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Independent medical assessment

Phillip Ertel, Burkay Adalig, Ipek Demircan, Belinda Lartey, Michael J Manyak
AIM: To assess attitudes and beliefs towards benign prostatic hyperplasia (BPH)/ lower urinary tract symptoms (LUTS) and its treatment among patients and physicians in Latin America, Asia Pacific and the Commonwealth of Independent States (CIS). METHODS: Cross-sectional, quantitative study conducted between December 2014 and September 2015. Separate questionnaires were administered to BPH/LUTS patients receiving drug treatment for their condition and to practising physicians who treat patients with BPH/LUTS...
October 2016: International Journal of Clinical Practice
Mario Maggi, Frederick C W Wu, Thomas H Jones, Graham Jackson, Hermann M Behre, Geoffrey Hackett, Antonio Martin-Morales, Giancarlo Balercia, Adrian S Dobs, Stefan T E Arver, Marcello Maggio, Glenn R Cunningham, Andrea M Isidori, Richard Quinton, Olivia A Wheaton, Flora S Siami, Raymond C Rosen
AIMS: The aim of this study was to assess cardiovascular (CV) safety of testosterone replacement therapy (TRT) in a large, diverse cohort of European men with hypogonadism (HG). METHODS: The Registry of Hypogonadism in Men (RHYME) was designed as a multi-national, longitudinal disease registry of men diagnosed with hypogonadism (HG) at 25 clinical sites in six European countries. Data collection included a complete medical history, physical examination, blood sampling and patient questionnaires at multiple study visits over 2-3 years...
October 2016: International Journal of Clinical Practice
Douglas Powell, Anburaj Muthumani, RuiPing Xia
OBJECTIVE: Quantify the effect of a continuous compared to discontinuous movement trajectory on parkinsonian rigidity and reflex responses to passive stretch and shortening. METHODS: Eighteen participants with Parkinson's disease (PD) performed passive wrist flexion and extension movements through a 90° range of motion at 50 °/sec using continuous (CONT) and discontinuous (DISC) movement trajectories. Participants were tested in both the OFF-MED and ON-MED states...
2016: Journal of Nature and Science
Alvaro Avezum, Gustavo B F Oliveira, Fernando Lanas, Patricio Lopez-Jaramillo, Rafael Diaz, J Jaime Miranda, Pamela Seron, Paul A Camacho-Lopez, Andres Orlandini, Antonio Bernabe-Ortiz, Antônio Cordeiro Mattos, Shofiqul Islam, Sumathy Rangarajan, Koon Teo, Salim Yusuf
BACKGROUND: Despite the availability of evidence-based therapies, there is no information on the use of medications for the secondary prevention of cardiovascular disease in urban and rural community settings in South America. OBJECTIVES: This study sought to assess the use, and its predictors, of effective secondary prevention therapies in individuals with a history of coronary heart disease (CHD) or stroke. METHODS: In the PURE (Prospective Urban Rural Epidemiological) study, we enrolled 24,713 individuals from South America ages 35 to 70 years from 97 rural and urban communities in Argentina, Brazil, Chile, and Colombia...
October 20, 2016: Global Heart
Adela Brahimaj, Taulant Muka, Maryam Kavousi, Joop S E Laven, Abbas Dehghan, Oscar H Franco
AIMS/HYPOTHESIS: Previous literature documents controversial results for the impact of dehydroepiandrosterone (DHEA) in glucose metabolism. We aimed to assess the associations between serum levels of DHEA and its main derivatives DHEA sulphate (DHEAS) and androstenedione, as well as the ratio of DHEAS to DHEA, and risk of type 2 diabetes. METHODS: We used data on serum levels of DHEA, DHEAS and androstenedione from 5189 middle-aged and elderly men and women from the prospective population-based Rotterdam Study...
October 22, 2016: Diabetologia
Anthony C Waddimba, Melissa Scribani, Nicole Krupa, John J May, Paul Jenkins
BACKGROUND: Widespread dissatisfaction among United States (U.S.) clinicians could endanger ongoing reforms. Practitioners in rural/underserved areas withstand stressors that are unique to or accentuated in those settings. Medical professionals employed by integrating delivery systems are often distressed by the cacophony of organizational change(s) that such consolidation portends. We investigated the factors associated with dis/satisfaction with rural practice among doctors/non-physician practitioners employed by an integrated healthcare delivery network serving 9 counties of upstate New York, during a time of organizational transition...
