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https://www.readbyqxmd.com/read/28917603/development-of-the-nurses-care-coordination-competency-scale-for-mechanically-ventilated-patients-in-critical-care-settings-in-japan-part-1-development-of-a-measuring-instrument
#1
Chie Takiguchi, Yumiko Yatomi, Tomoko Inoue
OBJECTIVES: To develop a draft scale measuring nurses' care coordination competency for care of mechanically ventilated patients in critical care settings. METHOD: The scale items and concepts were derived from semi-structured interviews with 28 professionals (14 nurses, eight physicians, three physical therapists, three clinical engineers) who are managing mechanically ventilated critical care patients. A grounded theory approach was used. After content validation by experts, two pilot tests were used to identify and correct non-discriminating items and vague items...
September 13, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28916164/-analysis-of-clinical-relevance-applied-to-3methods-of-reducing-weight-in-overweight-or-obesity-followed-up-for-one-year
#2
M L Tárraga Marcos, J M Panisello Royo, J A Carbayo Herencia, N Rosich Domenech, J Alins Presas, E Castell Panisello, P J Tárraga López
OBJECTIVE: To analyse the effect of the use/implementation of 3methods to reduce weight in overweight or obese patients during one year of follow up. MATERIAL AND METHODS: The design corresponds to a double-blind, randomised, controlled clinical trial with 3arms, and 12 months of follow-up. Patients were randomised into 3intervention groups: obesity motivational intervention, with a nurse previously trained in motivational intervention by expert psychologists (G1; n=60); lower intensity consultation, non-motivational group, with digital platform support (G2; N=61), and a third group that received recommendations for weight loss and follow-up in Primary Care Clinic (G3; n=59)...
September 12, 2017: Hipertensión y Riesgo Vascular
https://www.readbyqxmd.com/read/28915703/treatments-of-traumatic-neuropathic-pain-a-systematic-review
#3
REVIEW
Chenglun Yao, Xijie Zhou, Bin Zhao, Chao Sun, Keshav Poonit, Hede Yan
Traumatic neuropathic pain caused by traumatic neuroma has long been bothering both doctors and patients, the mechanisms of traumatic neuropathic pain are widely discussed by researchers and the treatment is challenging. Clinical treatment of painful neuroma is unclear. Numerous treatment modalities have been introduced by experts in this field. However, there is still no single standard recognized treatment. Different forms of treatments have been tested in animals and humans, but pharmacotherapies (antidepressants, antiepileptics) remain the basis of traumatic neuropathic pain management...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28914633/gaps-in-current-knowledge-and-priorities-for-future-research-in-dry-eye
#4
Ian J Saldanha, Kay Dickersin, Susan T Hutfless, Esen K Akpek
PURPOSE: Dry eye, a common yet underrecognized and evolving field, has few recommended treatment algorithms, mostly based on expert consensus rather than robust research evidence. There are high costs associated with managing dry eye and conducting research to identify effective and safe long-term treatments. To support evidence-based management of dry eye, our purpose was to identify and prioritize important clinical research questions for future clinical research. METHODS: We translated recommendations from the American Academy of Ophthalmology's 2013 Preferred Practice Patterns for dry eye into answerable clinical research questions about treatment effectiveness...
September 12, 2017: Cornea
https://www.readbyqxmd.com/read/28914561/oral-and-depot-progestin-therapy-for-endometriosis-towards-a-personalized-medicine
#5
Laura Buggio, Edgardo Somigliana, Giussy Barbara, Maria Pina Frattaruolo, Paolo Vercellini
Endometriosis is an estrogen-dependent chronic inflammatory disorder that requires a life-long management plan. Long-term adherence to treatment is pivotal to ensure an effective clinical management. In this optic, one of the cornerstone of endometriosis medical treatment is represented by progestins. Areas covered: This narrative review examines the clinical efficacy, safety and tolerability of oral and depot progestins used in the treatment of endometriosis. The material included in the current manuscript was obtained with a MEDLINE search through PubMed from inception until January 2017...
September 15, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#6
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28912289/using-best-interests-meetings-for-people-in-a-prolonged-disorder-of-consciousness-to-improve-clinical-and-ethical-management
#7
Derick T Wade
Current management of people with prolonged disorders of consciousness is failing patients, families and society. The causes include a general lack of concern, knowledge and expertise; a legal and professional framework which impedes timely and appropriate decision-making and/or enactment of the decision; and the exclusive focus on the patient, with no legitimate means to consider the broader consequences of healthcare decisions. This article argues that a clinical pathway based on the principles of (a) the English Mental Capacity Act 2005 and (b) using time-limited treatment trials could greatly improve patient management and reduce stress on families...
