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https://www.readbyqxmd.com/read/28541460/seminal-plasma-pro-inflammatory-cytokines-interferon-%C3%AE-ifng-and-c-x-c-motif-chemokine-ligand-8-cxcl8-fluctuate-over-time-within-men
#1
David J Sharkey, Kelton P Tremellen, Nancy E Briggs, Gustaaf A Dekker, Sarah A Robertson
STUDY QUESTION: Do seminal plasma pro-inflammatory cytokines interferon-γ (IFNG) and C-X-C motif chemokine ligand 8 (CXCL8) vary within individual men over time? SUMMARY ANSWER: IFNG exhibits substantial variation that is independent of duration of abstinence but correlates with lipopolysaccharide (LPS) content, while CXCL8 varies moderately in association with duration of abstinence. WHAT IS KNOWN ALREADY: Pro-inflammatory cytokines IFNG and CXCL8 in seminal fluid can adversely impact male and female fertility...
May 25, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28541234/psychiatric-specialty-training-in-greece
#2
EDITORIAL
M Margariti, V Kontaxakis, D Ploumpidis
The reform and development of psychiatric services require, in addition to financial resources, reserves in specialized human resources. The role of psychiatrists in this process, and at reducing the consequences of mental morbidity is evident. Psychiatrists are required to play a multifaceted role as clinicians, as experts in multidisciplinary team environments and as advisors in the recognition of public needs in mental health issues, as teachers and mentors for students and other health professionals, as researchers in order to enrich our knowledge in the scientific field of psychiatry, and as public health specialists in the development of the mental health services system...
January 2017: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/28535102/why-value-framework-assessments-arrive-at-different-conclusions-a-multiple-myeloma-case-study
#3
Kimberly Westrich, Lisabeth Buelt, Robert W Dubois
As the United States transitions from a volume-based health care system to one that rewards value, new frameworks are emerging to help patients, providers, and payers assess the value of medical services and biopharmaceutical products. These value assessment frameworks are intended to support various types of health care decision making. They have the potential to substantially affect patients, whether as tools for shared decision making with their doctors, as an input to care pathways used by providers, or through payer use of the frameworks to make coverage or reimbursement decisions...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530519/does-a-one-size-fits-all-cost-sharing-approach-incentivize-appropriate-medication-use-a-roundtable-on-the-fairness-and-ethics-associated-with-variable-cost-sharing
#4
Jennifer S Graff, Chuck Shih, Thomas Barker, Gabriela Dieguez, Cheryl Larson, Helen Sherman, Robert W Dubois
BACKGROUND: Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530117/combined-impact-of-smoking-and-early-life-exposures-on-adult-lung-function-trajectories
#5
James P Allinson, Rebecca Hardy, Gavin C Donaldson, Seif O Shaheen, Diana Kuh, Jadwiga A Wedzicha
BACKGROUND: Both adverse early life exposures and adult smoking can negatively influence adult lung function trajectory but few studies consider how the impact of early life exposures may be modified by subsequent smoking. METHODS: The Medical Research Council National Survey of Health and Development is a nationally representative cohort, initially of 5362 individuals, followed since enrolment at birth in March 1946. Using data collected prospectively across life and multilevel modelling we investigated how the relationships between early life exposures (infant lower respiratory infection, manual social class, home overcrowding and pollution exposure) and FEV1 and FVC trajectories between ages 43 and 60-64 were influenced by smoking behaviour...
May 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28527637/the-state-of-shared-decision-making-in-malaysia
#6
Yew Kong Lee, Chirk Jenn Ng
Shared decision making (SDM) activities in Malaysia began around 2010. Although the concept is not widespread, there are opportunities to implement SDM in both the public and private healthcare sectors. Malaysia has a multicultural society and cultural components (such as language differences, medical paternalism, strong family involvement, religious beliefs and complementary medicine) influence medical decision making. In terms of policy, the Ministry of Health has increasingly mentioned patient-centered care as a component of healthcare delivery while the Malaysian Medical Council's guidelines on doctors' duties mentioned collaborative partnerships as a goal of doctor-patient relationships...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28525526/critical-analysis-of-the-council-for-international-organizations-of-medical-sciences-2016-international-guidelines-for-health-related-research-involving-humans
#7
REVIEW
Miguel Hugo Kottow Lang
This paper presents a preliminary discussion of the Council for International Organizations of Medical Sciences (CIOMS), recently issued “International Ethical Guidelines for Health-related Research Involving Humans” (2016) that acknowledges the document’s declared concern of the protection of human subjects and awareness of their needs and interests in “low-resource settings”. Nevertheless, guideline recommendations present exceptional situations –vulnerability, mental incompetence- wherein voluntary and consented participation may be reduced or omitted under three concurrent conditions: compelling scientific value, the need to include persons that will not benefit directly from participation, exposure to minimal or slight risks...
