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Maya Balakrishnan, Rollin George, Ashish Sharma, David Y Graham, Hoda M Malaty
BACKGROUND: The USA has among the lowest gastric cancer incidence rates worldwide. AIM: To investigate whether increasing immigration from high cancer incidence countries has altered the GC incidence in a large US metropolitan area. METHODS: This was a retrospective cohort study among an underprivileged, multiethnic population in Texas. Gastric cancer cases diagnosed during 2005-2015 were identified using the cancer registry of the public medical care system for Harris County...
March 15, 2018: Digestive Diseases and Sciences
Emanuele F Osimo, Rudolf N Cardinal, Peter B Jones, Golam M Khandaker
Low-grade inflammation is a risk factor for depression, psychosis and other major psychiatric disorders. It is associated with poor response to antidepressant and antipsychotics, and could potentially be a treatment target. However, there is limited data on the prevalence of low-grade inflammation in major psychiatric disorders, and on the characteristics of patients who show evidence of inflammation. We examined the prevalence of low-grade inflammation and associated socio-demographic and clinical factors in acute psychiatric inpatients...
March 1, 2018: Psychoneuroendocrinology
Henry Anyimadu, Chandra Pingili, Vel Sivapalan, Yael Hirsch-Moverman, Sharon Mannheimer
Current guidelines suggest that HIV-infected patients should receive chemoprophylaxis against Pneumocystis jirovecii pneumonia (PJP) if they have a cluster determinant 4 (CD4) count <200 cells/mm3 or oropharyngeal candidiasis. Persons with CD4 percentage (CD4%) below 14% should also be considered for prophylaxis. Discordance between CD4 count and CD4% occurs in 16% to 25% of HIV-infected patients. Provider compliance with current PJP prophylaxis guidelines when such discordance is present was assessed. Electronic medical records of 429 HIV-infected individuals who had CD4 count and CD4% measured at our clinic were reviewed...
January 2018: Journal of the International Association of Providers of AIDS Care
Justin Ralph Abbatemarco, Mary Alissa Willis, Robert G Wilson, Sean J Nagel, Andre G Machado, Francois A Bethoux
OBJECTIVES: Stiff-person syndrome (SPS) is associated with axial rigidity superimposed on sustained muscle spasms. These symptoms commonly interfere with the performance of activities of daily living including ambulation. This retrospective case series evaluates the outcomes of screening tests and chronic infusion of intrathecal baclofen (ITB) in patients diagnosed with SPS treated in our spasticity clinic. MATERIALS AND METHODS: Patients were identified from an institutional review board-approved clinical registry of ITB therapy...
March 13, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Rodrigo Carmona, Benjamin Lê Cook, Enrique Baca-García, Ligia Chavez, Kiara Alvarez, Miren Iza, Margarita Alegría
Analyses of healthcare expenditures and adequacy are needed to identify cost-effective policies and practices that improve mental healthcare quality. Data are from 2010 to 2012 electronic health records from three hospital psychiatry departments in Madrid (n = 29,944 person-years) and three in Boston (n = 14,109 person-years). Two-part multivariate generalized linear regression and logistic regression models were estimated to identify site differences in mental healthcare expenditures and quality of care...
March 7, 2018: Journal of Behavioral Health Services & Research
Scott Powers, Junyang Qian, Kenneth Jung, Alejandro Schuler, Nigam H Shah, Trevor Hastie, Robert Tibshirani
When devising a course of treatment for a patient, doctors often have little quantitative evidence on which to base their decisions, beyond their medical education and published clinical trials. Stanford Health Care alone has millions of electronic medical records that are only just recently being leveraged to inform better treatment recommendations. These data present a unique challenge because they are high dimensional and observational. Our goal is to make personalized treatment recommendations based on the outcomes for past patients similar to a new patient...
March 6, 2018: Statistics in Medicine
Zixin Shu, Wenwen Liu, Huikun Wu, Mingzhong Xiao, Deng Wu, Ting Cao, Meng Ren, Junxiu Tao, Chuhua Zhang, Tangqing He, Xiaodong Li, Runshun Zhang, Xuezhong Zhou
BACKGROUND AND OBJECTIVE: Liver disease is a multifactorial complex disease with high global prevalence and poor long-term clinical efficacy and liver disease patients with different comorbidities often incorporate multiple phenotypes in the clinic. Thus, there is a pressing need to improve understanding of the complexity of clinical liver population to help gain more accurate disease subtypes for personalized treatment. METHODS: Individualized treatment of the traditional Chinese medicine (TCM) provides a theoretical basis to the study of personalized classification of complex diseases...
