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Good clinical practice

Amir Abukaresh, Rami Al-Abadlah, Bettina Böttcher, Khamis El-Essi
BACKGROUND: In the 2014 Palestinian annual health report, cerebrovascular accident was ranked as the third leading cause of death in the occupied Palestinian territory. Cerebrovascular accident is also one the most common causes of disability worldwide. Good management decreases mortality and morbidity. The aim of this study was to assess the current management of patients with ischaemic stroke at the Al-Shifa Hospital and to compare this with international guidelines. METHODS: For this clinical audit, we used simple random sampling to select files of patients admitted with the diagnosis of ischaemic stroke to the Al-Shifa Hospital...
February 21, 2018: Lancet
Maha Al-Faqawi, Yousef Abuowda, Alaa Eldeen Elmassry, Bettina Böttcher
BACKGROUND: The frequency and severity of chronic obstructive pulmonary disease (COPD) exacerbations are the most important determinants of prognosis in COPD. The aim of this study was to assess the management of patients presenting with COPD exacerbations at the Nasser Medical Complex in the Gaza Strip and to compare the management with the Global Initiative for Chronic Obstructive Lung Disease guidelines (GOLD 2015). METHODS: We reviewed the medical records of all patients admitted to Nasser Medical Complex and diagnosed with COPD exacerbation between Jan 1, 2014, and Dec 31, 2016...
February 21, 2018: Lancet
Victoria E Jackson, Helen Hurst, Sandip Mitra
INTRODUCTION: Arteriovenous fistulae remain the gold standard of vascular access in haemodialysis. There is currently no consensus on standardised methods of monitoring arteriovenous fistulae. Assessment techniques and practice remain widely variable. The purpose of this study is to determine whether existing evidence supports physical assessment as an effective tool and a good predictor of arteriovenous fistulae dysfunction to allow for timely intervention and improve outcomes. METHODS: A literature search was performed using CINAHL, PubMed, Medline and BNI databases and relevant search terms...
March 1, 2018: Journal of Vascular Access
Ziteng Zhang, Ling Zong, Baobin Xu, Ronghang Hu, Ming Ma, Haixiang Wei, Yanhong Meng
PURPOSE: To observe the clinical efficacy of the application of enhanced recovery after surgery (ERAS) in the perioperative period of esophageal carcinoma patients. METHODS: A total of 114 patients who were admitted to Affiliated Hospital of Jining Medical University for surgical treatment of esophageal carcinoma between June 2012 and June 2016 were enrolled and randomly divided into the intervention group and the regular group according to the difference of management procedures during the perioperative period...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Craig G J Newman, Adam D Bevins, John P Zajicek, John R Hodges, Emil Vuillermoz, Jennifer M Dickenson, Denise S Kelly, Simona Brown, Rupert F Noad
Introduction: Ensuring reliable administration and reporting of cognitive screening tests are fundamental in establishing good clinical practice and research. This study captured the rate and type of errors in clinical practice, using the Addenbrooke's Cognitive Examination-III (ACE-III), and then the reduction in error rate using a computerized alternative, the ACEmobile app. Methods: In study 1, we evaluated ACE-III assessments completed in National Health Service (NHS) clinics ( n  = 87) for administrator error...
2018: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
Henrieta Fraser, Niloufar Safinia, Nathali Grageda, Sarah Thirkell, Katie Lowe, Laura J Fry, Cristiano Scottá, Andrew Hope, Christopher Fisher, Rachel Hilton, David Game, Paul Harden, Andrew Bushell, Kathryn Wood, Robert I Lechler, Giovanna Lombardi
The concept of regulatory T cell (Treg)-based immunotherapy has enormous potential for facilitating tolerance in autoimmunity and transplantation. Clinical translation of Treg cell therapy requires production processes that satisfy the rigors of Good Manufacturing Practice (GMP) standards. In this regard, we report our findings on the implementation of a robust GMP compliant process for the ex vivo expansion of clinical grade Tregs, demonstrating the feasibility of this developed process for the manufacture of a final product for clinical application...
March 16, 2018: Molecular Therapy. Methods & Clinical Development
Andrew Leung Luk, Adrian Fai To Yau
Background: Overseas studies suggest that 10-20% of doctors are depressed, 30-45% have burnout, and many report dissatisfaction with work-life balance. A local study on public doctors showed that 31.4% of the respondents satisfied the criteria for high burnout. Young, but moderately experienced doctors who need to work shifts appeared most vulnerable. This study aims to explore the experiences of those public doctors who have managed their work difficulties and maintained professional enthusiasm for references in medical education and continuing professional training...
