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https://www.readbyqxmd.com/read/28646580/biosimilars-for-psoriasis-worldwide-overview-of-regulatory-guidelines-uptake-and-implications-for-dermatology-clinical-practice
#1
REVIEW
A D Cohen, J J Wu, L Puig, S Chimenti, R Vender, M Rajagopalan, R Romiti, C de la Cruz, L Skov, C Zachariae, H S Young, P Foley, J M van der Walt, L Naldi, A Blauvelt
The introduction of biologic drugs for the treatment of patients with psoriasis has revolutionized treatment paradigms and enabled numerous patients to achieve disease control with an acceptable safety profile. However, the high cost of biologics limits access to these medications for the majority of patients worldwide. In recent years, the introduction of biosimilars for inflammatory diseases has become a fast evolving field. The future use of biosimilars offers the potential for decreased cost and increased access to biologic drugs for patients with psoriasis...
June 24, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28646035/a-matter-of-life-and-death
#2
Justice Baker
Cases concerning the withdrawal or withholding of artificial nutrition and hydration from patients in a vegetative or minimally conscious state raise difficult medical, legal and ethical questions including the diagnosis and classification of disorders of consciousness, the legal processes to be followed, and the legal and ethical principles to be applied when making decisions. There is also an issue as to whether it is necessary or appropriate for such decisions to be taken by judges. This article, based on a lecture given in Oxford in October 2016, considers a number of these issues and concludes that any consideration of the question from the patient's point of view must include an objective analysis of what is in his or her best interests, as well as subjective expressions of wishes and feelings...
June 23, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28645974/assessing-medical-student-knowledge-and-attitudes-about-shared-decision-making-across-the-curriculum-protocol-for-an-international-online-survey-and-stakeholder-analysis
#3
Marie-Anne Durand, Renata Yen, Paul J Barr, Nan Cochran, Johanna Aarts, France Légaré, Malcolm Reed, A James O'Malley, Peter Scalia, Geneviève Painchaud Guérard, Glyn Elwyn
INTRODUCTION: Shared decision making (SDM) is a goal of modern medicine; however, it is not currently embedded in routine care. Barriers include clinicians’ attitudes, lack of knowledge and training and time constraints. Our goal is to support the development and delivery of a robust SDM curriculum in medical education. Our objective is to assess undergraduate medical students’ knowledge of and attitudes towards SDM in four countries. METHODS AND ANALYSIS: The first phase of the study involves a web-based cross-sectional survey of undergraduate medical students from all years in selected schools across the United States (US), Canada and undergraduate and graduate students in the Netherlands...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645945/how-can-we-ensure-that-the-coroner-s-autopsy-is-not-an-invasion-of-human-rights
#4
Stephen Leadbeatter, Ryk James
BACKGROUND: Despite public inquiries, and some changes to legislation following high-profile multiple homicides that were not detected by autopsy, coroners continue to rely largely on the autopsy. Regardless of the extent of quality failings and excess deaths at some hospitals, not detected through the coroner system, the autopsy is scarcely used by hospitals to monitor standards and educate. OBJECTIVE: To explore when a compulsory medicolegal autopsy should, and should not, be used...
June 23, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28645262/acute-myeloid-leukemia-and-pregnancy-clinical-experience-from-a-single-center-and-a-review-of-the-literature
#5
Nicola Stefano Fracchiolla, Mariarita Sciumè, Francesco Dambrosi, Francesca Guidotti, Manuela Wally Ossola, Giovanna Chidini, Umberto Gianelli, Daniela Merlo, Agostino Cortelezzi
BACKGROUND: Acute myeloid leukemia (AML) accounts for more than two thirds of leukemia during pregnancy and has an incidence of 1 in 75,000 to 100,000. Its clinical management remains a challenging therapeutic task both for patient and medical team, given to the therapy-attributable risks for mother and fetus and the connected counseling regarding pregnancy continuation. METHODS: We provided a review of updated literature and a comprehensive description of five maternal/fetal outcomes of AML cases diagnosed concomitantly to pregnancy and treated at our Institution from 2006 to 2012...
