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https://www.readbyqxmd.com/read/29156282/pesticides-in-agricultural-headwater-streams-in-southwestern-germany-and-effects-on-macroinvertebrate-populations
#1
Gero Weber, Nicole Christmann, Ann-Cathrin Thiery, Dieter Martens, Jochen Kubiniok
Pesticides are a major burden for stream ecosystems in the central European cultivated landscape. The objective of the present study was to investigate the applicability of ecological indicator methods in relation to toxicity of pesticides under the specific hydro-morphological conditions in small water bodies. Thus, an association of toxicity evaluating methods with different ecological indicators was to be attempted. Based on three random samples taken within the 2016 vegetation period, 23 headwater areas in the Saarland were investigated to test for pesticides and their metabolites...
November 17, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29155929/pan-asian-adapted-esmo-consensus-guidelines-for-the-management-of-patients-with-metastatic-colorectal-cancer-a-jsmo-esmo-initiative-endorsed-by-csco-kaco-mos-sso-and-tos
#2
T Yoshino, D Arnold, H Taniguchi, G Pentheroudakis, K Yamazaki, R-H Xu, T W Kim, F Ismail, I B Tan, K-H Yeh, A Grothey, S Zhang, J B Ahn, D Chong, L-T Chen, S Kopetz, T Eguchi-Nakajima, H Ebi, A Ohtsu, A Cervantes, K Muro, J Tabernero, H Minami, F Ciardiello, J-Y Douillard
The most recent version of the European Society for Medical Oncology (ESMO) consensus guidelines for the treatment of patients with metastatic colorectal cancer (mCRC) was published in 2016, identifying both a more strategic approach to the administration of the available systemic therapy choices, and a greater emphasis on the use of ablative techniques, including surgery. At the 2016 ESMO Asia Meeting, in December 2016, it was decided by both ESMO and the Japanese Society of Medical Oncology (JSMO) to convene a special guidelines meeting, endorsed by both ESMO and JSMO, immediately after the JSMO 2017 Annual Meeting...
November 16, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29155312/designing-clinical-studies-in-orthopedic-traumatology
#3
REVIEW
D M Rouleau
The design of clinical studies in orthopedic traumatology is challenging in several respects. In this era of evidence-based medicine, the pressure is high to choose our treatments solely based on randomized controlled studies. This type of study, when well-constructed, makes it possible to discern the best treatment for a specific fracture in a given group of patients and in connection with a specific outcome. Randomized controlled trials require a lot of resources and are not designed to answer all research questions...
November 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29155225/a-systematic-review-of-the-long-term-effectiveness-of-work-based-lifestyle-interventions-to-tackle-overweight-and-obesity
#4
REVIEW
Greta Tam, May P S Yeung
Obesity is one of the five leading global risks for mortality, accounting for 5% of deaths worldwide. Workplace health promotion programs have the potential to deliver population-level interventions combining physical activity and exercise. However, there is no recent critical review of trials on long-term effectiveness of multicomponent lifestyle interventions in the workplace targeting obesity. Good quality evidence is needed to develop optimal strategies to tackle adult obesity. 1035 studies were retrieved by literature search in MEDLINE, Embase, PSYCH INFO and Cochrane library from 2005 to September 2016...
November 16, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/29154691/optimal-screening-methods-to-detect-cardiac-disorders-in-athletes-an-evidence-based-review
#5
Zachary K Winkelmann, Ashley K Crossway
Reference/Citation:  Harmon KG, Zigman M, Drezner JA. The effectiveness of screening history, physical exam, and ECG to detect potentially lethal cardiac disorders in athletes: a systematic review/meta-analysis. J Electrocardiol. 2015;48(3):329-338. CLINICAL QUESTION:   Which screening method should be considered best practice to detect potentially lethal cardiac disorders during the preparticipation physical examination (PE) of athletes? DATA SOURCES:   The authors completed a comprehensive literature search of MEDLINE, CINAHL, Cochrane Library, Embase, Physiotherapy Evidence Database (PEDro), and SPORTDiscus from January 1996 to November 2014...
