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https://www.readbyqxmd.com/read/28103161/nurses-practice-in-preventing-postoperative-wound-infections-an-observational-study
#1
S Ding, F Lin, A P Marshall, B M Gillespie
OBJECTIVE: Surgical site infections (SSIs) are serious postoperative complications that may lead to undesired patient outcomes. Previous research has used survey and chart audit methods to describe wound care practices. However, little research has been published using contemporaneous observations to describe the surgical wound management practices of nurses. The aim of this study was to prospectively describe surgical nurses' postoperative wound care practices and the extent to which observed surgical wound practices aligned with evidence-based guideline recommendations...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28102830/can-exhaled-volatile-organic-compounds-predict-asthma-exacerbations-in-children
#2
Dillys van Vliet, Agnieszka Smolinska, Quirijn Jöbsis, Jean Muris, Philippe Rosias, Jan Dallinga, Edward Dompeling, Frederik van Schooten
Background Asthma control falls short of current goals of asthma management guidelines. Non-invasive monitoring of airway inflammation may help to improve the level of asthma control in children. Aim 1) To identify a set of exhaled volatile organic compounds (VOCs) that is most predictive for an asthma exacerbation in children. 2) To determine the chemical background of predictive VOCs. Methods In an one-year prospective observational study, 96 asthmatic children were studied . At clinical visits with an interval of 2 months, asthma control, fractional exhaled nitric oxide, lung function (FEV1, FEV1/VC) and VOCs in exhaled breath were determined by means of gas chromatography time-of-flight mass spectrometry...
January 19, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28102027/patient-engagement-in-hiv-care-and-treatment-in-zambia-2004-2014
#3
Neo Christopher Chung, Carolyn Bolton-Moore, Roma Chilengi, Margaret P Kasaro, Jeffrey S A Stringer, Benjamin H Chi
OBJECTIVE: To describe engagement along the HIV continuum of care using a large network of clinics in Zambia. METHODS: We employed a practical framework to describe retention along the HIV treatment cascade, using routinely collected clinical data available in resource-constrained settings. We included health facilities in four Zambian provinces with more than 300 enrolled patients over the age of 5 years. We described attrition at each step, from HIV enrolment to 720 days after ART initiation...
January 19, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28101937/methods-of-anorectal-manometry-vary-widely-in-clinical-practice-results-from-an-international-survey
#4
E V Carrington, H Heinrich, C H Knowles, S S Rao, M Fox, S M Scott
BACKGROUND: Ano-rectal manometry (ARM) is the most commonly performed investigation for assessment of anorectal dysfunction. Its use is supported by expert consensus documents and international guidelines. Variation in technology, data acquisition, and analysis affect results and clinical interpretation. This study examined variation in ARM between institutions to establish the status of current practice. METHODS: A 50-item web-based questionnaire assessing analysis and interpretation of ARM was distributed by the International Anorectal Physiology Working Group via societies representing practitioners that perform ARM...
January 18, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28101910/a-practical-approach-to-vaccination-of-patients-with-autoimmune-inflammatory-rheumatic-diseases-in-australia
#5
REVIEW
Peter Kk Wong, Hanish Bagga, Claire Barrett, Paddy Hanrahan, Doug Johnson, Amel Katrib, Karin Leder, Mona Marabani, Peta Pentony, John Riordan, Ray White, Laurel Young
Autoimmune inflammatory rheumatic diseases (AIIRD) such as rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) are often complicated by infection, which results in significant morbidity and mortality. The increased risk of infection is probably due to a combination of immunosuppressive effects of the AIIRD, comorbidities, and the use of immunosuppressive conventional synthetic disease modifying anti-rheumatic drugs (DMARDS) and more recently, targeted synthetic DMARDS and biologic DMARDS which block specific pro-inflammatory enzymes, cytokines or cell types...
