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https://www.readbyqxmd.com/read/28548628/endothelial-progenitor-cells-for-the-vascularization-of-engineered-tissues
#1
Erica Brown Peters
Self-assembled microvasculature from cocultures of endothelial cells and stromal cells have significantly advanced efforts to vascularize engineered tissues by enhancing perfusion rates <i>in vivo</i> and producing investigative platforms for microvascular morphogenesis <i>in vitro</i>. However, in order to clinically translate prevascularized constructs, the issue of endothelial cell source must be resolved. Endothelial progenitor cells (EPCs) can be noninvasively supplied from the recipient through adult peripheral and umbilical cord blood, as well as derived from induced pluripotent stem cells, alleviating antigenicity issues...
May 26, 2017: Tissue Engineering. Part B, Reviews
https://www.readbyqxmd.com/read/28547753/the-cost-effectiveness-of-patient-controlled-analgesia-vs-standard-care-in-patients-presenting-to-the-emergency-department-in-pain-who-are-subsequently-admitted-to-hospital
#2
C Pritchard, J E Smith, S Creanor, R Squire, A Barton, J Benger, L Cocking, P Ewings, M Rockett
The clinical effectiveness of patient-controlled analgesia has been demonstrated in a variety of settings. However, patient-controlled analgesia is rarely utilised in the emergency department. The aim of this study was to compare the cost-effectiveness of patient-controlled analgesia vs. standard care in participants admitted to hospital from the emergency department with pain due to traumatic injury or non-traumatic abdominal pain. Pain scores were measured hourly for 12 h using a visual analogue scale. Cost-effectiveness was measured as the additional cost per hour in moderate to severe pain avoided by using patient-controlled analgesia rather than standard care (the incremental cost-effectiveness ratio)...
May 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28544906/development-of-a-harmonized-patient-reported-outcome-questionnaire-to-assess-myelofibrosis-symptoms-in-clinical-trials
#3
Chad Gwaltney, Jean Paty, Virginia E Kwitkowski, Ruben A Mesa, Amylou C Dueck, Elektra J Papadopoulos, Lixia Wang, Joseph Feliciano, Stephen Joel Coons
Along with reducing spleen size, relieving symptom severity is a key objective of the treatment of myelofibrosis (MF). Several questionnaires have been developed for patient self-report of MF symptoms in clinical trials and each includes unique instructions, items, and/or response scales. This variability in questionnaire content increases uncertainty; it is unclear which questionnaire is the most appropriate for assessing MF symptoms and it makes comparisons across trials difficult. The Patient-Reported Outcome (PRO) Consortium's MF Working Group (WG) was established to review existing MF symptom questionnaires and to develop a harmonized, consensus-based PRO questionnaire for use in future MF trials...
May 12, 2017: Leukemia Research
https://www.readbyqxmd.com/read/28543920/uncertainty-increases-neural-indices-of-attention-in-obsessive-compulsive-disorder
#4
Raoul Dieterich, Tanja Endrass, Norbert Kathmann
BACKGROUND: Patients with obsessive-compulsive disorder (OCD) experience abnormally high levels of uncertainty, and unpredictability is evaluated negatively and not well tolerated. The current study examined neural correlates of attentional processing in response to experimentally induced uncertainty in OCD. METHODS: Twenty-four OCD patients and 24 healthy controls performed a task where neutral and negative pictures were preceded by a cue, either being predictive (certain condition) or nonpredictive (uncertain condition) of subsequent picture valence...
May 25, 2017: Depression and Anxiety
https://www.readbyqxmd.com/read/28543411/crowdsourcing-the-moral-limits-of-human-gene-editing
#5
Eric T Juengst
In 2015, a flourish of "alarums and excursions" by the scientific community propelled CRISPR/Cas9 and other new gene-editing techniques into public attention. At issue were two kinds of potential gene-editing experiments in humans: those making inheritable germ-line modifications and those designed to enhance human traits beyond what is necessary for health and healing. The scientific consensus seemed to be that while research to develop safe and effective human gene editing should continue, society's moral uncertainties about these two kinds of experiments needed to be better resolved before clinical trials of either type should be attempted...
May 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28541896/solving-inaccuracies-in-anatomical-models-for-electrocardiographic-inverse-problem-resolution-by-maximizing-reconstruction-quality
#6
Miguel Rodrigo, Andreu Climent, Alejandro Liberos, Ismael Hernandez-Romero, Angel Arenal, Javier Bermejo, Francisco Fernandez-Aviles, Felipe Atienza, Maria Guillem
Electrocardiographic Imaging (ECGI) has become an increasingly used technique for non-invasive diagnosis of cardiac arrhythmias, although the need for medical imaging technology to determine the anatomy hinders its introduction in the clinical practice. This work explores the ability of a new metric based on the inverse reconstruction quality for the location and orientation of the atrial surface inside the torso. Body surface electrical signals from 31 realistic mathematical models and four AF patients were used to estimate the optimal position of the atria inside the torso...
