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Variability in practice

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https://www.readbyqxmd.com/read/28822825/comparison-of-transforaminal-lumbar-interbody-fusion-outcomes-in-patients-receiving-rhbmp-2-versus-autograft
#1
Taleef R Khan, Kalin R Pearce, Steven J McAnany, Colleen M Peters, Munish C Gupta, Lukas P Zebala
BACKGROUND CONTEXT: Recombinant human bone morphogenetic protein 2 (rhBMP-2) plays a pivotal role in complex spine surgery. Despite its limited approval, the off-label use of rhBMP-2 is prevalent, particularly in transforaminal lumbar interbody fusions (TLIF) PURPOSE: To determine the effectiveness and safety of rhBMP-2 use in TLIF procedures versus autograft. STUDY DESIGN: Retrospective Cohort Study PATIENT SAMPLE: Patients older than 18 years undergoing spine surgery for lumbar degenerative spine disease at a single academic institution...
August 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28822474/the-effect-of-augmented-feedback-and-expertise-on-spinal-manipulation-skills-an-experimental-study
#2
Mégane Pasquier, Charlène Cheron, Claude Dugas, Arnaud Lardon, Martin Descarreaux
OBJECTIVES: The purpose of this study was to investigate the combined effect of augmented feedback and expertise on the performance and retention of basic motor learning spinal manipulation skills. METHODS: A total of 103 chiropractic students with various training expertise were recruited for the study. Participants were evaluated at baseline, immediately after trials of augmented feedback practice and 1 week later. During all 3 assessments, students were asked to perform several trials of the same spinal manipulation, for which the maximum preload force, onset of thrust, thrust duration, force and peak force, thrust duration, rate of force application, and any drop in preload force were calculated...
July 2017: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/28822398/variability-in-perioperative-fasting-practices-negatively-impacts-nutritional-support-of-critically-ill-intubated-patients
#3
Molly J Douglas, David Ciraulo
The aim of the study was to quantify nutritional losses related to pre- and postoperative fasts in critically ill intubated patients and to explore whether shorter fasts are safe and appropriate in this population. A retrospective review of mechanically ventilated adults undergoing surgery more than 24 hours after admission to a Level I trauma center over 15 months was done, which yielded 132 procedures and 81 unique patients. Ninety per cent of preoperative periods and 43 per cent of postoperative periods were affected by nonmedical barriers to feeding...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28822391/the-impact-of-hemodynamic-transesophageal-echocardiography-on-the-use-of-continuous-renal-replacement-therapy-in-trauma
#4
Madison Griffin, Brett Howard, Sam Devictor, Josh Ferenczy, Frances Cobb, D Benjamin Christie
Post-traumatic fluid management is a widely debated topic. No best-practice consensus exists. Adverse outcomes such as acute kidney injury or volume overload are common. Continuous renal replacement therapy (CRRT) is an adjunct therapy for severe acute renal failure and volume overload, but is costly and not without risk. Hemodynamic transesophageal echocardiography (hTEE) is widely accepted as a reliable way to monitor volume status of intensive care unit (ICU) patients. Although data exist evaluating hTEE and CRRT independently, there is a lack of research mutually inclusive of the two...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28821841/bacterial-foraging-optimization-genetic-algorithm-for-multiple-sequence-alignment-with-multi-objectives
#5
P Manikandan, D Ramyachitra
This research work focus on the multiple sequence alignment, as developing an exact multiple sequence alignment for different protein sequences is a difficult computational task. In this research, a hybrid algorithm named Bacterial Foraging Optimization-Genetic Algorithm (BFO-GA) algorithm is aimed to improve the multi-objectives and carrying out measures of multiple sequence alignment. The proposed algorithm employs multi-objectives such as variable gap penalty minimization, maximization of similarity and non-gap percentage...
