Read by QxMD icon Read


A Beltz, D Gösswein, S Zimmer, R H Stauber, J Hagemann, S Strieth, C Matthias, J Künzel
BACKGROUND: The TNM (tumor, nodes, metastasis) classification is updated periodically according to the literature and international recommendations. With the 8th edition, notable changes have been developed especially with regard to oropharyngeal cancer. MATERIALS AND METHODS: The modifications as well as the practicability of the classification for staging of oropharyngeal cancers are demonstrated on the basis of cases from the tumor database. RESULTS: The latest edition of the TNM classification realizes requirements to differentiate between human papilloma virus (HPV) positive and HPV-negative tumors during staging...
March 13, 2018: HNO
K Dalhoff, M Abele-Horn, S Andreas, M Deja, S Ewig, P Gastmeier, S Gatermann, H Gerlach, B Grabein, C P Heußel, G Höffken, M Kolditz, E Kramme, H Kühl, C Lange, K Mayer, I Nachtigall, M Panning, M Pletz, P-M Rath, G Rohde, S Rosseau, B Schaaf, D Schreiter, H Schütte, H Seifert, C Spies, T Welte
Nosocomial pneumonia (HAP) is a frequent complication of hospital care. Most data are available on ventilator-associated pneumonia. However, infections on general wards are increasing. A central issue are infections with multidrug resistant (MDR) pathogens which are difficult to treat in the empirical setting potentially leading to inappropriate use of antimicrobial therapy.This guideline update was compiled by an interdisciplinary group on the basis of a systematic literature review. Recommendations are made according to GRADE giving guidance for the diagnosis and treatment of HAP on the basis of quality of evidence and benefit/risk ratio...
January 2018: Pneumologie
S J Kilty, A Lasso, L Mfuna-Endam, M Y Desrosiers
INTRODUCTION: Endoscopic Polypectomy In Clinic (EPIC) is a recently described deescalated form of endoscopic sinus surgery (ESS) performed in the outpatient clinic for patients with chronic rhinosinusitis with polyps (CRSwNP). The quality of life benefit of EPIC in comparison to ESS is not known. The purpose of this study was to determine if the disease specific quality of life measured with the SNOT-22 attained with EPIC is similar to that attained with ESS for patients with CRSwNP. METHODS: A multi-institutional observational case-control study was performed to evaluate quality of life improvement in patients treated with ESS and EPIC for CRSwNP with a 3 month follow-up...
January 7, 2018: Rhinology
Marie-Emilie Dourthe, Stéphanie Bolle, Stéphane Temam, Anais Jouin, Line Claude, Yves Reguerre, Anne-Sophie Defachelles, Daniel Orbach, Brice Fresneau
In children, nasopharyngeal carcinoma (NPC) is a very rare tumor, mostly Epstein-Barr Virus related and quite always diagnosed at a locally advanced stage. With current protocols associating induction cisplatin-based chemotherapy and concomitant chemoradiotherapy, prognosis is excellent with overall survival higher than 85%. However, long-term toxicities are frequent. Improvement in radiation therapy modalities like intensity-modulated radiation therapy and new strategies with radiation dose adaptation to chemotherapy response have been introduced to reduce acute and long-term toxicities...
January 3, 2018: Journal of Pediatric Hematology/oncology
José Garnacho-Montero, Ana Díaz-Martín, Luisa Cantón-Bulnes, Paula Ramírez, Rafael Sierra, Dolores Arias-Verdú, Marina Rodríguez-Delgado, Ana Loza-Vázquez, Jesús Rodriguez-Gomez, Mónica Gordón, Ángel Estella, José Luis García-Garmendia
OBJECTIVE: The objective of this study was to evaluate the impact of the empirical therapy with fluconazole or an echinocandin on 30- and 90-day mortality in critically ill patients with candidemia. The outcome of patients in whom the empirical echinocandin was deescalated to fluconazole was also assessed. DESIGN: Retrospective, observational multicenter study. SETTING: Medical and surgical ICUs in nine Spanish hospitals. PATIENTS: Adult patients (≥ 18 yr) with an episode of Candida bloodstream infection during ICU admission from January 2011 to April 2016...
March 2018: Critical Care Medicine
Ester Orlandi, Lisa Licitra
No abstract text is available yet for this article.
