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https://www.readbyqxmd.com/read/29779301/updates-on-aaa-screening-and-surveillance
#1
Mayo Theivendran, Jason Chuen
BACKGROUND: Screening and diagnostic surveillance of latent conditions have a profound impact on public healthcare expenditure and clinical outcomes. Abdominal aortic aneurysm (AAA) remains one of the hallmark pathologies in vascular surgery and an area of intense research interest. OBJECTIVE: This article is the second of two that will outline current areas of controversy and research in AAA disease in order to support a more detailed understanding of issues in managing patients with this condition, and inform the development of Australasian clinical guidelines and health policy...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29779300/coroners-recommendations-for-prevention-of-resident-deaths-in-aged-care-the-role-of-primary-care-providers
#2
Georgia Aitken, Athena Demosthenous, Lyndal Bugeja, Melissa Willoughby, Carmel Young, Joseph E Ibrahim
BACKGROUND AND OBJECTIVES: Currently, very little is known about how coroners consider a role for general practitioners (GPs) and registered nurses (RNs) in recommendations for the prevention of premature death. Involving these professions in recommendations generally directed towards government organisations or residential aged care providers and management may contribute to more successful broader policy changes. The aim of this article was to examine whether coroners' recommendations describe a specific role for GPs and RNs in the prevention of premature death in residential aged care settings and, if so, what domains of practice were considered...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29779291/abdominal-aortic-aneurysm-an-update
#3
Jason Chuen, Mayo Theivendran
BACKGROUND: Abdominal aortic aneurysm (AAA) remains one of the hallmark pathologies in vascular surgery and an area of intense research interest. Treatment options have expanded in recent years to increase the range of morphology suitable for endovascular aneurysm repair (EVAR), and with potential implications on treatment thresholds. OBJECTIVE: This article is the first of two that will outline current treatment options for AAA, including areas of controversy and research in AAA disease, to inform the development of Australasian clinical guidelines and health policy...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29779264/compliance-to-follow-up-and-adherence-to-medication-in-hypertensive-patients-in-an-urban-informal-settlement-in-kenya-comparison-of-three-models-of-care
#4
Ng'endo Kuria, Anthony Reid, Philip Owiti, Hannock Tweya, Caleb Kipkurui Kibet, Lilian Mbau, Marcel Manzi, Victor Murunga, Tecla Namusonge, Joseph Kibachio
OBJECTIVE: To determine and compare, among three models of care, compliance to scheduled clinic appointments and adherence to anti-hypertensive medication of patients in an informal settlement of Kibera, Kenya. METHODS: Routinely collected patient data were used from three health facilities, six walkway clinics and one weekend/church clinic. Patients were eligible if they had received hypertension care for more than six months. Compliance with clinic appointments and self-reported adherence to medication were determined from clinic records and compared using the Chi-square test...
May 19, 2018: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29779232/crossed-clip-strangulation-for-the-management-of-small-intestinal-polyps-in-patients-with-peutz-jeghers-syndrome
#5
Tomonori Yano, Satoshi Shinozaki, Hironori Yamamoto
Peutz-Jeghers syndrome is an autosomal dominant disorder with multiple hamartomatous polyps throughout the gastrointestinal tract. The clinical history of patients with Peutz-Jeghers syndrome usually includes multiple laparotomies to treat intestinal obstruction caused by polyps. The development of double-balloon enteroscopy enables endoscopic resection of polyps, even in the distal small intestine. This article is protected by copyright. All rights reserved.
May 19, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29779231/specialist-perioperative-allergy-clinic-services-in-the-uk-2018-results-from-the-royal-college-of-anaesthetists-sixth-national-audit-project-nap6-investigation-of-perioperative-anaphylaxis
#6
W Egner, T M Cook, T Garcez, S Marinho, H Kemp, D N Lucas, K Floss, S Farooque, H Torevell, M Thomas, K Ferguson, S Nasser, S Karanam, K-L Kong, N McGuire, M Bellamy, A Warner, J Hitchman, L Farmer, N J N Harper
BACKGROUND: The Royal College of Anaesthetists 6th National Audit Project examined Grade 3-5 perioperative anaphylaxis for one year in the UK. OBJECTIVE: To describe the causes and investigation of anaphylaxis in the NAP6 cohort, in relation to published guidance and previous baseline survey results. METHODS: We used a secure registry to gather details of Grade 3-5 perioperative anaphylaxis. Anonymous reports were aggregated for analysis and reviewed in detail...
