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https://www.readbyqxmd.com/read/28530515/cost-effectiveness-of-strategies-to-increase-cervical-screening-uptake-at-first-invitation-strategic
#1
Apostolos Tsiachristas, Matthew Gittins, Henry Kitchener, Alastair Gray
Objective To assess the cost-effectiveness of strategies to increase cervical cancer screening uptake at first invitation (STRATEGIC trial). Methods We performed an economic analysis alongside the STRATEGIC trial, comparing each of seven novel interventions for improving cervical screening uptake with control general practices in Greater Manchester and Grampian (United Kingdom). A template was developed to measure the intervention costs. Trial estimates of screening uptake were combined with data from the literature to estimate healthcare costs of each intervention...
January 1, 2017: Journal of Medical Screening
https://www.readbyqxmd.com/read/28528615/chronic-tender-ulcers-on-the-calf-and-both-forearms
#2
Michael C Cameron, Mitsuya Katayama, Nishit S Patel, Philip D Shenefelt, Charurut Somboonwit
An elderly woman presented with a 3-month history of nonhealing, tender ulcers involving the right calf and both forearms. She denied any history of similar lesions or trauma. Two trials of oral antibiotics had led to no improvement. Her medical history was significant for rheumatoid arthritis treated with methotrexate, hydroxychloroquine, and prednisone. A review of clinical manifestations was otherwise negative for disease. Physical examination of the patient's right calf revealed two punched-out ulcers with central necrotic black eschars, underlying retiform purpuric pattern, and mild fibrinopurulent drainage (Figure 1)...
2017: Skinmed
https://www.readbyqxmd.com/read/28527588/mechanical-thrombectomy-for-acute-ischemic-stroke-in-a-patient-with-concomitant-spontaneous-intracerebral-hemorrhage
#3
Stefano Forlivesi, Paolo Bovi, Manuel Cappellari
Data from randomized clinical trials and current guidelines suggest that patients with anterior circulation occlusion with contraindications to intravenous thrombolysis may benefit from direct mechanical thrombectomy. Nevertheless, no data are available on the efficacy and safety of direct mechanical thrombectomy in patients with concomitant spontaneous intracerebral hemorrhage. We report the case of a 51-year-old woman with a spontaneous intracerebral hemorrhage in the right parietal and occipital lobes, who experienced, 7 days later, an occlusion of the proximal left middle cerebral artery...
May 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28522311/effect-of-second-timed-appointments-for-non-attenders-of-breast-cancer-screening-in-england-a-randomised-controlled-trial
#4
Prue C Allgood, Roberta Maroni, Sue Hudson, Judith Offman, Anne E Turnbull, Lesley Peacock, Jim Steel, Geraldine Kirby, Christine E Ingram, Julie Somers, Clare Fuller, Anthony G Threlfall, Rhian Gabe, Anthony J Maxwell, Julietta Patnick, Stephen W Duffy
BACKGROUND: In England, participation in breast cancer screening has been decreasing in the past 10 years, approaching the national minimum standard of 70%. Interventions aimed at improving participation need to be investigated and put into practice to stop this downward trend. We assessed the effect on participation of sending invitations for breast screening with a timed appointment to women who did not attend their first offered appointment within the NHS Breast Screening Programme (NHSBSP)...
