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https://www.readbyqxmd.com/read/28331043/world-health-organization-treatment-guidelines-for-drug-resistant-tuberculosis-2016-update
#1
Dennis Falzon, Holger J Schünemann, Elizabeth Harausz, Licé González-Angulo, Christian Lienhardt, Ernesto Jaramillo, Karin Weyer
Antimicrobial resistance is a major global concern. Tuberculosis (TB) strains resistant to rifampicin and other TB medicines challenge patient survival and public health. The World Health Organization (WHO) has published treatment guidelines for drug-resistant TB since 1997 and last updated them in 2016 based on reviews of aggregated and individual patient data from published and unpublished studies. An international expert panel formulated recommendations following the GRADE approach. The new WHO guidelines recommend a standardised 9-12 months shorter treatment regimen as first choice in patients with multidrug- or rifampicin-resistant TB (MDR/RR-TB) strains not resistant to fluoroquinolones or second-line injectable agents; resistance to these two classes of core second-line medicines is rapidly detectable with molecular diagnostics also approved by WHO in 2016...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28330818/cardio-onco-hematology-in-clinical-practice-position-paper-and-recommendations
#2
Teresa López-Fernández, Ana Martín García, Ana Santaballa Beltrán, Ángel Montero Luis, Ramón García Sanz, Pilar Mazón Ramos, Sonia Velasco Del Castillo, Esteban López de Sá Areses, Manuel Barreiro-Pérez, Rocío Hinojar Baydes, Leopoldo Pérez de Isla, Silvia Cayetana Valbuena López, Regina Dalmau González-Gallarza, Francisco Calvo-Iglesias, Juan José González Ferrer, Antonio Castro Fernández, Eva González-Caballero, Cristina Mitroi, Meritxell Arenas, Juan Antonio Virizuela Echaburu, Pascual Marco Vera, Andrés Íñiguez Romo, José Luis Zamorano, Juan Carlos Plana Gómez, José Luis López Sendón Henchel
Improvements in early detection and treatment have markedly reduced cancer-related mortality. However survival not only depends on effectively cure cancer, but prevention, diagnosis and treatment of cancer-related complications is also needed. Cardiovascular toxicity is a widespread problem across many classes of therapeutic schemes, however scientific evidence in the management of cardiovascular complications of onco-hematological patients is scarce, as these patients have been systematically excluded from clinical trials and current recommendations are based on expert consensus...
March 18, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28326850/multimodal-analgesia-in-moderate-to-severe-pain-a-role-for-a-new-fixed-combination-of-dexketoprofen-and-tramadol
#3
Giustino Varrassi, Magdi Hanna, Giorgos Macheras, Antonio Montero, Antonio Montes Perez, Winfried Meissner, Serge Perrot, Carmelo Scarpignato
Untreated and undertreated pain represent one of the most pervasive health problems, which is worsening as the population ages and accrues risk for pain. Multiple treatment options are available, most of which have one mechanism of action, and cannot be prescribed at unlimited doses due to the ceiling of efficacy and/or safety concerns. Another limitation of single-agent analgesia is that, in general, pain is due to multiple causes. Combining drugs from different classes, with different and complementary mechanism(s) of action, provides a better opportunity for effective analgesia at reduced doses of individual agents...
March 22, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28320168/a-systematic-comparison-of-key-features-of-ischemic-stroke-prevention-guidelines-in-low-and-middle-income-vs-high-income-countries
#4
REVIEW
Hernán Bayona, Mayowa Owolabi, Wuwei Feng, Paul Olowoyo, Joseph Yaria, Rufus Akinyemi, James R Sawers, Bruce Ovbiagele
BACKGROUND AND PURPOSE: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. However, key quality characteristics of guidelines issued in LMICs compared with those in High-Income Countries (HICs) have not been systematically studied. We aimed to compare important features of stroke prevention guidelines issued in these groups...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28303514/euglycemic-ketosis-in-patients-with-type-2-diabetes-on-sglt2-inhibitor-therapy-an-emerging-problem-and-solutions-offered-by-diabetes-technology
#5
A Pfützner, D Klonoff, L Heinemann, N Ejskjaer, J Pickup
Diabetic ketoacidosis is an infrequent but life-threatening acute complication of diabetes, affecting predominantly patients with type 1 diabetes, children, and pregnant women, where ketosis is usually associated with marked hyperglycemia. Recently, an increasing number of cases have been reported of euglycemic diabetic ketoacidosis in patients with type 2 diabetes receiving sodium-glucose cotransporter 2 inhibitor treatment in routine practice. There is a minor, but not negligible diabetic ketoacidosis risk associated with this drug class, which was not seen in randomized clinical trials...
