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https://www.readbyqxmd.com/read/28646526/adamts13-test-and-or-plasmic-clinical-score-in-management-of-acquired-thrombotic-thrombocytopenic-purpura-a-cost-effective-analysis
#1
Chong H Kim, Sierra C Simmons, Lance A Williams Iii, Elizabeth M Staley, X Long Zheng, Huy P Pham
BACKGROUND: The ADAMTS13 test distinguishes thrombotic thrombocytopenic purpura (TTP) from other thrombotic microangiopathies (TMAs). The PLASMIC score helps determine the pretest probability of ADAMTS13 deficiency. Due to inherent limitations of both tests, and potential adverse effects and cost of unnecessary treatments, we performed a cost-effectiveness analysis (CEA) investigating the benefits of incorporating an in-hospital ADAMTS13 test and/or PLASMIC score into our clinical practice...
June 23, 2017: Transfusion
https://www.readbyqxmd.com/read/28646095/estimated-reductions-in-provider-initiated-preterm-births-and-hospital-length-of-stay-under-a-universal-acetylsalicylic-acid-prophylaxis-strategy-a-retrospective-cohort-study
#2
Joel G Ray, Emily Bartsch, Alison L Park, Prakesh S Shah, Susie Dzakpasu
BACKGROUND: Hypertensive disorders, especially preeclampsia, are the leading reason for provider-initiated preterm birth. We estimated how universal acetylsalicylic acid (ASA) prophylaxis might reduce rates of provider-initiated preterm birth associated with preeclampsia and intrauterine growth restriction, which are related conditions. METHODS: We performed a cohort study of singleton hospital births in 2013 in Canada, excluding Quebec. We estimated the proportion of term births and provider-initiated preterm births affected by preeclampsia and/or intrauterine growth restriction, and the corresponding mean maternal and newborn hospital length of stay...
June 23, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28645039/fundamental-causes-of-accelerated-declines-in-colorectal-cancer-mortality-modeling-multiple-ways-that-disadvantage-influences-mortality-risk
#3
Sean A P Clouston, Marcie S Rubin, David Chae, Jeremy Freese, Barbara Nemesure, Bruce G Link
BACKGROUND: Improvements in colorectal cancer (CRC) mortality reflect the distribution of effective preventions. Social inequalities often generate unequal diffusion of medical interventions, resulting in disparate outcomes while preventions are being disseminated throughout the population. This study used a novel method to examine whether Race (Black versus White) and SES influenced when rates of CRC mortality started to decline, and how rapidly they did so. METHOD: Mortality counts from 1968-2010 were derived from death certificates of U...
June 13, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28640823/estimating-the-number-of-secondary-ebola-cases-resulting-from-an-unsafe-burial-and-risk-factors-for-transmission-during-the-west-africa-ebola-epidemic
#4
Amanda Tiffany, Benjamin D Dalziel, Hilary Kagume Njenge, Ginger Johnson, Roselyn Nugba Ballah, Daniel James, Abdoulaye Wone, Juliet Bedford, Amanda McClelland
BACKGROUND: Safely burying Ebola infected individuals is acknowledged to be important for controlling Ebola epidemics and was a major component of the 2013-2016 West Africa Ebola response. Yet, in order to understand the impact of safe burial programs it is necessary to elucidate the role of unsafe burials in sustaining chains of Ebola transmission and how the risk posed by activities surrounding unsafe burials, including care provided at home prior to death, vary with human behavior and geography...
June 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28639913/novel-roles-of-folic-acid-as-redox-regulator-modulation-of-reactive-oxygen-species-sinker-protein-expression-and-maintenance-of-mitochondrial-redox-homeostasis-on-hepatocellular-carcinoma
#5
Kun-Goung Lai, Chi-Fen Chen, Chun-Te Ho, Jun-Jen Liu, Tsan-Zon Liu, Chi-Liang Chern
We provide herein several lines of evidence to substantiate that folic acid (or folate) is a micronutrient capable of functioning as a novel redox regulator on hepatocellular carcinoma. First, we uncovered that folate deficiency could profoundly downregulate two prominent anti-apoptotic effectors including survivin and glucose-regulated protein-78. Silencing of either survivin or glucose-regulated protein-78 via small interfering RNA interfering technique established that both effectors could serve as reactive oxygen species sinker proteins...
