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https://www.readbyqxmd.com/read/28103467/-investigation-of-genetic-etiology-in-neurodegenerative-dementias-recommendations-from-the-centro-hospitalar-s%C3%A3-o-jo%C3%A3-o-neurogenetics-group
#1
João Massano, Miguel Leão, Carolina Garrett
In the past few years several gene mutations have been identified as causative of the most frequent neurodegenerative dementias (Alzheimer disease and frontotemporal dementia). These advances, along with the complex phenotype-genotype relationships and the costs associated with genetic testing, have often made it difficult for clinicians to decide with regard to a rational plan for the investigation of the genetic etiology of the degenerative dementias. The Centro Hospitalar São João Neurogenetics Group, a multidisciplinary team of Neurologists and Geneticists with special interest in neurogenetic disorders, devised consensus recommendations for the investigation of the genetic etiology of Alzheimer disease and frontotemporal dementia in clinical practice, based on international consensus documents (currently containing partly outdated information) and published scientific evidence on this topic...
October 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28102112/dutiful-daughters-hiv-aids-moral-pragmatics-female-citizenship-and-structural-violence-among-devadasis-in-northern-karnataka-india
#2
Shamshad Khan, Robert Lorway, Claudyne Chevrier, Sumit Dutta, Satyanarayana Ramanaik, Anu Roy, Parinita Bhattacharjee, Sharmistha Mishra, Stephen Moses, James Blanchard, Marissa Becker
Decades of research have documented how sex workers worldwide, particularly female sex workers (FSWs), shoulder a disproportionate burden of the HIV epidemic. In India, although a substantial progress has been made in controlling the epidemic, its prevalence among FSWs and the Devadasis (also called traditional sex workers) in northern Karnataka is still significantly high. On the other hand, much of the HIV prevention research has focused on their mapping and size estimation, typologies, bio-behavioural surveillance, condom use and other prevention technologies...
January 19, 2017: Global Public Health
https://www.readbyqxmd.com/read/28101972/an-evaluation-of-the-quality-of-evidence-available-to-inform-current-bone-conduction-hearing-device-national-policy
#3
Rishi Mandavia, Alex Carter, Nadine Haram, Elias Mossialos, Anne Gm Schilder
OBJECTIVES: In 2016 NHS England published the commissioning policy on Bone Conducting Hearing Devices (BCHDs). This policy was informed by updated evidence on the clinical and cost effectiveness of BCHDs as well as by the 2013 Bone Anchored Hearing Aid (BAHA) policy. Commissioning policies set the criteria for service delivery and therefore have a major impact on the care received by patients. It is important that stakeholders have a good appreciation of the available evidence informing policy, since this will promote engagement both with the policy as well as with future research leading on from the policy...
January 18, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28099643/balanced-crystalloids-for-septic-shock-resuscitation
#4
Thiago Domingos Corrêa, Alexandre Biasi Cavalcanti, Murillo Santucci Cesar de Assunção
Timely fluid administration is crucial to maintain tissue perfusion in septic shock patients. However, the question concerning which fluid should be used for septic shock resuscitation remains a matter of debate. A growing body of evidence suggests that the type, amount and timing of fluid administration during the course of sepsis may affect patient outcomes. Crystalloids have been recommended as the first-line fluids for septic shock resuscitation. Nevertheless, given the inconclusive nature of the available literature, no definitive recommendations about the most appropriate crystalloid solution can be made...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099488/-i-cannot-be-worried-living-with-chagas-disease-in-tropical-bolivia
#5
Colin J Forsyth
BACKGROUND: Chagas disease (CD) profoundly affects the social and emotional dimensions of patients' lives, and disproportionately impacts poor, marginalized populations in Latin America. Biomedical treatment for CD fails to reach up to 99% of the people affected, and in any case seldom addresses the emotional health or socioeconomic conditions of patients. This study examines patient strategies for coping with CD in the department of Santa Cruz, Bolivia. METHODOLOGY: In this ethnographic study, semistructured interviews took place from March-June 2013 with 63 patients who had previously tested positive for CD...
