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https://www.readbyqxmd.com/read/28214651/a-review-on-the-evolution-of-pd-1-pd-l1-immunotherapy-for-bladder-cancer-the-future-is-now
#1
REVIEW
Joaquin Bellmunt, Thomas Powles, Nicholas J Vogelzang
The treatment of bladder cancer has evolved over time to encompass not only the traditional modalities of chemotherapy and surgery, but has been particularly impacted by the use of immunotherapy. The first immunotherapy was the live, attenuated bacterial Bacillus Calmette-Guérin vaccine, which has been the standard of care non-muscle-invasive bladder cancer since 1990. Modern immunotherapy has focused on inhibitors of checkpoint proteins, which are molecules that impede immune function, thereby allowing tumor cells to grow and proliferate unregulated...
February 2, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28214074/subspecialty-training-and-certification-in-geriatric-psychiatry-a-25-year-overview
#2
Dorthea Juul, Christopher C Colenda, Jeffrey M Lyness, Laura B Dunn, Rita Hargrave, Larry R Faulkner
: The Institute of Medicine estimated that by 2030, from 10.1 to 14.4 million Americans aged 65 years or older will have mental health or substance use disorders. This article reviews the history and current status of training, certification, and practice in geriatric psychiatry against the backdrop of this "silver tsunami." The American Board of Psychiatry and Neurology (ABPN) administered the first subspecialty examination in geriatric psychiatry in 1991, and through 2015 3,329 certificates were awarded...
January 9, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28192477/impact-of-early-in-hospital-medication-review-by-clinical-pharmacists-on-health-services-utilization
#3
Corinne M Hohl, Nilu Partovi, Isabella Ghement, Maeve E Wickham, Kimberlyn McGrail, Lisa N Reddekopp, Boris Sobolev
BACKGROUND: Adverse drug events are a leading cause of emergency department visits and unplanned admissions, and prolong hospital stays. Medication review interventions aim to identify adverse drug events and optimize medication use. Previous evaluations of in-hospital medication reviews have focused on interventions at discharge, with an unclear effect on health outcomes. We assessed the effect of early in-hospital pharmacist-led medication review on the health outcomes of high-risk patients...
2017: PloS One
https://www.readbyqxmd.com/read/28186950/qualitative-study-of-paramedics-experiences-of-managing-seizures-a-national-perspective-from-england
#4
Adam J Noble, Darlene Snape, Steve Goodacre, Mike Jackson, Frances C Sherratt, Mike Pearson, Anthony Marson
OBJECTIVES: The UK ambulance service is expected to now manage more patients in the community and avoid unnecessary transportations to hospital emergency departments (ED). Most people it attends who have experienced seizures have established epilepsy, have experienced uncomplicated seizures and so do not require the full facilities of an ED. Despite this, most are transported there. To understand why, we explored paramedics' experiences of managing seizures. DESIGN AND SETTING: Semistructured interviews were conducted with a purposive sample of paramedics from the English ambulance service...
November 9, 2016: BMJ Open
https://www.readbyqxmd.com/read/28186947/survey-of-community-pharmacists-perception-of-electronic-cigarettes-in-london
#5
Ana C N Marques Gomes, Shereen Nabhani-Gebara, Reem Kayyali, Federico Buonocore, Gianpiero Calabrese
OBJECTIVES: To seek community pharmacists' perception on use, safety and possible effectiveness of e-cigarettes as quit smoking tools, and their future regulation. SETTING: A survey of a sample of 154 community pharmacies across London, UK. CONTEXT: E-cigarettes have exclusively established themselves in the market through consumers-led demand. To date, e-cigarettes still remain unregulated and can be easily purchased in shops, over the internet, but more controversially also in pharmacies in the UK...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28158120/terahertz-conductivity-engineering-in-surface-decorated-carbon-nanotube-films-by-gold-nanoparticles
#6
Debanjan Polley, Animesh Patra, Anjan Barman, Rajib Kumar Mitra
We report the controllable conductivity of single-walled carbon nanotubes (SWNTs) and multiwalled carbon nanotubes with their surface walls decorated by gold nanoparticles (Au NPs) with varying concentration in terahertz (THz) frequency range. Colloidal Au NPs of nominal diameter ∼15  nm are synthesized by the reduction of gold chloride solution using tri-sodium citrate. A simple chemical route is followed to attach Au NPs on the surfaces of both types of carbon nanotubes (CNTs). The attachment of Au NPs on the sidewalls of CNTs is confirmed by UV-visible spectroscopy and scanning electron microscope images...
