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https://www.readbyqxmd.com/read/29028958/development-of-clinical-prediction-models-for-surgery-and-complications-in-crohn-s-disease
#1
Leonardo Guizzetti, Guangyong Zou, Reena Khanna, Parambir S Dulai, William J Sandborn, Vipul Jairath, Brian G Feagan
Background and Aims: Crohn's disease-related complications account for a substantial proportion of inflammatory bowel disease-associated healthcare expenditure. Identifying patients at risk for complications may allow for targeted use of early therapeutic interventions to off-set this natural course. We aimed to develop risk prediction models for Crohn's disease-related surgery and complications. Methods: Using data from the Randomized Evaluation of an Algorithm for Crohn's Disease cluster-randomized clinical Trial (REACT), which involved 1898 patients from 40 community practices...
September 19, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29025270/design-of-a-randomized-clinical-trial-of-a-colorectal-cancer-screening-decision-aid-to-promote-appropriate-screening-in-community-dwelling-older-adults
#2
Christine E Kistler, Carol Golin, Carolyn Morris, Alexandra F Dalton, Russell P Harris, Rowena Dolor, Renée M Ferrari, Noel T Brewer, Carmen L Lewis
BACKGROUND: Appropriate colorectal cancer screening in older adults should be aligned with the likelihood of net benefit. In general, patient decision aids improve knowledge and values clarity, but in older adults, they may also help patients identify their individual likelihood of benefit and foster individualized decision-making. We report on the design of a randomized clinical trial to understand the effects of a patient decision aid on appropriate colorectal cancer screening. This report includes a description of the baseline characteristics of participants...
August 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/29022078/survival-benefit-of-mantle-cell-lymphoma-patients-enrolled-in-clinical-trials-a-joint-study-from-the-lysa-group-and-french-cancer-registries
#3
Alix Augustin, Steven Le Gouill, Rémy Gressin, Aurélie Bertaut, Alain Monnereau, Anne-Sophie Woronoff, Brigitte Trétarre, Patricia Delafosse, Xavier Troussard, Anne Moreau, Olivier Hermine, Marc Maynadié
PURPOSE: Mantle cell lymphoma (MCL) is a rare non-Hodgkin's lymphoma entity with a poor prognosis. Therapeutic advances have improved the survival of patients enrolled in clinical trials; however, their impact on patients outside clinical trials remains unclear. In this work, we compared patient outcome inside and outside clinical trials. METHODS: We identified MCL patients recorded in six French population-based registries between 2008 and 2012 to perform a comparison with patients enrolled in two prospective multicenter MCL clinical trials conducted by the LYSA group during the same period...
October 11, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29020435/blood-pressure-targets-for-the-treatment-of-people-with-hypertension-and-cardiovascular-disease
#4
REVIEW
Luis Carlos Saiz, Javier Gorricho, Javier Garjón, Mª Concepción Celaya, Lourdes Muruzábal, Mª Del Mar Malón, Rodolfo Montoya, Antonio López
BACKGROUND: Hypertension is a prominent preventable cause of premature morbidity and mortality. People with hypertension and established cardiovascular disease are at particularly high risk, so reducing blood pressure below standard targets may be beneficial. This strategy could reduce cardiovascular mortality and morbidity but could also increase adverse events. The optimal blood pressure target in people with hypertension and established cardiovascular disease remains unknown. OBJECTIVES: To determine if 'lower' blood pressure targets (≤ 135/85 mmHg) are associated with reduction in mortality and morbidity as compared with 'standard' blood pressure targets (≤ 140 to 160/ 90 to 100 mmHg) in the treatment of people with hypertension and a history of cardiovascular disease (myocardial infarction, angina, stroke, peripheral vascular occlusive disease)...
October 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29018966/safety-and-cost-benefit-of-an-ambulatory-program-for-patients-with-low-risk-neutropenic-fever-at-an-australian-centre
#5
Benjamin W Teh, Christine Brown, Trish Joyce, Leon J Worth, Monica A Slavin, Karin A Thursky
BACKGROUND: Neutropenic fever (NF) is a common complication of cancer chemotherapy. Patients at low risk of medical complications from NF can be identified using a validated risk assessment and managed in an outpatient setting. This is a new model of care for Australia. This study described the implementation of a sustainable ambulatory program for NF at a tertiary cancer centre over a 12-month period. METHODS: Peter MacCallum Cancer Centre introduced an ambulatory care program in 2014, which identified low-risk NF patients, promoted early de-escalation to oral antibiotics, and early discharge to a nurse-led ambulatory program...
