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https://www.readbyqxmd.com/read/29350780/an-evolutionary-concept-analysis-of-futility-in-healthcare
#1
Lauren Morata
AIM: To report a concept analysis of futility in healthcare. BACKGROUND: Each member of the healthcare team, the physician, the nurse, the patient, the family and all others involved perceive futility differently. The current evidence and knowledge in regard to futility in healthcare manifest a plethora of definitions, meanings and interpretations without consensus. DESIGN: Concept analysis. DATA SOURCES: Databases searched included Medline, Cumulative Index of Nursing and Allied Health Literature, Academic Search Premier, Cochrane Database of Systematic Reviews and PsycINFO...
January 19, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29349512/photobiomodulation-induces-in-vitro-re-epithelialization-via-nitric-oxide-production
#2
Manuela Rizzi, Mario Migliario, Stelvio Tonello, Vincenzo Rocchetti, Filippo Renò
Photobiomodulation is a widely used tool in regenerative medicine thanks to its ability to modulate a plethora of physiological responses. Wound re-epithelialization is strictly regulated by locally produced chemical mediators, such as nitric oxide (NO), a highly reactive free radical generated by the nitric oxide synthase (NOS) enzymatic family. In this study, it has been hypothesized that a 980-nm low-level laser stimulation could increase NO production in human keratinocytes and that such event might be directly related to the re-epithelialization process...
January 18, 2018: Lasers in Medical Science
https://www.readbyqxmd.com/read/29346222/-to-err-is-human-but-disclosure-must-be-taught-a-simulation-based-assessment-study
#3
Ashley C Crimmins, Ambrose H Wong, James W Bonz, Alina Tsyrulnik, Karen Jubanyik, James D Dziura, Kelly L Dodge, Leigh V Evans
INTRODUCTION: Although error disclosure is critical in promoting safety and patient-centered care, physicians are inconsistently trained in its practice, and few objective methods to assess competence exist. We used an immersive simulation scenario to determine whether providers with varying levels of clinical experience adhere to the disclosure safe practice guidelines when exposed to a serious adverse event simulation scenario. METHODS: This was a prospective cohort study with medical students, junior emergency medicine (EM) residents (PGY 1-2), senior EM residents (PGY 3-4), and attending EM physicians participating in a simulated case in which a scripted medication overdose resulted in an adverse event...
January 17, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29344267/break-breast-cancer-addiction-by-crispr-cas9-genome-editing
#4
REVIEW
Haitao Yang, MariaLynn Jaeger, Averi Walker, Daniel Wei, Katie Leiker, Tao Weitao
Breast cancer is the leading diagnosed cancer for women globally. Evolution of breast cancer in tumorigenesis, metastasis and treatment resistance appears to be driven by the aberrant gene expression and protein degradation encoded by the cancer genomes. The uncontrolled cancer growth relies on these cellular events, thus constituting the cancerous programs and rendering the addiction towards them. These programs are likely the potential anticancer biomarkers for Personalized Medicine of breast cancer. This review intends to delineate the impact of the CRSPR/Cas-mediated genome editing in identification and validation of these anticancer biomarkers...
2018: Journal of Cancer
https://www.readbyqxmd.com/read/29343464/cardiorespiratory-fitness-coronary-artery-calcium-and-cardiovascular-disease-events-in-a-cohort-of-generally-healthy-middle-aged-men-results-from-the-cooper-center-longitudinal-study
#5
Nina B Radford, Laura F DeFina, David Leonard, Carolyn E Barlow, Benjamin L Willis, Larry W Gibbons, Susan C Gilchrist, Amit Khera, Benjamin D Levine
Background -A robust literature demonstrates that coronary artery calcification (CAC) and cardiorespiratory fitness (CRF) are independent predictors of cardiovascular disease (CVD) events. Much less is known about the joint associations of CRF and CAC with CVD risk. In the setting of high CAC, high versus low CRF has been associated with decreased CVD events. The goal of this study was to assess the impact of continuous levels of CRF on CVD risk in the setting of increasing CAC burden. Methods -We studied 8,425 men without clinical CVD who underwent preventive medicine examinations that included an objective measurement of CRF and CAC between 1998-2007...
