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Stratification epidemiology

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https://www.readbyqxmd.com/read/28333258/anal-neoplasia-in-inflammatory-bowel-disease-classification-proposal-epidemiology-carcinogenesis-and-risk-management-perspectives
#1
Andrew Wisniewski, Jean-Francois Fléjou, Laurent Siproudhis, Laurent Abramowitz, Magali Svrcek, Laurent Beaugerie
Patients with inflammatory bowel disease (IBD) may develop, similarly to individuals from general population, rare cases of HPV-related anal canal squamous cell carcinoma (SCC) and their intra-epithelial precursor lesions, as well as very rare cases of anal canal adenocarcinoma. Patients with chronic perianal Crohn's disease (CD) are at substantial risk of developing SCC or adenocarcinoma from the fistula-lining epithelium, as well as SCC or adenocarcinoma arising from chronic anorectal ulcerations or strictures...
March 10, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28325597/relationships-between-acrylamide-and-glycidamide-hemoglobin-adduct-levels-and-allergy-related-outcomes-in-general-us-population-nhanes-2005-2006
#2
Jing Guo, Dongdong Yu, Na Lv, Rongpan Bai, Chunjing Xu, Guangdi Chen, Weiming Cao
BACKGROUND: Acrylamide-induced immunotoxicity and allergic dermatitis have been reported in animal experiments and clinical reports, respectively. However, epidemiological evidence from the general population is limited. OBJECTIVES: The purpose of the present study was to estimate the associations between acrylamide exposure and allergy-related outcomes in the general US population. METHODS: A total of 6982 subjects were selected from the National Health and Nutrition Examination Survey 2005-2006 (NHANES)...
March 18, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28323666/febrile-infant-update
#3
Kate Dorney, Richard G Bachur
PURPOSE OF REVIEW: The approach to febrile young infants remains challenging. This review serves as an update on the care of febrile infants less than 90 days of age with a focus on the changing epidemiology of serious bacterial infection (SBI), refinement of management strategies based on biomarkers, and the development of novel diagnostics. RECENT FINDINGS: There is high variability in the emergency department management of febrile young infants without significant differences in outcomes...
March 20, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28306673/hypertensive-crisis-an-update-on-clinical-approach-and-management
#4
Emrah Ipek, Ahmet Afşin Oktay, Selim R Krim
PURPOSE OF REVIEW: Here, we review current concepts on hypertensive crisis (HTN-C) with a focus on epidemiology, causes, pathophysiology and prognosis. We also offer a practical approach to the management of HTN-C. RECENT FINDINGS: HTN-C is characterized by a severe and abrupt increase in blood pressure (BP) with impending or progressive acute end-organ damage (EOD). HTN-C can be divided into hypertensive emergency (HTN-E) and hypertensive urgency (HTN-U) based on the presence or absence of acute EOD, respectively...
March 16, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28306628/pediatric-spinal-cord-injury-without-radiographic-abnormality-in-the-era-of-advanced-imaging
#5
Caitlin A Farrell, Megan Hannon, Lois K Lee
PURPOSE OF REVIEW: The current review describes the current evidence on pediatric spinal cord injury without radiographic abnormality (SCIWORA) with attention to the definition, epidemiology, and clinical presentation of the condition, as well as common MRI findings, management strategies, and outcomes. RECENT FINDINGS: Recent literature demonstrates that with more widespread MRI use, our understanding of SCIWORA has improved. The new literature, although still limited, provides a more granular conceptualization of patterns of injury as well as potential prognostic stratification of patients based on MRI findings...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28306572/neuromyelitis-optica-and-neuromyelitis-optica-spectrum-disorders
#6
Romain Marignier, Alvaro Cobo Calvo, Sandra Vukusic
PURPOSE OF REVIEW: The discovery of highly specific auto-antibodies directed against the water channel aquaporin 4 was a quantum leap in the definition, classification and management of neuromyelitis optica (NMO). Herein, we propose an update on epidemiological, clinical and therapeutic advances in the field, underlining unmet needs. RECENT FINDINGS: Large-scale epidemiological studies have recently provided a more precise evaluation of NMO prevalence and a better stratification regarding ethnicity and sex...
