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https://www.readbyqxmd.com/read/28088009/cardiac-output-and-systemic-vascular-resistance-clinical-assessment-compared-with-a-noninvasive-objective-measurement-in-children-with-shock
#1
Asma Razavi, Christopher J L Newth, Robinder G Khemani, Fernando Beltramo, Patrick A Ross
PURPOSE: To evaluate physician assessment of cardiac output and systemic vascular resistance in patients with shock compared with an ultrasonic cardiac output monitor (USCOM). To explore potential changes in therapy decisions if USCOM data were available using physician intervention answers. STUDY DESIGN: Double-blinded, prospective, observational study in a tertiary hospital pediatric intensive care unit. Forty children (<18years) admitted with shock, requiring ongoing volume resuscitation or inotropic support...
December 28, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28087132/practice-patterns-of-thoracic-radiotherapy-for-extensive-stage-small-cell-lung-cancer-survey-of-us-academic-thoracic-radiation-oncologists
#2
Carl M Post, Vivek Verma, Timur Mitin, Charles B Simone
PURPOSE: Despite the recent CREST trial demonstrating a survival benefit to thoracic radiotherapy (TRT) for patients with extensive-stage small-cell lung cancer (ES-SCLC) with response to chemotherapy, as well as endorsement by current National Comprehensive Cancer Network guidelines, TRT may not be uniformly delivered in clinical practice across all circumstances. METHODS AND MATERIALS: We surveyed US academic thoracic radiation oncologists regarding their practice patterns for TRT and assessed conditions in which withholding TRT could be warranted...
December 22, 2016: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28076248/prediabetes-screening-and-treatment-in-diabetes-prevention-the-impact-of-physician-attitudes
#3
Arch G Mainous, Rebecca J Tanner, Christopher B Scuderi, Maribeth Porter, Peter J Carek
PURPOSE: Detection and treatment of prediabetes is an effective strategy in diabetes prevention. However, most patients with prediabetes are not identified. Our objective was to evaluate the relationship between attitudes toward prediabetes as a clinical construct and screening/treatment behaviors for diabetes prevention among US family physicians. METHODS: An electronic survey of a national sample of academic family physicians (n 1248) was conducted in 2016. Attitude toward prediabetes was calculated using a summated scale assessing agreement with statements regarding prediabetes as a clinical construct...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28072798/reliability-and-safety-of-contra-lateral-oblique-view-for-interlaminar-epidural-needle-placement
#4
Richard Derby, Irina Melnik, Jongwoo Choi, Sang-Hoon Lee, Jeong-Eun Lee
Cord trauma is a risk with a cervical and thoracic interlaminar epidural approach to the epidural space. Intermittent lateral fluoroscopic imaging to detect needle depth is often cumbersome and may be difficult to interpret. In comparison, the contra-lateral oblique (CLO) fluoroscopic view is efficient and easy to interpret. However, the in vivo reliability and safety of this technique has not been formally investigated.The senior author collected fluoroscopic images on 278 consecutive patients undergoing an interlaminar epidural block at the T1-T2 level performed using a 17 gauge Tuohy needle...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28069356/radiology-reports-what-you-think-you-re-saying-and-what-they-think-you-re-saying
#5
Bonmyong Lee, Matthew T Whitehead
BACKGROUND: Image interpretation and translation into written language is an imperfect process. Yet, the radiology report represents the link between radiologist's opinion and patient's images. Increased access to images through remote viewing stations has made direct communication between radiologists and clinicians less commonplace. We are interested in how accurately the descriptive contents within radiology reports convey the feelings of the radiologist to the referring clinician...
November 16, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28068732/-concept-for-a-national-implant-registry-to-improve-patient-safety
#6
L Prantl, U von Fritschen, J Liebau, J von Hassel, E M Baur, P M Vogt, R E Giunta, R E Horch
Since the introduction of silicone implants, several events have led to considerable uncertainty among the patients, public, and users. So far, however, the necessary steps to significantly improving patient safety have not been taken in any of these cases. Requiring stricter approvals for medical devices, improving monitoring by the regulatory authorities and the revision of the Medical Devices Directive are all initial steps in the right direction towards a change in policy, but are insufficient as an early warning system...
December 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28065435/patient-involvement-and-language-barriers-problems-of-agreement-or-understanding
#7
Anne Marie Dalby Landmark, Jan Svennevig, Jennifer Gerwing, Pål Gulbrandsen
OBJECTIVE: This study aims to explicate efforts for realizing patient-centeredness (PCC) and involvement (SDM) in a difficult decision-making situation. It investigates what communicative strategies a physician used and the immediate, observable consequences for patient participation. METHODS: From a corpus of videotaped hospital encounters, one case in which the physician and patient used Norwegian as lingua franca was selected for analysis using conversation analysis (CA)...
