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https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#1
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28333033/freeze-all-cycle-in-reproductive-medicine-current-perspectives
#2
Matheus Roque, Marcello Valle, Alessandra Kostolias, Marcos Sampaio, Selmo Geber
The freeze-all strategy has emerged as an alternative to fresh embryo transfer (ET) during in vitro fertilization (IVF) cycles. Although fresh ET is the norm during assisted reproductive therapies (ART), there are many concerns about the possible adverse effects of controlled ovarian stimulation (COS) over the endometrium. The supra-physiologic hormonal levels that occur during a conventional COS are associated with modifications in the peri-implantation endometrium, which may be related to a decrease in pregnancy rates and poorer obstetric and perinatal outcomes when comparing fresh to frozen-thawed embryo transfers...
February 1, 2017: JBRA Assisted Reproduction
https://www.readbyqxmd.com/read/28331766/evaluation-of-breast-cancer-risk-levels-and-its-relation-with-breast-self-examination-practices-in-women
#3
Ruhuşen Kutlu, Ümmiye Biçer
OBJECTIVE: This study was performed to determine the breast cancer risk levels and its relation with the frequency of breast self-examination practices in women who were 20 years old and over. MATERIALS AND METHODS: This descriptive study was conducted on 867 women, who were 20 years old and over presenting to a family medicine outpatient clinic for any reasons. The participants filled in the "Breast Cancer Risk Assessment Form" which is recommended to assess the risk of breast cancer by the Ministry of Health...
January 2017: J Breast Health (2013)
https://www.readbyqxmd.com/read/28328012/free-fatty-acid-receptor-1-ffar1-as-an-emerging-therapeutic-target-for-type-2-diabetes-mellitus-recent-progress-and-prevailing-challenges
#4
REVIEW
Zheng Li, Xue Xu, Wenlong Huang, Hai Qian
The free fatty acid receptor 1 (FFAR1/GPR40) amplifies glucose-dependent insulin secretion; therefore, it has attracted widespread attention as a promising antidiabetic target. Current clinical proof of concept also indicates that FFAR1 agonists achieve the initially therapeutic endpoint for the treatment of type 2 diabetes mellitus (T2DM) without the hypoglycemic risk. Thus, many pharmaceutical companies and academic institutes are competing to develop FFAR1 agonists. However, several candidates have been discontinued in clinical trials, often without reporting the underlying reasons...
March 22, 2017: Medicinal Research Reviews
https://www.readbyqxmd.com/read/28306666/new-biomarkers-and-imaging-approaches-for-the-diagnosis-of-deep-venous-thrombosis
#5
Jordan K Schaefer, Benjamin Jacobs, Thomas W Wakefield, Suman L Sood
PURPOSE OF REVIEW: Symptoms suggestive of deep vein thrombosis (DVT) are extremely common in clinical practice, but unfortunately nonspecific. In both ambulatory and inpatient settings, clinicians are often tasked with evaluating these concerns. Here, we review the most recent advances in biomarkers and imaging to diagnose lower extremity DVT. RECENT FINDINGS: The modified Wells score remains the most supported clinical decision rule for risk stratifying patients...
March 16, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28297729/the-role-of-abo-blood-type-in-thrombosis-scoring-systems
#6
Massimo Franchini, Giuseppe Marano, Stefania Vaglio, Liviana Catalano, Simonetta Pupella, Giancarlo Maria Liumbruno
In addition to their major role in transfusion medicine, there is increasing evidence that ABO blood group antigens (complex carbohydrate molecules widely expressed on the surface of red blood cells and several other cell types) are implicated in the development of a wide array of pathologic conditions. In particular, intense research has been dedicated over the last 50 years to the study of the association between non-O blood type and the risk of developing cardiovascular disorders. Several pathways have been hypothesized to explain this relationship, the most reasonable implying the influence of the ABO blood group on circulating plasma levels of von Willebrand factor, factor VIII, and several inflammatory cytokines...
