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https://www.readbyqxmd.com/read/28453820/reliability-of-clinical-impact-grading-by-healthcare-professionals-of-common-prescribing-error-and-optimisation-cases-in-critical-care-patients
#1
Richard S Bourne, Rob Shulman, Mark Tomlin, Mark Borthwick, Will Berry, Gary H Mills
Objective: To identify between and within profession-rater reliability of clinical impact grading for common critical care prescribing error and optimisation cases. To identify representative clinical impact grades for each individual case. Design: Electronic questionnaire. Setting: 5 UK NHS Trusts. Participants: 30 Critical care healthcare professionals (doctors, pharmacists and nurses). Intervention: Participants graded severity of clinical impact (5-point categorical scale) of 50 error and 55 optimisation cases...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28448239/extranodal-marginal-zone-lymphoma-no-longer-just-a-sidekick
#2
Manali K Kamdar, Sonali M Smith
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
April 27, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28447414/review-of-d-dimer-testing-good-bad-and-ugly
#3
REVIEW
L-A Linkins, S Takach Lapner
D-dimer assays are commonly used in clinical practice to exclude a diagnosis of deep vein thrombosis or pulmonary embolism. More recently, they have been also been used to guide patients with unprovoked venous thromboembolism (VTE) when faced with the decision to continue or stop anticoagulation after initial treatment is complete. D-dimer assays vary widely with respect to the antibody used, method of capture, instrumentation required, and calibration standard. These differences have an important influence on the operating characteristics of the assays...
May 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28447020/impact-of-educational-intervention-on-knowledge-attitude-and-awareness-of-good-clinical-practice-among-health-care-providers
#4
Divya Goel, Rani Walia, Poonam Sharma, Harmanjeet Kaur, Pallak Agnihotri
BACKGROUND: Clinical trials play an important role in the generation of evidence-based data in health care practices. To ensure the credibility of data and the safety and well-being of the patients Good clinical practice (GCP) guidelines play an important role. At present, we have little knowledge about awareness of GCP guidelines among health care providers in India. AIM: To assess the level of awareness, and perception of the health care providers toward GCP and subsequent change in these after a dayer training session on GCP guidelines...
April 2017: Perspectives in Clinical Research
https://www.readbyqxmd.com/read/28446985/whack-a-mole-strategy-for-multifocal-ground-glass-opacities-of-the-lung
#5
REVIEW
Kenji Suzuki
Ground glass opacity (GGO) is a good prognostic indicator for lung cancer and is useful for physicians to predict prognosis. Due to recent advances in computed tomography (CT), the chance to encounter GGO is rapidly increasing in clinical practice. Based on the studies on radiological pathological correlation, GGO represents pathological lepidic growth and consolidation on CT represents pathologically invasive components. Thus, consolidation tumor ratio 0.5 or less means pathological less invasiveness for lung cancer...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28446213/manifesto-towards-a-clinically-oriented-psychometrics
#6
Andrew J Vickers, Ling Y Chen
BACKGROUND: New technologies to collect patient - reported outcomes have substantially solved the challenge of integrating a questionnaire in a busy clinical practice. At Memorial Sloan Kettering, we have been collecting patient reported outcomes electronically for many years. Our experience confirms the predicted benefits of obtaining patient reported outcomes but has also raised serious concerns about whether instruments developed for the research setting are appropriate for routine clinical use...
April 26, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28442009/-enhanced-recovery-after-surgery-from-theory-to-practice%C3%A2-what-do-we-need-to-do
#7
Guowei Che, Lunxu Liu, Qinghua Zhou
Enhanced recovery after surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes, shorter length of hospital stay and cost savings. But the current ERAS either by application of breadth or depth is not enough, why? The main reason is the lack of "operability, evaluation, repetition" ERAS protocol and suitable for clinical extensive application protocol. How to form the clinical available protocol? Operational mainly refers to the clinical scheme is simple and feasible, and protocol compliance is good; Evaluate refers to the methods used before, during and after are the objective evaluation criteria and plan; Repeatable is clinical scheme repeatability in the process of single or multiple center...
