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https://www.readbyqxmd.com/read/29346699/teaching-chronic-pain-in-the-family-medicine-residency
#1
Kimberly Zoberi, Kelly M Everard
BACKGROUND AND OBJECTIVES: Chronic pain is a significant condition affecting many Americans. Primary care physicians play an important role in chronic pain management, but many residents and physicians feel poorly prepared to manage it. METHODS: Data were collected as part of the 2016 Council of Academic Family Medicine Educational Research Alliance (CERA) Program Director Survey, which was sent electronically to 484 program directors in the United States. The authors sought to determine whether residency directors' attitudes about treating chronic pain were associated with the amount of time devoted to teaching family medicine residents about chronic pain assessment, therapy (use of opioids, use adjuvant pain medications, use of other nonopioids, use of nonpharmacological treatments), and risk management (risk assessment, use of pain management contracts, informed consent when prescribing opioids, and urine drug monitoring)...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29346430/estimation-of-inhalation-flow-profile-using-audio-based-methods-to-assess-inhaler-medication-adherence
#2
Terence E Taylor, Helena Lacalle Muls, Richard W Costello, Richard B Reilly
Asthma and chronic obstructive pulmonary disease (COPD) patients are required to inhale forcefully and deeply to receive medication when using a dry powder inhaler (DPI). There is a clinical need to objectively monitor the inhalation flow profile of DPIs in order to remotely monitor patient inhalation technique. Audio-based methods have been previously employed to accurately estimate flow parameters such as the peak inspiratory flow rate of inhalations, however, these methods required multiple calibration inhalation audio recordings...
2018: PloS One
https://www.readbyqxmd.com/read/29346209/the-society-of-thoracic-surgeons-the-society-of-cardiovascular-anesthesiologists-and-the-american-society-of-extracorporeal-technology-clinical-practice-guidelines-anticoagulation-during-cardiopulmonary-bypass
#3
Linda Shore-Lesserson, Robert A Baker, Victor A Ferraris, Philip E Greilich, David Fitzgerald, Philip Roman, John W Hammon
Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29346185/higher-art-adherence-is-associated-with-lower-systemic-inflammation-in-treatment-na%C3%A3-ve-ugandans-who-achieve-virologic-suppression
#4
Jose R Castillo-Mancilla, Mary Morrow, Yap Boum, Helen Byakwaga, Jessica E Haberer, Jeffrey N Martin, David Bangsberg, Samantha Mawhinney, Nicholas Musinguzi, Yong Huang, Russell P Tracy, Tricia H Burdo, Kenneth Williams, Conrad Muzoora, Peter W Hunt, Mark J Siedner
BACKGROUND: Residual systemic inflammation persists despite suppressive antiretroviral therapy (ART) and is associated with non-AIDS clinical outcomes. We aimed to evaluate the association between ART adherence and inflammation in Ugandans living with HIV who were predominantly receiving nevirapine-based ART with a thymidine analog backbone and were virologically suppressed by conventional assays. METHODS: Plasma concentrations of interleukin-6 (IL-6), D-dimer, soluble (s)CD14, sCD163, the kynurenine/tryptophan (K/T) ratio, in addition to CD8 T-cell activation, were measured at baseline and 6 months after ART initiation in treatment-naïve adults who achieved an undetectable plasma HIV RNA (<400 copies/mL) at their 6-month visit...
January 16, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29346063/linking-data-from-health-surveys-and-electronic-health-records-a-demonstration-project-in-two-chicago-health-center-clinics
#5
Fikirte Wagaw, Catherine A Okoro, Sunkyung Kim, Jessica Park, Fred Rachman
INTRODUCTION: Monitoring and understanding population health requires conducting health-related surveys and surveillance. The objective of our study was to assess whether data from self-administered surveys could be collected electronically from patients in urban, primary-care, safety-net clinics and subsequently linked and compared with the same patients' electronic health records (EHRs). METHODS: Data from self-administered surveys were collected electronically from a convenience sample of 527 patients at 2 Chicago health centers from September through November, 2014...
