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https://www.readbyqxmd.com/read/28346312/using-technology-to-enhance-discharge-teaching-and-improve-coping-for-patients-after-stroke
#1
Melissa A Schneider, Katrina A Howard
BACKGROUND: A diagnosis of stroke is a life-changing event. Effective discharge teaching after a stroke is crucial for recovery, but the overload of information can be overwhelming for patients and caregivers. PURPOSE: The purpose of this study was to examine differences in discharge readiness and postdischarge coping in patients admitted for stroke after the use of individualized postdischarge information/education provided via a technology package (including patient online portal access, e-mail/secure messaging) compared with current standard discharge teaching methods (verbal/written instructions)...
March 24, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28345547/contrast-dose-and-radiation-dose-reduction-in-abdominal-enhanced-computerized-tomography-scans-with-single-phase-dual-energy-spectral-computerized-tomography-mode-for-children-with-solid-tumors
#2
Tong Yu, Jun Gao, Zhi-Min Liu, Qi-Feng Zhang, Yong Liu, Ling Jiang, Yun Peng
BACKGROUND: Contrast dose and radiation dose reduction in computerized tomography (CT) scan for adult has been explored successfully, but there have been few studies on the application of low-concentration contrast in pediatric abdominal CT examinations. This was a feasibility study on the use of dual-energy spectral imaging and adaptive statistical iterative reconstruction (ASiR) for the reduction of radiation dose and iodine contrast dose in pediatric abdominal CT patients with solid tumors...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28345121/outcomes-of-a-randomized-controlled-trial-of-genomic-counseling-for-patients-receiving-personalized-and-actionable-complex-disease-reports
#3
Kevin Sweet, Amy C Sturm, Tara Schmidlen, Joseph McElroy, Laura Scheinfeldt, Kandamurugu Manickam, Erynn S Gordon, Shelly Hovick, J Scott Roberts, Amanda Ewart Toland, Michael Christman
There has been very limited study of patients with chronic disease receiving potentially actionable genomic based results or the utilization of genetic counselors in the online result delivery process. We conducted a randomized controlled trial on 199 patients with chronic disease each receiving eight personalized and actionable complex disease reports online. Primary study aims were to assess the impact of in-person genomic counseling on 1) causal attribution of disease risk, 2) personal awareness of disease risk, and 3) perceived risk of developing a particular disease...
March 27, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28344745/can-molecular-biomarkers-replace-a-clinical-risk-score-for-resectable-colorectal-liver-metastasis
#4
EDITORIAL
Torhild Veen, Kjetil Søreide
In resectable colorectal liver metastasis (CRLM) the role and use of molecular biomarkers is still controversial. Several biomarkers have been linked to clinical outcomes in CRLM, but none have so far become routine for clinical decision making. For several reasons, the clinical risk score appears to no longer hold the same predictive value. Some of the reasons include the ever expanding indications for liver resection, which now increasingly tend to involve extrahepatic disease, such as lung metastases (both resectable and non-resectable) and the shift in indication from "what is taken out" (e...
March 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28342265/efficacy-and-safety-of-edoxaban-for-treatment-of-portal-vein-thrombosis-following-danaparoid-sodium-in-patients-with-liver-cirrhosis
#5
Yuko Nagaoki, Hiroshi Aikata, Kana Daijo, Yuji Teraoka, Fumi Shinohara, Yuki Nakamura, Masahiro Hatooka, Kei Morio, Takashi Nakahara, Tomokazu Kawaoka, Masataka Tsuge, Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Hidenori Ochi, Kazuaki Chayama
AIM: To compare the efficacy and safety of edoxaban and warfarin for treatment of portal vein thrombosis (PVT) following danaparoid sodium in patients with liver cirrhosis. METHODS: Fifty cirrhotic patients with PVT treated initially for 2 weeks by danaparoid sodium were enrolled in this retrospective cohort study. Treatment was later switched to either edoxaban (n = 20) or warfarin (n = 30). We compared the efficacy and safety of edoxaban and warfarin for up to 6 months...
