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https://www.readbyqxmd.com/read/28412062/development-and-internal-validation-of-a-novel-model-to-identify-the-candidates-for-extended-pelvic-lymph-node-dissection-in-prostate-cancer
#1
Giorgio Gandaglia, Nicola Fossati, Emanuele Zaffuto, Marco Bandini, Paolo Dell'Oglio, Carlo Andrea Bravi, Giuseppe Fallara, Francesco Pellegrino, Luigi Nocera, Pierre I Karakiewicz, Zhe Tian, Massimo Freschi, Rodolfo Montironi, Francesco Montorsi, Alberto Briganti
BACKGROUND: Preoperative assessment of the risk of lymph node invasion (LNI) is mandatory to identify prostate cancer (PCa) patients who should receive an extended pelvic lymph node dissection (ePLND). OBJECTIVE: To update a nomogram predicting LNI in contemporary PCa patients with detailed biopsy reports. DESIGN, SETTING, AND PARTICIPANTS: Overall, 681 patients with detailed biopsy information, evaluated by a high-volume uropathologist, treated with radical prostatectomy and ePLND between 2011 and 2016 were identified...
April 12, 2017: European Urology
https://www.readbyqxmd.com/read/28409907/the-roles-of-prostate-specific-antigen-psa-density-prostate-volume-and-their-zone-adjusted-derivatives-in-predicting-prostate-cancer-in-patients-with-psa-less-than-20-0%C3%A2-ng-ml
#2
P Shen, J Zhao, G Sun, N Chen, X Zhang, H Gui, Y Yang, J Liu, K Shu, Z Wang, H Zeng
The aim of this study was to develop nomograms for predicting prostate cancer and its zonal location using prostate-specific antigen density, prostate volume, and their zone-adjusted derivatives. A total of 928 consecutive patients with prostate-specific antigen (PSA) less than 20.0 ng/mL, who underwent transrectal ultrasound-guided transperineal 12-core prostate biopsy at West China Hospital between 2011 and 2014, were retrospectively enrolled. The patients were randomly split into training cohort (70%, n = 650) and validation cohort (30%, n = 278)...
May 2017: Andrology
https://www.readbyqxmd.com/read/28400169/combined-clinical-parameters-and-multiparametric-magnetic-resonance-imaging-for-advanced-risk-modeling-of-prostate-cancer-patient-tailored-risk-stratification-can-reduce-unnecessary-biopsies
#3
Jan Philipp Radtke, Manuel Wiesenfarth, Claudia Kesch, Martin T Freitag, Celine D Alt, Kamil Celik, Florian Distler, Wilfried Roth, Kathrin Wieczorek, Christian Stock, Stefan Duensing, Matthias C Roethke, Dogu Teber, Heinz-Peter Schlemmer, Markus Hohenfellner, David Bonekamp, Boris A Hadaschik
BACKGROUND: Multiparametric magnetic resonance imaging (mpMRI) is gaining widespread acceptance in prostate cancer (PC) diagnosis and improves significant PC (sPC; Gleason score≥3+4) detection. Decision making based on European Randomised Study of Screening for PC (ERSPC) risk-calculator (RC) parameters may overcome prostate-specific antigen (PSA) limitations. OBJECTIVE: We added pre-biopsy mpMRI to ERSPC-RC parameters and developed risk models (RMs) to predict individual sPC risk for biopsy-naïve men and men after previous biopsy...
April 8, 2017: European Urology
https://www.readbyqxmd.com/read/28397559/cost-analysis-of-a-multidisciplinary-aerodigestive-clinic-are-such-clinics-financially-feasible
#4
Pamela A Mudd, Allison L Silva, Susan S Callicott, Nancy M Bauman
OBJECTIVE: Multidisciplinary clinics offer important value to pediatric patients with complex conditions that overlap specialties; however, such labor-intensive clinics are difficult to facilitate. We performed a cost analysis of our pediatric multidisciplinary aerodigestive clinic (MADC) to assess its financial feasibility at our tertiary care institution. METHOD: Revenue was based on net collections for clinic, professional, and hospital setting charges generated during 12 consecutive monthly MADCs beginning August 2013...
