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https://www.readbyqxmd.com/read/28742762/kdigo-clinical-practice-guideline-on-the-evaluation-and-care-of-living-kidney-donors
#1
Krista L Lentine, Bertram L Kasiske, Andrew S Levey, Patricia L Adams, Josefina Alberú, Mohamed A Bakr, Lorenzo Gallon, Catherine A Garvey, Sandeep Guleria, Philip Kam-Tao Li, Dorry L Segev, Sandra J Taler, Kazunari Tanabe, Linda Wright, Martin G Zeier, Michael Cheung, Amit X Garg
The 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors is intended to assist medical professionals who evaluate living kidney donor candidates and provide care before, during and after donation. The guideline development process followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guideline recommendations are based on systematic reviews of relevant studies that included critical appraisal of the quality of the evidence and the strength of recommendations...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28742730/predictive-model-for-neoplastic-potential-of-gallbladder-polyp
#2
Ju-Il Yang, Jong Kyun Lee, Dae Geon Ahn, Joo Kyung Park, Kwang Hyuck Lee, Kyu Taek Lee, Sang Ah Chi, Sin-Ho Jung
GOAL: To provide the statistical predictive model for neoplastic potential of gallbladder polyp (GBP). BACKGROUND: Many studies have attempted to define the risk factors for neoplastic potential of GBP. It remains difficult to precisely adapt the reported risk factors for the decision of surgery. Estimating the probability for neoplastic potential of GBP using a combination of several risk factors before surgical resection would be useful in patient consultation...
July 24, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28742539/translating-evidence-into-practice-in-acute-respiratory-distress-syndrome-teamwork-clinical-decision-support-and-behavioral-economic-interventions
#3
Michael W Sjoding
PURPOSE OF REVIEW: Although the treatment of the acute respiratory distress syndrome (ARDS) with low tidal volume (LTV) mechanical ventilation improves mortality, it is not consistently administered in clinical practice. This review examines strategies to improve LTV and other evidence-based therapies for patients with ARDS. RECENT FINDINGS: Despite the well established role of LTV in the treatment of ARDS, a recent multinational study suggests it is under-utilized in clinical practice...
July 22, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28742215/complementary-and-alternative-medicine-use-among-us-adults-with-headache-or-migraine-results-from-the-2012-national-health-interview-survey
#4
Yan Zhang, Jeff A Dennis, Matthew J Leach, Felicity L Bishop, Holger Cramer, Vincent C H Chung, Craig Moore, Romy Lauche, Ron Cook, David Sibbritt, Jon Adams
BACKGROUND: Given the safety concerns regarding pharmacological agents, and the considerable impact of headache and migraine on the sufferer's quality of life, many people seek other treatment options beyond conventional medication and care to address their symptoms; this includes complementary and alternative medicine (CAM). Some CAM interventions have shown promising results in clinical trials of headache and migraine management. Nonetheless, there has been little research exploring the reasons for using CAM, and the types of CAM used, among this population...
July 25, 2017: Headache
https://www.readbyqxmd.com/read/28741408/appropriateness-of-tympanostomy-tubes-in-the-boston-metropolitan-area-are-the-aao-hnsf-guidelines-being-met
#5
Amy L Hughes, David Roberson, Cassandra Bannos, Emily K Trudell, Louis Vernacchio
Introduction Otitis media (OM) is the most common reason children receive general anesthesia, with bilateral tympanostomy tube (TT) insertion the second most common surgery in children. Prior research suggests overuse of TT. As part of a project designed to improve appropriateness of OM referrals, we evaluated appropriateness of TT insertion in a patient cohort. Methods Patients younger than 9 years with initial otolaryngology (ORL) visits in academic and private office settings for OM from January 1, 2012, to August 31, 2013, were identified through claims database...
