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Evidence Based Medicine

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https://www.readbyqxmd.com/read/28734195/implementation-of-psychological-clinical-trials-in-epilepsy-review-and-guide
#1
REVIEW
Avani C Modi, Janelle Wagner, Aimee W Smith, Tanja S Kellermann, Rosa Michaelis
The International League Against Epilepsy (ILAE) Neuropsychiatry commission and United States Institute of Medicine report both identified cognitive and psychological comorbidities as a significant issue for individuals with epilepsy, with rates as high as 60%. However, there is a paucity of evidence-based treatments for many psychological conditions (e.g., learning disorders, cognitive disorders, behavioral disorders). Because of inherent challenges in the implementation of psychological therapy trials and specific considerations for the population with epilepsy, the focus of the current review was to provide guidance and recommendations to conduct psychological trials for individuals with epilepsy...
July 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28732324/anti-m%C3%A3-llerian-hormone-amh-levels-in-premenopausal-breast-cancer-patients-treated-with-taxane-based-adjuvant-chemotherapy-a-translational-research-project-of-the-success-a-study
#2
E K Trapp, J Steidl, B Rack, M S Kupka, U Andergassen, J Jückstock, A Kurt, T Vilsmaier, A de Gregorio, N de Gregorio, M Tzschaschel, C Lato, A Polasik, H Tesch, A Schneeweiss, M W Beckmann, P A Fasching, W Janni, V Müller
BACKGROUND: Premenopausal women undergoing chemotherapy are at high risk for premature ovarian failure and its long-term consequences. Data on potential markers to evaluate ovarian reserve pre- and posttreatment are limited. Anti-Müllerian hormone (AMH) known for ovarian reserve in reproductive medicine could be a surrogate marker and was assessed in premenopausal breast cancer patients of the SUCCESS A study (EUDRA-CT no. 2005-000490-21). METHODS: We identified 170 premenopausal patients, age ≤ 40 years at trial entry, who received FEC-Doc as taxane-anthracylince based chemotherapy...
July 18, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28731387/a-comparative-analysis-of-pulmonary-and-critical-care-medicine-guideline-development-methodologies
#3
Noah C Schoenberg, Alan F Barker, John Bernardo, Robin R Deterding, Jerrold J Ellner, Dean R Hess, Neil R MacIntyre, Fernando J Martinez, Kevin C Wilson
BACKGROUND: The Institute of Medicine (IOM) standards for guideline development have had unintended negative consequences. A more efficient approach is desirable. OBJECTIVE: To determine whether a modified Delphi process early during guideline development discriminates recommendations that should be informed by a systematic review from those that can be based upon expert consensus. METHODS: The same questions addressed by IOM-compliant pulmonary or critical care guidelines were addressed by expert panels using a modified Delphi process, the Convergence of Opinion on Recommendations and Evidence (CORE) process...
July 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28731036/stroke-in-women-from-evidence-to-inequalities
#4
REVIEW
Charlotte Cordonnier, Nikola Sprigg, Else Charlotte Sandset, Aleksandra Pavlovic, Katharina S Sunnerhagen, Valeria Caso, Hanne Christensen
Stroke is the second largest cause of disability-adjusted life-years lost worldwide. The prevalence of stroke in women is predicted to rise rapidly, owing to the increasing average age of the global female population. Vascular risk factors differ between women and men in terms of prevalence, and evidence increasingly supports the clinical importance of sex differences in stroke. The influence of some risk factors for stroke - including diabetes mellitus and atrial fibrillation - are stronger in women, and hypertensive disorders of pregnancy also affect the risk of stroke decades after pregnancy...
July 21, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28730671/many-faces-of-rationality-implications-of-the-great-rationality-debate-for-clinical-decision-making
#5
Benjamin Djulbegovic, Shira Elqayam
Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models...
July 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28729806/evidence-provided-for-the-use-of-oscillating-instruments-in-restorative-dentistry-a-systematic-review
#6
REVIEW
Panagiotis Ntovas, Spyridon Doukoudakis, John Tzoutzas, Panagiotis Lagouvardos
Oscillating diamond instruments are considered gentle sources for the removal of demineralized tooth hard tissues and the preparation of cavity angles and margins needed in minimally invasive dentistry. However, there is a question if literature provides enough evidence for their efficacy in restorative dentistry procedures. A literature search until May 2016 was conducted, using PubMed, Scopus, and The Cochrane Central Register of Controlled Trials databases. The quality of the studies was assessed using the recommendation of the Oxford Centre for Evidence-based Medicine...
April 2017: European Journal of Dentistry
https://www.readbyqxmd.com/read/28729428/fluorine-18-labeled-carboplatin-derivative-for-pet-imaging-of-platinum-drug-distribution
#7
Narottam Lamichhane, Gajanan K Dewkar, Sundaresan Gobalakrishnan, Li Wang, Purnima Jose, Muhammad Otabashi, Jean-Luc Morelle, Nicholas Farrell, Jamal Zweit
Increasing evidence indicates that reduced intracellular drug accumulation is the parameter most consistently associated with platinum drug resistance, and emphasizes the need to directly measure intra-tumor drug concentration. In the era of precision medicine and with the advent of powerful imaging and proteomics technologies, there is an opportunity to better understand drug resistance, by exploiting these techniques to provide new knowledge on drug-target interactions. Here, we are contributing to this endeavor by reporting on the development of a fluorine-18 labeled carboplatin derivative ((18)F-FCP) that can be used to potentially image drug uptake and retention, including intra-tumoral distribution, by positron emission tomography (PET)...
