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https://www.readbyqxmd.com/read/28723476/charting-recent-progress-and-challenges-in-metastatic-castration-resistant-prostate-cancer-is-there-an-optimal-treatment-sequence
#1
REVIEW
Stéphane Oudard, Pablo Maroto, Gaston Demonty, Winald R Gerritsen
CONTEXT: Recent developments in the treatment of metastatic castration-resistant prostate cancer (mCRPC) have led to uncertainty about the optimal sequence of agents. OBJECTIVE: To review and assess treatment options and sequence in patients with mCRPC. EVIDENCE ACQUISITION: To identify data on the optimal use of approved treatments, we searched PubMed for studies on the use of recently approved agents for men with mCRPC published before March 2015...
October 2016: European Urology Focus
https://www.readbyqxmd.com/read/28716994/diagnosis-and-management-of-perinatal-depression-and-anxiety-in-general-practice-a-meta-synthesis-of-qualitative-studies
#2
Elizabeth Ford, Suzanne Lee, Judy Shakespeare, Susan Ayers
BACKGROUND: Up to 20% of women experience anxiety and depression during the perinatal period. In the UK, management of perinatal mental health falls under the remit of GPs. AIM: This review aimed at synthesising the available information from qualitative studies on GPs' attitudes, recognition, and management of perinatal anxiety and depression. DESIGN AND SETTING: Meta-synthesis of the available published qualitative evidence on GPs' recognition and management of perinatal anxiety and depression...
July 17, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28710226/evaluating-the-predictive-strength-of-the-lace-index-in-identifying-patients-at-high-risk-of-hospital-readmission-following-an-inpatient-episode-a-retrospective-cohort-study
#3
Sarah Damery, Gill Combes
OBJECTIVE: To assess how well the LACE index and its constituent elements predict 30-day hospital readmission, and to determine whether other combinations of clinical or sociodemographic variables may enhance prognostic capability. DESIGN: Retrospective cohort study with split sample design for model validation. SETTING: One large hospital Trust in the West Midlands. PARTICIPANTS: All alive-discharge adult inpatient episodes between 1 January 2013 and 31 December 2014...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28707532/a-novel-diagnostic-aid-for-intra-abdominal-adhesion-detection-in-cine-mr-imaging-pilot-study-and-initial-diagnostic-impressions
#4
David Randall, Frank Joosten, Richard Ten Broek, Richard Gillott, Karna Dev Bardhan, Chema Strik, Wiesje Prins, Harry van Goor, John Fenner
OBJECTIVES: A non-invasive diagnostic technique for abdominal adhesions is not currently available. Capture of abdominal motion due to respiration in cine-MRI has shown promise, but is difficult to interpret. This article explores the value of a complimentary diagnostic aid to facilitate the non-invasive detection of abdominal adhesions using cine-MRI. METHOD: An image processing technique was developed to quantify the amount of sliding that occurs between the organs of the abdomen and the abdominal wall in sagittal cine-MRI slices...
July 14, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28703305/use-of-multicriteria-decision-analysis-for-assessing-the-benefit-and-risk-of-over-the-counter-analgesics
#5
Andrew Moore, Anne Crossley, Bernard Ng, Lawrence Phillips, Özgür Sancak, K D Rainsford
OBJECTIVES: To test the ability of a multicriteria decision analysis (MCDA) model to incorporate disparate data sources of varying quality along with clinical judgement in a benefit-risk assessment of six well-known pain-relief drugs. METHODS: Six over-the-counter (OTC) analgesics were evaluated against three favourable effects and eight unfavourable effects by seven experts who specialise in the relief of pain, two in a 2-day facilitated workshop whose input data and judgements were later peer-reviewed by five additional experts...
July 13, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28699815/improving-recruitment-to-healthcare-research-studies-clinician-judgements-explored-for-opting-mental-health-service-users-out-of-the-time-to-change-viewpoint-survey
#6
Vanessa Pinfold, Jessica Cotney, Sarah Hamilton, Craig Weeks, Elizabeth Corker, Sara Evans-Lacko, Diana Rose, Claire Henderson, Graham Thornicroft
BACKGROUND: There are significant challenges across the research pathway, including participant recruitment. This paper aims to explore the impact of clinician recruitment decision-making on sampling for a national mental health survey. METHOD: Clinical teams in 20 English mental healthcare provider organisations screened caseload lists, opting-out people whom, in their judgement, should not be approached to participate in a survey about stigma and discrimination...
July 12, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28697554/egocentric-versus-allocentric-spatial-memory-in-behavioral-variant-frontotemporal-dementia-and-alzheimer-s-disease
#7
Sicong Tu, Hugo J Spiers, John R Hodges, Olivier Piguet, Michael Hornberger
BACKGROUND: Diagnosis of behavioral variant frontotemporal dementia (bvFTD) can be challenging, in particular when patients present with significant memory problems, which can increase the chance of a misdiagnosis of Alzheimer's disease (AD). Growing evidence suggests spatial orientation is a reliable cognitive marker able to differentiate these two clinical syndromes. OBJECTIVE: Assess the integrity of egocentric and allocentric heading orientation and memory in bvFTD and AD, and their clinical implications...