January 18, 2018: Preventing Chronic Disease
https://www.readbyqxmd.com/read/29345515/safety-of-biologic-agents-for-psoriasis-in-patients-with-viral-hepatitis
#6
Nawaf AlMutairi, Hesham Alaadin Abouzaid
INTRODUCTION: Biologics are highly effective, important treatment options for moderate-to-severe psoriasis. Biologics are well tolerated and have few side effects. However, the use of biologics in patients with concomitant chronic viral hepatitis is debatable. Recent reports have suggested a very low associated risk of reactivation of chronic hepatitis B (HBV) and C (HCB). OBJECTIVE: To evaluate the safety and effectiveness of biologics for moderate to severe psoriasis patients with concomitant chronic viral hepatitis...
January 18, 2018: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/29344854/laser-microdissection-workflow-for-isolating-nucleic-acids-from-fixed-and-frozen-tissue-samples
#7
Yelena G Golubeva, Andrew C Warner
Laser Capture Microdissection has earned a permanent place among modern techniques connecting histology and molecular biology. Laser Capture Microdissection has become an invaluable tool in medical research as a means for collection of specific cell populations isolated from their environment. Such genomic sample enrichment dramatically increases the sensitivity and precision of downstream molecular assays used for biomarker discovery, monitoring disease onset and progression, and in the development of personalized medicine...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29344391/pilot-study-assessing-the-effect-of-continual-position-monitoring-technology-on-compliance-with-patient-turning-protocols
#8
Suann Cirigliano Schutt, Christine Tarver, Michelle Pezzani
Aim: The study aim was to evaluate if continual patient position monitoring, taking into account self-turns and clinician-assisted turns, would increase the percentage of time a patient's position changed at least every 2 hr. Background: While patient turning has clinical benefits, current models to help staff remember to turn patients, such as "turn clocks" and timers, have not resulted in high compliance with turning protocols. In addition, reminders are based on arbitrary 2-hr windows (such as turning on "even" hours) rather than on individual patient activity, including self-turns...
January 2018: Nursing Open
https://www.readbyqxmd.com/read/29344376/effectiveness-of-pharmacist-s-intervention-in-the-management-of-cardiovascular-diseases
#9
REVIEW
Stefano Omboni, Marina Caserini
The pharmacist may play a relevant role in primary and secondary prevention of cardiovascular diseases, mainly through patient education and counselling, drug safety management, medication review, monitoring and reconciliation, detection and control of specific cardiovascular risk factors (eg, blood pressure, blood glucose, serum lipids) and clinical outcomes. Systematic reviews of randomised controlled and observational studies have documented an improved control of hypertension, dyslipidaemia or diabetes, smoking cessation and reduced hospitalisation in patients with heart failure, following a pharmacist's intervention...
2018: Open Heart
https://www.readbyqxmd.com/read/29344318/noninvasive-long-term-monitoring-of-actinic-keratosis-and-field-cancerization-following-treatment-with-ingenol-mebutate-gel-0-015
#10
Orit Markowitz, Katie Wang, Amanda Levine, Michelle Schwartz, Sumeet Minhas, Eleanor Feldman, Daniel M Siegel
OBJECTIVE: To determine whether actinic keratosis and photodamaged perilesional areas (field cancerization) treated successfully with topical ingenol mebutate gel 0.015% remained clear one year later, and to treat actinic keratosis and perilesional skin not treated one year earlier. DESIGN: Single-center, single-arm, open-label extension of an original clinical study completed one year earlier. SETTING: An outpatient clinic. PARTICIPANTS: Fifteen of the original 28 study patients enrolled in and who completed the extension phase...
October 2017: Journal of Clinical and Aesthetic Dermatology
https://www.readbyqxmd.com/read/29343970/a-retrospective-examination-of-the-us-food-and-drug-administration-s-clinical-pharmacology-reviews-of-oncology-biologics-for-potential-use-of-therapeutic-drug-monitoring
#11
Brett Fleisher, Sihem Ait-Oudhia
Background: Biologics have gained traction for use in oncology, but have demonstrate clinical variability for efficacy and safety. Therapeutic drug monitoring (TDM) can benefit patients' outcomes from a biologic therapy when the latter has a defined therapeutic window. A clinically relevant therapeutic window may exist for biologics with established exposure-response (E-R) relationships for efficacy and/or safety and a documented maximum tolerated dose (MTD). Additionally, the inter-individual variability (IIV) on the clearance (CL) parameter could determine risks for patients falling outside the proposed therapeutic window...
