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https://www.readbyqxmd.com/read/29786462/multi-institutional-study-of-the-variability-in-target-delineation-for-six-targets-commonly-treated-with-radiosurgery
#1
Helena Sandström, Hidefumi Jokura, Caroline Chung, Iuliana Toma-Dasu
BACKGROUND: Although accurate delineation of the target is a key factor of success in radiosurgery there are no consensus guidelines for target contouring. AIM: The aim of the present study was therefore to quantify the variability in target delineation and discuss the potential clinical implications, for six targets regarded as common in stereotactic radiosurgery. MATERIAL AND METHODS: Twelve Gamma Knife centers participated in the study by contouring the targets and organs at risks and performing the treatment plans...
May 22, 2018: Acta Oncologica
https://www.readbyqxmd.com/read/29786179/-update-2017-of-the-kdigo-guidelines-on-chronic-kidney-disease-mineral-and-bone-disorder-ckd-mbd-what-are-the-real-changes
#2
Marzia Pasquali, Antonio Bellasi, Giuseppe Cianciolo, Carlo Massimetti, Maria Cristina Mereu, Luigi Morrone, Vincenzo Panuccio
Guidelines for the assessment, diagnosis and therapy of the alterations that characterize the CKD-MBD are an important support in the clinical practice of the nephrologist. Compared to the KDIGO guidelines published in 2009, the 2017 update made changes on some topics on which there was previously no strong evidence both in terms of diagnosis and therapy. The recommendations include the diagnosis of bone anomalies in CKD-MBD and the treatment of mineral metabolism abnormalities with particular regard to hyperphosphataemia, calcium levels, secondary hyperparathyroidism and anti-resorptive therapies...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29786044/prognostic-value-of-model-for-end-stage-liver-disease-incorporating-with-serum-sodium-score-for-development-of-acute-kidney-injury-after-liver-transplantation
#3
Yuan Cheng, Guo-Qing Wei, Qiu-Cheng Cai, Yi Jiang, Ai-Ping Wu
Background: Contribution of model for end-stage liver disease incorporating with serum sodium (MELD-Na) score in predicting acute kidney injury (AKI) after orthotopic liver transplantation (OLT) is yet to be identified. This study assessed the prognostic value of MELD-Na score for the development of AKI following OLT. Methods: Preoperative and surgery-related variables of 321 adult end-stage liver disease patients who underwent OLT in Fuzhou General Hospital were collected...
June 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29785685/network-meta-analysis-an-introduction-for-pharmacists
#4
Yina Xu, Mohamed Amine Amiche, Mina Tadrous
Network meta-analysis is a new tool used to summarize and compare studies for multiple interventions, irrespective of whether these interventions have been directly evaluated against each other. Network meta-analysis is quickly becoming the standard in conducting therapeutic reviews and clinical guideline development. However, little guidance is available to help pharmacists review network meta-analysis studies in their practice. Major institutions such as the Cochrane Collaboration, Agency for Healthcare Research and Quality, Canadian Agency for Drugs and Technologies in Health, and National Institute for Health and Care Excellence Decision Support Unit have endorsed utilizing network meta-analysis to establish therapeutic evidence and inform decision making...
May 21, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29785075/biliary-strictures-complicating-living-donor-liver-transplantation-problems-novel-insights-and-solutions
#5
REVIEW
Harshavardhan B Rao, Arjun Prakash, Surendran Sudhindran, Rama P Venu
Biliary stricture complicating living donor liver transplantation (LDLT) is a relatively common complication, occurring in most transplant centres across the world. Cases of biliary strictures are more common in LDLT than in deceased donor liver transplantation. Endoscopic management is the mainstay for biliary strictures complicating LDLT and includes endoscopic retrograde cholangiography, sphincterotomy and stent placement (with or without balloon dilatation). The efficacy and safety profiles as well as outcomes of endoscopic management of biliary strictures complicating LDLT is an area that needs to be viewed in isolation, owing to its unique set of problems and attending complications; as such, it merits a tailored approach, which is yet to be well established...
May 21, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29784746/role-of-molecular-pathology-in-the-treatment-of-anaplastic-gliomas-and-glioblastomas
#6
Matthias Holdhoff
The 2016 WHO Classification of Tumors of the Central Nervous System integrated molecular biomarkers into the classifications of malignant gliomas. Several markers now play a key role in our understanding of these tumors and are integral for clinical decision-making; these include codeletion of 1p and 19q and IDH1 and IDH2 mutations. The presentation by Matthias Holdhoff, MD, PhD, at the NCCN 23rd Annual Conference discussed the current understanding of anaplastic gliomas (WHO grade III) in the context of the new classification and its implications on clinical practice...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29784657/autism-spectrum-disorder-advances-in-diagnosis-and-evaluation
#7
REVIEW
Lonnie Zwaigenbaum, Melanie Penner
Autism spectrum disorder (ASD) has a variety of causes, and its clinical expression is generally associated with substantial disability throughout the lifespan. Recent advances have led to earlier diagnosis, and deep phenotyping efforts focused on high risk infants have helped advance the characterization of early behavioral trajectories. Moreover, biomarkers that measure early structural and functional connectivity, visual orienting, and other biological processes have shown promise in detecting the risk of autism spectrum disorder even before the emergence of overt behavioral symptoms...