May 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28397168/can-a-bayesian-belief-network-be-used-to-estimate-1-year-survival-in-patients-with-bone-sarcomas
#5
Rajpal Nandra, Michael Parry, Jonathan Forsberg, Robert Grimer
BACKGROUND: Extremity sarcoma has a preponderance to present late with advanced stage at diagnosis. It is important to know why these patients die early from sarcoma and to predict those at high risk. Currently we have mid- to long-term outcome data on which to counsel patients and support treatment decisions, but in contrast to other cancer groups, very little on short-term mortality. Bayesian belief network modeling has been used to develop decision-support tools in various oncologic diagnoses, but to our knowledge, this approach has not been applied to patients with extremity sarcoma...
April 10, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28396176/the-single-parameter-structure-based-isopsa-assay-demonstrates-improved-diagnostic-accuracy-for-detection-of-any-prostate-cancer-and-high-grade-prostate-cancer-compared-to-a-concentration-based-assay-of-total-prostate-specific-antigen-a-preliminary-report
#6
Eric A Klein, Arnon Chait, Jason M Hafron, Kenneth M Kernen, Kannan Manickam, Andrew J Stephenson, Mathew Wagner, Hui Zhu, Aimee Kestranek, Boris Zaslavsky, Mark Stovsky
BACKGROUND: IsoPSA is a serum-based assay that predicts prostate cancer (PCa) risk by partitioning isoforms of prostate-specific antigen (PSA) with an aqueous two-phase reagent. OBJECTIVES: To determine the diagnostic accuracy of IsoPSA in identifying the presence or absence of PCa and the presence of high-grade disease in a contemporary biopsy cohort. DESIGN, SETTING, AND PARTICIPANTS: Multicenter prospective study of 261 men scheduled for prostate biopsy at five academic and community centers in the USA enrolled between August 2015 and December 2016...
April 7, 2017: European Urology
https://www.readbyqxmd.com/read/28395423/-a-pilot-study-to-explore-a-registry-method-for-acute-cardiovascular-events
#7
L Hou, W Han, Y Tang, F Xue, S H Liang, W Z Wang, B Zhang, H Y Pang, Y Y Wang, Z X Wang, Y D Hu, L Wang, M T Zhang, J M Jiang
Objective: To explore a registry method for acute cardiovascular events in large-scale fields across China. Methods: This study was based on a community-based Kazakh cohort, including 1 668 persons with complete baseline data, conducted in Altay, Xinjiang. Acute cardiovascular events included acute myocardial infarction(ICD-10: I21-I22), sudden cardiac death (I46.1), and incident stroke (I60-I64) that occurred during the period from Oct 1, 2012 to Jun 30, 2016. There were three stages, a hospital-based search for checking medical records of inpatients in all four local hospitals, a community-based supplementary registry, and an extra survey for reducing false negatives, to complete this registry...
April 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28392080/an-exploratory-analysis-of-the-competing-effects-of-aggressive-decongestion-and-high-dose-loop-diuretic-therapy-in-the-dose-trial
#8
Jennifer S Hanberg, W H Wilson Tang, F Perry Wilson, Steven G Coca, Tariq Ahmad, Meredith A Brisco, Jeffrey M Testani
BACKGROUND: Effective decongestion of heart failure patients predicts improved outcomes, but high dose loop diuretics (HDLD) used to achieve diuresis predict adverse outcomes. In the DOSE trial, randomization to a HDLD intensification strategy (HDLD-strategy) improved diuresis but not outcomes. Our objective was to determine if potential beneficial effects of more aggressive decongestion may have been offset by adverse effects of the HDLD used to achieve diuresis. METHODS AND RESULTS: A post hoc analysis of the DOSE trial (n=308) was conducted to determine the influence of post-randomization diuretic dose and fluid output on the rate of death, rehospitalization or emergency department visitation associated with the HDLD-strategy...
March 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28387870/surgical-decision-making-from-image-based-biophysical-modeling-of-glioblastoma-not-ready-for-primetime
#9
Aymeric Amelot, Christophe Deroulers, Mathilde Badoual, Marc Polivka, Homa Adle-Biassette, Emmanuel Houdart, Antoine F Carpentier, Sebastien Froelich, Emmanuel Mandonnet
BACKGROUND: Biophysical modeling of glioma is gaining more interest for clinical practice. The most popular model describes aggressivity of tumor cells by two parameters: net proliferation rate (ρ) and propensity to migrate (D). The ratio ρ/D, which can be estimated from a single preoperative magnetic resonance imaging (MRI), characterizes tumor invasiveness profile (high ρ/D: nodular; low ρ/D: diffuse). A recent study reported, from a large series of glioblastoma multiforme (GBM) patients, that gross total resection (GTR) would improve survival only in patients with nodular tumors...
