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https://www.readbyqxmd.com/read/28544750/unexpected-ethical-dilemmas-in-sex-assignment-in-46-xy-dsd-due-to-5-alpha-reductase-type-2-deficiency
#1
Heather M Byers, Lauren H Mohnach, Patricia Y Fechner, Ming Chen, Inas H Thomas, Linda A Ramsdell, Margarett Shnorhavorian, Elizabeth A McCauley, Anne-Marie E Amies Oelschlager, John M Park, David E Sandberg, Margaret P Adam, Catherine E Keegan
Sex assignment at birth remains one of the most clinically challenging and controversial topics in 46,XY disorders of sexual development (DSD). This is particularly challenging in deficiency of 5-alpha reductase type 2 given that external genitalia are typically undervirilized at birth but typically virilize at puberty to a variable degree. Historically, most individuals with 5-alpha reductase deficiency were raised females. However, reports that over half of patients who underwent a virilizing puberty adopted an adult male gender identity have challenged this practice...
May 25, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28544626/countering-evidence-denial-and-the-promotion-of-pseudoscience-in-autism-spectrum-disorder
#2
Isabel M Smith, Noni E MacDonald
This commentary introduces a framework within which clinical and research experts in autism spectrum disorder (ASD) can address public instances of evidence denial and promotion of pseudoscience related to ASD. This is a generalized extension of work by a World Health Organization (WHO) group dedicated to reducing the influence of Vocal Vaccine Deniers through educating advocates in how to effectively defuse their arguments. The WHO guidelines were informed by conceptual work on the "denialism" phenomenon, and by studies in psychology, communication, vaccine science, and public health...
May 22, 2017: Autism Research: Official Journal of the International Society for Autism Research
https://www.readbyqxmd.com/read/28544474/breast-cancer-and-transplantation
#3
Germaine Wong, Eric Au, Sunil V Badve, Wai H Lim
Breast cancer is an important cancer among solid organ transplant recipients. While the incidence of breast cancer in solid organ transplant recipients is comparable to the age matched general population, the outcomes are generally poor. Interventions such as cancer screening which preclude the development of late stage disease through early detection are not well-studied, and clinical practice guidelines for cancer screening rely solely on recommendations from the general population. Among those with a prior breast cancer history, disease recurrence after transplantation is a rare but fearful event...
May 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28544308/use-of-a-new-end-stage-kidney-disease-risk-calculator-in-the-kidney-disease-improving-global-outcomes-guideline-to-evaluate-the-impact-of-different-living-kidney-donor-candidate-assessments
#4
Darren Lee, Momena Manzoor, Geoff Harley, John Whitlam, Natasha Cook, Suet-Wan Choy, Megan Sandiford, Charlotte Gibson, Lawrence P McMahon, Matthew A Roberts
AIM: The Kidney Disease Improving Global Outcomes (KDIGO) guideline recommends the incorporation of a new risk calculator that quantifies the end stage kidney disease (ESKD) risk based on a composite profile of risk factors in living kidney donor candidates (LKDCs). We compared the ESKD risk estimates in previously declined versus accepted LKDCs to evaluate the predictive capacity and potential impact of this tool. METHODS: Baseline 15-year and lifetime ESKD risk estimates without donation were calculated using the risk calculator for LKDCs assessed from two centres between 2007 and 2015...
May 20, 2017: Nephrology
https://www.readbyqxmd.com/read/28544273/use-of-clinical-guidelines-in-remote-australia-a-realist-evaluation
#5
Sandeep Reddy, Victoria Orpin, Sally Herring, Stephanie Mackie-Schneider, Janet Struber
AIM: The aim of this evaluation was to assess the acceptability, accessibility, and compliance with the 2014 editions of the Remote Primary Health Care Manuals (RPHCM) in health care centres across remote areas of Northern and Central Australia. METHOD: To undertake a comprehensive evaluation that considered context, the evaluation used a realist evaluation framework. The evaluation used a variety of methods including interviews and survey to develop and test a programme theory...
