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https://www.readbyqxmd.com/read/29353392/a-preliminary-survey-on-prevalence-and-knowledge-about-different-aspects-of-somnambulism-in-buner-district-of-khyber-pakhtunkhwa-pakistan
#1
Wajiha, Zaigham Hasan, Rabia Afridi, Lubna Rahman, Naveeda Akhtar Qureshi, Kausar Saeed, Humera Afridi
PURPOSE: Present study was aimed to investigate the prevalence and knowledge about different aspects of somnambulism in general population of Buner District, KP, Pakistan, during December 2015-November 2016. METHODS: Data was collected through convenient sampling technique which was comprised of structured and detailed questionnaire. Collected data regarding different actions performed by sleepwalkers were adjusted through a weighted variable to generalize results...
January 20, 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29353118/magnesium-supplementation-pharmacokinetics-in-cardiac-surgery-patients-with-normal-renal-function
#2
Peter Biesenbach, Johan Mårtensson, Eduardo Osawa, Glenn Eastwood, Salvatore Cutuli, Jessica Fairley, George Matalanis, Rinaldo Bellomo
BACKGROUND: Intravenous magnesium is routinely administered in intensive care units (ICU) to treat arrhythmias after cardiothoracic surgery. There are no data on the pharmacokinetics of continuous magnesium infusion therapy. OBJECTIVE: To investigate the pharmacokinetics of continuous magnesium infusion, focusing on serum and urinary magnesium concentration, volume of distribution and half-life. METHODS: We administered a 10 mmol bolus of magnesium-sulfate followed by a continuous infusion of 3 mmol/h for 12 h in twenty cardiac surgery patients...
January 11, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29351331/the-association-between-previous-and-future-severe-exacerbations-of-chronic-obstructive-pulmonary-disease-updating-the-literature-using-robust-statistical-methodology
#3
Mohsen Sadatsafavi, Hui Xie, Mahyar Etminan, Kate Johnson, J Mark FitzGerald
BACKGROUND: There is minimal evidence on the extent to which the occurrence of a severe acute exacerbation of COPD that results in hospitalization affects the subsequent disease course. Previous studies on this topic did not generate causally-interpretable estimates. Our aim was to use corrected methodology to update previously reported estimates of the associations between previous and future exacerbations in these patients. METHODS: Using administrative health data in British Columbia, Canada (1997-2012), we constructed a cohort of patients with at least one severe exacerbation, defined as an episode of inpatient care with the main diagnosis of COPD based on international classification of diseases (ICD) codes...
2018: PloS One
https://www.readbyqxmd.com/read/29350128/between-a-rock-a-bye-and-a-hard-place-mood-disorders-during-the-peripartum-period
#4
Michael Thomson, Verinder Sharma
Mood disorders including major depressive disorder and bipolar disorder are common during and after pregnancy. Timely identification and appropriate management of mood episodes is essential to maximize maternal well-being and minimize adverse outcomes. Failure to do so results in maternal suffering and impaired child bonding, and has the potential for devastating outcomes including suicide and infanticide. Women are routinely screened for unipolar depression during or after pregnancy but not for bipolar disorder, in spite of the fact that childbirth is associated with a major risk for onset or exacerbation of bipolar disorder...
