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https://www.readbyqxmd.com/read/28332404/conceptual-design-and-implantation-of-an-external-fixator-with-improved-mobility-for-knee-rehabilitation
#1
Gianluca Gatti
A hinged external fixator is used to allow early knee rehabilitation in case of injury or trauma, as an alternative approach to immobilization. It is mainly adopted for the treatment of dislocations, which involve tearing of the ligaments, and it basically consists of two links connected to each other by a revolute joint. Each link is fixed to the femur and tibia via pin fixation, and the revolute joint is approximately aligned to the knee flexion-extension (FE) axis. The advantage in its implantation is to protect ligament reconstruction, while allowing for an aggressive rehabilitation...
March 23, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28330467/mental-health-care-and-delivery-system-at-temeke-hospital-in-dar-es-salaam-tanzania
#2
Joel Seme Ambikile, Masunga K Iseselo
BACKGROUND: Low and middle income countries face many challenges in meeting mental health needs in their regions. Treatment of patients with mental disorders is inadequate in most of these countries and majority of individuals with severe mental disorders remain untreated. The bad news is that mental health problems in these countries are on the rise due to socioeconomic challenges being faced. Regardless of guidelines and directives provided by WHO for organizing mental health services, these countries continue to face many challenges in the effort to cater for mental health needs...
March 23, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28329432/user-compliance-with-documenting-on-a-track-and-trigger-based-observation-and-response-chart-a-two-phase-multi-site-audit-study
#3
Doug Elliott, Emily Allen, Sharon McKinley, Lin Perry, Christine Duffield, Margaret Fry, Robyn Gallagher, Rick Iedema, Michael Roche
AIMS: To examine user compliance and completeness of documentation with a newly designed Observation and Response Chart and whether a rapid response system call was triggered when clinically indicated. BACKGROUND: Timely recognition and responses to patient deterioration in hospital general wards remains a challenge for health care systems globally. Evaluating practice initiatives to improve recognition and response are required. DESIGN: Two-phase audit...
March 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28328942/the-value-of-theory-in-programmes-to-implement-clinical-guidelines-insights-from-a-retrospective-mixed-methods-evaluation-of-a-programme-to-increase-adherence-to-national-guidelines-for-chronic-disease-in-primary-care
#4
Jessica Sheringham, Francesca Solmi, Cono Ariti, Abigail Baim-Lance, Steve Morris, Naomi J Fulop
BACKGROUND: Programmes have had limited success in improving guideline adherence for chronic disease. Use of theory is recommended but is often absent in programmes conducted in 'real-world' rather than research settings. MATERIALS AND METHODS: This mixed-methods study tested a retrospective theory-based approach to evaluate a 'real-world' programme in primary care to improve adherence to national guidelines for chronic obstructive pulmonary disease (COPD). Qualitative data, comprising analysis of documents generated throughout the programme (n>300), in-depth interviews with planners (clinicians, managers and improvement experts involved in devising, planning, and implementing the programme, n = 14) and providers (practice clinicians, n = 14) were used to construct programme theories, experiences of implementation and contextual factors influencing care...
2017: PloS One
https://www.readbyqxmd.com/read/28327125/facilitating-informed-decisions-about-breast-cancer-screening-development-and-evaluation-of-a-web-based-decision-aid-for-women-in-their-40s
#5
Elena B Elkin, Valerie H Pocus, Alvin I Mushlin, Tessa Cigler, Coral L Atoria, Margaret M Polaneczky
BACKGROUND: Expert groups and national guidelines recommend individualized decision making about screening mammography for women in their 40s at low-to-average risk of breast cancer. We created Breast Screening Decisions (BSD), a personalized, web-based decision aid, to help women decide when to start and how often to have routine screening mammograms. We evaluated BSD in a large, prospective pilot trial of women and their clinicians. METHODS: Women ages 40-49 were invited to use BSD before a scheduled preventive care visit...
March 21, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28325164/development-of-a-decision-making-tool-for-reporting-drivers-with-mild-dementia-and-mild-cognitive-impairment-to-transportation-administrators
#6
Duncan H Cameron, Carla Zucchero Sarracini, Linda Rozmovits, Gary Naglie, Nathan Herrmann, Frank Molnar, John Jordan, Anna Byszewski, David Tang-Wai, Jamie Dow, Christopher Frank, Blair Henry, Nicholas Pimlott, Dallas Seitz, Brenda Vrkljan, Rebecca Taylor, Mario Masellis, Mark J Rapoport
BACKGROUND: Driving in persons with dementia poses risks that must be counterbalanced with the importance of the care for autonomy and mobility. Physicians often find substantial challenges in the assessment and reporting of driving safety for persons with dementia. This paper describes a driving in dementia decision tool (DD-DT) developed to aid physicians in deciding when to report older drivers with either mild dementia or mild cognitive impairment to local transportation administrators...
