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https://www.readbyqxmd.com/read/29136338/the-perspectives-of-medical-specialists-from-different-disciplines-on-the-management-of-systemic-lupus-erythematosus-an-interview-study
#1
David J Tunnicliffe, Davinder Singh-Grewal, Jonathan C Craig, Shilpanjali Jesudason, Peter Tugwell, Ming-Wei Lin, Sean G O'Neill, Daniel Sumpton, Allison Tong
OBJECTIVES: Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can affect multiple organ systems, with specialists from many disciplines often involved, which may lead to inconsistent care. We aimed to describe the attitudes and perspectives of specialists from different medical disciplines on the management of people with SLE. METHODS: Face-to-face, semi-structured interviews were conducted with rheumatologists (n=16), nephrologists (n=16), and immunologists (n=11) providing care to adults with SLE from 19 centers across Australia in 2015...
November 14, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/29136314/syncope-prognosis-based-on-emergency-department-diagnosis-a-prospective-cohort-study
#2
Cristian Toarta, Muhammad Mukarram, Kirtana Arcot, Soo-Min Kim, Sarah Gaudet, Marco L A Sivilotti, Brian H Rowe, Venkatesh Thiruganasambandamoorthy
OBJECTIVE: Relatively little is known about outcomes after disposition among syncope patients assigned various diagnostic categories during emergency department (ED) evaluation. We sought to measure the outcomes among these groups within 30 days of the initial ED visit. METHODS: We prospectively enrolled adult syncope patients at six EDs and excluded patients with pre-syncope, persistent mental status changes, intoxication, seizure, and major trauma. Patient characteristics, ED management, diagnostic impression (presumed vasovagal, orthostatic, cardiac, or other/unknown) at the end of the ED visit and physicians' confidence in assigning the etiology were collected...
November 14, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29135634/clearance-and-return-to-play-for-the-female-athlete-triad-clinical-guidelines-clinical-judgment-and-evolving-evidence
#3
Elizabeth A Joy, Aurelia Nattiv
No abstract text is available yet for this article.
November 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/29135619/the-heart-pathway-and-hospital-cost-savings
#4
Amy A Yau, Long T Nguyendo, LaKeesha L Lockett, Edward Michaud
Chest pain is a common complaint in emergency departments. Several guidelines and tools exist to help the clinician determine need for hospitalization. For low-risk patients, clinical judgment can underestimate a patient's risk of major adverse cardiac event. Implementation of an advanced diagnostic protocol with the HEART Pathway can reduce hospital cost. For our academic institution, we saw an approximate $1 million in total savings during the initial implementation year along with increased outpatient visits...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135328/when-the-solution-becomes-a-problem-an-educational-discussion
#5
Gustavo Frainer Barbosa
Presenting patients with the opportunity to restore their smiles using dental implants, which is a reliable and widely accepted technique, is highly recommended. Therefore, a correct clinical judgment and a, consequently, dental implant treatment planning is a central component of a good practice of implant dentistry. Moreover, to the oral clinician be able to make better decisions and reach a more accurate clinical judgment, it is necessary continuing professional development being, this development, an essential professional activity for dentists that intend planning implant treatments...
November 14, 2017: Journal of Oral Implantology
https://www.readbyqxmd.com/read/29132653/prefrontal-and-striatal-gamma-aminobutyric-acid%C3%A2-levels-and-the-effect-of-antipsychotic-treatment-in-first-episode-psychosis-patients
#6
Camilo de la Fuente-Sandoval, Francisco Reyes-Madrigal, Xiangling Mao, Pablo León-Ortiz, Oscar Rodríguez-Mayoral, Helgi Jung-Cook, Rodolfo Solís-Vivanco, Ariel Graff-Guerrero, Dikoma C Shungu
BACKGROUND: Abnormally elevated levels of gamma-aminobutyric acid (GABA) in the medial prefrontal cortex (mPFC) have been reported in antipsychotic-free patients with schizophrenia. Whether such GABA elevations are also present in other brain regions and persist after antipsychotic treatment has not been previously investigated. METHODS: Twenty-eight antipsychotic-naïve patients with first-episode psychosis (FEP) and 18 healthy control subjects completed the study...
October 10, 2017: Biological Psychiatry
https://www.readbyqxmd.com/read/29131714/understanding-variations-in-secondary-findings-reporting-practices-across-u-s-genome-sequencing-laboratories
#7
Sara Ackerman, Barbara Koenig
BACKGROUND: Increasingly used for clinical purposes, genome and exome sequencing can generate clinically relevant information that is not directly related to the reason for testing (incidental or secondary findings). Debates about the ethical implications of secondary findings were sparked by the American College of Medical Genetics (ACMG)'s 2013 policy statement, which recommended that laboratories report pathogenic alterations in 56 genes. Although wide variation in laboratories' secondary findings policies has been reported, little is known about its causes...
