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Medication use evaluation

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https://www.readbyqxmd.com/read/29679812/protective-role-of-nimbolide-against-chemotherapeutic-drug-hydroxyurea-induced-genetic-and-oxidative-damage-in-an-animal-model
#1
Md Fahim Ahmad, Mohd Owais Ansari, Sana Jameel, Ab Latif Wani, Nuzhat Parveen, Hifzur R Siddique, G G H A Shadab
Nimbolide is known to be an antioxidant found in neem plant. Hydroxyurea is a medication frequently used in sickle-cell disease, different cancers and HIV infection. The present study aimed to evaluate the adverse effect of HU and possible amelioration by nimbolide in Wistar rats. To test our hypothesis, we performed genotoxicity tests, biochemical assays, and histopathological studies. We observed that HU caused higher levels of genotoxicity in the treated animals. The observed genetic and oxidative damage might be due to the presence of reactive species as HU increased the level of the malondialdehyde-a biomarker of oxidative damage...
April 12, 2018: Environmental Toxicology and Pharmacology
https://www.readbyqxmd.com/read/29679728/magnetic-resonance-imaging-of-the-lumbar-spine-determining-clinical-impact-and-potential-harm-from-overuse
#2
Nathan M Wnuk, Tarik K Alkasab, Daniel I Rosenthal
BACKGROUND: Lumbar spine MRI is frequently said to be "overused" in the evaluation of low-back pain, yet data concerning the extent of overuse and on potential harmful effects are lacking. PURPOSE: To determine the proportion of examinations with a detectable impact on patient care (actionable outcomes). STUDY DESIGN: Retrospective cohort study PATIENT SAMPLE: 5,365 outpatient lumbar spine MR examinations OUTCOME MEASURES: Actionable outcomes included: 1) findings leading to an intervention making use of anatomical information such as surgery; 2) new diagnoses of cancer, infection, or fracture; or 3) following known lumbar spine pathology...
April 18, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29679721/effectiveness-evaluation-of-digital-virtual-simulation-application-in-teaching-of-gross-anatomy
#3
Xiaohua Deng, Guowei Zhou, Bing Xiao, Zirui Zhao, Yicheng He, Chujun Chen
INTRODUCTION: digital virtual simulation (DVS) is increasingly used to supplement the teaching of anatomy. DVS can provide the students with three-dimensional (3D) stereoscopic images and precise structures in anatomy teaching. We investigated the effects of digital virtual simulation (DVS) application in gross anatomy teaching. MATERIALS AND METHODS: fourth-year medical students (n=120), majoring clinical medicine in 2013 grade from Xiangya School of Medicine, Central South University, were assigned into four classes...
April 18, 2018: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/29679692/impact-of-fellowship-training-level-on-colonoscopy-quality-and-efficiency-metrics
#4
Hussein Bitar, Hassaan Zia, Muhammad Bashir, Pratyusha Parava, Muhammad Hanafi, William Tierney, Mohammad Madhoun
BACKGROUND & AIMS: Previous studies have described variable effects of fellow involvement on the adenoma detection rate (ADR), but few have stratified this effect by level of training. We aimed to evaluate the "fellow effect" on multiple procedural metrics including a newly defined adenoma management efficiency index, which may have a role in documenting colonoscopy proficiency for trainees. We also describe the impact of level of training on moderate sedation use. METHODS: We performed a retrospective review of 2024 patients (mean age 60...
April 18, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29679518/new-insights-in-the-use-of-pleural-ultrasonography-for-diagnosis-and-treatment-of-pleural-disease
#5
Giampietro Marchetti, Sabrina Arondi, Francesca Baglivo, Sara Lonni, Federico Quadri, Alberto Valsecchi, Nicola Venturoli, Paolo Ceruti
The use of transthoracic ultrasound has acquired a wide consensus among respiratory physicians during the last few years. The developing of portable and easily available devices favorites patient's bedside evaluation. Transthoracic ultrasound provides rapid, real-time and low-cost diagnostic information, allowing image-guided chest interventions and reducing procedural risks. The different acoustic impedance between aerated and not aerated organs produces artifacts known as A lines, B lines, sliding sign, lung point, etc...
