Patient's prefere

BACKGROUND: The optimal strategy for monitoring metastatic breast cancer (M-MBC) is unclear. Nevertheless, M-MBC influences patient's quality of life and it affects the use of resources in terms of both drugs and diagnostic exam prescription. We aim to disclose oncologists' approach on M-MBC, identifying controversial areas. METHODS: An anonymous online survey was conducted among GIM members who, based on their on-field experience, shared their own method for M-MBC planning...

BACKGROUND: Allogeneic haematopoietic stem cell transplantation (alloHSCT) is considered a standard treatment for patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL) achieving complete remission after induction containing tyrosine kinase inhibitors (TKIs). METHODS: We retrospectively compared results of myeloablative alloHSCT from either matched sibling donor (MSD) or unrelated donor (URD) with autologous (auto) HSCT for adults with Ph+ ALL in molecular remission, treated between 2007 and 2014...

PURPOSE: Due to the complexity of hematopoietic cell transplant trial treatments, informed consent forms are often long and difficult to read. We evaluated a two-column easy-to-read informed consent (ETRIC) form that incorporates elements of health literacy and readability in participants and centers participating in Blood and Marrow Transplant Clinical Trials Network (BMT CTN) clinical trials. METHODS: In a randomized study, 198 adult patients from 25 centers potentially eligible to participate in four BMT CTN interventional trials were randomized to ETRIC or standard consent form for that trial...

Diabetes is a frequent condition in pregnancy and achieving adequate glycemic control is of paramount importance. Insulin treatment is the gold standard, oral agents are more attractive, but their safety and efficiency should be a prerequisite for their use. We have more information regarding treatment of women with gestational diabetes mellitus where glyburide can induce a picture of fetal hyperinsulinism (higher birthweight and more neonatal hypoglycemia) whereas metformin requires supplemental insulin in a larger proportion of women but achieves satisfactory perinatal outcomes with the exception of preterm birth...

The number of patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) is increasing. Since these patients have a CHA2 DS2 -VASc score of 1 or higher, they should be treated with oral anticoagulation to prevent stroke. However, combination therapy with oral anticoagulation for prevention of embolic stroke and dual platelet inhibition for prevention of coronary thrombosis significantly increases bleeding complications. The optimal combination, intensity and duration of antithrombotic combination therapy is still not known...

The aim of this pilot study was to estimate the share of working time that staff in psychiatric hospitals theoretically spend on obligatory activities, such as training and further education, organizational and documentation tasks as well as statutory lecturing duties without patient contact. A total of 47 physicians, 39 nurses, 34 psychologists and 35 social workers from eight psychiatric hospitals were interviewed. The results reveal that the theoretically remaining time for direct patient contact is low...

OBJECTIVE: Anesthesiologic method with low bleeding level, risk level, and complication rate for surgical procedures on the hand without a tourniquet on an unsedated patient with the possibility for functional testing during surgery. INDICATIONS: Surgical procedures of the hand can be carried out using the wide awake technique depending on the patient's suitability and preference considering individual risk factors. CONTRAINDICATIONS: Absolute contraindications are allergies to the local anesthetic or its components...

OBJECTIVES: To explore general practitioners' (GPs) routines and considerations on (de)prescribing antihypertensive medication (AHM) in older patients, their judgement on usability of the current guideline and needs for future support. DESIGN: Semistructured interviews. SETTING: Dutch general practice. PARTICIPANTS: Fifteen GPs were purposively sampled based on level of experience and practice characteristics until saturation was reached...

OBJECTIVE: To summarise the evidence on determinants of health-related quality of life (HRQL) in Asian patients with breast cancer. DESIGN: Systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and registered with PROSPERO (CRD42015032468). METHODS: According to the PRISMA guidelines, databases of MEDLINE (PubMed), Embase and PsycINFO were systematically searched using the following terms and synonyms: breast cancer, quality of life and Asia...

OBJECTIVE: To examine the impact of the Preferred Drugs Initiative (PDI), an Irish health policy aimed at enhancing evidence-based cost-effective prescribing, on prescribing trends and the cost of prescription medicines across seven medication classes. DESIGN: Retrospective repeated cross-sectional study spanning the years 2011 - 2016. SETTING: Health Service Executive Primary Care Reimbursement Service pharmacy claims data for General Medical Services (GMS) patients, approximately 40% of the Irish population...

