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https://www.readbyqxmd.com/read/28431202/pharmacological-interventions-for-acute-pancreatitis
#1
REVIEW
Elisabetta Moggia, Rahul Koti, Ajay P Belgaumkar, Federico Fazio, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: In people with acute pancreatitis, it is unclear what the role should be for medical treatment as an addition to supportive care such as fluid and electrolyte balance and organ support in people with organ failure. OBJECTIVES: To assess the effects of different pharmacological interventions in people with acute pancreatitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 9), MEDLINE, Embase, Science Citation Index Expanded, and trial registers to October 2016 to identify randomised controlled trials (RCTs)...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28428892/a-comparison-of-earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-compared-to-standard-care-rehab-study-protocol-for-a-single-site-randomised-controlled-feasibility-trial
#2
Catherine Snelson, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, David Thickett, Emma Reeves, Aisling McLaughlin, Lauren Cooper, David McWilliams
BACKGROUND: Mortality from critical illness is improving, but survivors suffer from prolonged weakness and psychological and cognitive impairments. Maximising the recovery after critical illness has been highlighted as a research priority, especially in relation to an ageing population who present with higher rates of pre-morbid disability. Small studies have shown that starting rehabilitation early within the intensive care unit (ICU) improves short-term outcomes. Systematic reviews have highlighted the need for robust multicentre randomised controlled trials with longer term follow-up...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28427734/comparison-of-outcomes-and-prognosis-of-patients-with-versus-without-newly-diagnosed-diabetes-mellitus-after-primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction-the-horizons-ami-study
#3
Konstanze Ertelt, Sorin J Brener, Roxana Mehran, Ori Ben-Yehuda, Thomas McAndrew, Gregg W Stone
A history of diabetes mellitus (DM) is an independent predictor for adverse events in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. Outcomes of patients with STEMI and newly diagnosed DM (NDM) are less well described. We used the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial database to identify the outcomes at 30 days and 3 years according to no, known, and NDM in patients with STEMI...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28420661/person-centred-transition-programme-to-empower-adolescents-with-congenital-heart-disease-in-the-transition-to-adulthood-a-study-protocol-for-a-hybrid-randomised-controlled-trial-stepstones-project
#4
Mariela Acuña Mora, Carina Sparud-Lundin, Ewa-Lena Bratt, Philip Moons
INTRODUCTION: When a young person grows up, they evolve from an independent child to an empowered adult. If an individual has a chronic condition, this additional burden may hamper adequate development and independence. Transition programmes for young persons with chronic disorders aim to provide the necessary skills for self-management and participation in care. However, strong evidence on the effects of these interventions is lacking. Therefore, as part of the STEPSTONES project (Swedish Transition Effects Project Supporting Teenagers with chrONic mEdical conditionS), we propose a trial to assess the effectiveness of a structured, person-centred transition programme to empower adolescents with congenital heart disease in the transition to adulthood...
April 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28419735/hospital-use-in-aboriginal-and-non-aboriginal-patients-with-chronic-disease
#5
David Whyatt, Matthew Yap, Raji Tenneti, Glenn Pearson, Alistair Vickery
OBJECTIVE: The objective of this study was to compare rates of hospital utilisation in Aboriginal and non-Aboriginal peoples before and after hospital admission for chronic obstructive pulmonary disease, heart failure and/or type 2 diabetes mellitus. METHODS: This was a longitudinal cohort study from 2002 to 2014, which was conducted in all hospitals in Western Australia. The participants of this study were Aboriginal and non-Aboriginal patients with a principal diagnosis of heart failure, type 2 diabetes or chronic obstructive pulmonary disease, on admission to hospital, where such an event had not occurred in the previous 3 years...
