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https://www.readbyqxmd.com/read/29164601/clinical-decision-analysis-in-perinatology
#1
Rohan D'Souza, Prakesh S Shah, Beate Sander
Clinical decision-making in perinatology involves tradeoffs between two intricately related individuals - mother and fetus. Decision-making in perinatology is challenging due to competing interests of the mother and the fetus. Although decision analytic methods are increasingly used to develop processes for clinical and cost-effectiveness analyses in perinatology, there are no guidelines on the conduct and reporting of decision analysis studies that takes into account the complexities of the mother-fetus dyad...
November 21, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29164170/impact-of-procalcitonin-guided-antibiotic-management-on-antibiotic-exposure-and-outcomes-real-world-evidence
#2
Michael R Broyles
Background: Delayed pathogen identification and nonspecific clinical findings make definitive decisions regarding antibiotics challenging. The stimuli of bacterial toxins and inflammation make procalcitonin (PCT) unique in its ability to differentiate bacterial infection from other causes of inflammation, and thus it is useful for antibiotic management. The objective of our study was to evaluate the impact of a PCT algorithm (PCT-A) on current practice. Methods: A single-center, retrospective cohort study was conducted to evaluate the impact of adding PCT-A to stewardship practices...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29164166/juvenile-osteochondritis-dissecans-of-the-knee-does-magnetic-resonance-imaging-instability-correlate-with-the-need-for-surgical-intervention
#3
Simon Haeri Hendy, Darren de Sa, Kelly Ainsworth, Olufemi R Ayeni, Nicole Simunovic, Devin Peterson
Background: Several magnetic resonance imaging (MRI) classification systems have been developed to determine the degree of instability of juvenile osteochondritis dissecans (JOCD) lesions. Our current practice involves correlating the patients' symptoms with their MRI findings, but there are many cases in which this correlation is poor and results in incorrect classification of the stability of a JOCD lesion. Purpose: To determine whether certain MRI findings of JOCD instability are associated with the necessity for arthroscopic intervention to assess lesion stability...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29164163/neurocognitive-deficits-of-concussed-adolescent-athletes-at-self-reported-symptom-resolution-in-the-zurich-guidelines-era
#4
Peter K Kriz, Rebekah Mannix, Alex M Taylor, Danielle Ruggieri, William P Meehan
Background: Previous studies have evaluated high school and collegiate athletes in the pre-Zurich guidelines era; whether adolescent athletes demonstrate similar neurocognitive decrements in the current concussion management era remains unclear. Purpose: To assess for the presence of neurocognitive deficits in adolescents with a sport-related concussion at the time of self-reported symptom resolution. Study Design: Cross-sectional study; Level of evidence, 3...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29164057/diagnostic-and-prognostic-significance-of-methionine-uptake-and-methionine-positron-emission-tomography-imaging-in-gliomas
#5
REVIEW
Kamalakannan Palanichamy, Arnab Chakravarti
The present most common image diagnostic tracer in clinical practice for glioma is (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for brain tumors diagnosis and prognosis. PET is a promising molecular imaging technique, which provides real-time information on the metabolic behavior of the tracer. The diffusive nature of glioblastoma (GBM) and heterogeneity often make the radiographic detection by FDG-PET inaccurate, and there is no gold standard. FDG-PET often leads to several controversies in making clinical decisions due to their uptake by normal surrounding tissues, and pose a challenge in delineating treatment-induced necrosis, edema, inflammation, and pseudoprogression...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/29164037/guidelines-for-the-management-of-degenerative-cervical-myelopathy-and-acute-spinal-cord-injury-development-process-and-methodology
#6
Lindsay A Tetreault, Andrea C Skelly, Joseph R Dettori, Jefferson R Wilson, Allan R Martin, Michael G Fehlings
The Institute of Medicine defines clinical practice guidelines as "statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options." Guidelines help clinicians implement best evidence into practice and encourage informed shared decision making with patients. Guidelines are intended to enhance the quality of patient care by discouraging ineffective and potentially harmful interventions and standardizing practice...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164036/a-clinical-practice-guideline-for-the-management-of-acute-spinal-cord-injury-introduction-rationale-and-scope
#7
Michael G Fehlings, Lindsay A Tetreault, Jefferson R Wilson, Brian K Kwon, Anthony S Burns, Allan R Martin, Gregory Hawryluk, James S Harrop
