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https://www.readbyqxmd.com/read/28230448/opioid-use-for-pain-management-after-implementation-of-a-medicaid-short-acting-opioid-quantity-limit
#1
Catherine S Riggs, Sarah J Billups, Samantha Flores, Rachana J Patel, Rachel M F Heilmann, Jessica L Milchak
BACKGROUND: The United States is currently experiencing an opioid abuse epidemic. Many policies and programs have been implemented at local, state, and national levels in an attempt to decrease prescription opioid addiction and overdose. On August 1, 2014, Colorado Medicaid implemented a policy change that limited the quantity of short-acting opioids (SAOs) that could be filled through the Medicaid benefit to no more than 4 tablets per day, or 120 tablets in 30 days. OBJECTIVE: To compare mean total daily dose (TDD) of opioids purchased by Kaiser Permanente Colorado (KPCO) Medicaid patients before and after implementation of the Medicaid SAO quantity limit...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28229310/diagnosis-and-treatment-of-non-24-h-sleep-wake-disorder-in-the-blind
#2
REVIEW
Jonathan S Emens, Charmane I Eastman
Non-24-h sleep-wake disorder (non-24) is a circadian rhythm disorder occurring in 55-70% of totally blind individuals (those lacking conscious light perception) in which the 24-h biological clock (central, hypothalamic, circadian pacemaker) is no longer synchronized, or entrained, to the 24-h day. Instead, the overt rhythms controlled by the biological clock gradually shift progressively earlier or later (free run) in accordance with the clock's near-24-h period, resulting in a recurrent pattern of daytime hypersomnolence and night-time insomnia...
February 22, 2017: Drugs
https://www.readbyqxmd.com/read/28229019/is-there-a-relation-between-dental-anxiety-fear-and-general-psychological-status
#3
Tuba Talo Yildirim, Serkan Dundar, Alihan Bozoglan, Tahir Karaman, Neval Dildes, Filiz Acun Kaya, Eyyup Altintas, Faruk Oztekin, Osman Atas, Hilal Alan
BACKGROUND: Dental anxiety is a widespread problem in many populations. This problem can be a barrier to dental care and may lead to poor oral health. Dental anxiety may be related to psychological status. AIMS: The aim of the present study was to assess the levels of dental anxiety, dental fear, Beck Depression, and state-trait anxiety according to age, gender and education level in patients at the periodontology clinic in the Diyarbakır Mouth and Dental Health Center...
2017: PeerJ
https://www.readbyqxmd.com/read/28226414/methylene-blue-for-the-treatment-of-intractable-pain-associated-with-oral-mucositis
#4
Carlos J Roldan, Kent Nouri, Thomas Chai, Billy Huh
Oral mucositis is a common and often debilitating complication among cancer patients receiving radiation therapy to the head and neck or chemotherapy agents, or undergoing hematopoietic stem cell transplantation. Pain and decreased oral function associated with oral mucositis may persist long after the conclusion of therapy. Although most patients respond to conservative management, a subset of patients develop intractable pain with severe consequences. For some, the use of total parenteral nutrition with insertion of percutaneous endoscopic gastrostomy feeding tubes is the only alternative...
February 22, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28225851/effect-of-bauhinia-holophylla-treatment-in-streptozotocin-induced-diabetic-rats
#5
Marcelo S Pinheiro, Luhara S Rodrigues, Leila S, Rafaianne Q Moraes-Souza, Thaigra S Soares, Madileine F Américo, Kleber E Campos, Débora C Damasceno, Gustavo T Volpato
Bauhinia holophylla, commonly known as "cow's hoof", is widely used in Brazilian folk medicine for the diabetes treatment. Therefore, the aim of this study was at evaluating the aqueous extract effect of Bauhinia holophylla leaves treatment on the streptozotocin-induced diabetic rats. Diabetes was induced by Streptozotocin (40 mg/Kg) in female Wistar rats. Oral administration of aqueous extract of Bauhinia holophylla leaves was given to non-diabetic and diabetic rats at a dose of 400 mg/kg during 21 days. On day 17 of treatment, the Oral Glucose Tolerance Test was performed to determine the area under the curve...