February 1, 2018: JAMA Otolaryngology—Head & Neck Surgery
Vu Q Nguyen, Jessica L Mays, Marissa Lang, Yingxing Wu, Themistocles Dassopoulos, Miguel Regueiro, Alan Moss, Deborah D Proctor, Dario Sorrentino
BACKGROUND: Postoperative recurrence (POR) of Crohn's disease (CD) is common. Guidelines on POR management have recently been issued, but clinical practice may vary. AIMS: To examine the current clinical practice of POR management in the USA METHODS: A web-based survey was sent to all members of the American Gastroenterological Association and the American College of Gastroenterology. The survey consisted of multiple-choice questions with clinical scenarios to assess how participants manage POR...
November 17, 2017: Digestive Diseases and Sciences
Aaron Belknap, Daniel S Grosser, Daniel A Hale, Benjamin J Lang, Peter Colley, Raul Benavides, Neelam Dhiman
We performed a retrospective chart review of patients to determine if the Verigene Gram-negative blood culture (BC-GN) results would lead to earlier deescalation of empiric therapy for inpatients with GN bacteremia with Citrobacter spp., Enterobacter spp., Klebsiella spp., and Escherichia coli to appropriate targeted coverage. A total of 899 records were reviewed from April 2014 to February 2016 from three institutions within the Baylor Scott & White Health network. The cases were reviewed for initial antibiotic coverage, timing of Verigene results, change in antibiotic coverage, and how these changes related to the timing of Verigene results...
October 2017: Proceedings of the Baylor University Medical Center
Francesco Marras, Anna Casabianca, Federica Bozzano, Maria Libera Ascierto, Chiara Orlandi, Antonio Di Biagio, Emanuele Pontali, Chiara Dentone, Giancarlo Orofino, Laura Nicolini, Lucia Taramasso, Mauro Magnani, Francesco M Marincola, Ena Wang, Lorenzo Moretta, Andrea De Maria
The size of lentiviral DNA reservoirs reflects the effectiveness of immune responses against lentiviruses. So far, abundant information has been gathered on the control of HIV-1 replication. Understanding the innate mechanisms contributing to containment of the HIV DNA reservoir, however, are only partly clarified and are relevant to guiding interventions for reservoir containment or eradication. We studied the contribution of natural killer (NK) cell functional features in HIV patients controlling replication either spontaneously (HIV controllers [HIC]) or after progression and antiretroviral treatment (progressor patients [PP])...
December 1, 2017: Journal of Virology
Alexa R Lockwood, Nicole S Bolton, Mark D Winton, Jean T Carter
PURPOSE: Results of a study to formalize an antimicrobial stewardship program (ASP) in a small community hospital are presented. METHODS: The formalization process began with a gap analysis of the hospital's antimicrobial services, followed by the development of a fully integrated, multipharmacist ASP. The impact was studied with an institutional review board-approved study design. Retrospective pre-ASP data were pulled from March 1 to June 30, 2012 and 2013 patient records; prospective post-ASP data were collected for March 1 to June 30, 2015...
September 1, 2017: American Journal of Health-system Pharmacy: AJHP
Brian Shea, William Boyan, James Botta, Syed Ali, Yaniv Fenig, Ethan Paulin, Steven Binenbaum, Frank Borao
BACKGROUND: Bariatric surgery has become an increasingly popular method for weight loss and mitigation of co-morbidities in the obese population. Like any field, there is a desire to standardize and accelerate the postoperative period while maintaining safe outcomes. METHODS: All laparoscopic sleeve gastrectomies (LSG) and gastric bypasses (LGB) were performed over a 5-year period were logged along with several aspects of postoperative care. Trends were followed in aspects of postoperative care over years as well as any documentation of complications or re-admissions...
October 2017: Obesity Surgery
Mira A King
In this essay, the author proposes a new, integrated model for mental healthcare delivery called the PII solution, which builds on the successes of federal government programs and state initiatives. The PII solution includes prevention, intervention, and integration. As a community-centered approach, PII leverages existing programs in concert with new approaches to meet the diverse needs of patients with the spectrum of mental health disorders, from low risk to high risk. The PII solution can be applied to any subgroup in society to create a comprehensive plan to combat mental illness...
July 2017: Journal of Healthcare Management / American College of Healthcare Executives
Lynden Roberts, Kathleen Tymms, Julien de Jager, Geoffrey Littlejohn, Hedley Griffiths, Dave Nicholls, Paul Bird, Jennifer Young, Julie Hill, Jane Zochling
OBJECTIVES: To observe the choices of conventional disease modifying antirheumatic drugs (cDMARDs) and biologic DMARDs (bDMARDs) in the management of rheumatoid arthritis (RA) in Australian routine clinical practice, to assess treatment survival and determine the effect of cDMARDs/bDMARDs on disease activity. METHODS: Routinely collected, deidentified clinical data was sourced from 20 Australian rheumatology practices. RA patients aged ≥18 years, who had received cDMARDs/bDMARDs and a recorded subsequent visit, were included...
