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https://www.readbyqxmd.com/read/28211254/egyptian-tale-from-india-application-of-whole-exome-sequencing-in-diagnosis-of-atypical-familial-mediterranean-fever
#1
Pulukool Sandhya, Shamsudheen Karuthedath Vellarikkal, Aswin Nair, Rowmika Ravi, John Mathew, Rijith Jayarajan, Anoop Kumar, Ankit Verma, Ambily Sivadas, Debashish Danda, Sridhar Sivasubbu, Vinod Scaria
Clinical diagnosis of autoinflammatory diseases requires a high degree of clinical suspicion and clinching molecular evidence to substantiate the diagnosis. This is more so in populations with low prevalence of these disorders. In this report, we describe the case of a young man from India with recurrent fever and persistent arthritis. The patient's forefathers were of Egyptian ancestry who practiced consanguinity. Molecular genetic analysis using whole-exome sequencing suggested the presence of variants c...
February 17, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28210563/neoadjuvant-therapy-for-treatment-of-breast-cancer-the-way-forward-or-simply-a-convenient-option-for-patients
#2
COMMENT
Abhishek Chatterjee, John K Erban
The complexity of managing early stage breast cancer is well known. Optimal treatment is increasingly multidisciplinary and in the modern era informed by sophisticated molecular tools to help select and guide therapy. Major phase III trials have determined that the order of systemic therapy relative to surgery does not influence important endpoints such as event free survival and overall survival (OS), but questions remain as to how best to utilize these most essential services. For example, there is still uncertainty regarding the ideal timing, intensity, and duration of proposed therapy...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28210367/academic-primer-series-eight-key-papers-about-education-theory
#3
Michael Gottlieb, Megan Boysen-Osborn, Teresa M Chan, Sara M Krzyzaniak, Nicolas Pineda, Jordan Spector, Jonathan Sherbino
INTRODUCTION: Many teachers adopt instructional methods based on assumptions of best practices without attention to or knowledge of supporting education theory. Familiarity with a variety of theories informs education that is efficient, strategic, and evidence-based. As part of the Academic Life in Emergency Medicine Faculty Incubator Program, a list of key education theories for junior faculty was developed. METHODS: A list of key papers on theories relevant to medical education was generated using an expert panel, a virtual community of practice synthetic discussion, and a social media call for resources...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28209371/the-effect-of-patient-age-at-intervention-on-risk-of-implant-revision-after-total-replacement-of-the-hip-or-knee-a-population-based-cohort-study
#4
Lee E Bayliss, David Culliford, A Paul Monk, Sion Glyn-Jones, Daniel Prieto-Alhambra, Andrew Judge, Cyrus Cooper, Andrew J Carr, Nigel K Arden, David J Beard, Andrew J Price
BACKGROUND: Total joint replacements for end-stage osteoarthritis of the hip and knee are cost-effective and demonstrate significant clinical improvement. However, robust population based lifetime-risk data for implant revision are not available to aid patient decision making, which is a particular problem in young patient groups deciding on best-timing for surgery. METHODS: We did implant survival analysis on all patients within the Clinical Practice Research Datalink who had undergone total hip replacement or total knee replacement...
February 13, 2017: Lancet
https://www.readbyqxmd.com/read/28208144/conservative-versus-surgical-management-of-iatrogenic-tracheal-rupture
#5
Nikolaos Panagiotopoulos, Davide Patrini, Matthew Barnard, Efstratios Koletsis, Dimitrios Dougenis, David Lawrence
Iatrogenic tracheal rupture (ITR) represents a life-threatening condition requiring prompt diagnosis, management, and treatment. The management of ITR is challenging, and treatment options depend on tear location, size, injury extent, and the patient's respiratory status. Although this complication has been extensively reported in published literature, the best evidence practice, for the management, requires clarification. In this review, the authors focused on the establishment of a differential diagnosis and the potential mechanism of the injury, the decision-making process, and the therapeutic approaches...
January 9, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28206830/medical-student-beliefs-about-disclosure-of-mental-health-issues-a-qualitative-study
#6
Peter Winter, Andrew Rix, Andrew Grant
In 2012 the United Kingdom's General Medical Council (GMC) commissioned research to develop guidance for medical schools on how best to support students with mental illness. One of the key findings from medical student focus groups in the study was students' strong belief that medical schools excluded students on mental health grounds. Students believed mental illness was a fitness to practice matter that led to eventual dismissal, although neither personal experience nor empirical evidence supported this belief...
2017: Journal of Veterinary Medical Education
https://www.readbyqxmd.com/read/28205248/a-framework-for-transition-to-specialty-practice-programs
#7
Julia Morphet, Virginia Plummer, Bridie Kent, Julie Considine
AIM: To develop a framework for emergency nursing transition to specialty practice programs. BACKGROUND: Transition to Specialty Practice programs were introduced to fill workforce shortages and facilitate the transition of nurses to specialty nursing practice. These programs are recognised as essential preparation for emergency nurses. Emergency nursing Transition to Specialty Practice programs have developed in an ad hoc manner and as a result, program characteristics vary...
