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https://www.readbyqxmd.com/read/29779083/identifying-nonalcoholic-fatty-liver-disease-advanced-fibrosis-in-the-veterans-health-administration
#1
Yuval A Patel, Elizabeth J Gifford, Lisa M Glass, Marsha J Turner, Byungjoo Han, Cynthia A Moylan, Steve Choi, Ayako Suzuki, Dawn Provenzale, Christine M Hunt
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. Severe NAFLD with advanced fibrosis results in substantial morbidity and mortality. Associated with metabolic syndrome, NAFLD is often initially clinically silent, yet intensive lifestyle intervention with 7% or greater weight loss can improve or resolve NAFLD. Using a Veterans Health Administration (VHA) liver biopsy cohort, we evaluated simple noninvasive fibrosis scoring systems to identify NAFLD with advanced fibrosis (or severe disease) to assist providers...
May 19, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29778087/midwifery-management-of-pregnant-women-who-are-obese
#2
Margi Reither, Elaine Germano, Michele DeGrazia
INTRODUCTION: Obesity is associated with increased risks for adverse health outcomes during and after pregnancy in both the woman with obesity and her infant. This study was designed to investigate midwifery management of pregnant women with obesity. METHODS: Certified midwives and certified nurse-midwives who were members of the American College of Nurse-Midwives were sent a survey. The survey instrument was divided into 4 sections: demographic characteristics; practice guidelines and protocols; the role of the 2015 Levels of Maternal Care guidelines for referral, including transfer to a higher level of care; and factors that influence management of pregnant women with obesity...
May 19, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29773075/does-multidisciplinary-rehabilitation-of-tortured-refugees-represent-value-for-money-a-follow-up-of-a-danish-case-study
#3
Line Bager, Kristian Schultz Hansen, Carit Jacques Andersen, Shr-Jie Sharlenna Wang
BACKGROUND: The recent surge of asylum seekers in the European Union (EU) is raising questions about the EU's ability to integrate newcomers into the economy and into society; particularly those who need specialized services for the treatment of severe trauma. This study investigated whether rehabilitating traumatised refugees represents 'value-for-money' (VfM) in terms of intervention cost per health gain and in a long-term and societal perspective. METHODS: The economic evaluation comprised a cost-utility analysis (CUA) and a partial cost-benefit analysis (CBA)...
May 18, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29772095/effect-of-specific-exercise-strategy-on-strength-and-proprioception-in-volleyball-players-with-infraspinatus-muscle-atrophy
#4
José Inácio Salles, Victor Rodrigues Amaral Cossich, João Matheus Guimarães, Geraldo Motta Filho, Dylan Morrissey
Infraspinatus muscle atrophy is common in professional volleyball players, but it is unclear whether commonly observed strength and proprioception deficits can be reversed with training. Fifty-four participants were recruited into an infraspinatus atrophy group (IAG, n = 18) and a non-atrophy group (NAG, n=18) of elite volleyballers plus a healthy non-athletic control group (CG, n = 18). IAG were trained with a progressive, specific shoulder external rotator strengthening routine for 32 sessions over 8 weeks...
May 17, 2018: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/29771733/haemodilution-and-head-down-tilting-induce-functional-injury-in-the-rat-optic-nerve-a-model-for-peri-operative-ischemic-optic-neuropathy
#5
Steven Roth, John Dreixler, Nancy J Newman
BACKGROUND: Mechanisms of peri-operative ischaemic optic neuropathy remain poorly understood. Both specific pre-operative and intra-operative factors have been examined by retrospective studies, but no animal model currently exists. OBJECTIVES: To develop a rodent model of peri-operative ischaemic optic neuropathy. In rats, we performed head-down tilt and/or haemodilution, theorising that the combination damages the optic nerve. DESIGN: Animal study...