February 16, 2017: Anais da Academia Brasileira de Ciências
https://www.readbyqxmd.com/read/28224352/hcv-management-in-resource-constrained-countries
#6
REVIEW
Seng Gee Lim
With the arrival of all-oral directly acting antiviral (DAA) therapy with high cure rates, the promise of hepatitis C virus (HCV) eradication is within closer reach. The availability of generic DAAs has improved access to countries with constrained resources. However, therapy is only one component of the HCV care continuum, which is the framework for HCV management from identifying patients to cure. The large number of undiagnosed HCV cases is the biggest concern, and strategies to address this are needed, as risk factor screening is suboptimal, detecting <20% of known cases...
February 21, 2017: Hepatology International
https://www.readbyqxmd.com/read/28223874/towards-safety-of-oral-anti-cancer-agents-the-need-to-educate-our-pharmacists
#7
Sanaa Saeed Mekdad, Adher Dhaya AlSayed
Introduction: The global prevalence of cancer is rising. Use of oral anticancer medications has expanded exponentially. Knowledge about these medications as well as safe handling guidelines has not kept abreast with the rapidity these medications are applied in clinical practice. They pose serious hazards on all personal involved in handling these medications as well as on patients and their caregivers. We addressed the gaps in knowledge and safe handling of oral anticancer agents among pharmacists in institutional based cancer care...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28222678/tracheal-extubation-in-deeply-anesthetized-pediatric-patients-after-tonsillectomy-a-comparison-of-high-concentration-sevoflurane-alone-and-low-concentration-sevoflurane-in-combination-with-dexmedetomidine-pre-medication
#8
Meiqin Di, Yuan Han, Zhuqing Yang, Huacheng Liu, Xuefei Ye, Hongyan Lai, Jun Li, Wangning ShangGuan, Qingquan Lian
BACKGROUND: Dexmedetomidine can facilitate a smooth extubation process and reduce the requirement of sevoflurane and emergence agitation when administrated perioperatively. We aimed to observe the extubation process and the recovery characteristics in pediatric patients undergoing tonsillectomy while anesthetized with either high-concentration sevoflurane alone or low-concentration sevoflurane combined with pre-medication of single dose of intravenous dexmedetomidine. METHODS: Seventy-five patients (ASA I or II, aged 3-7 years) undergoing tonsillectomy were randomized into three equal groups: to receive intravenous saline (Group D0), dexmedetomidine 1 μg/kg (Group D1), or dexmedetomidine 2 μg/kg (Group D2) approximately 10 min before anesthesia...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28222641/genotyping-guided-approach-versus-the-conventional-approach-in-selection-of-oral-p2y12-receptor-blockers-in-chinese-patients-suffering-from-acute-coronary-syndrome
#9
Chor Cheung Tam, Janette Kwok, Anthony Wong, Arthur Yung, Catherine Shea, Shun Ling Kong, Wing Hong Tang, David Siu, Raymond Chan, Stephen Lee
Objective The CYP2C19 loss-of-function (LoF) allele is present in half of the East Asian population and is associated with high on-treatment platelet reactivity (HTPR). This study aimed to investigate whether a rapid genotyping-guided approach is feasible and efficacious for selecting P2Y12 receptor blockers in Chinese patients suffering from acute coronary syndrome (ACS). Methods This was a single-centre, prospective, randomized, open-label study. A total of 132 patients with ACS were randomized to the rapid genotyping-guided treatment group (GG, N = 65) or the standard treatment group (SG, N = 67)...
February 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28222436/recurrent-angioedema-occurrence-features-and-concomitant-diseases-in-an-italian-single-center-study
#10
Paola Triggianese, Maria Domenica Guarino, Chiara Pellicano, Mauro Borzi, Elisabetta Greco, Stella Modica, Caterina De Carolis, Roberto Perricone
BACKGROUND: Angioedema (AE) is a potentially life-threatening condition with hereditary (HAE), acquired (AAE), or iatrogenic causes. A careful workup allows for the identification of the etiology of attacks and the appropriate management. In this cohort study, based on a clinical practice setting, we aimed at investigating clinical and laboratory findings concerning different features of patients with recurrent AE who were referred to a single, tertiary-level center for HAE. METHODS: Clinical and laboratory data of patients fulfilling the criteria for C1-inhibitor-deficient HAE (C1-INH-HAE), C1-INH-AAE, angiotensin-converting enzyme inhibitor-related AE (ACEI-RA), and idiopathic AAE (I-AAE) were evaluated...
