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Clinical practice

Emilie M Flament, Keith R Berend, Jason M Hurst, Michael J Morris, Joanne B Adams, Adolph V Lombardi
BACKGROUND: In past decades, polyethylene wear was a major cause of failure in total knee arthroplasty (TKA). Polyethylene for use in arthroplasty has been vastly improved in recent years, with improved materials as well as manufacturing and sterilization processes. Testing has shown that infusion of vitamin E prevents oxidative degradation of polyethylene without remelting, allowing the material to maintain mechanical properties and wear resistance over time. The purpose of this study is to review the early result of patients undergoing primary TKA with vitamin E antioxidant-infused polyethylene inserts...
October 26, 2016: Surgical Technology International
David Misdrahi, Arnaud Tessier, Joel Swendsen, Fabrice Berna, Lore Brunel, Delphine Capdevielle, Isabelle Chereau, Jean-Marie Danion, Marie De Pradier, Jean-Michel Dorey, Caroline Dubertret, Julien Dubreucq, Catherine Faget, Franck Gabayet, Romain Rey, Raphaelle Richieri, Christine Passerieux, Aurélie Schandrin, Franck Schurhoff, Anne Marie Tronche, Mathieu Urbach, Pierre Michel Llorca, Guillaume Fond
OBJECTIVE: Medication nonadherence is one of the most important, and potentially modifiable, prognostic factors in the outcome of patients with schizophrenia. The aim of this article is to propose a new classification of adherence profiles according to the Medication Adherence Rating Scale (MARS) in a large community-dwelling sample of French patients with schizophrenia to provide a new tool to help clinicians in daily practice. METHODS: 319 community-dwelling patients from a national network of 10 Schizophrenia Expert Centers were interviewed between January 2009 and January 2014...
September 2016: Journal of Clinical Psychiatry
Sarah B Bateni, Frederick J Meyers, Richard J Bold, Robert J Canter
BACKGROUND: The impact of surgery on end of life care for patients with disseminated malignancy (DMa) is incompletely characterized. The purpose of this study was to evaluate postoperative outcomes impacting quality of care among DMa patients, specifically prolonged length of hospital stay, readmission, and disposition. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for years 2011-2012. DMa patients were matched to non-DMa patients with comparable clinical characteristics and operation types...
2016: PloS One
Mindi Zhao, Jianqiang Wu, Youhe Gao
Urine, reflecting many changes in the body, is a better source than blood for biomarker discovery. However, even under physiological conditions, the urine proteome often varies. Understanding how various regulating factors affect urine proteome helps link changes to urine proteome with urinary biomarkers of physiological conditions as well as corresponding diseases. To evaluate the possible impact of α1-adrenergic receptor on urine proteome, this study investigated effects of the specific inhibitor prazosin on the urine proteome in a rat model by using tandem mass tagging and two-dimensional liquid chromatography-tandem mass spectrometry...
2016: PloS One
Shuo Zhang, Xuelei Ma, Chenjing Zhu, Li Liu, Guoping Wang, Xia Yuan
Targeting immune cells or factors are effective for patients with solid tumors. Myeloid-derived suppressor cells (MDSCs) are known to have immunosuppressive functions, and the levels of MDSCs in patients with solid tumor are assumed to have prognostic values. This meta-analysis aimed at evaluating the relationship between MDSCs and the prognosis of patients with solid tumors. We searched articles in PUBMED and EMBASE comprehensively, updated to March 2016. Eight studies with 442 patients were included in the meta-analysis...
2016: PloS One
Chiung-Ying Huang, Szu-Ying Lee, Chung-Wei Yang, Szu-Chun Hung, Chih-Kang Chiang, Jenq-Wen Huang, Kuan-Yu Hung
BACKGROUND: Low lean body mass (LBM) is an indicator of malnutrition inflammation syndrome, which is common in hemodialysis (HD) patients. The creatinine index (CI) has been validated as a reliable method to estimate LBM and evaluate the protein-energy status of HD patients. However, the traditional creatinine index formula was complex. We sought to investigate the impact of CI derived from a new simple formula on Chinese HD patient outcomes. METHODS: In this retrospective cohort study, we enrolled 1269 patients who initiated HD between February 1981 and February 2012 and followed them until the end of February 2013...
2016: PloS One
Michelle T Nguyen, Laurence B McCullough, Frank A Chervenak
In obstetric practice, each pregnant woman presents with a composite of maternal and fetal characteristics that can alter the risk of significant harm without cesarean intervention. The hospital's availability of resources and the obstetrician's training, experience, and skill level can also alter the risk of significant harm without cesarean intervention. This paper proposes a clinical ethical framework that takes these clinical and organizational factors into account, to promote a deliberative rather than simplistic approach to decision-making and counseling about cesarean delivery...
