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https://www.readbyqxmd.com/read/29350780/an-evolutionary-concept-analysis-of-futility-in-healthcare
#1
Lauren Morata
AIM: To report a concept analysis of futility in healthcare. BACKGROUND: Each member of the healthcare team, the physician, the nurse, the patient, the family and all others involved perceive futility differently. The current evidence and knowledge in regard to futility in healthcare manifest a plethora of definitions, meanings and interpretations without consensus. DESIGN: Concept analysis. DATA SOURCES: Databases searched included Medline, Cumulative Index of Nursing and Allied Health Literature, Academic Search Premier, Cochrane Database of Systematic Reviews and PsycINFO...
January 19, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29350335/tools-for-assessment-of-the-appropriateness-of-prescribing-and-association-with-patient-related-outcomes-a-systematic-review
#2
REVIEW
Nashwa Masnoon, Sepehr Shakib, Lisa Kalisch-Ellett, Gillian E Caughey
BACKGROUND: There are tools and criteria in the literature aimed at distinguishing between appropriate and inappropriate medicines use. However, many have not been externally validated with regard to patient-related outcomes, potentially limiting their use in clinical practice. OBJECTIVES: The aim of the study was to conduct a systematic review to summarise (1) available prescribing appropriateness assessment tools and criteria, and (2) their associations with patient-related outcomes (external validity)...
January 19, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29349921/community-pharmacists-views-on-the-regulation-of-complementary-medicines-and-complementary-medicines-practitioners-a-qualitative-study-in-new-zealand
#3
Joanne Barnes, Rachael Butler
OBJECTIVES: To examine community pharmacists' perspectives on CMs regulation in New Zealand, where proposals for CMs regulations had recently been suspended and where, currently, CMs are only weakly regulated. METHODS: Qualitative, in-depth, semi-structured interviews with New Zealand practising community pharmacists are identified through purposive and convenience sampling. Data were analysed using a general inductive approach. KEY FINDINGS: Participants held mixed views regarding harmonisation of CMs regulations across Australia and NZ; some supported an NZ national regulatory framework for CMs, based on the Australian system...
January 19, 2018: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29349792/meta-analysis-of-gaussian-individual-patient-data-two-stage-or-not-two-stage
#4
Tim P Morris, David J Fisher, Michael G Kenward, James R Carpenter
Quantitative evidence synthesis through meta-analysis is central to evidence-based medicine. For well-documented reasons, the meta-analysis of individual patient data is held in higher regard than aggregate data. With access to individual patient data, the analysis is not restricted to a "two-stage" approach (combining estimates and standard errors) but can estimate parameters of interest by fitting a single model to all of the data, a so-called "one-stage" analysis. There has been debate about the merits of one- and two-stage analysis...
January 18, 2018: Statistics in Medicine
https://www.readbyqxmd.com/read/29349733/point-of-care-ultrasound-pocus-of-the-upper-airway
#5
REVIEW
Kong Eric You-Ten, Naveed Siddiqui, Wendy H Teoh, Michael S Kristensen
Airway management is a critical skill in the practice of several medical specialities including anesthesia, emergency medicine, and critical care. Over the years mounting evidence has showed an increasing role of ultrasound (US) in airway management. The objective of this narrative review is to provide an overview of the indications for point-of-care ultrasound (POCUS) of the upper airway. The use of US to guide and assist clinical airway management has potential benefits for both provider and patient. Ultrasound can be utilized to determine airway size and predict the appropriate diameter of single-lumen endotracheal tubes (ETTs), double-lumen ETTs, and tracheostomy tubes...
January 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29349667/comparison-of-enalapril-candesartan-and-intralesional-triamcinolone-in-reducing-hypertrophic-scar-development-an-experimental-study
#6
Canser Yilmaz Demir, Muhammet Eren Ersoz, Remzi Erten, Omer Faruk Kocak, Yilmaz Sultanoglu, Yildiray Basbugan
BACKGROUND: The purpose of this study was to compare the effects of oral enalapril, an angiotensin-converting enzyme inhibitor (ACE-I), oral candesartan, an angiotensin receptor blocker (ARB), and intralesional corticosteroid treatments in reducing scar formation. METHODS: Twenty male rabbits were divided into five study groups: A (sham), B (control), C (ACE-I), D (ARB) and E (intralesional corticosteroid). The rabbit ear hypertrophic scar model was used. The hypertrophic scars were photographed and analyzed with the program ImageJ quantitatively to determine the degree of collagen fibers...
January 18, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29349660/progestogen-hypersensitivity
#7
REVIEW
Rung-Chi Li, Kathleen M Buchheit, Jonathan A Bernstein
PURPOSE OF REVIEW: Progestogen hypersensitivity (PH) is a rare disorder which usually occurs in women of childbearing age with symptoms ranging from urticaria with or without angioedema, multiple organ involvement consistent with allergic anaphylaxis, to a spectrum of other non-evanescent skin eruptions. In this review, we present a clinical vignette of PH and discuss the clinical presentation and proposed pathomechanisms, diagnosis, and treatment of PH. RECENT FINDINGS: The hypersensitivity symptoms are associated with exogenous progestin exposure (e...
