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https://www.readbyqxmd.com/read/27933732/hypothesis-driven-physical-examination-curriculum
#1
Sharon Allen, Andrew Olson, Jeremiah Menk, James Nixon
BACKGROUND: Medical students traditionally learn physical examination skills as a rote list of manoeuvres. Alternatives like hypothesis-driven physical examination (HDPE) may promote students' understanding of the contribution of physical examination to diagnostic reasoning. We sought to determine whether first-year medical students can effectively learn to perform a physical examination using an HDPE approach, and then tailor the examination to specific clinical scenarios. Medical students traditionally learn physical examination skills as a rote list of manoeuvres CONTEXT: First-year medical students at the University of Minnesota were taught both traditional and HDPE approaches during a required 17-week clinical skills course in their first semester...
December 9, 2016: Clinical Teacher
https://www.readbyqxmd.com/read/27933720/autogenous-bone-grafting-for-treatment-of-osseous-defect-after-impacted-mandibular-third-molar-extraction-a-randomized-controlled-trial
#2
Jing Ge, Chi Yang, Jiawei Zheng, Yingkai Hu
BACKGROUND: Extraction of impacted mandibular third molar (M3) has been cited as causing osseous defect at the distal aspect of the adjacent second molar (M2). PURPOSE: This randomized controlled trial was aimed to evaluate the effect of autogenous bone grafting in situ for regeneration of periodontal osseous defect distal to the M2 compared with non-grafting after impacted M3 removal. MATERIALS AND METHODS: A total of 60 sites in 51 adult patients were enrolled and randomly assigned to the control group or the test group...
December 8, 2016: Clinical Implant Dentistry and related Research
https://www.readbyqxmd.com/read/27933616/efficacy-of-preoperative-ibuprofen-and-meloxicam-on-the-success-rate-of-inferior-alveolar-nerve-block-for-teeth-with-irreversible-pulpitis
#3
Yazdan Shantiaee, Sahar Javaheri, Amir Movahhedian, Sarah Eslami, Omid Dianat
OBJECTIVE: The purpose of this study was to determine whether premedication with ibuprofen or meloxicam increases the success rate of anaesthesia in teeth with irreversible pulpitis. MATERIALS AND METHODS: In this parallel, double-blind clinical trial, 92 patients diagnosed with irreversible pulpitis were randomly divided into four groups of 23 patients. The first group (the no-premedication group) received no premedication, the second group (the meloxicam group) received 7...
December 8, 2016: International Dental Journal
https://www.readbyqxmd.com/read/27933615/immediate-release-versus-controlled-release-carbamazepine-in-the-treatment-of-epilepsy
#4
REVIEW
Graham Powell, Matthew Saunders, Alexandra Rigby, Anthony G Marson
BACKGROUND: Carbamazepine (CBZ) is a commonly used drug for epilepsy that is associated with troublesome adverse events including dizziness, double vision, drowsiness, poor co-ordination and unsteadiness. These adverse events often occur during peaks in drug plasma concentration. These adverse events may limit the daily dose of CBZ that can be tolerated and reduce the chances of seizure control in patients who require high doses. A controlled-release formulation of CBZ delivers the same dose over a longer period of time when compared to a standard immediate-release formulation, thereby reducing post-dose peaks in CBZ plasma concentration and potentially reducing adverse events...
December 8, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27933580/headache-service-quality-evaluation-of-quality-indicators-in-14-specialist-care-centres
#5
Sara Schramm, Derya Uluduz, Raquel Gil Gouveia, Rigmor Jensen, Aksel Siva, Ugur Uygunoglu, Giorgadze Gvantsa, Maka Mania, Mark Braschinsky, Elena Filatova, Nina Latysheva, Vera Osipova, Kirill Skorobogatykh, Julia Azimova, Andreas Straube, Ozan Emre Eren, Paolo Martelletti, Valerio De Angelis, Andrea Negro, Mattias Linde, Knut Hagen, Aleksandra Radojicic, Jasna Zidverc-Trajkovic, Ana Podgorac, Koen Paemeleire, Annelien De Pue, Christian Lampl, Timothy J Steiner, Zaza Katsarava
BACKGROUND: The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). METHODS: Employing previously-developed instruments in 14 such centres, we made enquiries, in each, of health-care providers (doctors, nurses, psychologists, physiotherapists) and 50 patients, and analysed the medical records of 50 other patients...
