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https://www.readbyqxmd.com/read/27905893/computational-prediction-of-multidisciplinary-team-decision-making-for-adjuvant-breast-cancer-drug-therapies-a-machine-learning-approach
#1
Frank P Y Lin, Adrian Pokorny, Christina Teng, Rachel Dear, Richard J Epstein
BACKGROUND: Multidisciplinary team (MDT) meetings are used to optimise expert decision-making about treatment options, but such expertise is not digitally transferable between centres. To help standardise medical decision-making, we developed a machine learning model designed to predict MDT decisions about adjuvant breast cancer treatments. METHODS: We analysed MDT decisions regarding adjuvant systemic therapy for 1065 breast cancer cases over eight years. Machine learning classifiers with and without bootstrap aggregation were correlated with MDT decisions (recommended, not recommended, or discussable) regarding adjuvant cytotoxic, endocrine and biologic/targeted therapies, then tested for predictability using stratified ten-fold cross-validations...
December 1, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27903560/commonly-prescribed-drugs-associate-with-cognitive-function-a-cross-sectional-study-in-uk-biobank
#2
Alejo J Nevado-Holgado, Chi-Hun Kim, Laura Winchester, John Gallacher, Simon Lovestone
OBJECTIVE: To investigate medications associated with cognitive function. DESIGN: Population-based cross-sectional cohort study. SETTING: UK Biobank. PARTICIPANTS: UK Biobank participants aged 37-73 years who completed cognitive tests at the baseline visit in 2006-2010. MAIN OUTCOME MEASURES: Cognitive test outcomes on verbal-numerical reasoning test (n=165 493), memory test (n=482 766) and reaction time test (n=496 813)...
November 30, 2016: BMJ Open
https://www.readbyqxmd.com/read/27903209/incidence-and-cost-of-stress-ulcer-prophylaxis-after-discharge-from-the-intensive-care-unit-a-retrospective-study
#3
Benedict Tan, Richard Norman, Ed Litton, Chloe Heath, David J Hawkins, Ravi Krishnamurthy, Ravikiran Sonawane, Matthew H Anstey
OBJECTIVE: To describe current patterns in initiation and cessation of proton pump inhibitors (PPIs) for stress ulcer prophylaxis (SUP) in intensive care units, and to assess the costs associated with inappropriate (non-evidence-based) SUP. DESIGN, SETTING AND PARTICIPANTS: Retrospective observational study in five ICUs in Western Australia. We assessed the medical records of consecutive patients admitted to the ICUs between September 2013 and January 2015. Patients aged < 18 years were excluded...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27901208/gastric-and-renal-effects-of-cox-2-selective-and-non-selective-nsaids-in-rats-receiving-low-dose-aspirin-therapy
#4
Marcella Goetz Moro, Paula Katherine Vargas Sanchez, Mayara Vitorino Gevert, Emeline Maria Baller, Ana Flávia Tostes, Ana Caroline Lupepsa, Sinvaldo Baglie, Gilson Cesar Nobre Franco
The consumption of low-dose aspirin (LDA) to prevent cardiovascular disease continues to increase worldwide. Consequently, the number of chronic LDA users seeking dental procedures that require complementary acute anti-inflammatory medication has also grown. Considering the lack of literature evaluating this interaction, we analyzed the gastric and renal effects caused by a selective COX-2 inhibitor (etoricoxib) and a non-selective COX-2 inhibitor (ibuprofen) nonsteroidal anti-inflammatory drug (NSAID) in rats receiving chronic LDA therapy...