September 14, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28911283/australian-and-new-zealand-anaesthetic-allergy-group-perioperative-anaphylaxis-investigation-guidelines
#8
R J Scolaro, H M Crilly, E J Maycock, P T McAleer, K A Nicholls, M A Rose, Rih The
These guidelines are a consensus document developed by a working party of the Australian and New Zealand Anaesthetic Allergy Group (ANZAAG) to provide an approach to the investigation of perioperative anaphylaxis. They focus primarily on the use of skin testing as it is the investigation with the greatest clinical utility for the identification of the likely causative agent and potentially safer alternatives. The practicalities and process of skin testing, its limitations, and the place of other tests are discussed...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28911072/oncologist-use-and-perception-of-large-panel-next-generation-tumor-sequencing
#9
A M Schram, D Reales, J Galle, R Cambria, R Durany, D Feldman, E Sherman, J Rosenberg, G D'Andrea, S Baxi, Y Janjigian, W Tap, M Dickler, J Baselga, B S Taylor, D Chakravarty, J Gao, N Schultz, D B Solit, M F Berger, D M Hyman
Background: Genomic profiling is increasingly incorporated into oncology research and the clinical care of cancer patients. We sought to determine physician perception and use of enterprise-scale clinical sequencing at our center, including whether testing changed management and the reasoning behind this decision-making. Patients and methods: All physicians who consented patients to MSK-IMPACT, a next-generation hybridization capture assay, in tumor types where molecular profiling is not routinely performed were asked to complete a questionnaire for each patient...
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28911065/development-of-an-integrated-electronic-platform-for-patient-self-report-and-management-of-adverse-events-during-cancer-treatment
#10
P Holch, L Warrington, L C A Bamforth, A Keding, L E Ziegler, K Absolom, C Hector, C Harley, O Johnson, G Hall, C Morris, G Velikova
Background: Significant adverse events (AE) during cancer therapy disrupt treatment and escalate to emergency admissions. Approaches to improve the timeliness and accuracy of AE reporting may improve safety and reduce health service costs. Reporting AE via patient reported outcomes (PROs), can improve clinician-patient communication and making data available to clinicians in 'real-time' using electronic PROs (ePROs) could potentially transform clinical practice by providing easily accessible records to guide treatment decisions...
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28906340/contemporary-approach-to-joint-hypermobility-and-related-disorders
#11
Marco Castori, Alan Hakim
PURPOSE OF REVIEW: Joint hypermobility is a common, although largely ignored physical sign. Joint hypermobility is often asymptomatic but may be a feature of an underlying genetic disorder with systemic manifestations. The present article presents a comprehensive approach to considering joint hypermobility and clinically related issues in children and adults. RECENT FINDINGS: Ehlers-Danlos syndrome (EDS) is an umbrella term for various Mendelian connective tissue disorders sharing joint hypermobility, skin hyperextensibility, and tissue fragility...
September 12, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28905489/consensus-and-controversies-regarding-the-treatment-of-rhabdomyosarcoma
#12
REVIEW
Scott C Borinstein, Diana Steppan, Masanori Hayashi, David M Loeb, Michael S Isakoff, Odion Binitie, Andrew S Brohl, Julia A Bridge, Mark Stavas, Eric T Shinohara, William H Meyer, Damon R Reed, Lars M Wagner
Optimal treatment of rhabdomyosarcoma (RMS) requires multidisciplinary approach, incorporating chemotherapy with local control. Although current therapies are built on cooperative group trials, a comprehensive standard of care to guide clinical decision making has been lacking, especially for relapsed patients. Therefore, we assembled a panel of pediatric and adolescent and young adult sarcoma experts to develop treatment guidelines for managing RMS and to identify areas in which further research is needed...
September 14, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28904006/the-crash-report-emergency-management-dilemmas-facing-acute-physicians-in-patients-with-pulmonary-arterial-hypertension
#13
Laura C Price, Konstantinos Dimopoulos, Philip Marino, Rafael Alonso-Gonzalez, Colm McCabe, Aleksander Kemnpy, Lorna Swan, Maria Boutsikou, Ahmed Al Zahrani, Gerry J Coghlan, Benjamin E Schreiber, Luke S Howard, Rachel Davies, Mark Toshner, Joanna Pepke-Zaba, Alistair C Church, Andrew Peacock, Paul A Corris, James L Lordan, Sean Gaine, Robin Condliffe, David G Kiely, Stephen John Wort
Treatment of acute emergencies in patients with pulmonary arterial hypertension (PAH) can be challenging. In the UK and Ireland, management of adult patients with PAH is centred in eight nationally designated pulmonary hypertension (PH) centres. However, many patients live far from these centres and physicians in local hospitals are often required to manage PAH emergencies. A committee of physicians from nationally designated PH centres identified the 'most common' emergency clinical scenarios encountered in patients with PAH...
September 12, 2017: Thorax
https://www.readbyqxmd.com/read/28903985/molecular-tools-for-the-detection-and-deduction-of-azole-antifungal-drug-resistance-phenotypes-in-aspergillus-species
#14
REVIEW
Anna Dudakova, Birgit Spiess, Marut Tangwattanachuleeporn, Christoph Sasse, Dieter Buchheidt, Michael Weig, Uwe Groß, Oliver Bader
The incidence of azole resistance in Aspergillus species has increased over the past years, most importantly for Aspergillus fumigatus. This is partially attributable to the global spread of only a few resistance alleles through the environment. Secondary resistance is a significant clinical concern, as invasive aspergillosis with drug-susceptible strains is already difficult to treat, and exclusion of azole-based antifungals from prophylaxis or first-line treatment of invasive aspergillosis in high-risk patients would dramatically limit drug choices, thus increasing mortality rates for immunocompromised patients...
