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https://www.readbyqxmd.com/read/28749479/communicating-prognosis-with-parents-of-critically-ill-infants-direct-observation-of-clinician-behaviors
#1
R D Boss, M E Lemmon, R M Arnold, P K Donohue
OBJECTIVE: Delivering prognostic information to families requires clinicians to forecast an infant's illness course and future. We lack robust empirical data about how prognosis is shared and how that affects clinician-family concordance regarding infant outcomes. STUDY DESIGN: Prospective audiorecording of neonatal intensive care unit family conferences, immediately followed by parent/clinician surveys. Existing qualitative analysis frameworks were applied. RESULTS: We analyzed 19 conferences...
July 27, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28749276/obstetrical-and-postpartum-complications-in-lesser-madagascar-hedgehog-tenrecs-echinops-telfairi-four-cases
#2
Kimberly A Thompson, Dalen Agnew, Sally A Nofs, Tara M Harrison
Currently, little is known about diseases and health concerns in tenrecs, family Tenrecidae. During the past 10 yr of breeding lesser Madagascar hedgehog tenrecs ( Echinops telfairi ) at a single zoological institution, a diverse range of obstetric and postpartum complications have been observed: pyometra, metritis, retained fetal membranes, retained fetus, perinatal mortality, and maternal neglect with subsequent successful hand-rearing of neonates. Treatment of these problems is complicated in tenrecs because of their small size and secretive behavior...
June 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28748680/factors-associated-with-favorable-outcome-of-topiramate-migraine-prophylaxis-in-pediatric-patients
#3
Il Han Yoo, WooJoong Kim, Hunmin Kim, Byung Chan Lim, Hee Hwang, Jong Hee Chae, Jieun Choi, Ki Joong Kim
BACKGROUND AND PURPOSE: There are few studies that have investigated predictive factors related to migraine prophylaxis of which produced inconsistent results. The aim of this study was to identify factors that can predict the treatment response to topiramate prophylaxis in pediatric patients with migraine. METHODS: One hundred and thirteen patients who were older than 7 years and received topiramate for at least 3 months were recruited from the Seoul National University Bundang Hospital outpatient clinic from 2005 to 2014...
July 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28748507/intergenerational-neighborhood-attainment-and-the-legacy-of-racial-residential-segregation-a-causal-mediation-analysis
#4
Jeremy Pais
Advances in mediation analysis are used to examine the legacy effects of racial residential segregation in the United States on neighborhood attainments across two familial generations. The legacy effects of segregation are anticipated to operate through two primary pathways: a neighborhood effects pathway and an urban continuity pathway. The neighborhood effects pathway explains why parent's exposure to racial residential segregation during their family-rearing years can influence the residential outcomes of their children later in life...
July 26, 2017: Demography
https://www.readbyqxmd.com/read/28748266/treatment-of-chronic-heart-failure-in-germany-a-retrospective-database-study
#5
Stefan Störk, Renate Handrock, Josephine Jacob, Jochen Walker, Frederico Calado, Raquel Lahoz, Stephan Hupfer, Sven Klebs
BACKGROUND: Adherence to treatment guidelines affects outcomes in patients with chronic heart failure (HF). We investigated patient pathways and treatment patterns for HF in Germany. METHODS: This retrospective study used anonymous healthcare claims data from the German Health Risk Institute on individuals with statutory health insurance. Patients with uninterrupted data from 1 January 2009 to 31 December 2013 or death (whichever occurred first), and ≥2 recorded HF-related diagnoses in 2011, were included...
