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Evidence-base medicine

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https://www.readbyqxmd.com/read/29334498/evidence-based-interpretation-of-amyloid-%C3%AE-pet-results-a-clinician-s-tool
#1
David Bergeron, Rik Ossenkoppele, Robert Jr Laforce
BACKGROUND: Amyloid-β positron emission tomography (PET) allows for in vivo detection of fibrillar amyloid plaques, a pathologic hallmark of Alzheimer's disease (AD). However, amyloid-β PET interpretation is limited by the imperfect correlation between PET and autopsy, and the fact that it is positive in about 20% to 30% of cognitively normal individuals and non-AD dementias, especially when older or carrying the ε4 allele of apolipoprotein E (ApoE4). When facing a positive amyloid PET, clinicians have to evaluate the probability of a pathologic false positive as well as the probability of amyloid positivity being age-related, comorbid to a primary non-AD dementia (clinicopathologic false positive)...
January 12, 2018: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/29334237/safety-of-working-patterns-among-uk-neuroradiologists-what-can-we-learn-from-the-aviation-industry-and-cognitive-science
#2
John Reicher, Stuart Currie, Daniel Birchall
As the volume and complexity of imaging in the UK continues to rise, there is pressure on radiologists to spend increasing lengths of time reporting to cope with the growing workload. However, there is limited guidance for radiologists about structuring the working day to achieve the necessary balance between satisfactory reporting volume and maintaining quality and safety. We surveyed 86 Neuroradiologists (receiving 59 responses), regarding time spent reporting, frequency and duration of work breaks, and break activities...
January 15, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29333146/cystatin-c-is-indispensable-for-evaluation-of-kidney-disease
#3
Anders Grubb
The present minireview of the place of cystatin C in clinical medicine emphasizes, and discuss the evidence, that cystatin C-based GFR-estimating equations do not require the use of vague terms like race and sex, that cystatin C-based GFR-esti mating equations are useful for both children and adults, including the elderly, that the best GFR-estimation requires simultaneous use of both cystatin C- and creatinine-based equations, that cystatin C-based GFR-estimating equations are superior to creatinine-based equations in predicting end-stage renal disease, cardiovascular manifestations, hospitalisation and death, and, finally that cystatin C is required to diagnose the new syndrome "Shrunken Pore Syndrome" with its high mortality and morbidity, even in the absence of reduced GFR...
December 2017: EJIFCC
https://www.readbyqxmd.com/read/29332434/relationship-between-antimicrobial-resistance-programs-and-antibiotic-dispensing-for-upper-respiratory-tract-infection-an-analysis-of-australian-data-between-2004-and-2015
#4
Jianyun Wu, Daniel Taylor, Ludmila Ovchinikova, Aine Heaney, Tessa Morgan, Jonathan Dartnell, Rachel Holbrook, Lauren Humphreys, Lynn Weekes, Suzanne Blogg
Objective NPS MedicineWise aims to ensure that medicines are prescribed and used in a manner consistent with current evidence-based best practice. A series of nationwide educational and advertising interventions for general practitioners and consumers were implemented in Australia between 2009 and 2015 with the aim of reducing antibiotic prescriptions for upper respiratory tract infections (URTIs). The work described in this paper quantifies the change in antibiotic dispensing following these interventions...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29332025/prolegomena-to-a-true-integrative-medical-paradigm
#5
Babak Daneshfard, Mohammad Reza Sanaye, Majid Nimrouzi
When a paradigm starts to show signs of failure to cope with significant questions in any basic/applied branch of human knowledge, there come on the scene those who have perused the related literature enough to either answer those major questions according to the established paradigm or proffer a (wholly) new way of looking at things. In the latter case, the history of science tells us, a paradigm shift takes place. Modern medicine cannot be proven to be totally disconnected from its traditional roots. Where traditional medicine came to give its place to present-day conventional medicine, a number of humanistic aspects of healing, in addition to some axioms of old wisdom, were actually lost...
