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Practice management

Mohamed Nabil Elnaggar, Kahtan Jbeili, Nik Nik-Hussin, Mohandas Kozhippally, Joseph M Pappachan
Amiodarone is one of the most commonly prescribed antiarrhythmic agents in clinical practice owing to its efficacy, even with high toxicity profile. The high iodine content and the prolonged biological half-life of the drug can result in thyroid dysfunction in a high proportion of patients treated with amiodarone even after cessation of amiodarone. Both hypothyroidism and hyperthyroidism are common side effects that mandate regular monitoring of patients with thyroid function tests. Amiodarone-induced hypothyroidism (AIH) is diagnosed and managed in the same way as a usual case of hypothyroidism...
March 20, 2018: Experimental and Clinical Endocrinology & Diabetes
Tian Xie, Meie Wang, Chao Su, Weiping Chen
Soils provide the service of attenuating and detoxifying pollutants. Such ability, natural attenuation capacity (NAC), is one of the most important ecosystem services for urban soils. We improved the ecosystem-service performance index (EPX) model by integrating with entropy weight determination method to evaluate the NAC of residential soils in Beijing. Eleven parameters related to the soil process of pollutants fate and transport were selected and 115 residential soil samples were collected. The results showed that bulk density, microbial functional diversity and soil organic matter had high weights in the NAC evaluation...
March 17, 2018: Environmental Pollution
Roberto Pizzolotto, Antonio Mazzei, Teresa Bonacci, Stefano Scalercio, Nino Iannotta, Pietro Brandmayr
The impact of agricultural practices and soil management on the communities of arthropods living in the agricultural landscape is acknowledged as a critical issue by the literature, and it needs to be better investigated to improve the ecological sustainability of agriculture. In the present study, we aimed to study how soil management affect carabid species distribution in one of the most typical agroecosystem of the Mediterranean region, i.e. the olive grove. In South Italy olive plantations feature different types of soil management, from tillage to half- or full-cover cropping...
2018: PloS One
Emily S Mohn, Hua J Kern, Edward Saltzman, Susan H Mitmesser, Diane L McKay
The long-term use of prescription and over-the-counter drugs can induce subclinical and clinically relevant micronutrient deficiencies, which may develop gradually over months or even years. Given the large number of medications currently available, the number of research studies examining potential drug-nutrient interactions is quite limited. A comprehensive, updated review of the potential drug-nutrient interactions with chronic use of the most often prescribed medications for commonly diagnosed conditions among the general U...
March 20, 2018: Pharmaceutics
Stephen Ashford, Heather Williams, Ajoy Nair, Samantha Orridge, Lynne Turner-Stokes
BACKGROUND: Goal-classification of person-centred goals, using Goal Attainment Scaling for leg spasticity treatment. METHODS: The study was conducted in two phases: phase I, a retrospective review to evaluate categories of goal set in routine clinical practice. Findings were used to design a goal classification system. Phase II, a multi-centre study to confirm the goal categories. Goals set (n = 270) were analysed from data collected at three centres in the UK (one centre for phase I)...
March 20, 2018: Disability and Rehabilitation
Patricia Sobradillo Ecenarro, Marta Inchausti Iguiñiz, Sandra Pedrero Tejada, Nuria Marina Malanda, María Alfonso Imizcoz, Laura Ansola Marlasca, Bernardino Alcázar Navarrete
Chronic obstructive pulmonary disease is progressive and in its advanced stage is associated with major disability. Previous studies suggest that patients with this disease receive little palliative care, even in very advanced stages. Given this, our objectives were to describe the clinical practice of Spanish pulmonologists in the care of patients with end-stage chronic obstructive pulmonary disease, to identify potential barriers to implementing palliative care in these patients and to correlate these responses with doctor's years of experience...
March 20, 2018: COPD
Jose Luis Lopez-Campos, Stefano Centanni
The study of airway diseases continues to present several challenges for modern medicine. The different disease presentations with variables and overlapping features may result in a real challenge for the clinician. In this context, the concept of precision medicine has started to emerge in order to give answers to some of these challenges from a diagnostic and therapeutic point of view. The main reasons to target for precision medicine in chronic obstructive pulmonary disease (COPD) include that there is variability in the clinical presentation, there is no correlation between the different clinical variables at the patient level, there are a number of relevant clinical variables associated with outcomes, we do have specific therapies for specific patient types, and that there is variability in the clinical response to different therapies...
