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Good Clinical Practices

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https://www.readbyqxmd.com/read/28441339/still-searching-a-meta-synthesis-of-a-good-death-from-the-bereaved-family-member-perspective
#1
REVIEW
Kelly E Tenzek, Rachel Depner
The concept of a good death continues to receive attention in end-of-life (EOL) scholarship. We sought to continue this line of inquiry related to a good death by conducting a meta-synthesis of published qualitative research studies that examined a good death from the bereaved family member's perspective. Results of the meta-synthesis included 14 articles with 368 participants. Based on analysis, we present a conceptual model called The Opportunity Model for Presence during the EOL Process. The model is framed in socio-cultural factors, and major themes include EOL process engagement with categories of healthcare participants, communication and practical issues...
April 25, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28440529/-implementation-of-enhanced-recovery-after-surgery-in-nutritional-management-of-patients-undergoing-metabolic-surgery
#2
Tianzi Zhang, Qin Xu, Ningli Yang, Juan Tang, Hui Liang
Metabolic surgery is a gastrointestinal surgical procedure to treat obesity and its related co-morbidities with rapid development in recent years. Patients undergoing metabolic surgery have preoperative nutritional disorders, and the nutrition management for these patients is the key point of perioperative management. During the perioperative period, current research has preliminarily confirmed that perioperative managements including supplementation of micronutrients, preoperative evaluation of the weight loss, preoperative fasting and carbohydrate oral intake based on the full application of ERAS and characteristics of the patients undergoing metabolic surgery, are safe and effective in clinical practice...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28439490/watch-and-wait-policy-in-advanced-neuroendocrine-tumors-what-does-it-mean
#3
EDITORIAL
Nicola Fazio
Neuroendocrine neoplasms (NENs) are a group of rare and heterogeneous malignancies, which can develop in various organs. The clinical course of NENs is quite heterogeneous, with different spontaneous growth rates after diagnosis, and different degrees of sensitivity to the same therapy even when they have similar characteristics. Watch and wait (W and W), is a term coined to indicate observation being conducted to assess the evolution of the tumor without administering any anti-tumor therapy. It has been applied to NENs since in extremely rare cases they tend to remain stable for a long time...
April 10, 2017: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28439076/practice-makes-perfect-self-reported-adherence-a-positive-marker-of-inhaler-technique-maintenance
#4
Elizabeth Azzi, Pamela Srour, Carol Armour, Cynthia Rand, Sinthia Bosnic-Anticevich
Poor inhaler technique and non-adherence to treatment are major problems in the management of asthma. Patients can be taught how to achieve good inhaler technique, however maintenance remains problematic, with 50% of patients unable to demonstrate correct technique. The aim of this study was to determine the clinical, patient-related and/or device-related factors that predict inhaler technique maintenance. Data from a quality-controlled longitudinal community care dataset was utilized. 238 patients using preventer medications where included...
April 24, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28438759/palliative-care-clinicians-knowledge-of-the-law-regarding-the-use-of-the-deprivation-of-liberty-safeguards-dols
#5
Caroline Barry, Anna Spathis, Sarah Treaddell, Sally Carding, Stephen Barclay
OBJECTIVES: To examine palliative care clinicians' level of knowledge of the law regarding the use of the Deprivation of Liberty Safeguards (DoLS). METHODS: Regional postal survey of palliative care clinicians working in hospices in the East of England, undertaken in April 2015. Clinicians' level of knowledge was assessed by their response to 7 factual questions. Data regarding self-reported levels of confidence in applying the Safeguards was collected, alongside information regarding the number of times they had used DoLS in practice...
