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1.
Sensors (Basel) ; 22(22)2022 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-36433469

RESUMEN

This paper focuses on the classification of seven locomotion modes (sitting, standing, level ground walking, ramp ascent and descent, stair ascent and descent), the transitions among these modes, and the gait phases within each mode, by only using data in the frequency domain from one or two inertial measurement units. Different deep neural network configurations are investigated and compared by combining convolutional and recurrent layers. The results show that a system composed of a convolutional neural network followed by a long short-term memory network is able to classify with a mean F1-score of 0.89 and 0.91 for ten healthy subjects, and of 0.92 and 0.95 for one osseointegrated transfemoral amputee subject (excluding the gait phases because they are not labeled in the data-set), using one and two inertial measurement units, respectively, with a 5-fold cross-validation. The promising results obtained in this study pave the way for using deep learning for the control of transfemoral prostheses with a minimum number of inertial measurement units.


Asunto(s)
Amputados , Marcha , Humanos , Locomoción , Caminata , Redes Neurales de la Computación
2.
Crit Care Med ; 47(2): e120-e128, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30335623

RESUMEN

OBJECTIVES: Historically, patients with a hematologic malignancy have one of the highest mortality rates among cancer patients admitted to the ICU. Therefore, physicians are often reluctant to admit these patients to the ICU. The aim of our study was to examine the survival of patients who have a hematologic malignancy and multiple organ failure admitted to the ICU. DESIGN: This retrospective cohort study, part of the HEMA-ICU study group, was designed to study the survival of patients with a hematologic malignancy and organ failure after admission to the ICU. Patients were followed for at least 1 year. SETTING: Five university hospitals in the Netherlands. PATIENTS: One-thousand ninety-seven patients with a hematologic malignancy who were admitted at the ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Primary outcome was 1-year survival. Organ failure was categorized as acute kidney injury, respiratory failure, hepatic failure, and hemodynamic failure; multiple organ failure was defined as failure of two or more organs. The World Health Organization performance score measured 3 months after discharge from the ICU was used as a measure of functional outcome. The 1-year survival rate among these patients was 38%. Multiple organ failure was inversely associated with long-term survival, and an absence of respiratory failure was the strongest predictor of 1-year survival. The survival rate among patients with 2, 3, and 4 failing organs was 27%, 22%, and 8%, respectively. Among all surviving patients for which World Health Organization scores were available, 39% had a World Health Organization performance score of 0-1 3 months after ICU discharge. Functional outcome was not associated with the number of failing organs. CONCLUSIONS: Our results suggest that multiple organ failure should not be used as a criterion for excluding a patient with a hematologic malignancy from admission to the ICU.


Asunto(s)
Neoplasias Hematológicas/mortalidad , Unidades de Cuidados Intensivos/estadística & datos numéricos , Insuficiencia Multiorgánica/mortalidad , Femenino , Neoplasias Hematológicas/complicaciones , Neoplasias Hematológicas/terapia , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica/complicaciones , Insuficiencia Multiorgánica/terapia , Países Bajos/epidemiología , Estudios Retrospectivos , Análisis de Supervivencia , Resultado del Tratamiento
3.
Skeletal Radiol ; 48(2): 227-237, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29980827

