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https://www.readbyqxmd.com/read/29245184/evaluation-of-the-use-of-novel-biomarkers-to-augment-antimicrobial-stewardship-program-activities
#1
Kayla R Stover, Rachel M Kenney, Travis S King, Alan E Gross
As antimicrobial stewardship increasingly receives worldwide attention for improving patient care by optimizing antimicrobial therapy, programs are evaluating new tools that may augment antimicrobial stewardship activities. Biomarkers are objective, accurate, and reproducible measures that provide information about medical conditions. A systematic literature search using PubMed/MEDLINE databases was performed to evaluate the use of novel biomarkers as additions to the antimicrobial stewardship armamentarium...
December 15, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29243875/allometric-considerations-when-assessing-aortic-aneurysms-in-turner-syndrome-implications-for-activity-recommendations-and-medical-decision-making
#2
Holly Corbitt, Cheryl Maslen, Siddharth Prakash, Shaine A Morris, Michael Silberbach
In Turner syndrome, the potential to form thoracic aortic aneurysms requires routine patient monitoring. However, the short stature that typically occurs complicates the assessment of severity and risk because the relationship of body size to aortic dimensions is different in Turner syndrome compared to the general population. Three allometric formula have been proposed to adjust aortic dimensions, all employing body surface area: aortic size index, Turner syndrome-specific Z-scores, and Z-scores based on a general pediatric and young adult population...
December 15, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29240799/inappropriate-self-medication-among-adolescents-and-its-association-with-lower-medication-literacy-and-substance-use
#3
Chun-Hsien Lee, Fong-Ching Chang, Sheng-Der Hsu, Hsueh-Yun Chi, Li-Jung Huang, Ming-Kung Yeh
BACKGROUND: While self-medication is common, inappropriate self-medication has potential risks. This study assesses inappropriate self-medication among adolescents and examines the relationships among medication literacy, substance use, and inappropriate self-medication. METHOD: In 2016, a national representative sample of 6,226 students from 99 primary, middle, and high schools completed an online self-administered questionnaire. Multiple logistic regression analysis was used to examine factors related to inappropriate self-medication...
2017: PloS One
https://www.readbyqxmd.com/read/29239842/relative-rates-not-relative-risks-addressing-a-widespread-misinterpretation-of-hazard-ratios
#4
Rinku Sutradhar, Peter C Austin
The use of the Cox proportional hazards model is ubiquitous in modern medical research. Despite the widespread implementation of this model, the terminology and interpretation that is used to describe the estimate hazard ratio (HR) has become loose and, unfortunately, often incorrect. Although some journals offer guidelines that advise against reporting HRs as relative risks, these guidelines are frequently overlooked. Perhaps due to a lack of understanding, authors continue to interpret the resultant HR as a relative risk-such an interpretation is inappropriate and can be misleading...
November 7, 2017: Annals of Epidemiology
https://www.readbyqxmd.com/read/29239764/treatment-choices-for-the-glycaemic-management-of-patients-with-type-2-diabetes-and-chronic-kidney-disease-analysis-of-the-sail-patient-linked-dataset
#5
Thinzar Min, Gareth I Davies, Sam Rice, James Chess, Jeffrey W Stephens
AIMS: Chronic kidney disease (CKD) is common in type 2 diabetes and limits the treatment choices for glycaemic control. Our aim was to examine real-world prescribing for managing hyperglycaemia in the presence of CKD. METHODS: The SAIL (Secure Anonymised Information Linkage) databank was used to examine prescribing during the period from the 1st of January to 30th December 2014. CKD was defined as:- none or mild CKD, eGFR ≥60mL/min/1.73m2; moderate CKD eGFR <60mL/min/1...
November 23, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29238506/comparison-of-the-effect-of-topiramate-versus-gabapentin-on-neuropathic-pain-in-patients-with-polyneuropathy-a-randomized-clinical-trial
#6
Surena Nazarbaghi, Mohammad Reza Amiri-Nikpour, Aynaz Foroughi Eghbal, Rohollah Valizadeh
Background: Neuropathic pain is one of the most common complaints of neurologic clinics. Neuropathic pain is common and important and has inappropriate complications, and despite their importance, there is no effective treatment for them. Objective: Because of the importance of neuropathic pain and safe and effective treatment, in this study, we determined the effect of topiramate versus gabapentin in patients with neuropathic pain. Methods: In this randomized clinical trial, 30 patients with pain attributed to neuropathy who had at least one month of neuropathic pain in one area, were randomized to receive either gabapentin, titrated from 300 mg/day to a maximum of 900 mg/day or topiramate, titrated from 50 mg/day to a maximum of 100 mg/day after a 4-week period in the neurology clinic of Imam Khomeini Hospital of Urmia city, Iran in 2015...
