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https://www.readbyqxmd.com/read/27922167/cost-effectiveness-of-primarily-surgical-versus-primarily-conservative-treatment-of-acute-and-subacute-radiculopathies-due-to-intervertebral-disc-herniation-from-the-swiss-perspective
#1
Zanfina Ademi, Viktoria Gloy, Dominik Glinz, Heike Raatz, Joris Van Stiphout, Heiner C Bucher, Matthias Schwenkglenks
AIMS OF THE STUDY: To assess the cost-effectiveness of primarily surgical treatment (PST) versus primarily conservative treatment (PCT) in adults with intermediate severity, acute or subacute, lumbar radicular syndrome due to intervertebral disc herniation. METHODS: A decision analytic model from healthcare system and societal perspectives was used to compare outcomes and costs of PST with those of PCT (physiotherapy, epidural injection and medication). Treatment pathways and quality of life were obtained from published clinical trials...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27922028/a-randomized-double-blind-placebo-controlled-trial-to-examine-the-effectiveness-of-lubiprostone-on-constipation-symptoms-and-colon-transit-time-in-diabetic-patients
#2
Jennifer Christie, Sagar Shroff, Nikrad Shahnavaz, Latoya A Carter, Melanie S Harrison, Karan A Dietz-Lindo, John Hanfelt, Shanthi Srinivasan
OBJECTIVES: Constipation is the most common GI symptom in patients with diabetes mellitus (DM). Importantly, patients with constipation have lower health-related quality of life than those without constipation. Effective therapies for constipation are limited and there is a paucity of data evaluating the treatment of constipation in diabetics. METHODS: Diabetic patients with chronic idiopathic constipation (CIC) as defined by Rome III criteria were recruited from outpatient clinics at a tertiary-care center and a Veterans Administration Hospital...
December 6, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27921379/fibroids-that-do-not-distort-the-uterine-cavity-and-ivf-success-rates-an-observational-study-using-extensive-matching-criteria
#3
G Christopoulos, A Vlismas, R Salim, R Islam, G Trew, S Lavery
OBJECTIVE: To assess the impact of non-cavity-distorting fibroids on in vitro fertilisation (IVF) pregnancy outcomes. DESIGN: A retrospective, matched, single-centre, cohort study was performed. SETTING: The IVF unit of a tertiary, university hospital. POPULATION: We analysed all women with non-cavity-distorting uterine fibroids undergoing IVF/intracytoplasmic sperm injection (ICSI) cycles from 1 January 2011 to 1 May 2015...
December 5, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27921338/melancholic-and-atypical-depression-as-predictor-and-moderator-of-outcome-in-cognitive-behavior-therapy-and-pharmacotherapy-for-adult-depression
#4
Pim Cuijpers, Erica Weitz, Femke Lamers, Brenda W Penninx, Jos Twisk, Robert J DeRubeis, Sona Dimidjian, Boadie W Dunlop, Robin B Jarrett, Zindel V Segal, Steven D Hollon
BACKGROUND: Melancholic and atypical depression are widely thought to moderate or predict outcome of pharmacological and psychological treatments of adult depression, but that has not yet been established. This study uses the data from four earlier trials comparing cognitive behavior therapy (CBT) versus antidepressant medications (ADMs; and pill placebo when available) to examine the extent to which melancholic and atypical depression moderate or predict outcome in an "individual patient data" meta-analysis...
December 6, 2016: Depression and Anxiety
https://www.readbyqxmd.com/read/27921276/relationship-between-physician-adjudicated-adverse-events-and-patient-reported-health-related-quality-of-life-in-a-phase-ii-clinical-trial-nct01143402-of-patients-with-metastatic-uveal-melanoma
#5
Thomas M Atkinson, Jennifer L Hay, Alexander Shoushtari, Yuelin Li, Daniel J Paucar, Sloane C Smith, Ragini R Kudchadkar, Austin Doyle, Jeffrey A Sosman, Jorge Fernando Quevedo, Mohammed M Milhem, Anthony M Joshua, Gerald P Linette, Thomas F Gajewski, Jose Lutzky, David H Lawson, Christopher D Lao, Patrick J Flynn, Mark R Albertini, Takami Sato, Karl Lewis, Brian Marr, David H Abramson, Mark Andrew Dickson, Gary K Schwartz, Richard D Carvajal
PURPOSE: Clinical trials commonly use physician-adjudicated adverse event (AE) assessment via the common terminology criteria for adverse events (CTCAE) for decision-making. Patient-reported health-related quality of life (HRQoL) data are becoming more frequent in oncology; however, the relationship between physician-adjudicated AE assessment and HRQoL is understudied. METHODS: Data from a phase II trial (clinicaltrials.gov identifier: NCT01143402) where patients with metastatic uveal melanoma were randomized to receive selumetinib, an oral MEK inhibitor, or chemotherapy were analyzed...
