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https://www.readbyqxmd.com/read/28296762/effect-on-mother-and-child-of-eculizumab-given-before-caesarean-section-in-a-patient-with-severe-antiphospholipid-syndrome-a-case-report
#1
Alice Gustavsen, Lillemor Skattum, Grethe Bergseth, Bjorg Lorentzen, Yngvar Floisand, Vidar Bosnes, Tom Eirik Mollnes, Andreas Barratt-Due
RATIONALE: Antiphospholipid syndrome (APS) in pregnancy may trigger the life-threatening catastrophic antiphospholipid syndrome (CAPS). Complement activation is implicated in the pathogenesis, and inhibition of complement factor C5 is suggested as an additional treatment option. PATIENT CONCERNS, DIAGNOSIS AND INTERVENTIONS: We present a pregnant patient treated with the C5-inhibitor eculizumab due to high risk of developing devastating APS-related complications...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28286486/using-virtual-reality-in-the-treatment-of-gambling-disorder-the-development-of-a-new-tool-for-cognitive-behavior-therapy
#2
Stéphane Bouchard, Geneviève Robillard, Isabelle Giroux, Christian Jacques, Claudie Loranger, Manon St-Pierre, Maxime Chrétien, Annie Goulet
Virtual reality (VR) can be used in the treatment of gambling disorder to provide emotionally charged contexts (e.g., induce cravings) where patients can practice cognitive behavior therapy (CBT) techniques in the safety of the therapist's office. This raises practical questions, such as whether the cravings are sufficient to be clinically useful but also manageable enough to remain clinically safe. Pilot data are also needed to test the development of a treatment manual and prepare large randomized control trials...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28259854/does-early-intervention-improve-outcomes-in-physiotherapy-management-of-lumbar-radicular-syndrome-a-mixed-methods-study-protocol
#3
Michael Reddington, Stephen J Walters, Judith Cohen, Susan Baxter
INTRODUCTION: Lumbar radicular syndrome (LRS) can be a painful and debilitating condition. The optimum management strategies and their timing remain elusive despite extensive research. Surgery provides good short-term outcomes but has concomitant risks and costs. Physiotherapy is commonly practised for patients with LRS but its effects remain equivocal and there is a lack of consensus on the type, duration and timing of physiotherapy intervention. There is a lack of high-quality evidence into new and innovative management strategies and the timings of those strategies for LRS...
March 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28259274/use-and-effectiveness-of-ethyl-chloride-for-hand-injections
#4
Orrin I Franko, Peter J Stern
PURPOSE: Limited literature supports using ethyl chloride topical spray as an anesthetic for hand injections whereas documented risks include frostbite, skin irritation, and inhalation toxicity. We hypothesize that ethyl chloride spray imparts no benefit to patients' perception of pain or anxiety for routine hand injections. METHODS: We first surveyed all members of the American Society for Surgery of the Hand to discern the prevalence of ethyl chloride use during routine injections...
March 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28219324/non-anti-coagulant-factors-associated-with-filter-life-in-continuous-renal-replacement-therapy-crrt-a-systematic-review-and-meta-analysis
#5
Matthew Brain, Elizabeth Winson, Owen Roodenburg, John McNeil
BACKGROUND: Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis...
February 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28161744/burden-of-serious-fungal-infections-in-bangladesh
#6
H C Gugnani, D W Denning, R Rahim, A Sadat, M Belal, M S Mahbub
In Bangladesh there are several published papers on superficial mycoses. Deep mycoses are also recognized as an important emerging problem. Here, we estimate the annual incidence and prevalence of serious fungal infections in Bangladesh. Demographic data were obtained from world population reports and the data on TB and HIV extracted from the online publications on tuberculosis in Bangladesh and Asia Pacific research statistical data information resources AIDS Data HUB. All the published papers on fungal infections in Bangladesh were identified through extensive search of literature...
