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https://www.readbyqxmd.com/read/29151197/impact-of-the-dapivirine-vaginal-ring-on-sexual-experiences-and-intimate-partnerships-of-women-in-an-hiv-prevention-clinical-trial-managing-ring-detection-and-hot-sex
#1
Nicole D Laborde, Elizabeth Pleasants, Krishnaveni Reddy, Millicent Atujuna, Teopista Nakyanzi, Miria Chitukuta, Sarita Naidoo, Thesla Palanee-Phillips, Jared M Baeten, Elizabeth T Montgomery
Vaginally-inserted HIV prevention methods have been reported to impact the sexual experience for women and their partners, and hence impacts acceptability of and adherence to the method. We analyzed in-depth interviews and focus group discussions about participants' sexual experiences while wearing the ring, collected during the MTN-020/ASPIRE phase 3 safety and effectiveness trial of a dapivirine vaginal ring for HIV prevention in Malawi, South Africa, Uganda, and Zimbabwe. Most women reported that partners did not feel the ring during sex, however, women felt they had to manage their partners' interaction with or reaction to the ring...
November 18, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/29151002/management-of-arrhythmia-in-sepsis-and-septic-shock
#2
Martin Balik, Vojtech Matousek, Michal Maly, Tomas Brozek
The occurrence of supraventricular arrhythmias is associated with an unfavourable prognosis in septic shock. Available trials are difficult to apply in sepsis and septic shock patients due to included cohorts, control groups and because "one size does not fit all". The priorities in the critically ill are maintenance of a sinus rhythm and diastolic ventricular filling. The rate control modality should be reserved for chronic AF and in situations when a sinus rhythm is difficult to maintain due to extreme stress conditions resulting from a high dosage of vasoactive agents...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29150806/ticagrelor-a-review-in-long-term-secondary-prevention-of-cardiovascular-events
#3
Zaina T Al-Salama, Gillian M Keating, Susan J Keam
Ticagrelor (Brilique(®)) is an orally administered P2Y12 inhibitor. A long-term (maintenance) regimen of ticagrelor 60 mg twice daily is indicated in the EU for coadministration with low-dose aspirin 75-150 mg/day for the secondary prevention of atherothrombotic events in high-risk patients with a history of myocardial infarction (MI) of at least 1 year. Approval is based on the results of the PEGASUS-TIMI 54 trial that compared ticagrelor with placebo (in conjunction with low-dose aspirin) in stable patients who had had a spontaneous MI 1-3 years prior to enrolment and were at high risk of atherothrombotic events...
November 18, 2017: Drugs
https://www.readbyqxmd.com/read/29150479/impact-of-variation-in-functions-and-delivery-on-the-effectiveness-of-behavioural-and-mood-management-interventions-for-smoking-cessation-in-people-with-depression-protocol-for-a-systematic-review-and-meta-analysis
#4
Gemma Taylor, Paul Aveyard, Regina Van der Meer, Daniel Toze, Bobby Stuijfzand, David Kessler, Marcus Munafò
INTRODUCTION: Tobacco is the world's leading preventable cause of disease and death. People with depression are twice as likely to smoke and are less responsive to standard tobacco treatments as compared with the general population. A Cochrane systematic review of randomised controlled trials of smoking cessation treatment for smokers with current or historical depression found that adding mood management to usual smoking treatment improved quit rates. However, the review did not examine if variation in intervention delivery or intervention functions impacted on treatment effectiveness...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150474/core-outcome-sets-in-miscarriage-trials-cosmist-study-a-study-protocol
#5
Paul Smith, Natalie Cooper, Rima Dhillon-Smith, Emily O'Toole, T Justin Clark, Arri Coomarasamy
INTRODUCTION: 'Core outcome sets' are an agreed, standardised set of outcomes based on what key stakeholders (clinicians, patients, their partners, researchers, service developers, funding organisations and so on) consider the important outcomes in the management or prevention of a condition. This paper describes the rationale and design for the development of Core Outcome Sets for Miscarriage Trials. METHODS AND ANALYSIS: Systematic reviews, interviews and focus groups with patients and their partners will be conducted to identify potential core outcomes that will be introduced into a modified Delphi survey...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150457/combination-analgesia-for-neonatal-circumcision-a-randomized-controlled-trial
#6
Rana Sharara-Chami, Zavi Lakissian, Lama Charafeddine, Nadine Milad, Yaser El-Hout
OBJECTIVES: There is no consensus on the most effective pain management for neonatal circumcision. We sought to compare different modalities. METHODS: This is a double-blinded randomized controlled trial comparing 3 combination analgesics used during circumcision (EMLA + sucrose; EMLA + sucrose + dorsal penile nerve block [DPNB]; EMLA + sucrose + ring block [RB]) with the traditional topical analgesic cream EMLA alone. The trial was set in the normal nursery of a teaching hospital...
