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https://www.readbyqxmd.com/read/28088581/a-stepwise-algorithm-using-a-at-a-glance-first-line-test-for-the-non-invasive-diagnosis-of-advanced-liver-fibrosis-and-cirrhosis
#1
Jérôme Boursier, Victor de Ledinghen, Vincent Leroy, Rodolphe Anty, Sven Francque, Dominique Salmon, Adrien Lannes, Sandrine Bertrais, Frederic Oberti, Isabelle Fouchard-Hubert, Paul Calès
BACKGROUND & AIMS: Chronic liver diseases (CLD) are highly frequent and thus mainly managed by non-hepatologists. Because they lack access to the best non-invasive tests of liver fibrosis, these physicians cannot accurately determine the disease severity and the need for referral to a hepatologist. We aimed to implement an algorithm, comprising a new first-line test usable by all physicians, for the detection of advanced liver fibrosis in all CLD patients. METHODS: Diagnostic study: 3,754 CLD patients with liver biopsy were 2:1 randomized into derivation and validation sets...
January 11, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28088507/patient-reported-outcomes-and-opioid-use-in-outpatients-with-chronic-pain
#2
Lisa R Witkin, David Zylberger, Neel Mehta, Madeleine Hindenlang, Christopher Johnson, Jacob Kean, Susan D Horn, Charles E Inturrisi
: The Weill Cornell Medical College (WCMC) Pain Registry database contains patient characteristics, treatments, and outcomes for a prospective cohort of 1159 chronic pain patients who were seen at the WCMC Pain Medicine outpatient clinic from 7/08/2011 to 12/10/2014. Patients aged 45-64 comprised 43% followed by age >=65 at 37%. Fifty-eight percent were female. Average pain intensity (Brief Pain Inventory) was reported as mild by 22.3% of patients, moderate by 34.7%, and severe by 43...
January 11, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28088505/gaps-in-the-public-s-knowledge-about-chronic-pain-representative-sample-of-hispanic-residents-from-five-states
#3
Barbara J Turner, Yuanyuan Liang, Natalia Rodriguez, Melissa A Valerio, Andrea Rochat, Jennifer S Potter, Paula Winkler
: Educating the general public about chronic pain and its care is a national health priority. We evaluated knowledge, attitudes, and beliefs (KAB) of a five-state, population-based sample of Hispanics aged 35-75 without chronic pain, representing over 8.8 million persons. A web-based survey assessed KAB using an adapted version of the Survey of Pain Attitudes-Brief and self-reported knowledge about chronic pain (nothing, a little, a lot). In unweighted analyses of participants (n=346), mean age was 52...
January 11, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28088273/a-real-world-impact-of-cost-effectiveness-of-pegylated-interferon-ribavarin-regimens-on-treatment-na%C3%A3-ve-chronic-hepatitis-c-patients-in-taiwan
#4
Pei-Chien Tsai, Ta-Wei Liu, Meng-Hsuan Hsieh, Ming-Lun Yeh, Po-Cheng Liang, Yi-Hung Lin, Ching-I Huang, Chung-Feng Huang, Ming-Yen Hsieh, Nai-Jen Hou, Zu-Yau Lin, Shinn-Cherng Chen, Jee-Fu Huang, Chia-Yen Dai, Wan-Long Chuang, Ming-Lung Yu
Treatments with pegylated interferon/ribavirin (PEG-IFN/RBV) has been standard-of-care in patients with chronic hepatitis C virus (HCV) (CHC) infection and reimbursed in Taiwan. However, the actual cost-effectiveness remains unclear. We aimed to evaluate a real-world cost-effectiveness for CHC patients treated with PEG-IFN/RBV by using a clinical cohort with linkage to the National Health Insurance Research Database of Taiwan. The total and itemized medical-care expenses of outpatient visits of 117 treatment-naïve CHC patients with linkage to the two million sampling of the National Health Insurance Research Database were collected...
