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Independent medical assessment

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https://www.readbyqxmd.com/read/28092428/reproducibility-of-clinical-events-adjudications-in-a-trial-of-venous-thromboembolism-prevention
#1
P Girard, A Penaloza, F Parent, B Gable, O Sanchez, P Durieux, P Hausfater, S Dambrine, G Meyer, P-M Roy
BACKGROUND: When clinical trials use clinical endpoints, establishing independent Clinical Events Committees (CEC) is recommended to homogenize the interpretation of investigators data. However, the reproducibility of CEC adjudications is almost unexplored. OBJECTIVES: To assess the reproducibility of CEC adjudications in a trial of venous thromboembolism (VTE) prevention. METHODS: The PREVENU study, a multicenter trial of VTE prevention, included 15,351 hospitalized medical patients...
January 16, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28092320/does-a-platelet-transfusion-independently-affect-bleeding-and-adverse-outcomes-in-cardiac-surgery
#2
Fabienne M A van Hout, Esther K Hogervorst, Peter M J Rosseel, Johanna G van der Bom, Mohamed Bentala, Eveline L A van Dorp, Nan van Geloven, Anneke Brand, Nardo J M van der Meer, Leo M G van de Watering
BACKGROUND: Conflicting results have been reported concerning the effect of platelet transfusion on several outcomes. The aim of this study was to assess the independent effect of a single early intraoperative platelet transfusion on bleeding and adverse outcomes in cardiac surgery patients. METHODS: For this observational study, 23,860 cardiac surgery patients were analyzed. Patients who received one early (shortly after cardiopulmonary bypass while still in the operating room) platelet transfusion, and no other transfusions, were defined as the intervention group...
January 16, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28091770/relevance-of-surgery-in-patients-with-non-variceal-upper-gastrointestinal-bleeding
#3
S Dango, T Beißbarth, E Weiss, A Seif Amir Hosseini, D Raddatz, V Ellenrieder, J Lotz, B M Ghadimi, A Beham
INTRODUCTION: Upper GI bleeding remains one of the most common emergencies with a substantial overall mortality rate of up to 30%. In severe ill patients, death does not occur due to failure of hemostasis, either medical or surgical, but mainly from comorbidities, treatment complications, and decreased tolerated blood loss. Management strategies have changed dramatically over the last two decades and include primarily endoscopic intervention in combination with acid-suppressive therapy and decrease in surgical intervention...
January 14, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28091431/determinants-of-quality-of-life-among-community-dwelling-persons-with-spinal-cord-injury-a-path-analysis
#4
End Ekechukwu, J O Ikrechero, A O Ezeukwu, A V Egwuonwu, L Umar, U M Badaru
CONTEXT: Recent advancement in technology and medical care has resulted in an increase not only in disability arising from spinal cord injury (SCI) but also its attendant challenges such as poor quality of life (QoL). AIM: To test a theoretical model of predictors of QoL among persons with SCI. SETTINGS AND DESIGN: Study was conducted in the South Eastern Nigeria. A longitudinal study design was employed. MATERIALS AND METHODS: A total of 64 persons with SCI discharged from in-hospital admission participated in this study...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28090731/addition-of-ezetimibe-to-statins-for-patients-at-high-cardiovascular-risk-systematic-review-of-patient-important-outcomes
#5
REVIEW
Yutong Fei, Gordon Henry Guyatt, Paul Elias Alexander, Regina El Dib, Reed A C Siemieniuk, Per Olav Vandvik, Mark E Nunnally, Huda Gomaa, Rebecca L Morgan, Arnav Agarwal, Ying Zhang, Neera Bhatnagar, Frederick A Spencer
Ezetimibe is widely used in combination with statins to reduce low-density lipoprotein. We sought to examine the impact of ezetimibe when added to statins on patient-important outcomes. Medline, EMBASE, CINAHL, and CENTRAL were searched through July, 2016. Randomized controlled trials (RCTs) of ezetimibe combined with statins versus statins alone that followed patients for at least 6 months and reported on at least one of all-cause mortality, cardiovascular deaths, non-fatal myocardial infarctions (MI), and non-fatal strokes were included...