October 25, 2016: Journal of Perinatal Medicine
Jessica S Dalley, Patricia R Creary, Tiffany Durzi, C Meghan McMurtry
Although there are existing guidelines for teaching and learning skillful client communication, there remains a need to integrate a developmental focus into veterinary medical curricula to prepare students for interactions with children who accompany their companion animals. The objectives of this Teaching Tip are (1) to describe the use of a Teddy Bear Clinic Tour as an innovative, applied practice method for teaching veterinary students about clinical communication with children, and (2) to provide accompanying resources to enable use of this method to teach clinical communication at other facilities...
October 25, 2016: Journal of Veterinary Medical Education
David T Huang, Derek C Angus, Marc Moss, B Taylor Thompson, Niall D Ferguson, Adit Ginde, Michelle Ng Gong, Stephanie Gundel, Douglas L Hayden, R Duncan Hite, Peter C Hou, Catherine L Hough, Theodore J Iwashyna, Kathleen D Liu, Daniel S Talmor, Donald M Yealy
The Reevaluation Of Systemic Early neuromuscular blockade trial (ROSE) is a multicenter randomized trial designed to assess the efficacy and safety of early neuromuscular blockade in patients with moderate to severe acute respiratory distress syndrome. This document provides background for interpretation of the trial results, and highlights unique design approaches that may inform future trials of acute illness. We describe the process by which ROSE was chosen as the inaugural trial of the multidisciplinary Prevention and Early Treatment of Acute Lung Injury (PETAL) Network, provide the trial methodology using the Consolidated Standards of Reporting Trials (CONSORT) framework, and discuss key design challenges and their resolution...
October 25, 2016: Annals of the American Thoracic Society
Carolyn Talbott, Lynn Watson, Joseph Tariman, Matthew Sorenson
AIMS AND OBJECTIVES: The purpose of this study was to assess the acceptability and usability of a standardized communication tool for nurses. BACKGROUND AND SIGNIFICANCE: Communication is key in healthcare. On a daily, if not hourly, basis, nursing staff is inundated with new information regarding tools and resources, practice changes and the work environment. However, there is currently no standardized messaging or delivery method to effectively communicate new information...
October 25, 2016: Journal of Clinical Nursing
Barbara Farquharson, Marie Johnston, Karen Smith, Brian Williams, Shaun Treweek, Stephan U Dombrowski, Nadine Dougall, Purva Abhyankar
AIMS: To evaluate the efficacy of a behaviour change technique-based intervention and compare two possible modes of delivery (text+visual and text-only) with usual care. BACKGROUND: Patient delay prevents many people from achieving optimal benefit of time-dependent treatments for Acute Coronary Syndrome. Reducing delay would reduce mortality and morbidity, but interventions to change behaviour have had mixed results. Systematic inclusion of behaviour change techniques or a visual mode of delivery might improve the efficacy of interventions...
October 25, 2016: Journal of Advanced Nursing
Marília Silveira de Almeida Campos, Lorena Rocha Ayres, Manuela Roque Siane Morelo, Fabiana Angelo Marques, Leonardo Régis Leira Pereira
Several newer antiepileptic drugs (AEDs) have been introduced into clinical practice, offering choices for individualizing the treatment of epilepsy since AEDs have different efficacy and tolerability profiles. In particular, questions exist regarding which AEDs are the best options for the monotherapy of focal epilepsy. Is carbamazepine (CBZ), which is considered the standard treatment for focal epilepsy, still the best option for monotherapy of focal epilepsy, despite the emergence of new AEDs? In this systematic review, we compared the relative tolerability of all available AEDs for monotherapy of all types of epilepsy as well as their efficacy in the monotherapy of focal epilepsy...
October 25, 2016: Pharmacotherapy
Eva Vidomanova, Peter Racay, Ivana Pilchova, Erika Halasova, Jozef Hatok
Glioblastoma (GB) is the most frequent and biologically the most aggressive primary brain tumor in adults. Standard treatment for newly diagnosed GB consists of surgical resection, radiotherapy and chemotherapy. Resistance to therapy is a major obstacle, even with optimal treatment with a survival median of only 12-15 months. The heterogeneity and treatment response of GB makes this tumor type a challenging area of research. The aim of our study was to study the response of normal human astrocyte (HA) and human GB (T98G) cell lines to apoptosis inhibitors in vitro...
