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https://www.readbyqxmd.com/read/29682309/australasian-society-for-hiv-viral-hepatitis-and-sexual-health-medicine-hiv-pre-exposure-prophylaxis-clinical-guidelines-update-april-2018
#1
EDITORIAL
Edwina Wright, Andrew Grulich, Katy Roy, Mark Boyd, Vincent Cornelisse, Darren Russell, Darryl O'Donnell, Bill Whittaker, Levinia Crooks, Iryna Zablotska
Daily use of coformulated tenofovir and emtricitabine for HIV pre-exposure prophylaxis (PrEP) by populations at high risk of HIV infection is now recommended in guidelines from the United States, Europe and Australia and globally through the 2015 WHO guidelines. These 2017 Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine's (ASHM) PrEP Guidelines are an updated adaptation of the 2014 US Centers for Disease Control's PrEP guidelines and are designed to: •Support the prescription of PrEP using forms of coformulated tenofovir and emtricitabine that have been registered in Australia by the Therapeutic Goods Administration and other bioequivalent generic drugs that are available in Australia through self-importation, private prescription or Australian PrEP clinical trials•Assist clinicians in the evaluation of patients who are seeking PrEP•Assist clinicians in commencing and monitoring patients on PrEP including PrEP dosing schedules, management of side-effects and toxicity, use of PrEP in pregnancy and in chronic hepatitis B infection and how to cease PrEP Daily PrEP with co-formulated tenofovir and emtricitabine, used continuously or for shorter periods of time, is recommended in these guidelines as a key HIV-prevention option for men who have sex with men (MSM), transgender men and women, heterosexual men and women, and people who inject drugs (PWID) at substantial risk of HIV acquisition...
April 1, 2018: Journal of Virus Eradication
https://www.readbyqxmd.com/read/29681513/antimicrobial-consumption-and-resistance-in-adult-hospital-inpatients-in-53-countries-results-of-an-internet-based-global-point-prevalence-survey
#2
Ann Versporten, Peter Zarb, Isabelle Caniaux, Marie-Françoise Gros, Nico Drapier, Mark Miller, Vincent Jarlier, Dilip Nathwani, Herman Goossens
BACKGROUND: The Global Point Prevalence Survey (Global-PPS) established an international network of hospitals to measure antimicrobial prescribing and resistance worldwide. We aimed to assess antimicrobial prescribing and resistance in hospital inpatients. METHODS: We used a standardised surveillance method to collect detailed data about antimicrobial prescribing and resistance from hospitals worldwide, which were grouped by UN region. The internet-based survey included all inpatients (adults, children, and neonates) receiving an antimicrobial who were on the ward at 0800 h on one specific day between January and September, 2015...
April 19, 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29681163/patterns-of-narcotic-prescribing-by-orthopedic-surgeons-for-medicare-patients
#3
Matthew R Boylan, Kelly I Suchman, James D Slover, Joseph A Bosco
In recent years, narcotics have been subject to increased regulation and monitoring because of their side effects and potential for misuse. Currently, variation in prescribing patterns of narcotics among orthopedic surgeons is unknown. The Medicare Part D claims database was used to identify orthopedic surgeons who prescribed at least one schedule II or III narcotic during 2014. The median duration of a narcotic prescription was 8.2 days. The median prescription duration was shortest for hand surgeons (5.6 days) and longest for spine surgeons (12...
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29680485/-seclusion-and-mechanical-restraints-in-psychiatric-care-prescriptions-procedures-pharmacological-management-and-monitoring
#4
Chloé Tezenas du Montcel, Célia Kowal, Audrey Leherle, Soraya Kabbaj, Ariel Frajerman, Emmanuel Le Guen, Nora Hamdani, Franck Schürhoff, Marion Leboyer, Antoine Pelissolo, Baptiste Pignon
We will briefly summarize the French recommendations concerning the use of seclusion and mechanical restraint. Acute agitation and aggression or self-injurious activity during psychotic and manic episodes are the main indication of prescription of the coercive measures. Their prescriptions respect specific modalities that will be explained. Although they proved to be efficient, seclusion and restrain need to stay a last resort option, considering the risk of physical complications and psychological consequences...