March 16, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28297002/use-of-computerized-clinical-decision-support-systems-to-prevent-venous-thromboembolism-in-surgical-patients-a-systematic-review-and-meta-analysis
#7
Zachary M Borab, Michael A Lanni, Michael G Tecce, Christopher J Pannucci, John P Fischer
Importance: Health care professionals do not adequately stratify risk or provide prophylaxis for venous thromboembolism (VTE) among surgical patients. Computerized clinical decision support systems (CCDSSs) have been implemented to assist clinicians and improve prophylaxis for VTE. Objective: To evaluate the effect of implementing CCDSSs on the ordering of VTE prophylaxis and the rates of VTE. Data Sources: PubMed, MEDLINE via OVID, EMBASE via OVID, Scopus, Cochrane CENTRAL Register of Controlled Trials, and clinicaltrials...
March 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28292744/association-between-trial-registration-and-positive-study-findings-cross-sectional-study-epidemiological-study-of-randomized-trials-esort
#8
Ayodele Odutayo, Connor A Emdin, Allan J Hsiao, Mubeen Shakir, Bethan Copsey, Susan Dutton, Virginia Chiocchia, Michael Schlussel, Peter Dutton, Corran Roberts, Douglas G Altman, Sally Hopewell
Objective To assess whether randomised controlled trials (RCTs) that were registered were less likely to report positive study findings compared with RCTs that were not registered and whether the association varied by funding source.Design Cross sectional study.Study sample All primary RCTs published in December 2012 and indexed in PubMed by November 2013. Trial registration was determined based on the report of a trial registration number in published RCTs or the identification of the trial in a search of trial registries...
March 14, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28286813/risk-factors-of-non-fatal-unintentional-home-injuries-among-children-under-5-years-old-a-population-based-study
#9
Sedigheh Nouhjah, Sharareh R Niakan Kalhori, Azadeh Saki
INTRODUCTION: In addition to the annual mortality rate, unintentional home injury may result in temporary or permanent disability and requires medical attention and continuous care in millions of children. This study aimed to explore features and risk factors of these injuries. METHODS: In this cross-sectional study, demographic variables and epidemiologic pattern of home injuries among children under 5 years of age were collected via a population-based survey in seven main cities of Khuzestan province, southwest Iran, during September 2011 to December 2012...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285790/diagnosis-and-treatment-for-clinically-localized-prostate-cancer-adherence-to-the-european-association-of-urology-clinical-guidelines-in-a-nationwide-population-based-study-gescap-group
#10
F Gómez-Veiga, A Rodríguez-Antolín, B Miñana, C Hernández, J F Suárez, J M Fernández-Gómez, M Unda, J Burgos, A Alcaraz, P Rodríguez, R Medina, J Castiñeiras, C Moreno, E Pedrosa, J M Cózar
OBJECTIVE: To assess the adherence to European Association of Urology (EAU) guidelines in the management of prostate cancer (PCa) in Spain. PATIENTS AND METHODS: Epidemiological, population-based, study including a national representative sample of 3,918 incident patients with histopathological confirmation during 2010; 95% of the patient's sample was followed up for at least one year. Diagnosis along with treatment related variables (for localized PCa -low, intermediate, high and locally-advanced by D'Amico risk stratification) was recorded...
March 9, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28275898/functional-status-and-quality-of-life-among-breast-cancer-survivors-with-heart-failure-results-of-the-medicare-health-outcomes-survey
#11
Jordan M Harrison, Matthew A Davis, Debra L Barton, Nancy K Janz, Susan J Pressler, Christopher R Friese
PURPOSE: The purpose of this population-based study was to examine health-related quality of life (HRQOL) and functional status among breast cancer survivors with heart failure. METHODS: We examined Medicare Health Outcomes Survey data from women aged 65 and older diagnosed with breast cancer in the past 5 years. Surveys were linked to Surveillance, Epidemiology, and End Results cancer registries. Each woman identified with self-reported heart failure (n = 239) was matched to controls without heart failure (n = 685) using propensity scores...
