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https://www.readbyqxmd.com/read/29161400/the-evolution-of-robotic-surgery-surgical-and-anaesthetic-aspects
#1
H Ashrafian, O Clancy, V Grover, A Darzi
Robotic surgery pushes the frontiers of innovation in healthcare technology towards improved clinical outcomes. We discuss the evolution to five generations of robotic surgical platforms including stereotactic, endoscopic, bioinspired, microbots on the millimetre scale, and the future development of autonomous systems. We examine the challenges, obstacles and limitations of robotic surgery and its future potential including integrated real-time anatomical and immune-histological imaging and data assimilation with improved visualisation, haptic feedback and robot-surgeon interactivity...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161377/transmission-and-persistence-of-incf-conjugative-plasmids-in-the-gut-microbiota-of-full-term-infants
#2
Anuradha Ravi, Lorena Valdés-Varela, Miguel Gueimonde, Knut Rudi
Conjugative plasmids represent major reservoirs for horizontal transmission of antibiotic resistance (AR) and virulence genes. Our knowledge about the ecology and persistence of these plasmids in the gut microbiota remains limited. The IncF plasmids are the most widespread in clinical samples and in healthy humans. Therefore, the main aim is to study their ecology and association with the developing gut microbiota. Using a longitudinal (2, 10, 30 and 90 days) cohort of full-term infants, we investigated the transmission and persistence of IncFIA and IncFIB plasmids...
November 17, 2017: FEMS Microbiology Ecology
https://www.readbyqxmd.com/read/29161375/health-system-factors-affecting-implementation-of-integrated-management-of-childhood-illness-imci-qualitative-insights-from-a-south-african-province
#3
Himani Pandya, Wiedaad Slemming, Haroon Saloojee
The Integrated Management of Childhood Illness (IMCI) strategy has been adopted by 102 countries including South Africa, as the preferred primary health care (PHC) delivery strategy for sick children under 5 years. Despite substantial investment to support IMCI in South Africa, its delivery remains sub-optimal, with varied implementation in different settings. There is scarce research globally, and in the local context, examining the effects of health system characteristics on IMCI implementation. This study explored key determinants of IMCI delivery in a South African province, with a specific focus on health system building blocks using a health system dynamics framework...
November 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29160958/prognostic-value-of-an-immunohistochemical-signature-in-patients-with-esophageal-squamous-cell-carcinoma-undergoing-radical-esophagectomy
#4
Jin Meng, Junhua Zhang, Yingjie Xiu, Yan Jin, Jiaqing Xiang, Yongzhan Nie, Shen Fu, Kuaile Zhao
Here, we aimed to identify an immunohistochemical (IHC)-based classifier as a prognostic factor in patients with esophageal squamous cell carcinoma (ESCC). A cohort of 235 patients with ESCC undergoing radical esophagectomy (with complete clinical and pathological information) were enrolled in the study. Using the least absolute shrinkage and selection operator (LASSO) regression model, we extracted six IHC features associated with progression-free survival (PFS) and then built a classifier in the discovery cohort (n=141)...
November 21, 2017: Molecular Oncology
https://www.readbyqxmd.com/read/29160558/simpson-s-paradox-in-the-integrated-discrimination-improvement
#5
J Chipman, D Braun
The integrated discrimination improvement (IDI) is commonly used to compare two risk prediction models; it summarizes the extent a new model increases risk in events and decreases risk in non-events. The IDI averages risks across events and non-events and is therefore susceptible to Simpson's paradox. In some settings, adding a predictive covariate to a well calibrated model results in an overall negative (positive) IDI. However, if stratified by that same covariate, the strata-specific IDIs are positive (negative)...
December 10, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/29160497/clinical-indicators-for-nursing-diagnosis-ineffective-protection-in-adolescents-with-cancer
#6
Marília Mendes Nunes, Tânia Alteniza Leandro, Marcos Venícios de Oliveira Lopes, Viviane Martins da Silva
OBJECTIVE: To investigate scientific evidence related to the term protection and clinical indicators and etiologic factors for nursing diagnosis Ineffective protection in adolescents with cancer. METHOD: Integrative literature review in the databases of Scopus, Web of Science, National Library of Medicine and National Institutes of Health (PubMed) and Cochrane; by intersection of the descriptors protection and childhood cancer, which resulted in seven articles. These were insufficient for a comprehension of the term protection and aspects related to its impairment, therefore it was necessary to include a further three reference books...
November 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29160454/pharmaceutical-care-in-brazil-s-primary-health-care
#7
Patricia Sodré Araújo, Ediná Alves Costa, Augusto Afonso Guerra, Francisco de Assis Acurcio, Ione Aquemi Guibu, Juliana Álvares, Karen Sarmento Costa, Margô Gomes de Oliveira Karnikowski, Orlando Mario Soeiro, Silvana Nair Leite
OBJECTIVE: To characterize the activities of clinical nature developed by pharmacists in basic health units and their participation in educational activities aiming at health promotion. METHODS: This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015), a cross-sectional and exploratory study, of evaluative nature, consisting of a survey of information in a representative sample of cities, stratified by the Brazilian regions that constitute domains of study, and a subsample of primary health care services...
