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Cohort medicine

P D Tar, N A Thacker, M Babur, Y Watson, S Cheung, R A Little, R G Gieling, K J Williams, J P B O'Connor
Motivation: Imaging demonstrates that preclinical and human tumors are heterogeneous, i.e. a single tumor can exhibit multiple regions that behave differently during both normal development and also in response to treatment. The large variations observed in control group tumors can obscure detection of significant therapeutic effects due to the ambiguity in attributing causes of change. This can hinder development of effective therapies due to limitations in experimental design, rather than due to therapeutic failure...
March 14, 2018: Bioinformatics
Sarah Edgerley, Conor McKaigney, Devon Boyne, Darrell Ginsberg, Jeffrey Damon Dagnone, Andrew Koch Hall
AIM: Emergency medicine (EM) trainees often work nightshifts. We sought to measure how this circadian disruption affects EM resident performance during simulated resuscitations. METHODS: This retrospective cohort study enrolled EM residents at a single Canadian academic centre over a six-year period. Residents completed twice-annual simulation-based resuscitation-focused objective structured clinical examinations (OSCEs) with assessment in four domains (primary assessment, diagnostic actions, therapeutic actions and communication), and a global assessment score (GAS)...
March 12, 2018: Resuscitation
Ting Dong, Annesley Copeland, Matthew Gangidine, Deanna Schreiber-Gregory, E Matthew Ritter, Steven J Durning
PURPOSE: We conducted an in-depth empirical investigation to achieve a better understanding of the surgery clerkship from multiple perspectives, including the influence of clerkship sequence on performance, the relationship between self-logged work hours and performance, as well as the association between surgery clerkship performance with subsequent USMLE Step exams' scores. METHOD: The study cohort consisted of medical students graduating between 2015 and 2018 (n = 687)...
March 12, 2018: Journal of Surgical Education
Júlia Perera-Bel, Barbara Hutter, Christoph Heining, Annalen Bleckmann, Martina Fröhlich, Stefan Fröhling, Hanno Glimm, Benedikt Brors, Tim Beißbarth
BACKGROUND: A comprehensive understanding of cancer has been furthered with technological improvements and decreasing costs of next-generation sequencing (NGS). However, the complexity of interpreting genomic data is hindering the implementation of high-throughput technologies in the clinical context: increasing evidence on gene-drug interactions complicates the task of assigning clinical significance to genomic variants. METHODS: Here we present a method that automatically matches patient-specific genomic alterations to treatment options...
March 15, 2018: Genome Medicine
Brenda Si Elias, Ana Hanlon-Dearman, Betty Head, Geoffrey G Hicks
Translating to the Community (T2C) is a social bio-repository designed to advance new diagnostic tools and realign community-clinical processes, with the aim to mitigate the short-and-long term impacts of Fetal Alcohol Spectrum Disorder (FASD), prenatal alcohol exposure, and its co-morbidities and behaviors. In this paper, we describe the evolution of this repository as a new translational partnership to advance a precision medicine approach to FASD. Key to its evolution was a partnership between academic researchers, Indigenous communities, families and a regional diagnostic clinic...
March 15, 2018: Biochemistry and Cell Biology, Biochimie et Biologie Cellulaire
Ruwan Weerakkody, David Ross, David A Parry, Bulat Ziganshin, Jana Vandrovcova, Piyush Gampawar, Abdulshakur Abdullah, Jennifer Biggs, Julia Dumfarth, Yousef Ibrahim, Colin Bicknell, Mark Field, John Elefteriades, Nick Cheshire, Timothy J Aitman
PurposeThoracic aortic aneurysm/aortic dissection (TAAD) is a disorder with highly variable age of onset and phenotype. We sought to determine the prevalence of pathogenic variants in TAAD-associated genes in a mixed cohort of sporadic and familial TAAD patients and identify relevant genotype-phenotype relationships.MethodsWe used a targeted polymerase chain reaction and next-generation sequencing-based panel for genetic analysis of 15 TAAD-associated genes in 1,025 unrelated TAAD cases.ResultsWe identified 49 pathogenic or likely pathogenic (P/LP) variants in 47 cases (4...
March 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Gernot Kriegshäuser, Dietmar Enko, Hasmik Hayrapetyan, Stepan Atoyan, Christian Oberkanins, Tamara Sarkisian
PurposeThis work aimed at investigating demographic, clinical, and genetic characteristics of individuals experiencing their first familial Mediterranean fever (FMF) attack at age ≥40 years in a very large cohort of Armenian FMF patients.MethodsIn total, 10,370 Armenian patients diagnosed with FMF based on the Tel Hashomer criteria and carrying at least one MEFV mutant allele were included in this study.ResultsA total of 354 (3.40%) patients had late-onset FMF. Of these, 194 (54.80%) were female and 160 (45...