March 8, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28271556/where-next-for-delirium-research
#12
Rowan H Harwood, Elizabeth Teale
Clinicians who manage delirium must do so without key information required for evidence-based practice, not least lack of any clearly effective treatment for established delirium. Both the nature of delirium and the methods used to research it contribute to difficulties. Delirium is heterogeneous, with respect to motor subtype, aetiology, setting and the co-existence of dementia, and may be almost inevitable towards the end of life. Elements of assessment are subjective, so diagnosis can be uncertain or unreliable...
March 8, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28265125/pulmonary-embolism-the-astute-interventional-radiology-clinician
#13
REVIEW
Akhilesh K Sista
There has been a resurgence of interest in defining the optimal treatment for severe pulmonary embolism (PE), fueled by pivotal and provocative trials, new catheter-based medical devices, and growing evidence of deleterious short- and long-term outcomes. In this environment, and especially given the multidisciplinary nature of PE care, the interventional radiologist (IR) needs to become an astute, disease-specific expert. This review article describes the following "steps" an IR can take to reach this level: (1) understand PE stratification and epidemiology; (2) recognize the treatment goals for massive PE; (3) recognize the wide range of attitudes toward therapeutic escalation for submassive PE; (4) recognize what we do not know about the treatment of submassive PE and the limitations of current studies; (5) know the literature surrounding inferior vena cava filter insertion for severe PE; (6) integrate into the longitudinal care of the patient; and (7) be at the leading edge of new trials and technologies...
March 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28261908/acute-coronary-syndrome-screening-and-diagnostic-practice-variation
#14
Maame Yaa A B Maya Yiadom, Xulei Liu, Conor M McWade, Dandan Liu, Alan B Storrow
BACKGROUND: In the absence of the existing acute coronary syndrome guidelines directing the clinical practice implementation of ED screening and diagnosis, there is variable screening and diagnostic clinical practice across ED facilities. This practice diversity may be warranted. Understanding the variability may identify opportunities for more consistent practice. METHODS: This is a cross-sectional clinical practice epidemiology study with the emergency department (ED) as the unit of analysis characterizing variability in the acute coronary syndrome (ACS) evaluation across 62 diverse EDs...
March 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28256422/geographical-disparities-in-hiv-prevalence-and-care-among-men-who-have-sex-with-men-in-malawi-results-from-a-multisite-cross-sectional-survey
#15
Andrea L Wirtz, Gift Trapence, Dunker Kamba, Victor Gama, Rodney Chalera, Vincent Jumbe, Rosemary Kumwenda, Marriam Mangochi, Stephane Helleringer, Chris Beyrer, Stefan Baral
BACKGROUND: Epidemiological assessment of geographical heterogeneity of HIV among men who have sex with men (MSM) is necessary to inform HIV prevention and care strategies in the more generalised HIV epidemics across sub-Saharan Africa, including Malawi. We aimed to measure the HIV prevalence, risks, and access to HIV care among MSM across multiple localities to better inform HIV programming for MSM in Malawi. METHODS: Between Aug 1, 2011, and Sept 13, 2014, we recruited MSM into cross-sectional research via respondent-driven sampling (RDS) in seven districts of Malawi...