March 15, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28293104/factors-driving-customers-to-seek-health-care-from-pharmacies-for-acute-respiratory-illness-and-treatment-recommendations-from-drug-sellers-in-dhaka-city-bangladesh
#7
Fahmida Chowdhury, Katharine Sturm-Ramirez, Abdullah Al Mamun, A Danielle Iuliano, Mejbah Uddin Bhuiyan, Mohammod Jobayer Chisti, Makhdum Ahmed, Sabbir Haider, Mahmudur Rahman, Eduardo Azziz-Baumgartner
BACKGROUND: Pharmacies in Bangladesh serve as an important source of health service. A survey in Dhaka reported that 48% of respondents with symptoms of acute respiratory illness (ARI) identified local pharmacies as their first point of care. This study explores the factors driving urban customers to seek health care from pharmacies for ARI, their treatment adherence, and outcome. METHODS: A cross-sectional study was conducted among 100 selected pharmacies within Dhaka from June to December 2012...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#8
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28289385/plant-derived-phytocompound-embelin-in-cns-disorders-a-systematic-review
#9
REVIEW
Uday P Kundap, Saatheeyavaane Bhuvanendran, Yatinesh Kumari, Iekhsan Othman, Mohd Farooq Shaikh
A Central nervous system (CNS) disease is the one which affects either the spinal cord or brain and causing neurological or psychiatric complications. During the nineteenth century, modern medicines have occupied the therapy for many ailments and are widely used these days. Herbal medicines have often maintained popularity for historical and cultural reasons and also considered safer as they originate from natural sources. Embelin is a plant-based benzoquinone which is the major active constituent of the fruits of Embelia ribes Burm...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28288600/complementary-traditional-chinese-medicine-use-in-children-with-cerebral-palsy-a-nationwide-retrospective-cohort-study-in-taiwan
#10
Hou-Hsun Liao, Hung-Rong Yen, Chih-Hsin Muo, Yu-Chen Lee, Mei-Yao Wu, Li-Wei Chou, Mao-Feng Sun, Tung-Ti Chang
BACKGROUND: Complementary traditional Chinese medicine (TCM) has been used to treat patients with cerebral palsy (CP). However, large-scale surveys examining its use in the treatment of CP and associated disorders are lacking. METHODS: We enrolled 11,218 patients ≤ 18 years of age with CP in the Taiwanese National Health Insurance Research Database from 1995 to 2011. Patients were categorized as TCM users (n = 6,997; 62.37%) and non-TCM users (n = 4,221; 37...
March 14, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28287827/intensive-care-unit-educators-a-multicenter-evaluation-of-behaviors-residents-value-in-attendings
#11
Lekshmi Santhosh, Snigdha Jain, Anna Brady, Michelle Sharp, W Graham Carlos
RATIONALE: It is important for attendings to know which behaviors influence learner perceptions. To date, two studies focusing on general medicine attendings have been published addressing internal medicine residents' perceptions of attendings; there are no data on intensive care unit (ICU) attendings. OBJECTIVES: We sought to expand the evidence regarding this topic through a multicenter study at four geographically diverse academic medical centers. Our study focused on identifying the teaching behaviors of ICU physicians that learners observe in attendings they value as effective educators...
March 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28281378/faculty-experience-and-engagement-in-a-longitudinal-integrated-clerkship
#12
Sarah C Snow, Jennifer Gong, Jennifer E Adams
The authors sought to understand rewards and challenges of teaching third-year medical students in the University of Colorado School of Medicine (CUSOM) Denver Health Longitudinal Integrated Clerkship (DH-LIC) compared to teaching in rotation-based clerkships (RBCs). The authors considered implications for the recruitment and retention of faculty in clinical educational programs. Preceptors completed surveys at baseline and year-end. Of eligible faculty, 28 of 40 completed both baseline and year-end surveys...
March 10, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28276077/quantifying-the-reproducibility-of-lung-ventilation-images-between-4-dimensional-cone-beam-ct-and-4-dimensional-ct
#13
Henry C Woodruff, Chun-Chien Shieh, Fiona Hegi-Johnson, Paul J Keall, John Kipritidis
PURPOSE: Deformable image registration (DIR) based computed tomography ventilation imaging derived from four-dimensional cone-beam CT (CTVI(4)(DCBCT) ) can complement existing 4DCT-based methods (CTVI(4)(DCT) ) to track lung function changes over a course of lung cancer radiation therapy. However the accuracy of CTVI(4)(DCBCT) needs to be assessed since anatomic 4DCBCT has demonstrably poor image quality and small field of view (FOV) compared to treatment planning 4DCT. We perform a direct comparison between short interval CTVI(4)(DCBCT) and CTVI(4)(DCT) pairs to understand the patient specific image quality factors affecting the intermodality CTVI reproducibility in the clinic...
