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  1 / 23013 MEDLINE  
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[PMID]:28463867
[Au] Autor:McMahon B; Hudson J; Prewitt J; Carman MJ; Engleson M
[Ad] Endereço:Duke University Health System, Durham, North Carolina (Ms McMahon and Drs Hudson, Prewitt, and Carman); and Duke University Health System, Raleigh, North Carolina (Ms Engleson).
[Ti] Título:Measuring Fatigue in Triage: A Pilot Study.
[So] Source:Adv Emerg Nurs J;39(2):114-122, 2017 Apr/Jun.
[Is] ISSN:1931-4493
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:: Given the critical nature of triage in facilitating emergency department (ED) functions, an understanding of the factors that impact triage nurses' ability to accurately assign triage scores and the ways in which these factors may affect various patient outcomes is extremely important; yet, there exists a paucity of such research in the literature. To further develop this knowledge base, an investigation of triage nurse fatigue and the role it may play in the ability to accurately assign triage scores was developed. The purpose of this pilot study was to determine how the length of a triage shift affects perceived fatigue levels among triage nurses. This pilot study was conducted using a prospective, descriptive cohort design with 28 registered nurses at a university-affiliated community hospital in the southeastern United States. Fatigue data were collected every 2 hr while the subject was in triage over the course of eighteen 24-hr periods between November 2015 and April 2016. Fatigue was measured using a self-reported fatigue questionnaire that included 2 validated fatigue scales: Karolinska Sleepiness Scale and Samn-Perelli Seven-Point Fatigue Scale. Data were analyzed using SPSS and Microsoft Excel. Results indicate a strong correlation between the amount of time spent in triage and fatigue scores, with average fatigue scores increasing by 64.4%-75.2% over the course of a 12-hr shift. Findings suggest that there was a positive correlation between the length of a triage shift and perceived fatigue levels among triage nurses in the ED. The biggest percent increase in fatigue scores is between hours 4 and 8. Further studies are needed to determine optimal triage shift length as well as the effect of nursing fatigue on triage accuracy.
[Mh] Termos MeSH primário: Fadiga
Triagem
[Mh] Termos MeSH secundário: Seres Humanos
Projetos Piloto
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1097/TME.0000000000000143


  2 / 23013 MEDLINE  
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[PMID]:29209154
[Au] Autor:Tinsley GM; Hamm MA; Hurtado AK; Cross AG; Pineda JG; Martin AY; Uribe VA; Palmer TB
[Ad] Endereço:Energy Balance & Body Composition Laboratory, Musculoskeletal Assessment Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Box 43011, Lubbock, TX 79409 USA.
[Ti] Título:Effects of two pre-workout supplements on concentric and eccentric force production during lower body resistance exercise in males and females: a counterbalanced, double-blind, placebo-controlled trial.
[So] Source:J Int Soc Sports Nutr;14:46, 2017.
[Is] ISSN:1550-2783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Pre-workout supplements purportedly enhance feelings of energy, reduce fatigue and improve exercise performance. The purpose of this study was to examine the performance effects of caffeinated and non-caffeinated multi-ingredient pre-workout supplements. Methods: In a counterbalanced, double-blind, placebo-controlled design, eccentric and concentric force production during lower body resistance exercise on a mechanized squat device were assessed after supplement ingestion. Repetitions-in-reserve/RPE and subjective feelings of energy, focus and fatigue were also examined. Twenty-one resistance-trained adults (12 F, 9 M) completed three conditions in random order: caffeinated supplement, non-caffeinated supplement and placebo. Subjects were not informed of the presence of a placebo condition. Thirty minutes after supplement ingestion, a 3-repetition maximum test and 5 sets of 6 repetitions were completed using the squat device. Each repetition involved 4-s eccentric and concentric phases, and the force signal throughout each repetition was sampled from a load cell contained within the squat device. The scaled and filtered force signals were analyzed using customized software. Repeated measures analysis of variance and appropriate follow-up analyses were utilized to compare dependent variables, and relevant effect sizes (d) were calculated. Results: Supplement or placebo ingestion led to similar subjective responses ( > 0.05). Energy (+8 to 44%; d = 0.3 to 0.8) and focus (+8 to 25%; d = 0.3 to 0.5) were acutely increased by supplement or placebo ingestion and decreased as the exercise session progressed. Fatigue was acutely decreased by supplement or placebo ingestion (-7 to 38%; d = -0.1 to -0.6) and increased as the exercise session progressed. Eccentric and concentric forces were unimproved by supplementation during the exercise sets for both sexes. In the non-caffeinated supplement condition only, maximal eccentric force production was lower during sets 3 to 5, as compared to set 1 ( < 0.05). Effect size data indicated that both the caffeinated and non-caffeinated supplements may contribute to small increases in concentric force production in males (+5 to 20%, d = 0.2 to 0.4 relative to placebo), but not females. Conclusions: As compared to placebo, caffeinated and non-caffeinated multi-ingredient pre-workout supplements failed to improve concentric and eccentric force production. In males, effect size data indicate a possible small benefit of supplementation on concentric force production, although this was not statistically significant. When resistance-trained subjects were unaware of the presence of a placebo, resistance exercise performance was similar regardless of whether a placebo or multi-ingredient supplement was ingested.
