keyword
MENU ▼
Read by QxMD icon Read
search

Clinical uncertainty

keyword
https://www.readbyqxmd.com/read/29457866/epigenetic-effects-of-metformin-from-molecular-mechanisms-to-clinical-implications
#1
REVIEW
S C Bridgeman, G C Ellison, P E Melton, P Newsholme, Cds Mamotte
There is a growing body of evidence that links epigenetic modifications to type 2 diabetes. Researchers have more recently investigated effects of commonly used medications, including those prescribed for diabetes, on epigenetic processes. This work reviews the influence of the widely used antidiabetic drug metformin on epigenomics, microRNA levels and subsequent gene expression and potential clinical implications. Metformin may influence the activity of numerous epigenetic modifying enzymes, mostly via modulating the activation of AMP-activated protein kinase (AMPK)...
February 19, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29455482/-clinical-efficacy-of-unilateral-percutaneous-transfacet-screws-combined-with-contralateral-pedicle-screw-versus-bilateral-pedicle-screws-fixation-in-the-treatment-of-the-degenerative-lumbar-disease
#2
Rong-Xue Hao, Hui Zhou, Hao Pan, Jun Yue, Hui-Guo Chen, He-Jie Yang, Gao-Yong Jia, Dong Wang, Yan Lin, Hua-Zi Xu
OBJECTIVE: To investigate the surgical outcome of unilateral pedicle screw(UPS) after TLIF technique combined with contralateral percutaneous transfacet screw(PTS) fixation vs bilateral pedicle screws(BPS) fixation in treatment of degenerative lumbar disease. METHODS: From January 2009 to June 2012, 46 patients with degenerative lumbar diseases, including 30 males and 16 females with an average age of 51.5 years old, who were divided into two groups according to different fixation methods...
September 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29455243/2018-international-olympic-committee-consensus-statement-on-prevention-diagnosis-and-management-of-paediatric-anterior-cruciate-ligament-acl-injuries
#3
REVIEW
Clare L Ardern, Guri Ekås, Hege Grindem, Håvard Moksnes, Allen Anderson, Franck Chotel, Moises Cohen, Magnus Forssblad, Theodore J Ganley, Julian A Feller, Jón Karlsson, Mininder S Kocher, Robert F LaPrade, Mike McNamee, Bert Mandelbaum, Lyle Micheli, Nicholas Mohtadi, Bruce Reider, Justin Roe, Romain Seil, Rainer Siebold, Holly J Silvers-Granelli, Torbjørn Soligard, Erik Witvrouw, Lars Engebretsen
In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric anterior cruciate ligament (ACL) injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery and Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America, and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended...
February 17, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29455160/children-and-adolescents-experiences-of-primary-lymphoedema-semistructured-interview-study
#4
Camilla S Hanson, Johanna Newsom, Davinder Singh-Grewal, Nicholas Henschke, Margaret Patterson, Allison Tong
BACKGROUND: Congenital lymphoedema is a lifelong condition that has detrimental physical and psychosocial outcomes for young patients and burdensome treatment responsibilities that may hamper patients' motivation for self-management. There is limited research from the perspective of young people with primary lymphoedema. We aimed to describe the experiences and views of children and adolescents with lymphoedema to inform patient-centred practice. METHODS: Twenty patients (aged 8-21 years) with primary lymphoedema were purposively sampled from two paediatric clinics in Sydney, Australia, to participate in a semistructured interview...
February 17, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29454494/historical-perspectives-on-tardive-dyskinesia
#5
REVIEW
Stanley N Caroff, Gabor S Ungvari, David G Cunningham Owens
Tardive dyskinesia (TD) is a persistent hyperkinetic movement disorder associated with dopamine receptor blocking agents including antipsychotic medications. Although uncertainty and concern about this drug side effect has vacillated since its initial recognition 60 years ago, recent commercial interest in developing effective treatments has rekindled scientific and clinical interest after a protracted period of neglect. Although substantial research has advanced knowledge of the clinical features and epidemiology of TD, many fundamental questions raised by early investigators remain unresolved...