February 22, 2018: Computer Methods and Programs in Biomedicine
Karin Lisspers, Christer Janson, Kjell Larsson, Gunnar Johansson, Gunilla Telg, Marcus Thuresson, Björn Ställberg
BACKGROUND: Asthma is often associated with other diseases. To identify and manage comorbidities is important, as these conditions may increase the disease burden. OBJECTIVE: To describe the prevalence of comorbidities, disease burden and mortality across age groups in a large Swedish primary care real-life asthma population. METHODS: Observational cohort study of asthma patients, all ages, identified from electronic medical records by ICD-10-CM code, data from 36 primary care centers...
March 2018: Respiratory Medicine
Jason R Rudman, Christine Mei, Sara E Bressler, Susan H Blanton, Xue-Zhong Liu
Precision medicine (PM) proposes customized medical care based on a patient's unique genome, biomarkers, environment and behaviors. Hearing loss (HL) is the most common sensorineural disorder worldwide and is frequently caused by a single genetic mutation. With recent advances in PM tools such as genetic sequencing and data analysis, the field of HL is ideally positioned to adopt the strategies of PM. Here, we review current and future applications of PM in HL as they relate to the four core qualities of PM (P4): predictive, personalized, patient-centered, and participatory...
February 16, 2018: Journal of Genetics and Genomics, Yi Chuan Xue Bao
Barbara N Harding, Noel S Weiss, Rod L Walker, Eric B Larson, Sascha Dublin
PURPOSE: The purpose of the study is to determine if the use of a proton pump inhibitor (PPI) is associated with an increased fracture risk, as some prior studies have suggested. METHODS: This retrospective cohort study included data on 4438 participants aged 65 and older who had no fracture in the year prior to baseline and had ≥5 years of enrollment history in Kaiser Permanente Washington, an integrated healthcare delivery system in Seattle, WA, during 1994 to 2014...
February 28, 2018: Pharmacoepidemiology and Drug Safety
Steven Barnes, Julie Prescott
BACKGROUND: Extant evidence suggests that the proportion of adolescents suffering from anxiety disorders (ADs) has increased by up to 70% since the mid-1980s, with experience of anxiety at this stage associated with significant negative short- and long-term life outcomes. The existing therapeutic interventions (eg, cognitive behavioral therapy, CBT; attention bias modification, ABM) have proven to have clinically measurable benefits in reducing anxiety, but their efficacy is often compromised by social and practical barriers...
February 28, 2018: JMIR Serious Games
Kevin Selby, Gillian Bartlett-Esquilant, Jacques Cornuz
With their longitudinal patient relationships, primary care physicians and their care teams are uniquely situated to promote preventive medicine, including cancer screening. A confluence of forces is driving the demand for the personalization of cancer screening recommendations. Recommendations are increasingly based on individual patient preferences, medical history, genetic and environmental risk factors, and level of interaction with the healthcare system. Current examples include choices between colonoscopy, fecal testing, and emerging tests for colorectal cancer (CRC) screening; the use of genetic information and availability of home self-testing in cervical cancer screening; the integration of multiple risk factors and patient preferences to decide the intensity and length of breast cancer screening; and the issues of smoking cessation and competing priorities when deciding whether or not to pursue lung cancer screening...
2018: Public Health Reviews
Lasse Bjerg, Adam Hulman, Morten Charles, Marit Eika Jørgensen, Daniel Rinse Witte
AIMS: To describe to what extent microvascular complications exhibit clustering in persons with Type 1 diabetes, and to assess whether the presence of one complication modified the strength of the association between the other two. METHODS: We conducted a cross-sectional analysis of the electronic medical records of 2276 persons with Type 1 diabetes treated in a specialized care hospital in Denmark in 2013. We used log-linear analysis to describe associations between diabetic kidney disease, neuropathy and retinopathy and logistic regression models to quantify the magnitude of associations adjusting for potential confounders...
