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https://www.readbyqxmd.com/read/27933614/antiviral-agents-for-infectious-mononucleosis-glandular-fever
#1
REVIEW
Muireann De Paor, Kirsty O'Brien, Tom Fahey, Susan M Smith
BACKGROUND: Infectious mononucleosis (IM) is a clinical syndrome, usually caused by the Epstein Barr virus (EPV), characterised by lymphadenopathy, fever and sore throat. Most cases of symptomatic IM occur in older teenagers or young adults. Usually IM is a benign self-limiting illness and requires only symptomatic treatment. However, occasionally the disease course can be complicated or prolonged and lead to decreased productivity in terms of school or work. Antiviral medications have been used to treat IM, but the use of antivirals for IM is controversial...
December 8, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27919937/primary-care-referral-for-echocardiogram-refer-in-heart-failure-a-diagnostic-accuracy-study
#2
Clare J Taylor, Andrea K Roalfe, Rachel Iles, Fd Richard Hobbs, Pelham Barton, Martin R Cowie, Russell C Davis, Jon Deeks, Jonathan Mant, Deborah McCahon, Theresa McDonagh, George Sutton, Lynda Tait
BACKGROUND: Symptoms of breathlessness, fatigue, and ankle swelling are common in general practice but deciding which patients are likely to have heart failure is challenging. AIM: To evaluate the performance of a clinical decision rule (CDR), with or without N-Terminal pro-B type natriuretic peptide (NT-proBNP) assay, for identifying heart failure. DESIGN AND SETTING: Prospective, observational, diagnostic validation study of patients aged >55 years, presenting with shortness of breath, lethargy, or ankle oedema, from 28 general practices in England...
December 5, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27919396/think-time-a-novel-approach-to-analysis-of-clinicians-behavior-after-reduction-of-drug-drug-interaction-alerts
#3
Richard Schreiber, Julia A Gregoire, Jacob E Shaha, Steven H Shaha
OBJECTIVES: Pharmacologic interaction alerting offers the potential for safer medication prescribing, but research reveals persistent concerns regarding alert fatigue. Research studies have tried various strategies to resolve this problem, with low overall success. We examined the effects of targeted alert reduction on clinician behavior in a resource constrained hospital. METHODS: A physician and a pharmacy informaticist reduced alert levels of several drug-drug interactions (DDI) that clinicians almost always overrode with approval from and knowledge of the medical staff...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27914655/crohn-s-disease
#4
REVIEW
Joana Torres, Saurabh Mehandru, Jean-Frédéric Colombel, Laurent Peyrin-Biroulet
Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract, with increasing incidence worldwide. Crohn's disease might result from a complex interplay between genetic susceptibility, environmental factors, and altered gut microbiota, leading to dysregulated innate and adaptive immune responses. The typical clinical scenario is a young patient presenting with abdominal pain, chronic diarrhoea, weight loss, and fatigue. Assessment of disease extent and of prognostic factors for complications is paramount to guide therapeutic decisions...
November 30, 2016: Lancet
https://www.readbyqxmd.com/read/27913549/second-line-therapies-in-immune-thrombocytopenia
#5
Rachael F Grace, Cindy Neunert
Immune thrombocytopenia (ITP) is a rare, acquired autoimmune condition characterized by a low platelet count and an increased risk of bleeding. Although many children and adults with ITP will not need therapy beyond historic first-line treatments of observation, steroids, intravenous immunoglobulin (IVIG), and anti-D globulin, others will have an indication for second-line treatment. Selecting a second-line therapy depends on the reason for treatment, which can vary from bleeding to implications for health-related quality of life (HRQoL) to likelihood of remission and patient preference with regard to adverse effects, route of administration, and cost...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27901246/chemotherapy-for-advanced-non-small-cell-lung-cancer-in-the-elderly-population
#6
Fábio Nasser Santos, Tiago Biachi de Castria, Marcelo Rocha Souza Cruz, Rachel Riera
BACKGROUND: Approximately 50% of patients with newly diagnosed non-small cell lung cancer (NSCLC) are over 70 years of age at diagnosis. Despite this fact, these patients are underrepresented in randomized controlled trials (RCTs). As a consequence, the most appropriate regimens for these patients are controversial, and the role of single-agent or combination therapy is unclear. In this setting, a critical systematic review of RCTs in this group of patients is warranted. OBJECTIVES: To assess the effectiveness and safety of different cytotoxic chemotherapy regimens for previously untreated elderly patients with advanced (stage IIIB and IV) NSCLC...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27865552/relationship-between-voice-complaints-and-subjective-and-objective-measures-of-vocal-function-in-iranian-female-teachers
#7
Maryam Faham, Nahid Jalilevand, Farhad Torabinezhad Nejad, Erin Pearson Silverman, Akram Ahmadi, Zahra Ghayoumi Anaraki, Narges Jafari
OBJECTIVES: Teachers are at high risk of developing voice problems because of the excessive vocal demands necessitated by their profession. Teachers' self-assessment of vocal complaints, combined with subjective and objective measures of voice, may enable better therapeutic decision-making. This investigation compared audio-perceptual assessment and acoustic variables in teachers with and without voice complaints. METHODS: Ninety-nine teachers completed this cross-sectional study and were assigned to one of two groups: those "with voice complaint (VC)" and those "without voice complaint (W-VC)...
