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https://www.readbyqxmd.com/read/29349639/outcomes-in-syncope-research-a-systematic-review-and-critical-appraisal
#1
Monica Solbiati, Viviana Bozzano, Franca Barbic, Giovanni Casazza, Franca Dipaola, James V Quinn, Matthew J Reed, Robert S Sheldon, Win-Kuang Shen, Benjamin C Sun, Venkatesh Thiruganasambandamoorthy, Raffaello Furlan, Giorgio Costantino
Syncope is the common clinical manifestation of different diseases, and this makes it difficult to define what outcomes should be considered in prognostic studies. The aim of this study is to critically analyze the outcomes considered in syncope studies through systematic review and expert consensus. We performed a systematic review of the literature to identify prospective studies enrolling consecutive patients presenting to the Emergency Department with syncope, with data on the characteristics and incidence of short-term outcomes...
January 18, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29346042/treatment-of-malignant-pleural-mesothelioma-american-society-of-clinical-oncology-clinical-practice-guideline
#2
Hedy L Kindler, Nofisat Ismaila, Samuel G Armato, Raphael Bueno, Mary Hesdorffer, Thierry Jahan, Clyde Michael Jones, Markku Miettinen, Harvey Pass, Andreas Rimner, Valerie Rusch, Daniel Sterman, Anish Thomas, Raffit Hassan
Purpose To provide evidence-based recommendations to practicing physicians and others on the management of malignant pleural mesothelioma. Methods ASCO convened an Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, pathology, imaging, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1990 through 2017. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life...
January 18, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29345505/the-pharmacological-management-of-metabolic-syndrome
#3
Julie Rask Larsen, Lorena Dima, Christoph U Correll, Peter Manu
Introduction The metabolic syndrome includes a constellation of several well-established risk factors, which need to be aggressively treated in order to prevent overt type 2 diabetes and cardiovascular disease. While recent guidelines for the treatment of individual components of the metabolic syndrome focus on cardiovascular benefits as resulted from clinical trials, specific recent recommendations on the pharmacological management of metabolic syndrome are lacking. The objective of present paper was to review the therapeutic options for metabolic syndrome and its components, the available evidence related to their cardiovascular benefits, and to evaluate the extent to which they should influence the guidelines for clinical practice...
January 18, 2018: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29345234/current-approaches-to-epistaxis-treatment-in-primary-and-secondary-care
#4
Rafael Beck, Martin Sorge, Antonius Schneider, Andreas Dietz
BACKGROUND: The lifetime prevalence of epistaxis is approximately 60%, and 6-10% of the affected persons need medical care. In rare cases, severe bleeding calls for the rapid initiation of effective treatment. METHODS: This review is based on pertinent articles that were retrieved by a selective search PubMed, and on the authors' clinical experience. RESULTS: There are no German guidelines for the management of epistaxis. The available evidence consists mainly of retro spective analyses and expert opinions...
January 8, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29344451/evaluation-of-brainstorming-session-as-a-teaching-learning-tool-among-postgraduate-medical-biochemistry-students
#5
Binita Goswami, Anju Jain, Bidhan Chandra Koner
Background: The thrust for postgraduate teaching should be self-directed learning with equal participation by all students in academic discussions. Group discussions involve conduction of the discourse by a leader who guides the discussion as well as points out any wrong information. This discourages quieter students from participation with the fear of rebuke. Brainstorming is devoid of all such fallacies with no judgment and reprimand. Aim: The aim of this study was to use brainstorming as a teaching-learning tool among postgraduate students of medical biochemistry...
