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https://www.readbyqxmd.com/read/28437385/before-or-after-transplantation-a-review-of-the-cost-effectiveness-of-treating-waitlisted-patients-with-hepatitis-c
#1
Elliot B Tapper, Nezam H Afdhal, Michael P Curry
All patients with chronic hepatitis C virus (HCV) infections can and should be treated. Though highly effective direct-acting antiviral therapies are costly, the price of a cure is a 1-time investment that is outweighed by future benefits. For clinicians caring for patients requiring liver transplant, the key question relates to the timing of treatment: before or after liver transplantation? On 1 hand, treating HCV often improves our patients' model for end-stage liver disease (MELD) score, decreasing costs, and potentially improving longevity by reducing our patients' risk of death and transplantation...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28437349/a-new-navigational-tool-for-pedicle-screw-placement-in-patients-with-severe-scoliosis-a-pilot-study-to-prove-feasibility-accuracy-and-identify-operative-challenges
#2
Michael Putzier, Patrick Strube, Riccardo Cecchinato, Claudio Lamartina, Eike K Hoff
STUDY DESIGN: Pilot study. OBJECTIVE: To develop and validate the feasibility and accuracy of a newly designed navigational spinal instrument guiding tool for patient-matched thoracic and lumbar pedicle screw placement in patients with severe scoliosis, and to identify intraoperative challenges that may be relevant. SUMMARY OF BACKGROUND DATA: Pedicle screw placement is challenging in severely rotated scoliotic spine with small diameters and asymmetrical shape of the pedicles and vertebrae...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28436922/the-feasibility-of-manual-parameter-tuning-for-deformable-breast-mr-image-registration-from-a-multi-objective-optimization-perspective
#3
Kleopatra Pirpinia, Peter Bosman, Claudette Loo, Gonneke Winter-Warnars, Natasja Janssen, Astrid Scholten, Jan-Jakob Sonke, Marcel van Herk, Tanja Alderliesten
Deformable image registration is typically formulated as an optimization problem involving a linearly weighted combination of terms that correspond to objectives of interest (e.g., similarity, deformation magnitude). The weights, along with multiple other parameters, need to be manually tuned for each application, a task currently mainly addressed via trial-and-error approaches. Such approaches can only be successful if there is a sensible interplay between parameters, objectives, and desired registration outcome...
April 24, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28435495/areas-of-potential-impact-of-the-patient-protection-and-affordable-care-act-on-ems-a-synthesis-of-the-literature
#4
REVIEW
Daniel G Ostermayer, Charles A Brown, William G Fernandez, Emily Couvillon
INTRODUCTION: This comprehensive review synthesizes the existing literature on the Patient Protection and Affordable Care Act (ACA) as it relates to emergency medical services (EMS) in order to provide guidance for navigating current and future healthcare changes. METHODS: We conducted a comprehensive review to identify all existing literature related to the ACA and EMS and all sections within the federal law pertaining to EMS. RESULTS: Many changes enacted by the ACA directly affect emergency care with potential indirect effects on EMS systems...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434959/analysis-of-137-patients-who-underwent-endoscopic-transsphenoidal-pituitary-adenoma-resection-under-high-field-intraoperative-magnetic-resonance-imaging-navigation
#5
Huaping Zhang, Fuyu Wang, Tao Zhou, Peng Wang, Xiaolei Chen, Jiashu Zahng, Dingbiao Zhou
OBJECTIVE: Endonasal resection of the pituitary embodies the minimally invasive concept. Pure endoscopic resection of pituitary adenoma has become the most popular surgical approach. Intraoperative magnetic resonance imaging (iMRI) systems have been in use for endoscopic resection of pituitary adenomas. The study aimed to evaluate the effectiveness of iMRI and neuroimaging navigation techniques during endoscopic endonasal transsphenoidal surgery of pituitary adenomas. METHODS: Data from 137 patients who underwent resection of endoscopic pituitary adenoma under 1...
