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Risk Stratification

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https://www.readbyqxmd.com/read/29232260/high-alert-medication-stratification-tool-revised-an-exploratory-study-of-an-objective-standardized-medication-safety-tool
#1
Natalie C Washburn, Heather A Dossett, Andrew C Fritschle, Kerri E Degenkolb, Monica R Macik, Todd A Walroth
OBJECTIVE: To develop an objective tool designed to standardize the identification of high-alert medications (HAMs) according to patient safety risk. METHODS: Medications were evaluated using the High-Alert Medication Stratification Tool (HAMST). Tool revision occurred through assessing medications on an organization-approved HAM list and comparing scores with control medications not included on the list. Because of variations in HAMST interpretation by end users in interdisciplinary committees, a revision of the scoring tool was completed to create the High-Alert Medication Stratification Tool-Revised (HAMST-R), and the assessment was repeated...
December 12, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29232195/crossover-design-in-transcranial-direct-current-stimulation-studies-on-motor-learning-potential-pitfalls-and-difficulties-in-interpretation-of-findings
#2
Mana Biabani, Michael Farrell, Maryam Zoghi, Gary Egan, Shapour Jaberzadeh
Crossover designs are used by a high proportion of studies investigating the effects of transcranial direct current stimulation (tDCS) on motor learning. These designs necessitate attention to aspects of data collection and analysis to take account of design-related confounds including order, carryover, and period effects. In this systematic review, we appraised the method sections of crossover-designed tDCS studies of motor learning and discussed the strategies adopted to address these factors. A systematic search of 10 databases was performed and 19 research papers, including 21 experimental studies, were identified...
December 12, 2017: Reviews in the Neurosciences
https://www.readbyqxmd.com/read/29231962/symptoms-reported-by-frail-elderly-adults-independently-predict-30-day-hospital-readmission-or-emergency-department-care
#3
Lynn S Borkenhagen, Rozalina G McCoy, Rachel D Havyer, Stephanie M Peterson, James M Naessens, Paul Y Takahashi
OBJECTIVES: To assess the degree to which self-reported symptoms predict unplanned readmission or emergency department (ED) care within 30 days of high-risk, elderly adults enrolled in a posthospitalization care transition program (CTP). DESIGN: Retrospective cohort study. SETTING: Posthospitalization CTP at Mayo Clinic, Rochester, Minnesota, from January 1, 2013, through March 3, 2015. PARTICIPANTS: Frail, elderly adults (N = 230; mean age 83...
December 12, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29230975/negative-pap-tests-in-women-with-high-grade-cervical-lesions-on-follow-up-biopsies-contributing-factors-and-role-of-human-papillomavirus-genotyping
#4
Steven Goodman, Roxanne R Mody, Donna Coffey, Blythe K Gorman, Eric Luna, Donna Armylagos, Mary R Schwartz, Dina R Mody, Yimin Ge
BACKGROUND: Previous studies have indicated that negative Papanicolaou (Pap) tests can precede high-grade cervical lesions (HGCL) on biopsy. This study aims to determine the contributing factors for cytologic discrepancy and the potential role of human papilloma virus (HPV) testing in risk evaluation of women with negative Pap tests. METHODS: Of 42,797 Pap tests interpreted as negative for intraepithelial lesion or malignancy (NILM) from March 1, 2013 to December 30, 2014, 426 had available HPV testing and follow-up biopsy...
December 12, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/29230964/preventive-effect-of-diverting-stoma-on-anastomotic-leakage-after-laparoscopic-low-anterior-resection-with-double-stapling-technique-reconstruction-applied-based-on-risk-stratification
#5
Atsushi Hamabe, Masaaki Ito, Hideaki Nishigori, Yuji Nishizawa, Takeshi Sasaki
INTRODUCTION: During laparoscopic low anterior resection with double stapling technique reconstruction, it is necessary to securely implement rectal transection and anastomosis to prevent anastomotic leakage (AL). However, risk factors and preventive measures for AL are not known sufficiently. Therefore, this study aimed to elucidate risk factors associated with AL and to clarify strategies to prevent it. METHODS: We analyzed a total of 296 cases with rectal cancer who had undergone laparoscopic low anterior resection with double stapling technique reconstruction at the National Cancer Center Hospital East...
