54,194 results match your criteria Clinician News[Journal]


The impact of age on the validity of psychosis-risk screening in a sample of help-seeking youth.

Psychiatry Res 2019 Feb 10;274:30-35. Epub 2019 Feb 10.

Human Services Psychology Department, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA. Electronic address:

Self-report screening instruments offer promise in furthering early identification of at-risk youth, yet current efforts are limited by false positive rates. Identifying moderators of accuracy is a potential step towards improving identification and prevention efforts. We investigated the moderating effect of age on self-reported attenuated positive symptoms from the Prime Screen and clinician diagnosed clinical high-risk/early psychosis (CHR/EP) status. Read More

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http://dx.doi.org/10.1016/j.psychres.2019.02.020DOI Listing
February 2019

Torsion of a uterine leiomyoma - a rare cause of hemoperitoneum; a case report and review of the literature.

Med Ultrason 2019 Feb;21(1):77-82

1st Department of Obstetrics and Gynecology, University of Medecine and Pharmacy "Iuliu Hatieganu", Cluj Napoca, Romania.

Uterine leiomyomas are common benign uterine tumors but by contrast, their acute complications are very rare. We present an unusual case of 38-year-old woman that came to the emergency department with acute abdominal pain. The ultrasound revealed hemoperitoneum, a uterus with two intramural fibroids and a tender inhomogeneous pelvic mass that seems to connect with the uterus. Read More

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http://dx.doi.org/10.11152/mu-1784DOI Listing
February 2019

Advancing Women Leaders in Global Health: Getting to Solutions.

Ann Glob Health 2018 Nov 5;84(4):743-752. Epub 2018 Nov 5.

Stanford Center for Innovation in Global Health, Stanford Universitz, Stanford, US.

Background: Women comprise 75% of the health workforce in many countries and the majority of students in academic global health tracks but are underrepresented in global health leadership. This study aimed to elucidate prevailing attitudes, perceptions, and beliefs of women and men regarding opportunities and barriers for women's career advancement, as well as what can be done to address barriers going forward.

Methods: This was a convergent mixed-methods, cross-sectional, anonymous, online study of participants, applicants, and those who expressed an interest in the Women Leaders in Global Health Conference at Stanford University October 11-12, 2017. Read More

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http://dx.doi.org/10.9204/aogh.2384DOI Listing
November 2018

Humour in clinical-educational interactions between graduate student clinicians and people with aphasia.

Int J Lang Commun Disord 2019 Feb 19. Epub 2019 Feb 19.

Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.

Background: During clinical interactions, clinicians and people with aphasia (PWA) use humour and laughter for a range of purposes, most of which contribute to friendly interactions in which the participants appear to develop a positive regard for one another. Moreover, humour is a vital component of facework, or the processes interactants engage in to protect their own and one another's well-respected, public personas.

Aims: To examine the ways in which speech-language pathology graduate student clinicians enlist humour during one-on-one therapy sessions for PWA. Read More

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http://dx.doi.org/10.1111/1460-6984.12461DOI Listing
February 2019

Impact of access to novel therapies on the initial management of castrate-resistant prostate cancer: an Australian multicentre study.

Intern Med J 2019 Feb 18. Epub 2019 Feb 18.

Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.

Background: The impact of regulatory approvals of new therapies for castration-resistant prostate cancer (CRPC) in Australia is unclear.

Aims: To determine if changes in novel therapy access in Australia affected how clinicians initially managed men with newly-diagnosed CRPC.

Methods: Data from patients diagnosed with CRPC from 2013-2016 across three Australian hospitals were retrospectively collected. Read More

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http://dx.doi.org/10.1111/imj.14262DOI Listing
February 2019

Ethics of Incongruity: moral tension generators in clinical medicine.

Authors:
Nicholas Kontos

J Med Ethics 2019 Feb 18. Epub 2019 Feb 18.

Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.

Affectively uncomfortable concern, anxiety, indecisionand disputation over 'right' action are among the expressions of moral tension associated with ethical dilemmas. Moral tension is generated and experienced by people. While ethical principles, rules and situations must be worked through in any dilemma, each occurs against a backdrop of people who enact them and stand much to gain or lose depending on how they are applied and resolved. Read More

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http://dx.doi.org/10.1136/medethics-2018-105161DOI Listing
February 2019

The Early Psychosis Screener for Internet (EPSI)-SR: Predicting 12 month psychotic conversion using machine learning.

Schizophr Res 2019 Feb 14. Epub 2019 Feb 14.

Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093-0810, USA. Electronic address:

Introduction: A faster and more accurate self-report screener for early psychosis is needed to promote early identification and intervention.

