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https://www.readbyqxmd.com/read/28431428/computational-and-in-vitro-experimental-investigation-of-intrathecal-drug-distribution-parametric-study-of-the-effect-of-injection-volume-cerebrospinal-fluid-pulsatility-and-drug-uptake
#1
Kevin M Tangen, Roxanne Leval, Ankit I Mehta, Andreas A Linninger
BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430850/trends-in-hospitalization-for-hypertensive-emergency-and-relationship-of-end-organ-damage-with-in-hospital-mortality
#2
Mahek Shah, Shantanu Patil, Brijesh Patel, Shilpkumar Arora, Nilay Patel, Lohit Garg, Sahil Agrawal, Larry Jacobs, Susan P Steigerwalt, Matthew W Martinez
BACKGROUND: There are no comprehensive guidelines on management of hypertensive emergency (HTNE) and complications. Despite advances in antihypertensive medications HTNE is accompanied with significant morbidity and mortality. METHODS: We queried the 2002-2012 nationwide inpatient sample database to identify patients with HTNE. Trends in incidence of HTNE and in-hospital mortality were analyzed. Logistic regression analysis was used to assess the relationship between end-organ complications and in-hospital mortality...
April 20, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28430742/utility-of-single-photon-emission-tomography-computed-tomography-for-sentinel-lymph-node-localization-in-breast-cancer-patients
#3
Agnieszka Giżewska, Ewa Witkowska-Patena, Sebastian Osiecki, Andrzej Mazurek, Zofia Stembrowicz-Nowakowska, Mirosław Dziuk
OBJECTIVES: Sentinel lymph node (SLN) mapping is currently a routine technique in breast cancer management and preoperative scintigraphic imaging plays a crucial role in the process of SLN detection. The guidelines recommend performing planar acquisition and optional single-photon emission tomography/computed tomography (SPECT/CT) imaging. The aim of this study was to verify whether routine performing of SPECT/CT in addition to planar imaging increases the sensitivity of SLN detection in patients with early-stage breast cancer...
April 20, 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/28430713/a-national-survey-of-neonatologists-barriers-and-prerequisites-to-introduce-point-of-care-ultrasound-in-neonatal-icus
#4
Hussnain S Mirza, Gregory Logsdon, Anoop Pulickal, Mark Stephens, Rajan Wadhawan
Point-of-care (POC) ultrasound refers to the use of portable imaging. Although POC ultrasound is widely available to the neonatologists in Australia and Europe, neonatologists in the United States report limited availability. Our objective was to seek the US neonatologists' perception of barriers and prerequisites in adopting POC ultrasound in neonatal intensive care units. An online survey link was sent via e-mail to 3000 neonatologists included in the database maintained by the American Academy of Pediatrics...
April 20, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28430610/treatment-of-hepatocellular-carcinoma-with-portal-vein-tumor-thrombus-advances-and-challenges
#5
REVIEW
Jin-Fang Jiang, Yong-Cong Lao, Bao-Hong Yuan, Jun Yin, Xin Liu, Long Chen, Jian-Hong Zhong
Portal vein tumor thrombus is a frequent, challenging complication in hepatocellular carcinoma. Hepatocellular carcinoma patients with portal vein tumor thrombus may show worse liver function, less treatment tolerance and worse prognosis than patients without portal vein tumor thrombus, and they may be at higher risk of comorbidity related to portal hypertension. Western and some Asian guidelines stratify hepatocellular carcinoma with portal vein tumor thrombus together with metastatic hepatocellular carcinoma and therefore recommend only palliative treatment with sorafenib or other systemic agents...
February 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28430170/current-management-of-gout-practical-messages-from-eular-2016-guidelines
#6
George Nuki, Michael Doherty, Pascal Richette
The European League Against Rheumatism published updated recommendations for the management of gout in 2016, comprising 3 overarching principles and 11 key recommendations for clinical practice. Patient education about the pathophysiology of gout and its comorbidities, as well as the existence of effective treatments are important, and understanding the principles of managing acute attacks and eliminating urate crystals by lifelong lowering of the serum urate (SU) below a target level are essential. Advice about lifestyle, diet, weight, and other risk factors, as well as the need to screen for, and manage, comorbidities is emphasized...
