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Good Clinical Practices

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https://www.readbyqxmd.com/read/28334936/satisfaction-with-general-practice-care-in-german-patients-with-multimorbidity-a-cross-sectional-study
#1
Achim Mortsiefer, Attila Altiner, Annette Ernst, Hanna Kadusziewicz, Alice Krahe, Christine Mellert, Ingmar Schäfer, Carl-Otto Stolzenbach, Birgitt Wiese, Christin Löffler
Background.: Little is known about the quality of general practice care received by patients suffering from multimorbidity. Objectives.: To assess how patients with multimorbidity evaluate their General Practitioners (GPs') performance and to identify factors associated with high patient satisfaction levels. Methods.: Cross-sectional study in Germany using the EUROPEP questionnaire consisting of 23 items with a five-point Likert scale and covering two dimensions: clinical performance of the GP and organisation of care...
February 21, 2017: Family Practice
https://www.readbyqxmd.com/read/28334767/discomfort-during-bronchoscopy-performed-after-endobronchial-intubation-with-fentanyl-and-midazolam-a-prospective-study
#2
Daisuke Minami, Nagio Takigawa, Hirohisa Kano, Takashi Ninomiya, Toshio Kubo, Eiki Ichihara, Kadoaki Ohashi, Akiko Sato, Katsuyuki Hotta, Masahiro Tabata, Mitsune Tanimoto, Katsuyuki Kiura
Objective: Although endobronchial intubation during a bronchoscopic examination is useful for invasive procedures, it is not routine practice in Japan. The present study evaluated discomfort due to endobronchial intubation using fentanyl and midazolam sedation during bronchoscopy. Methods: Thirty-nine patients were enrolled prospectively from November 2014 to September 2015 at Okayama University Hospital. Fentanyl (20 µg) was administered to the patients just before endobronchial intubation, and fentanyl (10 µg) and midazolam (1 mg) were added as needed during the procedure...
February 23, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28334584/delayed-workup-of-rectal-bleeding-in-adult-primary-care-examining-process-of-care-failures
#3
Saul N Weingart, Elena M Stoffel, Daniel C Chung, Thomas D Sequist, Ruth I Lederman, Stephen R Pelletier, Helen M Shields
BACKGROUND: Although delayed colorectal cancer diagnoses figure prominently in medical malpractice claims, little is known about the quality of primary care clinicians' workup of rectal bleeding. METHODS: In this study, 438 patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for rectal bleeding, hemorrhoids, and blood in the stool at 10 Boston adult primary care practices. Following nurse chart abstraction, physician reviewers assessed the overall quality of care and key care processes...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28331610/a-reappraisal-of-the-mucoactive-activity-and-clinical-efficacy-of-bromhexine
#4
REVIEW
Alessandro Zanasi, Massimiliano Mazzolini, Ahmad Kantar
Since its introduction to the market in 1963, bromhexine, an over-the-counter drug, has been investigated for its activity in animal models and in humans with diverse respiratory conditions. Bromhexine is a derivate of the Adhatoda vasica plant used in some countries for the treatment of various respiratory diseases. Bromhexine has been found to enhance the secretion of various mucus components by modifying the physicochemical characteristics of mucus. These changes, in turn, increase mucociliary clearance and reduce cough...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28331129/impact-of-hematopoietic-progenitor-cell-count-as-an-indicator-for-optimal-timing-of-peripheral-stem-cell-harvest-in-clinical-practice
#5
Hiroaki Tanaka, Akihiro Ishii, Yasumasa Sugita, Ryo Shimizu, Fumi Sato, Yukie Sakuma, Rie Iwai, Shinichiro Kakuta
For optimizing CD34+ cell collection, appropriately timing peripheral blood stem cell harvest (PBSCH) initiation is crucial. Automatic cell analyzers with the immature myeloid information channel provide hematopoietic progenitor cell (HPC) count, a surrogate marker of CD34+ cells, which can be obtained within a few minutes without requiring monoclonal antibodies. The final decision on PBSCH initiation can be made using the HPC count obtained on the morning of the harvest day. Herein, we evaluated the impact of the HPC count as an indicator for the optimal timing of PBSCH in clinical practice over 9 years...
