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Klaus Felix Stein, Adriana Miclescu
Background In recent years, multidisciplinary rehabilitation (MDR) became an alternative treatment option for chronic non-cancer pain. MDR is mostly available in specialized pain units, usually at rehabilitation centers where the level of knowledge and therapeutically options to treat pain conditions are considered to be high. There is strong evidence that MDR in specialized pain units is affecting pain and improves the quality of life in a sustainable manner. There are few studies about MDR outcome in primary health care, especially in those units situated in rural areas and with a different population than that encountered in specialized hospitals...
December 29, 2017: Scandinavian Journal of Pain
Song Guo, Victoria Manning, Yi Yang, Puay Kee Koh, Edwin Chan, Nurun Nisa de Souza, Pryseley Nkouibert Assam, Rehena Sultana, Ruki Wijesinghe, Julius Pangjaya, Gomathinayagam Kandasami, Christopher Cheok, Kae Meng Lee, Kim Eng Wong
BACKGROUND: Many individuals leave costly inpatient detoxification programs prematurely because of the severity of withdrawal symptoms experienced. In the absence of opioid-assisted detoxification in Singapore, diazepam is used to manage withdrawal. However since diazepam is addictive, there is a need to explore the effectiveness of alternative medications. DESIGN AND PROCEDURES: The study aimed to examine the safety and efficacy of lofexidine, a non-opiate, non-addictive, alpha 2-adrenergic agonist in assisting opioid detoxification in Singapore, using a randomized, double-blind, investigator-initiated placebo-controlled trial comparing lofexidine against diazepam...
August 2018: Journal of Substance Abuse Treatment
S Medić, V Petrović, V Milosević, Z Lozanov-Crvenković, S Brkić, N Andrews, F de Ory, C Anastassopoulou
The present cross-sectional serosurvey constitutes the first effort to describe the varicella zoster virus (VZV) seroepidemiology in Serbia. An age-stratified serum bank of 3570 residual samples collected between 2015 and 2016 in each of the seven districts of the Vojvodina Province was tested for IgG anti-VZV antibodies with an enzyme immunoassay. Results were standardised into common units according to the European Sero-Epidemiology Network (ESEN2) methodology. Univariable and multivariable analyses were used to examine the relationships between standardised anti-VZV positivity or logarithmically transformed antibody titres and demographic features of study subjects...
June 18, 2018: Epidemiology and Infection
Patrick T Delaplain, Victor C Joe
The current system of burn care delivery attempts to meet the needs of the nearly 500 000 patients in the United States who require medical treatment annually. However, specialization of care and lack of fundamental burn and wound care knowledge among graduating medical trainees has unintended consequences, leaving the system inefficient, with inherent inequities in care delivery and with the potential to be overwhelmed in a mass casualty event. While increasing accessibility to specialty burn centers through technology could mitigate some of these problems, increased education is more practical...
June 1, 2018: AMA Journal of Ethics
Lianping Ti, Michelle Ng, Lindila Awendila, Patrizia Maria Carrieri
INTRODUCTION: People living with hepatitis C virus (HCV) infection are disproportionately over-represented in the healthcare system due to various individual and contextual circumstances, including comorbidities and socioeconomic marginalisation. With growing trends in morbidity and mortality related to HCV infection, HCV is becoming a significant health and financial burden on the healthcare system, particularly in acute hospital settings. It is noteworthy that with the advent of direct-acting antiviral therapy the increasing number of patients who are cured of HCV could potentially result in different patterns of hospital-related outcomes over time...
June 14, 2018: BMJ Open
Hang Shu, Taylan Morcol, Jie Zheng, Li-Dan Zhao, Kennelly J Edward, Chun-Lin Long
Acorus macrospadiceus is a common medicinal and food plant used different ethnic groups in Guizhou and surrounding areas. In this paper, the leaf and rhizome tissues of A. macrospadiceus were hydro-distilled to extract the volatile oils. The chemical constituents of these oils were analyzed by GC-MS and identified using the NIST 14.0 & NIST 14.0s mass spectral libraries. The relative contents of chemical constituents from the different plant parts were determined by area normalization. The analysis of A...
