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https://www.readbyqxmd.com/read/28634655/effect-of-adherence-on-pharmacokinetic-pharmacodynamic-relationships-of-oral-targeted-anticancer-drugs
#1
Evelina Cardoso, Chantal Csajka, Marie P Schneider, Nicolas Widmer
The emergence of oral targeted anticancer agents transformed several cancers into chronic conditions with a need for long-term oral treatment. Although cancer is a life-threatening condition, oncology medication adherence-the extent to which a patient follows the drug regimen that is intended by the prescriber-can be suboptimal in the long term, as in any other chronic disease. Poor adherence can impact negatively on clinical outcomes, notably because most of these drugs are given as a standard non-individualized dosage despite marked inter-individual variabilities that can lead to toxic or inefficacious drug concentrations...
June 20, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28632651/imaging-in-adult-congenital-heart-disease
#2
Stephanie S Gaydos, Akos Varga-Szemes, Rochelle N Judd, Pal Suranyi, David Gregg
There has been tremendous growth in the population of adults with congenital heart disease (CHD) over the last few decades because of advances in medical care. Whereas some cases are cured during childhood, most patients instead undergo palliation, which leaves them at risk for late complications. Lifelong clinical follow-up involving serial multimodality imaging is helpful to monitor and guide the treatment of late complications. Imaging of these individuals is challenging because of their unique anatomy and therefore requires careful consideration on a case-by-case basis...
July 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28632597/leadership-communication-and-negotiation-across-a-diverse-workforce-an-aoa-critical-issues-symposium
#3
Denis R Clohisy, Michael J Yaszemski, Joanne Lipman
The current workforce in the United States is rapidly changing and is increasingly inclusive of individuals from a broad range of ages, ethnicities, and cultural backgrounds. Engaging and leading a diverse workforce creates great opportunities for innovation and adaptation in our evolving medical economic and clinical care delivery environment. For optimal engagement of employees and partners, orthopaedic surgeons must develop the necessary skills for executing change inside complex organizations and across teams composed of a variety of providers and skilled workers...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28632283/the-impact-of-whole-genome-sequencing-on-the-primary-care-and-outcomes-of-healthy-adult-patients-a-pilot-randomized-trial
#4
Jason L Vassy, Kurt D Christensen, Erica F Schonman, Carrie L Blout, Jill O Robinson, Joel B Krier, Pamela M Diamond, Matthew Lebo, Kalotina Machini, Danielle R Azzariti, Dmitry Dukhovny, David W Bates, Calum A MacRae, Michael F Murray, Heidi L Rehm, Amy L McGuire, Robert C Green
Background: Whole-genome sequencing (WGS) in asymptomatic adults might prevent disease but increase health care use without clinical value. Objective: To describe the effect on clinical care and outcomes of adding WGS to standardized family history assessment in primary care. Design: Pilot randomized trial. (ClinicalTrials.gov: NCT01736566). Setting: Academic primary care practices. Participants: 9 primary care physicians (PCPs) and 100 generally healthy patients recruited at ages 40 to 65 years...
June 27, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28632021/neuromyelitis-optica-application-of-computer-diagnostics-to-historical-case-reports
#5
Pablo Garcia Reitboeck, Peter Garrard, Timothy Peters
The retrospective diagnosis of illnesses by medical historians can often be difficult and prone to bias, although knowledge of the medical disorders of historical figures is key to the understanding of their behavior and reactions. The recent application of computer diagnostics to historical figures allows an objective differential diagnosis to be accomplished. Taking an example from clinical neurology, we analyzed the earliest reported cases of Devic's disease (neuromyelitis optica) that commonly affects the optic nerve and spinal cord and was previously often confused with multiple sclerosis...
February 10, 2017: Journal of the History of the Neurosciences
https://www.readbyqxmd.com/read/28632013/task-demands-in-osces-influence-learning-strategies
#6
Alexandre Lafleur, Jonathan Laflamme, Jimmie Leppink, Luc Côté
THEORY: Models on pre-assessment learning effects confirmed that task demands stand out among the factors assessors can modify in an assessment to influence learning. However, little is known about which tasks in objective structured clinical examinations (OSCEs) improve students' cognitive and metacognitive processes. Research is needed to support OSCE designs that benefit students' metacognitive strategies when they are studying, reinforcing a hypothesis-driven approach. With that intent, hypothesis-driven physical examination (HDPE) assessments ask students to elicit and interpret findings of the physical exam to reach a diagnosis ("Examine this patient with a painful shoulder to reach a diagnosis")...
