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https://www.readbyqxmd.com/read/28646558/neurology-concepts-young-women-and-ischemic-stroke-evaluation-and-management-in-the-emergency-department
#1
Bernard P Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen
OBJECTIVE: Ischemic stroke is a leading cause of morbidity and mortality worldwide. While the incidence of ischemic stroke is highest in older populations, incidence of ischemic stroke in adults has been rising particularly rapidly among young (e.g. premenopausal) women. The evaluation and timely diagnosis of ischemic stroke in young women presents a challenging situation in the emergency department, due to a range of sex-specific risk factors and to broad differentials. The goals of this concepts paper are to summarize existing knowledge regarding the evaluation and management of young women with ischemic stroke in the acute setting...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28645968/development-of-a-meta-algorithm-for-guiding-primary-care-encounters-for-patients-with-multimorbidity-using-evidence-based-and-case-based-guideline-development-methodology
#2
Cathleen Muche-Borowski, Dagmar Lühmann, Ingmar Schäfer, Rebekka Mundt, Hans-Otto Wagner, Martin Scherer
OBJECTIVE: The study aimed to develop a comprehensive algorithm (meta-algorithm) for primary care encounters of patients with multimorbidity. We used a novel, case-based and evidence-based procedure to overcome methodological difficulties in guideline development for patients with complex care needs. STUDY DESIGN: Systematic guideline development methodology including systematic evidence retrieval (guideline synopses), expert opinions and informal and formal consensus procedures...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645463/etiologies-of-chronic-cough-in-pediatric-cohorts-chest-guideline-and-expert-panel-report
#3
Anne B Chang, John J Oppenheimer, Miles Weinberger, Cameron C Grant, Bruce K Rubin, Richard S Irwin
BACKGROUND: In children (aged ≤14-years) there is no published systematic review on the etiologies of chronic cough or, the relationship between obstructive sleep apnea (OSA) and chronic cough. We thus undertook systematic reviews based on key questions (KQs) using the PICO format. The KQs were: Among children with chronic (>4 weeks) cough: (1) are the common etiologies different from adults? (2) are the common etiologies age and/or setting dependent? and; (3) is obstructive sleep apnea (OSA) an etiology of chronic cough in children? METHODS: We used the CHEST expert cough panel's protocol and the American College of Chest Physicians (CHEST) methodological guidelines and GRADE framework...
June 20, 2017: Chest
https://www.readbyqxmd.com/read/28632283/the-impact-of-whole-genome-sequencing-on-the-primary-care-and-outcomes-of-healthy-adult-patients-a-pilot-randomized-trial
#4
Jason L Vassy, Kurt D Christensen, Erica F Schonman, Carrie L Blout, Jill O Robinson, Joel B Krier, Pamela M Diamond, Matthew Lebo, Kalotina Machini, Danielle R Azzariti, Dmitry Dukhovny, David W Bates, Calum A MacRae, Michael F Murray, Heidi L Rehm, Amy L McGuire, Robert C Green
Background: Whole-genome sequencing (WGS) in asymptomatic adults might prevent disease but increase health care use without clinical value. Objective: To describe the effect on clinical care and outcomes of adding WGS to standardized family history assessment in primary care. Design: Pilot randomized trial. (ClinicalTrials.gov: NCT01736566). Setting: Academic primary care practices. Participants: 9 primary care physicians (PCPs) and 100 generally healthy patients recruited at ages 40 to 65 years...
June 27, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28626510/multispecialty-rating-of-evidence-based-conditions-for-intravenous-immunoglobulin-therapy-using-a-3-axis-prioritization-algorithm
#5
Jordan S Orange, Matt Johnson, Barb Lennert, Katarzyna Shields, Michael Eaddy
BACKGROUND: A 3-axis prioritization algorithm was proposed and was evaluated in a US multispecialist pilot study to obtain uniform consensus regarding effective practices for the use of intravenous immunoglobulin (IVIG) therapy. OBJECTIVE: The primary objective was to use consensus-building methodologies to rate disease states for IVIG utilization while considering disease severity and the efficacy of alternative therapeutic options to IVIG from the perspective of US multispecialists...
