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https://www.readbyqxmd.com/read/29447356/barriers-to-the-availability-and-accessibility-of-controlled-medicines-for-chronic-pain-in-africa
#1
Elmang Nchako, Scottie Bussell, Carlos Nesbeth, Chisom Odoh
Africans endure a high burden of pain and suffering from HIV/AIDS and cancer, yet receive a meager amount of the world's pain medication. This tragedy occurs needlessly, given that inexpensive, effective and easily administered interventions are available. WHO has a 'three-step analgesic ladder' framework for managing cancer pain. This widely adopted clinical practice guideline is an integral part of palliative care programs and has also been applied to non-cancer pain. However, untreated pain is a major public health problem due to the discordance between scientific evidence and public policy...
February 13, 2018: International Health
https://www.readbyqxmd.com/read/29445919/appraisal-of-clinical-practice-guidelines-on-the-management-of-hypothyroidism-in-pregnancy-using-the-appraisal-of-guidelines-for-research-and-evaluation-ii-instrument
#2
REVIEW
Yuan Fang, Liang Yao, Jing Sun, Jian Zhang, Yanxia Li, Ruifei Yang, Kehu Yang, Limin Tian
PURPOSE: This study aimed to systematically evaluate the quality of guidelines for the management of hypothyroidism in pregnancy. METHOD: Systematic searches were conducted to identify hypothyroidism in pregnancy guidelines published in electronic databases and developers' websites. Four reviewers independently evaluated eligible guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Agreement among reviewers was measured using the intraclass correlation coefficient (ICC)...
February 14, 2018: Endocrine
https://www.readbyqxmd.com/read/29444768/web-based-just-in-time-information-and-feedback-on-antibiotic-use-for-village-doctors-in-rural-anhui-china-randomized-controlled-trial
#3
XingRong Shen, Manman Lu, Rui Feng, Jing Cheng, Jing Chai, Maomao Xie, Xuemeng Dong, Tao Jiang, Debin Wang
BACKGROUND: Excessive use of antibiotics is very common worldwide, especially in rural China; various measures that have been used in curbing the problem have shown only marginal effects. OBJECTIVE: The objective of this study was to test an innovative intervention that provided just-in-time information and feedback (JITIF) to village doctors on care of common infectious diseases. METHODS: The information component of JITIF consisted of a set of theory or evidence-based ingredients, including operation guideline, public commitment, and takeaway information, whereas the feedback component tells each participating doctor about his or her performance scores and percentages of antibiotic prescriptions...
February 14, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29444191/restoration-of-services-in-disrupted-infrastructure-systems-a-network-science-approach
#4
Aybike Ulusan, Ozlem Ergun
Due to the ubiquitous nature of disruptive extreme events, functionality of the critical infrastructure systems (CIS) is constantly at risk. In case of a disruption, in order to minimize the negative impact to the society, service networks operating on the CIS should be restored as quickly as possible. In this paper, we introduce a novel network science inspired measure to quantify the criticality of components within a disrupted service network and develop a restoration heuristic (Cent-Restore) that prioritizes restoration efforts based on this measure...
2018: PloS One
https://www.readbyqxmd.com/read/29439771/osteoporotic-pelvic-fractures
#5
Ludwig Oberkircher, Steffen Ruchholtz, Pol Maria Rommens, Alexander Hofmann, Benjamin Bücking, Antonio Krüger
BACKGROUND: The estimated incidence of osteoporotic pelvic fractures among persons over age 60 in Germany is 224 per 100 000 persons per year, and rising. A number of surgical treatment options are available, but clinical long-term data are lacking. METHODS: This review is based on pertinent publications and guidelines retrieved by a selective literature search, and on the authors' clinical experience. RESULTS: Patients often report one or more relatively trivial traumatic incidents leading up to the fracture...
