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Evidence-based medicine

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https://www.readbyqxmd.com/read/29352526/ectrims-ean-guideline-on-the-pharmacological-treatment-of-people-with-multiple-sclerosis
#1
X Montalban, R Gold, A J Thompson, S Otero-Romero, M P Amato, D Chandraratna, M Clanet, G Comi, T Derfuss, F Fazekas, H P Hartung, E Havrdova, B Hemmer, L Kappos, R Liblau, C Lubetzki, E Marcus, D H Miller, T Olsson, S Pilling, K Selmaj, A Siva, P S Sorensen, M P Sormani, C Thalheim, H Wiendl, F Zipp
BACKGROUND AND PURPOSE: Multiple sclerosis (MS) is a complex disease of the central nervous system. As new drugs are becoming available, knowledge on diagnosis and treatment must continuously evolve. There is therefore a need for a reference tool compiling current data on benefit and safety, to aid professionals in treatment decisions and use of resources across Europe. The European Committee of Treatment and Research in Multiple Sclerosis (ECTRIMS) and the European Academy of Neurology (EAN) have joined forces to meet this need...
January 19, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29352401/does-giving-parents-their-choice-of-interventions-for-child-behavior-problems-improve-child-outcomes
#2
Abigail H Gewirtz, Susanne S Lee, Gerald J August, Yaliu He
Empowering consumers to be active decision-makers in their own care is a core tenet of personalized, or precision medicine. Nonetheless, there is a dearth of research on intervention preferences in families seeking interventions for a child with behavior problems. Specifically, the evidence is inconclusive as to whether providing parents with choice of intervention improves child/youth outcomes (i.e., reduces externalizing problems). In this study, 129 families presenting to community mental health clinics for child conduct problems were enrolled in a doubly randomized preference study and initially randomized to choice or no-choice conditions...
January 20, 2018: Prevention Science: the Official Journal of the Society for Prevention Research
https://www.readbyqxmd.com/read/29352346/the-evolution-of-breast-reduction-publications-a-bibliometric-analysis
#3
Ümran Muslu
OBJECTIVE: This study aims to make a bibliometric analysis of the studies on breast reduction (BR) between the years 1980 and 2016 and identify important studies through trend topics as well as active authors, countries, universities, scientific journals, and citation and co-citation analyses about BR. BACKGROUND: Although BR looks like one of the cosmetic surgeries performed in order to restore the woman's appearance, in fact it is a reconstructive surgery that eliminates back pain, stance disorder, headache, shoulder pain, back and cervical disk hernia, difficulty in breathing, hollowness caused by bra straps, hygiene problems under breasts (e...
January 19, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29352052/estrogen-receptor-positive-breast-cancer-exploiting-signaling-pathways-implicated-in-endocrine-resistance
#4
REVIEW
Adam M Brufsky, Maura N Dickler
Advancements in molecular profiling and endocrine therapy (ET) have led to more focused clinical attention on precision medicine. These advances have expanded our understanding of breast cancer (BC) pathogenesis and hold promising implications for the future of therapy. The estrogen receptor-α is a predominant endocrine regulatory protein in the breast and in estrogen-induced BC. Successful targeting of proteins and genes within estrogen receptor (ER) nuclear and nonnuclear pathways remains a clinical goal...
January 19, 2018: Oncologist
https://www.readbyqxmd.com/read/29352006/machine-learning-in-cardiovascular-medicine-are-we-there-yet
#5
REVIEW
Khader Shameer, Kipp W Johnson, Benjamin S Glicksberg, Joel T Dudley, Partho P Sengupta
Artificial intelligence (AI) broadly refers to analytical algorithms that iteratively learn from data, allowing computers to find hidden insights without being explicitly programmed where to look. These include a family of operations encompassing several terms like machine learning, cognitive learning, deep learning and reinforcement learning-based methods that can be used to integrate and interpret complex biomedical and healthcare data in scenarios where traditional statistical methods may not be able to perform...
January 19, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29350335/tools-for-assessment-of-the-appropriateness-of-prescribing-and-association-with-patient-related-outcomes-a-systematic-review
#6
REVIEW
Nashwa Masnoon, Sepehr Shakib, Lisa Kalisch-Ellett, Gillian E Caughey
BACKGROUND: There are tools and criteria in the literature aimed at distinguishing between appropriate and inappropriate medicines use. However, many have not been externally validated with regard to patient-related outcomes, potentially limiting their use in clinical practice. OBJECTIVES: The aim of the study was to conduct a systematic review to summarise (1) available prescribing appropriateness assessment tools and criteria, and (2) their associations with patient-related outcomes (external validity)...
