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https://www.readbyqxmd.com/read/28329439/clinical-intuition-in-the-nursing-process-and-decision-making-a-mixed-studies-review
#1
REVIEW
Christina Melin-Johansson, Rebecca Palmqvist, Linda Rönnberg
AIM AND OBJECTIVES: To review what is characteristic of registered nurses' intuition in clinical settings, in relationships, and in the nursing process. BACKGROUND: Intuition is a controversial concept and nurses believe that there are difficulties in how they should explain their nursing actions or decisions based on intuition. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. More information on how nurses integrate intuition as a core element in daily clinical work would contribute to an improved understanding on how they go about this...
March 22, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28328833/drug-coated-balloon-in-combination-with-bare-metal-stent-strategy-for-de-novo-coronary-artery-disease-a-prisma-compliant-meta-analysis-of-randomized-clinical-trials
#2
Wenjie Lu, Yongjian Zhu, Zhanying Han, Xi Wang, Xule Wang, Chunguang Qiu
BACKGROUND: Studies examining the efficiency of drug-coated balloon (DCB) + bare metal stent (BMS) compared with stents alone for de novo lesions have reported inconsistent results. The present comprehensive meta-analysis of randomized controlled trials (RCTs) assessed and compared the clinical efficacy and safety of DCB + BMS with those of stents alone for de novo coronary artery disease. METHODS: We formally searched electronic databases before September 2016 to identify potential studies...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328802/curative-effect-of-neutral-macroporous-resin-hemoperfusion-on-treating-hemodialysis-patients-with-refractory-uremic-pruritus
#3
Wen-Hong Li, Yu-Min Yin, Hao Chen, Xiao-Dan Wang, He Yun, Hui Li, Jie Luo, Jin-Wen Wang
This study aims to investigate the efficacy and safety of neutral macroporous resin hemoperfusion in treating maintenance hemodialysis (MHD) patients with refractory uremic pruritus (RUP).Ninety patients were enrolled and were randomly divided into 3 groups: control group, experiment 1 group, and experiment 2 group. Clinical symptom scores of skin itching were recorded before and at 4 and 8 weeks after the treatment. In addition, serum parathyroid hormone (PTH), calcium (Ca), phosphorus (P), and C-reactive protein (CRP) were detected; and the calcium-phosphorus product ([Ca] × [P]) was calculated to compare the curative effect...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28327997/lumbar-fusion-for-degenerative-disease-a-systematic-review-and-meta-analysis
#4
Daniel Yavin, Steven Casha, Samuel Wiebe, Thomas E Feasby, Callie Clark, Albert Isaacs, Jayna Holroyd-Leduc, R John Hurlbert, Hude Quan, Andrew Nataraj, Garnette R Sutherland, Nathalie Jette
BACKGROUND: Due to uncertain evidence, lumbar fusion for degenerative indications is associated with the greatest measured practice variation of any surgical procedure. OBJECTIVE: To summarize the current evidence on the comparative safety and efficacy of lumbar fusion, decompression-alone, or nonoperative care for degenerative indications. METHODS: A systematic review was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (up to June 30, 2016)...
March 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327892/safety-and-efficacy-of-tachosil-absorbable-fibrin-sealant-patch-compared-with-current-practice-for-the-prevention-of-cerebrospinal-fluid-leaks-in-patients-undergoing-skull-base-surgery-a-randomized-controlled-trial
#5
Bernard George, Christian Matula, Lars Kihlström, Enrique Ferrer, Vilhelm Tetens
BACKGROUND: Cerebrospinal fluid (CSF) leakage associated with incomplete sealing of the dura mater is a major complication of intradural procedures. OBJECTIVE: To compare the efficacy and safety of adjunctive TachoSil (Takeda Pharma A/S, Roskilde, Denmark) with current practice for the prevention of postoperative CSF leaks in patients undergoing elective skull base surgery involving dura mater closure. METHODS: Patients were intraoperatively randomized to TachoSil or current practice immediately before primary dura closure by suturing ± duraplasty...