November 28, 2016: Brazilian Oral Research
https://www.readbyqxmd.com/read/27898134/quality-pain-care-for-older-adults-in-an-era-of-suspicion-and-scrutiny
#5
Barbara St Marie, Paul Arnstein
In two decades, the pendulum has swung from focusing on the undertreatment of pain by prescribers who fail to use medically necessary opioid agents to an intense focus on overprescribing opioid medications and the harms they cause. Within these two extremes rests the older adult with pain and in need of safe and effective care. Today, health care providers are practicing in an era of scrutiny, with new guidelines and regulations superseding their compassion and clinical judgment about the best treatment options when older adults have pain across the care continuum...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27895598/pharmacotherapy-for-alcohol-use-disorders-physicians-perceptions-and-practices
#6
Caridad Ponce Martinez, Priyanka Vakkalanka, Nassima Ait-Daoud
BACKGROUND AND OBJECTIVES: Alcohol use disorders (AUDs) are an important cause of morbidity and mortality. Despite the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommendations that medications be considered for patients with alcohol dependence, the mainstay of treatment has been counseling. We designed a survey to assess the treatment practices of psychiatrists and family medicine (FM) physicians in an effort to identify barriers to the use of pharmacotherapy and develop strategies to increase physician knowledge and utilization of these medications...
2016: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/27893495/integration-of-eeg-into-psychiatric-practice-a-step-toward-precision-medicine-for-autism-spectrum-disorder
#7
Ronald J Swatzyna, Jay D Tarnow, Robert P Turner, Alexandra J Roark, Erin K MacInerney, Gerald P Kozlowski
INTRODUCTION: Data from an EEG is not commonly used by psychiatrists to plan treatment and medication. However, EEG abnormalities such as isolated epileptiform discharges (IEDs) are found to be more prevalent in psychiatric patients, particularly those diagnosed with Autism Spectrum Disorder (ASD). Most medications prescribed for ASD lower seizure threshold and increase side-effects. Therefore, it may be prudent to order an EEG for ASD cases, especially those categorized as refractory...
November 22, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27892443/medication-adherence-pattern-and-factors-affecting-adherence-in-helicobacter-pylori-eradication-therapy
#8
S Shakya Shrestha, M Bhandari, S R Thapa, R Shrestha, R Poudyal, B Purbey, R B Gurung
Background Helicobacter pylori (H. pylori) infection is the most common chronic bacterial infection worldwide affecting approximately half of the world's population. A number of screening tests as well as complex multi-drug therapies are available for the detection and treatment of H. pylori infection. However, the optimum eradication rates of H. pylori infection can only be achieved if adherence to drug therapy is higher. Therefore, it is of utmost importance to determine the factors leading to poor adherence to obtain successful treatment outcomes...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27892441/a-prospective-study-of-commonly-prescribed-drugs-in-the-management-of-neuropathic-pain-and-its-medication-adherence-pattern
#9
R Shrestha, P Silwal, N Basnet, S Shakya Shrestha, R Shrestha, B R Pokharel
Background Neuropathic pain is one of the common complains of patients visiting neurology and orthopedic departments in hospitals. Management of neuropathic pain is difficult and is often symptomatic rather than being curative. Adherence to medication is necessary for pain management to be effective. However, there are various factors related to patient, physician, drug regimen and other socio-economic affecting adherence. Objective To study commonly prescribed drugs in neuropathic pain management and the medication adherence pattern including its associated factors...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27888985/azathioprine-response-in-patients-with-fibrotic-connective-tissue-disease-associated-interstitial-lung-disease
#10
Justin M Oldham, Cathryn Lee, Eleanor Valenzi, Leah J Witt, Ayodeji Adegunsoye, Scully Hsu, Lena Chen, Steven Montner, Jonathan H Chung, Imre Noth, Rekha Vij, Mary E Strek
BACKGROUND: Azathioprine is a commonly prescribed therapy for connective tissue disease-associated interstitial lung disease (CTD-ILD). Combination therapy that included azathioprine was recently shown to increase the risk of death and hospitalization in patients with idiopathic pulmonary fibrosis. Whether azathioprine increases the risk of adverse outcomes in patients with fibrotic CTD-ILD, including those with CTD-associated usual interstitial pneumonia (UIP), remains unknown. METHODS: A retrospective cohort analysis was performed to determine the combined incidence rate of death, transplant and respiratory hospitalization associated with azathioprine exposure...