March 24, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28341691/evaluating-collaborate-in-a-clinical-setting-analysis-of-mode-effects-on-scores-response-rates-and-costs-of-data-collection
#6
Paul J Barr, Rachel C Forcino, Rachel Thompson, Elissa M Ozanne, Roger Arend, Molly Ganger Castaldo, A James O'Malley, Glyn Elwyn
BACKGROUND: Shared decision-making (SDM) has become a policy priority, yet its implementation is not routinely assessed. To address this gap we tested the delivery of CollaboRATE, a 3-item patient reported experience measure of SDM, via multiple survey modes. OBJECTIVE: To assess CollaboRATE response rates and respondent characteristics across different modes of administration, impact of mode and patient characteristics on SDM performance and cost of administration per response in a real-world primary care practice...
March 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28340229/meaningful-use-in-the-safety-net-a-rapid-ethnography-of-patient-portal-implementation-at-five-community-health-centers-in-california
#7
Sara L Ackerman, Urmimala Sarkar, Lina Tieu, Margaret A Handley, Dean Schillinger, Kenneth Hahn, Mekhala Hoskote, Gato Gourley, Courtney Lyles
Objective: US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. Materials and Methods: Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n  = 12), informal focus groups with front-line staff ( n  = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n  = 45)...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28338470/reducing-scan-angle-using-adaptive-prior-knowledge-for-a-limited-angle-intrafraction-verification-live-system-for-conformal-arc-radiotherapy
#8
Yawei Zhang, Fang-Fang Yin, You Zhang, Lei Ren
PURPOSE: To develop an adaptive prior knowledge guided image estimation technique to reduce the scan angle needed in the Limited-Angle Intrafraction Verification (LIVE) system for 4D-CBCT reconstruction. METHOD: The LIVE system has been previously developed to reconstruct 4D volumetric images on-the-fly during arc treatment for intrafraction target verification and dose calculation. In this study, we developed an adaptive constrained free-form deformation reconstruction technique in LIVE to further reduce the scanning angle needed to reconstruct the 4D-CBCT images for faster intrafraction verification...
March 24, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28338118/unusual-discovery-after-an-examination-for-abdominal-pain-abernethy-1b-malformation-and-liver-adenomatosis-a-case-report
#9
Romeo Ioan Chira, Adriana Calauz, Simona Manole, Simona Valean, Petru Adrian Mircea
Congenital extrahepatic portosystemic shunt (Abernethy malformation) is a rare condition characterized by developmental abnormalities of the portal venous system resulting in the diversion of the portal blood from the liver to the systemic venous system through a complete or partial shunt of the portomesenteric blood. We report the case of an 18 year-old female examined for abdominal pain, presenting cholestasis syndrome and an elevated serum aspartate aminotransferase level. Liver ultrasound examination revealed the absence of the portal vein with a complete extrahepatic shunt of the portal blood, multiple focal liver lesions, and multiple associated vascular anomalies...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28336480/can-a-commercially-available-epid-dosimetry-system-detect-small-daily-patient-setup-errors-for-cranial-imrt-srs
#10
Emmelyn S Hsieh, Katherine S Hansen, Michael S Kent, Sanjeev Saini, Sonja Dieterich
PURPOSE: The purpose of this study was to determine if the Sun Nuclear PerFRACTION electronic portal imager device dosimetry software would be able to detect setup errors in a clinical setting and would be able to correctly identify the direction in which the setup error was introduced. METHODS AND MATERIALS: A 7-field intensity modulated radiation therapy (IMRT) treatment plan for a centrally located tumor was developed for 1 phantom and 5 canine cadaver heads...
December 24, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28335998/point-shear-wave-elastography-to-evaluate-and-monitor-changing-portal-venous-pressure-in-patients-with-decompensated-cirrhosis
#11
Hao Han, Jian Yang, Yu-Zheng Zhuge, Ming Zhang, Min Wu
This study evaluated whether the stiffness of the liver and spleen, measured using the point shear wave elastography (pSWE) technique, correlates with portal venous pressure (PVP) and whether the result extends to estimate the diminishing change in PVP (ΔPVP) in patients with decompensated cirrhosis. We evaluated the data of 67 prospectively enrolled patients who underwent both transjugular intrahepatic portosystemic shunt (TIPS) and pSWE. The stiffness of liver and spleen were evaluated by measuring shear wave velocity (SWV) to determine the statistical correlation with PVP...
