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https://www.readbyqxmd.com/read/28647926/importance-of-gold-guidelines-for-chronic-obstructive-pulmonary-disease
#1
J Sadlonova, D Osinova, E Rozborilova, O Osina, E Novakova, V Sadlonova
In December 2011, a major revision of GOLD 2011 guidelines was published based on the evidence-based medicine. The goal of GOLD 2011 is to determine the severity of the disease, its impact on the patient's health, and the risk of future events; all of which eventually guide therapy. A combined COPD assessment according to GOLD 2011 considers the patient's level of symptoms, spirometry abnormalities, risk of exacerbation, and the presence of comorbidities. GOLD 2011 stratifies patients into four basic groups labeled A, B, C, and D...
June 25, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28647738/outcome-and-treatment-of-antenatally-diagnosed-nonimmune-hydrops-fetalis
#2
Ahmed A Nassr, Amen Ness, Pardis Hosseinzadeh, Bahram Salmanian, Jimmy Espinoza, Victoria Berger, Eleonore Werner, Hadi Erfani, Stephen Welty, Zhoobin H Bateni, Amir A Shamshirsaz, Edwina Popek, Rodrigo Ruano, Alexis S Davis, Timothy C Lee, Sundeep Keswani, Darrell L Cass, Oluyinka O Olutoye, Michael A Belfort, Alireza A Shamshirsaz
INTRODUCTION: The objectives of this study were to evaluate the outcome of nonimmune hydrops fetalis in an attempt to identify independent predictors of perinatal mortality. MATERIAL AND METHODS: A retrospective cohort study was conducted including all cases of nonimmune hydrops from two tertiary care centers. Perinatal outcome was evaluated after classifying nonimmune hydrops into ten etiological groups. We examined the effect of etiology, site of fluid accumulation, and gestational age at delivery on postnatal survival...
June 24, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28647660/novel-oral-anticoagulants-in-patients-undergoing-cranial-surgery
#3
Davide Marco Croci, Maria Kamenova, Raphael Guzman, Luigi Mariani, Jehuda Soleman
BACKGROUND: The number of patients treated with NOACS is increasing. Despite growing clinical relevance, guidelines on the perioperative management of neurosurgical patients treated with NOACS are still lacking. OBJECTIVES: The aim of this study was to analyze the occurrence of postoperative bleeding events and factors which might influence bleeding rates of these patients. METHODS: Out of 1353 consecutive patients undergoing cranial neurosurgical procedures 30 patients (2...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28647562/post-operative-complications-of-spina-bifida-patients-undergoing-urological-laparotomy-a-multi-institutional-analysis
#4
Christopher J Loftus, David C Moore, Joshua A Cohn, Douglas F Milam, Roger R Dmochowski, Dan Wood, Melissa R Kaufman, Hadley M Wood
OBJECTIVE: To characterize peri-operative morbidity and mortality of adult spina bifida patients undergoing laparotomy. METHODS: We retrospectively studied the post-operative complications of 59 operations of spina bifida patients undergoing abdominal laparotomies for urological indications at three institutions. We evaluated post-operative complications using the Clavien-Dindo classification scale. RESULTS: The overall complication rate was 91...
June 21, 2017: Urology
https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#5
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28647407/external-validation-of-the-simple-null-please-clinical-score-in-predicting-outcome-of-out-of-hospital-cardiac-arrest
#6
Tatjana S Potpara, Miroslav Mihajlovic, Sanja Stankovic, Tanja Jozic, Irena Jozic, Milika R Asanin, Rajai Ahmad, Gregory Y H Lip
BACKGROUND: Rapid clinical decision-making on further management of patients with out-of-hospital cardiac arrest may be challenging. Recently, a 'futility' score (NULL-PLEASE) incorporating multiple adverse resuscitation features (Non-shockable rhythm, Unwitnessed arrest, Long no-flow or Long low-flow period, blood pH <7.2, Lactate >7.0 mmol/l, End-stage chronic kidney disease on dialysis, Age ≥85 years, Still resuscitation and Extra-cardiac cause) has been proposed to help identify out-of-hospital cardiac arrest patients unlikely to survive; however, external independent score validation is lacking...
