419,510 results match your criteria Physicians Practice [Journal]


Pros and cons of antithrombotic therapy in end-stage kidney disease: a 2019 update.

Nephrol Dial Transplant 2019 Mar 16. Epub 2019 Mar 16.

the Academy of Romanian Scientists (AOSR).

Dialysis patients manifest both an increased thrombotic risk and a haemorrhagic tendency. A great number of patients with chronic kidney disease requiring dialysis have cardiovascular comorbidities (coronary artery disease, atrial fibrillation or venous thromboembolism) and different indications for treatment with antithrombotics (primary or secondary prevention). Unfortunately, few randomized controlled trials deal with antiplatelet and/or anticoagulant therapy in dialysis. Read More

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http://dx.doi.org/10.1093/ndt/gfz040DOI Listing

The Impact of Raising the Bar for Clinical Trials in Ulcerative Colitis.

J Crohns Colitis 2019 Feb 14. Epub 2019 Feb 14.

University of Michigan, Ann Arbor, MI, USA.

In order to identify the practical implications for both health care practitioners and patients in understanding differences between the results of trials assessing therapies for ulcerative colitis [UC], we reviewed clinical trials of therapies for moderate to severe UC, with a focus on trial design. Over time, patient populations in UC trials have become more refractory, reflecting that patients are failing treatment with additional and different classes of drug, including conventional therapies, immunosuppressant drugs, and anti-tumour necrosis factor therapies. Outcomes used to measure efficacy have become increasingly stringent in order to meet the expectations of patients and physicians, and the requirements of regulatory bodies. Read More

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http://dx.doi.org/10.1093/ecco-jcc/jjz038DOI Listing
February 2019

Regional cortical thickness and neuroticism across the lifespan.

Psychiatry Res Neuroimaging 2019 Mar 7;286:39-44. Epub 2019 Mar 7.

Cognitive Neuroscience Division, Department of Neurology and the Taub Institute, Columbia University College of Physicians and Surgeons, 630 W 168th Street, New York, NY 10032, USA. Electronic address:

Neuroticism is associated with greater reactivity to stress and lifetime psychopathology. In the present study we examined the association between neuroticism and regional and total cortical thickness (CT) across the lifespan, accounting for gender. We also assessed interactions among these factors. Read More

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http://dx.doi.org/10.1016/j.pscychresns.2019.03.005DOI Listing

Workplace Harassment and Discrimination in Gynecology: Results of the AAGL Member Survey.

J Minim Invasive Gynecol 2019 Mar 13. Epub 2019 Mar 13.

Levine Cancer Institute at Atrium Health, Charlotte, NC.

Study Objective: To characterize workplace and sexual harassment and discrimination among physicians in gynecology.

Design: A beta-tested internet survey was distributed by email using the REDCap platform. All responses were anonymous. Read More

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http://dx.doi.org/10.1016/j.jmig.2019.03.004DOI Listing

Patient choice and provider competition - Quality enhancing drivers in primary care?

Soc Sci Med 2019 Jan 29;226:217-224. Epub 2019 Jan 29.

Health Services Research, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.

Patient choice of provider and provider competition have been introduced with the claim that they would lead to improved quality. For this to occur, certain conditions must be fulfilled on both the demand and the supply side. However, supply side-mechanisms - with provider behaviour as central - have been largely neglected in the literature, especially in primary care markets. Read More

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http://dx.doi.org/10.1016/j.socscimed.2019.01.042DOI Listing
January 2019

America's Health Care System is Broken: What Went Wrong and How We Can Fix It. Part 2: Health Insurance.

Authors:
Edward P Hoffer

Am J Med 2019 Mar 13. Epub 2019 Mar 13.

Laboratory of Computer Science, Massachusetts General Hospital, 50 Staniford Street, Suite 750, Boston, MA 02114.

Unlike most western democracies, health insurance in the United States is provided by a haphazard mix of employer-based plans, Medicare for those over 65 or on social security disability or chronic renal failure, Medicaid under varying state-dependent rules for some low-income recipients and no insurance for tens of millions. Administrative costs, which include both the direct costs of the insurers and the indirect costs imposed on physicians and hospitals, make up nearly 25% of our bloated national health care expenditures. This high cost adds no proven value to health care outcomes. Read More

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http://dx.doi.org/10.1016/j.amjmed.2019.02.039DOI Listing

Personality traits and personal values as retail pharmacy choice predictors in the context of pharmaceutical care requirements.

Res Social Adm Pharm 2019 Mar 8. Epub 2019 Mar 8.

