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https://www.readbyqxmd.com/read/28526182/pharmacologic-management-of-type-2-diabetes-mellitus-available-therapies
#1
James Thrasher
Choices for the treatment of type 2 diabetes mellitus (T2DM) have multiplied as our understanding of the underlying pathophysiologic defects has evolved. Treatment should target multiple defects in T2DM and follow a patient-centered approach that considers factors beyond glycemic control, including cardiovascular risk reduction. The American Association of Clinical Endocrinologists/American College of Endocrinology and the American Diabetes Association recommend an initial approach consisting of lifestyle changes and monotherapy, preferably with metformin...
May 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28523127/high-intensity-focused-ultrasound-hifu-ablation-of-benign-thyroid-nodules-a-systematic-review
#2
REVIEW
Brian Hung-Hin Lang, Arnold L H Wu
BACKGROUND: With an increasing number of imaging studies being done nowadays, the number of incidentally discovered thyroid nodules is expected to rise. Although many of these nodules are small and benign in nature, some do grow and may cause pressure and/or thyrotoxic symptoms. Surgical resection has traditionally been recommended for symptomatic nodules but is associated with risk of hypothyroidism, bleeding, infection, and nerve damage. High intensity focused ultrasound (HIFU) is one of the non-surgical thermal ablation techniques that may serve as an alternative in the treatment of benign thyroid nodules...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28515674/perioperative-management-of-patients-on-direct-oral-anticoagulants
#3
REVIEW
Virginie Dubois, Anne-Sophie Dincq, Jonathan Douxfils, Brigitte Ickx, Charles-Marc Samama, Jean-Michel Dogné, Maximilien Gourdin, Bernard Chatelain, François Mullier, Sarah Lessire
Direct oral anticoagulants (DOACs) have been licensed worldwide for several years for various indications. Each year, 10-15% of patients on oral anticoagulants will undergo an invasive procedure and expert groups have issued several guidelines on perioperative management in such situations. The perioperative guidelines have undergone numerous updates as clinical experience of emergency management has increased and perioperative studies including measurement of residual anticoagulant levels have been published...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28515109/updated-review-of-prevalence-of-major-risk-factors-and-use-of-screening-tests-for-cancer-in-the-united-states
#4
Ann Goding Sauer, Rebecca L Siegel, Ahmedin Jemal, Stacey A Fedewa
Much of the suffering and death from cancer could be prevented by more systematic efforts to reduce tobacco use and obesity, improve diet, and increase physical activity and use of established vaccines and screening tests. Monitoring the prevalence of cancer risk factors and preventive tests helps guide cancer prevention and early detection efforts. We provide an updated review, using data through 2015, of the prevalence of major risk factors, cancer screening, and vaccination for U.S. adults and youth. Cigarette smoking among adults decreased to 15...
May 17, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28514878/anticoagulant-cessation-following-atrial-fibrillation-ablation-limits-of-the-ecg-guided-approach
#5
Matteo Anselmino, Chiara Rovera, Giovanni Marchetto, Federico Ferraris, Davide Castagno, Fiorenzo Gaita
Long-term cessation of oral anticoagulation (OAC) following successful catheter or surgical ablation of atrial fibrillation (AF) is debated. Usually, in the presence of sinus rhythm at serial ECG recordings, the CHADS2, CHA2DS2VASc, and HAS-BLED scores are adopted to guide decision regarding OAC management. Areas covered: The safety of OAC cessation in patients without recurrent AF but with historically elevated risk for thromboembolism remains largely unknown. Taking the cue from two clinical cases, we provide an updated summary of the latest evidence regarding how to manage OAC after a successful atrial fibrillation ablation...
May 18, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28513858/an-adaptive-fuzzy-c-means-method-utilizing-neighboring-information-for-breast-tumor-segmentation-in-ultrasound-images
#6
Yuan Feng, Fenglin Dong, Xiaolong Xia, Chun-Hong Hu, Qianmin Fan, Yanle Hu, Mingyuan Gao, Sasa Mutic
PURPOSE: Ultrasound (US) imaging has been widely used in breast tumor diagnosis and treatment intervention. Automatic delineation of the tumor is a crucial first step, especially for the computer-aided diagnosis (CAD) and US-guided breast procedure. However, the intrinsic properties of US images such as low contrast and blurry boundaries pose challenges to the automatic segmentation of the breast tumor. Therefore, the purpose of this study is to propose a segmentation algorithm that can contour the breast tumor in US images...
