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https://www.readbyqxmd.com/read/27913059/cha2ds2-vasc-scores-and-major-bleeding-in-patients-with-nonvalvular-atrial-fibrillation-who-are-receiving-rivaroxaban
#1
W Frank Peacock, Sally Tamayo, Manesh Patel, Nicholas Sicignano, Kathleen P Hopf, Zhong Yuan
STUDY OBJECTIVE: Assessing stroke risk associated with nonvalvular atrial fibrillation depends on the evaluation of patient characteristics and clinical features. Clinicians must determine that the net clinical benefit from anticoagulation therapy outweighs its risk, namely, bleeding. Risk assessment for stroke is commonly performed by calculating a CHA2DS2-VASc (congestive heart failure/left ventricular dysfunction, hypertension, ≥75 years, diabetes mellitus, previous stroke or transient ischemic attack or thromboembolism, vascular disease, aged 65 to 74 years, sex female) score...
November 29, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27912971/efficacy-of-systemic-chemotherapy-plus-radical-nephroureterectomy-for-metastatic-upper-tract-urothelial-carcinoma
#2
Thomas Seisen, Tarun Jindal, Patrick Karabon, Akshay Sood, Joaquim Bellmunt, Morgan Rouprêt, Jeffrey J Leow, Malte W Vetterlein, Maxine Sun, Shaheen Alanee, Toni K Choueiri, Quoc-Dien Trinh, Mani Menon, Firas Abdollah
: Given the growing body of evidence supporting the benefit of primary tumor control for a wide range of metastatic malignancies, we hypothesized that chemotherapy plus radical nephroureterectomy (RNU) is associated with an overall survival (OS) benefit compared to chemotherapy alone for metastatic upper tract urothelial carcinoma (mUTUC). Within the National Cancer Data Base (2004-2012), we identified 398 (38.4%) and 637 (61.6%) patients who received chemotherapy plus RNU and chemotherapy alone, respectively...
November 29, 2016: European Urology
https://www.readbyqxmd.com/read/27911341/longer-duration-of-mao-b-inhibitor-exposure-is-associated-with-less-clinical-decline-in-parkinson-s-disease-an%C3%A2-analysis%C3%A2-of%C3%A2-net-pd-ls1
#3
Robert A Hauser, Ruosha Li, Adriana Pérez, Xuehan Ren, Dan Weintraub, Jordan Elm, John L Goudreau, John C Morgan, John Y Fang, Michael J Aminoff, Chadwick W Christine, Rohit Dhall, Chizoba C Umeh, James T Boyd, Natividad Stover, Maureen Leehey, Richard M Zweig, Anthony P Nicholas, Ivan Bodis-Wollner, Allison Willis, Karl Kieburtz, Barbara C Tilley
BACKGROUND: Monoamine oxidase type B (MAO-B) inhibitors exhibit neuroprotective effects in preclinical models of PD but clinical trials have failed to convincingly demonstrate disease modifying benefits in PD patients. OBJECTIVE: To perform a secondary analysis of NET-PD LS1 to determine if longer duration of MAO-B inhibitor exposure was associated with less clinical decline. METHODS: The primary outcome measure was the Global Outcome (GO), comprised of 5 measures: change from baseline in the Schwab and England (ADL) scale, the 39-item Parkinson's Disease Questionnaire (PDQ-39), the UPDRS Ambulatory Capacity Scale, the Symbol Digit Modalities Test, and the most recent Modified Rankin Scale...
November 30, 2016: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/27909972/can-we-estimate-short-and-intermediate-term-survival-in-patients-undergoing-surgery-for-metastatic-bone-disease
#4
Jonathan A Forsberg, Rikard Wedin, Patrick J Boland, John H Healey
BACKGROUND: Objective means of estimating survival can be used to guide surgical decision-making and to risk-stratify patients for clinical trials. Although a free, online tool ( www.pathfx.org ) can estimate 3- and 12-month survival, recent work, including a survey of the Musculoskeletal Tumor Society, indicated that estimates at 1 and 6 months after surgery also would be helpful. Longer estimates help justify the need for more durable and expensive reconstructive options, and very short estimates could help identify those who will not survive 1 month and should not undergo surgery...
