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https://www.readbyqxmd.com/read/28639415/anti-vascular-endothelial-growth-factor-for-diabetic-macular-oedema-a-network-meta-analysis
#1
REVIEW
Gianni Virgili, Mariacristina Parravano, Jennifer R Evans, Iris Gordon, Ersilia Lucenteforte
BACKGROUND: Diabetic macular oedema (DMO) is a common complication of diabetic retinopathy. Antiangiogenic therapy with anti-vascular endothelial growth factor (anti-VEGF) modalities can reduce oedema and thereby improve vision and prevent further visual loss. These drugs have replaced laser photocoagulation as the standard of care for people with DMO. OBJECTIVES: The 2014 update of this review found high-quality evidence of benefit with antiangiogenic therapy with anti-VEGF modalities, compared to laser photocoagulation, for the treatment of DMO...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28630743/comparison-of-five-video-assisted-intubation-devices-by-novice-and-expert-laryngoscopists-for-use-in-the-aeromedical-evacuation-environment
#2
Matthew C Wallace, SSgt Tyler Britton, Robbie Meek, Sharon Walsh-Hart, Col Todd E Carter, Steven J Lisco
BACKGROUND: The critically ill or injured patient undergoing military medical evacuation may require emergent intubation. Intubation may be life-saving, but it carries risks. The novice or infrequent laryngoscopist has a distinct disadvantage because experience is critical for the rapid and safe establishment of a secured airway. This challenge is compounded by the austere environment of the back of an aircraft under blackout conditions. This study determined which of five different video-assisted intubation devices (VAIDs) was best suited for in-flight use by U...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28626088/secondary-prevention-of-cardiovascular-disease-in-patients-with-type-2-diabetes-international-insights-from-the-tecos-trial
#3
Neha J Pagidipati, Ann Marie Navar, Karen S Pieper, Jennifer B Green, M Angelyn Bethel, Paul W Armstrong, Robert G Josse, Darren K McGuire, Yuliya Lokhnygina, Jan H Cornel, Sigrun Halvorsen, Timo E Strandberg, Tuncay Delibasi, Rury R Holman, Eric D Peterson
Background -Intensive risk factor modification significantly improves outcomes for patients with diabetes and cardiovascular disease (CVD). However, the degree to which secondary prevention treatment goals are achieved in international clinical practice is unknown. Methods -Attainment of 5 secondary prevention parameters-aspirin use, lipid control (low-density lipoprotein cholesterol <70 mg/dL or statin therapy), blood pressure control (<140 mmHg systolic, <90 mmHg diastolic), angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, and non-smoking status-was evaluated among 13,616 patients from 38 countries with diabetes and known CVD at entry into TECOS...
June 16, 2017: Circulation
https://www.readbyqxmd.com/read/28624760/how-do-smoking-cessation-medicines-compare-with-respect-to-their-neuropsychiatric-safety-a-protocol-for-a-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#4
Kyla H Thomas, Deborah Caldwell, Michael N Dalili, David Gunnell, Marcus R Munafò, Matt Stevenson, Nicky J Welton
INTRODUCTION: Cigarette smoking is one of the leading causes of early death in the UK and worldwide. Public health guidance recommends the use of varenicline, bupropion and nicotine replacement therapy (NRT) as smoking cessation aids in the UK. Additionally, the first electronic cigarette has been licensed for use as a smoking cessation medicine. However, there are ongoing concerns about the safety of these medicines. We present a protocol for a systematic review and network meta-analysis (NMA) to determine how these smoking cessation medicines compare to each other with respect to their neuropsychiatric safety in adult smokers...
June 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28617944/inequity-in-timing-of-prenatal-screening-in-new-zealand-who-are-our-most-vulnerable
#5
Olivia Payne, Avinesh Pillai, Michelle Wise, Peter Stone
BACKGROUND: In New Zealand (NZ), Maori and Pacific women are less likely to complete prenatal screening for Down's syndrome and other aneuploidies than other ethnic groups. Young women <20 have low rates of completed screening compared with women >20 years. Women living in deprived areas have lower completed screen rates than women living in more affluent areas. Combined first trimester screening has a superior sensitivity (85%) compared with second trimester screening (75%) for trisomy 21...
