 | | The Effect of Exercise Training on Blood Lipids: A systematic review | The Effect of Exercise Training on Blood Lipids: A systematic review
The Effect of Exercise Training on Blood Lipids: A systematic review
Summary: The Effect of Exercise Training on Blood Lipids
Exercise training (ExTr) improves lipid markers such as total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, and very low-density lipoprotein (VLDL). A systematic review and meta-analysis of 148 randomized controlled trials (RCTs) showed significant but modest improvements in these lipid markers with aerobic (AT), resistance (RT), and combined training (CT). The study found CT to be optimal for managing dyslipidemia. Meta-regression indicated that each additional weekly aerobic session and minute of training further improved TC and HDL levels. The analysis confirmed sufficient data to support the benefits of ExTr on lipid profiles.
Journal: Sports Medicine 2024
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| | Negative Asociation Between Harsh Parenting and Life Satisfaction: Negative coping style as mediator and peer support as moderator | Negative Asociation Between Harsh Parenting and Life Satisfaction: Negative coping style as mediator and peer support as moderator
Negative Asociation Between Harsh Parenting and Life Satisfaction: Negative coping style as mediator and peer support as moderator
Overview Life satisfaction refers to an individual’s self-evaluation of how satisfied they are with their own life. It is significantly positively correlated with mental health status and negatively correlated with depression.
It is necessary to pay attention to factors that influence life satisfaction.
This study explores the negative effects of harsh parenting on life satisfaction among Chinese college students. It also examines how negative coping styles mediate this relationship and how peer support can mitigate the effects of harsh parenting.
It finds that harsh parenting, which includes physical and verbal aggression, is prevalent in China and negatively impacts children's psychological development.
The findings highlight the importance of reducing harsh parenting and promoting peer support to enhance adolescents' life satisfaction. | 3 | | R525.00 | |
| | HIV and Aids Part 2 | HIV and Aids Part 2
Overview
HIV (Human Immunodeficiency Virus) is a virus transmitted through sexual contact, shared needles, and from mother to child during childbirth or breastfeeding. It belongs to the Retroviridae family. All patients who are diagnosed with HIV should be initiated on ART as soon as possible.
HIV can also lead to complications like dementia and chronic diarrhea with weight loss (HIV wasting syndrome).
Exceptions to this include patients presenting with cryptococcal meningitis (CM) or central nervous system tuberculosis (tuberculous meningitis (TBM) or tuberculoma).
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| | HIV and Aids Part 1 | HIV and Aids Part 1
Overview
HIV (Human Immunodeficiency Virus) is a virus transmitted through sexual contact, shared needles, and from mother to child during childbirth or breastfeeding. It belongs to the Retroviridae family. Symptoms vary depending on the stage of infection and these include: - Acute stage, which resembles the flu, with fever, malaise, and a generalized rash;
- Asymptomatic stage which generally, has no symptoms.
- Lymphadenopathy, which presents with swelling of lymph nodes, which can be a primary symptom.
- AIDs, which is the advanced stage marked by severe infections or cancers.
HIV can also lead to complications like dementia and chronic diarrhea with weight loss (HIV wasting syndrome).
Sharespike Knowledge Studio | 3 | | R485.00 | |
| | Ebola Virus Infection | Ebola Virus Infection
Overview
Ebola virus is one of at least 30 known viruses capable of causing viral hemorrhagic fever syndrome. The genus Ebolavirus currently is classified into 5 separate species: Sudan ebolavirus, Zaire ebolavirus, Tai Forest (Ivory Coast) ebolavirus, Reston ebolavirus, and Bundibugyo ebolavirus. The outbreak of Ebola virus disease in West Africa from 2014 to 2016, involving Zaire ebolavirus, was the largest outbreak of Ebola virus disease in history.
As of September 17, 2019, an active outbreak of Ebola virus disease in the Democratic Republic of the Congo (DRC) had resulted in 3,034 confirmed and 111 probable cases of Ebola virus disease, including 2,103 attributable deaths. An experimental vaccine has been credited with limiting the outbreak’s scope.
| 3 | | R500.00 | |
| | Pre-hospital Endotracheal Intubation in Severe Traumatic Brain Injury: Ventilation Targets and Mortality—a Retrospective Study of 308 Patients | Pre-hospital Endotracheal Intubation in Severe Traumatic Brain Injury: Ventilation Targets and Mortality—a Retrospective Study of 308 Patients
Pre-hospital Endotracheal Intubation in Severe Traumatic Brain Injury: Ventilation Targets and Mortality—a Retrospective Study of 308 Patients
Overview Traumatic brain injury (TBI) remains one of the main causes of mortality and long-term disability worldwide. Maintaining physiology of brain tissue to the greatest extent possible through optimal management of blood pressure, airway, ventilation, and oxygenation, improves patient outcome. We studied the quality of prehospital care in severe TBI patients by analysing adherence to recommended target ranges for ventilation and blood pressure, prehospital time expenditure, and their effect on mortality, as well as quality of prehospital ventilation assessed by arterial partial pressure of CO2 (PaCO2) at hospital admission. Normocapnia at hospital admission was strongly associated with reduced probability of mortality. Prehospital and on scene times had no impact on mortality. Conclusions PaCO2 at hospital admission is strongly associated with mortality risk, but normocapnia is achieved only in a minority of patients. Therefore, the time required for placement of an arterial cannula and prehospital blood gas analysis may be warranted in severe TBI patients requiring on-scene tracheal intubation.
Journal Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Volume 31 Issue 46 | 3 | | R420.00 | |
| | Risk stratification tools for patients with syncope in emergency medical services and emergency departments: a scoping review | Risk stratification tools for patients with syncope in emergency medical services and emergency departments: a scoping review
Risk stratification tools for patients with syncope in emergency medical services and emergency departments: a scoping review
Overview Risk stratification for patients experiencing syncope presents a significant challenge in (prehospital) emergency care. Emergency Medical Services (EMS) and Emergency Department (ED) professionals must quickly distinguish between high-risk and low-risk syncope patients, often under time constraints and with limited resources. Researchers conducted a comprehensive review to identify risk stratification tools for patients experiencing syncope in prehospital and emergency care settings. They reviewed 5385 studies, selecting 38 that discussed 19 distinct tools, mainly developed for Emergency Department (ED) use. One tool was designed specifically for Emergency Medical Services (EMS). Most tools lack thorough validation, though they typically include history, physical examination, electrocardiogram, and additional tests to assess risk. The study highlights the importance of developing validated risk stratification tools to improve the management of syncope patients in emergency settings.
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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| | Oral Transmucosal Fentanyl Citrate Analgesia in Prehospital Trauma Care: an observational cohort study | Oral Transmucosal Fentanyl Citrate Analgesia in Prehospital Trauma Care: an observational cohort study
Oral Transmucosal Fentanyl Citrate Analgesia in Prehospital Trauma Care: an observational cohort study
Overview
Pain is a common prehospital symptom in trauma patients and requires timely management. Recent studies have indicated that up to 43% of trauma patients experience inadequate analgesia after prehospital treatment, suggesting the need for improvement. Evidence supports the prehospital use of oral transmucosal fentanyl citrate (OTFC) in military settings.
This observational cohort study examined the use of oral transmucosal fentanyl citrate (OTFC) for prehospital trauma care in remote and challenging environments. Conducted at three ski and bike resorts in Switzerland, the study involved 177 patients treated by trained EMS providers. Results indicated that OTFC is safe, effective, and practical for managing severe pain without the need for intravenous lines. Side effects were rare and mild.
Journal Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Journal 31 Issue 2
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| | Diagnostic performance of Glial Fibrillary Acidic Protein and Prehospital Stroke Scale for identification of stroke and stroke subtypes in an unselected patient cohort with symptom onset < 4.5 h | Diagnostic performance of Glial Fibrillary Acidic Protein and Prehospital Stroke Scale for identification of stroke and stroke subtypes in an unselected patient cohort with symptom onset < 4.5 h
Diagnostic performance of Glial Fibrillary Acidic Protein and Prehospital Stroke Scale for identification of stroke and stroke subtypes in an unselected patient cohort with symptom onset < 4.5 h
Overview Rapid treatment of stroke is critical for patient outcomes. This study examined glial fibrillary acidic protein (GFAP) alone and with the Prehospital Stroke Score (PreSS) for identifying acute stroke within 4.5 hours of symptom onset. Clinical data and serum samples were collected from Treat-NASPP. Patients with suspected stroke and symptoms lasting = 4.5 hours had blood samples taken and were evaluated using NIHSS. NIHSS was later translated into PreSS, and GFAP was measured with SIMOA. Results showed GFAP alone identified ICrH in unselected patients. When combined with PreSS, GFAP identified subgroups with high proportions of stroke mimics, ICrH, LVO, and AIS (non-LVO strokes). Journal Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2023 31:1
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| | The Associations Between Sedentary Behaviour and Neck Pain | The Associations Between Sedentary Behaviour and Neck Pain
The Associations Between Sedentary Behaviour and Neck Pain
Overview Research shows a strong link between prolonged sitting and increased neck pain risk, particularly from computer and mobile phone use. Neck pain, a common musculoskeletal disorder, affects about 70% of people globally at least once in their life. The risk is rising due to modern lifestyles and work habits. From 2006 to 2016, disability from neck pain increased by 21.9%, impacting physical function, quality of life, and work efficiency, with high medical and social costs. This study assessed the relationship between daily sedentary behaviour and neck pain risk, examining different populations by age, sex, occupation, and lifestyle. It concluded that longer sedentary periods significantly increase neck pain risk. Preventative measures for high-risk groups, such as females and employees, are necessary. Public health initiatives should aim to reduce sedentary behaviours and promote physical activity to improve neck health and combat the global prevalence of neck pain.
Journal BMC Public Health | 3 | | R495.00 | |
| | The value of Clinical signs in the diagnosis of Degenerative Cervical Myelopathy – A Systematic review and Meta-analysis | The value of Clinical signs in the diagnosis of Degenerative Cervical Myelopathy – A Systematic review and Meta-analysis
The value of Clinical signs in the diagnosis of Degenerative Cervical Myelopathy – A Systematic review and Meta-analysis
Overview
Degenerative cervical myelopathy (DCM) is a progressive spine condition and the most common cause of spinal cord dysfunction globally. Patients with DCM can exhibit subtle, nonspecific symptoms in their upper and lower extremities, making it challenging to diagnose this condition initially. Symptoms reported by patients include bilateral arm paresthesia, reduced manual dexterity, gait instability, and weakness. Other symptoms may include neck pain or stiffness, Lhermitte’s phenomena, and urinary or fecal urgency or incontinence. The delayed diagnosis of DCM is likely due to a combination of its subtle symptoms, incomplete neurological assessments by clinicians, and a lack of public and professional awareness. Establishing diagnostic criteria for DCM could facilitate earlier referral for definitive management. This systematic review aims to determine (i) the diagnostic accuracy of various clinical signs and (ii) the association between clinical signs and disease severity in DCM. In conclusion, the presence of clinical signs indicating spinal cord compression should prompt healthcare professionals to conduct further investigations, such as neuroimaging, to either confirm or refute a diagnosis of DCM.
Journal Global Spine Volume 14 Issue 4
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| | Psychology of Abusive Human Behaviour | Psychology of Abusive Human Behaviour
Psychology of Abusive Human Behaviour
Overview
The aim of this article is to explore the psychology of abusive human behaviour with special attention to gaslighting, defamation of character, mockery, bullying, and mobbing, based on the so-far published scientific literature, and my own experience and observations. Abusive human behaviour can have various forms, but the motivation is almost always the same: power and control over the victim.
Abusive human behaviour can have various forms. The most common motivation for abusive behaviour is power and control over the victim. Abusers are possessive, although they usually deny their actions of blaming and controlling the victim, and on the other hand, are insecure and suffer from untreated mental health problems, including depression and suicidal ideation psychological abuse, especially if longer lasting, can cause serious psychological and even physical damage to the victim. Society should be more aware of the detrimental effects of abusive human behaviour in its variety of forms and be ready to offer adequate medical, psychological and legal help for the victim.
Journal Open Journal of Medical Psychology Volume 11 Issue 2 | 3 | | R485.00 | |
| | Factors influencing streaming to general practitioners in emergency departments: A qualitative study | Factors influencing streaming to general practitioners in emergency departments: A qualitative study
Factors influencing streaming to general practitioners in emergency departments: A qualitative study
Overview Emergency Department (ED) attendance is rising globally, with many cases that could be managed in general practice. In England, policies require some patients in EDs to be "streamed" or directed to general practitioners (GPs) working within or alongside EDs. However, evidence for this approach is limited, and the processes involved lack thorough exploration. This study investigates patient streaming to GPs across 10 sites in England. Using qualitative data from 186 observations and 226 interviews with healthcare professionals, six key themes were identified that influence streaming success: structural support, personnel development, effective protocols, negotiation of primary/secondary care boundaries, interprofessional relationships, and patient safety concerns. The study found that the skills of streaming nurses and the collaboration between streamers and GPs were critical for safe and effective streaming. However, there was no single streaming model linked to success. Instead, various factors contributed to good practice, and the issue of "inappropriate" streaming—where patients were misdirected—was identified as a challenge. The study offers key recommendations to improve streaming practices and highlights the importance of tailored solutions across different sites to enhance the effectiveness of streaming in EDs.
Journal: International Journal of Nursing Studies Volume 120 Issue 10 | 3 | | R485.00 | |
| | Physically Active Lifestyle Attenuates Impairments on Lung Function and Mechanics in Hypertensive Older Adults | Physically Active Lifestyle Attenuates Impairments on Lung Function and Mechanics in Hypertensive Older Adults
Physically Active Lifestyle Attenuates Impairments on Lung Function and Mechanics in Hypertensive Older Adults
Overview Physical activity attenuates hypertension in older adults, but its impact on pulmonary function and mechanics in hypertensive older adults is unknown. The study seeks to understand whether a physically active lifestyle can improve respiratory capacity, the mechanical efficiency of the lungs, and, consequently, the quality of life of these individuals, comparing data between groups of active and sedentary hypertensive older adults.
This is a cross-sectional study. 731 older adults were evaluated, stratified into two initial groups: hypertensive older adults (HE; n = 445) and non-hypertensive older adults (NHE; n = 286). For a secondary analysis, we used the International Physical Activity Questionnaire to sub-stratify HE and NHE into four groups: physically inactive hypertensive (PIH; n = 182), active hypertensive (AH; n = 110), physically inactive non-hypertensive (PINH; n = 104), and active non-hypertensive (ANH; n = 65). Lung function was measured by spirometry, and lung mechanics were assessed by impulse oscillometry.
It was concluded that hypertension is associated with impaired lung function and mechanics in older adults, and a physically active lifestyle attenuates these dysfunctions.
Journal
Advances in Respiratory Medicine Volume 92 Issue 4
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| | Inherited Thrombophilia and Risk of Thrombosis in Children with Cancer: A Single-center Experience | Inherited Thrombophilia and Risk of Thrombosis in Children with Cancer: A Single-center Experience
Inherited Thrombophilia and Risk of Thrombosis in Children with Cancer: A Single-center Experience
Overview Thrombosis is an increasingly recognized complication of childhood malignancy and its treatment. The incidence and etiology of pediatric cancer-related thrombosis is still not well understood. The aim of this study was to evaluate the prevalence of common prothrombotic genetic conditions in children with cancer, the frequency of thrombosis, and the role of inherited thrombophilia in the development of thrombosis in a pediatric oncology population.
Forty-seven children (36 treated for haematological malignancies and 11 for solid tumours) with a median age of 8.8. years (range 0.4 – 19.3 years) were included in the study. Genetic polymorphisms of Factor V Leiden (G1691A), prothrombin G20210A, and methylenetetrahydrofolate reductase (MTHFR) C677T were determined by real-time polymerase chain reaction-based DNA analysis.
It was concluded that thrombosis is an important complication of childhood cancer. The risk of thrombosis may be increased in patients with Factor V Leiden. In the absence of consensus guidelines, our results support the recommendation for thrombophilia screening in children with cancer.
Journal
Acta Medica Academica | 3 | | R485.00 | |
| | Factors Predictive of In-Hospital Mortality in Patients with Systemic Lupus Erythematosus: A Single-Centre Retrospective Analysis | Factors Predictive of In-Hospital Mortality in Patients with Systemic Lupus Erythematosus: A Single-Centre Retrospective Analysis
Factors Predictive of In-Hospital Mortality in Patients with Systemic Lupus Erythematosus: A Single-Centre Retrospective Analysis
Overview This article investigates the causes and factors predictive of in-hospital death among patients with systemic lupus erythematosus (SLE) admitted to a tertiary care hospital in Thailand.
They retrospectively reviewed the records of patients with SLE admitted between 2017 and 2021. We collected data related to age, sex, body mass index, comor¬bidities, disease duration, medication usage, clinical symptoms, vital signs, laboratory results, evidence of infection, presence of systemic inflammatory response syndrome, quick sepsis-related organ assessment scores, and SLE disease activity on the date of admission. The length of hospitalization, treatment administered, and subsequent clinical outcomes (including in-hospital complications and death) were also recorded.
It was concluded that infection was the major cause of mortality in patients with SLE. Prior hospitalization within 3 months, initial infection on admission, vasopressor use, and mechanical ventilation during admission are independent risk factors for in-hospital mortality in patients with SLE.
Journal
Acta medica academica
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| | Evaluation of the efficacy and safety of an innovative flavonoid lotion in patients with haemorrhoid: a randomised clinical trial | Evaluation of the efficacy and safety of an innovative flavonoid lotion in patients with haemorrhoid: a randomised clinical trial
Evaluation of the efficacy and safety of an innovative flavonoid lotion in patients with haemorrhoid: a randomised clinical trial
Overview
Haemorrhoids are one of the most common gastrointestinal and anal diseases. In olive oil and honey propolis, flavonoids have beneficial effects on improving vascular function and decreasing vascular resistance.