February 22, 2017: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/28222277/antibiotic-prophylaxis-in-blepharoplasty-review-of-the-current-literature
#11
REVIEW
Elie M Ferneini, Steven Halepas, Steven I Aronin
The purpose of this study was to provide an evidence-based overview of antibiotic prophylaxis in blepharoplasty. We performed a literature search that evaluated the risk of infection associated with blepharoplasty, as well as the risks and benefits of antibiotic prophylaxis. The overall infection rate associated with eyelid surgery is extremely low. However, the use of antibiotic prophylaxis has increased over the past 25 years in esthetic facial procedures. There is no standard of care for or against antibiotic prophylaxis, and routine practices vary widely...
February 1, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28221264/efficacy-and-safety-of-combined-oral-chelation-with-deferiprone-and-deferasirox-in-children-with-%C3%AE-thalassemia-major-an-experience-from-north-india
#12
Nupur Parakh, Jagdish Chandra, Sunita Sharma, Bhavna Dhingra, Rajesh Jain, DeoNath Mahto
OBJECTIVE: A combination of desferrioxamine with either deferiprone (DFP) or deferasirox (DFX) for patients with β-thalassemia major who do not achieve negative iron balance with monotherapy has been studied widely. However, poor compliance resulting from the need for parentral administration of desferrioxamine and its cost necessicitates combining 2 oral chelators. METHODS: A prospective study was conducted in patients with transfusion-dependent β-thalassemia major in a tertiary care center over 2 years...
February 17, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28220628/the-role-of-nicotinamide-in-acne-treatment
#13
REVIEW
Frances M Walocko, Ariel E Eber, Jonette E Keri, Mana A Al-Harbi, Keyvan Nouri
Safe and effective treatment options for acne vulgaris are needed to address side effects and increasing rates of antibiotic resistance from current treatments. Nicotinamide is a vitamin with potent anti-inflammatory properties that could offer a potential treatment option. We aim to summarize the relevant literature on the role of nicotinamide in acne vulgaris and discuss the next steps necessary to move this approach into clinical practice. We searched PubMed for clinical studies using nicotinamide for treatment of acne vulgaris...
February 21, 2017: Dermatologic Therapy
https://www.readbyqxmd.com/read/28220515/challenges-in-conducting-multicentre-multidisciplinary-longitudinal-studies-in-children-with-chronic-conditions
#14
Hillary L Broder, Canice E Crerand, Ryan R Ruff, Alexandre Peshansky, David B Sarwer, Lacey Sischo
OBJECTIVES: Conducting longitudinal, multicentre, multidisciplinary research for individuals with chronic conditions can be challenging. Despite careful planning, investigative teams must adapt to foreseen and unforeseen problems. Our objective is to identify challenges encountered and solutions sought in a recently completed observational, longitudinal study of youth with cleft lip and palate as well as their caregivers. METHODS: Data for analysis were derived from a 6-year, multicentre, prospective, longitudinal study of youth with cleft conducted from 2009 to 2015 that examined oral health-related quality of life and other related clinical observations over time in youth who had cleft-related surgery compared to those who did not...
February 21, 2017: Community Dentistry and Oral Epidemiology
https://www.readbyqxmd.com/read/28220322/serious-fungal-infections-in-the-philippines
#15
M C R Batac, D Denning
The Philippines is a low middle-income, tropical country in Southeast Asia. Infectious diseases remain the main causes of morbidity, including tuberculosis. AIDS/HIV prevalence is still low at <1%, but is rapidly increasing. Fungal disease surveillance has not been done, and its burden has never been estimated. This becomes more important as the population of immunocompromised patients increases, drawn from patients with AIDS, TB, malignancies, and autoimmune diseases requiring chronic steroid use. Using the methodology of the LIFE program ( www...
