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https://www.readbyqxmd.com/read/29031040/-treatment-refusal-in-pediatric-oncology
#1
A Špótová, K Husáková, A Hrašková, M Mikesková, J Puškáčová, S Hederová, M Jamárik, E Rabenseifertová, Z Jalovecká, A Kolenová, Z Šubová
BACKGROUND: Pediatric oncologists are often faced with situations in which parents or guardians refuse recommended treatment for curable childhood cancer. Deciding how to proceed in such situations is an ethical dilemma. The aim of this article is to consider optimal approaches when parents are strongly against oncological treatment, potentially compromising their childrens rights for health care and to the chance for cure. CASES: In this paper, we report two cases of treatment refusal from our department and the impact of such decisions on the children themselves...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/29031028/risk-factors-for-death-in-dogs-treated-for-esophageal-foreign-body-obstruction-a-retrospective-cohort-study-of-222-cases-1998-2017
#2
A G Burton, C T Talbot, M S Kent
BACKGROUND: Limited data exist describing risk factors for death, and long-term outcomes in dogs with esophageal foreign body (EFB) obstruction. HYPOTHESIS/OBJECTIVES: To evaluate short- and long-term outcomes, and analyze risk factors for death in dogs with EFB obstruction. We hypothesized duration of entrapment and treatment type would affect outcome. ANIMALS: A total of 222 dogs were treated for EFB obstruction at an emergency and referral hospital between March 1998 and March 2017...
October 14, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29029375/treatment-and-disease-management-of-multiple-sclerosis-patients-a-review-for-nurse-practitioners
#3
Cortnee Roman, Kara Menning
BACKGROUND AND PURPOSE: This review discusses the role of the nurse practitioner (NP) in evaluating the clinical effects, potential side effects, and monitoring requirements for treatment options in multiple sclerosis (MS) and provides guidance on how to help patients understand these issues. METHODS: A literature search was conducted on PubMed to identify publications on monitoring and disease management of MS patients. Additional resources included drug information web sites and package inserts...
October 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29028421/medical-student-reflections-on-geriatrics-moral-distress-empathy-ethics-and-end-of-life
#4
Mary E Camp, Haekyung Jeon-Slaughter, Anne E Johnson, John Z Sadler
INTRODUCTION: Medical students' early clinical encounters may influence their perceptions of geriatrics. This study examines reflective essays written by 3rd year medical students on required clinical rotations. METHODS: Using content analysis, the authors analyzed the essays' thematic content. The authors then used chi-square analysis to compare themes with geriatric patients (age 60+) to themes with other age groups. RESULTS: 120 out of 802 essays described a geriatric patient...
October 13, 2017: Gerontology & Geriatrics Education
https://www.readbyqxmd.com/read/29025746/clinical-prediction-model-for-time-in-therapeutic-range-while-on-warfarin-in-newly-diagnosed-atrial-fibrillation
#5
Brent A Williams, Michael A Evans, Ashley M Honushefsky, Peter B Berger
BACKGROUND: Though warfarin has historically been the primary oral anticoagulant for stroke prevention in newly diagnosed atrial fibrillation (AF), several new direct oral anticoagulants may be preferred when anticoagulation control with warfarin is expected to be poor. This study developed a prediction model for time in therapeutic range (TTR) among newly diagnosed AF patients on newly initiated warfarin as a tool to assist decision making between warfarin and direct oral anticoagulants...
October 12, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29025270/design-of-a-randomized-clinical-trial-of-a-colorectal-cancer-screening-decision-aid-to-promote-appropriate-screening-in-community-dwelling-older-adults
#6
Christine E Kistler, Carol Golin, Carolyn Morris, Alexandra F Dalton, Russell P Harris, Rowena Dolor, Renée M Ferrari, Noel T Brewer, Carmen L Lewis
BACKGROUND: Appropriate colorectal cancer screening in older adults should be aligned with the likelihood of net benefit. In general, patient decision aids improve knowledge and values clarity, but in older adults, they may also help patients identify their individual likelihood of benefit and foster individualized decision-making. We report on the design of a randomized clinical trial to understand the effects of a patient decision aid on appropriate colorectal cancer screening. This report includes a description of the baseline characteristics of participants...
