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https://www.readbyqxmd.com/read/28437795/effect-of-using-the-heart-score-in-patients-with-chest-pain-in-the-emergency-department-a-stepped-wedge-cluster-randomized-trial
#1
Judith M Poldervaart, Johannes B Reitsma, Barbra E Backus, Hendrik Koffijberg, Rolf F Veldkamp, Monique E Ten Haaf, Yolande Appelman, Herman F J Mannaerts, Jan-Melle van Dantzig, Madelon van den Heuvel, Mohamed El Farissi, Bernard J W M Rensing, Nicolette M S K J Ernst, Ineke M C Dekker, Frank R den Hartog, Thomas Oosterhof, Ghizelda R Lagerweij, Eugene M Buijs, Maarten W J van Hessen, Marcel A J Landman, Roland R J van Kimmenade, Luc Cozijnsen, Jeroen J J Bucx, Clara E E van Ofwegen-Hanekamp, Maarten-Jan Cramer, A Jacob Six, Pieter A Doevendans, Arno W Hoes
Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Design: Stepped-wedge, cluster randomized trial...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28437691/midwifery-participatory-curriculum-development-transformation-through-active-partnership
#2
Mary Sidebotham, Caroline Walters, Janine Chipperfield, Jenny Gamble
Evolving knowledge and professional practice combined with advances in pedagogy and learning technology create challenges for accredited professional programs. Internationally a sparsity of literature exists around curriculum development for professional programs responsive to regulatory and societal drivers. This paper evaluates a participatory curriculum development framework, adapted from the community development sector, to determine its applicability to promote engagement and ownership during the development of a Bachelor of Midwifery curriculum at an Australian University...
April 15, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28437690/a-guide-to-nursing-students-written-reflections-for-students-and-educators
#3
Jessica Naber, Liz Markley
Experiences from the clinical setting are ideal for building critical thinking skills if reflection is used as a teaching tool. Reflective writing is the purposeful and recurring inspection of thoughts, feelings, and occurrences that coordinate with experiences during practice. Reflecting on clinical experiences develops critical thinking ability, fosters self-understanding, facilitates coping, and leads to improvement in clinical practice (Kennison, 2006). Reflective writing allows students to combine clinical experiences and takeaways with didactic material to better understand both practice and instruction...
April 7, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28437625/imaging-guided-synergetic-therapy-of-orthotopic-transplantation-tumor-by-superselectively-arterial-administration-of-microwave-induced-microcapsules
#4
Shunsong Tang, Changhui Fu, Longfei Tan, Tianlong Liu, Jingsong Mao, Xiangling Ren, Hongying Su, Dan Long, Qianqian Chai, Zhongbing Huang, Xudong Chen, Jingzhuo Wang, Jun Ren, Xianwei Meng
It is an ambitious target to improve overall Hepatocellular Carcinoma therapeutic effects. Recently, MW ablation has emerged as a powerful thermal ablation technique, affording favorable survival with excellent local tumor control. To achieve better therapeutic effects of MW ablation, MW sensitizers are prepared for enhanced MW ablation to preferentially heat tumor territory. However, it is still not practicable for treatment of the orthotopic transplantation tumor. Herein, biocompatible and degradable methoxy poly(ethylene glycol)-poly(lactic-co-glycolic acid) (mPEG-PLGA) microcapsules with hierarchical structure have been designed for microwave-induced tumor therapy...
April 14, 2017: Biomaterials
https://www.readbyqxmd.com/read/28437495/a-practical-guide-to-understanding-and-treating-patellofemoral-pain
#5
John P Fulkerson
There is no shortcut to accurate diagnosis in the patellofemoral pain patient. Most important in the process is a desire and ability to specifically identify the structural and biomechanical origin of pain. This can be elusive and often requires a careful analysis of all factors affecting the patient, including documenting his or her specific history of pain origin and specific treatments to date, and acknowledging the patient's localization of the pain origin. Many patients can pinpoint the site of pain origin when given the time and encouragement to do so...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437492/clinical-rehabilitation-of-anterior-knee-pain-current-concepts
#6
Laurie A Hiemstra, Sarah Kerslake, Elizabeth A Arendt
Rehabilitation is the hallmark of the nonoperative treatment of anterior knee pain (AKP). Whether a patient has had appropriate rehabilitation can be assessed in the office with a selection of basic and advanced screening tests. Most important, providing specific instructions in your referral to a therapist skilled in treating patients with AKP can ensure that any identified deficits are appropriately addressed. The etiology of AKP is multifactorial. Whatever its "cause," AKP alters neuromuscular function, and correcting these altered body movement patterns will benefit the patient...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437386/the-international-liver-transplantation-society-living-donor-liver-transplant-recipient-guideline
#7
Charles M Miller, Cristiano Quintini, Anil Dhawan, Francois Durand, Julie K Heimbach, Hyung Leona Kim-Schluger, Eirini Kyrana, Sung-Gyu Lee, Jan Lerut, Chung-Mau Lo, Elizabeth Anne Pomfret
Living donor liver transplantation (LDLT) has been increasingly embraced around the world as an important strategy to address the shortage of deceased donor livers. The aim of this guideline, approved by the International Liver Transplantation Society (ILTS), is to provide a collection of expert opinions, consensus, and best practices surrounding LDLT. Recommendations were developed from an analysis of the National Library of Medicine living donor transplantation indexed literature using the Grading of Recommendations Assessment, Development and Evaluation methodology...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28437370/ethics-guide-recommendations-for-organ-donation-focused-physicians-endorsed-by-the-canadian-medical-association
#8
Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28437302/pain-management-in-the-opioid-dependent-pregnant-woman
#9
Rebecca R Safley, Jamie Swietlikowski
Opioid dependence is an epidemic in the United States, and the percentage of pregnant women who are opioid dependent has increased dramatically in the last decade. Pain management, already a concern for intrapartum and postpartum care, is complicated in the context of opioid dependence. This clinical review surveys the literature on pain management in opioid-dependent pregnant women to summarize current consensus and evidence to guide clinical practice. Points of consensus for pain management in opioid-dependent pregnant women include continual opioid maintenance therapy throughout the pregnancy and the postpartum period; adequate management of acute pain; the contraindication of opioid agonist-antagonists for pain management; and the need for interdisciplinary teams using a multimodal approach to provide optimal care to opioid-dependent pregnant women...