August 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28821598/quality-standards-in-upper-gastrointestinal-endoscopy-a-position-statement-of-the-british-society-of-gastroenterology-bsg-and-association-of-upper-gastrointestinal-surgeons-of-great-britain-and-ireland-augis
#6
Sabina Beg, Krish Ragunath, Andrew Wyman, Matthew Banks, Nigel Trudgill, D Mark Pritchard, Stuart Riley, John Anderson, Helen Griffiths, Pradeep Bhandari, Phillip Kaye, Andrew Veitch
This document represents the first position statement produced by the British Society of Gastroenterology and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, setting out the minimum expected standards in diagnostic upper gastrointestinal endoscopy. The need for this statement has arisen from the recognition that while technical competence can be rapidly acquired, in practice the performance of a high- quality examination is variable, with an unacceptably high rate of failure to diagnose cancer at endoscopy...
August 18, 2017: Gut
https://www.readbyqxmd.com/read/28821525/point-of-care-washing-of-allogeneic-red-blood-cells-for-the-prevention-of-transfusion-related-respiratory-complications-war-prc-a-protocol-for-a-multicenter-randomised-clinical-trial-in-patients-undergoing-cardiac-surgery
#7
Matthew A Warner, Ian J Welsby, Phillip J Norris, Christopher C Silliman, Sarah Armour, Erica D Wittwer, Paula J Santrach, Laurie A Meade, Lavonne M Liedl, Chelsea M Nieuwenkamp, Brian Douthit, Camille M van Buskirk, Phillip J Schulte, Rickey E Carter, Daryl J Kor
INTRODUCTION: The transfusion-related respiratory complications, transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO), are leading causes of transfusion-related morbidity and mortality. At present, there are no effective preventive strategies with red blood cell (RBC) transfusion. Although mechanisms remain incompletely defined, soluble biological response modifiers (BRMs) within the RBC storage solution may play an important role. Point-of-care (POC) washing of allogeneic RBCs may remove these BRMs, thereby mitigating their impact on post-transfusion respiratory complications...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28820856/perceived-wellness-associated-with-practice-and-competition-in-ncaa-division-i-football-players
#8
Aaron D Wellman, Sam C Coad, Patrick J Flynn, Ty K Siam, Christopher P McLellan
The present study assessed the influence of movement demands resulting from weekly practice sessions and games, on perceived wellness measurements taken post-game (Sunday) and 48 hours pre-game (Thursday) throughout the in-season period in National Collegiate Athletic Association (NCAA) division I football players. Thirty players were monitored using GPS receivers (Catapult Innovations OptimEye S5, Melbourne, Australia) during 12 games and 24 in-season practices. Movement variables included low-intensity distance, medium-intensity distance, high-intensity distance, sprint distance, total distance, player load, and acceleration and deceleration distance...
August 15, 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28820706/high-prevalence-of-treponema-pallidum-infection-in-brazilian-prisoners
#9
Maisa Estopa Correa, Julio Croda, Ana Rita Coimbra Motta de Castro, Sandra Maria do Valle Leone de Oliveira, Maurício Antonio Pompilio, Ronaldo Omizolo de Souza, Júlio Henrique Ferreira de Sá Queiroz, Kesia Esther da Silva, Albert L Ko, Simone Simionatto
The number of new syphilis cases in Brazil has risen alarmingly in recent years. However, there is limited data regarding syphilis prevalence in the Brazilian prison population. To facilitate the development of effective interventions, a cross-sectional study was undertaken to determine the prevalence of Treponema pallidum infection, active syphilis, and associated risk factors among Brazilian prisoners. We administered a questionnaire to a population-based sample of prisoners from 12 prisons in Central-West Brazil and collected sera for syphilis testing, from January to December 2013...
July 31, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28819992/insulin-delivery-and-nocturnal-glucose-control-in-children-and-adolescents-with-type-1-diabetes
#10
Martin Tauschmann, Roman Hovorka
Nocturnal glucose control remains challenging in children and adolescents with type 1 diabetes due to highly variable overnight insulin requirements. The issue may be addressed by glucose responsive insulin delivery based on real-time continuous glucose measurements. Areas covered: This review outlines recent developments of glucose responsive insulin delivery systems from a paediatric perspective. We cover threshold-based suspend application, predictive low glucose suspend, and more advanced single hormone and dual-hormone closed-loop systems...
