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https://www.readbyqxmd.com/read/28636092/impact-of-diagnosis-of-von-willebrand-disease-on-patient-outcomes-analysis-of-medical-insurance-claims-data
#1
R F Sidonio, K M Haley, D Fallaize
The inherited bleeding disorder von Willebrand disease (VWD) is challenging to diagnose owing to disease heterogeneity, lack of a definitive laboratory test and variations in diagnostic criteria. We evaluated the impact of diagnosis and diagnostic delay on patient outcomes. The PharMetrics Plus Database was interrogated for medical claims for VWD (ICD-9 286.4) and bleeding events between 1 January 2006 and 30 June 2015. Longitudinal analysis was performed of patients newly diagnosed with VWD (≥9 months' continuous enrolment before first VWD claim) through 24 months following diagnosis...
June 21, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28634699/cost-effective-analysis-of-disease-modifying-anti-rheumatic-drugs-in-rheumatoid-arthritis
#2
Ashit Syngle, Sudeep Kaur, Inderjeet Verma, Tanya Syngle, Vijaita Syngle
The main objective of the study was to perform the pharmacoeconomic analysis of synthetic disease-modifying anti-rheumatic drugs in rheumatoid arthritis patients. A prospective, observational study was conducted in 98 rheumatoid arthritis (RA) patients meeting 2010 Rheumatoid Arthritis Classification Criteria. Treatment-naive RA patients were initiated on synthetic disease-modifying anti-rheumatic drugs (DMARD/s) and followed up for 3 months. Average cost-effectiveness analysis was done by taking Health Assessment Questionnaire Disability Index (HAQ-DI) score as a measure of effectiveness...
June 21, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28634534/etiological-factors-of-short-stature-in-children-and-adolescents-experience-at-a-tertiary-care-hospital-in-egypt
#3
Almontaser Hussein, Hekma Farghaly, Eman Askar, Kotb Metwalley, Khaled Saad, Asmaa Zahran, Hisham A Othman
BACKGROUND: Accurate anthropometric measurements and critical analysis of growth data allow the clinician to promptly recognize children with short stature. The aim of this study was to determine the frequency of etiological factors causing short stature among children referred to the pediatric endocrinology clinic of Assiut University Children's Hospital, the main tertiary care center in Upper Egypt. METHODS: We conducted this descriptive observational study from May 2012 to December 2015, to analyze 637 children (boys 354, girls 283) with short stature...
May 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28634530/the-role-of-medical-education-in-the-development-of-the-scientific-practice-of-medicine
#4
Lucien Cardinal, Alan Kaell
The authors describe the important role of medical schools and graduate medical education programs (residencies) in relationship to the advances in Medicine witnessed during the twentieth century; diagnosis, prognosis and treatment were revolutionized. This historical essay details the evolution of the education system and the successful struggle to introduce a uniform, science-based curriculum and bedside education. The result was successive generations of soundly educated physicians prepared with a broad knowledge in science, an understanding of laboratory methods and the ability to practice medicine at the bedside...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28634503/monitoring-the-diagnostic-process-on-an-inpatient-neurology-service
#5
Amar Dhand, Robert Bucelli, Arun Varadhachary, Michael Tsiaklides, Gabriela de Bruin, Gurpreet Dhaliwal
The Institute of Medicine report Improving Diagnosis in Health Care called for tools to monitor physicians' diagnostic process. We addressed this need by developing a tool for clinicians to record and analyze their diagnostic process. The tool was a secure web application in which clinicians used a structured grading system to assess the relative impact of clinical, laboratory, and neuroimaging data for every new diagnosis. Four neurohospitalists used the tool for 6.5 months on a general neurology ward service at a single tertiary-level teaching hospital...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28633697/capacity-strengthening-through-pre-migration-tuberculosis-screening-programmes-irhwg-experiences
#6
P Douglas, D L Posey, D Zenner, J Robson, I Abubakar, G Giovinazzo
Effective tuberculosis (TB) prevention and care for migrants requires population health-based approaches that treat the relationship between migration and health as a progressive, interactive process influenced by many variables and addressed as far upstream in the process as possible. By including capacity building in source countries, pre-migration medical screening has the potential to become an integral component of public health promotion, as well as infection and disease prevention, in migrant-receiving nations, while simultaneously increasing capabilities in countries of origin...
