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Stratified medicine

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https://www.readbyqxmd.com/read/28442293/effect-of-appropriate-combination-therapy-on-mortality-of-patients-with-bloodstream-infections-due-to-carbapenemase-producing-enterobacteriaceae-increment-a-retrospective-cohort-study
#1
Belén Gutiérrez-Gutiérrez, Elena Salamanca, Marina de Cueto, Po-Ren Hsueh, Pierluigi Viale, José Ramón Paño-Pardo, Mario Venditti, Mario Tumbarello, George Daikos, Rafael Cantón, Yohei Doi, Felipe Francisco Tuon, Ilias Karaiskos, Elena Pérez-Nadales, Mitchell J Schwaber, Özlem Kurt Azap, Maria Souli, Emmanuel Roilides, Spyros Pournaras, Murat Akova, Federico Pérez, Joaquín Bermejo, Antonio Oliver, Manel Almela, Warren Lowman, Benito Almirante, Robert A Bonomo, Yehuda Carmeli, David L Paterson, Alvaro Pascual, Jesús Rodríguez-Baño
BACKGROUND: The best available treatment against carbapenemase-producing Enterobacteriaceae (CPE) is unknown. The objective of this study was to investigate the effect of appropriate therapy and of appropriate combination therapy on mortality of patients with bloodstream infections (BSIs) due to CPE. METHODS: In this retrospective cohort study, we included patients with clinically significant monomicrobial BSIs due to CPE from the INCREMENT cohort, recruited from 26 tertiary hospitals in ten countries...
April 21, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28438380/the-role-of-muscle-strengthening-in-exercise-therapy-for-knee-osteoarthritis-a-systematic-review-and-meta-regression-analysis-of-randomized-trials
#2
REVIEW
Cecilie Bartholdy, Carsten Juhl, Robin Christensen, Hans Lund, Weiya Zhang, Marius Henriksen
OBJECTIVES: To analyze if exercise interventions for patients with knee osteoarthritis (OA) following the American College of Sports Medicine (ACSM) definition of muscle strength training differs from other types of exercise, and to analyze associations between changes in muscle strength, pain, and disability. METHODS: A systematic search in 5 electronic databases was performed to identify randomized controlled trials comparing exercise interventions with no intervention in knee OA, and reporting changes in muscle strength and in pain or disability assessed as standardized mean differences (SMD) with 95% confidence intervals (95% CI)...
March 18, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28435485/impact-of-health-policy-changes-on-emergency-medicine-in-maryland-stratified-by-socioeconomic-status
#3
Laura Pimentel, David Anderson, Bruce Golden, Edward Wasil, Fermin Barrueto, Jon M Hirshon
INTRODUCTION: On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD's Medicare waiver ushered in a Global Budget Revenue (GBR) structure for hospital reimbursement. Our objective was to analyze the impact of these policy changes on emergency department (ED) utilization, hospitalization practices, insurance profiles, and professional revenue...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435240/risk-of-pneumonia-with-budesonide-containing-treatments-in-copd-an-individual-patient-level-pooled-analysis-of-interventional-studies
#4
Sally Hollis, Carin Jorup, Dan Lythgoe, Gunnar Martensson, Pontus Regnell, Göran Eckerwall
BACKGROUND: Concerns have been raised that treatment of COPD with inhaled corticosteroids may increase pneumonia risk. Responding to a request from the European Medicines Agency Pharmacovigilance Risk Assessment Committee, a pooled analysis of interventional studies compared pneumonia risk with inhaled budesonide-containing versus non-budesonide-containing treatments and the impact of other clinically relevant factors. METHODS: AstraZeneca-sponsored, parallel-group, double-blind, randomized controlled trials meeting the following criteria were included: >8 weeks' duration; ≥60 patients with COPD; inhaled budesonide treatment arm (budesonide/formoterol or budesonide); and non-budesonide-containing comparator arm (formoterol or placebo)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28431457/precision-medicine-and-pharmacogenetics-what-does-oncology-have-that-addiction-medicine-does-not
#5
Henry R Kranzler, Rachel V Smith, Robert Schnoll, Afaf Moustafa, Emma Greenstreet-Akman
BACKGROUND AND AIMS: Precision, personalized or stratified medicine, which promises to deliver the right treatment to the right patient, is a topic of international interest in both the lay press and the scientific literature. A key aspect of precision medicine is the identification of biomarkers that predict the response to medications (i.e. pharmacogenetics). We examined why, despite the great strides that have been made in biomarker identification in many areas of medicine, only in oncology has there been substantial progress in their clinical implementation...
