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https://www.readbyqxmd.com/read/28731517/mental-steps-differential-activation-of-internal-pacemakers-in-motor-imagery-and-in-mental-imitation-of-gait
#1
Lucia Maria Sacheli, Laura Zapparoli, Carlo De Santis, Matteo Preti, Catia Pelosi, Nicola Ursino, Alberto Zerbi, Giuseppe Banfi, Eraldo Paulesu
Gait imagery and gait observation can boost the recovery of locomotion dysfunctions; yet, a neurologically justified rationale for their clinical application is lacking as much as a direct comparison of their neural correlates. Using functional magnetic resonance imaging, we measured the neural correlates of explicit motor imagery of gait during observation of in-motion videos shot in a park with a steady cam (Virtual Walking task). In a 2 × 2 factorial design, we assessed the modulatory effect of gait observation and of foot movement execution on the neural correlates of the Virtual Walking task: in half of the trials, the participants were asked to mentally imitate a human model shown while walking along the same route (mental imitation condition); moreover, for half of all the trials, the participants also performed rhythmic ankle dorsiflexion as a proxy for stepping movements...
July 21, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28730951/penumbra-and-re-canalization-acute-computed-tomography-in-ischemic-stroke-evaluation-practise-study-protocol
#2
Salwa El-Tawil, Joanna Wardlaw, Ian Ford, Grant Mair, Tom Robinson, Lalit Kalra, Keith W Muir
Rationale Multimodal imaging, including computed tomography angiography and computed tomography perfusion imaging, yields additional information on intracranial vessels and brain perfusion and can differentiate between ischemic core and penumbra which may affect patient selection for intravenous thrombolysis. Hypothesis The use of multimodal imaging will increase the number of patients receiving intravenous thrombolysis and lead to better treatment outcomes. Sample size 400 patients. Methods and design PRACTISE is a prospective, multicenter, randomized, controlled trial in which patients presenting within 4...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28730950/statistical-analysis-plan-for-the-head-position-in-stroke-trial-headpost-an-international-cluster-cross-over-randomized-trial
#3
Laurent Billot, Mark Woodward, Hisatomi Arima, Maree L Hackett, Paula Muñoz Venturelli, Pablo M Lavados, Alejandro Brunser, Bin Peng, Liying Cui, Lily Song, Stephane Heritier, Stephen Jan, Sandy Middleton, Verónica V Olavarría, Joyce Lim, Thompson Robinson, Octavio Pontes-Neto, Caroline Watkins, Craig S Anderson
Background There is evidence to indicate that the lying flat head position increases cerebral blood flow and oxygenation in patients with acute ischemic stroke, but how these physiological effects translate into clinical outcomes is uncertain. The Head Position in Stroke Trial aims to determine the comparative effectiveness of lying flat (0°) compared to sitting up (≥30°) head positioning, initiated within 24 h of hospital admission for patients with acute stroke. Design An international, pragmatic, cluster-randomized, crossover, open, blinded outcome assessed clinical trial...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28729407/long-term-stroke-risk-prediction-in-patients-with-atrial-fibrillation-comparison-of-the-abc-stroke-and-cha2ds2-vasc-scores
#4
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Gregory Y H Lip, Francisco Marín
BACKGROUND: The ABC-stroke score (age, biomarkers [N-terminal fragment B-type natriuretic peptide, high-sensitivity troponin], and clinical history [prior stroke/transient ischemic attack]) was proposed to predict stroke in atrial fibrillation (AF). This score was derived/validated in 2 clinical trial cohorts in which patients with AF were highly selected and carefully followed-up. However, the median follow-up was 1.9 years in the trial cohort; therefore, its long-term predictive performance remains uncertain...
