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https://www.readbyqxmd.com/read/28535332/interventions-for-treating-anxiety-after-stroke
#1
REVIEW
Peter Knapp, C Alexia Campbell Burton, John Holmes, Jenni Murray, David Gillespie, C Elizabeth Lightbody, Caroline L Watkins, Ho-Yan Y Chun, Sharon R Lewis
BACKGROUND: Approximately 20% of stroke patients experience clinically significant levels of anxiety at some point after stroke. Physicians can treat these patients with antidepressants or other anxiety-reducing drugs, or both, or they can provide psychological therapy. This review looks at available evidence for these interventions. This is an update of the review first published in October 2011. OBJECTIVES: The primary objective was to assess the effectiveness of pharmaceutical, psychological, complementary, or alternative therapeutic interventions in treating stroke patients with anxiety disorders or symptoms...
May 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28447853/finding-balance-standardizing-practice-is-corseting-physician-judgement
#2
Peter J Pronovost, Stephen A Berry, Kathleen M Sutliffe
No abstract text is available yet for this article.
April 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28440855/accuracy-of-current-diagnostic-criteria-for-acute-bacterial-infection-in-older-adults-in-the-emergency-department
#3
Jeffrey M Caterino, Robert Leininger, David M Kline, Lauren T Southerland, Salman Khaliqdina, Christopher W Baugh, Daniel J Pallin, Kurt B Stevenson
OBJECTIVES: To compare the accuracy of the Loeb criteria, emergency department (ED) physicians' diagnoses, and Centers for Disease Control and Prevention (CDC) guidelines for acute bacterial infection in older adults with a criterion standard expert review. DESIGN: Prospective, observational study. SETTING: Urban, tertiary-care ED. PARTICIPANTS: Individuals aged 65 and older in the ED, excluding those who were incarcerated, underwent a trauma, did not speak English, or were unable to consent...
April 25, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28406719/structured-expert-consensus-on-actinic-keratosis-treatment-algorithm-focusing-on-daylight-pdt
#4
Piergiacomo Calzavara-Pinton, Merete Hædersdal, Kirk Barber, Nicole Basset-Seguin, María Emilia Del Pino Flores, Peter Foley, Gaston Galimberti, Rianne Gerritsen, Yolanda Gilarbete, Sally Ibbotson, Ketty Peris, Sheetal Sapra, Eleni Sotiriou, Luis Torezan, Claas Ulrich, Jonathan Guillemot, Janek Hendrich, Rolf-Markus Szeimies
BACKGROUND: A practical and up-to-date consensus among experts is paramount to further improve patient care in actinic keratosis (AK). OBJECTIVES: To develop a structured consensus statement on the diagnosis, classification, and practical management of AK based on up-to-date information. METHODS: A systematic review of AK clinical guidelines was conducted. This informed the preparation of a 3-round Delphi procedure followed by a consensus meeting, which combined the opinions of 16 clinical experts from 13 countries, to construct a structured consensus statement and a treatment algorithm positioning daylight photodynamic therapy (dl-PDT) among other AK treatment options...
April 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28338533/sepsis-patients-in-the-emergency-department-stratification-using-the-clinical-impression-score-predisposition-infection-response-and-organ-dysfunction-score-or-quick-sequential-organ-failure-assessment-score
#5
Vincent M Quinten, Matijs van Meurs, Anna E Wolffensperger, Jan C Ter Maaten, Jack J M Ligtenberg
OBJECTIVE: The aim of this study was to compare the stratification of sepsis patients in the emergency department (ED) for ICU admission and mortality using the Predisposition, Infection, Response and Organ dysfunction (PIRO) and quick Sequential Organ Failure Assessment (qSOFA) scores with clinical judgement assessed by the ED staff. PATIENTS AND METHODS: This was a prospective observational study in the ED of a tertiary care teaching hospital. Adult nontrauma patients with suspected infection and at least two Systemic Inflammatory Response Syndrome criteria were included...
May 8, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28300480/impossible-decision-an-investigation-of-risk-trade-offs-in-the-intensive-care-unit
#6
Tom W Reader, Geetha Reddy, Stephen J Brett
In the intensive care unit (ICU), clinicians must often make risk trade-offs on patient care. For example, on deciding whether to discharge a patient before they have fully recovered in order to create a bed for another, sicker, patient. When misjudged, these decisions can negatively influence patient outcomes: yet it can be difficult, if not impossible, for clinicians to evaluate with certainty the safest course of action. Using a vignette-based interview methodology, a naturalistic decision-making approach was utilised to study this phenomena...
