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https://www.readbyqxmd.com/read/28911079/do-not-throw-the-baby-out-with-the-bathwater-select-a-personalized-de-escalated-lenvatinib-schedule-allows-response-in-locally-advanced-dtc-while-controlling-major-drug-related-bleeding
#1
C Resteghini, L D Locati, P Bossi, C Bergamini, M Guzzo, L Licitra
No abstract text is available yet for this article.
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28895660/epidemiology-molecular-classification-and-who-grading-of-ependymoma
#2
Jens-Martin Hübner, Marcel Kool, Stefan M Pfister, Kristian W Pajtler
Ependymoma can arise throughout all compartments of the central nervous system with prevalence for intracranial and spinal location in children and adults, respectively. The current histopathology based WHO grading system distinguishes grade I, II 'classic', and III 'anaplastic' ependymoma. However, analysis of multiple cohorts of intracranial ependymoma demonstrate a wide variance in the utility of the grade II versus grade III distinction as a prognostic marker that may additionally be confounded by the anatomic compartment...
September 8, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28885936/vancomycin-vs-vancomycin-piperacillin-tazobactam-associated-acute-kidney-injury-in-noncritically-ill-patients-at-a-tertiary-care-military-treatment-facility
#3
Caleb W Anderson, Kathy S Cazares, Michael B Lustik, Shivam M Patel, Troy M Denunzio
BACKGROUND: Broad-spectrum antibiotics are often used as initial empiric therapy in patients at risk for infections by multidrug-resistant organisms. Emerging literature and anecdotal reports within Tripler Army Medical Center indicate an increased incidence of vancomycin-associated acute kidney injury when used in combination with piperacillin-tazobactam. This is a retrospective, single-center study comparing the incidence of acute kidney injury in noncritically ill patients receiving either vancomycin or vancomycin in combination with piperacillin-tazobactam in a 206-bed tertiary care military training facility...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28884434/clinical-predictors-of-malignancy-in-patients-with-pheochromocytoma-and-paraganglioma
#4
Mashaal Dhir, Wei Li, Melissa E Hogg, David L Bartlett, Sally E Carty, Kelly L McCoy, Sue M Challinor, Linwah Yip
BACKGROUND AND PURPOSE: Factors associated with malignancy in patients with pheochromocytoma (adrenal tumors, Pheo) and paraganglioma (extra-adrenal, PGL) are not well-defined and all patients require lifelong surveillance. The primary aim of our study was to determine genetic and clinical variables associated with malignancy in patients with Pheo/PGL. METHODS: Single institution retrospective review was performed of all patients who underwent surgery (1/95-1/15) for Pheo/PGL...
September 7, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28882419/carcinoma-in-situ-of-the-breast-in-new-south-wales-australia-current-status-and-trends-over-the-last-40-year
#5
Gemma Jacklyn, Stephen Morrell, Kevin McGeechan, Nehmat Houssami, Les Irwig, Nirmala Pathmanathan, Alexandra Barratt
BACKGROUND: The incidence of non-invasive breast cancer has increased substantially over time. We aim to describe temporal trends in the incidence of carcinoma in situ of the breast in New South Wales (NSW), Australia. METHODS: Descriptive study of trends in the incidence of ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS) in women who received a diagnosis from 1972 to 2012, recorded in the NSW Cancer Registry. RESULTS: Carcinoma in situ as a proportion of all breast cancer was 0...
September 4, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28866263/use-of-multiplex-pcr-based-molecular-diagnostics-in-diagnosis-of-suspected-cns-infections-in-tertiary-care-setting-a-retrospective-study
#6
Mahendra Javali, Purushottam Acharya, Aneesh Mehta, Aju Abraham John, Rohan Mahale, R Srinivasa
OBJECTIVES: CNS infections like meningitis and encephalitis pose enormous healthcare challenges due to mortality, sequelae and socioeconomic burden. In tertiary setting, clinical, microbiological, cytological and radiological investigations are not distinctive enough for diagnosing microbial etiology. Molecular diagnostics is filling this gap. We evaluated the clinical impact of a commercially available multiplex molecular diagnostic system - SES for diagnosing suspected CNS infections...
August 30, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28861382/minimalist-breast-conserving-surgical-approaches-for-inferiorly-sited-cancers
#7
Mona P Tan
Contemporary data suggests that breast conservation treatment (BCT) may confer a survival advantage when compared to mastectomy. Hence, it would be logical to adopt strategies which increase eligibility of successful BCT without compromising oncologic principles or cosmetic outcome. With respect to achieving good aesthetics, inferiorly sited breast cancers pose a particular technical challenge. A vast array of techniques, collectively referred to as oncoplastic breast surgery (OBS) have been developed to minimise post treatment distortion...
