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https://www.readbyqxmd.com/read/28368092/a-pediatric-institutional-acute-stroke-protocol-improves-timely-access-to-stroke-treatment
#1
Melissa Shack, Andrea Andrade, Priyanka P Shah-Basak, Manohar Shroff, Mahendranath Moharir, Ivanna Yau, Rand Askalan, Daune MacGregor, Mubeen F Rafay, Gabrielle A deVeber
AIM: We aimed to evaluate whether an institutional acute stroke protocol (ASP) could accelerate the diagnosis and secondary treatment of pediatric stroke. METHOD: We initiated an ASP in 2005. We compared 209 children (125 males, 84 females; median age 4.8y, interquartile range [IQR] 1.2-9.3y, range 0.09-17.7y) diagnosed with arterial ischemic stroke 'pre-protocol' (1992-2004) to 112 children (60 males, 52 females; median age 5.8y, IQR 1.0-11.4y, range 0.08-17.7y) diagnosed 'post-protocol' (2005-2012) for time-to-diagnosis, mode of diagnostic imaging, and time-to-treatment with antithrombotic medication (aspirin or anticoagulants)...
January 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28367012/the-2017-international-joint-working-group-recommendations-of-the-indian-college-of-cardiology-the-academic-college-of-emergency-experts-and-indusem-on-the-management-of-low-risk-chest-pain-in-emergency-departments-across-india
#2
Vivek Chauhan, Pavitra Kotini Shah, Sagar Galwankar, Maura Sammon, Prabhakar Hosad, Beeresha, Timothy B Erickson, David F Gaieski, Joydeep Grover, Anupama V Hegde, Terry Vanden Hoek, Bhavesh Jarwani, Himanshu Kataria, Kenneth A LaBresh, Cholenahally Nanjappa Manjunath, A C Nagamani, Anjali Patel, Ketan Patel, D Ramesh, R Rangaraj, Narendra Shamanur, L Sridhar, K H Srinivasa, Shweta Tyagi
There have been no published recommendations for the management of low-risk chest pain in emergency departments (EDs) across India. This is despite the fact that chest pain continues to be one of the most common presenting complaints in EDs. Risk stratification of patients utilizing an accelerated diagnostic protocol has been shown to decrease hospitalizations by approximately 40% with a low 30-day risk of major adverse cardiac events. The experts group of academic leaders from the Indian College of Cardiology and Academic College of Emergency Experts in India partnered with academic experts in emergency medicine and cardiology from leading institutions in the UK and USA collaborated to study the scientific evidence and make recommendations to guide emergency physicians working in EDs across India...
April 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28362329/bench-top-fabrication-of-an-all-pdms-microfluidic-electrochemical-cell-sensor-integrating-micro-nanostructured-electrodes
#3
Sokunthearath Saem, Yujie Zhu, Helen Luu, Jose Moran-Mirabal
In recent years, efforts in the development of lab-on-a-chip (LoC) devices for point-of-care (PoC) applications have increased to bring affordable, portable, and sensitive diagnostics to the patients' bedside. To reach this goal, research has shifted from using traditional microfabrication methods to more versatile, rapid, and low-cost options. This work focuses on the benchtop fabrication of a highly sensitive, fully transparent, and flexible poly (dimethylsiloxane) (PDMS) microfluidic (μF) electrochemical cell sensor...
