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Review of Systems

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241. How does feedback shared with interprofessional health care teams shape nursing performance improvement systems? A rapid realist review protocol. Full Text available with Trip Pro

How does feedback shared with interprofessional health care teams shape nursing performance improvement systems? A rapid realist review protocol. Nursing care quality varies between hospitals, and even between departments within the same institution. Suboptimal care can have deleterious consequences for patients such as lengthened hospital stay, nosocomial infection, pressure ulcers or death. Experts recommend the implementation of nursing performance improvement systems to assess team (...) to theorise operational feedback.The innovative combination of Actor-Network Theory with a realist methodology holds promise for the identification of explanatory equations in complex systems and theory development. A rapid realist review is relevant to address an enduring knowledge gap which requires theory development. This preliminary study lays the groundwork for a pioneering theory on feedback in nursing performance improvement systems that will subsequently inform a multiple case study.Prospero

2019 Systematic reviews

242. Local Anesthetic Systemic Toxicity: A Narrative Literature Review and Clinical Update on Prevention, Diagnosis and Management. (Abstract)

Local Anesthetic Systemic Toxicity: A Narrative Literature Review and Clinical Update on Prevention, Diagnosis and Management. The objective of this narrative review of local anesthetic systemic toxicity is to provide an update on its prevention, diagnosis and management.The authors employed a MEDLINE search using human, animal studies and case reports and summarize findings following the American Society of Regional Anesthesia and Pain Medicine practice advisories on local anesthetic systemic (...) toxicity.Between March 2014 and November 2016, there were 47 cases of systemic toxicity described. Twenty-two patients (47%) were treated with intravenous lipid emulsion and two patients (4.3%) died. Seizures were the most common presentation. The spectrum of presenting neurologic and cardiovascular symptoms and signs are broad and can be obscured by perioperative processes. Local anesthetic type, dosage and volume, site of injection and patient comorbidities influence the rate of absorption from site

2019 Plastic and reconstructive surgery

243. Prenatally diagnosed developmental abnormalities of the central nervous system and genetic syndromes: A practical review. Full Text available with Trip Pro

Prenatally diagnosed developmental abnormalities of the central nervous system and genetic syndromes: A practical review. Developmental brain abnormalities are complex and can be difficult to diagnose by prenatal imaging because of the ongoing growth and development of the brain throughout pregnancy and the limitations of ultrasound, often requiring fetal magnetic resonance imaging as an additional tool. As for all major structural congenital anomalies, amniocentesis with chromosomal microarray (...) and a karyotype is the first-line recommended test for the genetic work-up of prenatally diagnosed central nervous system (CNS) abnormalities. Many CNS defects, especially neuronal migration defects affecting the cerebral and cerebellar cortex, are caused by single-gene mutations in a large number of different genes. Early data suggest that prenatal diagnostic exome sequencing for fetal CNS defects will have a high diagnostic yield, but interpretation of sequencing results can be complex. Yet a genetic

2019 Prenatal diagnosis

244. Cutaneous candidiasis - an evidence-based review of topical and systemic treatments to inform clinical practice. (Abstract)

Cutaneous candidiasis - an evidence-based review of topical and systemic treatments to inform clinical practice. Cutaneous candidiasis is a common skin disease, and several treatments have been investigated within the last fifty years. Yet, systematic reviews are lacking, and evidence-based topical and systemic treatment strategies remain unclear. Thus, the aim of this review was to summarize efficacy and adverse effects of topical and oral therapies for cutaneous candidiasis in all age groups (...) . Two individual researchers searched PubMed and EMBASE for 'cutaneous candidiasis' and 'cutaneous candidiasis treatment', 'intertrigo', 'diaper dermatitis' and 'cheilitis'. Searches were limited to 'English language', 'clinical trials' and 'human subjects', and prospective clinical trials published in abstracts or articles were included. In total, 149 studies were identified, of which 44 were eligible, comprising 41 studies of 19 topical therapies and four studies of three systemic therapies

2019 Journal of the European Academy of Dermatology and Venereology

245. Conceptual analysis of health systems resilience: A scoping review. (Abstract)

Conceptual analysis of health systems resilience: A scoping review. System resilience has long been an area of study, and the term has become increasingly used across different sectors. Studies on resilience in health systems are more recent, multiplying particularly since the 2014 Ebola epidemic in West Africa. The World Health Organization (WHO) is calling for national governments to increase the resilience of their health systems. Concepts help define research objects and guide the analysis (...) . Yet, to be useful, concepts need to be clear and precise. We aimed to improve the conceptual understanding of health systems resilience by conducting a scoping review to describe the state of knowledge in this area. We searched for literature in 10 databases, and analyzed data using a list of themes. We evaluated the clarity and the precision of the concept of health systems resilience using Daigneault & Jacob's three dimensions of a concept: term, sense, and referent. Of the 1091 documents