August 2017: Gland Surgery
https://www.readbyqxmd.com/read/28855078/guided-de-escalation-of-antiplatelet-treatment-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-tropical-acs-a-randomised-open-label-multicentre-trial
#8
Dirk Sibbing, Dániel Aradi, Claudius Jacobshagen, Lisa Gross, Dietmar Trenk, Tobias Geisler, Martin Orban, Martin Hadamitzky, Béla Merkely, Róbert Gábor Kiss, András Komócsi, Csaba A Dézsi, Lesca Holdt, Stephan B Felix, Radoslaw Parma, Mariusz Klopotowski, Robert H G Schwinger, Johannes Rieber, Kurt Huber, Franz-Josef Neumann, Lukasz Koltowski, Julinda Mehilli, Zenon Huczek, Steffen Massberg
BACKGROUND: Current guidelines recommend potent platelet inhibition with prasugrel or ticagrelor for 12 months after an acute coronary syndrome managed with percutaneous coronary intervention (PCI). However, the greatest anti-ischaemic benefit of potent antiplatelet drugs over the less potent clopidogrel occurs early, while most excess bleeding events arise during chronic treatment. Hence, a stage-adapted treatment with potent platelet inhibition in the acute phase and de-escalation to clopidogrel in the maintenance phase could be an alternative approach...
August 25, 2017: Lancet
https://www.readbyqxmd.com/read/28851471/a-systematic-evaluation-of-impulsive-aggressive-behavior-in-psychogeriatric-inpatients-using-the-staff-observation-aggression-scale-revision-soas-r
#9
Myrella Paschali, Daniel Kamp, Claudia Reichmann, Michaela Jaenner, Christian Lange-Asschenfeldt, Tillmann Supprian
BACKGROUND: Impulsive-aggressive behavior is a significant challenge in geriatric psychiatry and requires professional evaluation and management. METHODS: SOAS-R scales (Staff Observation Aggression Scale-Revision) completed by medical staff on three secure psychiatric wards were analyzed during a period of 12 months. Patients were subdivided into the following two diagnostic subgroups: dementia and other diagnoses. RESULTS: A total of 146 aggressive incidents involving 66 patients were reported (8...
August 30, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28841096/unmet-needs-in-the-management-of-intra-abdominal-infections
#10
Philippe Montravers, Parvine Tashk, Alexy Tran Dinh
Intra-abdominal infections remain a leading cause of death, morbidity and resource use in surgical wards and intensive care units. The growing complexity of their management has led to new paradigms and unresolved issues in anti-infective therapy described in the current review. Areas covered: We analyzed the literature, recent guidelines, and expert opinions published over the last decade. Expert commentary: Prospective randomized trials are difficult to perform and observational studies or database analyses should be encouraged...
September 1, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28840933/implementing-a-workplace-violence-simulation-for-undergraduate-nursing-students-a-pilot-study
#11
Angel Johann Solorzano Martinez
Workplace violence (WPV) is an undesired phenomenon affecting nurses and nursing students. Nursing simulations allow students to learn and practice skills in a controlled setting. The development of the pilot study, "Mental Health Nursing Simulation on Workplace Violence," is presented. A simulated scenario using a standardized patient (SP) behaving as an agitated psychiatric patient was developed for undergraduate nursing students enrolled in a psychiatric nursing course. The simulation aimed to enhance students' knowledge about WPV, increase their confidence and ability to recognize signs of aggression, practice evidence-based interventions to de-escalate agitated patients, and evaluate the simulation...
August 24, 2017: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/28838799/the-potential-contribution-of-16s-ribosomal-rna-pcr-to-antimicrobial-stewardship-in-culture-negative-infection
#12
S O'Donnell, L Gaughan, M Skally, Z Baker, K O'Connell, E Smyth, F Fitzpatrick, H Humphreys
Empiric broad-spectrum antimicrobial therapy often results in culture-negative specimens making rationalisation of therapy difficult. We retrospectively reviewed 16S rRNA PCR results from 78 specimens in 60 patients. 16S rRNA was detected in 28 (47%) of patients with de-escalation of therapy in five (21%). Microbial DNA was not detected in 32 (53%) patients with antimicrobials discontinued in two (8%). Neurosurgical patients had a higher proportion of positive results (53% vs 34%) and treatment rationalisations (17% vs 12%)...
August 21, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28838210/de-escalating-and-escalating-treatments-for-early-stage-breast-cancer-the-st-gallen-international-expert-consensus-conference-on-the-primary-therapy-of-early-breast-cancer-2017
#13
G Curigliano, H J Burstein, E P Winer, M Gnant, P Dubsky, S Loibl, M Colleoni, M M Regan, M Piccart-Gebhart, H-J Senn, B Thürlimann, F André, J Baselga, J Bergh, H Bonnefoi, S Y Brucker, F Cardoso, L Carey, E Ciruelos, J Cuzick, C Denkert, A Di Leo, B Ejlertsen, P Francis, V Galimberti, J Garber, B Gulluoglu, P Goodwin, N Harbeck, D F Hayes, C-S Huang, J Huober, K Hussein, J Jassem, Z Jiang, P Karlsson, M Morrow, R Orecchia, K C Osborne, O Pagani, A H Partridge, K Pritchard, J Ro, E J T Rutgers, F Sedlmayer, V Semiglazov, Z Shao, I Smith, M Toi, A Tutt, G Viale, T Watanabe, T J Whelan, B Xu
The 15th St. Gallen International Breast Cancer Conference 2017 in Vienna, Austria reviewed substantial new evidence on loco-regional and systemic therapies for early breast cancer. Treatments were assessed in light of their intensity, duration and side-effects, seeking where appropriate to escalate or de-escalate therapies based on likely benefits as predicted by tumor stage and tumor biology. The Panel favored several interventions that may reduce surgical morbidity, including acceptance of 2 mm margins for DCIS, the resection of residual cancer (but not baseline extent of cancer) in women undergoing neoadjuvant therapy, acceptance of sentinel node biopsy following neoadjuvant treatment of many patients, and the preference for neoadjuvant therapy in HER2 positive and triple-negative, stage II and III breast cancer...
