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https://www.readbyqxmd.com/read/28806436/effectiveness-of-a-timing-and-coordination-group-exercise-program-to-improve-mobility-in-community-dwelling-older-adults-a-randomized-clinical-trial
#1
Jennifer S Brach, Subashan Perera, Sandra Gilmore, Jessie M VanSwearingen, Deborah Brodine, Neelesh K Nadkarni, Edmund Ricci
Importance: Timing and coordination exercises may be an important addition to community-based health promotion exercise programs to improve walking in older adults. Objective: To compare the effectiveness of the On the Move group exercise program, which focuses on the timing and coordination of movement, with a seated strength, endurance, and flexibility program (usual care) at improving function, disability, and walking ability of older adults. Design, Setting, and Participants: Cluster-randomized, single-blind intervention trial...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28798016/bayesian-analysis-a-practical-approach-to-interpret-clinical-trials-and-create-clinical-practice-guidelines
#2
John A Bittl, Yulei He
Bayesian analysis is firmly grounded in the science of probability and has been increasingly supplementing or replacing traditional approaches based on P values. In this review, we present gradually more complex examples, along with programming code and data sets, to show how Bayesian analysis takes evidence from randomized clinical trials to update what is already known about specific treatments in cardiovascular medicine. In the example of revascularization choices for diabetic patients who have multivessel coronary artery disease, we combine the results of the FREEDOM trial (Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease) with prior probability distributions to show how strongly we should believe in the new Class I recommendation ("should be done") for a preference of bypass surgery over percutaneous coronary intervention...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28775119/incidence-and-management-of-toxicity-associated-with-ibrutinib-and-idelalisib-a-practical-approach
#3
Iris de Weerdt, Suzanne M Koopmans, Arnon P Kater, Michel van Gelder
The use of novel B cell receptor signaling inhibitors results in high response rates and long progression-free survival in patients with indolent B cell malignancies, such as chronic lymphocytic leukemia, follicular lymphoma, mantle cell lymphoma and Waldenstroms macroglobulinemia. Ibrutinib, the first-in-class inhibitor or Bruton's tyrosine kinase, and idelalisib, the first-in-class inhibitor of phosphatidylinositol 3-kinase δ have recently been approved for several indolent B cell malignancies. These drugs especially foresee in previously unmet needs for patients with relapsed or refractory disease, high-risk cytogenetic or molecular abnormalities or with comorbidities...
August 3, 2017: Haematologica
https://www.readbyqxmd.com/read/28760223/clinical-profile-of-patients-with-type-2-diabetes-mellitus-treated-with-sodium-glucose-cotransporter-2-inhibitors-and-experience-in-real-world-clinical-practice-in-spain
#4
Gabriel Cuatrecasas, Fernando Goñi-Goicoechea
The main aim of the treatment of type 2 diabetes is overall control of cardiovascular risk factors. Almost 50% of patients with type 2 diabetes do not achieve glycaemic targets, and a much higher percentage do not achieve weight and blood pressure targets, despite the therapeutic arsenal that has appeared in the last decade for the treatment of this disease. In addition, antidiabetic secretatogues and insulin are associated with weight gain and an increased risk of hyperglycaemic episodes. Clinical practice guidelines recommend sodium-glucose cotransporter-2 inhibitors (SGLT2i) as an alternative in the same therapeutic step as the other options after initiation of metformin therapy...
November 2016: Medicina Clínica
https://www.readbyqxmd.com/read/28756383/relationship-between-initial-therapy-and-blood-pressure-control-for-high-risk-hypertension-patients-in-the-uk-a-retrospective-cohort-study-from-the-thin-general-practice-database
#5
Sharada Weir, Attila Juhasz, Jorge Puelles, Travis S Tierney
OBJECTIVE: To examine the UK practice patterns in treating newly diagnosed hypertension and to determine whether subgroups of high-risk patients are more or less likely to follow particular therapeutic protocols and to reach blood pressure goals. DESIGN: Retrospective cohort study. SETTING: This study examined adults in The Health Improvement Network (THIN) UK general practice medical records database who were initiated on medication for hypertension...
