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BMC Medicine

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https://www.readbyqxmd.com/read/29347988/efficacy-of-melatonin-for-sleep-disturbance-following-traumatic-brain-injury-a-randomised-controlled-trial
#1
Natalie A Grima, Shantha M W Rajaratnam, Darren Mansfield, Tracey L Sletten, Gershon Spitz, Jennie L Ponsford
BACKGROUND: The study aimed to determine the efficacy of melatonin supplementation for sleep disturbances in patients with traumatic brain injury (TBI). METHODS: This is a randomised double-blind placebo-controlled two-period two-treatment (melatonin and placebo) crossover study. Outpatients were recruited from Epworth and Austin Hospitals Melbourne, Australia. They had mild to severe TBI (n = 33) reporting sleep disturbances post-injury (mean age 37 years, standard deviation 11 years; 67% men)...
January 19, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29347975/single-low-dose-primaquine-for-blocking-transmission-of-plasmodium-falciparum-malaria-a-proposed-model-derived-age-based-regimen-for-sub-saharan-africa
#2
W Robert Taylor, Htee Khu Naw, Kathryn Maitland, Thomas N Williams, Melissa Kapulu, Umberto D'Alessandro, James A Berkley, Philip Bejon, Joseph Okebe, Jane Achan, Alfred Ngwa Amambua, Muna Affara, Davis Nwakanma, Jean-Pierre van Geertruyden, Muhindo Mavoko, Pascal Lutumba, Junior Matangila, Philipe Brasseur, Patrice Piola, Rindra Randremanana, Estrella Lasry, Caterina Fanello, Marie Onyamboko, Birgit Schramm, Zolia Yah, Joel Jones, Rick M Fairhurst, Mahamadou Diakite, Grace Malenga, Malcolm Molyneux, Claude Rwagacondo, Charles Obonyo, Endalamaw Gadisa, Abraham Aseffa, Mores Loolpapit, Marie-Claire Henry, Grant Dorsey, Chandy John, Sodiomon B Sirima, Karen I Barnes, Peter Kremsner, Nicholas P Day, Nicholas J White, Mavuto Mukaka
BACKGROUND: In 2012, the World Health Organization recommended blocking the transmission of Plasmodium falciparum with single low-dose primaquine (SLDPQ, target dose 0.25 mg base/kg body weight), without testing for glucose-6-phosphate dehydrogenase deficiency (G6PDd), when treating patients with uncomplicated falciparum malaria. We sought to develop an age-based SLDPQ regimen that would be suitable for sub-Saharan Africa. METHODS: Using data on the anti-infectivity efficacy and tolerability of primaquine (PQ), the epidemiology of anaemia, and the risks of PQ-induced acute haemolytic anaemia (AHA) and clinically significant anaemia (CSA), we prospectively defined therapeutic-dose ranges of 0...
January 18, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29332605/antidepressant-use-during-pregnancy-and-risk-of-autism-spectrum-disorder-and-attention-deficit-hyperactivity-disorder-systematic-review-of-observational-studies-and-methodological-considerations
#3
Daniel R Morales, Jim Slattery, Stephen Evans, Xavier Kurz
BACKGROUND: Antidepressant exposure during pregnancy has been associated with an increased risk of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) in several observational studies. We performed a systematic review of these studies to highlight the effect that important methodological limitations have on such analyses and to consider approaches to the conduct, reporting and interpretation of future studies. METHODS: A review of MEDLINE and EMBASE identified case-control, cohort and sibling studies assessing the risk of ASD and ADHD with antidepressant use during pregnancy...
January 15, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29325567/identifying-older-adults-at-risk-of-harm-following-elective-surgery-a-systematic-review-and-meta-analysis
#4
Jennifer Watt, Andrea C Tricco, Catherine Talbot-Hamon, Ba' Pham, Patricia Rios, Agnes Grudniewicz, Camilla Wong, Douglas Sinclair, Sharon E Straus
BACKGROUND: Elective surgeries can be associated with significant harm to older adults. The present study aimed to identify the prognostic factors associated with the development of postoperative complications among older adults undergoing elective surgery. METHODS: Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and AgeLine were searched for articles published between inception and April 21, 2016. Prospective studies reporting prognostic factors associated with postoperative complications (composite outcome of medical and surgical complications), functional decline, mortality, post-hospitalization discharge destination, and prolonged hospitalization among older adults undergoing elective surgery were included...
