Percutaneous image-guided cryoablation of spinal metastases: A systematic reviewAhmad Ozair
Percutaneous cryoablation (PCA) is a minimally invasive technique that has been recently used to treat spinal metastases with a paucity of data currently available in the literature. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Prospective or retrospective studies concerning metastatic spinal neoplasms treated with current generation PCA systems and with available data on safety and clinical outcomes were included. In the 8 included studies (7 retrospective, 1 prospective), a total of 148 patients (females = 63%) underwent spinal PCA. Tumors were located in the cervical (3/109 [2.8%], thoracic (74/109 [68.8%], lumbar (37/109 [33.9%], and sacrococcygeal (17/109 [15.6%] regions. Overall, 187 metastatic spinal lesions were treated. Thermo-protective measures (e.g., carbo-/hydro-dissection, thermocouples) were used in 115/187 [61.5%] procedures. For metastatic spinal tumors, the pooled mean difference (MD) in pain scores from baseline on the 0–10 numeric rating scale was 5.03 (95% confidence interval [CI]: 4.24 to 5.82) at a 1-month follow-up and 4.61 (95% CI: 3.27 to 5.95) at the last reported follow-up (range 24–40 weeks in 3/4 studies). Local tumor control rates ranged widely from 60% to 100% at varying follow-ups. Grade I-II complications were reported in 9/148 [6.1%] patients and grade III-V complications were reported in 3/148 [2.0%]) patients. PCA, as a stand-alone or adjunct modality, may be a viable therapy in appropriately selected patients with painful spinal metastases who were traditionally managed with open surgery and/or radiation therapy.
The final protocol (v5.3). Notable changes include:
1) Confirmation of audit standard (Page 6).
2) Refinement of inclusion and exclusion criteria (Page 7)
3) Confirmation of audit status (Appendix C)
4) Refinement of required data fields (Page 19) including definitions (Pages 20-25)
IMPACT OF HEALTH INFORMATICS TECHNOLOGY ON THE IMPLEMENTATION OF A MODIFIED E...hiij
The Modified Early Warning System (MEWS) is based on a patient score that helps the medical team monitor patients to identify a patient that may be experiencing a sudden decline in care. This study consists of a detailed review of clinical data and patient outcomes to assess impact of technology and patient care.There are a total of thirteen hospitals included in this review. These facilities have implemented vitals capture and the MEWS scoring system.
Adherence to Antiretroviral Therapy among HIVPositive Patients in Central Hos...Efe Clement Abel
Abstract: Adherence is the quantified level to which an individual follows a prescribed treatment and a low level of adherence to antiretroviral therapy(ART) adversely affects a patient’s treatment outcome and results in a rebound of plasma viraemia, development of resistant strains of HIV, more rapid immune deterioration, development of AIDS and death. This study is aimed at assessing the level of adherence to ART among HIV-positive patients assessing care in Central Hospital, Warri, Delta State, Nigeria. A descriptive cross-sectional study. Data were obtained using a semi-structured, interviewer-administered questionnaire and analysed using SPSS version 23. A total of 303 persons were recruited for the study. The mean age of respondents was 36.2±10.8years. Less than half of the subjects (45.5%) were adherent to their ART. Among the non-adherent subjects, the common reasons reported for missing doses of ART were forgetfulness (50.9%), too busy with other things (43.6%) and away from home (35.8%). This study showed that adherence to ART among the study population was poor. Forgetfulness, too busy with other things and being away from home were the most common reason for non-adherence. It is, therefore, recommended that; regular health education should be organised for HIV patients on ART on the importance of being adherent to their ART, regular assessment of adherence to ART should be carried out and a method of reminding patients who are non-adherent to ART on the need to take their ART as at when due should be considered as part of the routine services provided by ART centres.
Objective: To evaluate the utility of a targeted lecture in improving FP awareness amongst clinicians.
Design: This is a dual institution, prospective survey-based study assessing if an educational lecture can increase the likelihood of FP consideration, discussion, and referral.
Percutaneous image-guided cryoablation of spinal metastases: A systematic reviewAhmad Ozair
Percutaneous cryoablation (PCA) is a minimally invasive technique that has been recently used to treat spinal metastases with a paucity of data currently available in the literature. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Prospective or retrospective studies concerning metastatic spinal neoplasms treated with current generation PCA systems and with available data on safety and clinical outcomes were included. In the 8 included studies (7 retrospective, 1 prospective), a total of 148 patients (females = 63%) underwent spinal PCA. Tumors were located in the cervical (3/109 [2.8%], thoracic (74/109 [68.8%], lumbar (37/109 [33.9%], and sacrococcygeal (17/109 [15.6%] regions. Overall, 187 metastatic spinal lesions were treated. Thermo-protective measures (e.g., carbo-/hydro-dissection, thermocouples) were used in 115/187 [61.5%] procedures. For metastatic spinal tumors, the pooled mean difference (MD) in pain scores from baseline on the 0–10 numeric rating scale was 5.03 (95% confidence interval [CI]: 4.24 to 5.82) at a 1-month follow-up and 4.61 (95% CI: 3.27 to 5.95) at the last reported follow-up (range 24–40 weeks in 3/4 studies). Local tumor control rates ranged widely from 60% to 100% at varying follow-ups. Grade I-II complications were reported in 9/148 [6.1%] patients and grade III-V complications were reported in 3/148 [2.0%]) patients. PCA, as a stand-alone or adjunct modality, may be a viable therapy in appropriately selected patients with painful spinal metastases who were traditionally managed with open surgery and/or radiation therapy.
