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https://www.readbyqxmd.com/read/29049118/risk-factors-for-opioid-use-disorder-and-overdose
#1
Lynn R Webster
Opioid analgesics are recognized as a legitimate medical therapy for selected patients with severe chronic pain that does not respond to other therapies. However, opioids are associated with risks for patients and society that include misuse, abuse, diversion, addiction, and overdose deaths. Therapeutic success depends on proper candidate selection, assessment before administering opioid therapy, and close monitoring throughout the course of treatment. Risk assessment and prevention include knowledge of patient factors that may contribute to misuse, abuse, addiction, suicide, and respiratory depression...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29046259/assessing-the-impact-of-quality-improvement-measures-on-catheter-related-blood-stream-infections-and-catheter-salvage-experience-from-a-national-intestinal-failure-unit
#2
A Bond, A Teubner, M Taylor, C Cawley, A Abraham, M Dibb, P R Chadwick, M Soop, G Carlson, S Lal
BACKGROUND & AIMS: Prevention of catheter related blood stream infections (CRBSI) and salvage of infected central venous catheters (CVC) are vital to maintaining long term venous access in patients needing home parenteral nutrition (HPN). It remains unclear as to whether patients are best trained for catheter care at home or in hospital or whether CRBSIs are lower if the patient self-cares for the CVC. Furthermore, there is minimal data on the longer term outcome following salvage of infected catheter and limited consensus on agreed protocols for catheter salvage...
October 10, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29046212/-research-advances-in-hereditary-epilepsy-and-precision-drug-therapy
#3
Ge Lyu, Yun-Li Han
Epilepsy is a common nervous system disease. It has been found that the pathogenesis of epilepsy is associated mutations in various genes, including genes encoding voltage-dependent ion channel, genes encoding ligand-gated ion channel, and solute carrier family genes. Different types of epilepsy caused by different mutations have different responses to drugs, and therefore, diagnosis and medication guidance based on genes are new thoughts for developing therapies. With the application of next-generation sequencing technology, more and more genes will be determined, which helps to further study the pathogenic mechanism of mutant genes and provides a basis for precision drug therapy for epilepsy...
October 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29039263/integrating-family-planning-services-into-hiv-care-use-of-a-point-of-care-electronic-medical-record-system-in-lilongwe-malawi
#4
Hannock Tweya, Caryl Feldacker, Lisa B Haddad, Chimango Munthali, Mwatha Bwanali, Colin Speight, Layout G Kachere, Petros Tembo, Sam Phiri
BACKGROUND: Integrating family planning (FP) services into human immunodeficiency virus (HIV) clinical care helps improve access to contraceptives for women living with HIV. However, high patient volumes may limit providers' ability to counsel women about pregnancy risks and contraceptive options. OBJECTIVES: To assess trends in the use of contraceptive methods after implementing an  electronic medical record (EMR) system with FP questions and determine the reasons for non-use of contraceptives among women of reproductive age (15-49 years) receiving antiretroviral therapy (ART) at the Martin Preuss Center clinic in Malawi...
2017: Global Health Action
https://www.readbyqxmd.com/read/29038147/imputation-of-baseline-ldl-cholesterol-concentration-in-patients-with-familial-hypercholesterolemia-on-statins-or-ezetimibe
#5
Isabelle Ruel, Sumayah Aljenedil, Iman Sadri, Émilie de Varennes, Robert A Hegele, Patrick Couture, Jean Bergeron, Eric Wanneh, Alexis Baass, Robert Dufour, Daniel Gaudet, Diane Brisson, Liam R Brunham, Gordon A Francis, Lubomira Cermakova, James M Brophy, Arnold Ryomoto, G B John Mancini, Jacques Genest
BACKGROUND: Familial hypercholesterolemia (FH) is the most frequent genetic disorder seen clinically and is characterized by increased LDL cholesterol (LDL-C) (>95th percentile), family history of increased LDL-C, premature atherosclerotic cardiovascular disease (ASCVD) in the patient or in first-degree relatives, presence of tendinous xanthomas or premature corneal arcus, or presence of a pathogenic mutation in the LDLR, PCSK9, or APOB genes. A diagnosis of FH has important clinical implications with respect to lifelong risk of ASCVD and requirement for intensive pharmacological therapy...
