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Observation management

A Lyne, J Johnson, D Baldwin
BACKGROUND: Inhalation sedation (IHS), using nitrous oxide and oxygen, is a commonly used form of pharmacological behaviour management in paediatric dentistry. Previous studies suggest that IHS causes a delay in reaction time, which recovers to baseline within 10 min. AIM: To observe the reaction times (RT) of children before and after undergoing IHS for dental treatment. DESIGN: Sixty children from clinics at St Thomas' Hospital (London, UK) participated in this observational study...
March 16, 2019: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
Krystal Khoo, Ryan E K Man, Gwyn Rees, Preeti Gupta, Ecosse L Lamoureux, Eva K Fenwick
IMPORTANCE: Previous work has reported a link between diabetic retinopathy/diabetic macular edema (DR/DME) and psychosocial functioning, although the extent and direction of the association remains uncertain. OBJECTIVE: To determine the relationship between DR/DME and psychosocial functioning, the latter an umbrella term used to capture the emotional and social aspects of functioning which may include, for example, depression; depressive disorder; anxiety; vision-specific distress; diabetes-specific distress and emotional and social well-being...
March 16, 2019: Quality of Life Research
Karel Allegaert, Dick Tibboel, John van den Anker
Effective analgesia in neonates is relevant not only because of ethical aspects or empathy, but it is a crucial and integral part of medical and nursing care. However, there is also emerging evidence - although mainly in animal models - on the relation between the exposure to narcotics and impaired neurodevelopmental outcome, resulting in a CATCH-22 scenario. Consequently, a balanced approach is needed with the overarching intention to attain adequate pain management with minimal side effects. Despite the available evidence-based guidance on narcotics in ventilated neonates, observations on drug utilization still suggest an overall increase in exposure with extensive variability between units...
March 17, 2019: Handbook of Experimental Pharmacology
Talha Qureshi, T Peter Nguyen, Ruifei Wang, Diana Willis, Rajesh Shah, Jason K Hou
BACKGROUND: Anemia is a common complication of inflammatory bowel disease (IBD). Despite existing guidelines for anemia in IBD, it is frequently under-treated and the prevalence of anemia has remained high. To address this gap, the Crohn's and Colitis Foundation developed the Anemia Care Pathway (ACP). AIMS: To implement the ACP in a managed care setting and identify where it improves practice habits and where barriers remain. METHODS: The ACP was implemented from July 2016 through June 2017 and retrospectively studied...
March 16, 2019: Digestive Diseases and Sciences
Berthold H Jany, Robert Bals, Heike Buhr-Schinner, Michael Dreher, A Rembert Koczulla, Luitgard Jany, Andreas Meyer, Winfried Randerath
In comparison to other chronically ill people, patients suffering from chronic obstructive pulmonary disease (COPD) have many additional difficulties to face and conquer. Due to the contribution of avoidable causes of their illness ("smokers' lung"), society holds people with COPD responsible for their disease, which in return often leads to stigmatization and social isolation. In addition, COPD patients commonly belong to a less privileged social class, own a low socioeconomic status, and lower education...
March 15, 2019: Respiration; International Review of Thoracic Diseases
Heather Angier, Nathalie Huguet, Miguel Marino, Beverly Green, Heather Holderness, Rachel Gold, Megan Hoopes, Jennifer DeVoe
INTRODUCTION: Hypertension is a common chronic health condition. Having health insurance reduces hypertension risk; health insurance coverage could improve hypertension screening, treatment and management. The Medicaid eligibility expansion of the Affordable Care Act was ruled not to be required by the US Supreme Court. Subsequently, a 'natural experiment' was produced with some states expanding Medicaid eligibility while others did not. This presents a unique opportunity to learn whether and to what extent Medicaid expansion can affect healthcare access and services for patients at risk for and diagnosed with hypertension, and patients with undiagnosed hypertension...
March 15, 2019: BMJ Open
Christophe Courtieu, Arnaud Cornille, Melanie Vaast, Sandy Lacombe, Laure Panel
STUDY OBJECTIVE: The aim of this study was the evaluation of ambulatory surgery (AS) rate for pelvic organ prolapse (POP). DESIGN: It was a prospective observational study. DESIGN CLASSIFICATION: Level II-2. SETTING: Patients were divided in two groups: Group EAS: patients eligible to ambulatory surgery and Group NEAS: patients not eligible to AS. PATIENTS: all patients from August 2015 to November 2016 undergoing surgery for POP in our institution...