December 1, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27904903/prediction-of-severe-bleeding-after-coronary-surgery-the-will-bleed-risk-score
#5
Fausto Biancari, Debora Brascia, Francesco Onorati, Daniel Reichart, Andrea Perrotti, Vito G Ruggieri, Giuseppe Santarpino, Daniele Maselli, Giovanni Mariscalco, Riccardo Gherli, Antonino S Rubino, Marisa De Feo, Giuseppe Gatti, Francesco Santini, Magnus Dalén, Matteo Saccocci, Eeva-Maija Kinnunen, Juhani K E Airaksinen, Paola D'Errigo, Stefano Rosato, Francesco Nicolini
Severe perioperative bleeding after coronary artery bypass grafting (CABG) is associated with poor outcome. An additive score for prediction of severe bleeding was derived (n=2494) and validated (n=1250) in patients from the E-CABG registry. Severe bleeding was defined as E-CABG bleeding grades 2-3 (transfusion of >4 units of red blood cells or reoperation for bleeding). The overall incidence of severe bleeding was 6.4 %. Preoperative anaemia (3 points), female gender (2 points), eGFR <45 ml/min/1.73 m(2) (3 points), potent antiplatelet drugs discontinued less than five days (2 points), critical preoperative state (5 points), acute coronary syndrome (2 points), use of low-molecular-weight heparin/fondaparinux/unfractionated heparin (1 point) were independent predictors of severe bleeding...
December 1, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27903250/effectiveness-of-bovine-derived-xenograft-versus-bioactive-glass-with-periodontally-accelerated-osteogenic-orthodontics-in-adults-a-randomized-controlled-clinical-trial
#6
Maha A Bahammam
BACKGROUND: Periodontally accelerated osteogenic orthodontics (PAOO) combines periodontal therapy with orthodontic therapy, which minimises treatment time. This study compared the effectiveness of a bovine-derived xenograft with that of bioactive glass when combined with PAOO for the treatment of adult patients with moderate crowding of the teeth. METHODS: In this prospective, single-masked clinical trial, 33 orthodontic patients (20 women, 13 men; mean age 21.2 ± 1...
November 30, 2016: BMC Oral Health
https://www.readbyqxmd.com/read/27903138/partnerships-between-health-care-and-legal-providers-in-the-veterans-health-administration
#7
Jack Tsai, Margaret Middleton, Randye Retkin, Cindy Johnson, Kevin Kenneally, Scott Sherman, Robert A Rosenheck
Medical-legal partnerships (MLPs) represent an innovative service model in which lawyers are integrated into health care teams to address diverse legal problems that affect vulnerable populations. The Veterans Health Administration (VHA) operates the largest safety-net health care system in the country and serves many low-income and disabled veterans who could benefit from MLP services. In this column, the authors describe the development and operations of MLPs at four VHA medical centers that serve veterans who are homeless or who have serious mental illness...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27902693/the-long-term-benefits-of-increased-aspirin-use-by-at-risk-americans-aged-50-and-older
#8
David B Agus, Étienne Gaudette, Dana P Goldman, Andrew Messali
BACKGROUND: The usefulness of aspirin to defend against cardiovascular disease in both primary and secondary settings is well recognized by the medical profession. Multiple studies also have found that daily aspirin significantly reduces cancer incidence and mortality. Despite these proven health benefits, aspirin use remains low among populations targeted by cardiovascular prevention guidelines. This article seeks to determine the long-term economic and population-health impact of broader use of aspirin by older Americans at higher risk for cardiovascular disease...
2016: PloS One
https://www.readbyqxmd.com/read/27899400/study-protocol-a-phase-iii-randomised-double-blind-parallel-arm-stratified-block-randomised-placebo-controlled-trial-investigating-the-clinical-effect-and-cost-effectiveness-of-sertraline-for-the-palliative-relief-of-breathlessness-in-people-with-chronic-breathlessness
#9
Gareth J Watts, Katherine Clark, Meera Agar, Patricia M Davidson, Christine McDonald, Lawrence T Lam, Dimitar Sajkov, Nicola McCaffrey, Matthew Doogue, Amy P Abernethy, David C Currow
INTRODUCTION: Breathlessness remains a highly prevalent and distressing symptom for many patients with progressive life-limiting illnesses. Evidence-based interventions for chronic breathlessness are limited, and there is an ongoing need for high-quality research into developing management strategies for optimal palliation of this complex symptom. Previous studies have suggested that selective serotonin reuptake inhibitors such as sertraline may have a role in reducing breathlessness...
November 29, 2016: BMJ Open
https://www.readbyqxmd.com/read/27898668/the-long-term-safety-public-health-impact-and-cost-effectiveness-of-routine-vaccination-with-a-recombinant-live-attenuated-dengue-vaccine-dengvaxia-a-model-comparison-study
#10
Stefan Flasche, Mark Jit, Isabel Rodríguez-Barraquer, Laurent Coudeville, Mario Recker, Katia Koelle, George Milne, Thomas J Hladish, T Alex Perkins, Derek A T Cummings, Ilaria Dorigatti, Daniel J Laydon, Guido España, Joel Kelso, Ira Longini, Jose Lourenco, Carl A B Pearson, Robert C Reiner, Luis Mier-Y-Terán-Romero, Kirsten Vannice, Neil Ferguson
BACKGROUND: Large Phase III trials across Asia and Latin America have recently demonstrated the efficacy of a recombinant, live-attenuated dengue vaccine (Dengvaxia) over the first 25 mo following vaccination. Subsequent data collected in the longer-term follow-up phase, however, have raised concerns about a potential increase in hospitalization risk of subsequent dengue infections, in particular among young, dengue-naïve vaccinees. We here report predictions from eight independent modelling groups on the long-term safety, public health impact, and cost-effectiveness of routine vaccination with Dengvaxia in a range of transmission settings, as characterised by seroprevalence levels among 9-y-olds (SP9)...
