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https://www.readbyqxmd.com/read/29452450/-cost-comparison-of-licensed-intravitreal-therapies-for-insufficiently-anti-vegf-responding-fovea-involving-diabetic-macular-edema-in-germany
#1
Aljoscha S Neubauer, Christos Haritoglou, Michael W Ulbig
BACKGROUND: In the treatment of center-involving diabetic macular edema, despite initial therapy with an anti-VEGF compound, an insufficient response may occur. Further therapy options include a switch of anti-VEGF products or to corticosteroid implants, such as Fluocinolone acetonide or Dexamethasone. OBJECTIVES: Firstly, to investigate systematically which evidence-based study data are available describing the efficacy of in-label treatments after primary anti-VEGF treatment, secondly, to investigate which costs go along for the healthcare provider...
February 16, 2018: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/29452443/gender-comparison-of-medical-student-microsurgical-skills-in-a-laboratory-model
#2
Rowena Sudario-Lumague, Yuan-Cheng Chiang, Tsan-Shiun Lin
BACKGROUND: Perceived gender-related differences in surgical skills could limit opportunities available for any aspiring surgeon. There should be more available literature and logical analysis of these observations. The objective of this study is to evaluate the microsurgical skills of male and female medical students using a standard scale in the laboratory. METHODS: This study included medical students enrolled in the Kaohsiung Chang Gung Memorial Hospital from 2002 to 2015 who were evaluated by a senior consultant for their microsurgical skills...
February 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29452441/assessing-the-safety-and-efficacy-of-regional-anesthesia-for-lower-extremity-microvascular-reconstruction-enhancing-recovery
#3
Qing Zhao Ruan, Shawn Diamond, Scott Zimmer, Matthew L Iorio
BACKGROUND: Perioperative pain, increased sympathetic tone, and peripheral vasospasm may be safely managed with regional nerve blockade during microvascular reconstruction in the lower extremity. Limited reports exist in this setting; therefore, we evaluated our use of peripheral nerve catheters (PNCs) during microvascular limb salvage to determine safety and efficacy for both patient and flap. METHODS: A single-institution, retrospective review of a prospectively maintained database on all patients with lower extremity free tissue transfers between 2012 and 2017 was completed...
February 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29452422/asynchronous-and-pathological-windows-of-implantation-two-causes-of-recurrent-implantation-failure
#4
P Sebastian-Leon, N Garrido, J Remohí, A Pellicer, P Diaz-Gimeno
STUDY QUESTION: Is endometrial recurrent implantation failure (RIF) only a matter of an asynchronous (displaced) window of implantation (WOI), or could it also be a pathological (disrupted) WOI? SUMMARY ANSWER: Our predictive results demonstrate that both displaced and disrupted WOIs exist and can present independently or together in the same RIF patient. WHAT IS KNOWN ALREADY: Since 2002, many gene expression signatures associated with endometrial receptivity and RIF have been described...
February 14, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29452409/recruitment-and-retention-of-trainee-physicians-a-retrospective-analysis-of-the-motivations-and-influences-on-career-choice-of-trainee-physicians
#5
C Ryan, E Ward, M Jones
Background: Across the UK there are vacant physician posts at every level. This increases workload and stress for those who remain, in turn making substantive jobs less attractive. Aim: To understand the influences on career choice and retention in training of current trainee physicians. Methods: An online survey, with a combination of closed and free text questions, was developed to assess factors that affected career choices. This was sent to all core and higher specialty trainees in Scotland and Associate or Collegiate members of the Royal College of Physicians Edinburgh not training in Scotland...
February 14, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29452396/changes-in-access-to-primary-care-in-europe-and-its-patterning-2007-12-a-repeated-cross-sectional-study
#6
Klára Dimitrovová, Julian Perelman
Background: The strengthening of primary care (PC) has been encouraged as a strategy to achieve more efficient and equitable health systems. However, the Great Recession may have reduced access to PC. This paper analyses the change in access to PC and its patterning in 28 European countries between 2007 and 2012. Methods: We used data from the 2007 and 2012 waves of the EU-SILC questionnaire (n = 687 170). The dependent variable was the self-reported access to PC ('easy' vs...