March 22, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#7
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28320359/chronic-cough-conundrum-a-case-report-of-a-new-diagnosis-of-hiv-and-pulmonary-kaposi-s-sarcoma
#8
Pamela P Bailey, Marylou M Dryer, John P Piper, Sajjad Ahmad
BACKGROUND: When evaluating a common complaint such as cough, clinicians should rely on a patient's history and physical to guide them, but also not diverge from guidelines in screening and testing lest certain diagnoses be overlooked. CASE PRESENTATION: A 44 year old Hispanic male presented to a pulmonologist's office after failing multiple courses of antibiotics for chronic cough, now six months in duration. He described intermittent scant hemoptysis and an evanescent migratory non-pruritic rash occasionally noted on his trunk or limbs...
March 20, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28320312/the-effect-of-an-electronic-cognitive-aid-on-the-management-of-st-elevation-myocardial-infarction-during-caesarean-section-a-prospective-randomised-simulation-study
#9
Michael St Pierre, Bjoern Luetcke, Dieter Strembski, Christopher Schmitt, Georg Breuer
BACKGROUND: Cognitive aids have come to be viewed as promising tools in the management of perioperative critical events. The majority of published simulation studies have focussed on perioperative crises that are characterised by time pressure, rare occurrence, or complex management steps (e.g., cardiac arrest emergencies, management of the difficult airway). At present, there is limited information on the usefulness of cognitive aids in critical situations with moderate time pressure and complexity...
March 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28318318/non-guideline-recommended-prescribing-of-proton-pump-inhibitors-in-the-general-population
#10
Emma Mares-García, Antonio Palazón-Bru, Álvaro Martínez-Martín, David Manuel Folgado-de la Rosa, Avelino Pereira-Expósito, Vicente Francisco Gil-Guillén
OBJECTIVES: To determine the magnitude of non-guideline-recommended prescribing (NGRP) of proton pump inhibitors (PPIs) in the general population, its associated factors and expense. METHODS: We undertook a cross-sectional observational study in three community pharmacies in a Spanish region in 2013 involving a total of 302 patients with a prescription for PPIs. The main variable was the NGRP of PPIs. Secondary variables were: gender, age, antidepressants, osteoporosis, osteoarthritis, prescription cost per month and total number of chronic diseases...
March 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28317399/recent-advances-in-pediatric-celiac-disease
#11
Grace J Lee, John Y Kao
The incidence of celiac disease (CD) has increased over the last half-century, resulting in rising interest in identifying risk factors for CD. The necessity of duodenal biopsies in the diagnosis of CD has recently been challenged. Areas covered: This review covers the recent literature regarding the role of infant feeding practices, including breastfeeding and timing of gluten introduction, and the microbiota in the development of CD. Additionally, the application of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for a non-biopsy approach to the diagnosis of CD is reviewed...
March 20, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28301593/knowledge-attitudes-and-practices-of-south-african-healthcare-workers-regarding-the-prevention-and-treatment-of-influenza-among-hiv-infected-individuals
#12
Jazmin Duque, Sisanda Gaga, David Clark, Madeleine Muller, Bulenani Kuwane, Cheryl Cohen, Sibongile Walaza, Stefano Tempia, Puleng Ramatoboe, Tsakani Furumele, Marc-Alain Widdowson, Meredith L McMorrow, Adam L Cohen
BACKGROUND: The South African Department of Health (DOH) publishes annual guidelines identifying priority groups, including immunosuppressed individuals and healthcare workers (HCW), for influenza vaccination and treatment. How these guidelines have impacted HCW and their patients, particularly those infected with HIV, remains unknown. METHODS: We aimed to describe the knowledge, attitudes and practices regarding influenza and the vaccine among South African HCW...
2017: PloS One
https://www.readbyqxmd.com/read/28300955/prototype-app-for-voice-therapy-a-peer-review
#13
Paula Lavaissiéri, Paulo Eduardo Damasceno Melo
Purpose: Voice speech therapy promotes changes in patients' voice-related habits and rehabilitation. Speech-language therapists use a host of materials ranging from pictures to electronic resources and computer tools as aids in this process. Mobile technology is attractive, interactive and a nearly constant feature in the daily routine of a large part of the population and has a growing application in healthcare. To develop a prototype application for voice therapy, submit it to peer assessment, and to improve the initial prototype based on these assessments...
