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https://www.readbyqxmd.com/read/28214977/braf-mutated-colorectal-cancer-what-is-the-optimal-strategy-for-treatment
#1
REVIEW
Romain Cohen, Pascale Cervera, Magali Svrcek, Anna Pellat, Chantal Dreyer, Aimery de Gramont, Thierry André
The BRAF activating mutation, harbored by approximately 10% of colorectal cancers (CRC), confers dramatic prognosis to advanced diseases. In early-stage setting, the identification of the BRAF mutation does not impact the therapeutic decision. Yet, the BRAF mutation could be considered as a stratification factor in adjuvant trials, because of its prognostic impact after relapse. Moreover, both BRAF mutation and mismatch repair (MMR) statuses should be determined in all CRC to help identify sporadic tumors versus Lynch syndrome-related tumors...
February 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28199373/prevalence-of-maternal-hiv-infection-and-knowledge-on-mother-to-child-transmission-of-hiv-and-its-prevention-among-antenatal-care-attendees-in-a-rural-area-in-northwest-cameroon
#2
Carlson-Babila Sama, Vitalis F Feteh, Maxime Tindong, John T Tanyi, Nestor Mbinkar Bihle, Fru F Angwafo
BACKGROUND: In 2010, an estimated 141 new HIV infections occurred per day in Cameroon and reports suggest an upsurge of these rates by 2020 if current trends continue. Mother-to-child transmission (MTCT) of HIV is a major public health challenge, and maternal knowledge on HIV transmission during pregnancy and its prevention is important in curtailing paediatric HIV acquisition. OBJECTIVES: We aimed at establishing the prevalence of maternal HIV infection as well as assessing knowledge on HIV, MTCT and prevention of MTCT (PMTCT) of HIV among pregnant women in a rural area of Cameroon...
2017: PloS One
https://www.readbyqxmd.com/read/28157829/how-should-remote-clinical-monitoring-be-used-to-treat-alcohol-use-disorders-initial-findings-from-an-expert-round-table-discussion
#3
Alan Gordon, Adi Jaffe, A Thomas McLellan, Gary Richardson, Gregory Skipper, Michel Sucher, Carlos F Tirado, Harold C Urschel
Scientific evidence combined with new health insurance coverage now enable a chronic illness management approach to the treatment of alcohol use disorders (AUDs), including regular monitoring of blood alcohol content (BAC), as a useful indicator of disease control. Recent technical advances now permit many different types of remote, real-time monitoring of BAC. However, there is no body of research to empirically guide clinicians in how to maximize the clinical potential of remote BAC monitoring.As an initial step in guiding and supporting such research, the manufacturer of one remote BAC monitoring system sponsored a group of experienced clinicians and clinical researchers to discuss 8 issues that generally affect remote, clinical BAC monitoring of "adults in outpatient AUD treatment...
February 2, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28143520/which-patients-with-advanced-respiratory-disease-die-in-hospital-a-14-year-population-based-study-of-trends-and-associated-factors
#4
Irene J Higginson, Charles C Reilly, Sabrina Bajwah, Matthew Maddocks, Massimo Costantini, Wei Gao
BACKGROUND: Strategies in many countries have sought to improve palliative care and reduce hospital deaths for non-cancer patients, but their effects are not evaluated. We aimed to determine the trends and factors associated with dying in hospital in two common progressive respiratory diseases, and the impact of a national end of life care (EoLC) strategy to reduce deaths in hospital. METHODS: This population-based observational study linked death registration data for people in England dying from chronic obstructive pulmonary disease (COPD) or interstitial pulmonary diseases (IPD)...