July 26, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28748108/readyspeech-for-people-with-dysarthria-after-stroke-protocol-for-a-feasibility-randomised-controlled-trial
#6
Claire Mitchell, Audrey Bowen, Sarah Tyson, Paul Conroy
BACKGROUND: Dysarthria, a disordered speech production resulting from neuro-muscular impairment, is a common symptom after stroke. It causes significant problems for patients' speech intelligibility, communication, psychological well-being, social engagement and stroke recovery. Rehabilitation for dysarthria is variable in quality, intensity and duration, which may be, in part, due to the lack of good quality evidence. An online therapy programme, ReaDySpeech, has the potential to improve quality, intensity and duration of speech rehabilitation and was considered in a proof-of-concept study to be acceptable to speech and language therapists and patients which warranted further evaluation...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28747933/i-think-i-m-going-to-be-sick-an-eight-year-old-boy-with-emetophobia-and-secondary-food-restriction
#7
Sarabpreet Dosanjh, William Fleisher, Diana Sam
We present a case of an eight-year-old boy with a specific phobia of vomiting who developed subsequent food restriction and weight loss. Our case report includes a review of treatment modalities for specific phobias including cognitive behavioural and exposure therapy in young children and the importance of parental involvement in the treatment process. After an initial assessment and diagnosis of this boy with emetophobia, treatment took place over ten subsequent visits, one hour each in duration. His treatment included a cognitive approach utilizing exposure therapy to re-introduce foods to his diet, working through a fear hierarchy, addressing cognitive distortions/misconceptions and psychoeducational supports...
July 2017: Journal of the Canadian Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/28747237/mental-health-care-utilisation-among-internally-displaced-persons-in-ukraine-results-from-a-nation-wide-survey
#8
B Roberts, N Makhashvili, J Javakhishvili, A Karachevskyy, N Kharchenko, M Shpiker, E Richardson
Aims There are an estimated 1.5 million internally displaced persons (IDPs) in Ukraine because of the armed conflict in the east of the country. The aim of this paper is to examine utilisation patterns of mental health and psychosocial support (MHPSS) care among IDPs in Ukraine. METHODS: A cross-sectional survey design was used. Data were collected from 2203 adult IDPs throughout Ukraine between March and May 2016. Data on mental health care utilisation were collected, along with outcomes including post-traumatic stress disorder (PTSD), depression and anxiety...
July 27, 2017: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/28746576/quality-of-cervical-cancer-screening-in-brazil-external-assessment-of-the-pmaq
#9
Mara Rejane Barroso Barcelos, Rita de Cássia Duarte Lima, Elaine Tomasi, Bruno Pereira Nunes, Suele Manjourany Silva Duro, Luiz Augusto Facchini
OBJECTIVE: To examine whether demographic and socioeconomic variables and the variables of the organization of services are associated with the quality of cervical cancer screening. METHODS: This is a survey carried out in the health services of the five Brazilian regions in 2012. The sample consisted of users of basic health units participating in the Program for Improving Access and Quality of the Primary Care. The independent variables analyzed were: socioeconomic characteristics (municipal context), demographic characteristics (user profile), and two domains related to the organization of basic services (work structure and process)...
July 20, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28746341/association-of-prenatal-exposure-to-benzodiazepines-and-child-internalizing-problems-a-sibling-controlled-cohort-study
#10
Ragnhild E Brandlistuen, Eivind Ystrom, Sonia Hernandez-Diaz, Svetlana Skurtveit, Randi Selmer, Marte Handal, Hedvig Nordeng
BACKGROUND: During pregnancy, many women experience sleep problems and anxiety that require treatment. The long-term safety for the child of maternal benzodiazepine (BZD) and z-hypnotic use during pregnancy remains controversial. METHOD: We conducted a cohort and a sibling control study using data from the Norwegian Mother and Child Cohort Study. Data on use of BZD and z-hypnotics, internalizing and externalizing outcomes, and covariates were collected from mothers at gestational weeks 17 and 30 and when children were 0...