February 27, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28252536/a-quantile-analysis-of-plateau-and-driving-pressures-effects-on-mortality-in-patients-with-acute-respiratory-distress-syndrome-receiving-lung-protective-ventilation
#16
Jesús Villar, Carmen Martín-Rodríguez, Ana M Domínguez-Berrot, Lorena Fernández, Carlos Ferrando, Juan A Soler, Ana M Díaz-Lamas, Elena González-Higueras, Leonor Nogales, Alfonso Ambrós, Demetrio Carriedo, Mónica Hernández, Domingo Martínez, Jesús Blanco, Javier Belda, Dácil Parrilla, Fernando Suárez-Sipmann, Concepción Tarancón, Juan M Mora-Ordoñez, Lluís Blanch, Lina Pérez-Méndez, Rosa L Fernández, Robert M Kacmarek
OBJECTIVES: The driving pressure (plateau pressure minus positive end-expiratory pressure) has been suggested as the major determinant for the beneficial effects of lung-protective ventilation. We tested whether driving pressure was superior to the variables that define it in predicting outcome in patients with acute respiratory distress syndrome. DESIGN: A secondary analysis of existing data from previously reported observational studies. SETTING: A network of ICUs...
March 1, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28252306/-pregnancy-outcomes-in-women-with-gestational-diabetes-specific-subgroups-might-require-increased-attention
#17
V Bartáková, V Ťápalová, K Wágnerová, P Janků, J Bělobrádková, K Kaňková
OBJECTIVES: To compare peri-partal parameters between two groups of pregnant women - with and without gestational diabetes mellitus (GDM), to correlate degree of glucose abnormality with incidence of peri-partal morbidity and, finally, to analyse the potential effect of comorbidities (i.e. obesity, hypertension, thyreopathy, polycystic ovary syndrome, trombophylia, anemia, allergy, smoking) on pregnancy outcomes. DESIGN: Epidemiological observational "case-control" study...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28239004/cancer-mortality-in-the-mississippi-delta-region-descriptive-epidemiology-and-needed-future-research-and-interventions
#18
Whitney E Zahnd, Wiley D Jenkins, Georgia S Mueller-Luckey
The Delta Region is a federally designated, socioeconomically disadvantaged region of the United States covering 252 counties in eight states along the Mississippi River. The objective of this study is to describe the Region's cancer mortality burden. National Center for Health Statistics data were used to calculate age-adjusted mortality rates and rate ratios for the Delta Region for all cancers, lung, colorectal, breast (female), cervical, and prostate cancers. Rates were also calculated for comparison groups, and were stratified by gender, race, rurality, and socioeconomic status...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28237535/a-small-cohort-omega-3-pufa-supplement-study-implications-of-stratifying-according-to-lipid-membrane-incorporation-in-cardiac-surgical-patients
#19
Wendy T K Ip, Chanchal Chandramouli, Julian A Smith, Peter L McLennan, Salvatore Pepe, Lea M D Delbridge
BACKGROUND: Epidemiological studies and randomised clinical trials (RCTs) report disparate findings in relation to omega-3 polyunsaturated fatty acids (n-3 PUFA) benefit for cardiac patients. With RCTs interpretation is potentially confounded by background n-3 PUFA intake. The goal of this pilot, small cohort, pre-surgical supplementation study was to evaluate postoperative atrial fibrillation (AF) and cardiac molecular expression profiles employing two data analysis approaches - by treatment randomisation and by stratification using measured n-3 PUFA...
February 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28229201/-sudden-cardiac-death-epidemiology-pathophysiology-and-risk-stratification
#20
B Rudic, E Tülümen, V Liebe, J Kuschyk, I Akin, M Borggrefe
Sudden cardiac death (SCD) remains a major public health burden despite revolutionary progress in the last three decades in the treatment of ventricular tachyarrhythmia with the use of implantable cardioverter defibrillator (ICD) therapy. Survivors of sudden cardiac arrest are at high risk for recurrent tachyarrhythmia events. Early recognition of low left ventricular ejection fractions (≤35%) as a strong predictor of mortality and the causal association between ventricular tachyarrhythmia and SCD has led to a significant development of not only pharmacological antiarrhythmic therapy but also device-based prevention of SCD...
February 22, 2017: Herz
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