February 4, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28152791/improving-venous-thromboembolism-vte-prophylaxis-for-hospitalized-malignant-hematology-bone-marrow-transplant-heme-bmt-patients
#7
John Dzundza, Archana Ajmera, Ashley Gustafson, Mimi Lo, Richard Fong, Larissa Graff, Bao Dao, Rebecca Young, Lloyd Earl Damon, Thomas G Martin, Rebecca Leah Olin
79 Background: Hospitalized patients on the heme/BMT service at our academic cancer center have historically not received pharmacologic VTE prophylaxis (VTEP) due to concerns regarding thrombocytopenia and bleeding risk. However, a retrospective review of heme/BMT admissions from 2009 to 2013 revealed that 59% of hospital-acquired VTE cases occurred at a platelet count > 50 x 10E9/L, suggesting missed opportunities for VTE prevention. METHODS: To implement VTEP on the heme/BMT service, a multidisciplinary quality improvement team developed a pilot intervention with 5 strategies: 1) identification of heme/BMT-specific contraindications to VTEP, 2) standardized use of VTEP for all heme/BMT patients unless contraindications are present, 3) hold parameter for platelet count < 50 x 10E9/L within the VTEP order, 4) note template to document VTEP plan, and 5) provider, nurse, pharmacist, and patient education...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28025835/bedside-tunneled-dialysis-catheter-removal-a-lesson-learned-from-nephrology-trainees
#8
REVIEW
Tibor Fülöp, Mihály B Tapolyai, Mohit Agarwal, Arnaldo Lopez-Ruiz, Miklos Z Molnar, Neville R Dossabhoy
Semi-permanent dual-lumen tunneled (or tunneled-cuffed) hemodialysis catheters (TDC) are increasingly utilized during renal replacement therapy, while awaiting permanent access maturation or renal recovery. Although there is a wealth of literature focused on placement, infection prevention, and maintenance of catheter patency, circumstances and indications for TDC removal are less well understood. Timely removal of these catheters is an important management decision, with the length of TDC duration representing the largest cumulative risk factor for catheter-associated blood stream infections...
December 26, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27914502/rationale-and-design-of-the-progression-of-atherosclerotic-plaque-determined-by-computed-tomographic-angiography-imaging-paradigm-registry-a-comprehensive-exploration-of-plaque-progression-and-its-impact-on-clinical-outcomes-from-a-multicenter-serial-coronary
#9
Sang-Eun Lee, Hyuk-Jae Chang, Asim Rizvi, Martin Hadamitzky, Yong-Jin Kim, Edoardo Conte, Daniele Andreini, Gianluca Pontone, Valentina Volpato, Matthew J Budoff, Ilan Gottlieb, Byoung Kwon Lee, Eun Ju Chun, Filippo Cademartiri, Erica Maffei, Hugo Marques, Jonathon A Leipsic, Sanghoon Shin, Jung Hyun Choi, Namsik Chung, James K Min
BACKGROUND: The natural history of coronary artery disease (CAD) in patients with low-to-intermediate risk is not well characterized. Although earlier invasive serial studies have documented the progression of atherosclerotic burden, most were focused on high-risk patients only. The PARADIGM registry is a large, prospective, multinational dynamic observational registry of patients undergoing serial coronary computed tomographic angiography (CCTA). The primary aim of PARADIGM is to characterize the natural history of CAD in relation to clinical and laboratory data...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27720453/-new-patterns-of-substance-use-and-abuse-among-french-adolescents-a-knowledge-synthesis
#10
G Jeanne, D Purper-Ouakil, H Rigole, N Franc
AIM: There have been significant changes in adolescent consumption habits over the past fifteen years. New molecules have been synthesized, new devices created and a number of products have increased in popularity; and as a result clinicians sometimes lack information. We chose to focus on this population because of its vulnerability, as adolescents show low sensitivity to long-term outcomes of their actions and may be easily influenced by peers as regards experimentation of new drugs...
October 6, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27623121/-advocacy-for-the-establishment-of-a-comprehensive-strategy-to-reduce-the-burden-of-schizophrenic-disorders
#11
D Leguay
This article attempts to identify and put into perspective the different approaches that could globally prevent the suffering induced by schizophrenia, from the detection of early psychosis to the impact on individual and family functioning and emotional health. Schizophrenia causes, at the community level, a number of difficult consequences and associated costs, which likely could be reduced if specific strategies, already known and documented internationally, were applied. Two areas not explored in this article: the role of medication and the issue of suicide prevention...
