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Rational Clinical Examination

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https://www.readbyqxmd.com/read/28938415/rationalizing-thyroid-function-testing-which-tsh-cut-offs-are-optimal-for-testing-free-t4
#1
Meg Henze, Suzanne J Brown, Narelle C Hadlow, John P Walsh
Context: Thyroid function testing often utilizes TSH measurement first, then reflex testing for free T4 if TSH is outside reference range limits. The utility of different TSH cut-offs for reflex testing is unknown. Objective: To examine different TSH cut-offs for reflex free T4 testing. Design, setting and patients: We analyzed concurrent TSH and free T4 results from 120 403 individuals from a single laboratory in Western Australia (clinical cohort) and 4568 Busselton Health Study participants (community cohort)...
August 30, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28932912/behavioral-cognitive-and-emotional-coping-strategies-of-women-with-endometriosis-a-critical-narrative-review
#2
REVIEW
Cristina Zarbo, Agostino Brugnera, Luigi Frigerio, Chiara Malandrino, Massimo Rabboni, Emi Bondi, Angelo Compare
Endometriosis is a disabling and long-term medical condition affecting quality of life and mental health. Behavioral, cognitive, and emotional coping strategies, emotional intelligence, and metacognition could in part explain the link between the disease and impaired psychological and life functioning. This critical narrative review aimed at examining the state of the art of the relationships between endometriosis and these factors. According to PRISMA principles, we performed a systematic search for quantitative and qualitative studies on multiple electronic databases as regards coping strategies, emotional intelligence, and metacognition in women with endometriosis...
September 21, 2017: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/28932314/cost-effectiveness-analysis-of-treatment-acute-deep-vein-thrombosis-in-clinic-of-vascular-surgery-sarajevo
#3
Haris Vukas, Samra Kadić-Vukas, Adis Salihbegović, Muhamed Djedović, Dragan Totić, Haris Vranić, Amel Hadžimehmedagić
AIM: To compare hospital costs of acute deep vein thrombosis (ADVT) treatment in two periods of time. Evidence of repercussions on reducing costs during successful treatment. Attention was given to the necessity, costs and effectiveness of diagnostic procedures, treatment and complications. METHODS: A retrospective analysis of data obtained from patients medical history in a period from 2000 to 2016. Model management and safe practice of ADVT care consisted of clinical examination, laboratory, colour Doppler and invasive diagnostics...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28929083/emerging-therapies-for-stage-iii-non-small-cell-lung-cancer-stereotactic-body-radiation-therapy-and-immunotherapy
#4
REVIEW
Sameera S Kumar, Kristin A Higgins, Ronald C McGarry
The current standard of care for locally advanced non-small cell lung cancer (NSCLC) includes radiation, chemotherapy, and surgery in certain individualized cases. In unresectable NSCLC, chemoradiation has been the standard of care for the past three decades. Local and distant failure remains high in this group of patients, so dose escalation has been studied in both single institution and national clinical trials. Though initial studies showed a benefit to dose escalation, phase III studies examining dose escalation using standard fractionation or hyperfractionation have failed to show a benefit...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28918655/what-not-to-do-in-acute-otitis-media-the-top-five-recommendations-proposed-by-the-italian-society-of-preventive-and-social-pediatrics
#5
Elena Chiappini, Barbara Bortone, Mattia Doria, Massimo Landi, Giuseppe Di Mauro, Paola Marchisio
With the aim to reduce inappropriate procedures and antibiotic therapy in the management of acute otitis media (AOM) in children, the Italian Society of Preventive and Social Pediatrics (SIPPS) proposed a top five list of recommendations for clinical practice. Areas covered: AOM is one of the most frequent reasons for antibiotic prescription in pediatric age. The over-estimation of AOM is associated with inappropriate treatment, increased costs, adverse events and spread of antibiotic resistance. Thus, the most recent guidelines provided stringent diagnostic criteria and considered the 'watchful waiting' approach, limiting the immediate antibiotic therapy to a well-characterized subgroup of children...
