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Variability in practice

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https://www.readbyqxmd.com/read/29454293/health-professions-faculty-beliefs-confidence-use-and-perceptions-of-organizational-culture-and-readiness-for-ebp-a-cross-sectional-descriptive-survey
#1
Kerry A Milner, Holly B Bradley, Tammy Lampley
BACKGROUND: Evidence-based practice (EBP) is an essential skill and ethical obligation for all practicing health professions clinicians because of its strong association with improved health outcomes. Emerging evidence suggests that faculty who prepare these clinicians lack proficiency to teach EBP. OBJECTIVES: The purpose of this study was to describe; 1) health profession faculty beliefs about and confidence in their ability to teach and implement EBP, 2) use of EBP for education, 3) organizational culture and readiness for EBP; and to determine whether relationships exist among these variables...
February 8, 2018: Nurse Education Today
https://www.readbyqxmd.com/read/29454180/tryptophan-kynurenine-and-lipid-related-metabolites-as-blood-biomarkers-for-first-episode-drug-na%C3%A3-ve-patients-with-major-depressive-disorder-an-exploratory-pilot-case-control-study
#2
Nobuki Kuwano, Takahiro A Kato, Daiki Setoyama, Mina Sato-Kasai, Norihiro Shimokawa, Kohei Hayakawa, Masahiro Ohgidani, Noriaki Sagata, Hiroaki Kubo, Junji Kishimoto, Dongchon Kang, Shigenob Kanba
BACKGROUND: Early intervention in depression has been critical to prevent its negative impact including suicide. Recent blood biomarker studies for major depressive disorder (MDD) have suggested that tryptophan-kynurenine and lipid related metabolites are involved in the pathophysiology of MDD. However, there have been limited studies investigating these blood biomarkers in first-episode drug-naïve MDD, which are particularly important for early intervention in depression. METHODS: As an exploratory pilot case-control study, we examined the above blood biomarkers, and analyzed how these biomarkers are associated with clinical variables in first-episode drug-naïve MDD patients, based on metabolome/lipidome analysis...
January 31, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29453734/post-operative-imaging-assessment-of-non-functioning-pituitary-adenomas
#3
REVIEW
Kunal S Patel, Sanjay Dhawan, Renzhi Wang, Bob S Carter, James Y Chen, Clark C Chen
BACKGROUND: Non-functioning pituitary adenomas (NFAs) are the most common pituitary tumors. There is significant variability in clinical practice in terms of post-operative imaging evaluation. The objective of this manuscript is to provide an exhaustive review of published articles pertaining to the post-operative imaging evaluation of NFAs. METHODS: The MEDLINE database was queried for studies investigating imaging for the post-operative evaluation of pituitary adenomas...
February 16, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29453492/application-of-physiologically-based-pharmacokinetic-modeling-to-the-prediction-of-drug-drug-and-drug-disease-interactions-for-rivaroxaban
#4
Ruijuan Xu, Weihong Ge, Qing Jiang
PURPOSE: Rivaroxaban is a direct oral anticoagulant with a large inter-individual variability. The present study is to develop a physiologically based pharmacokinetic (PBPK) model to predict several scenarios in clinical practice. METHODS: A whole-body PBPK model for rivaroxaban, which is metabolized by the cytochrome P450 (CYP) 3A4/5, 2J2 pathways and excreted via kidneys, was developed to predict the pharmacokinetics at different doses in healthy subjects and patients with hepatic or renal dysfunction...
February 17, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29453451/prevalence-and-impact-of-baseline-resistance-associated-substitutions-on-the-efficacy-of-ledipasvir-sofosbuvir-or-simeprevir-sofosbuvir-against-gt1-hcv-infection
#5
Gary P Wang, Norah Terrault, Jacqueline D Reeves, Lin Liu, Eric Li, Lisa Zhao, Joseph K Lim, Giuseppe Morelli, Alexander Kuo, Josh Levitsky, Kenneth E Sherman, Lynn M Frazier, Ananthakrishnan Ramani, Joy Peter, Lucy Akuskevich, Michael W Fried, David R Nelson
Baseline resistance-associated substitutions (RASs) have variable impacts in clinical trials but their prevalence and impact in real-world patients remains unclear. We performed baseline resistance testing using a commercial assay (10% cutoff) for 486 patients treated with LDV/SOF or SMV/SOF, with or without ribavirin, in the multi-center, observational HCV-TARGET cohort. Linkage of RASs was evaluated in selected samples using a novel quantitative single variant sequencing assay. Our results showed that the prevalence of NS3, NS5A, NS5B RASs was 45%, 13%, and 8%, respectively, and 10% of patients harbored RASs in 2 or more drug classes...
