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https://www.readbyqxmd.com/read/28541749/multilevel-barriers-to-the-successful-implementation-of-lung-cancer-screening-why-does-it-have-to-be-so-hard
#1
Lisa Carter-Harris, Michael K Gould
The U.S. Preventive Services Task Force recommends lung cancer screening with low-dose computed tomography for long-term current and former smokers. However, lung cancer screening and its implementation is a complex issue. Screening has associated risks and potential harms that complicate the decision to screen for the patient, add to the already time-constrained clinical encounter for the provider, and present logistical and sociopolitical challenges in creating and implementing lung cancer screening programs for the health care system...
May 25, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28534248/immune-checkpoint-inhibitor-therapy-what-line-of-therapy-and-how-to-choose
#2
REVIEW
Chethan Ramamurthy, James L Godwin, Hossein Borghaei
Immunotherapy is now an established part of the treatment paradigm for advanced non-small cell lung cancer (NSCLC), but the line of therapy and the sequence of agents are still in flux. In this time when much is to be learned, the optimal therapy for most patients in both the first-line and previously treated settings is in the context of a clinical trial. For standard therapy, however, there are good data to support the practice of programmed death-ligand 1 (PD-L1) testing in the front-line advanced setting and to use pembrolizumab as first-line therapy for those with ≥50% PD-L1 expression...
June 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28506508/the-influence-of-substance-misuse-on-clinical-outcomes-following-burn
#3
Sarah Rehou, Stephanie Mason, Jessie MacDonald, Ruxandra Pinto, Marc G Jeschke
INTRODUCTION: Ongoing increases in the prevalence of substance misuse among burn-injured patients necessitate a contemporary analysis of the association between substance misuse and clinical outcomes in burn-injured adults. METHODS: We conducted a retrospective cohort study of 1199 patients admitted to a regional burn center. History of substance misuse was derived from a prospective clinical registry and categorized as alcohol, illicit drug, or both. The primary outcome was hospital length of stay; association of substance misuse and inpatient complications were secondary outcomes...
May 12, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28504975/ce-original-research-the-experiences-of-pregnant-smokers-and-their-providers
#4
Geraldine Rose Britton, Rosemary Collier, Sean McKitrick, Lori Marie Sprague, Joyce Rhodes-Keefe, Ann Feeney, Gary D James
: Background: The U.S. Department of Health and Human Services' initiative Healthy People 2020 targets tobacco use, including smoking during pregnancy, as a continuing major health concern in this country. Yet bringing the U.S. Public Health Service's 2008 clinical practice guideline, Treating Tobacco Use and Dependence, into routine prenatal care remains challenging. Our previous nurse-managed intervention study of rural pregnant women found no significant cessation effect and significant discordance between self-reported smoker status and urinary cotinine levels...
June 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28500778/phaeohyphomycosis-due-to-exophiala-infections-in-solid-organ-transplant-recipients-case-report-and-literature-review
#5
Kate E Oberlin, Anna J Nichols, Rossana Rosa, Adriana Dejman, Adela Mattiazzi, Giselle Guerra, George W Elgart, Lilian M Abbo
This case report and literature review underscores the cutaneous presentations of phaeohyphomycosis in the solid organ transplant population. Increased cognizance with prompt identification is critical. The therapy and clinical outcomes of phaeohyphomycosis, caused by the Exophiala genus, in the solid organ transplant population is analyzed to examine optimal care. This review highlights the inherent difficulties in providing the appropriate duration of antifungal therapy to avoid relapsing infections in immunosuppressed patients...
May 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28500091/forensic-age-estimation-using-the-medial-clavicular-epiphysis-a-study-review
#6
Mary B Buckley, Kevin R Clark
PURPOSE: To discuss current literature evaluating the medial clavicular epiphysis to assess an individual's age using various imaging modalities. METHODS: Four scholarly research databases were searched to find studies that examined living subjects. Several articles were included that used cadavers, and a textbook was used to detail the anatomy of the clavicle. Thirty-nine articles were analyzed. RESULTS: The literature indicated that several imaging modalities, including conventional radiography, computed tomography, magnetic resonance, and sonography, are being used to evaluate the medial clavicular epiphysis to estimate an individual's age in the forensic context...
May 2017: Radiologic Technology
https://www.readbyqxmd.com/read/28497559/macromolecular-structures-quality-assessment-and-biological-interpretation
#7
REVIEW
Dinakar M Salunke, Deepak T Nair
Structure determination using X-ray crystallography involves collection of diffraction data, determination of initial phases followed by iterative rounds of model building and crystallographic refinement to improve the phases and minimize the differences between calculated and observed structure factors. At each of these stages, a variety of statistical filters exist to ensure appropriate validation. Biologically important observations often come from interpretations of signals that need to be carefully deciphered from noise, and therefore human intervention is as important as the automated methods and filters...
