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https://www.readbyqxmd.com/read/28194188/primum-non-nocere-first-do-no-harm-and-then-feed-peanut
#1
Kyla Jade Hildebrand, Elissa Michele Abrams, Timothy K Vander Leek, Julia Elizabeth Mainwaring Upton, Douglas P Mack, Linda Kirste, Christine McCusker, Sandeep Kapur
The Addendum Guidelines for the Prevention of Peanut Allergy in the United States-Report of the NIAID-Sponsored Expert Panel were developed to build on previous food allergy guidelines after several key studies demonstrated the benefit of early introduction of allergenic foods. These landmark studies including the Learning Early about Peanut (LEAP), LEAP-On and Enquiring about Tolerance trials created a paradigm shift in food allergy prevention. The "take home" messages of this guideline include that peanut should be introduced early in the first year of life, and for the majority of infants, peanut can be introduced at home...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28188998/midwives-experiences-of-working-in-an-obstetric-high-dependency-unit-a-qualitative-study
#2
Isabelle J Eadie, Nicolette F Sheridan
OBJECTIVES: to understand the challenges experienced by midwives providing obstetric high dependency care and identify the training they perceive is needed for work in an obstetric high dependency unit. DESIGN: sixteen midwives who worked in the obstetric high dependency unit participated in one of three focus groups. Focus groups lasted 60-90minutes and were conducted in the workplace and facilitated by author (IE). Data were digitally recorded, transcribed and analysed manually by author (IE), specifically using a 'codebook' model to generate codes, categories and themes...
January 21, 2017: Midwifery
https://www.readbyqxmd.com/read/28121543/to-first-do-no-harm-you-must-start-with-good-evidence
#3
(no author information available yet)
The intrepid young oncologist's criticism of cancer screening and surrogate endpoints has stirred up controversy. Prasad thinks that providers should offer medical therapies that do more good than harm. "I mean things that matter to people, which is living longer, living better."
October 2016: Managed Care
https://www.readbyqxmd.com/read/28095818/when-parents-won-t-vaccinate-their-children-a-qualitative-investigation-of-australian-primary-care-providers-experiences
#4
Nina J Berry, Alexandra Henry, Margie Danchin, Lyndal J Trevena, Harold W Willaby, Julie Leask
BACKGROUND: Increasingly, the experiences and perceptions of parents who decline vaccination are the subject of investigation. However, the experiences of clinicians who encounter these parents in the course of their work has received little academic attention to date. This study aimed to understand the challenges faced and strategies used when general practitioners and immunising nurses encounter parents who choose not to vaccinate their children. METHODS: Primary care providers were recruited from regions identified through the Australian Childhood Immunisation Register (ACIR) as having higher than national average rates of registered objection to childhood vaccination...
January 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28093732/long-term-hormone-therapy-for-perimenopausal-and-postmenopausal-women
#5
REVIEW
Jane Marjoribanks, Cindy Farquhar, Helen Roberts, Anne Lethaby, Jasmine Lee
BACKGROUND: Hormone therapy (HT) is widely provided for control of menopausal symptoms and has been used for the management and prevention of cardiovascular disease, osteoporosis and dementia in older women. This is an updated version of a Cochrane review first published in 2005. OBJECTIVES: To assess effects of long-term HT (at least 1 year's duration) on mortality, cardiovascular outcomes, cancer, gallbladder disease, fracture and cognition in perimenopausal and postmenopausal women during and after cessation of treatment...
January 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28074754/legal-and-ethical-imperatives-for-using-certified-sign-language-interpreters-in-health-care-settings-how-to-do-no-harm-when-it-s-all-greek-sign-language-to-you
#6
Angela M Nonaka
Communication obstacles in health care settings adversely impact patient-practitioner interactions by impeding service efficiency, reducing mutual trust and satisfaction, or even endangering health outcomes. When interlocutors are separated by language, interpreters are required. The efficacy of interpreting, however, is constrained not just by interpreters' competence but also by health care providers' facility working with interpreters. Deaf individuals whose preferred form of communication is a signed language often encounter communicative barriers in health care settings...
September 1, 2016: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
https://www.readbyqxmd.com/read/28073541/the-main-nitrate-transporter-of-the-dinoflagellate-lingulodinium-polyedrum-is-constitutively-expressed-and-not-responsible-for-daily-variations-in-nitrate-uptake-rates
#7
Steve Dagenais Bellefeuille, David Morse
Dinoflagellates are unicellular eukaryotes capable of forming spectacular harmful algal blooms (HABs). Eutrophication of coastal waters by fertilizer runoff, nitrate in particular, has contributed to recent increases in the frequency, magnitude and geographic extent of HABs. Although physiological nitrate uptake and assimilation in dinoflagellates have often been measured in the field and in the laboratory, no molecular components involved in nitrate transport have yet been reported. This study reports the first identification and characterization of dinoflagellate nitrate transporters, found in the transcriptome of the bloom-forming Lingulodinium polyedrum...
