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https://www.readbyqxmd.com/read/28934799/factors-influencing-the-application-of-a-biopsychosocial-perspective-in-clinical-judgement-of-chronic-pain-interactive-management-with-medical-students
#1
Christopher P Dwyer, Phoebe E McKenna-Plumley, Hannah Durand, Emer M Gormley, Brian W Slattery, Owen M Harney, Padraig MacNeela, Brian E McGuire
BACKGROUND: Though there is wide support for the application of biopsychosocial perspectives in clinical judgement of chronic pain cases, such perspectives are often overlooked due to either inadequate training or attitudes favoring a biomedical approach. Recent research has indicated that despite such explanations, both established general practitioners (GP) and medical students account for some psychosocial factors when making clinical judgements regarding chronic pain cases, but report not being likely to apply these in real-world, clinical settings due to numerous factors, including available time with patients...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934790/factors-associated-with-successful-responses-to-transforaminal-balloon-adhesiolysis-for-chronic-lumbar-foraminal-stenosis-retrospective-study
#2
Doo Hwan Kim, Seong-Sik Cho, Yeon-Jin Moon, Koo Kwon, Kunhee Lee, Jeong-Gil Leem, Jin-Woo Shin, Ji Hyun Park, Seong-Soo Choi
BACKGROUND: Recently, transforaminal balloon adhesiolysis was introduced to manage patients with chronic radicular pain occurring with or without low back pain. However, the factors associated with successful responses to transforaminal balloon adhesiolysis are not known. OBJECTIVE: To evaluate the factors associated with successful responses to transforaminal balloon adhesiolysis for chronic lumbar spinal stenosis. STUDY DESIGN: This is a retrospective observational study...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934786/long-term-cost-utility-of-spinal-cord-stimulation-in-patients-with-failed-back-surgery-syndrome
#3
S Harrison Farber, Jing L Han, Aladine A Elsamadicy, Qasim Hussaini, Siyun Yang, Promila Pagadala, Beth Parente, Jichun Xie, Shivanand P Lad
BACKGROUND: Failed back surgery syndrome (FBSS) is a cause of significant morbidity for up to 40% of patients following spine surgery, and is estimated to cost almost $20 billion. Treatment options for these patients currently include conventional medical management (CMM), repeat operation, or spinal cord stimulation (SCS). Much of the published data regarding cost effectiveness of SCS comprise smaller scale randomized controlled trials (RCTs) rather than large databases capturing practices throughout the US...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934785/1-year-results-of-a-randomized-controlled-trial-of-conservative-management-vs-minimally-invasive-surgical-treatment-for-sacroiliac-joint-pain
#4
Julius Dengler Dengler, Djaya Kools, Robert Pflugmacher, Alessandro Gasbarrini, Domenico Prestamburgo, Paolo Gaetani, Eddie van Eeckhoven, Daniel Cher, Bengt Sturesson
BACKGROUND: Low back pain (LBP) emanating from the sacroiliac joint (SIJ) is a common finding. Devices to fuse the SIJ are now commercially available, but high-quality evidence supporting their effectiveness is limited. OBJECTIVES: To compare the safety and effectiveness of conservative management (CM) to minimally invasive sacroiliac joint fusion (SIJF) in patients with chronic LBP originating from the SIJ. STUDY DESIGN: Prospective, multicenter randomized controlled trial...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934781/posture-influences-the-extent-of-spread-of-contrast-medium-during-thoracic-epidurography-a-prospective-randomized-trial
#5
Ji Hee Hong, Sung Won Jung, Ji Hoon Park
BACKGROUND: Various factors influencing the distribution of sensory blockade in epidural anesthesia have been identified; however, reports on the effects of gravity and different postures in thoracic epidural anesthesia have been rare. Medications may be injected with the lateral decubitus or the neutral position; however, it is unclear whether the distribution range of medication is similar or significantly different between these 2 postures. OBJECTIVE: We focused on identifying the effect of different postures on the distribution of local anesthetics using epidurography at the thoracic level...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934780/efficacy-of-cannabis-based-medicines-for-pain-management-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#6
J Aviram, G Samuelly-Leichtag
BACKGROUND: The management of chronic pain is a complex challenge worldwide. Cannabis-based medicines (CBMs) have proven to be efficient in reducing chronic pain, although the topic remains highly controversial in this field. OBJECTIVES: This study's aim is to conduct a conclusive review and meta-analysis, which incorporates all randomized controlled trials (RCTs) in order to update clinicians' and researchers' knowledge regarding the efficacy and adverse events (AEs) of CBMs for chronic and postoperative pain treatment...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934739/differential-pressure-shunt-for-simultaneous-diversion-of-ventricular-fluid-and-extracerebral-fluid
#7
Daniel Craig, Ken R Winston, Zach Folzenlogen, Kathryn A Beauchamp
BACKGROUND/AIMS: The management of extracerebral collections of fluid in patients with hydrocephalus can be problematic for either their simultaneous separate management or sequential management, each of which may require multiple surgeries and the management of external drains. The object of this report is to review the experience with a shunt configuration that simultaneously diverts ventricular fluid and extracerebral fluid, whether subdural or subarachnoid in location, through different outflow resistances...
