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المصدر: The Journal of the American Dental Association. 153:1096-1103
مصطلحات موضوعية: medicine.medical_specialty, Orofacial pain, business.industry, Hearing loss, MEDLINE, Evidence based review, Scientific evidence, stomatognathic diseases, Otorhinolaryngology, medicine, medicine.symptom, Intensive care medicine, business, General Dentistry, Practical implications, Tinnitus
الوصف: Background The aim of this article is to discuss the scientific evidence available on the the pathophysiology and management of otologic complaints in patients with temporomandibular disorders (TMDs). Types of Studies Reviewed The authors conducted an electronic search in MEDLINE, Web of Science and ScienceDirect and retrieved all the relevant peer-reviewed journal articles available in English on the topic. No time restriction was applied. Results No consensus exists on the management of otologic symptoms in patients with concomitant TMD. The scientific evidence suggests that conservative or reversible TMD therapy might provide relief. However, this evidence is scarce and low, thus further studies with larger sample sizes and better designed methodological frameworks are needed. Until such evidence is available, dentists and orofacial pain specialists should treat TMD patients using current guidelines and refer those with otologic symptoms to an otolaryngologist. Practical Implications Given the wide range of potential pathophysiologies and treatments for each otologic symptom described in the TMD patient, close collaboration with otolaryngologists is essential to achieve the best patient care.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::34f16350e50615ca5870d6ea4efb7923Test
https://doi.org/10.1016/j.adaj.2021.07.029Test -
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المصدر: Revista Colombiana de Psiquiatría. 51:326-329
مصطلحات موضوعية: Paliperidone Palmitate, medicine.medical_specialty, Risperidone, Delusional disorder, Aggression, media_common.quotation_subject, Jealousy, Context (language use), medicine.disease, 030227 psychiatry, Scientific evidence, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, medicine, General Earth and Planetary Sciences, medicine.symptom, Psychology, Psychiatry, Psychiatric ward, 030217 neurology & neurosurgery, General Environmental Science, media_common, medicine.drug
الوصف: Introduction Although delusional jealousy accounts for merely 10% of delusional disorders, it is associated to risk of serious violence and suicide. With this clinical case, we intend to explore the difficulties in the pharmacological approach of delusional jealousy disorder and to summarise the most recent findings in the treatment of this condition. Methods Case report. Case presentation A 76-year-old man involuntarily admitted to a psychiatric ward due to threats of physical aggression to his wife in the context of irreducible ideas of her infidelity. Initially, we observed an improvement of symptomatology with risperidone and its long-acting injectable formulation, but the emergence of hypotensive side effects required the off-label use of paliperidone palmitate 50 mg/ml. Conclusions Few studies, mainly case reports, look at the specific treatment of delusional jealousy. Given the negative consequences for patients and for their spouses, better scientific evidence to treat this condition is needed.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3a0fb75782a5486db0d21cc56d547792Test
https://doi.org/10.1016/j.rcp.2020.12.004Test -
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المؤلفون: María de la Calle, Belén Guibert-Zafra, Nuria Gilabert-Iriondo, María Ángeles García-Herrero, Clara Ferrero-García-Loygorri, Cristina Montero-Valladares, Juan Carlos Molina-Cabañero, Andrea Mora-Capín, Raquel Porto-Abad, Rosario López-López
المصدر: Anales de Pediatría. 96:523-535
مصطلحات موضوعية: medicine.medical_specialty, business.industry, Acute gastroenteritis, medicine.disease, Comorbidity, Scientific evidence, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Pediatrics, Perinatology and Child Health, Moderate evidence, Isotonic, medicine, Work schedule, Intensive care medicine, business, Contraindication, Paediatric population
الوصف: Introduction The efficacy and safety of the rapid intravenous rehydration (RIR) guidelines in children affected by dehydration secondary to acute gastroenteritis is supported by current scientific evidence, but there is also great variability in its use in clinical practice. Objective To prepare a document with evidence-based recommendations about RIR in paediatric population. Methods The project was developed based on GRADE methodology, according to the following work schedule: Working Group training; creation of a catalogue of questions about research and definition of «relevant outcomes»; score and selection criteria for each item; bibliographic review; scientific evidence evaluation and synthesis (GRADE); review, discussion and creation of recommendations. 10 clinical questions and 15 relevant outcomes were created (7 about efficacy and 8 about security). Results Sixteen recommendations were set up, from which we can highlight as the main ones: (1) RIR is safe for children affected by mild-moderate dehydration secondary to acute gastroenteritis, unless expressly contraindicated or acute severe comorbidity (strong recommendation and moderate evidence). (2) Its use is recommended in this situation when oral rehydration has failed or due to contraindication (strong and high). (3) Isotonic fluids are recommended (strong and high), suggesting saline fluid as the first option (light and low), supplemented by glucose (2.5%) in those patients showing normoglycemia and ketosis (strong and moderate). (4) A rhythm of 20 cc/kg/h is recommended (strong and high) during 1-4 h (strong and moderate). Conclusions This document establishes consensus recommendations, based on the available scientific evidence, which could contribute to the standardisation of the use of RIR in our setting.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::714c1c0f2d0e8416c7f07a67378a6e56Test
