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https://www.readbyqxmd.com/read/27931680/reactivation-or-reinfection-in-adult-tuberculosis-is-that-the-question
#1
Pere-Joan Cardona
Looking at the chapter on "natural history" in any tuberculosis (TB) reference book, there is a kind of certainty regarding TB in adults. That is the concept of "post-primary" TB described as the reactivation of dormant bacilli hidden in an old lesion developed during infancy due to a type of local immunosuppression. Intriguingly, this concept involves at least two major uncertainties: how can dormant bacilli remain for such a long period, almost a lifetime, in an old lesion, taking into account granuloma dynamism; and what sort of local immunosuppression is the one that facilitates reactivation? The controversy between reactivation and exogenous reinfection as the cause of active TB started very soon in TB research...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/27929301/the-dark-side-of-the-sublime-distinguishing-a-threat-based-variant-of-awe
#2
Amie M Gordon, Jennifer E Stellar, Craig L Anderson, Galen D McNeil, Daniel Loew, Dacher Keltner
Theoretical conceptualizations of awe suggest this emotion can be more positive or negative depending on specific appraisal processes. However, the emergent scientific study of awe rarely emphasizes its negative side, classifying it instead as a positive emotion. In the present research we tested whether there is a more negative variant of awe that arises in response to vast, complex stimuli that are threatening (e.g., tornadoes, terrorist attack, wrathful god). We discovered people do experience this type of awe with regularity (Studies 1 & 4) and that it differs from other variants of awe in terms of its underlying appraisals, subjective experience, physiological correlates, and consequences for well-being...
December 8, 2016: Journal of Personality and Social Psychology
https://www.readbyqxmd.com/read/27926555/avoiding-radical-surgery-in-elderly-patients-with-rectal-cancer-is-cost-effective
#3
Christopher Rao, Arthur Sun Myint, Thanos Athanasiou, Omar Faiz, Antony Paul Martin, Brendan Collins, Fraser McLean Smith
BACKGROUND: Radical surgery is associated with significant perioperative mortality in elderly and comorbid populations. Emerging data suggest for patients with a clinical complete response after neoadjuvant chemoradiotherapy that a watch-and-wait approach may provide equivalent survival and oncological outcomes. OBJECTIVE: The purpose of this study was to compare the cost-effectiveness of watch and wait and radical surgery for patients with rectal cancer after a clinical complete response following chemoradiotherapy...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27925204/rabs-membrane-dynamics-and-parkinson-s-disease
#4
REVIEW
Bor Luen Tang
Genes encoding cellular membrane trafficking components, namely RAB7L1 and RAB39B, are more recently recognized factors associated with Parkinson's disease (PD). Encoded by a gene within the PARK16 locus, RAB7L1 interacts with Leucine-rich repeat kinase 2 (LRRK2) to act in intracellular transport processes that are likely important in neuronal survival and function. LRRK2 also directly phosphorylates a number of other Rab proteins. On the other hand, nonsense and missense mutations of the X-chromosome localized RAB39B, were shown to underlie X-linked intellectual disability (ID) in male patients with early-onset PD...
December 7, 2016: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/27925165/pugs-a-novel-scale-to-assess-perceptions-of-uncertainties-in-genome-sequencing
#5
Barbara B Biesecker, Samuel W Woolford, William Mp Klein, Kyle B Brothers, Kendall L Umstead, Katie L Lewis, Leslie G Biesecker, Paul Kj Han
Expectations of results from genome sequencing by end users are influenced by perceptions of uncertainty. This study aimed to assess uncertainties about sequencing by developing, evaluating, and implementing a novel scale. The Perceptions of Uncertainties in Genome Sequencing (PUGS) scale comprised ten items to assess uncertainties within three domains: clinical, affective, and evaluative. Participants (n=535) from the ClinSeq® NIH sequencing study completed a baseline survey that included the PUGS; responses (mean = 3...
December 7, 2016: Clinical Genetics
https://www.readbyqxmd.com/read/27923357/patient-preferences-for-palliative-treatment-of-locally-advanced-or-metastatic-gastric-cancer-and-adenocarcinoma-of-the-gastroesophageal-junction-a-choice-based-conjoint-analysis-study-from-germany
#6
R Hofheinz, J Clouth, J Borchardt-Wagner, U Wagner, E Weidling, M H Jen, P Brück
BACKGROUND: Decisions on palliative chemotherapy (CT) for locally advanced or metastatic gastric cancer (mGC) require trade-offs between potential benefits and risks for patients. Healthcare providers and payers agree that patient-preferences should be considered. We conducted a choice-based conjoint (CBC) analysis study in pre-treated patients from Germany with mGC or locally advanced or metastatic adenocarcinoma of the gastroesophageal junction (mGEJ-Ca), to evaluate their preferences when hypothetically selecting a CT regimen...