In this study, we aimed to produce a combination of these two substances in the form of lotions and assess their healing and side effects in comparison with routine treatment, anti-haemorrhoid ointment (containing hydrocortisone and lidocaine). Design In this randomised clinical trial study, 86 patients with grade 2 or more haemorrhoid degrees, diagnosed by colonoscopy, were divided into two groups, the case (n=44) and control (n=42). The case group was treated with flavonoid lotion, and the control group was treated with anti-haemorrhoid ointment two times per day for 1 month. Patients were followed weekly with history and physical examination. The data of the two groups were collected before and after the intervention and statistically analysed.
According to the results, it was concluded that flavonoid lotion can be an excellent alternative to topical chemical drugs, such as anti-haemorrhoid ointment, in treating haemorrhoid disease. Besides its effectiveness and safety, it can be easily manufactured and widely available to patient.
Journal
Acta medica academica
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| | Influence of pain neuroscience education and exercises for the management of neck pain: A meta-analysis of randomized controlled trials | Influence of pain neuroscience education and exercises for the management of neck pain: A meta-analysis of randomized controlled trials
Influence of pain neuroscience education and exercises for the management of neck pain: A meta-analysis of randomized controlled trials
Overview It is elusive to combine pain neuroscience education with exercises to treat neck pain, and this meta-analysis aims to study the efficacy of pain neuroscience education plus exercises for the treatment of neck pain. Several databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systemically searched from inception to August 2023, and we included the randomized controlled trials (RCTs) assessing the effect of pain neuroscience education plus exercises on the relief of neck pain.
It was concluded that pain neuroscience education plus exercises is effective for the relief of neck pain.
Journal Medicine Volume 103 Issue 48
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| | Enterobacter Infection | Enterobacter Infection
Overview
Enterobacter infections can include bacteremia, lower respiratory tract infections, skin and soft tissue infections, urinary tract infections (UTIs), endocarditis, intra-abdominal infections, septic arthritis, osteomyelitis, CNS infections, and ophthalmic infections. Enterobacter infections can necessitate prolonged hospitalization, multiple and varied imaging studies and laboratory tests, various surgical and nonsurgical procedures, and powerful and expensive antimicrobial agents. Enterobacter infections do not have a clinical presentation that is specific enough to differentiate them from other acute bacterial infections. Bacteremia Signs of Enterobacter bacteremia include various symptoms and cause lower respiratory tract infections can manifest identically to those caused by Streptococcus Pneumoniae or other organisms Enterobacter infections do not have a clinical presentation that is specific enough to differentiate them from other acute. This course addresses the symptoms and the causes.
Sharespike Knowledge Studio | 3 | | R485.00 | |
| | Early Diagnosis on ADHD: Is it Possible? | Early Diagnosis on ADHD: Is it Possible?
Early Diagnosis on ADHD: Is it Possible?
Overview Early diagnosis of ADHD is crucial to prevent significant functional impairment and economic burden. Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity. These symptoms can lead to various degrees of functional impairment across different settings. Individuals with undiagnosed ADHD are at higher risk of facing challenges such as imprisonment, depression, and drug misuse. If left undiagnosed and untreated, ADHD can impose a significant economic burden on society. Research in Mexico aimed to assess the accessibility to timely diagnoses for children and adolescents with ADHD, along with their primary caregivers. This pioneering study was conducted in two phases at specialized mental health services. The findings suggest that starting the Access Pathway where signs and symptoms of ADHD are first detected, particularly in schools, can prevent children from suffering the consequences of late diagnosis. School-based mental health service models have been successfully tested in other regions, making them a viable option to shorten the time required to obtain a timely diagnosis and mitigate the negative consequences associated with ADHD.
Journal: BMC Health Services Research
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| | Associations of Symptom Severity of Mentally ill parents on family functioning and children’s mental health | Associations of Symptom Severity of Mentally ill parents on family functioning and children’s mental health
Associations of Symptom Severity of Mentally ill parents on family functioning and children’s mental health
Overview Parental mental illness has a negative impact on children’s mental health. Often, the entire family structure suffers from the consequences of parental illness. The consequences of mental illness impact not only the affected persons themselves, but also the family environment (Perez et al., 2018). Especially children of mentally ill parents have been studied regarding their risk for psychopathology. Children of families with parents with mental illness also use a broad spectrum of mental health care, school-based support, and youth welfare services even if they are not yet diagnosed as having a mental disorder. Parental mental health problems constitute a significant risk for children’s mental health. Children of mentally ill parents have a significantly increased risk of developing a mental illness over the course of their childhood or adolescence compared to the general population. If a parent suffers from mental illness, the child is two to three times more likely to be mentally ill as well, with the risk elevating to a fivefold when both parents are affected The results of this study s underline the importance of personalized interventions in terms of parental symptom severity to minimize negative outcomes for children and the whole family.
Journal: Psychology 2024
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| | Effect of group sand play therapy on psychopathologies of adolescents with delinquent behaviours | Effect of group sand play therapy on psychopathologies of adolescents with delinquent behaviours
Effect of group sand play therapy on psychopathologies of adolescents with delinquent behaviours
Overview Adolescence is a period in which drastic changes occur in physiological, emotional, and cognitive aspects of development. Adolescents often express diverse conflicts and confusions stemming from physical changes, identity establishment, and environmental adaptation processes, which manifest as various problematic behaviours. These developmental conflicts often make adolescents vulnerable to delinquency and deviant behaviours. Glueck and Glueck investigated the differences between 500 delinquent adolescents and 500 typical adolescents from Boston, along parameters including relationship with parents, personality, and temperament, and suggested that individual traits such as defiance, impulsiveness, and emotional instability are predictors of delinquency. Prior research has established adolescent vulnerability to delinquent behaviour. This single arm, noninterventional, observational study investigated the effect of sand play therapy on the psychopathologies of adolescents with delinquent behaviour. A total of 68 adolescents participated in the study. Results of this study showed that group sand play therapy is effective in improving internalizing problems such as depression and anxiety, as well as externalizing problems of ADHD features and impulsiveness among adolescents with deviant behaviours.
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| | Prediction of osteoporosis using MRI and CT scans with unimodal and multimodal deep-learning models | Prediction of osteoporosis using MRI and CT scans with unimodal and multimodal deep-learning models
Prediction of osteoporosis using MRI and CT scans with unimodal and multimodal deep-learning models
Overview Osteoporosis involves the systematic degeneration of the human skeleton, leading to decreased quality of life and increased mortality risk. Predicting osteoporosis can help reduce these risks and enable patients to take necessary precautions. Deep-learning models have shown accurate results using various imaging modalities. This research aimed to develop unimodal and multimodal deep-learning diagnostic models to predict bone mineral loss in the lumbar vertebrae using magnetic resonance (MR) and computed tomography (CT) imaging. Osteoporosis is a systemic skeletal degenerative disease marked by the deterioration of bone tissue microstructure and low bone mineral density (BMD), resulting in increased bone fragility and fracture susceptibility. Fragility fractures are the main complication of osteoporosis, impacting morbidity, mortality, and quality of life. As the elderly population grows, osteoporosis prevalence is rising. By 2020, it was estimated that approximately 12.3 million individuals over 50 in the United States would have osteoporosis. Research by Tuzun et al. indicated that the prevalence of osteoporosis among Turkish citizens increases with age, affecting 3%-4% of individuals at age 50 and more than 30% by age 80. These numbers are projected to increase by 64% (870,000 men and 1,841,000 women) by 2035. This study showed that osteoporosis could be accurately predicted using the proposed models with both MR and CT images, with a multimodal approach enhancing prediction accuracy. Further research involving prospective studies with a larger patient cohort may facilitate integrating these technologies into clinical practice.
Journal Diagnostic and Interventional Radiology
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| | Serum Magnesium is Inversely Associated with Body Composition and Metabolic Syndrome | Serum Magnesium is Inversely Associated with Body Composition and Metabolic Syndrome
Serum Magnesium is Inversely Associated with Body Composition and Metabolic Syndrome
Overview
Magnesium is vital to maintain normal physiological functions. We aimed to identify the association between serum magnesium and different measures of body adiposity among Qatari adults. We hypothesized that the association was mediated by depression and sleep duration.
The study included 1000 adults aged 20 years and above who attended the Qatar Biobank Study (QBB) between 2012 and 2019. Body adiposity was assessed using dual-energy X-ray absorptiometry (DEXA). Serum magnesium concentration was measured. Sub-optimal magnesium was defined as magnesium concentration less than 0.85 mmol/L. The association was examined using linear regression.
It was concluded that there was an inverse association between serum magnesium and fat mass, especially among those with an adequate sleep duration and without chronic conditions including diabetes, hypertension and depression.
Journal
Diabetes, Metabolic Syndrome and Obesity Volume 2023 Issue 16
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| | Relationship between chronic disease and depression: the mediating effect of pain | Relationship between chronic disease and depression: the mediating effect of pain
Relationship between chronic disease and depression: the mediating effect of pain
Overview The incidence of depression was high in people who were female, less educated, unmarried, living in rural areas, and working. Chronic diseases have a high incidence in China and may cause pain and depression. However, the association of chronic diseases with pain and the incidence of depression has not been comprehensively investigated.
The study population was obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The main outcome was the incidence of depression. The main independent variable was chronic disease (no chronic disease, one chronic disease, and two or more chronic diseases). The mediators were the degree of pain (no pain, mild pain, and moderate to severe pain) and whether measures were taken to relieve pain (measures taken and no measures taken). In conclusion the degree of pain had a partial mediating effect on chronic disease and depression. Pain relief measures should be considered when treating patients with depression.
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| | Going Beyond the Visible in Type 2 Diabetes Mellitus: Defence Mechanisms and their Associations with Depression and Health-Related Quality of Life | Going Beyond the Visible in Type 2 Diabetes Mellitus: Defence Mechanisms and their Associations with Depression and Health-Related Quality of Life
Going Beyond the Visible in Type 2 Diabetes Mellitus: Defence Mechanisms and their Associations with Depression and Health-Related Quality of Life
Overview
Clinical psychological features may impact a person’s aptitude to deal with chronic diseases, leading to emotional distress, suffering, and a worse perceived quality of life (QoL). Chronic diseases are largely represented, and their incidence is constantly increasing all over the world. Type 2 Diabetes Mellitus (T2DM) is one of the most common chronic diseases and it is very difficult to manage, demanding long term self-management, which improves the perceived QoL. The aim of this study was to explore defence mechanisms, depression, QoL, time since diagnosis, and metabolic control in T2DM patients.
In conclusion of the study the correlations between defence mechanisms, depression and health-related QoL highlight the potential personification and protagonization, which may increase over time due to the illness intrusiveness and worsening of diabetes symptoms. The positive association between defensive strategies and well-being measures should be cautiously considered. URL: Going Beyond the Visible in Type 2 Diabetes Mellitus: Defence Mechanisms and Their Associations With Depression and Health-Related Quality of Life (nih.gov) | 3 | | R485.00 | |
| | Prevention of Common Mental Disorders | Prevention of Common Mental Disorders
Prevention of Common Mental Disorders
Overview
This article provides information on how to prevent common mental disorders such as depression and anxiety disorders. The concept of resilience was discussed with reference to risk factors and factors protecting against mental disorders.
The article deals with the prevention of mental disorders, describing its specificity and types. It also focuses on the importance of early intervention in the prevention of mental disorders, emphasizing the need for action already at the stage of infancy. The issues of difficulties in self-regulation in early childhood as a risk factor for the development of disorders in the area of mental health were also discussed, and the possibilities of preventive interventions in this regard were discussed
Statistics show that every year more and more people, including children and adolescents, suffer from mental disorders. Despite alarming data, government spending in the mental health area still does not meet mental health needs. Mental disorders are conditioned by many factors, both non-modifiable and modifiable. Modification of risk factors may, therefore, become an opportunity to reduce the probability of mental disorders, but it requires appropriately adapted interactions
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| | Psychological Distress during the Retirement Transition and the Role of Psychosocial Working Conditions and Social Living Environment | Psychological Distress during the Retirement Transition and the Role of Psychosocial Working Conditions and Social Living Environment
Psychological Distress during the Retirement Transition and the Role of Psychosocial Working Conditions and Social Living Environment
Mental health is determined by social, biological, and cultural factors and is sensitive to life transitions. We examine how psychosocial working conditions, social living environment, and cumulative risk factors are associated with mental health changes during the retirement transition.
Mental disorders are one of the leading causes of ill-health and disability, increasing the risk of chronic physical conditions and mortality. Mental health is determined by a range of socioeconomic, biological, and cultural factors and is sensitive to major life changes and transitions. Retirement is an important transitional period in late adulthood, traditionally considered as a stressful event, having negative consequences on mental health due to changes in established routines, loss of work-related roles and activities, and reduced income levels. However, there is accumulating evidence of retirement having positive effects on mental health potentially as a consequence of relief from stressful work, increased leisure time, increased physical activity longer sleep duration and fewer sleep difficulties
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| | Patients with Multiple Sclerosis in Psychotherapy: Processes of Meaning Making and Self Transformation | Patients with Multiple Sclerosis in Psychotherapy: Processes of Meaning Making and Self Transformation
Patients with Multiple Sclerosis in Psychotherapy: Processes of Meaning Making and Self Transformation
MS is a central nervous system disease which is characterised by demyelination, inflammation and neurodegeneration. There are about 2.2 million cases of MS worldwide.
The progression of the illness exhibits significant individual variation ranging from vision problems, fatigue, spasticity and pain to cognitive dysfunction and mood disorders
Recent empirical literature on autoimmune diseases has focused extensively on the implementation and evaluation of psychosocial interventions. Psychotherapy and counselling processes for multiple sclerosis (MS) have gained special attention given the cognitive and behavioural dimensions of the symptoms as well as their unpredictable course. The current study aims to gain a deeper understanding of the meaning making processes for persons with MS (PwMS) who are in psychotherapy treatment.
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| | Evaluation of the advantages of robotic versus laparoscopic surgery in elderly patients with colorectal cancer | Evaluation of the advantages of robotic versus laparoscopic surgery in elderly patients with colorectal cancer
Evaluation of the advantages of robotic versus laparoscopic surgery in elderly patients with colorectal cancer
Overview The incidence of colorectal cancer increases with aging. Curative-intent surgery based on a minimally invasive concept is expected to bring survival benefits to elderly patients (aged over 80 years) with colorectal cancer who are frequently with fragile health status and advanced tumours. The study explored survival outcomes in this patient population who received robotic or laparoscopic surgery and aimed to identify an optimal surgical option for those patients. The clinical materials and follow-up data were retrieved on elderly patients with colorectal carcinoma who received robotic or laparoscopic surgery in our institution. The pathological and surgical outcomes were compared to examine the efficacy and safety of the two approaches. The DFS (disease-free survival) and OS (overall survival) results at 3 years after surgery were assessed to explore the survival benefits. It was concluded that robotic surgery was prized for elderly patients with colorectal cancer who developed anemia and/or haematological conditions.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9942364/pdf/12877_2023_Article_3822.pdf
Journal BMC Geriatrics | 3 | | R485.00 | |
| | Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients | Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients
Long-Term Outcomes of Venous Resections in Pancreatic Ductal Adenocarcinoma Patients
Overview The objective was to investigate whether pancreatic resections (PR) for pancreatic ductal adenocarcinoma (PDAC) is associated with worse survival when resection of the superior mesenteric vein/portal vein (SMV/PV) is required. PR for PDAC with resection of the superior mesenteric vein/portal vein (SMV/PV, PR+V resection) may be associated with inferior overall survival (OS) compared with PR without the need for SMV/PV resection (PR–V). We hypothesized that PR+V results in lower OS compared with PR–V. Overall, 2403 patients were identified. Six hundred two underwent exploration only (EXP group), whereas 412 underwent pancreatic resection with (PR+V group) and 1389 (PR–V) without SMV/PV resection. Five-year OS for the PR+V group was lower (20% vs 30%) compared with PR–V, although multivariate Cox proportional hazards modeling could not associate PR+V status with OS (Hazard ratio 1.11, P = 0.408). When correcting for confounders, PR+V was not associated with lower OS compared with PR–V. Journal Annals of Surgery Open | 3 | | R450.00 | |
| | The role of CT in decision for acute appendicitis treatment | The role of CT in decision for acute appendicitis treatment
The role of CT in decision for acute appendicitis treatment
Overview Acute appendicitis is the most common cause of acute abdomen requiring surgery. Although the standard treatment has been surgery, it has been seen in recent years that treatment is possible with antibiotics and non-operative observation. In this study, our aim is to determine whether the computed tomography (CT) findings in patients diagnosed with acute appendicitis can be used for directing treatment. As the successful and unsuccessful medical treatment groups were compared, the only significant parameter was the severity of mural enhancement (P = .005). CT findings may be helpful in patients with uncomplicated acute appendicitis whose treatment surgeons are indecisive about. We can recommend surgical treatment in cases with appendix diameter =13 mm, intra-abdominal free fluid, appendicolith, high CT appendicitis score, and severe mural enhancement.
Journal Diagnostic Interventional Radiology
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| | Acceptability and deliverability of an auditory rhythmical cueing (ARC) training programme for use at home and outdoors to improve gait and physical activity post-stroke | Acceptability and deliverability of an auditory rhythmical cueing (ARC) training programme for use at home and outdoors to improve gait and physical activity post-stroke
Acceptability and deliverability of an auditory rhythmical cueing (ARC) training programme for use at home and outdoors to improve gait and physical activity post-stroke
Overview Although laboratory studies demonstrate that training programmes using auditory rhythmical cueing (ARC) may improve gait post-stroke, few studies have evaluated this intervention in the home and outdoors where deployment may be more appropriate. This manuscript reports stakeholder refinement of an ARC gait and balance training programme for use at home and outdoors, and a study which assessed acceptability and deliverability of this programme. Programme design and content were refined during stakeholder workshops involving physiotherapists and stroke survivors. A two-group acceptability and deliverability study was then undertaken. It was concluded that an ARC gait and balance training programme refined by key stakeholders was feasible to deliver and acceptable to participants and providers.
