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https://www.readbyqxmd.com/read/29166693/-the-biased-expert-an-unknown-quantity
#1
Wolfgang Meins
Academic publications have so far hardly paid any attention to the topic of biased medical experts or expert opinions. This is the first attempt to systematically describe and analyze the issue, drawing on the author's many years of giving expert opinions as a neuropsychiatrist on matters relating to social legislation and civil law. In addition to dealing with questions of definition, this article outlines the features of biased expert opinions, particularly focusing on the role of insurance and private experts...
November 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/29166245/evidence-supporting-li-rads-major-features-for-ct-and-mr-imaging-based-diagnosis-of-hepatocellular-carcinoma-a-systematic-review
#2
An Tang, Mustafa R Bashir, Michael T Corwin, Irene Cruite, Christoph F Dietrich, Richard K G Do, Eric C Ehman, Kathryn J Fowler, Hero K Hussain, Reena C Jha, Adib R Karam, Adrija Mamidipalli, Robert M Marks, Donald G Mitchell, Tara A Morgan, Michael A Ohliger, Amol Shah, Kim-Nhien Vu, Claude B Sirlin
The Liver Imaging Reporting and Data System (LI-RADS) standardizes the interpretation, reporting, and data collection for imaging examinations in patients at risk for hepatocellular carcinoma (HCC). It assigns category codes reflecting relative probability of HCC to imaging-detected liver observations based on major and ancillary imaging features. LI-RADS also includes imaging features suggesting malignancy other than HCC. Supported and endorsed by the American College of Radiology (ACR), the system has been developed by a committee of radiologists, hepatologists, pathologists, surgeons, lexicon experts, and ACR staff, with input from the American Association for the Study of Liver Diseases and the Organ Procurement Transplantation Network/United Network for Organ Sharing...
November 21, 2017: Radiology
https://www.readbyqxmd.com/read/29165794/leptomeningeal-metastasis-from-systemic-cancer-review-and-update-on-management
#3
REVIEW
Nancy Wang, Mia S Bertalan, Priscilla K Brastianos
Leptomeningeal metastasis is an uncommon and typically late complication of cancer with a poor prognosis and limited treatment options. Diagnosis is often challenging, with nonspecific presenting symptoms ranging from headache and confusion to focal neurologic deficits, such as cranial nerve palsies. Standard diagnostic evaluation involves a neurologic examination, magnetic resonance imaging of the brain and spine with gadolinium, and cytologic evaluation of the cerebral spinal fluid. Therapy entails a multimodal approach focused on palliation with surgery, radiation, and/or chemotherapy, which may be administered systemically or directly into the cerebral spinal fluid...
November 22, 2017: Cancer
https://www.readbyqxmd.com/read/29165595/con-the-role-of-diet-for-people-with-advanced-stage-5-ckd
#4
Graham Woodrow
Restriction of dietary protein intake has been used in the management of chronic kidney disease (CKD) for many decades, yet remains controversial, with marked variations in its application in clinical practice. There is extensive literature on the subject, with some expert opinion advocating the use of protein restriction based on the balance of the available evidence. The largest randomized trial of low-protein diets is the Modification of Diet in Renal Disease study. Despite multiple secondary analyses, the essential intention-to-treat analysis failed to demonstrate a benefit in the primary outcome of rate of decline of glomerular filtration rate...