January 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28100960/a-survey-of-thrombosis-experts-evaluating-practices-and-opinions-regarding-venous-thromboprophylaxis-in-patients-post-major-abdominal-surgery
#6
Bader Al Rawahi, Grégoire Le Gal, Rebecca Auer, Marc Carrier
BACKGROUND: Patients undergoing major abdominal surgery are at high risk for developing venous thromboembolism in the post-operative period. Current evidence-based guidelines recommend routine pharmacological venous thromboembolism prophylaxis in patient at moderate to high risk post major abdominal surgery. However, the type of agent, dose and duration of thromboprophylaxis remain unclear. We sought to survey current clinical practice and assess for potential clinical equipoise regarding pharmacological thromboprophylaxis post major abdominal surgery...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28100251/consensus-guideline-for-the-diagnosis-and-treatment-of-aromatic-l-amino-acid-decarboxylase-aadc-deficiency
#7
REVIEW
Tessa Wassenberg, Marta Molero-Luis, Kathrin Jeltsch, Georg F Hoffmann, Birgit Assmann, Nenad Blau, Angeles Garcia-Cazorla, Rafael Artuch, Roser Pons, Toni S Pearson, Vincenco Leuzzi, Mario Mastrangelo, Phillip L Pearl, Wang Tso Lee, Manju A Kurian, Simon Heales, Lisa Flint, Marcel Verbeek, Michèl Willemsen, Thomas Opladen
Aromatic L-amino acid decarboxylase deficiency (AADCD) is a rare, autosomal recessive neurometabolic disorder that leads to a severe combined deficiency of serotonin, dopamine, norepinephrine and epinephrine. Onset is early in life, and key clinical symptoms are hypotonia, movement disorders (oculogyric crisis, dystonia, and hypokinesia), developmental delay, and autonomic symptoms.In this consensus guideline, representatives of the International Working Group on Neurotransmitter Related Disorders (iNTD) and patient representatives evaluated all available evidence for diagnosis and treatment of AADCD and made recommendations using SIGN and GRADE methodology...
January 18, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28100201/developing-a-practice-guideline-for-the-occupational-health-services-by-using-a-community-of-practice-approach-a-process-evaluation-of-the-development-process
#8
Lydia Kwak, Charlotte Wåhlin, Kjerstin Stigmar, Irene Jensen
BACKGROUND: One way to facilitate the translation of research into the occupational health service practice is through clinical practice guidelines. To increase the implementability of guidelines it is important to include the end-users in the development, for example by a community of practice approach. This paper describes the development of an occupational health practice guideline aimed at the management of non-specific low back pain (LBP) by using a community of practice approach...
January 18, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28099977/a-step-by-step-clinical-approach-for-the-management-of-neuroendocrine-tumours
#9
A Yordanova, H Ahmadzadehfar, M Gonzalez-Carmona, C Strassburg, K Mayer, G Feldmann, I Schmidt-Wolf, R Lingohr, S Fischer, G Kristiansen, M Essler
Neuroendocrine tumours (NET) are rare neoplasms, but the incidence is permanently increasing. Most of the NETs are slow proliferating and clinically silent, and for that reason, they are often diagnosed at a stage with advanced disease. The complexity and diversity of the NET-biology require the treatment of patients in specialised centres to guarantee a qualified, multidisciplinary treatment planning. At our institution, we developed an interdisciplinary model for the assessment and treatment of NET. The aim was to adapt the guidelines to the clinical practice, exchange of current knowledge, and a tailored approach to the individual patient...
January 18, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28099516/clinical-practice-guidelines-for-rare-diseases-the-orphanet-database
#10
Sonia Pavan, Kathrin Rommel, María Elena Mateo Marquina, Sophie Höhn, Valérie Lanneau, Ana Rath
Clinical practice guidelines (CPGs) for rare diseases (RDs) are scarce, may be difficult to identify through Internet searches and may vary in quality depending on the source and methodology used. In order to contribute to the improvement of the diagnosis, treatment and care of patients, Orphanet (www.orpha.net) has set up a procedure for the selection, quality evaluation and dissemination of CPGs, with the aim to provide easy access to relevant, accurate and specific recommendations for the management of RDs...
