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https://www.readbyqxmd.com/read/29342309/prognostic-power-of-a-tumor-differentiation-gene-signature-for-bladder-urothelial-carcinomas
#1
Qianxing Mo, Fotis Nikolos, Fengju Chen, Zoe Tramel, Yu-Cheng Lee, Kazukuni Hayashi, Jing Xiao, Jianjun Shen, Keith Syson Chan
Background: Muscle-invasive bladder cancers (MIBCs) cause approximately 150 000 deaths per year worldwide. Survival for MIBC patients is heterogeneous, with no clinically validated molecular markers that predict clinical outcome. Non-MIBCs (NMIBCs) generally have favorable outcome; however, a portion progress to MIBC. Hence, development of a prognostic tool that can guide decision-making is crucial for improving clinical management of bladder urothelial carcinomas. Methods: Tumor grade is defined by pathologic evaluation of tumor cell differentiation, and it often associates with clinical outcome...
January 12, 2018: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/29342067/there-is-no-column-a-new-classification-for-acetabular-fractures
#2
Amir Herman, Shay Tenenbaum, Vladislav Ougortsin, Nachshon Shazar
BACKGROUND: The surgical treatment of acetabular fractures relies on the understanding of fracture architecture and their classification. The Judet and Letournel classification has been the cornerstone in understanding and treating acetabular fractures. Recently, there has been growing evidence of discrepancies and incompleteness in the Judet and Letournel classification, adversely affecting its clinical use. This study describes a novel comprehensive classification system that will direct surgical approach and fixation methods...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29342044/elevated-level-of-myeloperoxidase-deoxyribonucleic-acid-complex-in-the-middle-ear-fluid-obtained-from-patients-with-otitis-media-associated-with-antineutrophil-cytoplasmic-antibody-associated-vasculitis
#3
Shinya Morita, Yuji Nakamaru, Daigo Nakazawa, Fumihiko Hattanda, Haruki Shida, Yoshihiro Kusunoki, Kanako Watanabe, Sakiko Masuda, Dai Takagi, Masanobu Suzuki, Kimiko Hoshino, Atsushi Fukuda, Utano Tomaru, Akihiro Homma, Akihiro Ishizu
OBJECTIVE: The purpose was to explore the presence of myeloperoxidase (MPO)-deoxyribonucleic acid (DNA) complex as a surrogate marker of neutrophil extracellular traps (NETs) in the middle ear fluid, and to clarify the correlation between its quantifiable level and hearing outcome in patients with otitis media associated with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). STUDY DESIGN: Prospective study. SETTING: Tertiary referral center...
January 16, 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29340725/decision-making-in-management-of-the-complex-trauma-patient-changing-the-mindset-of-the-non-trauma-surgeon
#4
Linda Sonesson, Kenneth Boffard, Lars Lundberg, Martin Rydmark, Klas Karlgren
BACKGROUND: European surgeons are frequently subspecialized and trained primarily in elective surgical techniques. As trauma leaders, they may occasionally have to deal with complex polytrauma, advanced management techniques, differing priorities, and the need for multidisciplinary care. There is a lack of expertise, experience, and a low trauma volume, as well as a lack of research, with limited support as to the decision-making and teaching challenges present. We studied what experienced trauma experts describe as the challenges that are specific to the advanced surgical decision-making required, whether civilian, humanitarian, or military...
January 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29340680/association-of-bariatric-surgery-vs-medical-obesity-treatment-with-long-term-medical-complications-and-obesity-related-comorbidities
#5
Gunn Signe Jakobsen, Milada Cvancarova Småstuen, Rune Sandbu, Njord Nordstrand, Dag Hofsø, Morten Lindberg, Jens Kristoffer Hertel, Jøran Hjelmesæth
Importance: The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. Objective: To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Design, Setting, and Participants: Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29339011/facilitators-and-barriers-to-healthy-pregnancy-spacing-among-medicaid-beneficiaries-findings-from-the-national-strong-start-initiative
#6
Caitlin Cross-Barnet, Brigette Courtot, Ian Hill, Sarah Benatar, Morgan Cheeks, Jenny Markell
BACKGROUND: Closely spaced, unintended pregnancies are common among Medicaid beneficiaries and create avoidable risks for women and infants, including preterm birth. The Strong Start for Mothers and Newborns Initiative, a program of the Center for Medicare and Medicaid Innovation, intended to prevent preterm birth through psychosocially based enhanced prenatal care in maternity care homes, group prenatal care, and birth centers. Comprehensive care offers the opportunity for education and family planning to promote healthy pregnancy spacing...