July 1, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28691196/the-comprehensibility-of-pantomimes-produced-by-people-with-aphasia
#8
Karin van Nispen, W M E Mieke, E van de Sandt-Koenderman, Emiel Krahmer
BACKGROUND: People with aphasia (PWA) use pantomime, gesture in absence of speech, differently from non-brain-damaged people (NBDP). AIMS: To evaluate through an exploratory study the comprehensibility of PWA's pantomimes and to find out whether they can compensate for information PWA are unable to convey in speech. METHODS & PROCEDURES: A total of 273 naïve observers participated in one of two judgement tasks: forced-choice and open-ended questions...
July 10, 2017: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/28684104/acid-base-disorders-in-liver-disease
#9
REVIEW
Scheiner Bernhard, Lindner Gregor, Reiberger Thomas, Schneeweiss Bruno, Trauner Michael, Zauner Christian, Funk Georg-Christian
Next to the kidneys and lungs, the liver has been recognized as an important regulator of acid-base homeostasis. While respiratory alkalosis is the most common acid-base disorder in chronic liver disease, various complex metabolic acid-base disorders may occur with liver dysfunction. Although the standard variables of acid-base equilibrium, such as pH and overall base excess, often fail to unmask the underlying cause of acid-base disorders, the physical-chemical acid-base model allows a more in-depth pathophysiological understanding and clinical judgement of acid-base disorders in patients with liver diseases...
July 3, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28673672/electrophysiological-influence-of-temporal-occlusion-of-the-parent-artery-during-aneurysm-surgery
#10
Katsuya Komatsu, Takeshi Mikami, Rintaro Yokoyama, Yuto Suzuki, Shoichi Komura, Rei Enatsu, Shouhei Noshiro, Kei Miyata, Yukinori Akiyama, Nobuhiro Mikuni
Intraoperative monitoring of the motor evoked potential (MEP) during cerebral aneurysm surgery has been widely used to confirm surgical safety. In this study, we retrospectively analyzed the influence of the MEP amplitude resulting from temporal occlusion of the parent artery, and appropriate judgement in the surgery was discussed. Ten patients underwent temporal occlusion of the parent artery during aneurysm surgery, and five of these patients showed a decrease in the MEP amplitude following temporal arterial occlusion...
June 30, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28668586/the-art-of-preceptorship-a-qualitative-study
#11
Karina Nielsen, Jeanette Finderup, Lotte Brahe, Randi Elgaard, Anne Marie Elsborg, Vibeke Engell-Soerensen, Laila Holm, Hanne Juul, Irene Sommer
In the clinical nursing practice preceptorship is a widespread method to improve patient care by assisting nurses in developing the right clinical skills. However, little is known about how preceptorship should be practiced to achieve a positive learning outcome. The aim of the study was to investigate how preceptorship can be used in clinical practice to create learning and facilitate competence development. A qualitative study guided by a hermeneutic phenomenological approach and inspired by ethnographic fieldwork included 28 participant observations and 58 interviews...
June 21, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28664916/geriatric-assessment-is-superior-to-oncologists-clinical-judgement-in-identifying-frailty
#12
Lene Kirkhus, Jūratė Šaltytė Benth, Siri Rostoft, Bjørn Henning Grønberg, Marianne J Hjermstad, Geir Selbæk, Torgeir B Wyller, Magnus Harneshaug, Marit S Jordhøy
BACKGROUND: Frailty is a syndrome associated with increased vulnerability and an important predictor of outcomes in older cancer patients. Systematic assessments to identify frailty are seldom applied, and oncologists' ability to identify frailty is scarcely investigated. METHODS: We compared oncologists' classification of frailty (onc-frail) based on clinical judgement with a modified geriatric assessment (mGA), and investigated associations between frailty and overall survival...
June 29, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28663105/does-good-critical-thinking-equal-effective-decision-making-among-critical-care-nurses-a-cross-sectional-survey
#13
Salizar Mohamed Ludin
BACKGROUND: A critical thinker may not necessarily be a good decision-maker, but critical care nurses are expected to utilise outstanding critical thinking skills in making complex clinical judgements. Studies have shown that critical care nurses' decisions focus mainly on doing rather than reflecting. To date, the link between critical care nurses' critical thinking and decision-making has not been examined closely in Malaysia. AIM: To understand whether critical care nurses' critical thinking disposition affects their clinical decision-making skills...
June 26, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28657663/next-generation-deep-sequencing-corrects-diagnostic-pitfalls-of-traditional-molecular-approach-in-a-patient-with-prenatal-onset-of-pompe-disease
#14
Anne Chun-Hui Tsai, Yu-Wen Hung, Cary Harding, David M Koeller, Jing Wang, Lee-Jun C Wong
Pompe disease is a rare inherited metabolic disorder of glycogen metabolism caused by mutations in the GAA gene, encoding the acid α-1,4 glucosidase. Successful diagnosis of Pompe disease is achieved by clinical and biochemical evaluation followed by confirmation with DNA testing. Here, we report a male infant with a prenatal onset of cardiac symptoms and enzyme testing consistent with Pompe disease, but DNA testing by Sanger sequencing revealed no pathogenic variants. Due to the strong indication from clinical, enzymatic, and histological studies (despite the absence of molecular confirmation by traditional Sanger sequencing), enzyme replacement therapy (ERT) for Pompe disease was initiated...
