27,024 results match your criteria addressing clinical

Increasing Readiness for Early Integrated Palliative Oncology Care: Development and Initial Evaluation of the EMPOWER 2 Intervention.

J Pain Symptom Manage 2021 Apr 14. Epub 2021 Apr 14.

Tulane University; University Medical Center New Orleans. Electronic address:

Context: Early integrated palliative care improves quality of life, but palliative care programs are underutilized. Psychoeducational interventions explaining palliative care may increase patients' readiness for palliative care.

Objectives: To (1) collaborate with stakeholders to develop the EMPOWER 2 intervention explaining palliative care, (2) examine acceptability, (3) evaluate feasibility and preliminary efficacy. Read More

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Brain Metastases: An Update on Multi-disciplinary Approach of Clinical Management.

Neurochirurgie 2021 Apr 14. Epub 2021 Apr 14.

Department of Neurosurgery, University of Wisconsin School of Medicine & Public Health, UW Carbone Cancer Center, Madison, WI, USA. Electronic address:

Importance: Brain metastasis (BM) is the most common malignant intracranial neoplasm in adults with over 100,000 new cases annually in the United States and outnumbering primary brain tumors 10:1.

Observations:  The incidence of BM in adult cancer patients ranges from 10-40%, and is increasing with improved surveillance, effective systemic therapy, and an aging population. The overall prognosis of cancer patients is largely dependent on the presence or absence of brain metastasis, and therefore, a timely and accurate diagnosis is crucial for improving long-term outcomes, especially in the current era of significantly improved systemic therapy for many common cancers. Read More

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Adverse event rates associated with oral anticoagulant treatment early versus later after hospital discharge in older adults: a retrospective population-based cohort study.

CMAJ Open 2021 Apr-Jun;9(2):E364-E375. Epub 2021 Apr 16.

Division of Clinical Pharmacology & Toxicology (Holbrook), Department of Medicine and Department of Health Research Methods, Evidence, and Impact (Holbrook, Benipal, Greaves), McMaster University, Hamilton, Ont.; ICES (Paterson, Gomes); Institute of Health Policy, Management and Evaluation (Paterson), University of Toronto, Toronto, Ont.; Schulich School of Medicine and Dentistry (Lee), Western University, London, Ont.; Li Ka Shing Knowledge Institute (Martins, Gomes), St. Michael's Hospital, Toronto, Ont.

Background: Oral anticoagulants are commonly used high-risk medications, but little is known about their safety in transition from hospital to home. Our objective was to measure the rates of hemorrhage and thromboembolic events among older adults receiving oral anticoagulant treatment early after hospital discharge compared to later.

Methods: We conducted a retrospective population-based cohort study among Ontario residents aged 66 years or more who started, continued or resumed oral anticoagulant therapy at hospital discharge between September 2010 and March 2015. Read More

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Apelin-13 Protects Corpus Cavernosum Against Fibrosis Induced by High-Fat Diet in an MMP-Dependent Mechanism.

J Sex Med 2021 Apr 13. Epub 2021 Apr 13.

Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.

Background: An increased fibrosis of the corpora cavernosa is a prevalent process that underlies most cases of erectile dysfunction. Apelin, an endogenous circulating peptide, has been documented as an important effector on cardiovascular homeostasis, controlling vascular function and reducing fibrosis in multiple pathological conditions. Recently, initial studies have shown that Apelin, acting through the APJ receptor, also modulates penile erection, however, the role of this system on penile structure and intracorporal collagen remodeling has not been investigated yet. Read More

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Use of Three-dimensional Titanium Trusses for Arthrodesis Procedures in Foot and Ankle Surgery: A Retrospective Case Series.

J Foot Ankle Surg 2020 Aug 15. Epub 2020 Aug 15.

Program Director, Foot & Ankle Residency Training Program, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA. Electronic address:

Periarticular osseous defects pose a challenge when considering arthrodesis. Failure to restore the cubic content of bone can result in shortening and malalignment, as well as subsequent biomechanical issues. This study reports on 12 patients treated with patient-specific 3-D printed (7) and prefabricated titanium trusses (5). Read More

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A Multicenter, 10-Year Experience With Hepatocellular Adenoma: Risk Factors and Disease Course.

Am Surg 2021 Apr 16:31348211011084. Epub 2021 Apr 16.

Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.