January 2017: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/28088181/acute-and-chronic-kidney-disease-in-elderly-patients-with-hip-fracture-prevalence-risk-factors-and-outcome-with-development-and-validation-of-a-risk-prediction-model-for-acute-kidney-injury
#5
Christine J Porter, Iain K Moppett, Irene Juurlink, Jessica Nightingale, Christopher G Moran, Mark A J Devonald
BACKGROUND: Hip fracture is a common injury in older people with a high rate of postoperative morbidity and mortality. This patient group is also at high risk of acute kidney injury (AKI) and chronic kidney disease (CKD), but little is known of the impact of kidney disease on outcome following hip fracture. METHODS: An observational cohort of consecutive patients with hip fracture in a large UK secondary care hospital. Predictive modelling of outcomes using development and validation datasets...
January 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28087291/primary-care-perspectives-on-hepatitis-c-virus-screening-diagnosis-and-linking-patients-to-appropriate-care
#6
Edward Lebovics, Richard Torres, Lucinda K Porter
Enormous progress has been made in recent years toward effectively treating and curing patients with chronic hepatitis C (CHC). However, at least half of the possible 7 million individuals infected with hepatitis C virus (HCV) in the US remain undiagnosed. The formidable task of increasing the number of patients diagnosed, and subsequently linked to appropriate care has fallen to primary care clinicians, who are mandated by some US States to offer screening to individuals born between 1945 and 1965 (the Baby Boomer Generation)...
January 10, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28087156/french-national-consensus-clinical-guidelines-for-the-management-of-crohn-s-disease
#7
Laurent Peyrin-Biroulet, Yoram Bouhnik, Xavier Roblin, Guillaume Bonnaud, Hervé Hagège, Xavier Hébuterne
BACKGROUND: Crohn's disease (CD) is a chronic and disabling condition. There is no curative medical treatment but current treatments provide increasingly sustainable control of the disease and allow patients a better quality of life. There is limited evidence supporting CD management in specific clinical situations, thus precluding an evidence-based approach. AIMS: To help clinicians in making informed treatment decisions, a group of 59 French gastroenterologists with experience in the management of CD met to develop straightforward and practical algorithms based on the European Crohn's and Colitis Organisation (ECCO) recommendations...
December 22, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28086976/impact-of-a-tailored-program-on-the-implementation-of-evidence-based-recommendations-for-multimorbid-patients-with-polypharmacy-in-primary-care-practices-results-of-a-cluster-randomized-controlled-trial
#8
Cornelia Jäger, Tobias Freund, Jost Steinhäuser, Christian Stock, Johannes Krisam, Petra Kaufmann-Kolle, Michel Wensing, Joachim Szecsenyi
BACKGROUND: Multimorbid patients receiving polypharmacy represent a growing population at high risk for negative health outcomes. Tailoring is an approach of systematic intervention development taking account of previously identified determinants of practice. The aim of this study was to assess the effect of a tailored program to improve the implementation of three important processes of care for this patient group: (a) structured medication counseling including brown bag reviews, (b) the use of medication lists, and (c) structured medication reviews to reduce potentially inappropriate medication...
January 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28086918/atypical-monoarthritis-presentation-in-children-with-oligoarticular-juvenile-idiopathic-arthritis-a-case-series
#9
Natasha Lepore, Megan Cashin, Debra Bartley, Daniela Simona Ardelean
BACKGROUND: Oligoarticular juvenile idiopathic arthritis (oligoJIA), the most common chronic inflammatory arthritis of childhood, usually involves the knees and ankles. Severe oligoJIA monoarthritis presenting in a joint other than knees and ankles, is rare. FINDINGS: We report four children who presented with severe isolated arthritis of the hip, wrist or elbow and were diagnosed with oligoJIA. All four were girls with a median age of 11.5 years. Those with hip arthritis also met the classification criteria for juvenile-onset spondylarthopathy...
