keyword
MENU ▼
Read by QxMD icon Read
search

Clinical uncertainty

keyword
https://www.readbyqxmd.com/read/28107554/inclusion-of-a-variable-rbe-into-proton-and-photon-plan-comparison-for-various-fractionation-schedules-in-prostate-radiation-therapy
#1
Jakob Ödén, Kjell Eriksson, Iuliana Toma-Dasu
PURPOSE: A constant relative biological effectiveness (RBE) of 1.1 is currently used in proton radiation therapy to account for the increased biological effectiveness compared to photon therapy. However, there is increasing evidence that proton RBE vary with the linear energy transfer (LET), the dose per fraction and the type of the tissue. Therefore, this study aims to evaluate the impact of disregarding variations in RBE when comparing proton and photon dose plans for prostate treatments for various fractionation schedules using published RBE models and several α/β assumptions...
January 20, 2017: Medical Physics
https://www.readbyqxmd.com/read/28105886/interobserver-delineation-uncertainty-in-involved-node-radiation-therapy-inrt-for-early-stage-hodgkin-lymphoma-on-behalf-of-the-radiotherapy-committee-of-the-eortc-lymphoma-group
#2
Marianne C Aznar, Theodore Girinsky, Anne Kiil Berthelsen, Berthe Aleman, Max Beijert, Martin Hutchings, Yolande Lievens, Paul Meijnders, Peter Meidahl Petersen, Deborah Schut, Maja V Maraldo, Richard van der Maazen, Lena Specht
BACKGROUND AND PURPOSE: In early-stage classical Hodgkin lymphoma (HL) the target volume nowadays consists of the volume of the originally involved nodes. Delineation of this volume on a post-chemotherapy CT-scan is challenging. We report on the interobserver variability in target volume definition and its impact on resulting treatment plans. MATERIALS AND METHODS: Two representative cases were selected (1: male, stage IB, localization: left axilla; 2: female, stage IIB, localizations: mediastinum and bilateral neck)...
January 20, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28103773/agaricus-blazei-bioactive-compounds-and-their-effects-on-human-health-benefits-and-controversies
#3
Aline Cristine da Silva de Souza, Vanesa Gesser Correa, Geferson de Almeida Gonçalves, Andréia Assunção Soares, Adelar Bracht, Rosane Marina Peralta
BACKGROUND: The mushroom Agaricus blazei has evoked considerable scientific and practical interest in several fields, especially those linked to its medicinal properties. This review aims to summarize and evaluate the past decade findings related to nutritional and therapeutic uses of A. blazei, with especial emphasis on the most recent discoveries regarding its chemical composition and clinical investigations. METHODS: The specialized literature was searched for basic and clinical studies...
January 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28103626/nonalcoholic-fatty-liver-disease-in-adolescents-and-young-adults-the-next-frontier-in-the-epidemic
#4
REVIEW
Iliana Doycheva, Kymberly D Watt, Naim Alkhouri
Nonalcoholic fatty liver disease (NAFLD) is a significant health burden in adolescents and young adults (AYAs) with substantial rise in prevalence over the last decades. This parallels high rates of obesity and metabolic syndrome in this age group, with unhealthy lifestyle also playing an independent role. Genetic factors, gender, and ethnicity should be considered in a risk stratification model. NAFLD and nonalcoholic steatohepatitis (NASH) in AYAs often go unrecognized and if untreated, can progress eventually to cirrhosis requiring liver transplantation before the age of 40...
January 19, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28103532/timing-of-anticoagulant-re-initiation-following-intracerebral-hemorrhage-in-mechanical-heart-valves-survey-of-neurosurgeons-and-thrombosis-experts
#5
Fahad AlKherayf, Yan Xu, Harrison Westwick, Ioana Doina Moldovan, Philip S Wells
BACKGROUND: While oral anticoagulation (OAC) is universally indicated for patients with mechanical heart valves (MHVs), OAC resumption following anticoagulant-associated intracerebral hemorrhage (ICH) is an area of uncertainty. We sought to determine the practice preferences of North American neurosurgeons and thrombosis experts on optimal timing of OAC re-initiation. METHODS: A cross-sectional survey was disseminated to North American members of the American Association of Neurological Surgeons and the International Society for Thrombosis and Haemostasis...