March 20, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28333016/predictors-of-liver-toxicity-following-stereotactic-body-radiation-therapy-for-hepatocellular-carcinoma
#12
Michael Velec, Carol R Haddad, Tim Craig, Lisa Wang, Patricia Lindsay, James Brierley, Anthony Brade, Jolie Ringash, Rebecca Wong, John Kim, Laura A Dawson
PURPOSE: To identify risk factors associated with a decline in liver function after stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma. METHODS AND MATERIALS: Data were analyzed from patients with hepatocellular carcinoma treated on clinical trials of 6-fraction SBRT. Liver toxicity was defined as an increase in Child-Pugh (CP) score ≥2 three months after SBRT. Clinical factors, SBRT details, and liver dose-volume histogram (DVH) parameters were tested for association with toxicity using logistic regression...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28332992/clinical-implementation-of-a-model-based-in%C3%A2-vivo-dose-verification-system-for-stereotactic-body-radiation-therapy-volumetric-modulated-arc-therapy-treatments-using-the-electronic-portal-imaging-device
#13
Peter M McCowan, Ganiyu Asuni, Eric Van Uytven, Timothy VanBeek, Boyd M C McCurdy, Shaun K Loewen, Naseer Ahmed, Bashir Bashir, James B Butler, Amitava Chowdhury, Arbind Dubey, Ahmet Leylek, Maged Nashed
PURPOSE: To report findings from an in vivo dosimetry program implemented for all stereotactic body radiation therapy patients over a 31-month period and discuss the value and challenges of utilizing in vivo electronic portal imaging device (EPID) dosimetry clinically. METHODS AND MATERIALS: From December 2013 to July 2016, 117 stereotactic body radiation therapy-volumetric modulated arc therapy patients (100 lung, 15 spine, and 2 liver) underwent 602 EPID-based in vivo dose verification events...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28332100/expression-of-programmed-death-1-and-its-ligands-in-the-liver-of-biliary-atresia
#14
Pan-Liang Wang, Jun Wang, Ying Zhou, Xiao-Song Chen, Ke-Jun Zhou, Jie Wen, Jian-Jun Zhang, Wei Cai
BACKGROUND: An aberrant immune response is the predominant pathogenetic factor in biliary atresia (BA). Programmed death-1 (PD-1) and its two ligands, programmed death ligand-1 and programmed death ligand-2 (PD-L1 and PD-L2, respectively) play an important inhibitory role in immune reactions. We aimed to illustrate the expression of these molecules in BA. METHODS: Liver specimens were obtained from infants with BA during the Kasai procedure (early BA) and liver transplantation (late BA)...
March 22, 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28331640/a-case-of-hepatic-portal-venous-gas-hypothesis-of-a-transient-direct-communication-between-a-penetrating-antral-gastric-ulcer-and-mesenteric-varices
#15
Hassan M Ghoz, Shamlan M Sheikh, Kanika Khandelwal, Joseph Fiore, Nicholas James, Joel Weinstock
Hepatic portal venous gas (HPVG) is a rare radiological sign that usually signifies an acute intra-abdominal process, most commonly bowel ischemia and sepsis. Few reports described an association with underlying gastric pathologies. We report a 60-year-old patient who presented with melena and chills and was discovered to have a gastric ulcer that appeared to have penetrated into a mesenteric varix. This, in turn, likely caused development of HPVG associated with fungemia. Treatment with a proton pump inhibitor and bowel rest was sufficient to resolve symptoms and the HPVG...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28331456/primary-care-practice-reengineering-and-associations-with-patient-portal-use-service-utilization-and-disease-control-among-patients-with-hypertension-and-or-diabetes
#16
Eboni G Price-Haywood, Qingyang Luo
BACKGROUND: We describe the role of primary care reengineering in the Ochsner Health System (OHS) patient portal implementation strategy and compare subsequent trends in service utilization and disease control among portal users vs nonusers within this context. METHODS: This retrospective cohort study includes 101,019 patients with hypertension or diabetes who saw an OHS primary care provider (PCP) between 2012 and 2014. Inverse probability treatment weighting was used to reduce case-mix differences between study groups...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331142/usefulness-of-color-coding-resected-samples-from-a-pancreaticoduodenectomy-with-tissue-marking-dyes-for-a-detailed-examination-of-surgical-margin-surrounding-the-uncinate-process-of-the-pancreas