May 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28625839/surveillance-of-upper-respiratory-infections-by-using-newly-multiplex-pcr-assay-compared-to-conventional-methods-during-influenza-season-in-taiwan
#6
Shu-Chun Chiu, Yung-Cheng Lin, Hsiao-Chi Wang, Jen-Jen Hsu, Ting-Kai Yeh, Hsin-Fu Liu, Jih-Hui Lin
OBJECTIVES: To improve the diagnosis of laboratory surveillance, we conducted influenza-like illness (ILI) surveillance by using newly multiplex PCR Assay (FilmArray) compared to conventional methods during winter period in Taiwan. METHODS: Throat swabs from ILI patients presenting to physicians in sentinel practices were collected during 2016-2017 influenza season. RESULTS: A total of 52 samples were tested positive by FilmArray-Respiratory Panel, 40% of them were influenza A virus, subtype H3N2 viruses were the major epidemic strains...
June 15, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28625701/one-needle-one-syringe-only-one-time-a-survey-of-physician-and-nurse-knowledge-attitudes-and-practices-around-injection-safety
#7
Rachel A Kossover-Smith, Katelyn Coutts, Kelly M Hatfield, Ronda Cochran, Hana Akselrod, Melissa K Schaefer, Joseph F Perz, Katherine Bruss
BACKGROUND: To inform development, targeting, and penetration of materials from a national injection safety campaign, an evaluation was conducted to assess provider knowledge, attitudes, and practices related to unsafe injection practices. METHODS: A panel of physicians (n = 370) and nurses (n = 320) were recruited from 8 states to complete an online survey. Questions, using 5-point Likert and Spector scales, addressed acceptability and frequency of unsafe practices (eg, reuse of a syringe on >1 patient)...
June 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28620302/adoption-of-biosimilar-infliximab-for-rheumatoid-arthritis-ankylosing-spondylitis-and-inflammatory-bowel-diseases-in-the-eu5-a-budget-impact-analysis-using-a-delphi-panel
#8
Tim A Kanters, Jelena Stevanovic, Isabelle Huys, Arnold G Vulto, Steven Simoens
Introduction: Introducing biosimilar infliximab for the treatment in rheumatology (rheumatoid arthritis and ankylosing spondylitis) and inflammatory bowel disease (Crohn's disease and ulcerative colitis) may reduce treatment costs associated with biologics. This study aimed to investigate the budget impact of adopting biosimilar infliximab in five European countries, considering that the budget impact includes the adoption of biosimilar infliximab and the availability of biologic alternatives such as vedolizumab, biosimilar etanercept, biosimilar rituximab, and other relevant factors...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28619551/evidence-based-recommendations-for-the-management-of-acne-fulminans-and-its-variants
#9
Tanya Greywal, Andrea L Zaenglein, Hilary E Baldwin, Neal Bhatia, Karen A Chernoff, James Q Del Rosso, Lawrence F Eichenfield, Marc H Levin, James J Leyden, Diane M Thiboutot, Guy F Webster, Sheila Fallon Friedlander
BACKGROUND: Acne fulminans (AF) is a severe variant of inflammatory acne. It typically manifests as an explosive worsening and ulceration of skin lesions, and can be associated with systemic symptoms. However, there is a paucity of evidence-based information and no clear guidelines concerning the classification and treatment of AF. OBJECTIVE: To better define the spectrum of AF and its variants, devise optimal therapeutic approaches, and identify areas of future research...
July 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28617781/-the-italian-immunization-plan-2017-analysis-and-starting-point-for-the-regional-plans
#10
Viviana Santoro, Luca Morucci, Marco Ciabattini, Gian Loreto D'Alò, Maurizio D'Ercole, Rosaria Gallo, Roberto Mastrosanti, Alessio Russomanno, Elisa Terracciano, Laura Zaratti, Elisabetta Franco
The National Immunization Plan 2017-2019 has been approved on January 2017. This official document contains the new Italian guidelines to improve vaccination coverage in the country. We conducted an accurate and critical analysis of the document, highlighting its key points and critical issues, in order to offer an practical tool for writing the Regional Plans. The new immunization schedule and the establishment of a restricted panel for the vaccine vigilance are the most significant innovations of the Plan...