May 15, 2017: Medwave
https://www.readbyqxmd.com/read/28514888/seeing-is-believing-healthcare-professionals-perceptions-of-a-complex-intervention-to-improve-care-towards-the-end-of-life-a-qualitative-interview-study
#8
Katherine Bristowe, Irene Carey, Adrian Hopper, Susanna Shouls, Wendy Prentice, Irene J Higginson, Jonathan Koffman
BACKGROUND: Methods to improve care, trust and communication are important in acute hospitals. Complex interventions aimed at improving care of patients approaching the end of life are increasingly common. While evaluating outcomes of complex interventions is essential, exploring healthcare professionals' perceptions is also required to understand how they are interpreted; this can inform training, education and implementation strategies to ensure fidelity and consistency in use. AIM: To explore healthcare professionals' perceptions of using a complex intervention (AMBER care bundle) to improve care for people approaching the end of life and their understandings of its purpose within clinical practice...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28494920/clinical-efficacy-of-intravitreal-aflibercept-versus-panretinal-photocoagulation-for-best-corrected-visual-acuity-in-patients-with-proliferative-diabetic-retinopathy-at-52-weeks-clarity-a-multicentre-single-blinded-randomised-controlled-phase-2b-non-inferiority
#9
Sobha Sivaprasad, A Toby Prevost, Joana C Vasconcelos, Amy Riddell, Caroline Murphy, Joanna Kelly, James Bainbridge, Rhiannon Tudor-Edwards, David Hopkins, Philip Hykin
BACKGROUND: Proliferative diabetic retinopathy is the most common cause of severe sight impairment in people with diabetes. Proliferative diabetic retinopathy has been managed by panretinal laser photocoagulation (PRP) for the past 40 years. We report the 1 year safety and efficacy of intravitreal aflibercept. METHODS: In this phase 2b, single-blind, non-inferiority trial (CLARITY), adults (aged ≥18 years) with type 1 or 2 diabetes and previously untreated or post-laser treated active proliferative diabetic retinopathy were recruited from 22 UK ophthalmic centres...
May 5, 2017: Lancet
https://www.readbyqxmd.com/read/28472417/the-impact-of-specific-fertility-treatments-on-cognitive-development-in-childhood-and-adolescence-a-systematic-review
#10
Alice R Rumbold, Vivienne M Moore, Melissa J Whitrow, Tassia K Oswald, Lisa J Moran, Renae C Fernandez, Kurt T Barnhart, Michael J Davies
STUDY QUESTION: Does fertility treatment influence cognitive ability in school aged children, and does the impact vary with the type of treatment? SUMMARY ANSWER: The available high-quality evidence indicates that specific treatments may give rise to different effects on cognitive development, with certain treatments, including ICSI, associated with cognitive impairment. WHAT IS KNOWN ALREADY: Previous reviews of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally 'reassuring', but limited attention has been paid to the quality of this research...
May 4, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28468629/a-methodological-protocol-for-selecting-and-quantifying-low-value-prescribing-practices-in-routinely-collected-data-an-australian-case-study
#11
Jonathan Brett, Adam G Elshaug, R Sacha Bhatia, Kelsey Chalmers, Tim Badgery-Parker, Sallie-Anne Pearson
BACKGROUND: Growing imperatives for safety, quality and responsible resource allocation have prompted renewed efforts to identify and quantify harmful or wasteful (low-value) medical practices such as test ordering, procedures and prescribing. Quantifying these practices at a population level using routinely collected health data allows us to understand the scale of low-value medical practices, measure practice change following specific interventions and prioritise policy decisions. To date, almost all research examining health care through the low-value lens has focused on medical services (tests and procedures) rather than on prescribing...
