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https://www.readbyqxmd.com/read/29141462/a-safety-review-of-medications-used-for-labour-induction
#1
Lili Sheibani, Deborah A Wing
Induction of labour is a commonly performed procedure around the world. There are various medications used for induction including those commonly used for cervical ripening (prostaglandins) and oxytocin. The ideal agent is one that decreases the time to achieving delivery without compromising maternal or neonatal safety. The 'optimal safe agent' remains undetermined. Areas covered: This article reviews the safety of currently used induction agents. Prostaglandins and oxytocin have proven to be effective in labour induction, and their profiles will be reviewed in this article...
November 15, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29140125/diabetes-area-patent-participation-analysis-part-ii-years-2011-2016
#2
Markus Boehm, Matthew Crawford, Jamie E Moscovitz, Philip A Carpino
Diabetes is a metabolic disease characterized by elevated levels of plasma glucose. When untreated, diabetes increases the risk of developing co-morbidities such as cardiovascular disease. Several drugs, often used as part of combination therapies, have been approved to treat the disease, but these drugs will eventually fail to effectively control blood glucose levels, at which point insulin replacement therapy is required. A medical need exists for new anti-diabetic drugs that exhibit good efficacy with improved safety/toleration profiles and can be added on top of existing therapies, or that can provide additional benefits beyond glucose lowering such as pancreatic beta (β)-cell protection...
November 15, 2017: Expert Opinion on Therapeutic Patents
https://www.readbyqxmd.com/read/29137489/androgen-deprivation-therapy-for-the-treatment-of-prostate-cancer-a-focus-on-pharmacokinetics
#3
Charles F Polotti, Christopher J Kim, Nadiya Chuchvara, Alyssa B Polotti, Eric A Singer, Sammy Elsamra
Medical therapy has undergone many changes as our understanding of prostate cancer cell biology has improved. Androgen deprivation therapy (ADT) remains the mainstay of therapy for metastatic disease. Metastatic castrate-resistant prostate cancer (CRPC) is an important concern since we are unable to stop progression with currently available agents. Areas covered: Pharmacologic ADT is the most commonly used treatment for metastatic prostate cancer. Multiple agents are available for both first-line and second-line use: antiandrogens, estrogens, luteinizing hormone-releasing hormone agonists/antagonists, and CYP17 inhibitors...
November 15, 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29132620/identifying-and-prioritizing-the-tools-techniques-of-knowledge-management-based-on-the-asian-productivity-organization-model-apo-to-use-in-hospitals
#4
Hamid Khajouei, Reza Khajouei
INTRODUCTION: Appropriate knowledge, correct information, and relevant data are vital in medical diagnosis and treatment systems. Knowledge Management (KM) through its tools/techniques provides a pertinent framework for decision-making in healthcare systems. The objective of this study was to identify and prioritize the KM tools/techniques that apply to hospital setting. METHODS: This is a descriptive-survey study. Data were collected using a -researcher-made questionnaire that was developed based on experts' opinions to select the appropriate tools/techniques from 26 tools/techniques of the Asian Productivity Organization (APO) model...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29120249/alcohol-addiction-the-safety-of-available-approved-treatment-options
#5
Mariangela Antonelli, Anna Ferrulli, Luisa Sestito, Gabriele A Vassallo, Claudia Tarli, Carolina Mosoni, Maria M Rando, Antonio Mirijello, Antonio Gasbarrini, Giovanni Addolorato
Alcohol Use Disorder (AUD) is a leading cause of mortality and morbidity worldwide. At present disulfiram, naltrexone and acamprosate are approved for the treatment of AUD in U.S. and Europe. Nalmefene is approved in Europe and sodium oxybate is approved in Italy and Austria only. Baclofen received a "temporary recommendation for use" in France. Areas covered. The safety of the medications mentioned above on liver, digestive system, kidney function, nervous system, pregnancy and lactation and their possible side effects are described and discussed...
