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https://www.readbyqxmd.com/read/27914874/transmission-networks-and-risk-of-hiv-infection-in-kwazulu-natal-south-africa-a-community-wide-phylogenetic-study
#1
Tulio de Oliveira, Ayesha B M Kharsany, Tiago Gräf, Cherie Cawood, David Khanyile, Anneke Grobler, Adrian Puren, Savathree Madurai, Cheryl Baxter, Quarraisha Abdool Karim, Salim S Abdool Karim
BACKGROUND: The incidence of HIV infection in young women in Africa is very high. We did a large-scale community-wide phylogenetic study to examine the underlying HIV transmission dynamics and the source and consequences of high rates of HIV infection in young women in South Africa. METHODS: We did a cross-sectional household survey of randomly selected individuals aged 15-49 years in two neighbouring subdistricts (one urban and one rural) with a high burden of HIV infection in KwaZulu-Natal, South Africa...
November 30, 2016: Lancet HIV
https://www.readbyqxmd.com/read/27913563/-you-can-t-be-a-person-and-a-doctor-the-work-life-balance-of-doctors-in-training-a-qualitative-study
#2
Antonia Rich, Rowena Viney, Sarah Needleman, Ann Griffin, Katherine Woolf
OBJECTIVES: Investigate the work-life balance of doctors in training in the UK from the perspectives of trainers and trainees. DESIGN: Qualitative semistructured focus groups and interviews with trainees and trainers. SETTING: Postgraduate medical training in London, Yorkshire and Humber, Kent, Surrey and Sussex, and Wales during the junior doctor contract dispute at the end of 2015. Part of a larger General Medical Council study about the fairness of postgraduate medical training...
December 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27913029/pharmacovigilance-and-biomedical-informatics-a-model-for-future-development
#3
Paul Beninger, Michael A Ibara
PURPOSE: The discipline of pharmacovigilance is rooted in the aftermath of the thalidomide tragedy of 1961. It has evolved as a result of collaborative efforts by many individuals and organizations, including physicians, patients, Health Authorities, universities, industry, the World Health Organization, the Council for International Organizations of Medical Sciences, and the International Conference on Harmonisation. Biomedical informatics is rooted in technologically based methodologies and has evolved at the speed of computer technology...
November 29, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27912934/effect-of-sequential-treatment-with-tcm-syndrome-differentiation-on-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-aecopd-risk-window
#4
Li Jiansheng, Wang Haifeng, Li Suyun, Zhang Hailong, Yu Xueqing, Zhang Xiaoyun, Li Fengsen, Zhou Xianmei, Sun Zikai, Mao Yimin, Ma Lijun, Zhang Yijie, Zhang Guojun, Tang Bingxiang
OBJECTIVE: To evaluate the efficacy and safety of the comprehensive interventions based on three Traditional Chinese medicine (TCM) patterns therapy in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and AECOPD risk window. METHODS: A prospective, multi-center, single-blinded, double-dummy and randomized controlled clinical trial is being conducted to test the therapeutic effects of a sequential two stage treatment. A total of 364 patients were enrolled into this study with 182 in each treatment group (TCM and conventional)...
December 2016: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/27908638/using-the-acmge-milestones-as-a-handover-tool-from-medical-school-to-surgery-residency
#5
Lauren M Wancata, Helen Morgan, Gurjit Sandhu, Sally Santen, David T Hughes
OBJECTIVE: To map current medical school assessments for graduating students to the Accreditation Council for Graduate Medical Education (ACGME) milestones in general surgery, and to pass forward individual performance metrics on level 1 milestones to receiving residency programs. DESIGN: The study included 20 senior medical students who were accepted into surgery internship positions. Data from medical school performance assessments from the third-year surgery clerkship, fourth-year surgery rotations, fourth-year surgery boot camp, Clinical Competency Assessment Examination, and United States Medical Licensing Examination (USMLE) Step 1 and 2 examinations were used to map each student's competency assessments to the General Surgery Milestones based on a scoring system created and validated by independent assessors...
