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Amara Krag, Gregory L Holmes
Infantile spasms, one of the catastrophic epilepsies, can be a diagnostic challenge since the clinical manifestations may be subtle and may mimic benign conditions. Because of the rarity of the condition, primary care physicians and pediatricians may never see a case of infantile spasms during their career and may be unfamiliar with the seizure semiology. This is a serious issue since there is evidence that early diagnosis and treatment may improve outcome. Patients and families are increasingly using the internet more than their physician as a source of medical information about epilepsy...
October 17, 2016: Epilepsy & Behavior: E&B
Katherine Fairhurst, Lisa Leopardi, Thomas Satyadas, Guy Maddern
Breast cancer liver metastases have traditionally been considered incurable and any treatment given therefore palliative. Liver resections for breast cancer metastases are being performed, despite there being no robust evidence for which patients benefit. This review aims to determine the safety and effectiveness of liver resection for breast cancer metastases. A systematic literature review was performed and resulted in 33 papers being assembled for analysis. All papers were case series and data extracted was heterogeneous so a meta-analysis was not possible...
October 17, 2016: Breast: Official Journal of the European Society of Mastology
Rupert M Pearse, Tom E Abbott, Richard Haslop, Tahania Ahmad, Brennan C Kahan, Claudia Filipini, Andrew Rhodes, Marco Ranieri
BACKGROUND: Over 300 million patients undergo surgery worldwide each year. Postoperative morbidity - particularly respiratory complications - are most frequent and severe among high-risk patients undergoing major abdominal surgery. However, standard treatments, like physiotherapy or supplemental oxygen, often fail to prevent these. Preliminary research suggests that prophylactic continuous positive airways pressure (CPAP) can reduce the risk of postoperative respiratory complications...
October 20, 2016: Minerva Anestesiologica
Shaniece Criss, Dahiana Rodriguez, Roberta E Goldman
Our qualitative study examined how stresses of daily life affected substance use and perceived risk among Black and Hispanic adolescents. We conducted 11 focus groups with students aged 13-25 in public and alternative schools in Providence, Rhode Island, using Bourdieu's Social Practice theoretical approach to guide questioning and data analysis. Despite participants' frequent marijuana use, they perceived the emphasis society places on substance use as misguided, obfuscating the persistence of more critical problems such as stress and reduced opportunity resulting from neighborhood violence, poor schools, financial difficulties, and home troubles...
2016: Journal of Health Care for the Poor and Underserved
C R Carpenter, M Émond
No abstract text is available yet for this article.
October 2016: Netherlands Journal of Medicine
Joanna Granich, Alena Dass, Margherita Busacca, Dennis Moore, Angelika Anderson, Svetha Venkatesh, Thi Duong, Pratibha Vellanki, Amanda Richdale, David Trembath, Darin Cairns, Wendy Marshall, Tania Rodwell, Madeleine Rayner, Andrew J O Whitehouse
BACKGROUND: Evidence for early intensive behavioural interventions (EIBI) by therapists as an effective treatment for children with an Autism Spectrum Disorder (ASD) is growing. High-intensity and sustained delivery of quality EIBI is expensive. The TOBY (Therapy Outcomes by You) Playpad is an App-based platform delivering EIBI to facilitate learning for young children with ASD, while enabling parents to become co-therapists. Intervention targets include increasing joint attention, imitation and communication of children with ASD...
October 19, 2016: BMC Pediatrics
Anjali Nagpal, Chris Juttner, Monica Anne Hamilton-Bruce, Paul Rolan, Simon A Koblar
The encouraging pace of discovery and development in the field of regenerative medicine holds tremendous potential for bringing therapies to the clinic that may offer meaningful benefit to patients, particularly in diseases with no or suboptimal therapeutic options. Academic researchers will continue to play a critical role in developing concepts and therapies, thus determining whether regenerative medicine will be able to live up to this potential that clearly excites clinicians, researchers and patients alike...
October 17, 2016: Advanced Drug Delivery Reviews
Sarah H Wild, Janet Hanley, Stephanie C Lewis, John A McKnight, Lucy B McCloughan, Paul L Padfield, Richard A Parker, Mary Paterson, Hilary Pinnock, Aziz Sheikh, Brian McKinstry
[This corrects the article DOI: 10.1371/journal.pmed.1002098.].