2017: Journal of Clinical and Experimental Hematopathology: JCEH
https://www.readbyqxmd.com/read/28329788/defining-health-trajectories-in-older-adults-with-five-clinical-indicators
#6
Giola Santoni, Alessandra Marengoni, Amaia Calderón-Larrañaga, Sara Angleman, Debora Rizzuto, Anna-Karin Welmer, Francesca Mangialasche, Nicola Orsini, Laura Fratiglioni
Background: People age differently, challenging the identification of those more at risk of rapid health deterioration. This study aimed to explore the heterogeneity in the health of older adults by using five clinical indicators to detect age-related variation and individual health trajectories over time. Methods: Health of 3,363 people aged 60+ from the Swedish National study on Aging and Care-Kungsholmen (SNAC-K) assessed at baseline and at 3- and 6-year follow-ups...
October 19, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28328144/diagnosing-and-preventing-iron-overload
#7
Ganesh Ramanathan, John K Olynyk, Paolo Ferrari
Absolute or functional iron (Fe) deficiency is an important determinant of anemia in hemodialysis patients and parenteral Fe is routinely used to treat this condition in conjunction with erythropoiesis stimulating agents. While restoration of hemoglobin toward the target range is a good outcome of Fe replacement, it is well known that Fe overload and toxicity may be adverse consequences of this therapy. Dialysis clinical practice guidelines recommend tailoring Fe therapy based on transferrin saturation and serum ferritin levels...
March 22, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28327853/-latin-american-perspectives-on-person-centered-medicine
#8
Alberto Perales, Juan Mendoza, Rodolfo Armas, Oscar Cluzet
Person-centered medicine (PCM) is a programmatic global initiative led by the International College of Person-Centered Medicine. It has recently emerged in Latin America. It requires the use of scientific research as an instrument to generate the best clinical evidence, and humanism as the essence of medicine to help mankind. It is focused on not only combatting disease but also promoting the display of healthy human being potentials towards achieving well-being and comprehensive growth. Although the humanism of medicine in Latin America has been a distinctive characteristic of its practice, now, there is a worrying decline in its impact on healthcare...
October 2016: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28327572/the-role-of-genetic-counsellors-in-genomic-healthcare-in-the-united-kingdom-a-statement-by-the-association-of-genetic-nurses-and-counsellors
#9
Anna Middleton, Peter Marks, Anita Bruce, Liwsi K Protheroe-Davies, Cath King, Oonagh Claber, Catherine Houghton, Claire Giffney, Rhona Macleod, Claire Dolling, Sue Kenwrick, Diana Scotcher, Georgina Hall, Christine Patch, Laura Boyes
In the United Kingdom, genetic counsellors work together with clinical geneticists and clinical scientist colleagues within specialist genetics services, but they also often work in multidisciplinary teams (MDTs) outside of such services. There, they contribute genetic knowledge together with expert understanding of how to communicate genetic information effectively. They can offer education and support to the MDT, while providing management advice for both affected patients and the extended at-risk family members...
March 22, 2017: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/28326850/multimodal-analgesia-in-moderate-to-severe-pain-a-role-for-a-new-fixed-combination-of-dexketoprofen-and-tramadol
#10
Giustino Varrassi, Magdi Hanna, Giorgos Macheras, Antonio Montero, Antonio Montes Perez, Winfried Meissner, Serge Perrot, Carmelo Scarpignato
Untreated and undertreated pain represent one of the most pervasive health problems, which is worsening as the population ages and accrues risk for pain. Multiple treatment options are available, most of which have one mechanism of action, and cannot be prescribed at unlimited doses due to the ceiling of efficacy and/or safety concerns. Another limitation of single-agent analgesia is that, in general, pain is due to multiple causes. Combining drugs from different classes, with different and complementary mechanism(s) of action, provides a better opportunity for effective analgesia at reduced doses of individual agents...
