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Ju-Eun Song, Jeong-Ah Ahn, Sun-Kyoung Lee, Eun Ha Roh
The purpose of this study was to explore the factors influencing low birth rate among married women using the National Survey data in Korea. We compared the different influences on women's first and subsequent childbirths. This study was a secondary analysis using the "National Survey on Fertility and Family Health and Welfare", which was a nationally representative survey conducted by the Korea Institute for Health and Social Affairs. We analyzed the data of 3,482 married women (aged between 19 and 39 years) using SPSS 20...
2018: PloS One
Lisa B VanWagner, Samantha Montag, Lihui Zhao, Norrina B Allen, Donald M Lloyd-Jones, Arighno Das, Anton I Skaro, Samuel Hohmann, John J Friedewald, Josh Levitsky
BACKGROUND: In the general population, even mild renal disease is associated with increased cardiovascular (CV) complications. Whether this is true in liver transplant recipients (LTR) is unknown. METHODS: This was a retrospective cohort study of 671 LTR (2002-2012) from a large urban tertiary care center and 37,322 LTR using Vizient hospitalization data linked to the United Network for Organ Sharing. The MDRD4 equation estimated GFR (eGFR). Outcomes were 1-year CV complications (death/hospitalization from myocardial infarction, heart failure, atrial fibrillation, cardiac arrest, pulmonary embolism or stroke) and mortality...
March 20, 2018: Transplantation
Anna Lindfors, Åsa Åkesson, Christian Staf, Per Sjöli, Karin Sundfeldt, Pernilla Dahm-Kähler
OBJECTIVE: This study aimed to compare robotic and open surgery in elderly women diagnosed as having endometrial cancer, in terms of costs, survival, surgical outcome, and operating time. METHODS: Women 70 years or older undergoing open and robotic surgery for endometrial cancers were included consecutively before and after the introduction of robotic surgery at a tertiary center. Costs were calculated using the case-costing system, cost per patient, including the first 30 postoperative days...
March 20, 2018: International Journal of Gynecological Cancer
Sanjay V Desai, David A Asch, Lisa M Bellini, Krisda H Chaiyachati, Manqing Liu, Alice L Sternberg, James Tonascia, Alyssa M Yeager, Jeremy M Asch, Joel T Katz, Mathias Basner, David W Bates, Karl Y Bilimoria, David F Dinges, Orit Even-Shoshan, David M Shade, Jeffrey H Silber, Dylan S Small, Kevin G Volpp, Judy A Shea
Background Concern persists that inflexible duty-hour rules in medical residency programs may adversely affect the training of physicians. Methods We randomly assigned 63 internal medicine residency programs in the United States to be governed by standard duty-hour policies of the 2011 Accreditation Council for Graduate Medical Education (ACGME) or by more flexible policies that did not specify limits on shift length or mandatory time off between shifts. Measures of educational experience included observations of the activities of interns (first-year residents), surveys of trainees (both interns and residents) and faculty, and intern examination scores...
March 20, 2018: New England Journal of Medicine
Anne Marie Coleman, Zoë Chouliara, Kay Currie
The aim of this article is to explore the positive and negative impacts of working therapeutically in complex psychological trauma (CPT), particularly the field of gender-based violence (GBV) and childhood sexual abuse (CSA), from the clinicians' perspective. The focus was on the prospect of positive gains and growth for therapists. Twenty-one clinicians ( n = 21; counselors/psychotherapists and psychologists) from National Health Service (NHS) specialist trauma services, a community mental health team, and specialist sexual assault counseling organization participated...
March 1, 2018: Journal of Interpersonal Violence
Horacio Lejarraga, Diana M Kelmansky, Fernando Nunes
OBJECTIVE: To describe the dynamics of development along the early years of life among children living under unfavorable socioeconomic conditions. POPULATION AND METHODS: In 5401 children younger than 6 years old living in Florencio Varela and in the Matanza-Riachuelo River Basin (Matanza, Villa 21-24, Wilde, Villa Inflamable and Acuba), areas with a high proportion of families with unmet basic needs, a logistic regression analysis was used to estimate the median age at attainment of 13 psychomotor developmental milestones; differences between these ages and median age at attainment of milestones as per the national reference were plotted on the y-axis, while the median age as per the national reference was plotted on the x-axis...
