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https://www.readbyqxmd.com/read/28351116/management-of-people-with-early-or-very-early-stage-hepatocellular-carcinoma-an-attempted-network-meta-analysis
#1
REVIEW
Avik Majumdar, Davide Roccarina, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Hepatocellular carcinoma (primary liver cancer) is classified in many ways. The Barcelona Clinic Liver Cancer (BCLC) group staging classifies the cancer based on patient's life expectancy. People with very early- or early-stage hepatocellular carcinoma have single tumour or three tumours of maximum diameter of 3 cm or less, Child-Pugh status A to B, and performance status 0 (fully functional). Management of hepatocellular carcinoma is uncertain. OBJECTIVES: To assess the comparative benefits and harms of different interventions used in the treatment of early or very early hepatocellular carcinoma through a network meta-analysis and to generate rankings of the available interventions according to their safety and efficacy...
March 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28351063/from-communication-skills-to-skillful-communication-a-longitudinal-integrated-curriculum-for-critical-care-medicine-fellows
#2
Amanda L Roze des Ordons, Christopher J Doig, Philippe Couillard, Jason Lord
PROBLEM: Communication with patients and families in critical care medicine (CCM) can be complex and challenging. A longitudinal curricular model integrating multiple techniques within classroom and clinical milieus may facilitate skillful communication across diverse settings. APPROACH: In 2014-2015, the authors developed and implemented a curriculum for CCM fellows at the Cumming School of Medicine, University of Calgary, to promote the longitudinal development of skillful communication...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28351062/using-national-health-care-databases-and-problem-based-practice-analysis-to-inform-integrated-curriculum-development
#3
Amy J Baker, Mark R Raymond, Steven A Haist, John R Boulet
One challenge when implementing case-based learning, and other approaches to contextualized learning, is determining which clinical problems to include. This article illustrates how health care utilization data, readily available from the National Center for Health Statistics (NCHS), can be incorporated into an educational needs assessment to identify medical problems physicians are likely to encounter in clinical practice. The NCHS survey data summarize patient demographics, diagnoses, and interventions for tens of thousands of patients seen in various settings, including emergency departments (EDs), clinics, and hospitals...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28351026/common-variants-of-vitamin-d-receptor-gene-polymorphisms-and-susceptibility-to-coronary-artery-disease-a-systematic-review-and-meta-analysis
#4
Shahab Alizadeh, Kurosh Djafarian, Hamzeh Alizadeh, Reza Mohseni, Sakineh Shab-Bidar
BACKGROUND AND AIMS: ApaI, FokI, TaqI, and BsmI polymorphisms in the vitamin D receptor (VDR) gene have been reported to be associated with the risk of coronary artery disease (CAD), although the results of previous studies have been inconsistent. The aim of this study was to explore whether these polymorphisms play a role in the genetic susceptibility to CAD. METHODS: A comprehensive search of Medline and Embase databases was conducted for studies evaluating the association between the VDR polymorphisms and CAD risk...
March 29, 2017: Journal of Nutrigenetics and Nutrigenomics
https://www.readbyqxmd.com/read/28350950/spine-oncology-metastatic-spine-tumors
#5
David Choi, Mark Bilsky, Michael Fehlings, Charles Fisher, Ziya Gokaslan
Surgery for spinal metastases remains the mainstay treatment for pain, instability, and neurological deterioration due to tumor infiltration of the spine. However, several new therapies are emerging which may improve outcomes further, and in some cases even replace the need for surgery. We now have a better understanding of which factors influence survival and quality of life after surgery, and this underpins the development and application of new treatments, and assessment of outcome.Depending on genetic subtyping of tumors, novel immunotherapies and chemotherapies may be very effective in prolonging quality of life...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350935/screening-for-celiac-disease-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#6
Roger Chou, Christina Bougatsos, Ian Blazina, Katherine Mackey, Sara Grusing, Shelley Selph
Importance: Silent or subclinical celiac disease may result in potentially avoidable adverse health consequences. Objective: To review the evidence on benefits and harms of screening for celiac disease in asymptomatic adults, adolescents, and children 3 years and older for the US Preventive Services Task Force. Data Sources: Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews, searched to June 14, 2016...
