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https://www.readbyqxmd.com/read/28719134/development-and-implementation-of-a-clinical-pathway-for-cardiac-surgery-in-the-intensive-care-unit-effects-on-protocol-adherence
#1
Marion van der Kolk, Mark van den Boogaard, Corine Ter Brugge-Speelman, Jeroen Hol, Luc Noyez, Kees van Laarhoven, Hans van der Hoeven, Peter Pickkers
RATIONALE, AIMS AND OBJECTIVES: Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. METHODS: This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report...
July 18, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28718324/physical-health-and-drug-safety-in-individuals-with-schizophrenia
#2
Tamara Pringsheim, Martina Kelly, Doug Urness, Michael Teehan, Zahinoor Ismail, David Gardner
BACKGROUND: While antipsychotic medications are the mainstay of therapy for individuals with schizophrenia and psychotic disorders, their use is associated with adverse effects on physical health that require the attention and care of prescribers. METHODS: We used the ADAPTE process to adapt existing guideline recommendations from the National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) guidelines on the dosing of antipsychotics and antipsychotic polypharmacy, screening for adverse effects of antipsychotics, and management of metabolic and extrapyramidal side effects to the Canadian context...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28716637/update-on-the-management-of-abnormal-uterine-bleeding
#3
Yael Levy-Zauberman, Anne-Gaëlle Pourcelot, Perrine Capmas, Hervé Fernandez
Abnormal uterine bleeding (AUB) is a common complaint that affects large numbers of women from puberty to menopause. It negatively affects health by causing anemia, and impacts the quality of life of women affected. AUB also has an economic impact for both women and society. Therefore, it should not be under- or overestimate and diagnosis, investigations and treatment should be proposed, taking into account the scientific data available in the current state of medical knowledge. Using the new terminology and etiologic classification of AUB is essential to communicate properly around the subject...
July 14, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28716428/high-intensity-statin-treatments-in-clinically-stable-patients-on-aspirin-monotherapy-12-months-after-drug-eluting-stent-implantation-a-randomized-study
#4
Eui Im, Yun-Hyeong Cho, Yongsung Suh, Deok-Kyu Cho, Ae-Young Her, Yong Hoon Kim, Kyounghoon Lee, Woong Chol Kang, Kyeong Ho Yun, Sang-Yong Yoo, Sang-Sig Cheong, Dong-Ho Shin, Chul-Min Ahn, Jung-Sun Kim, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong-Ki Hong
INTRODUCTION AND OBJECTIVES: Current guidelines on the treatment of blood cholesterol recommend continuous maintenance of high-intensity statin treatment in drug-eluting stent (DES)-treated patients. However, high-intensity statin treatment is frequently underused in clinical practice after stabilization of DES-treated patients. Currently, the impact of continuous high-intensity statin treatment on the incidence of late adverse events in these patients is unknown. We investigated whether high-intensity statin treatment reduces late adverse events in clinically stable patients on aspirin monotherapy 12 months after DES implantation...
July 14, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28713443/e-healthcare-for-diabetes-mellitus-type-2-patients-a-randomised-controlled-trial-in-slovenia
#5
Rade Iljaž, Andrej Brodnik, Tatjana Zrimec, Iztok Cukjati
BACKGROUND: Telemonitoring and web-based interventions are increasingly used in primary-care practices in many countries for more effective management of patients with diabetes mellitus (DM). A new approach in treating patients with diabetes mellitus in family practices, based on ICT use and nurse practitioners, has been introduced and evaluated in this study. METHOD: Fifteen Slovene family practices enrolled 120 DM patients treated only with a diet regime and/or tablets into the study...
September 2017: Zdravstveno Varstvo
https://www.readbyqxmd.com/read/28711861/healthcare-infrastructure-capacity-to-respond-to-severe-acute-respiratory-infection-sari-and-sepsis-in-vietnam-a-low-middle-income-country
#6
Vu Quoc Dat, Nguyen Thanh Long, Kim Bao Giang, Pham Bich Diep, Ta Hoang Giang, Janet V Diaz
PURPOSE: This study investigated the availability of relevant structural and human resources needed for the clinical management of patients with severe acute respiratory infections and sepsis in critical care units in Vietnam. MATERIAL AND METHODS: A questionnaire survey was conducted by purposive sampling of 128 hospitals (36% of total hospitals in surveyed provinces), including 25 provincial and 103 district level hospitals, from 20 provinces in Vietnam. Data on availability of hospital characteristics, structural resources and health care workers was then analyzed...
