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https://www.readbyqxmd.com/read/28938749/the-testicular-transcriptome-associated-with-spermatogonia-differentiation-initiated-by-gonadotrophin-stimulation-in-the-juvenile-rhesus-monkey-macaca-mulatta
#1
Suresh Ramaswamy, William H Walker, Paula Aliberti, Rahil Sethi, Gary R Marshall, Alyxzandria Smith, Seyedmehdi Nourashrafeddin, Alicia Belgorosky, Uma R Chandran, Mark P Hedger, Tony M Plant
STUDY QUESTION: What is the genetic landscape within the testis of the juvenile rhesus monkey (Macaca mulatta) that underlies the decision of undifferentiated spermatogonia to commit to a pathway of differentiation when puberty is induced prematurely by exogenous LH and FSH stimulation? SUMMARY ANSWER: Forty-eight hours of gonadotrophin stimulation of the juvenile monkey testis resulted in the appearance of differentiating B spermatogonia and the emergence of 1362 up-regulated and 225 down-regulated testicular mRNAs encoding a complex network of proteins ranging from enzymes regulating Leydig cell steroidogenesis to membrane receptors, and from juxtacrine and paracrine factors to transcriptional factors governing spermatogonial stem cell fate...
October 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28938748/random-start-ovarian-stimulation-for-fertility-preservation-appears-unlikely-to-delay-initiation-of-neoadjuvant-chemotherapy-for-breast-cancer
#2
Joseph M Letourneau, Nikita Sinha, Kaitlyn Wald, Eve Harris, Molly Quinn, Tal Imbar, Evelyn Mok-Lin, A Jo Chien, Mitchell Rosen
STUDY QUESTION: Is random start ovarian stimulation associated with delays in initiation of neoadjuvant chemotherapy for breast cancer? SUMMARY ANSWER: Among women who complete fertility preservation (FP) consultation, random start ovarian stimulation is unlikely to delay time to initiation of neoadjuvant chemotherapy start. WHAT IS KNOWN ALREADY: Neoadjuvant chemotherapy is now a widely accepted treatment modality for operable breast cancer and random start ovarian stimulation is an increasingly-utilized modality for FP...
October 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28938728/modeling-of-live-birth-rates-and-cost-effectiveness-of-oocyte-cryopreservation-for-cancer-patients-prior-to-high-and-low-risk-gonadotoxic-chemotherapy
#3
B Lyttle Schumacher, N Grover, T Mesen, A Steiner, J Mersereau
STUDY QUESTION: What is the live-birth rate (LBR) and cost-effectiveness of fertility preservation with oocyte cryopreservation (FP-OC) compared to expectant management in cancer patients age 25-40 based on estimated gonadotoxicity of treatments 5 years after cancer diagnosis? SUMMARY ANSWER: Oocyte cryopreservation prior to cancer treatment is more costly, yet more effective (producing more live births), than not undergoing oocyte cryopreservation but it is most beneficial for patients undergoing high-risk chemotherapy (HRC)...
October 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28938310/administration-of-four-factor-prothrombin-complex-concentrate-for-a-life-threatening-bleed-in-a-jehovah-s-witness-patient
#4
Jennifer L Cole, Nathanael D McLeod
: Life-threatening bleeds are medical emergencies that require time-sensitive decision making. Patients of the Jehovah's Witness faith can present a challenging conundrum when their beliefs conflict with modern treatment options for haemorrhage. Providers may not be aware of the grades of acceptance of the newer products outside of packed red blood cells. Researchers present a case of using four-factor prothrombin complex concentrate in a Jehovah's Witness patient in a life-threatening gastrointestinal haemorrhage along with a brief review of the literature...
September 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28938289/discussing-benefits-and-risks-of-tracheostomy-what-physicians-actually-say
#5
Lauren M Hebert, Anne C Watson, Vanessa Madrigal, Tessie W October
OBJECTIVES: When contemplating tracheostomy placement in a pediatric patient, a family-physician conference is often the setting for the disclosure of risks and benefits of the procedure. Our objective was to compare benefits and risks of tracheostomy presented during family-physician conferences to an expert panel's recommendations for what should be presented. DESIGN: We conducted a retrospective review of 19 transcripts of audio-recorded family-physician conferences regarding tracheostomy placement in children...