March 31, 2017: Sensors
https://www.readbyqxmd.com/read/28327206/lessons-learned-from-additional-research-analyses-of-unsolved-clinical-exome-cases
#4
Mohammad K Eldomery, Zeynep Coban-Akdemir, Tamar Harel, Jill A Rosenfeld, Tomasz Gambin, Asbjørg Stray-Pedersen, Sébastien Küry, Sandra Mercier, Davor Lessel, Jonas Denecke, Wojciech Wiszniewski, Samantha Penney, Pengfei Liu, Weimin Bi, Seema R Lalani, Christian P Schaaf, Michael F Wangler, Carlos A Bacino, Richard Alan Lewis, Lorraine Potocki, Brett H Graham, John W Belmont, Fernando Scaglia, Jordan S Orange, Shalini N Jhangiani, Theodore Chiang, Harsha Doddapaneni, Jianhong Hu, Donna M Muzny, Fan Xia, Arthur L Beaudet, Eric Boerwinkle, Christine M Eng, Sharon E Plon, V Reid Sutton, Richard A Gibbs, Jennifer E Posey, Yaping Yang, James R Lupski
BACKGROUND: Given the rarity of most single-gene Mendelian disorders, concerted efforts of data exchange between clinical and scientific communities are critical to optimize molecular diagnosis and novel disease gene discovery. METHODS: We designed and implemented protocols for the study of cases for which a plausible molecular diagnosis was not achieved in a clinical genomics diagnostic laboratory (i.e. unsolved clinical exomes). Such cases were recruited to a research laboratory for further analyses, in order to potentially: (1) accelerate novel disease gene discovery; (2) increase the molecular diagnostic yield of whole exome sequencing (WES); and (3) gain insight into the genetic mechanisms of disease...
March 21, 2017: Genome Medicine
https://www.readbyqxmd.com/read/28327089/uniform-fdg-pet-guided-gradient-dose-prescription-to-reduce-late-radiation-toxicity-upgrade-rt-study-protocol-for-a-randomized-clinical-trial-with-dose-reduction-to-the-elective-neck-in-head-and-neck-squamous-cell-carcinoma
#5
Sven van den Bosch, Tim Dijkema, Martina C Kunze-Busch, Chris H J Terhaard, Cornelis P J Raaijmakers, Patricia A H Doornaert, Frank J P Hoebers, Marije R Vergeer, Bas Kreike, Oda B Wijers, Wim J G Oyen, Johannes H A M Kaanders
BACKGROUND: In definitive radiation therapy for head and neck cancer, clinically uninvolved cervical lymph nodes are irradiated with a so-called 'elective dose' in order to achieve control of clinically occult metastases. As a consequence of high-resolution diagnostic imaging, occult tumor volume has significantly decreased in the last decades. Since the elective dose is dependent on occult tumor volume, the currently used elective dose may be higher than necessary. Because bilateral irradiation of the neck contributes to dysphagia, xerostomia and hypothyroidism in a dose dependent way, dose de-escalation to these regions can open a window of opportunity to reduce toxicity and improve quality of life after treatment...
March 21, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28274211/redefining-radiotherapy-for-early-stage-breast-cancer-with-single-dose-ablative-treatment-a-study-protocol
#6
R K Charaghvandi, B van Asselen, M E P Philippens, H M Verkooijen, C H van Gils, P J van Diest, R M Pijnappel, M G G Hobbelink, A J Witkamp, T van Dalen, E van der Wall, T C van Heijst, R Koelemij, M van Vulpen, H J G D van den Bongard
BACKGROUND: A shift towards less burdening and more patient friendly treatments for breast cancer is currently ongoing. In low-risk patients with early-stage disease, accelerated partial breast irradiation (APBI) is an alternative for whole breast irradiation following breast-conserving surgery. MRI-guided single dose ablative APBI has the potential to offer a minimally burdening, non-invasive treatment that could replace current breast-conserving therapy. METHODS: The ABLATIVE study is a prospective, single arm, multicenter study evaluating preoperative, single dose, ablative radiation treatment in patients with early-stage breast cancer...
March 9, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28261896/identifying-low-risk-patients-for-early-discharge-from-emergency-department-without-using-subjective-descriptions-of-chest-pain-insights-from-providing-rapid-out-of-hospital-acute-cardiovascular-treatment-proact-3-and-4-trials
#7
Nariman Sepehrvand, Yinggan Zheng, Paul W Armstrong, Robert C Welsh, Justin A Ezekowitz
BACKGROUND: Several accelerated diagnostic protocols (ADP) have been developed to allow emergency department (ED) physicians to identify appropriate patients for safe early discharge after presentation with symptom of chest pain. Most ADPs require chest pain to be described and modify the algorithm based on the subjective chest pain characteristics. We investigated the performance of 3 established major ADPs simplified by eliminating the need for chest pain as a descriptor. METHODS: We pooled patients from PROACT-3 and 4 trials, in which patients presenting to emergency medical services (EMS) with chest pain or dyspnea were enrolled...
