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https://www.readbyqxmd.com/read/29352757/refractory-heartburn-a-challenging-problem-in-clinical-practice
#1
REVIEW
Gerson Domingues, Joaquim Prado P Moraes-Filho, Ronnie Fass
Gastroesophageal reflux disease (GERD) is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Heartburn and regurgitation are the typical symptoms of GERD. The treatment of GERD encompasses lifestyle modifications, pharmacological, endoscopic, and surgical therapy. The majority of the patients respond to 4-8 weeks of proton-pump inhibitors therapy, but 20-42% will demonstrate partial or complete lack of response to treatment. While these patients have been considered as having refractory heartburn, a subset of them does not have GERD or have not been adequately treated...
January 20, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29352629/an-in-silico-comparative-dosimetric-study-of-postmastectomy-locoregional-irradiation-using-intensity-modulated-vs-3-dimensional-conventional-radiotherapy
#2
Pooja Khullar, Charu Garg, Sujit Nath Sinha, Inderjit Kaur, Niloy Ranjan Datta
An in silico dosimetric evaluation of intensity-modulated radiation therapy (IMRT) vs 3-dimensional conventional radiation therapy (3D-CRT) treatment plans in postmastectomy radiation therapy (PMRT) to the chest wall and regional lymphatics was conducted. Twenty-five consecutive patients with breast cancer referred for locoregional PMRT, stages T2-4 with N1-3, were planned to receive 50 Gy in 25 fractions with IMRT. Additionally, a 3D-CRT plan was generated using identical contours for the clinical target volumes (CTV), planning target volumes (PTV), and organs at risk (OAR)...
January 15, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/29352586/the-impact-of-enhanced-recovery-after-surgery-eras-protocol-compliance-on-morbidity-from-resection-for-primary-lung-cancer
#3
Luke J Rogers, David Bleetman, David E Messenger, Natasha A Joshi, Lesley Wood, Neil J Rasburn, Timothy J P Batchelor
OBJECTIVE: The adoption of Enhanced Recovery After Surgery programs in thoracic surgery is relatively recent with limited outcome data. This study aimed to determine the impact of an Enhanced Recovery After Surgery pathway on morbidity and length of stay in patients undergoing lung resection for primary lung cancer. METHODS: This prospective cohort study collected data on consecutive patients undergoing lung resection for primary lung cancer between April 2012 and June 2014 at a regional referral center in the United Kingdom...
December 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29352368/endocrine-therapy-and-related-issues-in-hormone-receptor-positive-early-breast-cancer-a-roundtable-discussion-by-the-breast-cancer-therapy-expert-group-bcteg
#4
REVIEW
Jame Abraham, Humberto Caldera, Robert Coleman, Anthony Elias, Matthew P Goetz, Muaiad Kittaneh, Elyse Lower, Reshma Mahtani, E Terry Mamounas, Mark Pegram, Hope Rugo, Lee Schwartzberg, Tiffany Traina, Chuck Vogel
PURPOSE: Management of breast cancer is a rapidly evolving field, and, although evidence-based guidelines are available for clinicians to provide direction on critical issues in patient care, clinicians often left to address these issues in the context of community practice situations with their patients. These include the patient's comorbid conditions, actual versus perceived benefit of treatments, patient's compliance as well as financial/reimbursement issues, and long-term tolerability of therapy...
