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Rob Stenstrom, Daphne Ling, Eric Grafstein, Rolando Barrios, Chris Sherlock, Reka Gustafson, Farzaneh Osati, Iraj Poureslami, Aslam Anis
OBJECTIVES: The objective of this study was to estimate the seroprevalence of HIV infection and the acceptability of point-of-care HIV testing in an innercity Canadian emergency department. METHODS: We conducted a prospective cohort study in an urban tertiary care emergency department between August 2009 and January 2011. Randomly selected patients were enrolled using probabilistic sampling based on patient volumes. Inclusion criteria were age 19-75 years and ability to provide informed consent...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Yuki Ito, Eriko Shiraishi, Atsuko Kato, Takayuki Haino, Kouhei Sugimoto, Aikou Okamoto, Nao Suzuki
PURPOSE: To identify the utility and issues associated with the use of decision trees in oncofertility patient care in Japan. METHODS: A total of 35 women who had been diagnosed with cancer, but had not begun anticancer treatment, were enrolled. We applied the oncofertility decision tree for women published by Gardino et al. to counsel a consecutive series of women on fertility preservation (FP) options following cancer diagnosis. Percentage of women who decided to undergo oocyte retrieval for embryo cryopreservation and the expected live-birth rate for these patients were calculated using the following equation: expected live-birth rate = pregnancy rate at each age per embryo transfer × (1 - miscarriage rate) × No...
October 20, 2016: Journal of Adolescent and Young Adult Oncology
Tanya Bogoslovsky, Jessica Gill, Andreas Jeromin, Cora Davis, Ramon Diaz-Arrastia
Traumatic brain injury (TBI) is one of the leading causes of death and disability around the world. The lack of validated biomarkers for TBI is a major impediment to developing effective therapies and improving clinical practice, as well as stimulating much work in this area. In this review, we focus on different settings of TBI management where blood or cerebrospinal fluid (CSF) biomarkers could be utilized for predicting clinically-relevant consequences and guiding management decisions. Requirements that the biomarker must fulfill differ based on the intended context of use (CoU)...
October 18, 2016: Diagnostics
Bao-Lin Li, Wei Li, Jia-Qi Bi, Qing-Gang Meng, Jian-Feng Fei
OBJECTIVES: To identify frail and pre-frail patients in a group of patients older than 60 years. METHODS: The phenotype model of Fried's method was used to identify frailty and pre-frailty in total of 78 participants. Cognitive ability and psychosocial function tests were also given to 59 of the 78 patients. RESULTS: Prevalence of frailty and pre-frailty was 14.1% (11/78) and 46.2% (36/78), respectively. Of the 5 phenotype variables, weak grip strength was the most commonly seen variable with 53...
October 20, 2016: Physician and Sportsmedicine
Salima El Chehadeh, Renaud Touraine, Fabienne Prieur, Willie Reardon, Thierry Bienvenu, Sandrine Chantot-Bastaraud, Martine Doco-Fenzy, Emilie Landais, Christophe Philippe, Nathalie Marle, Patrick Callier, Anne-Laure Mosca-Boidron, Francine Mugneret, Nathalie Le Meur, Alice Goldenberg, Anne-Marie Guerrot, Pascal Chambon, Véronique Satre, Charles Coutton, Pierre-Simon Jouk, Françoise Devillard, Klaus Dieterich, Alexandra Afenjar, Lydie Burglen, Marie-Laure Moutard, Marie-Claude Addor, Sébastien Lebon, Danielle Martinet, Jean-Luc Alessandri, Bérénice Doray, Marguerite Miguet, Didier Devys, Pascale Saugier-Veber, Séverine Drunat, Bernard Aral, Valérie Kremer, Stéphane Rondeau, Anne-Claude Tabet, Julien Thevenon, Christel Thauvin-Robinet, Nathalie Perreton, Vincent Des Portes, Laurence Faivre
Duplication of the Xq28 region, involving MECP2 (dupMECP2), has been primarily described in males with severe developmental delay, spasticity, epilepsy, stereotyped movements and recurrent infections. Carrier mothers are usually asymptomatic with an extremely skewed X chromosome inactivation (XCI) pattern. We report a series of six novel symptomatic females carrying a de novo interstitial dupMECP2, and review the 14 symptomatic females reported to date, with the aim to further delineate their phenotype and give clues for genetic counselling...
October 19, 2016: Clinical Genetics
Karin N Wagner, Haikady Nagaraja, Dawn C Allain, Adam Quick, Stephen Kolb, Jennifer Roggenbuck
Although genetic testing for amyotrophic lateral sclerosis (ALS) is widely available, it is unknown what proportion of patients with ALS have access to genetic counseling and testing, and patient attitudes towards ALS genetic testing have not been studied. We conducted a national survey of ALS patients enrolled in the Agency for Toxic Substances and Disease Registry, which consisted of multiple choice questions and two 12 item Likert scale series assessing respondents' experience with and attitude toward genetic testing...