January 16, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28102933/what-if-a-tumor-is-significantly-enlarged-just-before-stereotactic-body-radiation-therapy-a-case-report-and-review-of-the-literature
#6
Hung-Jen Chen, Ji-An Liang, Chih-Yi Chen, Yang-Hao Yu, Chun-Ru Chien
Stereotactic body radiation therapy (SBRT) plays an important role in early stage non-small cell lung cancer. Tumor growth before radiotherapy planning (RTP) or during SBRT has been reported in lung cancer patients; however, little is known of growth during the period in-between (i.e. after RTP but before SBRT). An 83-year-old man referred to our hospital and diagnosed with medically inoperable non-small cell lung cancer was noted to have significant tumor progression on day 1 of cone beam computed tomography just before the planned SBRT delivery...
November 18, 2016: Thoracic Cancer
https://www.readbyqxmd.com/read/28102899/b-type-natriuretic-peptide-guided-treatment-for-heart-failure
#7
REVIEW
Julie McLellan, Carl J Heneghan, Rafael Perera, Alison M Clements, Paul P Glasziou, Karen E Kearley, Nicola Pidduck, Nia W Roberts, Sally Tyndel, F Lucy Wright, Clare Bankhead
BACKGROUND: Heart failure is a condition in which the heart does not pump enough blood to meet all the needs of the body. Symptoms of heart failure include breathlessness, fatigue and fluid retention. Outcomes for patients with heart failure are highly variable; however on average, these patients have a poor prognosis. Prognosis can be improved with early diagnosis and appropriate use of medical treatment, use of devices and transplantation. Patients with heart failure are high users of healthcare resources, not only due to drug and device treatments, but due to high costs of hospitalisation care...
December 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28102863/a-taxonomy-of-medical-uncertainties-in-clinical-genome-sequencing
#8
Paul K J Han, Kendall L Umstead, Barbara A Bernhardt, Robert C Green, Steven Joffe, Barbara Koenig, Ian Krantz, Leo B Waterston, Leslie G Biesecker, Barbara B Biesecker
PURPOSE: Clinical next-generation sequencing (CNGS) is introducing new opportunities and challenges into the practice of medicine. Simultaneously, these technologies are generating uncertainties of an unprecedented scale that laboratories, clinicians, and patients are required to address and manage. We describe in this report the conceptual design of a new taxonomy of uncertainties around the use of CNGS in health care. METHODS: Interviews to delineate the dimensions of uncertainty in CNGS were conducted with genomics experts and themes were extracted in order to expand on a previously published three-dimensional taxonomy of medical uncertainty...
January 19, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28102459/a-qualitative-exploration-of-clinician-views-and-experiences-of-treatment-decision-making-in-bipolar-ii-disorder
#9
Alana Fisher, Vijaya Manicavasagar, Louise Sharpe, Rebekah Laidsaar-Powell, Ilona Juraskova
This study qualitatively explored clinicians' views and experiences of treatment decision-making in BPII. Semi-structured interviews were conducted with 20 practising clinicians (n = 10 clinical psychologists, n = 6 GPs, n = 4 psychiatrists) with experience in treating adult outpatients with BPII. Interviews were audiotaped, transcribed verbatim and thematically analysed using framework methods. Professional experience, and preferences for patient involvement in decision-making were also assessed...
