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Patient decision aid

Elaine J Lin, Shivani Reddy, Vidhi V Shah, Jashin J Wu
The use of biologic medications has represented a great advancement in the treatment of moderate to severe plaque psoriasis and has improved patients' quality of life. Despite the increasing popularity of biologics, their neurological side effects have been a constant concern. Reports of demyelinating diseases associated with tumor necrosis factor α (TNF-α) inhibitors continue to accumulate. Additionally, efalizumab was withdrawn from the market in 2009 for causing progressive multifocal leukoencephalopathy (PML)...
January 2018: Cutis; Cutaneous Medicine for the Practitioner
Mary E Cooley, Hermine Poghosyan, Kim Sprunck-Harrild, Jonathan P Winickoff, Stephen B Edge, Karen M Emmons
Cancer survivors are a rapidly growing population and an important target for tobacco treatment interventions. Continued smoking after the diagnosis of cancer is associated with a higher risk of cancer recurrence and mortality. Systematic tobacco cessation programs are effective. This study surveyed American College of Surgeons Commission on Cancer (CoC) programs in the Northeast region of the USA regarding their tobacco control programs. Seventy percent of cancer survivors are treated within CoC programs. The purpose of this study was to describe the extent of implementation of tobacco treatment and determine the organizational delivery of tobacco treatment as measured by the presence of goals to address smoking, leadership support, and integration of tobacco treatment guidelines into care delivery...
March 8, 2018: Translational Behavioral Medicine
Takashi Kuragaichi, Yuma Kurozumi, Shogo Ohishi, Yasuo Sugano, Akihiro Sakashita, Norihiko Kotooka, Makoto Suzuki, Taiki Higo, Dai Yumino, Yasuko Takada, Seiko Maeda, Saori Yamabe, Koichi Washida, Tomonori Takahashi, Tomohito Ohtani, Yasushi Sakata, Yukihito Sato
BACKGROUND: Palliative care for heart failure (HF) patients is recommended in Western guidelines, so this study aimed to clarify the current status of palliative care for HF patients in Japan.Methods and Results:A survey was sent to all Japanese Circulation Society-authorized cardiology training hospitals (n=1,004) in August 2016. A total of 544 institutions (54%) returned the questionnaire. Of them, 527 (98%) answered that palliative care is necessary for patients with HF. A total of 227 (42%) institutions held a palliative care conference for patients with HF, and 79% of the institutions had <10 cases per year...
March 10, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Mary M Mitchell, Eric D Hansen, Tuo-Yen Tseng, Meng Shen, Cynda Rushton, Tom Smith, Nancy Hutton, Jennifer Wolfe, Lee Bone, Jeanne Keruly, Lawrence Wissow, Amy R Knowlton
CONTEXT & OBJECTIVE: Advance care planning (ACP) rates remain low, especially among people who are HIV positive, disadvantaged, and African American. While ACP can be a sensitive topic for clinicians and patients to discuss, health values clarification can be an important initial step. METHODS: Data were from the first 325 participants in the AFFIRM Care study, which enrolled adults living with HIV/AIDS in Baltimore, MD, who had histories of illicit drug use...
March 8, 2018: Journal of Pain and Symptom Management
Keamogetswe Molokoane-Mokgoro, Lara Nicole Goldstein, Mike Wells
INTRODUCTION: Ultrasound assessment of the inferior vena cava (IVC) has gained favour in aiding fluid management decisions for controlled, mechanically ventilated patients as well as in non-mechanically ventilated, spontaneously breathing patients. Its utility in spontaneously breathing patients during positive pressure non-invasive ventilation has not yet been determined. The use of the axillary vein, as an alternative option to the IVC due to its ease of accessibility and independence from intra-abdominal pressure, has also not been evaluated...
March 9, 2018: Emergency Medicine Journal: EMJ
Bart W Driesen, Evangeline G Warmerdam, Gert-Jan T Sieswerda, Paul H Schoof, Folkert J Meijboom, Felix Haas, Pieter R Stella, Adriaan O Kraaijeveld, Fabiola C M Evens, Pieter A F M Doevendans, Gregor J Krings, Arie P J van Dijk, Michiel Voskuil
OBJECTIVES: To describe the use of fractional flow reserve (FFR) and intravascular ultrasound (IVUS) in the evaluation of patients with anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS). BACKGROUND: ACAOS of the right and left coronary are rare, but may lead to symptoms and impose a risk for sudden cardiac death, depending on several anatomical features. Assessment and risk estimation is challenging in (nonathlete) adults, especially if they present without symptoms or with atypical complaints...