November 17, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29164029/a-clinical-practice-guideline-for-the-management-of-patients-with-acute-spinal-cord-injury-recommendations-on-the-type-and-timing-of-rehabilitation
#5
Michael G Fehlings, Lindsay A Tetreault, Bizhan Aarabi, Paul Anderson, Paul M Arnold, Darrel S Brodke, Kazuhiro Chiba, Joseph R Dettori, Julio C Furlan, James S Harrop, Gregory Hawryluk, Langston T Holly, Susan Howley, Tara Jeji, Sukhvinder Kalsi-Ryan, Mark Kotter, Shekar Kurpad, Brian K Kwon, Ralph J Marino, Allan R Martin, Eric Massicotte, Geno Merli, James W Middleton, Hiroaki Nakashima, Narihito Nagoshi, Katherine Palmieri, Anoushka Singh, Andrea C Skelly, Eve C Tsai, Alexander Vaccaro, Jefferson R Wilson, Albert Yee, Anthony S Burns
Introduction: The objective of this study is to develop guidelines that outline the appropriate type and timing of rehabilitation in patients with acute spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to rehabilitation in patients with acute SCI. A multidisciplinary guideline development group used this information, and their clinical expertise, to develop recommendations for the type and timing of rehabilitation...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164026/a-clinical-practice-guideline-for-the-management-of-patients-with-acute-spinal-cord-injury-recommendations-on-the-type-and-timing-of-anticoagulant-thromboprophylaxis
#6
Michael G Fehlings, Lindsay A Tetreault, Bizhan Aarabi, Paul Anderson, Paul M Arnold, Darrel S Brodke, Anthony S Burns, Kazuhiro Chiba, Joseph R Dettori, Julio C Furlan, Gregory Hawryluk, Langston T Holly, Susan Howley, Tara Jeji, Sukhvinder Kalsi-Ryan, Mark Kotter, Shekar Kurpad, Brian K Kwon, Ralph J Marino, Allan R Martin, Eric Massicotte, Geno Merli, James W Middleton, Hiroaki Nakashima, Narihito Nagoshi, Katherine Palmieri, Anoushka Singh, Andrea C Skelly, Eve C Tsai, Alexander Vaccaro, Jefferson R Wilson, Albert Yee, James S Harrop
Introduction: The objective of this study is to develop evidence-based guidelines that recommend effective, safe and cost-effective thromboprophylaxis strategies in patients with spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions relating to thromboprophylaxis in SCI. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as "we recommend," whereas a weaker recommendation is indicated by "we suggest...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29163939/infection-prevention-and-control-measures-and-tools-for-the-prevention-of-entry-of-carbapenem-resistant-enterobacteriaceae-into-healthcare-settings-guidance-from-the-european-centre-for-disease-prevention-and-control
#7
A P Magiorakos, K Burns, J Rodríguez Baño, M Borg, G Daikos, U Dumpis, J C Lucet, M L Moro, E Tacconelli, G Skov Simonsen, E Szilágyi, A Voss, J T Weber
Background: Infections with carbapenem-resistant Enterobacteriaceae (CRE) are increasingly being reported from patients in healthcare settings. They are associated with high patient morbidity, attributable mortality and hospital costs. Patients who are "at-risk" may be carriers of these multidrug-resistant Enterobacteriaceae (MDR-E).The purpose of this guidance is to raise awareness and identify the "at-risk" patient when admitted to a healthcare setting and to outline effective infection prevention and control measures to halt the entry and spread of CRE...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29162977/perioperative-management-of-patients-with-diabetes
#8
REVIEW
Vivien Leung, Kristal Ragbir-Toolsie
Hyperglycemia has long been recognized to have detrimental effects on postoperative outcomes in patients undergoing surgery. The manifestations of uncontrolled diabetes are manifold and can include risk of hyperglycemic crises, postoperative infection, poor wound healing, and increased mortality. There is substantial literature supporting the role of diligent glucose control in the prevention of adverse surgical outcomes, but considerable debate remains as to the optimal glucose targets. Hence, most organizations advocate the avoidance of hypoglycemia while striving for adequate glucose control in the perioperative period...
2017: Health Services Insights
https://www.readbyqxmd.com/read/29157038/applying-u-s-national-guidelines-for-ototoxicity-monitoring-in-adult-patients-perspectives-on-patient-populations-service-gaps-barriers-and-solutions
#9
Dawn Konrad-Martin, Gayla L Poling, Angela C Garinis, Candice E Ortiz, Jennifer Hopper, Keri O'Connell Bennett, Marilyn F Dille
OBJECTIVES: To promote establishment of effective ototoxicity monitoring programs (OMPs), this report reviews the U.S. national audiology guidelines in relation to "real world" OMP application. Background is provided on the mechanisms, risks and clinical presentation of hearing loss associated with major classes of ototoxic medications. DESIGN: This is a non-systematic review using PubMed, national and international agency websites, personal communications between ototoxicity experts, and results of unpublished research...
November 20, 2017: International Journal of Audiology
https://www.readbyqxmd.com/read/29157020/pharmacokinetic-drug-evaluation-of-mepolizumab-for-the-treatment-of-severe-asthma-associated-with-persistent-eosinophilic-inflammation-in-adults
#10
Lakshmi Kallur, Alexei Gonzalez-Estrada, Frank Eidelman, Ves Dimov
Mepolizumab is a humanized monoclonal antibody that binds to and inactivates IL-5. It is available as a subcutaneous preparation. The practical application of mepolizumab is as an add-on therapy in the treatment of severe eosinophilic asthma. Areas covered: This article was created from a comprehensive literature search with information taken from meta-analyses, systematic reviews, and clinical trials of adults. The articles that have been selected evaluate the use of mepolizumab and its role in eosinophilic asthma...