November 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27897172/adaptation-and-external-validation-of-the-european-randomised-study-of-screening-for-prostate-cancer-risk-calculator-for-the-chinese-population
#11
P K Chiu, M J Roobol, D Nieboer, J Y Teoh, S K Yuen, S M Hou, M K Yiu, C F Ng
BACKGROUND: To adapt the well-performing European Randomized Study of Screening for Prostate Cancer (ERSPC) risk calculator to the Chinese setting and perform an external validation. METHODS: The original ERSPC risk calculator 3 (RC3) for prostate cancer (PCa) and high-grade PCa (HGPCa) was applied to a development cohort of 3006 previously unscreened Hong Kong Chinese men with initial transrectal biopsies performed from 1997 to 2015, age 50-80 years, PSA 0.4-50 ng ml(-1) and prostate volume 10-150 ml...
November 29, 2016: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/27893953/leveraging-telehealth-to-bring-volunteer-physicians-into-underserved-communities
#12
Lori Uscher-Pines, Robert Rudin, Ateev Mehrotra
Many disadvantaged communities lack sufficient numbers of local primary care and specialty physicians. Yet tens of thousands of physicians, in particular those who are retired or semiretired, desire meaningful volunteer opportunities. Multiple programs have begun to use telehealth to bridge the gap between volunteer physicians and underserved patients. In this brief, we describe programs that are using this model and discuss the promise and pitfalls. Physician volunteers in these programs report that the work can be fulfilling and exciting, a cutting-edge yet convenient way to remain engaged and contribute...
November 28, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27893694/the-safety-and-efficacy-of-vitamin-k-antagonist-in-atrial-fibrillation-patients-with-previous-ulcer-bleeding-long-term-results-from-a-multicenter-study
#13
Seung-Jun Lee, Jung-Hoon Sung, Jin-Bae Kim, Min-Soo Ahn, Hye Young Lee, Jae-Sun Uhm, Hui-Nam Pak, Moon-Hyoung Lee, Jong-Yun Kim, Boyoung Joung
This study aimed to evaluate the safety and efficacy of vitamin K antagonist (VKA) in atrial fibrillation (AF) patients with previous ulcer bleeding.In this multicenter, retrospective analysis, clinical outcomes of 754 AF patients with a history of ulcer bleeding were evaluated. After ulcer treatment, 458 patients (61%) were treated with VKA, and the outcomes were compared to 296 patients (39%) without VKA.VKA treatment significantly increased major bleeding (7.3%/year vs 3.2%/year, P < 0.001), and reduced major adverse cardiac events (MACE) (5...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27889659/a-national-riparian-restoration-programme-in-new-zealand-is-it-value-for-money
#14
Adam J Daigneault, Florian V Eppink, William G Lee
National scale initiatives are being attempted in New Zealand (NZ) to meet important environmental goals following land-use intensification over recent decades. Riparian restoration to filter agricultural spillover effects is currently the most widely practised mitigation measure but few studies have investigated the cumulative value of these practices at a national level. We use an applied economic land use model the benefits (GHG emissions, N leaching, P loss, sedimentation and biodiversity gain) and relevant costs (fencing, alternative stock water supplies, restoration planting and opportunity costs) of restoring riparian margins (5-50 m) on all streams in NZ flowing through current primary sector land...
November 24, 2016: Journal of Environmental Management
https://www.readbyqxmd.com/read/27889277/evaluating-the-four-kallikrein-panel-of-the-4kscore-for-prediction-of-high-grade-prostate-cancer-in-men-in-the-canary-prostate-active-surveillance-study
#15
Daniel W Lin, Lisa F Newcomb, Marshall D Brown, Daniel D Sjoberg, Yan Dong, James D Brooks, Peter R Carroll, Matthew Cooperberg, Atreya Dash, William J Ellis, Michael Fabrizio, Martin E Gleave, Todd M Morgan, Peter S Nelson, Ian M Thompson, Andrew A Wagner, Yingye Zheng
BACKGROUND: Diagnosis of Gleason 6 prostate cancer can leave uncertainty about the presence of undetected aggressive disease. OBJECTIVE: To evaluate the utility of a four kallikrein (4K) panel in predicting the presence of high-grade cancer in men on active surveillance. DESIGN, SETTING, AND PARTICIPANTS: Plasma collected before the first and subsequent surveillance biopsies was assessed for 718 men prospectively enrolled in the multi-institutional Canary PASS trial...
