471,909 results match your criteria clinical practice

Obesity and the Risk of Infertility, Gestational Diabetes, and Type 2 Diabetes in Polycystic Ovary Syndrome.

Semin Reprod Med 2021 Apr 19. Epub 2021 Apr 19.

Monash Centre for Health Research and Implementation, Monash University, Victoria, Australia.

This review describes the relationship between obesity and the most common reproductive (infertility) and metabolic (gestational diabetes mellitus [GDM] and type 2 diabetes mellitus [T2DM]) consequences in polycystic ovary syndrome (PCOS). It also describes the vital role of lifestyle management for PCOS. PCOS is a heterogeneous endocrine disorder common in reproductive-age women. Read More

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[Update on diagnosis and therapy in frequent vestibular and balance disorders].

Fortschr Neurol Psychiatr 2021 Apr 19. Epub 2021 Apr 19.

LMU Klinikum, Neurologische Klinik und Deutsches Schwindel- und Gleichgewichtszentrum (DSGZ).

The 8 most frequent vestibular disorders account for more than 70% of all presentations of vertigo, dizziness, and imbalance. In acute (and mostly non-repetitive) vestibular disorders acute unilateral vestibulopathy and vestibular stroke are most important, in episodic vestibulopathies benign paroxysmal positional vertigo (BPPV), Menière's disease and vestibular migraine, and in chronic vestibular disorders bilateral vestibulopathy/presbyvestibulopathy, functional dizziness and cerebellar dizziness. In the last decade, internationally consented diagnostic criteria and nomenclature were established for the most frequent vestibular disorders, which can be easily applied in clinical practice. Read More

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May the Cleaning of Prescriptive Documents Using Best Evidence Reduce the Cost of Prescribed Healthcare?

Value Health Reg Issues 2021 Apr 16;25:108-111. Epub 2021 Apr 16.

National Research University Higher School of Economics, Moscow. Electronic address:

Objectives: Clinical practice is developing under influence of the evidence-based clinical practice guidelines (EBCPG). In Russia development of the documents prescribing the content of care is connected with the idea that they may be used as well for estimation of the cost of care. The outcome is the national healthcare legislation of 2011. Read More

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Applicability of GLI 2012 spirometry equation among preschool aged Jordanian.

Respir Med 2021 Apr 16;182:106397. Epub 2021 Apr 16.

Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan. Electronic address:

Objectives: The Validation of Global Lung Initiative (GLI 2012) equations is required prior to their application in clinical practice in different regions. This study validated the GLI 2012 equations in Middle Eastern preschool aged children, which was not previously conducted.

Study Design: Spirometry measures were collected from 765 (54% males) healthy 3 to 5-year-old Jordanian children. Read More

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Current perceptions of cancer nurses in France about their role and the evolution of nursing practices: Findings and perspectives.

Soc Sci Med 2021 Apr 3;277:113896. Epub 2021 Apr 3.

University of Saint-Etienne, Centre Hygée, Institut Presage, CIC-EC Inserm 1408, Saint-Etienne, France. Electronic address:

Background: Florence Nightingale lamented that nurses were seen as merely obedient and devoted. Our two previous oncology studies demonstrated the continuum of strictly curative care and paternalistic care practices among healthcare professionals. At a time when France has just formalized the nursing sciences, this article seeks to shed light on the specifics of the nursing role in oncology and the evolution of standard nursing practices in a rapidly changing environment. Read More

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Novel PD-1 inhibitor prolgolimab: expanding non-resectable/metastatic melanoma therapy choice.

Eur J Cancer 2021 Apr 16;149:222-232. Epub 2021 Apr 16.

JSC BIOCAD, Saint Petersburg, Russia.

