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https://www.readbyqxmd.com/read/28640966/linking-the-degree-of-virilization-in-females-with-congenital-adrenal-hyperplasia-to-genotype
#1
Semyon Gurgov, Kerlly J Bernabé, John Stites, Christopher M Cunniff, Karen Lin-Su, Diane Felsen, Maria I New, Dix P Poppas
Mutations of CYP21A2 variably decrease 21-hydroxylase activity and result in a spectrum of disease expressions in patients with congenital adrenal hyperplasia (CAH). We examined the association between CYP21A2 mutations and virilization (Prader score) in females with CAH. The study population included 187 CAH females with fully characterized CYP21A2 mutations. One hundred fifty-eight patients were sorted into groups by expected enzyme activity (percent of normal activity) of the less severely affected allele: (A) null, 0%; (B) I2G, 1%; (C) I172N, 2%; and (D) V281L, >2%...
June 22, 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28636707/incidence-and-predictors-of-opioid-prescription-at-discharge-after-traumatic-injury
#2
Muhammad Ali Chaudhary, Andrew J Schoenfeld, Alyssa F Harlow, Anju Ranjit, Rebecca Scully, Ritam Chowdhury, Meesha Sharma, Stephanie Nitzschke, Tracey Koehlmoos, Adil H Haider
Importance: In the current health care environment with increased scrutiny and growing concern regarding opioid use and abuse, there has been a push toward greater regulation over prescriptions of opioids. Trauma patients represent a population that may be affected by this regulation, as the incidence of pain at hospital discharge is greater than 95%, and opioids are considered the first line of treatment for pain management. However, the use of opioid prescriptions in trauma patients at hospital discharge has not been explored...
June 21, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28636675/probabilistic-population-aging
#3
Warren C Sanderson, Sergei Scherbov, Patrick Gerland
We merge two methodologies, prospective measures of population aging and probabilistic population forecasts. We compare the speed of change and variability in forecasts of the old age dependency ratio and the prospective old age dependency ratio as well as the same comparison for the median age and the prospective median age. While conventional measures of population aging are computed on the basis of the number of years people have already lived, prospective measures are computed also taking account of the expected number of years they have left to live...
2017: PloS One
https://www.readbyqxmd.com/read/28635208/association-of-clinical-characteristics-of-patients-presenting-with-influenza-like-illness-or-severe-acute-respiratory-illness-with-development-of-acute-respiratory-distress-syndrome
#4
Muhammad Ijaz, Muhammad Jaffar Khan, Jawad Khan, Usama Usama
Clinical judgement and suspicion of influenza based on signs and symptoms of influenza-like illness and severe acute respiratory illness are critical for better patient outcome. Whether clinical characteristics of patients are associated with the development of acute respiratory distress syndrome and PCR positivity of samples was the aim of this study. We included all patients (n=37) presenting with influenza like illness (ILI) or severe acute respiratory illness (SARI) to a tertiary care hospital in northwest Pakistan during December 2015 until the end of January 2016...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28634661/depression-and-art-initiation-among-hiv-serodiscordant-couples-in-kenya-and-uganda
#5
Jennifer Velloza, Connie Celum, Jessica E Haberer, Kenneth Ngure, Elizabeth Irungu, Nelly Mugo, Jared M Baeten, Renee Heffron
Depression is a known barrier for antiretroviral therapy (ART) adherence, but less is understood about its effects on ART initiation. We followed 1013 HIV-infected individuals participating in the Partners Demonstration Project, an open-label study of integrated pre-exposure prophylaxis (PrEP) and ART delivery for HIV serodiscordant couples in Kenya and Uganda. Associations between depression, measured annually with the Hopkins Symptoms Checklist-Depression (HSCL-D), and ART initiation were assessed with Cox proportional hazards regression...
