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accelerated diagnostic protocol

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https://www.readbyqxmd.com/read/29696079/profiling-plasma-extracellular-vesicle-by-pluronic-block-copolymer-based-enrichment-method-unveils-features-associated-with-breast-cancer-aggression-metastasis-and-invasion
#1
Zhenyu Zhong, Matthew Rosenow, Nick Xiao, David Spetzler
Extracellular vesicle (EV)-based liquid biopsies have been proposed to be a readily obtainable biological substrate recently for both profiling and diagnostics purposes. Development of a fast and reliable preparation protocol to enrich such small particles could accelerate the discovery of informative, disease-related biomarkers. Though multiple EV enrichment protocols are available, in terms of efficiency, reproducibility and simplicity, precipitation-based methods are most amenable to studies with large numbers of subjects...
2018: Journal of Extracellular Vesicles
https://www.readbyqxmd.com/read/29695327/high-sensitivity-troponin-the-sisyphean-pursuit-of-zero-percent-miss-rate-for-acute-coronary-syndrome-in-the-emergency-department
#2
REVIEW
Shane M Summers, Brit Long, Michael D April, Alex Koyfman, Curtis J Hunter
BACKGROUND: The United States Food and Drug Administration recently approved a high sensitivity troponin (hsTn) assay for use. Recent literature has investigated the diagnostic accuracy of hsTn for acute coronary syndrome (ACS) in the emergency department (ED) and its use in accelerated diagnostic protocols. OBJECTIVE: This article evaluates the existing literature and discusses incorporation of hsTn testing into ED clinical practice based on best available evidence...
April 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29656611/modified-breath-hold-compressed-sensing-3d-mr-cholangiopancreatography-with-a-small-field-of-view-and-high-resolution-acquisition-clinical-feasibility-in-biliary-and-pancreatic-disorders
#3
Liang Zhu, Huadan Xue, Zhaoyong Sun, Tianyi Qian, Elisabeth Weiland, Bernd Kuehn, Patrick Asbach, Bernd Hamm, Zhengyu Jin
BACKGROUND: Compressed-sensing (CS) accelerated 3D MR cholangiopancreatography (MRCP) could be acquired in both navigator-triggered (NT) and breath-hold (BH) mode, but the latter has been considered inferior in depicting pancreatic duct and diagnosing pancreatic duct-related diseases. PURPOSE: To prospectively evaluate the clinical feasibility of a modified 3D BH-CS-MRCP prototype protocol with small field-of-view (FOV) and higher spatial resolution, and to compare its performance to the original BH-CS-MRCP and NT-CS-MRCP...
April 14, 2018: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29558492/comparative-analysis-of-volatile-organic-compounds-for-the-classification-and-identification-of-mycobacterial-species
#4
Anne Küntzel, Peter Oertel, Sina Fischer, Andreas Bergmann, Phillip Trefz, Jochen Schubert, Wolfram Miekisch, Petra Reinhold, Heike Köhler
BACKGROUND: Species of Mycobacteriaceae cause serious zoonotic diseases in mammals, for example tuberculosis in humans, dogs, parrots, and elephants (caused by Mycobacterium tuberculosis) and in ruminants and humans (caused by M. bovis and M. caprae). Pulmonary diseases, lymphadenitis, skin diseases, and disseminated diseases can be caused by non-tuberculous mycobacteria (NTM). Diagnosis and differentiation among Mycobacterium species are currently done by culture isolation. The established diagnostic protocols comprise several steps that allow species identification...
2018: PloS One
https://www.readbyqxmd.com/read/29454508/the-has-choice-study-utilizing-the-heart-score-an-adp-and-shared-decision-making-to-decrease-admissions-in-chest-pain-patients
#5
Gregory Gafni-Pappas, Susanne D DeMeester, Michael A Boyd, Arun Ganti, Adam M Nicholson, Jeremy Albright, Juan Wu
OBJECTIVE: The HAS-Choice pathway utilizes the HEART Score, an accelerated diagnostic protocol (ADP), and shared decision-making using a visual aid in the evaluation of chest pain patients. We seek to determine if our intervention can improve resource utilization in a community emergency department (ED) setting while maintaining safe patient care. METHODS: This was a single-center prospective cohort study with historical that included ED patients ≥21years old presenting with a primary complaint of chest pain in two time periods...
