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[PMID]:29348138
[Au] Autor:Jaja BNR; Saposnik G; Lingsma HF; Macdonald E; Thorpe KE; Mamdani M; Steyerberg EW; Molyneux A; Manoel ALO; Schatlo B; Hanggi D; Hasan D; Wong GKC; Etminan N; Fukuda H; Torner J; Schaller KL; Suarez JI; Stienen MN; Vergouwen MDI; Rinkel GJE; Spears J; Cusimano MD; Todd M; Le Roux P; Kirkpatrick P; Pickard J; van den Bergh WM; Murray G; Johnston SC; Yamagata S; Mayer S; Schweizer TA; Macdonald RL; SAHIT collaboration
[Ad] Endereço:Division of Neurosurgery, St Michael's Hospital, Toronto, ON, Canada.
[Ti] Título:Development and validation of outcome prediction models for aneurysmal subarachnoid haemorrhage: the SAHIT multinational cohort study.
[So] Source:BMJ;360:j5745, 2018 01 18.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To develop and validate a set of practical prediction tools that reliably estimate the outcome of subarachnoid haemorrhage from ruptured intracranial aneurysms (SAH). DESIGN: Cohort study with logistic regression analysis to combine predictors and treatment modality. SETTING: Subarachnoid Haemorrhage International Trialists' (SAHIT) data repository, including randomised clinical trials, prospective observational studies, and hospital registries. PARTICIPANTS: Researchers collaborated to pool datasets of prospective observational studies, hospital registries, and randomised clinical trials of SAH from multiple geographical regions to develop and validate clinical prediction models. MAIN OUTCOME MEASURE: Predicted risk of mortality or functional outcome at three months according to score on the Glasgow outcome scale. RESULTS: Clinical prediction models were developed with individual patient data from 10 936 patients and validated with data from 3355 patients after development of the model. In the validation cohort, a core model including patient age, premorbid hypertension, and neurological grade on admission to predict risk of functional outcome had good discrimination, with an area under the receiver operator characteristics curve (AUC) of 0.80 (95% confidence interval 0.78 to 0.82). When the core model was extended to a "neuroimaging model," with inclusion of clot volume, aneurysm size, and location, the AUC improved to 0.81 (0.79 to 0.84). A full model that extended the neuroimaging model by including treatment modality had AUC of 0.81 (0.79 to 0.83). Discrimination was lower for a similar set of models to predict risk of mortality (AUC for full model 0.76, 0.69 to 0.82). All models showed satisfactory calibration in the validation cohort. CONCLUSION: The prediction models reliably estimate the outcome of patients who were managed in various settings for ruptured intracranial aneurysms that caused subarachnoid haemorrhage. The predictor items are readily derived at hospital admission. The web based SAHIT prognostic calculator (http://sahitscore.com) and the related app could be adjunctive tools to support management of patients.
[Mh] Termos MeSH primário: Aneurisma Roto/complicações
Aneurisma Intracraniano/complicações
Avaliação de Resultados da Assistência ao Paciente
Medição de Risco/métodos
Hemorragia Subaracnóidea/mortalidade
[Mh] Termos MeSH secundário: Estudos de Coortes
Escala de Resultado de Glasgow
Seres Humanos
Estudos Observacionais como Assunto
Prognóstico
Estudos Prospectivos
Ensaios Clínicos Controlados Aleatórios como Assunto
Sistema de Registros
Reprodutibilidade dos Testes
Hemorragia Subaracnóidea/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; VALIDATION STUDIES
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5745


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[PMID]:29265181
[Au] Autor:Horai M; Satoh S; Matsuo M; Iwanaga M; Horio K; Jo T; Takasaki Y; Kawaguchi Y; Tsushima H; Yoshida S; Taguchi M; Itonaga H; Sawayama Y; Taguchi J; Imaizumi Y; Hata T; Moriuchi Y; Haase D; Yoshiura KI; Miyazaki Y
[Ad] Endereço:Department of Haematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
[Ti] Título:Chromosomal analysis of myelodysplastic syndromes among atomic bomb survivors in Nagasaki.