May 19, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29779164/update-on-endothelin-receptor-antagonists-in-hypertension
#7
REVIEW
Michel Burnier
To review the most recent data on the development of endothelin receptor antagonists (ERAs) for the treatment of hypertension and the management of diabetic nephropathy RECENT FINDINGS: Recent reviews and meta-analyses of experimental and clinical data obtained with ERAs confirmed that endothelin receptor blockade is associated with significant decreases in blood pressure in essential hypertension but also in resistant hypertension. In addition, in patients with diabetic nephropathy, ERAs induce significant 30-40% decreases in albuminuria when administered on top of blockers of the renin-angiotensin system...
May 19, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29779159/an-etiological-approach-to-sexual-offender-assessment-case-formulation-incorporating-risk-assessment-cafira
#8
REVIEW
Leam A Craig, Martin Rettenberger
PURPOSE OF REVIEW: Case formulations (CF) have been the cornerstone of effective practice in clinical psychology since the 1950s and now form one of the core competencies in clinical and forensic assessment. The use of CFs within forensic settings is becoming more relevant when working with offenders who have experienced significant trauma, suffered from personality disorder, and have displayed sexually abusive behavior. Furthermore, most North American and European jurisdictions insist that expert witnesses adopt an idiosyncratic approach to risk assessment and consider the characteristics of the individual as part of a wider formulation of the problem behavior...
May 19, 2018: Current Psychiatry Reports
https://www.readbyqxmd.com/read/29779139/insomnia-short-sleep-duration-and-high-blood-pressure-recent-evidence-and-future-directions-for-the-prevention-and-management-of-hypertension
#9
REVIEW
Christina J Bathgate, Julio Fernandez-Mendoza
PURPOSE OF REVIEW: To summarize research from the past 2 years on the association between insomnia, short sleep duration, and hypertension and provide a critical analysis of the evidence and suggestions for future directions in this field. RECENT FINDINGS: Evidence indicates that the association between insomnia and elevated blood pressure (BP) or stage 1 and 2 hypertension is stronger in those with chronic insomnia, as compared to those with isolated insomnia symptoms, and primarily found in those with the insomnia with objective short sleep duration phenotype...
May 19, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29779137/ulnar-neuropathy-at-wrist-entrapment-at-a-very-congested-site
#10
Daniele Coraci, Claudia Loreti, Giulia Piccinini, Pietro E Doneddu, Silvia Biscotti, Luca Padua
Ulnar tunnel syndrome indicates ulnar neuropathy at different sites within the wrist. Several classifications of ulnar tunnel syndrome are present in literature, based upon typical nerve anatomy. However, anatomical variations are not uncommon and can complicate assessment. The etiology is also complex, due to the numerous potential causes of entrapment. Clinical examination, neurophysiological testing, and imaging are all used to support the diagnosis. At present, many therapeutic approaches are available, ranging from observation to surgical management...
May 19, 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29779129/practical-impact-of-a-decision-support-for-goal-directed-fluid-therapy-on-protocol-adherence-a-clinical-implementation-study-in-patients-undergoing-major-abdominal-surgery
#11
Alexandre Joosten, Reda Hafiane, Marco Pustetto, Luc Van Obbergh, Thierry Quackels, Alexis Buggenhout, Jean-Louis Vincent, Brigitte Ickx, Joseph Rinehart
The purpose of this study was to assess the effects of using a real time clinical decision-support system, "Assisted Fluid Management" (AFM), to guide goal-directed fluid therapy (GDFT) during major abdominal surgery. We compared a group of patients managed using the AFM system with a historical cohort of patients (control group) who had been managed using a manual GDFT strategy. Adherence to the protocol was defined as the relative intraoperative time spent with a stroke volume variation (SVV) < 13%...
May 19, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29779086/retrospective-study-of-nivolumab-for-patients-with-recurrent-high-grade-gliomas
#12
Megan Mantica, Ashley Pritchard, Frank Lieberman, Jan Drappatz
INTRODUCTION: Patients with recurrent high-grade gliomas (HGG) have limited treatment options. HGG utilize the PD-1 pathway to evade immune responses. Checkpoint inhibitors have demonstrated safety and clinical activity in patients with recurrent glioblastoma. We explored the efficacy of nivolumab in recurrent HGG with a primary objective of progression free survival (PFS) and overall survival (OS). METHODS: We retrospectively analyzed HGG patients treated with nivolumab in our institution...
May 19, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29779057/using-patient-reported-outcome-measures-to-deliver-enhanced-supportive-care-to-people-with-lung-cancer-feasibility-and-acceptability-of-a-nurse-led-consultation-model
#13
Grigorios Kotronoulas, Constantina Papadopoulou, Mhairi F Simpson, John McPhelim, Lynn Mack, Roma Maguire
PURPOSE: Developing new supportive/palliative care services for lung cancer should encompass effective ways to promptly identify and address patients' healthcare needs. We examined whether an in-clinic, nurse-led consultation model, which was driven by use of a patient-reported outcomes (PRO) measure, was feasible and acceptable in the identification of unmet needs in patients with lung cancer. METHODS: A two-part, repeated-measures, mixed-methods study was conducted...
