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https://www.readbyqxmd.com/read/28270240/-how-does-a-surgeon-decide-that-surgery-is-the-best-option-assessing-whether-or-not-to-operate
#1
J F Hamming, P J Marang-van de Mheen
All abdominal surgical procedures have a certain risk/benefit ratio. Recently, the way surgeons come to a decision whether to operate, or not, was discussed in the Annals of Surgery. First, the assessment of the decision for an operative versus a non-operative strategy was addressed on the basis of clinical vignettes. The perceptions concerning risk/benefit balance varied considerably between surgeons and these perceptions predicted the decision to operate. In a second paper, surgeons were randomized to either an arm in which they were exposed to a risk calculator or to a control arm...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28265666/atrial-fibrillation
#2
Peter Zimetbaum
This issue provides a clinical overview of atrial fibrillation, focusing on diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers...
March 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28238497/structured-clinical-decision-aids-are-seldom-compared-with-subjective-physician-judgment-and-are-seldom-superior
#3
David L Schriger, Joshua W Elder, Richelle J Cooper
STUDY OBJECTIVE: We determine how often studies that evaluate the performance of an aid for decisionmaking, be it a simple laboratory or imaging test or a complex multielement decision instrument, compare the aid's performance to independent, unaided physician judgment. METHODS: This was a cross-sectional survey of all Original Research and Brief Research Report articles in Annals of Emergency Medicine from 1998 to 2015. We included all articles that evaluated the performance of an aid for decisionmaking in assisting a physician with a decision about testing, treatment, diagnosis, or disposition...
February 23, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28166668/annals-express-association-between-plasma-proprotein-convertase-subtilisin-kexin-type-9-level-and-coronary-artery-calcification
#4
Xi Zhao, Hui-Wen Zhang, Sha Li, Yan Zhang, Rui-Xia Xu, Cheng-Gang Zhu, Na-Qiong Wu, Yuan-Lin Guo, Ping Qing, Xiao-Lin Li, Geng Liu, Qian Dong, Jing Sun, Jianjun Li
BACKGROUND: Plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) has been reported to be related to several risk factors and diseases such as inflammatory markers and coronary artery disease (CAD). The aim of present study was to investigate whether plasma PCSK9 level was associated with coronary artery calcification (CAC). METHODS: A total of 403 consecutive untreated patients with angina-like chest pain who received electron beam computed tomography (EBCT) were enrolled and a CAC score (CACS) was also measured...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28166666/annals-express-optimization-of-estradiol-assays-to-improve-utility-in-an-in-vitro-fertilization-setting
#5
Mary Peavey, Neval Akbas, William Gibbons, Paul Zarutskie, Sridevi Devaraj
BACKGROUND: Measurement of estradiol is an integral component for management of ovarian stimulation for in vitro fertilization (IVF). Automated immunoassays offer fast assay times and high throughput, with less sensitivity and specificity. The aim of this study is to optimize the estradiol assay in patients undergoing ovarian stimulation for IVF via comparison of estradiol values obtained using two immunoassays compared to mass spectrometry. METHODS: Patients undergoing ovarian stimulation were prospectively recruited...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28166561/tuberculosis
#6
Karen R Jacobson
This issue provides a clinical overview of tuberculosis, focusing on screening, prevention, diagnosis, and treatment. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers...
February 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28135841/annals-express-ten-year-standardization-of-lipids-and-high-sensitivity-c-reactive-protein-in-a-randomized-controlled-trial-to-assess-effects-of-statins-on-secondary-stroke-prevention-japan-statin-treatment-against-recurrent-stroke-j-stars
#7
Masakazu Nakamura, Tatsuyuki Fukukawa, Kazuo Kitagawa, Yoji Nagai, Naohisa Hosomi, Masayasu Matsumoto, Kazuo Minematsu, Shinichiro Uchiyama, Yoshihiro Miyamoto
BACKGROUND: The Japan Statin Treatment Against Recurrent Stroke (J-STARS) is a clinical trial that administered pravastatin for secondary stroke prevention. Lipid levels are a well- established risk factor for cerebrovascular diseases. Elevated high-sensitivity C-reactive protein (hs-CRP) indicates a high risk of inflammatory reactions. In clinical trials, internationally approved standardization is essential for obtaining study results that are comparable with those from overseas. Therefore, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and hs-CRP were standardized throughout a 10-year study period...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28135840/annals-express-a-systematic-evaluation-of-immunoassay-point-of-care-testing-to-define-impact-on-patients-outcomes
#8
Valentina Pecoraro, Giuseppe Banfi, Luca Germagnoli, Tommaso Trenti
BACKGROUND: Point of Care testing (POCT) has been developed to provide rapid test results. Most published studies focus on analytical performance, neglecting its impact on patient outcomes. OBJECTIVE: To review the analytical performance and accuracy of POCT specifically planned for immunoassay, and to evaluate the impact of faster results on patient management. METHODS: A search of electronic databases for studies reporting immunoassay results obtained in both POCT and central laboratory scenarios was performed...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28126598/reporting-of-data-monitoring-boards-in-publications-of-randomized-clinical-trials-is-often-deficient-acttion-systematic-review
#9
Jennifer S Gewandter, Rachel A Kitt, Matthew R Hunsinger, Joseph Poku, Jacqueline Lozano, Jenna Chaudari, Scott Evans, Robert A Gross, Michael P McDermott, Michael C Rowbotham, Dennis C Turk, Robert H Dworkin
OBJECTIVE: To examine whether primary reports of randomized clinical trials (RCTs) in six high-impact, general medical journals reported (1) whether or not a Data Monitoring Committee/Data and Safety Monitoring Board (DMC/DSMB) was used and (2) the composition of the responsibilities of the reported DSMB/DMCs. STUDY DESIGN AND SETTING: Systematic review of RCTs published in 2014 in Annals of Internal Medicine, BMJ, NEJM, JAMA, JAMA Internal Medicine, and Lancet...
