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https://www.readbyqxmd.com/read/28430600/risk-factors-for-the-recurrence-of-an-intracranial-saccular-aneurysm-following-endovascular-treatment
#1
De-Zhang Huang, Bin Jiang, Wei He, Yi-Hua Wang, Zhi-Gang Wang
BACKGROUND: This study was aimed to determine risk factors for the recurrence of an intracranial saccular aneurysm (ISA) following endovascular treatment. The findings will help medical professionals to identify patients having a high risk of ISA recurrence and assist them in developing appropriate follow-up plans. RESULTS: During the follow-up period, 12.6% of the patients (83/658) experienced recurrent ISAs. An analysis of related factors, including gender, age, hypertension, diabetes mellitus, smoking, tumor size, width of the aneurysm neck, the presence or absence of a rupture, the volume embolization ratio (VER), the application or nonapplication of a stent, and follow-up time, revealed that a tumor size > 10 mm in diameter, wide-necked aneurysms, an anterior communicating or middle cerebral artery aneurysm, an aneurysm rupture, a VER < 20%, the absence of stent assistance, and follow-up time were high-risk factors for the recurrence of ISAs...
April 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/28430569/courage-and-compassion-virtues-in-caring-for-so-called-difficult-patients
#2
Michael Hawking, Farr A Curlin, John D Yoon
What, if anything, can medical ethics offer to assist in the care of the "difficult" patient? We begin with a discussion of virtue theory and its application to medical ethics. We conceptualize the "difficult" patient as an example of a "moral stress test" that especially challenges the physician's character, requiring the good physician to display the virtues of courage and compassion. We then consider two clinical vignettes to flesh out how these virtues might come into play in the care of "difficult" patients, and we conclude with a brief proposal for how medical educators might cultivate these essential character traits in physicians-in-training...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28429340/controlled-prospective-observational-study-on-the-efficiency-and-tolerability-of-a-combination-of-potential-nrf2-inducing-antioxidants-and-micronutrients-as-pre-treatment-for-icsi-in-dyspermic-patients-with-previous-failure
#3
R Rago, M Gallo, A Dal Lago, E Licata, G Paciotti, M Amodei, C Meneghini, C Fabiani, G Dani, C Liberanome, D Antonaci, R Corno, D Miriello, G Giuffrida, B Giammusso
OBJECTIVE: To evaluate the efficiency of pre-treatment in dyspermic males in IVF couples with a combination of micronutrients, for the purpose of improving the fertilization rate, the implantation rate and the outcome of the pregnancy. PATIENTS AND METHODS: This controlled prospective clinical study was performed in two medically assisted reproduction centers. 59 males with mild oligo-astheno-teratospermia (OAT) were admitted to the study. All of them had a history of previous in vitro fertilization (IVF) attempts with female partners aged < 40 diagnosed having tubal or idiopathic infertility...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28427091/-development-and-evaluation-of-herzwegweiser-de-an-informational-website-designed-for-post-rehabilitation-support-of-cardiac-patients-and-their-healthcare-professionals-in-berlin-brandenburg
#4
Sabine Stamm-Balderjahn, Susanne Bartel, Kristin Wilke, Karla Spyra
ObjectiveThe internet portal 'herzwegweiser.de' was developed to assist individuals with cardiovascular diseases in the phase III rehabilitation in the region of Berlin-Brandenburg. It provides information on this specific disease as well as on aftercare services, e. g. regional cardiac groups. For the medical and therapeutic colleagues specific information such as treatment guidelines and a cardiac group placement service for trainers and medical doctors were set up. MethodsThe study was based on a mixed-methods design...
April 20, 2017: Die Rehabilitation
https://www.readbyqxmd.com/read/28426910/family-and-other-unpaid-caregivers-and-older-adults-with-and-without-dementia-and-disability
#5
Catherine Riffin, Peter H Van Ness, Jennifer L Wolff, Terri Fried
OBJECTIVES: To estimate the number of caregivers providing assistance to community-dwelling older persons with and without dementia and with or without substantial disability; to describe the characteristics of caregivers and care recipients in these groups; to characterize the health-related tasks that caregivers provide; and to estimate associations between the numbers of tasks and caregiver burden. DESIGN: Nationally representative surveys of caregivers and older adults in the United States...
April 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28426695/a-comparative-study-of-pediatric-open-pyeloplasty-laparoscopy-assisted-extracorporeal-pyeloplasty-and-robot-assisted-laparoscopic-pyeloplasty
#6
Sang Hoon Song, Chanwoo Lee, Jaeyoon Jung, Sung Jin Kim, Sungchan Park, Hyungkeun Park, Kun Suk Kim
PURPOSE: To compare the outcomes of open pyeloplasty (OP), laparoscopy-assisted extracorporeal (LEXP), and robotic-assisted laparoscopic pyeloplasty (RALP) for ureteropelvic junction obstruction in pediatric patients. METHODS: We retrospectively reviewed the age-matched cohort of 30 children who underwent OP, 30 who underwent LEXP, and 10 who underwent RALP at a single institution, from 1996 to 2014. Pre- and post-operative variables including success rate were compared among surgical groups...
