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https://www.readbyqxmd.com/read/28339692/decrease-in-unnecessary-vitamin-d-testing-using-clinical-decision-support-tools-making-it-harder-to-do-the-wrong-thing
#1
Andrew H Felcher, Rachel Gold, David M Mosen, Ashley B Stoneburner
Objective: To evaluate the impact of clinical decision support (CDS) tools on rates of vitamin D testing. Screening for vitamin D deficiency has increased in recent years, spurred by studies suggesting vitamin D's clinical benefits. Such screening, however, is often unsupported by evidence and can incur unnecessary costs. Materials and Methods: We evaluated how rates of vitamin D screening changed after we implemented 3 CDS tools in the electronic health record (EHR) of a large health plan: (1) a new vitamin D screening guideline, (2) an alert that requires clinician acknowledgement of current guidelines to continue ordering the test (a "hard stop"), and (3) a modification of laboratory ordering preference lists that eliminates shortcuts...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339677/development-of-a-food-allergy-knowledge-test-for-parents
#2
Amy L Hahn, Lynnda M Dahlquist, Jessica L Hoehn, Mary Elizabeth Bollinger
Objective : To create a measure of food allergy (FA) knowledge for parents of children with FA. The food allergy knowledge test (FAKT) was developed following rigorous test-construction guidelines. The preliminary 110-item pool content was developed in consultation with FA experts. After cognitive interviews and revisions, an 88-item preliminary version was administered to 370 parents of children with FA who were recruited online and from an allergy clinic. After item difficulty, discrimination, item-scale correlations analyses, and assessment of internal consistency, a revised 57-item version was administered to a new clinic-based sample (77 parents)...
February 19, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28339443/clinical-outcome-of-augmentation-enterocystoplasty-for-patients-with-ketamine-induced-cystitis
#3
Yu Khun Lee, Jia-Fong Jhang, Hann-Chorng Kuo
BACKGROUND: Ketamine abuse has become a global phenomenon in recent years. Ketamine-induced cystitis (KC) is a new clinical syndrome which can result in severely inflamed bladder and intractable bladder pain. Currently there is no guideline for managing patients with KC. OBJECTIVES: To analyze the clinical outcome of patients with KC managed with augmentation enterocystoplasty (AE). STUDY DESIGN: Retrospective interventional study. SETTING: A tertiary teaching hospital, Hualien Tzu Chi Hospital...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339144/australian-and-new-zealand-pulmonary-rehabilitation-guidelines
#4
Jennifer A Alison, Zoe J McKeough, Kylie Johnston, Renae J McNamara, Lissa M Spencer, Sue C Jenkins, Catherine J Hill, Vanessa M McDonald, Peter Frith, Paul Cafarella, Michelle Brooke, Helen L Cameron-Tucker, Sarah Candy, Nola Cecins, Andrew S L Chan, Marita T Dale, Leona M Dowman, Catherine Granger, Simon Halloran, Peter Jung, Annemarie L Lee, Regina Leung, Tamara Matulick, Christian Osadnik, Mary Roberts, James Walsh, Sally Wootton, Anne E Holland
BACKGROUND AND OBJECTIVE: The aim of the Pulmonary Rehabilitation Guidelines (Guidelines) is to provide evidence-based recommendations for the practice of pulmonary rehabilitation (PR) specific to Australian and New Zealand healthcare contexts. METHODS: The Guideline methodology adhered to the Appraisal of Guidelines for Research and Evaluation (AGREE) II criteria. Nine key questions were constructed in accordance with the PICO (Population, Intervention, Comparator, Outcome) format and reviewed by a COPD consumer group for appropriateness...
March 24, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28337931/utilizing-nutritional-genomics-to-tailor-diets-for-the-prevention-of-cardiovascular-disease-a-guide-for-upcoming-studies-and-implementations
#5
Dolores Corella, Oscar Coltell, George Mattingley, José V Sorlí, Jose M Ordovas
Personalized diets based on an individual's genome to optimize the success of dietary intervention and reduce genetic cardiovascular disease (CVD) risk, is one of the challenges most frequently discussed in the scientific community. Areas covered: The authors gathered literature-based evidence on nutritional genomics and CVD phenotypes, our own results and research experience to provide a critical overview of the current situation of using nutritional genomics to tailor diets for CVD prevention and to propose guidelines for future studies and implementations...