March 22, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28325580/perinatal-death-investigations-what-is-current-practice
#11
REVIEW
J W Nijkamp, N J Sebire, K Bouman, F J Korteweg, J J H M Erwich, S J Gordijn
Perinatal death (PD) is a devastating obstetric complication. Determination of cause of death helps in understanding why and how it occurs, and it is an indispensable aid to parents wanting to understand why their baby died and to determine the recurrence risk and management in subsequent pregnancy. Consequently, a perinatal death requires adequate diagnostic investigation. An important first step in the analysis of PD is to identify the case circumstances, including relevant details regarding maternal history, obstetric history and current pregnancy (complications are evaluated and recorded)...
March 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28324925/non-invasive-imaging-of-ventricular-activation-during-pacing-and-arrhythmia-methods-and-validation
#12
Long Yu, Steven Pogwizd, Bin He
Cardiovascular disease continued to be a leading killer world widely. Each year, about 400,000 cases of sudden cardiac arrest are reported in the U.S. alone. Clinically, radio-frequency ablative procedure has become widely applied in the treatment of ventricular arrhythmia. Non-invasive approaches have been demonstrated to be able to provide important information on the arrhythmogenesis and potentially assist in the clinical practice. In this work, we develop and validate a novel temporal sparse based imaging method, Cardiac Electrical Sparse Imaging (CESI)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28321422/autologous-tenocyte-injection-for-the-treatment-of-chronic-recalcitrant-gluteal-tendinopathy-a-prospective-pilot-study
#13
Thomas A Bucher, Jay R Ebert, Anne Smith, William Breidahl, Michael Fallon, Tao Wang, Ming-Hao Zheng, Gregory C Janes
BACKGROUND: Gluteal tendinopathy is a common cause of lateral hip pain, and existing conservative treatment modalities demonstrate high symptom recurrence rates. Autologous tenocyte injection (ATI) is a promising cell therapy that may be useful for the treatment of gluteal tendinopathy. PURPOSE: To investigate the safety and effectiveness of ATI, specifically in patients with chronic recalcitrant gluteal tendinopathy. STUDY DESIGN: Case series; Level of evidence, 4...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28321293/primary-prevention-in-chiropractic-practice-a-systematic-review
#14
REVIEW
Guillaume Goncalves, Christine Le Scanff, Charlotte Leboeuf-Yde
BACKGROUND: Chiropractors are primarily concerned with musculoskeletal disorders but have the responsibility to deal also with prevention in other areas. OBJECTIVES: To establish the prevalence of chiropractors who have a positive opinion on the use of primary prevention (PP), their actual use of PP, and the proportion of patients who consult for PP in relation to (i) musculoskeletal disorders, (ii) public health issues, or (iii) chiropractic treatment for wellness...
2017: Chiropractic & Manual Therapies
https://www.readbyqxmd.com/read/28321240/validation-of-veterans-specific-activity-questionnaire-to-assess-exercise-tolerance-of-chinese-elderly-with-coronary-heart-disease
#15
Yan Wang, Jing-Jing Shi, Bo-Zhong Wang
OBJECTIVE: The Veterans Specific Activity Questionnaire (VSAQ) has been used to assess exercise tolerance. Nevertheless, there is no validated Chinese version. The aim of this study is to determine whether a questionnaire-based method using the Chinese version of VSAQ (the modified VSAQ) is a practical tool to assess exercise tolerance of Chinese elderly with coronary heart disease. METHODS: One hundred thirty consecutive elderly patients who were diagnosed with coronary heart disease (CHD) (mean age 68...
