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Intervention thresholds

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https://www.readbyqxmd.com/read/28738455/-cost-effectiveness-and-affordability-of-strategy-for-preventing-mother-to-child-transmission-of-hepatitis-b-in-china
#1
Y Lin, S X Zhang, P C Yang, Y L Cai, Y H Zou
Objective: To evaluate the cost effectiveness of nationwide prevention of mother to child transmission (PMTCT) strategy for hepatitis B, and estimate the willing to pay and budget impacts on the PMTCT. Methods: The decision analytic Markov model for the PMTCT was constructed and a birth cohort of Chinese infants born in 2013 was used to calculate the cost-effectiveness of the PMTCT among them compared with those receiving no intervention. The parameters in the model were obtained from literatures of national surveys or Meta-analysis...
July 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28734710/use-of-trabecular-bone-score-tbs-as-a-complementary-approach-to-dual-energy-x-ray-absorptiometry-dxa-for-fracture-risk-assessment-in-clinical-practice
#2
Enisa Shevroja, Olivier Lamy, Lynn Kohlmeier, Fjorda Koromani, Fernando Rivadeneira, Didier Hans
Osteoporosis is a common bone disease characterized by low bone mass and altered bone microarchitecture, resulting in decreased bone strength with an increased risk of fractures. In clinical practice, physicians can assess the risk of fracture for a patient based on several risk factors. Some such as age, weight, and history of fractures after 50 years of age, parental fracture, smoking status, and alcohol intake are incorporated into FRAX, an assessment tool that estimates the 10-year probability of hip fracture and major osteoporotic fractures based on the individual's risk factors profile...
July 19, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28734709/worldwide-fracture-prediction
#3
Ghada El-Hajj Fuleihan, Marlene Chakhtoura, Jane A Cauley, Nariman Chamoun
The substantial increase in the burden of non-communicable diseases in general and osteoporosis in particular, necessitates the establishment of efficient and targeted diagnosis and treatment strategies. This chapter reviews and compares different tools for osteoporosis screening and diagnosis; it also provides an overview of different treatment guidelines adopted by countries worldwide. While access to dual-energy X-ray absorptiometry to measure bone mineral density (BMD) is limited in most areas in the world, the introduction of risk calculators that combine risk factors, with or without BMD, have resulted in a paradigm shift in osteoporosis screening and management...
July 19, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28733098/obesity-and-failure-of-nonsurgical-management-of-pediatric-both-bone-forearm-fractures
#4
Ugochi C Okoroafor, Lisa K Cannada, Jasmin L McGinty
PURPOSE: In pediatric extremity fractures treated nonsurgically, maintaining reduction can be difficult in obese children owing to the larger soft tissue envelope. The purpose of this study was to investigate the relationship between obesity and failure of nonsurgical management of pediatric both-bone forearm fractures. METHODS: We conducted a retrospective review of 129 skeletally immature patients older than 2 years who received nonsurgical treatment for closed radius and ulna shaft fractures at a level I pediatric trauma center between 2011 and 2014...
July 18, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28732576/frax-update
#5
John A Kanis, Nicholas C Harvey, Helena Johansson, Anders Odén, William D Leslie, Eugene V McCloskey
The fracture risk assessment tool, FRAX, was released in 2008 and provides country-specific algorithms for estimating individualized 10-year probability of hip and major osteoporotic fracture (hip, clinical spine, distal forearm, and proximal humerus). Since its release, models are now available for 63 countries, covering 79% of the world population. The website receives approximately 3 million visits annually. Following independent validation, FRAX has been incorporated into more than 80 guidelines worldwide...
July 18, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28727341/-use-of-trabecular-bone-score-as-a-complementary-approach-to-dxa-for-fracture-risk-assessment-in-clinical-practice
#6
Didier Hans, Enisa Shevroja, Olivier Lamy
Physicians can assess the risk of fracture based on bone density (BMD) and several risk factors. Some of them and BMD are incorporated into FRAX, an assessment tool that estimates the 10-years probability of fracture. BMD didn't take into account the microarchitecture. TBS is a texture parameter related to bone microarchitecture. A low TBS is associated with a history of fracture and the incidence of new fracture independently of BMD, clinical risk factors and FRAX. TBS is yet integrated in the FRAX tool, and this effect is of greatest utility for individuals who are close to an intervention threshold...
