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International Journal of Clinical Practice

David L Streiner
In 1763, the Philosophical Transactions of the Royal Society, London published a letter by a Mr. Bayes and Mr. Price called "An Essay towards Solving a Problem in the Doctrine of Chances".1 In fact, Mr. Bayes was the Reverend Thomas Bayes, a Dissenting (i.e., non-Church of England) minister who had actually died two years previously, thus turning the doctrine of "publish or perish" on its head. By itself, this letter was too vague to serve as the basis for an entire branch of statistics, much less the source of on-going controversy in the field...
February 15, 2019: International Journal of Clinical Practice
Shimpei Komoto, Shizuka Koh, Kenji Matsushita, Kohji Nishida
A 77-year-old Japanese female diagnosed with familial amyloid polyneuropathy type IV (FAP-IV) was referred for an ophthalmologic evaluation. Her general appearance showed a mask-like face because of facial nerve paralysis (Figure 1) and she exhibited tongue atrophy caused by hypoglossal nerve palsy (Figure 2). Corrected distance visual acuity was 6/9.6 meters in the right eye and 6/6 meters in the left eye. Intraocular pressure was 26 mm Hg in the right eye and 22 mm Hg in the left eye (normal range, 10 to 21 mm Hg)...
February 6, 2019: International Journal of Clinical Practice
Matthew J Leach, Heather Eaton, Tamara Agnew, Manisha Thakkar, Marlene Wiese
BACKGROUND: The past few decades have witnessed a surge in consumer, clinician and academic interest in the field of integrative health care (IHC). Yet, there is still uncertainty regarding the effectiveness of IHC for complex, long-term health conditions. OBJECTIVE: To assess the effectiveness of IHC for the management of any chronic health condition. METHODS: Seven databases and four clinical trial registries were searched from inception through to May 2018 for comparative/controlled clinical trials investigating the effectiveness of IHC for any chronic disease, and assessing any outcome...
February 5, 2019: International Journal of Clinical Practice
Aditya Narain, Chun Shing Kwok, Adam Lea, Paul Ridley, Richard Warwick, Ronald Manorekang Dokter, Nikita Goel, Chun Wai Wong, Adrian Shufflebotham, Lognathen Balacumaraswami, Mamas A Mamas
Since its introduction, coronary artery bypass grafting (CABG) has been the revascularisation intervention of choice in patients with complex coronary artery disease [1]. CABG is the most common cardiac surgical procedure [3]. Those reshospitalised within 30 days of discharge incur greater healthcare costs and have worse prognoses [4,5]. This article is protected by copyright. All rights reserved.
February 5, 2019: International Journal of Clinical Practice
Rasheedat T Zakare-Fagbamila, Elisabeth Seyferth, Tracy Z Cheng, Mary Clement, Bethany Stroup, Oren N Gottfried
OBJECTIVES: Up to half of all patients leave their outpatient clinic visit with an uncommunicated need. We designed the Clinic Satisfaction Tool (CST) as a low-cost, highly-utilized assessment of the spine clinic experience that improved communication in our multidisciplinary spine practice. The purpose of this study was to qualitatively analyze chief complaints and feedback from the CSTs to determine how spine clinic patients used the form, identify the most prevalent concerns, and mark areas for improvement...
January 31, 2019: International Journal of Clinical Practice
Jose J Egido, Rocio Gomez, Sotero P Romero, Jose L Andrey, Daniel Ramirez, Ana Rodriguez, Maria J Pedrosa, Francisco Gomez
AIMS: There is currently no consensus on the effect of treatment with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), on the prognosis of patients with heart failure and preserved ejection fraction (HFpEF). Therefore, we have analyzed the relationship of commencing treatment with ACEIs or ARBs and the prognosis of patients with incident HFpEF. METHODS: Retrospective study over 15 years on 3864 patients with HFpEF (GAMIC cohort)...
January 29, 2019: International Journal of Clinical Practice
Miguel Ángel Alaminos-Castillo, Ailec Ho-Plagaro, Sara García-Serrano, Concepción Santiago-Fernandez, Francisca Rodríguez-Pacheco, Lourdes Garrido-Sanchez, Cristina Rodriguez, Sergio Valdes, Montserrat Gonzalo, Francisco J Moreno-Ruiz, Alberto Rodríguez-Cañete, Custodia Montiel-Casado, Eduardo Garcia-Fuentes
AIMS: The paraoxonase-1 (PON1) enzyme could play an important role in the antioxidant capacity of HDL. However, there are no studies which analyze the evolution of the three activities of PON1 (PON arylesterase, PON paraoxonase and PON lactonase) after Roux-en-Y Gastric Bypass (RYGB) in morbidly obese subjects. We analyzed the association of PON concentration and activities with the evolution of morbidly obese subjects who underwent RYGB, and its relationship with biochemical variables and different atherogenic indices...
