Author(s) Serruys; Ono, Masafumi; Garg, Scot; Hara, Hironori; Kawashima, Hideyuki; Pompilio, Giulio; Andreini, Daniele; Holmes, David R.; Onuma, Yoshinobu; King III, Spencer B.
Source Journal of the American College of Cardiology (JACC); Jul 2021; vol. 78 (no. 4); p. 384-407
Publication Date Jul 2021
Author(s) Donovan T.; Milan S.J.; Adatia A.; Solkar Z.; Stovold E. et al.
Source Cochrane Database of Systematic Reviews; Jul 2021; vol. 2021 (no. 7)
Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To evaluate the effects of subcutaneous omalizumab versus placebo for asthma in adults and children.Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Author Merchant, Jayne
Source British Journal of Community Nursing (BR J COMMUNITY NURS); Jul 2021; 26(7)
Abstract The COVID-19 pandemic has required rapid adaptation of the community nursing service, including the introduction of online communication platforms to prevent COVID-19 transmission among staff. Remote working has protected the workforce in the community from being decimated through team sickness, but has resulted in nurses who are feeling anxious and isolated from their colleagues while experiencing increased workloads, with complex and often emotionally challenging situations. The pressures of community nursing and the associated impact on sickness absence relating to mental health are well documented. The resources made available to support staff wellbeing were increased during the pandemic, but there remains some disparity of access to these resources. There is much that can be done by the district nurse as a leader of a team to ensure that the pressures are managed in a way that promotes team cohesion and mutual respect, while ensuring that open communication about wellbeing is encouraged.
Author(s) Rana A.; Iqbal A.; Mustafa M.; Tahir S.
Institution(s) (Rana, Iqbal, Mustafa) GME, Nazareth Hospital, Philadelphia, PA, United States
(Tahir) Royal Blackburn Hospital, Blackburn, Lancashire, United Kingdom
Source Journal of General Internal Medicine; 2021; vol. 36
AbstractLEARNING OBJECTIVE #1: Recognising when to order CPK levels in patients with atypical presentations of rhabdomyolisis. LEARNING OBJECTIVE #2: Association of rhabdomyolysis with elevation in LFTs. CASE: A 26-year-old healthy caucasian female with no significant past medical history presented to the Emergency Department with complaints of three days of worsening bilateral lower extremity myalgia. After three months of relativly low physical activity, the patient decided to get back into shape, she started crossfit, and the next day completed a 3 mile hike even though she was sore from the previous day's workout. One day prior to presentation, the patient visited a different ED where they completed a doppler ultrasound of her bilateral lower extremities and after it was negative for DVT, discharged her with analgesics. The patient has never had symptoms like this in the past, has never been tested for metabolic disorders, is currently not on any medication, and denies alcohol or drug abuse. In the ED: CBC and BMP was unremarkable, myoglobinuria was present, CPK was 18760. AST 390 ALT 132, Creatinine within normal limits. Patient was subsiquently started on IV fluids. an ultrasound of the abdomen was done, the liver was unremarkable. Once the Patient's CPK decreased to more acceptable limits and her lower extremity myalgia resolved, she was discharged with lab work and a PCP followup in 3 days.
Author(s) Division of Cardiology, Ulsan Medical Center, Ulsan Hospital, Ulsan, South Korea.; Liew Houng Bang; Eun Jung Jun; Ae-Young Her; Ju-Hyun Chung; Garg, Scot; Joo Myung Lee; Joon-Hyung Doh; Chang-Wook Nam; Bon-Kwon Koo; Qiang Tang
Source Cardiology Journal; Jul 2021; vol. 28 (no. 4); p. 615-622
AbstractAlthough drug-eluting stents (DES) have become the mainstay of percutaneous coronary intervention, late and very late stent thrombosis remains a concern. Drug-coated balloons (DCB) have the advantage of preserving the anti-restenotic benefits of DES while minimizing potential long-term safety concerns. Currently the two methods to ensure successful DCB treatment of a stenotic lesion are angiography or physiology-guided DCB application. This review will evaluate these two methods based on previous evidence and make suggestions on how to perform DCB treatment more efficiently and safely.
Source British Journal of Community Nursing; Jul 2021; vol. 26 (no. 7); p. 318-323
AbstractThe COVID-19 pandemic has required rapid adaptation of the community nursing service, including the introduction of online communication platforms to prevent COVID-19 transmission among staff. Remote working has protected the workforce in the community from being decimated through team sickness, but has resulted in nurses who are feeling anxious and isolated from their colleagues while experiencing increased workloads, with complex and often emotionally challenging situations. The pressures of community nursing and the associated impact on sickness absence relating to mental health are well documented. The resources made available to support staff wellbeing were increased during the pandemic, but there remains some disparity of access to these resources. There is much that can be done by the district nurse as a leader of a team to ensure that the pressures are managed in a way that promotes team cohesion and mutual respect, while ensuring that open communication about wellbeing is encouraged.
Author(s) Khan M.
Source Anaesthesia; Jul 2021; vol. 76 ; p. 49
In critical care, 80% of airway-related critical incidents occur post-intubation. There is also a high frequency of re-intubations in critical care patients within 48 h of extubation. Therefore, being able to anticipate a difficult airway holds value. Higgs et al.  recommend that identifying difficult airway can reduce adverse events and the critical care multidisciplinary team should be aware of patients with a difficult airway via effective documentation and handover, so that risks are mitigated.
