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Pre-Test Probability

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https://www.readbyqxmd.com/read/29145893/normalization-of-the-microbiota-in-patients-after-treatment-for-colonic-lesions
#1
Marc A Sze, Nielson T Baxter, Mack T Ruffin, Mary A M Rogers, Patrick D Schloss
BACKGROUND: Colorectal cancer is a worldwide health problem. Despite growing evidence that members of the gut microbiota can drive tumorigenesis, little is known about what happens to it after treatment for an adenoma or carcinoma. This study tested the hypothesis that treatment for adenoma or carcinoma alters the abundance of bacterial populations associated with disease to those associated with a normal colon. We tested this hypothesis by sequencing the 16S rRNA genes in the feces of 67 individuals before and after treatment for adenoma (N = 22), advanced adenoma (N = 19), and carcinoma (N = 26)...
November 16, 2017: Microbiome
https://www.readbyqxmd.com/read/29144422/atypical-processing-of-novel-distracters-in-a-visual-oddball-task-in-autism-spectrum-disorder
#2
Estate M Sokhadze, Eva V Lamina, Emily L Casanova, Desmond P Kelly, Ioan Opris, Irma Khachidze, Manuel F Casanova
Several studies have shown that children with autism spectrum disorder (ASD) show abnormalities in P3b to targets in standard oddball tasks. The present study employed a three-stimulus visual oddball task with novel distracters that analyzed event-related potentials (ERP) to both target and non-target items at frontal and parietal sites. The task tested the hypothesis that children with autism are abnormally orienting attention to distracters probably due to impaired habituation to novelty. We predicted a lower selectivity in early ERPs to target, frequent non-target, and rare distracters...
November 16, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/29133377/information-provided-by-diagnostic-and-screening-tests-improving-probabilities
#3
REVIEW
Mark Weatherall
Uncertainty in clinical encounters is inevitable and despite this uncertainty clinicians must still work with patients to make diagnostic and treatment decisions. Explicit diagnostic reasoning based on probabilities will optimise information in relation to uncertainty. In clinical diagnostic encounters, there is often pre-existing information that reflects the probability any particular patient has a disease. Diagnostic testing provides extra information that refines diagnostic probabilities. However, in general diagnostic tests will be positive in most, but not all cases of disease (sensitivity) and may not be negative in all cases of disease absence (specificity)...
November 13, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29131822/impact-of-the-ebola-outbreak-on-trypanosoma-brucei-gambiense-infection-medical-activities-in-coastal-guinea-2014-2015-a-retrospective-analysis-from-the-guinean-national-human-african-trypanosomiasis-control-program
#4
Mariame Camara, Eric Ouattara, Alexandre Duvignaud, René Migliani, Oumou Camara, Mamadou Leno, Philippe Solano, Bruno Bucheton, Mamadou Camara, Denis Malvy
BACKGROUND: The 2014-2015 Ebola outbreak massively hit Guinea. The coastal districts of Boffa, Dubreka and Forecariah, three major foci of Human African Trypanosomiasis (HAT), were particularly affected. We aimed to assess the impact of this epidemic on sleeping sickness screening and caring activities. METHODOLOGY/PRINCIPAL FINDINGS: We used preexisting data from the Guinean sleeping sickness control program, collected between 2012 and 2015. We described monthly: the number of persons (i) screened actively; (ii) or passively; (iii) treated for HAT; (iv) attending post-treatment follow-up visits...
November 13, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29126642/human-exposure-assessment-to-antibiotic-resistant-escherichia-coli-through-drinking-water
#5
E O'Flaherty, C M Borrego, J L Balcázar, E Cummins
Antibiotic-resistant bacteria (ARB) are a potential threat to human health through drinking water with strong evidence of ARB presence in post treated tap water around the world. This study examines potential human exposure to antibiotic-resistant (AR) Escherichia coli (E. coli) through drinking water, the effect of different drinking water treatments on AR E. coli and the concentration of AR E. coli required in the source water for the EU Drinking Water Directive (DWD) (Council Directive 98/83/EC, 0CFU/100ml of E...