[So] Source:Br J Haematol;180(3):381-390, 2018 02.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The myelodysplastic syndromes (MDS) are clonal haematopoietic disorders that develop de novo and also secondary to chemotherapy and/or radiation therapy. We previously demonstrated that the risk of MDS is increased among atomic bomb survivors with significant correlation to radiation dose; however, the clinical characteristics of these survivors have not been well analysed. In this study, we investigated chromosomal abnormalities of MDS among survivors. The frequency of abnormal karyotypes was significantly higher, with more very poor risk karyotypes, according to the revised International Prognostic Scoring System, among those exposed close to the hypocentre compared with unexposed cases. However, abnormal karyotype frequency did not reflect the prognosis of exposed cases with respect to distance from the hypocentre. In addition, there was no difference in prognosis between exposed and unexposed cases. Among proximally exposed cases (<1·5 km from the hypocentre), chromosomal translocations and inversions were more frequent, and the frequency of structural alterations in chromosomes 3, 8, and 11 was significantly increased compared with unexposed cases. These results suggest that chromosomal alterations in MDS among survivors have different features compared with those in de novo or therapy-related MDS. Detailed molecular study is warranted.
[Mh] Termos MeSH primário: Aberrações Cromossômicas
Vítimas de Desastres
Síndromes Mielodisplásicas/epidemiologia
Síndromes Mielodisplásicas/genética
Armas Nucleares
Sobreviventes
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Contagem de Células Sanguíneas
Medula Óssea/patologia
Análise Citogenética
Feminino
Seres Humanos
Japão/epidemiologia
Masculino
Meia-Idade
Síndromes Mielodisplásicas/diagnóstico
Síndromes Mielodisplásicas/terapia
Avaliação de Resultados da Assistência ao Paciente
Sistema de Registros
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.15050


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[PMID]:28455460
[Au] Autor:Bentel JM; Thomas MA; Rodgers JJ; Arooj M; Gray E; Allcock R; Fermoyle S; Mancera RL; Cannell P; Parry J
[Ad] Endereço:Anatomical Pathology, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, Australia.
[Ti] Título:Erdheim-Chester disease associated with a novel, complex BRAF p.Thr599_Val600delinsArgGlu mutation.
[So] Source:BMJ Case Rep;2017, 2017 Apr 28.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BRAF mutation testing to determine eligibility for treatment with vemurafenib was performed on archival skin lesions of a 54-year-old patient diagnosed with Erdheim-Chester disease (ECD) in 1999. Sanger sequencing of DNA extracted from a 2008 skin lesion identified two non-contiguous base substitutions in , which were shown by next-generation sequencing (NGS) to be located in the same allele. Due to its long-standing duration, molecular evolution of disease was possible; however, both Sanger and NGS of a 2000 skin lesion were unsuccessful due to the poor quality of DNA. Finally, droplet digital PCR using a probe specific for this novel mutation detected the complex BRAF mutation in both the 2000 and 2008 lesions, indicating this case to be ECD with a novel underlying BRAF p.Thr599_Val600delinsArgGlu mutation. Although well at present, molecular modelling of the mutant BRAF suggests suboptimal binding of vemurafenib and hence reduced therapeutic effectiveness.
[Mh] Termos MeSH primário: Doença de Erdheim-Chester/genética
Histiocitose de Células de Langerhans/genética
Mutação
Proteínas Proto-Oncogênicas B-raf/genética
[Mh] Termos MeSH secundário: Inibidores Enzimáticos/uso terapêutico
Doença de Erdheim-Chester/etiologia
Doença de Erdheim-Chester/patologia
Histiocitose de Células de Langerhans/patologia
Seres Humanos
Indóis/uso terapêutico
Masculino
Meia-Idade
Avaliação de Resultados da Assistência ao Paciente
Pele/patologia
Neoplasias Cutâneas/genética
Sulfonamidas/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Enzyme Inhibitors); 0 (Indoles); 0 (Sulfonamides); 207SMY3FQT (vemurafenib); EC 2.7.11.1 (Proto-Oncogene Proteins B-raf)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


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[PMID]:28455461
[Au] Autor:Kulkarni MS; Vijayan S; Naik M; Rao SK
[Ad] Endereço:Department of Orthopaedics, Kasturba Medical College Manipal, Manipal University, Manipal, India.
