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Wells criteria

Daniel Panchik, Sarah Masco, Patrice Zinnikas, Brooke Hillriegel, Tori Lauder, Erica Suttmann, Vernon Chinchilli, Maureen McBeth, William Hermann
BACKGROUND:  Breast cancer-related lymphedema (BCRL) affects many areas of daily living. Individuals with lymphedema may experience chronic and progressive swelling, recurrent skin infections, and decreased self-image and quality of life. For many years, it was considered best practice for this population to avoid exercise; however, in recent years, research has begun to challenge this belief. This systematic review and meta-analyses examined the recent literature on the effects of exercise for patients with, or at risk for, BCRL to inform best practice...
June 23, 2018: Journal of Reconstructive Microsurgery
Jacob Robson, Molly O'Gorman, Amber McClain, Krishna Mutyala, Cassandra Davis, Carlos Barbagelata, Justin Wheeler, Rafael Firszt, Ken Smith, Raza Patel, Kathryn Peterson, Amy Lowichik, Stephen Guthery
BACKGROUND & AIMS: Eosinophilic esophagitis (EoE) is often detected in children and is considered to be a rare disease, with prevalence values reported to be below 60 cases per 100,000 persons. To determine whether the incidence of EoE in children in Utah exceeds estimates from regional reports, we calculated incidence and prevalence values over a 5-year period. METHODS: Using consensus guidelines for the diagnosis of EoE, we reviewed pathology records from in the Intermountain Healthcare pathology database, from July 1, 2011 through June 31, 2016...
June 20, 2018: Clinical Gastroenterology and Hepatology
Rodrigo Cristofoletti, Malcolm Rowland, Lawrence J Lesko, Henning Blume, Amin Rostami-Hodjegan, Jennifer B Dressman
The growth in the utilization of systems thinking principles has created a paradigm shift in the regulatory sciences and drug product development. Instead of relying extensively on end product testing and one-size-fits-all regulatory criteria, this new paradigm has focused on building quality into the product by design as well as fostering the development of product-specific, clinically relevant specifications. In this context, this commentary describes the evolution of bioequivalence regulations up to the current days and discusses the potential of applying a Bayesian-like approach, considering all relevant prior knowledge, to guide regulatory bioequivalence decisions in a patient-centric environment...
June 20, 2018: Journal of Pharmaceutical Sciences
J de Gelder, J A Lucke, L C Blomaard, A M Booijen, A J Fogteloo, S Anten, E W Steyerberg, J Alsma, S C E Klein Nagelvoort Schuit, A Brink, B de Groot, G J Blauw, S P Mooijaart
INTRODUCTION: Many screening instruments to predict adverse health outcomes in older patients visiting the emergency department (ED) have been developed, but successful implementation has been hampered because they are insufficiently validated or not tailored for the intended use of everyday clinical practice. The present study aims to refine and validate an existing screening instrument (the APOP screener) to predict 90-day functional decline or mortality in older ED patients. METHODS: Consecutive older patients (≥70 years) visiting the EDs of four hospitals were included and prospectively followed...
June 20, 2018: Experimental Gerontology
Anna Lombardo, Giuseppa Raitano, Domenico Gadaleta, Emilio Benfenati
Nontesting methods (NTM) proved to be a valuable resource for risk assessment of chemical substances. Indeed, they can be particularly useful when the information provided by different sources was integrated to increase the confidence in the final result. This integration can be sometimes difficult because different methods can lead to conflicting results, and because a clear guideline for integrating information from different sources was not available in the recent past. In this chapter, we present and discuss the recently published guideline from EFSA for integrating and weighting evidence for scientific assessment...
2018: Methods in Molecular Biology
Lindsey N Clark, Melissa C Helm, Rana Higgins, Kathleen Lak, Andrew Kastenmeier, Tammy Kindel, Matthew Goldblatt, Jon C Gould
BACKGROUND: Patients with a paraesophageal hernia may experience gastroesophageal reflux symptoms and/or obstructive symptoms such as dysphagia. Some patients with large and complex paraesophageal hernias unintentionally lose a significant amount of weight secondary to difficulty eating. A subset of patients will develop Cameron's erosions in the hernia, which contribute to anemia. Given the heterogeneous nature of patients who ultimately undergo paraesophageal hernia repair, we sought to determine if patients with anemia or malnutrition suffered from increased morbidity or mortality...
