Browsing by Subject "surveillance"

Now showing 1 - 8 of 8
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    ACR Appropriateness Criteria® Recurrent Hodgkin Lymphoma
    (Elsevier, 2016-12-15) Winkfield, Karen M.; Advani, Ranjana H.; Ballas, Leslie K.; Dabaja, Bouthaina S.; Dhakal, Sughosh; Flowers, Christopher R.; Ha, Chul Soo; Hoppe, Bradford S.; Mansur, David B.; Mendenhall, Nancy P.; Metzger, Monika L.; Plastaras, John P.; Roberts, Kenneth B.; Shapiro, Ronald; Smith, Sonali M.; Terezakis, Stephanie A.; Younes, Anas; Constine, Louis S.; Radiation Oncology, School of Medicine
    This topic addresses the management of recurrent Hodgkin lymphoma. While autologous stem cell transplantation may be appropriate for select cases of recurrent disease following comprehensive combined-modality therapy, other options exist for patients treated with lower-dose therapy for early-stage disease. Additionally, innovative targeted therapies provide newer salvage options to consider. The American College of Radiology Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation, or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. By combining the most recent medical literature and expert opinion, this revised guideline can aid clinicians in the complex decisionmaking associated with the management of recurrent Hodgkin lymphoma.
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    Aggressive Surveillance Is Needed to Detect Endoleaks and Junctional Separation between Device Components after Zenith Fenestrated Aortic Reconstruction
    (Elsevier, 2019) Wang, S. Keisin; Lemmon, Gary W.; Gupta, Alok K.; Dalsing, Michael C.; Sawchuk, Alan P.; Motaganahalli, Raghu L.; Murphy, Michael P.; Fajardo, Andres; Surgery, School of Medicine
    Background Junctional separation and resulting type IIIa endoleak is a well-known problem after EVAR (endovascular aneurysm repair). This complication results in sac pressurization, enlargement, and eventual rupture. In this manuscript, we review the incidence of this late finding in our experience with the Cook Zenith fenestrated endoprosthesis (ZFEN, Bloomington, IN). Methods A retrospective review was performed of a prospectively maintained institutional ZFEN fenestrated EVAR database capturing all ZFENs implanted at a large-volume, academic hospital system. Patients who experienced junctional separation between the fenestrated main body and distal bifurcated graft (with or without type IIIa endoleak) at any time after initial endoprosthesis implantation were subject to further evaluation of imaging and medical records to abstract clinical courses. Results In 110 ZFENs implanted from October 2012 to December 2017 followed for a mean of 1.5 years, we observed a 4.5% and 2.7% incidence of clinically significant junctional separation and type IIIa endoleak, respectively. Junctional separation was directly related to concurrent type Ib endoleak in all 5 patients. Three patients presented with sac enlargement. One patient did not demonstrate any evidence of clinically significant endoleak and had a decreasing sac size during follow-up imaging. The mean time to diagnosis of modular separation in these patients was 40 months. Junctional separation was captured in surveillance in 2 patients and reintervened upon before manifestation of endoleak. However, the remaining 3 patients completed modular separation resulting in rupture and emergent intervention in 2 and an aortic-related mortality in the other. Conclusions Junctional separation between the fenestrated main and distal bifurcated body with the potential for type IIIa endoleak is an established complication associated with the ZFEN platform. Therefore, we advocate for maximizing aortic overlap during the index procedure followed by aggressive surveillance and treatment of stent overlap loss captured on imaging.
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    Evaluation of fluoride and calcium concentrations in drinking water from public water fountains on a university campus
    (AGD, 2022-11) Tamayo-Cabeza, Guillermo; Lippert, Frank; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    Optimal exposure to fluoride and calcium from tap water is beneficial for dental caries prevention. Water fountains may be an important source of drinking water in work and educational settings. The aims of this study were to quantify the fluoride and calcium concentrations of drinking water samples collected from public water fountains on the Indiana University-Purdue University Indianapolis campus; compare the fluoride and calcium concentrations in water collected at 2 different times; and determine whether the presence or absence of a visible external filter affects fluoride and calcium concentrations. Ninety samples were collected from 45 water fountains accessible to the public, and 90 duplicate samples were collected 1 month later. A fluoride ion-selective electrode was used in conjunction with an ion-specific meter to determine fluoride concentration, while atomic absorption spectrometry in an air-acetylene flame was implemented to quantify the calcium concentration. The fluoride and calcium concentration of drinking water samples displayed ranges of 0.62 mg/L to 0.97 mg/L and 56.61 mg/L to 89.11 mg/L, respectively. The concentrations of fluoride and calcium in drinking water were slightly lower at the second collection period (P < 0.001; Wilcoxon signed rank test). No statistically significant differences were observed in the fluoride or calcium concentration of drinking water collected from water fountains with an external filter cartridge in comparison with fountains that did not have a filter. Fluoride concentrations were within the optimal range recommended by the US Public Health Service for fluoridated drinking water, and calcium concentrations were consistent with those reported in previous surveillance studies.
