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Selected Articles (selected + article)
Selected AbstractsCover Picture: Electrophoresis 21'2009ELECTROPHORESIS, Issue 21 2009Article first published online: 27 OCT 200 Issue no. 21 is a regular issue with Emphasis on "Nucleic Acids". The first part has 7 articles on nucleic acids covering various topics, e.g., sequencing, genotyping, PCR, insertion, mutation, etc. The remaining 11 articles are concerned with monoliths, pseudo-phases, coating, and sample pretreatment such as derivatization and concentration. Selected articles are: Applications of MALDI-TOF MS to large-scale human mtDNA population-based studies ((10.1002/elps.200900294)) Visual DNA as a diagnostic tool ((10.1002/elps.200900273)) Preliminary results for two-dimensional separation with high performance thin-layer chromatography and pressurized planar electrochromatography ((10.1002/elps.200900471)) [source] Cover Picture: Electrophoresis 20'2009ELECTROPHORESIS, Issue 20 2009Article first published online: 27 OCT 200 Issue no. 20 is a regular issue with an Emphasis on "Fundamentals and Methodologies". The bulk of this issue (13 articles) is on fundamentals and methodologies covering various topics, e.g. EOF, affinity CE, structural analysis of glycosphingolipids by CE-ESI-MS, on-line concentration, monolithic columns, etc. The other 6 articles are on protein separation and proteomics. Selected articles are: Micropump based on electroosmosis of the second kind ((10.1002/elps.200900271)) A splicing model-based DNA computing approach on microfluidic chip ((10.1002/elps.200900323)) Proteomic Characterization of Plasma-derived Clotting Factor VIII , von Willebrand Factor Concentrates ((10.1002/elps.200900270)) [source] Cover Picture: Electrophoresis 17'09ELECTROPHORESIS, Issue 17 2009Article first published online: 26 AUG 200 Issue no. 17 is an Emphasis Issue with 10 articles on various aspects of "Proteins and Proteomics" while the remaining 10 articles are arranged into 3 different parts including "Chip Technology", "Nucleic Acids", and "Methodologies, Assays and Applications." Selected articles are: Proteomic analysis of Oenococcus oeni freeze-dried culture to assess the importance of cell acclimation to conduct malolactic fermentation in wine ((10.1002/elps.200900228)) Complete sequencing and oxidative modification of Mn-SOD (SOD2) in medulloblastoma cells ((10.1002/elps.200900168)) Differentiation of Staphylococcus aureus strains by capillary electrophoresis, zeta potential and coagulase gene polymorphism ((10.1002/elps.200900186)) [source] Cover Picture: Electrophoresis 14'09ELECTROPHORESIS, Issue 14 2009Article first published online: 28 JUL 200 Issue no. 14 is an Emphasis Issue with 9 articles on various aspects of "Proteins and Proteomics" while the remaining 14 articles are arranged into 4 different parts including "Microfluidics and Miniaturization", "Genotyping and Transcriptomics", "Enantioseparations", and "Nanoparticles and Abused Drugs Analyses". Selected articles are: Effective elimination of nucleic acids from bacterial protein samples for optimized blue native polyacrylamide gel electrophoresis ((10.1002/elps.200900026)) 2-D difference in gel electrophoresis combined with Pro-Q Diamond staining: A successful approach for the identification of kinase/phosphatase targets ((10.1002/elps.200800780)) Microvalves actuated sandwich immunoassay on an integrated microfluidic system ((10.1002/elps.200800818)) Chemical gradient-mediated melting curve analysis for genotyping of SNPs ((10.1002/elps.200800729)) [source] Cover Picture: Electrophoresis 11'09ELECTROPHORESIS, Issue 11 2009Article first published online: 10 JUN 200 Issue no. 11 is a regular issue consisting of 22 research articles distributed over 5 parts including: (i) Proteins and Proteomics, (ii) EKC and CEC, (iii) Detection and Preconcentration Approaches, (iv) Enantioseparation and (v) Methodologies and Assays. Selected articles are: Quantifying Western blots: pitfalls of densitometry ((10.1002/elps.200800720)) Light emitting diode-induced chemiluminescence detection for capillary electrophoresis ((10.1002/elps.200800708)) Double sample preconcentration by in-line coupled large volume single drop microextraction and sweeping in capillary electrophoresis ((10.1002/elps.200800759)) [source] Cover Picture: Electrophoresis 6'09ELECTROPHORESIS, Issue 6 2009Article first published online: 23 MAR 200 Issue no. 6 is an Emphasis Issue with 7 articles on various aspects of "Proteins and Proteomics" while the remaining 15 articles are arranged into 4 different parts on "Genotyping and Sequencing", "Enantioseparations", "Non Aqueous CE", and "Methodologies and Applications." Selected articles are: Differences in protein distribution between human plasma preparations, EDTA-plasma and heparin-plasma, analyzed by non-denaturing micro-2-DE and MALDI-MS PMF 2-DE and MS analysis of key proteins in the adhesion of Lactobacillus plantarum, a first step toward early selection of probiotics based on bacterial biomarkers Centrifugal methods and devices for rapid in-gel digestion of proteins [source] Teaching Spirituality to Nurse Practitioner Students: The Importance of the Interconnection of Mind, Body, and SpiritJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 3 2001Margie Maddox EdD SpirituaLism is dormant, not dead, Let us hope. How to revive it, to rekindle it into