October 2016: L'Encéphale
https://www.readbyqxmd.com/read/27503315/retrievable-inferior-vena-cava-filters-in-geriatric-trauma-is-there-an-age-bias
#12
Daniel Urias, Jennifer Silvis, Lusine Mesropyan, Emma Oberlander, Thomas Simunich, James Tretter
BACKGROUND: Trauma patients are at increased risk for developing venous thromboembolic (VTE) disease. The EAST (Eastern Association for the Surgery of Trauma) practice management guidelines identified risk factors for VTE, as well as indications for prophylactic inferior vena cava filters (IVCF). In a 2009 study, our institution found a 26% retrieval rate for IVCF. Lack of retrieval was most consistently due to lack of follow-up. Our study is a follow-up analysis for retrieval rate of IVCF, since the formation of a geriatric trauma service...
January 2017: Injury
https://www.readbyqxmd.com/read/27449312/long-term-follow-up-concerning-safety-and-efficacy-of-novel-adhesion-prophylactic-agent-for-laparoscopic-myomectomy-in-the-prospective-randomized-adbee-study
#13
RANDOMIZED CONTROLLED TRIAL
Cristina Cezar, Garri Tchartchian, Matthias Korell, Nicole Ziegler, Kazuhisa Senshu, Maya Sophie De Wilde, Anja Herrmann, Angelika Larbig, Rudy Leon De Wilde
We conducted a prospective randomized single blind - subject study in the University Clinic of Gynecology of Pius-Hospital Oldenburg. The primary objective of the ADBEE study was to assess the safety and manageability of ADBLOCK when used as an adjunct to laparoscopic surgery for the primary of myomas in women wishing to improve pregnancy outcomes. The study population included 32 women aged between 18-45 years, in good general health condition, who have not completed their family planning and who are undergoing primary ('virgin') laparoscopic myomectomy with an aim to improve pregnancy outcomes...
August 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27405225/design-of-trust-a-non-interventional-multicenter-3-year-prospective-study-investigating-an-integrated-patient-management-approach-in-patients-with-relapsing-remitting-multiple-sclerosis-treated-with-natalizumab
#14
MULTICENTER STUDY
Tjalf Ziemssen, Achim Gass, Jens Wuerfel, Antonios Bayas, Björn Tackenberg, Volker Limmroth, Ralf Linker, Mathias Mäurer, Judith Haas, Martin Stangel, Matthias Meergans, Olof Harlin, Hans-Peter Hartung
BACKGROUND: Natalizumab provides rapid and high-efficacy control of multiple sclerosis disease activity with long-term stabilization. However, the benefits of the drug are countered by a risk of developing progressive multifocal leukoencephalopathy in patients infected with the John Cunningham Virus. Close monitoring is required in patients with increased progressive multifocal leukoencephalopathy risk receiving natalizumab in the long-term for an optimal benefit-risk evaluation. Standardized high-quality monitoring procedures may provide a superior basis for individual benefit and risk evaluation and thus improve treatment decisions...
July 12, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27317014/impact-of-a-guideline-for-the-management-of-antimicrobial-warfarin-interactions-in-the-inpatient-setting-and-across-transition-of-care
#15
Nghi B Ha, Katherine Yang, Sarah Hanigan, Brian Kurtz, Michael P Dorsch, Hannah Mak, Jerod Nagel
BACKGROUND: Drug-drug interactions (DDIs) with warfarin and antimicrobial agents are a common cause of international normalized ratio (INR) instability, which can affect the risk for bleeding and thrombotic events. OBJECTIVE: The purpose of this study was to assess the impact of a comprehensive guideline for the management of warfarin-antimicrobial DDIs across transitions of care. The guideline emphasizes improving identification of significant antimicrobial-warfarin DDIs during hospitalization, empirical warfarin dose modification based on DDI and baseline INR, patient education, documentation of the DDI, communication with outpatient providers regarding the DDI and anticipated antimicrobial stop date, and warfarin dose adjustment on discontinuation of antimicrobial...