March 17, 2017: Endocrine
https://www.readbyqxmd.com/read/28302925/best-practices-to-prevent-transmission-and-control-outbreaks-of-hand-foot-and-mouth-disease-in-childcare-facilities-a-systematic-review
#6
REVIEW
J Hy Chan, C K Law, E Hamblion, H Fung, J Rudge
INTRODUCTION: Hand, foot, and mouth disease continues to cause seasonal epidemics in the Asia-Pacific Region. Since the current Enterovirus 71 vaccines do not provide cross-protection for all Enterovirus species that cause hand, foot, and mouth disease, there is an urgent need to identify appropriate detection tools and best practice to prevent its transmission and to effectively control its outbreaks. This systematic review aimed to identify characteristics of outbreak and assess the impact and effectiveness of detection tools and public health preventive measures to interrupt transmission...
March 17, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28298911/autoantibodies-against-the-n-methyl-d-aspartate-receptor-subunit-nr1-untangling-apparent-inconsistencies-for-clinical-practice
#7
REVIEW
Hannelore Ehrenreich
This viewpoint review provides an integrative picture of seemingly contradictory work published on N-methyl-d-aspartate receptor 1 (NMDAR1) autoantibodies (AB). Based on the present state of knowledge, it gives recommendations for the clinical decision process regarding immunosuppressive treatment. Brain antigen-directed AB in general and NMDAR1-AB in particular belong to a preexisting autoimmune repertoire of mammals including humans. Specific autoimmune reactive B cells may get repeatedly (perhaps transiently) boosted by various potential stimulants (e...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28294866/-treatment-of-patients-with-stable-ischemic-heart-disease-in-real-clinical-practice-in-russia-the-choice-2-program
#8
G Glezer M, On Behalf Of The Choice-Study Participants On Behalf Of The Choice-Study Participants
OBJECTIVE: in the framework of an open post-marketing observational national program CHOICE-2 to assess correspondence between recommendations for management of patients with stable angina and actual clinical practice, as well as to assess effect of treatment with cytoprotector trimetazidine on clinical course of the disease. MATERIAL AND METHODS: Participating physicians (n=185 from 46 regions of Russian Federation) recruited 896 patients with ischemic heart disease (IHD)...
May 2016: Kardiologiia
https://www.readbyqxmd.com/read/28293671/pilot-phase-evaluation-of-the-elective-general-practice-class-results-of-student-surveys-of-the-first-two-years
#9
Franziska-Antonia Samos, Marcus Heise, Stephan Fuchs, Susanne Mittmann, Alexander Bauer, Andreas Klement
Background: Primary health care in rural regions is currently undergoing a global crisis in respect of the next generation of practitioners. National and international recommendations advise placing greater emphasis upon practical skills and competences in medical studies. It is also in the interest of training the next generation to include mentoring and longitudinal integration of contact to teaching practices for general medicine in an early stage. Consequently, the General Practice Class (KAM) was introduced in Halle in 2011 as an elective with 20 individually mentored students per year, beginning with the first subject-related semester...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/28290795/-a-breakthrough-in-the-treatment-of-patients-with-heart-failure-with-reduced-ejection-fraction-the-clinical-significance-of-the-paradigm-hf-trial
#10
Zh D Kobalava, S V Villevalde, O I Lukina
The implementation into clinical practice of new therapeutic strategies that could improve the prognosis of patients with heart failure (HF) with reduced ejection fraction (HFrEF) remains relevant. Innovative approach is to restore imbalances of neurohumoral systems by inhibiting angiotensin II receptor and neprilysin. The review presents the role of the natriuretic peptides system in the HFrEF pathophysiology, historical approaches to neurohormonal modulation, clinical pharmacology of the first in the class of angiotensin receptor and neprilysin inhibitor sakubitril/valsartan...
