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https://www.readbyqxmd.com/read/28266038/using-direct-antiglobulin-test-results-to-reduce-unnecessary-cold-agglutinin-testing
#1
Craig B Wilen, Garrett S Booth, Brenda J Grossman, William J Lane, Penny C Szklarski, Ronald Jackups
BACKGROUND: Cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia mediated by autoantibodies that preferentially react at 4°C. Laboratory testing for cold-reactive autoantibodies is laborious and may not be ordered judiciously, particularly in patients with a negative direct antiglobulin test (DAT). We sought to determine whether a negative DAT using anti-human complement (anti-C3) rules out elevated cold agglutinin (CA) titers and the diagnosis of CAD. STUDY DESIGN AND METHODS: We performed a retrospective study of patients with a CA test performed at three major academic medical centers: Barnes-Jewish Hospital (2003-2014), Vanderbilt University Medical Center (2007-2009), and Massachusetts General Hospital (2009-2014)...
March 7, 2017: Transfusion
https://www.readbyqxmd.com/read/28259520/derivation-and-external-validation-of-the-plasmic-score-for-rapid-assessment-of-adults-with-thrombotic-microangiopathies-a-cohort-study
#2
Pavan K Bendapudi, Shelley Hurwitz, Ashley Fry, Marisa B Marques, Stephen W Waldo, Ang Li, Lova Sun, Vivek Upadhyay, Ayad Hamdan, Andrew M Brunner, John M Gansner, Srinivas Viswanathan, Richard M Kaufman, Lynne Uhl, Christopher P Stowell, Walter H Dzik, Robert S Makar
BACKGROUND: Among the syndromes characterised by thrombotic microangiopathy, thrombotic thrombocytopenic purpura is distinguished by a severe deficiency in the ADAMTS13 enzyme. Patients with this disorder need urgent treatment with plasma exchange. Because ADAMTS13 activity testing typically requires prolonged turnaround times and might be unavailable in resource-poor settings, a method to rapidly assess the likelihood of severe ADAMTS13 deficiency is needed. METHODS: All consecutive adult patients presenting to three large academic medical centres in Boston, MA, USA, with thrombotic microangiopathy and a possible diagnosis of thrombotic thrombocytopenic purpura between Jan 8, 2004, and Dec 6, 2015, were included in an ongoing multi-institutional registry (the Harvard TMA Research Collaborative)...
March 1, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28254107/protocol-testing-the-relevance-of-acupuncture-theory-in-the-treatment-of%C3%A2-myofascial-pain-in-the-upper-trapezius-muscle
#3
Dale S Elsdon, Selina Spanswick, Chris Zaslawski, Peter C Meier
A protocol for a prospective single-blind parallel four-arm randomized placebo-controlled trial with repeated measures was designed to test the effects of various acupuncture methods compared with sham. Eighty self-selected participants with myofascial pain in the upper trapezius muscle were randomized into four groups. Group 1 received acupuncture to a myofascial trigger point (MTrP) in the upper trapezius. Group 2 received acupuncture to the MTrP in addition to relevant distal points. Group 3 received acupuncture to the relevant distal points only...
January 2017: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/28252677/increasing-clinical-faculty-engagement-in-problem-driven-research-the-magic-wand-initiative-at-massachusetts-general-hospital
#4
Lilit Garibyan, R Rox Anderson
No abstract text is available yet for this article.
March 2, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28238953/cost-effectiveness-of-screening-patients-with-gastroesophageal-reflux-disease-for-barrett-s-esophagus-with-a-minimally-invasive-cell-sampling-device
#5
Curtis R Heberle, Amir-Houshang Omidvari, Ayman Ali, Sonja Kroep, Chung Yin Kong, John M Inadomi, Joel H Rubenstein, Angela C Tramontano, Emily C Dowling, William D Hazelton, E Georg Luebeck, Iris Lansdorp-Vogelaar, Chin Hur
BACKGROUND & AIMS: It is important to identify patients with Barrett's esophagus (BE), the precursor to esophageal adenocarcinoma (EAC). Patients with BE are usually identified by endoscopy, which is expensive. The cytosponge, which collects tissue from the esophagus non-invasively, could be a cost-effective tool for screening individuals with gastroesophageal reflux disease (GERD), who are at increased risk for BE. We developed a model to analyze the cost effectiveness of using cytosponge in first-line screening of patients with GERD for BE with endoscopic confirmation, compared to endoscopy screening only, METHODS: We incorporated data from a large clinical trial of cytosponge performance into 2 validated microsimulation models of EAC progression (the esophageal adenocarcinoma model from the Massachusetts General Hospital and the microsimulation screening analysis model from Erasmus University Medical Center)...