May 15, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29771606/improved-motor-unit-number-estimate-when-motor-unit-alternation-is-addressed
#6
Bradley A DeForest, Jeffrey Winslow, Christine K Thomas
Motor unit number estimation (MUNE) is important for determining motoneuron survival with age or in conditions such as amyotrophic lateral sclerosis or spinal cord injury. The original incremental method, or approaches introduced to minimize alternation (e.g. multiple point stimulation), are most commonly used but accept the limitation that alternation of motor units may still inflate the estimate. Alternation occurs because axon thresholds are probabilistic and overlap for different axons, therefore different combination of motor units may respond at a given stimulus intensity...
May 17, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29771307/assessment-of-rosacea-symptom-severity-by-genome-wide-association-study-and-expression-analysis-highlights-immuno-inflammatory-and-skin-pigmentation-genes
#7
Jennifer L Aponte, Mathias N Chiano, Laura M Yerges-Armstrong, David A Hinds, Chao Tian, Akansha Gupta, Cong Guo, Dana J Fraser, Johannes M Freudenberg, Deepak K Rajpal, Margaret G Ehm, Dawn M Waterworth
Rosacea is a common, chronic skin disease of variable severity with limited treatment options. The cause of rosacea is unknown, but it is believed to be due to a combination of hereditary and environmental factors. Little is known about the genetics of the disease. We performed a genome-wide association study (GWAS) of rosacea symptom severity with data from 73,265 research participants of European ancestry from the 23andMe customer base. Seven loci had variants associated with rosacea at the genome-wide significance level (p≤5 × 10-8)...
May 16, 2018: Human Molecular Genetics
https://www.readbyqxmd.com/read/29769117/a-protocol-for-a-network-meta-analysis-of-interventions-to-treat-patients-with-sudden-sensorineural-hearing-loss
#8
Nadera Ahmadzai, Shaun Kilty, Dianna Wolfe, Jamie Bonaparte, David Schramm, Elizabeth Fitzpatrick, Vincent Lin, Wei Cheng, Becky Skidmore, David Moher, Brian Hutton
BACKGROUND: Hearing loss is one of the leading causes of disability worldwide, with greater than 20% of Canadian adults having measurable hearing loss in at least one ear. Patients with hearing loss experience impaired quality of life, and emotional and financial consequences that affect themselves and their families. Sudden sensorineural hearing loss (SSNHL) is a common but difficult to treat form of hearing loss that has a sudden onset of ≤ 72 h associated with various etiologies, with the majority of cases being idiopathic...
May 16, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29768457/choice-of-time-horizon-critical-in-estimating-costs-and-effects-of-changes-to-hiv-programmes
#9
Nicky McCreesh, Ioannis Andrianakis, Rebecca N Nsubuga, Mark Strong, Ian Vernon, Trevelyan J McKinley, Jeremy E Oakley, Michael Goldstein, Richard Hayes, Richard G White
BACKGROUND: Uganda changed its antiretroviral therapy guidelines in 2014, increasing the CD4 threshold for antiretroviral therapy initiation from 350 cells/μl to 500 cells/μl. We investigate what effect this change in policy is likely to have on HIV incidence, morbidity, and programme costs, and estimate the cost-effectiveness of the change over different time horizons. METHODS: We used a complex individual-based model of HIV transmission and antiretroviral therapy scale-up in Uganda...
2018: PloS One
https://www.readbyqxmd.com/read/29767650/immediate-effect-of-continuous-ultrasound-vs-sham-ultrasound-for-bilateral-masseter-myalgia-a-double-blinded-trial
#10
Haseeb Hussain, Heidi Crow, Yoly Gonzalez, W D McCall
AIMS: To investigate the local and segmental effects of therapeutic ultrasound at a dose of 0.4 w/cm2 with 100% duty cycle for 5 minutes compared to the effect of sham ultrasound on painful masticatory muscles. METHODS: A total of 20 adult female subjects with bilateral masseter myalgia diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were included. Each subject was randomized to either an active ultrasound group or a sham ultrasound group...
