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https://www.readbyqxmd.com/read/29342067/there-is-no-column-a-new-classification-for-acetabular-fractures
#1
Amir Herman, Shay Tenenbaum, Vladislav Ougortsin, Nachshon Shazar
BACKGROUND: The surgical treatment of acetabular fractures relies on the understanding of fracture architecture and their classification. The Judet and Letournel classification has been the cornerstone in understanding and treating acetabular fractures. Recently, there has been growing evidence of discrepancies and incompleteness in the Judet and Letournel classification, adversely affecting its clinical use. This study describes a novel comprehensive classification system that will direct surgical approach and fixation methods...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29338550/the-role-of-tumor-angiogenesis-as-a-therapeutic-target-in-colorectal-cancer
#2
Francesca Battaglin, Alberto Puccini, Rossana Intini, Marta Schirripa, Alessandra Ferro, Francesca Bergamo, Sara Lonardi, Vittorina Zagonel, Heinz-Josef Lenz, Fotios Loupakis
Angiogenesis is a complex process regulated by several pro- and anti-angiogenic factors, thus the loss of its fine equilibrium plays a key role in colorectal cancer (CRC) development and progression. Therapeutic agents targeting VEGF/VEGFR signaling, the main regulator of this process, proved to be effective across different treatment lines in metastatic CRC (mCRC) and contributed greatly to improve patients' survival in recent years. Areas covered: This review aimed to summarize the actual body of knowledge available on the VEGF pathway in CRC, including currently available anti-angiogenic drugs and treatment challenges, mechanisms of resistance, promising predictive biomarkers and future perspectives...
January 17, 2018: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/29338090/influence-of-provider-factors-and-race-on-uptake-of-breast-cancer-gene-expression-profiling
#3
Katherine E Reeder-Hayes, Stephanie B Wheeler, Christopher D Baggett, Xi Zhou, Ke Meng, Megan C Roberts, Lisa A Carey, Anne-Marie Meyer
BACKGROUND: Gene expression profiling (GEP) has been rapidly adopted for early breast cancer and can aid in chemotherapy decision making. Study results regarding racial disparities in testing are conflicting, and may reflect different care settings. To the authors' knowledge, data regarding the influence of provider factors on testing are scarce. METHODS: The authors used a statewide, multipayer, insurance claims database linked to cancer registry records to examine the impact of race and provider characteristics on GEP uptake in a cohort of patients newly diagnosed with breast cancer between 2005 and 2012...
January 16, 2018: Cancer
https://www.readbyqxmd.com/read/29334888/dicer-an-r-package-for-class-discovery-using-an-ensemble-driven-approach
#4
Derek S Chiu, Aline Talhouk
BACKGROUND: Given a set of features, researchers are often interested in partitioning objects into homogeneous clusters. In health research, cancer research in particular, high-throughput data is collected with the aim of segmenting patients into sub-populations to aid in disease diagnosis, prognosis or response to therapy. Cluster analysis, a class of unsupervised learning techniques, is often used for class discovery. Cluster analysis suffers from some limitations, including the need to select up-front the algorithm to be used as well as the number of clusters to generate, in addition, there may exist several groupings consistent with the data, making it very difficult to validate a final solution...
January 15, 2018: BMC Bioinformatics
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#5
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29330078/intraoperative-flow-cytometry-enables-the-differentiation-of-primary-central-nervous-system-lymphoma-from-glioblastoma
#6
Shunichi Koriyama, Masayuki Nitta, Takahiro Shioyama, Takashi Komori, Takashi Maruyama, Takakazu Kawamata, Yoshihiro Muragaki
OBJECTIVE: Accurate preoperative and intraoperative differentiation between primary central nervous system lymphoma (PCNSL) and glioblastoma (GBM) is sometimes difficult. Distinguishing between these tumors during surgery is important because surgical treatment is different between the two tumors. In this study, we established a new method of intraoperative differentiation between PCNSL and GBM using intraoperative flow cytometry (iFC), and we retrospectively tested whether iFC was useful for the intraoperative diagnosis of PCNSL and GBM...
January 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29328004/thoracolumbar-injury-classification-and-severity-score-in-children-a-reliability-study
#7
Ross L Dawkins, Joseph H Miller, Omar I Ramadan, Michael C Lysek, Elizabeth N Kuhn, Brandon G Rocque, Michael J Conklin, R Shane Tubbs, Beverly C Walters, Bonita S Agee, Curtis J Rozzelle
OBJECTIVE There are many classification systems for injuries of the thoracolumbar spine. The recent Thoracolumbar Injury Classification and Severity Score (TLICS) has been shown to be a reliable tool for adult patients. The aim of this study was to assess the reliability of the TLICS system in pediatric patients. The validity of the TLICS system is assessed in a companion paper. METHODS The medical records of pediatric patients with acute, traumatic thoracolumbar fractures at a single Level 1 trauma center were retrospectively reviewed...