March 16, 2017: Ergonomics
https://www.readbyqxmd.com/read/28295898/the-program-for-personnel-in-medical-institutions-in-japan-to-combat-child-maltreatment
#7
Koji Tanoue, Masayoshi Senda, Byongmun An, Midori Tasaki, Megumi Taguchi, Kosuke Kobashi, Shinji Oana, Fumitake Mizoguchi, Yuko Shiraishi, Fujiko Yamada, Makiko Okuyama, Kotaro Ichikawa
BACKGROUND: In 2014, we created the training program for personnel in medical institutions in Japan to combat child maltreatment. Our objective was to document the effectiveness of the program for professionals from multiple disciplines working in medical institutions. METHODS: The questionnaire designed for the training program included demographic questions such years of practice and area of specialty, i.e. physician, nurse, social worker, public health nurse, technician, and others, as well as experience with suspected child maltreatment cases and training in dealing with such cases...
March 11, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28265798/the-role-of-a-hospital-ethics-consultation-service-in-decision-making-for-unrepresented-patients
#8
Andrew M Courtwright, Joshua Abrams, Ellen M Robinson
Despite increased calls for hospital ethics committees to serve as default decision-makers about life-sustaining treatment (LST) for unrepresented patients who lack decision-making capacity or a surrogate decision-maker and whose wishes regarding medical care are not known, little is known about how committees currently function in these cases. This was a retrospective cohort study of all ethics committee consultations involving decision-making about LST for unrepresented patients at a large academic hospital from 2007 to 2013...
March 6, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28225495/the-multimorbidity-interaction-severity-index-misi-a-proof-of-concept-study
#9
Dimitri Gassmann, Marcus Cheetham, Klarissa Siebenhuener, Barbara M Holzer, Claudine Meindl-Fridez, Florian F Hildenbrand, Vanessa Virgini, Mike Martin, Edouard Battegay
Therapeutic decision-making for patients with multimorbidity (MM) is challenging. Clinical practice guidelines inadequately address harmful interactions and resulting therapeutic conflicts within and among diseases. A patient-specific measure of MM severity that takes account of this conflict is needed.As a proof of concept, we evaluated whether the new Multimorbidity Interaction Severity Index (MISI) could be used to reliably differentiate patients in terms of lower versus higher potential for harmful interactions...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28185464/differences-in-age-distribution-oncological-diagnoses-and-stage-in-roma-and-non-roma-cancer-patients-registered-at-the-outpatient-oncology-department-poprad-in-2014-and-2015-a-retrospective-study
#10
M Reckova, J Mardiak, J Beniak, M Kakalejcik, L Medvecova, S Cingelová, M Mego
BACKGROUND: Roma (Gypsies) constitute the largest ethnic minority in Slovakia. Although some studies have reported a higher prevalence of communicable diseases in Roma, there have been no studies on cancer prevalence in Roma. The aim of this study was to compare differences in age at diagnosis, oncological diagnoses, and stage between Roma and non-Roma patients registered at a single oncology outpatient department in Eastern Slovakia where substantial numbers of Roma patients are treated...
December 0: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28181019/evaluating-the-complementary-roles-of-an-sjt-and-academic-assessment-for-entry-into-clinical-practice
#11
Fran Cousans, Fiona Patterson, Helena Edwards, Kim Walker, John C McLachlan, David Good
Although there is extensive evidence confirming the predictive validity of situational judgement tests (SJTs) in medical education, there remains a shortage of evidence for their predictive validity for performance of postgraduate trainees in their first role in clinical practice. Moreover, to date few researchers have empirically examined the complementary roles of academic and non-academic selection methods in predicting in-role performance. This is an important area of enquiry as despite it being common practice to use both types of methods within a selection system, there is currently no evidence that this approach translates into increased predictive validity of the selection system as a whole, over that achieved by the use of a single selection method...
May 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28167517/the-need-to-optimize-adolescent-immunization
#12
Henry H Bernstein, Joseph A Bocchini
The adolescent period heralds the pediatric patient's transition into adulthood. It is a time of dynamic development during which effective preventive care measures can promote safe behaviors and the development of lifelong health habits. One of the foundations of preventive adolescent health care is timely vaccination, and every visit can be viewed as an opportunity to update and complete an adolescent's immunizations.In the past decade, the adolescent immunization schedule has expanded to include 2 doses of quadrivalent meningococcal conjugate vaccine, 1 dose of tetanus, diphtheria, acellular pertussis, absorbed vaccine, 2 or 3 doses of human papillomavirus vaccine, depending on the child's age, and an annual influenza vaccine...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28148572/the-predictive-validity-of-a-situational-judgement-test-a-clinical-problem-solving-test-and-the-core-medical-training-selection-methods-for-performance-in-specialty-training%C3%A2
#13
Fiona Patterson, Safiatu Lopes, Stephen Harding, Emma Vaux, Liz Berkin, David Black
The aim of this study was to follow up a sample of physicians who began core medical training (CMT) in 2009. This paper examines the long-term validity of CMT and GP selection methods in predicting performance in the Membership of Royal College of Physicians (MRCP(UK)) examinations. We performed a longitudinal study, examining the extent to which the GP and CMT selection methods (T1) predict performance in the MRCP(UK) examinations (T2). A total of 2,569 applicants from 2008-09 who completed CMT and GP selection methods were included in the study...
