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https://www.readbyqxmd.com/read/29331646/progress-in-the-management-of-advanced-thoracic-malignancies-in-2017
#1
REVIEW
Roberto Ferrara, Laura Mezquita, Benjamin Besse
The treatment paradigm of non-small cell lung cancer (NSCLC) underwent a major revolution during the course of 2017. Immune checkpoint inhibitors (ICIs) brought remarkable improvements in response and overall survival (OS) both in unselected pretreated patients and in untreated patients with PD-L1 expression ≥50%. Furthermore, compelling preliminary results were reported for new combinations of anti-PD-1/PD-L1 agents with chemotherapy or anti-CTLA4 inhibitors. The success of the ICIs appeared to extend to patients with small cell lung cancer (SCLC), mesothelioma or thymic tumors...
January 10, 2018: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/29330239/one-year-of-family-physicians-observations-on-working-with-medical-scribes
#2
Amelia Sattler, Tracy Rydel, Cathina Nguyen, Steven Lin
PURPOSE: The immense clerical burden felt by physicians is one of the leading causes of burnout. Scribes are increasingly being used to help alleviate this burden, yet few published studies investigate how scribes affect physicians' daily work, attitudes and behaviors, and relationships with patients and the workplace. METHODS: Using a longitudinal observational design, data were collected, over 1 year, from 4 physicians working with 2 scribes at a single academic family medicine practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29307097/robotic-inguinal-lymph-node-dissection-for-melanoma-a-novel-approach-to-a-complicated-problem
#3
G Alan Hyde, Nathan L Jung, Alvaro A Valle, Syamal D Bhattacharya, Christopher E Keel
BACKGROUND: Indications for superficial inguinal lymph node (ILN) dissection in melanoma include fine needle aspiration or clinically positive ILN and sentinel lymph nodes (SLN). Open inguinal lymphadenectomy may be complicated by poor wound healing, deep vein thrombosis, and lymphedema. Technical considerations and case series of a novel surgical approach, robotic inguinal lymphadenectomy, are presented. METHODS: This is a case series of four robotic ILN dissections for melanoma at a tertiary care facility...
January 6, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29301522/the-low-indexes-of-metabolism-intervention-trial-limit-design-and-baseline-data-of-a-randomized-controlled-clinical-trial-to-evaluate-how-alerting-primary-care-teams-to-low-metabolic-values-could-affect-the-health-of-patients-aged-75-or-older
#4
Nir Tsabar, Yan Press, Johanna Rotman, Bracha Klein, Yonatan Grossman, Maya Vainshtein-Tal, Sophia Eilat-Tsanani
BACKGROUND: Too-low body mass index (BMI), HbA1c% or cholesterol levels predicts poor survival. This study investigates whether e-mails about these low values, improve health of people older than 75 years. METHODS: LIMIT - an open label randomized trial - compares usual care to the addition of an e-mail which alerts the family physicians and nurses to low metabolic indexes of a specific patient and advises on nutritional and medical changes. PARTICIPANTS: Clalit Health Services (CHS) patients in the Northern and Southern Districts, aged ≥75 years with any of the following inclusion criteria: a...
January 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29297983/impact-of-training-on-intensive-care-providers-attitudes-and-knowledge-regarding-limitation-of-life-support-treatment-and-organ-donation-after-circulatory-death
#5
Maria Del Mar Lomero, María F Jiménez-Herrera, Mireia Llaurado-Serra, María A Bodí, Nuria Masnou, Eva Oliver, Alberto Sandiumenge
The limitation of life-sustaining treatment is common practice in critical care units, and organ donation after circulatory death has come to be included as an option within this care plan. Lack of knowledge and misunderstandings can raise barriers between health-care providers (e.g., confusion about professional roles, lack of collaboration, doubts about the legality of the process, and not respecting patients' wishes in the decision-making process). The aim of the present study was to determine the knowledge and attitudes of intensive care physicians and nurses before and after a multidisciplinary online training program...