September 22, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28934706/untreated-hypertension-as-predictor-of-in-hospital-mortality-in-intracerebral-hemorrhage-a-multi-center-study
#8
Mario Hevesi, Eric M Bershad, Mostafa Jafari, Stephan A Mayer, Magdy Selim, Jose I Suarez, Afshin A Divani
PURPOSE: Hypertension is a significant risk factor for intracerebral hemorrhage (ICH). The importance of managing blood pressure to reduce the risk of ICH has been recognized. However, few studies have focused on ICH outcomes due to untreated hypertension. MATERIALS AND METHODS: We conducted a 5-year, retrospective, multicenter study of 490 consecutive ICH patients with histories of untreated-hypertension (n=56), treated-hypertension (n=314), and normotension (n=120)...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28934705/vitamin-c-the-next-step-in-sepsis-management
#9
REVIEW
J Teng, A Pourmand, M Mazer-Amirshahi
Sepsis is a life-threatening medical condition, affecting approximately 26 million people worldwide every year. The disease is a continuum, marked by dysregulated inflammation and hemodynamic instability leading to shock, multi-system organ dysfunction, and death. Over the past decades, there has been a focus on the early identification and treatment of sepsis primarily with bundled and goal directed therapy. Despite these advances, morbidity and mortality has remained high, prompting investigation into novel therapies...
September 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28934404/organizational-and-managerial-factors-associated-with-clinical-practice-guideline-adherence-a-simulation-based-study-in-36-french-hospital-wards
#10
Florence Saillour-Glénisson, Marion Kret, Sandrine Domecq, Matthieu Sibé, Valentin Daucourt, Virginie Migeot, David Veillard, Philippe Michel
Objectives: To identify managerial and organizational characteristics of multi-specialty medicine wards and individual characteristics of health professionals that are most strongly associated with clinical practice guidelines (CPG) adherence. Design: Cross-sectional stratified cluster sample design. Setting: Data were gathered from 36 randomly selected multi-specialty medicine wards. Participants: The study population included all health professionals involved in patient care working in the participating wards...
August 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28934258/reports-of-unintended-consequences-of-financial-incentives-to-improve-management-of-hypertension
#11
Sylvia J Hysong, Richard SoRelle, Kristen Broussard Smitham, Laura A Petersen
BACKGROUND: Given the increase in financial-incentive programs nationwide, many physicians and physician groups are concerned about potential unintended consequences of providing financial incentives to improve quality of care. However, few studies examine whether actual unintended consequences result from providing financial incentives to physicians. We sought to document the extent to which the unintended consequences discussed in the literature were observable in a randomized clinical trial (RCT) of financial incentives...
2017: PloS One
https://www.readbyqxmd.com/read/28934089/postpartum-hemorrhage-with-transfusion-trends-near-misses-risk-factors-and-management-at-the-scale-of-a-perinatal-network
#12
M Marocchini, J Lauféron, C Quantin, P Sagot
OBJECTIVES: To analyze temporal trends and management of postpartum hemorrhage (PPH) with transfusion and its related maternal near-miss (MNM) cases between 2006 and 2014 and to study risk factors. MATERIAL AND METHODS: This retrospective cohort study from two prospective databases included 156,047 women giving birth in all the maternity hospitals of Burgundy. We analyzed temporal trends and the distribution of PPH with transfusion, the circumstances of transfer of patients between hospitals and factors associated with PPH with transfusion...
May 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28933940/an-assessment-of-primary-care-and-pulmonary-provider-perspectives-on-lung-cancer-screening
#13
Matthew Triplette, Erin K Kross, Blake A Mann, Joann G Elmore, Christopher G Slatore, Shahida Shahrir, Perrin E Romine, Paul D Frederick, Kristina Crothers
RATIONALE: Lung cancer screening (LCS) has a mortality benefit to high-risk smokers, but implementation remains suboptimal. Providers represent the key entry point to screening, and an understanding of provider perspectives on lung cancer screening is necessary to improve referral and overall implementation. OBJECTIVES: The objective of this study was to understand knowledge, beliefs, attitudes, barriers, and facilitators to screening in a diverse group of referring pulmonologists and primary care providers...