Methods: Self-report Likert-scale survey items were administered to individuals being screened with the Structured Interview for Psychosis-risk Syndromes (SIPS) and followed at eight early psychosis clinics. An a priori analytic plan included Spectral Clustering Analysis to reduce the item pool, followed by development of Support Vector Machine (SVM) classifiers. Read More

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http://dx.doi.org/10.1016/j.schres.2019.01.015DOI Listing
February 2019
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Should antipsychotic medications for schizophrenia be given for a lifetime? Replication of a naturalistic, long-term, follow-up study of antipsychotic treatment.

CNS Spectr 2019 Feb 19:1-7. Epub 2019 Feb 19.

4College of Medicine,University of Illinois,Chicago,Illinois,USA.

Objective: Because ethically and practically a randomized control trial of antipsychotics will never be done, we recently conducted and reported a 8- to 50-year, naturalistic follow-up from an academic clinic of patients with chronic schizophrenia on antipsychotic medication. We found that better medication adherence was a statistically significant predictor of better long-term global outcome and life satisfaction. Because there were important limitations on our findings, we now in this communication, using similar methodology, detail outcomes for a very different sample-inner city patients with chronic schizophrenia with a long past history of antipsychotic treatment, who were enrolled in clinical trials for new medications for schizophrenia. Read More

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http://dx.doi.org/10.1017/S109285291800144XDOI Listing
February 2019

Toward more efficient diagnostic criteria sets and rules: The use of optimization approaches in addiction science.

Addict Behav 2019 Feb 5. Epub 2019 Feb 5.

Department of Psychological Science, University of Missouri, United States.

Psychiatric diagnostic systems, such as The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), use expert consensus to determine diagnostic criteria sets and rules (DCSRs), rather than exploiting empirical techniques to arrive at optimal solutions (OS). Our project utilizes complete enumeration (i.e. Read More

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http://dx.doi.org/10.1016/j.addbeh.2019.02.005DOI Listing
February 2019

GLA:D Back: implementation of group-based patient education integrated with exercises to support self-management of back pain - protocol for a hybrid effectiveness-implementation study.

BMC Musculoskelet Disord 2019 Feb 18;20(1):85. Epub 2019 Feb 18.

Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.

Background: Reassuring patient education and exercise therapy are widely recommended interventions for back pain in clinical guidelines. However, many patients are offered non-guideline endorsed options, and strategies for effective implementation of guideline-based care have not yet been developed. This protocol outlines the evaluation of a strategy for nationwide implementation of standardised patient education and exercise therapy for people with persistent or recurrent back pain in a hybrid implementation-effectiveness design. Read More

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http://dx.doi.org/10.1186/s12891-019-2443-1DOI Listing
February 2019

The relationship between health-related quality of life and speech in patients with cleft palate.

Int J Pediatr Otorhinolaryngol 2019 Feb 8;120:112-117. Epub 2019 Feb 8.

Ghent University, Department of Rehabilitation Sciences, Speech-language Pathology/Audiology, Research Group, Ghent, Belgium; University of Pretoria, Faculty of Humanities, Department of Speech-Language Pathology and Audiology, Pretoria, South Africa.

Introduction: In health-care, current efforts focus on providing patient-centered care. Specifically for patients with velopharyngeal insufficiency, and by extent patients with cleft palate, the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) questionnaire (Skirko et al., 2012; 2013) allows the clinician to map the impact of speech and swallowing difficulties on the patient's health-related quality of life (HRQoL). Read More

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http://dx.doi.org/10.1016/j.ijporl.2019.02.018DOI Listing
February 2019

A Palm-Worn Device to Quantify Rigidity in Parkinson's Disease.

J Neurosci Methods 2019 Feb 15. Epub 2019 Feb 15.

Bionics Institute, East Melbourne, Victoria, Australia; Department of Medical Bionics, University of Melbourne, East Melbourne, Victoria, Australia.

Background: Parkinsonian rigidity is identified on clinical examination as resistance to passive movement. Measurement of rigidity commonly relies on ordinal rating scales (MDS-UPDRS), however instrumented objective measures may provide greater mechanistic insight.

New Method: We present a palm-worn instrument to objectively quantify rigidity on a continuous scale. Read More

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http://dx.doi.org/10.1016/j.jneumeth.2019.02.006DOI Listing
February 2019
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Practice patterns and role perception of advanced practice nurses: A nationwide cross-sectional study.

J Nurs Manag 2019 Feb 18. Epub 2019 Feb 18.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.

Aims: To provide an overview of the practice patterns of advanced practice nurses and to explore their perceptions of their role in Singapore.

