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https://www.readbyqxmd.com/read/29160002/a-randomized-double-blind-trial-of-needle-free-injected-lidocaine-versus-topical-anesthesia-for-infant-lumbar-puncture
#1
Ryan Caltagirone, Vidya R Raghavan, Kathleen Adelgais, Genie E Roosevelt
OBJECTIVES: Lumbar punctures (LPs) are commonly performed in febrile infants to evaluate for meningitis, and local anesthesia increases the likelihood of LP success. Traditional methods of local anesthesia require injection which may be painful or topical application which is not effective immediately. Recent advances in needle-free jet injection may offer a rapid alternative to these modalities. We compared a needle-free jet-injection system (J-Tip(™) ) with 1% buffered lidocaine to topical anesthetic (TA) cream for local anesthesia in infant LPs...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29155210/transition-from-androgenic-to-neurosteroidal-action-of-5%C3%AE-androstane-3%C3%AE-17%C3%AE-diol-through-the-type-a-%C3%AE-aminobutyric-acid-receptor-in-prostate-cancer-progression
#2
Ding Xia, Doan V Lai, Weijuan Wu, Zachary D Webb, Qing Yang, Lichao Zhao, Zhongxin Yu, Jessica E Thorpe, Bryan C Disch, Michael A Ihnat, Muralidharan Jayaraman, Danny N Dhanasekaran, Kelly L Stratton, Michael S Cookson, Kar-Ming Fung, Hsueh-Kung Lin
Androgen ablation is the standard of care prescribed to patients with advanced or metastatic prostate cancer (PCa) to slow down disease progression. Unfortunately, a majority of PCa patients under androgen ablation progress to castration-resistant prostate cancer (CRPC). Several mechanisms including alternative intra-prostatic androgen production and androgen-independent androgen receptor (AR) activation have been proposed for CRPC progression. Aldo-keto reductase family 1 member C3 (AKR1C3), a multi-functional steroid metabolizing enzyme, is specifically expressed in the cytoplasm of PCa cells; and positive immunoreactivity of the type A γ-aminobutyric acid receptor (GABAAR), an ionotropic receptor and ligand-gated ion channel, is detected on the membrane of PCa cells...
November 15, 2017: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/29146391/small-diameter-hysteroscopic-metroplasty-for-a-septate-uterus-after-open-assisted-laparoscopic-radical-trachelectomy
#3
Akimasa Takahashi, Hiroyuki Kanao, Nobuhiro Takeshima
STUDY OBJECTIVE: To describe a two-step fertility preservation technique for early-stage cervical cancer of a patient with a complete septate uterus. DESIGN: A step-by-step demonstration and explanation of the technique in a surgical video (Canadian Task Force Classification III). SETTING: Center for cancer, a tertiary referral center. The patient provided informed consent to use images and videos of the procedure. Institutional Review Board approval was not required for this kind of procedure...
November 13, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29143901/combined-vertebral-augmentation-and-radiofrequency-ablation-in-the-management-of-spinal-metastases-an-update
#4
REVIEW
Ning Mao Kam, Julian Maingard, Hong Kuan Kok, Dinesh Ranatunga, Duncan Brooks, William C Torreggiani, Peter L Munk, Michael J Lee, Ronil V Chandra, Hamed Asadi
Spinal metastases are the most commonly encountered tumour of the spine, occurring in up to 40% of patients with cancer. Each year, approximately 5% of cancer patients will develop spinal metastases. This number is expected to increase as the life expectancy of cancer patients increases. Patients with spinal metastases experience severe and frequently debilitating pain, which often decreases their remaining quality of life. With a median survival of less than 1 year, the goals of treatment in spinal metastases are reducing pain, improving or maintaining level of function and providing mechanical stability...
