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https://www.readbyqxmd.com/read/28938795/lipid-lowering-nutraceuticals-in-clinical-practice-position-paper-from-an-international-lipid-expert-panel
#1
Arrigo F G Cicero, Alessandro Colletti, Gani Bajraktari, Olivier Descamps, Dragan M Djuric, Marat Ezhov, Zlatko Fras, Niki Katsiki, Michel Langlois, Gustavs Latkovskis, Demosthenes B Panagiotakos, Gyorgy Paragh, Dimitri P Mikhailidis, Olena Mitchenko, Bernhard Paulweber, Daniel Pella, Christos Pitsavos, Željko Reiner, Kausik K Ray, Manfredi Rizzo, Amirhossein Sahebkar, Maria-Corina Serban, Laurence S Sperling, Peter P Toth, Dragos Vinereanu, Michal Vrablík, Nathan D Wong, Maciej Banach
In recent years, there has been growing interest in the possible use of nutraceuticals to improve and optimize dyslipidemia control and therapy. Based on the data from available studies, nutraceuticals might help patients obtain theraputic lipid goals and reduce cardiovascular residual risk. Some nutraceuticals have essential lipid-lowering properties confirmed in studies; some might also have possible positive effects on nonlipid cardiovascular risk factors and have been shown to improve early markers of vascular health such as endothelial function and pulse wave velocity...
September 1, 2017: Nutrition Reviews
https://www.readbyqxmd.com/read/28938289/discussing-benefits-and-risks-of-tracheostomy-what-physicians-actually-say
#2
Lauren M Hebert, Anne C Watson, Vanessa Madrigal, Tessie W October
OBJECTIVES: When contemplating tracheostomy placement in a pediatric patient, a family-physician conference is often the setting for the disclosure of risks and benefits of the procedure. Our objective was to compare benefits and risks of tracheostomy presented during family-physician conferences to an expert panel's recommendations for what should be presented. DESIGN: We conducted a retrospective review of 19 transcripts of audio-recorded family-physician conferences regarding tracheostomy placement in children...
September 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28936819/-the-scope-quality-and-safety-requirements-of-drug-abuse-testing
#3
Tuncay Küme, Çiğdem Karakükcü, Aslı Pınar, Hakan Coşkunol
The aim of this review is to inform about the scopes and requirements of drug abuse testing. Drug abuse testing is one of the tools for determination of drug use. It must fulfill the quality and safety requirements in judgmental legal and administrative decisions. Drug abuse testing must fulfill some requirements like selection of the appropriate test matrix, appropriate screening test panel, sampling in detection window, patient consent, identification of the donor, appropriate collection site, sample collection with observation, identification and control of the sample, specimen custody chain in preanalytical phase; analysis in authorized laboratories, specimen validity tests, reliable testing METHODS, strict quality control, two-step analysis in analytical phase; storage of the split specimen, confirmation of the split specimen in the objection, result custody chain, appropriate cut-off concentration, the appropriate interpretation of the result in postanalytical phase...
2017: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/28923535/creation-of-a-novel-digital-rectal-examination-evaluation-instrument-to-teach-and-assess-prostate-examination-proficiency
#4
Matthew B Clements, Karen M Schmidt, Steven E Canfield, Scott M Gilbert, Shiv R Khandelwal, Bridget F Koontz, Costas D Lallas, Stanley Liauw, Paul L Nguyen, Timothy N Showalter, Edouard J Trabulsi, Helen P Cathro, Noah S Schenkman, Tracey L Krupski
OBJECTIVE: To create a validated tool to measure digital rectal examination proficiency and aid with teaching of the examination. DESIGN: The Digital Rectal Examination Clinical Tool was created using a modified Delphi method with 5 urologists and 5 radiation oncologists. The instrument was then validated in a population of preclinical medical students examining male urological teaching associates, and clinical trainees (third- and fourth-year medical students and urology resident physicians) examining prospectively enrolled subjects...