December 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/29343557/dicer1-and-associated-conditions-%C3%A2-identification-of-at-risk-individuals-and-recommended-surveillance-strategies
#6
Kris Ann P Schultz, Gretchen M Williams, Junne Kamihara, Douglas R Stewart, Anne K Harris, Andrew J Bauer, Joyce Turner, Rachana Shah, Katherine Schneider, Kami Wolfe Schneider, Ann Garrity Carr, Laura A Harney, Shari Baldinger, A Lindsay Frazier, Daniel Orbach, Dominik T Schneider, David Malkin, Louis P Dehner, Yoav H Messinger, Ashley Hill
Pathogenic germline DICER1 variants cause a hereditary cancer predisposition syndrome with a variety of manifestations. In addition to conferring increased cancer risks for pleuropulmonary blastoma (PPB) and ovarian sex cord-stromal tumors, particularly Sertoli-Leydig cell tumor, individuals with pathogenic germline DICER1 variants may also develop lung cysts, cystic nephroma, renal sarcoma and Wilms tumor, nodular hyperplasia of the thyroid, nasal chondromesenchymal hamartoma, ciliary body medulloepithelioma, genitourinary embryonal rhabdomyosarcoma and brain tumors including pineoblastoma and pituitary blastoma...
January 17, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29343149/interventional-bronchoscopy-in-adults
#7
Diana H Yu, David Feller-Kopman
The field of interventional pulmonology (IP) is a rapidly maturing subspecialty of pulmonary medicine, which emphasizes advanced diagnostic and therapeutic bronchoscopy for the evaluation and management of central airway obstruction, mediastinal/hilar adenopathy and lung nodules/masses, as well as minimally invasive diagnostic and therapeutic pleural procedures. Areas covered: This review describes advances in diagnostic and therapeutic bronchoscopic techniques. Expert Commentary: In the past decade, there has been a remarkable growth in available technology and equipment, as well as clinical and translational research efforts focused on patient-centered outcomes...
January 18, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29340275/timing-of-transjugular-intrahepatic-portosystemic-shunt-for-budd-chiari-syndrome-an-italian-hepatologist-s-perspective
#8
Andrea Mancuso
Budd-Chiari syndrome (BCS) management flow-chart is derived from experts' opinion and is not evidence-based. Guidelines suggest BCS management should follow a stepwise strategy: medical therapy as first-line treatment, revascularization or transjugular intrahepatic portosystemic shunt (TIPS) if no response to medical therapy, and liver transplant as rescue therapy. Recent evidence suggests that only medical therapy results in a bad long-term outcome. The biggest criticism of guidelines is the indication that BCS should receive further treatment only when hemodynamic consequences of portal hypertension become clinically evident...
December 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/29338549/sedation-in-cardiac-arrhythmias-management
#9
Federico Guerra, Giulia Stronati, Alessandro Capucci
Procedural sedation is of paramount importance for a plethora of electrophysiological procedures. From electrical cardioversion to electrophysiology studies, device implantations, and catheter ablations, intraprocedural sedation and anesthesia have a pivotal role in allowing procedural success while ensuring patient safety and avoiding discomfort. Areas covered: The present review will discuss the current state-of-the-art in sedation and anesthesia during electrical cardioversion, cardiac implantable electronic device implantation, catheter ablation and electrophysiology studies...
January 17, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29338536/p2y12-receptor-inhibitors-an-evolution-in-drug-design-to-prevent-arterial-thrombosis
#10
Danny Kupka, Dirk Sibbing
P2Y12 inhibitors are a critical component of dual antiplatelet therapy (DAPT) - a combination of a P2Y12 receptor inhibitor and aspirin - which is the superior strategy to prevent arterial thrombosis in patients with acute coronary syndromes (ACS) and undergoing stent implantation. Areas covered: Basic science articles, clinical studies, and reviews from 1992-2017 were searched using Pubmed library to collet impactful literature. After an introduction to the purinergic receptor biology, this review summarizes current knowledge on P2Y12 receptor inhibitors including their specific pharmacodynamic as well as pharmacokinetic and drug interaction features...
January 17, 2018: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29338498/from-clinical-remission-to-residual-disease-activity-in-spondyloarthritis-and-its-potential-treatment-implications
#11
Fabio Massimo Perrotta, Antonia De Socio, Silvia Scriffignano, Ennio Lubrano
Remission or low disease activity should be the target of therapy in spondyloarthritis (SpA). Due to the complexity of the disease, several composite indices that assess all disease domains were proposed to define a status of low disease activity/remission in both axial and peripheral SpA. With the introduction, in the past years, of effective biologic and targeted synthetic treatments aimed at inhibiting key cytokines and intracellular pathways, the goal of clinical remission has become an achievable target in these conditions...