June 15, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28615391/practical-approach-to-evaluating-testicular-status-in-infants-and-children
#6
REVIEW
Elke E Mau, Michael P Leonard
OBJECTIVE: To review the differences between normal, retractile, ectopic, ascended, and undescended testes and to describe the optimal way to perform a testicular examination to distinguish one from the other, as well as to demonstrate that ultrasound imaging is not necessary and to clarify when to consider specialist referral. SOURCES OF INFORMATION: This paper is based on selected findings from a MEDLINE search on undescended testes and orchiopexy referrals, and on our experience at the Urology Clinic at the Children's Hospital of Eastern Ontario in Ottawa, including review of referrals to our clinic for undescended testes and the resultant findings of normal variants versus surgical cases...
June 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28608496/stress-ulcer-prophylaxis-in-the-intensive-care-unit-trial-detailed-statistical-analysis-plan
#7
M Krag, A Perner, J Wetterslev, T Lange, M P Wise, M Borthwick, S Bendel, P Pelosi, F Keus, A B Guttormsen, J C Schefold, T S Meyhoff, S Marker, M H Møller
BACKGROUND: In this statistical analysis plan, we aim to provide details of the pre-defined statistical analyses of the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) trial. The aim of the SUP-ICU trial is to assess benefits and harms of stress ulcer prophylaxis with a proton pump inhibitor in adult patients in the intensive care unit (ICU). METHODS: The SUP-ICU trial is an investigator-initiated, international, multicentre, randomised, blinded, parallel-group trial of intravenously pantoprazole 40 mg once daily vs...
June 12, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28607678/choosing-wisely-a-quality-improvement-initiative-to-decrease-unnecessary-preoperative-testing
#8
John Matulis, Stephen Liu, John Mecchella, Frederick North, Alison Holmes
Dartmouth-Hitchcock Medical Center is a rural, academic medical center in the northeastern United States; its General Internal Medicine (GIM) division performs about 900 low and intermediate surgical risk preoperative evaluations annually. Routine preoperative testing in these evaluations is widely considered a low-value service. Our baseline data sample showed unnecessary testing rates of approximately 36%. A multi-disciplinary team used a micro-systems approach to analyze the existing process and formulate a rapid cycle improvement strategy...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28606208/medical-requirements-during-a-natural-disaster-a-case-study-on-whatsapp-chats-among-medical-personnel-during-the-2015-nepal-earthquake
#9
Moumita Basu, Saptarshi Ghosh, Arnab Jana, Somprakash Bandyopadhyay, Ravikant Singh
OBJECTIVE: The objective of this study was to explore a log of WhatsApp messages exchanged among members of the health care group Doctors For You (DFY) while they were providing medical relief in the aftermath of the Nepal earthquake in April 2015. Our motivation was to identify medical resource requirements during a disaster in order to help government agencies and other responding organizations to be better prepared in any upcoming disaster. METHODS: A large set of WhatsApp (WhatsApp Inc, Mountain View, CA) messages exchanged among DFY members during the Nepal earthquake was collected and analyzed to identify the medical resource requirements during different phases of relief operations...
June 13, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28600510/discordance-in-her2-status-in-gastro-esophageal-adenocarcinomas-a-systematic-review-and-meta-analysis
#10
A Creemers, E Ter Veer, L de Waal, P Lodder, G K J Hooijer, N C T van Grieken, M F Bijlsma, S L Meijer, M G H van Oijen, H W M van Laarhoven
Trastuzumab combined with chemotherapy is standard of care for HER2 positive advanced gastro-esophageal cancers. The reported prevalence of HER2 discordance between primary tumors and corresponding metastases varies, hampering uniform patient selection for HER2 targeted therapy. This meta-analysis explores the influence of HER2 assessment methods on this discordance and investigates the prevalence of HER2 discordance in gastro-esophageal adenocarcinomas. PubMed, Embase and Cochrane databases were searched until January 2016...