Background: Role expansion of advanced practice nurses is increasingly popular in healthcare systems. However, their practice patterns remain variable, thereby introducing role ambiguity. Read More

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http://dx.doi.org/10.1111/jonm.12759DOI Listing
February 2019

Investigative practice into sudden death in epilepsy: A global survey.

Acta Neurol Scand 2019 Feb 18. Epub 2019 Feb 18.

Department of Intellectual Disability Neuropsychiatry, Cornwall Partnership NHS Foundation Trust, Truro, TR1 3QB, UK.

Objectives: Sudden death is a recognised consequence of epilepsy. Little is known about the practice of confirming the cause of sudden death from most nations. We sought to determine how often autopsy is undertaken, clinician confidence in cause of death, and identify the factors which may influence autopsy utilization. Read More

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http://dx.doi.org/10.1111/ane.13080DOI Listing
February 2019

Health State Utilities Associated with Treatment Options for Acute Myeloid Leukemia (AML).

J Med Econ 2019 Feb 18. Epub 2019 Feb 18.

f Jazz Pharmaceuticals, Inc. , Palo Alto , CA , USA.

Aims Acute myeloid leukemia (AML) treatment typically involves remission induction chemotherapy followed by consolidation chemotherapy. New treatments for AML have recently been introduced, including a chemotherapy formulation called CPX-351, which is administered via less time-intensive IV infusion than the standard "7 + 3" continuous infusion regimen of cytarabine plus an anthracycline. The purpose of this study was to estimate utilities that could be used in economic modeling of AML treatment. Read More

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http://dx.doi.org/10.1080/13696998.2019.1584108DOI Listing
February 2019

A web-based intervention for carers of individuals with anorexia nervosa (We Can): Trial protocol of a randomised controlled trial investigating the effectiveness of different levels of support.

Internet Interv 2019 Apr 22;16:76-85. Epub 2018 Feb 22.

King's College London, Institute of Psychiatry, Psychology and Neuroscience, Section of Eating Disorders, PO Box 59, 16, De Crespigny Park, London, SE5 8AF, UK.

Background: Anorexia nervosa (AN) is a life-threatening mental disorder that is associated with substantial caregiver burden. Carers of individuals with AN report high levels of distress and self-blame, and insufficient knowledge to help their loved ones. However, carers can have a very important role to play in aiding recovery from AN, and are often highly motivated to assist in the treatment process. Read More

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http://dx.doi.org/10.1016/j.invent.2018.02.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364327PMC

Addressing the information deficit in global health: lessons from a digital acute care platform in Sri Lanka.

BMJ Glob Health 2019 29;4(1):e001134. Epub 2019 Jan 29.

Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka.

Lack of investment in low-income and middle-income countries (LMICs) in systems capturing continuous information regarding care of the acutely unwell patient is hindering global efforts to address inequalities, both at facility and national level. Furthermore, this of lack of data is disempowering frontline staff and those seeking to support them, from progressing setting-relevant research and quality improvement. In contrast to high-income country (HIC) settings, where electronic surveillance has boosted the capability of governments, clinicians and researchers to engage in service-wide healthcare evaluation, healthcare information in resource-limited settings remains almost exclusively paper based. Read More

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http://dx.doi.org/10.1136/bmjgh-2018-001134DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352842PMC
January 2019

Klotho, fibroblast growth factor-23, and the renin-angiotensin system - an analysis from the PEACE trial.

Eur J Heart Fail 2019 Feb 18. Epub 2019 Feb 18.

Thrombolysis in Myocardial Infarction (TIMI) Study Group, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.

Aims: Klotho, an essential co-receptor for fibroblast growth factor (FGF)-23, has potentially beneficial inhibitory effects on the renin-angiotensin system. Limited data exist on the prognostic value of Klotho and FGF-23 levels in combination or their ability to predict benefit from angiotensin-converting enzyme (ACE) inhibition.

Methods And Results: A total of 3555 patients with stable ischaemic heart disease and left ventricular ejection fraction > 40% enrolled in the PEACE trial of trandolapril vs. Read More

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http://dx.doi.org/10.1002/ejhf.1424DOI Listing
February 2019

After the RESTART trial: six guidelines for clinical trials of early stuttering intervention.

Int J Lang Commun Disord 2019 Feb 17. Epub 2019 Feb 17.

Australian Stuttering Research Centre, The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia.

Background: The Rotterdam Evaluation Study of Stuttering Therapy randomized trial (RESTART) was seminal, comparing the Lidcombe Program with RESTART Demands and Capacities Model-based treatment (RESTART-DCM) for pre-school age children who stutter.

