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https://www.readbyqxmd.com/read/28936751/guidelines-versus-real-life-practice-the-case-of-colonoscopy-in-acromegaly
#1
M Parolin, F Dassie, L Russo, S Mazzocut, M Ferrata, E De Carlo, R Mioni, F Fallo, R Vettor, C Martini, P Maffei
PURPOSE: The aim of this study is to investigate guideline application and colonoscopy findings in real-life practice in acromegaly. METHODS: We conducted a retrospective observational non-interventional and cross-sectional analysis on 146 patients with acromegaly (ACRO) referred to our clinic. We evaluated colonoscopy data, focusing on the correlation between colonoscopy findings and hormonal/metabolic values. RESULTS: The total number of colonoscopies performed in ACRO patients increased from 6 in the period 1990-1994 to 57 in the period 2010-2014...
September 21, 2017: Pituitary
https://www.readbyqxmd.com/read/28936421/a-conceptual-framework-to-assess-effectiveness-in-wheelchair-provision
#2
Deepan C Kamaraj, Nathan Bray, Karen Rispin, Padmaja Kankipati, Jonathan Pearlman, Johan Borg
BACKGROUND: Currently, inadequate wheelchair provision has forced many people with disabilities to be trapped in a cycle of poverty and deprivation, limiting their ability to access education, work and social facilities. This issue is in part because of the lack of collaboration among various stakeholders who need to work together to design, manufacture and deliver such assistive mobility devices. This in turn has led to inadequate evidence about intervention effectiveness, disability prevalence and subsequent costeffectiveness that would help facilitate appropriate provision and support for people with disabilities...
2017: Afr J Disabil
https://www.readbyqxmd.com/read/28936150/prevalence-of-poor-glycemic-and-blood-pressure-control-and-pattern-of-drug-use-among-primary-health-care-outpatients-in-al-ahsa-saudi-arabia
#3
Promise M Emeka, Ahmed Al Mukalaf, Hussien Al Helal, Tahir M Khan, Mishial A Almukalf
OBJECTIVES: To assess drug use pattern and the effect on glycemic and blood pressure (BP) control in type 2 diabetes mellitus (T2DM) and hypertensive patients. Furthermore, to evaluate the duration of drug use and antecedence in diagnosis. METHODOLOGY: A cross-sectional study design, comprising interview/questionnaire targeting outpatients attending primary health centers in Al Ahsa was adopted. During the interview, their fasting blood glucose, weight, and height were measured, along with their BP...
July 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28935267/methylphenidate-doses-in-attention-deficit-hyperactivity-disorder-and-comorbid-substance-use-disorders
#4
Charlotte Skoglund, Lena Brandt, Brian D'Onofrio, Henrik Larsson, Johan Franck
Patients with Attention Deficit/Hyperactivity Disorder (ADHD) and comorbid Substance Use Disorders (SUD) are increasingly being treated with central stimulant medication despite limited evidence for its effectiveness. Lack of longitudinal follow-up studies of dosing and adverse effects has resulted in conflicting treatment guidelines. This study aims to explore whether individuals with ADHD and comorbid SUD are treated with higher stimulant doses than individuals with ADHD only, and whether doses increase over time as a sign of tolerance, a core symptom of addiction...
September 18, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28935163/optimising-the-diagnosis-of-prostate-cancer-in-the-era-of-multiparametric-magnetic-resonance-imaging-a-cost-effectiveness-analysis-based-on-the-prostate-mr-imaging-study-promis
#5
Rita Faria, Marta O Soares, Eldon Spackman, Hashim U Ahmed, Louise C Brown, Richard Kaplan, Mark Emberton, Mark J Sculpher
BACKGROUND: The current recommendation of using transrectal ultrasound-guided biopsy (TRUSB) to diagnose prostate cancer misses clinically significant (CS) cancers. More sensitive biopsies (eg, template prostate mapping biopsy [TPMB]) are too resource intensive for routine use, and there is little evidence on multiparametric magnetic resonance imaging (MPMRI). OBJECTIVE: To identify the most effective and cost-effective way of using these tests to detect CS prostate cancer...
September 18, 2017: European Urology
https://www.readbyqxmd.com/read/28934779/what-are-the-predictors-of-altered-central-pain-modulation-in-chronic-musculoskeletal-pain-populations-a-systematic-review
#6
Jacqui Clark, Jo Nijs, Gillian Yeowell, Peter Charles Goodwin
BACKGROUND: Altered central pain modulation is the predominant pain mechanism in a proportion of chronic musculoskeletal pain disorders and is associated with poor outcomes. Although existing studies predict poor outcomes such as persistent pain and disability, to date there is little consensus on what factors specifically predict altered central pain modulation. OBJECTIVES: To review the existing literature on the predictive factors specifically for altered central pain modulation in musculoskeletal pain populations...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28933789/trends-in-utilization-and-costs-of-brca-testing-among-women-aged-18-64-years-in-the-united-states-2003-2014
#7
Zhuo Chen, Katherine Kolor, Scott D Grosse, Juan L Rodriguez, Julie A Lynch, Ridgely Fisk Green, W David Dotson, M Scott Bowen, Muin J Khoury
PurposeWe examined 12-year trends in BRCA testing rates and costs in the context of clinical guidelines, national policies, and other factors.MethodsWe estimated trends in BRCA testing rates and costs from 2003 to 2014 for women aged 18-64 years using private claims data and publicly reported revenues from the primary BRCA testing provider.ResultsThe percentage of women with zero out-of-pocket payments for BRCA testing increased during 2013-2014, after 7 years of general decline, coinciding with a clarification of Affordable Care Act coverage of BRCA genetic testing...
