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https://read.qxmd.com/read/30980615/impact-of-updated-pediatric-hypertension-guidelines-on-progression-from-elevated-blood-pressure-to-hypertension-in-a-community-based-primary-care-population
#1
Elyse O Kharbanda, Steve E Asche, Steven P Dehmer, Alan R Sinaiko, Heidi L Ekstrom, Nicole Trower, Patrick J O'Connor
In 2017, definitions for pediatric hypertension were updated. A threshold of 130/80 mm Hg was introduced for stage 1 hypertension in adolescents, and children with obesity were removed from the reference population, lowering the 95th percentile, compared to the 2004 Fourth Report. The impact of these changes on care for youth with elevated blood pressure has not been well described. The objective of this study was to compare the 2017 and 2004 criteria for hypertension, evaluating how they impact estimates of risks for elevated blood pressure to progress to hypertension...
April 13, 2019: Journal of Clinical Hypertension
https://read.qxmd.com/read/30980154/-diabesity-obesity-and-type-2-diabetes-update-2019
#2
Hermann Toplak, Deborah Raphaela Leitner, Jürgen Harreiter, Friedrich Hoppichler, Thomas C Wascher, Karin Schindler, Bernhard Ludvik
For several years obesity and type 2 diabetes have been increasingly summarized under the name "diabesity". This is due to the fact that in most cases obesity precedes diabetes and is the most important risk factor for the worldwide increase of type 2 diabetes. The body mass index (BMI) is a very crude measure of body fatness in individuals. Even normal weight persons can have too much body fat in cases of a lack of muscle mass (sarcopenia), which is why additional measurements of waist circumference and body fatness, e...
April 12, 2019: Wiener Klinische Wochenschrift
https://read.qxmd.com/read/30977937/dermoscopy-use-in-uk-primary-care-a-survey-of-gps-with-a-special-interest-in-dermatology
#3
O T Jones, L C Jurascheck, M Utukuri, M M Pannebakker, J Emery, F M Walter
BACKGROUND: Melanoma accounts for 90% of skin cancer mortality and typically presents in primary care, where it can be challenging to distinguish from benign lesions. Dermoscopy is a tool for skin visualisation that is routinely used for melanoma diagnosis in secondary care. However, the role of dermoscopy in primary care remains unclear. OBJECTIVES: To determine views on, and use of, dermoscopy by dermatology-interested general practitioners (GPs). METHODS: An online questionnaire was emailed to the UK Primary Care Dermatology Society members in February 2018, and responses collected over the following four weeks...
April 12, 2019: Journal of the European Academy of Dermatology and Venereology: JEADV
https://read.qxmd.com/read/30975679/general-practitioners-awareness-of-the-recommendations-for-faecal-immunochemical-tests-fits-for-suspected-lower-gastrointestinal-cancers-a-national-survey
#4
Christian Von Wagner, Sandro Tiziano Stoffel, Madeline Freeman, Helga E Laszlo, Brian D Nicholson, Jessica Sheringham, Dorothy Szinay, Yasemin Hirst
OBJECTIVES: In July 2017, UK National Institute for Health and Care Excellence (NICE) published a diagnostic guidance (DG30) recommending the use of faecal immunochemical tests (FITs) for symptomatic patients who do not meet the urgent referral pathway for suspected colorectal cancer (CRC). We assessed general practitioners' (GP) awareness of DG30 in primary care 6 months after its publication. DESIGN AND SETTING: Cross-sectional online survey of GPs hosted by an English panel of Primary health care professionals...
April 11, 2019: BMJ Open
https://read.qxmd.com/read/30975667/the-impact-of-general-practitioners-working-in-or-alongside-emergency-departments-a-rapid-realist-review
#5
Alison Cooper, Freya Davies, Michelle Edwards, Pippa Anderson, Andrew Carson-Stevens, Matthew W Cooke, Liam Donaldson, Jeremy Dale, Bridie Angela Evans, Peter D Hibbert, Thomas C Hughes, Alison Porter, Tim Rainer, Aloysius Siriwardena, Helen Snooks, Adrian Edwards
OBJECTIVES: Worldwide, emergency healthcare systems are under intense pressure from ever-increasing demand and evidence is urgently needed to understand how this can be safely managed. An estimated 10%-43% of emergency department patients could be treated by primary care services. In England, this has led to a policy proposal and £100 million of funding (US$130 million), for emergency departments to stream appropriate patients to a co-located primary care facility so they are 'free to care for the sickest patients'...