2018: OncoTargets and Therapy
https://www.readbyqxmd.com/read/29343945/the-impact-of-pharmaceutical-interventions-on-the-rational-use-of-proton-pump-inhibitors-in-a-chinese-hospital
#12
Chuanwei Xin, Zhu Dong, Mengmeng Lin, Gong-Hua Li
Background: The prescriptions of proton pump inhibitors (PPIs) have raised concern due to both huge increase in medical expenditure and the possible long-term adverse events caused by them; therefore, an approach to taper off the irrational use of PPIs by patients is clinically warranted. The aim of this study was to evaluate the impact of pharmaceutical interventions on the rational use of PPIs. Patients and methods: A single-center, pre- to post-intervention study (pharmaceutical interventions group and control group) was performed in a Chinese hospital...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29343839/musical-auditory-stimulus-acutely-influences-heart-rate-dynamic-responses-to-medication-in-subjects-with-well-controlled-hypertension
#13
Eli Carlos Martiniano, Milana Drumond Ramos Santana, Érico Luiz Damasceno Barros, Maria do Socorro da Silva, David Matthew Garner, Luiz Carlos de Abreu, Vitor E Valenti
Music can improve the efficiency of medical treatment when correctly associated with drug action, reducing risk factors involving deteriorating cardiac function. We evaluated the effect of musical auditory stimulus associated with anti-hypertensive medication on heart rate (HR) autonomic control in hypertensive subjects. We evaluated 37 well-controlled hypertensive patients designated for anti-hypertensive medication. Heart rate variability (HRV) was calculated from the HR monitor recordings of two different, randomly sorted protocols (control and music) on two separate days...
January 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29343192/coverage-and-outcomes-of-antenatal-tests-for-infections-a-population-based-survey-in-the-province-of-trento-italy
#14
Michela Dalmartello, Fabio Parazzini, Mariangela Pedron, Riccardo Pertile, Lucia Collini, Carlo La Vecchia, Silvano Piffer
BACKGROUND: Rubella, syphilis, toxoplasmosis, cytomegalovirus (CMV), hepatitis B (HBV) and C (HCV), HIV, and Group B Streptococcus (GBS) infections may have very severe outcomes during pregnancy, and for this reason, monitoring of infections in pregnant women is a requirement of prenatal assistance. AIMS: To describe coverage and outcome of the screening for rubella, syphilis, toxoplasmosis, CMV, HBV, HCV, HIV, and Group B Streptococcus in pregnancy in the Autonomous Province of Trento, Northern Italy (538,600 inhabitants)...
January 17, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29342097/time-domain-near-infrared-spectroscopy-device-for-monitoring-muscle-oxidative-metabolism-custom-probe-and-in-vivo-applications
#15
Rebecca Re, Ileana Pirovano, Davide Contini, Lorenzo Spinelli, Alessandro Torricelli
Measurement of muscle oxidative metabolism is of interest for monitoring the training status in athletes and the rehabilitation process in patients. Time domain near infrared spectroscopy (TD NIRS) is an optical technique that allows the non-invasive measurement of the hemodynamic parameters in muscular tissue: concentrations of oxy- and deoxy-hemoglobin, total hemoglobin content, and tissue oxygen saturation. In this paper, we present a novel TD NIRS medical device for muscle oxidative metabolism. A custom-printed 3D probe, able to host optical elements for signal acquisition from muscle, was develop for TD NIRS in vivo measurements...
