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Experiences and perspectives related to shared decision-making among outpatients with degenerative joint disease in Taiwan: a qualitative study.

OBJECTIVES: Various treatment options are available for degenerative joint disease (DJD). During clinical visits, patients and clinicians collaboratively make decisions regarding the optimal treatment for DJD; this is the essence of shared decision-making (SDM). Here, we collated and assessed the SDM-related experiences and perspectives of outpatients with DJD in Taiwan. DESIGN: In-depth interviews and thematic analysis. SETTING: Primary care clinics of a regional teaching hospital in Taiwan, October 2021-May 2022. PARTICIPANTS: 21 outpatients with at least three visits for DJD and who were

Artificial intelligence in differentiating tropical infections: A step ahead.

BACKGROUND AND OBJECTIVE: Differentiating tropical infections are difficult due to its homogenous nature of clinical and laboratorial presentations among them. Sophisticated differential tests and prediction tools are better ways to tackle this issue. Here, we aimed to develop a clinician assisted decision making tool to differentiate the common tropical infections. METHODOLOGY: A cross sectional study through 9 item self-administered questionnaire were performed to understand the need of developing a decision making tool and its parameters. The most significant differential parameters among

Are Inferior Rectus Muscle Displacement and the Fracture's Size Associated With Surgical Repair Decisions and Clinical Outcomes in Patients With Pure Blowout Orbital Fracture?

PURPOSE: Although orbital blowout fractures are common, there is no consensus with respect to treatment decision making and long-term outcome. The purpose of this study was to evaluate the association between inferior rectus muscle (IRM) displacement and fracture size and the surgical repair decisions and clinical outcomes in patients with blowout fractures (BOFs). PATIENTS AND METHODS: We designed a prospective cohort study and enrolled all patients who presented to the University Hospital of Geneva for evaluation of a BOF. The primary predictor variables were the IRM grade, measuring the se

Older Patients and Conservative Kidney Management.

IMPORTANCE: In the US, dialysis remains the reflexive treatment option for end-stage kidney disease. Conservative kidney management (CKM), a nondialytic pathway, is infrequently utilized despite the burden dialysis often imposes on patients, caregivers, and health care systems. OBJECTIVE: To examine why older adults choose CKM, how caregivers influence this choice, and how nephrologists support CKM through advance care planning and palliative care referrals. DESIGN, SETTING, AND PARTICIPANTS: This qualitative study included secondary analysis of clinical notes and visit data from patients, c

Standardizing neonatal hypoxic ischemic encephalopathy evaluation and documentation practices.

BACKGROUND: Infants at risk for hypoxic ischemic encephalopathy (HIE) require a time sensitive evaluation and decision-making regarding treatment with therapeutic hypothermia (TH). Prior to this project, there was no standardized approach to evaluating these infants locally. METHODS: Included infants were "at risk for HIE," defined as meeting the "patient characteristics" and "biochemical criteria" per the institutional HIE pathway. Our primary outcome was documentation of an HIE therapeutic hypothermia evaluation (HIETHE) within the first six hours of life which included: (1) recognition of

[Ethical questions in the clinical use and research of electroconvulsive therapy].

Electroconvulsive therapy (ECT) is one of psychiatry's most long-standing and criticized treatments. Some of the criticisms come from the ethical aspect of ECT. The authors review the ethical issues of clinical application and research of ECT. ECT in the treatment of psychiatric patients is considered ethical, if it is conducted according to the four main principles of bioethics (beneficence, non-maleficence, autonomy and justice). ECT research should also comply with other international guidelines and research ethics codes. In recent decades, the principle of informed consent has become wides

Medical decision analysis for first-line therapy of chronic myeloid leukemia.

Several tyrosine kinase inhibitors (TKIs) are approved for the treatment of chronic myeloid leukemia (CML). Our goal was to develop a clinical decision-analytic model for evaluation of the long-term effectiveness of different therapy regimens. We developed a Markov cohort model with a lifelong time horizon for first-line treatment with imatinib, dasatinib or nilotinib. Seven strategies including combinations of TKIs, chemotherapy and stem cell transplant were evaluated. The model was parameterized using published trial data, the Austrian CML registry and practice patterns estimated by experts.