November 28, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27907982/learners-perspective-where-and-when-pre-residency-trainees-learn-more-to-achieve-their-core-clinical-competencies
#6
Eusang Ahn, Ducksun Ahn, Young-Mee Lee
PURPOSE: While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. METHODS: A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews...
December 2016: Korean Journal of Medical Education
https://www.readbyqxmd.com/read/27907900/insulin-resistance-in-polycystic-ovary-syndrome-a-systematic-review-and-meta-analysis-of-euglycaemic-hyperinsulinaemic-clamp-studies
#7
Samantha Cassar, Marie L Misso, William G Hopkins, Christopher S Shaw, Helena J Teede, Nigel K Stepto
STUDY QUESTION: What is the degree of intrinsic insulin resistance (IR) in women with polycystic ovary syndrome (PCOS) and the relative contribution of BMI to overall IR based on meta-analysis of gold standard insulin clamp studies? SUMMARY ANSWER: We report an inherent reduction (-27%) of insulin sensitivity (IS) in PCOS patients, which was independent of BMI. WHAT IS ALREADY KNOWN: PCOS is prevalent, complex and underpinned by IR but controversies surround the degree of intrinsic IR in PCOS, the effect of BMI and the impact of the different diagnostic criteria (NIH versus Rotterdam) in PCOS...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27906918/newborn-vitamin-k-prophylaxis-an-analysis-of-information-resources-for-parents-and-professionals
#8
Hayleigh Miller, Benjamin Wheeler, Nikki Kerruish
AIMS: Vitamin K prophylaxis represents one of the first healthcare decisions families make for their newborn. Information resources are an important component of this process. This study aimed to identify and analyse written information about vitamin K. METHODS: Resources concerning vitamin K prophylaxis for both parents and health professionals were accessed through tertiary hospitals in New Zealand and Australia, midwives associated with Queen Mary Maternity Centre (Dunedin, New Zealand), antenatal class providers in the Dunedin, New Zealand area, and an online search of Australian and New Zealand government and hospital websites, as well as the Centre for Disease Control (CDC) in the US...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27904601/evaluation-effects-of-nebulized-gentamicin-in-exacerbation-of-chronic-obstructive-lung-disease
#9
Forogh Soltaninejad, Soleiman Kheiri, Roya Habibian, Arshia Amra, Shahin Asgari-Savadjani
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. Exacerbation of COPD has negative effect on quality of life. Therapeutic effect of nebulized antibiotics in pulmonary infections has been reported previously. Hence, we evaluated the effect of nebulized gentamicin in acute exacerbation of COPD (AECOPD). MATERIALS AND METHODS: In this clinical trial study, 86 hospitalized patients with AECOPD were divided into two groups for using nebulized gentamicin twice daily (case group) and placebo (control group) for 5 days in addition to standard treatment...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27904214/results-of-neurolysis-in-established-upper-limb-volkmann-s-ischemic-contracture
#10
Dinesh K Meena, Srikiran Thalanki, Poornima Patni, Ram Khiladi Meena, Dinesh Bairawa, Chirag Bhatia
BACKGROUND: Treatment of established cases of Volkmann's ischemic contracture (VIC) of upper limb is very tedious. Since the period of Volkmann, various experimental works are being performed for its treatment, but none are effective. Disabilities from nerve palsy and hand muscle paralysis are more problematic than any other deformity in VIC. To solve these problems, we conducted a study to see the result of neurolysis of median and ulnar nerve and their subcutaneous placement in established cases of VIC...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27903038/clinical-practice-guidelines-and-principles-of-care-for-people-with-dementia-in-australia
#11
Suzanne M Dyer, Kate Laver, Constance D Pond, Robert G Cumming, Craig Whitehead, Maria Crotty
BACKGROUND: Dementia is a national health priority in Australia. Most people with dementia are over the age of 65 years, have a number of comorbidities and experience a trajectory of functional decline. General practitioners (GPs) have an important role in the diagnosis and management of people with dementia. The Cognitive Decline Partnership Centre's Clinical practice guidelines and principles of care for people with dementia (Guidelines) was recently approved by the National Health and Medical Research Council (NHMRC)...