May 21, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29784570/research-gaps-in-wilderness-medicine
#8
Daniel Tritz, Kody Dormire, Travis Brachtenbach, Joshua Gordon, Donald Sanders, David Gearheart, Julia Crawford, Matt Vassar
INTRODUCTION: Wilderness medicine involves the treatment of individuals in remote, austere environments. Given the high potential for injuries as well as the unique treatment modalities required in wilderness medicine, evidence-based clinical practice guidelines are necessary to provide optimal care. In this study, we identify evidence gaps from low-quality recommendations in wilderness medicine clinical practice guidelines and identify new/ongoing research addressing them. METHODS: We included relevant clinical practice guidelines from the Wilderness Medical Society and obtained all 1C or 2C level recommendations...
May 18, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29784453/executive-summary-of-outpatient-parenteral-antimicrobial-therapy-guidelines-of-the-spanish-society-of-clinical-microbiology-and-infectious-diseases-and-the-spanish-domiciliary-hospitalisation-society
#9
Luis Eduardo López Cortés, Abel Mujal Martínez, Magdalena Fernández Martínez de Mandojana, Natalia Martín, Mercè Gil Bermejo, Joan Solà Aznar, Eulalia Villegas Bruguera, Maria José Peláez Cantero, Pilar Retamar Gentil, Miriam Delgado Vicente, Víctor José González-Ramallo, Miguel Ángel Ponce González, Manuel Mirón Rubio, M Montserrat Gómez Rodríguez de Mendarozqueta, Miguel Ángel Goenaga Sánchez, Pedro Sanroma Mendizábal, Elena Delgado Mejía, Marcos Pajarón Guerrero
Outpatient parenteral antimicrobial therapy (OPAT) programmes make it possible to start or complete intravenous antimicrobial therapy for practically any type of infection at home, provided that patient selection is appropriate for the type of OPAT programme available. Although the clinical management of infections in the home setting is comparable in many respects to that offered in conventional hospitalization (selection of antibiotics, duration of treatment, etc.), there are many aspects that are specific to this care modality...
May 18, 2018: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29784432/outcome-quality-standards-in-pancreatic-oncologic-surgery-in-spain
#10
Luis Sabater, Isabel Mora, Juan Manuel Gámez Del Castillo, Javier Escrig-Sos, Elena Muñoz-Forner, Marina Garcés-Albir, Dimitri Dorcaratto, Joaquín Ortega
INTRODUCTION: To establish quality standards in oncologic surgery is a complex but necessary challenge to improve surgical outcomes. Unlike other tumors, there are no well-defined quality standards in pancreatic cancer. The aim of this study is to identify quality indicators in pancreatic oncologic surgery in Spain as well as their acceptable limits of variability. METHODS: Quality indicators were selected based on clinical practice guidelines, consensus conferences, reviews and national publications on oncologic pancreatic surgery between the years 2000 and 2016...
May 18, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29784254/evidence-based-practice-in-perianesthesia-nursing-application-of-the-american-geriatrics-society-clinical-practice-guideline-for-postoperative-delirium-in-older-adults
#11
Catherine Hebert
Delirium is a pervasive and dangerous syndrome for older adults in the perianesthesia setting, occurring in up to 60% of surgical cases. The American Geriatrics Society performed a systematic review to develop recommendations for the prevention and management of postoperative delirium in older adults. The recommendations emphasize nonpharmacologic interventions with a strong focus on reducing the use of psychoactive medication. Perianesthesia nurses can serve as leaders in translating these recommendations into evidence-based practice at the bedside for older adults...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784085/clinical-practice-guideline-prevention-of-blood-culture-contamination
#12
(no author information available yet)
No abstract text is available yet for this article.
May 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29783904/opportunity-to-discuss-ethical-issues-during-clinical-learning-experience
#13
Alvisa Palese, Silvia Gonella, Anne Destrebecq, Irene Mansutti, Stefano Terzoni, Michela Morsanutto, Pietro Altini, Anita Bevilacqua, Anna Brugnolli, Federica Canzan, Adriana Dal Ponte, Laura De Biasio, Adriana Fascì, Silvia Grosso, Franco Mantovan, Oliva Marognolli, Raffaela Nicotera, Giulia Randon, Morena Tollini, Luisa Saiani, Luca Grassetti, Valerio Dimonte
BACKGROUND: Undergraduate nursing students have been documented to experience ethical distress during their clinical training and felt poorly supported in discussing the ethical issues they encountered. Research aims: This study was aimed at exploring nursing students' perceived opportunity to discuss ethical issues that emerged during their clinical learning experience and associated factors. RESEARCH DESIGN: An Italian national cross-sectional study design was performed in 2015-2016...