January 3, 2018: Nursing & Health Sciences
https://www.readbyqxmd.com/read/29283927/are-informal-caregivers-of-persons-with-dementia-open-to-extending-medical-aid-in-dying-to-incompetent-patients-findings-from-a-survey-conducted-in-quebec-canada
#6
Gina Bravo, Claudie Rodrigue, Marcel Arcand, Jocelyn Downie, Marie-France Dubois, Sharon Kaasalainen, Cees M Hertogh, Sophie Pautex, Lieve Van den Block
Euthanasia is a controversial and complex issue, especially when involving incompetent patients. On December 10, 2015, Quebec became the first Canadian province to give access to medical aid in dying (MAiD) (ie, euthanasia performed by a physician) to competent patients who satisfy strictly defined criteria. Less than 2 years later, Quebec is considering extending MAiD to incompetent patients who made an advance request. With the objective of contributing scientific data to current societal debates, we conducted a survey among 471 informal caregivers of persons with dementia, reached through Alzheimer Societies...
December 27, 2017: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/29278566/job-openings-for-pas-by-specialty
#7
Perri Morgan, Brandi Leach, Kristine Himmerick, Christine Everett
OBJECTIVE: Physician assistants (PAs) have adapted to roles in virtually every practice specialty. One factor that has affected PAs' specialty choices has been the availability of jobs. We describe 2014 job postings for PAs at the national level by practice specialty. METHODS: National data on 2014 job postings for PAs were obtained from a leading labor analytics firm. Each job posting (N = 34,137) was coded with regard to practice specialty and analyzed descriptively...
January 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29273028/implementation-of-a-novel-population-panel-management-curriculum-among-interprofessional-health-care-trainees
#8
Catherine P Kaminetzky, Lauren A Beste, Anne P Poppe, Daniel B Doan, Howard K Mun, Nancy Fugate Woods, Joyce E Wipf
BACKGROUND: Gaps in chronic disease management have led to calls for novel methods of interprofessional, team-based care. Population panel management (PPM), the process of continuous quality improvement across groups of patients, is rarely included in health professions training for physicians, nurses, or pharmacists. The feasibility and acceptance of such training across different healthcare professions is unknown. We developed and implemented a novel, interprofessional PPM curriculum targeted to diverse health professions trainees...
December 22, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29241685/fenestrated-thoracic-endovascular-aortic-repair-using-physician-modified-stent-grafts-for-acute-type-b-aortic-dissection-with-unfavourable-landing-zone
#9
Jiechang Zhu, Lujing Zhao, Xiangchen Dai, Yudong Luo, Hailun Fan, Zhou Feng, Yiwei Zhang, Fanguo Hu
OBJECTIVES: The aim was to evaluate the early results of fenestrated thoracic endovascular aortic repair (fTEVAR) using physician modified stent grafts (PMSGs) to revascularise aortic branches for acute type B aortic dissection (ABAD) with unfavourable proximal landing zone. METHODS: Twenty consecutive patients who underwent fenestrated TEVAR using PMSGs between November 2015 and December 2016 were retrospectively reviewed. Pre-, intra-, and post-operative clinical data were recorded...
December 12, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29228837/feeling-inadequate-residents-stress-and-learning-at-primary-care-clinics-in-the-united-states
#10
Joanna Veazey Brooks, Sara J Singer, Meredith Rosenthal, Alyna T Chien, Antoinette S Peters
BACKGROUND: Educators hope that residents' experiences in primary care continuity clinics will influence more trainees to enter primary care careers. Unfortunately, evidence shows that outpatient primary care training in the United States is stressful and fails to promote primary care careers. We conducted qualitative interviews with residents to understand the source of stress and to explain this failure. METHODS: In-person individual interviews were conducted with 37 primary care residents training at outpatient clinics in the US...
