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https://www.readbyqxmd.com/read/28445608/sexual-and-gender-minority-adolescents-views-on-hiv-research-participation-and-parental-permission-a-mixed-methods-study
#1
Brian Mustanski, Ryan Coventry, Kathryn Macapagal, Miriam R Arbeit, Celia B Fisher
CONTEXT: Sexual and gender minority adolescents are underrepresented in HIV research, partly because institutional review boards (IRBs) are reluctant to waive parental permission requirements for these studies. Understanding teenagers' perspectives on parental permission and the risks and benefits of participating in HIV research is critical to informing evidence-based IRB decisions. METHODS: Data from 74 sexual and gender minority adolescents aged 14-17 who participated in an online focus group in 2015 were used to examine perspectives on the risks and benefits of participation in a hypothetical HIV surveillance study and the need for parental permission and adequate protections...
April 26, 2017: Perspectives on Sexual and Reproductive Health
https://www.readbyqxmd.com/read/28445354/a-prospective-randomized-trial-comparing-the-effects-of-lidocaine-in-breast-reduction-surgery
#2
Brian M Christie, Sahil Kapur, Steve J Kempton, Summer E Hanson, Yue Ma, Venkat K Rao
BACKGROUND: Use of dilute epinephrine tumescent solution in breast reduction surgery has been shown to significantly decrease operative blood loss without increasing perioperative complications. Lidocaine is commonly added to epinephrine to decrease postoperative pain. Evidence supporting this practice, however, is limited, and lidocaine toxicity has been reported. METHODS: With institutional review board approval, patients undergoing bilateral breast reduction surgery were assigned to receive either tumescent saline solution with epinephrine (1:1 million) (group 1), or tumescent saline solution with epinephrine (1:1 million) and lidocaine (0...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28441687/c-arm-positioning-is-a-significant-source-of-radiation-in-spine-surgery
#3
Elizabeth W Reiser, Rupen Desai, Sarah A Byrd, Harrison Farber, Deborah Chi, Cary S Idler, Robert E Isaacs
STUDY DESIGN: Prospective chart review. OBJECTIVE: It is well-known that radiation exposure during minimally invasive spine procedures can be substantial. Less interest has focused on setup radiation exposure before incision, including preoperative images used for surgical approach. The present study seeks to better quantify the significance of setup radiation in the total radiation exposure of minimally invasive spine surgery. SUMMARY OF BACKGROUND DATA: Radiographic localization is necessary in minimally invasive spine procedures to visualize anatomy, but increased radiation exposure is associated with health risks...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28441242/identifying-undiagnosed-pediatric-mental-illness-in-the-emergency-department
#4
La Vonne A Downey, Leslie S Zun
BACKGROUND: It is well known that pediatric psychiatric patients frequent emergency department (ED), but the number of patients with undiagnosed psychiatric illness presenting to an ED is not well known. Identification and referral of these patients may provide an opportunity for improved patient care. The primary study objective was to identify a tool that can screen for unsuspected psychiatric illness in pediatric patients who present to the ED with non-psychiatric-related complaints...
April 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28440325/multiparametric-mri-ultrasound-fusion-guided-biopsy-decreases-detection-of-indolent-cancer-in-african-american-men
#5
M Kongnyuy, M M Siddiqui, A K George, A Muthigi, A Sidana, M Maruf, B Turkbey, P L Choyke, B J Wood, P A Pinto
BACKGROUND: Analysis of systematic 12-core biopsies (SBx) has shown that African-American (AA) men tend to harbor higher risk prostate cancer (PCa) at presentation relative to other races. Multiparametric magnetic resonance imaging (mpMRI) and MRI-ultrasound fusion-guided biopsy (FBx) have been shown to diagnose more intermediate- and high-risk PCa in the general population; however, the efficacy in AA remains largely uncharacterized. We aim to evaluate the utility of FBx in an AA patient cohort...
April 25, 2017: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/28438726/analyzing-unstructured-communication-in-a-computer-mediated-environment-for-adults-with-type-2-diabetes-a-research-protocol
#6
Allison A Lewinski, Ruth A Anderson, Allison A Vorderstrasse, Edwin B Fisher, Wei Pan, Constance M Johnson
BACKGROUND: Individuals with type 2 diabetes have an increased risk for comorbidities such as heart disease, lower limb amputations, stroke, and renal failure. Multiple factors influence development of complications in a person living with type 2 diabetes; however, an individual's self-management behaviors may delay the onset of, or lessen the severity of, these complications. Social support provides personal, informal advice and knowledge that helps individuals initiate and sustain self-management and adherence...
