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https://www.readbyqxmd.com/read/28551774/continuous-glucose-monitoring-for-patients-with-type-1-diabetes-on-multiple-daily-injections-of-insulin-pros-and-cons
#1
Maria Ida Maiorino, Michela Petrizzo, Giuseppe Bellastella, Katherine Esposito
Continuous glucose monitoring associated with intensive insulin regimens represents a useful tool to lower HbA1c in selected adults with type 1 diabetes. Recent randomized controlled trials demonstrated greater glycemic benefits in type 1 diabetic patients treated with multiple daily injections of insulin and continuous glucose monitoring over usual care. These positive outcomes, however, are counter-balanced by several limitations that restrict the use of continuous glucose monitoring in the real life, including the apparent lack of benefits in children and pregnant diabetic women, the high cost, the stringent patients' selection, and the presence of a multi-disciplinary team with specific expertise...
May 27, 2017: Endocrine
https://www.readbyqxmd.com/read/28529192/short-and-long-term-outcomes-following-pelvic-exenteration-for-gynae-oncological-and-colorectal-cancers-a-9-year-consecutive-single-centre-cohort-study
#2
Mark Katory, Ross McLean, Edgar Paez, Ali Kucukmetin, Raj Naik
OBJECTIVES: Radical pelvic exenteration can be undertaken for locally invasive or recurrent disease in both colorectal and gynaecological malignancies. In the UK this procedure is usually undertaken by the respective surgical specialties who have undergone divergent surgical training. This study describes and compares outcomes between colorectal and gynae-oncological teams following pelvic exenteration for primary and recurrent gynaecological and colorectal cancers in a single-centre multi-disciplinary team...
May 19, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28526040/catching-a-floating-thrombus-a-case-report-on-the-treatment-of-a-large-thrombus-in-the-ascending-aorta
#3
Gijs Eduard de Maat, Giorgio Vigano, Massimo Alessandro Mariani, Ehsan Natour
BACKGROUND: The ascending aorta is an uncommon site for non-infective thrombus. In non-aneurysmal and non-atherosclerotic vessels this condition becomes extremely rare, while it represents a source of potential cerebral and peripheral embolic events. Currently, there is no consensus in the guidelines on how to treat a free floating thrombus in ascending aorta, therefore we present our decision making process and therapeutic strategy. CASE PRESENTATION: A healthy 48-year-old man was hospital admitted with acute abdominal pain...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28521194/preconception-care-for-women-with-type-2-diabetes-mellitus-a-mixed-methods-study-of-provider-knowledge-and-practice
#4
J Klein, J A Boyle, R Kirkham, C Connors, C Whitbread, J Oats, F Barzi, D McIntyre, I Lee, M Luey, J Shaw, A D H Brown, L J Maple-Brown
AIMS: Preconception care may decrease adverse pregnancy outcomes associated with pre-existing diabetes mellitus. Aboriginal Australians are at high risk of type 2 diabetes mellitus (T2DM), with earlier onset. We explored practitioner views on preconception care delivery for women with T2DM in the Northern Territory, where 31% of births are to Aboriginal women. METHODS: Mixed-methods study including cross-sectional survey of 156 health practitioners and 11 semi-structured interviews...
May 5, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28512745/implementation-of-multi-disciplinary-care-reduces-maternal-mortality-in-women-with-sickle-cell-disease-living-in-low-resource-setting
#5
Eugenia Vicky Asare, Edeghonghon Olayemi, Theodore Boafor, Yvonne Dei-Adomakoh, Enoch Mensah, Harriet Ghansah, Yvonne Osei-Bonsu, Selina Crabbe, Latif Musah, Charles Hayfron-Benjamin, Brittany Covert, Adetola A Kassim, Andra James, Mark Rodeghier, Michael R DeBaun, Samuel A Oppong
Sickle cell disease (SCD) is associated with adverse pregnancy outcome. In women with SCD living in low-resource settings, pregnancy is associated with significantly increased maternal and perinatal mortality rates. We tested the hypothesis that implementing a multidisciplinary obstetric and hematology care team in a low-resource setting would significantly reduce maternal and perinatal mortality rates. We conducted a before-and-after study, at the Korle-Bu Teaching Hospital in Accra, Ghana, to evaluate the effect of a multidisciplinary obstetric-hematology care team for women with SCD in a combined SCD-Obstetric Clinic...
