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https://www.readbyqxmd.com/read/29777729/pharmacogenetic-tests-to-guide-drug-treatment-in-depression-comparison-of-the-available-testing-kits-and-clinical-trials
#1
REVIEW
Chiara Fabbri, Joseph Zohar, Alessandro Serretti
The empirical approach to drug choice and dosing in depression often results into inadequate response and side effects. Pharmacogenetic (PGx) testing appears a promising way to implement personalized treatments. A systematic review was performed to identify available PGx tests, compare the genes they include with clinical guidelines and drug labels, and assess the quality of published clinical studies. ~40 commercial PGx tests are available and potential benefits were estimated for nine of them by clinical studies...
May 16, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/29776758/using-preference-learning-for-detecting-inconsistencies-in-clinical-practice-guidelines-methods-and-application-to-antibiotherapy
#2
Rosy Tsopra, Jean-Baptiste Lamy, Karima Sedki
Clinical practice guidelines provide evidence-based recommendations. However, many problems are reported, such as contradictions and inconsistencies. For example, guidelines recommend sulfamethoxazole/trimethoprim in child sinusitis, but they also state that there is a high bacteria resistance in this context. In this paper, we propose a method for the semi-automatic detection of inconsistencies in guidelines using preference learning, and we apply this method to antibiotherapy in primary care. The preference model was learned from the recommendations and from a knowledge base describing the domain...
May 15, 2018: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29776419/introduction-of-national-guidelines-for-restrictive-blood-transfusion-threshold-for-hip-fracture-patients-a-consecutive-cohort-study-based-on-complete-follow-up-in-national-databases
#3
Bjarke Viberg, Per Hviid Gundtoft, Jesper Schønnemann, Lasse Pedersen, Lis Røhl Andersen, Kjell Titlestad, Carsten Fladmose Madsen, Jens Lauritsen, Søren Overgaard
BACKGROUND: Randomized controlled trials have demonstrated that a restrictive red blood cell (RBC) transfusion strategy lowers transfusion frequency without affecting mortality. However, the external validity of these trials has not been tested in a large cohort. The purpose was to estimate the effect of introducing a National Clinical Guideline (NCG) for a restrictive hemoglobin transfusion threshold on transfusion frequency and mortality in hip fracture patients > 65 years old...
May 18, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29776337/should-statin-guidelines-consider-patient-preferences-eliciting-preferences-of-benefit-and-harm-outcomes-of-statins-for-primary-prevention-of-cardiovascular-disease-in-the-sub-saharan-african-and-european-contexts
#4
Henock G Yebyo, Hélène E Aschmann, Tsung Yu, Milo A Puhan
BACKGROUND: Patient preferences are key parameters to evaluate benefit-harm balance of statins for primary prevention but they are not readily available to guideline developers and decision makers. Our study aimed to elicit patient preferences for benefit and harm outcomes related to use of statins for primary cardiovascular disease prevention and to examine how the preferences differ across economically and socio-culturally different environments. METHODS: We conducted preference-eliciting surveys using best-worst scaling designed with a balanced incomplete-block design (BIBD) on 13 statins-related outcomes on 220 people in Ethiopia and Switzerland...
May 18, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29773353/nurses-knowledge-and-attitudes-regarding-pediatric-pain-management-in-western-australia
#5
Deborah Peirce, Victoria Corkish, Margie Lane, Sally Wilson
Despite clinical guidelines, suboptimal pediatric pain management persists. A local audit found poor guideline compliance. Inadequate knowledge is a recognized barrier to the delivery of evidence-based care. The aim of the study was to investigate nurses' knowledge and attitudes regarding pain management at an Australian tertiary pediatric hospital. A cross-sectional, descriptive study using the Pediatric Pain Knowledge and Attitudes Questionnaire (Revised) was distributed to 590 nurses in an Australian pediatric hospital...
