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Managing uncertainty

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https://www.readbyqxmd.com/read/28214419/recommendations-for-gonadotoxicity-surveillance-in-male-childhood-adolescent-and-young-adult-cancer-survivors-a-report-from-the-international-late-effects-of-childhood-cancer-guideline-harmonization-group-in-collaboration-with-the-pancaresurfup-consortium
#1
REVIEW
Roderick Skinner, Renee L Mulder, Leontien C Kremer, Melissa M Hudson, Louis S Constine, Edit Bardi, Annelies Boekhout, Anja Borgmann-Staudt, Morven C Brown, Richard Cohn, Uta Dirksen, Alexsander Giwercman, Hiroyuki Ishiguro, Kirsi Jahnukainen, Lisa B Kenney, Jacqueline J Loonen, Lilian Meacham, Sebastian Neggers, Stephen Nussey, Cecilia Petersen, Margarett Shnorhavorian, Marry M van den Heuvel-Eibrink, Hanneke M van Santen, William H B Wallace, Daniel M Green
Treatment with chemotherapy, radiotherapy, or surgery that involves reproductive organs can cause impaired spermatogenesis, testosterone deficiency, and physical sexual dysfunction in male pubertal, adolescent, and young adult cancer survivors. Guidelines for surveillance and management of potential adverse effects could improve cancer survivors' health and quality of life. Surveillance recommendations vary considerably, causing uncertainty about optimum screening practices. This clinical practice guideline recommended by the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium, developed using evidence-based methodology, critically synthesises surveillance recommendations for gonadotoxicity in male childhood, adolescent, and young adult (CAYA) cancer survivors...
February 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28214167/psychometric-evaluation-and-design-of-patient-centered-communication-measures-for-cancer-care-settings
#2
Bryce B Reeve, David M Thissen, Carla M Bann, Nicole Mack, Katherine Treiman, Hanna K Sanoff, Nancy Roach, Brooke E Magnus, Jason He, Laura K Wagner, Rebecca Moultrie, Kathryn D Jackson, Courtney Mann, Lauren A McCormack
OBJECTIVE: To evaluate the psychometric properties of questions that assess patient perceptions of patient-provider communication and design measures of patient-centered communication (PCC). METHODS: Participants (adults with colon or rectal cancer living in North Carolina) completed a survey at 2 to 3 months post-diagnosis. The survey included 87 questions in six PCC Functions: Exchanging Information, Fostering Health Relationships, Making Decisions, Responding to Emotions, Enabling Patient Self-Management, and Managing Uncertainty...
February 10, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28213853/to-pex-or-not-to-pex-what-to-do-for-the-contralateral-testis-when-a-nubbin-is-discovered
#3
REVIEW
John E Kehoe, Matthew S Christman
PURPOSE OF REVIEW: Testicular remnants or nubbins are commonly found in the evaluation and treatment of cryptorchidism. While much debate focuses on the management of the nubbin itself, there is also great uncertainty and variation in the management of the contralateral descended testis. Herein, we review the relevant literature informing the decision to perform a contralateral orchiopexy. RECENT FINDINGS: Although there is very little recent literature directly addressing the question, some studies have better characterized differences in practice, the risk of intravaginal torsion in the contralateral testis and potential consequences in the selection of technique...