March 9, 2018: Catheterization and Cardiovascular Interventions
A Carmona-Bayonas, F Gordo, C Beato, J Castaño Pérez, P Jiménez-Fonseca, J Virizuela Echaburu, J Garnacho-Montero
Cancer patients are a vulnerable group exposed to numerous and serious risks beyond cancer itself. In recent years, the prognosis of these individuals has improved substantially thanks to several advances such as immunotherapy, targeted molecular therapies, surgical techniques, or developments in support treatment. This coincides with the prolonged survival of oncological patients admitted to the ICU due to critical complications, and under the supervision of intensivists. The time has therefore come to revisit the intensive care support of these patients, which poses new professional as well as organizational challenges...
March 5, 2018: Medicina Intensiva
Brooke L Griffin, Rebecca H Stone, Shareen Y El-Ibiary, Sarah Westberg, Kayce Shealy, Alicia Forinash, Abigail Yancey, Kathleen Vest, Lamis R Karaoui, Sally Rafie, Cheryl Horlen, Nicole Lodise, Nicole Cieri-Hutcherson, Sarah McBane, Anahit Simonyan
OBJECTIVE: To provide guidance for clinicians on risk assessment of medication use during pregnancy and lactation. DATA SOURCES: Authors completed PubMed searches to identify articles focused on the use of medications in pregnancy, including fetal development, drug transfer across the placenta, trimester exposure, chronic conditions in pregnancy, medications in lactation, and lactation and chronic disease. STUDY SELECTION AND DATA EXTRACTION: Articles were reviewed to provide overall guidance to medication selection during pregnancy...
March 1, 2018: Annals of Pharmacotherapy
Cecilia Davis-Hayes, David R Baker, Thomas S Bottiglieri, William N Levine, Natasha Desai, James D Gossett, James M Noble
Purpose of review: In patients with a considerable history of sports-related concussion, the decision of when to discontinue participation in sports due to medical concerns including neurologic disorders has potentially life-altering consequences, especially for young athletes, and merits a comprehensive evaluation involving nuanced discussion. Few resources exist to aid the sports medicine provider. Recent findings: In this narrative review, we describe 10 prototypical vignettes based upon the authors' collective experience in concussion management and propose an algorithm to help clinicians navigate retirement discussions...
February 2018: Neurology. Clinical Practice
Garth Funston, Helena O'Flynn, Neil A J Ryan, Willie Hamilton, Emma J Crosbie
Early diagnosis of symptomatic gynecological cancer is likely to improve patient outcomes, including survival. The primary care practitioner has a key role to play in this-they must recognize the symptoms and signs of gynecological cancer and make prompt evidence-based decisions regarding further investigation and referral. However, this is often difficult as many of the symptoms of gynecological cancers are nonspecific and are more likely to be caused by benign rather than malignant disease. As primary care is generally the first point of patient contact, those working in this setting usually encounter cancer patients at an earlier, and possibly less symptomatic, stage than practitioners in secondary care...
March 7, 2018: Advances in Therapy
Rosemarijn Jansen, Kim Urgel, Maarten J Cramer, Egidius E H L van Aarnhem, Peter P M Zwetsloot, Pieter A Doevendans, Jolanda Kluin, Steven A J Chamuleau
Background: Clinical decision-making in symptomatic patients after mitral valve (MV) repair remains challenging as echocardiographic reference values are lacking. In native MV disease intervention is recommended for mean transmitral pressure gradient (TPG) >15 mmHg or systolic pulmonary artery pressure (SPAP) >60 mmHg at peak exercise. Insight into standard stress echo parameters after MV repair may therefore aid to clinical decision-making during follow-up. Hypothesis: Stress echocardiography derived parameters in asymptomatic patients after successful MV repair differ from current guidelines for native valves...
2018: Frontiers in Surgery
Jia Liu, Dongmei Zheng, Qiang Li, Xulei Tang, Zuojie Luo, Zhongshang Yuan, Ling Gao, Jiajun Zhao
BACKGROUND: Thyroid nodules are highly prevalent, but a robust, feasible method for malignancy differentiation has not yet been well documented. This study aimed to establish a practical model for thyroid nodule discrimination. METHODS: Records for 2984 patients who underwent thyroidectomy were analyzed. Clinical, laboratory, and US variables were assessed retrospectively. Multivariate logistic regression analysis was performed and a mathematical model was established for malignancy prediction...
