| | 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 | |
| | 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
| 3 | | R485.00 | |
| | Five-Minute Cognitive Test as A New Quick Screning of Cognitive Impairment in the Elderly | Five-Minute Cognitive Test as A New Quick Screning of Cognitive Impairment in the Elderly
Five-Minute Cognitive Test as A New Quick Screning 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 | |
| | 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 | |
| | Self-reported use of family physician, chiropractor and physiotherapy services among adult Canadians with chronic back disorders: an observational study | Self-reported use of family physician, chiropractor and physiotherapy services among adult Canadians with chronic back disorders: an observational study
Self-reported use of family physician, chiropractor and physiotherapy services among adult Canadians with chronic back disorders: an observational study
Overview Chronic back disorders (CBD) are prevalent, costly, and among the most common reasons for seeking primary care; however, little is known regarding the comparative use of family physician, chiropractic, and physiotherapy services among people with CBD in Canada. Elucidating these differences may identify potential gaps in access to care and inform the development of strategies to improve access. The research objectives were to investigate patterns of health care use and to profile factors associated with self-reported use of family physicians, chiropractors, and physiotherapists among adult Canadians with CBD. This complex survey employs population weights and bootstrapping to be representative of the Canadian population. Following descriptive analyses, we used multiple logistic regression to profile self-reported health care use while statistically controlling for possible confounding effects. After adjustment, differential patterns of utilization were evident between provider groups with respect to age, gender, socioeconomic status, rural/urban residence, functional limitations, and presence of co-morbidities.
Acknowledgment Authors: Brenna Bath, Josh Lawson, Dennis Ma and Catherine Trask Journal BMC Health Services Research
| 3 | | R465.00 | |
| | Educational program in onco-urology for young urologists: What are their needs? | Educational program in onco-urology for young urologists: What are their needs?
Educational program in onco-urology for young urologists: What are their needs?
Overview The emergence of new communication media such as digital contents are progressively replacing more traditional medias in the field of educational programs. Our purpose was to assess urologist in training aspirations regarding urological education. Members of a national urologist in training association were sent an anonymous online questionnaire regarding their medical formation in the field of urology. Responders interest for urological sub-specialty or education support (new tools and traditional support) were evaluated through a 5-point Likert scale. Overall, 109 young urologists (26%) responded to the survey. Urologic oncology was a priority regarding education for urologists in training. A majority of participants expressed a lack in their surgical education, revealing a reduced OR access and underlining utilization of new tools such as simulation. New digital contents such as social media or podcast achieved high interest for the participants, instead of more traditional media. It was founded that there is a need for educational content evolve and uses new digital media. Authors U. Pinar, L. Fretonb, B. Gondran-Tellier, M. Vallée, I. Dominiquee, M. Felber, Z.-E. Khene, E. Fortier, F. Lannes, C. Michiels, T. Grevez, N. Szablai, F. Bardetj, K. Kaulanjank, E. Seizilles de Mazancourtl, X. Matillonl, B. Pradere Journal Progrès en urologie
| 3 | | R420.00 | |
| | 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 | |
| | An integrative medicine case exemplar: The perspectives of a family physician credentialed in acupuncture | An integrative medicine case exemplar: The perspectives of a family physician credentialed in acupuncture
An integrative medicine case exemplar: The perspectives of a family physician credentialed in acupuncture
Overview Although the meaning of Integrative Medicine differs by individual patients, their demand for a more inclusive and integrative approach to care that utilizes both conventional and complementary medicine modalities has been increasing. Integrative medicine is an attempt to fulfil this growing demand for more holistic approaches to healthcare. One advantage of establishing a system that encourages more MCPs is that it allows patients to receive conventional and complementary medical care from one individual, but the time and expense of producing these MCPs poses a significant challenge in creating a pipeline of these individuals. If collaboration among clinicians was facilitated to provide patients with an integrative approach to their health care, this would allow the clinician to specialize in their area of focus; however, differing opinions and perspectives about how to care for the patient may pose significant communication challenges in the delivery of effective integrative care. Both approaches have the potential to create more access to integrative medicine for patients. Generous funding sources that create platforms for integrative medicine healthcare, such as The Bernard Osher Foundation’s support for Integrative Medicine, allow university–based community healthcare systems to generate research data that support evidence-based systemic change.
Authors Iman Majd, Paul S. Amieuxb, Sierra V. Cortes, Masa Sasagawa Journal Advances in Integrative Medicine 7 | 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 | |
| | HIV and Aids | HIV and Aids
Overview
HIV disease is caused by infection with HIV-1 or HIV-2, which are retroviruses in the Retroviridae family, Lentivirus genus. Human immunodeficiency virus (HIV) is a blood-borne virus typically transmitted via sexual intercourse, shared intravenous drug paraphernalia, and mother-to-child transmission (MTCT), which can occur during the birth process or during breastfeeding. The patient with HIV may present with signs and symptoms of any of the stages of HIV infection. No physical findings are specific to HIV infection; the physical findings are those of the presenting infection or illness. Examples of manifestations include acute seroconversion manifests as a flulike illness, consisting of fever, malaise, generalized rash, generalized lymphadenopathy is common and may be a presenting symptom. This course covers the screening, diagnosis, medication and management of Aids.
Author: Sharespike | 3 | | R425.00 | |
| | 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 | |
| | Acute Leukemia Part 2 | Acute Leukemia Part 2
Overview There are various forms of acute Leukemia of which most of these are discussed in Parts 1 and 2 of this study. In Part 2 Acute Lymphoblastic Leukemia (ALL) is disccused. Acute lymphoblastic leukemia (acute lymphocytic leukemia, ALL) is a malignant (clonal) disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow. Acute lymphoblastic leukemia (ALL) is the most common type of cancer and leukemia in children in the United States. Median age at diagnosis is 16 years. ALL accounts for 74% of pediatric leukemia cases. Historically, patients with ALL were divided into three prognostic groups: good risk, intermediate risk, and poor risk.
In adults, ALL is less common than acute myeloid leukemia (AML). The American Cancer Society estimates that 6150 cases of ALL (adult and pediatric) will occur in the United States in 2020, resulting in 1520 deaths. The estimated 5-year survival is 68.6%. The favourable survival rate is due to the high cure rate of ALL in children. Prognosis declines with increasing age, and the median age at death is 56 years. Only 20-40% of adults with acute lymphoblastic leukemia (ALL) are cured with current treatment regimens.
The diagnosis, treatment and effects of Leukemia are addressed here in Part 2.
Author Sharespike | 3 | | R425.00 | |
| | Acute Leukemia Part 1 | Acute Leukemia Part 1
Overview There are various forms of acute Leukemia of which most of these are discussed in Parts 1 and 2 of this study. In Part 1 Acute Lymphoblastic Leukemia is disccused. This is a malignant (clonal) disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow. A proposed mechanism for some cases of childhood ALL is a two-step process of genetic mutation and exposure to infection. In contrast, most adults with ALL have no identifiable risk factors.
Acute promyelocytic leukemia (APL) is a unique subtype of acute leukemia characterized by abnormal proliferation of promyelocytes, life-threatening coagulopathy, and the chromosome translocation. The discovery and elucidation of the molecular pathogenesis for APL has led to the introduction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) therapies, which improved the prognosis of APL patients significantly.
The diagnosis, treatment and effects of these types of Leukemia are addressed.
Author Sharespike
| 3 | | R425.00 | |
| | 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.
Authors Masashi Yamori, Mitsumasa Tamura, Masaki Mikami, Toshio Mori, Masaharu Noi, Yoshisato Machida, Shinya Koshinuma, Gaku Yamamoto Journal International Dental Journal | 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
Journal Internet Interventions 21 (2020) 100337
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| | An Interprofessional Approach to Oral Hygiene for Elderly Inpatients and the Perception of Caregivers Towards Oral Health Care | An Interprofessional Approach to Oral Hygiene for Elderly Inpatients and the Perception of Caregivers Towards Oral Health Care
An Interprofessional Approach to Oral Hygiene for Elderly Inpatients and the Perception of Caregivers Towards Oral Health Care
Overview The objective of this study was to investigate the effect of an interprofessional oral hygiene support program for elderly inpatients and the perception of caregivers of the elderly towards oral health care. Participants comprised 37 elderly inpatients requiring nursing care (17 males, 20 females) and 29 registered nurses who participated in the interprofessional oral health care support program as a caregiver (4 males, 25 females). In this program, inpatients received daily oral cleaning by registered nurses based on each patient’s oral health care plan. The number of microbes on the tongue surface of the inpatients was measured once a week for 12 weeks. Additionally, as an investigation of the perception of the caregivers towards oral health care, a questionnaire about the required frequency and duration for oral cleaning was conducted with registered nurses before and after the program to investigate the perception of the caregivers towards oral health care. The result was that significant differences were observed in the number of microbes on the tongue surface between baseline and at every measurement after the beginning of this program, except for the first week. It was concluded that implementation of the program decreased the number of microbes on the tongue surface of the elderly inpatients and improved the perception of their caregivers towards oral health care Authors Masahiro Ryu, Takayuki Ueda, Kaoru Sakurai Journal International Dental Journal
| 3 | | R380.00 | |
| | 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
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| | Comparison of Whole-Body Electromyostimulation versus Recognized Back-Strengthening Exercise Training on Chronic Nonspecific Low Back Pain: A Randomized Controlled Study | Comparison of Whole-Body Electromyostimulation versus Recognized Back-Strengthening Exercise Training on Chronic Nonspecific Low Back Pain: A Randomized Controlled Study
Comparison of Whole-Body Electromyostimulation versus Recognized Back-Strengthening Exercise Training on Chronic Nonspecific Low Back Pain: A Randomized Controlled Study
Overview Due to changing living and working conditions the incidence of nonspecific low back pain (LBP) is increasing continuously worldwide. Low back pain (LBP) affects almost everyone at least once in their lifetime. Various meta-analyses show promising effects on pain reduction for conventional exercise. However, the lack of time and, especially for pain patients, a fear of movement (“kinesiophobia”) as well as functional limitations often oppose participation in such activities. The aim of this randomized controlled trial is to compare WB-EMS with a recognized back-strengthening exercise protocol to determine the corresponding effects on chronic, nonspecific LBP in people suffering from this.
This randomized, controlled multicenter study is focused on novel and time-effective training technologies and LBP. In this contribution, the focus is primarily on the comparison of WB-EMS against a comparable conventional exercise training (CT). Two groups were chosen to complete a12-week program (WB-EMS: 1 × 20 min/week vs. CT: 1 × 45 min/week) specifically dedicated to LBP. The selection of the content of the active control group was based on the principles of WB-EMS training, which uses electrical stimulation to train mainly strength and stabilization in a very short time. Exercises were similar in all groups, with the focus on strengthening and stabilizing the trunk. Outcome measures were assessed by a four-week pain diary (before and during the last four weeks of intervention) as well as an isometric maximum strength measurement of the trunk muscles at baseline and after 12 weeks of intervention.
In summary, both, WB-EMS and conventional back-strengthening protocol are comparably effective in reducing nonspecific chronic LBP in this dedicated cohort. The result is particularly positive in terms of time effectiveness and offers an adequate alternative for people with limited time resources or other barriers to conventional training methods.
Authors WangshuYuan1 JianxiongShen2 LixiaChen1 HaiWang2 Keyi Yu2 HuiCong1 Jingya Zhou3 and Youxi Lin2
Journal Hindawi Pain Research and Management | 3 | | R465.00 | |
| | 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
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| | 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)
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| | 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. Acknowledgement
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.
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| | 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.