May 14, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29771618/differences-between-new-and-long-standing-us-gun-owners-results-from-a-national-survey
#6
Joseph Wertz, Deborah Azrael, David Hemenway, Susan Sorenson, Matthew Miller
OBJECTIVES: To quantify the proportion of current US gun owners who are new to owning firearms and compare new versus long-standing gun owners with respect to their firearms and firearm-related behaviors. METHODS: We performed a cross-sectional analysis of a nationally representative probability-based online survey conducted in 2015 in the United States. We defined new gun owners as current firearm owners who acquired all of their firearms within the past 5 years, but who lived in a home without a gun at some time over the past 5 years...
May 17, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29771251/-ebm-guidelines-protocols-knowledge-attitudes-and-utilization-in-the-era-of-law-on-professional-responsibility-and-safety-of-health-care
#7
Silvia Minozzi, Francesca Ruggiero, Matteo Capobussi, Marien González-Lorenzo, Micaela La Regina, Alessandro Squizzato, Lorenzo Moja, Francesco Orlandini
INTRODUCTION: <AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">The knowledge of principles and methods of Evidence Based Medicine (EBM) and the use of Clinical Practice Guidelines to inform clinical decisions are recognised as key instruments to improve the quality of care. In Italy the Parliament has revised the legal system that rules the responsibilities of health professionals and health care safety, prescribing health professionals to adhere to guidelines and good practice recommendations...
May 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29768161/-practical-aspects-of-anticoagulant-therapy-in-patients-with-atrial-fibrillation-and-arterial-hypertension
#8
Z D Kobalava, A A Shavarov
Atrial fibrillation (AF) represents the most frequent sustained cardiac arrhythmia, the prevalence of AF is 1-2 % in the general population and up to 6 % for population over 80 years. Arterial hypertension (AH) is the commonest background comorbidity in patients with AF. Patients with AF have 3-6‑fold increased risk of ischemic stroke in comparison to that in general population, additionally the presence of AH leads an 2-3‑fold increase in risk of subsequent stroke. Current clinical guidelines recommend long-time anticoagulant treatment for prevention of stroke and thromboembolic complications in majority of patients with confirmed AF...
2018: Kardiologiia
https://www.readbyqxmd.com/read/29765166/diagnosis-of-retrocochlear-lesions-with-emphasis-on-expansion-of-the-cerebellopontine-angle
#9
Bretislav Gal, Jan Rottenberg, Marta Pazourkova, Jiri Vanicek, Ermis Vogazianos
The correct diagnosis of CPA tumours is a relatively common issue in both neurological and ENT practice, the omission of which can have serious consequences for the patient. Properly set clinical guidelines and diagnostic protocols are key aspects of good clinical practice. In the case of CPA tumours, two options are available: the first is diagnosis with the help of an ABR as the primary tool for determining the group of patients with a possible tumour; the second is an MRI scan of the posterior cranial fossa...
April 17, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29765117/risk-of-poisoning-in-children-and-adolescents-with-adhd-a-systematic-review-and-meta-analysis
#10
Maite Ruiz-Goikoetxea, Samuele Cortese, Sara Magallón, Maite Aznárez-Sanado, Noelia Álvarez Zallo, Elkin O Luis, Pilar de Castro-Manglano, Cesar Soutullo, Gonzalo Arrondo
Poisoning, a subtype of physical injury, is an important hazard in children and youth. Individuals with ADHD may be at higher risk of poisoning. Here, we conducted a systematic review and meta-analysis to quantify this risk. Furthermore, since physical injuries, likely share causal mechanisms with those of poisoning, we compared the relative risk of poisoning and injuries pooling studies reporting both. As per our pre-registered protocol (PROSPERO ID CRD42017079911), we searched 114 databases through November 2017...
May 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29761156/viewpoint-and-practical-recommendations-from-a-movement-disorder-specialist-panel-on-objective-measurement-in-the-clinical-management-of-parkinson-s-disease
#11
REVIEW
Per Odin, K Ray Chaudhuri, Jens Volkmann, Angelo Antonini, Alexander Storch, Espen Dietrichs, Zvezdan Pirtošek, Tove Henriksen, Malcolm Horne, David Devos, Filip Bergquist
Motor aspects of Parkinson's disease, such as fluctuations and dyskinesia, can be reliably evaluated using a variety of "wearable" technologies, but practical guidance on objective measurement (OM) and the optimum use of these devices is lacking. Therefore, as a first step, a panel of movement disorder specialists met to provide guidance on how OM could be assessed and incorporated into clinical guidelines. A key aspect of the incorporation of OM into the management of Parkinson's disease (PD) is defining cutoff values that separate "controlled" from "uncontrolled" symptoms that can be modified by therapy and that relate to an outcome that is relevant to the person with PD (such as quality of life)...