April 18, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29679936/controversies-in-monitoring-metastatic-breast-cancer-during-systemic-treatment-results-of-a-gim-gruppo-italiano-mammella-survey
#5
Bonotto Marta, Basile Debora, Gerratana Lorenzo, Pelizzari Giacomo, Bartoletti Michele, Vitale Maria Grazia, Fanotto Valentina, Lisanti Camilla, Mansutti Mauro, Minisini Alessandro Marco, Aprile Giuseppe, De Laurentiis Michele, Montemurro Filippo, Del Mastro Lucia, Puglisi Fabio
BACKGROUND: The optimal strategy for monitoring metastatic breast cancer (M-MBC) is unclear. Nevertheless, M-MBC influences patient's quality of life and it affects the use of resources in terms of both drugs and diagnostic exam prescription. We aim to disclose oncologists' approach on M-MBC, identifying controversial areas. METHODS: An anonymous online survey was conducted among GIM members who, based on their on-field experience, shared their own method for M-MBC planning...
April 18, 2018: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29678119/exchange-sex-among-people-receiving-medical-care-for-hiv-in-the-united-states-medical-monitoring-project-2009-2013
#6
Oluwatosin Olaiya, Lina Nerlander, Christine L Mattson, Linda Beer
Many studies of persons who exchange sex for money or drugs have focused on their HIV acquisition risk, and are often limited to select populations and/or geographical locations. National estimates of exchange sex among people living with HIV (PLWH) who are in medical care, and its correlates, are lacking. To address these gaps, we analyzed data from the Medical Monitoring Project, a surveillance system that produces nationally representative estimates of behavioral and clinical characteristics of PLWH receiving medical care in the United States, to estimate the weighted prevalence of exchange sex overall, and by selected socio-demographic, behavioral and clinical characteristics...
April 20, 2018: AIDS Care
https://www.readbyqxmd.com/read/29677922/implementing-an-antibiotic-stewardship-information-system-to-improve-hospital-infection-control-a-co-design-process
#7
Mélanie R Maia, Alexandra Simões, Luís V Lapão
HAITooL information system design and implementation was based on Design Science Research Methodology, ensuring full participation, in close collaboration, of researchers and a multidisciplinary team of healthcare professionals. HAITooL enables effective monitoring of antibiotic resistance, antibiotic use and provides an antibiotic prescription decision-supporting system by clinicians, strengthening the patient safety procedures. The design, development and implementation process reveals benefits in organizational and behavior change with significant success...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29677414/a-multistep-approach-to-address-clinican-knowledge-attitudes-and-behavior-around-opioid-prescribing
#8
Sara Kohlbeck, Brenna Akert, Caroline Pace, Amy Zosel
INTRODUCTION: The Wisconsin Prescription Drug Monitoring Program (PDMP) was implemented in 2013 to reduce the misuse, abuse, and diversion of controlled substance prescriptions. OBJECTIVE: To evaluate provider knowledge, attitudes, and behaviors regarding the Wisconsin PDMP before and after study interventions. METHODS: An initial survey of clinicians, a focus group, pre- and posttests for an educational session, and a 3-month follow-up survey were utilized...
March 2018: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29674798/switching-of-antihypertensive-drugs-at-tertiary-care-government-hospital-hyderabad-india-a-cross-sectional-retrospective-investigation
#9
Varsha Varakantham, Ashok Kumar Kurakula Sailoo, Venkaiah Kodali, Dinesh Kumar Bharatraj
OBJECTIVE: Switching of antihypertensive drugs is attributed to uncontrolled blood pressure (BP) which imposes a great burden on health economics. But again, switching leads to accomplishment of the goal BP, thereby improving the health status. Such studies are well documented in developed nations but rarely reported in developing countries, especially in India. Therefore, the aim of this study was to evaluate various factors associated with switching of antihypertensive drugs. METHODS: A cross-sectional retrospective investigation was performed using a standardized schedule adapting the World Health Organization indicators for drug utilization in a tertiary care government hospital, Hyderabad, India...