July 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#5
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729311/a-review-of-rate-control-in-atrial-fibrillation-and-the-rationale-and-protocol-for-the-rate-af-trial
#6
Dipak Kotecha, Melanie Calvert, Jonathan J Deeks, Michael Griffith, Paulus Kirchhof, Gregory Yh Lip, Samir Mehta, Gemma Slinn, Mary Stanbury, Richard P Steeds, Jonathan N Townend
BACKGROUND AND OBJECTIVE: Atrial fibrillation (AF) is common and causes impaired quality of life, an increased risk of stroke and death as well as frequent hospital admissions. The majority of patients with AF require control of heart rate. In this article , we summarise the limited evidence from clinical trials that guides prescription, and present the rationale and protocol for a new randomised trial. As rate control has not yet been shown to reduce mortality, there is a clear need to compare the impact of therapy on quality of life, cardiac function and exercise capacity...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728605/surrogate-endpoints-in-oncology-when-are-they-acceptable-for-regulatory-and-clinical-decisions-and-are-they-currently-overused
#7
Robert Kemp, Vinay Prasad
BACKGROUND: Surrogate outcomes are not intrinsically beneficial to patients, but are designed to be easier and faster to measure than clinically meaningful outcomes. The use of surrogates as an endpoint in clinical trials and basis for regulatory approval is common, and frequently exceeds the guidance given by regulatory bodies. DISCUSSION: In this article, we demonstrate that the use of surrogates in oncology is widespread and increasing. At the same time, the strength of association between the surrogates used and clinically meaningful outcomes is often unknown or weak...
July 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28727668/comprehensive-cardiac-rehabilitation-for-secondary-prevention-after-transient-ischemic-attack-or-mild-stroke-psychological-profile-and-outcomes
#8
Peter L Prior, Vladimir Hachinski, Richard Chan, Karen Unsworth, Sharon Mytka, Michael Harnadek, Christina OʼCallaghan, Neville Suskin
PURPOSE: Having previously reported that comprehensive cardiac rehabilitation (CCR) is effective for secondary prevention post-transient ischemic attack (TIA)/mild nondisabling stroke (MNDS), we present psychometric findings for the same sample that elucidate subacute TIA/MNDS psychological outcomes and test whether CCR would be independently associated with psychological improvements. METHODS: In this prospective cohort trial patients with ≥1 risk factor, recruited from a stroke prevention clinic within 12 months (mean = 11...
July 19, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28727591/the-effectiveness-of-emla-as-a-primary-dressing-on-painful-chronic-leg-ulcers-a-pilot-randomized-controlled-trial
#9
Anne Purcell, Thomas Buckley, Judith Fethney, Jennie King, Wendy Moyle, Andrea P Marshall
OBJECTIVE: To evaluate the effectiveness of the eutectic mixture of local anesthetics (EMLA; Aspen Pharmacare, St. Leonards, New South Wales, Australia) as a primary dressing on painful chronic leg ulcers. DESIGN: A pilot randomized controlled trial. SETTING: The study was conducted across 6 community nursing procedure clinics located in a community nursing service in New South Wales, Australia. PARTICIPANTS: Sixty participants with painful chronic leg ulcers of varied etiology were recruited into the study...
August 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28727183/a-randomised-controlled-trial-on-a-nurse-led-smartphone-based-self-management-programme-for-patients-with-poorly-controlled-type-2-diabetes-a-study-protocol
#10
Wenru Wang, Betsy Seah, Ying Jiang, Violeta Lopez, Cherry Tan, Suan Tee Lim, Hongliang Ren, Yin Hao Khoo
AIM: To develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes for patients with poorly controlled type 2 diabetes in Singapore. BACKGROUND: Over the past decades, Asia has emerged as the 'diabetes epicentre' in the world due to rapid economic development, urbanisation and nutrition transition. There is an urgent need to develop more effective care management strategies in response to this rising diabetes epidemic...
July 20, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28726273/epigallocatechin-gallate-enhances-treatment-efficacy-of-oral-nifedipine-against-pregnancy-induced-severe-pre-eclampsia-a-double-blind-randomized-and-placebo-controlled-clinical-study
#11
D-D Shi, J-J Guo, L Zhou, N Wang
WHAT IS KNOWN AND OBJECTIVE: Oral nifedipine is commonly used to treat pre-eclampsia, one of the most severe complications during pregnancy, but its clinical efficacy is less than ideal. Epigallocatechin gallate (EGCG), a natural compound from green tea, could benefit cardiovascular health especially hypertension. We investigated the clinical efficacy of EGCG, when complemented with oral nifedipine, in treating pre-eclampsia. METHODS: A total of 350 pregnant women with severe pre-eclampsia were recruited and randomized to receive oral nifedipine, together with placebo (NIF+placebo) or EGCG (NIF+EGCG)...