November 16, 2016: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/27843571/cachexia-in-cancer-what-is-in-the-definition
#8
Greetje Vanhoutte, Mick van de Wiel, Kristin Wouters, Michaël Sels, Linda Bartolomeeussen, Sven De Keersmaecker, Caroline Verschueren, Veronique De Vroey, Annemieke De Wilde, Elke Smits, Kin Jip Cheung, Liesbeth De Clerck, Petra Aerts, Didier Baert, Caroline Vandoninck, Sofie Kindt, Sofie Schelfhaut, Marc Vankerkhoven, Annelies Troch, Lore Ceulemans, Hanne Vandenbergh, Sven Leys, Tim Rondou, Elke Dewitte, Kristel Maes, Patrick Pauwels, Benedicte De Winter, Luc Van Gaal, Dirk Ysebaert, Marc Peeters
OBJECTIVE: This study aimed to provide evidence-based results on differences in overall survival (OS) rate to guide the diagnosis of cancer cachexia. DESIGN: Data collection and clinical assessment was performed every 3 months (5 visits): baseline data, muscle strength, nutritional and psychosocial status. 2 definitions on cachexia using different diagnostic criteria were applied for the same patient population. Fearon et al's definition is based on weight loss, body mass index (BMI) and sarcopenia...
2016: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/27823651/first-line-antiangiogenics-for-metastatic-renal-cell-carcinoma-a-systematic-review-and-network-meta-analysis
#9
REVIEW
Benoît Rousseau, Emmanuelle Kempf, Gaelle Desamericq, Emilie Boissier, Marie Chaubet-Houdu, Charlotte Joly, Carolina Saldana, Helene Boussion, Cindy Neuzillet, Isabelle Macquin-Mavier, Stéphane Oudard, Laurent Salomon, Alexandre de la Taille, Christophe Tournigand
BACKGROUND: Sunitinib, pazopanib, sorafenib, axitinib and bevacizumab are the five recommended antiangiogenic agents in first-line therapy for metastatic renal cell carcinoma (mRCC). Because these drugs underwent simultaneous clinical development, no direct efficacy and safety comparison was ever conducted, thus preventing optimal therapy choices. METHODS: We performed a traditional and network meta-analysis to evaluate the efficacy and safety of mRCC-recommended first-line antiangiogenic agents...
November 2016: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/27814714/patient-preferences-for-treatment-of-castration-resistant-prostate-cancer-in-japan-a-discrete-choice-experiment
#10
Hiroji Uemura, Nobuaki Matsubara, Go Kimura, Akito Yamaguchi, Dianne Athene Ledesma, Marco DiBonaventura, Ateesha F Mohamed, Enrique Basurto, Ian McKinnon, Ed Wang, Kristen Concialdi, Aya Narimatsu, Yasuko Aitoku
BACKGROUND: Up to a fifth of patients diagnosed with prostate cancer (PC) will develop castration-resistant prostate cancer (CRPC), which has been associated with a poor prognosis. The aim of this study was to consider the patient perspective as part of the overall treatment decision-making process for CRPC, given that an alignment between patient preference and prescribing has been shown to benefit patient outcomes. This study examines preferences of patients with CRPC in Japan for treatment features associated with treatments like RA-223, abiraterone, and docetaxel and to examine the extent to which treatment preferences may vary between symptomatic and asymptomatic patients...
