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https://www.readbyqxmd.com/read/28437795/effect-of-using-the-heart-score-in-patients-with-chest-pain-in-the-emergency-department-a-stepped-wedge-cluster-randomized-trial
#1
Judith M Poldervaart, Johannes B Reitsma, Barbra E Backus, Hendrik Koffijberg, Rolf F Veldkamp, Monique E Ten Haaf, Yolande Appelman, Herman F J Mannaerts, Jan-Melle van Dantzig, Madelon van den Heuvel, Mohamed El Farissi, Bernard J W M Rensing, Nicolette M S K J Ernst, Ineke M C Dekker, Frank R den Hartog, Thomas Oosterhof, Ghizelda R Lagerweij, Eugene M Buijs, Maarten W J van Hessen, Marcel A J Landman, Roland R J van Kimmenade, Luc Cozijnsen, Jeroen J J Bucx, Clara E E van Ofwegen-Hanekamp, Maarten-Jan Cramer, A Jacob Six, Pieter A Doevendans, Arno W Hoes
Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Design: Stepped-wedge, cluster randomized trial...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28435467/ultrasound-elastography-review-of-techniques-and-clinical-applications
#2
REVIEW
Rosa M S Sigrist, Joy Liau, Ahmed El Kaffas, Maria Cristina Chammas, Juergen K Willmann
Elastography-based imaging techniques have received substantial attention in recent years for non-invasive assessment of tissue mechanical properties. These techniques take advantage of changed soft tissue elasticity in various pathologies to yield qualitative and quantitative information that can be used for diagnostic purposes. Measurements are acquired in specialized imaging modes that can detect tissue stiffness in response to an applied mechanical force (compression or shear wave). Ultrasound-based methods are of particular interest due to its many inherent advantages, such as wide availability including at the bedside and relatively low cost...
2017: Theranostics
https://www.readbyqxmd.com/read/28431096/a-new-rapid-resazurin-based-microdilution-assay-for-antimicrobial-susceptibility-testing-of-neisseria-gonorrhoeae
#3
Sunniva Foerster, Valentino Desilvestro, Lucy J Hathaway, Christian L Althaus, Magnus Unemo
Objectives: Rapid, cost-effective and objective methods for antimicrobial susceptibility testing of Neisseria gonorrhoeae would greatly enhance surveillance of antimicrobial resistance. Etest, disc diffusion and agar dilution methods are subjective, mostly laborious for large-scale testing and take ∼24 h. We aimed to develop a rapid broth microdilution assay using resazurin (blue), which is converted into resorufin (pink fluorescence) in the presence of viable bacteria. Methods: The resazurin-based broth microdilution assay was established using 132 N...
April 19, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28426345/economic-evaluation-of-ezetimibe-treatment-in-combination-with-statin-therapy-in-the-united-states
#4
Glenn M Davies, Ami Vyas, Carl A Baxter
AIMS: This study assessed the cost-effectiveness of ezetimibe with statin therapy versus statin monotherapy from a United States (US) payer perspective, assuming the impending patent expiration of ezetimibe. METHODS: A Markov-like economic model consisting of 28 distinct health states was used. Model population data were obtained from US linked claims and electronic medical records, with inclusion criteria based on diagnostic guidelines. Inputs came from recent clinical trials, meta-analyses, and cost-effectiveness analyses...
April 20, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28425520/an-innovative-chemical-strategy-for-pcr-free-genetic-detection-of-pathogens-by-an-integrated-electrochemical-biosensor
#5
S Petralia, E L Sciuto, M L Di Pietro, M Zimbone, M G Grimaldi, S Conoci
An innovative chemical strategy integrated in a miniaturized electrochemical device was developed for sensitive detection of a pathogen genome (HBV virus) without any amplification step. The results show a limit of detection comparable to the standard qRT-PCR method (20 copies per reaction), paving the way to future development of genetic PoC devices addressing automatized and low-cost molecular diagnostics.