September 21, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28933748/dietary-composition-independent-of-weight-loss-in-the-management-of-non-alcoholic-fatty-liver-disease
#8
REVIEW
Tannaz Eslamparast, Puneeta Tandon, Maitreyi Raman
Poor dietary composition is an important factor in the progression of non-alcoholic fatty liver disease (NAFLD). The majority of NAFLD patients follow diets with overconsumption of simple carbohydrates, total and saturated fat, with reduced intake of dietary fiber and omega-3 rich foods. Although lifestyle modifications including weight loss and exercise remain the keystone of NAFLD management, modifying dietary composition with or without a calorie-restricted diet may also be a feasible and sustainable strategy for NAFLD treatment...
July 26, 2017: Nutrients
https://www.readbyqxmd.com/read/28931440/core-outcomes-in-periodontal-trials-study-protocol-for-core-outcome-set-development
#9
Thomas J Lamont, Jan E Clarkson, David N J Ricketts, Peter A Heasman, Craig R Ramsay
BACKGROUND: There are a large number of clinical outcome measures used to assess the effectiveness of prevention and management strategies of periodontal diseases. This heterogeneity causes difficulties when trying to synthesise data for systematic reviews or clinical guidelines, reducing their impact. Core outcome sets are an agreed, standardised list of outcomes that should be measured and reported in all trials in specific clinical areas. We aim to develop a core outcome set for effectiveness trials investigating the prevention and management of periodontal disease in primary or secondary care...
September 20, 2017: Trials
https://www.readbyqxmd.com/read/28931399/principles-practices-and-knowledge-of-clinicians-when-assessing-febrile-children-a-qualitative-study-in-kenya
#10
Anneka M Hooft, Kelsey Ripp, Bryson Ndenga, Francis Mutuku, David Vu, Kimberly Baltzell, Linnet N Masese, John Vulule, Dunstan Mukoko, A Desiree LaBeaud
BACKGROUND: Clinicians in low resource settings in malaria endemic regions face many challenges in diagnosing and treating febrile illnesses in children. Given the change in WHO guidelines in 2010 that recommend malaria testing prior to treatment, clinicians are now required to expand the differential when malaria testing is negative. Prior studies have indicated that resource availability, need for additional training in differentiating non-malarial illnesses, and lack of understanding within the community of when to seek care play a role in effective diagnosis and treatment...
September 20, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28923493/diagnosis-and-quantification-of-the-iron-overload-through-magnetic-resonance
#11
J M Alústiza Echeverría, M C Barrera Portillo, A Guisasola Iñiguiz, A Ugarte Muño
There are different magnetic resonance techniques and models to quantify liver iron concentration. T2 relaxometry methods evaluate the iron concentration in the myocardium, and they are able to discriminate all the levels of iron overload in the liver. Signal intensity ratio methods saturate with high levels of liver overload and can not assess iron concentration in the myocardium but they are more accessible and are very standardized. This article reviews, in different clinical scenarios, when Magnetic Resonance must be used to assess iron overload in the liver and myocardium and analyzes the current challenges to optimize the aplication of the technique and to be it included in the clinical guidelines...
September 15, 2017: Radiología
https://www.readbyqxmd.com/read/28923476/evaluation-of-nutrition-support-practices-results-from-a-nationwide-survey
#12
Wajdy Abi Saleh, Pierre Bou Khalil, Krystel Ouaijan, Fayez Abillama, Sandra Akiki, Nehmat Ahmad, Lama Mattar
BACKGROUND: Multiple clinical guidelines are available to improve and standardize the delivery of nutrition support. However, recommendations are not being universally applied at the bedside due to challenges of resources and barriers of knowledge. Assessing the current level of nutrition support practice is the first step to understand the barriers and ultimately implement potential strategies to increase guideline adherence and promote quality nutrition support in hospitals. There are no published data concerning the practice of nutrition support in Lebanese hospitals...
September 7, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28922193/update-on-second-trimester-medical-abortion
#13
Klaira Lerma, Kate A Shaw
PURPOSE OF REVIEW: To review recent literature on second trimester abortion with medical methods. RECENT FINDINGS: Across studies published in the recent past, it is apparent that women prefer shorter procedures and procedure times. Several randomized controlled trials have confirmed adding mifepristone to the second trimester medication abortion regimen results in shorter abortion intervals from first misoprostol administration to complete fetal expulsion. A study of simultaneous administration of mifepristone and misoprostol yielded shorter mean 'total' abortion times, presenting several logistical advantages...