August 18, 2017: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/28819540/use-of-global-initiative-for-asthma-gina-guidelines-in-asthma-management-among-paediatric-residents-in-a-sub-saharan-african-country-a-cross-sectional-descriptive-study
#11
Adaeze Chikaodinaka Ayuk, Agozie Ubesie, Chioma Laura Odimegwu, Kenechukwu Iloh
INTRODUCTION: Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Despite abundance of asthma guidelines, prevalence has continued to increase globally. There is need to assess how the contents of asthma guidelines are put to clinical use by doctors in the management of children with asthma. This study aims at evaluating the clinical practice of paediatric residents in applying GINA guidelines...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28819089/follow-up-practices-of-surgeons-and-medical-oncologists-in-australia-and-new-zealand-following-resection-of-esophagogastric-cancers
#12
Tim Chew, Tim Bright, Timothy J Price, David I Watson, Peter G Devitt
PURPOSE: Follow-up practices for patients who have undergone surgical resection of esophagogastric malignancies are variable and poorly documented. To better understand practice, a questionnaire was used to survey surgeons and medical oncologists to determine whether any consensus exists. METHODS: An opt-in online questionnaire was sent to esophagogastric surgeons and medical oncologists via the membership lists for the Australian and New Zealand Gastric and Oesophageal Surgery Association (ANZGOSA), the Australian Gastro-Intestinal Trials Groups (AGITG), and the Medical Oncology Group of Australia (MOGA)...
August 15, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28818966/meta-analysis-using-individual-participant-data-from-randomised-trials-opportunities-and-limitations-created-by-access-to-raw-data
#13
Ewelina Rogozińska, Nadine Marlin, Shakila Thangaratinam, Khalid S Khan, Javier Zamora
Meta-analysis based on individual participant data (IPD), often described as the 'gold standard' for effectiveness evidence synthesis, is increasingly being deployed despite being more resource intensive than collating study-level results. Its professed virtues include the ability to incorporate unreported data and to standardise variables and their definitions across trials. In reality, the unreported data, although present in shared datasets, might still not be usable in the analysis. The characteristics of trial participants and their outcomes may be too diversely captured for harmonisation and too time and resource consuming to standardise...
August 17, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28818853/interobserver-agreement-and-image-quality-of-functional-cardiac-ultrasound-measures-used-in-a-randomised-trial-of-delayed-cord-clamping-in-preterm-infants
#14
Himanshu Popat, Kristy P Robledo, Lucille Sebastian, Nicholas Evans, Andrew Gill, Martin Kluckow, Sanjay Sinhal, Koert de Waal, William Tarnow-Mordi, David Osborn
OBJECTIVE: Functional cardiac ultrasound measures are used clinically and in trials for assessing the haemodynamic status of newborn infants. Superior vena cava (SVC) flow and right ventricular output (RVO) are established measures of systemic blood flow on the first postnatal day. The objective was to assess image quality and interobserver agreement of these measures in preterm infants enrolled in a randomised trial of immediate versus delayed cord clamping. DESIGN AND SETTING: Image quality and interobserver agreement for SVC flow, RVO and ductus arteriosus (DA) size were assessed on measurements taken at 3-6, 6-12 and 20-28 hours for the first 10 infants enrolled at each of four sites (total 40)...