January 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28099274/can-any-patients-with-chronic-myeloid-leukemia-outside-of-a-clinical-trial-have-their-tyrosine-kinase-inhibitor-discontinued
#6
Michael J Mauro
PURPOSE OF REVIEW: This article critically appraises the state of treatment-free remission as a strategy for patients with chronic myeloid leukemia (CML) in deep remission after therapy with tyrosine kinase inhibitors (TKIs). RECENT FINDINGS: Approximately half of patients with CML defined fairly narrowly by trial criteria - TKI sensitive, in deep molecular remission for a defined period - can successfully maintain protective levels of response after TKI cessation...
January 17, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28099214/rheumatoid-arthritis-selecting-monotherapy-versus-combination-therapy
#7
Nimish Mehta, Lynne Kolton Schneider, Emilie McCardell
The overall goal of therapy for patients with rheumatoid arthritis (RA) is to achieve low disease activity or remission and to prevent or control joint damage, prevent loss of function, and decrease pain. However, many patients with RA do not have the disease adequately controlled, and only a minority attain consistent remission. To successfully treat to target, rheumatologists need practical guidance to select monotherapy and combination therapy regimens based on available data. Differences in study design, dosing regimens, and data from defined and specific patient populations pose challenges to clinicians who treat patients with diverse characteristics and needs...
January 18, 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28097194/the-mystery-of-the-z-score
#8
REVIEW
Alexander E Curtis, Tanya A Smith, Bulat A Ziganshin, John A Elefteriades
Reliable methods for measuring the thoracic aorta are critical for determining treatment strategies in aneurysmal disease. Z-scores are a pragmatic alternative to raw diameter sizes commonly used in adult medicine. They are particularly valuable in the pediatric population, who undergo rapid changes in physical development. The advantage of the Z-score is its inclusion of body surface area (BSA) in determining whether an aorta is within normal size limits. Therefore, Z-scores allow us to determine whether true pathology exists, which can be challenging in growing children...
August 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28095892/comparative-effectiveness-and-cost-effectiveness-of-chuna-manual-therapy-versus-conventional-usual-care-for-nonacute-low-back-pain-study-protocol-for-a-pilot-multicenter-pragmatic-randomized-controlled-trial-pcrn-study
#9
Byung-Cheul Shin, Me-Riong Kim, Jae-Heung Cho, Jae-Young Jung, Koh-Woon Kim, Jun-Hwan Lee, Kibong Nam, Min Ho Lee, Eui-Hyoung Hwang, Kwang-Ho Heo, Namkwen Kim, In-Hyuk Ha
BACKGROUND: While Chuna manual therapy is a Korean manual therapy widely used primarily for low back pain (LBP)-related disorders in Korea, well-designed studies on the comparative effectiveness of Chuna manual therapy are scarce. METHODS/DESIGN: This study is the protocol for a three-armed, multicenter, pragmatic randomized controlled pilot trial. Sixty severe nonacute LBP patients (pain duration of at least 3 weeks, Numeric Rating Scale (NRS) ≥5) will be recruited at four Korean medicine hospitals...
January 17, 2017: Trials
https://www.readbyqxmd.com/read/28095838/communication-with-families-regarding-organ-and-tissue-donation-after-death-in-intensive-care-comfort-protocol-for-an-intervention-study
#10
Julie E Potter, Robert G Herkes, Lin Perry, Rosalind M Elliott, Anders Aneman, Jorge L Brieva, Elena Cavazzoni, Andrew T H Cheng, Michael J O'Leary, Ian M Seppelt, Val Gebski
BACKGROUND: Discussing deceased organ donation can be difficult not only for families but for health professionals who initiate and manage the conversations. It is well recognised that the methods of communication and communication skills of health professionals are key influences on decisions made by families regarding organ donation. METHODS: This multicentre study is being performed in nine intensive care units with follow-up conducted by the Organ and Tissue Donation Service in New South Wales (NSW) Australia...
