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https://www.readbyqxmd.com/read/28544615/suppressing-inflammation-in-rheumatoid-arthritis-does-patient-global-assessment-blur-the-target-a-practice-based-call-for-a-paradigm-change
#1
Ricardo J O Ferreira, Cátia Duarte, Mwidimi Ndosi, Maarten de Wit, Laure Gossec, J A P da Silva
OBJECTIVES: In current management paradigms of Rheumatoid Arthritis (RA), patient global assessment (PGA) is crucial to decide whether a patient has attained remission (target) or needs reinforced therapy. We investigated whether the clinical and psychological determinants of PGA are appropriate to support this important role. METHODS: This was a cross-sectional, single centre study including consecutive ambulatory RA patients. Data collection comprised swollen (SJC28) and tender joint counts (TJC28), C-Reactive protein (CRP), PGA, pain, fatigue, function, anxiety, depression, happiness, personality traits, and comorbidities...
May 23, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28544460/portable-oxygen-concentrators-versus-oxygen-cylinder-during-walking-in-interstitial-lung-disease-a-randomized-crossover-trial
#2
Yet H Khor, Christine F McDonald, Anita Hazard, Karen Symons, Glen Westall, Ian Glaspole, Nicole S L Goh, Anne E Holland
BACKGROUND AND OBJECTIVE: Ambulatory oxygen therapy is often provided to patients with interstitial lung disease (ILD). Lightweight portable oxygen concentrators (POCs) provide an alternative to traditional portable systems such as compressed oxygen cylinders; however, their efficacy in patients with ILD has not been assessed. This study aimed to evaluate the clinical performance of three ambulatory oxygen systems (two different POCs and a compressed oxygen cylinder) during 6-min walk tests (6MWTs) in patients with ILD and exertional desaturation...
May 23, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28544197/body-mass-index-and-healthcare-costs-a-systematic-literature-review-of-individual-participant-data-studies
#3
REVIEW
Seamus Kent, Francesco Fusco, Alastair Gray, Susan A Jebb, Benjamin J Cairns, Borislava Mihaylova
Excess weight is associated with increased total healthcare costs, but it is less well known how the associations between excess weight and costs vary across different types of healthcare service. We reviewed studies using individual participant data to estimate associations between body mass index and healthcare costs, and summarized how annual healthcare costs for overweight (body mass index 25 to <30 kg/m(2) ) and obese (≥30 kg/m(2) ) individuals compared with those for healthy weight individuals (18...
May 22, 2017: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28544106/inappropriate-prescribing-in-chronic-kidney-disease-a-systematic-review-of-prevalence-associated-clinical-outcomes-and-impact-of-interventions
#4
REVIEW
Wubshet Hailu Tesfaye, Ronald L Castelino, Barbara C Wimmer, Syed Tabish R Zaidi
INTRODUCTION: Adjusting doses of renally cleared medications and/or avoidance of nephrotoxic medications are standard clinical practices in chronic kidney disease (CKD), albeit the prevalence of inappropriate prescribing (IP) in these patients remains high. Therefore, this work sought to systematically review the prevalence of IP and compare the relative effectiveness of available interventions in reducing IP in CKD. METHODS: Studies were identified searching PubMed/Medline, EMBASE, Cochrane Library, IPA, Web of Science, Ovid/Medline, CINAHL, and PsychINFO databases...
May 23, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28542661/-benign-acute-childhood-myositis-clinical-series-and-literature-review
#5
Felipe Cavagnaro S M, Alejandra Aird G, Ingrid Harwardt R, Carmen Gloria Marambio Q
Benign acute childhood myositis (BACM) is a rare clinical condition that mainly affects pre-school and school age-children. It is usually preceded by a viral illness, particularly influenza virus infection. OBJECTIVE: To describe a cluster of BACM cases that were seen in a paediatric unit. PATIENTS AND METHODS: A retrospective series of cases that presented with a clinical picture suggestive of BACM between August and November 2012 in the paediatric emergency department of a private clinic...
