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https://www.readbyqxmd.com/read/28545264/reduction-of-dose-to-the-contralateral-breast-by-superflab-use-in-radiation-therapy-for-mammary-carcinomas
#1
Akanksha Solanki, Athiyaman M, Hemalatha A, H S Kumar
Background: Radiation therapy is an integral part of multimodality treatment for locally advanced carcinoma of breast. Radiation doses to nearby critical normal structures like heart, lungs, and contralateral breast (CLB increases risk of second malignancies. In this study, we measured doses to the CLB and studied effects of a 1 cm thickness superflap. Materials and Methods: Fifty post-mastectomy carcinoma breast patients were included in the study.Radiation therapy of 50 Gy was planned in 25 fractions, 5 days a week, using the Eclipse Treatment Planning System version 8...
April 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28544780/spinal-metastatic-disease-a-review-of-the-role-of-the-multidisciplinary-team
#2
REVIEW
Mark Curtin, Robert P Piggott, Evelyn P Murphy, Sudarshan Munigangaiah, Joseph F Baker, John P McCabe, Aiden Devitt
Historically, a simple approach centered on palliation was applicable to the majority of patients with metastatic spinal disease. With advances in diagnosis and treatment, a more complicated algorithm has devolved requiring a multidisciplinary approach with institutional commitment and support. We performed a database review including pertinent articles exploring the multidisciplinary management of spinal metastatic disease. The wide variation in clinical presentation and tumor response to treatment necessitates a multidisciplinary approach that integrates the diagnosis and treatment of the cancer, symptom management, and rehabilitation for optimal care of patients with spinal metastases...
May 24, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28543716/an-atopic-dermatitis-management-algorithm-for-primary-care-providers-and-assessment-of-its-usefulness-as-a-clinical-tool
#3
Maria E Miyar, Megan Brown, Karina L Vivar, Kimberly Jablon, Christy Boscardin, Moise L Levy, Joyce M Teng, Erin F Mathes
BACKGROUND/OBJECTIVES: There is a lack of primary care provider (PCP) understanding of atopic dermatitis (AD) treatments and topical steroid use. We designed an AD management algorithm for pediatric PCPs. We hypothesized that the algorithm would improve pediatric PCPs' knowledge of AD diagnosis and management. METHODS: Pediatric primary care resident and attending physicians at three residency programs were invited to participate in an electronic AD algorithm survey that contained demographic and 19 knowledge-based questions...
May 25, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28542336/does-ngal-reduce-costs-a-cost-analysis-of-urine-ngal-ungal-serum-creatinine-scr-for-acute-kidney-injury-aki-diagnosis
#4
Amay Parikh, John A Rizzo, Pietro Canetta, Catherine Forster, Meghan Sise, Omar Maarouf, Eugenia Singer, Antje Elger, Saban Elitok, Kai Schmidt-Ott, Jonathon Barasch, Thomas L Nickolas
INTRODUCTION: Urine neutrophil gelatinase-associated lipocalin (uNGAL) is a sensitive and specific diagnostic test for acute kidney injury (AKI) in the Emergency Department (ED), but its economic impact has not been investigated. We hypothesized that uNGAL used in combination with serum creatinine (sCr) would reduce costs in the management of AKI in patients presenting to the ED in comparison to using sCr alone. MATERIALS AND METHODS: A cost simulation model was developed for clinical algorithms to diagnose AKI based on sCr alone vs...
2017: PloS One
https://www.readbyqxmd.com/read/28542080/manuscript-title-multidisciplinary-point-of-care-testing-in-south-african-primary-healthcare-clinics-accelerates-hiv-art-initiation-but-does-not-alter-retention-in-care
#5
Wendy S Stevens, Natasha M Gous, William B MacLeod, Lawrence C Long, Ebrahim Variava, Neil A Martinson, Ian Sanne, Regina Osih, Lesley E Scott
BACKGROUND: Lack of accessible laboratory infrastructure limits HIV antiretroviral (ART) treatment initiation, monitoring and retention in many resource-limited settings. Point-of-care testing (POCT) is advocated as a mechanism to overcome these limitations. We executed a pragmatic, prospective, randomized, controlled trial comparing the impact of POCT versus standard-of-care (SOC) on treatment initiation and retention in care. METHOD: Selected POC technologies were embedded at 3 primary health clinics in South Africa...