October 21, 2016: Oncology Reports
Mara A McAdams-DeMarco, Hao Ying, Israel Olorundare, Elizabeth A King, Christine Haugen, Brian Buta, Alden L Gross, Rita Kalyani, Niraj M Desai, Nabil N Dagher, Bonnie E Lonze, Robert A Montgomery, Karen Bandeen-Roche, Jeremy D Walston, Dorry L Segev
BACKGROUND: Frailty increases early hospital readmission and mortality risk among kidney transplant (KT) recipients. While frailty represents a high-risk state for this population, the correlates of frailty, the patterns of the 5 frailty components, and the risk associated with these patterns are unclear. METHODS: 663 KT recipients were enrolled in a cohort study of frailty in transplantation (12/2008-8/2015). Frailty, ADL/IADL disability, CESD depression, education, and HRQOL were measured...
October 25, 2016: Transplantation
Chad A Bousman, Daniel J Müller, Chee H Ng, Keith Byron, Michael Berk, Ajeet B Singh
BACKGROUND: Pharmacogenetic-based dosing support tools have been developed to personalize antidepressant-prescribing practice. However, the clinical validity of these tools has not been adequately tested, particularly for specific antidepressants. OBJECTIVE: To examine the concordance between the actual dose and a polygene pharmacogenetic predicted dose of desvenlafaxine needed to achieve symptom remission. MATERIALS AND METHODS: A 10-week, open-label, prospective trial of desvenlafaxine among Caucasian adults with major depressive disorder (n=119) was conducted...
October 24, 2016: Pharmacogenetics and Genomics
Jayanth Sridhar, Yoshihiro Yonekawa, Ajay E Kuriyan, Anthony Joseph, Benjamin J Thomas, Michelle C Liang, Nadim Rayess, Nidhi Relhan, Jeremy D Wolfe, Chirag P Shah, Andre J Witkin, Harry W Flynn, Sunir J Garg
PURPOSE: To report the clinical presentation, microbiologic spectrum, and visual outcomes associated with acute-onset infectious endophthalmitis undergoing therapeutic pars plana vitrectomy. METHODS: Multicenter interventional retrospective noncomparative consecutive case series. Billing records were reviewed to identify all charts for patients undergoing pars plana vitrectomy within 14 days of diagnosis of acute-onset infectious endophthalmitis over a 4-year period at 5 large tertiary referral retina practices...
October 21, 2016: Retina
Han Wang, Huiqin Gao, Tianyu Jiao, Zhongli Luo
Postural instability and gait disturbance (PIGD) are common symptoms in patients with advanced Parkinson's disease (PD). The deep-brain stimulation (DBS) of the pedunculopontine nucleus (PPN) shows a promising effect on PIGD. However, the quantitative effects of PPN DBS for PD, especially for PIGD, and the efficacy of PPN DBS combined with levodopa are controversial and ambiguous to clinical practice. We carried out a meta-analysis of original researches on PPN to PIGD/PD from the electronic databases MEDLINE and EMBASE...
October 24, 2016: Neuroreport
Cheryl Fisher, Georgie Cusack, Kim Cox, Kathryn Feigenbaum, Gwenyth R Wallen
Organizations must ensure that nursing care delivery is based on best evidence. This article describes how a clinical research hospital used a competency-based approach to structure the development and execution of a strategic plan and integrated evidence-based practice concepts into the activities of nurses at all levels. The article will also describe the process for developing and implementing the competency across our department including outcomes achieved.
November 2016: Journal of Nursing Administration
Ga-Young Choi, Eun Koh, Sam Choi, Ji-Young Cho
This study examines the breast cancer screening behaviors of Korean American women focusing on their cultural beliefs and access to health care. A total of 111 Korean American women participated in the cross-sectional survey research. Korean American women who felt embarrassed about breast cancer screenings were less likely to have received clinical breast exams or mammograms. Implications to culturally competent social work practice in promoting their breast cancer screening behaviors are discussed.
October 25, 2016: Social Work in Health Care
Yu Karpov, N Logunova, D Tomilova, V Buza, Yu Khomitskaya
OBJECTIVE: The OPTIMA II study sought to evaluate rates of major adverse cardiac and cerebrovascular events (MACCE) during the long-term follow-up of chronic statin users who underwent percutaneous coronary intervention (PCI) with implantation of a drug-eluting stent (DES). RESEARCH DESIGN AND METHODS: OPTIMA II was a non-interventional, observational study conducted at a single center in the Russian Federation. Included patients were aged ≥18 years with stable angina who had received long-term (≥1 month) statin therapy prior to elective PCI with DES implantation and who had participated in the original OPTIMA study...
October 25, 2016: Current Medical Research and Opinion
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