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  • 1
    Language: English
    In: BMJ, 2016-03-31, Vol.352, p.i1758-i1758
    Subject(s): Abridged Index Medicus ; Clinical Trials as Topic - legislation & jurisprudence ; Computer Security - legislation & jurisprudence ; Europe ; Information Dissemination - legislation & jurisprudence
    ISSN: 1756-1833
    E-ISSN: 1756-1833
    Source: JSTOR Life Sciences
    Source: Single Journals
    Source: BMJ Journals - NESLi2
    Source: Alma/SFX Local Collection
    Source: Get It Now
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  • 2
    Language: English
    In: American journal of respiratory and critical care medicine, 2012-05-15, Vol.185 (10), p.1096-1103
    Description: Rationale: Up to one-third of patients with cystic fibrosis (CF) awaiting lung transplantation (LTX) die while waiting. Inclusion of computed tomography (CT) scores may improve survival prediction models such as the lung allocation score (LAS). Objectives: This study investigated the association between CT and survival in patients with CF screened for LTX. Methods: Clinical data and chest CTs of 411 patients with CF screened for LTX between 1990 and 2005 were collected from 17 centers. CTs were scored with the Severe Advanced Lung Disease (SALD) four-category scoring system, including the components infection/inflammation (INF), air trapping/hypoperfusion (AT), normal/hyperperfusion (NOR), and bulla/cysts (BUL). The volume of each componentwas computed using semiautomated software. Survival analysis included Kaplan-Meier curves and Cox regression models. Measurements and Main Results: Three hundred and sixty-six (186 males) of 411 patients entered the waiting list (median age, 23 yr; range, 5-58 yr). Subsequently, 67 of 366 (18%) died while waiting, 263 of 366 (72%) underwent LTX, and 36 of 366 (10%) were awaiting LTX at the census date. INF and LAS were significantly associated with waiting list mortality in univariate analyses. The multivariate Cox model including INF and LAS grouped in tertiles, and comparing tertiles 2 and 3 with tertile 1, showed waiting list mortality hazard ratios of 1.62 (95% confidence interval [95% CI], 0.78-3.36; P=0.19) and 2.65 (95% CI, 1.35-5.20; P = 0.005) for INF, and 1.42 (95% CI, 0.63-3.24; P=0.40), and 2.32 (95% CI, 1.17-4.60; P=0.016) for LAS, respectively. These results indicated that INF and LAS had significant, independent predictive value for survival. Conclusions: CT score INF correlates with survival, and adds to the predictive value of LAS. Copyright
    Subject(s): Abridged Index Medicus ; Adolescent ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Child ; Child, Preschool ; Cohort Studies ; Cystic fibrosis ; Cystic Fibrosis - diagnostic imaging ; Cystic Fibrosis - mortality ; Cystic Fibrosis - surgery ; Decision Support Techniques ; Female ; Humans ; Intensive care medicine ; Investigative techniques, diagnostic techniques (general aspects) ; Kaplan-Meier Estimate ; Lung disease ; Lung Transplantation ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Respiratory system ; Severity of Illness Index ; Tomography X-ray computed ; Waiting list survival ; Waiting Lists - mortality ; Young Adult
    ISSN: 1073-449X
    E-ISSN: 1535-4970
    Source: ProQuest Central
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  • 3
    Language: English
    In: Health and quality of life outcomes, 2020-05-14, Vol.18 (1), p.140-140
    Description: Health-related quality of life (HRQoL) is impaired in patients with stable angina but patients often present with other forms of chest pain. The aim of this study was to compare the pre-diagnostic HRQoL in patients with suspected coronary artery disease (CAD) according to angina type, gender, and presence of obstructive CAD. From the pilot study for the European DISCHARGE trial, we analysed data from 24 sites including 1263 patients (45.9% women, 61.1 ± 11.3 years) who were clinically referred for invasive coronary angiography (ICA; 617 patients) or coronary computed tomography angiography (CTA; 646 patients). Prior to the procedures, patients completed HRQoL questionnaires: the Short Form (SF)-12v2, the EuroQoL (EQ-5D-3 L) and the Hospital Anxiety and Depression Scale. Fifty-five percent of ICA and 35% of CTA patients had typical angina, 23 and 33% had atypical angina, 18 and 28% had non-anginal chest discomfort and 5 and 5% had other chest discomfort, respectively. Patients with typical angina had the poorest physical functioning compared to the other angina groups (SF-12 physical component score; 41.2 ± 8.8, 43.3 ± 9.1, 46.2 ± 9.0, 46.4 ± 11.4, respectively, all age and gender-adjusted p 〈 0.01), and highest anxiety levels (8.3 ± 4.1, 7.5 ± 4.1, 6.5 ± 4.0, 4.7 ± 4.5, respectively, all adjusted p 〈 0.01). On all other measures, patients with typical or atypical angina had lower HRQoL compared to the two other groups (all adjusted p 〈 0.05). HRQoL did not differ between patients with and without obstructive CAD while women had worse HRQoL compared with men, irrespective of age and angina type. Prior to a diagnostic procedure for stable chest pain, HRQoL is associated with chest pain characteristics, but not with obstructive CAD, and is significantly lower in women. Clinicaltrials.gov, NCT02400229.
