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rational clinical examination systematic review

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https://www.readbyqxmd.com/read/29136449/does-this-patient-have-acute-mountain-sickness-the-rational-clinical-examination-systematic-review
#1
REVIEW
David Meier, Tinh-Hai Collet, Isabella Locatelli, Jacques Cornuz, Bengt Kayser, David L Simel, Claudio Sartori
Importance: Acute mountain sickness (AMS) affects more than 25% of individuals ascending to 3500 m (11 500 ft) and more than 50% of those above 6000 m (19 700 ft). AMS may progress from nonspecific symptoms to life-threatening high-altitude cerebral edema in less than 1% of patients. It is not clear how to best diagnose AMS. Objective: To systematically review studies assessing the accuracy of AMS diagnostic instruments, including the visual analog scale (VAS) score, which quantifies the overall feeling of sickness at altitude (VAS[O]; various thresholds), Acute Mountain Sickness-Cerebral score (AMS-C; ≥0...
November 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28932912/behavioral-cognitive-and-emotional-coping-strategies-of-women-with-endometriosis-a-critical-narrative-review
#2
REVIEW
Cristina Zarbo, Agostino Brugnera, Luigi Frigerio, Chiara Malandrino, Massimo Rabboni, Emi Bondi, Angelo Compare
Endometriosis is a disabling and long-term medical condition affecting quality of life and mental health. Behavioral, cognitive, and emotional coping strategies, emotional intelligence, and metacognition could in part explain the link between the disease and impaired psychological and life functioning. This critical narrative review aimed at examining the state of the art of the relationships between endometriosis and these factors. According to PRISMA principles, we performed a systematic search for quantitative and qualitative studies on multiple electronic databases as regards coping strategies, emotional intelligence, and metacognition in women with endometriosis...
September 21, 2017: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/28911247/metabolic-pathways-and-pharmacokinetics-of-natural-medicines-with-low-permeability
#3
Mei Zeng, Lan Yang, Dan He, Yao Li, Mingxin Shi, Jingqing Zhang
Drug metabolism plays an important role in the drug disposal process. Differences in pharmacokinetics among individuals are the basis for personalized medicine. Natural medicines, formed by long-term evolution of nature, prioritize the action of a target protein with a drug. Natural medicines are valued for structural diversity, low toxicity, low cost, and definite biological activities. Metabolic pathway and pharmacokinetic research of natural medicines is highly beneficial for clinical dose adjustment and the development of personalized medicine...
September 14, 2017: Drug Metabolism Reviews
https://www.readbyqxmd.com/read/28763554/does-this-child-have-pneumonia-the-rational-clinical-examination-systematic-review
#4
REVIEW
Sonal N Shah, Richard G Bachur, David L Simel, Mark I Neuman
Importance: Pneumonia is a leading cause of morbidity and mortality in children. It is important to identify the clinical symptoms and physical examination findings associated with pneumonia to improve timely diagnosis, prevent significant morbidity, and limit antibiotic overuse. Objective: To systematically review the accuracy of symptoms and physical examination findings in identifying children with radiographic pneumonia. Data Sources and Study Selection: MEDLINE and Embase (1956 to May 2017) were searched, along with reference lists from retrieved articles, to identify diagnostic studies of pediatric pneumonia across a broad age range that had to include children younger than age 5 years (although some studies enrolled children up to age 19 years); 3644 unique articles were identified, of which 23 met inclusion criteria...
August 1, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28532673/-neuraxial-anesthesia-in-patients-with-multiple-sclerosis-a-systematic-review
#5
Helmar Bornemann-Cimenti, Nikki Sivro, Frederike Toft, Larissa Halb, Andreas Sandner-Kiesling
BACKGROUND AND OBJECTIVES: Current guidelines for neuraxial analgesia in patients with multiple sclerosis are ambiguous and offer the clinician only a limited basis for decision making. This systematic review examines the number of cases in which multiple sclerosis has been exacerbated after central neuraxial analgesia in order to rationally evaluate the safety of these procedures. METHODS: A systematic literature search with the keywords "anesthesia or analgesia" and "epidural, peridural, caudal, spinal, subarachnoid or intrathecal" in combination with "multiple sclerosis" was performed in the databases PubMed and Embase, looking for clinical data on the effect of central neuraxial analgesia on the course of multiple sclerosis...
July 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28512731/active-surveillance-for-prostate-cancer-how-to-do-it-right
#6
REVIEW
Juan D Garisto, Laurence Klotz
Prostate cancer is the most common malignancy affecting men. There has been a nearly 70% increase in new prostate cancer cases, mostly classified as low risk, that have been diagnosed in early stages as a consequence of prostate-specific antigen (PSA) screening. Data regarding the natural history of this disease confirm the clinical insignificance of low-grade prostate cancer, which is associated with scant or no metastatic dissemination. Active surveillance is a conservative management approach, conducted for those patients with "low-risk" or "favorable-risk" disease, which avoids long-term adverse effects on the patient's quality of life...