2017: PloS One
https://www.readbyqxmd.com/read/28746172/a-genetic-variant-in-the-catechol-o-methyl-transferase-comt-gene-is-related-to-age-dependent-differences-in-the-therapeutic-effect-of-calcium-channel-blockers
#11
Jiayue Xu, Adrian E Boström, Mohamed Saeed, Raghvendra K Dubey, Gérard Waeber, Peter Vollenweider, Pedro Marques-Vidal, Jessica Mwinyi, Helgi B Schiöth
Hypertension is the leading risk factor for cardiovascular disease and one of the major health concerns worldwide. Genetic factors impact both the risk for hypertension and the therapeutic effect of antihypertensive drugs. Sex- and age-specific variances in the prevalence of hypertension are partly induced by estrogen. We investigated 6 single nucleotide polymorphisms in genes encoding enzymes involved in estrogen metabolism in relation to sex- and age-specific differences in the systolic and diastolic blood pressure (SBP and DBP) outcome under the treatment of diuretics, calcium-channel blockers (CCBs), angiotensin-converting-enzyme inhibitors, and angiotensin-receptor blockers (ARBs)...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28746024/impact-of-longitudinal-electronic-health-record-training-for-residents-preparing-for-practice-in-patient-centered-medical-homes
#12
Jung G Kim, Hector P Rodriguez, Katherine At Estlin, Carl G Morris
INTRODUCTION: Competence in using an electronic health record (EHR) is considered a critical skill for physicians practicing in patient-centered medical homes (PCMHs), but few studies have examined the impact of EHR training for residents preparing to practice in PCMHs. This study explored the educational outcomes associated with comprehensive EHR training for family medicine residents. METHODS: The PCMH EHR training consisted of case-based routine clinic visits delivered to 3 resident cohorts (N = 18)...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28745400/voxel-based-magnetic-resonance-image-postprocessing-in-epilepsy
#13
Pascal Martin, Gavin P Winston, Philippa Bartlett, Jane de Tisi, John S Duncan, Niels K Focke
OBJECTIVE: Although the general utility of voxel-based processing of structural magnetic resonance imaging (MRI) data for detecting occult lesions in focal epilepsy is established, many differences exist among studies, and it is unclear which processing method is preferable. The aim of this study was to compare the ability of commonly used methods to detect epileptogenic lesions in magnetic resonance MRI-positive and MRI-negative patients, and to estimate their diagnostic yield. METHODS: We identified 144 presurgical focal epilepsy patients, 15 of whom had a histopathologically proven and MRI-visible focal cortical dysplasia; 129 patients were MRI negative with a clinical hypothesis of seizure origin, 27 of whom had resections...
July 26, 2017: Epilepsia
https://www.readbyqxmd.com/read/28744980/building-a-comprehensive-team-for-the-longitudinal-care-of-single-ventricle-heart-defects-building-blocks-and-initial-results
#14
Karen Texter, Jo Ann M Davis, Christina Phelps, Sharon Cheatham, John Cheatham, Mark Galantowicz, Timothy F Feltes
INTRODUCTION: With increasing survival of children with HLHS and other single ventricle lesions, the complexity of medical care for these patients is substantial. Establishing and adhering to best practice models may improve outcome, but requires careful coordination and monitoring. METHODS: In 2013 our Heart Center began a process to build a comprehensive Single Ventricle Team designed to target these difficult issues. RESULTS: Comprehensive Single Ventricle Team in 2014 was begun, to standardize care for children with single ventricle heart defects from diagnosis to adulthood within our institution...
July 26, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28744851/post-translational-regulation-of-antiviral-innate-signaling
#15
REVIEW
Yilong Zhou, Chenxi He, Wang Lin, Baoxue Ge
The innate immune system initiates immune responses by pattern-recognition receptors (PRR). Virus-derived nucleic acids are sensed by the retinoic acid-inducible gene I (RIG-I)-like receptor (RLR) family and the toll-like receptor (TLR) family as well as the DNA sensor cyclic GMP-AMP (cGAMP) synthase (cGAS). These receptors activate IRF3/7 and NF-κB signaling pathways to induce the expression of type I interferons (IFNs) and other cytokines firing antiviral responses within the cell. However, to achieve a favorable outcome for the host, a balanced production of IFNs and activation of antiviral responses is required...