October 10, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29016692/benefit-of-early-discharge-among-patients-with-low-risk-pulmonary-embolism
#6
Li Wang, Onur Baser, Phil Wells, W Frank Peacock, Craig I Coleman, Gregory J Fermann, Jeff Schein, Concetta Crivera
Clinical guidelines recommend early discharge of patients with low-risk pulmonary embolism (LRPE). This study measured the overall impact of early discharge of LRPE patients on clinical outcomes and costs in the Veterans Health Administration population. Adult patients with ≥1 inpatient diagnosis for pulmonary embolism (PE) (index date) between 10/2011-06/2015, continuous enrollment for ≥12 months pre- and 3 months post-index date were included. PE risk stratification was performed using the simplified Pulmonary Embolism Stratification Index...
2017: PloS One
https://www.readbyqxmd.com/read/29016225/asco-value-framework-highlights-the-relative-value-of-treatment-options-in-ovarian-cancer
#7
Jonathan Foote, Angeles Alvarez Secord, Margaret Liang, David E Cohn, Elizabeth Jewell, Laura J Havrilesky
PURPOSE: The ASCO value framework allows physicians and patients to compare the relative value of novel treatments. Our aim was to assess the value of three frontline ovarian cancer therapies by using this framework. METHODS: From phase III, randomized controlled clinical trial (RCT) data, the net health benefits (NHBs) for three frontline ovarian cancer treatment options-dose-dense paclitaxel (Japanese Gynecologic Oncology Group study JGOG 3016), intraperitoneal (IP)/intravenous (IV) chemotherapy (Gynecologic Oncology Group [GOG] study GOG 172), and concurrent plus maintenance bevacizumab (GOG 218 and the Seventh International Collaborative Ovarian Neoplasm study [ICON7])-were calculated...
October 10, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28988298/is-there-a-return-on-a-children-s-hospital-s-investment-in-a-pediatric-residency-s-community-health-track-a-cost-analysis
#8
Cara Lichtenstein, Denice Cora-Bramble, Mary Ottolini, Dewesh Agrawal
Academic Medical Centers incur significant expenses associated with training residents and caring for underserved populations. No previous studies have analyzed hospital-level graduate medical education economics for pediatric residency training. Using data from the 2010-2011 academic year, we quantified total direct costs per year for training 12 community health track (CHT) residents. Utilizing sensitivity analyses, we estimated revenues generated by residents in inpatient and outpatient settings. The total yearly direct cost of training 12 CHT residents was $922,640 including salaries, benefits, and administrative costs...
October 7, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28986242/rethinking-optimization-methods-identified-optimal-risk-thresholds-for-preventive-treatment-an-illustration-in-coronary-heart-disease
#9
A van Giessen, G A de Wit, K G M Moons, J A N Dorresteijn, H Koffijberg
INTRODUCTION: Treatment thresholds based on risk predictions can be optimized by considering various health (economic) outcomes and performing marginal analyses, but this is rarely performed. We demonstrate a general approach to identify treatment thresholds optimizing individual health (economic) outcomes, illustrated for statin treatment based on 10-year coronary heart disease (CHD) risk predicted by the Framingham risk score. METHODS: Creating a health economic model for a risk-based prevention strategy, risk thresholds can be evaluated on several outcomes of interest...