RESUMEN

OBJECTIVES: Intra-articular steroid injection (IASI) is an effective therapy for hip osteoarthritis (OA), but carries risks and provides significant pain relief to only two thirds of patients. We attempted to predict response to IASI in hip OA patients using baseline clinical, ultrasound, and MRI data. METHODS: Observational study of 97 subjects with symptomatic hip OA presenting for IASI. At baseline and 8 weeks we obtained hip MRI, grayscale and Doppler ultrasound, clinical range of motion (ROM), timed-up and go test (TUG) scores, and self-reported Western Ontario and McMaster Universities Osteoarthritis (WOMAC) pain, stiffness, and function scores. Bone-capsule distance (BCD) measurements of inflammation on hip ultrasound and MRI were measured at three locations: the proximal-most uncovered portion of the femoral head, the superficial-most (apex) portion of the femoral head, and the largest fluid pocket at the femoral neck. RESULTS: Ultrasound and MRI BCD correlated with each other significantly and strongly at the apex and neck. Power Doppler findings did not correlate significantly with any other imaging indices. Eight weeks post-injection, WOMAC pain, function, and stiffness scores significantly improved and TUG time improved nearly to the level of significance, but there were no significant changes in ultrasound, MRI, or Doppler indices. Baseline variables were not significantly different between responder and nonresponder WOMAC pain or TUG time cohorts. CONCLUSION: Basic measures of inflammation on ultrasound and MRI are highly related to each other, but provide little insight into patient function and pain after IASI. Other mechanisms to explain improvement in patient status after IASI are likely at work.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Osteoartritis de la Cadera/diagnóstico por imagen , Osteoartritis de la Cadera/tratamiento farmacológico , Manejo del Dolor/métodos , Esteroides/administración & dosificación , Ultrasonografía Doppler/métodos , Adulto , Anciano , Anciano de 80 o más Años , Medios de Contraste , Femenino , Humanos , Interpretación de Imagen Asistida por Computador , Inyecciones Intraarticulares , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Rango del Movimiento Articular , Índice de Severidad de la Enfermedad , Sinovitis , Resultado del Tratamiento
4.
AIDS Behav ; 22(3): 733-741, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-28190116

RESUMEN

The World Health Organization recommends early initiation of HIV antiretroviral therapy (ART) for all those infected with the virus at any CD4 count. Successfully reaching individuals with relatively high CD4 counts depends in large part on healthy individuals seeking testing and treatment; however, little is known about factors motivating this decision. We conducted a qualitative study to explore this issue among 25 young HIV-positive adults (age 18-35) with a CD4 count >350 cells/mm3 who recently started or made the decision to start ART in Gugulethu, South Africa. Using an inductive content analytical approach, we found that most individuals sought testing and treatment early in the disease progression because of a desire to appear healthy thereby avoiding stigma associated with AIDS. Other factors included social support, responsibilities and aspirations, normalcy of having HIV, and accessible services. These findings suggest that maintenance of physical appearance should be included in the development of novel testing and treatment interventions.


Asunto(s)
Infecciones por VIH/diagnóstico , Accesibilidad a los Servicios de Salud , Tamizaje Masivo/métodos , Motivación , Serodiagnóstico del SIDA , Antirretrovirales/uso terapéutico , Recuento de Linfocito CD4 , Progresión de la Enfermedad , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Humanos , Entrevistas como Asunto , Masculino , Investigación Cualitativa , Estigma Social , Apoyo Social , Sudáfrica/epidemiología , Adulto Joven
5.
J Appl Microbiol ; 124(1): 97-107, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29080234

RESUMEN

AIMS: To rationalize confusion in the literature concerning the analysis of combined antimicrobials, specifically to see if the combination index (CI) method of analysis was as rigorous as claimed. METHODS AND RESULTS: Data from previous studies of the inhibition of Staphylococcus aureus by mixed antimicrobials were re-analysed using the CI method and a model which takes account of differences in the concentration exponents of individual antimicrobials. CONCLUSIONS: The Chou-Talalay combination index method for the analysis of combined antimicrobials was found to be valid only in the specific cases where concentration exponents were equal. In these cases, the CI method was found to be a function of the residuals of fitting the additive model to the observed data. Where concentration exponents were not equal, the CI method was invalid, whereas the additive model took these differences into account. SIGNIFICANCE AND IMPACT OF STUDY: The CI method can be replaced wholly by the additive model described. The model allows simple regression to be used to analyse whole data sets and provides simple graphical output.


Asunto(s)
Antiinfecciosos/farmacología , Sinergismo Farmacológico , Modelos Teóricos , Farmacorresistencia Bacteriana , Humanos , Pruebas de Sensibilidad Microbiana , Staphylococcus aureus
6.
BMC Med Educ ; 18(1): 89, 2018 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-29720143

