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Sam R Emerson, Mark D Haub, Colby S Teeman, Stephanie P Kurti, Sara K Rosenkranz
Research points to postprandial glucose and TAG measures as preferable assessments of cardiovascular risk as compared with fasting values. Although elevated postprandial glycaemic and lipaemic responses are thought to substantially increase chronic disease risk, postprandial glycaemia and lipaemia have historically only been considered separately. However, carbohydrates and fats can generally 'compete' for clearance from the stomach, small intestine, bloodstream and within the peripheral cell. Further, there are previous data demonstrating that the addition of carbohydrate to a high-fat meal blunts the postprandial lipaemic response, and the addition of fat to a high-carbohydrate meal blunts the postprandial glycaemic response...
October 24, 2016: British Journal of Nutrition
Yasmin Anum Mohd Yusof
Since antiquity, ginger or Zingiber officinale, has been used by humans for medicinal purposes and as spice condiments to enhance flavor in cooking. Ginger contains many phenolic compounds such as gingerol, shogaol and paradol that exhibit antioxidant, anti-tumor and anti-inflammatory properties. The role of ginger and its constituents in ameliorating diseases has been the focus of study in the past two decades by many researchers who provide strong scientific evidence of its health benefit. This review discusses research findings and works devoted to gingerols, the major pungent constituent of ginger, in modulating and targeting signaling pathways with subsequent changes that ameliorate, reverse or prevent chronic diseases in human studies and animal models...
2016: Advances in Experimental Medicine and Biology
Christoph U Correll, Leslie Citrome, Peter M Haddad, John Lauriello, Mark Olfson, Stephen M Calloway, John M Kane
Long-acting injectable antipsychotics (LAIs) are among the most effective treatments in psychiatry, yet they remain underutilized in clinical practice. Although LAIs are typically used to maintain treatment adherence in patients with chronic schizophrenia, recent research has suggested that they may also provide an effective treatment strategy for patients with early-phase or first-episode disease. In October 2015, a group of 8 experts on the management of schizophrenia and LAIs met to evaluate the evidence surrounding the efficacy, safety, and cost-effectiveness of LAIs and to develop practical recommendations regarding the clinical use, education, and unmet needs related to LAIs...
2016: Journal of Clinical Psychiatry
Deepthi Kannan, Deepa Gurunathan
BACKGROUND: Dental charting is the basis of treatment in dentistry. It should be recorded to know the presence of healthy or diseased, for communication purpose with the colleagues and also used for reference purpose. The three commonly used systems are universal system, Federae Dentale Internationale numbering system (FDI) system, and Palmer/Zsigmondy system. Although these systems are in practice there are lot of confusions in referring a tooth which leads to mismanagement which eventually terminates the clinician-patient relationship...
July 2016: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
Ramadhani A Noor, Pascal Geldsetzer, Till Bärnighausen, Wafaie Fawzi
BACKGROUND: The World Health Organization's (WHO) antiretroviral therapy (ART) guidelines have generally been adopted rapidly and with high fidelity by countries in sub-Saharan Africa. Thus far, however, WHO has not published specific guidance on nutritional care and support for (non-pregnant) adults living with HIV despite a solid evidence base for some interventions. This offers an opportunity for a case study on whether national clinical guidelines in sub-Saharan Africa provide concrete recommendations in the face of limited guidance by WHO...
October 6, 2016: Globalization and Health
Saravanan Esakki, Joy MacDermid, Saipriya Vajravelu
Background: American Academy of Orthopaedic Surgeons (AAOS) distal radius fracture (DRF) clinical practice guidelines (CPG) are readily available to clinicians, patients, and policymakers. International Classification of Functioning, Disability, and Health (ICF) provides a framework for describing the impact of health conditions. The International Classification of Diseases-10th Revision (ICD-10) is a classification system to classify health conditions as specific disease or disorders. The aim of this study is to analyze and describe the scope and focus of the AAOS DRF CPG using the ICF and ICD-10 as a basis for content analysis, and to compare the content of the CPG with the ICF hand core sets as the reference standard...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
A Y Finlay, M S Salek, D Abeni, L Tomás Aragonés, O D van Cranenburgh, A W M Evers, G Jemec, D Linder, L Manolache, S E Marrón, C A C Prinsen, P Susitaival, P Chernyshov
The aim of this study was to describe the many ways in which quality of life (QoL) measurement may potentially be advantageous in routine clinical dermatology practice. Thirteen members of the EADV Task Force on Quality of Life, eight dermatologists, three health psychologists, one epidemiologist and one pharmacoepidemiologist, independently listed all of the ways they thought this may be advantageous. 108 different way of using QoL information in clinical practice were suggested (median per participant=8, range=4-15), and were classified into 20 descriptive groups...
