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https://www.readbyqxmd.com/read/28076528/the-brief-life-of-norplant%C3%A2-in-brazil-controversies-and-reassemblages-between-science-society-and-state
#1
Ana Cristina de Lima Pimentel, Cláudia Bonan Jannotti, Paula Gaudenzi, Luiz Antonio da Silva Teixeira
Norplant® is the brand name of the world's first registered subdermal hormonal contraceptive implant, developed by the laboratories of the Population Council, an international organisation working in the area of fertility and population growth. The article revisits the trajectory of this contraceptive in Brazil from its arrival through clinical trials to its eventual ban in 1986 by the Brazilian regulatory agency responsible for approving medications at the time. Its circulation generated controversies related to research practices, side effects and political uses of the drug as a birth control method...
January 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28076244/the-need-to-systematically-evaluate-clinical-practice-guidelines
#2
Allen F Shaughnessy, Lisa Cosgrove, Joel R Lexchin
Clinical practice guidelines abound. The recommendations contained in these guidelines are used not only to make decisions about the care of individual patients but also as practice standards to rate physician "quality." Physicians' confidence in guidelines is based on the supposition that there is a rigorous, objective process for developing recommendations based on the best available evidence. Though voluntary standards for the development of guidelines exist, the process of guideline development is unregulated and the quality of many guidelines is low...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28075182/dispersing-the-mists-an-experimental-history-of-medicine-study-into-the-quality-of-volatile-inhalations
#3
Barry Murnane, Cathal T Gallagher, Noel Snell, Mark Sanders, Ramin Moshksar, Darragh Murnane
BACKGROUND: Dr. Nelson's Improved Inhaler was first marketed with an advertisement in The Lancet in 1865. Revolutionary at the time for its ease of use and patient-friendliness, the inhaler is still in use for self-treatment by many all over the world. On the occasion of its 150th anniversary, this study reports an experimental historical medicine approach to identify evidence for the quality of vapor inhalers. METHODS: Through accessing reviews of the device's use by the contemporary medical establishment, it was established that Dr...
January 11, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28074748/possible-parkinson-s-disease-induced-by-chronic-manganese-supplement-ingestion
#4
Michael J Schuh
OBJECTIVE: The objective is to report a case of possible neurotoxicity resulting from an incorrect dietary supplement for osteoporosis taken at a toxic dose. SUMMARY: The case study examined here is a 37-year-old African-American female who consumed excessive manganese over a period of years, resulting in Parkinson's disease (PD). This patient was referred to the pharmacist pharmacotherapy service by a neurology physician. PD has been shown in the medical literature to be caused by chronic exposure to high levels of manganese...
December 1, 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28074423/effectiveness-of-risk-evaluation-and-mitigation-strategies-rems-for-lenalidomide-and-thalidomide-patient-comprehension-and-knowledge-retention
#5
Nancy A Brandenburg, Robert Bwire, John Freeman, Florence Houn, Paul Sheehan, Jerome B Zeldis
INTRODUCTION: The effectiveness of patient education activities conducted within the lenalidomide and thalidomide risk evaluation and mitigation strategies (REMS) programs was evaluated by measuring understanding of serious risk and safe-use messages. METHODS: Results from mandatory knowledge, attitude, and behavior surveys and voluntary patient surveys completed between June 2012 and June 2013 were analyzed, and responses to questions relating to compliance with birth control measures and understanding of safe-use messages are presented by patient risk category...
January 10, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28073791/rapid-deployment-aortic-replacement-radar-registry-in-spain-a-protocol
#6
Victor Bautista-Hernandez, Natalia Cal-Purriños, Jose M Arribas-Leal, Manuel Carnero-Alcazar, Jose F Gutierrez-Diez, Jose J Cuenca-Castillo
INTRODUCTION: Rapid deployment valves (RDV) represent a newly introduced approach to aortic valve replacement which facilitates surgical implantation and minimally invasive techniques, shortens surgical times and shows excellent haemodynamic performance. However, evidence on their safety, efficacy and potential complications is mostly fitted with small-volume and retrospective studies. Moreover, no current guidelines exist. To improve our knowledge on this technology, The Rapid Deployment Aortic Replacement (RADAR) Registry will be established across Spain with the aim of assessing RDV outcomes in the real-world setting...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28070824/tolerability-of-an-immunologically-enhanced-subcutaneous-immunotherapy-preparation-in-patients-treated-with-concomitant-allergy-immunotherapy-a-non-interventional-observational-study
#7
Rainer Reiber, Hendrik Wolf, Jörg Schnitker, Eike Wüstenberg
BACKGROUND: For causal treatment by allergy immunotherapy (AIT) a single or few allergen products for the clinically most relevant allergens are applied to treat multiple allergies, but few data on the tolerability of multiple AIT applications are available. OBJECTIVE: The aim of our study was to investigate safety and tolerability in patients treated by subcutaneous immunotherapy (SCIT) and concomitant SCIT or sublingual immunotherapy (SLIT) products. METHODS: In a non-interventional, observational study in Germany treatment of patients with a primary SCIT and concomitant AIT (SCIT or SLIT) was documented during the first 4 months of treatment...