December 6, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27922588/does-the-addition-of-ezetimibe-to-statins-reduce-cardiovascular-risk
#7
Francisca I Araya, Bruno Grassi
Statins are the mainstay of lipid-lowering therapy nowadays, since they reduce cardiovascular risk when used as primary or secondary prevention. However, only one third of the patients reach the goals established in several guidelines, and even if they do, they keep a risk higher than healthy controls. One of the new lipid-lowering agents is ezetimibe. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified nine systematic reviews comprising 67 trials overall...
December 5, 2016: Medwave
https://www.readbyqxmd.com/read/27922587/tinea-incognito-due-to-trichophyton-mentagrophytes-case-report
#8
Camila Quiñones, Paula Hasbún, Walter Gubelin
Tineas are frequent infections caused by dermatophytes that are able to invade keratinized tissue, causing rounded, erythematous, scaly lesions. Nonetheless, in tinea incognito the lesions are modified because of inappropriate use of topical corticosteroids or calcineurin inhibitors, making it difficult to diagnose. We present a case of a 12-year-old male child that presents with erythematous lesions on the right eyebrow, which at first was diagnosed as a contact dermatitis, so corticosteroids were indicated...
November 9, 2016: Medwave
https://www.readbyqxmd.com/read/27922585/are-erythropoiesis-stimulating-agents-beneficial-for-anemia-in-chronic-heart-failure-patients
#9
Diego Araneda, Gabriel Rada
Anemia is a common comorbidity among patients with chronic health failure and appears to be associated with increased mortality and morbidity. However, it is unclear whether correcting it with erythropoiesis stimulating agents improves clinical outcomes. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified 11 systematic reviews including 17 trials overall addressing the question of this article. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach...
November 23, 2016: Medwave
https://www.readbyqxmd.com/read/27922584/should-sodium-intake-be-restricted-in-chronic-heart-failure
#10
Victoria Castro-Gutiérrez, Gabriel Rada
Sodium restriction has been recommended in chronic heart failure for decades. However, the evidence about the benefit of this measure is not clear, and it might even increase risks. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified three systematic reviews incorporating 13 studies addressing the question of this article, 10 were randomized trials. We extracted data, combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach...
December 5, 2016: Medwave
https://www.readbyqxmd.com/read/27921140/cocaine-administration-dose-dependently-increases-sexual-desire-and-decreases-condom-use-likelihood-the-role-of-delay-and-probability-discounting-in-connecting-cocaine-with-hiv
#11
Matthew W Johnson, Evan S Herrmann, Mary M Sweeney, Robert S LeComte, Patrick S Johnson
OBJECTIVES: Although cocaine use has been linked to sexual HIV risk behavior for decades, the direct effects of cocaine on sexual desire and sexual decision-making are unexamined. Research suggests delay discounting (devaluation of future outcomes) and probability discounting (devaluation of uncertain outcomes) play roles in condom use decisions. This study examined the effect of cocaine administration on sexual desire, hypothetical condom use, and discounting tasks. METHODS: This double-blind, within-subjects study compared the effects of 0, 125, and 250 mg/70 kg oral cocaine HCl in 12 cocaine users...
December 5, 2016: Psychopharmacology
https://www.readbyqxmd.com/read/27918916/induced-optimism-as-mental-rehearsal-to-decrease-depressive-predictive-certainty
#12
Regina Miranda, Mariann Weierich, Valerie Khait, Justyna Jurska, Susan M Andersen
The present study examined whether practice in making optimistic future-event predictions would result in change in the hopelessness-related cognitions that characterize depression. Individuals (N = 170) with low, mild, and moderate-to-severe depressive symptoms were randomly assigned to a condition in which they practiced making optimistic future-event predictions or to a control condition in which they viewed the same stimuli but practiced determining whether a given phrase contained an adjective. Overall, individuals in the induced optimism condition showed increases in optimistic predictions, relative to the control condition, as a result of practice, but only individuals with moderate-to-severe symptoms of depression who practiced making optimistic future-event predictions showed decreases in depressive predictive certainty, relative to the control condition...