May 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
(no author information available yet)
The global refugee/migrant crisis of displacement because of persecution and conflict carries staggering implications of ambiguity and loss for the individuals affected. In 2013, approximately 25,000 displaced people sought asylum in the United States; many of whom have experienced state-sponsored physical and psychological torture. With Physicians for Human Rights (PHR), several medical student clinics work closely with immigration attorneys and University and Community based clinicians to assist U.S. asylum seekers in their asylum claims...
June 2018: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Gary L Beck Dallaghan, Joy Higgins, Adam Reinhardt
Background: Direct observations with focused feedback are critical components for medical student education. Numerous challenges exist in providing useful comments to students during their clerkships. Students' evaluations of the clerkship indicated they were not receiving feedback from preceptors or house officers. Objective: To encourage direct observation with feedback, Structured Patient Care Observation (SPCO) forms were used to evaluate third-year medical students during patient encounters...
January 2018: Journal of Medical Education and Curricular Development
Elizabeth M Schoenfeld, Hemal K Kanzaria, Denise D Quigley, Peter St Marie, Nikita Nayyar, Sarah H Sabbagh, Kyle L Gress, Marc A Probst
OBJECTIVES: As Shared Decision-Making (SDM) has received increased attention as a method to improve the patient-centeredness of emergency department (ED) care, we sought to determine patients' desired level of involvement in medical decisions and their perceptions of potential barriers and facilitators to SDM in the ED. METHODS: We surveyed a cross-sectional sample of adult ED patients at three academic medical centers across the United States. The survey included 32 items regarding patient involvement in medical decisions including a modified Control Preference Scale (CPS) and questions about barriers and facilitators to SDM in the ED...
June 13, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Luke Burgess, Sonia Hines, Kathryn Kynoch
The question of this review is: what is the association between emergency department length of stay and patient outcomes?More specifically, what is the association between the length of time a patient spends in the emergency department and outcomes, including, but not limited to: mortality, omitted episodes of care (e.g. non-administration of prescribed medication), adverse events, time to treatment (e.g. time to analgesia or time to operating theater), inpatient length of stay, leave without being seen rate and patient satisfaction?...
June 2018: JBI Database of Systematic Reviews and Implementation Reports
Marquis Philip Vawter, Robert Philibert, Brandi Rollins, Patricia L Ruppel, Terry W Osborn
This study developed potential blood-based biomarker tests for diagnosing and differentiating schizophrenia (SZ), bipolar disorder type I (BD), and normal control (NC) subjects using mRNA gene expression signatures. A total of 90 subjects ( n = 30 each for the three groups of subjects) provided blood samples at two visits. The Affymetrix exon microarray was used to profile the expression of over 1.4 million probesets. We selected potential biomarker panels using the temporal stability of the probesets and also back-tested them at two different visits for each subject...
May 2018: Molecular Neuropsychiatry
Shikha Chaganti, Bennett A Landman
Image registration involves identification of a transformation to fit a target image to a reference image space. The success of the registration process is vital for correct interpretation of the results of many medical image-processing applications, including multi-atlas segmentation. While there are several validation metrics employed in rigid registration to examine the accuracy of the method, non-rigid registrations (NRR) are validated subjectively in most cases, validated in offline cases, or based on image similarity metrics, all of which have been shown to poorly correlate with true registration quality...
March 2018: Proceedings of SPIE
Norberto Bilbeny, Juan Pablo Miranda, María Eliana Eberhard, Marisol Ahumada, Lorena Méndez, María Elena Orellana, Loreto Cid, Paola Ritter, Rodrigo Fernández
BACKGROUND AND AIMS: The prevalence of chronic non-cancer pain has not been specifically reported in Chile. METHODS: In order to assess its prevalence and impact, we designed a tool based on previously published survey studies. We analyzed a sample of 784 subjects to determine the prevalence of chronic non-cancer pain, with a maximum variability of 50%, a confidence interval (CI) of 95%, and an estimation error of 3.5%. Finally, a cross-sectional cell phone survey was conducted on a nationally representative probability sample of 865 subjects of over 18 years, in November 2013...
June 11, 2018: Scandinavian Journal of Pain
Yakov Flaumenhaft, Ofir Ben-Assuli
Personal health records (PHR) have been endorsed as a promising tool for the self-management of an individual's medical information, affording benefits to both the individual patient and the healthcare system as a whole. Nevertheless, adoption rates have been relatively slow and widespread acceptance has yet to be achieved. A significant obstacle often cited as delaying the implementation of these systems has been concern regarding the ability to properly ensure the security and privacy of this sensitive information...
