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BMC Medicine

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https://www.readbyqxmd.com/read/28803548/gestational-hypertensive-disorders-and-retinal-microvasculature-the-generation-r-study
#1
Laura Benschop, Sarah Schalekamp-Timmermans, Jeanine E Roeters van Lennep, Vincent W V Jaddoe, Tien Yin Wong, Carol Y Cheung, Eric A P Steegers, Kamran M Ikram
BACKGROUND: Changes in the microvasculature associated with pre-eclampsia and gestational hypertension have been proposed as a potential pathway in the development of cardiovascular disease. We examined whether gestational hypertensive disorders, such as pre-eclampsia and gestational hypertension, are related to the maternal retinal microvasculature status after pregnancy. METHODS: This study is part of an ongoing population-based prospective cohort study. During pregnancy and 6...
August 14, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28797265/risk-and-predictors-of-psoriasis-in-patients-with-breast-cancer-a-swedish-population-based-cohort-study
#2
Haomin Yang, Judith S Brand, Jingmei Li, Jonas F Ludvigsson, Emilio Ugalde-Morales, Flaminia Chiesa, Per Hall, Kamila Czene
BACKGROUND: The risk of psoriasis in patients with breast cancer is largely unknown, as available evidence is limited to case findings. We systematically examined the incidence and risk factors of psoriasis in patients with breast cancer. METHODS: A Swedish nationwide cohort of 56,235 breast cancer patients (2001-2012) was compared to 280,854 matched reference individuals from the general population to estimate the incidence and hazard ratio (HR) of new-onset psoriasis...
August 11, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28793891/characterizing-measles-transmission-in-india-a-dynamic-modeling-study-using-verbal-autopsy-data
#3
Stéphane Verguet, Edward O Jones, Mira Johri, Shaun K Morris, Wilson Suraweera, Cindy L Gauvreau, Prabhat Jha, Mark Jit
BACKGROUND: Decreasing trends in measles mortality have been reported in recent years. However, such estimates of measles mortality have depended heavily on assumed regional measles case fatality risks (CFRs) and made little use of mortality data from low- and middle-income countries in general and India, the country with the highest measles burden globally, in particular. METHODS: We constructed a dynamic model of measles transmission in India with parameters that were empirically inferred using spectral analysis from a time series of measles mortality extracted from the Million Death Study, an ongoing longitudinal study recording deaths across 2...
August 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28789659/consistency-and-sources-of-divergence-in-recommendations-on-screening-with-questionnaires-for-presently-experienced-health-problems-or-symptoms-a-comparison-of-recommendations-from-the-canadian-task-force-on-preventive-health-care-uk-national-screening-committee
#4
Brett D Thombs, Nazanin Saadat, Kira E Riehm, Justin Michael Karter, Akansha Vaswani, Bonnie K Andrews, Peter Simons, Lisa Cosgrove
BACKGROUND: Recently, health screening recommendations have gone beyond screening for early-stage, asymptomatic disease to include "screening" for presently experienced health problems and symptoms using self-report questionnaires. We examined recommendations from three major national guideline organizations to determine the consistency of recommendations, identify sources of divergent recommendations, and determine if guideline organizations have identified any direct randomized controlled trial (RCT) evidence for the effectiveness of questionnaire-based screening...
August 9, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28784170/pregnancy-pregnancy-loss-and-the-risk-of-cardiovascular-disease-in-chinese-women-findings-from-the-china-kadoorie-biobank
#5
Sanne A E Peters, Ling Yang, Yu Guo, Yiping Chen, Zheng Bian, Xiaocao Tian, Liang Chang, Shuo Zhang, Jiaqiu Liu, Tao Wang, Junshi Chen, Liming Li, Mark Woodward, Zhengming Chen
BACKGROUND: Pregnancy and pregnancy loss may be linked to cardiovascular disease (CVD). However, the evidence is still inconsistent, especially in East Asians, whose reproductive patterns differ importantly from those in the West. We examined the associations of pregnancy, miscarriage, induced abortion, and stillbirth with CVD incidence among Chinese women. METHODS: In 2004-2008, the nationwide China Kadoorie Biobank recruited 302,669 women aged 30-79 years from ten diverse localities...
