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https://www.readbyqxmd.com/read/28523862/transatlantic-medical-consultation-and-second-opinion-in-pediatric-cardiology-has-benefit-past-patient-care-a-case-study-in-videoconferencing
#1
Lubica Kovacikova, Martin Zahorec, Peter Skrak, Brian D Hanna, R Lee Vogel
BACKGROUND: Telemedicine is a rapidly evolving form of modern information and communication technology used to deliver clinical services and educational activities. OBJECTIVE: The aim of this article is to report and analyze our experience with transatlantic consultation via videoconferencing in pediatric cardiology. METHODS: In February, 2013, videoconferencing project was launched between a medium-volume pediatric cardiac center in Bratislava, Slovakia and subspecialty experts from a high-volume pediatric cardiac program at The Children's Hospital of Philadelphia (CHOP), USA...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28521532/new-antivirals-for-the-treatment-of-chronic-hepatitis-b
#2
Vincent Soriano, Pablo Barreiro, Laura Benitez, Jose M Peña, Carmen de Mendoza
Current treatment with oral nucleos(t)ides entecavir or tenofovir provide sustained suppression of HBV replication and clinical benefit in most chronic hepatitis B virus (HBV) infected persons. However, HBV rebound generally occurs upon drug discontinuation due to persistence of genomic HBV reservoirs as episomic cccDNA and chromosomic integrated HBV-DNA. There is renewed enthusiasm on HBV drug discovery following recent successes with antivirals for hepatitis C and immunotherapies for some cancers. Areas covered: New drugs that target distinct steps of the HBV life cycle are been developed, including inhibitors of viral entry, new polymerase inhibitors, capsid and assembly inhibitors, virus release blockers, and disruptors of cccDNA formation and transcription...
May 18, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28521526/the-impact-of-genetics-on-future-drug-discovery-in-schizophrenia
#3
Mitsuyuki Matsumoto, Noah M Walton, Hiroshi Yamada, Yuji Kondo, Gerard J Marek, Katsunori Tajinda
Failures of investigational new drugs (INDs) for schizophrenia have left huge unmet medical needs for patients. Given the recent lackluster results, it is imperative that new drug discovery approaches (and resultant drug candidates) target pathophysiological alterations that are shared in specific, stratified patient populations that are selected based on pre-identified biological signatures. One path to implementing this paradigm is achievable by leveraging recent advances in genetic information and technologies...
May 18, 2017: Expert Opinion on Drug Discovery
https://www.readbyqxmd.com/read/28516820/blogging-in-infectious-diseases-and-clinical-microbiology-assessment-of-blogosphere-content
#4
Gabriel Birgand, Rachael Troughton, Luke S P Moore, Esmita Charani, Timothy M Rawson, Enrique Castro-Sánchez, Alison H Holmes
OBJECTIVE To analyze influential infectious diseases, antimicrobial stewardship, infection control, or medical microbiology blogs and bloggers SETTING World wide web DESIGN We conducted a systematic search for blogs in accordance with the PRISMA guidelines in September 2015. METHODS A snowball sampling approach was applied to identify blogs using various search engines. Blogs were eligible if they (1) focused on infectious diseases, antimicrobial stewardship, infection control, or medical microbiology; (2) were intended for health professionals; and (3) were written in English and (4) were updated regularly...
May 18, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28516250/-choosing-wisely-recommendations-in-angiology
#5
O J Müller, R Sternitzky
BACKGROUND: The Choosing wisely initiative addresses measures of high medical impact which are frequently not appropriately performed according to expert opinion. OBJECTIVE: To increase the quality of indications by providing supportive information on diagnostic and therapeutic measures in the field of angiology. MATERIALS AND METHODS: As part of the Choosing wisely initiative, the German Society of Angiology has constructed five positive recommendations on underused measures and five negative recommendations concerning those possibly overused...
May 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28515812/cost-effectiveness-of-mirabegron-compared-to-tolterodine-er-4-mg-for-overactive-bladder-in-canada
#6
Sender Herschorn, Jameel Nazir, Barbara Ramos, Zalmai Hakimi
INTRODUCTION: This analysis compared the cost-effectiveness of once-daily regimens of mirabegron 50 mg and generic tolterodine ER 4 mg in a hypothetical cohort of previously treated patients with overactive bladder (OAB) in Canada. METHODS: A Markov model was developed to represent different health states according to OAB symptoms (frequency, incontinence), presence/absence of adverse events (AEs; dry mouth, constipation, blurred vision), and treatment status (on-treatment, discontinue treatment, restart previous treatment)...