life, is the great question , Florence Nightingale PURPOSE To describe the author's experience in locating and implementing a spiritual assessment tool in teaching a first semester clinical nurse prac-titioner (NP) course. DATA SOURCES Selected articles and responses of NP students to the use of the tool. CONCLUSIONS A spiritual assessment is an important component of a comprehensive health assessment. The use of a formal structured protocol provides a framework for beginning students to become comfortable with sprirituality and spiritual assessments and to begin to recognize spiritual distress in clients. IMPLICATIONS FOR PRACTICE The protocol used in the course is very extensive and might not be practical in a busy practice setting. An alternative, 4-point assessment is provided. [source] Screening of domestic violence against women in the perinatal setting: A systematic reviewJAPAN JOURNAL OF NURSING SCIENCE, Issue 2 2004Yaeko KATAOKA Abstract Aim:, To review published studies focusing on the screening of domestic violence (DV) against women, in particular, the instruments, the screening methods and the interventions used to help abused women after screening. Based on the results of the review, the suitability of introducing routine screening for DV in the perinatal setting in Japan would be assessed. Methods:, National Guideline Clearinghouse database, HSTAT, PubMed, CINAHL, the Cochrane Library and the Ichushi-Web were all used to searched from when records were first held until February 2003 for eligible primary studies and systematic reviews for this literature review. Each selected article was independently read and appraised by two reviewers who finally selected 12 primary studies and three systematic reviews that fulfilled the criteria for inclusion. Results:, Three studies evaluated screening instruments for DV (i.e. Abuse Assessment Screen, Partner Violence Screen and Violence Against Women Screen) and of these, the Violence Against Women Screen was the most valid, reliable and suitable for use in the clinical setting in Japan. The three studies that examined the screening method had differing results, but the one conducted in Japan showed a significantly higher rate of identification in the self-administered questionnaire group compared with the interview group. The six studies that tested the effectiveness of interventions for abused women showed that counseling sessions after screening and the advocacy program for postsheltered women were effective in reducing DV. Conclusion:, Routine screening of all pregnant women in Japan for DV should be introduced, considering the high burden of suffering that women expose to DV experience, and the existence of both acceptable screening instruments and effective interventions. [source] Recommendations for the Assessment and Reporting of Multivariable Logistic Regression in Transplantation LiteratureAMERICAN JOURNAL OF TRANSPLANTATION, Issue 7 2010A. C. Kalil Multivariable logistic regression is an important method to evaluate risk factors and prognosis in solid organ transplant literature. We aimed to assess the quality of this method in six major transplantation journals. Eleven analytical criteria and four documentation criteria were analyzed for each selected article that used logistic regression. A total of 106 studies (6%) out of 1,701 original articles used logistic regression analyses from January 1, 2005 to January 1, 2006. The analytical criteria and their respective reporting percentage among the six journals were: Linearity (25%); Beta coefficient (48%); Interaction tests (19%); Main estimates (98%); Ovefitting prevention (84%); Goodness-of-fit (3.8%); Multicolinearity (4.7%); Internal validation (3.8%); External validation (8.5%). The documentation criteria were reported as follows: Selection of independent variables (73%); Coding of variables (9%); Fitting procedures (49%); Statistical program (65%). No significant differences were found among different journals or between general versus subspecialty journals with respect to reporting quality. We found that the report of logistic regression is unsatisfactory in transplantation journals. Because our findings may have major consequences for the care of transplant patients and for the design of transplant clinical trials, we recommend a practical solution for the use and reporting of logistic regression in transplantation journals. [source] Gait characteristics of diabetic patients: a systematic reviewDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 3 2008L. Allet Abstract Patients with diabetes are at higher risk of experiencing fall-related injuries when walking than healthy controls. The underlying mechanism responsible for this is not yet clear. Thus we intend to summarize diabetic patients' gait characteristics and emphasize those which could be the possible underlying mechanisms for increased fall risk. This systematic review aims, in particular, to: (1) evaluate the quality of existing studies which investigate the gait characteristics of diabetic patients, (2) highlight areas of agreement and contradiction in study results, (3) discuss and emphasize parameters associated with fall risk, and (4) propose new orientations and further domains for research needed for their fall risk prevention. We conducted an electronic search of Pedro, PubMed, Ovid and Cochrane. Two authors independently assessed all abstracts. Quality