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https://www.readbyqxmd.com/read/27914154/short-and-long-term-efficacy-of-laparoscopic-ovarian-diathermy-in-women-with-polycystic-ovary-syndrome
#1
Rita Luz, Joana Barros, Ana Aguiar, Cátia Rodrigues, Ana Paula Soares, Joaquim Nunes, Sandra Sousa, Carlos Calhaz-Jorge
INTRODUCTION: Polycystic ovary syndrome is the most frequent cause of anovulatory infertility and management involves a multistep approach. Laparoscopic ovarian diathermy is accepted as a second-line treatment of patients who failed to respond to clomiphene citrate. The aims of this study were to determine the efficacy of this technique at short and long-term and to perform an analysis of predictive factors of spontaneous pregnancy. MATERIAL AND METHODS: This retrospective study involved 76 women who underwent laparoscopic ovarian diathermy between 2004 and 2013 in a university hospital...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27914136/physicians-should-provide-shared-decision-making-for-anti-tnf-therapy-to-inflammatory-bowel-disease-patients
#2
Jae Myung Cha, Dong Il Park, Sang Hyoung Park, Jeong Eun Shin, Wan Soo Kim, Suk Kyun Yang
Shared decision-making may increase the effectiveness of inflammatory bowel disease (IBD) treatment, as different anti-tumor necrosis factor (anti-TNF) administrations may have different effects on the quality of life (QOL). Patient preference is integral to the selection of anti-TNFs and their routes of administration, however, previous studies on the patient preference to anti-TNFs are inconsistent and limited. We evaluated the predictive factors for preferences to anti-TNF administrations in IBD patients between March and August in 2015...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27914127/impact-of-initial-vancomycin-trough-concentration-on-clinical-and-microbiological-outcomes-of-methicillin-resistant-staphylococcus-aureus-bacteremia-in-children
#3
Ree Nar Yoo, Seo Hee Kim, Jina Lee
It is important to use vancomycin in a proper manner to ensure optimal drug exposure. Despite extensive use of vancomycin in children, studies on its optimal trough concentration (Ctrough) in the pediatric population remained rare. This retrospective study included children < 18 years old with culture-confirmed methicillin-resistant Staphylococcus aureus (MRSA) bacteremia who were hospitalized in our institute from January 2010 to April 2014. Clinical characteristics, initial vancomycin dose, Ctrough and clinical/microbiological outcomes were retrospectively collected from medical records...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27913972/in-hospital-diagnosis-of-sleep-apnea-in-stroke-patients-using-a-portable-acoustic-device
#4
Clodagh M Ryan, Kelly Wilton, T Douglas Bradley, Hisham Alshaer
PURPOSE: Sleep apnea (SA) is highly prevalent in post-stroke patients. Due to physical disability and relative inaccessibility of polysomnography (PSG) to test for SA, patients with stroke frequently remain undiagnosed and untreated. Portable SA monitoring can facilitate at-home or in-hospital testing for SA. However, portable SA monitoring is not recommended in those with complex medical conditions, such as stroke, due to the lack of validation of portable monitoring in such patients...
December 2, 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27913775/role-of-b-type-natriuretic-peptide-in-predicting-in-hospital-outcomes-in-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-with-preserved-left-ventricular-function-a-5-year-retrospective-analysis
#5
Saraschandra Vallabhajosyula, Toufik Mahfood Haddad, Pranathi R Sundaragiri, Anas A Ahmed, Muhammad Sarfraz Nawaz, Hamza A A Rayes, Harish C Devineni, Arun Kanmanthareddy, Dustin A McCann, Christopher S Wichman, Ariel M Modrykamien, Lee E Morrow
BACKGROUND: The role of B-type natriuretic peptide (BNP) is less understood in the risk stratification of patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), especially in patients with normal left ventricular ejection fraction (LVEF). METHODS: This retrospective study from 2008 to 2012 evaluated all adult patients with AECOPD having BNP levels and available echocardiographic data demonstrating LVEF ≥40%. The patients were divided into groups 1, 2, and 3 with BNP ≤ 100, 101 to 500, and ≥501 pg/mL, respectively...