September 29, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Lenna Dawkins-Moultin, Andrea McDonald, Lisako McKyer
While health literacy research has experienced tremendous growth in the last two decades, the field still struggles to devise interventions that lead to lasting change. Most health literacy interventions are at the individual level and focus on resolving clinician-patient communication difficulties. As a result, the interventions use a deficit model that treats health literacy as a patient problem that needs to be fixed or circumvented. We propose that public health health literacy interventions integrate the principles of socioecology and critical pedagogy to develop interventions that build capacity and empower individuals and communities...
2016: Journal of Health Communication
John Shiguang Loy, Eskinder Eshetu Ali, Kevin Yi-Lwern Yap
BACKGROUND: The advent of smartphones has enabled a plethora of medical apps for disease management. As of 2012, there are 40,000 health care-related mobile apps available in the market. Since most of these medical apps do not go through any stringent quality assessment, there is a risk of consumers being misinformed or misled by unreliable information. In this regard, apps that target medication-related problems (MRPs) are not an exception. There is little information on what constitutes quality in apps that target MRPs and how good the existing apps are...
October 2016: Journal of Managed Care & Specialty Pharmacy
Jin-Shei Lai, Sally E Jensen, Zabin S Patel, Robert Listernick, Joel Charrow
Neurofibromatosis Type 1 (NF1) plexiform neurofibromas (pNFs) are associated with a variety of symptoms and concerns that affect patients' quality of life (QOL), highlighting the value of incorporating the patients' perspective when evaluating treatment outcomes. To better conceptualize the experience of patients with pNFs, this qualitative study sought to identify the most important outcomes to assess from the perspective of patients, families, and clinicians. Clinicians, patients age 5 years old and above, and parents of patients aged 5-17 years participated in semi-structured interviews to elicit the pNF symptoms/concerns considered most important to assess...
September 26, 2016: American Journal of Medical Genetics. Part A
Kathryn M Camp, Danuta Krotoski, Melissa A Parisi, Katrina A Gwinn, Bruce H Cohen, Christine S Cox, Gregory M Enns, Marni J Falk, Amy C Goldstein, Rashmi Gopal-Srivastava, Gráinne S Gorman, Stephen P Hersh, Michio Hirano, Freddie Ann Hoffman, Amel Karaa, Erin L MacLeod, Robert McFarland, Charles Mohan, Andrew E Mulberg, Joanne C Odenkirchen, Sumit Parikh, Patricia J Rutherford, Shawne K Suggs-Anderson, W H Wilson Tang, Jerry Vockley, Lynne A Wolfe, Steven Yannicelli, Philip E Yeske, Paul M Coates
In December 2014, a workshop entitled "Nutritional Interventions in Primary Mitochondrial Disorders: Developing an Evidence Base" was convened at the NIH with the goals of exploring the use of nutritional interventions in primary mitochondrial disorders (PMD) and identifying knowledge gaps regarding their safety and efficacy; identifying research opportunities; and forging collaborations among researchers, clinicians, patient advocacy groups, and federal partners. Sponsors included the NIH, the Wellcome Trust, and the United Mitochondrial Diseases Foundation...
September 20, 2016: Molecular Genetics and Metabolism
Judith M Conijn, Wilco H M Emons, Bethan F Page, Klaas Sijtsma, Willem Van der Does, Ingrid V E Carlier, Erik J Giltay
The aim of this study was to assess the extent to which discrepancy between self-reported and clinician-rated severity of depression are due to inconsistent self-reports. Response inconsistency threatens the validity of the test score. We used data from a large sample of outpatients (N = 5,959) who completed the self-report Beck Depression Inventory-II (BDI-II) and the clinician-rated Montgomery-Åsberg Depression Rating Scale (MADRS). We used item response theory based person-fit analysis to quantify the inconsistency of the self-report item scores...
September 14, 2016: Assessment
Chris Henshall, Nicholas R Latimer, Lloyd Sansom, Robyn L Ward
OBJECTIVES: Treatment switching occurs when patients in a randomized clinical trial switch from the treatment initially assigned to them to another treatment, typically from the control to experimental treatment. This study discusses the issues this raises and possible approaches to addressing them in trials of cancer drugs. METHODS: Stakeholders from around the world were invited to a 1.5-day Workshop in Adelaide, Australia. This study attempts to capture the key points from the discussion and the perspectives of the various stakeholder groups, but is not a formal consensus statement...
January 2016: International Journal of Technology Assessment in Health Care
Gillian D Sanders, Peter J Neumann, Anirban Basu, Dan W Brock, David Feeny, Murray Krahn, Karen M Kuntz, David O Meltzer, Douglas K Owens, Lisa A Prosser, Joshua A Salomon, Mark J Sculpher, Thomas A Trikalinos, Louise B Russell, Joanna E Siegel, Theodore G Ganiats
IMPORTANCE: Since publication of the report by the Panel on Cost-Effectiveness in Health and Medicine in 1996, researchers have advanced the methods of cost-effectiveness analysis, and policy makers have experimented with its application. The need to deliver health care efficiently and the importance of using analytic techniques to understand the clinical and economic consequences of strategies to improve health have increased in recent years. OBJECTIVE: To review the state of the field and provide recommendations to improve the quality of cost-effectiveness analyses...