July 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28755595/predicting-diffuse-microbial-pollution-risk-across-catchments-the-performance-of-scimap-and-recommendations-for-future-development
#6
Kenneth D H Porter, Sim M Reaney, Richard S Quilliam, Chris Burgess, David M Oliver
Microbial pollution of surface waters in agricultural catchments can be a consequence of poor farm management practices, such as excessive stocking of livestock on vulnerable land or inappropriate handling of manures and slurries. Catchment interventions such as fencing of watercourses, streamside buffer strips and constructed wetlands have the potential to reduce faecal pollution of watercourses. However these interventions are expensive and occupy valuable productive land. There is, therefore, a requirement for tools to assist in the spatial targeting of such interventions to areas where they will have the biggest impact on water quality improvements whist occupying the minimal amount of productive land...
July 26, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28753964/the-limpopo-non-metropolitan-drinking-water-supplier-response-to-a-diagnostic-tool-for-technical-compliance
#7
Avhashoni D Nefale, Ilunga Kamika, Chikwelu L Obi, Maggy Nb Momba
Water services providers should supply water that is fit for human consumption, taking into account multi-barrier approaches and technical aspects such as design aspects, operation monitoring, final water quality compliance monitoring, plant monitoring practices, maintenance, and risk management practices. Against this background, this study focused on applying the diagnostic tool for technical compliance as well as assessing the compliance of water treatment plants with management norms. Six plants in the Vhembe District Municipality were selected; the Vondo, Malamulele, Mutshedzi, and Mutale plants (conventional), and the Dzingahe and Tshedza package plants...
July 19, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28719091/multimodal-analgesia-as-an-alternative-to-the-risks-of-opioid-monotherapy-in-surgical-pain-management
#8
John J Savarese, Norman G Tabler
Clinicians have long been aware of the danger of overreliance on opioids to manage acute pain, such as the pain accompanying surgery. The risk of adverse drug events is higher with opioids than with any other common class of drugs. Overreliance on opioids increases length of stay and hospital costs, while decreasing patient satisfaction. Opioids can lead to problems that continue well after discharge, including chronic pain, abuse and addiction, and even death. Increasingly, prescribed opioids have proved to lead to heroin addiction...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28706166/-development-and-effects-of-an-instructional-coaching-program-regarding-children-with-attention-deficit-hyperactivity-disorder-for-elementary-school-teachers
#9
Shin Jeong Park, Wan Ju Park
PURPOSE: The aim of this study was to identify the effects of a newly developed instructional coaching program regarding Attention Deficit Hyperactivity Disorder (ADHD) for teachers. METHODS: Seventy teachers participated in this study involving a nonequivalent control group and a pretest-posttest design. The instructional coaching program consisted of eight 60-minute sessions. The program was developed through a theoretical development program involving six steps...
June 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/28693407/patterns-of-drugs-prescribed-for-dental-outpatients-in-nigeria-findings-and-implications
#10
Joseph O Fadare, Kazeem A Oshikoya, Obitade S Obimakinde, Abayomi O Sijuade, Jide M Afolayan, Adeyinka A Adeleke, Brian Godman, Damilola O Ojumu
OBJECTIVES: There are concerns with inappropriate prescribing of medicines among dentists especially antimicrobials. It is more concerning if this increases resistance rates. This study aimed to address this by assessing patterns of drugs prescribed for outpatients attending a hospital dental clinic in Nigeria. The findings will be used to plan future interventions, particularly around antimicrobial prescribing, where there are concerns. METHODS AND MATERIALS: Medical records of patients attending the dental clinic of a leading teaching hospital in Nigeria were evaluated...