November 4, 2016: BMC Urology
https://www.readbyqxmd.com/read/27800653/problem-based-learning-in-internal-medicine-virtual-patients-or-paper-based-problems-%C3%A5
#11
Monika Sobocan, Neja Turk, Dejan Dinevski, Radovan Hojs, Breda Pecovnik Balon
BACKGROUND: Teaching using paper problem-based learning (p-PBL) sessions has left some students fatigued with the learning process. Therefore, attempts have been made to replace p-PBL with digitally enhanced, decision-making PBL in the form of virtual patients (VPs). Student enthusiasm for substituting p-PBL with VPs has not been quantitatively evaluated on the intended educational effects. AIM: To determine the educational effects of substituting p-PBL sessions with VPs on undergraduate medical students in their internal medicine course...
November 1, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27782288/development-of-a-standardized-rating-tool-for-drug-alerts-to-reduce-information-overload
#12
Barbara Pfistermeister, Brita Sedlmayr, Andrius Patapovas, Gerald Suttner, Ozan Tektas, Aleksey Tarkhov, Johannes Kornhuber, Martin F Fromm, Thomas Bürkle, Hans-Ulrich Prokosch, Renke Maas
BACKGROUND: A well-known problem in current clinical decision support systems (CDSS) is the high number of alerts, which are often medically incorrect or irrelevant. This may lead to the so-called alert fatigue, an overriding of alerts, including those that are clinically relevant, and underuse of CDSS in general. OBJECTIVES: The aim of our study was to develop and to apply a standardized tool that allows its users to evaluate the quality of system-generated drug alerts...
October 26, 2016: Methods of Information in Medicine
https://www.readbyqxmd.com/read/27768923/early-tumour-response-as-a-survival-predictor-in-previously-treated-patients-receiving-triplet-hepatic-artery-infusion-and-intravenous-cetuximab-for-unresectable-liver-metastases-from-wild-type-kras-colorectal-cancer
#13
Mohamed Bouchahda, Valérie Boige, Denis Smith, Abdoulaye Karaboué, Michel Ducreux, Mohamed Hebbar, Céline Lepère, Christian Focan, Rosine Guimbaud, Pasquale Innominato, Sameh Awad, Carlos Carvalho, Salvatore Tumolo, Stephanie Truant, Thierry De Baere, Denis Castaing, Philippe Rougier, Jean-François Morère, Julien Taieb, René Adam, Francis Lévi
BACKGROUND: Early tumour shrinkage has been associated with improved survival in patients receiving cetuximab-based systemic chemotherapy for liver metastases from colorectal cancer (LM-CRC). We tested this hypothesis for previously treated LM-CRC patients receiving cetuximab (500 mg/m(2)) and triplet hepatic artery infusion (HAI) within European trial OPTILIV. METHODS: Irinotecan (180 mg/m(2)), 5-fluorouracil (2800 mg/m(2)) and oxaliplatin (85 mg/m(2)) were given as chronomodulated or conventional delivery...
October 17, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/27762159/experience-of-plastic-surgery-registrars-in-a-european-working-time-directive-compliant-rota
#14
Catherine de Blacam, Sean Tierney, Odhran Shelley
BACKGROUND: Surgical training requires exposure to clinical decision-making and operative experience in a supervised environment. It is recognised that learning ability is compromised when fatigued. The European Working Time Directive requires a decrease in working hours, but compliance reduces trainees' clinical exposure, which has profound implications for plastic surgery training. The aim of this study was to evaluate plastic surgery registrars' experience of an EWTD-compliant rota, and to examine its impact on patient care, education, and logbook activity...
