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https://www.readbyqxmd.com/read/29785662/the-timing-and-circumstances-of-the-implementation-of-pediatric-palliative-care-in-hungarian-pediatric-oncology
#1
Judit Nyirő, Szilvia Zörgő, Földesi Enikő, Katalin Hegedűs, Péter Hauser
Despite the continuous improvement of pediatric palliative care, medical professionals still face various barriers regarding its implementation; our aim was to investigate this question in Hungarian pediatric oncology practice. Structured interviews were carried out in person with physicians from the Hungarian Pediatric Oncology Group (n = 22). Codes were generated inductively with the aid of Atlas.ti 6.0 software. Most physicians placed the palliative care discussion at the end of curative treatment (n = 21) and preferred to conduct it in a team setting (n = 18), mainly in the presence of a psychologist...
May 21, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29785658/incidence-and-risk-factors-for-positive-urine-culture-at-the-time-of-pediatric-urologic-surgery
#2
Michael A Maccini, David J Chalmers, Vijaya M Vemulakonda, Jeffrey B Campbell
PURPOSE: Urinary tract infections are relatively common in pediatric patients. Unrecognized bacteriuria at the time of urologic surgery puts patients at increased risk for perioperative complications. Many pediatric urologists obtain preoperative or intraoperative urine cultures prior to surgery, but data are lacking regarding rates and risk factors for positive intraoperative urine cultures. We conducted a retrospective cohort study of patients undergoing pediatric urologic surgery to examine factors associated with positive intraoperative urine cultures...
May 21, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29783665/identification-of-novel-somatic-tp53-mutations-in-patients-with-high-grade-serous-ovarian-cancer-hgsoc-using-next-generation-sequencing-ngs
#3
Marica Garziera, Erika Cecchin, Vincenzo Canzonieri, Roberto Sorio, Giorgio Giorda, Simona Scalone, Elena De Mattia, Rossana Roncato, Sara Gagno, Elena Poletto, Loredana Romanato, Franca Sartor, Jerry Polesel, Giuseppe Toffoli
Somatic mutations in TP53 are a hallmark of high-grade serous ovarian cancer (HGSOC), although their prognostic and predictive value as markers is not well defined. Next-generation sequencing (NGS) can identify novel mutations with high sensitivity, that may be repurposed as potential druggable anti-cancer targets and aid in therapeutic decisions. Here, a commercial NGS cancer panel comprising 26 genes, including TP53 , was used to identify new genetic markers of platinum resistance and patient prognosis in a retrospective set of patients diagnosed with epithelial ovarian cancer...
May 18, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29783012/decisional-conflict-among-patients-considering-treatment-options-for-lumbar-herniated-disc
#4
Hwang Richard, Lambrechts Sylvia, Liu Hui, Christopher S Saigal, Kwan Lorna, Cisneros Crystal, Langston T Holly, Duru O Kenrik
BACKGROUND: Lumbar herniated disc is a "preference-sensitive" condition, in which the optimal treatment choice is crucially dependent on an informed patient's goals and values. Little is known about decisional conflict, defined as an individual's level of uncertainty regarding a decision, in patients considering treatment for lumbar herniated discs. Our work aims to identify factors associated with decisional conflict and areas for improved shared decision-making. METHODS: We prospectively surveyed patients seeking treatment for a lumbar herniated disc at L4-L5 and/or L5-S1 with a physician at the UCLA Spine Center...
May 18, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29782441/how-do-hearing-aid-owners-respond-to-hearing-aid-problems
#5
Rebecca J Bennett, Ariane Laplante-Lévesque, Robert H Eikelboom
BACKGROUND: Although hearing aids can improve hearing and communication, problems that arise following the acquisition of hearing aids can result in their disuse. This study aimed to gather perspectives of hearing aid owners and hearing health care clinicians about how hearing aid owners respond to problems that arise following hearing aid fitting, and then use these perspectives to generate a conceptual framework to better understand these responses. METHODS: Seventeen hearing aid owners and 21 hearing health care clinicians generated, sorted, and rated statements regarding how hearing aid owners respond to problems associated with hearing aid use...
May 18, 2018: Ear and Hearing
https://www.readbyqxmd.com/read/29781890/complexities-of-the-diagnostic-process
#6
Barbara Schildkrout
The diagnostic process is a highly complex, problem-solving enterprise. Yet, traditional case reports have not focused directly on this endeavor. Physicians could use the case format to present actual experiences of getting to a diagnosis. This approach would allow for modeling of nonjudgmental, self-reflective practices and also provide information to aid in studying the diagnostic endeavor. Given that diagnostic errors in medicine are widespread and constitute a serious public health problem, it is crucial for physicians to understand the diagnostic process as one step toward improving error rates...
