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https://www.readbyqxmd.com/read/28431590/delays-in-door-to-needle-time-for-acute-ischemic-stroke-in-the-emergency-department-a-comprehensive-stroke-center-experience
#1
Ashkan Mowla, Jordan Doyle, Navdeep S Lail, Hamidreza Rajabzadeh-Oghaz, Christopher Deline, Peyman Shirani, Marilou Ching, Annemarie Crumlish, Deborah A Steck, David Janicke, Elad I Levy, Robert N Sawyer
BACKGROUND: Current American Stroke Association guidelines recommend initiating intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) within 60min of patient arrival, given the benefits of IVT for AIS are time dependent. This study aimed to identify the delaying factors in door-to-needle time (DTN) in the emergency department of one of the largest comprehensive stroke centers in New York State. We also recommended measures to reduce the delays. METHODS: We retrospectively reviewed the medical charts of all AIS patients who received IVT in our emergency department patients between April 1, 2012 and December 31, 2015 to identify those with a DTN time of >60min...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28427510/central-nervous-system-gliomas
#2
REVIEW
Michele Reni, Elena Mazza, Silvia Zanon, Gemma Gatta, Charles J Vecht
Evidence-based practical guidelines on diagnosis, prognosis, and treatment on the most frequent adult brain tumours are delineated. In Europe, 27,000 new cases of malignant glial tumours and 1000 new cases of malignant ependymal tumours are diagnosed every year. The most common glial tumours are glioblastoma multiforme and anaplastic glioma, comprising more than 50% and 10%, respectively, of the total gliomas. Prognosis of gliomas is generally poor. Environmental and genetic factors have been correlated with an increased risk of developing brain tumours...
May 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28412442/human-brain-mapping-a-systematic-comparison-of-parcellation-methods-for-the-human-cerebral-cortex
#3
REVIEW
Salim Arslan, Sofia Ira Ktena, Antonios Makropoulos, Emma C Robinson, Daniel Rueckert, Sarah Parisot
The macro-connectome elucidates the pathways through which brain regions are structurally connected or functionally coupled to perform a specific cognitive task. It embodies the notion of representing and understanding all connections within the brain as a network, while the subdivision of the brain into interacting functional units is inherent in its architecture. As a result, the definition of network nodes is one of the most critical steps in connectivity network analysis. Although brain atlases obtained from cytoarchitecture or anatomy have long been used for this task, connectivity-driven methods have arisen only recently, aiming to delineate more homogeneous and functionally coherent regions...
April 13, 2017: NeuroImage
https://www.readbyqxmd.com/read/28388376/how-much-and-what-type-of-protein-should-a-critically-ill-patient-receive
#4
Juan B Ochoa Gautier, Robert G Martindale, Saúl J Rugeles, Ryan T Hurt, Beth Taylor, Daren K Heyland, Stephen A McClave
Protein loss, manifested as loss of muscle mass, is observed universally in all critically ill patients. Depletion of muscle mass is associated with impaired function and poor outcomes. In extreme cases, protein malnutrition is manifested by respiratory failure, lack of wound healing, and immune dysfunction. Protecting muscle loss focused initially on meeting energy requirements. The assumption was that protein was being used (through oxidation) as an energy source. In healthy individuals, small amounts of glucose (approximately 400 calories) protect muscle loss and decrease amino acid oxidation (protein-sparing effect of glucose)...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28384832/obsessive-compulsive-disorder-advances-in-diagnosis-and-treatment
#5
Matthew E Hirschtritt, Michael H Bloch, Carol A Mathews
Importance: Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder associated with significant impairment and a lifetime prevalence of 1% to 3%; however, it is often missed in primary care settings and frequently undertreated. Objective: To review the most current data regarding screening, diagnosis, and treatment options for OCD. Evidence Review: We searched PubMed, EMBASE, and PsycINFO to identify randomized controlled trials (RCTs), meta-analyses, and systematic reviews that addressed screening and diagnostic and treatment approaches for OCD among adults (≥18 years), published between January 1, 2011, and September 30, 2016...