December 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27900699/the-anconeus-triceps-lateral-flap-approach-for-total-elbow-arthroplasty-in-rheumatoid-arthritis
#12
A Celli, P Bonucci
BACKGROUND: The posterior approaches to the elbow are considered as to allow an excellent joint exposure for total elbow arthroplasty. One complication that is well recognized is the insufficiency of the extensor mechanism in particular with the patients with poor tendon quality as in the rheumatoid diseases. The purpose of this paper is to present a new triceps-splitting exposure for total elbow arthroplasty used in rheumatoid patients with their preliminary results. METHODS: Fifteen consecutive patients with rheumatoid disease at grades III to V of the Larsen grading scale underwent total elbow replacement using the new triceps-splitting exposure called anconeus-triceps lateral flap and it preserves the integrity of the medial proper triceps tendon...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27899400/study-protocol-a-phase-iii-randomised-double-blind-parallel-arm-stratified-block-randomised-placebo-controlled-trial-investigating-the-clinical-effect-and-cost-effectiveness-of-sertraline-for-the-palliative-relief-of-breathlessness-in-people-with-chronic-breathlessness
#13
Gareth J Watts, Katherine Clark, Meera Agar, Patricia M Davidson, Christine McDonald, Lawrence T Lam, Dimitar Sajkov, Nicola McCaffrey, Matthew Doogue, Amy P Abernethy, David C Currow
INTRODUCTION: Breathlessness remains a highly prevalent and distressing symptom for many patients with progressive life-limiting illnesses. Evidence-based interventions for chronic breathlessness are limited, and there is an ongoing need for high-quality research into developing management strategies for optimal palliation of this complex symptom. Previous studies have suggested that selective serotonin reuptake inhibitors such as sertraline may have a role in reducing breathlessness...
November 29, 2016: BMJ Open
https://www.readbyqxmd.com/read/27898477/costs-and-length-of-stay-for-the-acute-care-of-patients-with-motor-complete-spinal-cord-injury-following-cervical-trauma-the-impact-of-early-transfer-to-specialized-acute-sci-center
#14
Andréane Richard-Denis, Debbie Ehrmann Feldman, Cynthia Thompson, Étienne Bourassa-Moreau, Jean-Marc Mac-Thiong
OBJECTIVE: Acute spinal cord injury (SCI) centers aim to optimize outcome following SCI. However, there is no timeframe to transfer patients from regional to SCI centers in order to promote cost-efficiency of acute care. Our objective was to compare costs and length of stay (LOS) following early and late transfer to the SCI center. DESIGN: A retrospective cohort study involving 116 individuals was conducted. Group 1 (n = 87) was managed in an SCI center promptly after the trauma, whereas group 2 (n = 29) was transferred to the SCI center only after surgery...
November 24, 2016: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/27898141/bostadsort-avg%C3%A3-r-den-palliativa-v%C3%A3-rdens-resurser-och-kvalitet-satsningar-f%C3%A3-r-att-%C3%A3-ka-kompetensen-beh%C3%A3-vs
#15
Bertil Axelsson, Bengt Sallerfors, Carl Johan Furst
Access to palliative care is unequally distributed across Sweden and thus does not meet the needs. The holistic perspective of palliative care is sometimes contrasted with the usual medical focus on organ failure and disease. Palliative consultation teams provide specialist palliative care competencies for staff caring for patients in primary care, nursing homes and in hospitals. Efforts to increase knowledge and skills in palliative care is needed at undergraduate university level and through postgraduate and specialist training...