[Mh] Termos MeSH primário: Cafeína/farmacologia
Suplementos Nutricionais
Músculo Esquelético/efeitos dos fármacos
Músculo Esquelético/fisiologia
Treinamento de Resistência
[Mh] Termos MeSH secundário: Análise de Variância
Método Duplo-Cego
Fadiga
Feminino
Alimentos Formulados
Seres Humanos
Masculino
Resistência Física/efeitos dos fármacos
Resistência Física/fisiologia
Fatores Sexuais
Fenômenos Fisiológicos da Nutrição Esportiva
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
3G6A5W338E (Caffeine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1186/s12970-017-0203-x


  3 / 23013 MEDLINE  
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[PMID]:29376559
[Au] Autor:Lahart IM; Metsios GS; Nevill AM; Carmichael AR
[Ad] Endereço:Faculty of Education, Health and Wellbeing, University of Wolverhampton, Gorway Road, Walsall, West Midlands, UK, WS1 3BD.
[Ti] Título:Physical activity for women with breast cancer after adjuvant therapy.
[So] Source:Cochrane Database Syst Rev;1:CD011292, 2018 Jan 29.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Women with a diagnosis of breast cancer may experience short- and long-term disease and treatment-related adverse physiological and psychosocial outcomes. These outcomes can negatively impact prognosis, health-related quality of life (HRQoL), and psychosocial and physical function. Physical activity may help to improve prognosis and may alleviate the adverse effects of adjuvant therapy. OBJECTIVES: To assess effects of physical activity interventions after adjuvant therapy for women with breast cancer. SEARCH METHODS: We searched the Cochrane Breast Cancer Group (CBCG) Specialised Registry, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Physiotherapy Evidence Database (PEDro), SPORTDiscus, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform, on 18 September 2015. We also searched OpenGrey and Healthcare Management Information Consortium databases. SELECTION CRITERIA: We searched for randomised and quasi-randomised trials comparing physical activity interventions versus control (e.g. usual or standard care, no physical activity, no exercise, attention control, placebo) after adjuvant therapy (i.e. after completion of chemotherapy and/or radiation therapy, but not hormone therapy) in women with breast cancer. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed risk of bias, and extracted data. We contacted trial authors to ask for additional information when needed. We calculated an overall effect size with 95% confidence intervals (CIs) for each outcome and used GRADE to assess the quality of evidence for the most important outcomes. MAIN RESULTS: We included 63 trials that randomised 5761 women to a physical activity intervention (n = 3239) or to a control (n = 2524). The duration of interventions ranged from 4 to 24 months, with most lasting 8 or 12 weeks (37 studies). Twenty-eight studies included aerobic exercise only, 21 involved aerobic exercise and resistance training, and seven used resistance training only. Thirty studies described the comparison group as usual or standard care, no intervention, or control. One-fifth of studies reported at least 20% intervention attrition and the average physical activity adherence was approximately 77%.No data were available on effects of physical activity on breast cancer-related and all-cause mortality, or on breast cancer recurrence. Analysis of immediately postintervention follow-up values and change from baseline to end of intervention scores revealed that physical activity interventions resulted in significant small-to-moderate improvements in HRQoL (standardised mean difference (SMD) 0.39, 95% CI 0.21 to 0.57, 22 studies, 1996 women; SMD 0.78, 95% CI 0.39 to 1.17, 14 studies, 1459 women, respectively; low-quality evidence), emotional function (SMD 0.21, 95% CI 0.10 to 0.32, 26 studies, 2102 women, moderate-quality evidence; SMD 0.31, 95% CI 0.09 to 0.53, 15 studies, 1579 women, respectively; low-quality evidence), perceived physical function (SMD 0.33, 95% CI 0.18 to 0.49, 25 studies, 2129 women; SMD 0.60, 95% CI 0.23 to 0.97, 13 studies, 1433 women, respectively; moderate-quality