July 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28710715/clinical-utility-of-a-blood-based-protein-assay-to-increase-screening-of-elevated-risk-patients-for-colorectal-cancer-in-the-primary-care-setting
#7
John Peabody, David Paculdo, Eric Swagel, Steven Fugaro, Mary Tran
PURPOSE: Colorectal cancer (CRC) screening is effective in finding early stage CRC and dramatically improves survival rates. Despite this, the number of eligible patients who do not obtain CRC screening is unacceptably high. METHODS: We conducted a longitudinal, randomized controlled trial investigating the utility of a blood-based protein assay on the quality of care delivered by practicing PCPs in the United States. We used standardized simulated patients (CPVs), presenting with symptoms suggestive of a higher likelihood of CRC, to measure how frequently these PCPs ordered diagnostic colonoscopy...
July 14, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28710205/effect-of-interdisciplinary-care-on-weight-loss-a-randomised-controlled-trial
#8
Linda C Tapsell, Maureen Lonergan, Marijka J Batterham, Elizabeth P Neale, Allison Martin, Rebecca Thorne, Frank Deane, Gregory Peoples
OBJECTIVE: To determine the effectiveness of a novel interdisciplinary treatment compared with usual care on weight loss in overweight and obese adult volunteers. DESIGN: Single blinded controlled trial. Participants randomly assigned to usual care (C, general guideline-based diet and exercise advice), intervention (I, interdisciplinary protocol) or intervention + a healthy food supplement (30 g walnuts/day) (IW). SETTING: Community based study, Illawarra region, south of Sydney, Australia...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28710148/energy-protein-carbohydrate-and-lipid-intakes-and-their-effects-on-morbidity-and-mortality-in-critically-ill-adult-patients-a-systematic-review
#9
REVIEW
Anna Patkova, Vera Joskova, Eduard Havel, Miroslav Kovarik, Monika Kucharova, Zdenek Zadak, Miloslav Hronek
The guidelines for nutritional support in critically ill adult patients differ in various aspects. The optimal amount of energy and nutritional substrates supplied is important for reducing morbidity and mortality, but unfortunately this is not well known, because the topic is complex and every patient is individual. The aim of this review was to gather recent pertinent information concerning the nutritional support of critically ill patients in the intensive care unit (ICU) with respect to the energy, protein, carbohydrate, and lipid intakes and the effect of their specific utilization on morbidity and mortality...
July 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28709844/-transfusion-and-its-specific-problems-in-pediatrics-and-neonatology
#10
Y Pérel, C Runel, Y Huguenin, L Renesme, N Aladjidi
Principles of transfusion strategy have been used for neonates and children similar to adults. However, due to substantial discrepancies between physiology/pathology in children and in their adult counterparts, decisions, indications, and doses are different from those of adults, especially in neonates. Specific data and practice guidelines for blood product transfusion are reported owing to the experience of pediatrics and neonatology units and partners of the French Blood product bank.
July 11, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28709410/identification-of-barriers-and-facilitators-for-optimal-cesarean-section-care-perspective-of-professionals
#11
Sonja Melman, Rachel Hellen Petra Schreurs, Carmen Desiree Dirksen, Anneke Kwee, Jan Gerrit Nijhuis, Nicol Anna Cornelia Smeets, Hubertina Catharina Johanna Scheepers, Rosella Petronella Maria Gemma Hermens
BACKGROUND: The cesarean section (CS) rate has increased over recent decades with poor guideline adherence as a possible cause. The objective of this study was to explore barriers and facilitators for delivering optimal care as described in clinical practice guidelines. METHODS: Key recommendations from evidence-based guidelines were used as a base to explore barriers and facilitators for delivering optimal CS care in The Netherlands. Both focus group and telephone interviews among 29 different obstetrical professionals were performed...
