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Jianing Shi, Changming Cheng, Jun Ma, Choong-Chin Liew, Xiaoping Geng
Gastric cancer (stomach cancer) is the fifth most common malignancy and the third leading cause of cancer-associated mortality worldwide. Identifying gastric cancer patients at an early and curable stage of the disease is essential if mortality rates for this disease are to decrease. A non-invasive blood-based test that is an indicator of gastric cancer risk would likely be of benefit in identifying gastric cancer patients at an early stage, and such a test may enhance clinical decision making. This study identified a four-gene expression signature in peripheral blood samples associated with gastric cancer...
June 2018: Oncology Letters
P Collinet, X Fritel, C Revel-Delhom, M Ballester, P A Bolze, B Borghese, N Bornsztein, J Boujenah, T Brillac, N Chabbert-Buffet, C Chauffour, N Clary, J Cohen, C Decanter, A Denouël, G Dubernard, A Fauconnier, H Fernandez, T Gauthier, F Golfier, C Huchon, G Legendre, J Loriau, E Mathieu-d'Argent, B Merlot, J Niro, P Panel, P Paparel, C A Philip, S Ploteau, C Poncelet, B Rabischong, H Roman, C Rubod, P Santulli, M Sauvan, I Thomassin-Naggara, A Torre, J M Wattier, C Yazbeck, N Bourdel, M Canis
First-line diagnostic investigations for endometriosis are physical examination and pelvic ultrasound. The second-line investigations are: targeted pelvic examination performed by an expert clinician, transvaginal ultrasound performed by an expert physician sonographer (radiologist or gynaecologist), and pelvic MRI. Management of endometriosis is recommended when the disease has a functional impact. Recommended first-line hormonal therapies for the management of endometriosisrelated pain are combined hormonal contraceptives (CHCs) or the 52mg levonorgestrel-releasing intrauterine system (IUS)...
June 16, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Ronak Rengarajan, Peter A McCullough, Anima Chowdhury, Kristen M Tecson
Familial chylomicronemia syndrome (FCS) is a rare lipid disorder posing significant clinical burdens on patients. Due to its rarity, variety of presentations, and lack of universal diagnostic criteria, patients see an average of five physicians before diagnosis. We screened adults for a triglyceride level ≥1000 mg/dL from September 2015 to September 2016 and a history of pancreatitis and performed a thorough chart review on those who met the criteria. An adjudication panel used a definition that also called for supportive information including history of hypertriglyceridemia or family history of pancreatitis/hypertriglyceridemia...
July 2018: Proceedings of the Baylor University Medical Center
Susan P Mollan, Brendan Davies, Nick C Silver, Simon Shaw, Conor L Mallucci, Benjamin R Wakerley, Anita Krishnan, Swarupsinh V Chavda, Satheesh Ramalingam, Julie Edwards, Krystal Hemmings, Michelle Williamson, Michael A Burdon, Ghaniah Hassan-Smith, Kathleen Digre, Grant T Liu, Rigmor Højland Jensen, Alexandra J Sinclair
The aim was to capture interdisciplinary expertise from a large group of clinicians, reflecting practice from across the UK and further, to inform subsequent development of a national consensus guidance for optimal management of idiopathic intracranial hypertension (IIH). METHODS: Between September 2015 and October 2017, a specialist interest group including neurology, neurosurgery, neuroradiology, ophthalmology, nursing, primary care doctors and patient representatives met. An initial UK survey of attitudes and practice in IIH was sent to a wide group of physicians and surgeons who investigate and manage IIH regularly...
June 14, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Lydia Aoun Barakat, Dana W Dunne, Jeanette M Tetrault, Sarita Soares, David Chia, Onyema E Ogbuagu, John P Moriarty, Stephen J Huot, Michael L Green
PROBLEM: HIV-infected patients are living longer and are at increased risk of comorbidities. A qualified physician workforce is needed to care for this growing HIV population. APPROACH: This report describes the first 5 years of the development and implementation of a novel 3-year HIV Training Track (HIV TT) within the Primary Care Residency Program from 2012 to 2017. It outlines the process of building the infrastructure of the HIV TT, describes the curriculum development based on HIV-specific Entrustable Professional Activities (EPA), and provides the results of the program evaluation in the 5 year period OUTCOMES:: The program enrolled a cohort of 11 trainees with 5 graduates...
June 12, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Norihito Kaku, Kohji Hashiguchi, Yuki Iwanaga, Norihiko Akamatsu, Junichi Matsuda, Kosuke Kosai, Naoki Uno, Yoshitomo Morinaga, Takeshi Kitazaki, Hiroo Hasegawa, Taiga Miyazaki, Masaaki Fukuda, Koichi Izumikawa, Hiroshi Mukae, Katsunori Yanagihara
Although viruses are the major pathogen that causes upper respiratory tract infection (URTI) and acute bronchitis, antibiotics have been prescribed. This was a prospective observational study in influenza epidemics that enrolled adult outpatients who visited a hospital with respiratory tract infection symptoms. In this study, we evaluated the usefulness of FilmArray respiratory panel (RP). Fifty patients were enrolled. FilmArray RP detected the pathogens in 28 patients. The common pathogens were influenza virus (n = 14), respiratory syncytial virus (n = 6), and human rhinovirus (n = 6)...