April 20, 2017: Analyst
https://www.readbyqxmd.com/read/28424887/a-metagenomics-study-for-the-identification-of-respiratory-viruses-in-mixed-clinical-specimens-an-application-of-the-iterative-mapping-approach
#6
Yu-Nong Gong, Shu-Li Yang, Guang-Wu Chen, Yu-Wen Chen, Yhu-Chering Huang, Hsiao-Chen Ning, Kuo-Chien Tsao
Metagenomic approaches to detect viral genomes and variants in clinical samples have various challenges, including low viral titers and bacterial and human genome contamination. To address these limitations, we examined a next-generation sequencing (NGS) and iterative mapping approach for virus detection in clinical samples. We analyzed 40 clinical specimens from hospitalized children diagnosed with acute bronchiolitis, croup, or respiratory tract infections in which virus identification by viral culture or polymerase chain reaction (PCR) was unsuccessful...
April 19, 2017: Archives of Virology
https://www.readbyqxmd.com/read/28424278/detection-of-hpv-subtypes-by-mass-spectrometry-in-ffpe-tissue-specimens-a-reliable-tool-for-routine-diagnostics
#7
Mark Kriegsmann, Petra Wandernoth, Katharina Lisenko, Rita Casadonte, Rémi Longuespée, Norbert Arens, Jörg Kriegsmann
AIMS: Human papilloma virus (HPV) infection is a causative agent for approximately 5% of all new cancer cases in humans. The virus is detected in cervical, anal, vaginal, penile, vulvar and head and neck cancers and has prognostic implications. Thus, test systems are required to detect high-risk but also low-risk HPV subtypes with high specificity and sensitivity in a time-effective and cost-effective manner. In the present study we developed a new mass spectrometry (MS)-based test system for the detection of HPV infections in formalin-fixed paraffin-embedded (FFPE) tissue samples...
May 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28420236/human-hepatocarcinoma-cell-targeting-by-glypican-3-ligand-peptide-functionalized-silica-nanoparticles-implications-for-ultrasound-molecular-imaging
#8
Marco Di Paola, Alessandra Quarta, Francesco Conversano, Enzo Antonio Sbenaglia, Simona Bettini, Ludovico Valli, Giuseppe Gigli, Sergio Casciaro
Silica nanoparticles (SiNPs) are widely studied nanomaterials for their potential employment in advanced biomedical applications, like selective molecular imaging and targeted drug delivery. SiNPs are generally low cost and high biocompatible, can be easily functionalized with a wide variety of functional ligands and have been demonstrated to be effective in enhancing ultrasound contrast at clinical diagnostic frequencies. Therefore, SiNPs might be used as contrast agents in echographic imaging. In this work, we have developed a SiNPs-based system for the in vitro molecular imaging of hepatocellular carcinoma cells that express high levels of Glypican-3 protein (GPC-3) on their surface...
April 18, 2017: Langmuir: the ACS Journal of Surfaces and Colloids
https://www.readbyqxmd.com/read/28418455/the-development-and-performance-of-after-hours-primary-care-in-the-netherlands-a-narrative-review
#9
Marleen Smits, Martijn Rutten, Ellen Keizer, Michel Wensing, Gert Westert, Paul Giesen
In many Western countries, hospital emergency departments are overcrowded, leading to the desire to strengthen primary care, particularly after hours. To achieve this goal, an increasing number of Western nations are reorganizing their after-hours primary care systems into large-scale primary care physician (PCP) cooperatives. This article provides an overview of the organization, performance, and development of PCP cooperatives in the Netherlands. The Dutch after-hours primary care system might offer opportunities for other countries facing problems with after-hours care and inappropriate emergency department visits...
April 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28418451/cost-effectiveness-of-common-diagnostic-approaches-for-evaluation-of-asymptomatic-microscopic-hematuria
#10
Joshua A Halpern, Bilal Chughtai, Hassan Ghomrawi
Importance: Asymptomatic microscopic hematuria (AMH) is highly prevalent and may signal occult genitourinary (GU) malignant abnormality. Common diagnostic approaches differ in their costs and effectiveness in detecting cancer. Given the low prevalence of GU malignant abnormality among patients with AMH, it is important to quantify the cost implications of detecting cancer for each approach. Objective: To estimate the effectiveness, costs, and incremental cost per cancer detected (ICCD) for 4 common diagnostic approaches evaluating AMH...