June 20, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28634123/clinical-utility-of-chromosomal-aneusomy-in-individuals-at-high-risk-of-lung-cancer
#6
Anna E Barón, Severine Kako, William J Feser, Heather Malinowski, Daniel Merrick, Kavita Garg, Stephen Malkoski, Shannon Pretzel, Jill M Siegfried, Wilbur A Franklin, York Miller, Holly J Wolf, Marileila Varella-Garcia
INTRODUCTION: Low dose CT screening for lung cancer has a high false positive rate with frequent discovery of indeterminate pulmonary nodules. Noninvasive biomarkers are needed to reduce false positives and improve risk stratification. A retrospective longitudinal evaluation was performed to assess chromosomal aneusomy in sputum via fluorescence in situ hybridization (CA-FISH) in four nested case-control studies. METHODS: ROC analysis resulted in two grouped cohorts: High Risk (CO High Risk and CO Nodule; 68 Cases, 69 controls) and Screening (ACRIN/NLST and PLuSS; 97 Cases, 185 controls)...
June 17, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28633903/internal-validation-of-a-scoring-system-to-evaluate-the-probability-of-ureteral-stones-the-chokai-score
#7
Hiroki Fukuhara, Osamu Ichiyanagi, Shinichi Midorikawa, Hiroshi Kakizaki, Hisashi Kaneko, Norihiko Tsuchiya
OBJECTIVE: The CHOKAI and STONE scores are prediction models for ureteral stones. The aims of the present study were to evaluate the diagnostic performance, to examine the optimal cut-off value, and to compare the diagnostic performance of each model. METHODS: Patients who presented to our emergency department with renal colic were considered for this prospective study. We analyzed the predictive performance of both STONE and CHOKAI scores at their optimal cut-off values, using receiver operating characteristic (ROC) curve and area under the curve (AUC), as well as sensitivity, specificity, positive likelihood ratio (LR+), and negative likelihood ratio (LR-) at the optimal cut-off value...
June 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28633634/the-development-and-appraisal-of-a-tool-designed-to-find-patients-harmed-by-falsely-labelled-falsified-counterfeit-medicines
#8
Marija Anđelković, Einar Björnsson, Virgilio De Bono, Nenad Dikić, Katleen Devue, Daniel Ferlin, Miroslav Hanževački, Freyja Jónsdóttir, Mkrtich Shakaryan, Sabine Walser
BACKGROUND: Falsely labelled, falsified (counterfeit) medicines (FFCm's) are produced or distributed illegally and can harm patients. Although the occurrence of FFCm's is increasing in Europe, harm is rarely reported. The European Directorate for the Quality of Medicines & Health-Care (EDQM) has therefore coordinated the development and validation of a screening tool. METHODS: The tool consists of a questionnaire referring to a watch-list of FFCm's identified in Europe, including symptoms of their use and individual risk factors, and a scoring form...
June 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28633533/in-the-modern-era-of-percutaneous-coronary-intervention-is-cardiac-rehabilitation-engagement-purely-a-patient-or-a-service-level-decision
#9
Abdulrahman Al Quait, Patrick Doherty, Nils Gutacker, Joseph Mills
Aims Despite the proven benefits of cardiac rehabilitation (CR), utilization rates remain below recommendation in the percutaneous coronary intervention cohort in most European countries. Although extensive research has been carried out on CR uptake, no previous study has investigated the factors that lead patients to attend the initial CR baseline assessment (CR engagement). This paper attempts to provide new insights into CR engagement in the growing percutaneous coronary intervention population. Methods and results In total, we analysed data on 59,807 patients who underwent percutaneous coronary intervention during 2013 to 2016 (mean age 65 years; 25% female)...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28632094/the-interactive-effects-of-social-support-and-physical-functioning-on-hiv-medical-outcomes-among-african-americans-whom-inject-drugs
#10
Allysha C Maragh-Bass, Julie A Denison, Roland J Thorpe, Amy R Knowlton
Research suggests a syndemic of substance use, mental illness, and familial conflict is associated with poor HIV medical outcomes among African American persons living with HIV (PLHIV). Social support may facilitate positive health outcomes. This study explores psychosocial correlates of HIV medical outcomes, defined as undetectable viral load (UVL) and acute care minimization. Data were from baseline of the BEACON study (N = 351). UVL was ≤40 copies/mL. Acute care minimization was defined as no ER visits and/or hospitalizations in 6 months...
