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https://www.readbyqxmd.com/read/29667731/hemoglobin-s-monitoring-on-tosoh-g8-in-hemoglobin-a1c-mode-in-case-of-urgent-red-blood-cell-exchange
#1
Sophie Van Aelst, Helena Claerhout, Elke Nackers, Koen Desmet, Davy Kieffer
BACKGROUND: Pre- and post-transfusion hemoglobin S (HbS) levels are used to document the efficacy of red blood cell exchange (RCE) in patients with sickle cell disease (SCD). In case of urgent RCE a 24/7 short turn-around time (STAT) analysis, with the ability to identify and quantify HbS, is warranted. The use of TOSOH G8 (Tosoh Europe) is evaluated for this purpose, using the variant HbA1c mode. METHODS: Analytical performance of the HbS analysis on TOSOH G8 in variant HbA1c mode was evaluated, including assessment of imprecision and linearity for HbS...
April 18, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29667616/using-the-prostate-imaging-reporting-and-data-system-version-2-pi-rids-v2-to-detect-prostate-cancer-can-prevent-unnecessary-biopsies-and-invasive-treatment
#2
Chang Liu, Shi-Liang Liu, Zhi-Xian Wang, Kai Yu, Chun-Xiang Feng, Zan Ke, Liang Wang, Xiao-Yong Zeng
Prostate cancer (PCa) is one of the most common cancers among men globally. The authors aimed to evaluate the ability of the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) to classify men with PCa, clinically significant PCa (CSPCa), or no PCa, especially among those with serum total prostate-specific antigen (tPSA) levels in the "gray zone" (4-10 ng ml-1 ). A total of 308 patients (355 lesions) were enrolled in this study. Diagnostic efficiency was determined. Univariate and multivariate analyses, receiver operating characteristic curve analysis, and decision curve analysis were performed to determine and compare the predictors of PCa and CSPCa...
April 13, 2018: Asian Journal of Andrology
https://www.readbyqxmd.com/read/29667509/the-involvement-of-cancer-patients-in-the-four-stages-of-decision-making-preceding-continuous-sedation-until-death-a-qualitative-study
#3
Lenzo Robijn, Jane Seymour, Luc Deliens, Ida Korfage, Jayne Brown, Peter Pype, Agnes Van Der Heide, Kenneth Chambaere, Judith Rietjens
BACKGROUND: Involving patients in decision-making is considered to be particularly appropriate towards the end of life. Professional guidelines emphasize that the decision to initiate continuous sedation should be made in accordance with the wishes of the dying person and be preceded by their consent. AIM: To describe the decision-making process preceding continuous sedation until death with particular attention to the involvement of the person who is dying. DESIGN: Qualitative case studies using interviews...
April 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29667367/how-to-use-prior-knowledge-and-still-give-new-data-a-chance
#4
Kristina Weber, Rob Hemmings, Armin Koch
A common challenge for the development of drugs in rare diseases and special populations, eg, paediatrics, is the small numbers of patients that can be recruited into clinical trials. Extrapolation can be used to support development and licensing in paediatrics through the structured integration of available data in adults and prospectively generated data in paediatrics to derive conclusions that support licensing decisions in the target paediatric population. In this context, Bayesian analyses have been proposed to obtain formal proof of efficacy of a new drug or therapeutic principle by using additional information (data, opinion, or expectation), expressed through a prior distribution...
April 17, 2018: Pharmaceutical Statistics
https://www.readbyqxmd.com/read/29667359/predicting-responses-to-mechanical-ventilation-for-preterm-infants-with-acute-respiratory-illness-using-artificial-neural-networks
#5
Katharine Brigham, Samir Gupta, John C Brigham
Infants born prematurely are particularly susceptible to respiratory illness due to underdeveloped lungs, which can often result in fatality. Preterm infants in acute stages of respiratory illness typically require mechanical ventilation assistance, and the efficacy of the type of mechanical ventilation and its delivery has been the subject of a number clinical studies. With recent advances in machine learning approaches, particularly deep learning, it may be possible to estimate future responses to mechanical ventilation in real-time, based on ventilation monitoring up to the point of analysis...