April 4, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28369295/cranial-imaging-before-lumbar-puncture-in-adults-with-community-acquired-meningitis-clinical-utility-and-adherence-to-the-infectious-diseases-society-of-america-guidelines
#6
Lucrecia Salazar, Rodrigo Hasbun
Background: The Infectious Diseases Society of America (IDSA) guidelines delineate criteria for the use of computed tomography (CT) scan of the head before lumbar puncture (LP) in adults with community-acquired meningitis (CAM). There is limited data documenting adherence to these guidelines and assessing the clinical utility of brain imaging. Methods: A retrospective analysis from January, 2005 to January, 2010 in Houston, Texas. Results: Among 614 adults with CAM, 407 patients (66...
March 21, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28364357/treatment-of-diabetic-ketoacidosis-dka-hyperglycemic-hyperosmolar-state-hhs-novel-advances-in-the-management-of-hyperglycemic-crises-uk-versus-usa
#7
REVIEW
Ketan K Dhatariya, Priyathama Vellanki
PURPOSE OF REVIEW: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies that cause high morbidity and mortality. Their treatment differs in the UK and USA. This review delineates the differences in diagnosis and treatment between the two countries. RECENT FINDINGS: Large-scale studies to determine optimal management of DKA and HHS are lacking. The diagnosis of DKA is based on disease severity in the USA, which differs from the UK...
May 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28351523/quality-assessment-of-delineation-and-dose-planning-of-early-breast-cancer-patients-included-in-the-randomized-skagen-trial-1
#8
Giulio Francolini, Mette S Thomsen, Esben S Yates, Carine Kirkove, Ingelise Jensen, Egil S Blix, Claus Kamby, Mette H Nielsen, Mechthild Krause, Martin Berg, Ingvil Mjaaland, Andreas Schreiber, Unn-Miriam Kasti, Kristian Boye, Birgitte V Offersen
BACKGROUND AND PURPOSE: To report on a Quality assessment (QA) of Skagen Trial 1, exploring hypofractionation for breast cancer patients with indication for regional nodal radiotherapy. MATERIAL AND METHODS: Deviations from protocol regarding target volume delineations and dose parameters (Dmin, Dmax, D98%, D95% and D2%) from randomly selected dose plans were assessed. Target volume delineation according to ESTRO guidelines was obtained through atlas based automated segmentation and centrally approved as gold standard (GS)...
March 25, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28340220/her2-neu-status-determination-in-breast-cancer-a-single-institutional-experience-using-a-dual-testing-approach-with-immunohistochemistry-and-fluorescence-in-situ-hybridization
#9
James P Solomon, Marie Dell'Aquila, Oluwole Fadare, Farnaz Hasteh
Objectives: According to current guidelines, either immunohistochemistry (IHC) or in situ hybridization (ISH) can be used to determine human epidermal growth factor receptor 2 (Her2/neu) status in breast carcinoma. While the guidelines explicitly delineate result interpretation, there is no consensus on the most appropriate testing algorithm. Methods: The Her2/neu statuses of 369 consecutive cases of invasive breast cancer (from 351 patients) were assessed in a dual-testing algorithm that uses both IHC and fluorescence ISH (FISH)...
April 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28333597/when-is-parenteral-nutrition-appropriate
#10
Patricia Worthington, Jane Balint, Matthew Bechtold, Angela Bingham, Lingtak-Neander Chan, Sharon Durfee, Andrea K Jevenn, Ainsley Malone, Maria Mascarenhas, Daniel T Robinson, Beverly Holcombe
Parenteral nutrition (PN) represents one of the most notable achievements of modern medicine, serving as a therapeutic modality for all age groups across the healthcare continuum. PN offers a life-sustaining option when intestinal failure prevents adequate oral or enteral nutrition. However, providing nutrients by vein is an expensive form of nutrition support, and serious adverse events can occur. In an effort to provide clinical guidance regarding PN therapy, the Board of Directors of the American Society for Parenteral and Enteral Nutrition (ASPEN) convened a task force to develop consensus recommendations regarding appropriate PN use...
