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https://www.readbyqxmd.com/read/28538648/less-is-more-antibiotic-duration-and-outcomes-in-fournier-s-gangrene
#1
Margaret Lauerman, Olga Kolesnik, Kinjal Sethuraman, Ronald Rabinowitz, Manjari Joshi, Emily Clark, Deborah Stein, Thomas Scalea, Sharon Henry
BACKGROUND: Antibiotic management of Fournier's gangrene (FG) is without evidence-based guidelines, and is based on expert opinion. The effect of duration of antibiotic therapy on outcomes in FG is unknown. METHODS: A retrospective review was performed of FG patients from 2012-2015 at a single institution. Patients were managed by our institutional practice of complete primary wound closure as possible, with antibiotic duration according to physician judgement. Patients were stratified into multiple durations of antibiotic administration...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538493/committee-opinion-no-703-summary-asymptomatic-microscopic-hematuria-in-women
#2
(no author information available yet)
Asymptomatic microscopic hematuria is an important clinical sign of urinary tract malignancy. Asymptomatic microscopic hematuria has been variably defined over the years. In addition, the evidence primarily is based on data from male patients. However, whether the patient is a man or a woman influences the differential diagnosis of asymptomatic microscopic hematuria, and the risk of urinary tract malignancy (bladder, ureter, and kidney) is significantly less in women than in men. Among women, being older than 60 years, having a history of smoking, and having gross hematuria are the strongest predictors of urologic cancer...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28538461/dnp-preparation-in-supporting-critical-skills-for-magnet%C3%A2-program-directors
#3
Sarah Lackey
Magnet® organizations are required to identify a Magnet program director (MPD), who plays a critical role in attaining and maintaining Magnet designation. The evidence is sparse related to qualifications or recommended educational levels of those assuming an MPD role. In this article, the author discusses how one of the DNP Essentials, clinical scholarship and the use of analytical methods for evidence-based practice, is reported to prepare nurses for the MPD role.
June 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28538338/supporting-a-culture-of-evidence-based-policy-federal-funding-for-public-health-law-evaluation-research-1985-2014
#4
Jennifer K Ibrahim, Aaron A Sorensen, Heidi Grunwald, Scott Burris
OBJECTIVE: Law powerfully influences health and can be a critical tool for promoting population well-being. Evaluation research is needed to measure the health effects of law and guide policy making and implementation. The purpose of this study was to assess trends in National Institutes of Health (NIH) funding for scientific public health law research (PHLR). METHODS: Using data from the UberResearch NIH grant repository, we collected and coded all grants with a focus on health law between FY'85 and FY'14 and then analyzed the grants by funding agency and topic areas...
May 23, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28538334/influence-of-optic-disc-size-on-identifying-glaucomatous-optic-neuropathy
#5
Gregory J Nixon, Ronald K Watanabe, Michael Sullivan-Mee, Anthony DeWilde, Lisa Young, G Lynn Mitchell
PURPOSE: The aim of this study was to use a large group of observers to test prior research findings that suggest optic disc size, clinical evaluation of the neuroretinal rim (ISNT rule), and practitioner characteristics influence the accuracy of differentiating normal from glaucomatous optic nerves. METHODS: Participant observers were optometrists, optometry students, and vision scientists/researchers attending the 2013 American Academy of Optometry Annual Meeting...
June 2017: Optometry and Vision Science: Official Publication of the American Academy of Optometry
https://www.readbyqxmd.com/read/28538248/minimally-invasive-cardiac-output-technologies-in-the-icu-putting-it-all-together
#6
Ramon P Clement, Jaap J Vos, Thomas W L Scheeren
PURPOSE OF REVIEW: Haemodynamic monitoring is a cornerstone in the diagnosis and evaluation of treatment in critically ill patients in circulatory distress. The interest in using minimally invasive cardiac output monitors is growing. The purpose of this review is to discuss the currently available devices to provide an overview of their validation studies in order to answer the question whether these devices are ready for implementation in clinical practice. RECENT FINDINGS: Current evidence shows that minimally invasive cardiac output monitoring devices are not yet interchangeable with (trans)pulmonary thermodilution in measuring cardiac output...
