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https://www.readbyqxmd.com/read/30314468/how-general-practitioners-would-deprescribe-in-frail-oldest-old-with-polypharmacy-the-less-study
#1
Sophie Mantelli, Katharina Tabea Jungo, Zsofia Rozsnyai, Emily Reeve, Clare H Luymes, Rosalinde K E Poortvliet, Arnaud Chiolero, Nicolas Rodondi, Jacobijn Gussekloo, Sven Streit
BACKGROUND: Many oldest-old (> 80-years) with multimorbidity and polypharmacy are at high risk of inappropriate use of medication, but we know little about whether and how GPs would deprescribe, especially in the frail oldest-old. We aimed to determine whether, how, and why Swiss GPs deprescribe for this population. METHODS: GPs took an online survey that presented case-vignettes of a frail oldest-old patient with and without history of cardiovascular disease (CVD) and asked if they would deprescribe any of seven medications...
October 12, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30313076/development-of-a-survey-form-through-delphi-study-about-adverse-events-associated-with-the-miniscalpel-needle-for-application-in-prospective-observational-studies-regarding-safety-of-miniscalpel-needles-study-protocol
#2
Sang-Hoon Yoon, Haebeom Lee, Chan-Young Kwon, Damin Jeon, Hyunho Kim, Hee-Geun Jo, Aesook Shin, Younghee Yun, Jae-Uk Sul, Geon-Mok Lee, Jun-Hwan Lee, Jungtae Leem
BACKGROUND: Despite the wide usage of miniscalpel-needles (MSNs), information about MSN treatment-related adverse events (AEs) is insufficient. As the definition of AE might vary among physicians, without an exact definition for pain and hemorrhage, it is difficult to provide accurate information about AEs in MSN treatment to physicians, researchers, and patients. The aim of our study is to reach a consensus about the items and definitions of AEs that should be included in the survey form for prospective observational multicenter studies to record MSN treatment-related AEs...
October 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30312290/what-are-the-benefits-and-risks-of-total-arthroplasty-in-arthrodesed-knees
#3
Martín de Amesti, Luis Ortiz-Muñoz, Sebastián Irarrázaval
INTRODUCTION: The conversion of a previously arthrodesed knee to a total knee arthroplasty is an alternative seldom used. However, arthroplasty would provide greater functionality to the arthrodesed joint. Since it is a technically demanding procedure, not exempt from complications, there is controversy about the role of this intervention. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others...
September 28, 2018: Medwave
https://www.readbyqxmd.com/read/30311863/landscape-of-pain-in-parkinson-s-disease-impact-of-gender-differences
#4
Maria Angela Samis Zella, Caroline May, Thomas Müller, Maike Ahrens, Lars Tönges, Ralf Gold, Katrin Marcus, Dirk Woitalla
BACKGROUND/AIMS: Pain is a non-motor symptom of Parkinson's disease (PD). Few systematic studies have been carried out and there are still no guidelines on pain therapy in PD. Additionally, within the studies that do exist, gender-specific differences in pain perception are often the focus, though no consistent results have to date been obtained. The first main aim of our study was therefore to map pain in the largest PD study group to date, with the second being the analysis of the impact of different pain therapies in PD...
October 12, 2018: Neurological Research
https://www.readbyqxmd.com/read/30310391/do-we-really-know-the-duration-of-pain-after-rib-fracture
#5
Cumhur Murat Tulay, Sadik Yaldiz, Adnan Bilge
Introduction: The duration of pain after rib fracture is the question physicians are most frequently asked. The duration of pain following a traumatic rib fracture without any comorbidity is not widely published. Aim: We report our experience to investigate the duration of pain following isolated traumatic rib fractures without any traumatic comorbidity. Material and methods: We examined 182 patients with isolated rib fracture without any trauma to other body parts...