May 17, 2018: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/29780633/deep-learning-aided-decision-support-for-pulmonary-nodules-diagnosing-a-review
#7
REVIEW
Yixin Yang, Xiaoyi Feng, Wenhao Chi, Zhengyang Li, Wenzhe Duan, Haiping Liu, Wenhua Liang, Wei Wang, Ping Chen, Jianxing He, Bo Liu
Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29780240/feasibility-of-visual-aids-for-risk-evaluation-by-hospitalized-patients-with-coronary-artery-disease-results-from-face-to-face-interviews
#8
Carlos Alberto da Silva Magliano, Andrea Liborio Monteiro, Bernardo Rangel Tura, Claudia Silvia Rocha Oliveira, Amanda Rebeca de Oliveira Rebelo, Claudia Cristina de Aguiar Pereira
Purpose: Communicating information about risk and probability to patients is considered a difficult task. In this study, we aim to evaluate the use of visual aids representing perioperative mortality and long-term survival in the communication process for patients diagnosed with coronary artery disease at the National Institute of Cardiology, a Brazilian public hospital specializing in cardiology. Patients and methods: One-on-one interviews were conducted between August 1 and November 20, 2017...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29780209/near-infrared-fluorescence-image-guidance-in-plastic-surgery-a-systematic-review
#9
REVIEW
Anouk J M Cornelissen, Tom J M van Mulken, Caitlin Graupner, Shan S Qiu, Xavier H A Keuter, René R W J van der Hulst, Rutger M Schols
Background: Near-infrared fluorescence (NIRF) imaging technique, after administration of contrast agents with fluorescent characteristics in the near-infrared (700-900 nm) range, is considered to possess great potential for the future of plastic surgery, given its capacity for perioperative, real-time anatomical guidance and identification. This study aimed to provide a comprehensive literature review concerning current and potential future applications of NIRF imaging in plastic surgery, thereby guiding future research...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29779961/patient-satisfaction-with-the-consent-discussion-is-not-improved-by-showing-patients-their-computed-tomography-or-angiography-images-before-they-undergo-vascular-surgery
#10
Dominic LeBlanc, Adam H Power, Guy DeRose, Audra Duncan, Luc Dubois
OBJECTIVE: Patient-based decision aids and other multimedia tools have been developed to help enrich the preoperative discussion between surgeon and patient. Use of these tools, however, can be time-consuming and logistically challenging. We investigated whether simply showing patients their images from preoperative computed tomography (CT) or angiography would improve patients' satisfaction with the preoperative discussion. We also examined whether this improved the patient's understanding and trust and whether it contributed to increased preoperative anxiety...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29779401/evaluating-quantity-and-quality-of-literature-focusing-on-health-economics-and-pharmacoeconomics-in-gulf-cooperation-council-countries
#11
Islam Eljilany, Faris El-Dahiyat, Louise Elizabeth Curley, Zaheer-Ud-Din Babar
BACKGROUND: The importance of pharmacoeconomics and health economics has been augmented. It has the potential to provide evidence to aid in optimal decision-making in the funding of cost-effective medicines and services in Gulf Cooperation Council countries (G.C.C). OBJECTIVE: To evaluate the quality and quantity of health economic research published until the end of 2017 in G.C.C. METHOD: Studies were included according to inclusion and exclusion criteria...
May 19, 2018: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/29779361/palliative-and-end-of-life-care-for-heart-failure-patients-in-an-aging-society
#12
Takahiro Okumura, Akinori Sawamura, Toyoaki Murohara
The populations of Asian countries are expected to age rapidly in the near future, with a dramatic increase in the number of heart failure (HF) patients also anticipated. The need for palliative and end-of-life care for elderly patients with advanced HF is currently recognized in aging societies. However, palliative care and active treatment for HF are not mutually exclusive, and palliative care should be provided to reduce suffering occurring at any stage of symptomatic HF after the point of diagnosis. HF patients are at high risk of sudden cardiac death from the early stages of the disease onwards...
May 23, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29777420/what-role-do-masculine-norms-play-in-men-s-hiv-testing-in-sub-saharan-africa-a-scoping-review
#13
REVIEW
Katelyn M Sileo, Rebecca Fielding-Miller, Shari L Dworkin, Paul J Fleming
Men living with HIV/AIDS in sub-Saharan Africa are less likely to test for HIV than women. We conducted a scoping review in May of 2016 to identify how masculine norms influence men's HIV testing in sub-Saharan Africa. Our review yielded a total of 13 qualitative studies from 8 countries. Masculine norms create both barriers and facilitators to HIV testing. Barriers included emotional inexpression, gendered communication, social pressures to be strong and self-reliant, and the fear that an HIV positive result would threaten traditional social roles (i...
May 18, 2018: AIDS and Behavior
https://www.readbyqxmd.com/read/29777106/clinical-prediction-models-to-support-the-diagnosis-of-asthma-in-primary-care-a-systematic-review-protocol
#14
L Daines, S McLean, A Buelo, S Lewis, A Sheikh, H Pinnock
Substantial over-diagnosis and under-diagnosis of asthma in adults and children has recently been reported. As asthma is mostly diagnosed in non-specialist settings, a clinical prediction model (CPM) to aid the diagnosis of asthma in primary care may help improve diagnostic accuracy. We aim to systematically identify, describe, compare, and synthesise existing CPMs designed to support the diagnosis of asthma in children and adults presenting with symptoms suggestive of the disease, in primary care settings or equivalent populations...
