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https://www.readbyqxmd.com/read/28087513/how-accurate-is-a-single-cutpoint-to-identify-high-blood-pressure-in-adolescents
#1
Paolo Brambilla, Anita Andreano, Laura Antolini, Giorgio Bedogni, Alessandro Salvatoni, Lorenzo Iughetti, Luis Alberto Moreno, Angelo Pietrobelli, Simonetta Genovesi
In 2007 the International Diabetes Federation (IDF) proposed single blood pressure (BP) cutpoints (systolic: ≥130 mm Hg and diastolic: ≥85 mm Hg) for the diagnosis of high blood pressure (HBP) in adolescents. Before this proposal, HBP had been defined as BP at or above the 95th percentile for age, sex, and height percentile (reference standard). In this study, we evaluated the risk for misclassification when using the IDF single-cutpoints criteria. We first applied the IDF criteria to a reconstructed population with the same age, sex, and height distribution as the population used to develop the reference standard...
January 13, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28087291/primary-care-perspectives-on-hepatitis-c-virus-screening-diagnosis-and-linking-patients-to-appropriate-care
#2
Edward Lebovics, Richard Torres, Lucinda K Porter
Enormous progress has been made in recent years toward effectively treating and curing patients with chronic hepatitis C (CHC). However, at least half of the possible 7 million individuals infected with hepatitis C virus (HCV) in the US remain undiagnosed. The formidable task of increasing the number of patients diagnosed, and subsequently linked to appropriate care has fallen to primary care clinicians, who are mandated by some US States to offer screening to individuals born between 1945 and 1965 (the Baby Boomer Generation)...
January 10, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28081040/azathioprine-therapy-in-a-pediatric-tpmt-deficient-patient-still-an-option
#3
S A W van Moorsel, N Bevers, M Meurs, L K van Rossum, P M Hooymans, D R Wong
We describe the case of a pediatric patient on azathioprine therapy with previously undiagnosed homozygote thiopurine S-methyltransferase (TPMT) deficiency, resulting in myelotoxic thiopurine metabolite levels. The patient was successfully treated with a very low azathioprine dose of 50 mg once a week (4% of standard dose), guided by frequent thiopurine metabolite measurement and a close clinical surveillance. We demonstrate that azathioprine therapy still might be an effective and safe therapeutic option in pediatric thiopurine S-methyltransferase-deficient IBD patients...
February 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28079719/feasibility-of-using-hiv-care-continuum-outcomes-to-identify-geographic-areas-for-targeted-hiv-testing
#4
Amanda D Castel, Irene Kuo, Meriam Mikre, Toni Young, Meredith Haddix, Suparna Das, Geoffrey Maugham, Carol Reisen
BACKGROUND: Improved detection and linkage to care of previously undiagnosed HIV infections require innovative approaches to testing. We sought to determine the feasibility of targeted HIV testing in geographic areas, defined by continuum of care parameters, to identify HIV-infected persons needing linkage or engagement in care. METHODS: Using HIV surveillance data from Washington, DC, we identified census tracts that had an HIV prevalence >1% and were either above (higher risk areas-HRAs) or below (lower risk areas-LRAs) the median for 3 indicators: monitored viral load, proportion of persons out of care (OOC), and never in care...