December 14, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/28064343/quantitation-of-pet-signal-as-an-adjunct-to-visual-interpretation-of-florbetapir-imaging
#8
Michael J Pontecorvo, Anupa K Arora, Marybeth Devine, Ming Lu, Nick Galante, Andrew Siderowf, Catherine Devadanam, Abhinay D Joshi, Stephen L Heun, Brian F Teske, Stephen P Truocchio, Michael Krautkramer, Michael D Devous, Mark A Mintun
PURPOSE: This study examined the feasibility of using quantitation to augment interpretation of florbetapir PET amyloid imaging. METHODS: A total of 80 physician readers were trained on quantitation of florbetapir PET images and the principles for using quantitation to augment a visual read. On day 1, the readers completed a visual read of 96 scans (46 autopsy-verified and 50 from patients seeking a diagnosis). On day 2, 69 of the readers reinterpreted the 96 scans augmenting their interpretation with quantitation (VisQ method) using one of three commercial software packages...
January 7, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28063721/point-of-care-lung-ultrasound-of-children-with-acute-asthma-exacerbations-in-the-pediatric-emergency-department
#9
Samantha Dankoff, Patricia Li, Adam J Shapiro, Terry Varshney, Alexander S Dubrovsky
OBJECTIVES: Primary objective was to characterize lung ultrasound findings in children with asthma presenting with respiratory distress to the emergency department (ED). Secondary objectives included correlating these findings with patients' clinical course in the ED. METHODS: Eligible patients 2-17years of age, underwent a lung ultrasound by the study sonographer between November 2014 to December 2015. Positive lung ultrasound was defined as the presence of ≥1 of the following findings: ≥3 B-lines per intercostal space, consolidation and/or pleural abnormalities...
December 26, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28063368/venous-thromboembolism-incidence-recurrence-and-mortality-based-on-women-s-health-initiative-data-and-medicare-claims
#10
Dale R Burwen, Chunyuan Wu, Dominic Cirillo, Jacques E Rossouw, Karen L Margolis, Marian Limacher, Robert Wallace, Matthew Allison, Charles B Eaton, Monika Safford, Matthew Freiberg
INTRODUCTION: Our objective was to compare Medicare claims to physician review and adjudication of medical records for identifying venous thromboembolism (VTE), and to assess VTE incidence, recurrence, and mortality in a large national cohort of post-menopausal women followed up to 19years. MATERIALS AND METHODS: We used detailed clinical data from the Women's Health Initiative (WHI) linked to Medicare claims. Agreement between data sources was evaluated among 16,003 women during 1993-2010...
November 15, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/28060238/single-institution-early-experience-with-the-bundled-payments-for-care-improvement-initiative
#11
Richard Iorio, Joseph Bosco, James Slover, Yousuf Sayeed, Joseph D Zuckerman
The Centers for Medicare & Medicaid Services (CMS) implemented the Bundled Payments for Care Improvement (BPCI) initiative in 2011. Through BPCI, organizations enlisted into payment agreements that include both performance and financial accountability for episodes of care. To succeed, BPCI requires quality maintenance and care delivery at lower costs. This necessitates physicians and hospitals to merge interests. Orthopaedic surgeons must assume leadership roles in cost containment, surgical safety, and quality assurance to deliver cost-effective care...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28054286/predictive-validity-and-inter-rater-reliability-of-the-persian-version-of-full-outline-of-unresponsiveness-among-unconscious-patients-with-traumatic-brain-injury-in-an-intensive-care-unit
#12
Somayeh Momenyan, Sey Mojtaba Mousavi, Tahmineh Dadkhahtehrani, Fatemeh Sarvi, Reza Heidarifar, Faezeh Kabiri, Erfan Mohebi, Mohammad Koohbor
INTRODUCTION: The Glasgow Coma Scale (GCS) has some limitations when evaluating the unconscious patient. This study aims to validate the Persian version of the FOUR (Full Outline of Unresponsiveness) score as a proposed substitute. METHODS: Two nurses, two nursing students, and two physicians scored the prepared Persian version of the FOUR and GCS in 84 patients with acute brain injury. The inter-rater agreement for the FOUR and the GCS scores was evaluated by the weighted kappa (κ w)...
