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https://www.readbyqxmd.com/read/28886607/impact-of-clinical-registries-on-quality-of-patient-care-and-clinical-outcomes-a-systematic-review
#1
Dewan Md Emdadul Hoque, Varuni Kumari, Masuma Hoque, Rasa Ruseckaite, Lorena Romero, Sue M Evans
BACKGROUND: Clinical quality registries (CQRs) are playing an increasingly important role in improving health outcomes and reducing health care costs. CQRs are established with the purpose of monitoring quality of care, providing feedback, benchmarking performance, describing pattern of treatment, reducing variation and as a tool for conducting research. OBJECTIVES: To synthesise the impact of clinical quality registries (CQRs) as an 'intervention' on (I) mortality/survival; (II) measures of outcome that reflect a process or outcome of health care; (III) health care utilisation; and (IV) healthcare-related costs...
2017: PloS One
https://www.readbyqxmd.com/read/28884476/probiotics-for-preventing-urinary-tract-infection-in-people-with-neuropathic-bladder
#2
REVIEW
Swee-Ling Toh, Claire L Boswell-Ruys, Bon San B Lee, Judy M Simpson, Kate R Clezy
BACKGROUND: Neuropathic or neurogenic bladder describes a process of dysfunctional voiding as the result of injury in the brain, spinal cord or nerves innervating the bladder. People with neuropathic bladder, such as from spinal cord injury (SCI), are at significant risk of morbidity from urinary tract infections (UTI). Effective methods to prevent UTI in people with SCI have been sought for many years. Probiotics (micro-organisms that exert beneficial health effects in the host) have been recommended for bacterial interference of the urological tract to reduce colonisation by uropathogen and to manage the dual problems of infection and antibiotic resistance...
September 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28862528/infectious-complications-in-hiv-infected-kidney-transplant-recipients
#3
O Ailioaie, N Arzouk, M A Valantin, J Tourret, R O Calin, M Turinici, G Mircescu, B Barrou
Renal transplantation is now a viable alternative for dialysis in HIV-infected patients who achieve good immunovirological control with current antiretroviral therapy regimens available. However, there are few studies that analyze the incidence of post-transplant infections in this population. In this study, a retrospective analysis of data files of 24 HIV-infected kidney transplant (KT) recipients was undertaken, matched to 21 non-infected controls. All patients received induction with anti-interleukin-2 antibodies and were followed in the Pitié-Salpêtrière Hospital in Paris, France...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28830408/the-ktx360%C3%A2-study-a-multicenter-multisectoral-multimodal-telemedicine-based-follow-up-care-model-to-improve-care-and-reduce-health-care-costs-after-kidney-transplantation-in-children-and-adults
#4
L Pape, M de Zwaan, U Tegtbur, F Feldhaus, J K Wolff, L Schiffer, C Lerch, N Hellrung, V Kliem, G Lonnemann, H D Nolting, M Schiffer
BACKGROUND: Follow-up care after kidney transplantation is performed in transplant centers as well as in local nephrologist's practices in Germany. However, organized integrated care of these different sectors of the German health care system is missing. This organizational deficit as well as non-adherence of kidney recipients and longterm cardiovascular complications are major reasons for an impaired patient and graft survival. METHODS: The KTx360° study is supported by a grant from the Federal Joint Committee of the Federal Republic of Germany...
August 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28766066/outcome-of-kidney-transplantation-in-pediatric-patients-with-anca-associated-glomerulonephritis-a-single-center-experience
#5
Damien Noone, Rae S M Yeung, Diane Hebert
OBJECTIVES: Data on kidney transplant outcomes for pediatric patients with end-stage renal disease (ESRD) secondary to anti-neutrophil cytoplasmic antibody glomerulonephritis (ANCA GN), particularly granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), is limited. We describe our experience of kidney transplantation in pediatric ANCA GN patients. METHODS: We performed a retrospective review of patients with ANCA GN who developed ESRD and were transplanted at a single center between the years 2000 and 2014...
August 1, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28762577/assessing-barriers-to-adherence-in-routine-clinical-care-for-pediatric-kidney-transplant-patients
#6
Charles D Varnell, Kristin L Rich, Melissa Nichols, Devesh Dahale, Jens W Goebel, Ahna L H Pai, David K Hooper, Avani C Modi
Patient-identified barriers to immunosuppressive medications are associated with poor adherence and negative clinical outcomes in transplant patients. Assessment of adherence barriers is not part of routine post-transplant care, and studies regarding implementing such a process in a reliable way are lacking. Using the Model for Improvement and PDSA cycles, we implemented a system to identify adherence barriers, including patient-centered design of a barriers assessment tool, identification of eligible patients, clear roles for clinic staff, and creating a culture of non-judgmental discussion around adherence...
August 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28743270/pre-transplant-depression-as-a-predictor-of-adherence-and-morbidities-after-orthotopic-heart-transplantation
#7
Maja Delibasic, Burhan Mohamedali, Nikola Dobrilovic, Jaishankar Raman
BACKGROUND: Psychosocial factors are useful predictors of adverse outcomes after solid organ transplantation. Although depression is a known predictor of poor outcomes in patients who undergo orthotopic heart transplantation (OHT) and is actively screened for during pre-transplant evaluation, the effects of early identification of this entity on post-transplant outcomes are not clearly understood. The purpose of this study was to evaluate the impact of pre-transplant depression on outcomes after OHT...