January 25, 2019: International Journal of Clinical Practice
Chih-Wan Lin, Wei-I Huang, Pi-Hui Chao, Wen-Wen Chen, Fei-Yuan Hsiao
AIMS: Allopurinol carries a well-known risk of cutaneous adverse reactions (CARs). Although febuxostat, a xanthine-oxidase inhibitor with different chemical structure, has been considered an alternative to allopurinol, post-marketing case reports of life-threatening febuxostat-related CARs have been reported. We aimed to compare the risk of CARs between allopurinol and febuxostat in real-world settings and to assess the impact of the market entry of febuxostat on allopurinol use and associated CARs...
January 25, 2019: International Journal of Clinical Practice
Elia Touma, Naiel Bisharat
AIMS: To determine the relationship between trends in admission serum albumin and long term mortality in medical patients with hospital readmission. MATERIALS AND METHODS: We used a cohort of patients admitted to 5 departments of internal medicine during 3 years. Survival analysis was performed based on mean admission serum albumin levels and trends in albumin values from recurrent admissions. RESULTS: A total of 5396 patients had 16640 admissions (readmission cohort), another 9422 patients were admitted only once (single admission cohort)...
January 21, 2019: International Journal of Clinical Practice
José M Molero, Ana Moragas, Beatriz González López-Valcárcel, Lars Bjerrum, Josep M Cots, Carl Llor
AIMS: Few studies have evaluated the long-term impact of interventions on antibiotic prescription for lower respiratory tract infections (LRTI). This study was aimed at evaluating the use of antibiotics prescribed for LRTIs by general practitioners (GP) who underwent a multifaceted intervention carried out six years earlier. METHODS: GPs who had completed two registrations in 2008 and 2009 were again invited to participate in a third audit-based study in 2015. A multifaceted intervention was held one to three months before the second registration...
January 21, 2019: International Journal of Clinical Practice
Nazma Akter Nazu, Jaana Lindström, Päivi Rautiainen, Hilkka Tirkkonen, Katja Wikström, Teppo Repo, Tiina Laatikainen
AIMS: This study assessed type 2 diabetes treatment outcomes and process indicators using a comprehensive type 2 diabetes patient cohort in North Karelia, Finland, from 2011 to 2016. METHODS: Data from all diagnosed type 2 diabetes patients (n = 8,429) living in North Karelia was collated retrospectively from regional electronic patient records. We assessed whether HbA1c and LDL were measured and managed as recommended. RESULTS: The HbA1c measurement rate improved (78% vs...
January 21, 2019: International Journal of Clinical Practice
Anthony S Wierzbicki, Timothy M Reynolds
Pathology is not usually a glamourous subject. However, this year things have been different. "Bad Blood" - a book - and not just a song by Taylor Swift, won the Financial Times/McKinsey Business book of the year award. A presentation by the author was a standing room only ticketed event at the American Association of Clinical Chemistry meeting this year. What was the story? It contained blondes, blood, bankers (ex-Goldman Sachs-appropriately), and Silicon Valley skullduggery - a film is being made...
January 11, 2019: International Journal of Clinical Practice
Ahad Eshraghian, Saman Nikeghbalian, Kourosh Kazemi, Mohsenreza Mansoorian, Alireza Shamsaeefar, Hesameddin Eghlimi, Siavash Gholami, Heshmatollah Salahi, Seyed Ali Malek-Hosseini
AIM: Portal vein thrombosis (PVT) is a common complication amongst patients with liver cirrhosis. The PVT risk factors and its impact on post-liver transplant outcome has not been well defined, yet. This study aimed to investigate PVT prevalence, its risk factors and influence on early and long-term outcomes after liver transplantation. METHODS: Adult (>18 years) patients with liver cirrhosis undergoing liver transplantation between March 2013 to March 2015 were included...