October 20, 2016: Journal of Genetic Counseling
Amy R Reed
This article analyzes narrative illustrations in genetic counseling textbooks as a way of understanding professional habitus--the dispositions that motivate professional behavior. In particular, this analysis shows that there are significant differences in how the textbooks' expository and narrative portions represent Down syndrome, genetic counseling practice, and patient behaviors. While the narrative portions of the text position the genetic counseling profession as working in service to the values of genetic medicine, the expository portions represent genetic counselors as neutral parties...
October 19, 2016: Journal of Medical Humanities
Philippe Hernigou, Jean Charles Auregan, Damien Potage, François Roubineau, Charles Henri Flouzat Lachaniette, Arnaud Dubory
PURPOSE: Revision total hip arthroplasty (THA) is associated with increased rates of dislocation in obese patients. It is not known whether dual-mobility implants decrease dislocation in these patients with obesity. METHODS: We retrospectively reviewed two groups of revision THAs to compare the dislocation rate between 32 obese patients (BMI >30 kg/m(2)) with standard cups, and 35 obese patients (BMI >30 kg/m(2)) with dual-mobility cups. All patients received the same implants except for diameter head (32-mm head with standard cups and 28-mm head with dual mobility) and had the same cemented stem that was not changed at revision...
October 20, 2016: International Orthopaedics
Aaron J Krych, Patrick J Reardon, Nick R Johnson, Rohith Mohan, Logan Peter, Bruce A Levy, Michael J Stuart
PURPOSE: Medial meniscus posterior root tears (MMPRTs) are a significant source of pain and dysfunction, but little is known about the natural history and outcome and for non-operative management of these lesions. The purpose of this study was to evaluate (1) the mid-term clinical and radiographic outcomes of non-operative treatment of MMPRTs and (2) risk factors for worse outcomes. METHODS: A retrospective review was performed for patients with symptomatic, unrepaired MMPRTs and a minimum 2-year follow-up for IKDC and Tegner outcome scores...
October 19, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Yuka Mizusawa
Inherited arrhythmias, such as cardiomyopathies and cardiac ion channelopathies, along with coronary heart disease (CHD) are three most common disorders that predispose adults to sudden cardiac death. In the last three decades, causal genes in inherited arrhythmias have been successfully identified. At the same time, it has become evident that the genetic architectures are more complex than previously known. Recent advancements in DNA sequencing technology (next generation sequencing) have enabled us to study such complex genetic traits...
October 2016: Journal of Arrhythmia
Emily B Devine, Rafael Alfonso-Cristancho, N David Yanez, Todd C Edwards, Donald L Patrick, Cheryl A L Armstrong, Allison Devlin, Rebecca G Symons, Mark H Meissner, Ellen L T Derrick, Danielle C Lavallee, Larry G Kessler, David R Flum
Importance: Intermittent claudication (IC) is the most common presentation of infrainguinal peripheral artery disease. Both medical and revascularization interventions for IC aim to increase walking comfort and distance, but there is inconclusive evidence of the comparative benefit of revascularization given the possible risk of limb loss. Objective: To compare the effectiveness of a medical (walking program, smoking cessation counseling, and medications) vs revascularization (endovascular or surgical) intervention for IC in the community, focusing on outcomes of greatest importance to patients...
October 19, 2016: JAMA Surgery
Tamsin Phillips, Annibale Cois, Robert H Remien, Claude A Mellins, James A McIntyre, Greg Petro, Elaine J Abrams, Landon Myer
BACKGROUND: Antiretroviral therapy (ART) regimens containing efavirenz (EFV) are recommended as part of universal ART for pregnant and breastfeeding women. EFV may have appreciable side effects (SE), and ART adherence in pregnancy is a major concern, but little is known about ART SE and associations with adherence in pregnancy. METHODS: We investigated the distribution of patient-reported SE (based on Division of AIDS categories) and the association of SE with missed ART doses in a cohort of 517 women starting EFV+3TC/FTC+TDF during pregnancy...
2016: PloS One
Albert Vincent Berthier Brasil, Alisson R Teles, Marcelo Ricardo Roxo, Marcelo Neutzling Schuster, Eduardo Ballverdu Zauk, Gabriel da Costa Barcellos, Pablo Ramon Fruett da Costa, Nelson Pires Ferreira, Jorge Luiz Kraemer, Marcelo Paglioli Ferreira, Pedro Luis Gobbato, Paulo Valdeci Worm
Objective: To analyze the cumulative effect of risk factors associated with early major complications in postoperative spine surgery. Methods: Retrospective analysis of 583 surgically-treated patients. Early "major" complications were defined as those that may lead to permanent detrimental effects or require further significant intervention. A balanced risk score was built using multiple logistic regression. Results: Ninety-two early major complications occurred in 76 patients (13%)...
