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Clinical disease guidelines

Matthew W R Stevens, Daniel L King, Diana Dorstyn, Paul H Delfabbro
OBJECTIVE: While there is sufficient research and clinical evidence to support the inclusion of gaming disorder in the latest revision of the International Classification of Diseases (ICD-11), relatively little is known about the effectiveness of first-line psychological treatment for gaming disorder or Internet gaming disorder (IGD) as it is listed in the DSM-5. This systematic review employed meta-analytic techniques to determine the effectiveness of cognitive-behavioral therapy (CBT) for IGD on four key outcomes: IGD symptoms, anxiety, depression, and time spent gaming...
October 20, 2018: Clinical Psychology & Psychotherapy
Danielle B Rice, Brian Hutton, Patricia Poulin, Beth A Sproule, Dianna Wolfe, David Moher, Kednapa Thavorn, Gary Garber, Sheena Taha, Amy Porath, Melanie Willows, Leila Esmaeilisaraji, Fatemeh Yazdi, Beverley Shea, Becky Skidmore, Kimberly Corace
INTRODUCTION: The opioid crisis has resulted in increasing rates of death caused by problematic opioid use. Current clinical guidelines recommend that individuals with persons with opioid use disorder (OUD) receive pharmacological (eg, opioid agonist therapy) and psychosocial (eg, cognitive behavioural therapy) therapy; however, the best combination of pharmacologic and psychosocial components is not known. Our objective of the planned study is to conduct a comprehensive systematic review to assess the relative benefits of psychosocial interventions as an adjunct to opioid agonist therapy among persons with OUD...
October 18, 2018: BMJ Open
Nadia Panera, Barbara Barbaro, Claudia Della Corte, Antonella Mosca, Valerio Nobili, Anna Alisi
Nonalcoholic fatty liver disease (NAFLD) is a multifaceted disorder that ranges from simple fatty liver to nonalcoholic steatohepatitis (NASH) with or without fibrosis, which may evolve toward cirrhosis and hepatocellular carcinoma. It is currently considered a "global" and "epidemic" disease, whose prevalence is progressively increasing even in pediatric age. The incidence of NAFLD is very high in overweight/obese children, and a greater risk of disease progression is associated with severe obesity, highlighting the role of nutrition...
October 2018: Nutrition Research
Pooja S Jagadish, Mariana Aziz, Viswanatha Chinta, Rami N Khouzam
Annually in the United States, sudden cardiac death (including out-of-hospital cardiac arrests) is responsible for over 300,000 deaths, comprising 40%-50% of total mortality rates from cardiovascular disease. Among the highest-risk patients are those with ischemic and nonischemic cardiomyopathy who have a reduced left ventricular ejection fraction (≤ 35%-40%). However, not everyone is a candidate for an implantable cardioverter defibrillator. In 2002, the wearable cardioverter defibrillator (WCD) gained Food and Drug Administration approval for its efficacy in the prevention of sudden cardiac arrest or death in certain at-risk populations and has been making its way into national guidelines with Class IIa to IIb strength of evidence...
September 18, 2018: Current Problems in Cardiology
Mišo Gostimir, Rahul A Sharma, Adil Bhatti
OBJECTIVE: To use the perspectives of undergraduate program directors to assess the current structure and adequacy of undergraduate ophthalmology curricula at Canadian medical schools. DESIGN: Cross-sectional survey. PARTICIPANTS: Undergraduate ophthalmology program directors at each English-speaking Canadian medical school. METHODS: Program directors were identified and invited to participate in an online survey. The 18-question survey focused on key areas of undergraduate ophthalmology curricula, including length, timeline, setting, and nature of medical students' exposure to ophthalmology...
October 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Nick S R Lan, P Gerry Fegan, Bu B Yeap, Damon A Bell, Gerald F Watts
Dyslipidaemia is an important modifiable risk factor contributing to the increased risk of atherosclerotic cardiovascular disease in diabetes mellitus. However, determining when to initiate statin therapy in young adults with type 1 diabetes mellitus (T1DM) can often be challenging. This is due to a relative paucity of data in this area to guide management and for developing T1DM specific risk engines. Current recommendations from international guidelines offer differing approaches to cardiovascular risk stratification and management of dyslipidaemia in T1DM...
October 19, 2018: Diabetes/metabolism Research and Reviews
Prasan Deep Rath, Der-Yuan Chen, Jieruo Gu, Vivian W Y Lee, Nizar Abdulateef Al Ani, Khalid Shirazy, Lyndon Llamado
Although anti-tumor necrosis factor (TNF) agents have greatly improved the management of rheumatic diseases, their cost limits access to many patients throughout the world. As a result, patients and clinicians have turned to biosimilars to provide similar efficacy at a lower cost. Many of the regulatory guidelines in the Asia Pacific region are largely based on those of the European Medicines Agency and the World Health Organization; however, there are variations between countries. Additionally, in some countries, intended copies are available that were approved prior to the development of guidelines and have not fulfilled the requirements of a biosimilar...