February 3, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29454487/a-cost-utility-analysis-of-transcatheter-versus-surgical-aortic-valve-replacement-for-the-treatment-of-aortic-stenosis-in-the-population-with-intermediate-surgical-risk
#6
Derrick Y Tam, Avery Hughes, Stephen E Fremes, Saerom Youn, Rebecca L Hancock-Howard, Peter C Coyte, Harindra C Wijeysundera
OBJECTIVE: Although transcatheter aortic valve implantation has been shown to be noninferior to surgical aortic valve replacement in patients with severe aortic stenosis at intermediate surgical risk, the cost-effectiveness of this strategy in this population is unknown. Our objective was to conduct a cost-utility analysis comparing transcatheter aortic valve implantation with surgical aortic valve replacement in the population with intermediate risk severe aortic stenosis. METHODS: A fully probabilistic Markov model with 30-day cycles was constructed from the Canadian third-party payer's perspective to estimate the difference in cost and effectiveness (measured as quality-adjusted life years) of transcatheter aortic valve implantation versus surgical aortic valve replacement for intermediate-risk patients over a lifetime time horizon, discounted at 1...
February 2, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29454309/perceptions-about-screening-for-prostate-cancer-using-genetic-lifetime-risk-assessment-a-qualitative-study
#7
Pia Kirkegaard, Adrian Edwards, Trine Laura Overgaard Nielsen, Torben Falck Ørntoft, Karina Dalsgaard Sørensen, Michael Borre, Flemming Bro
BACKGROUND: Most health authorities do not recommend screening for prostate cancer with PSA tests in asymptomatic patients who are not at increased risk. However, opportunistic screening for prostate cancer is still wanted by many patients and it is widely used in primary care clinics, with potential for overdiagnosis and overtreatment. Better tools for risk assessment have been called for, to better target such opportunistic screening. Our aim was to explore perceptions about prostate cancer risk and subsequent opportunistic screening among patients who were not at increased risk of prostate cancer after a first PSA test plus a genetic lifetime risk assessment...
February 17, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29454186/use-of-pasteurised-human-donor-milk-across-neonatal-networks-in-england
#8
C Battersby, R Marciano Alves Mousinho, N Longford, N Modi
OBJECTIVES: To describe the use of pasteurised human donor milk (pHDM) in England and the influence of a human milk bank in the network. DESIGN: Prospective observational study SETTING: All 163 neonatal units (23 networks) in England 2012-2013. PATIENTS: Preterm infants born at <32 weeks gestational age (GA). MAIN OUTCOME MEASURES: Proportion of infants and care-days fed pHDM during the first 30 postnatal days by network METHODS: We extracted daily patient-level data from the National Neonatal Research Database (NNRD)...
February 14, 2018: Early Human Development
https://www.readbyqxmd.com/read/29453325/performance-of-the-2015-international-task-force-consensus-statement-risk-stratification-algorithm-for-implantable-cardioverter-defibrillator-placement-in-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy
#9
Gabriela M Orgeron, Anneline Te Riele, Crystal Tichnell, Weijia Wang, Brittney Murray, Aditya Bhonsale, Daniel P Judge, Ihab R Kamel, Stephan L Zimmerman, Harikrishna Tandri, Hugh Calkins, Cynthia A James
BACKGROUND: Ventricular arrhythmias are a feared complication of arrhythmogenic right ventricular dysplasia/cardiomyopathy. In 2015, an International Task Force Consensus Statement proposed a risk stratification algorithm for implantable cardioverter-defibrillator placement in arrhythmogenic right ventricular dysplasia/cardiomyopathy. METHODS AND RESULTS: To evaluate performance of the algorithm, 365 arrhythmogenic right ventricular dysplasia/cardiomyopathy patients were classified as having a Class I, IIa, IIb, or III indication per the algorithm at baseline...