March 2017: Igiene e Sanità Pubblica
https://www.readbyqxmd.com/read/28614100/acuity-prediction-using-emergency-medical-services-prenotifications-in-a-pediatric-emergency-department
#11
Kristy Williamson, Robert Gochman, Francesca Bullaro, Bradley Kaufman, William Krief
OBJECTIVES: Emergency medical services (EMS) prenotifications are critical, although they oftentimes inaccurately convey the arriving patient's true acuity, resulting in inappropriate preparation in the emergency department. The objectives of this study were (1) to determine interrater reliability of acuity prediction based on prenotifications among physicians and (2) to compare predicted versus actual patient acuity based on prenotifications. METHODS: A panel of physicians reviewed recordings of EMS prenotifications and then predicted the patient's acuity using the Emergency Severity Index (ESI)...
June 13, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28608183/acc-aats-aha-ase-asnc-scai-scct-sts-2017-appropriate-use-criteria-for-coronary-revascularization-in-patients-with-stable-ischemic-heart-disease-a-report-of-the-american-college-of-cardiology-appropriate-use-criteria-task-force-american-association-for-thoracic
#12
Manesh R Patel, John H Calhoon, Gregory J Dehmer, James Aaron Grantham, Thomas M Maddox, David J Maron, Peter K Smith
The American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and American Association for Thoracic Surgery, along with key specialty and subspecialty societies, have completed a 2-part revision of the appropriate use criteria (AUC) for coronary revascularization. In prior coronary revascularization AUC documents, indications for revascularization in acute coronary syndromes and stable ischemic heart disease (SIHD) were combined into 1 document. To address the expanding clinical indications for coronary revascularization, and to align the subject matter with the most current American College of Cardiology/American Heart Association guidelines, the new AUC for coronary artery revascularization were separated into 2 documents addressing SIHD and acute coronary syndromes individually...
June 12, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28606101/international-physician-survey-on-management-of-fop-a-modified-delphi-study
#13
Maja Di Rocco, Genevieve Baujat, Marta Bertamino, Matthew Brown, Carmen L De Cunto, Patricia L R Delai, Elisabeth M W Eekhoff, Nobuhiko Haga, Edward Hsiao, Richard Keen, Rolf Morhart, Robert J Pignolo, Frederick S Kaplan
Fibrodysplasia ossificans progressiva (FOP), a disabling disorder of progressive heterotopic ossification (HEO), is caused by heterozygous gain-of- function mutations in Activin receptor A, type I (ACVR1, also known as ALK2), a bone morphogenetic protein (BMP) type I receptor. Presently, symptomatic management is possible, but no definitive treatments are available. Although extensive guidelines for symptomatic management are widely used, regional preferences exist. In order to understand if there was worldwide consensus among clinicians treating FOP patients, an expert panel of physicians directly involved in FOP patient care was convened...
June 12, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28605678/trends-in-utilization-of-smoking-cessation-agents-before-and-after-the-passage-of-fda-boxed-warning-in-the-united-states
#14
Drishti Shah, Anuj Shah, Xi Tan, Usha Sambamoorthi
BACKGROUND: In 2009, the FDA required a black box warning (BBW) on bupropion and varenicline, the two commonly prescribed smoking cessation agents due to reports of adverse neuropsychiatric events. We investigated if there was a decline in use of bupropion and varenicline after the BBW by comparing the percent using these medications before and after BBW. METHODS: We conducted a retrospective observational study using data from the Medical Expenditure Panel Survey from 2007 to 2014...
