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https://www.readbyqxmd.com/read/28747060/treatment-persistence-during-therapeutic-sequences-with-adalimumab-and-infliximab-in-the-treatment-of-crohn-s-disease
#1
Carlos Taxonera, Pilar Robledo, Antonio Rodriguez
BACKGROUND AND AIM: Tumor necrosis factor (TNF) inhibitors have demonstrated efficacy and safety in the treatment Crohn's disease (CD). However, the loss of response over time means that they are usually used sequentially. The aim of this study was to compare treatment persistence with different sequences of TNF inhibitors in patients with active luminal CD. METHODS: A Markov model (3-month cycles) was developed to simulate the therapeutic sequences of beginning biological treatment with infliximab or adalimumab, with a time horizon of three years...
July 27, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28746915/molecular-and-functional-characterization-of-a-new-3-end-kit-juxtamembrane-deletion-in-a-duodenal-gist-treated-with-neoadjuvant-imatinib
#2
Vittorio Perfetti, Erik Laurini, Suzana Aulić, Maurizio Fermeglia, Roberta Riboni, Marco Lucioni, Elena Dallera, Sara Delfanti, Luigi Pugliese, Francesco Saverio Latteri, Andrea Pietrabissa, Sabrina Pricl
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. GISTs express the receptor tyrosine kinase KIT, and the majority of GISTs present KIT gain-of-function mutations that cluster in the 5' end of the receptor juxtamembrane domain. On the other hand, little information is known about GISTs carrying mutations in the 3' end of the KIT juxtamembrane domain. Here we report and discuss a clinical case of localized duodenal GIST whose molecular characterization revealed the presence of a new 21 nucleotide/7 amino acid deletion in the 3' end of KIT juxtamembrane domain (Δ574-580)...
July 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28745934/spinal-cord-injury-clinical-registries-improving-care-across-the-sci-care-continuum-by-identifying-knowledge-gaps
#3
Marcel F Dvorak, Christiana L Cheng, Nader Fallah, Argelio Santos, Derek Atkins, Suzanne Humphreys, Carly S Rivers, Barry A B White, Chester Ho, Henry Ahn, Brian K Kwon, Sean Christie, Vanessa K Noonan
Timely access and ongoing delivery of care and therapeutic interventions is needed to maximize recovery and function after traumatic spinal cord injury (tSCI). To ensure these decisions are evidence-based, access to consistent, reliable, and valid sources of clinical data is required. The Access to Care and Timing Model used data from the Rick Hansen SCI Registry (RHSCIR) to generate a simulation of healthcare delivery for persons after tSCI and to test scenarios aimed at improving outcomes and reducing the economic burden of SCI...
July 26, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28744962/inverse-estimation-of-cardiac-activation-times-via-gradient-based-optimisation
#4
Siri Kallhovd, Mary M Maleckar, Marie E Rognes
Computational modeling may provide a quantitative framework for integrating multi-scale data to gain insight into mechanisms of heart disease, identify and test pharmacological and electrical therapy and interventions, and support clinical decisions. Patient-specific computational cardiac models can help guide such procedures, and cardiac inverse modelling is a promising alternative to adequately personalize these models. Indeed, full cardiac inverse modelling is currently becoming computationally feasible; however, fundamental work to assess the feasibility of emerging techniques is still needed...
July 25, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28743698/high-flow-nasal-cannula-in-bronchiolitis-modeling-the-economic-effects-of-a-ward-based-protocol
#5
Catherine Collins, Titus Chan, Joan S Roberts, Wren L Haaland, Davene R Wright
OBJECTIVES: High-flow nasal cannula (HFNC) use has increased in patients with bronchiolitis, with the majority of use restricted to the ICU. Broadening HFNC to the wards may have substantial economic implications. This study compares the cost of a standardized clinical pathway that permits HFNC use in the wards for patients with bronchiolitis with an ICU-only HFNC care model. METHODS: We constructed a decision analytic model to simulate 2 options for treating bronchiolitic patients: one in which HFNC is used in the wards (ward HFNC) and one in which HFNC is restricted to the ICU (ICU HFNC)...
