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Jeremy R Beitler, Todd Sarge, Valerie M Banner-Goodspeed, Michelle N Gong, Deborah Cook, Victor Novack, Stephen H Loring, Daniel Talmor
Importance: Adjusting positive end-expiratory pressure (PEEP) to offset pleural pressure might attenuate lung injury and improve patient outcomes in acute respiratory distress syndrome (ARDS). Objective: To determine whether PEEP titration guided by esophageal pressure (PES), an estimate of pleural pressure, was more effective than empirical high PEEP-fraction of inspired oxygen (Fio2) in moderate to severe ARDS. Design, Setting, and Participants: Phase 2 randomized clinical trial conducted at 14 hospitals in North America...
February 18, 2019: JAMA: the Journal of the American Medical Association
Katharine Harding, Owain Williams, Mark Willis, James Hrastelj, Anthony Rimmer, Fady Joseph, Valentina Tomassini, Mark Wardle, Trevor Pickersgill, Neil Robertson, Emma Tallantyre
Importance: Uncertainty remains about how aggressively to treat early multiple sclerosis. High-efficacy disease-modifying therapies (DMTs) are often reserved for individuals expressing poor prognostic features at baseline. Objective: To analyze long-term outcomes in a population-based cohort according to initial treatment strategy. Design, Setting and Participants: In this cohort study, data were derived from January 1998 to December 2016, and analysis was performed in January 2017...
February 18, 2019: JAMA Neurology
Stefka Krumova, Adelina Pavlova, Kamelia Yotovska, Petia Genova-Kalou
BACKGROUND: Fever of unknown origin (FUO) is one of the greatest challenges for clinicians and patients. There are more than 200 etiological agents of FUO, among these the most common is the role of infection, neoplasms, and diseases of connective tissue. The aim of the present study is to investigate the role of the infectious agents parvovirus B19 (B19V) and Coxiella burnetii (C. burnetii) in the development of fever of unknown origin by a set of immunoenzymatic and molecular methods...
January 1, 2019: Clinical Laboratory
Kelsey C Coy, Ronald J Hazen, Heather S Kirkham, Ambrose Delpino, Aaron J Siegler
INTRODUCTION: Persistence on preexposure prophylaxis for HIV prevention (PrEP) medication has rarely been reported for periods greater than one year, or in real-world settings. This study used pharmacy fill records for PrEP users from a national chain pharmacy to describe persistence on PrEP medication over a two-year period, and to explore correlates with PrEP medication persistence in a real-world setting. METHODS: We analysed de-identified pharmacy fill records of 7148 eligible individuals who initiated PrEP in 2015 at a national chain pharmacy...
February 2019: Journal of the International AIDS Society
Victoria Thörnqvist, Roelinde Middelveld, Hay Mar Wai, Natalia Ballardini, Evalill Nilsson, Jennie Strömquist, Staffan Ahlstedt, Lennart Jan Nilsson, Jennifer L P Protudjer
Background: Food allergy is negatively associated with health-related quality of life (HRQL). Although differences exist between parents and children, less is known about age-specific differences amongst children. As such, we aimed to identify if age, as well as other factors, are associated with food allergy-specific HRQL in an objectively defined population of children. Methods: Overall, 63 children (boys: n = 36; 57.1%) with specialist-diagnosed food allergy to 1 + foods were included...
2019: Clinical and Translational Allergy
Chung-Chieh Yu, Chih-Yu Huang, Wei-Ke Kuo, Chung-Yao Chen
Objectives: To assess the effect of continuous positive airway pressure (CPAP) on nocturia in ischemic stroke patients with obstructive sleep apnea (OSA). Methods: This was a prospective and non-randomized controlled study in which ischemic stroke patients with OSA being treated in a rehabilitation ward were enrolled. The participants who tolerated CPAP were classified as the CPAP group, while those who refused or could not tolerate CPAP were classified as the control group...
2019: Clinical Interventions in Aging
A Vuagnat, F Jollant, M Abbar, K Hawton, C Quantin
AimsA large number of people present each day at hospitals for non-fatal deliberate self-harm (DSH). Examination of the short-term risk of non-fatal recurrence and mortality at the national level is of major importance for both individual medical decision-making and global organisation of care. METHODS: Following the almost exhaustive linkage (96%) of two national registries in France covering 45 million inhabitants (i.e. 70% of the whole population), information about hospitalisation for DSH in 2008-2009 and vital status at 1 year was obtained...
