, Rod Baker, Konrad Pesudovs
BACKGROUND: Many patient-reported outcome measures (PROMs) have been developed and/or used to measure the impact of amblyopia and strabismus on quality of life (QoL). Identifying the one with superior quality is important for evaluating the effectiveness of novel therapy for amblyopia and for directing improved clinical decision-making in adults considering strabismic surgery. Therefore, the aim of this review is to identify all PROMs previously developed/used to study the impact of amblyopia and/or strabismus on QoL and to appraise the quality and comprehensiveness of content of the disease-specific instruments...
June 21, 2017: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/28636163/the-pu-prom-a-patient-reported-outcome-measure-for-peptic-ulcer-disease
#5
Na Liu, Jing Lv, Jinchun Liu, Yanbo Zhang
OBJECTIVE: Patient-reported outcome measure (PROM) conceived to enable description of treatment-related effects, from the patient perspective, bring the potential to improve in clinical research, and to provide patients with accurate information. Therefore, the aim of this study was to develop a patient-centred peptic ulcer patient-reported outcome measure (PU-PROM) and evaluate its reliability, validity, differential item functioning (DIF) and feasibility. METHOD: To develop a conceptual framework and item pool for the PU-PROM, we performed a literature review and consulted other measures created in China and other countries...
June 21, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28634503/monitoring-the-diagnostic-process-on-an-inpatient-neurology-service
#6
Amar Dhand, Robert Bucelli, Arun Varadhachary, Michael Tsiaklides, Gabriela de Bruin, Gurpreet Dhaliwal
The Institute of Medicine report Improving Diagnosis in Health Care called for tools to monitor physicians' diagnostic process. We addressed this need by developing a tool for clinicians to record and analyze their diagnostic process. The tool was a secure web application in which clinicians used a structured grading system to assess the relative impact of clinical, laboratory, and neuroimaging data for every new diagnosis. Four neurohospitalists used the tool for 6.5 months on a general neurology ward service at a single tertiary-level teaching hospital...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28632250/measurement-of-hyperglycemia-and-impact-on-health-outcomes-in-people-with-cancer-challenges-and-opportunities
#7
Susan Storey, Marilyn J Hammer
PROBLEM IDENTIFICATION: Poor health outcomes have been associated with hyperglycemia in patients with and without diabetes. However, the impact of hyperglycemia on the health-related outcomes of patients with cancer has shown conflicting results. The purpose of this review was to explore definitions and measurement issues related to the assessment of hyperglycemia and the subsequent impact on the findings of health-related outcomes in adults with cancer.
. LITERATURE SEARCH: Four electronic databases were searched...
July 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28629376/radiation-therapy-for-older-patients-with-brain-tumors
#8
REVIEW
Giuseppe Minniti, Andrea Riccardo Filippi, Mattia Falchetto Osti, Umberto Ricardi
The incidence of brain tumors in the elderly population has increased over the last few decades. Current treatment includes surgery, radiotherapy and chemotherapy, but the optimal management of older patients with brain tumors remains a matter of debate, since aggressive radiation treatments in this population may be associated with high risks of neurological toxicity and deterioration of quality of life. For such patients, a careful clinical status assessment is mandatory both for clinical decision making and for designing randomized trials to adequately evaluate the optimal combination of radiotherapy and chemotherapy...
June 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28628677/impact-of-a-31-gene-expression-profiling-test-for-cutaneous-melanoma-on-dermatologists-clinical-management-decisions
#9
Aaron S Farberg, Alex M Glazer, Richard White, Darrell S Rigel
<p>Importance: Current guidelines for cutaneous malignant melanoma (CMM) provide general recommendations regarding surveillance while indicating that management should be tailored to patients' individual probability of recurrence. A 31-gene expression profile (31-GEP) test to predict metastatic risk has been previously validated, and classifies patients as either Class 1 (low risk) or Class 2 (high risk).</p> <p>Objective: To determine the impact of the 31-GEP test's result on clinical decision-making...
May 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28627841/clinical-decision-making-from-theory-to-practice%C3%A2-and-backward
#10
Lionel De Alencastro, Carole Clair, Isabella Locatelli, Mark H Ebell, Nicolas Senn
Being able to analyze all the successive steps of decision making from the first contact with the patient to the final diagnosis is complex because it refers sometimes to intuitive elements proper to each clinician. However, understanding how they integrate probabilities of diseases into their clinical practice and manage diagnostic uncertainties is crucial. This allows a more rational practice of medicine and identifying factors related to the patient, physician or context that may modify the clinical decision making...