April 24, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28438583/psychometric-assessment-of-the-chinese-version-of-the-abbreviated-expanded-prostate-cancer-index-composite-epic-26-and-the-clinical-practice-version-epic-cp-in-chinese-men-with-prostate-cancer
#6
Wendy Wt Lam, Michael A Tse, Chris Nl Ng, Edward Km Chung, Richard Fielding
PURPOSE: The Expanded Prostate Cancer Index Composite (EPIC) instrument was designed to assess a range of health-related quality of life issues specifically relevant to patients with prostate cancer. This study examined the validity and reliability of Chinese versions of the 26-item EPIC and of the 16-item EPIC for clinical practice (EPIC-CP) in Chinese patients with prostate cancer. MATERIALS AND METHODS: A Chinese version of the 26-item EPIC and the 16-item EPIC-CP were self-completed by 252 Chinese patients with prostate cancer who were recruited from three community-based cancer service centres...
April 21, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28438482/manufacture-and-preparation-of-human-placenta-derived-mesenchymal-stromal-cells-for-local-tissue-delivery
#7
Lee Lankford, Y Julia Chen, Zoe Saenz, Priyadarsini Kumar, Connor Long, Diana Farmer, Aijun Wang
BACKGROUND: In this study we describe the development of a Current Good Manufacturing Practice (CGMP)-compliant process to isolate, expand and bank placenta-derived mesenchymal stromal cells (PMSCs) for use as stem cell therapy. We characterize the viability, proliferation and neuroprotective secretory profile of PMSCs seeded on clinical-grade porcine small intestine submucosa extracellular matrix (SIS-ECM; Cook Biotech). METHODS: PMSCs were isolated from early gestation placenta chorionic villus tissue via explant culture...
April 21, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28438322/water-fat-dixon-sequences-in-the-evaluation-of-breast-implants-proposal-of-a-time-effective-rapid-approach-in-the-clinical-practice
#8
M Marcon, A S Becker, E J Ulbrich, T Frauenfelder, A Boss
AIM: To evaluate the diagnostic accuracy achieved from a fat-water Dixon sequence alone compared to a combination of a silicone-specific magnetic resonance imaging (MRI) sequence and a water-specific MRI sequence in the assessment of breast implants. MATERIALS AND METHODS: In this institutional review board (IRB)-approved study the integrity of breast implants was assessed retrospectively in 27 patients undergoing breast MRI at 3 T. A qualitative evaluation of (set 1) a silicon-selective water-saturated short tau inversion recovery (STIR) sequence in combination with a water-only Dixon dataset (total acquisition time 7 minutes 17 seconds), and of (set 2) fat-only and water-only Dixon datasets (4 minutes 8 seconds) was performed by two readers independently evaluating the following features: margin definition of the implant, water suppression homogeneity, image quality, presence of artefacts and their effects on the imaging interpretation, and diagnostic confidence...
April 21, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28436849/reverse-classification-accuracy-predicting-segmentation-performance-in-the-absence-of-ground-truth
#9
Vanya V Valindria, Ioannis Lavdas, Wenjia Bai, Konstantinos Kamnitsas, Eric O Aboagye, Andrea G Rockall, Daniel Rueckert, Ben Glocker
When integrating computational tools such as automatic segmentation into clinical practice, it is of utmost importance to be able to assess the level of accuracy on new data, and in particular, to detect when an automatic method fails. However, this is difficult to achieve due to absence of ground truth. Segmentation accuracy on clinical data might be different from what is found through cross-validation because validation data is often used during incremental method development, which can lead to overfitting and unrealistic performance expectations...
April 17, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28436709/transitioning-from-occupational-therapy-student-to-practicing-occupational-therapist-first-year-of-employment
#10
Randy P McCombie, Meredith E Antanavage
This research examined the transition from occupational therapy student to practicing occupational therapist over the course of one's first year of professional employment, as recalled by a sample of occupational therapists. Surveys were mailed to 500 occupational therapists randomly selected from membership in the American Occupational Therapy Association resulting in 202 returned surveys. Median year of graduation was 1998, ranging from 1967 to 2014. In general, respondents indicated the transition was positive...
April 24, 2017: Occupational Therapy in Health Care
https://www.readbyqxmd.com/read/28435905/transurethral-resection-of-the-prostate-bladder-explosion-and-hyponatremic-encephalopathy-a-rare-case-report-of-malpractice
#11
Giuseppe Vacchiano, Aldo Rocca, Rita Compagna, Anna Ginevra Immacolata Zamboli, Vera Cirillo, Lorenza Di Domenico, Veronica Di Nardo, Giuseppe Servillo, Bruno Amato
We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability...
