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https://www.readbyqxmd.com/read/28632953/updates-to-the-us-food-and-drug-administration-regulations-for-mifepristone-implications-for-clinical-practice-and-access-to-abortion
#1
Katherine E Simmonds, Margaret W Beal, Meghan K Eagen-Torkko
This article provides information on recent changes in the US Food and Drug Administration (FDA) labeling and safety regulations for mifepristone (Mifeprex). The revised label now permits midwives, advanced practice nurses, and physician assistants to order and prescribe mifepristone, eliminating the requirement for physician supervision. The updated label also extends eligibility for use from 49 to 70 days' gestation and decreases the number of required visits from 3 to 2. The recommended dose of mifepristone has been reduced, and the dosage, timing, and route of administration for misoprostol have also been changed to reflect current research...
May 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28628548/clinical-outcome-measures-for-lateropulsion-poststroke-an-updated-systematic-review
#2
Ryan Koter, Sara Regan, Caitlin Clark, Vicki Huang, Melissa Mosley, Erin Wyant, Chad Cook, Jeffrey Hoder
BACKGROUND AND PURPOSE: Contraversive Lateropulsion, also referred to as contraversive pushing, pusher behavior, and pusher syndrome, can be associated with increased hospital length of stay, increased health care costs, and delayed outcomes in persons with stroke. The purpose of this updated systematic review was to identify scales used to classify contraversive lateropulsion, investigate literature that addresses their clinimetric properties, and create a resource for clinicians recommending use in clinical practice...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28625099/toxicology-in-clinical-laboratories-challenging-times
#3
N W Brown
In recent years, there have been a number of significant developments in toxicology within clinical laboratories, both with the available instrumentation and in the range of compounds abused by the drug using communities. There have also been developments in the regulation of forensic science in the UK which may in time impact clinical toxicology. This review is designed to provide an update of these changes within toxicology to the more general pathology laboratory audience. For detailed information in specific areas, the reader is referred to the references in the text...
June 19, 2017: British Journal of Biomedical Science
https://www.readbyqxmd.com/read/28624312/non-lens-based-surgical-techniques-for-presbyopia-correction
#4
R Bilbao-Calabuig, F Llovet-Osuna
INTRODUCTION: Presbyopia is the most prevalent refractive error. With a progressive aging population, its surgical correction is an important challenge for the ophthalmology community, as well as the millions of patients who suffer from it, and who are increasingly demanding alternatives to its correction with glasses or contact lenses. MATERIAL AND METHODS: A review is presented with a synthesised discussion on the pathophysiological theories of presbyopia and an updated and analytical description of the non-lens involvement surgical techniques used to treat presbyopia...
June 14, 2017: Archivos de la Sociedad Española de Oftalmología
https://www.readbyqxmd.com/read/28619429/vitamin-d-and-multiple-sclerosis-an-update
#5
REVIEW
Charles Pierrot-Deseilligny, Jean-Claude Souberbielle
The most recent findings linking exposure to sun and vitamin D insufficiency to multiple sclerosis (MS) are reviewed. Due to insufficient sunshine and changing lifestyles, hypovitaminosis D is widespread in temperate countries. Numerous epidemiological studies have strongly suggested that sunshine and vitamin D insufficiency contributes to MS risk in these countries. Moreover, several large genetic studies in MS patients have recently stated unequivocally that diverse abnormalities involving vitamin D metabolism are related to the risk of the disease...
May 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28617750/skin-and-wound-care-in-lymphedema-patients-a-taxonomy-primer-and-literature-review
#6
Caroline E Fife, Wade Farrow, Adelaide A Hebert, Nathan C Armer, Bob R Stewart, Janice N Cormier, Jane M Armer
BACKGROUND: Lymphedema is a condition of localized protein-rich swelling from damaged or malfunctioning lymphatics. Because the immune system is compromised, there is a high risk of infection. Infection in patients with lymphedema may present in a variety of ways. OBJECTIVE: The goals of this review were to standardize the terminology of skin breakdown in the context of lymphedema, synthesize the available information to create best practice recommendations in support of the American Lymphedema Framework Project update to its Best Practices document, and create recommendations for further research...