April 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28434698/influence-of-component-rotation-in-total-knee-arthroplasty-on-tibiofemoral-kinematics-a-cadaveric-investigation
#6
Guenther Maderbacher, Armin Keshmiri, Hans R Springorum, Hermann Maderbacher, Joachim Grifka, Clemens Baier
BACKGROUND: Physiological tibiofemoral kinematics have been shown to be important for good knee function after total knee arthroplasty (TKA). The purpose of the present study was to investigate the influence of component rotation on tibiofemoral kinematics during knee flexion. We asked which axial component alignment best reconstructs physiological tibiofemoral kinematics and which combinations should be avoided. METHODS: Ten healthy cadaveric knees were examined...
April 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28430574/how-navigating-uncertainty-motivates-trust-in-medicine
#7
Jonathan B Imber
Three significant factors in the shaping of modern medicine contribute to broad perceptions about trust in the patient-physician relationship: moral, professional, and epidemiological uncertainty. Trusting a physician depends first on trusting a person, then trusting a person's skills and training, and finally trusting the science that underwrites those skills. This essay, in part based on my book, Trusting Doctors: The Decline of Moral Authority in American Medicine (Princeton University Press, 2008), will address the forms of uncertainty that contribute to the nature of difficult encounters in the patient-physician relationship...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430396/patient-and-caregiver-perspectives-on-decision-support-for-symptom-and-quality-of-life-management-during-cancer-treatment-implications-for-ehealth
#8
Mary E Cooley, Manan M Nayak, Janet L Abrahm, Ilana M Braun, Michael S Rabin, Jane Brzozowski, Christopher Lathan, Donna L Berry
OBJECTIVES: Adequate symptom and quality-of-life (SQL) management is a priority during cancer treatment. eHealth is a timely way to enhance patient-engagement, facilitate communication and improve health outcomes. The objectives of this study were to describe patient and caregivers' perspectives for providing, processing and managing SQL data to enhance communication and identify desired components for decision support. METHODS: Data were collected from 64 participants through questionnaires and focus groups...
April 21, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28429947/a-practical-guide-to-development-of-a-successful-robotic-abdominal-surgery-program-the-path-to-implementation
#9
Z Jutric, S Warner, Y Fong
The authors describe current situation in robotic assisted operations. The most important aspects of establishing a successful robotic program are patience and flexibility. The improved patient satisfaction, return to function, and decreased perioperative pain for patients and surgeons will be seen, but the road is long and requires careful navigation.Key Words: robot abdominal surgery - program development.
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28429801/the-dizzy-patient-don-t-forget-disorders-of-the-central-vestibular-system
#10
REVIEW
Thomas Brandt, Marianne Dieterich
Vertigo and dizziness are among the most common complaints in neurology clinics, and they account for about 13% of the patients entering emergency units. In this Review, we focus on central vestibular disorders, which are mostly attributable to acute unilateral lesions of the bilateral vestibular circuitry in the brain. In a tertiary interdisciplinary outpatient dizziness unit, central vestibular disorders, including vestibular migraine, comprise about 25% of the established diagnoses. The signs and symptoms of these disorders can mimic those of peripheral vestibular disorders with sustained rotational vertigo...
April 21, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28428081/intraoperative-image-guidance-compared-with-free-hand-methods-in-adolescent-idiopathic-scoliosis-posterior-spinal-surgery-a-systematic-review-on-screw-related-complications-and-breach-rates
#11
Andrew Chan, Eric Parent, Karl Narvacan, Cindy San, Edmond Lou
BACKGROUND CONTEXT: Severe adolescent idiopathic scoliosis (AIS) is a 3D spinal deformity requiring surgery to stop curve progression. Posterior spinal instrumentation and fusion with pedicle screws is the standard surgery for AIS curve correction. Vascular and neurologic complications related to screw-malpositioning are concerns in surgeries for AIS. Breach rates are reported at 15.7%, implant-related complications at 1.1% and neurologic deficit at 0.8%. Free-hand screw insertion remains the prevailing method of screw placement while image guidance has been suggested to improve placement accuracy...