February 1, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28138803/effectiveness-and-persistence-of-liraglutide-treatment-among-patients-with-type-2-diabetes-treated-in-primary-care-and-specialist-settings-a-subgroup-analysis-from-the-evidence-study-a-prospective-2-year-follow-up-observational-post-marketing-study
#5
Luc Martinez, Alfred Penfornis, Jean-Francois Gautier, Eveline Eschwège, Guillaume Charpentier, Amira Bouzidi, Pierre Gourdy
INTRODUCTION: The objective of this subgroup analysis is to investigate the effectiveness of liraglutide in people with type 2 diabetes (T2D) treated within the primary care physician (PCP) and specialist care settings. METHODS: EVIDENCE is a prospective, observational study of 3152 adults with T2D recently starting or about to start liraglutide treatment in France. We followed patients in the PCP and specialist settings for 2 years to evaluate the effectiveness of liraglutide in glycemic control and body weight reduction...
January 30, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28109269/an-appraisal-of-the-neglected-tropical-diseases-control-program-in-cameroon-the-case-of-the-national-program-against-onchocerciasis
#6
Tsi Njim, Leopold Ndemnge Aminde
BACKGROUND: Onchocerciasis is a severe parasitic infestation which causes disabling skin and subcutaneous tissue changes. Current global estimates suggest that it accounts for 1135.7 disability adjusted life years (DALYs) per 100,000 population. The disease is endemic in many African countries including Cameroon, probably suggesting that the current health policies are inadequate to achieve eradication of the disease. We aimed to appraise the current Onchocerciasis control program in Cameroon in the context of existing literature...
January 21, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28074618/review-article-dose-optimisation-of-infliximab-for-acute-severe-ulcerative-colitis
#7
REVIEW
P Hindryckx, G Novak, N Vande Casteele, D Laukens, C Parker, L M Shackelton, N Narula, R Khanna, P Dulai, B G Levesque, W J Sandborn, G D'Haens, B G Feagan, V Jairath
BACKGROUND: Although optimal medical management of acute severe ulcerative colitis (UC) is ill-defined, infliximab has become a standard of care. Accumulating evidence suggests an increased rate of infliximab clearance in patients with acute severe UC and a reduced colectomy rate with an intensified infliximab induction regimen. AIM: To assess the strength of the current evidence for the relationship between infliximab pharmacokinetics, dosing strategies and disease behaviour in patients with acute severe UC...
January 11, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28000212/interventions-to-improve-adherence-to-lipid-lowering-medication
#8
REVIEW
Mieke L van Driel, Michael D Morledge, Robin Ulep, Johnathon P Shaffer, Philippa Davies, Richard Deichmann
BACKGROUND: Lipid-lowering drugs are widely underused, despite strong evidence indicating they improve cardiovascular end points. Poor patient adherence to a medication regimen can affect the success of lipid-lowering treatment. OBJECTIVES: To assess the effects of interventions aimed at improving adherence to lipid-lowering drugs, focusing on measures of adherence and clinical outcomes. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO and CINAHL up to 3 February 2016, and clinical trials registers (ANZCTR and ClinicalTrials...
21, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27981681/development-and-validation-of-prescribing-quality-indicators-for-patients-with-type-2-diabetes
#9
Kirsten P J Smits, Grigory Sidorenkov, Nanno Kleefstra, Margriet Bouma, Marianne Meulepas, Jaco Voorham, Gerjan Navis, Henk J G Bilo, Petra Denig
AIM: Quality indicators are used to measure whether healthcare professionals act according to guidelines, but few indicators focus on the quality of pharmacotherapy for diabetes. The aim of this study was to develop and validate a set of prescribing quality indicators (PQIs) for type 2 diabetes in primary care, and to apply this set in practice. To take into account the stepwise treatment of chronic disease, clinical action indicators were specifically considered. METHODS: Potential PQIs were derived from clinical practice guidelines and evaluated using the RAND/UCLA Appropriateness Method, a modified Delphi panel...
January 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/27930732/adjuvant-radiation-therapy-alone-for-hpv-related-oropharyngeal-cancers-with-high-risk-features
#10
William Su, Jerry Liu, Brett A Miles, Eric M Genden, Krzysztof J Misiukiewicz, Marshall Posner, Vishal Gupta, Richard L Bakst
BACKGROUND: Current standard of care for oropharyngeal cancers with positive surgical margins and/or extracapsular extension is adjuvant chemoradiotherapy. It is unknown whether HPV+ oropharyngeal cancer benefits from this treatment intensification. OBJECTIVE: To investigate the outcomes of HPV+ patients treated with adjuvant radiotherapy alone when chemoradiotherapy was indicated based on high risk pathological features. They were compared with high risk HPV+ patients treated with adjuvant chemoradiotherapy...