January 17, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29338475/advances-in-atrioventricular-and-interventricular-optimization-of-cardiac-resynchronization-therapy-what-s-the-gold-standard
#12
Matthew K Rowe, Gerald C Kaye
Cardiac resynchronization therapy (CRT) is one of the most important advances in heart failure management in the last twenty years. Approximately one-third of patients appear not to respond to therapy. Although there are a number of possible mechanisms for non-response, an important factor is suboptimal atrioventricular (AV) and interventricular (VV) timing intervals. There remains controversy over whether routinely optimizing intervals is necessary and there is no agreed gold standard methodology. Optimization has classically been performed using echocardiography which has limits related to resource use, time-cost and variable reproducibility...
January 16, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29338456/an-update-on-the-safety-of-nutraceuticals-and-effects-on-lipid-parameters
#13
Arrigo F G Cicero, Alessandro Colletti
Cardiovascular diseases (CVDs) are the leading cause of mortality and disability in developed countries, whereas a large portion of patients in primary prevention have uncontrolled level of CVD risk factors. Dietary supplementation with bioactive natural compounds with demonstrated lipid-lowering effects is currently supported by the international guidelines for CVD prevention and some international expert panels. Areas covered: This review provides insights on issues concerning the tolerability and safety of the most commonly used nutraceuticals with demonstrated lipid-lowering effect in humans...
January 16, 2018: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29338452/an-update-on-diagnostic-and-prognostic-biomarkers-for-traumatic-brain-injury
#14
Kevin K Wang, Zhihui Yang, Tian Zhu, Yuan Shi, Richard Rubenstein, J Adrian Tyndall, Geoff T Manley
Traumatic brain injury (TBI) is a major worldwide neurological disorder of epidemic proportions. To date, there are still no FDA-approved therapies to treat any forms of TBI. Encouragingly, there are emerging data showing that biofluid-based TBI biomarker tests have the potential to diagnose the presence of TBI of different severities including concussion, and to predict outcome. Area covered: The authors provide an update on the current knowledge of TBI biomarkers, including protein biomarkers for neuronal cell body injury (UCH-L1, NSE), astroglial injury (GFAP, S100B), neuronal cell death (αII-spectrin breakdown products), axonal injury (NF proteins), white matter injury (MBP), post-injury neurodegeneration (total Tau and phospho-Tau), post-injury autoimmune response (brain antigen-targeting autoantibodies), and other emerging non-protein biomarkers...
January 17, 2018: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29338119/management-of-morning-hypertension-a-consensus-statement-of-an-asian-expert-panel
#15
REVIEW
Ji-Guang Wang, Kazuomi Kario, Chen-Huan Chen, Jeong-Bae Park, Satoshi Hoshide, Yong Huo, Hae-Young Lee, Yan Li, Masaki Mogi, Masanori Munakata, Sungha Park, Dingliang Zhu
Morning blood pressure (BP) surge is an important aspect of hypertension research. Morning BP monitoring could be a clinically relevant concept in the therapeutic management of hypertension and in the prevention of cardiovascular complications by defining and treating morning hypertension. Because antihypertensive medication is often taken in the morning, uncontrolled morning BP during the trough effect hours could be a hallmark of inadequate choice of antihypertensive regimen, such as the use of short- or intermediate-acting drugs, underdosing of drugs, or no use or underuse of combination therapy...
January 16, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29333401/management-of-immune-thrombocytopenia-korean-experts-recommendation-in-2017
#16
REVIEW
Jun Ho Jang, Ji Yoon Kim, Yeung-Chul Mun, Soo-Mee Bang, Yeon Jung Lim, Dong-Yeop Shin, Young Bae Choi, Ho-Young Yhim, Jong Wook Lee, Hoon Kook
Management options for patients with immune thrombocytopenia (ITP) have evolved substantially over the past decades. The American Society of Hematology published a treatment guideline for clinicians referring to the management of ITP in 2011. This evidence-based practice guideline for ITP enables the appropriate treatment of a larger proportion of patients and the maintenance of normal platelet counts. Korean authority operates a unified mandatory national health insurance system. Even though we have a uniform standard guideline enforced by insurance reimbursement, there are several unsolved issues in real practice in ITP treatment...