Faculty of Health Sciences, Medical University in Lublin, Chodźki St. 1, 20-093, Lublin, Poland. Electronic address:

Background: Pharmacists implementing and carrying out Pharmaceutical Care (PhC) need to possess interpersonal ("soft") competencies, similar to physicians, as well as the personality predisposition necessary to maintain effective interpersonal communication involved in a therapeutic relationship. This thesis agrees with John L. Holland's congruence theory according to which the decision to take up a given profession is a specific expression of personality. Read More

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http://dx.doi.org/10.1016/j.sapharm.2019.03.001DOI Listing

Phenibut exposures and clinical effects reported to a regional poison center.

Am J Emerg Med 2019 Mar 9. Epub 2019 Mar 9.

Minnesota Poison Control Center, Minneapolis, MN, United States of America; Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, United States of America.

Background: Phenibut is a synthetically produced central nervous system (CNS) depressant that is structurally similar to the inhibitory neurotransmitter γ-aminobutyric acid (GABA). Phenibut has been identified as a drug of abuse with numerous clinical effects in overdose and a withdrawal syndrome with chronic use. The purpose of this study is to report the incidence of exposure calls regarding phenibut to a poison center, describe the reasons for its use and clinical effects. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.02.044DOI Listing

FOLFOX and FOLFIRI Use in Stage IV Colon Cancer: Analysis of SEER-Medicare Data.

Clin Colorectal Cancer 2019 Jan 31. Epub 2019 Jan 31.

Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY; Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.

Background: Shortly after the year 2000, randomized trials demonstrated that patients with metastatic colon cancer treated with infusional 5-fluorouracil (5-FU)/leucovorin with either oxaliplatin (FOLFOX) or irinotecan (FOLFIRI) had a comparable progression-free survival benefit, superior to patients who received 5-FU/leucovorin alone. Factors associated with the initial receipt of the FOLFOX or FOLFIRI regimen are unknown. Our goal was to investigate the patterns and predictors of use for first-line FOLFOX and FOLFIRI. Read More

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http://dx.doi.org/10.1016/j.clcc.2019.01.005DOI Listing
January 2019

[Early diagnosis of a rare disease in children through better communication between parents, physicians and academic centers].

Z Evid Fortbild Qual Gesundhwes 2019 Mar 13. Epub 2019 Mar 13.

Institut und Poliklinik für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.

The correct and early diagnosis of a rare disease in children is of particular importance in regard to the frequently fateful consequences for young families. Even well-known rare diseases are diagnosed with unacceptable delay in many countries. After decades of studying medical histories with delayed diagnoses and the respective literature, we describe the often severe aftereffects of a late diagnosis. Read More

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http://dx.doi.org/10.1016/j.zefq.2019.02.008DOI Listing

Routine monitoring for heparin-induced thrombocytopenia following lower limb arthroplasty: Is it necessary? A prospective study in a UK district general hospital.

Orthop Traumatol Surg Res 2019 Mar 13. Epub 2019 Mar 13.

York Hospital NHS Foundation Trust, Wiggington Road, York, YO31 8HE, United Kingdom.

Introduction: Heparin-induced thrombocytopenia (HIT) is a potentially life-threatening condition associated with heparin administration. Many orthopaedic units routinely prescribe low-molecular-weight heparins as thromboprophylaxis after hip and knee arthroplasty.

Hypothesis: We postulated that routine platelet monitoring following heparin administration is of no clinical benefit. Read More

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http://dx.doi.org/10.1016/j.otsr.2018.12.012DOI Listing

Transmission of CMV, HTLV-1, and HIV through breastmilk.

Lancet Child Adolesc Health 2019 Apr;3(4):264-273

Pathogenesis and Control of Chronic Infection, INSERM, University Montpellier, Etablissement Français du Sang, CHU de Montpellier, Montpellier, France.

Breastfeeding is a crucial child survival intervention. However, the potential for transmission of viral infections from mother to child presents the dilemma of how best to interpret the benefits and risks of breastfeeding in different settings. In this Review, we compare the transmission dynamics, risk factors, and outcomes of infection with three chronic viruses transmitted through breastmilk: cytomegalovirus, human T-cell lymphotropic virus type 1, and HIV. Read More

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http://dx.doi.org/10.1016/S2352-4642(19)30024-0DOI Listing

Experienced physician descriptions of intuition in clinical reasoning: a typology.

Diagnosis (Berl) 2019 Mar 16. Epub 2019 Mar 16.

Sociology PhD Program, McMaster University, Hamilton, ON, Canada.

