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https://www.readbyqxmd.com/read/28823018/prevalence-and-nature-of-potential-drug-drug-interactions-among-kidney-transplant-patients-in-a-german-intensive-care-unit
#1
Julia Amkreutz, Alexander Koch, Lukas Buendgens, Anja Muehlfeld, Christian Trautwein, Albrecht Eisert
Background Complex polypharmacotherapy makes kidney transplant patients vulnerable to drug-drug interactions (DDIs). Objective To study prevalence and nature of potential DDIs (pDDIs) in kidney transplant patients. Setting Internal medicine ICU, University Hospital RWTH Aachen. Method In this retrospective observational study, pDDIs were identified in the first week after transplant from 1999 to 2010. Patients aged at least 18 years with prescription of at least two drugs were included. Patients with incomplete data were excluded...
August 19, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28822322/caffeine-s-influence-on-gambling-behavior-and-other-types-of-impulsivity
#2
Jon E Grant, Samuel R Chamberlain
BACKGROUND: Young adulthood is a developmental period frequently associated with occurrence of impulsive behaviors including gambling. It is estimated that 73% of children and 87% of adults in the United States regularly use caffeine. Questions remain, however, concerning the role of caffeine in the development and maintenance of impulsive behaviors such as gambling. METHODS: Sixty-one young adults with at least some degree of disordered gambling were recruited from two Mid-Western university communities in the United States using media advertisements...
August 12, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28820515/the-role-of-oncology-nurses-in-discussing-clinical-trials
#3
Susan A Flocke, Elizabeth Antognoli, Barbara J Daly, Brigid Jackson, Sarah E Fulton, Tasnuva M Liu, Jessica Surdam, Sharon Manne, Neal J Meropol
PURPOSE/OBJECTIVES: To describe oncology nurses' experiences discussing clinical trials with their patients, and to assess barriers to these discussions.
. RESEARCH APPROACH: A qualitative study designed to elicit narratives from oncology nurses. 
. SETTING: Community- and academic-based oncology clinics throughout the United States.
. PARTICIPANTS: 33 oncology nurses involved in direct patient care in community-based and large hospital-based settings...
September 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28819067/health-economics-of-targeted-intraoperative-radiotherapy-targit-iort-for-early-breast-cancer-a-cost-effectiveness-analysis-in-the-united-kingdom
#4
Anil Vaidya, Param Vaidya, Brigitte Both, Chris Brew-Graves, Max Bulsara, Jayant S Vaidya
OBJECTIVE: The clinical effectiveness of targeted intraoperative radiotherapy (TARGIT-IORT) has been confirmed in the randomised TARGIT-A (targeted intraoperative radiotherapy-alone) trial to be similar to a several weeks' course of whole-breast external-beam radiation therapy (EBRT) in patients with early breast cancer. This study aims to determine the cost-effectiveness of TARGIT-IORT to inform policy decisions about its wider implementation. SETTING: TARGIT-A randomised clinical trial (ISRCTN34086741) which compared TARGIT with traditional EBRT and found similar breast cancer control, particularly when TARGIT was given simultaneously with lumpectomy...
August 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28816410/new-insights-into-the-cellular-makeup-and-progenitor-potential-of-palatal-connective-tissues
#5
Emoke Pall, Mihai Cenariu, Adrian Kasaj, Adrian Florea, Andrada Soancă, Alexandra Roman, Carmen Georgiu
The present study investigated the regenerative potential of connective tissues harvested from two palatal areas widely used as donor sites for muco-gingival surgical approaches. Connective tissue grafts (CTGs) were obtained by de-epithelialisation of a free gingival graft (deCTG) and by a split flap approach from a previous donor site (reCTG). Two types of mesenchymal stem cell (MSCs) were isolated and were named de-epithelialised MSCs (deMSCs) and re-entry MSCs (reMSCs). The cells were characterised and cellular functionality was investigated...
