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https://www.readbyqxmd.com/read/28806638/patient-preferences-and-extended-release-naltrexone-a-new-opportunity-to-treat-opioid-use-disorders-in-ukraine
#1
Ruthanne Marcus, Iuliia Makarenko, Alyona Mazhnaya, Alexei Zelenev, Maxim Polonsky, Lynn Madden, Sergii Filippovych, Sergii Dvoriak, Sandra A Springer, Frederick L Altice
BACKGROUND: Scaling up HIV prevention for people who inject drugs (PWID) using opioid agonist therapies (OAT) in Ukraine has been restricted by individual and structural factors. Extended-release naltrexone (XR-NTX), however, provides new opportunities for treating opioid use disorders (OUDs) in this region, where both HIV incidence and mortality continue to increase. METHODS: Survey results from 1613 randomly selected PWID from 5 regions in Ukraine who were currently, previously or never on OAT were analyzed for their preference of pharmacological therapies for treating OUDs...
August 5, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28805805/whole-tumor-section-quantitative-image-analysis-maximizes-between-pathologists-reproducibility-for-clinical-immunohistochemistry-based-biomarkers
#2
Michael Barnes, Chukka Srinivas, Isaac Bai, Judith Frederick, Wendy Liu, Anindya Sarkar, Xiuzhong Wang, Yao Nie, Bryce Portier, Monesh Kapadia, Olcay Sertel, Elizabeth Little, Bikash Sabata, Jim Ranger-Moore
Pathologists have had increasing responsibility for quantitating immunohistochemistry (IHC) biomarkers with the expectation of high between-reader reproducibility due to clinical decision-making especially for patient therapy. Digital imaging-based quantitation of IHC clinical slides offers a potential aid for improvement; however, its clinical adoption is limited potentially due to a conventional field-of-view annotation approach. In this study, we implemented a novel solely morphology-based whole tumor section annotation strategy to maximize image analysis quantitation results between readers...
August 14, 2017: Laboratory Investigation; a Journal of Technical Methods and Pathology
https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#3
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28804763/effects-of-chest-physical-therapy-in-patients-with-non-tuberculous-mycobacteria
#4
Ashwin Basavaraj, Leopoldo Segal, Jonathan Samuels, Jeremy Feintuch, Joshua Feintuch, Kevin Alter, Daniella Moffson, Adrienne Scott, Doreen Addrizzo-Harris, Mengling Liu, David Kamelhar
Antibiotic therapy against non-tuberculous mycobacteria (NTM) is prolonged and can be associated with toxicity. We sought to evaluate whether chest physical therapy (PT) was associated with clinical improvement in patients with NTM not receiving anti-mycobacterial pharmacotherapy. A retrospective review of 77 subjects that were followed from June 2006 to September 2014 was performed. Baseline time point was defined as the first positive sputum culture for NTM; symptoms, pulmonary function, and radiology reports were studied...
2017: International Journal of Respiratory and Pulmonary Medicine
https://www.readbyqxmd.com/read/28804603/towards-a-more-transparent-hta-process-in-poland-new-polish-hta-methodological-guidelines
#5
Krzysztof Lach, Michal Dziwisz, Cécile Rémuzat, Mondher Toumi
Introduction: Health technology assessment (HTA) in Poland supports reimbursement decisions via the Polish HTA Agency (AOTMiT), whose guidelines were updated in 2016. Methods: We identified key changes introduced by the update and, before guideline publication, analysed discrepancies between AOTMiT assessments and the submitting marketing authorisation holders (MAHs) to elucidate the context of the update. We compared the clarity and detail of the new guidelines versus those of the UK's National Institute for Health and Care Excellence (NICE)...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28803497/exploring-the-potential-value-of-improved-care-for-secondary-hyperparathyroidism-with-a-novel-calcimimetic-therapy
#6
Björn Stollenwerk, Sergio Iannazzo, Kerry Cooper, Vasily Belozeroff
AIMS: This study explored the use of a value-based pricing approach for the new calcimimetic etelcalcetide indicated for the treatment of secondary hyperparathyroidism (SHPT) in patients receiving hemodialysis. It used the US payer perspective and applied the cost-effectiveness framework. Because etelcalcetide is an intravenous therapy that can be titrated for individual patients, and because its utilization is yet to be assessed in real world settings, a range of plausible doses were estimated for etelcalcetide to define a range of prices...
August 14, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28801876/tumor-dna-an-emerging-biomarker-in-head-and-neck-cancer
#7
Joseph A Bellairs, Rifat Hasina, Nishant Agrawal
Head and neck cancer (HNC) includes a diverse range of malignancies arising commonly from mucosal epithelia of the upper aerodigestive tract. Head and neck squamous cell carcinoma (HNSCC), the most common form of HNC, develops in the oral cavity, pharynx, and larynx and is associated with tobacco exposure, alcohol abuse, and infection with oncogenic viruses. Despite global advances in cancer care, HNSCC often presents with advanced disease and is associated with poor 5-year survival of ~50%. Genotyping tumor tissue to guide clinical decision-making is becoming commonplace in modern oncology, but in the management of HNSCC, tissue biopsies with cytopathology or histopathology remain the mainstay for diagnosis...