of the selected articles was scored, and the study results summarized and discussed. We considered 236 abstracts of which 28 entered our full text review. Agreement on data quality between two reviewers was high (kappa: 0.90). Authors investigating gait parameters in a diabetic population evaluated in particular parameters either associated with fall risk (speed, step length or step-time variability) or with ulcers (pressure). There is agreement that diabetic patients walk slower, with greater step variability, and present higher plantar pressure than healthy controls. We concluded that diabetic patients present gait abnormalities, some of which can lead to heightened fall risk. To understand its' underlying mechanisms, and to promote efficient prevention, further studies should analyse gait under ,real-life' conditions. Copyright © 2008 John Wiley & Sons, Ltd. [source] Experimental design comparison of studies evaluating doxorubicin nanoparticles in breast cancer therapyHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 3 2008Farman A. Moayed Background The unique properties of nanoparticles (NP) qualify these colloidal systems for a wide range of medical applications, including diagnosis and treatment. Particularly in cancer therapy, NP have significantly enhanced the potential of conventional imaging, radiotherapy, and chemotherapy and, consequently, offered new avenues for early interventions. So far, breast cancer has been one of the most studied cancer types with NP research, which can benefit the occupational breast cancer for the increasing number of women in the labor force in industry. Objectives The objective of this study is to compare the experimental designs of preclinical studies that assessed the effect of doxorubicin NP (DOX-NP) on the estrogen-dependent MCF-7 breast cancer cell line using a recently established quantitative Experimental Appraisal Instrument (ExpAI). Methods A systematic review of research articles published between August 2004 and August 2005 on NP and breast cancer treatment with doxorubicin was performed using various online databases and indexes available through the University of Cincinnati. Restrictive inclusion and exclusion criteria were defined leading to selection of four relevant articles that used comparable experimental designs. Critical appraisal of those studies was performed by five independent assessors using the ExpAI version 2.0 and the results were summarized in a table of evidence. Results The study design in the selected articles was either between groups or mixed, with sample sizes varying from n = 3,6, and the evaluation of the effect of DOX-NP either in vitro or in vivo. The cytotoxic drug doxorubicin was the input variable in all studies, whereas different end points such as pharmacokinetic parameters, cytotoxicity surrogates (e.g., growth inhibition, mitochondrial activity), and quantitative analysis of messenger RNA were used as output variables. Conclusions Although the articles assessed in this article were preclinical experimental studies, the results showed that doxorubicin NP drugs can be used effectively to enhance the delivery process in MCF-7 breast cancer cells by increasing the circulation time and targeting the tumor tissues. Considering the rising number of women in the labor force and the risk of occupational breast cancer, it can be concluded that DOX-NP may potentially be used as an effective anticancer drug on humans, but further research and studies are required to understand how DOX-NP drugs might react in the human body before using it on breast cancer patients. © 2008 Wiley Periodicals, Inc. [source] The smear layer in endodontics , a reviewINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2010D. R. Violich Abstract Root canal instrumentation produces a layer of organic and inorganic material called the smear layer that may also contain bacteria and their by-products. It can prevent the penetration of intracanal medicaments into dentinal tubules and influence the adaptation of filling materials to canal walls. This article provides an overview of the smear layer, focusing on its relevance to endodontics. The PubMed database was used initially; the reference list for smear layer featured 1277 articles, and for both smear layer dentine and smear layer root canal revealed 1455 publications. Smear layer endodontics disclosed 408 papers. A forward search was undertaken on selected articles and using some author names. Potentially relevant material was also sought in contemporary endodontic texts, whilst older books revealed historic information and primary research not found electronically, such that this paper does not represent a ,classical' review. Data obtained suggests that smear layer removal should enhance canal disinfection. Current methods of smear removal include chemical, ultrasonic and laser techniques , none of which are totally effective throughout the length of all canals or are universally accepted. If smear is to be removed, the method of choice seems to be the alternate use of ethylenediaminetetraacetic acid and sodium hypochlorite solutions. Conflict remains regarding the removal of the smear layer before filling root canals, with investigations required to determine the role of the smear layer in the outcomes of root canal treatment. [source] Oral hygiene care for residents with dementia: a literature reviewJOURNAL OF ADVANCED