July 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28616354/comparing-american-european-and-asian-practice-guidelines-for-aortic-diseases
#7
Jose Rozado, Maria Martin, Isaac Pascual, Daniel Hernandez-Vaquero, Cesar Moris
The aortic disease comprises a group of different pathologies of high prevalence, seriousness and ever changing by the medical and surgical investigations. Therefore cardiovascular scientific societies in USA, Europe and Asia have created Task Force on practice guidelines (PG) to develop, update and revise PG for aortic diseases. These documents issue recommendations on the diagnosis and management of different aortic diseases. The three societies agree on the recommendations about diagnostic tests and on the value of computed tomography and magnetic resonance as the main tools for the diagnosis and follow-up of aortic disease...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28610840/measuring-and-managing-health-system-performance-an-update-from-new-zealand
#8
Linda Maree Chalmers, Toni Ashton, Tim Tenbensel
In July 2016, New Zealand introduced a new approach to measuring and monitoring health system performance. This 'Systems Level Measure Framework' (SLMF) has evolved from the Integrated Performance and Incentive Framework (IPIF) previously reported in this journal. The SLMF is designed to stimulate a 'whole of system' approach that requires inter-organisational collaboration. Local 'Alliances' between government and non-government health sector organisations are responsible for planning and achieving improved health system outcomes such as reducing ambulatory sensitive hospitalisation for young children, and reducing acute hospital bed days...
June 2, 2017: Health Policy
https://www.readbyqxmd.com/read/28608183/acc-aats-aha-ase-asnc-scai-scct-sts-2017-appropriate-use-criteria-for-coronary-revascularization-in-patients-with-stable-ischemic-heart-disease-a-report-of-the-american-college-of-cardiology-appropriate-use-criteria-task-force-american-association-for-thoracic
#9
Manesh R Patel, John H Calhoon, Gregory J Dehmer, James Aaron Grantham, Thomas M Maddox, David J Maron, Peter K Smith
The American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and American Association for Thoracic Surgery, along with key specialty and subspecialty societies, have completed a 2-part revision of the appropriate use criteria (AUC) for coronary revascularization. In prior coronary revascularization AUC documents, indications for revascularization in acute coronary syndromes and stable ischemic heart disease (SIHD) were combined into 1 document. To address the expanding clinical indications for coronary revascularization, and to align the subject matter with the most current American College of Cardiology/American Heart Association guidelines, the new AUC for coronary artery revascularization were separated into 2 documents addressing SIHD and acute coronary syndromes individually...
June 12, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28604136/updates-in-venous-thromboembolism-management-evidence-published-in-2016
#10
Matthew Bartlett, Karen F Mauck, Dennis M Bierle, Rayya A Saadiq, Paul R Daniels
The management of venous thromboembolic disease (VTE) is rapidly evolving and staying updated on practice-changing evidence can be challenging. In an attempt to alleviate this daunting task, we sought to determine the most important practice-informing articles published in 2016 relevant to the non-specialist provider managing VTE. We performed a systematic search of the literature, limiting the search to a publication date of 2016 (see Supplementary Appendix). Two reviewers screened the 3819 resulting abstracts to identify high-quality, clinically relevant publications related to VTE management...
June 19, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28600490/treating-tobacco-dependence-guidance-for-primary-care-on-life-saving-interventions-position-statement-of-the-ipcrg
#11
O C P Van Schayck, S Williams, V Barchilon, N Baxter, M Jawad, P A Katsaounou, B J Kirenga, C Panaitescu, K W I G Tsiligianni, N Zwar, A Ostrem
Tobacco smoking is the world's leading cause of premature death and disability. Global targets to reduce premature deaths by 25% by 2025 will require a substantial increase in the number of smokers making a quit attempt, and a significant improvement in the success rates of those attempts in low, middle and high income countries. In many countries the only place where the majority of smokers can access support to quit is primary care. There is strong evidence of cost-effective interventions in primary care yet many opportunities to put these into practice are missed...