October 18, 2018: International Journal of Rheumatic Diseases
Toshihiko Tomita, Tadayuki Oshima, Hiroto Miwa
PURPOSE OF REVIEW: The purpose of this article is to review the recent literature and discuss the new approaches to the diagnosis and treatment of functional dyspepsia (FD). RECENT FINDINGS: According to the recent American College of Gastroenterology (ACG) and Canadian Association of Gastroenterology (CAG) guideline for dyspepsia, Helicobacter pylori (H. pylori) eradication is recommended as a first treatment option, and proton pump inhibitors (PPIs), tricyclic antidepressants, and prokinetics are listed as second-line therapy...
October 18, 2018: Current Gastroenterology Reports
Daisuke Kudo, Junichi Sasaki, Hiroto Ikeda, Yasukazu Shiino, Nobuaki Shime, Toru Mochizuki, Masanori Morita, Hiroshi Soeda, Hiroki Ohge, Jong Ja Lee, Masahisa Fujita, Isao Miyairi, Yasuyuki Kato, Manabu Watanabe, Hiroyuki Yokota
Aim: Infection control in the emergency department is important for hospital risk management; however, few clinical guidelines have been established. This study aimed to determine whether hospitals in Japan have infection control manuals, and investigate the contents of manuals, consulting systems, and isolation facilities for emergency departments. Methods: A total of 517 hospitals certified as educational institutions for board-certified acute care physicians in Japan were requested between March and May 2015 to provide a written evaluation of the infection control in the emergency department...
October 2018: Acute Medicine & Surgery
Stephanie R Rice, Jason K Molitoris, Melissa A L Vyfhuis, Martin J Edelman, Whitney M Burrows, Josephine Feliciano, Elizabeth M Nichols, Mohan Suntharalingam, James Donahue, Shamus R Carr, Joseph Friedberg, Shahed Badiyan, Charles B Simone, Steven J Feigenberg, Pranshu Mohindra
BACKGROUND: We questioned whether the National Comprehensive Cancer Network recommendations for brain magnetic resonance imaging (MRI) for patients with stage ≥ IB non-small-cell lung cancer (NSCLC) was high-yield compared with American College of Clinical Pharmacy and National Institute for Health and Care Excellence guidelines recommending stage III and above NSCLC. We present the prevalence and factors predictive of asymptomatic brain metastases at diagnosis in patients with NSCLC without extracranial metastases...
September 24, 2018: Clinical Lung Cancer
Angela Lamarca, Salvatore Galdy, Jorge Barriuso, Sharzad Moghadam, Elizabeth Beckett, Jane Rogan, Alison Backen, Catherine Billington, Mairéad G McNamara, Richard A Hubner, Angela Cramer, Juan W Valle
INTRODUCTION: Expression of human epidermal growth factor receptor (HER)2 and HER3 have been investigated in small BTC studies using variable scoring systems. METHODS: HER2 and HER3 overexpression/amplification were explored following internationally agreed guidelines using immunohistochemistry (IHC) and fluorescent in-situ hybridisation (FISH), respectively. Logistic regression and survival analysis (Kaplan Meier, Log rank test and Cox Regression) were used for statistical analysis...
2018: PloS One
María Alejandra Montoya-Giraldo, Dayana Vanessa Montoya, David Alexander Atehortúa, Jefferson Antonio Buendía, Andrés Felipe Zuluaga
Salbutamol is a β2 adrenergic agonist widely prescribed in patients with obstructive and restrictive lung diseases. The main side effects associated with its use are tachycardia and tremor. Myoclonus is an involuntary, irregular, abrupt, brief and sudden muscular contraction, which can be generalized, focal or multifocal. We report the case of a 61-year-old patient presenting with myoclonus difficult to treat who showed improvement only after the definitive discontinuation of the β2 adrenergic agonist. We describe the clinical findings, the interventions, and the outcomes related to the onset of myoclonus secondary to the use of salbutamol, as well as the possible genesis and importance of this adverse effect...
