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https://www.readbyqxmd.com/read/27906080/tonic-and-burst-spinal-cord-stimulation-waveforms-for-the-treatment-of-chronic-intractable-pain-study-protocol-for-a-randomized-controlled-trial
#1
Konstantin V Slavin, Richard B North, Timothy R Deer, Peter Staats, Kristina Davis, Roni Diaz
BACKGROUND: Burst stimulation is a novel form of neurostimulation for the treatment of chronic pain which has demonstrated promise in small uncontrolled studies, but has not yet gained approval for use in the U.S. We report the study methods for an ongoing multicenter, randomized, controlled, cross-over study designed to gain United States Food and Drug Administration (FDA) approval for burst stimulation. METHODS: Participants who are candidates for a currently approved neurostimulation device were enrolled and screened...
December 1, 2016: Trials
https://www.readbyqxmd.com/read/27905839/gene-therapy-to-cure-hiv-where-to-from-here
#2
Rowena Johnston
A variety of approaches are being tested to cure HIV, but with the exception of the Berlin patient case, none has been successful. The Berlin patient, positive for both HIV and acute myeloid leukemia (AML), received two stem cell transplants from a donor homozygous for the CCR5delta32 mutation. In the 8 years since his second transplant, he has remained free of both HIV and AML. This case provides strong proof-of-principle that a cure for HIV is possible and might be achieved through gene therapy. Several technological barriers must be resolved and are discussed here, including the safe delivery of the intervention throughout the body of the infected person, increased efficiency of gene editing, and avoidance of resistance to the therapy...
December 2016: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/27905681/childhood-immune-thrombocytopenia-a-nationwide-cohort-study-on-condition-management-and-outcomes
#3
Lamiae Grimaldi-Bensouda, Clémentine Nordon, Thierry Leblanc, Lucien Abenhaim, Slimane Allali, Corinne Armari-Alla, Claire Berger, Mary-France Courcoux, Fanny Fouyssac, Cécile Guillaumat, Corinne Guitton, Philippe Le Moine, Françoise Mazingue, Corinne Pondarré, Caroline Thomas, Marlène Pasquet, Yves Perel, Guy Leverger, Nathalie Aladjidi
OBJECTIVES: Nationwide prospective cohort study exploring (i) the factors associated with treatment initiation (vs. watchful waiting) in children with primary immune thrombocytopenia (ITP) followed in routine clinical practice and (ii) the predictors of chronicity at 12 months. PROCEDURE: Between 2008 and 2013, 23 centers throughout France consecutively included 257 children aged 6 months-18 years and diagnosed with primary ITP over a 5-year period. Data on ITP clinical features along with medical management were collected at baseline and 12 months...
December 1, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27905352/-future-perspective-of-pharmacoepidemiology-in-the-big-data-era-and-the-growth-of-information-sources
#4
Diego Macías Saint-Gerons, César de la Fuente Honrubia, Fernando de Andrés Trelles, Ferrán Catalá-López Catalá-López
The arrival of new drug into the market requires many years of previous research along with the need of continuous evaluation throughout the lifetime of the drug. This warrants pharmacoepidemiological research which may be defined as the study of the use and the effects of drugs in large populations. Nowadays this type of research seems more feasible thanks to the massive expansion of the information sources and data (e.g: clinical patient registries, electronic medical records). However there is a risk of information overload, fragmented evidence and given the enthusiasm aroused by the "Big Data", it must be emphasized that its nature is mainly observational, and therefore subject to bias and confusion...
December 1, 2016: Revista Española de Salud Pública
https://www.readbyqxmd.com/read/27904961/muscle-elastography-a-new-imaging-technique-for-multiple-sclerosis-spasticity-measurement
#5
G Illomei, G Spinicci, E Locci, M G Marrosu
Multiple sclerosis (MS) spasticity is currently evaluated on the basis of neurological examinations such as Ashworth Scale (AS) and 0-10 NRS. Severity of spasticity is difficult to quantify. We investigated the use of real time elastography (RTHE) ultrasounds for evaluating objectively the muscle fibers status in MS spasticity patients and their changes after a new antispasticity treatment. Two studies were performed. In study A, 110 MS patients underwent a neurological evaluation based on the AS and RTHE. The RTHE images were scored with the new 1-5 muscle fibers rigidity imaging scale, here called MEMSs (Muscle Elastography Multiple Sclerosis Score)...