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| | Sceptic Shock Part 2 | Sceptic 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 | |
| | Sceptic Shock Part 1 | Sceptic 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 | |
| | Brain Connectivity Changes after Osteopathic Manipulative Treatment: A Randomized Manual - Placebo Controlled Trial | Brain Connectivity Changes after Osteopathic Manipulative Treatment: A Randomized Manual - Placebo Controlled Trial
Brain Connectivity Changes after Osteopathic Manipulative Treatment: A Randomized Manual - Placebo Controlled Trial
Overview
The effects of osteopathic manipulative treatment (OMT) on functional brain connectivity in healthy adults is missing in the literature. The main advantage for patients is the effective relief of acute and chronic pain. Indeed, OMT was proved effective on conditions and disorders beyond the sensory and motor system, including the reduction of hospitalization length in a large population of preterm infants, effects in anxiety and fatigue in people with Multiple Sclerosis and on autonomic and neuroendocrine responses. The neurophysiological effects underlying clinical improvements are still under debate. Although models explaining the therapeutic effects of OMT include potential brain mechanisms, few studies have been carried out to investigate brain mechanism changes after OMT. Magnetic resonance imaging (MRI) research includes several different approaches to estimate cortical functions. Several of these approaches have demonstrated functional brain changes associated with OMT. Using Arterial Spin Labeling MRI, we recently demonstrated that the treatment of somatic dysfunctions induces cerebral perfusion changes in asymptomatic young participants. This research provides the first preliminary evidence of brain network connectivity changes due to OMT, opening further insights into potential effects of OMT on brain functional activity. Moreover, it suggests future investigations in this unexplored field, particularly on symptomatic subjects.
Authors Marco Tramontano, Francesco Cerritelli, Federica Piras, Barbara Spanò, Federica Tamburella, Fabrizio Piras, Carlo Caltagirone, and Tommaso Gili Journal Brain Sci. 2020 Dec; 10(12): 969. | 3 | | R410.00 | |
| | Neuromuscular Function of the Knee Joint Following Knee njuries: Does It Ever Get Back to Normal? A Systematic Review with Meta Analyses | Neuromuscular Function of the Knee Joint Following Knee njuries: Does It Ever Get Back to Normal? A Systematic Review with Meta Analyses
Neuromuscular Function of the Knee Joint Following Knee njuries: 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 | |
| | Prevalence of SARS-CoV-2 infection in general practitioners and nurses in primary care and nursing homes in the Healthcare Area of León and associated factors | Prevalence of SARS-CoV-2 infection in general practitioners and nurses in primary care and nursing homes in the Healthcare Area of León and associated factors
Prevalence of SARS-CoV-2 infection in general practitioners and nurses in primary care and nursing homes in the Healthcare Area of León and associated factors
Overview To evaluate the prevalence of and factors associated with SARS-CoV-2 infection in general practitioners and nurses from primary care centres and nursing homes in the Healthcare Area of León (Spain). The work centre, type of profession, COVID-19 infection, level of exposure, compliance with preventive measures, isolation (if required) and diagnostic tests carried out were collected. The determination of infection was made by differentiated rapid diagnostic test (dRDT), using a finger-stick whole-blood sample. The association of variables with infection was assessed by multivariable non-conditional logistic regression. No statistically significant differences were observed by sex, type of professional, level of exposure or compliance with preventive measures. The prevalence of SARS-CoV-2 infection in this group is low. A high number of professionals remain susceptible to SARS-CoV-2 infection and therefore protective measures should be taken, especially for professionals working in nursing homes.
Authors: V. Martín, T. Fernández-Villa, M. Lamuedra Gil de Gomez, O. Mencía-Ares, A. Rivero Rodríguez, S. Reguero Celada, M. Montoro Gómez, M.T. Nuevo Guisado, C. Villa Aller, C. Díez Flecha, A. Carvajal, J.P. Fernández Vázquez
Journal: Semergen. 2020;46(S1):42---46 | 3 | | R400.00 | |
| | Preventing infectious diseases for healthy ageing: The VITAL public-private partnership project | Preventing infectious diseases for healthy ageing: The VITAL public-private partnership project
Preventing infectious diseases for healthy ageing: The VITAL public-private partnership project
Overview Prevention of infectious diseases through immunisation of the growing ageing adult population is essential to improve healthy ageing. However, many licenced and recommended vaccines for this age group show signs of waning of the protective effect due to declining immune responses (immunosenescence) and decreasing vaccine uptake. Today’s major challenge is to improve vaccine effectiveness and uptake and to deploy efficient vaccination strategies for this age group. The Vaccines and Infectious diseases in the Ageing population (VITAL) project, with partners from 17 academic & research groups and public institutes as well as seven industry collaborators, aims to address this challenge. The ambition is to provide evidence-based knowledge to local decision makers. Using a holistic and multidisciplinary approach and novel analytical methods, VITAL will provide tools that allow the development of targeted immunisation programs for ageing adults in European countries. The project is based on four pillars focussing on the assessment of the burden of vaccine-preventable diseases in ageing adults, the dissection of the mechanisms underlying immuno-senescence, the analysis of the clinical and economic public health impact of vaccination strategies and the development of educational resources for healthcare professionals.
Authors Debbie Van Baarle, Kaatje Bollaerts, Giuseppe Del Giudice, Stephen Lockhart, Christine Luxemburger, Maarten J. Postma, Aura Timen, Baudouin Standaert
Journal Vaccine 38 (2020) 5896–5904 https://doi.org/10.1016/j.vaccine.2020.07.005
URL https://www.sciencedirect.com/science/article/pii/S0264410X20309051?via%3Dihub | 3 | | R425.00 | |
| | Ways in which healthcare interior environments are associated with perceived safety against infectious diseases and coping behaviours | Ways in which healthcare interior environments are associated with perceived safety against infectious diseases and coping behaviours
Ways in which healthcare interior environments are associated with perceived safety against infectious diseases and coping behaviours
Overview
Global pandemic outbreaks are a cause of fear. Healthcare workers (HCWs), especially those fighting the pathogens at the front line, are at higher risk of being infected while they treat patients. In addition, various environmental fomites in hospitals, which may carry infectious agents, can increase the risk of acquiring an infectious disease.
To deliver the best healthcare practice, it is critical that HCWs feel safe and protected against infectious diseases. The aim of this study was to improve understanding of HCWs’ hand hygiene (HH) behaviours and perceptions of infectious diseases from a psychological perspective.
This study found that an increase in the number of HH stations at convenient locations would increase HH compliance and perceived safety against infectious diseases among HCWs. In response to the current research gap in psychological aspects associated with HH, this study found that HCWs’ coping behaviours can be predicted by their perceived likelihood of contamination and perceived vulnerability.
Author S. Bae
Journal Journal of Hospital Infection 106 (2020) 107e114 https://doi.org/10.1016/j.jhin.2020.06.022
URL https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308774/pdf/main.pdf | 3 | | R420.00 | |
| | Probiotics and Protection of the Stomach | Probiotics and Protection of the Stomach
Probiotics and Protection of the Stomach
Overview Probiotics are living organisms and have beneficial effects when they colonize the body, assuming they can stay alive long enough to do so. Probiotic treatments are packed with bacteria, but once swallowed, their numbers are dramatically diminished by the stomach's acidity, lowering the chances of therapeutic effect. Probiotics can live or die under a variety of circumstances. One such circumstance is time. Some bacteria make spores which can live for many years and then blossom and grow. Most probiotics do not make spores, so they gradually die off if they do not find a comfortable place to grow, meaning a moist, warm friendly environment like the colon. Stomach acid is extraordinarily strong. It does and will kill most bacteria that get into the stomach each day. Antibiotics can also kill the bacteria in your body. So, how do you protect the probiotic bacteria you take, from this bacteria execution chamber which everyone has inside them?
Acknowledgements Du Pont Dinesco Capsugel R&D Team and Dr Keith Hutchison Elsevier – LWT Food Science and Technology
| 2 | | R0.00 | |
| | 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.
Acknowledgement 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.
Acknowledgement 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.
Acknowledgement
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. Acknowledgement
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.
Acknowledgement
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).
Acknowledgement
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).
Acknowledgement
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.
Acknowledgement
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.
Acknowledgement
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).
Acknowledgement
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: Acute Coronary Care Syndrome Part 1 | Clinical Practice guidelines: Acute Coronary Care Syndrome Part 1
Clinical Practice guidelines: Acute Coronary Care Syndrome Part 1
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 | |
| | Tuberculosis Part 2 | Tuberculosis Part 2
Overview
Tuberculosis (TB) (see the image below), a multisystemic disease with myriad presentations and manifestations, is the most common cause of infectious disease–related mortality worldwide. Although TB rates are decreasing in the United States, the disease is becoming more common in many parts of the world. In addition, the prevalence of drug-resistant TB is increasing worldwide. Classic clinical features associated with active pulmonary TB in elderly individuals with TB may not display typical signs and symptoms. The absence of any significant physical findings does not exclude active TB. Classic symptoms are often absent in high-risk patients, particularly those who are immunocompromised or elderly. It is important to isolate patients with possible TB in a private room with negative pressure.
Acknowledgements Authors:
Thomas E Herchline,Thomas E Herchline, Judith K Amorosa, Judith K Amorosa. | 3 | | R420.00 | |
| | Tuberculosis Part 1 | Tuberculosis Part 1
Overview Tuberculosis (TB) (see the image below), a multisystemic disease with myriad presentations and manifestations, is the most common cause of infectious disease–related mortality worldwide. Although TB rates are decreasing in the United States, the disease is becoming more common in many parts of the world. In addition, the prevalence of drug-resistant TB is increasing worldwide. Classic clinical features associated with active pulmonary TB in elderly individuals with TB may not display typical signs and symptoms. The absence of any significant physical findings does not exclude active TB. Classic symptoms are often absent in high-risk patients, particularly those who are immunocompromised or elderly. It is important to isolate patients with possible TB in a private room with negative pressure.
Acknowledgements Authors: Thomas E Herchline and Judith K Amorosa | 3 | | R420.00 | |
| | 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 | |
| | Acute Management of Stroke | Acute Management of Stroke
Acute Management of Stroke
Overview:
The goal for the acute management of patients with stroke is to stabilize the patient and to complete initial evaluation and assessment, including imaging and laboratory studies, within 60 minutes of patient arrival. Critical decisions focus on the need for intubation, blood pressure control, and determination of risk/benefit for thrombolytic intervention.
In patients with transient ischemic attacks (TIAs), failure to recognize the potential for near- term stroke, failure to perform a timely assessment for stroke risk factors, and failure to initiate primary and secondary stroke prevention exposes the patient to undue risk of stroke and exposes clinicians to potential litigation. TIAs confer a 10% risk of stroke within 30 days, and one half of the strokes occurring after a TIA, occurred within 48 hours.
Newer stroke trials have explored the benefit of using neuroimaging to select patients who are most likely to benefit from thrombolytic therapy and the potential benefits of extending the window for thrombolytic therapy beyond the guideline of 3 hours with t-PA and newer agents. CT angiography may demonstrate the location of vascular occlusion. CT perfusion studies can produce perfusion images and together with CT angiography are becoming more available and utilized in the acute evaluation of stroke patients. Advanced neuroimaging with diffusion and perfusion imaging may then serve an important role in identifying potentially salvageable tissue at risk and guiding clinical decision-making regarding therapy.
Acknowledgements:
Authors:
Edward C Jauch | 3 | | R440.00 | |
| | Hyperglycemia | Hyperglycemia
Overview:
Hyperglycemia (also spelled hyperglycaemia or hyperglycæmia), is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/l (200 mg/dl), but symptoms may not start to become noticeable until even higher values such as 13.9–16.7 mmol/l (~250–300 mg/dl). For diabetics, glucose levels that are too hyperglycemic can vary from person to person, mainly due to the person's renal threshold of glucose and overall glucose tolerance. Hypoglycemia, also known as low blood sugar, is a fall in blood sugar to levels below normal. This may result in a variety of symptoms including clumsiness, trouble talking, confusion, loss of consciousness, seizures or death. A feeling of hunger, sweating, shakiness and weakness may also be present. Symptoms typically come on quickly. The most common cause of hypoglycemia is medications used to treat diabetes mellitus such as insulin and sulfonylureas. Risk is greater in diabetics who have eaten less than usual, exercised more than usual or drunk alcohol. Other causes of hypoglycemia include kidney failure, certain tumours (such as insulinoma), liver disease, hypothyroidism, starvation, inborn error of metabolism, severe infections, reactive hypoglycemia and several drugs including alcohol. Low blood sugar may occur in otherwise healthy babies who have not eaten for a few hours.
