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https://www.readbyqxmd.com/read/28735357/promoting-and-protecting-public-health-how-the-european-union-pharmacovigilance-system-works
#1
Aniello Santoro, Georgy Genov, Almath Spooner, June Raine, Peter Arlett
This article provides an overview of the European Union pharmacovigilance system resulting from the rationalisation and strengthening delivered through the implementation of the revised pharmacovigilance legislation. It outlines the system aims, underlying principles, components and drivers for future change. At its core, the Pharmacovigilance Risk Assessment Committee is responsible for assessing all aspects of the risk management of medicinal products, thus ensuring that medicines approved for the European Union market are optimally used by maximising their benefits and minimising risks...
July 22, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28735276/mental-health-literacy-in-primary-care-canadian-research-and-education-for-the-advancement-of-child-health-canreach
#2
Eden S N McCaffrey, Samuel Chang, Geraldine Farrelly, Abdul Rahman, David Cawthorpe
The effectiveness of a continuing education programme in paediatric psychopharmacology designed for primary healthcare providers was objectively measured based on the assumption that training would lead to measurable changes in referral patterns and established clinical measures of referred patients. Using established, valid and reliable measures of clinical urgency embedded in to a regional healthcare system since 2002, the referrals to child and adolescent psychiatric services of physicians who participated in the training (n=99) were compared pretraining and post-training, and to non-participating/untrained referring physicians (n=7753) making referrals over the same time period...
July 22, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28735257/prognostic-factors-of-overall-survival-and-cancer-specific-survival-in-patients-with-resected-early-stage-rectal-adenocarcinoma-a-seer-based-study
#3
Ko-Chao Lee, Kuan-Chih Chung, Hong-Hwa Chen, Chia-Cheng Liu, Chien-Chang Lu
The benefits of radiotherapy for colorectal cancer are well documented, but the impact of adjuvant radiotherapy on early-stage rectal adenocarcinoma remains unclear. This study aimed to identify predictors of overall survival (OS) and cancer-specific survival (CSS) in patients with stage II rectal adenocarcinoma treated with preoperative or postoperative radiation therapy. Patients with early-stage rectal adenocarcinoma in the postoperative state were identified using the Surveillance, Epidemiology, and End Results database...
July 21, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28735135/endoscope-assisted-abscess-drainage-secondary-to-endoscope-assisted-tlif-1-year-follow-up
#4
Karthik Madhavan, Steven Shelby Burks, Lee Onn Chieng, Anand Veeravagu, Michael Y Wang
INTRODUCTION: Endoscopic discectomy and fusions have been gaining popularity in the recent past and are noted to be safe for its application in elderly population. It involves ultra-small incision for discectomy followed by placement of percutaneous screws in awake patients. Treatment of advanced spinal pathology using endoscope-assisted techniques are challenging. Although not common with endoscopic approach, post-operative infection can be problematic as there are no established guidelines on its management...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28735069/surgical-versus-non-surgical-approach-in-primary-desmoid-type-fibromatosis-patients-a-nationwide-prospective-cohort-from-the-french-sarcoma-group
#5
Nicolas Penel, Axel Le Cesne, Sylvie Bonvalot, Antoine Giraud, Emmanuelle Bompas, Maria Rios, Sébastien Salas, Nicolas Isambert, Pascaline Boudou-Rouquette, Charles Honore, Antoine Italiano, Isabelle Ray-Coquard, Sophie Piperno-Neumann, François Gouin, François Bertucci, Thomas Ryckewaert, Jean-Emmanuel Kurtz, Françoise Ducimetiere, Jean-Michel Coindre, Jean-Yves Blay
PURPOSE: The outcome of desmoid-type fibromatosis (DTF) is unpredictable. Currently, a wait-and-see approach tends to replace large en bloc resection as the first therapeutic approach. Nevertheless, there are no validated factors to guide the treatment choice. METHOD: We conducted a prospective study of 771 confirmed cases of DTF. We analysed event-free survival (EFS) based on the occurrence of relapse after surgery, progressive disease during the wait-and-see approach, or change in therapeutic strategy...