August 12, 2017: Cancer Metastasis Reviews
https://www.readbyqxmd.com/read/28800832/knowledge-of-appropriate-outpatient-pediatric-echocardiogram-ordering-in-primary-care-physicians-and-trainees
#8
Sean M Lang, Joshua A Daily, Micheal R FitzGerald, Xinyu Tang, Thomas H Best, James M Robbins, R Thomas Collins
Appropriate Use Criteria (AUC) for the initial use of outpatient pediatric echocardiography were established to aid all clinicians in the evaluation of children with possible heart disease, and limit low diagnostic yield studies. We sought to (1) assess PCPs' and trainees' awareness of the AUC document; (2) compare their knowledge of appropriate echocardiogram ordering with that of pediatric cardiologists; and (3) identify additional medical and nonmedical factors affecting PCP echocardiogram ordering. An online survey with clinical scenarios derived from the AUC guidelines was distributed to PCPs and trainees in Arkansas, and pediatric cardiologists from Arkansas Children's Hospital and Cincinnati Children's Hospital Medical Center...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28800569/surgery-for-refractory-coccygodynia-operative-versus-nonoperative-treatment
#9
John P Kleimeyer, Kirkham B Wood, Greger Lønne, Tyler Herzog, Kevin Ju, Lisa Beyer, Christine Park
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To evaluate the long-term outcomes for patients with refractory coccygodynia treated with coccygectomy compared to a nonsurgical regimen of sitting aids, physical therapy, medications, and injections. SUMMARY OF BACKGROUND DATA: The surgical treatment of coccygodynia remains controversial. To date, there has only been one small comparative study of surgical versus nonsurgical treatment...
August 15, 2017: Spine
https://www.readbyqxmd.com/read/28800520/a-modified-delphi-process-to-identify-clinical-and-research-priorities-in-patient-and-family-centred-critical-care
#10
Simon J W Oczkowski, Selena Au, Amanda Roze des Ordons, Marlyn Gill, Melissa L Potestio, Orla Smith, Tasnim Sinuff, Henry T Stelfox, Alison E Fox-Robichaud
PURPOSE: To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. MATERIALS AND METHODS: We engaged a panel of multidisciplinary stakeholders in a modified Delphi process. Items generated from a literature review and panelist suggestions were rated in 3 successive rounds on a scale from 1 to 7. Median score was used to rate each item's priority, with 5 or more indicating "essential priority," 4 or 5 "moderate priority" and 3 or less "low priority...
August 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28800276/enhancing-informed-consent-for-physician-aid-in-dying-potential-role-of-handout-on-possible-benefits-of-palliative-care
#11
Harry Peled, Kathleen E Bickel, Christina Puchalski
In the United States, physician aid in dying (PAD) is now legal in several states. However, neither a requirement for a palliative care (PC) consultation nor a defined education in PC exists for physicians participating in PAD or patients requesting assistance. Patients with advanced chronic and serious illness often experience complex physical, psychosocial, and spiritual distress. PC focuses on relieving this distress and improving patient quality of life through early identification and intervention in all domains of suffering, including physical, psychological, social, and spiritual...
August 11, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28797613/visual-aids-for-improving-patient-decision-making-in-severe-symptomatic-carotid-stenosis
#12
Sebastian Fridman, Gustavo Saposnik, Luciano A Sposato
BACKGROUND: Because of the large amount of information to process and the limited time of a clinical consult, choosing between carotid endarterectomy (CEA) and carotid angioplasty with stenting (CAS) can be confusing for patients with severe symptomatic internal carotid stenosis (ICA). GOAL: We aim to develop a visual aid tool to help clinicians and patients in the decision-making process of selecting between CEA and CAS. MATERIALS AND METHODS: Based on pooled analysis from randomized controlled trials including patients with symptomatic and severe ICA (SSICA), we generated visual plots comparing CEA with CAS for 3 prespecified postprocedural time points: (1) any stroke or death at 4 months, and (2) any stroke or death in the first 30 days and ipsilateral stroke thereafter at 5 years and (3) at 10 years...
August 7, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28797295/exploring-differences-in-the-use-of-the-statin-choice-decision-aid-and-diabetes-medication-choice-decision-aid-in-primary-care
#13
Aimee Yu Ballard, Maya Kessler, Marianne Scheitel, Victor M Montori, Rajeev Chaudhry
BACKGROUND: Shared decision making is essential to patient centered care, but can be difficult for busy clinicians to implement into practice. Tools have been developed to aid in shared decision making and embedded in electronic medical records (EMRs) to facilitate use. This study was undertaken to explore the patterns of use and barriers and facilitators to use of two decision aids, the Statin Choice Decision Aid (SCDA) and the Diabetes Medication Choice Decision Aid (DMCDA), in primary care practices where the decision aids are embedded in the EMR...