March 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Tina Djernis Gundersen, Lone Krebs, Ellen Christine Leth Loekkegaard, Steen Christian Rasmussen, Julie Glavind, Tine Dalsgaard Clausen
OBJECTIVES: To examine the association between postpartum urinary tract infection and intended mode of delivery as well as actual mode of delivery. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: All live births in Denmark between 2004 and 2010 (n=450 856). Births were classified by intended caesarean delivery (n=45 053) or intended vaginal delivery (n=405 803), and by actual mode of delivery: spontaneous vaginal delivery, operative vaginal delivery, emergency or planned caesarean delivery in labour or prelabour...
March 14, 2018: BMJ Open
Boaz Shulruf, Warwick Bagg, Mathew Begun, Margaret Hay, Irene Lichtwark, Allison Turnock, Emma Warnecke, Timothy J Wilkinson, Phillippa J Poole
OBJECTIVES: To estimate the efficacy of selection tools employed by medical schools for predicting the binary outcomes of completing or not completing medical training and passing or failing a key examination; to investigate the potential usefulness of selection algorithms that do not allow low scores on one tool to be compensated by higher scores on other tools. DESIGN, SETTING AND PARTICIPANTS: Data from four consecutive cohorts of students (3378 students, enrolled 2007-2010) in five undergraduate medical schools in Australia and New Zealand were analysed...
March 19, 2018: Medical Journal of Australia
F Popescu, C R Jaslow, W H Kutteh
STUDY QUESTION: Will the addition of 24-chromosome microarray analysis on miscarriage tissue combined with the standard American Society for Reproductive Medicine (ASRM) evaluation for recurrent miscarriage explain most losses? SUMMARY ANSWER: Over 90% of patients with recurrent pregnancy loss (RPL) will have a probable or definitive cause identified when combining genetic testing on miscarriage tissue with the standard ASRM evaluation for recurrent miscarriage...
March 12, 2018: Human Reproduction
F Pietrantonio, F Di Nicolantonio, A B Schrock, J Lee, F Morano, G Fucà, P Nikolinakos, A Drilon, J F Hechtman, J Christiansen, K Gowen, G M Frampton, P Gasparini, D Rossini, C Gigliotti, S T Kim, M Prisciandaro, J Hodgson, A Zaniboni, V K Chiu, M Milione, R Patel, V Miller, A Bardelli, L Novara, L Wang, S Pupa, G Sozzi, J Ross, M Di Bartolomeo, A Bertotti, S Ali, L Trusolino, A Falcone, F de Braud, C Cremolini
Background: Recognition of rare molecular subgroups is a challenge for precision oncology and may lead to tissue-agnostic approval of targeted agents. Here we aimed to comprehensively characterize the clinical, pathological and molecular landscape of RET rearranged metastatic colorectal cancer (mCRC). Patients and methods: In this case series, we compared clinical, pathological and molecular characteristics of 24 RET rearranged mCRC patients with those of a control group of 291 patients with RET negative tumors...
March 10, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Timothy E Sweeney, Tej D Azad, Michele Donato, Winston A Haynes, Thanneer M Perumal, Ricardo Henao, Jesús F Bermejo-Martin, Raquel Almansa, Eduardo Tamayo, Judith A Howrylak, Augustine Choi, Grant P Parnell, Benjamin Tang, Marshall Nichols, Christopher W Woods, Geoffrey S Ginsburg, Stephen F Kingsmore, Larsson Omberg, Lara M Mangravite, Hector R Wong, Ephraim L Tsalik, Raymond J Langley, Purvesh Khatri
OBJECTIVES: To find and validate generalizable sepsis subtypes using data-driven clustering. DESIGN: We used advanced informatics techniques to pool data from 14 bacterial sepsis transcriptomic datasets from eight different countries (n = 700). SETTING: Retrospective analysis. SUBJECTS: Persons admitted to the hospital with bacterial sepsis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A unified clustering analysis across 14 discovery datasets revealed three subtypes, which, based on functional analysis, we termed "Inflammopathic, Adaptive, and Coagulopathic...
March 13, 2018: Critical Care Medicine
Marion Semmler, Michael Döllinger, Rita R Patel, Anke Ziethe, Anne Schützenberger
OBJECTIVE/HYPOTHESIS: Laser-based three-dimensional (3D) imaging allows realistic visualization and absolute measurement of the vocal folds for comprehensive characterization of the oscillation pattern. STUDY DESIGN: Exploratory study with descriptive data analysis in healthy cohort. METHODS: The custom-developed miniaturized measuring device is an endoscopic camera-laser setup for stereo triangulation and suitable for in vivo application...