    Subject(s): Aged ; Angina ; Angina Pectoris - classification ; Angina Pectoris - diagnosis ; Angina Pectoris - physiopathology ; Chest pain ; Computed tomography angiography ; Coronary artery disease ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - physiopathology ; Female ; Health-related quality of life ; Humans ; Invasive coronary angiography ; Male ; Middle Aged ; Pilot Projects ; Quality of Life ; Research ; Sex Distribution ; Surveys and Questionnaires
    ISSN: 1477-7525
    E-ISSN: 1477-7525
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 4
    Language: English
    In: The American journal of medicine, 2009, Vol.122 (6), p.543-549
    Description: Abstract Background Coronary computed tomography angiography might improve the management of patients presenting to the emergency department with acute chest pain; however, noncoronary incidental findings are frequently detected. The prevalence and clinical significance of these findings have not been well described. Methods Consecutive patients presenting to the emergency department with acute chest pain and inconclusive initial evaluation between May 2005 and May 2007 underwent 64-slice coronary computed tomography angiography before hospital admission with noncoronary incidental findings immediately reported. An expert panel adjudicated which incidental findings changed in-hospital patient management, and projections for additional testing were based on standard medical practice. Results Among 395 patients (37.0% were female, mean age 53 ± 12 years), incidental findings were detected in 44.8% (n = 177): noncalcified pulmonary nodules (n = 94, 23.8%), simple liver cysts (n = 26, 6.6%), calcified pulmonary nodules (n = 16, 4.1%), and contrast-enhancing liver lesions (n = 9, 2.3%). In-hospital management was changed because of incidental finding reporting in 5 patients (1.3%), and a potential alternative diagnosis was offered in another 16 patients (4.1%). Subsequent diagnostic imaging tests were recommended in 81 patients (20.5%), including 74 chest computed tomography scans. After 6 months, biopsy was performed in 3 patients, revealing cancer in 2 (0.5%) who underwent successful tumor resection. Conclusion Clinically important findings are detected in up to 5% of patients with a lead symptom of acute chest pain and low to intermediate likelihood of acute coronary syndrome, but only few directly change patient management; 21% are recommended for further imaging tests, resulting in invasive procedures and detection of cancer in few patients.