August 8, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28780907/country-of-qualification-is-linked-to-doctors-general-medical-council-performance-assessment-rate-but-is-it-linked-to-their-clinical-competence
#6
LETTER
Richard Wakeford
Mehdizah and colleagues recently described the prevalence of General Medical Council regulatory performance assessments by doctors' country of primary medical qualification. This article has caused anger within the UK-international medical community because it identifies graduates of certain countries with significantly raised prevalence.The present article comments on evidence from published Royal College of General Practitioners' data that support these conclusions. However, in an increasingly international age of medical education, the ambiguity of attributions of qualifying from a certain country needs addressing...
August 7, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28774293/the-clinical-utility-of-the-urine-based-lateral-flow-lipoarabinomannan-assay-in-hiv-infected-adults-in-myanmar-an-observational-study
#7
Swe Swe Thit, Ne Myo Aung, Zaw Win Htet, Mark A Boyd, Htin Aung Saw, Nicholas M Anstey, Tint Tint Kyi, David A Cooper, Mar Mar Kyi, Josh Hanson
BACKGROUND: The use of the point-of-care lateral flow lipoarabinomannan (LF-LAM) test may expedite tuberculosis (TB) diagnosis in HIV-positive patients. However, the test's clinical utility is poorly defined outside sub-Saharan Africa. METHODS: The study enrolled consecutive HIV-positive adults at a tertiary referral hospital in Yangon, Myanmar. On enrolment, patients had a LF-LAM test performed according to the manufacturer's instructions. Clinicians managing the patients were unaware of the LF-LAM result, which was correlated with the patient's clinical course over the ensuing 6 months...
August 4, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28768513/clinical-and-laboratory-predictors-of-death-in-african-children-with-features-of-severe-malaria-a-systematic-review-and-meta-analysis
#8
Paulina Sypniewska, Jose F Duda, Isabella Locatelli, Clotilde Rambaud Althaus, Fabrice Althaus, Blaise Genton
BACKGROUND: The criteria for defining severe malaria have evolved over the last 20 years. We aimed to assess the strength of association of death with features currently characterizing severe malaria through a systematic review and meta-analysis. METHOD: Electronic databases (Medline, Embase, Cochrane Database of Systematic Reviews, Thomson Reuters Web of Knowledge) were searched to identify publications including African children with severe malaria. PRISMA guidelines were followed...
August 3, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28764757/how-accurate-is-the-surprise-question-at-identifying-patients-at-the-end-of-life-a-systematic-review-and-meta-analysis
#9
Nicola White, Nuriye Kupeli, Victoria Vickerstaff, Patrick Stone
BACKGROUND: Clinicians are inaccurate at predicting survival. The 'Surprise Question' (SQ) is a screening tool that aims to identify people nearing the end of life. Potentially, its routine use could help identify patients who might benefit from palliative care services. The objective was to assess the accuracy of the SQ by time scale, clinician, and speciality. METHODS: Searches were completed on Medline, Embase, CINAHL, AMED, Science Citation Index, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Open Grey literature (all from inception to November 2016)...
August 2, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28760142/the-renin-angiotensin-system-a-possible-new-target-for-depression
#10
REVIEW
João Vian, Círia Pereira, Victor Chavarria, Cristiano Köhler, Brendon Stubbs, João Quevedo, Sung-Wan Kim, André F Carvalho, Michael Berk, Brisa S Fernandes
Depression remains a debilitating condition with an uncertain aetiology. Recently, attention has been given to the renin-angiotensin system. In the central nervous system, angiotensin II may be important in multiple pathways related to neurodevelopment and regulation of the stress response. Studies of drugs targeting the renin-angiotensin system have yielded promising results. Here, we review the potential beneficial effects of angiotensin blockers in depression and their mechanisms of action. Drugs blocking the angiotensin system have efficacy in several animal models of depression...