April 21, 2017: Addiction
https://www.readbyqxmd.com/read/28418191/evaluation-of-chinese-herbal-medicine-jinlida-in-type-2-diabetes-patients-based-on-stratification-results-of-subgroup-analysis-from-12-week-trial
#6
Jiaxing Tian, Fengmei Lian, Libo Yang, Xiaolin Tong
BACKGROUND: Previous study found that the Chinese Herbal Medicine Jinlida could significantly enhance the hypoglycemic action of metformin compared to metformin alone. However, the advantage of Jinlida has not been clarified yet. We aimed to compare the efficacy of Jinlida in patients with T2DM based on stratification. METHODS: Data were analyzed from a 12-week, randomized, placebo-controlled, double-blind, multicenter study of Jinlida. The efficacy evaluation included HbA1c, FPG and 2hPG levels stratified by baseline HbA1c, sex, age, BMI, and duration of DM diagnosis...
April 18, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28416025/healthcare-innovation-and-patent-law-s-pharmaceutical-privilege-is-there-a-pharmaceutical-privilege-and-if-so-should-we-remove-it
#7
Graham Dutfield
This article reviews current trends in patent claims regarding personalised, stratified and precision medicine. These trends are not particularly well understood by policymakers, even less by the public, and are quite recent. Consequently, their implications for the public interest have hardly been thought out. Some see personalised and other secondary drug patent claims as promoting better targeted treatment. Others are inclined to see them as \manifestations of 'evergreening' whereby companies are, in some cases quite cynically, trying to extend market monopolies in old products or creating new monopolies based on supposedly improved versions of such earlier drugs...
April 18, 2017: Health Economics, Policy, and Law
https://www.readbyqxmd.com/read/28412632/seed-dormancy-and-germination-of-the-medicinal-holoparasitic-plant-cistanche-deserticola-from-the-cold-desert-of-northwest-china
#8
Jia Wang, Jerry M Baskin, Carol C Baskin, Guofang Liu, Xuejun Yang, Zhenying Huang
Cistanche deserticola is a holoparasitic plant with high medicinal value that reproduces only by seeds. However, the requirements for seed dormancy break and germination of this species remain unclear. The freshly matured dust-like seeds consist of a water-permeable seed coat and an undifferentiated oval-shaped embryo embedded in endosperm. No fresh seeds germinated in water or a 10(-5) M fluridone solution at any incubation temperature within 60 days. Length of embryos in seeds incubated in warm- and cold-started stratification sequences had increased 10...
April 8, 2017: Plant Physiology and Biochemistry: PPB
https://www.readbyqxmd.com/read/28410982/ehr-based-phenotyping-bulk-learning-and-evaluation
#9
Po-Hsiang Chiu, George Hripcsak
In data-driven phenotyping, a core computational task is to identify medical concepts and their variations from sources of electronic health records (EHR) to stratify phenotypic cohorts. A conventional analytic framework for phenotyping largely uses a manual knowledge engineering approach or a supervised learning approach where clinical cases are represented by variables encompassing diagnoses, medicinal treatments and laboratory tests, among others. In such a framework, tasks associated with feature engineering and data annotation remain a tedious and expensive exercise, resulting in poor scalability...
April 11, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28410792/accuracy-of-pecarn-catch-and-chalice-head-injury-decision-rules-in-children-a-prospective-cohort-study
#10
Franz E Babl, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, Mary McCaskill, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Mark D Lyttle, Silvia Bressan, Susan Donath, Charlotte Molesworth, Kim Jachno, Brenton Ward, Amanda Williams, Amy Baylis, Louise Crowe, Ed Oakley, Stuart R Dalziel
BACKGROUND: Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. METHODS: In this prospective observational study, we included children and adolescents (aged <18 years) with head injuries of any severity who presented to the emergency departments of ten Australian and New Zealand hospitals. We assessed the diagnostic accuracy of PECARN (stratified into children aged <2 years and ≥2 years), CATCH, and CHALICE in predicting each rule-specific outcome measure (clinically important traumatic brain injury [TBI], need for neurological intervention, and clinically significant intracranial injury, respectively)...
