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Four Year Prognostic Index

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161. Histopathologic features of the tumor budding in adenocarcinoma of the lung: tumor budding as an index to predict the potential aggressiveness. (PubMed)

Histopathologic features of the tumor budding in adenocarcinoma of the lung: tumor budding as an index to predict the potential aggressiveness. The term tumor budding has been applied to single cells or small clusters of up to four cells within the stromal tissue at the invasive margin of colorectal cancers. This morphologic feature is increasingly being recognized as an adverse prognostic factor. The purpose of this study was to evaluate the clinicopathologic significance of tumor budding (...) in adenocarcinomas of the lung.We investigated the relationship between tumor budding and clinicopathologic parameters of adenocarcinomas of the lung and the prognostic significance of tumor budding by reviewing the cases of 201 consecutive patients who had undergone complete resection of adenocarcinoma of the lung measuring 30 mm or less in diameter. We examined immunohistochemical profile of budding cells (BCs) by immunohistochemical staining with 14 antibodies.Tumor budding was observed in 78 (43.1

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2010 Journal of Thoracic Oncology

162. Tools to aid the clinical identification of end of life

, indicating their high scale reliability. Correlations between the SPEED scales and related assessment tools previously validated in other settings were high and statistically significant. Multidimensional Prognostic Index (MPI) for mortality based on information collected by the Multidimensional Assessment Schedule (SVaMA) - MPI- SVaMA (Italy & France) The Multidimensional Prognostic Index (MPI) for 1- year mortality was constructed and validated from a Comprehensive Geriatric Assessment (CGA) routinely (...) and/ or prognostication about the likely time of death within one year o aids non-palliative care clinicians to identify the possibility of a patient’s death within one year. • Settings of interest include acute care, aged care, primary care and home. • Tools designed for use solely in paediatric care to be excluded. • Terms which occur frequently in the palliative care literature have been defined in the NSW Framework for the Statewide Model for Palliative and End of Life Care Service Provision. These definitions

2018 Sax Institute Evidence Check

163. Dietary patterns and cardiovascular disease outcomes

and/or mortality. The Mediterranean diet received two Grade C recommendations for evidence relating to improvements in blood lipids and CVD events and/or mortality. A Low Glycaemic Index/Low Glycaemic Load (Low GI/GL) diet received one Grade C recommendation for improvements in body composition. In regards to dietary patterns and secondary prevention of CVD, three dietary patterns were evaluated resulting in four recommendations. The Portfolio diet has a Grade B recommendation for reduction in blood lipids (...) ? Primary prevention of CVD This section reviewed the evidence for systematic literature reviews and/or meta-analyses that reported exclusively the primary prevention of CVD outcomes and the risk factor in healthy population groups. Evidence-based statements, as detailed in Appendix 4, were able to be generated for four dietary patterns: Healthy/prudent diets; Mediterranean; Low GI/GL (Glycaemic Index/Glycaemic Load); and DASH. Based on the available evidence, the grade of recommendation was highest

2018 Sax Institute Evidence Check

164. PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines

tomography (PET) in the clinical management of patients with cancer, sarcoidosis, or epilepsy with respect to: ? Diagnosis and staging ? Assessment of treatment response ? Detection and restaging of recurrence ? Evaluation of metastasis Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management. INTRODUCTION In 2010, the Ontario PET Steering Committee (the Committee (...) clinical management, clinical outcomes, or treatment response; survival; quality of life; prognostic indicators; time until recurrence; or safety outcome (e.g., avoidance of unnecessary surgery). Exclusion Criteria 1. Letters and editorials. 3 RESULTS Literature Search Results Primary Studies and Systematic Reviews Eighty-two studies published between January and June 2017 met the inclusion criteria. A summary of the evidence from the 82 studies can be found in Appendix 1: Summary of studies from

