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https://www.readbyqxmd.com/read/28346805/brachytherapy-for-patients-with-prostate-cancer-american-society-of-clinical-oncology-cancer-care-ontario-joint-guideline-update
#1
Joseph Chin, R Bryan Rumble, Marisa Kollmeier, Elisabeth Heath, Jason Efstathiou, Tanya Dorff, Barry Berman, Andrew Feifer, Arthur Jacques, D Andrew Loblaw
Purpose To jointly update the Cancer Care Ontario guideline on brachytherapy for patients with prostate cancer to account for new evidence. Methods An Update Panel conducted a targeted systematic literature review and identified more recent randomized controlled trials comparing dose-escalated external beam radiation therapy (EBRT) with brachytherapy in men with prostate cancer. Results Five randomized controlled trials provided the evidence for this update. Recommendations For patients with low-risk prostate cancer who require or choose active treatment, low-dose rate brachytherapy (LDR) alone, EBRT alone, and/or radical prostatectomy (RP) should be offered to eligible patients...
March 27, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28344735/parental-influences-and-the-relationship-to-their-children-s-physical-activity-levels
#2
Nathan A Chiarlitti, Angela M Kolen
Engaging in a physically active lifestyle relates positively to current health and reduces chances of chronic diseases in the future. Given escalating health care costs, it is paramount to reduce illnesses associated with a lack of physical activity and thus critical to identify factors that influence physical activity - especially in children, with the opportunity for a lifetime impact. One of these influencing factors may be parents/guardians. The intent of this study was to examine the relationship between children's physical activity levels and parental factors including parental physical activity, support/encouragement, restrictiveness, and self-reported participation...
2017: International Journal of Exercise Science
https://www.readbyqxmd.com/read/28340143/protecting-pain-patients-the-evaluation-of-a-chronic-pain-educational-intervention
#3
Simon Holliday, Chris Hayes, Adrian Dunlop, Simon Morgan, Amanda Tapley, Kim Henderson, Briony Larance, Parker Magin
Introduction. : Advocacy and commercially funded education successfully reduced barriers to the provision of long-term opioid analgesia. The subsequent escalation of opioid prescribing for chronic noncancer pain has seen increasing harms without improved pain outcomes. Methods. : This was a one-group pretest-posttest design study. A multidisciplinary team developed a chronic pain educational package for general practitioner trainees emphasizing limitations, risk-mitigation, and deprescribing of opioids with transition to active self-care...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#4
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28337715/is-incremental-hemodialysis-ready-to-return-on-the-scene-from-empiricism-to-kinetic-modelling
#5
REVIEW
Carlo Basile, Francesco Gaetano Casino, Kamyar Kalantar-Zadeh
Most people who make the transition to maintenance dialysis therapy are treated with a fixed dose thrice-weekly hemodialysis regimen without considering their residual kidney function (RKF). The RKF provides effective and naturally continuous clearance of both small and middle molecules, plays a major role in metabolic homeostasis, nutritional status, and cardiovascular health, and aids in fluid management. The RKF is associated with better patient survival and greater health-related quality of life, although these effects may be confounded by patient comorbidities...
March 23, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28336527/a-phase-i-clinical-trial-of-single-agent-selinexor-in-acute-myeloid-leukemia
#6
Ramiro Garzon, Michael Savona, Rachid Baz, Michael Andreeff, Nashat Gabrail, Martin Gutierrez, Lynn Savoie, Morten Mau-Sorensen, Nina Wagner-Johnston, Karen Yee, T J Unger, Jean Richard Saint-Martin, Robert Carlson, Tami Rashal, Trinayan Kashyap, Boris Klebanov, Sharon Shacham, Michael Kauffman, Richard Stone
Selinexor is a novel, first-in-class, Selective Inhibitor of Nuclear Export (SINE) compound, which blocks XPO1 function, leads to nuclear accumulation of tumor suppressor proteins (TSPs) and induces cancer cell death. A phase I dose-escalation study was initiated to examine the safety and efficacy of selinexor in patients with advanced hematological malignancies. Ninety-five patients with relapsed or refractory acute myeloid leukemia (AML) were enrolled between January 2013 and June 2014 to receive 4, 8 or 10 doses of selinexor in 21- or 28-day cycle...
March 23, 2017: Blood
https://www.readbyqxmd.com/read/28333157/consensus-approach-to-nasal-high-flow-therapy-in-neonates
#7
B A Yoder, B Manley, C Collins, K Ives, A Kugelman, A Lavizzari, M McQueen
OBJECTIVE: Nasal high-flow therapy (nHFT) is commonly used for noninvasive respiratory support in the neonatal intensive care unit. Our objective was to determine which aspects of neonatal nHFT have achieved adequate evidence base to support consensus among experienced clinical investigators, and to document areas lacking consensus to promote future investigations. STUDY DESIGN: Prospective, modified Delphi collation of tabular queries related to specific aspects of neonatal nHFT...