May 16, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28511067/a-fuzzy-logic-based-tool-to-assess-beef-cattle-ranching-sustainability-in-complex-environmental-systems
#6
Sandra A Santos, Helano Póvoas de Lima, Silvia M F S Massruhá, Urbano G P de Abreu, Walfrido M Tomás, Suzana M Salis, Evaldo L Cardoso, Márcia Divina de Oliveira, Márcia Toffani S Soares, Antônio Dos Santos, Luiz Orcírio F de Oliveira, Débora F Calheiros, Sandra M A Crispim, Balbina M A Soriano, Christiane O G Amâncio, Alessandro Pacheco Nunes, Luiz Alberto Pellegrin
One of the most relevant issues in discussion worldwide nowadays is the concept of sustainability. However, sustainability assessment is a difficult task due to the complexity of factors involved in the natural world added to the human interference. In order to assess the sustainability of beef ranching in complex and uncertain tropical environment systems this paper describes a decision support system based on fuzzy rule-approach, the Sustainable Pantanal Ranch (SPR). This tool was built by a set of measurements and indicators integrated by fuzzy logic to evaluate the attributes of the three dimensions of sustainability...
May 13, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28502080/the-contemporary-role-of-ureterolysis-in-retroperitoneal-fibrosis-rpf-treatment-of-last-resort-or-first-intent-an-analysis-of-50-cases
#7
Tim O'Brien, Archie Fernando
OBJECTIVE: To determine the outcomes of open ureterolysis in a contemporary cohort of patients presenting with ureteric obstruction secondary to retroperitoneal fibrosis (RPF). PATIENTS AND METHODS: Prospective analysis of 50 patients undergoing open ureterolysis and omental wrap between January 2012 and January 2016 in a single centre managed by a multi-disciplinary RPF team. Minimum follow up of 1 year. Indications were: nephrostomy-dependent drainage (n=5); stent failure as evidenced by persistent hydronephrosis (n=20); severe stent symptoms (n=22); and patient choice/pre-emptive (n=3)...
May 14, 2017: BJU International
https://www.readbyqxmd.com/read/28499032/development-of-a-new-tool-for-systematic-observation-of-nursing-home-resident-and-staff-engagement-and-relationship
#8
A Lynn Snow, M Lindsey Jacobs, Jennifer A Palmer, Patricia A Parmelee, Rebecca S Allen, Nancy J Wewiorski, Michelle M Hilgeman, Latrice D Vinson, Dan R Berlowitz, Anne D Halli-Tierney, Christine W Hartmann
Purpose of Study: To develop a structured observational tool, the Resident-centered Assessment of Interactions with Staff and Engagement tool (RAISE), to measure 2 critical, multi-faceted, organizational-level aspects of person-centered care (PCC) in nursing homes: (a) resident engagement and (b) the quality and frequency of staff-resident interactions. Design and Methods: In this multi-method psychometric development study, we conducted (a) 120 hr of ethnographic observations in one nursing home and (b) a targeted literature review to enable construct development...
May 11, 2017: Gerontologist
https://www.readbyqxmd.com/read/28485255/a-system-based-intervention-to-improve-access-to-hyperacute-stroke-care
#9
Richard H Swartz, Elizabeth Linkewich, Shelley Sharp, Jacqueline Willems, Chris Olynyk, Nicola Tahair, Megan L Cayley, Mark T Bayley
BACKGROUND: Hyperacute stroke is a time-sensitive emergency for which outcomes improve with faster treatment. When stroke systems are accessed via emergency medical services (EMS), patients are routed to hyperacute stroke centres and are treated faster. But over a third of patients with strokes do not come to the hospital by EMS, and may inadvertently arrive at centres that do not provide acute stroke services. We developed and studied the impact of protocols to quickly identify and move "walk-in" patients from non-hyperacute hospitals to regional stroke centres (RSCs)...
May 9, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28482890/crisis-checklists-for-in-hospital-emergencies-expert-consensus-simulation-testing-and-recommendations-for-a-template-determined-by-a-multi-institutional-and-multi-disciplinary-learning-collaborative
#10
Christian P Subbe, John Kellett, Paul Barach, Catriona Chaloner, Hayley Cleaver, Tim Cooksley, Erik Korsten, Eilish Croke, Elinor Davis, Ashley Jr De Bie, Lesley Durham, Chris Hancock, Jilian Hartin, Tracy Savijn, John Welch
BACKGROUND: 'Failure to rescue' of hospitalized patients with deteriorating physiology on general wards is caused by a complex array of organisational, technical and cultural failures including a lack of standardized team and individual expected responses and actions. The aim of this study using a learning collaborative method was to develop consensus recomendations on the utility and effectiveness of checklists as training and operational tools to assist in improving the skills of general ward staff on the effective rescue of patients with abnormal physiology...
