Decreasing Physical Restraint in Acute Inpatient Psychiatric Hospitals: A Systematic Review.

A systematic review was conducted to identify methods used to decrease the application of physical restraints in acute inpatient psychiatric hospitals. A literature search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines using key words related to physical restraint. Three data-based studies met eligibility criteria.

Positron-Emission Tomography Scan-Directed Chemoradiation for Esophageal Squamous Cell Carcinoma: No Benefit for a Change in Chemotherapy in Positron-Emission Tomography Nonresponders.

Introduction: Preoperative or definitive chemoradiation is an accepted treatment for locally advanced esophageal squamous cell carcinoma (ESCC). The MUNICON study showed that positron-emission tomography (PET) response following induction chemotherapy was predictive of outcomes in patients with gastroesophageal junction adenocarcinoma. We evaluated the predictive value of PET following induction chemotherapy in ESCC patients and assessed the impact of changing chemotherapy during radiation in PET nonresponders.

Abdominal massage plus advice, compared with advice only, for neurogenic bowel dysfunction in MS: a RCT.

Background: Between 50% and 80% of people with multiple sclerosis (PwMS) experience neurogenic bowel dysfunction (NBD) (i.e. constipation and faecal incontinence) that affects quality of life and can lead to hospitalisation.

Risk factors for paclitaxel-induced peripheral neuropathy in patients with breast cancer.

Background: Paclitaxel induced peripheral neuropathy (PIPN) is a major debilitating side effect of paclitaxel in patients with breast cancer with no fully known mechanisms. The aim of the study was to find out the possible risk factors for PIPN.

Methods: Eligible patients with node positive breast cancer undergoing chemotherapy with paclitaxel were assessed.

Should Foreigners Get Costly Lifesaving Treatments in the United States?

Many foreign parents bring their children to the United States for medical treatments that are unavailable in their own country. Often, however, parents cannot afford expensive treatments. Doctors and hospitals then face a dilemma.

How frequently are hospitalized patients colonized with carbapenem-resistant Enterobacteriaceae (CRE) already on contact precautions for other indications?

Using samples collected for VRE surveillance, we evaluated unit admission prevalence of carbapenem-resistant Enterobacteriaceae (CRE) perirectal colonization and whether CRE carriers (unknown to staff) were on contact precautions for other indications. CRE colonization at unit admission was infrequent (3.9%).

Quality Control of Radiation Delivery for Lower Gastrointestinal Cancers.

Assessing the quality of health care delivered is a priority across medical specialties, but it is particularly critical for radiation oncology, a field with rapid introduction of new technologies and treatment paradigms. Deviation from acceptable standards can lead to delivery of inferior therapies and medical errors that can directly compromise patient clinical outcome, thus leading to disparities in quality of care. Professional oncologic specialty societies often take ownership of standardizing best practices by issuing evidence-based disease-specific consensus guidelines.

Between Access and Privacy: Challenges in Sharing Health Data.

Objective:  To summarize notable research contributions published in 2017 on data sharing and privacy issues in medical informatics.

Methods:  An extensive search of PubMed/Medline, Web of Science, ACM Digital Library, IEEE Xplore, and AAAI Digital Library was conducted to uncover the scientific contributions published in 2017 that addressed issues of biomedical data sharing, with a focus on data access and privacy. The selection process was based on three steps: (i) a selection of candidate best papers, (ii) the review of the candidate best papers by a team of international experts with respect to six predefined criteria, and (iii) the selection of the best papers by the editorial board of the Yearbook Results: Five best papers were selected.

The Clinical and Dosimetric Impact of Real-Time Target Tracking in Pancreatic SBRT.

Purpose: Motion often hinders the safe delivery of ablative doses of radiation in the treatment of pancreatic tumors. Real-time tumor-tracking methods are an emerging technique to increase the accuracy of delivery. In this study, we report on a large, retrospective cohort of pancreatic patients treated with real-time, fiducial-based, kV-image guidance of stereotactic body radiation therapy (SBRT).

Nonselective Chemical Inhibition of Sec7 Domain-Containing ARF GTPase Exchange Factors.

Small GTP-binding proteins from the ADP-ribosylation factor (ARF) family are important regulators of vesicle formation and cellular trafficking in all eukaryotes. ARF activation is accomplished by a protein family of guanine nucleotide exchange factors (GEFs) that contain a conserved catalytic Sec7 domain. Here, we identified and characterized Secdin, a small-molecule inhibitor of ARF-GEFs.

Prospective Study of Nonbeneficial Care in Neurocritical Care Unit.

