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https://www.readbyqxmd.com/read/28087402/accuracy-is-in-the-eyes-of-the-pathologist-the-visual-interpretive-process-and-diagnostic-accuracy-with-digital-whole-slide-images
#1
Tad T Brunyé, Ezgi Mercan, Donald L Weaver, Joann G Elmore
Digital whole slide imaging is an increasingly common medium in pathology, with application to education, telemedicine, and rendering second opinions. It has also made it possible to use eye tracking devices to explore the dynamic visual inspection and interpretation of histopathological features of tissue while pathologists review cases. Using whole slide images, the present study examined how a pathologist's diagnosis is influenced by fixed case-level factors, their prior clinical experience, and their patterns of visual inspection...
January 10, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28087390/family-building-after-breast-cancer-considering-the-effect-on-adherence-to-adjuvant-endocrine-therapy
#2
Catherine Benedict, Bridgette Thom, Eleonora Teplinsky, Jane Carleton, Joanne F Kelvin
Adherence to endocrine therapy (ET) is a longstanding problem in breast cancer (BC) survivorship care, particularly among younger women. Younger patients have reported lower ET initiation rates and greater rates of early discontinuation and are considered an "at risk" group for nonadherence. For women who hope to have children in the future, concerns about premature menopause and the implications of postponing childbearing for the 5 to 10 years of ET are widespread. Preliminary evidence suggests that prioritizing fertility, along with concerns about side effects, leads to ET noninitiation and early discontinuation...
December 24, 2016: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28087156/french-national-consensus-clinical-guidelines-for-the-management-of-crohn-s-disease
#3
Laurent Peyrin-Biroulet, Yoram Bouhnik, Xavier Roblin, Guillaume Bonnaud, Hervé Hagège, Xavier Hébuterne
BACKGROUND: Crohn's disease (CD) is a chronic and disabling condition. There is no curative medical treatment but current treatments provide increasingly sustainable control of the disease and allow patients a better quality of life. There is limited evidence supporting CD management in specific clinical situations, thus precluding an evidence-based approach. AIMS: To help clinicians in making informed treatment decisions, a group of 59 French gastroenterologists with experience in the management of CD met to develop straightforward and practical algorithms based on the European Crohn's and Colitis Organisation (ECCO) recommendations...
December 22, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28079726/the-charter-on-professionalism-for-health-care-organizations
#4
Barry E Egener, Diana J Mason, Walter J McDonald, Sally Okun, Meg E Gaines, David A Fleming, Bernie M Rosof, David Gullen, May-Lynn Andresen
In 2002, the Physician Charter on Medical Professionalism was published to provide physicians with guidance for decision making in a rapidly changing environment. Feedback from physicians indicated that they were unable to fully live up to the principles in the 2002 charter partly because of their employing or affiliated health care organizations. A multistakeholder group has developed a Charter on Professionalism for Health Care Organizations, which may provide more guidance than charters for individual disciplines, given the current structure of health care delivery systems...
January 10, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28079633/criterion-referenced-values-of-grip-strength-and-usual-gait-speed-using-instrumental-activities-of-daily-living-disability-as-the-criterion
#5
Meng-Chih Lee, Chih-Cheng Hsu, Yi-Fen Tsai, Ching-Yu Chen, Cheng-Chieh Lin, Ching-Yi Wang
BACKGROUND AND PURPOSE: Current evidence suggests that grip strength and usual gait speed (UGS) are important predictors of instrumental activities of daily living (IADL) disability. Knowing the optimum cut points of these tests for discriminating people with and without IADL disability could help clinicians or researchers to better interpret the test results and make medical decisions. The purpose of this study was to determine the cutoff values of grip strength and UGS for best discriminating community-dwelling older adults with and without IADL disability, separately for men and women, and to investigate their association with IADL disability...
January 10, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28078429/aims-and-tasks-in-parental-caregiving-for-children-receiving-palliative-care-at-home-a-qualitative-study
#6
Lisa M Verberne, Marijke C Kars, Antoinette Y N Schouten-van Meeteren, Diederik K Bosman, Derk A Colenbrander, Martha A Grootenhuis, Johannes J M van Delden
: In paediatric palliative care (PPC), parents are confronted with increasing caregiving demands. More children are cared for at home, and the need for PPC of children is lengthened due to technical and medical improvements. Therefore, a clear understanding of the content of parental caregiving in PPC becomes increasingly important. The objective is to gain insight into parental caregiving based on the lived experience of parents with a child with a life-limiting disease. An interpretative qualitative study using thematic analysis was performed...