April 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28437094/rational-design-of-an-ultrasensitive-quorum-sensing-switch
#10
Weiqian Zeng, Pei Du, Qiuli Lou, Lili Wu, Haoqian M Zhang, Chunbo Lou, Hongli Wang, Qi Ouyang
One of the purposes of synthetic biology is to develop rational methods that accelerate the design of genetic circuits, saving time and effort spent on experiments and providing reliably predictable circuit performance. We applied a reverse engineering approach to design an ultrasensitive transcriptional quorum-sensing switch. We want to explore how systems biology can guide synthetic biology in the choice of specific DNA sequences and their regulatory relations to achieve a targeted function. The workflow comprises network enumeration that achieves the target function robustly, experimental restriction of the obtained candidate networks, global parameter optimization via mathematical analysis, selection and engineering of parts based on these calculations, and finally, circuit construction based on the principles of standardization and modularization...
April 24, 2017: ACS Synthetic Biology
https://www.readbyqxmd.com/read/28437028/esut-educational-video-on-fluoroscopic-guided-puncture-in-pcnl-all-techniques-step-by-step
#11
Iason Kyriazis, Evangelos Liatsikos, Odysseas Sopilidis, Panagiotis Kallidonis, Andreas Skolarikos
OBJECTIVE: Kidney puncture during percutaneous nephrolithotomy (PCNL) is regarded as one of the most demanding aspects of the procedure and only a minority of urologists perform this step without assistance by a radiologist. Currently a wide variation of fluoroscopic guided techniques is available in clinical practice. In this work we describe the most common fluoroscopic guided access techniques in a step-by-step manner aiming to assist on the standardization of their technique and terminology...
April 24, 2017: BJU International
https://www.readbyqxmd.com/read/28436269/an-evaluation-of-single-case-reading-intervention-study-quality-for-students-with-and-at-risk-for-emotional-and-behavioral-disorders
#12
John William McKenna, Min Kyung Kim, Mikyung Shin, Kathleen Pfannenstiel
Researchers have noted the lack of research to guide reading practice for students with and at risk for emotional and behavioral disorders (EBD). Although comprehensive syntheses have identified promising practices and areas for future research, none have evaluated the rigor of studies according to quality indicators. The current study evaluated the extant single-case reading intervention research for this student population according to the What Works Clearinghouse (WWC) standards. Thirty studies met article selection criteria, 20 (66...
April 1, 2017: Behavior Modification
https://www.readbyqxmd.com/read/28436145/comparisons-of-the-clinical-outcomes-and-urodynamic-effects-of-mirabegron-versus-tolterodine-treatment-for-female-overactive-bladder-syndrome-a-subgroup-analysis-of-a-controlled-randomised-prospective-study
#13
Sheng-Mou Hsiao, Ting-Chen Chang, Chi-Hau Chen, Wen-Yih Wu, Ho-Hsiung Lin
OBJECTIVES: The impact of mirabegron on clinical outcome and urodynamic parameters may be important for clinical practice. Thus, the aim of this study was to compare the clinical outcomes and urodynamic effects of mirabegron (Betmiga 50 mg) versus tolterodine (Detrusitol ER 4 mg) treatment for women with overactive bladder syndrome (OAB). METHODS: Women with OAB were randomized to receive 12 weeks of mirabegron 50 mg, tolterodine extended-release 4 mg or placebo treatment...
April 23, 2017: Lower Urinary Tract Symptoms
https://www.readbyqxmd.com/read/28435000/context-dependent-intravital-imaging-of-therapeutic-response-using-intramolecular-fret-biosensors
#14
REVIEW
James R W Conway, Sean C Warren, Paul Timpson
Intravital microscopy represents a more physiologically relevant method for assessing therapeutic response. However, the movement into an in vivo setting brings with it several additional considerations, the primary being the context in which drug activity is assessed. Microenvironmental factors, such as hypoxia, pH, fibrosis, immune infiltration and stromal interactions have all been shown to have pronounced effects on drug activity in a more complex setting, which is often lost in simpler two- or three-dimensional assays...