April 11, 2019: BMJ Open
https://read.qxmd.com/read/30971397/management-of-cancer-associated-anemia-with-erythropoiesis-stimulating-agents-asco-ash-clinical-practice-guideline-update
#6
REVIEW
Julia Bohlius, Kari Bohlke, Roberto Castelli, Benjamin Djulbegovic, Maryam B Lustberg, Massimo Martino, Giannis Mountzios, Namrata Peswani, Laura Porter, Tiffany N Tanaka, Gianluca Trifirò, Hushan Yang, Alejandro Lazo-Langner
PURPOSE: To update the American Society of Clinical Oncology (ASCO)/American Society of Hematology (ASH) recommendations for use of erythropoiesis-stimulating agents (ESAs) in patients with cancer. METHODS: PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) and meta-analyses of RCTs in patients with cancer published from January 31, 2010, through May 14, 2018. For biosimilar ESAs, the literature search was expanded to include meta-analyses and RCTs in patients with cancer or chronic kidney disease and cohort studies in patients with cancer due to limited RCT evidence in the cancer setting...
April 23, 2019: Blood Advances
https://read.qxmd.com/read/30971385/-what-have-we-learnt-about-rotavirus-in-spain-in-the-last-10-years
#7
Javier Díez-Domingo, María Garcés-Sánchez, Francisco Giménez-Sánchez, Javier Colomina-Rodríguez, Federico Martinón-Torres
INTRODUCTION: Vaccines against rotavirus (RV) have been available in Spain since 2006, but they are neither recommended nor financed by the National Health System. Nevertheless, through recommendations of the Spanish Association of Paediatrics vaccination has achieved intermediate coverage. MATERIAL AND METHODS: A systematic literature review was performed on studies carried out in Spain in the last 12 years (2006-2018) on RV infection and vaccination. RESULTS: A total of 43 studies were identified that met the inclusion criteria...
April 7, 2019: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://read.qxmd.com/read/30969847/management-of-cancer-associated-anemia-with-erythropoiesis-stimulating-agents-asco-ash-clinical-practice-guideline-update
#8
Julia Bohlius, Kari Bohlke, Roberto Castelli, Benjamin Djulbegovic, Maryam B Lustberg, Massimo Martino, Giannis Mountzios, Namrata Peswani, Laura Porter, Tiffany N Tanaka, Gianluca Trifirò, Hushan Yang, Alejandro Lazo-Langner
PURPOSE: To update the American Society of Clinical Oncology (ASCO)/American Society of Hematology (ASH) recommendations for use of erythropoiesis-stimulating agents (ESAs) in patients with cancer. METHODS: PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) and meta-analyses of RCTs in patients with cancer published from January 31, 2010, through May 14, 2018. For biosimilar ESAs, the literature search was expanded to include meta-analyses and RCTs in patients with cancer or chronic kidney disease and cohort studies in patients with cancer due to limited RCT evidence in the cancer setting...
April 10, 2019: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://read.qxmd.com/read/30956693/vocal-cord-dysfunction-analysis-of-27-cases-and-updated-review-of-pathophysiology-management
#9
Shibu George, Sandeep Suresh
Introduction  Vocal cord dysfunction is characterized by unintentional paradoxical vocal cord movement resulting in abnormal inappropriate adduction, especially during inspiration; this predominantly manifests as unresponsive asthma or unexplained stridor. It is prudent to be well informed about the condition, since the primary presentation may mask other airway disorders. Objective  This descriptive study was intended to analyze presentations of vocal cord dysfunction in a tertiary care referral hospital...
April 2019: International Archives of Otorhinolaryngology
https://read.qxmd.com/read/30955515/update-in-the-management-of-pleural-effusions
#10
REVIEW
Matthew Aboudara, Fabien Maldonado
Pleural effusions are a common clinical problem for the primary care physician. Over the past 10 years, there has been a paradigm shift in the field due to emergence of new evidence, which includes the ubiquitous use of thoracic ultrasound, the reemergence of pleuroscopy as a diagnostic and therapeutic modality, the widespread use of indwelling pleural catheters for malignant pleural effusions, and the evidence-based approach to management of complex parapneumonic effusions. This review focuses on these advancements with an emphasis on practical clinical application...
