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https://www.readbyqxmd.com/read/29677415/acute-ischemic-stroke-in-a-young-woman-with-no-known-risk-factors
#1
Noureldin Abdelhamid, Salman Farooq, Amrou Sarraj
INTRODUCTION: We aim to highlight a potentially morbid consequence of foam-sclerotherapy for the treatment of varicose veins. CASE REPORT: We report a case of a 41-year-old woman with no significant medical history who presented to the emergency department with sudden onset of focal neurologic deficits. She had undergone varicose vein treatment with foam sclerotherapy 2 days prior. Magnetic resonance imaging of the brain showed acute cerebellar infarct. Computed tomography angiography was unremarkable...
March 2018: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29677066/agreement-analysis-what-he-said-she-said-versus-you-said
#2
Thomas R Vetter, Patrick Schober
Correlation and agreement are 2 concepts that are widely applied in the medical literature and clinical practice to assess for the presence and strength of an association. However, because correlation and agreement are conceptually distinct, they require the use of different statistics. Agreement is a concept that is closely related to but fundamentally different from and often confused with correlation. The idea of agreement refers to the notion of reproducibility of clinical evaluations or biomedical measurements...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29675745/a-proposal-for-an-atypical-femur-fracture-treatment-and-prevention-clinical-practice-guideline
#3
REVIEW
R Dell, D Greene
The prevention as well as the treatment of atypical femur fractures (AFFs) remains controversial but there have been many clinical recommendations suggested. We have summarized these recommendations as well as expanded upon them in this paper. INTRODUCTION: The purpose of the paper was to develop a clinical practice guideline that both treats AFF and decreases the risk of AFF in patients requiring antiresorptive medications. Examples of these medications include bisphosphonates and denosumab for the treatment of osteoporosis...
April 19, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29675055/shifting-paradigm-from-no-code-and-do-not-resuscitate-to-goals-of-care-policies
#4
Yaseen M Arabi, Abdulla A Al-Sayyari, Mohamed S Al Moamary
Policies addressing limitations of medical therapy in patients with advanced medical conditions are typically referred to as Code Status (No Code) policies or Do-Not-Resuscitate (DNR) status polices. Inconsistencies in implementation, understanding, decision-making, communication and management of No Code or DNR orders have led to delivery of poorer care to some patients. Several experts have called for a change in the current approach. The new approach, Goals of Care paradigm, aims to contextualize the decisions about resuscitation and advanced life support within the overall plan of care, focusing on choices of treatments to be given rather than specifically on treatments not to be given...
April 2018: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29674107/the-economics-of-private-practice-versus-academia-in-surgery
#5
Maria Baimas-George, Brian Fleischer, James R Korndorffer, Douglas Slakey, Christopher DuCoin
OBJECTIVE: Residents often make career decisions regarding future practice without adequate knowledge to the realities of professional life. Currently there is a paucity of data regarding economic differences between practice models. This study seeks to illuminate the financial differences of surgical subspecialties between academic and private practice. DESIGN: Data were collected from the Association of American Medical College (AAMC) and the Medical Group Management Association's (MGMA) 2015 reports of average annual salaries...
April 16, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29673398/assessment-of-orthotic-needs-in-iranian-veterans-with-ankle-and-foot-disorders
#6
Kamiar Ghoseiri, Mostafa Allami, Mohammad Reza Soroush
BACKGROUND: War-related traumas can lead to orthopedic and neurological disorders in victims. However, the scope of such disorders may expand months or even years after the trauma. Orthotic treatment as a rehabilitation process aims to enable people with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychological, and social functional levels. This study aimed to investigate the rate of using orthoses among Iranian veterans with neuromuscular and skeletal disorders of the ankle and foot...
April 20, 2018: Military Medical Research
https://www.readbyqxmd.com/read/29672668/distinct-effects-of-apathy-and-dopamine-on-effort-based-decision-making-in-parkinson-s-disease
#7
Campbell Le Heron, Olivia Plant, Sanjay Manohar, Yuen-Siang Ang, Matthew Jackson, Graham Lennox, Michele T Hu, Masud Husain
Effort-based decision-making is a cognitive process crucial to normal motivated behaviour. Apathy is a common and disabling complication of Parkinson's disease, but its aetiology remains unclear. Intriguingly, the neural substrates associated with apathy also subserve effort-based decision-making in animal models and humans. Furthermore, the dopaminergic system plays a core role in motivating effortful behaviour for reward, and its dysfunction has been proposed to play a crucial role in the aetiology of apathy in Parkinson's disease...