November 13, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/29160422/identification-of-the-difference-in-the-pathogenesis-in-heart-failure-arising-from-different-etiologies-using-a-microarray-dataset
#8
Guodong Yang, Shuping Chen, Aiqun Ma, Jun Lu, Tingzhong Wang
OBJECTIVES: Clinically, patients with chronic heart failure arising from different etiologies receive the same treatment. However, the prognoses of these patients differ. The purpose of this study was to elucidate whether the pathogenesis of heart failure arising from different etiologies differs. METHODS: Heart failure-related dataset GSE1145 was obtained from the Gene Expression Omnibus database. Differentially expressed genes were identified using R. A protein-protein interaction network of the differentially expressed genes was constructed using Search Tool for the Retrieval of Interacting Genes...
October 2017: Clinics
https://www.readbyqxmd.com/read/29160388/incremental-prognostic-value-of-the-incorporation-of-clinical-data-into-coronary-anatomy-data-in-acute-coronary-syndromes-syntax-grace-score
#9
Mateus Dos Santos Viana, Fernanda Lopes, Antonio Mauricio Dos Santos Cerqueira, Jessica Gonzalez Suerdieck, André Barcelos da Silva, Ana Clara Barcelos da Silva, Thiago Menezes Barbosa de Souza, Manuela Campelo Carvalhal, Marcia Maria Noya Rabelo, Luis Claudio Lemos Correia
BACKGROUND: When performing coronary angiography in patients with acute coronary syndrome (ACS), the anatomical extent of coronary disease usually prevails in the prognostic reasoning. It has not yet been proven if clinical data should be accounted for in risk stratification together with anatomical data. OBJECTIVE: To test the hypothesis that clinical data increment the prognostic value of anatomical data in patients with ACS. METHODS: Patients admitted with objective criteria for ACS and who underwent angiography during hospitalization were included...
November 13, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29160179/the-miage-calculator-a-dna-methylation-based-mitotic-age-calculator-of-human-tissue-types
#10
Ahrim Youn, Shuang Wang
Cell division is important in human aging and cancer. To estimate the number of cell divisions (mitotic age) of a given tissue type between individuals is of great interest as that not only allows to study biological aging using a new molecular aging target but also allows the stratification of prospective cancer risk. Here we introduce the MiAge Calculator, a mitotic age calculator based on a novel statistical framework, the MiAge model. MiAge is designed to quantitatively estimate mitotic age (total number of lifetime cell divisions) of a tissue using the stochastic replication errors accumulated in the epigenetic inheritance process during cell divisions...
November 21, 2017: Epigenetics: Official Journal of the DNA Methylation Society
https://www.readbyqxmd.com/read/29160163/cancer-risk-associated-with-nuclear-atypia-in-cytologically-indeterminate-thyroid-nodules-a-systematic-review-and-meta-analysis
#11
Pablo Valderrabano, Laila Khazai, Zachary J Thompson, Susan C Sharpe, Valentina D Tarasova, Kristen J Otto, Julie E Hallanger-Johnson, J Trad Wadsworth, Bruce M Wenig, Christine H Chung, Barbara A Centeno, Bryan McIver
BACKGROUND: Indeterminate categories of thyroid cytopathology (categories B-III and B-IV of the Bethesda system) are integrated by a heterogeneous spectrum of cytological scenarios that are generally clustered for analysis and management recommendations. It has been suggested that aspirates exhibiting nuclear atypia have a higher risk of malignancy. We assess whether cytologically indeterminate thyroid nodules with nuclear atypia have a significantly higher cancer risk than those without nuclear atypia...
November 21, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29160103/integration-site-analysis-in-gene-therapy-patients-expectations-and-reality
#12
Luca Biasco
Integration site analysis is one of the major tools for addressing the safety of gene therapy clinical protocols based on the use of integrating vectors. Over the past years, the study of viral insertions in gene therapy treated patients has allowed identifying insertional mutagenesis events, evaluating the safety of new viral vector platforms and tracking the in vivo clonal dynamics of genetically engineered cell products. While gene therapy is progressively expanding its impact on a broader area of clinical applications, increasingly more accessible, faster and more reliable safety readouts are required from integration site analysis...
November 21, 2017: Human Gene Therapy
https://www.readbyqxmd.com/read/29159886/radiomics-in-lung-cancer-its-time-is-here
#13
Mannudeep Kalra, Ge Wang, Colin G Orton
Of the 8.8 million deaths from cancer in 2015, per the World Health Organization, lung cancer was the most common cause of death (1.69 million). With the introduction of low-dose CT for lung cancer screening and emergence of precision medicine for often-fatal lung cancer, there is a need for deep access to critical information, i.e. radiomics, not possible with conventional subjective interpretation of CT images. Quantitative image analyses for radiomics have been applied in lung cancers to determine their spatial complexity, genomic composition, viability or aggressiveness, and responses to targeted therapies...
