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https://www.readbyqxmd.com/read/29154259/evaluation-of-coefficients-to-derive-organ-and-effective-doses-from-cone-beam-ct-cbct-scans-a-monte-carlo-study
#1
Abdullah Abuhaimed, Colin J Martin
Regular imaging is used throughout image guided radiation therapy (IGRT) to improve treatment delivery. In order for treatment procedures to be optimized, the doses delivered by imaging exposures should be taken into account. CT dosimetry methods based on the CT dose index (CTDI), measured with a 100 mm long pencil ionization chamber (CTDI<sub>100</sub>) in standard phantoms, are not designed for the cone beam CT (CBCT) imaging systems used in radiotherapy, therefore a modified version has been proposed for CBCT by the International Electrotechnical Commission (CTDI<sub>IEC</sub>)...
November 20, 2017: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
https://www.readbyqxmd.com/read/29152777/evidence-synthesis-from-aggregate-recurrent-event-data-for-clinical-trial-design-and-analysis
#2
Björn Holzhauer, Craig Wang, Heinz Schmidli
Information from historical trials is important for the design, interim monitoring, analysis, and interpretation of clinical trials. Meta-analytic models can be used to synthesize the evidence from historical data, which are often only available in aggregate form. We consider evidence synthesis methods for trials with recurrent event endpoints, which are common in many therapeutic areas. Such endpoints are typically analyzed by negative binomial regression. However, the individual patient data necessary to fit such a model are usually unavailable for historical trials reported in the medical literature...
November 20, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/29148070/growth-factors-for-diabetic-foot-ulcers-mixed-treatment-comparison-analysis-of-randomized-clinical-trials
#3
Kannan Sridharan, Gowri Sivaramakrishnan
AIMS: Topical growth factors accelerate wound healing in patients with diabetic foot ulcers (DFU). Due to the absence of head to head comparisons, we carried out Bayesian network meta-analysis to compare the efficacy and safety of growth factors. METHODS: Using an appropriate search strategy, randomized controlled trials on topical growth factors compared with standard of care in patients with DFU, were included. Proportion of patients with complete healing was the primary outcome...
November 17, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29143283/evaluation-of-sequential-spect-and-ct-for-targeted-radionuclide-therapy-dosimetry
#4
Tiantian Li, Nien-Yun Wu, Na Song, Greta S P Mok
PURPOSE: In targeted radionuclide therapy (TRT), a prior knowledge of the absorbed dose biodistribution is essential for pre-therapy treatment planning. Previously, we showed that non-rigid organ-by-organ registration in sequential quantitative SPECT images improved dose estimation. This study aims to investigate if sequential CT can further improve TRT dosimetric accuracy. METHODS: We simulated SPECT/CT acquisitions at 1, 12, 24, 72 and 144 h In-111 Zevalin post-injection using an analytical MEGP projector, modeling attenuation, scatter and collimator-detector response...
November 15, 2017: Annals of Nuclear Medicine
https://www.readbyqxmd.com/read/29143085/clinical-significance-of-new-magnetic-resonance-thoracic-ductography-before-thoracoscopic-esophagectomy-for-esophageal-cancer
#5
Junya Oguma, Soji Ozawa, Akihito Kazuno, Miho Nitta, Yamato Ninomiya, Kentaro Yatabe, Tetsu Niwa, Takakiyo Nomura
BACKGROUND: Preoperative simulation of the thoracic duct using magnetic resonance thoracic ductography (MRTD) would enable a safe lymph node dissection near the thoracic duct and the prevention of chylothorax after an esophagectomy. The aim of this study was to determine whether MRTD is useful for preventing injury to the thoracic duct during surgery and for reducing the incidence of chylothorax after surgery. METHODS: We evaluated 130 patients who underwent preoperative MRTD followed by a thoracoscopic esophagectomy for the treatment of thoracic esophageal cancer between August 2014 and April 2017 (MRTD group)...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29140596/florence-robotic-intracorporeal-neobladder-florin-a-new-reconfiguration-strategy-developed-following-the-ideal-guidelines
#6
Andrea Minervini, Davide Vanacore, Gianni Vittori, Martina Milanesi, Agostino Tuccio, Giampaolo Siena, Riccardo Campi, Andrea Mari, Andrea Gavazzi, Marco Carini
OBJECTIVE: To describe our step-by-step technique for robotic intracorporeal neobladder configuration, including the stages of conception, development and exploration of this surgical innovation, according to the IDEAL Collaboration guidelines. PATIENTS AND METHODS: FloRIN neobladder was performed after the following main surgical steps: isolation of 50 cm of ileum; bowel anastomosis; urethro-ileal anastomosis creating an asymmetrical U shape (30 cm distally and 20 cm proximally to anastomosis), ileum detubularisation; posterior wall reconfiguration as an L; bladder neck reconstruction; anterior folding of the posterior plate to reach the 12 o'clock position; uretero-enteral "orthotopic" bilateral anastomosis...
