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https://www.readbyqxmd.com/read/29779301/updates-on-aaa-screening-and-surveillance
#1
Mayo Theivendran, Jason Chuen
BACKGROUND: Screening and diagnostic surveillance of latent conditions have a profound impact on public healthcare expenditure and clinical outcomes. Abdominal aortic aneurysm (AAA) remains one of the hallmark pathologies in vascular surgery and an area of intense research interest. OBJECTIVE: This article is the second of two that will outline current areas of controversy and research in AAA disease in order to support a more detailed understanding of issues in managing patients with this condition, and inform the development of Australasian clinical guidelines and health policy...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29779291/abdominal-aortic-aneurysm-an-update
#2
Jason Chuen, Mayo Theivendran
BACKGROUND: Abdominal aortic aneurysm (AAA) remains one of the hallmark pathologies in vascular surgery and an area of intense research interest. Treatment options have expanded in recent years to increase the range of morphology suitable for endovascular aneurysm repair (EVAR), and with potential implications on treatment thresholds. OBJECTIVE: This article is the first of two that will outline current treatment options for AAA, including areas of controversy and research in AAA disease, to inform the development of Australasian clinical guidelines and health policy...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29779179/clinical-outcomes-of-complete-revascularization-using-either-angiography-guided-or-fractional-flow-reserve-guided-drug-eluting-stent-implantation-in-non-culprit-vessels-in-st-elevation-myocardial-infarction-patients-insights-from-a-study-based-on-a-systematic
#3
REVIEW
Alexandre Hideo-Kajita, Hector M Garcia-Garcia, Kayode O Kuku, Solomon S Beyene, Viana Azizi, Yael F Meirovich, Gebremedhin D Melaku, Aaphtaab Dheendsa, Echo J Brathwaite, Sameer Desale, Mohammad Soud, Kazuhiro Dan, Yuichi Ozaki, Ron Waksman, Michael Lipinski
Current guidelines recommend that percutaneous coronary intervention (PCI) should be restricted to the culprit vessel in ST elevation myocardial infarction (STEMI) patients with multi-vessel disease (MVD) and without cardiogenic shock. However, newer data suggests that performing complete revascularization (CR) in MVD patients may lead to better outcomes compared to intervention in the culprit vessel only. The aim of this meta-analysis is to examine the available data to determine if CR (using either angio- or fractional flow reserve guidance-FFR) following primary PCI in STEMI patients without cardiogenic shock impacts clinical outcomes...
May 19, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29779045/clinical-utility-of-fdg-pet-in-parkinson-s-disease-and-atypical-parkinsonism-associated-with-dementia
#4
REVIEW
Zuzana Walker, Federica Gandolfo, Stefania Orini, Valentina Garibotto, Federica Agosta, Javier Arbizu, Femke Bouwman, Alexander Drzezga, Peter Nestor, Marina Boccardi, Daniele Altomare, Cristina Festari, Flavio Nobili
PURPOSE: There are no comprehensive guidelines for the use of FDG PET in the following three clinical scenarios: (1) diagnostic work-up of patients with idiopathic Parkinson's disease (PD) at risk of future cognitive decline, (2) discriminating idiopathic PD from progressive supranuclear palsy, and (3) identifying the underlying neuropathology in corticobasal syndrome. METHODS: We therefore performed three literature searches and evaluated the selected studies for quality of design, risk of bias, inconsistency, imprecision, indirectness and effect size...
May 19, 2018: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29778713/concluding-commentary-on-current-trends-to-enhance-the-clinical-safety-of-pediatric-transfusion-focusing-on-prevention-of-untoward-complications-of-hsc-transplantation-newer-strategies-for-improving-the-standards-of-safety-quality-of-stem-cells-expansion-for
#5
REVIEW
Irena Sniecinski, Jerard Seghatchian
Clinical practice and related diagnostic, development and research [DDR] strategies in pediatric transfusion and transplantation cover a broad range of multidisciplinary studies, performed by many professionals involved in this most challenging clinical field [1]. This commentary on the current position and future perspectives in pediatric transfusion field is aimed to highlight major unresolved transfusion complications in pediatric patients, namely red blood cell and platelet alloimmunisation, and new ones such as nosocomial infection, thrombosis and multi-organ failure...
