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Variability in practice

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https://www.readbyqxmd.com/read/29224190/metabolic-surgery-for-the-treatment-of-type-2-diabetes-in-obese-individuals
#1
REVIEW
David E Cummings, Francesco Rubino
Several bariatric operations originally designed to promote weight loss have been found to powerfully treat type 2 diabetes, causing remission in most cases, through diverse mechanisms additional to the secondary consequences of weight loss. These observations have prompted consideration of such operations as 'metabolic surgery', used expressly to treat diabetes, including among patients who are only mildly obese or merely overweight. Large, long-term observational studies consistently demonstrate that bariatric/metabolic surgery is associated with reductions in all cardiovascular risk factors, actual cardiovascular events, microvascular diabetes complications, cancer and death...
December 9, 2017: Diabetologia
https://www.readbyqxmd.com/read/29223790/temporal-and-bi-directional-associations-between-sleep-duration-and-physical-activity-sedentary-time-in-children-an-international-comparison
#2
Yingyi Lin, Mark S Tremblay, Peter T Katzmarzyk, Mikael Fogelholm, Gang Hu, Estelle V Lambert, Carol Maher, Jose Maia, Timothy Olds, Olga L Sarmiento, Martyn Standage, Catrine Tudor-Locke, Jean-Philippe Chaput
The purpose of this multinational and cross-sectional study was to investigate whether nighttime sleep duration was associated with physical activity (PA) and sedentary time (SED) the following day, whether daytime PA/SED were associated with sleep duration the subsequent night, and whether the associations were modified by sex and study sites. Data from 5779 children aged 9-11years were analyzed. A waist-worn Actigraph GT3X+ accelerometer was used to assess children's 24-h movement behaviours for 7days, i...
December 6, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/29223761/chemsex-risk-behaviours-and-sexually-transmitted-infections-among-men-who-have-sex-with-men-in-dublin-ireland
#3
Ronan W Glynn, Niamh Byrne, Siobhan O'Dea, Adam Shanley, Mary Codd, Eamon Keenan, Mary Ward, Derval Igoe, Susan Clarke
BACKGROUND: Drug use for or during sex ('chemsex') among MSM has caused concern, because of the direct effects of the drugs themselves, and because of an increased risk of transmission of sexually transmitted infections (STIs). This study aimed to assess the prevalence of chemsex, associated behaviours and STIs among attendees at Ireland's only MSM-specific sexual health clinic in Dublin over a six week period in 2016. METHODS: The questionnaire collected demographic data, information on sexuality and sexual practice, self-reported history of treatment for STIs, and chemsex use...
December 7, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29223461/antenatal-consultations-at-extreme-prematurity-a-systematic-review-of-parent-communication-needs
#4
Ashraf Kharrat, Gregory P Moore, Stéphanie Beckett, Stuart G Nicholls, Margaret Sampson, Thierry Daboval
OBJECTIVE: To synthesize and describe parental expectations on how healthcare professionals should interact with them during a peripartum, antenatal consultation for extremely preterm infants. STUDY DESIGN: For this systematic literature review with textual narrative synthesis, we included studies that explored parental perspectives regarding the antenatal consultation for an extremely preterm infant. Electronic searches of Medline, CINAHL, PsycInfo, and Embase were conducted, along with a search of the grey literature...