November 17, 2017: Pediatrics
https://www.readbyqxmd.com/read/29150394/efficacy-of-prostatic-artery-embolization-for-catheter-dependent-patients-with-large-prostate-sizes-and-high-comorbidity-scores
#7
Shivank Bhatia, Vishal K Sinha, Bruce R Kava, Christopher Gomez, Sardis Harward, Sanoj Punnen, Issam Kably, Jeffrey Miller, Dipen J Parekh
PURPOSE: To evaluate efficacy and safety of prostate artery embolization (PAE) in urinary catheter-dependent patients with large prostate volumes and high comorbidity scores. MATERIALS AND METHODS: A retrospective single-center review was conducted of 30 patients with urinary retention at time of PAE from November 2014 through February 2017. Mean (range) age was 73.1 years (48-94 y), age-adjusted Charlson comorbidity index was 4.5 (0-10), duration of urinary retention was 63...
November 15, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29150274/neuroprotective-potential-of-high-dose-biotin
#8
Mark F McCarty, James J DiNicolantonio
A recent controlled trial has established that high-dose biotin supplementation - 100 mg, three times daily - has a stabilizing effect on progression of multiple sclerosis (MS). Although this effect has been attributed to an optimization of biotin's essential cofactor role in the brain, a case can be made that direct stimulation of soluble guanylate cyclase (sGC) by pharmacological concentrations of biotin plays a key role in this regard. The utility of high-dose biotin in MS might reflect an anti-inflammatory effect of cGMP on the cerebral microvasculature, as well on oligodendrocyte differentiation and on Schwann cell production of neurotrophic factors thought to have potential for managing MS...
November 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/29150233/management-of-first-depression-or-generalized-anxiety-disorder-episode-in-adults-in-primary-care-a-systematic-metareview
#9
Damien Driot, Michel Bismuth, Adrien Maurel, Julie Soulie-Albouy, Jordan Birebent, Stéphane Oustric, Julie Dupouy
CONTEXT: General Practitioners (GPs) are the leading antidepressants prescribers in Europe and in France. Difficulties in implementing existing recommendations in daily practice have been described. OBJECTIVE: The objective of this study was to elaborate two algorithms to guide GPs in the patient management for a first major depressive disorder (MDD) or generalized anxiety disorder (GAD) episode in primary care. DATA SOURCES: PubMed, Cochrane, and ISI Web of Science were explored using mainly the following keywords: depressive disorder, anxiety disorders, antidepressive agents or antidepressant...
November 14, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29150176/studies-on-in-vitro-hypoglycemic-effects-of-root-bark-of-caesalpinia-bonducella
#10
F J Sayyed, G H Wadkar
OBJECTIVE: The present investigation was undertaken to assess the hypoglycemic potential of ethanolic (ECB) and aqueous extracts (ACB) of root bark of Caesalpinia bonducella using various in vitro techniques. METHOD: The ethanolic and aqueous extracts of root bark of C. bonducella were studied for their effects on glucose adsorption capacity, in vitro glucose diffusion, in-vitro amylolysis kinetics and glucose transport across membrane of yeast cells. RESULT: It was observed that the extracts under study adsorbed glucose and the adsorption of glucose increased remarkably with an increase in glucose concentration...