May 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28623475/t1-mapping-in-cardiac-mri
#11
REVIEW
Dina Radenkovic, Sebastian Weingärtner, Lewis Ricketts, James C Moon, Gabriella Captur
Quantitative myocardial and blood T1 have recently achieved clinical utility in numerous pathologies, as they provide non-invasive tissue characterization with the potential to replace invasive biopsy. Native T1 time (no contrast agent), changes with myocardial extracellular water (edema, focal or diffuse fibrosis), fat, iron, and amyloid protein content. After contrast, the extracellular volume fraction (ECV) estimates the size of the extracellular space and identifies interstitial disease. Spatially resolved quantification of these biomarkers (so-called T1 mapping and ECV mapping) are steadily becoming diagnostic and prognostically useful tests for several heart muscle diseases, influencing clinical decision-making with a pending second consensus statement due mid-2017...
June 16, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28622412/textural-analysis-of-early-phase-spatiotemporal-changes-in-contrast-enhancement-of-breast-lesions-imaged-with-an-ultrafast-dce-mri-protocol
#12
Jana Milenković, Mehmet Ufuk Dalmış, Janez Žgajnar, Bram Platel
PURPOSE: New ultrafast view-sharing sequences have enabled breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to be performed at high spatial and temporal resolution. The aim of this study is to evaluate the diagnostic potential of textural features that quantify the spatiotemporal changes of the contrast-agent uptake in computer-aided diagnosis of malignant and benign breast lesions imaged with high spatial and temporal resolution DCE-MRI. METHOD: The proposed approach is based on the textural analysis quantifying the spatial variation of six dynamic features of the early-phase contrast-agent uptake of a lesion's largest cross-sectional area...
June 16, 2017: Medical Physics
https://www.readbyqxmd.com/read/28621903/histological-assessment-of-%C3%AE-amyloid-precursor-protein-immunolabelled-rectal-biopsies-aids-diagnosis-of-equine-grass-sickness
#13
R C Jago, S Scholes, T S Mair, G R Pearson, R S Pirie, I Handel, E M Milne, F Coyle, B C McGorum
BACKGROUND: An accurate, minimally invasive, ante mortem, diagnostic test for equine grass sickness (EGS) is currently lacking. While histological examination of haematoxylin-eosin stained rectal biopsies for chromatolytic neurons is insensitive as a diagnostic test for EGS, we hypothesised that the diagnostic accuracy could be improved by immunolabelling for β-amyloid precursor protein (β-APP) which has increased expression in cranial cervical ganglia (CCG) neuronal perikarya in EGS...
June 16, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28621810/adherence-to-standards-for-reporting-diagnostic-accuracy-in-emergency-medicine-research
#14
Lucas Gallo, Nadia Hua, Mathew Mercuri, Angela Silveira, Andrew Worster
BACKGROUND: Diagnostic tests are used frequently in the emergency department (ED) to guide clinical decision-making and, hence, influence clinical outcomes. The Standards for Reporting of Diagnostic Accuracy (STARD) criteria was developed to ensure diagnostic test studies are performed and reported to best inform clinical decision making in the ED. OBJECTIVE: To determine the extent to which diagnostic studies published in emergency medicine journals adhered to STARD 2003 criteria...
June 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28621318/natural-killer-like-signature-observed-post-therapy-in-locally-advanced-rectal-cancer-is-a-determinant-of-pathological-response-and-improved-survival
#15
Matthew Alderdice, Philip D Dunne, Aidan J Cole, Paul G O'Reilly, Darragh G McArt, Vicky Bingham, Marc-Aurel Fuchs, Stephen McQuaid, Maurice B Loughrey, Graeme I Murray, Leslie M Samuel, Mark Lawler, Richard H Wilson, Manuel Salto-Tellez, Vicky M Coyle
Around 12-15% of patients with locally advanced rectal cancer undergo a pathologically complete response (tumor regression grade 4) to long-course preoperative chemoradiotherapy; the remainder exhibit a spectrum of tumor regression (tumor regression grade 1-3). Understanding therapy-related transcriptional alterations may enable better prediction of response as measured by progression-free and overall survival, in addition to aiding the development of improved strategies based on the underlying biology of the disease...