July 20, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28734722/guidelines-for-the-understanding-and-management-of-pain-in-chronic-pancreatitis
#6
REVIEW
Asbjørn M Drewes, Stefan A W Bouwense, Claudia M Campbell, Güralp O Ceyhan, Myriam Delhaye, Ihsan Ekin Demir, Pramod K Garg, Harry van Goor, Christopher Halloran, Shuiji Isaji, John P Neoptolemos, Søren S Olesen, Tonya Palermo, Pankaj Jay Pasricha, Andrea Sheel, Tooru Shimosegawa, Eva Szigethy, David C Whitcomb, Dhiraj Yadav
Abdominal pain is the foremost complication of chronic pancreatitis (CP). Pain can be related to recurrent or chronic inflammation, local complications or neurogenic mechanisms with corresponding changes in the nervous systems. Both pain intensity and the frequency of pain attacks have been shown to reduce quality of life in patients with CP. Assessment of pain follows the guidelines for other types of chronic pain, where the multidimensional nature of symptom presentation is taken into consideration. Quantitative sensory testing may be used to characterize pain, but is currently used in a research setting in advanced laboratories...
July 13, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28734659/comparative-effectiveness-study-between-negative-pressure-wound-therapy-and-conventional-wound-dressing-on-perforator-flap-at-the-chinese-tertiary-referral-teaching-hospital
#7
Regis Ernest Mendame Ehya, Yong Zhao, Xun Zheng, Wanrong Yi, Guy-Armel Bounda, Zonghuan Li, Weidong Xiao, Aixi Yu
BACKGROUND: Perforator flap techniques with conventional wound dressing have being extensively used in the management of soft-tissue defects. However; the flap's survival rate is not always guaranteed and the wound healing time always long. The aim of this study was to investigate the clinical effectiveness use of a freshly transplanted perforator flap in conjunction with Vacuum-assisted closure (VAC) for better clinical outcomes. METHODS: A prospective, randomized, effectiveness study comparing the clinical outcomes of VAC versus traditional wrap and bandages for the treatment of open wounds that required hospital admission and operative debridement using perforator flaps, was carried out from March 1, 2014 to March 31, 2016 at Wuhan University Zhongnan Hospital...
July 12, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28734595/arrhythmias-after-left-ventricular-assist-device-implantation-incidence-and-management
#8
REVIEW
Anis J Kadado, Joseph G Akar, James P Hummel
The use of mechanical circulatory support has become an increasingly common practice in patients with heart failure, whether used as bridge to transplantation or as destination therapy. The last couple of decades has seen a drastic change in the functioning of the left ventricular assist devices (LVAD), changing from the first generation devices running on pulsatile flow to the current continuous flow devices. Atrial and ventricular arrhythmias are common among heart failure patients, and though the systematic circulation is well supported in patients on mechanical circulatory support, these arrhythmias can still be the cause of detrimental symptoms and lead to potentially fatal outcomes...
July 10, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28734547/management-of-hemostatic-disorders-in-patients-with-advanced-liver-disease-admitted-to-an-intensive-care-unit
#9
REVIEW
Ton Lisman, William Bernal
Patients with liver diseases frequently acquire complex changes in their hemostatic system. Traditionally, bleeding complications in patients with liver disease were ascribed to these hemostatic changes, and liver diseases were considered as an acquired bleeding disorder. Nowadays, it is increasingly acknowledged that patients with liver diseases are in "hemostatic rebalance" due to a commensurate decline in pro- and anticoagulant drivers. Indeed, both thrombosis and bleeding may complicate liver disease. Such complications may be particularly worrisome in critically ill patients with liver disease...
June 23, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28734266/air-quality-and-health-effects-of-biogenic-volatile-organic-compounds-emissions-from-urban-green-spaces-and-the-mitigation-strategies
#10
Yuan Ren, Zelong Qu, Yuanyuan Du, Ronghua Xu, Danping Ma, Guofu Yang, Yan Shi, Xing Fan, Akira Tani, Peipei Guo, Ying Ge, Jie Chang
Biogenic volatile organic compounds (BVOCs) emissions lead to fine particulate matter (PM2.5) and ground-level ozone pollution, and are harmful to human health, especially in urban areas. However, most BVOCs estimations ignored the emissions from urban green spaces, causing inaccuracies in the understanding of regional BVOCs emissions and their environmental and health effects. In this study, we used the latest local vegetation datasets from our field survey and applied an estimation model to analyze the spatial-temporal patterns, air quality impacts, health damage and mitigating strategies of BVOCs emissions in the Greater Beijing Area...
