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https://www.readbyqxmd.com/read/28550759/venous-thromboembolism-in-the-elderly-a-narrative-review
#1
REVIEW
T Tritschler, D Aujesky
Persons aged ≥65years not only account for over 60% of venous thromboembolism (VTE) events, they have also a higher mortality and VTE-related morbidity than younger patients, including anticoagulation-related bleeding and the postthrombotic syndrome. However, only few studies have focused specifically on VTE in older persons and practice guidelines commonly extrapolate study results from younger healthier patients to the multimorbid elderly. Evidence suggests that the clinical presentation is more subtle in the elderly with VTE and that commonly used diagnostic modalities, including clinical prediction rules, D-dimer tests, and planar ventilation-perfusion scans are less specific and efficient in older persons...
May 17, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28550660/achieving-smoking-cessation-in-individuals-with-schizophrenia-special-considerations
#2
REVIEW
Corinne Cather, Gladys N Pachas, Kristina M Cieslak, A Eden Evins
Premature mortality due to cardiovascular disease in those with schizophrenia is the largest lifespan disparity in the US and is growing; adults in the US with schizophrenia die, on average, 28 years earlier than those in the general population. The rate of smoking prevalence among individuals with schizophrenia is estimated to be from 64 to 79%. Smokers with schizophrenia have historically been excluded from most large nicotine-dependence treatment studies. However, converging evidence indicates that a majority of smokers with schizophrenia want to quit smoking, and that available pharmacotherapeutic smoking cessation aids are well tolerated by this population of smokers and are effective when combined with behavioral treatment...
May 26, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28550608/shifting-paradigms-in-the-medical-management-of-type-2-diabetes-reflections-on-recent-cardiovascular-outcome-trials
#3
Faramarz Ismail-Beigi, Etie Moghissi, Mikhail Kosiborod, Silvio E Inzucchi
An important challenge in the management of patients with type 2 diabetes is cardiovascular disease (CVD) prevention. While it is well established that intensive glycemic control prevents the onset and slows the progression of certain microvascular complications, such a strategy utilized in multiple clinical trials over the past few decades has failed to show a similar benefit with regard to cardiovascular events, including mortality. Despite this, a major hope has been the discovery of glucose-lowering medications that simultaneously improve cardiovascular outcomes...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28550480/characteristics-associated-with-quality-of-life-among-people-with-drug-resistant-epilepsy
#4
Leone Ridsdale, Gabriella Wojewodka, Emily Robinson, Sabine Landau, Adam Noble, Stephanie Taylor, Mark Richardson, Gus Baker, Laura H Goldstein
Quality of Life (QoL) is the preferred outcome in non-pharmacological trials, but there is little UK population evidence of QoL in epilepsy. In advance of evaluating an epilepsy self-management course we aimed to describe, among UK participants, what clinical and psycho-social characteristics are associated with QoL. We recruited 404 adults attending specialist clinics, with at least two seizures in the prior year and measured their self-reported seizure frequency, co-morbidity, psychological distress, social characteristics, including self-mastery and stigma, and epilepsy-specific QoL (QOLIE-31-P)...
May 26, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28550403/healthcare-utilization-and-costs-in-ards-survivors-a-1-year-longitudinal-national-us-multicenter-study
#5
A Parker Ruhl, Minxuan Huang, Elizabeth Colantuoni, Taruja Karmarkar, Victor D Dinglas, Ramona O Hopkins, Dale M Needham
PURPOSE: To evaluate (1) post-discharge healthcare utilization and estimated costs in ARDS survivors, and (2) the association between patient and intensive care-related variables, and 6-month patient status, with subsequent hospitalization and costs. METHODS: Longitudinal cohort study enrolling from four ARDSNet trials in 44 US hospitals. Healthcare utilization was collected via structured interviews at 6 and 12 months post-ARDS, and hospital costs estimated via the Medical Expenditure Panel Survey...