December 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28320323/changes-in-duration-of-action-of-rocuronium-following-decrease-in-hepatic-blood-flow-during-pneumoperitoneum-for-laparoscopic-gynaecological-surgery
#16
Yang Liu, Wen Cao, Yu Liu, Yun Wang, Ren Lang, Yun Yue, An-Shi Wu
BACKGROUND: A moderate insufflation pressure and deep neuromuscular blockade (NMB) have been recommended in laparoscopic surgery in consideration of the possible reduction in splanchnic perfusion due to the CO2-pneumoperitoneum. Since the liver is the major organ for rocuronium metabolism, the question of whether NMB of rocuronium would change with the variation of liver perfusion during pneumoperitoneum during laparoscopic surgery merits investigation. METHODS: In this prospective study, a total of sixty female patients scheduled for either selective laparoscopic gynaecological surgery (group laparoscopy) or laparotomy for gynaecological surgery (group control) were analyzed...
March 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28320168/a-systematic-comparison-of-key-features-of-ischemic-stroke-prevention-guidelines-in-low-and-middle-income-vs-high-income-countries
#17
REVIEW
Hernán Bayona, Mayowa Owolabi, Wuwei Feng, Paul Olowoyo, Joseph Yaria, Rufus Akinyemi, James R Sawers, Bruce Ovbiagele
BACKGROUND AND PURPOSE: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. However, key quality characteristics of guidelines issued in LMICs compared with those in High-Income Countries (HICs) have not been systematically studied. We aimed to compare important features of stroke prevention guidelines issued in these groups...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28319446/good-laboratory-practice-preclinical-safety-studies-for-gsk2696273-mlv-vector-based-ex-vivo-gene-therapy-for-adenosine-deaminase-deficiency-severe-combined-immunodeficiency-in-nsg-mice
#18
Nicola Carriglio, Jan Klapwijk, Raisa Jofra Hernandez, Michela Vezzoli, Franck Chanut, Rhiannon Lowe, Draghici Elena, Melanie Nord, Paola Albertini, Patrizia Cristofori, Jane Richards, Hazel Staton, Jonathan Appleby, Alessandro Aiuti, Aisha V Sauer
GSK2696273 (autologous CD34+ cells transduced with retroviral vector that encodes for the human adenosine deaminase [ADA] enzyme) is a gamma-retroviral ex vivo gene therapy of bone marrow-derived CD34+ cells for the treatment of adenosine deaminase deficiency severe combined immunodeficiency (ADA-SCID). ADA-SCID is a severe monogenic disease characterized by immunologic and nonimmunologic symptoms. Bone-marrow transplant from a matched related donor is the treatment of choice, but it is available for only a small proportion of patients...
March 2017: Human Gene Therapy. Clinical Development
https://www.readbyqxmd.com/read/28319248/cyclic-tensile-strain-enhances-human-mesenchymal-stem-cell-smad-2-3-activation-and-tenogenic-differentiation-in-anisotropic-collagen-glycosaminoglycan-scaffolds
#19
W G Grier, A S Moy, B A Harley
Stem cell research arose from the need to explore new therapeutic possibilities for intractable and lethal diseases. Although musculoskeletal disorders are basically nonlethal, their high prevalence and relative ease of performing clinical trials have facilitated the clinical application of stem cells in this field. However, few reliable clinical studies have been published, despite the plethora of in vitro and preclinical studies in stem cell research for regenerative medicine in the musculoskeletal system...
March 20, 2017: European Cells & Materials
https://www.readbyqxmd.com/read/28319041/practical-use-of-a-plastic-scintillator-for-quality-assurance-of-electron-beam-therapy
#20
Katsunori Yogo, Yuya Tatsuno, Masato Tsuneda, Yuki Aono, Daiki Mochizuki, Yoshiki Fujisawa, Akihiro Matsushita, Minoru Ishigami, Hiromichi Ishiyama, Kazushige Hayakawa
Quality assurance (QA) of the clinical electron beam is essential for performing accurate and safe radiation therapy. However, with advances in radiation therapy, QA tends to be labor-intensive and time consuming. Here, we propose the practical use of a tissue-equivalent plastic scintillator for quick and easy QA of clinical electron beams. This tool enabled us to verify simultaneously the constancy of output, beam quality, depth and lateral dose profiles during monthly QAs at lower doses of irradiation (small MUs)...
March 20, 2017: Physics in Medicine and Biology
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