March 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327200/a-first-in-human-phase-1-study-of-a-hepcidin-monoclonal-antibody-ly2787106-in-cancer-associated-anemia
#6
Saroj Vadhan-Raj, Rafat Abonour, Jonathan W Goldman, David A Smith, Christopher A Slapak, Robert L Ilaria, Ramon V Tiu, Xuejing Wang, Sophie Callies, Joanne Cox, Jay L Tuttle, Yiu-Keung Lau, Eric J Roeland
BACKGROUND: Hepcidin plays a central role in iron homeostasis and erythropoiesis. Neutralizing hepcidin with a monoclonal antibody (mAb) may prevent ferroportin internalization, restore iron efflux from cells, and allow transferrin-mediated iron transport to the bone marrow. This multicenter, phase 1 study evaluated the safety, pharmacokinetics (PK), pharmacodynamics (PD), and efficacy of a fully humanized mAb (LY2787106) with high affinity for hepcidin in cancer patients with anemia...
March 21, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28326908/sublingual-immunotherapy-tablets-as-a-disease-modifying-add-on-treatment-option-to-pharmacotherapy-for-allergic-rhinitis-and-asthma
#7
Stephen Brunton, Harold S Nelson, David I Bernstein, Simon Lawton, Susan Lu, Hendrik Nolte
Allergic rhinitis (AR) with or without conjunctivitis (AR/C) is associated with a significant health and economic burden, and is often accompanied by asthma. Pharmacotherapies are the mainstay treatment options for AR and asthma, but guidelines also recommend allergy immunotherapy (AIT). Unlike pharmacotherapies, AIT has the ability to modify the underlying immunologic mechanisms of AR and asthma with the potential for long-term benefits after treatment is discontinued. Immunotherapy may also prevent progression of AR/C to asthma...
March 22, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28325679/children-treated-for-lawn-mower-related-injuries-in-us-emergency-departments-1990-2014
#8
Karen S Ren, Thiphalak Chounthirath, Jingzhen Yang, Laura Friedenberg, Gary A Smith
OBJECTIVE: Investigate the epidemiology of lawn mower-related injuries to children in the US. METHODS: A retrospective analysis was conducted of children younger than 18years of age treated in US emergency departments for a lawn mower-related injury from 1990 through 2014 using data from the National Electronic Injury Surveillance System. RESULTS: An estimated 212,258 children <18years of age received emergency treatment for lawn mower-related injuries from 1990 through 2014, equaling an average annual rate of 11...
March 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28325264/role-of-ketogenic-metabolic-therapy-in-malignant-glioma-a-systematic-review
#9
REVIEW
Sebastian F Winter, Franziska Loebel, Jorg Dietrich
BACKGROUND: Coined as the "Warburg effect" and a recognized hallmark of cancer, energy metabolism is aberrantly geared towards aerobic glycolysis in most human cancers, including malignant glioma. Ketogenic metabolic therapy (KMT), i.e. nutritional intervention with ketogenic or low-glycemic diets, has been proposed as an anti-neoplastic strategy in glioma patients. MATERIALS AND METHODS: We here review the rationale and existing data investigating KMT in management of patients with malignant glioma and discuss the promise and potential challenges of this novel strategy...
April 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28325203/developing-and-evaluating-an-automated-all-cause-harm-trigger-system
#10
Christine Sammer, Susanne Miller, Cason Jones, Antoinette Nelson, Paul Garrett, David Classen, David Stockwell
BACKGROUND: From 2009 through 2012, the Adventist Health System Patient Safety Organization (AHS PSO) used the Global Trigger Tool method for harm identification and demonstrated harm reduction. Although the awareness of harm demonstrated opportunities for improvement across the system, leaders determined that the human and fiscal resources required to continue with a retrospective manual harm identification process were unsustainable. In addition, there was growing concern that the identification of harm after the patient's discharge did not allow for intervention during the hospital stay...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28325150/managing-expectations-in-the-transition-to-proof-of-concept-studies
#11
Thomas Kieber-Emmons, Issam Makhoul, Angela Pennisi, Eric R Siegel, Peter D Emanuel, Bejotaloh Monzavi-Karbassi, Zenon Steplewski, J Thaddeus Beck, Laura F Hutchins
BACKGROUND: As we are moving away from the traditional chemotherapy era to targeted therapy, the validity of old assessment paradigms associated with therapeutics are being raised in the context of immunotherapy. The old paradigm required elaborate assessment of toxicity with no expectation of efficacy in early phase trials. Safety data from Phase 1 and 2 studies with many immunotherapeutics show that they display limited toxicities and draw attention to the need to demonstrate efficacy in the early evaluation of new agents...
