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Giuseppe Taino, Franco Pugliese, Daniela Bonetti, Rossana Astengo, Marcello Imbriani
OBJECTIVES: The topic of appropriateness was defined as the new frontier of development of health interventions. RH Brook in an Editorial published in the BMJ in 1994 defines the appropriateness "… an intervention for which the expected benefits are greater (with a sufficient margin) the possible negative consequences … excluding economic considerations". In workplaces the goal of appropriateness should cover not only the actions of health surveillance and health protocols, but also and primarily all stages of the risk assessment process...
November 2017: Giornale Italiano di Medicina del Lavoro Ed Ergonomia
David S Ruppert, Ola L A Harrysson, Denis J Marcellin-Little, Laurence E Dahners, Paul S Weinhold
Transcutaneous osseointegrated prostheses provide stable connections to the skeleton while eliminating skin lesions experienced with socket prosthetics. Additive manufacturing can create custom textured implants capable of interfacing with amputees' residual bones. Our objective was to compare osseointegration of textured surface implants made by electron beam melting (EBM), an additive manufacturing process, to machine threaded implants. Whole body vibration was investigated to accelerate osseointegration...
June 11, 2018: Medical Engineering & Physics
Ameneh Safari, Yahya Safari
Evidence-based medicine (EBM) is defining proper and wise use of the best evidence in clinical decision for patient׳s care. This study have done with the aim of evaluating health information system for decision-making with EBM approach in educational hospital of Kermanshah city. The statistical population include all the specialist and specialty, and also head nurses of educational hospitals in Kermanshah city. The data collected by researcher made questionnaire. The content validities of the questionnaire were confirmed by experts to complete the questions of the questionnaire...
August 2018: Data in Brief
Claudia Mendoza-Pinto, Adriana Rojas-Villarraga, Nicolás Molano-González, Erick A Jiménez-Herrera, María de la Luz León-Vázquez, Álvaro Montiel-Jarquín, Mario García-Carrasco, Ricard Cervera
BACKGROUND: Observational studies have indicated a high but heterogeneous prevalence of low bone mineral density (BMD) and vertebral fractures (VF) in patients with systemic lupus erythematosus (SLE). Therefore, the objectives of this systematic review and meta-regression were: 1) to compare BMD between SLE patients and healthy controls and 2) to evaluate the relationship between BMD and glucocorticoid therapy and VF in SLE patients. METHODS AND FINDINGS: Articles were identified from electronic databases (PubMed, Embase, VHL, SciELO and the Cochrane Library)...
2018: PloS One
Jeffrey K Aronson, Adam La Caze, Michael P Kelly, Veli-Pekka Parkkinen, Jon Williamson
The role of mechanistic evidence tends to be under-appreciated in current evidence-based medicine (EBM), which focusses on clinical studies, tending to restrict attention to randomized controlled studies (RCTs) when they are available. The EBM+ programme seeks to redress this imbalance, by suggesting methods for evaluating mechanistic studies alongside clinical studies. Drug approval is a problematic case for the view that mechanistic evidence should be taken into account, because RCTs are almost always available...
June 11, 2018: Journal of Evaluation in Clinical Practice
Eleanor P Thong, Madhuni Herath, David R Weber, Sanjeeva Ranasinha, Peter R Ebeling, Frances Milat, Helena Teede
BACKGROUND: Type 1 diabetes mellitus (T1DM) is associated with skeletal fragility. While previous meta-analyses have demonstrated an increased risk of fracture in individuals with T1DM, little is known about fracture risk in T1DM, in the absence of age-related confounders. AIMS: To determine the risk of fracture in young and middle-aged adults with T1DM aged 18 to 50 years old. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Ovid MEDLINE, PubMed, EMBASE, EBM reviews, and relevant conference abstracts...
June 7, 2018: Clinical Endocrinology
Daniela Lucchesi, Simona Georgiana Popa, Veronica Sancho, Laura Giusti, Monia Garofolo, Giuseppe Daniele, Laura Pucci, Roberto Miccoli, Giuseppe Penno, Stefano Del Prato
BACKGROUND: High-density lipoproteins (HDLs) can exert anti-atherogenic effects. On top of removing excess cholesterol through reverse cholesterol transport, HDLs play beneficial actions on endothelial function and integrity. In particular, HDLs are strong determinant of endothelial progenitor cells (EPCs) number and function. To gain further insights into such an effect we characterized in vitro functionality of circulating "early" EPCs obtained from 60 type 2 diabetes individuals with low HDL-cholesterol (HDL-C) and 59 with high HDL-C levels...