November 2017: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/29671244/assessment-of-the-availability-cost-and-motivations-for-use-over-time-of-the-new-psychoactive-substances-benzodiazepines-diclazepam-flubromazepam-and-pyrazolam-in-the-uk
#10
Rachelle Abouchedid, Thea Gilks, Paul I Dargan, John R H Archer, David M Wood
INTRODUCTION: There has been increasing interest in the availability of non-prescription benzodiazepines and their sale as new psychoactive substances. We wanted to determine UK availability from Internet suppliers and motivations for use of three benzodiazepines (diclazepam, flubromazepam, and pyrazolam). METHODS: In November 2014 and March 2016, using the European Monitoring Centre for Drugs and Drug Addiction Snapshot Methodology, Internet search engines ( google...
April 18, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29669521/evaluation-of-candida-bloodstream-infection-and-antifungal-utilization-in-a-tertiary-care-hospital
#11
Tatiana Aporta Marins, Alexandre R Marra, Michael B Edmond, Marines Dalla Valle Martino, Paula Kiyomi Onaga Yokota, Ana Carolina Cintra Nunes Mafra, Marcelino Souza Durão Junior
BACKGROUND: Candida bloodstream infections carry a significant mortality risk, justifying the importance of adequate antifungal therapy. This study describes trends in antifungal consumption using the Defined Daily Dose (DDD) and Days of Therapy (DOT) metrics, identifies the microbiological profile, the time to initiation of empirical therapy, the adjustment after positive blood culture results for Candida, and the impact on in-hospital mortality rate in patients with candidemia. METHODS: An analysis of antifungal consumption from 2008 to 2016, and of candidemia cases from 2012 to 2016 was carried out in a private tertiary hospital...
April 18, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29669042/p-glycoprotein-on-blood-brain-barrier-plays-a-vital-role-in-fentanyl-brain-exposure-and-respiratory-toxicity-in-rats
#12
ChenChen Yu, Mei Yuan, HaiYing Yang, XiaoMei Zhuang, Hua Li
Fentanyl is a rapid-acting, short duration opioid analgesic agent. In recent years, increased prescription and illicit use of fentanyl drugs have led to major safety concerns and a growing death toll. However, the causes of fentanyl induced fatal adverse effects have not been thoroughly researched. The current study investigated P-glycoprotein (P-gp) modulated brain blood barrier (BBB) penetration of fentanyl and its resulting toxicity in vitro and in vivo. ATPase assays were performed together with bi-directional transport assays using Caco-2 cells in the presence and absence of tariquidar, a P-gp inhibitor, to confirm the P-gp substrate property of fentanyl...
April 14, 2018: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/29668527/opioid-and-benzodiazepine-use-before-injury-among-workers-in-washington-state-2012-2015
#13
Esi W Nkyekyer, Deborah Fulton-Kehoe, June Spector, Gary Franklin
OBJECTIVE: To characterize pre-injury prescription opioid and benzodiazepine use and its relationship with post-injury use and missed work among workers. METHODS: 313,543 Washington State Department of Labor and Industries workers' compensation injury claims from 2012-2015 were linked with State Prescription Monitoring Program data. Pre-injury prevalence of opioid and benzodiazepine use were compared between compensable and non-compensable claims, and between workers with and without post-injury prescriptions, using the Pearson Chi-Square test...
April 17, 2018: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29666045/general-practitioners-perspective-on-ehealth-and-lifestyle-change-qualitative-interview-study
#14
Carl Joakim Brandt, Gabrielle Isidora Søgaard, Jane Clemensen, Jens Sndergaard, Jesper Bo Nielsen
BACKGROUND: Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. OBJECTIVE: This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior for their patients and themselves...
April 17, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29665073/suicidal-ideation-in-lung-transplant-recipients-a-case-series
#15
Lauren Z Rynar, Mekhala S Merchant, Daniel F Dilling
BACKGROUND: Suicidality, a term referring to suicidal ideation and/or suicide attempts, has been understudied in lung transplant recipients, despite the well-documented period of high-stress following transplantation. Understanding the full clinical picture of psychiatric morbidity before and after lung transplant is vital to supporting survival. METHODS: Suicidality among lung transplant recipients was examined through case studies of five lung transplant recipients at Loyola University Medical Center in Chicago, IL...