[Ti] Título:A rare tumour of hand: angioleiomyoma.
[So] Source:BMJ Case Rep;2017, 2017 Apr 28.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Angioleiomyoma is a benign tumour composed of smooth muscle and vascular tissue. Because of the paucity of smooth muscles in the hand other than tunica media of the blood vessels, its occurrence is quite rare in the hand and only few cases are reported in the English literature. We present the case of a 49-year-old man with benign painless swelling on the dorsum of hand. Differential diagnosis of ganglion cyst and tendon sheath tumour were considered. However, excision biopsy revealed angioleiomyoma. At 2-year follow-up, the patient remained asymptomatic with no evidence of recurrence.
[Mh] Termos MeSH primário: Angiomioma/patologia
Angiomioma/cirurgia
Mãos/patologia
[Mh] Termos MeSH secundário: Assistência ao Convalescente
Angiomioma/diagnóstico por imagem
Diagnóstico Diferencial
Mãos/irrigação sanguínea
Seres Humanos
Masculino
Meia-Idade
Avaliação de Resultados da Assistência ao Paciente
Ultrassonografia/métodos
[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:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


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[PMID]:28450470
[Au] Autor:van Nieuwenhuizen KM; Hendrikse J; Klijn CJM
[Ad] Endereço:Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
[Ti] Título:New microbleed after blood-brain barrier leakage in intracerebral haemorrhage.
[So] Source:BMJ Case Rep;2017, 2017 Apr 27.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Cerebral microbleeds are increasingly recognised as biomarkers of small vessel disease. Several preclinical and clinical studies have suggested that chronic disruption of the blood-brain barrier is one of the mechanisms for the development of cerebral microbleeds.A 51-year-old man experienced two left parieto-occipital lobar intracerebral haemorrhages (ICHs) in the timespan of 2 years. Multiple microbleeds surrounding the two haemorrhages were found on MRI, but not at location distant from the haemorrhages. Ten months after the last haemorrhage, an MRI demonstrated a right occipital focus of contrast enhancement. Twenty months after the last ICH, a new cerebral microbleed had developed exactly at the location of the earlier contrast enhancement.This case demonstrates that blood-brain barrier disruption may be an important factor preceding the development of cerebral microbleeds.
[Mh] Termos MeSH primário: Barreira Hematoencefálica/patologia
Encéfalo/patologia
Hemorragia Cerebral/diagnóstico por imagem
[Mh] Termos MeSH secundário: Encéfalo/irrigação sanguínea
Encéfalo/diagnóstico por imagem
Hemorragia Cerebral/etiologia
Hemorragia Cerebral/patologia
Angiografia por Tomografia Computadorizada
Diagnóstico Diferencial
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Avaliação de Resultados da Assistência ao Paciente
[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:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29419692
[Au] Autor:Mohamadi A; Googanian A; Ahmadi A; Kamali A
[Ad] Endereço:Department of Neurosurgery.
[Ti] Título:Comparison of surgical or nonsurgical treatment outcomes in patients with thoracolumbar fracture with Score 4 of TLICS: A randomized, single-blind, and single-central clinical trial.
[So] Source:Medicine (Baltimore);97(6):e9842, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Thoracolumbar fractures are among the most common types of damages caused to the spinal cord .Therefore, the aim of this study was the comparison of surgical or nonsurgical treatment outcomes in patients with thoracolumbar fracture with score 4 of the thoracolumbar injury classification and severity (TLICS) METHODS:: This study was clinical trial and double blind. Patients with thoracolumbar fracture with score 4 of TLICS entered at this research. We divided patients in 2 groups randomly (each group 25 patients) and then we followed patients for 1 year after start of treatment. We checked duration of bedridden and absence work, pain every 3 months for 1 year and radiography every 3 months for 1 year. RESULTS: Pain in operative group was lower than nonoperative group (P = .02). Regional sagittal angles (RSA) in operative group was lower than nonoperative group in all time (P = .0001). Mean of time of return to work in operative group was lower than nonoperative group (P = .001). CONCLUSIONS: Pain and mean of time of return to work and RSA in operative group was lower than nonoperative group. The present data suggest the use of operative method in patients with thoracolumbar fracture with score 4 of TLICS.
