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https://www.readbyqxmd.com/read/29768314/medication-administration-delays-in-non-st-elevation-myocardial-infarction-analysis-of-1002-patients-admitted-to-an-academic-medical-center
#1
LeAnn N Denlinger, Ellen C Keeley
Our goal was to assess adherence to American College of Cardiology/American Heart Association guideline-based medical therapy in patients admitted with type I non-ST elevation myocardial infarction (NSTEMI) and to determine factors associated with medication administration delay. We performed a retrospective analysis using data from the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry. Baseline patient demographics, 12-lead electrocardiogram (ECG) findings, laboratory values, medications administered and the time they were administered, and in-hospital clinical outcomes were collected...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768072/an-integrated-developmental-four-year-medical-school-curriculum-in-palliative-care-a-longitudinal-content-evaluation-based-on-national-competency-standards
#2
Erin M Denney-Koelsch, Robert Horowitz, Timothy Quill, Constance D Baldwin
BACKGROUND: While palliative care (PC) competencies for medical school graduates have been defined, the lack of established curriculum models and assessment tools hampers curricular evaluation. OBJECTIVE: To describe the scope and content of the University of Rochester's longitudinal, integrated four-year PC curriculum after 17 years of implementation, review student evaluative responses, and compare the curriculum to national competency standards. DESIGN AND SETTING: Combining and reorganizing a published PC curriculum assessment tool and a list of medical school PC competencies, we created a novel nine-topic framework to assess the content coverage of our curriculum...
May 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29767669/identification-of-mutations-in-patients-with-acquired-pure-red-cell-aplasia
#3
Xinchao Zhang, Yi Shi, Lingjun Song, Chang Shen, Qi Cai, Zhou Zhang, Jun Wu, Guohui Fu, Weiwei Shen
Idiopathic acquired pure red cell aplasia (PRCA) is a rare, autoimmune-related disease. This study aimed to describe the previously unidentified DNA alterations associated with PRCA. Here, next generation sequencing using a panel containing 295 critical genes was applied to detect potentially pathogenic mutations in four patients with PRCA. A total of 529 mutations were identified and further classified into three categories, namely, uncertain (n = 25), likely benign (n = 20) and benign (n = 484) mutations, based on the American College of Medical Genetics and Genomics (ACMG) 2015 guidelines and ClinVar database...
May 15, 2018: Acta Biochimica et Biophysica Sinica
https://www.readbyqxmd.com/read/29764369/vareporter-variant-reporter-for-cancer-research-of-massive-parallel-sequencing
#4
Po-Jung Huang, Chi-Ching Lee, Ling-Ya Chiu, Kuo-Yang Huang, Yuan-Ming Yeh, Chia-Yu Yang, Cheng-Hsun Chiu, Petrus Tang
BACKGROUND: High throughput sequencing technologies have been an increasingly critical aspect of precision medicine owing to a better identification of disease targets, which contributes to improved health care cost and clinical outcomes. In particular, disease-oriented targeted enrichment sequencing is becoming a widely-accepted application for diagnostic purposes, which can interrogate known diagnostic variants as well as identify novel biomarkers from panels of entire human coding exome or disease-associated genes...
May 9, 2018: BMC Genomics
https://www.readbyqxmd.com/read/29762337/real-life-indications-to-ivabradine-treatment-for-heart-rate-optimization-in-patients-with-chronic-systolic-heart-failure
#5
Lara Tondi, Gabriele Fragasso, Roberto Spoladore, Giuseppe Pinto, Marco Gemma, Massimo Slavich, Cosmo Godino, Anna Salerno, Claudia Montanaro, Alberto Margonato
: Ivabradine is a selective and specific inhibitor of If current. With its pure negative chronotropic action, it is recommended by European Society of Cardiology and American College of Cardiology/American Heart Association guidelines in symptomatic heart failure patients (NYHA ≥ 2) with ejection fraction 35% or less, sinus rhythm and heart rate (HR) at least 70 bpm, despite maximally titrated β-blocker therapy. Data supporting this indication mainly derive from the SHIFT study, in which ivabradine reduced the combined endpoint of mortality and hospitalization, despite the fact that only 26% of patients enrolled were on optimal β-blocker doses...