October 16, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/29037196/unmet-clinical-needs-and-burden-in-angelman-syndrome-a-review-of-the-literature
#6
REVIEW
Anne C Wheeler, Patricia Sacco, Raquel Cabo
BACKGROUND: Angelman syndrome (AS) is a rare disorder with a relatively well-defined phenotype. Despite this, very little is known regarding the unmet clinical needs and burden of this condition, especially with regard to some of the most prevalent clinical features-movement disorders, communication impairments, behavior, and sleep. MAIN TEXT: A targeted literature review using electronic medical databases (e.g., PubMed) was conducted to identify recent studies focused on specific areas of the AS phenotype (motor, communication, behavior, sleep) as well as epidemiology, diagnostic processes, treatment, and burden...
October 16, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29033611/stable-ischemic-heart-disease-in-women-current-perspectives
#7
REVIEW
Fatima Samad, Anushree Agarwal, Zainab Samad
Cardiovascular disease is the leading cause of death in women accounting for 1 in every 4 female deaths. Pathophysiology of ischemic heart disease in women includes epicardial coronary artery, endothelial dysfunction, coronary vasospasm, plaque erosion and spontaneous coronary artery dissection. Angina is the most common presentation of stable ischemic heart disease (SIHD) in women. Risk factors for SIHD include traditional risks such as older age, obesity (body mass index [BMI] >25 kg/m(2)), smoking, hypertension, dyslipidemia, cerebrovascular and peripheral vascular disease, sedentary lifestyle, family history of premature coronary artery disease, metabolic syndrome and diabetes mellitus, and nontraditional risk factors, such as gestational diabetes, insulin resistance/polycystic ovarian disease, pregnancy-induced hypertension, pre-eclampsia, eclampsia, menopause, mental stress and autoimmune diseases...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/29031937/payer-database-and-geospatial-analysis-to-evaluate-practice-patterns-in-treating-allergy-in-north-carolina
#8
Matthew G Crowson, Kristine Schulz, Alex Ulvila, David L Witsell
OBJECTIVE: The objective of this study was to characterize the delivery of allergy care in North Carolina using a large payer charge database and visualization techniques. STUDY DESIGN: Geospatial database analysis. SETTING: North Carolina State claims database. SUBJECTS & METHODS: Medical data from the 2013 FAIR Health National Private Insurance Claims (FH NPIC) database for North Carolina was mined for CPT codes and charges for allergy testing, and for the preparation and provision of allergen immunotherapy...
October 10, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29030806/palliative-care-in-the-management-of-patients-with-advanced-heart-failure
#9
Susan E Lowey
Globally, there are 18-million individuals living with heart failure, a disease that is responsible for 12-15 million office visits and 6.5 million inpatient hospitalizations each year. As HF becomes advanced or end-stage, patients often live in a cycle of frequent transitions between care settings, and with unmet needs, including distress from inadequately managed symptoms. Prognostication in patients with heart failure can be challenging due to the unpredictable exacerbating-remitting illness trajectory that is associated with this progressive disease...
October 14, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29025128/opioid-therapy-for-chronic-pain-overview-of-the-2017%C3%A2-us-department-of-veterans-affairs-and-us-department-of-defense-clinical-practice-guideline
#10
Jack M Rosenberg, Brandon M Bilka, Sara M Wilson, Christopher Spevak
Description: The US Department of Veterans Affairs (VA) and US Department of Defense (DoD) revised the 2010 clinical practice guideline (CPG) for the management of opioid therapy for chronic pain, considering the specific needs of the VA and DoD and new evidence regarding prescribing opioid medication for non-end-of-life-related chronic pain. This paper summarizes the major recommendations and compares them with the US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids...