Acknowledgements:
Author:
Jasvinder Chawla
| 3 | | R410.00 | |
| | Skydiving: The audiological perspective | Skydiving: The audiological perspective
Skydiving: The audiological perspective
Overview
The main aim of this study was to explore the relationship between skydiving and audiology in South Africa. The sub-aims of the study focused on determining if skydivers were provided with safety precautions before they commenced with the dive, determining the middle ear pressure before and after the skydive and identifying the audiological symptoms that were present post-dive. This study also aimed at scrutinising the South African sports and recreation policy. Thirty-one skydivers were purposefully recruited to undergo a pre- and post-dive tympano-metric assessment. There is no information within the clearance forms that pertain to the audiological risks related to skydiving. There was a lack of information related to the risks of skydiving in the clearance forms at both dive schools. A statistically significant pressure change was noted in regular skydivers, regardless of the ability to equalise effectively during the skydive. This study identified the gaps in policy and clearance forms, highlighting the need for the inclusion of safety measures and risks in the documentation and legislation that governs the sport. Audiologists, sportspeople and medical advisors should be cognisant of the negative consequences that may be evident within the auditory system of skydivers.
Acknowledgement
Authors Dhanashree Pillay and Shaaista Dada
Journal South African Journal of Communication Disorders
| 3 | | R390.00 | |
| | Idiopathic sudden sensorineural hearing loss in dialysis patients | Idiopathic sudden sensorineural hearing loss in dialysis patients
Idiopathic sudden sensorineural hearing loss in dialysis patients
Overview
Although sudden sensorineural hearing loss (SSNHL) affects chronic kidney disease (CKD) patients more frequently than non-CKD patients, few reports have described SSNHL in dialysis patients. We aimed to review the characteristics of SSNHL in chronic dialysis patients and evaluate treatment responses to steroid therapy. End-stage renal disease was most frequently caused by diabetic nephropathy, chronic glomerulonephritis and unknown factors. Common accompanying symptoms included tinnitus, ear fullness and vertigo. The mean pure tone audiometry threshold at the initial presentation was 82.6 ± 22.4 dB.
Although the exact incidence of SSNHL has also not been determined in CKD patients, Charlene et al. reported a 1.57-fold higher incidence among CKD patients relative to non-CKD controls. Although we could not identify the specific cause of SSNHL in this population, our relatively large case series elucidates the precise clinical features of SSNHL in this population and demonstrates the outcomes of steroid treatment. A prospective study will be required to clarify the effects of treatment and the relationship between sudden hearing loss and chronic renal failure.
Acknowledgement
Authors Sun-Myoung Kang, Hyun Woo Lim and Hoon Yu
Journal Renal Failure
| 3 | | R425.00 | |
| | Pediatric Minor Head Injury 2.0: Moving from Injury Exclusion to Risk Stratification - Emergency Medicine Clinics of North America | Pediatric Minor Head Injury 2.0: Moving from Injury Exclusion to Risk Stratification - Emergency Medicine Clinics of North America
Pediatric Minor Head Injury 2.0: Moving from Injury Exclusion to Risk Stratification - Emergency Medicine Clinics of North America
Overview
ED and primary care provider visits for pediatric minor BHT continue to increase. Considerable variability exists in clinician evaluation and management of this generally low- risk population. CDRs should be used to assist providers in identification of very low-risk individuals, eliminating the need for cranial CT scans. The use of periods of observation before imaging can also decrease scanning rates. Outcome data from past retrospective studies as well as prospective data accumulated during the derivation and validation of the PECARN head injury decision rules for children less than 2 years and 2 to 18 years of age can be used to further risk stratify children with minor BHT who are at intermediate or high risk for ciTBI into more discrete categories.
Incorporation of decision aids into practice can be useful for increasing caregiver knowledge and accuracy of risk perception and improve provider identification of patient or caregiver preferences. This can help to facilitate shared decision-making regarding imaging or observation. For children in whom imaging is performed and is normal or shows only isolated linear skull fractures, the rates of deterioration and neurosurgical intervention are rare and, therefore, hospital admission can likely be avoided.
Acknowledgement
Author James (Jim) L. Homme, MD
Journal Emergency Medicine Clinics of North America
| 3 | | R425.00 | |
| | Use of steroid and nonsteroidal anti-inflammatories in the treatment of rheumatoid arthritis | Use of steroid and nonsteroidal anti-inflammatories in the treatment of rheumatoid arthritis
Use of steroid and nonsteroidal anti-inflammatories in the treatment of rheumatoid arthritis
Overview
Rheumatoid arthritis (RA) is a chronic, autoimmune, and systemic inflammatory disease of unknown etiology, which mainly affects joints and is characterized by symmetrical synovial inflammation, resulting in destruction of joint cartilage, significant pain, and severe disability. This study will evaluate the effectiveness and the safety of steroid and non-steroidal anti-inflammatory drugs for the treatment of patients with rheumatoid arthritis. Randomized clinical trials eligible for our systematic review will enrol adults with rheumatoid arthritis treated with anti-inflammatory drugs compared with a control group (placebo or active control) at any dose, duration, and route of administration and double blind studies.
Dichotomous data will be summarized as risk ratios; continuous data will be given as standard average differences with 95% confidence intervals. The evidence derived by this study will increase awareness of the effectiveness and safety of steroid and non-steroidal anti-inflammatory drugs for the treatment of rheumatoid arthritis. The results could guide patients and healthcare practitioners and help facilitate evidence-based shared care decision making.
Acknowledgement Author Mariana Del Grossi Moura, Luciane Cruz Lopes, Marcus Tolentino Silva, Sílvio Barberato-Filho, Rogério Heládio Lopes Motta and Cristiane de Cássia Bergamaschi,
Journal Medicine Baltimore 2018
| 3 | | R420.00 | |
| | Oral corticosteroids for asthma exacerbations might be associated with adrenal suppression: Are physicians aware of that? | Oral corticosteroids for asthma exacerbations might be associated with adrenal suppression: Are physicians aware of that?
Oral corticosteroids for asthma exacerbations might be associated with adrenal suppression: Are physicians aware of that?
Overview
Oral corticosteroids (OCS) are a mainstay of treatment for asthma exacerbations, and short-term OCS courses were generally considered to be safe. Our study aimed at investigating the integrity of the HPA axis in children with persistent asthma or recurrent wheezing at the beginning of an inhaled corticosteroids (ICS) trial. Morning basal cortisol was assessed just before the beginning of ICS, and 30, 60, and 90 days later, using Immulite® Siemens Medical Solutions Diagnostic chemiluminescent enzyme immunoassay (Los Angeles, USA; 2006).
In all, 140 children (0.3-15 years old) with persistent asthma or recurrent wheezing have been evaluated and 40% of them reported short-term OCS courses for up to 30 days before evaluation. Out of these, 12.5% had biochemical adrenal suppression but showed adrenal recovery during a three-month ICS trial treatment. In conclusion, short-term systemic courses of corticosteroids at conventional doses can put children at risk of HPA axis dysfunction. ICS treatment does not impair adrenal recovery from occurring. Health practitioners should be aware of the risk of a blunted cortisol response upon
Acknowledgement
Authors Cristina B. Barra, Maria Jussara F. Fontes, Marco Túlio G. Cintra, Renata C. Cruz, Janaína A. G. Rocha, Maíla Cristina C. Guimarães and Ivani Novato Silva
Journal Revista Da Associação Médica Brasileira
| 3 | | R420.00 | |
| | Immunogenomic Classification of Colo-rectal Cancer and Therapeutic Implications | Immunogenomic Classification of Colo-rectal Cancer and Therapeutic Implications
Immunogenomic Classification of Colo-rectal Cancer and Therapeutic Implications
Overview
The immune system has a substantial effect on colorectal cancer (CRC) progression. Additionally, the response to immunotherapeutic and conventional treatment options (e.g., chemotherapy, radiotherapy and targeted therapies) is influenced by the immune system.
The molecular characterization of colorectal cancer (CRC) has led to the identification of favourable and unfavourable immunological attributes linked to clinical outcome. With the definition of consensus molecular subtypes (CMSs) based on transcriptomic profiles, multiple characteristics have been proposed to be responsible for the development of the tumour immune microenvironment and corresponding mechanisms of immune escape.
In this review, a detailed description of proposed immune phenotypes as well as their interaction with different therapeutic modalities will be provided. Finally, possible strategies to shift the CRC immune phenotype towards a reactive, anti-tumour orientation are proposed per CMS. The recognition of the impact of the immune system on the progression of CRC has led to the identification and detailed characterization of tumour immune phenotypes.
Acknowledgement
Author Jessica Roelands, Peter J. K. Kuppen, Louis Vermeulen, Cristina Maccalli, Julie Decock, Ena Wang, Francesco M. Marincola, Davide Bedognetti and Wouter Hendrickx
Journal International Journal of Molecular Sciences Volume 18 Issue 10
Publisher PubMed | 3 | | R460.00 | |
| | Management of Accidental and Iatrogenic Foreign Body Injuries to Heart- Case Series | Management of Accidental and Iatrogenic Foreign Body Injuries to Heart- Case Series
Management of Accidental and Iatrogenic Foreign Body Injuries to Heart- Case Series
Overview
Accidental and iatrogenic foreign body injuries to heart require immediate attention and its timely management is cornerstone to the life of an individual. We describe in detail five cases of Accidental and iatrogenic foreign body injuries to heart encountered between January 2013 and July 2016. Our series included the following: needle stick injury to the right atrium retained catheter fragments in the distal main pulmonary artery, right ventricle injury during catheterisation study, right ventricle injury during permanent pacemaker lead placement, device migration in atrial septal defect closure. Foreign bodies were removed from the cardiac cavities when the patient presented with features of infection, cardiac tamponade, anxiety, and haemodynamic instability. Foreign bodies in the heart should be removed irrespective of their location and symptomatology. Asymptomatic foreign bodies diagnosed immediately after the injury with associated risk factors should be removed; asymptomatic foreign bodies without associated risks factors or diagnosed accidentally after the injury also need surgical intervention to allay fears of anxiety in patient and their relatives, to prevent any late complications as well as for medico-legal purpose.
ACKNOWLEDGEMENTS:
Authors: Rupesh Kumar; Sandeep Singh Rana; Sanjay Kumar; Deepanwita Das; Monalisa Datta
Journal: J Clin Diagn Res (Journal of Clinical Diagnostic Research) Volume 11 Issue 3
Publisher: JCDR Research and Publications Private Limited | 3 | | R410.00 | |
| | Quantification of Free-Living Community Mobility in Healthy Older Adults Using Wearable Sensors | Quantification of Free-Living Community Mobility in Healthy Older Adults Using Wearable Sensors
Quantification of Free-Living Community Mobility in Healthy Older Adults Using Wearable Sensors
Overview
Understanding determinants of community mobility disability is critical for developing interventions aimed at preventing or delaying disability in older adults. To understand these determinants, capturing and measuring community mobility has become a key factor. The objectives of this paper are to present and illustrate the signal processing workflow and outcomes that can be extracted from an activity and community mobility measurement approach based on GPS and accelerometer sensor data and 2) to explore the construct validity of the proposed measurement approach using data collected from healthy older adults in free-living conditions.
