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https://www.readbyqxmd.com/read/29230931/temporal-changes-in-glycaemic-thresholds-for-treatment-intensification-in-type-2-diabetes-in-an-urban-australian-setting-the-fremantle-diabetes-study
#1
Timothy M E Davis, Stephen A P Chubb, Bradley H Curtis, Helen Barraclough, Wendy A Davis
BACKGROUND: Pharmacotherapy and supportive care for diabetes in Australia are improving, with potential beneficial effects on therapeutic procrastination. AIMS: To determine whether glycaemic thresholds for therapeutic intensification in type 2 diabetes changed over the 15 years between Phases of the community-based Fremantle Diabetes Study (FDS). METHODS: We studied 531 Phase 1 participants (mean age 62.4 years, 54.2% males, median diabetes duration 3...
December 12, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29222268/tailoring-front-line-therapy-in-diffuse-large-b-cell-lymphoma-who-should-we-treat-differently
#2
REVIEW
Andrew Davies
Although there have been significant insights into the biology of diffuse large B-cell lymphoma (DLBCL) over recent years, progress in our therapeutic approach has been disappointing over the same timeframe. This is not for want of trying. In 2017, R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) remains the "gold standard," despite all of our insights into cell-of-origin and other subgroups. We have traditionally used clinical risk factors to tailor our therapies and have tested intensification of chemotherapy with little success...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29191171/self-assessment-of-the-mental-health-status-in-older-adults-in-poland-a-cross-sectional-study
#3
Mateusz Cybulski, Lukasz Cybulski, Elzbieta Krajewska-Kulak, Urszula Cwalina
BACKGROUND: Demographic aging of society poses numerous challenges, including the provision of health care to the elderly population. According to World Health Organization data, the most frequent mental disorders in the senior population are: dementia, depression, and drug and alcohol addiction. The aim of this study was to subjectively assess mental health status (the severity of non-psychotic symptoms of mental functions and depressive symptoms) in older adults of Bialystok (Poland)...
December 1, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/29153353/-something-humane-has-been-lost-re-evaluation-of-the-attitudes-of-senior-physicians-towards-the-g-drg-system-a-qualitative-normative-analysis
#4
Marco Knoll, Ina Otte, Sabine Salloch, Caroline Ruiner, Esta Kruppa, Jochen Vollmann
Only a few years after the implementation of the G-DRG (German Diagnosis Related Group) system physicians already began to complain of its negative effects on the quality of inpatient healthcare. The present study examines the recent experiences senior physicians have made with regard to the impact of the G-DRG system on the quality of healthcare and medical professionalism. Nine qualitative guided expert interviews were conducted focusing on the experiences of physicians in leading positions dealing with the G-DRG system in their everyday work...
November 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29148634/labor-delivery-and-postpartum-complications-in-nulliparous-women-with-female-genital-mutilation-admitted-to-karamara-hospital
#5
Wondimu Gudu, Mutasim Abdulahi
Objectives: To assess labor, delivery and postpartum complications in nulliparous women with FGM/C and evaluate the attitude of mothers towards elimination of FGM. Methods: A prospective hospital based study using structured questionnaire was conducted between January to March 2015 at Karamara hospital, Jijiga, Ethiopia. All nulliparous women admitted for labor and delivery were included. Data were collected regarding circumcision status, events of labor, delivery; postpartum and neonatal outcomes as well as attitude of mothers towards elimination of FGM/C...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29131308/glycosyltransferase-cascades-made-fit-for-chemical-production-integrated-biocatalytic-process-for-the-natural-polyphenol-c-glucoside-nothofagin
#6
Katharina Schmölzer, Martin Lemmerer, Bernd Nidetzky
Glycosyltransferase cascades are promising tools of biocatalysis for natural product glycosylation, but their suitability for actual production remains to be shown. Here, we demonstrate at a scale of 100 g isolated product the integrated biocatalytic production of nothofagin, the natural 3'-C-β-D-glucoside of the polyphenol phloretin. A parallel reaction cascade involving coupled C-glucosyltransferase and sucrose synthase was optimized for the one-pot glucosylation of phloretin from sucrose via an UDP/UDP-glucose shuttle...