July 25, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28740720/analysing-the-reasons-of-failure-of-surgical-mitral-repair-approaches-do-we-need-to-better-think-in-biomechanics
#6
Massimiliano Fraldi, Cristiano Spadaccio, Christos G Mihos, Francesco Nappi
The failure of mitral valve repair procedures revealed in the outcomes of the recent randomized studies is suggesting the necessity for a better understanding of the biomechanical mechanisms underlying the failure of the surgical approaches. Use of biomechanical modelling and finite element analysis (FEA) in cardiovascular research is an important aid in this context. In our group we developed a biomechanical model taking into account all the component of the mitral valve functional unit including the valve leaflets, the annulus, the papillary muscles, the chordae tendinea and the ventricular geometry...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28739242/helicopter-emergency-medical-service-simulation-training-in-the-extreme-simulation-based-training-in-a-mountain-weather-chamber
#7
Urs Pietsch, Ludwig Ney, Oliver Kreuzer, Armin Berner, Volker Lischke
Mountain rescue operations often confront crews with extreme weather conditions. Extremely cold temperatures make standard treatment sometimes difficult or even impossible. It is well-known that most manual tasks, including those involved in mountain rescue operations, are slowed by extremely cold weather. To lessen and improve the decrement in performance of emergency medical treatment caused by cold-induced manual impairment and inadequate medical equipment and supplies, simulation training in a weather chamber, which can produce wind and temperatures up to -22°C, was developed...
July 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28734531/event-based-control-of-depth-of-hypnosis-in-anesthesia
#8
Luca Merigo, Manuel Beschi, Fabrizio Padula, Nicola Latronico, Massimiliano Paltenghi, Antonio Visioli
BACKGROUND AND OBJECTIVE: In this paper, we propose the use of an event-based control strategy for the closed-loop control of the depth of hypnosis in anesthesia by using propofol administration and the bispectral index as a controlled variable. METHODS: A new event generator with high noise-filtering properties is employed in addition to a PIDPlus controller. The tuning of the parameters is performed off-line by using genetic algorithms by considering a given data set of patients...
August 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28728559/effect-of-insulin-therapy-and-dietary-adjustments-on-safety-and-performance-during-simulated-soccer-tests-in-people-with-type-1-diabetes-study-protocol-for-a-randomized-controlled-trial
#9
Javier Calvo-Marín, Gabriel Torrealba-Acosta, Matthew Campbell, Jesse Gaboury, Ajmol Ali, Chih Hao Chen-Ku
BACKGROUND: Despite the reduction in glycemic derangement in patients with type 1 diabetes mellitus (T1D) through dietary and therapeutic adjustments implemented before, during and after continuous exercise, evidence for its effectiveness with intermittent forms of exercise, such as soccer, is still lacking. METHODS/DESIGN: We designed a study protocol for a randomized, crossover, double-blinded, controlled trial, for the evaluation of the effect that a strategy of dietary and therapeutic modifications may have on safety and performance of persons with T1D in soccer training sessions and cognitive testing...
July 20, 2017: Trials
https://www.readbyqxmd.com/read/28725482/systems-biology-driving-drug-development-from-design-to-the-clinical-testing-of-the-anti-erbb3-antibody-seribantumab-mm-121
#10
REVIEW
Birgit Schoeberl, Art Kudla, Kristina Masson, Ashish Kalra, Michael Curley, Gregory Finn, Emily Pace, Brian Harms, Jaeyeon Kim, Jeff Kearns, Aaron Fulgham, Olga Burenkova, Viara Grantcharova, Defne Yarar, Violette Paragas, Jonathan Fitzgerald, Marisa Wainszelbaum, Kip West, Sara Mathews, Rachel Nering, Bambang Adiwijaya, Gabriela Garcia, Bill Kubasek, Victor Moyo, Akos Czibere, Ulrik B Nielsen, Gavin MacBeath
The ErbB family of receptor tyrosine kinases comprises four members: epidermal growth factor receptor (EGFR/ErbB1), human EGFR 2 (HER2/ErbB2), ErbB3/HER3, and ErbB4/HER4. The first two members of this family, EGFR and HER2, have been implicated in tumorigenesis and cancer progression for several decades, and numerous drugs have now been approved that target these two proteins. Less attention, however, has been paid to the role of this family in mediating cancer cell survival and drug tolerance. To better understand the complex signal transduction network triggered by the ErbB receptor family, we built a computational model that quantitatively captures the dynamics of ErbB signaling...
