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https://www.readbyqxmd.com/read/27915443/successful-combination-of-endoscopic-pyloromyotomy-and-balloon-dilatation-for-hypertrophic-pyloric-stenosis-in-an-older-child-a-novel-procedure
#1
Satoshi Yokoyama, Shiro Uyama, Hiroyoshi Iwagami, Yukitaka Yamashita
BACKGROUND: Hypertrophic pyloric stenosis (HPS) is a rare cause of gastric outlet obstruction beyond infancy. Ramstedt pyloromyotomy remains the gold standard treatment for HPS. This type of HPS can be managed successfully with pyloromyotomy under laparoscopic or open procedures. Endoscopic pyloric balloon dilation (EPBD) has not been recommended in the treatment of HPS, and there are only a small number of reported cases who had had successful endoscopic pyloromyotomy (EP) for HPS only in infants...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27915426/impact-of-a-medication-therapy-management-service-on-the-clinical-status-of-patients-with-chronic-obstructive-pulmonary-disease
#2
Kirla B Detoni, Isabela V Oliveira, Mariana M G Nascimento, Thaís R Caux, Mateus R Alves, Djenane Ramalho-de-Oliveira
Background At this moment, there is no information in the literature showing the impact of comprehensive medication management (CMM) service delivered to patients with chronic obstructive pulmonary disease. Objective This study aims to present the clinical outcomes of this service provided to patients with chronic obstructive pulmonary disease. Settings Public specialty pharmacy where high cost drug treatments are provided for medical conditions not covered by the primary care such as COPD, located in Minas Gerais State, Brazil...
December 3, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27915328/critical-care-nephrology-a-multidisciplinary-approach
#3
Lilia Rizo-Topete, Claudio Ronco
Acute kidney injury (AKI) is a serious medical condition affecting millions of people. Patients in intensive care unit (ICU) who develop AKI have increased morbidity and mortality, prolonged length of stay in ICU and hospital and increased costs, especially when they require renal replacement therapy. In the latter case, morbidity and mortality increase further. In order to meet the needs of the critically ill patients, a multidisciplinary care team is required, combining the efforts of physicians and nurses from different disciplines as well as nephrologists and intensivists...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27915320/retinopathy-of-prematurity-aiims-new-delhi-experience
#4
Sindhu Sivanandan, Parijat Chandra, Ashok K Deorari, Ramesh Agarwal
Retinopathy of prematurity (ROP) is a leading cause of potentially avoidable childhood blindness worldwide. With improvement in neonatal care, more preterm infants are surviving with a resultant increase in the number of ROP cases. In low-middle income countries, the disease epidemiology is characterized by the occurrence of ROP at higher birthweight in premature babies with greater severity at presentation. In this article, we describe the ROP screening and management program at the All India Institute of Medical Sciences (AIIMS), New Delhi that has evolved over last three decades...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27915265/the-ethics-of-unilateral-implantable-cardioverter-defibrillators-and-cardiac-resynchronization-therapy-with-defibrillator-deactivation-patient-perspectives
#5
Margaret Daeschler, Ralph J Verdino, James N Kirkpatrick
AIMS: Decisions about deactivation of implantable cardioverter defibrillators (ICDs) are complicated. Unilateral do-not-resuscitate (DNR) orders (against patient/family wishes) have been ethically justified in cases of medical futility. Unilateral deactivation of ICDs may be seen as a logical extension of a unilateral DNR order. However, the ethical implications of unilateral ICD deactivation have not been explored. METHODS AND RESULTS: Sixty patients who had an ICD or cardiac resynchronization therapy with defibrillator (CRT-D) were interviewed at a quaternary medical centre outpatient electrophysiology practice...
December 2, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27915164/can-the-cerebral-regional-oxygen-saturation-be-a-perfusion-parameter-in-shock
#6
Ashraf Al Tayar, Amr Abouelela, Khaja Mohiuddeen
INTRODUCTION: Shock, defined as a state of tissue hypoperfusion and the tissues reperfusion, is the main goal of management of shock. Increase in central venous saturation (CvSo2) and decrease in blood lactate level are useful in assessment of adequacy of tissue perfusion. Near-infrared spectroscopy is a noninvasive way to observe real-time changes in regional cerebral saturation and has been used in patients with different brain diseases. There is a small body of literature suggesting that cerebral regional oxygen saturation (CrSo2) monitoring added a value in assessment and management of intensive care unit (ICU) patients...
