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https://www.readbyqxmd.com/read/29222697/clinical-implications-of-rapid-eplex%C3%A2-respiratory-pathogen-panel-testing-compared-to-laboratory-developed-real-time-pcr
#1
Anneloes L van Rijn, Roel H T Nijhuis, Vincent Bekker, Geert H Groeneveld, Els Wessels, Mariet C W Feltkamp, Eric C J Claas
Rapid diagnosis of respiratory infections is of great importance for adequate isolation and treatment. Due to the batch-wise testing, laboratory-developed real-time polymerase chain reaction (PCR) assays (LDT) often result in a time to result of one day. Here, LDT was compared with rapid ePlex® Respiratory Pathogen (RP) Panel testing of GenMark Diagnostics (Carlsbad, CA, USA) with regard to time to result, installed isolation precautions, and antibacterial/antiviral treatment. Between January and March 2017, 68 specimens of 64 patients suspected of an acute respiratory infection were tested with LDT and the ePlex® RP panel...
December 8, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29220063/preventive-care-screening-in-the-puerto-rican-geriatric-population-a-formative-evaluation-of-patient-knowledge
#2
Vanessa Sepúlveda-Rivera, Christian Donato-Santana, Gil Diaz-Vega
OBJECTIVE: This study was meant to be the first step in bridging a gap in the literature concerning Puerto Rican geriatric patients' levels of knowledge concerning 4 preventive care screening tests: mammography, bone densitometry, colonoscopy, and lipid panels. METHODS: Patients 65 years old and older were interviewed at the University of Puerto Rico (UPR), Medical Sciences Campus, primary care clinics. Fisher's exact test was used to assess knowledge status for each screening test...
December 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/29217324/-medical-human-resources-planning-in-europe-a-literature-review-of-the-forecasting-models
#3
N Benahmed, D Deliège, A De Wever, M Pirson
BACKGROUND: Healthcare is a labor-intensive sector in which half of the expenses are dedicated to human resources. Therefore, policy makers, at national and internal levels, attend to the number of practicing professionals and the skill mix. This paper aims to analyze the European forecasting model for supply and demand of physicians. METHODS: To describe the forecasting tools used for physician planning in Europe, a grey literature search was done in the OECD, WHO, and European Union libraries...
December 4, 2017: Revue D'épidémiologie et de Santé Publique
https://www.readbyqxmd.com/read/29211320/consensus-statements-on-the-management-of-metastatic-prostate-cancer-from-the-hong-kong-urological-association-and-hong-kong-society-of-uro-oncology
#4
REVIEW
Darren Ming-Chun Poon, Chi-Kwok Chan, Tim-Wai Chan, Foon-Yiu Cheung, Philip Wai-Kay Kwong, Eric Ka-Chai Lee, Angus Kwong-Chuen Leung, Simon Yiu-Lam Leung, Wai-Kit Ma, Hing-Shing So, Po-Chor Tam, Lap-Yin Ho
OBJECTIVES: To establish a set of consensus statements to facilitate physician management strategies for patients with metastatic prostate cancer (mPC) in Hong Kong. MATERIALS AND METHODS: A local expert consensus was organised jointly by the two main professional organisations representing prostate cancer specialists in Hong Kong. A total of 12 experts were included in the consensus panel. Six of the most crucial and relevant areas of debate regarding the management of mPC were identified...
December 6, 2017: BJU International
https://www.readbyqxmd.com/read/29204975/characteristics-and-disparities-among-primary-care-practices-in-the-united-states
#5
David Michael Levine, Jeffrey A Linder, Bruce E Landon
BACKGROUND: Despite new incentives for US primary care, concerns abound that patient-centered practice capabilities are lagging. OBJECTIVE: Describe the practice structure, patient-centered capabilities, and payment relationships of US primary care practices; identify disparities in practice capabilities. DESIGN: Analysis of the 2015 Medical Organizations Survey (MOS), part of the nationally representative Medical Expenditure Panel Survey (MEPS)...
December 4, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29200346/public-and-private-payments-for-physician-office-visits
#6
Adam I Biener, Thomas M Selden
We used data for 2014-15 from the Medical Expenditure Panel Survey to estimate standardized payments for nonelderly adults' physician office visits by type of insurance. Adults with public insurance, especially Medicaid, had substantially lower provider payments, out-of-pocket spending, and third-party payments than their peers with employer-sponsored or Marketplace insurance. Quantifying public-private payment differences can help clarify choices for financing health care among low-income Americans.
