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All participants indicated that they were interested in a tool that addresses pain, memory and concentration. The main features that participants wanted were pain and symptom tracking as well as suggestions based on tracking information.
Patients are interested in using technology to help with self-management of their pain and symptoms following mTBI. Tools that help patients with self-management should integrate into health systems and provide ways to effectively interact with providers during the most vulnerable phases of recovery.
Patients are interested in using technology to help with self-management of their pain and symptoms following mTBI. Tools that help patients with self-management should integrate into health systems and provide ways to effectively interact with providers during the most vulnerable phases of recovery.
Many patients report questionable drug hypersensitivity reactions (DHR) to betalactam antibiotics. A workup is required for objectivation. Direct drug provocation tests (DPTs) omitting a prior allergy workup are increasingly recommended as the primary diagnostic approach. However, apart from the risk of severe side effects, DPTs often are a scarce resource in overloaded healthcare-systems. We investigated how many cases can be solved by drug-specific history, drug-specific IgE, and skin tests obviating the need for DPT.
We conducted a chart review in a retrospective cohort of 932 patients in an allergy outpatient centre from 2016 to 2017. Patients had been submitted to drug-specific history and specific IgE-, skin prick-, intradermal- and patch-tests with early and late readings with a series of penicillins and cephalosporins but DPTs were no option.
Overall, positive invitro and/or skin tests were found in 96/932 (10.3%) patients. Drug-specific IgE was detected in 40/932 (4.3%) patients, 61/787 (7.8%) patients had positive skin tests. Invitro tests to Pencillin V showed the highest rate of positivity 24/479 (5.0%) and early readings of ampicillin the highest amongst the skin tests (3/49, 6.1%). #link# Immediate skin tests were more often positive than delayed ones (7545). The combination of all parameters including drug-specific history solved 346/932 (37.1%) cases while 586/932 (62.9%) remained unresolved. Self-reported DHR could be less often confirmed in females and young children (p<0.05).
Testing with betalactams applying simple, cheap, and safe skin and blood tests can solve a third of DHR-cases on a high throughput scale.
Testing with betalactams applying simple, cheap, and safe skin and blood tests can solve a third of DHR-cases on a high throughput scale.
Neoadjuvant chemoradiotherapy (nCRT) followed by surgery in patients with resectable esophageal or esophagogastric junctional (GEJ) (Siewert I) cancer is associated with long term overall survival benefits. Up to one third of all patients submitted to nCRT present pathological complete response (pCR).
F-fluorodeoxyglucose positron emission tomography with CT (
F-FDG PET-CT) is an important tool for assessing treatment response. Purpose was to assess retrospectively the power of
F-FDG PET-CT in predicting pCR to evaluate the feasibility of a "watch and wait" approach.
Retrospective analysis of a prospective database with esophageal or GEJ submitted to pre-operative chemoradiation. Pre and pos treatment
F-FDG PET-CT were reviewed and classified using visual assessment and PERCIST criteria and the values of maximum standard uptake value were also recorded. Patients were classified as pCR or non-PCR.
F-FDG PET-CT and pathological findings were compared against each other.
Forty-three patients were included. The median age was 67 years and 90.7% were male. All patients underwent preoperative CRT and were evaluated with
F-FDG PET-CT pre and post treatment. Transthoracic surgery was performed in all patients. Histological type was adenocarcinoma in 37% and squamous cell carcinoma in 58%. pCR was achieved in 56% of cases. Visual assessment of
F-FDG PET-CT showed overall sensitivity 57.9%, specificity 62.5% and PERCIST criteria had 100% sensibility and 16.7% specificity.
F-FDG PET-CT is not an ideal predictor of pCR but if we use the PERCIST criteria we will have a high sensitivity and negative predictive value, avoiding false negative scans.
18F-FDG PET-CT is not an ideal predictor of pCR but if we use the PERCIST criteria we will have a high sensitivity and negative predictive value, avoiding false negative scans.The COVID-19 pandemic has disrupted parasitology curricula worldwide, which is expected to lead to the reshaping of parasitology education. Here, UNC2250 price share our experiences of remote teaching and learning of veterinary parasitology and discuss opportunities offered by remote teaching during COVID-19 lockdowns, enabling the development of interactive online parasitology courses.
One-way speaking valves were first engineered to improve communication in patients with tracheostomies. More recently, additional indications for one-way speaking valves have been explored, including improving ventilation, weaning, and reducing aspiration; however, safety and adverse events have not been well defined.
The aim of this study was to examine the cardiorespiratory changes that occur with prolonged use of a one-way speaking valve in relation to safety and efficacy.
A prospective observational study of adult patients (n=20) was carried out in a tertiary level intensive care unit. Continuous monitoring of cardiorespiratory parameters, including heart rate (beats per minutes), respiratory rate (breaths per minute), systolic, diastolic, and mean arterial pressure (mmHg), and oxygen saturations (%), was conducted for 2h whilst participants used a one-way speaking valve. The participants then continued to use the one-way speaking valve as long as tolerated. Data are reported as median and range (non-normative data) or as mean±standard deviation(normative data).
The time to tracheostomy was 17.5 (range=7-54) days after the initiation of mechanical ventilation, and the time to first use of the one-way speaking valve was 11.4 days (standard deviation=5.46) after tracheostomy. The participants tolerated using a one-way speaking valve (for more than 2h) after a median of 2 (range= 1-8) days from first use. There were no significant changes to any cardiorespiratory parameters over the 2-h period and also no adverse events in this study whilst participants used one-way speaking valves for up to 17 (range=5.5-17) hours.
The prolonged use of a one-way speaking valve is safe for patients who reached a threshold of 2h.
The prolonged use of a one-way speaking valve is safe for patients who reached a threshold of 2 h.