February 18, 2019: Epidemiology and Psychiatric Sciences
Wanda E Leal, Dylan B Jackson
AIMS: The current study aims to examine whether energy drink consumption is associated with intentions to try marijuana among adolescents who have never tried marijuana, and whether the effects of energy drink consumption on the intention to try marijuana vary between adolescents who have previously tried alcohol or cigarettes and those who have not. METHODS: This study employs a pooled cross-sectional design and uses a nationally representative sample of 8th (ages 13-14) and 10th (ages 15-16) grade adolescents from seven recent cohorts (2010-2016) of the Monitoring the Future (MTF) study...
February 10, 2019: Addictive Behaviors
Yong Yean Kim, Judy F Lew, Bahareh Keith, Taina Telisma, Eric J Nelson, Alexis C Brantly, Sonese Chavannes, Gina Anilis, Yang Yang, Mingjin Liu, Meer Taifur Alam, Mohammed H Rashid, J Glenn Morris, Valery E Madsen Beau De Rochars
OBJECTIVES: Acute Respiratory Infection (ARI) is the most common cause of childhood morbidity and mortality in developing countries, including Haiti. Our objective was to detect pathogens found in children with ARI in rural Haiti to help develop evidence-based guidelines for treatment and prevention. METHODS: Retrospective study of students with ARI at four schools in rural Haiti. Viral and/or bacterial pathogens were identified by qPCR in 177 nasal swabs collected from April 2013 through November 2015...
February 14, 2019: International Journal of Infectious Diseases: IJID
Marie-Claude Pelland-Marcotte, Catherine Tucker, Alicia Klaassen, Maria Laura Avila, Ali Amid, Nour Amiri, Suzan Williams, Jacqueline Halton, Leonardo R Brandão
BACKGROUND: Little is known about severe pulmonary embolism in children. We aimed to report pulmonary embolism outcomes, identify risk factors for unfavourable outcomes, and evaluate the discriminative ability of two clinical-severity indices in children. METHODS: In this retrospective cohort study, we included consecutive patients aged 18 years or younger with acute pulmonary embolism, objectively diagnosed radiologically or pathologically, between Jan 1, 2000, and Dec 31, 2016, from two Canadian paediatric hospitals (The Hospital for Sick Children, Toronto, ON, and the Children's Hospital of Eastern Ontario, Ottawa, ON)...
February 13, 2019: Lancet Haematology
Salem A Beshyah, Mohamed Hassanein, M Yakoob Ahmedani, Shehla Shaikh, Ebtesam M Ba-Essa, Magdy H Megallaa, Bachar Afandi, Fawzi Ibrahim, Talal Al-Muzaffar
OBJECTIVES: To describe the risk of hypoglycaemia during Ramadan and determine its risk factors, and the impact of hypoglycaemia on patients' behaviour. METHODS: A cross-sectional multi-country observational study, with data captured within 6 weeks after Ramadan 2015. Patients' and disease characteristics and its management, the risk of hypoglycaemia and patients' response to hypoglycaemia were recorded RESULTS: A cohort of 1759 patients; majority with type 2 diabetes mellitus from North Africa, Arabian Gulf, Saudi Arabia, and the Indian subcontinent...
February 14, 2019: Diabetes Research and Clinical Practice
Michel Bouchoucha, Noëlle Girault-Lidvan, Maria Hejnar, Florence Mary, Gheorges Airinei, Robert Benamouzig
BACKGROUND/AIMS: Psychological factors are involved in many functional gastrointestinal disorders including globus. The aim of the present study was to assess the clinical and psychological correlates associated with globus. PATIENTS AND METHODS: 707 patients (69% female, 45.2 ± 16.5 years, BMI 27.2 ± 11.7 kg/m2 ) filled an MMPI-2 questionnaire and a standard Rome III clinical questionnaire and were included in this cross sectional study. Data analysis was performed using a univariate analysis and a multivariate logistic regression with a backwards selection procedure on significant scales after a univariate analysis...
February 13, 2019: Clinics and Research in Hepatology and Gastroenterology
Tara D Mangal, Ana Roberta Pati Pascom, Juan F Vesga, Mariana Veloso Meireles, Adele Schwartz Benzaken, Timothy B Hallett
Emerging evidence suggests that HIV incidence rates in Brazil, particularly among men, may be rising. Here we use Brazil's integrated health systems data to develop a mathematical model, reproducing the complex surveillance systems and providing estimates of HIV incidence, number of people living with HIV (PLHIV), reporting rates and ART initiation rates. An age-structured deterministic model with a flexible spline was used to describe the natural history of HIV along with reporting and treatment rates. Individual-level surveillance data for 1,077,295 cases (HIV/AIDS diagnoses, ART dispensations, CD4 counts and HIV/AIDS-related deaths) were used to calibrate the model using Bayesian inference...
