Effective management of adverse events (AEs) is important to prevent treatment discontinuation and optimize hepatitis C virus infection eradication rates. The addition of direct-acting antiviral agents, telaprevir (TVR) or boceprevir to pegylated interferon (PEG-IFN) and ribavirin (RBV) represents a new era of therapy associated with an improvement in treatment response ...

PURPOSE: Clinical pathways are an important tool used to manage the quality in health care by standardizing processes. This study evaluated the impact of the implementation of a peer-reviewed clinical pathway in a large, integrated National Cancer Institute-Designated Comprehensive Cancer Center Network. METHODS: In 2003, we implemented a clinical pathway ...

To ascertain the surveillance and management practices for tracheotomy patients. Survey of tracheotomy management. An electronically distributed 26-question survey was distributed under the auspices of the American Academy of Otolaryngology-Head and Neck Surgery Foundation. There were 478 responses. The mean number of years in practice was 21.2 years (standard deviation ...

Contingency management (CM) is widely recognized as an evidence-based practice, but it is not widely used in either treatment settings or justice settings. CM is perceived as adaptable in justice settings given the natural inclination to use contingencies to improve compliance to desired behaviors. In the Justice Steps implementation study, ...

OBJECTIVE: To determine the best management of retrograde ejaculation to optimize the chance of conception. DESIGN: Systematic review. SETTING: Tertiary reproductive medicine center. PATIENT(S): Subfertile men with retrograde ejaculation. METHOD(S): Systematic search of studies using search terms "management" or "therapy" or "treatment" and "retrograde ejaculation." We excluded case reports and ...

The study was conducted in the central rift valley of Ethiopia to define Arsi-Bale goat keepers' breeding objectives and breeding practices and to describe flock management practices and rate of inbreeding in Arsi-Bale goat population. Two-stage sampling techniques were employed to select study sites and 202 respondents. Semistructured questionnaire and ...

While the complaints process is intended to improve healthcare, some doctors appear to practise defensive medicine after receiving a complaint. This response occurs in countries that use a tort-based medicolegal system as well as in countries with less professional liability. Defensive medicine is based on avoiding malpractice liability rather than ...

Arsenic trioxide has been used in traditional Chinese medicine for over 5000 years, but lost its appeal due to its toxicity. It was rediscovered in western medicine and enjoyed a renaissance from 1830 to 1930, as the first effective chemotherapy against syphilis, parasites and leukaemia. These years were also a ...

Objectives The British honours system is one of the oldest in the world rewarding individuals, including those of the medical profession. The authors were interested to see if any particular specialty was honoured to a greater extent. We aimed to establish the number of those honoured, the duration of clinical ...

Massive bleeding accounts for more than 50% of all trauma-related deaths within the first 48h following hospital admission and it can significantly raise the mortality rate of any kind of surgery. Despite this great clinical relevance, evidence on the management of massive bleeding is surprisingly scarce, and its treatment is ...

Reasons for performing study: Improved education of veterinarians and equine owners/managers is essential in implementing parasite control strategies that are less reliant on chemicals. Methods: This questionnaire study, conducted on 61 UK Thoroughbred (TB) establishments during 2009 and 2010, was designed to obtain an understanding of current helminth control practices ...

Indian system of medicine describes the usage of certain very toxic plant based drugs after performing a detoxification process (Shodhana samskara). Nerium indicum is traditionally used as a medicine though known to cause severe allergic symptoms, tachycardia and gastrointestinal effects leading to fatalities. In this study, the detoxification (shodhana) for ...

Studies published in general and specialty medical journals have the potential to improve emergency medicine (EM) practice, but there can be delayed awareness of this evidence because emergency physicians (EPs) are unlikely to read most of these journals. Also, not all published studies are intended for or ready for clinical ...

Introduction: Chronic urticaria is characterized by recurring episodes of spontaneous transient dermal wheals and pruritus, with or without angioedema, which can persist for ≥ 6 weeks. Chronic urticaria impairs quality of life, emphasizing the need for effective treatments. Professional societies and clinical experts have issued evidence-based recommendations for the management ...

ABSTRACT: BACKGROUND: Poor access to prompt and effective treatment for malaria contributes to high mortality and severe morbidity. In Kenya, it is estimated that only 12% of children receive anti-malarials for their fever within 24 hours. The first point of care for many fevers is a local medicine retailer, such ...

PURPOSE: To study the types, causes, and consequences of academic health center (AHC) "elephants," which the authors define as obvious problems that impair performance but which the community collectively does not discuss or confront. METHOD: Between April and June 2010, the authors polled all the chairs of departments of medicine ...