February 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29452930/mechanism-specific-rehabilitation-management-of-complex-regional-pain-syndrome-proposed-recommendations-from-evidence-synthesis
#6
Tara Packham, Janet Holly
STUDY DESIGN: Narrative review. INTRODUCTION: There are a variety of treatments with demonstrated effectiveness for the management of complex regional pain syndrome (CRPS). However given the variability in symptom presentation in this population, therapists may be unsure what treatments would be most effective for individual clients. PURPOSE OF THE STUDY: To present a brief synthesis of the literature and propose a rehabilitation version of a mechanism-specific management algorithm to guide personalized treatment of CRPS...
February 13, 2018: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/29452865/stereotactic-radiosurgery-for-multiple-brain-metastases-results-of-multicenter-benchmark-planning-studies
#7
David J Eaton, Jonathan Lee, Ian Paddick
PURPOSE: Stereotactic radiosurgery is indicated for treatment of multiple brain metastases. Various treatment platforms are available, but most comparisons are limited to single-center studies. As part of a national commissioning program, benchmark planning cases were completed by 21 clinical centers, providing a unique dataset of current practice across a large number of providers and equipment platforms. METHODS AND MATERIALS: Two brain metastases cases were provided, with images and structures predrawn, involving 3 and 7 lesions...
December 30, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29452832/delayed-endovascular-aortic-repair-is-associated-with-reduced-in-hospital-mortality-in-patients-with-blunt-thoracic-aortic-injury
#8
Christina L Marcaccio, Ryan P Dumas, Yanlan Huang, Wei Yang, Grace J Wang, Daniel N Holena
OBJECTIVE: The traditional approach to stable blunt thoracic aortic injury (BTAI) endorsed by the Society for Vascular Surgery is early (<24 hours) thoracic endovascular aortic repair (TEVAR). Recently, some studies have shown improved mortality in stable BTAI patients repaired in a delayed manner (≥24 hours). However, the indications for use of delayed TEVAR for BTAI are not well characterized, and its overall impact on the patient's survival remains poorly understood. We sought to determine whether delayed TEVAR is associated with a decrease in mortality compared with early TEVAR in this population...
February 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29452829/cribriform-plate-width-is-highly-variable-within-and-between-subjects
#9
Daniel H Coelho, Taylor S Pence, Mostafa Abdel-Hamid, Richard M Costanzo
OBJECTIVE: All successful endonasal surgery, including functional endoscopic sinus surgery (FESS), depends on knowledge of both anatomy and the specific variations that can occur between and within patients. Familiarity with these structures is a critical component in preventing complications from these procedures, and failure to understand subtle variation can have disastrous results. The aim of this study was to characterize the anatomical variations (if any) of the cribriform plate using a large cadaveric sample set...
February 13, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29452802/moving-to-human-trials-for-argon-neuroprotection-in-neurological-injury-a-narrative-review
#10
REVIEW
A J Gardner, D K Menon
Despite the global burden of brain injury, neuroprotective agents remain elusive. There are no clinically effective therapies which reduce mortality or improve long-term cognitive outcome. Ventilation could be an easily modifiable variable in resuscitation; gases are relatively simple to administer. Xenon is the prototypic agent of a new generation of experimental treatments which show promise. However, use is hindered by its prohibitive cost and anaesthetic properties. Argon is an attractive option, being cheaper, easy to transport, non-sedating, and mechanistically distinct from xenon...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452422/asynchronous-and-pathological-windows-of-implantation-two-causes-of-recurrent-implantation-failure
#11
P Sebastian-Leon, N Garrido, J Remohí, A Pellicer, P Diaz-Gimeno
STUDY QUESTION: Is endometrial recurrent implantation failure (RIF) only a matter of an asynchronous (displaced) window of implantation (WOI), or could it also be a pathological (disrupted) WOI? SUMMARY ANSWER: Our predictive results demonstrate that both displaced and disrupted WOIs exist and can present independently or together in the same RIF patient. WHAT IS KNOWN ALREADY: Since 2002, many gene expression signatures associated with endometrial receptivity and RIF have been described...
