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https://www.readbyqxmd.com/read/28814947/preserving-the-anti-scientific-linear-no-threshold-myth-authority-agnosticism-transparency-and-the-standard-of-care
#1
Bill Sacks, Jeffry A Siegel
The linear no-threshold (LNT) assumption is over 70 years old and holds that all ionizing radiation exposure leaves cumulative effects, all of which are harmful regardless of how low the dose or dose rate is. The claimed harm centers on the risk of future radiogenic cancer. This has been shown countless times to be fallacious, and hundreds of scientific studies-both experimental and observational/epidemiological-demonstrate that at low enough doses and dose rates, ionizing radiation stimulates an evolved adaptive response and therefore is beneficial to health, lowering rather than raising the risk of cancer...
July 2017: Dose-response: a Publication of International Hormesis Society
https://www.readbyqxmd.com/read/28810024/effect-of-an-intensive-lifestyle-intervention-on-glycemic-control-in-patients-with-type-2-diabetes-a-randomized-clinical-trial
#2
Mette Yun Johansen, Christopher Scott MacDonald, Katrine Bagge Hansen, Kristian Karstoft, Robin Christensen, Maria Pedersen, Louise Seier Hansen, Morten Zacho, Anne-Sophie Wedell-Neergaard, Signe Tellerup Nielsen, Ulrik Wining Iepsen, Henning Langberg, Allan Arthur Vaag, Bente Klarlund Pedersen, Mathias Ried-Larsen
Importance: It is unclear whether a lifestyle intervention can maintain glycemic control in patients with type 2 diabetes. Objective: To test whether an intensive lifestyle intervention results in equivalent glycemic control compared with standard care and, secondarily, leads to a reduction in glucose-lowering medication in participants with type 2 diabetes. Design, Setting, and Participants: Randomized, assessor-blinded, single-center study within Region Zealand and the Capital Region of Denmark (April 2015-August 2016)...
August 15, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28805782/-blunt-chest-trauma-possibilities-to-stabilize-multiple-and-floating-ribs-fractures
#3
A S Benyan
AIM: To improve surgical treatment of patients with multiple and flotating ribs fractures. MATERIAL AND METHODS: A comparative analysis of two groups of victims with rib fractures was carried out. 148 patients of the control group underwent conservative treatment, mechanical ventilation, skeletal traction. In 167 patients of the main group we used advanced surgical tactics based on differentiated, stepwise and combined chest stabilization including osteosynthesis of ribs and thoracoscopy...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28799195/sacral-nerve-stimulation-for-constipation-and-fecal-incontinence-in-children-long-term-outcomes-patient-benefit-and-parent-satisfaction
#4
P L Lu, I J N Koppen, D K Orsagh-Yentis, K Leonhart, E J Ambeba, K J Deans, P C Minneci, S Teich, K A Diefenbach, S A Alpert, M A Benninga, D Yacob, C Di Lorenzo
OBJECTIVE: To evaluate the long-term efficacy of sacral nerve stimulation (SNS) in children with constipation and describe patient benefit and parent satisfaction. METHODS: Using a prospective patient registry, we identified patients <21 years old with constipation treated with SNS for >2 years. We compared symptoms, medical treatment, PedsQL Gastrointestinal Symptom Scale (GSS), Fecal Incontinence Quality of Life Scale (FIQL), and Fecal Incontinence Severity Index (FISI) before SNS and at follow-up...
August 10, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28797248/the-role-of-bariatric-surgery-to-treat-diabetes-current-challenges-and-perspectives
#5
REVIEW
Chrysi Koliaki, Stavros Liatis, Carel W le Roux, Alexander Kokkinos
Bariatric surgery is emerging as a powerful weapon against severe obesity and type 2 diabetes mellitus (T2DM). Given its role in metabolic regulation, the gastrointestinal tract constitutes a meaningful target to treat T2DM, especially in light of accumulating evidence that surgery with gastrointestinal manipulations may result in T2DM remission (metabolic surgery). The major mechanisms mediating the weight loss-independent effects of bariatric surgery comprise effects on tissue-specific insulin sensitivity, β-cell function and incretin responses, changes in bile acid composition and flow, modifications of gut microbiota, intestinal glucose metabolism and increased brown adipose tissue metabolic activity...