NURSING, Issue 4 2005Jane Chalmers MS PhD Aim., This paper presents a literature review of oral hygiene care for adults with dementia in residential aged care facilities, including evidence for: (1) prevalence, incidence, experiences and increments of oral diseases; (2) use of assessment tools to evaluate residents' oral health; (3) preventive oral hygiene care strategies; and (4) provision of dental treatment. Background., The impact of dementia on residential care is ever-increasing and regular oral hygiene care provision is challenging for cognitively impaired residents. Although an abundance of oral hygiene care recommendations for older people have been published, the supporting evidence has not been clearly delineated. Methods., A review was conducted of English language publications (1980,2002), using a two-step approach (keyword electronic database search, supplemented with secondary search of cited references). All 306 selected articles were critically reviewed and systematically categorized. Results., Evidence confirmed clinicians' observations of poor oral health in older residents with dementia. Possible risk factors identified were: salivary dysfunction, polypharmacy, medical conditions, swallowing and dietary problems, functional dependence, oral hygiene care assistance and poor use of dental care. One comprehensive, reliable and validated oral assessment screening tool for residents with dementia had been published. Expert opinion indicated that oral assessment screening by staff and a dentist would be ideal at admission and regularly thereafter. Clinicians and researchers suggested that oral hygiene care strategies were effective in preventing oral diseases and appropriate for residents with dementia. Conclusion., These literature review findings supported the use of oral assessment screening tools by staff and efficacious preventive oral hygiene care strategies/products for adults with dementia in residential care facilities. Further research with this population is needed to develop and validate oral assessment tools and staff education programmes, trial preventive oral hygiene care strategies/products and trial dementia-focused behaviour management and communication strategies. [source] Quality and Outcomes of Heart Failure Care in Older Adults: Role of Multidisciplinary Disease-Management ProgramsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2002Ali Ahmed MD, FACP PURPOSE: To determine whether the management of heart failure by specialized multidisciplinary heart failure disease-management programs was associated with improved outcomes. BACKGROUND: The advent of angiotensin-converting enzyme inhibitors, beta-blockers, and spironolactone has revolutionized the management of heart failure. Randomized double-blind studies have demonstrated survival benefits of these drugs in heart failure patients. Nevertheless, in spite of these advances, heart failure continues to be a syndrome of poor outcomes.1,4 There is also evidence that a significant portion of heart failure patients does not receive this evidence-based therapy that reduces morbidity and mortality.5,7 Various disease-management programs have been proposed and tested to improve the quality of heart failure care. Most of these programs are specialized multidisciplinary heart failure clinics lead by cardiologists or heart failure specialists and conducted by nurses or nurse practitioners. Similar to the Department of Veterans Affairs (VA) multidisciplinary geriatric assessment clinics, these clinics also use many other services, including pharmacists, dietitians, physical therapists, and social workers. Some of these programs also have an affiliated home health service. Several observation studies, using mostly pre- and postcomparison designs, have demonstrated the effectiveness of these programs in the process of care, resource use, healthcare costs, and clinical outcomes in patients with heart failure.8 Risk of hospitalization was reduced by 50% to 85% in six of the studies.8 Subsequently, several randomized trials were conducted to determine the effectiveness of these programs. The purpose of this systematic review was to determine the effectiveness of these programs on mortality and hospitalization rates of heart failure patients. METHODS: Published articles on human randomized trials involving specialized heart failure disease-management programs in all languages were searched using Medline from 1966 to 1999 and other online databases using the following terms and Medical Subject Headings: case management (exp); comprehensive health care (exp); disease management (exp); health services research (exp); home care services (exp); clinical protocols (exp); patient care planning (exp); quality of health care (exp); nurse led clinics; special clinics; and heart failure, congestive (exp). In addition, a manual search of the bibliographies of searched articles was performed to identify articles otherwise missed in the above search. Personal communications were made with three authors to obtain further data on their studies. Using a data abstraction tool, two of the investigators separately abstracted data from the selected articles. Data from the selected studies were combined using the DerSimonian and Laird random effects model and the Mantel-Haenszel-Peto fixed effects model. Meta-Analyst 0.998 software (J. Lau, New England Medical Center, Boston, MA) was