March 28, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28350902/the-role-of-stewardship-in-addressing-antibacterial-resistance-stewardship-and-infection-control-committee-of-the-antibacterial-resistance-leadership-group
#7
Deverick J Anderson, Timothy C Jenkins, Scott R Evans, Anthony D Harris, Robert A Weinstein, Pranita D Tamma, Jennifer H Han, Ritu Banerjee, Robin Patel, Theoklis Zaoutis, Ebbing Lautenbach
Antibacterial resistance is increasing globally and has been recognized as a major public health threat. Antibacterial stewardship is the coordinated effort to improve the appropriate use of antibiotics with the aim to decrease selective pressure for multidrug-resistant organisms in order to preserve the utility of antibacterial agents. This article describes the activities of the Antibacterial Resistance Leadership Group (ARLG) in the area of antibacterial stewardship. To date, the ARLG has focused intensely on development of rapid diagnostic tests, which (when coupled with educational and institutional initiatives) will enable the robust stewardship that is needed to address the current crisis of antibacterial resistance...
March 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28350810/risky-sexual-practice-and-associated-factors-among-hiv-positive-adults-attending-anti-retroviral-treatment-clinic-at-gondar-university-referral-hospital-northwest-ethiopia
#8
Abiyot Abeje Molla, Abebaw Addis Gelagay
INTRODUCTION: Risky sexual practice among people living with HIV/AIDS is a public health concern because of the risk of transmission of the virus to sero-discordant partner/s. There is also the risk of re-infection with new, drug resistant viral strains between sero-concordant partners. However, there is lack of information on risky sexual practices among HIV positive adults. Therefore, this study aimed to assess risky sexual practice and associated factors among adult HIV positive clients at Gondar University Referral Hospital, Northwest Ethiopia, 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28350801/app-psen1-and-psen2-mutations-in-early-onset-alzheimer-disease-a-genetic-screening-study-of-familial-and-sporadic-cases
#9
Hélène-Marie Lanoiselée, Gaël Nicolas, David Wallon, Anne Rovelet-Lecrux, Morgane Lacour, Stéphane Rousseau, Anne-Claire Richard, Florence Pasquier, Adeline Rollin-Sillaire, Olivier Martinaud, Muriel Quillard-Muraine, Vincent de la Sayette, Claire Boutoleau-Bretonniere, Frédérique Etcharry-Bouyx, Valérie Chauviré, Marie Sarazin, Isabelle le Ber, Stéphane Epelbaum, Thérèse Jonveaux, Olivier Rouaud, Mathieu Ceccaldi, Olivier Félician, Olivier Godefroy, Maite Formaglio, Bernard Croisile, Sophie Auriacombe, Ludivine Chamard, Jean-Louis Vincent, Mathilde Sauvée, Cecilia Marelli-Tosi, Audrey Gabelle, Canan Ozsancak, Jérémie Pariente, Claire Paquet, Didier Hannequin, Dominique Campion
BACKGROUND: Amyloid protein precursor (APP), presenilin-1 (PSEN1), and presenilin-2 (PSEN2) mutations cause autosomal dominant forms of early-onset Alzheimer disease (AD-EOAD). Although these genes were identified in the 1990s, variant classification remains a challenge, highlighting the need to colligate mutations from large series. METHODS AND FINDINGS: We report here a novel update (2012-2016) of the genetic screening of the large AD-EOAD series ascertained across 28 French hospitals from 1993 onwards, bringing the total number of families with identified mutations to n = 170...
