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https://www.readbyqxmd.com/read/29054690/removable-rigid-dressings-for-postoperative-management-of-transtibial-amputations-a-review-of-published-evidence
#1
REVIEW
James P Reichmann, Phillip M Stevens, John Rheinstein, Christopher D Kreulen
Forty years of clinical experience and peer reviewed research studies support the use of non-weight bearing removable rigid dressings (RRD) as an effective means of post-operative management of transtibial amputations. We reviewed the published medical evidence regarding the use of RRDs as a postoperative management strategy, culminating in an evidence-based practice recommendation. Published peer reviewed literature on the topic was searched and classified by level of evidence based on the research design utilizing the scale recommended by the PM&R Journal (level I through V)...
October 17, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29053215/the-identification-of-barriers-to-insulin-therapy-and-approaches-for-overcoming-them
#2
REVIEW
D Russell-Jones, F Pouwer, K Khunti
Poor glycaemic control in type 2 diabetes (T2D) is a global problem despite the availability of numerous glucose-lowering therapies and clear guidelines for T2D management. Tackling clinical or therapeutic inertia, where the person with diabetes and/or their healthcare providers do not intensify treatment regimens despite this being appropriate, is key to improving patients' long-term outcomes. This gap between best practice and current level of care is most pronounced when considering insulin regimens, with studies showing that insulin initiation/intensification is frequently and inappropriately delayed for several years...
October 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29052946/hierarchical-evaluation-of-electrical-stimulation-protocols-for-chronic-wound-healing-an-effect-size-meta-analysis
#3
Charles Khouri, Sylvain Kotzki, Matthieu Roustit, Sophie Blaise, Francois Gueyffier, Jena-Luc Cracowski
Electrical stimulation (ES) has been tested for decades to improve chronic wound healing. However, uncertainty remains on the magnitude of the efficacy and on the best applicable protocol. We conducted an effect size meta-analysis to assess the overall efficacy of ES on wound healing, to compare the efficacy of the different modalities of electrical stimulation, and to determine whether efficacy differs depending on the wound etiology, size and age of the chronic wound. Twenty-nine randomized clinical trials with 1510 patients and 1753 ulcers were selected...
October 20, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29052289/exploring-implementation-of-the-careful-nursing-philosophy-and-professional-practice-model-%C3%A2-in-hospital-based-practice
#4
Sinéad Murphy, Raphael Mc Mullin, Sinéad Brennan, Therese Connell Meehan
AIM: To explore the effectiveness and feasibility of implementing the two clinical dimensions of the Careful Nursing Philosophy and Professional Practice Model(©) (Careful Nursing) in an acute care hospital. BACKGROUND: Implementation of a professional practice model by nurses in hospitals supports nurses' control over their practice and enhances the quality of their contribution to patient care. Implementing such change is complex and initially best approached on a small scale...
October 19, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/29052162/international-regulations-and-recommendations-for-utility-data-for-health-technology-assessment
#5
REVIEW
Donna Rowen, Ismail Azzabi Zouraq, Helene Chevrou-Severac, Ben van Hout
Recommendations and guidelines for the collection, generation, source and usage of utility data for health technology assessment (HTA) vary across different countries, with no international consensus. Many international agencies generate their own guidelines providing details on their preferred methods for HTA submissions, and there is variability in both what they recommend and the clarity and amount of detail provided in their guidelines. This article provides an overview of international regulations and recommendations for utility data in HTA for a selection of key HTA countries: Australia, Canada, France, Germany, the Netherlands, Spain (Catalonia), Sweden and the UK (England/Wales and Scotland)...