April 18, 2017: Methods: a Companion to Methods in Enzymology
https://www.readbyqxmd.com/read/28434954/coronal-multiplane-reconstructed-ct-image-determining-lateral-vertebral-notch-referred-pedicle-screw-entry-point-in-subaxial-cervical-spine-a-preclinical-study
#15
Chunyang Wu, Zhongren Huang, Zhimin Pan, Jiaquan Luo, Zhiyun Li, Junlong Zhong, Yiwei Chen, Zhimin Han, Kuniyoshi Abumi, Yoon Ha, Kai Cao
OBJECTIVE: Evaluate the feasibility of coronal multiplane reconstruction images (CMRI) of CT scan to determine subaxial cervical pedicle screw (PS) entry point and guide lateral vertebral notch (LVN)-referred technique for subaxial cervical PS insertion. METHODS: Forty cervical CT scans from volunteers were performed. Entry point of PS was determined through quantitating the PS entry point related to LVN on CMRI. Pedicle mediolateral angle (α) and cephalocaudad angle (β) were also measured to guide trajactory of PS insertion...
April 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28434918/forming-and-activating-an-internal-facilitation-group-for-successful-implementation-a-qualitative-study
#16
Megan B McCullough, Chris Gillespie, Beth Ann Petrakis, Ellen A Jones, Angela M Park, Carol VanDeusen Lukas, Adam J Rose
BACKGROUND: This study focuses on an implementation facilitation strategy to improve the delivery of anticoagulation care within pharmacy-run clinics across 8 Veterans Health Administration (VA) medical centers. Other studies have explored various models of implementation facilitation, including external facilitation (EF), internal facilitation (IF), and blended facilitation (BF) combining both approaches. This study focuses on the use of an internal facilitation team of anticoagulation coordinators representing 8 VA anticoagulation clinics to enhance the implementation process...
April 9, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28434797/patterns-of-care-survey-radiotherapy-for-women-with-locally-advanced-cervical-cancer
#17
Peter de Boer, Ina M Jürgenliemk-Schulz, Henrike Westerveld, Astrid A C de Leeuw, Raquel Dávila-Fajardo, Coen R N Rasch, Bradley R Pieters, Lukas J A Stalpers
BACKGROUND AND PURPOSE: Regarding latest developments, the need of a radiotherapy 'Patterns of Care' survey was expressed by the Dutch National Platform Radiotherapy for Gynaecological Cancer (LPRGT). Therefore, this study investigated current practice for cervical cancer in all 16 radiation oncology centres in the Netherlands specialised in gynaecological oncology. MATERIAL AND METHODS: A structured 'patterns of care' questionnaire was completed and followed by an in-depth interview with radiation oncologists from all radiotherapy centres specialised in gynaecological oncology...
April 20, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28434484/practical-aspects-in-the-management-of-statin-associated-muscle-symptoms-sams
#18
Ulrich Laufs, Krysztof J Filipiak, Ioanna Gouni-Berthold, Alberico L Catapano
BACKGROUND AND AIMS: Statin-associated muscle symptoms (SAMS) frequently cause statin non-adherence, switching and discontinuation, contributing to adverse cardiovascular (CV) outcomes. Therefore, the management of SAMS is key in the effective treatment of patients with cardiovascular disease (CVD), through achievement of maximum-tolerated statin dosing and other practical aspects. The aim of this article is to provide practical, focused advice for healthcare professionals on the management of patients with SAMS...
April 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/28434482/how-to-implement-clinical-guidelines-to-optimise-familial-hypercholesterolaemia-diagnosis-and-treatment
#19
Michel Farnier, Fernando Civeira, Olivier Descamps
BACKGROUND AND AIMS: Familial hypercholesterolaemia (FH) is a genetic disorder associated with significantly elevated plasma low-density lipoprotein cholesterol (LDL-C) and premature coronary heart disease (CHD). Optimal management of FH relies on early identification and treatment with statins alone or in combination with other lipid-lowering therapies. A lack of awareness of FH and its manifestations among primary care physicians and specialists has led to many individuals being misdiagnosed in the early stages of the disease, further increasing the risk of CHD and requiring much more intensive lipid-lowering strategies...
April 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/28434278/electronic-health-record-use-among-cancer-patients-insights-from-the-health-information-national-trends-survey
#20
Yulia A Strekalova
Over 90% of US hospitals provide patients with access to e-copy of their health records, but the utilization of electronic health records by the US consumers remains low. Guided by the comprehensive information-seeking model, this study used data from the National Cancer Institute's Health Information National Trends Survey 4 (Cycle 4) and examined the factors that explain the level of electronic health record use by cancer patients. Consistent with the model, individual information-seeking factors and perceptions of security and utility were associated with the frequency of electronic health record access...
April 1, 2017: Health Informatics Journal
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