November 21, 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29155929/pan-asian-adapted-esmo-consensus-guidelines-for-the-management-of-patients-with-metastatic-colorectal-cancer-a-jsmo-esmo-initiative-endorsed-by-csco-kaco-mos-sso-and-tos
#11
T Yoshino, D Arnold, H Taniguchi, G Pentheroudakis, K Yamazaki, R-H Xu, T W Kim, F Ismail, I B Tan, K-H Yeh, A Grothey, S Zhang, J B Ahn, D Chong, L-T Chen, S Kopetz, T Eguchi-Nakajima, H Ebi, A Ohtsu, A Cervantes, K Muro, J Tabernero, H Minami, F Ciardiello, J-Y Douillard
The most recent version of the European Society for Medical Oncology (ESMO) consensus guidelines for the treatment of patients with metastatic colorectal cancer (mCRC) was published in 2016, identifying both a more strategic approach to the administration of the available systemic therapy choices, and a greater emphasis on the use of ablative techniques, including surgery. At the 2016 ESMO Asia Meeting, in December 2016, it was decided by both ESMO and the Japanese Society of Medical Oncology (JSMO) to convene a special guidelines meeting, endorsed by both ESMO and JSMO, immediately after the JSMO 2017 Annual Meeting...
November 16, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29154106/diagnostic-criteria-for-idiopathic-pulmonary-fibrosis-a-fleischner-society-white-paper
#12
REVIEW
David A Lynch, Nicola Sverzellati, William D Travis, Kevin K Brown, Thomas V Colby, Jeffrey R Galvin, Jonathan G Goldin, David M Hansell, Yoshikazu Inoue, Takeshi Johkoh, Andrew G Nicholson, Shandra L Knight, Suhail Raoof, Luca Richeldi, Christopher J Ryerson, Jay H Ryu, Athol U Wells
This Review provides an updated approach to the diagnosis of idiopathic pulmonary fibrosis (IPF), based on a systematic search of the medical literature and the expert opinion of members of the Fleischner Society. A checklist is provided for the clinical evaluation of patients with suspected usual interstitial pneumonia (UIP). The role of CT is expanded to permit diagnosis of IPF without surgical lung biopsy in select cases when CT shows a probable UIP pattern. Additional investigations, including surgical lung biopsy, should be considered in patients with either clinical or CT findings that are indeterminate for IPF...
November 15, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29153743/what-do-help-seeking-measures-assess-building-a-conceptualization-framework-for-help-seeking-intentions-through-a-systematic-review-of-measure-content
#13
REVIEW
Margaret M White, Bonnie A Clough, Leanne M Casey
Mental health services are underutilised by people who could benefit from treatment. Research into help-seeking intentions (HSI) is required to support interventions to increase service use. Existing HSI measures are not psychometrically robust and problems with content validity undermine research in this field. Our purpose was to create a clear conceptualization of HSI and systematically review the content of existing measures. Previous researchers had defined help-seeking and intentions separately, so the first step was to create a more comprehensive definition...
November 10, 2017: Clinical Psychology Review
https://www.readbyqxmd.com/read/29153464/international-guideline-for-the-delineation-of-the-clinical-target-volumes-ctv-for-nasopharyngeal-carcinoma
#14
Anne W Lee, Wai Tong Ng, Jian Ji Pan, Sharon S Poh, Yong Chan Ahn, Hussain AlHussain, June Corry, Cai Grau, Vincent Grégoire, Kevin J Harrington, Chao Su Hu, Dora L Kwong, Johannes A Langendijk, Quynh Thu Le, Nancy Y Lee, Jin Ching Lin, Tai Xiang Lu, William M Mendenhall, Brian O'Sullivan, Enis Ozyar, Lester J Peters, David I Rosenthal, Yoke Lim Soong, Yungan Tao, Sue S Yom, Joseph T Wee
PURPOSE: Target delineation in nasopharyngeal carcinoma (NPC) often proves challenging because of the notoriously narrow therapeutic margin. High doses are needed to achieve optimal levels of tumour control, and dosimetric inadequacy remains one of the most important independent factors affecting treatment outcome. METHOD: A review of the available literature addressing the natural behaviour of NPC and correlation between clinical and pathological aspects of the disease was conducted...
