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https://www.readbyqxmd.com/read/28075425/management-of-fibromyalgia-practical-guides-from-recent-evidence-based-guidelines
#1
Winfried Häuser, Jacob Ablin, Serge Perrot, Mary-Ann Fitzcharles
Fibromyalgia (FM) is a prevalent and costly condition worldwide, affecting approximately 2% of the general population. Recent evidence- and consensus-based guidelines from Canada, Germany, Israel and the European League Against Rheumatism aim to support physicians in achieving a comprehensive diagnostic work-up of patients with chronic widespread pain (CWP) and to assist patients and physicians in shared decision making on treament options. Every patient with CWP requires at the first medical evaluation a complete history, medical examination and some laboratory tests (complete blood count, C-reactive protein, serum calcium, creatine phosphokinase, thyroid stimulating hormone, 25-OH vitamin D) to screen for metabolic or inflammatory causes of CWP...
January 4, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28072590/incorporating-the-patient-s-perspective-in-outcomes-research
#2
Betty Hsiao, Liana Fraenkel
PURPOSE OF REVIEW: Incorporation of the patients' perspective in clinical research is critical to ensure that outcomes measured reflect those, which matter most to patients. This review summarizes recent efforts to include the patients' perspective in the development of outcome measures and the importance of encouraging patient participation in decision-making and self-management. RECENT FINDINGS: Since the inclusion of fatigue as a patient-endorsed core outcome measure in rheumatoid arthritis (RA) trials, OMERACT has been instrumental in advocating for patient involvement in the development of core domains and instruments; current endeavors include cultivating an understanding of remission through the eyes of patients and gaining a sense of how to measure features of pain and 'stiffness' deemed as important to patients...
January 7, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28063462/going-digital-a-narrative-overview-of-the-clinical-and-organisational-impacts-of-ehealth-technologies-in-hospital-practice
#3
Justin Keasberry, Ian A Scott, Clair Sullivan, Andrew Staib, Richard Ashby
Objective The aim of the present study was to determine the effects of hospital-based eHealth technologies on quality, safety and efficiency of care and clinical outcomes.Methods Systematic reviews and reviews of systematic reviews of eHealth technologies published in PubMed/Medline/Cochrane Library between January 2010 and October 2015 were evaluated. Reviews of implementation issues, non-hospital settings or remote care or patient-focused technologies were excluded from analysis. Methodological quality was assessed using a validated appraisal tool...
January 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28041600/study-protocol-for-the-option-randomised-controlled-trial-on-the-effect-of-prioritising-treatment-goals-among-older-patients-with-cancer-in-a-palliative-setting
#4
M E Stegmann, J Schuling, T J N Hiltermann, A K L Reyners, H Burger, M Y Berger, A J Berendsen
PURPOSE: Traditionally, general practitioners (GPs) are not involved in cancer-related treatment decisions, despite their often long relationship with patients, and their unique position to explore patients' values, especially with older patients. Therefore, we designed a randomised controlled trial to study the effect, on self-efficacy related to treatment decisions, of a conversation about treatment goals between GPs and patients with cancer in a palliative setting. METHODS: We aim to include 168 patients aged ≥70 years with a diagnosis of non-curable cancer, due to consult their oncologist about treatment options...
February 2017: Maturitas
https://www.readbyqxmd.com/read/28040656/squat-test-performance-and-execution-in-children-with-and-without-cerebral-palsy
#5
M M Eken, J Harlaar, A J Dallmeijer, E de Waard, C A M van Bennekom, H Houdijk
BACKGROUND: Knowledge on lower extremity strength is imperative to informed decision making for children with cerebral palsy (CP) with mobility problems. However, a functional and clinically feasible test is not available. We aimed to determine whether the squat test is suitable for this purpose by investigating test performance and execution in children with cerebral palsy and typically developing (TD) peers. METHODS: Squat test performance, defined by the number of two-legged squats until fatigue (max 20), was assessed in twenty children with bilateral CP (6-19years; gross motor function classification system I-III) and sixteen TD children (7-16years)...