August 10, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28779781/vascular-access-should-be-tailored-to-the-patient
#6
REVIEW
Krzysztof Letachowicz, Przemysław Szyber, Tomasz Gołębiowski, Mariusz Kusztal, Waldemar Letachowicz, Wacław Weyde, Jerzy Garcarek, Marian Klinger
A cornerstone of hemodialysis treatment is the creation of a functional and durable dialysis vascular access. Every patient with chronic kidney disease should have a plan of renal replacement therapy and access site protection. Factors having a crucial impact on vascular access selection include age, comorbidity, vessel quality, prognosis, dialysis urgency, and surgeon's preferences. Our medical group have reviewed these factors in our patients and, based on recently published data, developed a clinical decision tree for dialysis access in the chronic kidney disease patient...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28777755/ads-5102-amantadine-extended-release-capsules-for-levodopa-induced-dyskinesia-in-parkinson-s-disease-ease-lid-2-study-interim-results-of-an-open-label-safety-study
#7
Robert A Hauser, Rajesh Pahwa, Caroline M Tanner, Wolfgang Oertel, Stuart H Isaacson, Reed Johnson, Larissa Felt, Mary Jean Stempien
BACKGROUND: Medical treatment of levodopa-induced dyskinesia (LID) in Parkinson's disease (PD) is an unmet need. ADS-5102 (amantadine) extended-release capsules is being developed for the treatment of LID in patients with PD. OBJECTIVE: Evaluate the long-term safety and tolerability of 274 mg ADS-5102 for LID in PD. METHODS: In an ongoing, open-label safety study (NCT02202551), PD patients with LID received 274 mg of ADS-5102 once daily at bedtime...
2017: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/28760582/improved-outcomes-with-proximal-radial-cephalic-arteriovenous-fistulas-compared-with-brachial-cephalic-arteriovenous-fistulas
#8
Dean J Arnaoutakis, Elise P Deroo, Patrick McGlynn, Maxwell D Coll, Michael Belkin, Dirk M Hentschel, C Keith Ozaki
BACKGROUND: Brachial-cephalic arteriovenous fistulas (BCFs) are associated with high-flow volumes, leading to potential risks such as arm swelling, steal syndrome, pseudoaneurysm (due to a pressurized access), and cephalic arch stenosis. We hypothesized that a proximal radial-cephalic fistula (prRCF) configuration mitigates these risks because a lower flow state is created. Furthermore, we also hypothesized that despite these lower flows, patencies (primary, primary assisted, secondary) are sustained...
July 28, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28755179/evidence-base-for-optimal-preoperative-preparation-for-bariatric-surgery-does-mandatory-weight-loss-make-a-difference
#9
REVIEW
Julie J Kim
PURPOSE OF REVIEW: Preoperative weight loss regimens prior to bariatric surgery have been a routine and common practice for many centers, in the US and around the world. The mandated participation in such programs has largely been influenced by loco-regional payer requirements. The relationship between adherence to a mandatory weight loss regimen and achieved preoperative weight loss as well as the clinical impact of preoperative weight loss on bariatric outcomes remains uncertain. RECENT FINDINGS: This review examines the available current literature, in the context of previous findings, regarding the impact of mandated preoperative weight loss regimens and mandatory weight loss on bariatric outcomes...
July 28, 2017: Current Obesity Reports
https://www.readbyqxmd.com/read/28751491/pediatric-chronic-critical-illness-reducing-excess-hospitalizations
#10
Renee D Boss, Erin P Williams, Carrie M Henderson, Rebecca R Seltzer, Miriam C Shapiro, Emily Hahn, Nancy Hutton
OBJECTIVES: The past 2 decades have seen an expanding pediatric population that is chronically critically ill: children with repeated and prolonged hospitalizations and ongoing dependence on technologies to sustain vital functions. Although illness complexity prompts many hospitalizations, our goal with this study was to explore modifiable patient, family, and health system contributions to excess hospital days for children with chronic critical illness (CCI). METHODS: Semistructured interviews were conducted with 51 stakeholders known for their CCI expertise...