2017: PloS One
https://www.readbyqxmd.com/read/28426544/neonatal-abstinence-syndrome-where-are-we-and-where-do-we-go-from-here
#7
Laura Brandt, Loretta P Finnegan
PURPOSE OF REVIEW: Over the last 15 years the prevalence of neonatal abstinence syndrome (NAS) increased almost five-fold. A considerable diversity seems to prevail in the management of NAS. This review provides an overview of factors affecting the expression and course of NAS, and recent developments in NAS assessment and treatment. RECENT FINDINGS: Apart from different pharmacological and nonpharmacological treatment modalities, maturity of the infant and genetic variations likely are (co)responsible for interpatient variability in NAS severity, despite similar maternal exposure...
April 19, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28426360/pharmaceutical-cognitive-enhancement-in-greek-university-students-differences-between-users-and-non-users-in-social-cognitive-variables-burnout-and-engagement
#8
Lambros Lazuras, Antonia Ypsilanti, Efthymios Lamprou, Christos Kontogiorgis
Pharmaceutical cognitive enhancement (PCE) represents the non-medical use of prescribed medication for the improvement of cognitive functioning and academic performance. Although there are some studies about PCE prevalence, it is less clear how users and non-users of PCE substances differ with respect to their positive and negative student experiences (e.g. academic burnout and engagement with studies) and in social cognitive variables that relate to decision-making and self-regulation of PCE use. The present study assessed whether students with different experiences of PCE substance use displayed differences in academic burnout, study engagement, and social cognitive variables relevant to PCE use...
June 7, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28426287/pregnancy-and-the-acceptability-of-computer-based-versus-traditional-mental-health-treatments
#9
Liisa Hantsoo, Jessica Podcasy, Mary Sammel, Cynthia Neill Epperson, Deborah R Kim
BACKGROUND: Recent recommendations urge increased depression screening in pregnant and postpartum women, potentially increasing demand for treatment. Computer-based psychotherapy treatments may address some of perinatal women's unique mental health treatment needs and barriers. MATERIALS AND METHODS: We conducted a quantitative survey of pregnant women (≥12 weeks of gestation) on preferences regarding computer-based therapies compared with traditional therapies (psychotherapy and medication)...
April 20, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28426127/postpartum-hypertension-etiology-diagnosis-and-management
#10
Kathryn J Sharma, Sarah J Kilpatrick
Importance: Postpartum hypertension complicates approximately 2% of pregnancies and, similar to antepartum severe hypertension, can have devastating consequences including maternal death. Objective: This review aims to increase the knowledge and skills of women's health care providers in understanding, diagnosing, and managing hypertension in the postpartum period. Results: Hypertension complicating pregnancy, including postpartum, is defined as systolic blood pressure 140 mm Hg or greater and/or diastolic blood pressure 90 mm Hg or greater on 2 or more occasions at least 4 hours apart...
April 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28426116/portuguese-expatriates-health-in-angola-and-mozambique-a-cross-sectional-study-increasing-awareness-and-need-for-more-surveillance
#11
Ana Glória Fonseca, Sara S Dias, João Luis Baptista, Jorge Torgal
Background: Increasing numbers of expatriates are working in sub-Saharan Africa. There is little published data on the complex population and this survey aimed at understanding expatriate morbidity by accessing self-reported health problems and malaria preventive practices. Methods: A cross-sectional web-based survey was conducted targeting Portuguese expatriates in Angola and Mozambique. Logistic regression analysis explored factors associated with self-reported health problems and psychological symptoms in the previous 3 months...
July 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28425577/postoperative-hemorrhage-and-hospital-revisit-after-transoral-robotic-surgery
#12
Joseph Zenga, Jasmina Suko, Dorina Kallogjeri, Patrik Pipkorn, Brian Nussenbaum, Ryan S Jackson
OBJECTIVES/HYPOTHESIS: To investigate the incidence and complications related to postoperative hemorrhage (POH) after transoral robotic surgery (TORS). STUDY DESIGN: Retrospective review of the State Inpatient Database (SID), the State Ambulatory Surgery Database (SASD), and the State Emergency Department Database (SEDD) from the Healthcare Cost and Utilization Project. METHODS: Patients were identified from the SID, SASD, and SEDD for the states of Florida, New York, and California from 2005 to 2013 who had an International Classification of Diseases, Ninth Edition code for a surgical procedure on the upper aerodigestive tract associated with a code for robotic-assisted surgery...