September 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/30306925/computer-assisted-oswestry-disability-questionnaire-evaluation-using-fuzzy-inference-systems
#6
Norbert Gal-Nadasan, Mihalea Crisan-Vida, Vasile Stoicu-Tivadar, Alexandra Gradea, Emanuela Gal-Nadasan
This paper proposes the evaluation of the Oswestry Disability Index (ODI) using a fuzzy inference system. The ODI is used to evaluate the impact of the low back pain on the patient's quality of life. The patient grades from 0 to 5 a number of 10 questions regarding usual daily activities. At the end a mathematical formula is used to calculate the degree of the impact/disability. It has been observed that this method easily can generate false positive results due to the fact that patients purposely try to score a higher degree so that they can benefit from advantages offered by the medical system...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/30306517/descending-noradrenergic-inhibition-an-important-mechanism-of-gabapentin-analgesia-in-neuropathic-pain
#7
Ken-Ichiro Hayashida, James C Eisenach
Gabapentinoids are effective in a wide range of animal pain models and in patients with neuropathic pain and has become one of first-line treatments for neuropathic pain. Because spinal plasticity and sensitization have been intensely studied in neuropathic pain, most laboratory studies have focused on actions of gabapentinoids in the spinal cord, where they reduce primary afferent traffic and excitation of spinal nociceptive neurons, via interaction with α2δ subunits of voltage-gated Ca2+ channels. However, a recent clinical study questioned the relevance of this in vitro and in vivo rodent studies by demonstrating a complete lack of clinical efficacy of intrathecal gabapentin in patients with chronic pain...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/30304938/development-and-preliminary-evaluation-of-a-pain-management-manual-for-hospice-providers-to-support-and-educate-family-caregivers
#8
Nai-Ching Chi, Soojeong Han, Emelia Barani, Debra Parker Oliver, Karla T Washington, Frances Marcus Lewis, Amy Walker, George Demiris
BACKGROUND: Family caregivers encounter many barriers to managing patients' pain in the home hospice setting. However, there are limited clinically applicable resources for hospice providers to help family caregivers identify and address these barriers. AIM: To develop a pain management manual for hospice providers to support family caregivers and conduct a preliminary providers' evaluation of the manual. DESIGN AND PARTICIPANTS: A pain management manual was developed and structured into 3 parts: (1) 5 common pain management case scenarios based on a secondary data analysis of a hospice clinical trial; (2) a list of suggested assessment questions and strategies for each case scenario was developed based on a caregiver framework; and (3) pain educational material was included from established clinical guidelines...
October 10, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/30304311/evaluation-of-body-image-quality-of-life-tactile-sensitivity-and-pain-in-women-with-breast-cancer-submitted-to-surgical-intervention
#9
Juliana Nishimura Bueno, Cinira Assad Simão Haddad, Samantha Karlla Lopes De Almeida Rizzi, Patricia Santolia Giron, Gil Facina, Afonso Celso Pinto Nazário
OBJECTIVE: Breast cancer is one of the most common types of tumor in the world and the most common among women. There are several treatments for breast cancer; however, the condition often can be accompanied by severe complications in a woman's life. To evaluate and compare body image perception, quality of life, tenderness, and pain in women with breast cancer during preoperative and postoperative periods of 30, 60 and 90 days. MATERIALS AND METHODS: We conducted a prospective longitudinal study...
June 2018: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/30301706/genital-sensations-in-persistent-genital-arousal-disorder-a-case-for-an-overarching-nosology-of-genitopelvic-dysesthesias
#10
REVIEW
Caroline F Pukall, Robyn Jackowich, Kayla Mooney, Susan M Chamberlain
INTRODUCTION: Persistent genital arousal disorder (PGAD) is a highly distressing and poorly understood condition characterized by unwanted sensations of genital arousal in the absence of subjective sexual desire. Research has shown that some individuals with PGAD also report orgasm, urinary, and pain symptoms, with 1 recent study specifically comparing a "painful persistent genital arousal symptom" group to a "non-painful persistent genital arousal symptom" group on various indicators given the highly frequent report of comorbid genitopelvic pain in their sample...
