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https://www.readbyqxmd.com/read/28092285/perioperative-%C3%AE-blockers-in-patients-undergoing-noncardiac-surgery-scientific-misconduct-and-clinical-guidelines
#1
Dhauna Karam, Rohit Arora
BACKGROUND: β-blocker use in perioperative period of noncardiac surgeries has been a topic of debate since many years. Earlier studies conducted in the 90s showed decreased cardiac adverse events and improved postoperative outcomes with β-blocker use. Based on this, the ACCF and ESC published guidelines strongly supporting β-blocker use. But contemporaneous studies conducted revealed conflicting evidence and have also proven some of the earlier studies to be fraudulent. Although ACCF guidelines have been updated to partially reflect the changes, ESC guidelines continue to support β-blocker use...
January 10, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28090764/incremental-and-infrequent-hemodialysis-a-new-paradigm-for-both-dialysis-initiation-and-conservative-management
#2
Connie M Rhee, Mehrdad Ghahremani-Ghajar, Yoshitsugu Obi, Kamyar Kalantar-Zadeh
Registry or national dialysis data show that a sizeable proportion of contemporary dialysis patients have substantial levels of residual kidney function especially upon transitioning to dialysis therapy. However, among incident hemodialysis patients, the prevailing paradigm has been to initiate "full-dose" thrice-weekly treatment schedules irrespective of native kidney function in most developed countries. Recognizing the benefits of residual kidney function upon the health and survival of dialysis patients, there has been growing interest in incremental hemodialysis, in which dialysis frequency and dose are tailored according to the degree of patients' residual kidney function...
January 13, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28089562/sequential-multiple-assignment-randomized-trials-an-opportunity-for-improved-design-of-stroke-reperfusion-trials
#3
William J Meurer, Nicholas J Seewald, Kelley Kidwell
BACKGROUND: Modern clinical trials in stroke reperfusion fall into 2 categories: alternative systemic pharmacological regimens to alteplase and "rescue" endovascular approaches using targeted thrombectomy devices and/or medications delivered directly for persistently occluded vessels. Clinical trials in stroke have not evaluated how initial pharmacological thrombolytic management might influence subsequent rescue strategy. A sequential multiple assignment randomized trial (SMART) is a novel trial design that can test these dynamic treatment regimens and lead to treatment guidelines that more closely mimic practice...
January 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28089304/management-of-prostate-cancer-in-elderly-patients-recommendations-of-a-task-force-of-the-international-society-of-geriatric-oncology
#4
REVIEW
Jean-Pierre Droz, Gilles Albrand, Silke Gillessen, Simon Hughes, Nicolas Mottet, Stéphane Oudard, Heather Payne, Martine Puts, Gilbert Zulian, Lodovico Balducci, Matti Aapro
CONTEXT: Prostate cancer is the most frequent male cancer. Since the median age of diagnosis is 66 yr, many patients require both geriatric and urologic evaluation if treatment is to be tailored to individual circumstances including comorbidities and frailty. OBJECTIVE: To update the 2014 International Society of Geriatric Oncology (SIOG) guidelines on prostate cancer in men aged >70 yr. The update includes new material on health status evaluation and the treatment of localised, advanced, and castrate-resistant disease...
January 11, 2017: European Urology
https://www.readbyqxmd.com/read/28089200/limitations-of-the-current-standards-of-care-for-treating-gout-and-crystal-deposition-in-the-primary-care-setting-a-review
#5
Robert T Keenan
PURPOSE: This article outlines several important issues regarding the management of patients with gout. The topics discussed include best practices for gout based on the most current guidelines, opportunities for improving gout management, and current and emerging therapies for gout. METHODS: [PubMed and Google Scholar databases] were search for all articles and trials published before 2016, using the key terms [hyperuricemia, gout, tophi, joint erosion, joint damage, treatment guidelines, American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), flare, comorbidity, epidemiology, adherence, serum uric acid (sUA), monosodium urate (MSU), <6 mg/dL, MSU crystal formation, as well as individual drug names and classes of treatments of interest (allopurinol, febuxostat, colchicine, non-steroidal anti-inflammatories (NSAIDs)]...
