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https://www.readbyqxmd.com/read/28550759/venous-thromboembolism-in-the-elderly-a-narrative-review
#1
REVIEW
T Tritschler, D Aujesky
Persons aged ≥65years not only account for over 60% of venous thromboembolism (VTE) events, they have also a higher mortality and VTE-related morbidity than younger patients, including anticoagulation-related bleeding and the postthrombotic syndrome. However, only few studies have focused specifically on VTE in older persons and practice guidelines commonly extrapolate study results from younger healthier patients to the multimorbid elderly. Evidence suggests that the clinical presentation is more subtle in the elderly with VTE and that commonly used diagnostic modalities, including clinical prediction rules, D-dimer tests, and planar ventilation-perfusion scans are less specific and efficient in older persons...
May 17, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28550349/choice-of-repairing-inguinal-hernia-in-children-open-versus-laparoscopy
#2
Venkatachalam Raveenthiran, Prakash Agarwal
Inguinal hernia is a common disorder of childhood that requires surgical repair at diagnosis. Traditionally, it is operated upon by open inguinal incision. However, with the introduction of laparoscopic repair in 1990, opinion of scientific community is divided concerning the best method of pediatric herniotomy. Educated parents, who long to have the choicest of the best, often gather information from internet and prefer to discuss their concerns with primary care physicians. This descriptive review is intended to provide practicing pediatricians with updated evidence-based information which will enable them to counsel parents regarding the choice of hernia repair...
May 27, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28550028/the-impact-of-a-hepatobiliary-multidisciplinary-team-assessment-in-patients-with-colorectal-cancer-liver-metastases-a-population-based-study
#3
Jennie Engstrand, Nikolaos Kartalis, Cecilia Strömberg, Mats Broberg, Anna Stillström, Tobias Lekberg, Eduard Jonas, Jacob Freedman, Henrik Nilsson
BACKGROUND: Assessing patients with colorectal cancer liver metastases (CRCLM) by a liver multidisciplinary team (MDT) results in higher resection rates and improved survival. The aim of this study was to evaluate the potentially improved resection rate in a defined cohort if all patients with CRCLM were evaluated by a liver MDT. PATIENTS AND METHODS: A retrospective analysis of patients diagnosed with colorectal cancer during 2008 in the greater Stockholm region was conducted...
May 26, 2017: Oncologist
https://www.readbyqxmd.com/read/28549687/toward-harmonization-of-interpretive-commenting-of-common-laboratory-tests
#4
REVIEW
Attila Bezzegh, Ildikó Takács, Éva Ajzner
Interpretive commenting (IC) is an integral part of postanalytical activities of laboratories when the clinical interpretation of laboratory results in the context of the clinical situation of a patient is provided. Harmonizing practices in IC can be an approach to ensure high-quality comments, which if followed by adequate clinical actions has a great potential in improving patient outcomes. This paper reviews basic work prior to harmonization of IC of common laboratory test results. Practices in IC are considerably diverse both within and between countries...
May 23, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28548580/a-review-of-the-impact-of-exclusion-criteria-on-the-generalizability-of-schizophrenia-treatment-research
#5
Keith Humphreys
Treatment research studies employ criteria that determine which patients are eligible to participate and which are not. When such exclusion criteria produce a treatment research sample that is a small and unrepresentative subset of all patients with a particular disease, clinicians may be hesitant to apply the research results in front-line clinical practice. Accordingly, the present paper reviews the English-language literature on exclusion criteria in schizophrenia treatment research and draws initial conclusions about their impact...