June 23, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28645137/-to-take-or-not-to-take-the-association-between-perceived-addiction-risk-expected-analgesic-response-and-likelihood-of-trying-novel-pain-relievers-in-self-identified-chronic-pain-patients
#6
D Andrew Tompkins, Andrew S Huhn, Patrick S Johnson, Michael T Smith, Eric C Strain, Robert R Edwards, Matthew W Johnson
BACKGROUND AND AIMS: Probability discounting refers to the effect of outcome uncertainty on decision making. Using probability discounting, we examined the degree to which self-identified chronic pain patients (CPP) were likely to try a novel analgesic medication given increasing addiction risk. We postulated that propensity for opioid misuse, trait impulsivity, and previous opioid experience would be positively associated with likelihood of risky medication use. DESIGN: This cross-sectional online study determined state/trait associations with addiction-related medication decisions in CPP...
June 23, 2017: Addiction
https://www.readbyqxmd.com/read/28644835/physician-assessments-of-drug-seeking-behavior-a-mixed-methods-study
#7
Michael A Fischer, John B McKinlay, Jeffrey N Katz, Eric Gerstenberger, Felicia Trachtenberg, Lisa D Marceau, Lisa C Welch
BACKGROUND: Pain complaints are common, but clinicians are increasingly concerned about overuse of opioid pain medications. This may lead patients with actual pain to be stigmatized as "drug-seeking," or attempting to obtain medications they do not require medically. We assessed whether patient requests for specific opioid pain medication would lead physicians to classify them as drug-seeking and change management decisions. METHODS AND FINDINGS: Mixed-methods analysis of interviews with 192 office-based primary care physicians after viewing video vignettes depicting patients presenting with back pain...
2017: PloS One
https://www.readbyqxmd.com/read/28644786/antecedents-and-consequences-of-medical-students-moral-decision-making-during-professionalism-dilemmas
#8
Lynn Monrouxe, Malissa Shaw, Charlotte Rees
Medical students often experience professionalism dilemmas (which differ from ethical dilemmas) wherein students sometimes witness and/or participate in patient safety, dignity, and consent lapses. When faced with such dilemmas, students make moral decisions. If students' action (or inaction) runs counter to their perceived moral values-often due to organizational constraints or power hierarchies-they can suffer moral distress, burnout, or a desire to leave the profession. If moral transgressions are rationalized as being for the greater good, moral distress can decrease as dilemmas are experienced more frequently (habituation); if no learner benefit is seen, distress can increase with greater exposure to dilemmas (disturbance)...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644261/is-intravenous-thrombolysis-safe-and-effective-in-central-retinal-artery-occlusion-a-critically-appraised-topic
#9
Oana M Dumitrascu, Joanne F Shen, Madhavi Kurli, Maria I Aguilar, Lisa A Marks, Bart M Demaerschalk, Dean M Wingerchuk, Cumara B O'Carroll
BACKGROUND: Central retinal artery occlusion (CRAO) is a neurological and ophthalmologic emergency associated with poor visual recovery. There is a dilemma regarding the appropriate treatment, as formal guidelines are lacking. Despite being considered an ocular equivalent of cerebral infarction, the time window of intravenous (IV) thrombolysis administration for maximum efficacy and safety in CRAO remains uncertain. OBJECTIVE: To critically assess the current evidence regarding the safety and effectiveness of IV thrombolysis in the treatment of patients with CRAO...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28644098/intracranial-solitary-fibrous-tumors-hemangiopericytomas-first-report-of-malignant-progression
#10
Caroline Apra, Karima Mokhtari, Philippe Cornu, Matthieu Peyre, Michel Kalamarides
OBJECTIVE Meningeal solitary fibrous tumors/hemangiopericytomas (MSFTs/HPCs) are rare intracranial tumors resembling meningiomas. Their classification was redefined in 2016 by the World Health Organization (WHO) as benign Grade I fibrohyaline type, intermediate Grade II hypercellular type, and malignant highly mitotic Grade III. This grouping is based on common histological features and identification of a common NAB2-STAT6 fusion. METHODS The authors retrospectively identified 49 cases of MSFT/HPC. Clinical data were obtained from the medical records, and all cases were analyzed according to this new 2016 WHO grading classification in order to identify malignant transformations...