October 19, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/29051276/precision-medicine-in-airway-diseases-moving-to-clinical-practice
#6
Alvar Agustí, Mona Bafadhel, Richard Beasley, Elisabeth H Bel, Rosa Faner, Peter G Gibson, Renaud Louis, Vanessa M McDonald, Peter J Sterk, Mike Thomas, Claus Vogelmeier, Ian D Pavord
On February 21, 2017, a European Respiratory Society research seminar held in Barcelona discussed how to best apply precision medicine to chronic airway diseases such as asthma and chronic obstructive pulmonary disease. It is now clear that both are complex and heterogeneous diseases, that often overlap and that both require individualised assessment and treatment. This paper summarises the presentations and discussions that took place during the seminar. Specifically, we discussed the need for a new taxonomy of human diseases, the role of different players in this scenario (exposome, genes, endotypes, phenotypes, biomarkers and treatable traits) and a number of unanswered key questions in the field...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29048357/health-philosophy-of-dietitians-and-its-implications-for-life-satisfaction-an-exploratory-study
#7
Patricia Grace-Farfaglia, Denise Pickett-Bernard, Andrea White Gorman, Jaleh Dehpahlavan
Studies of health providers suggest that satisfaction with life is related to their values and sense of purpose which is best achieved when their professional role is in harmony with personal philosophy. Cross-sectional surveys suggest that personal health beliefs and practices of health professionals influence their clinical counseling practices. However, little is known about the influence of health philosophy on the personal satisfaction with life for dietitians. This study recruited a randomly selected, cross-sectional sample to complete a self-administered online survey...
October 19, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/29048237/lenvatinib-for-the-treatment-of-radio-iodine-refractory-thyroid-cancer-in-real-life-practice
#8
Amandine Berdelou, Isabelle Borget, Yann Godbert, Thierry Nguyen, Marie-Eve Garcia, Cecile N Chougnet, Aurélie Ferru, Camille Buffet, Olivier Chabre, Olivier Huillard, Sophie Leboulleux, Martin Schlumberger
BACKGROUND: In the SELECT phase III trial in advanced radio-iodine refractory differentiated thyroid cancer (rDTC), lenvatinib improved median progression free survival (PFS) over placebo by almost 15 months and induces an objective response rate of 64.8%, but adverse events occurred in almost all patients. The present study evaluates the efficacy and toxicity of lenvatinib treatment in real-life practice. METHODS: Clinical charts of 88 consecutive patients treated with lenvatinib from July 2015 to June 2016 in 27 French centers were retrospectively reviewed...
October 19, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29047394/esprit-ethics-committee-proposals-for-long-term-medical-data-registries-in-rapidly-evolving-research-fields-a-future-proof-best-practice-approach
#9
S Oberbichler, W O Hackl, A Hörbst
BACKGROUND: Long-term data collection is a challenging task in the domain of medical research. Many effects in medicine require long periods of time to become traceable e.g. the development of secondary malignancies based on a given radiotherapeutic treatment of the primary disease. Nevertheless, long-term studies often suffer from an initial lack of available information, thus disallowing a standardized approach for their approval by the ethics committee. This is due to several factors, such as the lack of existing case report forms or an explorative research approach in which data elements may change over time...
October 18, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29046431/a-survey-of-perceived-effectiveness-of-part-4-maintenance-of-certification
#10
Joel S Tieder, Sean P Prall, Jimmy Beck, Erin Alberda, Debra Jensen, Deepthi Nair, Jan D Carline
OBJECTIVES: Evaluative assessment is needed to inform improvement of Part 4 Maintenance of Certification (MOC), a large-scale program that aims to improve physician knowledge, engagement, and skills in quality improvement (QI). We sought to determine if Part 4 MOC participation improves perceived educational and clinical outcomes by piloting a new physician survey. METHODS: We administered a new online survey (MOC Practice, Engagement, Attitude, and Knowledge Survey) to physicians at the beginning and end of a Part 4 MOC project sponsored by a pediatric hospital's American Board of Medical Specialties' portfolio program during 2015...
