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reviews in clinical medicine

Peter Langhorne, Janice M Collier, Patricia J Bate, Matthew Nt Thuy, Julie Bernhardt
BACKGROUND: Very early mobilisation (VEM) is performed in some stroke units and recommended in some acute stroke clinical guidelines. However, it is unclear whether very early mobilisation independently improves outcome after stroke. OBJECTIVES: To determine whether very early mobilisation (started as soon as possible, and no later than 48 hours after onset of symptoms) in people with acute stroke improves recovery (primarily the proportion of independent survivors) compared with usual care...
October 16, 2018: Cochrane Database of Systematic Reviews
Oriol Yélamos, Ralph P Braun, Konstantinos Liopyris, Zachary J Wolner, Katrin Kerl, Pedram Gerami, Ashfaq A Marghoob
Dermoscopy is increasingly used by clinicians (dermatologists, family physicians, podiatrists, doctors of osteopathic medicine, etc.) to inform clinical management decisions. Dermoscopic findings and/or images provided to pathologists offer an important insight into the clinician's diagnostic and management thought process. However, with limited dermoscopic training in dermatopathology, dermoscopic descriptions and images provided in the requisition form will provide little value to pathologists. Since most dermoscopic structures have direct histopathological correlates, dermoscopy can act as an excellent communication bridge between the clinician and the pathologist...
October 12, 2018: Journal of the American Academy of Dermatology
Denise Adams, Taixiang Wu, Xunzhe Yang, Shusheng Tai, Sunita Vohra
BACKGROUND: Chronic fatigue is increasingly common. Conventional medical care is limited in treating chronic fatigue, leading some patients to use traditional Chinese medicine therapies, including herbal medicine. OBJECTIVES: To assess the effectiveness of traditional Chinese medicine herbal products in treating idiopathic chronic fatigue and chronic fatigue syndrome. SEARCH METHODS: The following databases were searched for terms related to traditional Chinese medicine, chronic fatigue, and clinical trials: CCDAN Controlled Trials Register (July 2009), MEDLINE (1966-2008), EMBASE (1980-2008), AMED (1985-2008), CINAHL (1982-2008), PSYCHINFO (1985-2008), CENTRAL (Issue 2 2008), the Chalmers Research Group PedCAM Database (2004), VIP Information (1989-2008), CNKI (1976-2008), OCLC Proceedings First (1992-2008), Conference Papers Index (1982-2008), and Dissertation Abstracts (1980-2008)...
October 15, 2018: Cochrane Database of Systematic Reviews
Maria G Grammatikopoulou, Xenophon Theodoridis, Konstantinos Gkiouras, Eleni-Maria Stamouli, Myrsini-Eleni Mavrantoni, Theodore Dardavessis, Dimitrios P Bogdanos
BACKGROUND: Severe burns are associated with a plethora of profound metabolic, immunologic, and physiologic responses, demanding prompt and adequate management. The objective of the present study was to review, compare, and critically appraise medical nutrition therapy guidelines for adult patients with severe burns, and produce salient points for the future update of relevant guidelines. METHODS: A total of 8 clinical practice guidelines developed by the American Burn Association (ABA), the European Burn Association (EBA), the European Society for Parenteral and Enteral Nutrition (ESPEN), the Midlands National Health Service, the Society for Critical Care Medicine (SCCM)/American Society for Parenteral and Enteral Nutrition (ASPEN), the Spanish Society of Intensive Care Medicine and Coronary Units and Spanish Society of Parenteral and Enteral Nutrition, the Indian Association for Parenteral and Enteral Nutrition (IAPEN), and the International Society for Burn Injury regarding medical nutrition therapy in burn patients was independently reviewed by a team of 4 multidisciplinary researchers using the Appraisal of Guidelines for Research & Evaluation (AGREE II) instrument...
October 15, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Giti Ozgoli, Marzieh Saei Ghare Naz
Nausea and vomiting of pregnancy (NVP) is a common problem for pregnant women. Researchers have recently paid special attention to complementary medicine methods for the treatment of NVP. Regarding the high prevalence of NVP as well as maternal and fetal adverse effects of chemical drugs, the present study, focusing on clinical trials carried out in Iran, was conducted to assess safety and efficacy of different nonpharmacological methods in relieving NVP. This systematic review focused on randomized controlled trials (RCTs) and assessed complementary medicine on NVP for which databases including MedLib, Magiran, Iran Medex, SID, PubMed, Scopus, and Google Scholar search engines from 2000 to 2015 were searched...
2018: International Journal of Preventive Medicine
Ishanka Ayeshwari Talagala, Yasara Samarakoon, Sameera Senanayake, Chrishantha Abeysena
RATIONALE, AIMS, AND OBJECTIVES: Clinical practice guidelines (CPG) play a major role in patient care in Sri Lanka. This study evaluates the methodological quality of the Sri Lankan CPGs developed in 2007. METHODS: A total of 94 CPGs developed by several professional colleges in Sri Lanka in the year 2007 were evaluated by 2 independent reviewers using AGREE II instrument for their methodological quality. Item score being ≤3 points was defined as "poor quality"...
