• MeSH
• Ethanol pharmacology   MeSH
• Thyrotropin-Releasing Hormone secretion   MeSH
• Hypotonic Solutions MeSH
• Isotonic Solutions MeSH
• Rats MeSH
• Islets of Langerhans cytology   secretion   drug effects   MeSH
• Central Nervous System Depressants pharmacology   MeSH
• Calcium pharmacology   metabolism   MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Male MeSH
• Animals MeSH

• MeSH
• Insulin secretion   MeSH
• Islets of Langerhans secretion   MeSH
• Osmolar Concentration MeSH
• Signal Transduction MeSH

• Conspectus
• Ortopedie. Chirurgie. Oftalmologie
• NML Fields
• ortopedie

Trauma patients requiring massive transfusion represent a population at high risk for potentially preventable death. This review describes recent advances in the early recognition and treatment of the coagulopathy of trauma, as well as ongoing work to define optimal resuscitation strategies. RECENT FINDINGS: Damage control resuscitation involves the rapid correction of hypothermia and acidosis, direct treatment of coagulopathy, and early transfusion in trauma patients. Recent evidence demonstrates improved mortality and lower overall blood product usage with higher ratios of plasma and platelets to red blood cells transfused. Adjuncts to damage control resuscitation such as factor VIIa may also be beneficial. Thrombelastography and advances in point-of-care testing may provide timely measurements to help guide massive transfusion in patients based on their individual needs. SUMMARY: As optimal resuscitation strategies continue to evolve, recent efforts have focused on early and aggressive treatment of coagulopathy, with higher ratios of plasma and platelets to red blood cells transfused. Early evidence suggests that such strategies have a beneficial outcome in regards to trauma-related mortality.

• MeSH
• Factor VIIa therapeutic use   MeSH
• Blood Coagulation Disorders complications   MeSH
• Blood Transfusion methods   MeSH
• Humans MeSH
• Wounds and Injuries blood   therapy   MeSH
• Recombinant Proteins therapeutic use   MeSH
• Resuscitation MeSH
• Thrombelastography MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Exocytosis physiology   MeSH
• Cell Physiological Phenomena MeSH
• Peptides secretion   MeSH
• Publication type
• Review MeSH

BACKGROUND: Remote measurement technology refers to the use of mobile health technology to track and measure change in health status in real time as part of a person's everyday life. With accurate measurement, remote measurement technology offers the opportunity to augment health care by providing personalized, precise, and preemptive interventions that support insight into patterns of health-related behavior and self-management. However, for successful implementation, users need to be engaged in its use. OBJECTIVE: Our objective was to systematically review the literature to update and extend the understanding of the key barriers to and facilitators of engagement with and use of remote measurement technology, to guide the development of future remote measurement technology resources. METHODS: We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines involving original studies dating back to the last systematic review published in 2014. We included studies if they met the following entry criteria: population (people using remote measurement technology approaches to aid management of health), intervention (remote measurement technology system), comparison group (no comparison group specified), outcomes (qualitative or quantitative evaluation of the barriers to and facilitators of engagement with this system), and study design (randomized controlled trials, feasibility studies, and observational studies). We searched 5 databases (MEDLINE, IEEE Xplore, EMBASE, Web of Science, and the Cochrane Library) for articles published from January 2014 to May 2017. Articles were independently screened by 2 researchers. We extracted study characteristics and conducted a content analysis to define emerging themes to synthesize findings. Formal quality assessments were performed to address risk of bias. RESULTS: A total of 33 studies met inclusion criteria, employing quantitative, qualitative, or mixed-methods designs. Studies were conducted in 10 countries, included male and female participants, with ages ranging from 8 to 95 years, and included both active and passive remote monitoring systems for a diverse range of physical and mental health conditions. However, they were relatively short and had small sample sizes, and reporting of usage statistics was inconsistent. Acceptability of remote measurement technology according to the average percentage of time used (64%-86.5%) and dropout rates (0%-44%) was variable. The barriers and facilitators from the content analysis related to health status, perceived utility and value, motivation, convenience and accessibility, and usability. CONCLUSIONS: The results of this review highlight gaps in the design of studies trialing remote measurement technology, including the use of quantitative assessment of usage and acceptability. Several processes that could facilitate engagement with this technology have been identified and may drive the development of more person-focused remote measurement technology. However, these factors need further testing through carefully designed experimental studies. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) CRD42017060644; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=60644 (Archived by WebCite at http://www.webcitation.org/70K4mThTr).