December 18, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/28031762/effects-of-fatigue-on-throwing-performance-in-experienced-team-handball-players
#6
Alberto Nuño, Ignacio J Chirosa, Roland van den Tillaar, Rafael Guisado, Ignacio Martín, Isidoro Martinez, Luis J Chirosa
The purpose of this study was to investigate the effect of central and peripheral physiological fatigue on throwing accuracy and ball release velocity in team handball. Twenty male subjects (age 24.7 ± 3.9 yrs, body mass 88.5 ± 5.0 kg, body height 1.86 ± 0.05 m, training experience 12.7 ± 3.8 yrs) from one handball team participated in this study. The participants completed four sets of eight laps of a circuit that consisted of specific team handball drills/exercises, with decreasing recovery times between the laps in each set in order to induce physiological fatigue...
December 1, 2016: Journal of Human Kinetics
https://www.readbyqxmd.com/read/28028197/limited-cognitive-resources-explain-a-tradeoff-between-perceptual-and-metacognitive-vigilance
#7
Brian Maniscalco, Li Yan McCurdy, Brian Odegaard, Hakwan Lau
: Why do experimenters give subjects short breaks in long behavioral experiments? Whereas earlier studies suggest it is difficult to maintain attention and vigilance over long periods of time, it is unclear precisely what mechanisms benefit from rest after short experimental blocks. Here, we evaluate decline in both perceptual performance and metacognitive sensitivity (i.e., how well confidence ratings track perceptual decision accuracy) over time, and investigate whether characteristics of prefrontal cortical areas correlate with these measures...
December 27, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28003034/resistance-training-program-for-fatigue-management-in-the-workplace-exercise-protocol-in-a-cluster-randomized-controlled-trial
#8
Hélio Gustavo Santos, Luciana Dias Chiavegato, Daniela Pereira Valentim, Patricia Rodrigues da Silva, Rosimeire Simprini Padula
BACKGROUND: Fatigue is a multifactorial condition that leads to disease and loss in production, and it affects a large number of workers worldwide. This study aims to demonstrate a resistance exercise protocol that individuals will perform during the work schedule, and to evaluate the effectiveness of this exercises program for fatigue control. METHODS/DESIGN: This is a cluster randomized controlled trial with two arms and is assessor blinded. A total of 352 workers of both sexes, aged 18-65 years, from a medium-sized dairy plant were enrolled in this study...
December 22, 2016: BMC Public Health
https://www.readbyqxmd.com/read/28000358/a-feasibility-study-for-a-clinical-decision-support-system-prompting-hiv-testing
#9
D R Chadwick, C Hall, C Rae, Ml Rayment, M Branch, J Littlewood, A Sullivan
OBJECTIVES: Levels of undiagnosed HIV infection and late presentation remain high globally despite attempts to increase testing. The objective of this study was to evaluate a risk-based prototype application to prompt HIV testing when patients undergo routine blood tests. METHODS: Two computer physician order entry (CPOE) systems were modified using the application to prompt health care workers (HCWs) to add an HIV test when other tests selected suggested that the patient was at higher risk of HIV infection...
December 21, 2016: HIV Medicine
https://www.readbyqxmd.com/read/27995044/a-concise-drug-alerting-rule-set-for-chinese-hospitals-and-its-application-in-computerized-physician-order-entry-cpoe
#10
Yinsheng Zhang, Xin Long, Weihong Chen, Haomin Li, Huilong Duan, Qian Shang
BACKGROUND: A minimized and concise drug alerting rule set can be effective in reducing alert fatigue. OBJECTIVES: This study aims to develop and evaluate a concise drug alerting rule set for Chinese hospitals. The rule set covers not only western medicine, but also Chinese patent medicine that is widely used in Chinese hospitals. SETTING: A 2600-bed general hospital in China. METHODS: In order to implement the drug rule set in clinical information settings, an information model for drug rules was designed and a rule authoring tool was developed accordingly...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27988874/cognitive-functioning-and-heat-strain-performance-responses-and-protective-strategies
#11
REVIEW
Cyril Schmit, Christophe Hausswirth, Yann Le Meur, Rob Duffield
Despite the predominance of research on physical performance in the heat, many activities require high cognitive functioning for optimal performance (i.e. decision making) and/or health purposes (i.e. injury risk). Prolonged periods of demanding cognitive activity or exercise-induced fatigue will incur altered cognitive functioning. The addition of hot environmental conditions will exacerbate poor cognitive functioning and negatively affect performance outcomes. The present paper attempts to extract consistent themes from the heat-cognition literature to explore cognitive performance as a function of the level of heat stress encountered...
