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https://www.readbyqxmd.com/read/28098106/the-role-of-dynamic-renal-scintigraphy-on-clinical-decision-making-in-hydronephrotic-children
#1
Seçil Arslansoyu Çamlar, Nazlı Deveci, Alper Soylu, Mehmet Atilla Türkmen, Derya Özmen, Gamze Çapakaya, Salih Kavukçu
Hydronephrosis may be related to an obstructive cause, ureteropelvic/uretero-vesical junction obstruction or nonobstructive [vesicoureteral reflux (VUR)]. When an obstructive pathology is considered, dynamic renal scintigraphy may help to predict whether it is a true obstruction or not. In this study, we aimed to determine the contribution of dynamic renal scintigraphy with [99] mTc-MAG-3 to the clinical decision-making for surgery in hydronephrotic children. Files of the patients evaluated by MAG-3 scintigraphy for antenatal (AH)/postnatal (PH) hydronephrosis between 1992 and 2014 were reviewed...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28097324/molecular-based-recursive-partitioning-analysis-model-for-glioblastoma-in-the-temozolomide-era-a-correlative-analysis-based-on-nrg-oncology-rtog-0525
#2
Erica Hlavin Bell, Stephanie L Pugh, Joseph P McElroy, Mark R Gilbert, Minesh Mehta, Alexander C Klimowicz, Anthony Magliocco, Markus Bredel, Pierre Robe, Anca-L Grosu, Roger Stupp, Walter Curran, Aline P Becker, Andrea L Salavaggione, Jill S Barnholtz-Sloan, Kenneth Aldape, Deborah T Blumenthal, Paul D Brown, Jon Glass, Luis Souhami, R Jeffrey Lee, David Brachman, John Flickinger, Minhee Won, Arnab Chakravarti
Importance: There is a need for a more refined, molecularly based classification model for glioblastoma (GBM) in the temozolomide era. Objective: To refine the existing clinically based recursive partitioning analysis (RPA) model by incorporating molecular variables. Design, Setting, and Participants: NRG Oncology RTOG 0525 specimens (n = 452) were analyzed for protein biomarkers representing key pathways in GBM by a quantitative molecular microscopy-based approach with semiquantitative immunohistochemical validation...
January 12, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28096933/the-association-of-male-pattern-baldness-and-risk-of-cancer-and-high-grade-disease-among-men-presenting-for-prostate-biopsy
#3
Ghazi Al Edwan, Bimal Bhindi, David Margel, Karen Chadwick, Antonio Finelli, Alexandre Zlotta, John Trachtenberg, Neil Fleshner
INTRODUCTION: Androgens have been implicated in both male pattern baldness (MPB) and prostate cancer (PCa). We set out to prospectively determine if men with independently assessed MPB are at higher risk for PCa at biopsy and determine if any grade associations exist. METHODS: We prospectively enrolled 394 eligible patients presenting for prostate biopsy and independently determined their MPB pattern using the validated modified Norwood classification system (0: no balding; 1: frontal balding; 2: mild vertex balding; 3: moderate vertex balding; 4: sever vertex balding)...
November 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28096917/assessment-of-histopathological-features-of-needle-biopsy-in-recurrent-prostate-cancer-following-salvage-high-intensity-focused-ultrasound
#4
Michele Billia, Khurram M Siddiqui, Susanne Chan, Fan Li, Ali Al-Zahrani, Jose A Gomez, Joseph L Chin
INTRODUCTION: Local recurrence of prostate cancer (PCa) following radiotherapy may be treated with curative intent using salvage high-intensity focused ultrasound (s-HIFU). The interpretation of needle core biopsy specimens following s-HIFU is a daunting task, even for experienced pathologists. We describe various histopathological features encountered in biopsy specimens following whole-gland s-HIFU in one of the largest descriptive studies to date. METHODS: Fifty-five patients with biopsy-proven localized radio-recurrent PCa underwent s-HIFU and transrectal ultrasound (TRUS)-guided prostatic needle biopsies at 180 days post-treatment...