November 20, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/29154382/review-of-strategies-to-reduce-central-line-associated-bloodstream-infection-clabsi-and-catheter-associated-urinary-tract-infection-cauti-in-adult-icus
#6
Payal K Patel, Ashwin Gupta, Valerie M Vaughn, Jason D Mann, Jessica M Ameling, Jennifer Meddings
Central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) are costly and morbid. Despite evidence-based guidelines, Some intensive care units (ICUs) continue to have elevated infection rates. In October 2015, we performed a systematic search of the peer-reviewed literature within the PubMed and Cochrane databases for interventions to reduce CLABSI and/or CAUTI in adult ICUs and synthesized findings using a narrative review process. The interventions were categorized using a conceptual model, with stages applicable to both CAUTI and CLABSI prevention: (stage 0) avoid catheter if possible, (stage 1) ensure aseptic placement, (stage 2) maintain awareness and proper care of catheters in place, and (stage 3) promptly remove unnecessary catheters...
November 8, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29154379/proposed-in-training-electrocardiogram-interpretation-competencies-for-undergraduate-and-postgraduate-trainees
#7
Pavel Antiperovitch, Wojciech Zareba, Jonathan S Steinberg, Ljuba Bacharova, Larisa G Tereshchenko, Jeronimo Farre, Kjell Nikus, Takanori Ikeda, Adrian Baranchuk
Despite its importance in everyday clinical practice, the ability of physicians to interpret electrocardiograms (ECGs) is highly variable. ECG patterns are often misdiagnosed, and electrocardiographic emergencies are frequently missed, leading to adverse patient outcomes. Currently, many medical education programs lack an organized curriculum and competency assessment to ensure trainees master this essential skill. ECG patterns that were previously mentioned in literature were organized into groups from A to D based on their clinical importance and distributed among levels of training...
November 8, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29154236/risk-factors-of-pancreatitis-after-endoscopic-sphincterotomy-review-of-literature-and-practical-remarks-based-on-approximately-10-000-ercps
#8
Andrzej Jamry
Post-endoscopic pancreatitis (PEP) is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Depending on the presence of risk factors, PEP can occur in 4,1% to about 43% of patients. According to the European Society of Gastrointestinal Endoscopy (ESGE) guidelines, only three to patient-associated risk factors have been identified: suspected sphincter of Oddi dysfunction (SOD) (OR 4.09), female gender (OR 2.23), and previous pancreatitis (OR 2.46). Another three procedure-associated factors include cannulation attempt duration > 10 minutes (OR 1...
October 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29153960/barriers-and-facilitators-to-the-implementation-of-an-evidence-based-electronic-minimum-dataset-for-nursing-team-leader-handover-a-descriptive-survey
#9
Amy J Spooner, Leanne M Aitken, Wendy Chaboyer
INTRODUCTION: There is widespread use of clinical information systems in intensive care units however, the evidence to support electronic handover is limited. OBJECTIVES: The study aim was to assess the barriers and facilitators to use of an electronic minimum dataset for nursing team leader shift-to-shift handover in the intensive care unit prior to its implementation. METHODS: The study was conducted in a 21-bed medical/surgical intensive care unit, specialising in cardiothoracic surgery at a tertiary referral hospital, in Queensland, Australia...
November 15, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29153467/ovarian-torsion-in-pediatric-and-adolescent-patients-a-systematic-review
#10
Roshni Dasgupta, Elizabeth Renaud, Adam B Goldin, Robert Baird, Danielle B Cameron, Meghan A Arnold, Karen A Diefenbach, Ankush Gosain, Julia Grabowski, Yigit S Guner, Tim Jancelewicz, Akemi Kawaguchi, Dave R Lal, Tolulope A Oyetunji, Robert L Ricca, Julia Shelton, Stig Somme, Regan F Williams, Cynthia D Downard
OBJECTIVE: Ovarian torsion in pediatric patients is a rare event and is primarily managed by pediatric general surgeons. Torsion can be treated with detorsion of the ovary or oopherectomy. Oopherectomy is the most common procedure performed by pediatric general surgeons for ovarian torsion. The purpose of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee was to examine evidence from the medical literature and provide recommendations regarding the optimal treatment of ovarian torsion...