September 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29020908/cardiac-society-of-australia-and-new-zealand-position-statement-executive-summary-coronary-artery-calcium-scoring
#11
Christian R Hamilton-Craig, Clara K Chow, John F Younger, V M Jelinek, Jonathan Chan, Gary Yh Liew
Introduction This article summarises the Cardiac Society of Australia and New Zealand position statement on coronary artery calcium (CAC) scoring. CAC scoring is a non-invasive method for quantifying coronary artery calcification using computed tomography. It is a marker of atherosclerotic plaque burden and the strongest independent predictor of future myocardial infarction and mortality. CAC scoring provides incremental risk information beyond traditional risk calculators such as the Framingham Risk Score...
October 16, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29020844/nucleoside-nucleotide-analogues-in-the-treatment-of-chronic-hepatitis-b-infection-during-pregnancy-a-systematic-review
#12
Soheil Tavakolpour, Mohammad Darvishi, Hajar Sadat Mirsafaei, Mojtaba Ghasemiadl
BACKGROUND: Women of childbearing age who have developed chronic hepatitis B (CHB) infection, especially HBeAg-positive highly viraemic pregnant women, are largely responsible for the familial transmission of the infection. Therefore, choosing the most effective and safest antiviral medications to manage pregnant CHB patients is of crucial importance. MATERIALS AND METHODS: The PubMed and Scopus databases were searched through September 2017, for all the journal articles possessing original results regarding treatment of CHB pregnant women with any nucleos(t)ide analogue (NA) therapies, including lamivudine (LAM), adefovir (ADV), entecavir (ETV), telbivudine (LdT), and tenofovir (TDF)...
October 11, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/29019422/pharmacotherapy-of-mood-disorders-and-psychosis-in-pre-and-post-natal-women
#13
Beth Smith, Steven L Dubovsky
Untreated mood and psychotic disorders can have substantial adverse impacts on the patient, the fetus and the family, while treatment can ameliorate such problems. To address concerns by clinicians about the risks of psychotropic medications, this review addresses the risk/benefit analysis of somatic therapies for psychiatric disorders during pregnancy and lactation. Areas covered: All available research was reviewed on the impact on pregnancy and breastfeeding of mood and psychotic disorders, and of antidepressants, mood stabilizers, antipsychotic drugs, and electroconvulsive therapy...
October 11, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28993806/genetics-in-idiopathic-pulmonary-fibrosis-pathogenesis-prognosis-and-treatment
#14
REVIEW
Amarpreet Kaur, Susan K Mathai, David A Schwartz
Idiopathic pulmonary fibrosis (IPF), the most common form of idiopathic interstitial pneumonia (IIP), is characterized by irreversible scarring of the lung parenchyma and progressive decline in lung function leading to eventual respiratory failure. The prognosis of IPF is poor with a median survival of 3-5 years after diagnosis and no curative medical therapies. Although the pathogenesis of IPF is not well understood, there is a growing body of evidence that genetic factors contribute to disease risk. Recent studies have identified common and rare genetic variants associated with both sporadic and familial forms of pulmonary fibrosis, with at least one-third of the risk for developing fibrotic IIP explained by common genetic variants...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28993804/familial-hypercholesterolemia-a-systematic-review-of-guidelines-on-genetic-testing-and-patient-management
#15
Giuseppe Migliara, Valentina Baccolini, Annalisa Rosso, Elvira D'Andrea, Azzurra Massimi, Paolo Villari, Corrado De Vito
BACKGROUND: Familial hypercholesterolemia (FH) is an autosomal-dominant hereditary disorder of lipid metabolism that causes lifelong exposure to increased LDL levels resulting in premature coronary heart disease and, if untreated, death. Recent studies have shown its prevalence to be higher than previously considered, which has important implications for the mortality and morbidity of associated cardiovascular disease (CVD). Several clinical tools are used worldwide to help physicians diagnose FH, but nevertheless most patients remain undetected...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28986186/fatal-abdominal-compartment-syndrome-due-to-severe-triglyceride-induced-pancreatitis-in-early-pregnancy
#16
Tamanna Chibber, Paul S Gibson
Serum levels of maternal lipids rise physiologically in normal pregnancy, and women with underlying hypertriglyceridemia may experience dramatic elevations which place them at risk for pancreatitis. We describe the case of a woman with severe familial hypertriglyceridemia and prior pancreatitis who discontinued her lipid-lowering therapy early in pregnancy. She promptly developed severe abdominal pain and was hospitalized with acute pancreatitis during the late first trimester. Despite aggressive medical treatment and critical care monitoring, she developed abdominal compartment syndrome (ACS) with associated acute renal failure, which progressed to cardiorespiratory failure and was ultimately fatal...