May 24, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28544163/the-impact-of-clinical-practice-on-the-outcome-of-central-venous-access-devices-in-children-with-haemophilia
#6
K Khair, S Ranta, A Thomas, K Lindvall
INTRODUCTION: Central venous access devices facilitate home treatment in boys with haemophilia. These are usually fully implanted lines, referred to as ports. Caregivers are taught to manage the port using sterile techniques and maintaining patency by flushing with saline or heparin solution. National and international guidelines for the home care of ports are lacking. AIM: To evaluate if infection or occlusion rates differ between home care regimens used for ports in children with haemophilia...
May 24, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28544041/marked-variability-observed-in-inpatient-management-of-bronchiolitis-in-three-finnish-hospitals
#7
Varpu Elenius, Eija Bergroth, Petri Koponen, Sami Remes, Pedro A Piedra, Janice A Espinola, Matti Korppi, Carlos A Camargo, Tuomas Jartti
AIM: Infants hospitalised for bronchiolitis undergo examinations and treatments not supported by current research evidence and we investigated practice variations with regard to Finnish children under the age of two. METHODS: This prospective, multi-centre cohort study was conducted in paediatric units in three university hospitals in Finland from 2008-2010. Hospital medical records were reviewed to collect data on clinical course, testing and treatment. Data were analysed separately for children meeting our strict definition of bronchiolitis, aged under 12 months without a history of wheezing, and a loose definition, aged 12-23 months or with a history of wheezing...
May 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28543813/inhaled-pulmonary-vasodilator-therapy-for-management-of-right-ventricular-dysfunction-after-left-ventricular-assist-device-placement-and-cardiac-transplantation
#8
Leah A Sabato, David M Salerno, Jeremy D Moretz, Douglas L Jennings
Right ventricular failure (RVF) after cardiac transplant (CTX) or implantation of a continuous-flow left ventricular assist device (CF-LVAD) is associated with significant post-operative morbidity and mortality. A variety of modalities have been used to treat post-operative RVF, including management of volume status, intravenous inotropes and vasodilators, and right-sided mechanical support. Inhaled vasodilator agents are a unique treatment option aimed at minimizing systemic absorption by delivering therapy directly to the pulmonary vasculature...
May 24, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28543749/substance-use-disorders-in-prisoners-an-updated-systematic-review-and-meta-regression-analysis-in-recently-incarcerated-men-and-women
#9
REVIEW
Seena Fazel, Isabel A Yoon, Adrian J Hayes
AIMS: The aims were to (1) estimate the prevalence of alcohol and drug use disorders in prisoners on reception to prison, and (2) estimate and test sources of between study heterogeneity METHODS: Studies reporting the 12 month prevalence of alcohol and drug use disorders in prisoners on reception to prison from 1 January 1966 to 11 August 2015 were identified from 7 bibliographic indexes. Primary studies involving clinical interviews or validated instruments leading to DSM or ICD diagnoses were included; self-report surveys and investigations that assessed individuals more than 3 months after arrival to prison were not...
May 21, 2017: Addiction
https://www.readbyqxmd.com/read/28543735/the-repetition-of-behavioral-assessments-in-diagnosis-of-disorders-of-consciousness
#10
Sarah Wannez, Lizette Heine, Marie Thonnard, Olivia Gosseries, Steven Laureys
OBJECTIVE: To determine whether repeated examinations using the Coma Recovery Scale-Revised have an impact on diagnostic accuracy of patients with disorders of consciousness and to provide guidelines regarding the number of assessments required for obtaining a reliable diagnosis. METHODS: 123 adult patients with chronic disorders of consciousness were referred to our tertiary center. They were assessed at least 6 times with the Coma Recovery Scale-Revised within a 10-day period...
May 22, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28543408/validation-and-cross-cultural-adaptation-of-the-arabic-version-of-the-nasal-obstruction-symptom-evaluation-scale
#11
Mohamed A Amer, Ibrahim A Kabbash, Ahmed A Yonis, Saad Elzayat, Mohamed O Tomoum
OBJECTIVES/HYPOTHESIS: Validation and cross-cultural adaptation of the Nasal Obstruction Symptom Evaluation (NOSE) scale into the Arabic language with studying of its psychometric properties. STUDY DESIGN: Prospective instrument-validation study. METHODS: Guidelines for the cross-cultural adaptation process from the original English language scale into the Arabic language version were followed. We assessed the psychometric properties of the Arabic version of the NOSE scale (A-NOSE) (feasibility, reproducibility, internal consistency, reliability, discriminatory validity, responsiveness to change) in 101 consecutive patients who underwent septal surgery (preoperatively and 3 months postoperatively) and 102 asymptomatic controls...