November 30, 2016: Neurological Sciences
https://www.readbyqxmd.com/read/27904601/evaluation-effects-of-nebulized-gentamicin-in-exacerbation-of-chronic-obstructive-lung-disease
#6
Forogh Soltaninejad, Soleiman Kheiri, Roya Habibian, Arshia Amra, Shahin Asgari-Savadjani
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. Exacerbation of COPD has negative effect on quality of life. Therapeutic effect of nebulized antibiotics in pulmonary infections has been reported previously. Hence, we evaluated the effect of nebulized gentamicin in acute exacerbation of COPD (AECOPD). MATERIALS AND METHODS: In this clinical trial study, 86 hospitalized patients with AECOPD were divided into two groups for using nebulized gentamicin twice daily (case group) and placebo (control group) for 5 days in addition to standard treatment...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27904211/post-operative-pain-management-in-shoulder-surgery-suprascapular-and-axillary-nerve-block-by-arthroscope-assisted-catheter-placement
#7
H Çağdaş Basat, D Hakan Uçar, Mehmet Armangil, Berk Güçlü, Mehmet Demirtaş
BACKGROUND: Postoperative pain management is the part of shoulder surgery to improve patient satisfaction, start rehabilitation process rapidly and decrease for hospital stay. Various treatment modalities have been used for pain management, but they have some limitations, side effects and risks. Throughout intraoperative and postoperative period, nerve blocks have been used more popularly than others because of efficacy. For the regional nerve block, local anesthetic should be infiltrated close to the nerve for maximum effect...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27903854/geographical-variation-in-peritoneal-dialysis-catheter-insertion-and-initiation-within-the-united-states
#8
Achint Patel, Harshil Shah, Shanti Patel, Girish N Nadkarni, Jaime Uribarri
Peritoneal dialysis (PD) is an effective but underutilized renal replacement therapy modality. There are limited data regarding geographical variation in PD catheter insertion and utilization of PD as a first renal replacement therapy in the United States. We explored the variation in catheter insertion and initiation of PD utilizing 2 large, nationally representative databases. The incidence of catheter insertion differed significantly by geographical region, being highest in the South (7.30/100 end-stage renal disease [ESRD] patients; 95% confidence [CI] interval 6...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27903197/upfront-boost-gamma-knife-leading-edge-radiosurgery-to-flair-mri-defined-tumor-migration-pathways-in-174-patients-with-glioblastoma-multiforme-a-15-year-assessment-of-a-novel-therapy
#9
Christopher M Duma, Brian S Kim, Peter V Chen, Marianne E Plunkett, Ralph Mackintosh, Marlon S Mathews, Ryan M Casserly, Gustavo A Mendez, Daniel J Furman, Garrett Smith, Nathan Oh, Chad A Caraway, Ami R Sanathara, Robert O Dillman, Azzurra-Sky Riley, David Weiland, Lian Stemler, Ruslana Cannell, Daniela Alexandru Abrams, Alexa Smith, Christopher M Owen, Burton Eisenberg, Michael Brant-Zawadzki
OBJECTIVE Glioblastoma multiforme (GBM) is composed of cells that migrate through the brain along predictable white matter pathways. Targeting white matter pathways adjacent to, and leading away from, the original contrast-enhancing tumor site (termed leading-edge radiosurgery [LERS]) with single-fraction stereotactic radiosurgery as a boost to standard therapy could limit the spread of glioma cells and improve clinical outcomes. METHODS Between December 2000 and May 2016, after an initial diagnosis of GBM and prior to or during standard radiation therapy and carmustine or temozolomide chemotherapy, 174 patients treated with radiosurgery to the leading edge (LE) of tumor cell migration were reviewed...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903189/grade-ii-meningiomas-and-gamma-knife-radiosurgery-analysis-of-success-and-failure-to-improve-treatment-paradigm
#10
Charles A Valery, Matthieu Faillot, Ioannis Lamproglou, Jean-Louis Golmard, Catherine Jenny, Matthieu Peyre, Karima Mokhtari, Jean-Jacques Mazeron, Philippe Cornu, Michel Kalamarides