December 2017: Health Affairs
https://www.readbyqxmd.com/read/29198549/development-and-validation-of-a-taiwan-version-of-the-id-pain-questionnaire-id-pain-t
#7
Chih-Chao Yang, Long-Sun Ro, Yu-Chuan Tsai, Kon-Ping Lin, Wei-Zen Sun, Wei-Tse Fang, Shuu-Jiun Wang
BACKGROUND: Neuropathic pain (NeP) is distinct from nociceptive pain and has different underlying mechanisms requiring specific treatment strategies. To aid diagnosis, self-administered screening questionnaires (such as ID Pain) have been developed to help physicians identify patients with NeP. The aim of this study was to develop and validate a translated ID Pain questionnaire for Taiwanese subjects (ID Pain-T). METHODS: ID Pain, a 6-item self-administered questionnaire, score ranged from -1 to 5, was translated from English into Mandarin Chinese using local terms and back-translated by an expert panel...
November 30, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29196308/pseudohyponatraemia-secondary-to-hyperlipidaemia-in-obstructive-jaundice
#8
Samuel O Igbinedion, Sudha Pandit, Meher S Mavuram, Moheb Boktor
A 44-year-old man with uncontrolled diabetes and chronic pancreatitis presented with abdominal pain, jaundice and unintentional weight loss. Laboratory investigations were significant for hyponatraemia, an obstructive pattern of liver enzymes. Imaging was consistent with intrahepatic and extrahepatic biliary obstruction, and endoscopic evaluation revealed a long common bile duct stricture. Intravascular volume depletion, beer potomania and syndrome of inappropriate antidiuretic hormone (with concern for biliary or pancreatic malignancy) were considered in the work-up for the aetiology of the hyponatraemia...
December 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29187107/the-burdens-of-offering-ethical-and-practical-considerations
#9
Roxanne E Kirsch, Jillian Coronado, Peter P Roeleveld, James Tweddell, Antonio M Mott, Stephen J Roth
We reflect upon highlights of a facilitated panel discussion from the 2016 Pediatric Cardiac Intensive Care Society Meeting. The session was designed to explore challenges, share practical clinical experiences, and review ethical underpinnings surrounding decisions to offer intensive, invasive therapies to patients who have a poor prognosis for survival or are likely to be burdened with multiple residual comorbidities if survival is achieved. The discussion panel was representative of a variety of disciplines including pediatric cardiology, cardiac intensive care, nursing, and cardiovascular surgery as well as different health-care delivery systems...
November 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29178436/incremental-treatment-costs-attributable-to-overweight-and-obesity-in-patients-with-diabetes-quantile-regression-approach
#10
Seung-Mi Lee, In-Sun Choi, Euna Han, David Suh, Eun-Kyung Shin, Seyunghe Je, Sung Su Lee, Dong-Churl Suh
OBJECTIVE: This study aimed to estimate treatment costs attributable to overweight and obesity in patients with diabetes who were less than 65 years of age in the United States. METHODS: This study used data from the Medical Expenditure Panel Survey from 2001 to 2013. Patients with diabetes were identified by using the International Classification of Diseases, Ninth Revision, Clinical Modification code (250), clinical classification codes (049 and 050), or self-reported physician diagnoses...
November 27, 2017: Obesity
https://www.readbyqxmd.com/read/29175379/ex-vivo-sensitivity-profiling-to-guide-clinical-decision-making-in-acute-myeloid-leukemia-a-pilot-study
#11
Ronan T Swords, Diana Azzam, Hassan Al-Ali, Ines Lohse, Claude-Henry Volmar, Justin M Watts, Aymee Perez, Ana Rodriguez, Fernando Vargas, Roy Elias, Francisco Vega, Arthur Zelent, Shaun P Brothers, Taher Abbasi, Jonathan Trent, Shaukat Rangwala, Yehuda Deutsch, Eibhlin Conneally, Leylah Drusbosky, Christopher R Cogle, Claes Wahlestedt
A precision medicine approach is appealing for use in AML due to ease of access to tumor samples and the significant variability in the patients' response to treatment. Attempts to establish a precision medicine platform for AML, however, have been unsuccessful, at least in part due to the use of small compound panels and having relatively slow turn over rates, which restricts the scope of treatment and delays its onset. For this pilot study, we evaluated a cohort of 12 patients with refractory AML using an ex vivo drug sensitivity testing (DST) platform...
