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https://www.readbyqxmd.com/read/28509771/sedation-for-advanced-procedures-in-the-bronchoscopy-suite-proceduralist-or-anesthesiologist
#1
Michael Kern, Thoralf Kerner, Sascha Tank
PURPOSE OF REVIEW: This article focuses on the issue of sedation provided either by proceduralists or anesthesiologists for advanced bronchoscopy procedures. The relative merits of both approaches are presented. Current evidence from the literature and guideline recommendations relevant to this topic are reviewed. RECENT FINDINGS: In general, patient and proceduralist satisfaction as well as patient safety are increased when intravenous sedation is provided for advanced bronchoscopic procedures...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28493231/-drug-therapy-of-fibromyalgia-syndrome-updated-guidelines-2017-and-overview-of-systematic-review-articles
#2
C Sommer, R Alten, K-J Bär, M Bernateck, W Brückle, E Friedel, P Henningsen, F Petzke, T Tölle, N Üçeyler, A Winkelmann, W Häuser
BACKGROUND: The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. METHODS: The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest...
May 10, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28493229/-general-treatment-principles-coordination-of-care-and-patient-education-in-fibromyalgia-syndrome-updated-guidelines-2017-and-overview-of-systematic-review-articles
#3
F Petzke, W Brückle, U Eidmann, P Heldmann, V Köllner, T Kühn, H Kühn-Becker, M Strunk-Richter, M Schiltenwolf, M Settan, M von Wachter, M Weigl, W Häuser
BACKGROUND: The regular update of the guidelines on fibromyalgia syndrome, AWMF number 145/004, was scheduled for April 2017. METHODS: The guidelines were developed by 13 scientific societies and 2 patient self-help organizations coordinated by the German Pain Society. Working groups (n =8) with a total of 42 members were formed balanced with respect to gender, medical expertise, position in the medical or scientific hierarchy and potential conflicts of interest...
May 10, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28471945/metabolic-concerns-in-aging-hiv-infected-persons-from-serum-lipid-phenotype-to-fatty-liver
#4
Giovanni Guaraldi, Amedeo Lonardo, Liliana Maia, Frank J Palella
: Among HIV-infected persons, the assessment of nonalcoholic fatty liver disease (NAFLD) provides a window through which overall metabolic health can be evaluated. In this review, we summarize clinical data that support the roles of aging and metabolic dysregulation as factors contributing to fatty liver/NAFLD among HIV-infected persons.Age-related metabolic alterations include hepatic anatomic and functional changes, altered homeostasis of gastrointestinal microbiota and anthropometric changes (such as a shift of body fat depots from the subcutaneous to the visceral compartment) that are often associated with the development of insulin resistance and increased cardiovascular risk...
June 1, 2017: AIDS
https://www.readbyqxmd.com/read/28469298/where-are-we-with-bladder-preservation-for-muscle-invasive-bladder-cancer-in-2017
#5
REVIEW
Woodson Wade Smelser, Marcus A Austenfeld, Jeffrey Maxwell Holzbeierlein, Eugene Kang Lee
INTRODUCTION: In 2017, neoadjuvant, cisplatin-based chemotherapy followed by radical cystectomy (RC) is considered the gold standard therapy for muscle-invasive bladder based on randomized controlled trials. Across all tumor stages, this approach has been associated with the highest rates of disease-specific survival. However, RC is one of the most challenging procedures performed by urologic surgeons and carries with it significant risks of complications, hospital readmission, and even a small risk of mortality, in addition to lifestyle changes that can have long-term effects on well-being...
April 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28460695/reducing-fresh-tracheostomy-decannulations-following-implementation-of-a-fresh-tracheostomy-guideline
#6
REVIEW
Kristen Hood, Brennan Lewis, Cindy Darnell Bowens
Pediatric patients undergoing tracheostomy placement are often medically fragile with multiple comorbidities. The complexity of these patients partnered with the risks of a newly placed tracheostomy necessitates a clear understanding of patient management and clinical competence. At our institution, a quality improvement initiative was formed with a focus on increasing the safety of these patients by developing a postoperative care guideline.
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28443147/evaluation-of-lower-urinary-tract-symptoms-in-multiple-sclerosis-patients-review-of-the-literature-and-current-guidelines
#7
REVIEW
Shachar Moshe Aharony, Ornella Lam, Jacques Corcos
Multiple sclerosis (MS) is a unique neurological disease with a broad spectrum of clinical presentations that are time- and disease course-related. MS plaque location (intracranial and/or spinal) is a key feature in the pathophysiology of disease-related lower urinary tract symptoms (LUTS). The prevalence of these symptoms in MS patients is very high, with nearly 90% of them experiencing some degree of voiding dysfunction and/or incontinence. LUTS rarely present as primary MS manifestations and usually appear 6-8 years after the initial diagnosis...