September 15, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28921533/dental-treatment-in-the-era-of-new-anti-thrombotic-agents
#14
REVIEW
Sharonit Sahar-Helft, Tali Chackartchi, David Polak, Mordechai Findler
BACKGROUND: In recent years, there have been dramatic changes in anti-thrombotic treatment as a result of new anti-thrombotic agents, as well as changes in the indications for their use. As a consequence, dentists are encountering larger numbers of patients who are undergoing anti-thrombotic treatment and who have increased risk for bleeding. The current paper aims to review the literature regarding up-to-date anti-thrombotic treatment and provide information regarding their implications on dentistry...
September 17, 2017: International Dental Journal
https://www.readbyqxmd.com/read/28920972/-a-phd-completed-prevention-and-treatment-of-peri-implant-diseases-cleaning-of-titanium-dental-implant-surfaces
#15
A Louropoulou
The effect of various instruments on titanium dental implant surfaces was evaluated. Furthermore, a clinical guideline was developed regarding the diagnosis, prevention and treatment of peri-implant diseases. Air abrasive devices appear to be the most suitable meachnical instruments to remove biofilm from implant surfaces. From the available chemotherapeutica, (citric)acid and hydrogen peroxide seem to have the best potential. Regular controls and meticulous maintenance from both the patients and dental care professionals are mandatory to avoid problems...
September 2017: Nederlands Tijdschrift Voor Tandheelkunde
https://www.readbyqxmd.com/read/28918869/clinical-guidelines-in-asthma-and-chronic-obstructive-pulmonary-disease-how-useful-are-they-in-clinical-practice
#16
Bernardino Alcázar-Navarrete, Francisca Castellano Miñán, Pedro J Romero Palacios
No abstract text is available yet for this article.
September 14, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28918786/-treatment-of-meniscal-pathology
#17
Martin Wyman Rathcke, Martin Lind, Morten Ilum Boesen, Nis Nissen, Anders Ploug Boesen, Bjarne Mygind-Klavsen, Per Hölmich
The menisci play a major role in knee function regarding joint movement, stability, load distribution and load transmission. Injuries to the menisci cause pain, and meniscal tears are a common reason for patient referral. In Denmark, partial meniscectomy increased significantly until 2010, and several studies have questioned the long-term effect of meniscectomy as an overall procedure. A Danish national clinical guideline on knee meniscal pathology was published in May 2016, and this article is a short summary of updated knowledge on meniscal pathology and relevant conclusions from the guideline...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918666/treatment-options-for-severe-traumatic-brain-injuries-in-children-current-therapies-challenges-and-future-prospects
#18
Lisa A DelSignore, Robert C Tasker
Severe traumatic brain injury (TBI) afflicts many children and adults worldwide, resulting in high rates of morbidity and mortality. Recent therapeutic advances have focused on both surgical and medical treatment options, but none have been proven to reduce overall morbidity and mortality in this population. Areas covered: Several emerging therapies are addressed that focus on treating related secondary injuries and other clinical sequelae post-TBI during the acute injury phase (defined by authors as up to four weeks post-injury)...
September 22, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28918555/prognostic-factors-for-mortality-in-middle-aged-and-older-hemodialysis-patients-a-5-year-observational-study
#19
Kojiro Nagai, Motokazu Matsuura, Kenji Tsuchida, Hiro-Omi Kanayama, Toshio Doi, Jun Minakuchi
Clinical guidelines for hemodialysis therapy have been described in an evidence-based manner with most evidence from randomized control trials or retrospective studies in which all generations of the hemodialysis patients were enrolled. Therefore, the question still remains whether these guidelines can be applied to increasing older patients. This study is an observational study, including 735 patients who received maintenance hemodialysis in April 2006. At baseline, the participants' age was 62.1 ± 12...
September 16, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28918178/using-imaging-to-predict-treatment-response-in-genitourinary-malignancies
#20
REVIEW
Amir H Lebastchi, Matthew J Watson, Christopher M Russell, Arvin K George, Alon Z Weizer, Baris Turkbey
CONTEXT: Over the previous2 decades, there have been numerous advancements in the diagnostic evaluation, therapeutic management, and postoperative assessment of genitourinary malignancies. OBJECTIVE: To present a review of current and novel imaging modalities and their utility in the assessment of therapeutic response in the systemic management of renal, testicular, and prostate cancers. EVIDENCE ACQUISITION: A PubMed/Medline search of the current published literature inclusive of prospective and retrospective original research, systematic reviews, and meta-analyses was conducted evaluating imaging modalities for renal cell carcinoma, prostate cancer, and testicular cancer...
September 13, 2017: European Urology Focus
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