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https://www.readbyqxmd.com/read/28538746/medical-management-of-hidradenitis-suppurativa
#1
Lauren Av Orenstein, Robert G Micheletti
Hidradenitis suppurativa is a chronic inflammatory disease of the folliculo-infundibular unit for which no individual treatment is uniformly effective. A wide array of therapies has been reported successful in the treatment of hidradenitis, although few high-quality clinical trials have been conducted. Comparing the effectiveness of different therapies has proven challenging due to heterogeneity and limited validation of outcome measures. We performed a systematic review of clinical trials of medical treatments for hidradenitis, yielding 8 articles reporting on 9 trials of antibiotic, hormonal, and biologic therapies...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28538436/how-electronic-health-records-can-unmask-the-hidden-value-of-pas
#2
Folusho Ogunfiditimi, Scott P Sherry, Monica Foote, Sarah L Christie, Lisa P Shock, James Cawley, Aaron Browne
The Fee for Value (FFV) Task Force, a subgroup of the American Academy of PAs' Research and Strategic Initiatives Commission, has examined tools and mechanisms aimed at better clarifying the volume and value of PA work and how that work contributes to improving access to high-quality care. Establishing the value of PAs has been a challenging task for many healthcare providers. Often, PA value has been defined by their clinical productivity, without any clear direction as to what constitutes value versus productivity...
June 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28537997/where-are-we-heading-with-fluid-responsiveness-research
#3
Simon T Vistisen, Peter Juhl-Olsen
PURPOSE OF REVIEW: Fluid responsiveness prediction is not always possible with well established dynamic approaches such as passive leg raising or pulse pressure variation in the ICU. The purpose of the present review is to summarize emerging alternative techniques for fluid responsiveness prediction in adult critically ill patients and discuss their methodology and applicability. In addition, the future role of fluid responsiveness prediction in the ICU is discussed. RECENT FINDINGS: Several new dynamic techniques have been investigated and they all contribute to the applicability of fluid responsiveness techniques...
May 22, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28535614/elucidating-bottlenecks-of-the-efficient-preparation-of-an-ab5-hexamer-mucosal-adjuvant-protein-ltm-by-genetic-engineering
#4
Di Liu, Fabiao Hu, Wenpeng Wang, Dong Wu, Xiujuan He, Wenyun Zheng, Haipeng Liu, Xingyuan Ma
Escherichia coli heat-labile enterotoxin (LT) and its non-toxic mutant (LTm) are well-known powerful mucosal adjuvants and immunogens. However, the yields of these adjuvants from genetically engineered strains remain at extremely low levels, thereby hindering their extensive application in fundamental and clinical research. Therefore, efficient production of these adjuvant proteins from genetically engineered microbes is a huge challenge in the field of molecular biology. In order to explore expression bottlenecks of LTm in E...
May 24, 2017: Journal of Microbiology and Biotechnology
https://www.readbyqxmd.com/read/28535275/transportability-of-trial-results-using-inverse-odds-of-sampling-weights
#5
Daniel Westreich, Jessie K Edwards, Catherine R Lesko, Elizabeth Stuart, Stephen R Cole
Increasingly, the statistical and epidemiologic literature is turning its attention beyond issues of internal validity to questions of external validity. Here, we discuss some of the challenges of transporting a causal effect from a trial to a specific target population. We present an inverse odds weighting approach that can easily operationalize transportability. We derive these weights in closed form and illustrate their use with a simple numerical example. We discuss how the conditions required for the identification of internally valid causal effects are translated to apply to the identification of externally valid causal effects...
May 23, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28535206/clinical-exome-sequencing-reports-current-informatics-practice-and-future-opportunities
#6
Rajeswari Swaminathan, Yungui Huang, Caroline Astbury, Sara Fitzgerald-Butt, Katherine Miller, Justin Cole, Christopher Bartlett, Simon Lin
The increased adoption of clinical whole exome sequencing (WES) has improved the diagnostic yield for patients with complex genetic conditions. However, the informatics practice for handling information contained in whole exome reports is still in its infancy, as evidenced by the lack of a common vocabulary within clinical sequencing reports generated across genetic laboratories. Genetic testing results are mostly transmitted using portable document format, which can make secondary analysis and data extraction challenging...
May 23, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28535103/value-frameworks-for-the-patient-provider-interaction-a-comparison-of-the-asco-value-framework-versus-nccn-evidence-blocks-in-determining-value-in-oncology
#7
Bijal Shah-Manek, Joseph S Galanto, Huong Nguyen, Robert Ignoffo
BACKGROUND: To address the rising concern about oncology drug costs, the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) recently developed unique tools to help providers and patients make informed decisions about the value of an anticancer regimen. The ASCO Value Framework (AVF) allows users to generate a net health benefit (NHB) score along with drug acquisition costs for oncology regimens that have been compared in a prospective randomized clinical trial...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28533484/insights-from-animal-models-of-bladder-cancer-recent-advances-challenges-and-opportunities
#8
REVIEW
Bincy Anu John, Neveen Said
Bladder cancer (urothelial cancer of the bladder) is the most common malignancy affecting the urinary system with increasing incidence and mortality. Treatment of bladder cancer has not advanced in the past 30 years. Therefore, there is a crucial unmet need for novel therapies, especially for high grade/stage disease that can only be achieved by preclinical model systems that faithfully recapitulate the human disease. Animal models are essential elements in bladder cancer research to comprehensively study the multistep cascades of carcinogenesis, progression and metastasis...