November 11, 2017: Leukemia Research
https://www.readbyqxmd.com/read/29167761/european-thyroid-association-guidelines-for-ultrasound-malignancy-risk-stratification-of-thyroid-nodules-in-adults-the-eu-tirads
#12
Gilles Russ, Steen J Bonnema, Murat Faik Erdogan, Cosimo Durante, Rose Ngu, Laurence Leenhardt
Thyroid ultrasound (US) is a key examination for the management of thyroid nodules. Thyroid US is easily accessible, noninvasive, and cost-effective, and is a mandatory step in the workup of thyroid nodules. The main disadvantage of the method is that it is operator dependent. Thyroid US assessment of the risk of malignancy is crucial in patients with nodules, in order to select those who should have a fine needle aspiration (FNA) biopsy performed. Due to the pivotal role of thyroid US in the management of patients with nodules, the European Thyroid Association convened a panel of international experts to set up European guidelines on US risk stratification of thyroid nodules...
September 2017: European Thyroid Journal
https://www.readbyqxmd.com/read/29166411/a-machine-learning-approach-to-triaging-patients-with-chronic-obstructive-pulmonary-disease
#13
Sumanth Swaminathan, Klajdi Qirko, Ted Smith, Ethan Corcoran, Nicholas G Wysham, Gaurav Bazaz, George Kappel, Anthony N Gerber
COPD patients are burdened with a daily risk of acute exacerbation and loss of control, which could be mitigated by effective, on-demand decision support tools. In this study, we present a machine learning-based strategy for early detection of exacerbations and subsequent triage. Our application uses physician opinion in a statistically and clinically comprehensive set of patient cases to train a supervised prediction algorithm. The accuracy of the model is assessed against a panel of physicians each triaging identical cases in a representative patient validation set...
2017: PloS One
https://www.readbyqxmd.com/read/29165790/physician-interpretation-of-genomic-test-results-and-treatment-selection
#14
Lauren L Brusco, Chetna Wathoo, Kenna R Mills Shaw, Vijaykumar R Holla, Ann M Bailey, Amber M Johnson, Yekaterina B Khotskaya, Beate C Litzenburger, Nora S Sanchez, Jia Zeng, Elmer V Bernstam, Cathy Eng, Bryan K Kee, Rodabe N Amaria, Mark J Routbort, Gordon B Mills, John Mendelsohn, Funda Meric-Bernstam
BACKGROUND: Genomic testing is increasingly performed in oncology, but concerns remain regarding the clinician's ability to interpret results. In the current study, the authors sought to determine the agreement between physicians and genomic annotators from the Precision Oncology Decision Support (PODS) team at The University of Texas MD Anderson Cancer Center in Houston regarding actionability and the clinical use of test results. METHODS: On a prospective protocol, patients underwent clinical genomic testing for hotspot mutations in 46 or 50 genes...
November 22, 2017: Cancer
https://www.readbyqxmd.com/read/29162583/international-consensus-on-use-of-continuous-glucose-monitoring
#15
REVIEW
Thomas Danne, Revital Nimri, Tadej Battelino, Richard M Bergenstal, Kelly L Close, J Hans DeVries, Satish Garg, Lutz Heinemann, Irl Hirsch, Stephanie A Amiel, Roy Beck, Emanuele Bosi, Bruce Buckingham, Claudio Cobelli, Eyal Dassau, Francis J Doyle, Simon Heller, Roman Hovorka, Weiping Jia, Tim Jones, Olga Kordonouri, Boris Kovatchev, Aaron Kowalski, Lori Laffel, David Maahs, Helen R Murphy, Kirsten Nørgaard, Christopher G Parkin, Eric Renard, Banshi Saboo, Mauro Scharf, William V Tamborlane, Stuart A Weinzimer, Moshe Phillip
Measurement of glycated hemoglobin (HbA1c) has been the traditional method for assessing glycemic control. However, it does not reflect intra- and interday glycemic excursions that may lead to acute events (such as hypoglycemia) or postprandial hyperglycemia, which have been linked to both microvascular and macrovascular complications. Continuous glucose monitoring (CGM), either from real-time use (rtCGM) or intermittently viewed (iCGM), addresses many of the limitations inherent in HbA1c testing and self-monitoring of blood glucose...