June 5, 2018: Cardiovascular Diabetology
Scott W Kirkland, Elfriede Cross, Sandra Campbell, Cristina Villa-Roel, Brian H Rowe
BACKGROUND: Acute asthma is a common cause of presentations to acute care centres, such as the emergency department (ED), and while the majority of patients can be discharged, relapse requiring additional medical care is common. Systemic corticosteroids are a major part in the treatment of moderate to severe acute asthma; however, there is no clear evidence regarding the most effective route of administration for improving outcomes in patients discharged from acute care. OBJECTIVES: To examine the effectiveness and safety of a single dose of intramuscular (IM) corticosteroids provided prior to discharge compared to a short course of oral corticosteroids in the treatment of acute asthma patients discharged from an ED or equivalent acute care setting...
June 2, 2018: Cochrane Database of Systematic Reviews
Lavinia Maria Saraca, Ludovico Lazzari, Cinzia di Giuli, Alessandro Lavagna, Paola Mezzetti, Daniela Bovelli, Enrico Boschetti, Daniela Francisci
Myocarditis is an inflammatory disease of the myocardium. Viruses, such as enterovirus, adenovirus, parvovirus B19, HHV6 or cytomegalovirus (CMV) and autoimmune diseases are recognized causes of myocarditis. We describe the clinical case of a young Indian woman with SLE and a concomitant acute CMV related myocarditis with favourable outcome after ganciclovir therapy. CMV myocarditis may range from being a subclinical infection with incidental findings on ECG to a life threating presentation. There are no trials demonstrating the efficacy of antiviral therapy in myocarditis...
2018: IDCases
Volker Weißmann, Philipp Drescher, Hermann Seitz, Harald Hansmann, Rainer Bader, Anika Seyfarth, Annett Klinder, Anika Jonitz-Heincke
Additive manufacturing of lightweight or functional structures by selective laser beam (SLM) or electron beam melting (EBM) is widespread, especially in the field of medical applications. SLM and EBM processes were applied to prepare Ti6Al4V test specimens with different surface orientations (0°, 45° and 90°). Roughness measurements of the surfaces were conducted and cell behavior on these surfaces was analyzed. Hence, human osteoblasts were seeded on test specimens to determine cell viability (metabolic activity, live-dead staining) and gene expression of collagen type 1 (Col1A1), matrix metalloprotease (MMP) 1 and its natural inhibitor, TIMP1, after 3 and 7 days...
May 29, 2018: Materials
Geronimo Jimenez, Woan Shin Tan, Amrit K Virk, Chan Kee Low, Josip Car, Andy Hau Yan Ho
BACKGROUND: Advance care planning (ACP) involves important decision-making about future medical needs. The high volume and disparate nature of ACP research make it difficult to grasp the evidence and derive clear policy lessons for policymakers and clinicians. AIM: To synthesise ACP research evidence, and identify relevant contextual elements, program features, implementation principles and impacted outcomes to inform policy and practice. DESIGN: An overview of systematic reviews using the Cochrane Handbook of Systematic Reviews of Interventions was performed...
May 25, 2018: Journal of Pain and Symptom Management
Laura Barrachina, Ana Rosa Remacha, Antonio Romero, Pilar Zaragoza, Francisco José Vázquez, Clementina Rodellar
Mesenchymal stem cells (MSCs) are a promising treatment for equine musculoskeletal injuries because of their ability to regulate the inflammation and to differentiate into other cell types. Since interest in allogeneic therapy is rising, concerns about MSC immunogenicity need to be addressed. Differentiated MSCs from several species increase their expression of immunogenic molecules and induce alloresponses, but equine MSC immunogenic profile after differentiation has not been reported. Therefore, the aim of this study was to assess the gene expression of immunogenic markers in tri-lineage differentiated equine bone marrow derived MSCs (eBM-MSCs)...
June 2018: Veterinary Immunology and Immunopathology
Jessica Reid, Maria Makrides, Andrew J McPhee, Michael J Stark, Jacqueline Miller, Carmel T Collins
The aim of this study was to assess the effect of feeding high protein human milk fortifier (HMF) on growth in preterm infants. In this single-centre randomised trial, 60 infants born 28⁻32 weeks' gestation were randomised to receive a higher protein HMF providing 1.8 g protein ( n = 31) or standard HMF providing 1 g protein per 100 mL expressed breast milk (EBM) ( n = 29). The primary outcome was rate of weight gain. Baseline characteristics were similar between groups. There was no difference between high and standard HMF groups for weight gain (mean difference (MD) -14 g/week; 95% CI -32, 4; p = 0...