December 17, 2016: Sports Medicine
https://www.readbyqxmd.com/read/27977433/phase-i-dose-escalation-study-of-plitidepsin-in-combination-with-sorafenib-or-gemcitabine-in-patients-with-refractory-solid-tumors-or-lymphomas
#12
Sandrine Aspeslagh, Mark Stein, Rastilav Bahleda, Antoine Hollebecque, Gilles Salles, Emmanuel Gyan, Salvador Fudio, Sonia Extremera, Vicente Alfaro, Arturo Soto-Matos, Jean-Charles Soria
This phase I trial evaluated the combination of the marine-derived cyclodepsipeptide plitidepsin (trade name Aplidin) with sorafenib or gemcitabine in advanced cancer and lymphoma patients. The study included two treatment arms: a sorafenib/plitidepsin (S/P) and a gemcitabine/plitidepsin (G/P) arm. In the S/P arm, patients were treated orally with sorafenib continuous dosing at two dose levels (DL1: 200 mg twice daily and DL2: 400 mg twice daily) combined with plitidepsin (1.8 mg/m, day 1, day 8, day 15, and, q4wk, intravenously)...
December 13, 2016: Anti-cancer Drugs
https://www.readbyqxmd.com/read/27955874/driving-after-adolescent-concussion-advice-from-nurse-practitioners-in-the-absence-of-standardized-recommendations
#13
Tracy A Klein, Janessa M Graves, Jasmine Y Graham
INTRODUCTION: Nurse practitioners (NPs) are authorized to manage concussion recovery. Common adolescent activities, like driving, are omitted from guidelines. We investigated NP driving guidance and its clinical basis for restriction or limitation following adolescent concussion. METHOD: NPs completed a web-based questionnaire after viewing a scripted video scenario of an adolescent describing symptoms of concussion occurring 72 hours prior. Driving recommendations were collected using an open-ended query, then coded and categorized by type, characteristic, and basis...
December 9, 2016: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/27933614/antiviral-agents-for-infectious-mononucleosis-glandular-fever
#14
REVIEW
Muireann De Paor, Kirsty O'Brien, Tom Fahey, Susan M Smith
BACKGROUND: Infectious mononucleosis (IM) is a clinical syndrome, usually caused by the Epstein Barr virus (EPV), characterised by lymphadenopathy, fever and sore throat. Most cases of symptomatic IM occur in older teenagers or young adults. Usually IM is a benign self-limiting illness and requires only symptomatic treatment. However, occasionally the disease course can be complicated or prolonged and lead to decreased productivity in terms of school or work. Antiviral medications have been used to treat IM, but the use of antivirals for IM is controversial...
8, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27919937/primary-care-referral-for-echocardiogram-refer-in-heart-failure-a-diagnostic-accuracy-study
#15
Clare J Taylor, Andrea K Roalfe, Rachel Iles, Fd Richard Hobbs, Pelham Barton, Martin R Cowie, Russell C Davis, Jon Deeks, Jonathan Mant, Deborah McCahon, Theresa McDonagh, George Sutton, Lynda Tait
BACKGROUND: Symptoms of breathlessness, fatigue, and ankle swelling are common in general practice but deciding which patients are likely to have heart failure is challenging. AIM: To evaluate the performance of a clinical decision rule (CDR), with or without N-Terminal pro-B type natriuretic peptide (NT-proBNP) assay, for identifying heart failure. DESIGN AND SETTING: Prospective, observational, diagnostic validation study of patients aged >55 years, presenting with shortness of breath, lethargy, or ankle oedema, from 28 general practices in England...
