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https://www.readbyqxmd.com/read/29164052/development-of-novel-patient-derived-xenografts-from-breast-cancer-brain-metastases
#1
María J Contreras-Zárate, D Ryan Ormond, Austin E Gillen, Colton Hanna, Nicole L Day, Natalie J Serkova, Britta M Jacobsen, Susan M Edgerton, Ann D Thor, Virginia F Borges, Kevin O Lillehei, Michael W Graner, Peter Kabos, Diana M Cittelly
Brain metastases are an increasing burden among breast cancer patients, particularly for those with HER2(+) and triple negative (TN) subtypes. Mechanistic insight into the pathophysiology of brain metastases and preclinical validation of therapies has relied almost exclusively on intracardiac injection of brain-homing cells derived from highly aggressive TN MDA-MB-231 and HER2(+) BT474 breast cancer cell lines. Yet, these well characterized models are far from representing the tumor heterogeneity observed clinically and, due to their fast progression in vivo, their suitability to validate therapies for established brain metastasis remains limited...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/29160123/fast-tracking-for-total-knee-replacement-reduces-use-of-institutional-care-without-compromising-quality
#2
Konsta J Pamilo, Paulus Torkki, Mikko Peltola, Maija Pesola, Ville Remes, Juha Paloneva
Background and purpose - Fast-tracking shortens the length of the primary treatment period (length of stay, LOS) after total knee replacement (TKR). We evaluated the influence of the fast-track concept on the length of uninterrupted institutional care (LUIC) and other outcomes after TKR. Patients and methods - 4,256 TKRs performed in 4 hospitals between 2009-2010 and 2012-2013 were identified from the Finnish Hospital Discharge Register and the Finnish Arthroplasty Register. Hospitals were classified as fast track (Hospital A) and non-fast track (Hospitals B, C and D)...
November 21, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29152551/bladder-cancer-recovery-pathways-a-systematic-review
#3
Ian Maloney, Daniel C Parker, Michael S Cookson, Sanjay Patel
Background: Enhanced recovery pathways, also known as fast-track protocols, have been adopted since the early 2000s by various surgical specialties with the goal of improving patient outcomes and reducing the cost burden of major surgery on the health care system. Objective: To review the scientific literature on the origin of enhanced recovery pathways, track the contemporary utilization of such practices for patients undergoing radical cystectomy, and analyze the available data regarding their effect on morbidity, mortality, and treatment cost...
October 27, 2017: Bladder Cancer
https://www.readbyqxmd.com/read/29142744/-who-has-to-do-it-at-the-end-of-the-day-programme-officials-or-hospital-authorities-airborne-infection-control-at-drug-resistant-tuberculosis-dr-tb-centres-of-karnataka-india-a-mixed-methods-study
#4
Kibballi Madhukeshwar Akshaya, Hemant Deepak Shewade, Ottapura Prabhakaran Aslesh, Sharath Burugina Nagaraja, Abhay Subashrao Nirgude, Anil Singarajipura, Anil G Jacob
Background: Drug resistant tuberculosis (DR-TB) centers admit patients with DR-TB for initiation of treatment and thereby concentrate the patients under one setting. It becomes imperative to assess the compliance of DR-TB centres to national airborne infection control (AIC) guidelines and explore the provider perspectives into reasons for unsatisfactory compliance. Methods: This mixed methods study (triangulation design) was carried out across all the six DR-TB centers of Karnataka state, India, between November 2016 and April 2017...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29139277/tailor-management-to-the-patient-with-fibroids
#5
Marie O'Sullivan, Caroline Overton
Fibroids are benign, hormone-dependent tumours of uterine smooth muscle and connective tissue. They are commonly asymptomatic, but can cause symptoms such as heavy menstrual bleeding and pelvic pressure symptoms. Between 20 to 30% of women with heavy menstrual bleeding have fibroids. Fibroids are most prevalent in women aged 30-50 years and there may be a genetic predisposition. They are more common in black women than white women. Other risk factors include obesity and nulliparity. Asymptomatic women should only be referred if their uterus is palpable abdominally, if fibroids distort the uterine cavity or the uterus is larger than 12 cm in length...