May 15, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28515940/nivolumab-induced-autoimmune-diabetes-mellitus-presenting-as-diabetic-ketoacidosis-in-a-patient-with-metastatic-lung-cancer
#5
James Luke Godwin, Shuchie Jaggi, Imali Sirisena, Pankaj Sharda, Ajay D Rao, Ranee Mehra, Colleen Veloski
BACKGROUND: Advances in cancer immunotherapy have generated encouraging results in multiple malignancies refractory to standard chemotherapies. As the use of immune checkpoint inhibitors (ICI) proliferates, the incidence of autoimmune side effects associated with these agents, termed immune related adverse events (irAE), is expected to increase. The frequency of significant irAE in ICI treated patients is about 10-20% and early recognition is critical to prevent serious morbidity and even mortality...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28515936/pulse-dose-steroids-in-severe-pulmonary-arterial-hypertension-secondary-to-systemic-lupus-erythematosus
#6
Cody Lee, Jean Elwing
OBJECTIVE: The pulmonary vascular targeted treatment for systemic lupus erythematosus-associated pulmonary arterial hypertension is similar to other connective tissue disease-associated pulmonary arterial hypertension. In addition, there also appears to be a role for immunosuppression in the overall management. However, the optimal immunosuppressive regimen and what patients will respond to treatments are currently not clearly elucidated given the lack of randomized controlled trials on the subject...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28511086/local-endometrial-injury-in-women-with-failed-ivf-undergoing-a-repeat-cycle-a-randomized-controlled-trial
#7
Aleyamma Tk, Himanshu Singhal, Prasanna S Premkumar, Mousumi Acharya, Mohan S Kamath, Korula George
OBJECTIVE: To evaluate the effectiveness of local endometrial injury in women undergoing in vitro fertilization (IVF) with at least one previous unsuccessful attempt. STUDY DESIGN: Randomized controlled trial. Recruited women were randomized into two groups. In group A (pipelle group), women underwent pipelle biopsy twice in the luteal phase in the cycle prior to IVF. In group B (control), women did not undergo any intervention prior to IVF. The primary outcome was clinical pregnancy rate...
May 4, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28507839/issues-in-managing-hurthle-cell-carcinoma-of-thyroid-a-case-report
#8
Patricia Tai, Martin Korzeniowski, Evgeny Sadikov, Kurian Joseph, Angus Kirby, Jon Tonita, Aamer Mahmud
A 61-year-old woman noticed a right neck lump in October 2001. Fine needle aspiration showed follicular neoplasm, adenoma versus carcinoma. The ultrasound scan showed a solid mass of maximum dimension of 3.7 cm. She had a right thyroid lobectomy and isthmectomy in January 2002 (first surgery). The tissue specimen showed a 4.5 cm Hurthle cell carcinoma (HCC) with vascular invasion. There were no capsular invasion, extra-thyroidal extension, or margin involvement. A completion left lobectomy (second surgery) was performed two weeks later...
April 14, 2017: Curēus
https://www.readbyqxmd.com/read/28506267/a-qualitative-study-on-acceptable-levels-of-risk-for-pregnant-women-in-clinical-research
#9
Indira S E van der Zande, Rieke van der Graaf, Martijn A Oudijk, Johannes J M van Delden
BACKGROUND: There is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as a case-study...
May 15, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28500120/the-clinical-conundrum-of-diagnosing-and-treating-systemic-sarcoidosis-in-a-high-tb-burden-area
#10
Krishnadas Thulasidoss, Lavanya Asokan, Piyush Chandra, Pravinkumar Rejliwal
A 53-year-old woman from Southern India presented with weight loss, anorexia, fever and asthenia. Whole body positron emission tomography/computed tomography (PET-CT) showed fluorodeoxyglucose-avid mediastinal and abdominal lymphadenopathy with hepatic, splenic, parotid and lacrimal glandular inflammations. Endoscopic ultrasound-guided fine needle aspiration of subcarinal lymph node showed non-caseating granulomas. Initial serum ACE level was elevated but with normal calcium. Despite the suspicion of sarcoidosis, a trial of antituberculosis therapy was started empirically due to similar presentations of disseminated tuberculosis (TB) in this high endemic area...
May 12, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28499444/a-french-national-breast-and-thyroid-cancer-screening-programme-for-survivors-of-childhood-adolescent-and-young-adult-caya-cancers-denacapst-programme
#11
Charlotte Demoor-Goldschmidt, Delphine Drui, Isabelle Doutriaux, Gérard Michel, Pascal Auquier, Agnès Dumas, Claire Berger, Valérie Bernier, Sandrine Bohrer, Pierre-Yves Bondiau, Bruno Filhon, Brice Fresneau, Claire Freycon, Dinu Stefan, Sylvie Helfre, Angela Jackson, Christine Kerr, Anne Laprie, Julie Leseur, Marc-André Mahé, Caroline Oudot, Claire Pluchard, Stéphanie Proust, Hélène Sudour-Bonnange, Céline Vigneron, Nathalie Lassau, Martin Schlumberger, Cécile Faure Conter, Florent de Vathaire
BACKGROUND: Survival of childhood, adolescent and young adult (CAYA) cancers has increased with progress in the management of the treatments and has reached more than 80% at 5 years. Nevertheless, these survivors are at great risk of second cancers and non-malignant co-morbidities in later life. DeNaCaPST is a non-interventional study whose aim is to organize a national screening for thyroid cancer and breast cancer in survivors of CAYA cancers. It will study the compliance with international recommendations, with the aim, regarding a breast screening programme, of offering for every woman living in France, at equal risk, an equal screening...