February 2, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29436037/parental-use-of-sun-protection-for-their-children-does-skin-color-matter
#6
Marcus G Tan, Shudeshna Nag, Miriam Weinstein
BACKGROUND/OBJECTIVES: Excessive sun exposure during childhood is a risk factor for skin cancer. This study aimed to compare the frequency of ideal sun protection use between parents with lighter- and darker-skinned children and explore their attitudes and beliefs on sun safety and their choice of sun protection. METHODS: Parents of children aged 6 months to 6 years completed self-administered questionnaires about sun protection practices for their children. Parents assessed their child's Fitzpatrick phototype and were divided into lighter- (Fitzpatrick phototype I-III) and darker-skinned (Fitzpatrick phototype IV-VI) groups...
February 13, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29433990/follow-up-after-curative-treatment-for-oral-squamous-cell-carcinoma-a-critical-appraisal-of-the-guidelines-and-a-review-of-the-literature
#7
REVIEW
M T Brands, P A Brennan, A L M Verbeek, M A W Merkx, S M E Geurts
The oral cavity is the commonest subsite of head and neck squamous cell carcinoma (HNSCC). Because of the rising incidence and increasing survival, more patients will be enrolled in a routine follow-up program. This review gives an overview of the evidence and guideline recommendations concerning follow-up after oral squamous cell carcinoma (OSCC). There is limited evidence concerning the effectiveness of follow-up after OSCC. This lack of evidence is reflected in a variation in guideline recommendations with respect to test interval and duration (i...
January 12, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29432374/development-of-an-outpatient-guideline-for-optimal-anticoagulation-bridging-in-patients-with-durable-mechanical-circulatory-support
#8
Amy A Levesque, Jessica M Rimsans, Katelyn W Sylvester, Erin N Lyons, Katie A Frankel, Lara L Coakley, Maryclare Hickey, Krystin A Montoya, Mandeep R Mehra, Michael M Givertz, Garrick C Stewart, Jean M Connors
Patients with durable mechanical circulatory support are at increased risk of thromboembolic and bleeding complications. Current guidelines recommend that these patients receive chronic anticoagulation with warfarin to maintain a target international normalized ratio (INR) as specified by device manufacturers. Limited data exist regarding management of subtherapeutic INRs in this setting. To standardize clinical practice at our institution, we assembled a multidisciplinary task force including members from various specialties to develop a guideline for managing subtherapeutic INRs that incorporates published data and expert opinion...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29431292/chikungunya-a-rheumatologist-s-perspective
#9
REVIEW
Shefali Khanna Sharma, Sanjay Jain
Chikungunya (CHIK), a viral infection, is transmitted by Aedes mosquitoes. It is characterized by a phase of acute infection, which is sometimes followed by chronic rheumatisim in the form of arthralgia or myalgia that can last for months and even years. Several studies have been conducted to understand the mechanisms underlying inflammation associated with CHIK infection, persistence of viruses in monocytes-macrophages, and their relationship to the chronic symptoms. Chronic arthritis is one of the serious complications of CHIK infection, which is characterized by swelling and acute pain that poorly responds to treatment with analgesics...
February 12, 2018: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/29429390/belgian-guidelines-for-non-occupational-hiv-post-exposure-prophylaxis-2017
#10
Agnès Libois, Eric Florence, Inge Derdelinckx, Jean Cyr Yombi, Sophie Henrard, Françoise Uurlings, Stefaan Vandecasteele, Sabine D Allard, Rémy Demeester, Filip Van Wanzeele, Nathalie Ausselet, Stéphane De Wit
We present the updated Belgian guidelines for the use of non-occupational HIV post-exposure prophylaxis (NONOPEP). This document is inspired by UK guidelines 2015, adapted to the Belgian situation and approved by all AIDS reference centers in Belgium. When recommended, NONOPEP should be initiated as soon as possible, preferably within 24 h of exposure but can be offered up to 72 h. The duration of NONOPEP should be 28 days. These current guidelines include epidemiologic estimations, which can be used to calculate the risk of infection after a potential exposure and help to decide whether or not to start prophylaxis...