April 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28425352/overdose-in-young-children-treated-with-anti-reflux-medications-poisons-enquiry-evidence-of-excess-10-fold-dosing-errors-with-ranitidine
#13
C Crawford, M Anderson, G Cooper, G Jackson, J Thompson, A Vale, Shl Thomas, M Eddleston, D N Bateman
BACKGROUND: Accidental drug overdose is a common problem in young children. We examined the influence of formulation and dose in enquiries for different gastro-oesophageal reflux disease treatments in children under 5 years to the UK's National Poisons Information Service. METHODS: Overdose characteristics with ranitidine, omeprazole or domperidone were compared with those of metoclopramide and the H-1 antagonist chlorphenamine, for the period 1 July 2007 to 30 June 2015...
January 1, 2017: Human & Experimental Toxicology
https://www.readbyqxmd.com/read/28424157/childhood-adversity-and-risk-of-suicide-cohort-study-of-548%C3%A2-721-adolescents-and-young-adults-in-sweden
#14
Charlotte Björkenstam, Kyriaki Kosidou, Emma Björkenstam
Objective To examine the relation between childhood adversity, the role of school performance, and childhood psychopathology and the risk of suicide.Design Cohort study of register based indicators of childhood adversity (at ages 0-14) including death in the family (suicide analysed separately), parental substance abuse, parental psychiatric disorder, substantial parental criminality, parental separation/single parent household, receipt of public assistance, and residential instability.Setting Swedish medical birth register and various Swedish population based registers...
April 19, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28423852/using-the-mrc-framework-for-complex-interventions-to-develop-clinical-decision-support-a-case-study
#15
Dawn Dowding, Valentina Lichtner, S José Closs
The Medical Research Council (MRC) framework for complex interventions provides useful guidance to assist with the development and evaluation of health technology interventions such as decision support. In this paper we briefly summarise a project that focused on designing a decision support intervention to assist with the recognition, assessment and management of pain in patients with dementia in an acute hospital setting. We reflect on our experience of using the MRC framework to guide our study design, and highlight the importance of considering decision support interventions as complex interventions...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423773/introducing-a-method-for-transformation-of-paper-based-research-data-into-concept-based-representation-with-openehr
#16
Birgit Saalfeld, Erik Tute, Klaus-Hendrik Wolf, Michael Marschollek
Combining research data and clinical routine data is a chance for medical research. We present our method for the transformation of paper-based research data into a concept-based representation. With this representation the study data from research projects can be combined with data from clinical tools with less integration effort. We applied and verified our method using data from a current research study. In this paper we also show our main challenges and lessons learned. Clinical assessment data and study diaries from a long term study (n=24, 3 months observation time each, 17 different clinical assessments) stored on paper were used as the data set...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423749/monitoring-activities-related-to-medication-adherence-in-ambient-assisted-living-environments
#17
Patrice C Roy, Samina Raza Abidi, Syed Sibte Raza Abidi
A recent trend in healthcare is to motivate patients to self-manage their health conditions in home-based settings. Medication adherence is an important aspect in disease self-management since sub-optimal medication adherence by the patient can lead to serious healthcare costs and discomfort for the patient. In order to alleviate the limitations of self-reported medication adherence, we can use ambient assistive living (AAL) technologies in smart environments. Activity recognition services allow to retrieve self-management information related to medication adherence in a less intrusive way...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#18
Peter Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction and lack of efficacy...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28422537/morbidity-and-mortality-associated-with-prehospital-lift-assist-calls
#19
Lauren Leggatt, Kristine Van Aarsen, Melanie Columbus, Adam Dukelow, Michael Lewell, Matthew Davis, Shelley McLeod
INTRODUCTION: When an individual requires assistance with mobilization, emergency medical services (EMS) may be called. If a patient does not receive treatment on scene and is not transported to hospital, these are referred to as "Lift Assist" (LA) calls. It is possible this need for assistance represents a subtle onset of a disease process or decline in function. Without recognition or treatment, the patient may be at risk for recurrent falls, repeat EMS visits or worsening illness. OBJECTIVE: To examine the 14-day morbidity and mortality associated with LA calls and determine factors that are associated with increased risk of these outcomes...
April 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28421900/the-magnitude-and-factors-related-to-facility-based-maternal-mortality-in-mozambique
#20
Leonardo Chavane, Martinho Dgedge, Olivier Degomme, Osvaldo Loquiha, Marc Aerts, Marleen Temmerman
Facility-based maternal mortality remains an important public health problem in Mozambique. A number of factors associated with health system functioning can be described behind the occurrence of these deaths. This paper aimed to evaluate the magnitude of the health facility-based maternal mortality, its geographical distribution and to assess the health facility factors implicated in the occurrence of these deaths. A secondary analysis was done on data from the survey on maternal health needs performed by the Ministry of Health of Mozambique in 2008...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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