    Subject(s): Abridged Index Medicus ; Acute Coronary Syndrome - diagnostic imaging ; Adult ; Aged ; Angiography ; Biological and medical sciences ; Care and treatment ; Chest pain ; Chest Pain - diagnostic imaging ; Chest Pain - etiology ; Computed tomography ; Coronary Angiography - methods ; Cysts - diagnostic imaging ; Diagnosis ; Female ; General aspects ; Humans ; Incidental Findings ; Internal Medicine ; Liver Diseases - diagnostic imaging ; Lung Neoplasms - diagnostic imaging ; Male ; Medical sciences ; Middle Aged ; Patient outcomes ; Predictive Value of Tests ; Retrospective Studies ; Sensitivity and Specificity ; Solitary Pulmonary Nodule - diagnostic imaging ; Tomography, X-Ray Computed ; Usage
    ISSN: 0002-9343
    E-ISSN: 1555-7162
    Source: ScienceDirect Journals
    Source: Backfile Package - All of Back Files EBS [ALLOFBCKF]
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  • 5
    Language: English
    In: Journal of pediatric rehabilitation medicine, 2019, Vol.12 (1), p.37-47
    Description: Significant gaps in service delivery for children with acquired brain injury exist between healthcare and educational systems, such as the lack of coordinated efforts to transfer rehabilitation strategies to school settings. This paper attempts to address these issues and offer recommendations to bridge these gaps in care. The American Congress of Rehabilitation Medicine (ACRM), Brain Injury-Interdisciplinary Special Interest Group (BI-ISIG), Pediatric-Adolescent Task Force constructed and disseminated a survey to medical rehabilitation (N= 44) and education professionals (N= 40). Responses were analyzed quantitatively and qualitatively, achieving 〉 85% inter-coder reliability. Results highlighted differences between groups in methods for seeking new information, opinions on advocacy needs, and differing priorities given to various resources. These discrepancies have important implications for improved collaboration needed for assuring an appropriate continuum of service for this population. Recommendations include: 1) providing education and training regarding brain injury in the most cost-effective ways utilizing technology that crosses the barriers identified and reaches people in multiple settings; 2) direct and active communication between medical and educational professionals; and 3) developing an interdisciplinary Community of Practice to help bridge medical rehabilitation and school systems.
    Subject(s): Adolescent ; Brain Injuries - epidemiology ; Brain Injuries - etiology ; Brain Injuries - rehabilitation ; Child ; Communication Barriers ; Disabled Children - education ; Disabled Children - rehabilitation ; Education, Special - methods ; Education, Special - organization & administration ; Female ; Humans ; Interdisciplinary Communication ; Intersectoral Collaboration ; Male ; Population ; Quality Improvement - organization & administration ; Rehabilitation Research ; School Health Services ; Surveys and Questionnaires
    ISSN: 1874-5393
    E-ISSN: 1875-8894
    Source: Academic Search Ultimate
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  • 6
    Language: English
    In: PloS one, 2017, Vol.12 (8), p.e0181886-e0181886
    Description: Rabbits and monkeys immunized with HIV type 1 (HIV-1) native-like BG505 SOSIP.664 (BG505s) glycoprotein trimers are known to induce antibodies that can neutralize the autologous tier-2 virus. Here, we assessed the induction of HIV-1 trimer binding and neutralizing antibody (nAb) titres when BG505s trimers were also delivered by non-replicating simian (chimpanzee) adenovirus and non-replicating poxvirus modified vaccinia virus Ankara (MVA) vaccine vectors. First, we showed that approximately two-thirds and one-third of the trimers secreted from the ChAdOx1.BG505s (C) and MVA.BG505s (M) vaccine-infected cells, respectively, were cleaved and in a native-like conformation. Rabbits were immunized intramuscularly with these vaccine vectors and in some cases boosted with ISCOMATRIX™-adjuvanted BG505s protein trimer (P), using CCC, MMM, PPP, CPP, MPP and CMP vaccine regimens. We found that the peak trimer-binding antibody and tier-1A and autologous tier-2 nAb responses induced by the CC, CM, PPP, CPP, MPP and CMP regimens were comparable, although only PPP induced autologous tier-2 nAbs in all the immunized animals. Three animals developed weak heterologous tier-2 nAbs. These results demonstrate that ChAdOx1 and MVA vectors are useful delivery modalities for not only T-cell, but also antibody vaccine development
    Subject(s): Acquired immune deficiency syndrome ; Adenoviruses ; Adenoviruses, Simian - immunology ; AIDS ; AIDS Vaccines - immunology ; Animals ; Antibodies ; Antibodies, Neutralizing - immunology ; Artificial chromosomes ; Binding ; Biology and Life Sciences ; Cell Line ; Drug delivery systems ; env Gene Products, Human Immunodeficiency Virus - immunology ; Expression vectors ; Genomes ; Glycoproteins ; HEK293 Cells ; HIV ; HIV antibodies ; HIV Antibodies - immunology ; HIV-1 - immunology ; Human immunodeficiency virus ; Humans ; Immunization ; Immunoglobulins ; Immunology ; Infections ; Lymphocytes T ; Medicine and Health Sciences ; Methods ; Monkeys ; Neutralizing ; Pathology ; Protein Multimerization - immunology ; Rabbits ; Replicating ; Research ; Research and Analysis Methods ; Trimers ; Vaccination ; Vaccines ; Vaccinia virus - immunology ; Viral vaccines ; Viral Vaccines - immunology ; Virology ; Viruses
    ISSN: 1932-6203
    E-ISSN: 1932-6203
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 7
    Language: English
    In: Neuropsychological rehabilitation, 2020-01-02, Vol.30 (1), p.130-161
    Description: This paper updates guidelines for effective treatments of children with specific types of acquired brain injury (ABI) published in 2007 with more recent evidence. A systematic search was conducted for articles published from 2006 to 2017. Full manuscripts describing treatments of children (post-birth to 18) with acquired brain injury were included if study was published in peer-reviewed journals and written in English. Two independent reviewers and a third, if conflicts existed, evaluated the methodological quality of studies with an Individual Study Review Form and a Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Strength of study characteristics was used in development of practice guidelines. Fifty-six peer-reviewed articles, including 27 Class I studies, were included in the final analysis. Established guidelines for writing practice recommendations were used and 22 practice recommendations were written with details of potential treatment limitations. There was strong evidence for family/caregiver-focused interventions, as well as direct interventions to improve attention, memory, executive functioning, and emotional/behavioural functioning. A majority of the practice standards and guidelines provided evidence for the use of technology in delivery of interventions, representing an important trend in the field.