January 15, 2018: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/29331970/is-there-a-social-gradient-of-sarcopenia-a-meta-analysis-and-systematic-review-protocol
#6
Darci Green, Gustavo Duque, Nick Fredman, Aoun Rizvi, Sharon Lee Brennan-Olsen
INTRODUCTION: Sarcopenia (or loss of muscle mass and function) is a relatively new area within the field of musculoskeletal research and medicine. Investigating whether there is a social gradient, including occupation type and income level, of sarcopenia, as observed for other diseases, will contribute significantly to the limited evidence base for this disease. This new information may inform the prevention and management of sarcopenia and widen the evidence base to support existing and future health campaigns...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331247/a-biopsy-of-breast-cancer-mobile-applications-state-of-the-practice-review
#7
G Giunti, D H Giunta, E Guisado-Fernandez, J L Bender, L Fernandez-Luque
BACKGROUND: Breast cancer is the most common cancer in women. The use of mobile software applications for health and wellbeing promotion has grown exponentially in recent years. We systematically reviewed the breast cancer apps available in today's leading smartphone application stores and characterized them based on their features, evidence base and target audiences. METHODS: A cross-sectional study was performed to characterize breast cancer apps from the two major smartphone app stores (iOS and Android)...
February 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29331065/component-resolved-diagnostics-to-direct-in-venom-immunotherapy-important-steps-towards-precision-medicine
#8
Simon Blank, Maria Beatrice Bilò, Markus Ollert
Stings of Hymenoptera can induce IgE-mediated systemic and even fatal allergic reactions. Venom-specific immunotherapy (VIT) is the only disease-modifying and curative treatment of venom allergy. However, choosing the correct venom for VIT represents a necessary prerequisite for efficient protection against further anaphylactic sting reactions after VIT. In the past, therapeutic decisions based on the measurement of specific IgE (sIgE) levels to whole venom extracts were not always straightforward, especially when the patient was not able to identify the culprit insect...
January 13, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29331000/evaluation-of-peer-assisted-learning-in-evidence-based-medicine-course-a-pilot-study-at-university-of-glasgow
#9
Syed Hamid Habib, Muhammad Omar Malik, Sadia Fatima, Inayat Shah
BACKGROUND: Peer Assisted Learning (PAL) is a well-established approach in learning and is increasingly being utilized in the medical education system. It is a process where active help of peer group members is taken for learning. This study aimed to look at the impact of peer assisted learning on the students at the end of the session. METHODS: Sixteen Postgraduate students attending Evidence Based Medicine (EBM) course spanning over two semesters (6 months each) were recruited...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#10
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29330242/patient-perspectives-on-discussions-of-electronic-cigarettes-in-primary-care
#11
Mark P Doescher, Ming Wu, Elizabeth Rainwater, Ali S Khan, Dorothy A Rhoades
PURPOSE: Patient preferences regarding the role of the primary care provider (PCP) in discussing electronic cigarette (e-cigarette) use are unknown. METHODS: We administered a cross-sectional survey to 568 adult patients in a family medicine clinic to explore e-cigarette use, sources of information on e-cigarettes, perceived knowledge about e-cigarette health effects, views regarding PCP knowledge of e-cigarettes, interest in discussing e-cigarettes with PCPs and preferred format for e-cigarette information...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330235/primary-care-physician-perspectives-about-antipsychotics-and-other-medications-for-symptoms-of-dementia
#12
J William Kerns, Jonathan D Winter, Katherine M Winter, Terry Boyd, Rebecca S Etz
BACKGROUND: Guidelines, policies, and warnings have been applied to reduce the use of medications for behavioral and psychological symptoms of dementia (BPSD). Because of rare dangerous side effects, antipsychotics have been singled out in these efforts. However, antipsychotics are still prescribed "off label" to hundreds of thousands of seniors residing in nursing homes and communities. Our objective was to evaluate how and why primary-care physicians (PCPs) employ nonpharmacologic strategies and drugs for BPSD...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330232/interventions-must-be-realistic-to-be-useful-and-completed-in-family-medicine
#13
EDITORIAL
Marjorie A Bowman, Dean A Seehusen, Anne Victoria Neale
Being realistic while helping our patients is this issue's theme. Given the volume of tasks required in family medicine, recommendations for improvements in direct care or care measurement cannot just be evidence-based but must also be realistic. On the list of realistic: ordering antipsychotics for symptoms of dementia in the elderly, despite recommendations to not do so; ordering antidepressants without fear that the patient could develop hypertension; mental health care providers in primary care offices; forced choice for opioid management; plus agenda setting for visit efficiency...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#14
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29327681/updated-national-comprehensive-cancer-network-guidelines-for-treatment-of-head-and-neck-cancers-2010-2017
#15
Małgorzata Wierzbicka, Joanna Napierała
INTRODUCTION: The diagnostic and therapeutic recommendations have been changing over the years to improve treatment outcomes and quality of life of Head and Neck Cancer (HNC) patients. AIM: The aim of this study was to present currently recommended Head and Neck Cancer treatment guidelines based on the literature review with particular emphasis on novel approaches the NCCN algorithms. MATERIAL AND METHODS: The review of literature covering articles published in the last five years and pointing out essential changes in HNC treatment regarding evidence based medicine...