May 18, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28602277/development-and-validation-of-an-asthma-first-aid-knowledge-questionnaire
#15
Kate Luckie, Tsz Chun Pang, Vicky Kritikos, Bandana Saini, Rebekah Jane Moles
BACKGROUND: There is no gold standard outcome assessment for asthma first-aid knowledge. We therefore aimed to develop and validate an asthma first-aid knowledge questionnaire (AFAKQ) to be used before and after educational interventions. METHODS: The AFAKQ was developed based on a content analysis of existing asthma knowledge questionnaires and current asthma management guidelines. Content and face validity was performed by a review panel consisting of expert respiratory physicians, researchers and parents of school aged children...
May 29, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28602101/expert-panel-on-practice-patterns-in-the-management-of-cow-s-milk-protein-allergy-and-associated-economic-burden-of-disease-on-health-service-in-turkey
#16
Bulent Enis Sekerel, Oznur Seyhun
AIMS: To evaluate practice patterns in the management of cow's milk protein allergy (CMPA) and associated economic burden of disease on health service in Turkey. MATERIALS AND METHODS: This study was based on experts' views on the practice patterns in management of CMPA manifesting with either proctocolitis or eczema symptoms and, thereby, aimed to estimate economic burden of CMPA. Practice patterns were determined via patient flow charts developed by experts using the modified Delphi method for CMPA presented with proctocolitis and eczema...
June 22, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28597725/physicians-voices-what-skills-and-supports-are-needed-for-effective-practice-in-an-integrated-delivery-system-a-case-study-of-kaiser-permanente
#17
Benjamin Chesluk, Laura Tollen, Joy Lewis, Samantha DuPont, Marc H Klau
Payers are demanding that US health care become more accountable and integrated, posing new demands for physicians and the organizations that partner with them. We conducted focus groups with 30 physicians in a large integrated delivery system who had previous experience practicing in less integrated settings and asked about skills they need to succeed in this environment. Physicians identified 3 primary skills: orienting to teams and systems, engaging patients as individuals and as a panel, and integrating cost awareness into practice...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28597467/development-of-indicators-for-evaluating-the-appropriate-use-of-triazoles-for-invasive-fungal-disease-a-delphi-panel-survey
#18
W H Dong, G Z Zhang, J X Li, Y Wang, T T Wang, Y L Dong
WHAT IS KNOWN AND OBJECTIVES: Triazoles including fluconazole, itraconazole, voriconazole and posaconazole are now widely used, whereas in some countries, they are reportedly used in inappropriate way frequently; thus, it is clearly a matter of urgency to regulate the use of triazole drugs. Several studies have made good attempts to evaluate antifungal use, but they did not cover the entire medication process. This study aimed to establish indicators for the appropriate use of triazoles for invasive fungal disease, so as to produce a reference for evaluating and standardizing the rational application of triazole antifungals...
June 8, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28582986/reaching-national-consensus-on-the-core-clinical-skill-outcomes-for-family-medicine-postgraduate-training-programmes-in-south-africa
#19
Yusuf Akoojee, Robert Mash
BACKGROUND: Family physicians play a significant role in the district health system and need to be equipped with a broad range of clinical skills in order to meet the needs and expectations of the communities they serve. A previous study in 2007 reached national consensus on the clinical skills that should be taught in postgraduate family medicine training prior to the introduction of the new speciality. Since then, family physicians have been trained, employed and have gained experience of working in the district health services...
May 26, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28582338/management-of-patients-with-orthopaedic-implants-undergoing-dental-procedures
#20
Robert H Quinn, Jayson N Murray, Ryan Pezold, Kaitlyn S Sevarino
The American Academy of Orthopaedic Surgeons, in collaboration with the American Dental Association, has developed Appropriate Use Criteria (AUC) for the Management of Patients with Orthopaedic Implants Undergoing Dental Procedures. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Management of Patients with Orthopaedic Implants Undergoing Dental Procedures AUC clinical patient scenarios were derived from indications of patients with orthopaedic implants presenting for dental procedures, as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the use of prophylactic antibiotics...
June 2, 2017: Journal of the American Academy of Orthopaedic Surgeons
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