October 2017: Electronic Physician
https://www.readbyqxmd.com/read/29237045/informing-antimicrobial-stewardship-factors-associated-with-inappropriate-antimicrobial-prescribing-in-primary-care
#7
Alexander Singer, Sergio Fanella, Leanne Kosowan, Jamie Falk, Brenden Dufault, Kevin Hamilton, Ashley Walus
Background: Antimicrobial stewardship (AS) programs promote the optimal use of antimicrobials and safe patient care. With most antimicrobials prescribed in the ambulatory setting, establishing benchmark data is imperative to gauge the impact of future AS initiatives. Objectives: To determine the frequency of potentially inappropriate antimicrobial prescribing in primary care practices in Manitoba, Canada and to assess the association between potentially inappropriate antimicrobial prescribing and patient, prescriber and practice-related factors...
December 10, 2017: Family Practice
https://www.readbyqxmd.com/read/29236644/the-less-is-more-crusade-are-we-overmedicalizing-or-oversimplifying
#8
Lisa Rosenbaum
They called me Ms. Appropriate. When I was a cardiology fellow, health care costs were skyrocketing, and I considered devoting my career to curbing inappropriate use of medical resources. My first target, as a supervisor of cardiac stress tests, was referrals of patients for unnecessary testing —..
December 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29236303/impact-of-antimicrobial-stewardship-program-on-hospitalized-patients-at-the-intensive-care-unit-a-prospective-audit-and-feedback-study
#9
Maher R Khdour, Hussein O Hallak, Mamoon Al-Deyab, Mowafq A Nasif, Aliaa M Khalili, Ahamad A Dallashi, Mohammad B Khofash, Michael G Scott
AIMS: Inappropriate use of antibiotics is one of the most important factors contributing to the emergence of drug resistant pathogens. The purpose of this study was to measure the clinical impact of Antimicrobial Stewardship Program (ASP) interventions on hospitalized patients at the Intensive care unit at Palestinian Medical Complex. METHODS: A prospective audit with intervention and feedback by ASP team within 48-72h of antibiotic administration began in Sep, 2015...
December 13, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29234966/efficacy-and-feasibility-of-a-collaborative-multidisciplinary-program-for-antibiotic-prophylaxis-in-clean-wound-surgery
#10
Xinyu Li, Hong Chen, Shenyin Zhu, Yu Liu, Jiadan Yang, Zhe Yuan, Gaoqun Yao, Feng Qiu
Background Despite national and international guidelines and recommendations, inappropriate prophylactic antibiotic use for clean wound surgery remains a common phenomenon in many Chinese hospitals, causing higher medical costs and bacterial resistance. Objective To improve the prescribing behavior for antibiotic prophylaxis and decrease antibiotic abuse and/or misuse in clean wound surgery. Setting The teaching hospital of a medical university in Southwest China. Methods A collaborative multidisciplinary program involving educational, technical, and administrative strategies was undertaken...
December 12, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29233434/assessing-students-knowledge-regarding-the-roles-and-responsibilities-of-a-pharmacist-with-focus-on-care-transitions-through-simulation
#11
Erini S Serag-Bolos, Aimon C Miranda, Shyam R Gelot, Sheetal P Dharia, Kristy M Shaeer
BACKGROUND AND PURPOSE: To evaluate the impact of a pharmacist-focused transitions of care (TOC) simulation on students' perceptions and knowledge of pharmacist roles in the healthcare continuum. Educational Activity and Setting: Two simulations, highlighting pharmacist roles in various practice settings, were conducted within the Pharmaceutical Skills courses in the third-year doctor of pharmacy curriculum. Patient cases were built utilizing electronic medical records (EMR). Students' knowledge was assessed before and after the simulations regarding pharmacist involvement in medication reconciliation, reduction in patient readmissions, reduction of inappropriate medication use, roles and communication on an interprofessional team, and involvement with health information technology (HIT) during care transitions...
July 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29229499/molecular-diagnosis-of-suspected-tuberculosis-from-archived-smear-slides-from-the-balimo-region-papua-new-guinea
#12
Vanina Guernier, Tanya Diefenbach-Elstob, Daniel Pelowa, Sandra Pollard, Graham Burgess, Emma S McBryde, Jeffrey Warner
BACKGROUND: Tuberculosis (TB) is a serious health problem in Papua New Guinea (PNG) with an estimated 30,000 new cases and 3,800 deaths each year. In the Balimo region of the Western Province, the diagnosis relies on clinical manifestations and on the microscopic detection of acid-fast bacilli in sputum smears, a technique with limited sensitivity. METHODS: We carried out a molecular diagnosis assay targeting DNA extracted from archived sputum smear slides collected from the Balimo region (2012-2014), without the need for a viable culture...
December 8, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29229274/team-approach-to-manage-difficult-to-treat-tb-cases-experiences-in-europe-and-beyond
#13
L D'Ambrosio, G Bothamley, J A Caminero Luna, R Duarte, L Guglielmetti, M Muñoz Torrico, M C Payen, N Saavedra Herrera, M A Salazar Lezama, A Skrahina, M Tadolini, S Tiberi, N Veziris, G B Migliori
As recommended by the World Health Organization (WHO), optimal management of MDR-TB cases can be ensured by a multi-speciality consultation body known as 'TB Consilium'. This body usually includes different medical specialities, competences and perspectives (e.g., clinical expertise both for adults and children; surgical, radiological and public health expertise; psychological background and nursing experience, among others), thus lowering the risk of making mistakes - or managing the patients inappropriately, in order to improve their clinical outcomes...