July 20, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28725257/study-protocol-an-investigation-of-mother-infant-signalling-during-breastfeeding-using-a-randomised-trial-to-test-the-effectiveness-of-breastfeeding-relaxation-therapy-on-maternal-psychological-state-breast-milk-production-and-infant-behaviour-and-growth
#12
N H M Shukri, J Wells, F Mukhtar, M H S Lee, M Fewtrell
BACKGROUND: The physiological and psychological signalling between mother and infant during lactation is one of the prominent mother-infant factors that may influence breastfeeding outcomes. The infant can 'signal' his needs through vocalisation, and the mother can respond by allowing or restricting nipple access, which might alter the breast milk composition or volume. This may lead to parent-offspring conflict during the lactation period. Challenging infant behaviour has also been associated with maternal psychological distress, which might affect breastfeeding performance...
2017: International Breastfeeding Journal
https://www.readbyqxmd.com/read/28724394/development-of-newborn-screening-connect-nbs-connect-a-self-reported-patient-registry-and-its-role-in-improvement-of-care-for-patients-with-inherited-metabolic-disorders
#13
Yetsa Osara, Kathryn Coakley, Aishwarya Devarajan, Rani H Singh
BACKGROUND: Newborn Screening Connect (NBS Connect) is a web-based self-reported patient registry and resource for individuals and families affected by disorders included in the newborn screening panel. NBS Connect was launched in 2012 by Emory University after years of planning and grassroots work by professionals, consumers, and industry. Individuals with phenylketonuria (PKU), maple syrup urine disease (MSUD) or tyrosinemia (TYR) have been recruited through distribution of outreach materials, presentations at parent organization meetings and direct recruitment at clinic appointments...
July 19, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28722612/the-epidemiology-of-scabies-and-impetigo-in-relation-to-demographic-and-residential-characteristics-baseline-findings-from-the-skin-health-intervention-fiji-trial
#14
Lucia Romani, Margot J Whitfeld, Josefa Koroivueta, Mike Kama, Handan Wand, Lisi Tikoduadua, Meciusela Tuicakau, Aminiasi Koroi, Raijieli Ritova, Ross Andrews, John M Kaldor, Andrew C Steer
Scabies and associated impetigo are under-recognised causes of morbidity in many developing countries. To strengthen the evidence base for scabies control we undertook a trial of mass treatment for scabies. We report on the occurrence and predictors of scabies and impetigo in participants at baseline. Participants were recruited in six island communities and were examined for the presence of scabies and impetigo. In addition to descriptive analyses, logistic regression models were fit to assess the association between demographic variables and outcome of interest...
July 17, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28721992/comparative-evaluation-of-effectiveness-of-intra-pocket-anesthetic-gel-and-injected-local-anesthesia-during-scaling-and-root-planing-a-split-mouth-clinical-trial
#15
Kalyan Chintala, Sandhya Pavan Kumar, K Raja V Murthy
BACKGROUND AND AIM: Pain control is an important outcome measure for successful periodontal therapy. Injected local anesthesia has been used to secure anesthesia for scaling and root planing (SRP) and continues to be the anesthetic of choice for pain control. Alternatively, intra-pocket anesthetic gel has been used as an anesthetic during SRP. Hence, this clinical trial was done to compare the effectiveness of intra-pocket anesthetic gel and injected local anesthesia during SRP and also to assess the influence of intra-pocket anesthetic gel on treatment outcomes in chronic periodontitis patients...