Wearability and usability of the devices used to capture free-living community mobility impact participant compliance and the quality of the data. The construct validity of the proposed approach appears promising but requires further studies directed at populations with mobility impairments.
Acknowledgement
Author Patrick Boissy, Margaux Blamoutier, Simon Brière and Christian Duval Journal Frontiers in Public Health Volume 6 Article 216 | 3 | | R395.00 | |
| | The EQ-5D-5L is a valid approach to measure health related quality of life in patients undergoing bariatric surgery | The EQ-5D-5L is a valid approach to measure health related quality of life in patients undergoing bariatric surgery
The EQ-5D-5L is a valid approach to measure health related quality of life in patients undergoing bariatric surgery
Overview
Bariatric surgery is considered an effective treatment for individuals with severe and complex obesity. Besides reducing weight and improving obesity related comorbidities such as diabetes, bariatric surgery could improve patients' health-related quality of life. However, the frequently used instrument to measure quality of life, the EQ-5D has not been validated for use in bariatric surgery, which is a major limitation to its use in this clinical context. Our study undertook a psychometric validation of the 5 level EQ-5D (EQ-5D-5L) using clinical trial data to measure health-related quality of life in patients with severe and complex obesity undergoing bariatric surgery.
The most common types of bariatric surgery are laparoscopic Roux-en-Y gastric bypass, adjustable gastric band surgery and laparoscopic sleeve gastrectomy, with each having its respective benefits and risks. The Roux-en-Y gastric bypass restricts the volume of food eaten by creating a small thumb-sized pouch from the upper stomach and a bypass of the remaining stomach. Bypass alters physiology and anatomy in such a way as to achieve early and generally rapid weight loss but carries risks of serious early morbidity [4, 5]. Longer-term complications include the need for re-operation because of the development of internal hernias or intestinal obstruction and nutritional deficiencies
Acknowledgement
Authors Jilles M. Fermont1, Jane M. Blazeby, Chris A. Rogers, Sarah Wordsworth, on behalf of the By-Band-Sleeve Study Management Group
Journal PLoS One | 3 | | R460.00 | |
| | Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study | Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study
Community perspectives on HIV, violence and health surveillance in rural South Africa: a participatory pilot study
Overview
South Africa faces a complex burden of disease consisting of infectious and non–communicable conditions, injury and interpersonal violence, and maternal and child mortality. Inequalities in income and opportunity push disease burdens towards vulnerable populations, a situation to which the health system struggles to respond. There is an urgent need for health planning to account for the needs of marginalized groups in this context. Objectives were to develop a process to elicit the perspectives of local communities in the established Agincourt health and socio-demographic surveillance site (HDSS) in rural north–east South Africa on two leading causes of death: HIV/AIDS and violent assault, and on health surveillance as a means to generate information on health in the locality.
The groups identified a range of social and health systems issues including risky sexual health behaviors, entrenched traditional practices, alcohol and substance abuse, unstable relationships, and debt as causative. Participants also explained how compromised patient confidentiality in clinics, insensitive staff, and a biased judicial system were problematic for the treatment and reporting of both conditions. The discussions provided information not available from other sources on the social and health systems processes through which access to good quality health care is constrained in this setting.
Acknowledgement
Authors Nitya Hullur, Lucia D’Ambruoso, Kerstin Edin, Ryan G Wagner, Sizzy Ngobeni Kathleen Kahn, Stephen Tollman, Peter Byass
Journal Global Health Action Volume 6 Issue 1
| 3 | | R460.00 | |
| | Efficacy of Internet-delivered cognitive-behavioural therapy for the management of chronic pain in children and adolescents A systematic review and meta-analysis | Efficacy of Internet-delivered cognitive-behavioural therapy for the management of chronic pain in children and adolescents A systematic review and meta-analysis
Efficacy of Internet-delivered cognitive-behavioural therapy for the management of chronic pain in children and adolescents A systematic review and meta-analysis
Overview
Paediatric chronic pain is relatively common in the world. Although cognitive behaviour therapy (CBT) has been shown to be efficacious in children and adolescents, it is generally recognized that availability and accessibility of CBT are limited. However, Internet-delivered cognitive-behavioural therapy (ICBT) performs better in these areas. This systematic review aims to evaluate the clinical effects of ICBT for chronic pain in youth when compared with the control treatments.
We searched electronic databases to identify randomized controlled trials that compared ICBT with the control therapy for paediatric chronic pain. The primary outcomes were 95% confidence intervals and mean difference or standardized mean difference in change of pain intensity and activity limitations. Four trials met the inclusion criteria with a total of 404 participants of whom 208 received ICBT. Compared with pre-treatment, children reported significant, medium to large benefits on pain intensity, activity limitations, and parental protective behaviours after receiving ICBT immediately. ICBT for physical and psychological conditions in youth with chronic pain is a full potential therapy; it can be successful on clinically effects and socioeconomic benefits.
Acknowledgement
Author Wen-Xin Tang, Lu-Feng Zhang, Yan-Qiu Ai and Zhi-Song Li
Journal Medicine (Baltimore).
Publisher Wolters Kluwer Health, Inc. | 3 | | R390.00 | |
| | A new approach for analysis of facial growth and age estimation: Iris ratio | A new approach for analysis of facial growth and age estimation: Iris ratio
A new approach for analysis of facial growth and age estimation: Iris ratio
A new approach for analysis of facial growth and age estimation: Iris ratio
Overview
The study of facial growth is explored in many fields of science, including anatomy, genetics, and forensics. In the field of forensics, it acts as a valuable tool for combating child pornography. The present research proposes a new method, based on relative measurements and fixed references of the human face - specifically considering measurements of the diameter of the iris (iris ratio)- for the analysis of facial growth in association with age in children and sub-adults.
The outcomes indicated that facial structures grow with different timing in children and adolescents. The diameter of the iris was found to be the most stable measurement compared to the others and represented the best cephalometric measurement as a fixed reference for facial growth ratios (or indices). The method described shows promising potential for forensic applications, especially as part of the armamentarium against crimes involving child pornography and child abuse.
Acknowledgement
Authors
Carlos Eduardo Palhares Machado, Marta Regina Pinheiro Flores, Laise Nascimento Correia Lima, Rachel Lima Ribeiro Tinoco, Ademir Franco, Ana Cristina Barreto Bezerra, Martin Paul Evison and Marco Aure lio Guimarães.
Journal PLoS One Volume 12 Issue 7
Publisher Cross Mark
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501545/pdf/pone.0180330.pdf
| 3 | | R453.00 | |
| | Cerebral Venous Sinus Thrombosis in a patient with Ulcerative Colitis Flare | Cerebral Venous Sinus Thrombosis in a patient with Ulcerative Colitis Flare
Cerebral Venous Sinus Thrombosis in a patient with Ulcerative Colitis Flare
Cerebral Venous Sinus Thrombosis in a patient with Ulcerative Colitis Flare
Overview
Inflammatory bowel disease is characterized by a chronic inflammatory state and is therefore associated with abnormalities in coagulation and a hyper-coagulable state. Cerebral venous sinus thrombosis is a rare complication of inflammatory bowel disease yet contributes significant morbidity and mortality to those affected. Early diagnosis is critical, as a delay in diagnosis portends a worse prognosis.
The study starts by discussing the case of a seventeen-year-old female who presented with ulcerative colitis flare and developed new-onset seizures, found to be caused by a large venous sinus thrombosis. Evidence-based medicine supports IBD to be an independent risk factor for venous sinus thrombosis, as numerous studies have demonstrated a correlation.
The mechanism for this is multi-factorial and incompletely understood. Most healthcare professionals are not aware of this correlation and may not know how to quickly and confidently identify venous sinus thrombosis on various imaging modalities. This paper seeks to highlight the relationship, as a delay in diagnosis of CVT portends a worse prognosis in these young, at-risk patients.
Acknowledgement Author L. M. Conners , R. Ahad, P. H. Janda, and Z. Mudasir
Journal Case Reports in Neurological Medicine
Publisher Hindawi | 3 | | R480.00 | |
| | What Do We Know About Component Separation Techniques for Abdominal Wall Hernia Repair? | What Do We Know About Component Separation Techniques for Abdominal Wall Hernia Repair?
What Do We Know About Component Separation Techniques for Abdominal Wall Hernia Repair?
What Do We Know About Component Separation Techniques for Abdominal Wall Hernia Repair?
Overview
The component separation technique (CST) was introduced to abdominal wall reconstruction to treat large, complex hernias. It is very difficult to compare the published findings because of the vast number of technical modifications to CST as well as the heterogeneity of the patient population operated on with this technique.
CST without mesh should no longer be performed because of too high recurrence rates. Open anterior CST has too high a surgical site occurrence rate and henceforth should only be conducted as endoscopic and perforator sparing anterior CST. Open posterior CST and posterior CST with trans-versus abdominis release (TAR) produce better results than open anterior CST. To date, no significant differences have been found between endoscopic anterior, perforator sparing anterior CST and posterior CST with transversus abdominis release. Robot-assisted posterior CST with TAR is the latest, very promising alternative. The systematic use of biologic meshes cannot be recommended for CST.
CST should always be performed with mesh as endoscopic or perforator sparing anterior or posterior CST. Robot-assisted posterior CST with TAR is the latest development.
Acknowledgements
Hubert Scheuerlein , Andreas Thiessen, Christine Schug-Pass and Ferdinand Köckerling
Journal
Frontiers in Surgery
March 2018 | Volume 5 | Article 24
Publisher Cross Mark
| 3 | | R440.00 | |
| | Systemic low-grade inflammation in post-traumatic stress disorder: a systematic review Journal of Inflammation Research | Systemic low-grade inflammation in post-traumatic stress disorder: a systematic review Journal of Inflammation Research
Systemic low-grade inflammation in post-traumatic stress disorder: a systematic review Journal of Inflammation Research
Systemic low-grade inflammation in post-traumatic stress disorder: a systematic review
Overview
Studies examining post-traumatic stress disorder (PTSD) have either emphasized a relationship between PTSD and a systemically pro-inflammatory state or identified a link between PTSD and chronic disease. The aim of this study was to evaluate the evidence for a relationship between individuals with PTSD and systemic low-grade inflammation that has been proposed to underlie chronic disease development in this population.
Nine studies measuring systemic inflammation and discussing its role in chronic disease development were selected for inclusion in this review. The association between markers of systemic inflammation and PTSD was evaluated by the measurement of a variety of systemic inflammatory markers including acute-phase proteins, complement proteins, pro- and anti-inflammatory cytokines, natural killer cells, and white blood cells. In general, systemic inflammatory biomarkers were elevated across the studies in the PTSD groups.
There is evidence that PTSD is underpinned by the presence of a systemic low-grade inflammatory state. This inflammation may be the mechanism associated with increased risk for chronic disease in the PTSD population. From this, future research should focus on interventions that help to reduce inflammation, such as exercise. Acknowledgement
Author
Kathryn Speer, Dominic Upton, Stuart Semple and Andrew McKune
Journal
Journal of Inflammation Research 2018
Publisher
Dove Press
| 3 | | R450.00 | |
| | How Does Physical Activity Intervention Improve Self-Esteem and Self-Concept in Children and Adolescents? Evidence from a Meta-Analysis. | How Does Physical Activity Intervention Improve Self-Esteem and Self-Concept in Children and Adolescents? Evidence from a Meta-Analysis.
How Does Physical Activity Intervention Improve Self-Esteem and Self-Concept in Children and Adolescents? Evidence from a Meta-Analysis.
Overview The objective of this course is to perform a systematic review and meta-analysis for the effects of physical activity intervention on self-esteem and self-concept in children and adolescents, and to identify moderator variables by meta-regression. Relevant studies were identified through a comprehensive search of electronic databases. Study inclusion criteria were:
(1) intervention should be supervised physical activity,
(2) reported sufficient data to estimate pooled effect sizes of physical activity intervention on self-esteem or self-concept,
(3) participants' ages ranged from 3 to 20 years, and
(4) a control or comparison group was included. There was no significant effect of intervention of physical activity alone on any outcomes in non-RCTs, as well as in studies with intervention of physical activity combined with other strategies.