July 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28633630/clinical-characteristics-of-acute-hepatitis-a-outbreak-in-taiwan-2015-2016-observations-from-a-tertiary-medical-center
#7
Nan-Yu Chen, Zhuo-Hao Liu, Shian-Sen Shie, Tsung-Hsing Chen, Ting-Shu Wu
BACKGROUND: Acute hepatitis A is a fecal-oral transmitted disease related to inadequate sanitary conditions. In addition to its traditional classification, several outbreaks in the men who have sex with men (MSM) population have resulted in acute hepatitis A being recognized as a sexually transmitted disease. However, few studies have clarified the clinical manifestations in these outbreaks involving the MSM population. METHODS: Beginning in June 2015, there was an outbreak of acute hepatitis A involving the MSM population in Northern Taiwan...
June 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28633314/qualitative-identification-of-fentanyl-analogs-and-other-opioids-in-postmortem-cases-by-uhplc-ion-trap-msn
#8
Elisa N Shoff, M Elizabeth Zaney, Joseph H Kahl, George W Hime, Diane M Boland
Since 2013, the Miami-Dade County Medical Examiner Department has experienced an increase in the number of opioid-related deaths. The majority of cases coincided with the introduction of fentanyl into the local heroin supply. From 2014 to 2015, Miami-Dade County experienced a near 600% increase in fentanyl-related deaths, followed by an additional 200% increase in 2016. In 2015, two novel fentanyl analogs were identified in medical examiner cases: beta-hydroxythiofentanyl and acetyl fentanyl. In 2016, four additional fentanyl analogs emerged: para-fluoroisobutyryl fentanyl, butyryl fentanyl, furanyl fentanyl and carfentanil, as well as the synthetic opioid U-47700...
June 13, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28632968/perspective-on-precision-medicine-in-oncology
#9
Tali M Johnson
The topic of precision medicine is increasingly more prevalent in the general medical literature with oncology research leading the way. Many factors, such as, availability of targeted drugs, advances in laboratory science, and improved information systems, converged to make precision medicine research possible on a large scale at the National Cancer Institute. The resultant big data will spur new kinds of research in the decades to come, but until then, all clinicians are challenged to make sense of an overabundance of information when managing individual patients...
June 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28632918/predicting-inpatient-hypoglycaemia-in-hospitalized-patients-with-diabetes-a-retrospective-analysis-of-9584-admissions-with-diabetes
#10
K Stuart, N J Adderley, T Marshall, G Rayman, A Sitch, S Manley, S Ghosh, K A Toulis, K Nirantharakumar
AIMS: To explore whether a quantitative approach to identifying hospitalized patients with diabetes at risk of hypoglycaemia would be feasible through incorporation of routine biochemical, haematological and prescription data. METHODS: A retrospective cross-sectional analysis of all diabetic admissions (n=9584) from 1 January 2014 to 31 December 2014 was performed. Hypoglycaemia was defined as a blood glucose level of <4 mmol/l. The prediction model was constructed using multivariable logistic regression, populated by clinically important variables and routine laboratory data...
