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https://www.readbyqxmd.com/read/28340494/postoperative-care-of-patients-with-high-grade-glioma-is-there-a-real-need-for-the-neurocritical-icu-and-early-ct-scan
#1
Roberto Altieri, Fabio Cofano, Alessandro Agnoletti, Riccardo Fornaro, Marco Ajello, Francesco Zenga, Alessandro Ducati, Diego Garbossa
Background Pressure on economic resources now requires a careful rationalization of services. For adult patients with supratentorial gliomas, there is no consensus on the real need for care in a postoperative neurocritical intensive care unit (NICU) and on the timing of a postsurgical computed tomography (CT) scan. In this retrospective nonrandomized study, we assessed if and when there is a real need for NICU and if an early CT scan could be justified in the absence of neurologic worsening. Methods Of 264 patients, 21 were admitted to the NICU after the procedure as planned before the surgery for their clinical features (Karnofsky performance status < 70, American Society of Anesthesiologists score > 2, or Charlson Comorbidity Index > 5)...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28340449/right-hemisphere-pitch-mismatch-negativity-reduction-in-patients-with-major-depression-an-meg-study
#2
Noriaki Hirakawa, Yoji Hirano, Itta Nakamura, Shogo Hirano, Jinya Sato, Naoya Oribe, Takefumi Ueno, Shigenobu Kanba, Toshiaki Onitsuka
BACKGROUND: The mismatch negativity (MMN) component of the event-related potential and its magnetic counterpart, the MMNm, are generated by a mismatch between the physical features of a deviant stimulus and a neuronal sensory-memory trace produced by repetitive standard stimuli. Deficits in the MMN/MMNm have been reported in patients with major depression; however, the results are inconsistent. The present study investigated the pitch-MMNm in patients with major depression using whole-head 306-channel magnetoencephalography (MEG)...
March 19, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28340444/comparative-effectiveness-of-dual-action-versus-single-action-antidepressants-for-the-treatment-of-depression-in-people-living-with-hiv-aids
#3
Jon C Mills, Jeffrey S Harman, Robert L Cook, Nicole M Marlow, Christopher A Harle, R Paul Duncan, Angela M Bengtson, Brian W Pence
BACKGROUND: Depression is the most common psychiatric comorbidity among people living with HIV/AIDS (PLWHA). Little is known about the comparative effectiveness between different types of antidepressants used to treat depression in this population. We compared the effectiveness of dual-action and single-action antidepressants in PLWHA for achieving remission from depression. METHODS: We used data from the Centers for AIDS Research Network of Integrated Clinic Systems to identify 1175 new user dual-action or single-action antidepressant treatment episodes occurring from 2005 to 2014 for PLWHA diagnosed with depression...
March 19, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28340351/bedside-back-to-bench-building-bridges-between-basic-and-clinical-genomic-research
#4
Teri A Manolio, Douglas M Fowler, Lea M Starita, Melissa A Haendel, Daniel G MacArthur, Leslie G Biesecker, Elizabeth Worthey, Rex L Chisholm, Eric D Green, Howard J Jacob, Howard L McLeod, Dan Roden, Laura Lyman Rodriguez, Marc S Williams, Gregory M Cooper, Nancy J Cox, Gail E Herman, Stephen Kingsmore, Cecilia Lo, Cathleen Lutz, Calum A MacRae, Robert L Nussbaum, Jose M Ordovas, Erin M Ramos, Peter N Robinson, Wendy S Rubinstein, Christine Seidman, Barbara E Stranger, Haoyi Wang, Monte Westerfield, Carol Bult
Genome sequencing has revolutionized the diagnosis of genetic diseases. Close collaborations between basic scientists and clinical genomicists are now needed to link genetic variants with disease causation. To facilitate such collaborations, we recommend prioritizing clinically relevant genes for functional studies, developing reference variant-phenotype databases, adopting phenotype description standards, and promoting data sharing.