November 9, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29114613/acr-appropriateness-criteria-for-external-beam-radiation-therapy-treatment-planning-for-clinically-localized-prostate-cancer-part-ii-of-ii
#6
REVIEW
Nicholas G Zaorsky, Timothy N Showalter, Gary A Ezzell, Paul L Nguyen, Dean G Assimos, Anthony V D'Amico, Alexander R Gottschalk, Gary S Gustafson, Sameer R Keole, Stanley L Liauw, Shane Lloyd, Patrick W McLaughlin, Benjamin Movsas, Bradley R Prestidge, Al V Taira, Neha Vapiwala, Brian J Davis
Purpose: To present the most updated American College of Radiology (ACR) Appropriateness Criteria formed by an expert panel on the appropriate delivery of external beam radiation to manage stage T1 and T2 prostate cancer (in the definitive setting and post-prostatectomy) and to provide clinical variants with expert recommendations based on accompanying Appropriateness Criteria for target volumes and treatment planning. Methods and materials: The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a panel of multidisciplinary experts...
July 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29114115/data-requirements-and-the-basis-for-designing-health-information-kiosks
#7
REVIEW
Mina Afzali, Maryam Ahmadi, Zahra Mahmoudvand
Introduction: Health kiosks are an innovative and cost-effective solution that organizations can easily implement to help educate people. Aim: To determine the data requirements and basis for designing health information kiosks as a new technology to maintain the health of society. Methods: By reviewing the literature, a list of information requirements was provided in 4 sections (demographic information, general information, diagnostic information and medical history), and questions related to the objectives, data elements, stakeholders, requirements, infrastructures and the applications of health information kiosks were provided...
September 2017: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/29114107/clinical-and-para-clinical-information-needs-of-infertility-electronic-health-records-in-iran-a-delphi-study
#8
Mehrdad Farzandipour, Fateme Rangraz Jeddi, Hamid Reza Gilasi, Diana Shirzadi
Background: infertility is referred to the person's inability to conceive pregnancy after one year of intercourse without using protection. This study paves the ground for creating a complete, united, and coherent source of patients' medical information. Materials and Methods: this is an applied research of descriptive-cross sectional type which has been carried out through qualitative - quantitative methods. The sample of the present study was 50 specialists in the field of infertility which has been chosen based on purposive sampling method...
September 2017: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/29113525/biological-mechanisms-underlying-the-clinical-effects-of-allergen-specific-immunotherapy-in-asthmatic-children
#9
Corrado Pelaia, Alessandro Vatrella, Nicola Lombardo, Rosa Terracciano, Paolo Navalesi, Rocco Savino, Girolamo Pelaia
Allergen-specific immunotherapy (AIT) is indicated for patients with allergic asthma and/or allergic rhinitis, and can be implemented by either subcutaneous injection (SCIT) or sublingual administration (SLIT). AIT reduces asthma symptoms, lowers the use of pharmacologic controller therapy, and decreases the need for rescue medications. SLIT appears to be safer than SCIT, but SCIT seems to be more efficacious and acts earlier in allergic asthmatic children. Areas covered: This review looks at the pathobiology of allergic asthma as well as the role of regulatory T and B cells in allergen tolerance...
November 8, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/29108867/medicolegal-issues-for-the-respiratory-paediatrician
#10
REVIEW
Ian M Balfour-Lynn
The legal profession depends on expert witnesses, and indeed the first time an English Court relied on an expert medical witness was in the 14th century. Asking a specialist to comment on the standard of professional practice expected in their own specialty was first introduced in a 1767 case [1]. This article draws on 20 years of experience in medicolegal work relating to paediatric respiratory medicine. It highlights some of the legal principles that lie behind an expert opinion and what constitutes clinical negligence...
October 12, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/29108841/a-conceptual-framework-for-understanding-unintended-prolonged-opioid-use
#11
W Michael Hooten, Chad M Brummett, Mark D Sullivan, Jenna Goesling, Jon C Tilburt, Jessica S Merlin, Jennifer L St Sauver, Ajay D Wasan, Daniel J Clauw, David O Warner
An urgent need exists to better understand the transition from short-term opioid use to unintended prolonged opioid use (UPOU). The purpose of this work is to propose a conceptual framework for understanding UPOU that posits the influence of 3 principal domains that include the characteristics of (1) individual patients, (2) the practice environment, and (3) opioid prescribers. Although no standardized method exists for developing a conceptual framework, the process often involves identifying corroborative evidence, leveraging expert opinion to identify factors for inclusion in the framework, and developing a graphic depiction of the relationships between the various factors and the clinical problem of interest...