January 17, 2018: Circulation
https://www.readbyqxmd.com/read/29343167/a-cluster-randomised-feasibility-trial-of-clinically-assisted-hydration-in-cancer-patients-in-the-last-days-of-life
#6
Andrew N Davies, Melanie Waghorn, Katherine Webber, Sigurd Johnsen, Jeewaka Mendis, Julia Boyle
BACKGROUND: The provision of clinically assisted hydration at the end-of-life is one of the most contentious issues in medicine. AIM: The aim of this feasibility study was to answer the question 'can a definitive (adequately powered) study be done?' DESIGN: The study was a cluster randomised trial, with sites randomised on a one-to-one basis to intervention 'A' (regular mouth care and usual other care) or intervention 'B' (clinically assisted hydration, mouth care and usual other care)...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29341524/-what-s-new-in-ambulatory-general-internal-medicine%C3%A2
#7
Annick Gerber, Camille Buffle Genecand, Thierry Mach, David Schrumpf, Ana Rita Forte Marques, Jean Dupraz, Thomas Schmid
Many treatments are used every day in general medicine without any evidence of their efficacy. This last year, three randomised studies tried to prove the clinical utility of chondroitin/glucosamine in arthritis, cranberry in urinary infections, and acupuncture in migraine. Screening and management of prostate cancer are still controversial. Two recent studies help us advising our patients on this difficult topic. Muscle side effects from statins are well known and have been widely relayed by the press these last years, although myopathies are rare in clinical trials...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29340750/a-pilot-study-evaluating-the-efficacy-and-safety-of-artiss-human-fibrin-sealant-in-external-rhinoplasty
#8
Steven H Dayan, Jonathan T Bacos, Thuy-Van Ho, Nimit Gandhi, Selika Gutierrez-Borst
BACKGROUND: Fibrin sealant application in rhytidectomy has previously demonstrated a reduction in adverse events and drainage volume. Fibrin sealant offers multiple potential benefits including decreasing downtime, reducing complication rates, and improving patient satisfaction. In this study, we evaluated the efficacy and safety of ARTISS [fibrin sealant (human)] in external rhinoplasty. METHODS: Nine healthy participants between the ages of 18 and 50 seeking external rhinoplasty completed this study...
January 16, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29339948/update-on-functional-heartburn
#9
Takahisa Yamasaki, Jessica O'Neil, Ronnie Fass
The definition of functional heartburn has been refined over the years. It is currently described, based upon Rome IV criteria, as typical heartburn symptoms in the presence of normal upper endoscopy findings (including normal biopsies), normal esophageal pH testing, and a negative association between symptoms and reflux events. Functional heartburn is very common, affecting women more than men, and with reflux hypersensitivity makes up the majority of heartburn patients who fail twice-daily proton pump inhibitor therapy...
December 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29335863/integrative-medicine-on-optimizing-clopidogrel-and-aspirin-therapy
#10
REVIEW
Hui Chen
This article reviews the available published data on optimizing clopidogrel and aspirin therapy using translational and integrative medicine. Translational and evidence-based medical studies show that the CYP2C19 gene mutation (CYP2C19*2 and CYP2C19*3) could affect > 50% of the Chinese population, and that this mutation is closely associated with clopidogrel resistance and an increased risk of major adverse cardiovascular events, particularly stent thrombosis in patients following percutaneous coronary intervention (PCI)...