2019 Social Science & Medicine

246. Multiple food-borne trematodiases with profound systemic involvement: a case report and literature review. Full Text available with Trip Pro

Multiple food-borne trematodiases with profound systemic involvement: a case report and literature review. Food-borne trematodiases are an important group of neglected global diseases. Affected patients in regions with low prevalence usually experience delayed diagnosis, especially when presenting with atypical clinical symptoms. Here, we presented a rare case of a Chinese patient infected with three food-borne trematodiases.A 42-year-old man presented with diarrhea, lower extremity edema (...) stool examination, from which eggs of Clonorchis sinensis, Heterophyidae and Echinostomatidae were identified. Deposition of Clonorchis sinensis eggs was also observed from ileocecal squash slides. The patient was successfully treated with three cycles of praziquantel.Food-borne trematodiases may present with systemic involvement. Patients with dietary history of high risk or atypical ingestions should be evaluated for parasitic infection, even in non-endemic areas.

2019 BMC Infectious Diseases

247. Associations between patient and system characteristics and MET review within 48 h of admission to a teaching hospital: A retrospective cohort study. (Abstract)

Associations between patient and system characteristics and MET review within 48 h of admission to a teaching hospital: A retrospective cohort study. The Medical Emergency Team (MET) has enhanced the recognition and response to clinical deterioration in acute healthcare. However, patients reviewed by the MET are at increased risk of in-hospital death. Identifying patients at risk of deterioration may improve patient outcomes. AIM: To identify patient demographic, medical characteristics (...) and healthcare systems and processes at the time of admission (baseline), associated with Medical Emergency Team (MET) review within 48 h (MET-48 h) of admission. METHODS: Single-site, year-long, retrospective cohort comprising patients admitted for at least 24 h, using routinely collected hospital data. A three-stage modelling approach was used to identify baseline factors associated with MET-48 h RESULTS: The study included 15,695 patients with mean age 62.1 years (SD 19.6), male (53.5%), born in Australia

2019 European journal of internal medicine

248. Context-Aware Systems for Chronic Disease Patients: Scoping Review. Full Text available with Trip Pro

Context-Aware Systems for Chronic Disease Patients: Scoping Review. Context-aware systems, also known as context-sensitive systems, are computing applications designed to capture, interpret, and use contextual information and provide adaptive services according to the current context of use. Context-aware systems have the potential to support patients with chronic conditions; however, little is known about how such systems have been utilized to facilitate patient work.This study aimed (...) to characterize the different tasks and contexts in which context-aware systems for patient work were used as well as to assess any existing evidence about the impact of such systems on health-related process or outcome measures.A total of 6 databases (MEDLINE, EMBASE, CINAHL, ACM Digital, Web of Science, and Scopus) were scanned using a predefined search strategy. Studies were included in the review if they focused on patients with chronic conditions, involved the use of a context-aware system to support

2019 Journal of medical Internet research

249. Persuasive System Design Principles and Behavior Change Techniques to Stimulate Motivation and Adherence in Electronic Health Interventions to Support Weight Loss Maintenance: Scoping Review. Full Text available with Trip Pro

Persuasive System Design Principles and Behavior Change Techniques to Stimulate Motivation and Adherence in Electronic Health Interventions to Support Weight Loss Maintenance: Scoping Review. Maintaining weight after weight loss is a major health challenge, and eHealth (electronic health) solutions may be a way to meet this challenge. Application of behavior change techniques (BCTs) and persuasive system design (PSD) principles in eHealth development may contribute to the design of technologies (...) that positively influence behavior and motivation to support the sustainable health behavior change needed.This review aimed to identify BCTs and PSD principles applied in eHealth interventions to support weight loss and weight loss maintenance, as well as techniques and principles applied to stimulate motivation and adherence for long-term weight loss maintenance.A systematic literature search was conducted in PsycINFO, Ovid MEDLINE (including PubMed), EMBASE, Scopus, Web of Science, and AMED, from January 1

2019 Journal of medical Internet research

250. Mapping the use of soft systems methodology for change management in healthcare: a scoping review protocol. Full Text available with Trip Pro