May 11, 2017: IUBMB Life
https://www.readbyqxmd.com/read/28488842/sleep-disordered-breathing-in-heart-failure-patients-after-ventricular-assist-device-implantation-and-heart-transplantation
#8
Anindita Chowdhury, Reeba Mathew, Richard J Castriotta
Chronic heart failure (CHF) represents a major health and economic burden and is associated with high rates of hospital admission, morbidity, mortality and decreased quality-adjusted life years. New advances in the treatment of CHF such as ventricular assist devices (VADs) and heart transplantation have helped improve outcomes. Sleep-disordered breathing (SDB) is highly prevalent in CHF patients and the associated morbidity makes it essential for physicians to be more cognizant about its existence, interaction and need for treatment...
May 8, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28480082/life-threatening-hemopericardium-associated-with-rivaroxaban
#9
Sijan Basnet, Niranjan Tachamo, Biswaraj Tharu, Rashmi Dhital, Sushil Ghimire, Dilli Ram Poudel
Rivaroxaban is a novel oral anticoagulant used in the treatment of venous thromboembolism. The use of this medication has expanded over the recent years with resultant expansion of side effect profile. We present a case of a 56-year-old female who presented with shortness of breath and chest pain 12 weeks after starting rivaroxaban for left upper extremity deep vein thrombosis. She was later diagnosed with spontaneous hemopericardium requiring pericardial fluid drainage. Rarer side effects like this will be encountered more often with the increasing use of novel oral anticoagulants...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28469454/perioperative-management-of-thyroid-dysfunction
#10
REVIEW
Marcia Rashelle Palace
Due to the manifold effects of thyroid hormone across virtually all organ systems, the complications associated with thyroid dysfunction are numerous and diverse. The stresses encountered during the perioperative period may exacerbate underlying thyroid disorders, potentially precipitating decompensation and even death. Thus, it is of the utmost importance for the clinician to comprehend the mechanisms by which thyroid disease may complicate surgery and postoperative recovery and to be cognizant of the most effective means of optimizing the status of thyrotoxic and hypothyroid patients perioperatively...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28448435/a-resident-s-perspective-of-ovarian-cancer
#11
Christopher G Smith
Identifying, understanding, and curing disease is a lifelong endeavor for any medical practitioner. Equally as important is to be cognizant of the impact a disease has on the individual suffering from it, as well as on their family. Ovarian cancer is the leading cause of death from gynecologic malignancies. Symptoms are vague, and the disease is generally at an advanced stage at diagnosis. Efforts have been made to develop methods to identify ovarian cancer at earlier stages, thus improving overall mortality...
April 27, 2017: Diagnostics
https://www.readbyqxmd.com/read/28441215/does-low-dose-methotrexate-deserve-more-respect-from-clinicians
#12
Brent Luu, George W Rodway
Medical errors associated with low-dose methotrexate may be life-threatening. Prescribers should be cognizant of the medication's toxicities and the persistent challenges in preventing adverse events. This article reviews the properties of methotrexate and its common drug-drug interactions. Best practices from the Institute for Safe Medication Practices, aimed at reducing methotrexate errors, are highlighted.
May 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28439177/racial-and-ethnic-differences-in-a-linkage-with-the-national-death-index
#13
Eric A Miller, Frances A McCarty, Jennifer D Parker
OBJECTIVES: Differences in the availability of a Social Security Number (SSN) by race/ethnicity could affect the ability to link with death certificate data in passive follow-up studies and possibly bias mortality disparities reported with linked data. Using 1989-2009 National Health Interview Survey (NHIS) data linked with the National Death Index (NDI) through 2011, we compared the availability of a SSN by race/ethnicity, estimated the percent of links likely missed due to lack of SSNs, and assessed if these estimated missed links affect race/ethnicity disparities reported in the NHIS-linked mortality data...
2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/28416031/behavioral-and-psychological-symptoms-of-dementia-prevalence-symptom-groups-and-their-correlates-in-community-based-older-adults-with-dementia-in-singapore
#14
Janhavi Ajit Vaingankar, Siow Ann Chong, Edimansyah Abdin, Louisa Picco, Anitha Jeyagurunathan, Esmond Seow, Li Ling Ng, Martin Prince, Mythily Subramaniam
BACKGROUND: This study assessed the prevalence and factor structure of behavioral and psychological symptoms of dementia (BPSD) in a community-based sample of older adults with dementia and identified their correlates. METHODS: Data collected from 399 Singapore residents with dementia aged 60 years and above, interviewed along with a family/friend during a national survey, were used for this analysis. Neuropsychiatric Inventory Questionnaire assessed older adults' BPSD...