December 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27886040/malaria-knowledge-and-treatment-adherence-in-a-brazilian-amazon-community
#11
Taisa Guimarães de Souza, Annelita Almeida Oliveira Reiners, Rosemeiry Capriata de Souza Azevedo, Cor Jesus Fernandes Fontes, Rita Graziela Ferreira, Priscilla Uiara Do Carmo
INTRODUCTION: Malaria remains an important public health problem despite recent scientific breakthroughs regarding knowledge about malaria and treatment strategies. The objective of this study was to analyze malaria patients' knowledge about the disease, its treatment and prevention, linking it to drug treatment adherence. METHODOLOGY: A descriptive, cross-sectional, epidemiological survey study was conducted in the district of Três Fronteiras-MT. The study included 618 individuals who were interviewed and examined for Plasmodium infection...
November 24, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/27877025/medication-knowledge-of-patients-hospitalized-for-heart-failure-at-admission-and-after-discharge
#12
Florian Custodis, Franziska Rohlehr, Angelika Wachter, Michael Böhm, Martin Schulz, Ulrich Laufs
BACKGROUND: A substantial aspect of health literacy is the knowledge of prescribed medication. In chronic heart failure, incomplete intake of prescribed drugs (medication non-adherence) is inversely associated with clinical prognosis. Therefore, we assessed medication knowledge in a cohort of patients with decompensated heart failure at hospital admission and after discharge in a prospective, cross-sectional study. METHODS: One hundred and eleven patients presenting at the emergency department with acute decompensated heart failure were included (mean age 78...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27874998/factors-predictive-of-the-efficacy-of-bezafibrate-therapy-in-patients-with-primary-sclerosing-cholangitis
#13
Suguru Mizuno, Hiroyuki Isayama, Kenji Hirano, Takeo Watanabe, Naminatsu Takahara, Hirofumi Kogure, Saburo Matsubara, Yousuke Nakai, Minoru Tada, Kazuhiko Koike
AIM: Primary sclerosing cholangitis (PSC) is a rare cholestatic disease. We previously reported the effects of bezafibrate on elevated hepatobiliary enzyme levels in patients with this disease both retrospectively and prospectively. In this study, we assessed factors predictive of bezafibrate efficacy. METHODS: Twenty-five patients with PSC, who underwent bezafibrate therapy (400 mg per day) from November 2006 to June 2015, were evaluated. Treatment was judged as being effective if the levels of all of the hepatobiliary enzymes decreased after 12 weeks...
November 22, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/27873322/non-medical-prescribing-versus-medical-prescribing-for-acute-and-chronic-disease-management-in-primary-and-secondary-care
#14
REVIEW
Greg Weeks, Johnson George, Katie Maclure, Derek Stewart
BACKGROUND: A range of health workforce strategies are needed to address health service demands in low-, middle- and high-income countries. Non-medical prescribing involves nurses, pharmacists, allied health professionals, and physician assistants substituting for doctors in a prescribing role, and this is one approach to improve access to medicines. OBJECTIVES: To assess clinical, patient-reported, and resource use outcomes of non-medical prescribing for managing acute and chronic health conditions in primary and secondary care settings compared with medical prescribing (usual care)...
November 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27872568/weekly-iron-folic-acid-supplementation-plays-differential-role-in-maintaining-iron-markers-level-in-non-anaemic-and-anaemic-primigravida-a-randomized-controlled-study
#15
Hari Shankar, Neeta Kumar, Rajat Sandhir, Suneeta Mittal, Santosh Kurra, Lakhbir Dhaliwal, Gurjit Kaur, Nomita Chandhiok, B S Dhillon, D N Rao
: Anaemia during pregnancy is most commonly observed and highly prevalent in South-East Asia. Various effective programmes have been laid down for its management, mainly daily supplementation of iron folic acid (IFA) tablets. Following the same, standard obstetrical practice has included the IFA supplementation without requiring the determination of iron deficiency. In this study, a total of 120 primigravida (N = 60; non-anaemic (Hb > 11 g/dl) and N = 60 anaemic (Hb = 8-11 g/dl)) were selected among those attending the Antenatal Clinic in Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India...
