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https://www.readbyqxmd.com/read/29792940/a-randomized-control-trial-to-determine-the-effectiveness-and-physiological-effects-of-spinal-manipulation-and-spinal-mobilization-compared-to-each-other-and-a-sham-condition-in-patients-with-chronic-low-back-pain-study-protocol-for-the-relief-study
#1
Brian C Clark, David W Russ, Masato Nakazawa, Christopher R France, Stevan Walkowski, Timothy D Law, Megan Applegate, Niladri Mahato, Samuel Lietkam, James Odenthal, Daniel Corcos, Simeon Hain, Betty Sindelar, Robert J Ploutz-Snyder, James S Thomas
BACKGROUND: Low back pain (LBP) is one of the most common reasons for seeking medical care. Manipulative therapies are a common treatment for LBP. Few studies have compared the effectiveness of different types of manipulative therapies. Moreover, the physiologic mechanisms underlying these treatments are not fully understood. Herein, we present the study protocol for The Researching the Effectiveness of Lumbar Interventions for Enhancing Function Study (The RELIEF Study). METHODS AND STUDY DESIGN: The RELIEF Study is a Phase II RCT with a nested mechanistic design...
May 21, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29791709/sub-trochanteric-hip-fracture-following-core-decompression-for-osteonecrosis-in-a-patient-with-a-pre-existing-contralateral-occult-femoral-neck-fracture
#2
Ryan J Berger, Assem A Sultan, Connor Cole, Nipun Sodhi, Anton Khlopas, Michael A Mont
We present a unique case of a 62-year-old patient with bilateral osteonecrosis of the femoral heads secondary to corticosteroid use. She presented with an occult right femoral neck fracture and was treated with percutaneous pinning of the right femoral neck and a left-sided percutaneous drilling. Despite apparent appropriate technique, the patient sustained a left sub-trochanteric hip fracture while shifting in bed in the postoperative care unit and was taken back for cephalo-medullary nail fixation. Femoral head osteonecrosis may be an under-reported risk factor for development of pathological neck fractures...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29790166/physical-therapy-as-the-first-point-of-care-to-treat-low-back-pain-an-instrumental-variables-approach-to-estimate-impact-on-opioid-prescription-health-care-utilization-and-costs
#3
Bianca K Frogner, Kenneth Harwood, C Holly A Andrilla, Malaika Schwartz, Jesse M Pines
OBJECTIVE: To compare differences in opioid prescription, health care utilization, and costs among patients with low back pain (LBP) who saw a physical therapist (PT) at the first point of care, at any time during the episode or not at all. DATA SOURCES: Commercial health insurance claims data, 2009-2013. STUDY DESIGN: Retrospective analyses using two-stage residual inclusion instrumental variable models to estimate rates for opioid prescriptions, imaging services, emergency department visits, hospitalization, and health care costs...
May 23, 2018: Health Services Research
https://www.readbyqxmd.com/read/29790073/effect-of-low-back-pain-risk-stratification-strategy-on-patient-outcomes-and-care-processes-the-match-randomized-trial-in-primary-care
#4
Dan Cherkin, Benjamin Balderson, Rob Wellman, Clarissa Hsu, Karen J Sherman, Sarah C Evers, Rene Hawkes, Andrea Cook, Martin D Levine, Diane Piekara, Pam Rock, Katherine Talbert Estlin, Georgie Brewer, Mark Jensen, Anne-Marie LaPorte, John Yeoman, Gail Sowden, Jonathan C Hill, Nadine E Foster
BACKGROUND: The STarT Back strategy for categorizing and treating patients with low back pain (LBP) improved patients' function while reducing costs in England. OBJECTIVE: This trial evaluated the effect of implementing an adaptation of this approach in a US setting. DESIGN: The Matching Appropriate Treatments to Consumer Healthcare needs (MATCH) trial was a pragmatic cluster randomized trial with a pre-intervention baseline period. Six primary care clinics were pair randomized, three to training in the STarT Back strategy and three to serve as controls...