August 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/29024890/a-systematic-review-of-economic-evaluation-in-pancreatic-ductal-adenocarcinoma
#7
REVIEW
Claire Gérard, Philippe Fagnoni, Angélique Vienot, Christophe Borg, Samuel Limat, Franck Daval, François Calais, Julie Vardanega, Marine Jary, Virginie Nerich
OBJECTIVES: The economic evaluation (EE) of healthcare interventions has become a necessity. However, high quality needs to be ensured in order to achieve validated results and help making informed decisions. Thus, the objective of the present study was to systematically identify and review published pancreatic ductal adenocarcinoma-related EEs and to assess their quality. METHODS: Systematic literature research was conducted in PubMed and Cochrane to identify published EEs between 2000 and 2015...
October 9, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29022539/bibliometric-trends-of-south-african-environmental-health-articles-between-1998-and-2015-making-local-research-visible-and-retrievable
#8
C Y Wright, F Dominick, Z Kunene, T Kapwata, R A Street
BACKGROUND: South Africa (SA) has to grapple with multiple burdens of disease for which environmental factors have a role to play in both causation and prevention. This article describes a bibliometric review of environmental health indexed literature for SA over an 18-year period. OBJECTIVES: To provide an overview of the nature of SA-based published environmental health indexed research and to identify search challenges, frequently researched topics, and gaps and opportunities for future research...
September 22, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29022172/the-president-s-physician-an-african-play-emmanuel-babatunde-omobowale-2004-all-saints-publishers-ibadan-978-978-37727-3-1-77-pp
#9
Joseph Ajagunmolu Mayaki
This review examines issues relating to biomedical ethics and literature in the African drama The President's Physician by Emmanuel Babatunde Omobowale. The play investigates the psychological dilemma of Doctor Bituki Warunga, a personal physician to General Kalunga Ntibantunganyah who brutally and inhumanely rules Wavaria, a fictional African country. The doctor is faced with deciding to uphold the ethics of his profession versus terminating the tyrant's life to set the nation free. The play aims to help budding medical doctors rightly inculcate the principles of medical ethics-autonomy, beneficence, competence, and power-by providing a fictional platform to investigate difficult issues that can arise in clinical practice...
October 11, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29021207/impact-of-lifestyle-and-metformin-interventions-on-the-risk-of-progression-to-diabetes-and-regression-to-normal-glucose-regulation-in-overweight-or-obese-people-with-impaired-glucose-regulation
#10
William H Herman, Qing Pan, Sharon L Edelstein, Kieren J Mather, Leigh Perreault, Elizabeth Barrett-Connor, Dana M Dabelea, Edward Horton, Steven E Kahn, William C Knowler, Carlos Lorenzo, Xavier Pi-Sunyer, Elizabeth Venditti, Wen Ye
OBJECTIVE: Both lifestyle and metformin interventions can delay or prevent progression to type 2 diabetes mellitus (DM) in people with impaired glucose regulation, but there is considerable interindividual variation in the likelihood of receiving benefit. Understanding an individual's 3-year risk of progressing to DM and regressing to normal glucose regulation (NGR) might facilitate benefit-based tailored treatment. RESEARCH DESIGN AND METHODS: We used the values of 19 clinical variables measured at the Diabetes Prevention Program (DPP) baseline evaluation and Cox proportional hazards models to assess the 3-year risk of progression to DM and regression to NGR separately for DPP lifestyle, metformin, and placebo participants who were adherent to the interventions...
October 11, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29020522/teaching-learning-and-performance-in-the-surgical-workplace-insights-from-the-examination-of-intraoperative-interactions
#11
Gary Sutkin, Eliza Beth Littleton, Steven L Kanter, Anna T Cianciolo, Xiaodong Phoenix Chen, Alexandra Cope, Timothy Koschmann
This Conversations Starter article presents a selected research abstract from the 2017 Association of American Medical Colleges Central Region Group on Educational Affairs annual spring meeting. The abstract is paired with the integrative commentary of three experts who shared their thoughts stimulated by the study. These thoughts explore the value of examining intraoperative interactions among attending surgeons and residents for enhancing instructional scaffolding; entrustment decision making; and distinguishing teaching, learning, and performance in the workplace...
