Estrogens and melanoma: an important clinical question

2012 ◽  
Vol 7 (6) ◽  
pp. 587-588
Author(s):  
Maria Luisa Brandi
Keyword(s):  
Clinical Question ◽  
Important Clinical Question

1. German Retrospect

1883 ◽  
Vol 29 (127) ◽  
pp. 425-432
Author(s):  
W. W. Ireland
Keyword(s):  
Single Case ◽  
Careful Examination ◽  
Clinical Question ◽  
Common Cause ◽  
Mental Disturbance ◽  
Third Line ◽  
Uterine Diseases ◽  
Important Clinical Question

Dr. Ripping, in the “Zeitschrift für Psychiatrie (Band xxxix., Heft 1), considers the important clinical question of the relation of the diseases of the sexual organs in women to mental alienation. While he admits that changes in the uterus and its appendages, whether physiological or pathological, have an effect upon the mental susceptibilities of women, he is doubtful whether this effect is profound enough to become a potent cause of insanity. He is rather disposed to place such affections in the second or third line of causes as adjuvantia. The uterine diseases and the mental disturbance are sometimes the result of a common cause. “I have never observed,” writes Dr. Ripping, “a single case in which the insanity was a pure reflex neurosis of disease of the genital organs.” If in some patients this seemed to be probable, it was found on more careful examination that there were other circumstances which gave an easy and unforced explanation of the mental derangement. It is only after uterine disorders which, from their severity, implicate the whole organism, or lower the strength, as in continued bleedings, that insanity can be held to supervene as a result.

scholarly journals Unexplained chronic cytopenia: is it idiopathic cytopenia of undetermined significance or myelodysplastic syndrome

2019 ◽  
Vol 12 (10) ◽  
pp. e231323 ◽  
Author(s):  
Preethi Ramachandran ◽  
Burak Erdinc ◽  
Sonu Sahni ◽  
Boris Avezbakiyev
Keyword(s):  
Bone Marrow ◽  
Flow Cytometry ◽  
Myelodysplastic Syndrome ◽  
Peripheral Blood ◽  
Bone Marrow Failure ◽  
Genomic Analysis ◽  
Bone Marrow Examination ◽  
Clinical Question ◽  
Important Clinical Question ◽  
Undetermined Significance

Idiopathic cytopenia is a condition where there is a decrease in peripheral blood counts causing either anaemia, leucopoenia and thrombocytopaenia. Most cases of cytopenia reveal a cause on further workup. But very rarely, in some cases, a definitive cause could not be identified. Unexplained cytopenia becomes challenging and poses difficulty in diagnosis and management. Discriminating these groups of bone marrow failure disorders from myelodysplastic syndrome (MDS) becomes an important clinical question. We describe a case of a middle-aged Hispanic woman who presented with pancytopenia and on extensive workup did not reveal any specific cause. Her bone marrow examination revealed severely reduced megakaryocytes but with normal haemopoiesis of other lineages. Cytogenetics, flow cytometry, comprehensive next-generation whole genomic analysis did not reveal any abnormalities. She fit the criteria for idiopathic cytopenia of undetermined significance rather than MDS. She remained asymptomatic and her counts never improved with immunosuppressives or thrombopoietin mimetics.

scholarly journals Countercurrents: The Last Trial

2021 ◽  
Vol 28 (1) ◽  
pp. 275-277
Author(s):  
Steven A. Narod
Keyword(s):  
Clinical Question ◽  
Important Clinical Question

If you have been around long enough, you will have heard more than once that an important clinical question is about to be resolved by a study that is soon to be published [...]

scholarly journals The yield and usefulness of PAIN+ and PubMed databases for accessing research evidence on pain management: a randomized crossover trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vanitha Arumugam ◽  
Joy C. MacDermid ◽  
Dave Walton ◽  
Ruby Grewal
Keyword(s):  
Clinical Practice ◽  
Pain Management ◽  
Search Engine ◽  
Crossover Trial ◽  
Perceived Usefulness ◽  
Similar Process ◽  
Clinical Question ◽  
Current Clinical Practice ◽  
Search Terms ◽  
Randomized Crossover Trial