January 19, 2018: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/29349590/law-as-clinical-evidence-a-new-constitutivemodel-of-medical-education-and-decision-making
#8
Malcolm Parker, Lindy Willmott, Ben White, Gail Williams, Colleen Cartwright
Over several decades, ethics and law have been applied to medical education and practice in a way that reflects the continuation during the twentieth century of the strong distinction between facts and values. We explain the development of applied ethics and applied medical law and report selected results that reflect this applied model from an empirical project examining doctors' decisions on withdrawing/withholding treatment from patients who lack decision-making capacity. The model is critiqued, and an alternative "constitutive" model is supported on the basis that medicine, medical law, and medical ethics exemplify the inevitable entanglement of facts and values...
January 18, 2018: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29349584/-percutaneous-endoscopic-gastrostomy-in-geriatrics-indications-technique-and-complications
#9
Rainer Wirth
The technique of percutaneous endoscopic gastrostomy (PEG) was introduced in 1979 as a semi-invasive approach for children with the need for a gastric fistula in order to avoid an operative intervention. The suture pull-through method was rapidly established and is now omnipresent. Because scientific evidence is broadly missing, there is some uncertainty about the indications in geriatric medicine. Guidelines do not recommend the insertion of a PEG in patients with severe dementia and malnutrition. Tube feeding is mainly recommended as a temporary method for patients who cannot take oral nutrition for more than 3 days or for whom the energy intake for more than 10 days presumably covers less than 50% of their needs, assuming that the overall prognosis is reasonable...
January 18, 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29348109/review-beyond-conventional-therapies-complementary-and-alternative-medicine-in-the-management-of-hypertension-an-evidence-based-review
#10
Ang Peng Wong, Yaman Walid Kassab, Abdul Latiff Mohamed, Amelah Mohammed Abdul Qader
Hypertension is one of the major causes of morbidity and mortality. Worldwide, Hypertension is estimated to cause 7.5 million deaths, about 12.8% of the total of all deaths. This accounts for 57 million disability adjusted life years (DALYS) or 3.7% of total DALYS. This led WHO to set a target of 25% reduction in prevalence by 2025. To reach that, WHO has adopted non-conventional methods for the management of hypertension? Despite worldwide popularity of such non-conventional therapies, only small volume of evidence exists that supports its effectiveness...
January 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29347827/psychological-well-being-and-adherence-to-antiretroviral-therapy-among-adolescents-living-with-hiv-in-zambia
#11
Sumiyo Okawa, Sylvia Mwanza Kabaghe, Mwiya Mwiya, Kimiyo Kikuchi, Masamine Jimba, Chipepo Kankasa, Naoko Ishikawa
Physical and psychosocial changes during adolescence could influence the psychological well-being and adherence to antiretroviral therapy (ART) of adolescents living with HIV. However, few studies have assessed these two important issues in Zambia. This study aimed at addressing this gap by examining adolescents' depressive symptoms and ART adherence. This was a mixed-methods study conducted from April to July 2014. We recruited 200 adolescents, ages 15 to 19, who were already aware of their HIV status. We measured depressive symptoms using the short form of the Center for Epidemiologic Studies Depression Scale, and self-reported three-day adherence to ART...
January 18, 2018: AIDS Care
https://www.readbyqxmd.com/read/29346701/identifying-prevalence-and-characteristics-of-behavioral-health-education-in-family-medicine-clerkships-a-cera-study
#12
Mario P DeMarco, Renée M Betancourt, Kelly M Everard, Kent D W Bream
BACKGROUND AND OBJECTIVES: Many patients with behavioral health disorders do not seek or receive adequate care for their conditions. Among those that do, most will receive care in a primary care setting. To best meet this need, clinicians will need to demonstrate proficiency of behavioral health skills and evidence-based practices. We sought to explore the degree to which these skills are being taught in family medicine clerkships. METHODS: The Council of Academic Family Medicine's (CAFM) Educational Research Alliance (CERA) 2016 survey of clerkship directors (CDs) was sent to 141 CDs at US and Canadian medical schools with a required family medicine run course...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29346689/initial-development-and-validation-of-a-family-medicine-attitudes-questionnaire
#13
Julie Phillips, Jacob Prunuske, Laurie Fitzpatrick, Brian Mavis
BACKGROUND AND OBJECTIVES: Although many curricular and policy interventions are designed to influence students' attitudes toward family medicine, assessment of these interventions is limited by lack of a comprehensive, validated measure of students' attitudes. We sought to develop and validate a questionnaire that effectively assesses medical student attitudes toward family medicine. METHODS: A 31-item questionnaire was assessed for internal, external, and content validity...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29346426/proliferation-and-survival-of-human-amniotic-epithelial-cells-during-their-hepatic-differentiation
#14
Julieta L Maymó, Rodrigo Riedel, Antonio Pérez-Pérez, Marta Magatti, Bernardo Maskin, José Luis Dueñas, Ornella Parolini, Víctor Sánchez-Margalet, Cecilia L Varone
Stem cells derived from placental tissues are an attractive source of cells for regenerative medicine. Amniotic epithelial cells isolated from human amnion (hAECs) have desirable and competitive characteristics that make them stand out between other stem cells. They have the ability to differentiate toward all three germ layers, they are not tumorigenic and they have immunosuppressive properties. Although liver transplantation is the best way to treat acute and chronic hepatic failure patients, there are several obstacles...
