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https://www.readbyqxmd.com/read/28531395/nationwide-survey-of-nutritional-management-in-an-asian-upper-middle-income-developing-country-government-hospitals-combination-of-quantitative-survey-and-focus-group-discussion
#1
K Chittawatanarat, K Tosanguan, U Chaikledkaew, S Tejavanija, Y Teerawattananon
BACKGROUND & AIMS: The objective of this study was to identify the differences in pattern, process, and management of nutrition care in government hospitals in Thailand (an Asian upper-middle income developing country). METHODS: This is a combination of a quantitative nationwide questionnaire survey and focus group discussions. A total of 2300 questionnaires were sent to government hospitals across Thailand. The responders were divided by routine-nutrition screening/assessment unit vs...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28529202/an-evaluation-of-automated-chest-radiography-reading-software-for-tuberculosis-screening-among-public-and-private-sector-patients
#2
Md Toufiq Rahman, Andrew J Codlin, Md Mahfuzur Rahman, Ayenun Nahar, Mehdi Reja, Tariqul Islam, Zhi Zhen Qin, Md Abdus Shakur Khan, Sayera Banu, Jacob Creswell
Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert).Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receiver operating characteristic curve (AUC), and calculated the potential Xpert tests saved...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28515993/triage-amalgamated-dermoscopic-algorithm-tada-for-skin-cancer-screening
#3
Tova Rogers, Maria Marino, Stephen W Dusza, Shirin Bajaj, Michael A Marchetti, Ashfaq Marghoob
IMPORTANCE: Dermoscopic triage algorithms have been shown to improve beginners' abilities for identifying pigmented skin lesions requiring biopsy. OBJECTIVE: To estimate the diagnostic accuracy of the Triage Amalgamated Dermoscopic Algorithm (TADA) for pigmented and nonpigmented skin cancers. Secondarily, to compare TADAs performance to those of existing triage algorithms for the identification of pigmented skin cancers. DESIGN: Cross-sectional, observational, reader study that took place at a beginner and intermediate level dermoscopy course...
April 2017: Dermatology Practical & Conceptual
https://www.readbyqxmd.com/read/28507997/recognizing-sudden-cardiac-arrest-may-require-more-than-two-questions-during-telephone-triage-developing-a-complementary-checklist
#4
Amir Mirhaghi, Hojjat Shafaee, Javad Malekzadeh, Farzaneh Hasanzadeh
OBJECTIVE: To develop decision-support tools to identify patients experiencing sudden cardiac arrest (SCA). METHODS: Eighty calls related to SCA were content analyzed, and the contextual patterns that emerged were organized into a checklist. Two researchers independently analyzed the recorded calls and compared their findings. Eighteen dispatchers scored 20 cases (which included SCA and non-SCA cases) both with and without the checklist. Correct responses for each case and agreement among dispatchers have been reported...
April 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28506672/comparison-of-the-nosocomial-pneumonia-mortality-prediction-npmp-model-with-standard-mortality-prediction-tools
#5
M Srinivasan, N Shetty, S Gadekari, G Thunga, K Rao, V Kunhikatta
BACKGROUND: Severity or mortality prediction of nosocomial pneumonia could aid in the effective triage of patients and assisting physicians. AIM: To compare various severity assessment scoring systems for predicting intensive care unit (ICU) mortality in nosocomial pneumonia patients. METHODS: A prospective cohort study was conducted in a tertiary care university-affiliated hospital in Manipal, India. One hundred patients with nosocomial pneumonia, admitted in the ICUs who developed pneumonia after >48h of admission, were included...
April 15, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28495849/neoadjuvant-trials-in-er-breast-cancer-a%C3%A2-tool-for-acceleration-of-drug-development-and-discovery
#6
REVIEW
Angel L Guerrero-Zotano, Carlos L Arteaga
Neoadjuvant therapy trials offer an excellent strategy for drug development and discovery in breast cancer, particularly in triple-negative and HER2-overexpressing subtypes, where pathologic complete response is a good surrogate of long-term patient benefit. For estrogen receptor-positive (ER(+)) breast cancers, however, use of this strategy has been challenging because of the lack of validated surrogates of long-term efficacy and the overall good prognosis of the majority of patients with this cancer subtype...