September 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28937785/gaining-access-to-providing-medical-care-to-male-sport-teams-the-female-athletic-trainer-perspective
#6
Alicia Pike, Stephanie M Mazerolle, Jessica L Barrett
CONTEXT:   Female athletic trainers (ATs) can face barriers to employment within the profession. Although there is evidence for an increasing percentage of women in athletic training, the portion providing medical care to male sport teams within the professional sport and collegiate settings continues to be small. OBJECTIVE:   To investigate the experiences of female ATs when seeking employment with male sport teams within the Division I setting. DESIGN:   Qualitative study...
September 22, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28937535/validation-of-a-commercial-assay-and-decision-support-tool-for-routine-paclitaxel-therapeutic-drug-monitoring-tdm
#7
Markus Joerger, Stefanie Kraff, Ulrich Jaehde, Ralf A Hilger, Jodi B Courtney, Daniel J Cline, Sonali Jog, Irina Baburina, M C Miller, Salvatore J Salamone
BACKGROUND: The value of therapeutic drug monitoring (TDM) for paclitaxel was recently demonstrated in the largest TDM trial ever conducted in oncology. The trial demonstrated significant reduction in neuropathy when using TDM. Dose adjustment for paclitaxel was based on time above a threshold concentration (Tc>0.05). Tc>0.05 must be calculated with a pharmacokinetic model and complex non-linear mixed effects (NLME) software. The use of the software and chromatographic methods to measure paclitaxel require specialized expertise...
September 18, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28937513/entrustment-evidence-used-by-expert-gynecologic-surgical-teachers-to-determine-residents-autonomy
#8
Xiaodong Phoenix Chen, Amy M Sullivan, Joan M Bengtson, John L Dalrymple
OBJECTIVE: To identify entrustment evidence used by expert gynecologic surgical teachers to determine obstetrics and gynecology residents' level of autonomy in the operating room. METHODS: A qualitative interview study was undertaken from March to November 2016. Four selection criteria were used to define and purposefully sample expert gynecologic surgical teachers across the United States to represent all four geographic regions. All interviews were audio-recorded and transcribed...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937334/optimal-threshold-estimator-of-a-prognostic-marker-by-maximizing-a-time-dependent-expected-utility-function-for-a-patient-centered-stratified-medicine
#9
Etienne Dantan, Yohann Foucher, Marine Lorent, Magali Giral, Philippe Tessier
Defining thresholds of prognostic markers is essential for stratified medicine. Such thresholds are mostly estimated from purely statistical measures regardless of patient preferences potentially leading to unacceptable medical decisions. Quality-Adjusted Life-Years are a widely used preferences-based measure of health outcomes. We develop a time-dependent Quality-Adjusted Life-Years-based expected utility function for censored data that should be maximized to estimate an optimal threshold. We performed a simulation study to compare estimated thresholds when using the proposed expected utility approach and purely statistical estimators...
October 20, 2016: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/28936819/-the-scope-quality-and-safety-requirements-of-drug-abuse-testing
#10
Tuncay Küme, Çiğdem Karakükcü, Aslı Pınar, Hakan Coşkunol
The aim of this review is to inform about the scopes and requirements of drug abuse testing. Drug abuse testing is one of the tools for determination of drug use. It must fulfill the quality and safety requirements in judgmental legal and administrative decisions. Drug abuse testing must fulfill some requirements like selection of the appropriate test matrix, appropriate screening test panel, sampling in detection window, patient consent, identification of the donor, appropriate collection site, sample collection with observation, identification and control of the sample, specimen custody chain in preanalytical phase; analysis in authorized laboratories, specimen validity tests, reliable testing METHODS, strict quality control, two-step analysis in analytical phase; storage of the split specimen, confirmation of the split specimen in the objection, result custody chain, appropriate cut-off concentration, the appropriate interpretation of the result in postanalytical phase...