October 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29020367/clinical-outcomes-of-state-of-the-art-percutaneous-coronary-revascularization-in-patients-with-de-novo-three-vessel-disease-1-year-results-of-the-syntax-ii-study
#12
Javier Escaned, Carlos Collet, Nicola Ryan, Giovanni Luigi De Maria, Simon Walsh, Manel Sabate, Justin Davies, Maciej Lesiak, Raul Moreno, Ignacio Cruz-Gonzalez, Stephan P Hoole, Nick Ej West, J J Piek, Azfar Zaman, Farzin Fath-Ordoubadi, Rodney H Stables, Clare Appleby, Nicolas van Mieghem, Robert Jm van Geuns, Neal Uren, Javier Zueco, Pawel Buszman, Andres Iñiguez, Javier Goicolea, David Hildick-Smith, Andrzej Ochala, Dariusz Dudek, Colm Hanratty, Rafael Cavalcante, Arie Pieter Kappetein, David P Taggart, Gerrit-Anne van Es, Marie-Angèle Morel, Ton de Vries, Yoshinobu Onuma, Vasim Farooq, Patrick W Serruys, Adrian P Banning
Aims: To investigate if recent technical and procedural developments in percutaneous coronary intervention (PCI) significantly influence outcomes in appropriately selected patients with three-vessel (3VD) coronary artery disease. Methods and results: The SYNTAX II study is a multicenter, all-comers, open-label, single arm study that investigated the impact of a contemporary PCI strategy on clinical outcomes in patients with 3VD in 22 centres from four European countries...
August 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29020352/the-mida-mortality-risk-score-development-and-external-validation-of-a-prognostic-model-for-early-and-late-death-in-degenerative-mitral-regurgitation
#13
Francesco Grigioni, Marie-Annick Clavel, Jean-Louis Vanoverschelde, Christophe Tribouilloy, Rodolfo Pizarro, Marianne Huebner, Jean-Francois Avierinos, Andrea Barbieri, Rakesh Suri, Agnés Pasquet, Dan Rusinaru, Gaetano D Gargiulo, Pablo Oberti, Alexis Théron, Francesca Bursi, Hector Michelena, Siham Lazam, Catherine Szymanski, Vuyisile T Nkomo, Martin Schumacher, Letizia Bacchi-Reggiani, Maurice Enriquez-Sarano
Aims: In degenerative mitral regurgitation (DMR), lack of mortality scores predicting death favours misperception of individual patients' risk and inappropriate decision-making. Methods and results: The Mitral Regurgitation International Database (MIDA) registries include 3666 patients (age 66 ± 14 years; 70% males; follow-up 7.8 ± 5.0 years) with pure, isolated, DMR consecutively diagnosed by echocardiography at tertiary (European/North/South-American) centres...
August 13, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29019063/statin-prescribing-in-the-elderly-special-considerations
#14
REVIEW
M Leya, N J Stone
PURPOSE OF REVIEW: Our aim was to examine the current evidence behind prescribing statins to individuals over 65 years of age with emphasis on those older than 75. Individuals over 75 years of age may often have multiple comorbidities and take many medications. Additionally, they are often underrepresented in randomized controlled trials (RCTs) of statins in older populations. While results of RCTs demonstrate the benefit of statin therapy in both primary and secondary prevention patients, clinicians must more carefully consider adverse effects and drug-drug interactions before prescribing statin therapy as well as determining the intensity in older individuals...
October 11, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29018643/case-reports-case-series-from-clinical-practice-to-evidence-based-medicine-in-graduate-medical-education
#15
EDITORIAL
Jerry W Sayre, Hale Z Toklu, Fan Ye, Joseph Mazza, Steven Yale
Case reports and case series or case study research are descriptive studies that are prepared for illustrating novel, unusual, or atypical features identified in patients in medical practice, and they potentially generate new research questions. They are empirical inquiries or investigations of a patient or a group of patients in a natural, real-world clinical setting. Case study research is a method that focuses on the contextual analysis of a number of events or conditions and their relationships. There is disagreement among physicians on the value of case studies in the medical literature, particularly for educators focused on teaching evidence-based medicine (EBM) for student learners in graduate medical education...