Background Diagnostic intuition is a rapid, non-analytic, unconscious mode of reasoning. A small body of evidence points to the ubiquity of intuition, and its usefulness in generating diagnostic hypotheses and ascertaining severity of illness. Little is known about how experienced physicians understand this phenomenon, and how they work with it in clinical practice. Read More

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http://dx.doi.org/10.1515/dx-2018-0069DOI Listing

Contraception, Venous Thromboembolism, and Inflammatory Bowel Disease: What Clinicians (and Patients) Should Know.

Inflamm Bowel Dis 2019 Mar 16. Epub 2019 Mar 16.

Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts.

The peak incidence of the inflammatory bowel diseases (IBDs) is between the second and fourth decades of life, which coincides with prime reproductive years. Unplanned or mistimed pregnancies may account for nearly half of all pregnancies and are associated with adverse consequences such as a higher risk of delayed preconceptual care, increased risk of preterm birth, low birth weight, and adverse maternal and neonatal outcomes. Increased IBD activity during pregnancy is also associated with adverse pregnancy-related outcomes, such as miscarriage, intrauterine growth retardation, and preterm birth. Read More

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http://dx.doi.org/10.1093/ibd/izz025DOI Listing

Antiretroviral adherence, elevated viral load and drug resistant mutations in HIV-infected women initiating treatment in pregnancy: a nested case-control study.

Clin Infect Dis 2019 Mar 16. Epub 2019 Mar 16.

Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, USA.

Background: Elevated viral load (VL) early after antiretroviral therapy (ART) initiation appears frequently in pregnant and postpartum women living with HIV, however the relative contributions of pre-ART drug-resistant mutations (DRM) versus non-adherence in the aetiology of elevated VL are unknown.

Methods: Within a cohort of women initiating ART during pregnancy in Cape Town, South Africa, we compared women with elevated VL after initial suppression (cases, n=80) incidence-density matched to women who maintained suppression over time (controls, n=87). Groups were compared on pre-ART DRM and detection of antiretrovirals in stored plasma. Read More

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http://dx.doi.org/10.1093/cid/ciz209DOI Listing

[Which Proportion of Prescriptions in Germany is Evidence Based?]

Gesundheitswesen 2019 Mar 15. Epub 2019 Mar 15.

Allgemeinmedizin, Präventive und Rehabilitative Medizin, Philipps-Universität Marburg Fachbereich Medizin, Marburg.

Background: The provision of healthcare has to take into consideration evidence-based results from valid and relevant studies; this principle is included in German social laws. The prescribing assessment scheme (PAS) of the German National Association of Statutory Health Insurance Physicians contains a systematic appraisal of the benefit of drugs on the basis of their clinical evidence, their safety, and indications for their prescription.

Methods: We analysed nationwide prescription data of physicians that have contractual relationships with statutory health insurance funds in 2014. Read More

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http://dx.doi.org/10.1055/a-0842-6689DOI Listing

Pharmacology of Nutraceuticals with Lipid Lowering Properties.

High Blood Press Cardiovasc Prev 2019 Mar 15. Epub 2019 Mar 15.

Department of Molecular Medicine, University of Padova, Padua, Italy.

Lowering total and, in particular, LDL cholesterol reduces cardiovascular risk and clinical events. Cholesterol-lowering strategies are manifold. Better diets and positive lifestyle changes are the foremost approach; the use of functional foods, of food supplements/nutraceuticals, and pharmacological treatment must be considered in patients with increasing lipid abnormalities and or increasing cardiovascular risk. Read More

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http://dx.doi.org/10.1007/s40292-019-00311-xDOI Listing

Multiview Contouring for Breast Tumor on Magnetic Resonance Imaging.

J Digit Imaging 2019 Mar 15. Epub 2019 Mar 15.

Department of Computer Science, Tunghai University, Taichung, Taiwan.

The shape and contour of the lesion are shown to be effective features for physicians to identify breast tumor as benign or malignant. The region of the lesion is usually manually created by the physician according to their clinical experience; therefore, contouring tumors on breast magnetic resonance imaging (MRI) is difficult and time-consuming. For this purpose, an automatic contouring method for breast tumors was developed for less burden in the analysis and to decrease the observed bias to help in making decisions clinically. Read More

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http://dx.doi.org/10.1007/s10278-019-00190-7DOI Listing

Three-dimensional printed models of the rib cage in children with non-accidental injury as an effective visual-aid tool.

Pediatr Radiol 2019 Mar 15. Epub 2019 Mar 15.

Department of Radiology, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.