Integrating AI into Dentistry: Technical Pathways and Clinical Applications in Oral Diseases-A Comprehensive Overview.

The application of artificial intelligence (AI) technologies in the management of oral diseases is rapidly increasing, encompassing etiopathogenesis, disease course, diagnosis, treatment plans, and postoperative care. AI demonstrates exceptional performance in enhancing diagnostic accuracy and supporting clinical decision-making. This review provides a comprehensive overview of AI in dentistry, elucidating the neural network architectures and major implementation methods of AI. It focuses on specific application scenarios of AI-based models and evaluates their performance, and additionally hig…

Искусственный интеллект и множественный склероз: прошлое, настоящее и будущее.

Искусственная разведка (ИИ) в множестве склерозов (МС) представляет собой область, которая приобретает все большее значение. Мы рассматриваем исторический контекст, текущие виды применения и будущие перспективы АИ и машинного обучения (ML) в MS. В обзоре подчеркивается потенциал АИ в плане решения важнейших проблем в области управления МЗ, включая раннюю и точную диагностику, индивидуализированные стратегии лечения, прогнозирование и эффективный контроль за пациентами. Используя большие наборы данных и высокомерные данные, МА обещает глубокое понимание и укрепляет процессы принятия клинических

Совпадение в аннотации оригинала
Artificial intelligence (AI) in multiple sclerosis (MS) is an area of growing importance of growing importance. We review the historical con … By leveraging large datasets and high-dimensional data, AI promises profound insights and augments clinical decision-making processes. Additionally, the manuscript covers potential limitations and challenges facing AI use in MS clinical practice and research.

Impact of PSMA PET on Prostate Cancer Management.

PSMA-PET has been a practice-changing imaging biomarker for the management of men with PCa. Research suggests improved accuracy over conventional imaging and other PET radiotracers in many contexts. With multiple approved PSMA-targeting radiotracers, PSMA PET will become even more available in clinical practice. Its increased use requires an understanding of the prospective data available and caution when extrapolating from prior trial data that utilized other imaging modalities. Future trials leveraging PSMA PET for treatment optimization and management decision-making will ultimately drive i

5-Alpha reductase deficiency; an important cause of 46, XY DSD: Report of three cases within a family.

KEY CLINICAL MESSAGE: 5-Alpha reductase deficiency is an important cause of 46, XY disorder of sex development. Timely diagnosis and proper management by a multidisciplinary team can lead to a favorable outcome. Sex assignment should be deferred until puberty because spontaneous virilization occurs and the patient can engage in the decision-making process. ABSTRACT: 5-Alpha reductase deficiency is a genetic disorder causing 46, XY disorder of sex development (DSD). Typical clinical feature is a male with ambiguous genitalia or undervirilization at birth. Here we report three cases of this dis

Gastrointestinal Tract Considerations: Part II: How Should a Rheumatologist Best Manage Common Lower Gastrointestinal Tract Complaints in Systemic Sclerosis?

Lower gastrointestinal (GI) symptoms are a frequently encountered problem for clinicians managing patients with systemic sclerosis. The current management practices are focused on the treatment of symptoms with little information available on how to use GI investigations in daily practice. This review demonstrates how to integrate the objective assessment of common lower GI symptoms into clinical care with the aim of guiding clinical decision making. Understanding the type of abnormal GI function that is affecting a patient and determining which parts of the gut are impacted can help clinician

Nasal Packing in the Emergency Department: A Practical Review for Emergency Providers.

We performed a narrative review of epistaxis management in the emergency department. First, we examined the pathophysiology, the current typ … epistaxis clinical care pathway, based on current evidence, to aid emergency clinicians with their clinical decision-making processes.

A novel combined fluid dynamic and strain analysis approach identified abdominal aortic aneurysm rupture.