March 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28187516/collaborating-to-compete-blood-profiling-atlas-in-cancer-bloodpac-consortium
#8
R L Grossman, B Abel, S Angiuoli, J C Barrett, D Bassett, K Bramlett, G M Blumenthal, A Carlsson, R Cortese, J DiGiovanna, B Davis-Dusenbery, R Dittamore, D A Eberhard, P Febbo, M Fitzsimons, Z Flamig, J Godsey, J Goswami, A Gruen, F Ortuño, J Han, D Hayes, J Hicks, D Holloway, D Hovelson, J Johnson, H Juhl, R Kalamegham, R Kamal, Q Kang, G J Kelloff, M Klozenbuecher, A Kolatkar, P Kuhn, K Langone, R Leary, P Loverso, H Manmathan, A-M Martin, J Martini, D Miller, M Mitchell, T Morgan, R Mulpuri, T Nguyen, G Otto, A Pathak, E Peters, R Philip, E Posadas, D Reese, M G Reese, D Robinson, A Dei Rossi, H Sakul, J Schageman, S Singh, H I Scher, K Schmitt, A Silvestro, J Simmons, T Simmons, J Sislow, A Talasaz, P Tang, M Tewari, S Tomlins, H Toukhy, H R Tseng, M Tuck, A Tzou, J Vinson, Y Wang, W Wells, A Welsh, J Wilbanks, J Wolf, L Young, Jsh Lee, L C Leiman
The cancer community understands the value of blood profiling measurements in assessing and monitoring cancer. We describe an effort among academic, government, biotechnology, diagnostic, and pharmaceutical companies called the Blood Profiling Atlas in Cancer (BloodPAC) Project. BloodPAC will aggregate, make freely available, and harmonize for further analyses, raw datasets, relevant associated clinical data (e.g., clinical diagnosis, treatment history, and outcomes), and sample preparation and handling protocols to accelerate the development of blood profiling assays...
February 10, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28157539/the-undiagnosed-diseases-network-accelerating-discovery-about-health-and-disease
#9
Rachel B Ramoni, John J Mulvihill, David R Adams, Patrick Allard, Euan A Ashley, Jonathan A Bernstein, William A Gahl, Rizwan Hamid, Joseph Loscalzo, Alexa T McCray, Vandana Shashi, Cynthia J Tifft, Anastasia L Wise
Diagnosis at the edges of our knowledge calls upon clinicians to be data driven, cross-disciplinary, and collaborative in unprecedented ways. Exact disease recognition, an element of the concept of precision in medicine, requires new infrastructure that spans geography, institutional boundaries, and the divide between clinical care and research. The National Institutes of Health (NIH) Common Fund supports the Undiagnosed Diseases Network (UDN) as an exemplar of this model of precise diagnosis. Its goals are to forge a strategy to accelerate the diagnosis of rare or previously unrecognized diseases, to improve recommendations for clinical management, and to advance research, especially into disease mechanisms...
February 2, 2017: American Journal of Human Genetics
https://www.readbyqxmd.com/read/28110382/economic-evaluations-alongside-efficient-study-designs-using-large-observational-datasets-the-pleasant-trial-case-study
#10
Matthew Franklin, Sarah Davis, Michelle Horspool, Wei Sun Kua, Steven Julious
BACKGROUND: Large observational datasets such as Clinical Practice Research Datalink (CPRD) provide opportunities to conduct clinical studies and economic evaluations with efficient designs. OBJECTIVES: Our objectives were to report the economic evaluation methodology for a cluster randomised controlled trial (RCT) of a UK NHS-delivered public health intervention for children with asthma that was evaluated using CPRD and describe the impact of this methodology on results...
May 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28106936/whole-brain-vessel-wall-mri-a-parameter-tune-up-solution-to-improve-the-scan-efficiency-of-three-dimensional-variable-flip-angle-turbo-spin-echo
#11
Qi Yang, Zixin Deng, Xiaoming Bi, Shlee S Song, Konrad H Schlick, Nestor R Gonzalez, Debiao Li, Zhaoyang Fan
PURPOSE: To propose and evaluate a parameter tune-up solution to expedite a three-dimensional (3D) variable-flip-angle turbo spin-echo (TSE) sequence for whole-brain intracranial vessel wall (IVW) imaging. MATERIALS AND METHODS: Elliptical k-space sampling and prolonged echo train length (ETL), were used to expedite a 3D variable-flip-angle TSE-based sequence. To compensate for the potential loss in vessel wall signal, optimal combination of prescribed T2 and ETL was experimentally investigated on 22 healthy volunteers at 3 Tesla...