June 2017: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
https://www.readbyqxmd.com/read/28636653/the-ebola-virus-vp35-protein-binds-viral-immunostimulatory-and-host-rnas-identified-through-deep-sequencing
#6
Kari A Dilley, Alexander A Voorhies, Priya Luthra, Vinita Puri, Timothy B Stockwell, Hernan Lorenzi, Christopher F Basler, Reed S Shabman
Ebola virus and Marburg virus are members of the Filovirdae family and causative agents of hemorrhagic fever with high fatality rates in humans. Filovirus virulence is partially attributed to the VP35 protein, a well-characterized inhibitor of the RIG-I-like receptor pathway that triggers the antiviral interferon (IFN) response. Prior work demonstrates the ability of VP35 to block potent RIG-I activators, such as Sendai virus (SeV), and this IFN-antagonist activity is directly correlated with its ability to bind RNA...
2017: PloS One
https://www.readbyqxmd.com/read/28633672/influence-of-the-number-and-timing-of-malaria-episodes-during-pregnancy-on-prematurity-and-small-for-gestational-age-in-an-area-of-low-transmission
#7
Kerryn A Moore, Julie A Simpson, Jacher Wiladphaingern, Aung Myat Min, Mupawjay Pimanpanarak, Moo Kho Paw, Jathee Raksuansak, Sasithon Pukrittayakamee, Freya J I Fowkes, Nicholas J White, François Nosten, Rose McGready
BACKGROUND: Most evidence on the association between malaria in pregnancy and adverse pregnancy outcomes focuses on falciparum malaria detected at birth. We assessed the association between the number and timing of falciparum and vivax malaria episodes during pregnancy on small-for-gestational-age (SGA) and preterm birth. METHODS: We analysed observational data collected from antenatal clinics on the Thailand-Myanmar border (1986-2015). We assessed the effects of the total number of malaria episodes in pregnancy on SGA and the effects of malaria in pregnancy on SGA, very preterm birth, and late preterm birth, by the gestational age at malaria detection and treatment using logistic regression models with time-dependent malaria variables (monthly intervals)...
June 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28633387/anal-intercourse-among-female-sex-workers-in-c%C3%A3-te-d-ivoire-prevalence-determinants-and-model-based-estimates-of-the-population-level-impact-on-hiv-transmission
#8
Mathieu Maheu-Giroux, Stefan Baral, Juan F Vesga, Daouda Diouf, Souleymane Diabaté, Michel Alary, Kouamé Abo, Marie-Claude Boily
Current evidence suggests that anal intercourse (AI) during sex work is common in sub-Saharan Africa, but few studies investigated the contribution of heterosexual AI to HIV epidemics. Using a respondent-driven sampling survey of female sex workers (FSW) in Abidjan (2014), we estimated AI prevalence and frequency. Poisson regressions were used to identify AI determinants. About 20% of FSW (N = 466) engaged in AI during a normal week (95% confidence intervals: 15-26%). Women who performed AI were generally younger, had been selling sex for longer, were born in Côte d'Ivoire, reported higher sex-work income, more frequent sex in public places, and violence from clients than women not reporting AI...
June 14, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28632965/frequent-col4-mutations-in-familial-microhematuria-accompanied-by-later-onset-alport-nephropathy-due-to-focal-segmental-glomerulosclerosis
#9
Louiza Papazachariou, Gregory Papagregoriou, Despina Hadjipanagi, Panagiota Demosthenous, Konstantinos Voskarides, Constantina Koutsofti, Kostas Stylianou, Petros Ioannou, Dimitris Xydakis, Ioannis Tzanakis, Antonia Papadaki, Nicolaos Kallivretakis, Nicolaos Nikolakakis, Garyfalia Perysinaki, Daniel P Gale, Athanasios Diamantopoulos, Pavlos Goudas, Dimitris Goumenos, Andreas Soloukides, Ioannis Boletis, Christina Melexopoulou, Eleni Georgaki, Elena Frysira, Fifi Komianou, Dimitrios Grekas, Christos Paliouras, Polichronis Alivanis, George Vergoulas, Alkis Pierides, Eugenios Daphnis, Constantinos Deltas
Familial microscopic hematuria (FMH) is associated with a genetically heterogeneous group of conditions including the collagen-IV nephropathies, the heritable C3/CFHR5 nephropathy and the glomerulopathy with fibronectin deposits. The clinical course varies widely, ranging from isolated benign familial hematuria to end-stage renal disease (ESRD) later in life. We investigated 24 families using Next Generation Sequencing (NGS) for five genes: COL4A3, COL4A4, COL4A5, CFHR5 and FN1. In 17 families (71%), we found 15 pathogenic mutations in COL4A3/A4/A5, nine of them novel...