April 1, 2018: Archivos Argentinos de Pediatría
Mohan P Joshi, Chifumbe Chintu, Mirfin Mpundu, Dan Kibuule, Oliver Hazemba, Tenaw Andualem, Martha Embrey, Bayobuya Phulu, Heran Gerba
The multi-faceted complexities of antimicrobial resistance (AMR) require consistent action, a multidisciplinary approach, and long-term political commitment. Building coalitions can amplify stakeholder efforts to carry out effective AMR prevention and control strategies. We have developed and implemented an approach to help local stakeholders kick-start the coalition-building process. The five-step process is to (1) mobilise support, (2) understand the local situation, (3) develop an action plan, (4) implement the plan, and (5) monitor and evaluate...
March 20, 2018: Global Public Health
M Ruggeri, M Basile, C Drago, F R Rolli, A Cicchetti
BACKGROUND: Until very recently the only therapeutic alternative for the management of patients affected by gout/hyperuricemia that did not respond to a first-line treatment based on allopurinol alone or who cannot tolerate allopurinol was febuxostat, a xanthine oxidase non-purine-selective inhibitor. Lately, however, a new therapeutic alternative has become available for the management of this pathology: lesinurad, a urate transporter inhibitor. OBJECTIVE: To objective of this study was to evaluate the cost effectiveness of lesinurad/allopurinol in comparison with febuxostat as a second-line therapeutic strategy for the management of patients affected by gout and hyperuricemia that did not respond to a first-line therapy based on allopurinol alone...
March 19, 2018: PharmacoEconomics
Maria Kamusheva, Mariya Vassileva, Alexandra Savova, Manoela Manova, Guenka Petrova
Background: Policy makers face a lot of challenges in the process of drug reimbursement decision-making, especially in the context of entering the market of more and more innovative medicinal products (MPs). The aim of the current study is to make an overview of the reimbursement system development and to evaluate the access of innovative medicines, which have entered the EU-market in the period 2015-2017, in Bulgaria as reference example for middle-income European country. Methods: A literature and a legislative systematic review regarding the Bulgarian reimbursement system as well as a defining the number of available innovative reimbursed MPs in 2017 in Bulgaria was made...
2018: Frontiers in Public Health
Takashi Nagai, Taku Naiki, Keitaro Iida, Toshiki Etani, Ryosuke Ando, Shuzo Hamamoto, Yosuke Sugiyama, Hidetoshi Akita, Hiroki Kubota, Yoshihiro Hashimoto, Noriyasu Kawai, Takahiro Yasui
Background: Development of novel agents targeting the androgen axis has led to improved overall survival in castration-resistant prostate cancer (CRPC). This study aimed to investigate the optimal timing of treatment with one such agent, abiraterone acetate (AA), in Japanese patients. Materials and methods: Between July 2014 and February 2016, 106 CRPC patients were administered AA in Nagoya City University Hospital, Nagoya, Japan and in four affiliated hospitals following failure of primary combined androgen blockade (CAB)...
March 2018: Prostate International
Kemal Ugur Tufekci, Ufuk Vurgun, Onur Yigitaslan, Pembe Keskinoglu, Erdem Yaka, Kursad Kutluk, Sermin Genc
Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL), which is TNF receptor superfamily member, contributes to several diseases pathogenesis. The aim of this research was to investigate the relevance of serum TRAIL protein levels and mRNA expression in peripheral blood mononuclear cells (PBMC) of patients with stroke through 6 months follow-up. We enrolled patients with first-ever acute ischemic stroke ( n  = 95) and healthy controls ( n  = 95) in this study. Follow-up blood samples were collected from patients at day 7, 28, and 180 after the onset...
2018: Frontiers in Neurology
O O Olukoya, O A Adebiyi
Background: Malaria is of global health concern particularly among pregnant women. Nigeria contributes largely to global burden but coverage of Intermittent Preventive Treatment of malaria in pregnancy using Sulphadoxine pyrimethamine remains low. This study was conducted to determine the national situation of missed opportunity for IPTp-SP and attempted to look at correlates and predictors. Method: The study used secondary data analysis of the Nigeria Demographic Health Survey, 2013...
December 2017: Annals of Ibadan Postgraduate Medicine
Tsuyoshi Ohta, Kenji Okada, Maki Fukuda, Noritaka Masahira, Toshiki Matsuoka, Takaya Tsuno, Mitsuhiro Takemura
OBJECT: The purpose of this study was to investigate the safety and efficacy of intravenous low-dose alteplase for acute ischemic stroke patients with relative contraindications. METHODS: The consecutive series of patients admitted within 4.5 hours of ischemic stroke onset between September 2012 and April 2017 were retrospectively evaluated. A good outcome at 90 days and symptomatic intracerebral hemorrhage were evaluated to determine the association with intravenous low-dose alteplase, especially in the presence of relative contraindications...