February 1, 2017: Applied Optics
https://www.readbyqxmd.com/read/28152958/economic-evaluations-of-patient-navigation-programs-in-cancer-care
#7
Anne Girault, Claude Sicotte, Etienne Minvielle
: 14 Background: Lack of coordination is challenging our health care systems. This is especially true in cancer care, which is based on multiple treatment alternatives and several types of patient-professional interactions. One recommendation is to develop patient navigation programs based on telemedicine in order to avoid costs that are due to under-coordination among providers and/or between patients and providers. The objective of our study was to identify the evidence on the economic impact of such programs in oncology, and to develop a methodological framework to conduct economic evaluations...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152888/the-benefits-of-clinical-pathways-cp-for-radiation-oncology-in-a-large-cancer-care-network
#8
Sushil Beriwal, Hans Benson, Zach Lorinc, Amanda Barry, Kathleen Lokay
: 148 Background: UPMC CancerCenter and the University of Pittsburgh Cancer Institute (UPMC) created a radiation oncology CP program (now incorporated separately as Via Pathways) in 2003 to standardize care at 19 radiation sites. The program exists to ensure consistency and rapid adoption of best evidence-based care in a large, integrated NCI-designated comprehensive cancer center. METHODS: The web-based CP portal integrates with electronic medical records to provide point-of-care patient-specific decision support...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152738/designing-and-implementing-a-payment-system-to-support-cancer-care-coordination-a-literature-review
#9
Chloe Gerves-Pinquie, Etienne Minvielle
: 40 Background: Demands for new payment systems to better coordinate services along the care continuum are emerging in oncology. Among them, bundling payments for defined episodes of care are considered as a promising payment option. The study objective was to understand how to develop an optimal payment system in order to foster coordination between hospitals and post-acute providers, and to identify potential pitfalls associated with its implementation. METHODS: We conducted a literature review, exploring articles published between 2010 and 2015 in Medline...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28125081/prospective-comparison-of-the-cost-effectiveness-of-clinical-whole-exome-sequencing-with-that-of-usual-care-overwhelmingly-supports-early-use-and-reimbursement
#10
Zornitza Stark, Deborah Schofield, Khurshid Alam, William Wilson, Nessie Mupfeki, Ivan Macciocca, Rupendra Shrestha, Susan M White, Clara Gaff
PURPOSE: To undertake the first prospective cost-effectiveness study of whole-exome sequencing (WES) as an early, routine clinical test for infants with suspected monogenic disorders. METHODS: Cost data for diagnosis-related investigations and assessments were collected for a prospective, sequential clinical cohort of infants (N = 40) who underwent singleton WES in parallel to usual diagnostic care. We determined costs per patient, costs per diagnosis, and incremental costs per additional diagnosis for three alternative strategies for integrating WES into the diagnostic trajectory...
January 26, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28124093/neoadjuvant-radiotherapy-followed-by-mastectomy-and-immediate-breast-reconstruction-an-alternative-treatment-option-for-locally-advanced-breast-cancer
#11
Montserrat Pazos, Stefanie Corradini, Darius Dian, Vera von Bodungen, Nina Ditsch, Rachel Wuerstlein, Stephan Schönecker, Nadia Harbeck, Heike Scheithauer, Claus Belka
BACKGROUND: The optimal sequence of mastectomy with immediate breast reconstruction (IBR) and radiotherapy (RT) for the treatment of locally advanced breast cancer (LABC) is still under debate. Increased rates of postoperative complications are described following postmastectomy RT. Neoadjuvant RT aims to improve the aesthetic results and simplify the reconstructive pathway. PATIENTS: A total of 22 patients diagnosed with LABC and treated with neoadjuvant RT followed by mastectomy and IBR between 04/2012 and 03/2015 were retrospectively analyzed...
January 25, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28121649/borrow-or-serve-an-economic-analysis-of-options-for-financing-a-medical-school-education
#12
Mircea I Marcu, Arthur L Kellermann, Christine Hunter, Jerri Curtis, Charles Rice, Gail R Wilensky
PURPOSE: To understand the long-term economic implications of key pathways for financing a medical school education. METHOD: The authors calculated the net present value (NPV) of cash flow over a 30-year career for a 2013 matriculant associated with (1) self-financing, (2) federally guaranteed loans, (3) the Public Service Loan Forgiveness program, (4) the National Health Service Corps, (5) the Armed Forces Health Professions Scholarship Program, and (6) matriculation at the Uniformed Services University of the Health Sciences...
January 24, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28079606/relationship-between-alternative-resuscitation-strategies-host-response-and-injury-biomarkers-and-outcome-in-septic-shock-analysis-of-the-protocol-based-care-for-early-septic-shock-study
#13
John A Kellum, Francis Pike, Donald M Yealy, David T Huang, Nathan I Shapiro, Derek C Angus
OBJECTIVES: The Protocol-based Care for Early Septic Shock trial found no differences across alternative resuscitation strategies in all-cause mortality. A separate aim was to determine whether differences in resuscitation strategies affected trajectories of biomarkers of key pathways associated with downstream clinical outcomes of sepsis and whether there were differences in survival across treatment arms for patients with different baseline biomarker profiles. DESIGN: Secondary analysis of a large randomized clinical trial...
March 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28077451/the-increasing-use-of-cannabis-among-older-americans-a-public-health-crisis-or-viable-policy-alternative
#14
Brian Kaskie, Padmaja Ayyagari, Gary Milavetz, Dan Shane, Kanika Arora
Cannabis use among older Americans is increasing. Although much of this growth has been attributed to the entry of a more tolerant baby boom cohort into older age, recent evidence suggests the pathways to cannabis are more complex. Some older persons have responded to changing social and legal environments and are increasingly likely to take cannabis recreationally. Other older persons are experiencing age-related health care needs, and some take cannabis for symptom management, as recommended by a medical doctor...
