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https://www.readbyqxmd.com/read/28528388/fertility-sparing-for-young-patients-with-gynecologic-cancer-how-mri-can-guide-patient-selection-prior-to-conservative-management
#1
REVIEW
Sinead H McEvoy, Stephanie Nougaret, Nadeem R Abu-Rustum, Hebert Alberto Vargas, Elizabeth A Sadowski, Christine O Menias, Fuki Shitano, Shinya Fujii, Ramon E Sosa, Joanna G Escalon, Evis Sala, Yulia Lakhman
Historically, cancer treatment has emphasized measures for the "cure" regardless of the long-term consequences. Advances in cancer detection and treatment have resulted in improved outcomes bringing to the fore various quality of life considerations including future fertility. For many young cancer patients, fertility preservation is now an integral component of clinical decision-making and treatment design. Optimal fertility-sparing options for young patients with gynecologic cancer are influenced by patient age, primary cancer, treatment regimens, and patient preferences...
May 20, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28527497/informatics-and-technology-in-resident-education
#2
REVIEW
William Niehaus
Biomedical or clinical informatics is the transdisciplinary field that studies and develops effective uses of biomedical data, information technology innovations, and medical knowledge for scientific inquiry, problem solving, and decision making, with an emphasis on improving human health. Given the ongoing advances in information technology, the field of informatics is becoming important to clinical practice and to residency education. This article will discuss how informatics is specifically relevant to residency education and the different ways to incorporate informatics into residency education, and will highlight applications of current technology in the context of residency education...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28527386/gait-patterns-of-children-and-adolescents-with-charcot-marie-tooth-disease
#3
Elizabeth Wojciechowski, Amy Sman, Kayla Cornett, Jacqueline Raymond, Kathryn Refshauge, Manoj P Menezes, Joshua Burns
Gait abnormalities reported in childhood Charcot-Marie-Tooth disease (CMT) include foot-drop, reduced ankle power at push-off and increased knee and hip flexion for swing clearance ('steppage-gait'). The purpose of this study was to describe the gait patterns of 60 children aged 6-17 years with CMT (CMTall) and distinguish differences based on functional weakness using the CMT Pediatric Scale (CMTPedS). Data were captured using Vicon Nexus system and compared to 50 healthy norms. Data were subdivided into three groups denoting increasing severity of dorsiflexion and plantarflexion weakness from the CMTPedS: no difficulty heel or toe walking (CMTND), difficulty heel walking (CMTDH), difficulty toe and heel walking (CMTDTH)...
May 8, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28523862/transatlantic-medical-consultation-and-second-opinion-in-pediatric-cardiology-has-benefit-past-patient-care-a-case-study-in-videoconferencing
#4
Lubica Kovacikova, Martin Zahorec, Peter Skrak, Brian D Hanna, R Lee Vogel
BACKGROUND: Telemedicine is a rapidly evolving form of modern information and communication technology used to deliver clinical services and educational activities. OBJECTIVE: The aim of this article is to report and analyze our experience with transatlantic consultation via videoconferencing in pediatric cardiology. METHODS: In February, 2013, videoconferencing project was launched between a medium-volume pediatric cardiac center in Bratislava, Slovakia and subspecialty experts from a high-volume pediatric cardiac program at The Children's Hospital of Philadelphia (CHOP), USA...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28521931/hemodynamic-measurements-for%C3%A2-the%C3%A2-selection-of-patients-with-renal%C3%A2-artery%C3%A2-stenosis-a-systematic-review
#5
REVIEW
Peter M van Brussel, Tim P van de Hoef, Robbert J de Winter, Liffert Vogt, Bert-Jan van den Born
Interventions targeting renal artery stenoses have been shown to lower blood pressure and preserve renal function. In recent studies, the efficacy of catheter-based percutaneous transluminal renal angioplasty with stent placement has been called into question. In the identification of functional coronary lesions, hyperemic measurements have earned a place in daily practice for clinical decision making, allowing discrimination between solitary coronary lesions and diffuse microvascular disease. Next to differences in clinical characteristics, the selection of renal arteries suitable for intervention is currently on the basis of anatomic grading of the stenosis by angiography rather than functional assessment under hyperemia...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28521742/the-linguistic-validation-of-the-gut-feelings-questionnaire-in-three-european-languages
#6
Marie Barais, Johannes Hauswaldt, Daniel Hausmann, Slawomir Czachowski, Agnieszka Sowinska, Paul Van Royen, Erik Stolper
BACKGROUND: Physicians' clinical decision-making may be influenced by non-analytical thinking, especially when perceiving uncertainty. Incidental gut feelings in general practice have been described, namely, as "a sense of alarm" and "a sense of reassurance". A Dutch Gut Feelings Questionnaire (GFQ) was developed, validated and afterwards translated into English following a linguistic validation procedure. The aims were to translate the GFQ from English into French, German and Polish; to describe uniform elements as well as differences and difficulties in the linguistic validation processes; to propose a procedural scheme for future GFQ translations into other languages...