April 17, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29671858/disseminating-the-results-of-a-depression-management-study-in-an-urban-alaska-native-health-care-system
#8
Lisa G Dirks, Jaedon P Avey, Vanessa Y Hiratsuka, Denise A Dillard, Karen Caindec, Renee F Robinson
Increased attention to diagnostic accuracy in depression screening and management within primary care has demonstrated inadequate care when patients prematurely discontinue recommended treatments such as medication and counseling. Decision-support tools can enhance the medical decision-making process. In 2010, the Southcentral Foundation (SCF) Research Department developed a stakeholder-driven decision support tool to aid in depression management. This paper describes feedback from attendees at SCF's 2016 Alaska Native Health Research Forum (Forum) regarding a dissemination product highlighting the aforementioned study...
2018: American Indian and Alaska Native Mental Health Research: the Journal of the National Center
https://www.readbyqxmd.com/read/29671768/managing-complexity-exploring-decision-making-on-medication-by-young-adults-with-adhd
#9
Louise C Druedahl, Sofia Kälvemark Sporrong
Attention-deficit hyperactivity disorder (ADHD) causes difficulties with hyperactivity, impulsivity and inattention. Treatment of ADHD includes both medication and non-pharmacological options. Knowledge of treatment preferences by young adults with ADHD is sparse. The objective of this study was to explore the beliefs and experiences of young adults with ADHD related to their medication treatment decisions. Data were collected in Denmark in 2016 through a focus group and individual in-depth interviews. Conventional content analysis was used...
April 19, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29671726/what-about-learners-roles-in-the-operating-room-should-be-disclosed-to-patients
#10
Michael J Kirsch, Steven J Kasten
This case commentary primarily focuses on properly disclosing the participation of medical trainees when obtaining informed consent in the educational health care environment, particularly in relation to the development of institutional standardization of informed consent processes. The article addresses what it means to obtain informed consent, the elements thereof, and how ethical principles can be better applied to clinical practice in order to ensure truly informed consent. Concepts of capacity, disclosure of information, patient understanding, voluntary decision making, and consent are discussed as they relate to the case...
April 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29671399/automatic-infection-detection-based-on-electronic-medical-records
#11
Huaixiao Tou, Lu Yao, Zhongyu Wei, Xiahai Zhuang, Bo Zhang
BACKGROUND: Making accurate patient care decision, as early as possible, is a constant challenge, especially for physicians in the emergency department. The increasing volumes of electronic medical records (EMRs) open new horizons for automatic diagnosis. In this paper, we propose to use machine learning approaches for automatic infection detection based on EMRs. Five categories of information are utilized for prediction, including personal information, admission note, vital signs, diagnose test results and medical image diagnose...
April 11, 2018: BMC Bioinformatics
https://www.readbyqxmd.com/read/29669707/a-web-based-decision-tool-to-improve-contraceptive-counseling-for-women-with-chronic-medical-conditions-protocol-for-a-mixed-methods-implementation-study
#12
Justine P Wu, Laura J Damschroder, Michael D Fetters, Brian J Zikmund-Fisher, Benjamin F Crabtree, Shawna V Hudson, Mack T Ruffin Iv, Juliana Fucinari, Minji Kang, L Susan Taichman, John W Creswell
BACKGROUND: Women with chronic medical conditions, such as diabetes and hypertension, have a higher risk of pregnancy-related complications compared with women without medical conditions and should be offered contraception if desired. Although evidence based guidelines for contraceptive selection in the presence of medical conditions are available via the United States Medical Eligibility Criteria (US MEC), these guidelines are underutilized. Research also supports the use of decision tools to promote shared decision making between patients and providers during contraceptive counseling...
April 18, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29669391/translational-biomarkers-and-ex-vivo-models-of-joint-tissues-as-a-tool-for-drug-development-in-rheumatoid-arthritis
#13
Cecilie F Kjelgaard-Petersen, Adam Platt, Martin Braddock, Martin A Jenkins, Kishwar Musa, Emma Graham, Thorbjørn Gantzel, Gillian Slynn, Michael E Weinblatt, Morten A Karsdal, Christian S Thudium, Anne-C Bay-Jensen
OBJECTIVE: Rheumatoid arthritis (RA) is a chronic, autoimmune and degenerative joint disease leading to disability, reduced life quality, and increased mortality. Although several synthetic and biological disease modifying anti-rheumatic drugs (DMARDs) are available, there is still a medical need for novel drugs controlling disease progression. As only 10% of RA drug candidates that enter phase I trials are eventually FDA registered, there is an immediate requirement for translational drug development tools to facilitate early drug development decision making...