December 5, 2016: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/27920283/what-can-we-do-for-people-with-drug-resistant-epilepsy-the-2016-wartenberg-lecture
#6
Jerome Engel
Treatment goals for epilepsy are no seizures, no side effects, as soon as possible, but these goals are too often unmet. Approximately 1 million people in the United States continue to have seizures despite adequate treatment with antiseizure drugs, representing 40% of those with epilepsy, and 80% of the cost of epilepsy. Drug-resistant epilepsy (DRE) can be associated with developmental delay in infants and young children, and severe disability and morbidity in older children and adults, as well as a mortality rate 5-10 times that of the general population...
December 6, 2016: Neurology
https://www.readbyqxmd.com/read/27920153/urine-osmolality-response-to-tolvaptan-and-outcome-in-autosomal-dominant-polycystic-kidney-disease-results-from-the-tempo-3-4-trial
#7
Olivier Devuyst, Arlene B Chapman, Ron T Gansevoort, Eiji Higashihara, Ronald D Perrone, Vicente E Torres, Jaime D Blais, Wen Zhou, John Ouyang, Frank S Czerwiec
The vasopressin-cAMP-osmolality axis is abnormal in autosomal dominant polycystic kidney disease (ADPKD). In the Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease and Its Outcomes 3:4 Trial, a 3-year randomized, placebo-controlled trial in adults, the vasopressin V2 receptor antagonist tolvaptan slowed ADPKD progression in patients with preserved GFR. Here, we investigated the determinants of baseline urine osmolality (Uosm) and its value as a severity marker of ADPKD, the factors influencing the response to tolvaptan, and whether change in Uosm associated with key trial end points...
December 5, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27920089/world-endometriosis-society-consensus-on-the-classification-of-endometriosis
#8
Neil P Johnson, Lone Hummelshoj, G David Adamson, Jörg Keckstein, Hugh S Taylor, Mauricio S Abrao, Deborah Bush, Ludwig Kiesel, Rulla Tamimi, Kathy L Sharpe-Timms, Luk Rombauts, Linda C Giudice
STUDY QUESTION: What is the global consensus on the classification of endometriosis that considers the views of women with endometriosis? SUMMARY ANSWER: We have produced an international consensus statement on the classification of endometriosis through systematic appraisal of evidence and a consensus process that included representatives of national and international, medical and non-medical societies, patient organizations, and companies with an interest in endometriosis...
December 5, 2016: Human Reproduction
https://www.readbyqxmd.com/read/27919826/should-blood-pressure-goal-be-individualized-in-hypertensive-patients
#9
REVIEW
Alexandra Yannoutsos, Rania Kheder-Elfekih, Jean-Michel Halimi, Michel E Safar, Jacques Blacher
The aim of the present review is to consider the clinical relevance of individualized blood pressure (BP) goal under treatment in hypertensive patients according to their age, comorbidities or established cardiovascular (CV) disease. Evidence from large-scale randomized trials to support a lower BP goal, as initially recommended by guidelines in high-risk hypertensive patients, were lacking. Recently, the randomized intervention SPRINT trial studied two treatment targets for systolic BP (120mm Hg versus 140mm Hg in the intensive and standard treatment group, respectively) among high-risk hypertensive patients, without diabetes and without a history of prior stroke...
December 2, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27919389/older-patients-use-of-technology-for-a-post-discharge-nutritional-intervention-a-mixed-methods-feasibility-study
#10
T Lindhardt, M H Nielsen
BACKGROUND: Malnutrition is frequent in older people and a precursor for morbidity and hospitalisation; furthermore low intake and weight loss during and after hospitalisation is well-described. Such patients are often excluded from technology projects on account of lack of skills. This is a barrier for their access to many current and future health care offers. OBJECTIVES: To test the acceptability, feasibility and preliminary efficacy of technology-supported energy- and protein-enforced homedelivered meals for older patients discharged from hospital...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919285/a-randomised-patient-assessor-blinded-sham-controlled-trial-of-external-non-invasive-peripheral-nerve-stimulation-for-chronic-neuropathic-pain-following-peripheral-nerve-injury-en-pens-trial-study-protocol-for-a-randomised-controlled-trial
#11
Selina Johnson, Andreas Goebel, Roberta Richey, Emily Holmes, Dyfrig Hughes
BACKGROUND: Eight percent of people in the UK are estimated to have persistent (chronic) neuropathic pain, and for many there is no effective treatment. Medications are the most common first-line treatment but often have limited benefit or adverse events. Surgical treatments, such as spinal cord stimulation, are then often considered. External non-invasive peripheral nerve stimulation (EN-PENS) is a form of electrical stimulation that involves placing a pen-shaped electrode onto the skin, which can be easily self-administered by patients...