January 15, 2018: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/29335860/effectiveness-and-safety-of-chinese-medicine-for-idiopathic-pulmonary-fibrosis-a-systematic-review-and-meta-analysis
#11
Qi Wu, Yao Zhou, Fan-Chao Feng, Xian-Mei Zhou
OBJECTIVE: To evaluate the effectiveness and safety of Chinese medicine (CM) for Idiopathic pulmonary fifibrosis (IPF) patients. METHODS: To screened relevant articles, PubMed, Cochrane Library, Excerpta Medica Datase (EMBASE), China National Knowledge Infrastructure (CNKI), Chinese VIP Information (VIP), Wanfang Database and Chinese Biomedical Database (CBM) were searched in English or Chinese until December 2015 for randomized controlled trials, which compared CM treatment (CM group) with Western medicine or placebo (control group) on IPF...
January 15, 2018: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/29334511/evaluation-of-recombinant-factor-viia-tranexamic-acid-and-desmopressin-to-reduce-prasugrel-related-bleeding-a-randomised-placebo-controlled-study-in-a-rabbit-model
#12
Fanny Bonhomme, Thomas Lecompte, Charles M Samama, Anne Godier, Pierre Fontana
BACKGROUND: Prasugrel is a thienopyridine that inhibits platelet aggregation more rapidly and effectively than clopidogrel, with an increased bleeding risk. OBJECTIVE: The current study aimed to evaluate the efficacy of three nonspecific haemostatic drugs - recombinant activated factor VII (rFVIIa), tranexamic acid and desmopressin (DDAVP) - to limit blood loss after administration of prasugrel in a rabbit model of bleeding while also evaluating any prothrombotic effects...
January 13, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29332348/sorafenib-combined-with-radiofrequency-ablation-as-treatment-for-patients-with-hepatocellular-carcinoma-a-systematic-review-and-meta-analysis
#13
Lin Chen, Xingming Ma, Xin Liu, Xiaomeng Cui
PURPOSE: To evaluate the safety and efficacy of a combination of sorafenib and radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC). METHODS: A systematic literature search was conducted using PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), WanFang Database, for all years up to January 2017. Pooled analyses of overall survival (OS), tumor- free survival, recurrence rates and adverse events were performed...
November 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29332222/efficacy-of-crocus-sativus-saffron-in-treatment-of-major-depressive-disorder-associated-with-post-menopausal-hot-flashes-a-double-blind-randomized-placebo-controlled-trial
#14
Ladan Kashani, Sophia Esalatmanesh, Farzaneh Eftekhari, Samrand Salimi, Tahereh Foroughifar, Farnaz Etesam, Hamideh Safiaghdam, Ehsan Moazen-Zadeh, Shahin Akhondzadeh
PURPOSE: Due to concerns regarding the side effects of hormone therapy, many studies have focused on the development of non-hormonal agents for treatment of hot flashes. The aim of this study was to evaluate the efficacy and safety of saffron (stigma of Crocus sativus) in treatment of major depressive disorder associated with post-menopausal hot flashes. METHODS: Sixty women with post-menopausal hot flashes participated in this study. The patients randomly received either saffron (30 mg/day, 15 mg twice per day) or placebo for 6 weeks...
January 13, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29331970/is-there-a-social-gradient-of-sarcopenia-a-meta-analysis-and-systematic-review-protocol
#15
Darci Green, Gustavo Duque, Nick Fredman, Aoun Rizvi, Sharon Lee Brennan-Olsen
INTRODUCTION: Sarcopenia (or loss of muscle mass and function) is a relatively new area within the field of musculoskeletal research and medicine. Investigating whether there is a social gradient, including occupation type and income level, of sarcopenia, as observed for other diseases, will contribute significantly to the limited evidence base for this disease. This new information may inform the prevention and management of sarcopenia and widen the evidence base to support existing and future health campaigns...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331536/chronic-inflammation-and-sarcopenia-a-regenerative-cell-therapy-perspective
#16
Jagadish K Chhetri, Philipe de Souto Barreto, Bertrand Fougère, Yves Rolland, Bruno Vellas, Matteo Cesari
Sarcopenia is characterized by reduced skeletal muscle mass and strength in older individuals. It is one of the leading cause of physical limitation in older adults, and associated with wide spectrum of adverse events including disability and mortality. The phenomenon of chronic-inflammation or inflamm-aging with aging is known to be a major contributor to myriad of geriatric conditions including sarcopenia. Recent advances in regenerative medicine, in particular cell therapy have opened up new possibilities to ameliorate broad range of inflammatory disorders...