November 23, 2016: European Urology
https://www.readbyqxmd.com/read/27884965/-can-you-recommend-any-good-sti-apps-a-review-of-content-accuracy-and-comprehensiveness-of-current-mobile-medical-applications-for-stis-and-related-genital-infections
#16
Jo Gibbs, Voula Gkatzidou, Laura Tickle, Sarah R Manning, Tilna Tilakkumar, Kate Hone, Richard E Ashcroft, Pam Sonnenberg, S Tariq Sadiq, Claudia S Estcourt
OBJECTIVE: Seeking sexual health information online is common, and provision of mobile medical applications (apps) for STIs is increasing. Young people, inherently at higher risk of STIs, are avid users of technology, and apps could be appealing sources of information. We undertook a comprehensive review of content and accuracy of apps for people seeking information about STIs. METHODS: Search of Google Play and iTunes stores using general and specific search terms for apps regarding STIs and genital infections (except HIV), testing, diagnosis and management, 10 September 2014 to 16 September 2014...
November 24, 2016: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/27884850/comparative-effectiveness-and-safety-of-oral-anticoagulants-for-atrial-fibrillation-in-real-world-practice-a-population-based-cohort-study-protocol
#17
Anne Holbrook, Colin Dormuth, Richard Morrow, Agnes Lee, Sue Troyan, Guowei Li, Eleanor Pullenyegum
INTRODUCTION: Anticoagulants are arguably the most important drug family of all, based on the frequency and duration of their use, and the clinical importance and frequency of benefits and harms. Several direct acting oral anticoagulants (DOACs) have recently joined warfarin for the treatment of atrial fibrillation, with a resultant significant expansion in use of oral anticoagulants (OACs). Our objectives are to compare safety and effectiveness of DOACs versus warfarin in a full population where anticoagulation management is good and to identify which types of patients do better with DOACs versus warfarin and vice versa...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27883069/quality-of-life-and-cost-effectiveness-of-radiofrequency-ablation-versus-open-surgery-for-benign-thyroid-nodules-a-retrospective-cohort-study
#18
Wen-Wen Yue, Xiao-Long Li, Hui-Xiong Xu, Feng Lu, Li-Ping Sun, Le-Hang Guo, Ya-Ping He, Dan Wang, Zhi-Qiang Yin
This study is to compare the health-related quality of life (HRQoL) and cost-effectiveness of radiofrequency ablation (RFA) and open thyroidectomy (OT) for benign thyroid nodules (BTNs) treatment. HRQoL and utility were assessed for 404 BTN patients immediately before treatments (RFA:OT = 137:267) and at 6-month visit. A cost-effectiveness analysis was performed from societal perspective in the China context. Resource use (hospitalization, sick leaves) was collected. We used the net monetary benefit approach and computed cost-effectiveness acceptability curves for RFA and OT...
November 24, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27881290/mercury-eicosapentanoic-acid-and-docosahexaenoic-acid-demonstrate-limited-effect-on-plasma-paraoxonase-1-activity-and-blood-pressure-among-avid-seafood-consumers-in-the-long-island-study-of-seafood-consumption-ny-usa
#19
Charles Miller, Roxanne Karimi, Qiao Zhang, Jie Yang, Jaymie Meliker
BACKGROUND AND AIM: Moderate fish consumption is recommended for prevention of coronary heart disease (CHD) as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) have known beneficial effects on risk factors such as reducing blood pressure (BP) and increasing paraoxonase-1 (PON-1) activity. However concomitant methylmercury (MeHg) exposure from fish consumption may mitigate these benefits and the net effect on BP and PON-1 activity has not been extensively studied in western populations consuming diverse seafood types...
November 17, 2016: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/27874210/cost-effectiveness-of-using-cognitive-screening-tests-for-detecting-dementia-and-mild-cognitive-impairment-in-primary-care
#20
Thaison Tong, Praveen Thokala, Brian McMillan, Rob Ghosh, John Brazier
INTRODUCTION: We estimated the cost effectiveness of different cognitive screening tests for use by General Practitioners (GPs) to detect cognitive impairment in England. METHODS: A patient-level cost-effectiveness model was developed using a simulated cohort that represents the elderly population in England (65 years and older). Each patient was followed over a lifetime period. Data from published sources were used to populate the model. The costs include government funded health and social care, private social care and informal care...
November 22, 2016: International Journal of Geriatric Psychiatry
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