January 12, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29338893/the-desired-role-of-health-care-providers-in-guiding-older-patients-with-distal-radius-fractures-a-qualitative-analysis
#7
Helen E Huetteman, Melissa J Shauver, Jacob S Nasser, Kevin C Chung
PURPOSE: Understanding patient preferences for shared decision making is valuable for surgeons to advance patient-centered care, particularly in cases where there is not a clearly superior treatment option, like distal radius fracture. The existing evidence presents conflicting views on the desired role of the provider among older patients when making medical decisions. We aimed to investigate the perceived versus desired role of the provider in older adult patients with distal radius fracture...
January 12, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29337776/l%C3%A3-mann-index-at-diagnosis-predicts-the-risk-of-early-surgery-in-crohn-s-disease
#8
Wei Liu, Wei Zhou, Jianjian Xiang, Qian Cao, Jinzhou Zhu, Weilin Qi, Pengpeng Chen, Qingwen Xie
BACKGROUND: Identifying patients with Crohn's disease with rapid disease progress or high risk of early surgery is crucial to clinical decision making. OBJECTIVE: The aim was to evaluate the correlation between the Lémann index at diagnosis and abdominal surgery in the first year after Crohn's disease diagnosis and to find the risk factors for early surgery. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted at a single tertiary hospital...
February 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29334495/the-ethics-of-interventional-procedures-for-patients-too-ill-for-surgery
#9
Caroline G Kan, Michael Nurok
PURPOSE OF REVIEW: Minimally invasive interventional procedures are increasingly popular options for patients who are high-risk candidates for open surgical procedures. It is unclear how to proceed in the rare circumstance of a complication during an interventional procedure, where addressing the complication would require exposing the patient to the full risk that was being avoided with the minimally invasive technique. This review provides recommendations on how to approach this paradoxical scenario...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29331842/predicting-1-year-disability-and-mortality-of-injured-older-adults
#10
Alvin D Jeffery, Mary S Dietrich, Cathy A Maxwell
PURPOSE: The growing incidence of elderly patients injured from falls, combined with a growing understanding of the contribution of cognition and frailty to mortality, prompted this work. Our objective was to develop a clinical risk prediction model for prognosticating disability and mortality among injured older adults 1 year after hospitalization. METHODS: Secondary analysis of prospective longitudinal data from an urban Level 1 trauma center. A proportional odds regression model was used to model mortality and functional status as ordinal outcomes...
January 6, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#11
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29328004/thoracolumbar-injury-classification-and-severity-score-in-children-a-reliability-study
#12
Ross L Dawkins, Joseph H Miller, Omar I Ramadan, Michael C Lysek, Elizabeth N Kuhn, Brandon G Rocque, Michael J Conklin, R Shane Tubbs, Beverly C Walters, Bonita S Agee, Curtis J Rozzelle
OBJECTIVE There are many classification systems for injuries of the thoracolumbar spine. The recent Thoracolumbar Injury Classification and Severity Score (TLICS) has been shown to be a reliable tool for adult patients. The aim of this study was to assess the reliability of the TLICS system in pediatric patients. The validity of the TLICS system is assessed in a companion paper. METHODS The medical records of pediatric patients with acute, traumatic thoracolumbar fractures at a single Level 1 trauma center were retrospectively reviewed...
January 12, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29326842/barriers-to-peritoneal-dialysis-in-aboriginal-patients
#13
Anna T Mathew, Joonho Park, Mala Sachdeva, Manish M Sood, Karen Yeates
Background: Aboriginal people in Canada have an unduly high burden of end-stage kidney disease (ESKD) and many live in rural settings. Peritoneal dialysis (PD) is a home-based dialysis modality that may provide a valuable alternative to in-center hemodialysis which is relatively underutilized by the Aboriginal population. Objective: We aim to assess the barriers to PD utilization in Aboriginal patients with ESKD. Design: This article is a prospective observational cohort study...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29325764/self-management-model-in-the-scheduling-of-successive-appointments-in-rheumatology
#14
David Castro Corredor, José Luis Cuadra Díaz, Javier José Mateos Rodríguez, Joaquín Anino Fernández, María Dolores Mínguez Sánchez, Isabel María de Lara Simón, María Ángeles Tébar, Encarnación Añó, María Dolores Sanz, María Nieves Ballester
INTRODUCTION: The rheumatology service of Ciudad Real Hospital, located in an autonomous community of that same name that is nearly in the center of Spain, implemented a self-management model of successive appointments more than 10 years ago. Since then, the physicians of the department schedule follow-up visits for their patients depending on the disease, its course and ancillary tests. The purpose of this study is to evaluate and compare the self-management model for successive appointments in the rheumatology service of Ciudad Real Hospital versus the model of external appointment management implemented in 8 of the hospital's 15 medical services...