July 20, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28729171/exercise-therapy-in-juvenile-idiopathic-arthritis-a-systematic-review-and-meta-analysis
#8
REVIEW
Gregor Kuntze, Colleen Nesbitt, Jackie L Whittaker, Alberto Nettel-Aguirre, Clodagh Toomey, Shane Esau, Patricia K Doyle-Baker, Jena Shank, Julia Brooks, Susanne Benseler, Carolyn A Emery
OBJECTIVE: To conduct a systematic review to evaluate the efficacy of exercise interventions on improving outcomes across domains of functioning and disability in children and adolescents with Juvenile Idiopathic Arthritis (JIA). DATA SOURCES: Seven electronic databases were systematically searched up to December 2016. STUDY SELECTION: Original data, analytic prospective design, physical therapy led exercise intervention evaluation, children and adolescents with JIA, and assessment of functional, structural, activity, participation or quality of life outcomes...
July 17, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28729099/implementing-a-cervical-sentinel-lymph-node-biopsy-program-quality-improvement-in-gynaecologic-oncology
#9
Maria C Cusimano, Rachel Walker, Marcus Q Bernardini, Geneviève Bouchard-Fortier, Stephane Laframboise, Taymaa May, Joan Murphy, Barry Rosen, Al Covens, Blaise Clarke, Patricia Shaw, Marjan Rouzbahman, Ravi Mohan, Sarah E Ferguson
OBJECTIVE: Sentinel lymph node (SLN) biopsy is becoming a reasonable alternative to pelvic lymphadenectomy in early-stage cervical cancer. It is therefore imperative that centres without prior experience are able to successfully implement the procedure. The objectives of the current study were to (1) describe the process of implementing an SLN biopsy program with a novel peer mentorship component and (2) assess post-program quality improvement metrics, including SLN detection rate (DR) and diagnostic parameters...
August 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28728807/the-impact-of-team-based-primary-care-on-health-care-services-utilization-and-costs-quebec-s-family-medicine-groups
#10
Erin Strumpf, Mehdi Ammi, Mamadou Diop, Julie Fiset-Laniel, Pierre Tousignant
We investigate the effects on health care costs and utilization of team-based primary care delivery: Quebec's Family Medicine Groups (FMGs). FMGs include extended hours, patient enrolment and multidisciplinary teams, but they maintain the same remuneration scheme (fee-for-service) as outside FMGs. In contrast to previous studies, we examine the impacts of organizational changes in primary care settings in the absence of changes to provider payment and outside integrated care systems. We built a panel of administrative data of the population of elderly and chronically ill patients, characterizing all individuals as FMG enrollees or not...
July 1, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28727258/changing-systems-through-effective-teams-a-role-for-simulation
#11
Elizabeth D Rosenman, Rosemarie Fernandez, Ambrose H Wong, Michael Cassara, Dylan D Cooper, Maybelle Kou, Torrey A Laack, Ivette Motola, Jessica R Parsons, Benjamin R Levine, James A Grand
Teams are the building blocks of the healthcare system, with growing evidence linking the quality of health care to team effectiveness, and team effectiveness to team training. Simulation has been identified as an effective modality for team training and assessment. Despite this, there are gaps in methodology, measurement, and implementation that prevent maximizing the impact of simulation modalities on team performance. As part of the 2017 Academic Emergency Medicine Consensus Conference "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes," we explored the impact of simulation on various aspects of team effectiveness...
July 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28727148/treatment-of-intrahepatic-congenital-portosystemic-shunts-in-dogs-a-systematic-review
#12
REVIEW
M S Tivers, V J Lipscomb, D J Brockman
The aim of this study was to establish the evidence base for the treatment of intrahepatic congenital portosystemic shunts in dogs through a systematic review of the pertinent literature. Studies were filtered for evidence to answer the question "Which of the treatment options for intrahepatic CPSS in dogs offers the best short- and long-term outcome?" Studies were assigned a level of evidence based on a system published by the Oxford Centre for Evidence-Based Medicine. Thirty-two studies were included in the review...
July 20, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28725963/robot-assisted-surgery-for-mandibular-angle-split-osteotomy-using-augmented-reality-preliminary-results-on-clinical-animal-experiment
#13
Chaozheng Zhou, Ming Zhu, Yunyong Shi, Li Lin, Gang Chai, Yan Zhang, Le Xie
Mandibular angle split osteotomy (MASO) is a procedure widely used for prominent mandibular angles. However, conventional mandibular plastic surgery is invasive and high risk. It may induce postoperative neurosensory disturbance of the inferior alveolar nerve, fractures and infection due to the complexity of the anatomical structure and the narrow surgical field of view. The success rate of MASO surgery usually depends on the clinical experience and skills of the surgeon. To evaluate the performance of inexperienced plastic surgeons conducting this surgery, a self-developed and constructed robot system based on augmented reality is used...