evidence), anxiety (SMD -0.57, 95% CI -0.95 to -0.19, 7 studies, 326 women; SMD -0.37, 95% CI -0.63 to -0.12, 4 studies, 235 women, respectively; low-quality evidence), and cardiorespiratory fitness (SMD 0.44, 95% CI 0.30 to 0.58, 23 studies, 1265 women, moderate-quality evidence; SMD 0.83, 95% CI 0.40 to 1.27, 9 studies, 863 women, respectively; very low-quality evidence).Investigators reported few minor adverse events.Small improvements in physical activity interventions were sustained for three months or longer postintervention in fatigue (SMD -0.43, 95% CI -0.60 to -0.26; SMD -0.47, 95% CI -0.84 to -0.11, respectively), cardiorespiratory fitness (SMD 0.36, 95% CI 0.03 to 0.69; SMD 0.42, 95% CI 0.05 to 0.79, respectively), and self-reported physical activity (SMD 0.44, 95% CI 0.17 to 0.72; SMD 0.51, 95% CI 0.08 to 0.93, respectively) for both follow-up values and change from baseline scores.However, evidence of heterogeneity across trials was due to variation in intervention components (i.e. mode, frequency, intensity, duration of intervention and sessions) and measures used to assess outcomes. All trials reviewed were at high risk of performance bias, and most were also at high risk of detection, attrition, and selection bias. In light of the aforementioned issues, we determined that the evidence was of very low, low, or moderate quality. AUTHORS' CONCLUSIONS: No conclusions regarding breast cancer-related and all-cause mortality or breast cancer recurrence were possible. However, physical activity interventions may have small-to-moderate beneficial effects on HRQoL, and on emotional or perceived physical and social function, anxiety, cardiorespiratory fitness, and self-reported and objectively measured physical activity. The positive results reported in the current review must be interpreted cautiously owing to very low-to-moderate quality of evidence, heterogeneity of interventions and outcome measures, imprecision of some estimates, and risk of bias in many trials. Future studies with low risk of bias are required to determine the optimal combination of physical activity modes, frequencies, intensities, and durations needed to improve specific outcomes among women who have undergone adjuvant therapy.
[Mh] Termos MeSH primário: Neoplasias da Mama/terapia
Exercício
Treinamento de Resistência
[Mh] Termos MeSH secundário: Ansiedade/terapia
Neoplasias da Mama/psicologia
Quimioterapia Adjuvante
Depressão/terapia
Fadiga/etiologia
Feminino
Seres Humanos
Aptidão Física
Prognóstico
Qualidade de Vida
Radioterapia Adjuvante
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011292.pub2


  4 / 23013 MEDLINE  
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[PMID]:28368719
[Au] Autor:Bermejo JL; García-Massó X; Paillard T; Noé F
[Ad] Endereço:a Department of physical activity and sport sciences , University of Valencia , Valencia , Spain.
[Ti] Título:Fatigue does not conjointly alter postural and cognitive performance when standing in a shooting position under dual-task conditions.
[So] Source:J Sports Sci;36(4):429-435, 2018 Feb.
[Is] ISSN:1466-447X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This study investigated the effects of fatigue on balance control and cognitive performance in a standing shooting position. Nineteen soldiers were asked to stand while holding a rifle (single task - ST). They also had to perform this postural task while simultaneously completing a cognitive task (dual task - DT). Both the ST and DT were performed in pre- and post-fatigue conditions. In pre-fatigue, participants achieved better balance control in the DT than in the ST, thus suggesting that the increased cognitive activity associated with the DT improves balance control by shifting the attentional focus away from a highly automatised activity. In post-fatigue, balance control was degraded in both the ST and DT, while reaction time was enhanced in the first minutes following the fatiguing exercise without affecting the accuracy of response in the cognitive task, which highlights the relative independent effects of fatigue on balance control and cognitive performance.
