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https://www.readbyqxmd.com/read/28538622/towards-precision-medicine-accurate-predictive-modeling-of-infectious-complications-in-combat-casualties
#1
Christopher J Dente, Matthew Bradley, Seth Schobel, Beverly Gaucher, Timothy Buchman, Allan D Kirk, Eric Elster
BACKGROUND: The biomarker profile of trauma patients may allow for the creation of models to assist bedside decision making & prediction of complications. We sought to determine the utility of modeling in the prediction of bacteremia & pneumonia in combat casualties. METHODS: This is a prospective, observational trial of patients with complex wounds treated at Walter Reed National Military Medical Center (2007-2012). Tissue, serum and wound effluent samples were collected during operative interventions until wound closure...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28537981/development-of-education-and-research-in-anesthesia-and-intensive-care-medicine-at-the-university-teaching-hospital-in-lusaka-zambia-a-descriptive-observational-study
#2
Anna Janowicz, Tuma Kasole, Emily Measures, Meg Langley, Fastone M Goma, Feruza Ismailova, John A Kinnear, M Dylan Bould
BACKGROUND: Data from 2006 show that the practice of anesthesia at the University Teaching Hospital in Lusaka, Zambia was underdeveloped by international standards. Not only was there inadequate provision of resources related to environment, equipment, and drugs, but also a severe shortage of staff, with no local capability to train future physician anesthetic providers. There was also no research base on which to develop the specialty. This study aimed to evaluate patient care, education and research to determine whether conditions had changed a decade later...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28537833/bringing-transparency-to-medicine-exploring-physicians-views-and-experiences-of-the-sunshine-act
#3
Susan Chimonas, Nicholas J DeVito, David J Rothman
The Physician Payments Sunshine Act (PPSA) requires health care product manufacturers to report to the federal government payments more than $10 to physicians. Bringing unprecedented transparency to medicine, PPSA holds great potential for enabling medical stakeholders to manage conflicts of interest (COI) and build patient trust-crucial responsibilities of medical professionalism. The authors conducted six focus groups with 42 physicians in Chicago, IL, San Francisco, CA, and Washington, DC, to explore attitudes and experiences around PPSA...
June 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28535585/good-laboratory-standards-for-clinical-next-generation-sequencing-cancer-panel-tests
#4
REVIEW
Jihun Kim, Woong-Yang Park, Nayoung K D Kim, Se Jin Jang, Sung-Min Chun, Chang-Ohk Sung, Jene Choi, Young-Hyeh Ko, Yoon-La Choi, Hyo Sup Shim, Jae-Kyung Won
Next-generation sequencing (NGS) has recently emerged as an essential component of personalized cancer medicine due to its high throughput and low per-base cost. However, no sufficient guidelines for implementing NGS as a clinical molecular pathology test are established in Korea. To ensure clinical grade quality without inhibiting adoption of NGS, a taskforce team assembled by the Korean Society of Pathologists developed laboratory guidelines for NGS cancer panel testing procedures and requirements for clinical implementation of NGS...
May 2017: Journal of Pathology and Translational Medicine
https://www.readbyqxmd.com/read/28535316/residents-confidence-providing-primary-care-with-behavioral-health-integration
#5
Patrick Hemming, Amber Hewitt, Joseph J Gallo, Rodger Kessler, R B Levine
BACKGROUND AND OBJECTIVES: Behavioral health integration (BHI) entails integrated behavioral health clinicians (IBHCs) providing care-generally for mental health and substance abuse disorders and behavioral comorbidity- within the operational functioning of primary care. Because limited data exist regarding BHI in residency, we studied its impact on resident education by examining whether increased behavioral health (BH) co-management improved residents' perceived ability to treat BH conditions...