February 22, 2018: Journal of Diabetes and its Complications
Evan A DeZeeuw, Ashley M Coleman, Milap C Nahata
OBJECTIVES: The majority of studies on medication therapy management (MTM) have focused on the conduct of in-person comprehensive medication reviews (CMRs). Although face-to-face MTM services may be the most well-known mode of delivery, there are other ways CMRs can be implemented as part of an MTM service. Specifically, telephonic CMR is an alternative method of offering MTM services that many patients may welcome. The purpose of this commentary was to highlight current findings regarding the impact of telephonic CMRs as a component of MTM services on health outcomes...
February 1, 2018: American Journal of Managed Care
Megan B Cole, Brad Wright, Ira B Wilson, Omar Galárraga, Amal N Trivedi
BACKGROUND: To monitor progress towards eliminating health disparities, community health centers have reported on hypertension control, diabetes control, and birthweight by race and ethnicity since 2008. OBJECTIVE: To evaluate racial/ethnic time trends in quality outcomes in health centers and to assess both within- and between-center disparities in outcomes. DESIGN AND SAMPLE: Using 2009-2014 data from all US health centers (n = 1047 centers, serving 19...
February 16, 2018: Journal of General Internal Medicine
Christopher J Pannucci, Kory I Fleming
OBJECTIVE: Perioperative venous thromboembolism (VTE) risk can be quantified with the 2005 Caprini score. The Caprini score has previously been validated by review of the electronic medical record (EMR) in >3000 plastic surgery patients. However, the accuracy of Caprini-based risk stratification using the EMR, as opposed to face-to-face contact with the patient, remains unknown. METHODS: Plastic and reconstructive surgery patients who had surgery under general anesthesia, required postoperative admission, and were started on enoxaparin prophylaxis were identified...
February 13, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Michael B Rothberg, Bo Hu, Laura Lipold, Sarah Schramm, Xian Wen Jin, Andrea Sikon, Glen B Taksler
IMPORTANCE: Cervical cancer screening guidelines are in evolution. Current guidelines do not differentiate recommendations based on individual patient risk. OBJECTIVE: To derive and validate a tool for predicting individualized probability of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) at a single time point, based on demographic factors and medical history. DESIGN: The study design consisted of an observational cohort with hierarchical generalized linear regression modeling...
February 15, 2018: Cancer Causes & Control: CCC
Marilyn M Schapira, William E Barlow, Emily F Conant, Brian L Sprague, Anna N A Tosteson, Jennifer S Haas, Tracy Onega, Elisabeth F Beaber, Martha Goodrich, Anne Marie McCarthy, Sally D Herschorn, Celette Sugg Skinner, Tory O Harrington, Berta Geller
RATIONALE AND OBJECTIVES: The objective of this study was to evaluate the association of communication practices with timely follow-up of screening mammograms read as Breast Imaging Reporting and Data Systems (BI-RADS) 0 in the Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium. MATERIALS AND METHODS: A radiology facility survey was conducted in 2015 with responses linked to screening mammograms obtained in 2011-2014...
February 9, 2018: Academic Radiology
Peter Vermeir, Sophie Degroote, Hanne Van Tiggelen, Dominique Vandijck, Renaat Peleman, Rik Verhaeghe, An Mariman, Hubert Vermeersch, Dirk Vogelaers
Objectives To explore patient perceptions on personal comfort with participation in their own care process and on support of this patient participation through electronic health record (EHR) accessibility. Methods Explorative quantitative questionnaire study in ambulatory patients visiting the departments of General Internal Medicine or Head, Neck and Maxillo-Facial Surgery of a Belgian tertiary referral center. Results Patients were recruited by convenience sampling of 438 out of the total of 1270 patients visiting either one of these departments within a time period of two weeks...
February 12, 2018: Acta Clinica Belgica
Tian-Ying Chang, Yan Shan, Sai-Sai Liu, Song Xiao-Yue, Zheng-Yan Li, Li-Ping Du, Yan-Yan Li, Gao Douqing
AIM AND OBJECTIVE: To examine whether the information-motivation-behavioral skills (IMB) model could predict self-care behavior among Chinese peritoneal dialysis patients. BACKGROUND: Peritoneal dialysis is a treatment performed by patients or their caregivers in their own home. It is important to implement theory-based projects to increase the self-care of patients with peritoneal dialysis. The IMB model has been verified in diverse populations as a comprehensive, effective model to guide the design, implementation, and evaluation of self-care programs...
February 8, 2018: Journal of Clinical Nursing
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