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https://www.readbyqxmd.com/read/28231575/individual-biomarkers-using-molecular-personalized-medicine-approaches
#1
Hans P Zenner
Molecular personalized medicine tries to generate individual predictive biomarkers to assist doctors in their decision making. These are thought to improve the efficacy and lower the toxicity of a treatment. The molecular basis of the desired high-precision prediction is modern "omex" technologies providing high-throughput bioanalytical methods. These include genomics and epigenomics, transcriptomics, proteomics, metabolomics, microbiomics, imaging, and functional analyses. In most cases, producing big data also requires a complex biomathematical analysis...
February 24, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28230530/developing-a-multi-component-immune-model-for-evaluating-the-risk-of-respiratory-illness-in-athletes
#2
Maree Gleeson, David B Pyne, Lisa J Elkington, Sharron T Hall, John R Attia, Christopher Oldmeadow, Lisa G Wood, Robin Callister
Clinical and laboratory identification of the underlying risk of respiratory illness in athletes has proved problematic. The aim of this study was to determine whether clinical data, combined with immune responses to standardised exercise protocols and genetic cytokine polymorphism status, could identify the risk of respiratory illness (symptoms) in a cohort of highly-trained athletes. Male endurance athletes (n=16; VO2max 66.5 ± 5.1 mL.kg-1.min-1) underwent a clinical evaluation of known risk factors by a physician and comprehensive laboratory analysis of immune responses both at rest and after two cycling ergometer tests: 60 min at 65% VO2max (LONG); and 6 x 3 min intervals at 90% VO2max (INTENSE)...
2017: Exercise Immunology Review
https://www.readbyqxmd.com/read/28226332/responsible-safe-and-effective-prescription-of-opioids-for-chronic-non-cancer-pain-american-society-of-interventional-pain-physicians-asipp-guidelines
#3
Laxmaiah Manchikanti, Adam M Kaye, Nebojsa Nick Knezevic, Heath McAnally, Konstantin Slavin, Andrea M Trescot, Susan Blank, Vidyasagar Pampati, Salahadin Abdi, Jay S Grider, Alan D Kaye, Kavita N Manchikanti, Harold Cordner, Christopher G Gharibo, Michael E Harned, Sheri L Albers, Sairam Atluri, Steve M Aydin, Sanjay Bakshi, Robert L Barkin, Ramsin M Benyamin, Mark V Boswell, Ricardo M Buenaventura, Aaron K Calodney, David L Cedeno, Sukdeb Datta, Timothy R Deer, Bert Fellows, Vincent Galan, Vahid Grami, Hans Hansen, Standiford Helm Ii, Rafael Justiz, Dhanalakshmi Koyyalagunta, Yogesh Malla, Annu Navani, Kent H Nouri, Ramarao Pasupuleti, Nalini Sehgal, Sanford M Silverman, Thomas T Simopoulos, Vijay Singh, Daneshvari R Solanki, Peter S Staats, Ricardo Vallejo, Bradley W Wargo, Arthur Watanabe, Joshua A Hirsch
BACKGROUND: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28225303/initial-diagnostic-workup-of-acute-leukemia-guideline-from-the-college-of-american-pathologists-and-the-american-society-of-hematology
#4
Daniel A Arber, Michael J Borowitz, Melissa Cessna, Joan Etzell, Kathryn Foucar, Robert P Hasserjian, J Douglas Rizzo, Karl Theil, Sa A Wang, Anthony T Smith, R Bryan Rumble, Nicole E Thomas, James W Vardiman
CONTEXT: -A complete diagnosis of acute leukemia requires knowledge of clinical information combined with morphologic evaluation, immunophenotyping and karyotype analysis, and often, molecular genetic testing. Although many aspects of the workup for acute leukemia are well accepted, few guidelines have addressed the different aspects of the diagnostic evaluation of samples from patients suspected to have acute leukemia. OBJECTIVE: -To develop a guideline for treating physicians and pathologists involved in the diagnostic and prognostic evaluation of new acute leukemia samples, including acute lymphoblastic leukemia, acute myeloid leukemia, and acute leukemias of ambiguous lineage...