December 12, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29230958/treatment-related-mortality-in-relapsed-childhood-acute-lymphoblastic-leukemia
#6
Trausti Oskarsson, Stefan Söderhäll, Johan Arvidson, Erik Forestier, Thomas Leth Frandsen, Marit Hellebostad, Päivi Lähteenmäki, Ólafur G Jónsson, Ida Hed Myrberg, Mats Heyman
BACKGROUND: Treatment of relapsed childhood acute lymphoblastic leukemia (ALL) is particularly challenging due to the high treatment intensity needed to induce and sustain a second remission. To improve results, it is important to understand how treatment-related toxicity impacts survival. PROCEDURE: In this retrospective population-based study, we described the causes of death and estimated the risk for treatment-related mortality in patients with first relapse of childhood ALL in the Nordic Society of Paediatric Haematology and Oncology ALL-92 and ALL-2000 trials...
December 12, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29230178/human-cardiac-31p-mr-spectroscopy-at-3-tesla-cannot-detect-failing-myocardial-energy-homeostasis-during-exercise
#7
Adrianus J Bakermans, Jason N Bazil, Aart J Nederveen, Gustav J Strijkers, S Matthijs Boekholdt, Daniel A Beard, Jeroen A L Jeneson
Phosphorus-31 magnetic resonance spectroscopy (31P-MRS) is a unique non-invasive imaging modality for probing in vivo high-energy phosphate metabolism in the human heart. We investigated whether current 31P-MRS methodology would allow for clinical applications to detect exercise-induced changes in (patho-)physiological myocardial energy metabolism. Hereto, measurement variability and repeatability of three commonly used localized 31P-MRS methods [3D image-selected in vivo spectroscopy (ISIS) and 1D ISIS with 1D chemical shift imaging (CSI) oriented either perpendicular or parallel to the surface coil] to quantify the myocardial phosphocreatine (PCr) to adenosine triphosphate (ATP) ratio in healthy humans (n = 8) at rest were determined on a clinical 3 Tesla MR system...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29230144/risk-stratification-for-prevention-of-recurrence-of-postoperative-crohn-s-disease
#8
Shirley Cohen-Mekelburg, Yecheskel Schneider, Stephanie Gold, Ellen Scherl, Adam Steinlauf
Although there have been significant advances in medical therapies to treat Crohn's disease, an estimated 50% of patients will require surgery within the first decade of disease duration. Of these patients, a substantial number will develop recurrent symptoms within the first postoperative year. To prevent disease recurrence, many physicians use postoperative prophylactic therapy. Randomized, controlled trials, although limited in number, have demonstrated that a prophylactic postoperative strategy is effective at reducing recurrence (both clinical and endoscopic) in high-risk patients...
November 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29229743/meta-analysis-and-systematic-review-to-assess-the-role-of-soluble-fms-like-tyrosine-kinase-1-and-placenta-growth-factor-ratio-in-prediction-of-preeclampsia-the-sappphire-study
#9
Swati Agrawal, Ana Sofia Cerdeira, Christopher Redman, Manu Vatish
Preeclampsia is a major cause of morbidity and mortality worldwide. Numerous candidate biomarkers have been proposed for diagnosis and prediction of preeclampsia. Measurement of maternal circulating angiogenesis biomarker as the ratio of sFlt-1 (soluble FMS-like tyrosine kinase-1; an antiangiogenic factor)/PlGF (placental growth factor; an angiogenic factor) reflects the antiangiogenic balance that characterizes incipient or overt preeclampsia. The ratio increases before the onset of the disease and thus may help in predicting preeclampsia...
December 11, 2017: Hypertension
https://www.readbyqxmd.com/read/29229656/informing-future-research-for-carriage-of-multiresistant-gram-negative-bacteria-problems-with-recruiting-to-an-english-stool-sample-community-prevalence-study
#10
Donna M Lecky, Deborah Nakiboneka-Ssenabulya, Tom Nichols, Peter Hawkey, Kim Turner, Keun-Taik Chung, Mike Thomas, Helen Lucy Thomas, Li Xu McCrae, Sahida Shabir, Susan Manzoor, Adela Alvarez-Buylla, Steve Smith, Cliodna McNulty
OBJECTIVES: This study aims to highlight problems with recruiting to an English stool sample community prevalence study. It was part of a larger cross-sectional research to determine the risk factors for the presence of extended-spectrum beta-lactamase and carbapenemase-producing coliforms in stool samples of the asymptomatic general English population. SETTING: Four National Health Service primary care trusts (PCTs) of England representing a different section of the population of England: Newham PCT; Heart of Birmingham Teaching PCT; Shropshire County PCT; and Southampton City PCT...