May 16, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29778491/-national-consensus-on-the-cardiological-treatment-and-follow-up-of-kawasaki-disease
#6
Ana Barrios Tascón, Fernando Centeno Malfaz, Henar Rojo Sombrero, Elisa Fernández-Cooke, Judith Sánchez-Manubens, Javier Pérez-Lescure Picarzo
Kawasaki disease is a self-limiting acute vasculitis that affects small and medium-sized vessels, and is the most common cause of acquired heart disease in children in our environment. Up to 25% of untreated patients develop coronary aneurysms. It is suspected that an infectious agent may be the trigger of the disease, but the causative agent is still unknown. Based on the previous evidence, recommendations are proposed for the diagnosis, treatment of acute disease, and the long-term management of these patients, in order to unify criteria...
May 16, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29778456/the-challenge-of-controlling-the-copd-epidemic-chronic-obstructive-pulmonary-disease-unmet-needs
#7
Francesca Polverino, Bartolome Celli
Many unmet needs still remain in the assessment and treatment of patients with chronic obstructive pulmonary disease (COPD), particularly in relation to its under- and misdiagnosis, which lead to under- and mistreatment. This paucity of knowledge about the importance and presence of COPD, as well as its treatment, is seen with patients and carers as well as healthcare providers. This review considers the areas of key educational need, including the clinical characteristics of COPD, factors contributing to the disease, effective diagnosis, and clinical management of patients, and the implementation of treatment guidelines...
May 17, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29778437/state-level-adoption-of-national-guidelines-for-norovirus-outbreaks-in-health-care-settings
#8
Carl J Grafe, Catherine J Staes, Kensaku Kawamoto, Matthew H Samore, R Scott Evans
BACKGROUND: Clinical decision support (CDS) systems can help investigators use best practices when responding to outbreaks, but variation in guidelines between jurisdictions can make such systems hard to develop and implement. This study aimed to identify (1) the extent to which state-level guidelines adhere to national recommendations for norovirus outbreak response in health care settings and (2) the impact of variation between states on outbreak outcomes. METHODS: State guidelines were obtained from Internet searches and direct contact with state public health officials in early 2016...
May 16, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29778250/surgical-management-of-intraductal-papillary-mucinous-neoplasm-with-main-duct-involvement-an-international-expert-survey-and-case-vignette-study
#9
Lianne Scholten, Nadine C M van Huijgevoort, Marco J Bruno, Carlos Fernandez-Del Castillo, Sohei Satoi, Alain Sauvanet, Christopher Wolfgang, Paul Fockens, Suresh T Chari, Marco Del Chiaro, Jeanin E van Hooft, Marc G Besselink
BACKGROUND: The risk of invasive cancer in resected intraductal papillary mucinous neoplasm with main pancreatic duct involvement is 33%-60%. Most guidelines, therefore, advise resection of main duct intraductal papillary mucinous neoplasm and mixed type intraductal papillary mucinous neoplasm in surgically fit patients, although advice on the surgical strategy (partial or total pancreatectomy) differs. We performed a survey amongst international experts to guide the design of future studies and help to prepare for a single international set of guidelines...
May 16, 2018: Surgery
https://www.readbyqxmd.com/read/29778032/primary-lymphoma-of-appendix-presenting-as-acute-appendicitis-a-case-report
#10
Giuseppe Caristo, Guido Griseri, Rosario Fornaro, Antonio Langone, Angelo Franceschi, Veronica Errigo, Cecilia Ferrari, Marco Casaccia, Marco Frascio, Angelo Schirru
INTRODUCTION: Primary lymphomas of appendix are extremely rare tumors. The incidence is 0.015% of all gastrointestinal lymphomas. PRESENTATION OF CASE: We present a case of a 75 year-old male patient who presented with acute abdominal pain in the lower right quadrant and fever. DISCUSSION: The patient received laparotomic appendectomy. The definitive histopathological examination revealed the presence of diffuse large cell B-lymphoma of the appendix...