May 23, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28541108/using-qr-codes-to-enable-quick-access-to-information-in-acute-cancer-care
#6
Joanne Upton, Anna Olsson-Brown, Ernie Marshall, Joseph Sacco
Quick access to toxicity management information ensures timely access to steroids/immunosuppressive treatment for cancer patients experiencing immune-related adverse events, thus reducing length of hospital stays or avoiding hospital admission entirely. This article discusses a project to add a QR (quick response) code to a patient-held immunotherapy alert card. As QR code generation is free and the immunotherapy clinical management algorithms were already publicly available through the trust's clinical network website, the costs of integrating a QR code into the alert card, after printing, were low, while the potential benefits are numerous...
May 25, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28540816/numerical-evaluation-of-the-effect-of-electronically-steering-a-phased-array-transducer-axially-post-focal-shifting
#7
Mingjun Wang, Yufeng Zhou
PURPOSE: HIFU has been emerging as an effective and safe modality for the treatment of solid tumours and cancers. The focus shifting range of phased array HIFU transducer is an important safety concern because of the presence of grating lobe in the pre-focal region. However, previous studies were only based on linear acoustic wave model. MATERIALS AND METHODS: The nonlinear wave propagation from a 256-element phased array through multiple layered media was simulated using the angular spectrum approach (ASA) in marching fractional steps with the consideration of diffraction, attenuation and non-linearity effects by a second-order operator splitting scheme...
May 15, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28540779/planning-optimisation-and-evaluation-of-hyperthermia-treatments
#8
H P Kok, A N T J Kotte, J Crezee
BACKGROUND: Hyperthermia treatment planning using dedicated simulations of power and temperature distributions is very useful to assist in hyperthermia applications. This paper describes an advanced treatment planning software package for a wide variety of applications. METHODS: The in-house developed C++ software package Plan2Heat runs on a Linux operating system. Modules are available to perform electric field and temperature calculations for many heating techniques...
March 8, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28540598/parp-inhibitors-in-prostate-cancer
#9
REVIEW
Praveen Ramakrishnan Geethakumari, Matthew J Schiewer, Karen E Knudsen, Wm Kevin Kelly
The genomic landscape of metastatic prostate cancer (mPCa) reveals that up to 90% of patients harbor actionable mutations and >20% have somatic DNA repair gene defects (DRD). This provides the therapeutic rationale of PARP inhibition (PARPi) to achieve "synthetic lethality" in treating this fatal disease. Clinical trials with PARP inhibitors have shown significant response rates up to 88% for PCa patients having DRD like BRCA1/2 or ATM mutations. The FDA has awarded "breakthrough designation" to develop the PARPi olaparib in treating this subset of metastatic PCa patients...
June 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28540232/genital-pain-algorithm-for-management
#10
REVIEW
Nahomy Calixte, Jamin Brahmbhatt, Sijo Parekattil
Chronic testicular pain although becoming very common in our patient population poses a challenge to the physician, the patient and his family. The pathogenesis of chronic orchialgia (CO) is not well understood. The objective of this paper is to review the current literature on chronic testicular pain and its management and to propose an algorithm for its treatment. Abstracts, original papers and review articles were reviewed during a literature search using words such as testicular pain, CO, and microsurgical anatomy of spermatic cord...
