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https://www.readbyqxmd.com/read/28214977/braf-mutated-colorectal-cancer-what-is-the-optimal-strategy-for-treatment
#1
REVIEW
Romain Cohen, Pascale Cervera, Magali Svrcek, Anna Pellat, Chantal Dreyer, Aimery de Gramont, Thierry André
The BRAF activating mutation, harbored by approximately 10% of colorectal cancers (CRC), confers dramatic prognosis to advanced diseases. In early-stage setting, the identification of the BRAF mutation does not impact the therapeutic decision. Yet, the BRAF mutation could be considered as a stratification factor in adjuvant trials, because of its prognostic impact after relapse. Moreover, both BRAF mutation and mismatch repair (MMR) statuses should be determined in all CRC to help identify sporadic tumors versus Lynch syndrome-related tumors...
February 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28214475/hunter-and-new-england-healthpathways-a-4-year-journey-of-integrated-care
#2
Jane S Gray, Judith R Swan, Margaret A Lynch, Tracey M Tay, Marika-Jane Mackenzie, John H Wiggers, Karen A Harrison, Robert C McDonald, Ian P O'Dea, Louise M Harrigan, Sandra M Fitzgerald
Objective This paper describes the 4-year journey of Hunter and New England HealthPathways - a password-protected web-based portal designed to provide localised evidence-informed clinical and referral information to support general practice at the point of care.Methods A process evaluation was conducted in 2013, with a case study comparison performed in 2014 to assess impact of HealthPathways on patient referral and access to specialist care, followed by a review in 2016 of utilisation of the online portal to assess whether healthcare providers continued to access HealthPathways...
February 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28214255/clinical-outcomes-and-90-day-costs-following-hemiarthroplasty-or-total-hip-arthroplasty-for-hip-fracture
#3
Christine I Nichols, Joshua G Vose, Ryan M Nunley
BACKGROUND: In the era of bundled payments, many hospitals are responsible for costs from admission through 90 days postdischarge. Although bundled episodes for hip fracture will have a separate target price for the bundle, little is known about the 90-day resource use burden for this patient population. METHODS: Using Medicare 100% Standard Analytic Files (2010-2014), we identified patients undergoing hemiarthroplasty or total hip arthroplasty (THA). Patients were aged 65 and older with admitting diagnosis of closed hip fracture, no concurrent fractures of the lower limb, and no history of hip surgery in the prior 12 months baseline...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28212175/advances-in-epilepsy-gene-discovery-and-implications-for-epilepsy-diagnosis-and-treatment
#4
Joseph D Symonds, Sameer M Zuberi, Michael R Johnson
PURPOSE OF REVIEW: Epilepsy genetics is shifting from the academic pursuit of gene discovery to a clinical discipline based on molecular diagnosis and stratified medicine. We consider the latest developments in epilepsy genetics and review how gene discovery in epilepsy is influencing the clinical classification of epilepsy and informing new therapeutic approaches and drug discovery. RECENT FINDINGS: Recent studies highlighting the importance of mutation in GABA receptors, NMDA receptors, potassium channels, G-protein coupled receptors, mammalian target of rapamycin pathway and chromatin remodeling are discussed...