November 15, 2017: BJU International
https://www.readbyqxmd.com/read/29138584/repeated-intermittent-ulipristal-acetate-in-the-treatment-of-uterine-fibroids-a-cost-effectiveness-analysis
#7
Kirk Geale, Ertan Saridogan, Matthieu Lehmann, Pablo Arriagada, Marcus Hultberg, Martin Henriksson
There are limited treatment options available for women with moderate to severe symptoms of uterine fibroids (UFs) who wish to avoid surgery. For these women, treatment with standard pharmaceuticals such as contraceptives is often insufficient to relieve symptoms, and patients may require surgery despite their wish to avoid it. Clinical trials demonstrate that ulipristal acetate 5 mg (UPA) is an effective treatment for this patient group, but its cost-effectiveness has not been assessed in this population. A decision-analytic model was developed to simulate a cohort of patients in this population under treatment with UPA followed by surgery as needed compared to treatment with iron and non-steroidal anti-inflammatory drug (NSAID) followed by surgery as needed (best supportive care, BSC)...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29136270/60-seconds-to-survival-a-pilot-study-of-a-disaster-triage-video-game-for-prehospital-providers
#8
Mark X Cicero, Travis Whitfill, Kevin Munjal, Manu Madhok, Maria Carmen G Diaz, Daniel J Scherzer, Barbara M Walsh, Angela Bowen, Michael Redlener, Scott A Goldberg, Nadine Symons, James Burkett, Joseph C Santos, David Kessler, Ryan N Barnicle, Geno Paesano, Marc A Auerbach
INTRODUCTION: Disaster triage training for emergency medical service (EMS) providers is not standardized. Simulation training is costly and time-consuming. In contrast, educational video games enable low-cost and more time-efficient standardized training. We hypothesized that players of the video game "60 Seconds to Survival" (60S) would have greater improvements in disaster triage accuracy compared to control subjects who did not play 60S. METHODS: Participants recorded their demographics and highest EMS training level and were randomized to play 60S (intervention) or serve as controls...
April 2017: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/29135848/using-simulation-to-hardwire-bedside-shift-report
#9
Arvis K Connolly
Numerous attempts to move nursing handoff to the bedside failed within our organization. Upon retrospect, previous attempts lacked standardization, coordination, and clear expectations. With emphasis on implementing patient- and family-centered care to increase patient experience scores, we developed a standardized staff training methodology using didactic and simulation to address staff barriers to adoption, a standardized implementation process, and a process to hardwire the practice.
December 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29134571/optimizing-residents-performance-of-lumbar-puncture-an-rct-comparing-the-effect-of-preparatory-interventions-on-performance-and-self-confidence
#10
Mikael Johannes Vuokko Henriksen, Troels Wienecke, Helle Thagesen, Rikke Borre Vita Jacobsen, Yousif Subhi, Ryan Brydges, Charlotte Ringsted, Lars Konge
BACKGROUND: Lumbar puncture is often associated with uncertainty and limited experience on the part of residents; therefore, preparatory interventions can be essential. There is growing interest in the potential benefit of videos over written text. However, little attention has been given to whether the design of the videos impacts on subsequent performance. OBJECTIVE: To investigate the effect of different preparatory interventions on learner performance and self-confidence regarding lumbar puncture (LP)...