June 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28647406/unstable-angina-in-the-era-of-cardiac-troponin-assays-with-improved-sensitivity-a-clinical-dilemma
#7
K M Eggers, T Jernberg, B Lindahl
INTRODUCTION: There is an expectation that with the adoption of more sensitive cardiac troponin (cTn) assays, unstable angina would become a rarity. However, recent data from the SWEDEHEART registry demonstrated that 15% of patients admitted with non ST-elevation acute coronary syndrome (NSTE-ACS) still were regarded having unstable angina. We aimed to further investigate the clinical characteristics and outcome of these patients. METHODS: Retrospective registry-based analysis (SWEDEHEART) including 3204 unstable patients, 18,194 non ST-elevation myocardial infarction (NSTEMI) patients and 977 controls without acute cardiovascular disease...
June 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28647335/incidence-and-duration-of-increased-somatic-cell-count-in-swedish-dairy-cows-and-associations-with-milking-system-type
#8
J Frössling, A Ohlson, C Hallén-Sandgren
Mastitis is one of the most costly diseases in dairy cows worldwide. Increased somatic cell count (SCC) is an indication of mastitis, often subclinical, which implies bacterial infection without clinical signs of inflammation. The aim was to investigate the occurrence of elevated udder SCC (defined as ≥200,000 cells/mL) over the lactation period, and before and after the dry period, for cows of different parity. The aim was also to analyze the association between prevalence and incidence of increased udder SCC and information on cow and herd level, such as breed and milking system type...
June 21, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28646972/effectiveness-evaluation-of-the-positive-family-support-intervention-a-three-tiered-public-health-delivery-model-for-middle-schools
#9
Keith Smolkowski, John R Seeley, Jeffery M Gau, Tom J Dishion, Elizabeth A Stormshak, Kevin J Moore, Corrina A Falkenstein, Gregory M Fosco, S Andrew Garbacz
This article presents the results of an evaluation of Positive Family Support, an ecological family intervention and treatment approach to parent supports and family management training developed from a history of basic and translational research. This effectiveness trial, with 41 public middle schools randomly assigned to intervention or control, examined student-, teacher-, and parent-reported outcomes, as well as math and reading scores and school attendance. Multilevel analyses suggested that for students at risk for behavior problems, immediate-intervention schools outperformed control schools on parent-reported negative school contacts for students at risk for behavior problems...
June 2017: Journal of School Psychology
https://www.readbyqxmd.com/read/28646804/pilot-investigation-of-2-nondiet-approaches-to-improve-weight-and-health
#10
Kelly H Webber, Laurel Mellin, Lindsey Mayes, Igor Mitrovic, Matt Saulnier
Context • Weight loss and maintenance are associated with many health benefits, but long-term maintenance of weight loss remains elusive for many people. Overweight individuals are at higher risk than normal-weight individuals for stress-induced overeating. The use of stress-management tools in a weight loss program might decrease the physiological stress that fuels overeating and improve posttreatment maintenance of weight loss Objective • The study intended to compare the differences in outcomes between 2 approaches to achieving weight loss and changes in health-stress reduction and intuitive eating (IE)-during a 14-wk period...
June 23, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28646773/survival-outcomes-of-patients-with-lobular-carcinoma-in-situ-who-underwent-bilateral-mastectomy-or-partial-mastectomy
#11
Ze-Ming Xie, Jian Sun, Zhe-Yu Hu, Yao-Pan Wu, Peng Liu, Jun Tang, Xiang-Sheng Xiao, Wei-Dong Wei, Xi Wang, Xiao-Ming Xie, Ming-Tian Yang
AIM: To compare the survival outcomes between patients treated with bilateral mastectomy and partial mastectomy alone as the initial surgical management for primary lobular carcinoma in situ (LCIS). PATIENTS AND METHODS: Patients with histologically confirmed LCIS underwent partial mastectomy alone or bilateral mastectomy were identified by the SEER*Stat database (version 8.3.2) released in 2016. The primary outcome measure was all-cause mortality and the secondary outcome measure was breast cancer-specific mortality...