https://doi.org/10.1016/j.anpedi.2021.04.017Test -
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المصدر: Enfermería Clínica. 32:S64-S72
مصطلحات موضوعية: 0301 basic medicine, medicine.medical_specialty, 030109 nutrition & dietetics, Health professionals, business.industry, Cross-sectional study, General Medicine, Scientific evidence, Test (assessment), 03 medical and health sciences, 0302 clinical medicine, Family medicine, Developmental Milestone, medicine, Weaning, 030212 general & internal medicine, business, Baby-led weaning, General Nursing
الوصف: Objective Baby-led-weaning (BLW) is a novel model of complementary feeding. Although there is little scientific evidence to support the suitability or superiority of this complementary feeding model, BLW is followed by many families today. The aim was to evaluate the knowledge and attitudes of a group of parents and health professionals regarding BLW in Spain. Methods This research was designed as a cross-sectional study in a sample of 502 parents and 364 health professionals. Two questionnaires generated and disseminated through Google forms were used. The differences between groups of professionals were analyzed using the Chi-Square test. Results 92.3% of professionals and 93.4% of parents knew about BLW. They recommend BLW “always” in 39.8% and 69.3% of the cases, and “sometimes” in 49.7% and 24.9%, respectively. Of the health professionals, 80.5% recommended starting complementary feeding as of six months, 36% of them using BLW, 24% followed traditional weaning, 3.3% bottle feeding and the remaining 36% did not indicate. Eighty-three percent recommended chewing as soon as the child showed interest. Conclusion Both health professionals and parents recommend BLW and consider it helps promote the developmental milestones of the baby. Providing nurses with an adequate number of resources to guide parents on complementary feeding will continue to improve childcare.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::1e51f657578bab2266bccffa078c8cd9Test
https://doi.org/10.1016/j.enfcli.2021.04.005Test -
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المؤلفون: T. Marquillier, K. Slim
المصدر: Journal of Visceral Surgery. 159:144-149
مصطلحات موضوعية: Surgical research, medicine.medical_specialty, Sociology of scientific knowledge, business.industry, Subject (documents), General Medicine, Surgery, Scientific evidence, Systematic review, Research Design, Meta-analysis, medicine, Humans, business, Systematic Reviews as Topic, Research method, Primary research
الوصف: Summary Researchers and practitioners are faced with an exponential increase in the number of systematic reviews (SRs) (with or without meta-analysis), a so-called `secondary' research method that synthesizes data from primary research. This growing number, sometimes with discordant results on the same subject or with non-conclusions, has led to the introduction of the concept of reviews to synthesize SR in order to combine scientific knowledge useful to practitioners. These so-called ``umbrella reviews'' (UR) constitute a new tertiary research tool. Surgical research is no exception to this development but umbrella surgical reviews remain relatively rare. Any UR must be transparent and meet rigorous methodological criteria. The UR could thus provide answers to practical questions in the field of surgery, but only on condition that the bias of the included SRs is limited. Let us not forget that the base requirement of clinical surgical research remains the good methodological quality of clinical studies (primary research). Only thus can SRs or URs (secondary or tertiary research) be more useful and decisive.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::53d47807e26151e980a6315ae3f56492Test
https://doi.org/10.1016/j.jviscsurg.2021.10.001Test -
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المؤلفون: Juan Antonio Martínez López, Julia Martínez-Barrio, Nuria Martínez Sánchez, Laura Cano, Arantza Ais, María José Galindo
المصدر: Reumatología Clínica. 18:200-206
مصطلحات موضوعية: Pregnancy, medicine.medical_specialty, business.industry, Breastfeeding, medicine.disease, Scientific evidence, Rheumatology, Work (electrical), Multidisciplinary approach, Family planning, Family medicine, Health care, medicine, Immune-mediated inflammatory diseases, business
