Patients’ perceived needs for medical services for non-specific low back pain: A systematic scoping review

Background: An improved understanding of patients’ perceived needs for medical services for low back pain (LBP) will enable healthcare providers to better align service provision with patient expectations, thus improving patient and health care system outcomes. Thus, we aimed to identify the existing literature regarding patients’ perceived needs for medical services for LBP. Methods: A systematic scoping review was performed of publications identified from MEDLINE, EMBASE, CINAHL and PsycINFO (1990–2016). Descriptive data regarding each study, its design and methodology were extracted and risk of bias assessed. Aggregates of patients’ perceived needs for medical services for LBP were categorised. Results: 50 studies (35 qualitative, 14 quantitative and 1 mixed-methods study) from 1829 were relevant. Four areas of perceived need emerged: (1) Patients with LBP sought healthcare from medical practitioners to obtain a diagnosis, receive management options, sickness certification and legitimation for their LBP. However, there was dissatisfaction with the cursory and superficial approach of care. (2) Patients had concerns about pharmacotherapy, with few studies reporting on patients’ preferences for medications. (3) Of the few studies which examined the patients’ perceived need of invasive therapies, these found that patients avoided injections and surgeries (4) Patients desired spinal imaging for diagnostic purposes and legitimation of symptoms. Conclusions: Across many different patient populations with data obtained from a variety of study designs, common themes emerged which highlighted areas of patient dissatisfaction with the medical management of LBP, in particular, the superficial approach to care perceived by patients and concerns regarding pharmacotherapy. Patients perceive unmet needs from medical services, including the need to obtain a diagnosis, the desire for pain control and the preference for spinal imaging. These issues need to be considered in developing approaches for the management of LBP in order to improve patient outcomes

MicroRNA expression profiles in pediatric dysembryoplastic neuroepithelial tumors.

© Springer Science+Business Media New York 2015Among noncoding RNAs, microRNAs (miRNAs) have been most extensively studied, and their biology has repeatedly been proven critical for central nervous system pathological conditions. The diagnostic value of several miRNAs was appraised in pediatric dysembryoplastic neuroepithelial tumors (DNETs) using miRNA microarrays and receiving operating characteristic curves analyses. Overall, five pediatric DNETs were studied. As controls, 17 samples were used: the FirstChoice Human Brain Reference RNA and 16 samples from deceased children who underwent autopsy and were not present with any brain malignancy. The miRNA extraction was carried out using the mirVANA miRNA Isolation Kit, while the experimental approach included miRNA microarrays covering 1211 miRNAs. Quantitative real-time polymerase chain reaction was performed to validate the expression profiles of miR-1909* and miR-3138 in all samples initially screened with miRNA microarrays. Our findings indicated that miR-3138 might act as a tumor suppressor gene when down-regulated and miR-1909* as a putative oncogenic molecule when up-regulated in pediatric DNETs compared to the control cohort. Subsequently, both miRNA signatures might serve as putative diagnostic biomarkers for pediatric DNETs.Peer reviewedFinal Accepted Versio

The behaviour of lubricated EHD contacts subjected to vibrations

Machine components containing contacts working in elastohydrodynamic (EHD) conditions are often subjected to vibrations. These may be originated from the mechanism or machine the contact is part of, the surrounding environment and within the contact itself. The influence of vibrations upon the behaviour of elastohydrodynamic films has been studied experimentally in a number of papers, but a comprehensive study of the effect of the parameters of the oscillatory motion upon the film thickness has not been carried out yet. In this study the authors evaluate the effect of the frequency of the oscillatory motion upon the EHD film thickness. Optical interferometry is used to measure lubricant film thickness in a ball-on-flat disc arrangement. A high – speed camera records the interferometric images for later analysis and conversion into film thickness maps. The disc runs at a constant angular velocity while the ball is driven by the traction forces developed in the EHD film. In steady state conditions, this would ensure pure rolling conditions, however in the present investigation the ball is subjected to harmonic vibrations in a direction perpendicular to the plane of the film. The contact under study is lubricated by basic oils and the temperature is kept at a constant value of 60°C. The aim of this paper is to understand how vibrations influence the lubricant film formation

Multilayer Modelling of Lubricated Contacts: A New Approach Based on a Potential Field Description

A first integral approach, derived in an analogous fashion to Maxwell’s use of potential fields, is employed to investigate the flow characteristics, with a view to minimising friction, of shear-driven fluid motion between rigid surfaces in parallel alignment as a model for a lubricated joint, whether naturally occurring or engineered replacement. For a viscous bilayer arrangement comprised of immiscible liquids, it is shown how the flow and the shear stress along the separating interface is influenced by the mean thickness of the layers and the ratio of their respective viscosities. Considered in addition, is how the method can be extended for application to the more challenging problem of when one, or both, of the layers is a viscoelastic material

Electrocardiographic changes in a rare case of flecainide poisoning: a case report

Flecainide is a class Ic anti - arrhythmic drug with sodium channel blocking activities. We report a case of a 57 year - old woman who attempted a suicide by ingesting approximately 1,8 gr of flecainide. On the surface electrocardiogram this results in a large QRS complex and in prolongation of the QTc interval. Overdose with a class Ic drug is very uncommon, its management is difficult and the mortality high

Initial experience with a synthetic sealant PleuraSeal™ after pulmonary resections: a prospective study with retrospective case matched controls

The objective of this study was to evaluate postoperative outcome and efficacy of a hydrogel tissue sealant for prevention of alveolar leakage after open lung resections