April 6, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28385806/urine-ammonium-predicts-clinical-outcomes-in-hypertensive-kidney-disease
#10
Kalani L Raphael, David J Carroll, Jennifer Murray, Tom Greene, Srinivasan Beddhu
Metabolic acidosis is associated with poor outcomes in CKD. Because impaired renal ammonium excretion is important in the pathogenesis of acidosis, urine ammonium excretion might be a better and perhaps earlier acid-base indicator of risk than serum bicarbonate, particularly in patients without acidosis. We evaluated the association between baseline ammonium excretion and clinical outcomes in African American Study of Kidney Disease and Hypertension participants (n=1044). Median daily ammonium excretion was 19...
April 6, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28376459/health-benefits-and-cost-effectiveness-of-brief-clinician-tobacco-counseling-for-youth-and-adults
#11
Michael V Maciosek, Amy B LaFrance, Steven P Dehmer, Dana A McGree, Zack Xu, Thomas J Flottemesch, Leif I Solberg
PURPOSE: To help clinicians and care systems determine the priority for tobacco counseling in busy clinic schedules, we assessed the lifetime health and economic value of annually counseling youth to discourage smoking initiation and of annually counseling adults to encourage cessation. METHODS: We conducted a microsimulation analysis to estimate the health impact and cost effectiveness of both types of tobacco counseling in a US birth cohort of 4,000,000. The model used for the analysis was constructed from nationally representative data sets and structured literature reviews...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28376458/health-benefits-and-cost-effectiveness-of-asymptomatic-screening-for-hypertension-and-high-cholesterol-and-aspirin-counseling-for-primary-prevention
#12
Steven P Dehmer, Michael V Maciosek, Amy B LaFrance, Thomas J Flottemesch
PURPOSE: Our aim was to update estimates of the health and economic impact of clinical services recommended for the primary prevention of cardiovascular disease (CVD) for the comparative rankings of the National Commission on Prevention Priorities, and to explore differences in outcomes by sex and race/ethnicity. METHODS: We used a single, integrated, microsimulation model to generate comparable results for 3 services recommended by the US Preventive Services Task Force: aspirin counseling for the primary prevention of CVD and colorectal cancer, screening and treatment for lipid disorders (usually high cholesterol), and screening and treatment for hypertension...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28376187/a-novel-diagnostic-tool-for-selecting-patients-with-mesenchymal-type-colon-cancer-reveals-intratumor-subtype-heterogeneity
#13
Inge Ubink, Sjoerd G Elias, Cathy B Moelans, Miangela M Laclé, Wilhelmina M U van Grevenstein, Paul J van Diest, Inne H M Borel Rinkes, Onno Kranenburg
Background: Consensus molecular subtype 4 (CMS4) is a recently identified aggressive colon cancer subtype for which platelet-derived growth factor receptors (PDGFRs) and KIT are potential therapeutic targets. We aimed to develop a clinically applicable CMS4 reverse transcription polymerase chain reaction (RT-qPCR) test to select patients for PDGFR/KIT-targeted therapy. Methods: We used logistic regression to develop a CMS4 prediction rule based on microarray expression values of PDGFRA , PDGFRB , PDGFC , and KIT (566 training and 1259 test samples, using the 273-gene random forest classifier as CMS4 reference standard)...
August 1, 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28376113/risk-prediction-models-for-selection-of-lung-cancer-screening-candidates-a-retrospective-validation-study
#14
Kevin Ten Haaf, Jihyoun Jeon, Martin C Tammemägi, Summer S Han, Chung Yin Kong, Sylvia K Plevritis, Eric J Feuer, Harry J de Koning, Ewout W Steyerberg, Rafael Meza
BACKGROUND: Selection of candidates for lung cancer screening based on individual risk has been proposed as an alternative to criteria based on age and cumulative smoking exposure (pack-years). Nine previously established risk models were assessed for their ability to identify those most likely to develop or die from lung cancer. All models considered age and various aspects of smoking exposure (smoking status, smoking duration, cigarettes per day, pack-years smoked, time since smoking cessation) as risk predictors...