November 22, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27895088/hormonal-alterations-in-pcos-and-its-influence-on-bone-metabolism
#16
Abhaya Krishnan, Sridhar Muthusami
According to the World Health Organization (WHO) polycystic ovary syndrome (PCOS) occurs in 4-8% of women worldwide. The prevalence of PCOS in Indian adolescents is 12.2% according to ICMR (Indian Council of Medical Research) report. National Institute of Health documented that it affects approximately 5 million women of reproductive age in the United States . Hormonal imbalance is the characteristic of many women with polycystic ovarian syndrome. The impact of various endocrine changes in PCOS women and their relevance to bone remains to be documented...
November 28, 2016: Journal of Endocrinology
https://www.readbyqxmd.com/read/27893695/clinical-assessment-tests-in-evaluating-patients-with-chronic-obstructive-pulmonary-disease-a-cross-sectional-study
#17
Ming-Lung Chuang, I-Feng Lin, Chai-Yuan Lee
Exertional dyspnea scales (EDS) and health-related quality-of-life questionnaires (HRQoLQs) are used to assess chronic obstructive pulmonary disease (COPD). The GOLD guidelines categorize patients according to either 1 of these 2 domains, the lung function and the frequency of acute exacerbations in the preceding year, however with inconsistent results. Combining EDS and HRQoLQs may yield better results; however, the best combination is unclear. Whether the EDS quantifies the exercise capacity or the dyspnea perception is also unclear...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27891651/developing-a-bayesian-adaptive-design-for-a-phase-i-clinical-trial-a-case-study-for-a-novel-hiv-treatment
#18
Alexina J Mason, Juan Gonzalez-Maffe, Killian Quinn, Nicki Doyle, Ken Legg, Peter Norsworthy, Roy Trevelion, Alan Winston, Deborah Ashby
The design of phase I studies is often challenging, because of limited evidence to inform study protocols. Adaptive designs are now well established in cancer but much less so in other clinical areas. A phase I study to assess the safety, pharmacokinetic profile and antiretroviral efficacy of C34-PEG4 -Chol, a novel peptide fusion inhibitor for the treatment of HIV infection, has been set up with Medical Research Council funding. During the study workup, Bayesian adaptive designs based on the continual reassessment method were compared with a more standard rule-based design, with the aim of choosing a design that would maximise the scientific information gained from the study...
November 27, 2016: Statistics in Medicine
https://www.readbyqxmd.com/read/27890986/correlation-of-chest-computed-tomography-findings-with-dyspnea-and-lung-functions-in-post-tubercular-sequelae
#19
Ananya Panda, Ashu Seith Bhalla, Raju Sharma, Anant Mohan, Vishnu Sreenivas, Umasankar Kalaimannan, Ashish Dutt Upadhyay
AIMS: To study the correlation between dyspnea, radiological findings, and pulmonary function tests (PFTs) in patients with sequelae of pulmonary tuberculosis (TB). MATERIALS AND METHODS: Clinical history, chest computed tomography (CT), and PFT of patients with post-TB sequelae were recorded. Dyspnea was graded according to the Modified Medical Research Council (mMRC) scale. CT scans were analyzed for fibrosis, cavitation, bronchiectasis, consolidation, nodules, and aspergilloma...
November 2016: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/27886974/evaluating-coding-accuracy-in-general-surgery-residents-accreditation-council-for-graduate-medical-education-procedural-case-logs
#20
REVIEW
Fadi Balla, Tabitha Garwe, Prasenjeet Motghare, Tessa Stamile, Jennifer Kim, Heidi Mahnken, Jason Lees
INTRODUCTION: The Accreditation Council for Graduate Medical Education (ACGME) case log captures resident operative experience based on Current Procedural Terminology (CPT) codes and is used to track operative experience during residency. With increasing emphasis on resident operative experiences, coding is more important than ever. It has been shown in other surgical specialties at similar institutions that the residents' ACGME case log may not accurately reflect their operative experience...
November 2016: Journal of Surgical Education
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