RESUMEN

BACKGROUND: The future of dental education is at crossroads. This study used the parameter of the 2016 Dental Curriculum Hack-a-Thon to assess intra- and inter-institutional agreement between student and faculty views regarding dental curriculums to determine if there is an impact in student perceptions towards dental education from before and after the event. METHODS: This exploratory, cross-sectional study involved two surveys, with Survey 1 being distributed among four faculty-student pairs of the four participating dental schools answering 14 questions. Survey 2 assessed the views of 20 participating dental students through 26 questions in a pre- and post- event survey design. Descriptive statistics were used to explore differences in perceptions towards dental education across both instrument surveys. RESULTS: The results revealed valuable student insights regarding intra- and inter-institutional agreement relevant for the change in dental curriculum that needs to occur. Survey 2 revealed that mandatory attendance in didactic courses, electronic based examination preferences, and the preference of preclinical courses being held in the first and second years of a four-year dental curriculum were of particular importance to student participants. CONCLUSIONS: The results of this study indicate that exposure and participation in subjects pertaining to dental education can be influential on student preferences and opinions on how dental education should be delivered in a four-year curriculum.


Asunto(s)
Curriculum , Educación en Odontología/métodos , Docentes de Odontología , Retroalimentación Formativa , Estudiantes de Odontología , Estudios Transversales , Educación en Odontología/organización & administración , Educación en Odontología/tendencias , Humanos , New England , Distribución Aleatoria , Facultades de Odontología , Encuestas y Cuestionarios , Factores de Tiempo
7.
Clin Exp Allergy ; 47(6): 829-837, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28516451

RESUMEN

BACKGROUND: It has been proposed that the frequent ingestion of baked hen's egg or cow's milk accelerates the resolution of hen's egg or cow's milk allergy. This practice is being introduced into clinical practice. OBJECTIVE: To systematically review the evidence to determine whether the introduction of baked hen's egg or cow's milk into the diet of children with hen's egg or cow's milk allergies respectively leads to a larger proportion of children outgrowing these allergies than expected. METHODS: A systematic review of the literature was conducted in Medline, Embase and CINAHL. The inclusion criteria were as follows: randomized control trials, case-control or cohort studies; children aged 0-18 years with hen's egg or cow's milk allergy; baked hen's egg or cow's milk intervention with or without a comparator; and resolution of the hen's egg or cow's milk allergy as determined by food challenge as the outcome. Studies were critically appraised using the quality assessment tool for quantitative studies. PROSPERO reference CRD42015026029. RESULTS: We identified 851 and 2816 hen's egg and cow's milk articles respectively. Only three hen's egg and three cow's milk studies fulfilled our pre-specified inclusion criteria. The studies concluded that baked products either increased the likelihood of the resolution of allergy or accelerated resolution. However, when critiqued, all studies were classified as weak because they were observational, lacking an appropriate control group; this brings into doubt the study's conclusions. There were a number of examples of severe reactions to baked products. CONCLUSION: There is little evidence to address the hypothesis that the ingestion of baked hen's egg or cow's milk results in more patients outgrowing their hen's egg or cow's milk allergy respectively. Data are required from a trial comparing the resolution rates of baked-tolerant participants who are randomized to ingest or avoid baked products to assess the accuracy of this hypothesis.


Asunto(s)
Culinaria , Dieta , Hipersensibilidad al Huevo , Hipersensibilidad a la Leche , Humanos
8.
Osteoarthritis Cartilage ; 24(7): 1143-52, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-26836288

RESUMEN

OBJECTIVE: To evaluate the efficacy of intra-articular (IA) glucocorticoids for knee or hip osteoarthritis (OA) in specific subgroups of patients with severe pain and inflammatory signs using individual patient data (IPD) from existing trials. DESIGN: Randomized trials evaluating one or more IA glucocorticoid preparation in patients with knee or hip OA, published from 1995 up to June 2012 were selected from the literature. IPD obtained from original trials included patient and disease characteristics and outcomes measured. The primary outcome was pain severity at short-term follow-up (up to 4 weeks). The subgroup factors assessed included severe pain (≥70 points, 0-100 scale) and signs of inflammation (dichotomized in present or not) at baseline. Multilevel regression analyses were applied to estimate the magnitude of the effects in the subgroups with the individuals nested within each study. RESULTS: Seven out of 43 published randomized clinical trials (n = 620) were included. Patients with severe baseline pain had a significantly larger reduction in short-term pain, but not in mid- and long-term pain, compared to those with less severe pain at baseline (Mean Difference 13.91; 95% Confidence Interval 1.50-26.31) when receiving IA glucocorticoid injection compared to placebo. No statistical significant interaction effects were found between inflammatory signs and IA glucocorticoid injections compared to placebo and to tidal irrigation at all follow-up points. CONCLUSIONS: This IPD meta-analysis demonstrates that patients with severe knee pain at baseline derive more benefit from IA glucocorticoid injection at short-term follow-up than those with less severe pain at baseline.