March 23, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28332765/combating-blood-stream-infections-during-induction-chemotherapy-in-children-with-acute-myeloid-leukemia-single-center-results-in-india
#8
Divya Subburaj, Ramya Uppuluri, Dhaarani Jayaraman, Venkateshwaran Vellaichamyswaminathan, Sathishkumar Kandath, Revathi Raj
Optimal management of infectious complication is the biggest challenge in children receiving chemotherapy for acute myeloid leukemia (AML). We have analyzed the data of children undergoing AML induction chemotherapy at our center from 2002 to 2016 and found that Gram-negative infections are more predominant when compared to the published literature. There also has been a surge in multidrug-resistant (MDR) infections over the last 4 years, which has increased the need for supportive care and escalated the cost of care...
March 23, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28332328/paediatric-high-flow-nasal-cannula-therapy-in-children-with-bronchiolitis-a-retrospective-safety-and-efficacy-study-in-a-non-tertiary-environment
#9
Michelle Davison, Mike Watson, Leesa Wockner, Frances Kinnear
OBJECTIVE: The objective was to examine the safety and efficacy of high-flow nasal cannula (HFNC) therapy for children with bronchiolitis in a non-tertiary paediatric setting. METHODS: This was a single-centre retrospective study conducted over 26 months (March 2013-April 2015) on children aged 1-23 months with suspected bronchiolitis, who commenced on HFNC therapy in either the ED or the ward. Changes with respect to baseline data were analysed for effect on work of breathing (WOB), heart rate (HR) and respiratory rate (RR)...
April 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28326546/public-private-differences-in-short-term-neonatal-outcomes-following-birth-by-prelabour-caesarean-section-at-early-and-full-term
#10
Nicole Adams, Kristen S Gibbons, David Tudehope
BACKGROUND: Prelabour caesarean section (CS) at early term (37(0) -38(6)  weeks) is associated with higher rates of adverse short-term neonatal outcomes and higher costs than those performed at full term (39(0) -40(6)  weeks). Prelabour CS is more common in private than in public hospitals in Australia, particularly at early term. AIMS: To evaluate the impact of hospital sector (public or private) and timing of delivery on short-term neonatal outcomes following prelabour CS at term...
March 22, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28325241/radiation-oncology-in-the-developing-economies-of-central-and-eastern-europe
#11
REVIEW
Natia Esiashvili
Eastern Europe is represented by 22 countries of significant variability in population density and degree of economic development. They have been affected by past geopolitical isolation due to their association with the "Soviet Block." Currently, all Eastern European countries except Slovenia are low- or middle-income level and 10 of them are part of European Union. Health care systems in Central and Eastern Europe have been influenced by the legacy of centralized soviet-era governance; however, most countries, particularly in European Union zone, have gone through health care reforms directed toward modernizing infrastructure and staffing...
April 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28325204/from-board-to-bedside-how-the-application-of-financial-structures-to-safety-and-quality-can-drive-accountability-in-a-large-health-care-system
#12
J Matthew Austin, Renee Demski, Tiffany Callender, K H Ken Lee, Ann Hoffman, Lisa Allen, Deborah A Radke, Yungjin Kim, Ronald J Werthman, Ronald R Peterson, Peter J Pronovost
BACKGROUND: As the health care system in the United States places greater emphasis on the public reporting of quality and safety data and its use to determine payment, provider organizations must implement structures that ensure discipline and rigor regarding these data. An academic health system, as part of a performance management system, applied four key components of a financial reporting structure to support the goal of top-to-bottom accountability for improving quality and safety...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28321612/serial-serum-immunoglobulin-g-igg-trough-levels-in-patients-with-x-linked-agammaglobulinemia-on-replacement-therapy-with-intravenous-immunoglobulin-its-correlation-with-infections-in-indian-children
#13
Deepti Suri, Sagar Bhattad, Avinash Sharma, Anju Gupta, Amit Rawat, Shobha Sehgal, Surjit Singh, Sudhir Gupta
Patients with primary antibody deficiency (PAD) are being increasingly diagnosed in the developing world. However, care of these children continues to remain suboptimal due to financial and social constraints. Immunoglobulin (Ig) trough level is an important predicting factor for infections in children on replacement immunoglobulin therapy. There are no data on this aspect from the developing world. Therefore, we studied serial immunoglobulin G (IgG) trough levels in 14 children with X-linked agammaglobulinemia (XLA) receiving replacement intravenous immunoglobulin (IVIG)...