January 19, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29350393/is-it-possible-to-improve-compliance-in-hypertension-and-reduce-therapeutic-inertia-of-physicians-by-mandatory-periodical-examinations-of-workers
#5
Andrzej Marcinkiewicz, Michał Plewka, Wojciech Hanke, Paweł Kałużny, Marta Wiszniewska, Agnieszka Lipińska-Ojrzanowska, Jolanta Walusiak-Skorupa
BACKGROUND: Due to high prevalence, insufficient recognition and ineffectual treatment, hypertension (HT) still remains a major medical and socio-economic problem. There is a real necessity to develop effective prophylaxis for cardiovascular disorders (CVD), based on strategies which support compliance during long-term therapy. The Polish scheme of occupational health services (OHS) with mandatory periodical employee check-ups creates a unique opportunity for effective HT prophylaxis...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29349613/tumor-treating-fields-a-new-approach-to-glioblastoma-therapy
#6
REVIEW
Jonathan Rick, Ankush Chandra, Manish K Aghi
Glioblastoma is an aggressive brain malignancy with poor outcomes. Current standard of care involves surgery, radiotherapy and chemotherapy. Even with optimal treatment, 5-year survival rates are low. Many patients are unable to tolerate the considerable side effects that therapy involves and suffer from low quality of life. Anti-mitotic tumor treating fields have shown potential in treating glioblastoma with data suggesting that they prolong disease-free survival and overall survival. Novocure has marketed a device that generates these fields via externally placed electrodes...
January 18, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29349601/prospective-feasibility-analysis-of-a%C3%A2-novel-off-line-approach-for-mr-guided-radiotherapy
#7
Tilman Bostel, Asja Pfaffenberger, Stefan Delorme, Constantin Dreher, Gernot Echner, Peter Haering, Clemens Lang, Mona Splinter, Frederik Laun, Marco Müller, Oliver Jäkel, Jürgen Debus, Peter E Huber, Florian Sterzing, Nils H Nicolay
BACKGROUND: The present work aimed to analyze the feasibility of a shuttle-based MRI-guided radiation therapy (MRgRT) in the treatment of pelvic malignancies. PATIENTS AND METHODS: 20 patients with pelvic malignancies were included in this prospective feasibility analysis. Patients underwent daily MRI in treatment position prior to radiotherapy at the German Cancer Research Center. Positional inaccuracies, time and patient compliance were assessed for the application of off-line MRgRT...
January 18, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/29347854/a-systematic-review-of-health-economic-models-and-utility-estimation-methods-in-schizophrenia
#8
B Németh, A N Fasseeh, A Molnár, I Bitter, M Horváth, K Kóczián, Á Götze, B Nagy
There is a growing need for economic evaluations describing the disease course, as well as the costs and clinical outcomes related to the treatment of schizophrenia. Areas covered: A systematic review on studies describing health economic models in schizophrenia and a targeted literature review on utility mapping algorithms in schizophrenia were carried out. Models found in the review were collated and assessed in detail according to their type and various other attributes. Fifty-nine studies were included in the review...
January 19, 2018: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/29345415/investigating-complications-associated-with-occipital-nerve-stimulation-a-maude-study
#9
REVIEW
Joseph Doran, Max Ward, Brittany Ward, Boris Paskhover, Michael Umanoff, Antonios Mammis
OBJECTIVES: The objectives of this study are to utilize the MAUDE data base to enhance our understanding of the complication profile for Occipital Nerve Stimulation, a therapy for which the current level of evidence is limited. Additionally, it is our objective to describe a systematic approach to processing the MAUDE data, which addresses its flaws and enhances its utility. METHODS: From the FDA website, we accessed adverse events reports from the MAUDE data base for devices used in Occipital Nerve Stimulation between June 30, 2007 and June 30, 2017...
