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Variability in practice

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https://www.readbyqxmd.com/read/28102901/risk-of-arrhythmic-death-in-ischemic-heart-disease-a-prospective-controlled-observer-blind-investigation-over-10-years
#1
Thomas Pezawas, André Diedrich, David Robertson, Robert Winker, Bernhard Richter, Li Wang, Herwig Schmidinger
BACKGROUND: Risk of arrhythmic death is considered highest in ischemic heart disease with severe left ventricular ejection fraction (LVEF) reduction. Non-invasive testing should improve decision-making of prophylactic defibrillator (ICD) implantation. METHODS AND RESULTS: We enrolled 120 patients with ischemic heart disease and LVEF <50% and 30 control subjects without ischemic heart disease and normal LVEF. An initial assessment, a second assessment after 3 years, and a final follow-up comprised of: pharmacological baroreflex testing (BRS), short-term spectral (low frequency (LF) to high frequency (HF) ratio) and long-term time domain analysis of heart rate variability (SDNN), exercise Microvolt T-wave alternans (MTWA) and others...
January 19, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28102898/a-composite-autonomic-index-as-unitary-metric-for-heart-rate-variability-a-proof-of-concept
#2
Roberto Sala, Mara Malacarne, Nadia Solaro, Massimo Pagani, Daniela Lucini
BACKGROUND: This study addresses whether a unitary cardiac autonomic nervous system index (ANSI), obtained combining multiple metrics from Heart Rate Variability (HRV) into a radar plot could provide an easy appreciation of autonomic performance in a clinical setting. MATERIALS AND METHODS: Data are standardized using percentile ranking of autonomic proxies from a relatively large reference population (n= 1593, age 39±13 years). Autonomic indices are obtained from autoregressive spectral analysis of (ECG derived) HRV at rest and during standing up...
January 19, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28102500/rates-and-predictors-of-caesarean-section-for-first-and-second-births-a-prospective-cohort-of-australian-women
#3
Alexis Hure, Jennifer Powers, Catherine Chojenta, Deborah Loxton
Objective To determine rates of vaginal delivery, emergency caesarean section, and elective caesarean section for first and second births in Australia, and to identify maternal predictors of caesarean section. Methods Data were from the Australian Longitudinal Study on Women's Health. A total of 5275 women aged 18-38 years, who had given birth to their first child between 1996 and 2012 were included; 75.0% (n = 3956) had delivered a second child. Mode of delivery for first and second singleton birth(s) was obtained from longitudinal survey data...
January 19, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28101916/perceptions-of-cancer-of-unknown-primary-site-a-national-survey-of-australian-medical-oncologists
#4
Christos S Karapetis, Lisa Guccione, Martin Hn Tattersall, Helen Gooden, Claire M Vajdic, Sylvie Lambert, Monica Robotin, Linda Mileshkin, Penelope Schofield
INTRODUCTION: Despite being the 6(th) cause of cancer death in Australia, cancer of unknown primary (CUP) site remains poorly understood. AIMS: To describe practices relating to the diagnosis, investigation, classification, communication and management of CUP amongst medical oncologists. METHODS: We invited all members of the Medical Oncology Group of Australia to participate in a national, anonymous online survey about CUP. The survey collected data regarding diagnosis acceptance, diagnostic tests, treatment protocols and communication practices around the diagnosis of CUP...
January 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28101588/factors-controlling-sediment-load-in-the-central-anatolia-region-of-turkey-ankara-river-basin
#5
Umit Duru, Ellen Wohl, Mehdi Ahmadi
Better understanding of the factors controlling sediment load at a catchment scale can facilitate estimation of soil erosion and sediment transport rates. The research summarized here enhances understanding of correlations between potential control variables on suspended sediment loads. The Soil and Water Assessment Tool was used to simulate flow and sediment at the Ankara River basin. Multivariable regression analysis and principal component analysis were then performed between sediment load and controlling variables...
January 18, 2017: Environmental Management
https://www.readbyqxmd.com/read/28101533/experimental-design-and-data-analysis-issues-contribute-to-inconsistent-results-of-c-bouton-changes-in-amyotrophic-lateral-sclerosis
#6
S Shekar Dukkipati, Aouatef Chihi, Yiwen Wang, Sherif M Elbasiouny
The possible presence of pathological changes in cholinergic synaptic inputs [cholinergic boutons (C-boutons)] is a contentious topic within the ALS field. Conflicting data reported on this issue makes it difficult to assess the roles of these synaptic inputs in ALS. Our objective was to determine whether the reported changes are truly statistically and biologically significant and why replication is problematic. This is an urgent question, as C-boutons are an important regulator of spinal motoneuron excitability, and pathological changes in motoneuron excitability are present throughout disease progression...