October 18, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29046084/penetrating-neck-injuries-a-guide-to-evaluation-and-management
#11
J L Nowicki, B Stew, E Ooi
Introduction Penetrating neck injury is a relatively uncommon trauma presentation with the potential for significant morbidity and possible mortality. There are no international consensus guidelines on penetrating neck injury management and published reviews tend to focus on traditional zonal approaches. Recent improvements in imaging modalities have altered the way in which penetrating neck injuries are now best approached with a more conservative stance. A literature review was completed to provide clinicians with a current practice guideline for evaluation and management of penetrating neck injuries...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29045344/atrial-fibrillation-and-cardiac-resynchronization-therapy
#12
Maurizio Gasparini, Paola Galimberti
PURPOSE OF REVIEW: Atrial fibrillation and heart failure are commonly encountered in current clinical practice. This review aims to revisit the complex interaction of these two common situations and the best treatment whenever both occurs, especially focusing on heart failure patients undergoing cardiac resynchronization therapy (CRT). RECENT FINDINGS: It has been recently confirmed that in patients undergoing cardiac resynchronization therapy, 100% biventricular pacing percentage should be pursued...
October 17, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29045273/oneflorida-clinical-research-consortium-linking-a-clinical-and-translational-science-institute-with-a-community-based-distributive-medical-education-model
#13
Elizabeth Shenkman, Myra Hurt, William Hogan, Olveen Carrasquillo, Steven Smith, Andrew Brickman, David Nelson
PROBLEM: Developing a national pragmatic clinical trial infrastructure is central to understanding the effectiveness of interventions applied under usual conditions and where people receive health care. To address this challenge, three Florida universities- the University of Florida Clinical and Translational Science Institute, Florida State University (with its community-based distributive medical education model), and the University of Miami-created (2010-2013) a statewide consortium, the OneFlorida Clinical Research Consortium, to support the conduct of pragmatic clinical trials and provide mentored research experiences for medical and graduate students in real-world practice settings...
October 17, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29044787/intracardiac-ablation-for-atrioventricular-nodal-reentry-tachycardia-using-a-6%C3%A2-mm-distal-electrode-cryoablation-catheter-prospective-multicenter-north-american-study-icy-avnrt-study
#14
Peter Wells, Marc Dubuc, George J Klein, Dan Dan, Jean-Francois Roux, Evan Lockwood, Marcio Sturmer, David Dunbar, Paul Novak, Arun Rao, Brett J Peterson, Fred Kueffer, Kenneth A Ellenbogen
INTRODUCTION: Radiofrequency (RF) ablation is effective for slow pathway ablation, but carries a risk of inadvertent AV block requiring permanent pacing. By comparison, cryoablation with a 4 mm distal electrode catheter has not been reported to cause permanent AV block but has been shown to be less effective than RF ablation. We sought to define the safety and efficacy of a 6 mm distal electrode cryoablation catheter for slow pathway ablation in patients with atrioventricular nodal reentry tachycardia (AVNRT)...
October 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29043925/filipino-therapists-experiences-and-attitudes-of-interprofessional-education-and-collaboration-a-cross-sectional-survey
#15
Michael Palapal Sy
For the past more than 50 years, the World Health Organisation has acknowledged through empirical findings that health workers that learn together work together effectively to provide the best care for their patients. This study aimed to: (1) describe the perceived extent of interprofessional education (IPE) experience among Filipino occupational therapists (OTs), physical therapists (PTs), and speech-language-pathologists (SLPs); (2) identify their attitudes towards interprofessional collaboration (IPC); and (3) compare their attitudes towards IPC according to: prior IPE experience, classification of IPE experience, profession, years of practice, and practice setting...
November 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29043566/clinical-evaluation-and-physical-exam-findings-in-patients-with-anterior-shoulder-instability
#16
REVIEW
Vincent A Lizzio, Fabien Meta, Mohsin Fidai, Eric C Makhni
PURPOSE OF REVIEW: The goal of this paper is to provide an overview in evaluating the patient with suspected or known anteroinferior glenohumeral instability. RECENT FINDINGS: There is a high rate of recurrent subluxations or dislocations in young patients with history of anterior shoulder dislocation, and recurrent instability will increase likelihood of further damage to the glenohumeral joint. Proper identification and treatment of anterior shoulder instability can dramatically reduce the rate of recurrent dislocation and prevent subsequent complications...