February 14, 2018: European Journal of Public Health
https://www.readbyqxmd.com/read/29452374/response-to-the-importance-of-clinically-relevant-research-when-making-comparisons
#7
Honghua Hu, Janine Sleiman, Khalid Johani, Karen Vickery
No abstract text is available yet for this article.
February 14, 2018: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29452361/iui-review-and-systematic-assessment-of-the-evidence-that-supports-global-recommendations
#8
Ben Cohlen, Aartjan Bijkerk, Sheryl Van der Poel, Willem Ombelet
BACKGROUND: IUI with or without ovarian stimulation (OS) has become a first-line treatment option for many infertile couples, worldwide. The appropriate treatment modality for couples and their clinical management through IUI or IUI/OS cycles must consider maternal and perinatal outcomes, most notably the clinical complication of higher-order multiple pregnancies associated with IUI-OS. With a current global emphasis to continue to decrease maternal and perinatal mortality and morbidity, the World Health Organization (WHO) had established a multi-year project to review the evidence for the establishment of normative guidance for the implementation of IUI as a treatment to address fertility problems, and to consider its cost-effectiveness for lower resource settings...
February 14, 2018: Human Reproduction Update
https://www.readbyqxmd.com/read/29452357/del-nido-cardioplegia-in-adult-cardiac-surgery-beyond-single-valve-surgery
#9
Wan Kee Kim, Hong Rae Kim, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
OBJECTIVES: In recent years, the use of del Nido (DN) cardioplegia has been reported in single-valve surgery or isolated coronary artery bypass surgery with acceptable outcomes. The reports of its use in more complex adult cardiac procedures, however, have been scarce. METHODS: We enrolled a total of 149 adult patients who underwent heart valve surgery with the use of DN cardioplegia between May 2014 and December 2016. For a benchmark comparison, 892 patients who underwent cardiac valve surgery with blood cardioplegia during the same period served as controls...
February 14, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29452347/the-importance-of-clinically-relevant-research-when-making-comparisons
#10
Jack Fisher, C Tod Brindle, Stephen Porter
No abstract text is available yet for this article.
February 14, 2018: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29452327/effect-and-feasibility-of-endoscopic-surgery-in-the-spontaneous-intracerebral-hemorrhage-a-systematic-review-and-meta-analysis
#11
REVIEW
Zhong Yao, Xin Hu, Chao You, Min He
BACKGROUND: The spontaneous intracerebral hemorrhage remains a major cause for death and dependence. Endoscopic surgery (ES) is potential to improve outcomes, but the consensus on the superiority of ES is not achieved. We conducted a systematic review to clarify the effect ES in sICH and compare it with other treatment options (craniotomy, conservation and stereotactic aspiration [SA]). METHODS: We performed this review based on the Preferred Reporting Items for Systematic review and Meta-Analysis...
February 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29452318/bone-metabolic-markers-in-the-clinical-assessment-of-patients-with-superior-semicircular-canal-dehiscence-treated-with-middle-fossa-craniotomy
#12
Thien Nguyen, Carlito Lagman, John P Sheppard, Courtney Duong, Vera Ong, Jessica Poon, Yasmine Alkhalid, Daniel Azzam, Prasanth Romiyo, Giyarpuram N Prashant, Quinton Gopen, Isaac Yang
BACKGROUND: Superior semicircular canal dehiscence (SSCD) is a bony defect in the osseous shell of the petrous temporal bone. The pathophysiological association between osteoporosis and SSCD remains poorly understood. We aim to investigate the relationships between serum calcium, 25-hydroxyvitamin D, and thyroid stimulating hormone levels, and symptoms in adult patients with SSCD treated through a middle fossa craniotomy. METHODS: Patient demographics and clinical parameters were collected...