OBJECTIVE Grade II meningiomas, which currently account for 25% of all meningiomas, are subject to multiple recurrences throughout the course of the disease and represent a challenge for the neurosurgeon. Radiosurgery is increasingly performed for the treatment of Grade II meningiomas and is quite efficient in controlling relapses locally at the site of the lesion, but it cannot prevent margin relapses. The aim of this retrospective study was to analyze the technical parameters involved in producing marginal relapses and to optimize loco-marginal control to improve therapeutic strategy...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27901055/mediboost-a-patient-stratification-tool-for-interpretable-decision-making-in-the-era-of-precision-medicine
#11
Gilmer Valdes, José Marcio Luna, Eric Eaton, Charles B Simone, Lyle H Ungar, Timothy D Solberg
Machine learning algorithms that are both interpretable and accurate are essential in applications such as medicine where errors can have a dire consequence. Unfortunately, there is currently a tradeoff between accuracy and interpretability among state-of-the-art methods. Decision trees are interpretable and are therefore used extensively throughout medicine for stratifying patients. Current decision tree algorithms, however, are consistently outperformed in accuracy by other, less-interpretable machine learning models, such as ensemble methods...
November 30, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27900742/-precision-nursing-individual-based-knowledge-translation
#12
Li-Chi Chiang, Mei-Ling Yeh, Sui-Lung Su
U.S. President Obama announced a new era of precision medicine in the Precision Medicine Initiative (PMI). This initiative aims to accelerate the progress of personalized medicine in light of individual requirements for prevention and treatment in order to improve the state of individual and public health. The recent and dramatic development of large-scale biologic databases (such as the human genome sequence), powerful methods for characterizing patients (such as genomics, microbiome, diverse biomarkers, and even pharmacogenomics), and computational tools for analyzing big data are maximizing the potential benefits of precision medicine...
December 2016: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/27900707/fluoroscopy-guided-biodegradable-spacer-implantation-using-local-anesthesia-safety-and-efficacy-study-in-patients-with-massive-rotator-cuff-tears
#13
E Gervasi, E Maman, A Dekel, E Cautero
BACKGROUND: The management of massive rotator cuff tears (MRCTs) is challenging and associated with a high failure rates. Studies have shown that advanced age, lower American Society of Anesthesiologists physical status score and concomitant comorbidities are associated with higher risks of death and postoperative complications. This study was designed to assess the safety and efficacy of fluoroscopy-guided biodegradable spacer implantation under local anesthesia, in patients with MRCT and comorbidities completely or partially contraindicating surgeries under general anesthesia...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27899955/comparison-between-standard-and-reduced-volume-radiotherapy-in-bladder-preservation-trimodality-protocol-for-muscle-invasive-bladder-cancer-patients
#14
Waleed Arafat, Azza Darwish, George E Naoum, Wael Sameh, Gamal El Husseiny, Fathy Abd-El-Gawad, Mostafa Samir
AIM: Our aim is to compare the toxicity, pelvic nodal relapse, and overall survival of whole bladder irradiation only to the standard technique of whole pelvis irradiation followed by bladder boost in patients with muscle-invasive bladder carcinoma undergoing bladder preservation protocol. MATERIAL AND METHOD: A total of 60 patients with transitional cell carcinoma, stage T2-3, N0, M0 bladder cancer were subjected to maximal transurethral resection bladder tumour (TURB)...
2016: Ecancermedicalscience
https://www.readbyqxmd.com/read/27899401/neonatal-and-childhood-neurodevelopmental-health-and-educational-outcomes-of-children-exposed-to-antidepressants-and-maternal-depression-during-pregnancy-protocol-for-a-retrospective-population-based-cohort-study-using-linked-administrative-data
#15
Deepa Singal, Marni Brownell, Dan Chateau, Chelsea Ruth, Laurence Y Katz
INTRODUCTION: Antidepressants are commonly prescribed during pregnancy; however, there are inconsistent data on the safety of these medications during the prenatal period. To address this gap, this study will investigate short-term and long-term neurodevelopmental, physical and mental health, and educational outcomes of children who have been exposed to selective serotonin reuptake inhibitors (SSRIs) or selective serotonin norepinephrine reuptake inhibitors (SNRIs) and/or maternal depression during pregnancy...
