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https://www.readbyqxmd.com/read/28241191/a-large-skin-cancer-screening-quality-initiative-description-and-first-year-outcomes
#1
Laura K Ferris, Melissa I Saul, Yan Lin, Fei Ding, Martin A Weinstock, Alan C Geller, Jian-Min Yuan, Erica Neuren, Spandana Maddukuri, Francis X Solano, John M Kirkwood
Importance: The lack of prospective randomized clinical trials demonstrating that full-body skin examination (FBSE) reduces melanoma morbidity or mortality has prompted an "I" rating from the United States Preventive Services Task Force for population-based skin cancer screening. More data on these screening programs are needed. Objectives: To describe a skin cancer screening quality initiative in a large health care system and to determine if the intervention was associated with screening of a demographically higher-risk population than previous screening programs and if melanoma incidence and thickness differed in screened vs unscreened patients...
February 23, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28180045/juvenile-nasal-angiofibromas-a-comparison-of-modern-staging-systems-in-an-endoscopic-era
#2
Nicholas R Rowan, Nathan T Zwagerman, Molly E Heft-Neal, Paul A Gardner, Carl H Snyderman
Objectives To compare the clinical utility of four juvenile nasal angiofibroma (JNA) staging systems in a large cohort of patients. Design Retrospective case series. Setting Tertiary referral academic center. Participants Pediatric patients undergoing surgical resection of JNAs between January 2008 and June 2015. Main Outcome Measures Intraoperative blood loss and transfusions, number of staged operations, postoperative residual disease, and recurrent disease. Results In total, 34 patients were identified; all underwent preoperative embolization followed by surgery...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28156460/developing-and-piloting-an-electronic-telephone-triage-application
#3
Christine Carlisle, Colleen F Ford, Jan Hartman, Peggy Nikolajski, Carol Reidmiller, Justin S Rushford, Leslie Stewart, Amanda Barry, Melinda Krebs
68 Background: Telephone triage is a vital part of today's oncology practice and is often not standardized and measured to allow for quality improvement. UPMC CancerCenter (UPMC) has 31 outpatient clinics and is in need of a tool to streamline the current telephone triage process. UPMC and Via Oncology collaborated to develop and pilot a prototype of an electronic telephone triage application. The key components of the prototype were defined as decision support, EHR integration, reporting and workflow management...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152959/the-impact-of-a-just-culture-environment-on-the-reporting-of-medication-errors-near-misses
#4
Shani Michelle Weber
131 Background: UPMC CancerCenter is a large outpatient medical oncology network of 25 locations, located within a 200 mile radius of Pittsburgh, PA. The Cancer Center administers approximately 118,000 treatments and 38,000 injections per year by 200 oncology nurses. Staff members have been strongly encouraged for years to report not only medication errors but also near misses. Despite the continual encouragement it was suspected that the actual number of reported medication errors and near misses was frequently underreported...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152888/the-benefits-of-clinical-pathways-cp-for-radiation-oncology-in-a-large-cancer-care-network
#5
Sushil Beriwal, Hans Benson, Zach Lorinc, Amanda Barry, Kathleen Lokay
148 Background: UPMC CancerCenter and the University of Pittsburgh Cancer Institute (UPMC) created a radiation oncology CP program (now incorporated separately as Via Pathways) in 2003 to standardize care at 19 radiation sites. The program exists to ensure consistency and rapid adoption of best evidence-based care in a large, integrated NCI-designated comprehensive cancer center. METHODS: The web-based CP portal integrates with electronic medical records to provide point-of-care patient-specific decision support...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152745/prospectively-measuring-the-acuity-of-outpatient-chemotherapy-treatment-regimens-for-staffing-allocation
#6
Cheryl A Steele
48 Background: UPMC CancerCenter is a large outpatient medical oncology network of 25 locations, located within a 200 mile radius of Pittsburgh, PA. Covering all of these centers with a limited pool of float nurses was a daily challenge. The literature describes many attempts to quantify nursing workload retrospectively based upon complexity, hours of nursing time, etc. The ability to schedule staff equitability in advance is critical to managing staff. New targeted therapies and complicated treatment regimens which impact patient acuity bring to light the need for accurate acuity measurement...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28135704/implementation-of-a-new-upmc-gamma-knife-radiosurgery-quality-assurance-registry
#7
Ajay Niranjan, Denise Layne, Mark Briercheck, Svetlana Trofimova, Edward A Monaco Iii, Hideyuki Kano, L Dade Lunsford
OBJECT: In this report, we discuss the development of a new, comprehensive, Health Insurance Portability and Accountability Act-compliant electronic quality assurance (QA) registry for Gamma Knife (GK) radiosurgery patients. This registry can be used to query outcomes, link with current hospital electronic medical records, and share data with future corporate or national professional society registries under development. METHODS: A clinical task force comprising physicians and regulatory, legal, and information technology (IT) experts was created to define the nomenclature, regulatory requirements, hosting site, and required capabilities of the proposed system...