November 13, 2017: Biotechnology and Bioengineering
https://www.readbyqxmd.com/read/29131289/negative-predictors-of-treatment-success-in-outpatient-therapy-of-arterial-hypertension-in-poland-results-of-the-control-nt-observational-registry
#7
Krzysztof J Filipiak, Mariusz Tomaniak, Anna E Płatek, Filip M Szymański, Andrzej Tykarski
BACKGROUND: Identification of factors interfering with adequate control of arterial hypertension in the course of antihypertensive therapy is necessary to plan the strategy or reducing the incidence of cardiovascular disorders and optimize clinical practice guidelines. There have only been limited reliable studies describing the current status of hypertension treatment. AIM: The study objective was to conduct a screening assessment of the rate of uncontrolled hypertension among hypertensive patients coming to a routine follow-up visit, and to characterize patients with inadequate control of arterial hypertension in the aspect of their cardiovascular risk profile and therapeutic strategies used...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29108837/factors-associated-with-type-2-diabetes-mellitus-treatment-choice-across-four-european-countries
#8
Edith M Heintjes, Jetty A Overbeek, Gillian C Hall, Daniel Prieto-Alhambra, Francesco Lapi, Niklas Hammar, Irene D Bezemer
PURPOSE: The aim of this analysis was to identify factors associated with the choice of type 2 diabetes mellitus (T2DM) therapy at the time of intensification of antidiabetic treatment across 4 European countries. METHODS: Antidiabetic drug prescription/dispensing records and patients' characteristics were obtained from the electronic health care records of patients with T2DM from the Netherlands (NL), Italy, and Spain (ES) (all, 2007-2011); and the United Kingdom (UK; 2008-2012)...
November 3, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/29083969/personalized-care-and-the-role-of-insulin-as-a-vehicle-to-optimizing-treatments-in-diabetes-care
#9
Nella Bieszk, Michael Grabner, Wenhui Wei, John Barron, Ralph Quimbo, Tingjian Yan, Beth Biel, James W Chu
BACKGROUND: In patients with type 2 diabetes (T2D) with poor glycemic control, there is an unmet need for treatment optimization involving the initiation and/or intensification of insulin therapy, which is often delayed because of clinical inertia. Educational initiatives that target patients and physicians might be one way to address this need. OBJECTIVE: To evaluate the effectiveness of educational materials mailed to physicians and their patients in affecting initiation of insulin therapy and other health care outcomes...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29057642/insulin-therapy-for-adult-patients-with-type-2-diabetes-mellitus-a-position-statement-of-the-korean-diabetes-association-2017
#10
REVIEW
Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
The Korean Diabetes Association (KDA) has regularly updated its Clinical Practice Guidelines. In 2017, the KDA published a position statement on the use of antihyperglycemic agents for patients with type 2 diabetes mellitus (T2DM). Growing evidence from new multinational clinical trials using novel and traditional insulin analogues has also been accumulated. Following global trends, many results of clinical trials, especially concerning the clinical efficacy and safety of insulin therapy, have been published about Korean patients with T2DM...
November 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29056771/diagnostic-delays-in-rheumatic-diseases-with-associated-arthritis
#11
Filip Raciborski, Anna Kłak, Brygida Kwiatkowska, Bogdan Batko, Małgorzata Sochocka-Bykowska, Aleksandra Zoń-Giebel, Zbigniew Gola, Zbigniew Guzera, Maria Maślińska
OBJECTIVE: The objective of this study was to determine the length of delay in diagnosis of inflammatory rheumatic diseases, and to indicate the main factors responsible for such delays. MATERIAL AND METHODS: A retrospective multi-centre questionnaire survey carried out among 197 patients with diagnosed inflammatory rheumatic diseases or undergoing the diagnostic process. RESULTS: The most common early symptoms of inflammatory rheumatic disease included joint pain (94%), joint swelling (78%), morning joint stiffness (77%), fatigue (76%), and sleep disturbed by joint pain (74%)...