January 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28094135/diabetes-prevention-program-translation-in-the-veterans-health-administration
#11
Tannaz Moin, Laura J Damschroder, Mona AuYoung, Matthew L Maciejewski, Santanu K Datta, Jane E Weinreb, Nanette I Steinle, Charles Billington, Maria Hughes, Fatima Makki, Robert G Holleman, H Myra Kim, Amy S Jeffreys, Linda S Kinsinger, Jennifer A Burns, Caroline R Richardson
INTRODUCTION: This clinical demonstration trial compared the effectiveness of the Veterans Affairs Diabetes Prevention Program (VA-DPP) with an evidence-based usual care weight management program (MOVE!(®)) in the Veterans Health Administration health system. DESIGN: Prospective, pragmatic, non-randomized comparative effectiveness study of two behavioral weight management interventions. SETTING/PARTICIPANTS: Obese/overweight Veterans with prediabetes were recruited from three geographically diverse VA sites between 2012 and 2014...
January 13, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28092648/does-brief-chronic-pain-management-education-change-opioid-prescribing-rates-a-pragmatic-trial-in-australian-early-career-general-practitioners
#12
Simon Mark Holliday, Chris Hayes, Adrian J Dunlop, Simon Morgan, Amanda Tapley, Kim M Henderson, Mieke L van Driel, Elizabeth G Holliday, Jean I Ball, Andrew Davey, Neil Allan Spike, Lawrence Andrew McArthur, Parker John Magin
We aimed to evaluate the effect of pain education on opioid prescribing by early-career general practitioners. A brief training workshop was delivered to general practice registrars of a single regional training provider. The workshop significantly reduced "hypothetical" opioid prescribing (in response to paper-based vignettes) in an earlier evaluation. The effect of the training on "actual" prescribing was evaluated using a nonequivalent control group design nested within the Registrar Clinical Encounters in Training (ReCEnT) cohort study: 4 other regional training providers were controls...
February 2017: Pain
https://www.readbyqxmd.com/read/28089313/optimism-pessimism-and-pragmatism-musings-on-the-cost-of-medical-innovation
#13
EDITORIAL
Joseph G Rogers
No abstract text is available yet for this article.
January 4, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28088243/reducing-sedentary-time-in-adults-at-risk-of-type-2-diabetes-process-evaluation-of-the-stand-sedentary-time-and-diabetes-rct
#14
Stuart J H Biddle, Charlotte L Edwardson, Trish Gorely, Emma G Wilmot, Thomas Yates, Myra A Nimmo, Kamlesh Khunti, Melanie J Davies
BACKGROUND: Reducing sedentary behaviour may have important health implications. This study evaluated the potential enablers and barriers for outcomes of a randomised controlled trial (RCT) designed to evaluate a pragmatic education based intervention designed to reduce sedentary (sitting) behaviour in young adults at high risk of type 2 diabetes. METHODS: Data were collected from participants in the intervention group immediately after an educational workshop addressing sedentary time and diabetes risk (n = 71), through phone interviews 6 weeks (n = 45) after the workshop, and at the conclusion of the 12-month trial (n = 10)...
