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Primary care updates

Melanie A Ruffner, Jonathan M Spergel
PURPOSE OF REVIEW: Eosinophilic esophagitis (EoE) is a multifactorial, non-IgE-mediated inflammatory disorder of the esophagus and is the most common cause of food impaction in the pediatric population. The purpose of this review is to describe the current recommendations for diagnosis and management of EoE. RECENT FINDINGS: New data has associated EoE with other allergic disorders of the atopic march as well as several risk factors, which predispose to allergic conditions...
September 20, 2018: Current Opinion in Pediatrics
Francisco Pérez-Jiménez, Vicente Pascual, José Félix Meco, Pablo Pérez Martínez, Javier Delgado Lista, Monica Domenech, Ramon Estruch, Ana León-Acuña, José López-Miranda, Andrea Sánchez-Ramos, Cristina Soler I Ferrer, Cristina Soler-Rivas, Rosa Maria Solá Alberich, Pedro Valdivielso, Emilio Ros
Lifestyle is a complex concept that includes aspects external to ourselves that can modulate and influence our health. The knowledge of the relationship between lifestyle and cardiovascular risk does not attain the level of evidence achieved with clinical trials with drugs, because clinical studies are scarce and mainly of observational nature, albeit based on large cohorts. Nutritional epidemiology has the added difficulty of being based mostly on subjective dietary recall methods to ascertain nutrient and food intake over time, with the additional problems of incomplete data collection, variable measurements of adherence due to seasonal and geographical differences in food composition, and the changing eating behavior that human beings have over time...
September 17, 2018: Clínica e Investigación en Arteriosclerosis
Danielle Y Ponzio, Yu-Fen Chiu, Anthony Salvatore, Yuo-Yu Lee, Stephen Lyman, Russell E Windsor
This article was updated on September 19, 2018, because of a previous error. On page 1546, in the section titled "Discussion," the sentence that had read "Although a significant improvement was found in the vast majority of the inactive group, surprisingly, a majority of the active group (72.7%) reported a decrease in their activity levels below their baseline at 5 to 10 years postoperatively." now reads "Although a significant improvement was found in the vast majority of the inactive group, surprisingly, a majority of the active group (72...
September 19, 2018: Journal of Bone and Joint Surgery. American Volume
Rizky Abdulah, Widya N Insani, Dika P Destiani, Nurul Rohmaniasari, Nithya D Mohenathas, Melisa I Barliana
Background: The geriatric population is particularly vulnerable to being prescribed potentially inappropriate medication (PIM); however, the prevalence of this occurrence remains poorly investigated in Indonesia. Thus in this research, we focused on investigating the prevalence and predictors of PIM among the Indonesian geriatric population in a primary health care setting. Methods: A retrospective observational study was conducted in 25 primary health care facilities in Karawang District, Indonesia...
2018: Therapeutics and Clinical Risk Management
Rebecca R Turner, Liz Steed, Helen Quirk, Rosa U Greasley, John M Saxton, Stephanie Jc Taylor, Derek J Rosario, Mohamed A Thaha, Liam Bourke
BACKGROUND: This is an updated version of the original Cochrane Review published in the Cochrane Liibrary 2013, Issue 9. Despite good evidence for the health benefits of regular exercise for people living with or beyond cancer, understanding how to promote sustainable exercise behaviour change in sedentary cancer survivors, particularly over the long term, is not as well understood. A large majority of people living with or recovering from cancer do not meet current exercise recommendations...
September 18, 2018: Cochrane Database of Systematic Reviews
Nor Fadhilah Kamaruzzaman, Li Peng Tan, Khairun Anisa Mat Yazid, Shamsaldeen Ibrahim Saeed, Ruhil Hayati Hamdan, Siew Shean Choong, Weng Kin Wong, Alexandru Chivu, Amanda Jane Gibson
Infectious disease caused by pathogenic bacteria continues to be the primary challenge to humanity. Antimicrobial resistance and microbial biofilm formation in part, lead to treatment failures. The formation of biofilms by nosocomial pathogens such as Staphylococcus aureus ( S. aureus ), Pseudomonas aeruginosa ( P. aeruginosa ), and Klebsiella pneumoniae ( K. pneumoniae ) on medical devices and on the surfaces of infected sites bring additional hurdles to existing therapies. In this review, we discuss the challenges encountered by conventional treatment strategies in the clinic...
September 13, 2018: Materials
Zhiyuan Wu, Yafeng Liang, Zhihao Li, Guangjian Liu, Jianbin Zheng, Yunlong Zuo, Lijuan Li, Xiaojun Cao, Jianhui Zhang, Huiying Liang
OBJECTIVES: Sepsis-3 consensus suggests "the need to develop similar updated definitions for pediatric populations". Sequential organ failure assessment (SOFA) and systemic inflammatory response syndrome (SIRS) criteria are two systems widely used to define the status of infection. However, It is still unclear whether SOFA is more accurate than SIRS in predicting children mortality in low- and middle-income countries. Thus, we validated the accuracy of age-adapted SOFA and SIRS in predicating the poor prognosis of infected children in China's pediatric intensive care unit (PICU)...