OBJECTIVE: Surgery is an important part of the treatment modalities offered to older patients with cancer. Natural ageing processes lead to deterioration of organ function, making older patients more vulnerable and at risk for experiencing less-favourable outcomes and complications after surgery. Non-pharmaceutical interventions, such as music, may be preferable to medical interventions in older people, who are at risk for adverse effects and drug interactions due to altered physiology and drug metabolism...

OBJECTIVE: This study investigates the impact of introducing a post-general anesthesia ultrasound mapping (PAUS) on the type of vascular access chosen for hemodialysis in patients without previous accesses. METHODS: 203 of 297 consecutive patients met inclusion criteria and were reviewed. Within-subjects analysis was performed on patients with both an outpatient ultrasound-guided vein mapping and a PAUS using sign tests and Wilcoxon signed ranked tests. Further, a between-subjects analysis added patients with only the outpatient vein mapping; demographic and comorbidity data were analyzed using t-tests and chi-squared tests...

Trigeminal neuralgia (TN) is a painful condition characterized by excruciating facial pain, which has a serious impact on quality of life. Depression and anxiety have been commonly associated with TN, but clinical studies report that these comorbidities are frequently underdiagnosed and undertreated in TN patients. Herein it was investigated if rats submitted to the infraorbital nerve constriction (CION), a model of trigeminal neuropathic pain, would display anxiety- and depressive-like behaviors in addition to the facial sensory changes in different time points after the nerve injury...

BACKGROUND: Despite the slow adoption of Minimally Invasive Lobectomy (MIL), it is now a preferred approach for early lung cancer. Nevertheless, ongoing concerns regarding MIL oncologic effectiveness has led to calls for prospective, randomized trials. METHODS: Retrospective analysis of on-line databases, collected readings and other scholarly experiences of the experienced authors were used to construct this review. All available reports containing long-term survival comparisons for open versus MIL were tabulated...

PURPOSE: Comorbid depression is common in patients with epilepsy. However, the epilepsy-associated depression is generally atypical and has not been fully recognized by neurologists. This study aimed to compare the behavioral and pathological changes between the chronic lithium chloride-pilocarpine rat epilepsy model (Licl-pilocarpine model) and the Chronic Unpredictable Mild Stress rat depression model (CUMS model), to evaluate for differences between epilepsy-associated depression and primary depression...

For warfarin-treated patients with atrial fibrillation (AF) at low thromboembolic risk, recent studies have shown harm associated with periprocedural bridging using low-molecular-weight heparin. Clinician surveys have indicated a preference toward excessive bridging, especially among noncardiologists; however, little is known about actual practice patterns in these patients. We performed a retrospective evaluation of bridging in the setting of gastrointestinal endoscopy. We identified 938 patients with AF on warfarin who underwent esophagogastroduodenoscopy or colonoscopy between 2012 and 2016 at a tertiary health center...

BACKGROUND: Inflammatory back pain is a condition characterized by inflammation of the sacroiliac joints and lower spine. It is frequently seen in patients with spondyloarthropathies like ankylosing spondylitis, psoriatic arthritis, enteropathic arthritis and reactive arthritis. Inflammatory back pain can be caused by many other conditions like infection and crystal deposition such as gout. In this case, it is difficult to specifically identify gout as a cause by ordinary imaging like magnetic resonance imaging (MRI) or ultrasound...

BACKGROUND: The present study aimed to investigate smart device medical apps currently preferred by physicians in Saudi Arabia and the perceived impact of the apps on patient care. METHODS: Questionnaires for this cross-sectional study on smart device medical apps were randomly emailed to 384 physicians registered in the Saudi Commission of Health Specialists database. A total of 300 physicians returned completed questionnaires, with a response rate of 78.5%. Physician demographics and their perceptions of medical apps were assessed, including questions on the purpose, impact, and types of medical apps used...

A third of women in childbirth are inadequately monitored, partly due to the tools used. Some stakeholders assert that the current labour monitoring tools are not efficient and need improvement to become more relevant to childbirth attendants. The study objective was to explore the expectations of maternity service providers for a mobile childbirth monitoring tool in maternity facilities in a low-income country like Uganda. Semi-structured interviews of purposively selected midwives and doctors in rural-urban childbirth facilities in Uganda were conducted before thematic data analysis...

In recent times, health care professionals (HCP) have come across a number of migrants as their patients. The cultural differences lead to communicational challenges between the migrant patients and health care professionals. Our project aimed to discover HCPs' attitudes, challenges and needs on cross-cultural communication, so that we can develop an e-learning solution that would be helpful for them. By conducting interviews with HCPs, we identified five crucial categories of problems and the current solutions that experienced professionals use to tackle those problems...