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https://www.readbyqxmd.com/read/28918445/pre-emptive-intestinal-transplant-the-surgeon-s-point-of-view
#1
REVIEW
Augusto Lauro, Ignazio R Marino, Kishore R Iyer
Pre-emptive transplantation is a well-established practice for certain types of end-organ failure such as in the use of kidney transplantation. For irreversible intestinal failure, total parenteral nutrition (TPN) remains the gold standard, due to the suboptimal long-term results of intestinal transplantation. As such, the only role for pre-emptive transplantation, if at all, will be for patients identified to be at high risk of complications and mortality while on definitive long-term TPN. In these patients, the timing of early listing and transplantation could become life-saving, taking into account that mortality on the waiting list is still the highest for intestinal candidates...
September 16, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28918316/mr-guided-joint-reconstruction-of-activity-and-attenuation-in-brain-pet-mr
#2
Abolfazl Mehranian, Habib Zaidi, Andrew J Reader
With the advent of time-of-flight (TOF) PET scanners, joint maximum-likelihood reconstruction of activity and attenuation (MLAA) maps has recently regained attention for the estimation of PET attenuation maps from emission data. However, the estimated attenuation and activity maps are scaled by unknown scaling factors. We recently demonstrated that in hybrid PET-MR, the scaling issue of this algorithm can be effectively addressed by imposing MR spatial constraints on the estimation of attenuation maps using a penalized MLAA (P-MLAA(+)) algorithm...
September 13, 2017: NeuroImage
https://www.readbyqxmd.com/read/28917669/knowledge-driven-computational-modeling-in-alzheimer-s-research-current-state-and-future-trends
#3
Hugo Geerts, Martin Hofmann-Apitius, Thomas J Anastasio
Neurodegenerative diseases such as Alzheimer's disease (AD) follow a slowly progressing dysfunctional trajectory, with a large presymptomatic component and many comorbidities. Using preclinical models and large-scale omics studies ranging from genetics to imaging, a large number of processes that might be involved in AD pathology at different stages and levels have been identified. The sheer number of putative hypotheses makes it almost impossible to estimate their contribution to the clinical outcome and to develop a comprehensive view on the pathological processes driving the clinical phenotype...
September 14, 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/28917227/pharmacoeconomics-of-parenteral-nutrition-in-surgical-and-critically-ill-patients-receiving-structured-triglycerides-in-china
#4
Guo Hao Wu, Alexandra Ehm, Marco Bellone, Lorenzo Pradelli
BACKGROUND AND OBJECTIVES: A prior meta-analysis showed favorable metabolic effects of structured triglyceride (STG) lipid emulsions in surgical and critically ill patients compared with mixed medium-chain/long-chain triglycerides (MCT/LCT) emulsions. Limited data on clinical outcomes precluded pharmacoeconomic analysis. We performed an updated meta-analysis and developed a cost model to compare overall costs for STGs vs MCT/LCTs in Chinese hospitals. METHODS AND STUDY DESIGN: We searched Medline, Embase, Wanfang Data, the China Hospital Knowledge Database, and Google Scholar for clinical trials comparing STGs to mixed MCT/LCTs in surgical or critically ill adults published between October 10, 2013 and September 19, 2015...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28916139/online-adaptive-radiation-therapy
#5
REVIEW
Stephanie Lim-Reinders, Brian M Keller, Shahad Al-Ward, Arjun Sahgal, Anthony Kim
The current paradigm of radiation therapy has the treatment planned on a snapshot dataset of the patient's anatomy taken at the time of simulation. Throughout the course of treatment, this snapshot may vary from initial simulation. Although there is the ability to image patients within the treatment room with technologies such as cone beam computed tomography, the current state of the art is largely limited to rigid-body matching and not accounting for any geometric deformations in the patient's anatomy. A plan that was once attuned to the initial simulation can become suboptimal as the treatment progresses unless improved technologies are brought to bear...