Aims: To critique the methods of the RESTART trial to develop guidelines for its systematic replication and extension. Beyond that, to contribute to the refinement of existing methodological guidelines for early stuttering intervention. Read More

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http://dx.doi.org/10.1111/1460-6984.12463DOI Listing
February 2019

Chronic maxillary atelectasis (including silent sinus syndrome) can present bilaterally.

J Laryngol Otol 2019 Feb 18:1-5. Epub 2019 Feb 18.

Department of Otolaryngology Head and Neck Surgery,Westmead Hospital,Sydney,Australia.

Objective: Chronic maxillary atelectasis is a rare and underdiagnosed condition in which there is a persistent and progressive decrease in maxillary sinus volume secondary to inward bowing of the antral walls. Chronic maxillary atelectasis is typically unilateral. Simultaneous bilateral chronic maxillary atelectasis is extremely uncommon. Read More

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http://dx.doi.org/10.1017/S0022215119000252DOI Listing
February 2019

The molecular immunology of human susceptibility to fungal diseases: lessons from single gene defects of immunity.

Authors:
Donald C Vinh

Expert Rev Clin Immunol 2019 Feb 18. Epub 2019 Feb 18.

a Director, Infectious Disease Susceptibility Program, Associate Professor, FRQS Clinician-Scientist, Dept of Medicine (Division of Infect ious Diseases; Division of Allergy & Clinical Immunology), Dept of Medical Microbiology; Dept of Human Genetics , McGill University Health Centre - Research Institute , 1001 Decarie Blvd; Block E; Rm EM3-3230 (Mail Drop: EM3-3211), Montreal , Quebec , Canada H4A 3J1 , Ph (office); x42811 (admin assist); Fax. Email:

Introduction: Fungal diseases are a threat to human health. Therapies targeting the fungus continue to lead to disappointing results. Strategies targeting the host response represent unexplored opportunities for innovative treatments. Read More

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http://dx.doi.org/10.1080/1744666X.2019.1584038DOI Listing
February 2019

Risk assessment scales to predict risk of hospital treated repeat self-harm: A cost-effectiveness modelling analysis.

J Affect Disord 2019 Feb 11;249:208-215. Epub 2019 Feb 11.

Centre for Mental Health and Safety and Greater Manchester Patient Safety Translational Research Centre, United Kingdom; Centre for Mental Health and Safety, University of Manchester, Jean McFarlane Building Oxford Road, Manchester M13 9PL, United Kingdom; Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom.

Background: Risk scales are used widely for assessing individuals presenting to Emergency Departments (EDs) following self-harm. There is growing evidence that risk scales have limited clinical utility in identifying episodes at highest risk of repeat self-harm. However, their cost-effectiveness in terms of treatment allocation and subsequent repeat self-harm is unknown. Read More

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http://dx.doi.org/10.1016/j.jad.2019.02.036DOI Listing
February 2019

Revisiting systemic treatment of bacterial endophthalmitis: a review of intravitreal penetration of systemic antibiotics.

Clin Microbiol Infect 2019 Feb 13. Epub 2019 Feb 13.

Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research, University Hospital of Basel and University of Basel, Basel, Switzerland.

Background: Adjunctive systemic antibiotic therapy for treatment of bacterial endophthalmitis is controversial but common practice due to the severity of the disease. In absence of guidance documents, several antibiotic regimens are being used without applying evidence-based prescribing, thus leading to inappropriate treatment of this serious eye condition.

Objectives: To summarize available data on intravitreal penetration of systemically administered antibiotics and to discuss their usefulness from a microbiological and pharmacological point of view. Read More

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http://dx.doi.org/10.1016/j.cmi.2019.01.017DOI Listing
February 2019

Update in the classification and the role of intra-arterial stenting in the management of carotid body paragangliomas.

Head Neck 2019 Feb 16. Epub 2019 Feb 16.

Department of Otology & Skull Base Surgery, Gruppo Otologico, Piacenza, Italy.

Background: To review the Shamblin classification of carotid body paragangliomas (CBPs) and the role of intra-arterial stenting in their surgical management.

Methods: Retrospective case series of 20 patients with 28 CBPs that were surgically resected at our center. Intra-arterial stenting was performed in Shamblin II and II classes. Read More

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http://dx.doi.org/10.1002/hed.25567DOI Listing
February 2019

Evaluation of tools for annual capture of adherence to immunosuppressive medications after renal transplantation.

Transpl Int 2019 Feb 15. Epub 2019 Feb 15.

Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Background: Annual assessment of adherence would strengthen long-term outcome assessments from registry data. The objective of this study was to evaluate tools suitable for annual routine capture of adherence data in renal transplant recipients.