April 21, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28429665/the-2016-aha-acc-guideline-on-the-management-of-patients-with-lower-extremity-peripheral-artery-disease-an-interview-with-svm-members-of-the-writing-committee
#7
Ehrin J Armstrong, Heather L Gornik, Naomi M Hamburg, Scott Kinlay
No abstract text is available yet for this article.
April 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28429651/time-to-improve-statin-prescription-guidelines-in-low-risk-patients
#8
Jan W Balder, Jeroen K de Vries, Douwe J Mulder, Pieter W Kamphuisen
Background The challenge of the primary prevention of cardiovascular disease (CVD) is to identify patients who would benefit from treatment with statins. Statins are currently prescribed to many patients, even those at a low 10-year risk of CVD. These latter patients may not be eligible for statins according to current guidelines. Design This study investigated the prescription of guideline-consistent (according to guidelines) and guideline-inconsistent (not according to guidelines) lipid-lowering treatment in primary prevention in a large contemporary Dutch cohort study (Lifelines)...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28429577/investigating-general-medication-prescription-by-general-practitioners-during-a-12-month-randomized-controlled-weight-loss-trial
#9
N R Fuller, N S Lau, T P Markovic, I D Caterson
Much healthcare expenditure is on pharmaceutical drugs. Expenditure on medications has increased both in absolute terms, and as a proportion of total health expenditure. No previous studies have investigated the prescribing costs by general practitioners when managing patients during a weight loss intervention. This study evaluated the medication costs by individual class during a 1-year study in which 268 participants were randomized to one of two weight loss programmes, either standard care (SC) as defined by national guidelines, or a commercial provider (Weight Watchers) (CP)...
April 20, 2017: Clinical Obesity
https://www.readbyqxmd.com/read/28429560/is-there-a-role-for-newer-biomarkers-in-chronic-kidney-disease-mineral-and-bone-disorder-management
#10
Sven-Jean Tan, Michael Mx Cai
The current management of Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD) relies largely on clinical judgement and assessment of biochemical parameters including serum calcium, phosphate and intact parathyroid hormone concentrations. In the past two decades, there has been a leap in the understanding of the pathophysiology of CKD-MBD, leading to the discovery of novel biomarkers. The potential utility of these markers in this clinical setting is an area of intense investigation. In the absence of any guidelines aiding the clinician's understanding and application of these markers, we summarise the current available literature surrounding fibroblast growth factor-23, α-Klotho, sclerostin and serum calcification propensity testing and their respective assays in the context of CKD-MBD management...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429473/surgery-for-limited-stage-small-cell-lung-cancer
#11
REVIEW
Hayley Barnes, Katharine See, Stephen Barnett, Renée Manser
BACKGROUND: Current treatment guidelines for limited-stage small-cell lung cancer (SCLC) recommend concomitant platinum-based chemo-radiotherapy plus prophylactic cranial irradiation, based on the premise that SCLC disseminates early, and is chemosensitive. However, although there is usually a favourable initial response, relapse is common and the cure rate for limited-stage SCLC remains relatively poor. Some recent clinical practice guidelines have recommended surgery for stage 1 (limited) SCLC followed by adjuvant chemotherapy, but this recommendation is largely based on the findings of observational studies...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28429207/organizational-and-welfare-mode-of-breast-centers-network-a-survey-of-sicilian-radiologists
#12
Maria Adele Marino, Orazio Pennisi, Annalisa Donia, Carmelo Sofia, Claudio Guerra, Carmelo Privitera, Placido Romeo
The European Society of Breast Cancer Specialists has created quality indicators for breast units to establish the minimum standards of care for patients. In Italy, each region differs, indeed, in terms of health care and services warranted to patients suffering from breast cancer. Since Sicilian Regional Administration today is still disregarding implementation of the provisions contained in the proposal of the Ministry of Health entitled "Guidelines on Organizational and Health Care Methods of Breast Centers Network" in November 2015 the Sicilian Regional Group of the Italian Society of Radiology (SIRM) decided to carry out a survey to see the position of the Sicilian Healthcare System and define the gap to bridge over...