April 24, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28438431/phantom-to-clinic-development-of-hypofractionated-stereotactic-body-radiotherapy-for-early-stage-glottic-laryngeal-cancer
#7
Chuxiong Ding, Stephen G Chun, Baran D Sumer, Lucien A Nedzi, Ramzi E Abdulrahman, John S Yordy, Pam Lee, Brian Hrycushko, Timothy D Solberg, Chul Ahn, Robert D Timmerman, David L Schwartz
The purpose of this study was to commission and clinically test a robotic stereotactic delivery system (CyberKnife, Sunnyvale, CA) to treat early-stage glottic laryngeal cancer. We enrolled 15 patients with cTis-T2N0M0 carcinoma of the glottic larynx onto an institutional review board (IRB)-approved clinical trial. Stereotactic body radiotherapy (SBRT) plans prescribed 45 Gy/10 fractions to the involved hemilarynx. SBRT dosimetry was compared with (1) standard carotid-sparing laryngeal intensity-modulated radiation therapy (IMRT) and (2) selective hemilaryngeal IMRT...
April 21, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/28438322/water-fat-dixon-sequences-in-the-evaluation-of-breast-implants-proposal-of-a-time-effective-rapid-approach-in-the-clinical-practice
#8
M Marcon, A S Becker, E J Ulbrich, T Frauenfelder, A Boss
AIM: To evaluate the diagnostic accuracy achieved from a fat-water Dixon sequence alone compared to a combination of a silicone-specific magnetic resonance imaging (MRI) sequence and a water-specific MRI sequence in the assessment of breast implants. MATERIALS AND METHODS: In this institutional review board (IRB)-approved study the integrity of breast implants was assessed retrospectively in 27 patients undergoing breast MRI at 3 T. A qualitative evaluation of (set 1) a silicon-selective water-saturated short tau inversion recovery (STIR) sequence in combination with a water-only Dixon dataset (total acquisition time 7 minutes 17 seconds), and of (set 2) fat-only and water-only Dixon datasets (4 minutes 8 seconds) was performed by two readers independently evaluating the following features: margin definition of the implant, water suppression homogeneity, image quality, presence of artefacts and their effects on the imaging interpretation, and diagnostic confidence...
April 21, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#9
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28436741/deep-learning-at-chest-radiography-automated-classification-of-pulmonary-tuberculosis-by-using-convolutional-neural-networks
#10
Paras Lakhani, Baskaran Sundaram
Purpose To evaluate the efficacy of deep convolutional neural networks (DCNNs) for detecting tuberculosis (TB) on chest radiographs. Materials and Methods Four deidentified HIPAA-compliant datasets were used in this study that were exempted from review by the institutional review board, which consisted of 1007 posteroanterior chest radiographs. The datasets were split into training (68.0%), validation (17.1%), and test (14.9%). Two different DCNNs, AlexNet and GoogLeNet, were used to classify the images as having manifestations of pulmonary TB or as healthy...
April 24, 2017: Radiology
https://www.readbyqxmd.com/read/28435505/inter-rater-agreement-of-end-of-shift-evaluations-based-on-a-single-encounter
#11
Steven Warrington, Michael Beeson, Amber Bradford
INTRODUCTION: End-of-shift evaluation (ESE) forms, also known as daily encounter cards, represent a subset of encounter-based assessment forms. Encounter cards have become prevalent for formative evaluation, with some suggesting a potential for summative evaluation. Our objective was to evaluate the inter-rater agreement of ESE forms using a single scripted encounter at a conference of emergency medicine (EM) educators. METHODS: Following institutional review board exemption, we created a scripted video simulating an encounter between an intern and a patient with an ankle injury...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435501/impact-of-clinical-decision-support-on-radiography-for-acute-ankle-injuries-a-randomized-trial
#12
Shahein Tajmir, Ali S Raja, Ivan K Ip, James Andruchow, Patricia Silveira, Stacy Smith, Ramin Khorasani
INTRODUCTION: While only 15-20% of patients with foot and ankle injuries presenting to urgent care centers have clinically significant fractures, most undergo radiography. We examined the impact of electronic point-of-care clinical decision support (CDS) on adherence to the Ottawa Ankle Rules (OAR), as well as use and yield of foot and ankle radiographs in patients with acute ankle injury. METHODS: We obtained institutional review board approval for this randomized controlled study performed April 18, 2012-December 15, 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435496/-choosing-wisely-imaging-recommendations-initial-implementation-in-new-england-emergency-departments
#13
Ali S Raja, Arjun Venkatesh, Nathan Mick, Cristopher P Zabbo, Kohei Hasegawa, Janice A Espinola, Jane C Bittner, Carlos A Camargo
INTRODUCTION: In June 2016, the American College of Emergency Physicians (ACEP) Emergency Quality Network began its Reduce Avoidable Imaging Initiative, designed to "reduce testing and imaging with low risk patients through the implementation of Choosing Wisely recommendations." However, it is unknown whether New England emergency departments (ED) have already implemented evidence-based interventions to improve adherence to ACEP Choosing Wisely recommendations related to imaging after their initial release in 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435492/applying-systems-engineering-reduces-radiology-transport-cycle-times-in-the-emergency-department
#14
Benjamin A White, Brian J Yun, Michael H Lev, Ali S Raja
INTRODUCTION: Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434844/quality-and-value-of-subspecialty-reinterpretation-of-thoracic-ct-scans-of-patients-referred-to-a-tertiary-cancer%C3%A2-center
#15
Brett W Carter, Jeremy J Erasmus, Mylene T Truong, Jo-Anne O Shepard, Wayne Hofstetter, Ryan Clarke, Reginald F Munden, Joseph R Steele
INTRODUCTION: Patients referred to tertiary cancer centers often present with imaging studies performed and interpreted at other health care institutions. Although reinterpretation of imaging performed at another health care institution can reduce repeat imaging, unnecessary radiation dose, and cost, the benefit is uncertain. The purpose of this study is to evaluate the quality of initial imaging studies of patients seeking a second opinion at a tertiary cancer center, to compare the accuracy of initial interpretations to reinterpretations performed by subspecialty trained radiologists at a tertiary oncologic center, and to determine the potential impact on patient management...