July 25, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28736016/predictors-of-non-adherence-to-immunosuppressive-therapy-in-asian-liver-transplant-recipients
#8
J L Hartono, T Koh, G H Lee, P S Tan, M Muthiah, M M Aw, K Madhavan, A Kow, K B L Lim
BACKGROUND: Adherence to immunosuppressive medications has been shown to affect post-transplant outcomes. We aimed to determine the level of adherence to immunosuppressive therapy in liver transplant (LT) recipients and to elucidate factors associated with it, as well as patient preferences on the dosing schedule. METHODS: LT recipients were recruited during transplant clinic follow-up. A validated Morisky 8-item questionnaire was completed by patients to assess their adherence to immunosuppressive therapy...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28696505/feelings-of-indebtedness-and-guilt-toward-donor-and-immunosuppressive-medication-adherence-among-heart-transplant-htx-patients-as-assessed-in-a-cross-sectional-study-with-the-basel-assessment-of-adherence-to-immunosuppressive-medications-scale-baasis
#9
Yedida Shemesh, Anat Peles-Bortz, Yael Peled, Yedael HarZahav, Jacob Lavee, Dov Freimark, Semyon Melnikov
BACKGROUND: Nonadherence (NA) to immunosuppressive (IS) medications after organ transplant is a major risk factor for transplant failure, morbidity, and treatment costs. This study examined the association between feelings of indebtedness and guilt toward the donor, and IS medication adherence among HTx patients. METHODS: In this cross-sectional, descriptive, correlational study, a convenience sample of 102 HTx patients, from the outpatient facility of a tertiary medical center in Israel, completed the BAASIS, a validated instrument for assessing adherence, and reported their feelings of indebtedness and guilt toward the donor...
July 11, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28660366/nationwide-conversion-to-generic-tacrolimus-in-pediatric-kidney-transplant-recipients
#10
Derisha Naicker, Peter W Reed, Jane Ronaldson, Tonya Kara, William Wong, Chanel Prestidge
BACKGROUND: Bioequivalence between Tacrolimus Prograf® and generic tacrolimus formulations has been demonstrated in adult populations, however clinical experience and safety data regarding generic tacrolimus in pediatric transplant recipients is limited. This study aimed to evaluate conversion from Tacrolimus Prograf® to Sandoz® in pediatric renal transplant recipients nationwide. The primary outcome was a change in mean trough tacrolimus concentration. Additionally, changes in tacrolimus intra-patient coefficient of variation (CoV), allograft function, requirement for dose adjustments, and episodes of biopsy-proven rejection were evaluated...
June 28, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28607292/laparoscopic-total-colectomy-for-ulcerative-colitis-after-liver-transplantation-is-feasible
#11
Benjamin Darnis, Gilles Poncet, Maud Robert
Ulcero-haemorrhagic rectocolitis can occur after liver transplantation for sclerosing cholangitis. Total colectomy with or without proctectomy may be indicated in case of chronic drug-resistant colitis, dysplasia or cancer. Today, laparoscopic approach is the standard for such procedure in non-operated patients. We performed a completely laparoscopic total colectomy 5 years after a liver transplantation. There were a few peritoneal adherences, and we could safely perform the procedure almost as usual. It provided all the advantages of the laparoscopic approach in the post-operative course...
July 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28606904/transition-structures-and-timing-of-transfer-from-paediatric-to-adult-based-care-after-kidney-transplantation-in-germany-a-qualitative-study
#12
Jenny Prüfe, Marie-Luise Dierks, Dirk Bethe, Martina Oldhafer, Silvia Müther, Julia Thumfart, Markus Feldkötter, Anja Büscher, Katja Sauerstein, Matthias Hansen, Martin Pohl, Jens Drube, Florian Thiel, Susanne Rieger, Ulrike John, Christina Taylan, Katalin Dittrich, Sabine Hollenbach, Günter Klaus, Henry Fehrenbach, Birgitta Kranz, Carmen Montoya, Bärbel Lange-Sperandio, Bettina Ruckenbrod, Heiko Billing, Hagen Staude, Reinhard Brunkhorst, Krisztina Rusai, Lars Pape, Martin Kreuzer
OBJECTIVES: It is known that transition, as a shift of care, marks a vulnerable phase in the adolescents' lives with an increased risk for non-adherence and allograft failure. Still, the transition process of adolescents and young adults living with a kidney transplant in Germany is not well defined. The present research aims to assess transition-relevant structures for this group of young people. Special attention is paid to the timing of the process. SETTING: In an observational study, we visited 21 departments of paediatric nephrology in Germany...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28605392/transfer-of-mammary-gland-forming-ability-between-mammary-basal-epithelial-cells-and-mammary-luminal-cells-via-extracellular-vesicles-exosomes
#13
Meng-Chieh Lin, Shih-Yin Chen, Pei-Lin He, Wen-Ting Luo, Hua-Jung Li
Cells can communicate via exosomes, ~100-nm extracellular vesicles (EVs) that contain proteins, lipids, and nucleic acids. Non-adherent/mesenchymal mammary epithelial cell (NAMEC)-derived extracellular vesicles can be isolated from NAMEC medium via differential ultracentrifugation. Based on their density, EVs can be purified via ultracentrifugation at 110,000 x g. The EV preparation from ultracentrifugation can be further separated using a continuous density gradient to prevent contamination with soluble proteins...