October 3, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28979101/aversion-to-ambiguity-and-willingness-to-take-risks-affect-therapeutic-decisions-in-managing-atrial-fibrillation-for-stroke-prevention-results-of-a-pilot-study-in-family-physicians
#17
Stavroula Raptis, Jia Ning Chen, Florencia Saposnik, Roman Pelyavskyy, Andrew Liuni, Gustavo Saposnik
BACKGROUND: Anticoagulation is the therapeutic paradigm for stroke prevention in patients with atrial fibrillation (AF). It is unknown how physicians make treatment decisions in primary stroke prevention for patients with AF. OBJECTIVES: To evaluate the association between family physicians' risk preferences (aversion risk and ambiguity) and therapeutic recommendations (anticoagulation) in the management of AF for primary stroke prevention by applying concepts from behavioral economics...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28973626/delirium-in-older-persons-advances-in-diagnosis-and-treatment
#18
REVIEW
Esther S Oh, Tamara G Fong, Tammy T Hshieh, Sharon K Inouye
Importance: Delirium is defined as an acute disorder of attention and cognition. It is a common, serious, and often fatal condition among older patients. Although often underrecognized, delirium has serious adverse effects on the individual's function and quality of life, as well as broad societal effects with substantial health care costs. Objective: To summarize the current state of the art in diagnosis and treatment of delirium and to highlight critical areas for future research to advance the field...
September 26, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28973478/roux-en-y-gastric-bypass-surgery-in-the-management-of-familial-partial-lipodystrophy-type-1-fpld1
#19
Audrey Melvin, Claire Adams, Catherine Flanagan, Lisa Gaff, Barbara Gratton, Fiona Gribble, Geoffrey Roberts, Robert K Semple, Stephen O'Rahilly, Francesco Rubino, Anna Stears, David B Savage
Introduction: Familial partial lipodystrophy type 1 is an extreme form of central adiposity with peripheral lipodystrophy associated with severe manifestations of the metabolic syndrome, often poorly responsive to standard therapeutic approaches. Body mass index in FPLD1 varies but in many cases is below the level at which metabolic surgery is usually considered as a therapeutic option. Materials and Methods: We detailed the metabolic response to gastric bypass surgery of three patients with FPLD1, refractory to medical therapy...
July 26, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28965617/detection-of-familial-hypercholesterolemia-in-patients-from-a-general-practice-database
#20
Manuela Casula, Alberico L Catapano, Luigi Rossi Bernardi, Marco Visconti, Alberto Aronica
OBJECTIVES: Familial hypercholesterolemia (FH) is the most common monogenic lipid disorder associated with premature coronary heart disease. Early cholesterol-lowering therapy could effectively reduce cardiovascular disease morbidity and mortality in these patients. However, the majority of people with FH are undiagnosed, also due to low awareness and knowledge of FH in general practice, despite the high number of contacts GPs have with most of their patients which allows a systematic and effective approach to the detection of this condition...
October 2017: Atherosclerosis. Supplements
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