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Knowledge based treatment planning

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https://www.readbyqxmd.com/read/28749392/evaluation-of-evidence-for-pharmacokinetics-pharmacodynamics-based-dose-optimization-of-antimicrobials-for-treating-gram-negative-infections-in-neonates
#1
REVIEW
Nusrat Shafiq, Samir Malhotra, Vikas Gautam, Harpreet Kaur, Pravin Kumar, Sourabh Dutta, Pallab Ray, Nilima A Kshirsagar
BACKGROUND & OBJECTIVES: Neonates present a special subgroup of population in whom optimization of antimicrobial dosing can be particularly challenging. Gram-negative infections are common in neonates, and inpatient treatment along with critical care is needed for the management of these infections. Dosing recommendations are often extrapolated from evidence generated in older patient populations. This systematic review was done to identify the knowledge gaps in the pharmacokinetics-pharmacodynamics (PK-PD)-based optimized dosing schedule for parenteral antimicrobials for Gram-negative neonatal infections...
March 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28749165/impact-of-robotic-ultrasound-image-guidance-on-plan-quality-in-sbrt-of-the-prostate
#2
Stefan Gerlach, Ivo Kuhlemann, Floris Ernst, Christoph Fürweger, Alexander Schlaefer
OBJECTIVES: Ultrasound provides good image quality, fast volumetric imaging, and is established for abdominal image guidance. Robotic transducer placement may facilitate intra-fractional motion compensation in radiation therapy. We consider integration with the CyberKnife and study whether the kinematic redundancy of a seven-degrees-of-freedom robot allows for acceptable plan quality for prostate treatments. METHODS: Reference treatment plans were generated for ten prostate cancer cases previously treated with the CyberKnife...
July 27, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28747295/motivate-a-pretreatment-web-based-program-to-improve-attendance-at-uk-outpatient-services-among-adults-with-eating-disorders
#3
Sarah Muir, Ciarán Newell, Jess Griffiths, Kathy Walker, Holly Hooper, Sarah Thomas, Peter W Thomas, Jon Arcelus, James Day, Katherine M Appleton
BACKGROUND: In the UK, eating disorders affect upward of 725,000 people per year, and early assessment and treatment are important for patient outcomes. Around a third of adult outpatients in the UK who are referred to specialist eating disorder services do not attend, which could be related to patient factors related to ambivalence, fear, and a lack of confidence about change. This lack of engagement has a negative impact on the quality of life of patients and has implications for service costs...
July 26, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28734650/treatment-of-cracked-teeth
#4
Shaymaa Alkhalifah, Halimah Alkandari, Prem N Sharma, Alex J Moule
Although many options are proposed for the treatment of cracked posterior teeth, most treatment decisions are not evidence based. Thus, considerable individual variation can occur regarding treatment recommendations for the same scenario. To our knowledge, there are no studies in the literature assessing practitioners' attitudes toward the treatment of cracked teeth. This research recorded variations between general practitioners and specialist groups regarding the treatment approaches of cracked teeth. In a cross-sectional structured questionnaire survey, 32 prosthodontists, 34 endodontists, and 29 general practitioners working in public and private dental health services in Kuwait were assessed regarding their treatment approach to 5 different clinical cracked tooth scenarios...
July 19, 2017: Journal of Endodontics
https://www.readbyqxmd.com/read/28731267/heuristic-knowledge-based-planning-for-single-isocenter-stereotactic-radiosurgery-to-multiple-brain-metastases
#5
Benjamin P Ziemer, Parag Sanghvi, Jona Hattangadi-Gluth, Kevin L Moore
PURPOSE: Single-isocenter, volumetric modulated arc therapy (VMAT) stereotactic radiosurgery (SRS) for multiple brain metastases (multi-mets) can deliver highly conformal dose distributions and reduce overall patient treatment time compared to other techniques. However, treatment planning for multi-met cases is highly complex due to variability in numbers and sizes of brain metastases, as well as their relative proximity to organs-at-risk (OARs). The purpose of this study was to automate the VMAT planning of multi-met cases through a knowledge-based planning (KBP) approach that adapts single target SRS dose predictions to multiple target predictions...