June 20, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/28629728/antibiotic-resistance-determinants-and-clonal-relationships-among-multidrug-resistant-isolates-of-klebsiella-pneumoniae
#10
Santosh Kumar Singh, Mitali Mishra, Minu Sahoo, Shashank Patole, SuneetaSahu, SudhiRanjanMishra, Harapriya Mohapatra
In the present study, we performed PCR based screening to determine the presence of antibiotic resistance genes and sequencing to find mutation in QRDR region among fourteen isolates of K. pneumoniae. Association analysis was conducted to detect the co-resistance among the isolates. Multi-locus sequence analysis was carried out to determine the clonal relationship among them. All the K. pneumoniae isolates showed resistance to multiple antibiotics and exhibited cross-resistance to antibiotics. Although few isolates co-harbored variants of β-lactamase genes, others carried qnrBon plasmid and mutations in Quinolone-Resistant Determining Region (QRDR)...
June 16, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/28624748/value-of-diagnostic-imaging-for-the-symptomatic-male-breast-can-we-avoid-unnecessary-biopsies
#11
Eric T Foo, Amie Y Lee, Kimberly M Ray, Genevieve A Woodard, Rita I Freimanis, Bonnie N Joe
PURPOSE: To review the use of diagnostic breast imaging and outcomes for symptomatic male patients. METHODS: We retrospectively evaluated 122 males who underwent diagnostic imaging for breast symptoms at our academic center. RESULTS: The majority (94%) of cases had negative or benign imaging, with gynecomastia being the most common diagnosis (78%). There were two malignancies, both of which had positive imaging. Fifteen patients underwent percutaneous biopsy, and over half (53%) were palpation-guided biopsies initiated by the referring clinician despite negative imaging...
June 9, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28623028/impact-and-cost-effectiveness-of-rotavirus-vaccination-in-bangladesh
#12
Clint Pecenka, Umesh Parashar, Jacqueline E Tate, Jahangir A M Khan, Devin Groman, Stephen Chacko, Md Shamsuzzaman, Andrew Clark, Deborah Atherly
INTRODUCTION: Diarrheal disease is a leading cause of child mortality globally, and rotavirus is responsible for more than a third of those deaths. Despite substantial decreases, the number of rotavirus deaths in children under five was 215,000 per year in 2013. Of these deaths, approximately 41% occurred in Asia and 3% of those in Bangladesh. While Bangladesh has yet to introduce rotavirus vaccination, the country applied for Gavi support and plans to introduce it in 2018. This analysis evaluates the impact and cost-effectiveness of rotavirus vaccination in Bangladesh and provides estimates of the costs of the vaccination program to help inform decision-makers and international partners...
June 13, 2017: Vaccine
https://www.readbyqxmd.com/read/28622903/cell-saver-for-adult-spinal-deformity-surgery-reduces-cost
#13
Jeffrey L Gum, Leah Yacat Carreon, Michael P Kelly, Richard Hostin, Chessie Robinson, Douglas C Burton, David W Polly, Christopher I Shaffrey, Virginie LaFage, Frank J Schwab, Christopher P Ames, Han Jo Kim, Justin S Smith, R Shay Bess
STUDY DESIGN: Retrospective cohort. OBJECTIVES: To determine if the use of cell saver reduces overall blood costs in adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: Recent studies have questioned the clinical value of cell saver during spine procedures. METHODS: ASD patients enrolled in a prospective, multicenter surgical database who had complete preoperative and surgical data were identified. Patients were stratified into (1) cell saver available during surgery, but no intraoperative autologous infusion (No Infusion group), or (2) cell saver available and received autologous infusion (Infusion group)...
July 2017: Spine Deformity
https://www.readbyqxmd.com/read/28622739/impact-of-a-collaborative-strategy-to-reduce-the-inappropriate-use-of-acid-suppressive-therapy-in-non-intensive-care-unit-patients
#14
Kristen D Belfield, Arpi G Kuyumjian, Rafael Teran, Mariette Amadi, Melissa Blatt, Keri Bicking
BACKGROUND: Stress ulcer prophylaxis (SUP) is inappropriately prescribed in more than 30% of non-intensive care unit (ICU) patients, leading to unnecessary adverse events as well as increases in economic burden. OBJECTIVE: There was an increasing trend in the prophylactic use of acid suppressive therapy (AST) in non-critically ill patients at our institution, which prompted this initiative aimed at reducing the inappropriate use of AST in non-ICU patients. METHODS: This was a retrospective interventional study that consisted of formulation of a guideline, education to the hospitalist service, and intervention by clinical pharmacists...
July 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28621654/diabetes-risk-reduction-in-primary-care-evaluation-of-the-ontario-primary-care-diabetes-prevention-program
#15
Michael Hillmer, Guillermo A Sandoval, James A Elliott, Meera Jain, Tiffany Barker, Amy Prisniak, Stoni Astley, Laura Rosella
OBJECTIVES: Lifestyle interventions can reduce type 2 diabetes risk. The Primary Care Diabetes Prevention Program (PCDPP) was implemented by the Government of Ontario to lower diabetes risk. This study first evaluated the program, and second used a validated tool to estimate a potential population impact if the program were implemented more broadly in the province. METHODS: PCDPP was implemented in six primary care settings serving communities with high mortality risk due to chronic diseases...
