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Evidence medicine

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https://www.readbyqxmd.com/read/28214351/evidence-based-and-precision-medicine-two-of-a-kind
#1
W J Fokkens
In the last two decades, an enormous expansion of evidence has been produced in upper airway research. When writing the first EPOS document in 2005 only 5 RCT per year were performed in the area of CRS, in 2007 this changed to 25 per year and it became even higher in the recent years. Randomized Controlled Trials (RCTs) are the "gold standard" for evaluating treatment outcomes providing information on treatments "efficacy". To make life easier for clinicians, systematic reviews and meta-analysis further condense the available evidence...
February 18, 2017: Rhinology
https://www.readbyqxmd.com/read/28214137/japanese-guidelines-for-allergic-rhinitis-2017
#2
REVIEW
Kimihiro Okubo, Yuichi Kurono, Keiichi Ichimura, Tadao Enomoto, Yoshitaka Okamoto, Hideyuki Kawauchi, Harumi Suzaki, Shigeharu Fujieda, Keisuke Masuyama
Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 8th edition was published in 2016, and is widely used today...
February 14, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28214005/-review-of-national-and-international-guidelines-for-sentinel-lymph-node-biopsy-and-complementary-axillary-dissection-in-breast-cancer
#3
REVIEW
Laura Vincent, François Margueritte, Jennifer Uzan, Clémentine Owen, Julien Seror, Nicolas Pouget, Eugénie Guillot, Roman Rouzier
Management of breast cancer is based on national and international guidelines. These are defined on evidence-based medicine. The main purpose of this review is to compare the different guidelines for sentinel lymph node biopsy and completion axillary dissection after positive sentinel lymph node biopsy. This review of breast cancer guidelines led to identify consensus, but in some specific situations, they differ. The guidelines cannot be applied to all clinical cases, mandatoring multidisciplinary meetings are essential...
February 14, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28213967/extracellular-vesicles-from-bone-marrow-derived-mesenchymal-stem-cells-improve-survival-from-lethal-hepatic-failure-in-mice
#4
Hiroaki Haga, Irene K Yan, Kenji Takahashi, Akiko Matsuda, Tushar Patel
Stem cell-based therapies have potential for treatment of liver injury by contributing to regenerative responses, through functional tissue replacement or paracrine effects. The release of extracellular vesicles (EV) from cells has been implicated in intercellular communication, and may contribute to beneficial paracrine effects of stem cell-based therapies. Therapeutic effects of bone-marrow derived mesenchymal stem cells (MSC) and vesicles released by these cells were examined in a lethal murine model of hepatic failure induced by d-galactosamine/tumor necrosis factor-α (TNF-α)...
February 18, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28213697/danger-of-injudicious-use-of-tui-na-therapy-in-ankylosing-spondylitis
#5
Gen Zou, Guyi Wang, Jinxiu Li, Guobao Wu, Jia Huang, Siyang Huang
Tui-na is a very important component of Chinese medicine. It is a well-respected treatment modality known to be helpful and safe for a wide range of conditions. It can be considered as a certain kind of massage which is performed at acupoints, meridians, and collaterals by pushing, finger twisting, grasping thumb waving pressing, patting, palm twisting, and other manipulation techniques. At present, it is extensively used for relieving pain and stiffness associated with ankylosing spondylitis in China, even though there is a lack of evidence to support its validation and feasibility...
February 17, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28213454/towards-evidence-based-medicine-for-paediatricians
#6
Bob Phillips
No abstract text is available yet for this article.
March 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28212971/should-countries-set-an-explicit-health-benefits-package-the-case-of-the-english-national-health-service
#7
Peter C Smith, Kalipso Chalkidou
BACKGROUND: A fundamental debate in the transition towards universal health coverage concerns whether to establish an explicit health benefits package to which all citizens are entitled, and the level of detail in which to specify that package. At one extreme, the treatments to be funded, and the circumstances in which patients qualify for the treatment, might be specified in great detail, and be entirely mandatory. This would make clinicians little more than automata, carrying out prescribed practice...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212968/-what-goes-around-comes-around-lessons-learned-from-economic-evaluations-of-personalized-medicine-applied-to-digital-medicine
#8
Kathryn A Phillips, Michael P Douglas, Julia R Trosman, Deborah A Marshall
BACKGROUND: The growth of "big data" and the emphasis on patient-centered health care have led to the increasing use of two key technologies: personalized medicine and digital medicine. For these technologies to move into mainstream health care and be reimbursed by insurers, it will be essential to have evidence that their benefits provide reasonable value relative to their costs. These technologies, however, have complex characteristics that present challenges to the assessment of their economic value...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212966/estimating-preferences-for-complex-health-technologies-lessons-learned-and-implications-for-personalized-medicine
#9
Deborah A Marshall, Juan Marcos Gonzalez, Karen V MacDonald, F Reed Johnson
We examine key study design challenges of using stated-preference methods to estimate the value of whole-genome sequencing (WGS) as a specific example of genomic testing. Assessing the value of WGS is complex because WGS provides multiple findings, some of which can be incidental in nature and unrelated to the specific health concerns that motivated the test. In addition, WGS results can include actionable findings (variants considered to be clinically useful and can be acted on), findings for which evidence for best clinical action is not available (variants considered clinically valid but do not meet as high of a standard for clinical usefulness), and findings of unknown significance...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212647/an-interpretive-review-of-consensus-statements-on-clinical-guideline-development-and-their-application-in-the-field-of-traditional-and-complementary-medicine
#10
Jennifer Hunter, Matthew Leach, Lesley Braun, Alan Bensoussan
BACKGROUND: Despite ongoing consumer demand and an emerging scientific evidence-base for traditional and complementary medicine (T&CM), there remains a paucity of reliable information in standard clinical guidelines about their use. Often T&CM interventions are not mentioned, or the recommendations arising from these guidelines are unhelpful to end-users (i.e. patients, practitioners and policy makers). Insufficient evidence of efficacy may be a contributing factor; however, often informative recommendations could still be made by drawing on relevant information from other avenues...
