"How do Pilates Trained Physiotherapists utilize and value Pilates Exercise for MSK conditions? A Qualitative Study".

Background: Pilates is a popular exercise therapy approach offering numerous benefits, including muscular strength, flexibility, control, and core stability. Pilates has been widely utilized in the prevention and rehabilitation of a variety of musculoskeletal disorders.

Objectives: The aim of this study was to explore the experiences and opinions of Pilates trained NHS and private practice physiotherapists in the UK, regarding the perceived benefits, risks, delivery and rationale for this exercise method.

Medical Leaders Identify Personal Characteristics and Experiences that Contribute to Leadership Success in Medicine.

This article was migrated. The article was marked as recommended. The approach of medical educators to preparing learners for leadership reflects the emphasis leadership theories once placed on experiential learning.

Medical School Factors That Prepare Students to Become Leaders in Medicine.

Purpose: To identify medical school factors graduates in major leadership positions perceive as contributing to their leadership development.

Method: Using a phenomenological, qualitative approach, in August-November 2015 the authors conducted semistructured interviews with 48 medical leaders who were 1976-1999 baccalaureate-MD graduates of the University of Missouri-Kansas City School of Medicine (UMKC). At UMKC, they participated in longitudinal learning communities, the centerpiece for learning professional values and behaviors plus clinical skills, knowledge, and judgment, but received no formal leadership instruction.

Fluoroquinolone treatment of community-acquired pneumonia: a meta-analysis.

Objective: To determine the role of newer fluoroquinolones (FQs) for adults with community-acquired pneumonia (CAP) whose level of illness allows treatment with an oral antibiotic.

Methods: Meta-analysis of randomized controlled trials comparing a macrolide, beta-lactam, or doxycycline antibiotic with a newer oral FQ for the treatment of CAP.

Results: Patients (5118), most of whom were <60 years of age and free of coexisting diseases, were enrolled in 13 studies comparing an oral macrolide or beta-lactam antibiotic with an FQ for the treatment of CAP.

PEG site infections: the emergence of methicillin resistant Staphylococcus aureus as a major pathogen.

Objective: We reviewed the records of 126 patients who underwent PEG insertion during a 36-month period to determine the etiology of an observed increase in PEG-related infections.

Methods: Charts were reviewed to determine predictive factors of infection, the occurrence of infection, and culture results of infected sites. Insertion was performed in all cases using a standard sterile, pull-through technique.

Nutrition support in the critically ill patient.

Despite an absence of well-controlled studies demonstrating a clear mortality benefit, providing nutrition support in the critically ill patient has become routine in most ICU settings. Unless clearly contraindicated, patients should be fed enterally, using conventional isotonic feedings employing gastric or postpyloric access. When to begin nutrition support varies, depending on baseline nutritional status, anticipated time until oral feedings are resumed, and the degree of stress.

Monitoring drug therapy in the intensive care unit.

Drugs are among the most commonly administered therapeutic interventions received. In the intensive care unit (ICU), patients routinely receive more therapies than on general medical or surgical wards, and practitioners caring for these patients are presented with the challenge of monitoring each of these therapies for efficacy and toxicity. The goal of this article is to describe a conceptual approach that practitioners can use to monitor for drug efficacy and predictable and unpredictable adverse drug effects.

The rational clinical examination. Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy.

Context: Clinicians frequently withhold antibiotics that contain penicillin based on patients' self-reported clinical history of an adverse reaction to penicillin and the clinicians' own misunderstandings about the characteristics of a true penicillin allergy.

Objectives: To determine the likelihood of true penicillin allergy with consideration of clinical history and to evaluate the diagnostic value added by appropriate skin testing.

Data Sources: MEDLINE was searched for relevant English-language articles dated 1966 to October 2000.

A double-blind placebo controlled trial of oral midazolam as premedication before flexible sigmoidoscopy.

Objective: We aimed to determine the efficacy of oral midazolam as premedication to improve tolerance of flexible sigmoidoscopy.

Methods: Ninety-nine patients were randomized to receive 7.5 mg of oral midazolam solution mixed with apple juice or placebo (apple juice), 20 min before sigmoidoscopy.

Antibiotic classification: implications for drug selection.

This article presents a useful antibiotic classification model for the busy clinician who must select agents for patients in the critical care setting. The model organizes antibiotics based on their mechanism of action, ie, cell-wall inhibitors, nucleic acid inhibitors, and protein-synthesis inhibitors; clinicians are encouraged to further segregate agents within the broader categories by generation. An overview of the antimicrobial spectrum for each class is presented, and important differences within individual classes are highlighted.