Background: Management of hepatocellular adenoma (HA) is marked by a paucity of recent studies. Long-term follow-up data from an equal access health care system may facilitate our understanding of the natural disease course of HA and identify modifiable risk factors.

Methods: A multi-institutional, retrospective review of patients with HA from 2008-2017 was performed. Read More

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Medicinal Plants and Phytochemicals Regulating Insulin Resistance and Glucose Homeostasis in Type 2 Diabetic Patients: A Clinical Review.

Adv Exp Med Biol 2021 ;1308:161-183

Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Diabetes is a major health problem affecting more than four hundred million adults worldwide. The transition from normal glucose tolerance to type 2 diabetes (T2D) is preceded by increased Insulin resistance (IR), an independent predictor of the development of T2D in high risk (e.g. Read More

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January 2021

Optical coherence tomography and the proximal lacrimal drainage system: a major review.

Graefes Arch Clin Exp Ophthalmol 2021 Apr 16. Epub 2021 Apr 16.

Center for Ocular Regeneration, L.V. Prasad Eye Institute, Hyderabad, India.

Purpose: To provide a major review of the literature on diagnostic and therapeutic implications, techniques, and utility of anterior segment optical coherence tomography (OCT) for the proximal lacrimal drainage system (PLDS).

Methods: The authors performed a PubMed search of articles published in the English language on anterior segment OCT for the proximal lacrimal drainage system. Data captured include evolution, techniques, diagnostic utility, therapeutic monitoring, outcomes, and limitations. Read More

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Are Patient Expectations and Illness Perception Associated with Patient-reported Outcomes from Surgical Decompression in de Quervain's Tenosynovitis?

Clin Orthop Relat Res 2021 May;479(5):1147-1155

J. Blackburn, N. C. Chen, Hand and Arm Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Background: Psychological factors such as depression, pain catastrophizing, kinesiophobia, pain anxiety, and more negative illness perceptions are associated with worse pain and function in patients at the start of treatment for de Quervain's tenosynovitis. Longitudinal studies have found symptoms of depression and pain catastrophizing at baseline were associated with worse pain after treatment. It is important to study patients opting for surgery for their condition because patients should choose surgical treatment based on their values rather than misconceptions. Read More

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The Society for Obstetric Anesthesia and Perinatology Interdisciplinary Consensus Statement on Neuraxial Procedures in Obstetric Patients With Thrombocytopenia.

Anesth Analg 2021 Feb 4. Epub 2021 Feb 4.

From the *Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan †Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota ‡Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York §Department of Medicine, University of Washington School of Medicine, Seattle, Washington ‖Department of Medicine, Medical College of Wisconsin and Versiti, Milwaukee, Wisconsin ¶Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina #Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee **Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Langone Health, New York, New York ††Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, Liaison for the American College of Obstetricians and Gynecologists ‡‡Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts §§Taubman Health Sciences Library, University of Michigan Medical School, Ann Arbor, Michigan ‖‖Department of Medicine, University of Florida, Gainesville, Florida ¶¶Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina ##Department of Anesthesiology, Hospital for Special Surgery, Weill Cornell Medicine, New York, New York *#x002A;*Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, New York.

Because up to 12% of obstetric patients meet criteria for the diagnosis of thrombocytopenia in pregnancy, it is not infrequent that the anesthesiologist must decide whether to proceed with a neuraxial procedure in an affected patient. Given the potential morbidity associated with general anesthesia for cesarean delivery, thoughtful consideration of which patients with thrombocytopenia are likely to have an increased risk of spinal epidural hematoma with neuraxial procedures, and when these risks outweigh the relative benefits is important to consider and to inform shared decision making with patients. Because there are substantial risks associated with withholding a neuraxial analgesic/anesthetic procedure in obstetric patients, every effort should be made to perform a bleeding history assessment and determine the thrombocytopenia etiology before admission for delivery. Read More

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February 2021

Effects of an interprofessional communication approach on support needs, quality of life and mood of advanced lung cancer patients: a randomized trial.

Oncologist 2021 Apr 16. Epub 2021 Apr 16.

University Hospital Heidelberg, Dept. of General Practice and Health Services Research.

Background: To address the support needs of newly diagnosed lung cancer patients with limited prognosis, the Milestone Communication Approach (MCA) was developed and implemented. Main elements of the MCA are situation-specific conversations along the disease trajectory conducted by an interprofessional tandem of physician and nurse. Aim of the study was to evaluate the effects of MCA on addressing support needs, quality of life and mood as compared to standard oncological care. Read More

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Cultures of Practice: Specialty-Specific Differences in End-of-Life Conversations.

