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https://www.readbyqxmd.com/read/28431197/serum-c-reactive-protein-procalcitonin-and-lactate-dehydrogenase-for-the-diagnosis-of-pancreatic-necrosis
#1
REVIEW
Oluyemi Komolafe, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: The treatment of people with pancreatic necrosis differs from that of people with oedematous pancreatitis. It is important to know the diagnostic accuracy of serum C-reactive protein (CRP), serum procalcitonin, and serum lactate dehydrogenase (LDH) as a triage test for the detection of pancreatic necrosis in people with acute pancreatitis, so that an informed decision can be made as to whether the person with pancreatic necrosis needs further investigations such as computed tomography (CT) scan or magnetic resonance imaging (MRI) scan and treatment for pancreatic necrosis started...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28429560/is-there-a-role-for-newer-biomarkers-in-chronic-kidney-disease-mineral-and-bone-disorder-management
#2
Sven-Jean Tan, Michael Mx Cai
The current management of Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD) relies largely on clinical judgement and assessment of biochemical parameters including serum calcium, phosphate and intact parathyroid hormone concentrations. In the past two decades, there has been a leap in the understanding of the pathophysiology of CKD-MBD, leading to the discovery of novel biomarkers. The potential utility of these markers in this clinical setting is an area of intense investigation. In the absence of any guidelines aiding the clinician's understanding and application of these markers, we summarise the current available literature surrounding fibroblast growth factor-23, α-Klotho, sclerostin and serum calcification propensity testing and their respective assays in the context of CKD-MBD management...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429555/management-of-mineral-and-bone-disorders-in-renal-transplant-recipients
#3
Matthew J Damasiewicz, Peter R Ebeling
The management of post-transplantation bone disease is a complex problem that remains under-appreciated in clinical practice. In these patients, pre-existing metabolic bone disorder is further impacted by the use of immunosuppressive medications (glucocorticoids and calcineurin-inhibitors), variable post-transplantation renal allograft function and post-transplantation diabetes mellitus. The treatment of post-transplantation bone loss should begin pre-transplantation. All patients active on transplant waiting lists should be screened for bone disease...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28427496/mortality-risk-factors-in-intensive-care-unit-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-a-retrospective-cohort-study%C3%A2
#4
Michael Schmitz, Frank P Tillmann, Ausra Paluckaite, Erich A Laufer, Brian Rayner, Lars C Rump, Peter J Heering
BACKGROUND: Mortality of critically-ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) in an intensive-care setting continues to remain high. There is still uncertainty as to which factors should guide clinical judgement. METHODS: A cohort of 155 patients admitted to an intensive-care unit and necessitating RRT due to AKI were retrospectively analyzed. Demographic and clinical parameters at the time of RRT initiation were retrieved...
April 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28407997/the-diagnosis-of-urinary-tract-infection-in-young-children-duty-study-clinical-rule-economic-evaluation
#5
MULTICENTER STUDY
William Hollingworth, John Busby, Christopher C Butler, Kathryn O'Brien, Jonathan A C Sterne, Kerenza Hood, Paul Little, Michael Lawton, Kate Birnie, Emma Thomas-Jones, Kim Harman, Alastair D Hay
OBJECTIVE: To estimate the cost-effectiveness of a two-step clinical rule using symptoms, signs and dipstick testing to guide the diagnosis and antibiotic treatment of urinary tract infection (UTI) in acutely unwell young children presenting to primary care. METHODS: Decision analytic model synthesising data from a multicentre, prospective cohort study (DUTY) and the wider literature to estimate the short-term and lifetime costs and healthcare outcomes (symptomatic days, recurrent UTI, quality adjusted life years) of eight diagnostic strategies...
April 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28406719/structured-expert-consensus-on-actinic-keratosis-treatment-algorithm-focusing-on-daylight-pdt
#6
Piergiacomo Calzavara-Pinton, Merete Hædersdal, Kirk Barber, Nicole Basset-Seguin, María Emilia Del Pino Flores, Peter Foley, Gaston Galimberti, Rianne Gerritsen, Yolanda Gilarbete, Sally Ibbotson, Ketty Peris, Sheetal Sapra, Eleni Sotiriou, Luis Torezan, Claas Ulrich, Jonathan Guillemot, Janek Hendrich, Rolf-Markus Szeimies
BACKGROUND: A practical and up-to-date consensus among experts is paramount to further improve patient care in actinic keratosis (AK). OBJECTIVES: To develop a structured consensus statement on the diagnosis, classification, and practical management of AK based on up-to-date information. METHODS: A systematic review of AK clinical guidelines was conducted. This informed the preparation of a 3-round Delphi procedure followed by a consensus meeting, which combined the opinions of 16 clinical experts from 13 countries, to construct a structured consensus statement and a treatment algorithm positioning daylight photodynamic therapy (dl-PDT) among other AK treatment options...
