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Cleveland clinic review

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https://www.readbyqxmd.com/read/28421812/the-frequency-of-incidental-findings-and-subsequent-evaluation-in-low-dose-ct-scans-for-lung-cancer-screening
#1
Lillie Morgan, Humberto Choi, Michal Reid, Ali Khawaja, Peter J Mazzone
RATIONALE: The USPSTF recommends lung cancer screening with low-dose chest CT scans (LDCT) for a well-defined high-risk population. Data on the frequency and impact of incidental findings on LDCT scans performed within a centralized lung cancer screening program has not been reported. OBJECTIVES: Previous studies have reported IFs in the setting of clinical trials. We present our findings in a real clinical setting where the decision to manage these findings may depend on factors that are not captured in a research trial such as disclosing IFs, patient preferences, severity of comorbidities, and physician expertise...
April 19, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28421723/clinical-outcomes-of-proton-beam-therapy-for-choroidal-melanoma-at-a-single-institute-in-korea
#2
Tae Wan Kim, Euncheol Choi, Jeonghoon Park, Dong-Ho Shin, Su Kyung Jung, Susie Seok, Kwan Ho Cho, Joo-Young Kim, Dae Yong Kim, Tae Hyun Kim, Yang Kwon Suh, Yeon Joo Kim, Sung Ho Moon
Purpose: This study retrospectively evaluated the clinical outcomes and complications of proton beam therapy (PBT) in a single institution in Korea and quantitatively analyzed the change in tumor volume after PBT using magnetic resonance imaging (MRI). Materials and Methods: Twenty-four treatment-naïve patients who underwent PBT for choroidal melanoma between 2009 and 2015 were reviewed. Dose fractionation was 60-70 CGE over 5 fractions. Orbital MRIs were taken at baseline and 3, 6, and 12 months after PBT and annually thereafter...
April 19, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28410361/rates-of-intraocular-pressure-elevation-and-use-of-topical-antihypertensive-medication-after-descemet-stripping-automated-endothelial-keratoplasty
#3
Mona Kaleem, Faisal Ridha, Zryan Shwani, Bonnielin Swenor, Jeffrey Goshe, Annapurna Singh
PURPOSE: To investigate intraocular pressure (IOP) elevation and medication augmentation after Descemet stripping automated endothelial keratoplasty (DSAEK) in those with and without glaucoma. METHODS: The records of 379 patients who underwent DSAEK at the Cleveland Clinic Foundation between January 2009 and 2014 were retrospectively reviewed. Postoperative IOP elevations were considered significant if IOP was ≥22 mm Hg on at least 1 follow-up visit or if it increased by ≥10 mm Hg from baseline...
April 12, 2017: Cornea
https://www.readbyqxmd.com/read/28398932/brachial-arterial-pressure-monitoring-during-cardiac-surgery-rarely-causes-complications
#4
Asha Singh, Bobby Bahadorani, Brett J Wakefield, Natalya Makarova, Priya A Kumar, Michael Zhen-Yu Tong, Daniel I Sessler, Andra E Duncan
BACKGROUND: Brachial arterial catheters better estimate aortic pressure than radial arterial catheters but are used infrequently because complications in a major artery without collateral flow are potentially serious. However, the extent to which brachial artery cannulation promotes complications remains unknown. The authors thus evaluated a large cohort of cardiac surgical patients to estimate the incidence of related serious complications. METHODS: The institutional Society of Thoracic Surgeons Adult Cardiac Surgery Database and Perioperative Health Documentation System Registry of the Cleveland Clinic were used to identify patients who had brachial artery cannulation between 2007 and 2015...