April 20, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28429142/national-clinical-guidelines-for-non-surgical-treatment-of-patients-with-recent-onset-low-back-pain-or-lumbar-radiculopathy
#13
REVIEW
Mette Jensen Stochkendahl, Per Kjaer, Jan Hartvigsen, Alice Kongsted, Jens Aaboe, Margrethe Andersen, Mikkel Ø Andersen, Gilles Fournier, Betina Højgaard, Martin Bach Jensen, Lone Donbæk Jensen, Ture Karbo, Lilli Kirkeskov, Martin Melbye, Lone Morsel-Carlsen, Jan Nordsteen, Thorvaldur Skuli Palsson, Zoreh Rasti, Peter Frost Silbye, Morten Zebitz Steiness, Simon Tarp, Morten Vaagholt
PURPOSE: To summarise recommendations about 20 non-surgical interventions for recent onset (<12 weeks) non-specific low back pain (LBP) and lumbar radiculopathy (LR) based on two guidelines from the Danish Health Authority. METHODS: Two multidisciplinary working groups formulated recommendations based on the GRADE approach. RESULTS: Sixteen recommendations were based on evidence, and four on consensus. Management of LBP and LR should include information about prognosis, warning signs, and advise to remain active...
April 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28428699/putative-role-of-cardio-metabolic-risk-among-poorly-controlled-asthmatics-in-south-indian-population
#14
Murugaiyan Sathish Babu, K P Sreesoorya, Surendra K Menon, Subiman Saha, A R Srinivasan, S Arul Vijaya Vani, R Reeta, V Kuzhandai Velu
Mortality and morbidity attributed to asthma remains to be the biggest nightmare worldwide. Hence, the study was aimed to compare the cardio metabolic risk factors as assessed by Body mass index (BMI), waist hip ratio (WHR), serum triacylglycerol and uric acid in well controlled and poorly controlled asthmatics and to correlate these parameters with the severity of asthma. A case control study was conducted on 90 subjects who were segregated into well controlled asthmatics (n = 30) and poorly controlled asthmatics (n = 30) who were diagnosed based on Global initiative for Asthma management guidelines and healthy volunteers (n = 30)...
June 2017: Indian Journal of Clinical Biochemistry: IJCB
https://www.readbyqxmd.com/read/28428567/novel-oral-anticoagulants-and-exodontia-the-evidence
#15
S Nathwani, C Wanis
Background Haemostasis is crucial for the success of oral surgical treatment as bleeding problems can cause complications both pre- and post-operatively. Patients on anticoagulant drugs present a challenge due to their increased risk of bleeding.Aims To review the evidence for the management of oral surgery patients on novel oral anticoagulant therapy.Methods A literature review was conducted in May 2016 of free-text and MESH searches (keywords: apixaban, dabigatran, rivaroxaban and dental extractions) in the Cochrane Library, PubMed and CINAHL...
April 21, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28428168/testing-the-feasibility-and-usability-of-a-novel-smartphone-based-self-management-support-system-for-dialysis-patients-a-pilot-study
#16
Aki Hayashi, Satoko Yamaguchi, Kayo Waki, Katsuhito Fujiu, Norio Hanafusa, Takahiro Nishi, Hyoe Tomita, Haruka Kobayashi, Hideo Fujita, Takashi Kadowaki, Masaomi Nangaku, Kazuhiko Ohe
BACKGROUND: Diet and fluid restrictions that need continuous self-management are among the most difficult aspects of dialysis treatment. Smartphone applications may be useful for supporting self-management. OBJECTIVE: Our objective is to investigate the feasibility and usability of a novel smartphone-based self-management support system for dialysis patients. METHODS: We developed the Self-Management and Recording System for Dialysis (SMART-D), which supports self-monitoring of three mortality-related factors that can be modified by lifestyle: interdialytic weight gain and predialysis serum potassium and phosphorus concentrations...