Methods: A single centre open prospective trial included 295 renal transplant recipients on tacrolimus. Read More

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http://dx.doi.org/10.1111/tri.13412DOI Listing
February 2019

Influence of Transmucosal Area Morphology on Peri-Implant Bone Loss in Tissue-Level Implants.

Int J Oral Maxillofac Implants 2019 Feb 15. Epub 2019 Feb 15.

Purpose: To analyze peri-implant bone loss around two types of tissue-level implants (convergent and divergent transmucosal morphology) placed in the same region of either the maxilla or mandible in a single surgical session.

Materials And Methods: This prospective study included 21 patients who each received two implants, one with a convergent transmucosal collar (n = 21) the other with a divergent collar (n = 21). Implants were placed in a single surgical session, by the same clinician, in the same clinical setting at the Prosthodontic and Occlusion Unit, University of Valencia (Spain). Read More

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http://dx.doi.org/10.11607/jomi.7329DOI Listing
February 2019

Widespread Adoption of Guidelines Will Require Automated Clinician Decison Support.

Crit Care Med 2019 Mar;47(3):469-471

Division of Pulmonary and Critical Care, Department of Medicine, University of Utah, Salt Lake City, UT; and Division of Pulmonary and Critical Care, Department of Medicine, Intermountain Medical Center, Murray, UT Division of Pulmonary and Critical Care, Department of Medicine, Intermountain Medical Center, Murray, UT Interdepartmental Division of Critical Care Medicine; and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.

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http://dx.doi.org/10.1097/CCM.0000000000003546DOI Listing

Insights From Organized Crime for Disorganized Health Care.

Authors:
John H Wasson

J Ambul Care Manage 2019 Feb 13. Epub 2019 Feb 13.

Medicine and Community and Family Medicine, Dartmouth-Geisel School of Medicine, Lebanon, New Hampshire.

During college and medical school, the author's summer employment acquainted him with members of organized crime families. After a full career as a primary care clinician and geriatrician with research on improving health care delivery, the author opines that several insights from organized crime should be of interest to health care professionals: (1) don't damage the host; (2) protect the brand; and (3) lead necessary adaption. From these insights, the author presents symptoms of failure evidenced by the US health care system, followed by several adaptations that would reduce the system's costs, improve its image, and address future challenges. Read More

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http://dx.doi.org/10.1097/JAC.0000000000000273DOI Listing
February 2019

Double-Blind, Sham-Controlled, Pilot Study of Trigeminal Nerve Stimulation for ADHD.

J Am Acad Child Adolesc Psychiatry 2019 Jan 28. Epub 2019 Jan 28.

Semel Institute for Neuroscience and Human Behavior and David Geffen School of Medicine at UCLA, Los Angeles, CA.

Objective: Trigeminal nerve stimulation (TNS), a minimal risk, non-invasive neuromodulation method, has showed potential benefits for attention-deficit/hyperactivity disorder (ADHD) in an unblinded open study. This blinded sham-controlled trial was conducted to assess efficacy and safety of TNS for ADHD, as well as potential changes in brain spectral power using resting-state quantitative electroencephalography (qEEG).

Method: 62 children aged 8-12 years, with full-scale IQ ≥ 85 and KSADS-diagnosed ADHD, were randomized to four weeks nightly treatment with active or sham TNS, followed by one-week without intervention. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08908567193004
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http://dx.doi.org/10.1016/j.jaac.2018.11.013DOI Listing
January 2019
1 Read

Multicenter Trial of [F]fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Staging of Head and Neck Cancer and Negative Predictive Value and Surgical Impact in the N0 Neck: Results From ACRIN 6685.

J Clin Oncol 2019 Feb 15:JCO1801182. Epub 2019 Feb 15.

10 University of Arkansas for Medical Sciences, Little Rock, AR.

Purpose: The objective of this study was to determine the negative predictive value (NPV) of positron emission tomography (PET)/computed tomography (CT) for the clinically N0 neck on the basis of neck dissection.

Methods: Participants with newly diagnosed, first-time, head and neck squamous cell carcinoma (HNSCC) and at least one clinically N0 neck side for which dissection was planned were included. A total of 287 participants were prospectively enrolled from 23 American College of Radiology Imaging Network-qualified institutions. Read More

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http://dx.doi.org/10.1200/JCO.18.01182DOI Listing
February 2019
18.428 Impact Factor

Effectiveness of Tai Ji Quan vs Multimodal and Stretching Exercise Interventions for Reducing Injurious Falls in Older Adults at High Risk of Falling: Follow-up Analysis of a Randomized Clinical Trial.

JAMA Netw Open 2019 Feb 1;2(2):e188280. Epub 2019 Feb 1.