September 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28933782/cardiovascular-disease-in-the-eastern-mediterranean-region-epidemiology-and-risk-factor-burden
#14
REVIEW
Karam Turk-Adawi, Nizal Sarrafzadegan, Ibtihal Fadhil, Kathryn Taubert, Masoumeh Sadeghi, Nanette K Wenger, Nigel S Tan, Sherry L Grace
The Eastern Mediterranean region (EMR) comprises 22 countries or territories spanning from Morocco in the west to Pakistan in the east, and contains a population of almost 600 million people. Like many other developing regions, the burden of disease in the EMR has shifted in the past 30 years from primarily communicable diseases to noncommunicable diseases such as cardiovascular disease (CVD). Cardiovascular mortality in the EMR, mostly attributable to ischaemic heart disease, is expected to increase more dramatically in the next decade than in any other region except Africa...
September 21, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28933696/a-novel-topical-wound-therapy-delivery-system
#15
Ingrid Herskovitz, Flor E MacQuhae, Luis J Borda, Stephanie Bhagwandin, Juan A Paredes, Thais Polanco, John C Lantis, Paul J Kim, Tania J Phillips, Robert S Kirsner
INTRODUCTION: Wound care dressings have evolved over time, from bandaging to the development of occlusive dressings to negative pressure wound therapy. A novel therapeutic delivery system dressing has been cleared by the United States Food and Drug Administration. This semi occlusive wound dressing has been developed to provide local, continuous delivery of aqueous topical agents, such as therapeutics (anesthetics, antiseptics, antibiotics, steroids, topical beta-blockers, immune modulatory agents, growth factors, and fibrinolytic agents, among others), at a rate of about ¾ mL per day, thus maintaining a hydrated environment and providing topical treatment...
September 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28933676/bringing-humanity-into-view-action-research-with-qatar-s-ambulance-service
#16
Gill Coleman, Liz Wiggins
Purpose The purpose of this paper is to argue for the widening of attention in healthcare improvement efforts, to include an awareness of the humanity of people who work in the sector and an appreciation of the part human connection plays in engagement around good quality work. Theoretical frameworks and research approaches which draw on action-based, interpretive and systemic thinking are proposed, as a complement to current practices. Design/methodology/approach The paper describes the early stages of an action research (AR) project, which used the appreciative inquiry "4D" framework to conduct participative inquiry in Hamad Medical Corporation's ambulance service in Qatar, in which staff became co-researchers...
August 21, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/28933627/primary-care-for-mentally-ill-adults-in-acute-residential-treatment-facilities
#17
Linda Chafetz, Gerri Collins-Bride
Psychiatric bed capacity has decreased nationally with an impact on the number and the types of patients admitted to acute in-patient units. Acute residential programs provide alternatives to hospitals for patients with problems that do not meet criteria for admission. However, these settings may not have resources to respond to the medical co-morbidities associated with severe mental illness. To understand the medical needs of patients in these settings, this research examined data from a nurse-managed primary care outreach service...
September 21, 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28933570/developing-pictorial-asthma-action-plans-to-promote-self-management-and-health-in-rural-youth-with-asthma-a-qualitative-study
#18
Christina L Duncan, Heather A Walker, Laurel Brabson, Desireé N Williford, Lisa Hynes, Mary Beth Hogan
OBJECTIVE: Asthma action plans (AAPs) provide asthma management instructions to families; however, AAPs typically are written at a 7(th)-9(th) grade reading level, making them less useful in lower literacy families. There is a need to develop simpler AAP formats and content to optimize their utility across all families, including those who are rural and may be at risk for literacy concerns. Because using pictures can simplify and enhance health education, our study aim was to develop a pictorial AAP through a series of focus groups with key stakeholders - youth with asthma, caregivers, and physicians...
September 21, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28933211/traumatic-brain-injury-current-treatment-strategies-and-future-endeavors
#19
Michael Galgano, Gentian Toshkezi, Xuecheng Qiu, Thomas Russell, Lawrence Chin, Li-Ru Zhao
Traumatic brain injury (TBI) presents in various forms ranging from mild alterations of consciousness to an unrelenting comatose state and death. In the most severe form of TBI, the entirety of the brain is affected by a diffuse type of injury and swelling. Treatment modalities vary extensively based on the severity of the injury and range from daily cognitive therapy sessions to radical surgery such as bilateral decompressive craniectomies. Guidelines have been set forth regarding the optimal management of TBI, but they must be taken in context of the situation and cannot be used in every individual circumstance...
July 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28933175/-hiv-infection-a-new-disease-of-internal-medicine
#20
Svatava Snopková
Modern antiretroviral treatment belongs to the greatest success of current medicine. HIV infection has gone from a death sentence to a manageable chronic disease which develops several decades. Thanks to treatment advances, people with HIV can and do live long and full lives. In the last two decades, the incidence AIDS defining illnesses have been dramatically reduced especially opportunistic infections and malignancies, whereas the role of non-infection comorbidities has risen than age-matched HIV uninfected adults...
2017: Vnitr̆ní Lékar̆ství
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