July 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28741391/clinical-implications-benefits-and-pitfalls-of-using-and-reversing-non-vitamin-k-antagonist-oral-anticoagulants
#6
Alexandra S Moss, Gerasimos Dimitropoulos, Gregory Y H Lip
The use of non-Vitamin K antagonist oral anticoagulant (NOAC) drugs is increasingly common in clinical practice. As compared to vitamin K antagonists they are more straightforward to initiate, require no hematological monitoring and offer potentially more stable therapeutic indices. Concern has been raised with regard to their safety profiles particularly in the context of acute reversal in major bleeding. Further issues pertain to patient concordance. Areas Covered: This review article aims to provide an overview of the current evidence relating to NOAC safety as well as the management of NOAC-related major bleeding with particular emphasis on reversal agents in use and in development following a selective literature review...
July 25, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28740667/discordance-of-physician-clinical-judgment-vs-pneumonia-severity-index-psi-score-to-admit-patients-with-low-risk-community-acquired-pneumonia-a-prospective-multicenter-study
#7
Pedro J Marcos, Marcos I Restrepo, Francisco J González-Barcala, Nilam J Soni, Iria Vidal, Pilar Sanjuàn, Diego Llinares, Lucía Ferreira-Gonzalez, Carlos Rábade, Isabel Otero-González, Pedro Marcos, Héctor Verea-Hernando
BACKGROUND: The relationship between clinical judgment and the pneumonia severity index (PSI) score in deciding the site of care for patients with community-acquired pneumonia (CAP) has not been well investigated. The objective of the study was to determine the clinical factors that influence decision-making to hospitalize low-risk patients (PSI ≤2) with CAP. METHODS: An observational, prospective, multicenter study of consecutive CAP patients was performed at five hospitals in Spain...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740665/decrease-in-performance-status-after-lobectomy-mean-poor-prognosis-in-elderly-lung-cancer-patients
#8
Yo Kawaguchi, Jun Hanaoka, Yasuhiko Oshio, Masayuki Hashimoto, Tomoyuki Igarashi, Yoko Kataoka, Ryosuke Kaku, Yuki Namura, Akira Akazawa
BACKGROUND: Surgery remains the best treatment for obtaining cure in patients with resectable lung cancer, regardless of age. In elderly patients, however, the presumed fear of decreased performance status (PS) after lobectomy has resulted in the delivery of sub-optimal cancer surgery. Surgical decision making for such patients would become easier if post-lobectomy survival benefits and changes in PS were well defined. METHODS: We reviewed patients aged 75 years or older who received lobectomy for non-small cell lung cancer (NSCLC) at our hospital between January 2004 and December 2014...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740410/genotyping-of-hbv-and-tracking-of-resistance-mutations-in-treatment-na%C3%A3-ve-patients-with-chronic-hepatitis-b
#9
Sidelcina Rugieri Pacheco, Maria Isabel Magalhães Andrade Dos Santos, Andreas Stocker, Maria Alice Sant'Anna Zarife, Maria Isabel Schinoni, Raymundo Paraná, Mitermayer Galvão Dos Reis, Luciano Kalabric Silva
BACKGROUND AND AIMS: Resistance mutation analogs to nucleos(t)ides have been described in treatment-naïve patients with chronic hepatitis B (CHB), with clinical implications. The aim of this study was to investigate primary resistance mutations and genotypes circulating in patients naïve to chronic hepatitis B, in the Northern and Northeastern regions of Brazil. METHODS: We conducted a study of resistance mutations and genotypic characterization of hepatitis B virus (HBV) in 189 treatment-naïve patients chronically infected with HBV...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28739626/patient-reported-outcome-measures-proms-enhancing-decision-making-and-follow-up
#10
Robert Walker, Anthony Thomas Gough, Dan H Williams
A case presentation of patient undergoing elective total knee replacement. Patient-reported outcome measures prospectively collected electronically pre and postoperatively allowed real-time review, aiding follow-up and reducing the need for clinical, face-to-face follow-up.