Background: Prolgolimab is an IgG1 anti-PD-1 (programmed cell death protein 1) monoclonal antibody containing the Fc-silencing 'LALA' mutation. We assessed the efficacy and safety of two dosing regimens of prolgolimab in patients with advanced melanoma in a multicenter open-label parallel-arm phase II trial (MIRACULUM). We present the final analysis after 1 year of follow-up and additional efficacy results from 2 years of follow-up. Read More

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Care of frail and older adults: A content analysis of paramedic operational clinical practice guidelines.

Int Emerg Nurs 2021 Apr 16;56:101007. Epub 2021 Apr 16.

Tasmanian School of Medicine, College of Health and Medicine, Division of Paramedicine, University of Tasmania, Private Bag 34, Hobart 7001, Tasmania, Australia. Electronic address:

Introduction: Frailty rates are increasing with population ageing. In paramedicine, Clinical Practice Guidelines (CPGs) are essential documents that support decision making, yet little evidence exists regarding the support CPGs provide paramedics in the care of frail and older adults.

Aim: To investigate how CPGs support paramedics' care of frail and older adults. Read More

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Treatment with IgM-enriched immunoglobulin in sepsis: a matched case-control analysis.

J Crit Care 2021 Apr 5;64:120-124. Epub 2021 Apr 5.

Fundación Santa Fe de Bogotá, Bogotá, Colombia.

The therapeutic potential of IgM-enriched immunoglobulin preparations (IgGAM) in sepsis remains a field of debate. The use of polyclonal immunoglobulins as adjuvant therapy (Esen & Tugrul, 2009; Kaukonen et al., 2014; Molnár et al. Read More

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COVID-19: A call for mentorship in radiology.

Clin Imaging 2021 Apr 12;79:48-51. Epub 2021 Apr 12.

Department of Radiology, University MD Anderson Cancer Center, Houston, TX, USA. Electronic address:

During the COVID-19 pandemic, mentorship relationships have undergone significant strain. Sudden changes in the practice environment have caused radiologists to focus their attention to more immediate and essential clinical needs, thus leaving important extracurricular non-clinical endeavors like mentorship by the wayside. However, mentorship is essential more than ever during the pandemic to build strength and resilience in radiology. Read More

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Surgical Diseases are Common and Complicated for Criminal Justice Involved Populations.

J Surg Res 2021 Apr 16;265:27-32. Epub 2021 Apr 16.

The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire.

Background: At any given time, almost 2 million individuals are in prisons or jails in the United States. Incarceration status has been associated with disproportionate rates of cancer and infectious diseases. However, little is known about the burden emergency general surgery (EGS) in criminal justice involved (CJI) populations. Read More

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Burden of Kidney Disease, Health-Related Quality of Life, and Employment Among Patients Receiving Peritoneal Dialysis and In-Center Hemodialysis: Findings From the DOPPS Program.

Am J Kidney Dis 2021 Apr 16. Epub 2021 Apr 16.

St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. Electronic address:

Rationale & Objective: Individuals faced with decisions regarding kidney replacement therapy options need information on how dialysis treatments might affect daily activities and quality of life, and what factors might influence the evolution over time of the impact of dialysis on daily activities and quality of life.

Study Design: Observational cohort study.

Setting & Participants: 7,771 HD and PD participants from 6 countries participating in the Peritoneal and Dialysis Outcomes and Practice Patterns Studies (PDOPPS/DOPPS). Read More

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Identification of patient benefit from proton beam therapy in brain tumour patients based on dosimetric and NTCP analyses.

Radiother Oncol 2021 Apr 16. Epub 2021 Apr 16.

OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Dresden, Germany; German Cancer Consortium (DKTK), partner site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany, Helmholtz Association / Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany. Electronic address:

Background: The limited availability of proton beam therapy (PBT) requires individual treatment selection strategies, such as the model-based approach. In this study, we assessed the dosimetric benefit of PBT compared to photon therapy (XRT), analysed the corresponding changes in normal tissue complication probability (NTCP) on a variety of available models, and illustrated model-based patient selection in an in-silico study for patients with brain tumours.