June 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28588353/age-wise-association-of-carotid-intima-media-thickness-in-ischemic-stroke
#11
Yogesh Saxena, Vartika Saxena, Manish Mittal, Malini Srivastava, Shailendra Raghuvanshi
BACKGROUND: Ischemic stroke is often a sequel of atherosclerotic risk factors. Carotid intima-media thickness (CIMT) is a surrogate marker of early atherosclerotic changes. PURPOSE: It was hypothesized that CIMT is associated with ischemic stroke in adults across all ages. METHODS: A case control study was performed on 163 diagnosed cases of first-time ischemic stroke and age-(±1 SD) and gender-matched healthy control attendants reporting at a tertiary care hospital...
May 2017: Annals of Neurosciences
https://www.readbyqxmd.com/read/28583057/auricular-acupressure-in-the-prevention-of-postoperative-nausea-and-emesis-a-randomized-controlled-trial
#12
Cynthia Feng, Jovan Popovic, Richard Kline, Jung Kim, Rafael Matos, Sarah Lee, Joseph Bosco
INTRODUCTION: Successful antiemesis contributes significantly to quality, safety, and patient satisfaction. Patients undergoing general anesthesia often experience postoperative nausea and vomiting (PONV). Acupressure offers a side effect-free alternative to common first-line antiemetics. Because the patient may perceive needle acupuncture as uncomfortable, acupressure is a desirable alternative for the prevention of PONV. METHODS: This study was a randomized, prospective, double-blinded clinical trial investigating the effect of acupressure in patients with a history of PONV and motion sickness...
April 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28579376/a-new-measure-to-assess-asthma-s-impact-on-quality-of-life-from-the-patient-s-perspective
#13
Sandra R Wilson, Michael J Mulligan, Estela Ayala, Alan Chausow, Qiwen Huang, Sarah B Knowles, Santosh Gummidipundi, Mario Castro, Robert A Wise
BACKGROUND: The Asthma Impact on Quality of Life Scale (A-IQOLS) assesses the negative effect of asthma on quality of life (QoL) from the patient's perspective, using dimensions of Flanagan's Quality of Life Scale (QOLS), a measure of current QoL. OBJECTIVES: To determine and compare the psychometric properties of the A-IQOLS and QOLS, including their sensitivities to differences and changes in asthma status. METHODS: In a test-retest design (3-5 week interval), adults with persistent asthma underwent spirometry and were administered the A-IQOLS, other asthma outcome measures (ACT, ASUI, Marks and Juniper AQLQs), and QOLS...
June 1, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28577878/nurses-leading-change-to-advance-health
#14
Patricia Polansky, Mary Sue Gorski, Alexia Green, G Adriana Perez, Robert P Wise
BACKGROUND: The article includes a review of selected past and current leadership initiatives as well as a summary of three leadership meetings convened by The Center to Champion Nursing in America, a partnership of the Robert Wood Johnson Foundation (RWJF), AARP and the AARP Foundation. PURPOSE: These "Leadership in Action" meetings were designed to address the Campaign for Action's (CFA) goal to increase the number of nurse leaders in health- and health care-related boardrooms at the local, state and national levels...