Archives of Physiotherapy Vol. 12, Issue 1 | 3 | | R485.00 | |
| | An Implicit–Explicit Framework for Intervention Methods in Developmental Language Disorder | An Implicit–Explicit Framework for Intervention Methods in Developmental Language Disorder
An Implicit–Explicit Framework for Intervention Methods in Developmental Language Disorder
Overview
The growing interest in framing intervention approaches as either implicit or explicit calls for a discussion of what makes intervention approaches engage each of these learning systems, with the goal of achieving a shared framework. This tutorial presents evidence for the interaction between implicit and explicit learning systems, and it highlights the intervention characteristics that promote implicit or explicit learning as well as outcome measures that tap into implicit or explicit knowledge. This framework is then applied to eight common intervention approaches and notable combinations of approaches to unpack their differential engagement of implicit and explicit learning.
Many intervention characteristics (e.g., instructions, elicitation techniques, feedback) can be manipulated to move an intervention along the implicit–explicit continuum. Given the bias for using explicit learning strategies that develops throughout childhood and into adulthood, clinicians should be aware that most interventions (even those that promote implicit learning) will engage the explicit learning system. However, increased awareness of the implicit and explicit learning systems and their cognitive demands will allow clinicians to choose the most appropriate intervention for the target behaviour. | 3 | | R485.00 | |
| | Comorbidity and Severity in Childhood Apraxia of Speech: A Retrospective Chart Review | Comorbidity and Severity in Childhood Apraxia of Speech: A Retrospective Chart Review
Comorbidity and Severity in Childhood Apraxia of Speech: A Retrospective Chart Review
Overview
The purpose of this study was to investigate comorbidity prevalence and patterns in childhood apraxia of speech (CAS) and their relationship to severity. In this retroactive cross-sectional study, medical communication-related comorbidities were regressed on CAS severity as rated by speech-language pathologists during diagnosis. The relationship between CAS severity and the presence of four common comorbid conditions was also examined using ordinal or multinomial regressions. Children with comorbid intellectual disability (78.1%), receptive language impairment (72.5%), and nonspeech apraxia (37.3%; including limb, nonspeech oromotor, and oculomotor these comorbidities. However, children with comorbid autism spectrum disorder (33.6%) were no more likely to have severe CAS than children without autism.
Comorbidity appears to be the rule, rather than the exception, for children with CAS. Comorbid intellectual disability, receptive language impairment, and nonspeech apraxia confer additional risk for more severe forms of CAS. Findings are limited by being from a convenience sample of participants but inform future models of comorbidity.
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| | Robot-Assisted Sacro (hystero) Colpopexy with Anterior and Posterior Mesh Placement: impact on lower bowel tract function and clinical outcomes at mid-term follow-up | Robot-Assisted Sacro (hystero) Colpopexy with Anterior and Posterior Mesh Placement: impact on lower bowel tract function and clinical outcomes at mid-term follow-up
Robot-Assisted Sacro (hystero) Colpopexy with Anterior and Posterior Mesh Placement: impact on lower bowel tract function and clinical outcomes at mid-term follow-up
Overview
Robotic sacrocolpopexy (RSCP) is an established option for the treatment of apical, anterior, and proximal posterior compartment pelvic organ prolapses (POP). However, there is lack of evidence investigating how lower bowel tract symptoms (LBTS) may change after RSCP.
Data from consecutive patients treated with RSCP for stage 3 or higher POP from 2012 to 2019 at a single tertiary referral center with at least 1 year of follow-up were prospectively collected and retrospectively analysed. RSCP was performed following a standardized technique which always employed both anterior and posterior hand-shaped meshes.
Outcomes were collected at follow-up and analysed. LBTS were evaluated through the Wexner questionnaire. Overall, 114 women underwent RSCP. Eleven were excluded for missing data, whereas 12 had insufficient follow-up. Median follow-up was 42 [interquartile range (IQR), 19–62] months. Mean age was 65 ± 10 years. In our series, RSCP was mainly performed for anterior and apical/medium stage 3 POP (in 95.6% of patients). Anatomic success rate of and were treated with redo-SCP. No patient experienced clinically significant posterior vaginal wall prolapse after RSCP.
Of note, LBTS appear unaffected by posterior mesh placement, supporting its routine use to prevent posterior POP recurrence. Larger prospective studies are needed to confirm our results.
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| | Role of organizational psychology in dealing with human resources and the performance of the organization | Role of organizational psychology in dealing with human resources and the performance of the organization
Role of organizational psychology in dealing with human resources and the performance of the organization
Organizational psychology focuses mainly on taking care of corporate interests and the needs of employees. This seeks to provide a better life and better conditions for employees in their companies to help them be more productive and effective in their organization. This article focuses on how the organization is practicing the psychology of training and motivation for the growth of the organization.
This study was undertaken with the employees working in different organizations. The main focus is how organizational psychology creates an impact on the performance of the organization. This study was undertaken with the employees working in different organizations.
In this research, many participants agreed that motivation and training affect the employees’ performance. The outcomes revealed that organizational psychology has many roles in the participants’ organizations such as increasing the performance, the productivity, the efficiency of the employees and many others. | 3 | | R445.00 | |
| | Gaining a Better Understanding of the Types of Organizational Culture to Manage Suffering at Work | Gaining a Better Understanding of the Types of Organizational Culture to Manage Suffering at Work
Gaining a Better Understanding of the Types of Organizational Culture to Manage Suffering at Work
Overview
Organizational culture is a central concept in research due to its importance in organizational functioning and suffering of employees. To better manage suffering, it is necessary to better understand the intrinsic characteristics of each type of culture and its relationships with the environment.
According to the study by Schein (2010), the organizational culture is a pattern of basic values and presuppositions that are shared and learned by a group while resolving the problems of external adaptation and internal integration. Each culture represents a different set of values and presuppositions. All organizations have all four types but in different proportions. This is a typological model because it aims to identify archetypes using different effectiveness criteria.
Contrary to what most of the literature suggests, we found almost no relationship between the environmental variables and the culture types. Strategy and competencies, in contrast, do have a significant predictive capacity, showing 9 links with the Clan culture, 7 with the Hierarchy culture, and 10 with the Market culture. In conclusion, this study has found the important characteristics of the types of organizational culture that could be useful to better manage the suffering of employees.
| 3 | | R489.00 | |
| | The digital-era Industrial/Organisational Psychologist: Employers view of key service roles, skills and attributes | The digital-era Industrial/Organisational Psychologist: Employers view of key service roles, skills and attributes
The digital-era Industrial/Organisational Psychologist: Employers view of key service roles, skills and attributes
Overview The nature of the Fourth Industrial Revolution’s technology-driven work and business profoundly alters the foundational assumptions upon which industrial/organisational (I/O) psychologists in future will base their understanding of their professional roles in the modern workplace. The objective of the study was to gain deeper insight into South African employers’ views of the service roles, skills and attributes of the future-fit digital-era I/O psychologist. More research is needed on the service roles, skills and attributes that employers require from I/O psychologists as companies are transitioning to technology-enabled hybrid and flexible models of work. Digitally dexterous I/O psychologists should be at the forefront of technology and its impact on workplaces and the profession’s scope of practice.
The study adds to the Industrial/Organisational Psychology research literature and reveals the dire need for I/O psychologists to adapt and evolve their scope of practice services and products to ensure the continued relevance of the IOP profession. | 3 | | R425.00 | |
| | Prevalence and Factors Associated with Substance Use Among University Students in South Africa: implications for prevention | Prevalence and Factors Associated with Substance Use Among University Students in South Africa: implications for prevention
Prevalence and Factors Associated with Substance Use Among University Students in South Africa: implications for prevention
Substance use is an important public health concern in many countries across the globe. Among the public, institutions of higher learning have developed a reputation for inducing new substance use among students. In addition to socio-demographic factors, substance use and abuse among university students often appear to be related to psychological stressors typically related to the demand to adapt to the new environment and the pressures associated with academia. The purpose of this study was to identify the prevalence of, and factors associated with substance use among university students.
Findings of such studies show that the use of alcohol, particularly getting drunk and binge drinking, marijuana and non-prescription amphetamine, were considerably higher among university students when compared with their non-university attending peers.
It is hoped that the results, implications, limitation, and recommendation of the present study invokes increased focus and ignites novel or innovative thinking when undertaking research of similar nature.
Journal BMC Psychol. 2022; 10: 309 | 3 | | R485.00 | |
| | Hearing Loss, Tinnitus, and Dizziness in COVID-19: A Systematic Review and Meta-Analysis | Hearing Loss, Tinnitus, and Dizziness in COVID-19: A Systematic Review and Meta-Analysis
Hearing Loss, Tinnitus, and Dizziness in COVID-19: A Systematic Review and Meta-Analysis
Extensive studies indicate that severe acute respiratory syndrome coronavirus (SARS-CoV-2) involves human sensory systems. A lack of discussion, however, exists given the auditory–vestibular system involvement in CoV disease 2019 (COVID-19). The present systematic review and meta-analysis were performed to determine the event rate (ER) of hearing loss, tinnitus, and dizziness caused by SARS-CoV-2.
Databases (PubMed, ScienceDirect, Wiley) and World Health Organization updates were searched using combined keywords: ‘COVID-19,’ ‘SARS-CoV-2,’ ‘pandemic,’ ‘auditory dysfunction,’ ‘hearing loss,’ ‘tinnitus,’ ‘vestibular dysfunction,’ ‘dizziness,’ ‘vertigo,’ and ‘otologic symptoms.’ Twelve papers met the eligibility criteria and were included in the study. These papers were single group prospective, cross-sectional, or retrospective studies on otolaryngologic, neurologic, or general clinical symptoms of COVID-19 and had used subjective assessments for data collection (case histories/medical records). The results of the meta-analysis demonstrate that the ER of hearing loss (3.1%, CIs: 0.01–0.09), tinnitus (4.5%, CIs: 0.012–0.153), and dizziness (12.2%, CIs: 0.070–0.204) is statistically significant in patients with COVID-19 (Z = -4.469, p = 0.001).
Journal
The Canadian Journal of Neurological Sciences Inc. | 3 | | R465.00 | |
| | Loneliness, Ageism, and Mental Health: The buffering role of resilience in seniors | Loneliness, Ageism, and Mental Health: The buffering role of resilience in seniors
Loneliness, Ageism, and Mental Health: The buffering role of resilience in seniors
Ageism and loneliness are two relevant public health phenomena because of their negative impact on the senior's mental health. With the increase in average life expectancy, these tend to co-occur, which may increase the psychological distress (PD) of seniors. Resilience has been shown to be an important protective factor of seniors’ mental health, although its potential buffering role of public health risk factors with cumulative impact on mental health, such as loneliness and ageism, needs to be more studied.
Resilience was an important protective factor of mental health against the effects of ageism, and partially protected mental health from the effects of loneliness among seniors. It is suggested that resilience be considered as a factor to be integrated in future intervention programs for mental health. The practical applicability of this study is discussed.
Journal International Journal of Clinical Health Psychology Volume 23 Issue 1 | 3 | | R465.00 | |
| | Childhood Adverse Events and the Long-Term Effects on Mental Health | Childhood Adverse Events and the Long-Term Effects on Mental Health
Childhood Adverse Events and the Long-Term Effects on Mental Health
There has long been an association between family history and mental illness; however, recently researchers have focused on the correlation between childhood adverse events and mood disorders, specifically bipolar disorder. This study shows there is a strong correlation between CAE and PB, specifically, sexual abuse in females, maternal separation, economic difficulty and a family history of mental illness.
The findings suggest that females that experience childhood adverse events may be at a higher risk for developing bipolar disorder and the clinical outcome of bipolar disorder may also be affected by the type and number of childhood adverse events.
The results also suggest that schizophrenic spectrum disorders, bipolar disorder and major depressive disorder are associated with different childhood adverse events. Females who have recollections of childhood abuse are at an increased risk for depressive symptoms associated with bipolar disorder. Psychosocial interventions that are geared towards limiting childhood adverse events may reduce the incidence of mental illness, specifically bipolar disorder. | 3 | | R465.00 | |
| | Diagnostic Accuracy of 3D Ultrasound and Artificial Intelligence for Detection of Pediatric Wrist Injuries | Diagnostic Accuracy of 3D Ultrasound and Artificial Intelligence for Detection of Pediatric Wrist Injuries
Diagnostic Accuracy of 3D Ultrasound and Artificial Intelligence for Detection of Pediatric Wrist Injuries
Wrist trauma is common in children, typically requiring radiography for diagnosis and treatment planning. However, many children do not have fractures and are unnecessarily exposed to radiation. Ultrasound performed at bedside could detect fractures prior to radiography.
Fractures are the third leading cause of pediatric hospitalizations in Canada. Distal radius fractures account for up to 25% of fractures documented in children. Distal radius fractures typically occur in children falling on an outstretched hand and involve the metaphysis or physis. Depending on the area of injury, there can be a multitude of fracture patterns that affect treatment planning. Therefore, when children present to primary care clinics or emergency department (ED) with suspected wrist fractures, radiographs are the standard of care as they allow for precise examination of the anatomy. In most hospitals, routine radiographs are performed on patients with wrist trauma, but only half of the imaging reveals fractures. With the estimated cost of treating pediatric forearm fractures at $2 billion per year in the USA, streamlining care is desirable.,Obtaining radiographs in ED typically involves sending the patient to a separate diagnostic imaging area, where they wait in an additional queue, and transferring them back, a process which can add hours to an ED visit. If clinicians could determine at bedside who has a fracture and requires an X-ray, systemwide radiation doses and costs could be reduced and ED visits shortened.
The high sensitivity of 3D ultrasound and automated AI ultrasound interpretation suggests that ultrasound could potentially rule out fractures in the emergency department.
Journal Children
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| | A 20-Year Review of Biomechanical Experimental Studies on Spine Implants used for Percutaneous Surgical Repair of Vertebral Compression Fractures | A 20-Year Review of Biomechanical Experimental Studies on Spine Implants used for Percutaneous Surgical Repair of Vertebral Compression Fractures
A 20-Year Review of Biomechanical Experimental Studies on Spine Implants used for Percutaneous Surgical Repair of Vertebral Compression Fractures
A vertebral compression fracture (VCF) is an injury to a vertebra of the spine affecting the cortical walls and/or middle cancellous section. The most common risk factor for a VCF is osteoporosis, thus predisposing the elderly and postmenopausal women to this injury.
This article reviews over 20 years of scientific literature that has experimentally evaluated the biomechanics of percutaneous VCF repair methods. Specifically, this article describes the basic operating principles of the repair methods, the study protocols used to experimentally assess their biomechanical performance, and the actual biomechanical data measured, as well as giving several recommendations for future research directions.
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| | Motion of lumbar endplate in degenerative lumbar scoliosis with different cobb angle in vivo: Reflecting the biomechanics of the lumbar disc | Motion of lumbar endplate in degenerative lumbar scoliosis with different cobb angle in vivo: Reflecting the biomechanics of the lumbar disc
Motion of lumbar endplate in degenerative lumbar scoliosis with different cobb angle in vivo: Reflecting the biomechanics of the lumbar disc
Degenerative lumbar scoliosis (DLS) was defined as a coronal Cobb angle greater than 10°. DLS is a de novo scoliosis with no previous history and is mainly related to age with an incidence of up to 60%. DLS can cause severe symptoms, such as low back pain, radiculopathy, and neurogenic claudication. The pathogenesis of DLS is both complex and controversial. Intervertebral disc degeneration (DD) has also been implicated in the development of DLS.
This study explored the ROM of the lumbar vertebral endplate in vivo to reflect disc deformation using a dual fluoroscopic imaging system. It was reported that the repeatability of the method in reproducing in vivo human spine 6 degree of freedom. Intervertebral DD is believed to have a detrimental effect on the ROM of the spinal segments in degenerative scoliosis.
The study also aimed to investigate the relationship between DD and the ROM of the lumbar vertebral endplates in patients with DLS. We hypothesized that the ROM of the lumbar endplate would be different in DLS patients with different Cobb angles. DD can increase the ROM of the lumbar vertebral endplate in patients with DLS. | 3 | | R425.00 | |
| | Five-Minute Cognitive Test as A New Quick Screening of Cognitive Impairment in the Elderly | Five-Minute Cognitive Test as A New Quick Screening of Cognitive Impairment in the Elderly
Five-Minute Cognitive Test as A New Quick Screening of Cognitive Impairment in the Elderly
Overview
As old population is dramatically growing, the detection of early cognitive deficit will become increasingly crucial. Effective cognitive screening test with quick and convenient merits will ensure recognition of early cognitive deficit and timely intervention. This study aims to develop a new evaluation method for quickly and conveniently screening cognitive impairment in the elderly.
The five-minute cognitive test (FCT) was designed to capture deficits in five domains of cognitive abilities, including episodic memory, language fluency, time orientation, visuospatial function, and executive function. Subsequently, FCT efficiencies in differentiating normally cognitive ability from cognitive impairment were explored and compared with that of the Mini-Mental Status Evaluation (MMSE). Equipercentile equating method was utilized to create a crosswalk between scores of the FCT and MMSE. Further, the association of scores of the FCT and MMSE with hippocampal volumes was investigated.
Many screening tools are currently available, but no tools meet the four important requirements for widespread use in clinical practice or large-scale epidemiological studies — that is, capture a clinically acceptable range of cognitive domains, take short time to administrate (around 5 minutes), have high accuracy for detecting cognitive impairment, and incorporate visual recall, which is the earliest deficits in Alzheimer’s disease (AD) patients. The FCT is a novel, reliable, and valid cognitive screening test for the detection of dementia at early stages.
Journal
JKL International LLC Aging and Disease Volume 10, Number 6 URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6844584/pdf/ad-10-6-1258.pdf | 3 | | R425.00 | |
| | Exercise Interventions in Child and Adolescent Mental Health Care: An overview of the evidence and recommendations for implementation | Exercise Interventions in Child and Adolescent Mental Health Care: An overview of the evidence and recommendations for implementation
Exercise Interventions in Child and Adolescent Mental Health Care: An overview of the evidence and recommendations for implementation
Overview
The poor physical health of people with mental illness has long been established. A 15–20-year mortality gap arises from factors such as the likelihood of developing noncommunicable diseases, unhealthy lifestyle behaviors, reduced access to and provision of physical health care, and side-effects of medication.