[Mh] Termos MeSH primário: Tratamento Conservador
Vértebras Lombares
Traumatismos da Medula Espinal/cirurgia
Fraturas da Coluna Vertebral/cirurgia
Procedimentos Cirúrgicos Operatórios
Vértebras Torácicas
[Mh] Termos MeSH secundário: Adulto
Tratamento Conservador/efeitos adversos
Tratamento Conservador/métodos
Feminino
Seres Humanos
Vértebras Lombares/lesões
Vértebras Lombares/cirurgia
Masculino
Doenças do Sistema Nervoso/diagnóstico
Doenças do Sistema Nervoso/etiologia
Avaliação de Resultados da Assistência ao Paciente
Procedimentos Cirúrgicos Operatórios/efeitos adversos
Procedimentos Cirúrgicos Operatórios/métodos
Vértebras Torácicas/lesões
Vértebras Torácicas/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009842


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[PMID]:28455280
[Au] Autor:Dean S; Mathers JM; Calvert M; Kyte DG; Conroy D; Folkard A; Southworth S; Murray PI; Denniston AK
[Ad] Endereço:Health Education England (West Midlands), Birmingham, UK.
[Ti] Título:"The patient is speaking": discovering the patient voice in ophthalmology.
[So] Source:Br J Ophthalmol;101(6):700-708, 2017 06.
[Is] ISSN:1468-2079
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Eye disease can be devastating. The most feared impact is sight loss, but in a number of ophthalmic conditions, there can be wide-ranging systemic, psychological, emotional and social effects of both the disease and its treatment. External tests of visual function, such as visual acuity, are inadequate to understand the overall impact of ophthalmic disease on a patient's functional vision or daily life. This can lead to a discordance between the patient's priorities and perspective on the one hand and the efforts of clinicians and other stakeholders on the other hand. In this review, we discuss how the patient is uniquely placed to understand the impact of the disease and can use that position to transform ophthalmic care at the individual and collective level, from research to care delivery. We highlight how the "patient voice" can contribute to key areas, including priority setting in the research agenda, communicating the wide-ranging impact of disease and its treatment as assessed through qualitative research, identifying the outcome measures that matter to the patient through core outcome set development and reporting these outcomes through appropriate patient-reported outcome measures. We also consider the increasing power of the patient voice on health institutions, ranging from broadcasting an individual's experience of care he/she has received to patient societies influencing future health policy. Finally, we reflect on the challenges that need to be overcome for the patient voice to increasingly influence and improve the delivery of eye care in the future.
[Mh] Termos MeSH primário: Oftalmologia
Avaliação de Resultados da Assistência ao Paciente
Relações Médico-Paciente
Pesquisa Qualitativa
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180203
[Lr] Data última revisão:
180203
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1136/bjophthalmol-2016-309955


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[PMID]:29173764
[Au] Autor:Vyfhuis MAL; Bhooshan N; Molitoris J; Bentzen SM; Feliciano J; Edelman M; Burrows WM; Nichols EM; Suntharalingam M; Donahue J; Nagib M; Carr SR; Friedberg J; Badiyan S; Simone CB; Feigenberg SJ; Mohindra P
[Ad] Endereço:Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, United States. Electronic address: Liriano2@gmail.com.
[Ti] Título:Clinical outcomes of black vs. non-black patients with locally advanced non-small cell lung cancer.
[So] Source:Lung Cancer;114:44-49, 2017 Dec.