March 24, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28336789/percutaneous-therapy-for-tricuspid-regurgitation-a-new-frontier-for-interventional-cardiology
#6
Samir R Kapadia, Amar Krishnaswamy, E Murat Tuzcu
Functional tricuspid regurgitation (FTR) is common, whether in association with mitral or aortic valve disease or presenting as an isolated valvular disease. Several studies have shown that TR is associated with poor patient outcomes, though a cause-and-effect relationship of TR to mortality has not been proven. Similarly the impact of surgical treatment of TR on outcomes needs well-controlled randomized trials that are under planning. The current professional society guidelines for treatment of TR are based on expert opinions with a level of evidence C for all indications...
March 23, 2017: Circulation
https://www.readbyqxmd.com/read/28336028/guideline-implementation-energy-generating-devices-part%C3%A2-2-lasers
#7
Byron L Burlingame
Lasers have been used in the OR for many years and are essential tools in many different types of procedures. However, laser beams that come into contact with unintended targets directly or via reflection can cause injury to patients or personnel or pose other hazards, such as fires. The new AORN "Guideline for safe use of energy-generating devices" provides guidance on the use of all energy-generating devices in the OR. This article focuses on key points of the guideline that address the safe use of lasers...
April 2017: AORN Journal
https://www.readbyqxmd.com/read/28335859/making-it-new-again-insight-into-liver-development-regeneration-and-disease-from-zebrafish-research
#8
Shuang Wang, Sophie R Miller, Elke A Ober, Kirsten C Sadler
The adult liver of most vertebrates is predominantly comprised of hepatocytes. However, these cells must work in concert with biliary, stellate, vascular, and immune cells to accomplish the vast array of hepatic functions required for physiological homeostasis. Our understanding of liver development was accelerated as zebrafish emerged as an ideal vertebrate system to study embryogenesis. Through work in zebrafish and other models, it is now clear that the cells in the liver develop in a coordinated fashion during embryogenesis through a complex yet incompletely understood set of molecular guidelines...
2017: Current Topics in Developmental Biology
https://www.readbyqxmd.com/read/28335694/construction-of-three-dimensional-dermo-epidermal-skin-equivalents-using-cell-coating-technology-and-their-utilization-as-alternative-skin-for-permeation-studies-and-skin-irritation-tests
#9
Takami Akagi, Mayuka Nagura, Ayami Hiura, Hajime Kojima, Mitsuru Akashi
In vitro generated human skin equivalents are generating interest as promising tools in basic research, as alternatives to animal testing and for clinical applications in regenerative medicine. For prediction of skin irritation and corrosion, three-dimensional (3D) human skin equivalents consisting of differentiated human keratinocytes have been developed and some models have been internationally accepted. However, more delicate assessments using full-thickness skin models, such as skin sensitization tests cannot be performed because of the lack of a dermis containing fibroblasts or appendages...
March 23, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28334476/implementing-guidelines-for-preventing-identifying-and-treating-adolescent-overweight-and-obesity-school-nurses-perceptions-of-the-challenges-involved
#10
Sølvi Helseth, Kirsti Riiser, Bettina Holmberg Fagerlund, Nina Misvaer
AIMS AND OBJECTIVES: We aimed to gain a better understanding of school nurses' perceptions of the challenges involved in implementing national guidelines on managing overweight and obesity in adolescents. BACKGROUND: National guidelines for the management of childhood overweight and obesity are developed in many countries to translate scientific knowledge into practice. However, several challenges are involved in their implementation. DESIGN AND METHODS: A qualitative design with focus group interviews was chosen for data collection...