January 11, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28089153/temporal-trends-in-management-and-outcomes-of-patients-with-acute-coronary-syndrome-according-to-renal-function
#6
Mony Shuvy, Shmuel Chen, Dina Vorobeichik, Eilon Krashin, Nir Shlomo, Ilan Goldenberg, David Pereg
INTRODUCTION: Recent new therapeutic options have improved outcomes of acute coronary syndrome (ACS) patients. However, data regarding the incremental effect of the improved treatment on patients with renal dysfunction are limited. We sought to evaluate temporal trends in management and outcome of ACS patients according to renal function. METHODS: The study population consisted of all ACS patients enrolled in the Acute Coronary Syndromes Israeli Survey (ACSIS) during 2002-2013...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28088797/automated-interpretation-of-pulmonary-function-tests-in-adults-with-respiratory-complaints
#7
Marko Topalovic, Stefan Laval, Jean-Marie Aerts, Thierry Troosters, Marc Decramer, Wim Janssens
BACKGROUND: The use of pulmonary function tests is primarily based on expert opinion and international guidelines. Current interpretation strategies are using predefined cutoffs for the description of a typical pattern. OBJECTIVES: We aimed to explore the predicted disease outcome based on the American Thoracic Society/European Respiratory Society (ATS/ERS) interpreting strategy. Subsequently, we investigated whether an unbiased machine learning framework integrating lung function with clinical variables may provide alternative decision trees resulting in a more accurate diagnosis...
January 12, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28088302/the-cyp79a1-catalyzed-conversion-of-tyrosine-to-e-p-hydroxyphenylacetaldoxime-unravelled-using-an-improved-method-for-homology-modeling
#8
Dario Vazquez-Albacete, Marco Montefiori, Stefan Kol, Mohammed Saddik Motawia, Birger Lindberg Møller, Lars Olsen, Morten H H Nørholm
The vast diversity and membrane-bound nature of plant P450s makes it challenging to study the structural characteristics of this class of enzymes especially with respect to accurate intermolecular enzyme-substrate interactions. To address this problem we here apply a modified hybrid structure strategy for homology modeling of plant P450s. This allows for structural elucidation based on conserved motifs in the protein sequence and secondary structure predictions. We modeled the well-studied Sorghum bicolor cytochrome P450 CYP79A1 catalyzing the first step in the biosynthesis of the cyanogenic glucoside dhurrin...
January 11, 2017: Phytochemistry
https://www.readbyqxmd.com/read/28087549/engaging-stakeholders-and-target-groups-in-prioritising-a-public-health-intervention-the-creating-active-school-environments-case-online-delphi-study
#9
Katie L Morton, Andrew J Atkin, Kirsten Corder, Marc Suhrcke, David Turner, Esther M F van Sluijs
OBJECTIVES: Stakeholder engagement and public involvement are considered as integral to developing effective public health interventions and is encouraged across all phases of the research cycle. However, limited guidelines and appropriate tools exist to facilitate stakeholder engagement-especially during the intervention prioritisation phase. We present the findings of an online 'Delphi' study that engaged stakeholders (including young people) in the process of prioritising secondary school environment-focused interventions that aim to increase physical activity...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087181/challenging-the-99th-percentile-a-lower-troponin-cutoff-leads-to-low-mortality-of-chest-pain-patients
#10
Nils Arne Sörensen, Johannes Tobias Neumann, Francisco Ojeda, Tjark Schwemer, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Rule-out of non-ST-elevation myocardial infarction is based on consecutive measurements of cardiac troponins using the 99th percentile of the respective assay as cutoff. The new ESC guidelines alternatively offer rapid 1h algorithms with lower cutoffs than the 99th percentile for rule-out of non-ST-elevation myocardial infarction. We aimed to compare a recently introduced 1h algorithm based on a high-sensitivity cardiac troponin I (hs-TnI) cutoff of 6ng/L at 0h and 1h to the current standard of care using the 99th percentile (27ng/L) as cutoff with reference to follow-up events in a large chest pain cohort...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28081064/using-national-inpatient-death-rates-as-a-benchmark-to-identify-hospitals-with-inaccurate-cause-of-death-reporting-missouri-2009-2012
#11
Jennifer Lloyd, Ehsan Jahanpour, Brian Angell, Craig Ward, Andy Hunter, Cherri Baysinger, George Turabelidze
Reporting causes of death accurately is essential to public health and hospital-based programs; however, some U.S. studies have identified substantial inaccuracies in cause of death reporting. Using CDC's national inpatient hospital death rates as a benchmark, the Missouri Department of Health and Senior Services (DHSS) analyzed inpatient death rates reported by hospitals with high inpatient death rates in St. Louis and Kansas City metro areas. Among the selected hospitals with high inpatient death rates, 45...