February 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28072751/duodenal-plexiform-fibromyxoma-as-a-cause-of-obscure-upper-gastrointestinal-bleeding-a-case-report
#5
Demetrios Moris, Evangelia Spanou, Stavros Sougioultzis, Nikolaos Dimitrokallis, Polyxeni Kalisperati, Ioanna Delladetsima, Evangelos Felekouras
RATIONALE: We are reporting the first-to our knowledge-case of duodenal Plexiform Fibromyxoma causing obscure upper gastrointestinal bleeding. PATIENT CONCERNS: Plexiform fibromyxoma triggered recurrent upper gastrointestinal bleeding episodes in a 63-year-old man who remained undiagnosed, despite multiple hospitalizations, extensive diagnostic workups and surgical interventions (including gastrectomies), for almost 17 years. DIAGNOSES-INTERVENTIONS: During hospitalization for the last bleeding episode, an upper gastrointestinal endoscopy revealed an intestinal hemorrhagic nodule...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072741/daughter-and-mother-diagnosed-with-hereditary-multiple-exostoses-a-case-report-and-a-review-of-the-literature
#6
Cristina Oana Mărginean, Lorena Elena Meliţ, Maria Oana Mărginean
INTRODUCTION: Hereditary multiple exostoses (HME) or osteochondromatosis is a rare autosomal dominant disease characterized by multiple osteochondromas and skeletal deformities. PATIENT CONCERNS & DIAGNOSES: We present the case of a 5 years and 9 month-old patient who presented with inferior limb pain for approximately 6 months, associating also deformity of the right index finger for a month. Hand X-ray revealed a radiologic abnormality of the right radius, therefore the child was referred to our clinic for further investigations...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28070913/does-identification-of-previously-undiagnosed-conditions-change-care-seeking-behavior
#7
Rebecca M Myerson, Lisandro D Colantonio, Monika M Safford, Elbert S Huang
OBJECTIVE: To determine whether identification of previously undiagnosed high cholesterol, hypertension, and/or diabetes during an in-home assessment impacts care seeking among Medicare beneficiaries. DATA SOURCES/STUDY SETTING: Data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, which recruited African American and white participants across the continental United States from 2003-2007, were linked to Medicare claims. STUDY DESIGN: We used panel data models to analyze changes in doctor visits for evaluation and management of conditions after participants were assessed, utilizing the study's rolling recruitment to control for secular trends...
January 10, 2017: Health Services Research
https://www.readbyqxmd.com/read/28070647/-two-children-with-intermediate-uveitis-and-granuloma-annulare-from-the-same-neighbourhood
#8
A Nessmann, R Klein, P Herzer, M Zierhut
Two children from the same neighbourhood presented with concomitant granuloma annulare (GA) and intermediate uveitis (IU) at an interval of 2 weeks. A coincidence seemed unlikely, as IU is very rare in children and even more so in connection with GA. Thorough diagnosis was performed to exclude other associated diseases. No systemic disease, no special features of vaccination or medication, no history of infection, and no toxic cause could be found. An association between GA and IU based on other, as yet undiagnosed factors, is still possible...
January 9, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28066740/microinstability-of-the-hip-a-previously-unrecognized-pathology
#9
Ioanna Bolia, Jorge Chahla, Renato Locks, Karen Briggs, Marc J Philippon
BACKGROUND: Hip microinstability is an established diagnosis; however, its occurrence is still debated by many physicians. Diagnosis of hip microinstability is often challenging, due to a lack of specific signs or symptoms, and patients may remain undiagnosed for long periods. This may lead to early manifestation of degenerative joint disease. Consequently, careful patient and family history must be obtained and diagnostic imaging should follow. After a thorough clinical evaluation of the patient with suspected hip microinstability, the physician should focus on how to improve symptoms and functionality in daily and sports activities...
July 2016: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28065571/exposure-to-ddt-and-diabetic-nephropathy-among-mexican-americans-in-the-1999-2004-national-health-and-nutrition-examination-survey
#10
Charles J Everett, Olivia M Thompson, Clara E Dismuke
Concentrations of the pesticide DDT (dichlorodiphenyltrichloroethane) and its metabolite DDE (dichlorodiphenyldichloroethylene), in the blood of Mexican Americans, were evaluated to determine their relationships with diabetes and diabetic nephropathy. The data were derived from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 (unweighted N = 1,411, population estimate = 13,760,609). The sample included teens, 12-19 years old, which accounted for 19.8% of the data. The time of the study overlapped the banning of DDT in Mexico in the year 2000, and those participants born in Mexico were exposed to DDT before they immigrated to the US...
January 5, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28065523/a-web-based-registry-for-familial-hypercholesterolaemia
#11
Kathryn R Napier, Jing Pang, Leanne Lamont, Caroline E Walker, Hugh Js Dawkins, Adam A Hunter, Frank M van Bockxmeer, Gerald F Watts, Matthew I Bellgard
Familial hypercholesterolaemia (FH) is the most common and serious monogenic disorder of lipoprotein metabolism that leads to premature coronary heart disease. Patients with FH are often under-treated, and many remain undiagnosed. The deployment of the FH Australasia Network Registry is a crucial component of the comprehensive model of care for FH, which aims to provide a standardised, high-quality and cost-effective system of care that is likely to have the highest impact on patient outcomes. The FH Australasia Network Registry was customised using a registry framework that is an open source, interoperable system that enables the efficient customisation and deployment of national and international web-based disease registries that can be modified dynamically as registry requirements evolve...