May 26, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28550023/the-super-study-protocol-for-a-randomised-controlled-trial-comparing-follicle-stimulating-hormone-and-clomiphene-citrate-for-ovarian-stimulation-in-intrauterine-insemination
#6
N A Danhof, M van Wely, Cam Koks, J Gianotten, J P de Bruin, B J Cohlen, D P van der Ham, N F Klijn, Mha van Hooff, Fjm Broekmans, K Fleischer, Cah Janssen, J M Rijn van Weert, J van Disseldorp, M Twisk, M Traas, Mfg Verberg, M J Pelinck, J Visser, Dam Perquin, DES Boks, H R Verhoeve, C F van Heteren, Bwj Mol, S Repping, F van der Veen, M H Mochtar
OBJECTIVE: To study the effectiveness of four cycles of intrauterine insemination (IUI) with ovarian stimulation (OS) by follicle-stimulating hormone (FSH) or by clomiphene citrate (CC), and adherence to strict cancellation criteria. SETTING: Randomised controlled trial among 22 secondary and tertiary fertility clinics in the Netherlands. PARTICIPANTS: 732 women from couples diagnosed with unexplained or mild male subfertility and an unfavourable prognosis according to the model of Hunault of natural conception...
May 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/28550021/effects-of-continuous-positive-airway-pressure-on-neurocognitive-architecture-and-function-in-patients-with-obstructive-sleep-apnoea-study-protocol-for-a-multicentre-randomised-controlled-trial
#7
Huajun Xu, Hui Wang, Jian Guan, Hongliang Yi, Yingjun Qian, Jianyin Zou, Yunyan Xia, Yiqun Fu, Xinyi Li, Xiao Jiao, Hengye Huang, Pin Dong, Ziwei Yu, Jun Yang, Mingliang Xiang, Jiping Li, Yanqing Chen, Peihua Wang, Yizhou Sun, Yuehua Li, Xiaojian Zheng, Wei Jia, Shankai Yin
OBJECTIVES: Many clinical studies have indicated that obstructive sleep apnoea (OSA), the most common chronic sleep disorder, may affect neurocognitive function, and that treatment for continuous positive airway pressure (CPAP) has some neurocognitive protective effects against the adverse effects of OSA. However, the effects of CPAP treatment on neurocognitive architecture and function remain unclear. Therefore, this multicentre trial was designed to investigate whether and when neurocognitive architecture and function in patients with OSA can be improved by CPAP treatment and to explore the role of gut microbiota in improving neurocognitive function during treatment...
May 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/28549819/rivaroxaban-for-stroke-prevention-in-patients-with-nonvalvular-atrial-fibrillation-and-active-cancer
#8
Eva S Laube, Anthony Yu, Dipti Gupta, Yimei Miao, Patrick Samedy, Jonathan Wills, Stephen Harnicar, Gerald A Soff, Simon Mantha
Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the general population with nonvalvular atrial fibrillation (AF). However, there is little published evidence on the safety and efficacy of rivaroxaban for AF in patients with active cancer. The aim of this study was to assess the safety and efficacy of rivaroxaban in patients with active cancer and AF. The use of rivaroxaban in patients with cancer at the Memorial Sloan Kettering Cancer Center is monitored in the setting of a Quality Assessment Initiative...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28549592/economic-outcomes-of-pharmacist-physician-medication-therapy-management-for-polypharmacy-elderly-a-prospective-randomized-controlled-trial
#9
Hsiang-Wen Lin, Chih-Hsueh Lin, Chin-Kai Chang, Che-Yi Chou, I-Wen Yu, Cheng-Chieh Lin, Tsai-Chung Li, Chia-Ing Li, Yow-Wen Hsieh
BACKGROUND/PURPOSE: With an increasing geriatric population, the need for effective management of chronic conditions and medication use in the elderly is growing. Medication use in the elderly presents significant challenges due to changes in pharmacodynamic and pharmacokinetic profiles. We aimed to examine the impact of a collaborative physician-pharmacist medication therapy management (MTM) program for polypharmacy elderly patients. METHODS: Elderly patients with multiple chronic conditions on polypharmacy were enrolled in this prospective, randomized, and controlled study over 16 months of implementation...
May 23, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28549480/improving-the-appropriateness-of-antipsychotic-prescribing-in-nursing-homes-a-mixed-methods-process-evaluation-of-an-academic-detailing-intervention
#10
L Desveaux, M Saragosa, J Rogers, L Bevan, H Loshak, A Moser, S Feldman, L Regier, L Jeffs, N M Ivers
BACKGROUND: In 2014, nursing home administration and government officials were facing increasing public and media scrutiny around the variation of antipsychotic medication (APM) prescribing across Ontario nursing homes. In response, policy makers partnered to test an academic detailing (AD) intervention to address appropriate prescribing of APM in nursing homes in a cluster-randomized trial. This mixed-methods study aimed to explore how and why the AD intervention may have resulted in changes in the nursing home context...