October 15, 2018: Journal of Evaluation in Clinical Practice
Hadi Hassankhani, Amin Soheili, Samad S Vahdati, Farough A Mozaffari, Justin F Fraser, Neda Gilani
STUDY OBJECTIVE: We evaluate the extent and nature of treatment delays and the contributing factors influencing them for patients with acute ischemic stroke, as well as main barriers to stroke care in an Iranian emergency department (ED). METHODS: A retrospective chart review was conducted on 394 patients with acute ischemic stroke who were referred to the ED of a tertiary academic medical center in northwest Iran from March 21 to June 21, 2017. The steps of this review process included instrument development, medical records retrieval, data extraction, and data verification...
October 11, 2018: Annals of Emergency Medicine
J Solís García Del Pozo, C Olmeda Brull, J J de Arriba Méndez, M Corbí Pascual
Although heart failure is one of the most common clinical syndromes in medicine and has a high mortality rate, few patients have access to adequate palliative care for their clinical situation. Several trials have recently been published on the usefulness of starting palliative treatment along with cardiac treatment for patients with advanced heart failure. In this review, we analyse the aspects of diagnosing and controlling the symptoms of patients with advanced heart failure and provide a collection of clinical trials that have analysed the efficacy of a palliative intervention in this patient group...
October 11, 2018: Revista Clínica Española
Ricardo Jorge Dinis-Oliveira, Carolina Lanca Pereira, Diana Dias da Silva
BACKGROUND: Mescaline (3,4,5-trimethoxyphenethylamine), mainly found in the Peyote cactus (Lophophora williamsii), is one of the oldest known hallucinogenic agents that influence human and animal behavior, but its psychoactive mechanisms remain poorly understood. OBJECTIVES: This article aims to fully review pharmacokinetics and pharmacodynamics of mescaline, focusing on the in vivo and in vitro metabolic profile of the drug and its implications for the variability of response...
October 10, 2018: Current Molecular Pharmacology
Trevor Simard, Richard Jung, Alisha Labinaz, Mohammad Ali Faraz, F Daniel Ramirez, Pietro Di Santo, Ian Pitcher, Pouya Motazedian, Chantal Gaudet, Rebecca Rochman, Jeffrey Marbach, Paul Boland, Kiran Sarathy, Saleh Alghofaili, Juan J Russo, Etienne Couture, Robert S Beanlands, Benjamin Hibbert
Adenosine, a purine nucleoside, is produced broadly and implicated in the homeostasis of many cells and tissues. It signals predominantly via 4 purinergic adenosine receptors (ADORs) - ADORA1, ADORA2A, ADORA2B and ADORA3 in addition to non-ADOR mediated effects. Through these signaling mechanisms, adenosine exerts effects on numerous cell types crucial to maintaining vascular homeostasis, especially following vascular injury. Both in vitro and in vivo models have provided considerable insights into adenosine signaling and identified targets for therapeutic intervention...
October 10, 2018: Cardiovascular & Hematological Disorders Drug Targets
Joanna Drogosz, Anna Janecka
Sesquiterpene lactones, secondary metabolites of plants, present in a large number of species mostly from the Asteracea family, were used in the traditional medicine of many countries for the treatment of various pathological conditions. They exert a broad range of activities, including anti-inflammatory, anti-bacterial and anti-cancer properties. The best known sesquiterpene lactones which are already used as drugs or are in clinical trials are artemisinin, thapsigargin and parthenolide. Yet another sesquiterpene lactone, helenalin, an active component of Arnica montana, known for its strong anti-inflammatory activity, has been used for centuries in folk medicine to treat minor injuries...
October 12, 2018: Current Drug Targets
Xing-Yu Hong, Jie Lin, Wei-Wei Gu
Aberrant blood vessel functioning and systemic circulation are key causes for vascular disorders; cardiovascular, cerebrovascular, renal artery stenosis, and peripheral artery diseases. Epidemiological and basic science evidence supported genetic reasons, compounded by obesity, hypercholesterolemia, hypertension, diabetes, and smoking as risk factors. This is an umbrella review of risk factors and therapies in vascular disorders, exploring systematic reviews and meta-analyses studies in PubMed, Cochrane, Embase, and Central published in January 2000-May 2018...
October 14, 2018: Journal of Cellular Physiology
Fionnuala Mone, Elizabeth Quinlan-Jones, Mark D Kilby
Advances in prenatal genomics have enabled the assessment of not only the sub-microscopic structure of chromosomes using chromosomal microarray analysis, but also the detection of "pathogenic variants" to the resolution of a single base pair with the use of next generation sequencing. Research is emerging on the additional prenatal diagnostic yield that exome sequencing offers when structural fetal anomalies are detected on ultrasound examination, in particular the identification of monogenic abnormalities defining prognosis and recurrence of anomalies...