June 23, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28643812/-conscience-clause-in-end-of-life-care
#11
Ludovica De Panfilis, Daniela Cattaneo, Luisanna Cola, Maddalena Gasparini, Corinna Porteri, Daniela Tarquini, Alessandro Tiezzi, Simone Veronese, Silvia Zullo, Eugenio Pucci
The article proposes a critical reflection on issues that appeal to the conscience clause as part of end of life care can produce and what can guarantee freedom of conscience, self-determination of those involved and respect for the dignity of the sick person. After a philosophical and normative analysis, the article is organized on the basis of two important documents for discussion: a position paper of Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI) signed by several scientific societies "Grandi insufficienze d'organo end stage: cure intensive o cure palliative?" and the Design of Law currently being debated "Norme in materia di consenso informato e di disposizioni anticipate di trattamento"...
May 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28643671/-health-literacy-and-diabetes-control-in-patients-attending-a-university-outpatient-clinic-in-argentina
#12
Alexander Ariza Bolivar, Martín E Lanteri, Carla Y Cícero, Adriana Pérez, Félix M Puchulu, Raúl Mejía
Health literacy (HL) is a measure of a patient ability to read, understand and to take decisions on medical instructions. Patients with inadequate HL have poorer health outcomes than those with adequate HL. There is little information on HL levels in diabetic patients in Argentina. The aim of this study was to explore the association between HL and glycemic control in diabetic patients from a university hospital in Argentina. HL was assessed with the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA), glycemic control through glycosylated hemoglobin A1c (HbA1c); 156 patients (58% women) took part in the study...
2017: Medicina
https://www.readbyqxmd.com/read/28643113/-safety-culture-in-orthopedics-and-trauma-surgery-course-concept-interpersonal-competence-by-the-german-society-for-orthopaedics-and-trauma-dgou-and-lufthansa-aviation-training
#13
REVIEW
A-K Doepfer, R Seemann, D Merschin, R Stange, M Egerth, M Münzberg, M Mutschler, B Bouillon, R Hoffmann
Patient safety has become a central and measurable key factor in the routine daily medical practice. The human factor plays a decisive role in safety culture and has moved into focus regarding the reduction of treatment errors and undesired critical incidents. Nonetheless, the systematic training in communication and interpersonal competences has so far only played a minor role. The German Society of Orthopaedics and Trauma (DGOU) in cooperation with the Lufthansa Aviation Training initiated a course system for interpersonal competence...
June 22, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28642690/autonomy-in-depressive-patients-undergoing-dbs-treatment-informed-consent-freedom-of-will-and-dbs-potential-to-restore-it
#14
Timo Beeker, Thomas E Schlaepfer, Volker A Coenen
According to the World Health Organization, depression is one of the most common and most disabling psychiatric disorders, affecting at any given time approximately 325 million people worldwide. As there is strong evidence that depressive disorders are associated with a dynamic dysregulation of neural circuits involved in emotional processing, recently several attempts have been made to intervene directly in these circuits via deep brain stimulation (DBS) in patients with treatment-resistant major depressive disorder (MDD)...
2017: Frontiers in Integrative Neuroscience
https://www.readbyqxmd.com/read/28642511/the-mental-capacity-act-2005-considerations-for-obtaining-consent-for-dental-treatment
#15
O Modgill, C Bryant, S Moosajee
The Mental Capacity Act 2005 provides a legal framework within which specific decisions must be made when an individual lacks the mental capacity to make such decisions for themselves. With an increasingly aged, medically complex and in some cases socially isolated population presenting for dental care, dentists need to have a sound understanding of the appropriate management of patients who lack capacity to consent to treatment when they present in the dental setting. Patients with acute symptoms requiring urgent care and un-befriended patients present additional complexities...