May 2017: Family Medicine
https://www.readbyqxmd.com/read/28535123/topical-otic-drugs-in-a-multi-purpose-manufacturing-facility-a-guide-on-determination-and-application-of-permitted-daily-exposure-pde
#6
Lisa Wiesner, Maarten Prause, Ester Lovsin Barle
Due to newly introduced EU GMP guideline for Medicinal Products for Human and Veterinary use (PIC/S, 2015), product specific PDE for toxicological evaluation in multi-purpose facilities are required within a documented process for risk assessment. EMA (2014) guidance on setting PDE limits so far focused on systemic administration routes such as IV, oral or inhalation. This manuscript wants to give guidance on setting PDE values for risk management purposes in multi-purpose facilities for Active Pharmaceutical Ingredients (APIs) applied as topical otic drugs to the outer ear canal...
May 23, 2017: Pharmaceutical Development and Technology
https://www.readbyqxmd.com/read/28534685/biotin-interference-with-routine-clinical-immunoassays-understand-the-causes-and-mitigate-the-risks
#7
Shanika Samarasinghe, Farah Meah, Vinita Singh, Arshi Basit, Nicholas Emanuele, Mary Ann Emanuele, Alaleh Mazhari, Earle W Holmes
OBJECTIVES: The objectives of this report are to review the mechanisms of biotin interference with streptavidin/biotin-based immunoassays, identify automated immunoassay systems vulnerable to biotin interference, describe how to estimate and minimize the risk of biotin interference in vulnerable assays, and review the literature pertaining to biotin interference in endocrine function tests. METHODS: The data in the manufacturer's "Instructions for Use" for each of the methods utilized by seven immunoassay system were evaluated...
May 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28534323/-era-of-enhanced-recovery-after-surgery-and-robotic-gastric-cancer-surgery
#8
Yanbing Zhou
Enhanced recovery after surgery (ERAS) has been rapidly developing by combining several techniques with evidence-based adjustments, including preoperative education, preoperative carbohydrate loading, epidural or regional anesthesia, early initiation of enteral nutrition, ambulation and multi-modal pain management. The core part of ERAS is to reduce and reverse surgical stress and therefore greatly improve clinical outcome. Under the guidance of ERAS, perioperative management of robotic gastric cancer operation should follow the basic principles of ERAS and clinical pathway to maximize the advantages of the robotic surgery...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28534250/advancing-immunotherapy-in-metastatic-breast-cancer
#9
REVIEW
Mariam Mansour, Zhi Ling Teo, Stephen J Luen, Sherene Loi
Despite many advances in the treatment of breast cancer, the development of metastatic disease remains an incurable and frequent cause of cancer death for women worldwide. An improved understanding of the role of host immunosurveillance in modulating breast cancer disease biology, as well as impressive survival benefits seen to checkpoint blockade in other malignancies have provided great hope for an expanding role of immunotherapies in breast cancer management. While these novel therapies are currently being investigated in clinical trials, signals of efficacy, and tolerability in early phase studies suggest these will eventually make their way into standard practice algorithms...
June 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28533783/progress-on-azadirachta-indica-based-biopesticides-in-replacing-synthetic-toxic-pesticides
#10
REVIEW
Suman Chaudhary, Rupinder K Kanwar, Alka Sehgal, David M Cahill, Colin J Barrow, Rakesh Sehgal, Jagat R Kanwar
Over the years, extensive use of commercially available synthetic pesticides against phytophagous insects has led to their bioaccumulation in the environment causing increased resistance and reduction in soil biodiversity. Further, 90% of the applied pesticides enter the various environmental resources as a result of run-off, exposing the farmers as well as consumers of the agricultural produce to severe health issues. Therefore, growing attention has been given toward the development of alternate environmentally friendly pesticides/insecticides that would aid an efficient pest management system and also prevent chronic exposures leading to diseases...