April 20, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28433641/analysis-of-complications-of-pelvic-mesh-excision-surgery-using-the-clavien-dindo-classification-system
#16
Goran Rac, Alyssa Greiman, Andrew Rabley, T J Tipton, Leah R Chiles, Drew A Freilich, Ross Rames, Lindsey Cox, Michelle Koski, Eric S Rovner
PURPOSE: To describe and categorize complications in patients undergoing vaginal mesh excision surgery using the Clavien-Dindo classification system. MATERIALS AND METHODS: A retrospective review of 277 patients who underwent vaginal mesh extraction between 2007 and 2015 at a single institution was conducted with Institutional Review Board approval. Surgical complications were stratified using the Clavien-Dindo classification system. Complications were noted to be either peri-operative (prior to discharge) or post-operative (within 90 days)...
April 19, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28433453/attending-documentation-contribution-to-billing-at-an-academic-emergency-department-with-an-electronic-health-record
#17
Brian J Yun, Stephen C Dorner, Brian M Baccari, John Brennan, Karen Smith, Ali S Raja, Benjamin A White
INTRODUCTION: In emergency medicine (EM), patient care documentation serves many functions, including supporting reimbursement. In addition, many electronic health record systems facilitate automatically populating certain data fields. As a result, in the academic model, the attending's note may now more often recapitulate many of the same elements found in the resident's or physician assistant's (PA) note. We sought to determine the value of additional attending documentation, and how often the attending documentation prevented a downcoding event...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433224/the-importance-of-age-on-short-term-outcomes-associated-with-repair-of-giant-paraesophageal-hernias
#18
Mustapha A El Lakis, Stephen J Kaplan, Michal Hubka, Kamran Mohiuddin, Donald E Low
BACKGROUND: Older patients have an increased incidence of paraesophageal hernia (PEH) and can be denied surgical assessment due to the perception of increased complications and mortality. This study examines the influence of age and comorbidities on early complications and other short-term outcomes of PEH repair. METHODS: From 2000 to 2016, data of surgically treated patients with PEH were prospectively recorded in an Institutional Review Board-approved database...
April 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28432468/population-pharmacokinetics-of-intravenous-acetaminophen-in-japanese-patients-undergoing-elective-surgery
#19
Tsuyoshi Imaizumi, Shinju Obara, Midori Mogami, Yuzo Iseki, Makiko Hasegawa, Masahiro Murakawa
INTRODUCTION: Intravenous (i.v.) acetaminophen is administered during surgery for postoperative analgesia. However, little information is available on the pharmacokinetics of i.v. acetaminophen in Japanese patients undergoing surgery under general anesthesia. METHODS: The study was approved by the Institutional Review Board and registered at UMIN-CTR (UMIN000013418). Patients scheduled to undergo elective surgery under general anesthesia were enrolled after obtaining written informed consent...
April 21, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28432417/exploring-the-possibility-of-a-retrograde-embolism-pathway-from-the-facial-artery-to-the-ophthalmic-artery-system-in-vivo
#20
Hui Zheng, Lihong Qiu, Zonghui Liu, Yingjun Su, Xinyuan Pan, Sha Liu, Chenggang Yi
BACKGROUND: Blindness caused by soft tissue fillers is an extremely low-probability event, but it results in great concern because of its devastating consequences. Currently, the mechanism of an embolism is usually considered to be an accidental injection of fillers into the blood vessels of the face, such as a facial artery, and then retrograding into the ophthalmic artery system, which causes retinal ischemic necrosis. In addition, previous studies have shown that there are anastomoses between facial arteries and branches of the ophthalmic artery in cadavers...
April 21, 2017: Aesthetic Plastic Surgery
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