September 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27311089/-anmco-sic-sici-gise-sicch-consensus-document-clinical-approach-to-pharmacological-pretreatment-for-patients-undergoing-myocardial-revascularization
#16
Roberto Caporale, Giovanna Geraci, Michele Massimo Gulizia, Mauro Borzi, Furio Colivicchi, Alberto Menozzi, Giuseppe Musumeci, Marino Scherillo, Antonietta Ledda, Giuseppe Tarantini, Piersilvio Gerometta, Giancarlo Casolo, Dario Formigli, Francesco Romeo, Roberto Di Bartolomeo
The wide availability of drugs effective in reducing cardiovascular events and the use of myocardial revascularization have greatly improved the prognosis of patients with coronary artery disease. However, the combination of antithrombotic drugs to be administered before the exact knowledge of the coronary anatomy and before the consequent therapeutic strategy can, on one hand, allow to anticipate an optimal treatment but, on the other hand, may expose the patient to a bleeding risk not always necessary. In patients with ST-elevation acute coronary syndrome with an indication to primary angioplasty, the administration of unfractionated heparin and aspirin is considered the pre-procedural standard treatment...
June 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27299422/utility-of-routine-colonic-biopsies-in-pediatric-colonoscopic-polypectomy-for-benign-juvenile-hamartomatous-polyps
#17
Michael Malandra, Sunpreet Kaur, Ashish Chogle
INTRODUCTION: Benign juvenile hamartomatous polyps are common in pediatric gastrointestinal practice. We hypothesize that in the absence of gross mucosal abnormalities, the likelihood of histologic abnormalities from routine random colonic biopsies is low. METHODS: We performed a retrospective chart review identifying patients aged 1 to 18 years who underwent complete colonoscopy and polypectomy for suspected colorectal polyps from January 1, 2004 to July 1, 2014...
June 13, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27193032/when-doctors-share-visit-notes-with-patients-a-study-of-patient-and-doctor-perceptions-of-documentation-errors-safety-opportunities-and-the-patient-doctor-relationship
#18
Sigall K Bell, Roanne Mejilla, Melissa Anselmo, Jonathan D Darer, Joann G Elmore, Suzanne Leveille, Long Ngo, James D Ralston, Tom Delbanco, Jan Walker
BACKGROUND: Patient advocates and safety experts encourage adoption of transparent health records, but sceptics worry that shared notes may offend patients, erode trust or promote defensive medicine. As electronic health records disseminate, such disparate views fuel policy debates about risks and benefits of sharing visit notes with patients through portals. METHODS: Presurveys and postsurveys from 99 volunteer doctors at three US sites who participated in OpenNotes and postsurveys from 4592 patients who read at least one note and submitted a survey...
April 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27116688/different-prognostic-significance-of-cardiac-troponin-at-presentation-and-peak-cardiac-troponin-in-patients-with-non-st-segment-elevation-myocardial-infarction
#19
Gerasimos Siasos, George Lazaros, Evangelos Oikonomou, Theodoros Zografos, Dimitris Athanasiou, Manolis Vavuranakis, Alexis Antonopoulos, Vasiliki Tsigkou, Christodoulos Stefanadis, Athanasios G Papavassiliou, Dimitris Tousoulis
OBJECTIVES: Non-ST elevation myocardial infarction (NSTEMI) is one of the most common manifestations of acute coronary syndromes (ACS). We evaluated the prognostic role of cardiac troponin I (cTnI) at presentation and peak cardiac troponin I in patients with NSTEMI. METHODS: We consecutively enrolled 215 subjects presenting with NSTEMI. Subjects were followed up for 1 year. cTnI at presentation and the peak value of cTnI were measured. The primary end point was defined as cardiovascular death, readmission to hospital with heart failure and new ACS...
2016: Cardiology
https://www.readbyqxmd.com/read/27082665/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-position-statement-on-the-association-of-sglt-2-inhibitors-and-diabetic-ketoacidosis
#20
Yehuda Handelsman, Robert R Henry, Zachary T Bloomgarden, Sam Dagogo-Jack, Ralph A DeFronzo, Daniel Einhorn, Ele Ferrannini, Vivian A Fonseca, Alan J Garber, George Grunberger, Derek LeRoith, Guillermo E Umpierrez, Matthew R Weir
AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology DKA = diabetic ketoacidosis EMA = European Medicines Agency FDA = U.S. Food and Drug Administration SGLT-2 = sodium glucosecotransporter 2 T1D = type 1 diabetes T2D = type 2 diabetes.
June 2016: Endocrine Practice
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