April 13, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28571519/using-lean-manufacturing-principles-to-evaluate-wait-times-for-hiv-positive-patients-in-an-urban-clinic-in-kenya
#15
Aliza Monroe-Wise, Elizabeth Reisner, Kenneth Sherr, David Ojakaa, Lilian Mbau, Paul Kisia, Samuel Muhula, Carey Farquhar
As human immunodeficiency virus (HIV) treatment programs expand in Africa, delivery systems must be strengthened to support patient retention. Clinic characteristics may affect retention, but a relationship between clinic flow and attrition is not established. This project characterized HIV patient experience and flow in an urban Kenyan clinic to understand how these may affect retention. We used Toyota's lean manufacturing principles to guide data collection and analysis. Clinic flow was evaluated using value stream mapping and time and motion techniques...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28561869/caregivers-are-heroes-an-innovative-educational-strategy-designed-to-promote-compassion-caring-in-health-professional-students
#16
Nancy E Carson, Holly H Wise, Paul F Jacques
BACKGROUND: Compassionate care is recognized as an intrinsic element of patient-centered care. Although the evidence seems to indicate that compassionate care can be developed in health professions students, few methodologies reported have been interprofessional in nature. This paper describes Caregivers Are Heroes, an interprofessional educational strategy designed to imbue compassion/caring. METHODS: The sample population consisted of 51 caregivers and 170 students enrolled in three graduate programs during the 2014 summer semester...
2017: Journal of Allied Health
https://www.readbyqxmd.com/read/28561148/-preoperative-preparation-patient-blood-management-what-is-optimal
#17
Patrick Meybohm, Markus M Müller, Kai Zacharowski
Patient Blood Management (PBM) focusses on anemia management, the minimization of (unnecessary) iatrogenic blood loss and the exhaustion of natural tolerance to anemia with rational use of red blood cell transfusion. The focus of the current review article is now the preoperative phase with the following PBM components: management of anemia, pre-transfusion analytics and management of anticoagulants. Preoperative anemia is an independent risk factor for increased perioperative morbidity and mortality. In elective surgery, the causes of anemia should be diagnosed prior to surgery as early as possible, and if indicated, a specific treatment for treatable causes should be initiated...
May 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28559763/financial-toxicity-of-cancer-drugs-possible-remedies-from-an-ethical-perspective
#18
Georg Marckmann, Jürgen In der Schmitten
Spiraling costs of cancer treatments have become a major concern for the payers in the health care system and for individual patients suffering from the cancer drugs' financial toxicity. This article discusses possible solutions from an ethical perspective. First, it gives some orientation about what constitutes a fair price for innovative anticancer agents. While a definitive answer remains difficult, there are good reasons to enter into price negotiations with the pharmaceutical companies to align the price with the R&D costs and the added value of the product...
May 2017: Breast Care
https://www.readbyqxmd.com/read/28549464/is-the-delivery-of-a-quality-improvement-education-programme-in-obstetrics-and-gynaecology-for-final-year-medical-students-feasible-and-still-effective-in-a-shortened-time-frame
#19
Bridget Kool, Michelle R Wise, Roshini Peiris-John, Lynn Sadler, Faith Mahony, Susan Wells
BACKGROUND: Teaching clinical audit skills to nascent health professionals is one strategy to improve frontline care. The undergraduate medical curriculum at the University of Auckland provides improvement science theory and skills in Year 5 teaching, and the opportunity to put this into practice during an Obstetrics and Gynaecology (O&G) clinical attachment in Year 6. In 2015, a revised medical school curriculum at the university resulted in a planned reduction of the O&G attachment from five weeks to four, necessitating revision of the Year 6 Quality Improvement (QI) project...
May 26, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28539863/pulmonary-aspergillosis-as-opportunistic-mycoses-in-a-cohort-of-human-immunodeficiency-virus-infected-patients-report-from-a-tertiary-care-hospital-in-north-india
#20
Ravinder Kaur, Bhanu Mehra, Megh Singh Dhakad, Ritu Goyal, Richa Dewan
OBJECTIVE: The incidence of pulmonary aspergillosis in human immunodeficiency virus (HIV)-infected persons is rising. This study was designed to determine the prevalence of pulmonary aspergillosis in a cohort of HIV-positive patients (n = 71) presenting with lower respiratory tract infection at a tertiary care medical center in India. METHODS: Sputum samples were collected, and potassium hydroxide mount, cultural characteristics, and lactophenol cotton blue preparations were employed to aid in the identification of Aspergillus species...
April 2017: International Journal of Health Sciences
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