November 16, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/29142447/a-prospective-randomized-study-comparing-unipolar-versus-bipolar-hysteroscopic-myomectomy-in-infertile-women
#5
Kallol K Roy, Sandeep Metta, Yamini Kansal, Sunesh Kumar, Seema Singhal, Perumal Vanamail
Study Objective: To compare the operative and reproductive outcome of hysteroscopic myomectomy using unipolar resectoscope versus bipolar resectoscope in patients with infertility and menorrhagia. Design: Randomized, prospective, parallel, comparative, single-blinded study. Design Classification: Canadian Task Force classification I. Setting: Tertiary care institute. Patients: Sixty women with submucous myoma and infertility...
July 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/29141979/measurement-errors-in-dietary-assessment-using-self-reported-24-hour-recalls-in-low-income-countries-and-strategies-for-their-prevention
#6
Rosalind S Gibson, U Ruth Charrondiere, Winnie Bell
Securing accurate measurements of dietary intake across populations is challenging. Of the methods, self-reported 24-h recalls are often used in low-income countries (LICs) because they are quick, culturally sensitive, do not require high cognitive ability, and provide quantitative data on both foods and nutrients. Measuring intakes via 24-h recalls involves 1) collecting data on food intakes, 2) the appropriate use of relevant food-composition data for calculating nutrient intakes, and 3) statistically converting observed intakes to "usual intakes" for evaluating nutrient adequacy or relations between foods and nutrients and health outcomes...
November 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/29139314/cost-utility-analysis-of-life-long-prophylaxis-with-recombinant-factor-viii-fc-vs-recombinant-factor-viii-for-the-management-of-severe-haemophilia-a-in-sweden
#7
Nathaniel Henry, Jelena Jovanović, Max Schlueter, Persefoni Kritikou, Koo Wilson, Karl-Johan Myrén
AIMS: Prophylaxis with recombinant factor VIII (rFVIII) is the standard of care for severe haemophilia A in Sweden. The need for frequent injections with existing rFVIII products may, however, result in poor adherence to prophylaxis leading to increased bleeding and long-term joint damage. Recombinant FVIIIFc (rFVIIIFc) is an extended half-life fusion protein which can offer prolonged protection and reduced dosing frequency. The objective of this study was to evaluate the cost-utility of prophylaxis with rFVIIIFc in severe haemophilia A from the perspective of the Swedish health system...
November 15, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29133715/minimally-invasive-lateral-foraminotomy-with-partial-lateral-facetectomy-for-lumbar-radiculopathy-an-evaluation-of-facet-integrity-and-description-of-the-procedure
#8
Akshay Hari, Murali Krishna, Santosh Rajagandhi, Ankit Sharma, Rajakumar V Deshpande
Foraminal stenosis causing nerve root compression and radiculopathy is a relatively common pathology in the lumbar spine. The treatment of choice, when surgery is indicated, is foraminal decompression at the affected level, usually through a conventional midline open foraminotomy. Minimally invasive lateral foraminotomy with partial lateral facetectomy is a potentially effective surgical alternative when such a surgery is warranted. The evaluation of the efficacy and benefits of this approach for treatment of radiculopathy; an assessment of facet integrity; and, a detailed description of the procedure are also provided...
November 2017: Neurology India
https://www.readbyqxmd.com/read/29132827/high-performance-thin-layer-chromatographic-methods-in-the-evaluation-of-the-antioxidant-and-anti-hyperglycemic-activity-of-myrmecodia-platytyrea-as-a-promising-opportunity-in-diabetes-treatment
#9
S Agatonovic-Kustrin, D W Morton, A Adam, H H Mizaton, H Zakaria
The steady increase of diabetes is becoming a major burden on health care systems. As diabetic complications arise from oxidative stress, an antioxidant therapy along with anti-diabetic drugs is recommended. Myrmecodia or ant plant is highly valued as a traditional medicine in West Papua. It is used as an alternative treatment for diabetes, as the substances produced by ants can reduce blood sugar levels. The aim of this study was to develop and establish high-performance thin-layer chromatographic (HPTLC)-bioautographic methods to measure the antioxidant and hypoglycemic effects in different extracts from Myrmecodia platytyrea and to compare them with sterol content...