June 28, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28656952/-the-clinical-and-expert-evaluation-of-the-unfavourable-consequences-of-the-provision-of-the-dental-implantation-treatment
#15
A A Gusarov, T G Popova, V A Fetisov, E Yu Kuraeva, E A Shoniya
The clinical and expert evaluation of the unfavourable consequences of the provision of the inadequate dental implantation treatment has demonstrated the ever increasing number of justified complaints and civilian lawsuits instituted annually in connection with the infringements of health associated with the poor quality of the medical care provided to the patients. The authors present the results of commission forensic medical expertise performed on account of the civilian lawsuits instituted by a 74 year-old patient K...
2017: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/28653286/user-input-in-iterative-design-for-prevention-product-development-leveraging-interdisciplinary-methods-to-optimize-effectiveness
#16
Kate M Guthrie, Rochelle K Rosen, Sara E Vargas, Melissa Guillen, Arielle L Steger, Melissa L Getz, Kelley A Smith, Jaime J Ramirez, Erna M Kojic
The development of HIV-preventive topical vaginal microbicides has been challenged by a lack of sufficient adherence in later stage clinical trials to confidently evaluate effectiveness. This dilemma has highlighted the need to integrate translational research earlier in the drug development process, essentially applying behavioral science to facilitate the advances of basic science with respect to the uptake and use of biomedical prevention technologies. In the last several years, there has been an increasing recognition that the user experience, specifically the sensory experience, as well as the role of meaning-making elicited by those sensations, may play a more substantive role than previously thought...
June 26, 2017: Drug Delivery and Translational Research
https://www.readbyqxmd.com/read/28652879/are-renal-tumour-scoring-systems-better-than-clinical-judgement-at-predicting-partial-nephrectomy-complexity
#17
Ravi M Kumar, Luke T Lavallée, Darren Desantis, Sonya Cnossen, Ranjeeta Mallick, Ilias Cagiannos, Chris Morash, Rodney H Breau
INTRODUCTION: We aimed to determine how renal tumour scoring systems, such as RENAL, PADUA, and Centrality (C)-index, compare to clinical judgement at predicting time required for tumour removal and kidney reconstruction during partial nephrectomy. METHODS: A consecutive cohort of partial nephrectomy patients treated at The Ottawa Hospital, a tertiary care uro-oncological centre, was retrospectively reviewed. Preoperative axial images were reviewed by four experienced urological oncologists who independently rated the complexity of a partial nephrectomy from 1-10 to generate a clinical judgement score...
June 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28649385/the-practice-of-tracheostomy-decannulation-a-systematic-review
#18
REVIEW
Ratender Kumar Singh, Sai Saran, Arvind K Baronia
Decannulation is an essential step towards liberating tracheostomized patients from mechanical ventilation. However, despite its perceived importance, there is no universally accepted protocol for this vital transition. Presence of an intact sensorium coordinated swallowing and protective coughing are often the minimum requirements for a successful decannulation. Objective criteria for each of these may help better the clinical judgement of decannulation. In this systematic review on decannulation, we focus attention to this important aspect of tracheostomy care...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28639296/pathways-to-professionalism-quality-improvement-care-pathways-and-the-interplay-of-standardisation-and-clinical-autonomy
#19
Graham P Martin, David Kocman, Timothy Stephens, Carol J Peden, Rupert M Pearse
Care pathways are a prominent feature of efforts to improve healthcare quality, outcomes and accountability, but sociological studies of pathways often find professional resistance to standardisation. This qualitative study examined the adoption and adaptation of a novel pathway as part of a randomised controlled trial in an unusually complex, non-linear field - emergency general surgery - by teams of surgeons and physicians in six theoretically sampled sites in the UK. We find near-universal receptivity to the concept of a pathway as a means of improving peri-operative processes and outcomes, but concern about the impact on appropriate professional judgement...
June 21, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28637090/early-warning-systems-and-rapid-response-to-the-deteriorating-patient-in-hospital-a-realist-evaluation
#20
Jennifer Mcgaughey, Peter O'Halloran, Sam Porter, John Trinder, Bronagh Blackwood
AIM: To identify those contexts and mechanisms that enable or constrain the implementation of Rapid Response Systems on acute general hospital wards to recognise and respond to patient deterioration. BACKGROUND: Rapid Response Systems allow deteriorating patients to be recognised using Early Warning Systems, referred early via escalation protocols and managed at the bedside by competent staff. DESIGN: Realist Evaluation. METHODS: The research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland which followed the principles of Realist Evaluation...
June 21, 2017: Journal of Advanced Nursing
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