November 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29131559/diagnostic-challenges-and-problem-cases-in-salivary-gland-cytology-a-20-year-experience
#11
Sajad Salehi, Zahra Maleki
BACKGROUND: Fine-needle aspiration (FNA) is routinely performed to evaluate salivary gland lesions, and provides valuable information regarding the cytomorphologic features of the lesions. Occasionally, there are overlaps between benign and malignant conditions due to heterogeneity of the cell types, metaplastic changes, and sampling issues. Herein, the authors present a retrospective study of diagnostic pitfalls in salivary gland cytology and the simulating conditions. METHODS: A 20-year retrospective review (1995-2015) of medical records was performed searching for the cytology reports of patients who underwent FNA of the salivary gland with the words "amendment" or "revision...
November 13, 2017: Cancer
https://www.readbyqxmd.com/read/29129904/perception-survey-on-the-introduction-of-clinical-performance-examination-as-part-of-the-national-nursing-licensing-examination-in-korea
#12
Su Jin Shin, Yeong Kyeong Kim, Soon-Rim Suh, Duk Yoo Jung, Yunju Kim, Mi Kyoung Yim
Purpose: The purpose of this study was to analyze opinions about the action plan for implementation clinical performance exam as part of the national nursing licensing examination and presents the expected effects of the performance exam and aspects to consider regarding its implementation. Methods: This study used a mixed-methods design. Quantitative data were collected by a questionnaire survey, while qualitative data were collected by focus group interviews with experts...
October 25, 2017: Journal of Educational Evaluation for Health Professions
https://www.readbyqxmd.com/read/29126314/cost-effectiveness-analysis-of-nivolumab-for-treatment-of-platinum-resistant-recurrent-or-metastatic-squamous-cell-carcinoma-of-the-head-and-neck
#13
Kathryn R Tringale, Kate T Carroll, Kaveh Zakeri, Assuntina G Sacco, Linda Barnachea, James D Murphy
Background: The CheckMate 141 trial found that nivolumab improved survival for patients with recurrent or metastatic head and neck cancer (HNC). Despite the improved survival, nivolumab is much more expensive than standard therapies. This study assesses the cost-effectiveness of nivolumab for the treatment of HNC. Methods: We constructed a Markov model to simulate treatment with nivolumab or standard single-agent therapy for patients with recurrent or metastatic platinum-refractory HNC...
November 3, 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/29125912/an-in-vitro-examination-of-the-effects-of-altitude-on-dry-powder-inhaler-performance
#14
Conor A Ruzycki, Andrew R Martin, Reinhard Vehring, Warren H Finlay
BACKGROUND: The effects of altitude on dry powder inhaler (DPI) performance remain understudied. As existing standardized testing methodologies do not consider altitude, inhalation devices may be used in environments in which their performance has not been sufficiently characterized. METHODS: Six DPIs spanning a range of device resistances were examined in vitro in an environmental chamber mimicking a high-altitude environment equivalent to an altitude of 4200 m, with controls established at an altitude of 700 m...
November 10, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/29125784/identifying-the-population-with-serious-illness-the-denominator-challenge
#15
Amy S Kelley, Evan Bollens-Lund
BACKGROUND: To ensure seriously ill people and their families receive high-quality primary and specialty palliative care services, rigorous methods are needed to prospectively identify this population. OBJECTIVE: To define and operationalize a definition of serious illness for the purpose of identifying patients and caregivers who need primary or specialty palliative care services. DESIGN/SETTING: Two stages of work included (1) building expert consensus around a conceptual definition of serious illness and (2) using the National Health and Aging Trends Study linked to Medicare claims data to test a range of operational definitions composed of diagnoses, utilization, and markers of care needs...