2016: PloS One
https://www.readbyqxmd.com/read/27917770/evaluating-point-of-care-testing-for-glycosylated-haemoglobin-in-public-sector-primary-care-facilities-in-the-western-cape-south-africa
#11
R Mash, A Ugoagwu, C Vos, M Rensburg, R Erasmus
BACKGROUND: Diabetes mellitus contributes significantly to the burden of disease in South Africa (SA). Monitoring of glycaemic control with glycosylated haemoglobin (HbA1c) is recommended, even though current laboratory-based testing does not support immediate clinical decision-making. OBJECTIVES: To evaluate the costs and consequences for quality of care by introducing point-of-care (POC) testing for HbA1c for patients with type 2 diabetes at community health centres in Cape Town, SA...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27900923/-the-infection-risk-scan-in-clinical-practice-improving-infection-prevention-and-antibiotic-use-through-transparency
#12
I Willemsen, J A J W Kluytmans
OBJECTIVE: The increase in Highly Resistant Micro-Organisms (HRMO) in hospitals and nursing homes requires an intensification of infection prevention measures. This paper describes a new, standardised approach to infection prevention and monitoring of antibiotic use. DESIGN: Cross-sectional, observational study. METHOD: The Infection RIsk Scan (IRIS) measures a number of objectifiable variables in the field of infection prevention, including the dissemination of HRMO, the use of antibiotics and indwelling medical devices, environmental contamination, hand hygiene and personal hygiene of healthcare workers, and various infection control preconditions...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27875542/educational-outreach-with-an-integrated-clinical-tool-for-nurse-led-non-communicable-chronic-disease-management-in-primary-care-in-south-africa-a-pragmatic-cluster-randomised-controlled-trial
#13
Lara R Fairall, Naomi Folb, Venessa Timmerman, Carl Lombard, Krisela Steyn, Max O Bachmann, Eric D Bateman, Crick Lund, Ruth Cornick, Gill Faris, Thomas Gaziano, Daniella Georgeu-Pepper, Merrick Zwarenstein, Naomi S Levitt
BACKGROUND: In many low-income countries, care for patients with non-communicable diseases (NCDs) and mental health conditions is provided by nurses. The benefits of nurse substitution and supplementation in NCD care in high-income settings are well recognised, but evidence from low- and middle-income countries is limited. Primary Care 101 (PC101) is a programme designed to support and expand nurses' role in NCD care, comprising educational outreach to nurses and a clinical management tool with enhanced prescribing provisions...
November 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27858912/a-randomized-controlled-clinical-trial-on-the-impact-of-ccr5-blockade-with-maraviroc-in-early-infection-on-t-cell-dynamics
#14
RANDOMIZED CONTROLLED TRIAL
Maile Y Karris, Anya Umlauf, Florin Vaida, Douglas Richman, Susan Little, Davey Smith
BACKGROUND: Initiation of antiretroviral therapy (ART) in early HIV infection demonstrates clinical benefits including enhanced CD4 T-lymphocyte recovery and minimization of the latent HIV reservoir. Whether ART intensification with CCR5 blockade provides additional benefits is unknown. TRIAL DESIGN: This randomized controlled trial evaluated the impact of maraviroc (MVC) intensification in persons starting ART in acute and early HIV (AEH, within 3 months of estimated date of infection)...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27854311/care-seeking-for-diarrhoea-in-southern-malawi-attitudes-practices-and-implications-for-diarrhoea-control
#15
Salule Masangwi, Neil Ferguson, Anthony Grimason, Tracy Morse, Lawrence Kazembe
This paper examined care-seeking behaviour and its associated risk factors when a family member had diarrhoea. Data was obtained from a survey conducted in Chikwawa, a district in Southern Malawi. Chikwawa is faced with a number of environmental and socioeconomic problems and currently diarrhoea morbidity in the district is estimated at 24.4%, statistically higher than the national average of 17%. Using hierarchically built data from a survey of 1403 households nested within 33 communities, a series of two level binary logistic regression models with Bayesian estimation were used to determine predictors of care-seeking behaviour...