April 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28419017/the-evaluation-of-trauma-care-the-comparison-of-2-high-level-pediatric-emergency-departments-in-the-united-states-and-turkey
#6
Alkan Bal, Michael Cooper, Amanda Lee, Murat Anil, Halim Hennes
OBJECTIVE: The purpose of the study is to compare the outcomes of pediatric trauma patients with motor vehicle crashes (MVCs) and motor vehicle versus pedestrian crashes (MPCs) at a level 1 pediatric trauma center in the United States and a pediatric trauma center in Turkey. METHODS: The medical records of all pediatric MVC and MPC subjects presenting to the emergency departments (EDs) of a level 3 hospital in Turkey (Izmir Tepecik Training and Research Hospital [ITTRH]) and a level 1 pediatric trauma center in the United States (Children's Medical Center Dallas [CMCD]) over a 1-year period were reviewed...
April 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28417463/pharmacological-interventions-for-primary-sclerosing-cholangitis-an-attempted-network-meta-analysis
#7
REVIEW
Francesca Saffioti, Kurinchi Selvan Gurusamy, Neil Hawkins, Clare D Toon, Emmanuel Tsochatzis, Brian R Davidson, Douglas Thorburn
BACKGROUND: Primary sclerosing cholangitis is a chronic cholestatic liver disease that is associated with both hepatobiliary and colorectal malignancies, which can result in liver cirrhosis and its complications. The optimal pharmacological treatment for patients with primary sclerosing cholangitis remains controversial. OBJECTIVES: To assess the comparative benefits and harms of different pharmacological interventions in people with primary sclerosing cholangitis by performing a network meta-analysis, and to generate rankings of available pharmacological interventions according to their safety and efficacy...
March 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28417456/interventions-to-improve-adherence-to-inhaled-steroids-for-asthma
#8
REVIEW
Rebecca Normansell, Kayleigh M Kew, Elizabeth Stovold
BACKGROUND: Despite its proven efficacy in improving symptoms and reducing exacerbations, many patients with asthma are not fully adherent to their steroid inhaler. Suboptimal adherence leads to poorer clinical outcomes and increased health service utilisation, and has been identified as a contributing factor to a third of asthma deaths in the UK. Reasons for non-adherence vary, and a variety of interventions have been proposed to help people improve treatment adherence. OBJECTIVES: To assess the efficacy and safety of interventions intended to improve adherence to inhaled corticosteroids among people with asthma...
April 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28415162/value-of-doppler-evaluation-of-physically-abnormal-fistula-hemodynamic-guidelines-and-access-outcomes
#9
Seong Cho, Yu-Ji Lee, Sung-Rok Kim
Background/Aims: The strategy of access care at out center involves the use of ultrasound (USG) in case of physical examination (PE) abnormality. USG determines the need of angiography. This study investigated the possible association between the need for percutaneous transluminal angioplasty (PTA) and hemodynamic parameters of USG. The study also assessed the effects of this monitoring strategy on outcomes in comparison with a historical control. Methods: A retrospective study of the medical records of 127 patients (65 PTA, 62 non-PTA) was conducted...
April 18, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28413515/outcome-of-out-of-hospital-cardiac-arrest-after-fibrinolysis-with-reteplase-in-comparison-to-the-return-of-spontaneous-circulation-after-cardiac-arrest-score-in-a-geographic-region-without-emergency-coronary-intervention
#10
Thomas Luiz, Alexander Wilhelms, Christian Madler, Gregor Pollach, Bernd Haaff, Joachim Grüttner, Tim Viergutz
Coronary occlusion and pulmonary embolism are responsible for the majority of cases of out-of-hospital cardiac arrest (OHCA). Despite previous favourable results of pre-hospital fibrinolysis in cases of OHCA, the benefit could not be confirmed in a large controlled study using the fibrinolytic tenecteplase. For reteplase (r-PA), there are hardly any data regarding pre-hospital fibrinolysis during ongoing resuscitation. The present study reported results using r-PA therapy in a German physician-supported Emergency Medical Services system...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28413117/structure-specific-movement-patterns-in-patients-with-chronic-low-back-dysfunction-using-lumbar-combined-movement-examination
#11
Aubrey P Monie, Roger I Price, Christopher R P Lind, Kevin P Singer
OBJECTIVE: A test-retest cohort study was conducted to assess the use of a novel computer-aided, combined movement examination (CME) to measure change in low back movement after pain management intervention in 17 cases of lumbar spondylosis. Additionally we desired to use a CME normal reference range (NRR) to compare and contrast movement patterns identified from 3 specific structural pathologic conditions: intervertebral disc, facet joint, and nerve root compression. METHODS: Computer-aided CME was used before and after intervention, in a cohort study design, to record lumbar range of movement along with pain, disability, and health self-report questionnaires in 17 participants who received image-guided facet, epidural, and/or rhizotomy intervention...
