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https://www.readbyqxmd.com/read/28716567/moving-the-goalposts-a-comparison-of-different-definitions-for-primary-external-ventricular-drain-infection-and-its-risk-factors-a-multi-center-study-of-2575-patients
#1
Peter Y M Woo, Hoi-Tung Wong, Jenny K S Pu, Wai-Kei Wong, Larry Y W Wong, Michael W Y Lee, Kwong-Yui Yam, Wai-Man Lui, Wai-Sang Poon
External ventricular drainage is the most common procedure performed in daily neurosurgical practice. One devastating complication is ventriculostomy-associated infection, but the establishment of evidence-based management guidelines has been hindered by the lack of an universal definition. There is also limited data with regard to the utility of comorbidity health indices and surgery-related factors in predicting infection. This study aims to compare the incidence of infection according to five commonly used definitions and to identify risk factors for this complication...
July 14, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28705803/clinical-practice-guidelines-for-the-care-of-girls-and-women-with-turner-syndrome-proceedings-from-the-2016-cincinnati-international-turner-syndrome-meeting
#2
Claus H Gravholt, Niels H Andersen, Gerard S Conway, Olaf M Dekkers, Mitchell E Geffner, Karen O Klein, Angela E Lin, Nelly Mauras, Charmian A Quigley, Karen Rubin, David E Sandberg, Theo C J Sas, Michael Silberbach, Viveca Söderström-Anttila, Kirstine Stochholm, Janielle A van Alfen-van derVelden, Joachim Woelfle, Philippe F Backeljauw
Turner syndrome affects 25-50 per 100,000 females and can involve multiple organs through all stages of life, necessitating multidisciplinary approach to care. Previous guidelines have highlighted this, but numerous important advances have been noted recently. These advances cover all specialty fields involved in the care of girls and women with TS. This paper is based on an international effort that started with exploratory meetings in 2014 in both Europe and the USA, and culminated with a Consensus Meeting held in Cincinnati, Ohio, USA in July 2016...
September 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28695442/fistula-first-initiative-historical-impact-on-vascular-access-practice-patterns-and-influence-on-future-vascular-access-care
#3
Timmy Lee
The vascular access is the lifeline for the hemodialysis patient. In the United States, the Fistula First Breakthrough Initiative (FFBI) has been influential in improving use of arteriovenous fistulas (AVF) in prevalent hemodialysis patients. Currently, prevalent AVF rates are near the goal of 66% set forth by the original FFBI. However, central venous catheter (CVC) rates remain very high in the United States in patients initiating hemodialysis, nearly exceeding 80%. A new direction of the of the FFBI has focused on strategies to reduce CVC use, and subsequently the FFBI has now been renamed the "Fistula First-Catheter Last Initiative"...
July 10, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28687265/contextualizing-myocardial-infarction-comorbidities-and-priorities-in-older-adults
#4
REVIEW
Ashok Krishnaswami, Mathew S Maurer, Karen P Alexander
Cardiovascular care for older adults has become increasingly complex due to a rise in the concurrent comorbidity burden that accompanies senescence. Internists, hospitalists, and cardiologists often encounter geriatric patients with multiple chronic conditions needing acute cardiovascular care. Abnormal cardiac biomarker levels in patients with multiple non-cardiac conditions are a common reason for older adults to enter the hospital. This type of acute coronary syndrome, defined as a non-ST segment elevation myocardial infarction or, more precisely, type 2 myocardial infarction, often leads to substantial consternation...
July 4, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28672410/-prescription-of-benzodiazepines-and-z-drugs-by-german-general-practitioners-a-cross-sectional-study
#5
Dirk Moßhammer, Hannah Haumann, Rainer Muche, David Scheub, Stefanie Joos, Gunter Laux
Background Due to their addictive potential, benzodiazepine (BZ) and non-benzodiazepine-agonists (NBZ, so-called Z-drugs) should be taken no longer than 6 weeks. BZ and NBZ are primarily prescribed by general practitioners (GPs). Therefore, we aimed to analyze GPs' data on the patients collective, the amount of BZ/NBZ prescribed and the rate of private prescriptions. Methods We analyzed person years of 2-year intervals from 2009 to 2014 of the primary care CONTENT register that contains routine data from 31 general practitioners' practices...
July 3, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28660669/comparison-of-eye-movement-desensitization-and-reprocessing-therapy-cognitive-behavioral-writing-therapy-and-wait-list-in-pediatric-posttraumatic-stress-disorder-following-single-incident-trauma-a-multicenter-randomized-clinical-trial
#6
Carlijn de Roos, Saskia van der Oord, Bonne Zijlstra, Sacha Lucassen, Sean Perrin, Paul Emmelkamp, Ad de Jongh
BACKGROUND: Practice guidelines for childhood posttraumatic stress disorder (PTSD) recommend trauma-focused psychotherapies, mainly cognitive behavioral therapy (CBT). Eye movement desensitization and reprocessing (EMDR) therapy is a brief trauma-focused, evidence-based treatment for PTSD in adults, but with few well-designed trials involving children and adolescents. METHODS: We conducted a single-blind, randomized trial with three arms (n = 103): EMDR (n = 43), Cognitive Behavior Writing Therapy (CBWT; n = 42), and wait-list (WL; n = 18)...
