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Interest of conflict AND patients

Mohamed Fawzy, Mai Emad, Ali Mahran, Mohamed Sabry, Ahmed N Fetih, Hazem Abdelghafar, Salah Rasheed
STUDY QUESTION: Are pregnancy and birth rates affected by artificial oocyte activation (AOA) with SrCl2 or calcimycin after ICSI for couples with male-factor infertility linked to abnormal sperm morphology or for couples with previous ICSI cycles of unexplained low fertilization or inadequate fertilization associated with impaired oocyte morphology? SUMMARY ANSWER: AOA with either SrCl2 or calcimycin can improve the rates of clinical pregnancy, ongoing pregnancy and live birth compared with ICSI alone, and the two agents have diverse effects for different subgroups of patients...
August 7, 2018: Human Reproduction
Holger Langhof, Hannes Kahrass, Thomas Illig, Roland Jahns, Daniel Strech
Human biological materials and related data stored in biobanks are valuable resources for biomedical research. Transparent, effective, and efficient governance structures and procedures for access, compensation, and priority setting are needed, but recent debates indicate challenges in the practical application of such governance processes. This study aimed to assess the practical experiences and attitudes of biobank experts regarding the governance of biosample access, prioritization, and compensation. Qualitative, semi-structured telephone interviews were conducted with 20 biobank directors from eight countries...
August 8, 2018: European Journal of Human Genetics: EJHG
Willem Verpoest, Catherine Staessen, Patrick M Bossuyt, Veerle Goossens, Gheona Altarescu, Maryse Bonduelle, Martha Devesa, Talia Eldar-Geva, Luca Gianaroli, Georg Griesinger, Georgia Kakourou, Georgia Kokkali, Jana Liebenthron, Maria-Cristina Magli, Monica Parriego, Andreas G Schmutzler, Monica Tobler, Katrin van der Ven, Joep Geraedts, Karen Sermon
STUDY QUESTION: Does preimplantation genetic testing for aneuploidy (PGT-A) by comprehensive chromosome screening (CCS) of the first and second polar body to select embryos for transfer increase the likelihood of a live birth within 1 year in advanced maternal age women aged 36-40 years planning an ICSI cycle, compared to ICSI without chromosome analysis? SUMMARY ANSWER: PGT-A by CCS in the first and second polar body to select euploid embryos for transfer does not substantially increase the live birth rate in women aged 36-40 years...
August 6, 2018: Human Reproduction
Christopher J Rush, Ross T Campbell, Pardeep S Jhund, Mark C Petrie, John J V McMurray
Aims: Treatment 'effects' are often inferred from non-randomized and observational studies. These studies have inherent biases and limitations, which may make therapeutic inferences based on their results unreliable. We compared the conflicting findings of these studies to those of prospective randomized controlled trials (RCTs) in relation to pharmacological treatments for heart failure (HF). Methods and results: We searched Medline and Embase to identify studies of the association between non-randomized drug therapy and all-cause mortality in patients with HF until 31 December 2017...
August 1, 2018: European Heart Journal
Carol A Mathews, Robert Scott Mackin, Chia-Ying Chou, Soo Y Uhm, Larry David Bain, Sandra J Stark, Michael Gause, Ofilio R Vigil, John Franklin, Mark Salazar, Julian Plumadore, Lauren C Smith, Kiya Komaiko, Gillian Howell, Eduardo Vega, Joanne Chan, Monika B Eckfield, Janice Y Tsoh, Kevin Delucchi
Background: Treatment for hoarding disorder is typically performed by mental health professionals, potentially limiting access to care in underserved areas. Aims: We aimed to conduct a non-inferiority trial of group peer-facilitated therapy (G-PFT) and group psychologist-led cognitive-behavioural therapy (G-CBT). Method: We randomised 323 adults with hording disorder 15 weeks of G-PFT or 16 weeks of G-CBT and assessed at baseline, post-treatment and longitudinally (≥3 months post-treatment: mean 14...
July 2018: BJPsych Open
Nissim Ackshota, Alysa Nash, Ian Bussey, Mark Shasti, Luke Brown, Vijay Vishwanath, Zanaib Malik, Kelley E Banagan, Eugene Y Koh, Steven C Ludwig, Daniel E Gelb
BACKGROUND CONTEXT: The incidence of pyogenic vertebral osteomyelitis (PVO) continues to increase in the United States, highlighting the need to recognize unique challenges presented by these cases and develop effective methods of surgical management. To date, no prior research has focused on the outcomes of PVO requiring two or more contiguous corpectomies. PURPOSE: To describe our experience in the operative management of PVO in 56 consecutive patients who underwent multilevel corpectomies (≥2 vertebral bodies) via a combined approach...