May 19, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29779008/intervention-planning-for-the-reduce-maintenance-intervention-a-digital-intervention-to-reduce-reulceration-risk-among-patients-with-a-history-of-diabetic-foot-ulcers
#14
Kate Greenwell, Katy Sivyer, Kavita Vedhara, Lucy Yardley, Frances Game, Trudie Chalder, Gayle Richards, Nikki Drake, Katie Gray, John Weinman, Katherine Bradbury
OBJECTIVES: To develop a comprehensive intervention plan for the REDUCE maintenance intervention to support people who have had diabetic foot ulcers (DFUs) to sustain behaviours that reduce reulceration risk. METHODS: Theory-based, evidence-based and person-based approaches to intervention development were used. In phase I of intervention planning, evidence was collated from a scoping review of the literature and qualitative interviews with patients who have had DFUs (n=20)...
May 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/29778996/stent-and-flow-diverter-assisted-treatment-of-acutely-ruptured-brain-aneurysms
#15
José E Cohen, J Moshe Gomori, Ronen R Leker, Sergey Spektor, Hosni Abu El Hassan, Eyal Itshayek
OBJECTIVE: We present our experience with stent techniques in the management of acutely ruptured aneurysms, focusing on aneurysm occlusion rates, intraprocedural complications, and late outcomes. METHODS: We retrospectively reviewed the clinical records of patients treated by stent techniques during the early acute phase of aneurysmal rupture, from June 2011 to June 2016. Patients who underwent stenting for the management of unruptured aneurysms, or in a delayed fashion for a ruptured lesion, were excluded...
May 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29778817/extent-of-aortic-replacement-in-type-a-dissection-current-answers-for-an-endless-debate
#16
REVIEW
Stephen D Waterford, Rita L Gardner, Marc R Moon
BACKGROUND: The proximal and distal extent of surgery for type A dissection is the subject of this review article. METHODS: In this report, we summarize select series that illumine the issue at hand and provide insight into the surgical approach at our institution to DeBakey type I aortic dissections. RESULTS: For proximal extent, we discuss preservation of the aortic valve in the presence of aortic insufficiency, as well as management of the aortic root in the setting of root dilation...
May 17, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29778756/nurses-knowledge-attitudes-and-clinical-practice-in-pediatric-postoperative-pain-management
#17
Anja Hetland Smeland, Alison Twycross, Stefan Lundeberg, Tone Rustøen
Despite readily available evidence to guide practice, children continue to experience moderate to severe pain in hospital postoperatively. Reasons for this may include attitudes of nurses toward pain management and their lack of knowledge in key areas. To identify nurses' knowledge and clinical practice of pediatric postoperative pain management and whether there is a link between knowledge and practice. A descriptive cross-sectional study including a questionnaire and observations was conducted in postanesthesia care (recovery) units in six university hospitals in Norway...
May 16, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29778755/development-and-acceptability-assessment-of-a-self-management-intervention-to-prevent-acute-to-chronic-pain-transition-after-major-lower-extremity-trauma
#18
Mélanie Bérubé, Céline Gélinas, Géraldine Martorella, Nancy Feeley, José Côté, George-Yves Laflamme, Dominique M Rouleau, Manon Choinière
Transition from acute to chronic pain often occurs after major lower extremity trauma. Chronic pain has been found to negatively affect daily functioning, including the capacity to work and quality of life. Empirical data and an acceptability assessment were used to develop a self-management intervention aimed at preventing acute to chronic pain transition after major lower extremity trauma (i.e., iPACT-E-Trauma). Evidence from previous studies on preventive self-management interventions, combined with a biopsychosocial conceptual framework and clinical knowledge, helped define the key features of the preliminary version...
May 16, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29778713/concluding-commentary-on-current-trends-to-enhance-the-clinical-safety-of-pediatric-transfusion-focusing-on-prevention-of-untoward-complications-of-hsc-transplantation-newer-strategies-for-improving-the-standards-of-safety-quality-of-stem-cells-expansion-for
#19
REVIEW
Irena Sniecinski, Jerard Seghatchian
Clinical practice and related diagnostic, development and research [DDR] strategies in pediatric transfusion and transplantation cover a broad range of multidisciplinary studies, performed by many professionals involved in this most challenging clinical field [1]. This commentary on the current position and future perspectives in pediatric transfusion field is aimed to highlight major unresolved transfusion complications in pediatric patients, namely red blood cell and platelet alloimmunisation, and new ones such as nosocomial infection, thrombosis and multi-organ failure...
May 16, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#20
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
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