June 21, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28646356/pharmacotherapy-in-the-management-of-pediatric-obesity
#12
REVIEW
Aaron S Kelly, Claudia K Fox
PURPOSE OF REVIEW: This review provides a rationale for the use of pharmacotherapy in pediatric weight management, summarizes results of some of the key pediatric clinical trials of approved and "off-label" obesity medications, introduces new options in the pediatric pipeline, and offers a glimpse into the future of pediatric obesity medicine. RECENT FINDINGS: Despite the need for adjunctive treatments to enhance the outcomes of lifestyle modification therapy among youth with obesity, none of the obesity medications evaluated to date have been shown to meaningfully reduce BMI or cardiometabolic risk factors...
August 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28645976/a-combined-randomised-and-observational-study-of-surgery-for-fractures-in-the-distal-radius-in-the-elderly-crossfire-a-study-protocol
#13
Ian A Harris, Justine M Naylor, Andrew Lawson, Rachelle Buchbinder, Rebecca Ivers, Zsolt Balogh, Paul Smith, Rajat Mittal, Wei Xuan, Kirsten Howard, Arezoo Vafa, Piers Yates, Bertram Rieger, Geoff Smith, Ilia Elkinson, Woosung Kim, Mellick Chehade, Jai Sungaran, Kim Latendresse, James Wong, Sameer Viswanathan, Martin Richardson, Kush Shrestha, Herwig Drobetz, Phong Tran, Jeremy Loveridge, Richard Page, Raphael Hau, Roger Bingham, Jonathan Mulford, Ian Incoll
Fractures of the distal radius are common and occur in all age groups. The incidence is high in older populations due to osteoporosis and increased falls risk. Considerable practice variation exists in the management of distal radius fractures in older patients ranging from closed reduction with cast immobilisation to open reduction with plate fixation. Plating is currently the most common surgical treatment. While there is evidence showing no significant advantage for some forms of surgical fixation over conservative treatment, and no difference between different surgical techniques, there is a lack of evidence comparing two of the most common treatments used: closed reduction and casting versus plating...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645890/tailored-communication-within-mobile-apps-for-diabetes-self-management-a-systematic-review
#14
Heidi Holmen, Astrid Klopstad Wahl, Milada Cvancarova Småstuen, Lis Ribu
BACKGROUND: The prevalence of diabetes is increasing and with the requirements for self-management and risk of late complications, it remains a challenge for the individual and society. Patients can benefit from support from health care personnel in their self-management, and the traditional communication between patients and health care personnel is changing. Smartphones and apps offer a unique platform for communication, but apps with integrated health care personnel communication based on patient data are yet to be investigated to provide evidence of possible effects...
June 23, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28645803/grace-risk-score-sex-based-validity-of-in-hospital-mortality-prediction-in-canadian-patients-with-acute-coronary-syndrome
#15
Inna Y Gong, Shaun G Goodman, David Brieger, Chris P Gale, Derek P Chew, Robert C Welsh, Thao Huynh, J Paul DeYoung, Carolyn Baer, Gabor T Gyenes, Jacob A Udell, Keith A A Fox, Andrew T Yan
BACKGROUND: Although there are sex differences in management and outcome of acute coronary syndromes (ACS), sex is not a component of Global Registry of Acute Coronary Events (GRACE) risk score (RS) for in-hospital mortality prediction. We sought to determine the prognostic utility of GRACE RS in men and women, and whether its predictive accuracy would be augmented through sex-based modification of its components. METHODS: Canadian men and women enrolled in GRACE and Canadian Registry of Acute Coronary Events were stratified as ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation ACS (NSTE-ACS)...
June 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28645696/exercise-training-improves-functional-status-in-hypertensive-older-adults-under-angiotensin-converting-enzymes-inhibitors-medication
#16
Liliana C Baptista, Aristides M Machado-Rodrigues, Manuel Teixeira Veríssimo, Raul A Martins
BACKGROUND: The study aims to analyze the effect of three types of treatment on functional status, and cardiovascular risk outcomes in hypertensive older adults with comorbidities. METHODS: Participants (n=418) underwent one of the following 3 conditions: i) multicomponent exercise training 3times/week (MEX; n=116); ii) angiotensin converting enzyme inhibitors used mono-dose daily (ACEi; n=70); iii) combined exercise and ACEi drugs (ACEiMEX; n=232). The trial was completed by 82% of the participants (n=342): MEX (n=90); ACEi (n=66); ACEiMEX (n=186)...