September 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28922270/decision-making-in-pediatric-transport-team-dispatch-using-script-concordance-testing
#5
Prakadeshwari Rajapreyar, Karen Marcdante, Liyun Zhang, Pippa Simpson, Michael T Meyer
OBJECTIVES: Our objective was to compare decision-making in dispatching pediatric transport teams by Medical Directors of pediatric transport teams (serving as experts) to that of Pediatric Intensivists and Critical Care fellows who often serve as Medical Control physicians. Understanding decision-making around team composition and dispatch could impact clinical management, cost effectiveness, and educational needs. DESIGN: Survey was developed using Script Concordance Testing guidelines...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28911072/oncologist-use-and-perception-of-large-panel-next-generation-tumor-sequencing
#6
A M Schram, D Reales, J Galle, R Cambria, R Durany, D Feldman, E Sherman, J Rosenberg, G D'Andrea, S Baxi, Y Janjigian, W Tap, M Dickler, J Baselga, B S Taylor, D Chakravarty, J Gao, N Schultz, D B Solit, M F Berger, D M Hyman
Background: Genomic profiling is increasingly incorporated into oncology research and the clinical care of cancer patients. We sought to determine physician perception and use of enterprise-scale clinical sequencing at our center, including whether testing changed management and the reasoning behind this decision-making. Patients and methods: All physicians who consented patients to MSK-IMPACT, a next-generation hybridization capture assay, in tumor types where molecular profiling is not routinely performed were asked to complete a questionnaire for each patient...
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28895642/initiation-of-basal-insulin-analog-treatment-for-type-2-diabetes-and-reasons-behind-patients-treatment-persistence-behavior-real-world-data-from-germany
#7
Elisabeth Moennig, Magaly Perez-Nieves, Irene Hadjiyianni, Dachuang Cao, Jasmina Ivanova, Ralf Klask
Background Poor treatment persistence can affect the real-world effectiveness of insulin therapy. A cross-sectional online survey in 942 patients with type 2 diabetes from 7 different countries evaluated patient experience when initiating basal insulin and the reasons behind insulin persistence patterns. Here, we report the quantitative results for the subset of patients from Germany. Methods Adults with type 2 diabetes who had initiated basal insulin during the last 3-24 months, identified from market-research panels, participated in the survey...
September 11, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28893689/management-of-kpc-producing-klebsiella-pneumoniae-infections
#8
REVIEW
M Bassetti, D R Giacobbe, H Giamarellou, C Viscoli, G L Daikos, G Dimopoulos, F G De Rosa, E J Giamarellos-Bourboulis, G M Rossolini, E Righi, I Karaiskos, M Tumbarello, D P Nicolau, P L Viale, G Poulakou
BACKGROUND: Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-KP) has become one of the most important contemporary pathogens, especially in endemic areas. AIMS: our aim was to provide practical suggestion for physicians dealing with the management of KPC-KP infections in critically ill patients, based on expert opinions. SOURCES: PubMed search for relevant publications related to the management of KPC-KP infections. CONTENTS: a panel of experts developed a list of 12 questions to be addressed...
September 9, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28888853/monitoring-guidance-for-patients-with-hypophosphatasia-treated-with-asfotase-alfa
#9
REVIEW
Priya S Kishnani, Eric T Rush, Paul Arundel, Nick Bishop, Kathryn Dahir, William Fraser, Paul Harmatz, Agnès Linglart, Craig F Munns, Mark E Nunes, Howard M Saal, Lothar Seefried, Keiichi Ozono
Hypophosphatasia (HPP) is a rare, inherited, systemic, metabolic disorder caused by autosomal recessive mutations or a single dominant-negative mutation in the gene encoding tissue-nonspecific alkaline phosphatase (TNSALP). The disease is associated with a broad range of signs, symptoms, and complications, including impaired skeletal mineralization, altered calcium and phosphate metabolism, recurrent fractures, pain, respiratory problems, impaired growth and mobility, premature tooth loss, developmental delay, and seizures...
July 25, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28887347/pharmacists-supporting-population-health-in-patient-centered-medical-homes
#10
Antoinette B Coe, Hae Mi Choe
PURPOSE: The integral role of pharmacists in supporting population health initiatives in the patient-centered medical home (PCMH) model of care is described. SUMMARY: Population health initiatives focus on the health outcomes of a group of patients; in the PCMH model, such groups of patients, known as panels, may be defined as patients assigned to a care team or provider. The basic characteristics of the PCMH model include physician-led, team-based practice; coordinated and integrated care within the PCMH and in the patient's community; provision of safe, evidence-based, high-quality care; incorporation of health information technology and continuous quality improvement strategies into panel identification, documentation, and care processes; improved access to care (e...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28886811/assessing-genetic-expression-profiles-in-melanoma-prognosis
#11
REVIEW
Aaron S Farberg, Alex M Glazer, Richard R Winkelmann, Darrell S Rigel
A 31-genetic expression profile (31-GEP) test (DecisionDx-Melanoma, Castle Biosciences Inc, Friendswood, TX, USA) was developed as a diagnostic test to assist physicians in the management of cutaneous malignant melanoma. Based on a patient's primary tumor expression levels of a panel of genes (28 discriminating genes and 3 control genes), a lesion is classified as "low risk" (class 1) or "high risk" (class 2) for metastasis. Studies evaluating the clinical utility and impact of the 31-GEP test showed it positively influenced clinical management and patient care, as clinicians incorporated the additional data to modify their clinical recommendations in a risk-appropriate manner...