January 12, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29327248/introducing-new-technology-safely-into-urological-practice
#8
Siska Van Bruwaene, Benjamin Namdarian, Ben Challacombe, Ben Eddy, Ignace Billiet
PURPOSE: Surgical innovation is necessary to ensure continued improvement in patient care. However, several challenges unique to the surgical craft are encountered during the development and validation of such new technology. This article highlights some of these challenges and gives an overview of existing solutions. METHODS: A Pubmed review was performed about the "introduction of new technology" to identify challenges. Cross-referencing was used to explore the possible solutions per challenge...
January 11, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29325548/a-pre-post-study-testing-a-lung-cancer-screening-decision-aid-in-primary-care
#9
Daniel S Reuland, Laura Cubillos, Alison T Brenner, Russell P Harris, Bailey Minish, Michael P Pignone
BACKGROUND: The United States Preventive Services Task Force (USPSTF) issued recommendations for older, heavy lifetime smokers to complete annual low-dose computed tomography (LDCT) scans of the chest as screening for lung cancer. The USPSTF recommends and the Centers for Medicare and Medicaid Services require shared decision making using a decision aid for lung cancer screening with annual LDCT. Little is known about how decision aids affect screening knowledge, preferences, and behavior...
January 12, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29325162/an-analysis-of-adverse-events-in-the-rehabilitation-department-using-the-veterans-affairs-root-cause-analysis-system
#10
Gregory W Hagley, Peter D Mills, Brian Shiner, Robin R Hemphill
Background: Root cause analyses (RCA) are often completed in health care settings to determine causes of adverse events (AEs). RCAs result in action plans designed to mitigate future patient harm. National reviews of RCA reports have assessed the safety of numerous health care settings and suggested opportunities for improvement. However, few studies have assessed the safety of receiving care from physical therapists, occupational therapists, or speech and language pathology pathologists...
January 9, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29320640/syme-amputation-a-systematic-review
#11
Rudwina Braaksma, Pieter U Dijkstra, Jan H B Geertzen
BACKGROUND: In the decision-making process toward an amputation of the lower extremity, knowledge about patient-related outcomes after amputation and rehabilitation is important. We have not found a systematic review that provides this knowledge for Syme amputation. The aim of this study was to present an overview of outcomes after a Syme amputation grouped according to the International Classification of Functioning, Disability and Health (ICF) model, focusing on body structures and functions, activities, and participation...
January 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29317385/development-and-evaluation-of-a-mobile-personalized-blood-glucose-prediction-system-for-patients-with-gestational-diabetes-mellitus
#12
Evgenii Pustozerov, Polina Popova, Aleksandra Tkachuk, Yana Bolotko, Zafar Yuldashev, Elena Grineva
BACKGROUND: Personalized blood glucose (BG) prediction for diabetes patients is an important goal that is pursued by many researchers worldwide. Despite many proposals, only a few projects are dedicated to the development of complete recommender system infrastructures that incorporate BG prediction algorithms for diabetes patients. The development and implementation of such a system aided by mobile technology is of particular interest to patients with gestational diabetes mellitus (GDM), especially considering the significant importance of quickly achieving adequate BG control for these patients in a short period (ie, during pregnancy) and a typically higher acceptance rate for mobile health (mHealth) solutions for short- to midterm usage...
January 9, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29316995/prehospital-modified-heart-score-predictive-of-30-day-adverse-cardiac-events
#13
Jason P Stopyra, William S Harper, Tyson J Higgins, Julia V Prokesova, James E Winslow, Robert D Nelson, Roy L Alson, Christopher A Davis, Gregory B Russell, Chadwick D Miller, Simon A Mahler
Introduction The History, Electrocardiogram (ECG), Age, Risk Factors, and Troponin (HEART) score is a decision aid designed to risk stratify emergency department (ED) patients with acute chest pain. It has been validated for ED use, but it has yet to be evaluated in a prehospital setting. Hypothesis A prehospital modified HEART score can predict major adverse cardiac events (MACE) among undifferentiated chest pain patients transported to the ED. METHODS: A retrospective cohort study of patients with chest pain transported by two county-based Emergency Medical Service (EMS) agencies to a tertiary care center was conducted...
January 10, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29315023/sepsis-screening-current-evidence-and-available-tools
#14
Natacha Villegas, Laura J Moore
BACKGROUND: Early recognition of sepsis is challenging, especially in the surgical patient. Because of the non-specific nature of the initial signs and symptoms, delays in recognition are all too common. To improve the early identification of sepsis, screening tools have been developed, and several papers have described their results. This article reviews the available sepsis screening tools. METHODS: A PubMed search was performed using the search terms "sepsis" and "shock," "electronic alert," "clinical decision support," and "early warning systems...