February 22, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28224097/understanding-academic-clinicians-intent-to-treat-pediatric-obesity
#5
Claudia Frankfurter, Charles Cunningham, Katherine M Morrison, Heather Rimas, Karen Bailey
AIM: To examine the extent to which the theory of planned behavior (TPB) predicts academic clinicians' intent to treat pediatric obesity. METHODS: A multi-disciplinary panel iteratively devised a Likert scale survey based on the constructs of the TPB applied to a set of pediatric obesity themes. A cross-sectional electronic survey was then administered to academic clinicians at tertiary care centers across Canada from January to April 2012. Descriptive statistics were used to summarize demographic and item agreement data...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28223792/asthma-copd-overlap-syndrome-in-the-us-a-prospective-population-based-analysis-of-patient-reported-outcomes-and-health-care-utilization
#6
Carlos A Vaz Fragoso, Terrence E Murphy, George O Agogo, Heather G Allore, Gail J McAvay
BACKGROUND: Prior work suggests that asthma-COPD overlap syndrome (ACOS) has a greater health burden than asthma alone or COPD alone. In the current study, we have further evaluated the health burden of ACOS in a nationally representative sample of the US population, focusing on patient-reported outcomes and health care utilization and on comparisons with asthma alone and COPD alone. Patient-reported outcomes are especially meaningful, as these include functional activities that are highly valued by patients and are the basis for patient-centered care...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28222929/magnesium-an-overlooked-electrolyte
#7
Jaya Kala, Ala Abudayyeh
BACKGROUND: Hypermagnesemia is rare and usually iatrogenic. Due to decreased renal function, older patients are generally more susceptible to hypermagnesemia than are younger patients. Because it is not one of the commonly assessed electrolytes in the blood work panel of patients, high levels are usually missed. CASE REPORT: An elderly gentleman with history of leukemia presented with complaints of shortness of breath and extreme weakness while walking. He was diagnosed with severe hypermagnesemia, but unfortunately succumbed to cardiorespiratory arrest...
February 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28213563/development-and-validation-of-a-patient-reported-outcome-instrument-for-skin-involvement-in-patients-with-systemic-sclerosis
#8
Ada Man, Jeannette K Correa, Jessica Ziemek, Robert W Simms, David T Felson, Robert Lafyatis
OBJECTIVES: We developed a patient-reported outcome (PRO) instrument to assess the skin-related quality of life in patients with systemic sclerosis (SSc). METHODS: Participants with SSc provided input on skin-related health effects through focus groups. We developed items for scleroderma skin PRO (SSPRO) to encompass these effects. Further consideration from cognitive interviews and an expert panel led to reduction and modification of items. A 22-item SSPRO was field tested...
February 17, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28212648/formulation-of-evidence-based-messages-to-promote-the-use-of-physical-activity-to-prevent-and-manage-alzheimer-s-disease
#9
Kathleen A Martin Ginis, Jennifer Heisz, John C Spence, Ilana B Clark, Jordan Antflick, Chris I Ardern, Christa Costas-Bradstreet, Mary Duggan, Audrey L Hicks, Amy E Latimer-Cheung, Laura Middleton, Kirk Nylen, Donald H Paterson, Chelsea Pelletier, Michael A Rotondi
BACKGROUND: The impending public health impact of Alzheimer's disease is tremendous. Physical activity is a promising intervention for preventing and managing Alzheimer's disease. However, there is a lack of evidence-based public health messaging to support this position. This paper describes the application of the Appraisal of Guidelines Research and Evaluation II (AGREE-II) principles to formulate an evidence-based message to promote physical activity for the purposes of preventing and managing Alzheimer's disease...
February 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28202076/developing-quality-indicators-for-physician-staffed-emergency-medical-services-a-consensus-process
#10
Helge Haugland, Marius Rehn, Pål Klepstad, Andreas Krüger
BACKGROUND: There is increasing interest for quality measurement in health care services; pre-hospital emergency medical services (EMS) included. However, attempts of measuring the quality of physician-staffed EMS (P-EMS) are scarce. The aim of this study was to develop a set of quality indicators for international P-EMS to allow quality improvement initiatives. METHODS: A four-step modified nominal group technique process (expert panel method) was used. RESULTS: The expert panel reached consensus on 26 quality indicators for P-EMS...
