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Clinical disease guidelines

Carsten Gutt, Christian Jenssen, Ana-Paula Barreiros, Thorsten O Götze, Caroline S Stokes, Petra Lynen Jansen, Michael Neubrand, Frank Lammert
This guideline provides evidence-based key recommendations for the prevention, diagnosis and therapy of gallstones and upgrades the 2007 version. The guideline was developed by an interdisciplinary team of gastroenterologists and surgeons, and patient support groups under the auspice of the German Society for Gastroenterology and Metabolic Diseases and the German Society for General Surgery and Surgery of the Alimentary Tract. The guideline used structural S3 consensus-based methodology and includes statements on clinical practice, medical education, prevention, quality assurance, outcome analysis, and integration of outpatient and inpatient care for patients with gallstone diseases...
August 2018: Zeitschrift Für Gastroenterologie
Allan Pillay
Syphilis, caused by the bacterium Treponema pallidum, is on the rise in the United States particularly among men who have sex with men. The disease is complex with varied clinical manifestations and challenges remain in the laboratory diagnostic setting because T. pallidum is noncultivable and no single test can accurately diagnose all stages of the disease. There are missed opportunities for the use of direct detection tests in primary and secondary syphilis. The increasing use of different reverse sequence algorithms for serology testing without validation in populations with varying risks for syphilis makes the interpretation of test results difficult; this has led to concerns about diagnostic errors or overtreatment...
September 2018: Sexually Transmitted Diseases
Lindy Zhang, Allison M Martin, Kathy Ruble
Pediatric oncology patients treated with antineoplastic therapy have impaired immune systems that lead to loss of protective antibodies. They require reimmunization to protect against vaccine-preventable diseases. There are a paucity of studies on the clinical practice of pediatric oncologists and the available recommendations are heterogenous. This study describes current reimmunization practices among pediatric oncologists. We surveyed the Children's Oncology Group (COG)-identified principle investigators to capture clinical practices among pediatric oncologists within their institutions regarding reimmunization of non-hematopoietic stem cell transplantation patients...
August 10, 2018: Journal of Pediatric Hematology/oncology
Mitchell L Schubert
PURPOSE OF REVIEW: The present review summarizes the past year's literature, both clinical and basic science, regarding potential adverse effects of proton pump inhibitors. RECENT FINDINGS: Proton pump inhibitors are amongst the most widely prescribed and overprescribed medications worldwide. Although generally considered well tolerated, epidemiologic studies mining large databases have reported a panoply of purported serious adverse effects associated with proton pump inhibitors, including chronic kidney disease, cognitive decline, myocardial infarction, stroke, bone fracture and even death...
August 9, 2018: Current Opinion in Gastroenterology
Katie Beadon, Raquel Guimarães-Costa, Jean-Marc Léger
PURPOSE OF REVIEW: Multifocal motor neuropathy (MMN) has specific clinical and electrophysiologic features but can be difficult to diagnose if cases are not typical. Intravenous immunoglobulin (IVIg) remains the core initial and long-term treatment. In this review, recent advances in the diagnosis, monitoring and treatment of MMN are discussed. RECENT FINDINGS: The pathology of MMN likely depends on immune-mediated attack of the nodes of Ranvier and paranodal regions leading to conduction block...
August 9, 2018: Current Opinion in Neurology
Stefan Rutkowski, Piergiorgio Modena, Daniel Williamson, Kornelius Kerl, Karsten Nysom, Barry Pizer, Ute Bartels, Stephanie Puget, François Doz, Antony Michalski, Katja von Hoff, Mathilde Chevignard, Shivaram Avula, Matthew J Murray, Stefan Schönberger, Thomas Czech, Antoinette Y N Schouten-van Meeteren, Uwe Kordes, Christof M Kramm, Dannis G van Vuurden, Esther Hulleman, Geert O Janssens, Guirish A Solanki, Marie-Luise C van Veelen, Ulrich Thomale, Martin U Schuhmann, Chris Jones, Felice Giangaspero, Dominique Figarella-Branger, Torsten Pietsch, Steve C Clifford, Stefan M Pfister, Stefaan W Van Gool
Paediatric CNS tumours are the most common cause of childhood cancer-related morbidity and mortality, and improvements in their diagnosis and treatment are needed. New genetic and epigenetic information about paediatric CNS tumours is transforming the field dramatically. For most paediatric CNS tumour entities, subgroups with distinct biological characteristics have been identified, and these characteristics are increasingly used to facilitate accurate diagnoses and therapeutic recommendations. Future treatments will be further tailored to specific molecular subtypes of disease, specific tumour predisposition syndromes, and other biological criteria...