School of Kinesiology, Shanghai University of Sport, Shanghai, China.

Importance: Exercise has been shown to reduce injurious falls in older adults. Evidence, however, is lacking regarding the types of intervention that are most effective in preventing injurious falls among older adults at high risk of falling.

Objective: To determine the longer-term effectiveness of therapeutic tai ji quan intervention vs multimodal exercise and stretching exercise in decreasing injurious falls among older adults at high risk of falling. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.8280DOI Listing
February 2019

Association of a blood culture utilization intervention on antibiotic use in a pediatric intensive care unit.

Infect Control Hosp Epidemiol 2019 Feb 15:1-3. Epub 2019 Feb 15.

Division of Pediatric Infectious Diseases,Johns Hopkins School of Medicine,Baltimore, Maryland.

Blood cultures are essential for the evaluation of sepsis. However, they may sometimes be obtained inappropriately, leading to high false-positive rates, largely due to contamination.1 As a quality improvement project, clinician decision-support tools for evaluating patients with fever or signs and symptoms of sepsis were implemented in April 2014 in our pediatric intensive care unit (PICU). Read More

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http://dx.doi.org/10.1017/ice.2019.10DOI Listing
February 2019

Technological features of advanced skin protectants and an examination of the evidence base.

J Wound Care 2019 Feb;28(2):110-125

Head of Vascular Surgery Unit and Wound Centre; Department of Surgery, HFR Fribourg - Cantonal Hospital, Fribourg, Switzerland.

Products that provide a protective skin barrier play a vital role in defending the skin against the corrosive effect of bodily fluids, including wound exudate, urine, liquid faeces, stoma output and sweat. There are many products to choose from, which can be broadly categorised by ingredients. This article describes the differences in mechanisms of action between barrier products comprising petrolatum and/or zinc oxide, silicone film-forming polymers and cyanoacrylates, and compares the evidence on them. Read More

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http://dx.doi.org/10.12968/jowc.2019.28.2.110DOI Listing
February 2019

Incidental Finding of a Suspected Horizontal Root Fracture During Mucogingival Surgery.

Compend Contin Educ Dent 2019 Feb;40(2):114-118

Professor, School of Dental Medicine, Department of Periodontics and Endodontics, University at Buffalo, State University of New York, Buffalo, New York.

Periapical and bitewing radiographs lack the sensitivity to reliably diagnose horizontal root fractures, and, therefore, asymptomatic teeth with root fractures may remain undetected for years. This article reports a case in which a patient presented with a mucogingival defect on tooth No. 24 with no apparent history of dental trauma. Read More

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February 2019

A qualitative study of sexual and reproductive health communication with adolescent and young adult oncology patients.

Pediatr Blood Cancer 2019 Feb 15:e27673. Epub 2019 Feb 15.

Perini Family Survivors Center, Dana-Farber Cancer Institute, Boston, Massachusetts.

Background: Adolescent and young adult patients with cancer (AYAs) identify sexual and reproductive health (SRH) as an important but often neglected aspect of their comprehensive cancer care. The purpose of this study was to explore AYA perceptions and experiences of SRH communication with oncology clinicians.

Methods: Twenty-three AYA patients and survivors ages 15-25 years from a large academic oncology center participated in semistructured qualitative interviews investigating their experiences discussing SRH issues, including specific topics discussed, conversation barriers and facilitators, suggestions for clinicians on how to improve conversations, and education and resource needs. Read More

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http://dx.doi.org/10.1002/pbc.27673DOI Listing
February 2019

Genomics of posttraumatic stress disorder in veterans: Methods and rationale for Veterans Affairs Cooperative Study #575B.

Int J Methods Psychiatr Res 2019 Feb 14:e1767. Epub 2019 Feb 14.

School of Medicine, Yale University, New Haven, Connecticut, USA.

Objectives: Heritability in the risk for developing posttraumatic stress disorder (PTSD) has been established, but most genome-wide association studies (GWASs) of PTSD involve relatively small sample sizes and limited identification of associated genetic loci. This report describes the methodology of a Veterans Affairs (VA) Cooperative Studies Program GWAS of PTSD among combat-exposed U.S. Read More

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http://dx.doi.org/10.1002/mpr.1767DOI Listing
February 2019
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Animated stories of medical error as a means of teaching undergraduates patient safety: an evaluation study.

Perspect Med Educ 2019 Feb 14. Epub 2019 Feb 14.

Imperial College Healthcare NHS Trust, London, UK.

