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https://www.readbyqxmd.com/read/28942677/a-novel-device-for-intraoperative-photodynamic-therapy-dedicated-to-glioblastoma-treatment
#1
Clément Dupont, Serge Mordon, Pascal Deleporte, Nicolas Reyns, Maximilien Vermandel
AIM: Photodynamic therapy (PDT) appears to be a valuable new treatment modality for cancer therapy. Studies have reported successful application of PDT for glioblastoma. Here, we introduce a new device dedicated to intraoperative PDT delivered early after fluoro-guided resection combined with a transfer function that determines the treatment time based on the size of the surgical resection cavity. MATERIALS & METHODS: First, we describe the device, which is composed of a trocar, a balloon filled with a diffusing solution, and a fiber guide in which a cylindrical light diffuser is inserted...
September 25, 2017: Future Oncology
https://www.readbyqxmd.com/read/28940387/adaptive-designs-for-the-one-sample-log-rank-test
#2
Rene Schmidt, Andreas Faldum, Robert Kwiecien
Traditional designs in phase IIa cancer trials are single-arm designs with a binary outcome, for example, tumor response. In some settings, however, a time-to-event endpoint might appear more appropriate, particularly in the presence of loss to follow-up. Then the one-sample log-rank test might be the method of choice. It allows to compare the survival curve of the patients under treatment to a prespecified reference survival curve. The reference curve usually represents the expected survival under standard of the care...
September 22, 2017: Biometrics
https://www.readbyqxmd.com/read/28940002/-transregional-tracking-in-newborn-hearing-screening
#3
P Matulat, S Stroe, A Am Zehnhoff-Dinnesen
BACKGROUND AND OBJECTIVE: When patients in the universal newborn hearing screening program move from one geographical area to another between initial screening and medical follow-up, the responsibility for their tracking also moves from one screening center to another. As a result, these patients are lost to follow-up according to the center which had initial responsibility. In cooperation with the Association of German Hearing Screening Centers ("Verband Deutscher Hörscreening-Zentralen e...
September 22, 2017: HNO
https://www.readbyqxmd.com/read/28932923/dual-energy-bone-removal-computed-tomography-brct-preliminary-report-of-efficacy-of-acute-intracranial-hemorrhage-detection
#4
Norihito Naruto, Hidenori Tannai, Kazuma Nishikawa, Kentaro Yamagishi, Masahiko Hashimoto, Hideto Kawabe, Yuichi Kamisaki, Hisashi Sumiya, Satoshi Kuroda, Kyo Noguchi
PURPOSE: One of the major applications of dual-energy computed tomography (DECT) is automated bone removal (BR). We hypothesized that the visualization of acute intracranial hemorrhage could be improved on BRCT by removing bone as it has the highest density tissue in the head. This preliminary study evaluated the efficacy of a DE BR algorithm for the head CT of trauma patients. METHODS: Sixteen patients with acute intracranial hemorrhage within 1 day after head trauma were enrolled in this study...
September 20, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28931497/use-of-simulation-based-on-an-electronic-health-records-environment-to-evaluate-the-structure-and-accuracy-of-notes-generated-by-medical-scribes-proof-of-concept-study
#5
Robert Pranaat, Vishnu Mohan, Megan O'Reilly, Maxwell Hirsh, Karess McGrath, Gretchen Scholl, Deborah Woodcock, Jeffrey A Gold
BACKGROUND: The increasing adoption of electronic health records (EHRs) has been associated with a number of unintended negative consequences with provider efficiency and job satisfaction. To address this, there has been a dramatic increase in the use of medical scribes to perform many of the required EHR functions. Despite this rapid growth, little has been published on the training or assessment tools to appraise the safety and efficacy of scribe-related EHR activities. Given the number of reports documenting that other professional groups suffer from a number of performance errors in EHR interface and data gathering, scribes likely face similar challenges...
September 20, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28931340/lessons-learnt-from-early-failure-of-a-patient-trial-with-a-polymer-on-polymer-resurfacing-hip-arthroplasty
#6
Job L C Van Susante, Nico Verdonschot, L Paul A Bom, Pawel Tomaszewski, Pat Campbell, Edward Ebramzadeh, B Wim Schreurs
Background and purpose - Hip resurfacing (HR) is a treatment option promoted for hip arthritis in young and active patients. However, adverse reactions to metal are a concern and the search for non-metallic bearing options proceeds. We present the first clinical study performed in patients using a newly developed hydrophilic polymer-on-polymer hip resurfacing device. Patients and methods - After performing extensive hip simulator tests, biocompatibility testing and animal tests (ISO 14242-1,3; 10993-3,4,5,10,11), approval was obtained from the IRB committee to enroll 15 patients in the first clinical study in humans using this experimental polymer-on-polymer hip resurfacing device...