May 2016: Harmful Algae
https://www.readbyqxmd.com/read/28073178/polyclonal-and-monoclonal-antibodies-for-induction-therapy-in-kidney-transplant-recipients
#8
REVIEW
Penny Hill, Nicholas B Cross, A Nicholas R Barnett, Suetonia C Palmer, Angela C Webster
BACKGROUND: Prolonging kidney transplant survival is an important clinical priority. Induction immunosuppression with antibody therapy is recommended at transplantation and non-depleting interleukin-2 receptor monoclonal antibodies (IL2Ra) are considered first line. It is suggested that recipients at high risk of rejection should receive lymphocyte-depleting antibodies but the relative benefits and harms of the available agents are uncertain. OBJECTIVES: We aimed to: evaluate the relative and absolute effects of different antibody preparations (except IL2Ra) when used as induction therapy in kidney transplant recipients; determine how the benefits and adverse events vary for each antibody preparation; determine how the benefits and harms vary for different formulations of antibody preparation; and determine whether the benefits and harms vary in specific subgroups of recipients (e...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28070633/-acne-and-rosacea-in-pregnancy
#9
REVIEW
S K Bechstein, F Ochsendorf
Acne and rosacea are common chronic inflammatory skin diseases. During pregnancy these skin disorders may become aggravated, in rare cases occurring for the first time. There are no data available for rosacea and little data for acne concerning the course of these skin disorders during pregnancy. Up to 42% of the pregnant women suffer from acne. In 90% of these women the disease existed before pregnancy. In 1/3, however, acne relapsed during pregnancy after a prior disease-free period. In 60% acne deteriorated during pregnancy...
January 9, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28001142/perspective-medical-futility-a-contemporary-review
#10
Ellen Coonan
As medical technology has advanced, the question of medical futility has become a topic of intense debate both within the medical community and within society as a whole. However, a unanimous definition thereof is yet to be decided-some commentators are sceptical as to whether an agreement will ever be reached-and this continues to lead to difficulties, tension, and even legal action when a treating physician disagrees with a patient and/or a patient's family regarding care and treatment options. Although living in a pluralistic society presents one of the major reasons as to why, despite 30 years of intense discussion, no consensus has been made; the issue of medical futility will always be complex as it is, by nature, multifaceted, and numerous elements-including possible risks, evidence of the probability of benefit, the wishes of the patient (and family), professional standards, and cost-interact...
2016: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/27898998/nutritional-supplementation-for-hip-fracture-aftercare-in-older-people
#11
REVIEW
Alison Avenell, Toby O Smith, James P Curtain, Jenson Cs Mak, Phyo K Myint
BACKGROUND: Older people with hip fractures are often malnourished at the time of fracture, and subsequently have poor food intake. This is an update of a Cochrane review first published in 2000, and previously updated in 2010. OBJECTIVES: To review the effects (benefits and harms) of nutritional interventions in older people recovering from hip fracture. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, CENTRAL, MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, Embase, CAB Abstracts, CINAHL, trial registers and reference lists...
November 30, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27883874/structured-interdisciplinary-bedside-rounds-do-not-reduce-length-of-hospital-stay-and-28-day-re-admission-rate-among-older-people-hospitalised-with-acute-illness-an-australian-study
#12
Elizabeth Huynh, David Basic, Rinaldo Gonzales, Chris Shanley
Objective Structured interdisciplinary bedside rounds (SIBR) are being implemented across many hospitals in Australia despite limited evidence of their effectiveness. This study evaluated the effect of SIBR on two interconnected outcomes, namely length of stay (LOS) and 28-day re-admission.Methods In the present before-after study of 3644 patients, twice-weekly SIBR were implemented on two aged care wards. Although weekly case conferences were shortened during SIBR, all other practices remained unchanged. Demographic, medical and frailty measures were considered in appropriate analyses...
November 25, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27768655/measures-to-improve-diagnostic-safety-in-clinical-practice
#13
Hardeep Singh, Mark L Graber, Timothy P Hofer
Timely and accurate diagnosis is foundational to good clinical practice and an essential first step to achieving optimal patient outcomes. However, a recent Institute of Medicine report concluded that most of us will experience at least one diagnostic error in our lifetime. The report argues for efforts to improve the reliability of the diagnostic process through better measurement of diagnostic performance. The diagnostic process is a dynamic team-based activity that involves uncertainty, plays out over time, and requires effective communication and collaboration among multiple clinicians, diagnostic services, and the patient...