April 24, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28915960/pleiotropic-effects-of-metformin-to-rescue-statin-induced-muscle-injury-and-insulin-resistance-a-proposed-mechanism-and-potential-clinical-implications
#6
Nicholas W Carris, Srinivas M Tipparaju, David J Magness, Kalyan C Chapalamadugu, Ronald R Magness
The 2013 American Heart Association Blood Cholesterol Guidelines increased the number of patients recommended for statin therapy in the United States to 56million. Two common statin side effects are muscle pain, referred to as "statin-associated muscle symptoms", and increased risk for new onset type-2-diabetes mellitus. Up to 25% of statin users report muscle symptoms resulting in many patients being switched to lower dose or lower potency statins, or refusing statins altogether. The most likely signaling mechanisms for statin-associated muscle symptoms overlaps with the proposed mechanism of statin-induced insulin resistance...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28915897/development-of-a-complex-intervention-to-promote-appropriate-prescribing-and-medication-intensification-in-poorly-controlled-type-2-diabetes-mellitus-in-irish-general-practice
#7
Mark E Murphy, Molly Byrne, Atieh Zarabzadeh, Derek Corrigan, Tom Fahey, Susan M Smith
BACKGROUND: Poorly controlled type 2 diabetes mellitus (T2DM) can be seen as failure to meet recommended targets for management of key risk factors including glycaemic control, blood pressure and lipids. Poor control of risk factors is associated with significant morbidity, mortality and healthcare costs. Failure to intensify medications for patients with poor control of T2DM when indicated is called clinical inertia and is one contributory factor to poor control of T2DM. We aimed to develop a theory and evidence-based complex intervention to improve appropriate prescribing and medication intensification in poorly controlled T2DM in Irish general practice...
September 16, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28915580/molecular-and-functional-characterization-of-a-new-3-end-kit-juxtamembrane-deletion-in-a-duodenal-gist-treated-with-neoadjuvant-imatinib
#8
Vittorio Perfetti, Erik Laurini, Suzana Aulić, Maurizio Fermeglia, Roberta Riboni, Marco Lucioni, Elena Dallera, Sara Delfanti, Luigi Pugliese, Francesco Saverio Latteri, Andrea Pietrabissa, Sabrina Pricl
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. GISTs express the receptor tyrosine kinase KIT, and the majority of GISTs present KIT gain-of-function mutations that cluster in the 5' end of the receptor juxtamembrane domain. On the other hand, little information is known about GISTs carrying mutations in the 3' end of the KIT juxtamembrane domain. Here we report and discuss a clinical case of localized duodenal GIST whose molecular characterization revealed the presence of a new 21 nucleotide/7 amino acid deletion in the 3' end of KIT juxtamembrane domain (Δ574-580)...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28915158/simulation-training-for-family-planning-procedures
#9
Lisa M Goldthwaite, Kristina Tocce
PURPOSE OF REVIEW: To review the current evidence for use of simulation in family planning procedural training. RECENT FINDINGS: A variety of simulation models exist for abortion, contraception, and sterilization procedures, ranging from low to high fidelity. Most models for abortion and contraception are low fidelity, inexpensive, and provide opportunities for acquisition and practice of procedural skills. Hysteroscopic and laparoscopic simulation models for sterilization procedures are generally higher fidelity, and their use has been shown to increase knowledge, skill performance, and procedural comfort...
September 14, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28915144/the-development-of-a-clinical-peer-review-tool
#10
John D Lundeen, Rebecca J Warr, Cynthia G Cortes, Frankie Wallis, Jennifer J Coleman
Faculty evaluation for the purpose of promotion and tenure frequently includes peer review as a part of the process. Faculty review by a peer may provide an assessment of teaching effectiveness and information related to the faculty member's professional development activities. This article presents an innovative, evidence-based approach using selected National League for Nursing core competencies and International Nursing Association for Clinical Simulation and Learning clinical simulation standards in the development of a faculty peer review tool to gather data on clinical teaching to be used during the promotion and tenure process...
