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https://www.readbyqxmd.com/read/28936475/surgical-data-science-the-new-knowledge-domain
#1
S Swaroop Vedula, Gregory D Hager
Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care with the goal of maximizing quality and value of care. While innovations in diagnostic and therapeutic technologies have driven past improvements in quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytic techniques, and translation or integration of research findings into patient care...
April 2017: Innov Surg Sci
https://www.readbyqxmd.com/read/28935835/total-body-pet-maximizing-sensitivity-to-create-new-opportunities-for-clinical-research-and-patient-care
#2
Simon R Cherry, Terry Jones, Joel S Karp, Jinyi Qi, William Moses, Ramsey Badawi
Positron emission tomography (PET) is widely considered as the most sensitive technique available for non-invasively studying physiology, metabolism and molecular pathways in the living human being. However, the utility of PET, being a photon deficient modality, remains constrained by factors including low signal-to-noise ratio (SNR), long imaging times and concerns regarding radiation dose. Two developments offer the potential to dramatically increase the effective sensitivity of PET. First by increasing the geometric coverage to encompass the entire body, sensitivity can be increased by a factor of ~40 for total-body imaging or a factor of ~4-5 for imaging a single organ such as the brain or heart...
September 21, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28935397/standardization-of-care-for-pediatric-perforated-appendicitis-improves-outcomes
#3
Yasmine Yousef, Fouad Youssef, Michael Homsy, Trish Dinh, Kartikey Pandya, Hayden Stagg, Robert Baird, Jean-Martin Laberge, Dan Poenaru, Pramod Puligandla, Kenneth Shaw, Sherif Emil
BACKGROUND: The treatment of perforated appendicitis in children is characterized by significant variability in care, morbidity, resource utilization, and outcomes. We prospectively studied how minimization of care variability affects outcomes. METHODS: A clinical pathway for perforated appendicitis, in use for three decades, was further standardized in May 2015 by initiation of a disease severity classification, refinement of discharge criteria, standardization of the operation, and establishment of criteria for use of postoperative total parenteral nutrition, imaging, and invasive procedures...
September 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28934994/comparison-of-methods-for-estimating-contemporary-costs-an-application-to-liver-transplantation-in-the-united-kingdom
#4
Jeshika Singh, Louise Longworth
OBJECTIVES: Our study addresses the important issue of estimating treatment costs from historical data. It is a problem frequently faced by health technology assessment analysts. We compared four approaches used to estimate current costs when good quality contemporary data are not available using liver transplantation as an example. METHODS: First, the total cost estimates extracted for patients from a cohort study, conducted in the 1990s, were inflated using a published inflation multiplier...
September 22, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28933973/magnetic-resonance-imaging-in-the-early-detection-of-prostate-cancer-and-review-of-the-literature-on-magnetic-resonance-imaging-stratified-clinical-pathways
#5
Taimur Tariq Shah, Wilson King Lim To, Hashim Uddin Ahmed
With level 1 evidence now available on the diagnostic accuracy of multiparametric magnetic resonance imaging (MRI) we must now utilise this data in developing an MRI-stratified diagnostic pathway for the early detection of prostate cancer. Areas covered: A literature review was conducted and identified seven randomised control trials (RCT's) assessing the diagnostic accuracy of such a pathway against the previously accepted systematic/random trans-rectal ultrasound guided (TRUS) biopsy pathway. The studies were heterogeneous in their design...
September 21, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28933267/neonatal-plasticity-of-the-nociceptive-system-mechanisms-effects-and-treatment-of-repetitive-painful-procedures-during-nicu-admittance
#6
N J Van den Hoogen, J Patijn, D Tibboel, E A Joosten
INTRODUCTION: In Neonatal Intensive Care Unit (NICU), prematurely born infants undergo a range of skin breaking and painful procedures. At the same time, the spinal nociceptive system is in a sensitive developmental stage. Both neonatal repetitive painful procedures and their treatment can induce plasticity of the neonatal spinal nociceptive system, causing long-lasting alterations to pain processing and pain reactivity. METHODS: This review focuses on developmental processes related to the nociceptive network in the spinal dorsal horn and more specifically at mechanisms related to 1...
September 21, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28930953/proposed-clinical-pathway-for-nonoperative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#7
Bindi J Naik-Mathuria, Eric H Rosenfeld, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Adam Vogel, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Sandler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for nonoperative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (American Association of Surgeons for Trauma grade III-V) pancreatic injuries treated with NOM between 2010 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28928418/novel-and-classical-human-astroviruses-in-stool-and-cerebrospinal-fluid-comprehensive-screening-in-a-tertiary-care-hospital-switzerland
#8
Samuel Cordey, Diem-Lan Vu, Marie-Celine Zanella, Lara Turin, Aline Mamin, Laurent Kaiser
Classical human astroviruses (HAstV) are the third most common cause of non-bacterial acute gastroenteritis. Due to the lack of routine molecular assays, novel HAstV are underdiagnosed and the magnitude of their contribution to clinical disease remains unknown. To better understand their prevalence and the susceptible patient profile, we conducted a comprehensive screening of novel and classical HAstV in stool and cerebrospinal fluid (CSF) samples collected for clinical care in a tertiary care hospital using a specially designed rRT-PCR panel for the detection of novel (MLB1-3 and VA1-4) and classical HAstV...