2018: NPJ Parkinson's Disease
https://www.readbyqxmd.com/read/29758581/-managment-of-acute-low-back-pain-without-trauma-an-algorithm
#12
Carolin Melcher, Bernd Wegener, Volkmar Jansson, Wolf Mutschler, Karl-Georg Kanz, Christof Birkenmaier
BACKGROUND: Low back pain is a common problem for primary care providers, outpatient clinics and A&E departments. The predominant symptoms are those of so-called "unspecific back pain", but serious pathologies can be concealed by the clinical signs. Especially less experienced colleagues have problems in treating these patients, as - despite the multitude of recommendations and guidelines - there is no generally accepted algorithm. METHODS: After a literature search (Medline/Cochrane), 158 articles were selected from 15,000 papers and classified according to their level of evidence...
May 14, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29758578/-cf-lung-disease-a-german-s3-guideline-module-2-diagnostics-and-treatment-in-chronic-infection-with-pseudomonas-aeruginosa
#13
C Schwarz, B Schulte-Hubbert, J Bend, M Abele-Horn, I Baumann, W Bremer, F Brunsmann, D Dieninghoff, O Eickmeier, H Ellemunter, R Fischer, J Grosse-Onnebrink, J Hammermann, H Hebestreit, M Hogardt, C Hügel, M Hug, S Illing, A Jung, B Kahl, A Koitschev, R Mahlberg, J G Mainz, F Mattner, A Mehl, A Möller, C Muche-Borowski, T Nüßlein, M Puderbach, S Renner, E Rietschel, F C Ringshausen, S Schmidt, L Sedlacek, H Sitter, C Smaczny, B Tümmler, R Vonberg, M O Wielpütz, H Wilkens, B Wollschläger, J Zerlik, U Düesberg, S van Koningsbruggen-Rietschel
Cystic Fibrosis (CF) is the most common autosomal-recessive genetic disease affecting approximately 8000 people in Germany. The disease is caused by mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene leading to dysfunction of CFTR, a transmembrane chloride channel. This defect causes insufficient hydration of the epithelial lining fluid which leads to chronic inflammation of the airways. Recurrent infections of the airways as well as pulmonary exacerbations aggravate chronic inflammation, lead to pulmonary fibrosis and tissue destruction up to global respiratory insufficiency, which is responsible for the mortality in over 90 % of patients...
May 2018: Pneumologie
https://www.readbyqxmd.com/read/29756534/neurostimulant-prescribing-patterns-in-children-admitted-to-the-icu-after-traumatic-brain-injury
#14
Amanda Marie Morrison, Amy Houtrow, James Zullo, Patrick M Kochanek, Carol Vetterly, Ericka L Fink
Neurostimulant medications are commonly prescribed following traumatic brain injury (TBI) in adults; little is known about their use in children with TBI. Our objective was to analyze neurostimulant prescribing practices from 2005 to 2015 in children admitted to the intensive care unit (ICU) with TBI. We hypothesized that neurostimulant prescriptions have increased over time and are associated with older age and injury severity. A retrospective cohort study of patients aged 1 month to 18 years with an ICD-9-CM discharge diagnosis code for TBI admitted to the ICU between 2005 and 2015 in 37 pediatric hospitals included in the Pediatric Health Information System was conducted...
May 14, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29755298/addressing-female-genital-mutilation-cutting-fgm-c-in-the-era-of-clitoral-reconstruction-plastic-surgery
#15
REVIEW
Hannes Sigurjonsson, Malin Jordal
Purpose of the Review: The aim of this review is to give an overview of the recent evidence on clitoral reconstruction and other relevant reconstructive plastic surgery measures after female genital mutilation/cutting (FGM/C). Recent Findings: Recent publications present refinements and modifications of the surgical technique of clitoral reconstruction along with reconstruction of the labia majora and clitoral hood. Novel approaches with reposition of the clitoral nerve, anchoring of the labia majora, fat grafting, and full thickness mucosa grafts have been introduced...