October 2016: Arquivos de Neuro-psiquiatria
Rajkumar Bharatia, Manoj Chitale, Ganesh Narain Saxena, Raman Ganesh Kumar, Chikkalingaiah, Abhijit Trailokya, Kalpesh Dalvi, Suhas Talele
INTRODUCTION: Hypertension (HTN), being a major risk factor for cardiovascular diseases (CVDs), is an important issue of medical and public health. High blood pressure (BP) is ranked as the third most important risk factor for attributable burden of disease in south Asia (2010). Hypertension (HTN) exerts a substantial public health burden on cardiovascular health status and healthcare systems in India. Uncontrolled hypertension among adults with hypertension is associated with increased mortality...
July 2016: Journal of the Association of Physicians of India
Su Youn Kim, Falk R Ochsendorf
The fixed-dose combination adapalene 0.1%/benzoylperoxide 2.5% (A/BPO) was introduced as an acne vulgaris therapeutic in 2007. It combines anti-inflammatory, keratolytic, comedolytic, and antibacterial properties. Thus, it addresses several pathophysiological factors involved in the pathophysiology of acne. This review highlights the rationale for the use of this fixed-dose combination product, its therapeutic efficacy including effects on adherence and quality of life, its use for different forms of acne, and the side-effect profile...
2016: Therapeutics and Clinical Risk Management
Sheng-Yu Fan, I-Mei Lin, Jyh-Gang Hsieh, Chih-Jung Chang
CONTEXT: Psychosocial care is an important component of palliative care, which is also provided by physicians and nurses. OBJECTIVE: The aim of this study was to explore the experiences of physicians and nurses in palliative care regarding the process of psychosocial care, the difficulties, and the support needs from psychosocial care professionals. METHODS: A two-phase mixed methods study was conducted. In the first phase, 16 physicians and nurses with palliative care experience were recruited...
October 15, 2016: Journal of Pain and Symptom Management
Lise Paquet, Lisa Simmonds, Charles Yang, Shailendra Verma
OBJECTIVES: 1) To describe how women at high-risk for breast cancer (BC) perceive their at-risk status and the options available to manage this risk, before and after risk counselling; 2) to explore the contributions of pre-counselling demographic, clinical, cognitive and emotional factors to post-counselling risk management intentions. METHODS: 58 of 173 eligible patients (34%) enrolled and were asked to fill surveys including measures of 1) subjective risk, 2) illness (being at high-risk for BC) and 3) treatment (surveillance, lifestyle modifications, and chemoprevention) cognitions, 4) BC fear and 5) future risk management intentions, prior to and 3 months after risk consultation...
October 11, 2016: Patient Education and Counseling
Maria Luisa Fonte, Lauren Fietchner, Matteo Manuelli, Hellas Cena
BACKGROUND: The aim of this case report is to discuss the issue of nutritional therapy in patients taking warfarin. Patients are often prescribed vitamin K free diets without nutritional counseling, leading to possible health consequences. CASE PRESENTATION: A 52-year-old woman with obesity and hypertension was prescribed a low calorie diet by her family doctor in an effort to promote weight loss. After a pulmonary embolism, she was placed on anticoagulant therapy and on hospital discharge she was prescribed a vitamin K free diet to avoid interactions...
October 19, 2016: Nutrition Journal
Eric Wong, Jasmine J Leslie, Judith A Soon, Wendy V Norman
BACKGROUND: The Virtual Interprofessional Patients-Computer-Assisted Reproductive Health Education for Students (VIP-CARES) Project took place during the summers of 2010-2012 for eight weeks each year at the University of British Columbia (UBC). Undergraduate health care students worked collaboratively to develop virtual patient case-based learning modules on the topic of family planning. The purpose of this study was to evaluate the changes in perception towards interprofessional collaboration (IPC) among the participants, before and after the project...
October 19, 2016: BMC Medical Education
T Thomsen, M Aadahl, N Beyer, M L Hetland, K Løppenthin, J Midtgaard, R Christensen, B A Esbensen
BACKGROUND: Patients with rheumatoid arthritis (RA) spend a high proportion of their waking time in sedentary behaviour (SB) and have an increased risk of cardiovascular disease. Reduction of SB and increase in light intensity physical activity has been suggested as a means of improvement of health in patients with mobility problems. Short-term intervention studies have demonstrated that SB can be reduced by behavioural interventions in sedentary populations. To evaluate descriptively the feasibility of recruitment, randomisation, outcome assessments, retention and the acceptability of an individually tailored, theory-based behavioural intervention targeting reduction in daily sitting time in patients with RA...
October 18, 2016: BMC Musculoskeletal Disorders
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