June 9, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28600023/contrast-enhanced-ultrasound-in-vascular-surgery-review-and-update
#12
REVIEW
K Bredahl, X M Mestre, R V Coll, Q M Ghulam, H Sillesen, J Eiberg
Accurate imaging methods associated with minimum patient risk are important tools for clinical decision-making in vascular surgery. Today, traditional imaging methods, such as computed tomography angiography, magnetic resonance angiography and digital subtraction angiography are the preferred modalities. Ultrasound has only challenged these methods in assessment of carotid disease, aortic aneurysms, venous insufficiency and thromboembolism and in surveillance of in-situ bypasses. These practice patterns may change with the introduction of second generation ultrasound contrast agents which are easy to use, manageable and safe...
June 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28596261/kidney-cancer-version-2-2017-nccn-clinical-practice-guidelines-in-oncology
#13
Robert J Motzer, Eric Jonasch, Neeraj Agarwal, Sam Bhayani, William P Bro, Sam S Chang, Toni K Choueiri, Brian A Costello, Ithaar H Derweesh, Mayer Fishman, Thomas H Gallagher, John L Gore, Steven L Hancock, Michael R Harrison, Won Kim, Christos Kyriakopoulos, Chad LaGrange, Elaine T Lam, Clayton Lau, M Dror Michaelson, Thomas Olencki, Phillip M Pierorazio, Elizabeth R Plimack, Bruce G Redman, Brian Shuch, Brad Somer, Guru Sonpavde, Jeffrey Sosman, Mary Dwyer, Rashmi Kumar
The NCCN Guidelines for Kidney Cancer provide multidisciplinary recommendations for the clinical management of patients with clear cell and non-clear cell renal carcinoma. These guidelines are developed by a multidisciplinary panel of leading experts from NCCN Member Institutions consisting of medical oncologists, hematologists and hematologic oncologists, radiation oncologists, urologists, and pathologists. The NCCN Guidelines are in continuous evolution and are updated annually or sometimes more often, if new high-quality clinical data become available in the interim...
June 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28585456/potential-conflicts-in-midwifery-practice-regarding-conscientious-objection-to-abortions-in-scotland
#14
Valerie Fleming, Yvonne Robb
BACKGROUND: This study was developed as a result of a court case involving conflicts between midwives' professional practice and their faith when caring for women undergoing abortions in Scotland. RESEARCH QUESTIONS: What are practising Roman Catholics' perspectives of potential conflicts between midwives' professional practice in Scotland with regard to involvement in abortions and their faith? How relevant is the 'conscience clause' to midwifery practice today? and What are participants' understandings of Canon 1398 in relation to midwifery practice? RESEARCH DESIGN: The theoretical underpinning of this study was Gadamer's hermeneutic out of which the method developed by Fleming et al...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28579193/relativity-screens-for-misvalued-medical-services-impact-on-noninvasive-diagnostic-radiology
#15
Andrew B Rosenkrantz, Ezequiel Silva, C Matthew Hawkins
PURPOSE: In 2006, the AMA/Specialty Society Relative Value Scale Update Committee (RUC) introduced ongoing relativity screens to identify potentially misvalued medical services for payment adjustments. We assess the impact of these screens upon the valuation of noninvasive diagnostic radiology services. METHODS: Data regarding relativity screens and relative value unit (RVU) changes were obtained from the 2016 AMA Relativity Assessment Status Report. All global codes in the 2016 Medicare Physician Fee Schedule with associated work RVUs were classified as noninvasive diagnostic radiology services versus remaining services...