February 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28095758/ethical-difficulties-in-healthcare-a-comparison-between-physicians-and-nurses
#14
Cinzia Leuter, Carmen La Cerra, Santina Calisse, Danila Dosa, Cristina Petrucci, Loreto Lancia
BACKGROUND: Advances in biomedical sciences, technologies and care practices have resulted in an increase in ethical problems and a resulting growth of difficulties encountered by health workers in their professional activity. OBJECTIVE: The main objective of this study was to analyse knowledge in the ethical field and experience with and the propensity for using ethics consultations by nurses and physicians. METHODS: Between March and June 2014, a cross-sectional observational study was conducted on a sample of 351 nurses and 128 physicians in four central Italian hospitals...
January 18, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28053702/outcomes-of-an-inpatient-refeeding-protocol-in-youth-with-anorexia-nervosa-rady-children-s-hospital-san-diego-university-of-california-san-diego
#15
Tamara R Maginot, Maya M Kumar, Jacqueline Shiels, Walter Kaye, Kyung E Rhee
BACKGROUND: Current guidelines for nutritional rehabilitation in hospitalized restrictive eating disorder patients recommend a cautious approach to refeeding. Several studies suggest that higher calorie diets may be safe and effective, but have traditionally excluded severely malnourished patients. The goal of this study was to evaluate the safety of a higher calorie nutritional rehabilitation protocol (NRP) in a broad sample of inpatients with restrictive eating disorders, including those who were severely malnourished...
2017: Journal of Eating Disorders
https://www.readbyqxmd.com/read/28000339/people-with-epilepsy-receive-more-statins-than-the-general-population-but-have-no-higher-cardiovascular-risk-results-from-a-cross-sectional-study
#16
R M Vivanco-Hidalgo, R Elosua, A Gómez González, A Moreira, L Díez, M Grau, I R Degano, J Roquer
BACKGROUND AND PURPOSE: Epilepsy has been associated with cardiovascular comorbidity. Risk prediction equations are the standard tools in primary prevention of cardiovascular disease. Our aim was to compare the prevalence of cardiovascular risk factors (CVRFs), cardiovascular risk and statin use in people with epilepsy (PWE) and the general population. METHODS: The CVRFs and cardiovascular risk score were compared between 815 PWE from an outpatient register and 5336 participants from a general population cohort...
February 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/27966437/physician-consensus-on-preventability-and-predictability-of-readmissions-based-on-standard-case-scenarios
#17
L S van Galen, T Cooksley, H Merten, M Brabrand, C B Terwee, C H Nickel, C P Subbe, R Kidney, J Soong, L Vaughan, I Weichert, M H H Kramer, P W B Nanayakkara
BACKGROUND: Policy makers struggle with unplanned readmissions as a quality indicator since integrating preventability in such indicators is difficult. Most studies on the preventability of readmissions questioned physicians whether they consider a given readmission to be preventable, from which conclusions on factors predicting preventable readmissions were derived. There is no literature on the interobserver agreement of physician judgement. AIM: To assess the degree of agreement among physicians regarding predictability and preventability of medical readmissions...
December 2016: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/27941006/constructing-diagnostic-likelihood-clinical-decisions-using-subjective-versus-statistical-probability
#18
John Kinnear, Ruth Jackson
BACKGROUND: Although physicians are highly trained in the application of evidence-based medicine, and are assumed to make rational decisions, there is evidence that their decision making is prone to biases. One of the biases that has been shown to affect accuracy of judgements is that of representativeness and base-rate neglect, where the saliency of a person's features leads to overestimation of their likelihood of belonging to a group. This results in the substitution of 'subjective' probability for statistical probability...
December 9, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27920229/octreotide-use-in-post-cardiac-surgery-chylothorax-a-12-year-perspective
#19
Abdulrazaq Sheikh Aljazairi, Tauhid Ahmed Bhuiyan, Abdullah Hasan Alwadai, Rayd Abdulaziz Almehizia
Background Chylothorax following cardiothoracic surgery is a rare condition in pediatric patients with significant morbidity and mortality. Pharmacological management with octreotide suggests possible efficacy; however, current evidence is inadequate. The objective of this study was to assess the safety and efficacy of octreotide as a therapeutic option in this clinical setting. Methods This was a 12-year single-center retrospective cohort study of all patients (birth to 18-years old) who received octreotide for management of post-cardiac surgery chylothorax between January 2003 to August 2015...
January 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27878797/choosing-wisely-at-the-end-of-life-the-crucial-role-of-medical-indication
#20
Gian Domenico Borasio, Ralf J Jox
At the end of life, several treatments are administered routinely that lack medical indication and may cause significant harm to patients. Examples include artificial hydration and oxygen therapy in the dying phase, as well as enteral nutrition in advanced dementia. Medical indication is defined as the appropriateness of a therapeutic or diagnostic measure in the patient's concrete clinical situation, in light of the best available evidence. The decision about the absence or presence of a medical indication is a core competence of physicians...
2016: Swiss Medical Weekly
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