April 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/28441971/the-clinical-and-cost-effectiveness-of-stratified-care-for-patients-with-sciatica-the-scopic-randomised-controlled-trial-protocol-isrctn75449581
#8
Nadine E Foster, Kika Konstantinou, Martyn Lewis, Reuben Ogollah, Kate M Dunn, Danielle van der Windt, Ruth Beardmore, Majid Artus, Bernadette Bartlam, Jonathan C Hill, Sue Jowett, Jesse Kigozi, Christian Mallen, Benjamin Saunders, Elaine M Hay
BACKGROUND: Sciatica has a substantial impact on patients, and is associated with high healthcare and societal costs. Although there is variation in the clinical management of sciatica, the current model of care usually involves an initial period of 'wait and see' for most patients, with simple measures of advice and analgesia, followed by conservative and/or more invasive interventions if symptoms fail to resolve. A model of care is needed that does not over-treat those with a good prognosis yet identifies patients who do need more intensive treatment to help with symptoms, and return to everyday function including work...
April 26, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28441339/still-searching-a-meta-synthesis-of-a-good-death-from-the-bereaved-family-member-perspective
#9
REVIEW
Kelly E Tenzek, Rachel Depner
The concept of a good death continues to receive attention in end-of-life (EOL) scholarship. We sought to continue this line of inquiry related to a good death by conducting a meta-synthesis of published qualitative research studies that examined a good death from the bereaved family member's perspective. Results of the meta-synthesis included 14 articles with 368 participants. Based on analysis, we present a conceptual model called The Opportunity Model for Presence during the EOL Process. The model is framed in socio-cultural factors, and major themes include EOL process engagement with categories of healthcare participants, communication and practical issues...
April 25, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28440529/-implementation-of-enhanced-recovery-after-surgery-in-nutritional-management-of-patients-undergoing-metabolic-surgery
#10
Tianzi Zhang, Qin Xu, Ningli Yang, Juan Tang, Hui Liang
Metabolic surgery is a gastrointestinal surgical procedure to treat obesity and its related co-morbidities with rapid development in recent years. Patients undergoing metabolic surgery have preoperative nutritional disorders, and the nutrition management for these patients is the key point of perioperative management. During the perioperative period, current research has preliminarily confirmed that perioperative managements including supplementation of micronutrients, preoperative evaluation of the weight loss, preoperative fasting and carbohydrate oral intake based on the full application of ERAS and characteristics of the patients undergoing metabolic surgery, are safe and effective in clinical practice...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28439490/watch-and-wait-policy-in-advanced-neuroendocrine-tumors-what-does-it-mean
#11
EDITORIAL
Nicola Fazio
Neuroendocrine neoplasms (NENs) are a group of rare and heterogeneous malignancies, which can develop in various organs. The clinical course of NENs is quite heterogeneous, with different spontaneous growth rates after diagnosis, and different degrees of sensitivity to the same therapy even when they have similar characteristics. Watch and wait (W and W), is a term coined to indicate observation being conducted to assess the evolution of the tumor without administering any anti-tumor therapy. It has been applied to NENs since in extremely rare cases they tend to remain stable for a long time...
April 10, 2017: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28439076/practice-makes-perfect-self-reported-adherence-a-positive-marker-of-inhaler-technique-maintenance
#12
Elizabeth Azzi, Pamela Srour, Carol Armour, Cynthia Rand, Sinthia Bosnic-Anticevich
Poor inhaler technique and non-adherence to treatment are major problems in the management of asthma. Patients can be taught how to achieve good inhaler technique, however maintenance remains problematic, with 50% of patients unable to demonstrate correct technique. The aim of this study was to determine the clinical, patient-related and/or device-related factors that predict inhaler technique maintenance. Data from a quality-controlled longitudinal community care dataset was utilized. 238 patients using preventer medications where included...