July 11, 2017: Acta Odontologica Scandinavica
https://www.readbyqxmd.com/read/28689924/a-national-framework-for-an-antimicrobial-resistance-surveillance-system-within-iranian-healthcare-facilities-towards-a-global-surveillance-system
#11
Reza Safdari, Marjan GhaziSaeedi, Hossein Masoumi-Asl, Peyman Rezaei-Hachesu, Kayvan Mirnia, Taha Samad-Soltani
OBJECTIVES: The threat of antimicrobial resistance (AMR) is growing rapidly, perhaps more dramatically in developing countries. A demand to monitor, surveil and predict AMR has prompted the design and implementation of AMR surveillance systems (AMRSSs) at all geographic levels, especially in the national context. This study reviewed AMRSSs in leading countries and organisations in order to customise a comprehensive framework for a national system in Iran. METHODS: The research was conducted in two phases: a review of the literature and comparative analysis; and a knowledge, attitude and practice study...
July 6, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28684957/practice-guideline-summary-sudden-unexpected-death-in-epilepsy-incidence-rates-and-risk-factors-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology-and-the-american-epilepsy-society
#12
Cynthia Harden, Torbjörn Tomson, David Gloss, Jeffrey Buchhalter, J Helen Cross, Elizabeth Donner, Jacqueline A French, Anthony Gil-Nagel, Dale C Hesdorffer, W Henry Smithson, Mark C Spitz, Thaddeus S Walczak, Josemir W Sander, Philippe Ryvlin
OBJECTIVE: To determine the incidence rates of sudden unexpected death in epilepsy (SUDEP) in different epilepsy populations and address the question of whether risk factors for SUDEP have been identified. METHODS: Systematic review of evidence; modified Grading Recommendations Assessment, Development and Evaluation process for developing conclusions; recommendations developed by consensus. RESULTS: Findings for incidence rates based on 12 Class I studies include the following: SUDEP risk in children with epilepsy (aged 0-17 years) is 0...
May 2017: Epilepsy Currents
https://www.readbyqxmd.com/read/28681320/vegetation-dynamics-in-bishrampur-collieries-of-northern-chhattisgarh-india-eco-restoration-and-management-perspectives
#13
A Kumar, M K Jhariya, D K Yadav, A Banerjee
Phytosociological study in and around reclaimed coal mine site is an essential requirement for judging restoration impact on a disturbed site. Various studies have been aimed towards assessing the impact of different restoration practices on coal mine wastelands. Plantation scheme in a scientific way is the most suitable approach in this context. During the present investigation, an effort have been made to assess the vegetation dynamics through structure, composition, diversity, and forest floor biomass analysis in and around Bishrampur collieries, Sarguja division, northern Chhattisgarh, India...
August 2017: Environmental Monitoring and Assessment
https://www.readbyqxmd.com/read/28678906/assessment-of-the-effectiveness-of-physical-activity-interventions-in-the-brazilian-unified-health-system
#14
Evelyn Helena Corgosinho Ribeiro, Leandro Martin Totaro Garcia, Emanuel Péricles Salvador, Evelyn Fabiana Costa, Douglas Roque Andrade, Maria do Rosario Dias de Oliveira Latorre, Alex Antonio Florindo
OBJECTIVE: To assess the effect of interventions on the levels of physical activity of healthy adults, users of the Brazilian Unified Health System and attended by the Family Health Strategy. METHODS: Non-randomized experimental study with 157 adults allocated in three groups: 1) physical exercise classes (n = 54), 2) health education (n = 54), 3) control (n = 49). The study lasted for18 months, with 12 months of interventions and six months of follow-up after intervention...
June 26, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28669831/epidemiology-of-antifungal-resistance-in-human-pathogenic-yeasts-current-viewpoint-and-practical-recommendations-for-management
#15
Dimitrios Farmakiotis, Dimitrios P Kontoyiannis
In this review, we describe the epidemiology and clinical significance of resistance in Candida spp. and other non-Cryptococcus yeasts. The rise in echinocandin resistance, azole resistance and cross-resistance to ≥2 antifungal classes (multi-drug resistance: MDR) has been a worrisome trend, mainly in US large tertiary and oncology centers, particularly as it relates to C. glabrata. C. kefyr is also a concern, as it can be resistant to echinocandins and polyenes, especially in patients with hematologic malignancies...