February 15, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28210553/impact-of-value-based-breast-cancer-care-pathway-implementation-on-pre-operative-breast-magnetic-resonance-imaging-utilization
#5
Devina K S McCray, Stephen R Grobmyer, Holly J Pederson
BACKGROUND: Bilateral breast magnetic resonance imaging (MRI) is commonly used in the diagnostic workup of breast cancer (BC) to assess extent of disease and identify occult foci of disease. However, evidence for routine use of pre-operative MRI is lacking. Breast MRI is costly and can lead to unnecessary tests and treatment delays. Clinical care pathways (care paths) are value-based guidelines, which define management recommendations derived by expert consensus and available evidence based data...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28209746/a-phase-ii-randomized-trial-go27827-of-first-line-folfox-plus-bevacizumab-with-or-without-the-met-inhibitor-onartuzumab-in-patients-with-metastatic-colorectal-cancer
#6
Johanna C Bendell, Howard Hochster, Lowell L Hart, Irfan Firdaus, Joseph R Mace, Joshua J McFarlane, Mark Kozloff, Daniel Catenacci, Jessie J Hsu, Stephen P Hack, David S Shames, See-Chun Phan, Hartmut Koeppen, Allen L Cohn
BACKGROUND: Dysregulated hepatocyte growth factor/mesenchymal-epithelial transition (MET) signaling is associated with poor prognosis and resistance to vascular endothelial growth factor inhibition in metastatic colorectal cancer (mCRC). We report outcomes from a double-blind, multicenter phase II trial of the MET inhibitor onartuzumab in combination with mFOLFOX-6 and bevacizumab for mCRC (GO27827; NCT01418222). MATERIALS AND METHODS: Patients were randomized 1:1 to receive onartuzumab (10 mg/kg intravenously [IV]) or placebo plus mFOLFOX-6 and bevacizumab (5 mg/kg IV)...
February 16, 2017: Oncologist
https://www.readbyqxmd.com/read/28207728/discharge-outcomes-of-patients-referred-to-specialist-eye-clinic-from-diabetic-retinopathy-screening-in-northland-2014-15
#7
Pragnya Jagadish, David Dalziel
AIMS: To determine the discharge outcomes of patients seen in specialist eye clinic after referral from diabetic retinopathy screening (DRS). METHODS: Retrospective analysis of outcomes of a sample of 98 patients referred from DRS to specialist eye clinic. RESULTS: A sample of 98 patients were analysed following referral by DRS to specialist eye clinic from 16/4/14 to 16/4/15. Age at screening ranged from 13-88 years, with the main ethnic groups being Māori (57...
February 17, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28203225/regulation-of-sterol-biosynthesis-in-the-human-fungal-pathogen-aspergillus-fumigatus-opportunities-for-therapeutic-development
#8
REVIEW
Sourabh Dhingra, Robert A Cramer
Sterols are a major component of eukaryotic cell membranes. For human fungal infections caused by the filamentous fungus Aspergillus fumigatus, antifungal drugs that target sterol biosynthesis and/or function remain the standard of care. Yet, an understanding of A. fumigatus sterol biosynthesis regulatory mechanisms remains an under developed therapeutic target. The critical role of sterol biosynthesis regulation and its interactions with clinically relevant azole drugs is highlighted by the basic helix loop helix (bHLH) class of transcription factors known as Sterol Regulatory Element Binding Proteins (SREBPs)...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28202661/targeting-pak1
#9
REVIEW
Galina Semenova, Jonathan Chernoff
p21-Activated kinase 1 (PAK1) has attracted much attention as a potential therapeutic target due to its central role in many oncogenic signaling pathways, its frequent dysregulation in cancers and neurological disorders, and its tractability as a target for small-molecule inhibition. To date, several PAK1-targeting compounds have been developed as preclinical agents, including one that has been evaluated in a clinical trial. A series of ATP-competitive inhibitors, allosteric inhibitors and peptide inhibitors with distinct biochemical and pharmacokinetic properties represent useful laboratory tools for studies on the role of PAK1 in biology and in disease contexts, and could lead to promising therapeutic agents...
February 8, 2017: Biochemical Society Transactions
https://www.readbyqxmd.com/read/28202196/vulvar-postoperative-care-gestalt-or-evidence-based-medicine-a-comprehensive-systematic-review
#10
REVIEW
Alon D Altman, Christine Robinson
OBJECTIVE: This paper reviews all current literature for vulvar postoperative care, and forms a summary of evidence based practice. DATA SOURCES: Scopus, Cochrane Library, CINHAL, Web of Science Core Collection, PubMed, Embase, Google Scholar, clinicaltrials.gov and Medline databases were searched. METHODS OF STUDY SELECTION: Various combinations of key-terms were used to identify relevant articles. All identified primary research articles and review articles were then examined with their references in order to identify further relevant studies...