January 9, 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/28070707/value-based-assessment-of-radiology-reporting-using-radiologist-referring-physician-two-way-feedback-system-a-design-thinking-based-approach
#8
Faiq Shaikh, Kenneth Hendrata, Brian Kolowitz, Omer Awan, Rasu Shrestha, Christopher Deible
In the era of value-based healthcare, many aspects of medical care are being measured and assessed to improve quality and reduce costs. Radiology adds enormously to health care costs and is under pressure to adopt a more efficient system that incorporates essential metrics to assess its value and impact on outcomes. Most current systems tie radiologists' incentives and evaluations to RVU-based productivity metrics and peer-review-based quality metrics. In a new potential model, a radiologist's performance will have to increasingly depend on a number of parameters that define "value," beginning with peer review metrics that include referrer satisfaction and feedback from radiologists to the referring physician that evaluates the potency and validity of clinical information provided for a given study...
January 9, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28068732/-concept-for-a-national-implant-registry-to-improve-patient-safety
#9
L Prantl, U von Fritschen, J Liebau, J von Hassel, E M Baur, P M Vogt, R E Giunta, R E Horch
Since the introduction of silicone implants, several events have led to considerable uncertainty among the patients, public, and users. So far, however, the necessary steps to significantly improving patient safety have not been taken in any of these cases. Requiring stricter approvals for medical devices, improving monitoring by the regulatory authorities and the revision of the Medical Devices Directive are all initial steps in the right direction towards a change in policy, but are insufficient as an early warning system...
December 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28052563/self-reported-use-of-natural-health-products-among-rheumatology-patients-a-cross-sectional-survey
#10
Jill J Hall, Tharindri D Dissanayake, Darren Lau, Steven J Katz
OBJECTIVES: To describe the self-reported use of natural health products (NHPs) and identify characteristics that predict selected NHP use in rheumatology patients. METHODS: We conducted a cross-sectional survey of consecutive rheumatology patients in two major clinics in Edmonton, Alberta. Survey items included demographic data, rheumatologic diagnoses, prescribed medications, NHPs, and information regarding patients' use of NHPs. Selected NHPs of interest - defined to include joint-specific products, oils with putative joint benefits, and other non-vitamin, non-mineral products - were classified by 2 reviewers...
January 4, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28051985/eye-care-productivity-and-access-in-the-veterans-affairs-health-care-system
#11
Mary G Lynch, April Maa, William Delaune, Joel Chasan, Glenn C Cockerham
OBJECTIVES: Eye care in the Veterans Affairs Health Care System is challenged with increasing demand and higher prevalence of patients with complex ocular conditions. Understanding factors that impact eye care productivity and access is necessary for appropriate allocation of resources. The purpose of this study was to determine the impact of various eye clinic personnel on eye care provider productivity and patient access. METHODS: Utilizing data from the Veterans Health Administration National Data Warehouse, workload and level of staffing were analyzed...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28048866/su-f-i-47-optimizing-protocols-for-image-quality-and-dose-in-abdominal-ct-of-large-patients
#12
L Johnson, M Yester
PURPOSE: Newer CT scanners are able to use scout views to adjust mA throughout the scan in order to achieve a given noise level. However, given constraints of radiologist preferences for kVp and rotation time, it may not be possible to achieve an acceptable noise level for large patients. A study was initiated to determine for which patients kVp and/or rotation time should be changed in order to achieve acceptable image quality. METHODS: Patient scans were reviewed on two new Emergency Department scanners (Philips iCT) to identify patients over a large range of sizes...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048387/mo-a-brc-00-tg167-clinical-recommendations-for-innovative-brachytherapy-devices-and-applicators
#13
Ravinder Nath
: Although a multicenter, Phase III, prospective, randomized trial is the gold standard for evidence-based medicine, it is rarely used to evaluate innovative radiotherapy devices because of many practical and ethical reasons. It is usually sufficient to compare the dose distributions and dose rates for determining equivalence of the innovative device to an existing one. Thus, quantitative evaluation of the dosimetric characteristics of an innovative brachytherapy device or application is a critical part in which physicists are actively involved...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048202/we-h-brc-02-failure-mode-and-effect-analysis-of-liver-stereotactic-body-radiotherapy
#14
I Rusu, T Thomas, J Roeske, J Price, C Perino, I Mescioglu, M Surucu