2018: Frontiers in Public Health
Fahad Syed Naseerullah, Hemangkumar Javaiya, Avinash Murthy
Primary tumours of the heart are often encountered in clinical practice. Different autopsy series estimate the incidence to be anywhere from 0.001% to 0.19%. Cardiac lipoma is a rare type of tumour of the heart and pericardium. It comprises approximately 10-19% of all cardiac tumours. We present a case of a large cardiac lipoma in a fifty-year-old female. She presented with sharp chest pains, palpitations, and dizziness. Acute coronary syndrome was ruled out. A transthoracic echocardiogram showed an abnormal, large, fixed right atrial mass...
2018: Case Reports in Cardiology
Ruifu Yang, Mingwu Zhou, Chaofeng Xing, Shimin Li, Li Song, Jia Chen, Yingjie Xiong, Kai Zhang
Objective: To expound the clinical effect of a new operation by transplanting double segment triangular fibula flap with vascular pedicle to repair the forefoot with lateral bone defect, and to study how to improve the operation method in the following stage. Methods: The inclusion criteria: More than 2 phalangeal and metatarsal bones defects of the lateral forefoot, widespread skin and soft tissue defects on pelma and dorsal foot, and destruction of the anterior aspect of foot arch, which seriously affects the foot function...
December 2017: Saudi Journal of Biological Sciences
Hui Zhao, Mingsan Miao
OBJECTIVE: To explore the application characteristics of Zhongjing prescription topical Chinese medicine. METHODS: in this paper, according to the dosage form, Zhongjing topical agent will be divided into suppository, smoked lotion, apply is scattered, plug nasal powder four categories. Through an analysis on its books, records, and clinical applications, we are able to sum up the application characteristics of the zhongjing agent for external use. RESULTS: in the clinical medicine, topical Zhongjing prescription cure of the disease has a long history of the role, through the analysis of Zhongjing topical prescription whole thinking, dialectical thinking, and thinking and characteristics of treatment technology that has the characteristics of topical drugs, dosage form differentiation flexible, external treatment for internal diseases, both inside and outside...
December 2017: Saudi Journal of Biological Sciences
C B Terwee, C A C Prinsen, A Chiarotto, M J Westerman, D L Patrick, J Alonso, L M Bouter, H C W de Vet, L B Mokkink
BACKGROUND: Content validity is the most important measurement property of a patient-reported outcome measure (PROM) and the most challenging to assess. Our aims were to: (1) develop standards for evaluating the quality of PROM development; (2) update the original COSMIN standards for assessing the quality of content validity studies of PROMs; (3) develop criteria for what constitutes good content validity of PROMs, and (4) develop a rating system for summarizing the evidence on a PROM's content validity and grading the quality of the evidence in systematic reviews of PROMs...
March 17, 2018: Quality of Life Research
Anwar E Ahmed, Hamdan Al-Jahdali, Abeer N Alshukairi, Mody Alaqeel, Salma S Siddiq, Hanan A Alsaab, Ezzeldin A Sakr, Hamed A Alyahya, Munzir M Alandonisi, Alaa T Subedar, Nouf M Aloudah, Salim Baharoon, Majid A Alsalamah, Sameera Al Johani, Mohammed G Alghamdi
BACKGROUND: Rapidly and accurately identifying individuals who are at high risk for Middle East respiratory syndrome coronavirus (MERS-CoV) remains a major challenge for the medical and scientific communities. The aim of this study was to develop and validate a risk prediction model for the screening of suspected cases of MERS-CoV infection in patients who had developed pneumonia. METHODS: A two-center retrospective case-control study was done, including 360 patients with confirmed pneumonia who were evaluated for MERS-CoV infection by Real-time reverse-transcription polymerase chain reaction (rRT-PCR) from September 1, 2012 to June 1, 2016 at King Abdulaziz Medical City in Riyadh (KAMC-R) and King Fahd General Hospital in Jeddah (KFGH-JED)...
March 14, 2018: International Journal of Infectious Diseases: IJID
Thais Villela Peterson, Rodrigo Ambar Pinto, G Willy Davila, Sérgio Carlos Nahas, Edmund Chada Baracat, Jorge Milhem Haddad
INTRODUCTION AND HYPOTHESIS: The Pelvic Floor Bother Questionnaire (PFBQ) was designed to identify the presence and degree of bother associated with common pelvic floor symptoms. The PFBQ can be used in clinical practice and for research purposes, but it is not available in Brazilian Portuguese. We aimed to validate a cross-culturally adapted Brazilian Portuguese version of the PFBQ. METHODS: A pilot-tested version of the PFBQ translated from English was evaluated with Brazilian patients suffering from pelvic floor disorders...