May 15, 2018: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/29766842/continuous-low-dose-antibiotic-prophylaxis-to-prevent-urinary-tract-infection-in-adults-who-perform-clean-intermittent-self-catheterisation-the-antic-rct
#11
Robert Pickard, Thomas Chadwick, Yemi Oluboyede, Catherine Brennand, Alexander von Wilamowitz-Moellendorff, Doreen McClurg, Jennifer Wilkinson, Laura Ternent, Holly Fisher, Katherine Walton, Elaine McColl, Luke Vale, Ruth Wood, Mohamed Abdel-Fattah, Paul Hilton, Mandy Fader, Simon Harrison, James Larcombe, Paul Little, Anthony Timoney, James N'Dow, Heather Armstrong, Nicola Morris, Kerry Walker, Nikesh Thiruchelvam
BACKGROUND: People carrying out clean intermittent self-catheterisation (CISC) to empty their bladder often suffer repeated urinary tract infections (UTIs). Continuous once-daily, low-dose antibiotic treatment (antibiotic prophylaxis) is commonly advised but knowledge of its effectiveness is lacking. OBJECTIVE: To assess the benefit, harms and cost-effectiveness of antibiotic prophylaxis to prevent UTIs in people who perform CISC. DESIGN: Parallel-group, open-label, patient-randomised 12-month trial of allocated intervention with 3-monthly follow-up...
May 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29758649/framework-for-cascade-size-calculations-on-random-networks
#12
Rebekka Burkholz, Frank Schweitzer
We present a framework to calculate the cascade size evolution for a large class of cascade models on random network ensembles in the limit of infinite network size. Our method is exact and applies to network ensembles with almost arbitrary degree distribution, degree-degree correlations, and, in case of threshold models, for arbitrary threshold distribution. With our approach, we shift the perspective from the known branching process approximations to the iterative update of suitable probability distributions...
April 2018: Physical Review. E
https://www.readbyqxmd.com/read/29758592/comparison-of-a-therapeutic-only-versus-prophylactic-platelet-transfusion-policy-for-people-with-congenital-or-acquired-bone-marrow-failure-disorders
#13
REVIEW
Reem Malouf, Asma Ashraf, Andreas V Hadjinicolaou, Carolyn Doree, Sally Hopewell, Lise J Estcourt
BACKGROUND: Bone marrow disorders encompass a group of diseases characterised by reduced production of red cells, white cells, and platelets, or defects in their function, or both. The most common bone marrow disorder is myelodysplastic syndrome. Thrombocytopenia, a low platelet count, commonly occurs in people with bone marrow failure. Platetet transfusions are routinely used in people with thrombocytopenia secondary to bone marrow failure disorders to treat or prevent bleeding. Myelodysplastic syndrome is currently the most common reason for receiving a platelet transfusion in some Western countries...
May 14, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29755590/wide-pulse-high-frequency-low-intensity-neuromuscular-electrical-stimulation-has-potential-for-targeted-strengthening-of-an-intrinsic-foot-muscle-a-feasibility-study
#14
Darren C James, Matthew C Solan, Katya N Mileva
Background: Strengthening the intrinsic foot muscles is a poorly understood and largely overlooked area. In this study, we explore the feasibility of strengthening m . abductor hallucis (AH) with a specific paradigm of neuromuscular electrical stimulation; one which is low-intensity in nature and designed to interleave physiologically-relevant low frequency stimulation with high-frequencies to enhance effective current delivery to spinal motoneurones, and enable a proportion of force produced by the target muscle to be generated from a central origin...
2018: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/29754987/a-statewide-effort-to-reduce-high-dose-opioid-prescribing-through-coordinated-care-organizations
#15
Daniel M Hartung, Lindsey Alley, Gillian Leichtling, P Todd Korthuis, Christi Hildebran
BACKGROUND: Oregon's Medicaid program is delivered through 16 Coordinated Care Organizations (CCOs) participating in a statewide performance improvement program to reduce high-dose opioid prescribing. CCOs were allowed flexibility to develop their own dose targets and any policies, trainings, guidelines, and/or materials to meet these targets. In this study, we characterize CCO strategies to reduce high-dose opioid prescribing across the 16 CCOs. METHODS: We reviewed relevant CCO documents and conducted semi-structured interviews with CCO administrators to acquire opioid-related policies, practices, timelines and contextual factors...