April 20, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28521441/the-context-of-prostate-cancer-genomics-in-personalized-medicine
#7
Yanling Liu
Prostate cancer is one of the most common types of cancer in males. Heterogeneous genomic aberrations may lead to prostate cancer onset, progression and metastasis. This heterogeneity also contributes to the variety in cancer risk and outcomes, different drug responses and progression, observed between individual patients. Classical prognostic factors, including prostate-specific antigen, Gleason Score and clinical tumor staging, are not sufficient to portray the complexity of a clinically relevant cancer diagnosis, risk prognosis, treatment choice and therapy monitoring...
May 2017: Oncology Letters
https://www.readbyqxmd.com/read/28520904/sources-of-unsafe-primary-care-for-older-adults-a-mixed-methods-analysis-of-patient-safety-incident-reports
#8
Alison Cooper, Adrian Edwards, Huw Williams, Huw P Evans, Anthony Avery, Peter Hibbert, Meredith Makeham, Aziz Sheikh, Liam J Donaldson, Andrew Carson-Stevens
Background: older adults are frequent users of primary healthcare services, but are at increased risk of healthcare-related harm in this setting. Objectives: to describe the factors associated with actual or potential harm to patients aged 65 years and older, treated in primary care, to identify action to produce safer care. Design and Setting: a cross-sectional mixed-methods analysis of a national (England and Wales) database of patient safety incident reports from 2005 to 2013...
May 16, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28516435/management-considerations-in-cancer-patients-with-rheumatoid-arthritis
#9
Richard J Zogala, Kristina Goutsouliak, Maria E Suarez-Almazor
Rheumatoid arthritis is a common inflammatory disease that requires treatment with immunosuppressants to control symptoms and avoid joint destruction. Managing cancer in patients with concomitant rheumatoid arthritis poses special challenges that require close coordination of care between oncologists and rheumatologists. Potential clinical issues needing special consideration include: 1) perioperative management in patients undergoing cancer surgery, which often requires discontinuation of antirrheumatic therapy; 2) use of immunosuppressant therapies for rheumatoid arthritis, especially biologic agents that inhibit cytokine and immune pathways, which conceivably could affect immune-mediated antitumor responses (the issues are different in patients with active cancer vs those with a past history of cancer and no recurrences); 3) management in the palliative care setting; and 4) use of cancer immunotherapy, such as checkpoint inhibitor agents, in patients with pre-existing rheumatoid arthritis...
May 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28515241/use-of-biomarkers-and-multigene-assays-in-breast-cancer
#10
Lee S Schwartzberg
All patients with early breast cancer should be classified by subgroup through testing estrogen receptor, progesterone receptor, and HER2 status, with or without Ki-67 proliferation percentage. Genomic expression profiling aids clinical decision-making in most patients, because most are estrogen receptor-positive. The commercially available classifiers are prognostic for distant recurrence in node-negative and also node-positive patients. Patients at genomically low risk have excellent 5-year outcomes with endocrine therapy alone...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28514966/clinical-applications-of-pd-l1-bioassays-for-cancer-immunotherapy
#11
REVIEW
Delong Liu, Shuhang Wang, Wendy Bindeman
Programmed death ligand 1 (PD-L1) has emerged as a biomarker that can help to predict responses to immunotherapies targeted against PD-L1 and its receptor (PD-1). Companion tests for evaluating PD-L1 expression as a biomarker of response have been developed for many cancer immunotherapy agents. These assays use a variety of detection platforms at different levels (protein, mRNA), employ diverse biopsy and surgical samples, and have disparate positivity cutoff points and scoring systems, all of which complicate the standardization of clinical decision-making...
May 17, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28513993/patient-report-outcome-measures-in-orthopaedics
#12
REVIEW
Joel J Gagnier
Patient reported outcome measures (PROMs) are key tools when performing clinical research and PROM data are increasingly used to inform clinical decision-making, patient-centered care, health policy and more recently, reimbursement decisions. PROMs must possess particular properties before they are used. Thus purpose of this paper is to give an overview of PROMs, their definition, how their evidence can be assessed, how they should be reported in clinical research, how to choose PROMs, the types of PROMs available in orthopaedics, where these measures can be found, PROMs in orthopaedic clinical practice and what are some key next steps in this field...
May 17, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28513769/the-situation-of-nursing-education-in-latin-america-and-the-caribbean-towards-universal-health
#13
Silvia Helena De Bortoli Cassiani, Lynda Law Wilson, Sabrina de Souza Elias Mikael, Laura Morán Peña, Rosa Amarilis Zarate Grajales, Linda L McCreary, Lisa Theus, Maria Del Carmen Gutierrez Agudelo, Adriana da Silva Felix, Jacqueline Molina de Uriza, Nathaly Rozo Gutierrez
Objective: to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health. Method: quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. Results: a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31...