February 8, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29358427/the-suspected-cancer-scan-pathway-protocol-for-evaluating-a-new-standard-of-care-for-patients-with-non-specific-symptoms-of-cancer
#6
Brian D Nicholson, Jason Oke, Claire Friedemann Smith, Julie-Ann Phillips, Jennifer Lee, Lucy Abel, Sadie Kelly, Isabella Gould, Toni Mackay, Zoe Kaveney, Suzie Anthony, Shelley Hayles, Daniel Lasserson, Fergus Gleeson
INTRODUCTION: Cancer survival in England lags behind most European countries, due partly to lower rates of early stage diagnosis. We report the protocol for the evaluation of a multidisciplinary diagnostic centre-based pathway for the investigation of 'low-risk but not no-risk' cancer symptoms called the Suspected CANcer (SCAN) pathway. SCAN is a new standard of care being implemented in Oxfordshire; one of a number of pathways implemented during the second wave of the Accelerate, Coordinate, Evaluate (ACE) programme, an initiative which aims to improve England's cancer survival rates through establishing effective routes to early diagnosis...
January 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29314060/dynamic-field-of-view-imaging-to-increase-temporal-resolution-in-the-early-phase-of-contrast-media-uptake-in-breast-dce-mri-a-feasibility-study
#7
Federico D Pineda, Ty O Easley, Gregory S Karczmar
PURPOSE: To increase diagnostic accuracy of breast MRI by increasing temporal resolution and more accurately sampling the early kinetics of contrast media uptake. We tested the feasibility of accelerating bilateral breast DCE-MRI by reducing the FOV, allowing aliasing, and unfolding the resulting images. METHODS: Previous experience with an "ultrafast" protocol for bilateral breast DCE-MRI (6-10 s temporal resolution) showed that the number of significantly enhancing voxels is very low in the first 30-45 s after contrast media injection...
March 2018: Medical Physics
https://www.readbyqxmd.com/read/29282287/the-17-residue-long-n-terminus-in-huntingtin-controls-stepwise-aggregation-in-solution-and-on-membranes-via-different-mechanisms
#8
Nitin K Pandey, J Mario Isas, Anoop Rawat, Rachel V Lee, Jennifer Langen, Priyatama Pandey, Ralf Langen
Aggregation of huntingtin protein arising from expanded polyglutamine (polyQ) sequences in the exon-1 region of mutant huntingtin plays a central role in the pathogenesis of Huntington's disease. The huntingtin aggregation pathways are of therapeutic and diagnostic interest, but obtaining critical information from the physiologically relevant htt exon-1 (Httex1) protein has been challenging. Using biophysical techniques and an expression and purification protocol that generates clean, monomeric Httex1, we identified and mapped three distinct aggregation pathways: 1) unseeded in solution; 2) seeded in solution; and 3) membrane-mediated...
February 16, 2018: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/29279164/clinical-application-of-half-fourier-acquisition-single-shot-turbo-spin-echo-haste-imaging-accelerated-by-simultaneous-multi-slice-acquisition
#9
Jenni Schulz, José P Marques, Annemieke Ter Telgte, Anouk van Dorst, Frank-Erik de Leeuw, Frederick J A Meijer, David G Norris
As a single-shot sequence with a long train of refocusing pulses, Half-Fourier Acquisition Single-Shot Turbo-Spin-Echo (HASTE) suffers from high power deposition limiting use at high resolutions and high field strengths, particularly if combined with acceleration techniques such as simultaneous multi-slice (SMS) imaging. Using a combination of multiband (MB)-excitation and PINS-refocusing pulses will effectively accelerate the acquisition time while staying within the SAR limitations. In particular, uncooperative and young patients will profit from the speed of the MB-PINS HASTE sequence, as clinical diagnosis can be possible without sedation...
January 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29248334/diagnostic-accuracy-of-a-new-high-sensitivity-troponin-i-assay-and-five-accelerated-diagnostic-pathways-for-ruling-out-acute-myocardial-infarction-and-acute-coronary-syndrome
#10
Jaimi H Greenslade, Edward W Carlton, Christopher Van Hise, Elizabeth Cho, Tracey Hawkins, William A Parsonage, Jillian Tate, Jacobus Ungerer, Louise Cullen
STUDY OBJECTIVE: This diagnostic accuracy study describes the performance of 5 accelerated chest pain pathways, calculated with the new Beckman's Access high-sensitivity troponin I assay. METHODS: High-sensitivity troponin I was measured with presentation and 2-hour blood samples in 1,811 patients who presented to an emergency department (ED) in Australia. Patients were classified as being at low risk according to 5 rules: modified accelerated diagnostic protocol to assess patients with chest pain symptoms using troponin as the only biomarker (m-ADAPT), the Emergency Department Assessment of Chest Pain Score (EDACS) pathway, the History, ECG, Age, Risk Factors, and Troponin (HEART) pathway, the No Objective Testing Rule, and the new Vancouver Chest Pain Rule...