May 26, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28549471/the-shared-health-appointments-and-reciprocal-enhanced-support-shares-study-study-protocol-for-a-randomized-trial
#11
Michele Heisler, Jennifer Burgess, Jeffrey Cass, John F Chardos, Alexander B Guirguis, Sean M Jeffery, Lorrie A Strohecker, Adam S Tremblay, Wen-Chih Wu, Donna M Zulman
BACKGROUND: Diabetes shared medical appointments (SMAs) and reciprocal peer support programs have been found in efficacy trials to help adults with diabetes improve their self-management and achieve short-term gains in clinical and patient-centered outcomes. In order to translate this evidence to system-level interventions, there is a need for large-scale, pragmatic trials that examine the effectiveness, implementation, and costs of SMAs and reciprocal peer support across diverse settings...
May 26, 2017: Trials
https://www.readbyqxmd.com/read/28549455/inter-act-prevention-of-pregnancy-complications-through-an-e-health-driven-interpregnancy-lifestyle-intervention-study-protocol-of-a-multicentre-randomised-controlled-trial
#12
Annick Bogaerts, Lieveke Ameye, Margriet Bijlholt, Kelly Amuli, Dorine Heynickx, Roland Devlieger
BACKGROUND: Excessive maternal pre-pregnancy and gestational weight gain are related to pregnancy- and birth outcomes. The interpregnancy time window offers a unique opportunity to intervene in order to acquire a healthy lifestyle before the start of a new pregnancy. METHODS: INTER-ACT is an e-health driven multicentre randomised controlled intervention trial targeting women at high risk of pregnancy- and birth related complications. Eligible women are recruited for the study at day 2 or 3 postpartum...
May 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28549402/indications-for-medical-compression-stockings-in-venous-and-lymphatic-disorders-an-evidence-based-consensus-statement
#13
Eberhard Rabe, Hugo Partsch, Juerg Hafner, Christopher Lattimer, Giovanni Mosti, Martino Neumann, Tomasz Urbanek, Monika Huebner, Sylvain Gaillard, Patrick Carpentier
Objective Medical compression stockings are a standard, non-invasive treatment option for all venous and lymphatic diseases. The aim of this consensus document is to provide up-to-date recommendations and evidence grading on the indications for treatment, based on evidence accumulated during the past decade, under the auspices of the International Compression Club. Methods A systematic literature review was conducted and, using PRISMA guidelines, 51 relevant publications were selected for an evidence-based analysis of an initial 2407 unrefined results...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28549048/disposable-versus-reusable-absorbent-underpads-for-prevention-of-hospital-acquired-incontinence-associated-dermatitis-and-pressure-injuries
#14
Kathleen Francis, Sau Man Pang, Brenda Cohen, Helene Salter, Peter Homel
PURPOSE: The primary purpose of our study was to determine if there is a difference in the occurrence of hospital-acquired pressure injuries (HAPIs) and incontinence-associated dermatitis (IAD) in incontinent adults using a disposable versus reusable absorptive underpads. We also compared hospital length of stay in the 2 groups. DESIGN: Randomized controlled trial using cluster randomization based on inpatient care unit. SUBJECTS AND SETTING: Four hundred sixty-two patients admitted to 4 medical-surgical study units participated in the study; 252 used reusable underpads (control group) and 210 subjects used disposable underpads (intervention group)...
May 25, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28548648/electronic-retinal-implants-and-artificial-vision-journey-and-present
#15
REVIEW
J O Mills, A Jalil, P E Stanga
Retinitis pigmentosa and age-related macular degeneration are two significant causes of severe visual dysfunction. In both, the retinal photoreceptors degenerate, preventing successful conversion of light into electrical energy that is interpreted in the visual cortex as visual function. Artificial vision or visual function began over two centuries ago with the idea of creating artificial light pulses, or phosphenes, through cortical stimulation. The pursuit is now on to improve artificial visual function. Two retinal implants appear the most likely to succeed in the future having undergone multicentre human trials: the Argus II electronic epiretinal device (Second Sight Medical Products, CA, USA) and Alpha-IMS electronic subretinal device (Retina Implant AG, Germany)...