November 7, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29125695/age-adjusted-d-dimer-to-rule-out-deep-vein-thrombosis-findings-from-the-palladio-algorithm
#6
Nicoletta Riva, Giuseppe Camporese, Matteo Iotti, Eugenio Bucherini, Marc Righini, Pieter W Kamphuisen, Peter Verhamme, James D Douketis, Chiara Tonello, Paolo Prandoni, Walter Ageno
BACKGROUND: Age-adjusted D-dimer has been proposed to increase specificity for the diagnosis of venous thromboembolism (VTE). However, the accuracy of this threshold has been recently questioned. OBJECTIVES: To assess the diagnostic performance of age-adjusted D-dimer combined with clinical pre-test probability (PTP) in patients with suspected deep vein thrombosis (DVT). METHODS: PALLADIO (NCT01412242) was a multicentre management study that validated a new diagnostic algorithm, incorporating PTP, D-dimer (using manufacturers' cut-off), and limited or extended compression ultrasonography (CUS) in outpatients with clinically suspected DVT...
November 10, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29123632/management-of-post-endodontic-retreatment-pain-with-low-level-laser-therapy
#7
Mohammad Asnaashari, Hengameh Ashraf, Amir Houshang Daghayeghi, Seyed Masoud Mojahedi, Saranaz Azari-Marhabi
Introduction: Pharmacotherapy with analgesics and non-steroidal anti-inflammatory drugs has been traditionally used to relief post-operative pain of endodontic treatments. However, due to the side effects reported for these drugs, some efforts have been made to decrease the post-operative pain of the endodontic treatments through laser irradiation. The present study aimed to evaluate the effects of low level laser therapy (LLLT) on the reduction of pain after root canal retreatment. Methods: In this clinical trial, 61 patients requiring endodontic retreatments in posterior teeth were selected...
2017: Journal of Lasers in Medical Sciences
https://www.readbyqxmd.com/read/29122104/the-diagnosis-of-chronic-coronary-heart-disease
#8
Christian Albus, Jörg Barkhausen, Eckart Fleck, Jörg Haasenritter, Oliver Lindner, Sigmund Silber
BACKGROUND: Chronic coronary heart disease (CHD) and acute myocardial infarction are endemic conditions. In Germany, an estimated 900 000 cardiac catheterizations were performed in the year 2014, and a percutaneous intervention was carried out in 40% of these procedures. It would be desirable to lessen the number of invasive diagnostic procedures while preserving the reliability of diagnosis. In this article, we present the updated recommendations of the German National Care Guideline for Chronic CHD with regard to diagnostic evaluation...
October 20, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29121350/individualized-fsh-dosing-based-on-ovarian-reserve-testing-in-women-starting-ivf-icsi-a-multicentre-trial-and-cost-effectiveness-analysis
#9
Theodora C van Tilborg, Simone C Oudshoorn, Marinus J C Eijkemans, Monique H Mochtar, Ron J T van Golde, Annemieke Hoek, Walter K H Kuchenbecker, Kathrin Fleischer, Jan Peter de Bruin, Henk Groen, Madelon van Wely, Cornelis B Lambalk, Joop S E Laven, Ben Willem J Mol, Frank J M Broekmans, Helen L Torrance
STUDY QUESTION: Is there a difference in live birth rate and/or cost-effectiveness between antral follicle count (AFC)-based individualized FSH dosing or standard FSH dosing in women starting IVF or ICSI treatment? SUMMARY ANSWER: In women initiating IVF/ICSI, AFC-based individualized FSH dosing does not improve live birth rates or reduce costs as compared to a standard FSH dose. WHAT IS KNOWN ALREADY: In IVF or ICSI, ovarian reserve testing is often used to adjust the FSH dose in order to normalize ovarian response and optimize live birth rates...