February 2017: Kardiologiia
https://www.readbyqxmd.com/read/28287054/effects-and-feasibility-of-an-exercise-intervention-for-individuals-living-with-dementia-in-nursing-homes-study-protocol
#11
Lindsey Brett, Victoria Traynor, Paul Stapley, Shahla Meedya
BACKGROUND: Worldwide, there are an estimated 35.6 million individuals living with dementia. It is important that non-pharmacological therapies are utilized to help manage the symptoms of dementia, such as agitation, as they are the recommended first approach in best practice guidelines. METHODS: This protocol outlines a randomized controlled trial with a qualitative component which evaluated the effects and feasibility of a physical therapist-led physical exercise intervention on agitation of individuals living with dementia in nursing homes...
March 13, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28280892/antidepressant-pharmacotherapy-in-old-age-depression-a-review-and-clinical-approach
#12
REVIEW
Nathalie Pruckner, Vjera Holthoff-Detto
PURPOSE: Depression in old age is a disabling disease associated with functional and cognitive decline severely affecting quality of life. Studies specifically investigating antidepressant treatment for this special cohort of patients remain scarce and results are often conflicting. A narrative literature review was undertaken, synthesizing findings from published studies, systematic reviews, and treatment guidelines specifically conducted in elderly depressed patients to summarize implications and current recommendations as well as gaps in evidence for old-age pharmacologic treatment...
March 10, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28277828/cultivating-change-door-to-door-educational-outreach-to-improve-prescribing-practices-in-rural-veterans-with-ptsd
#13
Macgregor Montaño, Nancy C Bernardy, Kathleen Sherrieb
BACKGROUND: Clinical guidelines for the management of posttraumatic stress disorder (PTSD) recommend against the use of benzodiazepines. Benzodiazepines and PTSD are both associated with addiction-related risks. VA prescribing trends show continued use of benzodiazepines and polysedative use in veterans with PTSD, particularly in rural areas. The authors examine the use of an educational intervention to improve pharmacologic management of veterans with PTSD in rural clinics. METHODS: The VA Academic Detailing Service Informatics Toolset provides prescribing, demographic and risk factor data for veterans with PTSD treated at the White River Junction VA Medical Center (WRJ VA) and affiliated rural clinics in Vermont and New Hampshire...
March 9, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28267128/medical-adhesive-related-skin-injury-following-emergent-appendectomy-a-case-study-of-marsi-and-missed-opportunities-in-nursing-care
#14
Sylvia E Britt, Karen M Coles, Shannon S Polson
BACKGROUND: The potential for skin damage from adhesive products is documented in the literature. Nevertheless, health care providers continue to lack understanding of the impact and seriousness of skin injury associated with use of tapes or other adhesive devices when applied to a patient with a history or hypersensitivity or allergy to adhesives. CASE: A 67-year-old woman with a history of tape allergy underwent emergency appendectomy. Initial removal of an adhesive bandage placed over the surgical incision revealed medical adhesive-related skin injury (MARSI)...
March 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28244941/prenatal-breastfeeding-education-impact-on-infants-with-neonatal-abstinence-syndrome
#15
Kimberley Crook, Debra Brandon
BACKGROUND: Neonatal abstinence syndrome (NAS) is a growing problem in the United States, affecting 32,000 infants annually. Although breastfeeding would benefit infants with NAS, rates among these mothers are low. PURPOSE: The purpose of this quality improvement project was to increase breastfeeding rates and decrease hospital length of stay (LOS) for infants with NAS through prenatal breastfeeding initiatives. METHOD: A pre-/postquality improvement design was used to assess the relationship between breastfeeding initiatives on breastfeeding rates and LOS in infants with NAS...