January 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28424138/comparative-analysis-of-the-paravertebral-analgesic-pump-catheter-with-the-epidural-catheter-in-elderly-trauma-patients-with-multiple-rib-fractures
#8
COMPARATIVE STUDY
Brian S Shapiro, Tarik Wasfie, Mathew Chadwick, Kimberly R Barber, Raquel Yapchai
Presently, trauma guidelines recommend epidural analgesia as the optimal modality of pain relief from rib fractures. They are not ideally suited for elderly trauma patients and have disadvantages including bleeding risk. The paravertebral analgesic pump (PVP) eliminates such disadvantages and includes ease of placement in the trauma setting. This study compares pain control in patients treated by EPI versus PVP. This is a retrospective, historical cohort study comparing two methods of pain management in the trauma setting...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28413184/risk-of-ischemic-stroke-in-patients-with-non-valvular-atrial-fibrillation-not-receiving-oral-anticoagulants%C3%A3-korean-nationwide-population-based-study
#9
Si-Hyuck Kang, Eue-Keun Choi, Kyung-Do Han, So-Ryoung Lee, Woo-Hyun Lim, Myung-Jin Cha, Youngjin Cho, Il-Young Oh, Seil Oh
BACKGROUND: Atrial fibrillation, the most common cardiac arrhythmia, is associated with an elevated thromboembolic risk, including ischemic stroke. Guidelines recommend the stratification of individual stroke risk and tailored antithrombotic therapy. This study investigated the demographics, comorbidities, and prognosis of non-valvular AF (NVAF) in Korean patients.Methods and Results:We extracted data on 10,846 patients with newly diagnosed NVAF who were naïve to oral anticoagulants from the National Health Insurance Service-National Sample Cohort...
April 12, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28408193/imipramine-versus-placebo-for-multiple-functional-somatic-syndromes-stress-3-a-double-blind-randomised-study
#10
Johanne L Agger, Andreas Schröder, Lise K Gormsen, Jens S Jensen, Troels S Jensen, Per K Fink
BACKGROUND: Functional somatic syndromes, including chronic fatigue syndrome or irritable bowel syndrome, often co-exist. Treatment guidelines supported by high quality evidence exist for most functional somatic syndromes, but are lacking for multiple comorbid functional somatic syndromes. We aimed to assess the effect of the tricyclic antidepressant, imipramine, in patients with multiple functional somatic syndromes defined by the criteria for multiorgan bodily distress syndrome, a unifying diagnosis that encompasses most functional somatic syndromes and somatoform disorders...
May 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28376127/the-doc-screen-feasible-and-valid-screening-for-depression-obstructive-sleep-apnea-osa-and-cognitive-impairment-in-stroke-prevention-clinics
#11
Richard H Swartz, Megan L Cayley, Krista L Lanctôt, Brian J Murray, Ashley Cohen, Kevin E Thorpe, Michelle N Sicard, Karen Lien, Demetrios J Sahlas, Nathan Herrmann
BACKGROUND: Post-stroke Depression, Obstructive sleep apnea (OSA) and Cognitive impairment ("DOC") are associated with greater mortality, worse recovery and poorer quality of life. Best practice recommendations endorse routine screening for each condition; yet, all are under-assessed, diagnosed and treated. We seek to determine the feasibility and validity of an integrated tool ("DOC" screen) to identify stroke clinic patients at high-risk of depression, OSA, and cognitive impairment...
2017: PloS One
https://www.readbyqxmd.com/read/28373881/clinical-decision-support-systems-for-comorbidity-architecture-algorithms-and-applications
#12
Aihua Fan, Di Lin, Yu Tang
In this paper, we present the design of a clinical decision support system (CDSS) for monitoring comorbid conditions. Specifically, we address the architecture of a CDSS by characterizing it from three layers and discuss the algorithms in each layer. Also we address the applications of CDSSs in a few real scenarios and analyze the accuracy of a CDSS in consideration of the potential conflicts when using multiple clinical practice guidelines concurrently. Finally, we compare the system performance in our design with that in the other design schemes...
2017: International Journal of Telemedicine and Applications
https://www.readbyqxmd.com/read/28368273/consensus-statement-of-the-indian-academy-of-pediatrics-on-evaluation-and-management-of-learning-disability
#13
M K C Nair, Chhaya Prasad, Jeeson Unni, Anjan Bhattacharya, S S Kamath, Samir Dalwai
JUSTIFICATION: Learning Disability (LD) in children is a well-recognized developmental disorder, which has profound academic and psychosocial consequences. Due to the complex nature of LD and multiple disadvantages posed to the child due to LD, a multidisciplinary approach towards intervention is warranted. Given the paucity of evidence-based standardized treatment approaches, consensus guidelines for management of LD are needed. PROCESS: The meeting on formulation of national consensus guidelines on neurodevelopmental disorders was organized by Indian Academy of Pediatrics in Mumbai, on 18th and 19th December, 2015...