April 19, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28727192/current-evidence-for-endovascular-therapy-in-stroke-and-remaining-uncertainties-r1
#7
REVIEW
Ronan Motyer, Hamed Asadi, John Thornton, Patrick Nicholson, Hong Kuan Kok
Class 1 level A evidence now supports endovascular thrombectomy as best practice in the management of large vessel occlusion acute ischemic stroke. However, significant questions pertaining to initial imaging, radiological assessment, patient selection and therapeutic limits remain unanswered. A specific cohort of patients who benefit from endovascular thrombectomy has been established, although current uncertainties regarding selection of those not meeting top-tier evidence criteria may potentially deny certain patients the benefit of intervention...
July 20, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28726155/initial-weight-loss-response-as-an-indicator-for-providing-early-rescue-efforts-to-improve-long-term-treatment-outcomes
#8
REVIEW
Jessica L Unick, Christine A Pellegrini, Kathryn E Demos, Leah Dorfman
PURPOSE OF REVIEW: There is a large variability in response to behavioral weight loss (WL) programs. Reducing rates of obesity and diabetes may require more individuals to achieve clinically significant WL post-treatment. Given that WL within the first 1-2 months of a WL program is associated with long-term WL, it may be possible to improve treatment outcomes by identifying and providing additional intervention to those with poor initial success (i.e., "early non-responders"). We review the current literature regarding early non-response to WL programs and discuss how adaptive interventions can be leveraged as a strategy to "rescue" early non-responders...
September 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28724714/sedentary-time-in-older-adults-a-critical-review-of-measurement-associations-with-health-and-interventions
#9
REVIEW
Jennifer L Copeland, Maureen C Ashe, Stuart Jh Biddle, Wendy J Brown, Matthew P Buman, Sebastien Chastin, Paul A Gardiner, Shigeru Inoue, Barbara J Jefferis, Koichiro Oka, Neville Owen, Luís B Sardinha, Dawn A Skelton, Takemi Sugiyama, Shilpa Dogra
Sedentary time (ST) is an important risk factor for a variety of health outcomes in older adults. Consensus is needed on future research directions so that collaborative and timely efforts can be made globally to address this modifiable risk factor. In this review, we examined current literature to identify gaps and inform future research priorities on ST and healthy ageing. We reviewed three primary topics:(1) the validity/reliability of self-report measurement tools, (2) the consequences of prolonged ST on geriatric-relevant health outcomes (physical function, cognitive function, mental health, incontinence and quality of life) and(3) the effectiveness of interventions to reduce ST in older adults...
July 19, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28721090/muscle-injections-with-lidocaine-improve-resting-fatigue-and-pain-in-patients-with-chronic-fatigue-syndrome
#10
Roland Staud, Taylor Kizer, Michael E Robinson
OBJECTIVE: Patients with chronic fatigue syndrome (CFS) complain of long-lasting fatigue and pain which are not relieved by rest and worsened by physical exertion. Previous research has implicated metaboreceptors of muscles to play an important role for chronic fatigue and pain. Therefore, we hypothesized that blocking impulse input from deep tissues with intramuscular lidocaine injections would improve not only the pain but also fatigue of CFS patients. METHODS: In a double-blind, placebo-controlled study, 58 CFS patients received 20 mL of 1% lidocaine (200 mg) or normal saline once into both trapezius and gluteal muscles...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28719456/warning-criteria-for-intraoperative-neurophysiologic-monitoring
#11
Quanmeng Liu, Qinzhou Wang, Hongen Liu, William K K Wu, Matthew T V Chan
PURPOSE OF REVIEW: Intraoperative changes in somatosensory (SEP) and motor evoked potentials (MEPs) may indicate potential injury to the spinal cord and will require timely intervention to prevent permanent damage. This review focuses on the validity of currently recommended warning criteria for intraoperative evoked potential monitoring. RECENT FINDINGS: Current guideline recommends a decrease in SEP amplitude by 50% and MEP amplitude by 50-100% as warning signals for injury to the ascending sensory and descending motor pathway, respectively...