March 21, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28325090/using-stents-in-the-management-of-malignant-bowel-obstruction-the-current-situation-and-future-progress
#12
Alessandro Fugazza, Piera Alessia Galtieri, Alessandro Repici
The use of self-expanding metal stents (SEMS) has been considered an effective and safe alternative to emergency surgery as bridge to surgery or for palliation in advanced colorectal cancer even though more recent data have raised concerns on both early and long-term outcomes when patients are treated with bridge to surgery indications. Areas covered: A comprehensive literature review of articles on endoscopic management of malignant bowel obstruction was performed. Indication, technique, outcomes, benefits and risks of these treatments in acute malignant colonic obstruction were reviewed...
March 22, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28322168/pediatric-off-label-and-unlicensed-drug-use-and-its-implications
#13
Rajeshwari Gore, Preeta Kaur Chugh, Chakra Dhar Tripathi, Yangshen Lhamo, Sandhya Gautam
BACKGROUND: Worldwide, in the absence of standard pediatric prescribing information, clinicians often use medicines in children in a dosage form or for an indication that has not been approved for use. Inadequate clinical trials increase exposure to drugs that lack safety-efficacy data in pediatric population. Hence, off-label and unlicensed drug use must be regarded as a patient safety-issue that is known to be associated with increased risks of adverse drug reactions apart from under- or over-dosing due to lack of pharmacokinetic data...
March 17, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28321842/cutaneous-surgery-under-local-anesthesia-in-very-elderly-patients-90%C3%A2-years-of-age-and-older-is-as-safe-as-in-elderly-patients-ranging-in-age-from-75-to-80%C3%A2-years-old
#14
Taichi Imamura, Yasuhiro Nakamura, Ryota Tanaka, Yukiko Teramoto, Yuri Asami, Hiroshi Maruyama, Yasuhiro Fujisawa, Manabu Fujimoto, Akifumi Yamamoto
BACKGROUND: The number of very elderly patients who require surgery for cutaneous tumors is increasing. However, there is limited information on the safety of cutaneous surgery in such patients. METHODS: To evaluate the safety of cutaneous surgery in patients 90 years of age and older, we retrospectively reviewed the elderly patients who underwent surgery for cutaneous tumors under local anesthesia. Consecutive patients 90 years of age and older and 75-80 years old were included in the elderly group and the control group...
March 21, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28321575/safety-and-feasibility-of-laparoscopic-gastrectomy-for-gastric-cancer-patients-with-a-history-of-abdominal-surgery
#15
Kotaro Yamashita, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Yasunori Masuike, Masaaki Motoori, Yutaka Kimura, Yukinori Kurokawa, Tomoki Makino, Makoto Yamasaki, Kiyokazu Nakajima, Shuji Takiguchi, Masaki Mori, Yuichiro Doki
PURPOSE: To assess the safety and feasibility of laparoscopic gastrectomy (LG) for gastric cancer patients with a history of abdominal surgery (HAS). METHODS: This retrospective study analyzed data collected from gastric cancer patients with HAS, who underwent LG between 2004 and 2015. We compared the clinicopathological features that correlated with conversion to open surgery and the development of severe postoperative complications (Clavien-Dindo classification of grade III or higher)...