April 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28406548/dentists-use-of-validated-child-dental-anxiety-measures-in-clinical-practice-a-mixed-methods-study
#7
Hussain Alshammasi, Heather Buchanan, Paul Ashley
BACKGROUND: Assessing anxiety is an important part of the assessment of a child presenting for dental treatment; however, the use of dental anxiety scales in practice is not well-documented. AIMS: To introduce child dental anxiety scales, and to monitor the extent to which dentists used them; to explore the experience and views of dentists regarding anxiety assessment. DESIGN: A mixed-methods design was employed. METHOD: A protocol for child anxiety assessment was introduced to paediatric dentists in Eastman Dental Hospital...
April 12, 2017: International Journal of Paediatric Dentistry
https://www.readbyqxmd.com/read/28405783/how-do-clinical-genetics-consent-forms-address-the-familial-approach-to-confidentiality-and-incidental-findings-a-mixed-methods-study
#8
Sandi Dheensa, Gillian Crawford, Claire Salter, Michael Parker, Angela Fenwick, Anneke Lucassen
Genetic test results can be relevant to patients and their relatives. Questions thus arise around whether clinicians regard genetic information as confidential to individuals or to families, and about how they broach this and other issues, including the potential for incidental findings, in consent (forms) for genetic testing. We conducted a content analysis of UK-wide genetic testing consent forms and interviewed 128 clinicians/laboratory scientists. We found that almost all genetic services offered patients multiple, sometimes unworkable, choices on forms, including an option to veto the use of familial genetic information to benefit relatives...
April 12, 2017: Familial Cancer
https://www.readbyqxmd.com/read/28401708/how-veterans-health-administration-suicide-prevention-coordinators-assess-suicide-risk
#9
James L Pease, Jeri E Forster, Collin L Davidson, Brooke Dorsey Holliman, Emma Genco, Lisa A Brenner
This cross-sectional study was designed to examine the suicide risk assessment practices of Suicide Prevention Coordinators (SPCs) within the Veterans Health Administration. Specifically, this study sought to (1) identify factors SPCs consider most important in assessing risk and patient priority; (2) measure the level of consistency and agreement between SPCs in assessing suicide risk and prioritizing cases; and (3) measure individual SPC consistency between cases. SPCs (n = 63) responded to online survey questions about imminent and prolonged risk for suicide in response to 30 fictional vignettes...
March 2017: Clinical Psychology & Psychotherapy
https://www.readbyqxmd.com/read/28401657/validation-of-a-modified-early-warning-score-linked-situation-background-assessment-recommendation-sbar-communication-tool-a-mixed-methods-study
#10
Debora Burger, Sue Jordan, Una Kyriacos
AIMS AND OBJECTIVES: The objective of this study was to develop and validate a modified Situation-Background-Assessment-Recommendation communication tool incorporating components of the Cape Town Modified Early Warning Score vital signs chart for reporting early signs of clinical deterioration. BACKGROUND: Reporting early signs of physiological and clinical deterioration could prevent 'failure to rescue' or unexpected intensive care admission, cardiac arrest or death...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28393426/the-neuropsychology-of-delirium-advancing-the-science-of-delirium-assessment
#11
Zoë Tieges, Jonathan J Evans, Karin J Neufeld, Alasdair M J MacLullich
OBJECTIVE: The diagnosis of delirium depends on eliciting its features through mental status examination and informant history. However, there is marked heterogeneity in how these features are assessed, from binary subjective clinical judgement to more comprehensive methods supported by cognitive testing. The aim of this article is to review the neuropsychological research in delirium and suggest future directions in research and clinical practice. METHODS: We reviewed the neuropsychological literature on formal assessment and quantification of the different domains in delirium, focusing on the core feature of inattention...
April 9, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28388258/cognitive-continuum-theory-in-interprofessional-healthcare-a-critical-analysis
#12
Michelle Parker-Tomlin, Mark Boschen, Shirley Morrissey, Ian Glendon
Effective clinical decision making is among the most important skills required by healthcare practitioners. Making sound decisions while working collaboratively in interprofessional healthcare teams is essential for modern healthcare planning, successful interventions, and patient care. The cognitive continuum theory (CCT) is a model of human judgement and decision making aimed at orienting decision-making processes. CCT has the potential to improve both individual health practitioner, and interprofessional team understanding about, and communication of, clinical decision-making processes...
April 7, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28369712/computerized-data-driven-interpretation-of-the-intrapartum-cardiotocogram-a-cohort-study
#13
Antoniya Georgieva, Christopher W G Redman, Aris T Papageorghiou
Continuous intrapartum fetal monitoring remains a significant clinical challenge. We propose utilising cohorts of routinely collected data. We aim to combine non-classical (data-driven) and classical cardiotocography (CTG) features with clinical features into a system (OxSys), which generates automated alarms for the fetus at risk of intrapartum hypoxia. We hypothesise that OxSys can outperform clinical diagnosis of 'fetal distress', when optimised and tested over large retrospective datasets MATERIAL AND METHODS: We studied a cohort of 22,790 labouring women (≥36 weeks gestation)...