September 14, 2017: Nursing Education Perspectives
https://www.readbyqxmd.com/read/28914990/simulating-the-multi-disciplinary-care-team-approach-enhancing-student-understanding-of-anatomy-through-an-ultrasound-anchored-interprofessional-session
#11
Marianne T Luetmer, Beth A Cloud, James W Youdas, Wojciech Pawlina, Nirusha Lachman
Quality of healthcare delivery is dependent on collaboration between professional disciplines. Integrating opportunities for interprofessional learning in health science education programs prepares future clinicians to function as effective members of a multi-disciplinary care team. This study aimed to create a modified team-based learning (TBL) environment utilizing ultrasound technology during an interprofessional learning activity to enhance musculoskeletal anatomy knowledge of first year medical (MD) and physical therapy (PT) students...
September 15, 2017: Anatomical Sciences Education
https://www.readbyqxmd.com/read/28914600/reduction-of-18-f-fdg-dose-in-clinical-pet-mr-imaging-by-using-silicon-photomultiplier-detectors
#12
Tetsuro Sekine, Gaspar Delso, Konstantinos G Zeimpekis, Felipe de Galiza Barbosa, Edwin E G W Ter Voert, Martin Huellner, Patrick Veit-Haibach
Purpose To determine the level of clinically acceptable reduction in injected fluorine 18 ((18)F) fluorodeoxyglucose (FDG) dose in time-of-flight (TOF)-positron emission tomography(PET)/magnetic resonance (MR) imaging by using silicon photomultiplier (SiPM) detectors compared with TOF-PET/computed tomography (CT) using Lu1.8Y0.2SiO5(Ce), or LYSO, detectors in patients with different body mass indexes (BMIs). Materials and Methods Patients were enrolled in this study as part of a larger prospective study with a different purpose than evaluated in this study (NCT02316431)...
September 14, 2017: Radiology
https://www.readbyqxmd.com/read/28914396/the-expected-benefit-of-preventive-mastectomy-on-breast-cancer-incidence-and-mortality-in-brca-mutation-carriers-by-age-at-mastectomy
#13
Vasily Giannakeas, Steven A Narod
PURPOSE: Preventive breast surgery is offered to unaffected BRCA mutation carriers to prevent breast cancer incidence and mortality. The clinical benefit of preventive mastectomy can be measured in several ways, including extension of life expectancy (mean years of life gained) and by estimating the probability of surviving until age 80. We sought to estimate the expected benefit of a preventive mastectomy at various ages, using these indices of mortality, by simulating hypothetical cohorts of women...
September 15, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28914377/the-permeability-enhancing-mechanism-of-menthol-on-skin-lipids-a-molecular-dynamics-simulation-study
#14
Huanjie Wang, Fancui Meng
The stratum corneum (SC), the outermost layer of skin, represents the primary barrier to molecules penetrating the skin. Menthol is widely used in clinical medicine as a penetration enhancer due to its high efficiency and relative safety. In this study, molecular dynamics simulations have been performed to investigate the effect of menthol molecules on the structural and permeability of both single component and ternary mixed bilayers. The lipid matrix is modeled as pure ceramide (CER2) or as a 2:2:1 mixture of CER2, cholesterol (CHOL), and free fatty acid (FFA)...