March 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28328609/evaluation-of-dentoalveolar-trauma-in-children-and-adolescents-a-modified-classification-system-and-surgical-treatment-strategies-for-its-management
#11
Nadia Theologie-Lygidakis, Ourania K Schoinohoriti, Minas Leventis, Ioannis Iatrou
OBJECTIVE: To retrospectively analyze dentoalveolar trauma in pediatric patients, propose a modified classification, and delineate an approach for its urgent care from the surgeon's perspective. PATIENTS AND METHODS: Clinical records of patients, attended at the 'A. and P. Kyriakou' Children's Hospital Department of Oral and Maxillofacial Surgery from 2000 to 2015, were retrieved and data were analyzed. RESULTS: A total of 365 cases of dentoalveolar trauma, affecting 363 children and adolescents (221 males and 142 females), with an age range from 1 to 15 years, were treated in the authors' department...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28314252/clinical-target-volume-in-biliary-carcinoma-a-systematic-review-of-pathological-studies
#12
REVIEW
Ilaria Marinelli, Alessandra Guido, Lorenzo Fuccio, Andrea Farioli, Valeria Panni, Lucia Giaccherini, Alessandra Arcelli, Giorgio Ercolani, Giovanni Brandi, Silvia Cammelli, Andrea Galuppi, Gabriella Macchia, Rezarta Frakulli, Gian C Mattiucci, Francesco Cellini, Milly Buwenge, Matteo Renzulli, Francesco Deodato, Savino Cilla, Vincenzo Valentini, Vincenzo Tombolini, Rita Golfieri, Alessio G Morganti
BACKGROUND/AIM: Radiotherapy is a treatment option for both adjuvant and neo-adjuvant settings for biliary tract cancer. Guidelines on the delineation of the target volume of lymph nodes are lacking; only generic indications are available, without specific recommendations for different primary tumour locations (e.g. intrahepatic, extrahepatic biliary tract or gallbladder cancer). The aim of this study was to systematically review available literature to provide recommendations on lymph node target volume delineation in patients with unresectable biliary tumour...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28301492/variability-in-target-delineation-of-cervical-carcinoma-a-korean-radiation-oncology-group-study-krog-15-06
#13
Ji Hyeon Joo, Young Seok Kim, Byung Chul Cho, Chi Young Jeong, Won Park, Hak Jae Kim, Won Sup Yoon, Mee Sun Yoon, Ji-Yoon Kim, Jin Hwa Choi, Youngmin Choi, Joo-Young Kim
PURPOSE: To determine inter-observer variability in target volume definition of cervical cancer in radical and adjuvant radiotherapy (RT) settings. METHODS: Eight physicians contoured CTVs of 2 patients underwent definitive and postoperative RT. Each volume was analyzed using the individual/median volume ratio and generalized conformity index (CIgen). And center of mass (COM) of each contour was calculated. Expert agreement was quantified using an expectation maximization algorithm for Simultaneous Truth and Performance Level Estimation (STAPLE)...
2017: PloS One
https://www.readbyqxmd.com/read/28297436/simultaneously-integrated-boost-sib-spares-oar-and-reduces-treatment-time-in-locally-advanced-cervical-cancer
#14
Christine H Feng, Yasmin Hasan, Malgorzata Kopec, Hania A Al-Hallaq
We performed a dosimetric comparison of sequential IMRT (sIMRT) and simultaneously integrated boost (SIB) IMRT to boost PET-avid lymph nodes while concurrently treating pelvic targets to determine the potential of SIB IMRT to reduce overall treatment duration in locally advanced cervical cancer. Ten patients receiving definitive radiation therapy were identified retrospectively. RTOG consensus guidelines were followed to delineate the clinical target volume and organs at risk (OAR), which were then expanded per IMRT consortium guidelines to yield the planning target volume (PTV)...