July 19, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28734251/climatic-controls-of-ecohydrological-responses-in-the-highlands-of-northern-ethiopia
#11
Samuale Tesfaye, Emiru Birhane, Toon Leijnse, S E A T M van der Zee
Climate variability and recurrent droughts have a strong negative impact on agricultural production and hydrology in the highlands northern Ethiopia. Since the 1980s, numerous mitigation and land rehabilitation measures have been implemented by local and national authorities to reduce these impacts, are often poorly effective. As underlying reason may be that controlling relationships between climate and ecohydrology at medium-sized catchments (10-10,000km(2)) of semi-arid highlands are not well known. We investigated trends and relationships in precipitation, temperature, streamflow, and net primary productivity (NPP)...
July 19, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28734247/seasonal-variation-in-water-uptake-patterns-of-three-plant-species-based-on-stable-isotopes-in-the-semi-arid-loess-plateau
#12
Jian Wang, Bojie Fu, Nan Lu, Li Zhang
Water is a limiting factor and significant driving force for ecosystem processes in arid and semi-arid areas. Knowledge of plant water uptake pattern is indispensable for understanding soil-plant interactions and species coexistence. The 'Grain for Green' project that started in 1999 in the Loess Plateau of China has led to large scale vegetation change. However, little is known about the water uptake patterns of the main plant species that inhabit in this region. In this study, the seasonal variations in water uptake patterns of three representative plant species, Stipa bungeana, Artemisia gmelinii and Vitex negundo, that are widely distributed in the semi-arid area of the Loess Plateau, were identified by using dual stable isotopes of δ(2)H and δ(18)O in plant and soil water coupled with a Bayesian mixing model MixSIAR...
July 19, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28733910/a-review-study-to-evaluate-holmium-yag-laser-lithotripsy-with-flexible-ureteroscopy-in-patients-on-ongoing-oral-anticoagulant-therapy
#13
Bulent Altay, Bulent Erkurt, Selami Albayrak
The objective of this study was to evaluate the safety and efficacy of flexible ureteroscopy (FURS) and holmium:YAG laser lithotripsy for the treatment of upper urinary tract stones in patients on active oral anticoagulants. The records of 1081 patients who underwent flexible ureteroscopic holmium:YAG (Ho:YAG) laser lithotripsy for upper ureteral and renal calculi from 1999 to 2015 were retrospectively reviewed. A total of 84 patients on continuous oral anticoagulation or antiplatelet therapy (warfarin, aspirin, or clopidogrel) were identified...
July 22, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28733859/the-past-and-future-in-understanding-the-health-risks-of-and-responses-to-climate-variability-and-change
#14
Kristie L Ebi, Jeremy J Hess
Climate change and health was established as a formal field of endeavor in the early 1990s, with the number of publications increasing since the mid-2000s. The key findings in assessment reports from the Intergovernmental Panel on Climate Change in 1995, 2001, 2007, and 2014 indicate the progress in understanding the magnitude and pattern of the health risks of a changing climate. The assessments maintained a similar structure, focusing on assessing the state of knowledge of individual climate-sensitive health outcomes, with confidence in the key findings tending to increase over time with greater understanding...
July 21, 2017: International Journal of Biometeorology
https://www.readbyqxmd.com/read/28733759/management-of-gait-changes-and-fall-risk-in-mci-and-dementia
#15
REVIEW
Gilles Allali, Joe Verghese
Gait disorders and falls are very prevalent in aging, especially in older adults with cognitive impairment: older adults with dementia are 2-3 times more likely to fall than their non-demented counterparts. The management of gait disorders and falls in older adults with mild cognitive impairment (MCI) or dementia begins by their identification with the use of specific screening tools, such as measuring gait speed, use of dual-task gait tests, or diagnosing motoric cognitive risk syndrome, a newly described pre-dementia syndrome...