August 17, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28818646/best-practice-in-research-consensus-statement-on-ethnopharmacological-field-studies-consefs
#15
REVIEW
Michael Heinrich, Andreas Lardos, Marco Leonti, Caroline Weckerle, Merlin Willcox
BACKGROUND: Ethnopharmacological research aims at gathering information on local and traditional uses of plants and other natural substances. However, the approaches used and the methods employed vary, and while such a variability is desirable in terms of scientific diversity, research must adhere to well defined quality standards and reproducible methods OBJECTIVES: With ConSEFS (the Consensus Statement on Ethnopharmacological Field Studies) we want to define best-practice in developing, conducting and reporting field studies focusing on local and traditional uses of medicinal and food plants, including studies using a historical approach...
August 14, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28818258/imaging-of-high-risk-carotid-plaques-ultrasound
#16
Rafael S Cires-Drouet, Mahvash Mozafarian, Amir Ali, Siddhartha Sikdar, Brajesh K Lal
Duplex ultrasonography has a well-established role in the assessment of the degree of stenosis caused by carotid atherosclerosis. This assessment is derived from Doppler velocity changes induced by the narrowing lumen of the artery. New research into the mechanisms for plaque rupture and atheroembolic stroke indicates that the degree of narrowing is an imperfect predictor of stroke risk, and that other factors, such as plaque composition and remodeling and biomechanical forces acting on the plaque, can play a role...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28817978/transcutaneous-electrical-nerve-stimulation-tens-as-an-adjunct-for-pain-management-in-perioperative-settings-a-critical-review
#17
Mark I Johnson
Surgical procedures are ever more complex. Day-case surgical loads are increasing and the length of hospital stays are reducing. Management of pain in perioperative settings remains a challenge. Expert panels recommend a multimodal approach which is often interpreted by medical practitioners as polypharmacy. There is variability in non-pharmacological interventions offered to patients, although transcutaneous electrical nerve stimulation (TENS) has been used since the 1970s. Recommendations from expert panels are inconsistent about the use of TENS in perioperative pain settings...
August 18, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28817655/assessing-experience-in-the-deliberate-practice-of-running-using-a-fuzzy-decision-support-system
#18
Maria Isabel Roveri, Edison de Jesus Manoel, Andrea Naomi Onodera, Neli R S Ortega, Vitor Daniel Tessutti, Emerson Vilela, Nelson Evêncio, Isabel C N Sacco
The judgement of skill experience and its levels is ambiguous though it is crucial for decision-making in sport sciences studies. We developed a fuzzy decision support system to classify experience of non-elite distance runners. Two Mamdani subsystems were developed based on expert running coaches' knowledge. In the first subsystem, the linguistic variables of training frequency and volume were combined and the output defined the quality of running practice. The second subsystem yielded the level of running experience from the combination of the first subsystem output with the number of competitions and practice time...
2017: PloS One
https://www.readbyqxmd.com/read/28817506/maximum-distance-and-high-speed-distance-demands-by-position-in-ncaa-division-i-collegiate-football-games
#19
Gabriel J Sanders, Brad Roll, Corey A Peacock
The purpose of the study was to quantify the average and maximum distances traveled by NCAA division I football athletes during competitive games. Utilizing global positioning system (GPS) devices (Catapult Sports), total and low, moderate and high speed distances were quantified by each position. Understanding maximal workloads can enhance conditioning practice periodization protocols. A total of 40 football athletes were included in the analysis. For the data to be included, athletes were required to participate in ≥ 75% of the offensive or defensive snaps for any given game...
July 5, 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28817504/movement-demands-and-perceived-wellness-associated-with-pre-season-training-camp-in-ncaa-division-i-college-football-players
#20
Aaron D Wellman, Sam C Coad, Patrick J Flynn, Christopher P McLellan, Mike Climstein
The aims of the present study were to examine the movement demands of pre-season practice in National Collegiate Athletic Association (NCAA) division I college football players using portable global positioning system (GPS) technology and to assess perceived wellness associated with pre-season practice to determine if GPS-derived variables from the preceding day influence perceived wellness the following day. Twenty-nine players were monitored using GPS receivers (Catapult Innovations, Melbourne, Australia) during 20 pre-season practices...
July 5, 2017: Journal of Strength and Conditioning Research
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