Palliat Med Rep 2021 Mar 24;2(1):71-83. Epub 2021 Mar 24.

Department of Surgery, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.

Goals of care discussions at the end of life give opportunity to affirm the autonomy and humanity of dying patients. Best practices exist for communication around goals of care, but there is no research on differences in approach taken by different specialties engaging these conversations. To describe the communication practices of internal medicine (IM), emergency medicine (EM), and critical care (CC) physicians in a high-fidelity simulation of a terminally ill patient with stable and defined end-of-life preferences. Read More

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Food-related impulsivity assessed by longitudinal laboratory tasks is reduced in patients with binge eating disorder in a randomized controlled trial.

Sci Rep 2021 Apr 15;11(1):8225. Epub 2021 Apr 15.

Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Osianderstraße 5, 72076, Tübingen, Germany.

Food-related impulsivity, i.e. a food-related attentional bias proposed to be due to increased reward sensitivity and diminished inhibitory control, has been cross-sectionally associated with binge eating disorder. Read More

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The Results of Well-conducted Negative Clinical Trials Should Be Reported in a Peer-reviewed Journal.

Roy Fleischmann

J Rheumatol 2021 Apr 15. Epub 2021 Apr 15.

R. Fleischmann, Clinical Professor of Medicine, MD, Metroplex Clinical Research Center, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA. The author declares no conflict of interest. Address correspondence to Dr. R. Fleischmann, 8144 Walnut Hill Lane, Suite 810, Dallas, TX 75231, USA. Email:

We expect that the pathogenesis, manifestations, and successful management of disease will be fully reported in peer-reviewed journals. However, there are multiple publications addressing the likelihood that clinical trials that do not report a positive result are underreported in the medical literature, with a maximum of 50% of negative studies published, even after 5 years of availability of their results. Read More

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The challenges of becoming and being a clinician manager: a qualitative exploration of the perception of medical doctors in senior leadership roles at a large Australian health service.

BMC Health Serv Res 2021 Apr 15;21(1):351. Epub 2021 Apr 15.

Colac Area Health, Colac Victoria, Australia.

Background: In Australia, activity-based funding models have emphasized the need for hospitals to be accountable for their clinical performance. Clinician managers, with medical backgrounds are essential to ensuring high quality clinical performance and operational management of hospital services. The purpose of this study is to 1. Read More

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Sun safety knowledge, practices and attitudes in rural Australian farmers: a cross-sectional study in Western New South Wales.

BMC Public Health 2021 Apr 15;21(1):731. Epub 2021 Apr 15.

Bathurst Rural Clinical School, School of Medicine, Western Sydney University, PO Box 9008, Bathurst, NSW, 2795, Australia.

Background: Rates of skin cancer in Australia are amongst the highest in the world, with Western New South Wales (NSW) exhibiting very high prevalence. There is a large proportion of outdoor workers, including farmers, in Western NSW who have high levels of sun exposure and hence are at greater risk of developing skin cancer.

Aims: To characterise the current sun safety practices of farmers in Western NSW and explore their knowledge, attitudes and perceived barriers towards sun safety and its implementation. Read More

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Comparison of Methods to Reduce Bias From Clinical Prediction Models of Postpartum Depression.

JAMA Netw Open 2021 Apr 1;4(4):e213909. Epub 2021 Apr 1.

Center for Computational Health, IBM Research, Cambridge, Massachusetts.

Importance: The lack of standards in methods to reduce bias for clinical algorithms presents various challenges in providing reliable predictions and in addressing health disparities.

Objective: To evaluate approaches for reducing bias in machine learning models using a real-world clinical scenario.

Design, Setting, And Participants: Health data for this cohort study were obtained from the IBM MarketScan Medicaid Database. Read More

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Frailty in Patients With Hematologic Malignancies and Those Undergoing Transplantation: A Scoping Review.

Oncol Nurs Forum 2021 05;48(3):291-307

Virginia Commonwealth University.

Problem Identification: Although frailty is an important parameter in treatment planning and in predicting prognosis and overall survival among patients with hematologic malignancies and recipients of hematopoietic stem cell transplantation, frailty assessment tools are not standardized in clinical care settings. The purpose of this article is to provide an overview of the literature on frailty assessment tools in these patient populations.