April 24, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28438759/palliative-care-clinicians-knowledge-of-the-law-regarding-the-use-of-the-deprivation-of-liberty-safeguards-dols
#13
Caroline Barry, Anna Spathis, Sarah Treaddell, Sally Carding, Stephen Barclay
OBJECTIVES: To examine palliative care clinicians' level of knowledge of the law regarding the use of the Deprivation of Liberty Safeguards (DoLS). METHODS: Regional postal survey of palliative care clinicians working in hospices in the East of England, undertaken in April 2015. Clinicians' level of knowledge was assessed by their response to 7 factual questions. Data regarding self-reported levels of confidence in applying the Safeguards was collected, alongside information regarding the number of times they had used DoLS in practice...
April 24, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28438583/psychometric-assessment-of-the-chinese-version-of-the-abbreviated-expanded-prostate-cancer-index-composite-epic-26-and-the-clinical-practice-version-epic-cp-in-chinese-men-with-prostate-cancer
#14
Wendy Wt Lam, Michael A Tse, Chris Nl Ng, Edward Km Chung, Richard Fielding
PURPOSE: The Expanded Prostate Cancer Index Composite (EPIC) instrument was designed to assess a range of health-related quality of life issues specifically relevant to patients with prostate cancer. This study examined the validity and reliability of Chinese versions of the 26-item EPIC and of the 16-item EPIC for clinical practice (EPIC-CP) in Chinese patients with prostate cancer. MATERIALS AND METHODS: A Chinese version of the 26-item EPIC and the 16-item EPIC-CP were self-completed by 252 Chinese patients with prostate cancer who were recruited from three community-based cancer service centres...
April 21, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28438482/manufacture-and-preparation-of-human-placenta-derived-mesenchymal-stromal-cells-for-local-tissue-delivery
#15
Lee Lankford, Y Julia Chen, Zoe Saenz, Priyadarsini Kumar, Connor Long, Diana Farmer, Aijun Wang
BACKGROUND: In this study we describe the development of a Current Good Manufacturing Practice (CGMP)-compliant process to isolate, expand and bank placenta-derived mesenchymal stromal cells (PMSCs) for use as stem cell therapy. We characterize the viability, proliferation and neuroprotective secretory profile of PMSCs seeded on clinical-grade porcine small intestine submucosa extracellular matrix (SIS-ECM; Cook Biotech). METHODS: PMSCs were isolated from early gestation placenta chorionic villus tissue via explant culture...
April 21, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28438322/water-fat-dixon-sequences-in-the-evaluation-of-breast-implants-proposal-of-a-time-effective-rapid-approach-in-the-clinical-practice
#16
M Marcon, A S Becker, E J Ulbrich, T Frauenfelder, A Boss
AIM: To evaluate the diagnostic accuracy achieved from a fat-water Dixon sequence alone compared to a combination of a silicone-specific magnetic resonance imaging (MRI) sequence and a water-specific MRI sequence in the assessment of breast implants. MATERIALS AND METHODS: In this institutional review board (IRB)-approved study the integrity of breast implants was assessed retrospectively in 27 patients undergoing breast MRI at 3 T. A qualitative evaluation of (set 1) a silicon-selective water-saturated short tau inversion recovery (STIR) sequence in combination with a water-only Dixon dataset (total acquisition time 7 minutes 17 seconds), and of (set 2) fat-only and water-only Dixon datasets (4 minutes 8 seconds) was performed by two readers independently evaluating the following features: margin definition of the implant, water suppression homogeneity, image quality, presence of artefacts and their effects on the imaging interpretation, and diagnostic confidence...