#17
Satoshi Mizutani, Hideyuki Suzuki, Takayuki Aimoto, Seiji Yamagishi, Keisuke Mishima, Masanori Watanabe, Yasuhiko Kitayama, Norio Motoda, Saiko Isshiki, Eiji Uchida
BACKGROUND: Characteristics of a cancer-positive margin around a resected uncinate process of the pancreas (MUP) due to a pancreticoduodenectomy are difficult to understand by standardized evaluation because of its complex anatomy. The purposes of this study were to subclassify the MUP with tissue marking dyes of different colors and to identify the characteristics of sites that showed positivity for cancer cells in patients with pancreatic head carcinoma who underwent circumferential superior mesenteric arterial nerve plexus-preserving pancreaticoduodenectomy...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28328941/cynomolgus-monkeys-are-successfully-and-persistently-infected-with-hepatitis-e-virus-genotype-3-hev-3-after-long-term-immunosuppressive-therapy
#18
Noemi Rovaris Gardinali, Juliana Rodrigues Guimarães, Juliana Gil Melgaço, Yohan Britto Kevorkian, Fernanda de Oliveira Bottino, Yasmine Rangel Vieira, Aline Campos de Azevedo da Silva, Douglas Pereira Pinto, Laís Bastos da Fonseca, Leandro Schiavo Vilhena, Edilson Uiechi, Maria Cristina Carlan da Silva, Julio Moran, Renato Sérgio Marchevsky, Oswaldo Gonçalves Cruz, Rodrigo Alejandro Arellano Otonel, Amauri Alcindo Alfieri, Jaqueline Mendes de Oliveira, Ana Maria Coimbra Gaspar, Marcelo Alves Pinto
Epidemiological studies found that hepatitis E virus genotype 3 (HEV-3) infection was associated with chronic hepatitis and cirrhosis in immunocompromised patients. Our study aimed to investigate the relationship between the host immunosuppressive status and the occurrence of HEV-related chronic hepatitis. Here we describe a successful experimental study, using cynomolgus monkeys previously treated with tacrolimus, a potent calcineurin inhibitor immunosuppressant, and infected with a Brazilian HEV-3 strain isolated from naturally infected pigs...
2017: PloS One
https://www.readbyqxmd.com/read/28328234/quantification-of-basal-insulin-peglispro-and-human-insulin-in-adipose-tissue-interstitial-fluid-by-open-flow-microperfusion
#19
Katrin Tiffner, Beate Boulgaropoulos, Christian Höfferer, Thomas Birngruber, Niels Porksen, Helle Linnebjerg, Parag Garhyan, Eric Chen Quin Lam, Mary Pat Knadler, Thomas R Pieber, Frank Sinner
BACKGROUND: Restoration of the physiologic hepatic-to-peripheral insulin gradient may be achieved by either portal vein administration or altering insulin structure to increase hepatic specificity or restrict peripheral access. Basal insulin peglispro (BIL) is a novel, PEGylated basal insulin with a flat pharmacokinetic and glucodynamic profile and altered hepatic-to-peripheral action gradient. We hypothesized reduced BIL exposure in peripheral tissues explains the latter, and in this study assessed the adipose tissue interstitial fluid (ISF) concentrations of BIL compared with human insulin (HI)...
March 22, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28326356/effect-of-four-monthly-doses-of-a-human-monoclonal-anti-fgf23-antibody-krn23-on-quality-of-life-in-x-linked-hypophosphatemia
#20
Mary D Ruppe, Xiaoping Zhang, Erik A Imel, Thomas J Weber, Mark A Klausner, Takahiro Ito, Maria Vergeire, Jeffrey S Humphrey, Francis H Glorieux, Anthony A Portale, Karl Insogna, Munro Peacock, Thomas O Carpenter
X-linked hypophosphatemia (XLH) is characterized by lower extremity deformities that lead to bone and/or joint pain that result from decreased renal tubular reabsorption leading to hypophosphatemia caused by elevated levels of fibroblast growth factor 23 (FGF23). OBJECTIVE: Validate the use of SF-36v2 Health Survey (SF-36v2) and the Western Ontario and McMaster Osteoarthritis Index (WOMAC) to measure previously unstudied health-related quality of life (HRQoL) in XLH patients and determine the change in HRQoL before and after treatment with KRN23, a human monoclonal anti-FGF23 antibody...
December 2016: Bone Reports
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