March 23, 2017: Cell
https://www.readbyqxmd.com/read/28340323/a-key-to-the-backdoor-into-the-castle-the-clinical-ramifications-of-immunoediting-driven-by-antigenic-competition
#5
M G Hanna, Jason David Howard
Over the last decade the field of cancer biology has gained considerable data on genomic heterogeneity. This situation creates challenges and possibly opportunities for cancer treatment. The evolution of the tumor at all stages also requires the growing malignancy to confront and avoid the immune system. What we describe here is the interaction of two immune phenomena that work together to change the characteristics of the tumor, i.e., antigenic competition and immune editing. These two systems are mutually functional and their interaction is capable of altering the characteristics of the tumor for protection and survival in an immune competent host as well as restricting the diversity of the tumor clones...
March 24, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28340241/pragmatic-trial-informatics-a-perspective-from-the-nih-health-care-systems-research-collaboratory
#6
Rachel L Richesson, Beverly B Green, Reesa Laws, Jon Puro, Michael G Kahn, Alan Bauck, Michelle Smerek, Erik G Van Eaton, Meredith Zozus, W Ed Hammond, Kari A Stephens, Greg E Simon
Pragmatic clinical trials (PCTs) are research investigations embedded in health care settings designed to increase the efficiency of research and its relevance to clinical practice. The Health Care Systems Research Collaboratory, initiated by the National Institutes of Health Common Fund in 2010, is a pioneering cooperative aimed at identifying and overcoming operational challenges to pragmatic research. Drawing from our experience, we present 4 broad categories of informatics-related challenges: (1) using clinical data for research, (2) integrating data from heterogeneous systems, (3) using electronic health records to support intervention delivery or health system change, and (4) assessing and improving data capture to define study populations and outcomes...
March 14, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340234/detection-of-severe-digital-vasculopathy-in-systemic-sclerosis-by-colour-doppler-sonography-is-associated-with-digital-ulcers
#7
Susanne Lüders, Stefanie Friedrich, Sarah Ohrndorf, Anne-Marie Glimm, Gerd-Rüdiger Burmester, Gabriela Riemekasten, Marina Backhaus
Objective.: Colour Doppler ultrasonography (CDUS) is very important in general vascular diagnostic procedures. Its role in determining the extent of vasculopathy in Systemic Sclerosis (SSc) needs further investigation. The aim of this study was to compare the presence of altered arteries with nailfold capillaroscopy and clinical signs of ischaemia, that is, digital ulcers or pitting scars (DU/PS). A feasible CDUS protocol is provided. Methods.: Two thousand five hundred and twenty-eight arteries of the fingers, palms and wrists from 79 SSc patients (32 arteries per patient) were examined using CDUS...
March 17, 2017: Rheumatology
https://www.readbyqxmd.com/read/28340229/meaningful-use-in-the-safety-net-a-rapid-ethnography-of-patient-portal-implementation-at-five-community-health-centers-in-california
#8
Sara L Ackerman, Urmimala Sarkar, Lina Tieu, Margaret A Handley, Dean Schillinger, Kenneth Hahn, Mekhala Hoskote, Gato Gourley, Courtney Lyles
Objective: US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. Materials and Methods: Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n  = 12), informal focus groups with front-line staff ( n  = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n  = 45)...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340222/success-in-implementation-of-a-resident-in-service-examination-review-series
#9
Jessica A Forcucci, J Madison Hyer, Evelyn T Bruner, David N Lewin, Nicholas I Batalis
Objectives: Primary pathology board certification has been correlated with senior resident in-service examination (RISE) performance. We describe our success with an annual, month-long review series. Methods: Aggregate program RISE performance data were gathered for 3 years prior to and 3 years following initiation of the review series. In addition, mean United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge scores for residents participating in each RISE examination were obtained to control for incoming knowledge and test-taking ability...