Methods: For 92 patients treated at two PBT centres, volumetric modulated arc therapy treatment plans were retrospectively created for comparison with the clinically applied PBT plans. Read More

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Use of capsule endoscopy in Inflammatory Bowel Disease in clinical practice in Spain. Results from a national survey.

Gastroenterol Hepatol 2021 Apr 16. Epub 2021 Apr 16.

Unidad de Enfermedad Inflamatoria Intestinal, Hospital Universitari Mútua Terrassa, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain.

Introduction: Small bowel capsule endoscopy (SBCE) is a non-invasive diagnostic technique whose use in inflammatory bowel disease (IBD) has spread. A panenteric capsule, PillCam Crohn's (PCC), has recently been developed. We lack information on the availability and use of the CEID and PCC in our environment. Read More

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Cryptococcal meningoencephalitis: time for action.

Lancet Infect Dis 2021 Apr 16. Epub 2021 Apr 16.

Antimicrobial Pharmacodynamics and Therapeutics, Institute of Translational Medicine, University of Liverpool, Liverpool Health Partners, Liverpool, UK.

Cryptococcal meningoencephalitis was first described over a century ago. This fungal infection is preventable and treatable yet continues to be associated with excessive morbidity and mortality. The largest burden of disease resides in people living with HIV in low-income and middle-income countries. Read More

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Impact of the ICD-9-CM to ICD-10-CM transition on the incidence of severe maternal morbidity amongst delivery hospitalizations in the United States.

Am J Obstet Gynecol 2021 Apr 16. Epub 2021 Apr 16.

Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Quebec, Canada.

Background: Surveillance of maternal mortality and severe maternal morbidity (SMM) is important to identify temporal trends, evaluate the impact of clinical practice changes or interventions, and to monitor quality of care. A common source for SMM surveillance is hospital discharge data. On October 1, 2015 all hospitals in the United States transitioned from International Classification of Disease Version 9 Clinical Modification (ICD-9-CM) to International Classification of Disease Version 10 Clinical Modification (ICD-10-CM) coding for diagnoses and procedures. Read More

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The clinical applications of five-alpha reductase inhibitors.

Kevin R Loughlin

Can J Urol 2021 Apr;28(2):10584-10588

Harvard Medical School, Vascular Biology Laboratory, Boston Children's Hospital, Boston, Massachusetts, USA.

INTRODUCTION Five-alpha reductase (5-AR) deficiency was first identified by Imperato-McGinley and Walsh as the cause of pseudohermaphroditism in two separate studies. The discoveries led to the development of finasteride (inhibitor of type 2 isoenzyme of 5-AR) and dutasteride (inhibitor of type 1 and type 2 isoenzymes of 5-AR. Both drugs have been proven effective for the treatment of benign prostatic hyperplasia and improve voiding symptoms, reduce the risk of urinary retention and the need for prostate surgery. Read More

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Effects of nasopharyngeal microbiota in respiratory infections and allergies.

Clin Exp Pediatr 2021 Apr 15. Epub 2021 Apr 15.

Division of Pediatric Infectious Diseases, Departments of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.

The human microbiome, which consists of a collective cluster of commensal, symbiotic, and pathogenic microorganisms living in the human body, plays a key role in host health and immunity. The human nasal cavity harbors commensal bacteria that suppress the colonization of opportunistic pathogens. However, dysbiosis of the nasal microbial community is associated with many diseases, such as acute respiratory infections including otitis media, sinusitis and bronchitis and allergic respiratory diseases including asthma. Read More

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Chronic hypertension in pregnancy: synthesis of influential guidelines.

J Perinat Med 2021 Apr 19. Epub 2021 Apr 19.

Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Chronic hypertension in pregnancy accounts for a substantial proportion of maternal morbidity and mortality and is associated with adverse perinatal outcomes, most of which can be mitigated by appropriate surveillance and management protocols. The aim of this study was to review and compare recommendations of published guidelines on this condition. Thus, a descriptive review of influential guidelines from the National Institute for Health and Care Excellence, the Society of Obstetric Medicine of Australia and New Zealand, the International Society of Hypertension, the International Society for the Study of Hypertension in Pregnancy, the European Society of Cardiology, the International Federation of Gynecology and Obstetrics, the Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists on chronic hypertension in pregnancy was conducted. Read More

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Current use of botulinum neurotoxin in Aesthetic practice - Clinical guide and review.

J Cosmet Dermatol 2021 Apr 19. Epub 2021 Apr 19.

Instituto Boggio (Boggio Medical Institute), São Paulo, Brazil.

Background: Botulinum neurotoxin is one of the most versatile and widely used medical products in the world.

Aims: The review's focus is the plastic and dermatologic uses of botulinum neurotoxin currently supported by published data.

Methods: Relevant clinical articles regarding botulinum neurotoxin use in plastic surgery, dermatology, and general aesthetic literature were searched and reviewed. Read More

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Examining the utility of the Violence Prevention Climate scale: In a metropolitan Australian general hospital.

J Clin Nurs 2021 Apr 19. Epub 2021 Apr 19.

Department of Nursing, Midwifery and Health, Northumbria University, Newcastle-Upon-Tyne, UK.

Aim And Objectives: To evaluate and examine the utility of the Violence Prevention Climate scale by generalist healthcare professionals.

Background: Workplace violence in general hospital settings remains a challenge for healthcare organisations. High rates of violence are still being reported towards healthcare workers, despite organisational violence prevention strategies being implemented. Read More

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Improving hypertension knowledge, medication adherence, and blood pressure control: A feasibility study.

J Clin Nurs 2021 Apr 19. Epub 2021 Apr 19.

Department of Nursing, Johns Hopkins University School of Nursing, Baltimore, MD, USA.

Aims And Objectives: To examine the feasibility of a culturally tailored education programme for Haitian immigrants diagnosed with hypertension.

Background: Hypertension is a major public health problem, impacting more than 26% of the global population. The overall prevalence of hypertension is 45. Read More

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Enablers and barriers in hospital-to-home transitional care for stroke survivors and caregivers: A systematic review.

J Clin Nurs 2021 Apr 19. Epub 2021 Apr 19.

College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.

Aims And Objectives: To synthesise qualitative research evidence on the experience of stroke survivors and informal caregivers in hospital-to-home transitional care.

Background: Due to a shortened hospital stay, stroke survivors/caregivers must take over complex care on discharge from hospital to home. Gaps in the literature warrant a meta-synthesis of qualitative studies on perceived enablers and barriers during this crucial period. Read More

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A single-center real-life experience on effectiveness and safety of dupilumab in adolescents with severe atopic dermatitis in treatment with cyclosporine A.

J Eur Acad Dermatol Venereol 2021 Apr 19. Epub 2021 Apr 19.

Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Dupilumab, a fully human monoclonal antibody that inhibits the IL-4 receptor α subunit, has been recently approved for adolescents with inadequately controlled moderate-to-severe atopic dermatitis (AD). Although large clinical trials in adolescents have demonstrated its safety and efficacy1,2, few real life data are still available3. Studies carried out required a 4-week washout period for any systemic immunosuppressants prior to starting dupilumab. Read More

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Effectiveness of a family nurse-led programme on accuracy of blood pressure self-measurement: A randomised controlled trial.

J Clin Nurs 2021 Apr 19. Epub 2021 Apr 19.

Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.

Aims And Objectives: To evaluate the effectiveness of a Family Nurse Practitioner (FNP)-led programme on the degree of adherence of current recommendations on home blood pressure self-measurement (HBPM) as compared to routine care and management.

Background: HBPM plays an important role for monitoring hypertensive patients; however, patients' adherence to current guidelines is unsatisfactory. A nurse-led training programme in the community setting could be an effective strategy to achieve high level of patients' adherence to recommendations. Read More

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Systemic photoprotection in 2021.