February 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28210563/neoadjuvant-therapy-for-treatment-of-breast-cancer-the-way-forward-or-simply-a-convenient-option-for-patients
#4
COMMENT
Abhishek Chatterjee, John K Erban
The complexity of managing early stage breast cancer is well known. Optimal treatment is increasingly multidisciplinary and in the modern era informed by sophisticated molecular tools to help select and guide therapy. Major phase III trials have determined that the order of systemic therapy relative to surgery does not influence important endpoints such as event free survival and overall survival (OS), but questions remain as to how best to utilize these most essential services. For example, there is still uncertainty regarding the ideal timing, intensity, and duration of proposed therapy...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28207777/quantifying-the-value-of-perfect-information-in-emergency-vaccination-campaigns
#5
Naomi V Bradbury, William J M Probert, Katriona Shea, Michael C Runge, Christopher J Fonnesbeck, Matt J Keeling, Matthew J Ferrari, Michael J Tildesley
Foot-and-mouth disease outbreaks in non-endemic countries can lead to large economic costs and livestock losses but the use of vaccination has been contentious, partly due to uncertainty about emergency FMD vaccination. Value of information methods can be applied to disease outbreak problems such as FMD in order to investigate the performance improvement from resolving uncertainties. Here we calculate the expected value of resolving uncertainty about vaccine efficacy, time delay to immunity after vaccination and daily vaccination capacity for a hypothetical FMD outbreak in the UK...
February 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28207523/pharmacological-and-psychotherapeutic-interventions-for-management-of-poststroke-depression-a-bayesian-network-meta-analysis-of-randomized-controlled-trials
#6
Xuejun Sun, Linghui Deng, Shi Qiu, Xiang Tu, Deren Wang, Ming Liu
INTRODUCTION: Poststroke depression (PSD) constitutes an important complication of stroke, leading to great disability as well as increased mortality. Since which treatment for PSD should be preferred are still matters of controversy, we are aiming to compare and rank these pharmacological and nonpharmacological interventions. METHODS AND ANALYSIS: We will employ a network meta-analysis to incorporate both direct and indirect evidence from relevant trials. We will search PubMed, the Cochrane Library Central Register of Controlled Trials, Embase, and the reference lists of relevant articles for randomized controlled trials (RCT) of different PSD treatment strategies...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28207495/lipids-and-lipid-changes-with-synthetic-and-biologic-disease-modifying-antirheumatic-drug-therapy-in-rheumatoid-arthritis-implications-for-cardiovascular-risk
#7
Elena Myasoedova
PURPOSE OF REVIEW: To highlight recently published studies addressing lipid changes with disease-modifying antirheumatic drug use and outline implications on cardiovascular outcomes in rheumatoid arthritis (RA). RECENT FINDINGS: Growing evidence suggests lower lipid levels are present in patients with active RA vs. general population, and significant modifications of lipid profile with inflammation suppression. Increase in lipid levels in patients with RA on synthetic and biological disease-modifying antirheumatic drugs may be accompanied by antiatherogenic changes in lipid composition and function...
February 15, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28207411/reporting-altered-test-results-in-hemolyzed-samples-is-the-cure-worse-than-the-disease
#8
Giuseppe Lippi, Gianfranco Cervellin, Mario Plebani
The management of laboratory data in unsuitable (hemolyzed) samples remains an almost unresolved dilemma. Whether or not laboratory test results obtained by measuring unsuitable specimens should be made available to the clinicians has been the matter of fierce debates over the past decades. Recently, an intriguing alternative to suppressing test results and recollecting the specimen has been put forward, entailing the definition and implementation of specific algorithms that would finally allow reporting a preanalytically altered laboratory value within a specific comment about its uncertainty of measurement...
February 16, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28190403/using-typing-techniques-in-a-specific-outbreak-the-ethical-reflection-of-public-health-professionals
#9
B Rump, C Cornelis, F Woonink, J VAN Steenbergen, M Verweij, M Hulscher
Typing techniques are laboratory methods used in outbreak management to investigate the degree to which microbes found within an outbreak are related. Knowledge about relational patterns between microbes benefits outbreak management, but inevitably also tells us something about the relational patterns of the people hosting them. Since the technique is often used without explicit consent of all individuals involved, this may raise ethical questions. The aim of this study was to unravel the complex ethical deliberation of professionals over the use of such techniques...