January 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28090374/neurophysiological-measures-and-alcohol-use-disorder-aud-hypothesizing-links-between-clinical-severity-index-and-molecular-neurobiological-patterns
#6
Mario Vitali, Carmen Napolitano, Marlene Oscar Berman, Simona Flamminii Minuto, Gemma Battagliese, Maria Luisa Attilia, Eric R Braverman, Marina Romeo, Kenneth Blum, Mauro Ceccanti
BACKGROUND: In 1987, Cloninger proposed a clinical description and classification of different personality traits genetically defined and independent from each other. Moreover, he elaborated a specific test the TCI to investigate these traits/states. The study of craving in Alcohol Use Disorder (AUD) assumed a greater significance, since ever more data seems to suggest a direct correlation between high levels of craving and a higher risk of relapse in alcoholics. Thus, our study aim is to explore the possible correlations among TCI linked molecular neurobiological pattern (s), craving and alcohol addiction severity measures in a sample of Italian alcoholics...
April 2016: Journal of Addiction Research & Therapy
https://www.readbyqxmd.com/read/28090345/electronically-captured-patient-reported-physical-function-an-important-vital-sign-in-obesity-medicine
#7
J Fleming, G C Wood, C Seiler, A Cook, M R Lent, C D Still, P N Benotti, B A Irving
OBJECTIVES: Impaired physical function (i.e., inability to walk 200 feet, climb a flight of stairs or perform activities of daily living) predicts poor clinical outcomes and adversely impacts medical and surgical weight management. However, routine assessment physical function is seldom performed clinically. The PROMIS Physical Function Short Form 20a (SF-20a) is a validated questionnaire for assessing patient reported physical function, which includes published T-score percentiles adjusted for gender, age and education...
December 2016: Obesity Science & Practice
https://www.readbyqxmd.com/read/28089967/clinical-orofacial-examination-in-juvenile-idiopathic-arthritis-international-consensus-based-recommendations-for-monitoring-patients-in-clinical-practice-and-research-studies
#8
Peter Stoustrup, Marinka Twilt, Lynn Spiegel, Kasper Dahl Kristensen, Bernd Koos, Thomas Klit Pedersen, Annelise Küseler, Randy Q Cron, Shelly Abramowicz, Carlalberta Verna, Timo Peltomäki, Per Alstergren, Ross Petty, Sarah Ringold, Sven Erik Nørholt, Rotraud K Saurenmann, Troels Herlin
OBJECTIVE: To develop international consensus-based recommendations for the orofacial examination of patients with juvenile idiopathic arthritis (JIA), for use in clinical practice and research. METHODS: Using a sequential phased approach, a multidisciplinary task force developed and evaluated a set of recommendations for the orofacial examination of patients with JIA. Phase 1: A Delphi survey was conducted among 40 expert physicians and dentists with the aim of identifying and ranking the importance of items for inclusion...
January 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28089709/objective-assessment-of-dietary-patterns-by-use-of-metabolic-phenotyping-a-randomised-controlled-crossover-trial
#9
Isabel Garcia-Perez, Joram M Posma, Rachel Gibson, Edward S Chambers, Tue H Hansen, Henrik Vestergaard, Torben Hansen, Manfred Beckmann, Oluf Pedersen, Paul Elliott, Jeremiah Stamler, Jeremy K Nicholson, John Draper, John C Mathers, Elaine Holmes, Gary Frost
BACKGROUND: Accurate monitoring of changes in dietary patterns in response to food policy implementation is challenging. Metabolic profiling allows simultaneous measurement of hundreds of metabolites in urine, the concentrations of which can be affected by food intake. We hypothesised that metabolic profiles of urine samples developed under controlled feeding conditions reflect dietary intake and can be used to model and classify dietary patterns of free-living populations. METHODS: In this randomised, controlled, crossover trial, we recruited healthy volunteers (aged 21-65 years, BMI 20-35 kg/m(2)) from a database of a clinical research unit in the UK...