January 19, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29349921/community-pharmacists-views-on-the-regulation-of-complementary-medicines-and-complementary-medicines-practitioners-a-qualitative-study-in-new-zealand
#7
Joanne Barnes, Rachael Butler
OBJECTIVES: To examine community pharmacists' perspectives on CMs regulation in New Zealand, where proposals for CMs regulations had recently been suspended and where, currently, CMs are only weakly regulated. METHODS: Qualitative, in-depth, semi-structured interviews with New Zealand practising community pharmacists are identified through purposive and convenience sampling. Data were analysed using a general inductive approach. KEY FINDINGS: Participants held mixed views regarding harmonisation of CMs regulations across Australia and NZ; some supported an NZ national regulatory framework for CMs, based on the Australian system...
January 19, 2018: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29349792/meta-analysis-of-gaussian-individual-patient-data-two-stage-or-not-two-stage
#8
Tim P Morris, David J Fisher, Michael G Kenward, James R Carpenter
Quantitative evidence synthesis through meta-analysis is central to evidence-based medicine. For well-documented reasons, the meta-analysis of individual patient data is held in higher regard than aggregate data. With access to individual patient data, the analysis is not restricted to a "two-stage" approach (combining estimates and standard errors) but can estimate parameters of interest by fitting a single model to all of the data, a so-called "one-stage" analysis. There has been debate about the merits of one- and two-stage analysis...
January 18, 2018: Statistics in Medicine
https://www.readbyqxmd.com/read/29349667/comparison-of-enalapril-candesartan-and-intralesional-triamcinolone-in-reducing-hypertrophic-scar-development-an-experimental-study
#9
Canser Yilmaz Demir, Muhammet Eren Ersoz, Remzi Erten, Omer Faruk Kocak, Yilmaz Sultanoglu, Yildiray Basbugan
BACKGROUND: The purpose of this study was to compare the effects of oral enalapril, an angiotensin-converting enzyme inhibitor (ACE-I), oral candesartan, an angiotensin receptor blocker (ARB), and intralesional corticosteroid treatments in reducing scar formation. METHODS: Twenty male rabbits were divided into five study groups: A (sham), B (control), C (ACE-I), D (ARB) and E (intralesional corticosteroid). The rabbit ear hypertrophic scar model was used. The hypertrophic scars were photographed and analyzed with the program ImageJ quantitatively to determine the degree of collagen fibers...
January 18, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29349590/law-as-clinical-evidence-a-new-constitutivemodel-of-medical-education-and-decision-making
#10
Malcolm Parker, Lindy Willmott, Ben White, Gail Williams, Colleen Cartwright
Over several decades, ethics and law have been applied to medical education and practice in a way that reflects the continuation during the twentieth century of the strong distinction between facts and values. We explain the development of applied ethics and applied medical law and report selected results that reflect this applied model from an empirical project examining doctors' decisions on withdrawing/withholding treatment from patients who lack decision-making capacity. The model is critiqued, and an alternative "constitutive" model is supported on the basis that medicine, medical law, and medical ethics exemplify the inevitable entanglement of facts and values...
January 18, 2018: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29348109/review-beyond-conventional-therapies-complementary-and-alternative-medicine-in-the-management-of-hypertension-an-evidence-based-review
#11
Ang Peng Wong, Yaman Walid Kassab, Abdul Latiff Mohamed, Amelah Mohammed Abdul Qader
Hypertension is one of the major causes of morbidity and mortality. Worldwide, Hypertension is estimated to cause 7.5 million deaths, about 12.8% of the total of all deaths. This accounts for 57 million disability adjusted life years (DALYS) or 3.7% of total DALYS. This led WHO to set a target of 25% reduction in prevalence by 2025. To reach that, WHO has adopted non-conventional methods for the management of hypertension? Despite worldwide popularity of such non-conventional therapies, only small volume of evidence exists that supports its effectiveness...
January 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29346701/identifying-prevalence-and-characteristics-of-behavioral-health-education-in-family-medicine-clerkships-a-cera-study
#12
Mario P DeMarco, Renée M Betancourt, Kelly M Everard, Kent D W Bream
BACKGROUND AND OBJECTIVES: Many patients with behavioral health disorders do not seek or receive adequate care for their conditions. Among those that do, most will receive care in a primary care setting. To best meet this need, clinicians will need to demonstrate proficiency of behavioral health skills and evidence-based practices. We sought to explore the degree to which these skills are being taught in family medicine clerkships. METHODS: The Council of Academic Family Medicine's (CAFM) Educational Research Alliance (CERA) 2016 survey of clerkship directors (CDs) was sent to 141 CDs at US and Canadian medical schools with a required family medicine run course...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29346689/initial-development-and-validation-of-a-family-medicine-attitudes-questionnaire
#13
Julie Phillips, Jacob Prunuske, Laurie Fitzpatrick, Brian Mavis
BACKGROUND AND OBJECTIVES: Although many curricular and policy interventions are designed to influence students' attitudes toward family medicine, assessment of these interventions is limited by lack of a comprehensive, validated measure of students' attitudes. We sought to develop and validate a questionnaire that effectively assesses medical student attitudes toward family medicine. METHODS: A 31-item questionnaire was assessed for internal, external, and content validity...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29346221/a-validation-argument-for-a-simulation-based-training-course-centered-on-assessment-recognition-and-early-management-of-pediatric-sepsis
#14
Gary L Geis, Derek S Wheeler, Amy Bunger, Laura G Militello, Regina G Taylor, Jerome P Bauer, Terri L Byczkowski, Benjamin T Kerrey, Mary D Patterson
INTRODUCTION: Early recognition of sepsis remains one of the greatest challenges in medicine. Novice clinicians are often responsible for the recognition of sepsis and the initiation of urgent management. The aim of this study was to create a validity argument for the use of a simulation-based training course centered on assessment, recognition, and early management of sepsis in a laboratory-based setting. METHODS: Five unique simulation scenarios were developed integrating critical sepsis cues identified through qualitative interviewing...