May 9, 2017: Oncotarget
https://www.readbyqxmd.com/read/28532994/johne-s-disease-in-the-eyes-of-irish-cattle-farmers-a-qualitative-narrative-research-approach-to-understanding-implications-for-disease-management
#9
Conor G McAloon, Áine Macken-Walsh, Lisa Moran, Paul Whyte, Simon J More, Luke O'Grady, Michael L Doherty
Bovine Johne's Disease (JD) is a disease characterised by chronic granulomatous enteritis which manifests clinically as a protein-losing enteropathy causing diarrhoea, hypoproteinaemia, emaciation and, eventually death. Some research exists to suggest that the aetiologic pathogen Mycobacterium avium subspecies paratuberculosis may pose a zoonotic risk. Nationally coordinated control programmes have been introduced in many of the major milk producing countries across the world. However, JD is challenging to control in infected herds owing to limitations of diagnostic tests and the long incubation period of the disease...
June 1, 2017: Preventive Veterinary Medicine
https://www.readbyqxmd.com/read/28532763/nanomaterial-enabled-cancer-therapy
#10
REVIEW
Sabina Quader, Kazunori Kataoka
While cancer remains the major cause of death worldwide, nanomaterial (NM)-based diagnosis and treatment modalities are showing remarkable potential to better tackle clinical oncology by effectively targeting therapeutic agents to tumors. NMs can selectively accumulate in solid tumors, and they can improve the bioavailability and reduce the toxicity of encapsulated cytotoxic agents. Additional noteworthy functions of NMs in cancer treatment include the delivery of contrast agents to image tumor sites, delivery of genetic materials for gene therapy, and co-delivery of multiple agents to achieve combination therapy or simultaneous diagnostic and therapeutic outcomes...
May 19, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28532715/caretakers-barriers-to-pediatric-antiretroviral-therapy-adherence-in-vietnam-a-qualitative-and-quantitative-study
#11
C T Tran, T H Pham, K T Tran, T K C Nguyen, M Larsson
BACKGROUND: Poor antiretroviral therapy (ART) adherence leads to drug resistance and treatment failures. The options for second and third line ART regimens, particularly for pediatric patients, are very limited in low and middle-income countries. HIV-infected children are mostly passive drug-takers, thus caretakers play a very important role in assuring ART adherence. Pediatric ART adherence is still a challenging problem in Vietnam since non-adherence is the major risk factor for treatment failure...
June 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28532630/shared-decision-making-as-part-of-value-based-care-new-u-s-policies-challenge-our-readiness
#12
Erica S Spatz, Glyn Elwyn, Benjamin W Moulton, Robert J Volk, Dominick L Frosch
Shared decision making in the United States is increasingly being recognized as part of value-based care. During the last decade, several state and federal initiatives have linked shared decision making with reimbursement and increased protection from litigation. Additionally, private and public foundations are increasingly funding studies to identify best practices for moving shared decision making from the research world into clinical practice. These shifts offer opportunities and challenges for ensuring effective implementation...
May 20, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28532613/the-practice-of-evidence-based-medicine-involves-the-care-of-whole-persons
#13
W Scott Richardson
In this issue of the Journal, Dr. Fava posits that evidence-based medicine (EBM) was bound to fail. I share some of the concerns he expresses, yet I see more reasons for optimism. Having been on rounds with both Drs. Engel and Sackett, I reckon they would have agreed more than they disagreed. Their central teaching was the compassionate and well-informed care of sick persons. The model that emerged from these rounds was that patient care could be both person-centered and evidence-based, that clinical judgment was essential to both, and the decisions could and should be shared...
April 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28532511/challenges-and-strategies-for-implementing-genomic-services-in-diverse-settings-experiences-from-the-implementing-genomics-in-practice-ignite-network
#14
Nina R Sperber, Janet S Carpenter, Larisa H Cavallari, Laura J Damschroder, Rhonda M Cooper-DeHoff, Joshua C Denny, Geoffrey S Ginsburg, Yue Guan, Carol R Horowitz, Kenneth D Levy, Mia A Levy, Ebony B Madden, Michael E Matheny, Toni I Pollin, Victoria M Pratt, Marc Rosenman, Corrine I Voils, Kristen W Weitzel, Russell A Wilke, R Ryanne Wu, Lori A Orlando
BACKGROUND: To realize potential public health benefits from genetic and genomic innovations, understanding how best to implement the innovations into clinical care is important. The objective of this study was to synthesize data on challenges identified by six diverse projects that are part of a National Human Genome Research Institute (NHGRI)-funded network focused on implementing genomics into practice and strategies to overcome these challenges. METHODS: We used a multiple-case study approach with each project considered as a case and qualitative methods to elicit and describe themes related to implementation challenges and strategies...