August 1, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28756776/the-cross-national-epidemiology-of-social-anxiety-disorder-data-from-the-world-mental-health-survey-initiative
#11
Dan J Stein, Carmen C W Lim, Annelieke M Roest, Peter de Jonge, Sergio Aguilar-Gaxiola, Ali Al-Hamzawi, Jordi Alonso, Corina Benjet, Evelyn J Bromet, Ronny Bruffaerts, Giovanni de Girolamo, Silvia Florescu, Oye Gureje, Josep Maria Haro, Meredith G Harris, Yanling He, Hristo Hinkov, Itsuko Horiguchi, Chiyi Hu, Aimee Karam, Elie G Karam, Sing Lee, Jean-Pierre Lepine, Fernando Navarro-Mateu, Beth-Ellen Pennell, Marina Piazza, Jose Posada-Villa, Margreet Ten Have, Yolanda Torres, Maria Carmen Viana, Bogdan Wojtyniak, Miguel Xavier, Ronald C Kessler, Kate M Scott
BACKGROUND: There is evidence that social anxiety disorder (SAD) is a prevalent and disabling disorder. However, most of the available data on the epidemiology of this condition originate from high income countries in the West. The World Mental Health (WMH) Survey Initiative provides an opportunity to investigate the prevalence, course, impairment, socio-demographic correlates, comorbidity, and treatment of this condition across a range of high, middle, and low income countries in different geographic regions of the world, and to address the question of whether differences in SAD merely reflect differences in threshold for diagnosis...
July 31, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28750628/what-works-for-whom-in-the-management-of-diabetes-in-people-living-with-dementia-a-realist-review
#12
Frances Bunn, Claire Goodman, Peter Reece Jones, Bridget Russell, Daksha Trivedi, Alan Sinclair, Antony Bayer, Greta Rait, Jo Rycroft-Malone, Christopher Burton
BACKGROUND: Dementia and diabetes mellitus are common long-term conditions and co-exist in a large number of older people. People living with dementia (PLWD) may be less able to manage their diabetes, putting them at increased risk of complications such as hypoglycaemia. The aim of this review was to identify key mechanisms within different interventions that are likely to improve diabetes outcomes in PLWD. METHODS: This is a realist review involving scoping of the literature and stakeholder interviews to develop theoretical explanations of how interventions might work, systematic searches of the evidence to test and develop the theories and their validation with a purposive sample of stakeholders...
July 28, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28747225/epidemiology-and-outcomes-of-people-with-dementia-delirium-and-unspecified-cognitive-impairment-in-the-general-hospital-prospective-cohort-study-of-10-014-admissions
#13
Emma L Reynish, Simona M Hapca, Nicosha De Souza, Vera Cvoro, Peter T Donnan, Bruce Guthrie
BACKGROUND: Cognitive impairment of various kinds is common in older people admitted to hospital, but previous research has usually focused on single conditions in highly-selected groups and has rarely examined associations with outcomes. This study examined prevalence and outcomes of cognitive impairment in a large unselected cohort of people aged 65+ with an emergency medical admission. METHODS: Between January 1, 2012, and June 30, 2013, admissions to a single general hospital acute medical unit aged 65+ underwent a structured specialist nurse assessment (n = 10,014)...
July 27, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28747205/detection-of-antibiotic-resistance-is-essential-for-gonorrhoea-point-of-care-testing-a-mathematical-modelling-study
#14
Stephanie M Fingerhuth, Nicola Low, Sebastian Bonhoeffer, Christian L Althaus
BACKGROUND: Antibiotic resistance is threatening to make gonorrhoea untreatable. Point-of-care (POC) tests that detect resistance promise individually tailored treatment, but might lead to more treatment and higher levels of resistance. We investigate the impact of POC tests on antibiotic-resistant gonorrhoea. METHODS: We used data about the prevalence and incidence of gonorrhoea in men who have sex with men (MSM) and heterosexual men and women (HMW) to calibrate a mathematical gonorrhoea transmission model...