June 9, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Adam J Singer, Merry Taylor, Deborah LeBlanc, Kristen Meyers, Karol Perez, Henry C Thode, Jesse M Pines
BACKGROUND: Core laboratory testing may increase length of stay and delay care. OBJECTIVES: We compared length of emergency department (ED) care in patients receiving point-of-care testing (POCT) at triage vs. traditional core laboratory testing. METHODS: We conducted a prospective, case-controlled trial of adult patients with prespecified conditions requiring laboratory testing and had POCT performed by a nurse after triage for: a basic metabolic panel, troponin I, lactate, INR (i-STAT System), urinalysis (Beckman Coulter Icon), or urine pregnancy test...
June 7, 2018: Journal of Emergency Medicine
Stefania Gori, Fabio Puglisi, Michela Cinquini, Giovanni Pappagallo, Antonio Frassoldati, Laura Biganzoli, Laura Cortesi, Alba Fiorentino, Catia Angiolini, Corrado Tinterri, Andrea De Censi, Alessia Levaggi, Lucia Del Mastro
Premenopausal women with hormone receptor-positive early breast cancer are candidates for adjuvant endocrine therapy, as recommended by the major international guidelines. To date, adjuvant endocrine options for premenopausal women include tamoxifen with or without ovarian function suppression (OFS) or an aromatase inhibitor with OFS. Multiple strategies for endocrine treatment of premenopausal women with hormone-responsive breast cancer have been assessed, and the results of randomised clinical trials have been reported over the last years...
June 7, 2018: European Journal of Cancer
Mei-Chun Lin, Pei-Wei Shueng, Wei-Kuo Chang, Peter Mu-Hsin Chang, Hsin-Chun Feng, Muh-Hwa Yang, Pei-Jen Lou
Because of the anatomical location, patients with head and neck cancer (HNC) frequently experience dysphagia and malnutrition at the time of diagnosis and these conditions are often exacerbated after chemoradiotherapy. There is an emerging medical need to establish a consensus on nutritional intervention for these patients. A panel of 30 senior physicians and experts from multidisciplinary teams drafted clinical recommendations to improve the management of nutritional interventions in Taiwan and to provide updated treatment strategy recommendations in hope of improving the nutritional status of patients with HNC...
June 2018: Oral Oncology
Diana Barger, Olivier Leleux, Valérie Conte, Vincent Sapparrart, Marie Gapillout, Isabelle Crespel, Marie Erramouspe, Sandrine Delveaux, Francois Dabis, Fabrice Bonnet
BACKGROUND: Effective antiretroviral therapy has greatly reduced HIV-related morbidity and mortality, dramatically changing the demographics of the population of people living with HIV. The majority of people living with HIV in France are well cared for insofar as their HIV infection is concerned but remain at risk for age-associated comorbidities. Their long-term, potentially complex, and growing care needs make the routine, longitudinal assessment of health-related quality of life and other patient-reported outcomes of relevance in the current treatment era...
June 7, 2018: JMIR Research Protocols
Shu-Huan Huang, Yi-Fang Lin, Ming-Han Tsai, Shuan Yang, Mei-Ling Liao, Shao-Wen Chao, Cheng-Cheng Hwang
Conventional methods for identifying gastroenteritis pathogens are time consuming, more likely to result in a false-negative, rely on personnel with diagnostic expertise, and are dependent on the specimen status. Alternatively, molecular diagnostic methods permit the rapid, simultaneous detection of multiple pathogens with high sensitivity and specificity. The present study compared conventional methods with the Luminex xTAG Gastrointestinal Pathogen Panel (xTAG GPP) for the diagnosis of infectious gastroenteritis in northern Taiwan...
June 2018: Medicine (Baltimore)
Ann Versporten, Inge C Gyssens, Céline Pulcini, Annelie A Monnier, Jeroen Schouten, Romina Milanic, Mirjana Stanic Benic, Gianpiero Tebano, Marion Le Maréchal, Veronica Zanichelli, Benedikt Huttner, Vera Vlahovic-Palcevski, Herman Goossens, Marlies E Hulscher, Niels Adriaenssens
Background: The international Innovative Medicines Initiative (IMI) project DRIVE-AB (Driving Reinvestment in Research and Development and Responsible Antibiotic Use) aims to develop a global definition of 'responsible' antibiotic use. Objectives: To identify consensually validated quantity metrics for antibiotic use in the outpatient setting. Methods: First, outpatient quantity metrics (OQMs) were identified by a systematic search of literature and web sites published until 12 December 2014...