May 22, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29789301/orbita-2-bringing-some-oxygen-back-to-pci-in-stable-ischemic-heart-disease
#5
Ajay J Kirtane
With the presentation and publication of the ORBITA trial in late 2017,1 for the first time the cardiology community had the results of a blinded randomized trial examining the efficacy of percutaneous coronary intervention (PCI) for stable ischemic heart disease (SIHD). ORBITA was a mechanistic trial, carefully examining a host of endpoints in order to determine potentially measurable effects of PCI vs. a sham comparator at 6 weeks of follow-up. The trial was performed in 200 highly committed research subjects with single vessel SIHD who were treated within a protocol that put them on an average of ~3 antianginal medications, subjected them to serial assessments of symptom status and tests for ischemia, and led to multiple cardiac catheterization procedures (2 procedures for subjects in the PCI arm and 15% of the sham arm, and 3 procedures for the 85% of subjects in the sham arm who underwent post-study treatment with PCI)...
May 22, 2018: Circulation
https://www.readbyqxmd.com/read/29788967/towards-a-culturally-competent-health-professional-a-south-african-case-study
#6
Margaret Matthews, Jacqueline Van Wyk
BACKGROUND: South Africa (SA) has a growing multilingual and multicultural population of approximately 55 million people, and faces service delivery challenges due to a shortage in skilled health professionals. Many health care facilities still depict distinct racial and ethnic characteristics that date back to the apartheid era, and there are reports of racial intolerance or preferential treatment at some facilities. There is limited literature in South Africa on cultural competence or on how to train health professionals to provide culturally competent care...
May 22, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29788920/a-focus-group-study-to-understand-biases-and-confounders-in-a-cluster-randomized-controlled-trial-on-low-back-pain-in-primary-care-in-norway
#7
Erik L Werner, Ida Løchting, Kjersti Storheim, Margreth Grotle
BACKGROUND: Cluster randomized controlled trials are often used in research in primary care but creates challenges regarding biases and confounders. We recently presented a study on low back pain from primary care in Norway with equal effects in the intervention and the control group. In order to understand the specific mechanisms that may produce biases in a cluster randomized trial we conducted a focus group study among the participating health care providers. The aim of this study was to understand how the participating providers themselves influenced on the study and thereby possibly on the results of the cluster randomized controlled trial...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29788356/return-to-duty-rates-following-minimally-invasive-spine-surgery-performed-on-active-duty-military-patients-in-an-ambulatory-surgery-center
#8
Elder Granger, Stefan Prada, Zoltan Bereczki, Michael Weiss, Chip Wade, Reginald Davis
Background: Low back pain is a primary health care utilization driver in the US population. Health care evaluation visits for low back pain are as common as medical evaluation for the common cold. Low back pain is the most common reason for reductions in activities of daily living and work activity in the general population. Although these statistics are compelling, in the military population, there is arguably a significantly greater economic impact on the military population, as the cost to train, retain, and deploy a service member is a tremendous cost...
May 21, 2018: Military Medicine
https://www.readbyqxmd.com/read/29788287/provider-and-patient-satisfaction-with-the-integration-of-ambulatory-and-hospital-ehr-systems
#9
Chad D Meyerhoefer, Susan A Sherer, Mary E Deily, Shin-Yi Chou, Xiaohui Guo, Jie Chen, Michael Sheinberg, Donald Levick
Objective: The installation of EHR systems can disrupt operations at clinical practice sites, but also lead to improvements in information availability. We examined how the installation of an ambulatory EHR at OB/GYN practices and its subsequent interface with an inpatient perinatal EHR affected providers' satisfaction with the transmission of clinical information and patients' ratings of their care experience. Methods: We collected data on provider satisfaction through 4 survey rounds during the phased implementation of the EHR...