March 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28334194/swga-a-primer-design-toolkit-for-selective-whole-genome-amplification
#11
Erik L Clarke, Sesh A Sundararaman, Stephanie N Seifert, Frederic D Bushman, Beatrice H Hahn, Dustin Brisson
Motivation: Population genomic analyses are often hindered by difficulties in obtaining sufficient numbers of genomes for analysis by DNA sequencing. Selective whole-genome amplification (SWGA) provides an efficient approach to amplify microbial genomes from complex backgrounds for sequence acquisition. However, the process of designing sets of primers for this method has many degrees of freedom and would benefit from an automated process to evaluate the vast number of potential primer sets...
February 27, 2017: Bioinformatics
https://www.readbyqxmd.com/read/28333847/management-of-children-with-autism-spectrum-disorder-in-the-anesthesia-and-radiographic-context
#12
Ingalill G Berglund, Berit Björkman, Karing Enskär, Maria Faresjö, Karina Huus
OBJECTIVE: As a primary objective, this study purports to develop guidelines to better care for children with autism spectrum disorder (ASD), particularly regarding these children's preparation for anesthesia and radiologic procedures. METHODS: Using a Delphi method with an online distribution of questionnaire, guidelines for caring for children with ASD were created. Twenty-one participants were included in the expert panel. These participants were working with children with ASD in several anesthesia and radiology departments in Sweden...
March 21, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28333201/new-statistical-criteria-detect-phylogenetic-bias-caused-by-compositional-heterogeneity
#13
David A Duchêne, Sebastian Duchêne, Simon Y W Ho
In statistical phylogenetic analyses of DNA sequences, models of evolutionary change commonly assume that base composition is stationary through time and across lineages. This assumption is violated by many data sets, but it is unclear whether the magnitude of these violations is sufficient to mislead phylogenetic inference. We investigated the impacts of compositional heterogeneity on phylogenetic estimates using a method for assessing model adequacy. Based on a detailed simulation study, we found that common frequentist criteria are highly conservative, such that the model is often rejected when the phylogenetic estimates do not show clear signs of bias...
February 21, 2017: Molecular Biology and Evolution
https://www.readbyqxmd.com/read/28333179/obtaining-antibiotics-online-from-within-the-uk-a-cross-sectional-study
#14
Sara Elizabeth Boyd, Luke Stephen Prockter Moore, Mark Gilchrist, Ceire Costelloe, Enrique Castro-Sánchez, Bryony Dean Franklin, Alison Helen Holmes
Background: Improved antibiotic stewardship (AS) and reduced prescribing in primary care, with a parallel increase in personal internet use, could lead citizens to obtain antibiotics from alternative sources online. Objectives: A cross-sectional analysis was performed to: (i) determine the quality and legality of online pharmacies selling antibiotics to the UK public; (ii) describe processes for obtaining antibiotics online from within the UK; and (iii) identify resulting AS and patient safety issues...
February 17, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28332461/global-public-goods-for-health-weaknesses-and-opportunities-in-the-global-health-system
#15
Suerie Moon, John-Arne Røttingen, Julio Frenk
Since at least the 1990s, there has been growing recognition that societies need global public goods (GPGs) in order to protect and promote public health. While the term GPG is sometimes used loosely to denote that which is 'good' for the global public, we restrict our use of the term to its technical definition (goods that are non-excludable and non-rival in consumption) for its useful analytical clarity. Examples of important GPGs for health include standards and guidelines, research on the causes and treatment of disease, and comparative evidence and analysis...
April 2017: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/28332275/thyroid-dysfunction-in-patients-with-down-syndrome-results-from-a-multi-institutional-registry-study
#16
Jenifer Lavigne, Christianne Sharr, Ibrahim Elsharkawi, Al Ozonoff, Nicole Baumer, Campbell Brasington, Sheila Cannon, Blythe Crissman, Emily Davidson, Jose C Florez, Priya Kishnani, Angela Lombardo, Jordan Lyerly, Mary Ellen McDonough, Alison Schwartz, Kathryn Berrier, Susan Sparks, Kara Stock-Guild, Tomi L Toler, Kishore Vellody, Lauren Voelz, Brian G Skotko
The goals of this undertaking were to assess the outcomes of thyroid screening tests and adherence to thyroid screening guidelines across five Down syndrome (DS) specialty clinics in various states. Data related to thyroid screening were collected for 663 individuals across five clinics specializing in the comprehensive care of individuals with DS for a period of 1 year. Of the 663 participants, 47.7% of participants had a TSH and free T4 ordered at their DS specialty clinic visit. Approximately 19.0% (60/316) had a new thyroid disorder diagnosis made...