February 12, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29419926/neonatal-outcomes-in-the-birth-center-setting-a-systematic-review
#11
REVIEW
Julia C Phillippi, Kathleen Danhausen, Jill Alliman, R David Phillippi
INTRODUCTION: This systematic review investigates the effect of the birth center setting on neonatal mortality in economically developed countries to aid women and clinicians in decision making. METHODS: We searched the Google Scholar, CINAHL, and PubMed databases using key terms birth/birthing center or out of hospital with perinatal/neonatal outcomes. Ancestry searches identified additional studies, and an alert was set for new publications. We included primary source studies in English, published after 1980, conducted in a developed country, and researching planned birth in centers with guidelines similar to American Association of Birth Centers standards...
January 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29417215/organ-and-tissue-donation-in-a-regional-paediatric-intensive-care-unit-evaluation-of-practice
#12
Laura Carone, Shrirang Alurkar, Phoebe Kigozi, Harish Vyas
Approximately 2% of those on the organ transplant list in the UK are children. Early identification of donors and referral to organ donation teams (ODT) has proven to increase both the success rate of gaining consent and the number of organs actually retrieved. To evaluate the practice relating to organ donation for children receiving end-of-life care on a paediatric intensive care unit (PICU) measured against the National Guidelines. All children 0-18 who received their end-of-life care and died on the PICU...
February 7, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29416951/functional-mri-for-treatment-evaluation-in-patients-with-head-and-neck-squamous-cell-carcinoma-a-review-of-the-literature-from-a-radiologist-perspective
#13
REVIEW
Roland P Nooij, Jan J Hof, Peter Jan van Laar, Anouk van der Hoorn
Purpose of review: To show the role of functional MRI in patients treated for head and neck squamous cell carcinoma. Recent findings: MRI is commonly used for treatment evaluation in patients with head and neck tumors. However, anatomical MRI has its limits in differentiating between post-treatment effects and tumor recurrence. Recent studies showed promising results of functional MRI for response evaluation. Summary: This review analyzes possibilities and limitations of functional MRI sequences separately to obtain insight in the post-therapy setting...
2018: Current Radiology Reports
https://www.readbyqxmd.com/read/29415570/the-multiple-myeloma-treatment-landscape-international-guideline-recommendations-and-clinical-practice-in-europe
#14
Michele Cavo, Evangelos Terpos, Joan Bargay, Hermann Einsele, Jim Cavet, Richard Greil, Edwin de Wit
Guidelines provide recommendations on the management of multiple myeloma (MM), but there are no standard algorithms for the choice and sequencing of treatments. As a result, there is widespread variation in the interpretation and implementation of these guidelines. Areas covered: This review will cover: the real-world data on MM treatment patterns; the approved agents available for the treatment of MM; a comparative summary of the national and international clinical guidelines; a discussion on the impact reimbursement decisions have on treatment availability...
February 8, 2018: Expert Review of Hematology
https://www.readbyqxmd.com/read/29409539/eligibility-for-heroin-assisted-treatment-hat-among-people-who-inject-opioids-and-are-living-with-hiv-in-a-canadian-setting
#15
Jan Klimas, Huiru Dong, Nadia Fairbairn, Eugenia Socías, Rolando Barrios, Evan Wood, Thomas Kerr, Julio Montaner, M-J Milloy
OBJECTIVES: A growing body of evidence supports the effectiveness of injectable diacetylmorphine (i.e., heroin) for individuals with treatment-refractory opioid use disorder. Despite this evidence, and the increasing toll of opioid-associated morbidity and mortality, it remains controversial in some settings. To investigate the possible contribution of heroin-assisted treatment (HAT) to HIV treatment-related outcomes, we sought to estimate the proportion and characteristics of HIV-positive people who inject opioids that might be eligible for HAT in Vancouver, Canada...