April 11, 2017: Lancet
https://www.readbyqxmd.com/read/28403106/baseline-serum-albumin-and-other-common-clinical-markers-are-prognostic-factors-in-colorectal-carcinoma-a-retrospective-cohort-study
#11
Sagrario González-Trejo, José F Carrillo, D Darlene Carmona-Herrera, Patricia Baz-Gutiérrez, Roberto Herrera-Goepfert, Gloria Núñez, Francisco J Ochoa-Carrillo, Dolores Gallardo-Rincón, Vincenzo Aiello-Crocifoglio, Luis F Oñate-Ocaña
The aim of the present study was to define the prognostic role of baseline serum albumin (BSA) in colorectal cancer (CRC) across tumor-node-metastasis (TNM) stages and other well defined prognostic factors. Many prognostic models in medicine employ BSA to define or refine treatments in very specific settings; in CRC, BSA has been found to be a prognostic factor as well. A retrospective cohort study of consecutive patients with CRC demonstrated by biopsy, who attended a cancer center during a 7-year period. Multivariate analysis was utilized to define prognostic factors associated with overall survival (OS) employing the Cox model...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28397694/stratified-medicine-and-primary-biliary-cholangitis
#12
George F Mells, David E J Jones
No abstract text is available yet for this article.
May 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28397558/measurement-of-cough-aerodynamics-in-healthy-adults
#13
Aaron J Feinstein, Zhaoyan Zhang, Dinesh K Chhetri, Jennifer Long
IMPORTANCE: Cough is a critical human reflex and also among the most frequent symptoms in medicine. Despite the prevalence of disordered cough in laryngeal pathologies, comprehensive and quantitative evaluation of cough in these patients is lacking. OBJECTIVE: Herein we seek to establish normative values for cough aerodynamics to provide a population standard for reference in future studies. DESIGN, SETTING, AND PARTICIPANTS: Healthy subjects were recruited from an outpatient clinic to perform voluntary cough...
May 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28397459/assessment-of-the-link-between-xrcc1-arg399gln-polymorphism-and-breast-cancer-a-meta-analysis-in-a-single-ethnic-group
#14
Xin-Ping Chen, Hai-Feng Wen, Fan Zhang, Wei-Hua Xu, Zhi-Chao Ma, Sheng-Miao Fu
BACKGROUND: Although various individual studies have been conducted to determine the association between X-ray repair cross-complementing group 1 (XRCC1) Arg399Gln polymorphism and breast cancer, the results remain inconclusive. To assess the influence of XRCC1 Arg399Gln polymorphism on the risk of breast cancer, a metaanalysis was performed in a single ethnic group. METHODS: Eligible studies were identified via databases such as PubMed, Springer Link, Ovid, Chinese Wanfang Data Knowledge Service Platform, Chinese National Knowledge Infrastructure, and Chinese Biology Medicine, throughout February 2016...
April 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28390881/safe-selection-of-outpatient-joint-arthroplasty-patients-with-medical-risk-stratification-the-outpatient-arthroplasty-risk-assessment-score
#15
R Michael Meneghini, Mary Ziemba-Davis, Marshall K Ishmael, Alexander L Kuzma, Peter Caccavallo
BACKGROUND: Current patient selection criteria and medical risk stratification methods for outpatient primary total joint arthroplasty (TJA) surgery are unproven. This study assessed the predictive ability of a medically based risk assessment score in selecting patients for outpatient and short stay surgery. METHODS: A retrospective review of 1120 consecutive primary TJAs in an early discharge program was performed. An Outpatient Arthroplasty Risk Assessment ("OARA") score was developed by a high-volume arthroplasty surgeon and perioperative internal medicine specialist to stratify patients as "low-moderate risk (≤59)" and "not appropriate" (≥60) for early discharge...