November 14, 2017: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/29150163/the-management-of-diagnosed-heart-failure-in-older-people-in-primary-care
#11
REVIEW
Nicholas R Jones, F D Richard Hobbs, Clare J Taylor
Heart failure (HF) is a common condition affecting predominantly older people. Symptoms include breathlessness and fatigue, and can significantly reduce quality of life. HF rarely occurs in isolation, with most patients having several co-existing diseases requiring multiple medications. There is a large evidence base for treatment of HF with reduced ejection fraction, or HFrEF; however, many of the trials did not include older people with multimorbidity so their findings should be applied to this group with some caution...
December 2017: Maturitas
https://www.readbyqxmd.com/read/29149944/management-of-sepsis-induced-immunosuppression
#12
REVIEW
Fabienne Venet, Thomas Rimmelé, Guillaume Monneret
It is now well established that profound immunosuppression develops within a few days after sepsis onset in patients. This should be considered additional organ failure because it is associated with increased rate of nosocomial infections, mortality, and long-term complications, thus constituting the rationale for immunomodulation in patients. Nevertheless, the demonstration of the efficacy of such therapeutic strategy in improving deleterious outcomes in sepsis remains to be made. Results from clinical trials based on interleukin 7 and granulocyte macrophage colony-stimulating factor immunoadjuvant therapies in septic shock patients are expected for 2018...
January 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29149938/novel-interventions-what-s-new-and-the-future
#13
REVIEW
Jean-Louis Vincent, David Grimaldi
Despite decades of sepsis research, no specific therapies for sepsis have emerged and current management still relies on source control, antibiotics, and organ support. With improved understanding of sepsis pathophysiology and the development of new techniques to enable better characterization of patients with sepsis, clinical trials are beginning to better target new interventions at those patients most likely to respond. This article discusses advances in sepsis therapeutics designed to improve endothelial cell function, purify the blood to help restore immune homeostasis, and provide immunostimulation for patients with immune exhaustion...
January 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29149914/testing-the-effectiveness-of-a-motivational-interviewing-based-brief-intervention-for-substance-use-as-an-adjunct-to-usual-care-in-community-based-aids-service-organizations-study-protocol-for-a-multisite-randomized-controlled-trial
#14
Bryan R Garner, Heather J Gotham, Stephen J Tueller, Elizabeth L Ball, David Kaiser, Patricia Stilen, Kathryn Speck, Denna Vandersloot, Traci R Rieckmann, Michael Chaple, Erika G Martin, Steve Martino
BACKGROUND: In 2010, the first comprehensive National HIV/AIDS Strategy for the United States was released and included three goals: (1) reducing the number of people who become infected with HIV, (2) increasing access to care and improving health outcomes for people living with HIV, and (3) reducing HIV-related health disparities and health inequities. In 2013, as part of its effort to help address the National HIV/AIDS Strategy, the National Institute on Drug Abuse (NIDA) funded a type 2 effectiveness-implementation hybrid trial titled the Substance Abuse Treatment to HIV Care (SAT2HIV) Project...
November 17, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/29149912/trial-to-incentivise-adherence-for-diabetes-triad-study-protocol-for-a-randomised-controlled-trial
#15
Marcel Bilger, Mitesh Shah, Ngiap Chuan Tan, Kaye Louise Howard, Hui Yan Xu, Ecosse Luc Lamoureux, Eric Andrew Finkelstein
BACKGROUND: Many people with diabetes have suboptimal glycaemic control due to not being adherent to their treatment regimen. Behavioural economic theory suggests that the lack of adherence results from the disconnect between the timing of when costs and benefits accrue. One strategy to address this discontinuity is to offer patients a near-term benefit, such as a financial reward. Whereas there is evidence that rewards can improve treatment adherence and sometimes health outcomes, further research is needed to determine whether rewards are more effective when targeting processes or intermediary health outcomes...