• MeSH
• Child MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Prospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Remote Sensing Technology methods   MeSH
• Telemedicine methods   MeSH
• Patient Participation methods   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Systematic Review MeSH

• MeSH
• Depression drug therapy   genetics   metabolism   MeSH
• Pharmacologic Actions MeSH
• Genetic Markers genetics   drug effects   MeSH
• Data Interpretation, Statistical MeSH
• Humans MeSH
• Mianserin analogs & derivatives   adverse effects   therapeutic use   MeSH
• Paroxetine metabolism   adverse effects   therapeutic use   MeSH
• Polymorphism, Genetic immunology   radiation effects   MeSH
• Promoter Regions, Genetic immunology   radiation effects   MeSH
• Randomized Controlled Trials as Topic MeSH
• Selective Serotonin Reuptake Inhibitors metabolism   therapeutic use   MeSH
• Aged psychology   MeSH
• Serotonin genetics   metabolism   therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Aged psychology   MeSH

BACKGROUND: Smartphone apps and wearable devices could augment clinical practice by detecting changes in health status for multiple sclerosis (MS). This study sought to investigate potential barriers and facilitators for uptake and sustained use in (i) people with both relapsing remitting MS (RRMS) and progressive MS (PMS) and (ii) across different countries. METHODS: Twenty four participants with MS took part in four focus groups held in three countries (2 in the UK, 1 in Spain, and 1 in Italy) to investigate potential barriers and facilitators for mHealth technology. A systematic thematic analysis was used to extract themes and sub-themes. RESULTS: Facilitators and barriers were organised into functional technology-related factors and non-functional health-related and user-related factors. Twelve themes captured all requirements across the three countries for both RRMS and PMS. Key requirements included accommodation for varying physical abilities, providing information and memory aids. Potential negative effects on mood and providing choice and control as part of overcoming practical challenges were identified. CONCLUSIONS: We took a cross-national perspective and found many similarities between three European countries across people with RRMS and PMS. Future provision should accommodate the key requirements identified to engage people with MS in scalable mHealth interventions.

• MeSH
• Adult MeSH
• Cultural Diversity * MeSH
• Middle Aged MeSH
• Humans MeSH
• Disease Management * MeSH
• Disease Progression * MeSH
• Cross-Sectional Studies MeSH
• Multiple Sclerosis, Relapsing-Remitting diagnosis   ethnology   psychology   MeSH
• Multiple Sclerosis diagnosis   ethnology   psychology   MeSH
• Telemedicine methods   MeSH
• Focus Groups MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Italy MeSH
• Spain MeSH
• United Kingdom MeSH

BACKGROUND: Remote measurement technology (RMT), including the use of mobile phone apps and wearable devices, may provide the opportunity for real-world assessment and intervention that will streamline clinical input for years to come. In order to establish the benefits of this approach, we need to operationalize what is expected in terms of a successful measurement. We focused on three clinical long-term conditions where a novel case has been made for the benefits of RMT: major depressive disorder (MDD), multiple sclerosis (MS), and epilepsy. OBJECTIVE: The aim of this study was to conduct a consultation exercise on the clinical end point or outcome measurement priorities for RMT studies, drawing on the experiences of people with chronic health conditions. METHODS: A total of 24 participants (16/24 women, 67%), ranging from 28 to 65 years of age, with a diagnosis of one of three chronic health conditions-MDD, MS, or epilepsy-took part in six focus groups. A systematic thematic analysis was used to extract themes and subthemes of clinical end point or measurement priorities. RESULTS: The views of people with MDD, epilepsy, and MS differed. Each group highlighted unique measurements of importance, relevant to their specific needs. Although there was agreement that remote measurement could be useful for tracking symptoms of illness, some symptoms were specific to the individual groups. Measuring signs of wellness was discussed more by people with MDD than by people with MS and epilepsy. However, overlap did emerge when considering contextual factors, such as life events and availability of support (MDD and epilepsy) as well as ways of coping (epilepsy and MS). CONCLUSIONS: This is a unique study that puts patients' views at the forefront of the design of a clinical study employing novel digital resources. In all cases, measuring symptom severity is key; people want to know when their health is getting worse. Second, symptom severity needs to be placed into context. A holistic approach that, in some cases, considers signs of wellness as well as illness, should be the aim of studies employing RMT to understand the health of people with chronic conditions.

• MeSH
• Chronic Disease MeSH
• Exercise MeSH
• Depressive Disorder, Major * diagnosis   therapy   MeSH
• Humans MeSH
• Mobile Applications * MeSH
• Technology MeSH
• Check Tag
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Když outsiderka Greer dostane od svého spolužáka a idola Henryho pozvánku na lovecký víkend na jeho luxusním rodovém panství, věří, že ji čeká víkend snů. Místo toho ale bude muset bojovat o holé přežití. Štvanice začíná...