Three-dimensional (3-D) printing is gaining terrain in medical education, presurgical evaluation and recently as forensic evidence in court. Physicians, including radiologists, often provide expert testimony in court cases involving children with rib fractures and other injuries concerning for child physical abuse. Effectively communicating the complexities of fractures and other skeletal findings to nonmedical personnel using standard radiology studies can be challenging, especially during medical courtroom testimony. Read More

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http://dx.doi.org/10.1007/s00247-019-04368-7DOI Listing

Community Engagement and Equitable Policy: Promoting Resilience and Stability for Children in Immigrant Families in North Carolina.

N C Med J 2019 Mar-Apr;80(2):94-100

associate professor of pediatrics, University of South Carolina School of Medicine Greenville, Greenville, South Carolina; pediatrician, Prisma Health Children's Hospital-Upstate, Columbia, South Carolina; adjunct assistant professor of pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina

Immigrant families in North Carolina, despite multidimensional challenges in the context of national, state, and local policies, enrich our communities. Over the last 18 months, a small group of North Carolina Pediatric Society (NCPS) physicians with concerns about the health and emotional well-being of children in immigrant families have come together to address the challenges facing this vulnerable population. Our goal, as the newly formed NCPS Committee on Immigration, is to advance policy to support immigrant families in obtaining equitable health, educational, and economic opportunities in our state. Read More

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http://dx.doi.org/10.18043/ncm.80.2.94DOI Listing

Pan-TAM tyrosine kinase inhibitor BMS-777607 enhances anti-PD-1 mAb efficacy in a murine model of triple-negative breast cancer.

Cancer Res 2019 Mar 15. Epub 2019 Mar 15.

Department of Cell Biology and Molecular Medicine, Rutgers, Biomedical and Health Sciences Center.

Tyro3, Axl, and Mertk (abbreviated TAM) represent a family of homologous tyrosine kinase receptors known for their functional role in phosphatidylserine (PS)-dependent clearance of apoptotic cells and also for their immune modulatory functions in the resolution of inflammation. Previous studies in our laboratory have shown that Gas6/PS-mediated activation of TAM receptors on tumor cells leads to subsequent upregulation of PD-L1, defining a putative PS->TAM receptor->PD-L1 inhibitory signaling axis in the cancer microenvironment that may promote tolerance. In this study, we tested combinations of TAM inhibitors and PD-1 mAbs in a syngeneic orthotopic E0771 murine triple-negative breast cancer model, whereby tumor-bearing mice were treated with pan-TAM kinase inhibitor (BMS-777607) or anti-PD-1 alone or in combination. Read More

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http://dx.doi.org/10.1158/0008-5472.CAN-18-2614DOI Listing

Switching between P2Y inhibitors: Rationale, methods, and expected consequences.

Vascul Pharmacol 2019 Mar 12. Epub 2019 Mar 12.

Cardiology Division, CAST Policlinico Hospital, University of Catania, Catania, Italy.

The pharmacological and clinical differences of the three oral P2Y inhibitors (clopidogrel, prasugrel, ticagrelor) enable physicians to switch from one agent to another that it is considered more appropriate in the specific clinical setting. Moreover, the recent availability of cangrelor, the only intravenous P2Y inhibitor with a rapid onset and offset of its antiplatelet action, makes it necessary to switch from this agent to an oral P2Y inhibitor for a continued platelet inhibition after percutaneous coronary intervention. Several pharmacodynamic studies have provided information on how to change drug, in terms of timing and dosage, without running the risk of a temporary impairment of platelet inhibition. Read More

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http://dx.doi.org/10.1016/j.vph.2019.03.001DOI Listing

Interprofessional Teamwork During Family Meetings in the Pediatric Cardiac Intensive Care Unit.

J Pain Symptom Manage 2019 Mar 12. Epub 2019 Mar 12.

Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Background: Parents of children in the pediatric cardiac intensive care unit (CICU) report inadequate communication and a lack of empathy during conversations with their clinicians.

Objective: To assess quantitatively and qualitatively the contributions made by team members of different professions in communicating with parents during family meetings.

Design: Prospective observational study. Read More

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http://dx.doi.org/10.1016/j.jpainsymman.2019.03.002DOI Listing

Useful message in choosing optimal biological agents for patients with autoimmune arthritis.

Biochem Pharmacol 2019 Mar 12. Epub 2019 Mar 12.

Institute of Cellular and System Medicine, National Health Research Institute, Zhunan, Taiwan, ROC. Electronic address:

The introduction of biological disease-modifying antirheumatic drug (bDMARD) treatments for various types of autoimmune arthritis, such as rheumatoid arthritis, psoriatic arthropathy and ankylosing spondylitis, represents a new era of treatment for patients with a refractory response to conventional synthetic DMARDs (csDMARDs). Many new bDMARDs with different modalities or that target different pro-inflammatory molecules, likely cytokines, are rapidly emerging. Hence, physicians in the field may be confused about choosing appropriate bDMARDs for their patients. Read More

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http://dx.doi.org/10.1016/j.bcp.2019.03.007DOI Listing

A role for foregut tyrosine metabolism in glucose tolerance.