Background: Storytelling is a powerful form of communication which can improve attention and lead to lasting behavioural changes. Addressing the need to incorporate patient safety teaching into undergraduate medical curricula, it was hypothesized that medical students could benefit from hearing clinician stories of medical error. The medium of animation was considered to be a potentially engaging means of presenting stories of error to a large audience. Read More

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http://dx.doi.org/10.1007/s40037-019-0498-1DOI Listing
February 2019

"Told": the Word Most Correlated to Negative Online Hospital Reviews.

J Gen Intern Med 2019 Feb 14. Epub 2019 Feb 14.

Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.

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http://dx.doi.org/10.1007/s11606-019-04870-6DOI Listing
February 2019

A regression based phase I clinical trial for late-onset toxicities without clinician elicitation.

Contemp Clin Trials Commun 2019 Jun 30;14:100327. Epub 2019 Jan 30.

Louisiana State University Health Sciences Center, New Orleans, 2020 Gravier Street, New Orleans, LA, 70112, USA.

An extension of the isotonic regression based phase I clinical trial design is presented that incorporates partial follow-up times into estimation of the raw toxicity probabilities. This phase I clinical trial design, called the TITE-IR design, drastically decreases average trial duration by allowing patients to be treated immediately after being enrolled in a phase I clinical trial. The TITE-IR design does not require specification of a prior skeleton of toxicity probabilities like the continual reassessment method, has an additional trial parameter for controlling aggressiveness of dose escalation, and has an easily understood formula for estimating toxicity probabilities. Read More

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http://dx.doi.org/10.1016/j.conctc.2019.100327DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360989PMC

Improved Transitional Care Through an Innovative Hospitalist Model: Expanding Clinician Practice From Acute to Subacute Care.

Fed Pract 2018 Sep;35(9):28-34

is a Hospitalist Physician; is Director of Quality Improvement, Geriatrics Extended Care Service; and is Chief, Geriatrics and Extended Care Service, all at Veterans Affairs Boston Healthcare System in Massachusetts. Dr. Ruopp and Dr. Baughman are Instructors in Medicine and Dr. Simon is an Associate Professor of Medicine at Harvard Medical School in Boston, Massachusetts.

Hospitalist physician rotations between acute inpatient hospitals and subacute care facilities with dedicated time in each environment may foster quality improvement and educational opportunities. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366793PMC
September 2018

Prescribing for transgender patients.

Authors:
Louise Tomlins

Aust Prescr 2019 Feb 1;42(1):10-13. Epub 2019 Feb 1.

Taylor Square Private Clinic, Sydney.

With Greater Awareness And Social Acceptance Increasing Numbers Of Transgender Individuals Are Presenting For Gender-affirming Hormone Treatment There Should Be A Full Psychosocial Assessment By An Experienced Clinician Before Hormone Treatment Is Considered:

People Assigned As Males At Birth Who Transition To Female Gender Are Transgender Females Their Management Includes An Estrogen Plus An Anti-androgen:

People Assigned As Females At Birth Who Transition To Male Gender Are Transgender Males Their Hormone Treatment Is Testosterone:

Treatment Is Titrated So That Hormone Concentrations Are Equivalent To The Physiological Concentrations Of The Preferred Gender This Aims To Minimise Adverse Effects: Read More

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http://dx.doi.org/10.18773/austprescr.2019.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370611PMC
February 2019

The Electronic Asthma Management System (eAMS) Improves Primary Care Asthma Management.

Eur Respir J 2019 Feb 14. Epub 2019 Feb 14.

The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada.

A high prevalence of suboptimal asthma control is attributable to known evidence-practice gaps. We developed a computerised clinical decision support system (the Electronic Asthma Management System - eAMS) to address major care gaps and sought to measure its impact on care in adults with asthma.This was a 2-year interrupted time series study of usual care (year 1) eAMS (year 2) at 3 Canadian primary care sites. Read More

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http://dx.doi.org/10.1183/13993003.02241-2018DOI Listing
February 2019
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Assessing the quality of primary healthcare in seven Chinese provinces with unannounced standardised patients: protocol of a cross-sectional survey.

BMJ Open 2019 Feb 13;9(2):e023997. Epub 2019 Feb 13.

Xiangya School of Public Health, Central South University, Changsha, China.

Introduction: Primary healthcare (PHC) serves as the cornerstone for the attainment of universal health coverage (UHC). Efforts to promote UHC should focus on the expansion of access and on healthcare quality. However, robust quality evidence has remained scarce in China. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023997DOI Listing
February 2019

How often do both core competencies of shared decision making occur in family medicine teaching clinics?

Can Fam Physician 2019 Feb;65(2):e64-e75

Associate Professor in the Department of Family and Emergency Medicine and a researcher in the Office of Education and Professional Development at Laval University, Population Health and Optimal Health Practices at the Research Centre of the CHU de Québec, the Ottawa Hospital Research Institute in Ontario, and the CERSSPL-UL.