January 11, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28078208/influence-of-different-second-generation-antipsychotics-on-the-qtc-interval-a-pragmatic-study
#7
Roy E Olsen, Rune A Kroken, Sigmund Bjørhovde, Kristina Aanesen, Hugo A Jørgensen, Else-Marie Løberg, Erik Johnsen
AIM: To investigate whether differential influence on the QTc interval exists among four second generation antipsychotics (SGAs) in psychosis. METHODS: Data were drawn from a pragmatic, randomized head-to-head trial of the SGAs risperidone, olanzapine, quetiapine, and ziprasidone in acute admissions patients with psychosis, and with follow-up visits at discharge or maximally 6-9 wk, 3, 6, 12 and 24 mo. Electrocardiograms were recorded on all visits. To mimic clinical shared decision-making, the patients were randomized not to a single drug, but to a sequence of the SGAs under investigation...
December 22, 2016: World Journal of Psychiatry
https://www.readbyqxmd.com/read/28078204/treatment-adherence-in-bipolar-disorder-a-patient-centred-approach
#8
REVIEW
Subho Chakrabarti
About half of the patients diagnosed with bipolar disorder (BD) become non-adherent during long-term treatment, a rate largely similar to other chronic illnesses and one that has remained unchanged over the years. Non-adherence in BD is a complex phenomenon determined by a multitude of influences. However, there is considerable uncertainty about the key determinants of non-adherence in BD. Initial research on non-adherence in BD mostly limited itself to examining demographic, clinical and medication-related factors impacting adherence...
December 22, 2016: World Journal of Psychiatry
https://www.readbyqxmd.com/read/28077891/evaluation-the-relationship-between-thyroid-nodule-size-with-malignancy-and-accuracy-of-fine-needle-aspiration-biopsy-fnab
#9
Gholamali Godazandeh, Zahra Kashi, Sadegh Zargarnataj, Mehran Fazli, Robab Ebadi, Ensiyeh Hajializadeh Kerdabadi
INTRODUCTION: Some studies have shown largest thyroid nodule size, especially ≥4cm that can predict malignancy and reduce fine needle aspiration biopsy (FNAB) accuracy. Therefore, this study is designed to evaluate relationship between thyroid nodule sizes with malignancy and its effect on FNBA accuracy. MATERIALS AND METHODS: a retrospective analytical study design aims to investigate all patients with thyroid nodules who referred to surgery department of Imam-Khomeini Hospital of Mazandaran University of Medical Sciences in Sari from 20 March 2008 to 22 March 2014...
October 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28077428/reproductive-experiences-of-women-who-cryopreserved-oocytes-for-non-medical-reasons
#10
Karin Hammarberg, Maggie Kirkman, Natasha Pritchard, Martha Hickey, Michelle Peate, John McBain, Franca Agresta, Chris Bayly, Jane Fisher
STUDY QUESTION: What are the reproductive experiences of women who cryopreserve oocytes for non-medical reasons? SUMMARY ANSWER: One in three women had been pregnant at some stage in their lives and while most still wanted to have a child or another child, very few had used their stored oocytes, predominantly because they did not want to be single parents. WHAT IS KNOWN ALREADY: The number of healthy women who freeze oocytes to avoid age-related infertility is increasing...
January 6, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28076746/characteristics-of-patients-presenting-to-an-after-hours-clinic-results-of-a-magnet-analysis
#11
Lyle R Turner, Christopher Pearce, Madeleine Borg, Adam McLeod, Marianne Shearer, Danielle Mazza
After-hours access to general practice (GP) is critical to supporting accessibility and reducing emergency department demand. To understand who utilises after-hours GP services, this study examined the characteristics of presentations to an Eastern Melbourne after-hours clinic between 2005 and 2014. Descriptive analyses of patient and presentation characteristics, diagnoses, medications and pathology were conducted. Across the study period, 39.1% of presentations to the clinic (N=64,800) were by patients under 18 years of age...
January 12, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28075425/management-of-fibromyalgia-practical-guides-from-recent-evidence-based-guidelines
#12
Winfried Häuser, Jacob Ablin, Serge Perrot, Mary-Ann Fitzcharles
Fibromyalgia (FM) is a prevalent and costly condition worldwide, affecting approximately 2% of the general population. Recent evidence- and consensus-based guidelines from Canada, Germany, Israel and the European League Against Rheumatism aim to support physicians in achieving a comprehensive diagnostic work-up of patients with chronic widespread pain (CWP) and to assist patients and physicians in shared decision making on treament options. Every patient with CWP requires at the first medical evaluation a complete history, medical examination and some laboratory tests (complete blood count, C-reactive protein, serum calcium, creatine phosphokinase, thyroid stimulating hormone, 25-OH vitamin D) to screen for metabolic or inflammatory causes of CWP...
January 4, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28075109/patient-centered-communication-basic-skills
#13
M Jawad Hashim
Communication skills needed for patient-centered care include eliciting the patient's agenda with open-ended questions, especially early on; not interrupting the patient; and engaging in focused active listening. Understanding the patient's perspective of the illness and expressing empathy are key features of patient-centered communication. Understanding the patient's perspective entails exploring the patient's feelings, ideas, concerns, and experience regarding the impact of the illness, as well as what the patient expects from the physician...