November 10, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27915035/hyperinsulinaemic-hypoglycaemia-in-children-and-adults
#7
REVIEW
Pratik Shah, Sofia A Rahman, Huseyin Demirbilek, Maria Güemes, Khalid Hussain
Pancreatic β cells are functionally programmed to release insulin in response to changes in plasma glucose concentration. Insulin secretion is precisely regulated so that, under normal physiological conditions, fasting plasma glucose concentrations are kept within a narrow range of 3·5-5·5 mmol/L. In hyperinsulinaemic hypoglycaemia, insulin secretion becomes dysregulated (ie, uncoupled from glucose metabolism) so that insulin secretion persists in the presence of low plasma glucose concentrations. Hyperinsulinaemic hypoglycaemia is the most common cause of severe and persistent hypoglycaemia in neonates and children...
November 30, 2016: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/27914950/access-to-medications-for-medicare-enrollees-related-to-race-ethnicity-results-from-the-2013-medicare-current-beneficiary-survey
#8
Deborah A Taira, Chengli Shen, Marshaleen King, Doug Landsittel, Mary Helen Mays, Tetine Sentell, Janet Southerland
BACKGROUND: Prescription medications are taken by millions of Americans to manage chronic conditions and treat acute conditions. These medications, however, are not equally accessible to all. OBJECTIVE: To examine medication access by race/ethnicity among Medicare beneficiaries. METHODS: Using the 2013 Medicare Current Beneficiary Survey (n = 10.515), this study examined access to medications related to race/ethnicity, comparing non-Hispanic blacks and Hispanics to whites...
November 23, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27914817/what-really-happens-in-the-home-the-medication-environment-of-urban-minority-youth
#9
Andrea A Pappalardo, Kelly Karavolos, Molly A Martin
BACKGROUND: Asthma disproportionately affects minority youth. Understanding the home medication environment and its relation to medication adherence can shape interventions to improve health outcomes. OBJECTIVE: The objective of this study was to describe the asthma medication environment in the homes of urban minority youth and to determine predictors of medication use and technique in this population. METHODS: Baseline data from 2 cohorts of minority youth with asthma in Chicago were combined for cross-sectional analysis...
November 30, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27914816/clinical-approach-used-in-medical-consultations-for-allergic-like-events-following-immunization-case-series-report-in-relation-to-practice-guidelines
#10
Joseline G Zafack, Gaston De Serres, Isabelle Rouleau, Marie-Claude Gariépy, Rémi Gagnon, Jean-Philippe Drolet, Danuta M Skowronski
BACKGROUND: The Joint Task Force on Practice Parameters (JTFPP) guidelines for the investigation and reimmunization of patients who experienced allergic-like events (ALEs) after immunization are predicated on the likelihood of anaphylaxis, assessed through the time to symptom onset (≤ or >4 hours) and number of systems involved. OBJECTIVE: The objectives of this study were to compare the management of a series of patients with ALE in actual practice relative to JTFPP guidelines and to discuss key concepts and considerations in their use...
November 30, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27914815/findings-from-an-online-survey-assessing-the-burden-and-management-of-seasonal-allergic-rhinoconjunctivitis-in-us-patients
#11
Eli O Meltzer, Judith Rosen Farrar, Cary Sennett
BACKGROUND: Seasonal allergic rhinoconjunctivitis (SARC) affects ≥16% of the US population annually. Telephone and in-office surveys have demonstrated negative effects of allergic rhinitis (AR) symptoms on sleep, daily activities, productivity, concentration, and emotions. OBJECTIVE: The objective of this study was to assess the patient-perceived burden of SARC in relation to newer treatments, increased access to treatments, and changing management protocols. METHODS: An online survey of symptom experience, impact on daily life, and management was conducted in US respondents who suffer (or whose child suffers) from SARC symptoms...
November 30, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27914731/self-management-in-patients-with-diabetes-and-chronic-kidney-disease-is-associated-with-incremental-benefit-in-hrqol
#12
Edward Zimbudzi, Clement Lo, Sanjeeva Ranasinha, Peter G Kerr, Timothy Usherwood, Alan Cass, Gregory R Fulcher, Sophia Zoungas
AIMS: There is insufficient and inconsistent data regarding the association between diabetes self-management, the process of facilitating the knowledge, skill, and ability necessary for diabetes self-care, and health-related quality of life (HRQOL) in people with diabetes and moderate to severe chronic kidney disease (CKD). METHODS: In a cross sectional study, participation in diabetes self-management assessed by the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire and HRQOL was examined in 308 patients with diabetes and CKD (stages 3 to 5) recruited from outpatient diabetes and renal clinics of 4 public tertiary hospitals...
October 29, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27914698/under-prescription-of-statins-in-patients-with-non-alcoholic-fatty-liver-disease
#13
M Del Ben, F Baratta, L Polimeni, D Pastori, L Loffredo, M Averna, F Violi, F Angelico
BACKGROUND AND AIM: Non-alcoholic fatty liver disease (NAFLD) is a common disease associated with high cardiovascular risk. Management of dyslipidaemia plays a pivotal role in the prevention of CV events and statins have proved to be safe in these patients. However, in everyday clinical practice statin prescription is sometimes limited because of the concern of physicians about side-effects. The aim of the study was to investigate if the presence of NAFLD affects the prescription of lipid-lowering treatment in a large series of patients with cardio-metabolic disorders...