December 2, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27913610/whole-exome-sequencing-of-thymic-neuroendocrine-tumor-with-ectopic-acth-syndrome
#6
Yanli Li, Ying Peng, Xiuli Jiang, Yulong Cheng, Weiwei Zhou, Tingwei Su, Jing Xie, Xu Zhong, Dalong Song, Luming Wu, Liwen Fan, Min Li, Jie Hong, Weiqing Wang, Guang Ning, Yanan Cao
OBJECTIVE: Thymic neuroendocrine tumor is the second-most prevalent cause of ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS), which is a rare disease characterized by ectopic ACTH oversecretion from nonpituitary tumors. However, the genetic abnormalities of thymic neuroendocrine tumors with EAS remain largely unknown. We aim to elucidate the genetic abnormalities and identify the somatic mutations of potential tumor-related genes of thymic neuroendocrine tumors with EAS by whole exome sequencing...
February 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27913366/deepr-a-convolutional-net-for-medical-records
#7
Phuoc Nguyen, Truyen Tran, Nilmini Wickramasinghe, Svetha Venkatesh
Feature engineering remains a major bottleneck when creating predictive systems from electronic medical records. At present, an important missing element is detecting predictive regular clinical motifs from irregular episodic records. We present Deepr (short for Deep record), a new end-to-end deep learning system that learns to extract features from medical records and predicts future risk automatically. Deepr transforms a record into a sequence of discrete elements separated by coded time gaps and hospital transfers...
December 1, 2016: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/27913067/the-financial-impact-of-clinic-no-show-rates-in-an-academic-pediatric-otolaryngology-practice
#8
Zhen Huang, Mariam Ashraf, Heather Gordish-Dressman, Pamela Mudd
PURPOSE: To investigate determinants of no-show rates in an academic pediatric otolaryngology practice including appointment time, age, sex, new patient status, payer mix, and median household income by zip code. MATERIALS AND METHODS: Retrospective chart review of clinic no-show rates and patient demographics in a free standing children's hospital and affiliated outpatient clinics across eight providers in a one-year period. RESULTS: Analysis shows that the overall no-show rate across all providers was 15% with the highest rate of 19% in the zip code with the lowest median income...
November 23, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27913030/confounding-variables-and-the-performance-of-triggers-in-detecting-unreported-adverse-drug-reactions
#9
Fabiana Rossi Varallo, Carolina Dagli-Hernandez, Caroline Pagotto, Tales Rubens de Nadai, Maria Teresa Herdeiro, Patricia de Carvalho Mastroianni
PURPOSE: This study explored the performance of trigger in detecting adverse drug reactions (ADRs), the confounding variables impairing the causal association of the ADRs, and the underreporting rate by hospital health professionals. METHODS: A 6-month cross-sectional study was conducted in a public general hospital. Data collection was conducted in 2 stages: (1) screening of patient hospitalizations to identify suspected ADRs with 9 triggers developed by the Institute of Healthcare Improvement; and (2) chart review to perform the causality assessment of the suspected ADRs identified, to describe the confounding variables associated with detection of suspected ADRs that were not drug induced, and to analyze the positive predictive value of triggers in recognizing ADRs...
November 29, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27912923/predictors-of-30-day-mortality-in-patients-admitted-to-emergency-departments-for-acute-heart-failure
#10
Matthieu Marchetti, Antoine Benedetti, Olivier Mimoz, Jean-Yves Lardeur, Jérémy Guenezan, Nicolas Marjanovic
OBJECTIVES: Acute heart failure (AHF) is a leading cause of admission in emergency departments (ED). It is associated with significant in-hospital mortality, suggesting that there is room for improvement of care. Our aims were to investigate clinical patterns, biological characteristics and determinants of 30-day mortality. METHODS: We conducted a single site, retrospective review of adult patients (≥18years) admitted to ED for AHF over a 12-month period. Data collected included demographics, clinical, biological and outcomes data...