Mapping the use of soft systems methodology for change management in healthcare: a scoping review protocol. It is notoriously challenging to implement evidence-based care and to update and improve healthcare practices. One reason for the difficulty is the complexity of healthcare and the powerful influence of context on implementation and improvement efforts. Thus, there is a need for multifaceted, flexible change methods that takes these complexities into consideration. One approach that has (...) the potential in this regard is soft systems methodology (SSM). However, little is known about how SSM has been applied in healthcare settings, making it difficult to assess the usefulness of SSM for implementation science or improvement research. The aim of the proposed scoping review is to examine and map the use and outcomes of SSM in healthcare.The review will adapt the framework outlined by Arksey and O'Malley (2005). Citations will be uncovered through a comprehensive database search of the peer

2019 BMJ open

251. CHOROIDAL AND RETINAL THICKNESS IN SYSTEMIC AUTOIMMUNE AND INFLAMMATORY DISEASES: A REVIEW. (Abstract)

CHOROIDAL AND RETINAL THICKNESS IN SYSTEMIC AUTOIMMUNE AND INFLAMMATORY DISEASES: A REVIEW. In order to identify the risk of relapse and subclinical inflammatory stages of systemic autoimmune diseases, new tools are needed. In the recent years, choroidal and retinal thickness measured with ocular coherence tomography (OCT) have been proposed as an inflammatory marker for different systemic diseases, especially for conditions with a vascular component. Our aim in this article was to review (...) the literature regarding the role of choroidal and retinal thickness as a potential inflammatory marker in systemic autoimmune and inflammatory diseases measured by OCT. Current literature suggests that the choroid of patients thickens in active phases of inflammatory diseases with vascular involvement. This pattern is observed in lupus, systemic sclerosis, Behçet disease, spondylitis, and familial Mediterranean fever. Choroidal thickness may decrease with biological treatments, along with systemic

2019 Survey of Ophthalmology

252. Targeting the Immune System in Atherosclerosis: JACC State-of-the-Art Review. Full Text available with Trip Pro

Targeting the Immune System in Atherosclerosis: JACC State-of-the-Art Review. Atherosclerosis has long been known as an inflammatory disease. However, whether targeting inflammation improves outcomes was unproven until the recent results of CANTOS (Canakinumab Anti-Inflammatory Thrombosis Outcomes Study). In this review, we reflect on why it has taken a long time to prove the inflammatory hypothesis of atherosclerosis and derive important lessons for the future. In particular, we discuss (...) the off-target immune-modulatory effects of approved cardiovascular therapies, review the attempted anti-inflammatory therapies including the recently published CIRT (Cardiovascular Inflammation Reduction Trial), and discuss the likely reasons for their failures. We further build on CANTOS to review the immune-modulatory therapies for atherosclerosis currently in trials, and discuss the likelihood of their added value as well as the potential hazard associated with their use. We finally argue

2019 Journal of the American College of Cardiology

253. Motorized scooter injuries in the era of scooter-shares: A review of the national electronic surveillance system. (Abstract)

Motorized scooter injuries in the era of scooter-shares: A review of the national electronic surveillance system. There has been a spike in recent news regarding motorized scooter injuries due to the expansion of scooter sharing companies. Given the paucity of literature on this topic, the purpose of our study was to describe and quantify emergency department encounters associated with motorized scooter related injuries.The National Electronic Injury Surveillance System (NEISS) was queried

2019 American Journal of Emergency Medicine

254. Review of concentration yields in commercially available platelet-rich plasma (PRP) systems: a call for PRP standardization. (Abstract)

Review of concentration yields in commercially available platelet-rich plasma (PRP) systems: a call for PRP standardization. Platelet-rich plasma (PRP) has become increasingly popular in pain medicine with hopes of becoming a safe, effective alternative to routine treatments. However, given its autologous nature, PRP injectate may differ depending on the specific manufacturer and protocol. Currently, there is no standardization of reporting protocol. This systematic review compiles (...) and standardizes values on PRP preparation and final product composition of platelets, white cell count, and growth factors for ease of comparison. On review of 876 studies, 13 studies were selected according to our inclusion criteria. Data from 33 PRP systems and protocols were extracted and standardized. Overall, PRP final product concentrations as well as PRP preparation protocols varied widely between systems. However, platelet concentration was directly correlated with both volume of blood collected

2019 Regional Anesthesia and Pain Medicine

255. The introduction of a Parkinson's disease email alert system to allow for early specialist team review of inpatients. Full Text available with Trip Pro

The introduction of a Parkinson's disease email alert system to allow for early specialist team review of inpatients. Patients with Parkinson's disease (PWP) have complex healthcare needs, and compared to the general population, are more likely to have an unplanned emergency department (ED) attendance to hospital, along with poorer outcomes. Innovative methods of notification, when patients have an ED attendance are needed to allow for earlier specialist team interventions. This study describes (...) the introduction of an email alert (e-alert) for a specialist Parkinson's team. In addition, the reason for admission, specialist team interventions, length of stay, frequency of readmission, discharge destination, mortality and the bed cost per ED attendance or admission episode will be explored.The e-alert was developed in collaboration with academics, a Parkinson's specialist team and hospital Information technology (IT) specialists, by employing existing software and IT system platforms. Patients were