March 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28511597/understanding-sleep-wake-mechanisms-and-drug-discovery
#7
Ana Clementina Equihua-Benítez, Khalil Guzmán-Vásquez, René Drucker-Colín
Although not discernible at first glance, sleep is a highly active and regulated brain state. Although we spend practically one third of our lifetimes in this stage, its importance is often taken for granted. Sleep loss can lead to disease, error and economic loss. Our understanding of how sleep is achieved has greatly advanced in recent years, and with that, the management of sleep disorders has improved. Nevertheless, there is still room for improvement and recently many new compounds have reached clinical trials with a few being approved for commercial use...
May 17, 2017: Expert Opinion on Drug Discovery
https://www.readbyqxmd.com/read/28505029/treatment-options-for-failed-back-surgery-syndrome-fbss-patients-with-refractory-chronic-pain-an-evidence-based-approach
#8
Kasra Amirdelfan, Lynn Webster, Lawrence Poree, Vishad Sukul, Porter McRoberts
STUDY DESIGN: A significant number of lumbar post-surgical patients continue to suffer persistent pain and limited function and are termed to have "Failed back surgery syndrome" (FBSS). This review evaluates clinical trial data for the treatment of FBSS patients. OBJECTIVE: Using an evidence-based approach to evaluate FBSS treatments will assist clinicians in choosing the most effective options for FBSS patients. Furthermore, reducing the utilization of less effective therapies may result in substantial financial savings for this patient population...
April 12, 2017: Spine
https://www.readbyqxmd.com/read/28497442/-myths-and-evidence-on-the-use-of-botulinum-toxin-spasticity-in-adults-and-in-children-with-cerebral-palsy
#9
J C Martinez-Castrillo, J L Pena-Segura, P Sanz-Cartagena, X Alonso-Curco, J M Arbelo-Gonzalez, G Arriola-Pereda, M D Coll-Bosch, J A Conejero-Casares, A Garcia-Ribes, S Jauma-Classen, J Pagonabarraga, J Vidal-Valls, P J Garcia-Ruiz
INTRODUCTION: Spasticity is a medical problem with a high incidence that significantly impact on the quality of life of patients and their families. AIM: To analyze and to answer different questions about the use of botulinum toxin type A (BTA) in our clinical practice. DEVELOPMENT: A group of experts in neurology develop a list of topics related with the use of BTA. Two big groups were considered: spasticity in adults and in children with cerebral palsy...
May 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28495237/multigene-panels-in-ashkenazi-jewish-patients-yield-high-rates-of-actionable-mutations-in-multiple-non-brca-cancer-associated-genes
#10
Melissa K Frey, Gabriella Sandler, Rachel Sobolev, Sarah H Kim, Rachelle Chambers, Rebecca Y Bassett, Jessica Martineau, Katherine J Sapra, Leslie Boyd, John P Curtin, Bhavana Pothuri, Stephanie V Blank
OBJECTIVE: To evaluate the results of multigene panel testing among Ashkenazi Jewish compared with non-Ashkenazi Jewish patients. METHODS: We reviewed the medical records for all patients who underwent multigene panel testing and targeted BRCA1/2 testing at a single institution between 6/2013-1/2015. Clinical actionability for identified pathogenic mutations was characterized based on the National Comprehensive Cancer Network (NCCN) guidelines and consensus statements and expert opinion for genes not addressed by these guidelines...
May 8, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28481700/pediatric-status-epilepticus-improved-management-with-new-drug-therapies
#11
Alberto Verrotti, Michela Ambrosi, Piero Pavone, Pasquale Striano
Status Epilepticus (SE) is the most common neurological emergency of childhood. It requires prompt administration of appropriately selected anti-seizure medications. Areas covered: Following a distinction between estabilished and emergent drugs, we present pharmacological treatment options and their clinical utility in children, with a short mention on alternatives to drug treatment. We also propose an algorithm for the management of pediatric SE. For this review a Pubmed, Medline and Embase search was performed...