August 3, 2018: Spine Journal: Official Journal of the North American Spine Society
Ramez Nairooz, Marwan Saad, Ashwat S Dhillon, Haroon Yousaf, Lena Awar, Anilkumar Mehra, Ray V Matthews, David Shavelle, Leonardo Clavijo
BACKGROUND: The optimal stent for use in saphenous vein graft (SVG) intervention is still debatable. Multiple randomized trials have compared drug-eluting stents (DES) to bare metal stents (BMS) in SVG interventions with conflicting results. METHODS: Authors searched the online databases for randomized controlled trials (RCTs) comparing DES to BMS in SVG percutaneous coronary interventions (PCI). We performed a meta-analysis using a random effects model to calculate the odds ratio for outcomes of interest...
July 25, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
V Schächinger, H M Hoffmeister, M A Weber, C Stellbrink
Increasing complexity and new highly differentiated therapeutic procedures in cardiology result in a need for additional training beyond cardiology board certification. The German Cardiac Society therefore developed a variety of certifications of educational curricula and definition of specialized centers. Standardization and structuring in education and patient treatment, as defined by certifications may be helpful; however, introduction of certification can have serious consequences for hospital structure, the side effects of which may impair quality of treatment for individual patients...
August 2, 2018: Herz
Cory N Criss, Mark P MacEachern, Niki Matusko, Justin B Dimick, Melinda Maggard-Gibbons, Samir K Gadepalli
OBJECTIVE: To quantify the influence of financial conflict of interest (COI) payments on the reporting of clinical results for robotic surgery. DATA SOURCES AND STUDY SELECTION: A systematic search (Ovid MEDLINE databases) was conducted (May 2017) to identify randomized controlled trials (RCTs) and observational studies comparing the efficacy of the da Vinci robot on clinical outcomes. Financial COI data for authors (per study) were determined using open payments database...
July 31, 2018: Annals of Surgery
Harsh Singh, Om Biju Panta, Umesh Khanal, Ram Kumar Ghimire
Introduction: Renal cortical elastography has shown conflicting but promising results in evaluation of chronic kidney disease and other renal disorders. The purpose of this study was to establish a normogram of renal cortical elasticity values and assess their variation between right and left kidney and their relation with age, gender, body mass index, renal dimensions and skin to cortex distance. Methods: The study was a hospital based cross sectional study performed at Tribhuvan University Teaching Hospital, a tertiary care center in Kathmandu, Nepal...
October 2017: Journal of Medical Ultrasound
Tamara Kredo, Sara Cooper, Amber Abrams, Karen Daniels, Jimmy Volmink, Salla Atkins
BACKGROUND: There is increased international focus on improving the rigour of clinical practice guideline (CPG) development practices. However, few empirical studies on CPG development have been conducted in low- and middle-income countries. This paper explores national stakeholders' perceptions of processes informing CPG development for primary healthcare in South Africa, focusing on both their aspirations and views of what is actually occurring. METHODS: A qualitative study design was employed including individual interviews with 37 South African primary care CPG development role-players...
July 31, 2018: Health Research Policy and Systems
Laura Y Cabrera, Hayden M K Boyce, Rachel McKenzie, Robyn Bluhm
OBJECTIVE The research required to establish that psychiatric treatments are effective often depends on collaboration between academic clinical researchers and industry. Some of the goals of clinical practice and those of commercial developers of psychiatric therapies overlap, such as developing safe and effective treatments. However, there might also be incompatible goals; physicians aim to provide the best care they can to their patients, whereas the medical industry ultimately aims to develop therapies that are commercially successful...
August 2018: Neurosurgical Focus
Lucas M Bryant, Kelly E Daniels, David M Cognetti, Patrick Tassone, Adam J Luginbuhl, Joseph M Curry
Objectives: 1) review benefits and risks of cannabis use, with emphasis on otolaryngic disease processes; 2) define and review the endocannabinoid signaling system (ESS); and 3) review state and federal regulations for the use and research of cannabis and ESS modulators. Methods: This manuscript is a review of the current literature relevant to the stated objectives. Results: Cannabis (marijuana) use is increasing. It is the most widely used illicit substance in the world...
June 2018: Laryngoscope Investigative Otolaryngology
Go Nishikawa, Jia Luo, Vinay Prasad
IMPORTANCE: There is broad interest in patients who have exceptional responses to cancer drugs and only one prior systematic review of published case reports. OBJECTIVE: To systematically summarise case reports of patients who have had a super response to a cancer drug and determine patterns and completeness of documentation. DESIGN, SETTING AND PARTICIPANTS: This is a systematic search of biomedical literature and hand searches of seven prominent oncology journals...