April 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28427989/egocentric-and-allocentric-visuospatial-working-memory-in-premotor-huntington-s-disease-a-double-dissociation-with-caudate-and-hippocampal-volumes
#12
Katherine L Possin, Hosung Kim, Michael D Geschwind, Tacie Moskowitz, Erica T Johnson, Sharon J Sha, Alexandra Apple, Duan Xu, Bruce L Miller, Steven Finkbeiner, Christopher P Hess, Joel H Kramer
Our brains represent spatial information in egocentric (self-based) or allocentric (landmark-based) coordinates. Rodent studies have demonstrated a critical role for the caudate in egocentric navigation and the hippocampus in allocentric navigation. We administered tests of egocentric and allocentric working memory to individuals with premotor Huntington's disease (pmHD), which is associated with early caudate nucleus atrophy, and controls. Each test had 80 trials during which subjects were asked to remember 2 locations over 1-sec delays...
April 17, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/28427987/trajectory-planning-and-guided-punctures-with-isocentric-navigation-in-posterolateral-endoscopic-lumbar-discectomy-technical-note
#13
Guoxin Fan, Chuanfeng Wang, Xin Gu, Hailong Zhang, Shisheng He
BACKGROUND: Posterolateral endoscopic trasforaminal discectomy (PELD) requires an ideal percutaneous puncture to place the working channel for endoscopic discectomy. The conventional blinded punctures relies on the surgeons' experience and repeated fluoroscopy, which may increase radiation exposure. The study aimed to introduce isocentric navigation to plan trajectory and guide punctures in PELD. METHODS: Technical note and clinical outcomes of patients undergoing PELD with isocentric navigation were recorded in this report...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28427402/fluorescence-cholangiography-during-laparoscopic-cholecystectomy-in-a-patient-with-situs-inversus-totalis-a-case-report-and-literature-review
#14
Narongsak Rungsakulkij, Pongsatorn Tangtawee
BACKGROUND: Situs inversus totalis is a rare autosomal disorder in which the patient's affected visceral organs are a perfect mirror image of their normal positions. Surgery in these patients is technically challenging. Minimally invasive surgery such as laparoscopic cholecystectomy is the standard treatment for symptomatic cholelithiasis, but it can be difficult to perform. Laparoscopic cholecystectomy in patients with situs inversus totalis may be even more technically challenging. Fluorescence cholangiography is a new innovation in the field of navigation surgery...
April 20, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28426162/motion-corrected-simultaneous-cardiac-positron-emission-tomography-and-coronary-mr-angiography-with-high-acquisition-efficiency
#15
Camila Munoz, Radhouene Neji, Gastão Cruz, Andrew Mallia, Sami Jeljeli, Andrew J Reader, Rene M Botnar, Claudia Prieto
PURPOSE: Develop a framework for efficient free-breathing simultaneous whole-heart coronary magnetic resonance angiography (CMRA) and cardiac positron emission tomography (PET) on a 3 Tesla PET-MR system. METHODS: An acquisition that enables nonrigid motion correction of both CMRA and PET has been developed. The proposed method estimates translational motion from low-resolution 2D MR image navigators acquired at each heartbeat and 3D nonrigid respiratory motion between different respiratory bins from the CMRA data itself...
April 20, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28426148/three-dimensional-finite-element-based-deformable-image-registration-for-evaluation-of-pleural-cavity-irradiation-during-photodynamic-therapy
#16
Rozhin Penjweini, Michele M Kim, Timothy C Zhu
PURPOSE: Photodynamic therapy (PDT) is used after surgical resection to treat the microscopic disease for malignant pleural mesothelioma and to increase survival rates. As accurate light delivery is imperative to PDT efficacy, the deformation of the pleural volume during the surgery is studied on its impact on the delivered light fluence. In this study, a three-dimensional finite element-based (3D FEM) deformable image registration is proposed to directly match the volume of lung to the volume of pleural cavity obtained during PDT to have accurate representation of the light fluence accumulated in the lung, heart and liver (organs-at-risk) during treatment...