November 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29153464/international-guideline-for-the-delineation-of-the-clinical-target-volumes-ctv-for-nasopharyngeal-carcinoma
#11
Anne W Lee, Wai Tong Ng, Jian Ji Pan, Sharon S Poh, Yong Chan Ahn, Hussain AlHussain, June Corry, Cai Grau, Vincent Grégoire, Kevin J Harrington, Chao Su Hu, Dora L Kwong, Johannes A Langendijk, Quynh Thu Le, Nancy Y Lee, Jin Ching Lin, Tai Xiang Lu, William M Mendenhall, Brian O'Sullivan, Enis Ozyar, Lester J Peters, David I Rosenthal, Yoke Lim Soong, Yungan Tao, Sue S Yom, Joseph T Wee
PURPOSE: Target delineation in nasopharyngeal carcinoma (NPC) often proves challenging because of the notoriously narrow therapeutic margin. High doses are needed to achieve optimal levels of tumour control, and dosimetric inadequacy remains one of the most important independent factors affecting treatment outcome. METHOD: A review of the available literature addressing the natural behaviour of NPC and correlation between clinical and pathological aspects of the disease was conducted...
November 15, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29153075/is-whole-colon-investigation-by-colonoscopy-computerised-tomography-colonography-or-barium-enema-necessary-for-all-patients-with-colorectal-cancer-symptoms-and-for-which-patients-would-flexible-sigmoidoscopy-suffice-a-retrospective-cohort-study
#12
Wendy Atkin, Kate Wooldrage, Urvi Shah, Kate Skinner, Jeremy P Brown, Willie Hamilton, Ines Kralj-Hans, Michael R Thompson, Karen G Flashman, Steve Halligan, Siwan Thomas-Gibson, Margaret Vance, Amanda J Cross
BACKGROUND: For patients referred to hospital with suspected colorectal cancer (CRC), it is current standard clinical practice to conduct an examination of the whole colon and rectum. However, studies have shown that an examination of the distal colorectum using flexible sigmoidoscopy (FS) can be a safe and clinically effective investigation for some patients. These findings require validation in a multicentre study. OBJECTIVES: To investigate the links between patient symptoms at presentation and CRC risk by subsite, and to provide evidence of whether or not FS is an effective alternative to whole-colon investigation (WCI) in patients whose symptoms do not suggest proximal or obstructive disease...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29152831/laser-treatment-of-cutaneous-angiokeratomas-a-systematic-review
#13
REVIEW
Jannett Nguyen, Lance W Chapman, Dorota Z Korta, Christopher B Zachary
Angiokeratomas can present therapeutic challenges, especially in cases of extensive lesions, where traditional surgical methods carry high risks of scarring and hemorrhage. Argon, pulsed dye (PDL), neodymium-doped yttrium aluminum garnet (Nd:YAG), copper vapor, potassium titanyl phosphate, carbon dioxide, and erbium-doped yttrium aluminum garnet (Er:YAG) lasers have emerged as alternative options. To review the use and efficacy of lasers in treating angiokeratomas. A PubMed search identified randomized clinical trials, cohort studies, case series, and case reports involving laser treatment of cutaneous angiokeratomas...
November 19, 2017: Dermatologic Therapy
https://www.readbyqxmd.com/read/29151815/how-should-we-evaluate-research-on-counselling-and-the-treatment-of-depression-a-case-study-on-how-the-national-institute-for-health-and-care-excellence-s-draft-2018-guideline-for-depression-considered-what-counts-as-best-evidence
#14
Michael Barkham, Naomi P Moller, Joanne Pybis
Background: Health guidelines are developed to improve patient care by ensuring the most recent and 'best available evidence' is used to guide treatment recommendations. The National Institute for Health and Care Excellence's (NICE's ) guideline development methodology acknowledges that evidence needed to answer one question (treatment efficacy) may be different from evidence needed to answer another (cost-effectiveness, treatment acceptability to patients). This review uses counselling in the treatment of depression as a case study, and interrogates the constructs of 'best' evidence and 'best' guideline methodologies...
December 2017: Couns Psychother Res
https://www.readbyqxmd.com/read/29151401/evaluation-of-a-primary-care-paramedic-stemi-bypass-guideline
#15
Jonathan L Kwong, Garry Ross, Linda Turner, Chris Olynyk, Sheldon Cheskes, Adam Thurston, P Richard Verbeek
OBJECTIVE: Limited evidence supports primary care paramedic (PCP) direct transport of ST-segment elevation myocardial infarction (STEMI) patients for percutaneous coronary intervention (PCI). The goal of this study was to evaluate an urban-based PCP STEMI bypass guideline. METHODS: We reviewed consecutive Toronto Paramedic Services call reports between April 7, 2015, and May 31, 2016, regarding STEMI patients identified by PCPs. The primary outcome was patient assignment (stable versus unstable) according to guideline criteria...