May 17, 2018: Nutrients
Silvia Minozzi, Francesca Ruggiero, Matteo Capobussi, Marien González-Lorenzo, Micaela La Regina, Alessandro Squizzato, Lorenzo Moja, Francesco Orlandini
INTRODUCTION: <AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">The knowledge of principles and methods of Evidence Based Medicine (EBM) and the use of Clinical Practice Guidelines to inform clinical decisions are recognised as key instruments to improve the quality of care. In Italy the Parliament has revised the legal system that rules the responsibilities of health professionals and health care safety, prescribing health professionals to adhere to guidelines and good practice recommendations...
May 2018: Recenti Progressi in Medicina
Hilalion Ahn, Jason Tay, Beverley Shea, Brian Hutton, Risa Shorr, Greg A Knoll, Donald William Cameron, Juthaporn Cowan
BACKGROUND: Prophylactic immunoglobulin has been used with varying efficacy to reduce complications in hematopoietic stem cell transplant recipients. STUDY DESIGN AND METHODS: A systematic review and meta-analysis was conducted of randomized controlled trials that assessed clinical outcomes (overall survival, transplant-related mortality, graft-versus-host disease [GVHD], veno-occlusive disease [VOD], interstitial pneumonitis, disease relapse, cytomegalovirus [CMV] infection and disease, non-CMV infection) of immunoglobulin prophylaxis versus placebo in hematopoietic stem cell transplant recipients...
May 16, 2018: Transfusion
Zhipeng Wan, Wentao Jiang, Chong Wang, Qingyuan Wang, Yalan Li
Three dimensional (3D) printing is considered as an advanced manufacturing technology because of its additive nature. Electron beam melting (EBM) is a widely used 3D printing processes for the manufacturing of metal components. However, the products printed via this process generally contain micro porosities which affect mechanical properties, especially the fatigue property. In this paper, two types of EBM printed samples of the Ti-6Al-4V alloy, one with a round cross section and the other with a triangle cross section, were employed to investigate the existence of porosities using computed tomography (CT)...
October 1, 2017: Sheng Wu Yi Xue Gong Cheng Xue za Zhi, Journal of Biomedical Engineering, Shengwu Yixue Gongchengxue Zazhi
Julija Stoniute, David John Mott, Jing Shen
BACKGROUND: The time trade-off (TTO) technique is commonly used to elicit health state utilities. Nevertheless, when the health states being valued are temporary, the TTO approach may be unsuitable. A variant of TTO- chained TTO-has been suggested to be used when the health states are temporary, but little research has been done on how chained TTO should be conducted. OBJECTIVES: To systematically review the use of chained TTO in valuing temporary health states...
May 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Justin Paulsen, Morhaf Al Achkar
Background: Evidence-based medicine (EBM) plays a critical part in ensuring that practitioners use the soundest available medical procedures while avoiding ineffective ones. As such, it plays a key role in medical residency education. However, little research has shown what factors influence residents' adoption of habits in, self-efficacy in, and skills of EBM. Materials and methods: This study gathered responses from a cross section of family medicine residents and new interns from 40 different residencies across the USA...
2018: Advances in Medical Education and Practice
Daniel J Devoe, Megan S Farris, Parker Townes, Jean Addington
AIM: Attenuated psychotic symptoms (APSs) have been the primary emphasis in youth at clinical high risk (CHR) for psychosis for assessing symptomology and determining subsequent transition to a psychotic disorder. Previous reviews primarily focused on the efficacy of cognitive behavioural therapy (CBT) on APS; however, a comprehensive assessment of other interventions to date is lacking. Therefore, we conducted a systematic review and meta-analysis of all intervention studies examining APS in CHR youth...
May 11, 2018: Early Intervention in Psychiatry
Natalia Pushilina, Maxim Syrtanov, Egor Kashkarov, Tatyana Murashkina, Viktor Kudiiarov, Roman Laptev, Andrey Lider, Andrey Koptyug
Influence of manufacturing parameters (beam current from 13 to 17 mA, speed function 98 and 85) on microstructure and hydrogen sorption behavior of electron beam melted (EBM) Ti-6Al-4V parts was investigated. Optical and scanning electron microscopies as well as X-ray diffraction were used to investigate the microstructure and phase composition of EBM Ti-6Al-4V parts. The average &alpha; lath width decreases with the increase of the speed function at the fixed beam current (17 mA). Finer microstructure was formed at the beam current 17 mA and speed function 98...
May 10, 2018: Materials
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