February 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28199863/analysis-of-chemopredictive-assay-for-targeting-cancer-stem-cells-in-glioblastoma-patients
#11
Candace M Howard, Jagan Valluri, Anthony Alberico, Terrence Julien, Rida Mazagri, Robert Marsh, Hoyt Alastair, Antonio Cortese, Michael Griswold, Wanmei Wang, Krista Denning, Linda Brown, Pier Paolo Claudio
INTRODUCTION: The prognosis of glioblastoma (GBM) treated with standard-of-care maximal surgical resection and concurrent adjuvant temozolomide (TMZ)/radiotherapy remains very poor (less than 15 months). GBMs have been found to contain a small population of cancer stem cells (CSCs) that contribute to tumor propagation, maintenance, and treatment resistance. The highly invasive nature of high-grade gliomas and their inherent resistance to therapy lead to very high rates of recurrence. For these reasons, not all patients with similar diagnoses respond to the same chemotherapy, schedule, or dose...
February 12, 2017: Translational Oncology
https://www.readbyqxmd.com/read/28197620/measuring-practicing-clinicians-information-literacy-an-exploratory-analysis-in-the-context-of-panel-management
#12
Brian E Dixon, Katherine Barboza, Ashley E Jensen, Katelyn J Bennett, Scott E Sherman, Mark D Schwartz
BACKGROUND: As healthcare moves towards technology-driven population health management, clinicians must adopt complex digital platforms to access health information and document care. OBJECTIVES: This study explored information literacy, a set of skills required to effectively navigate population health information systems, among primary care providers in one Veterans' Affairs (VA) medical center. METHODS: Information literacy was assessed during an 8-month randomized trial that tested a population health (panel) management intervention...
February 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28194534/the-impact-of-physician-level-drug-budgets-on-prescribing-behavior
#13
Katharina Elisabeth Fischer, Taika Koch, Karel Kostev, Tom Stargardt
To contain pharmaceutical spending, drug budgets have been introduced across health systems. Apart from analyzing whether drug budgets fulfill their overall goal of reducing spending, changes in the cost and quality of prescribing and the enforcement mechanisms put in place need evaluation to assess the effectiveness of drug budgets at the physician level. In this study, we aim to analyze the cost and quality of prescribing conditional on the level of utilization of the drug budget and in view of varying levels of enforcement in cases of overspending...
February 13, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28188486/validation-of-a-method-for-retroperitoneal-tumor-segmentation
#14
Cristina Suárez-Mejías, José A Pérez-Carrasco, Carmen Serrano, José L López-Guerra, Tomás Gómez-Cía, Carlos L Parra-Calderón, Begoña Acha
PURPOSE: In 2005, an application for surgical planning called AYRA[Formula: see text] was designed and validated by different surgeons and engineers at the Virgen del Rocío University Hospital, Seville (Spain). However, the segmentation methods included in AYRA and in other surgical planning applications are not able to segment accurately tumors that appear in soft tissue. The aims of this paper are to offer an exhaustive validation of an accurate semiautomatic segmentation tool to delimitate retroperitoneal tumors from CT images and to aid physicians in planning both radiotherapy doses and surgery...
February 10, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28180146/-i-think-we-ve-got-too-many-tests-prenatal-providers-reflections-on-ethical-and-clinical-challenges-in-the-practice-integration-of-cell-free-dna-screening
#15
B L Gammon, S A Kraft, M Michie, M Allyse
BACKGROUND: The recent introduction of cell-free DNA-based non-invasive prenatal screening (cfDNA screening) into clinical practice was expected to revolutionize prenatal testing. cfDNA screening for fetal aneuploidy has demonstrated higher test sensitivity and specificity for some conditions than conventional serum screening and can be conducted early in the pregnancy. However, it is not clear whether and how clinical practices are assimilating this new type of testing into their informed consent and counselling processes...