May 23, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28543332/is-there-a-consensus-on-antibiotic-usage-for-dental-implant-placement-in-healthy-patients
#12
REVIEW
Joon Soo Park, Marc Tennant, Laurence J Walsh, Estie Kruger
OBJECTIVES: This systematic review aimed to determine whether there is consensus for antibiotic prescription in healthy patients undergoing implant placement. METHOD: A search of PubMed, Embase and Medline databases was conducted in January 2016 to find published journal articles on the use of antibiotics in implant placement, according to the PRISMA guidelines. The inclusion criteria were prospective human clinical trials investigating antibiotic usage during implant placement...
May 25, 2017: Australian Dental Journal
https://www.readbyqxmd.com/read/28543193/patterns-of-anaphylaxis-after-diagnostic-work-up-a-follow-up-study-of-226-patients-with-suspected-anaphylaxis
#13
Athamaica Ruiz Oropeza, Carsten Bindslev-Jensen, Sigurd Broesby-Olsen, Thomas Kristensen, Michael Boe Møller, Hanne Vestergaard, Henrik Fomsgaard Kjaer, Susanne Halken, Annmarie Lassen, Charlotte G Mortz
BACKGROUND: Most published studies on anaphylaxis are retrospective or register based. Data on subsequent diagnostic work-up are sparse. We aimed to characterize patients seen with suspected anaphylaxis at the emergency care setting (ECS), after subsequent diagnostic work-up at our Allergy Center (AC). METHODS: Prospective study including patients from the ECS, Odense University Hospital, during May 2013-April 2014. Possible anaphylaxis cases were daily identified based on a broad search profile including history and symptoms in patient records, diagnostic codes and pharmacological treatments...
May 19, 2017: Allergy
https://www.readbyqxmd.com/read/28543086/allergen-immunotherapy-for-allergic-asthma-a-systematic-review-and-meta-analysis
#14
REVIEW
Sangeeta Dhami, Artemisia Kakourou, Felix Asamoah, Ioana Agache, Susanne Lau, Jutel Marek, Antonella Muraro, Graham Roberts, Cezmi A Akdis, Matteo Bonini, Ozlem Cavkaytar, Breda Flood, Pawel Gajdanowicz, Kenji Izuhara, Ömer Kalayci, Ralph Mosges, Oscar Palomares, Oliver Pfaar, Sylwia Smolinska, Milena Sokolowska, Miqdad Asaria, Gopal Netuveli, Hader Zaman, Ather Akhlaq, Aziz Sheikh
BACKGROUND: To inform the development of the European Academy of Allergy and Clinical Immunonology's (EAACI) Guidelines on Allergen Immunotherapy (AIT) for allergic asthma, we assessed the evidence on the effectiveness, cost-effectiveness and safety of AIT. METHODS: We performed a systematic review, which involved searching nine databases. Studies were screened against pre-defined eligibility criteria and critically appraised using established instruments. Data were synthesized using random-effects meta-analyses...
May 19, 2017: Allergy
https://www.readbyqxmd.com/read/28542834/dentists-restorative-decision-making-and-implications-for-an-amalgamless-profession-part-5-knowledge-factors
#15
G Alexander, M S Hopcraft, M J Tyas, R H K Wong
BACKGROUND: A phase-down of amalgam in Australia is possible given the Australian Government intends to ratify the Minamata Convention. There is little research as to the influence of a dentist's knowledge on decision-making, which may be of use when determining the impact of any change. METHODS: An online survey relating to aspects of and attitudes to use of direct restorative materials was distributed to all dentists who were members of the Australian Dental Association or Members or Fellows of the Royal Australasian College of Dental Surgeons...