It was concluded that intervention of physical activity alone is associated with increased self-concept and self-worth in children and adolescents. And there is a stronger association with school-based and gymnasium-based intervention compared with other settings. Acknowledgement Author:
Liu M, Wu L, Ming Q Journal:
PLoS One.
| 3 | | R410.00 | |
| | Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications. | Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications.
Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications.
Overview
Concerning recent Italian laws and jurisprudential statements, guidelines application involves several difficulties in clinical practice, regarding prevention, diagnosis and therapy of venous thromboembolism. International scientific community systematically developed statements about this disease in order to optimize the available resources in prophylaxis, diagnosis and therapy. Incongruous prevention, missed or delayed diagnosis and/or inadequate treatment of this disease can frequently give rise to medico-legal litigation.
Acknowledgement
Author:
Vassalini M, Verzeletti A, De Ferrari F
Journal:
Monaldi archives for chest disease
Publisher:
PIME Editrice
http://www.monaldi-archives.org/index.php/macd/article/view/25/728
| 3 | | R430.00 | |
| | Medical Tourism. | Medical Tourism.
Overview
BACKGROUND: Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment.
OBJECTIVE:
This article provides an outline of the current research around medical tourism, especially its impact on Australians.
DISCUSSION:
Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad
Acknowledgement
Author:
Leggat P
Journal:
Australian family physician.
Publisher:
Focus Environmental
| 3 | | R360.00 | |
| | Suicide in Pretoria: A retrospective review, 2007 - 2010. | Suicide in Pretoria: A retrospective review, 2007 - 2010.
Suicide in Pretoria: A retrospective review, 2007 - 2010.
Overview
Background: The World Health Organization has declared suicide a global ealth crisis, predicting that ~1.53 million people will commit suicide annually by 2020.
Obejective:
A study from South Africa reviewed 1 018 suicide cases in Pretoria over 4 years (1997 - 2000). Our study was undertaken to establish whether there have been substantial changes in the profile of suicide victims who died in Pretoria a decade later.
Methods:
Case records at the Pretoria Medico-Legal Laboratory were reviewed retrospectively from 2007 to 2010.
Results:
A total of 957 suicide cases were identified. Hanging was the most common method of suicide, followed by self-inflicted firearm injury. The true incidence of suicidal intake of prescription drugs/medication was difficult to determine, because of a backlog at the state toxicology laboratories. White males and females appeared to be over-represented among suicide victims, but there has been an increase in suicide among blacks. There seems to have been a substantial decrease in the use of firearms to commit suicide - possibly reflecting a positive outcome of gun control legislation that has been introduced in the interim.
Conclusion: Suicide continues to constitute almost 10% of all fatalities admitted to the Pretoria Medico-Legal Laboratory, confirming suicide as a major cause of mortality in our society. Further research is needed to clarify the profile of suicidal deaths, with a view to informing resource allocation and to improve preventive strategies
Acknowledgement
Author:
Engelbrecht C, Blumenthal R, Morris NK, Saayman G
Journal:
South African medical journal.
Publisher:
SAMJ Research
http://www.samj.org.za/index.php/samj/article/view/12015/8182
| 3 | | R410.00 | |
| | Women's Health: Endometriosis. | Women's Health: Endometriosis.
Women's Health: Endometriosis.
OVERVIEW
Endometriosis is an often very painful female reproductive disorder that is on the rise in Western countries. It is estimated to affect between seven and 10 percent of all women in the general population.
Endometriosis is a female reproductive disorder which affects the lining of the uterus, otherwise known as the endometrium.[1] This oestrogen-dependent disorder is defined by the presence of endometrial tissue outside of the uterus and becomes apparent after the start of menses.[2]
Did you know that a number of primary musculoskeletal impairments can manifest as pelvic pain? It is therefore important to be aware of the common signs and symptoms of endometriosis presents, especially those which masks as musculoskeletal. Then, once the diagnosis of endometriosis has been made, there is much the physiotherapist can do to assist the patient to deal with the disease. This comprehensive course will provide you with a clear understanding of the disease and the role you can play both in its diagnosis and treatment. | 3 | | R360.00 | |
| | Application of cervical collars – An analysis of practical skills of professional emergency medical care providers. | Application of cervical collars – An analysis of practical skills of professional emergency medical care providers.
Application of cervical collars – An analysis of practical skills of professional emergency medical care providers.
Overview:
The application of a cervical collar is a standard procedure in trauma patients in emergency medicine. It is often observed that cervical collars are applied incorrectly, resulting in reduced immobilization of the cervical spine. The objective of this study was to analyze the practical skills of trained professional rescue personnel concerning the application of cervical collars.
Within emergency medical conferences, n = 104 voluntary test subjects were asked to apply a cervical collar to a training doll, wherein each step that was performed received an evaluation. Furthermore, personal and occupational data of all study participants were collected using a questionnaire. The most common
error consisted of incorrect adjustment of the size of the cervical collar (66%). No association was found between the correct application of the cervical collar and the occupational group of the test subjects (trained rescue personnel vs. emergency physicians) or the participation in certified trauma courses.
In conclusion despite pronounced subjective confidence regarding the application of cervical collars, this study allows the conclusion that there are general deficits in practical skills when cervical collars are applied. A critical assessment of the current training contents about trauma care must, therefore, be demanded.
ACKNOWLEDGEMENT
AUTHORS: Michael Kreinest1,2, Sarah Goller1,2, Geraldine Rauch3, Christian Frank4,2, Bernhard Gliwitzky2, Christoph G. Wölfl1,2, Stefan Matschke1, Matthias Münzberg 1,2*
JOURNAL: PLOS One
PUBLISHER: Public Library of Science
https://www.plos.org | 3 | | R355.00 | |
| | A critical Appraisal of Clinical Trials Conducted and Subsequent Drug Approvals in India and South Africa. | A critical Appraisal of Clinical Trials Conducted and Subsequent Drug Approvals in India and South Africa.
A critical Appraisal of Clinical Trials Conducted and Subsequent Drug Approvals in India and South Africa.
Overview
The drugs that are used in treating any condition, be it an innocuous cough or a life-threatening cancer are the hard work of human clinical trials. Of course, these trials are the only credible way to determine the safety and efficiency of drugs. As a matter of fact, without clinical trials, pharmaceutical research will not advance to improve disease management as well and the quality of life in human beings.
This study was therefore designed to assess the relation between the number of clinical trials conducted as well as respective new drug approvals in India and South Africa. The research was nonetheless conducted in four different settings, namely, USA, Europe, India and South Africa. The research was done though the construction and analysis of a comprehensive database of completed randomized controlled clinical trials based on clinical trials.
The results from distribution of the market application approvals between the EU/USA as well as India and South Africa revealed that out of clinical trials with the participation of test centers in India and/or South Africa, 39.6% (India) clinical trials and 60.1% (South Africa) clinical trials led to market authorization in the EU/USA without a New Drug Application (NDA) approval in India or South Africa.
ACKNOWLEDGEMENT
AUTHORS: Dnyanesh Limaye, Janka Marisa Langer, Tjorben Rühling, Gerhard Fortwengel JOURNAL: BMJ Journals
PUBLISHERS: group.bmj.com URL: http://bmjopen.bmj.com/
| 3 | | R345.00 | |
| | Acute Alcohol Use and Injury Patterns in Young Adult Prehospital Patients, | Acute Alcohol Use and Injury Patterns in Young Adult Prehospital Patients,
Acute Alcohol Use and Injury Patterns in Young Adult Prehospital Patients,
Overview
Alcohol consumption has been clearly revealed by emergency department (ED) based studies to be risk factor to sustaining an injury. However, it remains unclear how acute alcohol consumption affects injury patterns to various body regions.
This study was therefore carried out to determine if acute alcohol consumption is associated with differences in injury pattern among young adult patients with traumatic injuries presenting to emergency medical services (EMS). The data for this study was a cross sectional retrospective review of prehospital patient care reports (PCRs) that evaluated injured patients who presented to a collegiate EMS agency from January 1, 2011 to December 31, 2012. More so, PCRs were reviewed independently by two abstractors to determine if the patient was documented to have acutely consumed alcohol proximate to his/her injury.
Results from the findings nevertheless revealed that alcohol users were more likely to present with injury secondary to assault, fall/trip, as well as an unknown mechanism of injury.
ACKNOWLEDGEMENT
AUTHORS: David J. Barton BS, Frank W. Tift MD, Lauren E. Cournoyer BS, Julie T. Vieth MBChB & Korin B. Hudson MD
JOURNAL: Prehospital Emergency Care
PUBLISHERS: Taylor & Francis online
URL: http://dx.doi.org/10.3109/10903127.2015.1076101 | 3 | | R350.00 | |
| | Acute Effects of Breaking up Prolonged Sitting on Fatigue and Cognition. | Acute Effects of Breaking up Prolonged Sitting on Fatigue and Cognition.
Acute Effects of Breaking up Prolonged Sitting on Fatigue and Cognition.
Overview
There are many evidences that prolonged sitting has a negative effect or consequence on health. As a matter of fact, findings from previous experimental studies demonstrated that uninterrupted sitting is deleteriously associated with metabolic parameters, blood pressure and markers of haemostasis when compared to sitting that is interrupted with short bouts of physical activity.
The objective of this study was therefore to compare the acute effects of uninterrupted sitting with sitting interrupted by brief bouts of light-intensity walking on self-reported fatigue, cognition, neuroendocrine biomarkers and cardio metabolic risk markers in overweight/obese adults. The study was conducted in a laboratory in Melbourne, Australia meanwhile the design was a randomized two-condition crossover trial. The study was conducted on 19 overweight or obese adults between the ages of 45 and 75 years old.
Results from the study revealed that during the active condition, fatigue levels were lower whereas heart rates were higher compared to the sedentary condition. The conclusion was that interrupting prolonged sitting with light intensity walking breaks may be an effective fatigue counter measure acutely.
ACKNOWLEDGEMENT
AUTHORS: Patrik Wennberg, Carl-Johan Boraxbekk, Michael Wheeler, Bethany Howard, Paddy C Dempsey, Gavin Lambert, Nina Eikelis, Robyn Larsen, Parneet Sethi, Jessica Occleston, Jenny Hernestål- Boman, Kathryn A Ellis, Neville Owen, David W Dunstan
JOURNAL: BMJ Open
PUBLISHERS: BMJ
URL: http://bmjopen.bmj.com/ | 3 | | R380.00 | |
| | Body Psychotherapeutic Treatment for Anxiety Disorders. | Body Psychotherapeutic Treatment for Anxiety Disorders.
Body Psychotherapeutic Treatment for Anxiety Disorders.
Edited By: David Wilson
An introduction to the field of body psychotherapy, which aims to address anxiety by intervening at the bodily level rather than the traditional reliance on verbal talking cures. Modern attachment theory has accumulated a rich source of data based on decades of audio-visual recordings, documenting the genesis of our earliest non-verbal patterns of interpersonal relating. It is hoped that this introduction will pave the way for clinicians frustrated with the limits of the talking cure to undertake further exploration in both theory and techniques suggested by body psychotherapeutic traditions as an adjunct to their existing clinical repertoire. | 3 | | R400.00 | |
| | Cardiopulmonary Physiotherapy: Pulmonary Rehabilitation for Management of Chronic Obstructive Pulmonary Disease. | Cardiopulmonary Physiotherapy: Pulmonary Rehabilitation for Management of Chronic Obstructive Pulmonary Disease.
Cardiopulmonary Physiotherapy: Pulmonary Rehabilitation for Management of Chronic Obstructive Pulmonary Disease.