December 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29223421/a-prospective-multi-institutional-cohort-study-of-mediastinal-infections-after-cardiac-operations
#5
Louis P Perrault, Katherine A Kirkwood, Helena L Chang, John C Mullen, Brian C Gulack, Michael Argenziano, Annetine C Gelijns, Ravi K Ghanta, Bryan A Whitson, Deborah L Williams, Nancy M Sledz-Joyce, Brian Lima, Giampaolo Greco, Nishit Fumakia, Eric A Rose, John D Puskas, Eugene H Blackstone, Richard D Weisel, Michael E Bowdish
BACKGROUND: Mediastinal infections are a potentially devastating complication of cardiac operations. This study analyzed the frequency, risk factors, and perioperative outcomes of mediastinal infections after cardiac operations. METHODS: In 2010, 5,158 patients enrolled in a prospective study evaluating infections after cardiac operations and their effect on readmissions and mortality for up to 65 days after the procedure. Clinical and demographic characteristics, operative variables, management practices, and outcomes were compared for patients with and without mediastinal infections, defined as deep sternal wound infection, myocarditis, pericarditis, or mediastinitis...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29223128/child-protective-services-utilization-of-child-abuse-pediatricians-a-mixed-methods-study
#6
Rebecca Girardet, Kelly Bolton, Syed Hashmi, Emily Sedlock, Rachna Khatri, Nina Lahoti, James Lukefahr
Several children's hospitals and medical schools across Texas have child abuse pediatricians (CAPs) who work closely with child protection workers to help ensure accurate assessments of the likelihood of maltreatment in cases of suspected abuse and neglect. Since the state does not mandate which cases should be referred to a CAP center, we were interested in studying factors that may influence workers' decisions to consult a CAP. We used a mixed methods study design consisting of a focus group followed by a survey...
December 6, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29223108/impacts-of-sugarcane-agriculture-expansion-over-low-intensity-cattle-ranch-pasture-in-brazil-on-greenhouse-gases
#7
Camila Bolfarini Bento, Solange Filoso, Leonardo Machado Pitombo, Heitor Cantarella, Raffaella Rossetto, Luiz Antonio Martinelli, Janaina Braga do Carmo
Sugarcane is a widespread bioenergy crop in tropical regions, and the growing global demand for renewable energy in recent years has led to a dramatic expansion and intensification of sugarcane agriculture in Brazil. Currently, extensive areas of low-intensity pasture are being converted to sugarcane, while management in the remaining pasture is becoming more intensive, i.e., includes tilling and fertilizer use. In this study, we assessed how such changes in land use and management practices alter emissions of greenhouse gases (GHG) such as CO2, N2O and CH4 by measuring in situ fluxes for one year after conversion from low-intensity pasture to conventional sugarcane agriculture and management-intensive pasture...
December 6, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/29222917/diagnostic-modalities-for-non-alcoholic-fatty-liver-disease-nafld-non-alcoholic-steatohepatitis-nash-and-associated-fibrosis
#8
REVIEW
Zobair M Younossi, Rohit Loomba, Quentin M Anstee, Mary E Rinella, Elisabetta Bugianesi, Giulio Marchesini, Brent A Neuschwander-Tetri, Lawrence Serfaty, Francesco Negro, Stephen H Caldwell, Vlad Ratziu, Kathleen E Corey, Scott L Friedman, Manal F Abdelmalek, Stephen A Harrison, Arun J Sanyal, Joel E Lavine, Philippe Mathurin, Michael R Charlton, Zachary D Goodman, Naga P Chalasani, Kris V Kowdley, Jacob George, Keith Lindor
NAFLD is a spectrum comprised of isolated steatosis, NASH, advanced fibrosis, and cirrhosis. The majority of NAFLD subjects do not have NASH and don't carry a significant risk for adverse outcomes (cirrhosis and mortality). Globally, the prevalence of NAFLD is approximately 25%. In Asia, a gradient of high prevalence rates to low rates are noted from urban to rural areas. Given the prevalence of NAFLD, the clinical and economic burden of NAFLD and NASH can be substantial. With increasing recognition as an important liver disease, the diagnosis of NASH still requires a liver biopsy which is suboptimal...
December 9, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29222364/investigating-inpatient-medication-administration-using-the-theory-of-planned-behavior
#9
Joseph W Rogers, Marc Fleming, Joyce Tipton, Angela Ward, Kevin W Garey, Elizabeth P Pitman
PURPOSE: Results of a study to determine behavioral factors that help explain why nurses often do not obtain and administer medications from automated dispensing cabinets (ADCs) "one patient at a time" are reported. METHODS: To investigate nurses' frequent failure to adhere to best-practice standards for ADC use, a 12-item questionnaire developed using information obtained from an elicitation study and a focus group session was e-mailed to 755 nurses at an academic medical center...