April 17, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28416121/silent-coronary-heart-disease-in-patients-with-type-2-diabetes-application-of-a-screening-approach-in-a-follow-up-study
#11
Saula Vigili de Kreutzenberg, Anna Solini, Edoardo Vitolo, Alessandra Boi, Simonetta Bacci, Sara Cocozza, Rossella Nappo, Angela Rivellese, Angelo Avogaro, Marco Giorgio Baroni
AIMS: The cost-effectiveness of screening for silent coronary heart disease (CHD) in type 2 diabetes (DM2) is still debated. METHODS: We applied a diagnostic algorithm for silent CHD detection, in a cohort of 102 asymptomatic DM2 subjects (57±7years), attending 5 Italian outpatient clinics, to verify its predictive value. The risk of silent CHD was calculated considering classical risk factors, and presence of microangiopathy/macroangiopathy. Patients were divided in 3 groups, i...
April 4, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28415099/p594contrast-transthoracic-echocardiography-as-a-gatekeeper-for-patent-foramen-ovale-closure
#12
M Muratori, G Italiano, E Innocenti, L Fusini, M Mapelli, G Tamborini, S Ghulam Ali, P Gripari, A Maltagliati, F Celeste, M Pepi
Background.: The presence of patent foramen ovale (PFO) has been linked to many illness, including cryptogenic stroke, transient ischemic attack, migraine, platypnea-orthodeoxia syndrome and decompression sickness in scuba divers. Transesophageal echocardiography is the gold standard technique for the visualization of atrial septal anatomy, but it is a secondary level exam, not always available, with additional associated costs and not completely free from procedural risks. Standard transthoracic echocardiography (TTE) has a too low sensitivity for PFO screening...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28411630/an-immunochromatographic-assay-for-carcinoembryonic-antigen-on-cotton-thread-using-a-composite-of-carbon-nanotubes-and-gold-nanoparticles-as-reporters
#13
Xiaobo Jia, Tingting Song, Yan Liu, Lili Meng, Xun Mao
This paper describes a low-cost, sensitive, visual and rapid immunochromatographic assay method on cotton thread for carcinoembryonic antigen (CEA) detection by using novel carbon nanotube/gold nanoparticles (CNT/GNPs) nanocomposite reporter probe. CEA, a lung cancer protein biomarker, was used as analyte to demonstrate the principle of the immunochromatographic assay on cotton thread biosensor. In the presence of target CEA, the decreasing aggregation amount of CNT/GNPs nanocomposite reporter probes on the test zone induced directly readout by naked eye...
May 29, 2017: Analytica Chimica Acta
https://www.readbyqxmd.com/read/28410945/diagnostic-approach-in-fetal-coarctation-of-the-aorta-a-cost-utility-analysis
#14
Patrick D Evers, Daksha Ranade, Mark Lewin, Bhawna Arya
BACKGROUND: Coarctation of the aorta (CoA) is difficult to diagnose by fetal echocardiogram (F-Echo), often requiring multiple F-Echos during gestation and neonatal echocardiograms (N-Echos) after birth. Furthermore, CoA is the most common ductal-dependent lesion missed on routine physical exam. OBJECTIVES: We sought to determine the most cost-effective diagnostic approach in caring for infants in whom an initial F-Echo is concerning for CoA. METHODS: Four paradigms for management after initial F-Echo could not rule out CoA were compared, with a single paradigm involving additional F-Echos: (1) multiple F-Echos for diagnostic clarity and performance of N-Echo on neonates with remaining high suspicion for CoA on F-Echos (prenatal-multiple), (2) no further F-Echo and performance of N-Echo on neonates with high suspicion for CoA on initial F-Echo (postnatal-selective), (3) no further F-Echo and performance of N-Echo on all neonates (postnatal-all), and (4) no further F-Echo or N-Echo with reliance on routine physical exam to identify afflicted infants (postnatal-none)...
April 11, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28408157/microsoft-kinect-can-distinguish-differences-in-over-ground-gait-between-older-persons-with-and-without-parkinson-s-disease
#15
Moataz Eltoukhy, Christopher Kuenze, Jeonghoon Oh, Marco Jacopetti, Savannah Wooten, Joseph Signorile
Gait patterns differ between healthy elders and those with Parkinson's disease (PD). A simple, low-cost clinical tool that can evaluate kinematic differences between these populations would be invaluable diagnostically; since gait analysis in a clinical setting is impractical due to cost and technical expertise. This study investigated the between group differences between the Kinect and a 3D movement analysis system (BTS) and reported validity and reliability of the Kinect v2 sensor for gait analysis. Nineteen subjects participated, eleven without (C) and eight with PD (PD)...