2017: NPJ Systems Biology and Applications
https://www.readbyqxmd.com/read/28721113/telehealth-and-ehealth-in-nurse-practitioner-training-current-perspectives
#11
REVIEW
Carolyn M Rutledge, Karen Kott, Patty A Schweickert, Rebecca Poston, Christianne Fowler, Tina S Haney
Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28714013/glioblastoma-entities-express-subtle-differences-in-molecular-composition-and-response-to-treatment
#12
Joana Balça-Silva, Diana Matias, Anália Do Carmo, Luiz Gustavo Dubois, Ana Cristina Gonçalves, Henrique Girão, Nathalie Henriques Silva Canedo, Ana Helena Correia, Jorge Marcondes De Souza, Ana Bela Sarmento-Ribeiro, Maria Celeste Lopes, Vivaldo Moura-Neto
Glioblastoma (GBM) is a grade IV astrocytoma. GBM patients show resistance to chemotherapy such as temozolomide (TMZ), the gold standard treatment. In order to simulate the molecular mechanisms behind the different chemotherapeutic responses in GBM patients we compared the cellular heterogeneity and chemotherapeutic resistance mechanisms in different GBM cell lines. We isolated and characterized a human GBM cell line obtained from a GBM patient, named GBM11. We studied the GBM11 behaviour when treated with Tamoxifen (TMX) that, among other functions, is a protein kinase C (PKC) inhibitor, alone and in combination with TMZ in comparison with the responses of U87 and U118 human GBM cell lines...
July 7, 2017: Oncology Reports
https://www.readbyqxmd.com/read/28712801/the-effect-of-pelvic-tilt-and-femoral-head-size-on-hip-range-of-motion-to-impingement
#13
Thomas F McCarthy, Jim Nevelos, Randa K Elmallah, Morad Chughtai, Anton Khlopas, Vincent Alipit, Timothy C Wagner, Michael A Mont
BACKGROUND: About 50%-70% of dislocators have cups placed within so-called "safe zones." It has been postulated that factors such as femoral head size and pelvic tilt, obliquity, or rotation may influence postoperative stability. Therefore, we assessed varying degrees of pelvic tilt and head sizes on the range of motion (ROM) to impingement. METHODS: A hip simulator was used to import models of 10 subjects who performed object pickup, squatting, and low-chair rising...
June 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28712105/evaluation-of-a-low-cost-3d-printed-model-for-bronchoscopy-training
#14
Matteo Parotto, Joshua Qua Jiansen, Ahmed AboTaiban, Svetlana Ioukhova, Alisher Agzamov, Richard Cooper, Gerald O'Leary, Massimiliano Meineri
BACKGROUND: Flexible bronchoscopy is a fundamental procedure in anesthesia and critical care medicine. Learning this procedure is a complex task, but the use of simulation-based training provides significant advantages like enhanced patient safety. Access to bronchoscopy simulators may be limited in low resources settings. We developed a low-cost 3D printed bronchoscopy training model. METHODS: A parametric airway model was obtained from an online medical model repository and fabricated using a low-cost 3D printer...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28710715/clinical-utility-of-a-blood-based-protein-assay-to-increase-screening-of-elevated-risk-patients-for-colorectal-cancer-in-the-primary-care-setting
#15
John Peabody, David Paculdo, Eric Swagel, Steven Fugaro, Mary Tran
PURPOSE: Colorectal cancer (CRC) screening is effective in finding early stage CRC and dramatically improves survival rates. Despite this, the number of eligible patients who do not obtain CRC screening is unacceptably high. METHODS: We conducted a longitudinal, randomized controlled trial investigating the utility of a blood-based protein assay on the quality of care delivered by practicing PCPs in the United States. We used standardized simulated patients (CPVs), presenting with symptoms suggestive of a higher likelihood of CRC, to measure how frequently these PCPs ordered diagnostic colonoscopy...