January 12, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29321031/deprescribing-preventive-cardiovascular-medication-in-patients-with-predicted-low-cardiovascular-disease-risk-in-general-practice-the-ecstatic-study-a-cluster-randomised-non-inferiority-trial
#5
Clare H Luymes, Rosalinde K E Poortvliet, Nan van Geloven, Margot W M de Waal, Yvonne M Drewes, Jeanet W Blom, Nynke Smidt, Willem J J Assendelft, Wilbert B van den Hout, Wouter de Ruijter, Mattijs E Numans
BACKGROUND: The use of cardiovascular medication for the primary prevention of cardiovascular disease (CVD) is potentially inappropriate when potential risks outweigh the potential benefits. It is unknown whether deprescribing preventive cardiovascular medication in patients without a strict indication for such medication is safe and cost-effective in general practice. METHODS: In this pragmatic cluster randomised controlled non-inferiority trial, we recruited 46 general practices in the Netherlands...
January 11, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29316928/risk-of-fracture-among-patients-with-polymyalgia-rheumatica-and-giant-cell-arteritis-a-population-based-study
#6
Zoe Paskins, Rebecca Whittle, Alyshah Abdul Sultan, Sara Muller, Milica Blagojevic-Bucknall, Toby Helliwell, Samantha Hider, Edward Roddy, Christian Mallen
BACKGROUND: Glucocorticoids are associated with increased fracture risk and are the mainstay of treatment in polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). However, fracture risk in these conditions has not been previously quantified. The aim of this study was to quantify the risk of fracture among patients with PMR and GCA. METHODS: A retrospective cohort study was conducted using primary care records from the UK-based Clinical Practice Research Datalink...
January 10, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29316913/influence-of-demographic-changes-on-the-impact-of-vaccination-against-varicella-and-herpes-zoster-in-germany-a-mathematical-modelling-study
#7
Johannes Horn, Oliver Damm, Wolfgang Greiner, Hartmut Hengel, Mirjam E Kretzschmar, Anette Siedler, Bernhard Ultsch, Felix Weidemann, Ole Wichmann, André Karch, Rafael T Mikolajczyk
BACKGROUND: Epidemiological studies suggest that reduced exposure to varicella might lead to an increased risk for herpes zoster (HZ). Reduction of exposure to varicella is a consequence of varicella vaccination but also of demographic changes. We analyzed how the combination of vaccination programs and demographic dynamics will affect the epidemiology of varicella and HZ in Germany over the next 50 years. METHODS: We used a deterministic dynamic compartmental model to assess the impact of different varicella and HZ vaccination strategies on varicella and HZ epidemiology in three demographic scenarios, namely the projected population for Germany, the projected population additionally accounting for increased immigration as observed in 2015/2016, and a stationary population...
January 9, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29287587/simulations-for-designing-and-interpreting-intervention-trials-in-infectious-diseases
#8
M Elizabeth Halloran, Kari Auranen, Sarah Baird, Nicole E Basta, Steven E Bellan, Ron Brookmeyer, Ben S Cooper, Victor DeGruttola, James P Hughes, Justin Lessler, Eric T Lofgren, Ira M Longini, Jukka-Pekka Onnela, Berk Özler, George R Seage, Thomas A Smith, Alessandro Vespignani, Emilia Vynnycky, Marc Lipsitch
BACKGROUND: Interventions in infectious diseases can have both direct effects on individuals who receive the intervention as well as indirect effects in the population. In addition, intervention combinations can have complex interactions at the population level, which are often difficult to adequately assess with standard study designs and analytical methods. DISCUSSION: Herein, we urge the adoption of a new paradigm for the design and interpretation of intervention trials in infectious diseases, particularly with regard to emerging infectious diseases, one that more accurately reflects the dynamics of the transmission process...
December 29, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29282122/advice-and-care-for-patients-who-die-by-voluntarily-stopping-eating-and-drinking-is-not-assisted-suicide
#9
Andrew McGee, Franklin G Miller
BACKGROUND: A competent patient has the right to refuse foods and fluids even if the patient will die. The exercise of this right, known as voluntarily stopping eating and drinking (VSED), is sometimes proposed as an alternative to physician assisted suicide. However, there is ethical and legal uncertainty about physician involvement in VSED. Are physicians advising of this option, or making patients comfortable while they undertake VSED, assisting suicide? This paper attempts to resolve this ethical and legal uncertainty...