January 19, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/28098413/dermatomal-spread-following-posterior-transversus-abdominis-plane-block-in-pediatric-patients-our-initial-experience
#10
Maria A Hernandez, Tricia Vecchione, Karen Boretsky
INTRODUCTION: Several techniques for the transversus abdominis plane (TAP) block have been described. The extent of sensory changes using an ultrasound-guided posterior TAP block (pTAP) remains unclear in pediatric patients. The primary aim of this study was to report the extent of sensory changes achieved with pTAP; specifically the highest thoracic dermatome anesthetized. Secondary outcomes were pain scores (PS), opioid consumption, and complications. METHODS: We retrospectively reviewed the medical records of patients less than 21 years of age undergoing abdominal surgery with a unilateral or bilateral pTAP(s) for postoperative analgesia...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28097913/cost-consequence-analysis-of-different-active-flowable-hemostatic-matrices-in-cardiac-surgical-procedures
#11
D Makhija, M Rock, Y Xiong, J D Epstein, M R Arnold, O M Lattouf, D Calcaterra
BACKGROUND: A recent retrospective comparative effectiveness study found that use of FLOSEAL® Hemostatic Matrix in cardiac surgery was associated with significantly lower risks of complications, blood transfusions, surgical revisions and shorter length of surgery than use of SURGIFLO(®) Hemostatic Matrix. These outcome improvements in cardiac surgery procedures may translate to economic savings for hospitals and payers. OBJECTIVE: The objective of this study was to estimate the cost-consequence of two flowable hemostatic matrices (FLOSEAL or SURGIFLO) in cardiac surgeries for US hospitals...
January 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28097904/estimated-burden-of-cardiovascular-disease-and-value-based-price-range-for-evolocumab-in-a-high-risk-secondary-prevention-population-in-the-us-payer-context
#12
Peter P Toth, Mark Danese, Guillermo Villa, Yi Qian, Anne Beaubrun, Armando Lira, Jeroen P Jansen
AIM: To estimate real-world cardiovascular disease (CVD) burden and value-based price range of evolocumab for a US-context, high-risk, secondary-prevention population. MATERIALS AND METHODS: Burden of CVD was assessed using the UK-based Clinical Practice Research Datalink (CPRD) in order to capture complete CV burden including CV mortality. Patients on standard of care (SOC; high-intensity statins) in CPRD were selected based on eligibility criteria of FOURIER, a phase 3 CV outcomes trial of evolocumab, and categorized into 4 cohorts: high-risk prevalent atherosclerotic CVD (ASCVD) cohort (N = 1448), acute coronary syndrome (ACS) (N = 602), ischemic stroke (IS) (N = 151), and heart failure (HF) (N = 291) incident cohorts...
January 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28094586/perceptions-of-occupational-therapists-on-the-patient-protection-and-affordable-care-act-five-years-after-its-enactment
#13
Hon K Yuen, Hillary S Spicher, Madelyn R Semon, Leah M Winwood, Brian J Dudgeon
This study explored the perceptions of occupational therapists regarding the impact and implications of the Patient Protection and Affordable Care Act (PPACA or ACA) on occupational therapy practice. Fifteen occupational therapists participated in an interview to answer open-ended questions related to their thoughts and perceptions regarding the impact and implications of the ACA on their practice. The participants were practicing in eight different states and worked in five different settings with clinical experience ranging from 3 to 38 years; their positions ranged from staff therapist to owner of a free-standing outpatient clinic...
January 17, 2017: Occupational Therapy in Health Care
https://www.readbyqxmd.com/read/28094167/seizures-and-antiseizure-medications-are-important-to-parents-of-newborns-with-seizures
#14
Elizabeth Hill, Hannah Cranley Glass, Kelli Kelley, Marty Barnes, Stephanie Rau, Linda S Franck, Renée A Shellhaas
BACKGROUND: Neonatal seizures and antiseizure medications both have potentially serious consequences on the developing brain. As such, optimal treatment of neonatal seizures remains unclear. Moreover, little is known about parental experiences, concerns, or unanswered questions. We conducted an online survey to assess parental perspectives regarding neonatal seizures and their management, along with their suggestions for specific high priority research topics. METHODS: Parents whose children had neonatal seizures were recruited through social media support groups to complete an online survey...
October 8, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/28092609/horse-expert-an-aided-expert-system-for-diagnosing-horse-diseases
#15
H Qin, J Xiao, X Gao, H Wang
In contrast to the rapid development of the horse husbandry in China, the ability of horse veterinarians to diagnose diseases has not been improved and only a few domain experts have considerable expertise. At present, many expert systems have been developed for diseases diagnosis, but few for horse diseases diagnosis have been studied in depth. This paper presents the design and development of a computer-aided expert system for diagnosing horse diseases. We suggest an approach for diagnosis of horse diseases based on the analysis of diagnostic characteristics and the experiential knowledge of domain experts...