June 20, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28632578/acute-abdominal-pain-recognition-and-management-of-constipation-in-the-emergency-department
#11
Stefania Norbedo, Giulia Bassanese, Francesca Barbieri, Egidio Barbi
OBJECTIVE: The main aim of the study was to investigate the incidence and the clinically relevant features of functional constipation in patients evaluated for acute abdominal pain in a tertiary care pediatric emergency department. METHODS: This is a retrospective study. We analyzed 4394 medical records and recorded the information (demographics, triage code, symptoms, medical history, physical evaluation, laboratory tests, radiological studies, procedures, and treatments) of all patients admitted for acute abdominal pain to the emergency department of the IRCCS Burlo Garofolo, Trieste, during 2010 to 2013...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28632474/evaluation-of-the-concurrent-use-of-dolutegravir-and-metformin-in-human-immunodeficiency-virus-infected-patients
#12
Anne Masich, Melissa E Badowski, Michelle D Liedtke, Patricia P Fulco
An analysis of the interaction between dolutegravir and metformin was conducted in the HIV ambulatory clinic setting. This was a multicenter, retrospective case series evaluating adult, HIV-infected patients concurrently prescribed dolutegravir and metformin. Historical electronic medical records were utilized to collect case-specific data. Laboratory parameters including serum creatinine (SCr), hemoglobin A1c (HgbA1c), plasma HIV RNA, CD4 cell count, and lactate were reviewed. Adverse drug reactions were assessed using patient-reported gastrointestinal intolerance and hypoglycemic symptoms...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28631805/drug-therapy-for-chronic-idiopathic-axonal-polyneuropathy
#13
REVIEW
Janna Warendorf, Alexander Fje Vrancken, Ivo N van Schaik, Richard Ac Hughes, Nicolette C Notermans
BACKGROUND: Chronic idiopathic axonal polyneuropathy (CIAP) is an insidiously progressive sensory or sensorimotor polyneuropathy that affects elderly people. Although severe disability or handicap does not occur, CIAP reduces quality of life. CIAP is diagnosed in 10% to 25% of people referred for evaluation of polyneuropathy. There is a need to gather and review emerging evidence on treatments, as the number of people affected is likely to increase in ageing populations. This is an update of a review first published in 2004 and previously updated in 2006, 2008, 2011 and 2013...
June 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28631746/prevalence-of-androgen-deficiency-in-chronic-spinal-cord-injury-patients-suffering-from-erectile-dysfunction
#14
M Behnaz, Z Majd, M Radfar, H Ajami, M Qorbani, A Kokab
STUDY DESIGN: Retrospective cross-sectional study. OBJECTIVES: To estimate the prevalence of biochemical androgen deficiency in Iranian spinal cord injured men suffering from erectile dysfunction (ED) and to determine factors related to this problem. SETTING: An andrology clinic of a teaching hospital in Tehran. METHODS: Men, 18 years of age and older, with chronic (>2 years) spinal cord injury (SCI) suffering from ED were recruited...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28631620/effectiveness-of-pelvic-lead-blanket-to-reduce-the-doses-to-eye-lens-and-hands-of-interventional-cardiologists-and-assistant-nurses
#15
Włodzimierz Grabowicz, Joanna Karolina Domienik-Andrzejewska, Konrad Masiarek, Tomasz Górnik, Tomasz Grycewicz, Marcin Brodecki, Andrzej Lubiński
The aim of the present study is to analyse quantitatively the potential reduction of the doses to eye lens and the hands of an operator and a nurse by the pelvic lead blanket during coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA) procedures. Thermoluminescent dosimeters (TLDs) were used to assess dose levels to left eye lens and left and right fingers of both physician and nurses during single procedures performed with or without lead blanket. The measurements were carried out in one medical centre and include dosimetric data from100 procedures...
June 20, 2017: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
https://www.readbyqxmd.com/read/28631236/use-of-ctx-i-and-pinp-as-bone-turnover-markers-national-bone-health-alliance-recommendations-to-standardize-sample-handling-and-patient-preparation-to-reduce-pre-analytical-variability
#16
P Szulc, K Naylor, N R Hoyle, R Eastell, E T Leary
N-terminal propeptide of type I procollagen and C-terminal telopeptide of type I collagen are the reference standards for bone turnover markers for monitoring osteoporosis treatment. We provide recommendations for standardized sample handling and encompassing aspects of preanalytical variability to improve the reproductibility of their measurements, their reliability, and clinical interpretation. The International Osteoporosis Foundation and International Federation of Clinical Chemistry bone turnover marker standards working group have identified N-terminal propeptide of type I procollagen (PINP) and C-terminal telopeptide of type I collagen (CTX-I) in the blood to be the international reference standards for bone turnover markers for the prediction of fracture risk and monitoring of osteoporosis treatment...