June 20, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28645632/adjuvant-chemotherapy-guided-by-molecular-profiling-and-improved-outcomes-in-early-stage-non-small-cell-lung-cancer
#17
Gavitt A Woodard, Sue X Wang, Johannes R Kratz, Clara T Zoon-Besselink, Chun-Yuan Chiang, Matthew A Gubens, Thierry M Jahan, Collin M Blakely, Kirk D Jones, Michael J Mann, David M Jablons
INTRODUCTION: Many early stage non-small-cell lung cancer (NSCLC) patients who are not considered candidates for adjuvant treatment according to current guidelines do harbor occult metastasis, and have disease recurrence despite complete resection. Although National Comprehensive Cancer Network (NCCN) guidelines suggest clinicopathologic characteristics to identify high-risk patients for adjuvant intervention, molecular profiling more accurately predicts 5-year survival. Early evidence of clinical benefit from application of this molecular-based management strategy, however, has not been reported...
May 31, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28645262/acute-myeloid-leukemia-and-pregnancy-clinical-experience-from-a-single-center-and-a-review-of-the-literature
#18
Nicola Stefano Fracchiolla, Mariarita Sciumè, Francesco Dambrosi, Francesca Guidotti, Manuela Wally Ossola, Giovanna Chidini, Umberto Gianelli, Daniela Merlo, Agostino Cortelezzi
BACKGROUND: Acute myeloid leukemia (AML) accounts for more than two thirds of leukemia during pregnancy and has an incidence of 1 in 75,000 to 100,000. Its clinical management remains a challenging therapeutic task both for patient and medical team, given to the therapy-attributable risks for mother and fetus and the connected counseling regarding pregnancy continuation. METHODS: We provided a review of updated literature and a comprehensive description of five maternal/fetal outcomes of AML cases diagnosed concomitantly to pregnancy and treated at our Institution from 2006 to 2012...
June 23, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28645252/statin-use-reduces-cardiovascular-events-and-all-cause-mortality-amongst-chinese-patients-with-type-2-diabetes-mellitus-a-5-year-cohort-study
#19
Colman Siu Cheung Fung, Eric Yuk Fai Wan, Anca Ka Chun Chan, Cindy Lo Kuen Lam
BACKGROUND: The benefit of statin on the management of Type 2 Diabetes Mellitus (T2DM) among Chinese patients in primary care is not clear nor fully implemented in clinical practice. This study aimed to evaluate and quantify the benefit of statin on the overall cardiovascular risk and all-cause mortality in patients with T2DM. METHODS: Uncomplicated diabetic patients with baseline low-density-lipoprotein cholesterol (LDL-C) > 2.6 mmol/L and without statin use before baseline in 2010 were followed-up for 5 years for cardiovascular disease (CVD) events and all-cause mortality...
June 24, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28644979/intraoperative-fast-ripples-independently-predict-postsurgical-epilepsy-outcome-comparison-with-other-electrocorticographic-phenomena
#20
Shaun A Hussain, Gary W Mathern, Phoebe Hung, Julius Weng, Raman Sankar, Joyce Y Wu
In the surgical management of epilepsy, the resection of cortex exhibiting interictal fast ripples (250-500Hz) on electrocorticography has been linked to postoperative seizure-freedom. Although fast ripples appear to accurately identify the epileptogenic zone-the minimum tissue that must be removed at surgery to achieve seizure-freedom-it has not been established that fast ripples are a superior biomarker in comparison with multimodal presurgical neuroimaging and other electrocorticography abnormalities. Hence, in the prediction of postoperative seizure-freedom, we compared the value of fast ripples with other intraoperative electocorticography abnormalities including focal slowing, paroxysmal fast activity, intermittent spike discharges, continuous epileptiform discharges, focal attenuation, and intraoperative seizures, as well as complete resection of the lesion defined by MRI and other neuroimaging...
June 16, 2017: Epilepsy Research
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