November 13, 2017: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/29130416/prevalence-incidence-and-associated-factors-of-pressure-ulcers-in-home-palliative-care-patients-a-retrospective-chart-review
#8
Marco Artico, Angelo Dante, Daniela D'Angelo, Luciano Lamarca, Chiara Mastroianni, Tommasangelo Petitti, Michela Piredda, Maria Grazia De Marinis
BACKGROUND: Terminally ill patients are at high risk of pressure ulcers, which have a negative impact on quality of life. Data about pressure ulcers' prevalence, incidence and associated factors are largely insufficient. AIM: To document the point prevalence at admission and the cumulative incidence of pressure ulcers in terminally ill patients admitted to an Italian home palliative care unit, and to analyse the patients' and caregivers' characteristics associated with their occurrence...
October 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29129210/driving-dilemmas-a-guide-to-driving-assessment-in-primary-care
#9
REVIEW
Emily Morgan
Clinical assessment of fitness to drive can be a challenging part of primary care of older adults. There are no guidelines on screening for driver safety, so it falls to provider judgment on when to assess older drivers. This review offers recommendations on when to assess for driver safety based on red flag conditions, medications, acute events, and patient or family concerns. It reviews how to assess for visual, cognitive, and neuromuscular impairments and what to do as next steps for at-risk drivers once they are identified...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29121959/why-european-and-united-states-drug-regulators-are-not-speaking-with-one-voice-on-anti-influenza-drugs-regulatory-review-methodologies-and-the-importance-of-deep-product-reviews
#10
Shai Mulinari, Courtney Davis
BACKGROUND: Relenza represents the first neuraminidase inhibitor (NI), a class of drugs that also includes the drug Tamiflu. Although heralded as breakthrough treatments in influenza, NI efficacy has remained highly controversial. A key unsettled question is why the United States Food and Drug Administration (FDA) has approved more cautious efficacy statements in labelling than European regulators for both drugs. METHODS: We conducted a qualitative analysis of United States and European Union regulatory appraisals for Relenza to investigate the reasons for divergent regulatory interpretations, pertaining to Relenza's capacity to alleviate symptoms and reduce frequency of complications of influenza...
November 9, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/29120687/a-100-patient-clinical-evaluation-of-an-alternating-pressure-replacement-mattress-in-a-home-based-setting
#11
Jackie Stephen-Haynes, Rosie Callaghan
BACKGROUND: alternating pressure air mattresses (APAMs) support the prevention and management of pressure ulcers. A health and care NHS trust was seeking an APAM that would improve clinical outcomes in relation to pressure ulcers while considering financial cost. An APAM existed that could meet the trust's needs but there was a lack of evidence over its use in a community/home setting. This study examined the effect of using the Dual Professional (IQ Medical) APAM for patients at a high risk of pressure ulceration...
November 8, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29120667/listening-to-a-patient-an-exploratory-experimental-investigation-into-the-effects-of-vocalization-and-therapist-gender-on-interpreting-clinical-material
#12
Barry Dauphin, Stacey Halverson, Sarah Pouliot, Linda Slowik
Carefully listening to the patient is of paramount importance for psychoanalysis and psychoanalytic psychotherapy. The present study explored whether patient vocalization as well as the gender of the analyst play significant roles in clinical listening. Fifty-one psychoanalysts and psychoanalytic therapists were randomly assigned to listen to one of two dramatized psychoanalytic sessions. The content of the sessions was the same for both versions, but the sessions were dramatized differently. Some differences emerged between the versions, especially on ratings of reality testing, impulse control, pressured speech, patient was confusing, and awareness of imagery...
November 9, 2017: Bulletin of the Menninger Clinic
https://www.readbyqxmd.com/read/29120378/clinic-design-as-placebo-using-design-to-promote-healing-and-support-treatments
#13
Jonas Rehn, Kai Schuster
Analogously to the medical placebo effect, people seem to anticipate the quality of treatments based on external stimuli. In order to gain insights on the effect the built environment can have on a person's judgments and behavior with a particular focus on health related issues, a quantitative survey (N = 851) with four groups before and after the renovation of a rehabilitation clinic has been conducted. In line with an overall modernization of the clinic, the entrance, the lobby, and some patient rooms have been changed...
November 9, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/29116618/treatment-of-stable-angina-with-a-new-fixed-dose-combination-of-ivabradine-and-metoprolol-effectiveness-and-tolerability-in-routine-clinical-practice
#14
Dimitar Divchev, Georg Stöckl
INTRODUCTION: In this prospective, multicenter, observational cohort study, the effectiveness and tolerability of the first fixed-dose combination (FDC) formulation of the selective heart rate reducing agent ivabradine and the beta-blocker metoprolol was evaluated in stable angina pectoris (AP) patients in a clinical practice setting. METHODS: Stable AP outpatients received a FDC of ivabradine and metoprolol (b.i.d.) for 4 months, in addition to cardiovascular standard therapy...
December 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/29113937/characterization-of-gastrointestinal-adverse-effects-reporting-in-clinical-studies-of-corticosteroid-therapy
#15
Tone Westergren, Sigrid Narum, Marianne Klemp
OBJECTIVE: To examine whether 159 studies included in a previous meta-analysis reported on gastrointestinal bleeding or perforation in accordance with the the CONSORT extension for reporting harms outcomes (CONSORT Harms recommendations checklist), whether differences were associated with funding source, journal or publication year, and whether the CONSORT Harms checklist is a suitable tool for evaluation of adverse effects reporting. STUDY DESIGN AND SETTING: Articles were assessed for fulfilment of the CONSORT Harms recommendations, funding source, publication type and year...
