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1.
N Z Vet J ; 71(1): 27-32, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36165091

RESUMO

AIMS: To describe basic husbandry (veterinary care, substrate and bedding, toys, frequency of cleaning) provided to guinea pigs (Cavia porcellus) by a sample of owners in New Zealand. METHODS: Respondents were invited to complete a survey disseminated through the social media channels of animal interest and advocacy groups (3 September 2020 to 3 November 2020). Respondents who agreed to participate were asked a range of questions regarding the provision of husbandry to their oldest pet guinea pig. Descriptive statistics are reported here relating to husbandry, length of ownership, provision of substrate, bedding and toys, frequency of cleaning and veterinary care. RESULTS: A total of 503 responses were received, of which 329 complete responses were analysed. Of these respondents, 208/329 (63.2%) had owned guinea pigs for more than 2 years. Most owners provided a cage with a wooden base as substrate (144/321, 44.9%), bedding (308/329; 93.6%) and toys (169/329; 51.1%). Half (176/329; 53.5%) of respondents reported taking their guinea pig to a veterinarian. Just over half of the owners surveyed cleaned water (165/329; 50.1%) and food (181/329; 55.0%) bowls daily, and a third picked up droppings (109/329; 33.1%) daily. CONCLUSIONS AND CLINICAL RELEVANCE: While owners provided an array of toys, and a range of bedding and substrate types to their guinea pigs, cages were cleaned out less frequently than recommended, and it was common for guinea pig cages to be cleaned out less frequently than recommended. Future research is required to provide robust and evidence-based links between husbandry and the welfare of pet guinea pigs.


Assuntos
Criação de Animais Domésticos , Cobaias , Propriedade , Animais , Humanos , Estudos Transversais , Nova Zelândia , Propriedade/estatística & dados numéricos , Inquéritos e Questionários , Médicos Veterinários , Criação de Animais Domésticos/normas , Criação de Animais Domésticos/estatística & dados numéricos , Bem-Estar do Animal
2.
Neurol India ; 70(Supplement): S259-S262, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36412378

RESUMO

Background: Current methods used to measure the muscle strength required to achieve plantar flexion may yield highly variable results depending on the perception of the physician conducting the examination because these tests involve subjective and qualitative evaluation. Objective: To describe and evaluate the efficacy of a novel examination technique that can quantitatively measure plantar flexion in L5-S1 disc herniation. Materials and Methods: A total of 32 patients (average age: 49.4 years, range: 23-78) with L5-S1 disc herniations were included. The patient to be tested stood next to a table on which they could lean with their hands. The leg closer to the table was fully flexed at the knee, and the other foot was brought to maximum plantar flexion on the toes. At this point, a stopwatch was started to measure the time that passed until the muscles fatigued and the heel fell. The differences between the right and left plantar flexion times were noted. In addition, three different physicians graded muscle strength by using the classical "The Medical Research Council of the United Kingdom" method. Results: The time until fatigue in right and left plantar flexion was measured using the proposed method, and each test underwent a video recording. The Yilmaz-Ilbay plantar flexion test yielded the correct classification for all cases. Conclusion: We suggest that the proposed method "Yilmaz-Ilbay plantar flexion test" can serve as a useful, practical, and effective test to detect quantitative evaluation of plantar flexion in L5-S1 herniation.


Assuntos
Deslocamento do Disco Intervertebral , Extremidade Inferior , Vértebras Lombares , Força Muscular , Exame Neurológico , Humanos , Pessoa de Meia-Idade , Deslocamento do Disco Intervertebral/complicações , Deslocamento do Disco Intervertebral/diagnóstico , Exame Neurológico/métodos , Exame Neurológico/normas , Adulto Jovem , Adulto , Idoso
3.
Biomed Environ Sci ; 35(11): 992-1000, 2022 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-36443252

RESUMO

Objective: To investigate the baseline levels of microorganisms' growth on the hands of anesthesiologists and in the anesthesia environment at a cancer hospital. Methods: This study performed in nine operating rooms and among 25 anesthesiologists at a cancer hospital. Sampling of the hands of anesthesiologists and the anesthesia environment was performed at a ready-to-use operating room before patient contact began and after decontamination. Results: Microorganisms' growth results showed that 20% (5/25) of anesthesiologists' hands carried microorganisms (> 10 CFU/cm 2) before patient contact began. Female anesthesiologists performed hand hygiene better than did their male counterparts, with fewer CFUs ( P = 0.0069) and fewer species ( P = 0.0202). Our study also found that 55.6% (5/9) of ready-to-use operating rooms carried microorganisms (> 5 CFU/cm 2). Microorganisms regrowth began quickly (1 hour) after disinfection, and increased gradually over time, reaching the threshold at 4 hours after disinfection. Staphylococcus aureus was isolated from the hands of 20% (5/25) of anesthesiologists and 33.3% (3/9) of operating rooms. Conclusion: Our study indicates that male anesthesiologists need to pay more attention to the standard operating procedures and effect evaluation of hand hygiene, daily cleaning rate of the operating room may be insufficient, and we would suggest that there should be a repeat cleaning every four hours.