September 15, 2017: Journal of Molecular Modeling
https://www.readbyqxmd.com/read/28914216/-driving-with-alzheimer-s-disease
#15
M Jacobs, E P 't Hart, R A C Roos
OBJECTIVE: To summarise the available literature on driving with Alzheimer's disease (AD) and to investigate the relationship between driving and cognitive functioning. DESIGN: Literature review. METHOD: A systematic search of the electronic databases PubMed/MEDLINE was conducted to select the relevant literature on the driving competence of patients with Alzheimer's disease. RESULTS: A total of 31 studies were selected that investigated driving competence in AD using either an on-road driving assessment or a driving simulator...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28913897/studying-the-progression-of-amyloid-pathology-and-its-therapy-using-translational-longitudinal-model-of-accumulation-and-distribution-of-amyloid-beta
#16
Tatiana Karelina, O Demin, Oleg Demin, Sridhar Duvvuri, Timothy Nicholas
Long term effects of amyloid targeted therapy can be studied using a mechanistic translational model of Aβ distribution and aggregation calibrated on published data in mouse and human species. AD pathology is modelled utilizing age-dependent pathological evolution for rate constants and several variants of explicit functions for Aβ toxicity influencing cognitive outcomes (Adas-cog). Preventive Aβ targeted therapies were simulated to minimize the Aβ difference from healthy physiological levels. Therapeutic targeted simulations provided similar predictions for mouse and human...
September 15, 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/28913826/modeling-tolerance-development-for-the-effect-on-heart-rate-of-the-selective-s1p1-receptor-modulator-ponesimod
#17
Dominik Lott, Thorsten Lehr, Jasper Dingemanse, Andreas Krause
Ponesimod is a selective sphingosine-1-phosphate-1 (S1P1 ) receptor modulator currently under investigation for the treatment of multiple sclerosis. S1P receptor modulators reduce heart rate following treatment initiation. This effect disappears with repeated dosing, enabling development of innovative up-titration regimens to optimize patient safety. There are currently no published pharmacokinetic/pharmacodynamic models describing the heart rate reduction of S1P receptor modulators in humans. The model developed here provides quantification of this effect for ponesimod...
September 15, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28913766/computational-modeling-and-treatment-identification-in-the-myelodysplastic-syndromes
#18
REVIEW
Leylah M Drusbosky, Christopher R Cogle
PURPOSE OF REVIEW: This review discusses the need for computational modeling in myelodysplastic syndromes (MDS) and early test results. RECENT FINDINGS: As our evolving understanding of MDS reveals a molecularly complicated disease, the need for sophisticated computer analytics is required to keep track of the number and complex interplay among the molecular abnormalities. Computational modeling and digital drug simulations using whole exome sequencing data input have produced early results showing high accuracy in predicting treatment response to standard of care drugs...
September 14, 2017: Current Hematologic Malignancy Reports
https://www.readbyqxmd.com/read/28912896/investigation-of-the-safety-of-focused-ultrasound-induced-blood-brain-barrier-opening-in-a-natural-canine-model-of-aging
#19
Meaghan Anne O'Reilly, Ryan Matthew Jones, Edward Barrett, Anthony Schwab, Elizabeth Head, Kullervo Hynynen
Rationale: Ultrasound-mediated opening of the Blood-Brain Barrier(BBB) has shown exciting potential for the treatment of Alzheimer's disease(AD). Studies in transgenic mouse models have shown that this approach can reduce plaque pathology and improve spatial memory. Before clinical translation can occur the safety of the method needs to be tested in a larger brain that allows lower frequencies be used to treat larger tissue volumes, simulating clinical situations. Here we investigate the safety of opening the BBB in half of the brain in a large aged animal model with naturally occurring amyloid deposits...
2017: Theranostics
https://www.readbyqxmd.com/read/28912828/dendritic-immunotherapy-improvement-for-an-optimal-control-murine-model
#20
J C Rangel-Reyes, J C Chimal-Eguía, E Castillo-Montiel
Therapeutic protocols in immunotherapy are usually proposed following the intuition and experience of the therapist. In order to deduce such protocols mathematical modeling, optimal control and simulations are used instead of the therapist's experience. Clinical efficacy of dendritic cell (DC) vaccines to cancer treatment is still unclear, since dendritic cells face several obstacles in the host environment, such as immunosuppression and poor transference to the lymph nodes reducing the vaccine effect. In view of that, we have created a mathematical murine model to measure the effects of dendritic cell injections admitting such obstacles...
2017: Computational and Mathematical Methods in Medicine
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