February 14, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29452291/pharmacokinetic-models-to-assist-the-prescriber-in-choosing-the-best-tacrolimus-dose
#12
REVIEW
Jean-Baptiste Woillard, Franck Saint-Marcoux, Jean Debord, Anders Åsberg
Due to a high inter-individual variability in its pharmacokinetics, tacrolimus dose individualization is mandatory. Even though the expert opinion has defined the area under the curve (AUC) as the best marker to use when performing dose adjustment of tacrolimus, most centres only use trough levels. Multiple targets have been proposed for this parameter and physicians rely largely on their personal experience when making a decision about dose adjustment. Several population pharmacokinetics models (POPPK) allowing AUC determination have been developed, but only a few are actually used in routine practice for dose individualization...
February 13, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29451916/awareness-and-attitude-of-the-public-toward-personalized-medicine-in-korea
#13
Iyn-Hyang Lee, Hye-Young Kang, Hae Sun Suh, Sukhyang Lee, Eun Sil Oh, Hotcherl Jeong
OBJECTIVES: As personalized medicine (PM) is expected to greatly improve health outcomes, efforts have recently been made for its clinical implementation in Korea. We aimed to evaluate public awareness and attitude regarding PM. METHODS: We performed a self-administered questionnaire survey to 703 adults, who participated in the survey on a voluntary basis. The primary outcome measures included public knowledge, attitude, and acceptance of PM. We conducted multinomial multivariate logistic analysis for outcome variables with three response categories and performed multivariate logistic regression analyses for dichotomous outcome variables...
2018: PloS One
https://www.readbyqxmd.com/read/29451888/ecogeography-of-teosinte
#14
José de Jesús Sánchez González, José Ariel Ruiz Corral, Guillermo Medina García, Gabriela Ramírez Ojeda, Lino De la Cruz Larios, James Brendan Holland, Roberto Miranda Medrano, Giovanni Emmanuel García Romero
Adaptation of crops to climate change has motivated an increasing interest in the potential value of novel traits from wild species; maize wild relatives, the teosintes, harbor traits that may be useful to maize breeding. To study the ecogeographic distribution of teosinte we constructed a robust database of 2363 teosinte occurrences from published sources for the period 1842-2016. A geographical information system integrating 216 environmental variables was created for Mexico and Central America and was used to characterize the environment of each teosinte occurrence site...
2018: PloS One
https://www.readbyqxmd.com/read/29451862/neonatal-resuscitation-experience-curves-simulation-based-mastery-learning-booster-sessions-and-skill-decay-patterns-among-pediatric-residents
#15
Heideh H Matterson, Demian Szyld, Brad R Green, Heather B Howell, Martin V Pusic, Pradeep V Mally, Sean M Bailey
BACKGROUND: Following neonatal resuscitation program (NRP) training, decay in clinical skills can occur. Simulation-based deliberate practice (SBDP) has been shown to maintain NRP skills to a variable extent. Our study objectives were (a) to determine whether a single 30 min simulation-based intervention that incorporates SBDP and mastery learning (ML) can effectively restore skills and prevent skill decay and (b) to compare different timing options. METHODS: Following NRP certification, pediatric residents were randomly assigned to receive a video-recorded baseline assessment plus SBDP-ML refresher education at between 6 and 9 months (early) or between 9 and 12 months (late)...