Richard Casaburi, Ph.D., M.D., and Richard ZuWallack, M.D.
This online course discusses the successes and failures of a respiratory rehabilitation programme designed for an overweight, sedentary 61-year-old woman who has been diagnosed with chronic obstructive pulmonary disease.
| 3 | | R400.00 | |
| | Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self-controlled case series study. | Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self-controlled case series study.
Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self-controlled case series study.
OVERVIEW
There are evidences that drugs used in treating attention-deficit/hyperactivity disorder (ADHD) are efficacious in reducing symptoms of impulsivity and hyperactivity in children,1 but concerns have been expressed about possible adverse cardiovascular events with the first line treatment, methylphenidate.
Thus, the aim of this study was to determine whether treatment with methylphenidate in children and young people with attention-deficit/ hyperactivity disorder (ADHD) was associated with cardiovascular events. The design for this study was a self-controlled case series analysis meanwhile the setting was the Nationwide Health Insurance database, from 1 January 2008 to 31 December 2011, in South Korea. Participants of this study were 1224 patients aged =17 who had experienced an incident cardiovascular event and with at least one incident prescription for methylphenidate.
Major results of this study indicated that increased risk of arrhythmia was observed in all exposed time periods, that is, periods of treatment with methylphenidate - (incidence rate ratio 1.61, 95% confidence interval 1.48 to 1.74), and the risk was highest in the children who had congenital heart disease.
ACKNOWLEDGEMENT
AUTHORS: Ju-Young Shin, Elizabeth E Roughead, Byung-Joo Park, Nicole L Pratt
JOURNAL: Eighth International Congress on Peer Review and Scientific Publication
PUBLISHER: BMJ Group
URL: http://www.bmj.com | 3 | | R380.00 | |
| | Chiba Study of Mother and Childrens Health (C-Mach). | Chiba Study of Mother and Childrens Health (C-Mach).
Chiba Study of Mother and Childrens Health (C-Mach).
Overview
There are recent indications that dramatic changes in social and living conditions have led to an increase in allergy-related and lifestyle-related diseases as well as the emergence of mental health issues. Also, findings from Epidemiological researches that were carried out in European countries reveal that the nutritional environment from the fetal period to early childhood might affect the risks of non-communicable diseases (NCDs) in adulthood.
This study is therefore a birth cohort study based on the DOHaD hypothesis and involves multiomics analysis. The objective of this study was also to explore the effects of genetic and environmental factors particularly the foetal environment and post birth living environment on children’s health, and to identify potential biomarkers for these effects. The participants of this study were 433 women who were pregnant for less than 13 weeks and underwent an examination in one of the three hospitals that were used for the study.
The preliminary outcomes of the study were nevertheless obesity, endocrine and metabolic disorders, as well as developmental disorders.
ACKNOWLEDGEMENT
AUTHORS: Kenichi Sakurai, Hidenobu Miyaso, Akifumi Eguchi, Yoshiharu Matsuno, Midori Yamamoto, Emiko Todaka, Hideoki Fukuoka, Akira Hata, Chisato Mori
JOURNAL: Bmj Open
PUBLISHERS: group.bmj.com
URL: http://bmjopen.bmj.com/ | 3 | | R340.00 | |
| | Creating a Culture of Mindfulness in Medicine. | Creating a Culture of Mindfulness in Medicine.
Creating a Culture of Mindfulness in Medicine.
OVERVIEW
It is becoming increasingly complex to provide primary care since there is always the need to frequently address multiple medical issues at each patient visit. However, well-documented challenges faced by primary care clinicians have brought growing awareness to the issues of physician wellness and burnout and the potential subsequent impact on patients.
Thus, the objective of this study was to promote the cultivation of mindful awareness throughout our health system, creating a culture of mindfulness in medicine. During this research, a systems-level strategy was developed to promote health and resilience for clinicians and patients by preparing a group of clinician leaders to serve as catalysts to practice and teach mindfulness. The strategy nonetheless included three major steps, namely: (1) Select 5 primary care leaders to help foster mindful¬ness within both health care delivery and education; (2) Provide funds for these leaders to attend advanced mindfulness training designed specifically for clinicians; and (3) Foster mindfulness within our health system and beyond via collaborative planning meetings and seed money for implemen¬tation of projects.
Results indicated that all 5 leaders endorsed the personal value of the mindfulness training, with some describ¬ing it as life-changing.
ACKNOWLEDGEMENT
AUTHOR: Charlene Luchterhand, David Rakel, Cynthia Haq, Lisa Grant, DO, Angela Byars-Winston, Steve Tyska, Kathleen Engles,
JOURNAL: Health Innovations
PUBLISHER: Health Policy Publishing
URL: http://www.healthpolicypublishing.com
| 3 | | R400.00 | |
| | Diagnosis and Management of Asthma in Children. | Diagnosis and Management of Asthma in Children.
Diagnosis and Management of Asthma in Children.
OVERVIEW
Asthma is a very common illness faced by children the world over. With that said, rather than escalating treatment in severe and problematic cases of childhood cancer, a more systematic approach is needed to find a solution to this problem. Elements of the systematic approach included a review of the diagnosis, adherence, the ability to take drugs correctly as well as the environment of the children in question.
The objective of this article was therefore to review other articles concerning the treatment and management of childhood asthma that should prompt a focused and urgent review of what trigger factors led to asthma attacks and whether the attacks were appropriately managed. Some of the articles that were reviewed during this research were obtained from PubMed and Cochrane database.
However, only articles related to the diagnosis and practical management of asthma were selected for this research. Also, small trials and case series were excluded if the findings had been subsumed into a meta-analysis or Cochrane review.
ACKNOWLEDGEMENT
AUTHORS: Andrew Bush, (paediatrics) and Louise Fleming (senior clinical lecturer)
JOURNAL: BMJ Journals
PUBLISHER: BMJ Open
URL: https://www.group.bmj.com
| 3 | | R400.00 | |
| | Differentiating Types of Stress: Coping Methods in Explaining Mechanisms Underlying Types of Burnout. | Differentiating Types of Stress: Coping Methods in Explaining Mechanisms Underlying Types of Burnout.
Differentiating Types of Stress: Coping Methods in Explaining Mechanisms Underlying Types of Burnout.
Edited By: David Wilson.
Burnout occurs when professionals use ineffective coping strategies to try to protect themselves from work-related stress. The dimensions of ‘overload’ lack of development’ and ‘neglect’, belonging to the ‘frenetic’, ’under-challenged’ and ‘worn out’ subtypes, respectively, compromise a brief typological definition of burnout. The aim of the present study was to estimate the explanatory power of the different coping strategies on the development of burnout subtypes.
| 3 | | R400.00 | |
| | Disability pension due to common mental disorders and subsequent suicidal behaviour: a population-based prospective cohort study. | Disability pension due to common mental disorders and subsequent suicidal behaviour: a population-based prospective cohort study.
Disability pension due to common mental disorders and subsequent suicidal behaviour: a population-based prospective cohort study.
Overview
Disability Pension (DP) is a significant public health concern in many European countries. To this effect, adverse health outcomes, including suicide, in individuals on disability pension (DP) due to mental diagnoses have been reported. Surprisingly, scientific knowledge on possible risk factors for suicidal behaviour in this group, such as age, gender, underlying DP diagnoses, comorbidity and DP duration and grade, is sparse.
The objective of this study was therefore to investigate the associations of different measures of DP due to common mental disorders (CMD) with subsequent suicidal behaviour, considering gender and age differences. This study was nonetheless a population-based prospective cohort one based on Swedish nationwide registers. During this study, a cohort of 46 515 individuals aged 19–64 years on DP due to CMD throughout 2005 was followed-up for 5 years.
Results from this study however indicated that multivariate analyses showed that a main DP diagnosis of ‘stress related mental disorders’ was associated with a lower risk of subsequent suicidal behavior than depressive disorders.
ACKNOWLEDGEMENT
AUTHORS: Syed Ghulam Rahman, Kristina Alexanderson, Jussi Jokinen, Ellenor Mittendorfer Rutz
JOURNAL: BMJ Open
PUBLISHER: BMJ
URL: http://bmjopen.bmj.com/ | 3 | | R420.00 | |
| | Discrimination in the Workplace of People with Depressive Disorders. | Discrimination in the Workplace of People with Depressive Disorders.
Discrimination in the Workplace of People with Depressive Disorders.
Overview
The quality of an employment can contribute to the recovery of people with mental health problems. As a matter of fact, there exist evidences that employment is beneficial for people with Major Depressive Disorder (MDD) across different cultures. The hypothesis for this study was that employers’ attitudes have been shown to be negative towards workers with MDD.
This study therefore had three objectives. The first objective was to investigate if people with MDD anticipated and experienced discrimination when trying to find or keep paid employment. Secondly, to investigate if participants in high, middle and lower developed countries differ in these respects and finally if discrimination experiences are related to actual employment status. The participants of this study were 834 who had a diagnosis of MDD in the previous12 months. Data for this study was analyzed using the analysis of variance and generalized linear mixed models.
The result of this study was that almost 60% of respondents had stopped themselves from applying for work, education or training because of anticipated discrimination.
ACKNOWLEDGEMENT
AUTHORS: E P M Brouwers, J Mathijssen, T Van Bortel, L Knifton, K Wahlbeck, C Van Audenhove, N Kadri, Ch Chang, B R Goud, D Ballester, LF Tófoli, R Bello, M F Jorge-Monteiro, H Zäske, I Milac´ic´, A Uçok, C Bonetto, A Lasalvia, G Thornicroft, J Van Weeghel, the ASPEN/INDIGO Study Group
JOURNAL: BMJ Open
PUBLISHER: The BMJ Group
URL: http://www.bmj.com
| 3 | | R345.00 | |
| | Ebola Virus Disease: Clinical Review. | Ebola Virus Disease: Clinical Review.
Ebola Virus Disease: Clinical Review.
Overview
Ebola transmission may occur as a result of close contact with body fluids of infected patients. The incubation period for Ebola after infection is said to be 5-9 days, with a range of 1-21 days in 95% or more of patients,2 3 with the patients not considered infectious until they develop symptoms.
This article is therefore a clinical review whose objective is to investigate what makes the differential diagnosis of Ebola broad. This article therefore examines the causes of the Ebola virus as we as the pathophysiology of this infection. This article equally went further to examine the infection prevention and control measures are used to curb the spread of Ebola from one country to another.
The hypothesis here was that there is high likelihood of infected people travelling, thus, all countries are expected to have tested and practiced protocols ready for screening and managing Ebola patients. Of course the article also outlined some of the clinical features as well as the symptoms of the virus.
ACKNOWLEDGEMENT
AUTHORS:
Nicholas J Beeching, Manuel Fenech, Catherine F Houlihan
JOURNAL:
BMJ Open
| 3 | | R400.00 | |
| | Effectiveness of multidisciplinary team case management: difference-indifferences analysis. | Effectiveness of multidisciplinary team case management: difference-indifferences analysis.
Effectiveness of multidisciplinary team case management: difference-indifferences analysis.
OVERVIEW
Recently, there are increasing focus on increasing on the benefits of integrated care, to enable a more efficient and effective response to LTCs. This study was carried out in Single clinical commissioning group (CCG) in the UK’s National Health Service (NHS). The objective of this study was to evaluate a multidisciplinary team (MDT) case management intervention, at both the individual and practice levels.
The design that was used for this study was the difference-in-differences design with multiple intervention start dates, that hospital admissions data. The participants for this study were 2049 intervention patients using propensity scoring one-to-one with control patients. During the research, 30 practices were compared using a natural experiment through staged implementation.