February 15, 2017: Journal of Ethnicity in Substance Abuse
https://www.readbyqxmd.com/read/28631986/accuracy-statistics-in-predicting-independent-activities-of-daily-living-iadl-capacity-with-comprehensive-and-brief-neuropsychological-test-batteries
#11
Peter Karzmark, Gayle K Deutsch
This investigation was designed to determine the predictive accuracy of a comprehensive neuropsychological and brief neuropsychological test battery with regard to the capacity to perform instrumental activities of daily living (IADLs). Accuracy statistics that included measures of sensitivity, specificity, positive and negative predicted power and positive likelihood ratio were calculated for both types of batteries. The sample was drawn from a general neurological group of adults (n = 117) that included a number of older participants (age >55; n = 38)...
February 22, 2017: Applied Neuropsychology. Adult
https://www.readbyqxmd.com/read/28631964/evidence-based-assessment-of-adhd-diagnosis-in-children-and-adolescents
#12
Xuechun Zhou, Cecil R Reynolds, Jianjun Zhu, Randy W Kamphaus, Ou Zhang
This study illustrates the accuracy and efficiency of using an evidence-based assessment (EBA) strategy for diagnosis of attention-deficit/hyperactivity disorder (ADHD) by integrating the scale scores obtained on BASC-3 teacher and parent rating scales. The examined process used empirical diagnostic likelihood ratios (DLRs) derived from a sample of children with ADHD (N = 339) matched on demographic characteristics from the normative sample. The results show that behavioral scales of executive functioning and functional communication provided incremental utility in ADHD diagnosis...
February 22, 2017: Applied Neuropsychology. Child
https://www.readbyqxmd.com/read/28631720/contemporary-management-of-men-with-high-risk-localized-prostate-cancer-in-the-united-states
#13
A B Weiner, R S Matulewicz, E M Schaeffer, S L Liauw, J M Feinglass, S E Eggener
BACKGROUND: Surgery and radiation-based therapies are standard management options for men with clinically localized high-risk prostate cancer (PCa). Contemporary patterns of care are unknown. We hypothesize the use of surgery has steadily increased in more recent years. METHODS: Using the National Cancer Data Base for 2004-2013, all men diagnosed with high-risk localized PCa were identified using National Comprehensive Cancer Network criteria. Temporal trends in initial management were assessed...
June 20, 2017: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/28631387/umeclidinium-bromide-versus-placebo-for-people-with-chronic-obstructive-pulmonary-disease-copd
#14
REVIEW
Han Ni, Aung Htet, Soe Moe
BACKGROUND: People with chronic obstructive pulmonary disease (COPD) have poor quality of life, reduced survival, and accelerated decline in lung function, especially associated with acute exacerbations, leading to high healthcare costs. Long-acting bronchodilators are the mainstay of treatment for symptomatic improvement, and umeclidinium is one of the new long-acting muscarinic antagonists approved for treatment of patients with stable COPD. OBJECTIVES: To assess the efficacy and safety of umeclidinium bromide versus placebo for people with stable COPD...
June 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28631156/diagnosis-of-secondary-pulmonary-lymphangiectasia-in-congenital-heart-disease-a-novel-role-for-chest-ultrasound-and-prognostic-implications
#15
Christopher Z Lam, Tanmay Anant Bhamare, Tamadhir Gazzaz, David Manson, Tilman Humpl, Mike Seed
BACKGROUND: Secondary pulmonary lymphangiectasia is a complication of congenital heart disease that results from chronic pulmonary venous obstruction. OBJECTIVES: We aimed to evaluate the performance of chest ultrasound (US) in diagnosing secondary pulmonary lymphangiectasia and to review the clinical course of children with secondary pulmonary lymphangiectasia. MATERIALS AND METHODS: Chest US was performed on 26 children with hypoplastic left heart syndrome, total anomalous pulmonary venous connection or cor triatriatum in a prospective observational study...