June 28, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28657399/combination-sglt2-inhibitor-and-glp-1-receptor-agonist-therapy-a-complementary-approach-to-the-treatment-of-type-2-diabetes
#7
Robert S Busch, Michael P Kane
Among persons with type 2 diabetes (t2d), the development of glucose intolerance involves dysfunction in several organs and tissues, including the muscle, liver, pancreas, kidney, gastrointestinal tract, adipose tissue, and brain. individuals with t2d typically have a number of comorbidities, including hypertension, hyperlipidemia, and being overweight or obese, and are, consequently, at high cardiovascular risk. guidelines recommend a comprehensive care strategy that includes treatment of diabetes-related complications and comorbidities beyond those related to hyperglycemia...
June 28, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28655127/depression-screening-by-physical-therapists-practices-beliefs-barriers
#8
Patricia Fay, Susan L Edmond, Julia K Baron, Michelle Joshi
BACKGROUND: Depression, a common comorbidity encountered in physical therapy (PT) practice, negatively impacts outcomes. There is limited knowledge of PT practice patterns relative to screening for depression. OBJECTIVE: Objectives were to describe beliefs regarding depression, and identify practice patterns and perceived barriers regarding screening for depression among APTA Board Certified Orthopedic Clinical Specialist (OCS) PTs. METHODS: Surveys were distributed to all PT OCSs in the US; 416 responses were analyzed...
June 2, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28643811/-from-mild-cognitive-impairment-to-dementia-what-is-the-role-of-public-health
#9
Nicola Vanacore, Alessandra Di Pucchio, Eleonora Lacorte, Ilaria Bacigalupo, Flavia Mayer, Giulia Grande, Matteo Cesari, Marco Canevelli
Mild cognitive impairment (MCI) is a nosological entity proposed by Petersen in 1999 with the objective of identifying an early stage of dementia. The new diagnostic criteria for dementia, both those promoted by the International Working Group (IWG) and those defined by the National Institute of Aging (NIA), subsequently introduced a new model that starts with a preclinical phase, then proceeds with a prodromal phase, and ends with a phase of dementia. The condition known as subjective cognitive disorder (SCD) is included between the preclinic and the prodromal phases...
May 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28640938/obstructive-sleep-apnoea-and-polycystic-ovary-syndrome-a-comprehensive-review-of-clinical-interactions-and-underlying-pathophysiology
#10
REVIEW
Hassan Kahal, Ioannis Kyrou, Abd A Tahrani, Harpal S Randeva
Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in women of reproductive age. PCOS is associated with multiple co-morbidities including, obesity, insulin resistance and type 2 diabetes, as well as mood disorders and impaired quality of life (QoL). Obstructive sleep apnoea (OSA) is also a common medical condition that is often undiagnosed, particularly in women. OSA is associated with a similar spectrum of comorbidities to that observed in PCOS, including manifestations of the metabolic syndrome and impaired QoL, whilst obesity frequently constitutes a common denominator in the pathophysiology of both OSA and PCOS...
June 22, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28640443/pathophysiology-of-aortic-stenosis-and-mitral-regurgitation
#11
Gianluca L Perrucci, Marco Zanobini, Paola Gripari, Paola Songia, Bayan Alshaikh, Elena Tremoli, Paolo Poggio
The global impact of the spectrum of valve diseases is a crucial, fast-growing, and underrecognized health problem. The most prevalent valve diseases, requiring surgical intervention, are represented by calcific and degenerative processes occurring in heart valves, in particular, aortic and mitral valve. Due to the increasing elderly population, these pathologies will gain weight in the global health burden. The two most common valve diseases are aortic valve stenosis (AVS) and mitral valve regurgitation (MR)...
June 18, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/28615004/understanding-heart-failure-explaining-telehealth-a-hermeneutic-systematic-review
#12
Trisha Greenhalgh, Christine A'Court, Sara Shaw
BACKGROUND: Enthusiasts for telehealth extol its potential for supporting heart failure management. But randomised trials have been slow to recruit and produced conflicting findings; real-world roll-out has been slow. We sought to inform policy by making sense of a complex literature on heart failure and its remote management. METHODS: Through database searching and citation tracking, we identified 7 systematic reviews of systematic reviews, 32 systematic reviews (including 17 meta-analyses and 8 qualitative reviews); six mega-trials and over 60 additional relevant empirical studies and commentaries...
