Результаты поиска

Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults.

EDITORIAL NOTE: This editorial note has been published by the editors of Cochrane to alert readers that the following study included in this systematic review has an associated retraction. Associated studies with retractions of one or more study reports: Hollon SD, DeRubeis RJ, Fawcett J, Amsterdam JD, Shelton RC, Zajecka J, et al. Effect of cognitive therapy with antidepressant medications vs antidepressants alone on the rate of recovery in major depressive disorder: a randomised clinical trial. JAMA Psychiatry. 2014;71(10):1157–64. An assessment into the impact of removing this study on the

Payment methods for healthcare providers working in outpatient healthcare settings.

BACKGROUND: Changes to the method of payment for healthcare providers, including pay-for-performance schemes, are increasingly being used by governments, health insurers, and employers to help align financial incentives with health system goals. In this review we focused on changes to the method and level of payment for all types of healthcare providers in outpatient healthcare settings. Outpatient healthcare settings, broadly defined as 'out of hospital' care including primary care, are important for health systems in reducing the use of more expensive hospital services. OBJECTIVES: To asses

Anti-vascular endothelial growth factor combined with intravitreal steroids for diabetic macular oedema.

BACKGROUND: The combination of steroid and anti-vascular endothelial growth factor (VEGF) intravitreal therapeutic agents could potentially have synergistic effects for treating diabetic macular oedema (DMO). On the one hand, if combined treatment is more effective than monotherapy, there would be significant implications for improving patient outcomes. Conversely, if there is no added benefit of combination therapy, then people could be potentially exposed to unnecessary local or systemic side effects. OBJECTIVES: To assess the effects of intravitreal agents that block vascular endothelial g

Delayed antibiotic prescriptions for respiratory infections.

BACKGROUND: Concerns exist regarding antibiotic prescribing for respiratory tract infections (RTIs) owing to adverse reactions, cost, and antibacterial resistance. One proposed strategy to reduce antibiotic prescribing is to provide prescriptions, but to advise delay in antibiotic use with the expectation that symptoms will resolve first. This is an update of a Cochrane Review originally published in 2007, and updated in 2010 and 2013. OBJECTIVES: To evaluate the effects on clinical outcomes, antibiotic use, antibiotic resistance, and patient satisfaction of advising a delayed prescription of

Impact of breastfeeding or bottle-feeding on surgical wound dehiscence after cleft lip repair in infants: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this systematic review is to examine the impact of breastfeeding or bottle-feeding on surgical wound dehiscence after cleft lip repair in infants. BACKGROUND: Immediately after cleft lip repair in infants, breastfeeding and bottle-feeding are generally restricted. Alternative feeding methods such as spoon-feeding are recommended to avoid placing tension on the surgical wound. However, some studies have reported that alternative feeding methods are a source of stress to the infant and cause them to cry incessantly, resulting in postoperative weight l

What factors influence patient participation in an artificial intelligence-based initiative to optimise referrals from primary to specialist haematology care? A multicentre retrospective observational study in four Spanish hospitals.

ObjectivesIncreasing demand for haematological specialist care makes the optimisation of referrals and outpatient workflow a priority. Automated placing of standardised test orders prior to the first appointment may provide haematologists with necessary information to reach diagnoses and initiate treatment at the first patient encounter, reducing low-value follow-up appointments. We aimed to evaluate rates of patient participation in an initiative using artificial intelligence to place standardised test orders as well as reasons for non-participation, differences in the number of participants

Genetic determinants of testicular sperm extraction outcomes: insights from a large multicentre study of men with non-obstructive azoospermia.

STUDY QUESTION: What is the diagnostic yield and the pre-testicular sperm extraction (TESE) prognostic value of a non-obstructive azoospermia (NOA)-specific virtual gene panel? SUMMARY ANSWER: The diagnostic yield in our cohort was 6.1%, and by combining our data with published literature, we identified 11 genes compatible with testicular sperm production and 19 genes associated with no sperm retrieval in carriers of pathogenic (P) or likely pathogenic (LP) mutations. WHAT IS KNOWN ALREADY: Azoospermia, the most severe form of male infertility, affects ∼1% of the male population, with TESE b

Rethinking Femoral Head Biopsies in Geriatric Hip Fractures: Financial Burden vs Clinical Outcomes.