September 28, 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/27914657/ulcerative-colitis
#14
REVIEW
Ryan Ungaro, Saurabh Mehandru, Patrick B Allen, Laurent Peyrin-Biroulet, Jean-Frédéric Colombel
Ulcerative colitis is a chronic inflammatory disease affecting the colon, and its incidence is rising worldwide. The pathogenesis is multifactorial, involving genetic predisposition, epithelial barrier defects, dysregulated immune responses, and environmental factors. Patients with ulcerative colitis have mucosal inflammation starting in the rectum that can extend continuously to proximal segments of the colon. Ulcerative colitis usually presents with bloody diarrhoea and is diagnosed by colonoscopy and histological findings...
November 30, 2016: Lancet
https://www.readbyqxmd.com/read/27914632/the-us-food-and-drug-administration-s-risk-evaluation-and-mitigation-strategy-rems-program-current-status-and-future-direction
#15
Jasmanda Wu, Juhaeri Juhaeri
The US Food and Drug Administration (FDA) Amendments Act of 2007 granted the FDA new authorities to enhance drug safety by requiring application holders to submit a proposed Risk Evaluation and Mitigation Strategy (REMS). A REMS is a required risk management plan that uses tools beyond the package insert. REMS elements may include a medication guide and patient package insert for patients and a communication plan focused on health care professionals. Elements to assure safe use (ETASUs) are put in place to mitigate a specific known serious risk when other less restrictive elements of a REMS are not sufficient to mitigate such risk...
November 30, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27914497/acute-management-of-stroke-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants-addressing-real-world-anticoagulant-management-issues-in-stroke-aramis-registry-design-and-rationale
#16
Ying Xian, Adrian F Hernandez, Tina Harding, Gregg C Fonarow, Deepak L Bhatt, Robert E Suter, Yosef Khan, Lee H Schwamm, Eric D Peterson
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs, dabigatran, rivaroxaban, apixaban, and edoxaban) have been increasingly used as alternatives to warfarin for stroke prophylaxis in patients with atrial fibrillation. Yet there is substantial lack of information on how patients on NOACs are currently treated when they have an acute ischemic stroke and the best strategies for treating intracerebral hemorrhage for those on chronic anticoagulation with warfarin or a NOAC. These are critical unmet needs for real world clinical decision making in these emergent patients...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914295/sarcopenia-and-post-hospital-outcomes-in-older-adults-a-longitudinal-study
#17
Mario Ulises Pérez-Zepeda, Aldo Sgaravatti, Elsa Dent
INTRODUCTION: Sarcopenia poses a significant problem for older adults, yet very little is known about this medical condition in the hospital setting. The aims of this hospital-based study were to determine: (i) the prevalence of sarcopenia; (ii) factors associated with sarcopenia; and (iii) the association of sarcopenia with adverse clinical outcomes post-hospitalisation. METHODS: This is a longitudinal analysis of consecutive patients aged ≥70 years admitted to a Geriatric Management and Evaluation Unit (GEMU) ward...
November 17, 2016: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27913984/basal-insulin-persistence-associated-factors-and-outcomes-after-treatment-initiation-a-retrospective-database-study-among-people-with-type-2-diabetes-mellitus-in-japan
#18
Irene Hadjiyianni, Urvi Desai, Shuichi Suzuki, Jasmina I Ivanova, Dachuang Cao, Noam Y Kirson, Dai Chida, Caroline Enloe, Howard G Birnbaum, Magaly Perez-Nieves
INTRODUCTION: The objective of this study was to assess basal insulin persistence, associated factors, and economic outcomes for insulin-naïve people with type 2 diabetes mellitus (T2DM) in Japan. METHODS: People aged at least 18 years with T2DM with first claim for basal insulin between May 2006 and April 2013 (index date), no insulin use before index date, and continuous insurance coverage for 6 months before (baseline) and 12 months after index date were selected from the Japan Medical Center Database...
December 2, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#19
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27913813/-rehabilitation-after-hip-and-knee-endoprosthetic-treatment-in-the-elderly
#20
H Bork
Due to current demographic developments with a continuous increase in average life expectancy and improved medical treatment, the number of elderly patients with joint replacement of the lower extremities also has increased in recent years. Most of these patients have not only one but several chronic diseases requiring treatment and medication. Drug-drug interaction and functional restrictions of the elderly additionally reduce the postoperative psychophysical capacity; therefore, special knowledge in rehabilitative treatment and pain management is necessary...
December 2, 2016: Der Orthopäde
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