2018 Cancer Care Ontario

165. Guidelines on Diagnosis and Management of Syncope

4.2.3.4 Twenty-four-hour ambulatory and home blood pressure monitoring 1904 4.2.4 Electrocardiographic monitoring (non-invasive and invasive) 1905 4.2.4.1 In-hospital monitoring 1905 4.2.4.2 Holter monitoring 1905 4.2.4.3 Prospective external event recorders 1905 4.2.4.4 Smartphone applications 1906 4.2.4.5 External loop recorders 1906 4.2.4.6 Remote (at home) telemetry 1906 4.2.4.7 Implantable loop recorders 1906 4.2.4.8 Diagnostic criteria 1906 4.2.5 Video recording in suspected syncope 1907 4.2.5.1 (...) professionals in selecting the best management strategies for an individual patient with a given condition. Guidelines and their recommendations should facilitate decision making of health professionals in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate. A great number of guidelines have been issued in recent years by the European Society of Cardiology (ESC

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2018 European Society of Cardiology

166. Multimorbidity: a priority for global health research

the individual component conditions. 4 Executive summary5 Executive summary What are the evidence gaps? Most studies of the prevalence of multimorbidity have focused on older populations in HICs, while data from younger adults and LMICs are much more limited. Data identifying the most common clusters of conditions in populations and subgroups are also limited, as are data on the burden (e.g. years of life lost) generated by such clusters. While there are some data that suggest the prevalence of some types (...) of multimorbidity changed over time?Research priority 2: Which multimorbidity clusters cause the greatest burden? • Which clusters of conditions have the worst prognosis in terms of death and disability, as quantified by metrics such as ‘years of life lost’ (YLL) and ‘years lost due to disability’ (YLD)? • Which clusters have the greatest impact on patient- and carer-centric outcomes such as treatment burden and quality of life? • Which clusters result in the greatest healthcare utilisation and the greatest

2018 Academy of Medical Sciences

167. New and emerging technologies in neurophysiology and operating theatres

Magnetic resonance imaging MRN Magnetic resonance neurography MS Multiple sclerosis MUNIX Motor Unit Number Index NCS Nerve-conduction studies NHMRC National Health and Medical Research Council NIBS Non-invasive brain stimulation NICE National Institute for Health and Care Excellence (UK) NIRS Near infra-red spectroscopy OSA Obstructive sleep apnoea OSET International) Organisation of Societies for Electrophysiological Technology 6 TECHNOLOGY IN NEUROPHYSIOLOGY AND OPERATING THEATRES | SAX INSTITUTE PA (...) years? 2. What are the new and existing specialised skills required for the effective and safe uptake of the technologies identified in question one? Summary of methods This review used a rapid review methodology. Both the peer reviewed and grey literature were systematically searched to answer the review questions. Consultation with relevant experts, in both clinical practice and the medical technology industry, was also informally undertaken to aid the search process or interpretate evidence. Key

2018 Sax Institute Evidence Check

168. Quantitative Image Analysis of HER2 Immunohistochemistry for Breast Cancer

type of cancer in women and 1 in 8 women will develop breast cancer in her lifetime. 1 For breast cancer, the testing of prognostic and predictive biomarkers, including human epidermal growth factor receptor 2 (HER2), is the standard of care. HER2 status is determined in all patients with invasive breast cancer and provides important information to guide appropriate clinical management. Recognizing the importance of HER2 testing, the American Society of Clinical Oncology (ASCO) and the College (...) ) for articles published from January 1, 2006, through March 21, 2016. Database searches were supple- mented by additional searches for indexed and unindexed (grey) literature, expert panel members were polled for known unpub- lished or published studies of interest not already identi?ed, and the reference lists of included studies were scanned for relevant reports. Additional detail about the literature search and review including database search strings is available in the digital supplement content (see