Introduction.  Despite the growing importance of clinical guidelines, their adoption has encountered significant resistance among clinicians. We developed Standardized Clinical Assessment and Management Plans (SCAMPs) as an innovative, clinician-led approach to building, implementing, and constantly improving flexible guidelines. We hypothesized that SCAMPs would fit well within the culture of medicine ...

: We compared distress parameters and career satisfaction from survey results of surgeons from 14 specialties practicing in an academic versus private practice environment. : The 2008 American College of Surgeons survey evaluated demographic variables, practice characteristics, career satisfaction, and distress parameters using validated instruments. : The practice setting (academic ...

OBJECTIVE:: Few, if any, US studies have examined rates of criminal behaviors among patients in clinical samples. According to findings from non-US studies, mostly in psychiatric samples, rates of criminal behavior are higher than in the general population. In this study, we examined the prevalence of criminal behaviors in an ...

Objective: Psychiatry is awash with pharmacological acute behavioural disturbance protocols which list oral or intramuscular benzodiazepines and antipsychotics with numerous options. This results in frequent over-sedation and occasional profound sedation and death. This paper describes the development of a simplified sedation protocol for the pharmacological management of acute behavioural disturbance. ...

On 26 March 2011, when Parliament was dissolved for a federal election, Bill C-393 died on the Order Paper. The bill addressed flaws in Canada's Access to Medicines Regime (CAMR), which is supposed to facilitate the export of lower-cost medications, including HIV treatments, to developing countries.

Objective To assess current experiences and attitudes of hospital based paediatricians towards off-label medicine prescribing. Setting Paediatric hospital wards and out-patient clinics. Design A prospective, questionnaire based study. Results A 30 item questionnaire was sent to 300 hospital based paediatricians and 250 (83%) were returned completed. Over 69% of responders ...

Traditional medicine is believed to constitute a crucial healthcare option for poor or remote households in developing countries that have limited access to allopathic medicine and/or a strong cultural attachment to traditional medicine. However, little research has been performed on medicinal plant reliance in developing countries, and the determinants of ...

ABSTRACT: BACKGROUND: Evidence based medicine plays a crucial role as a tool that helps integrate research evidence into clinical practice. However, few reports have yet to examine its application in daily practice among resident physicians in Japan. The aim of this study was to assess the attitudes towards and knowledge ...

PURPOSE: The aim of the present investigation was to document the phytotherapeutic knowledge and veterinary healthcare management practices among the Tharu tribal community of Uttar Pradesh, India and to determine the consensus of such practices, in order to evaluate the potential for new veterinary drugs of herbal origin. METHODS: This ...

Objective-To identify changes in the teaching of nontechnical skills, knowledge, aptitudes, and attitudes (SKAs) at US colleges and schools of veterinary medicine between 1999 and 2009. Design-Cross-sectional survey. Sample-All 28 US colleges and schools of veterinary medicine. Procedures-An electronic questionnaire was sent to the entire study population. Results were compared ...

ABSTRACT: BACKGROUND: Clinical practice guidelines (CPGs) have become increasingly popular and the methodology to develop guidelines has evolved enormously. However, little attention has been given to the updating process, in contrast to the selection and appraisal of the available literature. We conducted an international survey to identify current practices in ...

Background:Artificial nutrition support is used in treating hospital patients and has been shown to reduce hospital stays. The NICE (National Collaborating Centre for Acute Care) guidelines are the first national consensus guidelines for dietetic practice in artificial nutrition. The aim of the current survey was to explore the influence of ...

Oesophageal soft food bolus obstruction (OSFBO) is a surgical emergency. However, no national guidelines exist regarding its management. This paper systematically reviews the literature with respect to the management of OSFBO. Relevant studies included were identified from the the Cochrane Library, the National Center for Biotechnology Information and the US ...

In 2007, a descriptive survey was mailed to all dairies in Glenn (G) and Tulare (T) Counties to identify current and future opportunities of manure management practices on California dairies. The purpose was to provide baseline information for development of outreach curriculum and a decision support tool to quantify potential ...

ABSTRACT: BACKGROUND: Animals have been used as medicinal resources throughout human history. Majority of wildlife used in traditional medicines is taken from the wild; hence demand by traditional medicine is a cause of over-exploitation of wild animals. Indiscriminate use of endangered species portends grievous implications for biodiversity conservation. This study ...

Research suggests that fairness perceptions matter to people who are asked to evaluate the acceptability of risks or risk management. Two separate national random surveys (n = 305 and n = 529) addressed Americans' concerns about and acceptance of nanotechnology risk management in the context of the degree to which they view scientists ...

