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Stressed out about stress testing? The utility of stress testing after non-ACS chest pain Stressed out about stress testing? The utility of stress testing after non-ACS chest pain - CanadiEM Stressed out about stress testing? The utility of stress testing after non-ACS chest pain In by Vivian Tam October 15, 2019 The Case Your next patient in the acute zone of the ED is Mr. Liu, a 53-year old man presenting with one hour of acute onset atypical chest pain. He has several risk factors (...) for coronary artery disease, including Type II diabetes, dyslipidemia and an 18 pack-year smoking history. He is hemodynamically stable. After two sets of normal high-sensitivity troponins and a normal EKG, you are confident that he is not suffering from an acute MI. You counsel him on diet and lifestyle modifications and ask him to follow up with his family doctor. However, you wonder if you should arrange further evaluation of his potential atherosclerotic disease with a stress test. What is the evidence
Accelerated Resolution Therapy for Post-Traumatic Stress Disorder, Anxiety Disorders, or Mood Disorders: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Accelerated Resolution Therapy for Post-Traumatic Stress Disorder, Anxiety Disorders, or Mood Disorders: Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Accelerated Resolution Therapy for Post-Traumatic Stress Disorder, Anxiety Disorders, or Mood Disorders: Clinical Effectiveness (...) , Cost-Effectiveness, and Guidelines Accelerated Resolution Therapy for Post-Traumatic Stress Disorder, Anxiety Disorders, or Mood Disorders: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Last updated: September 19, 2019 Project Number: RB1404-000 Product Line: Research Type: Non-Pharma Mental Health Intervention Report Type: Summary of Abstracts Result type: Report Question What is the clinical effectiveness of Accelerated Resolution Therapy (ART) for the treatment of adults with post
Nabilone for the Treatment of Post-Traumatic Stress Disorder: A Review of Clinical Effectiveness and Guidelines Nabilone for the Treatment of Post-Traumatic Stress Disorder: A Review of Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Nabilone for the Treatment of Post-Traumatic Stress Disorder: A Review of Clinical Effectiveness and Guidelines Nabilone for the Treatment of Post-Traumatic Stress Disorder: A Review of Clinical Effectiveness and Guidelines Last (...) updated: February 20, 2019 Project Number: RC1076-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of nabilone for the treatment of post-traumatic stress disorder in adults? What are the evidence-based guidelines regarding the use of nabilone for the treatment of post-traumatic stress disorder in adults? Key Message Overall, two primary clinical studies, including one randomized controlled trial and one
Internet-Based Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder Internet-Based Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder | CADTH.ca Find the information you need Internet-Based Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder Internet-Based Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder Last updated: October 2, 2019 Project Number: OP0537-000 Product Line: Result type: Report Expected Completion Date: March 27, 2020 Post (...) -Traumatic Stress Disorder (PTSD) occurs as a response to an acute traumatic event or an extreme stressor. Symptoms include fear, helplessness, hyperarousal, re-experiencing of the event, and avoidance of reminders of the event for at least one month. PTSD can be treated with pharmacological and psychological interventions such as cognitive behavioural therapy (CBT). CBT delivered through the Internet (iCBT) may mitigate barriers to accessing face-to-face CBT such as geographical distance or cost
The Effects of a Plant-Based Diet and Stress Reduction Techniques on PSA Doubling Time in Prostate Cancer Recurrence "The Effects of a Plant-Based Diet and Stress Reduction Techniques on P" by Amanda Barclay and Jacob McAvoy < > > > > > Title Author Date of Graduation Summer 8-10-2019 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background: Prostate cancer is the most common cancer affecting men. It is also very common for men (...) to suffer from recurrence after primary therapy is completed. The current most commonly used therapies for prostate cancer recurrence, hormonal therapy and radiation, have significant side effects. It is known that diet influences cancer prevention, progression, and recurrence. A plant-based diet, especially when combined with stress reduction techniques, may be a useful therapeutic option with fewer side effects for men with recurrent prostate cancer. This review examines the effects of a plant-based
Interventions for treating recurrent stress urinary incontinence after failed minimally invasive synthetic midurethral tape surgery in women. Surgery is a common treatment modality for stress urinary incontinence (SUI), usually offered to women for whom conservative treatments have failed. Midurethral tapes have superseded colposuspension because cure rates are comparable and recovery time is reduced. However, some women will not be cured after midurethral tape surgery. Currently (...) , there is no consensus on how to manage the condition in these women.This is an update of a Cochrane Review first published in 2013.To assess the effects of interventions for treating recurrent stress urinary incontinence after failed minimally invasive synthetic midurethral tape surgery in women; and to summarise the principal findings of economic evaluations of these interventions.We searched the Cochrane Incontinence Specialised Register, which contains trials identified from the Cochrane Central Register