July 2016: Ethics, Medicine, and Public Health
https://www.readbyqxmd.com/read/28179286/italian-prostate-biopsies-group-2016-updated-guidelines-insights
#16
REVIEW
Andrea Fandella, Vincenzo Scattoni, Andrea Galosi, Pietro Pepe, Michelangelo Fiorentino, Caterina Gaudiano, Marco Giampaoli, Roberta Gunelli, Pasquale Martino, Vittorino Montanaro, Rodolfo Montironi, Tiziana Pierangeli, Armando Stabile, Alessandro Bertaccini
AIM: To present a summary of the updated guidelines of the Italian Prostate Biopsies Group following the best recent evidence of the literature. MATERIALS AND METHODS: A systematic review of the new data emerging from 2012-2015 was performed by a panel of 14 selected Italian experts in urology, pathology and radiology. The experts collected articles published in the English-language literature by performing a search using Medline, EMBASE and the Cochrane Library database...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28166581/a-student-led-introduction-to-lesbian-gay-bisexual-and-transgender-health-for-first-year-medical-students
#17
Andrea M Grosz, Daniel Gutierrez, Andrea A Lui, Julia J Chang, Kathy Cole-Kelly, Henry Ng
BACKGROUND AND OBJECTIVES: Lesbian, gay, bisexual, and transgender (LGBT) individuals face significant health disparities. This is in part because many physicians are not sensitive to, and/or are underprepared to address, LGBT-specific concerns. To help meet this need, we, a group of second- and fourth-year medical students with faculty oversight, organized a session on LGBT health for first-year medical students. METHODS: The three second-year and one fourth-year student authors designed a mandatory session for the 167 first-years at Case Western Reserve University School of Medicine in Cleveland, OH...
January 2017: Family Medicine
https://www.readbyqxmd.com/read/28156626/effect-of-a-communication-skills-intervention-on-resident-comfort-and-knowledge-of-discussing-goals-of-care-and-advance-care-planning
#18
Elizabeth Golding, Aaron Lampkin, Mary Walker Larach, Lawrence Klima
: 50 Background: Inpatient providers are sometimes challenged with advanced care planning for their patients. At a teaching hospital, resident physicians find themselves tasked with this responsibility for inpatients they may have only just met, as well as in their assigned outpatient panel. Education on communication skills though has been shown to improve resident comfort level and knowledge of discussing goals of care and advance care planning. METHODS: Internal medicine categorical residents (n = 15) and preliminary (n = 3) residents at a university-affiliated, community hospital learned the fundamentals of discussing goals of care and advance care planning using selected modules from the Center for Advancing Palliative Care's (CAPC) online curriculum in communication skills during their outpatient clinic rotation from February through June 2016...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28155043/can-appealing-to-patient-altruism-reduce-overuse-of-health-care-services-an-experimental-survey
#19
Kevin R Riggs, Peter A Ubel, Brendan Saloner
BACKGROUND: A challenge to reducing overuse of health services is communicating recommendations against unnecessary health services to patients. The predominant approach has been to highlight the limited benefit and potential harm of such services for that patient, but the prudent use of health resources can also benefit others. Whether appealing to patient altruism can reduce overuse is unknown. OBJECTIVE: To determine whether altruistic appeals reduce hypothetical requests for overused services and affect physician ratings...
February 2, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28153989/sex-differences-in-1-year-all-cause-rehospitalization-in-patients-after-acute-myocardial-infarction-a-prospective-observational-study
#20
Rachel P Dreyer, Kumar Dharmarajan, Kevin F Kennedy, Philip G Jones, Viola Vaccarino, Karthik Murugiah, Sudhakar V Nuti, Kim G Smolderen, Donna M Buchanan, John A Spertus, Harlan M Krumholz
BACKGROUND: Compared with men, women are at higher risk of rehospitalization in the first month after discharge for acute myocardial infarction (AMI). However, it is unknown whether this risk extends to the full year and varies by age. Explanatory factors potentially mediating the relationship between sex and rehospitalization remain unexplored and are needed to reduce readmissions. The aim of this study was to assess sex differences and factors associated with 1-year rehospitalization rates after AMI...
February 7, 2017: Circulation
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