2018: PloS One
https://www.readbyqxmd.com/read/29346311/apoptotic-and-nonapoptotic-activities-of-pterostilbene-against-cancer
#15
REVIEW
Rong-Jane Chen, Hsiao-Che Kuo, Li-Hsin Cheng, Yu-Hsuan Lee, Wen-Tsan Chang, Bour-Jr Wang, Ying-Jan Wang, Hung-Chi Cheng
Cancer is a major cause of death. The outcomes of current therapeutic strategies against cancer often ironically lead to even increased mortality due to the subsequent drug resistance and to metastatic recurrence. Alternative medicines are thus urgently needed. Cumulative evidence has pointed out that pterostilbene (trans-3,5-dimethoxy-4-hydroxystilbene, PS) has excellent pharmacological benefits for the prevention and treatment for various types of cancer in their different stages of progression by evoking apoptotic or nonapoptotic anti-cancer activities...
January 18, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29346307/knowledge-and-attitudes-of-general-practitioners-and-sexual-health-care-professionals-regarding-human-papillomavirus-vaccination-for-young-men-who-have-sex-with-men
#16
Samuel W D Merriel, Carrie Flannagan, Joanna M Kesten, Gilla K Shapiro, Tom Nadarzynski, Gillian Prue
Men who have sex with men (MSM) may be at higher risk for human papillomavirus (HPV)-associated cancers. Healthcare professionals' recommendations can affect HPV vaccination uptake. Since 2016, MSM up to 45 years have been offered HPV vaccination at genitourinary medicine (GUM) clinics in a pilot programme, and primary care was recommended as a setting for opportunistic vaccination. Vaccination prior to potential exposure to the virus (i.e., sexual debut) is likely to be most efficacious, therefore a focus on young MSM (YMSM) is important...
January 18, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29346221/a-validation-argument-for-a-simulation-based-training-course-centered-on-assessment-recognition-and-early-management-of-pediatric-sepsis
#17
Gary L Geis, Derek S Wheeler, Amy Bunger, Laura G Militello, Regina G Taylor, Jerome P Bauer, Terri L Byczkowski, Benjamin T Kerrey, Mary D Patterson
INTRODUCTION: Early recognition of sepsis remains one of the greatest challenges in medicine. Novice clinicians are often responsible for the recognition of sepsis and the initiation of urgent management. The aim of this study was to create a validity argument for the use of a simulation-based training course centered on assessment, recognition, and early management of sepsis in a laboratory-based setting. METHODS: Five unique simulation scenarios were developed integrating critical sepsis cues identified through qualitative interviewing...
January 17, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29346209/the-society-of-thoracic-surgeons-the-society-of-cardiovascular-anesthesiologists-and-the-american-society-of-extracorporeal-technology-clinical-practice-guidelines-anticoagulation-during-cardiopulmonary-bypass
#18
Linda Shore-Lesserson, Robert A Baker, Victor A Ferraris, Philip E Greilich, David Fitzgerald, Philip Roman, John W Hammon
Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29344847/the-effect-of-surgical-management-of-endometrioma-on-the-ivf-icsi-outcomes-when-compared-with-no-treatment-a-systematic-review-and-meta-analysis
#19
M Nickkho-Amiry, R Savant, K Majumder, E Edi-O'sagie, M Akhtar
OBJECTIVE: To assess the impact of surgical management of endometrioma on the outcome of assisted reproduction treatment (ART). DESIGN: A systematic review and meta-analysis. SETTING: Department of reproductive medicine at teaching university hospital, UK. PATIENTS: Subfertile women with endometrioma undergoing ART. INTERVENTIONS: Surgical removal of endometrioma or expectant management. MAIN OUTCOME MEASURES: Clinical pregnancy rate, pregnancy rate, live birth rate, number of oocytes retrieved and number of embryos available and ovarian response to gonadotrophins...
January 17, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29344685/long-term-safety-and-efficacy-of-botulinum-toxin-a-treatment-in-adolescent-patients-with-axillary-bromhidrosis
#20
Tao Wang, Jiasheng Dong, Jinguang He
BACKGROUND: For adolescent bromhidrosis, the long-term safety and efficacy of botulinum toxin type A (BTX-A) treatment are not clear to date. PATIENTS AND METHODS: From June 2011 to July 2016, 62 adolescent patients with primary axillary bromhidrosis were recruited and 50 U of BTX-A was administered in each axilla. Repetitive injections were performed when the malodor returned. RESULTS: The average follow-up was 2.64 years. There were no reported local or systemic adverse effects...
January 17, 2018: Aesthetic Plastic Surgery
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