December 27, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29268738/models-and-analyses-to-understand-threats-to-polio-eradication
#10
LETTER
James S Koopman
To achieve complete polio eradication, the live oral poliovirus vaccine (OPV) currently used must be phased out after the end of wild poliovirus transmission. However, poorly understood threats may arise when OPV use is stopped. To counter these threats, better models than those currently available are needed. Two articles recently published in BMC Medicine address these issues. Mercer et al. (BMC Med 15:180, 2017) developed a statistical model analysis of polio case data and characteristics of cases occurring in several districts in Pakistan to inform resource allocation decisions...
December 22, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29268742/factors-associated-with-junior-doctors-decisions-to-apply-for-general-practice-training-programmes-in-the-uk-secondary-analysis-of-data-from-the-ukmed-project
#11
Thomas C E Gale, Paul J Lambe, Martin J Roberts
BACKGROUND: The UK, like many high-income countries, is experiencing a worsening shortfall of general practitioners (GPs) alongside an increasing demand for their services. At the same time, factors influencing junior doctors' decisions to apply for GP training are only partially understood and research in this area has been hampered by the difficulties in connecting the datasets that map the journey from student to qualified GP. The UK Medical Education Database (UKMED) has been established to ameliorate this problem by linking institutional data across the spectrum of medical education from school to specialty training...
December 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29258526/bringing-patient-centered-tuberculosis-diagnosis-into-the-light-of-day
#12
LETTER
J Lucian Davis
In 2015, the WHO End TB Strategy laid out ambitious goals to dramatically reduce tuberculosis (TB) deaths, incidence, and catastrophic costs through research, bold new strategies, and patient-centered care. In this commentary, recent evidence on sputum collection strategies for smear microscopy is reviewed, and the argument is made that redesigning smear microscopy as a patient-centered service offers the only realistic and widely available strategy to advance TB diagnostic care towards the initial End TB Strategy goals laid out for 2025...
December 20, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29254484/blood-lipids-and-lipoproteins-in-relation-to-incidence-and-mortality-risks-for-cvd-and-cancer-in-the-prospective-epic-heidelberg-cohort
#13
Verena Andrea Katzke, Disorn Sookthai, Theron Johnson, Tilman Kühn, Rudolf Kaaks
BACKGROUND: Circulating concentrations of lipid biomarkers are associated with risk of cardiovascular diseases (CVD). The evidence for a relationship with cancer risk, however, is not entirely consistent. This study aims to assess the relationships of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), apolipoprotein (a) (apo(a)), apoB-100, and lipoprotein(a) (Lp(a)) with risk of common cancer forms and total cancer mortality in comparison to incidence and mortality of CVD...
December 19, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29249202/modeling-hiv-hcv-coinfection-epidemiology-in-the-direct-acting-antiviral-era-the-road-to-elimination
#14
Victor Virlogeux, Fabien Zoulim, Pascal Pugliese, Isabelle Poizot-Martin, Marc-Antoine Valantin, Lise Cuzin, Jacques Reynes, Eric Billaud, Thomas Huleux, Firouze Bani-Sadr, David Rey, Anne Frésard, Christine Jacomet, Claudine Duvivier, Antoine Cheret, Laurent Hustache-Mathieu, Bruno Hoen, André Cabié, Laurent Cotte
BACKGROUND: HCV treatment uptake has drastically increased in HIV-HCV coinfected patients in France since direct-acting antiviral (DAA) treatment approval, resulting in HCV cure in 63% of all HIV-HCV patients by the end of 2015. We investigated the impact of scaling-up DAA on HCV prevalence in the whole HIV population and in various risk groups over the next 10 years in France using a transmission dynamic compartmental model. METHODS: The model was based on epidemiological data from the French Dat'AIDS cohort...