2017: Clinical Schizophrenia & related Psychoses
https://www.readbyqxmd.com/read/28546093/best-practice-guidance-for-the-use-of-strategies-improved-retention-in-randomised-trials-developed-from-two-consensus-workshops
#6
V Brueton, S P Stenning, F Stevenson, J Tierney, G Rait
OBJECTIVE: To develop best practice guidance for the use of retention strategies in randomised clinical trials (RCTs). DESIGN: Consensus development workshops. SETTING: Two UK Clinical Trials Units. PARTICIPANTS: 66 statisticians, clinicians, RCT coordinators, research scientists, research assistants, and data managers associated with RCTs. METHODS: The consensus development workshops were based on the consensus development conference method used to develop best practice for treatment of medical conditions...
May 22, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28543552/ethical-and-practical-realities-of-using-letters-for-recruitment-in-bereavement-research
#7
Ashleigh E Butler, Helen Hall, Beverley Copnell
Recruitment of participants into bereavement research may present many challenges for the research team. At present, there is little consensus for researchers and ethics committees on the most appropriate method of recruitment. There is some evidence that participants prefer to be contacted about research studies via letters. However, recruitment involving the use of a letter can occur in a number of ways, each with ethical and practical benefits and limitations. In a study of the experiences of bereaved parents, we used letters in three ways: direct mailing from the research team with an opt-out option; permission to mail letters obtained by social workers from a hospital-based follow-up program during routine contact; and letters mailed from the hospital's PICU research nurse at the hospital with instruction on how to opt in...
May 25, 2017: Research in Nursing & Health
https://www.readbyqxmd.com/read/28542692/association-between-undetected-10-2-visual-field-damage-and-vision-related-quality-of-life-in-patients-with-glaucoma
#8
Dana M Blumberg, Carlos Gustavo De Moraes, Alisa J Prager, Qi Yu, Lama Al-Aswad, George A Cioffi, Jeffrey M Liebmann, Donald C Hood
Importance: Recent evidence supports the presence of macular damage (within 8° of the central field) to retinal ganglion cells and associated central visual field (VF) defects in glaucoma, even in early stages. Despite this, to our knowledge, the association of 10-2 VF damage with vision-related quality of life (QOL) has not been well studied. Objective: To determine the association between QOL and visual function as measured by 24-2 and 10-2 VFs in patients with primary open-angle glaucoma and to test the hypothesis that patients with vision-related QOL disproportionate to their 24-2 VF status may exhibit 10-2 damage overlooked by the 24-2 test...
May 25, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28542450/research-data-management-in-academic-institutions-a-scoping-review
#9
Laure Perrier, Erik Blondal, A Patricia Ayala, Dylanne Dearborn, Tim Kenny, David Lightfoot, Roger Reka, Mindy Thuna, Leanne Trimble, Heather MacDonald
OBJECTIVE: The purpose of this study is to describe the volume, topics, and methodological nature of the existing research literature on research data management in academic institutions. MATERIALS AND METHODS: We conducted a scoping review by searching forty literature databases encompassing a broad range of disciplines from inception to April 2016. We included all study types and data extracted on study design, discipline, data collection tools, and phase of the research data lifecycle...
2017: PloS One
https://www.readbyqxmd.com/read/28539002/from-in-vivo-to-in-vitro-the-medical-device-testing-paradigm-shift
#10
Dayna Kerecman Myers, Alan M Goldberg, Albrecht Poth, Michael F Wolf, Joseph Carraway, James McKim, Kelly P Coleman, Richard Hutchinson, Ronald Brown, Harald F Krug, Anthony Bahinski, Thomas Hartung
Amid growing efforts to advance the replacement, reduction, and refinement of the use of animals in research, there is a growing recognition that in vitro testing of medical devices can be more effective, both in terms of cost and time, and also more reliable than in vivo testing. Although the technological landscape has evolved rapidly in support of these concepts, regulatory acceptance of alternative testing methods has not kept pace. Despite the acceptance by regulators of some in vitro tests (cytotoxicity, gene toxicity, and some hemocompatibility assays), many toxicity tests still rely on animals (irritation, sensitization, acute toxicity, reproductive/developmental toxicity), even where other industrial sectors have already abandoned them...