December 11, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29224942/fenestrated-endovascular-aortic-aneurysm-repair-using-physician-modified-endovascular-grafts-versus-company-manufactured-devices
#11
Shernaz S Dossabhoy, Jessica P Simons, Julie M Flahive, Francesco A Aiello, Parth Sheth, Edward J Arous, Louis M Messina, Andres Schanzer
OBJECTIVE: Fenestrated endografts are customized, patient-specific endovascular devices with potential to reduce morbidity and mortality of complex aortic aneurysm repair. With approval from the U.S. Food and Drug Administration, our center began performing fenestrated endovascular aneurysm repair through a physician-sponsored investigational device exemption (IDE #G130210), using both physician-modified endografts (PMEGs) and company-manufactured devices (CMDs). Because these techniques are associated with specific advantages and disadvantages, we sought to investigate differences in outcomes between PMEG and CMD cases...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29201289/evaluation-of-clinical-variables-according-to-follow-up-times-in-copd-results-from-on-sint-cohort
#12
José Luis López-Campos, Alberto Fernández-Villar, Cristina Represas Represas, Lucía Marín Barrera, Maribel Botana Rial, Cecilia López Ramírez, Ricard Casamor
Background: COPD is a chronic disease traditionally associated with increased symptoms as lung function deteriorates. Follow-up times in previous cohort studies were limited to a few years. Interestingly, newer longer observational studies show a more comprehensive picture on disease progression over time. Therefore, the question on the relevancy of the follow-up time in cohort studies remains open. Methods: The ON-SINT study is an observational, retrospective, nationwide, real-life cohort study, in which patients diagnosed with COPD were recruited between December 2011 and April 2013 by primary care (PC) and secondary care (SC) physicians...
2017: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29190666/movement-to-outpatient-hysterectomy-for-benign-indications-in-the-united-states-2008-2014
#13
Gaby Moawad, Emelline Liu, Chao Song, Alex Z Fu
INTRODUCTION: The past decade has witnessed adoption of conservative gynecologic treatments, including minimally invasive surgery (MIS), alongside steady declines in inpatient hysterectomies. It remains unclear what factors have contributed to trends in outpatient benign hysterectomy (BH), as well as whether these trends exacerbate disparities. MATERIALS AND METHODS: Retrospective cohort of 527,964 women ≥18 years old who underwent BH from 2008 to 2014. BH surgical approaches included: open/abdominal hysterectomy (AH), vaginal hysterectomy (VH), laparoscopic hysterectomy (LH), and robotic-assisted hysterectomy (RH)...
2017: PloS One
https://www.readbyqxmd.com/read/29189825/-appropriateness-and-surroundings-doing-more-does-not-mean-doing-better-choosing-wisely-an-unfulfilled-commitment
#14
Fulvio Camerini, Enrico Fabris, Gianfranco Sinagra
The attention of the medical community to the appropriateness of diagnostic and therapeutic procedures has increased in recent years, recognizing the need for a careful use of resources and for avoiding unnecessary and sometimes harmful medical tests, procedures and therapies. Not only healthcare providers, but also public, patients and politicians, should know the consequences of inappropriate decisions and behaviors. Indeed, inappropriateness has clinical (risks), economic (waste of resources), but also ethical implications (i...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29172050/a-longitudinal-study-of-latino-and-non-hispanic-mothers-and-fathers-depressive-symptoms-and-its-association-with-parent-child-communication
#15
REVIEW
Susan M De Luca, Yan Yueqi, Daley DiCorcia, Yolanda Padilla
BACKGROUND: Roughly 8% of the U.S. population report moderate or severe depression for two or more weeks and Latinos (3.7%) report higher rates of severe depression compared to non-Hispanic whites (2.6%) (Pratt and Brody, 2014). As the Latino population continues to grow in the U.S., there is little research on the manifestations for depression, and how this affects the family system longitudinally. METHODS: Based on data from the Fragile Families and Child Wellbeing Study, a 3-step latent class analysis examined the association of self-reported parental depressive symptoms and their children's perceived levels of closeness and openness to communicate with their parents over 9 years (N=3956 families)...