May 1, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29754324/cost-utility-analysis-of-an-intervention-designed-to-reduce-the-critical-handling-error-of-insufficient-inspiratory-effort
#16
Rebecca Forster, Aran Ratcliffe, Megan Lewis, Amy Crossley, Julio López Bastida, William C N Dunlop
OBJECTIVES: Up to 70-80% of patients use inhalers incorrectly. Dry-powder inhalers (DPIs) require forceful inhalation for optimal delivery, and approximately 40% of Global Initiative for Asthma (GINA)-defined Step-3+ patients inhale corticosteroid and long-acting beta-agonist through DPIs. The CRITIKAL study (Price et al. in J Allergy Clin Immunol Pract 5:1071-e9-1081-e9, 2017) found a statistically significant association between 'insufficient inspiratory effort' error and increased risk of uncontrolled asthma and hospitalisation-requiring exacerbations...
May 12, 2018: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/29753353/cost-effectiveness-of-a-technology-facilitated-depression-care-management-adoption-model-in-safety-net-primary-care-patients-with-type-2-diabetes
#17
Joel W Hay, Pey-Jiuan Lee, Haomiao Jin, Jeffrey J Guterman, Sandra Gross-Schulman, Kathleen Ell, Shinyi Wu
BACKGROUND: The Diabetes-Depression Care-Management Adoption Trial is a translational study of safety-net primary care predominantly Hispanic/Latino patients with type 2 diabetes in collaboration with the Los Angeles County Department of Health Services. OBJECTIVES: To evaluate the cost-effectiveness of an information and communication technology (ICT)-facilitated depression care management program. METHODS: Cost-effectiveness of the ICT-facilitated care (TC) delivery model was evaluated relative to a usual care (UC) and a supported care (SC) model...
May 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29752928/predicting-postoperative-day-1-hematocrit-levels-after-hysterectomy
#18
Sara H Rahman, Sarah Mayer, Katie Corcoran, Allan Mayer, Jonathan Shepherd
BACKGROUND: Swenson et al. developed a linear regression model to estimate postoperative day one (POD1) hematocrit (HCT) levels after benign hysterectomy. Predictive variables included pre-operative HCT, patient weight, estimated blood loss, intra-operative crystalloid volume, pre-operative platelet count, and hysterectomy route which predicted POD1 HCT ±5 for 100% of subjects using an internal validation set. OBJECTIVES: We aimed to externally validate the Swenson model using our hysterectomy population and to further validate the model in a cohort including robotic-assisted cases...
May 9, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29752036/blood-biomarkers-in-alzheimer-s-disease
#19
M Altuna-Azkargorta, M Mendioroz-Iriarte
INTRODUCTION: The early diagnosis of Alzheimer's disease (AD) via the use of biomarkers could facilitate the implementation and monitoring of early therapeutic interventions with the potential capacity to significantly modify the course of the disease. DEVELOPMENT: Classic cerebrospinal fluid biomarkers and approved structural and functional neuroimaging have a limited clinical application given their invasive nature and/or high cost. The identification of more accessible and less costly biomarkers, such as blood biomarkers, would facilitate application in clinical practice...
May 8, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29751849/effect-of-continuous-compression-stimulation-on-pressure-pain-threshold-and-muscle-spasms-in-older-adults-with-knee-osteoarthritis-a-randomized-trial
#20
Ryo Tanaka, Takuya Umehara, Yuuki Kawabata, Tomohiko Sakuda
OBJECTIVE: The purpose of this study was to assess the effect of continuous compression stimulation on pressure-pain threshold and muscle spasms in older adults with knee osteoarthritis. METHODS: Thirty-two older adults with knee osteoarthritis on outpatient visits were randomly divided into 2 groups. Those in the treatment group (n = 16) received 5-minute massage therapy (continuous compression stimulation), and those in the control group (n = 16) received sham massage therapy (touch without compression)...
May 2018: Journal of Manipulative and Physiological Therapeutics
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