May 14, 2018: Health Policy
Zhanetta A Chornenka, Elvira Ts Yasinska, Mariana I Grytsiuk
OBJECTIVE: Introduction: The number of patients with peptic ulcer increases annually. According to published data, patients with peptic ulcer constitute about 15% of those hospitalized with gastrointestinal diseases. The aim: That is why we set the task to evaluate the methods of preventive treatment and to choose the most effective one. PATIENTS AND METHODS: Materials and methods: For this purpose, we selected 103 patients with peptic ulcer without severe exacerbations and complications from one region (main group) and 101 patients from another region (control group) for observations...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Monica Bhutiani, Patrick M Jablonski, Jesse M Ehrenfeld, Matthew D McEvoy, Leslie C Fowler, Jonathan P Wanderer
BACKGROUND: The Accreditation Council of Graduate Medical Education requires monitoring of resident clinical and educational hours but does not require tracking daily work patterns or duty hour equity. Lack of such monitoring may allow for inequity that affects resident morale. No defined system for resident relief of weekday operating room (OR) clinical duties existed at our institution, leaving on-call residents to independently decide daily relief order. We developed an automated decision support tool (DST) to improve equitable decision making for clinical relief and assessed its impact on real and perceived relief equity...
June 5, 2018: Anesthesia and Analgesia
M C Noushad, Biji Balan, Shabhana Basheer, Shinsus Bin Usman, M K Muhammed Askar
Introduction: The spread of drug-resistant pathogens is one of the most serious threats to successful treatment of microbial diseases. Extracts of plants such as flowers, buds, seeds, leaves, twigs, bark, herbs, wood, fruits, and roots have evoked interest as sources of natural products. Irrigation with a broad-spectrum antiseptic substance and inter-appointment intracanal medication has become a standard regimen in root canal therapy. Aim: The aim of this study is to compare the antimicrobial efficacy of different natural extracts such as guava leaf extract, Aloe vera extract, papaya leaf extract, and cashew apple extract against Enterococcus faecalis and Candida albicans ...
April 2018: Contemporary Clinical Dentistry
Mitchell Duncan, Matthew K Newall, Vincent Caillet, Jeremy T Booth, Paul J Keall, Michael Lerch, Vladimir Perevertaylo, Anatoly B Rosenfeld, Marco Petasecca
PURPOSE: Radiation treatments delivered with real-time multileaf collimator (MLC) tracking currently lack fast pretreatment or real-time quality assurance. The purpose of this study is to test a 2D silicon detector, MagicPlate-512 (MP512), in a complex clinical environment involving real-time reconfiguration of the MLC leaves during target tracking. METHODS: MP512 was placed in the center of a solid water phantom and mounted on a motion platform used to simulate three different patient motions...
June 5, 2018: Journal of Applied Clinical Medical Physics
Bruno Lankoandé, Géraldine Duthé, Abdramane Soura, Gilles Pison
BACKGROUND: In sub-Saharan Africa, the literature on end of life is limited and focuses on place of death as an indicator of access and utilization of health-care resources. Little is known about population mobility at the end of life. OBJECTIVE: To document the magnitude, motivations and associated factors of short-term mobility before death among adults over 15 years of age in Burkina Faso and Senegal. METHODS: The study was based on deaths of adult residents reported in three Health and Demographic Surveillance System (HDSS) sites in urban (Ouagadougou) and semi-rural areas (Kaya) of Burkina Faso, and rural areas of Senegal (Mlomp)...
2018: Global Health Action
Kasra Maasumi, Rebecca L Michael, Alan M Rapoport
Migraine is a highly prevalent, complex neurological disorder. The burden of disease and the direct/indirect annual costs are enormous. Thus far, treatment options have been inadequate and mostly based on trial and error, leaving a significant unmet need for effective therapies. While the underlying pathophysiology of migraine is incompletely understood, blocking the calcitonin gene-related peptide (CGRP) using monoclonal antibodies targeting CGRP or its receptor and small molecule CGRP receptor antagonists (gepants) have emerged as a promising therapeutic opportunity for the management of migraine...
June 4, 2018: Drugs
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