January 23, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28121168/annals-express-do-all-screening-immunoassay-positive-buprenorphine-samples-need-to-be-confirmed
#10
Mohamed Saleem, Helen Martin, Anne Tolya, Penny Coates
Background Interference from opiates in the Microgenics CEDIA(®) Buprenorphine assay is known to produce false positive buprenorphine screening immunoassay results necessitating confirmatory buprenorphine testing by chromatography/mass spectrometry methods. Method We reviewed data on falsely positive buprenorphine immunoassay screen (cut-off ≥ 5µg/L) but negative for buprenorphine by GCMS (cut-off ≥ 5µg/L) and had a positive opiate immunoassay result (cut-off ≥ 300µg/L). Results were collected over 3 months and the data were evaluated to determine whether there is an opiate immunoassay screen concentration below which a false positive buprenorphine result will not occur...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28114791/annals-express-a-simple-rapid-and-validated-high-performance-liquid-chromatography-method-suitable-for-clinical-measurements-of-human-mercaptalbumin-and-nonmercaptalbumin
#11
Keiko Yasukawa, Tatsuo Shimosawa, Shigeo Okubo, Yutaka Yatomi
BACKGROUND: Human mercaptalbumin (HMA) and human nonmercaptalbumin (HNA) have been reported as markers for various pathological conditions, such as kidney and liver diseases. These markers play important roles in redox regulations throughout the body. Despite the recognition of these markers in various pathophysiologic conditions, measurements of HMA and HNA have not been popular because of the technical complexity and long measurement time of conventional methods. METHODS: Based on previous reports, we explored the optimal analytical conditions for a high-performance liquid chromatography (HPLC) method using an anion exchange column packed with a hydrophilic polyvinyl alcohol gel...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28032449/occurrence-over-time-and-regression-of-nonalcholic-fatty-liver-disease-in-type-2-diabetes
#12
Carlo Giorda, Gabriele Forlani, Roberta Manti, Natalia Mazzella, Salvatore De Cosmo, Maria Chiara Rossi, Antonio Nicolucci, Giuseppina Russo, Paolo Di Bartolo, Antonio Ceriello, Piero Guida
BACKGROUND: This analysis was aimed to assess the incidence, regression, and correlated factors of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes, which are poorly known. METHODS: Nonalcoholic fatty liver disease (defined as fatty liver index [FLI] score ≥ 60) in patients with type 2 diabetes, and related factors was investigated in a nationwide database containing information from the Italian network of diabetes clinics. A 10% variation of FLI was the cut-off considered in the analyses of a cohort of 5030 patients, which was separately conducted for those who developed, maintained, or recovered from FLI-assessed NAFLD (FLI-NAFLD) over a 3-year period...
December 29, 2016: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28032302/the-1925-diphtheria-antitoxin-run-to-nome-alaska-a-public-health-illustration-of-human-animal-collaboration
#13
Basil H Aboul-Enein, William C Puddy, Jacquelyn E Bowser
Diphtheria is an acute toxin-mediated superficial infection of the respiratory tract or skin caused by the aerobic gram-positive bacillus Corynebacterium diphtheriae. The epidemiology of infection and clinical manifestations of the disease vary in different parts of the world. Historical accounts of diphtheria epidemics have been described in many parts of the world since antiquity. Developed in the late 19th century, the diphtheria antitoxin (DAT) played a pivotal role in the history of public health and vaccinology prior to the advent of the diphtheria-tetanus toxoids and acellular pertussis (DTaP) vaccine...