December 2017: CNS Spectrums
https://www.readbyqxmd.com/read/29348712/assessment-of-ramadan-education-and-knowledge-among-diabetic-patients
#5
Mussa Hussain Almalki, Ibtihal Hussen, Shawana A Khan, Abdulrahman Almaghamsi, Fahad Alshahrani
Background: During Ramadan, Muslims fast from dawn until dusk for one lunar month every year. Most of the Muslim patients with diabetes are unaware of the potential complications that can occur while fasting, such as hypoglycemia. The aim of this study is to assess the the patient education level and patients' overall awareness of any possible complications that could occur while fasting during Ramadan and to determine how these patients deal with these complications. Methods: We conducted a cross-sectional study and surveyed diabetic patients about their diabetes-related knowledge over a period of 4 months from the outpatient clinic at the Obesity, Endocrine, and Metabolism Center at King Fahad Medical City...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
https://www.readbyqxmd.com/read/29347874/adjunctive-glucocorticoid-therapy-in-patients-with-septic-shock
#6
Balasubramanian Venkatesh, Simon Finfer, Jeremy Cohen, Dorrilyn Rajbhandari, Yaseen Arabi, Rinaldo Bellomo, Laurent Billot, Maryam Correa, Parisa Glass, Meg Harward, Christopher Joyce, Qiang Li, Colin McArthur, Anders Perner, Andrew Rhodes, Kelly Thompson, Steve Webb, John Myburgh
Background Whether hydrocortisone reduces mortality among patients with septic shock is unclear. Methods We randomly assigned patients with septic shock who were undergoing mechanical ventilation to receive hydrocortisone (at a dose of 200 mg per day) or placebo for 7 days or until death or discharge from the intensive care unit (ICU), whichever came first. The primary outcome was death from any cause at 90 days. Results From March 2013 through April 2017, a total of 3800 patients underwent randomization. Status with respect to the primary outcome was ascertained in 3658 patients (1832 of whom had been assigned to the hydrocortisone group and 1826 to the placebo group)...
January 19, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29344339/clozapine-discontinuation-in-early-schizophrenia-a-retrospective-case-note-review-of-patients-under-an-early-intervention-service
#7
Andrew Shaker, Rowena Jones
Aim: Research in patients with treatment-resistant schizophrenia has demonstrated that clozapine discontinuation is associated with poor outcomes. There is, however, a paucity of research investigating the impact of clozapine discontinuation specifically in younger patients with more recent onset schizophrenia. A case note review was therefore conducted to ascertain medium-term prognoses in patients with treatment-resistant schizophrenia under an early intervention service (EIS) following clozapine discontinuation...
January 2018: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/29343892/first-two-bilateral-hand-transplantations-in-india-part-4-immediate-post-operative-care-immunosuppression-protocol-and-monitoring
#8
Subramania Iyer, Mohit Sharma, P Kishore, Jimmy Mathew, R Janarthanan, Raghuveer Reddy, Abhijeet Wakure, Sundeep Vijayaraghavan, S M Chetan Mali, Visakh Varma, Ashish Chaudhari, Swapnil Dhake, Akshay Omkumar, George Kurian, Rajesh Nair, Anil Mathew, Zachariah Paul, Malini Eapen, Lalitha Biswas
Introduction: Being able to counter immune-mediated rejection has for decades been the single largest obstacle for the progress of vascular composite allotransplantation (VCA). The human immune system performs the key role of differentiating the 'self ' from the 'non-self '. This, although is quintessential to eliminate or resist infections, also resists the acceptance of an allograft which it promptly recognises as 'non-self'. Materials and Methods: Pre-operative evaluation of the recipient evaluation included immunological assessment in the form of panel reactive antibodies (PRA), human leucocyte antigen (HLA) typing, donor-specific antibody detection assays (DSA) and complement-dependent cytotoxicity assays (CDC)...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29343470/cognition-in-multiple-sclerosis-state-of-the-field-and-priorities-for-the-future
#9
REVIEW
James F Sumowski, Ralph Benedict, Christian Enzinger, Massimo Filippi, Jeroen J Geurts, Paivi Hamalainen, Hanneke Hulst, Matilde Inglese, Victoria M Leavitt, Maria A Rocca, Eija M Rosti-Otajarvi, Stephen Rao
Cognitive decline is recognized as a prevalent and debilitating symptom of multiple sclerosis (MS), especially deficits in episodic memory and processing speed. The field aims to (1) incorporate cognitive assessment into standard clinical care and clinical trials, (2) utilize state-of-the-art neuroimaging to more thoroughly understand neural bases of cognitive deficits, and (3) develop effective, evidence-based, clinically feasible interventions to prevent or treat cognitive dysfunction, which are lacking. There are obstacles to these goals...