November 3, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29101995/acr-appropriateness-criteria-%C3%A2-tinnitus
#12
Marcus M Kessler, Marwan Moussa, Julie Bykowski, Claudia F E Kirsch, Joseph M Aulino, Kevin L Berger, Asim F Choudhri, Terry D Fife, Isabelle M Germano, A Tuba Kendi, Jeffrey H Kim, Michael D Luttrull, Diego Nunez, Lubdha M Shah, Aseem Sharma, Vilaas S Shetty, Sophia C Symko, Rebecca S Cornelius
Tinnitus is the perception of sound in the absence of an external source. It is a common symptom that can be related to hearing loss and other benign causes. However, tinnitus may be disabling and can be the only symptom in a patient with a central nervous system process disorder. History and physical examination are crucial first steps to determine the need for imaging. CT and MRI are useful in the setting of pulsatile tinnitus to evaluate for an underlying vascular anomaly or abnormality. If there is concomitant asymmetric hearing loss, neurologic deficit, or head trauma, imaging should be guided by those respective ACR Appropriateness Criteria(®) documents, rather than the presence of tinnitus...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29101994/acr-appropriateness-criteria-%C3%A2-thoracic-aorta-interventional-planning-and-follow-up
#13
Gregory Bonci, Michael L Steigner, Michael Hanley, Aaron R Braun, Benoit Desjardins, Ron C Gaba, Kenneth L Gage, Jon S Matsumura, Eric E Roselli, David M Sella, Richard Strax, Nupur Verma, Clifford R Weiss, Karin E Dill
Thoracic endovascular aortic repair (TEVAR) has undergone rapid evolution and is now applied to a range of aortic pathologies. Imaging plays a vital role in the pre- and postintervention assessment of TEVAR patients. Accurate characterization of pathology and evaluation for high-risk anatomic features are necessary in the planning phase, and careful assessment for graft stability, aortic lumen diameter, and presence of endoleak are paramount in the follow-up period. CTA is the imaging modality of choice for pre- and postintervention assessment, and MRA is an acceptable alternative depending on patient stability and graft composition...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29101993/acr-appropriateness-criteria-%C3%A2-staging-of-pancreatic-ductal-adenocarcinoma
#14
Aliya Qayyum, Eric P Tamm, Ihab R Kamel, Peter J Allen, Hina Arif-Tiwari, Victoria Chernyak, Tamas A Gonda, Joseph R Grajo, Nicole M Hindman, Jeanne M Horowitz, Harmeet Kaur, Michelle M McNamara, Richard B Noto, Pavan K Srivastava, Tasneem Lalani
Pancreatic adenocarcinoma is associated with poor overall prognosis. Complete surgical resection is the only possible option for cure. As such, increasingly complex surgical techniques including sophisticated vascular reconstruction are being used. Continued advances in surgical techniques, in conjunction with use of combination systemic therapies, and radiation therapy have been suggested to improve outcomes. A key aspect to surgical success is reporting of pivotal findings beyond absence of distant metastases, such as tumor size, location, and degree of tumor involvement of specific vessels associated with potential perineural tumor spread...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29101992/acr-appropriateness-criteria-%C3%A2-sinonasal-disease
#15
Claudia F E Kirsch, Julie Bykowski, Joseph M Aulino, Kevin L Berger, Asim F Choudhri, David B Conley, Michael D Luttrull, Diego Nunez, Lubdha M Shah, Aseem Sharma, Vilaas S Shetty, Rathan M Subramaniam, Sophia C Symko, Rebecca S Cornelius
Imaging of sinonasal pathology may occur for assessment of rhinosinusitis or mass lesions. Rhinosinusitis is prevalent in up to 16% of the US population with annual economic burdens estimated at 22 billion dollars. Rhinosinusitis is characterized as acute or chronic based on symptom duration; if four or more episodes occur annually, the term recurrent acute rhinosinusitis (RARS) is used. In acute uncomplicated rhinosinusitis when inflammatory change remains in the paranasal sinuses and nasal cavity, imaging may not be required...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29101991/acr-appropriateness-criteria-%C3%A2-renovascular-hypertension
#16
Howard J Harvin, Nupur Verma, Paul Nikolaidis, Michael Hanley, Vikram S Dogra, Stanley Goldfarb, John L Gore, Stephen J Savage, Michael L Steigner, Richard Strax, Myles T Taffel, Jade J Wong-You-Cheong, Don C Yoo, Erick M Remer, Karin E Dill, Mark E Lockhart