October 31, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29169399/the-effects-of-using-the-predict-test-to-guide-the-antidepressant-treatment-of-depressed-patients-study-protocol-for-a-randomised-controlled-trial
#16
Jonathan Kingslake, Rebecca Dias, Gerard R Dawson, Judit Simon, Guy M Goodwin, Catherine J Harmer, Richard Morriss, Susan Brown, Boliang Guo, Colin T Dourish, Henricus G Ruhé, Anne G Lever, Dick J Veltman, Anneke van Schaik, Jürgen Deckert, Andreas Reif, Michael Stäblein, Andreas Menke, Philip Gorwood, Géraldine Voegeli, Victor Pérez, Michael Browning
BACKGROUND: Antidepressant medication is commonly used to treat depression. However, many patients do not respond to the first medication prescribed and improvements in symptoms are generally only detectable by clinicians 4-6 weeks after the medication has been initiated. As a result, there is often a long delay between the decision to initiate an antidepressant medication and the identification of an effective treatment regimen. Previous work has demonstrated that antidepressant medications alter subtle measures of affective cognition in depressed patients, such as the appraisal of facial expression...
November 23, 2017: Trials
https://www.readbyqxmd.com/read/29166305/botulinum-toxin-therapy-is-syringe-type-related-to-cost-effectiveness
#17
Mark Anthony Foglietti, Lauren Wright, Alanna Foglietti-Fostyk
INTRODUCTION: Clostridium botulinum toxin is effective through cleaving presynaptic proteins at the neuromuscular junction, which prevents the release of acetylcholine and inhibits muscle contraction. Several serotypes of botulinum toxin (BT) exist; however, only 2 types have been approved by the US Food and Drug Administration for commercial and medical use, A and B. Both types of BT must be administered intramuscularly with a syringe, but the type of syringe is the injector's preference...
November 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29158372/enhancing-next-generation-sequencing-guided-cancer-care-through-cognitive-computing
#18
Nirali M Patel, Vanessa V Michelini, Jeff M Snell, Saianand Balu, Alan P Hoyle, Joel S Parker, Michele C Hayward, David A Eberhard, Ashley H Salazar, Patrick McNeillie, Jia Xu, Claudia S Huettner, Takahiko Koyama, Filippo Utro, Kahn Rhrissorrakrai, Raquel Norel, Erhan Bilal, Ajay Royyuru, Laxmi Parida, H Shelton Earp, Juneko E Grilley-Olson, D Neil Hayes, Stephen J Harvey, Norman E Sharpless, William Y Kim
BACKGROUND: Using next-generation sequencing (NGS) to guide cancer therapy has created challenges in analyzing and reporting large volumes of genomic data to patients and caregivers. Specifically, providing current, accurate information on newly approved therapies and open clinical trials requires considerable manual curation performed mainly by human "molecular tumor boards" (MTBs). The purpose of this study was to determine the utility of cognitive computing as performed by Watson for Genomics (WfG) compared with a human MTB...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29157445/an-ensemble-deep-learning-based-approach-for-red-lesion-detection-in-fundus-images
#19
José Ignacio Orlando, Elena Prokofyeva, Mariana Del Fresno, Matthew B Blaschko
BACKGROUND AND OBJECTIVES: Diabetic retinopathy (DR) is one of the leading causes of preventable blindness in the world. Its earliest sign are red lesions, a general term that groups both microaneurysms (MAs) and hemorrhages (HEs). In daily clinical practice, these lesions are manually detected by physicians using fundus photographs. However, this task is tedious and time consuming, and requires an intensive effort due to the small size of the lesions and their lack of contrast. Computer-assisted diagnosis of DR based on red lesion detection is being actively explored due to its improvement effects both in clinicians consistency and accuracy...
January 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29153938/efficacy-and-safety-of-tribendimidine-versus-praziquantel-against-opisthorchis-viverrini-in-laos-an-open-label-randomised-non-inferiority-phase-2-trial
#20
Somphou Sayasone, Jennifer Keiser, Isabel Meister, Youthanavanh Vonghachack, Syda Xayavong, Kanpaseuth Senggnam, Khampheng Phongluxa, Jan Hattendorf, Peter Odermatt
BACKGROUND: Praziquantel is the only option for treatment of the liver fluke infection Opisthorchis viverrini. Tribendimidine could be an alternative drug. We aimed to assess the efficacy and safety of a single, oral dose of tribendimidine, compared with praziquantel administered in two doses, in participants with O viverrini infection. METHOD: We did an open-label, randomised, non-inferiority, phase 2 trial in children (8-14 years) and adolescents and adults (≥15 years) in Champasack province, southern Laos...
November 16, 2017: Lancet Infectious Diseases
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