January 13, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28080994/global-food-and-fibre-security-threatened-by-current-inefficiencies-in-fungal-identification
#12
REVIEW
Pedro W Crous, Johannes Z Groenewald, Bernard Slippers, Michael J Wingfield
Fungal pathogens severely impact global food and fibre crop security. Fungal species that cause plant diseases have mostly been recognized based on their morphology. In general, morphological descriptions remain disconnected from crucially important knowledge such as mating types, host specificity, life cycle stages and population structures. The majority of current fungal species descriptions lack even the most basic genetic data that could address at least some of these issues. Such information is essential for accurate fungal identifications, to link critical metadata and to understand the real and potential impact of fungal pathogens on production and natural ecosystems...
December 5, 2016: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/28079708/parenteral-nutrition-in-the-critically-ill
#13
Jan Gunst, Greet Van den Berghe
PURPOSE OF REVIEW: Feeding guidelines have recommended early, full nutritional support in critically ill patients to prevent hypercatabolism and muscle weakness. Early enteral nutrition was suggested to be superior to early parenteral nutrition. When enteral nutrition fails to meet nutritional target, it was recommended to administer supplemental parenteral nutrition, albeit with a varying starting point. Sufficient amounts of amino acids were recommended, with addition of glutamine in subgroups...
January 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28079519/trends-in-antimicrobial-susceptibility-for-azithromycin-and-ceftriaxone-in-neisseria-gonorrhoeae-isolates-in-amsterdam-the-netherlands-between-2012-and-2015
#14
Carolien M Wind, Maarten F Schim van der Loeff, Alje P van Dam, Henry Jc de Vries, Jannie J van der Helm
Resistance of Neisseria gonorrhoeae to azithromycin and ceftriaxone has been increasing in the past years. This is of concern since the combination of these antimicrobials is recommended as the first-line treatment option in most guidelines. To analyse trends in antimicrobial resistance, we retrospectively selected all consultations with a positive N. gonorrhoeae culture at the sexually transmitted infection clinic, Amsterdam, the Netherlands, from January 2012 through September 2015. Minimum inhibitory concentrations (MICs) for azithromycin and ceftriaxone were analysed per year, and determinants associated with decreased susceptibility to azithromycin (MIC > 0...
January 5, 2017: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/28079345/towards-reducing-the-risk-of-new-onset-diabetes-after-pancreatitis
#15
Chirag J Jivanji, Danielle H Soo, Maxim S Petrov
Metabolic abnormalities due to acute and chronic pancreatitis are common. In particular, post-pancreatitis diabetes mellitus (PPDM) is increasingly recognised as a distinct clinical entity. However, most of research in this field is focused on unravelling the pathogenesis of PPDM whereas research frontiers are rarely extended to reducing the risk of new onset diabetes after pancreatitis (NODAP). The recent development and validation of the PERSEUS score paved the way to identifying individuals after acute pancreatitis who are at high risk of developing NODAP...
January 12, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28078723/real-world-use-effectiveness-and-safety-of-anti-viral-treatment-in-chronic-hepatitis-c-genotype-3-infection
#16
M Cornberg, J Petersen, A Schober, S Mauss, K H W Böker, R Link, R Günther, Y Serfert, H Pfeiffer-Vornkahl, M P Manns, C Sarrazin, D Hüppe, T Berg, C Niederau
BACKGROUND: Treatment of chronic hepatitis C genotype 3 (GT3) is more challenging compared with other genotypes. Since 2014, several new treatment regimens have been approved but sometimes based on limited data. AIM: To validate the use, effectiveness and safety of anti-viral treatment in chronic hepatitis C genotype 3 infection under real-word conditions. METHODS: The German Hepatitis C-Registry is a large national non-interventional real-world study for patients with chronic hepatitis C...