November 4, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29113880/-enhanced-system-for-maternal-mortality-surveillance-in-france-context-and-methods
#16
C Deneux-Tharaux, M Saucedo
Maternal mortality, despite its rarity in rich countries, remains a fundamental indicator of maternal health. It is considered as a "sentinel event", consequence of dysfunctions of the health care system, often cumulative. In addition to the classical epidemiological surveillance outcomes-number of deaths, maternal mortality ratio and identification of the subgroups of women at risk-its study allows an accurate analysis of each deceased woman's trajectory to identify opportunities for improvements in the content or organization of care; the correction of which will make it possible to prevent deaths but also upstream morbid events affected by the same dysfunctions...
November 4, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29113534/the-relationship-between-neuropsychological-tests-of-visuospatial-function-and-lobar-cortical-thickness
#17
Davor N Zink, Justin B Miller, Jessica Z K Caldwell, Christopher Bird, Sarah J Banks
INTRODUCTION: Tests of visuospatial function are often administered in comprehensive neuropsychological evaluations. These tests are generally considered assays of parietal lobe function; however, the neural correlates of these tests, using modern imaging techniques, are not well understood. In the current study we investigated the relationship between three commonly used tests of visuospatial function and lobar cortical thickness in each hemisphere. METHOD: Data from 374 patients who underwent a neuropsychological evaluation and MRI scans in an outpatient dementia clinic were included in the analysis...
November 7, 2017: Journal of Clinical and Experimental Neuropsychology
https://www.readbyqxmd.com/read/29108796/multifunctional-neuroprotective-effect-of-withanone-a-compound-from-withania-somnifera-roots-in-alleviating-cognitive-dysfunction
#18
Anjali Pandey, Sarang Bani, Prabhu Dutt, Naresh Kumar Satti, Krishan Avtar Suri, Ghulam Nabi Qazi
Alzheimer's disease (AD) is a chronic disorder that slowly worsens and impairs the person's memory, learning, reasoning, judgment, communication and familiar tasks with loss of orientation. AD is characterized clinically by cognitive deficit and pathologically by the deposition of β amyloid plaques, neurofibrillary tangles, associated with degeneration of the cholinergic forebrain. Withanone (WS-2), a compound isolated from root extract of Withania somnifera at doses administered orally/day to wistar rats for duration of 21 days showed significant improvement in the cognitive skill by inhibiting amyloid β-42 and attenuated the elevated levels of pro-inflammatory cytokines like TNF alpha, IL-1 beta, IL-6, MCP-1, Nitric oxide, lipid peroxidation and both β- and γ- secretase enzymatic activity...
November 3, 2017: Cytokine
https://www.readbyqxmd.com/read/29107948/assessment-of-pleural-air-leakage-using-digital-chest-drainage-system-after-surgical-pulmonary-resection-comparison-of-visible-alveolar-air-leakage-with-the-digital-value-measured-by-a-digital-chest-drainage-system
#19
Ryo Mori, Koji Yamazaki, Fumihiro Shoji, Hidenori Kouso, Chie Ushijima, Naoko Miura, Tomoyoshi Takenaka, Sadanori Takeo
BACKGROUND: The sensitivity of postoperative pleural air leakage (PAL) after pulmonary resection is evaluated by a simple subjective grading method in clinical practice. A new electronic digital chest drainage evaluation system (DCS) recently became clinically available. This study was designed to evaluate the clinical application of the DCS in monitoring the airflow volume and managing postoperative PAL. METHODS: We prospectively enrolled 25 patients who underwent pulmonary resection...
2017: PloS One
https://www.readbyqxmd.com/read/29107010/combining-high-sensitivity-cardiac-troponin-and-b-type-natriuretic-peptide-in-the-detection-of-inducible-myocardial-ischemia
#20
Christian Puelacher, Max Wagener, Ursina Honegger, Mustafa Assadian, Nicolas Schaerli, Deborah Mueller, Ivo Strebel, Raphael Twerenbold, Jasper Boeddinghaus, Thomas Nestelberger, Karin Wildi, Zaid Sabti, Lorraine Sazgary, Patrick Badertscher, Jeanne du Fay de Lavallaz, Stella Marbot, Christoph Kaiser, Damian Wild, Michael J Zellweger, Tobias Reichlin, Christian Mueller
BACKGROUND: Single biomarker approaches provide only moderate accuracy in the non-invasive detection of exercise-induced myocardial ischemia. We therefore assessed the combination of the two most promising single biomarkers: high-sensitivity cardiac troponin I (hs-cTnI) and B-type natriuretic peptide (BNP). METHODS: Consecutive patients with suspected myocardial ischemia referred to stress myocardial perfusion single-photon emission tomography imaging (MPI) were enrolled...
November 8, 2017: Clinical Biochemistry
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