January 10, 2018: Experimental Gerontology
https://www.readbyqxmd.com/read/29330987/pattern-of-dyslipidaemia-and-its-association-with-hypovitaminosis-d-in-type-2-diabetes-mellitus
#17
Farhat Bashir, Zia Ullah Khan, Naresh Kumar Seetlani, Zaman Sheikh
BACKGROUND: Macrovascular atherosclerosis is an important long-term complication of type 2 diabetes mellitus. Concurrent dyslipidaemia acts as an additional risk factor for these complications. Hypovitaminosis D has been associated with adverse cardiovascular events. These modifiable risk factors of cardiovascular disease are inter-related. In the presence of an increasing incidence of type 2 diabetes mellitus and its associated metabolic abnormalities and widespread vitamin D deficiency in Pakistan, this association needs to be investigated...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330232/interventions-must-be-realistic-to-be-useful-and-completed-in-family-medicine
#18
EDITORIAL
Marjorie A Bowman, Dean A Seehusen, Anne Victoria Neale
Being realistic while helping our patients is this issue's theme. Given the volume of tasks required in family medicine, recommendations for improvements in direct care or care measurement cannot just be evidence-based but must also be realistic. On the list of realistic: ordering antipsychotics for symptoms of dementia in the elderly, despite recommendations to not do so; ordering antidepressants without fear that the patient could develop hypertension; mental health care providers in primary care offices; forced choice for opioid management; plus agenda setting for visit efficiency...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29327045/serial-in-office-intralesional-steroid-injections-in-airway-stenosis
#19
Caitlin Bertelsen, Hagit Shoffel-Havakuk, Karla O'Dell, Michael M Johns, Lindsay S Reder
Importance: Endoscopic dilation is the mainstay treatment strategy for subglottic and proximal tracheal stenosis (SGS/PTS). Its major limitation is restenosis requiring repeated surgery. Intralesional steroid injection (ISI) is a promising adjunctive treatment aimed at prolonging the effects of dilation. Objective: To evaluate the association of serial in-office ISI after endoscopic dilation with surgery-free interval (SFI) in adults with SGS/PTS. Design, Setting, and Participants: A retrospective study of adults with SGS/PTS who underwent at least 2 consecutive in-office ISI at the University of Southern California, Keck School of Medicine, over a 3-year period was conducted...
January 11, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29325707/successful-creation-of-pancreatic-cancer-organoids-by-means-of-eus-guided-fine-needle-biopsy-for-personalized-cancer-treatment
#20
Herve Tiriac, Juan Carlos Bucobo, Demetrios Tzimas, Suman Grewel, Joseph F Lacomb, Leahana M Rowehl, Satish Nagula, Maoxin Wu, Joseph Kim, Aaron Sasson, Shivakumar Vignesh, Laura Martello, Maria Munoz-Sagastibelza, Jonathan Somma, David A Tuveson, Ellen Li, Jonathan M Buscaglia
BACKGROUND AND AIMS: Pancreatic cancer organoids are tumor models of individualized human pancreatic ductal adenocarcinoma (PDA), created from surgical specimens and used for personalized treatment strategies. Unfortunately the vast majority of patients with PDA are not operative candidates. Creation of human PDA organoids at the time of initial tumor diagnosis is therefore critical. Our aim was to assess the feasibility of creating human PDA organoids by EUS fine-needle biopsy (EUS-FNB) in patients with PDA...
January 8, 2018: Gastrointestinal Endoscopy
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