May 26, 2017: Eye
https://www.readbyqxmd.com/read/28548196/-declaration-of-the-chilean-academy-of-medicine-of-law-20-850-%C3%A2-on-clinical-trials-of-pharmaceutical-products-and-medical-devices%C3%A2-and-of-the-bylaw-that-will-regulate-its-application
#16
Gloria López S, Gloria Valdés S, Emilio Roessler B, Vicente Valdivieso D
In Chile, high cost treatments required by selected medical conditions are financed by the State, according to Law 20.850. A bylaw under discussion by the Senate regulates clinical trials, posing complex issues that will endanger local interest in front-line research: 1. The exclusive and mandatory control bestowed to the Institute of Public Health during all stages of the trials and also the surveillance of institutions performing clinical trials, overriding their Clinical Research Review Boards; 2.The 10 year period during which any adverse event is assumed to have been caused by the medication or devise evaluated by the trial, unless the contrary is proven in a judicial process; 3...
March 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28547736/rice-bran-metabolome-contains-amino-acids-vitamins-cofactors-and-phytochemicals-with-medicinal-and-nutritional-properties
#17
Iman Zarei, Dustin G Brown, Nora Jean Nealon, Elizabeth P Ryan
BACKGROUND: Rice bran is a functional food that has shown protection against major chronic diseases (e.g. obesity, diabetes, cardiovascular disease and cancer) in animals and humans, and these health effects have been associated with the presence of bioactive phytochemicals. Food metabolomics uses multiple chromatography and mass spectrometry platforms to detect and identify a diverse range of small molecules with high sensitivity and precision, and has not been completed for rice bran...
December 2017: Rice
https://www.readbyqxmd.com/read/28547318/a-systematic-review-of-alpha-2-agonists-for-sedation-in-mechanically-ventilated-neurocritical-care-patients
#18
Alexandre Tran, Henrietta Blinder, Brian Hutton, Shane W English
The use of sedative medications is commonplace in intensive care units (ICUs) and an invaluable clinical tool for the intensive care physician. Sedation for critically ill, mechanically ventilated patients provides an opportunity to reduce anxiety, discomfort as well as ventilator intolerance and dyssynchrony. Alpha-2 agonists in particular have become increasingly popular for use in the neurocritical care population due to their proposed effectiveness in facilitating examinations and procedures as well as reducing the need for adjunctive agents...
May 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28546931/quality-of-life-in-glaucoma-patients-after-selective-laser-trabeculoplasty
#19
Myrjam De Keyser, Maya De Belder, Veva De Groot
AIM: To compare quality of life and treatment satisfaction between patients who had selective laser trabeculoplasty (SLT) and those on medication. METHODS: A prospective clinical trial on 143 glaucoma patients that received SLT and a control group that continued using anti glaucoma medication was conducted. Tear break-up time (BUT), punctuate keratitis, need for help, use of artificial tears and the treatment satisfaction survey of intraocular pressure (IOP) were measured at baseline, 6 and 12mo...
2017: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/28546877/amino-acid-medical-foods-provide-a-high-dietary-acid-load-and-increase-urinary-excretion-of-renal-net-acid-calcium-and-magnesium-compared-with-glycomacropeptide-medical-foods-in-phenylketonuria
#20
Bridget M Stroup, Emily A Sawin, Sangita G Murali, Neil Binkley, Karen E Hansen, Denise M Ney
Background. Skeletal fragility is a complication of phenylketonuria (PKU). A diet containing amino acids compared with glycomacropeptide reduces bone size and strength in mice. Objective. We tested the hypothesis that amino acid medical foods (AA-MF) provide a high dietary acid load, subsequently increasing urinary excretion of renal net acid, calcium, and magnesium, compared to glycomacropeptide medical foods (GMP-MF). Design. In a crossover design, 8 participants with PKU (16-35 y) provided food records and 24-hr urine samples after consuming a low-Phe diet in combination with AA-MF and GMP-MF for 1-3 wks...
2017: Journal of Nutrition and Metabolism
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