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Clinical Usefulness

Émilie Petitclerc, Luc J Hébert, Jean Mathieu, Johanne Desrosiers, Cynthia Gagnon
INTRODUCTION: Lower limb strength has never been characterized separately for late-onset and adult Myotonic Dystrophy Type 1 (DM1) phenotypes. METHODS: The purpose was to: 1) describe and compare lower limb strength between the 2 DM1 phenotypes, and 2) compare the impairment profiles obtained from 2 assessment methods [manual (MMT) and quantitative (QMT) muscle testing], among 107 patients. RESULTS: Both MMT and QMT showed more pronounced weakness in the adult phenotype...
October 26, 2016: Muscle & Nerve
B K Singleton, M Ahmed, C A Green, H Heimpel, M J Woźniak, L Ranjha, F Seeney, A Bomford, P Mehta, A Guest, R Mushens, M-J King
BACKGROUND: Bone marrow examination has been the confirmatory test for congenital dyserythropoietic anemia type II (CDAII). Occasional spherocytes on peripheral blood smear can confound the diagnosis. Since a screening test is still unavailable, we explored the feasibility of using flow cytometry as a preliminary screening method. METHODS: Thirteen monoclonal antibodies with specificities for eight erythrocyte membrane proteins were used in FACS analysis to probe the cellular features of red cells from CDAII, normal adults, hereditary spherocytosis (HS), and cord red cells...
October 26, 2016: Cytometry. Part B, Clinical Cytometry
Carrie D Patnode, Michelle L Henninger, Caitlyn A Senger, Leslie A Perdue, Evelyn P Whitlock
Importance: Although 80% of infants in the United States start breastfeeding, only 22% are exclusively breastfed up to around 6 months as recommended by a number of professional organizations. Objective: To systematically review the evidence on the benefits and harms of breastfeeding interventions to support the US Preventive Services Task Force in updating its 2008 recommendation. Data Sources: MEDLINE, PubMed, Cumulative Index for Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, and PsycINFO for studies published in the English language between January 1, 2008, and September 25, 2015...
October 25, 2016: JAMA: the Journal of the American Medical Association
Daniel S Joyce, Beatrix Feigl, Andrew J Zele
Purpose: We determine the effect of short-term light adaptation on the pupil light reflex and the melanopsin mediated post-illumination pupil response (PIPR). Inner and outer retinal photoreceptor contributions to the dark-adapted pupil response were estimated. Methods: In Experiment A, light adaptation was studied using short wavelength lights ranging from subthreshold to suprathreshold irradiances for melanopsin signaling that were presented before (5-60 seconds) and after (30 seconds) a melanopsin-exciting stimulus pulse...
October 1, 2016: Investigative Ophthalmology & Visual Science
Ji Yi, Zhen Puyang, Liang Feng, Lian Duan, Peiji Liang, Vadim Backman, Xiaorong Liu, Hao F Zhang
Purpose: Elastic light backscattering spectroscopy (ELBS) has exquisite sensitivity to the ultrastructural properties of tissue and thus has been applied to detect various diseases associated with ultrastructural alterations in their early stages. This study aims to test whether ELBS can detect early damage in retinal ganglion cells (RGCs). Methods: We used a mouse model of partial optic nerve crush (pONC) to induce rapid RGC death. We confirmed RGC loss by axon counting and characterized the changes in retinal morphology by optical coherence tomography (OCT) and in retinal function by full-field electroretinogram (ERG), respectively...
October 1, 2016: Investigative Ophthalmology & Visual Science
Stuart K Gardiner, Steven L Mansberger
Purpose: We have previously shown that sensitivities obtained at severely damaged visual field locations (<15-19 dB) are unreliable and highly variable. This study evaluates a testing algorithm that does not present very high contrast stimuli in damaged locations above approximately 1000% contrast, but instead concentrates on more precise estimation at remaining locations. Methods: A trained ophthalmic technician tested 36 eyes of 36 participants twice with each of two different testing algorithms: ZEST0, which allowed sensitivities within the range 0 to 35 dB, and ZEST15, which allowed sensitivities between 15 and 35 dB but was otherwise identical...
October 1, 2016: Investigative Ophthalmology & Visual Science
Matthew J Klebanoff, Jagpreet Chhatwal, Jacob D Nudel, Kathleen E Corey, Lee M Kaplan, Chin Hur
Importance: Severe obesity affects 4% to 6% of US youth and is increasing in prevalence. Bariatric surgery for the treatment of adolescents with severe obesity is becoming more common, but data on cost-effectiveness are limited. Objective: To assess the cost-effectiveness of bariatric surgery for adolescents with obesity using recently published results from the Teen-Longitudinal Assessment of Bariatric Surgery study. Design, Setting, and Patients: A state-transition model was constructed to compare 2 strategies: no surgery and bariatric surgery...