May 2017: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
https://www.readbyqxmd.com/read/28721628/disease-activity-handgrip-strengths-and-hand-dexterity-in-patients-with-rheumatoid-arthritis
#16
D Palamar, G Er, R Terlemez, I Ustun, G Can, M Saridogan
Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the hand joints and leading to impairment in hand functions. Evaluation of functional impairment is necessary for assessing patient's quality of life, disease activity, and treatment outcome. To date, many scientific studies assessed the disease activity of patients with RA, but little attention has been carried out to assess these patients' hand functions and dexterity. The purposes of this study were to determine the clinical relevance of the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), hand dexterity with the Purdue Pegboard Test (PPT), and handgrip strength and pinch strengths of RA patients and to look into their relation between each other...
July 18, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28721181/adding-sildenafil-vaginal-gel-to-clomiphene-citrate-in-infertile-women-with-prior-clomiphene-citrate-failure-due-to-thin-endometrium-a-prospective-self-controlled-clinical-trial
#17
A N Fetih, D M Habib, I I Abdelaal, M Hussein, G N Fetih, E R Othman
We aimed to investigate the effect of adding sildenafil vaginal gel to clomiphene citrate (CC) in infertile women with prior CC failure. METHODS: This is a self- controlled clinical trial. Women with CC failure (in prior 5 cycles) and thin endometrium were recruited (N = 42). In their 6th (CC only) cycle, women continued on CC 100 mg/ day for 5 days, and had measurement of endometrial thickness and Doppler assessment of uterine arteries on day of HCG administration. In the 7th cycle, women (N = 36) were given usual dose of CC supplemented with sildenafil vaginal gel (5 gm, containing 50 mg sildenafil) twice daily from cycle day 8 to day of HCG administration...
March 2017: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/28721095/chemotherapy-associated-paronychia-treated-with-2-povidone-iodine-a-series-of-cases
#18
Kara Capriotti, Joseph Capriotti, Jesse Pelletier, Kevin Stewart
BACKGROUND: Nail changes are known to occur during the use of chemotherapy for a variety of malignancies, particularly those treated with taxanes and EGFR inhibitors. There are currently no actively recruiting prospective clinical trials investigating potential treatments. There are also no US Food and Drug Administration-approved medical treatments for chemotherapy-associated paronychia and no consensus on the best way to treat these common chemotherapy-induced events. METHODS: A retrospective review of all cases presenting to a single dermatology private practice from June 2016 to January 2017 identified nine patients with chemotherapy-associated paronychia seeking treatment...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28720981/cerebral-reorganization-in-subacute-stroke-survivors-after-virtual-reality-based-training-a-preliminary-study
#19
Xiang Xiao, Qiang Lin, Wai-Leung Lo, Yu-Rong Mao, Xin-Chong Shi, Ryan S Cates, Shu-Feng Zhou, Dong-Feng Huang, Le Li
BACKGROUND: Functional magnetic resonance imaging (fMRI) is a promising method for quantifying brain recovery and investigating the intervention-induced changes in corticomotor excitability after stroke. This study aimed to evaluate cortical reorganization subsequent to virtual reality-enhanced treadmill (VRET) training in subacute stroke survivors. METHODS: Eight participants with ischemic stroke underwent VRET for 5 sections per week and for 3 weeks. fMRI was conducted to quantify the activity of selected brain regions when the subject performed ankle dorsiflexion...
2017: Behavioural Neurology
https://www.readbyqxmd.com/read/28720558/my-team-of-care-study-a-pilot-randomized-controlled-trial-of-a-web-based-communication-tool-for-collaborative-care-in-patients-with-advanced-cancer
#20
Teja Voruganti, Eva Grunfeld, Trevor Jamieson, Allison M Kurahashi, Bhadra Lokuge, Monika K Krzyzanowska, Muhammad Mamdani, Rahim Moineddin, Amna Husain
BACKGROUND: The management of patients with complex care needs requires the expertise of health care providers from multiple settings and specialties. As such, there is a need for cross-setting, cross-disciplinary solutions that address deficits in communication and continuity of care. We have developed a Web-based tool for clinical collaboration, called Loop, which assembles the patient and care team in a virtual space for the purpose of facilitating communication around care management...
July 18, 2017: Journal of Medical Internet Research
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