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Clinical inertia

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https://www.readbyqxmd.com/read/28531841/positive-affective-functioning-in-anhedonic-individuals-daily-life-anything-but-flat-and-blunted
#1
V E Heininga, E Van Roekel, J J Ahles, A J Oldehinkel, A H Mezulis
BACKGROUND: Anhedonia, the decreased interest and pleasure, is often described as 'flat' or 'blunted' positive affect (PA). Yet, little is known about PA functioning in anhedonic individuals' daily lives. The current study investigates PA reactivity to pleasurable experiences in anhedonia together with its relevant temporal dynamics (i.e., variability, instability, and inertia), and expands current knowledge by exploring the role of arousal therein. METHODS: Using the Experience Sampling Method (ESM), we collected 90 assessments of real-life PA experiences across 30 days in 18-24 year old individuals with anhedonia (N=69) and without anhedonia (N=69)...
April 21, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28524340/effectiveness-and-clinical-inertia-in-patients-with-antidiabetic-therapy
#2
Manuel Enrique Machado-Duque, Adriana Carolina Ramírez-Riveros, Jorge Enrique Machado-Alba
AIMS: To establish the effectiveness of antidiabetic therapy and the frequency of clinical inertia in the management of type 2 diabetes mellitus in Colombia. METHODS: A cross-sectional study with follow-up of patients who had been treated for at least 1 year and were receiving medical consultation for antidiabetic treatment. Effectiveness was established when haemoglobin-A1c levels were <7% and when clinical inertia was reached, which was defined as no therapeutic modifications despite not achieving management controls...
May 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28524123/-a-clinical-and-neuropsychological-study-of-patients-before-and-after-resection-of-third-ventricle-colloid-cysts
#3
S B Buklina, A N Konovalov, D I Pitskhelauri, M A Shkarubo, A A Poddubskaya, M V Kolycheva
The literature lacks studies of cognitive impairments in large groups of patients after resection of third ventricle colloid cysts. AIM: To evaluate cognitive impairments in patients before and after resection of third ventricle colloid cysts. MATERIAL AND METHODS: We performed a clinical and neuropsychological study of 52 patients with third ventricle colloid cysts using the Luria method (1962). Forty three patients were examined before and after cyst resection in the early postoperative period (three patients in this group were also examined in a long-term period of 3-7 months after surgery)...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28499512/the-organ-transplant-imperative
#4
REVIEW
Wil L Santivasi, Jacob J Strand, Paul S Mueller, Thomas J Beckman
More than 120,000 US patients were listed for solid organ transplants in 2016. Although data are scarce, we suspect that many of these patients will die while awaiting transplant and without engaging in goals-of-care discussions with their physicians. The challenges of addressing goals of care in patients with malignancy, end-stage renal disease, and heart failure have been studied. However, there is sparse literature on addressing goals of care throughout the dynamic process of transplant assessment and listing...
May 10, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28432748/future-challenges-and-therapeutic-opportunities-in-type-2-diabetes-changing-the-paradigm-of-current-therapy
#5
REVIEW
D R Owens, L Monnier, A H Barnett
Most algorithms for type 2 diabetes mellitus (T2DM) do not recommend treatment escalation until glycated haemoglobin (HbA1c) fails to reach the recommended target of 7% (53 mmol/mol) within approximately 3 months on any treatment regimen ('treat to failure'). Clinical inertia and/or poor adherence to therapy contribute to patients not reaching glycaemic targets when managed according to this paradigm. Clinical inertia exists across the entire spectrum of anti-diabetes therapies, although it is most pronounced when initiating and optimizing insulin therapy...
April 21, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28427405/ceiling-effect-in-emr-system-assimilation-a-multiple-case-study-in-primary-care-family-practices
#6
Marie-Claude Trudel, Josianne Marsan, Guy Paré, Louis Raymond, Ana Ortiz de Guinea, Éric Maillet, Thomas Micheneau
BACKGROUND: There has been indisputable growth in adoption of electronic medical record (EMR) systems in the recent years. However, physicians' progress in using these systems has stagnated when measured with maturity scales. While this so-called ceiling effect has been observed and its consequences described in previous studies, there is a paucity of research on the elements that could explain such an outcome. We first suggest that in the context of EMR systems we are in presence of a "tiered ceiling effect" and then we show why such phenomenon occurs...