March 18, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28340221/nationwide-multicentre-kidney-biopsy-study-of-japanese-patients-with-type-2-diabetes
#10
Kengo Furuichi, Yukio Yuzawa, Miho Shimizu, Akinori Hara, Tadashi Toyama, Hiroshi Kitamura, Yoshiki Suzuki, Hiroshi Sato, Noriko Uesugi, Yoshifumi Ubara, Satoshi Hisano, Yoshihiko Ueda, Shinichi Nishi, Hitoshi Yokoyama, Tomoya Nishino, Kentaro Kohagura, Daisuke Ogawa, Koki Mise, Yugo Shibagaki, Kenjiro Kimura, Masakazu Haneda, Hirofumi Makino, Seiichi Matsuo, Takashi Wada
Background.: The clinical and pathologic manifestations of nephropathy due to type 2 diabetes are diverse, but large-scale pathologic studies with long-term observations are limited. Methods.: Kidney biopsies and clinical data of 600 patients with type 2 diabetes were collected retrospectively from 13 centres across Japan. Thirteen pathologic findings (nine glomerular lesions, two interstitial lesions and two vascular lesions) were clearly defined and scored. Results...
March 2, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28340210/clinical-significance-of-isolated-myeloperoxidase-expression-in-pediatric-b-lymphoblastic-leukemia
#11
Matthew J Oberley, Sisi Li, Etan Orgel, Choo Phei Wee, Ashley Hagiya, Maurice R G O'Gorman
Objectives: Diagnosis of B-cell acute lymphoblastic leukemia (B-ALL) requires immunophenotypic evidence of B-lineage and absence of specific myeloid or T-lineage markers. Rare cases of otherwise typical B-ALL express myeloperoxidase (MPO) detectable by flow cytometry with an absence of other myeloid markers, but the clinical significance of this finding is not well studied. Methods: A retrospective cohort analysis of flow cytometry and clinical data was performed to investigate the clinical outcome of this specific group of patients...
March 15, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28340198/reasons-to-wait-or-to-treat-naive-patients-affected-by-chronic-hepatitis-c-with-low-fibrosis-stage-and-genotypes-2-or-3
#12
Lucio Boglione, Jessica Cusato, Giuseppe Cariti, Giovanni Di Perri, Antonio D'Avolio
New interferon (IFN)-free therapies are not currently available for all patients with chronic hepatitis C due to higher costs; in Italy, patients with genotype 2 (GT2) or GT3 without severe fibrosis can choose between wait or treatment with pegylated (PEG)-IFN and ribavirin. This study wants to examine the real rate of patients that accept or refused this therapy and the reasons related to decision. This prospective, observational analysis was performed at our centre between January 2014 and June 2015. Epidemiological, social and clinical data were collected in medical records; reasons for treatment acceptance/refusal were recorded through a questionnaire...
March 10, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28340197/the-evolution-and-benefit-of-device-therapy-in-patients-listed-for-heart-transplant
#13
Bert Vandenberk, Mark Hinderks, Gabor Voros, Christophe Garweg, Johan Vanhaecke, Rik Willems
Aims: The latest 2015 ESC Guidelines on the prevention of sudden cardiac death make a Class IIa recommendation for ICD implantation in patients listed for heart transplantation. This recommendation was based on expert consensus in view of the sparsity of data. Methods and results: All patients listed for heart transplantation at the University Hospitals of Leuven from 2002 until 2014 were studied retrospectively. Exclusion criteria were age <16 years, cardiac disease other than ischaemic or dilated cardiomyopathy and re-transplantation...
March 9, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28340184/a-cross-national-comparison-of-incident-reporting-systems-implemented-in-german-and-swiss-hospitals
#14
Tanja Manser, Michael Imhof, Constanze Lessing, Matthias Briner
Objective: This study aimed to empirically compare incident reporting systems (IRS) in two European countries and to explore the relationship of IRS characteristics with context factors such as hospital characteristics and characteristics of clinical risk management (CRM). Design: We performed exploratory, secondary analyses of data on characteristics of IRS from nationwide surveys of CRM practices. Setting: The survey was originally sent to 2136 hospitals in Germany and Switzerland...
March 7, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28340166/complete-blood-count-reference-ranges-from-a-rural-haitian-ambulatory-care-clinic
#15
Robert F Downey
Background: At rural healthcare centers in developing countries, it is difficult to recruit healthy individuals for reference range studies. So, in this study, I evaluated complete blood count (CBC) data to determine reference ranges for a rural Haitian population. Methods: A convenience sample of laboratory records was reviewed to obtain CBC results for 157 adult patients with normal screening examination results. Central 95% reference ranges were determined for male and female subjects...