August 7, 2017: Curēus
https://www.readbyqxmd.com/read/29017980/predisposing-factors-of-fracture-nonunion-after-posterior-c1-lateral-mass-screws-combined-with-c2-pedicle-laminar-screws-fixation-for-type-ii-odontoid-fracture
#16
Hui Wang
INTRODUCTION: The aim of this study was to explore the predisposing factors for fracture nonunion after C1 lateral screw combined with C2 pedicle/laminar screw for type II odontoid fracture, and hope to provide references in decision making and surgical planning for spinal surgeons. METHODS: This is a retrospective study. By retrieving the medical records from January 2010 to July 2015 in our hospital, 117 type II odontoid fracture patients were reviewed. According to the occurrence of fracture union at the final follow up, patients were divided into two groups: Union group and Non-union group...
October 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29017656/-development-and-construction-mode-of-critical-care-medicine-22-years-of-development-and-construction-of-intensive-care-units-of-guizhou-medical-university
#17
Difen Wang, Ying Liu, Jiangquan Fu, Yuanyi Liu, Yumei Cheng, Ying Wang, Liang Li, Ming Liu, Yan Tang, Feng Shen, Xu Liu, Jia Yuan, Xianjun Chen, Hongying Bi, Hongxia Wang, Wei Li, Qimin Chen, Cui Wang
OBJECTIVE: To provide decision-making basis for promoting the rapid and healthy development of critical care medicine/intensive care unit (ICU) through discussing the mode of development and construction of the department of ICU. METHODS: The situations of ICU of Affiliated Hospital of Guizhou Medical University from July 1994 to December 2016 were analyzed and summed up. Data of the situations in different development stages included the location and area of the ward, the number of beds, the number of physicians and nurses, the structure of academic titles and educational levels, the number of patients admitted to ICU per year, the proportion of patients used ventilator per year, the mortality, the mode of the discipline management, the number of medical postgraduates and undergraduates trained in the ICU, the number of teaching hours, the achievements, the number of research projects, the number of published monographs and papers, the number of the multicenter trials that we participated in, the construction of the team, the personal honor, and so on...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29017561/trial-and-error-evaluating-and-refining-a-community-model-of-hiv-testing-in-australia
#18
Kathleen E Ryan, Alisa Pedrana, David Leitinger, Anna L Wilkinson, Peter Locke, Margaret E Hellard, Mark Stoové
BACKGROUND: The 2012 regulatory approval of HIV rapid point of care (RPOC) tests in Australia and a national strategic focus on HIV testing provided a catalyst for implementation of non-clinical HIV testing service models. PRONTO! opened in 2013 as a two-year trial delivering peer-led community-based HIV RPOC tests targeting gay, bisexual and other men who have sex with men (GBM), with the aim of increasing HIV testing frequency. Initial data suggested this aim was not achieved and, as part of a broader service evaluation, we sought to explore client acceptability and barriers to testing at PRONTO! to refine the service model...
October 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29017505/study-protocol-patient-reported-outcomes-for-bladder-management-strategies-in-spinal-cord-injury
#19
Darshan P Patel, Sara M Lenherr, John T Stoffel, Sean P Elliott, Blayne Welk, Angela P Presson, Amitabh Jha, Jeffrey Rosenbluth, Jeremy B Myers
BACKGROUND: The majority of spinal cord injury (SCI) patients have urinary issues, such as incontinence, retention, and frequency. These problems place a significant burden on patients' physical health and quality of life (QoL). There are a wide variety of bladder management strategies available to patients with no clear guidelines on appropriate selection. Inappropriate bladder management can cause hospitalizations and serious complications, such as urosepsis and renal failure. Patients believe that both independence and ability to carry out daily activities are just as important as physical health in selecting the right bladder-management strategy but little is known about patient's QoL with different bladder managements...
October 10, 2017: BMC Urology
https://www.readbyqxmd.com/read/29017332/shared-decision-making-in-mental-health-the-importance-for-current-clinical-practice
#20
Victoria Alguera-Lara, Michelle M Dowsey, Jemimah Ride, Skye Kinder, David Castle
OBJECTIVES: We reviewed the literature on shared decision making (regarding treatments in psychiatry), with a view to informing our understanding of the decision making process and the barriers that exist in clinical practice. METHODS: Narrative review of published English-language articles. RESULTS: After culling, 18 relevant articles were included. Themes identified included models of psychiatric care, benefits for patients, and barriers...
October 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
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