January 1, 2018: Nursing Ethics
https://www.readbyqxmd.com/read/29783067/motor-retraining-more-for-functional-movement-disorders-outcomes-from-a-one-week-multidisciplinary-rehabilitation-program
#14
Alexandra Jacob, Darryl Kaelin, Abbey Roach, Craig Ziegler, Kathrin LaFaver
BACKGROUND: Functional Movement Disorders (FMD) are conditions of abnormal motor control thought to be caused by psychological factors. These disorders are commonly seen in neurological practice and prognosis is often poor. No consensus treatment guidelines have been established, however the role of physical therapy in addition to psychotherapy has increasingly been recognized. This study reports patient outcomes from a multidisciplinary FMD treatment program using motor retraining (MoRe) strategies...
May 18, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29783038/assessing-data-quality-and-the-variability-of-source-data-verification-auditing-methods-in-clinical-research-settings
#15
Lauren Houston, Yasmine Probst, Allison Martin
INTRODUCTION: Data audits within clinical settings are extensively used as a major strategy to identify errors, monitor study operations and ensure high-quality data. However, clinical trial guidelines are non-specific in regards to recommended frequency, timing and nature of data audits. The absence of a well-defined data quality definition and method to measure error undermines the reliability of data quality assessment. This review aimed to assess the variability of source data verification (SDV) auditing methods to monitor data quality in a clinical research setting...
May 18, 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29782437/skin-injuries-and-chlorhexidine-gluconate-based-antisepsis-in-early-premature-infants-a-case-report-and-review-of-the-literature
#16
Valentina Vanzi, Rosanna Pitaro
Early premature infants are subjected to many invasive procedures in neonatal intensive care units, and effective skin antisepsis is an essential step in caring for these vulnerable patients. Nevertheless, preterm infants have an anatomically and physiologically immature skin and preserving their skin integrity is essential to avoid the risk of local and systemic complications. Skin particularities of newborns reduce the list of available antiseptics in neonatology. Chlorhexidine gluconate (CHG) has excellent antiseptic properties and its antimicrobial efficacy cannot be understated, but there is great concern about its use for premature infants, referring to the risk of development skin injuries, such as skin erythema, burns, and blisters...
May 17, 2018: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#17
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29782295/diagnostic-and-treatment-strategies-of-dermatologists-for-treating-morphea-in-hungary
#18
Gábor Bali, Bernadett Hidvégi
Localized scleroderma is an uncommon disease, only infrequently encountered by dermatologists in private practices or even in larger academic centers. Because of its rarity, current treatment guidelines are mostly based on low-level clinical evidence and expert opinions. The aim of this study was to evaluate treatment strategies to treat localized scleroderma. A questionnaire was developed and sent to dermatologists in Hungary. 101 returned questionnaires were eligible for evaluation. 87.12% of clinicians employed local steroids...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29782209/practical-assessment-and-management-of-vulnerabilities-in-older-patients-receiving-chemotherapy-asco-guideline-for-geriatric-oncology
#19
Supriya G Mohile, William Dale, Mark R Somerfield, Mara A Schonberg, Cynthia M Boyd, Peggy S Burhenn, Beverly Canin, Harvey Jay Cohen, Holly M Holmes, Judith O Hopkins, Michelle C Janelsins, Alok A Khorana, Heidi D Klepin, Stuart M Lichtman, Karen M Mustian, William P Tew, Arti Hurria
Purpose To provide guidance regarding the practical assessment and management of vulnerabilities in older patients undergoing chemotherapy. Methods An Expert Panel was convened to develop clinical practice guideline recommendations based on a systematic review of the medical literature. Results A total of 68 studies met eligibility criteria and form the evidentiary basis for the recommendations. Recommendations In patients ≥ 65 years receiving chemotherapy, geriatric assessment (GA) should be used to identify vulnerabilities that are not routinely captured in oncology assessments...
May 21, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29781995/an-ecdysone-receptor-based-singular-gene-switch-for-deliberate-expression-of-transgene-with-robustness-reversibility-and-negligible-leakiness
#20
Seoghyun Lee, Minho Won, Ran Hee Hwang, Gang Min Hur, Hyunju Ro
Precise control of transgene expression is desirable in biological and clinical studies. However, because the binary feature of currently employed gene switches requires the transfer of two therapeutic expression units concurrently into a single cell, the practical application of the system for gene therapy is limited. To simplify the transgene expression system, we generated a gene switch designated as pEUI(+) encompassing a complete set of transgene expression modules in a single vector. Comprising of the GAL4 DNA-binding domain and modified EcR (GvEcR), a minimal VP16 activation domain fused with a GAL4 DNA-binding domain, as well as a modified Drosophila ecdysone receptor (EcR), the newly developed singular gene switch is highly responsive to the administration of a chemical inducer in a time- and dosage-dependent manner...
May 7, 2018: Journal of Visualized Experiments: JoVE
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