November 20, 2017: CJEM
https://www.readbyqxmd.com/read/29151295/-guidelines-for-standardizedmanagement-of-neutropenia-induced-by-chemotherapy-and-radiotherapy
#16
(no author information available yet)
Neutropenia is the most common hematologic toxicity of myelosuppressive chemotherapy and radiotherapy. The degree and duration of neutropenia are directly related to the risk of infection and even death, which can also affect the relative dose intensity of chemotherapy and the prognosis of patients. At present, clinicians tend to underestimate the harm of neutropenia, and are in lack of knowledge on granulocyte colony-stimulating factor(G-CSF), especially on prevention and treatment of neutropenia. Based on clinical evidence, the Chinese Society of Clinical Oncology (CSCO) develops guidelines on the assessment, prevention and treatment of neutropenia and the application of G-CSF...
November 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/29151010/same-day-discharge-after-total-joint-arthroplasty-the-future-may-be-now
#17
Vinay Aggarwal, Savyasachi Thakkar, Kristopher Collins, Jonathan Vigdorchik
Total joint arthroplasty has traditionally been performed as an inpatient procedure to mitigate the risks of perioperative complications, limited mobility, and pain control issues. Reducing readmissions and complications is increasingly important with the push toward outcomes based reimbursement. Nonetheless, there is a definite trend toward not only shortening postoperative length of stay but also toward considering a same day discharge arthroplasty model in appropriately selected patients. In this review, we outline the literature evidence regarding same day discharge in total joint arthroplasty and discuss our own institutional guidelines for appropriate patient selection as well as contraindications...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29150475/uptodate-adherence-to-grade-criteria-for-strong-recommendations-an-analytical-survey
#18
Thomas Agoritsas, Arnaud Merglen, Anja Fog Heen, Annette Kristiansen, Ignacio Neumann, Juan P Brito, Romina Brignardello-Petersen, Paul E Alexander, David M Rind, Per O Vandvik, Gordon H Guyatt
INTRODUCTION: UpToDate is widely used by clinicians worldwide and includes more than 9400 recommendations that apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. GRADE guidance warns against strong recommendations when certainty of the evidence is low or very low (discordant recommendations) but has identified five paradigmatic situations in which discordant recommendations may be justified. OBJECTIVES: Our objective was to document the strength of recommendations in UpToDate and assess the frequency and appropriateness of discordant recommendations...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150233/management-of-first-depression-or-generalized-anxiety-disorder-episode-in-adults-in-primary-care-a-systematic-metareview
#19
Damien Driot, Michel Bismuth, Adrien Maurel, Julie Soulie-Albouy, Jordan Birebent, Stéphane Oustric, Julie Dupouy
CONTEXT: General Practitioners (GPs) are the leading antidepressants prescribers in Europe and in France. Difficulties in implementing existing recommendations in daily practice have been described. OBJECTIVE: The objective of this study was to elaborate two algorithms to guide GPs in the patient management for a first major depressive disorder (MDD) or generalized anxiety disorder (GAD) episode in primary care. DATA SOURCES: PubMed, Cochrane, and ISI Web of Science were explored using mainly the following keywords: depressive disorder, anxiety disorders, antidepressive agents or antidepressant...
November 14, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29150215/lifestyles-guide-and-glaucoma-ii-diet-supplements-drugs-sleep-pregnancy-and-systemic-hypertension
#20
A Antón-López, J Moreno-Montañés, S Duch-Tuesta, P Corsino Fernández-Vila, J García-Feijoo, E Millá-Griñó, F J Muñoz-Negrete, L Pablo-Júlvez, I Rodríguez-Agirretxe, J L Urcelay-Segura, F Ussa-Herrera, M P Villegas-Pérez
PURPOSE: To establish evidence based guidelines to advise patients on the relationship between habits, diet, certain circumstances, diseases and glaucoma. METHODS: Review of all published articles on glaucoma and sports or other activities. The papers were classified according to the level of scientific evidence based on the Oxford Centre for Evidence-based Medicine classification. RESULTS: The evidence on the relationship between diet or supplements and the incidence or progression of glaucoma is insufficient to make a general recommendation for glaucoma patients...
November 14, 2017: Archivos de la Sociedad Española de Oftalmología
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