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Risk Stratification

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https://www.readbyqxmd.com/read/28727500/risk-stratification-of-adnexal-cysts-and-cystic-masses-clinical-performance-of-society-of-radiologists-in-ultrasound-guidelines
#1
Katherine E Maturen, Alexander D Blaty, Ashish P Wasnik, Krupa Patel-Lippmann, Jessica B Robbins, Lisa Barroilhet, Laura B Huffman, Elizabeth A Sadowski
Purpose To evaluate the performance of the 2010 Society of Radiologists in Ultrasound (SRU) consensus guidelines in the risk stratification of symptomatic and asymptomatic adnexal cysts. Materials and Methods An institutional review board-approved retrospective review was performed, including adnexal cysts detected with ultrasonography (US) with surgical diagnosis or at least 2 years of imaging or clinical follow-up, from January to June 2011. SRU management recommendations were scored as 0, no follow-up; 1, US follow-up; 2, magnetic resonance (MR) imaging follow-up; and 3, surgical evaluation...
July 20, 2017: Radiology
https://www.readbyqxmd.com/read/28725590/mri-fusion-biopsy-the-contemporary-experience
#2
REVIEW
Marc A Bjurlin, Andrew B Rosenkrantz, Samir S Taneja
Advancements in magnetic resonance imaging (MRI) and MRI-ultrasound (US)-fusion targeted biopsy have resulted in a paradigm shift in the diagnosis of prostate cancer by overcoming the limitations of systematic biopsy. Prebiopsy MRI and MRI-US-fusion biopsy results in an increased detection of clinically significant disease, reduction in the detection of indolent disease, and allows for tumor localization during targeted biopsy. With these advantages, we have adopted a prebiopsy MRI and MRI-US-fusion biopsy diagnostic care pathway for all men at risk for prostate cancer and have performed more than 1900 biopsies to date...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28725589/multi-parametric-magnetic-resonance-imaging-as-a-management-decision-tool
#3
REVIEW
David C Johnson, Robert E Reiter
The ability to image the prostate accurately and better characterize cancerous lesions makes multiparametric magnetic resonance imaging (mpMRI) an invaluable tool to improve management of localized prostate cancer (PCa). Improved risk stratification is warranted given the evidence of significant overtreatment of indolent PCa. mpMRI can more accurately rule out clinically significant PCa in men deciding between surveillance and definitive treatment to reduce overtreatment. mpMRI improves detection of clinically significant PCa, which helps minimize sampling error, a major limitation of the traditional diagnostic paradigm...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28725587/multi-parametric-mri-imaging-of-the-prostate-implications-for-focal-therapy
#4
REVIEW
James S Wysock, Herbert Lepor
The primary goal of a focal therapy treatment paradigm is to achieve cancer control through targeted tissue destruction while simultaneously limiting deleterious effects on peri-prostatic structures. Focal therapy approaches are employed in several oncologic treatment protocols, and have been shown to provide equivalent cancer control for malignancies such as breast cancer and renal cell carcinoma. Efforts to develop a focal therapy approach for prostate cancer have been challenged by several concepts including the multifocal nature of the disease and limited capability of prostate ultrasound and systematic biopsy to reliably localize the site(s) and aggressiveness of disease...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28725586/role-of-prostate-magnetic-resonance-imaging-in-active-surveillance
#5
REVIEW
Xiaosong Meng, Andrew B Rosenkrantz, Samir S Taneja
Active surveillance (AS) has emerged as a beneficial strategy for management of low risk prostate cancer (PCa) and prevention of overtreatment of indolent disease. However, selection of patients for AS using traditional 12-core transrectal prostate biopsy is prone to sampling error and presents a challenge for accurate risk stratification. In fact, around a third of men are upgraded on repeat biopsy which disqualifies them as appropriate AS candidates. This uncertainty affects adoption of AS among patients and physicians, leading to current AS protocols involving repetitive prostate biopsies and unclear triggers for progression to definitive treatment...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28725582/co-registration-of-mri-and-ultrasound-accuracy-of-targeting-based-on-radiology-pathology-correlation
#6
REVIEW
Win Shun Lai, Jessica G Zarzour, Jennifer B Gordetsky, Soroush Rais-Bahrami
We reviewed the role of multiparametric magnetic resonance imaging (MP-MRI) and methods of MRI guided biopsy including in-bore, cognitive fusion, and software-based fusion. MP-MRI has been developed, optimized, and studied as a means of improving prostate cancer detection beyond the standard evaluation that utilizes digital rectal examinations and serum prostate specific antigen (PSA). MP-MRI has been proven to be an excellent diagnostic imaging modality that improves prostate cancer detection and risk stratification by guiding biopsy samples...