May 19, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28480770/an-update-on-the-pharmacotherapeutic-management-of-lower-respiratory-tract-infections
#12
Mario Cazzola, Paola Rogliani, Stefano Aliberti, Francesco Blasi, Maria Gabriella Matera
Our knowledge about lower respiratory tract infections (LRTIs) has improved substantially in the last years, but the management of respiratory infections is still a challenge and we are still far from precision medicine in the treatment of LRTIs. Areas covered: The approaches developed in recent years to improve the pharmacotherapeutic management of LRTIs, such as novel diagnostic assays to facilitate medical decision-making, attempts for selecting an optimal empiric antibiotic regimen, and the role of new and possibly unproven adjunctive therapies, are described...
May 6, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28476375/provider-specific-quality-measurement-for-ercp-using-natural-language-processing
#13
Timothy D Imler, Stuart Sherman, Thomas F Imperiale, Huiping Xu, Fangqian Ouyang, Christopher Beesley, Charity Hilton, Gregory A Coté
BACKGROUND: Natural language processing (NLP) is an information retrieval technique that has been shown to accurately identify quality measures for colonoscopy. There are no systematic methods by which to track adherence to quality measures for ERCP, the highest risk endoscopic procedure widely used in practice. AIM: Our aim was to demonstrate the feasibility of using NLP to measure adherence to ERCP quality indicators across individual providers. METHODS: ERCPs performed by 6 providers at a single institution from 2006 to 2014 were identified...
May 2, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28473098/acr-appropriateness-criteria-%C3%A2-chronic-hip-pain
#14
Douglas N Mintz, Catherine C Roberts, Jenny T Bencardino, Steven J Baccei, Michelle S Caird, R Carter Cassidy, Eric Y Chang, Michael G Fox, Soterios Gyftopoulos, Mark J Kransdorf, Darlene F Metter, William B Morrison, Zehava S Rosenberg, Nehal A Shah, Kirstin M Small, Naveen Subhas, Siddharth Tambar, Jeffrey D Towers, Joseph S Yu, Barbara N Weissman
Chronic hip pain is a common clinical problem whose cause is often elucidated by imaging. The ACR Appropriateness Criteria for chronic hip pain define best practices of image ordering. Clinical scenarios are followed by the imaging choices and their appropriateness. The information is in ordered tables with an accompanying narrative explanation to guide physicians to order the right test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473097/acr-appropriateness-criteria-%C3%A2-chronic-extremity-joint-pain-suspected-inflammatory-arthritis
#15
Jon A Jacobson, Catherine C Roberts, Jenny T Bencardino, Marc Appel, Erin Arnold, Steven J Baccei, R Carter Cassidy, Eric Y Chang, Michael G Fox, Bennett S Greenspan, Soterios Gyftopoulos, Mary G Hochman, Douglas N Mintz, Joel S Newman, Zehava S Rosenberg, Nehal A Shah, Kirstin M Small, Barbara N Weissman
Evaluation for suspected inflammatory arthritis as a cause for chronic extremity joint pain often relies on imaging. This review first discusses the characteristic osseous and soft tissue abnormalities seen with inflammatory arthritis and how they may be imaged. It is essential that imaging results are interpreted in the context of clinical and serologic results to add specificity as there is significant overlap of imaging findings among the various types of arthritis. This review provides recommendations for imaging evaluation of specific types of inflammatory arthritis, including rheumatoid arthritis, seronegative spondyloarthropathy, gout, calcium pyrophosphate dihydrate disease (or pseudogout), and erosive osteoarthritis...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473096/acr-appropriateness-criteria-%C3%A2-chronic-chest-pain-high-probability-of-coronary-artery-disease
#16
Scott R Akers, Vandan Panchal, Vincent B Ho, Garth M Beache, Richard K J Brown, Brian B Ghoshhajra, S Bruce Greenberg, Joe Y Hsu, Gregory A Kicska, James K Min, Arthur E Stillman, Jadranka Stojanovska, Suhny Abbara, Jill E Jacobs