Asunto(s)
Osteoartritis de la Cadera , Glucocorticoides , Humanos , Inyecciones Intraarticulares , Articulación de la Rodilla , Osteoartritis de la Rodilla , Dolor , Ensayos Clínicos Controlados Aleatorios como Asunto
9.
J Appl Microbiol ; 118(1): 161-74, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25393511

RESUMEN

AIMS: To explore the predictions of a novel rearrangement of the Baranyi-Roberts model (BRM) with time to detection data obtained from optical density data of microbial growth. METHODS AND RESULTS: Growth of Escherichia coli and Salmonella Typhimurium under mild conditions of temperature (25-37°C), salt (0·086, 0·51 and 1·03 mol l(-1)) and pH (6·85-4·5) was examined using optical density. Time to detection (TTD) data were fitted to a model based on a rearrangement of the BRM. Observations showed compatibility with standard viable count studies and produced highly accurate specific growth rates and lag phase durations. At high salt and low pH, however, there was a substantial dependency on the initial inoculum for the observation of visible growth. At 30 and 37°C, with 1·03 mol l(-1) salt, and at pH <5·75, no visible growth was recorded for E. coli at initial inoculum levels below 10(7) CFU ml(-1). CONCLUSIONS: The rearranged BRM can be used directly with TTD data obtained from optical density measurements. SIGNIFICANCE AND IMPACT OF THE STUDY: A distinct advantage of the rearranged model is that it allows for a very simple interpretation of easily obtainable data using standard nonlinear regression. The rearranged model gives to TTD data the same modelling capability that the BRM gives to plate count data.


Asunto(s)
Escherichia coli/crecimiento & desarrollo , Modelos Biológicos , Salmonella typhimurium/crecimiento & desarrollo , Escherichia coli/efectos de los fármacos , Concentración de Iones de Hidrógeno , Salmonella typhimurium/efectos de los fármacos , Cloruro de Sodio/farmacología , Temperatura
10.
J Oral Maxillofac Surg ; 73(10): 1901-6, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25896566

RESUMEN

PURPOSE: Video laryngoscopy (VL) is an innovation in tracheal intubation that could be beneficial in an emergency situation. However, the technique could be detrimental if it prolongs intubation performed by an inexperienced physician. The purpose of this study was to compare direct laryngoscopy (DL) with VL skill for oral and maxillofacial surgery (OMS) residents and practitioners to assess the practicality of recommending the inclusion of VL as a component of OMS emergency airway management. MATERIALS AND METHODS: To address the research purpose, the authors designed and implemented a randomized crossover study investigating the performance of OMS residents and practitioners to intubate a mannequin using DL versus VL. The predictor variables were the experience level of the participants and their ability to intubate with DL and with VL. The outcome variables were time to view cords, the Cormack-Lehane glottis view achieved, the time to intubate the mannequin, and the total time for performing laryngoscopy and intubation. Comparisons of laryngoscopy and intubation and resident and practitioner experiences were compared using Cox proportional hazards survival analysis. RESULTS: Data from 22 OMS residents and 26 practitioners were assessed. The comparison outcomes between DL and VL showed that the time to view cords was shorter for VL, the Cormack-Lehane glottis view was better for VL, the time to intubate was shorter for DL, and the total time between techniques was not statistically different. OMS practitioners showed better times than OMS residents and showed adeptness with VL that was comparable to DL. CONCLUSION: The combined findings with OMS residents and practitioners showed comparable total intubating times between DL and VL, which is consistent with what has previously been reported with other medical colleagues.