May 16, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29787696/impact-of-risk-adjustment-on-provider-ranking-for-patients-with-low-back-pain-receiving-physical-therapy
#10
Daniel Deutscher, Mark W Werneke, Deanna Hayes, Jerome E Mioduski, Karon F Cook, Julie Fritz, Linda J Woodhouse, Paul W Stratford
Study Design Retrospective cohort. Background Impact of risk-adjustment on clinic quality ranking for patients treated in physical therapy outpatient clinics is unknown. Objectives To compare clinic ranking, based on unadjusted vs. risk-adjusted outcomes, for patients with low back pain (LBP) treated in physical therapy. Methods Secondary analysis of data from adult patients with LBP treated in outpatient physical therapy clinics during 2014-2016. Patients with complete outcomes data at admission and discharge were included to develop the risk-adjustment model...
May 22, 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29787330/the-myth-of-the-well-known-client
#11
Richard Lakeman
A common idiomatic phrase in mental health care is "well known" client, patient, or service user. This phrase is often followed by "to mental health services" or some such, suggesting that a "service" can really know anything. Notwithstanding mental health services, especially public ones are a repository for a lot of information, such as facts about people, their service use, diagnosis, notes and assessments of various kinds; this conglomeration of information is not knowing, any more than a library may be "knowing"...
May 22, 2018: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/29786534/-the-gynecological-pessary-is-it-really-a-device-of-another-age-a-fig-leaf
#12
E Nohuz, E Jouve, G Clement, B Jacquetin
OBJECTIVES: The use of pessary to put back up prolapsed organs to their normal position dates back prior to several millennia. This work aims to discuss its place in our clinical practice through an updated bibliographic review and emphasizes a hands-on approach to pessary fitting and management in terms of indication, pessary type selection, device' size, insertion, removal, follow-up visits and care. METHODS: A review of the literature, in the light of the latest publications and recommendations of French and international learned societies, as well as our own experience, were analyzed...
May 18, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29785455/robotic-assisted-laparoscopic-median-arcuate-ligament-release-7-year-experience-from-a-single-tertiary-care-center
#13
Usah Khrucharoen, Yen-Yi Juo, Yas Sanaiha, Yijun Chen, Juan C Jimenez, Erik P Dutson
BACKGROUND: Despite previous reports of robotic-assisted laparoscopic release for median arcuate ligament syndrome (MALS), the safety and efficacy profile of this approach has been difficult to establish due to the rarity of this diagnostic entity. We aim to present our experience from a tertiary minimally invasive surgery referral center. METHODS: A case series was performed whereby all patients who underwent robotic-assisted MAL release from July 2010 to July 2017 at our institution were included...
May 21, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29784818/acoustic-evolution-of-old-italian-violins-from-amati-to-stradivari
#14
Hwan-Ching Tai, Yen-Ping Shen, Jer-Horng Lin, Dai-Ting Chung
The shape and design of the modern violin are largely influenced by two makers from Cremona, Italy: The instrument was invented by Andrea Amati and then improved by Antonio Stradivari. Although the construction methods of Amati and Stradivari have been carefully examined, the underlying acoustic qualities which contribute to their popularity are little understood. According to Geminiani, a Baroque violinist, the ideal violin tone should "rival the most perfect human voice." To investigate whether Amati and Stradivari violins produce voice-like features, we recorded the scales of 15 antique Italian violins as well as male and female singers...
May 21, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29783088/evaluation-of-genotoxicity-and-mutagenic-effects-of-vector-dna-nanocomplexes-in-transfected-mesenchymal-stem-cells-by-flow-cytometry
#15
Alireza Nomani, Xuguang Chen, Arash Hatefi
In recent years, there has been a great deal of interest in ex-vivo genetic modification of mesenchymal stem cells (MSCs) to meet various biomedical needs. Considering the self-renewal potential of MSCs, it is critically important to ensure that transfection vectors (gene carriers) do not induce genotoxicity because they could theoretically turn a single stem cell into a cancer-initiating cell. Unfortunately, there is currently no reliable, unbiased, and quantitative method to measure genotoxicity (micronuclei formation) of gene carriers directly in transfected MSCs...