2017: Reumatologia
https://www.readbyqxmd.com/read/29053215/identification-of-barriers-to-insulin-therapy-and-approaches-to-overcoming-them
#12
REVIEW
David Russell-Jones, Frans Pouwer, Kamlesh Khunti
Poor glycaemic control in type 2 diabetes (T2D) is a global problem despite the availability of numerous glucose-lowering therapies and clear guidelines for T2D management. Tackling clinical or therapeutic inertia, where the person with diabetes and/or their healthcare providers do not intensify treatment regimens despite this being appropriate, is key to improving patients' long-term outcomes. This gap between best practice and current level of care is most pronounced when considering insulin regimens, with studies showing that insulin initiation/intensification is frequently and inappropriately delayed for several years...
October 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28993287/effectiveness-of-certified-diabetes-educators-following-pre-approved-protocols-to-redesign-diabetes-care-delivery-in-primary-care-results-of-the-remedies-4d-trial
#13
Janice C Zgibor, Maura A Maloney, Markku Malmi, Anthony Fabio, Shihchen Kuo, Francis X Solano, Debra Tilves, Lichuan Tu, Mayer B Davidson
OBJECTIVE: To evaluate the changes in HbA1c, blood pressure, and LDLc levels in participants from practices where certified diabetes educators (CDEs) implemented standardized protocols to intensify treatment compared with those receiveing usual care. RESEARCH DESIGN AND METHODS: This clustered, randomized, clinical trial was implemented in community-based primary care practices. Fifteen primary care practices and 240 patients with type 2 diabetes were randomized to the intervention (n=175) or usual care (n=65)...
October 6, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28964455/value-based-payments-and-incentives-to-improve-care-a-case-study-of-patients-with-type-2-diabetes-in-medicare-advantage
#14
Jesse Sussell, Kata Bognar, Taylor T Schwartz, Jason Shafrin, John J Sheehan, Wade Aubry, Dennis Scanlon
OBJECTIVES: To estimate the impact of increased glycated hemoglobin (A1C) monitoring and treatment intensification for patients with type 2 diabetes (T2D) on quality measures and reimbursement within the Medicare Advantage Star (MA Star) program. METHODS: The primary endpoint was the share of patients with T2D with adequate A1C control (A1C ≤ 9%). We conducted a simulation of how increased A1C monitoring and treatment intensification affected this end point using data from the National Health and Nutrition Examination Survey and clinical trials...
September 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28960144/blood-pressure-regulation-reviewing-evidence-for-interplay-between-common-dietary-sugars-and-table-salt
#15
Harry G Preuss, Dallas Clouatre, Anand Swaroop, Manashi Bagchi, Debasis Bagchi, Gilbert R Kaats
A popular concept is that the significant global progression in prevalence and intensification of elevated blood pressure (BP) levels is due in part to dietary indiscretions. Excess intake of several food sources causing overweight/obesity plays an important role in BP perturbations. However, certain nutrients are involved in ways other than via body fat accumulation, particularly table salt (sodium chloride) and popular refined carbohydrates like dietary sugars (sucrose, fructose, high fructose corn syrup)...
September 29, 2017: Journal of the American College of Nutrition
https://www.readbyqxmd.com/read/28945115/advances-in-immunotherapy-for-pediatric-acute-myeloid-leukemia
#16
Challice L Bonifant, Mireya Paulina Velasquez, Stephen Gottschalk
Achieving better disease control in patients diagnosed with acute myeloid leukemia (AML) has proven challenging. Overall survival has been impacted by addressing treatment related mortality with focused supportive care measures. Despite this improvement, it remains difficult to induce durable leukemia remissions despite aggressive chemotherapeutic regimens. The addition of hematopoietic stem cell transplants (HSCT) has allowed further treatment intensification and provided the benefit of graft-versus-leukemia (GVL) effect...