June 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28577827/normal-tissue-constraints-for-abdominal-and-thoracic-stereotactic-body-radiotherapy
#16
REVIEW
Erqi L Pollom, Alexander L Chin, Maximilian Diehn, Billy W Loo, Daniel T Chang
Although stereotactic body radiotherapy (SBRT) or stereotactic ablative radiotherapy has become an established standard of care for the treatment of a variety of malignancies, our understanding of normal tissue dose tolerance with extreme hypofractionation remains immature. Since Timmerman initially proposed normal tissue dose constraints for SBRT in the 2008 issue of Seminars of Radiation Oncology, experience with SBRT has grown, and more long-term clinical outcome data have been reported. This article reviews the modern toxicity literature and provides updated clinically practical and useful recommendations of SBRT dose constraints for extracranial sites...
July 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28575901/dissemination-approaches-to-participating-primary-care-providers-in-a-quality-improvement-program-addressing-opioid-use-in-central-appalachia
#17
Roberto Cardarelli, Charlotte Sue Workman, Sarah Weatherford, Stacey Whanger, Dana E King
OBJECTIVES: Practice-based research networks (PBRNs) have been described as new clinical laboratories for primary care research and dissemination. PBRNs, however, have struggled to disseminate research results in a meaningful way to participating providers and clinics. METHODS: The Central Appalachia Inter-Professional Pain Education Collaborative was developed to work with PBRN clinics using quality improvement methods, deliver statewide continuing education activities to address the issue of opioid use in patients with chronic pain, and develop a multimodal mechanism to disseminate project results to clinics and participating providers...
June 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28573551/two-dimensional-breast-dosimetry-improved-using-three-dimensional-breast-image-data
#18
REVIEW
John M Boone, Andrew M Hernandez, J Anthony Seibert
Conventional mammographic dosimetry has been developed over the past 40 years. Prior to the availability of high-resolution three-dimensional breast images, certain assumptions about breast anatomy were required. These assumptions were based on the information evident on two-dimensional mammograms; they included assumptions of thick skin, a uniform mixture of glandular and adipose tissue, and a median breast density of 50%. Recently, the availability of high-resolution breast CT studies has provided more accurate data about breast anatomy, and this, in turn, has provided the opportunity to update mammographic dosimetry...
June 1, 2017: Radiological Physics and Technology
https://www.readbyqxmd.com/read/28558697/does-an-electronic-cognitive-aid-have-an-effect-on-the-management-of-severe-gynaecological-turp-syndrome-a-prospective-randomised-simulation-study
#19
Michael St Pierre, Georg Breuer, Dieter Strembski, Christopher Schmitt, Bjoern Luetcke
BACKGROUND: Lack of familiarity with the content of current guidelines is a major factor associated with non-compliance by clinicians. It is conceivable that cognitive aids with regularly updated medical content can guide clinicians' task performance by evidence-based practices, even if they are unfamiliar with the actual guideline. Acute hyponatraemia as a consequence of TURP syndrome is a rare intraoperative event, and current practice guidelines have changed from slow correction to rapid correction of serum sodium levels...
May 30, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28558398/-guidelines-in-practice-the-new-s3-guideline-sleeping-disorders-sleep-related-abnormal-breathing
#20
Martin Gerlach, Bernd Sanner
Sleep related breathing disorders include central sleep apnea (CSA), obstructive sleep apnea (OSA), sleep-related hypoventilation, and sleep-related hypoxia. These disorders are frequent and growing in clinical relevance. The related chapter of the S3 guideline "Non-restorative sleep/Sleep disorders", published by the German Sleep Society (DGSM), has recently been updated in November 2016. Epidemiology, diagnostics, therapeutic procedures, and classification of sleep related disorders have been revised. Concerning epidemiology, a considerably higher mortality rate among pregnant women with OSA has been emphasized...
May 30, 2017: Pneumologie
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