January 2017: ENeuro
https://www.readbyqxmd.com/read/28101307/review-and-recommendations-on-management-of-adult-female-thalassemia-patients-with-hypogonadism-based-on-literature-review-and-experience-of-icet-a-network-specialists
#7
REVIEW
Vincenzo De Sanctis, Ashraf T Soliman, Heba Elsedfy, Alice Albu, Soad Al Jaouni, Salvatore Anastasi, Maria Grazia Bisconte, Duran Canatan, Soteroula Christou, Shahina Daar, Salvatore Di Maio, Mohamed El Kholy, Doaa Khater, Mohamed Elshinawy, Yurdanur Kilinc, Roberto Mattei, Hala H Mosli, Alessandra Quota, Maria Grazia Roberti, Praveen Sobti, Saif Al Yaarubi, Saveria Canpisi, Christos Kattamis
BACKGROUND: Multi-transfused thalassemia major (TM) patients frequently develop severe endocrine complications, mainly due to iron overload, anemia, and chronic liver disease, which require prompt diagnosis, treatment and follow-up by specialists. The most common endocrine complication documented is hypogonadotropic hypogonadism which increases with age and associated comorbidities. It is thus important for physicians to have a clear understanding of the pathophysiology and management of this disorder...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28100932/defecography-by-digital-radiography-experience-in-clinical-practice
#8
Amanda Nogueira de Sá Gonçalves, Marco Aurélio Sousa Sala, Rodrigo Ciotola Bruno, José Alberto Cunha Xavier, João Mauricio Canavezi Indiani, Marcelo Fontalvo Martin, Paulo Maurício Chagas Bruno, Marcelo Souto Nacif
OBJECTIVE: The objective of this study was to profile patients who undergo defecography, by age and gender, as well as to describe the main imaging and diagnostic findings in this population. MATERIALS AND METHODS: This was a retrospective, descriptive study of 39 patients, conducted between January 2012 and February 2014. The patients were evaluated in terms of age, gender, and diagnosis. They were stratified by age, and continuous variables are expressed as mean ± standard deviation...
November 2016: Radiologia Brasileira
https://www.readbyqxmd.com/read/28099516/clinical-practice-guidelines-for-rare-diseases-the-orphanet-database
#9
Sonia Pavan, Kathrin Rommel, María Elena Mateo Marquina, Sophie Höhn, Valérie Lanneau, Ana Rath
Clinical practice guidelines (CPGs) for rare diseases (RDs) are scarce, may be difficult to identify through Internet searches and may vary in quality depending on the source and methodology used. In order to contribute to the improvement of the diagnosis, treatment and care of patients, Orphanet (www.orpha.net) has set up a procedure for the selection, quality evaluation and dissemination of CPGs, with the aim to provide easy access to relevant, accurate and specific recommendations for the management of RDs...
2017: PloS One
https://www.readbyqxmd.com/read/28099092/training-and-development-of-canadian-wheelchair-basketball-players
#10
N Dehghansai, S Lemez, N Wattie, J Baker
Considering the growth in research, examining the development of mainstream sport athletes over the past two decades, studies examining development of athletes with disabilities have been surprisingly limited. While similarities in developmental trajectories between the two cohorts may exist regarding factors such as the value of practice, which tend to be universal regardless of context, disability-related issues (e.g. whether the disability was congenital or acquired) may influence the course of development, affecting variables such as starting age, training and developmental milestones...
January 18, 2017: European Journal of Sport Science
https://www.readbyqxmd.com/read/28099044/effect-of-early-skin-to-skin-mother-infant-contact-in-the-maintenance-of-exclusive-breastfeeding
#11
Rafael Vila-Candel, Kiri Duke, F Javier Soriano-Vidal, Enrique Castro-Sánchez
BACKGROUND: Breastfeeding has been shown to result in extensive physical and psychological benefits for both the mother and the newborn. However, the rate and duration of exclusive breastfeeding (EBF) remains low worldwide. Mother-infant skin-to-skin contact (SSC) immediately after birth has demonstrated results that support the argument for breastfeeding continuation. Research aim: This study aimed to investigate the prevalence of EBF 3 months postpartum and the effect of early SSC in maintaining optimal EBF practices for mothers and their healthy newborns...
January 1, 2017: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/28098627/global-collaboration-in-acute-care-clinical-research-opportunities-challenges-and-needs
#12
John C Marshall
The most impactful research in critical care comes from trials groups led by clinician-investigators who study questions arising through the day-to-day care of critically ill patients. The success of this model reflects both "necessity"-the paucity of new therapies introduced through industry-led research-and "clinical reality"-nuanced modulation of standard practice can have substantial impact on clinically important outcomes. Success in a few countries has fueled efforts to build similar models around the world and to collaborate on an unprecedented scale in large international trials...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098205/reliable-and-efficient-solution-of-genome-scale-models-of-metabolism-and-macromolecular-expression
#13
Ding Ma, Laurence Yang, Ronan M T Fleming, Ines Thiele, Bernhard O Palsson, Michael A Saunders
Constraint-Based Reconstruction and Analysis (COBRA) is currently the only methodology that permits integrated modeling of Metabolism and macromolecular Expression (ME) at genome-scale. Linear optimization computes steady-state flux solutions to ME models, but flux values are spread over many orders of magnitude. Data values also have greatly varying magnitudes. Standard double-precision solvers may return inaccurate solutions or report that no solution exists. Exact simplex solvers based on rational arithmetic require a near-optimal warm start to be practical on large problems (current ME models have 70,000 constraints and variables and will grow larger)...