November 30, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28063795/effect-of-new-tuberculosis-diagnostic-technologies-on-community-based-intensified-case-finding-a-multicentre-randomised-controlled-trial
#12
Gregory L Calligaro, Lynn S Zijenah, Jonathan G Peter, Grant Theron, Virginia Buser, Ruth McNerney, Wilbert Bara, Tsitsi Bandason, Ureshnie Govender, Michele Tomasicchio, Liezel Smith, Bongani M Mayosi, Keertan Dheda
BACKGROUND: Inadequate case detection results in high levels of undiagnosed tuberculosis in sub-Saharan Africa. Data for the effect of new diagnostic tools when used for community-based intensified case finding are not available, so we investigated whether the use of sputum Xpert-MTB/RIF and the Determine TB LAM urine test in two African communities could be effective. METHODS: In a pragmatic, randomised, parallel-group trial with individual randomisation stratified by country, we compared sputum Xpert-MTB/RIF, and if HIV-infected, the Determine TB LAM urine test (novel diagnostic group), with laboratory-based sputum smear microscopy (routine diagnostic group) for intensified case finding in communities with high tuberculosis and HIV prevalence in Cape Town, South Africa, and Harare, Zimbabwe...
January 4, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28063066/high-prevalence-of-undiagnosed-axial-spondyloarthritis-in-patients-with-chronic-low-back-pain-consulting-non-rheumatologist-specialists-in-belgium-suspect-study
#13
Laure Tant, Nadine Delmotte, Maria Van den Enden, Valerie Gangji, Herman Mielants
INTRODUCTION: Diagnosis of axial spondyloarthritis (SpA) can be delayed for several years mainly because of low awareness of axial SpA among non-rheumatologists who are the first interlocutors of potential SpA patients. One strategy to decrease the delay between appearance of first symptoms and diagnosis of axial SpA and to allow early management of the disease is to provide the non-rheumatologists with tools to identify patients requiring prompt referral to rheumatologists. This study was designed to evaluate in a real-world setting whether screening patients with chronic low back pain who consult physical medicine and rehabilitation (PMR) physicians, orthopedists, and ophthalmologists is useful in detecting axial SpA...
January 6, 2017: Rheumatology and Therapy
https://www.readbyqxmd.com/read/28062431/disseminated-histoplasmosis-presenting-as-diabetic-keto-acidosis-in-an-immunocompetent-patient
#14
Negin Niknam, Prashant Malhotra, Angela Kim, Seth Koenig
Histoplasma capsulatum causes a spectrum of manifestations from asymptomatic to fatal disseminated disease. Disseminated histoplasmosis is mostly seen in endemic areas among immunocompromised patients such as those with AIDS. Here, we present a patient living in a non-endemic area with previously undiagnosed diabetes mellitus, who presented with septic shock and diabetic ketoacidosis (DKA), and was ultimately diagnosed with disseminated histoplasmosis. The patient rapidly recovered on administration of intravenous liposomal amphotericin followed by oral itraconazole...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28061364/de-novo-truncating-variants-in-asxl2-are-associated-with-a-unique-and-recognizable-clinical-phenotype
#15
Vandana Shashi, Loren D M Pena, Katherine Kim, Barbara Burton, Maja Hempel, Kelly Schoch, Magdalena Walkiewicz, Heather M McLaughlin, Megan Cho, Nicholas Stong, Scott E Hickey, Christine M Shuss, Michael S Freemark, Jane S Bellet, Martha Ann Keels, Melanie J Bonner, Maysantoine El-Dairi, Megan Butler, Peter G Kranz, Constance T R M Stumpel, Sylvia Klinkenberg, Karin Oberndorff, Malik Alawi, Rene Santer, Slavé Petrovski, Outi Kuismin, Satu Korpi-Heikkilä, Olli Pietilainen, Palotie Aarno, Mitja I Kurki, Alexander Hoischen, Anna C Need, David B Goldstein, Fanny Kortüm
No abstract text is available yet for this article.