October 20, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27754861/deciphering-assumptions-about-stepped-wedge-designs-the-case-of-ebola-vaccine-research
#14
Adélaïde Doussau, Christine Grady
Ethical concerns about randomising persons to a no-treatment arm in the context of Ebola epidemic led to consideration of alternative designs. The stepped wedge (SW) design, in which participants or clusters are randomised to receive an intervention at different time points, gained popularity. Common arguments in favour of using this design are (1) when an intervention is likely to do more good than harm, (2) all participants should receive the experimental intervention at some time point during the study and (3) the design might be preferable for practical reasons...
October 17, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27726125/interventions-for-idiopathic-steroid-resistant-nephrotic-syndrome-in-children
#15
REVIEW
Elisabeth M Hodson, Sophia C Wong, Narelle S Willis, Jonathan C Craig
BACKGROUND: The majority of children who present with their first episode of nephrotic syndrome achieve remission with corticosteroid therapy. Children who fail to respond may be treated with immunosuppressive agents including calcineurin inhibitors (cyclosporin or tacrolimus) and with non-immunosuppressive agents such as angiotensin-converting enzyme inhibitors (ACEi). Optimal combinations of these agents with the least toxicity remain to be determined. This is an update of a review first published in 2004 and updated in 2006 and 2010...
October 11, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27716082/first-do-no-harm-pain-relief-for-the-peripheral-venous-cannulation-of-adults-a-systematic-review-and-network-meta-analysis
#16
Mary Bond, Louise Crathorne, Jaime Peters, Helen Coelho, Marcela Haasova, Chris Cooper, Quentin Milner, Vicki Shawyer, Christopher Hyde, Roy Powell
BACKGROUND: Peripheral venous cannulation is an everyday practice in hospitals, which many adults find painful. However, anaesthesia for cannulation is usually only offered to children. Inadequate pain relief is not only unpleasant for patients but may cause anxiety about further treatment and deter patients from seeking medical care in the future. The aim of this study is to discover the most effective local anaesthetic for adult peripheral venous cannulation and to find out how the pain of local anaesthetic application compares with that of unattenuated cannulation...
October 1, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27687114/non-invasive-positive-pressure-ventilation-for-acute-asthma-in-children
#17
Steven Kwasi Korang, Joshua Feinberg, Jørn Wetterslev, Janus C Jakobsen
BACKGROUND: Asthma is one of the most common reasons for hospital admission among children and constitutes a significant economic burden. Use of non-invasive positive pressure ventilation (NPPV) in the care of children with acute asthma has increased even though evidence supporting the intervention has been considered weak and clinical guidelines do not recommend the intervention. NPPV might be an effective intervention for acute asthma, but no systematic review has been conducted to assess the effects of NPPV as an add-on therapy to usual care in children with acute asthma...
September 30, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27633253/does-cost-sharing-do-more-harm-or-more-good-a-systematic-literature-review
#18
Katarzyna Kolasa, Marta Kowalczyk
BACKGROUND: There are positive and negative consequences of the implementation of out of pocket (OOP) payments as a source of the healthcare financing. On the one hand, OOP burden increases awareness of treatment costs and limits unnecessary use of healthcare services. On the other hand, it may prevent the sick from accessing needed care. Consequently there are several aspects that ought to be taken into consideration while defining the optimal structure of OOP payments. The objective of this study was twofold...
2016: BMC Public Health
https://www.readbyqxmd.com/read/27621243/adrenal-incidentalomas-a-guide-to-assessment-treatment-and-follow-up
#19
REVIEW
Stavroula A Paschou, Andromachi Vryonidou, Dimitrios G Goulis
Adrenal incidentalomas are clinically unsuspected lesions that are detected in adrenal glands during imaging procedures for other causes. With widespread use of imaging - both computed tomography (CT) and magnetic resonance imaging (MRI) - adrenal incidentalomas are now a common clinical problem. The two main clinical issues to be determined in this setting are the risk of malignancy and the hormonal activity of these lesions. The answers to these two questions, along with the clinical characteristics of each individual patient and co-morbidities, will guide the treatment strategy, which can vary from simple follow-up to surgical resection...
October 2016: Maturitas
https://www.readbyqxmd.com/read/27613936/high-prevalence-of-smoking-in-the-roma-population-seems-to-have-no-genetic-background
#20
Szilvia Fiatal, Réka Tóth, Ágota Moravcsik-Kornyicki, Zsigmond Kósa, János Sándor, Martin McKee, Róza Ádány
INTRODUCTION: The prevalence of smoking in Romani of both genders is significantly higher than in the general population. Our aim was to determine whether a genetic susceptibility contributes to the high prevalence of smoking among Roma in a study based on data collected from cross-sectional surveys. METHODS: Twenty single nucleotide polymorphisms known to be closely related to smoking behavior were investigated in DNA samples of Hungarian Roma (N = 1273) and general (N = 2388) populations...
December 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
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