January 8, 2018: Reumatología Clinica
https://www.readbyqxmd.com/read/29325548/a-pre-post-study-testing-a-lung-cancer-screening-decision-aid-in-primary-care
#15
Daniel S Reuland, Laura Cubillos, Alison T Brenner, Russell P Harris, Bailey Minish, Michael P Pignone
BACKGROUND: The United States Preventive Services Task Force (USPSTF) issued recommendations for older, heavy lifetime smokers to complete annual low-dose computed tomography (LDCT) scans of the chest as screening for lung cancer. The USPSTF recommends and the Centers for Medicare and Medicaid Services require shared decision making using a decision aid for lung cancer screening with annual LDCT. Little is known about how decision aids affect screening knowledge, preferences, and behavior...
January 12, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29324970/watson-for-oncology-and-breast-cancer-treatment-recommendations-agreement-with-an-expert-multidisciplinary-tumor-board
#16
S P Somashekhar, M-J Sepúlveda, S Puglielli, A D Norden, E H Shortliffe, C Rohit Kumar, A Rauthan, N Arun Kumar, P Patil, K Rhee, Y Ramya
Background: Breast cancer oncologists are challenged to personalize care with rapidly changing scientific evidence, drug approvals, and treatment guidelines. Artificial intelligence (AI) clinical decision-support systems (CDSSs) have the potential to help address this challenge. We report here the results of examining the level of agreement (concordance) between treatment recommendations made by the AI CDSS Watson for Oncology (WFO) and a multidisciplinary tumor board for breast cancer...
January 9, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29322168/patient-preferences-for-surgery-or-antibiotics-for-the-treatment-of-acute-appendicitis
#17
Alexis L Hanson, Ross D Crosby, Marc D Basson
Importance: Studies have compared surgical with nonsurgical therapy for acute uncomplicated appendicitis, but none of these studies have a patient-centered perspective. Objectives: To evaluate how patients might choose between surgical and nonsurgical therapy for acute uncomplicated appendicitis and to identify targets to make antibiotic treatment more appealing. Design, Setting, and Participants: This study comprised an online survey and an in-person sensitivity analysis survey...
January 10, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29318344/severe-casualties-from-bastille-day-attack-in-nice-france
#18
Federico Solla, Joseph Carboni, Arnaud Fernandez, Audrey Dupont, Nathalie Chivoret, Gilles Brézac, Virginie Rampal, Jean Bréaud
PURPOSE: To describe the most severe casualties from the July 14th, 2016 terror attack in Nice that were treated at the Lenval University Children's Hospital (LUCH) of Nice (France). METHODS: Retrospective study about casualties treated at LUCH from Bastille Day Attack with injuries resulting in the need for surgery, resuscitation, or death. The type of lesions and surgery, duration of hospitalizations, complications, psychological status, and outcome at discharge were collected...
January 9, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29316774/how-to-optimize-aesthetic-outcomes-in-implant-based-breast-reconstruction
#19
Maurizio Bruno Nava, Giuseppe Catanuto, Nicola Rocco
The evolution of breast reconstructive surgery keeps pace with the evolution of breast oncologic surgery. The reconstructive choice should always balance the optimal local control of disease and the best cosmetic result, reflecting an informed decision that is shared with the patient, who is always at the center of the decision-making process. Implant-based breast reconstruction following mastectomy represents a complex choice. In order to obtain optimal results, the following considerations are mandatory: thorough preoperative planning, a complete knowledge of the devices that are used, accurately performed surgery, and appropriate follow-up...
January 10, 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29315090/incidence-and-risk-factors-for-anastomotic-failure-in-1594-patients-treated-by-transanal-total-mesorectal-excision-results-from-the-international-tatme-registry
#20
Marta Penna, Roel Hompes, Steve Arnold, Greg Wynn, Ralph Austin, Janindra Warusavitarne, Brendan Moran, George B Hanna, Neil J Mortensen, Paris P Tekkis
OBJECTIVE: To determine the incidence of anastomotic-related morbidity following Transanal Total Mesorectal Excision (TaTME) and identify independent risk factors for failure. BACKGROUND: Anastomotic leak and its sequelae are dreaded complications following gastrointestinal surgery. TaTME is a recent technique for rectal resection, which includes novel anastomotic techniques. METHODS: Prospective study of consecutive reconstructed TaTME cases recorded over 30 months in 107 surgical centers across 29 countries...
January 5, 2018: Annals of Surgery
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