February 23, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28235809/management-and-outcome-of-patients-with-acute-coronary-syndrome-caused-by-plaque-rupture-versus-plaque-erosion-an%C3%A2-intravascular-optical-coherence-tomography-study
#6
Sining Hu, Yinchun Zhu, Yingying Zhang, Jiannan Dai, Lulu Li, Harold Dauerman, Tsunenari Soeda, Zhao Wang, Hang Lee, Chao Wang, Chunyang Zhe, Yan Wang, Gonghui Zheng, Shaosong Zhang, Haibo Jia, Bo Yu, Ik-Kyung Jang
BACKGROUND: Plaque rupture and erosion are the 2 most common mechanisms for acute coronary syndromes. However, the outcome of these 2 distinct pathologies in patients with acute coronary syndromes has never been studied. METHODS AND RESULTS: We retrospectively studied 141 patients with acute coronary syndromes who underwent optical coherence tomography (OCT) imaging of the culprit lesion prior to stenting from the Massachusetts General Hospital OCT Registry. Management (stent versus no stent), poststent OCT findings, and outcomes were compared...
February 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28230752/impact-of-particulate-matter-exposure-and-surrounding-greenness-on-chronic-absenteeism-in-massachusetts-public-schools
#7
Piers MacNaughton, Erika Eitland, Itai Kloog, Joel Schwartz, Joseph Allen
Chronic absenteeism is associated with poorer academic performance and higher attrition in kindergarten to 12th grade (K-12) schools. In prior research, students who were chronically absent generally had fewer employment opportunities and worse health after graduation. We examined the impact that environmental factors surrounding schools have on chronic absenteeism. We estimated the greenness (Normalized Difference Vegetation Index (NDVI)) and fine particulate matter air pollution (PM2.5) within 250 m and 1000 m respectively of each public school in Massachusetts during the 2012-2013 academic year using satellite-based data...
February 20, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28213837/brief-report-meeting-the-needs-of-medically-hospitalized-adults-with-autism-a-provider-and-patient-toolkit
#8
Jocelyn Carter, Sarabeth Broder-Fingert, Ann Neumeyer, Ann Giauque, Ann Kao, Christiana Iyasere
In an effort to meet the needs of adults with autism spectrum disorder (ASD) while hospitalized, a team of experts and providers from Massachusetts General Hospital (MGH), MGH for Children as well as parents of individuals with ASD was sparked in 2013. This became a multidisciplinary collaborative, the MGH Autism Care Collaborative, to improve adult care for inpatients with ASD. The collaborative was created with three goals in mind: (1) to educate internal medicine adult inpatient providers and staff on the unique needs of adults with ASD when hospitalized; (2) to create ASD specific resources for internal medicine adult inpatient providers; (3) to optimize patient care from admission to discharge among adults with ASD admitted to internal medicine services...