May 25, 2017: ALTEX
https://www.readbyqxmd.com/read/28537104/endoscopic-tattoo-the-importance-and-need-for-standardised-guidelines-and-protocol
#11
Mei Yang, Daniel Pepe, Christopher M Schlachta, Nawar A Alkhamesi
Preoperative endoscopic tattoo is becoming more important with the advent of minimally invasive surgery. Current practices are variable and are operator-dependent. There are no evidence-based guidelines to aid endoscopists in clinical practice. Furthermore, there are still a number of issues with endoscopic tattoo including poor intraoperative visualisation, complications from tattooing and inaccurate documentation leading to the need for intraoperative endoscopy, prolonged operative time and reoperation due to lack of oncologic resection...
January 1, 2017: Journal of the Royal Society of Medicine
https://www.readbyqxmd.com/read/28535709/a-critical-review-of-low-back-pain-guidelines
#12
Laran Chetty
Low back pain (LBP) remains one of the most common and challenging musculoskeletal conditions encountered by health care professionals and is a leading cause of absenteeism. Clinical guidelines are often considered best evidence in health care. The aim of this critical review was to assess the quality and recommendations of LBP guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. Electronic databases were used to identify LBP guidelines published between 2000 and 2015. Nine guidelines were selected for review from a total of 17...
May 1, 2017: Workplace Health & Safety
https://www.readbyqxmd.com/read/28532994/johne-s-disease-in-the-eyes-of-irish-cattle-farmers-a-qualitative-narrative-research-approach-to-understanding-implications-for-disease-management
#13
Conor G McAloon, Áine Macken-Walsh, Lisa Moran, Paul Whyte, Simon J More, Luke O'Grady, Michael L Doherty
Bovine Johne's Disease (JD) is a disease characterised by chronic granulomatous enteritis which manifests clinically as a protein-losing enteropathy causing diarrhoea, hypoproteinaemia, emaciation and, eventually death. Some research exists to suggest that the aetiologic pathogen Mycobacterium avium subspecies paratuberculosis may pose a zoonotic risk. Nationally coordinated control programmes have been introduced in many of the major milk producing countries across the world. However, JD is challenging to control in infected herds owing to limitations of diagnostic tests and the long incubation period of the disease...
June 1, 2017: Preventive Veterinary Medicine
https://www.readbyqxmd.com/read/28532259/ethnic-differences-in-response-to-directive-vs-non-directive-brief-intervention-for-subsyndromal-depression
#14
David Pan, Stanley J Huey, Lara H Heflin
OBJECTIVE: Analog research suggests that directive interventions might increase treatment engagement for non-symptomatic Asian American (AA) students; however, no studies have assessed whether directiveness improves therapy processes or clinical outcomes for AAs with mental health symptoms. This study tested the comparative efficacy of brief directive vs. non-directive intervention for AAs and European Americans (EAs) with subsyndromal depression. METHOD: Participants were randomly assigned directive, non-directive, or cultural values interview conditions, and assessed three times over six months...
May 22, 2017: Psychotherapy Research: Journal of the Society for Psychotherapy Research
https://www.readbyqxmd.com/read/28532210/the-linear-nonthreshold-lnt-model-as-used-in-radiation-protection-an-ncrp-update
#15
John D Boice
Purpose/Objective(s): The linear non-threshold (LNT) model has been used in radiation protection for over 40 years and has been hotly debated! It relies heavily on human epidemiology, with support from radiobiology. The scientific underpinnings include NCRP Report No. 136 ("Evaluation of the Linear-Nonthreshold Dose-Response Model for Ionizing Radiation"), UNSCEAR 2000, ICRP Publication 99 (2004) and the National Academies BEIR VII Report (NRC 2006). NCRP Scientific Committee 1-25 is reviewing recent epidemiologic studies focusing on dose-response models, including threshold, and the relevance to radiation protection...