November 22, 2016: Behaviour Research and Therapy
https://www.readbyqxmd.com/read/27917075/management-of-clostridium-difficile-infection
#13
Layth S Al-Jashaami, Herbert L DuPont
Since the discovery of Clostridium difficile infection (CDI) in the 1970s, there has been an increase in the incidence, severity, and recurrence rate of the disease. We reviewed the recent CDI literature in PubMed published before February 28, 2016 that focused on advances in therapy. Despite a large number of studies describing methods for diagnosing the disease, there is currently no definitive test that identifies this infection with certainty, which complicates therapy. Recommended therapy for CDI includes oral metronidazole for mild cases and oral vancomycin or fidaxomicin for moderate to severe cases, each given for 10 to 14 days...
October 2016: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27916177/could-disruption-of-the-shoulder-superior-capsule-be-the-essential-lesion-of-rotator-cuff-disease-possibly-but-questions-remain%C3%A2
#14
EDITORIAL
Nikhil N Verma, James H Lubowitz, Jefferson C Brand, Matthew T Provencher, Michael J Rossi
Rotator cuff disease remains a complex clinical problem with significant variation in pathology, clinical presentation, and management options. Functionally, humeral head depression is critical in restoring or maintaining arm elevation, and the shoulder superior capsule serves in this important function. Could disruption of the shoulder superior capsule be the "essential lesion" of rotator cuff disease? Possibly, but many questions remain unanswered, and substantial scientific evidence is required before we can assert with certainty that disruption of the superior capsule with resultant superior instability of the humeral head is the essential lesion of rotator cuff disease...
December 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27915446/superior-dislocation-of-the-patella-a-pathognomonic-finding-and-review-of-literature
#15
P W van Egmond, M C Vermeulen, C F van Dijke, H C A Graat
A 59-year-old woman with a painful right knee that became locked in extension after a trivial trauma was seen at the emergency room. This was caused by unloaded hyperextension in bed. She was diagnosed with a superior dislocation of the patella. A closed reduction was performed, but a recurrent episode was seen within a week. An arthroscopy was performed, in which the causative osteophytes were removed. In the 12-month follow-up after treatment, no recurrence was seen. A superior dislocation of the patella is caused by patellofemoral osteophytes that interlock...
December 3, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27911983/fibrin-glue-versus-sutures-for-conjunctival-autografting-in-primary-pterygium-surgery
#16
REVIEW
Vito Romano, Mario Cruciani, Luigi Conti, Luigi Fontana
BACKGROUND: Pterygium, a growth of the conjunctiva over the cornea, is a progressive disease leading in advanced stages to visual impairment, restriction of ocular motility, chronic inflammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence can be a problem. Currently the best surgical option in terms of recurrence is conjunctival autograft. To date the most common surgical methods of attaching conjunctival autografts to the sclera are through suturing or fibrin glue...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#17
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911487/external-inspection-of-compliance-with-standards-for-improved-healthcare-outcomes
#18
REVIEW
Gerd Flodgren, Daniela C Gonçalves-Bradley, Marie-Pascale Pomey
BACKGROUND: Inspection systems are used in healthcare to promote quality improvements (i.e. to achieve changes in organisational structures or processes, healthcare provider behaviour and patient outcomes). These systems are based on the assumption that externally promoted adherence to evidence-based standards (through inspection/assessment) will result in higher quality of healthcare. However, the benefits of external inspection in terms of organisational-, provider- and patient-level outcomes are not clear...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27908923/aerobic-exercise-and-cancer-related-fatigue-in-adults-a-re-examination-using-the-ivhet-model-for-meta-analysis
#19
George A Kelley, Kristi S Kelley
BACKGROUND: While the results of a recent meta-analysis using the traditional random-effects model yielded a statistically significant standardized mean difference (SMD) reduction in cancer-related fatigue (CRF) as a result of aerobic exercise, a recently developed inverse heterogeneity (IVhet) model has been shown to be more valid than the traditional random-effects model. The purpose of this study was to compare these previous meta-analytic results using the IVhet model. METHODS: Using data from a previous meta-analysis that included 36 SMD effect sizes (ES's) representing 2,830 adults (1,426 exercise, 1,404 control), results were pooled using the IVhet model...
December 1, 2016: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/27907242/a-city-wide-investigation-of-the-isotopic-distribution-and-source-of-tap-waters-for-forensic-human-geolocation-ground-truthing
#20
Momoko Ueda, Lynne S Bell
Human geolocation is prefaced on the accuracy of the geographic precision of mapped isotopic values for drinking water. As most people live in cities, it becomes important to understand city water supplies and how the isotopic values uniquely reflect that city. This study investigated the isotopic distribution of δ(2) H and δ(18) O from sourced tap waters that were collected from across the Metro Vancouver (MV) area (n = 135). The results revealed that the isotopic values reflect their water sources with a range of 5...
December 1, 2016: Journal of Forensic Sciences
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