January 18, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29344405/lee-silverman-voice-treatment-versus-standard-speech-and-language-therapy-versus-control-in-parkinson-s-disease-a-pilot-randomised-controlled-trial-pd-comm-pilot
#10
Catherine M Sackley, Christina H Smith, Caroline E Rick, Marian C Brady, Natalie Ives, Smitaa Patel, Rebecca Woolley, Francis Dowling, Ramilla Patel, Helen Roberts, Sue Jowett, Keith Wheatley, Debbie Kelly, Gina Sands, Carl E Clarke
Background: Speech-related problems are common in Parkinson's disease (PD), but there is little evidence for the effectiveness of standard speech and language therapy (SLT) or Lee Silverman Voice Treatment (LSVT LOUD®). Methods: The PD COMM pilot was a three-arm, assessor-blinded, randomised controlled trial (RCT) of LSVT LOUD®, SLT and no intervention (1:1:1 ratio) to assess the feasibility and to inform the design of a full-scale RCT. Non-demented patients with idiopathic PD and speech problems and no SLT for speech problems in the past 2 years were eligible...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29344355/impact-of-an-antifungal-stewardship-intervention-on-optimization-of-candidemia-management
#11
Hana Rac, Jamie L Wagner, S Travis King, Katie E Barber, Kayla R Stover
Background: Candidemia represents a leading cause of healthcare-associated bloodstream infections with significant morbidity and mortality. Previous studies have demonstrated that comprehensive care bundles improve candidemia management but are time-consuming. Objective: To determine the impact of a one-time targeted candidemia intervention on time to initiation of adequate therapy compared to standard of care. Methods: This Institutional Review Board (IRB)-approved, quasi-experiment evaluated a targeted candidemia intervention involving a single phone call to the primary team providing recommendations for care...
January 2018: Therapeutic Advances in Infectious Disease
https://www.readbyqxmd.com/read/29341967/new-modalities-for-the-administration-of-inhaled-nitric-oxide-in-intensive-care-units-after-cardiac-surgery-or-for-neonatal-indications-a-prospective-observational-study
#12
Philippe Gaudard, Claudio Barbanti, Bertrand Rozec, Philippe Mauriat, Mimoun M'rini, Gilles Cambonie, Jean Michel Liet, Claude Girard, Pierre Louis Leger, Ziad Assaf, Pierre Damas, Gauthier Loron, Laurent Lecourt, Julien Amour, Philippe Pouard
BACKGROUND: Nitric oxide (NO) has a well-known efficacy in pulmonary hypertension (PH), with wide use for 20 years in many countries. The objective of this study was to describe the current use of NO in real life and the gap with the guidelines. METHODS: This is a multicenter, prospective, observational study on inhaled NO administered through an integrated delivery and monitoring device and indicated for PH according to the market authorizations. The characteristics of NO therapy and ventilation modes were observed...
January 16, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29338568/lactoferrin-plus-health-education-versus-total-dose-infusion-tdi-of-low-molecular-weight-lmw-iron-dextran-for-treating-iron-deficiency-anemia-ida-in-pregnancy-a-randomized-controlled-trial
#13
A M Darwish, Fouly Ha, W H Saied, E Farah
BACKGROUND: Iron deficiency anemia (IDA) is one of the most common medical disorder disturbing pregnancies particularly in low resources countries, and contributes significantly to morbidities and mortalities. Thus, early diagnosis and prompt management of IDA is highly recommended. AIM: To Test the efficacy and safety of oral lactoferrin plus health education provided by a nurse versus total dose infusion (TDI) of low-molecular weight (LMW) iron dextran for treating IDA in the second and third trimester of pregnancy...
January 16, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29337837/accidental-rivaroxaban-intoxication-in-a-boy-some-lessons-in-managing-new-oral-anticoagulants-in-children
#14
Julieta Weirthein, Dennis Scolnik, Nili Yanai Milshtein, Tali Capua, Miguel Glatstein
Novel oral anticoagulants offer equivalent or improved therapeutic profiles compared with warfarin, with less risk of bleeding, no interactions with food, and no need for routine laboratory monitoring. Caution must be exercised in using these drugs in certain patient populations, for example, renal insufficiency, those receiving additional antithrombotic therapy, those with questionable compliance, children, and those with a high risk of gastrointestinal bleeding. One of the novel oral anticoagulants, rivaroxaban, is a direct Factor Xa inhibitor, used to reduce risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, deep vein thrombosis, and pulmonary embolism...
January 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29335863/integrative-medicine-on-optimizing-clopidogrel-and-aspirin-therapy
#15
REVIEW
Hui Chen
This article reviews the available published data on optimizing clopidogrel and aspirin therapy using translational and integrative medicine. Translational and evidence-based medical studies show that the CYP2C19 gene mutation (CYP2C19*2 and CYP2C19*3) could affect > 50% of the Chinese population, and that this mutation is closely associated with clopidogrel resistance and an increased risk of major adverse cardiovascular events, particularly stent thrombosis in patients following percutaneous coronary intervention (PCI)...