Objective: To assess how often risk communication and values clarification occur in routine family medicine practice and to explore factors associated with their occurrence.

Design: Qualitative and quantitative cross-sectional study.

Setting: Five university-affiliated family medicine teaching clinics across Quebec. Read More

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February 2019
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Exercise Testing Oversights Underlie Missed and Delayed Diagnosis of Catecholaminergic Polymorphic Ventricular Tachycardia in Young Sudden Cardiac Arrest Survivors.

Heart Rhythm 2019 Feb 11. Epub 2019 Feb 11.

Departments of Cardiovascular Medicine (Division of Heart Rhythm Services), Pediatric and Adolescent Medicine (Division of Pediatric Cardiology), and Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN. Electronic address:

Background: Catecholamingergic polymorphic ventricular tachycardia (CPVT) is characterized by adrenergically-induced VT, syncope, and sudden cardiac arrest (SCA). In the absence of structural disease, exercise-provoked premature ventricular contractions in bigeminy/couplets and non-sustained VT are highly predictive of CPVT.

Objective: To determine the number of missed/delayed CPVT diagnoses attributable to exercise testing oversights in a cohort of young SCA survivors. Read More

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http://dx.doi.org/10.1016/j.hrthm.2019.02.012DOI Listing
February 2019

Survivor and Clinician Assessment of Survivorship Care Plans for Hematopoietic Stem Cell Transplant Patients: An Engineering, Primary Care, and Oncology Collaborative for Survivorship Health.

Biol Blood Marrow Transplant 2019 Feb 11. Epub 2019 Feb 11.

University of Wisconsin, Madison; University of Wisconsin Carbone Cancer Center. Electronic address:

Background: The long-term care of hematopoietic stem cell transplant (HSCT) survivors poses special challenges due to a myriad of possible chronic and/or late complications. Survivorship care plans (SCPs) have been proposed as a tool to communicate information regarding the late effects of treatment and recommended follow-up care to clinicians and survivors. Our primary objective was to determine SCP content and format as well as to assess preferred timing of SCP provision following HSCT. Read More

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http://dx.doi.org/10.1016/j.bbmt.2019.02.003DOI Listing
February 2019

Two case reports of synchronous unilateral pleomorphic adenoma and cystadenolymphoma of the parotid gland with literature review.

J Ultrason 2018 ;18(75):369-373

Department of Otorhinolaryngology, Head and Neck Surgery , Klinikum Augsburg, Augsburg , Germany.

Synchronous unilateral tumors in the parotid glands account for less than 5-10% of all salivary gland neoplasms. Mostly these are cystadenolymphomas, but tumors of different histological types can be found as well. In these cases it is often pleomorphic adenoma in combination with cystadenolymphoma. Read More

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http://dx.doi.org/10.15557/JoU.2018.0055DOI Listing
January 2018

[Vitamin D deficiency and rickets : screening and treatment, practical aspects for clinicians].

Rev Med Suisse 2019 Feb;15(638):384-389

Unité romande de néphrologie pédiatrique, Hôpital des enfants, 1211 Genève 4.

Vitamin D deficiency is increasing in Switzerland. If cases of rickets are scarce, pediatricians are often dealing with patients presenting vitamin D deficiency. The increase in vitamin D deficiency is certainly due to modification of life habits in recent decades. Read More

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February 2019

Adjunctive simvastatin for treatment-resistant depression: study protocol of a 12-week randomised controlled trial.

BJPsych Open 2019 Jan;5(1):e13

Chair of Mood Disorders,Institute of Psychiatry, Psychology and Neuroscience,King's College London,UK.

Background: A third of patients diagnosed with major depressive disorder (MDD) experience treatment-resistant depression (TRD). Relatively few pharmacological agents have established efficacy for TRD. Therefore, the evaluation of novel treatments for TRD is a pressing priority. Read More

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http://dx.doi.org/10.1192/bjo.2018.84DOI Listing
January 2019
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Brain imaging in psychiatric disorders: target or screen?

BJPsych Open 2019 Jan;5(1):e4

Consultant Neuropsychiatrist and Director, Neuropsychiatry Unit,Royal Melbourne Hospital; andMelbourne Neuropsychiatry Centre,Melbourne Health and University of Melbourne,Australia.

SummaryThere is currently debate about when a clinician should consider neuroimaging for patients with a known psychiatric illness. We consider this topic and propose a set of 'red flags' to use to aid decision-making.Declaration of interestNone. Read More

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http://dx.doi.org/10.1192/bjo.2018.79DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343113PMC
January 2019
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