March 10, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28340152/sarcopenia-and-relationships-between-muscle-mass-measured-glomerular-filtration-rate-and-physical-function-in-patients-with-chronic-kidney-disease-stages-3-5
#16
Yunan Zhou, Matthias Hellberg, Philippa Svensson, Peter Höglund, Naomi Clyne
Background.: Sarcopenia and poor physical function are common in patients with chronic kidney disease (CKD). Our aim was to investigate the relationships between muscle mass and measured glomerular filtration rate (GFR) and between muscle mass and strength and balance, respectively, in patients with CKD stages 3-5. Methods.: This is a baseline data analysis of a randomized controlled clinical trial. A total of 148 adult patients with an estimated GFR <30 mL/min/1...
March 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28340149/individual-and-regional-determinants-for-physical-therapy-utilization-in-germany-multilevel-analysis-of-national-survey-data
#17
Alexander Rommel, Lars Eric Kroll
Background: Physical therapy (PT) is included in many clinical guidelines and a commonly used health service. However, access to its benefits should not strongly depend on social or demographic factors. Objective: The present study used the Andersen model to explain to what extent PT utilization in Germany depends on factors beyond medical need. Methods: The German Health Interview and Examination Survey for Adults (DEGS, 2008-2011; target population, 18-79 years) is part of the German health-monitoring system...
March 9, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28340135/modeling-longitudinal-data-and-its-impact-on-survival-in-observational-nephrology-studies-tools-and-considerations
#18
Elani Streja, Leanne Goldstein, Melissa Soohoo, Yoshitsugu Obi, Kamyar Kalantar-Zadeh, Connie M Rhee
Nephrologists and kidney disease researchers are often interested in monitoring how patients' clinical and laboratory measures change over time, what factors may impact these changes, and how these changes may lead to differences in morbidity, mortality, and other outcomes. When longitudinal data with repeated measures over time in the same patients are available, there are a number of analytical approaches that could be employed to describe the trends and changes in these measures, and to explore the associations of these changes with outcomes...
March 3, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28340117/an-evaluation-of-the-performance-of-the-dynamiker%C3%A2-fungus-1-3-%C3%AE-d-glucan-assay-to-assist-in-the-diagnosis-of-invasive-aspergillosis-invasive-candidiasis-and-pneumocystis-pneumonia
#19
P Lewis White, Jessica S Price, Raquel B Posso, Rosemary A Barnes
Invasive fungal disease (IFD) can be caused by a range of pathogens. Conventional diagnosis has the capacity to detect most causes of IFD, but poor performance limits impact. The introduction of non-culture diagnostics, including the detection of (1-3)-β-D-Glucan (BDG), has shown promising performance for the detection of IFD in variety of clinical settings. Recently, the Dynamiker® Fungus (1-3)-β-D-Glucan assay (D-BDG) was released as an IFD diagnostic test. This article describes an evaluation of the D-BDG assay for the diagnosis of invasive aspergillosis (IA), invasive candidiasis (IC) and Pneumocystis pneumonia (PCP) across several high-risk patient cohorts and provides comparative data with the Associates of Cape Cod Fungitell® and BioRad Platelia™ Aspergillus Ag (GM) assays...
March 3, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28340111/assessment-of-patient-reported-outcome-instruments-to-assess-chronic-low-back-pain
#20
Abhilasha Ramasamy, Mona L Martin, Steven I Blum, Hiltrud Liedgens, Charles Argoff, Rainer Freynhagen, Mark Wallace, Kelly P McCarrier, Donald M Bushnell, Noël V Hatley, Donald L Patrick
Objective. : To identify patient-reported outcome (PRO) instruments that assess chronic low back pain (cLBP) symptoms (specifically pain qualities) and/or impacts for potential use in cLBP clinical trials to demonstrate treatment benefit and support labeling claims. Design. : Literature review of existing PRO measures. Methods. : Publications detailing existing PRO measures for cLBP were identified, reviewed, and summarized. As recommended by the US Food & Drug Administration (FDA) PRO development guidance, standard measurement characteristics were reviewed, including development history, psychometric properties (validity and reliability), ability to detect change, and interpretation of observed changes...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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