May 3, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28462421/comparative-effectiveness-of-routine-invasive-coronary-angiography-for-managing-unstable-angina
#12
Sara Vogrin, Richard Harper, Elizabeth Paratz, Andrew MacIsaac, Jodie Burchell, Belinda Smith, Anthony Scott, Jongsay Yong, Vijaya Sundararajan
Background: Non-ST-segment elevation acute coronary syndromes include unstable angina and non-ST-segment elevation myocardial infarction. Most randomized controlled trials of routine versus selective invasive coronary angiography have high rates of crossover from control to intervention groups and do not include subgroup analysis for unstable angina. Consequently, no clear, specific recommendations exist regarding the use of angiography in unstable angina. Objective: To assess the effect of angiography on mortality in unstable angina, incorporating the results of additional cardiac procedures and events...
May 2, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28448782/amcp-partnership-forum-driving-value-and-outcomes-in-oncology
#13
(no author information available yet)
Innovation in cancer treatment has provided a wealth of recently available therapeutic agents and a healthy drug pipeline that promises to change the way we approach this disease and the lives of those affected in the years to come. However, the majority of these new agents, many of which are targeted to specific genomic features of various tumors, may challenge the health care system's ability to afford cancer care. This innovation drives the need to focus on the value of the treatments provided to patients with cancer and on methods to optimize the efficiency of the dollars we spend, in addition to the clinical value itself...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28442271/evaluation-of-the-xpert-hcv-viral-load-point-of-care-assay-from-venepuncture-collected-and-finger-stick-capillary-whole-blood-samples-a-cohort-study
#14
Jason Grebely, Francois M J Lamoury, Behzad Hajarizadeh, Yasmin Mowat, Alison D Marshall, Sahar Bajis, Philippa Marks, Janaki Amin, Julie Smith, Michael Edwards, Carla Gorton, Nadine Ezard, David Persing, Marika Kleman, Philip Cunningham, Beth Catlett, Gregory J Dore, Tanya L Applegate
BACKGROUND: Point-of-care hepatitis C virus (HCV) RNA testing offers an advantage over antibody testing (which only indicates previous exposure), enabling diagnosis of active infection in a single visit. In this study, we evaluated the performance of the Xpert HCV Viral Load assay with venepuncture and finger-stick capillary whole-blood samples. METHODS: Plasma and finger-stick capillary whole-blood samples were collected from participants in an observational cohort enrolled at five sites in Australia (three drug and alcohol clinics, one homelessness service, and one needle and syringe programme)...
April 21, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28410979/post-migration-follow-up-of-migrants-identified-to-be-at-increased-risk-of-developing-tuberculosis-at-pre-migration-screening-a-systematic-review-and-meta-analysis
#15
Isaac H Y Chan, Nishta Kaushik, Claudia C Dobler
BACKGROUND: Post-migration follow-up of migrants considered at increased risk of developing tuberculosis based on pre-migration screening abnormalities (high-risk migrants) is implemented in several low-incidence countries. We aimed to determine the rate of tuberculosis in this population to inform cross-border tuberculosis control policies. METHODS: We searched MEDLINE and Embase (since inception to Jan 12, 2017) for studies evaluating post-migration follow-up of high-risk migrants...
April 11, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28410792/accuracy-of-pecarn-catch-and-chalice-head-injury-decision-rules-in-children-a-prospective-cohort-study
#16
Franz E Babl, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, Mary McCaskill, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Mark D Lyttle, Silvia Bressan, Susan Donath, Charlotte Molesworth, Kim Jachno, Brenton Ward, Amanda Williams, Amy Baylis, Louise Crowe, Ed Oakley, Stuart R Dalziel
BACKGROUND: Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. METHODS: In this prospective observational study, we included children and adolescents (aged <18 years) with head injuries of any severity who presented to the emergency departments of ten Australian and New Zealand hospitals. We assessed the diagnostic accuracy of PECARN (stratified into children aged <2 years and ≥2 years), CATCH, and CHALICE in predicting each rule-specific outcome measure (clinically important traumatic brain injury [TBI], need for neurological intervention, and clinically significant intracranial injury, respectively)...