October 6, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Lui Jin Yao, Juriyati Jalil, Ali Attiq, Chiew Chia Hui, Nurul Aimi Zakaria
ETHNOPHARMACOLOGICAL RELEVANCE: Polyalthia is one of the largest and notable genera in Annonaceae family. Polyalthia species have been widely used in folklore medicine for the treatment of rheumatic fever, gastrointestinal ulcer and generalized body pain. Numerous in vitro and in vivo studies on Polyalthia Species have also corroborated the significant anti-inflammatory potential of its extracts and secondary metabolites. AIM OF THE STUDY: This review is an attempt to assess the anti-inflammatory activity of Polyalthia species by giving critical appraisal and establishing evidences of their traditional uses...
October 11, 2018: Journal of Ethnopharmacology
Krithika Chennapan, Samuel Mullinax, Eric Anderson, Mark J Landau, Kimberly Nordstrom, Rawle A Seupaul, Michael P Wilson
BACKGROUND: Patients presenting to the emergency department (ED) with psychiatric complaints often require medical screening to evaluate for a medical cause of their symptoms. OBJECTIVE: We sought to evaluate the existing literature on the medical screening of psychiatric patients and establish recommendations for ideal screening practices in Western-style EDs. METHODS: PubMed, PsycINFO, and were searched for clinical studies examining the medical screening of adult psychiatric patients in the ED or inappropriate referrals to psychiatry...
October 10, 2018: Journal of Emergency Medicine
Dingcheng Zhu, Sathi Roy, Ziyao Liu, Horst Weller, Wolfgang Parak, Neus Feliu
Tremendous efforts have been devoted to the development of future nanomedicines that can be specifically designed to incorporate responsive elements that undergo modification in structural properties upon external triggers. One potential use of such stimuli-responsive materials is to release encapsulated cargo upon excitation by an external trigger. Today, such stimuli-response materials allow for spatial and temporal tunability, which enables the controlled delivery of compounds in a specific and dose-dependent manner...
October 10, 2018: Advanced Drug Delivery Reviews
James K Ruffle, Adam D Farmer, Qasim Aziz
Technological advances in artificial intelligence (AI) represent an enticing opportunity to benefit gastroenterological practice. Moreover, AI, through machine or deep learning, permits the ability to develop predictive models from large datasets. Possibilities of predictive model development in machine learning are numerous dependent on the clinical question. For example, binary classifiers aim to stratify allocation to a categorical outcome, such as the presence or absence of a gastrointestinal disease. In addition, continuous variable fitting techniques can be used to predict quantity of a therapeutic response, thus offering a tool to predict which therapeutic intervention may be most beneficial to the given patient...
October 12, 2018: American Journal of Gastroenterology
Ai-Leng Foong, Kelly A Grindrod, Tejal Patel, Jamie Kellar
OBJECTIVE: To review the symptoms of serotonin toxicity (commonly referred to as serotonin syndrome ) and the causative drugs and their mechanisms of action, and to equip primary care providers with practical strategies to prevent and identify serotonin toxicity. QUALITY OF EVIDENCE: PubMed and Google Scholar were searched for relevant articles on serotonin toxicity, the causes, and the differential diagnosis using search terms related to serotonin toxicity ( serotonin syndrome, serotonin toxicity, serotonin overdose ), causes (individual names of drug classes, individual drug names), and diagnosis ( differential diagnosis, neuroleptic malignant syndrome, anticholinergic toxicity, discontinuation syndrome, malignant hyperthermia, serotonin symptoms )...
October 2018: Canadian Family Physician Médecin de Famille Canadien
Karol Wiśniewski, Jagoda Jóźwik-Pruska, Michał Bieńkowski, Ernest J Bobeff, Maciej Bryl, Joanna Kałużna-Czaplińska, Dariusz J Jaskólski
Despite enormous progress in medicine, symptomatic cerebral vasospasm (CVS), remains an unexplained clinical problem, which leaves both physicians and patients helpless and relying on chance, due to the lack of specific marker indicative of imminent danger as well as the lack of specific treatment. In our opinion CVS occurrence depends on dynamic disbalance between free radicals' formation (oxidative stress) and antioxidant activity. Isoprostanes are products of free-radical peroxidation of polyunsaturated fatty acids, and seem to mark a promising path for the research aiming to unravel its possible mechanism...
October 4, 2018: Neurologia i Neurochirurgia Polska
Kyeore Bae, Eunseok Kim, Jeong June Choi, Mi Kyung Kim, Hwa-Seung Yoo
Although anticancer traditional Korean medicine treatment (ACTKMT) is widely applied to patients with cancer together with, or in place of, conventional cancer treatment in Korea, the cohort evidence on its clinical effects is lacking. Therefore, this prospective cohort study is designed to evaluate the effect of ACTKMT on the survival and the clinical outcomes for patients being treated at an integrative oncology clinic.This is a single center, prospective cohort study of patients within 1 year after the diagnosis of primary lung, breast, gastric, colorectal, hepatic, uterine, or ovarian cancer...
October 2018: Medicine (Baltimore)
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