Search results for "ECIS"

showing 10 items of 2868 documents

A multiple biomarker risk score for guiding clinical decisions using a decision curve approach.

2011

Aims: We assessed whether a cardiovascular risk model based on classic risk factors (e.g. cholesterol, blood pressure) could refine disease prediction if it included novel biomarkers (C-reactive protein, N-terminal pro-B-type natriuretic peptide, troponin I) using a decision curve approach which can incorporate clinical consequences. Methods and results: We evaluated whether a model including biomarkers and classic risk factors could improve prediction of 10 year risk of cardiovascular disease (CVD; chronic heart disease and ischaemic stroke) against a classic risk factor model using a decision curve approach in two prospective MORGAM cohorts. This included 7739 men and women with 457 CVD …

AdultMalemedicine.medical_specialtyEpidemiologymedicine.drug_classBlood PressureDiseaseRisk AssessmentDecision Support TechniquesSex FactorsPredictive Value of TestsRisk FactorsInternal medicineTroponin INatriuretic Peptide BrainmedicineNatriuretic peptideHumansRisk thresholdProspective StudiesFramingham Risk Scorebusiness.industryTroponin IAge FactorsMiddle AgedPrognosisPeptide FragmentsSurgeryEuropeBlood pressureC-Reactive ProteinCholesterolCardiovascular DiseasesCohortBiomarker (medicine)FemaleCardiology and Cardiovascular MedicinebusinessBiomarkersEuropean journal of preventive cardiology
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Factors of local recurrence and organ preservation with transoral laser microsurgery in laryngeal carcinomas; CHAID decision-tree analysis.

2018

BACKGROUND Indications of transoral laser microsurgery (TLM) are conditioned by the risk of local relapse. OBJECTIVE To evaluate prognostic factors of local relapse and local control with TLM (LC-TLM). METHODS Local relapse and LC-TLM were evaluated in 1119 patients. Logistic regression and CHAID decision tree analysis were performed. RESULTS Local relapse correlated to previous radiotherapy failure (8.45, CI 95%: 2.64-27.03; P < .001), paraglottic involvement (2.42, CI: 1.41-4.15; P = .001), anterior commissure involvement (2.12, CI: 1.43-3.14; P < .001), grade of differentiation (1.74, CI: 1.18-2.57; P = .005), and alcohol consumption (1.4, CI: 0.99-1.98; P = .057). Local relapse tended t…

AdultMalemedicine.medical_specialtyMicrosurgerymedicine.medical_treatmentAnterior commissureLogistic regression03 medical and health sciencesYoung Adult0302 clinical medicineRisk FactorsMedicineHumansTransoral laser microsurgery030223 otorhinolaryngologyLaryngeal NeoplasmsAgedRetrospective StudiesAged 80 and overbusiness.industryCarcinomaDecision TreesOrgan PreservationMiddle AgedCHAIDSurgeryRadiation therapyLarynx carcinomaLogistic ModelsTreatment OutcomeOtorhinolaryngology030220 oncology & carcinogenesisFemaleLaser TherapyNeoplasm Recurrence LocalbusinessAlcohol consumptionHeadneck
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Adhesive Small Bowel Obstruction: Predictive Factors of Lack of Response in Conservative Management with Gastrografin

2015

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Gastrografin represents a useful tool in the diagnosis and management of adhesive small bowel obstruction (ASBO). The aim of this study is to identify variables with negative influence in nonoperative management with gastrografin. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; From August 2008 to March 2013, 223 consecutive patients with 235 episodes of ASBO were included and received gastrografin. A protocol for prospective data collection was developed. In order to explore factors related to the failure of nonoperative treatment, univariate and multivariate analysis were performed. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; One hundred…

AdultMalemedicine.medical_specialtyMultivariate analysisConservative managementClinical Decision-MakingGastrografinContrast MediaProspective dataTissue Adhesions030230 surgery03 medical and health sciencesPostoperative Complications0302 clinical medicineIntestine SmallmedicineHumansProspective StudiesAdhesive small bowel obstructionProspective cohort studyAgedDiatrizoate MeglumineAged 80 and overbusiness.industryGastroenterologyMiddle Agedmedicine.diseaseCombined Modality TherapySurgeryRadiographyBowel obstructionClinical trialTreatment Outcome030220 oncology & carcinogenesisCohortFemaleSurgerybusinessAdhesive syndromeIntestinal ObstructionPredictive factorsAbdominal surgery
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Personalized Pain Goals and Responses in Advanced Cancer Patients