May 15, 2017: Oncology (Williston Park, NY)
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
#7
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
https://www.readbyqxmd.com/read/27697136/childhood-depressive-disorders
#8
REVIEW
Rikke Thaarup Wesselhöft
Major depressive disorder (MDD) is a frequent and painful mental disorder considered among the five leading causes of disability in Western countries by the World Health Organization. MDD occurs at all ages, but childhood onset MDD has a more severe course with longer depressive episodes, more suicidality, and more frequent hospitalization, than later onset MDD. Childhood seems to be a window of opportunity for prevention of mental disorders, and subsequently prevention of MDD onset in childhood is recommended...
October 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27328966/economic-evidence-for-the-clinical-management-of-major-depressive-disorder-a-systematic-review-and-quality-appraisal-of-economic-evaluations-alongside-randomised-controlled-trials
#9
E Karyotaki, D Tordrup, C Buntrock, R Bertollini, P Cuijpers
AIMS: The aim of this systematic review of economic evaluations alongside randomised controlled trials (RCTs) was to provide a comprehensive overview of the evidence concerning cost-effectiveness analyses of common treatment options for major depression. METHODS: An existing database was used to identify studies reporting cost-effectiveness results from RCTs. This database has been developed by a systematic literature search in the bibliographic databases of PubMed, PsychINFO, Embase and Cochrane library from database inception to December 2014...
June 22, 2016: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/27171243/role-of-old-antimicrobial-agents-in-the-management-of-urinary-tract-infection
#10
REVIEW
Noha El Sakka, Ian M Gould
INTRODUCTION: Urinary tract infection (UTI) is a common infection worldwide. The increase in multidrug resistance together with the paucity of new antibiotics highlights the need for alternative antimicrobials for management of UTI. Among which are older antimicrobials that had been used in the past and now were stopped. AREAS COVERED: In this article, we examine the evidence in literature for the value of use of various antimicrobial agents in UTI. We conducted systematic Pubmed search and journal literature review including early research work on older agents addressed in relation to recent clinical data...
August 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27115266/does-this-patient-have-infectious-mononucleosis-the-rational-clinical-examination-systematic-review
#11
REVIEW
Mark H Ebell, Marlene Call, JoAnna Shinholser, Jack Gardner
IMPORTANCE: Early, accurate diagnosis of infectious mononucleosis can help clinicians target treatment, avoid antibiotics, and provide an accurate prognosis. OBJECTIVE: To systematically review the literature regarding the value of the clinical examination and white blood cell count for the diagnosis of mononucleosis. DATA SOURCES: The databases of PubMed (from 1966-2016) and EMBASE (from 1947-2015) were searched and a total of 670 articles and abstracts were reviewed for eligibility...
April 12, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26717031/will-neuroimaging-reveal-a-severe-intracranial-injury-in-this-adult-with-minor-head-trauma-the-rational-clinical-examination-systematic-review
#12
REVIEW
Joshua S Easter, Jason S Haukoos, William P Meehan, Victor Novack, Jonathan A Edlow
IMPORTANCE: Adults with apparently minor head trauma (Glasgow Coma Scale [GCS] scores ≥13 who appear well on examination) may have severe intracranial injuries requiring prompt intervention. Findings from clinical examination can aid in determining which adults with minor trauma have severe intracranial injuries visible on computed tomography (CT). OBJECTIVE: To assess systematically the accuracy of symptoms and signs in adults with minor head trauma in order to identify those with severe intracranial injuries...
December 22, 2015: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26601235/nanodiamonds-the-intersection-of-nanotechnology-drug-development-and-personalized-medicine
#13
REVIEW
Dean Ho, Chung-Huei Katherine Wang, Edward Kai-Hua Chow
The implementation of nanomedicine in cellular, preclinical, and clinical studies has led to exciting advances ranging from fundamental to translational, particularly in the field of cancer. Many of the current barriers in cancer treatment are being successfully addressed using nanotechnology-modified compounds. These barriers include drug resistance leading to suboptimal intratumoral retention, poor circulation times resulting in decreased efficacy, and off-target toxicity, among others. The first clinical nanomedicine advances to overcome these issues were based on monotherapy, where small-molecule and nucleic acid delivery demonstrated substantial improvements over unmodified drug administration...