January 13, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28086883/which-factors-affect-health-care-use-among-older-germans-results-of-the-german-ageing-survey
#10
André Hajek, Jens-Oliver Bock, Hans-Helmut König
BACKGROUND: It remains an open question how changes in predisposing, enabling, and need factors affect health care use. Consequently, we aimed to investigate how changes in these variables affect health care use in community-dwelling older persons longitudinally. METHODS: Data from two waves of the German Ageing Survey (DEAS), a representative sample of the community-dwelling German population aged ≥40 years, was used. Predictors of visits to general practitioners and specialists as well as hospital stays during a 12-month period were analyzed by fixed effects regressions...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28086870/a-pilot-study-of-a-community-health-agent-led-type-2-diabetes-self-management-program-using-motivational-interviewing-based-approaches-in-a-public-primary-care-center-in-s%C3%A3-o-paulo-brazil
#11
Thais Moura Ribeiro do Valle Nascimento, Ken Resnicow, Marcia Nery, Alexandra Brentani, Elizabeth Kaselitz, Pooja Agrawal, Simanjit Mand, Michele Heisler
BACKGROUND: Rates of noncommunicable diseases (NCDs) such as type 2 diabetes are escalating in low and middle-income countries such as Brazil. Scalable primary care-based interventions are needed to improve self-management and clinical outcomes of adults with diabetes. This pilot study examines the feasibility, acceptability, and outcomes of training community health agents (CHAs) in Motivational Interviewing (MI)-based counseling for patients with poorly controlled diabetes in a primary care center in São Paulo, Brazil...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28086853/taking-action-to-reduce-pain-action-study-rationale-design-and-protocol-of-a-randomized-trial-of-a-proactive-telephone-based-coaching-intervention-for-chronic-musculoskeletal-pain-among-african-americans
#12
Rozina H Bhimani, Lee J S Cross, Brent C Taylor, Laura A Meis, Steven S Fu, Kelli D Allen, Sarah L Krein, Tam Do, Robert D Kerns, Diana J Burgess
BACKGROUND: Rates of chronic pain are rising sharply in the United States and worldwide. Presently, there is evidence of racial disparities in pain treatment and treatment outcomes in the United States but few interventions designed to address these disparities. There is growing consensus that chronic musculoskeletal pain is best addressed by a biopsychosocial approach that acknowledges the role of psychological and environmental factors, some of which differ by race. METHODS/DESIGN: The primary aim of this randomized controlled trial is to test the effectiveness of a non-pharmacological, self-regulatory intervention, administered proactively by telephone, at improving pain outcomes and increasing walking among African American patients with hip, back and knee pain...
January 13, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28086849/successful-outcome-following-pneumonectomy-in-a-teenage-boy-with-cystic-fibrosis-a-case-report
#13
Zheyi Liew, Santosh Mallikarjuna, Asif Hasan, F Kate Gould, Su Bunn, Matthew F Thomas, Jim L Lordan, Christopher O'Brien, Malcolm Brodlie
BACKGROUND: Cystic fibrosis lung disease is generally a diffuse process however rarely one lung may become particularly damaged through chronic collapse and consolidation resulting in end-stage bronchiectasis with relative sparing of the contralateral lung. This clinical situation is sometimes referred to as "destroyed lung". Lung resection surgery is seldom indicated in cystic fibrosis and the associated medical literature is relatively sparse. CASE PRESENTATION: A 14 year old boy was referred to our centre for lung transplantation assessment...
January 13, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28086812/person-centred-care-in-chronic-kidney-disease-a-cross-sectional-study-of-patients-desires-for-self-management-support
#14
Kathryn Havas, Clint Douglas, Ann Bonner
BACKGROUND: People with chronic kidney disease (CKD) must self-manage their illness to assist with slowing disease-progression, but this is a complex task requiring support from healthcare professionals. Despite the established importance of person-centred care, people with CKD are rarely consulted regarding their desires for self-management support (SMS). METHODS: A cross-sectional survey was conducted face-to-face in a Queensland primary care clinic and distributed Australia-wide via an online interface promoted by Kidney Health Australia during 2015...
January 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28081594/management-of-direct-antiviral-agent-failures
#15
REVIEW
María Buti, Rafael Esteban
The current standard of care for patients with chronic hepatitis C virus (HCV) infection is a combination of direct-acting antiviral agents (DAAs). Most HCV patients treated with these drugs achieve viral elimination, but 1% to 15% fail to attain this objective. Treatment failures are usually related to relapse, and less often to on-treatment viral breakthrough. HCV drug resistant associated substitutions are detected in most patients who do not eliminate the virus. The risk of developing these variants depends on host- and virus-related factors, the properties of the drugs used, and the treatment strategies applied...