October 2016: PLoS Medicine
Mikhail Kissine, Elise Clin, Jessica de Villiers
Autism spectrum disorder (ASD) is characterized by primary pragmatic difficulties, out of step with verbal and non-verbal developmental level. This selective survey paper addresses three recent domains of research on pragmatic functions in autism. First, we provide an up-to-date discussion of how lack of sensitivity to social cues impacts early acquisition of words. Second, we review recent findings on the comprehension of non-literal language, pointing to a more refined clinical reality. Third, we describe recent developments in the study of conversation skills in autism...
October 2016: Médecine Sciences: M/S
Keith W Muir, Gary A Ford, Claudia-Martina Messow, Ian Ford, Alicia Murray, Andrew Clifton, Martin M Brown, Jeremy Madigan, Rob Lenthall, Fergus Robertson, Anand Dixit, Geoffrey C Cloud, Joanna Wardlaw, Janet Freeman, Philip White
OBJECTIVE: The Pragmatic Ischaemic Thrombectomy Evaluation (PISTE) trial was a multicentre, randomised, controlled clinical trial comparing intravenous thrombolysis (IVT) alone with IVT and adjunctive intra-arterial mechanical thrombectomy (MT) in patients who had acute ischaemic stroke with large artery occlusive anterior circulation stroke confirmed on CT angiography (CTA). DESIGN: Eligible patients had IVT started within 4.5 hours of stroke symptom onset. Those randomised to additional MT underwent thrombectomy using any Conformité Européene (CE)-marked device, with target interval times for IVT start to arterial puncture of <90 min...
October 18, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
H H G Handoll, S D Brealey, L Jefferson, A Keding, A J Brooksbank, A J Johnstone, J J Candal-Couto, A Rangan
OBJECTIVES: Accurate characterisation of fractures is essential in fracture management trials. However, this is often hampered by poor inter-observer agreement. This article describes the practicalities of defining the fracture population, based on the Neer classification, within a pragmatic multicentre randomised controlled trial in which surgical treatment was compared with non-surgical treatment in adults with displaced fractures of the proximal humerus involving the surgical neck...
October 2016: Bone & Joint Research
Dawn P Gill, Wendy Blunt, Ashleigh De Cruz, Brendan Riggin, Kate Hunt, Guangyong Zou, Shannon Sibbald, Karen Danylchuk, Merrick Zwarenstein, Cindy M Gray, Sally Wyke, Christopher Bunn, Robert J Petrella
BACKGROUND: Effective approaches that engage men in weight loss and lifestyle change are important because of worldwide increases, including in Canada, in obesity and chronic diseases. Football Fans in Training (FFIT), developed in Scotland, successfully tackled these problems by engaging overweight/obese male football fans in sustained weight loss and positive health behaviours, through program deliveries at professional football stadia. METHODS: Aims: 1) Adapt FFIT to hockey within the Canadian context and integrate with HealtheSteps™ (evidence-based lifestyle program) to develop Hockey Fans in Training (Hockey FIT); 2) Explore potential for Hockey FIT to help overweight/obese men lose weight and improve other outcomes by 12 weeks, and retain these improvements to 12 months; 3) Evaluate feasibility of recruiting and retaining overweight/obese men; 4) Evaluate acceptability of Hockey FIT; and 5) Conduct program optimization via a process evaluation...
October 19, 2016: BMC Public Health
Jennifer M Hensel, Jay Shaw, Lianne Jeffs, Noah M Ivers, Laura Desveaux, Ashley Cohen, Payal Agarwal, Walter P Wodchis, Joshua Tepper, Darren Larsen, Anita McGahan, Peter Cram, Geetha Mukerji, Muhammad Mamdani, Rebecca Yang, Ivy Wong, Nike Onabajo, Trevor Jamieson, R Sacha Bhatia
BACKGROUND: Mental illness is a substantial and rising contributor to the global burden of disease. Access to and utilization of mental health care, however, is limited by structural barriers such as specialist availability, time, out-of-pocket costs, and attitudinal barriers including stigma. Innovative solutions like virtual care are rapidly entering the health care domain. The advancement and adoption of virtual care for mental health, however, often occurs in the absence of rigorous evaluation and adequate planning for sustainability and spread...