    Subject(s): Acquired brain injury ; Children ; Cognitive rehabilitation ; Evidence-based systematic review ; Rehabilitation
    ISSN: 0960-2011
    E-ISSN: 1464-0694
    Source: Academic Search Ultimate
    Source: MLA International Bibliography with Full Text
    Source: SPORTDiscus with Full Text
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  • 8
    Language: English
    In: European radiology, 2020-09-09, Vol.31 (3), p.1471-1481
    Description: Objectives To test the accuracy of clinical pre-test probability (PTP) for prediction of obstructive coronary artery disease (CAD) in a pan-European setting. Methods Patients with suspected CAD and stable chest pain who were clinically referred for invasive coronary angiography (ICA) or computed tomography (CT) were included by clinical sites participating in the pilot study of the European multi-centre DISCHARGE trial. PTP of CAD was determined using the Diamond-Forrester (D+F) prediction model initially introduced in 1979 and the updated D+F model from 2011. Obstructive coronary artery disease (CAD) was defined by one at least 50% diameter coronary stenosis by both CT and ICA. Results In total, 1440 patients (654 female, 786 male) were included at 25 clinical sites from May 2014 until July 2017. Of these patients, 725 underwent CT, while 715 underwent ICA. Both prediction models overestimated the prevalence of obstructive CAD (31.7%, 456 of 1440 patients, PTP: initial D+F 58.9% (28.1–90.6%), updated D+F 47.3% (34.2–59.9%), both p 〈 0.001), but overestimation of disease prevalence was higher for the initial D+F ( p 〈 0.001). The discriminative ability was higher for the updated D+F 2011 (AUC of 0.73 95% confidence interval [CI] 0.70–0.76 versus AUC of 0.70 CI 0.67–0.73 for the initial D+F; p 〈 0.001; odds ratio (or) 1.55 CI 1.29–1.86, net reclassification index 0.11 CI 0.05–0.16, p 〈 0.001). Conclusions Clinical PTP calculation using the initial and updated D+F prediction models relevantly overestimates the actual prevalence of obstructive CAD in patients with stable chest pain clinically referred for ICA and CT suggesting that further refinements to improve clinical decision-making are needed. Trial registration https://www.clinicaltrials.gov/ct2/show/NCT02400229 Key Points • Clinical pre-test probability calculation using the initial and updated D+F model overestimates the prevalence of obstructive CAD identified by ICA and CT. • Overestimation of disease prevalence is higher for the initial D+F compared with the updated D+F. • Diagnostic accuracy of PTP assessment varies strongly between different clinical sites throughout Europe.