March 20, 2018: COPD
Francesco Carubbi, Alessia Alunno, Paola Cipriani, Onelia Bistoni, Rosa Scipioni, Vasiliki Liakouli, Piero Ruscitti, Onorina Berardicurti, Salvatore Di Bartolomeo, Roberto Gerli, Roberto Giacomelli
Current patient care in rheumatology relies primarily on a combination of traditional clinical assessment and standard laboratory tests. Investigators seek to discover new biomarkers and novel technologies such as the 'omics' boosted the research in this field. Mechanistic biomarkers such as cytokines, cell types, antibodies, signaling molecules, are rooted in the mechanism underlying the disease and can guide the clinical management of the disease. Conversely, descriptive biomarkers are byproducts of the disease process, depict the state of a disease but are not involved in its pathogenesis...
March 19, 2018: Current Rheumatology Reviews
Anne Marie Coleman, Zoë Chouliara, Kay Currie
The aim of this article is to explore the positive and negative impacts of working therapeutically in complex psychological trauma (CPT), particularly the field of gender-based violence (GBV) and childhood sexual abuse (CSA), from the clinicians' perspective. The focus was on the prospect of positive gains and growth for therapists. Twenty-one clinicians ( n = 21; counselors/psychotherapists and psychologists) from National Health Service (NHS) specialist trauma services, a community mental health team, and specialist sexual assault counseling organization participated...
March 1, 2018: Journal of Interpersonal Violence
Pedro Taffarel, German Bonetto, Facundo Jorro Barón, Claudia Meregalli
INTRODUCTION: Children in pediatric intensive care units (PICUs) are exposed to experiencing pain, stress and anxiety due to their disease, treatment or care setting. Adequate sedation and analgesia are key to their care, particularly in patients requiring mechanical ventilation (MV). OBJECTIVE: To determine the usual practice in sedation and analgesia management in patients requiring MV in PICUs in Argentina. MATERIAL AND METHODS: Descriptive, crosssectional, multi-center study conducted by means of e-mailed surveys...
April 1, 2018: Archivos Argentinos de Pediatría
Patty Leijten, G J Melendez-Torres, Frances Gardner, Jolien van Aar, Susanne Schulz, Geertjan Overbeek
Parenting programs for reducing disruptive child behavior are built on two main perspectives: relationship enhancement (i.e., unconditional sensitivity diminishes disruptiveness) and behavior management (i.e., conditional rewards diminish disruptiveness). Two meta-analyses (156 and 41 RCTs; Ntotal  = 15,768; Mchildage  = 1-11 years) tested the theoretical model that integrating relationship enhancement with behavior management is superior to behavior management alone. The integrative approach showed no overall superiority...
March 20, 2018: Child Development
Aine Cafferkey, Elizabeth Coyle, David Greaney, Sinead Harte, Niamh Hayes, Miriam Langdon, Birgitt Straub, Crina Burlacu
BACKGROUND: Simulation-based education is a modern training modality that allows healthcare professionals to develop knowledge and practice skills in a safe learning environment. The College of Anaesthetists of Ireland (CAI) was the first Irish postgraduate medical training body to introduce mandatory simulation training into its curriculum. Extensive quality assurance and improvement data has been collected on all simulation courses to date. AIMS: Describe The College of Anaesthetists of Ireland Simulation Training (CAST) programme and report the analysis of course participants' feedback...
March 20, 2018: Irish Journal of Medical Science
Magdalena Harris, Tim Rhodes
A life history approach enables study of how risk or health protection is shaped by critical transitions and turning points in a life trajectory and in the context of social environment and time. We employed visual and narrative life history methods with people who inject drugs to explore how hepatitis C protection was enabled and maintained over the life course. We overview our methodological approach, with a focus on the ethics in practice of using life history timelines and life-grids with 37 participants...