February 7, 2018: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/29409444/should-heart-age-calculators-be-used-alongside-absolute-cardiovascular-disease-risk-assessment
#16
Carissa Bonner, Katy Bell, Jesse Jansen, Paul Glasziou, Les Irwig, Jenny Doust, Kirsten McCaffery
BACKGROUND: National estimates of 'heart age' by government health organisations in the US, UK and China show most people have an older heart age than current age. While most heart age calculators are promoted as a communication tool for lifestyle change, they may also be used to justify medication when clinical guidelines advocate their use alongside absolute risk assessment. However, only those at high absolute risk of a heart attack or stroke are likely to benefit from medication, and it is not always clear how heart age relates to absolute risk...
February 7, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29401183/cognitive-aids-do-not-prompt-initiation-of-cardiopulmonary-resuscitation-in-simulated-pediatric-cardiopulmonary-arrests
#17
Kristen Nelson McMillan, Michael A Rosen, Nicole A Shilkofski, Jamie Haggerty Bradshaw, Mary Saliski, Elizabeth A Hunt
INTRODUCTION: Although American Heart Association guidelines exist for proper management of cardiopulmonary arrest (CPA), in-hospital cardiopulmonary resuscitation (CPR) may be of poor quality and is not performed in all indicated situations. Cognitive aids have been created to assist in rapid, accurate recall of guidelines for pediatric CPA management. METHODS: Pediatric residents participated in individual mock codes for two years. Using a high-fidelity simulator, each resident participated in a standardized scenario that required management of both pulseless ventricular tachycardia and pulseless electrical activity...
February 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29401059/survey-of-current-practice-in-the-fitting-and-fine-tuning-of-common-signal-processing-features-in-hearing-aids-for-adults
#18
Melinda C Anderson, Kathryn H Arehart, Pamela E Souza
BACKGROUND: Current guidelines for adult hearing aid fittings recommend the use of a prescriptive fitting rationale with real-ear verification that considers the audiogram for the determination of frequency-specific gain and ratios for wide dynamic range compression. However, the guidelines lack recommendations for how other common signal-processing features (e.g., noise reduction, frequency lowering, directional microphones) should be considered during the provision of hearing aid fittings and fine-tunings for adult patients...
February 2018: Journal of the American Academy of Audiology
https://www.readbyqxmd.com/read/29396792/role-of-interventional-radiology-in-managing-pediatric-liver-tumors-part-2-percutaneous-interventions
#19
REVIEW
C Matthew Hawkins, Alexander J Towbin, Derek J Roebuck, Eric J Monroe, Anne E Gill, Avnesh S Thakor, Richard B Towbin, Anne Marie Cahill, Matthew P Lungren
Hepatoblastoma and hepatocellular carcinoma (HCC) are the most common pediatric liver malignancies, with hepatoblastoma occurring more commonly in younger children and HCC occurring more commonly in older children and adolescents. Although surgical resection (including transplant when necessary) and systemic chemotherapy have improved overall survival rate for hepatoblastoma to approximately 80% from 30%, a number of children with this tumor type are not eligible for operative treatment. In contradistinction, pediatric HCC continues to carry a dismal prognosis with an overall 5-year survival rate of 30%...
February 2, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29396641/-information-services-for-melanoma-patients-and-awareness-among-those-affected
#20
J Brütting, M Bergmann, C Weber, C Berking, W Tilgen, D Schadendorf, F Meier
BACKGROUND: Besides medical consultations, various sources of information and support are available for melanoma patients (MP) in Germany from commercial and non-commercial providers; however, little is known about how they are perceived and accepted by MPs. MATERIAL AND METHODS: Between July and October 2016 a total of 529 melanoma patients were surveyed at 27 accredited German skin cancer centers by means of a standardized questionnaire. Their awareness and satisfaction with 12 given sources of information and counseling services (print, online and by telephone) were surveyed...
February 2, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
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