May 11, 2017: Cancer Discovery
https://www.readbyqxmd.com/read/28495830/establishing-recommendations-for-stroke-systems-in-the-thrombectomy-era-the-upstate-new-york-stakeholder-proceedings
#7
Zainab Magdon-Ismail, Curtis Benesch, Jeremy T Cushman, Ian Brissette, Andrew M Southerland, Ethan S Brandler, Cemal B Sozener, Sue Flor, Roseanne Hemmitt, Kathleen Wales, Krystal Parrigan, Steven R Levine
BACKGROUND AND PURPOSE: The American Heart Association/American Stroke Association and Department of Health Stroke Coverdell Program convened a stakeholder meeting in upstate NY to develop recommendations to enhance stroke systems for acute large vessel occlusion. METHODS: Prehospital, hospital, and Department of Health leadership were invited (n=157). Participants provided goals/concerns and developed recommendations for prehospital triage and interfacility transport, rating each using a 3-level impact (A [high], B, and C [low]) and implementation feasibility (1 [high], 2, and 3 [low]) scale...
May 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28487333/enhanced-detection-of-edema-in-malignant-anterior-circulation-stroke-edema-score-a-risk-prediction-tool
#8
Charlene Jennifer Ong, Jeffrey Gluckstein, Osvaldo Laurido-Soto, Yan Yan, Rajat Dhar, Jin-Moo Lee
BACKGROUND AND PURPOSE: Rapid recognition of those at high risk for malignant edema after stroke would facilitate triage for monitoring and potential surgery. Admission data may be insufficient for accurate triage decisions. We developed a risk prediction score using clinical and radiographic variables within 24 hours of ictus to better predict potentially lethal malignant edema. METHODS: Patients admitted with diagnosis codes of cerebral edema and ischemic stroke, NIHSS score (National Institute of Health Stroke Score) of ≥8 and head computed tomographies within 24 hours of stroke onset were included...
May 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28485904/-triage-duration-times-a-prospective-descriptive-study-in-a-level-1%C3%A2-emergency-department
#9
Stefano Bambi, Marco Ruggeri
INTRODUCTION: Triage is the most important tool for clinical risk management in emergency departments (ED). The timing measurement of its phases is fundamental to establish indicators and standards for the optimization of the system. OBJECTIVE: To evaluate the duration time of the phases of triage; to evaluate some variables exerting influence on nurses' performance. METHOD: prospective descriptive study performed in the ED of Careggi Teaching Hospital in Florence...
January 2017: Professioni Infermieristiche
https://www.readbyqxmd.com/read/28484942/minimal-training-sufficient-to-diagnose-pediatric-wrist-fractures-with-ultrasound
#10
Henrik Hedelin, Christian Tingström, Hanna Hebelka, Jon Karlsson
BACKGROUND: In children, non-fractured wrists generally need no treatment and those that are fractured may only require a 3-week cast without any clinical follow-up. The ability to perform a point-of-care triage decision if radiographs are needed could improve patient flow and decrease unnecessary radiographs. The aim of this study was to evaluate the role of ultrasound (US) as a point-of-care triage tool for pediatric wrist injuries with limited training. METHODS: Physicians with no previous US experience attended a 1...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28465003/the-modified-rapid-emergency-medicine-score-a-novel-trauma-triage-tool-to-predict-in-hospital-mortality
#11
Ross T Miller, Niaman Nazir, Tracy McDonald, Chad M Cannon
BACKGROUND: Trauma systems currently rely on imperfect and subjective tools to prioritize responses and resources, thus there is a critical need to develop a more accurate trauma severity score. Our objective was to modify the Rapid Emergency Medicine (REMS) Score for the trauma population and test its accuracy as a predictor of in-hospital mortality when compared to other currently used scores, including the Revised Trauma Score (RTS), the Injury Severity Score (ISS), the "Mechanism, Glasgow Coma Scale, Age and Arterial Pressure" (MGAP) score, and the Shock Index (SI) score...