March 2017: Practitioner
https://www.readbyqxmd.com/read/29128486/lower-dose-of-sufentanil-does-not-enhance-fast-track-significantly-a-randomized-study
#6
Rajesh Bhavsar, Pia Katarina Ryhammer, Jacob Greisen, Carl-Johan Jakobsen
OBJECTIVE: Adjustment in the doses of opioids has been a focus of interest for achieving better fast-track conditions in cardiac anesthesia, but relatively sparse information exists on the potential effect of psychologic and behavioral factors, such as stress, anxiety, and type of personality, on anesthesia requirements and patient turnover in the cardiac recovery unit (CRU); to the authors' knowledge, this particular focus has not been systematically investigated. In this randomized study, the authors tested the hypothesis that low-dose sufentanil, compared with a standard dose, can improve fast-track parameters and the overall quality of recovery...
August 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29125257/improving-door-to-needle-times-for-patients-with-suspected-neutropenic-sepsis
#7
Tracy Wild
Neutropenic sepsis is a potentially life-threatening complication of chemotherapy and has an associated mortality of 2% to 21%. Patients can deteriorate rapidly and are usually advised to attend their local emergency department (ED) for urgent assessment and antibiotic therapy within one hour of arrival. Delivery of this emergency care is, however, inconsistent, and at times suboptimal, due to a lack of awareness of the condition and of clinical expertise. This article discusses a collaborative project between an acute oncology service and an ED, which has improved and sustained compliance with this standard through a range of initiatives, including revised and integrated sepsis guidelines, education, sepsis champions and a fast-track patient pathway...
November 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29119289/local-antibiotic-decontamination-to-prevent-anastomotic-leakage-short-term-outcome-in-rectal-cancer-surgery
#8
Ulrich Wirth, Susanne Rogers, Kristina Haubensak, Stefan Schopf, Thomas von Ahnen, Hans Martin Schardey
PURPOSE: Anastomotic leakage still presents an issue in rectal cancer surgery with rates of about 11%. As bacteria play a critical role, there is the concept of perioperative local decontamination to prevent anastomotic leakage. METHODS: To ascertain the effectiveness of this treatment, we performed a retrospective analysis on 206 rectal resections with primary anastomosis and routine use of a selective decontamination of the digestive tract (SDD) regimen for local decontamination...
November 8, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29116559/perioperative-antiemetic-therapy-for-fast-track-laparoscopic-bariatric-surgery
#9
Olumuyiwa A Bamgbade, Oluwafemi Oluwole, Rong R Khaw
BACKGROUND: Postoperative nausea and vomiting (PONV) is problematic in bariatric surgery patients and has negative impacts on perioperative outcome. Antiemetic prophylaxis may reduce PONV. Perioperative antiemetic prophylaxis or therapy is crucial and may enhance fast-track bariatric surgery. This study examined the impact of intraoperative multimodal antiemetic prophylaxis on fast-track bariatric surgery. METHODS: This prospective observational clinical study explored the perioperative data of 400 consecutive laparoscopic bariatric surgery patients, over a 6-year period...
