International journal of clinical practice
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Int. J. Clin. Pract. · Dec 2020
Patient and Physician Perceptions of Knee and Hip Osteoarthritis Care: A Qualitative Study.
Knee and hip osteoarthritis (KHOA) are common, chronic conditions affecting function, morbidity and mortality. Although the societal burden is high and guidelines are available to guide management, many patients do not receive recommended care. We investigated patient and physician perspectives on barriers and facilitators to KHOA guideline-based treatment and patient experiences in living with KHOA and navigating care. ⋯ Although evidence-based treatments for KHOA exist, our study highlights patient and physician barriers to receipt of this care. Better educational resources and new models of care to address these barriers may contribute to improved osteoarthritis management.
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Int. J. Clin. Pract. · Dec 2020
A Nurse-led Atrial Fibrillation Clinic: Impact on Anticoagulation Therapy and Clinical Outcomes.
Nurses play a central role in the management of atrial fibrillation (AF) patients. An unresolved question is whether a nurse-led clinic would improve clinical outcomes. Herein, we investigated the impact of a nurse-led clinic on anticoagulation therapy and clinical outcomes in a cohort of naïve AF patients. ⋯ A nurse-led AF clinic may offer a "patient-centered" review and holistic follow-up, and it would be associated with a reduction of ischaemic stroke/TIA, without increasing bleeding complications. Further studies should confirm these results.
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Int. J. Clin. Pract. · Dec 2020
Randomized Controlled TrialComparing the different oxycodone doses of prevent oxycodone for prevention of preventing fentanyl-induced cough during induction of general anesthesia.
Fentanyl-induced cough (FIC) usually occurs after the intravenous administration of fentanyl during general anaesthesia induction. It is a transient condition depending on the fentanyl administration dose and injection speed. Oxycodone can also prevent FIC because it has been proven to treat coughing. This study aimed to evaluate the efficacy of different oxycodone doses to prevent FIC during general anaesthesia induction. ⋯ Oxycodone 0.075 mg/kg provided more effective FIC prevention during general anaesthesia induction.
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Urea is an emollient widely used in clinical dermatology to moisturise and protect the skin. Non-invasive techniques can be useful in evaluating and quantifying the moisturising and hydrating properties of topically applied urea. Amongst these, transepidermal water loss, skin conductance and capacitance are the most widely used. ⋯ Ultrasound and mechanical properties can be used to investigate the effects on skin smoothness and tone. In conclusion, urea is a fundamental ingredient of cosmetic and dermatological formulations and can have several positive effects on skin function. These can be easily investigated and monitored using non-invasive techniques measuring the stratum corneum function.
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Int. J. Clin. Pract. · Dec 2020
Randomized Controlled TrialA Comparative Study for the Effects of Nifedipine GITS and Amlodipine Besylate Administrated in Daytime or at Nighttime on Recovery of Blood Pressure Rhythm and Arterial Stiffness in the Young and Middle-aged Subjects with Non-dipper Hypertension (NARRAS): Design and Rationale.
Hypertensive patients with a blunted or absent nocturnal blood pressure (BP) drop (non-dipper) are associated with arterial stiffening and additional cardiovascular risk. Non-dipper hypertension is prevalent in young and middle-aged adults; but the optimal antihypertensive strategy remains unclear. There is a need to explore the effects of different antihypertensive agents and time of administration on recovery of dipper rhythm and arterial stiffness in this population. ⋯ NARRAS study is the first RCT to evaluate the effects of nifedipine GITS and amlodipine besylate on restoration of dipping rhythm and arterial elasticity, either administrated in the morning or evening, in younger non-dipper hypertensive subjects. The findings of NARRAS are likely to be potential to facilitate new therapeutic strategies for this condition.