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https://www.readbyqxmd.com/read/29166752/immunotherapy-treatment-an-issue-for-metabolic-response
#1
Luca Tagliabue, Antonella Capozza, Claudio Maioli, Andrea Luciani, Anna M Ierardi, Gianpaolo Carrafiello
Since the beginning of second decade of this century, when it was introduced in many oncologic scenarios, immunotherapy has become an important tool in the management of a growing number of cancers. Engaging the host immune system in cancer therapy seems to be useful, improving not only progression free survival but also overall survival, until the achieving the goal that many advanced cancers, previously considered without effective treatment options, have now become successfully treatable. Moreover, considering the relatively recent introduction of these drugs in clinical scenarios and the continuous releasing of new drugs, large validated clinical experiences are lacking and many issues are today debated; by the way, the evaluation of the response to immune-therapy poses major concerns...
November 22, 2017: Quarterly Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29166565/hospital-based-physicians-intubation-decisions-and-associated-mental-models-when-managing-a-critically-and-terminally-ill-older-patient
#2
Shannon Haliko, Julie Downs, Deepika Mohan, Robert Arnold, Amber E Barnato
BACKGROUND: Variation in the intensity of acute care treatment at the end of life is influenced more strongly by hospital and provider characteristics than patient preferences. OBJECTIVE: We sought to describe physicians' mental models (i.e., thought processes) when encountering a simulated critically and terminally ill older patient, and to compare those models based on whether their treatment plan was patient preference-concordant or preference-discordant. METHODS: Seventy-three hospital-based physicians from 3 academic medical centers engaged in a simulated patient encounter and completed a mental model interview while watching the video recording of their encounter...
November 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29166411/a-machine-learning-approach-to-triaging-patients-with-chronic-obstructive-pulmonary-disease
#3
Sumanth Swaminathan, Klajdi Qirko, Ted Smith, Ethan Corcoran, Nicholas G Wysham, Gaurav Bazaz, George Kappel, Anthony N Gerber
COPD patients are burdened with a daily risk of acute exacerbation and loss of control, which could be mitigated by effective, on-demand decision support tools. In this study, we present a machine learning-based strategy for early detection of exacerbations and subsequent triage. Our application uses physician opinion in a statistically and clinically comprehensive set of patient cases to train a supervised prediction algorithm. The accuracy of the model is assessed against a panel of physicians each triaging identical cases in a representative patient validation set...
2017: PloS One
https://www.readbyqxmd.com/read/29166342/important-considerations-for-performing-prepectoral-breast-reconstruction
#4
Hani Sbitany
Prepectoral breast reconstruction has emerged as an excellent technique for postmastectomy reconstruction, as it allows for full preservation of a patient's pectoralis major muscle and chest wall function. This reduces pain, eliminates animation deformity, and results in high patient satisfaction. Safely performed prepectoral breast reconstruction requires a careful patient selection process before committing to the procedure, taking into account comorbidities, radiation status, and oncologic criteria such as tumor location and breast cancer stage...
December 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29166296/emergency-intubations-in-a-high-volume-pediatric-emergency-department
#5
Jen Heng Pek, Gene Yong-Kwang Ong
INTRODUCTION: Resuscitation of critically ill children can be chaotic, and emergency airway management is often fraught with difficulties. This study aimed to characterize the Singaporean landscape of tracheal intubation in a pediatric emergency unit, placing emphasis on safety outcomes, procedural process of care, and provider training. METHODS: A retrospective review of all cases presented to the KK Women's and Children's Hospital from January 2009 to December 2013 with intubation carried out within the pediatric emergency unit was done...