used to determine risk ratios (RRs) with 95% confidence intervals (CIs) of mortality and hospitalization for patients receiving care through these specialized programs compared with those receiving usual care. The Cochran Q test was used to test heterogeneity among the studies, and sensitivity analyses were performed to examine the effect of various covariates, such as duration of intervention, and other characteristics of the disease-management programs. RESULTS: The original search resulted in 416 published articles, of which 35 met preliminary selection criteria. Of these, 11 were randomized trials and were selected for the meta-analysis. Studies that were not randomized trials, did not involve heart failure patients or disease-management programs, or had missing outcomes were excluded. Of the 11 studies selected, nine involved specialized follow-up using multidisciplinary teams and the remaining two involved follow-up by primary care physicians and telephone. These studies involved 1,937 heart failure patients with a mean age of 74. The follow-up period ranged from no follow-up (one study) to 1 year (one study). Patients receiving care from specialized heart failure disease-management programs had a 13% lower risk of hospitalization than those receiving usual care (summary RR = 0.87; 95% CI = 0.79,0.96), but the Cochran Q test demonstrated significant heterogeneity among the studies (P = .003). Subgroup analysis of the nine studies using specialized follow-up by a multidisciplinary team showed similar results (summary RR = 0.77, 95% CI = 0.68,0.86; test of heterogeneity, P> .50). Seven of the nine studies did not show any significant association between intervention and reduced hospitalization, but the two studies that used follow up by primary care physicians and telephone failed to show any significant reduction in hospitalization (summary RR = 0.94, 95% CI = 0.75,1.19). In fact, one of the studies demonstrated a higher risk of hospitalization for patients receiving intervention (RR = 1.26, 95% CI = 1.04,1.52). Of the 11 studies, only six reported mortality as an outcome. None of these studies found any association between intervention and mortality (summary RR = 1.15, 95% CI = 0.96,1.37; test of heterogeneity, P> .15). Five of the studies used quality of life or functional status as outcomes, and, of them, only one demonstrated significant positive association. The results of the sensitivity analyses were negative for any significant association with duration of intervention or follow-up or year of study. Eight studies performed cost analyses and seven demonstrated cost-effectiveness of the intervention. CONCLUSIONS: The authors concluded that specialized disease-management programs were cost-effective, and heart failure patients cared for by these programs were more likely to undergo fewer hospitalizations, but the study did not provide any conclusive association between these programs and quality of care or mortality. The authors recommend that disease-management programs involve patient education and specialized follow-up by a multidisciplinary team including home health care. [source] Use of exogenous erythropoietin in critically ill patientsJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 3 2004R. MacLaren PharmD Summary Objective:, Review the literature regarding the use of recombinant human erythropoietin (rHuEPO) to prevent red blood cell (RBC) transfusion in critically ill patients. Data sources:, A computerized search of MEDLINE and EMBASE from 1966 through June 2003 was conducted using the terms erythropoietin, anemia, hemoglobin, critical care, intensive care, surgery, trauma, burn, and transfusion. References of selected articles were reviewed. A manual search of critical care, surgery, trauma, burn, hematology, and pharmacy journals was conducted to identify relevant abstracts. Results:, Six randomized studies have evaluated exogenous administration of erythropoietin to prevent RBC transfusions in critically ill patients. Studies vary with respect to rHuEPO dosage regimens, dose of concurrently administered iron, patient characteristics, and transfusion thresholds. Administration of rHuEPO rapidly produces erythropoiesis to reduce the need for RBC transfusions. The largest study conducted to date used weekly rHuEPO administration and found a modest decrease in transfusion requirements although the time to first transfusion was delayed. Reduced intensive care unit (ICU) length of stay (LOS) was shown in only one study of surgical/trauma patients. Reduced LOS after ICU discharge was found in another study of severely ill patients (APACHE II score >22). Other clinical outcomes were not altered by rHuEPO use. No adverse events were associated with rHuEPO use although studies were not designed to evaluate safety. Conclusions:, rHuEPO reduces the need for transfusions. A cost-effectiveness analysis of rHuEPO for this indication is needed. Defining an optimal dosage regimen, identifying patients most likely to respond to rHuEPO, and determining risk factors for ICU associated anaemia would provide information for appropriate rHuEPO utilization. [source] Inhospital management of COPD exacerbations: a systematic review of the literature with regard to adherence to international guidelinesJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 6 2009Cathy Lodewijckx RN MSc PhD Cand Abstract Rationale, Chronic obstructive