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https://www.readbyqxmd.com/read/29786047/establishment-of-a-quantitative-medical-technology-evaluation-system-and-indicators-within-medical-institutions
#1
Suo-Wei Wu, Tong Chen, Qi Pan, Liang-Yu Wei, Qin Wang, Chao Li, Jing-Chen Song, Ji Luo
Background: The development and application of medical technologies reflect the medical quality and clinical capacity of a hospital. It is also an effective approach in upgrading medical service and core competitiveness among medical institutions. This study aimed to build a quantitative medical technology evaluation system through questionnaire survey within medical institutions to perform an assessment to medical technologies more objectively and accurately, and promote the management of medical quality technologies and ensure the medical safety of various operations among the hospitals...
June 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29785325/screening-for-malignant-melanoma-a-critical-assessment-in-historical-perspective
#2
Wolfgang Weyers
Screening for melanoma has been advocated for many years because early detection and excision have been regarded as the most important measure to lower mortality from that neoplasm. In the past decade, concern has been raised by epidemiologists that screening might result in excision chiefly of "inconsequential cancer," i.e., melanomas that would never have progressed into life-threatening tumors, a phenomenon referred to by the misleading term "overdiagnosis." Without any firm evidence, that speculation has been embraced worldwide, and incipient melanomas have been trivialized...
April 2018: Dermatology Practical & Conceptual
https://www.readbyqxmd.com/read/29782597/low-dose-radiation-18f-fluoride-pet-ct-in-the-assessment-of-unilateral-condylar-hyperplasia-of-the-mandible-preliminary-results-of-a-single-centre-experience
#3
G M Lima, S Diodato, E Costabile, G Cicoria, S Civollani, C Marchetti, P L Guidalotti, C Pettinato, C Nanni, S Fanti
Background: Unilateral condylar hyperplasia (UCH) of the mandible, or Hypercondylia, is a pathological condition that determines an abnormal growth of the affected condyle.Bone SPECT with Tc99m-diphosphonates is a successful tool in the diagnosis of UCH. EANM guidelines also suggest the use of 18F-NaF PET/CT, though it leads to a higher radiation exposure. Aim: As UCH patients are young, we aimed to develop a low dose 18F-Fluoride PET/CT protocol and compare it to a standard injected activity scan, to assess if the image quality remains unchanged...
2018: European journal of hybrid imaging
https://www.readbyqxmd.com/read/29781293/mindfulness-based-group-therapy-impact-on-psychiatrically-hospitalized-adolescents
#4
Deanna P Sams, Elizabeth D Handley, Linda J Alpert-Gillis
The practice of mindfulness has long been incorporated into psychotherapy. Research on the therapeutic benefits of mindfulness exists within adult populations, and emerging empirical evidence demonstrates the benefit of such practices in the treatment of adolescents in both clinical and non-clinical settings. However, there are extremely limited data on the practice of mindfulness with adolescents in a psychiatric hospital. The iMatter ( Improve Mindful ATTention, Enhance Relaxation) group is a manualized program developed to provide adolescents on a short-term psychiatric inpatient unit with an opportunity to learn and practice relaxation strategies, mindfulness exercises, and simple yoga poses...
May 1, 2018: Clinical Child Psychology and Psychiatry
https://www.readbyqxmd.com/read/29781232/predictors-of-outcomes-in-managing-breast-abscesses-a-large-retrospective-single-center-analysis
#5
Miriam David, Priyanka Handa, Maria Castaldi
We have retrospectively examined a wide range of clinical characteristics, sonographic features, microbiology, and antibiotic regimens in patients with breast abscesses to seek predictive features related to outcome. Because consensus for optimal treatment of breast abscesses has moved toward minimally invasive management using single or repeated needle aspiration (ASP) coupled with adjuvant antibiotics, we assessed whether any factors correlate with the need for repeat procedures by analyzing the number of ASPs and/or surgical incision and drainage (I&D) per abscess...
May 20, 2018: Breast Journal
https://www.readbyqxmd.com/read/29775736/surgical-consent-practice-in-the-uk-following-the-montgomery-ruling-a-national-cross-sectional-questionnaire-study
#6
Chris McKinnon, Dafydd Loughran, Roísín Finn, Madeline Coxwell-Matthewman, Deva Sanjeeva Jeyaretna, Adam P Williams
BACKGROUND: The Supreme Court case of Montgomery vs Lanarkshire Health Board in 2015 was a landmark case for consent practice in the UK which shifted focus from a traditional paternalistic model of consent towards a more patient-centered approach. Widely recognised as the most significant legal judgment on informed consent in the last 30 years, the case was predicted to have a major impact on the everyday practice of surgeons working in the UK National Health Service (NHS). Two years after the legal definition of informed consent was redefined, we carried out an audit of surgical consent practice across the UK to establish the impact of the Montgomery ruling on clinical practice...