September 11, 2018: Shock
Sara E Benjamin-Neelon, Brian Neelon, John Pearce, Elyse R Grossman, Sarah Gonzalez-Nahm, Meghan Slining, Kiyah Duffey, Natasha Frost
BACKGROUND: State policies have the potential to improve early care and education (ECE) settings, but little is known about the extent to which states are updating their licensing and administrative regulations, especially in response to national calls to action. In 2013, we assessed state regulations promoting infant physical activity in ECE and compared them with national recommendations. To assess change over time, we conducted this review again in 2018. METHODS: We reviewed regulations for all US states for child care centers (centers) and family child care homes (homes) and compared them with three national recommendations: (1) provide daily tummy time; (2) use cribs, car seats, and high chairs for their primary purpose; and (3) limit the use of restrictive equipment (e...
August 2018: Childhood Obesity
Sherilyn K D Houle, Caitlin A Carter, Ross T Tsuyuki, Kelly A Grindrod
OBJECTIVES: Recognizing pharmacists' increasing roles as primary care providers, programs offering remuneration for patient care services, and the administration of injections by pharmacists continue to be implemented. The objective of this article is to provide an update on remuneration programs available to pharmacists internationally for nondispensing services. DATA SOURCES: Systematic searches for relevant articles published from January 2013 to February 2018 across Pubmed (Medline), Embase, International Pharmaceutical Abstracts, Cochrane Library, Econlit, Scopus, and Web of Science...
September 5, 2018: Journal of the American Pharmacists Association: JAPhA
William C Miller, Irving F Hoffman, Brett S Hanscom, Tran V Ha, Kostyantyn Dumchev, Zubairi Djoerban, Scott M Rose, Carl A Latkin, David S Metzger, Kathryn E Lancaster, Vivian F Go, Sergii Dvoriak, Katie R Mollan, Sarah A Reifeis, Estelle M Piwowar-Manning, Paul Richardson, Michael G Hudgens, Erica L Hamilton, Jeremy Sugarman, Susan H Eshleman, Hepa Susami, Viet Anh Chu, Samsuridjal Djauzi, Tetiana Kiriazova, Duong D Bui, Steffanie A Strathdee, David N Burns
BACKGROUND: People who inject drugs (PWID) have a high incidence of HIV, little access to antiretroviral therapy (ART) and medication-assisted treatment (MAT), and high mortality. We aimed to assess the feasibility of a future controlled trial based on the incidence of HIV, enrolment, retention, and uptake of the intervention, and the efficacy of an integrated and flexible intervention on ART use, viral suppression, and MAT use. METHODS: This randomised, controlled vanguard study was run in Kyiv, Ukraine (one community site), Thai Nguyen, Vietnam (two district health centre sites), and Jakarta, Indonesia (one hospital site)...
September 1, 2018: Lancet
Sara Tomczyk, Tory Whitten, Stacy M Holzbauer, Ruth Lynfield
Adherence to clinical guidelines is recommended to promote appropriate antibiotic use in dentistry and address concerns about increasing antibiotic resistance. Guidelines for antibiotic prophylaxis before invasive dental procedures were updated in 2007 and 2015. In an effort to inform antibiotic stewardship efforts, a study was undertaken to assess the knowledge of antibiotic usage guidelines and antibiotic-prescribing practices among Minnesota dentists. During September 2015, a 22-question online survey was sent to the state dental association membership...
September 2018: General Dentistry
Christina Davidson, Patricia Bellows, Utsavi Shah, Lauren Hawley, Kathleen Drexler, Manisha Gandhi, Catherine Eppes, Haleh Sangi-Haghpeykar
OBJECTIVE: In 2010, the American College of Obstetricians & Gynecologists (ACOG) published a new clinical practice guideline on trial of labor after cesarean (TOLAC) that was considered less restrictive. It allowed for offering TOLAC to women with two prior cesarean deliveries, even without a prior vaginal delivery, and for labor induction. As a result, our hospital, a public tertiary care academic center, updated our TOLAC practice guideline to reflect ACOG's new recommendations...
September 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
Mark Minchin, Martin Roland, Judith Richardson, Shaun Rowark, Bruce Guthrie
BACKGROUND: The benefits of pay-for-performance schemes in improving the quality of care remain uncertain. There is little information on the effect of removing incentives from existing pay-for-performance schemes. METHODS: We conducted interrupted time-series analyses of electronic medical record (EMR) data from 2010 to 2017 for 12 quality-of-care indicators in the United Kingdom's Quality and Outcomes Framework for which financial incentives were removed in 2014 and 6 indicators for which incentives were maintained...