April 21, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29679368/quality-of-life-of-patients-with-gastrointestinal-cancers-undergoing-chemotherapy
#6
Ilufredo Y Tantoy, Bruce A Cooper, Anand Dhruva, Janine Cataldo, Steven M Paul, Yvette P Conley, Marilyn Hammer, Kord M Kober, Jon D Levine, Christine Miaskowski
PURPOSE: Findings regarding changes in the quality of life (QOL) of patients with gastrointestinal cancers (GI) undergoing chemotherapy (CTX) are inconclusive. Purpose was to evaluate for changes in QOL scores of patients with GI cancers over two cycles of CTX. METHODS: Patients (n = 397) completed disease-specific [i.e., Quality of Life-Scale-Patient Version (QOL-PV)] and generic [12-item Medical Outcomes Study Short Form Survey (SF-12)] measures of QOL a total of six times over two cycles of CTX...
April 21, 2018: Quality of Life Research
https://www.readbyqxmd.com/read/29679335/bariatric-surgery-in-immunocompromised-patients-outcomes-from-one-year-follow-up
#7
Manish Khaitan, Aparna Hegde, P D Rekha
BACKGROUND: Recent Research evidences from across the world indicate the usefulness of bariatric surgery in improving the immunological co-morbidities in patients with morbid obesity. AIM: The aim of the study was to evaluate the outcome from bariatric surgery in patients presenting with diabetes mellitus and or morbid obesity with immunological co-morbidities. METHODS: It was a retrospective cross-sectional study. Study included patients with morbid obesity with immunological co-morbidities, and additional co- morbidity of type 2 diabetes mellitus in about one third of the cases, who had undergone bariatric surgery during the period 2014-2016 at our center...
April 20, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29679177/impact-of-the-number-of-removed-lymph-nodes-on-recurrence-free-survival-in-stage-i-ovarian-clear-cell-carcinoma
#8
Yuji Takei, Suzuyo Takahashi, Shizuo Machida, Akiyo Taneichi, Takahiro Yoshiba, Yoshifumi Takahashi, Chikako Yoshida, Yasushi Saga, Shigeki Matsubara, Hiroyuki Fujiwara
BACKGROUND: Although there have been several reports regarding the significance of staging lymphadenectomy for early stage ovarian clear cell carcinoma (CCC) patients, there have been few reports focusing on the number of removed lymph nodes. The aim of this study was to evaluate the impact of the number of removed lymph nodes on recurrence-free survival (RFS) in stage I ovarian CCC. METHODS: The subjects were patients with ovarian CCC who underwent surgery between January 1988 and December 2013...
April 20, 2018: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29678983/older-patients-perception-of-deprescribing-in-resource-limited-settings-a-cross-sectional-study-in-an-ethiopia-university-hospital
#9
Henok Getachew Tegegn, Yonas Getaye Tefera, Daniel Asfaw Erku, Kaleab Taye Haile, Tamrat Befekadu Abebe, Fasil Chekol, Yonas Azanaw, Asnakew Achaw Ayele
OBJECTIVE: To assess older patients' attitude towards deprescribing of inappropriate medications. DESIGN: This was an institutional-based, quantitative, cross-sectional survey. SETTING: Outpatient clinics of the University of Gondar Referral and Teaching Hospital in Ethiopia. PARTICIPANTS: Patients aged 65 or older with at least one medication were enrolled in the study from 1 March to 30 June 2017. Excluded patients were those who had severe physical or psychological problems and who refused to participate...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678977/minimizing-icu-neurological-dysfunction-with-dexmedetomidine-induced-sleep-mindds-protocol-for-a-randomised-double-blind-parallel-arm-placebo-controlled-trial
#10
Kenneth T Shelton, Jason Qu, Federico Bilotta, Emery N Brown, Gaston Cudemus, David A D'Alessandro, Hao Deng, Alan DiBiasio, Jacob A Gitlin, Eunice Y Hahm, Lauren E Hobbs, Timothy T Houle, Reine Ibala, Marco Loggia, Kara J Pavone, Shahzad Shaefi, George Tolis, M Brandon Westover, Oluwaseun Akeju
INTRODUCTION: Delirium, which is prevalent in postcardiac surgical patients, is an acute brain dysfunction characterised by disturbances in attention, awareness and cognition not explained by a pre-existing neurocognitive disorder. The pathophysiology of delirium remains poorly understood. However, basic science and clinical studies suggest that sleep disturbance may be a modifiable risk factor for the development of delirium. Dexmedetomidine is a α-2A adrenergic receptor agonist medication that patterns the activity of various arousal nuclei similar to sleep...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678967/development-and-evaluation-of-an-algorithm-based-tool-for-medication-management-in-nursing-homes-the-amber-study-protocol