May 11, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29754767/preconception-carrier-screening-by-genome-sequencing-results-from-the-clinical-laboratory
#6
Sumit Punj, Yassmine Akkari, Jennifer Huang, Fei Yang, Allison Creason, Christine Pak, Amiee Potter, Michael O Dorschner, Deborah A Nickerson, Peggy D Robertson, Gail P Jarvik, Laura M Amendola, Jennifer Schleit, Dana Kostiner Simpson, Alan F Rope, Jacob Reiss, Tia Kauffman, Marian J Gilmore, Patricia Himes, Benjamin Wilfond, Katrina A B Goddard, C Sue Richards
Advances in sequencing technologies permit the analysis of a larger selection of genes for preconception carrier screening. The study was designed as a sequential carrier screen using genome sequencing to analyze 728 gene-disorder pairs for carrier and medically actionable conditions in 131 women and their partners (n = 71) who were planning a pregnancy. We report here on the clinical laboratory results from this expanded carrier screening program. Variants were filtered and classified using the latest American College of Medical Genetics and Genomics (ACMG) guideline; only pathogenic and likely pathogenic variants were confirmed by orthologous methods before being reported...
May 3, 2018: American Journal of Human Genetics
https://www.readbyqxmd.com/read/29749623/gastrointestinal-pathologists-perspective-on-managing-risk-in-the-distal-esophagus-convergence-on-a-pragmatic-approach
#7
Andrew M Bellizzi, Sara Hafezi-Bakhtiari, Maria Westerhoff, E Celia Marginean, Robert H Riddell
Here, we discuss recent updates and a continuing controversy in the diagnosis and management of Barrett's esophagus, specifically the recommendation that the irregular Z-line not be biopsied, the diminished status of ultrashort-segment Barrett's esophagus, the evidence basis for excluding and including the requirement of goblet cells for the diagnosis of Barrett's esophagus, and the conclusion that histologically confirmed low-grade dysplasia is best managed with endoscopic ablation rather than surveillance...
May 11, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29748356/variation-in-lipid-lowering-therapy-use-in-patients-with-low-density-lipoprotein-cholesterol-%C3%A2-190-mg-dl-insights-from-the-national-cardiovascular-data-registry-practice-innovation-and-clinical-excellence-registry
#8
Salim S Virani, Kevin F Kennedy, Julia M Akeroyd, Pamela B Morris, Vera A Bittner, Frederick A Masoudi, Neil J Stone, Laura A Petersen, Christie M Ballantyne
BACKGROUND: Patients with low-density lipoprotein cholesterol (LDL-C) ≥190 mg/dL are at high risk of atherosclerotic cardiovascular disease events. Treatment guidelines recommend intensive treatment in these patients. Variation in the use of lipid-lowering therapies (LLTs) in these patients in a national sample of cardiology practices is not known. METHODS AND RESULTS: Using data from the American College of Cardiology National Cardiovascular Data Registry-Practice Innovation and Clinical Excellence registry, we assessed the proportion of patients with LDL-C ≥190 mg/dL (n=49 447) receiving statin, high-intensity statin, LLT associated with ≥50% LDL-C lowering, ezetimibe, or a PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor between January 2013 and December 2016...
May 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29737035/systemic-lupus-erythematosus-in-a-patient-with-noonan-syndrome-like-disorder-with-loose-anagen-hair-1-more-than-a-chance-association
#9
Tomoko Uehara, Naoki Hosogaya, Nobutake Matsuo, Kenjiro Kosaki
Systemic lupus erythematosus (SLE) has been reported among patients with RASopathy. Five patients have been reported: three with SHOC2 variants, one with a PTPN11 variant, and one with a KRAS variant. SHOC2 variant might represent a relatively common predisposing factor for SLE among the RASopathy genes. However, the clinical details were only reported for two patients, while information on the remaining patient appeared only in a tabular format with minimal clinical description. Here, we report a patient with a SHOC2 variant and SLE...
May 7, 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29733503/use-of-the-thyroid-imaging-reporting-and-data-system-ti-rads-scoring-system-for-the-evaluation-of-subcentimeter-thyroid-nodules
#10
Vivian L Weiss, Rochelle F Andreotti, Kim A Ely
BACKGROUND: The American Thyroid Association (ATA) recommends fine-needle aspiration (FNA) biopsy of nodules measuring >1.5 cm with low-suspicion sonographic patterns or >1.0 cm with high/intermediate-suspicion features. Routine biopsy of nodules <1 cm is not recommended. However, despite these recommendations, subcentimeter nodules are often referred for FNA biopsy. METHODS: This was a retrospective chart review of consecutive thyroid FNAs during an 18-month period (1157 patients, 1491 nodules, 2016-2017) to evaluate age, sex, medical history, diagnoses, and follow-up...