May 19, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28538239/how-to-save-1-million-lives-in-a-year-in-low-and-middle-income-countries
#7
Colm P Travers, Wally A Carlo
Despite major improvements in reducing childhood mortality worldwide, over 5 million pregnancies per year end in stillbirths or neonatal deaths. The vast majority of these deaths occur in low- and middle-income countries. Many of these deaths are preventable with readily available evidence-based care practices. This review focuses on educational programs developed to reduce preventable deaths in newborn infants in low- and middle-income countries, including Essential Newborn Care and Helping Babies Breathe, a simplified version of the Neonatal Resuscitation Program...
2017: Neonatology
https://www.readbyqxmd.com/read/28537762/creation-of-an-integrated-knowledge-translation-process-to-improve-pediatric-emergency-care-in-canada
#8
Robin M Featherstone, Carly Leggett, Lisa Knisley, Mona Jabbour, Terry P Klassen, Shannon D Scott, Greg Van De Mosselaer, Lisa Hartling
TREKK (Translating Emergency Knowledge for Kids) was established to address knowledge needs to support care of children in general emergency departments. To achieve this goal, we developed an integrated knowledge translation (KT) process based on identified priorities to create the TREKK Evidence Repository, containing "knowledge pyramids" and Bottom Line Recommendations (summary documents) on the diagnosis and treatment of emergency pediatric conditions. The objective of this article is to describe our methods for developing and disseminating the TREKK Evidence Repository to improve pediatric emergency care in Canada...
May 24, 2017: Health Communication
https://www.readbyqxmd.com/read/28535545/portuguese-recommendations-for-the-use-of-methotrexate-in-rheumatic-diseases-2016-update
#9
Ana Catarina Duarte, Daniela Santos-Faria, Maria João Gonçalves, Alexandre Sepriano, Ana Filipa Mourão, Cátia Duarte, Joana Sousa Neves, Ana Filipa Águeda, Pedro Ávila Ribeiro, Alexandra Daniel, Adriano Neto, Ana Cordeiro, Ana Rodrigues, Anabela Barcelos, Cândida Silva, Cristina Ponte, Elsa Vieira-Sousa, Filipa Teixeira, Filipa Oliveira-Ramos, Filipe Araújo, Filipe Barcelos, Helena Canhão, Helena Santos, João Ramos, Joaquim Pereira, José Costa, José António Melo Gomes, Luís Cunha-Miranda, Lúcia Costa, Marcos Cerqueira, Margarida Cruz, Maria José Santos, Miguel Bernardes, Paula Oliveira, Pedro Abreu, Ricardo Figueira, Rita Barros, Sandra Falcão, Patrícia Pinto, Sofia Pimenta, Susana Capela, Vitor Teixeira, João Eurico Fonseca
BACKGROUND: Methotrexate (MTX) is the first-line drug in the treatment of rheumatoid arthritis (RA) and the most commonly prescribed disease modifying anti-rheumatic drug. Moreover, it is also used as an adjuvant drug in patients under biologic therapies, enhancing the efficacy of biologic agents. OBJECTIVES: To review the literature and update the Portuguese recommendations for the use of MTX in rheumatic diseases first published in 2009. METHODS: The first Portuguese guidelines for the use of MTX in rheumatic diseases were published in 2009 and were integrated in the multinational 3E Initiative (Evidence Expertise Exchange) project...
May 9, 2017: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/28534429/prevalence-and-costs-of-defensive-medicine-a-national-survey-of-italian-physicians
#10
Massimiliano Panella, Carmela Rinaldi, Fabrizio Leigheb, Sanita Knesse, Chiara Donnarumma, Seval Kul, Kris Vanhaecht, Francesco Di Stanislao
Objective To identify the prevalence of the practice of defensive medicine among Italian hospital physicians, its costs and the reasons for practising defensive medicine and possible solutions to reduce the practice of defensive medicine. Methods Cross-sectional web survey. Main outcome measures Number of physicians reporting having engaged in any defensive medicine behaviour in the previous year. Results A total of 1313 physicians completed the survey. Ninety-five per cent believed that defensive medicine would increase in the near future...