April 10, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28407436/optimal-antiretroviral-therapy-adherence-as-evaluated-by-case-index-score-tool-is-associated-with-virological-suppression-in-hiv-infected-adults-in-dakar-senegal
#16
A K Byabene, L Fortes-Déguénonvo, K Niang, M N Manga, A N H Bulabula, J B Nachega, M Seydi
OBJECTIVE: To determine the prevalence and factors associated with optimal antiretroviral therapy (ART) adherence and virological failure (VLF) among HIV-infected adults enrolled in the national ART program at the teaching hospital of Fann, Dakar, Senegal. METHODS: Cross-sectional study from 1/11/2013 to 30/01/2014. OUTCOMES: 1) optimal ART adherence by the Center for Adherence Support Evaluation (CASE) Index Score (>10); and 2) VLF (HIV-RNA>1,000 copies/mL)...
April 13, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28404952/high-throughput-detection-of-clinically-targetable-alterations-using-next-generation-sequencing
#17
Julie A Vendrell, David Grand, Isabelle Rouquette, Valérie Costes, Samira Icher, Janick Selves, Marion Larrieux, Aurore Barbe, Pierre Brousset, Jérôme Solassol
Next-generation sequencing (NGS) has revolutionized the therapeutic care of patients by allowing high-throughput and parallel sequencing of large numbers of genes in a single run. However, most of available commercialized cancer panels target a large number of mutations that do not have direct therapeutic implications and that are not fully adapted to low quality formalin-fixed, paraffin-embedded (FFPE) samples. Here, we designed an amplicon-based NGS panel assay of 16 currently actionable genes according to the most recent recommendations of the French National Cancer Institute (NCI)...
March 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/28404947/identification-of-urine-biomarkers-associated-with-lung-adenocarcinoma
#18
Weiwei Wang, Shanshan Wang, Man Zhang
Lung adenocarcinoma (LAC) progression is accompanied by changes in protein levels that may be reflected in body fluids, such as urine. Urine collected from LAC patients (n=34) and healthy controls (n=36) was analyzed via matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) combined with weak cationic exchange magnetic beads. The results revealed 76 urinary polypeptides significantly different between LAC patients and normal controls (P<0.05). Twenty-two of these peptides were up-regulated and 54 were down-regulated...
March 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/28403327/internal-control-for-real-time-polymerase-chain-reaction-based-on-ms2-bacteriophage-for-rna-viruses-diagnostics
#19
Miriam Ribas Zambenedetti, Daniela Parada Pavoni, Andreia Cristine Dallabona, Alejandro Correa Dominguez, Celina de Oliveira Poersch, Stenio Perdigão Fragoso, Marco Aurélio Krieger
BACKGROUND: Real-time reverse transcription polymerase chain reaction (RT-PCR) is routinely used to detect viral infections. In Brazil, it is mandatory the use of nucleic acid tests to detect hepatitis C virus (HCV), hepatitis B virus and human immunodeficiency virus in blood banks because of the immunological window. The use of an internal control (IC) is necessary to differentiate the true negative results from those consequent from a failure in some step of the nucleic acid test. OBJECTIVES: The aim of this study was the construction of virus-modified particles, based on MS2 bacteriophage, to be used as IC for the diagnosis of RNA viruses...
April 6, 2017: Memórias do Instituto Oswaldo Cruz
https://www.readbyqxmd.com/read/28402924/remote-tele-mentored-ultrasound-for-non-physician-learners-using-facetime-a-feasibility-study-in-a-low-income-country
#20
Thomas E Robertson, Andrea R Levine, Avelino C Verceles, Jessica A Buchner, James H Lantry, Alfred Papali, Marc T Zubrow, L Nathalie Colas, Marc E Augustin, Michael T McCurdy
PURPOSE: Ultrasound (US) is a burgeoning diagnostic tool and is often the only available imaging modality in low- and middle-income countries (LMICs). However, bedside providers often lack training to acquire or interpret US images. We conducted a study to determine if a remote tele-intensivist could mentor geographically removed LMIC providers to obtain quality and clinically useful US images. MATERIALS AND METHODS: Nine Haitian non-physician health care workers received a 20-minute training on basic US techniques...
April 7, 2017: Journal of Critical Care
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