April 20, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28413969/optimizing-the-management-of-uncontrolled-hypertension-what-do-triple-fixed-dose-drug-combinations-add
#7
Costas Thomopoulos, Georgios Katsimagklis, Stefanos Archontakis, Georgios Skalis, Thomas Makris
Fixed-dose triple drug combinations represent one of the latest innovations of pharmacotherapy for hypertension (HT). They combine a traditional renin-angiotensin system blocker, a diuretic and a calcium channel blocker. The main benefit is the simplification of treatment regimen because 3 different agents are combined at different doses in a single pill. Improving adherence to treatment partly explains why this kind of combination may effectively reduce blood pressure (BP). BP lowering by a single-pill triple-drug combination can be approximately predicted, by using appropriate formulas described in previous meta-analysis of randomized trials...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28395917/-compliance-with-recommendations-in-secondary-prevention-of-stroke-in-primary-care
#8
Carmen Tamayo-Ojeda, Neus Parellada-Esquius, Betlem Salvador-González, Pilar Ángeles Oriol-Torón, M Dolores Rodríguez-Garrido, Dolores Muñoz-Segura
OBJECTIVE: Knowing compliance with secondary prevention recommendations of stroke in primary care and to identify factors associated with compliance. DESIGN: Multi-centre cross-sectional. SETTING: Health primary care centres in a metropolitan area (944,280 inhabitants). PARTICIPANTS: Patients aged 18years and over with ischemic brain disease diagnosis prior to 6months before the study. MAIN MEASUREMENTS: Clinical history records of demographic variables, risk factors and cardiovascular comorbidity, drugs, blood pressure values (BP), LDL-cholesterol and medical visits by doctor and nurses after the event...
April 7, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28379024/-comments-on-current-guidelines-of-type-2-diabetes-mellitus-treatment
#9
Emil Martinka
In an effort to facilitate the widest possible application of recent findings in diabetology and the related medical fields, with regard to characteristics of medicines and current possibilities of using modern procedures, but also to their limitations due to the financial capacities of health insurance companies, SDS innovates its therapeutic recommendations for the treatment of diabetes mellitus on a regular basis. The most recent recommendations were issued by SDS in August 2016. The review discusses and describes several factors which the authors considered during their preparation: (1) Compliance with the findings of evidence-based medicine, compliance with reference recommendations (therapeutic recommendations ADA/EASD), compliance with summary characteristics of active substances in the treatment of diabetes mellitus and approved possibilities of their use, and compliance with indica-tive restrictions (IO) which define medical and economic conditions for health insurance covered treatment...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28375658/empagliflozin-linagliptin-single-pill-combination-therapy-for-patients-with-type-2-diabetes-mellitus
#10
Rajeev Kumar Jain
Type 2 diabetes mellitus (T2DM) is typically progressive, with sequential addition of therapies often needed to address increasing hyperglycemia over the disease course. Using treatments in combination may be preferred to sequential addition, as a means of providing a more rapid clinical response and potentially avoiding clinical inertia. In such cases, a single-pill combination can help to reduce pill burden. Although various single-pill combinations of oral glucose-lowering agents are available, empagliflozin/linagliptin was the first approved combination of a sodium glucose co-transporter 2 (SGLT2) inhibitor with a dipeptidyl peptidase 4 (DPP-4) inhibitor in the United States...
April 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28324932/an-ict-and-mobile-health-integrated-approach-to-optimize-patients-education-on-hypertension-and-its-management-by-physicians-the-patients-optimal-strategy-of-treatment-post-pilot-study
#11
Fabio Albini, Xiaoqiu Liu, Camilla Torlasco, Davide Soranna, Andrea Faini, Renata Ciminaghi, Ada Celsi, Matteo Benedetti, Antonella Zambon, Marco di Rienzo, Gianfranco Parati
INTRODUCTION: Uncontrolled hypertension is largely attributed to unsatisfactory doctor's engagement in its optimal management and to poor patients' compliance to therapeutic interventions. ICT and mobile Health solutions might improve these conditions, being widely available and providing highly effective communication strategies. OBJECTIVE: To evaluate whether ICT and mobile Health tools are able to improve hypertension control by improving doctors' engagement and by increasing patients' education and involvement, and their compliance to lifestyle modification and prescribed drug therapy...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28298899/decision-making-in-multiple-sclerosis-the-role-of-aversion-to-ambiguity-for-therapeutic-inertia-among-neurologists-discutir-ms
#12
Gustavo Saposnik, Angel P Sempere, Daniel Prefasi, Daniel Selchen, Christian C Ruff, Jorge Maurino, Philippe N Tobler
OBJECTIVES: Limited information is available on physician-related factors influencing therapeutic inertia (TI) in multiple sclerosis (MS). Our aim was to evaluate whether physicians' risk preferences are associated with TI in MS care, by applying concepts from behavioral economics. DESIGN: In this cross-sectional study, participants answered questions regarding the management of 20 MS case scenarios, completed 3 surveys, and 4 experimental paradigms based on behavioral economics...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28279950/insuonline-an-electronic-game-for-medical-education-on-insulin-therapy-a-randomized-controlled-trial-with-primary-care-physicians
#13
Leandro Arthur Diehl, Rodrigo Martins Souza, Pedro Alejandro Gordan, Roberto Zonato Esteves, Izabel Cristina Meister Coelho
BACKGROUND: Most patients with diabetes mellitus (DM) are followed by primary care physicians, who often lack knowledge or confidence to prescribe insulin properly. This contributes to clinical inertia and poor glycemic control. Effectiveness of traditional continuing medical education (CME) to solve that is limited, so new approaches are required. Electronic games are a good option, as they can be very effective and easily disseminated. OBJECTIVE: The objective of our study was to assess applicability, user acceptance, and educational effectiveness of InsuOnline, an electronic serious game for medical education on insulin therapy for DM, compared with a traditional CME activity...