This has been labeled an international human rights scandal, since a large proportion of this risk is preventable. In recognition of these disparities, international health bodies have produced guidance to address poor physical health, including the World Health Organization, World Psychiatric Association, and a Lancet Psychiatry Commission.
The use of physical activity interventions in mental health care for adults has a large academic evidence base and numerous examples of real-world implementation. However, the use of physical activity within mental health care for children and young people (CYP) has received less attention to date.
The key conclusions from this article, suggest there is an increasingly strong evidence base for the benefits of using physical activity interventions to improve, prevent, and manage physical and mental health outcomes in CYP with mental illness. However, more work needs to be done to improve the evidence base, refine its implementation into standard mental health care, and develop strategies for large-scale dissemination of such interventions across various care and cultural contexts.
The Association for Child and Adolescent Mental Health JCPP Advances | 3 | | R485.00 | |
| | Mixed reality applications in urology: Requirements and future potential | Mixed reality applications in urology: Requirements and future potential
Mixed reality applications in urology: Requirements and future potential
Overview Mixed reality (MR), the computer-supported augmentation of a real environment with virtual elements, becomes ever more relevant in the medical domain, especially in urology, ranging from education and training over surgeries. This study aimed to review existing MR technologies and their applications in urology. A non-systematic review of current literature was performed using the PubMed-Medline database using the medical subject headings (MeSH) term “mixed reality”, combined with one of the following terms: “virtual reality”, “augmented reality”, ‘’urology’’ and “augmented virtuality”. The relevant studies were utilized. It was found that medical students, urology residents and inexperienced urologists can gain experience thanks to MR technologies. MR applications are also used in patient education before interventions. For surgical support, the achievable accuracy is often not sufficient. The main challenges are the non-rigid nature of the genitourinary organs, intraoperative data acquisition, online and multimodal registration and calibration of devices. However, the progress made in recent years is tremendous in all respects and the gap is constantly shrinking.
Authors Gerd Reis, Mehmet Yilmaz, Jason Rambach, Alain Pagani, Rodrigo Suarez-Ibarrola, Arkadiusz Miernik, Paul Lesur, Nareg Minaskan
| 3 | | R400.00 | |
| | Effectiveness of an Eye-Cervical Re-Education Program in Chronic Neck Pain: A Randomized Clinical Trial | Effectiveness of an Eye-Cervical Re-Education Program in Chronic Neck Pain: A Randomized Clinical Trial
Effectiveness of an Eye-Cervical Re-Education Program in Chronic Neck Pain: A Randomized Clinical Trial
Overview:
Proprioceptive training is popularly applied as a therapeutic exercise method in physiotherapy. Its effects on pain and range of motion are only poorly evaluated. Adults with neck pain commonly experience hyperalgesia of cervical muscles, as evidenced by a reduced pressure pain threshold (PPT). Pain symptoms are thought to worsen in response to prolonged static muscle activity and/or repetitive job tasks, causing muscle metabolic disturbances. The reduced range of neck motion (ROM) is another objective finding widely investigated in CNP. It could be argued that the optimal functioning of the cervical musculature is related to the ROM; changes in neck muscle activation that result in an altered stiffness distribution may affect cervical passive stability as well as the passive and active ROM.
This study assesses the effectiveness of proprioceptive training with an Eye-Cervical Re-education Program to decrease pain and increase the joint range in chronic neck pain patients. All patients were treated with a multimodal physiotherapy intervention. The experimental group was supplemented with an exercise program that included eye-cervical proprioception.
In conclusion the eye-cervical re-education program is effective at relieving pain pressure thresholds in the upper trapezius, right levator scapula, and left splenius capitis and especially effective for increasing the cervical range of motion.
Acknowledgments: Authors: Veronica Perez-Cabezas, Carmen Ruiz-Molinero, Jose Jesus Jimenez-Rejano, Gema Chamorro Moriana, Gloria Gonzalez-Medina and Raquel Chillon-Martinez
Journal: Evidence-Based Complementary and Alternative Medicine | 3 | | R410.00 | |
| | Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study | Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study
Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study
Overview The spectrum of neurological and psychiatric complications associated with paediatric SARS-CoV-2 infection is poorly understood. This study aimed to analyse the range and prevalence of these complications in hospitalised children and adolescents. A national cohort study was conducted in the UK using an online network of secure rapid-response notification portals established by the CoroNerve study group. Patients were excluded if they did not have a neurological consultation or neurological investigations or both or did not meet the definition for confirmed SARS-CoV-2 infection (a positive PCR or respiratory or spinal fluid samples, serology for anti-SARS-CoV-2 IgG, or both). Individuals were classified as having either a primary neurological disorder associated with COVID-19 (COVID-19 neurology group) or PIMS-TS with neurological features (PIMS-TS neurology group). The denominator of all hospitalised children and adolescents with COVID-19 was collated from National Health Service England data. This study identified key differences between those with a primary neurological disorder versus those with PIMS-TS. Compared with patients with a primary neurological disorder, more patients with PIMS-TS needed intensive care, but outcomes were similar overall.
Authors Stephen T J Ray et al
Journal The Lancet Child & Adolescent Health | 3 | | R410.00 | |
| | Rural Family Medicine Clinicians’ Motivations to Participate in a Pragmatic Obesity Trial | Rural Family Medicine Clinicians’ Motivations to Participate in a Pragmatic Obesity Trial
Rural Family Medicine Clinicians’ Motivations to Participate in a Pragmatic Obesity Trial
Overview To understand the motivations of rural-practicing primary care clinicians who participate in an intensive multiyear pragmatic randomized behavioural obesity intervention trial, Rural Engagement in Primary Care for Optimizing Weight Reduction (RE-POWER).
Structured interviews were conducted with 21 family medicine clinicians who were study leads at participating rural practices. Themes emerged through an analysis of transcripts and interview notes by using the constant comparative method.
The analysis revealed 3 main themes. First, primary care clinicians participated in RE-POWER because it provided a concrete plan to address their recurring clinical care need for effective obesity treatment and management. Second, participation offered help to frustrated physicians who felt a deep professional duty to care for all their patients’ problems but were dissatisfied with current obesity management. Third, participation was also attractive to rural primary care clinicians because it provided a visible and sustainable way to demonstrate their commitment to improving the health of patients and the broader community.
The findings show that clinicians are motivated to try solutions for a clinical problem— in this case obesity—when that clinical problem is also closely connected to a particularly frustrating area of clinical care that challenges their professional identity. Our data suggest that a motivation to close the gap between ideal and real practice can become such a high priority that clinicians are sometimes willing to try potential solutions, such as engagement in research, that they otherwise would not consider.
Authors Joanna Veazey Brooks, PhD, MBE, Kim S. Kimminau, PhD, Stacy McCrea-Robertson, MS, and Christie Befort, PhD Journal Journal of the American Board of Family Medicine | 3 | | R455.00 | |
| | Influences for Gender Disparity in Academic Family Medicine in North American Medical Schools | Influences for Gender Disparity in Academic Family Medicine in North American Medical Schools
Influences for Gender Disparity in Academic Family Medicine in North American Medical Schools
Overview Women physicians continue to comprise the minority of leadership roles in Academic Family Medicine (AFM) faculty across North American medical schools. This study quantified the current state of gender disparity by analysing academic position, leadership ranking, and research productivity.
A database for 6,746 AFM faculty members was generated. Gender and academic profiles were obtained for 2,892 academic ranks and 1,706 leadership roles by searching faculty listings enlisted in Fellowship and Residency Electronic Interactive Database (FREIDA) and Canadian Resident Matching Service (CaRMS).
The results indicated that women hold 46.11% (3,110/6,746) of faculty positions. The proportional composition decreased with increasing academic ranking (49.84% assistant, 46.78% associate, and 41.5% full professor). The same decreasing trend was demonstrated with leadership rank (57.14% minor leadership, 47.65% second-in-command, and 36.61 first-in command). Compared to their gender counterparts, women in AFM demonstrated lower publication productivity as measured by citation number (p=0.04) and years of study (p=0.008).
In conclusion it was found that the composition of academic family medicine faculty members included in this study demonstrated gender disparity. Inclusivity initiatives and policies to tackle the issue of female retention, promotion, and recruitment need to be further explored.
Authors Szu-Yu Tina Chen, Sabeena Jalal, Maryam Ahmadi, Kiran Khurshid, Nizar Bhulani, Ateeq U. Rehman, Aftab Ahmad, Jeffrey Ding, Terri-Leigh R. Aldred, Faisal Khosa
Journal Cureus
| 3 | | R410.00 | |
| | Effect of Deep Cervical Flexor Muscle Training Using Pressure Biofeedback on Pain and Forward Head Posture in School Teachers with Neck Pain: An Observational Study | Effect of Deep Cervical Flexor Muscle Training Using Pressure Biofeedback on Pain and Forward Head Posture in School Teachers with Neck Pain: An Observational Study
Effect of Deep Cervical Flexor Muscle Training Using Pressure Biofeedback on Pain and Forward Head Posture in School Teachers with Neck Pain: An Observational Study
Overview: Teaching is one of the professions where incidence and prevalence of neck pain is high. Prolonged use of computers, which has further increased due to online teaching amid pandemic, is known to cause neck pain and alter posture, while people with forward head posture (FHP) are prone to develop neck pain and related disability. Research has shown that impairment of deep cervical flexor (DCF) muscles leads to insufficiency in coordination, activation, overload, and poor support on cervical structures that further lead to development of neck pain and altered neck posture. The objective of this study was to see the effect of DCF muscle training using pressure biofeedback on pain and FHP in schoolteachers with neck pain.
This observational study was conducted at medical center in school premises. Fifty-five schoolteachers aged between 25 and 40 years with experience of more than 5 years were invited to participate in this study. Pain and FHP were assessed using NPRS and cranio-vertebral angle using digital photograph technique, respectively, at baseline and end of four weeks of treatment.
This study shows that although pain and FHP improved following conventional exercises in schoolteachers with neck pain, mean improvement was more significant among those who received additional DCF muscle training using pressure biofeedback.
Acknowledgments:
Authors: Ahmad H. Alghadir and Zaheen A. Iqbal
Journal: BioMed Research International | 3 | | R465.00 | |
| | Hypertension Part 3 | Hypertension Part 3
Overview Hypertension is a leading risk factor for cardiovascular disease and a significant cause of morbidity and mortality. For patients who are symptomatic, however, uncontrolled elevations in blood pressure are true medical emergencies that require rapid intervention in the ED. It is therefore important to understand the disease of chronic hypertension and, perhaps more important, episodes of acute and uncontrolled elevations in blood pressure so that we, as prehospital care providers, can better stratify these patients into low- and high-risk groups that may or may not require transport to an ED for evaluation and treatment.
As we will discuss, it is reasonable to say that not every patient who presents with hypertension is at high risk of morbidity and mortality and absolutely requires evaluation and treatment at an ED. This is not to say EMTs and paramedics should talk patients out of going to EDs for evaluation. Rather, we will strive to give prehospital care providers a better understanding of the risks involved with acute hypertension so they can better work with their patients to find a solution that is safe, reasonable and responsible for everyone involved. This article discusses the topic of acute hypertension, hypertensive urgency and hypertensive emergencies in an effort to help EMS providers better understand these illnesses and help patients make the best decisions regarding their transport and care.
Authors:
Sharespike
| 3 | | R420.00 | |
| | Hypertension Part 2 | Hypertension Part 2
Overview Hypertension is a leading risk factor for cardiovascular disease and a significant cause of morbidity and mortality. For patients who are symptomatic, however, uncontrolled elevations in blood pressure are true medical emergencies that require rapid intervention in the ED. It is therefore important to understand the disease of chronic hypertension and, perhaps more important, episodes of acute and uncontrolled elevations in blood pressure so that we, as prehospital care providers, can better stratify these patients into low- and high-risk groups that may or may not require transport to an ED for evaluation and treatment.
As we will discuss, it is reasonable to say that not every patient who presents with hypertension is at high risk of morbidity and mortality and absolutely requires evaluation and treatment at an ED. This is not to say EMTs and paramedics should talk patients out of going to EDs for evaluation. Rather, we will strive to give prehospital care providers a better understanding of the risks involved with acute hypertension so they can better work with their patients to find a solution that is safe, reasonable and responsible for everyone involved. This article discusses the topic of acute hypertension, hypertensive urgency and hypertensive emergencies in an effort to help EMS providers better understand these illnesses and help patients make the best decisions regarding their transport and care.
Authors:
Sharespike
| 3 | | R420.00 | |
| | Bee Sting and Anaphylaxis | Bee Sting and Anaphylaxis
Bee Sting and Anaphylaxis
Overview Hymenoptera stings account for more deaths in the United States than any other envenomation. The order Hymenoptera includes Apis species, ie, bees (European, African), vespids (wasps, yellow jackets, hornets), and ants. Most deaths result from immediate hypersensitivity reactions and anaphylaxis. Severe anaphylactoid reactions occur occasionally when toxins directly stimulate mast cells. In addition to immunologic mechanisms, some injury occurs from direct toxicity. While most stings cause only minor problems, stings cause a significant number of deaths.
Target organs are the skin, vascular system, and respiratory system. Pathology is like other immunoglobulin E (IgE)–mediated allergic reactions. Anaphylaxis is a common and life-threatening consequence of Hymenoptera stings and is typically a result of sudden systemic release of mast cells and basophil mediators. Urticaria, vasodilation, bronchospasm, laryngospasm, and angioedema are prominent symptoms of the reaction. Respiratory arrest may result in refractory cases
This study aims to discuss the different stings, prognosis and emergency reactions and treatment thereto.
Author Sharespike | 3 | | R410.00 | |
| | COVID-19 among dentists in the United States A 6-month longitudinal report of accumulative prevalence and incidence | COVID-19 among dentists in the United States A 6-month longitudinal report of accumulative prevalence and incidence
COVID-19 among dentists in the United States A 6-month longitudinal report of accumulative prevalence and incidence
Overview In 2020, the Centers for Disease Control and Prevention and the American Dental Association released COVID-19 infection control interim guidance for US dentists, advising the use of optimal personal protection equipment during aerosol-generating procedures. The aim of this longitudinal study was to determine the cumulative prevalence and incidence rates of COVID-19 among dentists and to assess their level of engagement in specific infection control practices. US dentists were invited to participate in a monthly web-based survey from June through November 2020. The proportion of dentists tested for COVID-19 increased over time, as did the rate of dentists performing aerosol-generating procedures. Enhanced infection prevention and control strategies in the dental practice were reported by nearly every participant monthly, and rates of personal protection equipment optimization, such as changing masks after each patient, dropped over time. US dentists continue to show a high level of adherence to enhanced infection control procedures in response to the ongoing pandemic, resulting in low rates of cumulative prevalence of COVID-19. Dentists are showing adherence to a strict protocol for enhanced infection control, which should help protect their patients, their dental team members, and themselves. COVID-19 infections among practicing dentists will likely remain low if dentists continue to adhere to guidance.
Authors Marcelo W.B. Araujo, DDS, MS, PhD; Cameron G. Estrich, MPH, PhD; Matthew Mikkelsen, MA; Rachel Morrissey, MPA; Brittany Harrison, MA; Maria L. Geisinger, DDS, MS; Effie Ioannidou, DDS, MDS; Marko Vujicic Journal JADA
| 3 | | R425.00 | |
| | Oral Health and Autism Spectrum Disorders: A Unique Collaboration between Dentistry and Occupational Therapy | Oral Health and Autism Spectrum Disorders: A Unique Collaboration between Dentistry and Occupational Therapy
Oral Health and Autism Spectrum Disorders: A Unique Collaboration between Dentistry and Occupational Therapy
Overview
Children with autism spectrum disorders (ASD) are at risk for oral health disparities. With the dramatic rise in ASD prevalence to 1 in 54 children, it is likely that an increasing number of dental practitioners will encounter or be asked to treat children with ASD. This paper reviews explanations related to the increasing prevalence of ASD, provides reasons why children with ASD are at increased risk for poor oral health, and discusses unique interprofessional collaborations between dental practitioners and occupational therapists. Occupational therapists and dentists can work together to plan modifications to the dental environment or adapt dental protocols to reduce some of the barriers encountered by those with ASD, provide desensitization strategies before the clinic visit, or help a child with emotional regulation during clinical treatments.
Authors Dominique H. Como,Leah I. Stein Duker, José C. Polido and Sharon A. Cermak
Journal Int. J. Environ. Res. Public Health | 3 | | R425.00 | |
| | Amebiasis | Amebiasis
Overview Amebiasis is caused by Entamoeba histolytica, a protozoan that is found worldwide. The highest prevalence of amebiasis is in developing countries where barriers between human faeces and food and water supplies are inadequate.
Although most cases of amebiasis are asymptomatic, dysentery and invasive extraintestinal disease can occur. Amebic liver abscess is the most common manifestation of invasive amebiasis, but other organs can also be involved, including pleuropulmonary, cardiac, cerebral, renal, genitourinary, peritoneal, and cutaneous sites. In developed countries, amebiasis primarily affects migrants from and travellers to endemic regions, men who have sex with men, and immunosuppressed or institutionalized individuals.
The National Institute of Allergy and Infectious Diseases (NIAID) has classified E histolytica as a category B biodefense pathogen because of its low infectious dose, environmental stability, resistance to chlorine, and ease of dissemination through contamination of food and water supplies.
E histolytica is transmitted via ingestion of the cystic form (infective stage) of the protozoa. Viable in the environment for weeks to months, cysts can be found in soil contaminated with faecal, fertilizer, or water or on the contaminated hands of food handlers. Faecal-oral transmission can also occur in the setting of anal sexual practices or direct rectal inoculation through colonic irrigation devices.
Author Sharespike
| 3 | | R425.00 | |
| | Asthma Exacerbation Part 2 | Asthma Exacerbation Part 2
Asthma Exacerbation Part 2
Overview
Asthma is a common chronic disease worldwide and affects approximately 26 million persons in the United States. It is the most common chronic disease in childhood, affecting an estimated 7 million children, and it is a common cause of hospitalization for children in the United States.
