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Clinical instruction

Xing Chen, Detlef Wolf, Juliane Siebourg-Polster, Christian Czech, Ulrike Bonati, Dirk Fischer, Omar Khwaja, Martin Strahm
Progressive and irreversible muscle atrophy characterizes Spinal Muscular Atrophy (SMA) and other similar muscle disorder diseases. Objective assessment of muscle functions is an essential and important, although challenging, prerequisite for successful clinical trials. Current clinical rating scales restrain the movement abnormalities to certain predefined coarse-grained individual items. The Kinect 3-D sensor has emerged as a low-cost and portable motion sensing technology used to capture and track people's movement in many medical and research fields...
February 12, 2018: Journal of Visualized Experiments: JoVE
Xiao-Meng Zhang, Fan Li, Bing Zhang, Xiao-Fen Chen, Jing-Zhu Piao
The common Aconitum herbs in clinical application mainly include Aconiti Radix(Chuanwu), Aconiti Kusnezoffii Radix(Caowu) and Aconiti Lateralis Radix Praeparaia(Fuzi), all of which have toxicity. Therefore, the safety of using Chinese patent drugs including Aconitum herbs has become an hot topic in clinical controversy. Based on the data-mining methods, this study explored the characteristics and causes of adverse drug reactions/events (ADR/ADE) of the Chinese patent drugs including Aconitum, in order to provide pharmacovigilance and rational drug use suggestions for clinical application...
January 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
John W Kakareka, Anthony Z Faranesh, Randall H Pursley, Adrienne Campbell-Washburn, Daniel A Herzka, Toby Rogers, Josh Kanter, Kanishka Ratnayaka, Robert J Lederman, Thomas J Pohida
Hemodynamic recording during interventional cardiovascular procedures is essential for procedural guidance, monitoring patient status, and collection of diagnostic information. Recent advances have made interventions guided by magnetic resonance imaging (MRI) possible and attractive in certain clinical scenarios. However, in the MRI environment, electromagnetic interference (EMI) can cause severe distortions and artifacts in acquired hemodynamic waveforms. The primary aim of this paper was to develop and validate a system to minimize EMI on electrocardiogram (ECG) and invasive blood pressure (IBP) signals...
2018: IEEE Journal of Translational Engineering in Health and Medicine
M Gentry Byrd, Rocio B Quinonez, R Gary Rozier, Ceib Phillips, Marian Mehegan, Ledia Martinez, Kimon Divaris
Objectives Limited information exists on the extent oral health is addressed in the context of prenatal care. This study sought to investigate characteristics of primary care physicians (PCP) who provide oral health counseling to pregnant women. Methods The study relied upon data from the 2013 Survey of PCP on Oral Health. Provision of oral health counseling to pregnant women (sometimes vs. rarely/never) was the primary outcome. Covariates included respondents' demographic and practice characteristics, oral health-related training, knowledge, attitudes, preparedness and clinical behaviors...
March 16, 2018: Maternal and Child Health Journal
Emi Ushigome, Chikako Oyabu, Toru Tanaka, Goji Hasegawa, Masayoshi Ohnishi, Sei Tsunoda, Hidetaka Ushigome, Isao Yokota, Naoto Nakamura, Yohei Oda, Mai Asano, Muhei Tanaka, Masahiro Yamazaki, Michiaki Fukui
The prognostic significance of masked hypertension (MH) on the progression of diabetic nephropathy among patients with type II diabetes is not well documented. We examined the relationship between clinic systolic blood pressure (SBP) and morning home SBP measurements and progression to macroalbuminuria in patients with type II diabetes. We analyzed prospective cohort study data from 712 patients with type II diabetes. We classified the patients into the following four groups according to their clinic (130 mm Hg) and home (125 mm Hg) SBP measurements: controlled blood pressure group, white-coat hypertension group, MH group, and sustained hypertension (SH) group...
March 1, 2018: Journal of the American Society of Hypertension: JASH
Rebecca J Mullen, James Duhig, Andrea Russell, Linda Scarazzini, Fabio Lievano, Michael S Wolf
OBJECTIVE: To present evidence supporting best-practices for prescription drug labeling and educational materials. METHODS: Articles were selected from three online databases (PubMed, Embase, CINAHL). Eligible manuscripts were: 1) English-language, 2) randomized, controlled trials, and 3) focused on improving prescription drug labeling practices. RESULTS: Forty-nine articles were reviewed, and included both regulated label materials and pharmacy or health systems-generated tools...