الوصف: Background and objectives Family planning in women with immune-mediated inflammatory diseases is a challenge for healthcare teams, highlighting the need for standardized available evidence to provide patients with objective and agreed information. This study reflects the work performed by a multidisciplinary team in reviewing available scientific evidence, and the strategy agreed for family planning, pregnancy, postpartum, and breastfeeding in patients with immune-mediated inflammatory diseases. Methods A literature search was conducted, information was structured across the different stages (preconception, pregnancy, postpartum and breastfeeding), and an on-site meeting was convened, in which patients and healthcare providers participated. Results Specific materials, which are included in this work, were developed to guide clinical decisions to be agreed upon by patients and healthcare providers. Conclusion These materials meet the need for validated and updated information on the approach and use of indicated drugs for professionals responsible for the management of immune-mediated inflammatory diseases.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::33b9fb3293db83bb0721f396046baf4bTest
https://doi.org/10.1016/j.reuma.2020.11.007Test -
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المؤلفون: Frank C. Detterbeck, M. Patricia Rivera, Farhood Farjah, Louise M. Henderson, Gerard A. Silvestri, Robert A. Smith
المصدر: Chest. 161:826-832
مصطلحات موضوعية: Pulmonary and Respiratory Medicine, Time delays, medicine.medical_specialty, business.industry, Psychological intervention, Nodal staging, Guideline, Critical Care and Intensive Care Medicine, medicine.disease, Scientific evidence, Family medicine, medicine, Cardiology and Cardiovascular Medicine, Lung cancer, business, Research question, Pulmonologists
الوصف: Background Pretreatment invasive nodal staging is paramount for appropriate treatment decisions in non-small cell lung cancer. Despite guidelines recommending when to perform staging, many studies suggest that invasive nodal staging is underutilized. Attitudes and barriers to guideline-recommended staging are unclear. The National Lung Cancer Roundtable initiated this study to better understand factors associated with guideline-adherent nodal staging. Research Question What are the knowledge gaps, attitudes, and beliefs of thoracic surgeons and pulmonologists about invasive nodal staging? What are the barriers to guideline-recommended staging? Study Design and Methods A web-based survey to a random sample of pulmonologists and thoracic surgeons identified as members of CHEST in 2019. Survey domains included knowledge of invasive nodal staging guidelines, attitudes and beliefs towards implementation, and perceived barriers to guideline adherence. Results Among 453 responding physicians, 29% were unaware that invasive nodal staging guidelines exist. Among the 320 physicians who knew guidelines exist, attitudes towards the guidelines were favorable, with 91% agreeing guidelines are generalizable and 90% agreeing that recommendations improved their staging and treatment decisions. Approximately 80% responded that guideline recommendations are based on satisfactory levels of scientific evidence, and 50% stated a lack of evidence linking adherence to guidelines to changes in management or better patient outcomes. Nearly 9 in 10 physicians reported at least one barrier to guideline adherence. The most common barriers included patient anxiety associated with treatment delays (62%), difficulty implementing guidelines into routine practice (52%), and time delays of additional testing (51%). Interpretation Among physicians who responded to our survey, more than a quarter were unaware of invasive nodal staging guidelines. Attitudes towards guideline recommendations were positive although 20% reported insufficient evidence to support staging algorithms. Most physicians reported barriers to implementing guidelines. Multi-level interventions are likely needed to increase rates of guideline-recommended invasive nodal staging.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::ec4773a14c74f746f33c2605da3fbc3bTest
https://doi.org/10.1016/j.chest.2021.11.010Test -
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المؤلفون: M. Nieves Plana Farras, Antonio Collado Cruz, Cayetano Alegre de Miquel, Benigno Casanueva Fernández, Noé Brito García, Eva Trillo Calvo, Miriam Almirall Bernabé, Javier Rivera Redondo, Ángela Palao Tarrero, Pilar Montesó-Curto, Cristina Castillo Ojeda, Miguel Ángel Vallejo Pareja, Petra Díaz del Campo Fontecha, Carol Merino Argumánez
المصدر: Reumatología Clínica (English Edition). 18:131-140
مصطلحات موضوعية: medicine.medical_specialty, Coping (psychology), Fibromyalgia, business.industry, General Medicine, Disease, medicine.disease, Rheumatology, Scientific evidence, Patient satisfaction, Qualitative analysis, Internal medicine, Health care, Humans, Medicine, business, Intensive care medicine
الوصف: Objective To prevent the impairment of fibromyalgia patients due to harmful actions in daily clinical practice that are potentially avoidable. Methods A multidisciplinary team identified the main areas of interest and carried out an analysis of scientific evidence and established recommendations based on the evidence and “formal evaluation” or “reasoned judgment” qualitative analysis techniques. Results A total of 39 recommendations address diagnosis, unsafe or ineffective treatment interventions and patient and healthcare workers’ education. This part I shows the first 27 recommendations on the first 2 areas. Conclusions Establishing a diagnosis improves the patient's coping with the disease and reduces healthcare costs. NSAIDs, strong opioids and benzodiazepines should be avoided due to side effects. There is no good evidence to justify the association of several drugs. There is also no good evidence to recommend any complementary medicine. Surgeries show a greater number of complications and a lower degree of patient satisfaction and therefore should be avoided if the surgical indication is not clearly established.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1e87506610c085629e5e66314d25d5d1Test