Oral mucositis (OM) is a frequent adverse effect of allogenic or autologous hematopoietic SCT. It results from direct toxic injury to the mucosal epithelial cells by the immunosuppressive regimen. Here, we compared the incidence and severity of OM between a group of 24 patients who received proper oral management during ...

We provide a didactic example of how clinical trials can accommodate individualised patient information relative to design and analysis.

To describe an extensive process to implement guidelines for oxytocin use during labor and to report its effects on compliance to clinical practice guidelines after 1year. A multifaceted strategy was developed to involve all obstetric staff and identify possible local barriers to change in advance. The process lasted for more ...

ABSTRACT: BACKGROUND: Adverse drug reactions (ADRs) contribute to ill-health or life-threatening outcomes of therapy during management of infectious diseases. The exposure to anti-malarial and use of mobile phone technology to report ADRs following drug exposures were investigated in Sagamu - a peri-urban community in Southwest Nigeria. METHODS: Purchase of medicines ...

Purpose: To survey the practice of uveitis experts in the management of uveitic cataract and cystoid macular oedema (CMO). Methods: A structured questionnaire containing two clinical scenarios was sent to members of the International Uveitis Study Group (IUSG). The questionnaire surveyed both respondents' current practice and their perception of the ...

Background. Many studies have found acute gastrointestinal infections to be among the most likely reason for clinic visits among forward deployed soldiers and are considered a significant contributor to morbidity in this population. This occurs despite the controlled food and water distribution systems under which military populations operate. Furthermore, recent ...

Background/Objective: This study sought to determine whether case management was positively associated with improved outcomes and treatment compliance in those enrolled in a methadone maintenance treatment (MMT) program. Methods: An intervention group (n = 396) received case management while the other group (n = 1308) did not. Total N = ...

Medical herbalism is the most widespread and the most ancient form of medicine. This paper offers an account of medical herbalism in Malawi, and discusses the role of medicines - both plant and animal substances - in the social life of the matrilineal peoples of Malawi. It aims to counter ...

There is a paucity of audits in the speciality of Obstetrics and Gynaecology to estimate the standard of documentation of operation notes. Evidence from several audits across all specialities indicates the overall standard of reporting and documentation in medicine is poor, with many reports failing to contain important and pertinent ...

Newer medications have improved physicians' ability to control seizures, but have made epilepsy management even more complex. Here's how to find the most effective and safest treatment for your patient.

We describe the use of a new molecular assay for Trichomonas vaginalis (TV), the Gen-Probe Aptima TV (ATV) in female attendees at community clinics, a genitourinary (GU) medicine clinic and a prison GU medicine service. Positivity rates at community clinics and GU medicine were 0/382 (0%) and 3/358 (0.8%, 95% ...

Effective management of large protected conservation areas is challenged by political, institutional and environmental complexity and inconsistency. Knowledge generation and its uptake into management are crucial to address these challenges. We reflect on practice at the interface between science and management of the Greater Blue Mountains World Heritage Area (GBMWHA), ...

AIM: This paper serves to document and make known the folk medicinal uses of animals and animal products in the western part of the province of Granada (Andalusia, Spain), analyzing not only the species used, the administration methods and the ailments treated, but also the cultural implications of this traditional ...

PURPOSE: Although multimodal management of extremity soft tissue sarcoma (STS) is the standard of care, considerable variation exists in the sequencing of radiotherapy (RT) or chemotherapy (CT). Our goal was to identify factors responsible for this variation. METHODS: Members of specialty societies with an interest in STS were emailed a ...

Pedigree analysis constitutes a classical approach for the study of the evolution of genetic diversity, genetic structure, history and breeding practices within a given breed. As a consequence of selection pressure, management in closed populations and historical bottlenecks, many dog breeds have experienced considerable inbreeding and show (on the basis ...

Our complex health care system will not be error free for the foreseeable future. Certain interventions must be put into place to manage that risk, and staffing effectiveness is a critical part of clinical risk management. Application of research and practice can create a basis for a proactive risk management ...

From April 2008 to March 2010 in BEACH (Bettering the Evaluation and Care of Health), eczema was managed at a rate of 1.5 per 100 encounters, suggesting that it was managed by general practitioners about 1.8 million times per year nationally.

The Occupational Medicine Forum is prepared by the ACOEM Occupational and Environmental Medical Practice Committee and does not necessarily represent an official ACOEM position. The Forum is intended for health professionals and is not intended to provide medical or legal advice, including illness prevention, diagnosis or treatment, or regulatory compliance. ...