Asunto(s)
Intubación Intratraqueal/métodos , Laringoscopía/métodos , Maniquíes , Grabación de Cinta de Video , Estudios Cruzados , Humanos
11.
J Am Chem Soc ; 136(14): 5291-4, 2014 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-24628021

RESUMEN

Herein, we describe an operationally straightforward radiosynthesis of a chiral transition metal fluoride catalyst, [(18)F](salen)CoF, and its use for late-stage enantioselective aliphatic radiofluorination. We demonstrate the utility of the method by preparing single enantiomer experimental and clinically validated PET tracers that contain base-sensitive functional groups, epimerizable stereocenters, and nitrogen-rich motifs. Unlike the conventional radiosyntheses of these targets with [(18)F]KF, labeling with (salen)CoF is possible in the last step and under exceptionally mild conditions. These results constitute a rare example of a nucleophilic radiofluorination using a transition metal fluoride and highlight the potential of such reagents to enhance traditional methods for labeling aliphatic hydrocarbons.


Asunto(s)
Hidrocarburos Fluorados/química , Compuestos Organometálicos/síntesis química , Tomografía de Emisión de Positrones , Cobalto/química , Radioisótopos de Flúor , Estructura Molecular , Compuestos Organometálicos/química , Estereoisomerismo
12.
Osteoarthritis Cartilage ; 22(10): 1639-50, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25278073

RESUMEN

OBJECTIVE: We sought to develop a comprehensive scoring system for evaluation of pre-clinical models of osteoarthritis (OA) progression, and use this to evaluate two different classes of drugs for management of OA. METHODS: Post-traumatic OA (PTOA) was surgically induced in skeletally mature rats. Rats were randomly divided in three groups receiving either glucosamine (high dose of 192 mg/kg) or celecoxib (clinical dose) or no treatment. Disease progression was monitored utilizing micro-magnetic resonance imaging (MRI), micro-computed tomography (CT) and histology. Pertinent features such as osteophytes, subchondral sclerosis, joint effusion, bone marrow lesion (BML), cysts, loose bodies and cartilage abnormalities were included in designing a sensitive multi-modality based scoring system, termed the rat arthritis knee scoring system (RAKSS). RESULTS: Overall, an inter-observer correlation coefficient (ICC) of greater than 0.750 was achieved for each scored feature. None of the treatments prevented cartilage loss, synovitis, joint effusion, or sclerosis. However, celecoxib significantly reduced osteophyte development compared to placebo. Although signs of inflammation such as synovitis and joint effusion were readily identified at 4 weeks post-operation, we did not detect any BML. CONCLUSION: We report the development of a sensitive and reliable multi-modality scoring system, the RAKSS, for evaluation of OA severity in pre-clinical animal models. Using this scoring system, we found that celecoxib prevented enlargement of osteophytes in this animal model of PTOA, and thus it may be useful in preventing OA progression. However, it did not show any chondroprotective effect using the recommended dose. In contrast, high dose glucosamine had no measurable effects.


Asunto(s)
Inhibidores de la Ciclooxigenasa 2/uso terapéutico , Modelos Animales de Enfermedad , Osteoartritis de la Rodilla/diagnóstico , Osteoartritis de la Rodilla/tratamiento farmacológico , Pirazoles/uso terapéutico , Sulfonamidas/uso terapéutico , Animales , Ligamento Cruzado Anterior/cirugía , Quistes Óseos/diagnóstico , Quistes Óseos/tratamiento farmacológico , Quistes Óseos/etiología , Enfermedades de la Médula Ósea/diagnóstico , Enfermedades de la Médula Ósea/tratamiento farmacológico , Enfermedades de la Médula Ósea/etiología , Cartílago Articular/diagnóstico por imagen , Cartílago Articular/patología , Celecoxib , Progresión de la Enfermedad , Glucosamina/uso terapéutico , Traumatismos de la Rodilla , Imagen por Resonancia Magnética , Osteoartritis de la Rodilla/etiología , Osteofito/diagnóstico , Osteofito/tratamiento farmacológico , Osteofito/etiología , Ratas , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Sinovitis/diagnóstico , Sinovitis/tratamiento farmacológico , Sinovitis/etiología , Microtomografía por Rayos X
13.
Artículo en Inglés | MEDLINE | ID: mdl-38198271

RESUMEN

This paper leverages the OpenSim physics-based simulation environment for the forward dynamic simulation of an osseointegrated transfemoral amputee musculoskeletal model, wearing a generic prosthesis. A deep reinforcement learning architecture, which combines the proximal policy optimization algorithm with imitation learning, is designed to enable the model to walk by using three different observation states. The first is a complete state that includes the agent's kinematics, ground reaction forces, and muscle data; the second is a reduced state that only includes the kinematics and ground reaction forces; the third is an augmented state that combines the kinematics and ground reaction forces with a prediction of the muscle data generated by a fully-connected feed-forward neural network. The empirical results demonstrate that the model trained with the augmented observation state can achieve walking patterns with rewards and gait symmetry ratings comparable to those of the model trained with the complete observation state, while there are no symmetric walking patterns when using the reduced observation state. This paper shows the importance of including muscle data in a deep reinforcement learning architecture for the forward dynamic simulation of musculoskeletal models of transfemoral amputees.