May 18, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29782199/bacteriolysis-a-mere-laboratory-curiosity
#16
Isaac Ginsburg, Erez Koren
The role of bacteriolysis in the pathophysiology of microbial infections dates back to 1893 when Buchner and Pfeiffer reported for the first time the lysis of bacteria by immune serum and related this phenomenon to the immune response. Later on, basic anti-microbial peptides and certain beta-lactam antibiotics have been shown not only to kill microorganisms but also to induce bacteriolysis and the release of cell-wall components. In 2009, a novel paradigm was offered suggesting that the main cause of death in sepsis is due to the exclusive release from activated human phagocytic neutrophils (PMNs) traps adhering upon endothelial cells of highly toxic nuclear histone...
May 21, 2018: Critical Reviews in Microbiology
https://www.readbyqxmd.com/read/29782198/a-multidisciplinary-integrative-medicine-team-in-the-treatment-of-chronic-low-back-pain-an-observational-comparative-effectiveness-study
#17
Peter M Wayne, David M Eisenberg, Kamila Osypiuk, Brian J Gow, Claudia M Witt, Roger B Davis, Julie E Buring
OBJECTIVES: Chronic low-back pain (CLBP) is burdensome and costly, and a common condition for which adults use integrative therapies. The effectiveness of multidisciplinary integrative approaches has not been well studied. The purpose of this observational study was to compare characteristics and outcomes of CLBP patients treated at the Osher Clinical Center (OCC) versus other clinics at Brigham and Women's Hospital. DESIGN: Observational comparative effectiveness study...
May 21, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29781882/no-hiv-transmission-from-virally-suppressed-mothers-during-breastfeeding-in-rural-tanzania
#18
Ezekiel Luoga, Fiona Vanobberghen, Rahel Bircher, Amina Nyuri, Alex J Ntamatungiro, Dorcas Mnzava, Getrud J Mollel, Emilio Letang, Manuel Battegay, Maja Weisser, Anna Gamell
BACKGROUND: To what extent antiretroviral therapy (ART) reduces mother-to-child HIV transmission (MTCT) during breastfeeding remains unclear. We assessed the MTCT risk from mothers on ART to their infants during breastfeeding. SETTING: Ifakara, rural Tanzania. METHODS: We included infants born between 01/2013 and 05/2016 to mothers who initiated ART before delivery, had a negative HIV DNA-PCR at 4-12 weeks, and exclusively breastfed for ≥6 months...
May 16, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29781204/malignant-melanoma-with-osteosarcomatous-differentiation-in-a-lymph-node-metastasis
#19
Jasmine Saleh, Michael L Wang, Paul W Harms, Rajiv M Patel, Douglas R Fullen
Osteocartilaginous differentiation in malignant melanoma is rare and can pose a diagnostic challenge. In previously reported cases, melanomas were predominantly located on acral and mucosal sites with osteocartilaginous differentiation present in either primary or recurrent lesions. We report a case of a 52-year-old female with malignant melanoma located on the right upper back exhibiting osteosarcomatous differentiation only in the axillary lymph node metastasis. This case serves to highlight that the divergent differentiation can occur in lymph node metastases while being absent in the primary lesion...
May 20, 2018: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/29780586/asthma-related-health-services-and-asthma-control-among-women-in-puerto-rico
#20
María Calixta Ortiz-Rivera
Objectives: This study evaluates social, behavioral, and environmental determinants to differentiate between active and inactive asthma and how predisposing, enabling, and need factors elucidate asthma-related health services and asthma control among women in Puerto Rico. Methods: This study analyzed secondary cross-sectional data from a subsample of 625 adult females who participated in the Asthma Call Back Survey in Puerto Rico. Logistic and multinomial regression analyses were conducted to examine associations between explanatory variables and asthma outcomes...
2018: SAGE Open Medicine
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