May 23, 2017: International Journal of Radiation Biology
https://www.readbyqxmd.com/read/28531883/conventional-versus-ultrasound-guided-transbronchial-needle-aspiration-for-the-diagnosis-of-hilar-mediastinal-lymph-adenopathies-a-randomized-controlled-trial
#16
Martina Bonifazi, Irene Tramacere, Lina Zuccatosta, Federico Mei, Michele Sediari, Maria Cristina Paonessa, Stefano Gasparini
BACKGROUND: Conventional transbronchial needle aspiration (c-TBNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are both valuable diagnostic techniques for the diagnosis of hilar/mediastinal lesions. Although a superiority of EBUS-TBNA over c-TBNA may be expected, evidence-based data on a direct comparison between these 2 procedures are still lacking. OBJECTIVES: We aimed to test the superiority of EBUS-TBNA over c-TBNA in a randomized trial and to evaluate the cost-effectiveness profile of a staged strategy, including c-TBNA as initial test followed by EBUS-TBNA, in case of inconclusive results at rapid on-site evaluation...
May 23, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28528620/closing-the-gap-and-raising-the-bar-assessing-board-competency-in-quality-and-safety
#17
Patricia A McGaffigan, Beth Daley Ullem, Tejal K Gandhi
BACKGROUND: Despite recognition of the important role that governance and executive leaders play in ensuring patient safety and quality, little research has examined leaders' involvement in these areas beyond surveys that assess higher-level knowledge and understanding of patient and workforce safety concepts. METHODS: A survey was sent to a convenience sample of board members and CEOs, as well as unpaired safety and quality leaders (SQLs). The survey included approximately 36 questions asking board members and other non-CEO executives their knowledge, understanding, and board activities related to safety and quality, and SQLs their perceptions of their own boards' knowledge, understanding, and activities related to safety and quality...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28528376/isometric-handgrip-as-an-adjunct-for-blood-pressure-control-a-primer-for-clinicians
#18
REVIEW
Cheri L McGowan, David N Proctor, Ian Swaine, Robert D Brook, Elizabeth A Jackson, Phillip D Levy
Considered a global health crisis by the World Health Organization, hypertension (HTN) is the leading risk factor for death and disability. The majority of treated patients do not attain evidence-based clinical targets, which increases the risk of potentially fatal complications. HTN is the most common chronic condition seen in primary care; thus, implementing therapies that lower and maintain BP to within-target ranges is of tremendous public health importance. Isometric handgrip (IHG) training is a simple intervention endorsed by the American Heart Association as a potential adjuvant BP-lowering treatment...
June 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28528173/school-wellness-team-best-practices-to-promote-wellness-policy-implementation
#19
Erika Profili, Diana S Rubio, Hannah G Lane, Lea H Jaspers, Megan S Lopes, Maureen M Black, Erin R Hager
Schools with wellness teams are more likely to implement federally mandated Local Wellness Policies (LWPs, Local Education Agency-level policies for healthy eating/physical activity). Best practices have been developed for wellness teams based on minimal empirical evidence. The purpose of this study is to determine, among schools with wellness teams, associations between LWP implementation and six wellness team best practices (individually and as a sum score). An online survey targeting Maryland school wellness leaders/administrators (52...
May 17, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28527638/shared-decision-making-in-australia-in-2017
#20
Lyndal Trevena, Heather L Shepherd, Carissa Bonner, Jesse Jansen, Anne E Cust, Julie Leask, Narelle Shadbolt, Chris Del Mar, Kirsten McCaffery, Tammy Hoffmann
Shared Decision Making (SDM) is now firmly established within national clinical standards for accrediting hospitals, day procedure services, public dental services and medical education in Australia, with plans to align general practice, aged care and disability service. Implementation of these standards and training of health professionals is a key challenge for the Australian health sector at this time. Consumer involvement in health research, policy and clinical service governance has also increased, with a major focus on encouraging patients to ask questions during their clinical care...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
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