September 6, 2018: New England Journal of Medicine
Matthew Sloan, Ajay Premkumar, Neil P Sheth
BACKGROUND: The volume of primary total joint arthroplasty (TJA) procedures has risen in recent decades. However, recent procedure growth has not been at previously projected exponential rates. To anticipate the future expense of TJA, updated models are necessary to predict TJA volume in the U.S. METHODS: Retrospective review using the National Inpatient Sample, a representative sample of all hospital discharges within the U.S., was employed to determine the volume of primary TJA procedures performed from 2000 to 2014...
September 5, 2018: Journal of Bone and Joint Surgery. American Volume
Randy A Taplitz, Erin B Kennedy, Eric J Bow, Jennie Crews, Charise Gleason, Douglas K Hawley, Amelia A Langston, Loretta J Nastoupil, Michelle Rajotte, Kenneth V Rolston, Lynne Strasfeld, Christopher R Flowers
Purpose To provide an updated joint ASCO/Infectious Diseases Society of America (IDSA) guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with cancer and its treatment. Methods ASCO and IDSA convened an update Expert Panel and conducted a systematic review of relevant studies from May 2011 to November 2016. The guideline recommendations were based on the review of evidence by the Expert Panel. Results Six new or updated meta-analyses and six new primary studies were added to the updated systematic review...
September 4, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Mícheál de Barra, Claire L Scott, Neil W Scott, Marie Johnston, Marijn de Bruin, Nancy Nkansah, Christine M Bond, Catriona I Matheson, Pamela Rackow, A Jess Williams, Margaret C Watson
BACKGROUND: This review focuses on non-dispensing services from pharmacists, i.e. pharmacists in community, primary or ambulatory-care settings, to non-hospitalised patients, and is an update of a previously-published Cochrane Review. OBJECTIVES: To examine the effect of pharmacists' non-dispensing services on non-hospitalised patient outcomes. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, two other databases and two trial registers in March 2015, together with reference checking and contact with study authors to identify additional studies...
September 4, 2018: Cochrane Database of Systematic Reviews
(no author information available yet)
The authors of this statement update the recommendations of the American Academy of Pediatrics for the routine use of influenza vaccine and antiviral medications in the prevention and treatment of influenza in children. Highlights for the upcoming 2018-2019 season include the following:1. Annual influenza immunization is recommended for everyone 6 months and older, including children and adolescents.2. The American Academy of Pediatrics recommends an inactivated influenza vaccine (IIV), trivalent or quadrivalent, as the primary choice for influenza vaccination in children because the effectiveness of a live attenuated influenza vaccine against influenza A(H1N1) was inferior during past influenza seasons and is unknown for this upcoming season...
September 3, 2018: Pediatrics
Axel Bex, Laurence Albiges, Börje Ljungberg, Karim Bensalah, Saeed Dabestani, Rachel H Giles, Fabian Hofmann, Milan Hora, Markus A Kuczyk, Thomas B Lam, Lorenzo Marconi, Axel S Merseburger, Sergio Fernández-Pello, Rana Tahbaz, Yasmin Abu-Ghanem, Michael Staehler, Alessandro Volpe, Thomas Powles
Cytoreductive nephrectomy (CN) has been the standard of care in patients with metastatic clear-cell renal cancer who present with the tumour in place. The CARMENA trial compared systemic therapy alone with CN followed by systemic therapy. This article outlines the new guidelines based on these data. PATIENT SUMMARY: The CARMENA trial demonstrates that immediate cytoreductive nephrectomy should no longer be considered the standard of care in patients diagnosed with intermediate and poor risk metastatic renal cell carcinoma when medical treatment is required...
August 31, 2018: European Urology
Ian Roberts, Antonio Belli, Amy Brenner, Rizwana Chaudhri, Bukola Fawole, Tim Harris, Rashid Jooma, Abda Mahmood, Temitayo Shokunbi, Haleema Shakur
Background: Worldwide, traumatic brain injury (TBI) kills or hospitalises over 10 million people each year. Early intracranial bleeding is common after TBI, increasing the risk of death and disability. Tranexamic acid reduces blood loss in surgery and death due to bleeding in trauma patients with extra-cranial injury. Early administration of tranexamic acid in TBI patients might limit intracranial bleeding, reducing death and disability. The CRASH-3 trial aims to provide reliable evidence on the effect of tranexamic acid on death and disability in TBI patients...
2018: Wellcome Open Research
Chukwuemeka N Okafor, Whitney Barnett, Heather J Zar, Raymond Nhapi, Nastassja Koen, Steve Shoptaw, Dan J Stein
Violence against women remains a significant public health problem globally. The majority of longitudinal studies documenting the negative impact of intimate partner violence (IPV) on the mental health of women come from high-income countries. The aim of this study was to investigate the longitudinal association between emotional, physical, or sexual IPV and depression symptoms among South African women in a prospective cohort study. Participants were 981 South African women enrolled in the Drakenstein Child Health Study-a cohort study investigating the early life determinants of child health...
August 30, 2018: Journal of Interpersonal Violence
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