August 2018: Lancet Oncology
Jennifer P Lundine, Robert Dempster, Kirby Carpenito, Holly Miller-Tate, Wendelin Burdo-Hartman, Elizabeth Halpin, Omar Khalid
BACKGROUND: Swallowing dysfunction is a known complication for infants with complex congenital heart disease (CHD), but few studies have examined swallowing outcomes following the hybrid procedure for stage 1 palliation in children with single ventricle physiology. OBJECTIVES: (1) Identify the incidence of aspiration in all infants with single ventricle physiology who underwent the hybrid procedure and (2) Compare results of clinical bedside and instrumental swallowing evaluations to examine the predictive value of a less invasive swallowing assessment for this population of high-risk infants...
August 12, 2018: Congenital Heart Disease
Carina T Domingues, Milan Milojevic, Daniel J F M Thuijs, Nicolas M van Mieghem, Joost Daemen, Ron T van Domburg, A Pieter Kappetein, Stuart J Head
OBJECTIVES: The Heart Team has been recommended as standard care for patients with coronary artery disease (CAD). However, little is known about the real benefits, potential treatment delays and late outcomes of this approach. Our goal was to determine the safety and feasibility of multidisciplinary Heart Team decision making for patients with CAD. METHODS: We retrospectively assessed 1000 consecutive cases discussed by the Heart Team between November 2010 and January 2012...
August 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Tebit E Kwenti
Malaria and HIV, two of the world's most deadly diseases, are widespread, but their distribution overlaps greatly in sub-Saharan Africa. Consequently, malaria and HIV coinfection (MHC) is common in the region. In this paper, pertinent publications on the prevalence, impact, and treatment strategies of MHC obtained by searching major electronic databases (PubMed, PubMed Central, Google Scholar, ScienceDirect, and Scopus) were reviewed, and it was found that the prevalence of MHC in SSA was 0.7%-47.5% overall...
2018: Research and Reports in Tropical Medicine
Eldad Ben-Chetrit, Marco Gattorno, Ahmet Gul, Daniel L Kastner, Helen J Lachmann, Isabelle Touitou, Nicolino Ruperto
Autoinflammatory diseases (AIDs) are a relatively new family of disorders, defined about 19 years ago. Some of them are hereditary and some are not. The names given to these diseases do not follow any systematic guidelines, and sometimes the same disorder carries several names. The aim of this study is to refine the definition of AIDs and to provide some conventions for their naming. We focused mainly on monogenetic AIDs. Delphi technique, which enables consensus among a group of experts through internet and mail communication and questionnaires, was employed...
August 12, 2018: Annals of the Rheumatic Diseases
Jeremy R Glissen Brown, Prashant Singh
Coeliac disease (CD) develops in genetically susceptible individuals who, in response to unclear environmental triggers, develop an immune response triggered by gluten ingestion. It is now recognised as a global disease affecting about 0.7% of the world's population. The clinical presentation ranges from malabsorption to asymptomatic individuals diagnosed by screening high-risk groups. Diagnosis requires the demonstration of small intestinal villous atrophy in the presence of circulating coeliac auto-antibodies and/or an unequivocal response to a gluten-free diet (GFD)...
August 13, 2018: Paediatrics and International Child Health
Kevin C Heslin, Marguerite L Barrett
BACKGROUND: In October 2015, the United States transitioned health care diagnosis codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to the Tenth Revision (ICD-10-CM). Trend analyses of alcohol-related stays could show discontinuities solely from the change in classification systems. This study examined the impact of the ICD-10-CM coding system on estimates of hospital stays involving alcohol-related diagnoses. METHODS: This analysis used 2014-2017 administrative data from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project State Inpatient Databases for 17 states...
August 12, 2018: Alcoholism, Clinical and Experimental Research
Fernanda Barbosa C Rocha, Ana Beatriz Falcone, Antonio Carlos Buzaid, Juliana Martins Pimenta, Gustavo Schvartsman, Antonio Luiz Frasson
PURPOSE: Breast cancer neoadjuvant chemotherapy (NAC) consists of the administration of cytotoxic and targeted drugs prior to breast surgery, with the objective of reducing the tumor burden to allow breast conservation. NAC also aims to improve long-term treatment outcomes such as disease-free and overall survival. To optimize clinical practice with the best available evidence for breast cancer patients in the setting of neoadjuvant treatment, the Brazilian Society of Breast Surgeons (Sociedade Brasileira de Mastologia-SBM) held a consensus conference to develop this guideline...
August 11, 2018: Breast Cancer Research and Treatment
Daniel J Lee, Zhiguo Zhao, Li-Ching Huang, Tatsuki Koyoma, Matthew J Resnick, David F Penson, Daniel A Barocas, Karen E Hoffman
PURPOSE: Racial disparities are apparent in the management and outcomes for prostate cancer; however, disparities in compliance to quality measures for radiation therapy for prostate cancer have not been previously studied. Therefore, the goal of the study was to characterize disparities in the compliance rates with quality measures. METHODS: The comparative effectiveness analysis of radiation therapy and surgery study is a population-based, prospective cohort study that enrolled 3708 men with clinically localized prostate cancer from 2011 to 2012...