PURPOSE: To identify areas of improvement in our liver stereotactic body radiation therapy (SBRT) program, using failure mode and effect analysis (FMEA). METHODS: A multidisciplinary group consisting of one physician, three physicists, one dosimetrist and two therapists was formed. A process map covering 10 major stages of the liver SBRT program from the initial diagnosis to post treatment follow-up was generated. A total of 102 failure modes, together with their causes and effects, were identified...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048159/mo-a-brc-02-tg167-report-detailed-description
#15
M Rivard
: Although a multicenter, Phase III, prospective, randomized trial is the gold standard for evidence-based medicine, it is rarely used to evaluate innovative radiotherapy devices because of many practical and ethical reasons. It is usually sufficient to compare the dose distributions and dose rates for determining equivalence of the innovative device to an existing one. Thus, quantitative evaluation of the dosimetric characteristics of an innovative brachytherapy device or application is a critical part in which physicists are actively involved...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047768/th-ab-207a-06-the-use-of-realistic-phantoms-to-predict-ct-dose-to-pediatric-patients
#16
D Carver, S Kost, P Segars, N Fraser, D Pickens, R Price, M Stabin
PURPOSE: To predict pediatric patient dose from diagnostic CT scans using Monte Carlo simulation of realistic reference phantoms of various ages, weights, and heights. METHODS: A series of deformable pediatric reference phantoms using Non-Uniform Rational B-Splines (NURBS) was developed for a large range of ages, percentiles, and reference anatomy. Individual bones were modeled using age-dependent factors, and red marrow was modeled as functions of age and spatial distribution based on Cristy1...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046849/mo-de-bra-01-flipped-physics-courses-within-a-radiologic-technologist-program-video-production-and-long-term-outcomes
#17
T Oshiro, M Donaghy, A Slechta
PURPOSE: To determine if the flipped class format has an effect on examination results for a radiologic technologist (RT) program and discuss benefits from creating video resources. METHODS: From 2001-2015, students had taken both a radiological physics and quality control (QC) class as a part of their didactic training. In 2005/2006, the creation of videos of didactic lectures and QC test demonstrations allowed for a flip where content was studied at home while exercises and reviews were done in-class...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046775/mo-a-brc-01-tg167-report-introduction
#18
R Nath
: Although a multicenter, Phase III, prospective, randomized trial is the gold standard for evidence-based medicine, it is rarely used to evaluate innovative radiotherapy devices because of many practical and ethical reasons. It is usually sufficient to compare the dose distributions and dose rates for determining equivalence of the innovative device to an existing one. Thus, quantitative evaluation of the dosimetric characteristics of an innovative brachytherapy device or application is a critical part in which physicists are actively involved...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045920/alterations-in-evoked-otoacoustic-emissions-by-the-use-of-meglumine-antimoniate-in-american-tegumentary-leishmaniasis-patients
#19
Débora Cristina de Oliveira Bezerra, Renata Oliveira de Barcelos, Ellen Carvalho de Castro, Claudia Cristina Jardim Duarte, Raquel de Vasconcellos Carvalhaes Oliveira, Tania Salgado de Sousa Torraca, Maria Helena de Araújo-Melo, Frederico Pereira Bom Braga, Benivaldo Ramos Ferreira Terceiro, Lúcia Regina do Nascimento Brahim Paes, Armando de Oliveira Schubach, Cláudia Maria Valete-Rosalino
INTRODUCTION: Tegumentary Leishmaniasis (TL) is a neglected, non-contagious, infectious disease, caused by different protozoa species of the Leishmania genus that affects skin and mucous membranes. Meglumine Antimoniate (MA), the first drug of choice for TL treatment in Brazil, has already been associated with cochlear toxicity, which is defined as damages of the cochlea caused by exposure to chemical substances, resulting in reversible or irreversible hearing loss. Auditory monitoring for cochlear toxicity aims at the early detection of auditory disorders, enabling, when possible, hearing to be preserved or an early auditory rehabilitation...
2017: PloS One
https://www.readbyqxmd.com/read/28044249/evaluation-of-facebook-and-twitter-monitoring-to-detect-safety-signals-for-medical-products-an-analysis-of-recent-fda-safety-alerts
#20
Carrie E Pierce, Khaled Bouri, Carol Pamer, Scott Proestel, Harold W Rodriguez, Hoa Van Le, Clark C Freifeld, John S Brownstein, Mark Walderhaug, I Ralph Edwards, Nabarun Dasgupta
INTRODUCTION: The rapid expansion of the Internet and computing power in recent years has opened up the possibility of using social media for pharmacovigilance. While this general concept has been proposed by many, central questions remain as to whether social media can provide earlier warnings for rare and serious events than traditional signal detection from spontaneous report data. OBJECTIVE: Our objective was to examine whether specific product-adverse event pairs were reported via social media before being reported to the US FDA Adverse Event Reporting System (FAERS)...
January 2, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
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