pulmonary disease (COPD) exacerbations are a leading cause of hospitalization. Suboptimal inhospital management is expected to lead to more frequent exacerbations and recurrent hospital admission, and is associated with increased mortality. Aims, To explore inhospital management of COPD and to compare the results with recommendations from international guidelines. Methods, A literature search was carried out for relevant articles published 2000,2009 in the databases Medline, Cochrane Library, Cumulative Index for Nursing and Allied Health Literature and Invert. In addition, the reference lists of the selected articles were examined. Main inclusion criteria were as follows: COPD, exacerbation, hospitalization, description of inpatient management, and clinical trials. Assessment and treatment strategies in different studies were analysed and compared with American Thoracic Society-European Respiratory Society and Global Initiative for Chronic Obstructive Lung Disease guidelines. Outcomes were analysed. Results, Seven eligible studies were selected. Non-pharmacological treatment was infrequently explored. When compared with international guidelines, diagnostic assessment and therapy were suboptimal, especially non-pharmacological treatment. Respiratory physicians were more likely to perform recommended interventions than non-respiratory physicians. Conclusions, Adherence to international guidelines is low for inhospital management of COPD exacerbations, especially in terms of non-pharmacological treatment. Further investigation is recommended to explore strategies like care pathways that improve performance of recommended interventions. [source] A Selective Review of Maternal Sleep Characteristics in the Postpartum PeriodJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2009Lauren P. Hunter ABSTRACT Objective: To determine the current knowledge of postpartum womens' sleep patterns, sleep disturbances, consequences of sleep disturbances, and known strategies for prevention in order to provide best practice recommendations for health care providers. Data Sources: A literature search from 1969 through February 2008 was conducted using the CINHL, Index of Allied Health Literature, Ovid, PsycINFO, and PubMed electronic databases in addition to reference lists from selected articles and other key references. Search terms included sleep, postpartum, sleep deprivation, and sleep disturbance. Study Selection: A critical review of all relevant articles from the data sources was conducted with attention to the needs of postpartum womens' sleep and implications for health care providers. Data Extraction: Literature was reviewed and organized into groups with similar characteristics. Data Synthesis: An integrative review of the literature summarized the current state of research related to sleep alterations in postpartum women. Conclusions: Postpartum women experience altered sleep patterns that may lead to sleep disturbances. The most common reasons for sleep disturbances are related to newborn sleep and feeding patterns. Although present, the relationships among sleep disturbance, fatigue, and depression in postpartum women lack clarity due to their ambiguous definitions and the variety of the studies conducted. Providers should encourage prenatal education that assists the couple in developing strategies for decreasing postpartum sleep deprivation. Alterations of in-hospital care and home care should be incorporated to improve the new family's sleep patterns. [source] Prevalence of Xerostomia in Population-based Samples: A Systematic ReviewJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2 2006M.F. Orellana DDS Abstract The consequences of xerostomia on oral health have been studied for decades; however, the actual prevalence of this disorder on the general population remains controversial. The purpose of this systematic review was to determine the prevalence of xerostomia in population-based samples. Electronic databases were screened for relevant articles and reference lists of pertinent articles were also hand-searched. Thirteen articles meeting the final inclusion criteria were identified. Based on the definition of xerostomia used in this review, only publications including a subjective diagnosis of the disorder were included. All of the self-repotted diagnoses were achieved through a questionnaire either by mail, telephone, interview or self-administered by the patient. There was a variation across papers regarding number and content of the questions as well as guidelines for the diagnosis of xerostomia (i.e. answer yes to one or more than one question). The prevalence of xerostomia in the selected articles ranged from 0.9% to 64.8%. The majority of these studies were performed in Scandinavia. In 9 of the articles, the studied samples were 50 years and older. None of the studies evaluated the prevalence xerostomia among individuals younger than 18 years. Based on these observations, it can be concluded that there is a need for population-based studies on prevalence of xerostomia in regions other than Scandinavia. A standardized protocol to diagnose xerostomia needs to be developed. Patient-perceived treatment needs and impact on quality of life should be included to have a complete picture of public health implications of the disease. [source] Are peripheral and neuraxial blocks with ultrasound guidance more effective and safe