October 2017: Dermatologic Clinics
https://www.readbyqxmd.com/read/28886193/estimating-the-incidence-of-interstitial-lung-diseases-in-the-cree-of-eeyou-istchee-northern-qu%C3%A3-bec
#12
Matthieu Storme, Alexandre Semionov, Deborah Assayag, Michael Lefson, Darlene Kitty, David Dannenbaum, Jill Torrie, Pierre Lejeune, Elizabeth Robinson, Faiz Ahmad Khan
BACKGROUND: Little is known about the epidemiology of interstitial lung disease (ILD) amongst Canada's Indigenous populations. Clinicians working in Eeyou Istchee (the Cree territory of the James Bay region of Québec, population 17, 956) suspected that ILD was more common in this area. We sought to identify all prevalent and incident cases of ILD in Eeyou Istchee between 2006 and 2013, to describe characteristics of affected patients, distribution of subtypes, and estimate disease incidence...
2017: PloS One
https://www.readbyqxmd.com/read/28876188/the-impact-of-insurance-gain-and-discussions-with-healthcare-providers-on-quitting-smoking
#13
Clare Brown, Feifei Wei
Tobacco use is the leading preventable cause of death in the United States. Analyzing the ability for different mechanisms to reduce smoking rates can provide healthcare systems with information to establish the most effective smoking cessation efforts. Health insurance provides individuals with direct mechanisms to curb smoking behavior, such as access to smoking cessation resources. Gaining insurance may additionally indirectly influence smoking cessation by altering risk perceptions. Behavioral economic theory suggests that gaining health insurance may reduce current smokers' rate of discounting on the future, which could increase smoking cessation...
September 6, 2017: Behavioral Medicine
https://www.readbyqxmd.com/read/28871586/using-a-cd45dim-cd123bright-hla-drneg-phenotyping-protocol-to-gate-basophils-in-fc-for-airway-allergy-cd123-does-not-decrease
#14
Salvatore Chirumbolo, Geir Bjorklund, Antonio Vella
Physicians in the field of respiratory medicine are particularly concerned about the availability of a reliable diagnostic tool to investigate respiratory allergy. Usually, basophils are easy to obtain from peripheral blood and therefore they represent a reproducible model to assess allergy in individuals. Cell assays called basophil activation tests (BATs) are widespread tools for allergy diagnosis and are easily available in most of the medical labs. The strategy by which basophils are captured in a flow cytometry protocol has met many suggestions, recommendations and experimental novelties in recent years, yet the debate needs to be further expanded...
2017: Advances in Respiratory Medicine
https://www.readbyqxmd.com/read/28864058/barriers-to-insulin-initiation-in-elderly-patients-with-type-2-diabetes-mellitus-in-brazil
#15
Freddy G Eliaschewitz, Mauricio A de Paula, Hermelinda C Pedrosa, Antônio Carlos Pires, João Eduardo N Salles, Marcos Antônio Tambascia, Luiz Alberto A Turatti
AIMS: We aimed to explore insulin initiation barriers in the Brazilian Type 2 Diabetes Mellitus (T2DM) elderly population, according to the physician's perspective, and suggest strategies to overcome them. METHODS: A 45-questions survey addressing issues as clinical characteristics, barriers to insulinization, and treatment strategies in elderly patients with T2DM, was sent to six endocrinologists from different Brazilian locations. Thereafter, all the respondents participated in a panel discussion to validate their responses and collect additional relevant data...