[Mh] Termos MeSH primário: Cognição/fisiologia
Fadiga/fisiopatologia
Armas de Fogo
Militares/psicologia
Equilíbrio Postural/fisiologia
Análise e Desempenho de Tarefas
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1080/02640414.2017.1313443


  5 / 23013 MEDLINE  
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[PMID]:28463150
[Au] Autor:Gay HA; Sanda MG; Liu J; Wu N; Hamstra DA; Wei JT; Dunn RL; Klein EA; Sandler HM; Saigal CS; Litwin MS; Kuban DA; Hembroff L; Regan MM; Chang P; Michalski JM; Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium
[Ad] Endereço:Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri. Electronic address: hiramgay@wustl.edu.
[Ti] Título:External Beam Radiation Therapy or Brachytherapy With or Without Short-course Neoadjuvant Androgen Deprivation Therapy: Results of a Multicenter, Prospective Study of Quality of Life.
[So] Source:Int J Radiat Oncol Biol Phys;98(2):304-317, 2017 06 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The long-term effects of neoadjuvant androgen deprivation therapy (NADT) with radiation therapy on participant-reported health-related quality of life (HRQOL) have not been characterized in prospective multicenter studies. We evaluated HRQOL for 2 years among participants undergoing radiation therapy (RT) with or without NADT for newly diagnosed, early-stage prostate cancer. METHODS AND MATERIALS: We analyzed longitudinal cohort data from the Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment Consortium to ascertain the HRQOL trajectory of men receiving NADT with external beam RT (EBRT) or brachytherapy. HRQOL was measured using the expanded prostate cancer index composite 26-item questionnaire at 2, 6, 12, and 24 months after the initiation of NADT. We used the χ or Fisher exact test to compare the shift in percentages between groups that did or did not receive NADT. Analyses were conducted at the 2-sided 5% significance level. RESULTS: For subjects receiving EBRT, questions regarding the ability to have an erection, ability to reach an orgasm, quality of erections, frequency of erections, ability to function sexually, and lack of energy were in a significantly worse dichotomized category for the patients receiving NADT. Comparing the baseline versus 24-month outcomes, 24%, 23%, and 30% of participants receiving EBRT plus NADT shifted to the worse dichotomized category for the ability to reach an orgasm, quality of erections, and ability to function sexually compared with 14%, 13%, and 16% in the EBRT group, respectively. CONCLUSIONS: Compared with baseline, at 2 years, participants receiving NADT plus EBRT compared with EBRT alone had worse HRQOL, as measured by the ability to reach orgasm, quality of erections, and ability to function sexually. However, no difference was found in the ability to have an erection, frequency of erections, overall sexual function, hot flashes, breast tenderness/enlargement, depression, lack of energy, or change in body weight. The improved survival in intermediate- and high-risk patients receiving NADT and EBRT necessitates pretreatment counseling of the HRQOL effect of NADT and EBRT.
[Mh] Termos MeSH primário: Antagonistas de Androgênios/efeitos adversos
Braquiterapia/efeitos adversos
Terapia Neoadjuvante/efeitos adversos
Orgasmo
Ereção Peniana
Neoplasias da Próstata/terapia
Qualidade de Vida
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Antagonistas de Androgênios/uso terapêutico
Peso Corporal/efeitos dos fármacos
Peso Corporal/efeitos da radiação
Braquiterapia/métodos
Braquiterapia/estatística & dados numéricos
Mama/efeitos dos fármacos
Mama/efeitos da radiação
Distribuição de Qui-Quadrado
Terapia Combinada/efeitos adversos
Terapia Combinada/métodos
Terapia Combinada/estatística & dados numéricos
Depressão/etiologia
Disfunção Erétil/etiologia
Fadiga/etiologia
Fogachos/etiologia
Seres Humanos
Masculino
Meia-Idade
Terapia Neoadjuvante/métodos
Terapia Neoadjuvante/estatística & dados numéricos
Orgasmo/efeitos dos fármacos
Orgasmo/efeitos da radiação
Ereção Peniana/efeitos dos fármacos
Ereção Peniana/efeitos da radiação
Estudos Prospectivos
Antígeno Prostático Específico/sangue
Neoplasias da Próstata/sangue
Neoplasias da Próstata/patologia
Inquéritos e Questionários
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Androgen Antagonists); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  6 / 23013 MEDLINE  
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[PMID]:29293261
[Au] Autor:Gibbons C; Pagnini F; Friede T; Young CA
[Ad] Endereço:The Primary Care Unit, University of Cambridge, Forvie Site, Robinson Way, Cambridge, Cambridgeshire, UK, CB2 0SR.