November 7, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29112544/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-day-surgery-and-fast-track-surgery
#10
Linas Venclauskas, Juan V Llau, Jean-Yves Jenny, Per Kjaersgaard-Andersen, Øivind Jans
: In recent years, day surgery and fast-track surgery have experienced a continuous increase in volume. Many procedures are now performed on an outpatient protocol, including general, orthopaedic, oncological, reconstructive or vascular surgery. The management of these patients is safe, but the incidence of venous thromboembolism in this population remains unknown. Several risk factors can be identified and stratified derived from studies of inpatient surgical management (e.g. Caprini score). Recommendations for thromboprophylaxis should be tailored from the assessment of both personal and procedure-related risk factors, although with a lack of evidence for application in outpatient management...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29110954/effect-of-motor-subtypes-of-delirium-in-the-intensive-care-unit-on-fast-track-failure-after-cardiac-surgery
#11
Anna Lee, Jing Lan Mu, Chun Hung Chiu, Tony Gin, Malcolm John Underwood, Gavin Matthew Joynt
OBJECTIVE: The purpose of the study was to evaluate the association between motor subtypes of postoperative delirium in the intensive care unit and fast-track failure (a composite outcome of prolonged stay in the intensive care unit >48 hours, intensive care unit readmission, and 30-day mortality) after cardiac surgery. METHODS: This was a secondary analysis of a prospective cohort study of 600 consecutive adults undergoing cardiac surgery at a university hospital in Hong Kong (July 2013 to July 2015)...
September 30, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29107471/quality-of-care-indicators-in-inflammatory-bowel-disease-in-a-tertiary-referral-center-with-open-access-and-objective-assessment-policies
#12
Lorant Gonczi, Zsuzsanna Kurti, Petra Anna Golovics, Barbara Dorottya Lovasz, Orsolya Menyhart, Anna Seres, Liza Dalma Sumegi, Alexander Gal, Akos Ilias, Papp Janos, Krisztina Barbara Gecse, Talat Bessisow, Waqqas Afif, Alain Bitton, Zsuzsanna Vegh, Peter Laszlo Lakatos
BACKGROUND: In the management of inflammatory bowel diseases, there is considerable variation in quality of care. AIMS: The aim of this study was to evaluate structural, access/process components and outcome quality indicators in our tertiary referral IBD center. METHODS: In the first phase, structural/process components were assessed, followed by the second phase of formal evaluation of access and management on a set of consecutive IBD patients with and without active disease (248CD/125UC patients, median age 35/39 years)...
October 9, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29107317/retraction-notice-to-fast-track-for-elderly-patients-is-it-feasible-for-colorectal-surgery-international-journal-of-surgery-12-2014-s20-s22
#13
Rita Compagna, Giovanni Aprea, Davide De Rosa, Maurizio Gentile, Giovanni Cestaro, Gabriele Vigliotti, Tommaso Bianco, Guido Massa, Maurizio Amato, Salvatore Massa, Bruno Amato
No abstract text is available yet for this article.
November 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29103757/liquid-biopsy-an-emerging-prognostic-and-predictive-tool-in-head-and-neck-squamous-cell-carcinoma-hnscc-focus-on-circulating-tumor-cells-ctcs
#14
REVIEW
P Economopoulou, I Kotsantis, E Kyrodimos, E S Lianidou, A Psyrri
Molecular diversity and continuing evolution of metastatic tumors are not easily captured by tissue biopsies. Development of non-invasive diagnostic tools, such asanalysis of circulating tumor DNA (ctDNA), Circulating Tumor Cells (CTCs) and exosomes provides the opportunity to assess a blood sample in order to monitor tumor change and extract molecular information from cancers at a given time. "Liquid biopsy", which refers to molecular analysis of tumor's genetic features based on circulating genetic material in the peripheral blood, is already used to monitor disease response and track mechanisms of drug resistance in solid tumors...
November 2017: Oral Oncology
https://www.readbyqxmd.com/read/29102512/ninety-day-morbidity-and-mortality-in-risk-screened-and-optimized-patients-undergoing-two-team-fast-track-simultaneous-bilateral-tka-compared-with-unilateral-tka-a-prospective-study
#15
Vikas Kulshrestha, Santhosh Kumar, Barun Datta, V K Sinha, Gaurav Mittal
BACKGROUND: Simultaneous bilateral total knee arthroplasty (SBTKA) offers significant socioeconomic benefits. However, retrospective studies and public health data show increased mortality and morbidity rates in patients undergoing SBTKA compared with those undergoing unilateral TKA (UTKA), and there have been recommendations against the use of SBTKA. High-volume centers, which feature careful patient selection and fast-tracked surgery, continue to perform SBTKA and have published their results in favor of the procedure...
