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https://www.readbyqxmd.com/read/28812922/a-circulating-micro-rna-signature-serves-as-a-diagnostic-and-prognostic-indicator-in-sarcoidosis
#1
Christian Ascoli, Yue Huang, Cody Schott, Benjamin A Turturice, Ahmed Metwally, David L Perkins, Patricia W Finn
Micro-RNAs (miRNAs) act as post-transcriptional regulators of gene expression. In sarcoidosis, aberrant miRNA expression may enhance immune responses mounted against an unknown antigenic agent. We tested whether a distinct miRNA signature functions as a diagnostic biomarker and explored its role as an immune modulator in sarcoidosis. Expression of miRNAs from peripheral blood mononuclear cells from subjects that met clinical and histopathologic criteria for sarcoidosis were compared to those from matched controls in the ACCESS study...
August 16, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28812150/respiratory-complications-after-colonic-procedures-in-chronic-obstructive-pulmonary-disease-does-laparoscopy-offer-a-benefit
#2
Sarath Sujatha-Bhaskar, Reza Fazl Alizadeh, Colette S Inaba, Christina Y Koh, Mehraneh D Jafari, Steven D Mills, Joseph C Carmichael, Michael J Stamos, Alessio Pigazzi
BACKGROUND: Patients with severe chronic obstructive pulmonary disease (COPD) are at a higher risk for postoperative respiratory complications. Despite the benefits of a minimally invasive approach, laparoscopic pneumoperitoneum can substantially reduce functional residual capacity and raise alveolar dead space, potentially increasing the risk of respiratory failure which may be poorly tolerated by COPD patients. This raises controversy as to whether open techniques should be preferentially employed in this population...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28811714/sex-dependent-difference-in-the-effect-of-metformin-on-colorectal-cancer-specific-mortality-of-diabetic-colorectal-cancer-patients
#3
Jung Won Park, Jin Ha Lee, Ye Hyun Park, Soo Jung Park, Jae Hee Cheon, Won Ho Kim, Tae Il Kim
AIM: To assess factors associated with the higher effect of metformin on mortality in diabetic colorectal cancer (CRC) patients, since the factors related to the effectiveness of metformin have not been identified yet. METHODS: Between January 2000 and December 2010, 413 patients diagnosed with both stage 3/4 CRC and diabetes mellitus were identified. Patients' demographics and clinical characteristics were analyzed. The effect of metformin on CRC-specific mortality and the interactions between metformin and each adjusted factor were evaluated...
July 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28811354/safety-and-efficacy-of-baricitinib-through-128-weeks-in-an-open-label-longterm-extension-study-in-patients-with-rheumatoid-arthritis
#4
Edward C Keystone, Mark C Genovese, Douglas E Schlichting, Inmaculada de la Torre, Scott D Beattie, Terence P Rooney, Peter C Taylor
OBJECTIVE: To assess the safety and efficacy of baricitinib in patients with rheumatoid arthritis (RA) up to 128 weeks in a phase IIb study (NCT01185353). METHODS: After a 24-week blinded period, eligible patients entered an initial 52-week open-label extension (OLE); patients receiving 8 mg once daily (QD) continued with that dose and all others received 4 mg QD. Doses could be escalated to 8 mg QD at 28 or 32 weeks at investigator discretion when ≥ 6 tender and ≥ 6 swollen joints were present...
August 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28811244/comparison-of-the-clinical-course-of-clostridium-difficile-infection-in-gdh-positive-toxin-negative-patients-diagnosed-by-pcr-to-those-with-a-positive-toxin-test
#5
Julia Origüen, Laura Corbella, María Ángeles Orellana, Mario Fernández-Ruiz, Francisco López-Medrano, Rafael San Juan, Manuel Lizasoain, Tamara Ruiz-Merlo, Alejandra Morales-Cartagena, Guillermo Maestro, Patricia Parra, Jennifer Villa, Rafael Delgado, José María Aguado
OBJECTIVES: To evaluate the potential role of PCR-based assays in the overdiagnosis of Clostridium difficile infection (CDI) by using a validated diagnostic algorithm in daily clinical practice. METHODS: We performed a retrospective cohort study evaluating all C. difficile-positive stool samples identified at our institution during a 12-month period, to compare outcomes and recurrence rate between patients with a positive enzyme-immunoassay (EIA) for both glutamate dehydrogenase (GDH) and toxin A/B ("toxin-positive group"), with those with GDH-positive, toxin-negative samples in which the diagnosis was made by a positive PCR-based assay ("toxin-/PCR+ group")...