January 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28097711/pharmacists-perceptions-of-pay-for-performance-versus-fee-for-service-remuneration-for-the-management-of-hypertension-through-pharmacist-prescribing
#14
Meagen M Rosenthal, Nimisha Desai, Sherilyn K D Houle
OBJECTIVES: As pharmacists expand their roles as patient care providers, remuneration must be offered for patient care activities apart from dispensing. Most jurisdictions paying for such services utilize the fee-for-service (FFS) model, while little is known about the role of pay for performance (P4P) within the pharmacy profession. This study aimed to elicit the experience of pharmacists practicing under both models within the Alberta Clinical Trial in Optimizing Hypertension (RxACTION) study in Alberta, Canada...
January 18, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28097673/schoolyard-shade-and-sun-exposure-assessment-of-personal-monitoring-during-children-s-physical-activity
#15
Jennifer K Vanos, Grant R McKercher, Kylie Naughton, Marc Lochbaum
Childhood exposure to ultraviolet radiation (UVR) is a major risk factor for the development of melanoma later in life. However, it is challenging to accurately determine personal outdoor exposure to UVR, specifically erythemally-weighted UVR (UVEry ), due to technological constraints, variable time-activity patterns, and the influence of outdoor environmental design. To address this challenge, the current study utilized mobile and stationary techniques to examine the UVEry exposures of 14 children in a schoolyard in Lubbock, TX in spring 2016...
January 18, 2017: Photochemistry and Photobiology
https://www.readbyqxmd.com/read/28097657/public-trust-in-health-information-sharing-a-measure-of-system-trust
#16
Jodyn E Platt, Peter D Jacobson, Sharon L R Kardia
OBJECTIVE: To measure public trust in a health information sharing in a broadly defined health system (system trust), inclusive of health care, public health, and research; to identify individual characteristics that predict system trust; and to consider these findings in the context of national health initiatives (e.g., learning health systems and precision medicine) that will expand the scope of data sharing. DATA SOURCES: Survey data (n = 1,011) were collected in February 2014...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28097426/functional-diversity-increases-ecological-stability-in-a-grazed-grassland
#17
Lauren M Hallett, Claudia Stein, Katharine N Suding
Understanding the factors governing ecological stability in variable environments is a central focus of ecology. Functional diversity can stabilize ecosystem function over time if one group of species compensates for an environmentally driven decline in another. Although intuitively appealing, evidence for this pattern is mixed. We hypothesized that diverse functional responses to rainfall will increase the stability of vegetation cover and biomass across rainfall conditions, but that this effect depends on land-use legacies that maintain functional diversity...
January 17, 2017: Oecologia
https://www.readbyqxmd.com/read/28097415/anesthesia-practices-for-interventional-radiology-in-europe
#18
Alessandra Vari, Afshin Gangi
PURPOSE: The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe. METHODS: Anonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology...
January 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28096918/perioperative-outcomes-following-radical-prostatectomy-for-patients-with-disseminated-cancer-an-analysis-of-the-national-surgical-quality-improvement-program-database
#19
Raj Satkunasivam, Christopher J D Wallis, James Byrne, Azik Hoffman, Douglas C Cheung, Girish S Kulkarni, Avery B Nathens, Robert K Nam
INTRODUCTION: We sought to determine whether patients undergoing radical prostatectomy (RP) in the context of disseminated cancer have higher 30-day complications. METHODS: We conducted a retrospective cohort study of the National Surgical Quality Improvement Program (NSQIP) database. Men undergoing RP (from January 1, 2005 to December 31, 2014) for prostate cancer were identified and stratified by presence (n=97) or absence (n=27 868) of disseminated cancer. The primary outcome was major complications (death, re-operation, cardiac or neurologic events) within 30 days of surgery...
November 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28096901/exploring-musculoskeletal-injuries-in-the-podiatry-profession-an-international-cross-sectional-study
#20
Cylie M Williams, Stefania Penkala, Peter Smith, Terry Haines, Kelly-Ann Bowles
BACKGROUND: Workplace injury is an international costly burden. Health care workers are an essential component to managing musculoskeletal disorders, however in doing this, they may increase their own susceptibility. While there is substantial evidence about work-related musculoskeletal disorders across the health workforce, understanding risk factors in specific occupational groups, such as podiatry, is limited. The primary aim of this study was to determine the prevalence and intensity of work related low back pain in podiatrists...
2017: Journal of Foot and Ankle Research
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