December 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29222309/using-pharmacokinetics-to-individualize-hemophilia-therapy
#10
REVIEW
Alfonso Iorio
Prevention and treatment of bleeding in hemophilia requires that plasma clotting factor activity of the replaced factor exceeds a defined target level. Most clinical decisions in hemophilia are based on implicit or explicit application of pharmacokinetic measures. The large interindividual variability in pharmacokinetics of factor concentrates suggests that relying on the average pharmacokinetic characteristics of factor concentrates would not allow optimizing the treatment of individual patients; for example, adjusting the frequency of infusions and targeting a specific clotting factor activity level on a case-by-case basis...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222277/how-should-we-sequence-and-combine-novel-therapies-in-cll
#11
REVIEW
Matthew S Davids
With the recent approval of several effective and well-tolerated novel agents (NAs), including ibrutinib, idelalisib, venetoclax, and obinutuzumab, patients with chronic lymphocytic leukemia (CLL) have more therapeutic options than ever before. The availability of these agents is both an important advance for patients but also a challenge for practicing hematologist/oncologists to learn how best to sequence NAs, both with respect to chemoimmunotherapy (CIT) and to other NAs. The sequencing of NAs in clinical practice should be guided both by an individual patient's prognostic markers, such as FISH and immunoglobulin heavy chain variable region (IGHV)-mutation status, as well as the patient's medical comorbidities and goals of care...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222275/the-mutational-landscape-of-chronic-lymphocytic-leukemia-and-its-impact-on-prognosis-and-treatment
#12
REVIEW
Gianluca Gaidano, Davide Rossi
The typical genome of chronic lymphocytic leukemia (CLL) carries ∼2000 molecular lesions. Few mutations recur across patients at a frequency >5%, whereas a large number of biologically and clinically uncharacterized genes are mutated at lower frequency. Approximately 80% of CLL patients carry at least 1 of 4 common chromosomal alterations, namely deletion 13q14, deletion 11q22-23, deletion 17p12, and trisomy 12. Knowledge of the CLL genome has translated into the availability of molecular biomarkers for prognosis and treatment prediction...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222074/changes-of-oxygen-consumption-and-heart-rate-after-acute-myocardial-infarction-during-6-month-follow-up
#13
Yuri Choe, Jae-Young Han, In-Sung Choi, Hyeng-Kyu Park
BACKGROUND: Exercise intensity is a particularly important determinant of physiological responses to exercise training in patients with acute myocardial infarction. Heart rate (HR) is commonly used as a practical way of prescribing and monitoring exercise as specific intensities based on linear relationship between the percentage of maximum heart rate (%HRmax) and the percentage of maximum oxygen consumption (%VO2max) regardless of age, sex or exercise mode. OBJECTIVE: To examine the change in variability in the correlation between %HRmax and %VO2maxafter acute myocardial infarction...
December 5, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29221969/variability-in-gastrostomy-tube-placement-for-intracerebral-hemorrhage-patients-at-us-hospitals
#14
David Y Hwang, Benjamin P George, Adam G Kelly, Eric B Schneider, Kevin N Sheth, Robert G Holloway
OBJECTIVE: We sought to characterize the variability among US hospitals with regard to gastrostomy tube placement for inpatients with intracerebral hemorrhage (ICH). METHODS: Using the Nationwide Inpatient Sample, we examined variations in the annual rate of gastrostomy tube placement from 2002 to 2011 for ICH patients admitted to hospitals with 30 or more annual ICH admissions. We then directly compared, among these hospitals, their individual frequencies of gastrostomy tube placement for ICH patients over the same time period...
December 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29221956/global-burden-of-molar-incisor-hypomineralization
#15
REVIEW
Falk Schwendicke, Karim Elhennawy, Seif Reda, Katrin Bekes, David J Manton, Joachim Krois
OBJECTIVES: We aimed to systematically review and meta-analyze the global, super-regional, regional and national prevalence of molar-incisor-hypomineralization (MIH) and to determine the numbers of prevalent and incident cases on different spatial scales. The review was registered (PROSPERO CRD42017063842). SOURCES: Five electronic databases (Medline, EMBASE, LILACS, Web of Science, Google Scholar) were searched systematically. STUDY SELECTION: Observational studies on the prevalence of MIH were included and the prevalence on different spatial scales (global, super-regional, regional, national) synthesized using random-effects meta-analyses...