In patients with chronic chest pain in the setting of high probability of coronary artery disease (CAD), imaging has major and diverse roles. First, imaging is valuable in determining and documenting the presence, extent, and severity of myocardial ischemia, hibernation, scarring, and/or the presence, site, and severity of obstructive coronary lesions. Second, imaging findings are important in determining the course of management of patients with suspected chronic myocardial ischemia and better defining those patients best suited for medical therapy, angioplasty/stenting, or surgery...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473095/acr-appropriateness-criteria-%C3%A2-chronic-back%C3%A2-pain%C3%A2-suspected-sacroiliitis-spondyloarthropathy
#17
Stephanie A Bernard, Mark J Kransdorf, Francesca D Beaman, Ronald S Adler, Behrang Amini, Marc Appel, Erin Arnold, R Carter Cassidy, Bennett S Greenspan, Kenneth S Lee, Michael J Tuite, Eric A Walker, Robert J Ward, Daniel E Wessell, Barbara N Weissman
Inflammatory sacroiliitis or the seronegative axial spondyloarthropathies often presents as back pain or sacroiliac joint pain of more than 3-month duration with inflammatory symptoms and typically in patients younger than 45 years of age. Imaging plays an important role in diagnosis and disease monitoring. This article addresses the appropriate sequence of initial imaging for evaluation of a suspected spondyloarthropathy, the imaging follow-up of treatment response and the special considerations for imaging of trauma in patients with ankylosis of the spine...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473094/acr-appropriateness-criteria-%C3%A2-vascular-claudication-assessment-for-revascularization
#18
Osmanuddin Ahmed, Michael Hanley, Shelby J Bennett, Ankur Chandra, Benoit Desjardins, Kenneth L Gage, Marie D Gerhard-Herman, Michael Ginsburg, Heather L Gornik, Isabel B Oliva, Michael L Steigner, Richard Strax, Nupur Verma, Frank J Rybicki, Karin E Dill
Vascular claudication is a symptom complex characterized by reproducible pain and weakness in an active muscle group due to peripheral arterial disease. Noninvasive hemodynamic tests such as the ankle brachial index, toe brachial index, segmental pressures, and pulse volume recordings are considered the first imaging modalities necessary to reliably establish the presence and severity of arterial obstructions. Vascular imaging is consequently used for diagnosing individual lesions and triaging patients for medical, percutaneous, or surgical intervention...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473093/acr-appropriateness-criteria-%C3%A2-urinary-tract%C3%A2-infection-child
#19
Boaz K Karmazyn, Adina L Alazraki, Sudha A Anupindi, Molly E Dempsey, Jonathan R Dillman, Scott R Dorfman, Matthew D Garber, Sheila G Moore, Craig A Peters, Henry E Rice, Cynthia K Rigsby, Nabile M Safdar, Stephen F Simoneaux, Andrew T Trout, Sjirk J Westra, Sandra L Wootton-Gorges, Brian D Coley
Urinary tract infection (UTI) is common in young children and may cause pyelonephritis and renal scarring. Long-term complications from renal scarring are low. The role of imaging is to evaluate for underlying urologic abnormalities and guide treatment. In neonates there is increased risk for underlying urologic abnormalities. Evaluation for vesicoureteral reflux (VUR) may be appropriate especially in boys because of higher prevalence of VUR and to exclude posterior urethral valve. In children older than 2 months with first episode of uncomplicated UTI, there is no clear benefit of prophylactic antibiotic...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473092/acr-appropriateness-criteria-%C3%A2-suspected-pulmonary-hypertension
#20
Arlene Sirajuddin, Edwin F Donnelly, Traves P Crabtree, Travis S Henry, Mark D Iannettoni, Geoffrey B Johnson, Ella A Kazerooni, Fabien Maldonado, Kathryn M Olsen, Carol C Wu, Tan-Lucien Mohammed, Jeffrey P Kanne
Pulmonary hypertension may be idiopathic or related to a large variety of diseases. Various imaging examinations that may be helpful in diagnosing and determining the etiology of pulmonary hypertension are discussed. Imaging examinations that may aid in the diagnosis of pulmonary hypertension include chest radiography, ultrasound echocardiography, ventilation/perfusion scans, CT, MRI, right heart catheterization, pulmonary angiography, and fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel...
May 2017: Journal of the American College of Radiology: JACR
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