December 30, 2017: Otolaryngologia Polska
https://www.readbyqxmd.com/read/29325731/pharmacogenomic-testing-in-child-and-adolescent-psychiatry-an-evidence-based-review
#16
Anna M Wehry, Laura Ramsey, Shane E Dulemba, Sarah A Mossman, Jeffrey R Strawn
Significant advances have been made in the application of pharmacogenomic testing for the treatment of patients with psychiatric disorders. Over the past decade, a number of studies have evaluated the utility of pharmacogenomic testing in pediatric patients with psychiatric disorders. The evidence base for pharmacogenomic testing in youth with depressive and anxiety disorders as well as attention/deficit hyperactivity disorder (ADHD) is reviewed in this article. General pharmacogenomic principles are summarized and functional polymorphisms in P450 enzymes (and associated metabolizer phenotypes), the serotonin transporter promoter polymorphisms, serotonin 2 A receptor genes (e...
January 8, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29325555/the-readiness-of-hospital-pharmacists-in-kuwait-to-practise-evidence-based-medicine-a-cross-sectional-study
#17
Ali Jasem Buabbas, Fatemah Mohammad Alsaleh, Hamza Mohamad Al-Shawaf, Ali Abdullah, Abdullah Almajran
BACKGROUND: The evolving role of pharmacists in providing pharmaceutical care, as part of the healthcare team, challenges them to acquire up-to-date knowledge of medicines to make the best clinical decisions. The volume of medical literature is on the increase, and it is important to utilise these resources to optimise patients' therapeutic outcomes. This study aimed at assessing the readiness of government hospital pharmacists in practising evidence-based medicine (EBM) in Kuwait in regards to their attitude, knowledge and skills, as well as the perceived barriers and facilitators...
January 11, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29325349/-introduction-and-interpretation-of-guidelines-on-thromboprophylaxis-in-the-perioperative-period-of-urological-surgery
#18
X Wang, Z Y Liu
Venous thromboembolism had drawn great attention of global experts, as it is the third leading cause of cardiovascular-associated death, ranking after coronary heart disease and stroke. Numerous health care organizations had introduced guidelines for thromboprophylaxis during the perioperative period in their own fields. The paper reviewed the available guidelines pertaining to urological surgery from America Urological Association, American College of Chest Physicians and European Association of Urology. Compared with the first two guidelines, the European Association of Urology guideline is a milestone which recommended the most detailed prophylactic measures for the procedure-specific and patient-specific according to the evidence-based medicine...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29324546/applying-precision-medicine-to-ovarian-cancer-proof-of-principle-for-a-molecular-second-look
#19
Melissa Schwartz, Olga Camacho-Vanegas, Ashley M Wood, Matthew Dashkoff, Courtney Whitelock, Timothy T Harkins, Carmel J Cohen, Ann Marie Beddoe, Peter Dottino, John A Martignetti
OBJECTIVES: The objectives of this study were to assess if targeted investigation for tumor-specific mutations by ultradeep DNA sequencing of peritoneal washes of ovarian cancer patients after primary surgical debulking and chemotherapy, and clinically diagnosed as disease free, provides a more sensitive and specific method to assess actual treatment response and tailor future therapy and to compare this "molecular second look" with conventional cytology and histopathology-based findings...
January 10, 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29324063/granulomatous-lung-inflammation-is-nanoparticle-type-dependent
#20
Yves Pacheco, Marine Ponchon, Serge Lebecque, Alain Calender, Jean François Bernaudin, Dominique Valeyre, Marc Iglarz, Daniel S Strasser, Rolf Studer, Diego Freti, Toufiq Renno, Abederrazzaq Bentaher
BACKGROUND: Nanoparticles are increasingly suspected as a strong etiologic factor of granuloma formation. AIM OF THE STUDY: The aim of our study was to compare lung inflammatory response and histology changes following exposure of mice to two widely used nanoparticles: carbon nanotubes (MWCNT) and cadmium-based nanoparticles (QDOT705) in an attempt to better our understanding of granulomatous inflammation. MATERIALS AND METHODS: Various groups of mice were included: control mice and mice that were intranasally instilled with QDOT or MWCNT...
January 11, 2018: Experimental Lung Research
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