March 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28350741/short-article-noninvasive-assessment-of-portal-hypertension-and-detection-of-esophageal-varices-in-cirrhosis-state-of-the-art
#10
Ana C de Oliveira
Portal hypertension (PHT) is a major consequence of any chronic liver disease and it is the main cause of complications in patients with cirrhosis. Measurement of hepatic vein pressure gradient is considered the gold standard for PHT assessment, together with its diagnosis and prognosis relevance. Even though hepatic vein pressure gradient measurement is a safe procedure, it is still considered an invasive technique and not widely available. There is thus a need for noninvasive methods that can predict the progression of PHT as well as the presence and the risk of complications related to esophageal varices...
May 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28350730/pas-in-orthopedics-in-the-vha-s-community-based-outpatient-clinics
#11
Daniel O Reed, Roderick S Hooker
In the Veterans Health Administration (VHA) system, most orthopedic care takes place in the VA medical centers (VAMCs). Because most patients receiving orthopedic care were referred by adult medicine providers, more widely deploying physician assistants (PAs) in orthopedic medicine might help offset this workload. An orthopedic medicine demonstration project recruited, trained, and positioned PAs in community-based outpatient clinics (CBOCs) to improve access to care. The project involved surgeons at the Houston VAMC instructing five newly employed PAs in a wide range of orthopedic evaluation and management strategies before their assignment to a CBOC...
April 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28350645/the-use-of-bowel-protocols-in-critically-ill-adult-patients-a-systematic-review-and-meta-analysis
#12
Simon J W Oczkowski, Erick H Duan, Amy Groen, Dawn Warren, Deborah J Cook
OBJECTIVE: Constipation is common among critically ill patients and has been associated with adverse patient outcomes. Many ICUs have developed bowel protocols to treat constipation; however, their effect on clinical outcomes remains uncertain. We conducted a systematic review to determine the impact of bowel protocols in critically ill adults. DATA SOURCES: We searched MEDLINE, Embase, CINAHL, CENTRAL, ISRCTN, ClinicalTrials.gov, and conference abstracts until January 2016...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28350640/in-class-active-videogame-supplementation-and-adherence-to-cardiac-rehabilitation
#13
Jorge Manuel Arsénio Dos Santos Ruivo, Kay Karim, Roisin OʼShea, Rosa Celeste Santos Oliveira, Louis Keary, Claire OʼBrien, John Patrick Gormley
PURPOSE: The application of active videogames (AVGs) during cardiac rehabilitation (CR) sessions could potentially facilitate patient adherence. The feasibility, safety, and efficacy of in-class AVG supplementation as an alternative to conventional phase 2 programs were investigated. METHODS: A pilot, evaluator-blinded, intention-to-treat, randomized controlled trial recruited 32 low-moderate risk CR participants and allocated them to conventional or AVG-supplemented exercise...
March 24, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28350555/apheresis-in-food-allergies
#14
Lamia Dahdah, Giovanna Leone, Mariacristina Artesani, Carla Riccardi, Oscar Mazzina
PURPOSE OF REVIEW: The prevalence of IgE-mediated food allergy and anaphylaxis has risen rapidly in developed countries, and countries with rapid industrialization may follow. Therapies include elimination diets, Oral ImmunoTherapy, and the administration of biologics, but high serum IgE levels may preclude their use. Consequently, decreasing IgE becomes a rational approach and could be obtained by immunoapheresis. The aim of this review is to evaluate the rationale and advantages of immunoapheresis...
March 27, 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28350527/seasonal-and-annual-variation-in-trematode-infection-of-stream-snails-elimia-proxima-in-the-southern-appalachian-mountains-of-virginia
#15
Sally Zemmer, Jennie Wyderko, Jeronimo Da Silva Neto, Ivonne Cedillos, Letitia Clay, E F Benfield, Lisa K Belden
Understanding temporal variation of host-pathogen dynamics can be important for predicting disease risks and anticipating how disease systems may change in response to natural or human disturbances. Seasonal changes in weather, especially those associated with changes in temperature or precipitation, are often a key component of temporal changes in infection risk and can have important impacts on disease systems. However, these patterns can be difficult to track due to interannual variation and the need for longer-term, multi-year surveillance efforts...