March 2, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28631681/-the-evaluation-of-the-quality-of-life-in-a-healthy-population-with-the-use-of-the-comq-12-questionnaire
#7
S Ya Kosyakov, Yu V Minavnina, K N Bgantseva, A L Dryupin
The COMQ-12 questionnaire has been elaborated to evaluate the deterioration in the quality of life of the subjects suffering from chronic suppurative otitis media (CSOM) based on the reports of the patients themselves. This questionnaire is of special interest in that it allows to register the complaints of the patients stated by them in the order of priority beginning from those that are responsible for the most pronounced manifestations of the impairment in the quality of life. It, in turn, helps the medical practitioner to rationally organize the treatment of a concrete patient taking into consideration his or her individual expectations...
2017: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/28631433/forensic-radiology-pitfalls-ct-imaging-in-gunshot-wounds-of-the-head
#8
Mark A Giffen, Jason A Powell, Jerri McLemore
Computed tomography (CT) imaging is increasingly used in emergency departments and trauma services and is being offered as a supplemental tool with autopsy in coroner's and medical examiner's offices throughout the United States. The availability of CT images in lieu of traditional X-rays for medicolegal autopsies may lead to misinterpretation of images for forensic pathologists who are not familiar with these types of images. Forensic pathologists must become familiar with CT imaging, the basis of CT image formation and how to interpret CT images appropriately...
June 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28631236/use-of-ctx-i-and-pinp-as-bone-turnover-markers-national-bone-health-alliance-recommendations-to-standardize-sample-handling-and-patient-preparation-to-reduce-pre-analytical-variability
#9
P Szulc, K Naylor, N R Hoyle, R Eastell, E T Leary
N-terminal propeptide of type I procollagen and C-terminal telopeptide of type I collagen are the reference standards for bone turnover markers for monitoring osteoporosis treatment. We provide recommendations for standardized sample handling and encompassing aspects of preanalytical variability to improve the reproductibility of their measurements, their reliability, and clinical interpretation. The International Osteoporosis Foundation and International Federation of Clinical Chemistry bone turnover marker standards working group have identified N-terminal propeptide of type I procollagen (PINP) and C-terminal telopeptide of type I collagen (CTX-I) in the blood to be the international reference standards for bone turnover markers for the prediction of fracture risk and monitoring of osteoporosis treatment...
June 19, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28630951/phenotyping-hypotensive-patients-in-critical-care-using-hospital-discharge-summaries
#10
Yang Dai, Sharukh Lokhandwala, William Long, Roger Mark, Li-Wei H Lehman
Among critically-ill patients, hypotension represents a failure in compensatory mechanisms and may lead to organ hypoperfusion and failure. In this work, we adopt a data-driven approach for phenotype discovery and visualization of patient similarity and cohort structure in the intensive care unit (ICU). We used Hierarchical Dirichlet Process (HDP) as a nonparametric topic modeling technique to automatically learn a d-dimensional feature representation of patients that captures the latent "topic" structure of diseases, symptoms, medications, and findings documented in hospital discharge summaries...
February 2017: IEEE-EMBS International Conference on Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28630551/exploring-legal-restrictions-regulatory-reform-and-geographic-disparities-in-abortion-access-in-thailand
#11
Grady Arnott, Grace Sheehy, Orawee Chinthakanan, Angel M Foster
Despite decades of advocacy among Thai governmental and nongovernmental actors to remove abortion from the country's 1957 Criminal Code, this medically necessary service remains significantly legally restricted. In 2005, in the most recent regulatory reform to date, the Thai Medical Council established regulatory measures to allow a degree of physician interpretation within the confines of the existing law. Drawing on findings from a review of institutional policies and legislative materials, key informant interviews, and informal discussions with health service providers, government representatives, and nonprofit stakeholders, this article explores how legal reforms and health policies have shaped the abortion landscape in Thailand and influenced geographic disparities in availability and accessibility...
June 2017: Health and Human Rights
https://www.readbyqxmd.com/read/28630374/classifying-the-body-in-marlene-dumas-the-image-as-burden
#12
Anthea Gordon
Medical photography, and in particular dermatological imagery, is often assumed to provide an objective, and functional, representation of disease and that it can act as a diagnostic aid. By contrast, artistic conceptions of the images of the body tend to focus on interpretative heterogeneity and ambiguity, aiming to create or explore meaning rather than enact a particular function. In her 2015 retrospective exhibition at the Tate Modern, South African artist Marlene Dumas questions these disciplinary divides by using medical imagery (among other photographic sources) as the basis for her portraits...
June 19, 2017: Medical Humanities
https://www.readbyqxmd.com/read/28630267/a-structured-review-of-antithrombotic-therapy-in-peripheral-artery-disease-with-a-focus-on-revascularization-a-tasc-intersociety-consensus-for-the-management-of-peripheral-artery-disease-initiative
#13
REVIEW
Connie N Hess, Lars Norgren, Gary M Ansel, Warren H Capell, John P Fletcher, F Gerry R Fowkes, Anders Gottsäter, Kerry Hitos, Michael R Jaff, Joakim Nordanstig, William R Hiatt
Peripheral artery disease affects >200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality. Limb revascularization is recommended to improve function and quality of life for symptomatic patients with peripheral artery disease with intermittent claudication who have not responded to medical treatment. For patients with critical limb ischemia, the goals of revascularization are to relieve pain, help wound healing, and prevent limb loss. The baseline risk of cardiovascular and limb-related events demonstrated among patients with stable peripheral artery disease is elevated after revascularization and related to atherothrombosis and restenosis...
