Search results for "Evidence-based"
showing 10 items of 353 documents
Perioperative antibiotic prophylaxis in plastic surgery: A prospective study of 1100 adult patients.
2011
Summary Background Although guidelines for antibiotic prophylaxis to prevent surgical site infections (SSIs) exist, specific guidelines for plastic surgery are missing and there is a tendency towards excessive administration of antibiotics. A total of 1100 patients were prospectively studied according to an evidence-based protocol to investigate if limiting antibiotic prophylaxis to high-risk cases does increase the infection rate. Methods Between April 2009 and April 2010, 1100 consecutive patients undergoing elective reconstructive or cosmetic procedures were enrolled. Procedures were classified into four groups, and prophylactic antibiotics were only administered perioperatively in 23.4%…
Further Neuroimaging Evidence for the Deficit Subtype of Schizophrenia
2015
The clinical heterogeneity of schizophrenia has hindered neurobiological investigations aimed at identifying neural correlates of the disorder.To identify network-based biomarkers across the spectrum of impairment present in schizophrenia by separately evaluating individuals with deficit and nondeficit subtypes of this disorder.A university hospital network-based neuroimaging study was conducted between February 1, 2007, and February 28, 2012. Participants included patients with schizophrenia (n = 128) and matched healthy controls (n = 130) from two academic centers and patients with bipolar I disorder (n = 39) and matched healthy controls (n = 43) from a third site. Patients with schizophr…
Impact of the WHO depression guideline on patient care by psychiatrists: a randomized controlled trial.
2008
AbstractBackgroundScientific literature reviews aim to summarize the state of knowledge and published empirical evidence. In contrast, medical guidelines are intervention tools that aim to improve physician behaviour and patient outcome. They can have positive effects, but they can also have negative effects. Their effects must be tested by research.MethodsIn a randomized controlled trial, 103 psychiatrists in private practice were either provided with the WHO depression guideline only (information group), or provided with the WHO depression guideline and trained for one day in this guideline (intervention group), or left uninformed (control group). They then treated a total of 497 patients…
Mental distress following inpatient substance use treatment, modified by substance use; comparing voluntary and compulsory admissions
2017
Background Treatment services to patients with substance use disorders (SUDs), including those mandated to treatment, needs to be evaluated and evidence based. The Norwegian Municipal Health Care Act (NMHCA) calls for compulsory treatment for persons with “severe and life-threatening substance use disorder” if these individuals are not otherwise willing to be voluntarily treated and consequently risk their lives over drug use. Mental distress is known to be high among SUD patients admitted to inpatient treatment. The purpose of this study is to describe changes in mental distress from admission to a 6-month follow-up in patients with SUDs, which underwent either voluntary or compulsory trea…
Individualizing Standardized Tests
2013
Author's version of an article in the journal: Qualitative Health Research. Also available from the publisher at: http://dx.doi.org/10.1177/1049732313499073 In assessing geriatric patients' functional status, health care professionals use a number of standardized tests. These tests have defined administration procedures that restrict communication and interaction with patients. In this article, we explore the experiences of occupational therapists and physiotherapists acting as standardized test administrators. Drawing on fieldwork, interviews with physiotherapists and occupational therapists, and observations of test situations on acute geriatric wards, we suggest that the test situation g…
Changes in Health Utility, Disability, and Health-Related Quality of Life in Patients After Spinal Fusion
2014
STUDY DESIGN Prospective longitudinal database study. OBJECTIVE To evaluate changes in health utility, disability, and health-related quality of life (HRQOL) in patients undergoing spinal fusion. SUMMARY OF BACKGROUND DATA Recently, measuring disability, HRQOL, and health utility has become important when defining the value of surgical interventions. METHODS Data of spinal fusion patients from a prospective longitudinal database were analyzed. Health utility was captured by SF-6D (six dimensional health state classification from the 36-dimensional Short Form Health Survey) score, disability by Oswestry Disability Index, and HRQOL by the 36-Item Short Form Health Survey. The changes in these…
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…
Prevention of haemophilic arthropathy during childhood. May common orthopaedic management be extrapolated from patients without inhibitors to patient…
2008
We recommend prophylaxis in haemophilic children with an inhibitor as a way of preventing the musculoskeletal impairment that is likely to affect them. This approach has been used for children without inhibitors with excellent results. If prophylaxis is not feasible, we suggest that intensive on-demand treatment should be given. Two agents, recombinant activated FVII (rFVIIa) and activated prothrombin complex concentrates (aPCC), are currently used to control haemostasis either for prophylaxis or intensive on-demand treatment. As it is recombinant, rFVIIa would seem more appropriate to be employed in children. aPCC could be used in adults, or in the event of an unsatisfactory response to rF…
Access to an online video enhances the consent process, increases knowledge, and decreases anxiety of caregivers with children scheduled for inguinal…
2019
Abstract Background There is limited time within the clinical workflow of most pediatric surgeons to obtain a comprehensive, well informed consent. This study evaluates whether ad-lib access to an online video on the consent dialogue enhances the consent process for inguinal hernia repair (IHR) in children. Methods The study was approved by the state ethics board. A 6-min video of a consent speech on IHR was produced and uploaded to a nonpublic online channel, explaining the condition, procedure, complications, and postoperative expectations. A total of 50 families were randomized to conventional, face-to-face consenting in clinic either with (intervention) or without (control) access to th…
Mesh or no mesh: a hamletic dilemma to prevent Renal Allograft Compartment Syndrome (RACS)
2014
Tension-free muscle closure is essential in kidney transplantation, both in adult and pediatric patients. Tight muscle closure may lead to renal allograft compartment syndrome either due to compression of the renal parenchyma or due to kinking of the renal vessels. It may also cause kinking of the transplant kidney ureter, wound dehiscence and incisional hernia. Many techniques have been proposed in an attempt to achieve tension-free closure. There is a wrong belief among surgeons that using prosthetic mesh may increase the incidence of infective complications in these immunosuppressed patients. Also, there is fear that one is not able to monitor the renal graft by ultrasound and perform bi…