The pathophysiology of asthma is complex and involves airway inflammation, intermittent airflow obstruction, and bronchial hyperresponsiveness. The mechanism of inflammation in asthma may be acute, subacute, or chronic, and the presence of airway edema and mucus secretion also contributes to airflow obstruction and bronchial reactivity. Varying degrees of mononuclear cell and eosinophil infiltration, mucus hypersecretion, desquamation of the epithelium, smooth muscle hyperplasia, and airway remodelling are present. Physical findings vary with the severity of the asthma and with the absence or presence of an acute episode and its severity. Pharmacologic management includes the use of relief and control agents.
Author Sharespike | 3 | | R465.00 | |
| | Asthma Exacerbation Part 1 | Asthma Exacerbation Part 1
Asthma Exacerbation Part 1
Overview
Asthma is a common chronic disease worldwide and affects approximately 26 million persons in the United States. It is the most common chronic disease in childhood, affecting an estimated 7 million children, and it is a common cause of hospitalization for children in the United States.
The pathophysiology of asthma is complex and involves airway inflammation, intermittent airflow obstruction, and bronchial hyperresponsiveness. The mechanism of inflammation in asthma may be acute, subacute, or chronic, and the presence of airway edema and mucus secretion also contributes to airflow obstruction and bronchial reactivity. Varying degrees of mononuclear cell and eosinophil infiltration, mucus hypersecretion, desquamation of the epithelium, smooth muscle hyperplasia, and airway remodelling are present. Physical findings vary with the severity of the asthma and with the absence or presence of an acute episode and its severity. Pharmacologic management includes the use of relief and control agents. Author Sharespike | 3 | | R465.00 | |
| | The role of the dentist in the diagnosis and management of pediatric obstructive sleep apnea | The role of the dentist in the diagnosis and management of pediatric obstructive sleep apnea
The role of the dentist in the diagnosis and management of pediatric obstructive sleep apnea
Overview
The objective of this article is to review the role of the dentist in the early diagnosis of pediatric obstructive sleep apnoea (OSA) and to provide an in-depth review of the best evidence-based practices available to treat and/or to refer these patients for intervention. A narrative review was performed using indexed data bases (PubMed, Medline, EMBASE, OVID, Scopus and Cochrane) up to year 2020, and approximately 1000 articles were reviewed. The articles included were those with the best information provided.
Detailed review of the literature suggests that the role of the dentist has been redefined owing to their expertise in the orofacial region. Every patient consulting a dental practice is not merely a dental patient; he/she also requires a comprehensive medical review. The role of the dentist is pivotal in pediatric patients once diagnosed with OSA; as the patients grow, growth modification can be achieved, and future management will be easier. Initiating dental treatments during growth can benefit patients two-fold, saving them from malocclusion, and intervening in orofacial structural growth can help to avoid cumbersome treatments, such as CPAP and various surgeries. Proper diagnosis and management of systemic illnesses can prevent compromised quality of life, delays in treatment, morbidity and, in some cases, mortality.
Authors: Hafiz M. Moin Anwer, Hamad N. Albagieh, Mythili Kalladka, Harmeet K. Chiang, Shaima Malik , Sean W. McLaren, Junad Khan
Journal: Saudi Dental Journal
| 3 | | R420.00 | |
| | Differences in the Knowledge and Experience of Physicians and Dentists About Medication-Related Osteonecrosis of the Jaw in Osteoporotic Patients | Differences in the Knowledge and Experience of Physicians and Dentists About Medication-Related Osteonecrosis of the Jaw in Osteoporotic Patients
Differences in the Knowledge and Experience of Physicians and Dentists About Medication-Related Osteonecrosis of the Jaw in Osteoporotic Patients
Overview Prevention of medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis requires the cooperation of physicians and dentists. This study investigated the knowledge, experience, and behaviour related to medical and dental cooperation for MRONJ prevention in patients with osteoporosis between physicians and dentists practising in the Shiga prefecture. A cross-sectional study was conducted to investigate the cooperation between practising physicians and dentists for preventing osteonecrosis of the jaw (ONJ) in patients with osteoporosis using 2 separate questionnaires from July 28, 2018, to February 3, 2019. The behaviour of physicians and dentists was insufficient to enable medical and dental cooperation for the prevention of MRONJ in patients with osteoporosis. The lack of cooperation between physicians and dentists during osteoporosis treatment is documented in this study. | 3 | | R420.00 | |
| | Assessment of SARS-CoV-2 infection-in dentists and supporting staff at a university dental hospital in Argentina | Assessment of SARS-CoV-2 infection-in dentists and supporting staff at a university dental hospital in Argentina
Assessment of SARS-CoV-2 infection-in dentists and supporting staff at a university dental hospital in Argentina
Overview Oral healthcare professionals are at increased risk of infection by SARS-CoV-2. The aim of this study was to evaluate the prevalence of COVID-19 in a population of workers who provided services during the COVID19 pandemic at a dental care and educational institution in the Buenos Aires Metropolitan Area. This was a descriptive, cross-sectional study including 358 workers who provided essential services during the first 180 days of the COVID-19 pandemic at the Dental Hospital at Buenos Aires University School of Dentistry (FOUBA). Following epidemiological data, these workers underwent diagnostic testing for COVID-19 (1- nasal or throat swab tests; 2- blood test for enzyme-linked immunosorbent assays [ELISA]; 3- commercial rapid serology test). Three diagnostic tests were implemented. Rapid tests were performed on 290 subjects, with 255 negative results
For this sample of dentists, dental assistants and nonclinical personnel, the weighted prevalence of COVID-19 was 4%.
Authors Sebastian Puia, Jorge Pasart, Ariel Gualtieri, Francisco Somoza, Carolina Melo, Milton Alessandrelo, Patricio Gatti, Aldo Squassi, Pablo Alejandro Rodriguez
Journal Journal of Oral Biology and Craniofacial Research | 3 | | R410.00 | |
| | Pain Management through Neurocognitive Therapeutic Exercises in Hypermobile Ehlers–Danlos Syndrome Patients with Chronic Low Back Pain | Pain Management through Neurocognitive Therapeutic Exercises in Hypermobile Ehlers–Danlos Syndrome Patients with Chronic Low Back Pain
Pain Management through Neurocognitive Therapeutic Exercises in Hypermobile Ehlers–Danlos Syndrome Patients with Chronic Low Back Pain
Overview The hypermobile type of Ehlers–Danlos syndrome (hEDS) is likely the most common hereditary disorder of connective tissue mainly characterized by joint hypermobility. Patients with hEDS suffer joint pain, in particular low back pain, commonly resistant to drug therapy. The aim of this research was to evaluate a neurocognitive rehabilitation approach based not only on the motion and function recovery but also on the pain management. In this nonrandomized clinical trial, eighteen hEDS patients (4 males and 14 females) with mean age 21 years (range 13-55) were recruited and evaluated before and after three months of rehabilitation treatment. The clinical results observed in this study seem to confirm the role of a specific neurocognitive rehabilitation program in the chronic pain management in the Ehlers–Danlos syndrome; the rehabilitation treatment should be tailored on patient problems and focused not only in the recovery of movement but also on pain perception.
Authors Claudia Celletti, Teresa Paolucci , Loredana Maggi, Giordana Volpi, Mariangela Billi, Roberta Mollica,and Filippo Camerota
Journal Hindawi BioMed Research International | 3 | | R435.00 | |
| | Applying machine learning on health record data from general practitioners to predict suicidality | Applying machine learning on health record data from general practitioners to predict suicidality
Applying machine learning on health record data from general practitioners to predict suicidality
Overview Suicidal behaviour is difficult to detect in the general practice. Machine learning (ML) algorithms using routinely collected data might support General Practitioners (GPs) in the detection of suicidal behaviour. In this paper, we applied machine learning techniques to support GPs recognizing suicidal behaviour in primary care patients using routinely collected general practice data. Machine learning was applied to predict suicidal behaviour using general practice data. Our results showed that these techniques can be used as a complementary step in the identification and stratification of patients at risk of suicidal behaviour. The results are encouraging and provide a first step to use automated screening directly in clinical practice. Additional data from different social domains, such as employment and education, might improve accuracy.
Authors Kasper van Mens, Elke Elzinga, Mark Nielen, Joran Lokkerbol, Rune Poortvliet, Gé Donker, Marianne Heins, Joke Korevaarc, Michel Dückers, Claire Aussems, Marco Helbich, Bea Tiemens, Renske Gilissen, Aartjan Beekman, Derek de Beurs
| 3 | | R425.00 | |
| | Differences in Nonspecific Low Back Pain Between Young Adult Females with and without Lumbar Scoliosis | Differences in Nonspecific Low Back Pain Between Young Adult Females with and without Lumbar Scoliosis
Differences in Nonspecific Low Back Pain Between Young Adult Females with and without Lumbar Scoliosis
Overview There is no consensus as to whether NSLBP in scoliosis patients is related to scoliosis per se or is just a normal symptom that could happen in anyone. The aim of this study was to compare the differences in NSLBP between young adult female patients with and without lumbar scoliosis and to provide a theoretical basis for differential treatment of NSLBP in patients with and without lumbar scoliosis.
Ninety female young adults with NSLBP were divided into scoliosis and non-scoliosis groups. Characteristics of pain, lumbar mobility, muscle strength, Cobb angle, axial trunk rotation (ATR) angle, and surface electromyography (SEMG) signal were compared between the two groups. After the various results, it was concluded that the characteristics of NSLBP experienced by patients with lumbar scoliosis were distinct from those of NSLBP experienced by non-scoliotic patients. The treatment of NSLBP in scoliotic patients should be different from that in non-scoliotic patients.
Authors WangshuYuan1 JianxiongShen2 LixiaChen1 HaiWang2 Keyi Yu2 HuiCong1 Jingya Zhou3 and Youxi Lin2
Journal Hindawi Pain Research and Management
| 3 | | R435.00 | |
| | Imagined and Actual Acupuncture Effects on Chronic Low Back Pain: A Preliminary Study | Imagined and Actual Acupuncture Effects on Chronic Low Back Pain: A Preliminary Study
Imagined and Actual Acupuncture Effects on Chronic Low Back Pain: A Preliminary Study
Overview
Research suggests that imagined experiences can produce brain responses similar to those produced by actual experiences. Shared brain responses that support both imagination and perception may underlie the functional nature of mental imagery. In a previous study, acupuncture and imagery were combined to develop a new treatment method, video-guided acupuncture imagery treatment (VGAIT). We found that VGAIT significantly increased pain thresholds in healthy subjects. The aim of this study is to extend our previous finding by investigating whether VGAIT can relieve symptoms in patients with chronic low back pain. The study showed the results of all three treatments (VGAIT, real, and sham acupuncture) significantly reduced pain severity as measured by a low back pain bothersomeness score. VGAIT produced similar effects to real acupuncture (p = 0:97) and non-significantly greater pain bothersomeness relief compared to sham acupuncture (p = 0:14). Additional analysis showed that there was no significant difference on the sensations evoked by different treatment modalities. In conclusion these findings support VGAIT as a promising method for pain management.
Authors Jin Cao, Scott P. Orr, Georgia Wilson, and Jian Kong
Journal Hindawi Neural Plasticity
| 3 | | R465.00 | |
| | Intra-Articular versus Subacromial Corticosteroid Injection for the Treatment of Adhesive Capsulitis: A Meta-Analysis and Systematic Review | Intra-Articular versus Subacromial Corticosteroid Injection for the Treatment of Adhesive Capsulitis: A Meta-Analysis and Systematic Review
Intra-Articular versus Subacromial Corticosteroid Injection for the Treatment of Adhesive Capsulitis: A Meta-Analysis and Systematic Review
Overview
Adhesive capsulitis is one of the most well-known causes of pain and stiffness of the shoulder. Corticosteroid injections have been used for many years. However, it is still controversial where corticosteroid should be injected, whether subacromial or intra-articular.
The objective of this meta-analysis was to compare the effects of intra-articular (IA) and subacromial (SA) corticosteroid injections for the treatment of adhesive capsulitis. The Cochrane risk of bias tool and PEDro score were used to evaluate the quality of the studies. The primary clinical outcomes including VAS, Constant score, ASES score, and ROM were collected. The secondary outcome of corticosteroid-related adverse reactions was also compared between the two groups. The results were evaluated and compared at five time points. All studies were of low risk of bias and medium-high quality with the PEDro score =5 points. It was concluded that when corticosteroid injection is used to treat adhesive capsulitis, both injection sites can be selected.
Authors Xiaoke Shang, Zhong Zhang, Xuelin Pan, Jian Li and Qi Li
Journal Hindawi Biomedical Research International | 3 | | R425.00 | |
| | Incidence and Risk Factors of Low Back Pain in Marathon Runners | Incidence and Risk Factors of Low Back Pain in Marathon Runners
Incidence and Risk Factors of Low Back Pain in Marathon Runners
Overview The occurrence of low back pain (LBP) in marathon runners has been poorly understood. This study aimed to describe the risk factors and identify whether these factors can cause LBP in these athletes by using a self-developed questionnaire which was randomly distributed to 850 runners of running a half or a full marathon. Participants responded with the questionnaire focusing on previous training and running conditions after their competitions. In the final models, risk factors, including warm-up activities, fatigue, running gait posture, and environmental temperature, were significantly associated with LBP in marathoners. It was concluded that although LBP was uncommon in marathoners, it was linked to the factors such as insufficient warm-up activities, fatigue, poor running gait posture, and uncomfortable environmental temperature. Although future studies may be necessary these findings could still be useful for protecting the lower back area of runners clinically. Authors Bao Wu, 1,2 Chang-Cheng Chen , 2 Juan Wang , 2 and Xue-Qiang Wang Journal Hindawi Pain Research and Management Volume 2021, Article ID 666030 | 3 | | R465.00 | |
| | Ischemic Stroke Part 2 | Ischemic Stroke Part 2
Overview
Ischemic stroke is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Acute ischemic stroke is caused by thrombotic or embolic occlusion of a cerebral artery and is more common than haemorrhagic stroke.
We should consider stroke in any patient presenting with acute neurologic deficit or any alteration in level of consciousness. Although symptoms can occur alone, they are more likely to occur in combination. No historical feature distinguishes ischemic from haemorrhagic stroke, although nausea, vomiting, headache, and sudden change in level of consciousness are more common in haemorrhagic strokes. In younger patients, a history of recent trauma, coagulopathies, illicit drug use (especially cocaine), migraines, or use of oral contraceptives should be elicited.
Emergent brain imaging is essential for evaluation of acute ischemic stroke. Noncontrast computed tomography (CT) scanning is the most commonly used form of neuroimaging in the acute evaluation of patients with apparent acute stroke.
Involvement of a physician with a special interest and training in stroke is ideal. Stroke care units with specially trained nursing and allied healthcare personnel have clearly been shown to improve outcomes.
Author Sharespike
| 3 | | R410.00 | |
| | Ischemic Stroke Part 1 | Ischemic Stroke Part 1
Overview
Ischemic stroke is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Acute ischemic stroke is caused by thrombotic or embolic occlusion of a cerebral artery and is more common than haemorrhagic stroke.
We should consider stroke in any patient presenting with acute neurologic deficit or any alteration in level of consciousness. Although symptoms can occur alone, they are more likely to occur in combination. No historical feature distinguishes ischemic from haemorrhagic stroke, although nausea, vomiting, headache, and sudden change in level of consciousness are more common in haemorrhagic strokes. In younger patients, a history of recent trauma, coagulopathies, illicit drug use (especially cocaine), migraines, or use of oral contraceptives should be elicited.
Emergent brain imaging is essential for evaluation of acute ischemic stroke. Noncontrast computed tomography (CT) scanning is the most commonly used form of neuroimaging in the acute evaluation of patients with apparent acute stroke.
Involvement of a physician with a special interest and training in stroke is ideal. Stroke care units with specially trained nursing and allied healthcare personnel have clearly been shown to improve outcomes.
Author Sharespike
| 3 | | R410.00 | |
| | Vertigo, DIzziness and Imbalance | Vertigo, DIzziness and Imbalance
Vertigo, DIzziness and Imbalance
Overview
Dizziness and vertigo are among the most common symptoms causing patients to visit a physician (as common as back pain and headaches). Falling can be a direct consequence of dizziness in this population, and the risk is compounded in elderly persons with other neurologic deficits and chronic medical problems.
Mild hearing loss is the most common disability worldwide. The incidence of hearing loss is 25% in people younger than 25 years, and it reaches 40% in persons older than 40 years. About 25% of the population report tinnitus.
Primary care physicians evaluate most cases of dizziness and related symptoms. Their role and that of neurologists in this setting has increased over the past decade. This article outlines the clinical approach to dizziness with emphasis on differentiating peripheral from central dizziness and on office management of the most common diseases. It also addresses indications for referral to an otolaryngologist or neuro-otologist and for specialized auditory and vestibular testing.
To diagnose dizziness, physicians must use the essential tools of history, clinical examination, and follow-up. The etiology in most of these patients mainly involves a vestibular disorder, such as BPPV, Ménière disease, or bilateral vestibular hypofunction. Appropriate management and follow-up are necessary to improve the well-being of these patients.
Authors
Sharespike
| 3 | | R425.00 | |
| | Ventricular Tachycardia Part 2 | Ventricular Tachycardia Part 2
Ventricular Tachycardia Part 2
Overview
Ventricular tachycardia (VT) or ventricular fibrillation (VF) is responsible for most of the sudden cardiac deaths in the United States, at an estimated rate of approximately 300,000 deaths per year. VT refers to any rhythm faster than 100 (or 120) beats/min, with three or more irregular beats in a row, arising distal to the bundle of His. The rhythm may arise from the working ventricular myocardium, the distal conduction system, or both.
Symptoms of VT are often a function of the associated heart rate, or the causal process, such as an acute myocardial infarction (MI). They may include the following bulleted items. VT may also be asymptomatic, or the symptoms may be those of the associated triggered therapy (eg, an implantable cardioverter-defibrillator [ICD] shock).