May 12, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28495681/a-comparative-analysis-of-costs-of-single-and-dual-rapid-hiv-and-syphilis-diagnostics-results-from-a-randomised-controlled-trial-in-colombia
#12
Carol Dayo Obure, Hernando Gaitan-Duarte, Ricardo Losada Saenz, Lina Gonzalez, Edith Angel-Muller, Maura Laverty, Freddy Perez
BACKGROUND: HIV and congenital syphilis are major public health burdens contributing to substantial perinatal morbidity and mortality globally. Although studies have reported on the costs and cost-effectiveness of rapid diagnostic tests (RDTs) for syphilis screening within antenatal care in a number of resource-constrained settings, empirical evidence on country-specific cost and estimates of single RDTs compared with dual RDTs for HIV and syphilis are limited. METHODS: A cluster randomised controlled study design was used to compare the incremental costs of two testing algorithms: (1) single RDTs for HIV and syphilis and (2) dual RDTs for HIV and syphilis, in 12 health facilities in Bogota and Cali, Colombia...
May 11, 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28495299/a-randomized-comparison-of-a-novel-nitinol-frame-low-dose-copper-intrauterine-contraceptive-and-a-copper-t380s-intrauterine-contraceptive
#13
Matthew F Reeves, Bob Katz, Juan M Canela, Mark J Hathaway, Michael G Tal
OBJECTIVE: We sought to compare VeraCept (VC175), a novel nitinol intrauterine contraceptive (IUC) with 175 square-mm of copper surface area, to a copper T380S IUC. STUDY DESIGN: We enrolled parous women into a randomized subject-blinded comparison of VC175 and a copper T380S in a 2:1 fashion at a single clinic. The primary outcomes were total adverse events and continuation at 12months. We also examined pain on insertion, ease of placement, expulsion, tolerability and pregnancy...
May 8, 2017: Contraception
https://www.readbyqxmd.com/read/28486704/cost-effectiveness-analysis-of-lifestyle-intervention-in-obese-infertile-women
#14
A M van Oers, M A Q Mutsaerts, J M Burggraaff, W K H Kuchenbecker, D A M Perquin, C A M Koks, R van Golde, E M Kaaijk, J M Schierbeek, N F Klijn, Y M van Kasteren, J A Land, B W J Mol, A Hoek, H Groen
STUDY QUESTION: What is the cost-effectiveness of lifestyle intervention preceding infertility treatment in obese infertile women? SUMMARY ANSWER: Lifestyle intervention preceding infertility treatment as compared to prompt infertility treatment in obese infertile women is not a cost-effective strategy in terms of healthy live birth rate within 24 months after randomization, but is more likely to be cost-effective using a longer follow-up period and live birth rate as endpoint...
May 9, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28483270/the-impact-of-written-information-and-counseling-woman-pro-ii-program-on-symptom-outcomes-in-women-with-vulvar-neoplasia-a-multicenter-randomized-controlled-phase-ii-study
#15
Silvia Raphaelis, Hanna Mayer, Stefan Ott, Michael D Mueller, Enikö Steiner, Elmar Joura, Beate Senn
OBJECTIVE: To determine whether written information and/or counseling based on the WOMAN-PRO II Program decreases symptom prevalence in women with vulvar neoplasia by a clinically relevant degree, and to explore the differences between the 2 interventions in symptom prevalence, symptom distress prevalence, and symptom experience. METHODS: A multicenter randomized controlled parallel-group phase II trial with 2 interventions provided to patients after the initial diagnosis was performed in Austria and Switzerland...