December 2016: Journal of Headache and Pain
https://www.readbyqxmd.com/read/27933555/pharmacist-s-comprehensive-geriatric-assessment-introduction-and-evaluation-at-elderly-patient-admission
#6
Faiza Rhalimi, Mounir Rhalimi, Alain Rauss
BACKGROUND: The role of the clinical pharmacist within the healthcare system remains unclear. OBJECTIVE: Our objective was to describe a pharmacist's comprehensive geriatric assessment (pCGA) at admission of elderly patients and to assess its relevance in terms of medication compliance and pharmacist interventions (PIs). METHODS: We conducted a prospective interventional study over 29 months in a 34-bed medical/rehabilitation geriatric ward in a French geriatric hospital...
December 8, 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27933514/changes-in-cardiac-repolarisation-during-spontaneous-nocturnal-hypoglycaemia-in-subjects-with-type-1-diabetes-a-preliminary-report
#7
Minna L Koivikko, Tuomas Kenttä, Pasi I Salmela, Heikki V Huikuri, Juha S Perkiömäki
AIMS: Experimental studies have revealed that hypoglycaemia can result in morphological changes in electrocardiographic repolarisation in subjects with type 1 diabetes. However, the influence of spontaneous nocturnal hypoglycaemia on repolarisation morphology in a 'real life' situation is not clear. METHODS: Adults with type 1 diabetes (n = 11) underwent continuous glucose monitoring with a subcutaneous sensor and digital 12-lead ECG recording for three nights...
December 8, 2016: Acta Diabetologica
https://www.readbyqxmd.com/read/27933489/patients-understanding-and-use-of-analgesia-for-postnatal-pain-following-hospital-discharge
#8
Antonia M W Wong, Syed Tabish R Zaidi
Background Postnatal pain is one of the limiting factors in the recovery of women from child birth. Despite the routine prescribing of analgesics for postnatal pain, limited research is available on the use of analgesics by the women in postnatal period. Objective To measure the utilisation and effectiveness of prescribed oral analgesics, the incidence and severity of pain, and factors associated with poor pain control on the fifth-day post-hospital discharge in postnatal women. Setting A tertiary referral women's hospital of Western Australia...
December 9, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27933487/evaluation-of-standardized-triple-intrathecal-therapy-toxicity-in-oncohematological-pediatric-patients
#9
Raquel Olmos-Jiménez, María Sacramento Díaz-Carrasco, Ana Galera-Miñarro, Juan Francisco Pascual-Gazquez, Alberto Espuny-Miró
Background The administration of triple intrathecal therapy with methotrexate, cytarabine and a corticosteroid for the prophylaxis and treatment of neoplastic cell infiltration in the central nervous system in hematological malignancies is a widespread practice. There is limited information available about its toxicity profile. Several factors related to intrathecal preparation can affect toxicity. Thus, it was decided to standardize intrathecal chemotherapy, trying to obtain the best toxicity profile. Objective To assess the toxicity of a standardized triple intrathecal chemotherapy in oncohematological pediatric patients and to establish risk factors of toxicity...
December 8, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27933481/fixation-preference-test-reliability-for-the-detection-of-amblyopia-in-patients-with-strabismus-and-interexaminer-agreement
#10
Kadriye Erkan Turan, Hande Taylan Sekeroglu, Sevilay Karahan, Ali Sefik Sanac
PURPOSE: The purpose of this study was to analyze the reliability of the fixation preference test (FPT) in the detection of amblyopia, and to determine interexaminer agreement. METHODS: Eighty patients whose visual acuity could be tested objectively and had a horizontal misalignment of more than 10 prism diopters were enrolled. The best corrected visual acuity (BCVA) and orthoptic findings were all recorded. Non-preferred eye in primary position and fixation preference grade were assessed independently by two masked experienced examiners...