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    Monitoring patients with eosinophilic esophagitis in routine clinical practice - International Expert Recommendations
    (Elsevier, 2023) von Arnim, Ulrike; Biedermann, Luc; Aceves, Seema S.; Bonis, Peter A.; Collins, Margaret H.; Dellon, Evan S.; Furuta, Glenn T.; Gonsalves, Nirmala; Gupta, Sandeep; Hirano, Ikuo; Lucendo, Alfredo J.; Miehlke, Stephan; Oliva, Salvatore; Schlag, Christoph; Schoepfer, Alain; Straumann, Alex; Vieth, Michael; Bredenoord, Albert J.; Pediatrics, School of Medicine
    Background & Aims There are no studies or recommendations on optimal monitoring strategies for patients with eosinophilic esophagitis (EoE). Our objective was to develop guidance on how to monitor EoE patients in routine clinical practice, on the basis of available clinical evidence and expert opinion. Methods A multidisciplinary, international group of EoE experts identified the following important three questions during several consensus meetings: why, by what means and when to monitor EoE patients. A steering committee was named and three teams were formed to review literature and to formulate statements for each topic. In a Delphi survey a level of agreement of ≥75% was defined as threshold value for acceptance. In a final conference, results were presented, critical points and comments on the statements were discussed and statements were rephrased/rewritten if necessary. Results 18 EoE experts (14 adult and pediatric gastroenterologists, 2 pathologists and 2 allergists) with a median of 21.7 years in clinical practice, mostly academic or university- based, completed the Delphi survey, which included 11 statements and a proposed algorithm for monitoring EoE patients. Each statement attained ≥75% agreement. Participants discussed and debated mostly about the statement concerning surveillance intervals for EoE patients with stable disease. Conclusions It was concluded that effective maintenance treatment probably reduces the development of EoE complications, and regular, structured and under certain conditions individualized clinical follow-up is recommended to assess disease activity while opening a window to monitoring side-effects, adjusting therapy and encouraging adherence to treatment. Follow-up should comprise symptom assessment and periodic or repeated endoscopy with histological assessment in specific EoE settings.
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    Population-Level Effects of Human Papillomavirus Vaccination Programs on Infections with Nonvaccine Genotypes.
    (CDC, 2016-10) Mesher, David; Soldan, Kate; Lehtinen, Matti; Beddows, Simon; Brisson, Marc; Brotherton, Julia M. L.; Chow, Eric P. F.; Cummings, Teresa; Drolet, Mélanie; Fairley, Christopher K.; Garland, Suzanne M.; Kahn, Jessica A.; Kavanagh, Kimberley; Markowitz, Lauri; Pollock, Kevin G.; Söderlund-Strand, Anna; Sonnenberg, Pam; Tabrizi, Sepehr N.; Tanton, Clare; Unger, Elizabeth; Thomas, Sara L.; Department of Pediatrics, IU School of Medicine
    After introduction of vaccination, some prevalences of nonvaccine types changed, without clear evidence for type replacement.
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    The spectrum of respiratory pathogens among returning Hajj pilgrims: myths and reality
    (Elsevier, 2016-06) Gautret, Phillipe; Benkouiten, Samir; Al-Tawfiq, Jaffar A.; Memish, Ziad A.; Department of Medicine, IU School of Medicine
    Enhanced surveillance systems have been implemented recently in many countries in order to rapidly detect and investigate any possible cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection among travellers returning from the Middle East, including notably Hajj pilgrims. According to the available surveillance data, only a few sporadic travel-associated MERS-CoV cases have been reported outside the Arabian Peninsula so far, mainly in Europe, North Africa, and Asia. These have resulted in no cases, or limited numbers of secondary cases except in Korea. The vast majority of viral respiratory infections in pilgrims returning home have been due to seasonal influenza viruses, rhinoviruses, and other known coronaviruses distinct from the MERS coronavirus. Influenza vaccination should be a priority for all Hajj pilgrims, as recommended by experts.
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    Tailoring Surveillance Colonoscopy in Patients with Advanced Adenomas
    (Elsevier, 2021) Kahi, Charles J.; Myers, Laura J.; Stump, Timothy E.; Imler, Timothy D.; Sherer, Eric A.; Larson, Jason; Imperiale, Thomas F.; Medicine, School of Medicine
    Background and Aims Patients with advanced colorectal adenomas (AA) are directed to undergo intensive surveillance. However, the benefit derived from surveillance may be outweighed by the risk of death from non-colorectal cancer (CRC) causes, leading to uncertainty on how best to individualize follow-up. The aim of this study was to derive a risk prediction model and risk index that estimates and stratifies the risk for non-colorectal cancer mortality (NCM) subsequent to diagnosis and removal of AA. Methods We conducted a retrospective cohort study of Veterans > 40 years who had colonoscopy for diagnostic or screening indications at 13 VAMCs between 2002 and 2009, and had one or more AAs. The primary outcome was non-CRC mortality (NCM) using a fixed follow-up time period of 5 years. Logistic regression using the lasso technique was used to identify factors independently associated with non-CRC mortality (NCM), and an index based on points from regression coefficients was constructed to estimate risk of 5-year NCM. Results We identified 2,943 Veterans with AA (mean age (SD) 63 (8.6) years, 98% male, 74% white), with an overall 5-year mortality of 16.7%, which was nearly all due to NCM (16.6%). Age, comorbidity burden, specific comorbid conditions, and hospitalization within the preceding year were independently associated with NCM. The risk prediction model had a goodness of fit (calibration) p-value of 0.41, and c-statistic (discrimination) of 0.74 (95% CI, 0.71-0.76). Based on comparable 5-year risks of NCM, the scores comprised 3 risk categories: low (score of 0-1), intermediate (score of 2-4) and high (score of ≥ 5), in which NCM occurred in 6.5%, 14.1%, and 33.2%, respectively. Conclusions We derived a risk prediction model that identifies Veterans at high risk of NCM within 5 years, and who are thus unlikely to benefit from further surveillance.
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    Using Information Entropy to Monitor Chief Complaint Characteristics and Quality
    (2013) Grannis, Shaun J; Dixon, Brian E.; Xia, Yuni; Wu, Jianmin
    As we enter the 'big medical data' era, a new core competency is to continuously monitor quality of data collected from electronic sources, including population surveillance data sources. We describe how entropy, a fundamental information measure, can help monitor the characteristics of chief complaints in an operational surveillance system.