May 22, 2017: BMC Medical Genomics
https://www.readbyqxmd.com/read/28532482/-ensure-that-you-are-well-aware-of-the-risks-you-are-taking%C3%A2-actions-and-activities-medical-tourists-informal-caregivers-can-undertake-to-protect-their-health-and-safety
#15
Valorie A Crooks, Rebecca Whitmore, Jeremy Snyder, Leigh Turner
BACKGROUND: When seeking care at international hospitals and clinics, medical tourists are often accompanied by family members, friends, or other caregivers. Such caregiver-companions assume a variety of roles and responsibilities and typically offer physical assistance, provide emotional support, and aid in decision-making and record keeping as medical tourists navigate unfamiliar environments. While traveling abroad, medical tourists' caregiver-companions can find themselves confronted with challenging communication barriers, financial pressures, emotional strain, and unsafe environments...
May 22, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28532218/flow-chamber-and-microfluidic-approaches-for-measuring-thrombus-formation-in-genetic-bleeding-disorders
#16
Rogier M Schoeman, Marcus Lehmann, Keith B Neeves
Platelet adhesion and aggregation, coagulation, fibrin formation, and fibrinolysis are regulated by the forces and flows imposed by blood at the site of a vascular injury. Flow chambers designed to observe these events are an indispensable part of doing hemostasis and thrombosis research, especially with human blood. Microfluidic methods have provided the flexibility to design flow chambers with complex geometries and features that more closely mimic the anatomy and physiology of blood vessels. Additionally, microfluidic systems with integrated optics and/or pressure sensors and on-board signal processing could transform what have been primarily research tools into clinical assays...
May 22, 2017: Platelets
https://www.readbyqxmd.com/read/28532184/a-review-of-invasive-and-non-invasive-sensory-feedback-in-upper-limb-prostheses
#17
Pamela Svensson, Ulrika Wijk, Anders Björkman, Christian Antfolk
The constant challenge to restore sensory feedback in prosthetic hands has provided several research solutions, but virtually none has reached clinical fruition. A prosthetic hand with sensory feedback that closely imitates an intact hand and provides a natural feeling may induce the prosthetic hand to be included in the body image and also reinforces the control of the prosthesis. Areas covered: This review presents non-invasive sensory feedback systems such as mechanotactile, vibrotactile, electrotactile and combinational systems which combine the modalities; multi-haptic feedback...
May 22, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28531943/recent-trends-in-zikv-research-a-step-away-from-cure
#18
REVIEW
Aftab Alam, Nikhat Imam, Anam Farooqui, Shahnawaz Ali, Md Zubbair Malik, Romana Ishrat
Zika virus (ZikV) is a member of the Flaviviridae virus family, genus Flavivirus has emerged as a potential threat to human health worldwide. Consequences of vertical infections includes microcephaly with brain and eye anomalies, and adult infections includes Guillain-Barrésyndrome (GBS), brain ischemia, myelitis and meningoencephalitis. To develop a better treatment, many efforts are being made, like drug-repurposing concept for FDA-approved drugs for antiviral activity are screened against ZikV infection and emerging as a promising alternative to expedite drug development and various vaccines like DNA, ZPIV, LAIV, mRNA and AGS-v vaccines have been designed and in under clinical trial phases...
May 17, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28530526/warfarin-management-and-outcomes-in-patients-with-nonvalvular-atrial-fibrillation-within-an-integrated-health-care-system
#19
JaeJin An, Fang Niu, Chengyi Zheng, Nazia Rashid, Robert A Mendes, Diana Dills, Lien Vo, Prianka Singh, Amanda Bruno, Daniel T Lang, Paul T Le, Kristin P Jazdzewski, Gustavus Aranda
BACKGROUND: Warfarin is a common treatment option to manage patients with nonvalvular atrial fibrillation (NVAF) in clinical practice. Understanding current pharmacist-led anticoagulation clinic management patterns and associated outcomes is important for quality improvement; however, currently little evidence associating outcomes with management patterns exists. OBJECTIVES: To (a) describe warfarin management patterns and (b) evaluate associations between warfarin treatment and clinical outcomes for patients with NVAF in an integrated health care system...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530320/-medical-research-improves-quality-of-care
#20
Yoram Yagil
The Barzilai Medical Center has recently been designated as an Academic Medical Center. The challenge to become an academic center arose from the realization that the level and quality of care provided to patients are necessarily improved when clinical medicine is practiced in a teaching and research environment. Indeed, after years of close working ties between the Barzilai Medical Center in Ashkelon and the Ben-Gurion University of the Negev, the center officially became an Academic Medical Center and was recognized as one of the two leading clinical campuses of the Faculty of Health Sciences...
August 2016: Harefuah
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