April 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28391967/physicians-talking-about-sex-sexuality-and-protection-with-adolescents
#5
REVIEW
Lindsay Fuzzell, Cleveland G Shields, Stewart C Alexander, J Dennis Fortenberry
Adolescent-physician communication about sexual behaviors, sexuality, and protective behaviors is vital for the support of sexual minorities and the prevention of sexually transmitted infections and unintended pregnancies. The objective of this review is to identify sexual topics that physicians and adolescents discuss during medical encounters and examine the quantity and quality of that communication. We performed a systematic literature review of major databases through May 2016. We identified 33 papers that focused on adolescent-physician communication about three major sexual health topics: coital or noncoital sexual behaviors, sexual orientation or attractions, and sexually protective or preventative behaviors...
April 5, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28370509/multimodal-imaging-of-suspicious-choroidal-neoplasms-in-a-primary-eye-care-clinic
#6
REVIEW
Gurpinderjeet Kaur, Scott A Anthony
Small suspicious choroidal neoplasms commonly present a diagnostic challenge in primary eye-care clinics, where they are most likely to present. Differentiating benign from malignant choroidal neoplasms is essential for facilitating early diagnosis and treatment, potentially decreasing the risk of metastasis and vision loss in some cases. The purpose of this review is to describe the clinical, spectral-domain optical coherence tomography and fundus autofluorescence features of suspicious choroidal neoplasms in a case series of patients presenting to a primary eye-care clinic at the Veterans Health Administration, Cleveland, Ohio, USA...
March 28, 2017: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/28318820/sarcoidosis-associated-small-fiber-neuropathy-in-a-large-cohort-clinical-aspects-and-response-to-ivig-and-anti-tnf-alpha-treatment
#7
Jinny O Tavee, Karen Karwa, Zubair Ahmed, Nicolas Thompson, Joseph Parambil, Daniel A Culver
OBJECTIVE: Small fiber neuropathy commonly affects patients with sarcoidosis and is often refractory to standard immunosuppressive therapies used for systemic disease. The clinical features of sarcoidosis-associated small fiber neuropathy (SSFN) and its response to medical therapy have not been described in a large population. METHODS: We performed a retrospective review of patients with SSFN seen at the Cleveland Clinic over a 4-year period. RESULTS: SSFN was identified in 143 individuals although other causes of neuropathy were found in 28 cases...
March 9, 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28298708/outcomes-of-sacral-nerve-stimulation-for-faecal-incontinence-in-northern-ireland
#8
G W Irwin, B V Dasari, R Irwin, D Johnston, K Khosraviani
BACKGROUND: Sacral nerve root stimulation (SNS) is an effective and developing therapy for faecal incontinence, a debilitating condition that can result in social and personal incapacitation. OBJECTIVES: The objectives of this study are to assess the morbidity of the procedure, improvement in the incontinence scores and Quality of Life (QoL) following SNS. MATERIALS AND METHODS: Patients were identified from the Northern Ireland regional SNS service from 2006 to 2012...
January 2017: Ulster Medical Journal
https://www.readbyqxmd.com/read/28290001/choroid-plexus-tumors-in-adult-and-pediatric-populations-the-cleveland-clinic-and-university-hospitals-experience
#9
Michal Bahar, Hasan Hashem, Tanya Tekautz, Sarah Worley, Anne Tang, Peter de Blank, Johannes Wolff
Choroid plexus tumors (CPT) are rare neoplasms accounting for 1-4% of all pediatric brain tumors. They are divided into choroid plexus papilloma (CPP), atypical choroid plexus papilloma (APP) and choroid plexus carcinoma (CPC). CPTs are known to primarily affect children less than 2 years of age. Gross total resection is the most important predictor of survival especially in CPC. Although small case series have been published, limited clinical data are available to describe treatment and outcome of CPTs. More clinical data would be necessary to complete the picture, particularly in populations that are not age limited...