April 21, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28436849/reverse-classification-accuracy-predicting-segmentation-performance-in-the-absence-of-ground-truth
#17
Vanya V Valindria, Ioannis Lavdas, Wenjia Bai, Konstantinos Kamnitsas, Eric O Aboagye, Andrea G Rockall, Daniel Rueckert, Ben Glocker
When integrating computational tools such as automatic segmentation into clinical practice, it is of utmost importance to be able to assess the level of accuracy on new data, and in particular, to detect when an automatic method fails. However, this is difficult to achieve due to absence of ground truth. Segmentation accuracy on clinical data might be different from what is found through cross-validation because validation data is often used during incremental method development, which can lead to overfitting and unrealistic performance expectations...
April 17, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28436709/transitioning-from-occupational-therapy-student-to-practicing-occupational-therapist-first-year-of-employment
#18
Randy P McCombie, Meredith E Antanavage
This research examined the transition from occupational therapy student to practicing occupational therapist over the course of one's first year of professional employment, as recalled by a sample of occupational therapists. Surveys were mailed to 500 occupational therapists randomly selected from membership in the American Occupational Therapy Association resulting in 202 returned surveys. Median year of graduation was 1998, ranging from 1967 to 2014. In general, respondents indicated the transition was positive...
April 24, 2017: Occupational Therapy in Health Care
https://www.readbyqxmd.com/read/28435905/transurethral-resection-of-the-prostate-bladder-explosion-and-hyponatremic-encephalopathy-a-rare-case-report-of-malpractice
#19
Giuseppe Vacchiano, Aldo Rocca, Rita Compagna, Anna Ginevra Immacolata Zamboli, Vera Cirillo, Lorenza Di Domenico, Veronica Di Nardo, Giuseppe Servillo, Bruno Amato
We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability...
January 2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28434948/international-and-multidisciplinary-expert-recommendations-for-the-use-of-biologics-in-systemic-lupus-erythematosus
#20
REVIEW
Jean-François Kleinmann, Florence Tubach, Véronique Le Guern, Alexis Mathian, Christophe Richez, David Saadoun, Karim Sacre, Jérémie Sellam, Raphaèle Seror, Zahir Amoura, Emmanuel Andres, Sylvain Audia, Brigitte Bader-Meunier, Gilles Blaison, Bernard Bonnotte, Patrice Cacoub, Sophie Caillard, Laurent Chiche, Olivier Chosidow, Nathalie Costedoat-Chalumeau, Claire Daien, Eric Daugas, Nairouz Derdèche, Andrea Doria, Olivier Fain, Fadi Fakhouri, Dominique Farge, Cem Gabay, Sylvie Guillo, Eric Hachulla, Najia Hajjaj-Hassouni, Mohamed Hamidou, Frédéric A Houssiau, Noémie Jourde-Chiche, Isabelle Koné-Paut, Aïcha Ladjouz-Rezig, Olivier Lambotte, Dan Lipsker, Xavier Mariette, Nicolas Martin-Silva, Thierry Martin, François Maurier, Roderich Meckenstock, Arsène Mékinian, Olivier Meyer, Shirine Mohamed, Jacques Morel, Bruno Moulin, Denis Mulleman, Thomas Papo, Vincent Poindron, Xavier Puéchal, Leonardo Punzi, Pierre Quartier, Laurent Sailler, Amar Smail, Martin Soubrier, Agnès Sparsa, Zoubida Tazi-Mezalek, Leith Zakraoui, Stéphane Zuily, Jean Sibilia, Jacques-Eric Gottenberg
BACKGROUND/PURPOSE: Despite conventional immunosuppressants, active and steroid-dependent systemic lupus erythematosus (SLE) represents a therapeutic challenge. Only one biologic, belimumab, has been approved, but other biologics are sometimes used off-label. Given the lack of evidence-based data in some clinical situations encountered in real life, we developed expert recommendations for the use of biologics for SLE. METHODS: The recommendations were developed by a formal consensus method...
April 18, 2017: Autoimmunity Reviews
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