October 18, 2016: BMC Psychiatry
Leila Rooshenas, Daisy Elliott, Julia Wade, Marcus Jepson, Sangeetha Paramasivan, Sean Strong, Caroline Wilson, David Beard, Jane M Blazeby, Alison Birtle, Alison Halliday, Chris A Rogers, Rob Stein, Jenny L Donovan
BACKGROUND: Randomised controlled trials (RCTs) are essential for evidence-based medicine and increasingly rely on front-line clinicians to recruit eligible patients. Clinicians' difficulties with negotiating equipoise is assumed to undermine recruitment, although these issues have not yet been empirically investigated in the context of observable events. We aimed to investigate how clinicians conveyed equipoise during RCT recruitment appointments across six RCTs, with a view to (i) identifying practices that supported or hindered equipoise communication and (ii) exploring how clinicians' reported intentions compared with their actual practices...
October 2016: PLoS Medicine
Sara Gianella, Jeff Taylor, Timothy R Brown, Andy Kaytes, Cristian L Achim, David J Moore, Susan J Little, Ron J Ellis, Davey M Smith
Despite extensive investigations, we still do not fully understand the dynamics of the total body HIV reservoir and how sub-reservoirs in various compartments relate to one another. Studies using macaque models are enlightening but eradication strategies will still need to be tested in humans. To take the next steps in understanding and eradicating HIV reservoirs throughout the body, we propose to develop a "peri-mortem translational research model" of HIV-infected individuals (called 'The Last Gift'), which is similar to existing models in cancer research...
October 14, 2016: AIDS
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
September 2016: Journal of Hypertension
Lawrence Appel
With the exception of a few isolated populations, elevated blood pressure is a worldwide pandemic with staggering consequences for individuals, care givers, health care delivery systems, and insurers, including governments. It is well-recognized that the burden of hypertension and its adverse consequences is greater in low- and middle-income countries than economically developed countries. BP-related outcomes also differ by region, with a predominance of stroke in southeast Asian countries and a predominance of ischemic heart disease in the US and Western Europe...
September 2016: Journal of Hypertension
Gennaro Giustino, Robert M A Van der Boon, Javier Molina-Martin de Nicolas, Nicolas Dumonteil, Alaide Chieffo, Peter P T de Jaegere, Didier Tchetche, Bertrand Marcheix, Damien Millischer, Romain Cassagneau, Didier Carrié, Nicolas M Van Mieghem, Antonio Colombo
AIMS: We sought to evaluate the impact of permanent pacemaker (PPM) implantation on two-year mortality and one-year left ventricular ejection fraction recovery (∆LVEFR=one-year LVEF-baseline LVEF) after transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: We pooled patient-level data from four European institutions with significant TAVI volume. Outcomes were compared between patients without PPM (no-PPM), patients with PPM prior to TAVI (old-PPM) and patients with PPM implanted after TAVI (new-PPM)...
October 20, 2016: EuroIntervention
Jimmie Leppink, Patricia O'Sullivan, Kal Winston
The overall purpose of the 'Statistical Points and Pitfalls' series is to help readers and researchers alike increase awareness of how to use statistics and why/how we fall into inappropriate choices or interpretations. We hope to help readers understand common misconceptions and give clear guidance on how to avoid common pitfalls by offering simple tips to improve your reporting of quantitative research findings. Each entry discusses a commonly encountered inappropriate practice and alternatives from a pragmatic perspective with minimal mathematics involved...
October 17, 2016: Perspectives on Medical Education
Anna-Lisa Vollmer, Britta Wrede, Katharina J Rohlfing, Pierre-Yves Oudeyer
One of the big challenges in robotics today is to learn from human users that are inexperienced in interacting with robots but yet are often used to teach skills flexibly to other humans and to children in particular. A potential route toward natural and efficient learning and teaching in Human-Robot Interaction (HRI) is to leverage the social competences of humans and the underlying interactional mechanisms. In this perspective, this article discusses the importance of pragmatic frames as flexible interaction protocols that provide important contextual cues to enable learners to infer new action or language skills and teachers to convey these cues...
2016: Frontiers in Neurorobotics
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