February 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29452223/grade-guidelines-19-assessing-the-certainty-of-evidence-describing-the-relative-importance-of-outcomes-or-values-and-preferences-risk-of-bias-and-indirectness
#13
Yuan Zhang, Pablo Alonso Coello, Gordon Guyatt, Juan Jose Yepes-Nunez, Elie A Akl, Glen Hazlewood, Hector Pardo-Hernandez, Itziar Etxeandia-Ikobaltzeta, Amir Qaseem, John W Williams, Peter Tugwell, Signe Flottorp, Yaping Chang, Yuqing Zhang, Reem A Mustafa, María Ximena Rojas, Holger J Schünemann
OBJECTIVE: The GRADE working group defines patient values and preferences as the relative importance patients place on the main health outcomes. We provide GRADE guidance for assessing the risk of bias and indirectness domains for certainty of evidence about the relative importance of outcomes. STUDY DESIGN AND SETTING: We applied the GRADE domains to rate the certainty of evidence in the importance of outcomes to several systematic reviews, iteratively reviewed draft guidance and consulted GRADE members and other stakeholders for feedback...
February 13, 2018: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29452222/essential-medicines-availability-is-still-suboptimal-in-many-countries-a-scoping-review
#14
REVIEW
Mersiha Mahmić-Kaknjo, Antonia Jeličić-Kadić, Ana Utrobičić, Kit Chan, Lisa Bero, Ana Marušić
OBJECTIVE: To identify uses of WHO Model list of essential medicines (EM) and summarize studies examining essential medicines (EM) and national EM lists (NEMLs). STUDY DESIGN AND SETTING: In this scoping review, we searched PubMed, Scopus, WHO website and WHO Regional Databases for studies on NEMLs, reimbursement medicines lists, and WHO EML, with no date or language restrictions. RESULTS: 3,144 retrieved documents were independently screened by two reviewers; 100 full-text documents were analyzed; 37 contained data suitable for quantitative and qualitative analysis on EMs availability (11 documents), medicines for specific diseases (13 documents), and comparison of WHO EML and NEMLs (13 documents)...
February 13, 2018: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29452218/tnf%C3%AE-disrupts-blood-brain-barrier-integrity-to-maintain-prolonged-depressive-like-behavior-in-mice
#15
Yuyan Cheng, Sachi Desse, Ana Martinez, Ryan J Worthen, Richard S Jope, Eleonore Beurel
Recovery from major depressive disorder is difficult, particularly in patients who are refractory to antidepressant treatments. To examine factors that regulate recovery, we developed a prolonged learned helplessness depression model in mice. After the induction of learned helplessness, mice were separated into groups that recovered or did not recover within 4 weeks. Comparisons were made between groups in hippocampal proteins, inflammatory cytokines, and blood brain barrier (BBB) permeability. Compared with mice that recovered and control mice, non-recovered mice displaying prolonged learned helplessness had greater hippocampal activation of glycogen synthase kinase-3 (GSK3), higher levels of tumor necrosis factor-α (TNFα), interleukin-17A, and interleukin-23, increased permeability of the blood brain barrier (BBB), and lower levels of the BBB tight junction proteins occludin, ZO1, and claudin-5...
February 13, 2018: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/29452195/construction-and-evaluation-of-the-immune-protection-of-a-recombinant-divalent-protein-composed-of-the-mrpa-from-mr-p-fimbriae-and-flagellin-of-proteus-mirabilis-strain-against-urinary-tract-infection
#16
Mehri Habibi, Mohammad Reza Asadi Karam, Saeid Bouzari
Urinary tract infections (UTI) caused by Proteus mirabilis are prevalent among the catheterized patients. There is no effective vaccine to reduce the frequency of UTIs caused by P. mirabilis. In the present study, the immune responses and effectiveness of different combinations of MrpA and flagellin (FliC) of P. mirabilis were assessed intranasally in the mice model. The addition of FliC as adjuvant to MrpA in fusion form significantly raised the mucosal IgA and cellular (IFN-γ and IL-17) responses and maintained the serum IgG responses for 180 days after the first vaccination...