July 14, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28710576/the-effect-of-iodine-uptake-on-radiation-dose-absorbed-by-patient-tissues-in-contrast-enhanced-ct-imaging-implications-for-ct-dosimetry
#16
Kostas Perisinakis, Antonis Tzedakis, Kostas Spanakis, Antonios E Papadakis, Adam Hatzidakis, John Damilakis
OBJECTIVES: To investigate the effect of iodine uptake on tissue/organ absorbed doses from CT exposure and its implications in CT dosimetry. METHODS: The contrast-induced CT number increase of several radiosensitive tissues was retrospectively determined in 120 CT examinations involving both non-enhanced and contrast-enhanced CT imaging. CT images of a phantom containing aqueous solutions of varying iodine concentration were obtained. Plots of the CT number increase against iodine concentration were produced...
July 14, 2017: European Radiology
https://www.readbyqxmd.com/read/28707638/mimicking-rashes-use-of-moulage-technique-in-undergraduate-assessment-at-the-aga-khan-university-karachi
#17
Saniya Raghib Sabzwari, Azam Afzal, Kashmira Nanji
BACKGROUND: The use of simulated patients in student assessment is supported by the Best Evidence Medical Education and U.S. Agency for Healthcare Research and Quality, and it provides a safe and effective alternative to real patients in many situations. To assess the validity and feasibility of moulage technique-where a cosmetically constructed rash is used on simulated patients-two dermatologic rashes were developed using moulage simulation on standardized patients at Aga Khan University Hospital for 3rd year medical summative Objective Structured Clinical Examination (OSCE)...
January 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/28707188/hemodynamic-benefits-of-counterpulsation-implantable-percutaneous-and-intraaortic-rotary-blood-pumps-an-in-silico-and-in-vitro-study
#18
Yu Wang, Steven C Koenig, Michael A Sobieski, Mark S Slaughter, Guruprasad A Giridharan
Mechanical circulatory support (MCS) devices have become a standard therapy for heart failure (HF) patients. MCS device designs may differ by level of support, inflow and/or outflow cannulation sites, and mechanism(s) of cardiac unloading and blood flow delivery. Investigation and direct comparison of hemodynamic parameters that help characterize performance of MCS devices has been limited. We quantified cardiac and vascular hemodynamic responses for different types of MCS devices. Continuous flow (CF) left ventricular (LV) assist devices (LVAD) with LV or left atrial (LA) inlet, counterpulsation devices, percutaneous CF LVAD, and intra-aortic rotary blood pumps (IARBP) were quantified using established computer simulation and mock flow loop models...
July 13, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28705402/-development-of-an-objective-structured-clinical-examination-osce-for-evaluating-clinical-competence-in-vascular-medicine
#19
J Risse, T Busato, V Dufrost, M Perri, S Zuily, D Wahl
OBJECTIVES: Vascular medicine is now a clinical specialty in France. During their studies, students will acquire clinical reasoning in addition to technical skills. An Objective Structured Clinical Examination (OSCE) is considered as the gold standard for evaluating clinical competence. Our main objective was to evaluate the feasibility and acceptability of OSCE for the evaluation of students, secondarily their performance. METHODS: Three representative clinical cases of the specialty were developed...
May 2017: J Med Vasc
https://www.readbyqxmd.com/read/28704290/developing-a-conversational-virtual-standardized-patient-to-enable-students-to-practice-history-taking-skills
#20
Kellen Maicher, Douglas Danforth, Alan Price, Laura Zimmerman, Bruce Wilcox, Beth Liston, Holly Cronau, Laurie Belknap, Cynthia Ledford, David Way, Doug Post, Allison Macerollo, Milisa Rizer
INTRODUCTION: Although traditional virtual patient simulations are designed to teach and assess clinical reasoning skills, few employ conversational dialogue with the patients. The virtual standardized patients (VSPs) described herein represent standardized patients that students interview using natural language. Students take histories and develop differential diagnoses of the VSPs as much as they would with standardized or actual patients. The student-VSP interactions are recorded, creating a comprehensive record of questions and the order in which they were asked, which can be analyzed to assess information-gathering skills...
April 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
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