February 15, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28203120/international-lessons-in-new-methods-for-grading-and-integrating-cost-effectiveness-evidence-into-clinical-practice-guidelines
#8
REVIEW
Kathryn M Antioch, Michael F Drummond, Louis W Niessen, Hindrik Vondeling
Economic evidence is influential in health technology assessment world-wide. Clinical Practice Guidelines (CPG) can enable economists to include economic information on health care provision. Application of economic evidence in CPGs, and its integration into clinical practice and national decision making is hampered by objections from professions, paucity of economic evidence or lack of policy commitment. The use of state-of-art economic methodologies will improve this. Economic evidence can be graded by 'checklists' to establish the best evidence for decision making given methodological rigor...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28202047/health-workforce-metrics-pre-and-post-2015-a-stimulus-to-public-policy-and-planning
#9
Francisco Pozo-Martin, Andrea Nove, Sofia Castro Lopes, James Campbell, James Buchan, Gilles Dussault, Teena Kunjumen, Giorgio Cometto, Amani Siyam
BACKGROUND: Evidence-based health workforce policies are essential to ensure the provision of high-quality health services and to support the attainment of universal health coverage (UHC). This paper describes the main characteristics of available health workforce data for 74 of the 75 countries identified under the 'Countdown to 2015' initiative as accounting for more than 95% of the world's maternal, newborn and child deaths. It also discusses best practices in the development of health workforce metrics post-2015...
February 15, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28201979/wide-variation-in-sexually-transmitted-infection-testing-and-counselling-at-aboriginal-primary-health-care-centres-in-australia-analysis-of-longitudinal-continuous-quality-improvement-data
#10
Barbara Nattabi, Veronica Matthews, Jodie Bailie, Alice Rumbold, David Scrimgeour, Gill Schierhout, James Ward, Rebecca Guy, John Kaldor, Sandra C Thompson, Ross Bailie
BACKGROUND: Chlamydia, gonorrhoea and syphilis are readily treatable sexually transmitted infections (STIs) which continue to occur at high rates in Australia, particularly among Aboriginal Australians. This study aimed to: explore the extent of variation in delivery of recommended STI screening investigations and counselling within Aboriginal primary health care (PHC) centres; identify the factors associated with variation in screening practices; and determine if provision of STI testing and counselling increased with participation in continuous quality improvement (CQI)...
February 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28196898/increased-radial-access-is-not-associated-with-worse-femoral-outcomes-for-percutaneous-coronary-intervention-in-the-united-kingdom
#11
William Hulme, Matthew Sperrin, Evangelos Kontopantelis, Karim Ratib, Peter Ludman, Alex Sirker, Tim Kinnaird, Nick Curzen, Chun Shing Kwok, Mark De Belder, James Nolan, Mamas A Mamas
BACKGROUND: The radial artery is increasingly adopted as the primary access site for cardiac catheterization because of patient preference, lower bleeding rates, cost effectiveness, and reduced risk of mortality in high-risk patient groups. Concerns have been expressed that operators/centers have become increasingly unfamiliar with transfemoral access. The aim of this study was to assess whether a change in access site practice toward transradial access nationally has led to worse outcomes in percutaneous coronary intervention procedures performed through the transfemoral access approach...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28196182/what-surgeons-need-to-know-about-gender-confirmation-surgery-when-providing-care-for-transgender-individuals-a-review
#12
Jens U Berli, Gail Knudson, Lin Fraser, Vin Tangpricha, Randi Ettner, Frederic M Ettner, Joshua D Safer, Julie Graham, Stan Monstrey, Loren Schechter
Importance: In 2014, the US Department of Health and Human Services decided that its 1981 exclusion of transsexual surgical treatments from Medicare coverage was based on outdated, incomplete, and biased science and did not reflect current evidence or standards of care, and the exclusion was therefore lifted. As a direct result of this decision, surgeons nationwide are seeing an increase in consultations for surgical therapy to help transgender and gender-nonconforming individuals. Although some clinicians may have the technical training for such surgical procedures, in many cases, they may not have a full understanding of the complex and comprehensive care required to provide optimal health care for transgender individuals...
February 8, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28195451/staging-and-follow-up-of-cutaneous-melanoma-patients
#13
Carlota Gutiérrez García-Rodrigo, Ambra Antonini, Tea Rocco, Cristina Pellegrini, Maria C Fargnoli
INTRODUCTION: Melanoma is responsible for the greatest number of deaths caused by skin malignancies. The purpose of monitoring patients diagnosed with melanoma is to allow early detection of recurrence and any subsequent primary tumors. Several dermatological and oncological societies developed their own set of guidelines for the surveillance and management of melanoma patients depending on the stage of the disease. The object of this article is to provide a comprehensive, systematic overview that summarizes and interprets previous studies, to characterize current practices regarding progression of melanoma, division into stages of development, and subsequent surveillance...