October 11, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28942908/integrating-function-directed-treatments-into-palliative-care
#17
REVIEW
Andrea L Cheville, Melissa Morrow, Sean Robinson Smith, Jeffrey R Basford
The growing acceptance of palliative care has created opportunities to increase the use of rehabilitation services among populations with advanced disease, particularly those with cancer. Broader delivery has been impeded by the lack of a shared definition for palliative rehabilitation and a mismatch between patient needs and established rehabilitation service delivery models. We propose the definition that, in the advanced cancer population, palliative rehabilitation is function-directed care delivered in partnership with other clinical disciplines and aligned with the values of patients who have serious and often incurable illnesses in contexts marked by intense and dynamic symptoms, psychological stress, and medical morbidity to realize potentially time-limited goals...
September 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28936586/role-of-structured-individual-patient-education-in-the-prevention-of-vascular-complications-in-newly-diagnosed-type-2-diabetes-the-individual-therapeutic-education-in-newly-diagnosed-type-2-diabetes-intend-randomized-controlled-trial
#18
Adriana Coppola, Livio Luzi, Tiziana Montalcini, Andrea Giustina, Carmine Gazzaruso
OBJECTIVE: Recent studies showed that a structured patient therapeutic education (PTE) may decrease both mortality and the development of diabetes complications. Nevertheless, no data are available in the literature on the impact of individual PTE on the complications in newly diagnosed type 2 diabetic patients. Aim of the present randomized controlled trial is to evaluate the impact of individual PTE on the occurrence of macrovascular complications in newly diagnosed type 2 diabetic patients when compared to usual care (UC) and group PTE...
September 21, 2017: Endocrine
https://www.readbyqxmd.com/read/28929083/emerging-therapies-for-stage-iii-non-small-cell-lung-cancer-stereotactic-body-radiation-therapy-and-immunotherapy
#19
REVIEW
Sameera S Kumar, Kristin A Higgins, Ronald C McGarry
The current standard of care for locally advanced non-small cell lung cancer (NSCLC) includes radiation, chemotherapy, and surgery in certain individualized cases. In unresectable NSCLC, chemoradiation has been the standard of care for the past three decades. Local and distant failure remains high in this group of patients, so dose escalation has been studied in both single institution and national clinical trials. Though initial studies showed a benefit to dose escalation, phase III studies examining dose escalation using standard fractionation or hyperfractionation have failed to show a benefit...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28912200/development-and-validation-of-electronic-quality-measures-to-assess-care-for-patients-with-transient-ischemic-attack-and-minor-ischemic-stroke
#20
Dawn M Bravata, Laura J Myers, Eric Cheng, Mathew Reeves, Fitsum Baye, Zhangsheng Yu, Teresa Damush, Edward J Miech, Jason Sico, Michael Phipps, Alan Zillich, Jason Johanning, Seemant Chaturvedi, Curt Austin, Jared Ferguson, Bailey Maryfield, Kathy Snow, Susan Ofner, Glenn Graham, Rachel Rhude, Linda S Williams, Greg Arling
BACKGROUND: Despite interest in using electronic health record (EHR) data to assess quality of care, the accuracy of such data is largely unknown. We sought to develop and validate transient ischemic attack and minor ischemic stroke electronic quality measures (eQMs) using EHR data. METHODS AND RESULTS: A random sample of patients with transient ischemic attack or minor ischemic stroke, cared for in Veterans Health Administration facilities (fiscal year 2011), was identified...
September 2017: Circulation. Cardiovascular Quality and Outcomes
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