November 10, 2017: Journal of Chromatography. A
https://www.readbyqxmd.com/read/29127851/autonomy-to-health-care-professionals-as-a-vehicle-for-value-based-health-care-results-of-a-quasi-experiment-in-hospital-governance
#10
Kristian Nørgaard Larsen, Søren Rud Kristensen, Rikke Søgaard
Health care systems increasingly aim to create value for money by simultaneous incentivizing of quality along with classical goals such as activity increase and cost containment. It has recently been suggested that letting health care professionals choose the performance metrics on which they are evaluated may improve value of care by facilitating greater employee initiative, especially in the quality domain. There is a risk that this strategy leads to loss of performance as measured by the classical goals, if these goals are not prioritized by health care professionals...
November 6, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29125409/interdependence-in-decision-making-by-medical-consultants-implications-for-improving-the-efficiency-of-inpatient-physician-services
#11
Adam S Wilk, Lena M Chen
OBJECTIVES: Hospital administrators are seeking to improve efficiency in medical consultation services, yet whether consultants make decisions to provide more or less care is unknown. We examined how medical consultants account for prior consultants' care when determining whether to provide intensive consulting care or sign off in the treatment of complex surgical inpatients. We applied three distinct theoretical frameworks in the interpretation of our results. METHODS: We performed a retrospective cohort study of consultants' care intensity, measured alternately using a dummy variable for providing two or more days consulting (versus one) and a continuous measure of total days consulting, with 100% Medicare claims data from 2007-2010...
November 10, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29120687/a-100-patient-clinical-evaluation-of-an-alternating-pressure-replacement-mattress-in-a-home-based-setting
#12
Jackie Stephen-Haynes, Rosie Callaghan
BACKGROUND: alternating pressure air mattresses (APAMs) support the prevention and management of pressure ulcers. A health and care NHS trust was seeking an APAM that would improve clinical outcomes in relation to pressure ulcers while considering financial cost. An APAM existed that could meet the trust's needs but there was a lack of evidence over its use in a community/home setting. This study examined the effect of using the Dual Professional (IQ Medical) APAM for patients at a high risk of pressure ulceration...
November 8, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29120106/balancing-the-scales-negotiating-father-s-parental-leave-use
#13
Judy Beglaubter
Studying couples who shared parental leave presents the opportunity to explore decision-making processes that may challenge conventional care arrangement typical of early parenthood. Interviews with 33 Canadian heterosexual couples indicate gendered sticking points in the division of official leave time. Whether fathers took leave because of their personal desires or material circumstances, this study finds that men and women did not enter negotiations on a level playing field. Strong cultural support for mothers'-but not fathers'-time with baby tipped the scales toward maternal care giving, even when couples wanted to share parental leave...
November 2017: Canadian Review of Sociology, Revue Canadienne de Sociologie
https://www.readbyqxmd.com/read/29118275/a-mid-level-dental-provider-in-oregon-dental-hygienists-perceptions
#14
Amy E Coplen, Kathryn Bell, Gail L Aamodt, Lynn Ironside
Purpose: Many states are exploring alternative provider models and examining the role of the dental hygienist to address access to care challenges as the United States continues to face increasing demands for oral healthcare services. The purpose of this study was to assess dental hygienists' opinions in the state of Oregon regarding the current limitations of dental hygienists' scope of practice, perceived need for a mid-level provider in Oregon, and personal interest in becoming a mid-level provider.Methods: In December 2013 a survey was mailed to a sample of 1,231 dental hygienists registered in Oregon representing 30% of the licentiates...