Mol Metab 2019 Feb 27. Epub 2019 Feb 27.

Department of Medicine and the Naomi Berrie Diabetes Center, Columbia University, College of Physicians and Surgeons, New York, NY, 10032, USA. Electronic address:

Objective: We hypothesized that DA and L-DOPA derived from nutritional tyrosine and the resultant observed postprandial plasma excursions of L-DOPA and DA might affect glucose tolerance via their ability to be taken-up by beta cells and inhibit glucose-stimulated β-cell insulin secretion.

Methods: To investigate a possible circuit between meal-stimulated 3,4-dihydroxy-L-phenylalanine (L-DOPA) and dopamine (DA) production in the GI tract and pancreatic β-cells, we: 1) mapped GI mucosal expression of tyrosine hydroxylase (TH) and aromatic amino acid decarboxylase (AADC); 2) measured L-DOPA and DA content of GI mucosal tissues following meal challenges with different L-tyrosine (TYR) content, 3) determined whether meal TYR content impacts plasma insulin and glucose excursions; and 4) characterized postprandial plasma excursions of L-DOPA and DA in response to meal tyrosine content in rodents and a population of bariatric surgery patients. Next, we characterized: 1) the metabolic transformation of TYR and L-DOPA into DA in vitro using purified islet tissue; 2) the metabolic transformation of orally administrated stable isotope labeled TYR into pancreatic DA, and 3) using a nuclear medicine technique, we studied endocrine beta cells in situ release and binding of DA in response to a glucose challenge. Read More

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http://dx.doi.org/10.1016/j.molmet.2019.02.008DOI Listing
February 2019

Mind the gaps: What we don't know about cognitive impairment in essential tremor.

Parkinsonism Relat Disord 2019 Mar 1. Epub 2019 Mar 1.

Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.

Introduction: Although the hallmark feature of essential tremor (ET) is tremor, there is growing appreciation that cognitive impairment also occurs, including increased prevalence of mild cognitive impairment (MCI) and increased prevalence and incidence of dementia. With emerging knowledge of ET-cognitive impairment, come fundamental questions regarding its course, bases, predictors and clinical outcomes. Studies in the general population and in Parkinson's disease (PD), a related movement disorder, offer a starting point from which to begin filling these clinically important knowledge gaps. Read More

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http://dx.doi.org/10.1016/j.parkreldis.2019.02.038DOI Listing

Exploring the relevance and extent of small airways dysfunction in asthma (ATLANTIS): baseline data from a prospective cohort study.

Lancet Respir Med 2019 Mar 12. Epub 2019 Mar 12.

University of Arizona College of Medicine, Department of Medicine, Tucson, AZ, USA.

Background: Small airways dysfunction (SAD) is well recognised in asthma, yet its role in the severity and control of asthma is unclear. This study aimed to assess which combination of biomarkers, physiological tests, and imaging markers best measure the presence and extent of SAD in patients with asthma.

Methods: In this baseline assessment of a multinational prospective cohort study (the Assessment of Small Airways Involvement in Asthma [ATLANTIS] study), we recruited participants with and without asthma (defined as Global Initiative for Asthma severity stages 1-5) from general practices, the databases of chest physicians, and advertisements at 29 centres across nine countries (Brazil, China, Germany, Italy, Spain, the Netherlands, the UK, the USA, and Canada). Read More

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http://dx.doi.org/10.1016/S2213-2600(19)30049-9DOI Listing

Reduction in pediatric gastroenterology ED visits can be sustained through physician accountability and financial incentives.

Am J Emerg Med 2019 Mar 8. Epub 2019 Mar 8.

Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, United States of America; Division of Trauma, Emergency Surgery, Surgical Critical Care, Massachusetts General Hospital, Boston, MA, United States of America. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2019.03.011DOI Listing

Reply.

J Allergy Clin Immunol 2019 Mar 12. Epub 2019 Mar 12.

Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY.

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http://dx.doi.org/10.1016/j.jaci.2019.01.036DOI Listing

Associations Between Autonomic and Orthostatic Self-report and Physician Ratings of Orthostatic Intolerance in Youth.

Clin Ther 2019 Mar 12. Epub 2019 Mar 12.