2020

Abstract Objective To assess the personalized pain intensity goal (PPIG), the achievement of a personalized pain goal response (PPGR), and patients' global impression (PGI) in advanced cancer patients after a comprehensive pain and symptom management. Design Prospective, longitudinal Setting Acute pain relief and palliative/supportive care. Subjects 689 advanced cancer patients. Methods Measurement of Edmonton Symptom Assessment Score (ESAS) and personalized pain intensity goal (PPIG) at admission (T0). After a week (T7) personalized pain goal response (PPGR) and patients' global impression (PGI) were evaluated. Results The mean PPIG was 1.33 (SD 1.59). A mean decrease in pain intensity of …

AdultMalemedicine.medical_specialtyPalliative careAdolescentSymptom assessmentYoung Adult03 medical and health sciences0302 clinical medicineHumansPain ManagementMedicine030212 general & internal medicinePrecision MedicineAcute painAgedPain MeasurementAged 80 and overbusiness.industrySymptom managementMinimal clinically important differenceClinical ResponseGeneral MedicineCancer PainMiddle AgedAdvanced cancerIntensity (physics)Anesthesiology and Pain Medicine030220 oncology & carcinogenesisPhysical therapyFemalePain IntensityNeurology (clinical)businessCancer painGoals
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End-of-life situations in cardiology: a qualitative study of physicians' and nurses' experience in a large university hospital.

2018

IF 2.335 (2-year Impact Factor); International audience; Background: rofessional societies call for integration of end-of-life discussions early in the trajectory of heart failure, yet it remains unclear where current practices stand in relation to these recommendations. We sought to describe the perceptions and attitudes of caregivers in cardiology regarding end-of-life situations.Methods: e performed a qualitative study using semi-directive interviews in the cardiology department of a university teaching hospital in France. Physicians, nurses and nurses’ aides working full-time in the department at the time of the study were eligible. Participants were asked to describe how they experienc…

AdultMalemedicine.medical_specialtyPalliative careAttitude of Health Personnellcsh:Special situations and conditionsClinical Decision-MakingPsychological interventionCardiologyContext (language use)Legislation030204 cardiovascular system & hematologyNursing Staff Hospital03 medical and health sciences0302 clinical medicine[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular systemProfessional-Family RelationsInternal medicinemedicineHumans030212 general & internal medicineQualitative ResearchHeart FailureTerminal Carelcsh:RC952-1245Palliative CareGeneral MedicineProfessional-Patient RelationsMiddle Aged[SDV.ETH] Life Sciences [q-bio]/Ethics[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system[SDV.ETH]Life Sciences [q-bio]/Ethics3. Good healthDistressHospitalistsCardiologyDisease ProgressionProfessional associationFemaleInterdisciplinary CommunicationCardiology Service HospitalFranceThematic analysisPsychologyAdvance DirectivesQualitative researchResearch ArticleEnd-of-lifeBMC palliative care
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Space for intuition - the 'Surprise'-Question in haemato-oncology: Qualitative analysis of experiences and perceptions of haemato-oncologists.

2019

Background: Early integration of palliative care can improve outcomes for people with cancer and non-cancer diagnoses. However, prediction of survival for individuals is challenging, in particular in patients with haematological malignancies who are known to have limited access to palliative care. The ‘Surprise’-Question can be used to facilitate referral to palliative care. Aim: To explore experiences, views and perceptions of haemato-oncologists on the use of the ‘Surprise’-Question in the haemato-oncology outpatients clinics of a university hospital in Germany. Design: A qualitative study using individual semi-structured interviews transcribed verbatim and analysed thematically based on …

AdultMalemedicine.medical_specialtyPalliative careAttitude of Health Personnelmedia_common.quotation_subjectDecision MakingHematologic NeoplasmsHospitals UniversityInterviews as TopicQualitative analysisPerceptionGermanymedicineHumansMedical diagnosisReferral and ConsultationQualitative Researchmedia_commonOncologistsbusiness.industryPalliative CareGeneral MedicineMiddle AgedPrognosisSurpriseAnesthesiology and Pain MedicineFamily medicineHematologic NeoplasmsFemalebusinessIntuitionQualitative researchIntuitionPalliative medicine
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Personalized goal for insomnia and clinical response in advanced cancer patients.