May 11, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28512767/duration-of-major-and-minor-depressive-episodes-and-associated-risk-indicators-in-a-psychiatric-epidemiological-cohort-study-of-the-general-population
#14
M Ten Have, B W J H Penninx, M Tuithof, S van Dorsselaer, M Kleinjan, J Spijker, R de Graaf
OBJECTIVE: Hardly any studies exist on the duration of major depressive disorder (MDD) and factors that explain variations in episode duration that lack biases. This limits clinical decision-making and leaves patients wondering when they will recover. METHOD: Data were used from the Netherlands Mental Health Survey and Incidence Study-2, a psychiatric epidemiological cohort study among a nationally representative adult population. Respondents with a newly originated depressive episode were selected: 286 MDD and 107 minor depressive disorder (MinDD) cases...
May 16, 2017: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/28512731/active-surveillance-for-prostate-cancer-how-to-do-it-right
#15
REVIEW
Juan D Garisto, Laurence Klotz
Prostate cancer is the most common malignancy affecting men. There has been a nearly 70% increase in new prostate cancer cases, mostly classified as low risk, that have been diagnosed in early stages as a consequence of prostate-specific antigen (PSA) screening. Data regarding the natural history of this disease confirm the clinical insignificance of low-grade prostate cancer, which is associated with scant or no metastatic dissemination. Active surveillance is a conservative management approach, conducted for those patients with "low-risk" or "favorable-risk" disease, which avoids long-term adverse effects on the patient's quality of life...
May 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28509654/clinical-reasoning-embodied-meaning-making-in-physiotherapy
#16
Anoop Chowdhury, Wenche Schrøder Bjorbækmo
This article examines physiotherapists' lived experience of practicing physiotherapy in primary care, focusing on clinical reasoning and decision-making in the case of a patient we call Eva. The material presented derives from a larger study involving two women participants, both with a protracted history of neck and shoulder pain. A total of eight sessions, all of them conducted by the first author, a professional physiotherapist, in his own practice room, were videotaped, after which the first author transcribed the sessions and added reflective notes...
May 16, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28508800/electronic-health-records-in-prehospital-care
#17
Katharina Rohrer
Documentation is an essential part and duty in all clinical settings. "ELGA" (short for "Elektronische Gesundheitsakte") is the Austrian Electronic Health Record and aims to support the process of clinical decision-making. However the use case of integrating ELGA to an out-of-hospital setting is not defined yet. This work explores the special requirements in prehospital care. The aim of research is to identify needed information and processes at the emergency scene to establish appropriate decisions about diagnosis, treatments and transport...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28508725/evaluating-change-in-virtual-reality-adoption-for-brain-injury-rehabilitation-following-knowledge-translation
#18
Stephanie M N Glegg, Liisa Holsti, Sue Stanton, Steven Hanna, Diana Velikonja, Barbara Ansley, Denise Sartor, Christine Brum
PURPOSE: To evaluate the impact of knowledge translation (KT) on factors influencing virtual reality (VR) adoption and to identify support needs of therapists. HYPOTHESES: Intervention will be associated with improvements in therapists' perceived ease of use and self-efficacy, and an associated increase in intentions to use VR. METHOD: Single group mixed-methods pre-test-post-test evaluation of convenience sample of physical, occupational and rehabilitation therapists (n=37) from two brain injury rehabilitation centres...
April 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28508456/age-and-sex-based-reference-ranges-for-non-invasive-ventricular-repolarisation-parameters
#19
Annabella Braschi, Maurizio G Abrignani, Vincenzo C Francavilla, Vincenzo Abrignani, Giuseppe Francavilla
BACKGROUND: Some electrocardiographic parameters are able to assess indirectly ventricular repolarisation homogeneity. It is consequently essential to discriminate between normal and abnormal values in clinical decision-making. Considering there is still not a consensus about normal cut-off values, the aim of this study was to document reference intervals in all age groups of a healthy population, providing for age- and sex-percentile tables, which can be used easily and quickly in clinical practice...
May 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28508440/has-evidence-based-medicine-ever-been-modern-a-latour-inspired-understanding-of-a-changing-ebm
#20
Sietse Wieringa, Eivind Engebretsen, Kristin Heggen, Trish Greenhalgh
Evidence-based health care (EBHC), previously evidence-based medicine (EBM), is considered by many to have modernized health care and brought it from an authority-based past to a more rationalist, scientific grounding. But recent concerns and criticisms pose serious challenges and urge us to look at the fundamentals of a changing EBHC. In this paper, we present French philosopher Bruno Latour's vision on modernity as a framework to discuss current changes in the discourse on EBHC/EBM. Drawing on Latour's work, we argue that the early EBM movement had a strong modernist agenda with an aim to "purify" clinical reality into a dichotomy of objective "evidence" from nature and subjective "preferences" from human society and culture...
May 16, 2017: Journal of Evaluation in Clinical Practice
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