January 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28089608/piloting-the-united-kingdom-prescribing-safety-assessment-with-pharmacist-prescribers-in-scotland
#10
Fiona Reid, Ailsa Power, Derek Stewart, Anne Watson, Leon Zlotos, Derna Campbell, Trudi McIntosh, Simon Maxwell
BACKGROUND: Prescribing is a complex task requiring considerable knowledge and skills. The Prescribing Safety Assessment (PSA) was developed by the British Pharmacological Society and the United Kingdom (UK) Medical Schools Council. Between February and June 2014, over 7000 final year medical students undertook the PSA, with an overall pass rate of 94%. Independent prescribing for suitably trained pharmacists was introduced in the UK in 2006. To date there has been little focus on any objective measures of prescribing safety...
January 6, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28088527/navigation-in-the-electronic-health-record-a-review-of-the-safety-and-usability-literature
#11
REVIEW
Lisette C Roman, Jessica S Ancker, Stephen B Johnson, Yalini Senathirajah
OBJECTIVE: Inefficient navigation in electronic health records has been shown to increase users' cognitive load, which may increase potential for errors, reduce efficiency, and increase fatigue. However, navigation has received insufficient recognition and attention in the electronic health record (EHR) literature as an independent construct and contributor to overall usability. Our aims in this literature review were to (1) assess the prevalence of navigation-related topics within the EHR usability and safety research literature, (2) categorize types of navigation actions within the EHR, (3) capture relationships between these navigation actions and usability principles, and (4) collect terms and concepts related to EHR navigation...
January 11, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28087288/outcome-of-adult-patients-attended-by-rapid-response-teams-a-systematic-review-of-the-literature
#12
REVIEW
Joonas Tirkkonen, Tero Tamminen, Markus Skrifvars
BACKGROUND: An abundance of studies have investigated the impact of rapid response teams (RRTs) on in-hospital cardiac arrest rates. However, existing RRT data appear highly variable in terms of both study quality and reported uses of limitations of care, patient survival and patient long-term outcome. METHODS: A systematic electronic literature search (January, 1990-March, 2016) of the PubMed and Cochrane databases was performed. Bibliographies of articles included in the full-text review were searched for additional studies...
January 10, 2017: Resuscitation
https://www.readbyqxmd.com/read/28086868/the-impact-of-students-and-curriculum-on-self-study-during-clinical-training-in-medical-school-a-multilevel-approach
#13
J Barbosa, A Silva, M A Ferreira, M Severo
BACKGROUND: In higher education, the focus has shifted from the acquisition of knowledge to learning objectives and skills. This means that, the majority of student learning time is spent independently working outside the classroom. Students take an active role in setting goals, deciding how to achieve them, and planning individual study time. Although extensive research has recognized the importance of curriculum and students' characteristics in time devoted to self-study, it is still unclear to what extent these variables affect time to study...
January 13, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28086754/making-the-most-of-mealtimes-m3-protocol-of-a-multi-centre-cross-sectional-study-of-food-intake-and-its-determinants-in-older-adults-living-in-long-term-care-homes
#14
Heather H Keller, Natalie Carrier, Susan Slaughter, Christina Lengyel, Catriona M Steele, Lisa Duizer, K Steve Brown, Habib Chaudhury, Minn N Yoon, Alison M Duncan, Veronique M Boscart, George Heckman, Lita Villalon
BACKGROUND: Older adults living in long term care (LTC) homes are nutritionally vulnerable, often consuming insufficient energy, macro- and micronutrients to sustain their health and function. Multiple factors are proposed to influence food intake, yet our understanding of these diverse factors and their interactions are limited. The purpose of this paper is to fully describe the protocol used to examine determinants of food and fluid intake among older adults participating in the Making the Most of Mealtimes (M3) study...