May 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28482388/-a-follow-up-report-of-childhood-hepatoblastoma-from-74-cases-in-a-single-center
#11
T Y Wang, C Pan, J Y Tang, Q D Ye, M Zhou, Y J Gao, W T Hu
Objective: To investigate the efficacy and the prognostic factors in pediatric hepatoblastoma according to the standard diagnostic and therapeutic regimen. Method: Eighty-four consecutive patients were enrolled in this study between June 2000 and June 2015. Diagnosis and staging was decided by the multi-disciplinary team including oncologists, surgeons, pathologists and sub-specialized radiologists refering to protocol of Children's Oncology Group(COG) and International Society of Pediatric Oncology Liver Tumor Study Group (SIOPEL) in a case observational study...
May 4, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28472939/chronic-hypersensitivity-pneumonitis-identification-of-key-prognostic-determinants-using-automated-ct-analysis
#12
Joseph Jacob, Brian J Bartholmai, Ryoko Egashira, Anne Laure Brun, Srinivasan Rajagopalan, Ronald Karwoski, Maria Kokosi, David M Hansell, Athol U Wells
BACKGROUND: Chronic hypersensitivity pneumonitis (CHP) has a variable disease course. Computer analysis of CT features was used to identify a subset of CHP patients with an outcome similar to patients with idiopathic pulmonary fibrosis (IPF). METHODS: Consecutive patients with a multi-disciplinary team diagnosis of CHP (n = 116) had pulmonary function tests (FEV1, FVC, DLco, Kco, and a composite physiologic index [CPI]) and CT variables predictive of mortality evaluated by analysing visual and computer-based (CALIPER) parenchymal features: total interstitial lung disease (ILD) extent, honeycombing, reticular pattern, ground glass opacities, pulmonary vessel volume (PVV), emphysema, and traction bronchiectasis...
May 4, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28464835/streamlining-staging-of-lung-and-colorectal-cancer-with-whole-body-mri-study-protocols-for-two-multicentre-non-randomised-single-arm-prospective-diagnostic-accuracy-studies-streamline-c-and-streamline-l
#13
Stuart A Taylor, Sue Mallett, Anne Miles, Sandy Beare, Gauraang Bhatnagar, John Bridgewater, Rob Glynne-Jones, Vicky Goh, Ashley M Groves, Sam M Janes, Dow Mu Koh, Steve Morris, Alison Morton, Neal Navani, Alf Oliver, Anwar R Padhani, Shonit Punwani, Andrea G Rockall, Steve Halligan
BACKGROUND AND AIMS: Rapid and accurate cancer staging following diagnosis underpins patient management, in particular the identification of distant metastatic disease. Current staging guidelines recommend sequential deployment of various imaging platforms such as computerised tomography (CT) and positron emission tomography (PET) which can be time and resource intensive and onerous for patients. Recent studies demonstrate that whole body magnetic resonance Imaging (WB-MRI) may stage cancer efficiently in a single visit, with potentially greater accuracy than current staging investigations...
May 2, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28462182/evaluation-of-temporomandibular-disorders-before-and-after-orthognathic-surgery-therapeutic-considerations-on-a-sample-of-76-patients
#14
Carlo di Paolo, Giorgio Pompa, Paolo Arangio, Anna di Nunno, Stefano Di Carlo, Daniele Rosella, Piero Papi, Piero Cascone
OBJECTIVES: Temporomandibular disorders may be associated with dental and facial malformations. The aim of this study is to record the prevalence of TMDs in patients scheduled for orthognathic surgery, reporting the development of TMDs and symptoms during the entire period of the treatment, and demonstrating the benefits of a team effort on this population. MATERIALS AND METHODS: Assessment of temporomandibular status was performed using the RDC/TMD criteria at T0 (prior to orthodontic therapy), T1 (3 months after the surgery), and T2 post-therapeutic cycle (6 to 12 months postoperatively)...
March 2017: Journal of International Society of Preventive & Community Dentistry
https://www.readbyqxmd.com/read/28461968/the-tactics-and-technique-of-musculoskeletal-biopsy
#15
REVIEW
G Ulrich Exner, Michael O Kurrer, Nadja Mamisch-Saupe, Stephen R Cannon
The treatment of musculoskeletal neoplasms and infection is usually based on an initial diagnostic biopsy.Prior to biopsy, a hypothesis should be formed about the most likely diagnosis and a differential diagnosis. These deliberations should consider whether the lesion is a primary benign or malignant tumour, a metastasis, a haematological problem or an infection.A tactical plan should be developed which evaluates the necessity, the risk, the approach and finally defines the technique of biopsy most likely to achieve a representative result in the clinical case...