The final protocol (v5.3). Notable changes include:
1) Confirmation of audit standard (Page 6).
2) Refinement of inclusion and exclusion criteria (Page 7)
3) Confirmation of audit status (Appendix C)
4) Refinement of required data fields (Page 19) including definitions (Pages 20-25)
IMPACT OF HEALTH INFORMATICS TECHNOLOGY ON THE IMPLEMENTATION OF A MODIFIED E...hiij
The Modified Early Warning System (MEWS) is based on a patient score that helps the medical team monitor patients to identify a patient that may be experiencing a sudden decline in care. This study consists of a detailed review of clinical data and patient outcomes to assess impact of technology and patient care.There are a total of thirteen hospitals included in this review. These facilities have implemented vitals capture and the MEWS scoring system.
Adherence to Antiretroviral Therapy among HIVPositive Patients in Central Hos...Efe Clement Abel
Abstract: Adherence is the quantified level to which an individual follows a prescribed treatment and a low level of adherence to antiretroviral therapy(ART) adversely affects a patient’s treatment outcome and results in a rebound of plasma viraemia, development of resistant strains of HIV, more rapid immune deterioration, development of AIDS and death. This study is aimed at assessing the level of adherence to ART among HIV-positive patients assessing care in Central Hospital, Warri, Delta State, Nigeria. A descriptive cross-sectional study. Data were obtained using a semi-structured, interviewer-administered questionnaire and analysed using SPSS version 23. A total of 303 persons were recruited for the study. The mean age of respondents was 36.2±10.8years. Less than half of the subjects (45.5%) were adherent to their ART. Among the non-adherent subjects, the common reasons reported for missing doses of ART were forgetfulness (50.9%), too busy with other things (43.6%) and away from home (35.8%). This study showed that adherence to ART among the study population was poor. Forgetfulness, too busy with other things and being away from home were the most common reason for non-adherence. It is, therefore, recommended that; regular health education should be organised for HIV patients on ART on the importance of being adherent to their ART, regular assessment of adherence to ART should be carried out and a method of reminding patients who are non-adherent to ART on the need to take their ART as at when due should be considered as part of the routine services provided by ART centres.
Objective: To evaluate the utility of a targeted lecture in improving FP awareness amongst clinicians.
Design: This is a dual institution, prospective survey-based study assessing if an educational lecture can increase the likelihood of FP consideration, discussion, and referral.
The international survey on the management of allergic rhinitis by physicians...Georgi Daskalov
ORIGINAL RESEARCH Open Access
The international survey on the management of
allergic rhinitis by physicians and patients
(ISMAR)
Carlos E Baena-Cagnani
1
†
ˆ
, Giorgio W Canonica
2*
, Mohamed Zaky Helal
3
†
, René Maximiliano Gómez
4
†
,
Enrico Compalati
2
†
, Mario E Zernotti
5
†
, Mario Sanchez-Borges
6
†
, Fabio F Morato Castro
7
†
,
Margarita Murrieta Aguttes
8
†
, Aida López-Garcia
9
†
, Faheem A Tadros
10
†
and ISMAR Study Group
A questionnaire based survey on awareness of clinical trials among general po...pharmaindexing
The aim of the questionnaire based survey was to find the extend of awareness of clinical trials among general population among the different category of people in Chennai. The project was carried out among the general population living in and around Chennai. While recruiting the subjects care was taken to include different strata of the society and the informed consent was obtained from each subject before starting the study The participants was provided with the “Evaluation tool to assess the perception of clinical trials among general population”.
Prospective Study of Acute Appendicitis with its Clinical, Radiological Profi...semualkaira
Acute appendicitis is the most common condition encountered in general surgical practice. Alvarado and Modified Alvarado Scores (MASS) are the commonly used scoring
systems for its diagnosis, but its performance has been found to
be poor in certain populations. Hence, we compared the RIPASA
score with MASS, to find out which is a better diagnostic tool for
acute appendicitis in the Indian population.