in children?PEDIATRIC ANESTHESIA, Issue 2 2009KASIA RUBIN MD Summary Background and aims:, The efficacy and safety of ultrasound guided (USG) pediatric peripheral nerve and neuraxial blocks in children have not been evaluated. In this review, we have looked at the success rate, efficacy and complications with USG peripheral nerve blocks and compared with nerve stimulation or anatomical landmark based techniques in children. Methods:, All suitable studies in MEDLINE, EMBASE Drugs and Cochrane Evidence Based Medicine Reviews: Cochrane Database of Systemic Reviews databases were identified. In addition, citation review and hand search of recent pediatric anesthesia and surgical journals were done. All three authors read all selected articles independently and a consensus was achieved. All randomized controlled trials (RCTs) comparing USG peripheral and neuraxial blocks with other techniques in children were included. Results:, Ultrasound guidance has been demonstrated to improve block characteristics in children including shorter block performance time, higher success rates, shorter onset time, longer block duration, less volume of local anesthetic agents and visibility of neuraxial structures. Conclusion:, Clinical studies in children suggest that US guidance has some advantages over more traditional nerve stimulation,based techniques for regional block. However, the advantage of US guidance on safety over traditional has not been adequately demonstrated in children except ilio-inguinal blocks. [source] Prevention of relapse and interventions for enhancing medication adherence in schizophrenia: An East Asian perspectiveASIA-PACIFIC PSYCHIATRY, Issue 2 2010Salleh Mohd Razali MPM FAMM Abstract Introduction: Studies investigating the efficacy of interventions for improving treatment non-adherence in schizophrenia have generated contrasting findings. The present review examined psychosocial interventions for improving medication adherence and prevention of relapse among patients with schizophrenia in developing countries in the Asia-Pacific. Methods: The relevant literature and systematic review were identified by computerized searches using keywords, and hand-searched for other selected articles. Results: The reasons for poor medication adherence were complex and heterogenous. Psychoeducation programs alone are ineffective in achieving good medication adherence because they do not lead to attitudinal and behavioral changes. The greatest improvement in adherence was seen with interventions employing a combination of educational, behavioral and cognitive strategies. Unfortunately, few relevant studies from this region were found. There were some interventions related to psychoeducation and compliance therapy (CT) that were successfully conducted by nurses. Patients in developing countries generally had better family support, but strong stigma towards mental illness and interference by traditional healers led to poor treatment adherence. Lack of facilities and shortage of medical professionals aggravated the situation. Discussion: Intervention to improve treatment adherence and prevention of relapse among patients with schizophrenia should be incorporated into existing psychiatric services. Adherence to treatment in patients with schizophrenia could be improved if continuously supported and monitored by caregivers and treating doctors, to facilitate a change in the patient's attitude. Paramedical personnel, such as psychiatric nurses, could be actively involved in intervention programs because of the shortage of medical professionals in this region. [source] Trends in Clinical Toxicology: Advances That May Change Your PracticeBASIC AND CLINICAL PHARMACOLOGY & TOXICOLOGY, Issue 1 2005Sage W. Wiener We review selected articles that have advanced our thinking about consequential issues such as gastrointestinal decontamination, paracetamol poisoning, ethanol withdrawal, cocaine-associated chest pain, carbon monoxide poisoning and over-anticoagulation. [source] Nevoid basal cell carcinoma syndrome: Relation with desmoplastic medulloblastoma in infancyCANCER, Issue 3 2003A population-based study, review of the literature Abstract BACKGROUND Patients with nevoid basal cell carcinoma syndrome (NBCCS) are believed to be predisposed to develop early-onset neoplasms including medulloblastomas (MB). The desmoplastic subtype of MB is associated most commonly with NBCCS. The goals of this study were to demonstrate the relation between desmoplastic MB and NBCCS and to evaluate the concomitant diagnosis of NBCCS and MB. METHODS The medical records of 76 consecutive children who received surgical treatment for MB between 1970 and 2000 were studied. A review of the literature was performed based on the National Library of Medicine database and bibliographies of selected articles were scanned. RESULTS The authors reported three patients with NBCCS who received surgical treatment for an MB during infancy. The literature review identified 33 patients with NBCCS who were treated for MB at a mean age of 28 months. The desmoplastic subtype was the only histopathologic subtype of MB reported in the NBCCS population. Although patients with NBCCS are predisposed to develop multiple basal cell carcinomas and intracranial tumors in the field of irradiation, the prognosis for syndromic MBs was much better compared with the prognosis for sporadic MBs. CONCLUSIONS Patients