January 14, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28087548/early-lens-extraction-with-intraocular-lens-implantation-for-the-treatment-of-primary-angle-closure-glaucoma-an-economic-evaluation-based-on-data-from-the-eagle-trial
#15
Mehdi Javanbakht, Augusto Azuara-Blanco, Jennifer M Burr, Craig Ramsay, David Cooper, Claire Cochran, John Norrie, Graham Scotland
OBJECTIVE: To investigate the cost-effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma (PACG) compared to standard care. DESIGN: Cost-effectiveness analysis alongside a multicentre pragmatic two-arm randomised controlled trial. Patients were followed-up for 36 months, and data on health service usage and health state utility were collected and analysed within the trial time horizon. A Markov model was developed to extrapolate the results over a 5-year and 10-year time horizon...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087156/french-national-consensus-clinical-guidelines-for-the-management-of-crohn-s-disease
#16
Laurent Peyrin-Biroulet, Yoram Bouhnik, Xavier Roblin, Guillaume Bonnaud, Hervé Hagège, Xavier Hébuterne
BACKGROUND: Crohn's disease (CD) is a chronic and disabling condition. There is no curative medical treatment but current treatments provide increasingly sustainable control of the disease and allow patients a better quality of life. There is limited evidence supporting CD management in specific clinical situations, thus precluding an evidence-based approach. AIMS: To help clinicians in making informed treatment decisions, a group of 59 French gastroenterologists with experience in the management of CD met to develop straightforward and practical algorithms based on the European Crohn's and Colitis Organisation (ECCO) recommendations...
December 22, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28079778/association-of-intended-route-of-delivery-and-maternal-morbidity-in-twin-pregnancy
#17
Sarah Rae Easter, Julian N Robinson, Ellice Lieberman, Daniela Carusi
OBJECTIVE: To evaluate maternal morbidity in twin pregnancies according to intended mode of delivery. METHODS: We assembled a 7-year retrospective cohort (2007-2014) of women delivering viable, vertex-presenting twins beyond 32 weeks of gestation without contraindication to labor or uterine scar. We classified women as undergoing a trial of labor to attempt vaginal birth or choosing an elective cesarean delivery. Our primary outcome was a measure of composite maternal morbidity including death, postpartum hemorrhage, infection, major procedure, readmission for infection or reoperation, need for dilation and evacuation for hemorrhage or infection, venous thromboembolism, small bowel obstruction or ileus, or intensive care unit admission...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28078313/unilobar-surgery-for-symptomatic-epileptic-spasms
#18
Carmen Barba, Roberto Mai, Laura Grisotto, Francesca Gozzo, Simona Pellacani, Laura Tassi, Stefano Francione, Flavio Giordano, Francesco Cardinale, Renzo Guerrini
OBJECTIVE: To assess factors associated with favorable seizure outcome after surgery for symptomatic epileptic spasms and improve knowledge on pathophysiology of this seizure type. METHODS: Inclusion criteria were: (1) age between 6 months and 15 years at surgery; (2) active epileptic spasms; (3) follow-up after surgery >1 year. RESULTS: We retrospectively studied 80 children (aged 1.3 ± 2 years at seizure onset; 5.8 ± 4 years at surgery, 11...
January 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/28078208/influence-of-different-second-generation-antipsychotics-on-the-qtc-interval-a-pragmatic-study
#19
Roy E Olsen, Rune A Kroken, Sigmund Bjørhovde, Kristina Aanesen, Hugo A Jørgensen, Else-Marie Løberg, Erik Johnsen
AIM: To investigate whether differential influence on the QTc interval exists among four second generation antipsychotics (SGAs) in psychosis. METHODS: Data were drawn from a pragmatic, randomized head-to-head trial of the SGAs risperidone, olanzapine, quetiapine, and ziprasidone in acute admissions patients with psychosis, and with follow-up visits at discharge or maximally 6-9 wk, 3, 6, 12 and 24 mo. Electrocardiograms were recorded on all visits. To mimic clinical shared decision-making, the patients were randomized not to a single drug, but to a sequence of the SGAs under investigation...
December 22, 2016: World Journal of Psychiatry
https://www.readbyqxmd.com/read/28077861/economics-and-obesity-policy
#20
REVIEW
J L Lusk
This paper elucidates the challenges surrounding the economics of some popular obesity-related policy proposals. Solid economic justifications for anti-obesity policies are often lacking, and pragmatically evidence suggests policies like fat and soda taxes or restrictions on food stamp spending are unlikely to substantively affect obesity prevalence. In short, many of the same factors that make obesity such a complicated and multifaceted issue extend to the economic analysis public health policies.International Journal of Obesity accepted article preview online, 12 January 2017...
January 12, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
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