November 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29166261/pressure-injury-risk-factors-in-adult-critical-care-patients-a-review-of-the-literature
#6
Jill Cox
Critically ill patients require complex care in a technologically sophisticated environment where they are highly vulnerable to pressure-related injuries. However, pressure injury (PI) development remains a multifactorial phenomenon in critically ill persons; true risk is both pervasive and elusive. The purpose of this comprehensive review of the empirical literature was to examine the risk factors associated with PIs among adult patients admitted to contemporary intensive care units (ICUs). Inclusion criteria stipulated publications were to be peer-reviewed, quantitative studies with a focus on pressure ulcer (PU) risk factors in adult critical care patients published between 2010 and 2016 in which statistical analysis involved multivariate analysis using PU development as the outcome variable...
November 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/29166203/temporal-profile-of-care-following-mild-traumatic-brain-injury-predictors-of-hospital-admission-follow-up-referral-and-six-month-outcome
#7
John K Yue, Ethan A Winkler, Sourabh Sharma, Mary J Vassar, Jonathan J Ratcliff, Frederick K Korley, Seth A Seabury, Adam R Ferguson, Hester F Lingsma, Sacha Meeuws, Opeolu M Adeoye, Jonathan W Rick, Caitlin K Robinson, Siena M Duarte, Esther L Yuh, Pratik Mukherjee, Sureyya S Dikmen, Thomas W McAllister, Ramon Diaz-Arrastia, Alex B Valadka, Wayne A Gordon, David O Okonkwo, Geoffrey T Manley
OBJECTIVE: To investigate the clinical management and medical follow-up of patients with mild traumatic brain injury (mTBI) presenting to emergency departments (EDs). METHODS: Overall, 168 adult patients with mTBI from the prospective, multicentre Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Pilot study with Glasgow Coma Scale (GCS) 13-15, no polytrauma and alive at six months were included. Predictors for hospital admission, three-month follow-up referral and six-month functional disability (Glasgow Outcome Scale-Extended (GOSE) ≤ 6) were analysed using multivariable regression...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29166197/combining-natural-ingredients-and-beliefs-the-dayak-tribe-s-experience-caring-for-sick-children-with-traditional-medicine
#8
Shinta Widiastuty Anggerainy, Dessie Wanda, Happy Hayati
Instead of seeking conventional health care, the Dayak tribe in Borneo, Indonesia, treats sick children at home with traditional medicine. The objective of this descriptive, qualitative study was to explore the Dayak tribe's use of traditional medicine to care for sick children. Comprehensive interviews were conducted with 10 caregivers, with collected data analyzed using content analysis. Key recurring themes identified were: 1) traditional medicine as first aid; 2) ease of access and cost-effectiveness; 3) traditional medicine was not always effective; 4) a combination of natural ingredients and beliefs; 5) the importance of "communicating" with plants; and 6) engagement with metaphysical forces...
2017: Compr Child Adolesc Nurs
https://www.readbyqxmd.com/read/29165775/re-operative-abdominal-predictive-score-a-prognostic-model-combining-acute-re-intervention-predictive-index-and-intra-abdominal-pressure
#9
Caridad de Dios Soler-Morejón, Tomás Ariel Lombardo-Vaillant, Teddy Osmín Tamargo-Barbeito, Robert Wise, Manu L N G Malbrain
BACKGROUND: The decision to re-operate after abdominal surgery is still difficult, especially in the setting of intra-abdominal sepsis. Mathematical models provide a good aid to both diagnosis and decision-making. METHODS: A prospective observational study was conducted with 300 patients consecutively admitted to the intensive care unit of an academic institution affiliated to Calixto García Medical Faculty following abdominal surgery from January 2008 to January 2010...