November 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27912898/a-clinical-prediction-model-for-prolonged-air-leak-after-pulmonary-resection
#11
Adam Attaar, Daniel G Winger, James D Luketich, Matthew J Schuchert, Inderpal S Sarkaria, Neil A Christie, Katie S Nason
OBJECTIVE: Prolonged air leak increases costs and worsens outcomes after pulmonary resection. We aimed to develop a clinical prediction tool for prolonged air leak using pretreatment and intraoperative variables. METHODS: Patients who underwent pulmonary resection for lung cancer/nodules (from January 2009 to June 2014) were stratified by prolonged parenchymal air leak (>5 days). Using backward stepwise logistic regression with bootstrap resampling for internal validation, candidate variables were identified and a nomogram risk calculator was developed...
October 14, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27912757/the-sydney-triage-to-admission-risk-tool-start-to-predict-emergency-department-disposition-a-derivation-and-internal-validation-study-using-retrospective-state-wide-data-from-new-south-wales-australia
#12
Michael M Dinh, Saartje Berendsen Russell, Kendall J Bein, Kris Rogers, David Muscatello, Richard Paoloni, Jon Hayman, Dane R Chalkley, Rebecca Ivers
BACKGROUND: Disposition decisions are critical to the functioning of Emergency Departments. The objectives of the present study were to derive and internally validate a prediction model for inpatient admission from the Emergency Department to assist with triage, patient flow and clinical decision making. METHODS: This was a retrospective analysis of State-wide Emergency Department data in New South Wales, Australia. Adult patients (age ≥ 16 years) were included if they presented to a Level five or six (tertiary level) Emergency Department in New South Wales, Australia between 2013 and 2014...
December 3, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27912203/prognostic-factors-associated-with-15-year-mortality-in-patients-with-hospitalized-systolic-hf-results-of-the-observational-community-based-epical-cohort-study
#13
Nelly Agrinier, Nathalie Thilly, Serge Briançon, Yves Juillière, Paul-Michel Mertes, Jean-Pierre Villemot, François Alla, Faiez Zannad
AIMS: Little data on very long-term survival and associated prognostic factors in heart failure (HF) are available. The aim was to describe 15-year survival and to identify the baseline prognostic factors associated with mortality in a community-based sample of patients hospitalized for systolic HF. METHODS: Vital status was collected 15years after inclusion of 352 patients hospitalized for systolic HF born in France from the prospective cohort EPICAL. The prognostic value of baseline socioeconomic, clinical and biological characteristics on 15-year mortality was assessed using Cox models...
November 12, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27911975/transfusion-requirements-in-esrd-patients-admitted-with-gi-hemorrhage-undergoing-inpatient-endoscopy
#14
Conor McCartney, Shrihari Santosh, Setu Patolia, Sadashiv Santosh
OBJECTIVES: To date there are no studies evaluating the utilization of blood products in patients with end-stage renal disease (ESRD) with gastrointestinal (GI) hemorrhage. This study estimated transfusion needs and determined predictors available at the time of admission for patients with ESRD admitted to a university hospital with GI bleeding requiring inpatient endoscopy. METHODS: A retrospective chart review was performed on all patients with ESRD who underwent inpatient endoscopy for suspected GI bleeding between 2009 and 2015...
December 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27911937/an-investigation-of-the-outcomes-of-pgy-students-cognition-of-and-persistent-behavior-in-learning-through-the-intervention-of-the-flipped-classroom-in-taiwan
#15
Sheng-Der Hsu, Cheng-Jueng Chen, Wei-Kuo Chang, Yih-Jin Hu
The Postgraduate Year (PGY) Program allows doctors-in-training to learn about the diagnosis, treatment and nursing of various common, general diseases. These items form the core curriculum and are mostly learned through caring for patients and clinical teaching. Doctors-in-training are evaluated for their knowledge through written tests or assignments, based on which the effectiveness of their training is also assessed; however, this generally produces a negative learning attitude among them. So we introduced the flipped classroom into PGY training program to change PGY students' learning behavior...