February 17, 2017: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/28208198/the-pulmonary-embolism-response-team-what-is-the-ideal-model
#9
Josanna Rodriguez-Lopez, Richard Channick
Treatment of patients with intermediate- and high-risk pulmonary embolism (PE) is a controversial area. Many therapeutic options exist, and deciding on appropriate treatment can be difficult. In addition, multiple specialties are often involved in the care of PE patients. To better organize the response to serious PE patients, several hospitals and academic centers across the United States, spearheaded by Massachusetts General Hospital, have created pulmonary embolism response teams (PERTs). The goal of a PERT is to have a single multidisciplinary team of experts in thromboembolic disease, who can respond rapidly to patients with acute PE, and offer consultation with the full spectrum of therapeutic options...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208140/first-diagnosis-of-atrial-fibrillation-at-the-time-of-stroke
#10
Leila H Borowsky, Susan Regan, Yuchiao Chang, Alison Ayres, Steven M Greenberg, Daniel E Singer
BACKGROUND: Atrial fibrillation (AF) is a major cause of ischemic stroke. Individuals with undiagnosed AF lack the stroke protection afforded by oral anticoagulants. We obtained a contemporary estimate of the percentage of AF patients newly diagnosed at the time of stroke. METHODS: We identified patients admitted to the Massachusetts General Hospital (MGH) from January 1, 2010 to December 31, 2013 with acute ischemic stroke and either previously or newly diagnosed AF using hospital stroke registry data and stroke and AF ICD-9 code searches of hospital databases...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28207913/differentiating-residual-symptoms-of-depression-from-adverse-events-among-patients-initiating-treatment-with-an-antidepressant
#11
Marlene P Freeman, Lauren Fisher, Alisabet Clain, Richard Rabbitt, James Pooley, Lee Baer, Maurizio Fava
BACKGROUND: In treated patients with major depressive disorder (MDD), residual symptoms are common and challenging to disentangle from possible antidepressant side effects. Our objective was to prospectively differentiate between rates of residual symptoms and treatment-emergent side effects. METHODS: Participants in an episode of MDD were enrolled in a 6-week trial of an antidepressant. Assessments occurred at baseline and after 6 weeks of treatment, using the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) and the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (MGH CPFQ)...
February 2017: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/28194567/ultrastructural-characterization-of-mammary-analogue-secretory-carcinoma-of-the-salivary-glands-a-distinct-entity-from-acinic-cell-carcinoma
#12
Julie Guilmette, Gunnlaugur P Nielsen, William C Faquin, Martin Selig, Vânia Nosé, Anthony W S Chi, Peter M Sadow
Mammary analogue secretory carcinoma (MASC) of the salivary glands is a recently described neoplasm of the salivary glands with a characteristic morphology complemented by a specific cytogenetic translocation and gene rearrangements. Although immunophenotypic and cytogenetic differences allow for a more reliable distinction, ultrastructural features can also provide important information about the relationship between MASC, classic acinic cell carcinoma (AciCC), and AciCC intercalated duct cell-predominant variant...
February 13, 2017: Head and Neck Pathology
https://www.readbyqxmd.com/read/28192645/cytological-molecular-and-clinical-features-of-noninvasive-follicular-thyroid-neoplasm-with-papillary-like-nuclear-features-versus-invasive-forms-of-follicular-variant-of-papillary-thyroid-carcinoma
#13
Liena Zhao, Dora Dias-Santagata, Peter M Sadow, William C Faquin
BACKGROUND: The noninvasive follicular variant of papillary thyroid carcinoma (PTC) has an indolent clinical behavior in comparison with other PTCs, including the invasive follicular variant of papillary thyroid carcinoma (IFVPTC). Recently, the term noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was introduced to emphasize the low biological potential of these tumors. This study compares clinical, cytological, and molecular features of NIFTP and IFVPTC...
February 13, 2017: Cancer
https://www.readbyqxmd.com/read/28159496/androgen-deprivation-with-or-without-radiation-therapy-for-clinically-node-positive-prostate-cancer-lin-cc-gray-pj-jemal-a-efstathiou-ja-surveillance-and-health-services-research-program-intramural-research-american-cancer-society-atlanta-ga-ccl-aj-department
#14
Eggener Scott
BACKGROUND: Clinically lymph node-positive (cN+) prostate cancer (PCa) is an often-fatal disease. Its optimal management remains largely undefined given a lack of prospective, randomized data to inform practice. We sought to describe modern practice patterns in the management of cN+PCa and assess the effect of adding radiation therapy (RT) to androgen deprivation therapy (ADT) on survival using the National Cancer Data Base. METHODS: Patients with cN+PCa and without distant metastases diagnosed between 2004 and 2011 were included...