2019 College of American Pathologists

169. Management of Stroke in Neonates and Children

scientific statement on pediatric stroke was published 10 years ago. Although stroke has long been recognized as an adult health problem causing substantial morbidity and mortality, it is also an important cause of acquired brain injury in young patients, occurring most commonly in the neonate and throughout childhood. This scientific statement represents a synthesis of data and a consensus of the leading experts in childhood cardiovascular disease and stroke. Methods— Members of the writing group were (...) stroke, and updates in regard to areas of childhood stroke that have not received close attention such as sickle cell disease. Each section is highlighted with considerations for clinical practice, attendant controversies, and knowledge gaps. This statement provides the practicing provider with much-needed updated information in this field. Much has transpired since the last scientific statement on pediatric stroke was published 10 years ago. Although stroke has long been recognized as an adult

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2019 American Heart Association

170. Heart Disease and Stroke Statistics

after myocardial infarction (MI), lower risk of atrial fibrillation, and greater positive psychological functioning (dispositional optimism). Among children, from 1999 to 2000 to 2015 to 2016, prevalence of nonsmoking, ideal total cholesterol, and ideal BP improved. For example, nonsmoking among children aged 12 to 19 years went from 76% to 94%. However, meeting ideal levels for physical activity, body mass index (BMI), and blood glucose did not improve. For example, prevalence of ideal BMI declined (...) and have less improvement with radiofrequency ablation. Peripheral Artery Disease and Aortic Diseases (Chapter 23) A recent Danish trial in men aged 65 to 74 years reported that screening of peripheral artery disease (with ankle-brachial index), abdominal aortic aneurysm (with abdominal ultrasound), and hypertension followed by optimal care resulted in a 7% lower risk of 5-year mortality compared with no screening. African Americans have a 37% higher amputation risk than white individuals. In adjusted

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2019 American Heart Association

171. AIM Cancer Treatment Pathways

National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol. 2003 Nov 15;21(22):4165-4174. 43. Jones S, Holmes FA, O'Shaughnessy J, et al. Docetaxel With Cyclophosphamide Is Associated With an Overall Survival Benefit Compared With Doxorubicin and Cyclophosphamide: 7-Year Follow-Up of US Oncology Research Trial 9735. J Clin Oncol. 2009 Mar 10;27(8):1177- 1783. 44. Perez EA, Romond EH, Suman VJ, et al. Four-year follow-up of trastuzumab plus adjuvant chemotherapy for operable human (...) guidelines should be consulted to determine whether proposed services will be covered. Effective February 4, 2019 14 22. Green MC, Buzdar AU, Smith T, et al. Weekly paclitaxel improves pathologic complete remission in operable breast cancer when compared with paclitaxel once every 3 weeks. J Clin Oncol. 2005 Sep 1;23(25):5983-5992. 23. Perez EA, Romond EH, Suman VJ, et al. Four-year follow-up of trastuzumab plus adjuvant chemotherapy for operable human epidermal growth factor receptor 2-positive breast

2019 AIM Specialty Health

172. What is the most accurate and cost-effective direct test (ELF test, hyaluronic acid, P3NP, Fibroscan or ARFI elastography) for detecting and staging liver fibrosis and/or cirrhosis in patients with diagnosed or suspected non-alcoholic fatty liver disease,

of interest had sensitivity =70% for detection of fibrosis and cirrhosis in patients with hepatitis C or non-alcoholic fatty liver disease (NAFLD). ? In a meta-analysis of 13 studies (n=1,163) the direct imaging tests Fibroscan® and ARFI elastography had similar sensitivity and specificity for the detection of significant fibrosis and cirrhosis. ? In a meta-analysis of four studies (n=612) Fibroscan® imaging was slightly more sensitive and more specific for diagnosing cirrhosis compared with the ELF test™ (...) direct measure of fibrosis and cirrhosis. SHTG Evidence note | 6 Table 2: categories of liver fibrosis tests Category Tests* Indirect tests Fibrosis-4 (FIB4) score, aspartate transaminase: alanine transaminase (AST:ALT) ratio, AST:platelet ratio index (APRI) score, NAFLD fibrosis score Serum biomarkers (direct tests) Enhanced liver fibrosis (ELF) test™, hyaluronic acid, N-terminal propeptide type III procollagen (P3NP or PIIINP) Imaging tests (direct tests) Transient elastography (Fibroscan®