Renovascular hypertension is the most common type of secondary hypertension and is estimated to have a prevalence between 0.5% and 5% of the general hypertensive population, and an even higher prevalence among patients with severe hypertension and end-stage renal disease, approaching 25% in elderly dialysis patients. Investigation for renal artery stenosis is appropriate when clinical presentation suggests secondary hypertension rather than primary hypertension, when there is not another known cause of secondary hypertension, and when intervention would be carried out if a significant renal artery stenosis were identified...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29101990/acr-appropriateness-criteria-%C3%A2-iliac-artery-occlusive-disease
#17
Alexander Z Copelan, Baljendra S Kapoor, Ali F AbuRahma, Thomas R Cain, Drew M Caplin, Khashayar Farsad, M-Grace Knuttinen, Margaret H Lee, Joseph J McBride, Jeet Minocha, Stephen P Reis, Paul J Rochon, Colette M Shaw, Jonathan M Lorenz
Iliac artery occlusive disease can present as a sudden-onset acute thrombotic or thromboembolic event or as a chronic progressive atherosclerotic process that presents as claudication progressing to rest pain. Depending on the clinical presentation, the diagnosis is usually confirmed through Doppler vascular ultrasound, CT angiography, or MR angiography; the choice of imaging is usually based on modality availability and the presence of patient comorbidities such as chronic kidney disease. The Trans-Atlantic Inter-Society Consensus II classification system is commonly used to describe the extent of the peripheral vascular disease...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29101989/acr-appropriateness-criteria-%C3%A2-radiologic-management-of-central-venous-access
#18
Colette M Shaw, Shrenik Shah, Baljendra S Kapoor, Thomas R Cain, Drew M Caplin, Khashayar Farsad, M-Grace Knuttinen, Margaret H Lee, Joseph J McBride, Jeet Minocha, Elizabeth V Robilotti, Paul J Rochon, Richard Strax, Elrond Y L Teo, Jonathan M Lorenz
Obtaining central venous access is one of the most commonly performed procedures in hospital settings. Multiple devices such as peripherally inserted central venous catheters, tunneled central venous catheters (eg, Hohn catheter, Hickman catheter, C. R. Bard, Inc, Salt Lake City UT), and implantable ports are available for this purpose. The device selected for central venous access depends on the clinical indication, duration of the treatment, and associated comorbidities. It is important for health care providers to familiarize themselves with the types of central venous catheters available, including information about their indications, contraindications, and potential complications, especially the management of catheters in the setting of catheter-related bloodstream infections...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29101988/acr-appropriateness-criteria-%C3%A2-penetrating-neck%C3%A2-injury
#19
Jason W Schroeder, Thomas Ptak, Amanda S Corey, Osmanuddin Ahmed, Walter L Biffl, Joseph A Brennan, Ankur Chandra, Michael Ginsburg, Michael Hanley, Christopher H Hunt, Michele M Johnson, Tabassum A Kennedy, Nandini D Patel, Bruno Policeni, Charles Reitman, Michael L Steigner, Shirley I Stiver, Richard Strax, Matthew T Whitehead, Karin E Dill
In patients with penetrating neck injuries with clinical soft injury signs, and patients with hard signs of injury who do not require immediate surgery, CT angiography of the neck is the preferred imaging procedure to evaluate extent of injury. Other modalities, such as radiography and fluoroscopy, catheter-based angiography, ultrasound, and MR angiography have their place in the evaluation of the patient, depending on the specific clinical situation and question at hand. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29101987/acr-appropriateness-criteria-%C3%A2-ovarian-cancer%C3%A2-screening
#20
Pari V Pandharipande, Kathryn P Lowry, Caroline Reinhold, Mostafa Atri, Carol B Benson, Priyadarshani R Bhosale, Edward D Green, Stella K Kang, Yulia Lakhman, Katherine E Maturen, Refky Nicola, Gloria M Salazar, Thomas D Shipp, Lynn Simpson, Betsy L Sussman, Jennifer Uyeda, Darci J Wall, Bradford Whitcomb, Carolyn M Zelop, Phyllis Glanc
There has been much interest in the identification of a successful ovarian cancer screening test, in particular, one that can detect ovarian cancer at an early stage and improve survival. We reviewed the currently available data from randomized and observational trials that examine the role of imaging for ovarian cancer screening in average-risk and high-risk women. We found insufficient evidence to recommend ovarian cancer screening, when considering the imaging modality (pelvic ultrasound) and population (average-risk postmenopausal women) for which there is the greatest available published evidence; randomized controlled trials have not demonstrated a mortality benefit in this setting...
November 2017: Journal of the American College of Radiology: JACR
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