Objective: We sought to determine whether a set of simple criteria can identify patients in the neuroscience intensive care unit (NICU) at high risk of poor outcome and delivery of nonbeneficial care early in the course of their illness. Secondarily, factors affecting limitation of care protocols were assessed.

Methods: We prospectively identified patients who were admitted to the NICU with partial loss of brainstem reflexes persisting for >24 hours due to an intrinsic lesion of the brain (trauma, stroke, hemorrhage, etc.

Using Patient Risk Factors to Identify Whether Carbapenem-Resistant Infections Are Caused by Carbapenemase-Producing Organisms.

Evaluating all inpatient carbapenem-resistant (CRE) infections over a 1-year period, 47% were caused by carbapenemase-producing (CP) organisms. Compared with non-CP-CRE patients, patients with CP-CRE had an 18-fold greater odds of a recent stay in a foreign health care facility and a 3-fold greater odds of transfer from a post-acute care facility.

Total neoadjuvant therapy for rectal cancer.

While outcomes for patients with locally advanced disease have improved considerably with combined modality therapy, there is now an emphasis on developing risk-adapted treatment strategies. Moreover, the primary cause of death from locally advanced rectal cancer is related to distant progression, which now exceeds the rate of local failure. Thus, the necessity to optimally address micrometastatic disease has led to increasing interest in delivering chemotherapy in the neoadjuvant setting rather than in the postoperative setting.

Metabolomic profiling to improve glomerular filtration rate estimation: a proof-of-concept study.

Background: Estimation of glomerular filtration rate (GFR) using estimated glomerular filtration rate creatinine (eGFRcr) is central to clinical practice but has limitations. We tested the hypothesis that serum metabolomic profiling can identify novel markers that in combination can provide more accurate GFR estimates.

Methods: We performed a cross-sectional study of 200 African American Study of Kidney Disease and Hypertension (AASK) and 265 Multi-Ethnic Study of Atherosclerosis (MESA) participants with measured GFR (mGFR).

Trends in intensity modulated radiation therapy use for locally advanced rectal cancer at National Comprehensive Cancer Network centers.

Purpose: Intensity modulated radiation therapy (IMRT) has been rapidly incorporated into clinical practice because of its technological advantages over 3-dimensional conformal radiation therapy (CRT). We characterized trends in IMRT utilization in trimodality treatment of locally advanced rectal cancer at National Comprehensive Cancer Network cancer centers between 2005 and 2011.

Methods And Materials: Using the prospective National Comprehensive Cancer Network Colorectal Cancer Database, we determined treatment patterns for 976 patients with stage II-III rectal cancer who received pelvic radiation therapy at contributing centers between 2005 and 2011.

Intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in rectal cancer treated with neoadjuvant concurrent chemoradiation: a meta-analysis and pooled-analysis of acute toxicity.

Background: To compare the acute gastrointestinal (GI) and genitourinary (GU) toxicity profiles between intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT) in rectal cancer patients treated with neoadjuvant chemoradiation (NCRT) using meta-analysis and pooled-analysis from published articles.

Methods: Literature search was performed in PubMed and EMBASE from inception to March 2017. The odd ratios (ORs) were calculated and random effects model was used for meta-analysis.

Endoluminal high-dose-rate brachytherapy for locally recurrent or persistent esophageal cancer.

Purpose: Management of locally recurrent or persistent esophageal cancer (EC) after standard chemoradiation is challenging. This study updates our experience of treating medically inoperable EC patients with endoluminal high-dose-rate brachytherapy (EHDRBT) including the patients treated with a novel multiballoon channel centering esophageal applicator.

Methods And Materials: Thirty-three consecutive patients with early-stage primary (n = 7), posttreatment persistent (n = 7), and recurrent (n = 19) EC treated with EHDRBT at our institution were included.

Radiation Dose-Volume Effects for Liver SBRT.

Stereotactic body radiation therapy (SBRT) has emerged as an effective, noninvasive treatment option for primary liver cancer and metastatic disease occurring in the liver. Although SBRT can be highly effective for establishing local control in hepatic malignancies, a tradeoff exists between tumor control and normal tissue complications. The objective of the present study was to review the normal tissue dose-volume effects for SBRT-induced liver and gastrointestinal toxicities and derive normal tissue complication probability models.

Evaluation of respiratory motion-corrected cone-beam CT at end expiration in abdominal radiotherapy sites: a prospective study.

Background: Cone beam computed tomography (CBCT) for radiotherapy image guidance suffers from respiratory motion artifacts. This limits soft tissue visualization and localization accuracy, particularly in abdominal sites. We report on a prospective study of respiratory motion-corrected (RMC)-CBCT to evaluate its efficacy in localizing abdominal organs and improving soft tissue visibility at end expiration.