July 27, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28745410/short-and-medium-term-outcomes-following-primary-ileocaecal-resection-for-crohn-s-disease-in-two-specialist-centres
#11
A de Buck van Overstraeten, E J Eshuis, S Vermeire, G Van Assche, M Ferrante, G R D'Haens, C Y Ponsioen, A Belmans, C J Buskens, A M Wolthuis, W A Bemelman, A D'Hoore
BACKGROUND: Despite improvements in medical therapy, the majority of patients with Crohn's disease still require surgery. The aim of this study was to report safety, and clinical and surgical recurrence rates, including predictors of recurrence, after ileocaecal resection for Crohn's disease. METHODS: This was a cohort analysis of consecutive patients undergoing a first ileocaecal resection for Crohn's disease between 1998 and 2013 at one of two specialist centres...
July 26, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28737451/long-term-quality-of-life-outcomes-following-nissen-versus-toupet-fundoplication-in-patients-with-gastroesophageal-reflux-disease
#12
Rebecca L Gunter, Amber L Shada, Luke M Funk, Xing Wang, Jacob A Greenberg, Anne O Lidor
INTRODUCTION: Laparoscopic fundoplication is the gold standard treatment for gastroesophageal reflux disease (GERD) refractory to medical management. Although many studies have compared Nissen fundoplication (NF) to Toupet fundoplication (TF), it is unclear which operation provides the best long-term reflux control. The objective of this study was to evaluate long-term quality-of-life (QoL) outcomes after NF versus TF. METHODS: Clinical data from our single academic institutional foregut database were used to identify patients who underwent NF or TF (June 2010 to May 2016)...
July 24, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28734706/emerging-minimally-invasive-treatment-options-for-male-lower-urinary-tract-symptoms
#13
REVIEW
Giuseppe Magistro, Christopher R Chapple, Mostafa Elhilali, Peter Gilling, Kevin T McVary, Claus G Roehrborn, Christian G Stief, Henry H Woo, Christian Gratzke
CONTEXT: Lower urinary tract symptoms (LUTS) are one of the most common and troublesome nonmalignant conditions affecting quality of life in aging men. A spectrum of established medical and surgical options is available to provide relief of bothersome LUTS. Both the adverse events of medication and the morbidity with surgical treatment modalities have to be counterbalanced against efficacy. Novel minimally invasive treatment options aim to be effective, ideally to be performed in an ambulatory setting under local anaesthesia and to offer a more favourable safety profile than existing reference techniques...
July 19, 2017: European Urology
https://www.readbyqxmd.com/read/28719539/inflammatory-bowel-disease-pharmacist-adherence-counseling-improves-medication-adherence-in-crohn-s-disease-and-ulcerative-colitis
#14
Darren K Tiao, Webber Chan, Jayson Jeganathan, Jenny T Chan, Jonathan Perry, Christian P Selinger, Rupert W Leong
BACKGROUND: While inflammatory bowel diseases (IBD) require long-term medication usage to maintain remission, nonadherence is common and adversely associated with poorer clinical outcomes. Personalized IBD Pharmacist Adherence Counselling, based on the Health Beliefs Model of medication perception, may increase medication adherence. METHODS: This prospective multi-center longitudinal parallel study recruited consecutive IBD subjects that were classified as baseline medication non-adherers and adherers...
August 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28714753/pediatric-acute-onset-neuropsychiatric-syndrome-response-to-oral-corticosteroid-bursts-an-observational-study-of-patients-in-an-academic-community-based-pans-clinic
#15
Kayla Brown, Cristan Farmer, Bahare Farhadian, Joseph Hernandez, Margo Thienemann, Jennifer Frankovich
BACKGROUND: Sudden-onset severe obsessive-compulsive symptoms and/or severely restrictive food intake with at least two coinciding, similarly debilitating neuropsychiatric symptoms define Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). When associated with Group A Streptococcus, the syndrome is labeled Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections (PANDAS). An abnormal immune response to infection and subsequent neuroinflammation is postulated to play an etiologic role...