March 5, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Hsing-Lin LinMD, Yih-Wen Tarng, Tung-Ho WuMD, Fong-Dee Huang, Wen-Yen Huang, Yi-Pin ChouMD
BACKGROUND: Serious blunt chest trauma usually induces hemothorax, pneumothorax, and rib fracture. Early video-assisted thoracoscopic surgery (VATS) to evacuate retained hemothorax is one commonly used treatment. In this study, a new strategy was implemented to combine VATS with fractured rib fixation simultaneously. METHODS: This prospective observational study was performed from January 2013 to April 2018. All patients were aged 18 years or older and had blunt chest trauma with displaced fractures in more than three ribs...
March 13, 2019: International Journal of Surgery
Muhammad Waqas, Kunal Vakharia, Peter V Weimer, Eisa Hashmi, Jason M Davies, Adnan H Siddiqui
INTRODUCTION: Embolization of the middle meningeal artery has emerged as a minimally invasive means of managing subdural hematoma. The purpose of this study was to systematically review the literature on the safety and effectiveness of this treatment and to share our clinical experience. METHODS: This review was registered with the International prospective register of systematic reviews (PROSPERO). Public/Publisher Medline (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica dataBASE (EMBASE) and the Cochrane Library were searched using Medical Subject Headings (MeSH) terms for MMA embolization and CSDH from January 2000 through November 2018...
March 13, 2019: World Neurosurgery
Matthew T Bender, David A Zarrin, Jessica K Campos, Li-Mei Lin, Judy Huang, Justin M Caplan, Rafael J Tamargo, Geoffrey P Colby, Alexander L Coon
INTRODUCTION: Flow diversion is increasingly used for off-label treatments of distal circulation aneurysms. Reports of use in sub-2.0mm vessels are scant. METHODS: A prospectively-collected, IRB-approved cerebral aneurysm database was reviewed to identify patients who underwent flow diversion with a 2.5mm diameter PED. RESULTS: Sixty-seven aneurysms were treated in 67 procedures (66(99%) successful, 64(96%) single device, 2(3%) with two devices) in 57 patients...
March 13, 2019: World Neurosurgery
Tina Van den Meersche, Geertrui Rasschaert, Freddy Haesebrouck, Els Van Coillie, Lieve Herman, Stephanie Van Weyenberg, Els Daeseleire, Marc Heyndrickx
The presence and dissemination of antibiotic residues, antibiotic resistance genes and zoonotic bacteria in the environment is of growing concern worldwide. Manure management practices, such as biological removal of nitrogen from swine manure, may help to decrease levels of antibiotic residues, antibiotic resistance genes and zoonotic bacteria present in manure before fertilization, thereby reducing environmental contamination. Therefore, the aim of this study was to monitor the presence and fate of seven antibiotic residues (colistin, sulfadiazine, trimethoprim, doxycycline, oxytetracycline, ceftiofur and tylosin A), nine antibiotic resistance genes (tet(B), tet(L), tet(M), tet(O), tet(Q), tet(W), erm(B), erm(F) and sul2) and two zoonotic bacteria (Salmonella Typhimurium and Campylobacter coli) during biological nitrogen removal from swine manure over time...
March 14, 2019: Ecotoxicology and Environmental Safety
Yasutoshi Shinoda, Yuki Komatsu, Yukio Sekiguchi, Akihiko Nogami, Kazutaka Aonuma, Masaki Ieda
BACKGROUND: Radiofrequency ablation at the aortic root has the potential risk of aortic regurgitation (AR). OBJECTIVE: This study investigated the incidence and clinical features of iatrogenic AR after catheter ablation of idiopathic ventricular arrhythmias (VAs) originating from the aortic root. METHODS: We studied 45 consecutive patients with idiopathic VAs originating from the aortic cusps (AC group; n=32) and papillary muscles (control group; n=13) who underwent ablation via a retrograde aortic approach and serial echocardiography before and within 24 hours after the ablation procedure...
March 13, 2019: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Thomas Oliver, Brandon Ciaudelli, David A Cohen
Anticoagulation-related nephropathy might just be the most common diagnosis you've never heard of. Formerly known as warfarin-induced nephropathy, until it was observed with numerous other anticoagulants and broadened to anticoagulation-related nephropathy. It is a potentially devastating disorder with serious and life-changing consequences if not recognized and diagnosed swiftly. As the clinician is faced with new acute renal failure, it is important to appreciate those factors that place patients at greater risk of anticoagulation-related nephropathy...
March 13, 2019: American Journal of Medicine
Kosmas I Paraskevas, Gert J de Borst, Frank J Veith
OBJECTIVE: Randomized controlled trials (RCTs) constitute level I evidence and are used as the backbone of guidelines and recommendations for treatment. Although RCTs are theoretically the studies of choice for the assessment of the effectiveness of health care interventions, these trials (and their interpretation) may sometimes result in erroneous conclusions, erroneous therapeutic decisions, and incorrect recommendations. We aimed to check the applicability of the results of RCTs to everyday practice...