September 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28297341/assessment-of-monte-carlo-algorithm-for-compliance-with-rtog-0915-dosimetric-criteria-in-peripheral-lung-cancer-patients-treated-with-stereotactic-body-radiotherapy
#15
Damodar Pokhrel, Sumit Sood, Rajeev Badkul, Hongyu Jiang, Christopher McClinton, Christopher Lominska, Parvesh Kumar, Fen Wang
The purpose of the study was to evaluate Monte Carlo-generated dose distributions with the X-ray Voxel Monte Carlo (XVMC) algorithm in the treatment of peripheral lung cancer patients using stereotactic body radiotherapy (SBRT) with non-protocol dose-volume normalization and to assess plan outcomes utilizing RTOG 0915 dosimetric compliance criteria. The Radiation Therapy Oncology Group (RTOG) protocols for non-small cell lung cancer (NSCLC) currently require radiation dose to be calculated using tissue density heterogeneity corrections...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28294631/abm-clinical-protocol-3-supplementary-feedings-in-the-healthy-term-breastfed-neonate-revised-2017
#16
Ann Kellams, Cadey Harrel, Stephanie Omage, Carrie Gregory, Casey Rosen-Carole
A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
March 15, 2017: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/28264483/evolutionary%C3%A2-developments%C3%A2-in%C3%A2-interpreting%C3%A2-the%C3%A2-gluten-induced%C3%A2-mucosal%C3%A2-celiac%C3%A2-lesion-%C3%A2-an%C3%A2-archimedian%C3%A2-heuristic
#17
REVIEW
Michael N Marsh, Calvin J Heal
The evolving history of the small intestinal biopsy and its interpretation-and misinterpretations-are described in this paper. Certain interpretative errors in the technical approaches to histological assessment are highlighted-even though we may never be rid of them. For example, mucosal "flattening" does not reduce individual villi to their cores, as still seems to be widely believed. Neither is the mucosa undergoing an atrophic process-since it can recover structurally. Rather, the intestinal mucosa manifests a vast hypertrophic response resulting in the formation of large plateaus formed from partially reduced villi and their amalgamation with the now increased height and width of the inter-villous ridges: this is associated with considerable increases in crypt volumes...
February 28, 2017: Nutrients
https://www.readbyqxmd.com/read/28262474/multi-institutional-randomized-trial-testing-the-utility-of-an-interactive-three-dimensional-contouring-atlas-among-radiation-oncology-residents
#18
Erin F Gillespie, Neil Panjwani, Daniel W Golden, Jillian Gunther, Tobias R Chapman, Jeffrey V Brower, Robert Kosztyla, Grant Larson, Pushpa Neppala, Vitali Moiseenko, Julie Bykowski, Parag Sanghvi, James D Murphy
PURPOSE: The delivery of safe and effective radiation therapy relies on accurate target delineation, particularly in the era of highly conformal treatment techniques. Current contouring resources are fragmented and can be cumbersome to use. The present study reports on the efficacy and usability of a web-based contouring atlas compared with those of existing contouring resources in a randomized trial. METHODS AND MATERIALS: We enrolled radiation oncology residents into a 2-phase contouring study...
December 9, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28253088/association-between-telomere-length-chronic-kidney-disease-and-renal-traits-a-systematic-review
#19
Oluwatoyin I Ameh, Ikechi G Okpechi, Collet Dandara, André-Pascal Kengne
Telomere length (TL) is an important biological variable that can influence a variety of disease-related complex traits as well as host-environment interactions such as drug and nutritional responses. Chronic kidney disease (CKD) is a common global health challenge especially with the currently aging world population. We conducted a PubMed database search according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines for systematic reviews. Studies in adults (18 years and above) in which TL was determined and correlated with CKD, renal traits, and function were included, while animal model studies were excluded...
March 2017: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/28244412/delineation-of-internal-mammary-nodal-target-volumes-in-breast-cancer-radiation-therapy
#20
Krishan R Jethwa, Mohamed M Kahila, Katie N Hunt, Lindsay C Brown, Kimberly S Corbin, Sean S Park, Elizabeth S Yan, Judy C Boughey, Robert W Mutter
PURPOSE: The optimal clinical target volume for internal mammary (IM) node irradiation is uncertain in an era of increasingly conformal volume-based treatment planning for breast cancer. We mapped the location of gross internal mammary lymph node (IMN) metastases to identify areas at highest risk of harboring occult disease. METHODS AND MATERIALS: Patients with axial imaging of IMN disease were identified from a breast cancer registry. The IMN location was transferred onto the corresponding anatomic position on representative axial computed tomography images of a patient in the treatment position and compared with consensus group guidelines of IMN target delineation...
March 15, 2017: International Journal of Radiation Oncology, Biology, Physics
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