January 13, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28079254/pharmacological-treatment-of-vascular-risk-factors-for-reducing-mortality-and-cardiovascular-events-in-patients-with-abdominal-aortic-aneurysm
#15
REVIEW
Lindsay Robertson, Edmond Atallah, Gerard Stansby
BACKGROUND: Pharmacological prophylaxis has been proven to reduce the risk of cardiovascular events in individuals with atherosclerotic occlusive arterial disease. However, the role of prophylaxis in individuals with abdominal aortic aneurysm (AAA) remains unclear. Several studies have shown that despite successful repair, those people with AAA have a poorer rate of survival than healthy controls. People with AAA have an increased prevalence of coronary heart disease and risk of cardiovascular events...
January 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28078462/assessment-of-predictive-factors-for-recurrence-in-laparoscopic-ventral-hernia-repair-using-a-bridging-technique
#16
P Hauters, J Desmet, D Gherardi, S Dewaele, H Poilvache, P Malvaux
AIM: To assess the long-term incidence and predictive factors for recurrence after laparoscopic ventral hernia repair using a bridging technique. METHODS: The study group consisted of 213 consecutive patients operated by laparoscopy for primary ventral (n = 158) or incisional hernia (n = 55) between 2001 and 2014. Patients had a repair without fascia closure by intra-peritoneal onlay placement of a Parietex(®) composite mesh centred on the defect with an overlap of at least 3 cm...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28077072/diabetes-mellitus-medication-use-and-catastrophic-healthcare-expenditure-among-adults-aged-50-years-in-china-and-india-results-from-the-who-study-on-global-ageing-and-adult-health-sage
#17
Shingai Douglas Gwatidzo, Jennifer Stewart Williams
BACKGROUND: Expenditure on medications for highly prevalent chronic conditions such as diabetes mellitus (DM) can result in financial impoverishment. People in developing countries and in low socioeconomic status groups are particularly vulnerable. China and India currently hold the world's two largest DM populations. Both countries are ageing and undergoing rapid economic development, urbanisation and social change. This paper assesses the determinants of DM medication use and catastrophic expenditure on medications in older adults with DM in China and India...
January 11, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28076926/yoga-treatment-for-chronic-non-specific-low-back-pain
#18
REVIEW
L Susan Wieland, Nicole Skoetz, Karen Pilkington, Ramaprabhu Vempati, Christopher R D'Adamo, Brian M Berman
BACKGROUND: Non-specific low back pain is a common, potentially disabling condition usually treated with self-care and non-prescription medication. For chronic low back pain, current guidelines state that exercise therapy may be beneficial. Yoga is a mind-body exercise sometimes used for non-specific low back pain. OBJECTIVES: To assess the effects of yoga for treating chronic non-specific low back pain, compared to no specific treatment, a minimal intervention (e...
January 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28076253/presenting-signs-of-multiple-myeloma-and-the-effect-of-diagnostic-delay-on-the-prognosis
#19
Neta Goldschmidt, Leora Zamir, Alina Poperno, Nathan R Kahan, Ora Paltiel
BACKGROUND: Presenting symptoms of multiple myeloma (MM) are vague and nonspecific. Early detection poses a diagnostic challenge in primary care. We assessed whether clinical and laboratory data could provide early clues to MM diagnosis and whether time to detection affects survival. METHODS: A retrospective population-based study, including 110 men and women diagnosed with MM between 2002 and 2011, and matched cancer-free controls presenting with back pain. Clinical and laboratory data were extracted from medical records for the 2-year period prior to diagnosis of MM/back pain complaint...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28075612/comparison-of-mechanical-versus-hand-administration-of-iv-contrast-agents-for-pediatric-pulmonary-ct-angiography
#20
Matthew A Zapala, David Zurakowski, Edward Y Lee
OBJECTIVE: The purpose of this study was to assess the difference between mechanical versus hand administration of IV contrast agents on the diagnostic quality of pediatric pulmonary CT angiography (CTA). MATERIALS AND METHODS: A retrospective review of the medical records was performed to detect pediatric patients (≤ 18 years) with pulmonary CTA performed between September 2012 and March 2015. Patients were placed into two cohorts on the basis of the method of contrast administration (mechanical vs hand)...
January 11, 2017: AJR. American Journal of Roentgenology
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