April 20, 2017: Medical Physics
https://www.readbyqxmd.com/read/28425112/beyond-guidelines-discretionary-practice-in-face-to-face-triage-nursing
#17
Lars E F Johannessen
This article draws on ethnographic data from a Norwegian emergency primary care clinic (EPCC) to explore nurses' discretionary application of guidelines. Specifically, it analyses nurses' discretionary use of the Manchester Triage System (MTS) when performing face-to-face triage, that is, assessing the urgency of patients' complaints. The analysis shows how nurses assessed patients at odds with MTS prescriptions by collecting supplementary data, engaging in differential diagnostic and holistic reasoning, relying on emotion and intuition, and allowing colleagues and patients to influence their reasoning...
April 20, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28425055/what-are-the-oncologic-and-functional-outcomes-after-joint-salvage-resections-for-juxtaarticular-osteosarcoma-about-the-knee
#18
Jing Li, Zhen Wang, Chuanlei Ji, Guojing Chen, Dong Liu, Haodong Zhu
BACKGROUND: Joint salvage surgery for patients with juxtaarticular osteosarcoma remains challenging, especially when the tumor invades the epiphysis. Because patients are surviving longer with current chemotherapy regimens, it is advantageous to retain native joints if possible, especially in young patients. However, the results using joint-preserving tumor resections in this context have not been well characterized. QUESTIONS/PURPOSES: (1) What are the functional outcomes after limb salvage surgery at a minimum of 3 years? (2) What are the oncologic outcomes? (3) Is joint salvage surgery for epiphyseal tumors associated with an increased risk of local recurrence compared with metaphyseal tumors not invading the epiphysis? (4) What are the complications associated with joint salvage surgery? METHODS: Between 2004 and 2013, we treated 117 patients with juxtaarticular osteosarcoma; of those, 43 (38%) were treated with joint salvage surgery, and 41 (95%) of the 43 patients are included in our study...
April 19, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28424659/online-measurement-of-microembolic-signal-burden-by-transcranial-doppler-during-catheter-ablation-for-atrial-fibrillation-results-of-a-multicenter-trial
#19
Christian von Bary, Thomas Deneke, Thomas Arentz, Anja Schade, Heiko Lehrmann, Sabine Fredersdorf, Dobri Baldaranov, Lars Maier, Felix Schlachetzki
INTRODUCTION: Left atrial pulmonary vein isolation (PVI) is an accepted treatment option for patients with symptomatic atrial fibrillation (AF). This procedure can be complicated by stroke or silent cerebral embolism. Online measurement of microembolic signals (MESs) by transcranial Doppler (TCD) may be useful for characterizing thromboembolic burden during PVI. In this prospective multicenter trial, we investigated the burden, characteristics, and composition of MES during left atrial catheter ablation using a variety of catheter technologies...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28423827/parallel-design-of-browsing-scheme-and-data-model-for-multi-level-hierarchical-application-devoted-to-management-of-patient-with-infectious-disease-in-primary-care
#20
Adrien Ugon, Catherine Duclos, Salamata Konate, Sarah Arnedos Lopez, Hechem Yazidi, Alain Venot, Marie-Christine Jaulent, Rosy Tsopra
Many decision systems are based on a hierarchical approach, enriching the known context used to finally choose the right potential action. Designing the scheme for browsing the clinical guidelines is a task devoted to expert in infectious diseases. Designing the data model is a task devoted to the expert in data modeling. As a consequence, browsing scheme and data model generally differ in terms of abstraction levels. While the browsing scheme proposes to navigate into depth, the data model stays flat. We propose here a novel method to design in parallel the browsing scheme and the data model so that both of them reflect the different abstraction levels in decision process...
2017: Studies in Health Technology and Informatics
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