March 14, 2018: Laryngoscope
Ahmad Khobrani, Nirali H Patel, Richard L George, Neil L McNinch, Rami A Ahmed
Trauma is a leading cause of morbidity and mortality in infants and children worldwide. Trauma education is one of the most commonly reported deficiencies in pediatric emergency medicine (PEM) training. In this study, we describe the creation of a pediatric trauma boot camp in which trainees' basic knowledge, level of confidence, teamwork, and communication skills are assessed. The primary goal of this pilot study was to create a simulation-based pediatric trauma curriculum for PEM fellows and emergency medicine residents utilizing Kern's curricular conceptual framework...
2018: Emergency Medicine International
Farnaz Dehghan, Shila Haghighat, Hadiseh Ramezanian, Mehdi Karami, Mohammad Reza Rezaei
Background: The aim of this study is to determine the predictive value of ultrasonography for results of local steroid injection in patients with carpal tunnel syndrome (CTS). Materials and Methods: This prospective cohort study was conducted during a 1-year period in outpatient clinics of rehabilitation and physical medicine including 35 patients with moderate and severe CTS who receive ultrasonography-guided local steroid injection. The Boston self-assessment questionnaire and electrodiagnosis parameters were recorded at baseline, 1 month, and 3 months after therapy...
2018: Advanced Biomedical Research
Pooya Mobadersany, Safoora Yousefi, Mohamed Amgad, David A Gutman, Jill S Barnholtz-Sloan, José E Velázquez Vega, Daniel J Brat, Lee A D Cooper
Cancer histology reflects underlying molecular processes and disease progression and contains rich phenotypic information that is predictive of patient outcomes. In this study, we show a computational approach for learning patient outcomes from digital pathology images using deep learning to combine the power of adaptive machine learning algorithms with traditional survival models. We illustrate how these survival convolutional neural networks (SCNNs) can integrate information from both histology images and genomic biomarkers into a single unified framework to predict time-to-event outcomes and show prediction accuracy that surpasses the current clinical paradigm for predicting the overall survival of patients diagnosed with glioma...
March 12, 2018: Proceedings of the National Academy of Sciences of the United States of America
(no author information available yet)
Chris S Earl, Teh Wooi Keong, Shi-qi An, Sarah Murdoch, Yvonne McCarthy, Junkal Garmendia, Joseph Ward, J Maxwell Dow, Liang Yang, George A O'Toole & Robert P RyanThe above article, published May 20 2015 in EMBO Molecular Medicine , has been retracted by agreement between the authors of the study, CSE, TWK, SQA, SM, YMcC, JG, JW, JMD, LY, RPR, the journal Chief Editor and the EMBO Head of Scientific Publications in accordance with the outcomes of independent investigations conducted by the University of Dundee and University College Cork...
March 12, 2018: EMBO Molecular Medicine
Driss Berdaï, Florence Thomas-Delecourt, Karine Szwarcensztein
Early market access of health products is associated with a larger number of requests for information by the health authorities. Compared with these expectations, the growing expansion of health databases represents an opportunity for responding to questions raised by the authorities. The computerised nature of the health system provides numerous sources of data, and first and foremost medical/administrative databases such as the French National Inter-Scheme Health Insurance Information System (SNIIRAM) database...
December 30, 2017: Thérapie
Orçun Çiftci, Kerem Can Yılmaz, Atilla Sezgin, Mehmet Bülent Özin, İbrahim Haldun Müderrisoğlu, Mehmet Haberal
OBJECTIVES: Cardiac implantable electrical devices are widely used for patients with advanced heart failure and are usually explanted during orthotopic heart transplant. However, lead fragments and the pulse generator are sometimes left after the procedure. Given the concerns of infectious and thromboembolic complications, their removal is recommended. Herein, we report our experience with cardiac implantable electrical device explantation after orthotopic heart transplant. MATERIALS AND METHODS: We included recipients of heart transplants performed at Başkent University Faculty of Medicine, Department of Cardiovascular Surgery, who underwent lead and pulse generator explantation by manual traction between January 2012 and June 2017...
March 2018: Experimental and Clinical Transplantation
James Watson, Robert M Barker-Davies, Alexander N Bennett, Daniel T P Fong, Patrick C Wheeler, Mark Lewis, Craig Ranson
Objective: Several lower limb tendinopathy treatment modalities involve identification of pathological paratendinous or intratendinous neovascularisation to target proposed co-location of painful neoneuralisation. The ability to reliably locate and assess the degree of neovascularity is therefore clinically important. The Modified Ohberg Score (MOS) is frequently used to determine degree of neovascularity, but reliability has yet to be established among Sport and Exercise Medicine (SEM) consultants...
2018: BMJ Open Sport & Exercise Medicine
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