April 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29232768/modification-of-the-thrombolysis-in-myocardial-infarction-risk-score-for-patients-presenting-with-chest-pain-to-the-emergency-department
#11
Jaimi H Greenslade, Kimberly Chung, William A Parsonage, Tracey Hawkins, Martin Than, John W Pickering, Louise Cullen
OBJECTIVE: To develop a modified Thrombolysis in Myocardial Infarction (TIMI) score to effectively risk stratify patients presenting to the ED with chest pain. METHODS: A prospective observational study was conducted at two metropolitan EDs. Data were obtained during patient interview. The primary outcome was major adverse cardiovascular events (MACE) within 30 days of presentation. Two separate modifications of the TIMI score were developed. These scores were compared to the original TIMI in terms of the area under the receiver operating characteristic curve and diagnostic accuracy statistics (sensitivity, specificity, positive and negative predictive values)...
February 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29163434/neglected-australian-arboviruses-and-undifferentiated-febrile-illness-addressing-public-health-challenges-arising-from-the-developing-northern-australia-government-policy
#12
Narayan Gyawali, Richard S Bradbury, John G Aaskov, Andrew W Taylor-Robinson
The Australian Government is currently promoting the development of Northern Australia, with an associated increase in the local population. Consequent to this is the public health threat posed by heightened human exposure to many previously neglected arboviruses that are indigenous to the region. This initiative to support economic activity in the tropical north of the continent is leading to the accelerated expansion of an infection-naïve human population into hitherto un-encountered ecosystems inhabited by reservoir animals and vectors for these arboviruses...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29138293/icare-acs-improving-care-processes-for-patients-with-suspected-acute-coronary-syndrome-a-study-of-cross-system-implementation-of-a-national-clinical-pathway
#13
Martin P Than, John W Pickering, Jeremy M Dryden, Sally J Lord, S Andrew Aitken, Sally J Aldous, Kate E Allan, Michael W Ardagh, John W N Bonning, Rosie Callender, Laura R E Chapman, Jonathan P Christiansen, Andre P J Cromhout, Louise Cullen, Joanne M Deely, Gerard P Devlin, Katherine A Ferrier, Christopher M Florkowski, Christopher M A Frampton, Peter M George, Gregory J Hamilton, Allan S Jaffe, Andrew J Kerr, G Luke Larkin, Richard M Makower, Timothy J E Matthews, William A Parsonage, W Frank Peacock, Bradley F Peckler, Niels C van Pelt, Louise Poynton, A Mark Richards, Anthony G Scott, Mark B Simmonds, David Smyth, Oliver P Thomas, Andrew C Y To, Stephen A Du Toit, Richard W Troughton, Kim M Yates
BACKGROUND: Efforts to safely reduce length of stay for emergency department patients with symptoms suggestive of acute coronary syndrome (ACS) have had mixed success. Few system-wide efforts affecting multiple hospital emergency departments have ever been evaluated. We evaluated the effectiveness of a nationwide implementation of clinical pathways for potential ACS in disparate hospitals. METHODS: This was a multicenter pragmatic stepped-wedge before-and-after trial in 7 New Zealand acute care hospitals with 31 332 patients investigated for suspected ACS with serial troponin measurements...
January 23, 2018: Circulation
https://www.readbyqxmd.com/read/29096671/community-led-responses-for-elimination-core-a-study-protocol-for-a-community-randomized-controlled-trial-assessing-the-effectiveness-of-community-level-reactive-focal-drug-administration-for-reducing-plasmodium-falciparum-infection-prevalence-and-incidence
#14
Daniel J Bridges, John M Miller, Victor Chalwe, Hawela Moonga, Busiku Hamainza, Rick Steketee, Kafula Silumbe, Jenala Nyangu, David A Larsen
BACKGROUND: Zambia is pushing for, and has made great strides towards, the elimination of malaria transmission in Southern Province. Reactive focal test and treat (RFTAT) using rapid diagnostic tests and artemether-lumefantrine (AL) has been key in making this progress. Reactive focal drug administration (RFDA) using dihydroartemisinin-piperaquine (DHAP), may be superior in accelerating clearance of the parasite reservoir in humans due to the provision of enhanced chemoprophylactic protection of at-risk populations against new infections...