May 2019: Medical Clinics of North America
https://read.qxmd.com/read/30951460/dynamic-deephit-a-deep-learning-approach-for-dynamic-survival-analysis-with-competing-risks-based-on-longitudinal-data
#11
Changhee Lee, Jinsung Yoon, Mihaela Van Der Schaar
Currently available risk prediction methods are limited in their ability to deal with complex, heterogeneous, and longitudinal data such as that available in primary care records, or in their ability to deal with multiple competing risks. This paper develops a novel deep learning approach that is able to successfully address current limitations of standard statistical approaches such as landmarking and joint modeling. Our approach, which we call Dynamic-DeepHit, flexibly incorporates the available longitudinal data comprising various repeated measurements (rather than only the last available measurements) in order to issue dynamically updated survival predictions for one or multiple competing risk(s)...
April 3, 2019: IEEE Transactions on Bio-medical Engineering
https://read.qxmd.com/read/30950507/non-invasive-positive-pressure-ventilation-cpap-or-bilevel-nppv-for-cardiogenic-pulmonary-oedema
#12
REVIEW
Nicolas Berbenetz, Yongjun Wang, James Brown, Charlotte Godfrey, Mahmood Ahmad, Flávia Mr Vital, Pier Lambiase, Amitava Banerjee, Ameet Bakhai, Matthew Chong
BACKGROUND: Non-invasive positive pressure ventilation (NPPV) has been used to treat respiratory distress due to acute cardiogenic pulmonary oedema (ACPE). We performed a systematic review and meta-analysis update on NPPV for adults presenting with ACPE. OBJECTIVES: To evaluate the safety and effectiveness of NPPV compared to standard medical care (SMC) for adults with ACPE. The primary outcome was hospital mortality. Important secondary outcomes were endotracheal intubation, treatment intolerance, hospital and intensive care unit length of stay, rates of acute myocardial infarction, and adverse event rates...
April 5, 2019: Cochrane Database of Systematic Reviews
https://read.qxmd.com/read/30938184/a-group-visit-for-high-risk-pediatric-asthma-patients-a-quality-improvement-initiative-to-improve-asthma-care
#13
Margaret Fallon, Linda Haynes, Tatiana Cadet, Sheila Petrosino, Esther Cazeau, Jessica Solis, Joanne Cox, Ann Chen Wu, Faye F Holder-Niles
INTRODUCTION: Asthma disproportionately affects poor and minority children. Limited parental knowledge and confidence in asthma management, as well as stress from chronic illness, may contribute to poor outcomes. Novel approaches for providing care are essential for this vulnerable population. Our objective was to evaluate the feasibility and impact of an asthma group visit for high-risk children. METHODS: Our primary care practice cares for more than 2600 children with asthma...
April 2, 2019: Clinical Pediatrics
https://read.qxmd.com/read/30935680/-girl-just-pray-%C3%A2-factors-that-influence-breast-and-cervical-cancer-screening-among-black-women-in-rochester-mn
#14
Starr K Sage, Chamika Hawkins-Taylor, Rev Andre Crockett, Joyce E Balls-Berry
BACKGROUND: Black women in Minnesota and beyond have a greater burden of death due to some cancers than their White counterparts. Delayed screening and treatment may explain these disparate statistics. The purpose of this study was to work in collaboration with a local Black faith-based organization to gain an updated understanding of Black women's knowledge, attitudes, and behaviors related to breast and cervical cancer, and determine to what extent known factors persist as barriers to accessing cancer screening among Black women in Rochester, MN...
March 29, 2019: Journal of the National Medical Association
https://read.qxmd.com/read/30933309/support-during-pregnancy-for-women-at-increased-risk-of-low-birthweight-babies
#15
REVIEW
Christine E East, Mary A Biro, Suzanne Fredericks, Rosalind Lau
BACKGROUND: Studies consistently show a relationship between social disadvantage and low birthweight. Many countries have programmes offering special assistance to women thought to be at risk for giving birth to a low birthweight infant. These programmes, collectively referred to in this review as additional social support, may include emotional support, which gives a person a feeling of being loved and cared for, tangible/instrumental support, in the form of direct assistance/home visits, and informational support, through the provision of advice, guidance and counselling...