December 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/29228827/conservative-versus-active-management-in-hellp-syndrome-results-from-a-cohort-study
#11
Marie Cavaignac-Vitalis, Fabien Vidal, M D Caroline Simon-Toulza, Pierre Boulot, Paul Guerby, Elodie Chantalat, Parant M D Olivier
OBJECTIVE: HELLP syndrome exposes to severe maternal and fetal complications. Prompt delivery is thus recommended after 34 weeks of gestation, or earlier in case of nonreassuring maternofetal conditions. However, no consensus has been raised in the treatment of HELLP syndrome occurring before 34 weeks of gestation, when both maternal and fetal conditions are stable: it remains still unclear whether an active attitude should be prioritized over expectant management. Herein we aimed to compare mother and child outcomes according to the type of obstetrical management, either active or conservative...
December 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29228760/development-and-validation-of-a-prognostic-nomogram-for-colorectal-cancer-after-radical-resection-based-on-individual-patient-data-from-three-large-scale-phase-iii-trials
#12
Michitaka Honda, Koji Oba, Takashi Akiyoshi, Hiromichi Maeda, Kosuke Kashiwabara, Mitsuro Kanda, Shuhei Mayanagi, Toru Aoyama, Chikuma Hamada, Sotaro Sadahiro, Yosuke Fukunaga, Masashi Ueno, Junichi Sakamoto, Shigetoyo Saji, Takaki Yoshikawa
Background: Few prediction models have so far been developed and assessed for the prognosis of patients who undergo curative resection for colorectal cancer (CRC). Materials and Methods: We prepared a clinical dataset including 5,530 patients who participated in three major randomized controlled trials as a training dataset and 2,263 consecutive patients who were treated at a cancer-specialized hospital as a validation dataset. All subjects underwent radical resection for CRC which was histologically diagnosed to be adenocarcinoma...
November 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29228722/prognostic-factors-for-histiocytic-and-dendritic-cell-neoplasms
#13
Joji Shimono, Hiroaki Miyoshi, Fumiko Arakawa, Kensaku Sato, Takuya Furuta, Reiji Muto, Eriko Yanagida, Yuya Sasaki, Daisuke Kurita, Keisuke Kawamoto, Koji Nagafuji, Koichi Ohshima
Histiocytic and dendritic cell neoplasms are rare and poorly studied. We report the clinical characteristics and prognostic factors in such cases in Japan. We investigated the clinical characteristics and survival in 87 adult patients with histiocytic and dendritic cell neoplasms. Fifty patients had histiocytic sarcoma, 12 had Langerhans cell histiocytosis, 11 had follicular dendritic cell sarcoma, 8 had Langerhans cell sarcoma, 6 had interdigitating cell sarcoma and 1 had indeterminate dendritic cell sarcoma...
November 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29228138/american-society-of-anesthesiologists-physical-status-facilitates-risk-stratification-of-elderly-patients-undergoing-thoracoscopic-lobectomy
#14
Ruoyu Zhang, Thomas Kyriss, Jürgen Dippon, Matthias Hansen, Enole Boedeker, Godehard Friedel
OBJECTIVES: Accurate risk assessments are particularly important for elderly patients being considered for lobectomy. Considering the positive effects of the thoracoscopic approach on postoperative outcomes, we sought to review the reliability of the established risk factors for elderly patients undergoing thoracoscopic lobectomy. METHODS: From January 2009 to March 2016, 441 patients in our institution underwent thoracoscopic lobectomy for early-stage lung cancer...
December 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29227754/genetic-variant-in-mir-124-decreased-the-susceptibility-to-esophageal-squamous-cell-carcinoma-in-a-chinese-kazakh-population
#15
Fei Wu, Mei Li, Weiyan You, Yu Ji, Xiaobin Cui, Jianming Hu, Yunzhao Chen, Lijuan Pang, Shugang Li, Yutao Wei, Lan Yang, Feng Li
AIMS: Esophageal squamous cell carcinoma (ESCC) is characterized by high prevalence and mortality worldwide, and it is very highly prevalent in China. ESCC is caused by various factors, including microRNAs (miRNAs) whose expression have been shown to play a major role in tumor generation. Single nucleotide polymorphisms (SNPs) in miRNAs could affect susceptibility to numerous cancers. This study aimed to evaluate the relationship between SNPs in miR-124 and ESCC risk in the Chinese Kazakh population...