September 13, 2016: JAMA: the Journal of the American Medical Association
Michael J Blaha
Current American College of Cardiology/American Heart Association guidelines for the management of patients with elevated blood cholesterol increasingly emphasize assessment of atherosclerotic cardiovascular disease (ASCVD) risk in deciding when to initiate pharmacotherapy. The decision to treat is based primarily on mathematical integration of traditional risk factors, including age, sex, race, lipid values, systolic blood pressure, hypertension therapy, diabetes mellitus, and smoking. Advanced risk testing is selectively endorsed for patients when the decision to treat is otherwise uncertain, or more broadly interpreted as those patients who are at so-called "intermediate risk" of ASCVD events using traditional risk factors alone...
September 15, 2016: American Journal of Cardiology
Rory Collins, Christina Reith, Jonathan Emberson, Jane Armitage, Colin Baigent, Lisa Blackwell, Roger Blumenthal, John Danesh, George Davey Smith, David DeMets, Stephen Evans, Malcolm Law, Stephen MacMahon, Seth Martin, Bruce Neal, Neil Poulter, David Preiss, Paul Ridker, Ian Roberts, Anthony Rodgers, Peter Sandercock, Kenneth Schulz, Peter Sever, John Simes, Liam Smeeth, Nicholas Wald, Salim Yusuf, Richard Peto
This Review is intended to help clinicians, patients, and the public make informed decisions about statin therapy for the prevention of heart attacks and strokes. It explains how the evidence that is available from randomised controlled trials yields reliable information about both the efficacy and safety of statin therapy. In addition, it discusses how claims that statins commonly cause adverse effects reflect a failure to recognise the limitations of other sources of evidence about the effects of treatment...
September 6, 2016: Lancet
Lisa Corbin, Rebecca Childs, Caitlin Dilli, Mary K Christian, Ban Wong, Daisy Dong-Cedar, Benzi M Kluger
Background: Acupuncture use is increasing worldwide for many conditions, including movement disorders. Clinical research in acupuncture has also increased to test anecdotal reports of clinical benefits empirically and investigate potential mechanisms. Method: This article describes considerations for designing a double-blinded, randomized, placebo-controlled clinical trial of acupuncture for fatigue in Parkinson's disease (PD) and describes the current authors' experience in the implementation and early conduct of this trial...
August 1, 2016: Medical Acupuncture
Jessica Greene, Rebecca M Sacks, Judith H Hibbard, Valerie Overton
BACKGROUND: Primary care provider (PCP) support of patient self-management may be important mechanism to improving patient health outcomes. In this paper we develop a PCP-reported measure of clinician strategies for supporting patient self-management, and we psychometrically test and validate the measure. METHODS: We developed survey items based upon effective self-management support strategies identified in a prior mixed methods study. We fielded a survey in the fall of 2014 with 139 Fairview Health Services PCPs, and conducted exploratory factor analysis and Cronbach's Alpha to test for scale reliability...
September 2, 2016: Healthcare
Matthew Thompson, Bernhard Weigl, Annette Fitzpatrick, Nicole Ide
Current frameworks for evaluating diagnostic tests are constrained by a focus on diagnostic accuracy, and assume that all aspects of the testing process and test attributes are discrete and equally important. Determining the balance between the benefits and harms associated with new or existing tests has been overlooked. Yet, this is critically important information for stakeholders involved in developing, testing, and implementing tests. This is particularly important for point of care tests (POCTs) where tradeoffs exist between numerous aspects of the testing process and test attributes...
2016: IEEE Journal of Translational Engineering in Health and Medicine
Shannon A Novosad, Mathew R P Sapiano, Cheri Grigg, Jason Lake, Misha Robyn, Ghinwa Dumyati, Christina Felsen, Debra Blog, Elizabeth Dufort, Shelley Zansky, Kathryn Wiedeman, Lacey Avery, Raymund B Dantes, John A Jernigan, Shelley S Magill, Anthony Fiore, Lauren Epstein
BACKGROUND: Sepsis is a serious and often fatal clinical syndrome, resulting from infection. Information on patient demographics, risk factors, and infections leading to sepsis is needed to integrate comprehensive sepsis prevention, early recognition, and treatment strategies. METHODS: To describe characteristics of patients with sepsis, CDC and partners conducted a retrospective chart review in four New York hospitals. Random samples of medical records from adult and pediatric patients with administrative codes for severe sepsis or septic shock were reviewed...
2016: MMWR. Morbidity and Mortality Weekly Report
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