April 17, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29664203/trends-and-patterns-of-opioid-analgesic-prescribing-regional-and-rural-urban-variations-in-kentucky-from-2012-to-2015
#16
Huong Luu, Svetla Slavova, Patricia R Freeman, Michelle Lofwall, Steven Browning, Heather Bush
PURPOSE: Increased opioid analgesic prescribing (OAP) has been associated with increased risk of prescription opioid diversion, misuse, and abuse. We studied regional and rural-urban variations in OAP trends in Kentucky, from 2012 to 2015, and examined potential county-level risk and protective factors. METHODS: This study used prescription drug monitoring data. Marginal models employing generalized estimating equations were used to model repeated counts of residents with opioid analgesic prescriptions within county-quarter, 2012-2015, with offset for resident population, by rural-urban classification exposure, and adjusting for time-varying socioeconomic and relevant health status measures...
April 17, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29663538/methylxanthine-drug-monitoring-with-wearable-sweat-sensors
#17
Li-Chia Tai, Wei Gao, Minghan Chao, Mallika Bariya, Quynh P Ngo, Ziba Shahpar, Hnin Y Y Nyein, Hyejin Park, Junfeng Sun, Younsu Jung, Eric Wu, Hossain M Fahad, Der-Hsien Lien, Hiroki Ota, Gyoujin Cho, Ali Javey
Drug monitoring plays crucial roles in doping control and precision medicine. It helps physicians tailor drug dosage for optimal benefits, track patients' compliance to prescriptions, and understand the complex pharmacokinetics of drugs. Conventional drug tests rely on invasive blood draws. While urine and sweat are attractive alternative biofluids, the state-of-the-art methods require separate sample collection and processing steps and fail to provide real-time information. Here, a wearable platform equipped with an electrochemical differential pulse voltammetry sensing module for drug monitoring is presented...
April 16, 2018: Advanced Materials
https://www.readbyqxmd.com/read/29656805/multiple-opioid-prescriptions-among-privately-insured-dental-patients-in-the-united-states-evidence-from-claims-data
#18
Niodita Gupta, Marko Vujicic, Andrew Blatz
BACKGROUND: Multiple or high dosage opioid prescriptions increase the risk of experiencing drug misuse and overdose. The authors examine index (first) and follow-up opioid prescriptions for 1 year among privately insured dental patients in the United States from 2010 through 2015. METHODS: The authors used the 2010 through 2015 Truven Health MarketScan Research databases and the Prescription Drug Monitoring Program Training Technical Assistance Center conversion data set...
April 12, 2018: Journal of the American Dental Association
https://www.readbyqxmd.com/read/29628633/dosimetric-comparison-of-treatment-plans-using-physical-wedge-and-enhanced-dynamic-wedge-for-the-planning-of-breast-radiotherapy
#19
Zhenia Gopalakrishnan, Raghuram K Nair, P Raghukumar, B Sarin
The aim of this study is to compare the physical wedge (PW) with enhanced dynamic wedge (EDW) to determine the difference in the dose distribution affecting the treated breast and the contralateral breast, lungs, heart, esophagus, spine, and surrounding skin in the radiotherapy of breast cancer. Computed tomography (CT) data sets of 30 breast cancer patients were selected from the database for the study. The treatment plans which were executed with PW were re-planned with EDW without changing the beam parameters...
January 2018: Journal of Medical Physics
https://www.readbyqxmd.com/read/29626076/predicting-opioid-use-disorder-in-patients-with-chronic-pain-who-present-to-the-emergency-department
#20
Robert Andrew Gardner, Kori L Brewer, Dennis B Langston
BACKGROUND: Emergency department (ED) patients with chronic pain challenge providers to make quick and accurate assessments without an in-depth pain management consultation. Emergency physicians need reliable means to determine which patients may receive opioid therapy without exacerbating opioid use disorder (OUD). METHODS: Eighty-nine ED patients with a chief complaint of chronic pain were enrolled. Researchers administered questionnaires and reviewed medical and state prescription monitoring database information...
April 6, 2018: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
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