August 12, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28811074/management-of-multidrug-resistant-gram-negative-bacilli-infections-in-solid-organ-transplant-recipients-set-gesitra-seimc-reipi-recommendations
#6
REVIEW
J M Aguado, J T Silva, M Fernández-Ruiz, E Cordero, J Fortún, C Gudiol, L Martínez-Martínez, E Vidal, L Almenar, B Almirante, R Cantón, J Carratalá, J J Caston, E Cercenado, C Cervera, J M Cisneros, M G Crespo-Leiro, V Cuervas-Mons, J Elizalde-Fernández, M C Fariñas, J Gavaldà, M J Goyanes, B Gutiérrez-Gutiérrez, D Hernández, O Len, R López-Andujar, F López-Medrano, P Martín-Dávila, M Montejo, A Moreno, A Oliver, A Pascual, E Pérez-Nadales, A Román-Broto, R San-Juan, D Serón, A Solé-Jover, M Valerio, P Muñoz, J Torre-Cisneros
Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection...
July 26, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28810873/six-month-adherence-to-statin-use-and-subsequent-risk-of-major-adverse-cardiovascular-events-mace-in-patients-discharged-with-acute-coronary-syndromes
#7
Gaoqiang Xie, Yihong Sun, Phyo Kyaw Myint, Anushka Patel, Xingzi Yang, Min Li, Xian Li, Tao Wu, Shenshen Li, Runlin Gao, Yangfeng Wu
BACKGROUND: The evidence of adherence to statin decreasing risk of major adverse cardiovascular events (MACEs) is still lack among patients discharged with acute coronary syndrome (ACS). Our objective is to determine the relationship between six-month adherence to statins and subsequent risk of MACEs in patients discharged with ACS. METHODS: Using two prospective registry cohorts (CPACS-1 and -2), we analyzed data from 12,516 consecutive patients with ACS who were prescribed statin at hospital discharge and survived beyond 6 months without recurrent myocardial infarction (MI) or stroke...
August 15, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28810566/correlation-analysis-between-the-ldl-c-in-serum-and-the-onset-of-transient-ischemic-attack-caused-by-csvd
#8
Yaqi Chen, Mei Hu, Hongying Gong
The aim of this study was to investigate the correlation between the low-density lipoprotein cholesterol (LDL-C) in serum and the onset of transient ischemic attack caused by cerebral small vascular disease (CSVD). Between September 2012 and September 2015, 249 patients who were diagnosed as CSVD were randomly enrolled in this study. According to MRI results, patients were divided into the patient and control groups. In the patient group, the patients were further subdivided into the white matter lesion (WML) group (n=86) and lacunar infarction (LI) group (n=53)...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28809926/impact-of-fortified-versus-unfortified-lipid-based-supplements-on-morbidity-and-nutritional-status-a-randomised-double-blind-placebo-controlled-trial-in-ill-gambian-children
#9
Stefan A Unger, Saikou Drammeh, Jahid Hasan, Kabiru Ceesay, Edrisa Sinjanka, Sainey Beyai, Bakary Sonko, Bai Lamin Dondeh, Anthony J Fulford, Sophie E Moore, Andrew M Prentice
BACKGROUND: Multiple micronutrients (MMN) are commonly prescribed in pediatric primary healthcare in sub-Saharan Africa to improve nutritional status and appetite without evidence for their effectiveness or international clinical guidelines. Community-wide MMN supplementation has shown limited and heterogeneous impact on growth and morbidity. Short-term ready-to-use therapeutic foods in acutely sick children in a hospital setting also had limited efficacy regarding subsequent growth. The effectiveness of MMN in improving morbidity or growth in sick children presenting for primary care has not been assessed...
August 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28809741/hepatitis-c-virus-infection-outcomes-among-immigrants-to-canada-a-retrospective-cohort-analysis
#10
Curtis L Cooper, Kednapa Thavorn, Ecaterina Damian, Daniel J Corsi
INTRODUCTION AND AIM: HCV-infected immigrants contribute to the total prevalence in Canada and other developed nations. Little is known about engagement in care, access to service, and treatment outcomes in recipients of Direct Acting Antiviral (DAA) HCV therapies among immigrants living with HCV. MATERIAL AND METHODS: HCV patients assessed at The Ottawa Hospital Viral Hepatitis Clinic between 2000-2016 were identified. Immigration history, race, socioeconomic status, HCV work-up, treatment and outcome data were evaluated...