July 26, 2017: European Journal of Immunology
https://www.readbyqxmd.com/read/28744703/pathways-of-intergenerational-transmission-of-advantages-during-adolescence-social-background-cognitive-ability-and-educational-attainment
#16
Wiebke Schulz, Reinhard Schunck, Martin Diewald, Wendy Johnson
Educational attainment in adolescence is of paramount importance for attaining higher education and for shaping subsequent life chances. Sociological accounts focus on the role of differences in socioeconomic resources in intergenerational reproduction of educational inequalities. These often disregard the intergenerational transmission of cognitive ability and the importance of children's cognitive ability to educational attainment. Psychological perspectives stress the importance of cognitive ability for educational attainment but underemphasize potentially different roles of specific socioeconomic resources in shaping educational outcomes, as well as individual differences in cognitive ability...
July 25, 2017: Journal of Youth and Adolescence
https://www.readbyqxmd.com/read/28743661/chronic-pain-patient-physician-engagement-and-family-communication-associated-with-drug-using-hiv-patients-discussing-advanced-care-planning-with-their-physicians
#17
Eric D Hansen, Mary M Mitchell, Tom Smith, Nancy Hutton, Jeanne Keruly, Amy R Knowlton
CONTEXT: In the era of effective antiretroviral therapy, persons living with HIV/AIDS (PLWHA) are living longer, transforming HIV into a serious chronic illness, warranting patient-provider discussion about advanced care planning (ACP). Evidence is needed to inform physicians on how to approach ACP for these patients. Chronic pain is common in PLWHA, particularly in those who have substance use disorders; although it is known this population is at risk for poorer patient-physician engagement, the effects on ACP are unknown...
July 22, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28743562/robotic-assisted-laparoscopic-artificial-urinary-sphincter-and-mace-procedure-on-a-pediatric-patient
#18
Paulo Renato Marcelo Moscardi, Natalia Ballesteros, Abd-El-Rahman Abd-El-Barr, Mariarita Salvitti, Miguel Castellan
OBJECTIVE: To describe robotic-assisted laparoscopic artificial urinary sphincter (RAL-AUS) placement and a Malone antegrade continent enema (MACE) procedure on a 6-year-old girl. PATIENTS AND RESULTS: Our patient is a 6-year-old girl with myelomeningocele. She was totally incontinent of urine and chronic constipated despite aggressive bowel regimen. Preoperative workup included renal and bladder ultrasound showing normal findings. Video-urodynamics was also obtained showing low leak point pressure (25 cm H2O) with no reflux...
July 8, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28743319/nationwide-survey-on-current-management-strategies-of-toddler-s-fractures
#19
Jade Seguin, Daniel Brody, Patricia Li
BACKGROUND: Tibial fractures are common in children less than 3 years old. The traditional management involves immobilization in an above knee cast for both confirmed (positive x-ray) and presumed (normal x-ray) toddler's fractures. This carries health care implications and causes unnecessary burden for patients and their families. There is a paucity of literature describing the ideal immobilization strategy for this injury. OBJECTIVES: To determine: 1) the variation between Canadian emergency departments in management of toddler's fractures; 2) the variation in management between confirmed and presumed toddler's fractures; 3) the association between demographic variables and immobilization strategies...
July 26, 2017: CJEM
https://www.readbyqxmd.com/read/28743105/statistical-interactions-from-a-growth-curve-perspective
#20
Sean M Devlin, Jaya M Satagopan
Logistic regression is widely used to evaluate the association between risk factors and a binary outcome. The logistic curve is symmetric around its point of inflection. Alternative families of curves, such as the additive Gompertz or Guerrero-Johnson models, have been proposed in various scenarios due to their asymmetry: disease risk may initially increase rapidly and be followed by a longer period where the rate of growth slowly decreases. When modeling binary outcomes in relation to risk factors, an additive logistic model may not provide a good fit to the data...
July 26, 2017: Human Heredity
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