March 9, 2017: Medical Physics
https://www.readbyqxmd.com/read/28275627/inappropriateness-in-laboratory-medicine-an-elephant-in-the-room
#14
Giuseppe Lippi, Chiara Bovo, Marcello Ciaccio
Appropriateness of diagnostic testing can be conventionally described as prescription of the right test, using the right method, at the right time, to the right patient, with the right costs and for producing the right outcome. There is ongoing debate about the real burden of inappropriateness in laboratory diagnostics. The media coverage of this issue has also recently led to either over- or under-emphasizing the clinical, organizational and economic consequences. This is quite problematic, inasmuch as some reliable data are available in the current scientific literature, showing that inappropriateness of laboratory testing can be as high as 70%...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28271978/lessons-from-cuba-for-global-precision-medicine-cyp2d6-genotype-is-not-a-robust-predictor-of-cyp2d6-ultrarapid-metabolism
#15
Pedro Dorado, Idilio González, María Eugenia G Naranjo, Fernando de Andrés, Eva María Peñas-Lledó, Luis Ramón Calzadilla, Adrián LLerena
A long-standing question and dilemma in precision medicine is whether and to what extent genotyping or phenotyping drug metabolizing enzymes such as CYP2D6 can be used in real-life global clinical and societal settings. Although in an ideal world using both genotype and phenotype biomarkers are desirable, this is not always feasible for economic and practical reasons. Moreover, an additional barrier for clinical implementation of precision medicine is the lack of correlation between genotype and phenotype, considering that most of the current methods include only genotyping...
January 2017: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/28270209/innovative-regenerative-medicines-in-the-eu-a-better-future-in-evidence
#16
EDITORIAL
Mark S Corbett, Andrew Webster, Robert Hawkins, Nerys Woolacott
BACKGROUND: Despite a steady stream of headlines suggesting they will transform the future of healthcare, high-tech regenerative medicines have, to date, been quite inaccessible to patients, with only eight having been granted an EU marketing licence in the last 7 years. Here, we outline some of the historical reasons for this paucity of licensed innovative regenerative medicines. We discuss the challenges to be overcome to expedite the development of this complex and rapidly changing area of medicine, together with possible reasons to be more optimistic for the future...
March 8, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28266888/self-efficacy-perceptions-of-interprofessional-education-and-practice-in-undergraduate-healthcare-students
#17
Brett Williams, Bronwyn Beovich, Linda Ross, Caroline Wright, Dragan Ilic
Self-efficacy is an individual's perception of their ability to be successful in a given endeavour and it has been shown to have an important role in successful university education and clinical performance of healthcare workers. This article examines the self-efficacy beliefs of undergraduate healthcare students (n = 388) for the skills required for interprofessional education and interprofessional collaboration. The students were enrolled at an Australian university from the disciplines of public health, social work, and paramedic practice...
March 7, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28266713/personalised-dosing-of-medicines-for-children
#18
REVIEW
Basma Al-Metwali, Hussain Mulla
OBJECTIVES: Doses for most drugs are determined from population-level information, resulting in a standard ?one-size-fits-all' dose range for all individuals. This review explores how doses can be personalised through the use of the individuals' pharmacokinetic (PK)-pharmacodynamic (PD) profile, its particular application in children, and therapy areas where such approaches have made inroads. KEY FINDINGS: The Bayesian forecasting approach, based on population PK/PD models that account for variability in exposure and response, is a potent method for personalising drug therapy...
March 7, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28255743/the-role-and-limitations-of-cochrane-reviews-at-the-bedside-a%C3%A2-systematic-synopsis-of-five-pediatric-subspecialties
#19
Sascha Meyer, Martin Poryo, Sara Khosrawikatoli, Yvonne Goda, Michael Zemlin
BACKGROUND: Cochrane meta-analyses provide the physician at the bedside with the most relevant, up-to-date clinical information. However, implementation of evidence-based medicine (EBM) at the bedside may be difficult for a variety of reasons. The aim of this study was to assess relevant issues and obstacles related to implementing EBM in pediatrics in real life at the bedside/cotside. METHODS: We performed five systematic literature reviews of all published Cochrane reviews in neonatology (1996-2010), pediatric neurology (1996-2010), pediatric gastroenterology (1993-2012), pediatric cardiology (2001-2015), and complementary and alternative medicine (1996-2012; CAM) in children and neonates...
March 2, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28254182/herbal-medications-in-cardiovascular%C3%A2-medicine
#20
REVIEW
Rosa Liperoti, Davide L Vetrano, Roberto Bernabei, Graziano Onder
Herbal medications are commonly used for clinical purposes, including the treatment of cardiovascular conditions. Compared with conventional medications, herbal medications do not require clinical studies before their marketing or formal approval from regulatory agencies, and for this reason their efficacy and safety are rarely proven. In this review, we summarize available evidence on herbal medications mostly used in cardiovascular medicine. We show that the use of these medications for the treatment of cardiovascular diseases is often not supported by scientific evidence...
March 7, 2017: Journal of the American College of Cardiology
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