2018: Current Sexual Health Reports
https://www.readbyqxmd.com/read/29755097/-expectation-for-surgery-in-multi-modality-treatment-in-non-small-cell-lung-cancer
#16
Kenji Sugio
Clinical N2-stageⅢA non-small cell lung cancer(NSCLC) is known to be quite heterogeneous. Many clinical trials proved the effect of postoperative adjuvant chemotherapy for locally advanced NSCLC, which is recommended as grade C1 by Clinical Guideline for Lung Cancer, however, induction treatment for clinical N2-stageⅢA remains still controversial. We showed retrospective data of concurrent chemoradiotherapy using S-1 and cisplatin followed by surgery, which may provide a better prognosis for locally advanced NSCLC patients...
April 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29753398/cardiovascular-risk-prediction-in-ckd
#17
REVIEW
Shoshana H Ballew, Kunihiro Matsushita
Cardiovascular disease is an important complication for patients with chronic kidney disease (CKD), warranting accurate risk prediction, but clinical guidelines are inconsistent regarding whether or how to use information on measures of CKD for predicting risk. Recent large meta-analyses have shown that key CKD measures (estimated glomerular filtration rate and albuminuria) improve cardiovascular risk prediction beyond traditional risk factors, especially when albuminuria is added to prediction models. In addition, several recent studies have shown that the use of filtration markers other than serum creatinine, cystatin C, and β2 -microglobulin can improve cardiovascular risk prediction...
May 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29752849/prognostic-impact-of-inter-hospital-variation-in-adjuvant-chemotherapy-for-stage-ii-iii-colorectal-cancer-patients-a-nationwide-study
#18
Keiichi Arakawa, Kazushige Kawai, Toshiaki Tanaka, Keisuke Hata, Kenichi Sugihara, Hiroaki Nozawa
AIM: Clinical guidelines recommend adjuvant chemotherapy for high-risk patients with stage II-III colorectal cancer. However, chemotherapeutic administration rates differ significantly between hospitals. We assessed the prognostic benefit of adjuvant chemotherapy in patients with stage IIb/c colorectal cancer, and the prognostic impact of inter-hospital variations in the administration of adjuvant chemotherapy for stage II-III colorectal cancer. METHOD: We conducted a multicenter, retrospective study of 17,757 stage II-III colorectal cancer patients, treated between 1997 and 2008 in 23 hospitals in Japan...
May 12, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29752833/understanding-diagnostic-safety-in-emergency-medicine-a-case-by-case-review-of-closed-ed-malpractice-claims
#19
Nancy Lemoine, Antonio Dajer, Joseph Konwinski, Dianne Cavanaugh, Catherine Besthoff, Hardeep Singh
The report Improving Diagnosis in Health Care calls for collaboration between professional liability insurance carriers and health care providers to identify opportunities to improve diagnostic performance. We used this collaborative approach and involved risk management/patient safety professionals and emergency medicine physician reviewers to analyze diagnosis-related emergency medicine closed claims from a large malpractice insurer. Our aim was to identify opportunities for risk reduction and to develop an approach for improving at-risk processes...
May 12, 2018: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/29752650/traumatic-knee-injury-correlation-of-radiographic-effusion-size-with-the-presence-of-internal-derangement-on-magnetic-resonance-imaging
#20
Nathan D Cecava, Shane Dieckman, Kevin P Banks, Liem T Mansfield
PURPOSE: Traumatic knee injury is a common clinical presentation. However, knee internal derangement often goes undiagnosed on physical exam. The authors hypothesize that patients with suprapatellar joint effusion greater than 10 mm anteroposterior diameter on lateral radiograph have a high likelihood of knee internal derangement on magnetic resonance imaging. MATERIALS AND METHODS: A retrospective review of knee radiographs and magnetic resonance imaging in 198 patients age 18-40 years with acute knee injury was performed...
May 8, 2018: Emergency Radiology
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