September 20, 2017: Emerging Microbes & Infections
https://www.readbyqxmd.com/read/28927389/follow-up-care-after-treatment-for-prostate-cancer-protocol-for-an-evaluation-of-a-nurse-led-supported-self-management-and-remote-surveillance-programme
#9
Jane Frankland, Hazel Brodie, Deborah Cooke, Claire Foster, Rebecca Foster, Heather Gage, Jake Jordan, Ines Mesa-Eguiagaray, Ruth Pickering, Alison Richardson
BACKGROUND: As more men survive a diagnosis of prostate cancer, alternative models of follow-up care that address men's enduring unmet needs and are economical to deliver are needed. This paper describes the protocol for an ongoing evaluation of a nurse-led supported self-management and remote surveillance programme implemented within the secondary care setting. METHODS/DESIGN: The evaluation is taking place within a real clinical setting, comparing the outcomes of men enrolled in the Programme with the outcomes of a pre-service change cohort of men, using a repeated measures design...
September 19, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28926505/do-all-clavicle-fractures-in-children-need-to-be-managed-by-orthopedic-surgeons
#10
John Adamich, Andrew Howard, Mark Camp
OBJECTIVES: Although many uncomplicated pediatric fractures do not require routine long-term follow-up with an orthopedic surgeon, practitioners with limited experience dealing with pediatric fractures will often defer to a strategy of frequent clinical and radiographic follow-up. Development of an evidence-based clinical care pathway can help unnecessary radiation exposure to this patient population and reduce costs to patient families and the health care system. METHODS: A retrospective analysis including patients who presented to the Hospital for Sick Children (SickKids) for management of clavicle fractures was performed...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28923905/acute-coronary-syndromes-the-way-forward-from-mechanisms-to-precision-treatment
#11
REVIEW
Filippo Crea, Peter Libby
Well into the 21st century, we still triage acute myocardial infarction on the basis of the presence or absence of ST-segment elevation, a century-old technology. Meanwhile, we have learned a great deal about the pathophysiology and mechanisms of acute coronary syndromes (ACS) at the clinical, pathological, cellular, and molecular levels. Contemporary imaging studies have shed new light on the mechanisms of ACS. This review discusses these advances and their implications for clinical management of the ACS for the future...
September 19, 2017: Circulation
https://www.readbyqxmd.com/read/28923762/translating-basic-research-into-clinical-practice-vitamin-d-in-asthma-mechanisms-of-action-and-considerations-for-clinical-trials
#12
REVIEW
Paul E Pfeffer, Catherine M Hawrylowicz
There is increasing interest in the therapeutic utility of vitamin D in asthma, supported by a significant body of evidence on epidemiological associations between vitamin D insufficiency and worse asthma control. In support of a causal relationship, vitamin D beneficially modulates diverse immunological pathways in heterogeneous asthma endotypes, regulating the actions of lymphocytes, mast cells, antigen-presenting cells and structural cells to dampen excessive inflammatory responses. Allergic asthma is characterised by a failure of immune tolerance, and development of pathological responses to inhaled aeroallergens, and vitamin D has been extensively shown to support immune regulation...
September 15, 2017: Chest
https://www.readbyqxmd.com/read/28923225/randomized-clinical-trials-in-colon-and-rectal-cancer
#13
REVIEW
Atif Iqbal, Thomas J George
Surgery remains the mainstay of treatment for colon and rectal cancers. Colon cancer outcomes have improved with laparoscopic techniques, enhanced recovery pathways, and adjuvant chemotherapy. Adjuvant 5-fluorouracil with or without oxaliplatin in stage III and possibly high-risk stage II colon cancer is associated with improved survival. Multimodality management of rectal cancer continues to evolve; total mesorectal excision is the cornerstone. Oncologic results do not support the use of laparoscopic resection in rectal cancer...
October 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28923179/drugs-and-hyperglycemia-a-practical-guide
#14
REVIEW
Vandana Jain, Ronak Kumar Patel, Zaureen Kapadia, Sneha Galiveeti, Maryann Banerji, Lisel Hope
Drug-induced diabetes is one of the factors contributing to the increasing incidence of diabetes worldwide. This review considers the frequency, pathogenesis and treatment of drug-induced diabetes. Drugs that induce diabetes include hormonal therapy, especially glucocorticoids and androgen blockers, cardiovascular drugs, especially statins, beta-blockers and diuretics, antipsychotics, especially clozapine, olanzapine and quetiapine, antiretrovirals (protease inhibitors and non-reverse transcriptase inhibitors - NRTIs) and other drugs (mechanistic target of rapamycin inhibitors -mTORs, post organ transplantation drugs, tyrosine kinase inhibitors and interferon-alpha)...