Clinically, VT may be reflected in symptoms such as syncope, palpitations, and dyspnea. It is often, but not always, associated with hemodynamic compromise, particularly if the left ventricle is impaired or the heart rate is especially fast. With some exceptions, VT is associated with increased risk of sudden death.
Author Sharespike
| 3 | | R425.00 | |
| | Ventricular Tachycardia Part 1 | Ventricular Tachycardia Part 1
Ventricular Tachycardia Part 1
Overview
Ventricular tachycardia (VT) or ventricular fibrillation (VF) is responsible for most of the sudden cardiac deaths in the United States, at an estimated rate of approximately 300,000 deaths per year. VT refers to any rhythm faster than 100 (or 120) beats/min, with three or more irregular beats in a row, arising distal to the bundle of His. The rhythm may arise from the working ventricular myocardium, the distal conduction system, or both.
Symptoms of VT are often a function of the associated heart rate, or the causal process, such as an acute myocardial infarction (MI). They may include the following bulleted items. VT may also be asymptomatic, or the symptoms may be those of the associated triggered therapy (eg, an implantable cardioverter-defibrillator [ICD] shock).
Clinically, VT may be reflected in symptoms such as syncope, palpitations, and dyspnea. It is often, but not always, associated with hemodynamic compromise, particularly if the left ventricle is impaired or the heart rate is especially fast. With some exceptions, VT is associated with increased risk of sudden death.
Author Sharespike
| 3 | | R425.00 | |
| | The Effects of a Recollection-Based Occupational Therapy Program of Alzheimer’s Disease: A Randomized Controlled Trial | The Effects of a Recollection-Based Occupational Therapy Program of Alzheimer’s Disease: A Randomized Controlled Trial
The Effects of a Recollection-Based Occupational Therapy Program of Alzheimer’s Disease: A Randomized Controlled Trial
Overview:
Considering the high socio-economic costs related to the increasing number of dementia patients and their poor quality of life and that of their families, it is important to identify the condition early on and provide an appropriate intervention. This study organized a recollection-based occupational therapy program: a nonpharmacological intervention consisting of five categories of activities (physical, horticultural, musical, art, and instrumental activity of daily living; IADL) and applied it to those having a mild stage of Alzheimer’s disease. The experimental group participated in a total of 24 sessions––five times per week for one hour per session––while the control group took part in regular activities offered by the existing facilities. The experimental group presented improved cognitive functions, reduced depression, and enhanced quality of life; the two groups showed a statistically significant difference in every category. This study is meaningful in that it made a cognitive stimulation program concerning five different categories, implemented it for people suffering mild dementia, and confirmed positive outcomes. If a systemic version of the program is offered in dementia care facilities, it is expected to make a considerable contribution to the care of dementia patients.
Acknowledgements: Authors: DeokJu Kim
Journal: Occupational Therapy International | 3 | | R435.00 | |
| | The eye: ‘‘An organ that must not be forgotten in coronavirus disease 2019 (COVID-2019) pandemic’’ | The eye: ‘‘An organ that must not be forgotten in coronavirus disease 2019 (COVID-2019) pandemic’’
The eye: ‘‘An organ that must not be forgotten in coronavirus disease 2019 (COVID-2019) pandemic’’
Overview The coronavirus family is a group of zoonotic viruses with some recognized reservoirs particularly some bats. A novel coronavirus emerged in the province of Wuhan (China) in December of 2019.The number of infected patients with serious respiratory infection quickly spread around the world to become a global pandemic. The clinical presentation and viral pathogenesis of the coronavirus disease named COVID-19 indicated that the virus is transmitted from person to person through infected droplets entering the respiratory mucosa. Close contact with infected individuals particularly in crowded environments has characterized the rapid spread of the infection. Clinical manifestations of the viral infection have mentioned the presence of some ocular findings such as conjunctival congestion, conjunctivitis and even corneal injury associated with the classical COVID-19 infection. Some animal models of different coronaviruses eye infection shave described the viral pathogenesis through tear and conjunctival sampling. On the other hand, we are recommended protective measure to prevent contagion and limit the spread of the virus in health care professionals and contact lenses wearers.
ACKNOWLEDGMENTS Authors Sandra C. Durán C, Diana C. Mayorga G Journal Journal of Optometry (2020)
| 3 | | R435.00 | |
| | Coronavirus Disease 19 (COVID-19): Implications for Clinical Dental Care | Coronavirus Disease 19 (COVID-19): Implications for Clinical Dental Care
Coronavirus Disease 19 (COVID-19): Implications for Clinical Dental Care
Overview: The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated coronavirus disease has gripped the entire international community and caused widespread public health concerns. Despite global efforts to contain the disease spread, the outbreak is still on a rise because of the community spread pattern of this infection.
This is a zoonotic infection, similar to other coronavirus infections, that is believed to have originated in bats and pangolins and later transmitted to humans. Once in the human body, this coronavirus (SARS-CoV-2) is abundantly present in nasopharyngeal and salivary secretions of affected patients, and its spread is predominantly thought to be respiratory droplet/contact in nature. Dental professionals, including endodontists, may encounter patients with suspected or confirmed SARS-CoV-2 infection and will have to act diligently not only to provide care but at the same time prevent nosocomial spread of infection.
Thus, the aim of this article is to provide a brief overview of the epidemiology, symptoms, and routes of transmission of this novel infection. In addition, specific recommendations for dental practice are suggested for patient screening, infection control strategies, and patient management protocol.
Authors: Amber Ather, BDS, DDS, Biraj Patel, BDS, Nikita B. Ruparel, MS, DDS, PhD, Anibal Diogenes, DDS, MS, PhD, and Kenneth M. Hargreaves, DDS, PhD
Journal: JOE – Journal of Endodontics
| 3 | | R435.00 | |
| | Wide Complex Tachycardia | Wide Complex Tachycardia
Overview
Correct diagnosis of wide complex tachycardia (WCTs) can be challenging. With EMS providers' ever-expanding scope of practice, it is no longer safe to label any rhythm that is wide and fast as ventricular tachycardia (VT). Though many paramedic curricula do not address advanced cardiac dysrhythmias and treatments, several EMS departments have protocols that require advanced training in 12-lead ECG interpretation and treatment of specific cardiac dysrhythmias. One must possess the proper diagnostic tools and knowledge to decide whether a WCT is VT or SVT with aberrant conduction. EMS providers should be able to differentiate VT and SVT with aberrant conduction with confidence and a high degree of certainty. In order to understand the visual differences between VT and SVT with aberrant conduction, one must first understand the basic pathophysiology behind the two dysrhythmias. The first steps are maintenance of the patient’s airway with assisted breathing if necessary, cardiac monitoring to identify the heart rhythm, monitoring of blood pressure and oximetry, and establishing intravenous access. In the emergency setting, a wide-complex tachycardia always should be considered as ventricular tachycardia unless proven otherwise, as treatment must be initiated immediately to avoid degeneration into ventricular fibrillation.
| 3 | | R425.00 | |
| | Unstable Angina | Unstable Angina
Overview
Unstable angina belongs to the spectrum of clinical presentations referred to collectively as acute coronary syndromes (ACSs), which also includes ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). Unstable angina is considered to be an ACS in which there is myocardial ischemia without detectable myocardial necrosis (ie, cardiac biomarkers of myocardial necrosis —such as creatine kinase MB isozyme, troponin, myoglobin—are not released into the circulation).
With unstable angina, symptoms may (1) occur at rest; (2) become more frequent, severe, or prolonged than the usual pattern of angina; (3) change from the usual pattern of angina; or (4) not respond to rest or nitro-glycerine. Symptoms of unstable angina are similar to those of myocardial infarction (MI).
The traditional term unstable angina was meant to signify the intermediate state between myocardial infarction (MI) and the more chronic state of stable angina. The old term pre-infarction angina conveys the clinical intent of intervening to attenuate the risk of MI or death. Patients with this condition have also been categorized by presentation, diagnostic test results, or course over time; these categories include new-onset angina, accelerating angina, rest angina, early postinfarct angina, and early post-revascularization angina.
This course deals with the causes and management of unstable angina.
| 3 | | R425.00 | |
| | Severe Distress – COVID 19 | Severe Distress – COVID 19
Severe Distress – COVID 19
Overview Since the emergence of the 2019 novel coronavirus (SARS-CoV-2) infection in December 2019, the coronavirus disease 2019 (COVID-19) has rapidly spread across the globe. The clinical spectrum of patients with COVID-19 ranges from asymptomatic or mild symptoms to critical disease with a high risk of mortality. Coronavirus disease 2019 (COVID-19) is the illness associated with the novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus was initially noted during an outbreak of respiratory illness in the population of Wuhan, the capital of Hubei province, China. The first cases were seen in November 2019, with COVID-19 quickly spreading throughout the city. The World Health Organization (WHO) was notified of the outbreak on December 31, 2019. The cases continued to spread outside of the area and then across the world. COVID-19 was reported as a global health emergency by the end of January 2020. As the worldwide case numbers increased, the WHO declared on March 11, 2020, that COVID-19 had reached the pandemic stage.
The virus is now known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease it causes is called coronavirus disease 2019 (COVID-19). In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic.
| 3 | | R425.00 | |
| | Septic Shock Part 2 | Septic Shock Part 2
Overview
Sepsis is defined as life-threatening organ dysfunction due to dysregulated host response to infection, and organ dysfunction is defined as an acute change in total Sequential Organ Failure Assessment (SOFA) score of 2 points or greater secondary to the infection cause. Septic shock occurs in a subset of patients with sepsis and comprises of an underlying circulatory and cellular/metabolic abnormality that is associated with increased mortality.
Patients with sepsis may present in a myriad of ways, and a high index of clinical suspicion is necessary to identify subtle presentations. The hallmarks of sepsis and septic shock are changes that occur at the microvascular and cellular level and may not be clearly manifested in the vital signs or clinical examination.
Patients with sepsis and septic shock require admission to the hospital. Initial treatment includes support of respiratory and circulatory function, supplemental oxygen, mechanical ventilation, and volume infusion.
In the past few decades, the discovery of endogenous mediators of the host response has led to the recognition that the clinical syndrome of sepsis is the result of excessive activation of host defence mechanisms rather than the direct effect of microorganisms. Sepsis and its sequelae represent a continuum of clinical and pathophysiologic severity.
Author Sharespike
| 3 | | R425.00 | |
| | Septic Shock Part 1 | Septic Shock Part 1
Overview
Sepsis is defined as life-threatening organ dysfunction due to dysregulated host response to infection, and organ dysfunction is defined as an acute change in total Sequential Organ Failure Assessment (SOFA) score of 2 points or greater secondary to the infection cause. Septic shock occurs in a subset of patients with sepsis and comprises of an underlying circulatory and cellular/metabolic abnormality that is associated with increased mortality.
Patients with sepsis may present in a myriad of ways, and a high index of clinical suspicion is necessary to identify subtle presentations. The hallmarks of sepsis and septic shock are changes that occur at the microvascular and cellular level and may not be clearly manifested in the vital signs or clinical examination.
Patients with sepsis and septic shock require admission to the hospital. Initial treatment includes support of respiratory and circulatory function, supplemental oxygen, mechanical ventilation, and volume infusion.
In the past few decades, the discovery of endogenous mediators of the host response has led to the recognition that the clinical syndrome of sepsis is the result of excessive activation of host defence mechanisms rather than the direct effect of microorganisms. Sepsis and its sequelae represent a continuum of clinical and pathophysiologic severity.
Author Sharespike
| 3 | | R425.00 | |
| | Respiratory Distress Syndrome | Respiratory Distress Syndrome
Respiratory Distress Syndrome
Overview
Respiratory distress syndrome, also known as hyaline membrane disease, occurs almost exclusively in premature infants. The incidence and severity of respiratory distress syndrome are related inversely to the gestational age of the new-born infant.
Shortness of breath is a common complaint encountered by the EMS provider. We often hear it as part of a litany of other S/S or as a primary chief complaint. In either case SOB is never to be taken lightly and its causes should always be thoroughly investigated. My desire with this article is to give you some tips on how to streamline your treatment and formulate your thoughts as to how to proceed. In all cases the EMS team is responsible to respond to the needs of the patient. Hypoxia, regardless of the source needs to be vigorously addressed. The lungs need to be opened or cleared as determined by the physical exam. The cause of the SOB needs to be determined and addressed. Education and counselling of parents, caregivers, and families of premature infants must be undertaken as part of discharge planning. These individuals should be advised of the potential problems infants with respiratory distress syndrome may encounter during and after their nursery stay.
Author
Sharespike
| 3 | | R425.00 | |
| | Preeclampsia for MD's | Preeclampsia for MD's
Overview
Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks' gestation and can present as late as 4-6 weeks post-partum. It is clinically defined by hypertension and proteinuria, with or without pathologic edema.
Preeclampsia is defined as the presence of (1) a systolic blood pressure (SBP) greater than or equal to 140 mm Hg or a diastolic blood pressure (DBP) greater than or equal to 90 mm Hg or higher, on two occasions at least 4 hours apart in a previously normotensive patient, OR (2) an SBP greater than or equal to 160 mm Hg or a DBP greater than or equal to 110 mm Hg or higher (In this case, hypertension can be confirmed within minutes to facilitate timely antihypertensive therapy.).
In addition to the blood pressure criteria, proteinuria of greater than or equal to 0.3 grams in a 24-hour urine specimen, a protein (mg/dL)/creatinine (mg/dL) ratio of 0.3 or higher, or a urine dipstick protein of 1+ (if a quantitative measurement is unavailable) is required to diagnose preeclampsia.
Eclampsia is defined as seizures that cannot be attributable to other causes in a woman with preeclampsia. HELLP syndrome (haemolysis, elevated liver enzyme, low platelets) may complicate severe preeclampsia.
Because the clinical manifestations of preeclampsia can be heterogeneous, diagnosing preeclampsia may not be straightforward. Preeclampsia without severe features may be asymptomatic. Many cases are detected through routine prenatal screening.
Authors
Sharespike
| 3 | | R380.00 | |
| | Dyspnea: Pathophysiology and a clinical approach - EMT | Dyspnea: Pathophysiology and a clinical approach - EMT
Dyspnea: Pathophysiology and a clinical approach - EMT
Overview
Dyspnea is defined as a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity and may either be acute or chronic. This is a common and often distressing symptom reported by patients, and accounts for nearly half of hospital admissions.
The distinct sensations often reported by patients include effort/work of breathing, chest tightness, and air hunger (a feeling of not enough air on inspiration). Dyspnea should be assessed by the intensity of these sensations, the degree of distress involved, and its burden or impact on instrumental activities.
Dyspnea is a common and often distressing symptom and a frequent reason for general practitioner and clinic visits. Dyspnea is symptom, and its experience is subjective and varies greatly among individuals exposed to the same stimuli or with similar pathologies. This differential experience of Dyspnea among individuals emanates from interactions among multiple physiological, psychological, social, and environmental factors that induce secondary physiological and behavioural responses. The management of Dyspnea will depend on the underlying cause.
Author
Sharespike | 3 | | R420.00 | |
| | Emphysema, Chronic obstructive pulmonary disease (COPD), Asthma | Emphysema, Chronic obstructive pulmonary disease (COPD), Asthma
Emphysema, Chronic obstructive pulmonary disease (COPD), Asthma
Overview Emphysema and chronic bronchitis are airflow-limited states contained within the disease state known as chronic obstructive pulmonary disease (COPD). Just as asthma is no longer grouped with COPD, the current definition of COPD put forth by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) also no longer distinguishes between emphysema and chronic bronchitis.
Emphysema is pathologically defined as an abnormal permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by the destruction of alveolar walls and without obvious fibrosis. This process leads to reduced gas exchange, changes in airway dynamics that impair expiratory airflow, and progressive air trapping. Clinically, the term emphysema is used interchangeably with chronic obstructive pulmonary disease, or COPD.
The theory surrounding this definition has been around since the 1950s, with a key concept of irreversibility and/or permanent acinar damage. However, new data posit that increased collagen deposition leads to active fibrosis, which inevitably is associated with breakdown of the lung’s elastic framework.
Discussions on how obstructive diseases share similar phenotypes have been emerging and evolving within the literature. This course provides a particularly good outline.
Author Sharespike
| 3 | | R435.00 | |
| | Hypertension Part 1 | Hypertension Part 1
Overview
Hypertension is a leading risk factor for cardiovascular disease and a significant cause of morbidity and mortality. For patients who are symptomatic, however, uncontrolled elevations in blood pressure are true medical emergencies that require rapid intervention in the ED. It is therefore important to understand the disease of chronic hypertension and, perhaps more important, episodes of acute and uncontrolled elevations in blood pressure so that we, as prehospital care providers, can better stratify these patients into low- and high-risk groups that may or may not require transport to an ED for evaluation and treatment.
As we will discuss, it is reasonable to say that not every patient who presents with hypertension is at high risk of morbidity and mortality and absolutely requires evaluation and treatment at an ED. This is not to say EMTs and paramedics should talk patients out of going to EDs for evaluation. Rather, we will strive to give prehospital care providers a better understanding of the risks involved with acute hypertension so they can better work with their patients to find a solution that is safe, reasonable and responsible for everyone involved. This article discusses the topic of acute hypertension, hypertensive urgency and hypertensive emergencies in an effort to help EMS providers better understand these illnesses and help patients make the best decisions regarding their transport and care.
Authors:
Sharespike
| 3 | | R420.00 | |
| | Burn Resuscitation and Early Management | Burn Resuscitation and Early Management
Burn Resuscitation and Early Management
Overview Burn resuscitation refers to the replacement of fluids in burn patients to combat the hypovolemia and hypoperfusion that can result from the body’s systemic response to burn injury. The history of modern burn resuscitation can be traced back to observations made after large urban fires at the Rialto Theatre (New Haven, Conn) in 1921 and the Coconut Grove nightclub (Boston, Mass) in 1942. At the time, physicians noted that some patients with large burns survived the event but died from shock in the observation periods. Underhill and Moore identified the concept of thermal injury–induced intravascular fluid deficits in the 1930s and 1940s, and Evans soon followed with the earliest fluid resuscitation formulas in 1952. Up to that point, burns covering as little as 10-20% of total body surface area (TBSA) were associated with high rates of mortality.