March 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Henry Chubb, Rashed Karim, Sébastien Roujol, Marta Nuñez-Garcia, Steven E Williams, John Whitaker, James Harrison, Constantine Butakoff, Oscar Camara, Amedeo Chiribiri, Tobias Schaeffter, Matthew Wright, Mark O'Neill, Reza Razavi
BACKGROUND: Cardiovascular magnetic resonance (CMR) imaging has been used to visualise post-ablation atrial scar (PAAS), generally employing a three-dimensional (3D) late gadolinium enhancement (LGE) technique. However the reproducibility of PAAS imaging has not been determined. This cross-over study is the first to investigate the reproducibility of the technique, crucial for both future research design and clinical implementation. METHODS: Forty subjects undergoing first time ablation for atrial fibrillation (AF) had detailed CMR assessment of PAAS...
March 19, 2018: Journal of Cardiovascular Magnetic Resonance
Wan-Hsuan Lu, Chih-Wan Lin, Chen-Yu Wang, Liang-Kung Chen, Fei-Yuan Hsiao
BACKGROUND: The objectives of this study were to characterize the burden of herpes zoster, as well as the longitudinal and incremental changes of healthcare service utilization among individuals with herpes zoster and postherpetic neuralgia (PHN) compared to those without. METHODS: Using the National Health Insurance Research Database (NHIRD), we established a herpes zoster cohort of people diagnosed with herpes zoster between 2004 and 2008 as study cases. Another subset of the NHIRD, which was randomly selected from all elderly beneficiaries between 2004 and 2008 served as a non-herpes-zoster elderly control pool...
March 20, 2018: BMC Public Health
Sonia Singh, Ruiguang Song, Anna Satcher Johnson, Eugene McCray, H Irene Hall
Background: HIV infection is a persistent health concern in the United States, and men who have sex with men (MSM) continue to be the most affected population. Objective: To estimate HIV incidence and prevalence and the percentage of undiagnosed HIV infections overall and among MSM. Design: Cross-sectional analysis. Setting: National HIV Surveillance System. Participants: Persons aged 13 years and older with diagnosed HIV infection...
March 20, 2018: Annals of Internal Medicine
Angelica G Mancone, Alyssa R Dickey, Brian M Fitzgerald, Gregory P Kraus, Sandeep T Dhanjal
Introduction: Wrong site peripheral nerve blocks are included in the National Quality Forum and Joint Commission's category of "never event." Multiple attempts have been made by various groups in an effort to eliminate these events. Prior attempts to eliminate these never events include the Regional Block Preprocedural Checklist provided by the American Society of Regional Anesthesia (ASRA) taskforce. Following a series of errors involving anticoagulation prior to regional anesthesia, our department saw a need for a more comprehensive checklist...
March 15, 2018: Military Medicine
Hiroyuki Kishino, Kenichi Takahashi, Miyuki Sawata, Yoshiyuki Tanaka
Hepatitis B vaccines are highly effective in preventing hepatitis B virus infection and have been included in the national immunization program of Japan since 2016. Heptavax®-II is one of two hepatitis B vaccine products licensed in Japan, and its manufacturing process is being modified to reduce variability of manufacturing and optimize immunogenicity. In this study (NCT01463683), the immunogenicity and safety of a modified-process hepatitis B vaccine (mpHBV) were compared to those of the licensed Heptavax®-II...
March 19, 2018: Human Vaccines & Immunotherapeutics
Samah W Al-Jabi, Ansam Sous, Fatimah Jorf, Mahmoud Taqatqa, Mahdi Allan, Lamees Sawalha, Enas Lubadeh, Sa'ed H Zyoud, Waleed M Sweileh
BACKGROUND: The increasing incidence of end-stage renal disease in the Palestinian population and the effect of the disease on the psychological status of the patient underlie the importance of increasing knowledge about the mental health status of patients with end-stage renal disease. The aim of this study was to estimate the prevalence of depression in Palestinian patients treated with haemodialysis and its correlation with patients' clinical characteristics, health-related quality of life (HRQoL), and adherence to medications...
February 21, 2018: Lancet
Qusay Abdoh, Lubna Kharraz, Khubaib Ayoub, Jana Khraim, Wafaa Awad, Aysha Sbeah, Safaa Turman
BACKGROUND: Bacterial resistance to antibiotics is considered the most important determinant of treatment failure. Monitoring the evolution of antimicrobial resistance to common antibiotics is therefore of special importance for clinicians. The frequency of resistance to antibiotics in Helicobacter pylori isolates is increasing. The aim of this study was to determine the pattern of H pylori antibiotic resistance at the An-Najah National University Hospital. METHODS: In this cross-sectional study, we recruited patients older than 18 year who were admitted to the An-Najah National University Hospital...
February 21, 2018: Lancet
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