February 12, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28196549/mental-health-related-stigma-and-pathways-to-care-for-people-at-risk-of-psychotic-disorders-or-experiencing-first-episode-psychosis-a-systematic-review
#11
P C Gronholm, G Thornicroft, K R Laurens, S Evans-Lacko
BACKGROUND: Stigma associated with mental illness can delay or prevent help-seeking and service contact. Stigma-related influences on pathways to care in the early stages of psychotic disorders have not been systematically examined. METHOD: This review systematically assessed findings from qualitative, quantitative and mixed-methods research studies on the relationship between stigma and pathways to care (i.e. processes associated with help-seeking and health service contact) among people experiencing first-episode psychosis or at clinically defined increased risk of developing psychotic disorder...
February 15, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28195937/an-updated-protocol-for-evaluating-chest-pain-and-managing-acute-coronary-syndromes
#12
Christopher R Kelly, Ajay J Kirtane, Jennifer Stant, Gregg W Stone, Robert M Minutello, S Chiu Wong, Honeyleen Manuzon, Roxanne Gerow-Smith, Nancy Kelley, LeRoy E Rabbani
Clinical pathways can optimize care both across and within institutions, but regular updates to these pathways based on new clinical trials, professional guidelines, and Food and Drug Administration approvals are essential. Herein we describe the most recent revisions to the New York-Presbyterian Hospital (Columbia University Medical Center and Weill Cornell Medical Center) clinical pathway for acute coronary syndromes and chest pain, which incorporates novel data regarding the timing and administration of P2Y12 inhibition (including the intravenous P2Y12 inhibitor cangrelor) and the appropriateness of prolonged (>1 year) dual antiplatelet therapy for the secondary prevention of ischemic events...
March 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28192477/impact-of-early-in-hospital-medication-review-by-clinical-pharmacists-on-health-services-utilization
#13
Corinne M Hohl, Nilu Partovi, Isabella Ghement, Maeve E Wickham, Kimberlyn McGrail, Lisa N Reddekopp, Boris Sobolev
BACKGROUND: Adverse drug events are a leading cause of emergency department visits and unplanned admissions, and prolong hospital stays. Medication review interventions aim to identify adverse drug events and optimize medication use. Previous evaluations of in-hospital medication reviews have focused on interventions at discharge, with an unclear effect on health outcomes. We assessed the effect of early in-hospital pharmacist-led medication review on the health outcomes of high-risk patients...
2017: PloS One
https://www.readbyqxmd.com/read/28188529/dual-color-multiplex-analysis-of-protein-microarrays-for-precision-medicine
#14
Solomon Yeon, Florian Bell, Michael Shultz, Grace Lawrence, Michael Harpole, Virginia Espina
Generating molecular information in a clinically relevant time frame is the first hurdle to truly integrating precision medicine in health care. Reverse phase protein microarrays are being utilized in clinical trials for quantifying posttranslationally modified signal transduction proteins and cellular signaling pathways, allowing direct comparison of the activation state of proteins from multiple specimens, or individual patient specimens, within the same array. This technology provides diagnostic and therapeutic information critical to precision medicine...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28188036/outcomes-of-an-accelerated-care-pathway-for-pediatric-blunt-solid-organ-injuries-in-a-public-healthcare-system
#15
Oluwatomilayo Daodu, Mary Brindle, Carlos R Alvarez-Allende, Lisette Lockyer, Bryce Weber, Steven R Lopushinsky
PURPOSE: An accelerated clinical care pathway for solid organ abdominal injuries was implemented at a level one pediatric trauma center. The impact on resource utilization and demonstration of protocol safety was assessed. METHODS: Data were collected retrospectively on patients admitted with blunt abdominal solid organ injuries from 2012 to 2015. Patients were subdivided into pre- and post-protocol groups. Length of hospital stay (LOS) and failure of non-operative treatment were the primary outcomes of interest...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28186950/qualitative-study-of-paramedics-experiences-of-managing-seizures-a-national-perspective-from-england
#16
Adam J Noble, Darlene Snape, Steve Goodacre, Mike Jackson, Frances C Sherratt, Mike Pearson, Anthony Marson
OBJECTIVES: The UK ambulance service is expected to now manage more patients in the community and avoid unnecessary transportations to hospital emergency departments (ED). Most people it attends who have experienced seizures have established epilepsy, have experienced uncomplicated seizures and so do not require the full facilities of an ED. Despite this, most are transported there. To understand why, we explored paramedics' experiences of managing seizures. DESIGN AND SETTING: Semistructured interviews were conducted with a purposive sample of paramedics from the English ambulance service...