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28629398/anaplastic-astrocytoma-mimicking-progressive-multifocal-leucoencephalopathy-a-case-report-and-review-of-the-overlapping-syndromes
#14
Ema Kantorová, Michal Bittšanský, Štefan Sivák, Eva Baranovičová, Petra Hnilicová, Vladimír Nosáľ, Daniel Čierny, Kamil Zeleňák, Wolfgang Brück, Egon Kurča
BACKGROUND: Co-occurrence of multiple sclerosis (MS) and glial tumours (GT) is uncommon although occasionally reported in medical literature. Interpreting the overlapping radiologic and clinical characteristics of glial tumours, MS lesions, and progressive multifocal leukoencephalopathy (PML) can be a significant diagnostic challenge. CASE PRESENTATION: We report a case of anaplastic astrocytoma mimicking PML in a 27-year-old patient with a 15-year history of MS...
June 19, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28628695/efficiency-and-interpretability-of-text-paging-communication-for-medical-inpatients-a-mixed-methods-analysis
#15
Adam Luxenberg, Brian Chan, Raman Khanna, Urmimala Sarkar
No abstract text is available yet for this article.
June 19, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28628660/systematic-review-of-emergency-medicine-clinical-practice-guidelines-implications-for-research-and-policy
#16
Arjun K Venkatesh, Dan Savage, Benjamin Sandefur, Kenneth R Bernard, Craig Rothenberg, Jeremiah D Schuur
INTRODUCTION: Over 25 years, emergency medicine in the United States has amassed a large evidence base that has been systematically assessed and interpreted through ACEP Clinical Policies. While not previously studied in emergency medicine, prior work has shown that nearly half of all recommendations in medical specialty practice guidelines may be based on limited or inconclusive evidence. We sought to describe the proportion of clinical practice guideline recommendations in Emergency Medicine that are based upon expert opinion and low level evidence...
2017: PloS One
https://www.readbyqxmd.com/read/28628522/patient-experiences-of-partnering-with-healthcare-professionals-for-hand-hygiene-compliance-a-systematic-review
#17
Samantha Butenko, Craig Lockwood, Alexa McArthur
BACKGROUND: Healthcare-associated infections pose a significant risk to patients in acute healthcare settings such as hospitals. Increasingly, patients are encouraged to be active participants and partner with healthcare professionals to positively influence their own safety and overall experience throughout their healthcare journey. Patient-focused safety initiatives include the empowerment of patients to be active partners with healthcare professionals in order to influence the hand hygiene behaviors and compliance of the healthcare professionals providing care to them...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28627840/teaching-clinical-reasoning-is-more-like-detective-work-than-you-might-imagine
#18
Marie-Claude Audétat, Arabelle Rieder, Johanna Sommer
When supervising a medical student or a doctor in training, it is useful to know the different stages of clinical reasoning in order to identify at what stage the learner encounters a difficulty in making the right decision. Is he having trouble characterizing the clinical problem ? Is he generating the right hypotheses that are adapted to the data collection ? Is it a problem of verification of assumptions ? Of interpreting the data ? Of presumptive diagnosis or a poor choice of an intervention plan ? By making a pedagogical diagnosis, the supervisor will be more effective in adapting his recommendations in a more targeted way to the specific difficulties of the student or young colleague...
May 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28625275/advance-directives-and-powers-of-attorney-in-intensive-care-patients
#19
Geraldine de Heer, Bernd Saugel, Barbara Sensen, Charlotte Rübsteck, Hans O Pinnschmidt, Stefan Kluge
BACKGROUND: Advance directives and powers of attorney are increasingly common, yet data on their use in clinical situations remain sparse. METHODS: In this single center cross-sectional study, we collected data by questionnaire from 1004 intensive care patients in a university hospital. The frequencies of advance directives and powers of attorney were determined, and the factors affecting them were studied with multivariate logistic regression analysis. RESULTS: Usable data were obtained from 998 patients...
June 5, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28621753/media-coverage-of-alcohol-issues-a-critical-political-economy-framework-a-case-study-from-ireland
#20
Julien Mercille
There is a growing literature on news media representations of alcohol-related issues. However, current scholarship has neglected critical political economic frameworks to interpret media coverage of alcohol. This paper presents such a framework that conceives of news organisations as corporations that share the values and interests of political and economic elites. The media are thus expected to present viewpoints that are more aligned with the alcohol industry than the scientific consensus on public health policy would warrant...
June 16, 2017: International Journal of Environmental Research and Public Health
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