https://doi.org/10.1016/j.reumae.2021.02.002Test -
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المصدر: American Journal of Infection Control. 50:141-147
مصطلحات موضوعية: Joinpoint regression, Epidemiology, business.industry, Health Policy, media_common.quotation_subject, Public Health, Environmental and Occupational Health, World Health Organization, United States, World health, Scientific evidence, Search Engine, Trend analysis, Infectious Diseases, Country level, Hygiene, Environmental health, Health care, Humans, Medicine, Hand Hygiene, Health Facilities, business, Hand Disinfection, media_common, Public awareness
الوصف: Background: Scientific evidence suggest that hand hygiene as one of the most effective measures to control infection. To promote good hand hygiene practices, the World Health Organization introduced May 5 as World Hand Hygiene Day (WHHD), and international stakeholders established Global Handwashing Day (GHD) on October 15. However, its contributions to raising public awareness of hand hygiene is unclear. Methods: This study evaluates the impact of the WHHD and GHD on the public awareness of hand hygiene in Japan, the United Kingdom, the United States, and worldwide from 2016 to 2020, using the relative search volume of "Hand hygiene" in Google Trends as a surrogate. To identify a statistically significant timepoint of a trend change, we performed Joinpoint regression analysis. Results: Upticks of the relative search volumes as well as joinpoints were noted worldwide around the WHHD and GHD from 2016 to 2019, but no joinpoints were identified around the WHHD and GHD in 2020. No such changes were observed in Japan, the United Kingdom, and the United States during these periods. Conclusions: While the WHHD was originally established to raise awareness of hand hygiene in healthcare facilities, our result suggests that the WHHD and GHD may not have effectively disseminated the importance of hand hygiene to the general public at a country level. Additional policy measures to advocate hand hygiene to the public are necessary to communicate its benefits. (c) 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::66eac3b40905e48c1d294f13b7ff342bTest
https://doi.org/10.1016/j.ajic.2021.08.033Test -
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المؤلفون: Kat Schwartz, Jennifer Villani, Elizabeth Neilson, Quyen Ngo-Metzger, Erin M. Ellis, Elizabeth A. Vogt, Carrie N. Klabunde
المصدر: American Journal of Preventive Medicine. 62:e77-e86
مصطلحات موضوعية: medicine.medical_specialty, Epidemiology, Task force, Clinical study design, Advisory Committees, Public Health, Environmental and Occupational Health, MEDLINE, law.invention, Scientific evidence, Randomized controlled trial, law, Family medicine, Preventive Health Services, medicine, Humans, Psychology, Citation
الوصف: Introduction The U.S. Preventive Services Task Force (USPSTF) issues “Insufficient Evidence” (I) statements when scientific evidence is inadequate for making recommendations about clinical preventive services. Insufficient Evidence statements may be changed to definitive recommendations if new research closes evidence gaps. This study examines the characteristics of evidence that informed changes from I statements to definitive recommendations, including NIH's role as a funder. Methods A total of 11 USPSTF Insufficient Evidence statements that were changed between 2010 and 2019 were assessed. Study designs, bibliometric influence, and funding sources for scientific articles cited in USPSTF evidence reviews were characterized for each I statement. Data were analyzed in 2019–2020. Results Most I statements (82%) changed to a B grade; an average of 8.4 years elapsed between issuing the I statement and releasing the definitive recommendation. An average of 63 (range=19−253) articles were included in each USPSTF evidence review. NIH support was cited in 28.8% of articles, on average. The proportion of NIH-funded articles reporting RCT designs was similar to that of non–NIH-funded articles (64.5% vs 59.5%). A higher proportion of NIH-funded articles were rated good quality for study design (39.0%) than the proportion of non–NIH-funded articles (24.4%). Bibliometric influence measured by relative citation ratios was higher for NIH-funded (mean=14.78) than for non–NIH-funded (mean=5.07) articles. Conclusions Study designs and funding supports varied widely across topics, but overall, NIH was the largest single funder of evidence informing 11 changed USPSTF I statements. Enhanced efforts by NIH and other stakeholders to address I statement evidence gaps are needed.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1432db410294e64c03c41887ddf66f14Test
https://doi.org/10.1016/j.amepre.2021.07.014Test