2017: PloS One
https://www.readbyqxmd.com/read/28099214/rheumatoid-arthritis-selecting-monotherapy-versus-combination-therapy
#11
Nimish Mehta, Lynne Kolton Schneider, Emilie McCardell
The overall goal of therapy for patients with rheumatoid arthritis (RA) is to achieve low disease activity or remission and to prevent or control joint damage, prevent loss of function, and decrease pain. However, many patients with RA do not have the disease adequately controlled, and only a minority attain consistent remission. To successfully treat to target, rheumatologists need practical guidance to select monotherapy and combination therapy regimens based on available data. Differences in study design, dosing regimens, and data from defined and specific patient populations pose challenges to clinicians who treat patients with diverse characteristics and needs...
January 18, 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28099074/new-developments-in-breast-cancer-screening-and-treatment
#12
Sarah Tilstra, Melissa McNeil
The clinical update serves as a brief review of recently published, high-impact, and potentially practice-changing journal articles summarized for our readers. In this clinical update, we selected top recent articles regarding breast health that may change the clinical practice of women's health providers. We identified articles by reviewing high-impact medical and women's health journals as well as national practice guidelines. Three of our articles are dedicated to the rapid changes in breast cancer screening...
January 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28098628/the-abcdef-bundle-science-and-philosophy-of-how-icu-liberation-serves-patients-and-families
#13
E Wesley Ely
Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the postintensive care syndrome." Patients with postintensive care syndrome are robbed of their normal cognitive, emotional, and physical capacity and cannot resume their previous life. The ICU Liberation Collaborative is a real-world quality improvement initiative being implemented across 76 ICUs designed to engage strategically the ABCDEF bundle through team- and evidence-based care...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098395/first-uhplc-ms-ms-method-coupled-with-automated-on-line-spe-for-quantification-both-of-tacrolimus-and-everolimus-in-peripheral-blood-mononuclear-cells-and-its-application-on-samples-from-co-treated-pediatric-patients
#14
Debora Pensi, Amedeo De Nicolò, Michele Pinon, Clarissa Pisciotta, Pier Luigi Calvo, Antonello Nonnato, Renato Romagnoli, Francesco Tandoi, Giovanni Di Perri, Antonio D'Avolio
Tacrolimus (TAC, FK-506) and everolimus (EVE, RAD001) are immunosuppressors used to treat pediatric patients undergoing liver transplantation. Their hematic TDM by liquid chromatography became standard practice. However, it does not always reflect concentrations at their active site. Our aim was to develop and validate a new method for the simultaneous TAC and EVE quantification into target cells: Peripheral-Blood-Mononuclear-Cells (PBMCs). PBMCs were collected using Cell-Preparation-Tubes; cells number and MCV were evaluated by an automatic cell counter...
January 18, 2017: Journal of Mass Spectrometry: JMS
https://www.readbyqxmd.com/read/28097936/experimental-study-on-tissue-phantoms-to-understand-the-effect-of-injury-and-suturing-on-human-skin-mechanical-properties
#15
Arnab Chanda, Vinu Unnikrishnan, Zachary Flynn, Kim Lackey
Skin injuries are the most common type of injuries occurring in day-to-day life. A skin injury usually manifests itself in the form of a wound or a cut. While a shallow wound may heal by itself within a short time, deep wounds require surgical interventions such as suturing for timely healing. To date, suturing practices are based on a surgeon's experience and may vary widely from one situation to another. Understanding the mechanics of wound closure and suturing of the skin is crucial to improve clinical suturing practices and also to plan automated robotic surgeries...