March 7, 2018: BMC Endocrine Disorders
Akanksha Juneja, Bharti Rana, R K Agrawal
BACKGROUND AND OBJECTIVES: Schizophrenia is a severe brain disorder primarily diagnosed through externally observed behavioural symptoms due to the dearth of established clinical tests. Functional magnetic resonance imaging (fMRI) can capture the distortions caused by schizophrenia in the brain activation. Hence, it can be useful for developing a decision model that performs computer-aided diagnosis of schizophrenia. But, fMRI data is huge in dimension. Therefore dimension reduction is indispensable...
March 2018: Computer Methods and Programs in Biomedicine
Rui Li
Patient data in clinical research often includes large amounts of structured information, such as neuroimaging data, neuropsychological test results, and demographic variables. Given the various sources of information, we can develop computerized methods that can be a great help to clinicians to discover hidden patterns in the data. The computerized methods often employ data mining and machine learning algorithms, lending themselves as the computer-aided diagnosis (CAD) tool that assists clinicians in making diagnostic decisions...
2018: Methods in Molecular Biology
Hiroshi Nagata, Soichiro Ishihara, Koji Oba, Toshiaki Tanaka, Keisuke Hata, Kazushige Kawai, Hiroaki Nozawa
BACKGROUND: Detection of peritoneal metastasis remains challenging due to the limited sensitivity of current examination methods. This study aimed to establish a prediction model for estimating the individual risk of postoperative peritoneal metastasis from colon cancer to facilitate early interventions for high-risk patients. METHODS: This study investigated 1720 patients with stages 1-3 colon cancer who underwent curative resection at the University of Tokyo Hospital between 1997 and 2015...
March 5, 2018: Annals of Surgical Oncology
Amanda F Dempsey, Jennifer Pyrznawoski, Steven Lockhart, Juliana Barnard, Elizabeth J Campagna, Kathleen Garrett, Allison Fisher, L Miriam Dickinson, Sean T O'Leary
Importance: The incidence of human papillomavirus (HPV)-related cancers is more than 35 000 cases in the United States each year. Effective HPV vaccines have been available in the United States for several years but are underused among adolescents, the target population for vaccination. Interventions to increase uptake are needed. Objective: To evaluate the effect of a 5-component health care professional HPV vaccine communication intervention on adolescent HPV vaccination...
March 5, 2018: JAMA Pediatrics
Matthew L Zerden, Tara Castellano, Kemi M Doll, Gretchen S Stuart, M Cris Munoz, Kim A Boggess
OBJECTIVES: In women receiving sterilization, the removal of the entire fallopian tube, a procedure referred to as a risk-reducing salpingectomy (RRS), reduces subsequent ovarian cancer risk compared with standard tubal sterilization procedures. There are limited data on which surgical procedure women will choose when educated about the benefits of an RRS. Our objective was to study the proportion of women desiring sterilization that would choose an RRS. METHODS: This cohort study included women 30 years of age and older with a living biological child who requested laparoscopic sterilization at a tertiary academic hospital...
March 2018: Southern Medical Journal
Rajesh Nair
No abstract text is available yet for this article.
March 2018: Southern Medical Journal
Muhammad Waqas Khan, Susanne Muehlschlegel
Shared decision making is a collaborative decision-making process between health care providers and patients or their surrogates, taking into account the best scientific evidence available while considering the patient's values, goals, and preferences. Decision aids are tools enabling SDM. This article discusses shared decision making in general and in the intensive care unit in particular and facilitators and barriers for the creation and implementation of International Patient Decision Aids Standards Collaboration-compliant decision aids for the intensive care unit and neuro-intensive care unit...
April 2018: Neurosurgery Clinics of North America
Mae O Gordon, Michael A Kass
PURPOSE: To utilize results from the Ocular Hypertension Study that can aid patients and clinicians to make evidence based decisions about the management of ocular hypertension DESIGN: 1636 participants with ocular hypertension were randomized to treatment with topical ocular hypotensive treatment or close observation. The goal of treatment was a 20% reduction in intraocular pressure and an intraocular pressure of < 24 mmHg. After a mean of 7.5 years, participants in the observation group also received treatment...
February 28, 2018: American Journal of Ophthalmology
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