March 8, 2018: Patient Education and Counseling
Morad Chughtai, John J Kelly, Jared M Newman, Assem A Sultan, Anton Khlopas, Nipun Sodhi, Anil Bhave, Michael C Kolczun, Michael A Mont
This study evaluated the use of telerehabilitation during the postoperative period for patients who underwent total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA). Specifically, this study evaluated the following: (1) patient compliance and adherence to the program, (2) time spent performing physical therapy exercises, (3) the usability of the virtual rehabilitation platform, and (4) clinical outcome scores in a selected primary knee arthroplasty cohort. A total of 157 consecutive patients underwent TKA ( n  = 18) or UKA ( n  = 139)...
March 16, 2018: Journal of Knee Surgery
Robert W Irwin, Jeffrey Smith, S Barry Issenberg
The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Physical Medicine and Rehabilitation (ABPMR) developed milestones for evaluation of resident physicians that include proper musculoskeletal ultrasound (MSUS) examination of major joints. To date, there have been no published data demonstrating acquisition and retention of these skills and correlation with the milestone evaluation. The investigators developed and implemented a curriculum in musculoskeletal ultrasound examination for Physical Medicine and Rehabilitation (PM&R) residents at a large academic medical center...
March 15, 2018: American Journal of Physical Medicine & Rehabilitation
Nicholas M Pantelides, Jeyaram R Srinivasan
BACKGROUND: Implant rippling is a frequent complication following breast augmentation or implant-based reconstruction and results in significant patient dissatisfaction. Traditionally, the treatment has been to replace the implant, often placing it in a subpectoral pocket to reduce the risk of recurrence. Other techniques, such as increasing the implant size or tightening the capsule, can also be used. Recently, however, there has been much interest in alternative treatments, including fat grafting or insertion of an acellular dermal matrix...
March 15, 2018: Aesthetic Plastic Surgery
P Sargos, T Charleux, R L Haas, A Michot, C Llacer, L Moureau-Zabotto, G Vogin, C Le Péchoux, C Verry, A Ducassou, M Delannes, A Mervoyer, N Wiazzane, J Thariat, M P Sunyach, M Benchalal, J D Laredo, M Kind, P Gillon, G Kantor
PURPOSE: The purpose of this study was to evaluate, during a national workshop, the inter-observer variability in target volume delineation for primary extremity soft tissue sarcoma radiation therapy. METHODS AND MATERIALS: Six expert sarcoma radiation oncologists (members of French Sarcoma Group) received two extremity soft tissue sarcoma radiation therapy cases 1: one preoperative and one postoperative. They were distributed with instructions for contouring gross tumour volume or reconstructed gross tumour volume, clinical target volume and to propose a planning target volume...
March 12, 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Alexander Buchholz, Laura Ueberham, Kaja Gorczynska, Borislav Dinov, Sebastian Hilbert, Nikolaos Dagres, Daniela Husser, Gerhard Hindricks, Andreas Bollmann
BACKGROUND: Apixaban is a non-vitamin K oral anticoagulant and has been approved for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (AF). Current labelling recommends dose reduction based on patients age, weight and renal function. OBJECTIVES: The aim of this study was to analyze adherence to current labeling instructions concerning initial apixaban dosing in clinical practice and to identify factors associated with inappropriate dose reduction...
March 15, 2018: Clinical Cardiology
Paul I Musey, John A Lee, Cassandra A Hall, Jeffrey A Kline
BACKGROUND: Approximately 80% of patients presenting to emergency departments (ED) with chest pain do not have any true cardiopulmonary emergency such as acute coronary syndrome (ACS). However, psychological contributors such as anxiety are thought to be present in up to 58%, but often remain undiagnosed leading to chronic chest pain and ED recidivism. METHODS: To evaluate ED provider beliefs and their usual practices regarding the approach and disposition of patients with low risk chest pain associated with anxiety, we constructed a 22-item survey using a modified Delphi technique...
March 14, 2018: BMC Emergency Medicine
Yuan Cao, Shi-Hua Lin, Ding Zhu, Feng Xu, Zhi-Hua Chen, Hua-Hao Shen, Wen Li
BACKGROUND WeChat is a convenient and popular social medium, and it seems to be an appropriate platform for education and management of patients. This study sought to identify usefulness in clinical control of cough-variant asthma (CVA). MATERIAL AND METHODS A randomized controlled trial was conducted among 80 CVA patients. After being assigned to either the traditional group (TG) or the WeChat group (WG), they received the same inhalation therapy, but patients in WG received additional education and instruction via our public account on the WeChat application...