March 13, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28265841/surgical-outcomes-in-patients-with-cushing-s-disease-the-cleveland-clinic-experience
#10
Philip C Johnston, Laurence Kennedy, Amir H Hamrahian, Zahrae Sandouk, James Bena, Betul Hatipoglu, Robert J Weil
CONTEXT: Transsphenoidal surgery (TSS) to resect a pituitary adenoma is considered first-line treatment for patients with Cushing's disease (CD). Early, post-operative remission rates >80% are expected for patients with a microadenoma (≤ 10 mm) visible on magnetic resonance (MR) imaging. OBJECTIVE: To report surgical outcomes and predictors of remission in a specialist center for patients with CD. PATIENTS AND METHODS: Clinical data was obtained from a prospective CD database in addition to review of all electronic medical, laboratory and surgical patient records...
March 6, 2017: Pituitary
https://www.readbyqxmd.com/read/28251356/midterm-outcomes-of-injectable-bulking-agents-for-fecal-incontinence-a-systematic-review-and-meta-analysis
#11
REVIEW
K D Hong, J S Kim, W B Ji, J W Um
BACKGROUND: Various bulking agents have been used to treat fecal incontinence. While short-term outcomes are attractive, there is still a lack of long-term data. The aim of this systematic review and meta-analysis was to investigate the midterm outcomes of treatment with injectable bulking agents and to identify predictive factors for improvement in incontinence. METHODS: PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched using the terms injection, bulking agents, and fecal incontinence...
March 1, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28238491/ovarian-transposition-a-surgical-option-for-fertility-preservation
#12
Sara E Arian, Linnea Goodman, Rebecca L Flyckt, Tommaso Falcone
OBJECTIVE: To describe and demonstrate a novel surgical method for laparoscopic ovarian transposition. In this video, we present a unique minimally invasive technique for transposing the ovaries, whereby the ovary is tunneled through the peritoneum. DESIGN: Video presentation of clinical article. The video uses animations and a surgical case to demonstrate the detailed surgical technique for laparoscopic ovarian transposition with a unique feature. Institutional review board approval was not required for this video presentation...
April 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28228614/current-solutions-for-long-segment-tracheal-reconstruction
#13
Ahmed A Abouarab, Hany H Elsayed, Hussein Elkhayat, Ahmed Mostafa, David C Cleveland, Ahmed El Nori
This article is a continuation of previous reviews about the appropriate method for long-segment tracheal reconstruction. We attempted to cover the most recent, successful and promising results of the different solutions for reconstruction that are rather innovative and suitable for imminent clinical application. Latest efforts to minimize the limitations associated with each method have been covered as well. In summary, autologous and allogenic tissue reconstruction of the trachea have been successful methods for reconstruction experimentally and clinically...
February 23, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28210553/impact-of-value-based-breast-cancer-care-pathway-implementation-on-pre-operative-breast-magnetic-resonance-imaging-utilization
#14
Devina K S McCray, Stephen R Grobmyer, Holly J Pederson
BACKGROUND: Bilateral breast magnetic resonance imaging (MRI) is commonly used in the diagnostic workup of breast cancer (BC) to assess extent of disease and identify occult foci of disease. However, evidence for routine use of pre-operative MRI is lacking. Breast MRI is costly and can lead to unnecessary tests and treatment delays. Clinical care pathways (care paths) are value-based guidelines, which define management recommendations derived by expert consensus and available evidence based data...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28156576/embedded-palliative-medicine-model-for-inpatient-solid-tumor-oncology-patients-utilizing-corounding-and-consultation-criteria-a-quality-improvement-pilot
#15
Bassam N Estfan, Alberto J Montero
148 Background: Hospitalized patients (pts) on solid tumor oncology (STO) services have palliative needs including pain management. This quality improvement project sought to establish a new STO-specific co-rounding PM consult service, evaluate the use of consult criteria for STO inpatients, assess the impact/interest in an embedded service, improve access to PM for STO pts and improve palliative education to STO teams. METHODS: During October 2015 to January 2016, a new PM consult service was established for the 2 STO inpatient services at Cleveland Clinic...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152966/analysis-of-the-results-of-implementation-of-a-pregnancy-screening-policy-at-a-comprehensive-cancer-center