January 17, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29346209/the-society-of-thoracic-surgeons-the-society-of-cardiovascular-anesthesiologists-and-the-american-society-of-extracorporeal-technology-clinical-practice-guidelines-anticoagulation-during-cardiopulmonary-bypass
#15
Linda Shore-Lesserson, Robert A Baker, Victor A Ferraris, Philip E Greilich, David Fitzgerald, Philip Roman, John W Hammon
Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29344685/long-term-safety-and-efficacy-of-botulinum-toxin-a-treatment-in-adolescent-patients-with-axillary-bromhidrosis
#16
Tao Wang, Jiasheng Dong, Jinguang He
BACKGROUND: For adolescent bromhidrosis, the long-term safety and efficacy of botulinum toxin type A (BTX-A) treatment are not clear to date. PATIENTS AND METHODS: From June 2011 to July 2016, 62 adolescent patients with primary axillary bromhidrosis were recruited and 50 U of BTX-A was administered in each axilla. Repetitive injections were performed when the malodor returned. RESULTS: The average follow-up was 2.64 years. There were no reported local or systemic adverse effects...
January 17, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29344576/clinical-exposure-to-transgender-medicine-improves-students-preparedness-above-levels-seen-with-didactic-teaching-alone-a-key-addition-to-the-boston-university-model-for-teaching-transgender-healthcare
#17
Jason A Park, Joshua D Safer
Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients...
2018: Transgender Health
https://www.readbyqxmd.com/read/29344523/clinical-skills-temporal-degradation-assessment-in-undergraduate-medical-education
#18
Joseph Fisher, Rebecca Viscusi, Adam Ratesic, Cameron Johnstone, Ross Kelley, Angela M Tegethoff, Jessica Bates, Elaine H Situ-Lacasse, William J Adamas-Rappaport, Richard Amini
Introduction: Medical students' ability to learn clinical procedures and competently apply these skills is an essential component of medical education. Complex skills with limited opportunity for practice have been shown to degrade without continued refresher training. To our knowledge there is no evidence that objectively evaluates temporal degradation of clinical skills in undergraduate medical education. The purpose of this study was to evaluate temporal retention of clinical skills among third year medical students...
January 2018: Journal of Advances in Medical Education & Professionalism
https://www.readbyqxmd.com/read/29344455/qualitative-assessment-of-learning-strategies-among-medical-students-using-focus-group-discussions-and-in-depth-interviews
#19
Anuradha Sujai Joshi, Jaishree Deepak Ganjiwale, Jagdish Varma, Praveen Singh, Jyoti Nath Modi, Tejinder Singh
Background: Globally, students with top academic performance and high intellectual capacity usually opt to study medicine. However, once students get enrolled, their academic performance varies widely. Such variations appear to be determined by various factors, one of them being types of learning strategies adopted by students. The learning strategies utilized by the students with better academic performance are likely to be more effective learning strategies. Aims and Objectives: The objective is to identify effective learning strategies used by medical students...
December 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/29344416/lycium-barbarum-a-traditional-chinese-herb-and-a-promising-anti-aging-agent
#20
REVIEW
Yanjie Gao, Yifo Wei, Yuqing Wang, Fang Gao, Zhigang Chen
Lycium barbarum has been used in China for more than 2,000 years as a traditional medicinal herb and food supplement. Lycium barbarum contains abundant Lycium barbarum polysaccharides (LBPs), betaine, phenolics, carotenoids (zeaxanthin and β-carotene), cerebroside, 2-O-β-d-glucopyranosyl-l-ascorbic acid (AA-2βG), β-sitosterol, flavonoids and vitamins (in particular, riboflavin, thiamine, and ascorbic acid). LBPs are the primary active components of Lycium barbarum. In this review, we discuss the pharmacological activities of LBPs and other major components...
December 2017: Aging and Disease
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