May 17, 2017: Medical Physics
https://www.readbyqxmd.com/read/28511234/indications-results-and-clinical-impact-of-endoscopic-ultrasound-eus-guided-sampling-in-gastroenterology-european-society-of-gastrointestinal-endoscopy-esge-clinical-guideline-updated-january-2017
#7
Jean-Marc Dumonceau, Pierre H Deprez, Christian Jenssen, Julio Iglesias-Garcia, Alberto Larghi, Geoffroy Vanbiervliet, Guruprasad P Aithal, Paolo G Arcidiacono, Pedro Bastos, Silvia Carrara, László Czakó, Gloria Fernández-Esparrach, Paul Fockens, Àngels Ginès, Roald F Havre, Cesare Hassan, Peter Vilmann, Jeanin E van Hooft, Marcin Polkowski
For pancreatic solid lesions, ESGE recommends performing endoscopic ultrasound (EUS)-guided sampling as first-line procedure when a pathological diagnosis is required. Alternatively, percutaneous sampling may be considered in metastatic disease.Strong recommendation, moderate quality evidence.In the case of negative or inconclusive results and a high degree of suspicion of malignant disease, ESGE suggests re-evaluating the pathology slides, repeating EUS-guided sampling, or surgery.Weak recommendation, low quality evidence...
May 16, 2017: Endoscopy
https://www.readbyqxmd.com/read/28508116/comparing-visual-search-and-eye-movements-in-bilinguals-and-monolinguals
#8
Ileana Ratiu, Michael C Hout, Stephen C Walenchok, Tamiko Azuma, Stephen D Goldinger
Recent research has suggested that bilinguals show advantages over monolinguals in visual search tasks, although these findings have been derived from global behavioral measures of accuracy and response times. In the present study we sought to explore the bilingual advantage by using more sensitive eyetracking techniques across three visual search experiments. These spatially and temporally fine-grained measures allowed us to carefully investigate any nuanced attentional differences between bilinguals and monolinguals...
May 15, 2017: Attention, Perception & Psychophysics
https://www.readbyqxmd.com/read/28506641/guiding-multimodal-registration-with-learned-optimization-updates
#9
Benjamin Gutierrez-Becker, Diana Mateus, Loic Peter, Nassir Navab
In this paper, we address the multimodal registration problem from a novel perspective, aiming to predict the transformation aligning images directly from their visual appearance. We formulate the prediction as a supervised regression task, with joint image descriptors as input and the output are the parameters of the transformation that guide the moving image towards alignment. We model the joint local appearance with context aware descriptors that capture both local and global cues simultaneously in the two modalities, while the regression function is based on the gradient boosted trees method capable of handling the very large contextual feature space...
May 6, 2017: Medical Image Analysis
https://www.readbyqxmd.com/read/28506420/update-on-the-role-of-ultrasound-guided-radiofrequency-ablation-for-thyroid-nodule-treatment
#10
Maija Radzina, Vito Cantisani, Madara Rauda, Michael Bachmann Nielsen, Caroline Ewertsen, Ferdinando D'Ambrosio, Peteris Prieditis, Salvatore Sorrenti
Thyroid nodules can be frequently detected in general population, most of them are benign, however malignant cases are rising in the past decades. Ultrasound (US) is the most common imaging modality to assess thyroid nodular lesions, plan patient work-up and guide minimally invasive treatment. The present review paper has been researched to evaluate the current status of radiofrequency ablation (RFA) treatment in order to evaluate indications, techniques, complications, limitations and outcome assessment in benign solid, partially cystic nodules and recurrent malignant nodules...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28500517/role-of-non-statins-ldl-c-thresholds-and-special-population-considerations-a-look-at-the-updated-2016-acc-consensus-committee-recommendations
#11
REVIEW
Bhavin B Adhyaru, Terry A Jacobson
PURPOSE OF REVIEW: The 2013 ACC/AHA Cholesterol guidelines was a major paradigm shift in the management and treatment of dyslipidemia. The new guidelines outlined "statin benefit groups," highlighted weighing the benefit versus risks of statin therapy ("net benefit"), and discussed the importance of shared decision making between patients and providers in primary prevention. While there was widespread agreement on the main groups benefiting from statin therapy, there was significant controversy regarding LDL-C goals and thresholds, the role of non-statin therapy, and the use of statins in specific populations...
June 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28499872/interaction-of-flavivirus-with-their-mosquito-vectors-and-their-impact-on-the-human-health-in-the-americas
#12
Anayansi Valderrama, Yamilka Diaz, Sandra López-Vergès
Some of the major arboviruses with public health importance, such as dengue, yellow fever, Zika and West Nile virus are mosquito-borne or mosquito-transmitted Flavivirus. Their principal vectors are from the family Culicidae, Aedes aegypti and Aedes albopictus being responsible of the urban cycles of dengue, Zika and yellow fever virus. These vectors are highly competent for transmission of many arboviruses. The genetic variability of the vectors, the environment and the viral diversity modulate the vector competence, in this context, it is important to determine which vector species is responsible of an outbreak in areas where many vectors coexist...