[Ti] Título:Treatment of fatigue in amyotrophic lateral sclerosis/motor neuron disease.
[So] Source:Cochrane Database Syst Rev;1:CD011005, 2018 Jan 02.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), is terminal, progressive neurological condition for which there are no curative treatments. Among people with ALS/MND, fatigue is a common and debilitating symptom, which is characterised by reversible motor weakness and whole-body tiredness that is only partially relieved by rest. The effectiveness of pharmacological or non-pharmacological treatments for fatigue in ALS/MND is not yet established. OBJECTIVES: To assess the effects of pharmacological and non-pharmacological interventions for fatigue in ALS/MND. SEARCH METHODS: We searched the following databases on 5 September 2017: Cochrane Neuromuscular Specialised Register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL Plus, and ERIC. We also searched two clinical trials registries. SELECTION CRITERIA: We selected randomised and quasi-randomised controlled trials of any intervention which sought to reduce fatigue for people with ALS/MND. We included studies if reduction in fatigue was a primary or secondary outcome of the trial. DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by Cochrane. MAIN RESULTS: We included one pharmacological (modafinil) study and three non-pharmacological studies (resistance exercise, respiratory exercise, and repetitive transcranial magnetic stimulation (rTMS)), involving a total of 86 participants with ALS/MND. None of the included studies were free from risk of bias. Since there was only one trial for each intervention, no meta-analysis was possible. All studies assessed fatigue using the Fatigue Severity Scale (FSS; scale from 9 to 63, higher scores indicate more fatigue). Information for assessing bias was often lacking in study reports, making the risk of bias unclear across several domains in all trials. Blinding of participants was not possible in exercise trials, but the outcome assessment was blinded.We found very low-quality evidence suggesting possible improvements in fatigue for modafinil treatment versus placebo (MD -11.00, 95% CI -23.08 to 1.08), respiratory exercise versus a sham intervention (MD -9.65, 95% CI -22.04 to 2.73), and rTMS versus sham rTMS (data not provided), which warrant further investigation to clarify the efficacy of these treatments for fatigue in ALS/MND. We found no clear improvements in fatigue for resistance exercise versus usual care (MD 0.20, 95% CI -10.98 to 11.38; very low-quality evidence).Three participants in the modafinil group dropped out of the modafinil study, two citing issues with headache and one with chest tightness; other adverse effects were anxiety, nausea, dizziness, and sialorrhoea (probably ALS-related). The trials reported no adverse effects of exercise or rTMS.We cannot be certain about the effects of any of the interventions studied because of imprecision (small numbers of participants, wide CI), and possible study limitations. AUTHORS' CONCLUSIONS: It is impossible to draw firm conclusions about the effectiveness of interventions to improve fatigue for people with ALS/MND as there are few randomised studies, and the quality of available evidence is very low.
[Mh] Termos MeSH primário: Esclerose Amiotrófica Lateral/complicações
Compostos Benzidrílicos/uso terapêutico
Exercícios Respiratórios/métodos
Fadiga/terapia
Treinamento de Resistência/métodos
Estimulação Magnética Transcraniana/métodos
[Mh] Termos MeSH secundário: Fadiga/etiologia
Seres Humanos
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Benzhydryl Compounds); R3UK8X3U3D (modafinil)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011005.pub2


  7 / 23013 MEDLINE  
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[PMID]:29210764
[Au] Autor:Khanade K; Sasangohar F; Sutherland SC; Alexander KE
[Ad] Endereço:Department of Industrial and Systems Engineering, Texas A&M University, College Station (Mr Khanade and Dr Sasangohar); Department of Psychology, University of Houston-Clear Lake, Houston (Dr Sutherland); and Department of Clinical and Applied Sciences-Nursing, University of Houston-Clear Lake, Houston (Dr Alexander).
