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Nonsteroidal anti-inflammatory drugs are effective treatment for acute renal colic | Cochrane

Acute renal colic is the pain caused by the blockage of urine flow secondary to urinary stones. The prevalence of kidney stone is thought to be between 2% to 3%, and the incidence has been increasing in recent years due to changes in diet and lifestyle. The renal colic pain is usually a sudden intense pain located in the flank or abdominal areas. This usually happens when a urinary stone blocks the ureter (the tube connecting the kidneys to the bladder). Different types of pain killers are used to ease the discomfort. Nonsteroidal anti-inflammatory drugs (NSAIDs) and antispasmodics (treatment that suppresses muscle spasms) are used commonly to relieve pain and discomfort. This review aimed to assess the effectiveness of commonly used non-opioid pain killers in adult patients with acute renal colic pain. Fifty studies enrolling 5734 participants were included in this review. Treatments varied greatly and combining of studies was difficult. We found that overall NSAIDs were more effective than other non-opioid pain killers including antispasmodics for pain reduction and need for additional medication. We also found that the combining NSAIDs with antispasmodics did not increase the efficacy. No serious adverse effects were reported by any of the included studies.  
cochrane.org
about 4 years ago
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BMA calls for 20% sugar tax to subsidise cost of fruit and vegetables

The British Medical Association is calling on the government to introduce a 20% tax on sugary drinks to help tackle the increasing prevalence of obesity and diet related health problems in the United Kingdom by using the money to subsidise the cost of fruit and vegetables.1  
feeds.bmj.com
about 4 years ago
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Outpatient psychological therapy for adults with anorexia | Cochrane

Anorexia nervosa is a severe and disabling mental health disorder of self starvation. In the general population the lifetime prevalence of anorexia nervosa may be as high as 5 in 100 women. About one in 10 people with anorexia nervosa is male. Psychological therapies are the main treatment and most people are treated as outpatients. A number of different types of therapy are used, from dynamic (where past issues are explored) to very directive cognitive-behavioural therapies (where specific advice is given and people are required to keep records of their eating behaviour). It is important to know which psychological therapy is most likely to help people recover. This review aimed to assess evidence about the effects of individual psychological therapy (therapy provided to one person as opposed to a group) delivered in outpatient settings to older adolescents and adults with anorexia nervosa.  
cochrane.org
about 4 years ago
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In brief

Female genital mutilation occurs throughout England and Wales: An estimated 137 000 women and girls in England and Wales have undergone genital mutilation, with the highest prevalence in the south London borough of Southwark (47.4 per 1000 girls and women aged 14-59), a study says.1 All the 10 boroughs with the highest prevalence were in London. Outside the capital, a high prevalence was also seen in Manchester (16.2 per 1000), Slough (15.5), Bristol (14.8), Leicester (12.9), and Birmingham (12.4). No borough was free of the practice, which has been illegal in the United Kingdom since 1985.  
feeds.bmj.com
about 4 years ago
Www.bmj
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In brief

Female genital mutilation occurs throughout England and Wales: An estimated 137 000 women and girls in England and Wales have undergone genital mutilation, with the highest prevalence in the south London borough of Southwark (47.4 per 1000 girls and women aged 14-59), a study says.1 All the 10 boroughs with the highest prevalence were in London. Outside the capital, a high prevalence was also seen in Manchester (16.2 per 1000), Slough (15.5), Bristol (14.8), Leicester (12.9), and Birmingham (12.4). No borough was free of the practice, which has been illegal in the United Kingdom since 1985.  
feeds.bmj.com
about 4 years ago
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Compelling evidence linking sugary drinks with diabetes

Global estimates of diabetes prevalence continue to outpace previous projections, as virtually all regions of the world continue to see a large and growing prevalence.1 Proposals by diabetes prevention experts for how to change these trends have included both structured programmes for adults at high risk for type 2 diabetes (the “high risk approach”) and environmental and food policies to help change risk factors in the whole population (the “population approach”).1 Promising programmes for those at high risk are already underway and need to be expanded,2 but complementary shifts in underlying risk factors in the broader population are also needed. The list of risk factors for type 2 diabetes is long, with dozens of demographic, behavioural, and genetic risk factors now identified.3 Unfortunately the list of simple, consensus based levers to change population risk factors and substantially influence the risk for type 2 diabetes remains short.  
feeds.bmj.com
about 4 years ago
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Survey Data Often Understate True Disease Prevalence and Sometimes Vastly Overstate Its Growth

(Business Wire)  Disease prevalence estimates that rely solely on responses to surveys inquiring about treatment or diagnosis tend to understate true prevalence and obscure prevalence trends. For example, treated diabetes prevalence was less than half of true prevalence in 1999-2000. Over the ensuing twelve years, the rate of increase in treated prevalence was more than 50 percent higher than that of true prevalence.  
promotedstories.com
about 4 years ago
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cme-education.php

Aside from noncompliance on the part of patients and a system of health care in Nigeria plagued with poor regulatory and infrastructural problems, doctors could be amazed how we as care providers are contributing to the increasing prevalence of .......(read more)  
medenhanz.com
about 4 years ago
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Critical Care

Limited information exists on the etiology, prevalence, and significance of hyperdynamic left ventricular ejection fraction (HDLVEF) in the intensive care unit (ICU). Our aim in the present study was to compare characteristics and outcomes of patients with HDLVEF with those of patients with normal left ventricular ejection fraction in the ICU using a large, public, deidentified critical care database.  
ccforum.com
about 4 years ago
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Pain in Women: Rheumatology