May 9, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28499532/updates-on-the-recognition-prevention-and-management-of-hypertension-in-pregnancy
#13
REVIEW
Jessica R Jackson, Anthony R Gregg
Systematic reviews with meta-analysis represent the highest level of evidence used to guide clinical practice. The defining criteria used to diagnose preeclampsia have evolved, and will likely continue to evolve. Proteinuria is sufficient but not necessary when defining preeclampsia. Hypertension without proteinuria but with severe features is diagnostic. The methods used to measure urinary protein have changed. The gold standard remains the 24-hour urine test. The efficacy of low-dose aspirin in preventing preeclampsia is a function of baseline risk...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28495976/optogenetic-inhibition-of-ventral-pallidum-neurons-impairs-context-driven-salt-seeking
#14
Stephen E Chang, Elizabeth B Smedley, Katherine J Stansfield, Jeffrey J Stott, Kyle S Smith
Salt appetite, in which animals can immediately seek out salt when under a novel state of sodium deprivation, is a classic example of how homeostatic systems interface with learned associations to produce an on-the-fly updating of motivated behavior. Neural activity in the ventral pallidum (VP) has been shown to encode changes in the value of salt under such conditions, both the value of salt itself (Tindell et al., 2006) and the motivational value of its predictive cues (Tindell et al., 2009; Robinson & Berridge, 2013)...
May 11, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28494574/endoscopic-management-of-peri-pancreatic-fluid-collections
#15
REVIEW
Hon Chi Yip, Anthony Yuen Bun Teoh
In the past decade, there has been a progressive paradigm shift in the management of peri-pancreatic fluid collections after acute pancreatitis. Refinements in the definitions of fluid collections from the updated Atlanta classification have enabled better communication amongst physicians in an effort to formulate optimal treatments. Endoscopic ultrasound (EUS)-guided drainage of pancreatic pseudocysts has emerged as the procedure of choice over surgical cystogastrostomy. The approach provides similar success rates with low complications and better quality of life compared with surgery...
May 12, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28493224/-psychotherapy-and-psychological-procedures-for-fibromyalgia-syndrome-updated-guidelines-2017-and-overview-of-systematic-review-articles
#16
V Köllner, K Bernardy, W Greiner, L Krumbein, H Lucius, M Offenbächer, M Sarholz, M Settan, W Häuser
BACKGROUND: The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. METHODS: The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest...
May 10, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28493110/bem-based-simulation-of-lung-respiratory-deformation-for-ct-guided-biopsy
#17
Dong Chen, Weisheng Chen, Lipeng Huang, Xuegang Feng, Terry Peters, Lixu Gu
PURPOSE: Accurate and real-time prediction of the lung and lung tumor deformation during respiration are important considerations when performing a peripheral biopsy procedure. However, most existing work focused on offline whole lung simulation using 4D image data, which is not applicable in real-time image-guided biopsy with limited image resources. In this paper, we propose a patient-specific biomechanical model based on the boundary element method (BEM) computed from CT images to estimate the respiration motion of local target lesion region, vessel tree and lung surface for the real-time biopsy guidance...
May 10, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28492904/screening-for-thyroid-cancer-updated-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#18
Jennifer S Lin, Erin J Aiello Bowles, Selvi B Williams, Caitlin C Morrison
Importance: The incidence of detected thyroid cancer cases has been increasing in the United States since 1975. The majority of thyroid cancers are differentiated cancers with excellent prognosis and long-term survival. Objective: To systematically review the benefits and harms associated with thyroid cancer screening and treatment of early thyroid cancer in asymptomatic adults to inform the US Preventive Services Task Force. Data Sources: Searches of MEDLINE, PubMed, and the Cochrane Central Register of Controlled Trials for relevant studies published from January 1966 through January 2016, with active surveillance through December 2016...
May 9, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28491495/dorsolateral-prefrontal-cortex-contributes-to-the-impaired-behavioral-adaptation-in-alcohol-dependence
#19
Sinem Balta Beylergil, Anne Beck, Lorenz Deserno, Robert C Lorenz, Michael A Rapp, Florian Schlagenhauf, Andreas Heinz, Klaus Obermayer
Substance-dependent individuals often lack the ability to adjust decisions flexibly in response to the changes in reward contingencies. Prediction errors (PEs) are thought to mediate flexible decision-making by updating the reward values associated with available actions. In this study, we explored whether the neurobiological correlates of PEs are altered in alcohol dependence. Behavioral, and functional magnetic resonance imaging (fMRI) data were simultaneously acquired from 34 abstinent alcohol-dependent patients (ADP) and 26 healthy controls (HC) during a probabilistic reward-guided decision-making task with dynamically changing reinforcement contingencies...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28490940/systemic-therapy-in-the-curative-treatment-of-head-and-neck-squamous-cell-cancer-cancer-care-ontario-clinical-practice-guideline
#20
E Winquist, C Agbassi, B M Meyers, J Yoo, K K W Chan
OBJECTIVE: The aim of the present work was to make recommendations about the use of systemically administered drugs in combination or in sequence with radiation (rt) or surgery, or both, for cure or organ preservation, or both, in patients with locally advanced nonmetastatic (stages iii-ivb) squamous cell carcinoma of the head and neck (lascchn). METHODS: The Meta-analysis of Chemotherapy in Head and Neck Cancer (mach-nc) reports have, de facto, guided practice since 2000, and so we searched the literature for systematic reviews published from January 2000 to February 2015 in reference to five research questions...
April 2017: Current Oncology
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