INTRODUCTION: Femoral head specimens are often sent for histopathology after geriatric femoral neck fractures in patients with past history of malignancies. However, the cost-effectiveness of this practice is unclear and the clinical impact and effect on patient management has yet to be ascertained. METHODS: This is a retrospective review of all femoral head histopathology specimens registered in our center from 2003 to 2023. Patients <65 years of age were excluded from the study. Patient demographics were analyzed. Clinical notes and radiographic information were retrieved for all cases with

Представление результатов анализа диабетических осложнений с головы до ног: всеобъемлющий радиологический обзор.

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

Local surgical complication rates in patients receiving surgery without immediate post-operative radiation therapy for lower extremity bone metastases.

PURPOSE: Pathological metastatic fractures in lower-extremity weight bearing bones often require surgical reconstruction. Post-operative radiation is routinely recommended following surgical reconstruction. This study evaluated the clinical outcomes of patients that undergo surgical fixation of an established or an impending pathologic lower extremity fracture without post-operative radiation. MATERIALS AND METHODS: A retrospective chart review of patients at Sunnybrook Health Sciences Center between 2007 and 2019 was performed. Descriptive statistical analyses were performed. RESULTS: A tot

External validation of the Bayesian Estimated Tools for Survival (BETS) models in patients with surgically treated skeletal metastases.

BackgroundWe recently developed two Bayesian networks, referred to as the Bayesian-Estimated Tools for Survival (BETS) models, capable of estimating the likelihood of survival at 3 and 12 months following surgery for patients with operable skeletal metastases (BETS-3 and BETS-12, respectively). In this study, we attempted to externally validate the BETS-3 and BETS-12 models using an independent, international dataset.MethodsData were collected from the Scandinavian Skeletal Metastasis Registry for patients with extremity skeletal metastases surgically treated at eight major Scandinavian referr

Comprehensive Review of Prevention and Management Strategies for Medication-related Osteonecrosis of the Jaw (MRONJ).

PURPOSE: To assess and classify the strategies employed in various dental specialities for the prevention and management of medication-related osteonecrosis of the jaw (MRONJ). MATERIALS AND METHODS: A comprehensive literature review was conducted, acquiring studies sourced from Google Scholar and PubMed. The emphasis was on studies published in recent years, focusing on successful MRONJ prevention techniques across various dental specialties. RESULTS: Four types of prevention were identified. Primary prevention strategies include optimizing oral hygiene, managing dental caries, and extracti

Trend and burden of adult cancer-related hospitalizations in the United States.

To calculate national trends and estimates of cancer-related hospitalizations, hospital outcomes, and hospitalization costs. The current study was a retrospective analysis of National Inpatient Sample data, collected during 2008 to 2019. Adult cancer hospitalizations were identified by Clinical Classifications Software codes. We estimated weighted frequencies, proportions, and trends in cancer-related hospitalizations, hospital outcomes, and hospitalization costs. The primary outcome of the study was cancer-related hospitalizations, and secondary outcomes were the reasons for hospitalization,

Evaluation of Emergency Department Visits by Oncology Patients: A Running Comparison to Admissions and ED Visits Under the CMS OP-35 Ruling.

BackgroundCancer is the second leading cause of death in the United States. The incidence of emergency department (ED) visits by oncology patients has grown over the past years. Some ED visits are medically unnecessary and could be prevented with improved prevention measures.ObjectivesTo evaluate the incidence and causes of ED visits by cancer patients and evaluate outcomes and disposition of ED visits.MethodsThis single-center, retrospective chart review was conducted in a tertiary medical hospital. We collected data using an electronic medical record and included oncology patients with activ

Durotomy During Outpatient Lumbar Discectomy Should Not Preclude Same-Day Discharge: A Case Series.