March 21, 2017: Journal of Clinical Immunology
https://www.readbyqxmd.com/read/28321393/an-integrated-approach-to-falls-prevention-a-model-for-linking-clinical-and-community-interventions-through-the-massachusetts-prevention-and-wellness-trust-fund
#14
Laura J Coe, Julie Ann St John, Santhi Hariprasad, Kalpana N Shankar, Patricia A MacCulloch, Amy L Bettano, Jean Zotter
Older adult falls continue to be a public health priority across the United States-Massachusetts (MA) being no exception. The MA Prevention and Wellness Trust Fund (PWTF) program within the MA Department of Public Health aims to reduce the physical and economic burdens of chronic health conditions by linking evidence-based clinical care with community intervention programs. The PWTF partnerships that focused on older adult falls prevention integrated the Centers for Disease Control and Prevention's Stopping Elderly Accidents, Death and Injuries toolkit into clinical settings...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28321145/drug-pricing-transparency-the-new-retail-revolution
#15
Kaitlyn N Dana, John B Hertig, Robert J Weber
As spending on medications in the United States increases with each passing year, the need for drug pricing transparency by manufacturers also increases. Drug spending, excluding rebates and discounts, was $309.5 billion in 2015, up 8.5% from 2014. Drug pricing transparency has been a topic of debate across the health care system. This column reviews the issue of drug pricing and emphasizes the need for transparency in this area. We will discuss factors that influence drug pricing, policies and ways to reduce the rising costs of drugs, and the role of pharmacy leaders in managing this problem...
February 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28315060/results-of-a-phase-ib-trial-of-combination-immunotherapy-with-a-cd8-%C3%A2-t-cell-eliciting-vaccine-and-trastuzumab-in-breast-cancer-patients
#16
G Travis Clifton, Jennifer K Litton, Karen Arrington, Sathibalan Ponniah, Nuhad K Ibrahim, Victor Gall, Gheath Alatrash, George E Peoples, Elizabeth A Mittendorf
BACKGROUND: CD8+ T cell-eliciting vaccines are being investigated in breast cancer patients. Preclinical data showed that trastuzumab increases the susceptibility of tumor cells to lysis by vaccine-generated CD8+ T cells, suggesting potential benefit of a combination immunotherapy strategy. The current trial was undertaken to demonstrate the safety of this approach. METHODS: This study was designed as a dose-escalation trial enrolling clinically disease-free, human leukocyte antigen A2+ or A3+ , human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients...
March 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28298899/decision-making-in-multiple-sclerosis-the-role-of-aversion-to-ambiguity-for-therapeutic-inertia-among-neurologists-discutir-ms
#17
Gustavo Saposnik, Angel P Sempere, Daniel Prefasi, Daniel Selchen, Christian C Ruff, Jorge Maurino, Philippe N Tobler
OBJECTIVES: Limited information is available on physician-related factors influencing therapeutic inertia (TI) in multiple sclerosis (MS). Our aim was to evaluate whether physicians' risk preferences are associated with TI in MS care, by applying concepts from behavioral economics. DESIGN: In this cross-sectional study, participants answered questions regarding the management of 20 MS case scenarios, completed 3 surveys, and 4 experimental paradigms based on behavioral economics...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28298034/a-protocol-for-postoperative-admission-of-elective-craniotomy-patients-to-a-non-icu-or-step-down-setting
#18
Jeffrey E Florman, Deborah Cushing, Lynne A Keller, Anand I Rughani
OBJECTIVE Selecting the appropriate patients undergoing craniotomy who can safely forgo postoperative intensive care unit (ICU) monitoring remains a source of debate. Through a multidisciplinary work group, the authors redefined their institutional care process for postoperative monitoring of patients undergoing elective craniotomy to include transfer from the postanesthesia care unit (PACU) to the neurosurgical floor. The hypothesis was that an appropriately selected group of patients undergoing craniotomy could be safely managed outside the ICU in the postoperative period...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28291450/establishing-a-joint-theater-trauma-system-during-phase-zero-operations
#19
Jennifer J Walker, Zsolt T Stockinger, Colin G Chinn
OBJECTIVES: Military personnel risk injury due to accidents, disasters, and military threats during Phase Zero "shaping" operations. Medical facilities must be poised to respond. METHODS: The U.S. Pacific Command (PACOM) Area of Responsibility (AOR) covers more than 50% of the earth's surface; relevant Clinical Practice Guidelines must include the maritime setting and extended evacuation periods. Military hospitals in the region are not connected by a defined Trauma System...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290926/soldier-readiness-processing-time-for-a-new-paradigm-in-managing-musculoskeletal-injuries-after-deployment
#20
Daniel I Rhon, Kerrie J Golden, Amy J Trevino, Brian S Hatler
BACKGROUND: The drowning impact that musculoskeletal injuries (MSI) have on Soldier readiness, deployability, and escalating health care costs is growing. These injuries are associated with approximately 25 million lost duty days each year. The need to curb costs and improve efficacy and efficiency of health care delivery is pressing. This requires the consideration of new paradigms for clinical pathways and health care delivery processes. Soldiers returning from a deployment go through a screening process to ensure any medical, dental, and administrative issues are adequately addressed...
March 2017: Military Medicine
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