2017: Frontiers in Plant Science
https://www.readbyqxmd.com/read/28533290/pharmaceutical-grade-chondroitin-sulfate-is-as-effective-as-celecoxib-and-superior-to-placebo-in-symptomatic-knee-osteoarthritis-the-chondroitin-versus-celecoxib-versus-placebo-trial-concept
#11
Jean-Yves Reginster, Jean Dudler, Tomasz Blicharski, Karel Pavelka
OBJECTIVES: Chondroitin sulfate 800 mg/day (CS) pharmaceutical-grade in the management of symptomatic knee osteoarthritis consistent with the European Medicines Agency guideline. METHODS: A prospective, randomised, 6-month, 3-arm, double-blind, double-dummy, placebo and celecoxib (200 mg/day)-controlled trial assessing changes in pain on a Visual Analogue Scale (VAS) and in the Lequesne Index (LI) as coprimary endpoints. Minimal-Clinically Important Improvement (MCII), Patient-Acceptable Symptoms State (PASS) were used as secondary endpoints...
May 22, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28532856/implementation-of-a-referral-to-discharge-glycemic-control-initiative-for-reduction-of-surgical-site-infections-in-gynecologic-oncology-patients
#12
Laura Hopkins, Jennifer Brown-Broderick, James Hearn, Janine Malcolm, James Chan, Wendy Hicks-Boucher, Filomena De Sousa, Mark C Walker, Sylvain Gagné
OBJECTIVE(S): To evaluate the frequency of surgical site infections before and after implementation of a comprehensive, multidisciplinary perioperative glycemic control initiative. STUDY METHODS: As part of a CUSP (Comprehensive Unit-based Safety Program) initiative, between January 5 and December 18, 2015, we implemented comprehensive, multidisciplinary glycemic control initiative to reduce SSI rates in patients undergoing major pelvic surgery for a gynecologic malignancy ('Group II')...
May 20, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28532612/why-evidence-based-medicine-failed-in-patient-care-and-medicine-based-evidence-will-succeed
#13
Ralph I Horwitz, Burton H Singer
Evidence-based medicine (EBM) has succeeded in strengthening the evidence base for population medicine. Where EBM has failed is in answering the practicing doctor's question of what a likely outcome would be when a given treatment is administered to a particular patient with her own distinctive biological and biographical (life experience) profile. We propose Medicine-based evidence (MBE), based on the profiles of individual patients, as the evidence base for individualized or personalized medicine. MBE will build an archive of patient profiles using data from all study types and data sources, and will include both clinical and socio-behavioral information...
April 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28532553/the-potential-impact-of-public-health-interventions-in-preventing-kidney-disease
#14
REVIEW
Rohina Joshi, Oommen John, Vivekanand Jha
The years of life lost and years lived with disability resulting from chronic kidney disease (CKD) increased globally by 90% and 49.5%, respectively, between 1990 and 2013. In addition to the traditional factors, infections, low birthweight, environmental factors, and low socioeconomic status contribute to the CKD burden in low- and middle-income countries. System-level challenges such as poor appreciation of the burden, insufficient human resources, high health care costs, poor referral pathways, unreliable health information systems, and inadequate medicine supply pose barriers to CKD control...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532470/health-care-professionals-attitudes-towards-evidence-based-medicine-in-the-workers-compensation-setting-a-cohort-study
#15
Nieke A Elbers, Robin Chase, Ashley Craig, Lyn Guy, Ian A Harris, James W Middleton, Michael K Nicholas, Trudy Rebbeck, John Walsh, Simon Willcock, Keri Lockwood, Ian D Cameron
BACKGROUND: Problems may arise during the approval process of treatment after a compensable work injury, which include excess paperwork, delays in approving services, disputes, and allegations of over-servicing. This is perceived as undesirable for injured people, health care professionals and claims managers, and costly to the health care system, compensation system, workplaces and society. Introducing an Evidence Based Medicine (EBM) decision tool in the workers' compensation system could provide a partial solution, by reducing uncertainty about effective treatment...