Asunto(s)
Amputados , Miembros Artificiales , Humanos , Caminata/fisiología , Marcha/fisiología , Fenómenos Biomecánicos
14.
Clin Radiol ; 68(8): 785-91, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23561226

RESUMEN

AIM: To analyse the imaging findings at the sterno-costo-clavicular (SCC) joint region using whole-body (WB) magnetic resonance imaging (MRI) in healthy individuals to minimize misinterpretation as changes due to spondyloarthritis (SpA). MATERIALS AND METHODS: As part of a cross-sectional study of 122 SpA patients, 75 healthy individuals (42/33 males/females; median age 30.3 years; range 17.7-63.8 years) were scanned using sagittal and coronal WB short tau inversion recovery (STIR) and T1-weighted MRI sequences. The SCC region was analysed independently by seven readers for bone marrow oedema (BMO), erosions, subchondral fat signal intensity (FSI), and joint fluid accumulation. RESULTS: SCC changes simulating inflammation were reported by four or more of the seven readers in 15 (20%) healthy individuals (12 male/three female; median age 32.1 years; range 20.2-48 years). Thirteen individuals (17%) had changes at the manubriosternal joint (MSJ); five had BMO, one BMO + erosion, four erosion, two erosion + FSI, and one FSI only. Changes at the sternoclavicular joint occurred in three individuals (4%) encompassing erosion, erosion + FSI + BMO, and joint fluid accumulation, respectively. One patient had both MSJ and sternoclavicular joint changes. CONCLUSIONS: Findings mimicking inflammatory changes occurred in healthy individuals, particularly in the MSJ. Awareness of this is important in recognition of SCC inflammation in SpA.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Espondiloartritis/diagnóstico , Articulación Esternoclavicular/patología , Imagen de Cuerpo Entero , Adolescente , Adulto , Enfermedades Asintomáticas , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Articulación Esternoclavicular/anatomía & histología
15.
Endoscopy ; 44 Suppl 3: SE106-15, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23012114

RESUMEN

Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on professional requirements and training includes 23 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of surveillance and other elements in the screening process, including multi-disciplinary diagnosis and management of the disease.


Asunto(s)
Competencia Clínica/normas , Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer/normas , Tamizaje Masivo/organización & administración , Grupo de Atención al Paciente/normas , Garantía de la Calidad de Atención de Salud , Neoplasias Colorrectales/prevención & control , Educación Médica Continua/normas , Educación Continua en Enfermería/normas , Unión Europea , Humanos , Tamizaje Masivo/normas , Grupo de Atención al Paciente/organización & administración , Garantía de la Calidad de Atención de Salud/métodos , Garantía de la Calidad de Atención de Salud/organización & administración
16.
Endoscopy ; 44 Suppl 3: SE116-30, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23012115

RESUMEN

Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in pathology in colorectal cancer screening and diagnosis includes 23 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of the screening process, including multi-disciplinary diagnosis and management of the disease.


Asunto(s)
Adenocarcinoma/patología , Adenoma/patología , Pólipos del Colon/patología , Neoplasias Colorrectales/patología , Detección Precoz del Cáncer/normas , Tamizaje Masivo/normas , Garantía de la Calidad de Atención de Salud , Adenocarcinoma/prevención & control , Pólipos Adenomatosos/patología , Neoplasias Colorrectales/prevención & control , Detección Precoz del Cáncer/métodos , Unión Europea , Humanos , Mucosa Intestinal/patología , Tamizaje Masivo/métodos , Tamizaje Masivo/organización & administración , Clasificación del Tumor , Invasividad Neoplásica , Estadificación de Neoplasias , Garantía de la Calidad de Atención de Salud/métodos , Garantía de la Calidad de Atención de Salud/organización & administración , Manejo de Especímenes/métodos , Manejo de Especímenes/normas
17.
Endoscopy ; 44 Suppl 3: SE131-9, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23012116

RESUMEN

Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in pathology was supplemented by an annex describing in greater detail some issues raised in the chapter, particularly details of special interest to pathologists. The content of the annex is presented here to promote international discussion and collaboration by making the issues discussed in the guidelines known to a wider professional and scientific community.