October 2017: Journal of Dental Hygiene: JDH
https://www.readbyqxmd.com/read/29118078/exploring-interprofessional-relationships-between-dental-hygienists-and-health-professionals-in-rural-canadian-communities
#15
Janice C Grant, Zul Kanji
Purpose: For most Canadians living in rural communities, limited access to dental care can negatively impact oral and general health. This narrative, tertiary review of the literature explores the outcomes of interprofessional relationships between dental hygienists and other health professionals on individuals residing in rural communities in Canada. Themes addressed include: implementing interprofessional education experiences in entry-to-practice health programs, interprofessional dynamics in primary health care teams, health perceptions in rural communities, and barriers and enablers to interprofessional relationships...
August 2017: Journal of Dental Hygiene: JDH
https://www.readbyqxmd.com/read/29110577/moral-economy-and-moral-capital-in-the-community-of-clinical-practice
#16
Chrystal Jaye, Jessica Young, Tony Egan, Martyn Williamson
This New Zealand study used focused ethnography to explore the activities of communities of clinical practice (CoCP) in a community-based long-term conditions management program within a large primary health care clinic. CoCP are the informal vehicles by which patient care was delivered within the program. Here, we describe the CoCP as a micro-level moral economy within which values such as trust, respect, authenticity, reciprocity, and obligation circulate as a kind of moral capital. As taxpayers, citizens who become patients are credited with moral capital because the public health system is funded by taxes...
November 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/29109115/use-of-an-electronic-consultation-system-in-primary-care-a-qualitative-interview-study
#17
Jon Banks, Michelle Farr, Chris Salisbury, Elly Bernard, Kate Northstone, Hannah Edwards, Jeremy Horwood
BACKGROUND: The level of demand on primary care continues to increase. Electronic or e-consultations enable patients to consult their GP online and have been promoted as having potential to improve access and efficiency. AIM: To evaluate whether an e-consultation system improves the ability of practice staff to manage workload and access. DESIGN AND SETTING: A qualitative interview study in general practices in the West of England that piloted an e-consultation system for 15 months during 2015 and 2016...
November 6, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29107892/implementation-of-deinstitutionalization-of-child-care-institutions-in-post-soviet-countries-the-case-of-azerbaijan
#18
Aytakin Huseynli
Institutional care has proven to be detrimental for child development. This study examined the status of the State Program on Deinstitutionalization and Alternative Care (SPDAC), a public policy aimed at transforming 55 institutions covering 14,500 children during 2006-2016 in Azerbaijan. The success of this public policy was crucial for the country's entire child welfare system. The study used a crosssectional, descriptive, exploratory, and qualitative method. Data were collected through in-depth, semistructured interviews and archival resources...
November 3, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29105310/role-of-glucocorticoids-in-kawasaki-disease
#19
Masaru Miura
Although treatment with intravenous immunoglobulin (IVIg) with aspirin is the standard of care for children with Kawasaki disease (KD), 15-20% of patients fail to respond and experience persistent or recurrent fever after completion of IVIg administration. These IVIg non-responders are at high risk for coronary artery lesions (CAL), and may need alternative or supplemental therapy. Based on retrospective studies (albeit with low evidence levels), glucocorticoid therapy was hitherto thought to worsen CAL. However, subsequent prospective studies have shown that prednisolone or IV methylprednisolone pulse as the initial or rescue therapy is effective in reducing CAL...
November 3, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/29102982/randomised-controlled-non-inferiority-trial-of-primary-care-based-facilitated-access-to-an-alcohol-reduction-website
#20
Paul Wallace, Pierliugi Struzzo, Roberto Della Vedova, Francesca Scafuri, Costanza Tersar, Charilaos Lygidakis, Richard McGregor, Emanuele Scafato, Rachael Hunter, Nick Freemantle
BACKGROUND: Brief interventions (BIs) delivered in primary care have been shown to be effective in reducing risky drinking, but implementation is limited. Facilitated access to a digital application offers a novel alternative to face-to-face intervention, but its relative effectiveness is unknown. METHODS: Primary care-based, non-inferiority, randomised controlled trial comparing general practitioner (GP) facilitated access to an interactive alcohol reduction website (FA) with face-to-face BI for risky drinking...
November 3, 2017: BMJ Open
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