July 21, 2017: Medical Physics
https://www.readbyqxmd.com/read/28727985/comparative-study-and-analytical-verification-of-pcr-methods-for-the-diagnosis-of-congenital-chagas-disease
#6
Carolina Inés Cura, Juan Carlos Ramírez, Marcelo Rodríguez, Constanza Lopez-Albízu, Lucía Irazu, Karenina Scollo, Sergio Sosa-Estani
Congenital infection is currently the first cause of new cases of Chagas disease in Argentina and nonendemic areas worldwide. Its diagnosis is of utmost importance to guarantee curative treatment. To improve such diagnosis, a transfer process of PCR tests to the national laboratory network has been initiated. We performed a comparative study of four PCR assays [two end-point PCR and two duplex real-time quantitative PCR (qPCR) procedures] to detect Trypanosoma cruzi DNA in blood samples. Because satellite DNA and kinetoplastid DNA qPCR methods have the best performance and the use of two different molecular targets for confirmatory purposes has been recommended, these methods selected to perform the transfer process and, in consequence, subjected to an analytical verification protocol based on international guidelines...
July 17, 2017: Journal of Molecular Diagnostics: JMD
https://www.readbyqxmd.com/read/28724394/development-of-newborn-screening-connect-nbs-connect-a-self-reported-patient-registry-and-its-role-in-improvement-of-care-for-patients-with-inherited-metabolic-disorders
#7
Yetsa Osara, Kathryn Coakley, Aishwarya Devarajan, Rani H Singh
BACKGROUND: Newborn Screening Connect (NBS Connect) is a web-based self-reported patient registry and resource for individuals and families affected by disorders included in the newborn screening panel. NBS Connect was launched in 2012 by Emory University after years of planning and grassroots work by professionals, consumers, and industry. Individuals with phenylketonuria (PKU), maple syrup urine disease (MSUD) or tyrosinemia (TYR) have been recruited through distribution of outreach materials, presentations at parent organization meetings and direct recruitment at clinic appointments...
July 19, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28717978/-treatment-strategy-and-planning-for-pilon-fractures
#8
REVIEW
Thomas Mittlmeier, Alice Wichelhaus
BACKGROUND: Pilon fractures are mainly severe and prognostically serious injuries with a high rate of relevant soft tissue involvement. The adequate decision making and choice of treatment in the early phase of trauma are of paramount importance for the final outcome. This essentially encompasses the management of the soft tissue damage, the surgical planning and the differentiated selection of procedures. GOALS/MATERIAL AND METHODS: Most concepts of staged treatment nowadays offer a wide range of options which are integrated into expert-based algorithms...
July 17, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28716205/attitudes-towards-worm-egg-counts-and-targeted-selective-treatment-against-equine-cyathostomins
#9
H Rose Vineer, F Vande Velde, K Bull, E Claerebout, E R Morgan
Gastrointestinal nematodes present a major threat to the health and welfare of equids worldwide. Anthelmintic resistance (AR) is increasingly reported and challenges effective control in horses and ponies in many regions. The use of faecal worm egg counts (FECs) to support targeted treatment (FEC-TT) and targeted selective treatment (FEC-TST) has been promoted as an effective deworming strategy that may prolong the useful life of anthelmintics and reduce the costs associated with parasite control. However, treatment applied at set intervals or on pre-determined dates remains common...