July 27, 2018: European Journal of Cancer
Christie Schumacher, Golbarg Moaddab, Monique Colbert, Mary Ann Kliethermes
BACKGROUND: Recent changes in the health care delivery landscape have expanded opportunities for clinical pharmacists in the ambulatory care setting. This article describes the successful integration of a clinical pharmacist-led chronic disease management service in a patient-centered medical home (PCMH) and accountable care organization (ACO) environment. PROGRAM DESCRIPTION: In 2008, the year before PCMH implementation, 36% of patients who were hospitalized at Advocate Trinity Hospital for a heart failure exacerbation were readmitted within 30 days of their hospital stay for heart failure exacerbation...
August 2018: Journal of Managed Care & Specialty Pharmacy
Shan-Qi Lee, Aravind Sesagiri Raamkumar, Jinhui Li, Yuanyuan Cao, Kanokkorn Witedwittayanusat, Luxi Chen, Yin-Leng Theng
BACKGROUND: The behavior of medication nonadherence is distinguished into primary and secondary nonadherence. Primary nonadherence (PNA) is not as thoroughly studied as secondary nonadherence. OBJECTIVE: To explore and synthesize contributing factors to PNA based on the existing body of literature. METHODS: A search was performed on the PubMed, PsycINFO, CINAHL, and ScienceDirect databases to identify previously published scholarly articles that described the "factors," "reasons," "determinants" or "facilitators" of PNA...
August 2018: Journal of Managed Care & Specialty Pharmacy
Micheal Raad, Amit Jain, Mitchell Huang, Richard L Skolasky, Daniel M Sciubba, Khaled M Kebaish, Brian J Neuman
BACKGROUND CONTEXT: . Validity and responsiveness of the Patient Reported Outcomes Measurement Information System (PROMIS) have been investigated in several orthopaedic subspecialties. PROMIS has shorter completion time and greater research flexibility for the heterogeneous adult spinal deformity (ASD) population versus the Oswestry Disability Index (ODI) and Scoliosis Research Society 22-item questionnaire (SRS-22r). PURPOSE: . Evaluate the validity and responsiveness of PROMIS in ASD surgery during the early postoperative period...
July 24, 2018: Spine Journal: Official Journal of the North American Spine Society
Nicholas J Goel, Prateek Agarwal, Arka N Mallela, Kalil G Abdullah, Zarina S Ali, Ali K Ozturk, Neil R Malhotra, James M Schuster, H Isaac Chen
BACKGROUND AND CONTEXT: The impact of underlying liver disease on surgical outcomes has been recognized in a wide variety of surgical disciplines. However, less empiric data is available about the importance of liver disease in spinal surgery. PURPOSE: To measure the independent impact of underlying liver disease on 30-day outcomes following surgery for the degenerative cervical spine. STUDY DESIGN: Retrospective comparative study PATIENT SAMPLE: A cohort of 21,207 patients undergoing elective surgery for degenerative disease of the cervical spine from the American College of Surgeons National Quality Improvement Program (ACS-NSQIP)...
July 24, 2018: Spine Journal: Official Journal of the North American Spine Society
J-B Stukenborg, J P Alves-Lopes, M Kurek, H Albalushi, A Reda, V Keros, V Töhönen, R Bjarnason, P Romerius, M Sundin, U Norén Nyström, C Langenskiöld, H Vogt, L Henningsohn, R T Mitchell, O Söder, C Petersen, K Jahnukainen
STUDY QUESTION: Does chemotherapy exposure (with or without alkylating agents) or primary diagnosis affect spermatogonial quantity in human prepubertal testicular tissue? SUMMARY ANSWER: Spermatogonial quantity is significantly reduced in testes of prepubertal boys treated with alkylating agent therapies or with hydroxyurea for sickle cell disease. WHAT IS KNOWN ALREADY: Cryopreservation of spermatogonial stem cells, followed by transplantation into the testis after treatment, is a proposed clinical option for fertility restoration in children...
July 25, 2018: Human Reproduction
Alison E Turnbull, Sarina K Sahetya, E Lee Daugherty Biddison, Christiane S Hartog, Gordon D Rubenfeld, Dominique D Benoit, Bertrand Guidet, Rik T Gerritsen, Mark R Tonelli, J Randall Curtis
Medical professionals are expected to prioritize patient interests, and most patients trust physicians to act in their best interest. However, a single patient is never a physician's sole concern. The competing interests of other patients, clinicians, family members, hospital administrators, regulators, insurers, and trainees are omnipresent. While prioritizing patient interests is always a struggle, it is especially challenging and important in the ICU setting where most patients lack the ability to advocate for themselves or seek alternative sources of care...
July 25, 2018: Intensive Care Medicine
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