July 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28707063/liquid-chromatography-mass-spectrometry-methods-for-the-intracellular-determination-of-drugs-and-their-metabolites-a-focus-on-antiviral-drugs
#12
REVIEW
Pierre-André Billat, Franck Saint-Marcoux
Understanding the efficacy and/or toxicity of most drugs requires effective intracellular measurements of the drug and its metabolites. Nevertheless, the most common plasma marker of the biological effect of the drug is the area under the curve. Compared with drug determination in whole blood or urine, various difficulties occur in the development of analytical methods for intracellular measurements. We propose step-by-step guidelines to develop an analytical method exploring intracellular concentrations of antivirals and/or their metabolites...
July 13, 2017: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/28706098/changes-in-hypertension-prevalence-awareness-treatment-and-control-rates-over-20-years-in-national-capital-region-of-india-results-from-a-repeat-cross-sectional-study
#13
Ambuj Roy, Pradeep A Praveen, Ritvik Amarchand, Lakshmy Ramakrishnan, Ruby Gupta, Dimple Kondal, Kalpana Singh, Meenakshi Sharma, Deepak Kumar Shukla, Nikhil Tandon, Kolli Srinath Reddy, Anand Krishnan, Dorairaj Prabhakaran
BACKGROUND AND OBJECTIVES: Despite being one of the leading risk factors of cardiovascular mortality, there are limited data on changes in hypertension burden and management from India. This study evaluates trend in the prevalence, awareness, treatment and control of hypertension in the urban and rural areas of India's National Capital Region (NCR). DESIGN AND SETTING: Two representative cross-sectional surveys were conducted in urban and rural areas (survey 1 (1991-1994); survey 2 (2010-2012)) of NCR using similar methodologies...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28704320/recurrence-rate-and-graft-stability-with-fibrin-glue-compared-with-suture-and-autologous-blood-coagulum-for-conjunctival-autograft-adherence-in-pterygium-surgery-a-meta-analysis
#14
Rituparna Maiti, Somnath Mukherjee, Debasish Hota
PURPOSE: To minimize recurrence and improve graft stability after pterygium surgery, conjunctival autograft adherence is done using fibrin glue (FG) or autologous blood coagulum (ABC). But there are studies that have reported conflicting or inconclusive results. This meta-analysis was conducted to evaluate the postoperative recurrence rate and graft stability after using FG, sutures, and ABC. METHODS: MEDLINE, Cochrane databases, and ICTRP were searched and PRISMA guidelines as well as recommended meta-analysis practices were followed...
July 11, 2017: Cornea
https://www.readbyqxmd.com/read/28703878/obstetric-hemorrhage-and-safe-blood-for-transfusion-in-ethiopia-the-challenges-of-bridging-the-gap
#15
REVIEW
Addisalem Taye Makuria, Daniel Gebremichael, Habtemariam Demoz, Azmach Hadush, Yetmgeta Abdella, Yemane Berhane, Naynesh Kamani
BACKGROUND: Obstetric hemorrhage is a leading cause of maternal death in sub-Saharan Africa, and the shortage of blood for transfusion is a contributory factor. In Ethiopia, the National Blood Bank Service continues to be confronted with challenges in its efforts to ensure the availability of blood for health care facilities. This paper reviews the available data on the contribution of obstetric hemorrhage to maternal mortality and examines the current status of the blood supply in Ethiopia...