February 27, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28237404/pharmacogenetics-in-cardiovascular-diseases-state-of-the-art-and-implementation-recommendations-of-the-french-national-network-of-pharmacogenetics-rnpgx
#16
Fabien Lamoureux, Thomas Duflot
The use of genomic markers to predict drug response and effectiveness has the potential to improve healthcare by increasing drug efficacy and minimizing adverse effects. Polymorphisms associated with inter-individual variability in drug metabolism, transport, or pharmacodynamics of major cardiovascular drugs have been identified. These include single nucleotide polymorphisms (SNP) affecting clinical outcomes in patients receiving antiplatelet agents, oral anticoagulants and statins. Based on clinical evidence supporting genetic testing in the management of cardiovascular diseases using these drug classes, this short review presents clinical guidance regarding current pharmacogenetics implementation in routine medical practice...
January 30, 2017: Thérapie
https://www.readbyqxmd.com/read/28237236/influenza-a-virus-in-swine-breeding-herds-combination-of-vaccination-and-biosecurity-practices-can-reduce-likelihood-of-endemic-piglet-reservoir
#17
L A White, M Torremorell, M E Craft
Recent modelling and empirical work on influenza A virus (IAV) suggests that piglets play an important role as an endemic reservoir. The objective of this study is to test intervention strategies aimed at reducing the incidence of IAV in piglets and ideally, preventing piglets from becoming exposed in the first place. These interventions include biosecurity measures, vaccination, and management options that swine producers may employ individually or jointly to control IAV in their herds. We have developed a stochastic Susceptible-Exposed-Infectious-Recovered-Vaccinated (SEIRV) model that reflects the spatial organization of a standard breeding herd and accounts for the different production classes of pigs therein...
March 1, 2017: Preventive Veterinary Medicine
https://www.readbyqxmd.com/read/28217600/primary-care-hypnotic-and-anxiolytic-prescription-reviewing-prescribing-practice-over-8-years
#18
Lloyd D Hughes, Neil Raitt, Muhammed Awais Riaz, Sarah-Jane Baldwin, Kay Erskine, Gail Graham
INTRODUCTION: Over the last few years, hypnotic and anxiolytic medications have had their clinical efficacy questioned in the context of concerns regarding dependence, tolerance alongside other adverse effects. It remains unclear how these concerns have impacted clinical prescribing practice. MATERIALS AND METHODS: This is a study reviewing community-dispensed prescribing data for patients on the East Practice Medical Center list in Arbroath, Scotland, in 2007, 2011 and 2015...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28213044/hepatocellular-carcinoma-screening-associated-with-early-tumor-detection-and-improved-survival-among-patients-with-cirrhosis-in-the-united-states
#19
Amit G Singal, Sahil Mittal, Olutola A Yerokun, Chul Ahn, Jorge Marrero, Adam Yopp, Neehar D Parikh, Steve J Scaglione
BACKGROUND: Professional societies recommend hepatocellular carcinoma screening in patients with cirrhosis but high-quality data evaluating its effectiveness to improve early tumor detection and survival in "real world" clinical practice are needed. AIMS: Characterize the association between hepatocellular carcinoma screening and early tumor detection, curative treatment, and overall survival among patients with cirrhosis. METHODS: We performed a retrospective cohort study of patients diagnosed with hepatocellular carcinoma between June 2012 and May 2013 at four health systems in the United States...
February 14, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28212146/multimodal-analgesia-for-acute-postoperative-and-trauma-related-pain
#20
Rosemary C Polomano, Mechele Fillman, Nicholas A Giordano, April Hazard Vallerand, Kelly L Wiltse Nicely, Carla R Jungquist
: Multimodal analgesia, which combines analgesic drugs from different classes and employs analgesic techniques that target different mechanisms of pain, is recommended in the treatment of acute postoperative and trauma-related pain because its synergistic effect maximizes pain relief at lower analgesic doses, thereby reducing the risk of adverse drug effects. Using a case-based approach, this article reviews various multimodal analgesic therapies used in the treatment of acute pain; discusses their benefits; and summarizes findings from related research, recommendations from evidence-based practice guidelines, and expert consensus reports...
March 2017: American Journal of Nursing
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