October 6, 2018: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/30301632/identification-of-a-patient-acceptable-symptomatic-state-score-for-the-international-hip-outcome-tool-in-people-undergoing-hip-arthroscopy
#11
Samuel Maxwell, Nicholas Pergaminelis, Jesse Renouf, Oren Tirosh, Phong Tran
PURPOSE: To determine a Patient Acceptable Symptomatic State (PASS) score for the 33-item International Hip Outcome Tool (iHOT-33) in people undergoing hip arthroscopy for primary diagnoses of femoroacetabular impingement syndrome, acetabular labral tears, and/or ligamentum teres pathology. METHODS: Consecutive participants underwent hip arthroscopy by a single surgeon between August 2011 and May 2016. Participants were included if they were between ages 18 and 60 years and underwent hip arthroscopy for femoroacetabular impingement syndrome, acetabular labral tears, or ligamentum teres pathology...
October 6, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/30299482/assessment-of-ovarian-reserve-after-cystectomy-versus-one-step-laser-vaporization-in-the-treatment-of-ovarian-endometrioma-a-small-randomized-clinical-trial
#12
M Candiani, J Ottolina, E Posadzka, S Ferrari, L M Castellano, I Tandoi, L Pagliardini, A Nocun, R Jach
STUDY QUESTION: Does CO2 laser vaporization offer better results in treating endometrioma in terms of ovarian reserve preservation compared to traditional cystectomy? SUMMARY ANSWER: Assessing both antral follicle count (AFC) and serum anti-Müllerian hormone (AMH) levels as measures of ovarian reserve, the results suggest that CO2 technology may be an alternative treatment for endometrioma, causing minimal damage to adjacent healthy ovarian tissue. WHAT IS KNOWN ALREADY: Excisional surgery has been questioned as an ideal surgical approach for endometriomas because it is associated with potential reduction of ovarian reserve...
October 9, 2018: Human Reproduction
https://www.readbyqxmd.com/read/30299028/new-medical-device-coating-mouth-gel-for-temporary-relief-of-teething-symptoms-a-pilot-randomised-open-label-controlled-study
#13
Serban Rosu, Dionisio F Barattini, Filippo Murina, Mihai Gafencu
BACKGROUND: This study verified the feasibility of the monthly recruitment rate, tested the Face, Legs, Activity, Cry and Consolability Pain Assessment Tool (FLACC) for pain in infants and collected preliminary efficacy and safety data of a new proprietary oral gel formulation of high-molecularweight hyaluronan (HMWHA) for the relief of teething. Results will support the design a future main trial vs local anaesthetic, that is currently the only clinically proven pain reliever. METHODS: This was a pilot, randomised, controlled, multicentre, open-label, parallel-group trial...
October 4, 2018: Minerva Pediatrica
https://www.readbyqxmd.com/read/30298596/decision-making-in-dentistry-related-to-temporomandibular-disorders-a-5-yr-follow-up-study
#14
Anna Lövgren, Linnea Karlsson Wirebring, Birgitta Häggman-Henrikson, Anders Wänman
Temporomandibular disorders (TMDs) are common, but many patients with such disorders go undetected and under-treated. Our aim was to evaluate the outcome of using a screening tool (5 yr after it was first implemented), on the clinical decision-making for patients with TMDs. Adults who attended for a dental check-up at the Public Dental Health Services in Västerbotten, Sweden, answered three screening questions (3Q/TMD) on frequent jaw pain, pain on jaw function, and catching/locking of the jaw. The dental records of a random sample of 200 individuals with at least one positive response to 3Q/TMD (3Q screen-positive patients) and 200 individuals with all negative responses (3Q screen-negative patients) were reviewed for TMD-related treatment decisions...
October 8, 2018: European Journal of Oral Sciences
https://www.readbyqxmd.com/read/30296576/patient-reported-outcomes-unbiased-by-length-of-follow-up-after-lumbar-degenerative-spine-surgery-do-we-need-2-years-of-follow-up
#15
Victor E Staartjes, Alessandro Siccoli, Marlies P de Wispelaere, Marc L Schröder
BACKGROUND: In modern clinical research, the accepted minimum follow-up for patient-reported outcome measures (PROMs) after lumbar spine surgery is 24 months, particularly after fusion. Recently, this minimum requirement has been called into question. PURPOSE: We aim to quantify the concordance of 1- and 2-year PROMs to evaluate the importance of long-term follow-up after elective lumbar spine surgery. STUDY DESIGN: Retrospective analysis of data from a prospective registry...