[Is] ISSN:1872-8332
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The black population remains underrepresented in clinical trials despite reports suggesting greater incidence and deaths from locally advanced non-small cell lung cancer (NSCLC). We determined outcomes for black and non-black patients in a well-annotated cohort treated with either definitive chemoradiation (CRT; bimodality) or CRT followed by surgery (trimodality therapy). MATERIALS AND METHODS: A retrospective analysis of 355 stage III NSCLC patients treated with curative intent at the University of Maryland, Medical Center, between January 2000-December 2013 was performed. The Kaplan-Meier approach and the Cox proportional hazards models were used to analyze overall survival (OS) and freedom-from-recurrence (FFR) in black and non-black patients. The chi-square test was used to compare categorical variables. RESULTS: Black patients comprised 42% of the cohort and were more likely to be younger (p<0.0001), male (p=0.030), single (p<0.0001), reside in lower household income zipcodes (p<0.0001), have an Eastern Cooperative Oncology Group (ECOG) performance status >0 (p<0.001), and less likely to undergo surgery (p<0.0001). With a median follow-up of 15 months for all patients and 89 months for surviving patients (range:1-186 months), median OS times for black and non-black patients were 22 and 24 months, respectively (p=0.698). FFR rates were also comparable between the two groups (p=0.468). Surgery improved OS in both cohorts. Race was not a significant predictor for OS or FFR even when adjusted for other factors. CONCLUSIONS: We found similar oncologic outcomes in black and non-black NSCLC patients when treated with curative intent in a comprehensive cancer center setting, despite epidemiologic differences in presentation and receipt of care. Future efforts to improve outcomes in black patients could focus on addressing modifiable social disparities.
[Mh] Termos MeSH primário: Afroamericanos/etnologia
Carcinoma Pulmonar de Células não Pequenas/patologia
Neoplasias Pulmonares/patologia
Avaliação de Resultados da Assistência ao Paciente
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Carcinoma Pulmonar de Células não Pequenas/epidemiologia
Carcinoma Pulmonar de Células não Pequenas/cirurgia
Carcinoma Pulmonar de Células não Pequenas/terapia
Quimiorradioterapia/métodos
Intervalo Livre de Doença
Feminino
Disparidades nos Níveis de Saúde
Seres Humanos
Incidência
Neoplasias Pulmonares/epidemiologia
Neoplasias Pulmonares/cirurgia
Neoplasias Pulmonares/terapia
Masculino
Meia-Idade
Estadiamento de Neoplasias
Estudos Retrospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:28746708
[Au] Autor:Thyrian JR; Hertel J; Wucherer D; Eichler T; Michalowsky B; Dreier-Wolfgramm A; Zwingmann I; Kilimann I; Teipel S; Hoffmann W
[Ad] Endereço:German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany.
[Ti] Título:Effectiveness and Safety of Dementia Care Management in Primary Care: A Randomized Clinical Trial.
[So] Source:JAMA Psychiatry;74(10):996-1004, 2017 Oct 01.
[Is] ISSN:2168-6238
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Dementia care management (DCM) can increase the quality of care for people with dementia. Methodologically rigorous clinical trials on DCM are lacking. Objective: To test the effectiveness and safety of DCM in the treatment and care of people with dementia living at home and caregiver burden (when available). Design, Setting, and Participants: This pragmatic, general practitioner-based, cluster-randomized intervention trial compared the intervention with care as usual at baseline and at 12-month follow-up. Simple 1:1 randomization of general practices in Germany was used. Analyses were intent to treat and per protocol. In total, 6838 patients were screened for dementia (eligibility: 70 years and older and living at home) from January 1, 2012, to March 31, 2016. Overall, 1167 (17.1%) were diagnosed as having dementia, and 634 (9.3%) provided written informed consent to participate. Interventions: Dementia care management was provided for 6 months at the homes of patients with dementia. Dementia care management is a model of collaborative care, defined as a complex intervention aiming to provide optimal treatment and care for patients with dementia and support caregivers using a computer-assisted assessment determining a personalized array of intervention modules and subsequent success monitoring. Dementia care management was targeted at the individual patient level and was