- A preliminary report on the effect of gabapentin pretreatment on periprocedural pain during in-office posterior nasal nerve cryoablation. [Journal Article]Int Forum Allergy Rhinol 2019IF
- CONCLUSIONS: Preprocedure gabapentin significantly reduces immediate and delayed postprocedural patient discomfort following PNN cryoablation.
- [Caffeine, the most frequently consumed psychostimulant: a narrative review article]. [Journal Article]Fortschr Neurol Psychiatr 2019FN
- Caffeine is the worldwide most frequently consumed psychostimulant. Its availability is nearly unlimited and in Europe it is not subject to state regulation. Apart from its primary role as an ingredient or additive in numerous beverages it also has medical use in apnea of prematurity, as an adjuvant in pain therapy and has regulatory approval for the short-term treatment of symptoms of fatigue. I…
Caffeine is the worldwide most frequently consumed psychostimulant. Its availability is nearly unlimited and in Europe it is not subject to state regulation. Apart from its primary role as an ingredient or additive in numerous beverages it also has medical use in apnea of prematurity, as an adjuvant in pain therapy and has regulatory approval for the short-term treatment of symptoms of fatigue. In doses typically administered caffeine's mechanism of action as a psychostimulant is presumably primarily based on central antagonism at adenosine receptors (A1- und A2A-receptors), which facilitates central inhibition of adenosine-mediated reduction of the activity of the dopaminergic and ascending arousal system. Metabolisation of caffeine mainly depends on cytochrome P450 1A2. Thus, factors that influence the activity of CYP 1A2 (e. g. medication, pregnancy), may induce remarkable changes of pharmacokinetic parameters. Caffeine improves vigilance, attention and reaction time, particularly in sleep-deprived individuals. Moreover, it may improve endurance performances in sports and muscle strength. Intoxications with caffeine are rare, however can be fatal. In general, caffeine use seems not harmful within typical doses of intake. Caffeine features several, however not all characteristics of potentially addictive drugs; withdrawal after termination of a longer period of use and tolerance are known. In the DSM-5 "caffeine use disorder" is categorized as a possible future disorder that currently needs further study. The pattern of caffeine use of patients should be considered in the medical practice.
- Minority stress adds an additional layer to fear of childbirth in lesbian and bisexual women, and transgender people. [Journal Article]Midwifery 2019; 79:102551M
- CONCLUSIONS: LBTs with FOC are a particularly vulnerable group of patients, whose needs must be addressed in healthcare.The findings call attention to the need for LBT-competent treatment prior to, and throughout pregnancy and childbirth. In the most vulnerable patients, caregivers must work extensively to build trust, in order to explore and reduce FOC.
- Psychometric properties of the Slovak version of the Birth Satisfaction Scale (BSS) and Birth Satisfaction Scale-Revised (BSS-R). [Journal Article]Midwifery 2019; 79:102550M
- CONCLUSIONS: The Slovak version of the 10-item BSS-R has been found to have excellent psychometric properties and can be used as a valid outcome measure of birth satisfaction in Slovak hospital settings.
- Women's experiences of waterbirth compared with conventional uncomplicated births. [Journal Article]Midwifery 2019; 79:102547M
- CONCLUSIONS: A waterbirth seems to empower and enhance women's capacity for those who choose this alternative. Waterbirth can improve their birth experience and can possibly make women less dependent on the midwife.To provide waterbirth could be a way of empowering women and giving them a positive birth experience.
- Midwives are getting hurt: UK survey of the prevalence and risk factors for developing musculoskeletal symptoms. [Journal Article]Midwifery 2019; 79:102546M
- CONCLUSIONS: This first survey of UK Midwives reveals a very high prevalence of low back, neck and shoulder symptoms, resulting in sickness absenteeism, reduction in normal activities and changing roles. Age, years in practice, body mass index, working hours, job satisfaction and job stress are contributory factors.This study highlights the prevalence and impact of musculoskeletal symptoms and the potential harmful impacts on their working life and patient care. The findings will promote risk-awareness and national actions for risk management.
- Potential opioid-related adverse events following spine surgery in elderly patients. [Journal Article]Clin Neurol Neurosurg 2019; 186:105550CN
- CONCLUSIONS: Potential ORADEs in spine surgery in elderly patients are common and are associated with longer hospitalizations and decreased hospital revenue. Perioperative pain management strategies that reduce ORADEs may improve patient care and increase hospital revenue.
- Response to "Patient-reported symptom severity among 22,650 cancer outpatients in the last 6 months of life." [Letter]
- Ventilator Withdrawal in Anticipation of Death: The Simulation Lab as an Educational Tool in Palliative Medicine. [Journal Article]
- Simulation is a growing model of education in many medical disciplines. Withdrawal of mechanical ventilation is an important skillset for palliative medicine practitioners who must be facile with a variety of end-of-life scenarios and is well suited to the simulation laboratory. We describe a novel approach using high fidelity simulation to design a curriculum to teach Hospice & Palliative Medici…
Simulation is a growing model of education in many medical disciplines. Withdrawal of mechanical ventilation is an important skillset for palliative medicine practitioners who must be facile with a variety of end-of-life scenarios and is well suited to the simulation laboratory. We describe a novel approach using high fidelity simulation to design a curriculum to teach Hospice & Palliative Medicine (HPM) fellows the practical aspects of managing a compassionate terminal extubation. This simulation session aims to equip palliative fellows with a knowledge base of respiratory physiology and mechanical ventilation as well as the practical experience of performing a terminal extubation. We designed a 3 hour simulation session which includes a one hour didactic followed by 2 hours of simulation, with 4 cases that focus on different teaching points regarding symptom management and practical aspects of removing the endotracheal tube . The session was designed as an annual session for HPM fellows in our region during a collaborative educational conference. Based on feedback, the session is scheduled for the beginning of the academic year and each fellow is given the opportunity to physically remove the endotracheal tube. Simulation can be effectively used to teach practical and complex bedside skills such as withdrawal of mechanical ventilation to palliative medicine trainees. This method of teaching could be expanded to teach other advanced hospice and palliative care skills.
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- Challenges in Implementing Hospice Clinical Trials: Preserving Scientific Integrity While Facing Changing Environments. [Journal Article]
- CONCLUSIONS: Researchers would do well to review their protocol and statistics early in a clinical trial. They should be prepared for adjustments to accommodate market and environmental changes outside their control. Ongoing data monitoring, specifically related to recruitment, is advised.