June 22, 2018: Surgical Endoscopy
Abby I Metzler, Carrie E Robertson
PURPOSE OF REVIEW: In this article, we review illustrative case descriptions of both primary and secondary visual snow from our clinic. We discuss recently proposed criteria for visual snow syndrome and offer a slight modification of these criteria. We also discuss the theories on the pathophysiological mechanisms of visual snow, as well as the current approach to treatment. RECENT FINDINGS: Visual snow is a condition where patients see constant, innumerable flickering dots throughout the visual field, similar to "TV static...
June 22, 2018: Current Neurology and Neuroscience Reports
Sebastian Rauer, Lidia Stork, Horst Urbach, Angeliki Stathi, Anna Marx, Patrick Süß, Marco Prinz, Wolfgang Brück, Imke Metz
OBJECTIVE: To report on 2 women with multiple sclerosis (MS) who developed severe neurologic deterioration and a drug reaction with eosinophilia and systemic symptoms (DRESS) after treatment with 2 and 4 subcutaneous injections of daclizumab, respectively. METHODS: This report includes clinical, MRI, and histopathologic data. RESULTS: Daclizumab is a humanized monoclonal antibody that binds the interleukin-2 receptor. It was approved for the treatment of relapsing MS...
June 22, 2018: Neurology
Salma Ladhani, Brianna Empringham, Kuan-Wen Wang, Carol Portwine, Laura Banfield, Russell J de Souza, Lehana Thabane, M Constantine Samaan
INTRODUCTION: Acute lymphoblastic leukaemia is the most common paediatric cancer. Survivors of childhood acute lymphoblastic leukaemia (SALL) are at risk of obesity and related cardiometabolic diseases including type 2 diabetes, hypertension, stroke and cardiovascular events. Therefore, it is important to address obesity in this population as this may help mitigate future cardiometabolic comorbidities. In this systematic review, we aim to assess current treatment strategies including lifestyle interventions, pharmacotherapy and bariatric surgery to manage overweight and obesity in SALL...
June 22, 2018: BMJ Open
Zachary D W Dezman, David A Gorelick, Carl A Soderstrom
BACKGROUND: Non-alcohol substance use disorders (drug use disorders [DUDs]) are common in trauma patients. OBJECTIVE: To determine the test characteristics of a 4-item drug CAGE questionnaire to detect DUDs in a cohort of adult trauma inpatients. METHODS: Observational cross-sectional cohort of 1,115 adult patients admitted directly to a level-one trauma center between September, 1994 and November, 1996. All participants underwent both a 4-item drug CAGE questionnaire and the substance use disorder section of a structured psychiatric diagnostic clinical interview (SCID) (DSM-IIIR criteria), administered by staff unaware of their clinical status...
June 13, 2018: Injury
María Goñi, Neil Basu, Alison D Murray, Gordon D Waiter
While fatigue is prevalent in chronic diseases, the neural mechanisms underlying this symptom remain unknown. Magnetic resonance imaging (MRI) has the potential to enable us to characterize this symptom. The aim of this review was to gather and appraise the current literature on MRI studies of fatigue in chronic diseases. We systematically searched the following databases: MedLine, PsycInfo, Embase and Scopus (inception to April 2016). We selected studies according to a predefined inclusion and exclusion criteria...
June 21, 2018: Diagnostics
Maya L Henry, Stephanie M Grasso
Speech-language pathologists play a crucial role in the assessment and treatment of individuals with primary progressive aphasia (PPA). The speech-language evaluation is a critical aspect of the diagnostic and rehabilitative process, informing differential diagnosis as well as intervention planning and monitoring of cognitive-linguistic status over time. The evaluation should include a thorough case history and interview and a detailed assessment of speech-language and cognitive functions, with tasks designed to detect core and associated deficits outlined in current diagnostic criteria...
July 2018: Seminars in Speech and Language
Stefanie Braig, Simon Berger, David Rothenbacher, Stefanie Schmid, Thomas Seufferlein, Hermann Brenner, Dietrich Rothenbacher, Harald Gündel
PURPOSE: We aimed to describe time trends in functional dyspepsia and the association of dyspepsia-related factors, Helicobacter pylori (H. pylori) and work-related stress with functional dyspepsia in white collar employees in 1996 and 2015. MATERIALS AND METHODS: Repeat cross-sectional study conducted in 1996 (n = 190, response rate = 76.1) and 2015 (n = 195, response rate = 40.2) within a health insurance company in South-West Germany. Dyspeptic symptoms measured according to the Rome III criteria, effort-reward imbalance and further work- or dyspepsia-related factors were assessed by self-administered questionnaire...