July 13, 2017: Transfusion
https://www.readbyqxmd.com/read/28702957/non-invasive-ventilation-for-the-management-of-acute-hypercapnic-respiratory-failure-due-to-exacerbation-of-chronic-obstructive-pulmonary-disease
#16
REVIEW
Christian R Osadnik, Vanessa S Tee, Kristin V Carson-Chahhoud, Joanna Picot, Jadwiga A Wedzicha, Brian J Smith
BACKGROUND: Non-invasive ventilation (NIV) with bi-level positive airway pressure (BiPAP) is commonly used to treat patients admitted to hospital with acute hypercapnic respiratory failure (AHRF) secondary to an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). OBJECTIVES: To compare the efficacy of NIV applied in conjunction with usual care versus usual care involving no mechanical ventilation alone in adults with AHRF due to AECOPD. The aim of this review is to update the evidence base with the goals of supporting clinical practice and providing recommendations for future evaluation and research...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28702612/rapid-label-free-cd4-testing-using-a-smartphone-compatible-device
#17
Manoj Kumar Kanakasabapathy, Hardik J Pandya, Mohamed Shehata Draz, Manjyot Kaur Chug, Magesh Sadasivam, Shreya Kumar, Behzad Etemad, Vinish Yogesh, Mohammadali Safavieh, Waseem Asghar, Jonathan Z Li, Athe M Tsibris, Daniel R Kuritzkes, Hadi Shafiee
The most recent guidelines have called for a significant shift towards viral load testing for HIV/AIDS management in developing countries; however point-of-care (POC) CD4 testing still remains an important component of disease staging in multiple developing countries. Advancements in micro/nanotechnologies and consumer electronics have paved the way for mobile healthcare technologies and the development of POC smartphone-based diagnostic assays for disease detection and treatment monitoring. Here, we report a simple, rapid (30 minutes) smartphone-based microfluidic chip for automated CD4 testing using a small volume (30 μL) of whole blood...
July 12, 2017: Lab on a Chip
https://www.readbyqxmd.com/read/28701182/do-we-really-need-to-differentiate-mesenchymal-stem-cells-into-insulin-producing-cells-for-attenuation-of-the-autoimmune-responses-in-type-1-diabetes-immunoprophylactic-effects-of-precursors-to-insulin-producing-cells
#18
Anshu Sharma, Rajni Rani
BACKGROUND: Type 1 diabetes (T1D) is a multifactorial autoimmune disorder where pancreatic beta cells are lost before the clinical manifestations of the disease. Administration of mesenchymal stem cells (MSCs) or MSCs differentiated into insulin-producing cells (IPCs) have yielded limited success when used therapeutically. We have evaluated the immunoprophylactic potentials of precursors to insulin-producing cells (pIPCs) and IPCs in nonobese diabetic (NOD) mice to ask a basic question: do we need to differentiate MSCs into IPCs or will pIPCs suffice to attenuate autoimmune responses in T1D? METHODS: Bone marrow-derived MSCs from Balb/c mice were characterized following the International Society for Cellular Therapy (ISCT) guidelines...
July 12, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28700767/effect-of-non-insulin-based-glucose-lowering-therapies-on-cardiovascular-outcomes-in-patients-with-type-2-diabetes
#19
Szymon L Wiernek, Matthew A Cavender
Current guidelines for the treatment of patients with diabetes are focused on improving glycemic control and treating appropriate cardiovascular (CV) risk factors. Basic recommendations include blood pressure management with a goal of <140 mm Hg systolic pressure, statin therapy in all patients ≥40 years of age with diabetes (moderate intensity for all, and high intensity if at high risk of CVD events), and aspirin therapy in all adults at increased CV risk (10-year risk of CVD events >10%). Oral antihyperglycemic medications remain the cornerstone of treatment for optimizing glucose control in patients with diabetes...
June 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28700523/dried-blood-spots-combined-with-ultra-high-performance-liquid-chromatography-mass-spectrometry-for-the-quantification-of-the-antipsychotics-risperidone-aripiprazole-pipamperone-and-their-major-metabolites
#20
Camille Tron, Sanne M Kloosterboer, Bart C H van der Nagel, Rixt A Wijma, Bram Dierckx, Gwen C Dieleman, Teun van Gelder, Birgit C P Koch
BACKGROUND: Risperidone, aripiprazole, and pipamperone are antipsychotic drugs frequently prescribed for the treatment of comorbid behavioral problems in children with autism spectrum disorders. Therapeutic drug monitoring (TDM) could be useful to decrease side effects and to improve patient outcome. Dried blood spot (DBS) sample collection seems to be an attractive technique to develop TDM of these drugs in a pediatric population. The aim of this work was to develop and validate a DBS assay suitable for TDM and home sampling...
August 2017: Therapeutic Drug Monitoring
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