May 5, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28475396/-in-god-we-trust-and-other-factors-influencing-trial-of-labor-vs-repeat-cesarean-section
#16
Meir Pomeranz, Nissim Arbib, Limor Haddif, Hana Reissner, Yitzhak Romem, Tal Biron
PURPOSE: To investigate factors influencing women's decisions to undergo trial of labor after cesarean (TOLAC) or elective repeat cesarean delivery (ERCD) based on the Multidimensional Health Locus of Control (MHLC), religious observance and family planning. MATERIAL AND METHODS: Cross-sectional study of candidates for TOLAC or ERCD at two hospitals in Israel. Eligible women completed a demographic questionnaire and Form C of the MHLC scale. RESULTS: The study included 197 women...
May 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28473943/cyclosporine-is-a-potential-curative-treatment-option-for-advanced-thymoma
#17
Yusuke Isshiki, Hiroaki Tanaka, Yoshio Suzuki, Yukihiro Yoshida
BACKGROUND: Thymectomy can effectively cure most thymoma patients; however, patients with advanced thymoma typically require chemotherapy, which is associated with limited efficacy in this context. Here we provide the first report of a patient with recurrent thymoma who achieved complete remission (CR) using cyclosporine therapy. CASE PRESENTATION: A 63-year-old woman who had undergone resection surgery for recurrent type B1 thymoma developed pure red cell aplasia (PRCA), and CT findings revealed thymoma recurrence...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28470971/impact-of-integrated-services-on-hiv-testing-a-nonrandomized-trial-among-kenyan-family-planning-clients
#18
Kathryn Church, Charlotte E Warren, Isolde Birdthistle, George B Ploubidis, Keith Tomlin, Weiwei Zhou, James Kimani, Timothy Abuya, Charity Ndwiga, Sedona Sweeney, Susannah H Mayhew
The impact of integrated reproductive health and HIV services on HIV testing and counseling (HTC) uptake was assessed among 882 Kenyan family planning clients using a nonrandomized cohort design within six intervention and six "comparison" facilities. The effect of integration on HTC goals (two tests over two years) was assessed using conditional logistic regression to test four "integration" exposures: a training and reorganization intervention; receipt of reproductive health and HIV services at recruitment; a functional measure of facility integration at recruitment; and a woman's cumulative exposure to functionally integrated care across different facilities over time...
May 4, 2017: Studies in Family Planning
https://www.readbyqxmd.com/read/28466375/impressive-and-durable-response-to-nivolumab-in-a-patient-with-metastatic-type-2-papillary-renal-cell-carcinoma-on-label-but-without-evidence
#19
Diego A Adrianzen Herrera, Sarah B Fleisig, Benjamin A Gartrell
Nivolumab is a treatment option for patients with metastatic renal cell carcinoma (RCC) previously treated with targeted antiangiogenic therapy. Papillary renal cell carcinoma (PRCC) comprises 10-15% of RCC cases but non-clear cell subtypes were excluded from the immunotherapy trials. We report the case of a woman with recurrent metastatic PRCC who had an impressive therapeutic response to nivolumab with no significant adverse events. She had previously been treated with sunitinib and pazopanib with no response...
May 2, 2017: Investigational New Drugs
https://www.readbyqxmd.com/read/28463789/effects-of-mindfulness-on-maternal-stress-depressive-symptoms-and-awareness-of-present-moment-experience-a-pilot-randomised-trial
#20
Jill Beattie, Helen Hall, Mary Anne Biro, Christine East, Rosalind Lau
OBJECTIVE: To determine the feasibility and acceptability and measure the effects of a mindfulness intervention compared to a pregnancy support program on stress, depressive symptoms and awareness of present moment experience. DESIGN: A pilot randomised trial using mixed methods. PARTICIPANTS AND SETTING: Forty-eight women attending a maternity service were randomly allocated to a mindfulness-based or pregnancy support program. MEASURES: Perceived Stress Scale, Edinburgh Postnatal Depression Scale, Mindfulness Attention Awareness Scale, and Birth Outcomes...
April 22, 2017: Midwifery
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