February 13, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28187937/anticipating-species-distributions-handling-sampling-effort-bias-under-a-bayesian-framework
#10
Duccio Rocchini, Carol X Garzon-Lopez, Matteo Marcantonio, Valerio Amici, Giovanni Bacaro, Lucy Bastin, Neil Brummitt, Alessandro Chiarucci, Giles M Foody, Heidi C Hauffe, Kate S He, Carlo Ricotta, Annapaola Rizzoli, Roberto Rosà
Anticipating species distributions in space and time is necessary for effective biodiversity conservation and for prioritising management interventions. This is especially true when considering invasive species. In such a case, anticipating their spread is important to effectively plan management actions. However, considering uncertainty in the output of species distribution models is critical for correctly interpreting results and avoiding inappropriate decision-making. In particular, when dealing with species inventories, the bias resulting from sampling effort may lead to an over- or under-estimation of the local density of occurrences of a species...
February 7, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28185892/lack-of-patient-clinician-concordance-in-cancer-patients-its-relation-with-patient-variables
#11
Kavita D Chandwani, Fengmin Zhao, Gary R Morrow, Teresa L Deshields, Lori M Minasian, Judith Manola, Michael J Fisch
CONTEXT: Patients with cancer are bothered by its diagnosis, treatment, and associated uncertainty. Lack of concordance (LOC) of patients' reporting of their symptoms and quality of life (QOL) with that of their clinicians has been observed in cancer care. However, information regarding the reporting of patients' bother due to aspects of cancer experience and their clinicians' assessment is lacking. OBJECTIVES: To describe cancer patients' bother due to aspects of their disease experience and explore the concordance (LOC) or a lack thereof between patients' and clinicians' reporting of patients' bother and factors associated with it...
February 6, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28185579/a-fuzzy-method-for-rna-seq-differential-expression-analysis-in-presence-of-multireads
#12
Arianna Consiglio, Corrado Mencar, Giorgio Grillo, Flaviana Marzano, Mariano Francesco Caratozzolo, Sabino Liuni
BACKGROUND: When the reads obtained from high-throughput RNA sequencing are mapped against a reference database, a significant proportion of them - known as multireads - can map to more than one reference sequence. These multireads originate from gene duplications, repetitive regions or overlapping genes. Removing the multireads from the mapping results, in RNA-Seq analyses, causes an underestimation of the read counts, while estimating the real read count can lead to false positives during the detection of differentially expressed sequences...
November 8, 2016: BMC Bioinformatics
https://www.readbyqxmd.com/read/28184978/readiness-for-transition-to-adult-health-care-for-young-adolescents-with-congenital-heart-disease
#13
Kimberly T Stewart, Nita Chahal, Adrienne H Kovacs, Cedric Manlhiot, Ahlexxi Jelen, Tanveer Collins, Brian W McCrindle
This study evaluates transition readiness, medical condition knowledge, self-efficacy, and illness uncertainty in young adolescents (ages 12 to 15 years) with congenital heart disease (CHD), and medical, patient, and parental factors associated with transition readiness. We enrolled 82 patients with moderate or complex CHD (n = 36, 44% male; mean age 13.6 ± 1.3 years), and their parents. Patients completed standardized self-report measures: Transition Readiness Assessment Questionnaire (TRAQ), MyHeart scale, General Self-Efficacy scale, and Children's Uncertainty in Illness Scale...
February 10, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28181144/novel-bone-metabolism-associated-hormones-the-importance-of-the-pre-analytical-phase-for-understanding-their-physiological-roles
#14
REVIEW
Giovanni Lombardi, Mosè Barbaro, Massimo Locatelli, Giuseppe Banfi
The endocrine function of bone is now a recognized feature of this tissue. Bone-derived hormones that modulate whole-body homeostasis, are being discovered as for the effects on bone of novel and classic hormones produced by other tissues become known. Often, however, the data regarding these last generation bone-derived or bone-targeting hormones do not give about a clear picture of their physiological roles or concentration ranges. A certain degree of uncertainty could stem from differences in the pre-analytical management of biological samples...