April 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28542568/nesfatin-1-like-peptide-is-a-novel-metabolic-factor-that-suppresses-feeding-and-regulates-whole-body-energy-homeostasis-in-male-wistar-rats
#6
Kavishankar Gawli, Naresh Ramesh, Suraj Unniappan
Nucleobindin-1 has high sequence similarity to nucleobindin-2, which encodes the anorectic and metabolic peptide, nesfatin-1. We previously reported a nesfatin-1-like peptide (NLP), anorectic in fish and insulinotropic in mice islet beta-like cells. The main objective of this research was to determine whether NLP is a metabolic regulator in male Wistar rats. A single intraperitoneal (IP) injection of NLP (100 μg/kg BW) decreased food intake and increased ambulatory movement, without causing any change in total activity or energy expenditure when compared to saline-treated rats...
2017: PloS One
https://www.readbyqxmd.com/read/28542281/gait-asymmetry-ankle-spasticity-and-depression-as-independent-predictors-of-falls-in-ambulatory-stroke-patients
#7
Ta-Sen Wei, Peng-Ta Liu, Liang-Wey Chang, Sen-Yung Liu
BACKGROUND: Falls are the leading cause of injury in stroke patients. However, the cause of a fall is complicated, and several types of risk factors are involved. Therefore, a comprehensive model to predict falls with high sensitivity and specificity is needed. METHODS: This study was a prospective study of 112 inpatients in a rehabilitation ward with follow-up interviews in patients' homes. Evaluations were performed 1 month after stroke and included the following factors: (1) status of cognition, depression, fear of fall and limb spasticity; (2) functional assessments [walking velocity and the Functional Independence Measure (FIM)]; and (3) objective, computerized gait and balance analyses...
2017: PloS One
https://www.readbyqxmd.com/read/28542089/patients-confidence-in-methods-of-blood-pressure-assessment-and-their-reported-adherence-to-antihypertensive-medications
#8
Paul Alvarez, Jennifer Zeng, Laura Tuttle, Anthony J Viera
OBJECTIVE: Adherence to antihypertensive medications is often less than optimal. Research suggests that patients have limited confidence regarding whether office blood pressure (BP) assessments represent their 'true' BP, which may further promote poor adherence to BP-lowering medication. We assessed peoples' confidence in the methods of BP assessment and examined the associations between patients' confidence levels and medication adherence comparing office and home BP-monitoring techniques...
May 24, 2017: Blood Pressure Monitoring
https://www.readbyqxmd.com/read/28541965/increasing-health-portal-utilization-in-cardiac-ambulatory-patients-a-pilot-project
#9
Carmen L Shaw, Gayle L Casterline, Dennis Taylor, Maureen Fogle, Bradi Granger
Increasing health portal participation actively engages patients in their care and improves outcomes. The primary aim for this project was to increase patient health portal utilization. Nurses used a tablet-based demo to teach patients how to navigate the health portal. Assigning health videos to the portal was a tactic used to increase utilization. Each patient participant was surveyed about health portal utilization at initial nurse navigator appointment, day of procedure, and 30 days after discharge. Seventy-three percent (n = 14) of the 19 selected patients received the intervention; 36% (n = 4) of patients reported using a health portal feature; meaningful use metric preintervention increased from 12% to 16% after the intervention; 16% and 18% of patients viewed assigned videos in their health portal prior to procedure and after hospital discharge...
May 25, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28541913/virtual-spirometry-and-activity-monitoring-using-multichannel-electrical-impedance-plethysmographs-in-ambulatory-settings
#10
Hassan Aqeel Khan, Amit Gore, Jeffrey Ashe, Shantanu Chakrabartty
Continuous monitoring of respiratory patterns and physical activity levels can be useful for remote health management of patients with conditions such as heart disease and chronic obstructive pulmonary disease. In a clinical setting, spirometers serve as the gold standard for monitoring respiratory patterns such as breathing rate and changes in lung volume. However, direct measurements using a spirometer requires placement of a sensor in the patient's airway and is thus infeasible for continuous monitoring in nonclinical, ambulatory settings...