August 11, 2018: Cancer Causes & Control: CCC
Melissa A Markowitz, Lauren N Wood, Shlomo Raz, Loren G Miller, David A Haake, Ja-Hong Kim
INTRODUCTION AND HYPOTHESIS: Acute, uncomplicated cystitis is one of the most common bacterial infections seen in clinical practice. Quality improvement and antibiotic stewardship efforts to optimize cystitis management rely on clinicians managing patients in a manner recommended by experts and guidelines. However, it is unclear if recent recommendations for cystitis from experts and guidelines from US medical societies that provide recommendations are well aligned. METHODS: We examined recommendations and guidelines for acute, symptomatic cystitis in women published in US medical societies' journals from January 1, 2008, to December 31, 2016, within the fields of family medicine, obstetrics and gynecology, internal medicine, female pelvic medicine and reconstructive surgery, and infectious diseases...
August 11, 2018: International Urogynecology Journal
A Hillary Steinhart, Remo Panaccione, Laura Targownik, Brian Bressler, Reena Khanna, John K Marshall, Waqqas Afif, Charles N Bernstein, Alain Bitton, Mark Borgaonkar, Usha Chauhan, Brendan Halloran, Jennifer Jones, Erin Kennedy, Grigorios I Leontiadis, Edward V Loftus, Jonathan Meddings, Paul Moayyedi, Sanjay Murthy, Sophie Plamondon, Greg Rosenfeld, David Schwartz, Cynthia H Seow, Chadwick Williams
Background: Fistulas occur in about 25% of patients with Crohn's disease (CD) and can be difficult to treat. The aim of this consensus was to provide guidance for the management of patients with perianal fistulizing CD. Methods: A systematic literature search identified studies on the management of fistulizing CD. The quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach...
August 6, 2018: Inflammatory Bowel Diseases
Jordan A Holmes, Roger F Anderson, Leroy G Hoffman, Timothy N Showalter, Mohit Kasibhatla, Sean P Collins, Michael A Papagikos, Brittany D Barbosa, Lori J Stravers, Zahra Mahbooba, Andrew Z Wang, Ronald C Chen
BACKGROUND: Prostate cancer survivors who receive androgen deprivation therapy (ADT) are at increased risk of cardiovascular disease. They require coordinated care between cancer specialist and primary care physicians (PCPs) to monitor for cancer control and manage cardiovascular risk factors. METHODS: We prospectively enrolled 103 men receiving ADT with radiotherapy from 7 institutions to assess cardiovascular risk factors and survivorship care. Medical records, fasting labs, and patient-reported outcomes using a validated instrument were assessed at baseline (pre-treatment) and 1 year post-RT...
August 9, 2018: International Journal of Radiation Oncology, Biology, Physics
Corrado Garbazza, Mauro Manconi
Restless legs syndrome/Willis-Ekbom disease is a common disorder during pregnancy that may significantly impact on the health of affected women, leading to negative consequences in the short and long term. An accurate diagnosis helps to recognize the syndrome and choose the optimal therapeutic strategy, based on the characteristics and needs of the patient. This article summarizes the main treatment options recommended by the consensus clinical guidelines of the International Restless Legs Syndrome Study Group and provides a short guide to the management of restless leg syndrome during pregnancy in clinical practice...
September 2018: Sleep Medicine Clinics
Nicole J Boczek, Katharina Hopp, Lacey Benoit, Daniel Kraft, Margot A Cousin, Patrick R Blackburn, Charles D Madsen, Gavin R Oliver, Asha A Nair, Jie Na, Diana W Bianchi, Geoffrey Beek, Peter C Harris, Pavel Pichurin, Eric W Klee
Whole exome sequencing (WES) is utilized in diagnostic odyssey cases to identify the underlying genetic cause associated with complex phenotypes. Recent publications suggest that WES reveals the genetic cause in ~25% of these cases and is most successful when applied to children with neurological disease. The residual 75% of cases remain genetically elusive until more information becomes available in the literature or functional studies are pursued. WES performed on three families with presumed ciliopathy diagnoses, including orofaciodigital (OFD) syndrome, fetal encephalocele, or Joubert-related disorder, identified compound heterozygous variants in C2CD3...
August 10, 2018: European Journal of Human Genetics: EJHG
Konstantinos Assimakopoulos, Katerina Karaivazoglou, Evangelia-Eirini Tsermpini, Georgia Diamantopoulou, Christos Triantos
OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent medical condition, which may lead to severe complications including cirrhosis and hepatocellular carcinoma. Its chronic course and its association with obesity and diabetes mellitus augment the long-term impact of NAFLD on patients' health and quality of life (QoL) and put great strain on healthcare systems worldwide. Research is growingly focusing on NAFLD patients' QoL in an attempt to describe the full spectrum of disease burden and tackle its future consequences...
September 2018: Journal of Psychosomatic Research
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