with NBCCS have an increased risk for other malignancies, especially radiation-induced neoplasms. Early diagnosis of this syndrome is important for the selection of appropriate adjuvant treatment and family genetic counseling. The authors did not advocate the use of radiotherapy as an adjuvant treatment in desmoplastic MB diagnosed in children younger than 5 years of age. They suggested that the desmoplastic subtype of MB in children younger than 2 years of age is a major diagnostic criterion for the diagnosis of NBCCS. Cancer 2003;98:618,24. © 2003 American Cancer Society. DOI 10.1002/cncr.11537 [source] A review of EEG and ERP studies in bipolar disorderACTA NEUROPSYCHIATRICA, Issue 2 2009Racheal Degabriele Objective:, The electroencephalogram (EEG) can be a useful tool in determining differences in general neural activity and specific waveforms in individuals with a number of psychiatric disorders. This paper aims to outline and discuss significant findings in EEG and event-related potential (ERP) research into bipolar disorder (BD). Methods:, A literature review was performed through searches of MedLine, EMBASE, CINAHL and PsycInfo medical research databases for papers published from 1985 onwards. References of selected articles were also examined for other relevant studies. Results:, Differences in general EEG data were found in subjects with BD, namely increased theta and delta and decreased alpha wave bands. Changes in EEG were also found in euthymic BD subjects and those undergoing medication programmes. ERP studies commonly report prolonged latencies and reduced amplitudes in the P300 component. Hyperfunctioning of the right hemisphere in BD was also reported in some studies, although further confirmation of this finding is required. Finally, the effects of medication and the role that genetics plays in EEG still remain unclear. Conclusions:, The literature reviewed demonstrates supporting evidence for the presence of significant differences in EEG and ERP data in subjects with BD. However, methodological considerations such as varying mood states and medication status of the patients need to be followed more stringently for future research to bring about a robust model of the cognitive deficits of BD. [source] Magnetic resonance spectroscopy in anxiety disordersACTA NEUROPSYCHIATRICA, Issue 2 2008Clarissa Trzesniak Objective:, Magnetic resonance spectroscopy (MRS) is a non-invasive in vivo method used to quantify metabolites that are relevant to a wide range of brain processes. This paper briefly describes neuroimaging using MRS and provides a systematic review of its application to anxiety disorders. Method:, A literature review was performed in the PubMed, Lilacs and Scielo databases using the keywords spectroscopy and anxiety disorder. References of selected articles were also hand-searched for additional citations. Results:, Recent studies have shown that there are significant metabolic differences between patients with anxiety disorders and healthy controls in various regions of the brain. Changes were mainly found in N -acetylaspartate, which is associated with neuronal viability, but some of them were also seen in creatine, a substance that is thought to be relatively constant among individuals with different pathological conditions. Conclusions:, MRS is a sophisticated neuroimaging technique that has provided useful insights into the biochemical and neurobiological basis of many anxiety disorders. Nevertheless, its utilization in some anxiety disorders is still modest, particularly social phobia and generalised anxiety. Although it is an extremely useful advance in neuroimaging, further research in other brain areas and patient populations is highly advisable. [source] 12 Highly Interactive Teaching: A "HIT" with ResidentsACADEMIC EMERGENCY MEDICINE, Issue 2008Linda Regan Covering the core content of emergency medicine during residency training is both a time consuming and challenging endeavor. One of the more significant challenges in graduate medical education is to develop more interactive, less didactic teaching modalities. In an attempt to develop a more interactive educational curriculum, we interspersed weekly sessions titled "Highly Interactive Teaching" (HIT) with standard formal lecture didactics. A primary focus of many educators in emergency medicine is teaching residents how to manage the undifferentiated patient. To this end, we revised our curriculum to include 34 four-hour symptom/chief complaint-based sessions. The first hour is an introductory lecture on the general approach to a patient with the specified complaint. Residents then divide into small groups which rotate through specific case-based sections covering varied diagnoses which might present with the symptom complaint. These faculty-run small groups use a case-based approach, either high or low simulation-based or oral boards-based format. Each faculty then is required to sum up the salient points of their section. The final hour of the day is an evidenced-based review of supporting literature. Residents are required to read and critique selected articles for the audience so that the basis for diagnosis and management decisions can be discussed as a large group discussion. We believe this change in format will help residents not only to become more active learners, but also to become more astute clinicians. [source] | |||||||||||||||||||||||||