April 25, 2017: Injury
https://www.readbyqxmd.com/read/28457177/high-sensitivity-cardiac-troponin-assays-from-improved-analytical-performance-to-enhanced-risk-stratification
#12
Marek Kozinski, Magdalena Krintus, Jacek Kubica, Grazyna Sypniewska
Implementation of cardiac troponin (cTn) assays has revolutionized the diagnosis, risk stratification, triage and management of patients with suspected myocardial infarction (MI). The Universal Definition of MI brought about a shift in the diagnostics of MI, from an approach primarily based on electrocardiography (ECG) to one primarily based on biomarkers. Currently, detection of a rise and/or fall in concentration or activity of myocardial necrosis biomarkers, preferentially cTns, with at least one value above the 99th percentile upper reference limit (URL), is the essential component for the diagnosis of MI...
May 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28452898/accuracy-of-prehospital-triage-protocols-in-selecting-major-trauma-patients-a-systematic-review
#13
Eveline A J van Rein, Roderick M Houwert, Amy C Gunning, Rob Lichtveld, Luke P H Leenen, Mark van Heijl
BACKGROUND: Prehospital trauma triage ensures proper transport of patients at risk of severe injury to hospitals with an appropriate corresponding level of trauma care. Incorrect triage results in undertriage and overtriage. The American College of Surgeons Committee on Trauma recommends an undertriage rate below 5% and an overtriage rate below 50% for prehospital trauma triage protocols. In order to find the most accurate prehospital trauma triage protocol, a clear overview of all currently available protocols and corresponding outcomes is necessary...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28440675/near-infrared-spectroscopy-nirs-to-detect-traumatic-intracranial-haematoma-a-systematic-review-and-meta-analysis
#14
Robert J Brogan, Vassilios Kontojannis, Bhavin Garara, Hani J Marcus, Mark H Wilson
OBJECTIVES AND METHODS: Head injury is the most common trauma presentation to UK emergency departments, with around 1.2 million patients each year. The key management principal for this time critical illness remains early surgical intervention. With the development of handheld near-infrared spectroscopy (NIRS) devices, there is now the possibility of triaging and diagnosing these patients immediately, where computed tomography (CT) scanner is unavailable. NIRS has two related but distinct potential uses within clinical medicine...
April 25, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28436211/primary-hpv-testing-verification-a-retrospective-ad-hoc-analysis-of-screening-algorithms-on-women-doubly-tested-for-cytology-and-hpv
#15
Jessica Tracht, Allison Wrenn, Isam-Eldin Eltoum
BACKGROUND: To evaluate human papillomavirus (HPV) testing as a primary screening tool, we retrospectively analyzed data comparing (1) HPV testing to the algorithms of the ATHENA Study: (2) cytology alone, (3) cytology with ASCUS triage in women 25-29 and (4) cotesting ≥ 30 or (5) cotesting ≥ 25. METHODS: We retrospectively analyzed data from women tested with both cytology and HPV testing from 2010 to 2013. Cumulative risk (CR) for CIN3+ was calculated...
April 23, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28424459/development-and-outcomes-of-a-primary-care-based-sleep-assessment-service-in-canterbury-new-zealand
#16
Michael J Epton, Paul T Kelly, Brett I Shand, Sallyanne V Powell, Judith N Jones, Graham R B McGeoch, Michael C Hlavac
Prior to 2007, increasing demand for sleep services, plus inability to adequately triage severity, led to long delays in sleep assessment and accessing continuous positive airway pressure. We established a community sleep assessment service carried out by trained general practices using a standardised tool and overnight oximetry. All cases were discussed at a multi-disciplinary meeting, with four outcomes: severe obstructive sleep apnoea treated with continuous positive airway pressure; investigation with more complex studies; sleep physician appointment; no or non-severe sleep disorder for general practitioner management...