July 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28719151/staged-treatment-in-early-psychosis-a-sequential-multiple-assignment-randomised-trial-of-interventions-for-ultra-high-risk-of-psychosis-patients
#12
REVIEW
Barnaby Nelson, G Paul Amminger, Hok Pan Yuen, Nicky Wallis, Melissa J Kerr, Lisa Dixon, Cameron Carter, Rachel Loewy, Tara A Niendam, Martha Shumway, Sarah Morris, Julie Blasioli, Patrick D McGorry
AIM: Previous research indicates that preventive intervention is likely to benefit patients "at risk" of psychosis, in terms of functional improvement, symptom reduction and delay or prevention of onset of threshold psychotic disorder. The primary aim of the current study is to test outcomes of ultra high risk (UHR) patients, primarily functional outcome, in response to a sequential intervention strategy consisting of support and problem solving (SPS), cognitive-behavioural case management and antidepressant medication...
July 18, 2017: Early Intervention in Psychiatry
https://www.readbyqxmd.com/read/28719049/pulmonary-vein-stenosis-in-patients-with-smith-lemli-opitz-syndrome
#13
Aaron R Prosnitz, Jane Leopold, Mira Irons, Kathy Jenkins, Amy E Roberts
OBJECTIVE: To describe a group of children with co-incident pulmonary vein stenosis and Smith-Lemli-Opitz syndrome and to generate hypotheses as to the shared pathogenesis of these disorders. DESIGN: Retrospective case series. PATIENTS: Five subjects in a pulmonary vein stenosis cohort of 170 subjects were diagnosed with Smith-Lemli-Opitz syndrome soon after birth. RESULTS: All five cases were diagnosed with Smith-Lemli-Opitz syndrome within 6 weeks of life, with no family history of either disorder...
July 18, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28718051/coronary-heart-disease-preoperative-gesture-interactive-diagnostic-system-based-on-augmented-reality
#14
Yi-Bo Zou, Yi-Min Chen, Ming-Ke Gao, Quan Liu, Si-Yu Jiang, Jia-Hui Lu, Chen Huang, Ze-Yu Li, Dian-Hua Zhang
Coronary heart disease preoperative diagnosis plays an important role in the treatment of vascular interventional surgery. Actually, most doctors are used to diagnosing the position of the vascular stenosis and then empirically estimating vascular stenosis by selective coronary angiography images instead of using mouse, keyboard and computer during preoperative diagnosis. The invasive diagnostic modality is short of intuitive and natural interaction and the results are not accurate enough. Aiming at above problems, the coronary heart disease preoperative gesture interactive diagnostic system based on Augmented Reality is proposed...
August 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28716786/online-versus-face-to-face-pulmonary-rehabilitation-for-patients-with-chronic-obstructive-pulmonary-disease-randomised-controlled-trial
#15
Simon Bourne, Ruth DeVos, Malcolm North, Anoop Chauhan, Ben Green, Thomas Brown, Victoria Cornelius, Tom Wilkinson
OBJECTIVE: To obtain evidence whether the online pulmonary rehabilitation(PR) programme 'my-PR' is non-inferior to a conventional face-to-face PR in improving physical performance and symptom scores in patients with COPD. DESIGN: A two-arm parallel single-blind, randomised controlled trial. SETTING: The online arm carried out pulmonary rehabilitation in their own homes and the face to face arm in a local rehabilitation facility. PARTICIPANTS: 90 patients with a diagnosis of chronic obstructive pulmonary disease (COPD), modified Medical Research Council score of 2 or greater referred for pulmonary rehabilitation (PR), randomised in a 2:1 ratio to online (n=64) or face-to-face PR (n=26)...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28708899/the-cost-effectiveness-of-a-quality-improvement-program-to-reduce-maternal-and-fetal-mortality-in-a-regional-referral-hospital-in-accra-ghana
#16
David M Goodman, Rohit Ramaswamy, Marc Jeuland, Emmanuel K Srofenyoh, Cyril M Engmann, Adeyemi J Olufolabi, Medge D Owen
OBJECTIVE: To evaluate the cost-effectiveness of a quality improvement intervention aimed at reducing maternal and fetal mortality in Accra, Ghana. DESIGN: Quasi-experimental, time-sequence intervention, retrospective cost-effectiveness analysis. METHODS: Data were collected on the cost and outcomes of a 5-year Kybele-Ghana Health Service Quality Improvement (QI) intervention conducted at Ridge Regional Hospital, a tertiary referral center in Accra, Ghana, focused on systems, personnel, and communication...