#11
Susanne Erzkamp, Olaf Rose
BACKGROUND: Residents of nursing homes are susceptible to risks from medication. Medication Reviews (MR) can increase clinical outcomes and the quality of medication therapy. Limited resources and barriers between healthcare practitioners are potential obstructions to performing MR in nursing homes. Focusing on frequent and relevant problems can support pharmacists in the provision of pharmaceutical care services. This study aims to develop and evaluate an algorithm-based tool that facilitates the provision of Medication Management in clinical practice...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678966/an-evaluation-of-prescribing-trends-and-patterns-of-claims-within-the-preferred-drugs-initiative-in-ireland-2011-2016-an-interrupted-time-series-study
#12
Ronald McDowell, Kathleen Bennett, Frank Moriarty, Sarah Clarke, Michael Barry, Tom Fahey
OBJECTIVE: To examine the impact of the Preferred Drugs Initiative (PDI), an Irish health policy aimed at enhancing evidence-based cost-effective prescribing, on prescribing trends and the cost of prescription medicines across seven medication classes. DESIGN: Retrospective repeated cross-sectional study spanning the years 2011 - 2016. SETTING: Health Service Executive Primary Care Reimbursement Service pharmacy claims data for General Medical Services (GMS) patients, approximately 40% of the Irish population...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678964/technology-enabled-examinations-of-cardiac-rhythm-optic-nerve-oral-health-tympanic-membrane-gait-and-coordination-evaluated-jointly-with-routine-health-screenings-an-observational-study-at-the-2015-kumbh-mela-in-india
#13
Pratik Shah, Gregory Yauney, Otkrist Gupta, Vincent Patalano Ii, Mrinal Mohit, Rikin Merchant, S V Subramanian
OBJECTIVES: Technology-enabled non-invasive diagnostic screening (TES) using smartphones and other point-of-care medical devices was evaluated in conjunction with conventional routine health screenings for the primary care screening of patients. DESIGN: Dental conditions, cardiac ECG arrhythmias, tympanic membrane disorders, blood oxygenation levels, optic nerve disorders and neurological fitness were evaluated using FDA-approved advanced smartphone powered technologies...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678813/prognostic-significance-of-nuisance-bleeding-in-anticoagulated-patients-with-atrial-fibrillation
#14
Emily C O'Brien, DaJuanicia N Holmes, Laine E Thomas, Gregg C Fonarow, Larry A Allen, Bernard J Gersh, Peter R Kowey, Daniel E Singer, Michael D Ezekowitz, Gerald V Naccarelli, Jack E Ansell, Paul S Chan, Kenneth W Mahaffey, Alan S Go, James V Freeman, James A Reiffel, Eric D Peterson, Jonathan P Piccini, Elaine M Hylek
Background -Bleeding is commonly cited as a reason for stopping oral anticoagulants (OAC). Whether minor bleeding events ("nuisance bleeding", NB) in patients with atrial fibrillation (AF) on OAC are associated with OAC discontinuation, major bleeding and stroke/systemic embolism (SSE), is unknown. Methods -Within the ORBIT-AF prospective, outpatient registry, we identified 6771 patients ≥18 years of age at 172 sites with AF and eligible followup visits. NB was ascertained from the medical record and was defined as minor bleeding that did not require medical attention (e...
April 20, 2018: Circulation
https://www.readbyqxmd.com/read/29678564/prescription-medication-use-among-community-based-us-adults-with-chronic-low-back-pain-a-cross-sectional-population-based-study
#15
Anna Shmagel, Linh Ngo, Kristine Ensrud, Robert Foley
Many classes of medications have been evaluated in chronic low back pain (cLBP), however their utilization in the community remains unclear. We examine patterns of prescription medication use among Americans with cLBP in a nationally representative, community-based sample. The Back Pain Survey was administered to a representative sample of US adults aged 20-69 (N = 5103) during the 2009-2010 cycle of the National Health and Nutrition Examination Survey (NHANES). cLBP was defined as self-reported pain in the area between the lower posterior margin of the ribcage and the horizontal gluteal fold on most days for at least 3 months (N = 700)...