[Ti] Título:Deriving Information Requirements for a Smart Nursing System for Intensive Care Units.
[So] Source:Crit Care Nurs Q;41(1):29-37, 2018 Jan/Mar.
[Is] ISSN:1550-5111
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The workplace environment for intensive care nursing is highly stressful, with long working hours and a dynamic workload that may induce fatigue. The resulting stress and fatigue may reduce nurses' efficiency and may contribute to medical errors. A smart wearable system is being designed to help nurses who experience high levels of stress and fatigue at work. This article documents the systematic process of deriving information requirements from 2 focus groups conducted separately with nurses and nurse managers working in various Southeastern Texas hospitals. While nurses expected functionality such as memory aid tools, health assessment, and stress-reducing exercises, nurse managers expected information about the overall status of the unit's fatigue/stress levels as well as nurses' communication and movement patterns. The derived information requirements will act as an objective assessment of needs and would set the stage for the design of a stress-monitoring tool.
[Mh] Termos MeSH primário: Unidades de Terapia Intensiva
Recursos Humanos de Enfermagem no Hospital/psicologia
Dispositivos Eletrônicos Vestíveis/utilização
Carga de Trabalho/psicologia
[Mh] Termos MeSH secundário: Fadiga/prevenção & controle
Fadiga/psicologia
Feminino
Grupos Focais
Seres Humanos
Masculino
Erros Médicos/prevenção & controle
Estresse Psicológico/prevenção & controle
Estresse Psicológico/psicologia
Inquéritos e Questionários
Texas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1097/CNQ.0000000000000183


  8 / 23013 MEDLINE  
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[PMID]:29390512
[Au] Autor:Kelkar AH; Jacob KS; Yousif EB; Farrell JJ
[Ad] Endereço:Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL.
[Ti] Título:Venous thromboembolism related to cytomegalovirus infection: A case report and literature review.
[So] Source:Medicine (Baltimore);96(51):e9336, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Herein, we present a case of seemingly unprovoked portal vein thrombosis (PVT) occurring in the context of an acute cytomegalovirus (CMV) infection and prolonged debilitating fatigue. PATIENT CONCERNS: A 46-year-old male airline pilot presented with a 2 week history of abdominal pain, nausea, vomiting, watery diarrhea, and daily recurrent fevers. This was in the context of progressive, debilitating fatigue for 3 months forcing the patient to leave his job. DIAGNOSES: Computed tomography of the abdomen revealed PVT, which was managed initially by heparin infusion. Cefepime was ordered for broad-spectrum antibiotic management of sepsis and possible septic thrombosis. Further workup exposed elevated transaminases consistent with mild hepatitis without synthetic dysfunction and colonoscopy revealed colitis. A comprehensive evaluation for liver disease was notable for a markedly elevated ferritin level. Spiking fevers and neutrophilia persisted for several days despite empiric antimicrobial treatment, but eventually resolved. The remainder of the workup was negative except for positive CMV IgM titer and viral load. This raised suspicion for a hypercoagulable state caused by CMV hepatitis with CMV-induced PVT. Heparin was transitioned to warfarin at the time of discharge. INTERVENTIONS: Given the patient's immunocompetent state and resolution of fevers, antiviral therapy for CMV infection was not initiated. OUTCOMES: The patient continued to improve with a normalization of the serum ferritin level and anticoagulation therapy was stopped after 6 months. LESSONS: There is mounting support for infectious causes of venous thromboembolism (VTE) based on existing molecular biology and clinical research. Meta-analysis of existing data showed that between 1.9% and 9.1% of patients hospitalized with VTE had concurrent acute CMV infection. Theoretical mechanisms for this association include transient formation of antiphospholipid antibodies, transient formation of antibodies targeting CMV capsule phospholipids with procoagulant properties, and direct infection of the endothelial cells. We hope this case will serve as a reminder to consider CMV as a transient cause of PVT and VTE, particularly in light of 2016 guidelines for unprovoked VTE recommending lifelong anticoagulation. We also plan to prospectively study the association of unprovoked VTE and acute CMV infection in our own hospital system.