May 7, 2018: Cancer Cytopathology
https://www.readbyqxmd.com/read/29728521/financial-relationships-between-neurologists-and-industry-the-2015-open-payments-database
#11
Aditi Ahlawat, Pushpa Narayanaswami
OBJECTIVE: To analyze research and nonresearch payments from the pharmaceutical and device industry to neurologists in 2015 using the Centers for Medicare and Medicaid Services (CMS) Open Payments database. METHODS: In this retrospective database analysis, we computed the percentage of neurologists in the United States receiving payments, the median/mean payments per neurologist, payment categories, regional trends, and sponsors. We computed the number of practicing neurologists from the Association of American Medical Colleges State Physician Workforce data book, 2015...
May 4, 2018: Neurology
https://www.readbyqxmd.com/read/29728395/-scn5a-na-v-1-5-variant-functional-perturbation-and-clinical-presentation-variants-of-a-certain-significance
#12
Brett M Kroncke, Andrew M Glazer, Derek K Smith, Jeffrey D Blume, Dan M Roden
BACKGROUND: Accurately predicting the impact of rare nonsynonymous variants on disease risk is an important goal in precision medicine. Variants in the cardiac sodium channel SCN5A (protein NaV 1.5; voltage-dependent cardiac Na+ channel) are associated with multiple arrhythmia disorders, including Brugada syndrome and long QT syndrome. Rare SCN5A variants also occur in ≈1% of unaffected individuals. We hypothesized that in vitro electrophysiological functional parameters explain a statistically significant portion of the variability in disease penetrance...
May 2018: Circulation. Genomic and precision medicine
https://www.readbyqxmd.com/read/29727914/germline-mutations-in-dna-repair-genes-are-associated-with-bladder-cancer-risk-and-unfavorable-prognosis
#13
Rong Na, Yishuo Wu, Guangliang Jiang, Hongjie Yu, Xiaoling Lin, Meilin Wang, Carly A Conran, Richard J Fantus, Ning Zhang, Shenghua Liu, Brian T Helfand, S Lilly Zheng, William B Isaacs, Qiang Ding, Zhoujun Shen, Jianfeng Xu
OBJECTIVES: Germline DNA repair gene mutations in bladder cancer (BCa) are poorly characterized. We therefore sought to perform a systematic evaluation of whether these mutations are associated with increased risk of BCa and aggressive disease. MATERIALS AND METHODS: Germline DNA from 98 BCa patients was analyzed for 54 DNA repair genes using a customized targeted sequencing panel. Population control data were obtained from the public databases Exome Aggregation Consortium database (ExAC) and Genome Aggregation Database (gnomAD)...
May 4, 2018: BJU International
https://www.readbyqxmd.com/read/29724424/acr-appropriateness-criteria-%C3%A2-suspected-thoracic-aortic-aneurysm
#14
Shelby J Bennett, Karin E Dill, Michael Hanley, Osmanuddin Ahmed, Benoit Desjardins, Kenneth L Gage, Michael Ginsburg, Ali Khoynezhad, Isabel B Oliva, Michael L Steigner, Richard Strax, Nupur Verma, Frank J Rybicki
Although the incidence of thoracic aortic aneurysm is on the rise, initial imaging diagnosis can present a challenge for many clinicians. Providers are faced with many imaging choices as part of the initial workup. Considering level of invasiveness, relative radiation level, and quality of associated diagnostic data, CT angiography and MR angiography are believed to be the most appropriate options for radiological diagnosis of suspected thoracic aortic aneurysm. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724416/acr-appropriateness-criteria-%C3%A2-breast-implant-evaluation
#15
Ana P Lourenco, Linda Moy, Paul Baron, Aarati D Didwania, Roberta M diFlorio, Samantha L Heller, Anna I Holbrook, Alana A Lewin, Tejas S Mehta, Bethany L Niell, Priscilla J Slanetz, Ashley R Stuckey, Daymen S Tuscano, Nina S Vincoff, Susan P Weinstein, Mary S Newell
Breast implant imaging varies depending on patient age, implant type, and symptoms. For asymptomatic patients (any age, any implant), imaging is not recommended. Rupture of saline implants is often clinically evident, as the saline is resorbed and there is a change in breast contour. With saline implants and equivocal clinical findings, ultrasound (US) is the examination of choice for patients less than 30 years of age, either mammography/digital breast tomosynthesis or US may be used for those 30 to 39 years of age, and mammography/digital breast tomosynthesis is used for those 40 years and older...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29718797/cep250-mutations-associated-with-mild-cone-rod-dystrophy-and-sensorineural-hearing-loss-in-a-japanese-family
#16
Daiki Kubota, Kiyoko Gocho, Sachiko Kikuchi, Keiichiro Akeo, Masahiro Miura, Kunihiko Yamaki, Hiroshi Takahashi, Shuhei Kameya
BACKGROUND: CEP250 encodes the C-Nap1 protein which belongs to the CEP family of proteins. C-Nap1 has been reported to be expressed in the photoreceptor cilia and is known to interact with other ciliary proteins. Mutations of CEP250 cause atypical Usher syndrome which is characterized by early-onset sensorineural hearing loss (SNHL) and a relatively mild retinitis pigmentosa. This study tested the hypothesis that the mild cone-rod dystrophy (CRD) and SNHL in a non-consanguineous Japanese family was caused by CEP250 mutations...