March 1, 2018: Qualitative Health Research
Kate Winskell, Robyn Singleton, Gaelle Sabben
Distinctive longitudinal narrative data, collected during a critical 18-year period in the history of the HIV epidemic, offer a unique opportunity to examine how young Africans are making sense of evolving developments in HIV prevention and treatment. More than 200,000 young people from across sub-Saharan Africa took part in HIV-themed scriptwriting contests held at eight discrete time points between 1997 and 2014, creating more than 75,000 narratives. This article describes the data reduction and management strategies developed for our cross-national and longitudinal study of these qualitative data...
March 1, 2018: Qualitative Health Research
Samuel James Alexander Dobson, Kanna Mannadiar Jayaprakasan
We conducted a retrospective review into the role of commonly prescribed conventional adjuvant treatments in improving live birth rates after recurrent miscarriage (RM). Data from 301 couples attending the RM clinic in two Tertiary teaching hospitals were analysed with their live birth rate following a further pregnancy and a prevalence of conditions investigated in RM being the main outcomes measured. We found that 26% of women had explained RM and 74% had unexplained RM. Adjuvant versus conservative management did not improve the live birth rates in those with unexplained RM (68...
March 20, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Hanifi Şahin, Oya Soylu Karapınar, Eda Adeviye Şahin, Kenan Dolapçıoğlu, Ali Baloğlu
A broader range of more effective compression techniques are needed in the patients who have an intractable postpartum haemorrhage due to uterine atony despite medical treatment and B-Lynch sutures. The aim of this study was to report the outcome of a series of patients with haemorrhage who were managed by double B-Lynch suture. Fourteen patients who were treated in a tertiary hospital between July 2010 and February 2015 were included in the study. The intractable haemorrhage rate was 0.35% over 5 years (14/4000 births)...
March 20, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Lance B Irons, Heidi Flatin, Maya T Harrington, Turaj Vazifedan, John W Harrington
This article assesses parental confidence and current behavioral techniques used by mostly African American caregivers of young children in an urban Southeastern setting, including their use and attitudes toward corporal punishment (CP). Two hundred and fifty parental participants of children aged 18 months to 5 years completed a survey on factors affecting their behavioral management and views on CP. Statistical analysis included χ2 test and logistic regression with confidence interval significance determined at P <...
March 1, 2018: Clinical Pediatrics
Simon J Mitchell, Michael H Bennett, Phillip Bryson, Frank K Butler, David J Doolette, James R Holm, Jacek Kot, Pierre Lafère
Guidelines for the pre-hospital management of decompression illness (DCI) had not been formally revised since the 2004 Divers Alert Network/Undersea and Hyperbaric Medical Society workshop held in Sydney, entitled "Management of mild or marginal decompression illness in remote locations". A contemporary review was initiated by the Diver's Alert Network and undertaken by a multinational committee with members from Australasia, the USA and Europe. The process began with literature reviews by designated committee members on: the diagnosis of DCI; first aid strategies for DCI; remote triage of possible DCI victims by diving medicine experts; evacuation of DCI victims; effect of delay to recompression in DCI; pitfalls in management when DCI victims present at hospitals without diving medicine expertise and in-water recompression...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Bram D Vermeulen, Peter D Siersema
OPINION STATEMENT: PURPOSE OF REVIEW: Esophageal stents are used in clinical practice for endoscopic treatment of a wide variety of esophageal diseases and conditions. This review provides key principles and a literature update on the utility and limitations of esophageal stenting in clinical practice. RECENT FINDINGS: Indications for esophageal stenting can be subdivided into two groups. The first group consists of patients with malignant or benign dysphagia, in which an esophageal stent restores luminal patency...
March 19, 2018: Current Treatment Options in Gastroenterology
Olubukola Oyetunde, Veronika Williams
Background Oral rehydration salt (ORS) is an affordable and effective intervention for the management of acute watery diarrhoea (AWD), especially in children under 5 years. A knowledge/practice gap exists among community pharmacists (CPs) in Lagos, Nigeria, and in many low to middle income countries. This gap results in underutilization of ORS for diarrhoea management. Objective The objective was to explore CPs' views of the barriers and facilitators to the use of ORS in practice. Setting Community pharmacy practices, Lagos, Nigeria...
March 20, 2018: International Journal of Clinical Pharmacy
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