December 5, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27919396/think-time-a-novel-approach-to-analysis-of-clinicians-behavior-after-reduction-of-drug-drug-interaction-alerts
#16
Richard Schreiber, Julia A Gregoire, Jacob E Shaha, Steven H Shaha
OBJECTIVES: Pharmacologic interaction alerting offers the potential for safer medication prescribing, but research reveals persistent concerns regarding alert fatigue. Research studies have tried various strategies to resolve this problem, with low overall success. We examined the effects of targeted alert reduction on clinician behavior in a resource constrained hospital. METHODS: A physician and a pharmacy informaticist reduced alert levels of several drug-drug interactions (DDI) that clinicians almost always overrode with approval from and knowledge of the medical staff...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27914655/crohn-s-disease
#17
REVIEW
Joana Torres, Saurabh Mehandru, Jean-Frédéric Colombel, Laurent Peyrin-Biroulet
Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract, with increasing incidence worldwide. Crohn's disease might result from a complex interplay between genetic susceptibility, environmental factors, and altered gut microbiota, leading to dysregulated innate and adaptive immune responses. The typical clinical scenario is a young patient presenting with abdominal pain, chronic diarrhoea, weight loss, and fatigue. Assessment of disease extent and of prognostic factors for complications is paramount to guide therapeutic decisions...
November 30, 2016: Lancet
https://www.readbyqxmd.com/read/27913549/second-line-therapies-in-immune-thrombocytopenia
#18
Rachael F Grace, Cindy Neunert
Immune thrombocytopenia (ITP) is a rare, acquired autoimmune condition characterized by a low platelet count and an increased risk of bleeding. Although many children and adults with ITP will not need therapy beyond historic first-line treatments of observation, steroids, intravenous immunoglobulin (IVIG), and anti-D globulin, others will have an indication for second-line treatment. Selecting a second-line therapy depends on the reason for treatment, which can vary from bleeding to implications for health-related quality of life (HRQoL) to likelihood of remission and patient preference with regard to adverse effects, route of administration, and cost...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27901246/chemotherapy-for-advanced-non-small-cell-lung-cancer-in-the-elderly-population
#19
Fábio Nasser Santos, Tiago Biachi de Castria, Marcelo Rocha Souza Cruz, Rachel Riera
BACKGROUND: Approximately 50% of patients with newly diagnosed non-small cell lung cancer (NSCLC) are over 70 years of age at diagnosis. Despite this fact, these patients are underrepresented in randomized controlled trials (RCTs). As a consequence, the most appropriate regimens for these patients are controversial, and the role of single-agent or combination therapy is unclear. In this setting, a critical systematic review of RCTs in this group of patients is warranted. OBJECTIVES: To assess the effectiveness and safety of different cytotoxic chemotherapy regimens for previously untreated elderly patients with advanced (stage IIIB and IV) NSCLC...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27865552/relationship-between-voice-complaints-and-subjective-and-objective-measures-of-vocal-function-in-iranian-female-teachers
#20
Maryam Faham, Nahid Jalilevand, Farhad Torabinezhad, Erin Pearson Silverman, Akram Ahmadi, Zahra Ghayoumi Anaraki, Narges Jafari
OBJECTIVES: Teachers are at high risk of developing voice problems because of the excessive vocal demands necessitated by their profession. Teachers' self-assessment of vocal complaints, combined with subjective and objective measures of voice, may enable better therapeutic decision-making. This investigation compared audio-perceptual assessment and acoustic variables in teachers with and without voice complaints. METHODS: Ninety-nine teachers completed this cross-sectional study and were assigned to one of two groups: those "with voice complaint (VC)" and those "without voice complaint (W-VC)...
November 16, 2016: Journal of Voice: Official Journal of the Voice Foundation
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