Clinical decision-making for surgical repair of abdominal aortic aneurysms based on maximum aortic diameter presents limitations as rupture can occur below threshold for some aneurysms, whereas others are stable at large sizes. The proposed approach combines hemodynamics and geometric indices with in vivo deformation analysis to assess local weakening of the aortic wall for a case of impending rupture that was confirmed during open surgical repair. A new combined index, the Regional Rupture Potential, is introduced to help the assessment of individual aneurysms and their rupture risk, providin…

Management of recurrent shoulder instability in patients with epilepsy.

Epileptic seizures can cause dislocation of the shoulder. Recurrent instability is common and occurs soon after the first dislocation. Significant bone loss from the humeral head and glenoid is thought to be responsible for this, and therefore the majority of surgical approaches focus on bone augmentation of the glenohumeral joint. Understanding of the current management strategies and the anatomic lesions associated with seizure-related shoulder instability will guide clinical decision-making. The purpose of this article was to review the pathoanatomy, treatment options, and clinical outcomes…

Orthognathic surgery in the presence of temporomandibular dysfunction: what happens next?

One of the most well-known yet perhaps controversial conditions affecting temporomandibular dysfunction (TMD) and the signs and symptoms of facial pain and clinical outcomes after orthognathic surgery procedures is temporomandibular joint internal derangement. This article provides an overview of the mutual relationship between orthognathic surgery and TMD, with especial consideration to internal derangement. The existing literature is reviewed and analyzed and the pertinent findings are summarized. The objective is to guide oral and maxillofacial surgeons in their clinical decision making whe

Early bilateral nephrectomy in infantile autosomal recessive polycystic kidney disease.

The management of neonatal autosomal recessive polycystic kidney disease (ARPKD) complicated by severe pulmonary insufficiency presents complex clinical challenges. Where massive nephromegaly exists, early bilateral nephrectomy, supportive peritoneal dialysis and early aggressive nutrition can minimise infant mortality. Consensus, however, is lacking on the role and optimal timing of nephrectomy, with decision-making driven by the patient's clinical condition and the expertise of the centre. We report on our experience of an infant with ARPKD requiring neonatal renal replacement therapy and su

[Toxoplasmic retinochoroiditis: relapse vs choroidal neovascular membrane].

CLINICAL CASE: We report four patients with both decreased visual acuity and retinochoroidal lesions compatible with ocular toxoplasmosis in which a diagnosis of active toxoplasmic retinochoroiditis or choroidal neovascular membrane was made based on a specifically designed diagnostic screening. DISCUSSION: In the context of a compatible clinical picture, with retinochoroidal scars and low grade or absence of inflammation, choroidal neovascular membranes may mimic active toxoplasmic retinochoroiditis and vice-versa. A thorough ophthalmic, serological, and immunological examination (in ocular

Anticoagulation after intracerebral haemorrhage: individualised management in a complex prothrombotic setting.

The decision to resume anticoagulation after intracerebral haemorrhage is a major clinical challenge, with current evidence offering limited guidance on balancing thrombotic and haemorrhagic risks. We present a case that highlights the intersection of multiple rare but clinically significant conditions against a background of prothrombotic risk. The patient's course exemplifies the complex interplay between thrombosis and bleeding and the therapeutic dilemmas surrounding the timing and choice of anticoagulation. Current evidence, derived largely from observational cohorts and small randomised

Impact of routine FDG-PET/CT on locoregional treatment decisions in breast cancer patients receiving preoperative systemic therapy.

PURPOSE: This study evaluates the clinical impact of routine FDG-PET/CT on locoregional treatment in a large cohort of breast cancer patients scheduled for preoperative systemic therapy (PST). METHODS: Patients scheduled for PST were identified from a retrospective database between 2011 and 2020 at our hospital. All patients underwent staging by FDG-PET/CT prior to PST. The rate of regional upstaging by FDG-PET/CT compared to initial locoregional staging was assessed, as well as its implications on surgical and radiotherapeutic management. Logistic regression analysis was used to evaluate the