December 18, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29228943/reconsidering-the-prognosis-of-major-depressive-disorder-across-diagnostic-boundaries-full-recovery-is-the-exception-rather-than-the-rule
#15
Judith Verduijn, Josine E Verhoeven, Yuri Milaneschi, Robert A Schoevers, Albert M van Hemert, Aartjan T F Beekman, Brenda W J H Penninx
BACKGROUND: Major depressive disorder (MDD) is often handled as an episodic and isolated disorder, resulting in an optimistic view about its prognosis. Herein, we test the idea that the prognosis of MDD changes if we vary the perspective in terms of (1) a longer time frame and (2) a broader diagnostic conceptualisation including dysthymia, (hypo)mania and anxiety disorders as relevant outcomes. METHODS: Patients with current MDD at baseline (n = 903) and available 2-, 4-, and/or 6-year follow-up assessments were selected from the Netherlands Study of Depression and Anxiety, a psychiatric cohort study...
December 12, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29301536/the-health-impacts-of-climate-related-migration
#16
Patricia Schwerdtle, Kathryn Bowen, Celia McMichael
BACKGROUND: Changes in climate, in conjunction with other drivers of mobility, shape human migration. While there is an increasing focus on the adaptive potential of migration, the health impacts of climate-related migration, including planned relocation and forced displacement, have not been thoroughly examined. The Intergovernmental Panel on Climate Change stated that migration is currently, and will increasingly be, influenced by environmental degradation and climate change, and that it needs to be addressed in a focused and coordinated manner...
December 11, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29224572/individual-collective-and-transgenerational-traumatization-in-the-yazidi
#17
LETTER
Jan Ilhan Kizilhan, Michael Noll-Hussong
In recent years, Islamic terrorism has manifested itself with an unexpectedly destructive force. Despite the fact that Islamic terrorism commences locally in most cases, it has spread its terror worldwide. In August 2014, when troops of the self-proclaimed 'Islamic State' conquered areas of northern Iraq, they turned on the long-established religious minorities in the area with tremendous brutality, especially towards the Yazidis. Vast numbers of men were executed, and women and children were abducted and willfully subjected to sexual violence...
December 11, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29224570/mapping-the-evidence-on-pharmacological-interventions-for-non-affective-psychosis-in-humanitarian-non-specialised-settings-a-unhcr-clinical-guidance
#18
Giovanni Ostuzzi, Corrado Barbui, Charlotte Hanlon, Sudipto Chatterjee, Julian Eaton, Lynne Jones, Derrick Silove, Peter Ventevogel
BACKGROUND: Populations exposed to humanitarian emergencies are particularly vulnerable to mental health problems, including new onset, relapse and deterioration of psychotic disorders. Inadequate care for this group may lead to human rights abuses and even premature death. The WHO Mental Health Gap Action Programme Intervention Guide (mhGAP-IG), and its adaptation for humanitarian settings (mhGAP-HIG), provides guidance for management of mental health conditions by non-specialised healthcare professionals...
December 11, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29224569/humanitarian-and-primary-healthcare-needs-of-refugee-women-and-children-in-afghanistan
#19
LETTER
Ariel Higgins-Steele, David Lai, Paata Chikvaidze, Khaksar Yousufi, Zelaikha Anwari, Richard Peeperkorn, Karen Edmond
This Commentary describes the situation and healthcare needs of Afghans returning to their country of origin. With more than 600,000 Afghans returned from Pakistan and approximately 450,000 Afghans returned from Iran in 2016, the movement of people, which has been continuing in 2017, presents additional burden on the weak health system and confounds new health vulnerabilities especially for women and children. Stewardship and response is required at all levels: the central Ministry of Public Health, Provincial Health Departments and community leaders all have important roles, while continued support from development partners and technical experts is needed to assist the health sector to address the emergency and primary healthcare needs of returnee and internally displaced women, children and families...
December 11, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29221453/the-extra-cost-of-comorbidity-multiple-illnesses-and-the-economic-burden-of-non-communicable-diseases
#20
Sébastien Cortaredona, Bruno Ventelou
BACKGROUND: The literature offers competing estimates of disease costs, with each study having its own data and methods. In 2007, the Dutch Center for Public Health Forecasting of the National Institute for Public Health and the Environment provided guidelines that can be used to set up cost-of-illness (COI) studies, emphasising that most COI analyses have trouble accounting for comorbidity in their cost estimations. When a patient has more than one chronic condition, the conditions may interact such that the patient's healthcare costs are greater than the sum of the costs for the individual diseases...
December 8, 2017: BMC Medicine
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