September 19, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28915554/resistance-to-ctla-4-checkpoint-inhibition-reversed-through-selective-elimination-of-granulocytic-myeloid-cells
#6
Paul E Clavijo, Ellen C Moore, Jianhong Chen, Ruth J Davis, Jay Friedman, Young Kim, Carter Van Waes, Zhong Chen, Clint T Allen
PURPOSE: Local immunosuppression remains a critical problem that limits clinically meaningful response to checkpoint inhibition in patients with head and neck cancer. Here, we assessed the impact of MDSC elimination on responses to CTLA-4 checkpoint inhibition. EXPERIMENTAL DESIGN: Murine syngeneic carcinoma immune infiltrates were characterized by flow cytometry. Granulocytic MDSCs (gMDSCs) were depleted and T-lymphocyte antigen-specific responses were measured...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28911247/metabolic-pathways-and-pharmacokinetics-of-natural-medicines-with-low-permeability
#7
Mei Zeng, Lan Yang, Dan He, Yao Li, Mingxin Shi, Jingqing Zhang
Drug metabolism plays an important role in the drug disposal process. Differences in pharmacokinetics among individuals are the basis for personalized medicine. Natural medicines, formed by long-term evolution of nature, prioritize the action of a target protein with a drug. Natural medicines are valued for structural diversity, low toxicity, low cost, and definite biological activities. Metabolic pathway and pharmacokinetic research of natural medicines is highly beneficial for clinical dose adjustment and the development of personalized medicine...
September 14, 2017: Drug Metabolism Reviews
https://www.readbyqxmd.com/read/28891406/clinical-practice-guideline-evaluation-of-the-neck-mass-in-adults
#8
Melissa A Pynnonen, M Boyd Gillespie, Benjamin Roman, Richard M Rosenfeld, David E Tunkel, Laura Bontempo, Itzhak Brook, Davoren Ann Chick, Maria Colandrea, Sandra A Finestone, Jason C Fowler, Christopher C Griffith, Zeb Henson, Corinna Levine, Vikas Mehta, Andrew Salama, Joseph Scharpf, Deborah R Shatzkes, Wendy B Stern, Jay S Youngerman, Maureen D Corrigan
Objective Neck masses are common in adults, but often the underlying etiology is not easily identifiable. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. Malignant neoplasms far exceed any other etiology of adult neck mass. Importantly, an asymptomatic neck mass may be the initial or only clinically apparent manifestation of head and neck cancer, such as squamous cell carcinoma (HNSCC), lymphoma, thyroid, or salivary gland cancer. Evidence suggests that a neck mass in the adult patient should be considered malignant until proven otherwise...
September 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28874138/erp29-controls-invasion-and-metastasis-of-gastric-carcinoma-by-inhibition-of-epithelial-mesenchymal-transition-via-pi3k-aktsignaling-pathway
#9
Jianxin Ye, Jinsheng Huang, Jie Xu, Qiang Huang, Jinzhou Wang, Wenjing Zhong, Xinjian Lin, Yun Li, Xu Lin
BACKGROUND: Gastric cancer (GC) accounts for the fourth most occurring malignancy and the third major cause of cancer death. Identifying novel molecular signaling pathways participating in gastric tumorigenesis and progression is pivotal for rational design of targeted therapies to improve advanced GC outcome. Recently, the endoplasmic reticulum (ER) protein 29 (ERp29) has been shown to inversely associate with primary tumor development and function as a tumor suppressor in breast cancer...
September 6, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28863449/glioblastoma-targeted-therapy-updated-approaches-from-recent-biological-insights
#10
M Touat, A Idbaih, M Sanson, K L Ligon
Glioblastoma (WHO grade IV astrocytoma) is the most frequent primary brain tumor in adults, representing a highly heterogeneous group of neoplasms that are among the most aggressive and challenging cancers to treat. An improved understanding of the molecular pathways that drive malignancy in glioblastoma has led to the development of various biomarkers and the evaluation of several agents specifically targeting tumor cells and the tumor microenvironment. A number of rational approaches are being investigated, including therapies targeting tumor growth factor receptors and downstream pathways, cell cycle and epigenetic regulation, angiogenesis and antitumor immune response...
July 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28860840/influence-of-organizational-culture-on-provider-adherence-to-the-diabetic-clinical-practice-guideline-using-the-competing-values-framework-in-palestinian-primary-healthcare-centers
#11
Mahmoud Radwan, Ali Akbari Sari, Arash Rashidian, Amirhossein Takian, Sanaa Abou-Dagga, Aymen Elsous
BACKGROUND: Diabetes mellitus (DM) is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH) and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA) by using the competing values framework (CVF) and examining its influence on the adherence to the Clinical Practice Guideline (CPG) for DM...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28859181/clinical-application-of-newly-developed-custom-made-mouthpiece-for-scuba-diving
#12
Toshiaki Hirose, Tomoya Gonda, Yoshinobu Maeda
PURPOSE: To describe a method for customizing scuba diving mouthpieces, to examine their usability, and to assess divers' satisfaction with their use. MATERIALS AND METHODS: A rational method for fabricating custom-made mouthpieces for scuba diving was developed. Twenty scuba divers agreed to use a custom-made mouthpiece for at least 4 weeks. After mouthpiece use, participants completed an 11-item questionnaire. RESULTS: Custom-made mouthpieces had significantly lower scores for all items on the questionnaire except uncomfortable sensation, indicating that they were more comfortable than ready-made mouthpieces...