November 7, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29121269/individualized-versus-standard-fsh-dosing-in-women-starting-ivf-icsi-an-rct-part-2-the-predicted-hyper-responder
#10
Simone C Oudshoorn, Theodora C van Tilborg, Marinus J C Eijkemans, G Jur E Oosterhuis, Jaap Friederich, Marcel H A van Hooff, Evert J P van Santbrink, Egbert A Brinkhuis, Jesper M J Smeenk, Janet Kwee, Corry H de Koning, Henk Groen, Cornelis B Lambalk, Ben Willem J Mol, Frank J M Broekmans, Helen L Torrance
STUDY QUESTION: Does a reduced FSH dose in women with a predicted hyper response, apparent from a high antral follicle count (AFC), who are scheduled for IVF/ICSI lead to a different outcome with respect to cumulative live birth rate and safety? SUMMARY ANSWER: Although in women with a predicted hyper response (AFC > 15) undergoing IVF/ICSI a reduced FSH dose (100 IU per day) results in similar cumulative live birth rates and a lower occurrence of any grade of ovarian hyperstimulation syndrome (OHSS) as compared to a standard dose (150 IU/day), a higher first cycle cancellation rate and similar severe OHSS rate were observed...
November 7, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29108786/early-phase-clinical-trial-designs-state-of-play-and-adapting-for-the-future
#11
J A Harrington, T C Hernandez-Guerrero, B Basu
The process of anti-cancer drug development is complex, with high attrition rates. Factors that may optimise this process include well-constructed and relevant pre-clinical testing and use of biomarkers for patient selection. However, the design of early phase clinical trials will probably play a vital role in both the robust clinical investigation of new targeted therapies and in streamlining drug development. In this overview, we assess current concepts in phase I clinical trials, highlighting issues and opportunities to improve their meaningfulness...
November 3, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29107851/are-wisc-iq-scores-in-children-with-mathematical-learning-disabilities-underestimated-the-influence-of-a-specialized-intervention-on-test-performance
#12
Katharina Lambert, Birgit Spinath
BACKGROUND: Intelligence measures play a pivotal role in the diagnosis of mathematical learning disabilities (MLD). Probably as a result of math-related material in IQ tests, children with MLD often display reduced IQ scores. However, it remains unclear whether the effects of math remediation extend to IQ scores. AIMS: The present study investigated the impact of a special remediation program compared to a control group receiving private tutoring (PT) on the WISC IQ scores of children with MLD...
October 28, 2017: Research in Developmental Disabilities
https://www.readbyqxmd.com/read/29102995/selecting-ph-cut-offs-for-the-safe-verification-of-nasogastric-feeding-tube-placement-a-decision-analytical-modelling-approach
#13
Melody Zhifang Ni, Jeremy R Huddy, Oliver H Priest, Sisse Olsen, Lawrence D Phillips, Patrick M M Bossuyt, George B Hanna
OBJECTIVES: The existing British National Patient Safety Agency (NPSA) safety guideline recommends testing the pH of nasogastric (NG) tube aspirates. Feeding is considered safe if a pH of 5.5 or lower has been observed; otherwise chest X-rays are recommended. Our previous research found that at 5.5, the pH test lacks sensitivity towards oesophageal placements, a major risk identified by feeding experts. The aim of this research is to use a decision analytic modelling approach to systematically assess the safety of the pH test under cut-offs 1-9...
November 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/29102761/a-rapid-scoring-tool-to-assess-mutation-probability-in-patients-with-inherited-cardiac-disorders
#14
Dominica Zentner, Tina Thompson, Jessica Taylor, Michael Bogwitz, Alison Trainer, Jitendra Vohra, Ingrid Winship, Paul A James
AIMS: To explore clinical features and relationship with positive mutation ascertainment in inherited heart diseases in order to develop a clinical tool to assist identification of individuals in whom to offer genetic testing. A clinical tool that increases pre test probability of mutation detection would have the benefits of improving patient counselling, prioritising cases for MPS and allowing equity in decision making. METHODS AND RESULTS: Consecutive MPS mutation detection testing cases were identified (September 2014 - December 2015, n = 126)...
November 1, 2017: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/29098714/a-potential-new-form-of-jail-diversion-and-reconnection-to-mental-health-services-ii-demonstration-of-feasibility
#15
Michael T Compton, Simone Anderson, Beth Broussard, Samantha Ellis, Brooke Halpern, Luca Pauselli, Marsha O'Neal, Benjamin G Druss, Mark Johnson
Given fragmentation between mental health and criminal justice systems, we tested the feasibility of implementing a potential new form of pre-booking jail diversion. Our "linkage system" consists of three steps: (i) individuals with serious mental illnesses and an arrest history give special consent to be enrolled in a statewide database; (ii) if an officer has an encounter with an enrolled patient and runs a routine background check, he or she receives an electronic message to call; and (iii) the "linkage specialist" provides brief telephonic assistance to the officer...