December 6, 2016: Trials
https://www.readbyqxmd.com/read/27919096/should-we-screen-for-vitamin-d-deficiency-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#12
Howard Libman, Alan O Malabanan, Gordon J Strewler, Eileen E Reynolds
The U.S. Preventive Services Task Force (USPSTF) recently issued guidelines on screening for vitamin D deficiency. The guidelines were based on randomized trials of vitamin D deficiency screening and treatment, as well as on case-control studies nested within the Women's Health Initiative. The USPSTF concluded that current evidence is insufficient to assess the benefits and harms of screening for vitamin D deficiency in asymptomatic adults. Compared with placebo or no treatment, vitamin D was associated with decreased mortality; however, benefits were no longer seen after trials of institutionalized persons were excluded...
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27918972/a-typical-antipsychotics-normalize-low-gamma-evoked-oscillations-in-patients-with-schizophrenia
#13
Manuel Alegre, Patricio Molero, Miguel Valencia, Guillermo Mayner, Felipe Ortuño, Julio Artieda
The symptoms of schizophrenia might be mediated by a cortical network disconnection which may disrupt the cortical oscillatory activity. Steady-state responses are an easy and consistent way to explore cortical oscillatory activity. A chirp-modulated tone (increasing the frequency of the modulation in a linear manner) allows a fast measure of the steady-state response to different modulation rates. With this approach, we studied the auditory steady-state responses in two groups of patients with schizophrenia (drug-naive and treated with atypical antipsychotic drugs), in order to assess the differences in their responses with respect to healthy subjects, and study any potential effect of medication...
November 26, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/27918931/effectiveness-of-an-educational-intervention-the-encourage-autonomous-self-enrichment-program-in-patients-with-chronic-kidney-disease-a-randomized-controlled-trial
#14
Hiroko Joboshi, Michiyo Oka
BACKGROUND: Self-management is an important step toward preventing and impeding the progression of chronic kidney disease. However, patients with chronic kidney disease may have few or no subjective symptoms and therefore might consider self-management to be unnecessary. Effective support and encouragement of self-management in patients with chronic kidney disease is therefore required. OBJECTIVES: This study tested the effectiveness of the Encourage Autonomous Self-Enrichment patient education program, which supports patient autonomy and intrinsic motivations with the aim of improving self-efficacy and sustaining self-management, on perceived self-efficacy, self-management behaviors, and physiological endpoints (blood pressure and renal function parameters) in patients with chronic kidney disease...
November 22, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27918881/a-preliminary-investigation-of-a-relapse-prevention-mobile-application-to-maintain-smoking-abstinence-among-individuals-with-posttraumatic-stress-disorder
#15
Terrell A Hicks, Shaun P Thomas, Sarah M Wilson, Patrick S Calhoun, Eric R Kuhn, Jean C Beckham
OBJECTIVES: Smokers with posttraumatic stress disorder (PTSD) have increased difficulty achieving and maintaining abstinence. Contingency management approaches to smoking cessation interventions have demonstrated short-term efficacy, but are limited by high rates of relapse. The goal of this pilot study was to evaluate the usability and feasibility of a smartphone-based smoking cessation application (Stay Quit Coach) designed to prevent relapse among individuals with PTSD. METHODS: Smokers (N = 11) were randomized to 1) QUIT4EVER, an intervention combining mobile contingency management smoking cessation counseling and medications, and Stay Quit Coach or 2) a contact control condition that was identical to QUIT4EVER except Stay Quit Coach was not included...