August 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28828746/clinical-safety-of-renaming-encapsulated-follicular-variant-of-papillary-thyroid-carcinoma-is-niftp-truly-benign
#14
David N Parente, Wouter P Kluijfhout, Pim J Bongers, Raoul Verzijl, Karen M Devon, Lorne E Rotstein, David P Goldstein, Sylvia L Asa, Ozgur Mete, Jesse D Pasternak
BACKGROUND: Renaming encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) to noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was recently suggested to prevent the overtreatment, cost and stigma associated with this low-risk entity. The purpose of this study is to document the incidence and further assess the clinical outcomes of reclassifying EFVPTC to NIFTP. METHODS: We searched synoptic pathologic reports from a high-volume academic endocrine surgery hospital from 2004 to 2013...
August 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28822393/identifying-futile-interfacility-surgical-transfers
#15
Kristy Kummerow Broman, Sharon E Phillips, Jesse M Ehrenfeld, Mayur B Patel, Oscar M Guillamondegui, Kenneth W Sharp, Richard A Pierce, Benjamin K Poulose, Michael D Holzman
Surgeons perceive that some surgical transfers are futile, but the incidence and risk factors of futile transfer are not quantified. Identifying futile interfacility transfers could save cost and undue burdens to patients and families. We sought to describe the incidence and factors associated with futile transfers. We conducted a retrospective cohort study from 2009 to 2013 including patients transferred to a tertiary referral center for general or vascular surgical care. Futile transfers were defined as resulting in death or hospice discharge within 72 hours of transfer without operative, endoscopic, or radiologic intervention...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28810278/-infections-in-patients-with-home-ventilation
#16
Christian Giesa, Fabian Wolter, Santiago Ewig
In patients with home ventilation, there is a markedly higher probability for lower respiratory infections or pneumonia and severe courses due to comorbidity. Tracheobronchitis and pneumonia are often difficult to distinguish. Tracheobronchitis with pronounced secretion which can't be controlled otherwise can be an indication for antimicrobial therapy.There are no data available in order to establish a recommendation for the initial empiric calculated antimicrobial therapy in patients with home ventilation...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28802774/a-rule-based-dose-finding-design-for-use-in-stroke-rehabilitation-research-methodological-development
#17
E Colucci, A Clark, C E Lang, V M Pomeroy
BACKGROUND: Dose-optimisation studies as precursors to clinical trials are rare in stroke rehabilitation. OBJECTIVE: To develop a rule-based, dose-finding design for stroke rehabilitation research. DESIGN: 3+3 rule-based, dose-finding study. Dose escalation/de-escalation was undertaken according to preset rules and a mathematical sequence (modified Fibonacci sequence). The target starting daily dose was 50 repetitions for the first cohort...
January 20, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28800797/a-modern-day-fight-club-the-stabilization-and-management-of-acutely-agitated-patients-in-the-emergency-department
#18
REVIEW
Andrew New, Veronica Theresa Tucci, Juan Rios
This article is an overview of the treatment and management of acutely agitated patients as they present in the emergency department or emergency psychiatric facility. This article focuses on how a patient encounter may unfold and what issues need to be considered along the way. Verbal de-escalation is emphasized as a standard of care, including the offering of environmental changes and medications when indicated. Approved medications are reviewed as well as the proper use of restraints.
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28797822/mental-health-nurses-emotions-exposure-to-patient-aggression-attitudes-to-and-use-of-coercive-measures-cross-sectional-questionnaire-survey
#19
Rahul Jalil, Jorg W Huber, Judith Sixsmith, Geoffrey L Dickens
BACKGROUND: Mental health nurses are exposed to patient aggression, and required to manage and de-escalate aggressive incidents; coercive measures such as restraint and seclusion should only be used as a last resort. An improved understanding of links between nurses' exposure to aggression, attitudes to, and actual involvement in, coercive measures, and their emotions (anger, guilt, fear, fatigue, sadness), could inform preparation and education for prevention and management of violence...
July 31, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28794513/rheumatoid-arthritis-dmard-de-escalation-let-the-patient-guide-you
#20
Yoshiya Tanaka
No abstract text is available yet for this article.
August 10, 2017: Nature Reviews. Rheumatology
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