November 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28096740/unanswered-clinical-questions-a-survey-of-specialists-and-primary-care-providers
#5
Ellen Brassil, Bridget Gunn, Anant M Shenoy, Rebecca Blanchard
OBJECTIVE: With the myriad of cases presented to clinicians every day at our integrated academic health system, clinical questions are bound to arise. Clinicians need to recognize these knowledge gaps and act on them. However, for many reasons, clinicians might not seek answers to these questions. Our goal was to investigate the rationale and process behind these unanswered clinical questions. Subsequently, we explored the use of biomedical information resources among specialists and primary care providers and identified ways to promote more informed clinical decision making...
January 2017: Journal of the Medical Library Association: JMLA
https://www.readbyqxmd.com/read/28096725/added-value-of-contrast-enhanced-ultrasound-on-biopsies-of-focal-hepatic-lesions-invisible-on-fusion-imaging-guidance
#6
Tae Wook Kang, Min Woo Lee, Kyoung Doo Song, Mimi Kim, Seung Soo Kim, Seong Hyun Kim, Sang Yun Ha
OBJECTIVE: To assess whether contrast-enhanced ultrasonography (CEUS) with Sonazoid can improve the lesion conspicuity and feasibility of percutaneous biopsies for focal hepatic lesions invisible on fusion imaging of real-time ultrasonography (US) with computed tomography/magnetic resonance images, and evaluate its impact on clinical decision making. MATERIALS AND METHODS: The Institutional Review Board approved this retrospective study. Between June 2013 and January 2015, 711 US-guided percutaneous biopsies were performed for focal hepatic lesions...
January 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28093430/development-and-validation-of-a-prediction-model-for-gestational-hypertension-in-a-ghanaian-cohort
#7
Edward Antwi, Rolf H H Groenwold, Joyce L Browne, Arie Franx, Irene A Agyepong, Kwadwo A Koram, Kerstin Klipstein-Grobusch, Diederick E Grobbee
OBJECTIVE: To develop and validate a prediction model for identifying women at increased risk of developing gestational hypertension (GH) in Ghana. DESIGN: A prospective study. We used frequencies for descriptive analysis, χ(2) test for associations and logistic regression to derive the prediction model. Discrimination was estimated by the c-statistic. Calibration was assessed by calibration plot of actual versus predicted probability. SETTING: Primary care antenatal clinics in Ghana...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28092685/precision-oncology-for-acute-myeloid-leukemia-using-a-knowledge-bank-approach
#8
Moritz Gerstung, Elli Papaemmanuil, Inigo Martincorena, Lars Bullinger, Verena I Gaidzik, Peter Paschka, Michael Heuser, Felicitas Thol, Niccolo Bolli, Peter Ganly, Arnold Ganser, Ultan McDermott, Konstanze Döhner, Richard F Schlenk, Hartmut Döhner, Peter J Campbell
Underpinning the vision of precision medicine is the concept that causative mutations in a patient's cancer drive its biology and, by extension, its clinical features and treatment response. However, considerable between-patient heterogeneity in driver mutations complicates evidence-based personalization of cancer care. Here, by reanalyzing data from 1,540 patients with acute myeloid leukemia (AML), we explore how large knowledge banks of matched genomic-clinical data can support clinical decision-making. Inclusive, multistage statistical models accurately predicted likelihoods of remission, relapse and mortality, which were validated using data from independent patients in The Cancer Genome Atlas...
January 16, 2017: Nature Genetics
https://www.readbyqxmd.com/read/28090639/the-psychometric-validation-of-the-epds-k-among-korean-women-does-it-only-measure-depressive-symptoms
#9
Young-Sun Rhee, Jeong-Hwan Park, Hee-Jung Cha, Kye-Ha Kim
PURPOSE: The purpose of this study was to test the validity of the Edinburgh Postnatal Depression Scale-Korean (EPDS-K) and compare the specified models (one-, two-, three-factor model, and a model in the current study) in pregnant, first-trimester Korean women. DESIGN AND METHODS: The study consisted of two groups of 100 first-trimester Korean women recruited from maternity clinics in Korea. FINDINGS: The results show that the EPDS-K has depression, anxiety, and anhedonia factors, and that the validity of the EPDS-K with Korean women is questionable...