February 8, 2017: Endocrine
https://www.readbyqxmd.com/read/28178920/learning-health-safety-within-non-technical-skills-interprofessional-simulation-education-a-qualitative-study
#15
Morris Gordon, Christopher W R Fell, Helen Box, Michael Farrell, Alison Stewart
BACKGROUND: Healthcare increasingly recognises and focusses on the phenomena of 'safe practice' and 'patient safety.' Success with non-technical skills (NTS) training in other industries has led to widespread transposition to healthcare education, with communication and teamwork skills central to NTS frameworks. OBJECTIVE: This study set out to identify how the context of interprofessional simulation learning influences NTS acquisition and development of 'safety' amongst learners...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28178775/diagnosis-prevention-and-management-of-bronchiolitis-in-children-review-of-current-controversies
#16
Samantha A House, Shawn L Ralston
Viral bronchiolitis is a common and costly condition among young children worldwide, contributing to high medical expenditures in industrialized countries and significant mortality in low-income countries. Much research has focused on therapy for this disease entity, though the standard of care remains merely supportive. Current areas of active research include the nuances of defining bronchiolitis, a deeper exploration of causative viruses, the role and development of preventive strategies, and associated long-term outcomes...
April 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28178363/ranolazine-for-stable-angina-pectoris
#17
REVIEW
Carlos A Salazar, Juan E Basilio Flores, Liz E Veramendi Espinoza, Jhon W Mejia Dolores, Diego E Rey Rodriguez, César Loza Munárriz
BACKGROUND: Stable angina pectoris is a chronic medical condition with significant impact on mortality and quality of life; it can be macrovascular or microvascular in origin. Ranolazine is a second-line anti-anginal drug approved for use in people with stable angina. However, the effects of ranolazine for people with angina are considered to be modest, with uncertain clinical relevance. OBJECTIVES: To assess the effects of ranolazine on cardiovascular and non-cardiovascular mortality, all-cause mortality, quality of life, acute myocardial infarction incidence, angina episodes frequency and adverse events incidence in stable angina patients, used either as monotherapy or as add-on therapy, and compared to placebo or any other anti-anginal agent...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28177887/use-of-social-network-analysis-and-global-sensitivity-and-uncertainty-analyses-to-better-understand-an-influenza-outbreak
#18
Jianhua Liu, Hongbo Jiang, Hao Zhang, Chun Guo, Lei Wang, Jing Yang, Shaofa Nie
In the summer of 2014, an influenza A(H3N2) outbreak occurred in Yichang city, Hubei province, China. A retrospective study was conducted to collect and interpret hospital and epidemiological data on it using social network analysis and global sensitivity and uncertainty analyses. Results for degree (χ2=17.6619, P<0.0001) and betweenness(χ2=21.4186, P<0.0001) centrality suggested that the selection of sampling objects were different between traditional epidemiological methods and newer statistical approaches...
February 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/28177515/methadone-for-cancer-pain
#19
REVIEW
Alexander B Nicholson, Graeme R Watson, Sheena Derry, Philip J Wiffen
BACKGROUND: This is an updated review originally published in 2004 and first updated in 2007. This version includes substantial changes to bring it in line with current methodological requirements. Methadone is a synthetic opioid that presents some challenges in dose titration and is recognised to cause potentially fatal arrhythmias in some patients. It does have a place in therapy for people who cannot tolerate other opioids but should be initiated only by experienced practitioners. This review is one of a suite of reviews on opioids for cancer pain...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28176430/managing-uncertainty-in-the-clinical-prediction-of-risk-of-harm-bringing-a-bayesian-approach-to-forensic-mental-health
#20
Conor Duggan, Roland Jones
Predicting the likelihood of harm posed by mentally disordered offenders remains controversial. It is proposed that a Bayesian approach may help quantify the uncertainty surrounding such prediction. An example of this approach quantifying the risk of breast cancer in the event of a positive mammogram is provided. Copyright © 2017 John Wiley & Sons, Ltd.
February 2017: Criminal Behaviour and Mental Health: CBMH
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