May 18, 2018: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29775736/surgical-consent-practice-in-the-uk-following-the-montgomery-ruling-a-national-cross-sectional-questionnaire-study
#15
Chris McKinnon, Dafydd Loughran, Roísín Finn, Madeline Coxwell-Matthewman, Deva Sanjeeva Jeyaretna, Adam P Williams
BACKGROUND: The Supreme Court case of Montgomery vs Lanarkshire Health Board in 2015 was a landmark case for consent practice in the UK which shifted focus from a traditional paternalistic model of consent towards a more patient-centered approach. Widely recognised as the most significant legal judgment on informed consent in the last 30 years, the case was predicted to have a major impact on the everyday practice of surgeons working in the UK National Health Service (NHS). Two years after the legal definition of informed consent was redefined, we carried out an audit of surgical consent practice across the UK to establish the impact of the Montgomery ruling on clinical practice...
May 15, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29775092/a-prospective-multi-centre-us-clinical-trial-to-determine-accuracy-of-febridx-point-of-care-testing-for-acute-upper-respiratory-infections-with-and-without-a-confirmed-fever
#16
Nathan I Shapiro, Wesley H Self, Jeffrey Rosen, Stephan C Sharp, Michael R Filbin, Peter C Hou, Amisha D Parekh, Michael C Kurz, Robert Sambursky
BACKGROUND: FebriDx is a 10-minute disposable point-of-care test designed to identify clinically significant systemic host immune responses and aid in the differentiation of bacterial and viral respiratory infection by simultaneously detecting C-reactive protein (CRP) and myxovirus resistance protein A (MxA) from a fingerstick blood sample. FebriDx diagnostic accuracy was evaluated in the emergency room and urgent care setting. METHODS: A prospective, multicentre, observational cohort study of acute upper respiratory tract infections (URIs), with and without a confirmed fever at the time of enrolment, was performed to evaluate the diagnostic accuracy of FebriDx to identify clinically significant bacterial infection with host response and acute pathogenic viral infection...
May 18, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29773965/funds-allocation-in-npos-the-role-of-administrative-cost-ratios
#17
Christian Burkart, Tina Wakolbinger, Fuminori Toyasaki
Performance measurement of Non-Profit Organizations (NPOs) is of increasing importance for aid agencies, policy-makers and donors. A widely used benchmark for measuring the efficiency of NPOs is the overhead cost ratio, consisting of the total money spent on administration and fundraising relative to the budget. Donors generally favor a lower overhead cost ratio as it ensures that more money directly reaches beneficiaries. Unlike fundraising expenses, administrative costs do not contribute to advertising the actions of an NPO even though they account for a significant proportion of overhead cost...
2018: Central European Journal of Operations Research
https://www.readbyqxmd.com/read/29771683/an-individualized-strategy-to-estimate-the-effect-of-deformable-registration-uncertainty-on-accumulated-dose-in-the-upper-abdomen
#18
Yibing Wang, Steven F Petit, Eliana Vasquez Osorio, Vikas Gupta, Alejandra Méndez Romero, Ben J M Heijmen
In the abdomen, it is challenging to assess the accuracy of deformable image registration (DIR) for individual patients, due to the lack of clear anatomical landmarks, which can hamper clinical applications that require high accuracy DIR, such as adaptive radiotherapy. In this study, we propose and evaluate a methodology for estimating the impact of uncertainties in DIR on calculated accumulated dose in the upper abdomen, in order to aid decision making in adaptive treatment approaches. 
 Sixteen liver metastasis patients treated with SBRT were evaluated...
May 17, 2018: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29768401/near-real-time-forecasting-for-cholera-decision-making-in-haiti-after-hurricane-matthew
#19
Damiano Pasetto, Flavio Finger, Anton Camacho, Francesco Grandesso, Sandra Cohuet, Joseph C Lemaitre, Andrew S Azman, Francisco J Luquero, Enrico Bertuzzo, Andrea Rinaldo
Computational models of cholera transmission can provide objective insights into the course of an ongoing epidemic and aid decision making on allocation of health care resources. However, models are typically designed, calibrated and interpreted post-hoc. Here, we report the efforts of a team from academia, field research and humanitarian organizations to model in near real-time the Haitian cholera outbreak after Hurricane Matthew in October 2016, to assess risk and to quantitatively estimate the efficacy of a then ongoing vaccination campaign...
May 16, 2018: PLoS Computational Biology
https://www.readbyqxmd.com/read/29766138/risk-stratification-tools-in-emergency-general-surgery
#20
REVIEW
Joaquim Michael Havens, Alexandra B Columbus, Anupamaa J Seshadri, Carlos V R Brown, Gail T Tominaga, Nathan T Mowery, Marie Crandall
The use of risk stratification tools (RST) aids in clinical triage, decision making and quality assessment in a wide variety of medical fields. Although emergency general surgery (EGS) is characterized by a comorbid, physiologically acute patient population with disparately high rates of perioperative morbidity and mortality, few RST have been explicitly examined in this setting. We examined the available RST with the intent of identifying a tool that comprehensively reflects an EGS patients perioperative risk for death or complication...
2018: Trauma surgery & acute care open
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