May 23, 2017: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/28541137/clinical-use-of-continuous-glucose-monitoring-in-adults-with-type-2-diabetes
#11
Anders L Carlson, Deborah M Mullen, Richard M Bergenstal
Hemoglobin A1c is an excellent population health measure for the risk of vascular complications in diabetes, while continuous glucose monitoring (CGM) is a tool to help personalize a diabetes treatment plan. The value of CGM in individuals with type 1 diabetes (T1D) has been well demonstrated when compared with utilizing self-monitoring of blood glucose (SMBG) to guide treatment decisions. CGM is a tool for patients and clinicians to visualize the important role that diet, exercise, stress management, and the appropriate selection of diabetes medications can have in managing type 2 diabetes (T2D)...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28540339/leukocyte-telomere-length-and-serum-levels-of-high-molecular-weight-adiponectin-and-dehydroepiandrosterone-sulfate-could-reflect-distinct-aspects-of-longevity-in-japanese-centenarians
#12
Yuji Aoki, Masato Aoki, Kazuya Yamada
Leukocyte telomere length and serum levels of high-molecular-weight adiponectin and dehydroepiandrosterone-sulfate (DHEA-S) were assessed in association with nutrition and performance status (PS) in Japanese centenarians. Twenty-three centenarians (five men, 18 women) were classified according to their PS 1 (nearly fully ambulatory, n = 2), 2 (in bed less than 50% of daytime, n = 10), 3 (in bed greater than 50%, n = 6), and 4 (completely bedridden, n = 5). Leukocyte telomere length was determined by the hybridization protection assay, and the adiponectin and DHEA-S levels were measured by chemiluminescent enzyme immunoassay...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28540084/body-composition-and-metabolic-syndrome-components-on-lipodystrophy-different-subtypes-associated-with-hiv
#13
Livia Bertazzo Sacilotto, Paulo Câmara Marques Pereira, João Paulo Vieira Manechini, Sílvia Justina Papini
HIV-associated lipodystrophy syndrome (HALS) is characterized by body fat redistribution as a consequence of the antiretroviral therapy (ART) introduction, associated with an increased risk of cardiovascular disease development. Subjective diagnosis, classified between three subtypes according to the body region on which fat is lost and/or accumulated, named lipoatrophy, lipohypertrophy, and mixed lipodystrophy, is possibly accompanied with metabolic alterations. Forty people living with HIV/AIDS (PLHA), with clinical diagnosis of HALS and from both genders, were assessed...
2017: Journal of Nutrition and Metabolism
https://www.readbyqxmd.com/read/28540039/successful-withdrawal-from-high-dose-benzodiazepine-in-a-young-patient-through-electronic-monitoring-of-polypharmacy-a-case-report-in-an-ambulatory-setting
#14
REVIEW
Hèctor R Loscertales, Valerie Wentzky, Kenneth Dürsteler, Johannes Strasser, Kurt E Hersberger, Isabelle Arnet
BACKGROUND: Dependence on high-dose benzodiazepines (BZDs) is well known and discontinuation attempts are generally unsuccessful. A well established protocol for high-dose BZD withdrawal management is lacking. We present the case of withdrawal from high-dose lorazepam (>20 mg daily) in an unemployed 35-year-old male outpatient through agonist substitution with long-acting clonazepam and electronic monitoring over 28 weeks. METHODS: All medicines were repacked into weekly 7 × 4 cavity multidose punch cards with an electronic monitoring system...
May 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28539477/bacterial-colonization-and-succession-in-a-newly-opened-hospital
#15
Simon Lax, Naseer Sangwan, Daniel Smith, Peter Larsen, Kim M Handley, Miles Richardson, Kristina Guyton, Monika Krezalek, Benjamin D Shogan, Jennifer Defazio, Irma Flemming, Baddr Shakhsheer, Stephen Weber, Emily Landon, Sylvia Garcia-Houchins, Jeffrey Siegel, John Alverdy, Rob Knight, Brent Stephens, Jack A Gilbert
The microorganisms that inhabit hospitals may influence patient recovery and outcome, although the complexity and diversity of these bacterial communities can confound our ability to focus on potential pathogens in isolation. To develop a community-level understanding of how microorganisms colonize and move through the hospital environment, we characterized the bacterial dynamics among hospital surfaces, patients, and staff over the course of 1 year as a new hospital became operational. The bacteria in patient rooms, particularly on bedrails, consistently resembled the skin microbiota of the patient occupying the room...