Assuntos
Anestesiologistas , Higiene das Mãos , Feminino , Humanos , Masculino , Anestesia , Anestesiologistas/estatística & dados numéricos , Desinfecção/normas , Higiene das Mãos/normas , Higiene das Mãos/estatística & dados numéricos , Infecções Estafilocócicas , Salas Cirúrgicas/normas , Salas Cirúrgicas/estatística & dados numéricos , Staphylococcus aureus/isolamento & purificação
5.
JAMA ; 328(20): 2060-2062, 2022 11 22.
Artigo em Inglês | MEDLINE | ID: mdl-36413243

RESUMO

This study includes clinical laboratories that participated in the first general chemistry proficiency testing survey in 2022 to assess awareness and adoption of new equations from the Chronic Kidney Disease Epidemiology Collaboration for estimated glomerular filtration rate (eGFR) that eliminated race-adjustment factors, including one based on creatinine and one based on creatinine and cystatin C.


Assuntos
Serviços de Laboratório Clínico , Taxa de Filtração Glomerular , Fidelidade a Diretrizes , Laboratórios Clínicos , Serviços de Laboratório Clínico/normas , Creatinina , Laboratórios Clínicos/normas , Estados Unidos , Conhecimentos, Atitudes e Prática em Saúde
6.
JAMA ; 328(17): 1689-1690, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36318120

RESUMO

This Viewpoint discusses the US Supreme Court's decision in Dobbs v Jackson Women's Health Organization, describes how that decision threatens birth equity for some racial and social groups, and suggests a reproductive justice approach to address racial and social inequalities and ensure reproductive freedom and autonomy for all people.


Assuntos
Aborto Legal , Equidade em Saúde , Direitos Sexuais e Reprodutivos , Decisões da Suprema Corte , Feminino , Humanos , Gravidez , Aborto Legal/legislação & jurisprudência , Equidade em Saúde/legislação & jurisprudência , Equidade em Saúde/normas , Equidade em Saúde/tendências , Estados Unidos , Direitos Sexuais e Reprodutivos/legislação & jurisprudência , Direitos Sexuais e Reprodutivos/normas , Direitos Sexuais e Reprodutivos/tendências
8.
JAMA ; 328(17): 1697-1698, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36318119

RESUMO

This Viewpoint discusses how states' restrictions on abortion will affect medical students' training in providing reproductive health care and also create moral distress by being forced to provide care that may harm patients.


Assuntos
Educação Médica , Princípios Morais , Decisões da Suprema Corte , Humanos , Educação Médica/ética , Educação Médica/legislação & jurisprudência , Educação Médica/métodos , Educação Médica/normas , Estudantes de Medicina , Estados Unidos
9.
JAMA ; 328(17): 1747-1765, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36318128

RESUMO

Importance: It is uncertain whether hormone therapy should be used for the primary prevention of chronic conditions such as heart disease, osteoporosis, or some types of cancers. Objective: To update evidence for the US Preventive Services Task Force on the benefits and harms of hormone therapy in reducing risks for chronic conditions. Data Sources: PubMed/MEDLINE, Cochrane Library, EMBASE, and trial registries from January 1, 2016, through October 12, 2021; surveillance through July 2022. Study Selection: English-language randomized clinical trials and prospective cohort studies of fair or good quality. Data Extraction and Synthesis: Dual review of abstracts, full-text articles, and study quality; meta-analyses when at least 3 similar studies were available. Main Outcomes and Measures: Morbidity and mortality related to chronic conditions; health-related quality of life. Results: Twenty trials (N = 39 145) and 3 cohort studies (N = 1 155 410) were included. Participants using estrogen only compared with placebo had significantly lower risks for diabetes over 7.1 years (1050 vs 903 cases; 134 fewer [95% CI, 18-237]) and fractures over 7.2 years (1024 vs 1413 cases; 388 fewer [95% CI, 277-489]) per 10 000 persons. Risks per 10 000 persons were statistically significantly increased for gallbladder disease over 7.1 years (1113 vs 737 cases; 377 more [95% CI, 234-540]), stroke over 7.2 years (318 vs 239 cases; 79 more [95% CI, 15-159]), venous thromboembolism over 7.2 years (258 vs 181 cases; 77 more [95% CI, 19-153]), and urinary incontinence over 1 year (2331 vs 1446 cases; 885 more [95% CI, 659-1135]). Participants using estrogen plus progestin compared with placebo experienced significantly lower risks, per 10 000 persons, for colorectal cancer over 5.6 years (59 vs 93 cases; 34 fewer [95% CI, 9-51]), diabetes over 5.6 years (403 vs 482 cases; 78 fewer [95% CI, 15-133]), and fractures over 5 years (864 vs 1094 cases; 230 fewer [95% CI, 66-372]). Risks, per 10 000 persons, were significantly increased for invasive breast cancer (242 vs 191 cases; 51 more [95% CI, 6-106]), gallbladder disease (723 vs 463 cases; 260 more [95% CI, 169-364]), stroke (187 vs 135 cases; 52 more [95% CI, 12-104]), and venous thromboembolism (246 vs 126 cases; 120 more [95% CI, 68-185]) over 5.6 years; probable dementia (179 vs 91 cases; 88 more [95% CI, 15-212]) over 4.0 years; and urinary incontinence (1707 vs 1145 cases; 562 more [95% CI, 412-726]) over 1 year. Conclusions and Relevance: Use of hormone therapy in postmenopausal persons for the primary prevention of chronic conditions was associated with some benefits but also with an increased risk of harms.