July 26, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28743299/the-public-health-value-of-vaccines-beyond-efficacy-methods-measures-and-outcomes
#15
A Wilder-Smith, I Longini, P L Zuber, T Bärnighausen, W J Edmunds, N Dean, V Masserey Spicher, M R Benissa, B D Gessner
BACKGROUND: Assessments of vaccine efficacy and safety capture only the minimum information needed for regulatory approval, rather than the full public health value of vaccines. Vaccine efficacy provides a measure of proportionate disease reduction, is usually limited to etiologically confirmed disease, and focuses on the direct protection of the vaccinated individual. Herein, we propose a broader scope of methods, measures and outcomes to evaluate the effectiveness and public health impact to be considered for evidence-informed policymaking in both pre- and post-licensure stages...
July 26, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28738862/impact-of-ischemic-preconditioning-on-surgical-treatment-of-brain-tumors-a-single-center-randomized-double-blind-controlled-trial
#16
Arthur H A Sales, Melanie Barz, Stefanie Bette, Benedikt Wiestler, Yu-Mi Ryang, Bernhard Meyer, Martin Bretschneider, Florian Ringel, Jens Gempt
BACKGROUND: Postoperative ischemia is a frequent phenomenon in patients with brain tumors and is associated with postoperative neurological deficits and impaired overall survival. Particularly in the field of cardiac and vascular surgery, the application of a brief ischemic stimulus not only in the target organ but also in remote tissues can prevent subsequent ischemic damage. We hypothesized that remote ischemic preconditioning (rIPC) in patients with brain tumors undergoing elective surgical resection reduces the incidence of postoperative ischemic tissue damage and its consequences...
July 25, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28735571/ethics-review-in-compassionate-use
#17
Jan Borysowski, Hans-Jörg Ehni, Andrzej Górski
BACKGROUND: Compassionate use is the use of unapproved drugs outside of clinical trials. So far, compassionate use regulations have been introduced in the US, Canada, many European countries, Australia and Brazil, and treatment on a compassionate use basis may be performed in Japan and China. However, there are important differences between relevant regulations in individual countries, particularly that approval by a research ethics committee (institutional review board) is a requirement for compassionate use in some countries (e...
July 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28728605/surrogate-endpoints-in-oncology-when-are-they-acceptable-for-regulatory-and-clinical-decisions-and-are-they-currently-overused
#18
Robert Kemp, Vinay Prasad
BACKGROUND: Surrogate outcomes are not intrinsically beneficial to patients, but are designed to be easier and faster to measure than clinically meaningful outcomes. The use of surrogates as an endpoint in clinical trials and basis for regulatory approval is common, and frequently exceeds the guidance given by regulatory bodies. DISCUSSION: In this article, we demonstrate that the use of surrogates in oncology is widespread and increasing. At the same time, the strength of association between the surrogates used and clinically meaningful outcomes is often unknown or weak...
July 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28724431/biological-embedding-of-childhood-adversity-from-physiological-mechanisms-to-clinical-implications
#19
REVIEW
Anne E Berens, Sarah K G Jensen, Charles A Nelson
BACKGROUND: Adverse psychosocial exposures in early life, namely experiences such as child maltreatment, caregiver stress or depression, and domestic or community violence, have been associated in epidemiological studies with increased lifetime risk of adverse outcomes, including diabetes, heart disease, cancers, and psychiatric illnesses. Additional work has shed light on the potential molecular mechanisms by which early adversity becomes "biologically embedded" in altered physiology across body systems...
July 20, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28720102/environmental-lifestyle-factors-in-the-pathogenesis-and-prevention-of-type-2-diabetes
#20
REVIEW
Hubert Kolb, Stephan Martin
BACKGROUND: Environmental and lifestyle changes, in addition to the ageing of populations, are generally believed to account for the rapid global increase in type 2 diabetes prevalence and incidence in recent decades. DISCUSSION: In this review, we present a comprehensive overview of factors contributing to diabetes risk, including aspects of diet quality and quantity, little physical activity, increased monitor viewing time or sitting in general, exposure to noise or fine dust, short or disturbed sleep, smoking, stress and depression, and a low socioeconomic status...
July 19, 2017: BMC Medicine
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