2019

Aim: The aim of this study was to assess the Personalized Insomnia Intensity Goal (PIIG), the achievement of Personalized Goal Response (PGR), and Patient Global Impression (PGI) after a comprehensive symptom management. Patients and methods: Advanced cancer patients admitted to palliative care units rated pain and symptoms intensity and their PIIG by using the Edmonton Symptom Assessment Score (ESAS) (T0). In patients with significant levels of insomnia, the achievement of target expected (PIIG) was measured (patient goal response, PIGR), as well the patient global impression (PGI), by the minimal clinically important difference (MCID), after a comprehensive symptom management (T7). Result…

AdultMalemedicine.medical_specialtyPalliative careInsomniaDecision MakingPainSymptom assessmentGlobal impression of change03 medical and health sciences0302 clinical medicineInternal medicineAdvanced cancerNeoplasmsSleep Initiation and Maintenance DisordersInsomniamedicineHumansPain ManagementIn patient030212 general & internal medicineAgedAged 80 and overSymptom managementbusiness.industryMinimal clinically important differencePalliative CareMiddle AgedAdvanced cancerIntensity (physics)HospitalizationOncology030220 oncology & carcinogenesisPersonalized symptom goalFemalemedicine.symptomSymptom AssessmentbusinessGoalsSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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A systematic approach to medical decision-making of uncommon clinical pictures: A case of ulcerative skin lesions by palm tree thorn injury and a one…

2005

In clinical practice, the clinician is challenged with symptoms and/or signs at times apparently insoluble by diagnostic and/ or therapeutic means. We propose that in these cases, we have to use an EBM approach in which evidence may be looked up in every available clinical report and bibliographic databases are used for searching that evidence. We report on a case of ulcerative skin lesions apparently insoluble by expert dermatologists following a conventional diagnostic and therapeutic process. We use this case report for illustrating a systematic approach to resolve diagnostic and therapeutic questions using a bibliographic database search (like MEDLINE and EMBASE). Both a systematic appr…

AdultMalemedicine.medical_specialtyPathologyOne year follow upmedical decision-makingMEDLINEDecision MakingAlternative medicineMEDLINEthorn injuryulcerative skin lesionWounds PenetratingHealth InformaticsDiagnosis DifferentialClinical reportHealth Information Managementuncommon clinical picturemedicineHumansIntensive care medicineGeneral NursingLegEvidence-Based Medicinebusiness.industryLeg UlcerMedical decision makingDatabases BibliographicBibliographic databasepalm treeItalyPalmbusinessSkin lesionMedical InformaticsMedical Informatics and the Internet in Medicine
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Improvement of non-invasive markers of NAFLD from an individualised, web-based exercise program

2019

BACKGROUND Lifestyle modifications remain the cornerstone of treatment in non-alcoholic fatty liver disease (NAFLD). However, they requently fail related to the inability of patients to implement lasting changes. AIMS To evaluate the effects of a short, web-based, individualised exercise program on non-invasive markers of hepatic steatosis, inflammation and fibrosis. METHODS Patients with histologically confirmed NAFLD underwent an 8-week, web-based, individualised exercise program that contained bidirectional feedback. RESULTS Forty-four patients entered the study and 41 completed the assigned training goal (93.2%). In the completer population, 8 weeks of individualised exercise increased …

AdultMalemedicine.medical_specialtyPopulationGastroenterology03 medical and health sciencesYoung Adult0302 clinical medicineFibrosisNon-alcoholic Fatty Liver DiseaseInternal medicineMedicineHumansPharmacology (medical)030212 general & internal medicineYoung adultExercise physiologyPrecision MedicineeducationExerciseLife Styleeducation.field_of_studyInternetHepatologybusiness.industryFatty liverGastroenterologyMiddle Agedmedicine.disease3. Good healthExercise TherapyQuality of LifeElasticity Imaging Techniques030211 gastroenterology & hepatologyFemaleSteatosisbusinessHepatic fibrosisTransient elastographyBiomarkersAlimentary Pharmacology & Therapeutics
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Nurses' decision-making, practices and perceptions of patient involvement in medication administration in an acute hospital setting.

2019

To describe nurses' decision-making, practices and perceptions of patient involvement in medication administration in acute hospital settings.Medication errors cause unintended harm to patients. Nurses have a major role in ensuring patient safety in medication administration practices in hospital settings. Investigating nurses' medication administration decision-making and practices and their perceptions of patient involvement, may assist in developing interventions by revealing how and when to involve patients during medication administration in hospital.A descriptive exploratory study design.Twenty nurses were recruited from two surgical and two medical wards of a major metropolitan hospi…

AdultMalemedicine.medical_specialtySafety ManagementCritical CareDecision MakingPsychological interventionExploratory researchNursing Staff Hospital03 medical and health sciencesPatient safetyYoung Adult0302 clinical medicinemedicineHumansMedication Errors030212 general & internal medicinePatient participationCase report formGeneral Nursing030504 nursingDescriptive statisticsbusiness.industryAustraliaMiddle AgedHarmFamily medicineFemaleThematic analysisPatient Participation0305 other medical sciencebusinessNurse-Patient RelationsJournal of advanced nursing
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