January 17, 2018: Neurology
https://www.readbyqxmd.com/read/29342846/mental-health-and-drivers-of-need-in-emergent-and-non-emergent-emergency-department-ed-use-do-living-location-and-non-emergent-care-sources-matter
#10
Moira C McManus, Robert J Cramer, Maureen Boshier, Muge Akpinar-Elci, Bonnie Van Lunen
Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations...
January 13, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29342019/hot-spotting-as-a-strategy-to-identify-high-cost-surgical-populations
#11
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
OBJECTIVE: The aim of this study was to determine the feasibility of "hot spotting" in elective surgical populations. BACKGROUND: Prospective identification of high-cost patients, known as "hot spotting," is well developed in medical populations, but has not been performed in surgical populations. Population-based management of surgical expenditures requires identification of high-cost surgical patients to allow for effective implementation of cost-saving strategies...
January 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29341936/rheumatic-manifestations-among-cancer-patients-treated-with-immune-checkpoint-inhibitors
#12
REVIEW
Merav Lidar, Eitan Giat, Daniela Garelick, Yuval Horowitz, Howard Amital, Yael Steinberg-Silman, Jacob Shachter, Ronnie Shapira-Frommer, Gal Markel
BACKGROUND: The use of immune checkpoint inhibitors (ICI) has grown incessantly since they were first approved in 2014. These monoclonal antibodies inhibit T cell activation, yielding a dramatic tumor response with improved survival. However, immunotherapy is frequently hampered by immune adverse events (iAE) such as hypophysitis, colitis, hepatitis, pneumonitis and rash. Until recently, rheumatic side effects were only infrequently reported. Aim To describe the rheumatic manifestations encountered among patients treated with ICIs in a large tertiary cancer center in Israel METHODS: The cancer center's patient registry was screened for patients who had ever been treated with ipilimumab, pembrolizumab and/or nivolumab with relevant data gathered from clinical charts...
January 13, 2018: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29340619/recurrent-serious-infections-in-patients-with-rheumatoid-arthritis-results-from-the-british-society-for-rheumatology-biologics-register
#13
Sujith Subesinghe, Andrew Ian Rutherford, Rachel Byng-Maddick, Kimme Leanne Hyrich, James Benjamin Galloway
Objectives: To establish the rate of recurrent infection in RA patients recruited to the British Society for Rheumatology Biologics Register - Rheumatoid Arthritis. Secondary objectives were to establish whether the organ class of index infection predicted future serious infection (SI). Methods: Using data from the British Society for Rheumatology Biologics Register - Rheumatoid Arthritis, a prospective observational cohort, we identified patients with at least one episode of SI...
January 10, 2018: Rheumatology
https://www.readbyqxmd.com/read/29338994/both-patients-and-maternity-care-providers-can-benefit-from-payment-reform-four-steps-to-prepare
#14
Malini A Nijagal, Neel T Shah, Jeff Levin-Scherz
Many Medicaid programs and private health plans are implementing new models of maternity care reimbursement, and clinicians face mounting pressure to demonstrate high quality care at lower cost. Clinicians will be better prepared to meet these challenges with a fuller understanding of new payment models and the opportunities they present. We describe the structure of maternity care "episode payments" and recommend four ways that clinicians can prepare for success as value-based payment models are implemented: identify opportunities to improve outcomes and experience, measure quality, reduce waste and work in teams across settings...