March 14, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Carllini Barroso Vicentini, Juliana Cama Ramacciato, Francisco Carlos Groppo, Rubens Gonçalves Teixeira, Rogério Heládio Lopes Motta
PURPOSE: The aim of the present study was to compare two therapeutic protocols of dexamethasone for the prevention of postoperative swelling, pain, and other complications after the extraction of impacted third molars, in a prospective, randomized, crossover, double-blinded clinical trial. METHODS: Fifty patients with symmetrical impaction of third molars were randomly assigned to two different protocols of dexamethasone for each side. Patients underwent two sessions performed at a 21-day interval...
March 13, 2018: Oral and Maxillofacial Surgery
Guo Yu, Dan-Na Wu, Yan Gong, Guo-Fu Li, Hong-Hao Zhou
PURPOSE: The labeling information, authorized by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA), is expected to guide the method of drug administration with reference to meal intake, aiming at ensuring favorable safety profile and achieving optimal drug exposure. However, interactions between meals and a specific oral anticancer medication are complicated in that could be strongly affected by inter-individual variability in pharmacokinetics, meal compositions, and the timing of drug administration with respect to meal intake, which could lead to conflicting meal recommendations between regulatory authorities...
March 13, 2018: European Journal of Clinical Pharmacology
Se-Ho Park, Sung-Hee Cho, Ji-Young Han
Purpose: The purpose of this study was to evaluate the efficacy of the modified plaque score (MPS) for assessing the oral hygiene status of periodontitis patients. Methods: A total of 116 patients were included in this study. After evaluation of the Löe and Silness gingival index (GI), Silness and Löe plaque index (PlI), O'Leary plaque control record (PCR), and MPS, patients were randomly assigned to either a conventional tooth brushing instruction (C-TBI) group (n=56) or a professional intraoral tooth brushing instruction (P-TBI) group (n=60)...
February 2018: Journal of Periodontal & Implant Science
Severine L. Staub, Eckart Teubner, Nicola U. Zitzmann
The aim of this retrospective study was to investigate the clinical outcome of Dalbo®-Rotex® retention elements in a private practice. The majority of the retention elements was fixed with self-adhesive composite cement, and in almost 40% the exposed root surface was additionally covered with composite. The success rate of 96.3% after 24 months in a total of 50 included patients (response rate 48.5%) demonstrated that a simple and cost-effective fixation of removable dentures using prefabricated, chair-side inserted retention elements is feasible...
March 12, 2018: Swiss Dental Journal
S Reich-Schupke, E Mohren, M Stücker
BACKGROUND: Implementation of guideline recommendations for the diagnosis and therapy of lipedema and lymphedema seems to be problematic in daily routine. Systematic data for Germany are missing. The aim of the study was data collection regarding diagnosis and therapy of lymphologic diseases in an outpatient setting. METHODS: Monocentric, prospective survey of patients from a lymphologic outpatient clinic using a standardized questionnaire focusing on diagnostics and therapy at the initial diagnosis...
March 12, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Marlen Sulamanidze, George Sulamanidze, Constantin Sulamanidze
INTRODUCTION: The aesthetic manifestations of the aging process in the cheekbone, cheek and infraorbital areas are especially concerning for patients, so rejuvenating interventions in these areas are most in demand. OBJECTIVE: To introduce the experience of our clinic for aesthetic manipulation using Aptos (anti-ptosis) thread lifting methods in the midface area. METHODS: Among the surgical interventions that we used were Aptos thread lifting methods both in combination with lower blepharoplasty, and without it...
March 12, 2018: Aesthetic Plastic Surgery
Z Mohd Normani, W H Wan Suhailah, N O Nik Adilah
INTRODUCTION: Tinnitus is a common complaint among patients with ear diseases and can be serious if not treated. Recently, a Malay tinnitus questionnaire, known as the "Borang Evaluasi Soal selidik Tinnitus" (BEST) had been developed and preliminarily validated among Malayspeaking population. The aims of the present study were to determine the test-retest reliability and responsiveness of the BEST questionnaire. METHOD: Forty-six Malay adults (aged 23-74 years) with tinnitus were enrolled...
February 2018: Medical Journal of Malaysia
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