Psychological interventions in reducing stress, depression and anxiety among parents of children and adolescents with developmental disabilities: A systematic review and meta-analysis To evaluate the effectiveness of psychological interventions in reducing stress, depression and anxiety among parents of children and adolescents with developmental disabilities.A systematic review and a meta-analysis.Seven electronic databases (CINAHL, CENTRAL, EMBASE, ProQuest Dissertation and Theses, PsycINFO (...) -analysis found that psychological interventions significantly reduced parental stress at postintervention but not at 3-6 months' postintervention. Inconclusive evidence was found for the effectiveness of psychological interventions in reducing parental depression and anxiety.Psychological interventions appeared to reduce parental stress temporarily. Healthcare professionals can offer varied psychological interventions for parents to choose from. Policymakers can ease accessibility and affordability
Multiple session early psychological interventions for the prevention of post-traumatic stress disorder. The prevention of long-term psychological distress following traumatic events is a major concern. Systematic reviews have suggested that individual psychological debriefing is not an effective intervention at preventing post-traumatic stress disorder (PTSD). Over the past 20 years, other forms of intervention have been developed with the aim of preventing PTSD.To examine the efficacy (...) of psychological interventions aimed at preventing PTSD in individuals exposed to a traumatic event but not identified as experiencing any specific psychological difficulties, in comparison with control conditions (e.g. usual care, waiting list and no treatment) and other psychological interventions.We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO and ProQuest's Published International Literature On Traumatic Stress (PILOTS) database to 3 March 2018
Theta-Burst Transcranial Magnetic Stimulation for Posttraumatic Stress Disorder Posttraumatic stress disorder (PTSD) is a highly prevalent psychiatric disorder associated with disruption in social and occupational function. Transcranial magnetic stimulation (TMS) represents a novel approach to PTSD, and intermittent theta-burst stimulation (iTBS) is a new, more rapid administration protocol with data supporting efficacy in depression. The authors conducted a sham-controlled study of iTBS
Systematic Review: Expressive arts interventions to address psychosocial stress in healthcare workers. To synthesize evidence about the effectiveness of expressive arts interventions used to reduce psychosocial stress among healthcare workers.Quantitative systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.SocINDEX, PsycINFO, Pubmed, CINAHL.Databases were searched from 1997-2017. Fourteen studies met the criteria for final selection.Most (...) in burnout, stress, and emotional outcomes. Overall, music and art-based interventions had greater impact on well-being than storytelling or narrative.This systematic review provides preliminary evidence for the effectiveness of expressive arts interventions.Care for others is a preeminent value in health care; however, this can come at the expense of caring for oneself. Psychosocial stress poses a significant threat to the well-being of the healthcare workforce. Expressive arts interventions provide
The effect of physical activity interventions on occupational stress for health personnel: A systematic review High occupational stress and its implications on health in people who are working in the healthcare sector are well-documented. However, less is known about beneficial effects physical activity interventions might have on occupational stress in healthcare settings.This systematic review aims to identify the current evidence on the effect of physical activity interventions on stress (...) outcomes in health personnel.A systematic review with quality assessment.PsycINFO, Medline and CINAHL databases were searched in February 2018 using a combination of synonyms of the terms "health personnel", "physical activity" and "occupational stress". The search was repeated in March 2019.N = 18 experimental studies were included, representing three specified physical activity intervention types (yoga, tai chi and qigong) and different non-specific worksite training programs. Nine studies conducted
Effect of an ICU Diary on Posttraumatic Stress Disorder Symptoms Among Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial. Keeping a diary for patients while they are in the intensive care unit (ICU) might reduce their posttraumatic stress disorder (PTSD) symptoms.To assess the effect of an ICU diary on the psychological consequences of an ICU hospitalization.Assessor-blinded, multicenter, randomized clinical trial in 35 French ICUs from October 2015 to January 2017
Comparison of Heart Rate Blood Pressure Product Versus Age-Predicted Maximum Heart Rate as Predictors of Cardiovascular Events During Exercise Stress Echocardiography Exercise stress echocardiograms (ESEs) are a functional cardiovascular (CV) test typically used for the investigation of coronary artery disease. ESEs are often terminated at a predetermined age-predicted maximum heart rate (APMHR) to facilitate timely acquisition of ultrasound images at peak exercise. Although an APMHR of 85