April 19, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28422844/ultrasound-is-helpful-to-differentiate-bethesda-class-iii-thyroid-nodules-a-prisma-compliant-systematic-review-and-meta-analysis
#17
REVIEW
Lu-Ying Gao, Ying Wang, Yu-Xin Jiang, Xiao Yang, Ru-Yu Liu, Xue-Hua Xi, Shen-Ling Zhu, Rui-Na Zhao, Xing-Jian Lai, Xiao-Yan Zhang, Bo Zhang
BACKGROUND: Fine-needle aspiration (FNA) is the most dependable tool to triage thyroid nodules for medical or surgical management. However, Bethesda class III cytology, namely "follicular lesion of undetermined significance" (FLUS) or "atypia of undetermined significance" (AUS), is a major limitation of the US-FNA in assessing thyroid nodules. As the most important imaging method, ultrasound (US) has a high efficacy in diagnosing thyroid nodules. This meta-analysis aimed to assess the role of US in evaluating Bethesda class III thyroid nodules...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28418867/early-detection-of-gastric-cancer-using-global-genome-wide-and-irf4-elmo1-clip4-and-msc-dna-methylation-in-endoscopic-biopsies
#18
Francesca Pirini, Sassan Noazin, Martha H Jahuira-Arias, Sebastian Rodriguez-Torres, Leah Friess, Christina Michailidi, Jaime Cok, Juan Combe, Gloria Vargas, William Prado, Ethan Soudry, Jimena Pérez, Tikki Yudin, Andrea Mancinelli, Helen Unger, Carmen Ili-Gangas, Priscilla Brebi-Mieville, Douglas E Berg, Masamichi Hayashi, David Sidransky, Robert H Gilman, Rafael Guerrero-Preston
Clinically useful molecular tools to triage gastric cancer patients are not currently available. We aimed to develop a molecular tool to predict gastric cancer risk in endoscopy-driven biopsies obtained from high-risk gastric cancer clinics in low resource settings.We discovered and validated a DNA methylation biomarker panel in endoscopic samples obtained from 362 patients seen between 2004 and 2009 in three high-risk gastric cancer clinics in Lima, Perú, and validated it in 306 samples from the Cancer Genome Atlas project ("TCGA")...
March 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28416251/initial-asthma-severity-assessment-tools-as-predictors-of-hospitalization
#19
Natalia Paniagua, Amaia Elosegi, Isabel Duo, Ana Fernandez, Elisa Mojica, Lorea Martinez-Indart, Santiago Mintegi, Javier Benito
BACKGROUND: Assessment tools to classify and prioritize patients, such as systems of triage, and indicators of severity, such as clinical respiratory scores, are helpful in guiding the flow of asthmatic patients in the emergency department. OBJECTIVE: Our aim was to assess the performance of the Pediatric Assessment Triangle (PAT), triage level (TL), Pulmonary Score (PS), and initial O2 saturation (O2 sat), in predicting hospitalization in pediatric acute asthma exacerbations...
April 14, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28412995/development-and-validation-of-prediction-models-for-risks-of-complications-in-early-onset-pre-eclampsia-prep-a-prospective-cohort-study
#20
Shakila Thangaratinam, John Allotey, Nadine Marlin, Ben W Mol, Peter Von Dadelszen, Wessel Ganzevoort, Joost Akkermans, Asif Ahmed, Jane Daniels, Jon Deeks, Khaled Ismail, Ann Marie Barnard, Julie Dodds, Sally Kerry, Carl Moons, Richard D Riley, Khalid S Khan
BACKGROUND: The prognosis of early-onset pre-eclampsia (before 34 weeks' gestation) is variable. Accurate prediction of complications is required to plan appropriate management in high-risk women. OBJECTIVE: To develop and validate prediction models for outcomes in early-onset pre-eclampsia. DESIGN: Prospective cohort for model development, with validation in two external data sets. SETTING: Model development: 53 obstetric units in the UK...
April 2017: Health Technology Assessment: HTA
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