June 16, 2017: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28620733/management-of-congenital-diaphragmatic-hernia-in-newborn-paradigm-shift-and-ethical-issues
#16
Sushmita Nitin Bhatnagar, Yogesh Kumar Sarin
Management of congenital diaphragmatic hernia (CDH) begins soon after it is detected, whether antenatally or postnatally. Assessment of the severity of the condition, associated congenital anomalies, maternal health and related issues, weight of the fetus/baby, mode of delivery, timing of delivery, immediate appropriate management of the baby with CDH at birth, appropriate utilization of available treatment modalities as well as infrastructure of the treating institute have an impact on the outcome of the neonate...
June 16, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28619229/cost-effectiveness-of-xpert-mtb-rif-for-tuberculosis-diagnosis-in-south-africa-a-real-world-cost-analysis-and-economic-evaluation
#17
Anna Vassall, Mariana Siapka, Nicola Foster, Lucy Cunnama, Lebogang Ramma, Katherine Fielding, Kerrigan McCarthy, Gavin Churchyard, Alison Grant, Edina Sinanovic
BACKGROUND: In 2010 a new diagnostic test for tuberculosis, Xpert MTB/RIF, received a conditional programmatic recommendation from WHO. Several model-based economic evaluations predicted that Xpert would be cost-effective across sub-Saharan Africa. We investigated the cost-effectiveness of Xpert in the real world during national roll-out in South Africa. METHODS: For this real-world cost analysis and economic evaluation, we applied extensive primary cost and patient event data from the XTEND study, a pragmatic trial examining Xpert introduction for people investigated for tuberculosis in 40 primary health facilities (20 clusters) in South Africa enrolled between June 8, and Nov 16, 2012, to estimate the costs and cost per disability-adjusted life-year averted of introducing Xpert as the initial diagnostic test for tuberculosis, compared with sputum smear microscopy (the standard of care)...
July 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28617810/population-level-impact-of-an-accelerated-hiv-response-plan-to-reach-the-unaids-90-90-90-target-in-c%C3%A3-te-d-ivoire-insights-from-mathematical-modeling
#18
Mathieu Maheu-Giroux, Juan F Vesga, Souleymane Diabaté, Michel Alary, Stefan Baral, Daouda Diouf, Kouamé Abo, Marie-Claude Boily
BACKGROUND: National responses will need to be markedly accelerated to achieve the ambitious target of the Joint United Nations Programme on HIV/AIDS (UNAIDS). This target aims for 90% of HIV-positive individuals to be aware of their status, for 90% of those aware to receive antiretroviral therapy (ART), and for 90% of those on treatment to have a suppressed viral load by 2020, with each individual target reaching 95% by 2030. We aimed to estimate the impact of various treatment-as-prevention scenarios in Côte d'Ivoire, one of the countries with the highest HIV incidence in West Africa, with unmet HIV prevention and treatment needs, and where key populations are important to the broader HIV epidemic...
June 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28613271/an-evaluation-of-the-proposed-worker-protection-standard-with-respect-to-pesticide-exposure-and-parkinson-s-disease
#19
Alica Stubnova Sparling, David W Martin, Lillian B Posey
Citing a lack of information, the U.S. Environmental Protection Agency prudently did not account for the benefits of averting many chronic diseases in analyzing the Worker Protection Standards (WPS) revisions. We demonstrate that sufficient information can exist, using the example of the benefits to agricultural workers of reduced Parkinson's disease (PD) due to reduced pesticide exposure. We define the benefits as the monetary value gained by improving quality of lives of people who would otherwise develop PD, plus the value of medical care cost averted and income not lost due to being healthy...
June 14, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28613035/total-laparoscopic-hysterectomy-for-endometrial-cancer-in-a-renal-transplantation-patient-receiving-peritoneal-dialysis-case-report-and-literature-review
#20
Mamoru Kakuda, Eiji Kobayashi, Yusuke Tanaka, Yutaka Ueda, Kiyoshi Yoshino, Tadashi Kimura
Improved surgical techniques and immunosuppressant medications for organ transplantation have resulted in a significant increase in the number of women undergoing renal transplantation. Peritoneal dialysis (PD), a common supportive therapy for chronic renal failure, is also used in cases of renal transplantation failure. Herein, we report the first case of a rare total conventional laparoscopic gynecologic hysterectomy performed for endometrial cancer in a patient undergoing life-supportive PD as a result of renal transplantation failure...
June 14, 2017: Journal of Obstetrics and Gynaecology Research
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