Burns are a serious cause of human suffering and mortality globally. As many as 5% of burn victims will die as a result of their injuries, and many others will suffer disability, disfigurement, or scarring. This course addresses vital information regarding burn resuscitation and the early management thereof.
| 3 | | R465.00 | |
| | Convulsions and Seizures | Convulsions and Seizures
Overview
Emergency services attend patients who are having a seizure on almost a daily basis. Consequently, they should understand the disease processes related to seizures and be confident in their prehospital management. In general, with the exception of a patient in Status Epilepticus, seizure management should be relatively straight forward.
So, what is a seizure and what causes it? Basically, a seizure is any unusually excessive neuronal firing from the brain which manifests as changes in a patient’s motor/sensory control, sensory perception, behaviour and autonomic function.
At a chemical level a seizure occurs when there is a sudden biochemical imbalance between the excitatory neurotransmitters and inhibitory neurotransmitters. The primary excitatory neurotransmitter found in the human central nervous system is called N-Methyl D Aspartate (NMDA); whereas the primary inhibitory neurotransmitter is called gamma-amino butyric acid (GABA). When there is an imbalance between these chemical mediators repeated firing and excitations of the neuronal cells occur.
Depending on the area of the brain in which this occurs, the seizure will manifest as a focal seizure, sensory change, behaviour disturbance, or complete tonic and clonic muscular activity. This course addresses important aspects relating to convulsions and seizures
| 3 | | R460.00 | |
| | Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides. | Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides.
Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides.
Overview The aim of the study was to evaluate the use of specific collagen peptides in reducing pain in athletes with functional knee problems during sport. The primary outcome of the study was in change in pain intensity during activity, which was evaluated by the participants and the attending physicians using a visual analogue scale. As secondary endpoints, pain intensity under resting conditions, the range of motion of the knee joint, and the use of additional therapeutic options were assessed. Due to the high joint mobility at baseline, no significant changes of this parameter could be detected. The use of additional treatment options was significantly reduced after BCP intake. The study demonstrated that the supplementation of specific collagen peptides in young adults with functional knee problems led to a statistically significant improvement of activity related joint pain.
Authors: Denise Zdzieblik, Steffen Oesser, Albert Gollhofer and Daniel König
| 3 | | R420.00 | |
| | The Effect of Hearing Aid Use on Cognition in Older Adults: Can We Delay Decline or Even Improve Cognitive Function? | The Effect of Hearing Aid Use on Cognition in Older Adults: Can We Delay Decline or Even Improve Cognitive Function?
The Effect of Hearing Aid Use on Cognition in Older Adults: Can We Delay Decline or Even Improve Cognitive Function?
Overview: Hearing loss is a modifiable risk factor for dementia in older adults. Whether hearing aid use can delay the onset of cognitive decline is unknown. Participants in this study (aged 62–82 years) were assessed before and 18 months after hearing aid fitting on hearing, cognitive function, speech perception, quality of life, physical activity, loneliness, isolation, mood, and medical health.
At baseline, multiple linear regression showed hearing loss and age predicted significantly poorer executive function performance, while tertiary education predicted significantly higher executive function and visual learning performance. At 18 months after hearing aid fitting, speech perception in quiet, self-reported listening disability and quality of life had significantly improved. Group mean scores across the cognitive test battery showed no significant decline, and executive function significantly improved.
Authors: Julia Sarant, David Harris, Peter Busby, Paul Maru, Adrian Schembri, Ulrike Lemke and Stefan Launer
Article: J. Clin. Med. 2020
| 3 | | R380.00 | |
| | Catastrophe in Radiology: Considerations Beyond Common Emergencies | Catastrophe in Radiology: Considerations Beyond Common Emergencies
Catastrophe in Radiology: Considerations Beyond Common Emergencies
Overview Organizations around the world increasingly prepare for the “what ifs” of our environments. Regulating and certifying agencies mandate organizational plans for threat management to include risk factor identification, threat mitigation, prevention (when possible), response to, and recovery from the event. Disasters often occur without warning and have the potential to affect large numbers of people. Those in the radiology environment experience unique effects on them, their equipment, and their ability to provide quality patient care. Lessons can be learned by reviewing events and their impact on imaging departments around the world. Radiology departments need to be actively involved in the disaster planning and the management of disasters when they occur. Common themes emerge regardless of the type of disaster, and these themes should be included in all planning.
Even with an ever-increasing amount of information available and regulations to comply with, radiology departments are still often excluded from a hospital's disaster management plan and drills. Often, it is not until an organization experiences a catastrophic event that the identification of a plan for radiology's role during a disaster comes to mind.
Authors Valerie Aarne Grossman
Journal Journal of Radiology Nursing | 3 | | R455.00 | |
| | Neuromuscular Function of the Knee Joint Following Knee Injuries: Does It Ever Get Back to Normal? A Systematic Review with Meta Analyses | Neuromuscular Function of the Knee Joint Following Knee Injuries: Does It Ever Get Back to Normal? A Systematic Review with Meta Analyses
Neuromuscular Function of the Knee Joint Following Knee Injuries: Does It Ever Get Back to Normal? A Systematic Review with Meta Analyses
Overview
Knee injury is an independent risk factor for the development of knee osteoarthritis (OA) in young adults. The prevalence of post-traumatic OA (PTOA) can be as high as 80% at 10+years after the initial injury, with 4–6 times higher odds compared to a non-injured knee. PTOA mainly affects a younger and more active population when compared to non-traumatic OA, resulting in longer years lived with disability [5], and surgical interventions 7–9 years earlier in life. Therefore, prevention strategies for PTOA development require particular attention.
There is also evidence of bilateral neuromuscular changes following unilateral knee injury, suggesting a requirement for healthy control groups instead of using the contralateral ‘healthy leg’ for an unbiased evaluation of post-traumatic neuromuscular alterations. Therefore, this study aimed to determine how neuromuscular function of the knee joint changes over time following knee injuries involving ligament, meniscus or cartilage compared to healthy controls.
Neuromuscular deficits persist for years post-injury/surgery, though most evidence is from ACL injured populations. Muscle strength deficits are accompanied by neural alterations and changes in control and timing of muscle force, but more studies are needed to fill the evidence gaps we have identified. Better characterisation and therapeutic strategies addressing these deficits could improve rehabilitation outcomes, and potentially prevent PTOA.
Authors Beyza Tayfur, Chedsada Charuphongsa, Dylan Morrissey, Stuart Charles Miller
Journal
Sports Medicine
| 3 | | R410.00 | |
| | COVID-2019 -A comprehensive pathology insight | COVID-2019 -A comprehensive pathology insight
COVID-2019 -A comprehensive pathology insight
Overview Corona virus disease-2019 (COVID-19) caused by severe acute respiratory syndrome corona virus-2 (SARS CoV- 2), a highly contagious single stranded RNA virus genetically related to SARS CoV. The lungs are the main organs affected leading to pneumonia and respiratory failure in severe cases that may need mechanical ventilation. Occasionally patient may present with gastro-intestinal, cardiac and neurologic symptoms with or without lung involvement. Pathologically, the lungs show either mild congestion and alveolar exudation or acute respiratory distress syndrome (ARDS) with hyaline membrane or histopathology of acute fibrinous organizing pneumonia (AFOP) that parallels disease severity. Other organs like liver and kidneys may be involved secondarily.
Currently the treatment is principally symptomatic and prevention by proper use of personal protective equipment and other measures is crucial to limit the spread. During the pandemic there is paucity of literature on pathological features including pathogenesis, hence in this review we provide the current pathology centred understanding of COVID-19. Furthermore, the pathogenetic pathway is pivotal in the development of therapeutic targets.
Authors Chandrakumar Shanmugam, Abdul Rafi Mohammed, Swarupa Ravuri, Vishwas Luthra, Narasimhamurthy Rajagopal, Saritha Karre
Journal Pathology - Research and Practice 216 (2020) 153222
| 3 | | R440.00 | |
| | Application of tele-podiatry in diabetic foot management: A series of illustrative cases | Application of tele-podiatry in diabetic foot management: A series of illustrative cases
Application of tele-podiatry in diabetic foot management: A series of illustrative cases
Overview Telemedicine had been proposed as a tool to manage diabetes, but its role in management of diabetic foot ulcer is still evolving. The COVID-19 pandemic and related social restrictions have necessitated the use of telemedicine in the management of diabetic foot disease (tele-podiatry), particularly of patients classified as low-risk.
This article is a report of three cases of varied diabetic foot problems assessed during the present pandemic using different forms of telemedicine for triaging, management of low-risk cases and for follow-up. Telemedicine is a good screening tool for diagnosing and managing low-risk subjects with diabetic foot problems and enables a triaging system for deciding on hospital visits and hospitalization.
Telemedicine offers several benefits in the management of diabetic foot disease, although it also has some limitations. Based on the experience during the pandemic it is recommended its judicious use in the triaging of patients of diabetic foot disease and management of low-risk cases. Future innovation in technology and artificial intelligence may help in better tele-podiatry care in the time to come.
Acknowledgements Authors Karakkattu V. Kavitha, Shailesh R. Deshpande, Anil P. Pandit, Ambika G. Unnikrishnan
Journal Diabetes & Metabolic Syndrome: Clinical Research & Reviews
| 3 | | R410.00 | |
| | Clinical Practice Guidelines: Trauma Part 2 | Clinical Practice Guidelines: Trauma Part 2
Clinical Practice Guidelines: Trauma Part 2
Overview “Injury is an increasingly significant health problem throughout the world. Every day, 16 000 people die from injuries, and for every person who dies, several thousand more are injured, many of them with permanent sequelae. Injury accounts for 16% of the global burden of disease. The burden of death and disability from injury is especially notable in low- and middle-income countries. By far the greatest part of the total burden of injury, approximately 90%, occurs in such countries” (Mock et al., 2004).
The focus of pre-hospital trauma management remains the rapid access and extrication of patients to allow for the rapid assessment and control of bleeding, the airway and ventilation. There is a renewed focus on the importance of rapid transport as the most important factor for trauma survival remains time to access of definitive care and operative haemostasis.
Bleeding remains one of the most important contributors to traumatic death. The prevention of the trauma triad of death: hypothermia, acidosis and coagulopathy remain an important goal. Haemodilution and the role of pre-hospital fluid management has also received significant attention. Many well-developed trauma systems are moving towards restrictive fluid management regimes, specific haemodynamic targets and the introduction of pre-hospital initiation of blood product administration. The control and prevention of bleeding remains a central focus for pre-hospital providers.
Acknowledgement Journal:
Clinical Practice Guidelines (July 2018)
Publisher:
Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Pediatric Gastroenteritis | Clinical Practice Guidelines: Pediatric Gastroenteritis
Clinical Practice Guidelines: Pediatric Gastroenteritis
Overview
Infective gastroenteritis in young children is characterised by the sudden onset of diarrhoea, with or without vomiting. Most cases are due to an enteric virus, but some are caused by bacterial or protozoal infections. The illness usually resolves without treatment within days; however, symptoms are unpleasant and affect both the child and family or carers. Severe diarrhoea can quickly cause dehydration, which may be life threatening (National Institute for Health and Care Excellence, 2009).
Oral rehydration therapy is replacement of fluids and electrolytes, such as sodium, potassium, and chloride necessary for normal physiological functions and is effective in 95% of cases of mild to moderate dehydration. Oral rehydration therapy is less invasive, less expensive, is associated with less morbidity and can be dispensed outside of the hospital setting, while being as effective as IV treatment (Medical Services Commission, 2010).
Acknowledgement
Journal:
Clinical Practice Guidelines (July 2018)
Publisher:
Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Pain and Procedural Sedation | Clinical Practice Guidelines: Pain and Procedural Sedation
Clinical Practice Guidelines: Pain and Procedural Sedation
Overview “The management of acute traumatic pain is a crucial component of pre-hospital care and yet the assessment and administration of analgesia is highly variable, frequently suboptimal, and often determined by consensus-based protocols” (Gausche-Hill et al., 2014). Pain management is also frequently based on the assessment of need by a provider, rather than the requirements of patients. Historically only Entonox and morphine have been available for pre-hospital pain management in the local setting with the more recent introduction of ketamine. Availability of appropriate and effective treatment options, especially for non-ALS providers, remains a challenge.
Situations requiring procedural sedation and analgesia in the pre-hospital setting are common and may range from alignment of fracture to extrication and complex disentanglement during medical rescue. Until recently South African pre-hospital providers did not have agents suitable for this purpose, particularly in the setting of severe trauma and hypotension. As ketamine has been introduced into some scopes of practice providing safe and effective dissociative procedural analgesia has become a possibility. However, the use of procedural sedation and analgesia is not without risks and, at this time, no uniform practice has been suggested in the South African pre-hospital setting. Acknowledgement Journal:
Clinical Practice Guidelines (July 2018)
Publisher:
Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Obstetrics and Gynaecology Part 4 | Clinical Practice Guidelines: Obstetrics and Gynaecology Part 4
Clinical Practice Guidelines: Obstetrics and Gynaecology Part 4
Overview
There were no evidence-based clinical practice guidelines addressing obstetric issues from a purely pre-hospital emergency services perspective. Despite this, there were many high-quality recommendations from in hospital and other types of health facilities (e.g. midwife run delivery units) which are directly applicable to pre-hospital management of obstetrics. The delivery and birth process will ideally not occur in the pre-hospital environment, but every practitioner needs to be able to manage a delivery and to intervene where necessary within the limits of their scope of practice.
Journal:
Clinical Practice Guidelines (July 2018)
Publisher:
Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Obstetrics and Gynecology Part 3 | Clinical Practice Guidelines: Obstetrics and Gynecology Part 3
Clinical Practice Guidelines: Obstetrics and Gynecology Part 3
Overview
There were no evidence-based clinical practice guidelines addressing obstetric issues from a purely pre-hospital emergency services perspective. Despite this, there were many high-quality recommendations from in hospital and other types of health facilities (e.g. midwife run delivery units) which are directly applicable to pre-hospital management of obstetrics. The delivery and birth process will ideally not occur in the pre-hospital environment, but every practitioner needs to be able to manage a delivery and to intervene where necessary within the limits of their scope of practice.
Journal:
Clinical Practice Guidelines (July 2018)
Publisher:
Health Professions Council of South Africa
| 3 | | R410.00 | |
| | Clinical Practice Guidelines: Obstetrics and Gynaecology Part 2 | Clinical Practice Guidelines: Obstetrics and Gynaecology Part 2
Clinical Practice Guidelines: Obstetrics and Gynaecology Part 2
Overview
There were no evidence-based clinical practice guidelines addressing obstetric issues from a purely pre-hospital emergency services perspective. Despite this, there were many high-quality recommendations from in hospital and other types of health facilities (e.g. midwife run delivery units) which are directly applicable to pre-hospital management of obstetrics. The delivery and birth process will ideally not occur in the pre-hospital environment, but every practitioner needs to be able to manage a delivery and to intervene where necessary within the limits of their scope of practice.
Journal:
Clinical Practice Guidelines (July 2018)
Publisher:
Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Obstetrics and Gynecology Part 1 | Clinical Practice Guidelines: Obstetrics and Gynecology Part 1
Clinical Practice Guidelines: Obstetrics and Gynecology Part 1
Overview
There were no evidence-based clinical practice guidelines addressing obstetric issues from a purely pre-hospital emergency services perspective. Despite this, there were many high-quality recommendations from in hospital and other types of health facilities (e.g. midwife run delivery units) which are directly applicable to pre-hospital management of obstetrics. The delivery and birth process will ideally not occur in the pre-hospital environment, but every practitioner needs to be able to manage a delivery and to intervene where necessary within the limits of their scope of practice.
Journal: Clinical Practice Guidelines (July 2018)
Publisher: Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Neonatal Resuscitation | Clinical Practice Guidelines: Neonatal Resuscitation
Clinical Practice Guidelines: Neonatal Resuscitation
Overview
Monitoring equipment for neonates and infants may not be uniformly available to all EMS providers. All ALS providers should have monitoring equipment appropriate for neonates. It is recommended that oximetry be used when resuscitation can be anticipated, when PPV is administered, when central cyanosis persists beyond the first 5 to 10 minutes of life, or when supplementary oxygen is administered.
In summary, from the evidence reviewed in the 2010 CoSTR and subsequent review of delaying cord clamping and cord milking in preterm new-borns in the 2015 ILCOR systematic review, delaying cord clamping for longer than 30 seconds is reasonable for both term and preterm infants who do not require resuscitation at birth. It is recommended that the temperature of newly born non-asphyxiated infants be maintained between 36.5°C and 37.5°C after birth through admission and stabilisation. Targeted temperature management requires specific equipment and well established systems and protocol and system wide clinical governance. In neonates it may also require the establishment of dedicated, specialized and equipped retrieval teams.
Journal: Clinical Practice Guidelines (July 2018)
Publisher: Health Professions Council of South Africa
| 3 | | R410.00 | |
| | Clinical Practice Guidelines: Fever and Sepsis | Clinical Practice Guidelines: Fever and Sepsis
Clinical Practice Guidelines: Fever and Sepsis
Overview
Feverish illness in young children usually indicates an underlying infection and is a cause of concern for parents and carers. Despite advances in healthcare, infections remain a leading cause of death in children under the age of 5 years. Fever in young children can be a diagnostic challenge for healthcare professionals because it is often difficult to identify the cause. In most cases, the illness is due to a self-limiting viral infection. However, fever may also be the presenting feature of serious bacterial infections such as meningitis and pneumonia. A significant number of children have no obvious cause of fever despite careful assessment. These children with fever without apparent source are of concern to healthcare professionals because it is especially difficult to distinguish between simple viral illnesses and life-threatening bacterial infections in this group.