May 22, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28532204/management-of-allergic-rhinitis-in-the-era-of-effective-over-the-counter-treatments
#16
Warner W Carr, Barbara P Yawn
Allergic rhinitis (AR) may be regarded as a trivial issue unworthy of the doctor's time, and with the availability of many different over-the-counter (OTC) treatments, up to two thirds of patients self-manage AR before seeking medical care. Yet, AR can have a significant impact on health-related quality of life and is associated with a greater detriment to work productivity than other chronic diseases such as diabetes and hypertension. For many patients, the impact on quality of life is greater than suggested by reported symptoms and should also be a focus of treatment...
May 22, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28530520/cardiovascular-disease-and-gout-real-world-experience-evaluating-patient-characteristics-treatment-patterns-and-health-care-utilization
#17
Michael H Pillinger, Sripal Bangalore, Alyssa B Klein, Scott Baumgartner, Robert Morlock
BACKGROUND: Gout, hyperuricemia, and cardiovascular disease (CVD) are prevalent conditions in the United States, and while they share common risk factors such as obesity, hypertension, hypercholesterolemia, and type 2 diabetes mellitus, relatively little is known about what patient and disease characteristics may link CVD with hyperuricemia and gout and how the presence of both diseases affects management decisions differently than for patients with gout alone. OBJECTIVE: To identify differences in patient characteristics, patterns of urate-lowering therapy (ULT) use, and gout control in gout patients with and without cardiovascular comorbidity...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530054/-traditional-chinese-medicine-in-treatment-of-atopic-dermatitis
#18
Orit Schachter, David Perla, Shoshana Greenberger, Aviv Barzilai, Sharon Baum
BACKGROUND: Atopic dermatitis is a common chronic inflammatory skin disease, affecting up to 15-30% of children in industrialized countries. As there is no definitive cure for atopic dermatitis, patients often seek other complementary therapeutic options, such as traditional Chinese medicine (TCM). TCM comprises numerous treatment modalities for the management of atopic dermatitis including acupuncture and herbal medicine. We report a case of a two and a half year old child with atopic dermatitis exacerbation treated successfully with TCM...
October 2016: Harefuah
https://www.readbyqxmd.com/read/28529969/antioxidant-and-synergistic-antidiabetic-activities-of-a-three-plant-preparation-used-in-cameroon-folk-medicine
#19
Bruno Moukette Moukette, Vicky Jocelyne Ama Moor, Cacral Prosper Biapa Nya, Pauline Nanfack, Francine Tankeu Nzufo, Marcel Azabji Kenfack, Jeanne Yonkeu Ngogang, Constant Anatole Pieme
Introduction. Several plant preparations like a mixture of aqueous extracts of Spilanthes africana; Portulaca oleracea; and Sida rhombifolia are currently utilized in Foumban (West Cameroon) to manage diabetes. The aim of this study is to investigate the antidiabetic property of the aqueous mixture of three plant extracts (1 : 1 : 1) on streptozotocin induced diabetes rats. Methods. Diabetes was induced to rats by intraperitoneal (i.p.) injection of streptozotocin (STZ) at a dose of 50 mg/kg b.w...
2017: International Scholarly Research Notices
https://www.readbyqxmd.com/read/28529913/critical-care-management-and-intensive-care-unit-outcomes-following-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#20
Sumit Kapoor, Adel Bassily-Marcus, Rafael Alba Yunen, Parissa Tabrizian, Sabrine Semoin, Joseph Blankush, Daniel Labow, John Oropello, Anthony Manasia, Roopa Kohli-Seth
AIM: To study the early postoperative intensive care unit (ICU) management and complications in the first 2 wk of patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Our study is a retrospective, observational study performed at Icahn School of Medicine at Mount Sinai, quaternary care hospital in New York City. All adult patients who underwent CRS and HIPEC between January 1, 2007 and December 31, 2012 and admitted to ICU postoperatively were studied...
May 4, 2017: World Journal of Critical Care Medicine
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