October 22, 2016: BMC Health Services Research
Parker Magin, Rebecca Stewart, Allison Turnock, Amanda Tapley, Elizabeth Holliday, Nick Cooling
Underperforming trainees requiring remediation may threaten patient safety and are challenging for vocational training programs. Decisions to institute remediation are high-stakes-remediation being resource-intensive and emotionally demanding on trainees. Detection of underperformance requiring remediation is particularly problematic in general (family) practice. We sought to establish early-training assessment instruments predictive of general practice (GP) trainees' subsequently requiring formal remediation...
October 21, 2016: Advances in Health Sciences Education: Theory and Practice
Ahmad Masri, Vidyasagar Kalahasti, Lars G Svensson, Eric E Roselli, Douglas Johnston, Donald Hammer, Paul Schoenhagen, Brian P Griffin, Milind Y Desai
BACKGROUND: -In patients with a dilated proximal ascending aorta and trileaflet aortic valve (TAV), we sought to assess a) factors independently associated with increased long-term mortality and b) the incremental prognostic utility of indexing aortic root to patient height. METHODS: -We studied consecutive patients with a dilated aortic root (≥4 cm) that underwent echocardiography and gated contrast-enhanced thoracic aortic computed tomography or magnetic resonance angiography between 2003-2007...
October 21, 2016: Circulation
Wei-Cheng Chen, Kuo-Yang Huang, Chih-Wei Yao, Cing-Feng Wu, Shinn-Jye Liang, Chia-Hsiang Li, Chih-Yeh Tu, Hung-Jen Chen
BACKGROUND: Although many risk models have been tested in patients who undergo extracorporeal membrane oxygenation, few have been assessed for patients who received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support in the emergency department (ED). This study aimed to successfully predict outcomes of patients with cardiac or noncardiac failure who received VA-ECMO in the ED within 24 hours of arrival at the ED. METHOD: This retrospective, observational cohort study included 154 patients, who were classified as cardiac (n = 127) and noncardiac (n = 27) patients and received VA-ECMO within 24 hours after arrival at the China Medical University Hospital ED in Taiwan between January 2009 and September 2014...
October 22, 2016: Critical Care: the Official Journal of the Critical Care Forum
Eileen Hoskin, Analia Veitz-Keenan
Data sourcesCochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Clinical and the WHO International Clinical Trials Registry Platform. There were no language restrictions.Study selectionRandomised controlled trials which compared the relief of pain with systemic antibiotics and analgesics against placebo and analgesics in the preoperative phase of irreversible pulpitis. The primary interest was pain control with an antibiotic or without one in the presence of analgesics...
September 2016: Evidence-based Dentistry
Mahlet Fikreyesus, Matiwos Soboka, Garumma Tolu Feyissa
BACKGROUND: Psychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH). METHODS: Data were collected using interviewer administered questionnaire...
October 20, 2016: BMC Psychiatry
Lauren E Arthur, Russell S Kizor, Adrian G Selim, Mieke L van Driel, Leonardo Seoane
BACKGROUND: Ventilator-associated pneumonia (VAP) is a significant cause of morbidity and mortality, complicating the medical course of approximately 10% of mechanically-ventilated patients, with an estimated attributable mortality of 13%. To treat VAP empirically, the American Thoracic Society currently recommends antibiotic therapy based on the patients' risk of colonisation by an organism with multidrug resistance. The selection of initial antibiotic therapy in VAP is important, as inappropriate initial antimicrobial treatment is associated with higher mortality and longer hospital stay in intensive care unit (ICU) patients...
October 20, 2016: Cochrane Database of Systematic Reviews
Josefin Sundh, Scott Montgomery, Mikael Hasselgren, Mary Kämpe, Christer Janson, Björn Ställberg, Karin Lisspers
Health status is a prognostic factor included in the assessment of chronic obstructive pulmonary disease (COPD). The aim of our study was to examine the associations of clinical factors with change in health status over a 7-year follow-up period. In 2005, 970 randomly selected primary and secondary care patients with a COPD diagnosis completed questionnaires including the Clinical COPD Questionnaire (CCQ); and in 2012, 413 completed the CCQ questionnaire again. Linear regression used difference in mean total CCQ score between 2005 and 2012 as the dependent variable...