December 2017: Blood Research
https://www.readbyqxmd.com/read/29332754/conservative-management-of-thumb-carpometacarpal-osteoarthritis-an-italian-survey-of-current-clinical-practice
#17
Jorge Hugo Villafañe, Kristin Valdes, Virginia O'Brien, Monica Seves, Raquel Cantero-Téllez, Pedro Berjano
OBJECTIVE: The purpose of this study was to elucidate expert opinion on the conservative treatment of thumb carpometacarpal (CMC) joint osteoarthritis (OA). METHODS: A 21-item survey to determine the practice patterns of Italian hand therapists who treat arthritis of the CMC joint was developed and distributed through a professional online survey service to assure confidentiality and anonymity. RESULTS: Of the respondents, 80.8% were physical therapists; the remaining 19...
January 2018: Journal of Bodywork and Movement Therapies
https://www.readbyqxmd.com/read/29331946/management-of-patients-on-antithrombotic-agents-undergoing-emergency-and-elective-endoscopy-joint-asian-pacific-association-of-gastroenterology-apage-and-asian-pacific-society-for-digestive-endoscopy-apsde-practice-guidelines
#18
Francis K L Chan, Khean-Lee Goh, Nageshwar Reddy, Kazuma Fujimoto, Khek Yu Ho, Seiji Hokimoto, Young-Hoon Jeong, Takanari Kitazono, Hong Sik Lee, Varocha Mahachai, Kelvin K F Tsoi, Ming-Shiang Wu, Bryan P Yan, Kentaro Sugano
This Guideline is a joint official statement of the Asian Pacific Association of Gastroenterology (APAGE) and the Asian Pacific Society for Digestive Endoscopy (APSDE). It was developed in response to the increasing use of antithrombotic agents (antiplatelet agents and anticoagulants) in patients undergoing gastrointestinal (GI) endoscopy in Asia. After reviewing current practice guidelines in Europe and the USA, the joint committee identified unmet needs, noticed inconsistencies, raised doubts about certain recommendations and recognised significant discrepancies in clinical practice between different regions...
January 13, 2018: Gut
https://www.readbyqxmd.com/read/29331546/clinically-localized-prostate-cancer-aua-astro-suo-guideline-part-ii-recommended-approaches-and-details-of-specific-care-options
#19
Martin G Sanda, Jeffrey A Cadeddu, Erin Kirkby, Ronald C Chen, Tony Crispino, Joann Fontanarosa, Stephen J Freedland, Kirsten Greene, Laurence H Klotz, Danil V Makarov, Joel B Nelson, George Rodrigues, Howard M Sandler, Mary Ellen Taplin, Jonathan R Treadwell
PURPOSE: This guideline is structured to provide a clinical framework stratified by cancer severity to facilitate care decisions and guide the specifics of implementing the selected management options. The summary presented herein represents Part II of the two-part series dedicated to Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline discussing risk stratification and care options by cancer severity. Please refer to Part I for discussion of specific care options and outcome expectations and management...
January 10, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29331453/are-privacy-enhancing-technologies-for-genomic-data-ready-for-the-clinic-a-survey-of-medical-experts-of-the-swiss-hiv-cohort-study
#20
Jean-Louis Raisaro, Paul J McLaren, Jacques Fellay, Matthias Cavassini, Catherine Klersy, Jean-Pierre Hubaux
PURPOSE: Protecting patient privacy is a major obstacle for the implementation of genomic-based medicine. Emerging privacy-enhancing technologies can become key enablers for managing sensitive genetic data. We studied physicians' attitude toward this kind of technology in order to derive insights that might foster their future adoption for clinical care. METHODS: We conducted a questionnaire-based survey among 55 physicians of the Swiss HIV Cohort Study who tested the first implementation of a privacy-preserving model for delivering genomic test results...
January 10, 2018: Journal of Biomedical Informatics
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