Background and objectivesWith advances in surgical techniques over the past 40 years, single-level lumbar hemilaminectomy and microdiscectomy (HLMD) has become a standard outpatient surgery. Incidental durotomy is a common complication of lumbar decompression surgeries and often precludes same-day discharge based on preexisting paradigms, involving bedrest that have no empirical support, but often lead to increased complications in available evidence-based studies. Limited data exist regarding the safety of same-day discharge after lumbar decompression involving an incidental durotomy. The obj

Less is more: inverting the paradigm across the cancer care continuum.

Cancer care often operates under the assumption that 'more is better', resulting in frequent testing, intensive treatments, and constant follow-up. However, this approach has unintended consequences and places significant burdens on patients, providers, and healthcare systems. At the same time, cancer care is evolving rapidly and the number of cancer survivors continues to grow, highlighting the urgent need for reform.In the Netherlands, important efforts are taking place to de-escalate and de-implement ineffective practices across the cancer care continuum, from screening to palliative care.

Совпадение в полном тексте источника
… Particularly in cancer care, the assumption that ‘more is better’ often results in frequent testing, intensive treatments, and long term follow-up. 2 , 3 However, this approach has unintended consequences, including unnecessary procedures, side effects, increased burdens on hospitals and staff, high …

Palliative transpedicular partial corpectomy without anterior vertebral reconstruction in lower thoracic and thoracolumbar junction spinal metastases.

BackgroundThe thoracolumbar junction is the transition from a stiff (thoracic spine) to a mobile zone (lumbar spine) and is relatively unstable compared with the thoracic and lumbar portions of the spine. The need for anterior reconstruction after a corpectomy has been emphasized by several authors. However, for patients with a relatively short life expectancy, anterior reconstruction may be unnecessary. Posterior instrumentation alone may be sufficient to provide pain relief and stability for such patients. The goal of this study was to assess the postoperative outcomes and survival rates of

Dural Lymphomas Unmasked: A Narrative Review of Extra-Axial Mimics and a Pragmatic Diagnostic Decision Algorithm.

Dural-based lymphomas are rare extranodal non-Hodgkin lymphomas that span from indolent primary dural entities, most commonly the extranodal marginal zone (mucosa-associated lymphoid tissue) lymphoma, to aggressive variants that are primary or represent secondary involvement from systemic lymphoma. They overlap radiologically with benign meningiomas, dural metastases, and immune-mediated pachymeningitis, creating a risk of anchoring bias, delayed diagnosis, and unnecessarily extensive resections when limited tissue sampling would be sufficient for diagnosis. We conducted a structured narrative

Таймпаническая мембрана Вовлечение Множественной Миэломы: Доклад о деле.

Эксклюзивное участие (EMI) в Multieloma (MM) является редким, но агрессивным субъектом, который обычно встречается в продвинутых или рецидивированных случаях MM. Хотя этиологические проявления нечасты, они могут имитировать обычные подстрекательские или неопластические патологии и могут быть диагностической задачей для клинического врача. Презентация дела: 65-летняя женщина с историей повторной рефрактории Multieloma (RRMMM), представленная в нашем амбулаторном отделении отоларингологии с четырехмесячной историей правосторонней атуральной полноты и небольшим эпизодом водяной оторреи. Отоскопия

Подозрительные результаты КТ, указывающие на медиастинит или стернальный остеомиелит у пациентов, не инфицированных в клинике, после сердечной хирургии: A 10-Year Одноцентральное ретроспективное исследование.

Предыстория/цели: Послестернотомный медиастинит и грудной остеомиелит являются серьезными осложнениями в результате операции на сердце, связанной со значительной заболеваемостью и смертностью. Вычисленная томография (ТТ) широко используется для оценки предполагаемой инфекции, однако частота, с которой, согласно сообщениям КТ, инфекция у клинически неинфицированных пациентов после стернотомии является слабой. Методы: Ретроспективное исследование было проведено в центре сердечной хирургии третьей ступени. С помощью институционального хранилища данных все взрослые пациенты, проходящие сердечную о