August 8, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28809619/the-effect-of-hiv-status-on-clinical-outcomes-of-surgical-sepsis-in-kwazulu-natal-province-south-africa
#11
Samantha Green, Victor Y Kong, Jocinta Odendaal, Benn Sartorius, Damian L Clarke, Petra Brysiewicz, Jereme L Bruce, Grant L Laing, Wanda Bekker
BACKGROUND: KwaZulu-Natal Province, South Africa (SA), has long been the epicentre of the HIV epidemic, but the impact of HIV co-infection on the clinical outcomes of emergency surgical patients with sepsis remains largely unknown. OBJECTIVE: To review our experience with the management of patients with HIV co-infection and to compare the disease spectrum and outcome with those without HIV infection. METHODS: A retrospective study was undertaken at the Pietermaritzburg Metropolitan Surgical Service (PMSS), SA over a 5-year period from January 2010 to December 2014...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28809389/cost-effectiveness-analysis-of-telephone-based-support-for-the-management-of-pressure-ulcers-in-people-with-spinal-cord-injury-in-india-and-bangladesh
#12
M Arora, L A Harvey, J V Glinsky, H S Chhabra, M S Hossain, N Arumugam, P K Bedi, I D Cameron, A J Hayes
OBJECTIVE: To determine from a societal perspective the cost-effectiveness and cost-utility of telephone-based support for management of pressure ulcers. STUDY DESIGN: Cost-effectiveness and cost-utility analysis of a randomised clinical trial. SETTING: Tertiary centre in India and Bangladesh. METHODS: An economic evaluation was conducted alongside a randomised clinical trial comparing 12 weeks of telephone-based support (intervention group) with usual care (control group)...
August 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28809384/the-impact-of-cholecystectomy-after-endoscopic-sphincterotomy-for-complicated-gallstone-disease
#13
B Joseph Elmunzer, Mohamed Noureldin, Katherine A Morgan, David B Adams, Gregory A Coté, Akbar K Waljee
OBJECTIVES: Cholecystectomy after endoscopic sphincterotomy (ES) is associated with improved outcomes compared to ES alone, however randomized trials have included mainly fit surgical candidates. Our objective was to assess the impact of cholecystectomy after ES among elderly patients, in whom the perceived risks of surgery may be increased and the prevailing bias may be to defer cholecystectomy. METHODS: We performed adjusted analyses comparing clinical outcomes in patients ≥65 years of age who did and did not undergo follow-up cholecystectomy after endoscopic sphincterotomy for choledocholithiasis, ascending cholangitis, or gallstone pancreatitis...
August 15, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28809132/impact-of-primary-tracheoesophageal-puncture-on-outcomes-after-total-laryngectomy
#14
Aru Panwar, Oleg Militsakh, Robert Lindau, Andrew Coughlin, Harlan Sayles, Katherine R Rieke, William Lydiatt, Daniel Lydiatt, Russell Smith
Objectives To identify differences in postoperative wound complications associated with a primary tracheoesophageal puncture (TEP) at the time of laryngectomy versus no TEP. Study Design Retrospective review of large national data set. Setting Academic and nonacademic health care facilities in United States, contributing de-identified, risk-adjusted clinical data to the American College of Surgeons National Surgical Quality Improvement Program. Subjects and Methods The National Surgical Quality Improvement Program data set for years 2006 to 2012 identified 430 patients who underwent total laryngectomy with or without a primary TEP...
August 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28808507/cyp2c19-genetic-variation-and-individualized-clopidogrel-prescription-in-a-cardiology-clinic
#15
Seyed Abbas Mirabbasi, Koroush Khalighi, Yin Wu, Stanley Walker, Bahar Khalighi, Wuqiang Fan, Archana Kodali, Gang Cheng
Background: Clopidogrel (Plavix) is an antiplatelet medication that is routinely used in patients with cardiovascular disease. Cytochrome P2C19 enzymes play a major role in its metabolism, which determines its varied therapeutic level and its effectiveness. Objectives: To customize clopidogrel therapy and evaluate its efficacy by using CYP2C19 genotypic and phenotypic information to improve clinical outcomes in patients. Methods: A total of 465 patients with underlying cardiovascular disease were selected from our out-patient cardiology clinic...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28807801/impact-of-diabetes-mellitus-on-clinical-outcomes-and-quality-of-life-after-transcatheter-aortic-valve-implantation-for-severe-aortic-valve-stenosis
#16
Tomasz Tokarek, Artur Dziewierz, Agata Wiktorowicz, Maciej Bagienski, Lukasz Rzeszutko, Danuta Sorysz, Pawel Kleczynski, Dariusz Dudek
BACKGROUND: Diabetes mellitus (DM) has been considered as a marker of poor prognosis after cardiac surgery. We sought to investigate the impact of DM on clinical outcomes and quality of life (QoL) after transcatheter aortic valve implantation (TAVI). METHODS: A total of 148 consecutive patients with symptomatic, severe aortic stenosis who underwent TAVI were included. Baseline characteristics, procedural and long-term clinical outcomes as well as the results of frailty and QoL assessment with EQ-5D-3L questionnaire were compared between patients with and without DM...