December 8, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/29229070/infective-endocarditis-an-update-for-dental-surgeons
#14
REVIEW
Andrew Narendran Robinson, Paul Anantharajah Tambyah
Infective endocarditis (IE) is associated with significant morbidity and mortality. The prevention of infective endocarditis, for many years, has involved the identification of at risk patients undergoing medical or dental procedures and the use of pre-procedural antibiotic prophylaxis. However, evidence regarding the effectiveness of such measures is lacking while evidence is mounting for the adverse effects of inappropriate antibiotic use. International guidelines for antibiotic prophylaxis were amended, radically in some cases to reflect this...
December 2017: Singapore Dental Journal
https://www.readbyqxmd.com/read/29228989/physicians-lack-of-knowledge-a-possible-reason-for-red-blood-cell-transfusion-overuse
#15
Roni Rahav Koren, Celia Suriu, Orly Yakir, Luiza Akria, Masad Barhoum, Andrei Braester
BACKGROUND: A significant percentage of red blood cell transfusions are inappropriately overused. This study investigated physicians from the western Galilee in terms of their knowledge of transfusion medicine as a potential reason for red blood cell overuse, and assessed the influence of personal background characteristics on their knowledge. METHODS: Data were collected via anonymous questionnaires. The questionnaires included a personal background section and a professional section...
December 12, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29224571/-worried-to-death-the-assessment-and-management-of-anxiety-in-patients-with-advanced-life-limiting-disease-a-national-survey-of-palliative-medicine-physicians
#16
N Atkin, V Vickerstaff, B Candy
BACKGROUND: Anxiety adversely affects quality of life and is common in adults with advanced life-limiting disease. There are no UK-wide guidelines on the assessment and management of anxiety in this specific population and there is little evidence regarding drug treatments. This study aimed to explore how palliative care physicians assess and manage anxiety in their patients, and to identify barriers encountered. METHODS: A cross-sectional survey was undertaken of all physicians working in specialist palliative care in the UK who were members of the Association for Palliative Medicine...
December 11, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29222712/categorization-and-association-analysis-of-risk-factors-for-adverse-drug-events
#17
REVIEW
Lina Zhou, Anamika Paul Rupa
PURPOSE: Adverse drug events (ADE) are among the leading causes of morbidity and hospitalization. This review analyzes risk factors for ADE, particularly their categorizations and association patterns, the prevalence, severity, and preventability of ADE, and method characteristics of reviewed studies. METHODS: Literature search was conducted via PubMed, Science Direct, CINAHL, and MEDLINE. A review was conducted of research articles that reported original data about specific risk factors for ADE since 2000...
December 8, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29221946/-facing-a-dilemma-in-elderly-complex-and-vulnerable-patients-to-stop-or-not-to-stop-prevention
#18
Laura Llobet Vila, Josep Maria Manresa Domínguez, José Manuel Carmona Segado, Alícia Franzi Sisó, Rosa Vallès Balasch, Isabel Martínez Díaz
OBJECTIVES: 1-To know the preventive prescription (statin, antiplatelet drugs, bisphosphonates, calcium and vitamin D and Vit B12) of elderly patients previously identified as a CCD (with a complex chronic disease) and ACD (with advanced chronic disease and lifetime expectancy of less than 12 months) who died during 2015. 2-To assess the correct indication of Proton Pump Inhibitors (PPI) to determine potentially avoidable medication. DESIGN: Retrospective observational study...
December 5, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/29221501/lean-methodology-reduces-inappropriate-use-of-antipsychotics-for-agitation-at-a-psychiatric-hospital
#19
Joshana K Goga, Antonio Depaolo, Sunil Khushalani, J Ken Walters, Robert Roca, Marc Zisselman, Christopher Borleis
OBJECTIVE: To Evaluate the Effects of Applying Lean Methodology-Improving Quality Increasing Efficiency by Eliminating Waste and Reducing Costs-An Approach To Decrease the Prescribing Frequency of Antipsychotics for The Indication of Agitation. DESIGN: Historically Controlled Study. SETTING: Bheppard Pratt Health System is the Largest Private Provider of Psychiatric Care in Maryland With a Total Bed Capacity of 300. There Were 4 337 Patient Days From November 1 2012 to October 31 2013 on the Dementia Unit...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29217876/nocturnal-enuresis-in-india-are-we-diagnosing-and-managing-correctly
#20
REVIEW
N M Reddy, H Malve, R Nerli, P Venkatesh, I Agarwal, V Rege
Nocturnal enuresis is a common problem affecting school-aged children worldwide. Although it has significant impact on child's psychology, it is always under-recognized in India and considered as a condition which will outgrow with advancing age. Nocturnal enuresis classified as primary or secondary and monosymptomatic or nonmonosymptomatic. Factors that cause enuresis include genetic factors, bladder dysfunction, psychological factors, and inappropriate antidiuretic hormone secretion, leading to nocturnal polyuria...
November 2017: Indian Journal of Nephrology
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