Acute spinal cord injury (SCI) is a traumatic event that results in disturbances to normal sensory, motor, or autonomic function and ultimately affects a patient's physical, psychological, and social well-being. The management of patients with SCI has drastically evolved over the past century as a result of increasing knowledge on injury mechanisms, disease pathophysiology, and the role of surgery. There still, however, remain controversial areas surrounding available management strategies for the treatment of SCI, including the use of corticosteroids such as methylprednisolone sodium succinate, the optimal timing of surgical intervention, the type and timing of anticoagulation prophylaxis, the role of magnetic resonance imaging, and the type and timing of rehabilitation...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164035/a-clinical-practice-guideline-for-the-management-of-patients-with-degenerative-cervical-myelopathy-recommendations-for-patients-with-mild-moderate-and-severe-disease-and-nonmyelopathic-patients-with-evidence-of-cord-compression
#8
Michael G Fehlings, Lindsay A Tetreault, K Daniel Riew, James W Middleton, Bizhan Aarabi, Paul M Arnold, Darrel S Brodke, Anthony S Burns, Simon Carette, Robert Chen, Kazuhiro Chiba, Joseph R Dettori, Julio C Furlan, James S Harrop, Langston T Holly, Sukhvinder Kalsi-Ryan, Mark Kotter, Brian K Kwon, Allan R Martin, James Milligan, Hiroaki Nakashima, Narihito Nagoshi, John Rhee, Anoushka Singh, Andrea C Skelly, Sumeet Sodhi, Jefferson R Wilson, Albert Yee, Jeffrey C Wang
Study Design: Guideline development. Objectives: The objective of this study is to develop guidelines that outline how to best manage (1) patients with mild, moderate, and severe myelopathy and (2) nonmyelopathic patients with evidence of cord compression with or without clinical symptoms of radiculopathy. Methods: Five systematic reviews of the literature were conducted to synthesize evidence on disease natural history; risk factors of disease progression; the efficacy, effectiveness, and safety of nonoperative and surgical management; the impact of preoperative duration of symptoms and myelopathy severity on treatment outcomes; and the frequency, timing, and predictors of symptom development...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164034/guidelines-for-the-management-of-degenerative-cervical-myelopathy-and-spinal-cord-injury-an-introduction-to-a-focus-issue
#9
Michael G Fehlings, Brian K Kwon, Lindsay A Tetreault
Study Design: Introduction to a guidelines project. Objectives: The objective of this focus issue is to present guidelines that outline how to best manage patients with degenerative cervical myelopathy (DCM) and spinal cord injury (SCI). Topics addressed in this focus issue include: 1) management strategies for patients with mild, moderate and severe DCM; and 2a) timing of surgical decompression; b) the use of methylprednisolone sodium succinate; c) the type and timing of anticoagulation strategies; d) the role of magnetic resonance imaging in clinical decision making and outcome prediction; and e) the type and timing of rehabilitation in patients with SCI...
September 2017: Global Spine Journal
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
#10
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/29164028/a-clinical-practice-guideline-for-the-management-of-patients-with-acute-spinal-cord-injury-recommendations-on-the-role-of-baseline-magnetic-resonance-imaging-in-clinical-decision-making-and-outcome-prediction
#11
Michael G Fehlings, Allan R Martin, Lindsay A Tetreault, Bizhan Aarabi, Paul Anderson, Paul M Arnold, Darrel 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, 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 guideline is to outline the role of magnetic resonance imaging (MRI) in clinical decision making and outcome prediction in patients with traumatic spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to the use of MRI in patients with traumatic SCI. This review focused on longitudinal studies that controlled for baseline neurologic status. A multidisciplinary Guideline Development Group (GDG) used this information, their clinical expertise, and patient input to develop recommendations on the use of MRI for SCI patients...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164027/a-clinical-practice-guideline-for-the-management-of-degenerative-cervical-myelopathy-introduction-rationale-and-scope
#12
Michael G Fehlings, Lindsay A Tetreault, K Daniel Riew, James W Middleton, Jeffrey C Wang
Degenerative cervical myelopathy (DCM) is a progressive spine disease and the most common cause of spinal cord dysfunction in adults worldwide. Patients with DCM may present with common signs and symptoms of neurological dysfunction, such as paresthesia, abnormal gait, decreased hand dexterity, hyperreflexia, increased tone, and sensory dysfunction. Clinicians across several specialties encounter patients with DCM, including primary care physicians, rehabilitation specialists, therapists, rheumatologists, neurologists, and spinal surgeons...