May 25, 2017: Australian Dental Journal
https://www.readbyqxmd.com/read/28542709/maternal-deaths-in-the-nordic-countries
#16
Siri Vangen, Birgit Bødker, Liv Ellingsen, Sissel Saltvedt, Mika Gissler, Reynir T Geirsson, Lill T Nyfløt
INTRODUCTION: Despite the seriousness of the event, maternal deaths are substantially underreported. There is often a missed opportunity to learn from such tragedies. The aim of the study was to identify maternal deaths in the five Nordic countries, to classify causes of death based on internationally acknowledged criteria, and to identify areas that would benefit from further teaching, training or research to possibly reduce the number of maternal deaths. MATERIAL AND METHODS: We present data for the years 2005-2013...
May 23, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28542671/folfoxiri-plus-bevacizumab-as-conversion-therapy-for-patients-with-initially-unresectable-metastatic-colorectal-cancer-a-systematic-review-and-pooled-analysis
#17
Gianluca Tomasello, Fausto Petrelli, Michele Ghidini, Alessandro Russo, Rodolfo Passalacqua, Sandro Barni
Importance: The combination of fluorouracil, oxaliplatin, and irinotecan plus bevacizumab (FOLFOXIRI-Bev) is an established and effective first-line chemotherapy regimen for metastatic colorectal cancer. However, resection rates of metastases and overall survival with this schedule have never been systematically evaluated in published studies including, but not limited to, the TRIBE (TRIplet plus BEvacizumab) trial. Objective: To assess the clinical efficacy of FOLFOXIRI-Bev, including outcomes and rates of surgical conversions...
May 25, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28542614/evaluation-of-the-sepsis-flow-chip-assay-for-the-diagnosis-of-blood-infections
#18
Antonio Galiana, Javier Coy, Adelina Gimeno, Noemi Marco Guzman, Francisco Rosales, Esperanza Merino, Gloria Royo, Juan Carlos Rodríguez
BACKGROUND: Blood infections are serious complex conditions that generally require rapid diagnosis and treatment. The big challenge is to reduce the time necessary to make a diagnosis with current clinical microbiological methods so as to improve the treatment given to patients. METHODS: In this study, we assess for the first time the Sepsis Flow Chip assay, which is a novel diagnostic assay for simultaneous rapid-detection of the vast majority of bloodstream pathogens, including Gram-positive and Gram-negative bacteria and fungi, in the same assay, and for the detection of most common antibiotic resistance genes...
2017: PloS One
https://www.readbyqxmd.com/read/28542330/quality-of-meta-analysis-in-nursing-fields-an-exploration-based-on-the-jbi-guidelines
#19
Yuying Hou, Jinhui Tian, Jun Zhang, Rongrong Yun, Zhigang Zhang, Kee-Hsin Chen, Caiyun Zhang, Bo Wang
BACKGROUND: Meta-analysis is often regarded as one of the best sources of evidence for clinical nurses due to its rigorous design and scientific reflection of the true results of nursing interventions. The quality of a meta-analysis is critical to the work of clinical decision-makers. Therefore, the objective of this study was to use the JBI guidelines to summarize the quality of RCT-based meta-analyses of reports published in domestic nursing professional journals, with a view to standardizing the research process and reporting methods...
2017: PloS One
https://www.readbyqxmd.com/read/28542286/clinical-impact-of-chronic-obstructive-pulmonary-disease-on-non-cystic-fibrosis-bronchiectasis-a-study-on-1-790-patients-from-the-spanish-bronchiectasis-historical-registry
#20
David De la Rosa, Miguel-Angel Martínez-Garcia, Rosa Maria Giron, Montserrat Vendrell, Casilda Olveira, Luis Borderias, Luis Maiz, Antoni Torres, Eva Martinez-Moragon, Olga Rajas, Francisco Casas, Rosa Cordovilla, Javier de Gracia
BACKGROUND: Few studies have evaluated the coexistence of bronchiectasis (BE) and chronic obstructive pulmonary disease (COPD) in series of patients diagnosed primarily with BE. The aim of this study was to analyse the characteristics of patients with BE associated with COPD included in the Spanish Bronchiectasis Historical Registry and compare them to the remaining patients with non-cystic fibrosis BE. METHODS: We conducted a multicentre observational study of historical cohorts, analysing the characteristics of 1,790 patients who had been included in the registry between 2002 and 2011...
2017: PloS One
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