The primary measures of direct intervention included accident and emergency (A&E) visits; inpatient non-elective stays, 30-day re-admissions; inpatient elective stays, outpatient visits and admissions for ambulatory care sensitive conditions. The secondary measures on the other hand included inpatient length of stay; total cost of secondary care Services and patient satisfaction. This study was nonetheless concluded that the intervention does not meet its primary aim, and the clinical significance and cost effectiveness of these small practice-level effects is debatable.
ACKNOWLEDGEMENT
AUTHORS: Jonathan Stokes, Søren Rud Kristensen, Kath Checkland, Peter Bower
JOURNAL: Bmj Open
PUBLISHER: group.bmj.com
URL: http://bmjopen.bmj.com/ | 3 | | R350.00 | |
| | Exploring the views of GPs, people with dementia and their carers on assistive technology. | Exploring the views of GPs, people with dementia and their carers on assistive technology.
Exploring the views of GPs, people with dementia and their carers on assistive technology.
OVERVIEW
The purpose of this study is to explore the views and experiences of people with dementia, their family carers and general practitioners (GPs) on their knowledge and experience of accessing information about, and use of, assistive technology (AT) in dementia care. 56 participants comprising 17 GPs, 13 people with dementia and 26 family carers.
The results of this study were that 4 main themes emerged: awareness and experience of AT accessing information on AT; roles and responsibilities in the current care system and the future commissioning of AT services. All participants had practical experience of witnessing AT being used in practice. For people with dementia and their families, knowledge was usually gained from personal experience rather than from health and social care professionals. For GPs, knowledge was largely gained through experiential, patient-led learning. All groups acknowledged the important role of the voluntary sector but agreed a need for clear information pathways for AT; such pathways were perceived to be essential to both service providers and service commissioners.
In conclusion, it was found that people with dementia and their family carers appear to be mainly responsible for driving a gradual increase in both awareness and the use of AT in dementia care. GPs should be equipped with the relevant knowledge to ensure families living with dementia receive appropriate information and support to enable them to live independently for as long as possible. There is an urgent need to simplify current complex community care pathways; as demonstrated in other chronic health conditions, a single point of access and a named lead professional may improve future care.
ACKNOWLEDGEMENTS
AUTHORS: Lisa Newton,1 Claire Dickinson,1 Grant Gibson,2 Katie Brittain,1 Louise Robinson1
JOURNAL: BMJ Open Journal
PUBLISHER: Elsevier
URL: https://www.journals.bmj.com | 3 | | R345.00 | |
| | Extended Prediction Rule to Optimise Early Detection of Heart Failure in Older Persons with Non-Acute Shortness of Breath. | Extended Prediction Rule to Optimise Early Detection of Heart Failure in Older Persons with Non-Acute Shortness of Breath.
Extended Prediction Rule to Optimise Early Detection of Heart Failure in Older Persons with Non-Acute Shortness of Breath.
OVERVIEW
Heart failure is an epidemic that is causing high rates in mortality, substantial lost in the quality of life as well as high healthcare costs. Older people are more susceptible to heart failure even though diagnosing it at an early stage is difficult since its symptoms are non-specific.
The objective of this study was therefore to develop a screening rule for detecting heart failure in the elderly with a diagnosis of chronic obstructive pulmonary disease. It is worth mentioning that this screening rule was developed based on an existing rule. During this study, cross-sectional data were used to validate, update and extend the original prediction rule according to a standardised state-of-the-art stepwise approach. The participants of this study were community-dwelling older people aged about 65 years old. These participants suffered from shortness of breath on exertion.
This study nonetheless resulted in excellent prediction of heart failure in the large domain of the elderly with shortness of breath.
ACKNOWLEDGEMENT
AUTHORS: Evelien E S van Riet, Arno W Hoes, Alexander Limburg, Marcel A J Landman,
JOURNAL: BMJ Open
PUBLISHER: BMJ Open Group
URL: http://www.group.bmj.com
| 3 | | R330.00 | |
| | Factors Influencing the Inclusion of Complementary and Alternative Medicine (CAM) in Undergraduate Medical Education. | Factors Influencing the Inclusion of Complementary and Alternative Medicine (CAM) in Undergraduate Medical Education.
Factors Influencing the Inclusion of Complementary and Alternative Medicine (CAM) in Undergraduate Medical Education.
OVERVIEW
This paper examines the inclusion (or otherwise) of complementary and alternative medicine (CAM) in medical syllabi in UK medical schools. The objective of this study was therefore to investigate the views and practices of UK medical schools regarding the inclusion (or exclusion) of complementary and alternative medicine (CAM) in undergraduate medical curricula.
This study was however done through an email survey of UK medical schools offering MBBS as well as its equivalent degrees. The results of this study suggested that all respondents indicated that their curricula included CAM elements. It is imperative to mention that the quantity of CAM within curricula varied widely between medical schools, as did the methods by which CAM education was delivered.
The results further suggested that the requirements of the General Medical Council were the strongest factor influencing the inclusion of CAM, medical student preferences were also important. This study was however concluded that it could be useful for the General Medical Council to clarify the extent to which CAM should be incorporated into the curriculum.
ACKNOWLEDGEMENT
AUTHORS: Kevin R Smith
JOURNAL: Journal of Epidemiology and Community Health
PUBLISHER: BMJ Open Group
URL: http://www.group.bmj.com | 3 | | R330.00 | |
| | Hearing Loss in Workers Exposed to Epoxy Adhesives and Noise. | Hearing Loss in Workers Exposed to Epoxy Adhesives and Noise.
Hearing Loss in Workers Exposed to Epoxy Adhesives and Noise.
OVERVIEW
Organic solvents are heavily used in industries and there are evidences that exposure to organic solvents has hazardous effects on hearing. Yet, the effects of organic solvents on hearing are difficult to evaluate. The reason is that workers are usually exposed to a mixture of solvents with widely varying compositions and concentrations. However, the objective of this cross-sectional study was thus to investigate the risk of hearing loss among workers exposed to epoxy adhesives and noise.
During the study, 182 stone workers who were exposed to both epoxy adhesives and noise were recruited. Other participants of the study composed of 89 stone workers who were exposed to noise only, and 43 workers from the administrative staff who had not been exposed to adhesives or noise. The demographic data, occupational history as well as the medical history of participants were obtained through face to-face interviews, arranged physical examinations as well as through pure-tone audiometric tests.
Results from the study however indicated that epoxy adhesives exacerbate hearing impairment in noisy environments, with the main impacts occurring in the middle and high frequencies.
ACKNOWLEDGEMENT
AUTHORS: Hsiao-Yu Yang, Ruei-Hao Shie, Pau-Chung Chen
JOURNAL: Journal of Epidemiology and Community Health
PUBLISHER: BMJ Open Group
URL: http://www.group.bmj.com
| 3 | | R335.00 | |
| | Home visits in primary care: contents and organisation in daily practice. Study protocol of a cross-sectional study. | Home visits in primary care: contents and organisation in daily practice. Study protocol of a cross-sectional study.
Home visits in primary care: contents and organisation in daily practice. Study protocol of a cross-sectional study.
OVERVIEW
In most industrialized countries, Medical care of homebound patients by home visits is an integral part of primary care. However, the organization of home visits may differ depending on organization of the primary care system. The hypothesis for this study was that because of socio demography as well as changes in the health system, the need for home visits is projected to increase rather than decrease.
The objective of this study was thus, to provide information on content and organization of home visits since such information is needed to assure sufficient medical care for home bound visits. This cross-sectional study was conducted over a period of 12 months. During the study, all home visits of each participating family practice are documented within a 1-week time-period. Almost 303 (of 2677) family practitioners expressed their interest to participate to generate data on the content and organisational characteristics of home visits.
Descriptive and multivariate analysis of data were carried out using non-parametric methods. This study ended up receiving ethical approval by the Ethical Commission of the TU Dresden and adheres to the Declaration of Helsinki.
ACKNOWLEDGEMENT
AUTHORS: Karen Voigt, Stefan Bojanowski, Stephanie Taché, Roger Voigt, Antje Bergmann
JOURNAL: Disease in Childhood
PUBLISHER: BMJ Open Group
URL: http://www.group.bmj.com
| 3 | | R370.00 | |
| | How Rheumatoid Arthritis Affects a Woman’s Sexual Well-Being. | How Rheumatoid Arthritis Affects a Woman’s Sexual Well-Being.
How Rheumatoid Arthritis Affects a Woman’s Sexual Well-Being.
Catriona Boffard, Sexologist (ECPS).
Rheumatoid arthritis (RA) is a chronic auto-immune disease, which primarily affects the joints in the body. This leads to inflammation of the joints and affects the body systemically. It can lead to progressive joint destruction and disability, due to persistent inflammation and is the most common form of polyarthritis. | 3 | | R400.00 | |
| | Impact Analysis Studies of Clinical Prediction Rules Relevant to Primary Care. | Impact Analysis Studies of Clinical Prediction Rules Relevant to Primary Care.
Impact Analysis Studies of Clinical Prediction Rules Relevant to Primary Care.
OVERVIEW
Clinical prediction rules (CPRs) are clinical tools that quantify the individual contributions physical examination and investigations contribute towards diagnosis, prognosis or likely response to treatment in a patient. Clinical prediction rules (CPRs) should therefore undergo impact analysis to evaluate their effect on patient care.
The objective of this study was thus to narratively review and critically appraise CPR impact analysis studies relevant to primary care. The setting for this study was primary meanwhile the participants were children and adults. The method used in this study was a randomized controlled trial (RCT) that was controlled before, after and interrupted time series.
Results from this study revealed that out of the 18 studies, 10 reported an improvement in primary outcome with CPR implementation. Similarly, out of musculoskeletal studies, 5 were effective in altering targeted physician behaviour in ordering imaging for patients presenting with ankle, knee and neck musculoskeletal injuries. The study was concluded that despite the increasing interest in developing and validating CPRs relevant to primary care, relatively few have gone through impact analysis.
ACKNOWLEDGEMENT
AUTHORS: Emma Wallace, Maike J M Uijen, Barbara Clyne, Atieh Zarabzadeh, Claire Keogh, Rose Galvin, Susan M Smith, Tom Fahey
JOURNAL: Journal of Clinical Pathology
PUBLISHER: BMJ Open Group
URL: http://www.group.bmj.com | 3 | | R340.00 | |
| | Important Common Eye Conditions: Cataracts. | Important Common Eye Conditions: Cataracts.
Important Common Eye Conditions: Cataracts.
Overview
There is a great need to be aware of common eye conditions and subsequently recognize them. Cataract is a popular eye condition that needs to be treated correctly to avoid complications. This paper therefore explores the various forms and symptoms of cataracts. It equally goes to explore the best possible ways to carry out cataract diagnosis. Of course, the paper also investigated the various treatments of cataract as well as the consequences in terms of associated illnesses.
It is also worth mentioning that this article equally highlights the important and need for eyes to be checked regularly against cataract. This article was written as a result of a respectable size survey in the USA which revealed that about 47% of the adults that were questioned worried more about losing their sight than losing their memory.
One of the major conclusions of this article is nonetheless the fact that there exist a great level of ignorance in very community that is not aware of the warning signs of eye diseases and conditions that could cause damage as well as blindness if not detected and treated in time.
ACKNOWLEDGEMENT
AUTHORS: Dr Cyril John Harrisberg
JOURNAL:
PUBLISHER:
URL:
| 3 | | R375.00 | |
| | Influence of work-related psychosocial factors on the prevalence of chronic pain and quality of life in patients with chronic pain. | Influence of work-related psychosocial factors on the prevalence of chronic pain and quality of life in patients with chronic pain.
Influence of work-related psychosocial factors on the prevalence of chronic pain and quality of life in patients with chronic pain.
OVERVIEW
Chronic pain among workers is not only an economic burden but also a major public health concern. Working is also a cause of chronic pain although most people need to continue working despite the pain to make a living except they get a sick leave or retirement.