Center for Community Research, DePaul University, Chicago, IL, USA. Electronic address:

Purpose: There is no known biological marker or physical assessment to diagnose chronic fatigue syndrome (CFS), leaving physicians to heavily rely on self-report measures regarding the symptoms associated with CFS. Common symptoms of CFS include difficulty sleeping, joint pain, headaches, sore throat, cognitive dysfunction, physical exhaustion, dizziness, and nausea. Because of the overlap among CFS symptoms and autonomic functioning, we examined the association between 2 self-report measures of orthostatic and autonomic symptoms and a physician's report of autonomic functioning (measures of changes in blood pressure and pulse) to further understand the association among autonomic functioning within individuals with symptoms of CFS. Read More

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http://dx.doi.org/10.1016/j.clinthera.2019.02.010DOI Listing

Measuring cause-and-effect relationships without randomized clinical trials: Quasi-experimental methods for gynecologic oncology research.

Gynecol Oncol 2019 Mar;152(3):533-539

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, United States of America.

Clinical research in gynecologic oncology has seen a proliferation of studies that investigate the effectiveness of treatments using existing data sources such as cancer registries, electronic health records, and insurance claims. These observational studies are often feasible when randomized trial may not be, and may be more generalizable than randomized trials, because of greater diversity in the study populations. While statistical methods such as multivariable regression, matching, stratification, and weighting can adjust for the confounding in observational studies, statistical adjustment cannot control for confounders that are unmeasured in the data. Read More

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http://dx.doi.org/10.1016/j.ygyno.2018.11.006DOI Listing

Determinants of frailty in primary care patients with COPD: the Greek UNLOCK study.

BMC Pulm Med 2019 Mar 15;19(1):63. Epub 2019 Mar 15.

Department of Social Medicine, Faculty of Medicine, University of Crete, Voutes Campus, GR-71003, Heraklion, Crete, Greece.

Background: Frailty is a state of increased vulnerability that has a significant risk of unfavorable outcomes such as increased dependency and/or death, but little is known about frailty in people with chronic obstructive pulmonary disease (COPD).

Method: We aimed to determine the prevalence of frailty in COPD patients and to identify the associated risk factors. Two hundred fifty-seven COPD patients enrolled from primary care in Greece between 2015 and 2016. Read More

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http://dx.doi.org/10.1186/s12890-019-0824-8DOI Listing

Korean childhood asthma study (KAS): a prospective, observational cohort of Korean asthmatic children.

BMC Pulm Med 2019 Mar 15;19(1):64. Epub 2019 Mar 15.

Division of Allergy and Chronic Respiratory Diseases, Center for Biomedical Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Osong, South Korea.

Background: Asthma is a syndrome composed of heterogeneous disease entities. Although it is agreed that proper asthma endo-typing and appropriate type-specific interventions are crucial in the management of asthma, little data are available regarding pediatric asthma.

Methods: We designed a cluster-based, prospective, observational cohort study of asthmatic children in Korea (Korean childhood Asthma Study [KAS]). Read More

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http://dx.doi.org/10.1186/s12890-019-0829-3DOI Listing

The use of predictive scores in the management of patients with carbapenem resistant Klebsiella pneumoniae infection.

Expert Rev Anti Infect Ther 2019 Mar 15. Epub 2019 Mar 15.

a Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola Malpighi , University of Bologna.

Introduction: Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections are associated with high morbidity and mortality rates. A therapeutic approach based on the patient risk stratification could improve outcome and avoid antibiotic misuse. Area covered: English literature search, from 2008 to 2018, was done using PubMed database. Read More

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http://dx.doi.org/10.1080/14787210.2019.1595590DOI Listing
March 2019
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Analysis of Machine Learning Algorithms for Diagnosis of Diffuse Lung Diseases.

Methods Inf Med 2018 Nov 15;57(5-06):272-279. Epub 2019 Mar 15.

Instituto de Computação, Universidade Federal de Alagoas, Maceió, Brazil.

Computational Intelligence Re-meets Medical Image Processing A Comparison of Some Nature-Inspired Optimization Metaheuristics Applied in Biomedical Image Registration BACKGROUND:  Diffuse lung diseases (DLDs) are a diverse group of pulmonary disorders, characterized by inflammation of lung tissue, which may lead to permanent loss of the ability to breathe and death. Distinguishing among these diseases is challenging to physicians due their wide variety and unknown causes. Computer-aided diagnosis (CAD) is a useful approach to improve diagnostic accuracy, by combining information provided by experts with Machine Learning (ML) methods. Read More

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http://dx.doi.org/10.1055/s-0039-1681086DOI Listing
November 2018

Prehospital Telemedical Emergency Management of Severely Injured Trauma Patients.

Methods Inf Med 2018 Nov 15;57(5-06):231-242. Epub 2019 Mar 15.

