Early inspirations from times gone by

American Journal of Medical Genetics Part A, EarlyView.


from Genetics via xlomafota13 on Inoreader https://ift.tt/2voGdzQ
via IFTTT

Esomeprazole and aspirin in Barrett's oesophagus (AspECT): A randomised factorial trial

The Lancet

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2vk3D9K
via IFTTT

Long-term treatment with proton pump inhibitors is effective in children with eosinophilic esophagitis

Journal of Pediatric Gastroenterology and Nutrition

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2OwJW7f
via IFTTT

Incidence, risk factors, and clinical effects of recurrent diverticular hemorrhage: A large cohort study

Gastroenterology

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2vqB22q
via IFTTT

Shared decision-making for postoperative analgesia: A semistructured qualitative study

BACKGROUND Shared decision-making (SDM) and decision-support tools have attracted broad support in healthcare as they improve medical decision-making. Experts disagree on how these can help patients evaluate their present situation and possible outcomes of therapy, and how they might reduce decisional conflict. Little is known about their implementation, especially in anaesthesiology. OBJECTIVE To obtain a more fundamental understanding of pre-operative SDM and evaluate the use of a decision-support tool for postoperative analgesia after major thoracic and abdominal surgery. DESIGN A qualitative study with semistructured, in-depth interviews of patients and professionals. SETTING Patient recruitment took place at the Radboud University Medical Centre in Nijmegen and the Canisius Wilhelmina Hospital in Nijmegen, a nonacademic teaching centre. Professionals of the Radboud University Medical Centre were invited to participate in the interviews. PARTICIPANTS Interviews were performed with 10 individual patients and two focus groups both consisting of eight different professionals. MAIN OUTCOME MEASURES To gain insight into the provision of pre-operative information, decision-making processes and the clarity and usability of a prototype decision-support tool. RESULTS Professionals seemed to provide their patients with information directed towards the application of epidural analgesia, providing little attention to its negative effects. For many patients, the information was not tailored to their needs. Patients' involvement in decision-making was minimal, but they did not feel a need for more involvement. They were positive about the decision-support tool, although they indicated that it would not have influenced their treatment decision. Professionals expressed their doubt about the capacity of their patients to fully understand the decisions involved and about the clinical usability of the decision-support tool, because patients might misinterpret the information provided. CONCLUSION The results of this study suggest that both patients and professionals did not adhere to some 'self-evident' principles of SDM when postoperative analgesia after major thoracic and abdominal surgery was discussed. Correspondence to Dr Martin J.L. Bucx, MD, PhD, Consultant, Anaesthesiologist and Clinical Epidemiologist, Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Internal Postal Code 717, PO Box 9101, 6500 HB Nijmegen, The Netherlands Tel: +31 24 361 45 53; fax: +31 24 354 04 62; e-mail: Martin.Bucx@Radboudumc.nl Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (https://ift.tt/2ylyqmW). © 2018 European Society of Anaesthesiology

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2AutFwQ
via IFTTT

Electromyographic effect of using different attentional foci during the front plank exercise

Objective The aim of this cross-sectional study was to examine whether an internal focus on different core muscles during the isometric prone plank exercise increase muscle activity. Design Twenty university students performed 5 different conditions: regular prone plank (external focus) and prone plank with an internal focus on different muscles. Surface electromyography (EMG) signals were recorded for the upper rectus abdominis (UP ABS), lower rectus abdominis (LOW ABS), external oblique (OBLIQ) and lumbar erector spinae (LUMB). Results For the UP ABS, an internal focus on using any muscle increased activity. For the LOW ABS, internal focus on any muscle except the LUMB increased activity. No changes were found for OBLIQ and LUMB activity. Conclusion UP ABS and LOW ABS activities increased during an internal focus on the abdominal muscles. OBLIQ and LUMB activities were non-affected by an internal focus on any muscle. Corresponding author: Juan Carlos Colado: Department of Physical Education and Sports. University of Valencia. C/ Gascó Oliag 3. 46010, Valencia (Spain). Phone: (+34) 963 983 470. juan.colado@uv.es; Author Disclosures: The authors did not receive financial support for this study, they have no professional relationship with the equipment used during this study, and there are no known conflicts of interest associated with this publication that could have influenced its outcome. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2M5H1AV
via IFTTT

The Impact of Introducing a Physical Medicine and Rehabilitation Trauma Consultation Service to an Academic Level I Trauma Center

Abstract: Objective Prior retrospective studies suggest that early physical medicine and rehabilitation (PM&R) consultation for trauma patients improves outcome and reduces acute care length of stay (LOS). There have not been controlled studies to evaluate this impact. This study assesses the impact of PM&R consultations on acute trauma patients. Design This study compared measured outcomes before and after the introduction of a PM&R consultation service to the trauma program at a large academic hospital. The primary outcome measure was acute care LOS. Results The 274 historical controls and 76 patients who received a PM&R consultation were not different in injury severity score (ISS), age, or gender. LOS was not different between the two groups. However, when early (8 days) consults were compared, the early group had a markedly lower LOS (12 vs. 30 days, p

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2LHybNN
via IFTTT