April 13, 2017: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/28411696/first-10-month-results-of-the-vascular-quality-initiative-varicose-vein-registry
#12
Andrea T Obi, Danielle C Sutzko, Jose I Almeida, Lowell Kabnick, Jack L Cronenwett, Nicholas H Osborne, Brajesh K Lal, Thomas W Wakefield
OBJECTIVE: The Vascular Quality Initiative Varicose Vein Registry (VQI VVR) represents a new Patient Safety Organization database launched in January 2015 as a collaborative effort between the American Venous Forum and the Society for Vascular Surgery. This study was undertaken to identify real-world trends among treatment choices and outcomes of varicose vein patients. METHODS: Registry data prospectively captured anatomic, procedural, and outcome data for patients with C2 or more severe disease undergoing intervention for venous varicosities from January to November 2015...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28411029/clinical-and-economic-impact-of-a-multisciplinary-intervention-to-reduce-bleeding-risk-in-patients-with-acute-coronary-syndrome
#13
Ana de Lorenzo-Pinto, Ana Herranz-Alonso, Begoña Cuéllar-Basterrechea, José María Bellón-Cano, María Sanjurjo-Sáez, Héctor Bueno
INTRODUCTION AND OBJECTIVES: To evaluate the clinical and economic impact of a multidisciplinary program to reduce bleeding events in patients with acute coronary syndrome through optimization of antithrombotic therapy. METHODS: We designed a preintervention (PRE) and postintervention (POST) quasi-experimental study using a retrospective analysis of 2 cohorts. The first cohort was analyzed to detect correctable measures contributing to bleeding (PRE). Afterward, a quality improvement intervention with a bundle of recommendations was implemented...
April 11, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28410792/accuracy-of-pecarn-catch-and-chalice-head-injury-decision-rules-in-children-a-prospective-cohort-study
#14
Franz E Babl, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, Mary McCaskill, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Mark D Lyttle, Silvia Bressan, Susan Donath, Charlotte Molesworth, Kim Jachno, Brenton Ward, Amanda Williams, Amy Baylis, Louise Crowe, Ed Oakley, Stuart R Dalziel
BACKGROUND: Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. METHODS: In this prospective observational study, we included children and adolescents (aged <18 years) with head injuries of any severity who presented to the emergency departments of ten Australian and New Zealand hospitals. We assessed the diagnostic accuracy of PECARN (stratified into children aged <2 years and ≥2 years), CATCH, and CHALICE in predicting each rule-specific outcome measure (clinically important traumatic brain injury [TBI], need for neurological intervention, and clinically significant intracranial injury, respectively)...
April 11, 2017: Lancet
https://www.readbyqxmd.com/read/28409870/comparative-efficacy-and-safety-of-anti-platelet-agents-in-cerebral-ischemic-disease-a-network-meta-analysis
#15
Da Wa, Pa Zhu, Ziwen Long
We performed this network meta-analysis (NMA) to enhance the corresponding evidence of the relative efficacy and safety of different anti-platelet agents in cerebral ischemic disease. PubMed and EMBASE were searched systematically for relevant studies. Outcomes were compared using odds ratios (ORs) and 95% credible intervals (CrI). Each agent was ranked according to the value of surface under the cumulative ranking curve (SUCRA). Publication bias was evaluated by funnel plots while consistency between direct and indirect comparison was analyzed by node splitting and heat plots...