January 20, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28087265/myocardial-relaxation-is-accelerated-by-fast-stretch-not-reduced-afterload
#12
Charles S Chung, Charles W Hoopes, Kenneth S Campbell
Fast relaxation of cross-bridge generated force in the myocardium facilitates efficient diastolic function. Recently published research studying mechanisms that modulate the relaxation rate has focused on molecular factors. Mechanical factors have received less attention since the 1980s when seminal work established the theory that reducing afterload accelerates the relaxation rate. Clinical trials using afterload reducing drugs, partially based on this theory, have thus far failed to improve outcomes for patients with diastolic dysfunction...
February 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/28062616/early-rule-out-and-rule-in-strategies-for-myocardial-infarction
#13
REVIEW
Louise A Cullen, Nicholas L Mills, Simon Mahler, Richard Body
BACKGROUND: Patients with chest pain comprise a large proportion of emergency presentations and place a major burden on healthcare resources. Therefore, efforts to safely and rapidly identify those with and without acute myocardial infarction (AMI) are needed. The challenge for clinicians is to accurately identify patients with acute coronary syndromes, while balancing the need to safely and rapidly reassure and discharge those without serious conditions. CONTENT: This review summarizes the evidence to date on optimum accelerated strategies for the rule-in and rule-out of AMI, using strategies focused on optimum use of troponin results...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28043600/benefits-and-challenges-of-molecular-diagnostics-for-childhood-tuberculosis
#14
Cristina Gutierrez
Expanding tuberculosis (TB)-diagnostic services, including access to rapid tests, is a World Health Organization (WHO) strategy to accelerate progress toward ending TB. Faster and more sensitive molecular tests capable of diagnosing TB and drug-resistant TB have the technical capacity to address limitations associated with smears and cultures by increasing accuracy and shortening turnaround times as compared with those of these conventional laboratory methods. Nucleic acid amplification assays used to detect and analyze Mycobacterium tuberculosis (MTB)-complex nucleic acids can be used directly on specimens from patients suspected of having TB...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/27931558/time-to-shift-from-contemporary-to-high-sensitivity-cardiac-troponin-in-diagnosis-of-acute-coronary-syndromes
#15
REVIEW
Jamshed J Dalal, C K Ponde, Brian Pinto, C N Srinivas, Joy Thomas, Sunil Kumar Modi, Sanjay Mehta, Suvin Shetty, Manimarane, Bhupen Desai
Early rule-in and rule-out of non-ST-segment elevation myocardial infarction (NSTEMI) is a challenge. In patients with inconclusive findings on ECG, cardiac biomarkers play a crucial role in the diagnosis. The introduction of the new high-sensitive cardiac troponin test (hs-TnI assay) has changed the landscape of NSTEMI diagnosis. The new hs-TnI assay can detect troponin values at a lower level compared with a contemporary cardiac troponin (cTn) assay. The hs-cTnI assay has a coefficient of variation of ≤10%, well below the 99th percentile value...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27891190/cell-free-dna-promoter-hypermethylation-in-plasma-as-a-diagnostic-marker-for-pancreatic-adenocarcinoma
#16
Stine Dam Henriksen, Poul Henning Madsen, Anders Christian Larsen, Martin Berg Johansen, Asbjørn Mohr Drewes, Inge Søkilde Pedersen, Henrik Krarup, Ole Thorlacius-Ussing
BACKGROUND: Pancreatic cancer has a 5-year survival rate of only 5-7%. Difficulties in detecting pancreatic cancer at early stages results in the high mortality and substantiates the need for additional diagnostic tools. Surgery is the only curative treatment and unfortunately only possible in localized tumours. A diagnostic biomarker for pancreatic cancer will have a major impact on patient survival by facilitating early detection and the possibility for curative treatment. DNA promoter hypermethylation is a mechanism of early carcinogenesis, which can cause inactivation of tumour suppressor genes...