March 16, 2018: International Urogynecology Journal
Alfonso Vaquero-Picado, Joaquín Núñez de Armas, Samuel Antuña, Raúl Barco
BACKGROUND AND HYPOTHESIS: Radial head arthroplasty (RHA) is a reliable procedure to manage complex injuries of the elbow, but complications due to inadequate sizing have been observed. Radiocapitellar morphometry has been studied widely, but RHA preoperative planning is not yet well defined. We hypothesized that specific morphologic parameters of the radiocapitellar joint measured with simple clinical software for radiographic analysis could be useful tools for clinical practice to predict RHA size preoperatively...
March 13, 2018: Journal of Shoulder and Elbow Surgery
Meisser Vidal Madera Anaya, Juan Victor Franco, Ángela María Merchán-Galvis, Carmen R Gallardo, Xavier Bonfill Cosp
BACKGROUND: The applicability of clinical practice guidelines (CPGs) on treatments for oral cancer remains unknown since there are no systematic assessments of their quality. Thus, the objective of this study is to identify and assess the quality of them. METHODS: We conducted a systematic search to identify CPGs that provided recommendations on treatments for oral cancer. The quality of each included CPG was determined using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, by four appraisers independently...
March 10, 2018: Cancer Treatment Reviews
Wayne W Morriss, Miodrag S Milenovic, Faye M Evans
There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program...
April 2018: Anesthesia and Analgesia
Susana García-Gutiérrez, José M Quintana López, Ane Antón-Ladislao, María Soledad Gallardo Rebollal, Irene Rilo Miranda, Miren Morillas Bueno, Nekane Murga Eizagaetxebarria, Ricardo Palenzuela Arocena, Esther Pulido, Irantzu Barrio Beraza, Urko Aguirre Larracoechea, Inmaculada Arostegui
OBJECTIVES: To validate the EAHFE-3D scale, based on the Acute Heart Failure in Emergency Departments registry, in a cohort of patients attended for acute heart failure. MATERIAL AND METHODS: Study of a multipurpose cohort of patients with acute heart failure in 3 hospitals in the Basque Country between 2011 and 2013. We extracted age, baseline New York Heart Association functional class, systolic blood pressure, baseline arterial oxygen saturation, sodium level in blood, and emergency department treatments (noninvasive mechanical ventilation, use of inotropic agents and vasopressors) in order to calculate each patient's EAHFE-3D score...
2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
Yasser Helmy
BACKGROUND: Non-surgical nasal job has been practiced and published with doubtful concerns about efficiency and safety among physicians and aesthetic surgeons. AIM: of the work to share our experiences in non-surgical rhinoplasty using filler, Botox, and thread with presentation of aesthetic and complication outcome. PATIENT AND METHODS: Retrospective analysis of the aesthetic and complication outcomes and techniques for non-surgical remodeling rhinoplasty using fillers, Botox, and PDO absorbable threads in 332 cases...
March 15, 2018: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
Lucía Fernández, Alejandra Leivas, Jaime Valentín, Adela Escudero, Dolores Corral, Raquel de Paz, Maria Vela, David Bueno, Rebeca Rodríguez, Juan Manuel Torres, Mariana Díaz-Almirón, Eduardo López-Collazo, Joaquin Martinez-Lopez, Antonio Pérez-Martínez
BACKGROUND: Cancer immunotherapy involving natural killer (NK) cells has gained interest. Here we report two methods to obtain interleukin (IL)-15-activated NK cells for clinical use. STUDY DESIGN AND METHODS: IL-15-activated NK cell products were obtained after 1) enrichment from healthy haploidentical donors' peripheral blood mononuclear cells (PBMNCs) collected by nonmobilized apheresis by a two-step magnetic procedure, depletion of CD3+ cells followed by selection of CD56+ cells and ex vivo overnight stimulation with IL-15 (NKIL15); and 2) expansion using the K562-mb15-41BBL cell line (NKAE), from autologous PBMNCs from patients with multiple myeloma or expansion from healthy haploidentical PBMNCs obtained from whole blood using the same previous cell line...
March 14, 2018: Transfusion
Fred Brouns
In the past, different types of diet with a generally low-carbohydrate content (< 50-< 20 g/day) have been promoted, for weight loss and diabetes, and the effectiveness of a very low dietary carbohydrate content has always been a matter of debate. A significant reduction in the amount of carbohydrates in the diet is usually accompanied by an increase in the amount of fat and to a lesser extent, also protein. Accordingly, using the term "low carb-high fat" (LCHF) diet is most appropriate...
March 14, 2018: European Journal of Nutrition
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