June 16, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28620998/a-survey-of-speech-language-therapy-provision-for-people-with-post-stroke-dysarthria-in-the-uk
#16
Nick Miller, Steven Bloch
BACKGROUND: A large number of people who experience a stroke are affected by dysarthria. This may be in isolation or in association with aphasia and/or dysphagia. Despite evidence highlighting the psychological and social impact of having post-stroke dysarthria and a number of clinical guidelines that make recommendations for appropriate management, little is known currently about UK service delivery issues relating to speech and language therapy (SLT) assessment and treatment for this group...
June 16, 2017: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/28620564/moyamoya-syndrome-in-a-child-with-neurofibromatosis-type-1-magnetic-resonance-imaging-as-a-tool-for-clinical-decision-making
#17
Jonathan Mayl, Hanisha Patel, Tushar Chandra
Moyamoya syndrome is a rare cerebrovasculopathy of unknown etiology which is associated with multiple risk factors. Moyamoya was first discovered in Japan and is reported to have an increased prevalence in the Japanese population. The term "Moyamoya" translates into "puff of smoke" and is named after the finding of the collateral cerebral vasculature that develops secondary to occlusion of an internal carotid artery at the entrance into the circle of Willis. This collateral vasculature characterizes the disease...
May 9, 2017: Curēus
https://www.readbyqxmd.com/read/28619778/in-patients-with-severe-uncontrolled-asthma-does-knowledge-of-adherence-and-inhaler-technique-using-electronic-monitoring-improve-clinical-decision-making-a-protocol-for-a-randomised-controlled-trial
#18
Matshediso C Mokoka, Lorna Lombard, Elaine M MacHale, Joanne Walsh, Breda Cushen, Imran Sulaiman, Damien Mc Carthy, Fiona Boland, Frank Doyle, Eoin Hunt, Desmond M Murphy, John Faul, Marcus Butler, Kathy Hetherington, J Mark FitzGerald, Job Fm van Boven, Liam G Heaney, Richard B Reilly, Richard W Costello
INTRODUCTION: Many patients with asthma remain poorly controlled despite the use of inhaled corticosteroids and long-acting beta agonists. Poor control may arise from inadequate adherence, incorrect inhaler technique or because the condition is refractory. Without having an objective assessment of adherence, clinicians may inadvertently add extra medication instead of addressing adherence. This study aims to assess if incorporating objectively recorded adherence from the Inhaler Compliance Assessment (INCA) device and lung function into clinical decision making provides more cost-effective prescribing and improves outcomes...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28619524/molecular-determinants-of-radiosensitivity-in-normal-and-tumor-tissue-a-bioinformatic-approach
#19
Athanasia Pavlopoulou, Pantelis Bagos, Vasiliki Koutsandrea, Alexandros G Georgakilas
Although radiation therapy is a treatment of choice for cancer, a high percentage of patients develop adverse effects in normal tissue following radiotherapy, mainly, due to genetic factors. Notably, although it is established that a lower dose of ionizing radiation can minimize the tumor cell population in radiosensitive cancer patients, the sensitivity of tumor cells to radiation has not gained enough attention. In this mini-review, the molecular pathways/mechanisms and the related molecules involved in clinically relevant radiotoxicity, as well as normal and tumor cell radiosensitivity, were investigated for various types of cancers employing bioinformatics approaches...
June 12, 2017: Cancer Letters
https://www.readbyqxmd.com/read/28618973/from-clinical-uncertainties-to-precision-medicine-the-emerging-role-of-the-gut-barrier-and-microbiome-in-small-bowel-functional-diseases
#20
Wojciech Marlicz, Diana Yung, Karolina Skonieczna-Żydecka, Igor Loniewski, Saskia van Hemert, Beata Loniewska, Anastasios Koulaouzidis
Over the last decade, remarkable progress has been made in the understanding of disease pathophysiology. Many new theories expound on the importance of emerging factors such as microbiome influences, genomics/omics, stem cells, innate intestinal immunity or mucosal barrier complexities. This has introduced a further dimension of uncertainty into clinical decision-making, but equally, may shed some light on less well-understood and difficult to manage conditions. Areas covered: Comprehensive review of the literature on gut barrier and microbiome relevant to small bowel pathology...
June 16, 2017: Expert Review of Gastroenterology & Hepatology
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