Literature Search: A systematic search of CINAHL®, Embase®, MEDLINE®, PubMed®, and Web of Science was performed using keywords and controlled vocabulary for the concepts "bone marrow transplants," "hematologic neoplasms," and "frailty. Read More

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Corona virus-related Disease Pandemic: A Review on Machine Learning Approaches and Treatment Trials on Diagnosed Population for Future Clinical Decision Support.

Curr Med Imaging 2021 Apr 13. Epub 2021 Apr 13.

Department of Computer Science and Engineering, Professor, LBEF Campus, Kathmandu. Nepal.

Objective: Corona virus-related disease, a deadly illness, has raised public health issues worldwide. The majority of individuals infected are multiplying. The government takes aggressive steps to quarantine people, people exposed to infection, and clinical trials for treatment. Read More

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Virtual Study-Abroad Through Web Conferencing: Sharing Knowledge and Building Cultural Appreciation in Nursing Education and Practice.

J Transcult Nurs 2021 Apr 15:10436596211009583. Epub 2021 Apr 15.

The Ohio State University, Columbus, OH, USA.

Background: With a focus on building global citizens, a U.S. and Norwegian academic collaborative partnership fostered clinical learning experiences addressing cultural and health care comparisons. Read More

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An appraisal of current service delivery and future models of care for young people with gender dysphoria.

Eur J Pediatr 2021 Apr 14. Epub 2021 Apr 14.

Department of Paediatric Endocrinology, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, UK.

The clinical needs of young people with gender dysphoria (GD) have outpaced the capacity of health services to provide appropriate care. The study aimed to explore the interface of Paediatric Endocrinology and young people with GD, detailing the clinical characteristics and the clinical care provided, in order to inform future service development. Medical records of all young people with GD (n=91, 59 (65%) birth-assigned females and 32 (35%) birth-assigned males) referred to Paediatric Endocrinology during 2011-2019 for puberty suppression were reviewed. Read More

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An anatomical composite nasal lining subunit technique in primary cleft nose correction.

Derek A Mendonca

JPRAS Open 2021 Jun 6;28:72-76. Epub 2021 Mar 6.

Adjunct Clinical Associate Professor, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates.

Current primary cleft nose correction techniques are associated with a significant rate of long term alar collapse. The nasal lining on the cleft side has been observed to be distorted and deficient. Nasal endoscopy was used to map the two dimensional topography of the anterior nasal airway lining in a normal and patient with unilateral cleft lip. Read More

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Overall Survival After Systemic Treatment in High-volume Versus Low-volume Metastatic Hormone-sensitive Prostate Cancer: Systematic Review and Network Meta-analysis.

Eur Urol Focus 2021 Apr 11. Epub 2021 Apr 11.

Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada.

Context: Novel prospective randomized controlled observations addressing combination therapy in metastatic hormone-sensitive prostate cancer (mHSPC) have demonstrated promising overall survival (OS) outcomes.

Objective: To compare these novel findings and systematically review and address them within formal network meta-analyses (NMAs) that include observations from other prospective randomized controlled trials (RCTs).

Evidence Acquisition: First, we focused on abiraterone, enzalutamide, apalutamide, and docetaxel effects on OS in mHSPC using the PRISMA methodology. Read More

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Understanding factors associated with sarcopenic obesity in older African women from a low-income setting: a cross-sectional analysis.

BMC Geriatr 2021 Apr 14;21(1):247. Epub 2021 Apr 14.

Health Sciences and Sport, University of Stirling, Stirling, Scotland.

Background: High rates of food insecurity, obesity and obesity-related comorbidities in ageing South African (SA) women may amplify the risk of developing sarcopenic obesity. This study aimed to investigate the prevalence and correlates of sarcopenic obesity and its diagnostic components [grip strength, appendicular skeletal muscle mass (ASM) and body mass index (BMI)] in older SA women from a low-income setting.

Methods: This cross-sectional study recruited black SA women between the ages of 60-85 years (n = 122) from a low-income community. Read More

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Addressing the changing rehabilitation needs of patients undergoing thoracic surgery.

Daniel Langer

Chron Respir Dis 2021 Jan-Dec;18:1479973121994783

Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium.