No difference in catheter sepsis between standard and antiseptic central venous catheters. A prospective randomized trial.

Objective: To determine the efficacy of antiseptic compared with standard triple lumen central venous catheters (CVCs) in reducing the incidence of catheter sepsis and catheter site infection in patients with CVCs for total parenteral nutrition.

Design: A prospective, randomized, controlled trial.

Setting: Truman Medical Center, the public teaching hospital for University of Missouri, Kansas City, School of Medicine.

Predicting the patient at low risk for lymph node metastasis with localized prostate cancer: an analysis of four statistical models.

Purpose: Statistical models using preoperative Prostate-Specific Antigen, Gleason primary grade or score of the biopsy specimen, and clinical stage have been developed to predict those patients with clinically localized prostate cancer at low risk for lymph node metastasis. It has been recommended that these patients do not require pelvic lymph node dissections. Four such models were evaluated to assess their accuracy in identifying this subgroup of patients.

Recent advances: parenteral nutrition support.

Even though there is an abundance of research related to the clinical and physiologic effects of parenteral nutrition and specific nutritional substrates, few new products have been released for clinical use. This review illustrates some of the directions being taken in the future development of parenteral nutrition products and some new perspectives related to the current effects (or lack of effects) of TPN. When considering the individual effects of specific nutrient substrates (arginine, glutamine, LCTs, MCTs, SCFAs) as reviewed here, it becomes apparent that the infusion of parenteral nutrition has the potential to produce a variety of metabolic responses that could be both beneficial and harmful.

Theophylline disposition following parenteral feeding of malnourished patients.

Objective: To investigate the effect of parenteral nutrition on theophylline disposition in malnourished patients.

Design: Before-after trial.

Setting: Tertiary care center.

The effects of sucralfate suspension and diphenhydramine syrup plus kaolin-pectin on radiotherapy-induced mucositis.

A prospective, double-blind study compared the effectiveness of sucralfate suspension with diphenhydramine syrup plus kaolin-pectin in reducing severity and pain of radiation-induced oropharyngeal mucositis. Fourteen patients who received at least 4600 cGy to the oral cavity used one of the mouth rinses four times a day, beginning at 1600 cGy. Data were collected on daily perceived pain and helpfulness of mouth rinse, weekly mucositis grade, weight change, and interruption of therapy.

Enteral feeding in the hypoalbuminemic patient.

Previous studies have correlated intolerance of isotonic, intact protein enteral solutions with hypoalbuminemia. The purpose of this retrospective study was to determine whether the level of serum albumin (SA) influenced tolerance of such an enteral nutrient solution (ENS). All patients who received Entrition during 1987 for a minimum of 48 hr were studied for the first 10 days of enteral feeding.

Branched-chain amino acid support of stressed patients.

Branched-chain amino acid-enriched formulas have been evaluated in a number of clinical trials. The efficacy of these solutions in the management of stressed patients is controversial. This review discusses the proposed benefits of the branched-chain amino acid-fortified solutions and summarizes prospective clinical trials regarding their use in stressed patients.

Theophylline and diaphragmatic contractility. Investigation of a dose-response relationship.

Our study evaluated whether a dose-response relationship exists for theophylline and diaphragmatic contractility within the usual therapeutic range for theophylline. The study, involving 16 patients with mild to moderate chronic obstructive pulmonary disease, was done in a randomized, placebo-controlled, double-blind, crossover fashion. We found no statistically significant effect of theophylline on diaphragmatic contractility at mean theophylline concentrations of 5.

Should dihydroergotamine-heparin be used for prevention of postoperative thromboembolism?

The combination of heparin 5000 U and dihydroergotamine 0.5 mg (HDHE) was marketed in the U.S.

Elevation of serum aluminum in humans on a two-day sucralfate regimen.

Serum aluminum concentrations were determined in ten healthy subjects treated with phenytoin 500 mg and with sucralfate and phenytoin in a crossover fashion. Each subject received four 1,000-mg sucralfate tablets between 8 AM and 10 PM one day before the study, and this was repeated during the study day. A total of eight doses of sucralfate was administered over the two-day period.

Effect of sucralfate on phenytoin bioavailability.

The mechanism of action of the antiulcer agent, sucralfate, involves drug binding to proteins, pepsin, and bile salts. The potential for sucralfate to bind to, and inhibit the oral absorption of, concurrently-administered drugs has been studied for very few agents. Phenytoin bioavailability was studied following a single dose of phenytoin 500 mg po in nine normal subjects during a control period and when given with sucralfate.