August 25, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28860269/diagnostic-accuracy-of-a-clinical-diagnosis-of-idiopathic-pulmonary-fibrosis-an-international-case-cohort-study
#16
Simon L F Walsh, Toby M Maher, Martin Kolb, Venerino Poletti, Richard Nusser, Luca Richeldi, Carlo Vancheri, Margaret L Wilsher, Katerina M Antoniou, Jüergen Behr, Elisabeth Bendstrup, Kevin Brown, Lucio Calandriello, Tamera J Corte, Vincent Cottin, Bruno Crestani, Kevin Flaherty, Ian Glaspole, Jan Grutters, Yoshikazu Inoue, Maria Kokosi, Yasuhiro Kondoh, Vasileios Kouranos, Michael Kreuter, Kerri Johannson, Eoin Judge, Brett Ley, George Margaritopoulos, Fernando J Martinez, Maria Molina-Molina, António Morais, Hilario Nunes, Ganesh Raghu, Christopher J Ryerson, Moises Selman, Paolo Spagnolo, Hiroyuki Taniguchi, Sara Tomassetti, Dominique Valeyre, Marlies Wijsenbeek, Wim Wuyts, David Hansell, Athol Wells
We conducted an international study of idiopathic pulmonary fibrosis (IPF) diagnosis among a large group of physicians and compared their diagnostic performance to a panel of IPF experts.A total of 1141 respiratory physicians and 34 IPF experts participated. Participants evaluated 60 cases of interstitial lung disease (ILD) without interdisciplinary consultation. Diagnostic agreement was measured using the weighted kappa coefficient (κw). Prognostic discrimination between IPF and other ILDs was used to validate diagnostic accuracy for first-choice diagnoses of IPF and were compared using the C-index...
August 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28854226/socioeconomic-position-and-health-services-use-in-germany-and-spain-during-the-great-recession
#17
Lourdes Lostao, Siegfried Geyer, Romana Albaladejo, Almudena Moreno-Lostao, Juana M Santos, Enrique Regidor
OBJECTIVE: The relationship of socioeconomic position with the use of health services may have changed with the emergence of the economic crisis. This study shows that relationship before and during the economic crisis, in Germany and in Spain. METHODS: Data from the 2006 and 2011 Socio-Economic Panel carried out in Germany, and from the 2006 and 2011 National Health Surveys carried out in Spain were used. The health services investigated were physician consultations and hospitalization...
2017: PloS One
https://www.readbyqxmd.com/read/28854079/identification-of-patients-with-statin-intolerance-in-a-managed-care-plan-a-comparison-of-2-claims-based-algorithms
#18
Brandon K Bellows, Amy M Sainski-Nguyen, Cody J Olsen, Susan H Boklage, Scott Charland, Matthew P Mitchell, Diana I Brixner
BACKGROUND: While statins are safe and efficacious, some patients may experience statin intolerance or treatment-limiting adverse events. Identifying patients with statin intolerance may allow optimal management of cardiovascular event risk through other strategies. Recently, an administrative claims data (ACD) algorithm was developed to identify patients with statin intolerance and validated against electronic medical records. However, how this algorithm compared with perceptions of statin intolerance by integrated delivery networks remains largely unknown...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28853115/effects-of-mandatory-screening-labs-in-directing-the-disposition-of-the-apparently-healthy-psychiatric-patient-in-the-emergency-department
#19
Karyn E Kagel, Meghan Smith, Ilya V Latyshenko, Christopher Mitchell, Andrew Kagel
OBJECTIVE: To determine whether mandatory psychiatric admission laboratory tests yield results that change the disposition of a patient with primary psychiatric complaint from admission to a psychiatric service to admission to a medical service. METHODS: This was a single center retrospective cohort chart review study approved by the facility Institutional Review Board in which we used a records database maintained by the emergency department's social workers to access the records of every patient that presented to our emergency department with a psychiatric chief complaint between the dates of December 1, 2011, and December 1, 2013...
July 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/28845476/opioid-prescription-drug-use-and-expenditures-in-us-outpatient-physician-offices-evidence-from-two-nationally-representative-surveys
#20
Zaina P Qureshi, M Rifat Haider, Rosa Rodriguez-Monguio, Nikki R Wooten, Ruslan V Nikitin, Sarah Ball, Kelly Barth, Ronit Elk, Ronnie Horner, Charles Bennett
BACKGROUND: Opioids are widely prescribed for their analgesic properties. Chronic opioid use is a persistent problem in the US. Nevertheless, little is known about its prescribing and utilization patterns and overall expenditures. OBJECTIVE: This study examined secular trends in opioid prescription drug utilization and expenditures, along with factors associated with opioid prescription drug use in US physician offices. METHODS: National Ambulatory Medical Care Survey (NAMCS) and Medical Expenditure Panel Survey (MEPS) data (2006-2010), both nationally representative surveys, were used to assess the trend, predictors of opioid prescription among US adults (more than 18 years) and the opioid-associated expenditures as a whole and borne by the patients in outpatient settings...
2017: Cancer Ther Oncol Int J
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