2017: International Journal of Rheumatology
Michael Gnant, Nadia Harbeck, Christoph Thomssen
For the second time, the St. Gallen Consensus Conference on early breast cancer treatment standards took place in Vienna, Austria, where it will remain for the foreseeable future (next date: March 20-23, 2019). With the probably most prominent line-up of global breast cancer experts and more than 3,000 participants from over 100 countries, the 2017 St. Gallen/Vienna conference again was a huge success. A generation change took place with respect to the Conference Co-Chairpersons. Traditionally, the experts from all continents reviewed publications from the past 2 years, and discussed whether new diagnostic or therapeutic means were ready for routine everyday practice...
May 2017: Breast Care
Cdr Jennifer M Zicko, Lcdr Rebecca A Schroeder, Cdr William S Byers, Lt Adam M Taylor, Cdr Dennis L Spence
BACKGROUND: Staff members working on our nonmental health (non-MH) units (i.e., medical-surgical [MS] units) were not educated in recognizing or deescalating behavioral emergencies. Published evidence suggests a behavioral emergency response team (BERT) composed of MH experts who assist with deescalating behavioral emergencies may be beneficial in these situations. Therefore, we sought to implement a BERT on the inpatient non-MH units at our military treatment facility. AIMS: The objectives of this evidence-based practice process improvement project were to determine how implementation of a BERT affects staff and patient safety and to examine nursing staffs' level of knowledge, confidence, and support in caring for psychiatric patients and patients exhibiting behavioral emergencies...
October 2017: Worldviews on Evidence-based Nursing
Pierre Annede, Sébastien Gouy, Renaud Mazeron, Enrica Bentivegna, Pierre Maroun, Claire Petit, Isabelle Dumas, Alexandra Leary, Catherine Genestie, Catherine Lhommé, Eric Deutsch, Philippe Morice, Patricia Pautier, Christine Haie-Meder, Cyrus Chargari
PURPOSE: The phase III European Organization for Research and Treatment of Cancer 55874 study has shown that external beam radiotherapy (EBRT) given as adjuvant treatment decreased locoregional recurrences from 40% to 20% in patients (pts) with localized uterine sarcomas (US). No data exist, however, on the place of brachytherapy (BT). MATERIAL AND METHODS: We conducted a single-center retrospective analysis of pts receiving adjuvant BT of the vaginal vault based on the vaginal mold technique as part of their multimodal adjuvant treatment for a high-grade US from 1985 to 2015...
February 2017: Oncologist
Eric M Mortensen
No abstract text is available yet for this article.
February 2017: Annals of the American Thoracic Society
Edward Hickey, Eric Pham-Hung, Yaroslavna Nosikova, Fredrik Halvorsen, Michael Gritti, Steven Schwartz, Christopher A Caldarone, Glen Van Arsdell
BACKGROUND: We introduced the National Aeronautics and Space Association threat-and-error model to our surgical unit. All admissions are considered flights, which should pass through stepwise deescalations in risk during surgical recovery. We hypothesized that errors significantly influence risk deescalation and contribute to poor outcomes. METHODS: Patient flights (524) were tracked in real time for threats, errors, and unintended states by full-time performance personnel...
April 2017: Annals of Thoracic Surgery
S Andrew Skillington, Dorina Kallogjeri, James S Lewis, Jay F Piccirillo
Importance: Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) has a favorable prognosis, and p16 immunohistochemistry is a surrogate marker of high-risk HPV infection and strong prognosticator. Given this favorable prognosis, treatment de-escalation for p16-positive OPSCC is now being considered with the goal of decreasing treatment-associated morbidity without compromising tumor control. The role of adjuvant chemotherapy in this setting is becoming increasingly unclear...
March 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
I El-Battrawy, U Ansari, M Behnes, W Kirschstein, S Britsch, C Jabbour, C Fastner, V Bill, M Borggrefe, I Akin
We report on the case of a 49-year-old man who presented with increasing dyspnea and a skin rash. The community-acquired pneumonia was initially treated with broad spectrum antibiotics. The patient's respiratory condition rapidly worsened and the clinical picture of Waterhouse-Friderichsen syndrome developed with disseminated intravasal coagulopathy and necrosis of the toes. An infection with Capnocytophaga canimorsus, which had been caused by an initially unmentioned dog bite was confirmed. In view of the fulminant course and the high risk of operative treatment of the ubiquitous necroses in all limbs, a joint decision for deescalation of therapy was made together with relatives...
March 2017: Der Internist
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"