March 20, 2017: Surgery Today
https://www.readbyqxmd.com/read/28321165/fibrin-sealant-for-closure-of-mucosal-penetration-at-the-cardia-during-peroral-endoscopic-myotomy-a-retrospective-study-at-a-single-center
#16
Wen-Gang Zhang, En-Qiang Linghu, Hui-Kai Li
AIM: To assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia during peroral endoscopic myotomy (POEM). METHODS: Twenty-four patients who underwent POEM and experienced mucosal injury of the cardia during the procedure were retrospectively identified. Of the 24 patients, 21 had mucosal penetration and 3 had only slight mucosal damage without penetration. The 21 patients with mucosal penetration received fibrin sealant for closure at the site of penetration...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28321061/effects-of-denosumab-on-bone-metabolic-markers-and-bone-mineral-density-in-patients-treated-with-glucocorticoids
#17
Masato Sawamura, Atsushi Komatsuda, Masaru Togashi, Hideki Wakui, Naoto Takahashi
Objective We performed a prospective study to determine the efficacy and safety of denosumab on bone metabolic indices and bone mineral density (BMD) in 29 patients receiving long-term glucocorticoids (GCs) who had clinical risk factors for fracture. Methods Among these patients, 16 had systemic lupus erythematosus (SLE), 6 RA, 4 other autoimmune diseases, and 3 renal diseases. All patients received donosumab 60 mg at baseline and 6 months. Serum N-terminal cross-linked telopeptide of type I collagen (NTX) and bone-specific alkaline phosphatase (BAP) levels were measured as bone metabolic indices...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28319822/comparison-of-intravenous-versus-topical-tranexamic-acid-in-primary-total-hip-and-knee-arthroplasty-an-updated-meta-analysis
#18
REVIEW
Jinwei Xie, Qinsheng Hu, Qiang Huang, Jun Ma, Yiting Lei, Fuxing Pei
BACKGROUND: The appropriate route for administering tranexamic acid in primary total hip (THA) and knee arthroplasty (TKA) remains controversial. The purpose of this meta-analysis was to compare the efficacy and safety of topical or intravenous tranexamic acid. METHODS: PubMed, EMBASE, and the Cochrane Library databases were systematically searched for randomized controlled trials (RCTs) comparing topical and intravenous tranexamic acid following primary THA or TKA...
March 10, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28319448/rationale-and-design-of-a-phase-1-clinical-trial-to-evaluate-hsv-g207-alone-or-with-a-single-radiation-dose-in-children-with-progressive-or-recurrent-malignant-supratentorial-brain-tumors
#19
Alicia M Waters, James M Johnston, Alyssa T Reddy, John Fiveash, Avi Madan-Swain, Kara Kachurak, Asim K Bag, G Yancey Gillespie, James M Markert, Gregory K Friedman
Primary central nervous system tumors are the most common solid neoplasm of childhood and the leading cause of cancer-related death in pediatric patients. Survival rates for children with malignant supratentorial brain tumors are poor despite aggressive treatment with combinations of surgery, radiation, and chemotherapy, and survivors often suffer from damaging lifelong sequelae from current therapies. Novel innovative treatments are greatly needed. One promising new approach is the use of a genetically engineered, conditionally replicating herpes simplex virus (HSV) that has shown tumor-specific tropism and potential efficacy in the treatment of malignant brain tumors...
March 2017: Human Gene Therapy. Clinical Development
https://www.readbyqxmd.com/read/28319229/patient-mortality-during-unannounced-accreditation-surveys-at-us-hospitals
#20
Michael L Barnett, Andrew R Olenski, Anupam B Jena
Importance: In the United States, hospitals receive accreditation through unannounced on-site inspections (ie, surveys) by The Joint Commission (TJC), which are high-pressure periods to demonstrate compliance with best practices. No research has addressed whether the potential changes in behavior and heightened vigilance during a TJC survey are associated with changes in patient outcomes. Objective: To assess whether heightened vigilance during survey weeks is associated with improved patient outcomes compared with nonsurvey weeks, particularly in major teaching hospitals...
March 20, 2017: JAMA Internal Medicine
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