April 11, 2017: Lancet
https://www.readbyqxmd.com/read/28408323/apolipoprotein-a-isoform-size-lipoprotein-a-concentration-and-coronary-artery-disease-a-mendelian-randomisation-analysis
#17
Danish Saleheen, Philip C Haycock, Wei Zhao, Asif Rasheed, Adam Taleb, Atif Imran, Shahid Abbas, Faisal Majeed, Saba Akhtar, Nadeem Qamar, Khan Shah Zaman, Zia Yaqoob, Tahir Saghir, Syed Nadeem Hasan Rizvi, Anis Memon, Nadeem Hayyat Mallick, Mohammad Ishaq, Syed Zahed Rasheed, Fazal-Ur-Rehman Memon, Khalid Mahmood, Naveeduddin Ahmed, Philippe Frossard, Sotirios Tsimikas, Joseph L Witztum, Santica Marcovina, Manjinder Sandhu, Daniel J Rader, John Danesh
BACKGROUND: The lipoprotein(a) pathway is a causal factor in coronary heart disease. We used a genetic approach to distinguish the relevance of two distinct components of this pathway, apolipoprotein(a) isoform size and circulating lipoprotein(a) concentration, to coronary heart disease. METHODS: In this mendelian randomisation study, we measured lipoprotein(a) concentration and determined apolipoprotein(a) isoform size with a genetic method (kringle IV type 2 [KIV2] repeats in the LPA gene) and a serum-based electrophoretic assay in patients and controls (frequency matched for age and sex) from the Pakistan Risk of Myocardial Infarction Study (PROMIS)...
April 10, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28404012/a-non-endoscopic-device-to-sample-the-oesophageal-microbiota-a-case-control-study
#18
Daffolyn R Fels Elliott, Alan W Walker, Maria O'Donovan, Julian Parkhill, Rebecca C Fitzgerald
BACKGROUND: The strongest risk factor for oesophageal adenocarcinoma is reflux disease, and the rising incidence of this coincides with the eradication of Helicobacter pylori, both of which might alter the oesophageal microbiota. We aimed to profile the microbiota at different stages of Barrett's carcinogenesis and investigate the Cytosponge as a minimally invasive tool for sampling the oesophageal microbiota. METHODS: In this case-control study, 16S rRNA gene amplicon sequencing was done on 210 oesophageal samples from 86 patients representing the Barrett's oesophagus progression sequence (normal squamous controls [n=20], non-dysplastic [n=24] and dysplastic Barrett's oesophagus [n=23], and oesophageal adenocarcinoma [n=19]), relevant negative controls, and replicates on the Illumina MiSeq platform...
January 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28402555/deregulation-of-the-endometrial-stromal-cell-secretome-precedes-embryo-implantation-failure
#19
Ruban Rex Peter Durairaj, Asma Aberkane, Lukasz Polanski, Yojiro Maruyama, Miriam Baumgarten, Emma S Lucas, Siobhan Quenby, Jerry K Y Chan, Nick Raine-Fenning, Jan J Brosens, Hilde Van de Velde, Yie Hou Lee
STUDY QUESTION: Is implantation failure following ART associated with a perturbed decidual response in endometrial stromal cells (EnSCs)? SUMMARY ANSWER: Dynamic changes in the secretome of decidualizing EnSCs underpin the transition of a hostile to a supportive endometrial microenvironment for embryo implantation; perturbation in this transitional pathway prior to ART is associated with implantation failure. WHAT IS KNOWN ALREADY: Implantation is the rate-limiting step in ART, although the contribution of an aberrant endometrial microenvironment in IVF failure remains ill defined...
April 10, 2017: Molecular Human Reproduction
https://www.readbyqxmd.com/read/28402417/grandmaternal-smoke-exposure-reduces-female-fertility-in-a-murine-model-with-great-grandmaternal-smoke-exposure-unlikely-to-have-an-effect
#20
N J Camlin, A G Jarnicki, R L Vanders, K A Walters, P M Hansbro, E A McLaughlin, J E Holt
STUDY QUESTION: What effect does multigenerational (F2) and transgenerational (F3) cigarette smoke exposure have on female fertility in mice? SUMMARY ANSWER: Cigarette smoking has a multigenerational effect on female fertility. WHAT IS KNOWN ALREADY: It has been well established that cigarette smoking decreases female fertility. Furthermore, a growing body of evidence suggests that smoking during pregnancy decreases the fertility of daughters and increases cancer and asthma incidence in grandchildren and great-grandchildren...
June 1, 2017: Human Reproduction
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