2017: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/28936618/defining-and-measuring-diagnostic-uncertainty-in-medicine-a-systematic-review
#11
Viraj Bhise, Suja S Rajan, Dean F Sittig, Robert O Morgan, Pooja Chaudhary, Hardeep Singh
BACKGROUND: Physicians routinely encounter diagnostic uncertainty in practice. Despite its impact on health care utilization, costs and error, measurement of diagnostic uncertainty is poorly understood. We conducted a systematic review to describe how diagnostic uncertainty is defined and measured in medical practice. METHODS: We searched OVID Medline and PsycINFO databases from inception until May 2017 using a combination of keywords and Medical Subject Headings (MeSH)...
September 21, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28936235/health-literacy-and-atrial-fibrillation-relevance-and-future-directions-for-patient-centred-care
#12
Konstantinos N Aronis, Brittany Edgar, Wendy Lin, Maria Auxiliadora Parreiras Martins, Michael K Paasche-Orlow, Jared W Magnani
Atrial fibrillation (AF) is a common cardiac arrhythmia with significant clinical outcomes, and is associated with high medical and social costs. AF is complicated for patients because of its specialised terminology, long-term adherence, symptom monitoring, referral to specialty care, array of potential interventions and potential for adversity. Health literacy is a frequently under-recognised, yet fundamental, component towards successful care in AF. Health literacy is defined as the capacity to obtain, process and understand health information, and has had markedly limited study in AF...
2017: European Cardiology
https://www.readbyqxmd.com/read/28935665/evaluating-the-impact-of-implementing-a-clinical-practice-guideline-for-febrile-infants-with-positive-respiratory-syncytial-virus-or-enterovirus-testing
#13
Adrienne DePorre, David D Williams, Jennifer Schuster, Jason Newland, Jacqueline Bartlett, Rangaraj Selvarangan, Keith Mann, Russell McCulloh
OBJECTIVES: To evaluate clinical practice patterns and patient outcomes among febrile low-risk infants with respiratory syncytial virus (RSV) infection or enterovirus (EV) meningitis after implementing a clinical practice guideline (CPG) that provides recommendations for managing febrile infants with RSV infection and EV meningitis. METHODS: Our institution implemented a CPG for febrile infants, which gives explicit recommendations for managing both RSV-positive and EV-positive infants in 2011...
September 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28935129/environmental-design-for-end-of-life-care-an-integrative-review-on-improving-quality-of-life-and-managing-symptoms-for-patients-in-institutional-settings
#14
REVIEW
Rana Sagha Zadeh, Paul Eshelman, Judith Setla, Laura Kennedy, Emily Hon, Aleksa Basara
CONTEXT: The environment in which end-of-life care is delivered can support or detract from the physical, psychological, social, and spiritual needs of patients, their families, and their caretakers. OBJECTIVES: This review aims to organize and analyze the existing evidence related to environmental design factors that improve the quality of life and total well-being of people involved in end-of-life care and to clarify directions for future research. METHOD: This integrated literature review synthesized and summarized research evidence from the fields of medicine, environmental psychology, nursing, palliative care, architecture, interior design, and evidence-based design...
September 18, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28934985/factors-influencing-on-scene-time-in-a-rural-norwegian-helicopter-emergency-medical-service-a-retrospective-observational-study
#15
Øyvind Østerås, Jon-Kenneth Heltne, Bjørn-Christian Vikenes, Jörg Assmus, Guttorm Brattebø
BACKGROUND: Critically ill patients need to be immediately identified, properly managed, and rapidly transported to definitive care. Extensive prehospital times may increase mortality in selected patient groups. The on-scene time is a part of the prehospital interval that can be decreased, as transport times are determined mostly by the distance to the hospital. Identifying factors that affect on-scene time can improve training, protocols, and decision making. Our objectives were to assess on-scene time in the Helicopter Emergency Medical Service (HEMS) in our region and selected factors that may affect it in specific and severe conditions...