February 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29452978/the-management-of-antibodies-in-heart-transplantation-an-ishlt-consensus-document
#10
Jon Kobashigawa, Monica Colvin, Luciano Potena, Duska Dragun, Maria G Crespo-Leiro, Juan F Delgado, Michael Olymbios, Jayan Parameshwar, Jignesh Patel, Elaine Reed, Nancy Reinsmoen, E Rene Rodriguez, Heather Ross, Randall C Starling, Dolly Tyan, Simon Urschel, Andreas Zuckermann
Despite the successes from refined peri-operative management techniques and immunosuppressive therapies, antibodies remain a serious cause of morbidity and mortality for patients both before and after heart transplantation. Patients awaiting transplant who possess antibodies against human leukocyte antigen are disadvantaged by having to wait longer to receive an organ from a suitably matched donor. The number of pre-sensitized patients has been increasing, a trend that is likely due to the increased use of mechanical circulatory support devices...
January 31, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29452867/deep-inspiration-breath-hold-level-variability-and-deformation-in-locoregional-breast-irradiation
#11
Leigh Conroy, Sarah Quirk, Elizabeth Watt, Gillian Ecclestone, Jessica L Conway, Ivo A Olivotto, Tien Phan, Wendy L Smith
PURPOSE: The purpose of this study was to evaluate the dosimetric effect of breath hold level variability and deformation on breast, chest wall, internal mammary chain (IMC) nodes, and heart. METHODS AND MATERIALS: Left-sided post-lumpectomy (n = 12) and postmastectomy (n = 3) patients underwent deep inspiration breath hold (DIBH) and exhale breath hold (EBH) computed tomography (CT) scans. Forward-planned locoregional breast plans were created on the DIBH scan...
February 13, 2018: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29451921/the-effectiveness-of-non-surgical-intervention-foot-orthoses-for-paediatric-flexible-pes-planus-a-systematic-review-update
#12
Sindhrani Dars, Hayley Uden, Helen A Banwell, Saravana Kumar
BACKGROUND: Flexible pes planus (flat feet) in children is a common presenting condition in clinical practice due to concerns amongst parents and caregivers. While Foot Orthoses (FOs) are a popular intervention, their effectiveness remains unclear. Thus, the aim of this systematic review was to update the current evidence base for the effectiveness of FOs for paediatric flexible pes planus. METHODS: A systematic search of electronic databases (Cochrane, Medline, AMED, EMBASE, CINHAL, SportDiscus, Scopus and PEDro) was conducted from January 2011 to July 2017...
2018: PloS One
https://www.readbyqxmd.com/read/29448311/enhancing-decision-making-about-adjuvant-chemotherapy-in-early-breast-cancer-following-endopredict-testing
#13
Lesley Fallowfield, Lucy Matthews, Shirley May, Valerie Jenkins, David Bloomfield
Chemotherapy side-effects can be substantial. There is increasing recognition that some oestrogen receptor positive (ER+ve), human epidermal growth factor receptor 2 negative (HER2-ve) patients with breast cancer derive no benefit from chemotherapy and experience only iatrogenic harm. Gene expression profiling tests help refine recurrence risk and likely chemotherapy benefit. EndoPredict® is one such test, which classifies risks of distant recurrence as low or high in patients treated with surgery and adjuvant endocrine therapy alone...
February 15, 2018: Psycho-oncology
https://www.readbyqxmd.com/read/29446570/gratitude-protective-buffering-and-cognitive-dissonance-how-families-respond-to-pediatric-whole-exome-sequencing-in-the-absence-of-actionable-results
#14
Allison Werner-Lin, Lori Zaspel, Mae Carlson, Rebecca Mueller, Sarah A Walser, Ria Desai, Barbara A Bernhardt
Clinical genome and exome sequencing (CGES) may identify variants leading to targeted management of existing conditions. Yet, CGES often fails to identify pathogenic diagnostic variants and introduces uncertainties by detecting variants of uncertain significance (VUS) and secondary findings. This study investigated how families understand findings and adjust their perspectives on CGES. As part of NIH's Clinical Sequencing Exploratory Research Consortium, children were recruited from clinics at the Children's Hospital of Pennsylvania (CHOP) and offered exome sequencing...