November 17, 2017: Trials
https://www.readbyqxmd.com/read/29149909/testing-the-implementation-and-sustainment-facilitation-isf-strategy-as-an-effective-adjunct-to-the-addiction-technology-transfer-center-attc-strategy-study-protocol-for-a-cluster-randomized-trial
#16
Bryan R Garner, Mark Zehner, Mathew R Roosa, Steve Martino, Heather J Gotham, Elizabeth L Ball, Patricia Stilen, Kathryn Speck, Denna Vandersloot, Traci R Rieckmann, Michael Chaple, Erika G Martin, David Kaiser, James H Ford
BACKGROUND: Improving the extent to which evidence-based practices (EBPs)-treatments that have been empirically shown to be efficacious or effective-are integrated within routine practice is a well-documented challenge across numerous areas of health. In 2014, the National Institute on Drug Abuse funded a type 2 effectiveness-implementation hybrid trial titled the substance abuse treatment to HIV Care (SAT2HIV) Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI) for substance use as an adjunct to usual care within AIDS service organizations (ASOs) as part of its MIBI Experiment...
November 17, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/29149776/effect-of-nebulized-3-hypertonic-saline-with-salbutamol-on-management-of-acute-asthma-in-outpatient-adults-a-double-blind-randomized-clinical-trial-in-emergency-department
#17
Arash Forouzan, Kambiz Masoumi, Ali Delirrooyfard, Ali Asgari Darian, Laaya Mokhtar Gandomani
Asthma is one of the most common disorders of respiratory tract, management of which still remains as a serious health problem. This study aimed to compare the efficacy of 3% hypertonic saline (HS) plus salbutamol with solely salbutamol on management of acute adults' asthma based on peak flow meter findings. In this double-blind randomized clinical trial, 340 adult patients with acute asthma attacks admitted to emergency department of Ahvaz Golestan and Emam hospitals were enrolled during 2014-2015. The patients were allocated randomly to intervention group (nebulized 2...
October 2017: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/29149618/effectiveness-of-a-patient-centred-empowerment-based-intervention-programme-among-patients-with-poorly-controlled-type-2-diabetes-a-randomised-controlled-trial
#18
Li Cheng, Janet W H Sit, Kai-Chow Choi, Sek-Ying Chair, Xiaomei Li, Yuning Wu, Junhong Long, Meihua Tao
BACKGROUND: Despite extensive efforts and advances in evidence-based diabetes management, poor glycaemic control still remains a challenge in many countries. There is a paucity of research addressing the needs of patients with poorly controlled type 2 diabetes, or exploring the effectiveness of empowerment-based interventions in this vulnerable population. OBJECTIVES: To evaluate the effectiveness of a patient-centred, empowerment-based programme on glycaemic control and self-management behaviours among patients with poorly controlled type 2 diabetes...
November 3, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29149474/interventions-for-old-world-cutaneous-leishmaniasis
#19
REVIEW
Julio Heras-Mosteiro, Begoña Monge-Maillo, Mariona Pinart, Patricia Lopez Pereira, Emely Garcia-Carrasco, Pedro Campuzano Cuadrado, Ana Royuela, Irene Mendez Roman, Rogelio López-Vélez
BACKGROUND: Cutaneous leishmaniasis, caused by a parasitic infection, is considered one of the most serious skin diseases in many low- and middle-income countries. Old World cutaneous leishmaniasis (OWCL) is caused by species found in Africa, Asia, the Middle East, the Mediterranean, and India. The most commonly prescribed treatments are antimonials, but other drugs have been used with varying success. As OWCL tends to heal spontaneously, it is necessary to justify the use of systemic and topical treatments...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29149384/brain-metabolism-and-severe-pediatric-traumatic-brain-injury
#20
Heidi Griffiths, Manu S Goyal, Jose A Pineda
Age-dependent changes in brain metabolism may influence the response to and tolerance of secondary insults, potentially affecting outcomes. More complete characterization of brain metabolism across the clinical trajectory of severe pediatric TBI is needed to improve our ability to measure and better mitigate the impact of secondary insults. Better management of secondary insults will impact clinical care and the probability of success of future neuroprotective clinical trials. Improved bedside monitoring and imaging technologies will be required to achieve these goals...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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