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https://www.readbyqxmd.com/read/28820896/a-strategy-for-scaling-up-access-to-comprehensive-care-in-adults-with-chagas-disease-in-endemic-countries-the-bolivian-chagas-platform
#1
Maria-Jesus Pinazo, Jimy Pinto, Lourdes Ortiz, Jareth Sánchez, Wilson García, Ruth Saravia, Mirko-R Cortez, Silvia Moriana, Enric Grau, Daniel Lozano, Joaquim Gascon, Faustino Torrico
BACKGROUND: Bolivia has the highest prevalence of Chagas disease (CD) in the world (6.1%), with more than 607,186 people with Trypanosoma cruzi infection, most of them adults. In Bolivia CD has been declared a national priority. In 2009, the Chagas National Program (ChNP) had neither a protocol nor a clear directive for diagnosis and treatment of adults. Although programs had been implemented for congenital transmission and for acute cases, adults remained uncovered. Moreover, health professionals were not aware of treatment recommendations aimed at this population, and research on CD was limited; it was difficult to increase awareness of the disease, understand the challenges it presented, and adapt strategies to cope with it...
August 18, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28820363/incidence-of-perioperative-medical-complications-and-mortality-among-elderly-patients-undergoing-surgery-for-spinal-deformity-analysis-of-3519-patients
#2
Amit Jain, Hamid Hassanzadeh, Varun Puvanesarajah, Eric O Klineberg, Daniel M Sciubba, Michael P Kelly, D Kojo Hamilton, Virginie Lafage, Aaron J Buckland, Peter G Passias, Themistocles S Protopsaltis, Renaud Lafage, Justin S Smith, Christopher I Shaffrey, Khaled M Kebaish
OBJECTIVE Using 2 complication-reporting methods, the authors investigated the incidence of major medical complications and mortality in elderly patients after surgery for adult spinal deformity (ASD) during a 2-year follow-up period. METHODS The authors queried a multicenter, prospective, surgeon-maintained database (SMD) to identify patients 65 years or older who underwent surgical correction of ASD from 2008 through 2014 and had a minimum 2 years of follow-up (n = 153). They also queried a Centers for Medicare & Medicaid Services claims database (MCD) for patients 65 years or older who underwent fusion of 8 or more vertebral levels from 2005 through 2012 (n = 3366)...
August 18, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28820347/association-between-eye-diagnosis-and-positive-syphilis-test-results-in-a-large-urban-sexually-transmitted-infection-primary-care-clinic-population
#3
Ann-Marie Lobo, Yan Gao, Laura Rusie, Magda Houlberg, Supriya D Mehta
In 2015, the Centers for Disease Control and Prevention (CDC) and the American Academy of Ophthalmology (AAO) released clinical advisories on rising cases of ocular syphilis. We examined the association between eye disease and syphilis infection among primary care and sexually transmitted infection (STI) clinic patients attending an urban lesbian, gay, bisexual, transgender (LGBT) health center. We conducted a retrospective medical record review of all patients who underwent syphilis testing at Howard Brown Health between 1 January 2010 and 31 December 2015...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28820309/advanced-cone-beam-ct-venous-angiographic-imaging
#4
Visish M Srinivasan, Gouthami Chintalapani, Edward A M Duckworth, Peter Kan
OBJECTIVE The evaluation of the venous neurovasculature, especially the dural venous sinuses, is most often performed using MR or CT venography. For further assessment, diagnostic cerebral angiography may be performed. Three-dimensional rotational angiography (3D-RA) can be applied to the venous system, producing 3D rotational venography (3D-RV) and cross-sectional reconstructions, which function as an adjunct to traditional 2D digital subtraction angiography. METHODS After querying the database of Baylor St...
August 18, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28820296/long-term-hemodynamic-changes-and-blood-pressure-in-atherosclerotic-major-cerebral-artery-disease
#5
Hiroshi Yamauchi, Shinya Kagawa, Masaaki Takahashi, Tatsuya Higashi
In patients with major cerebral artery disease, lower blood pressure might reduce blood flow in the collateral pathways, thereby impairing the growth of cerebral collaterals, inhibiting hemodynamic improvement. We evaluated the hemodynamic status twice using positron emission tomography and (15)O-gas, over time, in 89 medically treated patients with atherosclerotic internal carotid artery or middle cerebral artery disease that had no ischemic episodes during follow-up (mean, 28 ± 23 months). Changes in the mean hemispheric values of hemodynamic parameters in the territory of the diseased artery at follow-up were correlated with the mean blood pressure values at the baseline and follow-up examinations...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28819916/early-surgical-intervention-for-acute-ulcerative-colitis-is-associated-with-improved-postoperative-outcomes
#6
Ira L Leeds, Brindusa Truta, Alyssa M Parian, Sophia Y Chen, Jonathan E Efron, Susan L Gearhart, Bashar Safar, Sandy H Fang
BACKGROUND: Timing of surgical intervention for acute ulcerative colitis has not been fully examined during the modern immunotherapy era. Although early surgical intervention is recommended, historical consensus for "early" ranges widely. The purpose of this study was to evaluate outcomes according to timing of urgent surgery for acute ulcerative colitis. METHODS: All non-elective total colectomies in ulcerative colitis patients were identified in the National Inpatient Sample from 2002 to 2014...