January 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28097532/medication-overuse-in-chronic-pain
#16
REVIEW
Eric S Hsu
PURPOSE OF REVIEW: Chronic pain is usually managed by various pharmacotherapies after exhausting the conservative modalities such as over-the-counter choices. The goal of this review is to investigate current state of opioids and non-opioid medication overuse that includes NSAIDs, skeletal muscle relaxants, antidepressants, membrane stabilization agents, and benzodiazepine. How to minimize medication overuse and achieve better outcome in chronic pain management? RECENT FINDINGS: Although antidepressants and membrane stabilization agents contribute to the crucial components for neuromodulation, opioids were frequently designated as a rescue remedy in chronic pain since adjunct analgesics usually do not provide instantaneous relief...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28096916/an-audit-of-referral-and-treatment-patterns-of-high-risk-prostate-cancer-patients-in-alberta
#17
Majed Alghamdi, Amandeep Taggar, Derek Tilley, Marc Kerba, Xanthoula Kostaras, Geoffrey Gotto, Michael Sia
INTRODUCTION: We aimed to determine the impact of clinical practice guidelines (CPG) on rates of radiation oncologist (RO) referral, androgen-deprivation therapy (ADT), radiation therapy (RT), and radical prostatectomy (RP) in patients with high-risk prostate cancer (HR-PCa). METHODS: All men >18 years, diagnosed with PCa in 2005 and 2012 were identified from the Alberta Cancer Registry. Patient age, aggregated clinical risk group (ACRG) score, Gleason score (GS), pre-treatment prostate-specific antigen (PSA), RO referral, and treatment received were extracted from electronic medical records...
November 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28096438/infection-prophylaxis-in-peritoneal-dialysis-patients-results-from-an-australia-new-zealand-survey
#18
Denise J Campbell, David W Mudge, Martin P Gallagher, Wai H Lim, Ranganathan Dwarakanathan, Walaa Saweirs, Jonathan C Craig
♦ Background: Clinical practice guidelines aim to reduce the rates of peritoneal dialysis (PD)-related infections, a common complication of PD in end-stage kidney disease patients. We describe the clinical practices used by Australian and New Zealand nephrologists to prevent PD-related infections in PD patients. ♦ Methods: A survey of PD practices in relation to the use of antibiotic and antifungal prophylaxis in PD patients was conducted of practicing nephrologists identified via the Australia and New Zealand Society of Nephrology (ANZSN) membership in 2013...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28096333/biophysical-properties-of-the-clinical-stage-antibody-landscape
#19
Tushar Jain, Tingwan Sun, Stéphanie Durand, Amy Hall, Nga Rewa Houston, Juergen H Nett, Beth Sharkey, Beata Bobrowicz, Isabelle Caffry, Yao Yu, Yuan Cao, Heather Lynaugh, Michael Brown, Hemanta Baruah, Laura T Gray, Eric M Krauland, Yingda Xu, Maximiliano Vásquez, K Dane Wittrup
Antibodies are a highly successful class of biological drugs, with over 50 such molecules approved for therapeutic use and hundreds more currently in clinical development. Improvements in technology for the discovery and optimization of high-potency antibodies have greatly increased the chances for finding binding molecules with desired biological properties; however, achieving drug-like properties at the same time is an additional requirement that is receiving increased attention. In this work, we attempt to quantify the historical limits of acceptability for multiple biophysical metrics of "developability...
January 17, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28096207/use-of-strategies-to-improve-door-to-needle-times-with-tissue-type-plasminogen-activator-in-acute-ischemic-stroke-in-clinical-practice-findings-from-target-stroke
#20
Ying Xian, Haolin Xu, Barbara Lytle, Jason Blevins, Eric D Peterson, Adrian F Hernandez, Eric E Smith, Jeffrey L Saver, Steven R Messé, Mary Paulsen, Robert E Suter, Mathew J Reeves, Edward C Jauch, Lee H Schwamm, Gregg C Fonarow
BACKGROUND: The implementation of Target: Stroke Phase I, the first stage of the American Heart Association's national quality improvement initiative to accelerate door-to-needle (DTN) times, was associated with an average 15-minute reduction in DTN times. TARGET: Stroke phase II was launched in April 2014 with a goal of promoting further reduction in treatment times for tissue-type plasminogen activator (tPA) administration. METHODS AND RESULTS: We conducted a second survey of Get With The Guidelines-Stroke hospitals regarding strategies used to reduce delays after Target: Stroke and quantify their association with DTN times...
January 2017: Circulation. Cardiovascular Quality and Outcomes
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