February 13, 2018: Microbial Pathogenesis
https://www.readbyqxmd.com/read/29452165/the-beneficial-role-of-early-exercise-training-following-stroke-and-possible-mechanisms
#17
REVIEW
Ying Xing, Si-Dong Yang, Fang Dong, Man-Man Wang, Ya-Shuo Feng, Feng Zhang
Exercise training is a regular therapy for stroke patients in clinic. However, whether the early exercise is beneficial for stroke patients is still controversial. The review was performed in databases of OVID, PUBMED, and ISI Web of Science, from respective inception to December 2017. In this review, we summarize the effect of different exercise intensity, initiation time, and style on ischemic stroke. Moreover, the possible mechanism is also discussed. The conclusion is that the voluntary exercise is better in promoting the functional recovery following stroke compared to forced exercise; too early initiated exercise might play a harmful role following stroke, while early initiated exercise might exert benefits after stroke; mild and moderate intensity exercise training could generate better neuroprotection in comparison with high intensity exercise training; early excise training could regulate the process of brain edema, cell apoptosis, oxidative damage, stem cells and other mechanisms in order to exert neuroprotection for brain...
February 13, 2018: Life Sciences
https://www.readbyqxmd.com/read/29452164/proposal-for-a-new-subtype-of-the-zoonotic-genotype-3-hepatitis-e-virus-hev-3l
#18
Luca De Sabato, Philippe Lemey, Bram Vrancken, Lebana Bonfanti, Letizia Ceglie, Gabriele Vaccari, Ilaria Di Bartolo
The near-complete genomic sequences of two hepatitis E virus (HEV) strains, detected from feces of infected pigs, were obtained. Phylogenetic analysis and p-distance comparisons of the complete coding regions showed a close relationship to the French swine strain FR-SHEV3c-like detected in 2006 (p-distance value 0.101), belonging to HEV-3 but not assigned to any known subtype. The three HEV sequences showed, relatively high nucleotide distances (p-distance >0.129) compared to the other defined HEV subtype references and unclassified strains...
February 13, 2018: Virus Research
https://www.readbyqxmd.com/read/29452142/in-vitro-in-vivo-evaluation-of-an-oral-ghost-drug-delivery-device-for-the-delivery-of-salmon-calcitonin
#19
Angus R Hibbins, Mershen Govender, Sunaina Indermun, Pradeep Kumar, Lisa C du Toit, Yahya E Choonara, Viness Pillay
An orally administered site-specific Oral Ghost Drug Delivery (OGDD) Device was developed and evaluated for the administration of salmon calcitonin. In vitro drug release studies have been undertaken using biorelevant media as well as aspirated gastrointestinal fluid from a Large White pig in addition to characterization of a formulated trimethyl chitosan blend formulated and prepared into a loaded mini-pellet system. In vivo drug release analysis in a Large White pig model has further been undertaken on the OGDD device and a commercial intramuscular injection to ascertain the release properties of the OGDD device in an animal model in comparison with the currently used treatment option for the administration of salmon calcitonin...
February 13, 2018: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29452099/a-systematic-review-and-meta-analysis-comparing-pigtail-catheter-and-chest-tube-as-the-initial-treatment-for-pneumothorax
#20
Su-Huan Chang, Yi-No Kang, Hsin-Yi Chiu, Yu-Han Chiu
BACKGROUND: The optimal initial treatment approach for pneumothorax remains controversial. This systemic review and meta-analysis investigated the effectiveness of small-bore pigtail catheter (PC) drainage in comparison with that of large-bore chest tube (LBCT) drainage as the initial treatment approach for all subtypes of pneumothorax. METHODS: We systematically searched PubMed and Embase for observational studies and randomized controlled trials published up to October 9, 2017, that compared PC and LBCT as the initial treatment for pneumothorax...
February 13, 2018: Chest
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