April 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28540147/candida-prosthetic-joint-infection-a-review-of-treatment-methods
#11
REVIEW
Fernando Cobo, Javier Rodríguez-Granger, Antonio Sampedro, Luis Aliaga-Martínez, José María Navarro-Marí
Fungal microorganisms are still a rare cause of bone and joint infections. We report a new case of knee prosthetic joint infection due to Candida albicans in a patient with a previous two-stage right knee arthroplasty for septic arthritis due to S. epidermidis occurred several months ago. Moreover, the treatment in 76 cases of Candida prosthetic joint infection has been discussed. Forty patients were female and mean age at diagnosis was 65.7 (± SD 18) yrs. No risk factors for candidal infection were found in 25 patients...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28539541/sleep-disordered-breathing-in-heart-failure%C3%A3-a-therapeutic-dilemma
#12
Nobuhiko Haruki, John S Floras
Sleep-disordered breathing (SDB) occurs in approximately 50% of patients with reduced left ventricular ejection fraction receiving contemporary heart failure (HF) therapies. Obstructive (OSA) and central sleep apneas (CSA) interrupt breathing by different mechanisms but impose qualitatively similar autonomic, chemical, mechanical, and inflammatory burdens on the heart and circulation. Because contemporary evidence-based drug and device HF therapies have little or no mitigating effect on the acute or long-term consequences of such stimuli, there is a sound mechanistic rationale for targeting SDB to reduce cardiovascular event rates and prolong life...
May 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28539420/a-selective-role-for-dopamine-in-learning-to-maximize-reward-but-not-to-minimize-effort-evidence-from-patients-with-parkinson-s-disease
#13
Vasilisa Skvortsova, Bertrand Degos, Marie-Laure Welter, Marie Vidailhet, Mathias Pessiglione
Instrumental learning is a fundamental process through which agents optimize their choices, taking into account various dimensions of available options, such as the possible reward or punishment outcomes, and the costs associated with potential actions. While the implication of dopamine in learning from choice outcomes is well established, less is known about its role in learning the action costs such as effort. Here, we tested the ability of patients with Parkinson's disease (PD) to maximize monetary rewards and minimize physical efforts in a probabilistic instrumental learning task...
May 24, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28537934/alternative-treatments-for-chronic-spontaneous-urticaria-beyond-the-guideline-algorithm
#14
Gino A Vena, Marcus Maurer, Nicoletta Cassano, Torsten Zuberbier
PURPOSE OF REVIEW: The international EAACI/GALEN/EDF/WAO guideline suggests a stepwise approach for the therapeutic management of chronic spontaneous urticaria (CSU), outlined in an algorithm. The aim of this article is to summarize and review the evidence available on alternative treatment options for CSU outside of this algorithm. RECENT FINDINGS: Although CSU is a common disease, there are a limited number of high-quality studies, and only antihistamines and omalizumab are licensed for its treatment...
May 22, 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28537773/a-new-generation-of-comfort-care-order-sets-aligning-protocols-with-current-principles
#15
Melissa A Bender, Caroline Hurd, Nicole Solvang, Kathy Colagrossi, Diane Matsuwaka, J Randall Curtis
BACKGROUND: There are few published comfort care order sets for end-of-life symptom management, contributing to variability in treatment of common symptoms. At our academic medical centers, we have observed that rapid titration of opioid infusions using our original comfort care order set's titration algorithm causes increased discomfort from opioid toxicity. OBJECTIVE: The aim of this study was to describe the process and outcomes of a multiyear revision of a standardized comfort care order set for clinicians to treat end-of-life symptoms in hospitalized patients...
May 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28537645/use-of-an-ovine-collagen-dressing-with-intact-extracellular-matrix-to-improve-wound-closure-times-and-reduce-expenditures-in-a-us-military-veteran-hospital-outpatient-wound-center
#16
Daniel T Ferreras, Sean Craig, Rebecca Malcomb
A novel, comprehensive decision-making and treatment algorithm was established within a US government-run military veteran hospital in an attempt to standardize the process of outpatient wound care and streamline costs. All patients were systematically evaluated and treated using the comprehensive algorithm over a span of nine months. After three months of adherence to the algorithm, the algorithm was modified to include ovine-based collagen extracellular matrix (CECM) dressings as a first-line conventional treatment strategy for all appropriate wounds...