May 23, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28540813/measurement-and-analysis-of-the-impact-of-time-interval-temperature-and-radiation-dose-on-tumour-cell-survival-and-its-application-in-thermoradiotherapy-plan-evaluation
#7
C M van Leeuwen, A L Oei, R Ten Cate, N A P Franken, A Bel, L J A Stalpers, J Crezee, H P Kok
PURPOSE: Biological modelling of thermoradiotherapy may further improve patient selection and treatment plan optimisation, but requires a model that describes the biological effect as a function of variables that affect treatment outcome (e.g. temperature, radiation dose). This study aimed to establish such a model and its parameters. Additionally, a clinical example was presented to illustrate the application. METHODS: Cell survival assays were performed at various combinations of radiation dose (0-8 Gy), temperature (37-42 °C), time interval (0-4 h) and treatment sequence (radiotherapy before/after hyperthermia) for two cervical cancer cell lines (SiHa and HeLa)...
May 9, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28540608/ethics-and-medical-toxicology-research
#8
Jeremy Sugarman, Andrew Stolbach
Optimizing care in medical toxicology necessitates designing and conducting ethical research. Nevertheless, the context of medical toxicology can make clinical research ethically challenging for a variety of reasons: medical toxicology is typified by relative rare conditions; making precise and rapid diagnoses is often fraught with uncertainty; emergent and urgent clinical exigencies make consent difficult or impossible; and some exposures are stigmatized or related to illegal activities that can compromise collecting accurate data from patients...
May 24, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28540400/imaging-of-cerebral-ischemic-edema-and-neuronal-death
#9
REVIEW
Rüdiger von Kummer, Imanuel Dzialowski
PURPOSE: In acute cerebral ischemia, the assessment of irreversible injury is crucial for treatment decisions and the patient's prognosis. There is still uncertainty how imaging can safely differentiate reversible from irreversible ischemic brain tissue in the acute phase of stroke. METHODS: We have searched PubMed and Google Scholar for experimental and clinical papers describing the pathology and pathophysiology of cerebral ischemia under controlled conditions...
May 24, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28537939/current-perspectives-on-revascularization-in-multivessel-st-elevation-myocardial-infarction
#10
Guy Witberg, Ran Kornowski
Up to 50% of patients presenting with ST elevation myocardial infarction (STEMI) are found to have multivessel coronary artery disease. These patients have a worse prognosis compared with the overall STEMI population. Two revascularization strategies are possible for these patients: treating the infarct-related artery percutaneous coronary intervention (IRA-PCI) only or achieving Complete revascularization (CR), either through an immediate multivessel PCI during the index angiography or during a second-staged procedure...
May 19, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28536804/modeling-dynamic-contrast-enhanced-mri-data-with-a-constrained-local-aif
#11
Chong Duan, Jesper F Kallehauge, Carlos J Pérez-Torres, G Larry Bretthorst, Scott C Beeman, Kari Tanderup, Joseph J H Ackerman, Joel R Garbow
PURPOSE: This study aims to develop a constrained local arterial input function (cL-AIF) to improve quantitative analysis of dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) data by accounting for the contrast-agent bolus amplitude error in the voxel-specific AIF. PROCEDURES: Bayesian probability theory-based parameter estimation and model selection were used to compare tracer kinetic modeling employing either the measured remote-AIF (R-AIF, i.e...
May 23, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/28534114/pediatric-hypothyroidism-diagnosis-and-treatment
#12
Ari J Wassner
Thyroid hormone has important physiologic functions in nearly every organ system. The critical role of thyroid hormone in growth and in physical and neurologic development lends particular importance to the prompt diagnosis and appropriate treatment of hypothyroidism in infants and children. Congenital hypothyroidism is common and has potentially devastating neurologic consequences. While the approach to diagnosis and treatment of severe congenital hypothyroidism is well established, data continue to emerge about the genetic causes, clinical significance, and prognosis of the milder forms of congenital hypothyroidism that are increasingly being diagnosed by newborn screening...
May 22, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28533912/portal-vein-thrombosis-in-patients-with-cirrhosis
#13
Leona von Köckritz, Andrea De Gottardi, Jonel Trebicka, Michael Praktiknjo
Portal vein thrombosis (PVT) is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare, but can be life-threatening. However, different aspects of clinical relevance, diagnosis and management of PVT are still areas of uncertainty and investigation in international guidelines. In this article, we elaborate on PVT classification, geographical differences in clinical presentation and standards of diagnosis, and briefly on the current pathophysiological understanding and risk factors...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28532470/health-care-professionals-attitudes-towards-evidence-based-medicine-in-the-workers-compensation-setting-a-cohort-study
#14
Nieke A Elbers, Robin Chase, Ashley Craig, Lyn Guy, Ian A Harris, James W Middleton, Michael K Nicholas, Trudy Rebbeck, John Walsh, Simon Willcock, Keri Lockwood, Ian D Cameron
BACKGROUND: Problems may arise during the approval process of treatment after a compensable work injury, which include excess paperwork, delays in approving services, disputes, and allegations of over-servicing. This is perceived as undesirable for injured people, health care professionals and claims managers, and costly to the health care system, compensation system, workplaces and society. Introducing an Evidence Based Medicine (EBM) decision tool in the workers' compensation system could provide a partial solution, by reducing uncertainty about effective treatment...