2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28065328/use-of-personal-protective-equipment-among-health-care-personnel-results-of-clinical-observations-and-simulations
#8
JaHyun Kang, John M O'Donnell, Bonnie Colaianne, Nicholas Bircher, Dianxu Ren, Kenneth J Smith
BACKGROUND: Very little is known about how health care personnel (HCP) actually use personal protective equipment (PPE). METHODS: The clinical PPE practices of 50 HCP from selected units at the University of Pittsburgh Medical Center (UPMC) Presbyterian Hospital were videotaped with HCP consent. For 2 PPE simulation sessions (simple and full-body sets), 82 HCP were recruited throughout the UPMC system. Simulation practices were videotaped and examined using fluorescent powder with ultraviolet lighting...
January 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28048130/su-g-tep4-05-an-evaluation-of-a-low-dose-rate-ldr-prostate-brachytherapy-procedure-using-a-failure-modes-and-effects-analysis-fmea
#9
S-K Cheong, J Kim
PURPOSE: The aim of the study is the application of a Failure Modes and Effects Analysis (FMEA) to access the risks for patients undergoing a Low Dose Rate (LDR) Prostate Brachytherapy Treatment. METHODS: FMEA was applied to identify all the sub processes involved in the stages of identifying patient, source handling, treatment preparation, treatment delivery, and post treatment. These processes characterize the radiation treatment associated with LDR Prostate Brachytherapy...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27899675/jet2-viewer-a-database-of-predicted-multiple-possibly-overlapping-protein-protein-interaction-sites-for-pdb-structures
#10
Hugues Ripoche, Elodie Laine, Nicoletta Ceres, Alessandra Carbone
The database JET2 Viewer, openly accessible at http://www.jet2viewer.upmc.fr/, reports putative protein binding sites for all three-dimensional (3D) structures available in the Protein Data Bank (PDB). This knowledge base was generated by applying the computational method JET(2) at large-scale on more than 20 000 chains. JET(2) strategy yields very precise predictions of interacting surfaces and unravels their evolutionary process and complexity. JET2 Viewer provides an online intelligent display, including interactive 3D visualization of the binding sites mapped onto PDB structures and suitable files recording JET(2) analyses...
January 4, 2017: Nucleic Acids Research
https://www.readbyqxmd.com/read/27893191/young-investigator-challenge-molecular-testing-in-noninvasive-follicular-thyroid-neoplasm-with-papillary-like-nuclear-features
#11
Xiaoyin Sara Jiang, Grant P Harrison, Michael B Datto
BACKGROUND: Molecular testing provides an important ancillary study for thyroid nodules with indeterminate cytology. The nomenclature shift to "noninvasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP) will impact the performance of molecular tests. For the current study, the authors reviewed the performance of the Afirma gene-expression classifier (GEC) and the University of Pittsburgh Medical Center (UPMC) targeted mutation panel tests in thyroid nodules that were subsequently diagnosed as NIFTP on surgical resection...
December 2016: Cancer
https://www.readbyqxmd.com/read/27889492/surgical-complications-following-early-genitourinary-reconstructive-surgery-for-congenital-adrenal-hyperplasia-interim-analysis-at-6-years
#12
Pankaj P Dangle, Andy Lee, Rajeev Chaudhry, Francis X Schneck
OBJECTIVE: To review the intermediate- to long-term surgical complications following feminizing reconstructive surgery for patients with congenital adrenal hyperplasia (CAH) at a single tertiary center. Genitourinary reconstructive surgery is pivotal to favorable cosmetic and functional outcomes for patients with CAH. MATERIALS AND METHODS: We conducted a retrospective review identifying 26 patients from April 2003 to April 2015 who underwent genitourinary reconstructive surgeries...
November 23, 2016: Urology
https://www.readbyqxmd.com/read/27880082/perceived-performance-and-impact-of-a-non-physician-led-interprofessional-team-in-a-trauma-clinic-setting
#13
Julia Driessen, Johanna E Bellon, Joel Stevans, Raquel M Forsythe, Benjamin R Reynolds, A Everette James
Faced with the challenge of meeting the wide degree of post-discharge needs in their trauma population, the University of Pittsburgh Medical Center (UPMC) developed a non-physician-led interprofessional team to provide follow-up care at its UPMC Falk Trauma Clinic. We assessed this model of care using a survey to gauge team member perceptions of this model, and used clinic visit documentation to apply a novel approach to assessing how this model improves the care received by clinic patients. The high level of perceived team performance and cohesion suggests that this model has been successful thus far from a provider perspective...