October 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/28903473/baseline-anatomical-assessment-of-the-uterus-and-ovaries-in-infertile-women-a-systematic-review-of-the-evidence-on-which-assessment-methods-are-the-safest-and-most-effective-in-terms-of-improving-fertility-outcomes
#15
Sarah C Armstrong, Marian Showell, Elizabeth A Stewart, Robert W Rebar, Sheryl Vanderpoel, Cynthia M Farquhar
BACKGROUND: This review focuses on the initial presentation of women who suspect that they are infertile, and how best to assess the anatomy of their uterus and ovaries in order to investigate the cause of their infertility, and potentially improve desired fertility outcomes. This review was undertaken as part of a World Health Organization initiative to assess the evidence available to address guidance for the diagnosis and treatment of infertility within a global context. Providing access to care for infertile women will help to ease the psycho-social burdens, such as ostracization, intimate partner violence and other negative consequences of being involuntarily childless or unable to become pregnant despite desiring a biological child or children...
September 1, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/28902700/effectiveness-of-collaboration-between-emergency-department-and-intensive-care-unit-teams-on-mortality-rates-of-patients-presenting-with-critical-illness-a-systematic-review
#16
Kerchelle McDowald, Svetlana Direktor, Elizabeth A Hynes, Anna Sahadeo, Margaret E Rogers
BACKGROUND: The increasing volume of adult patients with critical illness entering emergency departments (EDs) burdens the resources of EDs worldwide. This subpopulation faces a high risk of mortality because they require specialized care which many EDs are not yet poised to deliver. An element crucial to delivering care and decreasing the mortality of critically ill patients in the ED is expert collaborative practice across disciplines. Several ED and intensive care unit (ICU) collaborative models exist including: emergency department intensive care units (EDICU) and medical emergency teams (MET)...
September 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28902523/functional-assessment-of-lesion-severity-without-using-the-pressure-wire-coronary-imaging-and-blood-flow-simulation
#17
Michail I Papafaklis, Michail C Mavrogiannis, Panagiotis K Siogkas, Lampros S Lakkas, Christos S Katsouras, Dimitrios I Fotiadis, Lampros K Michalis
Hemodynamic indices derived from measurements with the pressure wire (primarily fractional flow reserve [FFR]) have been established as a reliable tool for assessing coronary stenoses and improving clinical decision making. However, the use of the pressure wire constitutes a hurdle for the universal adoption of physiology-guided patient management. Technological advancements have enabled the large-scale application of blood flow simulation (computational fluid dynamics [CFD]) to medical imaging, thereby enabling the virtual assessment of coronary physiology...
September 13, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28901786/effect-of-gestational-age-on-the-epidemiology-of-late-onset-sepsis-in-neonatal-intensive-care-units-a-review
#18
Elsa de Palma Afonso, Stijn Blot
Neonatal sepsis is a major cause of morbidity and mortality. Late-onset sepsis affects a significant percentage of infants admitted to the neonatal intensive care unit (NICU). Most affected newborns are preterm or low birth weight, but late-onset sepsis also affects late preterm and term infants. Understanding how gestational age affects the epidemiology of late-onset sepsis can be of use when defining strategies for its prevention and clinical management in NICU. Areas covered: Available evidence suggests the incidence and mortality of late-onset sepsis is higher in preterm and VLBW infants, but pathogen distribution and risk exposure is similar across all infants admitted to NICU...
September 13, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28901643/renal-function-monitoring-in-heart-failure-what-is-the-optimal-frequency-a-narrative-review
#19
REVIEW
A Al-Naher, D J Wright, M A J Devonald, M Pirmohamed
The second most common cause of hospitalisation due to adverse drug reactions in the UK is renal dysfunction due to diuretics, particularly in patients with heart failure, where diuretic therapy is a mainstay of treatment regimens. Therefore the optimal frequency for monitoring renal function in these patients is an important consideration for preventing renal failure and hospitalisation. This review looks at the current evidence for optimal monitoring practices of renal function in patients with heart failure according to national and international guidelines on the management of heart failure (AHA/NICE/ESC/SIGN)...
September 13, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28901221/direct-oral-anticoagulant-reversal-how-when-and-issues-faced
#20
Mikhail S Dzeshka, Daniele Pastori, Gregory Y H Lip
The number of atrial fibrillation (AF) patients requiring thrombo-prophylaxis with oral anticoagulation is greatly increasing. The introduction of non-vitamin K oral anticoagulants (NOACs) in addition to standard therapy with dose-adjusted warfarin has increased the therapeutic options for AF patients. Despite a generally better safety profile of the NOACs, the risk of major bleedings still persists, and the management of serious bleeding is a clinical challenge. Areas covered: In the current review, risk of major bleeding in patients taking NOACs and general approaches to manage bleeding depending on severity, with a particular focus on specific reversal agents, are discussed...
September 13, 2017: Expert Review of Hematology
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