October 17, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29043514/efficacy-of-a-triplet-and-doublet-based-chemotherapy-as-first-line-therapy-in-patients-with-her2-negative-metastatic-gastric-cancer-a-retrospective-analysis-from-the-clinical-practice
#17
Maria Maddalena Laterza, Luca Pompella, Angelica Petrillo, Giuseppe Tirino, Annalisa Pappalardo, Michele Orditura, Teresa Troiani, Fortunato Ciardiello, Natale Di Martino, Ferdinando De Vita
The best choice of chemotherapy regimen for patients with metastatic gastric cancer is still debated. Although several studies support a superior efficacy of a triplet chemotherapy regimen over a doublet-based regimen, the magnitude of this benefit appears small and accompanied by an increased toxicity. Based on this background, we evaluated the outcome of patients with HER2-negative metastatic gastric cancer (mGC) who received in the clinical practice a triplet or doublet regimen as first-line therapy. A total of 165 patients (pts) with HER2-negative mGC treated outside of clinical trials at our department with FOLFOX-4 or ECX from 2012 and 2015 were included in our retrospective analysis: FOLFOX-4: 86 pts; ECX: 79 pts...
October 17, 2017: Medical Oncology
https://www.readbyqxmd.com/read/29042825/antithrombotics-in-trauma-management-strategies-in-the-older-patients
#18
REVIEW
Henna Wong, Nicola Lovett, Nicola Curry, Ku Shah, Simon J Stanworth
The ageing population has resulted in a change in the demographics of trauma, and older adult trauma now accounts for a growing number of trauma admissions. The management of older adult trauma can be particularly challenging, and exhibits differences to that of the younger age groups affected by trauma. Frailty syndromes are closely related with falls, which are the leading cause of major trauma in older adults. Comorbid disease and antithrombotic use are more common in the older population. Physiological changes that occur with ageing can alter the expected clinical presentation of older persons after injury and their susceptibility to injury...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/29042749/a-review-of-results-after-implantation-of-a-secondary-intraocular-lens-to-correct-residual-refractive-error-after-cataract-surgery
#19
Kjell Gunnar Gundersen, Rick Potvin
PURPOSE: The purpose of this study was to provide clinical outcomes data related to secondary intraocular lens (IOL) implantation for the correction of residual refractive error after cataract surgery. PATIENTS AND METHODS: A chart review was conducted to identify all eyes implanted with the monofocal spherical or toric AddOn(®) secondary IOL. Data were collated from charts where uncomplicated initial cataract surgery was completed. Measures of interest included the original IOL implanted, the postoperative refractive error (before secondary IOL implantation) and the associated corrected and uncorrected visual acuities (VAs)...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29040999/hepatic-function-during-repeated-tace-procedures-and-prognosis-after-introducing-sorafenib-in-patients-with-unresectable-hepatocellular-carcinoma-multicenter-analysis
#20
Atsushi Hiraoka, Takashi Kumada, Masatoshi Kudo, Masashi Hirooka, Yohei Koizumi, Yoichi Hiasa, Kazuto Tajiri, Hidenori Toyoda, Toshifumi Tada, Hironori Ochi, Koji Joko, Noritomo Shimada, Akihiro Deguchi, Toru Ishikawa, Michitaka Imai, Kunihiko Tsuji, Kojiro Michitaka
BACKGROUND/AIM: We evaluated the relationship of hepatic function with repeated transarterial catheter chemoembolization (TACE) and prognosis after sorafenib treatment in various patient cohorts. METHODS: Study 1 comprised of 212 Barcelona clinic liver cancer stage-B (BCLC-B) HCC patients classified as Child-Pugh A (CP-A) and who had received repeated TACE treatments (r-TACE) (naïve:recurrence = 66:146). Study 2 comprised of 435 patients with unresectable HCC classified as CP-A in who sorafenib was introduced (naïve:recurrence = 37:398; CP score 5:6 = 282:153; macro-vessel invasion [MVI]+: extrahepatic metastasis [EHM]+ both negative = 124:226:143)...
2017: Digestive Diseases
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