December 1, 2016: Polish Journal of Veterinary Sciences
https://www.readbyqxmd.com/read/28091358/a-survey-of-exercise-advice-and-recommendations-in-united-kingdom-paediatric-cardiac-clinics
#16
Craig A Williams, Lucy Gowing, Richard Horn, Alan Graham Stuart
BACKGROUND: Physical activity and exercise have important health benefits for children and adolescents with CHD. The objective of this study was to survey the provision of advice and recommendations in United Kingdom paediatric CHD clinics. METHODS: A three-page questionnaire was sent out to paediatric cardiac consultants in the United Kingdom, paediatric consultants with expertise in cardiology, and nursing staff (Paediatricians with Expertise in Cardiology Special Interest Group), as well as all members of the British Congenital Cardiovascular Association...
January 16, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28090226/more-use-of-peritoneal-dialysis-gives-significant-savings-a-systematic-review-and-health-economic-decision-model
#17
Eva Pike, Vida Hamidi, Tove Ringerike, Torbjorn Wisloff, Marianne Klemp
BACKGROUND: Patients with end-stage renal disease (ESRD) are in need of renal replacement therapy as dialysis and/or transplantation. The prevalence of ESRD and, thus, the need for dialysis are constantly growing. The dialysis modalities are either peritoneal performed at home or hemodialysis (HD) performed in-center (hospital or satellite) or home. We examined effectiveness and cost-effectiveness of HD performed at different locations (hospital, satellite, and home) and peritoneal dialysis (PD) at home in the Norwegian setting...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28089498/anticoagulants-in-ischemia-guided-management-of-non-st-elevation-acute-coronary-syndromes
#18
REVIEW
Martin Mayer
BACKGROUND: The most recent joint guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC) on the management of non-ST-elevation acute coronary syndromes (NSTE-ACS) are a result of a substantial and considered undertaking, and those involved deserve much recognition for their efforts. However, the handling of anticoagulants seems somewhat inadequate, and this is a highly-relevant matter when managing NSTE-ACS. OBJECTIVE OF THE REVIEW: Among areas of potential uncertainty, emergency medicine professionals might still be left wondering about the particulars of anticoagulant therapy when pursuing ischemia-guided management of NSTE-ACS (that is, managing NSTE-ACS without an intent for early invasive measures, such as coronary angiography and revascularization)...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28088109/carbetocin-versus-oxytocin-for-prevention-of-post-partum-haemorrhage-at-caesarean-section-in-the-united-kingdom-an-economic-impact-analysis
#19
Helen A van der Nelson, Tim Draycott, Dimitrios Siassakos, Christopher W H Yau, Anthony J Hatswell
OBJECTIVE: To determine the economic impact of the introduction of carbetocin for the prevention of postpartum haemorrhage (PPH) at caesarean section, compared to oxytocin. STUDY DESIGN: The model is a decision tree conducted from a UK National Health Service perspective. 1500 caesarean sections (both elective and emergency) were modelled over a 12 month period. Efficacy data was taken from a published Cochrane meta-analysis, and costs from NHS Reference costs, the British National Formulary and the NHS electronic Medicines Information Tool...
January 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28086887/patients-and-physicians-perceptions-and-attitudes-about-oral-anticoagulation-and-atrial-fibrillation-a-qualitative-systematic-review
#20
Gemma Mas Dalmau, Elisenda Sant Arderiu, María Belén Enfedaque Montes, Ivan Solà, Sandra Pequeño Saco, Pablo Alonso Coello
BACKGROUND: Oral anticoagulant therapy reduces the risk of stroke in patients with atrial fibrillation, but many patients are still not prescribed this therapy. The causes of underuse of vitamin K antagonists oral anticoagulants are not clear but could be related, in part, to patients' and physicians' perceptions and attitudes towards the benefits and downsides of this treatment. The purpose of this systematic review was to evaluate and synthesize patients' and physicians' perceptions and attitudes towards the benefits and downsides of vitamin K antagonist, in order to explore potential factors related with its underuse...
January 13, 2017: BMC Family Practice
keyword
keyword
81222
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"