August 17, 2017: Microscopy Research and Technique
https://www.readbyqxmd.com/read/28816023/community-sensitization-and-decision-making-for-trial-participation-a-mixed-methods-study-from-the-gambia
#6
Susan Dierickx, Sarah O'Neill, Charlotte Gryseels, Edna Immaculate Anyango, Melanie Bannister-Tyrrell, Joseph Okebe, Julia Mwesigwa, Fatou Jaiteh, René Gerrets, Raffaella Ravinetto, Umberto D'Alessandro, Koen Peeters Grietens
BACKGROUND: Ensuring individual free and informed decision-making for research participation is challenging. It is thought that preliminarily informing communities through 'community sensitization' procedures may improve individual decision-making. This study set out to assess the relevance of community sensitization for individual decision-making in research participation in rural Gambia. METHODS: This anthropological mixed-methods study triangulated qualitative methods and quantitative survey methods in the context of an observational study and a clinical trial on malaria carried out by the Medical Research Council Unit Gambia...
August 16, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28815153/high-risk-drug-drug-interactions-between-clinical-practice-guidelines-for-management-of-chronic-conditions
#7
Geoffrey J Tso, Samson W Tu, Mark A Musen, Mary K Goldstein
Clinicians and clinical decision-support systems often follow pharmacotherapy recommendations for patients based on clinical practice guidelines (CPGs). In multimorbid patients, these recommendations can potentially have clinically significant drug-drug interactions (DDIs). In this study, we describe and validate a method for programmatically detecting DDIs among CPG recommendations. The system extracts pharmacotherapy intervention recommendations from narrative CPGs, normalizes the terms, creates a mapping of drugs and drug classes, and then identifies occurrences of DDIs between CPG pairs...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28815107/introducing-a-comprehensive-informatics-framework-to-promote-breast-cancer-risk-assessment-and-chemoprevention-in-the-primary-care-setting
#8
Joseph Finkelstein, Jeffrey Wood, Katherine D Crew, Rita Kukafka
Breast cancer is the most commonly diagnosed cancer among women in the United States, and current routine screening prevention methods are costly and expose patients to unnecessary risks of overtreatment. The utilization of a risk-based stratification model, genetic testing, and chemoprevention could decrease the incidence of invasive breast cancer but uptake has been low among high-risk women. The goal of this project was to implement a comprehensive informatics framework to promote breast cancer risk assessment and chemoprevention in the primary care setting that was informed by potential user feedback...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28814999/centralization-of-liver-cancer-surgery-and-impact-on-multidisciplinary-teams-working-on-stage-iv-colorectal-cancer
#9
REVIEW
Elroy Patrick Weledji
Surgical resection is the most effective treatment approach for colorectal liver metastases but only a minority of patients is suitable for upfront surgery. The treatment strategies of stage IV colorectal cancer have shifted towards a continuum of care in which medical and surgical treatment combinations are tailored to the clinical setting of the individual patient. The optimization of treatment through appropriate decision-making and multimodal therapy for stage IV colorectal cancer require a joint multidisciplinary meeting in a centralized liver cancer unit...
June 14, 2017: Oncology Reviews
https://www.readbyqxmd.com/read/28813176/validating-the-concept-of-copd-control-a-real-world-cohort-study-from-the-united-kingdom
#10
Anjan Nibber, Alison Chisholm, Juan José Soler-Cataluña, Bernardino Alcazar, David Price, Marc Miravitlles
The concept of Chronic Obstructive Pulmonary Disease (COPD) control has been developed to inform therapeutic decision-making. We explored the validity of a definition of COPD control in a representative population of patients with COPD in the United Kingdom. Electronic medical records and linked COPD questionnaire data from the Optimum Patient Care Research Database were used to characterize control status. Patients were aged ≥40 years, with spirometry-confirmed COPD, current or ex-smokers, and continuous records throughout the study period...