January 16, 2017: Perspectives in Psychiatric Care
https://www.readbyqxmd.com/read/28090446/quantitative-imaging-methods-in-osteoporosis
#10
REVIEW
Ling Oei, Fjorda Koromani, Fernando Rivadeneira, M Carola Zillikens, Edwin H G Oei
Osteoporosis is characterized by a decreased bone mass and quality resulting in an increased fracture risk. Quantitative imaging methods are critical in the diagnosis and follow-up of treatment effects in osteoporosis. Prior radiographic vertebral fractures and bone mineral density (BMD) as a quantitative parameter derived from dual-energy X-ray absorptiometry (DXA) are among the strongest known predictors of future osteoporotic fractures. Therefore, current clinical decision making relies heavily on accurate assessment of these imaging features...
December 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28090403/a-review-of-the-relationship-of-atrial-fibrillation-and-acute-coronary-syndrome
#11
Bory Kea, Tahroma Alligood, Vincent Manning, Merritt Raitt
Atrial fibrillation (AF) is the most common arrhythmia encountered by clinicians. Clinical decision-making focuses on reducing ischemic stroke risk in AF patients; however, AF is also associated with an increased risk of acute coronary syndromes (ACS). Patients with ACS and concurrent AF are less likely to receive appropriate therapies and more likely to experience adverse outcomes than ACS patients in sinus rhythm (SR). Clinicians may be able to stratify ACS patients at increased risk of AF development based on clinical characteristics...
September 2016: Current Emergency and Hospital Medicine Reports
https://www.readbyqxmd.com/read/28089767/the-correlation-between-a-short-term-conventional-electroencephalography-in-the-first-day-of-life-and-brain-magnetic-resonance-imaging-in-newborns-undergoing-hypothermia-for-hypoxic-ischemic-encephalopathy
#12
Rawad Obeid, Yoshimi Sogawa, Satyanarayana Gedela, Monica Naik, Vince Lee, Richard Telesco, Jessica Wisnowski, Christine Magill, Michael J Painter, Ashok Panigrahy
OBJECTIVE: Electroencephalograph recorded in the first day of life in newborns treated with hypothermia for hypoxic-ischemic encephalopathy could be utilized as a predictive tool for the severity of brain injury on magnetic resonance imaging and mortality. STUDY DESIGN: This work was a retrospective study of newborns who were admitted for therapeutic hypothermia due to hypoxic-ischemic encephalopathy. All enrolled infants underwent encephalography within the first 24 hours of life and underwent brain magnetic resonance imaging after rewarming...
November 3, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/28089295/inter-rater-reliability-of-distal-ureteral-diameter-ratio-compared-to-grade-of-vur
#13
A R Swanton, A M Arlen, S E Alexander, K Kieran, D W Storm, C S Cooper
INTRODUCTION AND OBJECTIVE: Management of vesicoureteral reflux (VUR) remains controversial, and reflux grade constitutes an important prognostic factor. Recent work has suggested that distal ureteral diameter ratio (UDR) is a predictive factor relative to clinical outcome independent of grade. Previous studies have noted significant inter-rater variability with grading of VUR. The present study compared inter-rater reliability of reflux grade and UDR in children with primary VUR. STUDY DESIGN: Four pediatric urologists independently reviewed, in a blinded fashion, voiding cystourethrograms...
December 1, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28088837/disease-severity-classification-using-quantitative-magnetic-resonance-imaging-data-of-cartilage-in-femoroacetabular-impingement
#14
Lisa L Henn, John Hughes, Eleena Iisakka, Jutta Ellermann, Shabnam Mortazavi, Connor Ziegler, Mikko J Nissi, Patrick Morgan
Femoroacetabular impingement (FAI) is a condition in which subtle deformities of the femoral head and acetabulum (hip socket) result in pathological abutment during hip motion. FAI is a common cause of hip pain and can lead to acetabular cartilage damage and osteoarthritis. For some patients with FAI, surgical intervention is indicated, and it can improve quality of life and potentially delay the onset of osteoarthritis. For other patients, however, surgery is contraindicated because significant cartilage damage has already occurred...
January 15, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28088349/stroke-biomarkers-in-clinical-practice-a-critical-appraisal
#15
REVIEW
Geelyn J L Ng, Amy M L Quek, Christine Cheung, Thiruma V Arumugam, Raymond C S Seet
Biomarkers provide critical mechanistic insights to key biologic processes that occur during cerebral ischemia which, when carefully applied, can improve clinical decision-making in acute stroke management. The translation of a blood-based biomarker in ischemic stroke to clinical practice is challenging, in part, due to the complexity of ischemic stroke pathogenesis and the presence of a blood-brain barrier that restricts the release of brain-specific markers into the circulation. The pathologic and clinical aspects of ischemic stroke are described in this review, where a non-exhaustive list of biomarkers that interrogate different aspects of ischemic stroke such as oxidative damage, inflammation, thrombus formation, cardiac function and brain injury are described...