April 18, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29668609/the-success-of-opening-single-chronic-total-occlusion-lesions-to-improve-myocardialviabilitytrial-sos-comedy-study-protocol-of-a-prospective-multicenter-study
#14
Rongchong Huang, Xiantao Song, Haishan Zhang, Wen Tian, Zheng Huang, Xingwei Zhang, Junqing Yang, Dongfeng Zhang, Jian Wu, Lei Zhong, Henry H Ting
AIMS: Success of opening single (SOS)-comedy is a prospective multicenter study to compare the improvement in the decrease of myocardial viability by percutaneous coronary intervention (PCI) with that by optimal medical therapy (OMT) alone in patients with chronic total occlusion (CTO) of a single coronary artery. METHODS AND RESULTS: The risks and the benefits of both options (PCI and OMT) were listed in a CTO decision aid (DA). Eligible participants detected by invasive coronary angiography (ICA) or coronary computed tomography angiography (CCTA) were divided into PCI or OMT groups according to patients' choice after shared-decision making process with DA...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29668190/bedsharing-at-home-breastfeeding-and-sudden-infant-death-recommendations-for-health-professionals
#15
Alejandro Jenik, Roxana Conti
The Sudden and Unexpected Infant Death Task Force together with the Subcommittee on Breastfeeding of the Sociedad Argentina de Pediatría have issued updated recommendations on bedsharing with the parents, a practice which remains controversial. Sleeping with the mother maximizes breastfeeding, which is protective against Sudden Infant Death. There is a small group of infants that have been associated with an increased risk of Sudden Infant Death and fatal sleeping accidents in certain circumstances. These hazards include parental smoking, sedating drugs or medication and alcohol consumption prior to sleep and sofa sharing situations...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29667509/the-involvement-of-cancer-patients-in-the-four-stages-of-decision-making-preceding-continuous-sedation-until-death-a-qualitative-study
#16
Lenzo Robijn, Jane Seymour, Luc Deliens, Ida Korfage, Jayne Brown, Peter Pype, Agnes Van Der Heide, Kenneth Chambaere, Judith Rietjens
BACKGROUND: Involving patients in decision-making is considered to be particularly appropriate towards the end of life. Professional guidelines emphasize that the decision to initiate continuous sedation should be made in accordance with the wishes of the dying person and be preceded by their consent. AIM: To describe the decision-making process preceding continuous sedation until death with particular attention to the involvement of the person who is dying. DESIGN: Qualitative case studies using interviews...
April 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29667311/how-japanese-nurses-participate-in-decision-making-infants-with-congenital-life-threatening-conditions
#17
Sohei Shitaya, Nobue Nakamura, Naho Sato
BACKGROUND: In Japan, owing to the progress in medical technology, more children with congenital life-threatening conditions survive than ever before. Nurses who care for these children may also influence decision making in difficult situations. AIM: We aimed to describe Japanese nurses' approach toward medical decision making when caring for families of infants with congenital life-threatening conditions. Frequently, these nurses must care for and support parents with ambivalent feelings...
April 2018: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/29667023/liraglutide-effects-on-upper-gastrointestinal-investigations-implications-prior-to-bariatric-surgery
#18
Renuca Modi, Peter Rye, Sarah Cawsey, Daniel W Birch, Arya M Sharma
Liraglutide is a glucagon-like peptide type 1 (GLP-1) analogue that is approved for long-term obesity management in North America. While bariatric surgery remains the gold standard for weight loss, an increasing number of patients are on liraglutide in the setting of ongoing workup for bariatric surgery. The presence of gastrointestinal symptoms prior to bariatric surgery may prompt testing for dysmotility, which affects surgical decision making. Here we report six cases where treatment with liraglutide was associated with reversible reduction in gastric and esophageal motility in screening for bariatric surgery...
April 17, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29666554/effect-of-different-pre-analytical-conditions-on-plasma-lactate-concentration
#19
Ivana Rako, Ana Mlinaric, Monika Dozelencic, Gordana Fressl Juros, Dunja Rogic
Introduction: Plasma lactate is a frequently used and important parameter for medical decision making. To setup a pre-analytical algorithm, we aimed to investigate the influence of different test tube additives, aliquoting, ice storage and haemolysis on plasma lactate concentrations for possible sparing critically ill (ICU) patients of additional blood drawing. Materials and methods: In our study (N = 177), lactate concentration and haemolysis index (HI) were measured in aliquoted (AHP) and unaliquoted (HP) Li-heparin, NaF/K3 EDTA and NaF/KOX plasma, centrifuged within 15 minutes after venipuncture, on Cobas c501 analyzer...
June 15, 2018: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/29666295/lung-ultrasound-prior-to-spontaneous-breathing-trial-is-not-helpful-in-weaning-the-decision-making-process
#20
Ana Carolina P Antonio, Marli M Knorst, Cassiano Teixeira
BACKGROUND: Lung ultrasound is increasingly becoming a diagnostic tool in the critical care setting. B-pattern on a lung ultrasound is an artifact composed of multiple B-lines and correlates with interstitial edema. A randomized controlled trial concluded that bedside thoracic ultrasound could predict postextubation distress through changes in lung aeration during a weaning procedure; however, it could not screen patients before performance of a spontaneous breathing trial (SBT). METHODS: We conducted a 2-year, prospective, multicenter, observational study in 2 adult medical-surgical ICUs in southern Brazil...
April 17, 2018: Respiratory Care
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