December 2017: Diabetes Care
https://www.readbyqxmd.com/read/29160381/quality-of-communication-questionnaire-for-copd-patients-receiving-palliative-care-translation-and-cross-cultural-adaptation-for-use-in-brazil
#16
Flávia Del Castanhel, Suely Grosseman
OBJECTIVE: To translate the Quality of Communication Questionnaire (QOC) to Portuguese and adapt it for use in Brazil in COPD patients receiving palliative care. METHODS: After approval from the first author of the original QOC and the local research ethics committee, the original, 13-item version of the questionnaire was independently translated to Brazilian Portuguese by two Brazilian translators fluent in English. The two translations were analyzed by a bilingual physician and the two Brazilian translators, who reached a consensus and produced another Portuguese version of the QOC...
September 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/29149338/multiplex-respiratory-virus-testing-for-antimicrobial-stewardship-a-prospective-assessment-of-antimicrobial-use-and-clinical-outcomes-among-hospitalized-adults
#17
Makeda Semret, Ian Schiller, Barbara Ann Jardin, Charles Frenette, Vivian G Loo, Jesse Papenburg, Shelly A McNeil, Nandini Dendukuri
Background: Respiratory tract infections are frequent causes of hospitalization and initiation of empirical antimicrobial therapy. Testing for a broad panel of respiratory viruses has been advocated as a useful tool for antibiotic stewardship. We conducted a prospective observational study to assess the impact of rapid viral test results on antimicrobial prescriptions and clinical outcomes among hospitalized adults. Methods: Eight hundred patients admitted with respiratory symptoms were tested by a 12-virus respiratory panel (RVP) during 3 consecutive winters in Montreal, Canada...
November 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29146826/social-preferences-of-future-physicians
#18
Jing Li, William H Dow, Shachar Kariv
We measure the social preferences of a sample of US medical students and compare their preferences with those of the general population sampled in the American Life Panel (ALP). We also compare the medical students with a subsample of highly educated, wealthy ALP subjects as well as elite law school students and undergraduate students. We further associate the heterogeneity in social preferences within medical students to the tier ranking of their medical schools and their expected specialty choice. Our experimental design allows us to rigorously distinguish altruism from preferences regarding equality-efficiency tradeoffs and accurately measure both at the individual level rather than pooling data or assuming homogeneity across subjects...
November 16, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29133195/a-self-administered-questionnaire-to-measure-the-painful-symptoms-of-endometriosis-results-of-a-modified-delphi-survey-of-patients-and-physicians
#19
Arnaud Fauconnier, Stéphanie Staraci, Emile Daraï, Philippe Decamps, Michelle Nisolle, Pierre Panel, Horace Roman, Rym Boulkedid
PURPOSE: To develop a questionnaire based on patients' verbal descriptors, to measure the painful symptoms of endometriosis METHODS: We performed a two-round modified DELPHI procedure mixing endometriosis patients and physicians to select a set of statements to describe the painful symptoms of endometriosis. Each panelist rated each statement based on diagnosis validity and clarity. The clinicians were experts in endometriosis management selected from various geographic regions in France...
November 10, 2017: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/29132628/the-use-of-computerized-physician-order-entry-with-clinical-decision-support-reduces-practice-variance-in-ordering-preoperative-investigations-a-retrospective-cohort-study
#20
Eileen Yilin Sim, Daryl Jian An Tan, Hairil Rizal Abdullah
BACKGROUND AND GOAL OF STUDY: Over-ordering of routine preoperative investigations is prevalent. Adherence to institutional guidelines differs among physicians. Our institution integrated a Clinical Decision Support (CDS) model into our hospital's Computerized Physician Ordering Entry (CPOE) system to guide physician orders. We investigate if the implementation of CDS into CPOE increases physician adherence to our institutional guidelines. METHODS: A retrospective cohort study in a tertiary academic hospital over 18 months...
December 2017: International Journal of Medical Informatics
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