April 14, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28406488/making-genomic-medicine-evidence-based-and-patient-centered-a-structured-review-and-landscape-analysis-of-comparative-effectiveness-research
#16
REVIEW
Kathryn A Phillips, Patricia A Deverka, Harold C Sox, Muin J Khoury, Lewis G Sandy, Geoffrey S Ginsburg, Sean R Tunis, Lori A Orlando, Michael P Douglas
Comparative effectiveness research (CER) in genomic medicine (GM) measures the clinical utility of using genomic information to guide clinical care in comparison to appropriate alternatives. We summarized findings of high-quality systematic reviews that compared the analytic and clinical validity and clinical utility of GM tests. We focused on clinical utility findings to summarize CER-derived evidence about GM and identify evidence gaps and future research needs. We abstracted key elements of study design, GM interventions, results, and study quality ratings from 21 systematic reviews published in 2010 through 2015...
April 13, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28405343/role-of-depression-in-diabetes-management-in-an-ethnic-minority-population-a-case-of-korean-americans-with-type-2-diabetes
#17
Miyong To Kim, Kim Byeng Kim, Jisook Ko, Yuri Jang, David Levine, Hochang Benjamin Lee
BACKGROUND: Comorbid depression and diabetes mellitus (DM) compound challenges to disease management such as low health literacy, insufficient access to care, and social or linguistic isolation. Korean Americans (KAs), predominantly first-generation immigrants, suffer from a high prevalence of type 2 DM and depression. Limited research on KAs has prevented the development of effective interventions. OBJECTIVES: To compare the prevalence of depression in KAs with DM and all Americans with/without DM, and to explore correlates of comorbid DM and depression and strategies to address KAs' DM and depression...
2017: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/28404647/randomised-comparison-of-needle-aspiration-and-chest-tube-drainage-in-spontaneous-pneumothorax
#18
A Thelle, M Gjerdevik, M SueChu, O M Hagen, P Bakke
Guidelines on spontaneous pneumothorax are contradictory as to intervention between needle aspiration (NA) and chest tube drainage (CTD). Studies show poor adherence to guidelines.Three Norwegian hospitals included patients with primary (PSP) and secondary (SSP) spontaneous pneumothorax. Patients underwent NA or CTD as the primary intervention. The main outcome was duration of hospital stay. Secondary outcomes were immediate- and 1-week success rates and complications.127 patients were included, including 48 patients with SSP...
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28404622/choice-of-stent-for-percutaneous-coronary-intervention-of-saphenous-vein-grafts
#19
Javaid Iqbal, Chun Shing Kwok, Evangelos Kontopantelis, Mark A de Belder, Peter F Ludman, Adrian Large, Rob Butler, Amr Gamal, Tim Kinnaird, Azfar Zaman, Mamas A Mamas
BACKGROUND: There are limited data on comparison of contemporary drug-eluting stent (DES) platforms, previous generation DES, and bare-metal stents (BMS) for percutaneous coronary intervention in saphenous vein grafts (SVG). We aimed to assess clinical outcomes following percutaneous coronary intervention to SVG in patients receiving bare-metal stents (BMS), first-generation DES, and newer generation DES in a large unselected national data set from the BCIS (British Cardiovascular Intervention Society)...
April 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28403876/development-of-a-core-outcome-set-for-effectiveness-trials-aimed-at-optimising-prescribing-in-older-adults-in-care-homes
#20
Anna N Millar, Amrit Daffu-O'Reilly, Carmel M Hughes, David P Alldred, Garry Barton, Christine M Bond, James A Desborough, Phyo K Myint, Richard Holland, Fiona M Poland, David Wright
BACKGROUND: Prescribing medicines for older adults in care homes is known to be sub-optimal. Whilst trials testing interventions to optimise prescribing in this setting have been published, heterogeneity in outcome reporting has hindered comparison of interventions, thus limiting evidence synthesis. The aim of this study was to develop a core outcome set (COS), a list of outcomes which should be measured and reported, as a minimum, for all effectiveness trials involving optimising prescribing in care homes...
April 12, 2017: Trials
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