August 2015: Science Advances
https://www.readbyqxmd.com/read/26547467/does-this-patient-with-chest-pain-have-acute-coronary-syndrome-the-rational-clinical-examination-systematic-review
#14
REVIEW
Alexander C Fanaroff, Jennifer A Rymer, Sarah A Goldstein, David L Simel, L Kristin Newby
IMPORTANCE: About 10% of patients with acute chest pain are ultimately diagnosed with acute coronary syndrome (ACS). Early, accurate estimation of the probability of ACS in these patients using the clinical examination could prevent many hospital admissions among low-risk patients and ensure that high-risk patients are promptly treated. OBJECTIVE: To review systematically the accuracy of the initial history, physical examination, electrocardiogram, and risk scores incorporating these elements with the first cardiac-specific troponin...
November 10, 2015: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26241601/does-this-patient-have-posttraumatic-stress-disorder-rational-clinical-examination-systematic-review
#15
REVIEW
Michele R Spoont, John W Williams, Shannon Kehle-Forbes, Jason A Nieuwsma, Monica C Mann-Wrobel, Raz Gross
IMPORTANCE: Posttraumatic stress disorder (PTSD) is a relatively common mental health condition frequently seen, though often unrecognized, in primary care settings. Identifying and treating PTSD can greatly improve patient health and well-being. OBJECTIVE: To systematically review the utility of self-report screening instruments for PTSD among primary care and high-risk populations. EVIDENCE REVIEW: We searched MEDLINE and the National Center for PTSD's Published International Literature on Traumatic Stress (PILOTS) databases for articles published on screening instruments for PTSD published from January 1981 through March 2015...
August 4, 2015: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/25560713/comparative-effectiveness-of-pharmacologic-interventions-for-knee-osteoarthritis-a-systematic-review-and-network-meta-analysis
#16
REVIEW
Raveendhara R Bannuru, Christopher H Schmid, David M Kent, Elizaveta E Vaysbrot, John B Wong, Timothy E McAlindon
BACKGROUND: The relative efficacy of available treatments of knee osteoarthritis (OA) must be determined for rational treatment algorithms to be formulated. PURPOSE: To examine the efficacy of treatments of primary knee OA using a network meta-analysis design, which estimates relative effects of all treatments against each other. DATA SOURCES: MEDLINE, EMBASE, Web of Science, Google Scholar, Cochrane Central Register of Controlled Trials from inception through 15 August 2014, and unpublished data...
January 6, 2015: Annals of Internal Medicine
https://www.readbyqxmd.com/read/25523678/re-does-this-man-with-lower-urinary-tract-symptoms-have-bladder-outlet-obstruction-the-rational-clinical-examination-a-systematic-review
#17
EDITORIAL
Steven A Kaplan
No abstract text is available yet for this article.
January 2015: Journal of Urology
https://www.readbyqxmd.com/read/25458628/using-systematic-reviews-to-guide-decision-making-about-family-witnessed-resuscitation
#18
REVIEW
Susan W Salmond, Lisa M Paplanus, Amita Avadhani
Family-witnessed resuscitation (FWR) allows family members to be present while emergency cardiac life support measures are applied. This article describes the use of systematic reviews to inform best clinical policy on FWR. The authors searched Medline and CINAHL for relevant systematic reviews and retrieved four. The reviews were then tested for rigor and validity using the open source Critical Appraisal Skills Programme from the Institute of Health Science, University of Oxford. The reviews were assessed to be of acceptable quality and therefore good sources of evidence to guide practice and policy development...
December 2014: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/25457080/analgesics-sedatives-anticonvulsant-drugs-and-the-cooled-brain
#19
REVIEW
Guido Wassink, Christopher A Lear, Katherine C Gunn, Justin M Dean, Laura Bennet, Alistair J Gunn
Multiple randomized controlled trials have shown that prolonged, moderate cerebral hypothermia initiated within a few hours after severe hypoxia-ischemia and continued until resolution of the acute phase of delayed cell death reduces mortality and improves neurodevelopmental outcome in term infants. The challenge is now to find ways to further improve outcomes. In the present review, we critically examine the evidence that conventional analgesic, sedative, or anticonvulsant agents might improve outcomes, in relation to the known window of opportunity for effective protection with hypothermia...
April 2015: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/25234478/rational-pain-management-in-complex-regional-pain-syndrome-1-crps-1-a-network-meta-analysis
#20
Maria M Wertli, Alphons G H Kessels, Roberto S G M Perez, Lucas M Bachmann, Florian Brunner
OBJECTIVE: Guidelines for complex regional pain syndrome (CRPS) 1 advocate several substance classes to reduce pain and support physical rehabilitation, but guidance about which agent should be prioritized when designing a therapeutic regimen is not provided. Using a network meta-analytic approach, we examined the efficacy of all agent classes investigated in randomized clinical trials of CRPS 1 and provide a rank order of various substances stratified by length of illness duration. DESIGN: In this study a network meta-analysis was conducted...
September 2014: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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