October 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29099030/repurposing-established-compounds-to-target-pancreatic-cancer-stem-cells-cscs
#16
REVIEW
Bernhard W Renz, Jan G D'Haese, Jens Werner, C Benedikt Westphalen, Matthias Ilmer
The diagnosis of pancreatic ductal adenocarcinoma (PDAC) carries a dismal prognosis, in particular, when patients present with unresectable disease. While significant progress has been made in understanding the biology of PDAC, this knowledge has not translated into a clear clinical benefit and current chemotherapeutic strategies only offer a modest improvement in overall survival. Accordingly, novel approaches are desperately needed. One hypothesis that could-at least in part-explain the desolate response of PDAC to chemotherapy is the so-called cancer stem cell (CSC) concept, which attributes specific traits, such as chemoresistance, metastatic potential and a distinct metabolism to a small cellular subpopulation of the whole tumor...
June 19, 2017: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29096663/measuring-what-matters-to-rare-disease-patients-reflections-on-the-work-by-the-irdirc-taskforce-on-patient-centered-outcome-measures
#17
Thomas Morel, Stefan J Cano
Our ability to evaluate outcomes which genuinely reflect patients' unmet needs, hopes and concerns is of pivotal importance. However, much current clinical research and practice falls short of this objective by selecting outcome measures which do not capture patient value to the fullest. In this Opinion, we discuss Patient-Centered Outcomes Measures (PCOMs), which have the potential to systematically incorporate patient perspectives to measure those outcomes that matter most to patients. We argue for greater multi-stakeholder collaboration to develop PCOMs, with rare disease patients and families at the center...
November 2, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29081870/fun-during-knee-rehabilitation-feasibility-and-acceptability-testing-of-a-new-android-based-training-device
#18
Thomas Sanjay Weber-Spickschen, Christian Colcuc, Alexander Hanke, Jan-Dierk Clausen, Paul Abraham James, Hauke Horstmann
PURPOSE: The initial goals of rehabilitation after knee injuries and operations are to achieve full knee extension and to activate quadriceps muscle. In addition to regular physiotherapy, an android-based knee training device is designed to help patients achieve these goals and improve compliance in the early rehabilitation period. This knee training device combines fun in a computer game with muscular training or rehabilitation. Our aim was to test the feasibility and acceptability of this new device...
2017: Open Medical Informatics Journal
https://www.readbyqxmd.com/read/29079672/fast-tracked-rehabilitation-and-return-to-sport-of-an-elite-rugby-player-with-a-complicated-posterolateral-corner-injury-and-associated-peroneal-paralysis
#19
L D A Paget, P P F M Kuijer, M Maas, G M M J Kerkhoffs
Acute posterolateral corner injuries of the knee with associated hamstring avulsions and peroneal paralysis are rare in rugby. Regain of motor function following a complete paralysis is documented to be 38%. To our knowledge, only one case describes return to preinjury level of competitive sport taking up to 27 months. A 24-year-old international level rugby player, a medical student, sustained an acute posterolateral knee injury with associated anterior cruciate ligament tear, bicep femoris and semimembranosus avulsions as well as a complete peroneal paralysis...
October 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29079371/impact-of-revised-triage-to-improve-throughput-in-an-emergency-department-with-limited-traditional-fast-track-population
#20
Ryan M Gardner, Nathan A Friedman, Michael Carlson, Tamala S Bradham, Tyler W Barrett
BACKGROUND: Emergency department (ED) crowding is associated with patient safety concerns, increased patients left without being seen (LWBS), low patient satisfaction, and lost ED revenue. The objective was to measure the impact of a revised triage process on ED throughput. METHODS: This study took place at an urban, university-affiliated, adult ED with an annual census of 70,000 and admission rate of 34%. The revised triage approach included: identifying eligible patients at triage based on complaint, comorbidities, and illness acuity; and reallocating a nurse practitioner (NP) into our triage area...
October 7, 2017: American Journal of Emergency Medicine
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