November 29, 2016: BMJ Open
https://www.readbyqxmd.com/read/27899338/high-touch-and-high-tech-ht2-proposal-transforming-patient-engagement-throughout-the-continuum-of-care-by-engaging-patients-with-portal-technology-at-the-bedside
#16
Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Alison M Aldrich, Daniel M Walker, Milisa K Rizer, Susan D Moffatt-Bruce, Timothy R Huerta
BACKGROUND: For patients with complex care needs, engagement in disease management activities is critical. Chronic illnesses touch almost every person in the United States. The costs are real, personal, and pervasive. In response, patients often seek tools to help them manage their health. Patient portals, personal health records tethered to an electronic health record, show promise as tools that patients value and that can improve health. Although patient portals currently focus on the outpatient experience, the Ohio State University Wexner Medical Center (OSUWMC) has deployed a portal designed specifically for the inpatient experience that is connected to the ambulatory patient portal available after discharge...
November 29, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27899178/choice-of-a-hemodynamic-model-for-occlusive-thrombosis-in-arteries
#17
David N Ku, Lauren D C Casa, Susan M Hastings
Intravascular thrombosis can lead to heart attacks and strokes that together are the leading causes of death in the US (Kochanek, K.D., Murphy, S.L., Xu, J.Q., 2014). The ability to identify the offending biofluid mechanical conditions and predict the timescale of thrombotic occlusion in vessels and devices may improve patient outcomes. A computational model was developed to describe the growth of thrombus based on the local hemodynamic shear rate. The model predicts thrombus deposition based on initial geometric and fluid mechanical conditions, which are updated throughout the simulation to reflect the changing lumen dimensions...
November 12, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27899169/is-it-time-to-incorporate-the-left-atrial-size-to-the-current-stroke-risk-scoring-systems-for-atrial-fibrillation-%C3%A2
#18
Jonathan D Gardner, William Paul Skelton, Rami N Khouzam
Primary care physicians and cardiologists rely on risk scoring systems, which consist of a number of clinical variables used together, to predict stroke risk in patients with atrial fibrillation (AF). Ultimately, this helps in determining the need for anticoagulation. Left atrial size is not used in any stroke risk scoring system to stratify patients at risk for cardioembolic stroke. Throughout the literature, there is much debate surrounding the use of left atrial size as an additional risk factor for stroke in patients with and without AF...
September 2016: Current Problems in Cardiology
https://www.readbyqxmd.com/read/27899105/non-invasive-mechanical-ventilation-after-heart-surgery-in-children
#19
Sarah Fernández Lafever, Blanca Toledo, Miguel Leiva, Maite Padrón, Marina Balseiro, Angel Carrillo, Jesús López-Herce
BACKGROUND: The purpose of the study was to analyze the characteristics and evolution of non-invasive mechanical ventilation (NIV) in the postoperative period of heart surgery in children. METHODS: Retrospective observational study including all children requiring NIV after heart surgery in a single center pediatric intensive care unit (PICU) between 2001 and 2012. Demographic characteristics, ventilation parameters and outcomes were registered, comparing the first 6 years of the study with the last 6 years...
November 29, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27898736/long-term-antiretroviral-treatment-adherence-in-hiv-infected-adolescents-and-adults-in-uganda-a-qualitative-study
#20
Seth C Inzaule, Raph L Hamers, Cissy Kityo, Tobias F Rinke de Wit, Maria Roura
BACKGROUND: Long-term success of HIV antiretroviral therapy requires near-perfect adherence, maintained throughout one's lifetime. However, perceptions towards ART and patterns of adherence may change during the life course. We assessed challenges to long-term adherence in adolescents and adults in three regional HIV treatment centers in Uganda. METHODS: We conducted 24 in-depth interviews and 2 focus group discussions with a total of 33 health-care providers and expert clients (HIV patients on long-term ART who assist with adherence support of fellow patients)...
2016: PloS One
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