August 11, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28807551/the-optimal-cut-off-of-blood-pressure-related-to-left-ventricular-diastolic-dysfunction-and-remodeling-in-asian-diabetic-patients
#17
Ju Young Jung, Sung Keun Park, Jae-Hong Ryoo, Chang-Mo Oh, Jeong Gyu Kang, Kanghee Moon, Keum Ok Lee, Joong-Myung Choi
BACKGROUND: Although a recent randomized trial found no difference between intensive and standard blood pressure (BP) control in patients with diabetes mellitus (DM), the debate over the optimal BP target continues. Thus, the present study investigated the effect of BP on the subclinical left ventricular (LV) function and structural changes in diabetic patients. METHOD: A total of 2649 patients with DM who received echocardiography were enrolled in this study. Study population was stratified by three groups according to BP and presence of hypertension (normal, <130/80mmHg; prehypertension, ≥130/80mmHg without hypertension; hypertension, ≥140/90mmHg or history of hypertension)...
August 11, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28807423/coping-with-the-stress-in-the-cardiac-intensive-care-unit-can-mindfulness-be-the-answer
#18
Nadya Golfenshtein, Janet A Deatrick, Amy J Lisanty, Barbara Medoff-Cooper
BACKGROUND: Mothers of infants with complex congenital heart disease are exposed to increased stress which has been associated with numerous adverse health outcomes. The coping mechanisms these mothers use critically effect the familial illness adaptation and most likely infant outcomes. Currently no data-based strategies have been developed for mothers to facilitate their coping, and proactively promote their adaptation in the critical care settings. A potential strategy is mindfulness which is currently used in other clinical settings with stress-reduction effects...
August 11, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28807189/effect-of-non-monetary-incentives-on-uptake-of-couples-counselling-and-testing-among-clients-attending-mobile-hiv-services-in-rural-zimbabwe-a-cluster-randomised-trial
#19
Euphemia L Sibanda, Mary Tumushime, Juliet Mufuka, Sue Napierala Mavedzenge, Stephano Gudukeya, Sergio Bautista-Arredondo, Karin Hatzold, Harsha Thirumurthy, Sandra I McCoy, Nancy Padian, Andrew Copas, Frances M Cowan
BACKGROUND: Couples' HIV testing and counselling (CHTC) is associated with greater engagement with HIV prevention and care than individual testing and is cost-effective, but uptake remains suboptimal. Initiating discussion of CHTC might result in distrust between partners. Offering incentives for CHTC could change the focus of the pre-test discussion. We aimed to determine the impact of incentives for CHTC on uptake of couples testing and HIV case diagnosis in rural Zimbabwe. METHODS: In this cluster-randomised trial, 68 rural communities (the clusters) in four districts receiving mobile HIV testing services were randomly assigned (1:1) to incentives for CHTC or not...
September 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28806992/comparison-of-an-alternative-schedule-of-extended-care-contacts-to-a-self-directed-control-a-randomized-trial-of-weight-loss-maintenance
#20
Gareth R Dutton, Marissa A Gowey, Fei Tan, Dali Zhou, Jamy Ard, Michael G Perri, Cora E Lewis
BACKGROUND: Behavioral interventions for obesity produce clinically meaningful weight loss, but weight regain following treatment is common. Extended care programs attenuate weight regain and improve weight loss maintenance. However, less is known about the most effective ways to deliver extended care, including contact schedules. METHODS: We compared the 12-month weight regain of an extended care program utilizing a non-conventional, clustered campaign treatment schedule and a self-directed program among individuals who previously achieved ≥5% weight reductions...
August 15, 2017: International Journal of Behavioral Nutrition and Physical Activity
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