March 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29446496/the-voice-of-nurses-novice-nurses-first-experiences-in-a-clinical-setting-a-longitudinal-diary-study
#15
Yvonne Hoeve Ten, Saskia Kunnen, Jasperina Brouwer, Petrie F Roodbol
AIMS AND OBJECTIVES: To gain greater understanding of which personal and professional demands novice nurses are confronted with and what can be done to improve the transition from novice to professional staff nurse. BACKGROUND: Novice nurses are confronted with a lot of physical, emotional and intellectual changes in the role-transition process from student nurse to professional staff nurse, which are often related to feelings of confusion, uncertainty and stress...
February 15, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29445528/an-update-on-mandibular-advancement-devices-for-the-treatment-of-obstructive-sleep-apnoea-hypopnoea-syndrome
#16
REVIEW
Shadi Basyuni, Michal Barabas, Tim Quinnell
Continuous positive airway pressure (CPAP) remains the gold standard treatment for obstructive sleep apnoea hypopnoea syndrome (OSAHS). However, the high efficacy of CPAP is offset by intolerance and poor compliance, which can undermine effectiveness. This means that alternatives to CPAP are also necessary. In recent years, oral appliances have emerged as the leading alternative to CPAP. There is now a strong body of evidence supporting their use in OSAHS and clinical guidelines now recommend their use in mild OSAHS and in more severe cases when CPAP fails...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29444257/comparison-of-strategies-and-incidence-thresholds-for-vi-conjugate-vaccines-against-typhoid-fever-a-cost-effectiveness-modeling-study
#17
Nathan C Lo, Ribhav Gupta, Jeffrey D Stanaway, Denise O Garrett, Isaac I Bogoch, Stephen P Luby, Jason R Andrews
Background: Typhoid fever remains a major public health problem globally. While new Vi conjugate vaccines hold promise for averting disease, the optimal programmatic delivery remains unclear. We aimed to identify the strategies and associated epidemiologic conditions under which Vi conjugate vaccines would be cost-effective. Methods: We developed a dynamic, age-structured transmission and cost-effectiveness model that simulated multiple vaccination strategies with a typhoid Vi conjugate vaccine from a societal perspective...
February 12, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29442335/early-assessment-of-the-likely-cost-effectiveness-of-single-use-flexible-video-bronchoscopes
#18
Christoffer Lilja Terjesen, Julia Kovaleva, Lars Ehlers
BACKGROUND: Bronchoscopic procedures are common in the clinical setting, with estimates indicating 500,000 are undertaken per year in the USA alone. These procedures are generally regarded as safe. Unfortunately, a risk of cross-contamination between patients, with possible subsequent infection, is associated with the re-usable technology typically used in these procedures. OBJECTIVE: Our objective was to conduct an early cost-effectiveness analysis (CEA) of single-use flexible video bronchoscope technology compared with the current reusable technology in a US hospital intensive care setting...
June 2017: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29442206/thrown-into-the-world-of-independent-practice-from-unexpected-uncertainty-to-new-identities
#19
Brett Schrewe
One of the most exciting yet stressful times in a physician's life is transitioning from supervised training into independent practice. The majority of literature devoted to this topic has focused upon a perceived gap between clinical and non-clinical skills and interventions taken to address it. Building upon recent streams of scholarship in identity formation and adaptation to new contexts, this work uses a Heideggerian perspective to frame an autoethnographical exploration of the author's transition into independent paediatric practice...
February 13, 2018: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/29441699/psychosocial-functioning-and-risk-factors-among-siblings-of-children-with-cancer-an-updated-systematic-review
#20
REVIEW
Kristin Long, Vicky Lehmann, Cynthia Gerhardt, Aubrey Carpenter, Anna Marsland, Melissa Alderfer
OBJECTIVES: Siblings' psychosocial adjustment to childhood cancer is poorly understood. This systematic review summarizes findings and limitations of the sibling literature since 2008, provides clinical recommendations, and offers future research directions. METHOD: MEDLINE/Pubmed, CINAHL, and PsycINFO were searched for articles related to siblings, psychosocial functioning, and pediatric cancer. After systematic screening, studies meeting inclusion criteria were rated for scientific merit, and findings were extracted and synthesized...
February 13, 2018: Psycho-oncology
keyword
keyword
81222
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"