January 1, 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28534277/how-do-small-groups-make-decisions-a-theoretical-framework-to-inform-the-implementation-and-study-of-clinical-competency-committees
#11
Saad Chahine, Sayra Cristancho, Jessica Padgett, Lorelei Lingard
In the competency-based medical education (CBME) approach, clinical competency committees are responsible for making decisions about trainees' competence. However, we currently lack a theoretical model for group decision-making to inform this emerging assessment phenomenon. This paper proposes an organizing framework to study and guide the decision-making processes of clinical competency committees.This is an explanatory, non-exhaustive review, tailored to identify relevant theoretical and evidence-based papers related to small group decision-making...
May 22, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/28534244/proposal-of-a-simple-optical-coherence-tomography-based-scoring-system-for-progression-of-age-related-macular-degeneration
#12
Jianqin Lei, Siva Balasubramanian, Nizar Saleh Abdelfattah, Muneeswar G Nittala, SriniVas R Sadda
PURPOSE: To develop a simple, clinically practical, optical coherence tomography (OCT)-based scoring system for early age-related macular degeneration (AMD) to prognosticate risk for progression to late AMD. METHODS: We retrospectively reviewed OCT images (512 × 128 macular cube, Cirrus) from 138 patients diagnosed of early AMD in at least one eye and follow-up of at least 12 months. For patients with early AMD in both eyes, only the right eye was chosen as the study eye for longitudinal assessment...
May 22, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28534243/elevated-prevalence-of-suicide-attempts-among-victims-of-police-violence-in-the-usa
#13
Jordan E DeVylder, Jodi J Frey, Courtney D Cogburn, Holly C Wilcox, Tanya L Sharpe, Hans Y Oh, Boyoung Nam, Bruce G Link
Recent evidence suggests that police victimization is widespread in the USA and psychologically impactful. We hypothesized that civilian-reported police victimization, particularly assaultive victimization (i.e., physical/sexual), would be associated with a greater prevalence of suicide attempts and suicidal ideation. Data were drawn from the Survey of Police-Public Encounters, a population-based survey of adults (N = 1615) residing in four US cities. Surveys assessed lifetime exposure to police victimization based on the World Health Organization domains of violence (i...
May 22, 2017: Journal of Urban Health: Bulletin of the New York Academy of Medicine
https://www.readbyqxmd.com/read/28534169/-capacity-to-consent-to-treatment-in-dementia-patients-interdisciplinary-perspectives
#14
REVIEW
Julia Haberstroh, Tanja Müller
BACKGROUND: Currently, there are no concrete, evidence-based default procedures to adequately assess the capacity to consent to medical treatment. This explains why different raters use individual heuristics, differing both within and between disciplines. The lack of a procedure that is standardized, validated, and equally accepted across disciplines to assess the capacity to consent to treatment has led to an uncertainty in legal and medical practice regarding appropriate action and decision making...
May 22, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28533823/high-school-teachers-openness-to-adopting-new-practices-the-role-of-personal-resources-and-organizational-climate
#15
Stacy R Johnson, Elise T Pas, Deanna Loh, Katrina J Debnam, Catherine P Bradshaw
Although evidence-based practices for students' social, emotional, and behavioral health are readily available, their adoption and quality implementation in schools are of increasing concern. Teachers are vital to implementation; yet, there is limited research on teachers' openness to adopting new practices, which may be essential to successful program adoption and implementation. The current study explored how perceptions of principal support, teacher affiliation, teacher efficacy, and burnout relate to teachers' openness to new practices...