June 29, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28638244/cardiac-rehabilitation-for-patients-with-coronary-artery-disease-a-practical-guide-to-enhance-patient-outcomes-through-continuity-of-care
#16
Catherine Giuliano, Belinda J Parmenter, Michael K Baker, Braden L Mitchell, Andrew D Williams, Katie Lyndon, Tarryn Mair, Andrew Maiorana, Neil A Smart, Itamar Levinger
Coronary artery disease (CAD) is a leading cause of disease burden worldwide. Referral to cardiac rehabilitation (CR) is a class I recommendation for all patients with CAD based on findings that participation can reduce cardiovascular and all-cause mortality, as well as improve functional capacity and quality of life. However, programme uptake remains low, systematic progression through the traditional CR phases is often lacking, and communication between health care providers is frequently suboptimal, resulting in fragmented care...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28634218/high-quality-statin-trials-support-the-2013-acc-aha-cholesterol-guidelines-after-hope-3-the-multi-ethnic-study-of-atherosclerosis
#17
Martin B Mortensen, Matthew J Budoff, Dong Li, Khurram Nasir, Michael J Blaha, Veit Sandfort, Carlos J Rodriguez, Pamela Ouyang, Erling Falk
The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline on cholesterol treatment to prevent atherosclerotic cardiovascular disease (ASCVD) has been criticized for lowering the risk thresholds for primary prevention with statin therapy. Although the ≥ 7.5% (class I) and ≥ 5% (class IIa) 10-year ASCVD risk thresholds were identified as new indications for treatment by extrapolating results obtained in randomized controlled trials (RCT) of statin therapy, results from population-based European cohorts indicate that >30% of individuals eligible for statin therapy by class I recommendations do not have RCT data supporting statin efficacy...
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28632239/feasibility-of-mind-body-movement-programs-for-cancer-survivors
#18
Kristine K Browning, Jennifer Kue, Felisha Lyons, Janine Overcash
PURPOSE/OBJECTIVES: To evaluate mind-body movement exercise (MBME) classes (yoga, tai chi, and Qigong) for cancer survivors. 
. DESIGN: A single-group, repeated-measures design.
. SETTING: The Ohio State University Wexner Medical Center-Arthur G. James Cancer Hospital in Columbus.
. SAMPLE: 33 adult cancer survivors, with any cancer diagnosis, participating in MBME classes.
. METHODS: The researchers sought to examine feasibility of multiple data collection time points and data collection measures; acceptability; and changes to physical, emotional, and biometric measures over time, as a result of participation in MBME classes...
July 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28628660/systematic-review-of-emergency-medicine-clinical-practice-guidelines-implications-for-research-and-policy
#19
Arjun K Venkatesh, Dan Savage, Benjamin Sandefur, Kenneth R Bernard, Craig Rothenberg, Jeremiah D Schuur
INTRODUCTION: Over 25 years, emergency medicine in the United States has amassed a large evidence base that has been systematically assessed and interpreted through ACEP Clinical Policies. While not previously studied in emergency medicine, prior work has shown that nearly half of all recommendations in medical specialty practice guidelines may be based on limited or inconclusive evidence. We sought to describe the proportion of clinical practice guideline recommendations in Emergency Medicine that are based upon expert opinion and low level evidence...
2017: PloS One
https://www.readbyqxmd.com/read/28625315/cancer-de-l%C3%A2-ovaire-prise-en-charge-pluridisciplinaire-du-cancer-de-l%C3%A2-ovaire-en-premi%C3%A3-re-ligne-recommandations-saint-paul-de-vence-2016
#20
Jean-Marc Classe, Frédéric Guyon, Claire Falandry, Mojgan Devouassoux-Shisheboran, Frédéric Selle, Florence Joly
Recommendations for the clinical practice of Nice-Saint-Paul de Vence The treatment of advanced epithelial ovarian cancer is multidisciplinary involving surgical teams and surgery and medical oncology, experienced in the management of this disease, following published quality criteria. The strategy must be validated in multidisciplinary consultation meeting (RCP) before any treatment. The pre-therapeutic assessment includes the histological diagnosis, evaluation of the tumor extension (biological assessment, markers, imaging, laparoscopy), assessment of the general state (operability), in order to answer the question of feasibility of an initial optimal surgery...
May 2017: Bulletin du Cancer
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