January 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29338537/antidepressant-prescriptions-and-mental-health-nurses-an-observational-study-in-dutch-general-practice-from-2011-to-2015
#15
Tessa Magnée, Derek P de Beurs, Francois G Schellevis, Peter F Verhaak
PURPOSE: The purpose of this study was to investigate developments in antidepressant prescriptions by Dutch general practitioners, alongside the national introduction of mental health nurses. Antidepressant prescriptions are very common in general practice, but are often not in line with recommendations. The recent introduction of mental health nurses may have decreased antidepressant prescriptions, as general practitioners (GPs) have greater potential to offer psychological treatment as a first choice option instead of medication...
January 17, 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29337440/-addictions
#16
Jacques Besson, Jeremy Grivel, Alexander Tomei, Mélina Andronicos, Daniele Zullino, Gabriel Thorens, Stergios Tsartsalis, Isabelle Gothuey, Monique Séguin
This year, the actuality for addictions in this edition addresses four points. The disease model of addiction is criticized by the cognitive neurosciences which need to consider the agentivity of the persons. Regarding the societal actuality, clinical pharmacology review of cannabidiol presents an update on legal cannabis. The suicidality of excessive gamblers may be prevented specifically. Addiction and first psychotic episodes need an integrated care.
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29336749/heroic-measures-for-an-american-hero-attempting-to-save-the-life-of-general-douglas-macarthur
#17
Theodore N Pappas
General Douglas MacArthur was a towering public figure on an international stage for the first half of the 20th century. He was healthy throughout his life but developed a series of medical problems when he entered his 80s. This article reviews the General's medical care during two separate life-threatening medical crises that required surgical intervention. The first episode occurred in 1960 when MacArthur presented with renal failure due to an obstructed prostate. Four years later after his 84th birthday, MacArthur developed bile duct obstruction from common duct stones...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336240/treatment-of-anemia-in-patients-with-solid-tumors-receiving-chemotherapy-in-palliative-setting-usual-practice-versus-guidelines
#18
Robin de Putter, Karen Geboes, Marc De Man, Simon Van Belle
Background Anemia is frequent in patients with cancer and is often multifactorial. Treatment depends on etiology and can consist of transfusions, intravenous iron (IV Fe), and/or erythropoiesis-stimulating agents (ESA). Several studies have shown that cancer-related anemia is undertreated. The aim of this study is to compare usual practice in a university hospital with the international guidelines. Methods Using the hospital and pharmacy informatics all adults (≥18 years), who received a treatment for anemia (transfusion, IV Fe, ESA) from February to August 2016 during palliative chemotherapy, were identified...
January 16, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29335813/organic-acidurias-in-adults-late-complications-and-management
#19
Ali Tunç Tuncel, Nikolas Boy, Marina A Morath, Friederike Hörster, Ulrike Mütze, Stefan Kölker
Organic acidurias (synonym, organic acid disorders, OADs) are a heterogenous group of inherited metabolic diseases delineated with the implementation of gas chromatography/mass spectrometry in metabolic laboratories starting in the 1960s and 1970s. Biochemically, OADs are characterized by accumulation of mono-, di- and/or tricarboxylic acids ("organic acids") and corresponding coenzyme A, carnitine and/or glycine esters, some of which are considered toxic at high concentrations. Clinically, disease onset is variable, however, affected individuals may already present during the newborn period with life-threatening acute metabolic crises and acute multi-organ failure...
January 15, 2018: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/29335397/pediatric-renal-transplantation-focus-on-current-transition-care-and-proposal-of-the-rise-to-transition-protocol
#20
Rupesh Raina, Joseph Wang, Vinod Krishnappa, Maria Ferris
The transition from pediatric to adult medical services is an important time in the life of an adolescent or young adult with a renal transplant. Failure of proper transition can lead to medical non-adherence and subsequent loss of graft and/or return to dialysis. The aim of this study was to conduct a systematic review and survey to assess the challenges and existing practices in transition of renal transplant recipient children to adult services, and to develop a transition protocol. We conducted a literature review and performed a survey of pediatric nephrologists across the United States to examine the current state of transition care...
January 16, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
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