September 21, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28934785/1-year-results-of-a-randomized-controlled-trial-of-conservative-management-vs-minimally-invasive-surgical-treatment-for-sacroiliac-joint-pain
#16
Julius Dengler Dengler, Djaya Kools, Robert Pflugmacher, Alessandro Gasbarrini, Domenico Prestamburgo, Paolo Gaetani, Eddie van Eeckhoven, Daniel Cher, Bengt Sturesson
BACKGROUND: Low back pain (LBP) emanating from the sacroiliac joint (SIJ) is a common finding. Devices to fuse the SIJ are now commercially available, but high-quality evidence supporting their effectiveness is limited. OBJECTIVES: To compare the safety and effectiveness of conservative management (CM) to minimally invasive sacroiliac joint fusion (SIJF) in patients with chronic LBP originating from the SIJ. STUDY DESIGN: Prospective, multicenter randomized controlled trial...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934769/assessment-and-modelling-of-general-practice-and-community-setting-capacity-for-medical-trainees-in-northern-new-zealand
#17
Felicity Goodyear-Smith, Abbas Al-Murrani
AIMS: To estimate the capacity of general practice to accommodate undergraduate and postgraduate medical trainees, and model efficient ways to utilise identified capacity and increase capacity. METHODS: We conducted an online survey, with phone follow-up to non-responders, of all general practices in the northern half of New Zealand. The main outcome measures were current placements and future intentions for taking medical trainees; factors influencing decisions and possible incentives to take trainees...
September 22, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28934174/attitudes-beliefs-and-predictors-of-male-circumcision-promotion-among-medical-university-students-in-a-traditionally-non-circumcising-region
#18
Maria Ganczak, Marcin Korzeń, Maciej Olszewski
Objective: To evaluate the beliefs of medical university students regarding male circumcision (MC), as well as attitudes and the predictors of its promotion in the case of adults at risk of HIV. Methods: A cross-sectional survey was conducted between 2013-2016 at the Medical University in Szczecin, Poland, among final year Polish/foreign students from Northern Europe, using a standardized questionnaire. Results: There were 539 participants, median age 25 years, 40.8% males, and 66.8% were Polish nationals. The MC rate was 16...
September 21, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28934086/towards-ontology-based-decision-support-systems-for-complex-ultrasound-diagnosis-in-obstetrics-and-gynecology
#19
P Maurice, F Dhombres, E Blondiaux, S Friszer, L Guilbaud, N Lelong, B Khoshnood, J Charlet, N Perrot, E Jauniaux, D Jurkovic, J-M Jouannic
INTRODUCTION: We have developed a new knowledge base intelligent system for obstetrics and gynecology ultrasound imaging, based on an ontology and a reference image collection. This study evaluates the new system to support accurate annotations of ultrasound images. We have used the early ultrasound diagnosis of ectopic pregnancies as a model clinical issue. MATERIAL AND METHODS: The ectopic pregnancy ontology was derived from medical texts (4260 ultrasound reports of ectopic pregnancy from a specialist center in the UK and 2795 Pubmed abstracts indexed with the MeSH term "Pregnancy, Ectopic") and the reference image collection was built on a selection from 106 publications...
May 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28933940/an-assessment-of-primary-care-and-pulmonary-provider-perspectives-on-lung-cancer-screening
#20
Matthew Triplette, Erin K Kross, Blake A Mann, Joann G Elmore, Christopher G Slatore, Shahida Shahrir, Perrin E Romine, Paul D Frederick, Kristina Crothers
RATIONALE: Lung cancer screening (LCS) has a mortality benefit to high-risk smokers, but implementation remains suboptimal. Providers represent the key entry point to screening, and an understanding of provider perspectives on lung cancer screening is necessary to improve referral and overall implementation. OBJECTIVES: The objective of this study was to understand knowledge, beliefs, attitudes, barriers, and facilitators to screening in a diverse group of referring pulmonologists and primary care providers...
September 21, 2017: Annals of the American Thoracic Society
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