October 5, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/30296418/adult-outpatients-with-acute-cough-due-to-suspected-pneumonia-or-influenza-chest-guideline-and-expert-panel-report
#16
Adam T Hill, Philip M Gold, Ali El Solh, Joshua P Metlay, Belinda Ireland, Richard S Irwin
BACKGROUND: Patients commonly present to primary care services with upper and lower respiratory tract infections and guidelines to help clinicians investigate and treat acute cough due to suspected pneumonia and influenza are needed. METHODS: A systematic search was carried out with eight PICO questions related to acute cough with suspected pneumonia or influenza. RESULTS: There was a lack of randomized controlled trials in the setting of outpatients presenting with acute cough due to suspected pneumonia or influenza that were not hospitalized...
October 5, 2018: Chest
https://www.readbyqxmd.com/read/30293410/the-provision-of-simple-written-material-does-not-significantly-improve-physical-activity-rates-in-a-population-with-musculoskeletal-problems-a-double-blinded-randomised-controlled-trial
#17
Patrick C Wheeler
BACKGROUND: Physical activity has been shown to have significant health benefits to individuals, being effective in the treatment and prevention of multiple different conditions. However, despite these benefits, rates of physical activity remain low in the western world and less than 40% of people in the UK meet physical activity recommendations. Musculoskeletal pain can be a barrier to activity, and patients with pain can stop all activity out of fear of harm. This project seeks to see if simple written advice can influence activity rates and behaviours...
October 1, 2018: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/30292436/chest-pain-in-the-absence-of-obstructive-coronary-artery-disease-a-critical-review-of-current-concepts-focusing-on-sex-specificity-microcirculatory-function-and-clinical-implications
#18
Laurien E Zijlstra, Marianne Bootsma, J Wouter Jukema, Martin J Schalij, Hubert W Vliegen, Albert V G Bruschke
Patients presenting with chest pain suggestive of coronary artery disease (CAD) who at coronary arteriography appear to be free of obstructive disease have presented a diagnostic and therapeutic challenge since the 1970's. Studies in female patient populations have suggested that this is predominantly a women's syndrome usually caused by microvascular endothelial dependent and independent dysfunction. A critical review of the literature focusing on studies including both women and men revealed that apart from a higher incidence of this syndrome in women there are no clinical relevant differences between both sexes...
October 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/30290395/-assessment-of-the-ops-code-8918-multimodal-pain-therapy
#19
Martin Schwarze, Dierk F Hollo, Marcus Schiltenwolf
Interdisciplinary multimodal pain therapy is the gold standard in the treatment of chronic pain. Due to an overall increase in case numbers, the number of MDK examinations leading to the assessment of primary incorrect occupancy is also increasing. This results in a multitude of social court disputes in which medical assessments are required. With knowledge of the legal norms and relevant guidelines or other recommendations, the expert can take this topic step by step. The starting point here is the evaluation of the patient file, followed by the examination of the medical indication, the implementation of the therapy and, finally, the answers to the questions of proof...
October 5, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/30287674/research-priorities-in-fragility-fractures-of-the-lower-limb-and-pelvis-a-uk-priority-setting-partnership-with-the-james-lind-alliance
#20
Miguel A Fernandez, Laura Arnel, Jenny Gould, Alwin McGibbon, Richard Grant, Philip Bell, Stuart White, Mark Baxter, Xavier Griffin, Tim Chesser, David Keene, Rebecca S Kearney, Catherine White, Matthew L Costa
OBJECTIVE: To determine research priorities in fragility fractures of the lower limb and pelvis which represent the shared priorities of patients, their friends and families, carers and healthcare professionals. DESIGN/SETTING: A national (UK) research priority setting partnership. PARTICIPANTS: Patients over 60 years of age who have experienced a fragility fracture of the lower limb or pelvis; carers involved in their care (both in and out of hospital); family and friends of patients; healthcare professionals involved in the treatment of these patients including but not limited to surgeons, anaesthetists, paramedics, nurses, general practitioners, physicians, physiotherapists and occupational therapists...
October 3, 2018: BMJ Open
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