January 4, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28048870/su-f-j-81-evaluation-of-automated-deformable-registration-between-planning-computed-tomography-ct-and-daily-cone-beam-ct-images-over-the-course-of-prostate-cancer-radiotherapy
#13
J Matney, J Hammers, O Kaidar-Person, A Wang, R Chen, S Das, L Marks, P Mavroidis
PURPOSE: To compute daily dose delivered during radiotherapy, deformable registration needs to be relatively fast, automated, and accurate. The aim of this study was to evaluate the performance of commercial deformable registration software for deforming between two modalities: planning computed tomography (pCT) images acquired for treatment planning and cone beam (CB) CT images acquired prior to each fraction of prostate cancer radiotherapy. METHODS: A workflow was designed using MIM Software™ that aligned and deformed pCT into daily CBCT images in two steps: (1) rigid shifts applied after daily CBCT imaging to align patient anatomy to the pCT and (2) normalized intensity-based deformable registration to account for interfractional anatomical variations...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048724/su-f-j-84-comparison-of-quantitative-deformable-image-registration-evaluation-tools-application-to-prostate-igart
#14
N Dogan, E Weiss, W Sleeman, G Christensen, J Williamson, J Ford
PURPOSE: Errors in displacement vector fields (DVFs) generated by Deformable Image Registration (DIR) algorithms can give rise to significant uncertainties in contour propagation and dose accumulation in Image-Guided Adaptive Radiotherapy (IGART). The purpose of this work is to assess the accuracy of two DIR algorithms using a variety of quality metrics for prostate IGART. METHODS: Pelvic CT images were selected from an anonymized database of nineteen prostate patients who underwent 8-12 serial scans during radiotherapy...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048633/tu-ab-202-08-generating-organ-surfaces-to-overcome-random-contouring-errors-and-slice-thickness-variations-on-multimodality-images
#15
S Oh, E Weiss, G Christensen, G Hugo, J Williamson
PURPOSE: To propose a new method that generates smooth organ surface meshes that overcomes random contouring errors and volume averaging artifacts for hollow organs. METHODS: The proposed contour-to-smooth mesh generation method (CSMG) consists of two parts; 1) reconstructing the inner and outer surfaces of the hollow organ with triangular meshes based on parametric active surface (PAS) and 2) modifying the reconstructed inner surface in order to satisfy minimum wall thickness constraints and matching the patient's known organ wall volume...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048509/th-a-brc-03-aapm-tg218-measurement-methods-and-tolerance-levels-for-patient-specific-imrt-verification-qa
#16
M Miften
: AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. LEARNING OBJECTIVES: 1. Understand the progression of technology since the first TG publication 2...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048202/we-h-brc-02-failure-mode-and-effect-analysis-of-liver-stereotactic-body-radiotherapy
#17
I Rusu, T Thomas, J Roeske, J Price, C Perino, I Mescioglu, M Surucu
PURPOSE: To identify areas of improvement in our liver stereotactic body radiation therapy (SBRT) program, using failure mode and effect analysis (FMEA). METHODS: A multidisciplinary group consisting of one physician, three physicists, one dosimetrist and two therapists was formed. A process map covering 10 major stages of the liver SBRT program from the initial diagnosis to post treatment follow-up was generated. A total of 102 failure modes, together with their causes and effects, were identified...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048080/su-f-t-80-a-mobile-application-for-intra-operative-electron-radiotherapy-treatment-planning
#18
C Williams, E Crowley, J Wolfgang
PURPOSE: Intraoperative electron radiotherapy (IORT) poses a unique set of challenges for treatment planning. Planning must be performed in a busy operating room environment over a short timeframe often with little advance knowledge of the treatment depth or applicator size. Furthermore, IORT accelerators can have a large number of possible applicators, requiring extensive databooks that must be searched for the appropriate dosimetric parameters. The goal of this work is to develop a software tool to assist in the planning process that is suited to the challenges faced in the IORT environment...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048018/su-f-j-52-a-novel-approach-to-x-ray-tube-quality-assurance-for-cbct-systems-in-order-to-better-assess-the-patient-imaging-dose-in-a-large-multi-unit-treatment-facility
#19
L Buckley, R Webb, C Lambert, B Nyiri, L Gerig
PURPOSE: To standardize the tube calibration for Elekta XVI cone beam CT (CBCT) systems in order to provide a meaningful estimate of the daily imaging dose and reduce the variation between units in a large centre with multiple treatment units. METHODS: Initial measurements of the output from the CBCT systems were made using a Farmer chamber and standard CTDI phantom. The correlation between the measured CTDI and the tube current was confirmed using an Unfors Xi detector which was then used to perform a tube current calibration on each unit...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047977/su-f-t-291-development-of-physician-driven-clinically-relevant-pass-fail-criteria-for-a-dvh-based-imrt-patient-specific-qa-program
#20
A Price, M Lawrence, S Das, L Rankine
PURPOSE: To derive and implement physician driven metrics for dose volume histogram (DVH)-based patient specific quality assurance (QA) for prostate radiation therapy based on clinically relevant deviations. METHODS: An observership study presented 3 radiation oncology physicians from our institution with a series of artificial DVH-based IMRT QA results, each generated by introducing iteratively larger perturbations from a planned DVH (from our pool of 20 real patient plans) to portions of the bladder, rectum, and planning target volume (PTV) DVHs...
June 2016: Medical Physics
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