March 13, 2019: Journal of Vascular Surgery
Louis Marcellin, Pietro Santulli, Mathilde Bourdon, Clémence Comte, Chloé Maignien, Pierre Alexandre Just, Isabelle Streuli, Bruno Borghese, Charles Chapron
OBJECTIVE: To examine whether serum antimüllerian hormone (AMH) levels correlate with the size of ovarian endometrioma (OMA). DESIGN: An observational cross-sectional study. SETTING: A university hospital. PATIENT(S): Two hundred and sixty-seven nonpregnant women, aged 18-42 years, with no prior history of surgery for endometriosis and a histologically documented ovarian cyst. INTERVENTION(S): Surgical management for a benign ovarian cyst...
March 13, 2019: Fertility and Sterility
Samantha Stephens, Shahriar Shams, Joshua Lee, Stephanie A Grover, Giulia Longoni, Tara Berenbaum, Marcia Finlayson, Robert W Motl, E Ann Yeh
OBJECTIVES: To examine the longitudinal relationship between physical activity and fatigue and depression among youth with demyelinating conditions. STUDY DESIGN: From September 2013 to March 2017, we performed a longitudinal study of consecutive youth diagnosed at their first visit with pediatric onset multiple sclerosis (POMS) or monophasic acquired demyelinating syndromes (mono-ADS) at a neuroinflammatory disorders clinic in a tertiary children's hospital. Fatigue was determined at each visit by the Pediatric Quality of Life Multidimensional Fatigue Scale, depressive symptoms by the Center of Epidemiologic Studies Depression Children Rating Scale, and physical activity level by the Godin Leisure Time Exercise Questionnaire...
March 13, 2019: Journal of Pediatrics
Laura M Mackey, Catherine Blake, Maire-Brid Casey, Camillus K Power, Ray Victory, Conor Hearty, Brona M Fullen
OBJECTIVE: To establish if health literacy (HL) is linked to poorer outcomes and behaviours in patients with chronic pain. DESIGN: A prospective cross-sectional observational study. SETTING: Multidisciplinary out-patient pain clinics in three university teaching hospitals. PATIENTS: New patients (n=131) referred to the pain clinic with a history of chronic pain (>12 weeks). METHODS: A questionnaire was distributed to chronic pain patients attending their first appointment...
November 15, 2018: Physiotherapy
Vanessa Petry do Canto, Claudia Elizabeth Thompson, Paulo Augusto Netz
The global production of plastics increases every year, because these materials are widely used in several segments of modern life. Polyurethanes are a very important class of polymers, used in many areas of everyday life, from automotive equipments to mattresses. The waste management usually involves accumulation in landfills, incineration, and reuse processes. However, bioremediation processes are being increasingly tested, due to the efficiency of enzymes in the degradation, besides adding value to the generated waste...
March 6, 2019: Journal of Molecular Graphics & Modelling
Hamidreza Mahmoudi, Kamran Balighi, Soheil Tavakolpour, Maryam Daneshpazhooh
During the recent decade, several studies have confirmed the high efficacy of targeting the CD20 molecules using rituximab (RTX). Recently, RTX has been suggested as the first-line treatment of pemphigus vulgaris (PV). In this study, the records of all the PV patients, who had received RTX in Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences between the 2009 and 2017, have been reviewed for any sign of disease worsening within three months after treatment. We have observed three PV patients from 612 RTX-exposed patients, who had experienced worsening of disease more than one time after discrete RTX cycles after the first infusion of RTX...
March 12, 2019: International Immunopharmacology
M Taffurelli, A Pellegrini, I Meattini, L Orzalesi, C Tinterri, M Roncella, D Terribile, F Caruso, G Tazzioli, G Pollini, D Friedman, C Mariotti, E Cianchetti, C Cabula, R Thomas, C Cedolini, F Rovera, M Grassi, G Lucani, A Cappella, M Bortul, G Stacul, F Scarabeo, E Procaccini, V Galimberti
BACKGROUND: Breast angiosarcoma is a malignant mesenchymal neoplasm, which accounts for approximately 2% of all soft tissue sarcomas. Secondary breast angiosarcoma (SBA) may be related to chronic lymphedema after a mastectomy with lymph node dissection (Stewart Treves syndrome) and previous radiotherapy for complications from breast radiation treatment. It is a very rare condition; therefore, diagnosis and management are still a challenge. METHODS: The ANISC collected SBA data by means of a survey sent to all Italian breast centres in the ANISC...
March 7, 2019: Breast: Official Journal of the European Society of Mastology
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