January 15, 2018: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/29335671/feasibility-acceptability-and-preliminary-effectiveness-of-a-4-week-mindfulness-based-cognitive-therapy-protocol-for-hospital-employees
#16
Christina M Luberto, Rachel S Wasson, Kristen M Kraemer, Richard W Sears, Carly Hueber, Sian Cotton
Hospital employees may experience occupational stress and burnout, which negatively impact quality of life and job performance. Evidence-based interventions implemented within the hospital setting are needed to promote employees' well-being. We offered a 4-week Mindfulness-Based Cognitive Therapy group program for hospital employees, and used a mixed-methods practice-based research approach to explore feasibility, acceptability, and effects on stress and burnout. Participants were 65 hospital employees (Mage = 44...
December 2017: Mindfulness
https://www.readbyqxmd.com/read/29334496/oxygen-in-the-critically-ill-friend-or-foe
#17
Elisa Damiani, Abele Donati, Massimo Girardis
PURPOSE OF REVIEW: To examine the potential harmful effects of hyperoxia and summarize the results of most recent clinical studies evaluating oxygen therapy in critically ill patients. RECENT FINDINGS: Excessive oxygen supplementation may have detrimental pulmonary and systemic effects because of enhanced oxidative stress and inflammation. Hyperoxia-induced lung injury includes altered surfactant protein composition, reduced mucociliary clearance and histological damage, resulting in atelectasis, reduced lung compliance and increased risk of infections...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29332072/medical-management-of-movement-disorders
#18
Marina Picillo, Renato P Munhoz
Pharmacological treatment is the cornerstone in the management of movement disorders. Although most available treatment options have no impact on the underlying process of each movement disorder, symptomatic therapies can significantly improve patient's quality of life and level of disability. Here, we review the current knowledge on clinical symptomatic management of Parkinson's disease (both early and advanced stages), essential tremor, dystonia, and chorea. Ideally, treatment should be carried out by specialists with reasonable experience in movement disorders, as it needs to be tailored for each patient depending on several appraisals, including but not limited to patients' needs, compliance issues, potential side effects, caregiver support, and presence of comorbidities...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332054/dementia-and-atrial-fibrillation-a-dangerous-combination-for-ischemic-stroke-and-mortality
#19
Daniele Pastori, Kazuo Miyazawa, Gregory Y H Lip
The risk of developing dementia is increased in patients with atrial fibrillation (AF), with the incidence of both conditions increasing with aging. Patients with dementia frequently do not receiving adequate thrombo-prophylaxis, because of the inability to monitor INR and/or to achieve and maintain good compliance with anticoagulant treatment. Under-treatment is therefore an important contributor to the increased risk of ischemic stroke and mortality in this subgroup of AF patients. In newly-diagnosed patients with AF starting oral anticoagulation, the presence of cognitive impairment should be considered in addition to the calculation of the SAMe-TT2R2 score, as part of an integrated decision management pathway to choose the most appropriate oral anticoagulant [i...
2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29330339/hiv-positive-kidney-donor-selection-for-hiv-positive-transplant-recipients
#20
Elmi Muller, Zunaid Barday
The risks associated with transplanting HIV-positive kidneys into HIV-positive recipients have not been well studied. Since 2008, 43 kidneys from 25 HIV-positive deceased donors have been transplanted into patients who are HIV positive in Cape Town, South Africa. Among the donors, 19 (76%) died secondary to trauma. The average age for donors was 34 (interquartile range, 19-52) years old. In some donors, only one kidney was used because of a limited number of suitable recipients on the waiting list. Only two donors had been previously exposed to antiretroviral triple therapy...
January 12, 2018: Journal of the American Society of Nephrology: JASN
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