2019 BMC health services research

256. Type and use of digital technology in learning health systems: a scoping review protocol. Full Text available with Trip Pro

Type and use of digital technology in learning health systems: a scoping review protocol. Health systems in North America and Europe have been criticised for their lack of safety, efficiency and effectiveness despite rising healthcare costs. In response, healthcare leaders and researchers have articulated the need to transform current health systems into continuously and rapidly learning health systems (LHSs). While digital technology has been envisioned as providing the transformational power (...) related to learning health systems. Records selection will be done in duplicate by two reviewers applying pre-defined inclusion and exclusion criteria. Data extraction from selected records will be done by two reviewers using a piloted data charting form. Results will be synthesised through a descriptive numerical summary and a mapping of digital technology use onto types of LHSs and phases of learning within LHSs.Ethical approval is not required for this scoping review. Preliminary results

2019 BMJ open

257. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome caused by first-line antituberculous drugs: two case reports and a review of the literature. (Abstract)

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome caused by first-line antituberculous drugs: two case reports and a review of the literature. Patients suffering from drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome caused by first-line antituberculous drugs often need to be re-treated rapidly. Patch tests prior to the re-introduction of antituberculosis drugs are rarely performed.We aim to highlight those drugs most often involved in DRESS from (...) antituberculosis drugs, illustrate the potential value of patch tests to identify these culprit(s), and provide insights in how to rapidly re-treat these patients.A detailed description of the work-up of two illustrative patients, together with a literature review of similar cases, is provided.All first-line antituberculosis drugs may cause DRESS syndrome, but rifampicin and isoniazid are most frequently involved. Patch tests can be performed sooner than usually advised in the context of DRESS syndrome

2019 Contact Dermatitis

258. Cardiac arrhythmia detection outcomes among patients monitored with the Zio patch system: a systematic literature review. Full Text available with Trip Pro

Cardiac arrhythmia detection outcomes among patients monitored with the Zio patch system: a systematic literature review. Cardiac arrhythmias can be serious and life threatening, and can impose significant burden on healthcare systems. Recent technological advances in ambulatory electrocardiogram recorders have led to the development of unobtrusive wearable biosensors which allow physicians to study patients' continuous cardiac rhythm data collected over multiple weeks. The objective (...) of this systematic literature review was to summarize evidence on the clinical effectiveness of the Zio patch ('Zio'; iRhythm Technologies), a long-term, continuous, uninterrupted cardiac monitoring system.Findings from searches of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials, as well as grey literature, were screened by two reviewers to identify studies reporting cardiac arrhythmia detection outcomes among patients monitored with Zio for an intended duration ≥7 days.23 publications

2019 Current medical research and opinion

259. From Focal Lipid Storage to Systemic Inflammation: JACC Review Topic of the Week. Full Text available with Trip Pro

From Focal Lipid Storage to Systemic Inflammation: JACC Review Topic of the Week. Concepts of atherogenesis have evolved considerably with time. Early animal experiments showed that a cholesterol-rich diet could induce fatty lesion formation in arteries. The elucidation of lipoprotein metabolism ultimately led to demonstrating the clinical benefits of lipid lowering. The view of atheromata as bland accumulations of smooth muscle cells that elaborated an extracellular matrix that could entrap

2019 Journal of the American College of Cardiology

260. Musculoskeletal Ultrasound in Systemic Lupus Erythematosus: Systematic Literature Review by the Lupus Task Force of the OMERACT Ultrasound Working Group. (Abstract)

Musculoskeletal Ultrasound in Systemic Lupus Erythematosus: Systematic Literature Review by the Lupus Task Force of the OMERACT Ultrasound Working Group. To identify and synthesize the best available evidence on the application of musculoskeletal ultrasound (US) in patients with systemic lupus erythematosus (SLE) and to present the measurement properties of US in different elementary lesion and pathologies.A systematic literature search of PubMed, Embase and the Cochrane Library was performed (...) (3/15, 20%) evaluated inter-observer reliability but none had evaluated intra-observer reliability. Criterion validity was assessed in 1 study (1/15, 7%). Responsiveness was not considered in any of the studies.This literature review demonstrates the need of further research and validation work to define the role of US as an outcome measurement instrument for the musculoskeletal manifestations in SLE patients.

2019 Journal of Rheumatology

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