November 22, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29165644/-the-money-can-be-a-motivator-to-me-a-little-but-mostly-pbf-just-helps-me-to-do-better-in-my-job-an-exploration-of-the-motivational-mechanisms-of-performance-based-financing-for-health-workers-in-malawi
#10
Julia Lohmann, Danielle Wilhelm, Christabel Kambala, Stephan Brenner, Adamson S Muula, Manuela De Allegri
Performance-based financing (PBF) is assumed to improve health care delivery by motivating health workers to enhance their work performance. However, the exact motivational mechanisms through which PBF is assumed to produce such changes are poorly understood to date. Although PBF is increasingly recognized as a complex health systems intervention, its motivational effect for individual health workers is still often reduced to financial 'carrots and sticks' in the literature and discourse. Aiming to contribute to the development of a more comprehensive understanding of the motivational mechanisms, we explored how PBF impacted health worker motivation in the context of the Malawian Results-based Financing for Maternal and Newborn Health (RBF4MNH) Initiative...
November 20, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29165627/health-literacy-and-patient-outcomes-in-chronic-kidney-disease-a-systematic-review
#11
Dominic M Taylor, Simon Fraser, Chris Dudley, Gabriel C Oniscu, Charles Tomson, Rommel Ravanan, Paul Roderick
Background: Limited health literacy affects 25% of people with chronic kidney disease (CKD), and may reduce self-management skills resulting in poorer clinical outcomes. By disproportionately affecting people with low socio-economic status and non-white ethnicity, limited health literacy may promote health inequity. Methods: We performed a systematic review of quantitative studies of health literacy and clinical outcomes among adults with CKD. Results: A total of 29 studies (13 articles; 16 conference abstracts) were included...
November 20, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29165624/cost-and-potential-avoidability-of-antibiotic-associated-adverse-drug-reactions-in-children
#12
Julie N Beck, Sarah L Suppes, Claire R Smith, Brian R Lee, J Steven Leeder, Michelle VanDoren, Jason G Newland, Jennifer L Goldman
We identified 375 children who visited the emergency department or urgent care clinic at Children's Mercy Hospitals & Clinics for antibiotic adverse drug reactions over a 1-year period, and the total cost for these visits was $170 893.20. Of these ADRs, 17% were likely avoidable. The potential negative consequences of antibiotics should be considered at the point of prescribing.
November 20, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29165621/treatment-of-tuberculosis-in-complex-emergencies-in-developing-countries-a-scoping-review
#13
Geraldine Munn-Mace, Divya Parmar
Almost 172 million people live in complex emergencies globally resulting from political and/or economic instability. The provision and continuity of health care in complex emergencies remain a significant challenge. Health agencies are often hesitant to implement tuberculosis programmes in particular because its treatment requires a longer commitment than most acute diseases. However, not treating tuberculosis promptly increases mortality and untreated tuberculosis further increases the incidence of tuberculosis...
November 20, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29165604/carbapenemase-producing-organisms-a-global-scourge
#14
Robert A Bonomo, Eileen M Burd, John Conly, Brandi M Limbago, Laurent Poirel, Julie A Segre, Lars F Westblade
The dramatic increase in the prevalence and clinical impact of infections caused by bacteria producing carbapenemases is a global health concern. Carbapenemase production is especially problematic when encountered in members of the family Enterobacteriaceae. Due to their ability to readily spread and colonize patients in health care environments, preventing the transmission of these organisms is a major public health initiative and coordinated international effort is needed to contain the risk of infection...
October 16, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29165600/missed-opportunities-to-identify-occupational-asthma-in-acute-secondary-care
#15
P R Ellis, G I Walters
Background: Occupational asthma (OA) accounts for one in six cases of new-onset adult asthma. Despite this it remains under-recognized in the UK. Delayed and missed diagnoses of OA lead to poor health outcomes for workers at significant cost to the UK economy. The burden of occupational aetiology on hospital admissions with asthma is not known. Aims: To measure how frequently medical professionals consider occupational aetiology in patients presenting to secondary care with acute asthma symptoms...