conducted by 6 study nurses with dementia care-specific qualifications. Main Outcomes and Measures: Quality of life, caregiver burden, behavioral and psychological symptoms of dementia, pharmacotherapy with antidementia drugs, and use of potentially inappropriate medication. Results: The mean age of 634 patients was 80 years. A total of 407 patients received the intended treatment and were available for primary outcome measurement. Of these patients, 248 (60.9%) were women, and 204 (50.1%) lived alone. Dementia care management significantly decreased behavioral and psychological symptoms of dementia (b = -7.45; 95% CI, -11.08 to -3.81; P < .001) and caregiver burden (b = -0.50; 95% CI, -1.09 to 0.08; P = .045) compared with care as usual. Patients with dementia receiving DCM had an increased chance of receiving antidementia drug treatment (DCM, 114 of 291 [39.2%] vs care as usual, 31 of 116 [26.7%]) after 12 months (odds ratio, 1.97; 95% CI, 0.99 to 3.94; P = .03). Dementia care management significantly increased quality of life (b = 0.08; 95% CI, 0 to 0.17; P = .03) for patients not living alone but did not increase quality of life overall. There was no effect on potentially inappropriate medication (odds ratio, 1.86; 95% CI, 0.62 to 3.62; P = .97). Conclusions and Relevance: Dementia care management provided by specifically trained nurses is an effective collaborative care model that improves relevant patient- and caregiver-related outcomes in dementia. Implementing DCM in different health care systems should become an active area of research. Trial Registration: clinicaltrials.gov Identifier: NCT01401582.
[Mh] Termos MeSH primário: Demência
Cuidados de Enfermagem/métodos
Administração dos Cuidados ao Paciente/métodos
Qualidade de Vida
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Cuidadores/psicologia
Efeitos Psicossociais da Doença
Demência/diagnóstico
Demência/psicologia
Demência/terapia
Feminino
Seres Humanos
Vida Independente/psicologia
Masculino
Monitorização Fisiológica/métodos
Avaliação de Resultados da Assistência ao Paciente
Atenção Primária à Saúde/métodos
Técnicas Psicológicas
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180124
[Lr] Data última revisão:
180124
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170727
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jamapsychiatry.2017.2124


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[PMID]:29292344
[Au] Autor:Benjamin B; Pietrzak JRT; Tahmassebi J; Haddad FS
[Ad] Endereço:University College London Hospitals, 235 Euston Road, NW1 2BU, London, UK.
[Ti] Título:A functional comparison of medial pivot and condylar knee designs based on patient outcomes and parameters of gait.
[So] Source:Bone Joint J;100-B(1 Supple A):76-82, 2018 Jan.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The outcome of total knee arthroplasty (TKA) is not always satisfactory. The purpose of this study was to identify satisfaction and biomechanical features characterising the gait of patients who had undergone TKA with either an anatomical single radius design or a medial pivot design. We hypothesised that the latter would provide superior function. PATIENTS AND METHODS: This is a study of a subset of patients recruited into a prospective randomised study of a single radius design a medial pivot design, with a minimum follow-up of one year. Outcome measurements included clinical scores (Knee Society Score (KSS) and Oxford Knee Score (OKS)) and gait analysis using an instrumented treadmill. RESULTS: There was no statistically significant difference between the two groups for both the KSS and OKS. There was also no statistical significance in cadence, walking speed, stride length and stance time, peak stride, mid support and push-off forces. CONCLUSION: This study corroborates a previous study by the same authors that showed equally good results in clinical outcome and gait between the conventional single radius and medial pivot designs under stringent testing conditions. Cite this article: 2018;(1 Supple A)100-B:76-82.
[Mh] Termos MeSH primário: Artroplastia do Joelho/instrumentação
Marcha
Prótese do Joelho
Avaliação de Resultados da Assistência ao Paciente
Desenho de Prótese
Recuperação de Função Fisiológica
[Mh] Termos MeSH secundário: Idoso
Artroplastia do Joelho/reabilitação
Fenômenos Biomecânicos
Feminino
Seres Humanos
Masculino
Meia-Idade
Satisfação do Paciente
Estudos Prospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B1.BJJ-2017-0605.R1



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