Zentrum für Telemedizin Bad Kissingen, Bad Kissingen, Germany.

Background:  Trauma is a global burden. Emergency medical services (EMS) provide care for individuals who have serious injuries or suffered a major trauma.

Objective:  This paper provides a comprehensive overview of telemedicine applications in prehospital trauma care. Read More

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http://dx.doi.org/10.1055/s-0039-1681089DOI Listing
November 2018

Does external medical review reduce disability insurance inflow?

Authors:
Helge Liebert

J Health Econ 2019 Jan 14;64:108-128. Epub 2019 Jan 14.

Center for Disability and Integration, Department of Economics, University of St. Gallen, Rosenbergstr. 51, 9000 St. Gallen, Switzerland. Electronic address:

This paper investigates the effects of introducing external medical review for disability insurance (DI) in a system relying on treating physician testimony for eligibility determination. Using a unique policy change and administrative data from Switzerland, I show that medical review reduces DI incidence by 23%. Incidence reductions are closely tied to difficult-to-diagnose conditions, suggesting inaccurate assessments by treating physicians. Read More

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http://dx.doi.org/10.1016/j.jhealeco.2018.12.005DOI Listing
January 2019

Development and evaluation of a standardized research definition for opioid overdose outcomes.

Subst Abus 2019 Mar 15:1-9. Epub 2019 Mar 15.

a Institute for Health Research , Kaiser Permanente Colorado , Denver , Colorado , USA.

Background: Increasing epidemiologic and intervention research is being conducted on opioid overdose, a serious and potentially fatal outcome. However, there is little consensus on how to verify opioid overdose outcomes for research purposes. To ensure reproducibility, minimize misclassification, and permit data harmonization across studies, standardized and consistent overdose definitions are needed. Read More

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https://www.tandfonline.com/doi/full/10.1080/08897077.2018.1
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http://dx.doi.org/10.1080/08897077.2018.1546263DOI Listing
March 2019
2 Reads

Comparing Apples to Oranges?

Anesthesiology 2019 Apr;130(4):528-529

From the Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (C.L.H.) the Center for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons/New York-Presbyterian Hospital, New York, New York (D.B.).

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http://dx.doi.org/10.1097/ALN.0000000000002633DOI Listing

Endocrine consequences of neuroblastoma treatment in children: 20 years' experience of a single center.

J Pediatr Endocrinol Metab 2019 Mar 15. Epub 2019 Mar 15.

Division of Pediatric Endocrinology, University Department of Pediatrics, CHU Liège, Liège, Belgium.

Background Neuroblastoma (NBL) is a child neoplasia affecting extracranial tissue of neuroectodermal origin. It accounts for 10% of solid malignancies in children and is characterized by a survival rate approaching 70%, confronting physicians with the emergence of an adult survivor population who have been previously exposed to surgery, cytotoxic drugs, radiation therapy or metaiodobenzylguanidine (MIBG) therapy. All these treatments potentially affect the endocrine system. Read More

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http://dx.doi.org/10.1515/jpem-2018-0273DOI Listing

Botulinum toxin: a review of applications for the head and neck.

Gen Dent 2019 Mar-Apr;67(2):55-58

Botulinum toxin (BTX) is a popular cosmetic therapy administered by both dentists and physicians. The ability of the toxin to locally paralyze muscles has led to the use of BTX as a potential therapy for a variety of medical conditions. This article will discuss the current head and neck applications of BTX. Read More

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Secondary phimosis after circumcision.

Turk J Urol 2019 Jan 22;45(2):135-138. Epub 2019 Jan 22.

Department of Pediatric Surgery, Katip Çelebi University Tepecik Training and Research Hospital, İzmir, Turkey.

Objective: Male circumcision is one of the most common surgical procedures worldwide. Although it is widely performed because of health issues, in Muslim-majority countries, the primary motivation yielding to male circumcision is religious. It is a relatively safe procedure with a low overall complication rate. Read More

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http://dx.doi.org/10.5152/tud.2018.94984DOI Listing
January 2019

[Respectful ethnic profiling in the care sector].

Ned Tijdschr Geneeskd 2019 Mar 1;163. Epub 2019 Mar 1.

Amsterdam UMC, afd. Inwendige geneeskunde, Endocrinologie en Metabolisme, locatie UvA-AMC.

Physicians sometimes use ethnicity as part of their clinical reasoning. Using ethnicity can sometimes, however, lead to bias and may lead to discrimination or racial discrimination. In this article we discuss some examples of wrongful medical profiling based on ethnicity, but also show how ethnic profiling can be performed respectfully. Read More

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Slovenian health care system and possibilities for freelance medical specialists.