June 19, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28630688/prevalence-of-antimicrobial-resistant-pathogens-from-blood-cultures-results-from-a-laboratory-based-nationwide-surveillance-in-ghana
#17
Japheth Awuletey Opintan, Mercy Jemima Newman
BACKGROUND: Blood stream infections (BSI) are critical medical conditions with high morbidity and mortality. There is paucity of information on BSI from surveillance studies in Ghana. AIM: This study sought to demonstrate how useful BSI data can be gleaned from population-based surveillance, especially from resource-limited settings. METHODS: Data from a nationwide surveillance of antimicrobial drug resistance (AMR) in Ghana were extracted and analyzed...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28630192/in-vitro-activity-of-aztreonam-avibactam-against-enterobacteriaceae-and-pseudomonas-aeruginosa-isolated-by-clinical-laboratories-in-40-countries-from-2012-to-2015
#18
James A Karlowsky, Krystyna M Kazmierczak, Boudewijn L M de Jonge, Meredith A Hackel, Daniel F Sahm, Patricia A Bradford
The combination of the monobactam, aztreonam, and the non-β-lactam β-lactamase inhibitor, avibactam, is currently in clinical development for the treatment of serious infections caused by metallo-β-lactamase (MBL)-producing Enterobacteriaceae, a difficult to treat subtype of carbapenem-resistant Enterobacteriaceae for which therapeutic options are currently very limited. The present study tested clinically significant isolates of Enterobacteriaceae (n=51,352) and Pseudomonas aeruginosa (n=11,842) collected from hospitalized patients in 208 medical center laboratories from 40 countries from 2012 to 2015 for in vitro susceptibility to aztreonam-avibactam, aztreonam, and comparator antimicrobial agents using standard broth microdilution methodology...
June 19, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28629749/a-distinct-biomolecular-profile-identifies-monoclonal-mast-cell-disorders-in-patients-with-idiopathic-anaphylaxis
#19
Melody C Carter, Avanti Desai, Hirsh D Komarow, Yun Bai, Sarah T Clayton, Alicia S Clark, Karina N Ruiz-Esteves, Lauren M Long, Daly Cantave, Todd M Wilson, Linda M Scott, Olga Simakova, Mi-Yeon Jung, Jamie Hahn, Irina Maric, Dean D Metcalfe
BACKGROUND: Clonal mast cell disorders are known to occur in a subset of patients with systemic reactions to Hymenoptera stings. This observation has prompted the question as to whether clonal mast cell disorders also occur in patients with idiopathic anaphylaxis (IA). OBJECTIVE: We sought to determine the prevalence of clonal mast cell disorders among patients with IA, criteria to identify those patients who require a bone marrow biopsy and whether the pathogenesis of IA involves a hyper-responsive mast cell compartment...
June 16, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28629398/anaplastic-astrocytoma-mimicking-progressive-multifocal-leucoencephalopathy-a-case-report-and-review-of-the-overlapping-syndromes
#20
Ema Kantorová, Michal Bittšanský, Štefan Sivák, Eva Baranovičová, Petra Hnilicová, Vladimír Nosáľ, Daniel Čierny, Kamil Zeleňák, Wolfgang Brück, Egon Kurča
BACKGROUND: Co-occurrence of multiple sclerosis (MS) and glial tumours (GT) is uncommon although occasionally reported in medical literature. Interpreting the overlapping radiologic and clinical characteristics of glial tumours, MS lesions, and progressive multifocal leukoencephalopathy (PML) can be a significant diagnostic challenge. CASE PRESENTATION: We report a case of anaplastic astrocytoma mimicking PML in a 27-year-old patient with a 15-year history of MS...
June 19, 2017: BMC Cancer
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