March 9, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28271251/efficacy-and-safety-of-metformin-and-sitagliptin-based-triple-antihyperglycemic-therapy-strategy-a-multicenter-randomized-controlled-non-inferiority-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
Wen Xu, Yiming Mu, Jiajun Zhao, Dalong Zhu, Qiuhe Ji, Zhiguang Zhou, Bin Yao, Anhua Mao, Samuel S Engel, Bin Zhao, Yan Bi, Longyi Zeng, Xingwu Ran, Juming Lu, Linong Ji, Wenying Yang, Weiping Jia, Jianping Weng
Despite the current guideline's recommendation of a timely stepwise intensification therapy, the "clinical inertia", termed as the delayed treatment intensification, commonly exists in the real world, which may be partly due to the relatively little substantial evidence and no clear consensus regarding the efficacy and safety of triple oral agents in patients inadequately controlled with dual therapy. In this clinical trial performed in 237 centers in China, 5,535 type 2 diabetic patients inadequately controlled by previous therapies were treated with a stable metformin/sitagliptin dual therapy for 20 weeks...
March 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/28265910/-adherence-problems-and-clinical-inertia-11-strategies-keeping-patients-with-diabetes-onboard
#15
REVIEW
Bernhard Kulzer
No abstract text is available yet for this article.
March 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28246928/raloxifene-improves-bone-mechanical-properties-in-mice-previously-treated-with-zoledronate
#16
Cory N Meixner, Mohammad W Aref, Aryaman Gupta, Erin M B McNerny, Drew Brown, Joseph M Wallace, Matthew R Allen
Bisphosphonates represent the gold-standard pharmaceutical agent for reducing fracture risk. Long-term treatment with bisphosphonates can result in tissue brittleness which in rare clinical cases manifests as atypical femoral fracture. Although this has led to an increasing call for bisphosphonate cessation, few studies have investigated therapeutic options for follow-up treatment. The goal of this study was to test the hypothesis that treatment with raloxifene, a drug that has cell-independent effects on bone mechanical material properties, could reverse the compromised mechanical properties that occur following zoledronate treatment...
February 28, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28226549/an-ict-and-mobile-health-integrated-approach-to-optimize-patients-education-on-hypertension-and-its-management-by-physicians-the-patients-optimal-strategy-of-treatment-post-pilot-study
#17
Fabio Albini, Xiaoqiu Liu, Camilla Torlasco, Davide Soranna, Andrea Faini, Renata Ciminaghi, Ada Celsi, Matteo Benedetti, Antonella Zambon, Marco di Rienzo, Gianfranco Parati, Fabio Albini, Xiaoqiu Liu, Camilla Torlasco, Davide Soranna, Andrea Faini, Renata Ciminaghi, Ada Celsi, Matteo Benedetti, Antonella Zambon, Marco di Rienzo, Gianfranco Parati, Renata Ciminaghi, Marco di Rienzo, Davide Soranna, Ada Celsi, Gianfranco Parati, Fabio Albini, Antonella Zambon, Xiaoqiu Liu, Andrea Faini, Camilla Torlasco, Matteo Benedetti
INTRODUCTION: Uncontrolled hypertension is largely attributed to unsatisfactory doctor's engagement in its optimal management and to poor patients' compliance to therapeutic interventions. ICT and mobile Health solutions might improve these conditions, being widely available and providing highly effective communication strategies. OBJECTIVE: To evaluate whether ICT and mobile Health tools are able to improve hypertension control by improving doctors' engagement and by increasing patients' education and involvement, and their compliance to lifestyle modification and prescribed drug therapy...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28222959/clinical-inertia-time-to-reappraise-the-terminology
#18
EDITORIAL
Kamlesh Khunti, Melanie J Davies
No abstract text is available yet for this article.
April 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28183347/application-of-incident-command-structure-to-clinical-trial-management-in-the-academic-setting-principles-and-lessons-learned
#19
Penny S Reynolds, Mary J Michael, Bruce D Spiess
BACKGROUND: Clinical trial success depends on appropriate management, but practical guidance to trial organisation and planning is lacking. The Incident Command System (ICS) is the 'gold standard' management system developed for managing diverse operations in major incident and public health arenas. It enables effective and flexible management through integration of personnel, procedures, resources, and communications within a common hierarchical organisational structure. Conventional ICS organisation consists of five function modules: Command, Planning, Operations, Logistics, and Finance/Administration...
February 9, 2017: Trials
https://www.readbyqxmd.com/read/28155046/early-combination-therapy-with-oral-glucose-lowering-agents-in-type-2-diabetes
#20
REVIEW
Cristina Bianchi, Giuseppe Daniele, Angela Dardano, Roberto Miccoli, Stefano Del Prato
Despite the considerable burden of disease associated with type 2 diabetes mellitus (T2DM), most patients are not at, or are unable to achieve, recommended glycemic targets. This is partly because of the relentless progressive nature of the disease, but it may also be attributable to the current diabetes treatment paradigm. The recommended stepwise approach may lead to frequent early treatment failure with prolonged periods of elevated glucose as a consequence of clinical inertia and delays in achieving optimal glycemic control...
March 2017: Drugs
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