2017: PloS One
https://www.readbyqxmd.com/read/28707234/the-elusive-search-for-optimal-blood-pressure-targets
#17
REVIEW
Alan H Gradman
BP treatment thresholds/targets determine when to initiate treatment and to what level BP should be reduced. The Seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) recommended a target of <140/90 for most patients and a target <130/80 mmHg for patients with diabetes or chronic kidney disease. Subsequently, meta-analyses, retrospective studies relating on-treatment BP to clinical outcomes and two large, randomized clinical trials (RCTs) have re-evaluated BP targets...
August 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28706467/ketogenic-diet-benefits-body-composition-and-well-being-but-not-performance-in-a-pilot-case-study-of-new-zealand-endurance-athletes
#18
Caryn Zinn, Matthew Wood, Mikki Williden, Simon Chatterton, Ed Maunder
BACKGROUND: Low-carbohydrate, high-fat and ketogenic diets are increasingly adopted by athletes for body composition and sports performance enhancements. However, as yet, there is no consensus on their efficacy in improving performance. There is also no comprehensive literature on athletes' experiences while undertaking this diet. The purpose of this pilot work was two-fold: i. to examine the effects of a non-calorie controlled ketogenic diet on body composition and performance outcomes of endurance athletes, and ii...
2017: Journal of the International Society of Sports Nutrition
https://www.readbyqxmd.com/read/28706081/brief-stimulus-exposure-fully-remediates-temporal-processing-deficits-induced-by-early-hearing-loss
#19
David B Green, Michelle M Mattingly, Yi Ye, Jennifer D Gay, Merri J Rosen
In childhood, partial hearing loss can produce prolonged deficits in speech perception and temporal processing. Early therapeutic interventions targeting temporal processing may improve later speech-related outcomes, however. Gap detection is a measure of auditory temporal resolution that relies on auditory cortex (ACx), and early auditory deprivation alters intrinsic and synaptic properties in ACx. Thus, early deprivation should induce deficits in gap detection, which should be reflected in ACx gap sensitivity...
July 13, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28704936/effects-of-a-new-nutraceutical-formulation-berberine-red-yeast-rice-and-chitosan-on-non-hdl-cholesterol-levels-in-individuals-with-dyslipidemia-results-from-a-randomized-double-blind-placebo-controlled-study
#20
Valentina Spigoni, Raffaella Aldigeri, Monica Antonini, Maria Maddalena Micheli, Federica Fantuzzi, Andrea Fratter, Marzia Pellizzato, Eleonora Derlindati, Ivana Zavaroni, Riccardo C Bonadonna, Alessandra Dei Cas
Increased non high-density lipoprotein (HDL)/low-density lipoprotein (LDL) cholesterol levels are independent risk factors for cardiovascular (CV) mortality with no documented threshold. A new combination of nutraceuticals (berberine 200 mg, monacolin K 3 mg, chitosan 10 mg and coenzyme Q 10 mg) with additive lipid-lowering properties has become available. The aim of the study is to test the efficacy of the nutraceutical formulation (one daily) in lowering non-HDL cholesterol vs. placebo at 12 weeks in individuals with non-HDL-cholesterol levels ≥160 mg/dL...
July 12, 2017: International Journal of Molecular Sciences
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