December 11, 2017: Genetic Testing and Molecular Biomarkers
https://www.readbyqxmd.com/read/29227531/discovery-of-a-novel-six-long-non-coding-rna-signature-predicting-survival-of-colorectal-cancer-patients
#16
Qiaowei Fan, Bingrong Liu
Colorectal cancer (CRC) is one of the most leading causes of cancer deaths worldwide. In the study, we aimed to identify key long non-coding RNAs (lncRNAs) significantly associated with prognosis of CRC and develop an expression-based lncRNA signature to provide surviv-al risk prediction for CRC patients. LncRNA expression profiles and clinical information of CRC patients were collected from The Cancer Genome Atlas (TCGA) database. 618 differen-tially expressed lncRNAs were identified between CRC and normal tissues...
December 11, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/29227414/the-diagnostic-process-of-stable-angina-still-many-doubts-since-heberden-s-first-description-250-years-ago
#17
Irene Raso, Ilaria Passarelli, Gioacchino Valenti, Gabriele Crimi, Stefano de Servi
: Since Heberden's first description, stable angina has represented a challenge for the clinicians. Even the most recent guidelines seem ineffective to correctly identify patients who should be sent to cath labs. Still too many patients who undergo coronary angiography are found not to have significant lesions; moreover, its extensive use as the first diagnostic test leads to revascularizations with uncertain appropriateness and prognostic significance. These considerations underline the importance of noninvasive testing before sending patients to invasive coronary angiography...
December 8, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29227012/superior-anti-suicidal-effects-of-electroconvulsive-therapy-in-unipolar-disorder-and-bipolar-depression
#18
Chih-Sung Liang, Chi-Hsiang Chung, Pei-Shen Ho, Chia-Kuang Tsai, Wu-Chien Chien
OBJECTIVES: Electroconvulsive therapy (ECT) has long been believed to reduce suicidal tendencies in patients with affective disorders; however, ECT recipients, who constitute the most severely ill and suicidal patients, are not eligible to participate in head-to-head randomized controlled trials. Large-scale studies are required to investigate the anti-suicidal effects of ECT vs psychopharmacotherapy. METHODS: A nationwide retrospective cohort study design was used...
December 11, 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/29226763/mipss70-mutation-enhanced-international-prognostic-score-system-for-transplantation-age-patients-with-primary-myelofibrosis
#19
Paola Guglielmelli, Terra L Lasho, Giada Rotunno, Mythri Mudireddy, Carmela Mannarelli, Maura Nicolosi, Annalisa Pacilli, Animesh Pardanani, Elisa Rumi, Vittorio Rosti, Curtis A Hanson, Francesco Mannelli, Rhett P Ketterling, Naseema Gangat, Alessandro Rambaldi, Francesco Passamonti, Giovanni Barosi, Tiziano Barbui, Mario Cazzola, Alessandro M Vannucchi, Ayalew Tefferi
Purpose To develop a prognostic system for transplantation-age patients with primary myelofibrosis (PMF) that integrates clinical, cytogenetic, and mutation data. Patients and Methods The study included 805 patients with PMF age ≤ 70 years recruited from multiple Italian centers and the Mayo Clinic (Rochester, MN), forming two independent learning and validation cohorts. A Cox multivariable model was used to select from among a list of 22 variables those that were predictive of overall survival (OS). Integrated clinical and genetic prognostic models with (MIPSS70-plus) or without (MIPSS70) cytogenetic information were developed...
December 9, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29226712/-risk-stratification-before-thoracic-surgery-perioperative-pulmonary-rehabilitation
#20
Attila Vágvölgyi, Zsolt Rozgonyi, Pál Vadász, János Tamás Varga
INTRODUCTION: Besides the oncology and operative surgical technics, functional aspects influence the operability of lung cancer. Preoperative risk stratification, evaluation of postoperative complications needs to be considered. AIM: To review international literature and experiences of our institute. METHOD: We focused the literature of risk stratification of thoracic surgery. Lung function, lung mechanics, chest kinematics, exercise physiology were considered...
December 2017: Orvosi Hetilap
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