Asunto(s)
Adenocarcinoma/patología , Adenoma/patología , Pólipos del Colon/patología , Neoplasias Colorrectales/patología , Detección Precoz del Cáncer/normas , Tamizaje Masivo/normas , Garantía de la Calidad de Atención de Salud , Adenocarcinoma/prevención & control , Adenoma/clasificación , Pólipos del Colon/clasificación , Neoplasias Colorrectales/clasificación , Neoplasias Colorrectales/prevención & control , Detección Precoz del Cáncer/métodos , Unión Europea , Humanos , Mucosa Intestinal/patología , Clasificación del Tumor , Invasividad Neoplásica , Terminología como Asunto
18.
Endoscopy ; 44 Suppl 3: SE140-50, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23012117

RESUMEN

Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on management of lesions detected in colorectal cancer screening includes 32 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of the screening process, including multi-disciplinary diagnosis and management of the disease.


Asunto(s)
Adenocarcinoma/terapia , Neoplasias Colorrectales/terapia , Detección Precoz del Cáncer/normas , Tamizaje Masivo/normas , Lesiones Precancerosas/terapia , Garantía de la Calidad de Atención de Salud , Adenocarcinoma/diagnóstico , Adenocarcinoma/prevención & control , Adenoma/diagnóstico , Adenoma/terapia , Pólipos del Colon/diagnóstico , Pólipos del Colon/terapia , Colonoscopía/normas , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/prevención & control , Terapia Combinada/métodos , Terapia Combinada/normas , Unión Europea , Humanos , Lesiones Precancerosas/diagnóstico
19.
Endoscopy ; 44 Suppl 3: SE151-63, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23012119

RESUMEN

Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on colonoscopic surveillance following adenoma removal includes 24 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of surveillance and other elements in the screening process, including multi-disciplinary diagnosis and management of the disease.


Asunto(s)
Adenoma/cirugía , Pólipos del Colon/cirugía , Colonoscopía/normas , Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer/normas , Vigilancia de la Población/métodos , Garantía de la Calidad de Atención de Salud , Adenocarcinoma/diagnóstico , Adenocarcinoma/prevención & control , Adenoma/patología , Pólipos del Colon/patología , Colonoscopía/métodos , Neoplasias Colorrectales/prevención & control , Neoplasias Colorrectales/cirugía , Detección Precoz del Cáncer/métodos , Unión Europea , Adhesión a Directriz/normas , Humanos , Garantía de la Calidad de Atención de Salud/métodos , Garantía de la Calidad de Atención de Salud/organización & administración , Mejoramiento de la Calidad , Recurrencia , Medición de Riesgo
20.
Endoscopy ; 44 Suppl 3: SE88-105, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23012124

RESUMEN

Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in endoscopy includes 50 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of endoscopy and other elements in the screening process, including multidisciplinary diagnosis and management of the disease.


Asunto(s)
Colonoscopía/normas , Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer/normas , Tamizaje Masivo/normas , Garantía de la Calidad de Atención de Salud , Citas y Horarios , Competencia Clínica , Colonoscopía/instrumentación , Colonoscopía/métodos , Neoplasias Colorrectales/prevención & control , Sedación Consciente/normas , Detección Precoz del Cáncer/métodos , Unión Europea , Humanos , Consentimiento Informado/normas , Tamizaje Masivo/métodos , Tamizaje Masivo/organización & administración , Evaluación de Procesos y Resultados en Atención de Salud , Seguridad del Paciente , Garantía de la Calidad de Atención de Salud/métodos , Garantía de la Calidad de Atención de Salud/organización & administración , Mejoramiento de la Calidad , Sigmoidoscopía/instrumentación , Sigmoidoscopía/métodos , Sigmoidoscopía/normas
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