January 2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28434948/international-and-multidisciplinary-expert-recommendations-for-the-use-of-biologics-in-systemic-lupus-erythematosus
#12
REVIEW
Jean-François Kleinmann, Florence Tubach, Véronique Le Guern, Alexis Mathian, Christophe Richez, David Saadoun, Karim Sacre, Jérémie Sellam, Raphaèle Seror, Zahir Amoura, Emmanuel Andres, Sylvain Audia, Brigitte Bader-Meunier, Gilles Blaison, Bernard Bonnotte, Patrice Cacoub, Sophie Caillard, Laurent Chiche, Olivier Chosidow, Nathalie Costedoat-Chalumeau, Claire Daien, Eric Daugas, Nairouz Derdèche, Andrea Doria, Olivier Fain, Fadi Fakhouri, Dominique Farge, Cem Gabay, Sylvie Guillo, Eric Hachulla, Najia Hajjaj-Hassouni, Mohamed Hamidou, Frédéric A Houssiau, Noémie Jourde-Chiche, Isabelle Koné-Paut, Aïcha Ladjouz-Rezig, Olivier Lambotte, Dan Lipsker, Xavier Mariette, Nicolas Martin-Silva, Thierry Martin, François Maurier, Roderich Meckenstock, Arsène Mékinian, Olivier Meyer, Shirine Mohamed, Jacques Morel, Bruno Moulin, Denis Mulleman, Thomas Papo, Vincent Poindron, Xavier Puéchal, Leonardo Punzi, Pierre Quartier, Laurent Sailler, Amar Smail, Martin Soubrier, Agnès Sparsa, Zoubida Tazi-Mezalek, Leith Zakraoui, Stéphane Zuily, Jean Sibilia, Jacques-Eric Gottenberg
BACKGROUND/PURPOSE: Despite conventional immunosuppressants, active and steroid-dependent systemic lupus erythematosus (SLE) represents a therapeutic challenge. Only one biologic, belimumab, has been approved, but other biologics are sometimes used off-label. Given the lack of evidence-based data in some clinical situations encountered in real life, we developed expert recommendations for the use of biologics for SLE. METHODS: The recommendations were developed by a formal consensus method...
April 18, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28432483/what-s-in-a-gold-standard-in-defence-of-randomised-controlled-trials
#13
Marius Backmann
The standardised randomised clinical trial (RCT) has been exceedingly popular in medical research, economics, and practical policy making. Recently, RCTs have faced criticism. First, it has been argued by John Worrall that we cannot be certain that our sample is not atypical with regard to possible confounding factors. I will argue that at least in the case of medical research, we know enough about the relevant causal mechanisms to be justified to ignore a number of factors we have good reason not to expect to be disruptive...
April 21, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28432090/international-variations-in-clinical-practice-guidelines-for-palliative-sedation-a-systematic-review
#14
REVIEW
Ebun Abarshi, Judith Rietjens, Lenzo Robijn, Augusto Caraceni, Sheila Payne, Luc Deliens, Lieve Van den Block
OBJECTIVES: Palliative sedation is a highly debated medical practice, particularly regarding its proper use in end-of-life care. Worldwide, guidelines are used to standardise care and regulate this practice. In this review, we identify and compare national/regional clinical practice guidelines on palliative sedation against the European Association for Palliative Care (EAPC) palliative sedation Framework and assess the developmental quality of these guidelines using the Appraisal Guideline Research and Evaluation (AGREE II) instrument...
April 20, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28431689/-behavioral-activation-programs-a-tool-for-treating-depression-efficiently
#15
C Dondé, R Moirand, A Carre
INTRODUCTION: Major depressive disorder (MDD) is a debilitating disorder, and its treatment often requires complex and costly psychological therapies. Behavioral activation (BA) is a simple, effective and affordable psychotherapy recommended in the treatment of MDD. OBJECTIVES: (i) Explain the theoretical basis of BA and its application in clinical practice. (ii) Review the randomized controlled trials examining BA as a treatment for MDD through a systematic search of the existing literature...