October 3, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28976544/multi-institutional-nomogram-predicting-benign-prostate-pathology-on-magnetic-resonance-ultrasound-fusion-biopsy-in-men-with-a-prior-negative-12-core-systematic-biopsy
#10
Matthew Truong, Bokai Wang, Jennifer B Gordetsky, Jeffrey W Nix, Thomas P Frye, Edward M Messing, John V Thomas, Changyong Feng, Soroush Rais-Bahrami
BACKGROUND: Prostate multiparametric magnetic resonance imaging (mpMRI) may be recommended for patients with a prior negative systematic biopsy (SB). However, a proportion of these patients will continue to have no prostate cancer (PCa) identified on magnetic resonance/ultrasound fusion biopsy (FB) despite abnormal mpMRI findings. METHODS: In this multi-institutional, retrospective study, clinical and mpMRI parameters were assessed for 285 consecutive patients with at least 1 prior negative biopsy who underwent FB for a Prostate Imaging Reporting and Data System (PI-RADS) score of 3 to 5 at the University of Rochester Medical Center from December 2014 to December 2016, or at the University of Alabama at Birmingham from February 2014 to February 2017...
October 4, 2017: Cancer
https://www.readbyqxmd.com/read/28941605/prevention-of-left-ventricular-thrombus-formation-and-systemic-embolism-after-anterior-myocardial-infarction-a%C3%A2-systematic-literature-review
#11
REVIEW
Alexandra Bastiany, Marie-Eve Grenier, Alexis Matteau, Samer Mansour, Benoit Daneault, Brian J Potter
BACKGROUND: Anterior myocardial infarction (MI) with apical dysfunction is associated with an increased risk of left ventricular thrombus (LVT) formation and systemic embolism (SE). However, the role for prophylactic anticoagulation in current practice is a matter of debate. METHODS: We conducted a systematic review of peer-reviewed original articles in either English or French on the benefit of combining anticoagulation with standard therapy for the prevention of LVT/SE after MI by searching PubMed, Ovid/MedLine/Embase, the Cochrane Library, and Google Scholar...
October 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28935868/importance-of-time-in-therapeutic-range-on-bleeding-risk-prediction-using-clinical-risk-scores-in-patients-with-atrial-fibrillation
#12
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Gregory Y H Lip, Francisco Marín
Bleeding risk with vitamin K antagonists (VKAs) is closely related to the quality of anticoagulation in atrial fibrillation (AF) patients, reflected by time in therapeutic range (TTR). Here we compared the discrimination performance of different bleeding risk scores and investigated if adding TTR would improve their predictive value and clinical usefulness. We included 1361 AF patients stables on VKA for at least 6 months. Bleeding risk was assessed by the HAS-BLED, ATRIA, ORBIT and HEMORR2HAGES scores. Major bleeding events were recorded after a median of 6...
September 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28931618/predicting-major-bleeding-in-ischemic-stroke-patients-with-atrial-fibrillation
#13
Nina A Hilkens, Ale Algra, Jacoba P Greving
BACKGROUND AND PURPOSE: Performance of risk scores for major bleeding in patients with atrial fibrillation and a previous transient ischemic attack or ischemic stroke is not well established. We aimed to validate risk scores for major bleeding in patients with atrial fibrillation treated with oral anticoagulants after cerebral ischemia and explore the net benefit of oral anticoagulants among bleeding risk categories. METHODS: We analyzed 3623 patients with a history of transient ischemic attack or stroke included in the RE-LY trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)...
September 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28931531/clinical-and-cost-effectiveness-of-the-lightning-process-in-addition-to-specialist-medical-care-for-paediatric-chronic-fatigue-syndrome-randomised-controlled-trial
#14
Esther M Crawley, Daisy M Gaunt, Kirsty Garfield, William Hollingworth, Jonathan A C Sterne, Lucy Beasant, Simon M Collin, Nicola Mills, Alan A Montgomery
OBJECTIVE: Investigate the effectiveness and cost-effectiveness of the Lightning Process (LP) in addition to specialist medical care (SMC) compared with SMC alone, for children with chronic fatigue syndrome (CFS)/myalgic encephalitis (ME). DESIGN: Pragmatic randomised controlled open trial. Participants were randomly assigned to SMC or SMC+LP. Randomisation was minimised by age and gender. SETTING: Specialist paediatric CFS/ME service. PATIENTS: 12-18 year olds with mild/moderate CFS/ME...
September 20, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28929602/chromium-supplementation-in-women-with-polycystic-ovary-syndrome-systematic-review-and-meta-analysis
#15
Xiao-Lei Tang, Zheng Sun, Lei Gong
AIM: Increasing evidence has suggested that chromium supplementation may improve the clinical symptoms of polycystic ovary syndrome (PCOS), yet the results have been inconsistent. To derive a more precise estimation of the efficacy of chromium, a meta-analysis was performed. METHODS: Studies published in PubMed, EMBASE and the Cochrane Library up to April 2017 were retrieved. Standardized mean differences (SMD) with 95%CI were calculated for net changes using random-effects or fixed-effects models...