June 23, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28642011/comparison-of-indian-council-for-medical-research-and-lunar-databases-for-categorization-of-male-bone-mineral-density
#16
Surya K Singh, Vivek Patel, Balram Gupta
The mainstay of diagnosis of osteoporosis is dual-energy X-ray absorptiometry (DXA) scan measuring areal bone mineral density (BMD) (g/cm(2)). The aim of the present study was to compare the Indian Council of Medical Research database (ICMRD) and the Lunar ethnic reference database of DXA scans in the diagnosis of osteoporosis in male patients. In this retrospective study, all male patients who underwent a DXA scan were included. The areal BMD (g/cm(2)) was measured at either the lumbar spine (L1-L4) or the total hip using the Lunar DXA machine (software version 8...
June 19, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28641717/soluble-cd14-subtype-a-new-biomarker-in-predicting-the-outcome-of-critically-ill-septic-patients
#17
Giovanni Matera, Angela Quirino, Cinzia Peronace, Pio Settembre, Vito Marano, Maria T Loria, Nadia Marascio, Luisa Galati, Giorgio S Barreca, Aida Giancotti, Bruno Amantea, Maria C Liberto, Alfredo Focà
BACKGROUND: We evaluated the role of presepsin (soluble CD14 subtype, sCD14-ST) in predicting the outcome of critically ill septic patients in parallel with procalcitonin and C-reactive protein. METHODS: This study was an observational, prospective study that enrolled 58 surgical and medical intensive care unit patients with suspected sepsis. All studied subjects were retrospectively stratified into survivors and nonsurvivors based on 28 days survival and according to microbiological results in blood culture positive and negative groups...
June 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28641646/-clinical-characteristics-and-long-term-outcome-of-125-chinese-young-patients-with-essential-thrombocythemia
#18
Rong-Feng Fu, Xiao-Fan Liu, Wei Liu, Yue-Ting Huang, Yun-Fei Chen, Hui-Yuan Li, Man-Kai Ju, Ren-Chi Yang, Lei Zhang
OBJECTIVE: To investigate the clinical characteristics and long-term outcome of Chinese young patients (≤40 years) with essential thrombocythemia(ET), and to develop a thrombosis predicting model specific for young patients with ET, so as to provide a new evidence for risk stratification and treatment. METHODS: Medical records of 125 Chinese young patients with newly diagnosed of ET were retrospectively analyzed. RESULTS: The median age at diagnosis was 32 (18-40) years old, with 37 males and 88 females...
June 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/28641378/staff-perceptions-of-key-factors-guiding-nursing-home-search-and-selection-within-the-veterans-health-administration
#19
Edward Alan Miller, Stefanie Gidmark, Emily Gadbois, James L Rudolph, Orna Intrator
Background and Objectives: Veterans enter nursing homes (NHs) for short-term postacute, rehabilitation, respite, or end-of-life care. They also enter NHs on a long-term basis due to frailty, disability, functional deficits, and cognitive impairment. Little is known about how a particular NH is chosen once the decision to enter a NH has been made. This study identified VA staff perceptions of the key factors influencing the search and selection of NHs within the Veterans Health Administration (VHA)...
June 21, 2017: Gerontologist
https://www.readbyqxmd.com/read/28641352/-do-general-surgeons-feel-adequately-prepared-for-the-complex-questions-associated-with-the-handling-of-multi-resistant-pathogens-results-of-the-mr2-survey
#20
Matthias May, Philipp J Spachmann, Steffen Lebentrau, Harald Schumacher, Christian Gilfrich, Hans-Martin Fritsche, Malte Vetterlein, Sabine Brookman-May, Martin Schostak, Florian M Wagenlehner, Maximilian Burger, Alexander Novotny, Robert Obermaier
Background At the present time, there is no evidence available as to the knowledge of general surgeons regarding multi-resistant pathogens (MRP) and the rational use of antibiotic medication (antibiotic stewardship/ABS) compared with physicians from other disciplines. Methods As part of the MR2 survey (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria - a survey focussing on German hospitals), a questionnaire comprising 4 + 35 items was distributed to urologists, internists, gynaecologists and general surgeons in 18 hospitals...
June 2017: Zentralblatt Für Chirurgie
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