November 18, 2017: Occupational Medicine
https://www.readbyqxmd.com/read/29165543/identification-of-older-adults-with-frailty-in-the-emergency-department-using-a-frailty-index-results-from-a-multinational-study
#16
Audrey-Anne Brousseau, Elsa Dent, Ruth Hubbard, Don Melady, Marcel Émond, Éric Mercier, Andrew P Costa
Objective: frailty is a central concept in geriatric medicine, yet its utility in the Emergency Department (ED) is not well understood nor well utilised. Our objectives were to develop an ED frailty index (FI-ED), using the Rockwood cumulative deficits model and to evaluate its association with adverse outcomes. Method: this was a large multinational prospective cohort study using data from the interRAI Multinational Emergency Department Study. The FI-ED was developed from the Canadian cohort and validated in the multinational cohort...
November 20, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29165358/understanding-the-molecular-genetics-of-basal-cell-carcinoma
#17
REVIEW
Cristina Pellegrini, Maria Giovanna Maturo, Lucia Di Nardo, Valeria Ciciarelli, Carlota Gutiérrez García-Rodrigo, Maria Concetta Fargnoli
Basal cell carcinoma (BCC) is the most common human cancer and represents a growing public health care problem. Several tumor suppressor genes and proto-oncogenes have been implicated in BCC pathogenesis, including the key components of the Hedgehog pathway, PTCH1 and SMO, the TP53 tumor suppressor, and members of the RAS proto-oncogene family. Aberrant activation of the Hedgehog pathway represents the molecular driver in basal cell carcinoma pathogenesis, with the majority of BCCs carrying somatic point mutations, mainly ultraviolet (UV)-induced, and/or copy-loss of heterozygosis in the PTCH1 gene...
November 22, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29165152/detection-of-antibiotic-resistant-acinetobacter-baumannii-in-various-hospital-environments-potential-sources-for-transmission-of-acinetobacter-infections
#18
Zahra Shamsizadeh, Mahnaz Nikaeen, Bahram Nasr Esfahani, Seyed Hamed Mirhoseini, Maryam Hatamzadeh, Akbar Hassanzadeh
BACKGROUND: Antibiotic resistant Acinetobacter baumannii has emerged as one of the most problematic hospital acquired pathogens around the world. This study was designed to investigate the presence of antibiotic resistant A. baumannii in various hospital environments. METHODS: Air, water and inanimate surface samples were taken in different wards of four hospitals and analyzed for the presence of A. baumannii. Confirmed A. baumannii isolates were analyzed for antimicrobial susceptibility and also screened for the presence of three most common OXA- type carbapenemase-encoding genes...
May 8, 2017: Environmental Health and Preventive Medicine
https://www.readbyqxmd.com/read/29165127/perspectives-acquired-through-long-term-epidemiological-studies-on-the-great-east-japan-earthquake
#19
REVIEW
Toru Tsuboya, Mariko Inoue, Michihiro Satoh, Kei Asayama
The Great East Japan Earthquake (GEJE) and subsequent tsunamis that occurred in 2011 caused extensive and severe structural damage and interrupted numerous research activities; however, the majority of such activities have been revived, and further public health researches and activities have started to follow the population affected by the disaster. In this mini-review, we overview our recent activities regarding epidemiologic studies in Miyagi Prefecture, the region most affected by the GEJE. Through our study processes, we were able to identify the particular characteristics of vulnerable populations, and provide ideas that may help save lives and reduce the amount of damage caused by a future disaster...
March 15, 2017: Environmental Health and Preventive Medicine
https://www.readbyqxmd.com/read/29165005/models-of-care-in-tele-ophthalmology-a-scoping-review
#20
Liam J Caffery, Monica Taylor, Glen Gole, Anthony C Smith
The objective of this review was to identify and describe telehealth models of care for ophthalmic services. We conducted a scoping review of the literature to identify how ophthalmic care can be delivered by telehealth. We searched the PubMed database to identify relevant articles which were screened based on pre-defined inclusion criteria. For included articles, data were extracted, categorised and analysed. Synthesis of findings was performed narratively. The scoping review included 78 articles describing 62 discrete tele-ophthalmic models of care...
January 1, 2017: Journal of Telemedicine and Telecare
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