Comparative Efficacy and Acceptability of Pharmacological, Psychotherapeutic, and Combination Treatments in Adults With Posttraumatic Stress Disorder: A Network Meta-analysis Posttraumatic stress disorder (PTSD) is a prevalent mental disorder, with a high risk of chronicity, comorbidity, and functional impairment; PTSD is complicated to treat, and the debate on the best treatment approach is ongoing.To examine comparative outcomes and acceptability of psychotherapeutic and pharmacological
Surgical interventions for women with stress urinary incontinence: systematic review and network meta-analysis of randomised controlled trials. To compare the effectiveness and safety of surgical interventions for women with stress urinary incontinence.Systematic review and network meta-analysis.Randomised controlled trials evaluating surgical interventions for the treatment of stress urinary incontinence in women.Identification of relevant randomised controlled trials from Cochrane reviews (...) , and open colposuspension are more effective than other procedures for stress urinary incontinence in the short to medium term. Data on long term effectiveness and adverse events are, however, limited, especially around the comparative adverse events profiles of MUS and non-MUS procedures. A better understanding of complications after surgery for stress urinary incontinence is imperative.PROSPERO CRD42016049339.Published by the BMJ Publishing Group Limited. For permission to use (where not already
Systematic Review - Relationship of Deployment-related Mild Traumatic Brain Injury to Posttraumatic Stress Disorder, Depressive Disorders, Substance Use Disorders, Suicidal Ideation, and Anxiety Disorders 4 March 2019 Prepared for: Department of Veterans Affairs Veterans Health Administration Health Services Research & Development Service Washington, DC 20420 Prepared by: Evidence Synthesis Program (ESP) Center Portland VA Medical Center Portland, OR Mark Helfand, MD, MPH, MS, Director (...) Relationship of Deployment-related Mild Traumatic Brain Injury to Posttraumatic Stress Disorder, Depressive Disorders, Substance Use Disorders, Suicidal Ideation, and Anxiety Disorders: A Systematic Review Authors: Principal Investigator: Nancy Greer, PhD Timothy J. Wilt, MD, MPH Co-Investigators: Princess Ackland, PhD, MSPH Roderick MacDonald, MS Nina Sayer, PhD Michele Spoont, PhD Brent Taylor, PhD Research Assistants: Lauren McKenzie, MPH Christina Rosebush, MPH Evidence Synthesis Program 4 Relationship
Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: Groundwork for a Publicly Available Repository of Randomized Controlled Trial Data Technical Brief Number 32 R Technical Brief Number 32 Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: Groundwork for a Publicly Available Repository of Randomized Controlled Trial Data Prepared for: Agency for Healthcare (...) -EHC018-EF May 2019 ii Key Messages Purpose The purpose of this project was to identify and abstract data from randomized controlled trials (RCTs) of posttraumatic stress disorder (PTSD) interventions to support the development of a publicly accessible data repository by the National Center for Posttraumatic Stress Disorder. Key Messages • We abstracted data from 318 RCTs, including psychotherapeutic interventions (55%), pharmacologic interventions (30%), and complementary and integrative
Randomised controlled trial comparing narrative exposure therapy with present-centred therapy for older patients with post-traumatic stress disorder Evidence-based treatment and age-specific services are required to address the needs of trauma-affected older populations. Narrative exposure therapy (NET) may present an appropriate treatment approach for this population since it provides prolonged exposure in a lifespan perspective. As yet, however, no trial on this intervention has been (...) conducted with older adults from Western Europe.AimsExamining the efficacy of NET in a sample of older adults.Out-patients with post-traumatic stress disorder (PTSD), aged 55 years and over, were randomly assigned to either 11 sessions of NET (n = 18) or 11 sessions of present-centred therapy (PCT) (n = 15) and assessed on the Clinician-Administered PTSD Scale (CAPS) pre-treatment, post-treatment and at follow-up. Total scores as well as symptom scores (re-experience, avoidance and hyperarousal) were
Validation of a Model Predicting De Novo Stress Urinary Incontinence in Women Undergoing Pelvic Organ Prolapse Surgery To validate a previously developed prediction model for de novo stress urinary incontinence (SUI) after undergoing vaginal surgery for pelvic organ prolapse (POP).Model performance was determined using a cohort of women who participated in two, 14-center randomized trials in the Netherlands that evaluated whether postoperative SUI 1 year after surgery was reduced (...) with or without concomitant midurethral sling at the time of surgery for symptomatic women who had at least stage 2 POP. Age, number of previous vaginal births, urine leakage associated with urgency, history of diabetes, body mass index, preoperative stress test result, and placement of a midurethral sling were used to calculate the predicted probability of an individual developing de novo SUI. Predicted probabilities were compared with outcomes and quantitated using the concordance index and calibration