The rehabilitation needs of individuals undergoing thoracic surgery are changing, especially as surgical management is increasingly being offered to patients who are at risk of developing functional limitations during and after hospital discharge. In the past rehabilitative management of these patients was frequently limited to specific respiratory physiotherapy interventions in the immediate postoperative setting with the aim to prevent postoperative pulmonary complications. In the past two decades, this focus has shifted toward pulmonary rehabilitation interventions that aim to improve functional status of individuals, both in the pre- and (longer-term) postoperative period. Read More

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Cannabis use, pulmonary function, and lung cancer susceptibility: A Mendelian randomization study.

J Thorac Oncol 2021 Apr 11. Epub 2021 Apr 11.

Lunenfeld-Tanenbaum Research Institute, Sinai Health System; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

Introduction: Because of widespread use, understanding the pulmonary effects of cannabis use is important but its role independent from tobacco smoking is yet to be elucidated. We used Mendelian randomization (MR) to assess the effect of genetic liability to lifetime cannabis use and cannabis use disorder on pulmonary function and lung cancer.

Methods: We used four single nucleotide polymorphisms (SNPs) associated with lifetime cannabis use (p value <5x10) from a genome-wide association study (GWAS) of 184,765 individuals of European descent from the International Cannabis Consortium, 23andme and UK Biobank as instrumental variables. Read More

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High prevalence of NRTI and NNRTI drug resistance among ART-experienced, hospitalized inpatients.

J Acquir Immune Defic Syndr 2021 Apr 1. Epub 2021 Apr 1.

Epicentre, Médecins sans Frontières, Paris, France OCP, Médecins sans Frontières, Nairobi, Kenya OCP, Médecins sans Frontières, Homa Bay, Kenya OCB, Médecins sans Frontières, Kinshasa, DRC Kenya Medical Research Institute/Centre for Global Health Research, Kisumu, Kenya Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa Southern African Medical Unit, Médecins sans Frontières, Cape Town, South Africa Centre for Infectious Disease Epidemiology and Research, University of Cape Town, South Africa OCP, Médecins sans Frontières, Paris, France.

Background: Patients hospitalized with advanced HIV have a high mortality risk. We assessed viremia and drug resistance amongst differentiated care services and explored whether expediting the switching of failing treatments may be justified.

Setting: Hospitals in the Democratic Republic of Congo (HIV hospital), and Kenya (general hospital including HIV care). Read More

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Impact of Individual, Organizational, and Technological Factors on the Implementation of an Online Portal to Support a Clinical Pathway Addressing Psycho-Oncology Care: Mixed Methods Study.

JMIR Hum Factors 2021 04 14;8(2):e26390. Epub 2021 Apr 14.

Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia.

Background: Clinical pathways (CPs) can improve patient outcomes but can be complex to implement. Technologies, such as clinical decision support (CDS) tools, can facilitate their use, but require end-user testing in clinical settings.

Objective: This study applied the Technology Acceptance Model to evaluate the individual, organizational, and technological contexts impacting application of a portal to facilitate a CP for anxiety and depression (the ADAPT Portal) in a metropolitan cancer service. Read More

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Knowledge, attitudes, and perceptions related to telemedicine among young doctors and nursing staff at the King Abdul-Aziz University Hospital Jeddah, KSA.

Niger J Clin Pract 2021 Apr;24(4):464-469

Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.

Objective: To investigate the knowledge, perceptions, and attitude of young doctors and nurses at Kind Abdulaziz University Hospital (KAUH) Jeddah, KSA, regarding the effectiveness of telemedicine in dealing with the patients for either follow-up or continuous monitoring of chronic diseases.

Material And Methods: This prospective cross-sectional study was carried out on the young doctors and nursing staff at KAUH. An online questionnaire addressing all the required fields, i. Read More

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Improving data quality in observational research studies: Report of the Cure Glomerulonephropathy (CureGN) network.

Contemp Clin Trials Commun 2021 Jun 17;22:100749. Epub 2021 Feb 17.

NYU Langone Health, Department of Pediatrics, Division of Nephrology, New York, NY, USA.

Background: High data quality is of crucial importance to the integrity of research projects. In the conduct of multi-center observational cohort studies with increasing types and quantities of data, maintaining data quality is challenging, with few published guidelines.

Methods: The Cure Glomerulonephropathy (CureGN) Network has established numerous quality control procedures to manage the 70 participating sites in the United States, Canada, and Europe. Read More

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