    Subject(s): Computed Tomography ; Computed Tomography Angiography ; Coronary Angiography ; Coronary artery disease ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - epidemiology ; Coronary heart disease ; Coronary Stenosis - diagnostic imaging ; Coronary Stenosis - epidemiology ; Diagnostic Radiology ; Europe ; Female ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Male ; Medicine ; Medicine & Public Health ; Neuroradiology ; Patient Discharge ; Pilot Projects ; Predictive Value of Tests ; Prevalence ; Probability of disease ; Radiology ; Risk Assessment ; Risk Factors ; Ultrasound
    ISSN: 0938-7994
    E-ISSN: 1432-1084
    Source: Alma/SFX Local Collection
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  • 9
    Language: English
    In: Thorax, 2021-03, Vol.76 (3), p.316-317
    Description: Whole body and dedicated cardiac fluorodeoxyglucose (FDG)-positron emission tomography (PET) was performed 60 min after radiotracer injection following a special patient preparation to suppress physiological myocardial uptake of glucose. A comprehensive electrophysiological study was positive for inducible sustained ventricular tachycardia, and an implantable cardioverter-defibrillator was inserted. FDG-PET can be used to guide both diagnosis and management of sarcoidosis,1 2 and may be useful for assessing treatment response, disease extent, occult disease,3 and may have utility in stratifying prognosis4 and FDG-PET and cardiac MRI can be complementary,5 but there is significant radiation exposure associated with repeated PET imaging.
    Subject(s): Adult ; Biopsy ; Diagnosis, Differential ; Fluorodeoxyglucose F18 - pharmacology ; Granulomas ; Humans ; Magnetic resonance imaging ; Male ; Metabolism ; Positron Emission Tomography Computed Tomography - methods ; Radiopharmaceuticals - pharmacology ; Sarcoidosis ; Sarcoidosis - diagnosis ; Tomography
    ISSN: 0040-6376
    E-ISSN: 1468-3296
    Source: Hellenic Academic Libraries Link
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  • 10
    Language: English
    In: Journal of medical genetics, 2015-11, Vol.52 (11), p.754-761
    Description: BackgroundRare de novo mutations have been implicated as a significant cause of idiopathic intellectual disability. Large deletions encompassing 10p11.23 have been implicated in developmental delay, behavioural abnormalities and dysmorphic features, but the genotype–phenotype correlation was not delineated. Mutations in WAC have been recently reported in large screening cohorts of patients with intellectual disability or autism, but no full phenotypic characterisation was described.MethodsClinical and molecular characterisation of six patients with loss-of-function WAC mutations identified by whole exome sequencing was performed. Clinical data were obtained by retrospective chart review, parental interviews, direct patient interaction and formal neuropsychological evaluation.ResultsFive heterozygous de novo WAC mutations were identified in six patients. Three of the mutations were nonsense, and two were frameshift; all are predicted to cause loss of function either through nonsense-mediated mRNA decay or protein truncation. Clinical findings included developmental delay (6/6), hypotonia (6/6), behavioural problems (5/6), eye abnormalities (5/6), constipation (5/6), feeding difficulties (4/6), seizures (2/6) and sleep problems (2/6). All patients exhibited common dysmorphic features, including broad/prominent forehead, synophrys and/or bushy eyebrows, depressed nasal bridge and bulbous nasal tip. Posteriorly rotated ears, hirsutism, deep-set eyes, thin upper lip, inverted nipples, hearing loss and branchial cleft anomalies were also noted.ConclusionsOur case series show that loss-of-function mutations in WAC cause a recognisable genetic syndrome characterised by a neurocognitive phenotype and facial dysmorphism. Our data highly suggest that WAC haploinsufficiency is responsible for most of the phenotypic features associated with deletions encompassing 10p11.23.
    Subject(s): Abnormalities, Multiple - diagnosis ; Abnormalities, Multiple - genetics ; Adaptor Proteins, Signal Transducing - genetics ; Adult ; Analysis ; Behavioral Symptoms - diagnosis ; Behavioral Symptoms - genetics ; Child ; Child, Preschool ; Developmental delay ; Developmental Disabilities - diagnosis ; Developmental Disabilities - genetics ; DNA Mutational Analysis ; Exome ; Female ; Gene mutations ; Genetic aspects ; Genetic Association Studies ; Humans ; Infant ; Infant, Newborn ; Male ; Muscle Hypotonia - diagnosis ; Muscle Hypotonia - genetics ; Mutation ; Phenotype ; Pregnancy ; Research ; Risk factors ; Syndrome
    ISSN: 0022-2593
    E-ISSN: 1468-6244
    Source: Hellenic Academic Libraries Link
    Source: BMJ Journals - NESLi2
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