December 5, 2017: Journal of Dentistry
https://www.readbyqxmd.com/read/29221620/-nomograms-in-routine-clinical-practice-methodology-interest-and-limitations
#16
Thomas Filleron, Léonor Chaltiel, Eva Jouve, Bastien Cabarrou, Julia Gilhodes, Amélie Lusque, Eliane Mery, Florence Dalenc, Alejandra Martinez
In order to help the clinician, mathematical models including several clinical and pathological variables are proposed in the literature with the aim to predict the occurrence of an event of interest. Nomograms allow individual prognosis for each patient. When they are developed, validated and correctly used, nomograms can provide important information for patients' care. But, despite the strong interest in nomograms in oncology, statistical methodologies used remain unknown from the medical community. This paper presents the major steps in the development, the validation and the clinical use of nomograms...
December 5, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/29221530/parenting-practices-and-associations-with-development-delays-among-young-children-in-dominican-republic
#17
Omolara Thomas Uwemedimo, Afrin Howlader, Giselina Pierret
BACKGROUND: According to the World Health Organization, >200 million children in low- and middle-income countries experience developmental delays. However, household structure and parenting practices have been minimally explored as potential correlates of developmental delay in low- and middle-income countries, despite potential as areas for intervention. OBJECTIVE: The objective of the study was to examine associations of developmental delays with use of World Health Organization-recommended parenting practices among a clinic-based cohort of children aged 6-60 months attending in La Romana, Dominican Republic...
May 2017: Annals of Global Health
https://www.readbyqxmd.com/read/29221293/distance-saturation-product-of-the-6-minute-walk-test-predicts-mortality-of-patients-with-non-cystic-fibrosis-bronchiectasis
#18
Meng-Heng Hsieh, Yueh-Fu Fang, Fu-Tsai Chung, Chung-Shu Lee, Yu-Chen Chang, Yuan-Zhang Liu, Cheng-Hsien Wu, Horng-Chyuan Lin
Background: Previous surveillance methods to monitor the prognoses of patients with bronchiectasis are too complex for use in daily practice. The 6-minute walk test (6MWT) is a simple exercise test to predict the prognosis of chronic obstructive airway disease and numerous chronic lung diseases, including idiopathic pulmonary fibrosis. No studies have investigated exercise-induced oxygen desaturation (EID) and distance-saturation product (DSP) of 6MWT to predict the prognoses of patients with bronchiectasis...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29220777/scenario-modelling-of-land-use-land-cover-changes-in-munessa-shashemene-landscape-of-the-ethiopian-highlands
#19
Mengistie Kindu, Thomas Schneider, Martin Döllerer, Demel Teketay, Thomas Knoke
Models under a set of scenarios are used to simulate and improve our understanding of land use/land cover (LULC) changes, which is central for sustainable management of a given natural resource. In this study, we simulated and examined the possible future LULC patterns and changes in Munessa-Shashemene landscape of the Ethiopian highlands covering four decades (2012-2050) using a spatially explicit GIS-based model. Both primary and secondary sources were utilized to identify relevant explanatory variables (drivers) and LULC datasets for the model...
December 5, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29220551/consensus-on-the-management-of-patients-with-psoriatic-arthritis-in-a-dermatology-setting
#20
P Gisondi, G Altomare, F Ayala, A Conti, P Dapavo, C De Simone, C Foti, L Idolazzi, E Lubrano, G Malara, A Marchesoni, I Olivieri, A Parodi, K Peris, S Piaserico, C Salvarani, R Scarpa, G Girolomoni
BACKGROUND: Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis (PsO). Early diagnosis and prompt therapeutic intervention are crucial for limiting PsA progression and prevention of disability. Dermatologists are in a privileged position to detect early PsA. The management of patients with PsA in the dermatology setting is widely variable. OBJECTIVE: To provide practical recommendations for the management of patients with PsA in the dermatology setting including early diagnosis and treatment...
December 8, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
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