Clin Exp Dermatol 2021 Apr 19. Epub 2021 Apr 19.

Department of Dermatology, Aalborg University Hospital, Aalborg, Denmark.

Systemic photoprotection aims to negate the negative effects of ultraviolet radiation-induced DNA damage. Systemic supplements might be used as a monotherapy or in combination with topical sunscreens. Using the keywords 'carotenoids,' 'flavonoids,' 'systemic photoprotection,' 'polyphenols' and 'polypodium leucotomos extract," we searched the databases MEDLINE and EMBASE to find relevant English-language articles. Read More

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Wi-Fi enabled dermoscopy: What is the potential in clinical practice and pedagogy?

Clin Exp Dermatol 2021 Apr 19. Epub 2021 Apr 19.

Department of Dermatology & STD, North Delhi Municipal Corporation Medical College & Hindu Rao Hospital, New Delhi, India.

Wi-Fi (Wireless Fidelity) is a wireless networking technology which operates without using any cables or wiring. Various computing devices, such as, mobile phones, laptops, smart televisions, and desktops are inherently Wi-Fi enabled. Compared to the use of conventional dermoscopy, the use of Wi-Fi in dermatoscopes is relatively unexplored. Read More

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Prospective cohort study: Causes of stillbirth in Australia 2013-2018.

Aust N Z J Obstet Gynaecol 2021 Apr 19. Epub 2021 Apr 19.

NHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - University of Queensland, Brisbane, Queensland, Australia.

Background: Stillbirth is a major public health problem that is slow to improve in Australia. Understanding the causes of stillbirth through appropriate investigation is the cornerstone of prevention and important for parents to understand why their baby died.

Aim: The aim of this study is to assess compliance with the Perinatal Society of Australia and New Zealand (PSANZ) Perinatal Mortality Clinical Practice Guidelines (2009) for stillbirths. Read More

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Complications of abortion and need for appropriate ultrasound assessment and peri-abortion care.

Aust N Z J Obstet Gynaecol 2021 Apr 19. Epub 2021 Apr 19.

Department of Gynaecology, St Vincent's Hospital, Sydney, New South Wales, Australia.

Abortion is an essential medical service; however, the lack of standardised protocols and follow-up can cause unintended harm. We present four cases of post-abortion complications presenting to a Sydney tertiary hospital which could have been avoided by appropriate ultrasound prior to abortion and peri-abortion care. While social progress has led to significant reforms in abortion law, clinical guidelines must also be updated and consistently applied to ensure safety of this practice. Read More

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Prevalence and Distribution of Ankle Joint Equinus in 249 Consecutive Patients Attending a Foot and Ankle Specialty Clinic.

J Am Podiatr Med Assoc 2021 Mar;111(2)

Background: The definition of equinus varies from less than 0° to less than 25° of dorsiflexion with the foot at 90° to the leg. Despite its pervasive nature and broad association with many lower-extremity conditions, the prevalence of ankle equinus is unclear. Furthermore, there are few data to suggest whether equinus is predominantly a bilateral finding or isolated to the affected limb only. Read More

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Knowledge, attitude, perception, and preventative practices towards COVID-19 in sub-Saharan Africa: A scoping review.

PLoS One 2021 19;16(4):e0249853. Epub 2021 Apr 19.

Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa.

Background: Knowledge, attitudes, perception, and preventative practices regarding coronavirus- 2019 (COVID-19) are crucial in its prevention and control. Several studies have noted that the majority of people in sub-Saharan African are noncompliant with proposed health and safety measures recommended by the World Health Organization (WHO) and respective country health departments. In most sub-Saharan African countries, noncompliance is attributable to ignorance and misinformation, thereby raising questions about people's knowledge, attitudes, perception, and practices towards COVID-19 in these settings. Read More

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