February 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28219635/direct-oral-anticoagulant-or-warfarin-related-major-bleeding-characteristics-reversal-strategies-and-outcomes-from-a-multi-center-observational-study
#16
Yan Xu, Sam Schulman, Dar Dowlatshahi, Anne M Holbrook, Christopher S Simpson, Lois E Shepherd, Philip S Wells, Antonio Giulivi, Tara Gomes, Muhammad Mamdani, Wayne Khuu, Eliot Frymire, Ana P Johnson
BACKGROUND: Direct oral anticoagulants (DOACs) have expanded the armamentarium for antithrombotic therapy. While DOAC-related major bleeds were associated with favourable outcomes compared to warfarin in clinical trials, warfarin was reversed in <40% of cases, raising concerns about the generalizability of this finding. METHODS: Consecutive patients ≥66 years presenting to five tertiary care hospitals across three cities in Ontario, Canada with diagnoses that included hemorrhage from October 2010 to March 2015...
February 17, 2017: Chest
https://www.readbyqxmd.com/read/28218938/voices-from-family-medicine-on-becoming-a-family-physician
#17
William B Ventres
In this essay-part memoir, part reflection, and part oral history-I review my early professional development, a several years' long progression after residency training, during which I grew from functioning as a technically competent primary care doctor to being a capable and compassionate family physician. As part of that development, and with my colleague John Frey, MD, I interviewed several of the founders of the modern family medicine movement. Here I review some of their answers to the fundamental question of my early practice years: What does it mean to be a family physician? I cite some of their words of wisdom, those of particular import for me, and discuss how these words both helped me become a family physician and ring true even today as we approach the 50th anniversary of the founding of family medicine...
February 2017: Family Medicine
https://www.readbyqxmd.com/read/28217581/status-of-governmental-oral-health-care-delivery-system-in-haryana-india
#18
Ashish Vashist, Swati Parhar, Ramandeep Singh Gambhir, Ramandeep Kaur Sohi, Puneet Singh Talwar
BACKGROUND: Health system should be organized to meet the needs of entire population of the nation. This means that the state has the direct responsibility for the health of its population and improving the quality of life through research, education, and provision of health services. The present study was conducted to evaluate the government oral health care delivery system in Haryana, India. MATERIALS AND METHODS: The present cross-sectional study was conducted among 135 dental care units (DCUs) of various primary health centers (PHCs), community health centers (CHCs), and general hospitals (GHs) existing in the state by employing a cluster random sampling technique...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28217549/anticoagulation-control-among-patients-with-nonvalvular-atrial-fibrillation-a-single-tertiary-cardiac-center-experience
#19
Shaban Mohammed, Amer H S Aljundi, Mohamed Kasem, Mohammed Alhashemi, Ayman El-Menyar
There is a limited knowledge about the predictors of anticoagulation control in patients with nonvalvular atrial fibrillation (NVAF). Furthermore, few reports addressed the role of time in therapeutic range (TTR) that could reflect the safety and efficacy of anticoagulation therapy. We aimed to assess factors that affect the quality of anticoagulation therapy utilizing TTR in patients with NVAF. A retrospective observational study was conducted for patients with NVAF who were maintained on warfarin >6 months at a tertiary cardiac care hospital...
January 2017: Journal of Advanced Pharmaceutical Technology & Research
https://www.readbyqxmd.com/read/28217520/elevated-glycated-hemoglobin-predicts-macrosomia-among-asian-indian-pregnant-women-wings-9
#20
Balaji Bhavadharini, Manni Mohanraj Mahalakshmi, Mohan Deepa, Ranjani Harish, Belma Malanda, Arivudainambi Kayal, Anne Belton, Ponnusamy Saravanan, Unnikrishnan Ranjit, Ram Uma, Ranjit Mohan Anjana, Viswanathan Mohan
AIM: The aim of this study was to determine the optimal glycated hemoglobin (HbA1c) cut point for diagnosis of gestational diabetes mellitus (GDM) and to evaluate the usefulness of HbA1c as a prognostic indicator for adverse pregnancy outcomes. METHODS: HbA1c estimations were carried out in 1459 pregnant women attending antenatal care centers in urban and rural Tamil Nadu in South India. An oral glucose tolerance test was carried out using 75 g anhydrous glucose, and GDM was diagnosed using the International Association of the Diabetes and Pregnancy Study Groups criteria...
January 2017: Indian Journal of Endocrinology and Metabolism
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