[Mh] Termos MeSH primário: Infecções por Citomegalovirus/complicações
Veia Porta
Tromboembolia Venosa/virologia
[Mh] Termos MeSH secundário: Anticoagulantes/uso terapêutico
Fadiga/etiologia
Hepatite Viral Humana/complicações
Hepatite Viral Humana/virologia
Seres Humanos
Masculino
Meia-Idade
Pilotos
Tromboembolia Venosa/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009336


  9 / 23013 MEDLINE  
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[PMID]:29390501
[Au] Autor:Guo T; Chen Z; Tai X; Liu Z; Zhu M
[Ad] Endereço:Yunnan University of Traditional Chinese Medicine, Kunming 650500, China.
[Ti] Título:Space-time acupuncture for intractable cough after lupus nephropathy: A case report and literature review.
[So] Source:Medicine (Baltimore);96(51):e9309, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Some intractable chronic cough remains a common complaint for seeking medical care. Unexplained cough in lupus nephropathy patient is rare and therapeutic options are limited. PATIENT CONCERNS: A 57 year-old woman with a 7-year history of lupus nephropathy. She has suffered from chronic cough for 3 years accompanied with chronic low back pain and fatigue, as the conventional therapy cannot relieve the symptoms. DIAGNOSES: The woman is diagnosed as intractable cough after lupus nephropathy. INTERVENTIONS: 9 times space-time acupuncture (STA) treatment was performed. OUTCOMES: The cough, as well as other uncomfortable symptoms like chronic low-back pain and fatigue have resolved, and no relapse for one year follow-up. LESSONS: STA may be an effective therapy to treat intractable chronic cough.
[Mh] Termos MeSH primário: Terapia por Acupuntura
Tosse/terapia
Nefrite Lúpica/complicações
[Mh] Termos MeSH secundário: Doença Crônica
Fadiga/terapia
Feminino
Seres Humanos
Dor Lombar/terapia
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009309


  10 / 23013 MEDLINE  
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[PMID]:29384937
[Au] Autor:Zhang W; Huang Z; Jin Y
[Ad] Endereço:Department of Rehabilitation Medicine, Panyu Central Hospital, Guangzhou, China.
[Ti] Título:Acupuncture as a primary and independent treatment for a patient with chronic insomnia: One-year follow-up case report.
[So] Source:Medicine (Baltimore);96(52):e9471, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Insomnia is a common disease. Till date, no study has reported the long-term (up to 1 year) outcomes of acupuncture as a primary and independent treatment in patients with insomnia. This report aims to present response of patient who was treated by acupuncture. This patient was evaluated with polysomnography. PATIENT CONCERNS: A 40-year-old patient had been diagnosed with insomnia for 2 years and getting worse since 1 month ago. He had undergone depression and anxiety emotion, but refused to take medical treatment for chronic insomnia. DIAGNOSES: In this study, the diagnosis of chronic insomnia was based on the International Classification of Sleep Disorders insomnia. The patient had no obvious differential diagnosis. INTERVENTIONS: Acupuncture treatment was planned for this patient who refused to take medical treatment with chronic insomnia. So the patient received 1 hour of acupuncture treatment for 12 weeks. OUTCOME: Polysomnographic evaluation was performed at baseline and 3 months, and 1 year after acupuncture treatment. He was asked to keep a diary of all his insomnia-related symptoms. All outcome measures substantially improved. Moreover, during the observation period, the patient's sleep quality did not worsen. LESSONS: After acupuncture treatment, improvements of subjective symptoms such as unrefreshing sleep, sleep disturbances, accompanied symptoms (morning headache, fatigue, and mood worsening) were observed. Remarkable improvement was recorded by polysomnographic parameters. The costs of the treatment of insomnia may be reduced, if this therapy was proved useful in future controlled studies.
[Mh] Termos MeSH primário: Terapia por Acupuntura/métodos
Distúrbios do Início e da Manutenção do Sono/terapia
[Mh] Termos MeSH secundário: Adulto
Doença Crônica
Fadiga/etiologia
Seguimentos
Cefaleia/etiologia
Seres Humanos
Masculino
Polissonografia
Distúrbios do Início e da Manutenção do Sono/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009471



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