April 20, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28428157/texting-and-mobile-phone-app-interventions-for-improving-adherence-to-preventive-behavior-in-adolescents-a-systematic-review
#17
Sherif M Badawy, Lisa M Kuhns
BACKGROUND: Many preventable behaviors contribute to adolescent mortality and morbidity. Non-adherence to preventive measures represents a challenge and has been associated with worse health outcomes in this population. The widespread use of electronic communication technologies by adolescents, particularly the use of text messaging (short message service, SMS) and mobile phones, presents new opportunities to intervene on risk and preventive risk behavior, but little is known about their efficacy...
April 19, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28428095/sjogren-s-syndrome-clinical-aspects
#18
Frederick B Vivino
Sjogren's syndrome (SS) is the 2nd most common chronic autoimmune rheumatic disease and associated with a high burden of illness. Morbidity arises not only from untreated xerostomia and keratoconjunctivitis sicca but also from extra-glandular manifestations and the development of non-Hodgkin's B cell lymphomas. Proper diagnosis of SS requires objective evidence of dry eyes and/or objective evidence of dry mouth and proof of autoimmunity. The recent development of new international classification criteria and clinical practice guidelines for SS should not only enhance the existing standards of care but also facilitate further studies to improve future diagnosis and management...
April 17, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/28428019/radiation-therapy-for-oropharyngeal-squamous-cell-carcinoma-executive-summary-of-an-astro-evidence-based-clinical-practice-guideline
#19
David J Sher, David J Adelstein, Gopal K Bajaj, David M Brizel, Ezra E W Cohen, Aditya Halthore, Louis B Harrison, Charles Lu, Benjamin J Moeller, Harry Quon, James W Rocco, Erich M Sturgis, Roy B Tishler, Andy Trotti, John Waldron, Avraham Eisbruch
PURPOSE: To present evidence-based guidelines for the treatment of oropharyngeal squamous cell carcinoma (OPSCC) with definitive or adjuvant radiation therapy (RT). METHODS AND MATERIALS: The American Society for Radiation Oncology convened the OPSCC Guideline Panel to perform a systematic literature review investigating the following key questions: (1) When is it appropriate to add systemic therapy to definitive RT in the treatment of OPSCC? (2) When is it appropriate to deliver postoperative RT with and without systemic therapy following primary surgery for OPSCC? (3) When is it appropriate to use induction chemotherapy in the treatment of OPSCC? (4) What are the appropriate dose, fractionation, and volume regimens with and without systemic therapy in the treatment of OPSCC? RESULTS: Patients with stage IV and stage T3 N0-1 OPSCC treated with definitive RT should receive concurrent high-dose intermittent cisplatin...
April 11, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28427875/easl-2017-clinical-practice-guidelines-on-the-management-of-hepatitis-b-virus-infection
#20
Pietro Lampertico, Kosh Agarwal, Thomas Berg, Maria Buti, Harry L A Janssen, George Papatheodoridis, Fabien Zoulim, Frank Tacke
Hepatitis B virus (HBV) infection remains a global public health problem with changing epidemiology due to several factors including vaccination policies and migration. This Clinical Practice Guideline presents updated recommendations for the optimal management of HBV infection. Chronic HBV infection can be classified into five phases: (I) HBeAg-positive chronic infection, (II) HBeAg-positive chronic hepatitis, (III) HBeAg-negative chronic infection, (IV) HBeAg-negative chronic hepatitis and (V) HBsAg-negative phase...
April 18, 2017: Journal of Hepatology
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