June 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28725572/novel-panel-of-protein-biomarkers-to-predict-response-to-bortezomib-containing-induction-regimens-in-multiple-myeloma-patients
#7
Kay Reen Ting, Michael Henry, Justine Meiller, Annemarie Larkin, Martin Clynes, Paula Meleady, Despina Bazou, Paul Dowling, Peter O'Gorman
BACKGROUND: Multiple myeloma (MM) is a complex heterogeneous disease. Various risk stratification models have been recommended including cytogenetic and FISH analysis to identify high-risk patients who may benefit from novel treatments, but such facilities are not widely available. The International Scoring System (ISS) using beta-2-microglobulin and albumin remains a widely used prognostic scoring system in many clinical practices; however it is not useful in predicting response to treatment in MM...
December 2017: BBA Clinical
https://www.readbyqxmd.com/read/28725272/brazilian-guidelines-on-prevention-of-cardiovascular-disease-in-patients-with-diabetes-a-position-statement-from-the-brazilian-diabetes-society-sbd-the-brazilian-cardiology-society-sbc-and-the-brazilian-endocrinology-and-metabolism-society-sbem
#8
REVIEW
Marcello Casaccia Bertoluci, Rodrigo Oliveira Moreira, André Faludi, Maria Cristina Izar, Beatriz D Schaan, Cynthia Melissa Valerio, Marcelo Chiara Bertolami, Ana Paula Chacra, Marcus Vinicius Bolivar Malachias, Sérgio Vencio, José Francisco Kerr Saraiva, Roberto Betti, Luiz Turatti, Francisco Antonio Helfenstein Fonseca, Henrique Tria Bianco, Marta Sulzbach, Adriana Bertolami, João Eduardo Nunes Salles, Alexandre Hohl, Fábio Trujilho, Eduardo Gomes Lima, Marcio Hiroshi Miname, Maria Teresa Zanella, Rodrigo Lamounier, João Roberto Sá, Celso Amodeo, Antonio Carlos Pires, Raul D Santos
BACKGROUND: Since the first position statement on diabetes and cardiovascular prevention published in 2014 by the Brazilian Diabetes Society, the current view on primary and secondary prevention in diabetes has evolved as a result of new approaches on cardiovascular risk stratification, new cholesterol lowering drugs, and new anti-hyperglycemic drugs. Importantly, a pattern of risk heterogeneity has emerged, showing that not all diabetic patients are at high or very high risk. In fact, most younger patients who have no overt cardiovascular risk factors may be more adequately classified as being at intermediate or even low cardiovascular risk...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28725066/editorial-best-practices-in-surveillance-of-barrett-s-esophagus
#9
Sachin Wani, Srinivas Gaddam
Endoscopic surveillance in Barrett's esophagus (BE) has numerous limitations and thus provides several opportunities for improving the effectiveness of our current surveillance strategies. Several risk stratification and prediction tools have been investigated to identify patients at highest risk for progression to esophageal adenocarcinoma (EAC). Persistence of non-dysplastic BE (NDBE) has been proposed as an indicator of lower risk of progression to EAC. This editorial highlights the variable results and methodologies in studies evaluating persistence of NDBE as a risk stratification tool in the surveillance of BE patients and provides guidance for optimizing outcomes in BE patients enrolled in surveillance programs...
July 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28724618/initiation-of-sevelamer-and-mortality-among-hemodialysis-patients-treated-with-calcium-based-phosphate-binders
#10
Hirotaka Komaba, Mia Wang, Masatomo Taniguchi, Suguru Yamamoto, Takanobu Nomura, Douglas E Schaubel, Abigail R Smith, Jarcy Zee, Angelo Karaboyas, Brian Bieber, Masafumi Fukagawa, Francesca Tentori
BACKGROUND AND OBJECTIVES: Prior studies have shown that sevelamer attenuates progression of arterial calcification and may reduce the risk of death compared with calcium-based phosphate binders. In clinical practice, however, sevelamer is used not only as an alternative but also as an add-on therapy in patients already being treated with calcium-based phosphate binders. We analyzed the Dialysis Outcomes and Practice Patterns Study (DOPPS) data to test the hypothesis that the initiation of sevelamer is associated with improved survival in patients on hemodialysis treated with calcium-based phosphate binders...