June 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28614079/do-not-resuscitate-with-no-surrogate-and-no-advance-directive-an-ethics-case-study
#13
Jamie Diamond, Umesh Gidwani, Rosamond Rhodes
Do-not-resuscitate (DNR) orders are typically signed by physicians in conjunction with patients or their surrogate decision makers in order to instruct healthcare providers not to perform cardiopulmonary resuscitation (CPR). Both the medical literature and CPR guidelines fail to address when it is appropriate for physicians to sign DNR orders without any knowledge of a patient's wishes. We explore the ethical issues surrounding instituting a two-physician DNR for a dying patient with multiple comorbidities and no medical record on file, no advance directives, and no surrogate decision maker...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28571934/intensive-glycemic-control-in-younger-and-older-u-s-adults-with-type-2-diabetes
#14
Sarah Casagrande, Catherine C Cowie, Judith E Fradkin
AIMS: To determine the extent to which older vs. younger adults with diabetes intensively control glycemia. METHODS: Participants were age≥40years who self-reported a physician diagnosis of diabetes in the 2009-2014 National Health and Nutrition Examination Surveys (N=1554). Intensive glycemic control was defined as A1c<7.0% and taking insulin, sulfonylureas, or ≥2 glycemic medications. Logistic regression was used to determine the adjusted odds of intensive control in older (≥65years) vs...
May 18, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28562155/challenges-of-implementing-fibromyalgia-treatment-guidelines-in-current-clinical-practice
#15
Lesley M Arnold, Daniel J Clauw
The current diagnostic and treatment pathway for patients with fibromyalgia (FM) is lengthy, complex, and characterized by multiple physician visits with an average 2-year wait until diagnosis. It is clear that effective identification and appropriate treatment of FM remain a challenge in current clinical practice. Ideally, FM management involves a multidisciplinary approach with the preferable patient pathway originating in primary care but supported by a range of health care providers, including referral to specialist care when necessary...
June 19, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28552061/polypharmacy-in-cardiovascular-medicine-problems-and-promises
#16
Mehran Abolbashari, Tracy E Macaulay, Thomas F Whayne, Debabrata Mukherjee, Sibu Saha
Polypharmacy is now a frequent aspect and reality of current medicine practice, driven by managing multiple comorbidities, especially in older adults. However and unfortunately, polypharmacy can expose patients to adverse drug reactions, and drug-drug or drug-disease interactions. On the other hand, clinicians are often hesitant to add new drugs to complex regimens even when recommended by evidence-based medicine and guidelines. In addition, there is frequently a failure to assess which medications might not be beneficial and may therefore be stopped...
May 28, 2017: Cardiovascular & Hematological Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/28546302/considerations-and-controversies-in-managing-chronic-kidney-disease-an-update
#17
REVIEW
Lalita Prasad-Reddy, Diana Isaacs, Alexander Kantorovich
PURPOSE: Current considerations and controversies surrounding the management of chronic kidney disease (CKD) are reviewed. SUMMARY: Patients diagnosed with CKD require a unique clinical approach to prevent medication toxicities and ensure appropriate management of disease-progressing comorbidities, and they require attention to commonly occurring complications that may affect disease control and impact quality of life, including anemia and CKD-bone-mineral disorder (CKD-BMD)...
June 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28544037/using-experience-based-co-design-for-the-development-of-physical-activity-provision-in-non-acute-rehabilitation-and-recovery-mental-health-care
#18
Evan Matthews, Mary Cowman, Suzanne Denieffe
Despite advances in recovery focused mental health care, people with severe mental illness (SMI) experience multiple physical comorbidity compounded by unhealthy lifestyle behaviours including low levels of physical activity (Vancampfort et al. 2017; Walker et al. 2015). Responding to this, international policy is moving to include physical activity as part of fundamental care for people with severe mental illness (Pratt et al. 2016; Richardson et al. 2005). Incorporation of physical activity into mental health service provision should adopt an approach that is in keeping with best practice, recovery orientated guidelines of mental health service provision, with particular consideration shown to incorporating service users as partners in care plan development and delivery (Department of Health, 2001; Department of Health and Children, 2006)...
May 19, 2017: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/28509771/sedation-for-advanced-procedures-in-the-bronchoscopy-suite-proceduralist-or-anesthesiologist
#19
Michael Kern, Thoralf Kerner, Sascha Tank
PURPOSE OF REVIEW: This article focuses on the issue of sedation provided either by proceduralists or anesthesiologists for advanced bronchoscopy procedures. The relative merits of both approaches are presented. Current evidence from the literature and guideline recommendations relevant to this topic are reviewed. RECENT FINDINGS: In general, patient and proceduralist satisfaction as well as patient safety are increased when intravenous sedation is provided for advanced bronchoscopic procedures...
August 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28493231/-drug-therapy-of-fibromyalgia-syndrome-updated-guidelines-2017-and-overview-of-systematic-review-articles
#20
C Sommer, R Alten, K-J Bär, M Bernateck, W Brückle, E Friedel, P Henningsen, F Petzke, T Tölle, N Üçeyler, A Winkelmann, 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...
June 2017: Der Schmerz
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