January 11, 2017: Gerontologist
https://www.readbyqxmd.com/read/28075460/roles-of-oncogenes-and-tumor-suppressor-genes-in-osteoclastogenesis-review
#15
Akari Minami, Mako Ogino, Noriko Nakano, Mayuko Ichimura, Atsuko Nakanishi, Toshiyuki Murai, Yasuko Kitagishi, Satoru Matsuda
Osteoporosis is a bone disease that poses a tremendous burden to health care. The receptor activator of nuclear factor-κB (RANK) and its ligand (RANKL) have been a major focus of this research field. RANKL signaling not only activates a variety of downstream signaling pathways required for osteoclast development, but crosstalk with other signaling pathways also adjusts bone homeostasis both in normal physiology and in bone disease. Consequently, novel drugs specifically targeting RANK-RANKL and their signaling pathways in osteoclasts are expected to revolutionize the treatment of various bone diseases such as osteoporosis...
February 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28069626/paramedics-views-on-their-seizure-management-learning-needs-a-qualitative-study-in-england
#16
Frances C Sherratt, Darlene Snape, Steve Goodacre, Mike Jackson, Mike Pearson, Anthony G Marson, Adam J Noble
INTRODUCTION: The UK ambulance service often attends to suspected seizures. Most persons attended to will not require the facilities of a hospital emergency department (ED) and so should be managed at scene or by using alternative care pathways. Most though are transported to ED. One factor that helps explain this is paramedics can have low confidence in managing seizures. OBJECTIVES: With a view to ultimately developing additional seizure management training for practicing paramedics, we explored their learning needs, delivery preferences and potential drivers and barriers to uptake and effectiveness...
January 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28064527/child-violence-experiences-in-institutionalised-orphanage-care
#17
Lorraine Sherr, Kathryn J Roberts, Natasha Gandhi
Institutions are not necessarily good environments for children. In the face of challenges such as HIV, Ebola, poverty, conflict and disaster the numbers have grown rather than reduced. Some countries have closed institutions down -driven by findings that cognitive developmental delay is associated with institutional care. Yet insight into abuse and violence within institutionalised settings is neglected. Maltreatment -violence and abuse -may be an issue. This systematic review series addresses violence and abuse experiences in institutionalised care, exploring firstly the frequency of abuse/violence in institutions, secondly any interventions to reduce such violence or abuse and thirdly the perpetrators of such violence or abuse...
January 9, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28057860/contribution-of-canonical-nonhomologous-end-joining-to-chromosomal-rearrangements-is-enhanced-by-atm-kinase-deficiency
#18
Ragini Bhargava, Caree R Carson, Gabriella Lee, Jeremy M Stark
A likely mechanism of chromosomal rearrangement formation involves joining the ends from two different chromosomal double-strand breaks (DSBs). These events could potentially be mediated by either of two end-joining (EJ) repair pathways [canonical nonhomologous end joining (C-NHEJ) or alternative end joining (ALT-EJ)], which cause distinct rearrangement junction patterns. The relative role of these EJ pathways during rearrangement formation has remained controversial. Along these lines, we have tested whether the DNA damage response mediated by the Ataxia Telangiectasia Mutated (ATM) kinase may affect the relative influence of C-NHEJ vs...
January 24, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28047032/su-f-e-08-medical-physics-as-a-teaching-tool-for-high-school-science-curriculum
#19
L Buckley
PURPOSE: Delivering high school science curriculum in a timely manner and in way that is accessible to all students is a challenge for teachers. Although many high schools offer career workshops, these are typically directed at senior students and do not relate directly to details of the curriculum. The objective of this initiative was to create a series of lectures that use medical physics to relate many aspects of the high school science curriculum to tangible clinical applications and to introduce students to alternate pathways into a career in health sciences...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28024825/automated-diabetic-retinopathy-image-assessment-software-diagnostic-accuracy-and-cost-effectiveness-compared-with-human-graders
#20
Adnan Tufail, Caroline Rudisill, Catherine Egan, Venediktos V Kapetanakis, Sebastian Salas-Vega, Christopher G Owen, Aaron Lee, Vern Louw, John Anderson, Gerald Liew, Louis Bolter, Sowmya Srinivas, Muneeswar Nittala, SriniVas Sadda, Paul Taylor, Alicja R Rudnicka
OBJECTIVE: With the increasing prevalence of diabetes, annual screening for diabetic retinopathy (DR) by expert human grading of retinal images is challenging. Automated DR image assessment systems (ARIAS) may provide clinically effective and cost-effective detection of retinopathy. We aimed to determine whether ARIAS can be safely introduced into DR screening pathways to replace human graders. DESIGN: Observational measurement comparison study of human graders following a national screening program for DR versus ARIAS...
December 23, 2016: Ophthalmology
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