August 17, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28819817/estimation-of-entrance-surface-air-kerma-due-to-diagnostic-x-ray-examinations-of-adult-patients-in-uttarakhand-india-and-establishment-of-local-diagnostic-reference-levels
#7
Satish C Uniyal, Vineet Chaturvedi, Sunil D Sharma, Shailendra Raghuvanshi
It is well established that diagnostic X-ray practices must be optimised to keep patient radiation dose as low as compatible with providing the diagnostic information required. For effective optimisation of diagnostic exposures, the International Commission on Radiological Protection (ICRP) introduced the concept of diagnostic reference levels (DRLs) in 1996. The present study aimed to carry out an extensive dose survey of diagnostic radiography installations in the Uttarakhand region of India to establish local DRL Values for the different diagnostic practices...
August 17, 2017: Australasian Physical & Engineering Sciences in Medicine
https://www.readbyqxmd.com/read/28819513/strengthening-and-expanding-the-capacity-of-health-worker-education-in-zambia
#8
Charles Michelo, Joseph Mumba Zulu, Moses Simuyemba, Benjamin Andrews, Max Katubulushi, Benjamin Chi, Evariste Njelesani, Bellington Vwalika, Kasonde Bowa, Margaret Maimbolwa, James Chipeta, Fastone Goma, Selestine Nzala, Sekelani Banda, John Mudenda, Yusuf Ahmed, Lotti Hachambwa, Craig Wilson, Sten Vermund, Yakub Mulla
INTRODUCTION: Zambia is facing a chronic shortage of health care workers. The paper aimed at understanding how the Medical Education Partnership Initiative (MEPI) program facilitated strengthening and expanding of the national capacity and quality of medical education as well as processes for retaining faculty in Zambia. METHODS: Data generated through documentary review, key informant interviews and observations were analyzed using a thematic approach. RESULTS: The MEPI program triggered the development of new postgraduate programs thereby increasing student enrollment...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28818864/palliative-care-for-hospitalized-patients-with-stroke-results-from-the-2010-to-2012-national-inpatient-sample
#9
Tarvinder Singh, Steven R Peters, David L Tirschwell, Claire J Creutzfeldt
BACKGROUND AND PURPOSE: Substantial variability exists in the use of life-prolonging treatments for patients with stroke, especially near the end of life. This study explores patterns of palliative care utilization and death in hospitalized patients with stroke across the United States. METHODS: Using the 2010 to 2012 nationwide inpatient sample databases, we included all patients discharged with stroke identified by International Classification of Diseases-Ninth Revision codes...
August 17, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28818629/hospice-she-yelped-examining-the-quantity-and-quality-of-decision-support-available-to-patient-and-families-considering-hospice
#10
Grace Finnigan-Fox, Dan D Matlock, Channing E Tate, Christopher E Knoepke, Larry A Allen
BACKGROUND: Whether to engage hospice is one of the most difficult medical decisions patients and families make. Meanwhile, misperceptions about hospice persist. Within this context, the breadth and depth of patient decision support materials for hospice is unknown. OBJECTIVE: Identify available patient decision aids (PtDAs) relating information about hospice care and compare that information to the informational needs expressed by real-world healthcare consumers...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28818507/optimizing-quality-of-endoscopy-in-inflammatory-bowel-disease-focus-on-surveillance-and-management-of-colorectal-dysplasia-using-interactive-image-and-video-based-teaching
#11
Tonya R Kaltenbach, Roy M Soetikno, Rebecca DeVivo, Loren A Laine, Alan Barkun, Kenneth R McQuaid
BACKGROUND & AIMS: Varying recommendations regarding the detection and management of dysplasia can lead to uncertainty and may have impeded the uptake of strategies that could improve surveillance in patients with inflammatory bowel disease (IBD). As such, an educational event was held to assist in disseminating the recently published Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients: International Consensus Recommendations (SCENIC)...