October 26, 2016: JAMA Surgery
Paul C Cremer, Yuping Wu, Haitham M Ahmed, Lee M Pierson, Danielle M Brennan, Mouaz H Al-Mallah, Clinton A Brawner, Jonathan K Ehrman, Steven J Keteyian, Roger S Blumenthal, Michael J Blaha, Leslie Cho
Importance: Risk assessment tools for exercise treadmill testing may have limited external validity. Cardiovascular mortality has decreased in recent decades, and women have been underrepresented in prior cohorts. Objectives: To determine whether exercise and clinical variables are associated with differential mortality outcomes in men and women and to assess whether sex-specific risk scores better estimate all-cause mortality. Design, Setting, and Participants: This retrospective cohort study included 59 877 patients seen at the Cleveland Clinic Foundation (CCF cohort) from January 1, 2000, through December 31, 2010, and 49 278 patients seen at the Henry Ford Hospital (FIT cohort) from January 1, 1991, through December 31, 2009...
October 26, 2016: JAMA Cardiology
Jarrod D Frizzell, Li Liang, Phillip J Schulte, Clyde W Yancy, Paul A Heidenreich, Adrian F Hernandez, Deepak L Bhatt, Gregg C Fonarow, Warren K Laskey
Importance: Several attempts have been made at developing models to predict 30-day readmissions in patients with heart failure, but none have sufficient discriminatory capacity for clinical use. Machine-learning (ML) algorithms represent a novel approach and may have potential advantages over traditional statistical modeling. Objective: To develop models using a ML approach to predict all-cause readmissions 30 days after discharge from a heart failure hospitalization and to compare ML model performance with models developed using "conventional" statistically based methods...
October 26, 2016: JAMA Cardiology
Jin-Young Jang, Yong Chan Shin, Youngmin Han, Joon Seong Park, Ho-Seong Han, Ho Kyoung Hwang, Dong Sup Yoon, Jae Keun Kim, Yoo Seok Yoon, Dae Wook Hwang, Chang Moo Kang, Woo Jung Lee, Jin Seok Heo, Mee Joo Kang, Ye Rim Chang, Jihoon Chang, Woohyun Jung, Sun-Whe Kim
Importance: The rate of postoperative pancreatic fistula (POPF) after distal pancreatectomy ranges from 13% to 64%. To prevent POPF, polyglycolic acid (PGA) mesh was introduced, but its effect has been evaluated only in small numbers of patients and retrospective studies. Objective: To evaluate the efficacy of PGA mesh in preventing POPF after distal pancreatectomy. Design, Setting, and Participants: Prospective randomized clinical, single-blind (participant), parallel-group trial at 5 centers between November 2011 and April 2014...
October 26, 2016: JAMA Surgery
Paolo Fusar-Poli, Grazia Rutigliano, Daniel Stahl, André Schmidt, Valentina Ramella-Cravaro, Shetty Hitesh, Philip McGuire
Importance: Pretest risk estimation is routinely used in clinical medicine to inform further diagnostic testing in individuals with suspected diseases. To our knowledge, the overall characteristics and specific determinants of pretest risk of psychosis onset in individuals undergoing clinical high risk (CHR) assessment are unknown. Objectives: To investigate the characteristics and determinants of pretest risk of psychosis onset in individuals undergoing CHR assessment and to develop and externally validate a pretest risk stratification model...
October 26, 2016: JAMA Psychiatry
Stephanie DeAnda, Laura Bosch, Diane Poulin-Dubois, Pascal Zesiger, Margaret Friend
Purpose: The aim of this study was to develop the Language Exposure Assessment Tool (LEAT) and to examine its cross-linguistic validity, reliability, and utility. The LEAT is a computerized interview-style assessment that requests parents to estimate language exposure. The LEAT yields an automatic calculation of relative language exposure and captures qualitative aspects of early language experience. Method: Relative language exposure as reported on the LEAT and vocabulary size at 17 months of age were measured in a group of bilingual language learners with varying levels of exposure to French and English or Spanish and English...
October 25, 2016: Journal of Speech, Language, and Hearing Research: JSLHR
Ekkehard Grünig, Nicola Benjamin, Tobias J Lange, Ulrich Krueger, Hans Klose, Claus Neurohr, Heinrike Wilkens, Michael Halank, Hans-Jürgen Seyfarth, Matthias Held, Andrew Traube, Michelle Pernow, E Robert Grover, Benjamin Egenlauf, Felix Gerhardt, Thomas Viethen, Stephan Rosenkranz
BACKGROUND: Subcutaneous treprostinil has dose-dependent beneficial effects in patients with severe pulmonary arterial hypertension, but adverse effects like infusion site pain can lead to treatment discontinuation. OBJECTIVES: The objective of this study was to evaluate safety, tolerability and clinical effects of a rapid up-titration dosing regimen of subcutaneous treprostinil using proactive infusion site pain management. METHODS: Effects of rapid up-titration dosing regimen on tolerability and clinical parameters were evaluated in this 16-week, open-label multi-centre study...