April 18, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28407088/borderline-resectable-pancreatic-cancer-conceptual-evolution-and-current-approach-to-image-based-classification
#15
J W Gilbert, B Wolpin, T Clancy, J Wang, H Mamon, A B Shinagare, J Jagannathan, M Rosenthal
BACKGROUND: Diagnostic imaging plays a critical role in the initial diagnosis and therapeutic monitoring of pancreatic adenocarcinoma. Over the past decade, the concept of "borderline resectable" pancreatic cancer has emerged to describe a distinct subset of patients existing along the spectrum from resectable to locally advanced disease for whom a microscopically margin-positive (R1) resection is considered relatively more likely, primarily due to the relationship of the primary tumor with surrounding vasculature...
April 12, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28404474/does-having-a-difficult-child-lead-to-poor-maternal-mental-health
#16
Ann M Kingsbury, Alexandra Clavarino, Abdullah Mamun, Nargess Saiepour, J M Najman
OBJECTIVES: Considerable evidence suggests maternal psychopathology influences that of their offspring. The probability of a reverse causal pathway has been only rarely considered but is a concern, given around 10% of children manifest mental impairment during their early years. This study determines the extent to which child behavior problems at ages 5 and 14 years are associated with mothers' mental health at 21 years post birth. STUDY DESIGN: Longitudinal study...
February 7, 2017: Public Health
https://www.readbyqxmd.com/read/28395535/the-experience-of-attempting-to-return-to-work-following-spinal-cord-injury-a-systematic-review-of-the-qualitative-literature
#17
Gillean Hilton, Carolyn Unsworth, Gregory Murphy
PURPOSE: This review sought to answer the question "What are the barriers and facilitators influencing people's experience of return to work following spinal cord injury?" METHODS: Studies that met the selection criteria were identified, presented and critically appraised using National Institute for Health and Care Excellence guidelines. Thematic synthesis was completed with studies possessing strong methodological rigor. Synthesis and interpretation involved three stages; coding of primary data; development of descriptive themes reflective of the primary data; and establishment of analytical themes to answer the review question...
April 11, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28385655/incidence-and-risk-factors-for-surgical-site-infection-after-open-reduction-and-internal-fixation-of-tibial-plateau-fracture-a-systematic-review-and-meta-analysis
#18
REVIEW
Jiashen Shao, Hengrui Chang, Yanbin Zhu, Wei Chen, Zhanle Zheng, Huixin Zhang, Yingze Zhang
BACKGROUND: This study aimed to quantitatively summarize the risk factors associated with surgical site infection after open reduction and internal fixation of tibial plateau fracture. METHODS: Medline, Embase, CNKI, Wanfang database and Cochrane central database were searched for relevant original studies from database inception to October 2016. Eligible studies had to meet quality assessment criteria according to the Newcastle-Ottawa Scale, and had to evaluate the risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture...
April 4, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28369018/anatomical-description-of-zygomatic-foramina-in-african-american-skulls
#19
Yue Zhao, Rao V Chundury, Alexander D Blandford, Julian D Perry
PURPOSE: The zygomaticofacial/temporal/orbital nerve is a terminal branch of the zygomatic nerve and exits the orbit through zygomatic foramina. The nomenclature in the literature varies with some studies identifying all 3 foramina on the malar surface of the zygoma, while others describe each along different aspects of the zygoma. In this study, foramen on the malar surface of the zygoma is termed zygomatic foramen, and the authors describe anatomical variations in the position and number of these foramina in an African American population...
March 31, 2017: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28368735/correlates-of-postpartum-maternal-functioning-in-a-low-income-obstetric-population
#20
Jennifer L Barkin, Amy McKeever, Brad Lian, Stephen R Wisniewski
BACKGROUND: Perinatal mental health has been characterized primarily via depression evaluation. However, there may be advantages to complementary assessment of postpartum functional status. OBJECTIVE: The purpose of this study was to examine sociodemographic and clinical factors associated with maternal functioning in low-income obstetrics patients. DESIGN: One hundred and twenty-eight women receiving postpartum obstetrical care at a large medical center in medically underserved, Middle Georgia were screened for depressive symptoms with the Edinburgh Postnatal Depression Scale...
March 2017: Journal of the American Psychiatric Nurses Association
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