April 18, 2017: L'Encéphale
https://www.readbyqxmd.com/read/28431640/rapid-assessment-of-drugs-of-abuse
#16
Joesph R Wiencek, Jennifer M Colby, James H Nichols
Laboratory testing for drugs of abuse has become standard practice in many settings both forensic and clinical. Urine is the predominant specimen, but other specimens are possible including hair, nails, sweat, and oral fluid. Point-of-care test kits provide for rapid analysis at the site where specimens are collected allowing for immediate action on the results. POCT is based on immunochromatography where the drug in the patient's sample competes with drug and antibody conjugates in the test to develop or block the development of a colored line...
2017: Advances in Clinical Chemistry
https://www.readbyqxmd.com/read/28430765/breastfeeding-knowledge-of-health-professionals-working-in-municipal-healthcare-centers-in-maipu-chile
#17
Laura Medel Marambio, Dafna Benadof, Carol Toro Huerta
INTRODUCTION: Healthcare provider’s knowledge has been identified as a factor associated with clinical practice skills and exclusive breastfeeding prevalence. OBJECTIVES: To evaluate the level of knowledge and training in breastfeeding of healthcare provider’s that work in family healthcare centers of Maipu, Chile, (midwifes, physicians, nurses and nutritionists). To determine association among level of knowledge, profession and breastfeeding training. METHODS: Quantitative, cross-sectional, analytical study...
April 6, 2017: Medwave
https://www.readbyqxmd.com/read/28430740/low-dose-computed-tomography-scans-with-automatic-exposure-control-for-patients-of-different-ages-undergoing-cardiac-pet-ct-and-spect-ct
#18
Ching-Ching Yang, Bang-Hung Yang, Chun-Yuan Tu, Tung-Hsin Wu, Shu-Hsin Liu
PURPOSE: This study aimed to evaluate the efficacy of automatic exposure control (AEC) in order to optimize low-dose computed tomography (CT) protocols for patients of different ages undergoing cardiac PET/CT and single-photon emission computed tomography/computed tomography (SPECT/CT). METHODS: One PET/CT and one SPECT/CT were used to acquire CT images for four anthropomorphic phantoms representative of 1-year-old, 5-year-old and 10-year-old children and an adult...
April 20, 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/28429969/advances-in-pharmacotherapeutic-management-of-common-skin-diseases-in-neonates-and-infants
#19
Annalisa Patrizi, Iria Neri, Giampaolo Ricci, Francesca Cipriani, Giulia Maria Ravaioli
neonatal and infantile skin diseases are frequently encountered in the clinical practice and represent worldwide a socioeconomic issue. They encompass a wide range of acquired or congenital conditions, including infections, vascular lesions and inflammatory diseases and can present with different degrees of severity, leading in some cases to dramatic complications. Areas covered: In this paper we report the most recent evidences on the management of some common skin diseases in neonates and infants. Hemangiomas, viral, fungal and bacterial infections, omphalitis, atopic and seborrhoeic dermatitis, napkin disease will be treated and discussed...
May 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28429403/accuracy-of-computed-tomographic-arthrography-for-assessment-of-articular-cartilage-defects-in-the-ovine-stifle
#20
Fanny Hontoir, Peter Clegg, Vincent Simon, Nathalie Kirschvink, Jean-Francois Nisolle, Jean-Michel Vandeweerd
Articular cartilage defects are one of the features of osteoarthritis in animals and humans. Early detection of cartilage defects is a challenge in clinical veterinary practice and also in translational research studies. An accurate, diagnostic imaging method would be desirable for detecting and following up lesions in specific anatomical regions of the articular surface. The current prospective experimental study aimed to describe the accuracy of computed tomographic arthrography (CTA) for detecting cartilage defects in a common animal model used for osteoarthritis research, the ovine stifle (knee, femoropatellar/femorotibial) joint...
April 20, 2017: Veterinary Radiology & Ultrasound
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