November 15, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29150883/finding-the-needle-in-the-haystack-is-teledermoscopy-s-task
#15
Lara Ferrándiz, Almudena Fernández-Orland, David Moreno-Ramírez
We read with interest the recent letter in this journal by Kukutsch et al. as to the opinion of an international group of experts on dermoscopy about the practice of teledermoscopy (TDC) between primary care physicians (PCPs) and a remote dermatologist. This article is protected by copyright. All rights reserved.
November 17, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29149644/assessing-the-risk-of-laparoscopic-morcellation-of-occult-uterine-sarcomas-during-hysterectomy-and-myomectomy-literature-review-and-the-isge-recommendations
#16
REVIEW
Ornella Sizzi, Lucia Manganaro, Alfonso Rossetti, Matteo Saldari, Giuseppe Florio, Alessandro Loddo, Robert Zurawin, Bruno van Herendael, Dusan Djokovic
OBJECTIVE: This project of the International Society for Gynecologic Endoscopy (ISGE) had the objective to review the literature and provide recommendations on the occult sarcoma risk assessment in patients who are candidates for minimally invasive gynecological surgery involving intra-abdominal electromechanical tissue morcellation. STUDY DESIGN: The ISGE Task Force for Estimation of the Risk in Endoscopic Morcellation initially defined key topics and clinical questions which may guide a comprehensive preoperative patient assessment...
November 7, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29148858/from-bench-to-almost-bedside-the-long-road-to-a-licensed-ebola-virus-vaccine
#17
Gary Wong, Emelissa J Mendoza, Francis A Plummer, George F Gao, Gary P Kobinger, Xiangguo Qiu
The Ebola virus (EBOV) disease epidemic during 2014-16 in West Africa has accelerated the clinical development of several vaccine candidates that have demonstrated efficacy in the gold standard nonhuman primate (NHP) model, namely cynomolgus macaques. Areas covered: This review discusses the pre-clinical research and if available, clinical evaluation of the currently available EBOV vaccine candidates, while emphasizing the translatability of pre-clinical data generated in the NHP model to clinical data in humans...
November 17, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/29148851/airway-geometry-airway-flow-and-particle-measurement-methods-implications-on-pulmonary-drug-delivery
#18
A Kourmatzis, S Cheng, H-K Chan
The effectiveness of drug delivery to the lungs is inextricably linked to the fundamental interactions that occur between particles and flow in the extrathoracic airway. Research in this field requires time resolved in-vivo and in-vitro measurements of three separate, yet intricately linked parameters: i) airway flow, ii) airway geometry, and iii) drug particle characteristics. A number of recent significant developments have been made in the experimental diagnostic tools used to characterise these parameters...
November 17, 2017: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/29148850/atad2-in-cancer-a-pharmacologically-challenging-but-tractable-target
#19
Muzammal Hussain, Yang Zhou, Yu Song, H M Adnan Hameed, Hao Jiang, Yaoquan Tu, Jiancun Zhang
ATAD2 protein is an emerging oncogene that has strongly been linked to the etiology of multiple advanced human cancers. Therapeutically, despite the fact that genetic suppression/knockdown studies have validated it as a compelling drug target for future therapeutic development, recent druggability assessment data suggest that direct targeting of ATAD2's bromodomain (BRD) may be a very challenging task. ATAD2's BRD has been predicted as a "difficult to drug" or "least druggable" target due to the concern that its binding pocket, and the areas around it, seem to be unfeasible for ligand binding...
November 17, 2017: Expert Opinion on Therapeutic Targets
https://www.readbyqxmd.com/read/29148847/emerging-therapeutic-targets-in-myeloproliferative-neoplasms-and-peripheral-t-cell-leukemia-and-lymphomas
#20
Anna Orlova, Bettina Wingelhofer, Heidi A Neubauer, Barbara Maurer, Angelika Berger-Becvar, György Miklós Keserű, Patrick T Gunning, Peter Valent, Richard Moriggl
Hematopoietic neoplasms are often driven by gain-of-function mutations of the JAK-STAT pathway together with mutations of chromatin remodeling and DNA damage control pathways. The interconnection between the JAK-STAT pathway, epigenetic regulation or DNA damage control is still poorly understood in cancer cell biology. Areas covered: Here, we focus on a broader description of mutational insights into myeloproliferative neoplasms and peripheral T-cell leukemia and lymphomas, since sequencing efforts have identified similar combinations of driver mutations in these diseases covering different lineages...
November 17, 2017: Expert Opinion on Therapeutic Targets
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