March 9, 2017: CoDAS
https://www.readbyqxmd.com/read/28299710/high-resolution-microultrasound-%C3%AE-us-investigation-of-the-gastrointestinal-gi-tract
#14
Thineskrishna Anbarasan, Christine E M Démoré, Holly Lay, Mohammed R S Sunoqrot, Romans Poltarjonoks, Sandy Cochran, Benjamin F Cox
High resolution, microultrasound (μUS) scanning of the gastrointestinal (GI) tract has potential as an important transmural imaging modality to aid in diagnosis. Operating at higher frequencies than conventional clinical ultrasound instruments, μUS is capable of providing scanned images of the GI tract with higher resolution. To investigate the use of μUS for this application, a phantom which is cost effective, within ethical guidelines and, most importantly, similar in histology to the human GI tract is necessary...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28299273/guidelines-for-patient-specific-jawline-definition-with-titanium-implants-in-esthetic-deformity-and-malformation-surgery
#15
Maurice Yves Mommaerts
CONTEXT: Asymmetry and unfavorable esthetics of the jawline have become possible to correct in three dimensions using computer aided design and computer aided manufacturing. AIMS: The aim of this study was to provide esthetic, technical, and operative guidelines for mandibular angle and border augmentation using patient-specific titanium implants made by selective laser melting. SETTINGS AND DESIGN: University hospital - prospective registry...
July 2016: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28292204/a-national-survey-of-the-management-of-patients-with-incidental-meningioma-in-the-united-kingdom
#16
Mujtaba H Mohammad, Emmanuel Chavredakis, Rasheed Zakaria, Andrew Brodbelt, Michael D Jenkinson
BACKGROUND: Incidental meningiomas are increasingly being diagnosed due to widespread use of brain imaging. Treatment options include surveillance, surgery and stereotactic radiosurgery, but the natural history of these tumours is not fully understood and there are no accepted management guidelines to aid clinical decision-making. The aim of this study was to assess current practice in the United Kingdom and identify areas of variation for further study. METHODS: A questionnaire was distributed to all members of the Society of British Neurosurgeons (SBNS)...
March 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28291728/variation-in-emergency-percutaneous-coronary-intervention-in-ventilated-patients-in-the-uk-insights-from-a-national-database
#17
John Rawlins, Peter F Ludman, Darragh O'Neil, Mamas A Mamas, Mark de Belder, Simon Redwood, Adrian Banning, Andrew Whittaker, Nick Curzen
AIMS: Pre-procedural ventilation is a marker of high risk in PCI patients. Causes include out-of-hospital cardiac arrest (OHCA) and cardiogenic shock. OHCA occurs in approximately 60,000 patients in the UK per annum. No consensus exists regarding the need/timing of coronary angiography ± revascularization without ST elevation. The aim was to describe the national variation in the rate of emergency PCI in ventilated patients. METHODS AND RESULTS: Using the UK national database for PCI in 2013, we identified all procedures performed as 'emergency' or 'salvage' for whom ventilation had been initiated before the PCI...
February 13, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28290932/primary-care-of-men-who-have-sex-with-men-in-the-u-s-military-in-the-post-don-t-ask-don-t-tell-era-a-review-of-recent-progress-health-needs-and-challenges
#18
Wesley R Campbell, Mojgan Jahan, Mary F Bavaro, Robert J Carpenter
BACKGROUND: With repeal of "Don't Ask, Don't Tell" (DADT) in 2011 and the Supreme Court decision regarding Section 3 of the Defense of Marriage Act (DOMA) in 2013, military providers are now able to openly address unique health needs of lesbian, gay, and bisexual (LGB) service members and their same-sex spouse beneficiaries. These federal laws created health care barriers, either real or perceived, between providers and patients and often limited medical research involving LGB patients in the Military Health System (MHS)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28289963/use-of-patient-decision-aids-increased-younger-women-s-reluctance-to-begin-screening-mammography-a-systematic-review-and-meta-analysis
#19
Ilya Ivlev, Erin N Hickman, Marian S McDonagh, Karen B Eden
BACKGROUND: As breast cancer screening guidelines have changed recently, additional investigation is needed to understand changes in women's behavior after using breast cancer screening patient decision aids (BCS-PtDAs) and the potential effect on mammography utilization. This systematic review and meta-analysis sought to evaluate the effect of BCS-PtDAs on changes in women's intentions to undergo screening mammography and whether women deciding to begin or discontinue screening mammography displayed similar changes in screening intentions after using a BCS-PtDA...
March 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28289524/assessment-of-stable-coronary-artery-disease-by-cardiovascular-magnetic-resonance-imaging-current-and-emerging-techniques
#20
REVIEW
James R J Foley, Sven Plein, John P Greenwood
Coronary artery disease (CAD) is a leading cause of death and disability worldwide. Cardiovascular magnetic resonance (CMR) is established in clinical practice guidelines with a growing evidence base supporting its use to aid the diagnosis and management of patients with suspected or established CAD. CMR is a multi-parametric imaging modality that yields high spatial resolution images that can be acquired in any plane for the assessment of global and regional cardiac function, myocardial perfusion and viability, tissue characterisation and coronary artery anatomy, all within a single study protocol and without exposure to ionising radiation...
February 26, 2017: World Journal of Cardiology
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