July 19, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28725962/optimal-positioning-of-the-nipple-areola-complex-in-men-using-the-mohrenheim-estimated-tangential-tracking-line-mett-line-an-intuitive-approach
#14
Tobias R Mett, Nicco Krezdorn, Rosalia Luketina, Maria K Boyce, Helga Henseler, Ramin Ipaktchi, Peter M Vogt
INTRODUCTION: The reconstruction of the body shape after post-bariatric surgery or high-grade gynecomastia involves, besides skin tightening, the repositioning of anatomical, apparent landmarks. The surgeon usually defines these during the preoperative planning. In particular, the positions of the nipple-areola complexes (NAC) should contribute to the gender-appropriate appearance. While in the female breast numerous methods have been developed to determine the optimal position of the NACs, there are only a few, metric and often impractical algorithms for positioning the nipples and areoles in the male...
July 19, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28725620/attenuation-of-diabetic-nephropathy-in-streptozotocin-induced-diabetic-rats-by-punica-granatum-linn-leaves-extract
#15
Snehal Nitin Mestry, Jayesh Bachu Dhodi, Sangita Balbhim Kumbhar, Archana Ramesh Juvekar
With an objective to develop Complementary and Alternative Medicine for the treatment of diabetic nephropathy, the present study investigated the protective effects of methanolic extract of Punica granatum leaves (MPGL) in streptozotocin-induced diabetic nephropathy. Diabetic nephropathy has become a leading cause of end stage renal failure worldwide. P. granatum, due to its anti-diabetic, anti-inflammatory and antioxidant activities may retard the progression of diabetic nephropathy. In this study, diabetes was induced by a single injection of streptozotocin (STZ, 45 mg/kg, i...
July 2017: Journal of Traditional and Complementary Medicine
https://www.readbyqxmd.com/read/28724917/endocannabinoids-have-opposing-effects-on-behavioral-responses-to-nociceptive-and-non-nociceptive-stimuli
#16
Torrie Summers, Brandon Hanten, Warren Peterson, Brian Burrell
The endocannabinoid system is thought to modulate nociceptive signaling making it a potential therapeutic target for treating pain. However, there is evidence that endocannabinoids have both pro- and anti-nociceptive effects. In previous studies using Hirudo verbana (the medicinal leech), endocannabinoids were found to depress nociceptive synapses, but enhance non-nociceptive synapses. Here we examined whether endocannabinoids have similar bidirectional effects on behavioral responses to nociceptive vs. non-nociceptive stimuli in vivo...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28724707/towards-evidence-based-medicine-for-paediatricians
#17
Bob Phillips
No abstract text is available yet for this article.
August 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28724567/towards-evidence-based-emergency-medicine-best-bets-from-the-manchester-royal-infirmary
#18
Janos Baombe
No abstract text is available yet for this article.
August 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28724419/real-life-clinical-practice-results-with-vinflunine-in-patients-with-relapsed-platinum-treated-metastatic-urothelial-carcinoma-an-italian-multicenter-study-movie-goirc-01-2014
#19
Rodolfo Passalacqua, Silvia Lazzarelli, Maddalena Donini, Rodolfo Montironi, Rosa Tambaro, Ugo De Giorgi, Sandro Pignata, Raffaella Palumbo, Giovanni Luca Ceresoli, Gianluca Del Conte, Giuseppe Tonini, Franco Morelli, Franco Nolè, Stefano Panni, Ermanno Rondini, Annalisa Guida, Paolo Andrea Zucali, Laura Doni, Elisa Iezzi, Caterina Caminiti
BACKGROUND: Vinflunine is the only chemotherapeutic agent shown to improve survival in platinum-refractory patients with metastatic transitional cell carcinoma of the urothelium (TCCU) in a phase III clinical trial, which led to product registration for this indication in Europe. The aim of this study was to assess the efficacy of vinflunine and to evaluate the prognostic significance of risk factors in a large, unselected cohort of patients with metastatic TCCU treated according to routine clinical practice...
July 19, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28724394/development-of-newborn-screening-connect-nbs-connect-a-self-reported-patient-registry-and-its-role-in-improvement-of-care-for-patients-with-inherited-metabolic-disorders
#20
Yetsa Osara, Kathryn Coakley, Aishwarya Devarajan, Rani H Singh
BACKGROUND: Newborn Screening Connect (NBS Connect) is a web-based self-reported patient registry and resource for individuals and families affected by disorders included in the newborn screening panel. NBS Connect was launched in 2012 by Emory University after years of planning and grassroots work by professionals, consumers, and industry. Individuals with phenylketonuria (PKU), maple syrup urine disease (MSUD) or tyrosinemia (TYR) have been recruited through distribution of outreach materials, presentations at parent organization meetings and direct recruitment at clinic appointments...
July 19, 2017: Orphanet Journal of Rare Diseases
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