September 2017: International Journal of Prosthodontics
https://www.readbyqxmd.com/read/28804700/abridged-version-of-the-awmf-guideline-for-the-medical-clinical-diagnostics-of-indoor-mould-exposure-s2k-guideline-of-the-german-society-of-hygiene-environmental-medicine-and-preventive-medicine-ghup-in-collaboration-with-the-german-association-of-allergists
#13
Gerhard A Wiesmüller, Birger Heinzow, Ute Aurbach, Karl-Christian Bergmann, Albrecht Bufe, Walter Buzina, Oliver A Cornely, Steffen Engelhart, Guido Fischer, Thomas Gabrio, Werner Heinz, Caroline E W Herr, Jörg Kleine-Tebbe, Ludger Klimek, Martin Köberle, Herbert Lichtnecker, Thomas Lob-Corzilius, Rolf Merget, Norbert Mülleneisen, Dennis Nowak, Uta Rabe, Monika Raulf, Hans Peter Seidl, Jens-Oliver Steiß, Regine Szewszyk, Peter Thomas, Kerttu Valtanen, Julia Hurraß
This article is an abridged version of the AWMF mould guideline "Medical clinical diagnostics of indoor mould exposure" presented in April 2016 by the German Society of Hygiene, Environmental Medicine and Preventive Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin, GHUP), in collaboration with the above-mentioned scientific medical societies, German and Austrian societies, medical associations and experts. Indoor mould growth is a potential health risk, even if a quantitative and/or causal relationship between the occurrence of individual mould species and health problems has yet to be established...
2017: Allergo Journal International
https://www.readbyqxmd.com/read/28763554/does-this-child-have-pneumonia-the-rational-clinical-examination-systematic-review
#14
REVIEW
Sonal N Shah, Richard G Bachur, David L Simel, Mark I Neuman
Importance: Pneumonia is a leading cause of morbidity and mortality in children. It is important to identify the clinical symptoms and physical examination findings associated with pneumonia to improve timely diagnosis, prevent significant morbidity, and limit antibiotic overuse. Objective: To systematically review the accuracy of symptoms and physical examination findings in identifying children with radiographic pneumonia. Data Sources and Study Selection: MEDLINE and Embase (1956 to May 2017) were searched, along with reference lists from retrieved articles, to identify diagnostic studies of pediatric pneumonia across a broad age range that had to include children younger than age 5 years (although some studies enrolled children up to age 19 years); 3644 unique articles were identified, of which 23 met inclusion criteria...
August 1, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28753826/programmed-death-ligand-1-expression-in-upper-tract-urothelial-carcinoma
#15
Stephanie L Skala, Tzu-Ying Liu, Aaron M Udager, Alon Z Weizer, Jeffrey S Montgomery, Ganesh S Palapattu, Javed Siddiqui, Xuhong Cao, Kristina Fields, Ahmed E Abugharib, Moaaz Soliman, Khaled S Hafez, David Miller, Cheryl T Lee, Ajjai Alva, Arul M Chinnaiyan, Todd M Morgan, Daniel E Spratt, Hui Jiang, Rohit Mehra
BACKGROUND: Urothelial carcinoma (UC) is the most common malignancy of the urinary tract. Upper tract (renal pelvis and ureter) urothelial carcinomas (UTUC) account for approximately 5% of UCs but a significant subset are invasive and associated with poor clinical outcomes. OBJECTIVE: To evaluate programmed death-ligand 1 (PD-L1) expression in UTUC. DESIGN, SETTING, AND PARTICIPANTS: UTUC cases from 1997-2016 were retrospectively identified from the surgical pathology database at a single large academic institution...