January 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28074589/on-patient-well-being-and-professional-authority
#14
Mildred Z Solomon
Two papers in this issue address the limits of surrogates' authority when making life-and-death decisions for dying family members or friends. Using palliative sedation as an example, Jeffrey Berger offers a conceptual argument for bounding surrogate authority. Since freedom from pain is an essential interest, when imminently dying, cognitively incapacitated patients are in duress and their symptoms are not manageable in any other way, clinicians should be free to offer palliative sedation without surrogate consent, although assent should be sought and every effort made to work with surrogates as harmoniously as possible...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28074585/a-good-death
#15
Tia Powell, Adira Hulkower
A good death is hard to find. Family members tell us that loved ones die in the wrong place-the hospital-and do not receive high-quality care at the end of life. This issue of the Hastings Center Report offers two articles from authors who strive to provide good end-of-life care and to prevent needless suffering. We agree with their goals, but we have substantial reservations about the approaches they recommend. Respect for the decisions of patients and their surrogates is a relatively new and still vulnerable aspect of medical care...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28074581/conflating-capacity-authority-why-we-re-asking-the-wrong-question-in-the-adolescent-decision-making-debate
#16
Erica K Salter
Whether adolescents should be allowed to make their own medical decisions has been a topic of discussion in bioethics for at least two decades now. Are adolescents sufficiently capacitated to make their own medical decisions? Is the mature-minor doctrine, an uncommon legal exception to the rule of parental decision-making authority, something we should expand or eliminate? Bioethicists have dealt with the curious liminality of adolescents-their being neither children nor adults-in a variety of ways. However, recently there has been a trend to rely heavily, and often exclusively, on emerging neuroscientific and psychological data to answer these questions...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28073972/awareness-and-attitude-regarding-reproductive-options-of-persons-carrying-a-brca-mutation-and-their-partners
#17
J J G Gietel-Habets, C E M de Die-Smulders, I A P Derks-Smeets, A Tibben, V C G Tjan-Heijnen, R van Golde, E Gomez-Garcia, C M Kets, L A D M van Osch
STUDY QUESTION: To what extent are BRCA mutation carriers and their partners in the Netherlands aware about preimplantation genetic diagnosis (PGD) and prenatal diagnosis (PND) as reproductive options and what is their attitude towards these options? SUMMARY ANSWER: Awareness of PGD (66%) and PND (61%) among BRCA mutation carriers and their partners is relatively high and 80% and 26%, respectively, of BRCA carriers and their partners find offering PGD and PND for hereditary breast and ovarian cancer (HBOC) acceptable...
January 9, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28073146/value-based-care-in-hepatology
#18
REVIEW
Mario Strazzabosco, John I Allen, Elizabeth O Teisberg
The migration from legacy fee-for-service reimbursement to payments linked to high value health care is accelerating in the United States because of new legislation and re-design of payments from the Centers for Medicare and Medicaid Services (CMS). Since patients with chronic diseases account for substantial use of health care resources, payers and health systems are focusing on maximizing the value of care for these patients. Since chronic liver diseases impose a major health burden worldwide affecting the health and lives of many individuals and families as well as substantial costs for individuals and payers, hepatologists must understand how they can improve their practices ...
January 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28073085/effect-of-investigator-observation-on-gait-parameters-in-individuals-with-and-without-chronic-low-back-pain
#19
Joshua Vickers, Austin Reed, Robert Decker, Bryan P Conrad, Marissa Olegario-Nebel, Heather K Vincent
Despite the ubiquity of gait assessment in clinic and research, it is unclear how observation impacts gait, particularly in persons with chronic pain and psychological stress. We compared temporal spatial gait patterns in people with and without chronic low back pain (CLBP) when they were aware and unaware of being observed. This was a repeated-measures, deception study in 55 healthy persons (32.0±12.4 yr, 24.2±2.7kg/m(2)) and persons with CLBP (51.9±17.9 yr, 27.8±4.4kg/m(2)). Participants performed one condition in which they were unaware of observation (UNW), and three conditions under investigator observation: (1) aware of observation (AWA), (2) investigators watching cadence, (3) investigators watching step length...
January 3, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28072712/seniorlab-a-prospective-observational-study-investigating-laboratory-parameters-and-their-reference-intervals-in-the-elderly
#20
Martin Risch, Urs Nydegger, Lorenz Risch
BACKGROUND: In clinical practice, laboratory results are often important for making diagnostic, therapeutic, and prognostic decisions. Interpreting individual results relies on accurate reference intervals and decision limits. Despite the considerable amount of resources in clinical medicine spent on elderly patients, accurate reference intervals for the elderly are rarely available. The SENIORLAB study set out to determine reference intervals in the elderly by investigating a large variety of laboratory parameters in clinical chemistry, hematology, and immunology...
January 2017: Medicine (Baltimore)
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