March 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28158168/ultrasound-guided-radiofrequency-lesioning-of-the-articular-branches-of-the-femoral-nerve-for-the-treatment-of-chronic-post-arthroplasty-hip-pain
#15
David J Kim, Shiqian Shen, George M Hanna
BACKGROUND: Total hip arthroplasty (THA) is a common surgical treatment for several conditions of the hip. While the majority of patients obtain satisfactory results, many develop chronic post-arthroplasty hip pain that can be difficult to treat. OBJECTIVE: We evaluate the effectiveness of cooled (60°C) radiofrequency lesioning of the articular branches of the femoral nerve (ABFN) as a minimally invasive treatment for patients suffering from chronic post-arthroplasty hip pain...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28157692/bayesian-variable-selection-methods-for-matched-case-control-studies
#16
Josephine Asafu-Adjei, G Tadesse Mahlet, Brent Coull, Raji Balasubramanian, Michael Lev, Lee Schwamm, Rebecca Betensky
Matched case-control designs are currently used in many biomedical applications. To ensure high efficiency and statistical power in identifying features that best discriminate cases from controls, it is important to account for the use of matched designs. However, in the setting of high dimensional data, few variable selection methods account for matching. Bayesian approaches to variable selection have several advantages, including the fact that such approaches visit a wider range of model subsets. In this paper, we propose a variable selection method to account for case-control matching in a Bayesian context and apply it using simulation studies, a matched brain imaging study conducted at Massachusetts General Hospital, and a matched cardiovascular biomarker study conducted by the High Risk Plaque Initiative...
January 31, 2017: International Journal of Biostatistics
https://www.readbyqxmd.com/read/28143416/combination-therapy-with-rituximab-low-dose-cyclophosphamide-and-prednisone-for-idiopathic-membranous-nephropathy-a-case-series
#17
Frank B Cortazar, David E Leaf, Charles T Owens, Karen Laliberte, William F Pendergraft, John L Niles
BACKGROUND: Membranous nephropathy is a common cause of the nephrotic syndrome. Treatment with standard regimens fails to induce complete remission in most patients. We evaluated the efficacy of combination therapy with rituximab, low-dose, oral cyclophosphamide, and an accelerated prednisone taper (RCP) for the treatment of idiopathic membranous nephropathy. METHODS: We analyzed 15 consecutive patients with idiopathic membranous nephropathy treated with RCP at Massachusetts General Hospital...
February 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28141582/radiation-shielding-calculation-for-digital-breast-tomosynthesis-rooms-with-an-updated-workload-survey
#18
Kai Yang, Thomas J Schultz, Xinhua Li, Bob Liu
PURPOSE: To present shielding calculations for clinical digital breast tomosynthesis (DBT) rooms with updated workload data from a comprehensive survey and to provide reference shielding data for DBT rooms. METHODS: The workload survey was performed from eight clinical DBT (Hologic Selenia Dimensions) rooms at Massachusetts General Hospital (MGH) for the time period between 10/1/2014 and 10/1/2015. Radiation output related information tags from the DICOM header, including mAs, kVp, beam filter material and gantry angle, were extracted from a total of 310 421 clinical DBT acquisitions from the PACS database...
March 20, 2017: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
https://www.readbyqxmd.com/read/28125073/the-association-between-igf-1-levels-and-the-histologic-severity-of-nonalcoholic-fatty-liver-disease
#19
Laura E Dichtel, Kathleen E Corey, Joseph Misdraji, Miriam A Bredella, Melanie Schorr, Stephanie A Osganian, Brian J Young, Joshua C Sung, Karen K Miller
OBJECTIVES: The mechanisms responsible for the development of nonalcoholic fatty liver disease (NAFLD) and progression to nonalcoholic steatohepatitis (NASH) are incompletely understood. Growing evidence suggests that growth hormone (GH) and insulin-like growth factor-1 (IGF-1) may have roles in the development and progression of NAFLD. We hypothesized that lower serum IGF-1 levels would be associated with increased liver fat accumulation, inflammation, and fibrosis in a group of meticulously phenotyped obese subjects with liver biopsies...
January 26, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28122904/evolution-of-cerebral-microbleeds-after-cranial-irradiation-in-medulloblastoma-patients
#20
Duangnapa Roongpiboonsopit, Hugo J Kuijf, Andreas Charidimou, Li Xiong, Anastasia Vashkevich, Sergi Martinez-Ramirez, Helen A Shih, Corey M Gill, Anand Viswanathan, Jorg Dietrich
OBJECTIVE: To characterize the temporal and spatial pattern of cerebral microbleeds (CMBs) after cranial irradiation in patients with medulloblastoma. METHODS: We retrospectively identified patients with medulloblastoma treated with craniospinal irradiation at the Massachusetts General Hospital between 1999 and 2015. Longitudinal MRI including T2*-weighted gradient-recalled echo (GRE) sequences were reviewed, and the prevalence, spatial pattern, and risk factors associated with CMBs were characterized...
February 21, 2017: Neurology
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