March 2017: School Mental Health
https://www.readbyqxmd.com/read/28533475/first-line-palliative-her2-targeted-therapy-in-her2-positive-metastatic-breast-cancer-is-less-effective-after-previous-adjuvant-trastuzumab-based-therapy
#16
Hánah N Rier, Mark-David Levin, Joost van Rosmalen, Monique M E M Bos, Jan C Drooger, Paul de Jong, Johanneke E A Portielje, Elisabeth M P Elsten, Albert-Jan Ten Tije, Stefan Sleijfer, Agnes Jager
BACKGROUND: Survival of patients with human epidermal growth receptor 2 (HER2)-positive metastatic breast cancer (MBC) has improved dramatically since trastuzumab has become available, although the disease eventually progresses in most patients. This study investigates the outcome (overall survival [OS] and time to next treatment [TNT]) in MBC patients pretreated with trastuzumab in the adjuvant setting (TP-group) compared with trastuzumab-naïve patients (TN-group) in order to investigate the possibility of trastuzumab resistance...
May 22, 2017: Oncologist
https://www.readbyqxmd.com/read/28533474/weekly-low-dose-versus-three-weekly-high-dose-cisplatin-for-concurrent-chemoradiation-in-locoregionally-advanced-non-nasopharyngeal-head-and-neck-cancer-a-systematic-review-and-meta-analysis-of-aggregate-data
#17
Petr Szturz, Kristien Wouters, Naomi Kiyota, Makoto Tahara, Kumar Prabhash, Vanita Noronha, Ana Castro, Lisa Licitra, David Adelstein, Jan B Vermorken
BACKGROUND: Three-weekly high-dose cisplatin (100 mg/m(2)) is considered the standard systemic regimen given concurrently with postoperative or definitive radiotherapy in locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). However, due to unsatisfactory patient tolerance, various weekly low-dose schedules have been increasingly used in clinical practice. The aim of this meta-analysis was to compare the efficacy, safety, and compliance between these two approaches...
May 22, 2017: Oncologist
https://www.readbyqxmd.com/read/28533062/predicting-inpatient-delirium-the-awol-delirium-risk-stratification-score-in-clinical-practice
#18
Ethan G Brown, S Andrew Josephson, Noriko Anderson, Mary Reid, Melissa Lee, Vanja C Douglas
Inpatient delirium improves with multicomponent interventions by hospital staff, though the resources needed are often limited. Risk-stratification to predict delirium is a useful first step to help triage resources, but the performance of risk-stratification as part of a functioning multicomponent pathway has not been assessed. We retrospectively studied the performance of a validated delirium prediction rule, the AWOL score, as a part of a multicomponent delirium care pathway in practice on a university hospital ward...
May 19, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28532894/-spanish-adaptation-of-the-2016-european-guidelines-on-cardiovascular-disease-prevention-in-clinical-practice
#19
Miguel Ángel Royo-Bordonada, Pedro Armario, José María Lobos Bejarano, Juan Pedro-Botet, Fernando Villar Álvarez, Roberto Elosua, Carlos Brotons Cuixart, Olga Cortés, Benilde Serrano, Miguel Camafort Babkowski, Antonio Gil Núñez, Antonio Pérez, Antonio Maiques, Ana de Santiago Nocito, Almudena de Castro, Eduardo Alegría, Ciro Baeza, María Herranz, Susana Sans, Pilar Campos
The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk...
May 19, 2017: Semergen
https://www.readbyqxmd.com/read/28532881/preliminary-evidence-of-regional-interdependent-inhibition-using-a-diaphragm-release-to-specifically-induce-an-immediate-hypoalgesic-effect-in-the-cervical-spine
#20
Calum A McCoss, Ross Johnston, Darren J Edwards, Charles Millward
In clinical practice, Osteopaths and Manual Therapists commonly direct treatment towards the diaphragm by the use of a 'Diaphragm Release'. Currently, there is paucity within the literature to support the use of this technique, specifically in pain outcomes. This research aims to support a neurophysiological mechanism based upon the osteopathic principle "The body is a unit". Demonstrating that directing treatment to distal tissue which is neurologically related can reduce pain in the originating spinal segments...
April 2017: Journal of Bodywork and Movement Therapies
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