November 9, 2016: BMJ Open
https://www.readbyqxmd.com/read/28186060/model-driven-paediatric-cardiomyopathy-pathways-a-clinical-impact-assessment
#17
Karl A Stroetmann, Rainer Thiel
Intermediate results from an ongoing health technology assessment exercise of a simulation model of paediatric cardiomyopathy are reported. Comprehensive data on paediatric cardiomyopathy/heart failure, treatment options, incidence and prevalence, prognoses for different outcomes to be expected were collected. Based on this knowledge, a detailed clinical pathway model was developed and validated against the clinical workflow in a tertiary paediatric care hospital. It combines three disease stages and various treatment options with estimates of the probabilities of a child moving from one stage to another...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28183732/association-of-bronchiolitis-clinical-pathway-adherence-with-length-of-stay-and-costs
#18
Mersine A Bryan, Arti D Desai, Lauren Wilson, Davene R Wright, Rita Mangione-Smith
OBJECTIVES: To examine the associations between the level of adherence to bronchiolitis clinical pathway recommendations, health care use, and costs. METHODS: We conducted a retrospective cohort study of 267 patients ≤24 months old diagnosed with bronchiolitis from 12/2009 to 7/2012. Clinical pathway adherence was assessed by using a standardized scoring system (0-100) for 18 quality measures obtained by medical record review. Level of adherence was categorized into low, middle, and high tertiles...
February 9, 2017: Pediatrics
https://www.readbyqxmd.com/read/28183338/ultrasound-detected-pathologies-cluster-into-groups-with-different-clinical-outcomes-data-from-3000-community-referrals-for-shoulder-pain
#19
Gui Tran, Elizabeth M A Hensor, Aaron Ray, Sarah R Kingsbury, Philip O'Connor, Philip G Conaghan
BACKGROUND: Ultrasound is increasingly used to evaluate shoulder pain, but the benefits of this are unclear. In this study, we examined whether ultrasound-defined pathologies have implications for clinical outcomes. METHODS: We extracted reported pathologies from 3000 ultrasound scans of people with shoulder pain referred from primary care. In latent class analysis (LCA), we identified whether individual pathologies clustered in groups. Optimal group number was determined by the minimum Bayesian information criterion...
February 10, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28183322/impact-of-a-pharmacist-led-medication-review-on-hospital-readmission-in-a-pediatric-and-elderly-population-study-protocol-for-a-randomized-open-label-controlled-trial
#20
Pierre Renaudin, Karine Baumstarck, Aurélie Daumas, Marie-Anne Esteve, Stéphane Gayet, Pascal Auquier, Michel Tsimaratos, Patrick Villani, Stéphane Honore
BACKGROUND: Early hospital readmission of patients after discharge is a public health problem. One major cause of hospital readmission is dysfunctions in integrated pathways between community and hospital care that can cause adverse drug events. Furthermore, the French ENEIS 2 study showed that 1.3% of hospital stays originated from serious adverse drug events in 2009. Pharmacy-led medication reviews at hospital transitions are an effective means of decreasing medication discrepancies when conducted at admission or discharge...
February 9, 2017: Trials
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