April 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28362212/does-clinical-improvement-of-symptomatic-degenerative-lumbar-disease-impact-obesity
#15
Jacob R Joseph, Zishaan Farooqui, Brandon W Smith, Elyne N Kahn, Xilin Liu, Frank La Marca, Paul Park
OBJECTIVE Obesity and low-back pain associated with degenerative spondylosis or spondylolisthesis are common comorbid conditions. Many patients report that the pain and disability associated with degenerative lumbar disease are key factors in their inability to lose weight. The aim of this retrospective study was to determine if there is an association between improved functional status and weight loss following a successful transforaminal lumbar interbody fusion (TLIF) procedure. METHODS A retrospective cohort study of patients who underwent single-level TLIF was performed...
March 31, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28355459/laboratory-monitoring-of-non-vitamin-k-antagonist-oral-anticoagulant-use-in-patients-with-atrial-fibrillation-a-review
#16
John W Eikelboom, Daniel J Quinlan, Jack Hirsh, Stuart J Connolly, Jeffrey I Weitz
Importance: The non-vitamin K antagonist oral anticoagulants (NOACs) apixaban, dabigatran, edoxaban, and rivaroxaban are administered in fixed doses without anticoagulant monitoring. Randomized trials show that unmonitored NOAC therapy is at least as effective as and safer than dose-adjusted warfarin for stroke prevention in patients with nonvalvular atrial fibrillation. Subgroup analyses indicate that plasma drug levels or anticoagulant activity of the NOACs predict stroke and bleeding...
March 29, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28347442/clinical-impact-and-value-of-workstation-single-sign-on
#17
George A Gellert, John F Crouch, Lynn A Gibson, George S Conklin, S Luke Webster, John A Gillean
BACKGROUND: CHRISTUS Health began implementation of computer workstation single sign-on (SSO) in 2015. SSO technology utilizes a badge reader placed at each workstation where clinicians swipe or "tap" their identification badges. OBJECTIVE: To assess the impact of SSO implementation in reducing clinician time logging in to various clinical software programs, and in financial savings from migrating to a thin client that enabled replacement of traditional hard drive computer workstations...
May 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28343849/oral-anticoagulant-therapy-for-older-patients-with-atrial-fibrillation-a-review-of-current-evidence
#18
REVIEW
Mario Bo, Enrica Grisoglio, Enrico Brunetti, Yolanda Falcone, Niccolò Marchionni
Atrial fibrillation is more frequent in older patients, who have a higher risk of cardioembolic stroke and thromboembolism. Oral anticoagulant therapy is the standard of treatment for stroke prevention; however, under-prescription is still very common in older patients. The reasons underlying this phenomenon have not been systematically investigated, and true contraindications only partially account for it. An intimate skepticism on the real benefit-risk balance of oral anticoagulant therapy in the oldest patients seems to derive from the fact that most studies supporting it were conducted decades ago and included younger patients, with overall better functional and clinical status...
March 24, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28342190/expanded-medicaid-dental-coverage-under-the-affordable-care-act-an-analysis-of-minnesota-emergency-department-visits
#19
Nadia Laniado, Victor M Badner, Ellen Johnson Silver
OBJECTIVES: Hospital emergency departments (EDs) function as the safety net for patients with non-traumatic dental conditions (NTDCs). With the implementation of Medicaid expansion under the Affordable Care Act (ACA) many adults became eligible for dental benefits. We examined the impact of "early" Medicaid expansion in Minnesota on ED visits for NTDCs from 2008 (prereform) to 2014 (postreform). METHODS: Data from the State Emergency Department Databases for Minnesota were analyzed for 2 years: 2008 and 2014...
March 24, 2017: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28342189/straight-to-test-colonoscopy-for-two-week-wait-referrals-improves-time-to-diagnosis-of-colorectal-cancer-and-is-feasible-in-a-high-volume-unit
#20
A Banerjea, J Voll, A Chowdhury, A Siddika, S Thomson, R Briggs, D J Humes
AIM: We have introduced "straight-to-test" (STT) colonoscopy as part of our two-week wait (2WW) pathway to address increasing numbers of urgent referrals for colorectal cancer (CRC) with in the National Health Service. In this study we evaluated the ability of this initiative to shorten the time to diagnosis of CRC. METHODS: We amended our 2WW referral form to include performance status and comorbidities. General practitioners were asked to provide data on estimated glomerular filtration rate and full blood count/ferritin...
March 25, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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