August 16, 2017: COPD
https://www.readbyqxmd.com/read/28807617/measurement-of-peripheral-venous-catheter-related-phlebitis-a-cross-sectional-study
#11
Katarina Göransson, Ulrika Förberg, Eva Johansson, Maria Unbeck
BACKGROUND: Many instruments for measurement of peripheral venous catheter (PVC)-related phlebitis are available, but no consensus exists on their applicability in clinical practice. This absence of consensus affects the ability to identify and compare proportions of PVCs causing phlebitis within and across hospitals as the range varies between 2% and 62% in previous studies. We hypothesised that the instruments' ability to identify phlebitis varies. The aim of this study is to illustrate the complexity of application of phlebitis instruments to a clinical dataset...
August 11, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28806783/the-utilization-of-critical-care-ultrasound-to-assess-hemodynamics-and-lung-pathology-on-icu-admission-and-the-potential-for-predicting-outcome
#12
Wanhong Yin, Yi Li, Xueying Zeng, Yao Qin, Dong Wang, Tongjuan Zou, Ling Su, Yan Kang
AIM: Critical care ultrasound (CCUS) has been used by many Intensive Care Units(ICUs) worldwide, so as to guiding the diagnosis and the treatment. However, none of the publications currently systematically describe the utilization of CCUS to analyze the characteristics of hemodynamics and lung pathology upon the new admission to ICU and its potential role in patients' prognosis prediction. In this retrospective clinical study, we have demonstrated and analyzed the characteristics of hemodynamics and lung pathology assessed by CCUS and investigated its potential to predict patient outcome...
2017: PloS One
https://www.readbyqxmd.com/read/28802696/community-acquired-pneumonia-visualized-on-computed-tomography-but-not-chest-x-ray-pathogens-severity-and-clinical-outcomes
#13
Cameron P Upchurch, Carlos G Grijalva, Richard G Wunderink, Derek J Williams, Grant W Waterer, Evan J Anderson, Yuwei Zhu, Eric M Hart, Frank Carroll, Anna M Bramley, Seema Jain, Kathryn M Edwards, Wesley H Self
BACKGROUND: The clinical significance of pneumonia visualized on computed tomography (CT) in the setting of a normal chest x-ray (CXR) is uncertain. METHODS: In a multicenter prospective surveillance study of adults hospitalized with community-acquired pneumonia (CAP), we compared the presenting clinical features, pathogens, and outcomes of patients with pneumonia visualized on CT but not on concurrent CXR (CT-only pneumonia) and those with pneumonia visualized on CXR...
August 9, 2017: Chest
https://www.readbyqxmd.com/read/28800520/a-modified-delphi-process-to-identify-clinical-and-research-priorities-in-patient-and-family-centred-critical-care
#14
Simon J W Oczkowski, Selena Au, Amanda Roze des Ordons, Marlyn Gill, Melissa L Potestio, Orla Smith, Tasnim Sinuff, Henry T Stelfox, Alison E Fox-Robichaud
PURPOSE: To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. MATERIALS AND METHODS: We engaged a panel of multidisciplinary stakeholders in a modified Delphi process. Items generated from a literature review and panelist suggestions were rated in 3 successive rounds on a scale from 1 to 7. Median score was used to rate each item's priority, with 5 or more indicating "essential priority," 4 or 5 "moderate priority" and 3 or less "low priority...
August 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28799452/syncope-current-knowledge-uncertainties-and-strategies-for-management-optimisation-in-the-emergency-department
#15
Filippo Numeroso, Gianluigi Mossini, Giuseppe Lippi, Gianfranco Cervellin
Admission rates and expenditures for syncope remain high. This unsatisfactory management could be due to several factors, including lack of evidence-based strategy, poor accuracy of clinical decision rules, difficulty in disseminating guidelines, as well as uncertainties concerning management of intermediate-risk patients and role of observation protocols and syncope units. To optimise management, it has been proposed to adopt a pragmatic, symptoms-based definition of syncope and a classification related to the underlying mechanism rather than suspected aetiology...