January 17, 2018: Sensors
https://www.readbyqxmd.com/read/29341939/the-quest-for-equivalence-of-test-results-the-pilgrimage-of-the-dutch-calibration-2-000-program-for-metrological-traceability
#16
REVIEW
Rob T P Jansen, Christa M Cobbaert, Cas Weykamp, Marc Thelen
Calibration 2.000 was initiated 20 years ago for standardization and harmonization of medical tests. The program also intended to evaluate adequate implementation of the In Vitro Diagnostics (IVD) 98/79/EC directive, in order to ensure that medical tests are fit-for-clinical purpose. The Calibration 2.000 initiative led to ongoing verification of test standardization and harmonization in the Netherlands using commutable external quality assessment (EQA)-tools and a type 1 EQA-design, where feasible. National support was guaranteed by involving all laboratory professionals as well as laboratory technicians responsible for EQA and quality officers...
January 17, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29341860/risk-management-of-free-radicals-involved-in-air-travel-syndromes-by-antioxidants
#17
Jeum-Nam Kim, Byung-Mu Lee
Frequent air travelers and airplane pilots may develop various types of illnesses. The environmental risk factors associated with air travel syndromes (ATS) or air travel-related adverse health outcomes raised concerns and need to be assessed in the context of risk management and public health. Accordingly, the aim of the present review was to determine ATS, risk factors, and mechanisms underlying ATS using scientific data and information obtained from Medline, Toxline, and regulatory agencies. Additional information was also extracted from websites of organizations, such as the International Air Transport Association (IATA), International Association for Medical Assistance to Travelers (IAMAT), and International Civil Aviation Organization (ICAO)...
January 17, 2018: Journal of Toxicology and Environmental Health. Part B, Critical Reviews
https://www.readbyqxmd.com/read/29341843/smart-care-based-on-telemonitoring-and-telemedicine-for-type-2-diabetes-care-multi-center-randomized-controlled-trial
#18
Ji Yun Jeong, Jae-Han Jeon, Kwi-Hyun Bae, Yeon-Kyung Choi, Keun-Gyu Park, Jung-Guk Kim, Kyu Chang Won, Bong Soo Cha, Chul Woo Ahn, Dong Won Kim, Chang Hee Lee, In-Kyu Lee
BACKGROUND: This study was performed to determine the effectiveness of the Smart Care service on glucose control based on telemedicine and telemonitoring compared with conventional treatment in patients with type 2 diabetes. MATERIALS AND METHODS: This 24-week prospective multi-center randomized controlled trial involved 338 adult patients with type 2 diabetes at four university hospitals in South Korea. The patients were randomly assigned to a control group (group A, n = 113), a telemonitoring group (group B, n = 113), or a telemedicine group (group C, n = 112)...
January 17, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29341052/-routine-outcome-monitoring-in-anxiety-disorders-diagnosis-specific-versus-generic-assessment-instruments
#19
M van der Mheen, L M Ter Mors, M A VAN den Hout, D C Cath
Mental health institutions increasingly utilise routine outcome monitoring (rom) in order to assess treatment effectiveness. It remains unclear which instruments are more sensitive to change with regard to rom in patients with an anxiety disorder: diagnosis-specific or generic instruments.<br/> AIM: To compare the sensitivity of diagnosis-specific versus generic rom-instruments in patients with an anxiety disorder.<br/> METHOD: 160 adults with an anxiety disorder received cognitive behavioural therapy at the Altrecht Academic Anxiety Centre...
2018: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/29340912/predictors-of-hypoglycemia-in-hospitalized-patients-with-diabetes-mellitus
#20
Amit Akirov, Oren Amitai, Hiba Masri-Iraqi, Talia Diker-Cohen, Tzipora Shochat, Yoav Eizenberg, Ilan Shimon
Hypoglycemia is common among hospitalized patients with diabetes mellitus (DM), and is associated with increased morbidity and mortality. Identify pre-admission risk factors associated with in-hospital hypoglycemia. Historical prospectively collected data of adult DM patients hospitalized to medical wards between 2011 and 2013. Hypoglycemia and serious hypoglycemia were defined as at least one blood glucose measurement ≤ 70 and < 54 mg/dl, respectively, during hospitalization. The primary outcome was in-hospital hypoglycemia...
January 16, 2018: Internal and Emergency Medicine
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