June 1, 2018: Journal of Antimicrobial Chemotherapy
Djillali Annane, Lamia Ouanes-Besbes, Daniel de Backer, Bin DU, Anthony C Gordon, Glenn Hernández, Keith M Olsen, Tiffany M Osborn, Sandra Peake, James A Russell, Sergio Zanotti Cavazzoni
PURPOSE: We set out to summarize the current knowledge on vasoactive drugs and their use in the management of shock to inform physicians' practices. METHODS: This is a narrative review by a multidisciplinary, multinational-from six continents-panel of experts including physicians, a pharmacist, trialists, and scientists. RESULTS AND CONCLUSIONS: Vasoactive drugs are an essential part of shock management. Catecholamines are the most commonly used vasoactive agents in the intensive care unit, and among them norepinephrine is the first-line therapy in most clinical conditions...
June 4, 2018: Intensive Care Medicine
Allison Lollier, Elisa M Rodriguez, Frances G Saad-Harfouche, Christy A Widman, Martin C Mahoney
This pilot study was undertaken to identify characteristics and approaches (e.g., social, behavioral, and/or systems factors) which differentiate primary care medical offices achieving higher rates of HPV vaccination. Eligible primary care practice sites providing care to adolescent patients were recruited within an eight county region of western New York State between June 2016 and July 2016. Practice sites were categorized as higher (n = 3) or lower performing (n = 2) based on three dose series completion rates for HPV vaccinations among females aged 13-17 years...
June 2018: Preventive Medicine Reports
Naimi Johansson, Niklas Jakobsson, Mikael Svensson
BACKGROUND: Differences in health care utilization across geographical areas are well documented within several countries. If the variation across areas cannot be explained by differences in medical need, it can be a sign of inefficiency or misallocation of public health care resources. METHODS: In this observational, longitudinal panel study we use regional level data covering the 21 Swedish regions (county councils) over 13 years and a random effects model to assess to what degree regional variation in outpatient physician visits is explained by observed demand factors such as health, demography and socio-economic factors...
June 4, 2018: BMC Health Services Research
Mel Hudson Smith, David Smith
OBJECTIVE: To examine the influence of dimensions of service quality on patient experience of primary care. DATA SOURCES/STUDY SETTING: Data from the national GP Patient Survey in England 2014/15, with responses from 858,351 patients registered at 7,918 practices. STUDY DESIGN: Expert panel and principal component analysis helped identify relevant dimensions of service quality. Regression was then used to examine the relationships between these dimensions and reported patient experience...
June 3, 2018: Health Services Research
HyeRin Roh, Lauren Nirta
PURPOSE: The aim was to present our experiences implementing a cultural diversity (CD) education program. METHODS: The authors held a 4-hour CD class for third-year medical students. The aim of the class was to facilitate students to realize and reflect on the importance of CD on healthcare delivery in Korea. The class was comprised of an orientation about CD in Korea, physicians and multicultural guests sharing their experiences with students, small group discussion, and Q&A panel with multicultural guests...
June 2018: Korean Journal of Medical Education
Magda Tasma, Lukas O Roebroek, Edith J Liemburg, Henderikus Knegtering, Philippe A Delespaul, Albert Boonstra, Marte Swart, Stynke Castelein
BACKGROUND: Routinely monitoring of symptoms and medical needs can improve the diagnostics and treatment of medical problems, including psychiatric. However, several studies show that few clinicians use Routine Outcome Monitoring (ROM) in their daily work. We describe the development and first evaluation of a ROM based computerized clinical decision aid, Treatment-E-Assist (TREAT) for the treatment of psychotic disorders. The goal is to generate personalized treatment recommendations, based on international guidelines combined with outcomes of mental and physical health acquired through ROM...
June 1, 2018: BMC Psychiatry
Alison M Elliott, Christèle du Souich, Shelin Adam, Nick Dragojlovic, Clara van Karnebeek, Tanya N Nelson, Anna Lehman, Larry D Lynd, Jan M Friedman
BACKGROUND: Access to clinical diagnostic genome-wide sequencing (GWS; exome or whole genome sequencing) is limited in British Columbia. The establishment of a translational research initiative (CAUSES) to provide diagnostic genome-wide sequencing for 500 children necessitated the development of a genomic consultation service, a clinical service established to provide consultation for physicians considering GWS for their pediatric patients throughout British Columbia. The Genomic Consultation Service provides patient-specific genomic advice that may include: GWS, multi-gene panel, single gene test, referral to medical genetics for clinical evaluation, or no genetic testing...
May 30, 2018: Molecular Genetics & Genomic Medicine
Ramzi Shawahna, Sara Qiblawi, Haifa Ghanayem
Background: Breastfeeding women with hypogalactia are commonly recommended to use fenugreek as a galactogogue. This study aimed to achieve formal consensus among breastfeeding women and healthcare providers on which potential harms and benefits of using fenugreek need to be communicated and discussed during clinical consultations. Methods: A two-iterative round Delphi technique was used in two separate panels of breastfeeding women ( n = 65) and healthcare providers ( n = 56) to achieve formal consensus on a list of 24 and 16 items related to potential harms and benefits of fenugreek...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
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