March 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28390478/clinical-phenotypes-and-endophenotypes-of-atopic-dermatitis-where-are-we-and-where-should-we-go
#16
REVIEW
Thomas Bieber, Angelo M D'Erme, Cezmi A Akdis, Claudia Traidl-Hoffmann, Roger Lauener, Georg Schäppi, Peter Schmid-Grendelmeier
Atopic dermatitis (AD) is a paradigmatic chronic inflammatory skin disease characterized by a complex pathophysiology and a wide spectrum of the clinical phenotype. Despite this high degree of heterogeneity, AD is still considered a single disease and usually treated according to the "one-size-fits-all" approach. Thus more tailored prevention and therapeutic strategies are still lacking. As for other disciplines, such as oncology or rheumatology, we have to approach AD in a more differentiated way (ie, to dissect and stratify the complex clinical phenotype into more homogeneous subgroups based on the endophenotype [panel of biomarkers]) with the aim to refine the management of this condition...
April 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28386916/identification-of-factors-that-may-influence-the-selection-of-first-line-biologic-therapy-for-people-with-psoriasis-a-prospective-multi-centre-cohort-study
#17
N J Davison, R B Warren, K J Mason, K McElhone, B Kirby, A D Burden, C H Smith, K Payne, C E M Griffiths
BACKGROUND: The Psoriasis Stratification to Optimise Relevant Therapy (PSORT) consortium has a collective aim to develop a prescribing algorithm to help stratify eligible psoriasis patients to the most appropriate biologic treatment. To facilitate the adoption of a stratified approach, it is necessary to first understand the factors driving the choice of first-line biologic therapy. OBJECTIVES: To identify and quantify factors which influence the selection of the first-line biologic therapy for people with psoriasis...
April 7, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28382734/maternal-super-obesity-and-risk-for-intensive-care-unit-admission-in-the-mfmu-cesarean-registry
#18
Marcela C Smid, Sarah K Dotters-Katz, Arthur J Vaught, Catherine J Vladutiu, Kim A Boggess, David M Stamilio
INTRODUCTION: Obesity is risk factor for intensive care unit (ICU) admission in non-pregnant populations. Less is known about maternal obesity and ICU admission risk. The objective of this study was to estimate the association between maternal obesity and ICU admission among women who delivered via cesarean or vaginal birth after cesarean (VBAC). MATERIAL AND METHOD: This is a retrospective cohort analysis of women who delivered via VBAC or cesarean in the Maternal-Fetal Medicine Unit (MFMU) Cesarean Registry...
April 6, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28374869/non-surgical-management-of-chronic-rhinosinusitis-with-nasal-polyps-based-on-clinical-cytological-grading-a-precision-medicine-based-approach
#19
M Gelardi, L Iannuzzi, M De Giosa, S Taliente, N De Candia, N Quaranta, E De Corso, V Seccia, G Ciprandi
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disorder that strongly impacts patients' quality of life. CRSwNP is still a challenge for ENT specialists due to its unknown pathogenesis, difficult control and frequent relapse. We tested the hypothesis that a new standardised therapeutic approach based on individual clinical-cytological grading (CCG), may improve control of the disease and prevent the needing for surgery. We analysed 204 patients suffering from bilateral CRSwNP, 145 patients of whom regularly assumed therapy, respecting the planned check-up, and were considered cases; 59 patients were not assuming therapy as indicated and were considered as controls...
February 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28374304/septum-enhanced-mammaplasty-in-inferocentral-pedicled-breast-reduction-for-macromastia-and-gigantomastia-patients
#20
Aurelio Portincasa, Francesco Ciancio, Luigi Cagiano, Alessandro Innocenti, Domenico Parisi
BACKGROUND: Inferior pedicle and free nipple grafting are commonly used as breast reduction techniques for patients with breast hypertrophy and gigantomastia. Limitations of these techniques are, respectively, possible vascular compromise and total/partial necrosis of the nipple-areola complex (NAC). The authors describe the innovative inferocentral pedicled reduction mammaplasty (ICPBR) enhanced by preservation of Würinger's septum for severe hypertrophic breasts. MATERIALS AND METHODS: Among 287 breast reductions performed between January 2001 and 2015, 83 (28...
April 3, 2017: Aesthetic Plastic Surgery
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