February 14, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/28193204/development-of-a-wheelchair-mobility-skills-test-for-children-and-adolescents-combining-evidence-with-clinical-expertise
#14
Marleen Elisabeth Sol, Olaf Verschuren, Laura de Groot, Janke Frederike de Groot
BACKGROUND: Wheelchair mobility skills (WMS) training is regarded by children using a manual wheelchair and their parents as an important factor to improve participation and daily physical activity. Currently, there is no outcome measure available for the evaluation of WMS in children. Several wheelchair mobility outcome measures have been developed for adults, but none of these have been validated in children. Therefore the objective of this study is to develop a WMS outcome measure for children using the current knowledge from literature in combination with the clinical expertise of health care professionals, children and their parents...
February 13, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28192563/evaluation-of-evidence-of-statistical-support-and-corroboration-of-subgroup-claims-in-randomized-clinical-trials
#15
Joshua D Wallach, Patrick G Sullivan, John F Trepanowski, Kristin L Sainani, Ewout W Steyerberg, John P A Ioannidis
Importance: Many published randomized clinical trials (RCTs) make claims for subgroup differences. Objective: To evaluate how often subgroup claims reported in the abstracts of RCTs are actually supported by statistical evidence (P < .05 from an interaction test) and corroborated by subsequent RCTs and meta-analyses. Data Sources: This meta-epidemiological survey examines data sets of trials with at least 1 subgroup claim, including Subgroup Analysis of Trials Is Rarely Easy (SATIRE) articles and Discontinuation of Randomized Trials (DISCO) articles...
February 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28191040/moisturisers-for-the-treatment-of-foot-xerosis-a-systematic-review
#16
REVIEW
Justin Parker, Rolf Scharfbillig, Sara Jones
BACKGROUND: Xerosis, literally dryness of the skin, of the foot is a common condition encountered clinically, which can lead to discomfort and predisposition to infection. Currently, there are no evidence-based recommendations on which moisturiser formulations best alleviate xerotic symptoms. The aim of this review was to guide clinical practice in the treatment of primary and diabetes related foot xerosis, by identifying from the existing literature the most effective ingredient or formulation of topical treatments for symptoms of primary foot xerosis in the general population...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/28190557/moving-the-needle-toward-high-quality-pediatric-surgical-care-how-can-we-achieve-this-goal-through-prioritization-measurement-and-more-effective-collaboration
#17
REVIEW
Shawn J Rangel
Over the past decade, the American College of Surgeons Pediatric National Surgical Quality Improvement Program (NSQIP-Pediatric) has greatly improved upon our ability to measure, benchmark and compare outcomes as they relate to pediatric surgical care. Several factors have served to mold the program's evolution and data collection paradigm over time. These have included a broader understanding of what quality measures should be captured and compared from the perspectives of different stakeholders, identification of conditions where quality and process improvement efforts may have the greatest relative impact from a public health perspective, and increasing evidence in support of collaborative networks to accelerate quality improvement through the dissemination of best practices...
January 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28188854/the-effects-of-a-single-bout-of-exercise-on-motor-memory-interference-in-the-trained-and-untrained-hemisphere
#18
Benedikt Lauber, Steffen Franke, Wolfgang Taube, Albert Gollhofer
Increasing evidence suggests that cardiovascular exercise has positive effects on motor memory consolidation. In this study, we investigated whether a single session of high-intensity interval training (HIIT) mitigates the effects of practicing an interfering motor task. Furthermore, learning and interference effects were assessed in the actively trained and untrained limb as it is known that unilateral motor learning can cause bilateral adaptations. Subjects performed a ballistic training and then the HIIT either before (HIIT_before) or after (HIIT_after) practicing an interfering accuracy task (AT)...
February 8, 2017: Neuroscience
https://www.readbyqxmd.com/read/28188579/cardiac-biomarkers-of-acute-coronary-syndrome-from-history-to-high-sensitivity-cardiac-troponin
#19
REVIEW
Pankaj Garg, Paul Morris, Asma Lina Fazlanie, Sethumadhavan Vijayan, Balazs Dancso, Amardeep Ghosh Dastidar, Sven Plein, Christian Mueller, Philip Haaf
The role of cardiac troponins as diagnostic biomarkers of myocardial injury in the context of acute coronary syndrome (ACS) is well established. Since the initial 1st-generation assays, 5th-generation high-sensitivity cardiac troponin (hs-cTn) assays have been developed, and are now widely used. However, its clinical adoption preceded guidelines and even best practice evidence. This review summarizes the history of cardiac biomarkers with particular emphasis on hs-cTn. We aim to provide insights into using hs-cTn as a quantitative marker of cardiomyocyte injury to help in the differential diagnosis of coronary versus non-coronary cardiac diseases...
February 11, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28188198/best-practices-in-summative-assessment
#20
REVIEW
Jonathan D Kibble
The goal of this review is to highlight key elements underpinning excellent high-stakes summative assessment. This guide is primarily aimed at faculty members with the responsibility of assigning student grades and is intended to be a practical tool to help throughout the process of planning, developing, and deploying tests as well as monitoring their effectiveness. After a brief overview of the criteria for high-quality assessment, the guide runs through best practices for aligning assessment with learning outcomes and compares common testing modalities...
March 1, 2017: Advances in Physiology Education
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