2016: Clinical Epigenetics
https://www.readbyqxmd.com/read/27744578/comparing-an-accelerated-3d-fast-spin-echo-sequence-cs-space-for-knee-3-t-magnetic-resonance-imaging-with-traditional-3d-fast-spin-echo-space-and-routine-2d-sequences
#17
Faysal F Altahawi, Kevin J Blount, Nicholas P Morley, Esther Raithel, Imran M Omar
PURPOSE: To compare a faster, new, high-resolution accelerated 3D-fast-spin-echo (3D-FSE) acquisition sequence (CS-SPACE) to traditional 2D and high-resolution 3D sequences for knee 3-T magnetic resonance imaging (MRI). MATERIALS AND METHODS: Twenty patients received knee MRIs that included routine 2D (T1, PD ± FS, T2-FS; 0.5 × 0.5 × 3 mm(3); ∼10 min), traditional 3D FSE (SPACE-PD-FS; 0.5 × 0.5 × 0.5 mm(3); ∼7.5 min), and accelerated 3D-FSE prototype (CS-SPACE-PD-FS; 0...
January 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/27735933/the-real-time-quaking-induced-conversion-assay-for-detection-of-human-prion-disease-and-study-of-other-protein-misfolding-diseases
#18
Matthias Schmitz, Maria Cramm, Franc Llorens, Dominik Müller-Cramm, Steven Collins, Ryuichiro Atarashi, Katsuya Satoh, Christina D Orrù, Bradley R Groveman, Saima Zafar, Walter J Schulz-Schaeffer, Byron Caughey, Inga Zerr
The development and adaption of in vitro misfolded protein amplification systems has been a major innovation in the detection of abnormally folded prion protein scrapie (PrP(Sc)) in human brain and cerebrospinal fluid (CSF) samples. Herein, we describe a fast and efficient protein amplification technique, real-time quaking-induced conversion (RT-QuIC), for the detection of a PrP(Sc) seed in human brain and CSF. In contrast to other in vitro misfolded protein amplification assays-such as protein misfolding cyclic amplification (PMCA)-which are based on sonication, the RT-QuIC technique is based on prion seed-induced misfolding and aggregation of recombinant prion protein substrate, accelerated by alternating cycles of shaking and rest in fluorescence plate readers...
November 2016: Nature Protocols
https://www.readbyqxmd.com/read/27698176/a-randomised-controlled-study-of-standard-versus-accelerated-deflation-of-the-terumo-radial-band-haemostasis-device-after-transradial-diagnostic-cardiac-catheterisation
#19
J Han Deuling, Robert P Vermeulen, Ad Fm van den Heuvel, Remco Aj Schurer, Pim van der Harst
BACKGROUND: Radial access is the preferential access route in patients undergoing diagnostic coronary angiography. We hypothesised that we could reduce hospital stay and improve patient comfort by accelerated deflation of the radial compression device (Terumo radial band). AIMS: The aim of this study was to compare accelerated pressure reduction with a standard Terumo radial band protocol with regard to local bleeding complications and reported pain scores after cardiac catheterisation...
October 3, 2016: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/27692518/treatment-planning-strategy-for-whole-brain-radiotherapy-with-hippocampal-sparing-and-simultaneous-integrated-boost-for-multiple-brain-metastases-using-intensity-modulated-arc-therapy
#20
Damodar Pokhrel, Sumit Sood, Christopher McClinton, Xinglei Shen, Christopher Lominska, Habeeb Saleh, Rajeev Badkul, Hongyu Jiang, Melissa Mitchell, Fen Wang
PURPOSE: To retrospectively evaluate the accuracy, plan quality and efficiency of intensity-modulated arc therapy (IMAT) for hippocampal sparing whole-brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) in patients with multiple brain metastases (m-BM). MATERIALS AND METHODS: A total of 5 patients with m-BM were retrospectively replanned for HS-WBRT with SIB using IMAT treatment planning. The hippocampus was contoured on diagnostic T1-weighted magnetic resonance imaging (MRI) which had been fused with the planning CT image set...
January 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
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