July 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28739478/an-overview-of-clinical-guidelines-for-the-management-of-vertebral-compression-fracture-a-systematic-review
#11
REVIEW
Patrícia Parreira, Chris G Maher, Rodrigo Z Megale, Lyn March, Manuela L Ferreira
BACKGROUND CONTEXT: Vertebral compression fractures are the most common type of osteoporotic fracture comprising approximately 1.4 million cases worldwide. Clinical practice guidelines can be powerful tools for promoting evidence-based practice, as they integrate research findings in order to support decision-making. However, currently available clinical guidelines and recommendations, established by different medical societies, are sometimes contradictory. PURPOSE: The aim of this study was to appraise the recommendations and methodological quality of international clinical guidelines for the management of VCFs...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28739455/decision-making-in-critical-limb-ischemia-a-markov-simulation
#12
Aaron J Deutsch, C Charles Jain, Kimberly G Blumenthal, Mark W Dickinson, Anne M Neilan
BACKGROUND: Critical limb ischemia (CLI) is a feared complication of peripheral vascular disease that often requires surgical management and may require amputation of the affected limb. OBJECTIVE: To use a decision model to inform clinical management for a 63-year-old woman with CLI and multiple medical comorbidities, including advanced heart failure and diabetes. METHODS: Markov decision model evaluating four strategies: amputation, surgical bypass, endovascular therapy (e...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739202/the-relationship-between-dietary-intake-growth-and-body-composition-in-phenylketonuria
#13
Maureen Evans, Helen Truby, Avihu Boneh
AIM: Phenylketonuria (PKU) is an inborn error of protein metabolism that results from perturbation in phenylalanine hydroxylase activity leading to elevated blood levels of phenylalanine (phe). We aimed to explore the relationships between dietary patterns (total-protein, natural-protein, amino-acid formula), and the ratio of protein to energy intake with growth and body composition. METHOD: Longitudinal prospective data (1-6 measurements) of growth, dietary intake and body composition in patients treated with phe-restricted diet only (D-PKU; n=32), and tetrahydrobiopterin (BH4)±phe-restricted diet (BH4-PKU; n=5) were collected over a two-year period...
July 20, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28738746/how-do-clinical-competency-committees-use-different-sources-of-data-to-assess-residents-performance-on-the-internal-medicine-milestones-a-mixed-methods-pilot-study
#14
Andem Ekpenyong, Elizabeth Baker, Ilene Harris, Ara Tekian, Richard Abrams, Shalini Reddy, Yoon Soo Park
PURPOSE: This study examines how Clinical Competency Committees (CCCs) synthesize assessment data to make judgments about residents' clinical performances. METHODS: Between 2014 and 2015, after four six-month reporting periods to the Accreditation Council for Graduate Medical Education (ACGME), 7 of 16 CCC faculty at Rush University Medical Center completed questionnaires focused on their perspectives about rating residents on their achievement of the milestones and participated in a focus group...
July 25, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28738325/a-proposal-of-the-european-association-for-the-study-of-obesity-to-improve-the-icd-11-diagnostic-criteria-for-obesity-based-on-the-three-dimensions-etiology-degree-of-adiposity-and-health-risk
#15
Johannes Hebebrand, Jens-Christian Holm, Euan Woodward, Jennifer Lyn Baker, Ellen Blaak, Dominique Durrer Schutz, Nathalie J Farpour-Lambert, Gema Frühbeck, Jason G C Halford, Lauren Lissner, Dragan Micic, Dana Mullerova, Gabriela Roman, Karin Schindler, Hermann Toplak, Tommy L S Visscher, Volkan Yumuk
Diagnostic criteria for complex medical conditions caused by a multitude of both genetic and environmental factors should be descriptive and avoid any attribution of causality. Furthermore, the wording used to describe a disorder should be evidence-based and avoid stigmatization of the affected individuals. Both terminology and categorizations should be readily comprehensible for healthcare professionals and guide clinical decision making. Uncertainties with respect to diagnostic issues and their implications may be addressed to direct future clinical research...