November 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29125413/a-computational-fluid-dynamics-simulation-framework-for-ventricular-catheter-design-optimization
#16
Sofy H Weisenberg, Stephanie C TerMaath, Charlotte N Barbier, Judith C Hill, James A Killeffer
OBJECTIVE Cerebrospinal fluid (CSF) shunts are the primary treatment for patients suffering from hydrocephalus. While proven effective in symptom relief, these shunt systems are plagued by high failure rates and often require repeated revision surgeries to replace malfunctioning components. One of the leading causes of CSF shunt failure is obstruction of the ventricular catheter by aggregations of cells, proteins, blood clots, or fronds of choroid plexus that occlude the catheter's small inlet holes or even the full internal catheter lumen...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29122556/effect-of-imaging-frequency-on-ptv-margins-and-geographical-miss-during-image-guided-radiation-therapy-for-prostate-cancer
#17
Meetakshi Gupta, Poonam Gamre, Sadhana Kannan, Ganesh Rokde, Rahul Krishnatry, Vedang Murthy
BACKGROUND: The relationship between frequency of imaging during image guided radiation therapy (IGRT) and planning target volume (PTV) margin remains unclear. This issue is of practical significance given resource and time intensive nature of IGRT. The purpose of this study was to evaluate PTV margins with predefined and commonly used less-than-daily IGRT schedules using data obtained from patients treated with daily IGRT for prostate cancer. METHODS AND MATERIALS: Daily setup error and 3-dimensional daily alignment data for a total of 108 consecutive patients with prostate cancer treated with 2700 fractions of daily image guidance on tomotherapy were retrospectively analyzed...
October 7, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29122046/model-based-cost-effectiveness-of-conventional-and-innovative-chemo-radiation-in-lung-cancer
#18
Mathilda L Bongers, Dirk de Ruysscher, Cary Oberije, Philippe Lambin, Carin A Uyl-de Groot, José Belderbos, Veerle M H Coupé
INTRODUCTION: Optimizing radiotherapy with or without chemotherapy through advanced imaging and accelerated radiation schemes shows promising results in locally advanced non-small-cell lung cancer (NSCLC). This study compared the cost-effectiveness of positron emission tomography-computed tomography based isotoxic accelerated sequential chemo-radiation (SRT2) and concurrent chemo-radiation with daily low-dose cisplatin (CRT2) with standard sequential (SRT1) and concurrent chemo-radiation (CRT1)...
November 10, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29121839/simplifying-piperacillin-tazobactam-dosing-pharmacodynamics-of-utilizing-only-4-5-or-3-375-g-doses-for-patients-with-normal-and-impaired-renal-function
#19
Abrar K Thabit, Mordechai Grupper, David P Nicolau, Joseph L Kuti
OBJECTIVES: To evaluate the pharmacodynamic exposure of piperacillin/tazobactam across the renal function range using 4.5 or 3.375 g dosing regimens. METHODS: A 5000-patient Monte Carlo simulation was conducted to determine the probability of achieving 50% free time above the minimum inhibitory concentration ( fT > MIC) for piperacillin. Proposed regimens, using solely 4.5 or 3.375 g strengths, were compared with regimens listed in piperacillin/tazobactam prescribing information over creatinine clearance (CrCl) ranges of 120 mL/min to hemodialysis...
December 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29121195/a-national-survey-of-simulation-use-in-university-programs-in-communication-sciences-and-disorders
#20
Carol C Dudding, Elizabeth E Nottingham
Purpose: This study provides a framework for understanding the range and diversity of simulation use, along with the benefits and challenges to the growth of simulation in university programs in communication sciences and disorders (CSD) across the United States. Method: A web-based questionnaire was developed and deployed to educators in undergraduate and graduate speech-language pathology and audiology programs in the American Speech-Language-Hearing Association EdFind database (N = 309)...
November 9, 2017: American Journal of Speech-language Pathology
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