October 20, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27733099/modelling-and-simulation-for-table-tennis-referee-regulation-based-on-finite-state-machine
#15
Jianjiang Cui, Zixuan Liu, Long Xu
As referee's decisions are made artificially in traditional table tennis matches, many factors in a match, such as fatigue and subjective tendency, may lead to unjust decision. Based on finite state machine (FSM), this paper presents a model for table tennis referee regulation to substitute manual decisions. In this model, the trajectory of the ball is recorded through a binocular visual system while the complete rules extracted from the International Table Tennis Federation (ITTF) rules are described based on FSM...
October 13, 2016: Journal of Sports Sciences
https://www.readbyqxmd.com/read/27730534/living-with-cancer-an-educational-intervention-in-cancer-patients-can-improve-patient-reported-knowledge-deficit
#16
Leslie Padrnos, Robert Bennett, Heidi Kosiorek, Amylou C Dueck, Donald Northfelt, Joseph Mikhael, Raoul Tibes, Nandita Khera, Ruben A Mesa
A cancer diagnosis requires significant information to facilitate health care decision making, understand management options, and health care system navigation. Patient knowledge deficit can decrease quality of life and health care compliance. Surveys were distributed to attendees of the Mayo Clinic "Living with and Surviving Cancer" patient symposium January 2015. Follow-up survey was sent to participants 3 months after the symposium. Surveys included demographic data and patient-reported disease comprehension, symptom burden, desired information, and quality-of-life assessment...
October 11, 2016: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/27726215/factors-associated-with-current-and-severe-physical-side-effects-after-prostate-cancer-treatment-what-men-report
#17
L Steentjes, S Siesling, F J Drummond, J G van Manen, L Sharp, A Gavin
We identified patient and disease characteristics associated with (1) "current" physical side-effects of any severity; and (2) "severe" physical side-effects "ever" experienced by 3,348 (54%) prostate cancer (PCa) survivors in Ireland diagnosed 2-18 years previously. Postal questionnaires collected symptoms at diagnosis, post-biopsy complications, comorbidities, primary treatments and physical side-effects post-treatment (urinary incontinence, erectile dysfunction, libido loss, bowel problems, breast changes, hot flushes, and fatigue, "ever" and "current" at time of questionnaire completion)...
October 10, 2016: European Journal of Cancer Care
https://www.readbyqxmd.com/read/27725653/does-decision-fatigue-impact-manuscript-acceptance-an-analysis-of-editorial-decisions-by-the-american-journal-of-gastroenterology
#18
James Kwan, Libby Stein, Sean Delshad, Sunny Johl, Hannah Park, Bibiana Martinez, Lindsey Topp, Brennan M R Spiegel
No abstract text is available yet for this article.
October 11, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27701879/correlating-symptoms-and-their-changes-with-survival-in-patients-with-brain-metastases
#19
Erin Wong, Leigha Rowbottom, May Tsao, Liying Zhang, Rachel McDonald, Cyril Danjoux, Elizabeth Barnes, Stephanie Chan, Edward Chow
OBJECTIVE: Having a clear prognosis for patients with brain metastases allows health care practitioners (HCPs) to determine appropriate palliative management and assist patients when making informed treatment decisions. The objective of this study was to determine the prognostic significance of commonly experienced symptoms as well as their changes. METHODS: Overall survival (OS) was calculated from the date of consultation for palliative radiotherapy to date of death or censored at last follow-up date...
September 9, 2016: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/27681684/the-impairing-effect-of-mental-fatigue-on-visual-sustained-attention-under-monotonous-multi-object-visual-attention-task-in-long-durations-an-event-related-potential-based-study
#20
Zizheng Guo, Ruiya Chen, Kan Zhang, Yirun Pan, Jianhui Wu
The impairing effects of mental fatigue on visual sustained attention were assessed by event-related potentials (ERPs). Subjects performed a dual visual task, which includes a continuous tracking task (primary task) and a random signal detection task (secondary task), for 63 minutes nonstop in order to elicit ERPs. In this period, the data such as subjective levels of mental fatigue, behavioral performance measures, and electroencephalograms were recorded for each subject. Comparing data from the first interval (0-25 min) to that of the second, the following phenomena were observed: the subjective fatigue ratings increased with time, which indicates that performing the tasks leads to increase in mental fatigue levels; reaction times prolonged and accuracy rates decreased in the second interval, which indicates that subjects' sustained attention decreased...
2016: PloS One
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