July 19, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28723773/development-and-validation-of-risk-stratification-delirium-prediction-model-for-critically-ill-patients-a-prospective-observational-single-center-study
#11
Yu Chen, Hang Du, Bao-Hua Wei, Xue-Ni Chang, Chen-Ming Dong
The objective is to develop a model based on risk stratification to predict delirium among adult critically ill patients and whether early intervention could be provided for high-risk patients, which could reduce the incidence of delirium.We designed a prospective, observational, single-center study. We examined 11 factors, including age, APACHE-II score, coma, emergency operation, mechanical ventilation (MV), multiple trauma, metabolic acidosis, history of hypertension, delirium and dementia, and application of Dexmedetomidine Hydrochloride...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723762/recombinant-human-tsh-stimulated-thyroglobulin-levels-at-remnant-ablation-predict-structural-incomplete-response-to-treatment-in-patients-with-differentiated-thyroid-cancer
#12
Jeonghoon Ha, Min Hee Kim, Kwanhoon Jo, Yejee Lim, Ja Seong Bae, Sohee Lee, Moo Il Kang, Bong Yun Cha, Dong Jun Lim
In patients with differentiated thyroid cancer, stimulated thyroglobulin (sTg) levels after thyroid hormone withdrawal (THW) at remnant ablation (RA) and at 6 to 12 months are known to have good prognostic value. This study aimed to evaluate the prognostic impacts and best cutoff values of sTg levels under recombinant human thyroid stimulating hormone (rhTSH) treatment at RA and at follow-up. A total of 151 patients were enrolled, of whom 77 were followed up with rhTSH-stimulated Tg (rhTSH-sTg) and 74 with THW-stimulated Tg (THW-sTg) at 6 to 12 months after rhTSH-aided RA...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723702/reducing-falls-in-the-inpatient-hospital-setting
#13
Catherine M Melin
AIM: This quality improvement project's objective was to introduce and assess a process change to potentially reduce fall rates on an inpatient medical-surgical unit. METHODS: The Iowa Model of Evidence-Based Practice was used to guide the implementation of this project. This project was piloted over a 3-month period from October to December 2016 on a 38-bed medical-surgical unit at a community-based hospital in the southeastern United States. Prior to the implementation of this quality improvement project, staff received falls education using a modified pre-existing falls prevention protocol, with a focus on increasing the consistency of bed/chair alarm use for patients identified as being at risk for falling...
July 18, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28723631/cbl-b-predicts-postoperative-survival-in-patients-with-resectable-pancreatic-ductal-adenocarcinoma
#14
Qian Dong, Yuteng Ma, Yao Zhang, Xiujuan Qu, Zhi Li, Yafei Qi, Yunpeng Liu, Ce Li, Kai Li, Xianghong Yang, Xiaofang Che
Casitas B-lineage lymphoma b (Cbl-b) is a ubiquitin-protein ligase and a signal transducing adaptor protein involved in immune regulation, and it may be involved in the development and progression of cancer. We investigated the association between Cbl-b expression and prognosis in patients with resectable pancreatic ductal adenocarcinoma (PDAC). The clinicopathological characteristics and survival data of 134 patients with surgery for PDAC between January 2009 and February 2012 were retrospectively evaluated, and Cbl-b expression was assayed by immunohistochemical staining...
June 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28723493/proteinuria-in-patients-undergoing-renal-cancer-surgery-impact-on-overall-survival-and-stability-of-renal-function
#15
Zhiling Zhang, Juping Zhao, Joseph Zabell, Erick Remer, Jianbo Li, Jack Campbell, Wen Dong, Diego Aguilar Palacios, Tulsi Patel, Sevag Demirjian, Steven C Campbell
BACKGROUND: Proteinuria is included in the Kidney Disease: Improving Global Outcomes (KDIGO) risk stratification for chronic kidney disease (CKD) in the general population. However, the importance of proteinuria in patients with renal cancer has not been adequately studied. OBJECTIVE: To evaluate the prognostic impact of preoperative proteinuria on overall survival (OS) and renal function stability (RFS) for patients managed with renal cancer surgery. DESIGN, SETTING, AND PARTICIPANTS: From 1999 to 2008, 977 patients who underwent renal cancer surgery had preoperative data recorded for the glomerular filtration rate (GFR) estimated using the CKD Epidemiology Collaboration equation (G1 ≥90, G2 60-89, G3a 45-59, G3b 30-44, G4 15-29, and G5 <15ml/min/1...