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28537441/characteristics-resource-utilization-and-safety-profile-of-patients-prescribed-with-neuropathic-pain-treatments-a-real-world-evidence-study-on-general-practices-in-europe
#17
Pablo Katz, Valeria Pegoraro, Hiltrud Liedgens
OBJECTIVES: To identify characteristics, resource utilization, and safety profile of patients prescribed with lidocaine 5% medicated plaster, pregabalin, gabapentin, amitriptyline and duloxetine when experiencing pain in the real-world setting of general practitioners (GPs) in Europe. METHODS: Retrospective analysis on real world data from IMS Health Longitudinal Patient Database. Patients with at least one prescription of the drugs of interest during 2014 were selected and those with a non-neuropathic pain-related diagnosis were excluded...
May 24, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28537061/dolutegravir-lamivudine-as-initial-therapy-in-hiv-1-infected-arv-naive-patients-48-week-results-of-the-paddle-pilot-antiretroviral-design-with-dolutegravir-lamivudine-study
#18
Pedro Cahn, María José Rolón, María Inés Figueroa, Ana Gun, Patricia Patterson, Omar Sued
INTRODUCTION: A proof-of-concept study was designed to evaluate the antiviral efficacy, safety and tolerability of a two-drug regimen with dolutegravir 50 mg once daily (QD) plus lamivudine 300 mg once daily as initial highly active antiretroviral therapy (HAART) among antiretroviral (ARV)-naive patients. METHODS: PADDLE is a pilot study including 20 treatment-naive adults. To be selected, participants had no IAS-USA-defined resistance, HIV-1 RNA ≤100,000 copies/mL at screening and negative HBsAg...
May 9, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28536644/microrna-548c-3p-inhibits-t98g-glioma-cell-proliferation-and-migration-by-downregulating-c-myb
#19
Jianyi Lu, Min Zhang, Xiao Yang, Tong Cui, Jinpo Dai
MicroRNAs (miRNAs/miRs) are short non-coding RNAs (between 20 and 22 nucleotides) that regulate gene expression by binding to the 3'-untranslated region of target mRNA, and preventing protein translation or inducing mRNA destabilization. miRNAs are predicted to target ~60% of all mRNAs, therefore providing a marked degree of regulation of a number of cellular processes. In the present study, the expression of miR-548c-3p was determined by reverse transcription-quantitative polymerase chain reaction analysis and demonstrated to be markedly downregulated in clinical malignant glioma tissues and the glioma T98G cell line compared with normal human brain tissue...
May 2017: Oncology Letters
https://www.readbyqxmd.com/read/28536438/optimizing-radiotherapy-protocols-using-computer-automata-to-model-tumour-cell-death-as-a-function-of-oxygen-diffusion-processes
#20
Perrine Paul-Gilloteaux, Vincent Potiron, Grégory Delpon, Stéphane Supiot, Sophie Chiavassa, François Paris, Sylvain V Costes
The concept of hypofractionation is gaining momentum in radiation oncology centres, enabled by recent advances in radiotherapy apparatus. The gain of efficacy of this innovative treatment must be defined. We present a computer model based on translational murine data for in silico testing and optimization of various radiotherapy protocols with respect to tumour resistance and the microenvironment heterogeneity. This model combines automata approaches with image processing algorithms to simulate the cellular response of tumours exposed to ionizing radiation, modelling the alteration of oxygen permeabilization in blood vessels against repeated doses, and introducing mitotic catastrophe (as opposed to arbitrary delayed cell-death) as a means of modelling radiation-induced cell death...
May 23, 2017: Scientific Reports
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