January 9, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29310605/a-randomized-controlled-trial-of-a-skills-training-for-oncologists-and-a-communication-aid-for-patients-to-stimulate-shared-decision-making-about-palliative-systemic-treatment-choice-study-protocol
#15
I Henselmans, E M A Smets, J C J M de Haes, M G W Dijkgraaf, F Y de Vos, H W M van Laarhoven
BACKGROUND: Systemic treatment for advanced cancer offers uncertain and sometimes little benefit while the burden can be high. Hence, treatment decisions require Shared Decision Making (SDM). The CHOICE trial examines the separate and combined effect of oncologist training and a patient communication aid on SDM in consultations about palliative systemic treatment. METHODS: A RCT design with four parallel arms will be adopted. Patients with metastatic or irresectable cancer with a median life expectancy <12 months who meet with a medical oncologist to discuss the start or continuation of palliative systemic treatment are eligible...
January 8, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29310353/complex-pelvic-ring-injuries-associated-with-floating-knee-in-a-poly-trauma-patient-a-case-report
#16
Yuebin Zhou, Honggang Guo, Zhiwei Cai, Yuan Zhang
RATIONALE: Complex pelvic ring fracture associated with floating knee is comparatively rare which usually results from high-energy trauma including vehicle-related accidence, falls from height, and earthquake-related injury. To our knowledge, few literatures have documented such injuries in the individual patient. Management of both injuries present challenges for surgical management and postoperative care. The purpose of this study is to prove the feasibility and benefits of damage control orthopedics (DCO)...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29306457/cost-effectiveness-of-pcsk9-inhibition-in-addition-to-standard-lipid-lowering-therapy-in-patients-at-high-risk-for-vascular-disease
#17
Manon C Stam-Slob, Yolanda van der Graaf, Anthonius de Boer, Jacoba P Greving, Frank L J Visseren
BACKGROUND: As proprotein convertase subtilisin-kexin type 9 (PCSK9) monoclonal antibodies are entering the market, we assessed the cost-effectiveness of PCSK9 inhibition added to standard lipid-lowering therapy in patient groups at high risk for major adverse cardiovascular events (MACE). METHODS: A lifetime Markov Model was designed to estimate healthcare costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) for PCSK9 inhibition added to standard therapy in patients with Familial Hypercholesterolemia (FH), patients with vascular disease at high MACE recurrence risk, and patients with vascular disease with diabetes mellitus...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29306355/neurophysiology-of-the-pelvic-floor-in-clinical-practice-a-systematic-literature-review
#18
REVIEW
Fiorella Bianchi, Giovanna M Squintani, M Osio, A Morini, C Bana, G Ardolino, M Barbieri, L Bertolasi, R Caramelli, F Cogiamian, A Currà, G de Scisciolo, C Foresti, V Frasca, E Frasson, M Inghilleri, L Maderna, L Motti, E Onesti, M C Romano, U Del Carro
Neurophysiological testing of the pelvic floor is recognized as an essential tool to identify pathophysiological mechanisms of pelvic floor disorders, support clinical diagnosis, and aid in therapeutic decisions. Nevertheless, the diagnostic value of these tests in specific neurological diseases of the pelvic floor is not completely clarified. Seeking to fill this gap, the members of the Neurophysiology of the Pelvic Floor Study Group of the Italian Clinical Neurophysiology Society performed a systematic review of the literature to gather available evidence for and against the utility of neurophysiological tests...
October 2017: Functional Neurology
https://www.readbyqxmd.com/read/29304328/use-of-intraoperative-computed-tomography-in-craniomaxillofacial-trauma-surgery
#19
Karl Cuddy, Baber Khatib, R Bryan Bell, Allen Cheng, Ashish Patel, Melissa Amundson, Eric J Dierks
PURPOSE: The use of technology to aid in assessment, planning, and management of complex craniomaxillofacial injuries is increasingly common. Preoperative computed tomography (CT) evaluation is considered the standard of care, and intraoperative imaging is becoming increasingly accessible. Limited data exist regarding the implication of intraoperative CT on decision making in the management of all sites of facial fractures. The purposes of this study were to characterize the use of an intraoperative CT scanner for craniomaxillofacial surgery within our institution, to quantify the effect of intraoperative CT on surgical decision making, and to attempt to provide guidance on when to use this technology...
December 13, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29298540/healthcare-utilization-and-costs-of-children-with-attention-deficit-hyperactivity-disorder-initiating-atomoxetine-versus-extended-release-guanfacine
#20
Cliff Molife, Virginia S Haynes, Allen Nyhuis, Douglas E Faries, Steve Gelwicks, Douglas K Kelsey, Carlos I Alatorre
OBJECTIVES: To compare 1-year direct healthcare costs and utilization among children and adolescents initiating non-stimulant medications atomoxetine (ATX) or extended-release guanfacine (GXR). METHODS: In this retrospective, observational cohort study, children and adolescents ages 6-17 years with ADHD who had ≥1 prescription claim for ATX or GXR between 12/31/2009-1/1/2011 were identified in the MarketScan Commercial or Multi-State Medicaid claims databases...
January 3, 2018: Current Medical Research and Opinion
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