July 22, 2017: Obesity Facts
https://www.readbyqxmd.com/read/28738000/comparison-of-cardiac-output-measured-by-use-of-computed-tomography-and-thermodilution-in-dogs
#16
Sharon Tenenbaum, Fernando L Garcia-Pereira, Clifford R Berry, Tori Obert
OBJECTIVE To compare cardiac output (CO) measured by use of CT coronary angiography and thermodilution (criterion-referenced standard) at various CO values, record adverse effects, and determine the time needed to measure CO. ANIMALS 5 healthy purpose-bred Beagles (2 males and 3 females). PROCEDURES A prospective nonrandomized crossover study was conducted. Dogs were premedicated with butorphanol tartrate (0.2 mg•kg(-1), IM). Anesthesia was induced by IV administration of etomidate (1 to 2 mg•kg(-1)) and midazolam (0...
August 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28737659/summary-of-kidney-disease-improving-global-outcomes-kdigo-clinical-practice-guideline-on-the-evaluation-and-care-of-living-kidney-donors
#17
Krista L Lentine, Bertram L Kasiske, Andrew S Levey, Patricia L Adams, Josefina Alberú, Mohamed A Bakr, Lorenzo Gallon, Catherine A Garvey, Sandeep Guleria, Philip Kam-Tao Li, Dorry L Segev, Sandra J Taler, Kazunari Tanabe, Linda Wright, Martin G Zeier, Michael Cheung, Amit X Garg
Kidney Disease: Improving Global Outcomes (KDIGO) engaged an evidence review team and convened a work group to produce a guideline to evaluate and manage candidates for living kidney donation. The evidence for most guideline recommendations is sparse and many "ungraded" expert consensus recommendations were made to guide the donor candidate evaluation and care before, during, and after donation. The guideline advocates for replacing decisions based on assessments of single risk factors in isolation with a comprehensive approach to risk assessment using the best available evidence...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28737199/-giant-splenic-cyst-in-a-teenager-girl-case-report
#18
Beatriz Martínez Torres, Manuel Medina García, Miguel Ángel Zafra Anta, Alejandro José García Muñoz-Najar, Juan C Tardío Dovao
Giant nonparasitic splenic epidermoid cysts are relatively uncommon. These lesions can lead abdominal pain, but most of then are asymptomatic, and they are discovered incidentally. We report a 13-y old female with a giant splenic epidermoid cystic, given the special interest of diagnostic and therapeutic decision-making of this rare entity. CASE REPORT: A 13-y old female with clinical history of abdominal pain since the last two months. On physical examination a firm, tender mass was palpable in left hypochondrium...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28737048/ototoxicity-monitoring-in-children-treated-with-platinum-chemotherapy
#19
Beth Brooks, Kristin Knight
OBJECTIVE: To review the prevalence, mechanisms, clinical presentation, risk factors and implications of platinum-induced ototoxicity in paediatric cancer patients based on published evidence, discuss options for monitoring hearing in young children during treatment and review long-term follow-up guidelines. DESIGN: Narrative literature review. RESULTS: Children treated with cisplatin are at high risk of hearing loss and early, accurate identification of ototoxicity is important for medical decision making and hearing rehabilitation...
July 24, 2017: International Journal of Audiology
https://www.readbyqxmd.com/read/28736390/-side-effects-are-central-effects-that-challenge-retention-in-hiv-treatment-programmes-in-six-sub-saharan-african-countries-a-multicountry-qualitative-study
#20
Jenny Renju, Mosa Moshabela, Estelle McLean, William Ddaaki, Morten Skovdal, Fred Odongo, Dominic Bukenya, Joyce Wamoyi, Oliver Bonnington, Janet Seeley, Basia Zaba, Alison Wringe
OBJECTIVES: To explore the bodily and relational experience of taking antiretroviral therapy (ART) and the subsequent effect on retention in HIV care in six sub-Saharan African countries. METHODS: In-depth interviews were conducted with 130 people living with HIV (PLHIV) who had initiated ART, 38 PLHIV who were lost to follow-up and 53 healthcare workers (HCWs) in Kenya, Uganda, Tanzania, Malawi, Zimbabwe and South Africa. PLHIV were purposely selected to include a range of HIV treatment histories...
July 2017: Sexually Transmitted Infections
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