June 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28631046/adherence-of-rheumatoid-arthritis-patients-to-biologic-disease-modifying-antirheumatic-drugs-a-cross-sectional-study
#16
Natalia Mena-Vazquez, Sara Manrique-Arija, Lucía Yunquera-Romero, Inmaculada Ureña-Garnica, Marta Rojas-Gimenez, Carla Domic, Francisco Gabriel Jimenez-Nuñez, Antonio Fernandez-Nebro
The aims of this study were to evaluate adherence of rheumatoid arthritis (RA) patients to biological disease-modifying antirheumatic drugs (bDMARDs), identify potential risk factors, and analyze the discriminative ability of the Morisky-Green test (MGT) to detect bDMARD nonadherence. One hundred and seventy-eight adult RA patients treated with bDMARDs were included. Adherence was measured using the medication possession ratio (MPR) of the previous 6 months. An MPR >80% was considered good adherence. Patient demographics, clinical characteristics, and MGT scores were assessed through a standardized clinical interview at the cross-sectional date...
June 19, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28630234/multiparametric-model-for-penumbral-flow-prediction-in-acute-stroke
#17
Michelle Livne, Tabea Kossen, Vince I Madai, Olivier Zaro-Weber, Walter Moeller-Hartmann, Kim Mouridsen, Wolf-Dieter Heiss, Jan Sobesky
BACKGROUND AND PURPOSE: Identification of salvageable penumbra tissue by dynamic susceptibility contrast magnetic resonance imaging is a valuable tool for acute stroke patient stratification for treatment. However, prior studies have not attempted to combine the different perfusion maps into a predictive model. In this study, we established a multiparametric perfusion imaging model and cross-validated it using positron emission tomography perfusion for detection of penumbral flow. METHODS: In a retrospective analysis of 17 subacute stroke patients with consecutive magnetic resonance imaging and H2O15 positron emission tomography scans, perfusion maps of cerebral blood flow, cerebral blood volume, mean transit time, time-to-maximum, and time-to-peak were constructed and combined using a generalized linear model (GLM)...
June 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28629995/intraosseous-compared-to-intravenous-drug-resuscitation-in-out-of-hospital-cardiac-arrest
#18
Bryan A Feinstein, Benjamin A Stubbs, Tom Rea, Peter J Kudenchuk
AIMS: Although the intraosseous (IO) route is increasingly used for vascular access in out-of-hospital cardiac arrest (OHCA), little is known about its comparative effectiveness relative to intravenous (IV) access. We evaluated clinical outcomes following OHCA comparing drug administration via IO versus IV routes. METHODS: This retrospective cohort study evaluated Emergency Medical Services (EMS)-treated adults with atraumatic OHCA in a large metropolitan EMS system between 9/1/2012-12/31/2014...
June 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28629385/administrative-algorithms-to-identify-avascular-necrosis-of-bone-among-patients-undergoing-upper-or-lower-extremity-magnetic-resonance-imaging-a-validation-study
#19
Medha Barbhaiya, Yan Dong, Jeffrey A Sparks, Elena Losina, Karen H Costenbader, Jeffrey N Katz
BACKGROUND: Studies of the epidemiology and outcomes of avascular necrosis (AVN) require accurate case-finding methods. The aim of this study was to evaluate performance characteristics of a claims-based algorithm designed to identify AVN cases in administrative data. METHODS: Using a centralized patient registry from a US academic medical center, we identified all adults aged ≥18 years who underwent magnetic resonance imaging (MRI) of an upper/lower extremity joint during the 1...
June 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28628706/diagnostic-accuracy-of-fecal-immunochemical-test-in-patients-at-increased-risk-for-colorectal-cancer-a-meta-analysis
#20
Anastasia Katsoula, Paschalis Paschos, Anna-Bettina Haidich, Apostolos Tsapas, Olga Giouleme
Importance: The potential role of the fecal immunochemical test (FIT) for screening patients at increased risk for colorectal cancer (CRC) has not yet been elucidated. Objective: To assess the diagnostic accuracy of FIT for CRC or advanced neoplasia (AN) in asymptomatic patients at above-average risk. Data Sources: MEDLINE, EMBASE, Cochrane Library, and gray literature sources through August 2016. Study Selection: Diagnostic studies evaluating the accuracy of FIT for CRC or AN in patients with a personal or familial history of CRC using colonoscopy as the reference standard...
June 19, 2017: JAMA Internal Medicine
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