Exploring Knowledge, Attitudes and Practices of ICU Health Workers Regarding ...QUESTJOURNAL
Background: Nosocomial Infection is a localized or systemic infection acquired at any health care facility including hospitals by a patient admitted for any reason other than the pathology present during admission. Including an infection acquired in a healthcare facility that manifest 48 hours after the patient's admission or discharge. Objective: Themain aim of this study is toassess the level of knowledge, attitudes and practice of ICU health personnel with regards to the spread of nosocomial infections. Methodology: A cross-sectional and facility based study was conducted from March to November 2016 at King Khalid hospital in Najran, Saudi Arabia. By adopting convenience technique, 50 subjects had been recruited to participate in this study. Results: 62% of respondentswere female. The mean age was 29 years. Concerning educational status, 54% of the participants have Bsc. professionally most of them (48%) were nurses. 60% of the participants have less than three year working experience in ICU.86% of them highlighted that hands must be washed with soap and water or even rubbed with alcohol before contacting with patients. Additionally, the result reveals that employees who had master degree or above displayed higher mean knowledge scores as compared to the other two groups (diploma or less & bachelor) (0.7147 & 4.6656) respectively. High significant statistical differences were found between the three academic groups in relation to sharp devices, personal protective equipment (gloves, gowns &masks), care of intravenous infusion therapy, central line care and urinary catheter care (F=4.594, F=7.982, F=5.539, F=4.471, F=15.310, F=4.345) respectively at p < 0.05. Recommendation & conclusion: Health workers in ICU (King Khalid hospital) showed adequate knowledge and faire attitude regarding universal precautions
Clinical Research is a most knowledge-intensive and interesting field in the pharmaceutical industry. There are more than 2, 50,000 positions unemployed in global Pharmaceutical industry.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Patient Recruitment simplified
1. Genelife Clinical Research
Your trust worthy partner in product development
Patient recruitment Simplified
Disease Surveillance Report (DSR)
Disease Surveillance is the systematic and periodical collection of
information on the occurrence, distribution, and trends for prevalence
of disease. It is an essential obligation for early detection of emerging
(new) or re-emerging (resurgent) infectious diseases. However, in con-
text of Clinical Research Disease Surveillance is predominantly used to
identify site & Investigator according to prevalence of disease for high-
er and cost effective patient recruitment. PATIENT RECRUITMENT
“Generally considered to be biomedical or health-related research THERAPEUTIC AREAS
studies in human beings that follow a pre-defined protocol”. Clinical-
1. Respiratory
Trials.gov
2. Dermatology
Patient recruitment is one of the most imperative tasks that is needed to 3. Oncology
be performed for conducting a significant clinical research. In clinical
4. Hematology
research subject recruitment is often stand by as a huge challenge as
more than 80% of global trials fail to enroll on time, with 52% delayed 5. Gastroenterology
by 1-6 months; this kind of delay not only leads to unforeseen deficit to 6. Endocrinology/Diabetes
the sponsor but also tends to affect the outcome.
7. Neurology
Although in comparison to the western frontier the patient enrollment 8. Nephrology
rate in India is about 3-4 times higher; but as most of the CRO’s are
9. Andrology/Urology
operating at places where clinical studies are already being conducted
recruitment is going to be a key hitch because the patient population is 10. Psychiatry
shrinking. 11. Internal Medicine
12. Orthopedics
Keeping recruitment problem in mind we at Genelife have modified Disease surveillance for
Clinical Research purpose.
Genelife deploys DSR as a tool for deriving a solution for enhancing the investigator/site selec-
tion and patient recruitment process. The primary focus of the survey was to screen unsullied
and experienced site/investigator on the basis of patient pool and to understand the disease trend
in India. Secondly it was also focused to build empathy with the site/investigator and to spread
awareness about the importance of Clinical research and GCP at unexplored or new sites. DSR
also used to make out referral sites moreover to make the generation of the feasibility report
faster.
Genelife has conducted a questionnaire survey amongst the investigator to access the patient
pool and the disease trends across all regions of India. The Questionnaire was focus on to as-
sess Experience of the investigator in conducting Clinical research, Prevalence of the disease
and Number of patient he/she can recruit (with respect to therapeutic area). It also tried to as-
sess the experience and interest of the Doctor/ Investigator/Site in conducting a Clinical Re-
search.
The DSR was conducted in two phases. In 1st phase therapeutic areas were chosen according to
the number of Clinical Trials going on in India & future assumptions along with general physi-
cian’s database. The therapeutic areas included in this phase were Cardiology, Dermatology,
Gastroenterology, Oncology, Orthopedics and Diabetes. In 2nd Phase Genelife identified the
therapeutic area for which we were contacted more, which includes Allergy /Asthma, Endocri-
nology, Infectious Disease, Metabolic Disorders, Nephrology, Obstetrics/Gynecology, Surgery
(Cardiac surgery for medical device), Urology etc. Genelife Clinical Research has isolated India
into four demographic region east, west, north and south. A questionnaire was distributed
amongst the Investigators/Doctors.
Genelife has reached almost 800 Investigators/Doctors of different therapeutic area across India
evaluating their experience in conducting Clinical Research and accessing the patient pool.
Genelife with the help of Disease surveillance survey attempted to access fresh site and the
Doctor/investigator who were interested in conduction of the clinical research but were not
trained nor having knowledge of conducting a Clinical Research.
Questions and Comments/Suggestion e-mail us at: iftekhark@genelifecr.com or call +91-22-65242666