Acknowledgement
Journal: Clinical Practice Guidelines (July 2018) Publisher: Health Professions Council of South Africa
| 3 | | R410.00 | |
| | Clinical Practice Guidelines: Cerebrovascular Accident (Stroke) and General Care in Emergencies | Clinical Practice Guidelines: Cerebrovascular Accident (Stroke) and General Care in Emergencies
Clinical Practice Guidelines: Cerebrovascular Accident (Stroke) and General Care in Emergencies
Overview
There is growing evidence that good early stroke management can reduce damage to the brain and minimise the effects of stroke. Because of this early recognition of stroke, the subsequent response of individuals to having a stroke, and the timing and method by which people are transferred to hospital are important to ensure optimal outcomes. In this hyperacute phase of care, the ambulance service provides a central, coordinating role (Australian Government Health and Medical Research Council, 2007). Appropriate diagnosis of stroke and immediate referral to a stroke team is vital given advances in hyperacute treatments (Australian Government Health and Medical Research Council, 2007).
As in all scene responses, EMS personnel must assess and manage the patient’s airway, breathing, and circulation. Most patients with acute ischemic stroke do not require emergency airway management or acute interventions for respiratory and circulatory support (Jauch et al., 2013).
Journal: Clinical Practice Guidelines (July 2018)
Publisher: Health Professions Council of South Africa
| 3 | | R410.00 | |
| | Clinical Practice Guidelines: Airway Part 2 | Clinical Practice Guidelines: Airway Part 2
Clinical Practice Guidelines: Airway Part 2
Overview
Oxygen is one of the most common medications administered during the care of patients who present with medical emergencies. At present, oxygen appears to be administered for three main indications in the emergency setting, of which only one is evidence-based (British Thoracic Society Emergency Oxygen Guideline Group, 2008).
Firstly, oxygen is given to correct hypoxaemia as there is good evidence that severe hypoxaemia is harmful. Secondly, oxygen is administered to ill patients prophylactically to prevent hypoxaemia. Recent evidence suggests that this practice may place patients at increased risk of the development of hypoxaemia, reactive oxygen species, and absorption atelectasis amongst other adverse effects. Thirdly, a very high proportion of medical oxygen is administered because most clinicians believe that oxygen can alleviate breathlessness; however, there is no evidence that oxygen relieves breathlessness in non-hypoxemic patients (British Thoracic Society Emergency Oxygen Guideline Group, 2008).
Journal: Clinical Practice Guidelines (July 2018)
Publisher: Health Professions Council of South Africa
| 3 | | R410.00 | |
| | Clinical Practice Guidelines: Adult Resuscitation Part 3 | Clinical Practice Guidelines: Adult Resuscitation Part 3
Clinical Practice Guidelines: Adult Resuscitation Part 3
Overview
The correct and timely identification of cardiac arrest is critical to ensuring (1) the appropriate dispatch of a high-priority response, (2) the provision of telephone CPR instructions, and (3) the activation of community first responders carrying automated external defibrillators (AED) (Travers et al., 2015). Rapid defibrillation is a powerful predictor of successful resuscitation following ventricular fibrillation (VF) sudden cardiac arrest (SCA). (Berg et al., 2010a)
Advanced life support (ALS) is still considered a vital link in the chain of survival for patients with out-of-hospital cardiac arrest. Despite this the quality of evidence for many ALS interventions remains poor (Callaway et al., 2015) as do the outcomes of patients, particularly those suffering unwitnessed out-of-hospital cardiac arrest were CPR and defibrillation is delayed. As part of the development of these guidelines, the core guideline panel opted to adopt the AHA resuscitation guidelines for advanced cardiac life support. It should therefore be noted that for recommendations not reviewed by the AHA in the 2015 edition, the 2010 recommendation are considered valid.
Journal: Clinical Practice Guidelines (July 2018)
Publisher: Health Professions Council of South Africa
| 3 | | R410.00 | |
| | Clinical Practice Guidelines: Adult Resuscitation Part 2 | Clinical Practice Guidelines: Adult Resuscitation Part 2
Clinical Practice Guidelines: Adult Resuscitation Part 2
Overview
The correct and timely identification of cardiac arrest is critical to ensuring (1) the appropriate dispatch of a high-priority response, (2) the provision of telephone CPR instructions, and (3) the activation of community first responders carrying automated external defibrillators (AED) (Travers et al., 2015). Rapid defibrillation is a powerful predictor of successful resuscitation following ventricular fibrillation (VF) sudden cardiac arrest (SCA). (Berg et al., 2010a)
Advanced life support (ALS) is still considered a vital link in the chain of survival for patients with out-of-hospital cardiac arrest. Despite this the quality of evidence for many ALS interventions remains poor (Callaway et al., 2015) as do the outcomes of patients, particularly those suffering unwitnessed out-of-hospital cardiac arrest were CPR and defibrillation is delayed. As part of the development of these guidelines, the core guideline panel opted to adopt the AHA resuscitation guidelines for advanced cardiac life support. It should therefore be noted that for recommendations not reviewed by the AHA in the 2015 edition, the 2010 recommendation are considered valid.
Journal: Clinical Practice Guidelines (July 2018)
| 3 | | R410.00 | |
| | Clinical Practice Guidelines: Adult Resuscitation Part 1 | Clinical Practice Guidelines: Adult Resuscitation Part 1
Clinical Practice Guidelines: Adult Resuscitation Part 1
Overview
The correct and timely identification of cardiac arrest is critical to ensuring (1) the appropriate dispatch of a high-priority response, (2) the provision of telephone CPR instructions, and (3) the activation of community first responders carrying automated external defibrillators (AED) (Travers et al., 2015). Rapid defibrillation is a powerful predictor of successful resuscitation following ventricular fibrillation (VF) sudden cardiac arrest (SCA). (Berg et al., 2010a)
Advanced life support (ALS) is still considered a vital link in the chain of survival for patients with out-of-hospital cardiac arrest. Despite this the quality of evidence for many ALS interventions remains poor (Callaway et al., 2015) as do the outcomes of patients, particularly those suffering unwitnessed out-of-hospital cardiac arrest were CPR and defibrillation is delayed. As part of the development of these guidelines, the core guideline panel opted to adopt the AHA resuscitation guidelines for advanced cardiac life support. It should therefore be noted that for recommendations not reviewed by the AHA in the 2015 edition, the 2010 recommendation are considered valid.
Acknowledgement
Journal: Clinical Practice Guidelines (July 2018)
Publisher: Health Professions Council of South Africa
| 3 | | R410.00 | |
| | Clinical Practice Guidelines: Airway Part 1 | Clinical Practice Guidelines: Airway Part 1
Clinical Practice Guidelines: Airway Part 1
Overview
Oxygen is one of the most common medications administered during the care of patients who present with medical emergencies. At present, oxygen appears to be administered for three main indications in the emergency setting, of which only one is evidence-based (British Thoracic Society Emergency Oxygen Guideline Group, 2008).
Firstly, oxygen is given to correct hypoxaemia as there is good evidence that severe hypoxaemia is harmful. Secondly, oxygen is administered to ill patients prophylactically to prevent hypoxaemia. Recent evidence suggests that this practice may place patients at increased risk of the development of hypoxaemia, reactive oxygen species, and absorption atelectasis amongst other adverse effects. Thirdly, a very high proportion of medical oxygen is administered because most clinicians believe that oxygen can alleviate breathlessness; however, there is no evidence that oxygen relieves breathlessness in non-hypoxemic patients (British Thoracic Society Emergency Oxygen Guideline Group, 2008).
Journal: Clinical Practice Guidelines (July 2018)
Publisher: Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Acute Coronary Care Syndrome Part 2 | Clinical Practice Guidelines: Acute Coronary Care Syndrome Part 2
Clinical Practice Guidelines: Acute Coronary Care Syndrome Part 2
Overview
Chest pain and acute dyspnoea are among the most frequent causes of out-of-hospital emergency medical services (EMS) activation. The challenge of the pre-hospital management of chest pain, beyond rapid diagnosis, is the treatment and transfer of patients with major cardiovascular emergencies to adequate centres (Beygui et al., 2015). The required system infrastructure (i.e. local protocols and pathways of care) needs to be in place for EMS cardiovascular emergency objectives to be met. Not all recommendations below are readily implementable as local infrastructure must still be developed in South Africa. The care of ST-elevation myocardial infarction (STEMI) patients in the pre-hospital setting should be based on regional STEMI networks. Such networks include one or more hospitals and EMS organisations which have a shared protocol for the choice of reperfusion strategy, adjunctive therapy and patient transfer in order to provide consistent treatment to patients. Such protocols should be formally discussed between all components of the network and be available in writing (Beygui et al., 2015). Acknowledgement
Journal: Clinical Practice Guidelines (July 2018) Publisher: Health Professions Council of South Africa
| 3 | | R410.00 | |
| | Clinical Practice Guidelines: Respiratory | Clinical Practice Guidelines: Respiratory
Clinical Practice Guidelines: Respiratory
Overview
Asthma is a common condition which produces a significant workload for general practice, hospital outpatient clinics and inpatient admissions. Much of this morbidity relates to poor management (British Thoracic Society, 2014). Chronic obstructive pulmonary disease (COPD) is a group of disorders characterised by airway inflammation and airflow limitation that is not fully reversible. COPD should be distinguished from asthma because it is a progressive, disabling disease with increasingly serious complications and exacerbations. The symptoms, signs and physiology of these conditions can overlap with asthma and differentiation can be difficult, particularly in middle-aged smokers presenting with breathlessness and cough. This difficulty is compounded by the fact that most COPD patients exhibit some degree of reversibility with bronchodilators. Patients with severe chronic asthma, chronic bronchiolitis, bronchiectasis and cystic fibrosis may also present with a similar clinical pattern and partially reversible airflow limitation (The Thoracic Society of Australia and New Zealand, 2002). Acknowledgement
Journal: Clinical Practice Guidelines (July 2018) Publisher: Health Professions Council of South Africa | 3 | | R410.00 | |
| | Clinical Practice Guidelines: Seizures | Clinical Practice Guidelines: Seizures
Clinical Practice Guidelines: Seizures
Overview
Paediatric and adult seizures are managed in essentially the same way, with the focus on identification, injury prevention, rapid termination and prevention of ongoing seizures; ongoing attention must be paid to reversal of the cause of the seizure. Important differences in children relate to febrile seizures (covered in section 3: Fever & Sepsis) and easily correctable causes such as hypoglycaemia. Acknowledgement
Journal: Clinical Practice Guidelines (July 2018) Publisher: Health Professions Council of South Africa | 3 | | R410.00 | |
| | Viral Pneumonia Part 3 | Viral Pneumonia Part 3
Overview The reported incidence of viral pneumonia (see the image below) has increased during the past decade. In part, this apparent increase simply reflects improved diagnostic techniques, but an actual increase appears to have also occurred. Depending on the virulence of the organism, as well as the age and comorbidities of the patient, viral pneumonia can vary from a mild, self-limited illness to a life-threatening disease. This course is divided into 3 parts covering the aspects of Pneumonia leading into the much dreaded COVID 19 The influenza viruses are the most common viral cause of pneumonia. Primary influenza pneumonia manifests with persistent symptoms of cough, sore throat, headache, myalgia, and malaise for more than three to five days. Respiratory syncytial virus (RSV) is the most frequent cause of lower respiratory tract infection in infants and children and the second most common viral cause of pneumonia in adults.
Parainfluenza virus (PIV) is second in importance only to RSV as a cause of lower respiratory tract disease in children and pneumonia and bronchiolitis in infants younger than 6 months. PIV pneumonia and bronchiolitis are caused primarily by the PIV-3 strain. The signs and symptoms include fever, cough, coryza, dyspnea with rales, and wheezing.
Acknowledgements Authors:
Zab Mosenifar and Richard Brawerman | 3 | | R420.00 | |
| | Viral Pneumonia Part 2 | Viral Pneumonia Part 2
Overview The reported incidence of viral pneumonia (see the image below) has increased during the past decade. In part, this apparent increase simply reflects improved diagnostic techniques, but an actual increase appears to have also occurred. Depending on the virulence of the organism, as well as the age and comorbidities of the patient, viral pneumonia can vary from a mild, self-limited illness to a life-threatening disease. This course is divided into 3 parts covering the aspects of Pneumonia leading into the much dreaded COVID 19. The influenza viruses are the most common viral cause of pneumonia. Primary influenza pneumonia manifests with persistent symptoms of cough, sore throat, headache, myalgia, and malaise for more than three to five days. Respiratory syncytial virus (RSV) is the most frequent cause of lower respiratory tract infection in infants and children and the second most common viral cause of pneumonia in adults.
Parainfluenza virus (PIV) is second in importance only to RSV as a cause of lower respiratory tract disease in children and pneumonia and bronchiolitis in infants younger than 6 months. PIV pneumonia and bronchiolitis are caused primarily by the PIV-3 strain. The signs and symptoms include fever, cough, coryza, dyspnea with rales, and wheezing.
Acknowledgements Authors:
Zab Mosenifar and Richard BrawermanThe University of Pretoria | 3 | | R420.00 | |
| | Viral Pneumonia Part 1 | Viral Pneumonia Part 1
Overview The reported incidence of viral pneumonia (see the image below) has increased during the past decade. In part, this apparent increase simply reflects improved diagnostic techniques, but an actual increase appears to have also occurred. Depending on the virulence of the organism, as well as the age and comorbidities of the patient, viral pneumonia can vary from a mild, self-limited illness to a life-threatening disease.
This course is divided into 3 parts covering the aspects of Pneumonia leading into the much dreaded COVID 19. The influenza viruses are the most common viral cause of pneumonia. Primary influenza pneumonia manifests with persistent symptoms of cough, sore throat, headache, myalgia, and malaise for more than three to five days. Respiratory syncytial virus (RSV) is the most frequent cause of lower respiratory tract infection in infants and children and the second most common viral cause of pneumonia in adults.
Parainfluenza virus (PIV) is second in importance only to RSV as a cause of lower respiratory tract disease in children and pneumonia and bronchiolitis in infants younger than 6 months. PIV pneumonia and bronchiolitis are caused primarily by the PIV-3 strain. The signs and symptoms include fever, cough, coryza, dyspnea with rales, and wheezing.
Acknowledgements
Authors:
Zab Mosenifar and Richard Brawerman | 3 | | R420.00 | |
| | Malaria | Malaria
Overview Malaria is a potentially life-threatening disease caused by infection with Plasmodium protozoa transmitted by an infective female Anopheles mosquito. Patients with malaria typically become symptomatic a few weeks after infection, though the symptomatology and incubation period may vary, depending on host factors and the causative species. Most patients with malaria have no specific physical findings, but splenomegaly may be present. In patients with suspected malaria, obtaining a history of recent or remote travel to an endemic area is critical. Asking explicitly if they travelled to a tropical area at any time in their life may enhance recall. Maintain a high index of suspicion for malaria in any patient exhibiting any malarial symptoms and having a history of travel to endemic areas.
It is also important to determine the patient's immune status, age, and pregnancy status; allergies or other medical conditions that he or she may have; and medications that he or she may be using.
Acknowledgements Authors:
Thomas E Herchline, Thomas E Herchline, Ryan Q Simon
| 3 | | R420.00 | |
| | Diabetes Mellitus Part 2 | Diabetes Mellitus Part 2
Overview Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. Poorly controlled type 2 diabetes is associated with an array of microvascular, macrovascular, and neuropathic complications.
Microvascular complications of diabetes include retinal, renal, and possibly neuropathic disease. Macrovascular complications include coronary artery and peripheral vascular disease. Diabetic neuropathy affects autonomic and peripheral nerves.
This course focuses on the diagnosis and treatment of type 2 diabetes and its acute and chronic complications, other than those directly associated with hypoglycemia and severe metabolic disturbances, such as hyperosmolar hyperglycemic state (HHS) and diabetic ketoacidosis (DKA).
Acknowledgements Author:
Khardori | 3 | | R420.00 | |
| | Diabetes Mellitus Part 1 | Diabetes Mellitus Part 1
Overview Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. Poorly controlled type 2 diabetes is associated with an array of microvascular, macrovascular, and neuropathic complications.
Microvascular complications of diabetes include retinal, renal, and possibly neuropathic disease. Macrovascular complications include coronary artery and peripheral vascular disease. Diabetic neuropathy affects autonomic and peripheral nerves.
This course focuses on the diagnosis and treatment of type 2 diabetes and its acute and chronic complications, other than those directly associated with hypoglycemia and severe metabolic disturbances, such as hyperosmolar hyperglycemic state (HHS) and diabetic ketoacidosis (DKA).
Acknowledgements Author:
Khardori | 3 | | R420.00 | |
| | Primary care randomised controlled trial of a tailored interactive website for the self-management of respiratory infections (Internet Doctor). | Primary care randomised controlled trial of a tailored interactive website for the self-management of respiratory infections (Internet Doctor).
Primary care randomised controlled trial of a tailored interactive website for the self-management of respiratory infections (Internet Doctor).
OVERVIEW
Respiratory tract infection (RTI) is very common and most people suffer from it every year. Some people even suffer from it more than once with consulting primary care at least once each year, which represents a significant call on healthcare resources.
The objective of this stud was to assess an internet-delivered intervention providing advice to manage respiratory tract infections (RTIs). The design for this study was an open pragmatic parallel group randomized controlled trial meanwhile the setting was primary care in the United Kingdom. The participants of this study were adults (aged =18) registered with general practitioners, recruited by postal invitation. The intervention of this research however tailored advices about the diagnosis, natural history, symptom management (particularly paracetamol/ibuprofen use) and when to seek further help.
Out of the 3044 participants that were recruited for this study, 852 in the intervention group and 920 in the control group reported 1 or more RTIs, among whom there was a modest increase in NHS direct contacts in the intervention group (intervention 37/1574 (2.4%) versus control 20/1661 (1.2%); multivariate risk ratio (RR) 2.25 (95% CI 1.00 to 5.07, p=0.048)).
ACKNOWLEDGEMENT
AUTHORS: Paul Little, Beth Stuart, Panayiota Andreou, Lisa McDermott, Judith Joseph, Mark Mullee, Mike Moore, Sue Broomfield, Tammy Thomas, Lucy Yardley
JOURNAL: Respiratory Medicine
PUBLISHER: BMJ Open
URL: http://bmjopen.bmj.com | 3 | | R330.00 | |