September 21, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28929330/development-of-a-rapid-analysis-method-for-bone-resection-margins-for-oral-squamous-cell-carcinoma-by-immunoblotting
#7
Claudia Haase, Bernd Lethaus, Ruth Knüchel-Clarke, Frank Hölzle, Angela Cassataro, Till Braunschweig
The purpose of this proof-of-principle study was to develop a rapid and approachable method to analyse bone resection margins in patients with oral squamous cell carcinoma (OSCC) in an intraoperative setting, similar to assessing frozen sections of soft tissue. Bone excision and risk of remaining tumour cells could be minimised, thus improving reconstruction measures and facilitating convalescence. Frozen, sawed wafers of porcine bone artificially combined with porcine skin (simulating OSCC properties) were used to develop and evaluate a new molecular method: protein transfer from non-decalcified, sawed wafers onto a membrane stained by immunofluorescence (Tissue-ProtTrans)...
September 19, 2017: Head and Neck Pathology
https://www.readbyqxmd.com/read/28928795/sensitivity-analysis-of-the-integral-quality-monitoring-system%C3%A2-using-monte-carlo-simulation
#8
Oluwaseyi M Oderinde, F C P du Plessis
The Integral Quality Monitoring (IQM) System is a real-time beam output verifying system that validates the integrity and accuracy of patient treatment plan (TP) data during radiation treatment. The purpose of this study was to evaluate the sensitivity of the IQM to errors in segment using EGSnrc/BEAMnrc Monte Carlo (MC) codes. Sensitivity analysis (SA) techniques were applied to study the significance of small alterations of field sizes (segments) on the IQM signal response. One hundred and eighty multileaf segments were analyzed with methods that include scatter plots (SP), brute force, variance-based (VAR), and standard regression coefficient SA...
2017: Computational and Mathematical Methods in Medicine
https://www.readbyqxmd.com/read/28922807/tedizolid-is-highly-bactericidal-in-the-treatment-of-pulmonary-mycobacterium-avium-complex-disease
#9
Devyani Deshpande, Shashikant Srivastava, Jotam G Pasipanodya, Pooi S Lee, Tawanda Gumbo
Objectives: To determine if tedizolid is effective for pulmonary Mycobacterium avium complex (MAC) disease, and to use pharmacokinetics/pharmacodynamics to design optimal doses. Methods: We performed an exposure-response experiment in the hollow-fibre system model of intracellular MAC (HFS-MAC). We mimicked the tedizolid concentration-time profiles achieved in the lungs of patients treated once daily for 28 days. The HFS-MAC was sampled at intervals to determine the tedizolid pharmacokinetics and MAC intracellular burden...
September 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28922806/linezolid-as-treatment-for-pulmonary-mycobacterium-avium-disease
#10
Devyani Deshpande, Shashikant Srivastava, Jotam G Pasipanodya, Tawanda Gumbo
Objectives: To identify the pharmacokinetic/pharmacodynamic parameters and exposures of linezolid in the treatment of pulmonary Mycobacterium avium complex (MAC) disease. Methods: Human-derived monocytes infected with MAC were inoculated into hollow-fibre systems for dose-effect and dose-scheduling studies. We mimicked linezolid concentration-time profiles achieved in adult human lungs treated for 28 days. Sampling to confirm that the intended linezolid pharmacokinetics had been achieved, and for enumeration of MAC colony-forming units, was performed based on repetitive sampling from each system over the 28 days...
September 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28920524/remotely-supported-prehospital-ultrasound-a-feasibility-study-of-real-time-image-transmission-and-expert-guidance-to-aid-diagnosis-in-remote-and-rural-communities
#11
Leila Eadie, John Mulhern, Luke Regan, Alasdair Mort, Helen Shannon, Ashish Macaden, Philip Wilson
Introduction Our aim is to expedite prehospital assessment of remote and rural patients using remotely-supported ultrasound and satellite/cellular communications. In this paradigm, paramedics are remotely-supported ultrasound operators, guided by hospital-based specialists, to record images before receiving diagnostic advice. Technology can support users in areas with little access to medical imaging and suboptimal communications coverage by connecting to multiple cellular networks and/or satellites to stream live ultrasound and audio-video...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28919794/parenteral-nutrition-including-an-omega-3-fatty-acid-containing-lipid-emulsion-for-intensive-care-patients-in-china-a-pharmacoeconomic-analysis
#12
Yufei Feng, Chao Li, Tian Zhang, Lorenzo Pradelli
BACKGROUND/OBJECTIVES: Parenteral nutrition (PN) incorporating omega-3 fatty-acid-enriched lipid emulsions has been shown to be cost effective in Western populations. A pharmacoeconomic evaluation was performed within the Chinese intensive care unit (ICU) setting. This assessed whether the additional acquisition cost of PN with omega-3 fatty-acid-enriched lipid emulsion (SMOFlipid) vs standard PN was offset by improved clinical outcomes that can reduce subsequent costs. MATERIALS AND METHODS: A pharmacoeconomic discrete event simulation model was developed, based on an update to efficacy data from a previous international meta-analysis, with China-specific clinical and economic input parameters...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28919394/concomitant-chemotherapy-and-radiotherapy-with-sbrt-boost-for-unresectable-stage-iii-non-small-cell-lung-cancer-a-phase-i-study
#13
Kristin A Higgins, Rathi N Pillai, Zhengjia Chen, Sibo Tian, Chao Zhang, Pretesh Patel, Suchita Pakkala, Jay Shelton, Seth D Force, Felix G Fernandez, Conor E Steuer, Taofeek K Owonikoko, Suresh S Ramalingam, Jeffrey D Bradley, Walter J Curran
PURPOSE: Stereotactic Body Radiation Therapy (SBRT) is now the standard of care in medically inoperable stage I non-small cell lung cancer, yielding high rates of local control. It is unknown if SBRT can be safely utilized in the locally advanced NSCLC setting. This multi-institution phase I study evaluated the safety of 44 Gy conventionally fractionated thoracic radiation with concurrent chemotherapy plus a dose escalated SBRT boost to both the primary tumor and involved mediastinal lymph nodes...