May 7, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29777729/pharmacogenetic-tests-to-guide-drug-treatment-in-depression-comparison-of-the-available-testing-kits-and-clinical-trials
#11
REVIEW
Chiara Fabbri, Joseph Zohar, Alessandro Serretti
The empirical approach to drug choice and dosing in depression often results into inadequate response and side effects. Pharmacogenetic (PGx) testing appears a promising way to implement personalized treatments. A systematic review was performed to identify available PGx tests, compare the genes they include with clinical guidelines and drug labels, and assess the quality of published clinical studies. ~40 commercial PGx tests are available and potential benefits were estimated for nine of them by clinical studies...
May 16, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/29777554/development-and-feasibility-testing-of-an-avatar-based-education-application-for-patients-with-acute-coronary-syndrome
#12
Jintana Tongpeth, Hui Yun Du, Robyn A Clark
AIMS: To develop and evaluate an interactive, avatar-based education application, for improving patients' knowledge of, and response to, ACS symptoms. BACKGROUND: A patient's ability to recognise and respond to the symptoms of acute coronary syndrome (ACS) is imperative for seeking timely medical intervention. Innovative patient education interventions are needed to support patient education and patient self-care. METHODS: Participatory action research methods were used to engage consumers with cardiac and IT experts to develop an avatar-based education application...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29777519/combination-glucose-lowering-therapy-plans-in-t2dm-case-based-considerations
#13
REVIEW
Lawrence Blonde, Susana Dipp, Daniel Cadena
Type 2 diabetes mellitus (T2DM) is a complex disease, and while lifestyle interventions remain the cornerstone of therapy, most patients will also require pharmacotherapy. Current diabetes treatment guidelines and algorithms recommend an individualized approach to setting glycemic goals and selecting treatment. Although a single antihyperglycemic agent may be appropriate as the initial T2DM pharmacotherapy, the progressive nature of the disease due to declining pancreatic β-cell function will result in the vast majority of T2DM patients eventually requiring two or more antihyperglycemic agents...
May 18, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29777373/safety-and-feasibility-of-pulmonary-artery-pressure-guided-heart-failure-therapy-rationale-and-design-of-the-prospective-cardiomems-monitoring-study-for-heart-failure-mems-hf
#14
Christiane E Angermann, Birgit Assmus, Stefan D Anker, Johannes Brachmann, Georg Ertl, Friedrich Köhler, Stephan Rosenkranz, Carsten Tschöpe, Philip B Adamson, Michael Böhm
BACKGROUND: Wireless monitoring of pulmonary artery (PA) pressures with the CardioMEMS HF™ system is indicated in patients with New York Heart Association (NYHA) class III heart failure (HF). Randomized and observational trials have shown a reduction in HF-related hospitalizations and improved quality of life in patients using this device in the United States. OBJECTIVE: MEMS-HF is a prospective, non-randomized, open-label, multicenter study to characterize safety and feasibility of using remote PA pressure monitoring in a real-world setting in Germany, The Netherlands and Ireland...
May 19, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29777044/the-impact-of-sign-glaucoma-guidelines-on-false-positive-referrals-from-community-optometrists-in-central-scotland
#15
Samantha Sii, Ahmad Nasser, Cheng Yi Loo, Catherine Croghan, Alan Rotchford, Pankaj Kumar Agarwal
BACKGROUND: Since the introduction of National Institute for Health and Care Excellence glaucoma guidelines 2009, the number of referrals from community optometrists to hospital eye services has increased across the UK, resulting in increase in first visit discharge rates (FVDRs). AIM: To assess the impact of Scottish Intercollegiate Guidelines Network (SIGN) 144 on quality of referrals from community optometrists. METHODOLOGY: A retrospective study of patient records who attended as new adult glaucoma referrals to clinics in Princess Alexandra Eye Pavilion, Edinburgh, and in Greater Glasgow and Clyde, was carried out across October-November 2014 (group 1) and September-October 2016 (group 2), before and after the introduction of SIGN 144...