Int J Health Plann Manage 2019 Mar 15. Epub 2019 Mar 15.

Faculty of Organizational Sciences, University of Maribor, Kranj, Slovenia.

Introduction: The purpose of the article is to present the results of the research aimed at establishing the current situation in the health care system in Slovenia and verifying whether the possibility and support exist for the introduction of a freelance medical specialist.

Methods: We conducted a survey among physicians and health care managers. The sample framework covered the total population of physicians and health care managers in Slovenia; surveys were completed by 318 physicians and 52 health care managers. Read More

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http://dx.doi.org/10.1002/hpm.2766DOI Listing

Evidenced-based radiology? A single-institution review of imaging referral appropriateness including monetary and dose estimates for inappropriate scans.

Ir J Med Sci 2019 Mar 14. Epub 2019 Mar 14.

Mater Misericordiae University Hospital, Eccles St., Dublin, 7, Ireland.

Background: There has been a year on year increase in imaging requests at our academic institution. The iRefer guidelines are produced by the Royal College of Radiologists in the UK and are designed to prevent inappropriate imaging and radiation exposure. They have been available to general practitioners and hospital physicians in Ireland since March 2015. Read More

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http://dx.doi.org/10.1007/s11845-019-02005-8DOI Listing

[Medical care situation of patients with ankylosing spondylitis and psoriatic arthritis in Germany : Medical care situation of patients with spondyloarthritis (SpA): ankylosing spondylitis (AS) and psoriatic arthritis (PsA) from the perspective of rheumatologists in private practice and hospitals in Germany-Results of the research project "SpA Loop-Life of Outpatients"].

Z Rheumatol 2019 Mar 15. Epub 2019 Mar 15.

CIRI/Rheumatologie & Fraunhofer IME-Translationale Medizin und Pharmakologie, Goethe-Universität, Frankfurt am Main, Deutschland.

Background: The prevalence of spondyloarthritis (SpA) in Germany is approximately 1-1.4% and includes predominantly axial SpA (axSpA) and predominantly peripheral SpA. Ankylosing spondylitis (AS) belongs to the group of axial SpA but also exhibits peripheral manifestations. Read More

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http://dx.doi.org/10.1007/s00393-019-0619-6DOI Listing

[Medical assistant-a profession in a state of flux].

Z Rheumatol 2019 Mar 12. Epub 2019 Mar 12.

rheumapraxis an der hase, Osnabrück, Deutschland.

New treatment strategies and treatment possibilities as well as undertreatment due to the lack of medical specialists especially in rheumatology, necessitate a qualified further training of rheumatological assistant personnel. The increasing independent work of medical and rheumatological assistants expected by physicians with respect to patient management and practice organization, necessitates an intensive cooperation between the two professional groups. The aim is to guarantee the competent treatment of chronically ill patients with rheumatism. Read More

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http://link.springer.com/10.1007/s00393-019-0610-2
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http://dx.doi.org/10.1007/s00393-019-0610-2DOI Listing
March 2019
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Computer-Aided Diagnosis System for Detection of Stomach Cancer with Image Processing Techniques.

J Med Syst 2019 Mar 14;43(4):99. Epub 2019 Mar 14.

Department of Gastroenterology, Faculty of Medicine, Selcuk University, 42031, Konya, Turkey.

Stomach cancer is a type of cancer that is hard to detect at an early stage because it gives almost no symptoms at the beginning. Stomach cancer is an increasing incidence of cancer both in the World as well as in Turkey. The most common method used worldwide for gastric cancer diagnosis is endoscopy. Read More

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http://link.springer.com/10.1007/s10916-019-1203-y
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http://dx.doi.org/10.1007/s10916-019-1203-yDOI Listing
March 2019
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Clinical Use of Measurable Residual Disease in Acute Myeloid Leukemia.

Curr Treat Options Oncol 2019 Mar 14;20(4):28. Epub 2019 Mar 14.

Department of Hematology, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, DK-8200, Aarhus N, Denmark.

Opinion Statement: Treatment of acute myeloid leukemia (AML) remains a high-risk venture for the patient suffering from the disease. There is a real risk of succumbing to the treatment rather than the disease, and even so, cure is much less than certain. Since the establishment of complete remission as a prerequisite for cure in the 1960s, a number of years passed before advanced techniques for detecting minute amounts of disease matured sufficiently for clinical implementation. Read More

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http://link.springer.com/10.1007/s11864-019-0627-4
Publisher Site
http://dx.doi.org/10.1007/s11864-019-0627-4DOI Listing
March 2019
2 Reads