September 1, 2017: Preventive Veterinary Medicine
https://www.readbyqxmd.com/read/28715904/considerations-for-optimal-management-of-patients-with-pulmonary-arterial-hypertension-a-multi-stakeholder-roundtable-discussion
#10
Sean M Studer, Martha Kingman, Luis Calo, H Eric Cannon, Jeffrey D Dunn, Thomas James, Sonya J Lewis, Robert J Gilkin, Janis A Pruett
A roundtable panel of national and regional managed care decision makers and providers met to discuss pulmonary arterial hypertension (PAH) and strategies for management. As a rare, complex disease with high economic costs and potentially devastating outcomes, PAH necessitates that managed care providers balance optimal care with efficient use of healthcare resources. PAH specialists are recognized by health plans as knowledgeable experts and integral partners in managing patients and resources. The diagnosis of PAH must be confirmed by a right heart catheterization...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28712852/osteonecrosis-of-the-jaws-a-review-and-update-in-etiology-and-treatment
#11
Guilherme H Ribeiro, Emanuely S Chrun, Kamile L Dutra, Filipe I Daniel, Liliane J Grando
INTRODUCTION: Osteonecrosis of the jaws can result either from radiation, used in radiotherapy for treatment of malignant tumors, or medications used for bone remodeling and anti-angiogenesis such as bisphosphonates. These conditions can be associated with triggering factors such as infection, trauma and decreased vascularity. The management of patients with osteonecrosis of the jaws requires caution since there is no specific treatment that acts isolated and decidedly. However, different treatment modalities can be employed in an associated manner to control and stabilize lesions...
June 24, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28711334/fully-automated-comprehensive-knowledge-based-planning-for-stereotactic-radiosurgery-preclinical-validation-through-blinded-physician-review
#12
Benjamin P Ziemer, Satomi Shiraishi, Jona A Hattangadi-Gluth, Parag Sanghvi, Kevin Lawrence Moore
PURPOSE: As knowledge-based planning (KBP) attempts to augment and potentially supplant manual treatment planning, it is imperative to ensure any implementation maintains or improves overall plan quality in any disease site. The purpose of this study was to demonstrate the overall quality of KBP-driven automated stereotactic radiosurgery (SRS) treatment planning using blinded physician comparison and determine systematic factors predictive of physician plan preference to guide future KBP refinement...
April 19, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28694623/adherence-to-antiepileptic-therapy-in-adults
#13
Sowmya Chinnaiyan, Sarala Narayana, Venkatarathnamma Puttappa Nanjappa
CONTEXT: Epilepsy is a neurological disorder affecting 70 million worldwide. The high incidence of relapse can be attributed to nonadherence, thus increasing the incidence of refractory epilepsy to 10%-20%. AIMS: This study was planned to determine rate of adherence and factors affecting adherence using Antiepileptic Adherence Questionnaire and Baseline Adherence Questionnaire. MATERIALS AND METHODS: A cross-sectional, questionnaire-based study was carried out at a rural hospital from May to September 2015...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28693407/patterns-of-drugs-prescribed-for-dental-outpatients-in-nigeria-findings-and-implications
#14
Joseph O Fadare, Kazeem A Oshikoya, Obitade S Obimakinde, Abayomi O Sijuade, Jide M Afolayan, Adeyinka A Adeleke, Brian Godman, Damilola O Ojumu
OBJECTIVES: There are concerns with inappropriate prescribing of medicines among dentists especially antimicrobials. It is more concerning if this increases resistance rates. This study aimed to address this by assessing patterns of drugs prescribed for outpatients attending a hospital dental clinic in Nigeria. The findings will be used to plan future interventions, particularly around antimicrobial prescribing, where there are concerns. METHODS AND MATERIALS: Medical records of patients attending the dental clinic of a leading teaching hospital in Nigeria were evaluated...
July 11, 2017: Acta Odontologica Scandinavica
https://www.readbyqxmd.com/read/28686468/the-experiences-of-people-with-borderline-personality-disorder-admitted-to-acute-psychiatric-inpatient-wards-a-meta-synthesis
#15
Anna Stapleton, Nicola Wright
BACKGROUND: Acute psychiatric inpatient care is recommended for people with borderline personality disorder (BPD) to manage a crisis. Qualitative research exploring service user experience is valuable for the development of evidence-based treatment guidelines. AIM: To conduct a meta-synthesis of qualitative research exploring the experiences of people with BPD on acute psychiatric inpatient wards. METHODS: Literatures searches of five electronic databases...