2018 Evidence Notes from Healthcare Improvement Scotland

173. Nivolumab

have questions please contact us via jon.brassey@tripdatabase.com Top results for nivolumab 1. Nivolumab (Opdivo) for Melanoma after complete resection of Stage IIIb/c or Stage IV Melanoma (adjuvant therapy) Nivolumab (Opdivo) for Melanoma after complete resection of Stage IIIb/c or Stage IV Melanoma (adjuvant therapy) ‐ NIHR Innovation Observatory ☰ Menu Search Filter by Specialty Filter by Year Nivolumab (Opdivo) for Melanoma after complete resection of Stage IIIb/c or Stage IV Melanoma (...) compared with best supportive care. {{author}} {{($index , , , , , , & . Steve J Edwards 2018 3. Nivolumab for treating squamous cell carcinoma of the head and neck after platinum-based chemotherapy Niv Nivolumab for treating squamous cell olumab for treating squamous cell carcinoma of the head and neck after carcinoma of the head and neck after platinum-based chemother platinum-based chemotherap apy y T echnology appraisal guidance Published: 22 November 2017 nice.org.uk/guidance/ta490 © NICE 2018

2018 Trip Latest and Greatest

174. Metoprolol

in patients with essential hypertension. Given intrinsic differences between these agents, we (...) hypothesized that atenolol and metoprolol succinate would have disparate effects on vascular function. This study included 24 patients with hypertension (age 56 ± 2 years, 8 female, body mass index 28 ± 1) and featured a randomized, double-blind, crossover design. Each β-blocker (atenolol or metoprolol succinate) was taken by patients once daily for a 4-week period. Measures of vascular function included (...) peripheral augmentation index (AIx) and pulse wave amplitude reactive hyperemia index from peripheral 2011 2. Metoprolol USE OF METOPROLOL IN PREGNANCY 0344 892 0909 USE OF METOPROLOL IN PREGNANCY (Date of issue: March 2016 , Version: 2 ) This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a . Please encourage all women to complete an . Summary Metoprolol is a cardioselective

2018 Trip Latest and Greatest

175. Hip fracture

the association between repositioning and pressure ulcer incidence among bed-bound elderly hip fracture patients, using data from a 2004-2007 cohort study in nine Maryland and Pennsylvania hospitals. Eligible patients (n=269) were age (...) ≥ 65 years, underwent hip fracture surgery, and were bed-bound at index study visits (during the first 5 days of hospitalization). Information about repositioning on the days of index visits was collected from patient charts; study nurses assessed presence of stage 2 (...) RCT identified methods for definitive evaluation. {{author}} {{($index , , , , , , , , , , , , , , , , , & . Nefyn H Williams 1, 2 2017 3. Internal fixation versus conservative treatment for elderly patients with a trochanteric hip fracture in conjunction with post-stroke hemiplegia. OBJECTIVE: To retrospectively evaluated Gamma nail internal fixation in the treatment of elderly patients with post-stroke hemiplegia experiencing trochanteric hip fracture . METHODS: The patients were obtained

2018 Trip Latest and Greatest

176. Carvedilol

was to compare the anti-anginal and metabolic effects of carvedilol and atenolol in patients with stable angina pectoris. A total of 89 patients (mean 2016 5. Carvedilol Compared to Metoprolol Succinate in the Treatment and Prognosis of Patients With Stable Chronic Heart Failure: The Carvedilol or Metoprolol Evaluation Study (COMES). BACKGROUND: β-Blockers exert a prognostic benefit in the treatment of chronic heart failure. Their pharmacological properties vary. The only substantial comparative trial (...) to date-the Carvedilol or Metoprolol European Trial-has compared carvedilol with short-acting metoprolol tartrate at different dose equivalents. We (...) therefore addressed the relative efficacy of equal doses of carvedilol and metoprolol succinate on survival in multicenter hospital outpatients with chronic heart failure. METHODS AND RESULTS: Four thousand sixteen patients with stable systolic chronic heart failure who were using either carvedilol or metoprolol succinate were identified