December 15, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28723377/external-validation-of-the-mskcc-and-imdc-risk-models-in-patients-treated-with-targeted-therapy-as-a-first-line-and-subsequent-second-line-treatment-a-japanese-multi-institutional-study
#16
Nobuyuki Tanaka, Ryuichi Mizuno, Keiichi Ito, Suguru Shirotake, Yota Yasumizu, Ayako Masunaga, Yujiro Ito, Yasumasa Miyazaki, Masayuki Hagiwara, Kent Kanao, Shuji Mikami, Ken Nakagawa, Tetsuo Momma, Takeshi Masuda, Tomohiko Asano, Masafumi Oyama, Mototsugu Oya
BACKGROUND: Two risk models, the Memorial Sloan Kettering Cancer Center (MSKCC) model and the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model, have been studied in metastatic renal cell carcinoma (mRCC) treated with targeted therapy. OBJECTIVE: To validate externally the predictive accuracies of the MSKCC and IMDC models for prognosis in mRCC patients treated with first-line and subsequent second-line targeted therapy. DESIGN, SETTING, AND PARTICIPANTS: A total of 311 patients were assessed retrospectively...
August 2016: European Urology Focus
https://www.readbyqxmd.com/read/28721912/exosomes-and-exosomal-micrornas-in-prostate-cancer-radiation-therapy
#17
REVIEW
Bijaya Malla, Kathrin Zaugg, Erik Vassella, Daniel M Aebersold, Alan Dal Pra
Despite current risk stratification systems using traditional clinicopathologic factors, many localized and locally advanced prostate cancers fail radical treatment (ie, radical prostatectomy, radiation therapy with or without androgen deprivation therapy). Therefore, a pressing need exists for enhanced methods of disease stratification through novel prognostic and predictive tools that can reliably be applied in clinical practice. Exosomes are 50- to 150-nm small vesicles released by cancer cells that reflect the genetic and nongenetic materials of parent cancer cells...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28721485/non-additive-and-epistatic-effects-of-hla-polymorphisms-contributing-to-risk-of-adult-glioma
#18
Chenan Zhang, Adam J de Smith, Ivan V Smirnov, John K Wiencke, Joseph L Wiemels, John S Witte, Kyle M Walsh
Although genome-wide association studies have identified several susceptibility loci for adult glioma, little is known regarding the potential contribution of genetic variation in the human leukocyte antigen (HLA) region to glioma risk. HLA associations have been reported for various malignancies, with many studies investigating selected candidate HLA polymorphisms. However, no systematic analysis has been conducted in glioma patients, and no investigation into potential non-additive effects has been described...
July 18, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28721448/-pi-rads-2-0-for-prostate-mri
#19
T Franiel, M Röthke
The PI-RADS 2.0 classification was established by an international collaboration of the European Society of Urogenital Radiology (ESUR), the American College of Radiology (ACR), and AdMetech Foundation to globally standardize the acquisition and interpretation of multiparametric prostate magnetic resonance imaging (MRI). The PI-RADS 2.0 aims to improve the detection, localization, staging and risk stratification of patients with suspected or histologically confirmed prostate cancer. Suspicious areas on T2-weighted (T2w) MRI, diffusion-weighted MRI (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) were assessed for the presence of a clinically significant prostate cancer with scale from 1 to 5 with 5 being most likely to represent clinically significant prostate cancer...
July 18, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28721070/association-of-estrogen-receptor-%C3%AE-pvuii-and-xbai-polymorphisms-with-prostate-cancer-susceptibility-and-risk-stratification-a-meta-analysis-from-case-control-studies
#20
Yining Zhao, Xi Zheng, Lijie Zhang, Qiang Hu, Yitian Guo, Hua Jiang, Shennan Shi, Xiang Zhang
BACKGROUND: Studies on the association between two single nucleotide polymorphisms (SNPs) in estrogen receptor α (ERα), PvuII (rs2234693 T>C) and XbaI (rs9340799 A>G), and the prostate cancer risk are inconsistent. Therefore, we performed a meta-analysis to derive a more accurate estimation of this relationship. METHODS: A literature search of PubMed, Embase, Web of Science databases until October 1, 2016, was conducted. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of this association...
2017: OncoTargets and Therapy
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