Author(s) Ranson ; Nuttall, Graham; Paton, Robin W.
Source Journal of Foot & Ankle Surgery; Jul 2021; vol. 60 (no. 4); p. 702-705
The aim of this retrospective study was to assess our management of Congenial Talipes Equinovarus (CTEV) in relation to national standards published by the British Society for Children's Orthopaedic Surgery (BSCOS). A secondary aim was to evaluate if a more tailored bracing regime than advocated in the traditional Ponseti technique, would be appropriate for some cases of CTEV. One hundred and thirty-three feet in 96 patients were treated between June 2006 and January 2016. All patients were clinically assessed prospectively by the senior author at initial presentation using the Harrold & Walker classification system. A combination of the senior author's database, Elogbook and trust IT systems were used for data collection. The results of Ponseti surgical procedures such as tendoachilles release and tibialis transfer fell within the BSCOS guidelines. The rate of radical subtalar surgical release was higher than advocated (12.3%) which was partly due to the number of primary syndromal patients in the series. There was a significantly lower mean time spent in bracing of 14.3 months (95% confidence interval 14.8-19.3) compared to recommended national guidelines. There was a clinically significant difference in the lower relapse rate of female patients compared to male patients and also a higher propensity of surgical intervention in male patients. In addition, there was a statistically significant difference in both time spent in bracing, between H&W classifications and between patients who had bracing removed pre walking age or post walking age. This potentially demonstrates a more tailored bracing regime may be possible when applied to less severely affected feet and the condition may be more benign in female cases.
Author(s) McElhone ; Abbott, Janice; Hurley, Margaret; Burnell, Jane; Lanyon, Peter et al.
Source Rheumatology; Jul 2021; vol. 60 (no. 7); p. 3262-3267
Objective SLE is characterized by relapses and remissions. We aimed to describe the frequency, type and time to flare in a cohort of SLE patients. Methods SLE patients with one or more 'A' or 'B' BILAG-2004 systems meeting flare criteria ('new' or 'worse' items) and requiring an increase in immunosuppression were recruited from nine UK centres and assessed at baseline and monthly for 9 months. Subsequent flares were defined as: severe (any 'A' irrespective of number of 'B' flares), moderate (two or more 'B' without any 'A' flares) and mild (one 'B'). Results Of the 100 patients, 94% were female, 61% White Caucasians, mean age (s. d.) was 40.7 years (12.7) and mean disease duration (s. d.) was 9.3 years (8.1). A total of 195 flares re-occurred in 76 patients over 781 monthly assessments (flare rate of 0.25/patient-month). There were 37 severe flares, 32 moderate flares and 126 mild flares. By 1 month, 22% had a mild/moderate/severe flare and 22% had a severe flare by 7 months. The median time to any 'A' or 'B' flare was 4 months. Severe/moderate flares tended to be in the system(s) affected at baseline, whereas mild flares could affect any system. Conclusion. In a population with active SLE we observed an ongoing rate of flares from early in the follow-up period with moderate–severe flares being due to an inability to fully control the disease. This real-world population study demonstrates the limitations of current treatments and provides a useful reference population from which to inform future clinical trial design.
Coronary artery bypass grafting versus percutaneous coronary intervention in ischaemic heart failure. Can reliable treatment decisions in high-risk patients be based on non-randomized data?
Author(s) Ono M.; Onuma Y.; Serruys P.W. (firstname.lastname@example.org); Garg S.
Source European Heart Journal; Jul 2021; vol. 42 (no. 27); p. 2665-2669
Limb girdle muscular dystrophy R12 (LGMD 2L, anoctaminopathy) mimicking idiopathic inflammatory myopathy: key points to prevent misdiagnosis
Author(s) Marago I.; Roberts M.; Lilleker J.B.; Roncaroli F.; DuPlessis D. et al.
Source Rheumatology (Oxford, England); Jul 2021
OBJECTIVES: Diagnosing the idiopathic inflammatory myopathies (IIMs) can be challenging as several conditions, including genetic myopathies such as limb girdle muscular dystrophy type R12 (LGMD 2l, anoctaminopathy), mimic the presentation. Here we describe learning points identified from review of four patients with LGMD 2l who were initially incorrectly diagnosed with IIM. Our aim is to provide clinicians working in adult rheumatology services with a toolkit to help identify non-inflammatory presentations of myopathy.
The Impact of Prehabilitation on Patient Outcomes in Hepatobiliary, Colorectal, and Upper Gastrointestinal Cancer Surgery: A PRISMA-Accordant Meta-analysis
Author(s) Lambert J.E.; Keegan T.J.; Gaffney C.J.; Subar D.A.; Hayes L.D.
Source Annals of surgery; Jul 2021; vol. 274 (no. 1); p. 70-77
OBJECTIVE: To determine the impact of prehabilitation on hospital length of stay, functional capacity, complications, and mortality after surgery in patients with hepatobiliary, colorectal, and upper gastrointestinal cancer. BACKGROUND: "Prehabilitation" encompasses exercise, nutrition, and psychosocial interventions to optimize health before surgery. The benefits of prehabilitation are ill-defined.
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