UCSD School of Medicine and the Diana Padelford Binkley Foundation bring you this groundbreaking series to improve awareness of the prevalence and severity o...  
youtube.com
about 4 years ago
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Critical Care

Metrics typically used to report the performance of an early warning score (EWS), such as the area under the receiver operator characteristic curve or C-statistic, are not useful for pre-implementation analyses. Because physiological deterioration has an extremely low prevalence of 0.02 per patient-day, these metrics can be misleading. We discuss the statistical reasoning behind this statement and present a novel alternative metric more adequate to operationalize an EWS. We suggest that pre-implementation evaluation of EWSs should include at least two metrics: sensitivity; and either the positive predictive value, number needed to evaluate, or estimated rate of alerts. We also argue the importance of reporting each individual cutoff value.  
ccforum.com
about 4 years ago
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Critical Care

Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep venous thrombosis (DVT), is a common and severe complication of critical illness. Although well documented in the general population, the prevalence of PE is less known in the ICU, where it is more difficult to diagnose and to treat. Critically ill patients are at high risk of VTE because they combine both general risk factors together with specific ICU risk factors of VTE, like sedation, immobilization, vasopressors or central venous catheter. Compression ultrasonography and computed tomography (CT) scan are the primary tools to diagnose DVT and PE, respectively, in the ICU. CT scan, as well as transesophageal echography, are good for evaluating the severity of PE. Thromboprophylaxis is needed in all ICU patients, mainly with low molecular weight heparin, such as fragmine, which can be used even in cases of non-severe renal failure. Mechanical thromboprophylaxis has to be used if anticoagulation is not possible. Nevertheless, VTE can occur despite well-conducted thromboprophylaxis.  
ccforum.com
about 4 years ago
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Prolonged antibiotics for purulent bronchiectasis in children and adults | Cochrane

Non-cystic fibrosis (CF) bronchiectasis is a chronic respiratory condition characterised by abnormal dilatation of the airways. Although its global prevalence is largely unknown, available data from Australia, New Zealand, the United States and England show that bronchiectasis is now diagnosed with increasing frequency. The lungs of patients with bronchiectasis have excessive secretions, which tend to consist of different types of micro-organisms. Long-term antibiotic therapy was proposed to halt persistent and ongoing damage to the lung due to insult from micro-organisms. Therefore, we seek to assess the effects of prolonged antibiotic therapy on patients with bronchiectasis.  
cochrane.org
about 4 years ago
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Critical Care

Brunner et al. [1] showed a higher than previously described prevalence of renal tubular acidosis (RTA) in critically ill patients with hyperchloremic metabolic acidosis (HMA). They elegantly demonstrated that this condition often remains unrecognized owing to the simultaneous presence of metabolic alkalosis, mainly attributed to low plasma albumin levels, and was not associated with increased morbidity or mortality. HMA was thought to result from altered renal chloride handling as seen in RTA and was considered a nonharmful physiological response.  
ccforum.com
about 4 years ago
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Critical Care

Methicillin-resistant Staphylococcus aureus (MRSA) remains an important pathogen in pneumonia. Bacteremia may secondarily complicate MRSA pneumonia. The epidemiology and outcomes associated with bacteremia in the setting of MRSA pneumonia are unknown. We sought to describe the prevalence of bacteremia in MRSA pneumonia and its impact on hospital mortality and length of stay (LOS).  
ccforum.com
about 4 years ago
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Time to question the NHS diabetes prevention programme

A new Public Health England report on the rising prevalence of type 2 diabetes proposes targeting people with non-diabetic hyperglycaemia (defined as an HbA1c concentration of 42-47 mmol/mol) with behavioural interventions (diet and exercise). 1 Action for this group (10.7% of the adult population) is to be the cornerstone of the NHS Diabetes Prevention Programme, which will be rolled out nationally from 2016.2  
feeds.bmj.com
about 4 years ago
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Non-pharmacological interventions for people with epilepsy and intellectual disabilities | Cochrane

Epilepsy is a neurological condition characterised by involuntary activity of the brain, which manifests in seizures. The rate of epilepsy in people with intellectual diabilities is significantly higher than in the general population. Epilepsy in this population is often less responsive to antiepileptic drugs (AEDs) and is associated with higher rates of morbidity and mortality. One relevant study comparing two surgical procedures has been included in this review. This study found that anterior corpus callosotomy (a procedure in which a section of the corpus callosum is severed) with anterior temporal lobectomy (a procedure in which part of the temporal lobe is removed) is more effective than anterior temporal lobectomy alone in improving quality of life and performance on IQ tests among people with epilepsy and intellectual disabilities. No support was found for a relative benefit of either procedure for improved seizure control. This review accentuates the lack of randomised controlled trials (RCTs) evaluating non-pharmacological interventions for people with epilepsy and intellectual disabilities. Given the prevalence and nature of epilepsy in this population, well-designed RCTs are needed to ascertain the effects of non-pharmacological interventions on seizure and behavioural outcomes in people with intellectual disabilities. However, good quality evidence derived from RCTs including the non-intellectually disabled should be assessed for side effects and efficacy before such studies are undertaken.  
cochrane.org
about 4 years ago