October 20, 2016: NPJ Primary Care Respiratory Medicine
Nastasia Marinus, Liene Bervoets, Guy Massa, Kenneth Verboven, An Stevens, Tim Takken, Dominique Hansen
BACKGROUND: Cardiopulmonary exercise testing is advised ahead of exercise intervention in obese adolescents to assess medical safety of exercise and physical fitness. Optimal validity and reliability of test results are required to identify maximal exercise effort. As fat oxidation during exercise is disturbed in obese individuals, it remains an unresolved methodological issue whether the respiratory gas exchange ratio (RER) is a valid marker for maximal effort during exercise testing in this population...
October 20, 2016: Journal of Sports Medicine and Physical Fitness
M J Lin, F Baky, B C Housley, N Kelly, E Pletcher, J D Balshi, S P Stawicki, D C Evans
INTRODUCTION: Clinical information continues to be limited regarding changes in the temporal risk profile for readmissions during the initial postoperative year in vascular surgery patients. We set out to describe the associations between demographics, clinical outcomes, comorbidity indices, and hospital readmissions in a sample of patients undergoing common extremity revascularization or dialysis access (ERDA) procedures. We hypothesized that factors independently associated with readmission will evolve from "short-term" to "long-term" determinants at 30-, 180-, and 360-day postoperative cutoff points...
October 2016: Journal of Postgraduate Medicine
Daniel Ben-Eliezer, Eldad Yechiam
Considered an antidepressant and anti-anxiety agent, Hypericum perforatum affects multiple neurotransmitters in a non-competitive synergistic manner, and may have nootropic potential. We quantitatively reviewed the pre-clinical literature to examine if there is a cognitive-enhancing effect of H. perforatum in healthy rodents. Additionally, within these studies, we compared the effects observed in intact rodents versus those whose performance has been impaired, mostly through stress manipulations. The meta-analysis incorporated studies that examined the effect of H...
October 20, 2016: Scientific Reports
Lidia M V R Moura, Emad N Eskandar, Mursal Hassan, Joel Salinas, Andrew J Cole, Daniel B Hoch, Sydney S Cash, John Hsu
OBJECTIVE: To compare postoperative seizure-free survival between older and younger adults. METHODS: A retrospective cohort of 107 temporal lobe epilepsy patients with a diagnosis of mesial temporal sclerosis (MTS) received anterior temporal lobectomy (ATL) between 1993 and 2014. We divided the lower three quartiles (younger) and top quartile (older, all 47+ years) of patients, then reviewed patient registry and electronic medical records to determine time to first self-reported seizure after ATL, the primary outcome (mean=3...
September 30, 2016: Epilepsy Research
Jeong-Min Kim, Kwang-Yeol Park, Dong-Woo Shin, Moo-Seok Park, Oh-Sang Kwon
BACKGROUND AND AIMS: Elevated serum homocysteine level is known to be associated with increased risk of vascular event due to endothelial senescence. We investigated the association between serum homocysteine level and cerebral arteriosclerosis status including intracranial vascular calcification and atherosclerosis burden. METHODS: We identified 1193 consecutive patients (mean age = 68.6 ± 12.7, 537 female patients) who were admitted with acute cerebral infarction or transient ischemic attack from a single university medical center...
October 13, 2016: Atherosclerosis
James C Blankenship, Wayne A Powell, Dawn R Gray, Peter L Duffy
Interventional cardiology has finally completed, after 26 years of advocacy, a professional hat trick: independent board certification, membership as a unique specialty in the American Medical Association House of Delegates (AMA HOD), and recognition by the Centers for Medicaid and Medicare Services (CMS) as a separate medical specialty. This article points out how these distinctions for interventional cardiology and its professional society, the Society for Cardiovascular Angiography and Interventions (SCAI), have led to clear and definite benefits for interventional cardiologists and their patients...
October 19, 2016: Catheterization and Cardiovascular Interventions
L Naffaa, M Rubin, A C Stamler, M Haddad, C Saade
AIM: To investigate the frequency of sonographic findings that required neurosurgical consultation for all referred outpatients suspected to have benign macrocrania (BMC). MATERIALS AND METHODS: A retrospective review was performed from September 2011 until June 2015 for all outpatients referred to the ultrasound (US) department for BMC. Electronic medical records, US images, and reports were reviewed in conjunction with follow-up imaging. Each review consisted of gender, specialty of referring physician, first head circumference, head circumference at or closest to the time of the head US, the last head circumference, and any neurological issue prior to the US, at the time of US, or following the US, and clinical outcomes...
October 15, 2016: Clinical Radiology
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