February 17, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28212560/use-of-complementary-and-alternative-medicine-cam-in-cancer-patients-an-italian-multicenter-survey
#11
Massimiliano Berretta, Chiara Della Pepa, Paolo Tralongo, Alberto Fulvi, Ferdinando Martellotta, Arben Lleshi, Guglielmo Nasti, Rossella Fisichella, Carmela Romano, Chiara De Divitiis, Rosaria Taibi, Francesco Fiorica, Raffaele Di Francia, Anna Di Mari, Lino Del Pup, Anna Crispo, Paolo De Paoli, Adriano Santorelli, Vincenzo Quagliariello, Rosario Vincenzo Iaffaioli, Umberto Tirelli, Gaetano Facchini
INTRODUCTION: Complementary and Alternative Medicine (CAM) include a wide range of products (herbs, vitamins, minerals, and probiotics) and medical practices, developed outside of the mainstream Western medicine. Patients with cancer are more likely to resort to CAM first or then in their disease history; the potential side effects as well as the costs of such practices are largely underestimated. PATIENTS AND METHOD: We conducted a descriptive survey in five Italian hospitals involving 468 patients with different malignancies...
December 25, 2016: Oncotarget
https://www.readbyqxmd.com/read/28212381/complementary-and-alternative-medicine-for-the-treatment-of-bronchiolitis-in-infants-a-systematic-review
#12
Kok Pim Kua, Shaun Wen Huey Lee
BACKGROUND: Bronchiolitis is a common cause of hospitalization among infants. The limited effectiveness of conventional medication has prompted the use of complementary and alternative medicine (CAM) as alternative or adjunctive therapy for the management of bronchiolitis. AIMS: To determine the effectiveness and safety of CAM for the treatment of bronchiolitis in infants aged less than 2 years. METHODS: A systematic electronic search was performed in Medline, Embase, CINAHL, AMED, and Cochrane Central Register of Controlled Trials (CENTRAL) from their respective inception to June 30, 2016 for studies evaluating CAM as an intervention to treat bronchiolitis in infants (1 month to 2 years of age)...
2017: PloS One
https://www.readbyqxmd.com/read/28212313/chemoprevention-of-rat-mammary-carcinogenesis-by-apiaceae-spices
#13
Farrukh Aqil, Jeyaprakash Jeyabalan, Radha Munagala, Srivani Ravoori, Manicka V Vadhanam, David J Schultz, Ramesh C Gupta
Scientific evidence suggests that many herbs and spices have medicinal properties that alleviate symptoms or prevent disease. In this study, we examined the chemopreventive effects of the Apiaceae spices, anise, caraway, and celery seeds against 17β-estrogen (E2)-mediated mammary tumorigenesis in an ACI (August-Copenhagen Irish) rat model. Female ACI rats were given either control diet (AIN 93M) or diet supplemented with 7.5% (w/w) of anise, caraway, or celery seed powder. Two weeks later, one half of the animals in each group received subcutaneous silastic implants of E2...
February 16, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28211784/generic-antiretrovirals-for-the-treatment-of-hiv-a-novel-challenge-for-western-countries-%C3%A2
#14
Dario Cattaneo, Massimo Andreoni, Gianpiero Carosi, Roberto Cauda, Adriano Lazzarin, Giuliano Rizzardini
The introduction of generic antiretroviral medications in developing countries has resulted in significant CD4 cell restoration, HIV viral decline, and a noteworthy reduction in the time to initiation of therapy. Projection models have also predicted significant cost saving associated with the extensive diffusion of generic antiretrovirals in developed countries. However, some uncertainties on generics have recently been raised. These concerns mainly relate to the adequacy of the study design for bioequivalence testing, the potential for uncontrolled switching from one generic to another, and the loss of adherence if patients switched from fixed-dose coformulations to single components in order to incorporate the new generic drugs...