February 7, 2019: Epidemics
J D Quigley
Provision of nutrients in appropriate amounts to meet nutrient requirements for growth, production, and reproduction is the basis for modern animal nutrition. Ration formulation systems predict nutrient requirements based on numerous inputs and then predict nutrient supply based on predicted intake and nutrient content of feeds. Energy systems are used to predict energy supply based on gross caloric content of feeds followed by adjustments for digestion and metabolism of ingested energy. Many models of energy supply use static coefficients of digestibility based on nutrient composition of feed...
February 13, 2019: Journal of Dairy Science
Tanis J Ferman, Andrew P Keaveny, Terry Schneekloth, Michael G Heckman, Emily Vargas, Adriana Vasquez, Teresa Rummans, C Burcin Taner, Shehzad K Niazi
BACKGROUND: Increasing numbers of patients over the age of 60 are undergoing liver transplantation. OBJECTIVE: We sought to determine whether age or clinical morbidities were associated with pre- and post-transplant executive and memory performance using the Brief Test of Adult Cognition by Telephone (BTACT). METHODS: Participants included 36 recipients with n = 20 in the older group (>60 y) and n = 16 in the younger group (≤60 years)...
January 23, 2019: Psychosomatics
Garrett K Berger, Peyton L Nisson, Whitney S James, Kristen N Kaiser, R John Hurlbert
OBJECTIVEEwing sarcoma (ES) is among the most prevalent of bone sarcomas in young people. Less often, it presents as a primary lesion of the spine (5%-15% of patients with ES).METHODSA systematic literature search was performed, querying several scientific databases per PRISMA guidelines. Inclusion criteria specified all studies of patients with surgically treated ES located in the spine. Patient age was categorized into three groups: 0-13 years (age group 1), 14-20 years (age group 2), and > 21 (age group 3)...
February 15, 2019: Journal of Neurosurgery. Spine
Karthik Madhavan, Lee Onn Chieng, Valerie L Armstrong, Michael Y Wang
OBJECTIVEDiscitis and osteomyelitis are seen in end-stage renal disease (ESRD) patients due to repeated vascular access for hemodialysis and urinary tract infections leading to recurrent bacteremia. Discitis and osteomyelitis are underdiagnosed due to the nonspecific initial presentation of back pain. In this article, we review the literature for better understanding of the problem and the importance of early diagnosis by primary care physicians and nephrologists. In addition, we discuss the decision-making, follow-up, management, and neurological outcomes...
February 15, 2019: Journal of Neurosurgery. Spine
Beatriz Rodríguez-Sánchez, David Cantarero-Prieto
The aim of this study is to explain the trends in socioeconomic inequality and diabetes outcomes in terms of hospital admission and death in old European people. The sample includes 73,301 individuals, across 16 European countries taken from the Survey of Health, Ageing and Retirement in Europe (SHARE). People being diagnosed of diabetes were more likely to be admitted to hospital than those without diabetes, although its effect dropped after controlling for clinical and functional complications. Largest asscociations were observed in women, people aged 50-65 years old, with medium educational level and medium household income...
January 17, 2019: Economics and Human Biology
Eyal Melzer, Gill Smollan, Amit Hupert, Ronen Fluss, Ilana Tal, Mayan Gilboa, Tal Zilberman-Daniels, Naty Keller, Galia Rahav, Gili Regev-Yochay
OBJECTIVES: The role of asymptomatic carriers in CDI epidemiology is not fully understood. Our aim was to evaluate CD carriage prevalence on admission, associated risk factors and the risk to develop CDI. METHODS: A ten-week surveillance program for CD carriage of all medical patients admitted to the Sheba Medical Center was implemented, utilizing admission rectal swab PCR (Xpert C. difficile; Cepheid). Healthcare Facility-Onset CDI (HO-CDI) was recorded and divided into HO-CDI diagnosed in CD carriers and non-carriers...
February 13, 2019: Clinical Microbiology and Infection
Rose Wesche, Derek A Kreager, Mark E Feinberg, Eva S Lefkowitz
Well-liked adolescents are more likely than their peers to engage in sexual behaviors, which may place them at higher risk of negative outcomes such as sexually transmitted infections and unwanted pregnancy. Yet, little is known regarding whether peer acceptance in adolescence predicts sexual outcomes in young adulthood. Understanding developmental links between peer acceptance and sexual outcomes will inform theories of how peers affect health and can help identify targets for health promotion efforts. Using longitudinal sociometric data from 1878 participants in the PROSPER study (54% female, 82% White, mean age = 11...
February 15, 2019: Journal of Youth and Adolescence
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