#16
David Cleveland, Alma Yvette DeJesus, Lee Cheng, Elizabeth Ann Wagar, Charles F Levenback, Maria Alma Rodriguez
256 Background: Institutional implementation of a standard pregnancy screening policy for women will enhance the safe and timely delivery of treatment throughout the care continuum. In 2012, we developed and implemented an initial policy on pregnancy screening test (PST). The policy indicated that all providers should fully discuss with their female patients of child bearing potential regarding the potential risks of cancer treatment on fertility and the adverse effects on the fetus. The providers should also discuss the contraceptive options with female patients and their partners prior to diagnostic studies and/or treatment...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152944/a-single-institution-s-experience-with-the-value-of-fdg-pet-ct-imaging-in-patients-with-newly-diagnosed-stage-iib-iiib-breast-cancer
#17
Katherine Glass, Chad W Cummings, Alberto J Montero, Jame Abraham, Halle C F Moore, G Thomas Budd
123 Background: The Cleveland Clinic is utilizing disease specific teams to craft care paths for value based disease management. The report by Groheux (JNCI 2012; 104:1879-1887), reported (18) FDG-PET-CT detected distant metastasis in 10.7, 17.5 and 36.5% of stage IIB- IIIB breast cancer patients. Based on this report, the breast team incorporated (18) FDG-PET- CT imaging for initial staging of IIB-IIIB patients. METHODS: Treatment algorithms were developed by a multi-disciplinary breast cancer team...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152895/effects-of-admission-adm-source-time-and-provider-on-inpatient-inpt-oncology-onc-outcomes-at-the-cleveland-clinic-foundation-ccf
#18
Lindsey Martin Goodman, Lisa A Rybicki, Alberto J Montero, Bassam N Estfan, Carolyn Best, James Stevenson
140 Background: The quality of care transfers is known to influence clinical outcomes. In an inpt onc setting at a major tertiary care referral center, patient (pt) adm originate from many different areas and times. A detailed evaluation of onc adm by source of transfer, admission time, and provider type, may identify opportunities to improve inpt clinical outcomes. METHODS: We retrospectively reviewed all adm to the inpt solid tumor onc service from July - December 2014 from CCF regional hospital emergency departments (ED), outside hospital (OSH) ED, OSH inpt services, and CCF outpt clinics...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152866/leveraging-web-based-interface-systems-with-institutional-databases-to-improve-compliance-with-survivorship-care-plans
#19
Patricia Chapman, David Cleveland, Paula A Lewis-Patterson, Guadalupe R Palos, Maria Alma Rodriguez
161 Background: ASCO's Clinical Oncology Clinical Expert Statement on Cancer Survivorship Planning addressed the importance of using survivorship care plans (SCPs) to improve survivors' care. Evolving information technology strategies, such as web-based systems, offer real-time reporting tools to track providers' adherence for completion of SCPs. Our abstract reports on the creation of a web-based system to monitor survivors' care. METHODS: Ongoing audits of SCPs indicated broad variation in compliance rates with SCPs...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152742/prophylactic-use-of-granulocyte-colony-stimulating-factors-g-csf-in-cancer-patients-adherence-to-nccn-guidelines
#20
Vyshak Alva Venur, Shraddha Narechania, Paul Elson, Hamed Daw, Timothy Peter Spiro, Abdo Haddad
209 Background: G-CSF are used for prophylactic and therapeutic treatment of febrile neutropenia (FN). NCCN guidelines (version 1.2015) recommend prophylactic use of G-CSF based on the chemotherapy regimen and patient related risk factors, especially for the high (> 20%) and intermediate (10-20%) risk groups for developing FN. This study investigates the practice patterns and adherence to NCCN guidelines for use of G-CSF at a community based academic outpatient facility. METHODS: Cleveland Clinic IRB was obtained...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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