The hypothesis of this study was that the therapeutic effect of vocational rehabilitation may depend on psychosocial factors related to the workplace. Thus, the aim of the study was to test this hypothesis as well as examine the association of work-related psychosocial factors with the prevalence of chronic pain or health related quality of life (HRQoL) among workers with chronic pain. During this study, 1764 workers aged 20–59 years were examined in the pain-associated cross-sectional epidemiological survey in Japan.
The outcomes of this study were chronic pain prevalence among all workers and low Euro QoL prevalence among workers with chronic pain according to the degree of workplace social support and job satisfaction. One of the significant results of this study was that chronic pain prevalence was higher among males reporting job dissatisfaction compared with those reporting job satisfaction.
ACKNOWLEDGEMENT
AUTHORS: Keiko Yamada, Ko Matsudaira, Hironori Imano, Akihiko Kitamura, Hiroyasu Iso
JOURNAL: Esmo Open: Cancer Horizons
PUBLISHER: BMJ Group
URL: https://www.bmjopen.bmj.com | 3 | | R360.00 | |
| | Initiating Antiretroviral Therapy for HIV at a Patient’s First Clinic Visit. | Initiating Antiretroviral Therapy for HIV at a Patient’s First Clinic Visit.
Initiating Antiretroviral Therapy for HIV at a Patient’s First Clinic Visit.
OVERVIEW
The late presentation of patients for care and high rates of attrition from care between HIV testing and ART initiation, with baseline median CD4 cell counts remaining well below 200 cells/mm3 are some of the most persistent operational challenges facing antiretroviral therapy (ART) programs for HIV/AIDS in sub-Saharan.
The purpose of this study was therefore to estimate the effect on uptake of ART and viral suppression of an accelerated initiation algorithm that allowed treatment-eligible patients to be dispensed their first supply of antiretroviral medications on the day of their first HIV-related clinic visit. This study was nonetheless conducted in two public sector clinics in South Africa, notably a primary health clinic (PHC) and a hospital-based HIV clinic. The participants of this study were averagely 18 years old non-pregnant patients receiving a positive HIV test or first treatment-eligible CD4 count were randomized to standard or rapid initiation.
The study was however concluded that offering single-visit ART initiation to adult patients in South Africa increased uptake of ART by 36% and viral suppression by 26%.
ACKNOWLEDGEMENT
AUTHORS: Sydney Rosen, Mhairi Maskew, Matthew P. Fox, Cynthia Nyoni, Constance Mongwenyana, Given Malete, Ian Sanne, Dorah Bokaba, Celeste Sauls, Julia Rohr1, Lawrence Long
JOURNAL: PLOS Medicine
PUBLISHER: PLOS
URL: https://www.plos.org | 3 | | R365.00 | |
| | Is herpes zoster an additional complication in old age alongside comorbidity and multiple medications? Results of the post hoc analysis of the 12-month. | Is herpes zoster an additional complication in old age alongside comorbidity and multiple medications? Results of the post hoc analysis of the 12-month.
Is herpes zoster an additional complication in old age alongside comorbidity and multiple medications? Results of the post hoc analysis of the 12-month.
OVERVIEW
Shingles, or herpes zoster (HZ), is caused by reactivation, of varicella-zoster virus (VZV) from a latent infection in the dorsal root ganglion.
The purpose of this study was thus to examine the burden of comorbidity, polypharmacy and herpes zoster (HZ), an infectious disease, and its main complication post-herpetic neuralgia (PHN) in young (50–70 years of age: 70-) and old (=70 years of age: 70+) patients. This study took place in primary care in France from November 20, 2006 to September 12, 2008. For this study, 644 general practitioners (GPs) collected data from 1358 patients aged 50 years or more with acute eruptive HZ. Validated questionnaires were used to investigate HZ and PHN burden, pain, quality of life (QoL).
The results of this study indicated that older patients more frequently presented with comorbidities, frequently took analgesics and had poorer response on all questionnaires, indicating greater burden, at inclusion as compared with younger patients.
ACKNOWLEDGEMENT
AUTHORS: Gisèle Pickering et al.
JOURNAL: BMJ Open
PUBLISHER: BMJ Group
URL: http://www.bmjopen.bmj.com
| 3 | | R330.00 | |
| | Leisure-Activity Participation to Prevent Later Life Cognitive Decline. | Leisure-Activity Participation to Prevent Later Life Cognitive Decline.
Leisure-Activity Participation to Prevent Later Life Cognitive Decline.
OVERVIEW
Leisure activity has a role to play in preventing later cognitive life decline. As a matter of fact, the prevention of cognitive decline within the spectrum of normal ageing to mild cognitive impairment (MCI) and cognitive impairment with dementia among the elderly has become largely acknowledged as a major public health issue worldwide. This study was therefore carried out following PRISMA guidelines in order to achieve a systematic review. Thus, the objective of this study was to examine many peer review empirical research publications that focused on leisure activity, cognitive decline as well as its prevention. In terms of the research method, 52 articles published between the years 2000 and 2011were searched from reputable databases. Some of the articles were obtained from PubMed/Medline reSEARCH, CINHAL, Ovid MEDLINE, Embase, Web of Science, PsychoINFO, ERIC Proquest, the Cochrane library, as well as PsycARTICLES databasis. Results from the study nevertheless supports the conception that participating in leisure activities could significantly prevent dementia. The results were however interpreted using the Human Occupation Model that focuses on key factors which have been identified to have a link between participation in leisure activities and the prevention of dementia.
ACKNOWLEDGEMENT AUTHORS: Mandana Fallahpour, Lena Borell Mark Luborsky, and Louise Nygard
JOURNAL: Scandanavian Journal of Occupational Therapy
PUBLISHER: Taylor & Francis Group
URL: http://dx.doi.org/10.3109/11038128.2015.1102320
| 3 | | R395.00 | |
| | Lumbar Spine: Taping for Pain Relief of Spinal Conditions. | Lumbar Spine: Taping for Pain Relief of Spinal Conditions.
Lumbar Spine: Taping for Pain Relief of Spinal Conditions.
OVERVIEW
Low back pain can be difficult to treat. Management of chronic low back pain and leg pain requires a multifactorial approach. This course will not only help you to identify the underlying causative factors of LBP, but will also provide you with techniques that will enable you to assist patients to increase their active control of the passively unstable and associated areas in a way that will minimise symptom re-occurrences. Add an important modality to your tool box.
Spinal pain, particularly nerve root pain, can be extremely disabling for a patient. Treatment usually alleviates symptoms but the treatment effect can be short lived with the symptoms often returning with a vengeance. Chronic symptoms may even be exacerbated with treatment, as long-term adaptive changes in the soft tissues can be difficult to alter. Equally, unravelling the cause of the pain can be a challenge for the clinician, the symptoms can be quite remote from the site of pain.
Additionally, there may be confounding problems of hyper/ hypomobility in the surrounding soft tissues making response to treatment less predictable. If clinicians can minimize treatment exacerbations and prolong treatment effectiveness then they can expedite a patient’s recovery from low back pain. | 3 | | R400.00 | |
| | Mindful Meditation: A Review of Core Research and Theories, and Implications for Clinical Psychotherapeutic Applications. | Mindful Meditation: A Review of Core Research and Theories, and Implications for Clinical Psychotherapeutic Applications.
Mindful Meditation: A Review of Core Research and Theories, and Implications for Clinical Psychotherapeutic Applications.
Edited By: David Wilson.
The present module investigates one of the most elegantly simple methods of intervention i.e. mindful or breath meditation. Mindful meditation (MM) is rooted in ancient Eastern techniques, but has become a very popular, almost faddish method, applied and practised free of any specific religious belief systems. It has been used to assist in the treatment of a vast array of concerns; from physical illnesses, to pain and stress modulation, through to depression, anxiety, panic disorders, addictions and even attention deficits.
This module includes an article discussing basic principles of mindful meditation in treating anxiety and depression. A podcast from the University of California, Los Angeles (UCLA) Mindfulness Awareness Research Centre (MARC) is attached in order to provide a sample of the most basic guided breath meditation. This is NOT compulsory, but the interested researcher is encouraged to explore the innumerable sites which offer free access to different audio-visual meditation experiences. | 3 | | R400.00 | |
| | Musculoskeletal Ultrasound: Focused Impact on MRI. | Musculoskeletal Ultrasound: Focused Impact on MRI.
Musculoskeletal Ultrasound: Focused Impact on MRI.
OVERVIEW
The objective of this article is to compare and contrast image interpretation, accuracy, observer variability, economic impact and education with regard to musculoskeletal ultrasound and MRI because these factors will influence the growth of musculoskeletal ultrasound and the impact on MRI.
The use of musculoskeletal ultrasound continues to grow and there are a numerous factors that impact MRI. The development of less expensive portable ultrasound machines has opened the market to non-radiologists and application for musculoskeletal ultrasound has broadened. Selective substitution of musculoskeletal ultrasound for MRI can result in significant cost saving to the health care system. Although this change could decrease the use of MRI, issues related to accuracy, variability, education, and competence must be addressed.
ACKNOWLEDGEMENTS:
AUTHOR: Jon A. Jacobson1
JOURNAL: American Journal of Roentgenology
PUBLISHER:ARRS
URL: https:/www.arrs.org
| 3 | | R400.00 | |
| | Occupational Therapy and Sexual and Reproductive Health Promotion in Adolescence: A Case Study. | Occupational Therapy and Sexual and Reproductive Health Promotion in Adolescence: A Case Study.
Occupational Therapy and Sexual and Reproductive Health Promotion in Adolescence: A Case Study.
OVERVIEW
In recent years in Brazil, occupational therapy has increasingly approached the field of health promotion. Thus, the occupational therapists are confronted with different demands especially concerning the adolescent public.
The purpose of this study was therefore to describe an occupational therapy intervention aimed at sexual and reproductive health promotion in adolescents. Fifty-eight adolescents nonetheless participated in this study before, during and after the interventions. It is worth mentioning that during the study, educational activities such as puzzles, storytelling, mime and board game which had been constructed by occupational therapy faculty and students were used. The games were employed as mediators for gaining knowledge in sexual and reproductive health. Data for this study was collected through questionnaire, audio recordings and field diaries meanwhile it was analysed by descriptive statistics and thematic content analysis.
The results nevertheless showed the adolescents’ increased knowledge of sexual and reproductive health information immediately after the intervention.
ACKNOWLEDGEMENT
AUTHOR: Gontijo DT, de Sena e Vasconcelos AC, Monteiro RJ, Facundes VL, Trajano Mde, de Lima LS
JOURNAL: Occupational Therapy International
PUBLISHER: Wiley Online
URL: http://onlinelibrary.wiley.com | 3 | | R375.00 | |
| | Orthopaedic Medicine General Principles Part 1. | Orthopaedic Medicine General Principles Part 1.
Orthopaedic Medicine General Principles Part 1.
Orthopaedic medicine is concerned with the diagnosis and treatment of soft-tissue lesions. These disorders effect a substantial proportion of all patients in general and family medicine; cases are additionally found in departments of orthopaedic surgery, rheumatology, neurology, and casualty and, in particular, physiotherapy and sports clinics. Soccer or later nearly everyone suffers some such complaint.
In broad terms, these disorders embrace conditions commonly called arthritis, rheumatism, fibrositis, neck ache, backache, lumbago, sprained back muscles, sacroiliac strain, sciatica, trapped nerve, pulled muscles, frozen shoulder, tennis elbow, strained wrist, repetitive strain injuries (RSI), sprained knee and ankle, aches, sprains, inflammation and sports injuries generally.
However, this broad nomenclature encompasses what is in reality a multitude of distinct and readily distinguishable conditions. Once accurately diagnosed they permit the formation of rapid and effective treatment, without which the pain and disability may persist unnecessarily for weeks, months or years.
Soft-tissue lesions are thus a common cause of unavoidable pain. | 3 | | R400.00 |