November 2, 2017: Behavioral Sciences & the Law
https://www.readbyqxmd.com/read/29097867/dysphagia-thinking-outside-the-box
#16
REVIEW
Hamish Philpott, Mayur Garg, Dunya Tomic, Smrithya Balasubramanian, Rami Sweis
Dysphagia is a common symptom that is important to recognise and appropriately manage, given that causes include life threatening oesophageal neoplasia, oropharyngeal dysfunction, the risk of aspiration, as well as chronic disabling gastroesophageal reflux (GORD). The predominant causes of dysphagia varies between cohorts depending on the interplay between genetic predisposition and environmental risk factors, and is changing with time. Currently in white Caucasian societies adopting a western lifestyle, obesity is common and thus associated gastroesophageal reflux disease is increasingly diagnosed...
October 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29081993/is-more-research-always-needed-estimating-optimal-sample-sizes-for-trials-of-retention-in-care-interventions-for-hiv-positive-east-africans
#17
Jennifer Uyei, Lingfeng Li, R Scott Braithwaite
INTRODUCTION: Given the serious health consequences of discontinuing antiretroviral therapy, randomised control trials of interventions to improve retention in care may be warranted. As funding for global HIV research is finite, it may be argued that choices about sample size should be tied to maximising health. METHODS: For an East African setting, we calculated expected value of sample information and expected net benefit of sampling to identify the optimal sample size (greatest return on investment) and to quantify net health gains associated with research...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29066216/performance-of-the-genotype-mtbdrsl-assay-for-the-detection-second-line-anti-tuberculosis-drug-resistance
#18
Young Seok Lee, Bo Young Lee, Kyung-Wook Jo, Tae Sun Shim
The rapid detection of drug-resistant tuberculosis (TB) is important to improve treatment outcomes and prevent disease transmission. The GenoType MTBDRsl assay (MTBDRsl assay) was developed to detect fluoroquinolone (FQ) and second-line injectable drug (SLID) resistance. The aim of this study was to evaluate the performance and clinical utility of MTBDRsl assay. We retrospectively reviewed patient medical records with MTBDRsl assay data between December 2011 and February 2017. MTBDRsl assay results were compared with that of phenotypic drug susceptibility testing...
October 20, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29064366/spot-protein-creatinine-ratio-and-spot-albumin-creatinine-ratio-in-the-assessment-of-pre-eclampsia-a-diagnostic-accuracy-study-with-decision-analytic-model-based-economic-evaluation-and-acceptability-analysis
#19
Jason Waugh, Richard Hooper, Edmund Lamb, Stephen Robson, Andrew Shennan, Fiona Milne, Christopher Price, Shakila Thangaratinam, Vladislav Berdunov, Jenn Bingham
BACKGROUND: The National Institute for Health and Care Excellence (NICE) guidelines highlighted the need for 'large, high-quality prospective studies comparing the various methods of measuring proteinuria in women with new-onset hypertensive disorders during pregnancy'. OBJECTIVES: The primary objective was to evaluate quantitative assessments of spot protein-creatinine ratio (SPCR) and spot albumin-creatinine ratio (SACR) in predicting severe pre-eclampsia (PE) compared with 24-hour urine protein measurement...
October 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29063164/pre-concentration-and-separation-of-bacteria-by-volume-coupling-electrophoresis-on-supercritical-water-etched-fused-silica-capillary-with-two-segments-of-different-internal-diameters-and-inner-surface-roughnesses
#20
Marie Horká, Pavel Karásek, Michal Roth, Filip Růžička
The transient isotachophoretic stacking and sweeping was used for the on-line large-volume sample pre-concentration of bacteria, Escherichia coli and Staphylococcus aureus cells (methicillin-susceptible or methicillin-resistant), in the initial stage of micellar electrokinetic chromatography using a non-ionogenic surfactant or of capillary electrophoresis, respectively. These procedures were employed in single-piece fused silica capillary etched with supercritical water with two different internal diameter segments featuring different inner surface roughness...
October 23, 2017: Analytical and Bioanalytical Chemistry
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