December 28, 2018: International Journal of Clinical Practice
Zhe Sun, Yuqi Liu, Ye Zhang, Xinhong Guo, Yong Xu
BACKGROUND: Novel oral anticoagulants are the cornerstone of therapy for non-valvular atrial fibrillation patients to lower the risk of ischemic stroke. Given the lack of head-to-head comparisons among oral anticoagulants, a Bayesian analysis was used to evaluate their safety and efficacy based on studies from real-world practice. METHODS: The PubMed, Embase, Cochrane, and Web of Science databases were searched for relevant studies. Bayesian analyses were conducted to estimate hazard ratios (HR) and 95% credible intervals (CrI) for the safety and efficacy oral anticoagulants...
December 27, 2018: International Journal of Clinical Practice
Jonathan P Law, Luke Pickup, Jonathan N Townend, Charles J Ferro
The toast "Vive la difference! - Long live the difference!" is routinely used to celebrate individual variation, particularly of men and women 1 . However, arguably the phrase promotes male and female conformity to stereotypes, ignoring the wide spectrum of abilities and diverse characteristics within each gender group. There may be equally large differences within each gender than between the sexes?. This article is protected by copyright. All rights reserved.
December 23, 2018: International Journal of Clinical Practice
T K Olesen, M A Denys, A S Goessaert, E Bruneel, V Decalf, T Helleputte, J Paul, P Gramme, K Everaert
PURPOSE: The main objective of our study was to determine which combination of modifiable and non-modifiable parameters that could discriminate patients with nocturia from those without nocturia. This will allow to study the etiology of nocturia and to estimate the treatment effect that address bladder capacity or nocturnal urine production on the number of nocturnal voids without need to uniform definitions for nocturnal polyuria or a reduced functional bladder capacity. METHOD: This was a post-hoc analysis of 3 prospective, observational studies conducted in Ghent University...
December 16, 2018: International Journal of Clinical Practice
Richard Albert Stein
Chronic wounds, often called ulcers, are a worldwide challenge and were recently referred to as a silent epidemic [1-4]. They have been classified into vascular, diabetic, and pressure ulcers, have a significant impact on the individual, the healthcare system, and society as a whole [5-7], and affect virtually all aspects of life [8, 9]. The medical and socioeconomic impact of chronic ulcers is escalating worldwide, a trend at least partly driven by escalating health care costs, an aging population, an increase in the incidence of diabetes, and the obesity pandemic [1, 10, 11]...
December 12, 2018: International Journal of Clinical Practice
Nasir Wabe, Maria R Dahm, Ling Li, Robert Lindeman, Alex Eigenstetter, Johanna I Westbrook, Andrew Georgiou
OBJECTIVE: To determine variation in pathology test ordering practices and identify associated factors for adult patients presenting to emergency departments (ED) with chest pain and subsequently admitted with ischaemic heart disease. METHODS: A retrospective study across six hospital EDs in New South Wales, Australia. A total of 6769 patient presentations between January 2014 and December 2017 met the inclusion criteria. Ordered pathology tests were grouped into three categories based on Australasian College for Emergency Medicine and the Royal College of Pathologists of Australasia recommendations: category I (no restriction in ordering), category II (can be ordered after consulting a supervisor) and category III (not for routine ordering in ED)...
December 10, 2018: International Journal of Clinical Practice
A H Heald, T Palit, M Livingston, C Duff, A Fryer
The study is important because many patients with T2DM appear to be tested for thyroid dysfunction on a regular basis, which is not what guidance advocates. Previously we have demonstrated that adherence to guidance is patchy sometimes resulting in thyroid hormone status being tested less than is advised. Nevertheless this testing appears to be worthwhile as we have shown that there is increased likelihood of developing thyroid dysfunction in T2DM - we would therefore propose that screening for thyroid dysfunction should be part of routine practice While there is no specific guidance to support regular thyroid function testing in patients with T2DM, we suggest that annual screening should be considered, in order not to miss developing hypothyroidism in people with T2DM...
December 7, 2018: International Journal of Clinical Practice
Paul M Ryan
A multitude of epidemiological cross-sectional and case-control studies have now indicated that overly-stringent or 'tight' glycaemic control in the elderly is at best of no benefit to the patient and at worst a reckless endeavour. Rodiguez-Poncelas et al. recently demonstrated that this issue remains unresolved by presenting data in the International Journal of Clinical Practice on this somewhat under-acknowledged aspect of diabetes care.1 Perhaps now is the time for physicians to take note and implement a mantra of 'leave well enough alone' in the case of the diabetic elderly...
December 5, 2018: International Journal of Clinical Practice
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