September 20, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28928911/prediction-of-low-birth-weight-delivery-by-maternal-status-and-its-validation-decision-curve-analysis
#16
Mehri Rejali, Marjan Mansourian, Zohre Babaei, Babak Eshrati
BACKGROUND: In this study, we evaluated assessed elements connected with low birth weight (LBW) and used decision curve analysis (DCA) to define a scale to anticipate the probability of having a LBW newborn child. METHODS: This hospital-based case-control study was led in Arak Hospital in Iran. The study included 470 mothers with LBW neonate and 470 mothers with natural neonates. Information were gathered by meeting moms utilizing preplanned organized questionnaire and from hospital records...
2017: International Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28917227/pharmacoeconomics-of-parenteral-nutrition-in-surgical-and-critically-ill-patients-receiving-structured-triglycerides-in-china
#17
Guo Hao Wu, Alexandra Ehm, Marco Bellone, Lorenzo Pradelli
BACKGROUND AND OBJECTIVES: A prior meta-analysis showed favorable metabolic effects of structured triglyceride (STG) lipid emulsions in surgical and critically ill patients compared with mixed medium-chain/long-chain triglycerides (MCT/LCT) emulsions. Limited data on clinical outcomes precluded pharmacoeconomic analysis. We performed an updated meta-analysis and developed a cost model to compare overall costs for STGs vs MCT/LCTs in Chinese hospitals. METHODS AND STUDY DESIGN: We searched Medline, Embase, Wanfang Data, the China Hospital Knowledge Database, and Google Scholar for clinical trials comparing STGs to mixed MCT/LCTs in surgical or critically ill adults published between October 10, 2013 and September 19, 2015...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28905065/be-positive-optimizing-pramlintide-from-microcanonical-analysis-of-amylin-isoforms
#18
Rafael B Frigori
Amylin, or human islet amyloid polypeptide (hIAPP), is a 37-residue hormone synergistic to insulin and co-secreted with it by β-cells in the pancreas. The deposition of its cytotoxic amyloid fibrils is strongly related to the progression of Type II diabetes (T2D) and islet graft failures. Notably, isoforms from some mammalian species, such as rats (rIAPP) and porcine (pIAPP), present a few key mutations preventing aggregation. This has lead to biotechnological development of drugs for adjunct therapies of T2D, such as pramlintide, a variant of hIAPP inspired by rIAPP whose proline substitutions have β-strand fibril-breaking properties...
September 27, 2017: Physical Chemistry Chemical Physics: PCCP
https://www.readbyqxmd.com/read/28893833/anticoagulation-for-nonvalvular-atrial-fibrillation-influence-of-epidemiologic-trends-and-clinical-practice-patterns-on-risk-stratification-and-net-clinical-benefit
#19
Richard W Asinger, Gautam R Shroff, Mengistu A Simegn, Charles A Herzog
No abstract text is available yet for this article.
September 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28890151/when-to-perform-preoperative-bone-scintigraphy-for-kidney-cancer-staging-indications-for-preoperative-bone-scintigraphy
#20
Alessandro Larcher, Fabio Muttin, Nicola Fossati, Paolo Dell'Oglio, Ettore Di Trapani, Armando Stabile, Francesco Ripa, Francesco Trevisani, Cristina Carenzi, Maria Picchio, Alberto Briganti, Andrea Salonia, Alexandre Mottrie, Roberto Bertini, Francesco Montorsi, Umberto Capitanio
OBJECTIVES: To identify an objective and reproducible strategy for preoperative staging bone scintigraphy [BS] in patients diagnosed with renal cell carcinoma [RCC], since in absence of objective criteria, the decision to perform preoperative BS remains a subjective practice. METHODS: 2,008 RCC patients treated with surgery and prospectively included into an institutional database. The study outcome was presence of one or more bone lesions suspicious for metastases at staging BS...
September 7, 2017: Urology
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