April 17, 2018: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29667311/how-japanese-nurses-participate-in-decision-making-infants-with-congenital-life-threatening-conditions
#6
Sohei Shitaya, Nobue Nakamura, Naho Sato
BACKGROUND: In Japan, owing to the progress in medical technology, more children with congenital life-threatening conditions survive than ever before. Nurses who care for these children may also influence decision making in difficult situations. AIM: We aimed to describe Japanese nurses' approach toward medical decision making when caring for families of infants with congenital life-threatening conditions. Frequently, these nurses must care for and support parents with ambivalent feelings...
April 2018: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/29667263/assumptions-made-when-preparing-drug-exposure-data-for-analysis-have-an-impact-on-results-an-unreported-step-in-pharmacoepidemiology-studies
#7
Stephen R Pye, Thérèse Sheppard, Rebecca M Joseph, Mark Lunt, Nadyne Girard, Jennifer S Haas, David W Bates, David L Buckeridge, Tjeerd P van Staa, Robyn Tamblyn, William G Dixon
PURPOSE: Real-world data for observational research commonly require formatting and cleaning prior to analysis. Data preparation steps are rarely reported adequately and are likely to vary between research groups. Variation in methodology could potentially affect study outcomes. This study aimed to develop a framework to define and document drug data preparation and to examine the impact of different assumptions on results. METHODS: An algorithm for processing prescription data was developed and tested using data from the Clinical Practice Research Datalink (CPRD)...
April 17, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29667151/ethical-and-legal-concerns-with-nevada-s-brain-death-amendments
#8
Greg Yanke, Mohamed Y Rady, Joseph L Verheijde
In early 2017, Nevada amended its Uniform Determination of Death Act (UDDA), in order to clarify the neurologic criteria for the determination of death. The amendments stipulate that a determination of death is a clinical decision that does not require familial consent and that the appropriate standard for determining neurologic death is the American Academy of Neurology's (AAN) guidelines. Once a physician makes such a determination of death, the Nevada amendments require the withdrawal of life-sustaining treatment within twenty-four hours with limited exceptions...
April 17, 2018: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29667145/ethical-challenges-faced-by-healthcare-professionals-who-care-for-suicidal-patients-a-scoping-review
#9
Victoria Saigle, Eric Racine
For each one of the approximately 800,000 people who die from suicide every year, an additional twenty people attempt suicide. Many of these attempts result in hospitalization or in contact with other healthcare services. However, many personal, educational, and institutional barriers make it difficult for healthcare professionals to care for suicidal individuals. We reviewed literature that discusses suicidal patients in healthcare settings in order to highlight common ethical issues and to identify knowledge gaps...
April 17, 2018: Monash Bioethics Review
https://www.readbyqxmd.com/read/29667116/intraoperative-pancreatic-cancer-detection-using-tumor-specific-multimodality-molecular-imaging
#10
Willemieke S Tummers, Sarah E Miller, Nutte T Teraphongphom, Adam Gomez, Idan Steinberg, David M Huland, Steve Hong, Sri-Rajasekhar Kothapalli, Alifia Hasan, Robert Ertsey, Bert A Bonsing, Alexander L Vahrmeijer, Rutger-Jan Swijnenburg, Teri A Longacre, George A Fisher, Sanjiv S Gambhir, George A Poultsides, Eben L Rosenthal
BACKGROUND: Operative management of pancreatic ductal adenocarcinoma (PDAC) is complicated by several key decisions during the procedure. Identification of metastatic disease at the outset and, when none is found, complete (R0) resection of primary tumor are key to optimizing clinical outcomes. The use of tumor-targeted molecular imaging, based on photoacoustic and fluorescence optical imaging, can provide crucial information to the surgeon. The first-in-human use of multimodality molecular imaging for intraoperative detection of pancreatic cancer is reported using cetuximab-IRDye800, a near-infrared fluorescent agent that binds to epidermal growth factor receptor...