Assuntos
Doença Crônica , Estrogênios , Terapia de Reposição Hormonal , Pós-Menopausa , Progestinas , Feminino , Humanos , Comitês Consultivos/normas , Comitês Consultivos/tendências , Doença Crônica/epidemiologia , Doença Crônica/mortalidade , Doença Crônica/prevenção & controle , Estrogênios/efeitos adversos , Estrogênios/uso terapêutico , Fraturas Ósseas/prevenção & controle , Terapia de Reposição Hormonal/efeitos adversos , Terapia de Reposição Hormonal/métodos , Hormônios/efeitos adversos , Hormônios/uso terapêutico , Prevenção Primária , Progestinas/efeitos adversos , Progestinas/uso terapêutico , Estudos Prospectivos , Qualidade de Vida , Medição de Risco , Estados Unidos , Incontinência Urinária/induzido quimicamente , Tromboembolia Venosa/induzido quimicamente
10.
JAMA ; 328(17): 1691-1692, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36318126

RESUMO

This Viewpoint discusses how limited or blocked access to legal abortion will affect the provision of emergency and critical care, including negative effects on patient health, legal intrusion into the patient-physician decision-making process, and concerns about legal jeopardy.


Assuntos
Aborto Induzido , Serviços Médicos de Emergência , Acesso aos Serviços de Saúde , Decisões da Suprema Corte , Feminino , Humanos , Gravidez , Aborto Induzido/legislação & jurisprudência , Aborto Legal/legislação & jurisprudência , Aborto Espontâneo , Serviços Médicos de Emergência/legislação & jurisprudência , Serviços Médicos de Emergência/normas , Acesso aos Serviços de Saúde/legislação & jurisprudência , Acesso aos Serviços de Saúde/normas , Estados Unidos
20.
J Surg Educ ; 79(6): e225-e234, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36333174

RESUMO

OBJECTIVE: The ACS/APDS Resident Skills Curriculum's Objective Structured Assessment of Technical Skills (OSATS) consists of task-specific checklists and a global rating scale (GRS) completed by raters. Prior work demonstrated a need for rater training. This study evaluates the impact of a rater-training curriculum on scoring discrimination, consistency, and validity for handsewn bowel anastomosis (HBA) and vascular anastomosis (VA). DESIGN/ METHODS: A rater training video model was developed, which included a GRS orientation and anchoring performances representing the range of potential scores. Faculty raters were randomized to rater training or no rater training and were asked to score videos of resident HBA/VA. Consensus scores were assigned to each video using a modified Delphi process (Gold Score). Trained and untrained scores were analyzed for discrimination and score spread and compared to the Gold Score for relative agreement. RESULTS: Eight general and eight vascular surgery faculty were randomized to score 24 HBA/VA videos. Rater training increased rater discrimination and decreased rating scale shrinkage for both VA (mean trained score: 2.83, variance 1.88; mean untrained score: 3.1, variance 1.14, p = 0.007) and HBA (mean trained score: 3.52, variance 1.44; mean untrained score: 3.42, variance 0.96, p = 0.033). On validity analyses, a comparison between each rater group vs Gold Score revealed a moderate training impact for VA, trained κ=0.65 vs untrained κ=0.57 and no impact for HBA, R1 κ = 0.71 vs R2 κ = 0.73. CONCLUSION: A rater-training curriculum improved raters' ability to differentiate performance levels and use a wider range of the scoring scale. However, despite rater training, there was persistent disagreement between faculty GRS scores with no groups reaching the agreement threshold for formative assessment. If technical skill exams are incorporated into high stakes assessments, consensus ratings via a standard setting process are likely a more valid option than individual faculty ratings.


Assuntos
Lista de Checagem , Currículo , Internato e Residência , Anastomose Cirúrgica , Consenso , Humanos , Internato e Residência/normas
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