February 2017: EFORT Open Rev
https://www.readbyqxmd.com/read/28457231/disease-management-in-the-treatment-of-patients-with-chronic-heart-failure-who-have-universal-access-to-health-care-a-randomized-controlled-trial
#16
Ofra Kalter-Leibovici, Dov Freimark, Laurence S Freedman, Galit Kaufman, Arnona Ziv, Havi Murad, Michal Benderly, Barbara G Silverman, Nurit Friedman, Tali Cukierman-Yaffe, Elad Asher, Avishay Grupper, Dorit Goldman, Miriam Amitai, Shlomi Matetzky, Mordechai Shani, Haim Silber
BACKGROUND: The efficacy of disease management programs in improving the outcome of heart failure patients remains uncertain and may vary across health systems. This study explores whether a countrywide disease management program is superior to usual care in reducing adverse health outcomes and improving well-being among community-dwelling adult patients with moderate-to-severe chronic heart failure who have universal access to advanced health-care services and technologies. METHODS: In this multicenter open-label trial, 1,360 patients recruited after hospitalization for heart failure exacerbation (38%) or from the community (62%) were randomly assigned to either disease management or usual care...
May 1, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28436977/provision-of-long-term-monitoring-and-late-effects-services-following-adult-allogeneic-haematopoietic-stem-cell-transplant-a-survey-of-uk-nhs-based-programmes
#17
A Hamblin, D M Greenfield, M Gilleece, N Salooja, M Kenyon, E Morris, N Glover, P Miller, H Braund, A Peniket, B E Shaw, J A Snowden
Despite international guidelines, optimal delivery models of late effects (LE) services for HSCT patients are unclear from the clinical, organizational and economic viewpoints. To scope current LE service delivery models within the UK NHS (National Health Service), in 2014, we surveyed the 27 adult allogeneic HSCT centres using a 30-question online tool, achieving a 100% response rate. Most LE services were led and delivered by senior physicians (>80% centres). Follow-up was usually provided in a dedicated allograft or LE clinic for the first year (>90% centres), but thereafter attrition meant that only ~50% of patients were followed after 5 years...
April 24, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28436184/delaying-cognitive-and-physical-decline-through-multidomain-interventions-for-residents-with-mild-to-moderate-dementia-in-dementia-care-units-in-taiwan-a-prospective-cohort-study
#18
Chih-Kuang Liang, Ming-Yueh Chou, Liang-Yu Chen, Kuei-Yu Wang, Shih-Yi Lin, Liang-Kung Chen, Yu-Te Lin, Tsung-Yun Liu, Ching-Hui Loh
AIM: To develop experimental multi-domain interventions for older people with mild-to-moderate dementia, and to evaluate the effect of delaying cognitive and physical decline, and improvement or prevention of geriatric syndromes during 1-year follow up. METHODS: Participants aged 65 years and older with mild-to-moderate dementia (clinical dementia rating [CDR] 1 or 2) were grouped as intervention in Jia-Li Veterans Home and usual care model in the community (Memory clinic)...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28432404/pediatric-neuro-mri-tricks-to-minimize-sedation
#19
REVIEW
Matthew J Barkovich, Duan Xu, Rahul S Desikan, Cassandra Williams, A James Barkovich
Magnetic resonance imaging (MRI) is the workhorse modality in pediatric neuroimaging because it provides excellent soft-tissue contrast without ionizing radiation. Until recently, studies were uninterpretable without sedation; however, given development of shorter sequences, sequences that correct for motion, and studies showing the potentially deleterious effects of sedation on immature laboratory animals, it is prudent to minimize sedation when possible. This manuscript provides basic guidelines for performing pediatric neuro MRI without sedation by both modifying technical factors to reduce scan time and noise, and using a multi-disciplinary team to coordinate imaging with the patient's biorhythms...
April 22, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28428504/-assessment-and-strategy-for-nociceptive-pain-in-cancer
#20
Gakuji Osawa, Etsuko Aruga
Pain is classified as either nociceptive pain, which results from a nociceptor stimulation, or neuropathic pain, which results from a lesion of the neural pathway. Clinically, in many cases, pain consists of a single origin but multiple origins are also possible. In this paper, we outline an assessment and strategy for nociceptive pain in cancer. The onset time, location, feature, strength, and etiology were included as categories for the assessment of pain. Furthermore, we added a psychosocial assessment to the physical assessment, which ensured comprehensive pain evaluation...
April 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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