May 2, 2018: Ophthalmic Genetics
https://www.readbyqxmd.com/read/29717635/sexual-and-gender-minority-health-in-medical-curricula-in-new-england-a-pilot-study-of-medical-student-comfort-competence-and-perception-of-curricula
#17
Nicole Sitkin Zelin, Charlotte Hastings, Brendin R Beaulieu-Jones, Caroline Scott, Ana Rodriguez-Villa, Cassandra Duarte, Christopher Calahan, Alexander J Adami
BACKGROUND: Sexual and gender minority (SGM) individuals experience high rates of harassment and discrimination when seeking healthcare, which contributes to substantial healthcare disparities. Improving physician training about gender identity, sexual orientation, and the healthcare needs of SGM patients has been identified as a critical strategy for mitigating these disparities. In 2014, the Association of American Medical Colleges (AAMC) published medical education competencies to guide undergraduate medical education on SGM topics...
December 2018: Medical Education Online
https://www.readbyqxmd.com/read/29710243/preventability-of-early-versus-late-hospital-readmissions-in-a-national-cohort-of-general-medicine-patients
#18
Kelly L Graham, Andrew D Auerbach, Jeffrey L Schnipper, Scott A Flanders, Christopher S Kim, Edmondo J Robinson, Gregory W Ruhnke, Larissa R Thomas, Sunil Kripalani, Eduard E Vasilevskis, Grant S Fletcher, Neil J Sehgal, Peter K Lindenauer, Mark V Williams, Joshua P Metlay, Roger B Davis, Julius Yang, Edward R Marcantonio, Shoshana J Herzig
Background: Many experts believe that hospitals with more frequent readmissions provide lower-quality care, but little is known about how the preventability of readmissions might change over the postdischarge time frame. Objective: To determine whether readmissions within 7 days of discharge differ from those between 8 and 30 days after discharge with respect to preventability. Design: Prospective cohort study. Setting: 10 academic medical centers in the United States...
May 1, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29708784/lung-cancer-screening-guidelines-how-readable-are-internet-based-patient-education-resources
#19
David Richard Hansberry, Michael D White, Michael D'Angelo, Arpan V Prabhu, Sarah Kamel, Paras Lakhani, Baskaran Sundaram
OBJECTIVE: Following the findings of the National Lung Screening Trial, several national societies from multiple disciplines have endorsed the use of low-dose chest CT to screen for lung cancer. Online patient education materials are an important tool to disseminate information to the general public regarding the proven health benefits of lung cancer screening. This study aims to evaluate the reading level at which these materials related to lung cancer screening are written. MATERIALS AND METHODS: The four terms "pulmonary nodule," "radiation," "low-dose CT," and "lung cancer screening" were searched on Google, and the first 20 online resources for each term were downloaded, converted into plain text, and analyzed using 10 well-established readability scales...
April 30, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29700846/rethinking-medical-oaths-using-the-physician-charter-and-ethical-virtues
#20
Alexander M Greiner, Lauris C Kaldjian
OBJECTIVE: Medical oaths express ethical values that are essential to the trust within the patient-physician relationship and medicine's commitment to society. However, the contents of oaths vary between medical schools and therefore raise questions about which ethical values should be included in a medical oath. More than a decade has passed since this variability was last analysed in North America, and since that time the Physician Charter on Medical Professionalism has gained considerable attention, raising the possibility that the Charter may be influencing medical oaths and making them more consistent...
April 27, 2018: Medical Education
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