September 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28733748/preoperative-botulinum-toxin-a-enabling-defect-closure-and-laparoscopic-repair-of-complex-ventral-hernia
#16
Omar Rodriguez-Acevedo, Kristen E Elstner, Anita S W Jacombs, John W Read, Rodrigo Tomazini Martins, Fernando Arduini, Michael Wehrhahm, Colette Craft, Peter H Cosman, Anthony N Dardano, Nabeel Ibrahim
INTRODUCTION: Operative management of complex ventral hernia still remains a significant challenge for surgeons. Closure of large defects in the unprepared abdomen has serious pathophysiological consequences due to chronic contraction and retraction of the lateral abdominal wall muscles. We report outcomes of 56 consecutive patients who had preoperative Botulinum toxin A (BTA) abdominal wall relaxation facilitating closure and repair. METHODS: This was a prospective observational study of 56 patients who underwent ultrasound-guided BTA into the lateral abdominal oblique muscles prior to elective ventral hernia repair between November 2012 and January 2017...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28733724/motion-monitoring-during-a%C3%A2-course-of-lung-radiotherapy-with-anchored-electromagnetic-transponders-quantification-of-inter-and-intrafraction-motion-and-variability-of-relative-transponder-positions
#17
Daniela Schmitt, Simeon Nill, Falk Roeder, Daniela Gompelmann, Felix Herth, Uwe Oelfke
PURPOSE: Anchored electromagnetic transponders for tumor motion monitoring during lung radiotherapy were clinically evaluated. First, intrafractional motion patterns were analyzed as well as their interfractional variations. Second, intra- and interfractional changes of the geometric transponder positions were investigated. MATERIALS AND METHODS: Intrafractional motion data from 7 patients with an upper or middle lobe tumor and three implanted transponders each was used to calculate breathing amplitudes, overall motion amount and motion midlines in three mutual perpendicular directions and three-dimensionally (3D) for 162 fractions...
July 21, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28733461/should-heart-failure-be-regarded-as-a-terminal-illness-requiring-palliative-care-a-study-of-heart-failure-patients-carers-and-clinicians-understanding-of-heart-failure-prognosis-and-its-management
#18
Rachel Stocker, Helen Close, Helen Hancock, A Pali S Hungin
OBJECTIVES: Communication and planning for heart failure (HF) care near the end of life is known to be complex. Little is known about how the patient experience of palliative assessment and communication needs change over time, and how this might inform management. Our aim was to explore experiences of giving or receiving a prognosis and advanced palliative care planning (ACP) for those with HF. METHODS: We carried out a longitudinal grounded theory study, employing in-depth interviews with 14 clinicians (primary and secondary care) and observations of clinic and home appointments, followed by a series of interviews with 13 patients with HF and 9 carers...
July 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28733378/is-it-time-to-change-the-type-2-diabetes-treatment-paradigm-no-metformin-should-remain-the-foundation-therapy-for-type-2-diabetes
#19
Silvio E Inzucchi
Most treatment guidelines, including those from the American Diabetes Association/European Association for the Study of Diabetes and the International Diabetes Federation, suggest metformin be used as the first-line therapy after diet and exercise. This recommendation is based on the considerable body of evidence that has accumulated over the last 30 years, but it is also supported on clinical grounds based on metformin's affordability and tolerability. As such, metformin is the most commonly used oral antihyperglycemic agent in the U...
August 2017: Diabetes Care
https://www.readbyqxmd.com/read/28733377/is-it-time-to-change-the-type-2-diabetes-treatment-paradigm-yes-glp-1-ras-should-replace-metformin-in-the-type-2-diabetes-algorithm
#20
Muhammad Abdul-Ghani, Ralph A DeFronzo
Most treatment guidelines, including those from the American Diabetes Association/European Association for the Study of Diabetes and the International Diabetes Federation, suggest metformin be used as the first-line therapy after diet and exercise. This recommendation is based on the considerable body of evidence that has accumulated over the last 30 years, but it is also supported on clinical grounds based on metformin's affordability and tolerability. As such, metformin is the most commonly used oral antihyperglycemic agent in the U...
August 2017: Diabetes Care
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