2016: PloS One
https://www.readbyqxmd.com/read/27911891/severe-carbamazepine-intoxication-in-children-analysis-of-a-40-case-series
#16
Mehmet Acikgoz, M Sukru Paksu, Ahmet Guzel, Abdurrahman Alacam, Fatma Alacam
BACKGROUND We compared the factors that might impact the severity and the prognosis of carbamazepine (CBZ) intoxication in children, as well as the efficacy levels of the treatment options. MATERIAL AND METHODS Demographic information and clinical and laboratory findings for 40 patients were evaluated retrospectively. Predictive parameters for the development of serious complications were studied. RESULTS Median age of patients was 14 years; 65% of the patients were female. The most common pathological clinical finding and laboratory abnormality were inability to awaken the patient and hyperglycemia (45% and 60%, respectively)...
December 2, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27911584/clinicopathological-characteristics-and-prognosis-for-survival-after-enucleation-of-uveal-melanoma-in-chinese-patients-long-term-follow-up
#17
Han Yue, Jiang Qian, Yifei Yuan, Rui Zhang, Yingwen Bi, Fengxi Meng, Yi Xuan
PURPOSE: To summarize the clinicopathological characteristics and prognosis of uveal melanoma (UM) after enucleation in Chinese patients. METHODS: Between 2003 and 2012, a series of 171 patients with UM received enucleation at the Eye & ENT Hospital of Fudan University in Shanghai. Patient clinical information was collected. Pathological examination and BAP1 staining of the enucleated eyes were conducted. Univariate and multivariate Cox proportional hazard regressions were conducted to determine the risk factors, and the survival rates were calculated and compared...
December 2, 2016: Current Eye Research
https://www.readbyqxmd.com/read/27911143/factors-predicting-life-threatening-infections-with-respiratory-syncytial-virus-in-adult-patients
#18
Se Yoon Park, Taeeun Kim, Young Rock Jang, Min-Chul Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo, Sung-Han Kim
BACKGROUND: Respiratory syncytial virus (RSV) is a significant cause of acute respiratory illness with a clinical spectrum ranging from self-limiting upper respiratory infection to severe lower respiratory infection in elderly persons as well as young children. However, there are limited data on risk factors for life-threatening infections that could guide the appropriate use of antiviral agents in adult patients with RSV. METHODS: We conducted a retrospective cohort study from October 2013 to September 2015...
December 2, 2016: Infectious Diseases
https://www.readbyqxmd.com/read/27911103/tools-for-outcome-prediction-in-patients-with-community-acquired-pneumonia
#19
Faheem Khan, Mark B Owens, Marcos Restrepo, Pedro Povoa, Ignacio Martin-Loeches
Community-acquired pneumonia (CAP) is one of the most common causes of mortality world-wide. The mortality rate of patients with CAP is influenced by the severity of the disease, treatment failure and the requirement for hospitalization and/or intensive care unit (ICU) management, all of which may be predicted by biomarkers and clinical scoring systems. Areas Covered: We review the recent literature examining the efficacy of established and newly-developed clinical scores, biological and inflammatory markers such as C-Reactive protein (CRP), procalcitonin (PCT) and Interleukin-6 (IL-6), whether used alone or in conjunction with clinical severity scores to assess the severity of CAP, predict treatment failure, guide acute in-hospital or ICU admission and predict mortality...
December 2, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27910800/routine-x-ray-of-the-chest-is-not-justified-in-staging-of-cutaneous-melanoma-patients
#20
Caroline Asirvatham Gjørup, Helle Westergren Hendel, Rita Kaae Pilegaard, Cecilie Balslev Willert, Lisbet Rosenkrantz Hölmich
INTRODUCTION: The incidence of cutaneous melanoma is increasing in Denmark and worldwide. However, the prevalence of distant metastases at the time of diagnosis has decreased to 1%. We therefore questioned the value of routine preoperative chest X-ray (CXR) for staging asymptomatic melanoma patients and hypothesised that routine CXR is not justified. METHODS: A retrospective study was conducted on patients undergoing wide local excision and sentinel lymph node biopsy for cutaneous melanoma in the period from 2010 to 2014...
December 2016: Danish Medical Journal
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