February 16, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29451451/critical-assessment-of-pediatric-neurosurgery-patient-parent-educational-information-obtained-via-the-internet
#16
Michael Garcia, Christopher Daugherty, Bertha Ben Khallouq, Todd Maugans
OBJECTIVE The Internet is used frequently by patients and family members to acquire information about pediatric neurosurgical conditions. The sources, nature, accuracy, and usefulness of this information have not been examined recently. The authors analyzed the results from searches of 10 common pediatric neurosurgical terms using a novel scoring test to assess the value of the educational information obtained. METHODS Google and Bing searches were performed for 10 common pediatric neurosurgical topics (concussion, craniosynostosis, hydrocephalus, pediatric brain tumor, pediatric Chiari malformation, pediatric epilepsy surgery, pediatric neurosurgery, plagiocephaly, spina bifida, and tethered spinal cord)...
February 16, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29451086/efficient-robust-doubly-adaptive-regularized-regression-with-applications
#17
Rohana J Karunamuni, Linglong Kong, Wei Tu
We consider the problem of estimation and variable selection for general linear regression models. Regularized regression procedures have been widely used for variable selection, but most existing methods perform poorly in the presence of outliers. We construct a new penalized procedure that simultaneously attains full efficiency and maximum robustness. Furthermore, the proposed procedure satisfies the oracle properties. The new procedure is designed to achieve sparse and robust solutions by imposing adaptive weights on both the decision loss and the penalty function...
January 1, 2018: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/29451006/different-indexes-of-glycemic-variability-as-identifiers-of-patients-with-risk-of-hypoglycemia-in-type-2-diabetes-mellitus
#18
Ana M Gómez, Oscar M Muñoz, Alejandro Marin, Maria Camila Fonseca, Martin Rondon, María Alejandra Robledo Gómez, Andrei Sanko, Dilcia Lujan, Maira García-Jaramillo, Fabian Mauricio León Vargas
INTRODUCTION: Recent publications frequently introduce new indexes to measure glycemic variability (GV), quality of glycemic control, or glycemic risk; however, there is a lack of evidence supporting the use of one particular parameter, especially in clinical practice. METHODS: A cohort of type 2 diabetes mellitus (T2DM) patients in ambulatory care were followed using continuous glucose monitoring sensors (CGM). Mean glucose (MG), standard deviation, coefficient of variation (CV), interquartile range, CONGA1, 2, and 4, MAGE, M value, J index, high blood glucose index, and low blood glucose index (LBGI) were estimated...
February 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29450979/guidance-on-home-blood-pressure-monitoring-a-statement-of-the-hope-asia-network
#19
Kazuomi Kario, Sungha Park, Peera Buranakitjaroen, Yook-Chin Chia, Chen-Huan Chen, Romeo Divinagracia, Satoshi Hoshide, Jinho Shin, Saulat Siddique, Jorge Sison, Arieska Ann Soenarta, Guru Prasad Sogunuru, Jam Chin Tay, Yuda Turana, Lawrence Wong, Yuqing Zhang, Ji-Guang Wang
Hypertension is an important modifiable cardiovascular risk factor and a leading cause of death throughout Asia. Effective prevention and control of hypertension in the region remain a significant challenge despite the availability of several regional and international guidelines. Out-of-office measurement of blood pressure (BP), including home BP monitoring (HBPM), is an important hypertension management tool. Home BP is better than office BP for predicting cardiovascular risk and HBPM should be considered for all patients with office BP ≥ 130/85 mm Hg...
February 16, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29450831/comparison-of-different-strategies-for-providing-fecal-microbiota-transplantation-to-treat-patients-with-recurrent-clostridium-difficile-infection-in-two-english-hospitals-a-review
#20
REVIEW
Simon D Goldenberg, Rahul Batra, Ian Beales, Jonathan Leith Digby-Bell, Peter Miles Irving, Lee Kellingray, Arjan Narbad, Ngozi Franslem-Elumogo
Fecal microbiota transplant (FMT) has emerged as a highly efficacious treatment for difficult cases of refractory and/or recurrent Clostridium difficile infection (CDI). There have been many well-conducted randomized controlled trials and thousands of patients reported in case series that describe success rates of approximately 90% following one or more FMT. Although the exact mechanisms of FMT have yet to be fully elucidated, replacement or restoration of a 'normal' microbiota (or at least a microbiota resembling those who have never had CDI) appears to have a positive effect on the gut dysbiosis that is thought to exist in these patients...
February 15, 2018: Infectious Diseases and Therapy
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