2018: PloS One
Bethany A Matus, Kayla M Bridges, John V Logomarsino
BACKGROUND: Individualized feeding care plans and safe handling of milk (human or formula) are critical in promoting growth, immune function, and neurodevelopment in the preterm infant. Feeding errors and disruptions or limitations to feeding processes in the neonatal intensive care unit (NICU) are associated with negative safety events. Feeding errors include contamination of milk and delivery of incorrect or expired milk and may result in adverse gastrointestinal illnesses. PURPOSE: The purpose of this review was to evaluate the effect(s) of centralized milk preparation, use of trained technicians, use of bar code-scanning software, and collaboration between registered dietitians and registered nurses on feeding safety in the NICU...
June 21, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Jonathan Wagner, Piergiuseppe Agostoni, Ross Arena, Romualdo Belardinelli, Daniel Dumitrescu, Alfred Hager, Jonathan Myers, Rainer Rauramaa, Marshall Riley, Tim Takken, Arno Schmidt-Trucksäss
Heart failure with reduced ejection fraction (HFrEF) is common in the developed world and results in significant morbidity and mortality. Accurate risk assessment methods and prognostic variables are therefore needed to guide clinical decision making for medical therapy and surgical interventions with the ultimate goal of decreasing risk and improving health outcomes. The purpose of this review is to examine the role of cardiopulmonary exercise testing (CPET) and its most commonly used ventilatory gas exchange variables for the purpose of risk stratification and management of HFrEF...
May 22, 2018: American Heart Journal
Sunil Kr Jha, T H Yoon, Zhaoqing Pan
The present study is based on the application of a multivariate statistical analysis approach for the selection of optimal descriptors of nanomaterials with the objective of robust qualitative modeling of their toxicity. A novel data mining protocol has been developed for the selection of an optimal subset of descriptors of nanomaterials by using the well-known multivariate method principal component analysis (PCA). The selected subsets of descriptors were validated for qualitative modeling of the toxicity of nanomaterials in the PC space...
June 18, 2018: Computers in Biology and Medicine
Philipp Kanzow, Annette Wiegand, Nairn H F Wilson, Christopher D Lynch, Igor R Blum
OBJECTIVES: To identify potential changes in various aspects of teaching and to ascertain whether previously found inconsistencies in the teaching of criteria, indications and operative techniques for the repair of defective composite restorations at German dental schools have been resolved. METHODS: A validated questionnaire was used to gain the information sought. It was sent to all dental schools in Germany (n = 30). Whenever possible, data were compared to previous studies conducted in 2000 and 2009...
June 19, 2018: Journal of Dentistry
Xiqiang Wang, Xiude Fan, Shuaifei Ji, Aiqun Ma, Tingzhong Wang
BACKGROUND: Neutrophil to lymphocyte ratio (NLR) has been indicated to be an independent predictor for all-cause mortality or adverse events in a variety of diseases. However, no consistent conclusions regarding it's relevance to patients with heart failure have been made. This meta-analysis was conducted to assess the significance of NLR in patients with heart failure. METHODS: Pubmed and Embase databases were searched for eligible studies that reported the association between NLR and heart failure through September 2017...
June 19, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Stine Ulrik Mikkelsen, Lasse Kjaer, Mads Emil Bjørn, Trine Alma Knudsen, Anders Lindholm Sørensen, Christen Bertel Lykkegaard Andersen, Ole Weis Bjerrum, Nana Brochmann, Daniel El Fassi, Torben A Kruse, Thomas Stauffer Larsen, Hans Torben Mourits-Andersen, Claus Henrik Nielsen, Niels Pallisgaard, Mads Thomassen, Vibe Skov, Hans Carl Hasselbalch
Interferon-α2 reduces elevated blood cell counts and splenomegaly in patients with myeloproliferative neoplasms (MPN) and may restore polyclonal hematopoiesis. Its use is limited by inflammation-mediated toxicity, leading to treatment discontinuation in 10-30% of patients. Ruxolitinib, a potent anti-inflammatory agent, has demonstrated benefit in myelofibrosis (MF) and polycythemia vera (PV) patients. Combination therapy (CT) with these two agents may be more efficacious than monotherapy with either, potentially improving tolerability of interferon-α2 as well...
June 22, 2018: Cancer Medicine
Julia Lühnen, Ingrid Mühlhauser, Anke Steckelberg
BACKGROUND: The patient's consent to a medical procedure must be preceded by a pre-procedure discussion with the physician that is documented on a standardized form. Evidence suggests that these forms lack information that would be relevant for an informed decision. METHODS: We carried out a systematic literature search up to February 2017 for evidence on the quality and efficacy of informed consent forms. The definition of criteria for the evaluation of meta-information, content, and presentation were derived from current guidelines for evidence-based health information...
June 1, 2018: Deutsches Ärzteblatt International
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