April 17, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29678531/-restructuring-of-medical-specialist-treatment-using-the-example-of-ambulatory-special-medical-care-asv-taking-a-critical-look-at-its-aims-and-implementation
#16
REVIEW
Robert Dengler, Manfred Cassens
With the GKV-VStG act in 2012, the former section 116b SGB V was transformed into ambulatory special medical care (ASV). This system comprises the diagnosis and therapy of rare or complex diseases which are difficult to treat, in need of a special qualification of doctors, an interdisciplinary cooperation and/or special facilities. For the first time, a uniform regulatory framework was established for the participation of office- as well as hospital-based doctors in ambulatory care. There is no planning of demand or licensed permission...
April 18, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29678530/improved-overall-survival-and-locoregional-disease-control-with-concurrent-pd-1-pathway-inhibitors-and-stereotactic-radiosurgery-for-lung-cancer-patients-with-brain-metastases
#17
Emily Schapira, Harper Hubbeling, Beow Y Yeap, William A Mehan, Alice T Shaw, Kevin Oh, Justin F Gainor, Helen A Shih
PURPOSE: Despite the emerging role of programmed cell death-1 (PD-1) pathway inhibitors for patients with advanced lung cancer, a paucity of data are available on the activity of these agents among patients with brain metastases. We investigated the outcomes of PD-1 pathway inhibitors and stereotactic radiosurgery (SRS) for the treatment of patients with brain metastases from lung cancer. METHODS AND MATERIALS: We retrospectively reviewed the medical records of non-small-cell lung cancer patients with brain metastases consecutively treated with PD-1 pathway inhibitors and SRS at our institution from 2012 to 2017...
March 22, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29678528/endocrine-remission-after-pituitary-stereotactic-radiosurgery-differences-in-rates-of-response-for-matched-cohorts-of-cushing-disease-and-acromegaly-patients
#18
Daniel M Trifiletti, Zhiyuan Xu, Sunil W Dutta, Alfredo Quiñones-Hinojosa, Jennifer Peterson, Mary Lee Vance, Jason P Sheehan
PURPOSE: To compare and describe the time to endocrine remission and new hypopituitarism among patients with growth hormone (GH) and adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas after radiosurgery, controlling for several known prognostic factors. METHODS AND MATERIALS: An institutional review board-approved, institutional retrospective analysis of patients with GH- and ACTH-secreting pituitary adenomas was performed, with matching for patient sex, age at radiosurgery, interval between the last resection and radiosurgery, use of previous radiation therapy, whole sella treatment, suprasellar extension, cavernous sinus invasion, and margin dose...
February 20, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29678454/top-100-cited-articles-on-radiation-exposure-in-medical-imaging-a-bibliometric-analysis
#19
Jason Kinnin, Tarek N Hanna, Marc Jutras, Babar Hasan, Rick Bhatia, Faisal Khosa
BACKGROUND: Bibliometric analyses by highest number of citations can help researchers and funding agencies in determining the most influential articles in a field. The main objective of this analysis was to identify the top 100 cited articles addressing radiation exposure from medical imaging and assess their characteristics. METHODS: Relevant articles were extracted from the Scopus database after a systematic search by researchers using an iteratively defined Boolean search string...
March 20, 2018: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29678449/using-primary-organotypic-mouse-midbrain-cultures-to-examine-developmental-neurotoxicity-of-silver-nanoparticles-across-two-genetic-strains
#20
Brittany A Weldon, Julie Juyoung Park, Sungwoo Hong, Tomomi Workman, Russell Dills, Ji Hyun Lee, William C Griffith, Terrance J Kavanagh, Elaine M Faustman
Micromass culture systems have been developed as three-dimensional organotypic in vitro alternatives to test developmental toxicity. We have optimized a murine-based embryonic midbrain micromass system in two genetic strains to evaluate neurodevelopmental effects of gold-cored silver nanoparticles (AgNPs) of differing sizes and coatings-20 nm AgCitrate, 110 nm AgCitrate, and 110 nm AgPVP. AgNPs are increasingly used in consumer, commercial, and medical products for their antimicrobial properties and observations of Ag in adult and fetal brain following in vivo exposures to AgNPs have led to concerns about the potential for AgNPs to elicit adverse effects on neurodevelopment and neurological function...
April 17, 2018: Toxicology and Applied Pharmacology
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