May 15, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29775421/probability-of-heat-intolerance-standardized-interpretation-of-heat-tolerance-testing-results-versus-specialist-judgment
#7
Haggai Schermann, Erin Craig, Einat Yanovich, Itay Ketko, Gary Kalmanovich, Ran Yanovich
CONTEXT:   The heat-tolerance test (HTT) is a screening tool for secondary prevention of exertional heat illness by the Israel Defense Forces. To discern participant tolerance, recruits are exposed to intermediate environmental and exercise stresses, and their physiological responses, core temperature, and heart rate are monitored. When their physiological measures rise at a higher rate or exceed the upper levels of absolute values compared with other participants, heat intolerance (HI) is diagnosed...
April 2018: Journal of Athletic Training
https://www.readbyqxmd.com/read/29773324/comparison-of-pitch-strength-with-perceptual-and-other-acoustic-metric-outcome-measures-following-medialization-laryngoplasty
#8
Adam D Rubin, Cristina Jackson-Menaldi, Lisa M Kopf, Katherine Marks, Jean Skeffington, Mark D Skowronski, Rahul Shrivastav, Eric J Hunter
INTRODUCTION: The diagnoses of voice disorders, as well as treatment outcomes, are often tracked using visual (eg, stroboscopic images), auditory (eg, perceptual ratings), objective (eg, from acoustic or aerodynamic signals), and patient report (eg, Voice Handicap Index and Voice-Related Quality of Life) measures. However, many of these measures are known to have low to moderate sensitivity and specificity for detecting changes in vocal characteristics, including vocal quality. OBJECTIVE: The objective of this study was to compare changes in estimated pitch strength (PS) with other conventionally used acoustic measures based on the cepstral peak prominence (smoothed cepstral peak prominence, cepstral spectral index of dysphonia, and acoustic voice quality index), and clinical judgments of voice quality (GRBAS [grade, roughness, breathiness, asthenia, strain] scale) following laryngeal framework surgery...
May 14, 2018: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/29771250/-grade-evidence-to-decision-etd-frameworks-a-systematic-and-transparent-approach-to-making-well-informed-healthcare-choices-2-clinical-practice-guidelines
#9
Gian Paolo Morgano, Elena Parmelli, Laura Amato, Primiano Iannone, Marco Marchetti, Lorenzo Moja, Marina Davoli, Holger Schünemann
In the first article in this series we described the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Evidence to Decision (EtD) frameworks and their rationale for different types of decisions. In this second article, we describe the use of EtD frameworks for clinical recommendations and how it can help clinicians and patients who use those recommendations. EtD frameworks for clinical practice recommendations provide a structured and transparent approach for guideline panels. The framework helps ensure consideration of key criteria that determine whether an intervention should be recommended and that judgments are informed by the best available evidence...
May 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29767295/violation-of-expectations-about-movement-and-goal-achievement-leads-to-sense-of-agency-reduction
#10
Riccardo Villa, Emmanuele Tidoni, Giuseppina Porciello, Salvatore Maria Aglioti
The control of one's own movements and of their impact on the external world generates a feeling of control referred to as Sense of Agency (SoA). SoA is experienced when actions match predictions and is reduced by unpredicted events. The present study investigated the contribution of monitoring two fundamental components of action-movement execution and goal achievement-that have been most often explored separately in previous research. We have devised a new paradigm in which participants performed goal-directed actions while viewing an avatar's hand in a mixed-reality scenario...
May 16, 2018: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/29765569/bolton-discrepancy-in-an-iranian-population-and-its-relation-with-maxillary-lateral-incisors-size
#11
Shabnam Ajami, Hamidreza Fattahi, Mahsa Zare, Peyman Jenabi
Background: Bolton's two main ratios describing the proportional size of upper and lower teeth, could contribute to estimating the excess or deficiency of tooth size necessary to obtain an ideal occlusion. However, the mean Bolton values are not the same among different societies. Determining the prevalence of tooth size deviations from population-specific Bolton indices might help local orthodontists to have a more concise treatment plan. Objective: The study aimed to define the prevalence of clinically significant tooth size discrepancies (TSD) in an Iranian population and to evaluate the influence of lateral incisors' size on this discrepancy...
March 2018: Electronic Physician
https://www.readbyqxmd.com/read/29764698/translucency-thresholds-for-dental-materials
#12
Marianne Salas, Cristina Lucena, Luis Javier Herrera, Ana Yebra, Alvaro Della Bona, María M Pérez
OBJECTIVE: To determine the translucency acceptability and perceptibility thresholds for dental resin composites using CIEDE2000 and CIELAB color difference formulas. METHODS: A 30-observer panel performed perceptibility and acceptability judgments on 50 pairs of resin composites discs (diameter: 10mm; thickness: 1mm). Disc pair differences for the Translucency Parameter (ΔTP) were calculated using both color difference formulas (ΔTP00 ranged from 0.11 to 7.98, and ΔTPab ranged from 0...