May 22, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28532354/the-road-to-certainty-and-back
#15
Gerald Westheimer
The author relates his intellectual journey from eye-testing clinician to experimental vision scientist. Starting with the quest for underpinning in physics and physiology of vague clinical propositions and of psychology's acceptance of thresholds as "fuzzy-edged," and a long career pursuing a reductionist agenda in empirical vision science, his journey led to the realization that the full understanding of human vision cannot proceed without factoring in an observer's awareness, with its attendant uncertainty and open-endedness...
October 14, 2016: Annual Review of Vision Science
https://www.readbyqxmd.com/read/28531203/potential-health-gains-for-patients-with-metastatic-renal-cell-carcinoma-in-daily-clinical-practice-a-real-world-cost-effectiveness-analysis-of-sequential-first-and-second-line-treatments
#16
S De Groot, H M Blommestein, W K Redekop, S Sleijfer, L A L M Kiemeney, E Oosterwijk, C A Uyl-de Groot
INTRODUCTION: Randomised controlled trials have shown that targeted therapies like sunitinib are effective in metastatic renal cell carcinoma (mRCC). Little is known about the current use of these therapies, and their associated costs and effects in daily clinical practice. We estimated the real-world cost-effectiveness of different treatment strategies comprising one or more sequentially administered drugs. METHODS: Analyses were performed using patient-level data from a Dutch population-based registry including patients diagnosed with primary mRCC from January 2008 to December 2010 (i...
2017: PloS One
https://www.readbyqxmd.com/read/28530533/respiratory-motion-management-in-pet-ct-applications-and-clinical-usefulness
#17
Luca Guerra, Elena De Ponti, Sabrina Morzenti, Chiara Spadavecchia, Cinzia Crivellaro
Although breathing movement can introduce heavy bias in both image quality and quantitation, currently there is lack of interest for the respiratory motion management in PET/CT imaging. The respiratory gating technology has shown significant benefits on image quality, reducing motion related artifacts and increasing quantification. Indeed, many papers have demonstrated that there is a consistent increase of the Standardized Uptake Value (SUV) in gated PET images when compared to ungated ones, particularly for the small lesions located both in liver and in lung...
May 19, 2017: Current Radiopharmaceuticals
https://www.readbyqxmd.com/read/28530523/cost-effectiveness-of-peginterferon-beta-1a-and-alemtuzumab-in-relapsing-remitting-multiple-sclerosis
#18
Ankur A Dashputre, Khalid M Kamal, Gauri Pawar
BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system, affecting 2.5 million people globally and 400,000 people in the United States. While no cure exists for MS, the goal is to manage the disease using disease-modifying therapies (DMTs), which have been shown to slow disease progression and prevent relapses. Relapsing-remitting MS (RRMS) is the most common form of MS at the time of diagnosis. Peginterferon beta-1a (PEG) and alemtuzumab (ALT) were recently approved and have demonstrated good clinical outcomes, including reduced relapse rates in clinical trials...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28529122/shared-decision-making-a-buzz-word-in-the-netherlands-the-pace-quickens-towards-nationwide-implementation%C3%A2
#19
Trudy van der Weijden, Heleen Post, Paul L P Brand, Haske van Veenendaal, Ton Drenthen, Linda Aj van Mierlo, Peep Stalmeier, Olga C Damman, Anne Stiggelbout
Currently, shared decision making (SDM) is on the agenda among target patient representative groups, policy makers and professional bodies. Although the International Conference for Shared Decision Making (ISDM) 2011 generated a positive boost, hesitation was also felt among Dutch clinicians, who are challenged by many new tasks. No hesitation is seen among the majority of patients, opting mostly for the SDM model. We haven't reached these patients' needs fully yet, given disappointing research data on patients' experiences and professional behaviour...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28528578/a-cluster-randomized-trial-to-reduce-caesarean-delivery-rates-in-quebec-cost-effectiveness-analysis
#20
Mira Johri, Edmond S W Ng, Clara Bermudez-Tamayo, Jeffrey S Hoch, Thierry Ducruet, Nils Chaillet
BACKGROUND: Widespread increases in caesarean section (CS) rates have sparked concerns about risks to mothers and infants and rising healthcare costs. A multicentre, two-arm, cluster-randomized trial in Quebec, Canada assessed whether an audit and feedback intervention targeting health professionals would reduce CS rates for pregnant women compared to usual care, and concluded that it reduced CS rates without adverse effects on maternal or neonatal health. The effect was statistically significant but clinically small...
May 22, 2017: BMC Medicine
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