December 8, 2016: International Ophthalmology
https://www.readbyqxmd.com/read/27933480/alternatives-to-the-baseline-kub-for-ctkub-detected-calculi-evaluation-of-ct-scout-and-average-and-maximum-intensity-projection-images
#11
Hin-Boon Matthew Lew, James Han-Su Seow, Chandra Padmini Hewavitharana, Sally Burrows
PURPOSE: A CT of the kidneys, ureters, and bladder (CTKUB) is the investigation of choice in suspected renal colic. Plain kidney, ureter, and bladder radiographs (KUB) can be used to monitor the progress of a stone if radiographically visible on a baseline KUB. This study aims to determine if a low-dose CT Scout, thick-slab average intensity projection (AIP), or maximum intensity projection (MIP) images are suitable as substitutes for a baseline KUB. METHOD: A retrospective review of patients from a tertiary adult institute that had a positive CTKUB and a KUB within 4 h of the CT was performed...
December 8, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27933446/permanent-tooth-agenesis-in-non-syndromic-robin-sequence-and-cleft-palate-prevalence-and-patterns
#12
Anneline de Smalen, Daan P F van Nunen, Ruurd R Hermus, Edwin M Ongkosuwito, Arjen J van Wijk, J Peter W Don Griot, Corstiaan C Breugem, Gem J C Kramer
OBJECTIVES: Partial tooth agenesis is frequently observed in Robin sequence. Tooth anomalies are increasingly considered as an extended phenotype of the cleft palate population. The study objective was to compare the prevalence and patterns of tooth agenesis in a group of patients with non-syndromic Robin sequence (ns-RS) and a group with non-syndromic cleft palate (ns-CP). MATERIALS AND METHODS: The panoramic radiographs of 115 ns-RS and 191 ns-CP patients were assessed for agenesis of the permanent dentition (excluding third molars) and the patterns recorded using the Tooth Agenesis Code...
December 9, 2016: Clinical Oral Investigations
https://www.readbyqxmd.com/read/27933396/totally-laparoscopic-total-gastrectomy-using-the-overlap-method-early-outcomes-of-50-consecutive-cases
#13
Tae-Gyun Lee, In-Seob Lee, Jeong-Hwan Yook, Byung-Sik Kim
BACKGROUND: Construction of an esophagojejunostomy is still a challenging procedure in totally laparoscopic total gastrectomy (TLTG), and there is no standard anastomosing method. The aims of this study were to describe our TLTG with the overlap method using a linear stapler and report surgical outcomes. METHODS: From January 2015 to April 2016, 50 patients underwent TLTG using the overlap method for gastric cancer. The procedures were performed by a single surgeon, and the patients' medical records were reviewed...
December 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27933394/men-and-women-show-similar-survival-rates-after-breast-cancer
#14
Paulo Franscisco Mascarenhas Bender, Letícia Lima de Oliveira, Célia Regina Costa, Suzana Sales de Aguiar, Anke Bergmann, Luiz Claudio Santos Thuler
PURPOSE: To compare the disease-free survival (DFS) and overall survival (OS) rates of men and women undergoing treatment for breast cancer. METHODS: A retrospective cohort study of patients with breast cancer diagnosed and treated at the Cancer Hospital III of the National Cancer Institute of Brazil, Rio de Janeiro, Brazil, between 1999 and 2013. Male breast cancer cases were matched for age, year of diagnosis, and clinical staging to three female cases (1:3). Patient characteristics were abstracted from hospital records and medical charts...
December 8, 2016: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/27933386/endoscopic-submucosal-dissection-specimens-in-early-colorectal-cancer-lateral-margins-macroscopic-techniques-and-possible-pitfalls
#15
Alicia Dessain, Christophe Snauwaert, Pamela Baldin, Pierre Deprez, Louis Libbrecht, Hubert Piessevaux, Anne Jouret-Mourin
Endoscopic submucosal dissection (ESD) allows en-bloc resection of superficial gastrointestinal tumors, providing specimens on which lateral margin analysis can be performed reliably. Positive lateral margins have been linked to higher rates of recurrence/residual tumor. There are no guidelines for macroscopic processing of lateral margins. Currently, most institutions use parallel lateral sections, which are difficult to interpret. We use perpendicular lateral sections, hypothesizing that it decreases potential artifactually positive lateral margins...