March 29, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28364669/suggestion-of-brca1-c-5339t-c-p-l1780p-variant-confer-from-unknown-significance-to-likely-pathogenic-based-on-clinical-evidence-in-korea
#14
Jai Min Ryu, Goeun Kang, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Se Kyung Lee, Soo Youn Bae, Sungmin Park, Hyun-June Paik, Jong-Won Kim, Sung-Shin Park, Jeong Eon Lee, Sung-Won Kim
PURPOSE: We describe a rationale for the re-classification of the BRCA1 c.5539T>C (L1780P) variant using a clinical evidence. METHODS: A retrospective review was conducted to identify all patients with breast or ovarian cancer and the L1780P variant between 2002 and 2015 at a single institution. RESULTS: We identified the BRCA1/2 genetic mutation test results of 1223 breast cancer patients and 174 patients with ovarian cancer. Of the 160 BRCA 1/2 variant unknown significance, 16 (10...
March 29, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28363288/temporal-detection-and-analysis-of-guideline-interactions
#15
Luca Anselma, Luca Piovesan, Paolo Terenziani
BACKGROUND: Clinical practice guidelines (CPGs) are assuming a major role in the medical area, to grant the quality of medical assistance, supporting physicians with evidence-based information of interventions in the treatment of single pathologies. The treatment of patients affected by multiple diseases (comorbid patients) is one of the main challenges for the modern healthcare. It requires the development of new methodologies, supporting physicians in the treatment of interactions between CPGs...
February 2017: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/28352017/basilic-vein-transposition-a-viable-alternative-for-multiple-failed-arteriovenous-fistulas-a-single-center-experience
#16
Saurabh Sudhir Chipde, Santosh Agrawal, Jaisukh Kalathia, Udit Mishra, Rajeev Agrawal
Primary use of the autogenous arteriovenous access is recommended by the National Kidney Foundation-Dialysis Outcomes Quality Initiative guidelines. In spite of troublesome comorbidities associated with basilic vein transposition (BVT), it is still the most preferred technique when autologous veins are not suitable to construct radio-cephalic fistula (RCF) and brachiocephalic fistula (BCF), arteriovenous fistula (AVF). The present study highlights our experience with BVT, with small incision technique, over a period of two years with excellent outcome...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28341399/early-postoperative-blood-pressure-and-blood-loss-after-cardiac-surgery-a-retrospective-analysis
#17
Cagla Demirci, Florian Zeman, Christof Schmid, Bernhard Floerchinger
BACKGROUND: Increased blood loss after cardiac surgery is a risk factor for patient morbidity and mortality. Guidelines for postoperative haemodynamics management recommend normotensive blood pressure to avoid increased chest drain volumes. The aim of this study was to verify the correlation of early postoperative hypertension and blood loss in patients after cardiac surgery during the early postoperative period. METHODS: Postoperative mean blood pressure values and chest drain volumes of 431 patients were registered by an intensive care monitoring system during first 60minutes after intensive care admission...
March 22, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28329125/outcomes-in-patients-with-cardiovascular-implantable-electronic-device-infection-managed-with-chronic-antibiotic-suppression
#18
Eugene M Tan, Daniel C DeSimone, M Rizwan Sohail, Larry M Baddour, Walter R Wilson, James M Steckelberg, Abinash Virk
Background.: Most cardiovascular implantable electronic device (CIED) recipients are elderly, have multiple comorbid conditions, and are at increased risk of CIED infection (CIEDI). Current guidelines recommend complete device removal in patients with CIEDI to prevent relapse and mortality. However, comorbidities or other factors may preclude device removal, thus prompting a nonsurgical approach that includes chronic antibiotic suppression (CAS). There are limited data on outcomes of patients receiving CAS for CIEDI...
June 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28315549/substance-abuse-and-addiction-implications-for-pain-management-in-patients-with-cancer%C3%A2
#19
Yu-Ping Chang
BACKGROUND: Substance use disorders (SUDs) are chronic diseases that may complicate the nursing care of patients with cancer, affecting their ability to adhere to treatment protocols, responses to cancer pain, and use of opioids for analgesia. OBJECTIVES: This article explores how the presence of an SUD may affect oncology nursing care and pain management. METHODS: The PubMed and CINAHL® databases were searched for articles from 1980-2016 using the keywords cancer, cancer pain, addiction, substance abuse, and alcoholism...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28280860/-clinical-magnetic-resonance-imaging-frequent-incidental-cerebral-findings
#20
A Müller, P Ditter, S Weidauer, H-H Schild, E Hattingen
The increasing use of magnetic resonance imaging (MRI) in clinical diagnostics means that patients and physicians are confronted more often with incidental findings. In the literature there are fluctuating data on the incidence of such findings and guidelines concerning the further procedure exist in only very few cases, such as incidental aneurysms and pituitary adenomas. The diagnostic and therapeutic implications which can be derived from incidental findings depend on multiple factors, such as anatomical location, patient age, comorbidity and patient wishes...
March 9, 2017: Der Radiologe
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