August 14, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28818260/transcranial-doppler-monitoring-for-microemboli-a-marker-of-a-high-risk-carotid-plaque
#12
J David Spence
In the United States, 90% of carotid intervention is being performed for asymptomatic carotid stenosis, even though 90% of patients would be better treated with intensive medical therapy. This is being justified by comparing risks of stroke or death with medical therapy during clinical trials completed decades ago (approximately 2% per year) with risks of intervention with carotid artery stenting (CAS) versus carotid endarterectomy in recent trials that did not have a medical arm. Such extrapolations are, simply put, invalid...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818255/clinical-need-design-and-goals-for-the-carotid-revascularization-and-medical-management-for-asymptomatic-carotid-stenosis-trial
#13
Brajesh K Lal, James F Meschia, Thomas G Brott
Prior clinical trials produced evidence-based treatment recommendations for patients with asymptomatic carotid stenosis that may not be appropriate for clinical decision-making today. High-quality patient outcomes data to allow informed decision making regarding the optimal management of high-grade asymptomatic internal carotid artery stenosis is lacking. The results of the Asymptomatic Carotid Atherosclerosis Study were published in 1995 based on a randomized patient enrollment in the 1990s. Outcomes after endarterectomy, stenting, and medical treatment for these patients have all improved in the subsequent 2 decades...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28818016/association-between-proportion-of-us-medical-graduates-and-program-characteristics-in-gastroenterology-fellowships
#14
Amporn Atsawarungruangkit
BACKGROUND: Gastroenterology is one of the most competitive internal medicine fellowship. However, factors that associated with program competitiveness have not been documented. OBJECTIVE: The objective of this study was to evaluate associations between characteristics of gastroenterology fellowship programs and their competitiveness through the proportion of US medical graduates for the academic year 2016/17. DESIGN: This study used a retrospective, cross-sectional design with data obtained from the American Medical Association...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28818004/identification-and-treatment-of-augmentation-in-patients-with-restless-legs-syndrome-practical-recommendations
#15
James Geyer, Richard Bogan
Restless legs syndrome (RLS) is a chronic disorder causing clinically significant discomfort to approximately 3% of adults. Although RLS was first identified centuries ago, our understanding of this disorder, its causes, and its treatments is still evolving. In particular, our knowledge of the potential negative effects of RLS treatments, including dopaminergic augmentation, continues to expand. Augmentation, which refers to a paradoxical treatment-related increase in RLS symptoms, has been associated with all three dopamine agonists approved for the treatment of RLS - rotigotine, pramipexole, and ropinirole...
August 18, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28817780/us-internists-awareness-and-use-of-overtreatment-guidelines-a-national-survey
#16
Kira L Ryskina, Eric S Holmboe, Elizabeth Bernabeo, Rachel M Werner, Judy A Shea, Judith A Long
OBJECTIVES: To assess physician views and perceived adoption of overtreatment guidelines and measure whether adoption of these guidelines influenced the recommendation of a targeted service. STUDY DESIGN: A cross-sectional survey mailed from July 2014 to January 2015 to 902 internists who completed residency between 2003 and 2013, randomly selected from the American Medical Association Masterfile. METHODS: Poisson regression was used to model the rate of recommending a targeted service included in the guidelines, based on the level of guideline adoption...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28817764/limited-functioning-after-remission-of-an-anxiety-disorder-as-a-trait-effect-versus-a-scar-effect-results-of-a-longitudinal-general-population-study
#17
Simone M E Schopman, Margreet Ten Have, Saskia van Dorsselaer, Ron de Graaf, Neeltje M Batelaan
OBJECTIVE: After remission of an anxiety disorder, subjects often experience persistent functional impairments. We examined whether impairments in mental and physical functioning following remission are a continuation of premorbid lower functioning (trait effect), due to impairments that develop during the anxiety disorder and persist beyond recovery (scar effect), or both. METHODS: Data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a prospective psychiatric epidemiologic study among the general population with a 3-wave design (6-year follow-up, with the study starting in 2007 and ending in 2015)...
August 15, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28817481/incorporating-dynamic-assessment-of-fluid-responsiveness-into-goal-directed-therapy-a-systematic-review-and-meta-analysis
#18
Joseph M Bednarczyk, Jason A Fridfinnson, Anand Kumar, Laurie Blanchard, Rasheda Rabbani, Dean Bell, Duane Funk, Alexis F Turgeon, Ahmed M Abou-Setta, Ryan Zarychanski
OBJECTIVE: Dynamic tests of fluid responsiveness have been developed and investigated in clinical trials of goal-directed therapy. The impact of this approach on clinically relevant outcomes is unknown. We performed a systematic review and meta-analysis to evaluate whether fluid therapy guided by dynamic assessment of fluid responsiveness compared with standard care improves clinically relevant outcomes in adults admitted to the ICU. DATA SOURCES: Randomized controlled trials from MEDLINE, EMBASE, CENTRAL, clinicaltrials...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28817367/nutrition-implications-for-long-term-survivors-of-pancreatic-cancer-surgery
#19
Maria Q B Petzel, Leah Hoffman
With slowly increasing survival rates in pancreatic cancer and international consensus guidelines recommending surgical resection of premalignant lesions, survival post-pancreatic resection is increasing. With longer survival time, the significant comorbidities of such major surgery have far-reaching effects on the nutrition status of the survivor of pancreatic cancer. This review describes the many nutrition-related side effects of pancreatic surgery, including the development of pancreatic enzyme insufficiency, micronutrient deficiencies, diabetes, fatty liver, and metabolic bone disease...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28817304/medical-education-and-leadership-in-breastfeeding-medicine
#20
Julie Scott Taylor, Esther Bell
Physicians' experience with high quality training in breastfeeding during their medical education is historically varied. The process of becoming a board-certified physician entails more than 20 years of education, and although medical school and residency training timelines and courses are relatively standardized across the United States and even internationally, breastfeeding education varies greatly across schools and programs. The Academy of Breastfeeding Medicine (ABM) exists, in part, because historically, physicians have received too little clinical training in breastfeeding and infant nutrition...
August 17, 2017: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
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