November 21, 2017: Medical Physics
https://www.readbyqxmd.com/read/29159675/diffusion-weighted-imaging-demystified-the-technique-and-potential-clinical-applications-for-soft-tissue-imaging
#14
REVIEW
Shivani Ahlawat, Laura M Fayad
Diffusion-weighted imaging (DWI) is a fast, non-contrast technique that is readily available and easy to integrate into an existing imaging protocol. DWI with apparent diffusion coefficient (ADC) mapping offers a quantitative metric for soft tissue evaluation and provides information regarding the cellularity of a region of interest. There are several available methods of performing DWI, and artifacts and pitfalls must be considered when interpreting DWI studies. This review article will review the various techniques of DWI acquisition and utility of qualitative as well as quantitative methods of image interpretation, with emphasis on optimal methods for ADC measurement...
November 20, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29159464/anti-mag-associated-cerebellar-ataxia-and-response-to-rituximab
#15
Panagiotis Zis, Dasappaiah Ganesh Rao, Nigel Hoggard, Ptolemaios Georgios Sarrigiannis, Marios Hadjivassiliou
BACKGROUND: Myelin-associated glycoprotein (MAG) is a glycoprotein specific to Schwann cells. Schwann cells produce myelin for nerve cells in the peripheral nervous system. MAG also plays a role in the central nervous system (CNS) by maintaining myelin integrity and inhibiting axonal regeneration from cerebellar neurons. There is a well-established link between distal demyelinating neuropathy and anti-MAG antibodies in patients with monoclonal gammopathy of unknown significance. We describe a series of five patients with anti-MAG antibodies with evidence of cerebellar rather than just sensory ataxia and our experience of treatment with rituximab...
November 20, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29159313/fibrosis-and-atrial-fibrillation-computerized-and-optical-mapping-a-view-into-the-human-atria-at-submillimeter-resolution
#16
Brian J Hansen, Jichao Zhao, Vadim V Fedorov
Recent studies strongly suggest that the majority of atrial fibrillation (AF) patients with diagnosed or subclinical cardiac diseases have established or even pre-existing fibrotic structural remodeling, which may lead to conduction abnormalities and reentrant activity that sustain AF. As conventional treatments fail to treat AF in far too many cases, an urgent need exists to identify specific structural arrhythmogenic fibrosis patterns, which may maintain AF, in order to identify effective ablation targets for AF treatment...
June 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29159246/integrating-clinical-dermoscopy-and-reflectance-confocal-microscopy-findings-into-correctly-identifying-a-nevoid-melanoma
#17
Manu Jain, Ashfaq A Marghoob
No abstract text is available yet for this article.
November 2017: JAAD Case Reports
https://www.readbyqxmd.com/read/29159201/interactions-between-retroviruses-and-the-host-cell-genome
#18
REVIEW
Valentina Poletti, Fulvio Mavilio
Replication-defective retroviral vectors have been used for more than 25 years as a tool for efficient and stable insertion of therapeutic transgenes in human cells. Patients suffering from severe genetic diseases have been successfully treated by transplantation of autologous hematopoietic stem-progenitor cells (HSPCs) transduced with retroviral vectors, and the first of this class of therapies, Strimvelis, has recently received market authorization in Europe. Some clinical trials, however, resulted in severe adverse events caused by vector-induced proto-oncogene activation, which showed that retroviral vectors may retain a genotoxic potential associated to proviral integration in the human genome...
March 16, 2018: Molecular Therapy. Methods & Clinical Development
https://www.readbyqxmd.com/read/29159200/analyzing-the-genotoxicity-of-retroviral-vectors-in-hematopoietic-cell-gene-therapy
#19
REVIEW
Luca Biasco, Michael Rothe, Hildegard Büning, Axel Schambach
Retroviral vectors, including those derived from gammaretroviruses and lentiviruses, have found their way into the clinical arena and demonstrated remarkable efficacy for the treatment of immunodeficiencies, leukodystrophies, and globinopathies. Despite these successes, gene therapy unfortunately also has had to face severe adverse events in the form of leukemias and myelodysplastic syndromes, related to the semi-random vector integration into the host cell genome that caused deregulation of neighboring proto-oncogenes...
March 16, 2018: Molecular Therapy. Methods & Clinical Development
https://www.readbyqxmd.com/read/29159193/prep2-a-biomarker-based-algorithm-for-predicting-upper-limb-function-after-stroke
#20
Cathy M Stinear, Winston D Byblow, Suzanne J Ackerley, Marie-Claire Smith, Victor M Borges, P Alan Barber
Objective: Recovery of motor function is important for regaining independence after stroke, but difficult to predict for individual patients. Our aim was to develop an efficient, accurate, and accessible algorithm for use in clinical settings. Clinical, neurophysiological, and neuroimaging biomarkers of corticospinal integrity obtained within days of stroke were combined to predict likely upper limb motor outcomes 3 months after stroke. Methods: Data from 207 patients recruited within 3 days of stroke [103 females (50%), median age 72 (range 18-98) years] were included in a Classification and Regression Tree analysis to predict upper limb function 3 months poststroke...
November 2017: Annals of Clinical and Translational Neurology
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