March 3, 2017: Journal of Parasitology
https://www.readbyqxmd.com/read/28346963/point-of-care-testing-in-neurosurgery
#16
Christopher Beynon, Lars Wessels, Andreas W Unterberg
Coagulation disorders can have a major impact on the outcome of neurosurgical patients. The central nervous system is located within the closed space of the skull, and therefore, intracranial hemorrhage can lead to intracranial hypertension. Acute brain injury has been associated with alterations of various hemostatic parameters. Point-of-care (POC) techniques such as rotational thromboelastometry are able to identify markers of coagulopathy which are not reflected by standard assessment of hemostasis (e.g...
March 27, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28346878/how-appropriate-are-the-english-language-test-requirements-for-non-uk-trained-nurses-a-qualitative-study-of-spoken-communication-in-uk-hospitals
#17
Carole Sedgwick, Mark Garner
BACKGROUND: Non-native speakers of English who hold nursing qualifications from outside the UK are required to provide evidence of English language competence by achieving a minimum overall score of Band 7 on the International English Language Testing System (IELTS) academic test. OBJECTIVES: To describe the English language required to deal with the daily demands of nursing in the UK. To compare these abilities with the stipulated levels on the language test. DESIGN: A tracking study was conducted with 4 nurses, and focus groups with 11 further nurses...
March 6, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28346734/when-meta-analysis-fails-a-case-about-stomata
#18
Christian Körner
In a recent paper, Yan et al. (2017) offered a statistical re-assessment of the response of stomata density in leaves to environmental conditions using published data sets, including (pre-)historical time series, environmental gradients and manipulative experiments. The authors arrive at a few trends and they conclude that the issue is complicated, responses vary and there is a need for better research. This meta-analysis, like many previous ones, suffered from insufficient or missing data stratification and employing inappropriate assumptions...
March 27, 2017: Global Change Biology
https://www.readbyqxmd.com/read/28346622/future-of-family-medicine-faculty-development-in-sub-saharan-africa
#19
Paul R Larson, Patrick Chege, Bruce Dahlman, Christine Gibson, Ann Evensen, Maria C Colon-Gonzalez, Stephanie Onguka, Roberta Lamptey, William E Cayley, Bich-May Nguyen, Brian Johnson, Sawra Getnet, Memoona Hasnain
BACKGROUND AND OBJECTIVES: High-quality family medicine education is needed in sub-Saharan Africa to facilitate the future growth of primary care health systems. Current faculty educators recognize the value of dedicated teacher training and ongoing faculty development. However, they are constrained by inadequate faculty development program availability and institutional support. METHODS: A cross-sectional study design was used to conduct a qualitative needs assessment comprised of 37 in-depth, semi-structured interviews of individual faculty trainers from postgraduate family medicine training programs in eight sub-Saharan African countries...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28346621/current-status-of-family-medicine-faculty-development-in-sub-saharan-africa
#20
Paul R Larson, Patrick Chege, Bruce Dahlman, Christine Gibson, Ann Evensen, Maria C Colon-Gonzalez, Stephanie Onguka, Roberta Lamptey, William E Cayley, Bich-May Nguyen, Brian Johnson, Sawra Getnet, Memoona Hasnain
BACKGROUND AND OBJECTIVES: Reducing the shortage of primary care physicians in sub-Saharan Africa requires expansion of training programs in family medicine. Challenges remain in preparing, recruiting, and retaining faculty qualified to teach in these pioneering programs. Little is known about the unique faculty development needs of family medicine faculty within the sub-Saharan African context. The purpose of this study was to assess the current status and future needs for developing robust family medicine faculty in sub-Saharan Africa...
March 2017: Family Medicine
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