December 2016: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28081567/risk-of-rebleeding-and-mortality-in-cirrhotic-patients-with-peptic-ulcer-bleeding-a-12-year-nationwide-cohort-study
#16
Shih-Cheng Yang, Chien-Ning Hsu, Chih-Ming Liang, Wei-Chen Tai, Cheng-Kun Wu, Chih-Wei Shih, Ming-Kun Ku, Lan-Ting Yuan, Jiunn-Wei Wang, Kuo-Lun Tseng, Tsung-Hsing Hung, Seng-Howe Nguang, Pin-I Hsu, Deng-Chyang Wu, Seng-Kee Chuah
Although a few studies have investigated the risks of peptic ulcer bleeding (PUB) in cirrhotic patients, large population-based studies on in-hospital and long-term reports on recurrent PUB in a cohort of cirrhotic patients are lacking. This 12-year nationwide cohort study aimed to investigate the risks of in-hospital and long-term rebleeding and mortality in cirrhotic patients and to identify possible risk factors. Patient data from 1997 to 2008 were extracted from the National Health Insurance Research Database in Taiwan...
2017: PloS One
https://www.readbyqxmd.com/read/28081231/physical-activity-energy-expenditure-nutritional-habits-quality-of-sleep-and-stress-levels-in-shift-working-health-care-personnel
#17
Frederick Charles Roskoden, Janine Krüger, Lena Johanna Vogt, Simone Gärtner, Hans Joachim Hannich, Antje Steveling, Markus M Lerch, Ali A Aghdassi
BACKGROUND: Among health care personnel working regular hours or rotating shifts can affect parameters of general health and nutrition. We have investigated physical activity, sleep quality, metabolic activity and stress levels in health care workers from both groups. METHODS: We prospectively recruited 46 volunteer participants from the workforce of a University Medical Department of which 23 worked in rotating shifts (all nursing) and 21 non-shift regular hours (10 nursing, 13 clerical staff)...
2017: PloS One
https://www.readbyqxmd.com/read/28079872/is-use-of-multiple-antihypertensive-agents-to-achieve-blood-pressure-control-associated-with-adverse-pregnancy-outcomes
#18
S E Allen, A Tita, S Anderson, J R Biggio, Dr L M Harper
OBJECTIVE: We assessed whether requiring >1 medication for blood pressure control is associated with adverse pregnancy outcomes. STUDY DESIGN: Retrospective cohort of 974 singletons with chronic hypertension at a tertiary care center. Subjects on >1 antihypertensive agent were compared with those on one agent <20 weeks gestational age with results stratified by average blood pressure (<140/90 and ⩾140/90 mm Hg) from prenatal visits. The primary maternal outcome was preeclampsia; the primary neonatal outcome was small for gestational age (<10th percentile)...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28079549/contemporary-methods-allowing-for-safe-and-convenient-use-of-amniotic-membrane-as-a-biologic-wound-dressing-for-burns
#19
David N Herndon, Ludwik K Branski
Partial-thickness burns involve damage to the upper layer of skin, which leaves nerve endings exposed, and therefore represent the most painful of several categories of thermal injuries. Historically, partial-thickness burns were treated conservatively by debriding the blisters, by daily tubbing and washing, and the application of new bandages with topical medications. Human amniotic membrane has been used for centuries as a biological wound dressing. In the past 20 years, there has been an increasing body of literature addressing the use of amniotic tissue in chronic wounds and burns...
February 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28079409/promoting-awareness-of-neonatal-menstruation
#20
Paola Bianchi, Giuseppe Benagiano, Ivo Brosens
Neonatal uterine bleeding (NUB) has been carefully studied in the past through case reports, small series, clinical cohort studies, pathology investigations of fetal and neonatal. Following a historical recount, this review summarizes biological mechanisms conditioning NUB, starting from the persistence till birth of an 'ontogenetic progesterone resistance' (OPR), causing decreased responsiveness of target tissues to bioavailable progesterone. Several pregnancy-related conditions, such as preeclampsia, fetal growth restriction, prematurity, post-maturity and even Rhesus or ABO incompatibility, influence the occurrence of NUB...
January 12, 2017: Gynecological Endocrinology
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