July 17, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28711453/a-roadmap-for-evaluating-the-use-and-value-of-durable-ventricular-assist-device-therapy
#16
EDITORIAL
Sarah T Ward, Qixing Liang, Francis D Pagani, Min Zhang, Robert L Kormos, Keith D Aaronson, Andrew D Althouse, Brahmajee K Nallamothu, Donald S Likosky
Heart failure is a disease characterized by profound human suffering with limitations in survival despite treatment with guideline-directed medical therapies. Patients with heart failure frequently progress to advanced stages and often require cardiac transplantation or implantation of left ventricular assist devices (LVADs) to extend survival and improve quality of life. As the number of suitable heart donors, number of experienced medical centers and patient comorbidities place restrictions on the feasibility of cardiac transplantation, implantation of LVADs has emerged as a more frequently applied treatment as either a bridge to transplantation or as permanent therapy...
June 23, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28708339/-advance-directives-and-advance-care-planning
#17
Petra Vayne-Bossert, Christiane Vailloud, Dominique Ducloux, Caroline Matis, Laurence Déramé
Advance directives (AD) and Advance Care Planning (ACP) are two measures a person may undertake to assure that their treatment preferences will be respected until the end of his / her life. Anticipation is based on an open and honest communication between the patient, the durable medical power of attorney and the health care professionals. ADs and ACPs are based on a person's values and beliefs that are important to his quality of life. ACP is a continuing process, initiated by health care professionals and integrated into the health care plan of a person...
February 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28701263/treatment-for-anal-fissure-is-there-a-safe-option
#18
Justin T Brady, Alison R Althans, Ruel Neupane, Eslam M G Dosokey, Murad A Jabir, Harry L Reynolds, Scott R Steele, Sharon L Stein
BACKGROUND: Surgeons often approach anal fissure with chemical denervation (Botulinum toxin, BT) instead of initial lateral internal sphincterotomy (LIS) due to concerns for long-term incontinence. We evaluated the characteristics and outcomes of patients who received BT or LIS. METHODS: We performed a retrospective chart review of patients undergoing LIS and BT for anal fissure between 2009 and 2015. In 2015, a telephone survey was performed to evaluate durability, long-term incontinence and patient satisfaction...
July 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28698663/medical-devices-for-the-treatment-of-obesity
#19
REVIEW
Phong Ching Lee, John Dixon
Obesity is a major public health concern that leads to numerous metabolic, mechanical and psychological complications. Although lifestyle interventions are the cornerstone of obesity management, subsequent physiological neurohormonal adaptations limit weight loss, strongly favour weight regain and counteract sustained weight loss. A range of effective therapies are therefore needed to manage this chronic relapsing disease. Bariatric surgery delivers substantial, durable weight loss but limited access to care, perceived high risks and costs restrict uptake...
July 12, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28697893/mechanical-valves-in-the-pulmonary-position-an-international-retrospective-analysis
#20
Hanna Pragt, Joost P van Melle, Hoda Javadikasgari, Dong Man Seo, John M Stulak, Igor Knez, Jürgen Hörer, Christian Muñoz-Guijosa, Mahyar G Dehaki, Hong Ju Shin, Joseph A Dearani, Maziar G Dehaki, Petronella G Pieper, Christine Eulenburg, Laura Dos, Tjark Ebels
OBJECTIVE: Life expectancy of patients with congenital heart disease has improved over the past decades, increasing the need for a durable pulmonary prosthetic valve. Biological valves in various forms have become the valve of choice for pulmonary valve replacement (PVR), but structural valve deterioration is unavoidable in the long term. Use of a mechanical valve could be an alternative, but data on long-term outcomes are sparse. METHODS: We retrospectively collected and analyzed data on 364 patients with mechanical valves implanted in the pulmonary position between 1965 and 2014...
May 20, 2017: Journal of Thoracic and Cardiovascular Surgery
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