2018 Trip Latest and Greatest

177. Genetic testing for Alport syndrome

-characterised phenotype and low risk of leakage. MSAC also noted that genetic testing is accepted as the reference standard for diagnosis of AS and recognised that there was a clinical need for genetic testing to reduce the need for renal biopsy, to provide prognostic information on the expected course of the disease, and to inform family planning decisions, including from cascade testing of relatives of probands. MSAC recommended that the fee for the testing of affected individuals and the fee for cascade (...) testing should each be consistent with those for similar genetic tests for breast and ovarian cancer (MBS items 73296 and 73297 – characterisation of germline gene mutations of the BRCA1 and BRCA2 genes and one or more genes). MSAC advised that all three AS- related genes would need to be sequenced at the same time by the MBS-funded test of affected individuals. 2 MSAC recommended a review of the MBS items in two years to assess uptake and ensure that the proposed fees continue to reflect the actual

2018 Medical Services Advisory Committee

178. International evidence-based guideline for the assessment and management of polycystic ovary syndrome (PCOS)

at or before full reproductive maturity, 8 years post menarche. This includes those with PCOS features before combined oral contraceptive pill (COCP) commencement, those with persisting features and those with significant weight gain in adolescence. 1.1.4 CPP Ovulatory dysfunction can still occur with regular cycles and if anovulation needs to be confirmed serum progesterone levels can be measured. 1.2 Biochemical hyperandrogenism 1.2.1 EBR Calculated free testosterone, free androgen index or calculated (...) . In approving the guideline recommendations, NHMRC considers that they meet the NHMRC standard for clinical practice guidelines. This approval is valid for a period of five years. NHMRC is satisfied that the guideline recommendations are systematically derived, based on the identification and synthesis of the best available scientific evidence, and developed for health professionals practising in an Australian health care setting. This publication reflects the views of the authors and not necessarily

2018 European Society of Human Reproduction and Embryology

179. ESC/ESH Management of Arterial Hypertension

ARB Angiotensin receptor blocker ASCOT Anglo-Scandinavian Cardiac Outcomes Trial AV Atrioventricular BMI Body mass index BP Blood pressure bpm Beats per minute BSA Body surface area CAD Coronary artery disease CAPPP Captopril Prevention Project CCB Calcium channel blocker CHA2DS2-VASc Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, Stroke, Vascular disease, Age 65–74 years, Sex category (female) CKD Chronic kidney disease CK-MB Creatinine kinase-muscle/brain CMR Cardiac (...) obesity (measured by waist circumference) Physical inactivity Psychosocial stress, including vital exhaustion Family history of premature CVD (occurring at age <55 years in men and <60 years in women) Autoimmune and other inflammatory disorders Major psychiatric disorders Treatment for infection with human immunodeficiency virus Atrial fibrillation LV hypertrophy CKD Obstructive sleep apnoea syndrome BMI = body mass index; CKD = chronic kidney disease; CVD = cardiovascular disease; LV = left

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2018 European Society of Cardiology

180. Fourth Universal Definition of Myocardial Infarction

that showed no thrombi in the coronary arteries of 31% of deceased patients with an MI. The clinical entity was referred to as coronary thrombosis, although use of the term ‘MI’ ultimately prevailed. Over the years, several different definitions of MI have been used, leading to controversy and confusion. Hence, a general and worldwide definition for MI was needed. This occurred for the first time in the 1950–70s, when working groups from the World Health Organization (WHO) established a primarily (...) ). The categories of patients with STEMI, NSTEMI, or unstable angina are customarily included in the concept of ACS. In addition to these categories, MI may be classified into various types based on pathological, clinical, and prognostic differences, along with different treatment strategies. 7.1 Myocardial infarction type 1 MI caused by atherothrombotic coronary artery disease (CAD) and usually precipitated by atherosclerotic plaque disruption (rupture or erosion) is designated as a type 1 MI. The relative

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2018 European Society of Cardiology

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