October 27, 2016: Respiration; International Review of Thoracic Diseases
Jacques Klein, Arachk de Górski, Daniel Benamran, Jean-Paul Vallee, Thomas De Perrot, Gregory J Wirth, Christophe E Iselin
INTRODUCTION: The study aimed to evaluate 3 different modalities of transrectal ultrasound (TRUS)-guided prostate biopsies (PBs; 2D-, 3D- and targeted 3D-TRUS with fusion to MRI - T3D). Primary end point was the detection rate of prostate cancer (PC). Secondary end point was the detection rate of insignificant PC according to the Epstein criteria. PATIENTS AND METHODS: Inclusion of 284 subsequent patients who underwent 2D-, 3D- or T3D PB from 2011 to 2015. All patients having PB for initial PC detection with a serum prostate-specific antigen value ≤20 ng/ml were included...
October 27, 2016: Urologia Internationalis
Anders Fytagoridis, Mattias Åström, Jennifer Samuelsson, Patric Blomstedt
BACKGROUND: The caudal zona incerta (cZi) and posterior subthalamic area (PSA) are an emerging deep brain stimulation (DBS) target for essential tremor (ET). OBJECTIVES: To evaluate the efficacy of tremor control in relation to the anatomical locations of stimulation fields in 50 patients with ET and DBS of the cZi. METHODS: A total of 240 contacts were evaluated separately with monopolar stimulation, and amplitudes were optimized for improvement of tremor and hand function...
October 27, 2016: Stereotactic and Functional Neurosurgery
Anjali Singh, Pramod K Mishra, Sundeep Singh Saluja, Majid A Talikoti, Pawan Kirtani, Abul Kalam Najmi
BACKGROUND/OBJECTIVE: Proto-oncogenes (HER-2) and tumor suppressor genes (p53) are commonly deregulated in gallbladder cancer (GBC). Available literature discloses skewed data from endemic Asian countries, especially north India. This study evaluates the prognostic significance of HER-2 and p53 in GBC patients from two major hospitals. METHODS: Sixty resectable tumor and control specimens were prospectively collected from December 2012 to January 2016. Immunohistochemical staining was done using monoclonal antibodies to semiquantitatively evaluate HER-2 and p53 protein expression...
October 27, 2016: Oncology
Kwangwoo Park, Sungjin Park, Mi-Jin Jeon, Jinhyun Choi, Jun Won Kim, Yoon Jin Cho, Won-Seok Jang, Yo Sup Keum, Ik Jae Lee
The 3D-printed boluses were used during the radiation therapy of the chest wall in six patients with breast cancer after modified radical mastectomy (MRM). We measured the in-vivo skin doses while both conventional and 3D-printed boluses were placed on the chest wall and compared the mean doses delivered to the ipsilateral lung and the heart. The homogeneity and conformity of the dose distribution in the chest wall for both types of boluses were also evaluated. The uniformity index on the chest skin was improved when the 3D-printed boluses were used, with the overall average skin dose being closer to the prescribed one in the former case (-0...
October 23, 2016: Oncotarget
Jeremy A Goettel, Roopali Gandhi, Jessica E Kenison, Ada Yeste, Gopal Murugaiyan, Sharmila Sambanthamoorthy, Alexandra E Griffith, Bonny Patel, Dror S Shouval, Howard L Weiner, Scott B Snapper, Francisco J Quintana
Existing therapies for inflammatory bowel disease that are based on broad suppression of inflammation result in variable clinical benefit and unwanted side effects. A potential therapeutic approach for promoting immune tolerance is the in vivo induction of regulatory T cells (Tregs). Here we report that activation of the aryl hydrocarbon receptor using the non-toxic agonist 2-(1'H-indole-3'-carbonyl)-thiazole-4-carboxylic acid methyl ester (ITE) induces human Tregs in vitro that suppress effector T cells through a mechanism mediated by CD39 and Granzyme B...
October 25, 2016: Cell Reports
Magnus Ekström
No abstract text is available yet for this article.
October 27, 2016: New England Journal of Medicine
Maria Freytsis, Julia C Phillippi, Kim J Cox, Amy Romano, Leslie Cragin
In 2014, the American College of Nurse-Midwives (ACNM) launched a project called Clarity in Collaboration to develop data definitions related to midwifery and maternity care delivery processes. These definitions are needed to ensure midwifery care delivered in collaborative care models is accurately and consistently captured in clinical documentation systems, data registries, and systems being developed as part of health care restructuring and payment reform. The Clarity in Collaboration project builds on the efforts of the Women's Health Registry Alliance (WHRA), which was recently established by the American College of Obstetricians and Gynecologists...
October 26, 2016: Journal of Midwifery & Women's Health
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