April 17, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29666880/-influence-of-staffing-levels-on-conflicts-in-inpatient-psychiatric-care
#11
A Nienaber, A Heinz, M A Rapp, F Bermpohl, M Schulz, J Behrens, M Löhr
Acute psychiatric wards are an important element in the mental healthcare of people at risk for acute harm to others or self-harm. Unfortunately, aggression, violence (conflict) and the use of coercion (containment) are still part of psychiatric care. The decisive factor for the correct handling of these situations is the quantity as well as the quality of the employees. Therefore, the present study dealt with the care situation on acute psychiatric wards. The hypothesis is that both the number of beds on the acute psychiatric ward and the number of caregivers have an impact on the occurrence of conflict and containment...
April 17, 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/29666813/ground-glass-opacities-management-in-the-lung-cancer-screening-era
#12
REVIEW
Marcello Migliore, Mariaconcetta Fornito, Manuela Palazzolo, Alessandra Criscione, Mariapia Gangemi, Francesco Borrata, Paolo Vigneri, Marco Nardini, Joel Dunning
Pulmonary ground glass opacity (GGO) is becoming an important clinical dilemma in oncology as its diagnosis in clinical practice is increasing due to the introduction of low dose computed tomography (CT) scan and screening. The incidence of cancer in GGO has been reported as high as 63%. The purpose of this manuscript is to review best available evidence papers on management of GGO in lung cancer to address the following questions: (I) how to correlate CT findings with malignancy; (II) when and who operate? (III) how to perform intraoperative detection of intrapulmonary GGO? (IV) wedge, segmentectomy or lobectomy? Taking a cue from a clinical scenario, a review on PubMed was conducted...
March 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29666804/surveillance-versus-esophagectomy-in-esophageal-cancer-patients-with-a-clinical-complete-response-after-induction-chemoradiation
#13
REVIEW
Tara R Semenkovich, Bryan F Meyers
There currently exists an area of controversy in treatment of esophageal cancer for patients who have an apparent clinical complete response (cCR) after induction chemoradiation. A standard treatment is to offer these patients an esophagectomy, but increasingly there is interest from both the patient and provider for active surveillance with so-called "salvage" esophagectomies for local recurrence as an alternative treatment paradigm. In this article, we review the existing evidence that stakeholders should consider for clinical decision-making in this specific patient population, including: the accuracy of post-induction clinical restaging, the reliability of operative risk assessment, the feasibility and adherence to surveillance strategies, and the observed outcomes in these patients after salvage esophagectomy or continued active surveillance...
February 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29666787/cardiac-output-monitoring-in-preterm-infants
#14
REVIEW
Matthew McGovern, Jan Miletin
Maintaining optimal circulatory status is a key component of preterm neonatal care. Low-cardiac output (CO) in the preterm neonate leads to inadequate perfusion of vital organs and has been linked to a variety of adverse outcomes with heightened acute morbidity and mortality and adverse neurodevelopmental outcomes. Having technology available to monitor CO allows us to detect low-output states and potentially intervene to mitigate the unwanted effects of reduced organ perfusion. There are many technologies available for the monitoring of CO in the preterm neonatal population and while many act as useful adjuncts to aid clinical decision-making no technique is perfect...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29666690/small-cell-neuroendocrine-carcinoma-of-the-cervix-masquerading-as-a-cervical-fibroid-report-of-a-rare-entity
#15
Mukta Pujani, Kanika Singh, Varsha Chauhan, Raina Chawla, Rashmi Ahuja
Primary neuroendocrine tumours of the cervix are extremely rare, with an incidence of only 0.5-1%; as such, these entities can present a clinical and diagnostic challenge. Small-cell neuroendocrine carcinomas of the cervix are highly aggressive tumours that have a tendency to metastasise. We report a 44-year-old woman who presented to the Gynaecology Clinic of the Employees State Insurance Corporation Medical College & Hospital, Faridabad, India, in 2016 with menorrhagia . Based on a clinical examination, she was provisionally diagnosed with a cervical fibroid...