November 2, 2017: Trials
https://www.readbyqxmd.com/read/29077588/implementation-of-a-5-minute-magnetic-resonance-imaging-screening-protocol-for-prostate-cancer-in-men-with-elevated-prostate-specific-antigen-before-biopsy
#15
Jakob Weiss, Petros Martirosian, Mike Notohamiprodjo, Sascha Kaufmann, Ahmed E Othman, Ulrich Grosse, Konstantin Nikolaou, Sergios Gatidis
PURPOSE: The aims of this study were to establish a 5-minute magnetic resonance (MR) screening protocol for prostate cancer in men before biopsy and to evaluate effects on Prostate Imaging Reporting and Data System (PI-RADS) V2 scoring in comparison to a conventional, fully diagnostic multiparametric MR imaging (mpMRI) approach. MATERIALS AND METHODS: Fifty-two patients with elevated prostate-specific antigen levels and without prior biopsy were prospectively included in this institutional review board-approved study...
March 2018: Investigative Radiology
https://www.readbyqxmd.com/read/29028638/malignant-hyperthermia-versus-thyroid-storm-in-a-patient-with-symptomatic-graves-disease-a-case-report
#16
Sara M Strowd, Michael B Majewski, Jennifer Asteris
Malignant hyperthermia and thyroid storm are intraoperative emergencies with overlapping symptoms but different treatment protocols. We faced this diagnostic dilemma in a 25-year-old patient with symptomatic hyperthyroidism, elevated free T3 and free T4, and low thyroid-stimulating hormone from Graves disease despite treatment with propranolol 80 mg daily and methimazole 40 mg every 8 hours. During thyroidectomy, he developed hyperthermia and hypercarbia without tachycardia. When the rate of rise of PaCO2 and temperature accelerated, we treated the patient for malignant hyperthermia, a diagnosis subsequently confirmed by genetic testing...
October 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28987133/implementing-change-evaluating-the-accelerated-chest-pain-risk-evaluation-acre-project
#17
William A Parsonage, Tanya Milburn, Sarah Ashover, Wade Skoien, Jaimi H Greenslade, Louise McCormack, Louise Cullen
OBJECTIVE: To evaluate hospital length of stay (LOS) and admission rates before and after implementation of an evidence-based, accelerated diagnostic protocol (ADP) for patients presenting to emergency departments (EDs) with chest pain. DESIGN: Quasi-experimental design, with interrupted time series analysis for the period October 2013 - November 2015. Setting, participants: Adults presenting with chest pain to EDs of 16 public hospitals in Queensland. INTERVENTION: Implementation of the ADP by structured clinical re-design...
August 4, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28976478/compressed-sensing-accelerated-3-dimensional-magnetic-resonance-cholangiopancreatography-application-in-suspected-pancreatic-diseases
#18
Liang Zhu, Xi Wu, Zhaoyong Sun, Zhengyu Jin, Elisabeth Weiland, Esther Raithel, Tianyi Qian, Huadan Xue
OBJECTIVES: The aims of this study were to prospectively evaluate image quality, duct visibility, and diagnostic performance in duct-related pathologies of compressed-sensing (CS) accelerated 3-dimensional (3D) magnetic resonance cholangiopancreatography (MRCP) prototype protocols and compare these with those of conventional 3D MRCP protocol in patients with suspected pancreatic diseases. MATERIAL AND METHODS: The institutional review board approved this prospective study and all patients provided written informed consent...
March 2018: Investigative Radiology
https://www.readbyqxmd.com/read/28961567/abbreviated-mri-and-accelerated-mri-for-screening-and-diagnosis-of-breast-cancer
#19
Deepa Sheth, Hiroyuki Abe
Although published studies have revealed that magnetic resonance imaging (MRI) is by far the most effective imaging modality for cancer detection, it is currently considered cost-ineffective for screening women at an intermediate risk for breast cancer. The concept of an "abbreviated MRI" protocol has recently emerged as a possible solution for reducing the cost of MRI. The abbreviated MRI is a shortened version of the standard MRI, consisting of a single early phase dynamic contrast enhanced (DCE) series. Several clinical studies have shown that this MRI protocol would not affect sensitivity or specificity for breast MRI screening purposes...
October 2017: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/28950384/diagnostic-accuracy-of-an-mri-protocol-of-the-knee-accelerated-through-parallel-imaging-in-correlation-to-arthroscopy
#20
Johannes Walter Schnaiter, Frank Roemer, Axel McKenna-Kuettner, Hans-Joachim Patzak, Matthias Stefan May, Rolf Janka, Michael Uder, Wolfgang Wuest
PURPOSE:  Parallel imaging allows for a considerable shortening of examination times. Limited data is available about the diagnostic accuracy of an accelerated knee MRI protocol based on parallel imaging evaluating all knee joint compartments in a large patient population compared to arthroscopy. MATERIALS AND METHODS:  162 consecutive patients with a knee MRI (1.5 T, Siemens Aera) and arthroscopy were included. The total MRI scan time was less than 9 minutes...
March 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
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