Abstract Introduction PAIN+ and PubMed are two electronic databases with two different mechanisms of evidence retrieval. PubMed is used to “Pull” evidence where clinicians can enter search terms to find answers while PAIN+ is a newly developed evidence repository where along with “Pull” service there is a “Push” service that alerts users about new research and the associated quality ratings, based on the individual preferences for content and altering criteria. Purpose The primary purpose of the study was to compare yield and usefulness of PubMed and PAIN+ in retrieving evidence to address clinical research questions on pain management. The secondary purpose of the study was to identify what search terms and methods were used by clinicians to target pain research. Study design Two-phase double blinded randomized crossover trial. Methods Clinicians (n = 76) who were exposed to PAIN+ for at least 1 year took part in this study. Participants were required to search for evidence 2 clinical question scenarios independently. The first clinical question was provided to all participants and thus, was multi-disciplinary. Participants were randomly assigned to search for evidence on their clinical question using either PAIN+ or PubMed through the electronic interface. Upon completion of the search with one search engine, they were crossed over to the other search engine. A similar process was done for a second scenario that was discipline-specific. The yield was calculated using number of retrieved articles presented to participants and usefulness was evaluated using a series of Likert scale questions embedded in the testing. Results Multidisciplinary scenario: Overall, the participants had an overall one-page yield of 715 articles for PAIN+ and 1135 articles for PubMed. The topmost article retrieved by PAIN+ was rated as more useful (p = 0.001). While, the topmost article retrieved by PubMed was rated as consistent with current clinical practice (p = 0.02). PubMed (48%) was preferred over PAIN+ (39%) to perform multidisciplinary search (p = 0.02). Discipline specific scenario: The participants had an overall one-page yield of 1046 articles for PAIN+ and 1398 articles for PubMed. The topmost article retrieved by PAIN+ was rated as more useful (p = 0.001) and consistent with current clinical practice (p = 0.02) than the articles retrieved by PubMed. PAIN+ (52%) was preferred over PubMed (29%) to perform discipline specific search. Conclusion Clinicians from different disciplines find both PAIN+ and PubMed useful for retrieving research studies to address clinical questions about pain management. Greater preferences and perceived usefulness of the top 3 retrieved papers was observed for PAIN+, but other dimensions of usefulness did not consistently favor either search engine. Trial registration Registered with ClinicalTrials.gov Identifier: NCT01348802, Date: May 5, 2011.

The Use of Breathing Exercises in the Treatment of Chronic, Nonspecific Low Back Pain

2017 ◽  
Vol 26 (5) ◽  
pp. 452-458 ◽  
Author(s):  
Barton E. Anderson ◽  
Kellie C. Huxel Bliven
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
Lung Function ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Low Back ◽  
Bottom Line ◽  
Breathing Exercises

Clinical Scenario:Research has shown a link between poor core stability and chronic, nonspecific low back pain, with data to suggest that alterations in core muscle activation patterns, breathing patterns, lung function, and diaphragm mechanics may occur. Traditional treatment approaches for chronic, nonspecific low back pain focus on exercise and manual therapy interventions, however it is not clear whether breathing exercises are effective in treating back pain.Focused Clinical Question:In adults with chronic, nonspecific low back pain, are breathing exercises effective in reducing pain, improving respiratory function, and/or health related quality of life?Summary of Key Findings:Following a literature search, 3 studies were identified for inclusion in the review. All reviewed studies were critically appraised at level 2 evidence and reported improvements in either low back pain or quality of life following breathing program intervention.Clinical Bottom Line:Exercise programs were shown to be effective in improving lung function, reducing back pain, and improving quality of life. Breathing program frequencies ranged from daily to 2–3 times per week, with durations ranging from 4 to 8 weeks. Based on these results, athletic trainers and physical therapists caring for patients with chronic, nonspecific low back pain should consider the inclusion of breathing exercises for the treatment of back pain when such treatments align with the clinician’s own judgment and clinical expertise and the patient’s preferences and values.Strength of Recommendation:Grade B evidence exists to support the use of breathing exercises in the treatment of chronic, nonspecific low back pain.

Clinical Question

2007 ◽  
Vol 11 (2) ◽  
pp. 122
Author(s):  
Thomas M. Julian ◽  
Mark Spitzer ◽  
Leo Twiggs
Keyword(s):  
Clinical Question

The Effectiveness of a Psychoeducational Program in Increasing Mental Health Knowledge in Collegiate Athletes: A Critically Appraised Topic

2021 ◽  
pp. 1-5
Author(s):  
Alexis Peters ◽  
Julliana Tapia ◽  
Stephanie H. Clines
Keyword(s):  
Mental Health ◽  
Student Athletes ◽  
Health Knowledge ◽  
Collegiate Athletes ◽  
Clinical Question ◽  
Bottom Line ◽  
Psychoeducational Program ◽  
Mental Health Knowledge

Focused Clinical Question: Does the implementation of a psychoeducational program increase mental health knowledge among collegiate student-athletes? Clinical Bottom Line: There is consistent, limited-quality patient-oriented evidence to suggest that implementation of a psychoeducational program is effective in increasing mental health knowledge in collegiate student-athletes based on the guidelines of the strength of recommendation taxonomy.

Oral Food Challenges: The Design must Reflect the Clinical Question

2015 ◽  
Vol 15 (8) ◽  
Author(s):  
Mary Feeney ◽  
Tom Marrs ◽  
Gideon Lack ◽  
George Du Toit
Keyword(s):  
Clinical Question ◽  
Food Challenges
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