December 13, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28723805/acute-pancreatitis-induced-by-etoposide-lobaplatin-combination-chemotherapy-used-for-the-treatment-of-lung-cancer-a-case-report-and-literature-review
#16
REVIEW
Cheng-Liang Cao, Peng-Yu Duan, Wang-Jun Zhang, Le Li, Feng-Zhi Qu, Bei Sun, Gang Wang
RATIONALE: Drug-induced pancreatitis (DIP) is a rare type of pancreatitis that is not usually observed in the clinical practice. It is generally difficult to distinguish from acute pancreatitis (AP) induced by other causes. PATIENT CONCERNS: Here, we report a 62-year-old Chinese female patient with "small cell lung cancer" as the initial presentation. Because the patient could not bear the surgical treatment, the chemotherapy composed of lobaplatin and etoposide was performed...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723667/resistance-to-ctla-4-checkpoint-inhibition-reversed-through-selective-elimination-of-granulocytic-myeloid-cells
#17
Paul E Clavijo, Ellen C Moore, Jianhong Chen, Ruth J Davis, Jay Friedman, Young Kim, Carter Van Waes, Zhong Chen, Clint T Allen
PURPOSE: Local immunosuppression remains a critical problem that limits clinically meaningful response to checkpoint inhibition in patients with head and neck cancer. Here, we assessed the impact of MDSC elimination on responses to CTLA-4 checkpoint inhibition. EXPERIMENTAL DESIGN: Murine syngeneic carcinoma immune infiltrates were characterized by flow cytometry. Granulocytic MDSCs (gMDSCs) were depleted and T-lymphocyte antigen-specific responses were measured...
June 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28707817/evaluation-of-free-or-anchored-antimicrobial-peptides-as-candidates-for-the-prevention-of-orthopaedic-device-related-infections
#18
Francesca D'Este, Debora Oro, Gerard Boix-Lemonche, Alessandro Tossi, Barbara Skerlavaj
The prevention of implant-associated infection, one the most feared complications in orthopaedic surgery, remains a major clinical challenge and urges development of effective methods to prevent bacterial colonization of implanted devices. Alpha-helical antimicrobial peptides (AMPs) may be promising candidates in this respect due to their potent and broad-spectrum antimicrobial activity, their low tendency to elicit resistance and possible retention of efficacy in the immobilized state. The aim of this study was to evaluate the potential of five different helical AMPs, the cathelicidins BMAP-27 and BMAP-28, their (1-18) fragments and the rationally designed, artificial P19(9/G7) peptide, for the prevention of orthopaedic implant infections...
July 14, 2017: Journal of Peptide Science: An Official Publication of the European Peptide Society
https://www.readbyqxmd.com/read/28693067/-chinese-expert-consensus-for-non-antiinfective-effects-and-clinical-use-of-macrolides
#19
J T Lin, Y M Zhang, X Zhou, C Z Wang, M Huang, C T Liu, C G Wu, H Y Wan, W C Yu, Y R Dai
Important/potential value of macrolides has been proved in the management of chronic respiratory diseases by increasing basic and clinical trials.Through three face-to-face discussions, 10 experts examined important data and drafted this consensus related to macrolides: (1) mechanism of non-antiinfective effects; (2) clinical use in chronic respiratory diseases; (3) cautions of long-term use.The mechanism out of non-antiinfective effects includes anti-inflammatory effect, modifying airway secretion, immune-regulation related to antibacterial effect, corticoid saving effect and anti-viral effect...
July 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28668900/serum-heparin-binding-epidermal-growth-factor-like-growth-factor-hb-egf-as-a-biomarker-for-primary-ovarian-cancer
#20
Kohei Miyata, Fusanori Yotsumoto, Satoshi Fukagawa, Chihiro Kiyoshima, Nam Sung Ouk, Daichi Urushiyama, Tomohiro Ito, Takahiro Katsuda, Masamitsu Kurakazu, Ryota Araki, Ayako Sanui, Daisuke Miyahara, Masaharu Murata, Kyoko Shirota, Hiroshi Yagi, Tadao Takono, Kiyoko Kato, Nobuo Yaegashi, Kohei Akazawa, Masahide Kuroki, Shin'ichiro Yasunaga, Shingo Miyamoto
Ovarian cancer is the most lethal malignancy among gynaecological cancers. Although many anticancer agents have been developed for the treatment of ovarian cancer, it continues to have an extremely poor prognosis. Heparin-binding epidermal growth factor-like grown factor (HB-EGF) has been reported to be a rational therapeutic target for ovarian cancer. Here, we evaluated the clinical significance of serum HB-EGF by examining the association between prognosis and serum HB-EGF levels in patients with primary ovarian cancer...
July 2017: Anticancer Research
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