July 7, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28686320/the-emerging-science-of-precision-medicine-and-pharmacogenomics-for-parkinson-s-disease
#16
Haydeh Payami
Current therapies for Parkinson's disease are problematic because they are symptomatic and have adverse effects. New drugs have failed in clinical trials because of inadequate efficacy. At the core of the problem is trying to make one drug work for all Parkinson's disease patients, when we know this premise is wrong because (1) Parkinson's disease is not a single disease, and (2) no two individuals have the same biological makeup. Precision medicine is the goal to strive for, but we are only at the beginning stages of building the infrastructure for one of the most complex projects in the history of science, and it will be a long time before Parkinson's disease reaps the benefits...
July 7, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/28686090/how-accurate-is-invisalign-in-nonextraction-cases-are-predicted-tooth-positions-achieved
#17
Thorsten Grünheid, Charlene Loh, Brent E Larson
OBJECTIVE: To evaluate the accuracy of Invisalign technology in achieving predicted tooth positions with respect to tooth type and direction of tooth movement. MATERIALS AND METHODS: The posttreatment models of 30 patients who had nonextraction Invisalign treatment were digitally superimposed on their corresponding virtual treatment plan models using best-fit surface-based registration. The differences between actual treatment outcome and predicted outcome were computed and tested for statistical significance for each tooth type in mesial-distal, facial-lingual, and occlusal-gingival directions, as well as for tip, torque, and rotation...
July 7, 2017: Angle Orthodontist
https://www.readbyqxmd.com/read/28682095/the-role-of-the-psychologist-with-disorders-of-consciousness-in-inpatient-pediatric-neurorehabilitation-a-case-series
#18
Sarah Lahey, Cynthia Beaulieu, Karen Sandbach, Angela Colaiezzi, Staci Balkan
PURPOSE/OBJECTIVE: The psychologist in an inpatient pediatric neurorehabilitation setting provides a vital role in the assessment, treatment, and management of pediatric patients with disorders of consciousness (DoC). Competencies are drawn from several specialty areas of professional psychology, including rehabilitation psychology, pediatric neuropsychology, and pediatric psychology. This specialized knowledge forms the basis for tailoring assessment and treatment plans specific to the individual brain injury profile, with the goals of enhancing diagnosis, prognosis, and care transition decision...
July 6, 2017: Rehabilitation Psychology
https://www.readbyqxmd.com/read/28681501/systematic-development-of-esthetics-and-function-in-a-young-patient-with-maxillary-dental-aplasia
#19
D Edelhoff, O Prandtner, R Saeidi Pour, A Wichelhaus, A Liebermann
OBJECTIVES: Full-arch rehabilitations in young patients suffering from dental agenesis should compensate for the reduced vertical dimension of occlusion and restore both esthetics and function at minimal biological cost. This requires precise planning and maximum patient compliance during the preprosthetic phase. The pretreatment period with tooth-colored splints promotes a predictable outcome of the final restorations. Clinical considerations: Thanks to better restorative materials and adhesive techniques and increased knowledge of how to preserve sound tooth structures, prosthetic dentistry has increasingly turned toward minimally invasive procedures...
July 6, 2017: Journal of Esthetic and Restorative Dentistry
https://www.readbyqxmd.com/read/28670629/statistical-analysis-plan-for-stage-1-embarc-establishing-moderators-and-biosignatures-of-antidepressant-response-for-clinical-care-study
#20
Eva Petkova, R Todd Ogden, Thaddeus Tarpey, Adam Ciarleglio, Bei Jiang, Zhe Su, Thomas Carmody, Philip Adams, Helena C Kraemer, Bruce D Grannemann, Maria A Oquendo, Ramin Parsey, Myrna Weissman, Patrick J McGrath, Maurizio Fava, Madhukar H Trivedi
Antidepressant medications are commonly used to treat depression, but only about 30% of patients reach remission with any single first-step antidepressant. If the first-step treatment fails, response and remission rates at subsequent steps are even more limited. The literature on biomarkers for treatment response is largely based on secondary analyses of studies designed to answer primary questions of efficacy, rather than on a planned systematic evaluation of biomarkers for treatment decision. The lack of evidence-based knowledge to guide treatment decisions for patients with depression has lead to the recognition that specially designed studies with the primary objective being to discover biosignatures for optimizing treatment decisions are necessary...
June 2017: Contemporary Clinical Trials Communications
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