March 23, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28331823/small-pulmonary-nodules-in-baseline-and-incidence-screening-rounds-of-low-dose-ct-lung-cancer-screening
#17
REVIEW
Joan E Walter, Marjolein A Heuvelmans, Matthijs Oudkerk
Currently, lung cancer screening by low-dose computed tomography (LDCT) is widely recommended for high-risk individuals by US guidelines, but there still is an ongoing debate concerning respective recommendations for European countries. Nevertheless, the available data regarding pulmonary nodules released by lung cancer screening studies could improve future screening guidelines, as well as the clinical practice of incidentally detected pulmonary nodules on routine CT scans. Most lung cancer screening trials present results for baseline and incidence screening rounds separately, clustering pulmonary nodules initially found at baseline screening and newly detected pulmonary nodules after baseline screening together...
February 2017: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28331566/person-centered-prediction-of-survival-in-population-based-screening-program-by-an-intelligent-clinical-decision-support-system
#18
Reza Safdari, Elham Maserat, Hamid Asadzadeh Aghdaei, Amir Hossein Javan Amoli, Hamid Mohaghegh Shalmani
AIM: To survey person centered survival rate in population based screening program by an intelligent clinical decision support system. BACKGROUND: Colorectal cancer is the most common malignancy and major cause of morbidity and mortality throughout the world. Colorectal cancer is the sixth leading cause of cancer death in Iran. In this survey, we used cosine similarity as data mining technique and intelligent system for estimating survival of at risk groups in the screening plan...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28331487/a-clinical-trial-protocol-to-treat-massive-africanized-honeybee-apis-mellifera-attack-with-a-new-apilic-antivenom
#19
Alexandre Naime Barbosa, Leslie Boyer, Jean-Philippe Chippaux, Natalia Bronzatto Medolago, Carlos Antonio Caramori, Ariane Gomes Paixão, João Paulo Vasconcelos Poli, Mônica Bannwart Mendes, Lucilene Delazari Dos Santos, Rui Seabra Ferreira, Benedito Barraviera
BACKGROUND: Envenomation caused by multiple stings from Africanized honeybees Apis mellifera constitutes a public health problem in the Americas. In 2015, the Brazilian Ministry of Health reported 13,597 accidents (incidence of seven cases per 100,000 inhabitants) with 39 deaths (lethality of 0.25%). The toxins present in the venom, which include melittin and phospholipase A2, cause lesions in diverse organs and systems that may be fatal. As there has been no specific treatment to date, management has been symptomatic and supportive only...
2017: Journal of Venomous Animals and Toxins Including Tropical Diseases
https://www.readbyqxmd.com/read/28331043/world-health-organization-treatment-guidelines-for-drug-resistant-tuberculosis-2016-update
#20
Dennis Falzon, Holger J Schünemann, Elizabeth Harausz, Licé González-Angulo, Christian Lienhardt, Ernesto Jaramillo, Karin Weyer
Antimicrobial resistance is a major global concern. Tuberculosis (TB) strains resistant to rifampicin and other TB medicines challenge patient survival and public health. The World Health Organization (WHO) has published treatment guidelines for drug-resistant TB since 1997 and last updated them in 2016 based on reviews of aggregated and individual patient data from published and unpublished studies. An international expert panel formulated recommendations following the GRADE approach. The new WHO guidelines recommend a standardised 9-12 months shorter treatment regimen as first choice in patients with multidrug- or rifampicin-resistant TB (MDR/RR-TB) strains not resistant to fluoroquinolones or second-line injectable agents; resistance to these two classes of core second-line medicines is rapidly detectable with molecular diagnostics also approved by WHO in 2016...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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