March 28, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28369456/pediatric-consultations-negative-word-use-and-parent-satisfaction
#14
Marco Gemmiti, Selei Hamed, Johannes Wildhaber, Cosette Pharisa, Petra L Klumb
This study investigates the impact of pediatricians' negative-word use on parents' affective quality and satisfaction judgements during the medical encounter.  In total, 68 medical consultations were videotaped and pediatricians' communication transcribed for analysis. We used the Linguistic Inquiry and Word Count application to measure the amount of negative words used by the pediatrician. Parents rated their momentary mood as well as their satisfaction at the end of the encounter.  Pediatricians' negative-word use was negatively linked to parents' affect quality, but not with the satisfaction ratings after the medical visit...
March 21, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28338533/sepsis-patients-in-the-emergency-department-stratification-using-the-clinical-impression-score-predisposition-infection-response-and-organ-dysfunction-score-or-quick-sequential-organ-failure-assessment-score
#15
Vincent M Quinten, Matijs van Meurs, Anna E Wolffensperger, Jan C Ter Maaten, Jack J M Ligtenberg
OBJECTIVE: The aim of this study was to compare the stratification of sepsis patients in the emergency department (ED) for ICU admission and mortality using the Predisposition, Infection, Response and Organ dysfunction (PIRO) and quick Sequential Organ Failure Assessment (qSOFA) scores with clinical judgement assessed by the ED staff. PATIENTS AND METHODS: This was a prospective observational study in the ED of a tertiary care teaching hospital. Adult nontrauma patients with suspected infection and at least two Systemic Inflammatory Response Syndrome criteria were included...
March 23, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28331972/safe-sleeping-positions-practice-and-policy-for-babies-with-cleft-palate
#16
Karen Davies, Iain A Bruce, Patricia Bannister, Peter Callery
Guidance recommends 'back to sleep' positioning for infants from birth in order to reduce the risk of sudden infant death. Exceptions have been made for babies with severe respiratory difficulties where lateral positioning may be recommended, although uncertainty exists for other conditions affecting the upper airway structures, such as cleft palate. This paper presents research of (i) current advice on sleep positioning provided to parents of infants with cleft palate in the UK; and (ii) decision making by clinical nurse specialists when advising parents of infants with cleft palate...
March 22, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28329417/nursing-judgement-and-decision-making-using-the-sedation-withdrawal-score-sws-in-children
#17
Jennie Craske, Bernie Carter, Ian H Jarman, Lyvonne N Tume
AIMS: The aim of the study was to evaluate registered children's nurses' approaches to the assessment and management of withdrawal syndrome in children. BACKGROUND: Assessment of withdrawal syndrome is undertaken following critical illness when the child's condition may be unstable with competing differential diagnoses. Assessment tools aim to standardise and improve recognition of withdrawal syndrome. Making the right decisions in complex clinical situations requires a degree of mental effort and it is not known how nurses make decisions when undertaking withdrawal assessments...
March 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28316930/transudative-pleural-effusion-of-malignant-etiology-rare-but-real
#18
Lindsey Johnson, Hafiz Abdul Moiz Fakih, Salim Daouk, Shaheera Saleem, Ali Ataya
A 62-year-old female presented to the emergency room with one-month history of epigastric abdominal pain, nausea and vomiting. She endorsed progressive dyspnea over two weeks. CT of the abdomen demonstrated bilateral pleural effusions and pancreatic inflammation, so the working diagnosis was pancreatitis. A diagnostic thoracentesis was performed and the pleural fluid analysis was classified as transudate by Light's criteria. Given the atypical features in history and concern for malignancy, fluid was sent for cytological examination and immunohistochemistry which suggested a mucinous malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28306586/voice-outcomes-post-total-laryngectomy
#19
Anne Hurren, Nick Miller
PURPOSE OF REVIEW: A consensus and body of robust evidence has developed regarding optimal laryngeal voice outcome measures. This contrasts with a lack of clarity for equivalent assessments in alaryngeal voice. Addressing this situation would enable clinicians to select the best tools currently available to facilitate research, audit and clinical practice. This is important because of the limited knowledge regarding the optimal surgical or reconstruction techniques and rehabilitation regimes for the laryngectomy population...
March 16, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28303438/using-health-technology-assessment-to-assess-the-value-of-new-medicines-results-of-a-systematic-review-and-expert-consultation-across-eight-european-countries
#20
Aris Angelis, Ansgar Lange, Panos Kanavos
BACKGROUND: Although health technology assessment (HTA) systems base their decision making process either on economic evaluations or comparative clinical benefit assessment, a central aim of recent approaches to value measurement, including value based assessment and pricing, points towards the incorporation of supplementary evidence and criteria that capture additional dimensions of value. OBJECTIVE: To study the practices, processes and policies of value-assessment for new medicines across eight European countries and the role of HTA beyond economic evaluation and clinical benefit assessment...
March 16, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
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