November 15, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/27801415/-comparative-evaluation-of-the-intensity-of-reparative-processes-in-the-lower-extremity-soft-tissues-of-diabetic-patients-receiving-local-negative-pressure-wound-treatment-and-standard-wound-care
#16
G R Galstyan, A Yu Tokmakova, E L Zaitseva, L P Doronina, I A Voronkova, R V Molchkov
AIM: To study the intensity of soft tissue repair in patients with diabetic foot syndrome (DFS) during local negative pressure wound treatment versus standard wound care. SUBJECTS AND METHODS: The investigators estimated the clinical (wound sizes, local tissue oxygenation), histological (light microscopy), and immunohistochemical (CD31, CD68, MMP-9, and TIMP-1) markers for reparative processes in patients with DFS during vacuum therapy versus standard wound care...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27792661/treatment-intensification-for-hypertension-in-us-ambulatory-medical-care
#17
Lin Mu, Kenneth J Mukamal
BACKGROUND: Hypertension is widely prevalent yet remains uncontrolled in nearly half of US hypertensive adults. Treatment intensification for hypertension reduces rates of major cardiovascular events and all-cause mortality, but clinical inertia remains a notable impediment to further improving hypertension control. This study examines the likelihood and determinants of treatment intensification with new medication in US ambulatory medical care. METHODS AND RESULTS: Using the nationally representative National Ambulatory Medical Care Survey (2005-2012) and National Hospital Ambulatory Medical Care Survey (2005-2011), we identified adult primary care visits with diagnosed hypertension and documented blood pressure exceeding goal targets and assessed the weighted prevalence and odds ratios of treatment intensification by initiation or addition of new medication...
October 22, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27785777/current-management-of-childhood-acute-myeloid-leukemia
#18
Jeffrey E Rubnitz
The outcome for children with acute myeloid leukemia (AML) has improved significantly over the past 30 years, with complete remission and overall survival rates exceeding 90 and 60%, respectively, in recent clinical trials. However, these improvements have not been achieved by the introduction of new agents. Instead, intensification of standard chemotherapy, more precise risk classification, improvements in supportive care, and the use of minimal residual disease to monitor response to therapy have all contributed to this success...
February 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/27762199/using-an-electronic-platform-interactively-to-improve-treatment-outcome-in-patients-with-rheumatoid-arthritis-new-developments-from-the-danbio-registry
#19
Merete L Hetland, Niels Steen Krogh, Kim Hørslev-Petersen, Berit Schiøttz-Christensen, Inge Juul Sørensen, Jensen Dorte Vendelbo
OBJECTIVES: Electronic platforms have been developed to help the clinician monitor disease activity in rheumatoid arthritis (RA) to support at treat-to-target strategy. We present an initiative to interactively improve disease control in patients with rheumatoid arthritis. METHODS: In patients who presented with one or more swollen joints AND moderate/high disease activity (i.e. either CDAI≥10.1 and/or DAS-28CRP>3.2, which is automatically calculated in the DANBIO registry), a red alert was shown, which activated a pop-up: "This patient has at least one swollen joint AND either CDAI≥ 10...
September 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27742406/role-of-transoral-robotic-surgery-in-current-head%C3%A2-%C3%A2-neck-practice
#20
REVIEW
David Hamilton, Vinidh Paleri
Morbidity and mortality associated with increasingly radical doses of chemoradiotherapy have led many to question the current standard of care in head and neck cancer. Recently, surgeons have developed minimally invasive, transoral techniques which have demonstrated excellent survival and favourable functional outcomes. Transoral robotic surgery (TORS) is the most recent, cutting edge in the evolution of transoral techniques; TORS allows surgeons unprecedented access to and visualisation of the upper aerodigestive tract...
October 11, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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