January 11, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28087821/selection-of-first-line-therapy-in-multiple-sclerosis-using-risk-benefit-decision-analysis
#16
David Bargiela, Matthew T Bianchi, M Brandon Westover, Lori B Chibnik, Brian C Healy, Philip L De Jager, Zongqi Xia
OBJECTIVE: To integrate long-term measures of disease-modifying drug efficacy and risk to guide selection of first-line treatment of multiple sclerosis. METHODS: We created a Markov decision model to evaluate disability worsening and progressive multifocal leukoencephalopathy (PML) risk in patients receiving natalizumab (NTZ), fingolimod (FGL), or glatiramer acetate (GA) over 30 years. Leveraging publicly available data, we integrated treatment utility, disability worsening, and risk of PML into quality-adjusted life-years (QALYs)...
January 13, 2017: Neurology
https://www.readbyqxmd.com/read/28087134/factors-influencing-and-modifying-the-decision-to-pursue-genetic-testing-for-skin-cancer-risk
#17
Alexander L Fogel, Prajakta D Jaju, Shufeng Li, Bonnie Halpern-Felsher, Jean Y Tang, Kavita Y Sarin
BACKGROUND: Across cancers, the decision to pursue genetic testing is influenced more by subjective than objective factors. However, skin cancer, which is more prevalent, visual, and multifactorial than many other malignancies, may offer different motivations for pursuing such testing. OBJECTIVES: The primary objective was to determine factors influencing the decision to receive genetic testing for skin cancer risk. A secondary objective was to assess the impact of priming with health questions on the decision to receive testing...
January 10, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28081211/development-and-validation-of-a-clinical-prediction-rule-for-bacteremia-among-maintenance-hemodialysis-patients-in-outpatient-settings
#18
Sho Sasaki, Takeshi Hasegawa, Hiroo Kawarazaki, Atsushi Nomura, Daisuke Uchida, Takahiro Imaizumi, Masahide Furusho, Hiroki Nishiwaki, Shingo Fukuma, Yugo Shibagaki, Shunichi Fukuhara
BACKGROUND: To our knowledge, no reliable clinical prediction rule (CPR) for identifying bacteremia in hemodialysis (HD) patients has been established. The aim of this study was to develop a CPR for bacteremia in maintenance HD patients visiting the outpatient department. METHODS: This multicenter cohort study involved consecutive maintenance HD patients who visited the outpatient clinic or emergency room of seven Japanese institutions between August 2011 and July 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28079400/dysphagia-therapy-post-stroke-an-exploration-of-the-practices-and-clinical-decision-making-of-speech-language-pathologists-in-australia
#19
Olivia Jones, Jade Cartwright, Anne Whitworth, Naomi Cocks
PURPOSE: A variety of dysphagia management options are available for the treatment of dysphagia following a stroke, however, it is unknown which of these approaches are most commonly utilised by Australian speech-language pathologists (SLPs) and whether particular factors influence decision-making. METHOD: The aim of this study was to investigate, through an online survey, the treatment practices of SLPs in Australia for the treatment of dysphagia post-stroke and identify the factors influencing treatment decisions...
January 12, 2017: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28077529/poor-agreement-in-significant-findings-between-meta-analyses-and-subsequent-large-randomized-trials-in-perioperative-medicine
#20
REVIEW
H Sivakumar, P J Peyton
BACKGROUND: The reliability of meta-analysis (MA) in predicting the findings of subsequent large randomized controlled trials (RCTs) has not been assessed in perioperative medicine and anaesthesia. METHODS: Using Medline and PubMed, large RCTs (n≥1000) published since 2000 in the anaesthesia and perioperative medicine/critical care literature were identified. All previous MAs of RCTs investigating the same intervention and population were sourced. For all reported major morbid endpoints common to each, results (significant/non-significant P<0...
October 2016: British Journal of Anaesthesia
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