December 5, 2016: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/27918196/riboflavin-as-an-independent-and-accurate-biomarker-for-adherence-in-a-randomized-double-blind-and-placebo-controlled-clinical-trial
#16
V-M Sadagopa Ramanujam, Fatima Nayeem, Karl E Anderson, Yong-Fang Kuo, Nai-Wei Chen, Hyunsu Ju, Lee-Jane W Lu
BACKGROUND: Medication adherence is critical for success of clinical trials. OBJECTIVE: To assess oral riboflavin is an adherence marker. METHODS: Riboflavin was incorporated into active treatment and placebo pills for a clinical trial lasting for 2 years. RESULTS: The accuracy (area under the receiver operating curve) of urinary riboflavin was 0.91 as a binary classifier of adherence, and was similar or better than for two active study ingredients daidzein (0...
December 5, 2016: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/27917869/neurophysiological-characterization-of-attentional-performance-dysfunction-in-schizophrenia-patients-in-a-reverse-translated-task
#17
Jared W Young, Andrew W Bismark, Yinming Sun, Wendy Zhang, Meghan McIlwain, Ibrahim Grootendorst, Gregory A Light
Attentional dysfunction in schizophrenia (SZ) contributes to the functional deficits ubiquitous to the disorder. Identifying the neural substrates of translational measures of attentional dysfunction would prove invaluable for developing therapeutics. Attentional performance is typically assessed via continuous performance tasks (CPTs), though many place additional cognitive demands with little cross-species test-relevance. Herein, event related potentials (ERPs) were utilized to investigate the neurophysiological correlates of attention and response inhibition of SZ and healthy participants, while they performed the cross-species translated five-choice CPT (5C-CPT)...
December 5, 2016: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27917771/socioeconomic-and-modifiable-predictors-of-blood-pressure-control-for-hypertension-in-primary-care-attenders-in-the-western-cape-south-africa
#18
N Folb, M O Bachmann, E D Bateman, K Steyn, N S Levitt, V Timmerman, C Lombard, T A Gaziano, L R Fairall
BACKGROUND: Low socioeconomic status is associated with the risk of hypertension. There are few reports of the effect of socioeconomic and potentially modifiable factors on the control of hypertension in South Africa (SA). OBJECTIVES: To investigate associations between patients' socio-economic status and characteristics of primary healthcare facilities, and control and treatment of blood pressure in hypertensive patients. METHODS: We enrolled hypertensive patients attending 38 public sector primary care clinics in the Western Cape, SA, in 2011, and followed them up 14 months later as part of a randomised controlled trial...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27917405/efficacy-and-safety-of-3-week-response-guided-triple-direct-acting-antiviral-therapy-for-chronic-hepatitis-c-infection-a-phase-2-open-label-proof-of-concept-study
#19
George Lau, Yves Benhamou, Guofeng Chen, Jin Li, Qing Shao, Dong Ji, Fan Li, Bing Li, Jialiang Liu, Jinlin Hou, Jian Sun, Cheng Wang, Jing Chen, Vanessa Wu, April Wong, Chris L P Wong, Stella T Y Tsang, Yudong Wang, Leda Bassit, Sijia Tao, Yong Jiang, Hui-Mien Hsiao, Ruian Ke, Alan S Perelson, Raymond F Schinazi
BACKGROUND: To shorten the course of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, we examined the antiviral efficacy and safety of 3 weeks of response-guided therapy with an NS3 protease inhibitor and dual NS5A inhibitor-NS5B nucleotide analogue. METHODS: In this open-label, phase 2a, single centre study, Chinese patients with chronic HCV genotype 1b infection without cirrhosis were randomly allocated by a computer program to one of three treatment groups (sofosbuvir, ledipasvir, and asunaprevir; sofosbuvir, daclatasvir, and simeprevir; or sofosbuvir, daclatasvir, and asunaprevir) until six patients in each group (1:1:1) achieved an ultrarapid virological response (plasma HCV RNA <500 IU/mL by day 2, measured by COBAS TaqMan HCV test, version 2...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27917369/management-of-multiple-myeloma-and-usage-of-bortezomib-perspective-from-india-and-ukraine
#20
Amit Garg, Mykhaylo Morgunskyy, Yogesh Belagali, Namita Gupta, Shyam Prasad Akku
Novel treatment strategies have remarkably improved the multiple myeloma (MM) patients' survival, with associated increased costs. A joint panel meet of international experts from India and Ukraine was held in New Delhi on May 19, 2016 focusing on MM management, bortezomib role, unmet medical needs, and current challenges. The health-care system for oncology in India is majorly private vs. government-based in Ukraine. In India, electrophoresis, serum-free light chain assays, bone marrow tests, and X-rays are available modes of diagnosis...
2016: Frontiers in Oncology
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