January 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/27845339/a-combination-of-muc5ac-and-ca19-9-improves-the-diagnosis-of-pancreatic-cancer-a-multicenter-study
#14
Sukhwinder Kaur, Lynette M Smith, Asish Patel, Melanie Menning, Duncan C Watley, Saad S Malik, Shiv Ram Krishn, Kavita Mallya, Abhijit Aithal, Aaron R Sasson, Sonny L Johansson, Maneesh Jain, Shailender Singh, Sushovan Guha, Chandrakanth Are, Massimo Raimondo, Michael A Hollingsworth, Randall E Brand, Surinder K Batra
OBJECTIVES: Pancreatic cancer (PC) is a lethal malignancy that lacks specific diagnostic markers. The present study explores the diagnostic potential of the most differentially overexpressed secretory mucin MUC5AC alone and in combination with CA19-9 using multi-center training and validation sets. METHODS: The expression of MUC5AC in benign pancreatic pathologies, PC precursor lesions, primary PC tissues and metastatic lesions was evaluated by immunohistochemistry...
January 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27783544/evaluating-the-impact-of-sample-medication-on-subsequent-patient-adherence
#15
Janice L Pringle, Arnie Aldridge, Shannon M Kearney, Kim Grasso, John Radack, Susan Hogue, Chronis Manolis
BACKGROUND: Medication nonadherence is problematic throughout health care practice. Patient nonadherence is a result of several factors, such as financial issues, confusion about the medication, or concerns about possible side effects. Efforts to improve adherence have been implemented, but new strategies are needed to ensure that patients fill their medication prescriptions and adhere to their prescribed use. OBJECTIVE: To investigate whether providing patients with a free 30-day supply of medication at the point of care via a dispensing kiosk-a secure, computerized cabinet placed in the prescriber's office-that provides sample medication and educational materials had a measurable impact on adherence and health care cost...
November 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27780583/development-of-an-evidence-based-decision-pathway-for-vestibular-schwannoma-treatment-options
#16
Faina Linkov, Benita Valappil, Jacob McAfee, Sharon L Goughnour, Douglas M Hildrew, Andrew A McCall, Igor Linkov, Barry Hirsch, Carl Snyderman
OBJECTIVE: To integrate multiple sources of clinical information with patient feedback to build evidence-based decision support model to facilitate treatment selection for patients suffering from vestibular schwannomas (VS). METHODS: This was a mixed methods study utilizing focus group and survey methodology to solicit feedback on factors important for making treatment decisions among patients. Two 90-minute focus groups were conducted by an experienced facilitator...
January 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27675951/outcomes-of-stage-ii-endometrial-cancer-upmc-cancer-center-experience
#17
H Berhane, B S Gill, M Bernard, A Olawaiye, S Paniti, J L Kelley, S Beriwal
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27619390/development-of-an-inflammatory-bowel-disease-research-registry-derived-from-observational-electronic-health-record-data-for-comprehensive-clinical-phenotyping
#18
Alyce J M Anderson, Benjamin Click, Claudia Ramos-Rivers, Dmitriy Babichenko, Ioannis E Koutroubakis, Douglas J Hartman, Jana G Hashash, Marc Schwartz, Jason Swoger, Arthur M Barrie, Michael A Dunn, Miguel Regueiro, David G Binion
BACKGROUND: Inflammatory bowel disease (IBD) is a heterogeneous collection of chronic inflammatory disorders of the digestive tract. Clinical, genetic, and pathological heterogeneity makes it increasingly difficult to translate efficacy studies into real-world practice. Our objective was to develop a comprehensive natural history registry derived from multi-year observational data to facilitate effectiveness and clinical phenotypic research in IBD. METHODS: A longitudinal, consented registry with prospectively collected data was developed at UPMC...
November 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27557451/the-diagnostic-accuracy-of-somatosensory-evoked-potentials-in-evaluating-new-neurological-deficits-after-posterior-cervical-fusions
#19
Parthasarathy D Thirumala, Samyuktha R Melachuri, Jaspreet Kaur, David Ninaci, Manasa K Melachuri, Miguel E Habeych, Donald J Crammond, Jeffrey R Balzer
STUDY DESIGN: This study examined the diagnostic accuracy of significant changes of somatosensory evoked potentials (SSEPs) to evaluate and predict post-operative neurological deficits after posterior cervical fusions (PCF). 846 eligible patients underwent PCF at the University of Pittsburgh Medical Center (UPMC), from 2010 to 2012. OBJECTIVE: to assess the specificity and sensitivity of intraoperative monitoring in predicting post-operative neurological deficits during PCF...
August 24, 2016: Spine
https://www.readbyqxmd.com/read/27472895/improvement-in-protein-domain-identification-is-reached-by-breaking-consensus-with-the-agreement-of-many-profiles-and-domain-co-occurrence
#20
Juliana Bernardes, Gerson Zaverucha, Catherine Vaquero, Alessandra Carbone
Traditional protein annotation methods describe known domains with probabilistic models representing consensus among homologous domain sequences. However, when relevant signals become too weak to be identified by a global consensus, attempts for annotation fail. Here we address the fundamental question of domain identification for highly divergent proteins. By using high performance computing, we demonstrate that the limits of state-of-the-art annotation methods can be bypassed. We design a new strategy based on the observation that many structural and functional protein constraints are not globally conserved through all species but might be locally conserved in separate clades...
July 2016: PLoS Computational Biology
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