May 24, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28539381/impact-of-chamber-dilatation-on-the-prognostic-value-of-left-ventricular-geometry-in-hypertension
#16
Paolo Verdecchia, Fabio Angeli, Giovanni Mazzotta, Claudia Bartolini, Marta Garofoli, Adolfo Aita, Cristina Poltronieri, Maria Gabriella Pinzagli, Francesca Valecchi, Stefania Martone, Elisa Ramundo, Dario Turturiello, Gianpaolo Reboldi
BACKGROUND: The different geometric patterns of the left ventricle may or may not coexist with chamber dilatation. The prognostic impact of such a combination is unclear. METHODS AND RESULTS: We studied a cohort of 2635 initially untreated patients with hypertension, mean age 50 years. At entry, 24-hour ambulatory blood pressure progressively increased across the patterns of normal geometry, concentric left ventricular (LV) remodeling, eccentric nondilated LV hypertrophy (LVH), eccentric dilated LVH, concentric nondilated LVH, and concentric dilated LVH...
May 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28538811/patient-survival-and-risk-of-death-after-prostate-cancer-treatment-in-the-brazilian-unified-health-system
#17
Sonia Faria Mendes Braga, Mirian Carvalho de Souza, Raphael Romie de Oliveira, Eli Iola Gurgel Andrade, Francisco de Assis Acurcio, Mariangela Leal Cherchiglia
OBJECTIVE: Analyze the probability of specific survival and factors associated with the risk of death of patients with prostate cancer who received outpatient cancer treatment in the Brazilian Unified Health System, Brazil. METHODS: Retrospective cohort study using the National Database of Oncology, developed through the deterministic-probabilistic pairing of health information systems: outpatient (SIA), hospital (SIH) and mortality (SIM). The probability of overall and specific survival was estimated by the time elapsed between the date of the first ambulatory treatment, from 2002 to 2003, until the patient's death or the end of the study...
May 15, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28538452/proximal-femoral-shortening-after-cephalomedullary-nail-insertion-for-intertrochanteric-fractures
#18
Ron Gilat, Omri Lubovsky, Ehud Atoun, Ronen Debi, Ornit Cohen, Yoram A Weil
OBJECTIVE: To assess the incidence of proximal femoral shortening (PFS) and its effect on the patient outcomes when intertrochanteric fractures were treated with a cephalomedullary nail (CMN). DESIGN: Retrospective cohort study. SETTINGS: Level II trauma center. PATIENTS: Forty-eight consecutive patients with OTA/AO 31-A intertrochanteric fractures. INTERVENTION: All patients were treated with a Gamma3 CMN (Stryker, Kalamazoo, MI)...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28537660/relation-between-blood-pressure-variability-and-early-renal-damage-in-hypertensive-patients
#19
L-H Yin, W-J Yan, Z-X Guo, F-Z Zhou, H-Y Zhang
OBJECTIVE: The objective of the present study was to observe the relation between blood pressure variability (BPV) and early renal damage in hypertensive patients. PATIENTS AND METHODS: A total of 118 hypertensive patients were consecutively selected. General parameters including sex, age, duration, and grade of hypertension, antihypertensive drugs taken, smoking status, blood sugar, blood lipid level, body mass index, indexes of 24-h ambulatory blood pressure monitoring and renal function including cystatin C (CysC), serum creatinine (SCr), angiotensin II (Ang II), microalbuminuria (mALb), and urine creatinine (UCr) were measured...
May 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28537547/increasing-proportion-of-carbapenemase-producing-enterobacteriaceae-and-emergence-of-a-mcr-1-producer-through-a-multicentric-study-among-hospital-based-and-private-laboratories-in-belgium-from-september-to-november-2015
#20
Te Din Huang, Pierre Bogaerts, Catherine Berhin, Martin Hoebeke, Caroline Bauraing, Youri Glupczynski
Carbapenemase-producing Enterobacteriaceae (CPE) strains have been increasingly reported in Belgium. We aimed to determine the proportion of CPE among Enterobacteriaceae isolated from hospitalised patients and community outpatients in Belgium in 2015. For the hospitalised patients, the results were compared to a previous similar survey performed in the same hospitals in 2012. Twenty-four hospital-based and 10 private laboratories collected prospectively 200 non-duplicated Enterobacteriaceae isolates from clinical specimens...
May 11, 2017: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
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