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
#13
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/29164024/a-clinical-practice-guideline-for-the-management-of-patients-with-acute-spinal-cord-injury-and-central-cord-syndrome-recommendations-on-the-timing-%C3%A2-24-hours-versus-24-hours-of-decompressive-surgery
#14
Michael G Fehlings, Lindsay A Tetreault, Jefferson R Wilson, 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, 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, Albert Yee, James S Harrop
Objective: To develop recommendations on the timing of surgical decompression in patients with traumatic spinal cord injury (SCI) and central cord syndrome. Methods: A systematic review of the literature was conducted to address key relevant questions. A multidisciplinary guideline development group used this information, along with their clinical expertise, to develop recommendations for the timing of surgical decompression in patients with SCI and central cord syndrome...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29163351/computed-tomography-perfusion-alberta-stroke-program-early-computed-tomography-score-is-associated-with-hemorrhagic-transformation-after-acute-cardioembolic-stroke
#15
Lan Liu, Bo Wu, Jinglong Zhao, Yanyan Cao, Nikita Dedhia, Louis R Caplan, Qiaoshu Wang
Alberta Stroke Program Early Computed Tomography (CT) score (ASPECTS) has been applied to CT perfusion (CTP) with good interrater agreement to predict early ischemic stroke, and it can be useful in decision making in acute ischemic stroke. The aim of the present study was to assess the predictive value of CTP ASPECTS of hemorrhagic transformation (HT) in acute cardioembolic stroke. This is a single-enter, retrospective study. All patients hospitalized with acute cardioembolic stroke from January 2008 to September 2013 were included...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29163238/impairment-of-working-memory-decision-making-and-executive-function-in-the-first-degree-relatives-of-people-with-panic-disorder-a-pilot-study
#16
Zhenhe Zhou, Dongjie Ni
Background: Panic disorder (PD) patients present impairments of working memory, decision-making, and executive function. However, whether the first-degree relatives (FDRs) of people with PD present abnormal characteristics, including clinical and neuropsychological aspects, in comparison to the general population, has not been studied. Investigation and understanding of the abnormal neuropsychological characteristics of the FDRs of people with PD will contribute to the prevention and treatment of PD...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29163069/notes-on-the-recent-history-of-neuroscience-in-africa
#17
REVIEW
Vivienne A Russell
Neuroscience began with neuroanatomy and neurosurgery in Egypt more than 5000 years ago. Knowledge grew over time and specialized neurosurgery centers were established in north Africa in the eleventh century. However, it was not until the twentieth century that neuroscience research became established in sub-Saharan Africa. In most African countries, clinical research focused on understanding the rationale and improving treatment of epilepsy, infections, nutritional neuropathies, stroke and tumors. Significant advances were made...
2017: Frontiers in Neuroanatomy
https://www.readbyqxmd.com/read/29162676/the-role-of-genetic-counseling-in-pompe-disease-after-patients-are-identified-through-newborn-screening
#18
Andrea M Atherton, Debra Day-Salvatore
An important part of the coordinated care by experienced health care teams for all Pompe disease patients, whether diagnosed through newborn screening (NBS), clinical diagnosis, or prenatal diagnosis, is genetic counseling. Genetic counseling helps families better understand medical recommendations and options presented by the patient's health care team so they can make informed decisions. In addition to providing important information about the inheritance and genetic risks, genetic counseling also provides information about Pompe disease and available treatments and resources and should be offered to families with an affected child and all adults diagnosed with Pompe disease...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/29162582/standardizing-clinically-meaningful-outcome-measures-beyond-hba1c-for-type-1-diabetes-a-consensus-report-of-the-american-association-of-clinical-endocrinologists-the-american-association-of-diabetes-educators-the-american-diabetes-association-the-endocrine
#19
REVIEW
Gina Agiostratidou, Henry Anhalt, Dana Ball, Lawrence Blonde, Evgenia Gourgari, Karen N Harriman, Aaron J Kowalski, Paul Madden, Alicia H McAuliffe-Fogarty, Molly McElwee-Malloy, Anne Peters, Sripriya Raman, Kent Reifschneider, Karen Rubin, Stuart A Weinzimer
OBJECTIVE: To identify and define clinically meaningful type 1 diabetes outcomes beyond hemoglobin A1c (HbA1c) based upon a review of the evidence, consensus from clinical experts, and input from researchers, people with type 1 diabetes, and industry. Priority outcomes include hypoglycemia, hyperglycemia, time in range, diabetic ketoacidosis (DKA), and patient-reported outcomes (PROs). While priority outcomes for type 1 and type 2 diabetes may overlap, type 1 diabetes was the focus of this work...
December 2017: Diabetes Care
https://www.readbyqxmd.com/read/29162279/clinical-decision-support-of-radiotherapy-treatment-planning-a-data-driven-machine-learning-strategy-for-patient-specific-dosimetric-decision-making
#20
Gilmer Valdes, Charles B Simone, Josephine Chen, Alexander Lin, Sue S Yom, Adam J Pattison, Colin M Carpenter, Timothy D Solberg
BACKGROUND AND PURPOSE: Clinical decision support systems are a growing class of tools with the potential to impact healthcare. This study investigates the construction of a decision support system through which clinicians can efficiently identify which previously approved historical treatment plans are achievable for a new patient to aid in selection of therapy. MATERIAL AND METHODS: Treatment data were collected for early-stage lung and postoperative oropharyngeal cancers treated using photon (lung and head and neck) and proton (head and neck) radiotherapy...
November 18, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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