January 5, 2017: American Journal of Human Genetics
https://www.readbyqxmd.com/read/28060834/estimating-the-cost-effectiveness-of-one-time-screening-and-treatment-for-hepatitis-c-in-korea
#16
Do Young Kim, Kwang-Hyub Han, Byungyool Jun, Tae Hyun Kim, Sohee Park, Thomas Ward, Samantha Webster, Phil McEwan
BACKGROUND AND AIMS: This study aims to investigate the cost-effectiveness of a one-time hepatitis C virus (HCV) screening and treatment program in South Korea where hepatitis B virus (HBV) prevails, in people aged 40-70, compared to current practice (no screening). METHODS: A published Markov model was used in conjunction with a screening and treatment decision tree to model patient cohorts, aged 40-49, 50-59 and 60-69 years, distributed across chronic hepatitis C (CHC) and compensated cirrhosis (CC) health states (82...
2017: PloS One
https://www.readbyqxmd.com/read/28060112/spontaneous-fracture-and-migration-of-a-totally-implanted-port-device-to-pulmonary-artery-in-acute-leukemia-child
#17
Olfa Kassar, Rania Hammemi, Mahdi Ben Dhaou, Samir Kammoun, Moez Elloumi
Totally implanted port devices are important for the administration of fluid and chemotherapeutic agents. However, their use may be associated with serious complications, such as catheter fracture and embolism. Most data on port catheter embolization consist of isolated case reports. We report a 6-year-old boy with relapse of an acute lymphoblastic leukemia. He presented with dysfunction of his totally implanted port device. Radiologic examination revealed a catheter fracture. Echocardiography showed the catheter embolized into the right ventricle...
January 5, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28059955/diagnosis-of-opportunistic-infections-hiv-co-infections-tuberculosis
#18
Lesley Scott, Pedro da Silva, Catharina C Boehme, Wendy Stevens, Chris Gilpin
PURPOSE OF REVIEW: Tuberculosis (TB) incidence has declined ∼1.5% annually since 2000, but continued to affect 10.4 million individuals in 2015, with 1/3 remaining undiagnosed or underreported. The diagnosis of TB among those co-infected with HIV is challenging as TB remains the leading cause of death in such individuals. Accurate and rapid diagnosis of active TB will avert mortality in both adults and children, reduce transmission, and assist in timeous decisions for antiretroviral therapy initiation...
January 5, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28058104/severe-lower-limb-ischemia-by-massive-arterial-thrombosis-revealing-an-acute-myeloid-leukemia-needing-for-leg-amputation-clinical-and-emotional-aspects-related-to-the-communication-with-the-patient-and-his-family
#19
Paolo D'Angelo, Calogero Taormina, Clara Mosa, Floriana Di Marco, Fabrizio Valentino, Angela Trizzino, Paola Guadagna, Francesco Talarico
Large vessel thrombosis is a very rare clinical presentation of acute leukemia, generally associated with coagulopathy, usually characteristic of acute promyelocytic leukemia. A 13- year-old boy with a previously undiagnosed acute myeloid leukemia was referred to our hospital with acute ischemia of the right lower limb due to occlusion of the right external iliac artery, treated with emergency double surgical thromboembolectomy and chemotherapy. The thrombotic complication resulted in leg amputation. Now the boy is well in complete remission, with a good social integration and quality of life, 30 months after completing treatment...
November 17, 2016: Pediatric Reports
https://www.readbyqxmd.com/read/28057995/an-undiagnosed-giant-right-renal-hydatid-cyst-treated-laparoscopically-case-report-and-review-of-literature
#20
Elsawi Osman, Ziauddin Khan, Abdulmenem Abualsel, Tanweer Bhatty
Hydatid disease caused by the tape worm Echinococcus granulosus is a rare occurrence in the urinary system in general. We are hereby presenting a case of a gentleman in his fourth decade with a giant right renal hydatid cyst. The clinical manifestations, radiological features, and serology were all not suggestive of hydatid disease; however, typical Echinococcus scolices were detected histologically following cyst aspiration. The giant cyst was successfully treated laparoscopically.
October 2016: Urology Annals
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