February 17, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28211155/utah-obstetricians-opinions-of-planned-home-birth-and-conflicting-nice-acog-guidelines-a-qualitative-study
#15
Emily Rainey, Sara Simonsen, Joseph Stanford, Kimberley Shoaf, Jami Baayd
BACKGROUND: The United Kingdom's National Institute for Health and Care Excellence (NICE) recently published recommendations that support planned home birth for low-risk women. The American College of Obstetricians and Gynecologists (ACOG) remains wary of planned home birth, asserting that hospitals and birthing centers are the safest birth settings. Our objective was to examine opinions of obstetricians in Salt Lake City, Utah about home birth in the context of rising home birth rates and conflicting guidelines...
February 17, 2017: Birth
https://www.readbyqxmd.com/read/28210931/serotonin-syndrome-from-5-hydroxytryptophan-supplement-ingestion-in-a-9-month-old-labrador-retriever
#16
Hopkins Jennifer, Pardo Mariana, Bischoff Karyn
INTRODUCTION: 5-Hydroxytryptophan (5-HTP) supplements are available over the counter and labeled as sleeping aids and anxiolytics for human use. 5-HTP is a serotonin precursor and overdose can lead to serotonin syndrome. CASE REPORT: A 9-month-old female Labrador retriever was evaluated after ingestion of a 5-HTP supplement. Signs of agitation developed within 1 h of ingestion, and emesis was attempted by the owner with  3% hydrogen peroxide (H2O2) orally. On presentation, the dog was obtunded, bilaterally mydriatic and salivating...
February 16, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28210658/patellar-maltracking-persists-in-adolescent-females-with-patellofemoral-pain-a-longitudinal-study
#17
Victor R Carlson, Barry P Boden, Aricia Shen, Jennifer N Jackson, Katharine E Alter, Frances T Sheehan
BACKGROUND: Patellofemoral pain is one of the most common conditions seen in sports medicine practices, particularly among adolescent females. However, the natural history of the underlying pathology in patellofemoral pain during puberty remains poorly understood. PURPOSE: The purpose of this longitudinal study is to assess changes in patellar maltracking patterns in subjects with patellofemoral pain as they mature from mid- to late adolescence. STUDY DESIGN: Cohort study; Level of evidence, 3...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28210654/postoperative-rehabilitation-after-rotator-cuff-repair-a-web-based-survey-of-aana-and-aossm-members
#18
Scott Mollison, Jason J Shin, Alexander Glogau, R Cole Beavis
BACKGROUND: Postoperative rehabilitation after arthroscopic rotator cuff repair (ARCR) remains controversial and suffers from limited high-quality evidence. Therefore, appropriate use criteria must partially depend on expert opinion. HYPOTHESIS/PURPOSE: The purpose of the study was to determine and report on the standard and modified rehabilitation protocols after ARCR used by member orthopaedic surgeons of the American Orthopaedic Society for Sports Medicine (AOSSM) and the Arthroscopy Association of North America (AANA)...
January 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28210521/the-right-to-die-in-chronic-disorders-of-consciousness-can-we-avoid-the-slippery-slope-argument
#19
REVIEW
Rocco Salvatore Calabrò, Antonino Naro, Rosaria De Luca, Margherita Russo, Lory Caccamo, Alfredo Manuli, Alessia Bramanti, Placido Bramanti
Managing individuals with chronic disorders of consciousness raises ethical questions about the appropriateness of maintaining life-sustaining treatments and end-of-life decisions for those who are unable to make decisions for themselves. For many years, the positions fostering the "sanctity" of human life (i.e., life is inviolable in any case) have led to maintaining life-sustaining treatments (including artificial nutrition and hydration) in patients with disorders of consciousness, allowing them to live for as long as possible...
November 2016: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/28210367/academic-primer-series-eight-key-papers-about-education-theory
#20
Michael Gottlieb, Megan Boysen-Osborn, Teresa M Chan, Sara M Krzyzaniak, Nicolas Pineda, Jordan Spector, Jonathan Sherbino
INTRODUCTION: Many teachers adopt instructional methods based on assumptions of best practices without attention to or knowledge of supporting education theory. Familiarity with a variety of theories informs education that is efficient, strategic, and evidence-based. As part of the Academic Life in Emergency Medicine Faculty Incubator Program, a list of key education theories for junior faculty was developed. METHODS: A list of key papers on theories relevant to medical education was generated using an expert panel, a virtual community of practice synthetic discussion, and a social media call for resources...
February 2017: Western Journal of Emergency Medicine
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