November 2016: Saudi Journal of Biological Sciences
https://www.readbyqxmd.com/read/27871302/glycopyrrolate-in-comparison-to-hyoscine-hydrobromide-and-placebo-in-the-treatment-of-hypersalivation-induced-by-clozapine-gothic1-study-protocol-for-a-randomised-controlled-feasibility-study
#16
Inti Qurashi, Simon Chu, Nusrat Husain, Richard J Drake, Imran Chaudhry, J F W Deakin
BACKGROUND: Clozapine is the only medication licensed for the treatment of resistant schizophrenia in the UK. Although efficacious, a common and unpopular side effect of clozapine treatment is clozapine-induced hypersalivation (CIH), which can contribute to non-adherence. The standard treatment for CIH in the UK is hyoscine hydrobromide but this may aggravate cognitive deficits in patients with schizophrenia while glycopyrrolate may be an effective alternative with a more tolerable side effect profile...
November 21, 2016: Trials
https://www.readbyqxmd.com/read/27869390/-factors-related-to-treatment-adherence-in-patients-with-tuberculosis-in-pereira-colombia-2012-2013
#17
Magally Dueñes, Dora Cardona
INTRODUCTION: According to the World Health Organization, the adherence to the tuberculosis treatment is the extent to which a patient's medication taking coincides with the prescribed treatment. The sum of cured patients and those who have completed treatment (directly observed therapy strategy, DOTS) are pragmatic indicators of the adherence. The patients who do not complete treatment correspond to non-adherents. Objective: To determine the relationship between anti-tuberculosis treatment adherence and socio-demographic, economic, clinical, and drug-related objective and subjective factors in patients over 18 years of age...
September 1, 2016: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/27869327/the-selective-serotonin-re-uptake-inhibitor-fluoxetine-directly-inhibits-osteoblast-differentiation-and-mineralization-during-fracture-healing-in-mice
#18
V Bradaschia-Correa, A M Josephson, D Mehta, M Mizrahi, S S Neibart, C Liu, O D Kennedy, A B Castillo, K A Egol, P Leucht
Chronic use of selective serotonin re-uptake inhibitors (SSRI) for the treatment of depression has been linked to osteoporosis. In this study, we investigated the effect of chronic SSRI use on fracture healing in two murine models of bone regeneration. First, we performed a comprehensive analysis of endochondral bone healing in a femur fracture model. C57/BL6 mice treated with fluoxetine, the most commonly prescribed SSRI, developed a normal cartilaginous soft-callus at 14 days after fracture and demonstrated a significantly smaller and biomechanically weaker bony hard-callus at 28 days...
November 21, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/27867512/a-service-improvement-project-to-review-prescribing-information-provided-by-general-practitioners-for-new-referrals-to-a-uk-national-health-service-hospital-pain-clinic-potential-implications-of-cyp2d6-enzyme-inhibition
#19
Helen Radford, Pauline Fitzgerald, Stephen Martin, Mark I Johnson
INTRODUCTION: Chronic pain is often managed using co-prescription of analgesics and adjuvants, with concomitant medication prescribed for comorbidities. Patients may have suboptimal response to some analgesics or be at risk of drug interactions or adverse drug reactions (ADRs) due to polypharmacy affecting CYP2D6 enzyme activity. The aim of the service improvement project was to determine the proportion of patients referred to a specialist pain service in the UK National Health Service (NHS) by general practitioners (GPs) who may be at risk of suboptimal analgesic response or ADRs due to CYP2D6 inhibition through polypharmacy...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27855664/challenges-in-detecting-and-diagnosing-substance-use-in-women-in-the-acute-psychiatric-department-a-naturalistic-cohort-study
#20
Torill Vassli Sallaup, Arne Einar Vaaler, Valentina Cabral Iversen, Ismail Cuneyt Guzey
BACKGROUND: This study examines sex differences in substance use and substance use disorder in the acute psychiatric department, and possible interactions between sex and clinical and social factors associated with this phenomenon. METHODS: Data concerning substance use were collected in a naturalistic cohort study (n = 384, 51.6% male, 48.4% female) in an acute psychiatric department. Recent intake of substances at admission, diagnosis of substance use disorder and demographic and socioeconomic information were recorded...
November 17, 2016: BMC Psychiatry
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