December 8, 2016: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/27933383/the-burden-of-rotator-cuff-surgery-in-italy-a-nationwide-registry-study
#16
Umile Giuseppe Longo, Giuseppe Salvatore, Giacomo Rizzello, Alessandra Berton, Mauro Ciuffreda, Vincenzo Candela, Vincenzo Denaro
PURPOSE: This study aimed to estimate the yearly number of RC surgeries in Italy, a country with universal access to healthcare for its population, from 2001 to 2014, based on official information source as hospitalization records. A secondary aim was to explore geographical variation in equity in access to RC surgery between three macroregions of Italy (North, Center and South). A tertiary aim was to perform statistical projections of the number of RC procedure volumes and rates on the basis of data from 2001 to 2014...
December 8, 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27933382/the-impact-of-hereditary-multiple-exostoses-on-quality-of-life-satisfaction-global-health-status-and-pain
#17
Riccardo D'Ambrosi, Vincenza Ragone, Camilla Caldarini, Nicola Serra, Federico Giuseppe Usuelli, Renato Mario Facchini
PURPOSE: The aim of the study was to evaluate quality of life (QOL), global health status, pain, and level of satisfaction in patients with hereditary multiple exostoses (HME), and to correlate the association between the severity of diseases and age, sex, number of surgical procedures, and number of exostoses. METHODS: The data of 50 patients with HME were retrospectively evaluated and recorded. QOL was evaluated with the Short-Form Health Survey (SF-12) questionnaire, the 12-Item General Health Questionnaire (GHQ-12), and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF); intensity of pain was measured using the visual analogue scale (VAS)...
December 8, 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27933375/a-novel-method-of-adrenal-venous-sampling-via-an-antecubital-approach
#18
Xiongjing Jiang, Hui Dong, Meng Peng, Wuqiang Che, Yubao Zou, Lei Song, Huimin Zhang, Haiying Wu
PURPOSE: Currently, almost all adrenal venous sampling (AVS) procedures are performed by femoral vein access. The purpose of this study was to establish the technique of AVS via an antecubital approach and evaluate its safety and feasibility. MATERIALS AND METHODS: From January 2012 to June 2015, 194 consecutive patients diagnosed as primary aldosteronism underwent AVS via an antecubital approach without ACTH simulation. Catheters used for bilateral adrenal cannulations were recorded...
December 8, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27933366/deficits-in-autonomic-indices-of-emotion-regulation-and-reward-processing-associated-with-prescription-opioid-use-and-misuse
#19
Eric L Garland, Craig J Bryan, Yoshio Nakamura, Brett Froeliger, Matthew O Howard
RATIONALE: Prescription opioid misuse and high-dose opioid use may result in allostatic dysregulation of hedonic brain circuitry, leading to reduced emotion regulation capacity. In particular, opioid misuse may blunt the ability to experience and upregulate positive affect from natural rewards. OBJECTIVES: The purpose of this study was to examine associations between opioid use/misuse and autonomic indices of emotion regulation capability in a sample of chronic pain patients receiving prescription opioid pharmacotherapy...
December 8, 2016: Psychopharmacology
https://www.readbyqxmd.com/read/27933151/improving-asthma-care-in-a-pediatric-resident-clinic
#20
Julia Lee, Albina Gogo, Daniel Tancredi, Erik Fernandez Y Garcia, Ulfat Shaikh
There is variation in pediatric asthma management in the outpatient setting. Adherence to national asthma guidelines provides a systematic standardized approach to asthma management. There is a gap between usual and guideline-consistent asthma care in resident clinics. Practice improvement modules aimed at improving resident physician adherence to asthma care guidelines have not been consistently utilized and have not yet been studied. Our aim was to increase guideline consistent care in our pediatric resident clinic in a twelve-month period via increasing performance on the following measures to 75%: spirometry testing; influenza immunization recommendation; level of control assessed through the use of a standardized questionnaire; appropriate medications per national guideline; and use of written asthma action plans...
2016: BMJ Quality Improvement Reports
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