May 12, 2018: Dental Materials: Official Publication of the Academy of Dental Materials
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#13
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29762147/managing-menopause-by-combining-evidence-with-clinical-judgment
#14
Chrisandra Shufelt, Joann Manson
In the United States, nearly 10 million women are currently in the menopause transition and 2.25 million women are 51 years of age, which is the average age of menopause. Approximately 75% of these women will experience vasomotor symptoms such as hot flashes and night sweats. Menopause hormone therapy (HT) remains the most effective treatment for menopausal symptoms, but the decision to use HT is complex and requires balancing the benefits and risks for the individual patient. The decision also requires clinical judgment and shared decision making with the patient...
May 14, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29761677/pleural-fluid-b-type-natriuretic-peptide-level-as-an-additional-indicator-for-the-fluid-s-etiology
#15
Ronen Zalts, Tomer Twizer, Ronit Leiba, Amir Karban
BACKGROUND: The identification of the etiology of a pleural effusion can be difficult. Measurement of serum B-type natriuretic peptide (BNP) levels is helpful in the diagnosis of congestive heart failure (CHF) as a cause of respiratory failure, but pleural fluid BNP measurement is still not part of the workup for pleural effusion. OBJECTIVES: To identify the correlation between pleural fluid BNP levels and clinical diagnosis. METHODS: In this cross-sectional study, data from 107 patients admitted to the department of internal medicine between November 2009 and January 2015 were obtained from medical records...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29761073/radiation-oncology-in-the-21st-century-prospective-randomized-trials-that-changed-practice%C3%A2-or-didn-t
#16
REVIEW
Kaveh Zakeri, C Norman Coleman, Bhadrasain Vikram
In a two-part article published in 2009, we discussed the limitations of conventional radiation therapy, the challenges of studying new technologies in radiation oncology, and summarized the state-of-the science for various malignancies (1, 2). Here, we summarize some of the most important prospective, randomized trials that during the intervening years have attempted to improve the tumor control and/or decrease the adverse effects of radiation therapy. For consistency, we have focused here on the null and alternate hypotheses as articulated by the investigators at the onset of each trial, since the outcome of the investigational treatment should be considered clinically significant only if the null hypothesis was rejected...
2018: Frontiers in Oncology
https://www.readbyqxmd.com/read/29760917/factors-associated-with-glycemic-status-and-ability-to-adapt-to-changing-demands-in-people-with-and-without-type-2-diabetes-mellitus-a-cross-sectional-study
#17
Bertha Cecilia Salazar-González, Esther C Gallegos-Cabriales, Alicia Rivera-Castillo, Arnulfo González-Cantú, Marco Vinicio Gómez-Meza, Jesús Zacarías Villarreal-Pérez
Objectives: Type 2 diabetes mellitus studies focus on metabolic indicators and different self-reported lifestyle or care behaviors. Self-reported instruments involve conscious process therefore responses might not reflect reality. Meanwhile implicit responses involve automatic, unconscious processes underlying social judgments and behavior. No studies have explored the combined influence of both metabolic indicators and implicit responses on lifestyle practices in type 2 diabetes mellitus patients...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29760850/predictors-of-short-term-outcomes-after-syncope-a-systematic-review-and-meta-analysis
#18
Thomas A Gibson, Robert E Weiss, Benjamin C Sun
Introduction: We performed a systematic review and meta-analysis to identify predictors of serious clinical outcomes after an acute-care evaluation for syncope. Methods: We identified studies that assessed for predictors of short-term (≤30 days) serious clinical events after an emergency department (ED) visit for syncope. We performed a MEDLINE search (January 1, 1990 - July 1, 2017) and reviewed reference lists of retrieved articles. The primary outcome was the occurrence of a serious clinical event (composite of mortality, arrhythmia, ischemic or structural heart disease, major bleed, or neurovascular event) within 30 days...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29757571/localized-chromophobe-renal-cell-carcinoma-preoperative-imaging-judgment-and-laparoscopic-simple-enucleation-for-treatment
#19
Wenbiao Ren, Bichen Xue, Jiandong Qu, Longfei Liu, Chao Li, Xiongbing Zu
OBJECTIVE: To evaluate the preoperative imaging manifestation and therapeutic effect of laparoscopic simple enucleation (SE) for localized chromophobe renal cell carcinoma (chRCC). MATERIALS AND METHODS: Clinical data of 36 patients who underwent laparoscopic SE of localized chRCC at our institute were retrospectively analyzed. All patients underwent preoperative renal protocol CT (unenhanced, arterial, venous, and delayed images). CT scan characteristics were evaluated...
April 30, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29757121/management-of-electrolyte-disorders-also-the-method-matters
#20
Joris Richard Delanghe
INTRODUCTION: For the last few decades, electrolyte determinations in plasma or serum are carried out by reliable potentiometric methods. In recent years, a marked technical evolution has taken place, where the clinical analysis of common analytes (e.g. electrolytes) is partly moving from centralised clinical core laboratories to near-patient point-of-care testing. METHODS: As the measuring principle used by point-of-care testing markedly differs from the one used in core laboratories, sodium results are not always interchangeable in critically ill patients due to the different sensitivity of the analytical methods for the electrolyte exclusion effect...
May 14, 2018: Acta Clinica Belgica
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