January 12, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28078483/theoretical-characterization-on-photoelectric-properties-of-benzothiadiazole-and-fluorene-based-small-molecule-acceptor-materials-for-the-organic-photovoltaics
#17
Mingyue Sui, Shuangbao Li, Qingqing Pan, Guangyan Sun, Yun Geng
The upper efficiency of heterojunction organic photovoltaics depends on the increased open-circuit voltage (V oc) and short-circuit current (J sc). So, a higher lowest unoccupied molecular orbital (LUMO) level is necessary for organic acceptor material to possess higher V oc and more photons absorbsorption in the solar spectrum is needed for larger J sc. In this article, we theoretically designed some small molecule acceptors (2∼5) based on fluorene (F), benzothiadiazole, and cyano group (CN) referring to the reported acceptor material 2-[{7-(9,9-di-n-propyl-9H-fluoren-2-yl)benzo[c][1,2,5]thiadiazol-4-yl}methylene]malononitrile (1), the crucial parameters affecting photoelectrical properties of compounds 2∼5 were evaluated by the density functional theory (DFT) and time dependent density functional theory (TDDFT) methods...
January 2017: Journal of Molecular Modeling
https://www.readbyqxmd.com/read/28078082/core-components-for-effective-infection-prevention-and-control-programmes-new-who-evidence-based-recommendations
#18
Julie Storr, Anthony Twyman, Walter Zingg, Nizam Damani, Claire Kilpatrick, Jacqui Reilly, Lesley Price, Matthias Egger, M Lindsay Grayson, Edward Kelley, Benedetta Allegranzi
Health care-associated infections (HAI) are a major public health problem with a significant impact on morbidity, mortality and quality of life. They represent also an important economic burden to health systems worldwide. However, a large proportion of HAI are preventable through effective infection prevention and control (IPC) measures. Improvements in IPC at the national and facility level are critical for the successful containment of antimicrobial resistance and the prevention of HAI, including outbreaks of highly transmissible diseases through high quality care within the context of universal health coverage...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28078078/radiotherapy-in-the-management-of-gist-state-of-the-art-and-new-potential-scenarios
#19
L Gatto, M Nannini, M Saponara, V Di Scioscio, G Beltramo, G P Frezza, G Ercolani, A D Pinna, A Astolfi, M Urbini, G Brandi, G Biasco, M A Pantaleo
BACKGROUND: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. The main treatment for localized gastrointestinal stromal tumors is surgical resection. Unresectable or advanced GIST are poorly responsive to conventional cytotoxic chemotherapy but the introduction of tyrosine kinase inhibitors (TKIs) marked a revolutionary step in the treatment of these patients, radically improving prognosis and clinical benefit. Historically GIST has been considered radiation-resistant, and the role of radiotherapy in the management of patients with GIST is currently restricted to symptomatic palliation in current treatment guidelines...
2017: Clinical Sarcoma Research
https://www.readbyqxmd.com/read/28077751/performance-of-health-workers-using-an-electronic-algorithm-for-the-management-of-childhood-illness-in-tanzania-a-pilot-implementation-study
#20
Clotilde Rambaud-Althaus, Amani Shao, Josephine Samaka, Ndeniria Swai, Seneca Perri, Judith Kahama-Maro, Marc Mitchell, Valérie D'Acremont, Blaise Genton
In low-resource settings, where qualified health workers (HWs) are scarce and childhood mortality high, rational antimicrobial prescription for childhood illnesses is a challenge. To assess whether smartphones running guidelines, as compared with paper support, improve consultation process and rational use of medicines for children, a pilot cluster-randomized controlled study was conducted in Tanzania. Nine primary health-care facilities (HFs) were randomized into three arms: 1) paper algorithm, 2) electronic algorithm on a smartphone, and 3) control...
January 11, 2017: American Journal of Tropical Medicine and Hygiene
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