April 1, 2019: Cochrane Database of Systematic Reviews
https://read.qxmd.com/read/30924787/screening-depression-and-related-conditions-via-text-messaging-versus-interview-assessment-protocol-for-a-randomized-study
#16
Haomiao Jin, Shinyi Wu
BACKGROUND: Depression is an often underdiagnosed and, therefore, untreated comorbidity for low-income, racially or ethnically diverse patients with a chronic illness such as diabetes. Recent updates from the US Preventive Services Task Force guidelines in 2016 recommend depression screening for every adult but does not suggest the mode of assessment. Short message service (SMS) text messaging is an inexpensive, private, and scalable approach to provide depression screening and monitoring; it can also alleviate many barriers, such as transportation, childcare, and clinical visit time faced by the low-income population, in receiving a diagnosis of depression...
March 29, 2019: JMIR Research Protocols
https://read.qxmd.com/read/30922554/-antineoplastic-drug-induced-nausea-and-vomiting-what-is-the-clinical-practice-in-2018-an-update-of-afsos-clinical-guidelines
#17
REVIEW
Nicolas Jovenin, Audrey Eche-Gass, Stéphane Chèze, Vincent Launay-Vacher, Didier Mayeur, Jean-Baptiste Rey, Florence Joly, Ivan Krakowski, Florian Scotté
Antineoplastic drug induced nausea and vomiting (ANDINV) (previously named: Chemotherapy-induced nausea and vomiting [CINV]) are one of the most feared adverse effect for patients who begin treatment with anti-cancer treatments and their bad control have a negative impact in the management of these patients. In this review article, it is proposed an update of French-speaking Association for oncologic supportive care (AFSOS) clinical practice of CINV guidelines. This update became necessary for several reasons: newly available anti-emetic drugs; new data published about individual risk factors of CINV; new antineoplastic agents available; changing in emetic risk levels for some molecules in the international guidelines...
March 25, 2019: Bulletin du Cancer
https://read.qxmd.com/read/30922367/blood-based-molecular-biomarkers-for-alzheimer-s-disease
#18
REVIEW
Henrik Zetterberg, Samantha C Burnham
A major barrier to the effective conduct of clinical trials of new drug candidates against Alzheimer's disease (AD) and to identifying patients for receiving future disease-modifying treatments is the limited capacity of the current health system to find and diagnose patients with early AD pathology. This may be related in part to the limited capacity of the current health systems to select those people likely to have AD pathology in order to confirm the diagnosis with available cerebrospinal fluid and imaging biomarkers at memory clinics...
March 28, 2019: Molecular Brain
https://read.qxmd.com/read/30921525/clinical-practice-guideline-tonsillectomy-in-children-update-executive-summary
#19
Ron B Mitchell, Sanford M Archer, Stacey L Ishman, Richard M Rosenfeld, Sarah Coles, Sandra A Finestone, Norman R Friedman, Terri Giordano, Douglas M Hildrew, Tae W Kim, Robin M Lloyd, Sanjay R Parikh, Stanford T Shulman, David L Walner, Sandra A Walsh, Lorraine C Nnacheta
OBJECTIVE: This update of a 2011 guideline developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall...
February 2019: Otolaryngology—Head and Neck Surgery
https://read.qxmd.com/read/30920131/immunity-targeted-approaches-to-the-management-of-chronic-and-recurrent-upper-respiratory-tract-disorders-in-children
#20
Wojciech Feleszko, Ricardo Marengo, Antonio Sousa Vieira, Karol Ratajczak, José Luis Mayorga Butrón
BACKGROUND/OBJECTIVE OF REVIEW: Summarise the current evidence and address key questions concerning the use of conservative and immunity-targeted approaches to recurrent and chronic upper respiratory tract infections (URTIs), with a focus on the paediatric population. SEARCH STRATEGY/EVALUATION METHOD: Literature searches were conducted in March 2017 and updated in September 2017 using: Academic Search Complete; CENTRAL; Health Source: Nursing/Academic Edition; MEDLINE; clinicaltrials...
March 28, 2019: Clinical Otolaryngology
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