September 1, 2018: Biomédica: Revista del Instituto Nacional de Salud
Beatrice Ruggerone, Marco Giraldi, Saverio Paltrinieri, Paola Scarpa
BACKGROUND: Several breeds have physiological peculiarities that induce variations in reference intervals (RIs) compared with the general canine population. Shetland sheepdogs (SSs) are reported to be more predisposed to different diseases (eg, hyperlipidemia, gallbladder mucocele, and hypothyroidism). Consequently, a breed-specific approach is more often required. OBJECTIVES: The aim of this study was to determine whether the RIs of the general canine population could be applied to that of SSs, and to generate breed-specific RIs, where appropriate...
October 18, 2018: Veterinary Clinical Pathology
G R Tabeeva
Alzheimer's disease and vascular dementia are two most common causes of dementia in late life. The combination of Alzheimer's type dementia and vascular dementia is the third most common form of dementia, especially in the elderly. Most clinical forms of dementia are characterized by the presence of 'overlap' symptoms of both neurodegenerative and vascular pathology, which makes it expedient to consider mixed dementia as a separate entity characterized by clinical presentations, course and the rate of progression of cognitive decline...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Mojtaba Nouhi, Mohamad Hadian, Alireza Olyaeemanesh
BACKGROUND: Surgical intervention is one of the common therapeutic interventions applied to a vast class of diseases. Unwarranted variation in practice style in different locations is considered as practice style variations (PSVs), which cause undesirable effects on patient health status and economic consequences. The magnitude of the variations in surgical interventions and its effects on clinical outcomes of patients and also utilization of resources have been investigated in recent years...
October 2018: Medicine (Baltimore)
Jason E Lang
PURPOSE OF REVIEW: Asthma is a common chronic disease of the airways characterized by recurrent respiratory symptoms, bronchoreactivity, and airway inflammation. The high toll on quality of life has led to sustained efforts to understand the factors leading to asthma inception and poor disease control. Obesity is another increasingly common pediatric disease, which appears to increase the risk for incident asthma and worsened disease severity. Currently, our understanding of how obesity affects asthma risk and affects its phenotypic characteristics remains incomplete...
October 16, 2018: Current Opinion in Pulmonary Medicine
Fabio Midulla, Laura Petrarca, Antonella Frassanito, Greta Di Mattia, Anna M Zicari, Raffaella Nenna
Bronchiolitis is the most common acute lower respiratory tract infection in infants and the first cause of hospitalization in this age group. Despite it has been studied for over 70 years, its management remains controversial and nowadays the treatment is only supportive. Pediatricians should be well acquainted with the clinical course of the disease. In particular, they should know that the severity of respiratory symptoms peaks between days 3-7 of the disease and dehydration is a key sign to consider for the management...
October 18, 2018: Minerva Pediatrica
Li-Jun Su, Yu-Liang Wang, Tao Han, Shan Qiao, Ke-Jun Zang, Huai-Kuan Wu, Yong-Xin Su, Ling-Ling Liu, Xue-Wu Liu
Background: Treatment of myoclonic seizures in myoclonic epilepsy with ragged-red fibers (MERRFs) has been empirical and ineffective. Guideline on this disease is not available. Additional trials must be conducted to find more suitable treatments for it. In this study, the antimyoclonic effects of monotherapies, including levetiracetam (LEV), clonazepam (CZP), valproic acid (VPA), and topiramate (TPM) compared to combination therapy group with LEV and CZP on MERRF, were evaluated to find a more advantageous approach on the treatment of myoclonic seizures...
October 20, 2018: Chinese Medical Journal
Zhi-Zhong Li, Ying Tao, Su Wang, Cheng-Qian Yin, Yu-Long Gao, Yu-Tong Cheng, Zhao Li, Chang-Sheng Ma
Background: Unfractionated heparin (UFH), despite its limitations, has been used as the primary anticoagulant alternative during the percutaneous coronary intervention (PCI). Some studies indicated that intravenous enoxaparin could be an effective and safe option. Our team used enoxaparin alone at one time according to the guidelines (Class IIA) and found a little catheter thrombosis during PCI. We recommend a new anticoagulation strategy using enoxaparin in combination with UFH. Enoxaparin has a more predictable anticoagulant response with no need of repeatedly monitoring anticoagulation during PCI...
October 20, 2018: Chinese Medical Journal
M Augustin, A Langenbruch, M Gutknecht, K Reich, A Körber, D Maaßen, U Mrowietz, D Thaçi, R von Kiedrowski, M A Radtke
BACKGROUND: Assessment of disease severity is an essential component of psoriasis management. Moderate-to-severe disease qualifies for systemic treatment but different definitions are used. OBJECTIVES: To analyse the impact of different severity definitions for psoriasis in real-world healthcare. METHODS: Cross-sectional data on 3274 patients with psoriasis from more than 200 dermatology offices and clinics across Germany were analysed for disease severity based on Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI)...
October 17, 2018: British Journal of Dermatology
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