August 10, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28796974/benchmarking-aided-decision-making-in-a-signal-detection-task
#14
Megan L Bartlett, Jason S McCarley
OBJECTIVE: A series of experiments examined human operators' strategies for interacting with highly (93%) reliable automated decision aids in a binary signal detection task. BACKGROUND: Operators often interact with automated decision aids in a suboptimal way, achieving performance levels lower than predicted by a statistically ideal model of information integration. To better understand operators' inefficient use of decision aids, we compared participants' automation-aided performance levels with the predictions of seven statistical models of collaborative decision making...
September 2017: Human Factors
https://www.readbyqxmd.com/read/28795994/potential-and-actual-health-hazards-in-the-dense-urban-operational-environment-critical-gaps-and-solutions-for-military-occupational-health
#15
Steven L Patterson, Blair C R Dancy, Danielle L Ippolito, Jonathan D Stallings
: This paper presents environmental health risks which are prevalent in dense urban environments.We review the current literature and recommendations proposed by environmental medicine experts in a 2-day symposium sponsored by the Department of Defense and supported by the Johns Hopkins University Applied Physics Laboratory.Key hazards in the dense urban operational environment include toxic industrial chemicals and materials, water pollution and sewage, and air pollution. Four critical gaps in environmental medicine were identified: prioritizing chemical and environmental concerns, developing mobile decision aids, personalized health assessments, and better real-time health biomonitoring...
August 8, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28795426/blinded-histopathological-characterisation-of-pole-exonuclease-domain-mutant-endometrial-cancers-sheep-in-wolf-s-clothing
#16
Inge C Van Gool, Jef E H Ubachs, Ellen Stelloo, Cor D de Kroon, Jelle J Goeman, Vincent T H B M Smit, Carien L Creutzberg, Tjalling Bosse
AIMS: POLE exonuclease domain mutations identify a subset of endometrial cancer (EC) patients with an excellent prognosis. Implementation of this biomarker has been suggested to refine adjuvant treatment decisions, but the necessary sequencing is not widely performed and relatively expensive. Therefore, we aimed to identify histopathological and immunohistochemical characteristics to aid the detection of POLE-mutant ECs. METHODS AND RESULTS: Fifty-one POLE-mutant endometrioid, 67 POLE-wild-type endometrioid and 15 POLE-wild-type serous ECs were included (total N=133)...
August 10, 2017: Histopathology
https://www.readbyqxmd.com/read/28795254/an-efficient-method-for-kidney-allocation-problem-a-credibility-based-fuzzy-common-weights-data-envelopment-analysis-approach
#17
Sahar Ahmadvand, Mir Saman Pishvaee
Given the perennial imbalance and chronic scarcity between the demand for and supply of available organs, organ allocation is one of the most critical decisions in the management of organ transplantation networks. Organ allocation systems undergo rapid revisions for the sake of improved outcomes in terms of both equity and medical efficiency. This paper presents a Data Envelopment Analysis (DEA)-based model to evaluate the efficiency of possible patient-organ pairs for kidney allocation in order to enhance the fitness of organ allocation under inherent uncertainty in such problem...
August 9, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28792080/dynamic-predictions-with-time-dependent-covariates-in-survival-analysis-using-joint-modeling-and-landmarking
#18
Dimitris Rizopoulos, Geert Molenberghs, Emmanuel M E H Lesaffre
A key question in clinical practice is accurate prediction of patient prognosis. To this end, nowadays, physicians have at their disposal a variety of tests and biomarkers to aid them in optimizing medical care. These tests are often performed on a regular basis in order to closely follow the progression of the disease. In this setting, it is of interest to optimally utilize the recorded information and provide medically relevant summary measures, such as survival probabilities, which will aid in decision making...
August 9, 2017: Biometrical Journal. Biometrische Zeitschrift
https://www.readbyqxmd.com/read/28791782/predicting-short-term-risk-of-arrhythmia-among-patients-with-syncope-the-canadian-syncope-arrhythmia-risk-score
#19
Venkatesh Thiruganasambandamoorthy, Ian G Stiell, Marco L A Sivilotti, Brian H Rowe, Muhammad Mukarram, Kirtana Arcot, Kenneth Kwong, Andrew D McRae, George A Wells, Monica Taljaard
BACKGROUND: Syncope can be caused by serious occult arrhythmias not evident during initial emergency department (ED) evaluation. We sought to develop a risk-tool for predicting 30-day arrhythmia or death after ED disposition. METHODS: We conducted a multicenter prospective cohort study at six tertiary-care EDs and included adults (≥16 years) with syncope. We collected standardized variables from clinical evaluation, and investigations including ECG and troponin at index presentation...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28789825/the-effect-of-the-quality-of-vital-sign-recording-on-clinical-decision-making-in-a-regional-acute-care-trauma-ward
#20
Claire M Keene, Victor Y Kong, Damian L Clarke, Petra Brysiewicz
PURPOSE: Recording vital signs is important in the hospital setting and the quality of this documentation influences clinical decision making. The Modified Early Warning Score (MEWS) uses vital signs to categorise the severity of a patient's physiological derangement and illustrates the clinical impact of vital signs in detecting patient deterioration and making management decisions. This descriptive study measured the quality of vital sign recordings in an acute care trauma setting, and used the MEWS to determine the impact the documentation quality had on the detection of physiological derangements and thus, clinical decision making...
July 5, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
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