May 18, 2018: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29776852/indications-for-mars-mri-in-patients-treated-with-articular-surface-replacement-xl-total-hip-arthroplasty
#16
James W Connelly, Vincent P Galea, Inari Laaksonen, Sean J Matuszak, Rami Madanat, Orhun Muratoglu, Henrik Malchau
BACKGROUND: The purpose of this study was to identify which patient and clinical factors are predictive of adverse local tissue reaction (ALTR) and to use these factors to create a highly sensitive algorithm for indicating metal artifact reduction sequence magnetic resonance imaging (MARS-MRI) in Articular Surface Replacement (ASR) XL total hip arthroplasty patients. Our secondary aim was to compare our algorithm to existing national guidelines on when to take MARS-MRI in metal-on-metal total hip arthroplasty patients...
April 19, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29776825/a-review-of-research-efforts-to-address-the-2008-acep-guideline-for-mild-traumatic-brain-injury
#17
Jack Manquen, Tyler Combs, Anya Mazur-Mosiewicz, Donald Sanders, Michael Schiesel, Joshua Gordon, Michelle Farabough, Matt Vassar
BACKGROUND: The objective of this study was to evaluate the temporal relationship between clinical practice guideline development and subsequent research performed, with the goal of providing more data on areas of sparse evidence that serve to underlie guideline recommendations. We aimed to assess the quality of current research efforts to address the American College of Emergency Physicians guideline and to provide suggestions for future research of mild traumatic brain injury. METHODS: We identified clinical practice guideline recommendations with low levels of underlying evidence and searched ClinicalTrials...
May 8, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776758/using-preference-learning-for-detecting-inconsistencies-in-clinical-practice-guidelines-methods-and-application-to-antibiotherapy
#18
Rosy Tsopra, Jean-Baptiste Lamy, Karima Sedki
Clinical practice guidelines provide evidence-based recommendations. However, many problems are reported, such as contradictions and inconsistencies. For example, guidelines recommend sulfamethoxazole/trimethoprim in child sinusitis, but they also state that there is a high bacteria resistance in this context. In this paper, we propose a method for the semi-automatic detection of inconsistencies in guidelines using preference learning, and we apply this method to antibiotherapy in primary care. The preference model was learned from the recommendations and from a knowledge base describing the domain...
May 15, 2018: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29776710/pharmacokinetics-pharmacodynamics-computer-decision-support-technologies-and-antimicrobial-stewardship-the-compass-and-rudder
#19
REVIEW
Robert C Owens, Catharine C Bulik, David R Andes
The first guidelines for conducting antimicrobial stewardship in the hospitalized setting were published in 2007. These guidelines recommend that stewardship programs employ the science of pharmacokinetics-pharmacodynamics (PK-PD) as well as adopting computerized decision support technologies when possible. The United States Food and Drug Administration have adopted PK-PD as a cornerstone in the evaluation of antimicrobial agents during clinical development. The core principles of PK-PD center around describing the relationship between drug exposure indexed to the susceptibility of the infecting bacterial pathogen and patient response...
April 13, 2018: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29776444/mediastinal-staging-of-non-small-cell-lung-cancer-by-endobronchial-and-endoscopic-ultrasonography-with-or-without-additional-surgical-mediastinoscopy-mediastrial-study-protocol-of-a-multicenter-randomised-controlled-trial
#20
Jelle E Bousema, Marcel G W Dijkgraaf, Nicole E Papen-Botterhuis, Hermien W Schreurs, Jos G Maessen, Erik H van der Heijden, Willem H Steup, Jerry Braun, Valentin J J M Noyez, Fieke Hoeijmakers, Naomi Beck, Martijn van Dorp, Niels J M Claessens, Birgitta I Hiddinga, Johannes M A Daniels, David J Heineman, Harmen R Zandbergen, Ad F T M Verhagen, Paul E van Schil, Jouke T Annema, Frank J C van den Broek
BACKGROUND: In case of suspicious lymph nodes on computed tomography (CT) or fluorodeoxyglucose positron emission tomography (FDG-PET), advanced tumour size or central tumour location in patients with suspected non-small cell lung cancer (NSCLC), Dutch and European guidelines recommend mediastinal staging by endosonography (endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS)) with sampling of mediastinal lymph nodes. If biopsy results from endosonography turn out negative, additional surgical staging of the mediastinum by mediastinoscopy is advised to prevent unnecessary lung resection due to false negative endosonography findings...
May 18, 2018: BMC Surgery
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