February 2018: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29666554/effect-of-different-pre-analytical-conditions-on-plasma-lactate-concentration
#16
Ivana Rako, Ana Mlinaric, Monika Dozelencic, Gordana Fressl Juros, Dunja Rogic
Introduction: Plasma lactate is a frequently used and important parameter for medical decision making. To setup a pre-analytical algorithm, we aimed to investigate the influence of different test tube additives, aliquoting, ice storage and haemolysis on plasma lactate concentrations for possible sparing critically ill (ICU) patients of additional blood drawing. Materials and methods: In our study (N = 177), lactate concentration and haemolysis index (HI) were measured in aliquoted (AHP) and unaliquoted (HP) Li-heparin, NaF/K3 EDTA and NaF/KOX plasma, centrifuged within 15 minutes after venipuncture, on Cobas c501 analyzer...
June 15, 2018: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/29666133/medical-overuse-in-the-iranian-healthcare-system-a-systematic-review-protocol
#17
Morteza Arab-Zozani, Mohammad Zakaria Pezeshki, Rahim Khodayari-Zarnaq, Ali Janati
INTRODUCTION: Lack of resources is one of the main problems of all healthcare systems. Recent studies have shown that reducing the overuse of medical services plays an important role in reducing healthcare system costs. Overuse of medical services is a major problem in the healthcare system, and it threatens the quality of the services, can harm patients and create excess costs for patients. So far, few studies have been conducted in this regard in Iran. The main objective of this systematic review is to perform an inclusive search for studies that report overuse of medical services in the Iranian healthcare system...
April 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29666073/ventricular-assist-device-utilization-in-heart-transplant-candidates-nationwide-variability-and-impact-on-waitlist-outcomes
#18
Lauren K Truby, A Reshad Garan, Raymond C Givens, Koji Takeda, Hiroo Takayama, Pauline N Trinh, Melana Yuzefpolskaya, Maryjane A Farr, Yoshifumi Naka, Paolo C Colombo, Veli K Topkara
BACKGROUND: Continuous-flow left ventricular assist devices (CF-LVADs) have become a standard treatment choice in advanced heart failure patients. We hypothesized that practice patterns with regards to CF-LVAD utilization vary significantly among transplant centers and impact waitlist outcomes. METHODS AND RESULTS: The United Network for Organ Sharing registry was queried to identify adult patients who were waitlisted for heart transplantation (HT) between 2008 and 2015...
April 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29665800/mda-5-associated-rapidly-progressive-interstitial-lung-disease-with-recurrent-pneumothoraces-a-case-report
#19
Safi Alqatari, Peter Riddell, Sinead Harney, Michael Henry, Grainne Murphy
BACKGROUND: Clinically hypomyopathic dermatomyositis is a rare disease that is important to recognize, investigate and treat early as it is associated with poor prognosis. In a proportion of patients, myositis specific antibodies could be negative, but with high clinical suspicion, myositis associated antibodies should be ordered. Anti-MDA-5 antibodies was reported in literature to be associated with severe and rapidly progressive interstitial lung disease, with few case reports of pneumothorax and/or pneumomediastinum...
April 17, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29665763/neuroimaging-radiological-interpretation-system-niris-for-acute-traumatic-brain-injury-tbi
#20
Max Wintermark, Ying Li, Victoria Y Ding, Yingding Xu, Bin Jiang, Robyn L Ball, Michael Zeineh, Alisa Gean, Pina Sanelli
To develop an outcome-based NeuroImaging Radiological Interpretation System (NIRIS) for acute traumatic brain injury (TBI) patients that would standardize the interpretation of non-contrast head CTs and consolidate imaging findings into ordinal severity categories that would inform specific patient management actions and that could be used as a clinical decision support tool. We retrospectively identified all patients transported to our emergency department by ambulance or helicopter, for whom a trauma alert was triggered per established criteria and who underwent a non-contrast head CT due to suspicion of TBI, between November 2015 and April 2016...
April 18, 2018: Journal of Neurotrauma
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