December 29, 2016: Journal of Medical Humanities
https://www.readbyqxmd.com/read/28030676/aortic-stenosis
#14
Faisal G Bakaeen, Todd K Rosengart, Blase A Carabello
This issue provides a clinical overview of aortic stenosis, focusing on screening, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers...
January 3, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27956461/l-dopa-therapy-interferes-with-urine-catecholamine-analysis-in-children-with-suspected-neuroblastoma-a-case-series
#15
Alison U Kelly, Rajeev Srivastava, Ellie Dow, D Fraser Davidson
Neuroblastoma is the most common solid extracranial malignancy diagnosed in childhood. Clinical presentation is variable, and metastatic disease is common at diagnosis. Analyses of urinary catecholamines and their metabolites are commonly requested as a first-line investigation when clinical suspicion exists. Levodopa (L-Dopa) therapy is utilized as a treatment for a number of disorders in childhood, including Dopa-responsive dystonia. Neuroblastoma may mimic some of the clinical features of this disorder. L-Dopa can interfere with analysis of urinary catecholamines and their metabolites and complicate the interpretation of results...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/27941128/development-of-a-liquid-chromatography-tandem-mass-spectrometry-method-for-the-simultaneous-measurement-of-voriconazole-posaconazole-and-itraconazole
#16
John M Wadsworth, Anna M Milan, James Anson, Andrew S Davison
Background Azole-based antifungals are the first-line therapy for some of the most common mycoses and are now also being used prophylactically to protect immunocompromised patients. However, due to variability in both their metabolism and bioavailability, therapeutic drug monitoring is essential to avoid toxicity but still gain maximum efficacy. Methods Following protein precipitation of serum with acetonitrile, 20  µL of extract was injected onto a 2.1 × 50 mm Waters Atlantis dC18 3  µm column...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/27938574/-effects-of-neoadjuvant-chemoradiotherapy-on-the-rates-of-sphincter-preserving-surgery-in-lower-rectal-cancer-and-analysis-of-their-prognostic-factors
#17
X J Wang, P Chi, H M Lin, X R Lu, Y Huang, Z B Xu, S H Huang, Y W Sun, D X Ye
Objectives: To identify independent factors of sphincter preserving surgery, and to evaluated whether preoperative chemoradiotherapy (CRT) improves the sphincter preservation rate for lower rectal cancers. Methods: A total of 541 consecutive patients who underwent curative surgery for locally advanced rectal cancer (cT3-4Nx or cTxN+ ) within 6 cm of the anal verge with or without neoadjuvant CRT in Department of Colorectal Surgery, Union Hospital, Fujian Medical University between September 2000 and September 2013 were reviewed...
June 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27935651/epidemiology-of-diabetic-kidney-disease-in-adult-patients-with-type-1-diabetes-in-italy-the-amd-annals-initiative
#18
Antonio Pacilli, Francesca Viazzi, Paola Fioretto, Carlo Giorda, Antonio Ceriello, Stefano Genovese, Giuseppina Russo, Pietro Guida, Roberto Pontremoli, Salvatore De Cosmo
BACKGROUND: Patients with type 1 diabetes mellitus are at increased risk of death. This risk appears to be modulated by kidney dysfunction. The aim of this study was to evaluate the prevalence of diabetic kidney disease (DKD), its traits, and clinical correlates in a large sample of patients with type 1 diabetes. METHODS: Clinical data of 20 464 patients with type 1 diabetes were extracted from electronic medical records. Estimated glomerular filtration rate (eGFR) and increased urinary albumin excretion were considered...
December 9, 2016: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/27919097/preoperative-evaluation-for-noncardiac-surgery
#19
Steven L Cohn
This issue provides a clinical overview of preoperative evaluation for noncardiac surgery, focusing on risk factors, elements of evaluation, medication management, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers...
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27884661/association-of-kidney-disease-measures-with-risk-of-renal-function-worsening-in-patients-with-hypertension-and-type-2-diabetes
#20
Francesca Viazzi, Pamela Piscitelli, Carlo Giorda, Antonio Ceriello, Stefano Genovese, Giuseppina T Russo, Paola Fioretto, Pietro Guida, Salvatore De Cosmo, Roberto Pontremoli
AIMS: To assess the role of kidney disease measures on the development of chronic kidney disease (CKD) in patients with type 2 diabetes (T2D) and hypertension (HT). METHODS: Clinical records from a total of 17,160 patients with T2D and HT, a baseline estimated glomerular filtration rate (eGFR) values ≥60mL/min/1.73m(2), evaluation for albuminuria and regular visits during a four-year follow-up were retrieved and analyzed. The incidence of eGFR <60mL/min/1.73m(2) and/or a reduction >30% from baseline was evaluated...
October 29, 2016: Journal of Diabetes and its Complications
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