October 2017: Maturitas
https://www.readbyqxmd.com/read/28922385/metabolomics-analyses-identify-platelet-activating-factors-and-heme-breakdown-products-as-lassa-fever-biomarkers
#15
Trevor V Gale, Timothy M Horton, Donald S Grant, Robert F Garry
Lassa fever afflicts tens of thousands of people in West Africa annually. The rapid progression of patients from febrile illness to fulminant syndrome and death provides incentive for development of clinical prognostic markers that can guide case management. The small molecule profile of serum from febrile patients triaged to the Viral Hemorrhagic Fever Ward at Kenema Government Hospital in Sierra Leone was assessed using untargeted Ultra High Performance Liquid Chromatography Mass Spectrometry. Physiological dysregulation resulting from Lassa virus (LASV) infection occurs at the small molecule level...
September 18, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28922133/aligning-event-logs-to-task-time-matrix-clinical-pathways-in-bpmn-for-variance-analysis
#16
Hui Yan, Pieter Van Gorp, Uzay Kaymak, Xudong Lu, Lei Ji, Choo Chiap Chiau, Hendriks H M Korsten, Huilong Duan
Clinical pathways (CPs) are popular healthcare management tools to standardise care and ensure quality. Analysing CP compliance levels and variances is known to be useful for training and CP redesign purposes. Flexible semantics of the Business Process Model and Notation (BPMN) language has been shown to be useful for the modeling and analysis of complex protocols. However, in practical cases one may want to exploit that CPs often have the form of Task-Time matrices. This paper presents a new method parsing complex BPMN models and aligning traces to the models heuristically...
September 18, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28919797/quality-of-care-in-inflammatory-bowel-disease-results-of-a-prospective-controlled-cohort-study-in-germany-netibd
#17
Jana Langbrandtner, Angelika Hüppe, Petra Jessen, Jürgen Büning, Susanna Nikolaus, Heiner Raspe, Bernd Bokemeyer
BACKGROUND/AIMS: Patients with inflammatory bowel disease (IBD) need comprehensive, interdisciplinary and cross-sectoral health care. In Germany, evidence-based care pathways have been developed to improve the quality of care of IBD patients. We aimed to evaluate the effects of the implementation of some of these recommendations on patient-related outcomes. METHODS: In a region of North Germany, outpatients with IBD were recruited by gastroenterologists (intervention group)...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28918995/cutaneous-adverse-events-of-targeted-therapies-for-hematolymphoid-malignancies
#18
REVIEW
Julia D Ransohoff, Bernice Y Kwong
The identification of oncogenic drivers of liquid tumors has led to the rapid development of targeted agents with distinct cutaneous adverse event (AE) profiles. The diagnosis and management of these skin toxicities has motivated a novel partnership between dermatologists and oncologists in developing supportive oncodermatology clinics. In this article we review the current state of knowledge of clinical presentation, mechanisms, and management of the most common and significant cutaneous AEs observed during treatment with targeted therapies for hematologic and lymphoid malignancies...
July 14, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28917630/decision-making-about-healthcare-related-tests-and-diagnostic-strategies-international-guidelines-show-variability-in-their-approaches
#19
Reem A Mustafa, Wojtek Wiercioch, Ingrid Arevalo-Rodriguez, Adrienne Cheung, Barbara Prediger, Liudmila Ivanova, Matthew Ventresca, Jan Brozek, Nancy Santesso, Patrick Bossuyt, Amit X Garg, Nancy Lloyd, Monika Lelgemann, Diedrich Bühler, Holger Schünemann
OBJECTIVE: To describe and compare current practices in developing guidelines about the use of health care related tests and diagnostic strategies (HCTDS) STUDY DESIGN AND SETTING: We sampled 37 public health and clinical practice guidelines about HCTDS from various sources without language restrictions. RESULTS: Detailed descriptions of the systems used to assess the quality of evidence and develop recommendations were challenging to find within guidelines. We observed much variability among and within organizations with respect to how they develop recommendations about HCTDS...
September 13, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28917629/decision-making-about-healthcare-related-tests-and-diagnostic-strategies-a-qualitative-study-with-experts-suggests-that-test-accuracy-data-alone-is-rarely-sufficient-for-decision-making
#20
Reem A Mustafa, Wojtek Wiercioch, Matthew Ventresca, Jan Brozek, Holger J Schünemann
OBJECTIVE: To identify the critical factors that determine recommendations and other decisions about health care related tests and diagnostic strategies (HCTDS). METHODS: We used a qualitative descriptive approach and conducted semi-structured in-depth interviews with 24 international experts (informants) in evidence and decisions about HCTDS. RESULTS: Although test accuracy (TA) was the factor most commonly considered by organizations when developing recommendations about HCTDS, informants agreed that TA is necessary but rarely, if ever, sufficient and may be misleading when solely considered...
September 13, 2017: Journal of Clinical Epidemiology
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