August 11, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28797577/comparison-of-two-dimensional-methods-versus-three-dimensional-scanning-systems-in-the-assessment-of-total-body-surface-area-estimation-in-burn-patients
#16
Helene Retrouvey, Justin Chan, Shahriar Shahrokhi
BACKGROUND: Accurate measurement of percent total body surface area (%TBSA) burn is crucial in the management of burn patients for calculating the estimated fluid resuscitation, determining the need to transfer to a specialized burn unit and probability of mortality. %TBSA can be estimated using many methods, all of which are relatively inaccurate. Three-dimensional (3D) systems have been developed to improve %TBSA calculation and consequently optimize clinical decision-making. The objective of this study was to compare the accuracy of percent total burn surface area calculation by conventional methods against novel 3D methods...
August 7, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28793866/strategies-for-the-prevention-of-perinatal-hepatitis-b-transmission-in-a-marginalized-population-on-the-thailand-myanmar-border-a-cost-effectiveness-analysis
#17
Angela Devine, Rebecca Harvey, Aung Myat Min, Mary Ellen T Gilder, Moo Koh Paw, Joy Kang, Isabella Watts, Borimas Hanboonkunupakarn, François Nosten, Rose McGready
BACKGROUND: Data on the cost effectiveness of hepatitis B virus (HBV) screening and vaccination strategies for prevention of vertical transmission of HBV in resource limited settings is sparse. METHODS: A decision tree model of HBV prevention strategies utilised data from a cohort of 7071 pregnant women on the Thailand-Myanmar border using a provider perspective. All options included universal HBV vaccination for newborns in three strategies: (1) universal vaccination alone; (2) universal vaccination with screening of women during antenatal visits with rapid diagnostic test (RDT) plus HBV immune globulin (HBIG) administration to newborns of HBV surface antigen positive women; and (3) universal vaccination with screening of women during antenatal visits plus HBIG administration to newborns of women testing HBV e antigen positive by confirmatory test...
August 9, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28780540/the-postoperative-handover-a-focus-group-interview-study-with-nurse-anaesthetists-anaesthesiologists-and-pacu-nurses
#18
Maria Randmaa, Maria Engström, Christine Leo Swenne, Gunilla Mårtensson
OBJECTIVES: To investigate different professionals' (nurse anaesthetists', anaesthesiologists', and postanaesthesia care unit nurses') descriptions of and reflections on the postoperative handover. DESIGN: A focus group interview study with a descriptive design using qualitative content analysis of transcripts. SETTING: One anaesthetic clinic at two hospitals in Sweden. PARTICIPANTS: Six focus groups with 23 healthcare professionals involved in postoperative handovers...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28776639/postpartum-obstetric-red-cell-transfusion-practice-a-retrospective-study-in-a-tertiary-obstetric-centre
#19
Benjamin Stephens, Farah Sethna, Philip Crispin
BACKGROUND: Traditional management of anaemia due to postpartum haemorrhage (PPH) has relied upon salvage therapy with red cell transfusion. Recently published guidance recommends a change in approach toward holistic patient blood management. AIMS: To determine whether postpartum red cell transfusion practices are consistent with best practice and to identify opportunities for improvement. MATERIALS AND METHODS: A retrospective audit of postpartum red cell transfusions was conducted at a tertiary level obstetrics unit...
August 4, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28776144/-validation-of-medical-ethical-decisions-at-the-bedside-by-the-autopsy-experience-of-the-ethics-committee-at-the-stuttgart-clinic
#20
REVIEW
A Bosse, C Schupp
BACKGROUND: Ethics consultations in a clinical setting can be challenging, specifically with respect to limiting therapeutic interventions in terminally ill patients. Some decisions will even be controversial. OBJECTIVE: Can a clinical autopsy be used to confirm the recommendations given by the ethics committee, i. e. limitation of therapy to palliative care? MATERIAL AND METHODS: We report an exemplary case of a patient with endocarditis and subsequent septic cerebral infarction...
August 3, 2017: Der Pathologe
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