September 12, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28918445/pre-emptive-intestinal-transplant-the-surgeon-s-point-of-view
#14
REVIEW
Augusto Lauro, Ignazio R Marino, Kishore R Iyer
Pre-emptive transplantation is a well-established practice for certain types of end-organ failure such as in the use of kidney transplantation. For irreversible intestinal failure, total parenteral nutrition (TPN) remains the gold standard, due to the suboptimal long-term results of intestinal transplantation. As such, the only role for pre-emptive transplantation, if at all, will be for patients identified to be at high risk of complications and mortality while on definitive long-term TPN. In these patients, the timing of early listing and transplantation could become life-saving, taking into account that mortality on the waiting list is still the highest for intestinal candidates...
September 16, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28916397/computational-assessment-of-model-based-wave-separation-using-a-database-of-virtual-subjects
#15
Bernhard Hametner, Magdalena Schneider, Stephanie Parragh, Siegfried Wassertheurer
The quantification of arterial wave reflection is an important area of interest in arterial pulse wave analysis. It can be achieved by wave separation analysis (WSA) if both the aortic pressure waveform and the aortic flow waveform are known. For better applicability, several mathematical models have been established to estimate aortic flow solely based on pressure waveforms. The aim of this study is to investigate and verify the model-based wave separation of the ARCSolver method on virtual pulse wave measurements...
September 12, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28915580/molecular-and-functional-characterization-of-a-new-3-end-kit-juxtamembrane-deletion-in-a-duodenal-gist-treated-with-neoadjuvant-imatinib
#16
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)...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28910470/a-comparison-of-ventilation-rates-between-a-standard-bag-valve-mask-and-a-new-design-in-a-prehospital-setting-during-training-simulations
#17
Joseph T Costello, Paul B Allen, Robert Levesque
BACKGROUND: Excessive ventilation of sick and injured patients is associated with increased morbidity and mortality. Combat Medical Systems® (CMS) is developing a new bag-valve-mask (BVM) designed to limit ventilation rates. The purpose of this study was to compare ventilation rates between a standard BVM device and the CMS device. METHODS: This was a prospective, observational, semirandomized, crossover study using Army Medics. Data were collected during Brigade Combat Team Trauma Training classes at Camp Bullis, Texas...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28906326/tissue-engineering-strategies-for-auricular-reconstruction
#18
Michael J Schroeder, Mark S Lloyd
Simulating natural characteristics and aesthetics in reconstructed ears has provided a complex 3-dimensional puzzle for those treating patients with microtia. Costochondral grafts remain the gold standard for autologous reconstruction. However, other options such as Medpor and prosthetics are indicated depending on patient circumstances and personal choice. Research into tissue engineering offers an alternative method to a traditional surgical approach that may reduce donor-site morbidity. However, tissue engineering for microtia reconstruction brings new challenges such as cell sourcing, promotion of chondrogenesis, scaffold vascularization, and prevention of scaffold contraction...
September 12, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28906285/impact-of-missing-physiologic-data-on-performance-of-the-simplified-acute-physiology-score-3-risk-prediction-model
#19
Lars Engerström, Thomas Nolin, Caroline Mårdh, Folke Sjöberg, Göran Karlström, Mats Fredrikson, Sten M Walther
OBJECTIVES: The Simplified Acute Physiology 3 outcome prediction model has a narrow time window for recording physiologic measurements. Our objective was to examine the prevalence and impact of missing physiologic data on the Simplified Acute Physiology 3 model's performance. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Sixty-three ICUs in the Swedish Intensive Care Registry. PATIENTS: Patients admitted during 2011-2014 (n = 107,310)...
September 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28905390/validation-of-the-gatortail-method-for-accurate-sizing-of-pulmonary-vessels-from-3d-medical-images
#20
Walter G O'Dell, Anne K Gormaley, David A Prida
PURPOSE: Detailed characterization of changes in vessel size is crucial for the diagnosis and management of a variety of vascular diseases. Because clinical measurement of vessel size is typically dependent on the radiologist's subjective interpretation of the vessel borders, it is often prone to high inter- and intra-user variability. Automatic methods of vessel sizing have been developed for two-dimensional images but a fully three-dimensional (3D) method suitable for vessel sizing from volumetric X-ray computed tomography (CT) or magnetic resonance imaging has heretofore not been demonstrated and validated robustly...
September 14, 2017: Medical Physics
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