Articles: cations.
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Minerva anestesiologica · Sep 2022
Brain death and the internet: evaluating the readability and quality of online health information.
Brain death has been accepted medically and legally as biological death. Nevertheless, it is a difficult concept for the public to understand, resulting in a reliance on online resources for clarity. When the information is inaccurate, misleading, or elusive, the internet could have adverse effects on the public's decision-making. Here we aimed to assess the quality and readability of information regarding brain death on the internet. ⋯ Online health information on brain death exceeds the National Institutes of Health recommended reading levels. Our results emphasize the need to establish quality guidelines to improve the comprehensiveness of health website content. Brain death is still a contentious topic; therefore, reliable, and easy-to-read online educational materials can help public understand the concept of brain death and potentially improve the transplant rate.
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To investigate whether early changes in fear of movement (kinesiophobia), self-efficacy and catastrophizing were mediators of the relationship between allocation to the pre-habilitation intervention and later changes in health outcomes. ⋯ Prehabilitation interventions for spinal fusion surgery have been found to improve health outcomes for patients. Theory-based interventions that target key mechanisms are more effective at improving outcomes than non-theory-based interventions. While no mediating effects were found for this particular intervention, the analysis suggests that the underlying theoretical model and treatment targets are appropriate and could drive improvement if more strongly targeted.
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Minerva anestesiologica · Sep 2022
Multidrug-resistant infections in solid organ transplant recipients: a focus on risk factors, prevention and treatment strategies.
Solid organ transplantation is the best therapeutic option for patients with end-stage organ disease and, according to the data from international registries, there has been a steady increase in numbers and results. However, post‑transplant infections remain a fearsome complication with, in the last decade, an increasing incidence of episodes due to antibiotic‑resistant bacteria and opportunistic agents. In this paper, we summarized the most relevant and updated knowledge concerning infections from multidrug‑resistant germs in solid organ transplant recipients, focusing on risk factors, treatment and prevention strategies, and antimicrobial pharmacokinetics relevant to this population of patients.
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Classification of musculoskeletal pain based on underlying pain mechanisms (nociceptive, neuropathic, and nociplastic pain) is challenging. In the absence of a gold standard, verification of features that could aid in discrimination between these mechanisms in clinical practice and research depends on expert consensus. This Delphi expert consensus study aimed to: (1) identify features and assessment findings that are unique to a pain mechanism category or shared between no more than 2 categories and (2) develop a ranked list of candidate features that could potentially discriminate between pain mechanisms. ⋯ Consensus was reached for 196 of 292 features presented to the panel (clinical examination-134 features, quantitative sensory testing-34, imaging and diagnostic testing-14, and pain-type questionnaires-14). From the 196 features, consensus was reached for 76 features as unique to nociceptive (17), neuropathic (37), or nociplastic (22) pain mechanisms and 120 features as shared between pairs of pain mechanism categories (78 for neuropathic and nociplastic pain). This consensus study generated a list of potential candidate features that are likely to aid in discrimination between types of musculoskeletal pain.
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Current prognostic models for brain metastases (BMs) have been constructed and validated almost entirely with data from patients receiving up-front radiotherapy, leaving uncertainty about surgical patients. ⋯ We developed and internally validated a prediction model that accurately predicts 6-month survival after neurosurgical resection for BM and allows for meaningful risk stratification. Future efforts should focus on external validation of our model.