June 3, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28535528/chronic-allograft-injury-an-overview-of-pathogenesis-and-treatment-strategies
#14
Hector M Madariaga, Leonardo V Riella
Chronic allograft injury (CAI) remains one of the biggest challenges in transplantation as it directly affects the long-term allograft survival, an area in which the scientific and transplantation communities have struggled to improve outcomes. Therefore, understanding the mechanisms of CAI is paramount to implement preventive measures and novel therapeutic options. In this review, we will address the latest evidence on CAI, potential etiologies and risk factors including non-adherence, antibody-mediated rejection, recurrence of glomerular disease, BK nephropathy, and calcineurin nephrotoxicity...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28460645/statin-use-and-hip-fractures-in-u-s-kidney-transplant-recipients
#15
Chandan Vangala, Colin R Lenihan, Maria E Montez-Rath, Sumi Sukumaran Nair, Sankar D Navaneethan, Venkat Ramanathan, Wolfgang C Winkelmayer
BACKGROUND: Basic and translational research supports beneficial effects of statins on bone metabolism. Clinical studies suggest that statin use may reduce the risk of hip fractures in the general population. Whether statin use is associated with hip fracture risk in kidney transplant recipients, a particularly high-risk group for this outcome, is unknown. METHODS: From the U.S. Renal Data System (2007-2011), we identified all hip fracture events recorded in Medicare billing claims of first-time kidney transplant recipients...
May 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28457016/patterns-of-primary-care-utilization-before-and-after-living-kidney-donation
#16
Jennifer L Alejo, Xun Luo, Allan B Massie, Macey L Henderson, Sandra R DiBrito, Jayme E Locke, Tanjala S Purnell, Brian J Boyarsky, Saad Anjum, Samantha E Halpern, Dorry L Segev
BACKGROUND: Annual visits with a primary care provider (PCP) are recommended for living kidney donors to monitor long-term health postdonation, yet adherence to this recommendation is unknown. METHODS: We surveyed 1170 living donors from our center from 1970 to 2012 to ascertain frequency of PCP visits pre- and postdonation. Interviews occurred median (IQR) 6.6 (3.8-11.0) years post-transplant. We used multivariate logistic regression to examine associations between donor characteristics and PCP visit frequency...
July 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28428716/transition-after-pediatric-liver-transplantation-perceptions-of-adults-adolescents-and-parents
#17
Norman Junge, Katarina Migal, Imeke Goldschmidt, Ulrich Baumann
AIM: To develop a locally adapted, patient-focused transition-program, we evaluated the perceptions of adult and adolescent patients and parents regarding transition-programs and transfer. METHODS: We evaluated these perceptions by analyzing the responses of pre-transfer adolescents (n = 57), their parents (n = 57) and post-transfer adults (n = 138) from a cohort of pediatric-liver-transplant-patients using a self-designed questionnaire. Furthermore, we compared a responder group with a non-responder group as well as the provided answers with baseline characteristics and clinical outcomes to exclude selection bias, characterize high-risk patients for non-adherence and test for gender differences...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28374343/factors-relevant-to-medication-non-adherence-in-kidney-transplant-a-systematic-review
#18
Stephanie Belaiche, Bertrand Décaudin, Sébastien Dharancy, Christian Noel, Pascal Odou, Marc Hazzan
Background Medication non-adherence is a major issue after transplant that can lead to misdiagnosis, rejection, poor health affecting quality of life, graft loss or death. Several estimations of adherence and related factors have previously been described but conclusions leave doubt as to the most accurate assessment method. Aim of the review To identify the factors most relevant to medication non-adherence in kidney transplant in current clinical practice. Method This systematic review is registered in the PROSPERO data base and follows the Prisma checklist...
April 3, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28356080/patient-reported-non-adherence-and-immunosuppressant-trough-levels-are-associated-with-rejection-after-renal-transplantation
#19
Jennifer Scheel, Sandra Reber, Lisa Stoessel, Elisabeth Waldmann, Sabine Jank, Kai-Uwe Eckardt, Franziska Grundmann, Frank Vitinius, Martina de Zwaan, Anna Bertram, Yesim Erim
BACKGROUND: Different measures of non-adherence to immunosuppressant (IS) medication have been found to be associated with rejection episodes after successful transplantation. The aim of the current study was to investigate whether graft rejection after renal transplantation is associated with patient-reported IS medication non-adherence and IS trough level variables (IS trough level variability and percentage of sub-therapeutic IS trough levels). METHODS: Patient-reported non-adherence, IS trough level variability, percentage of sub-therapeutic IS trough levels, and acute biopsy-proven late allograft rejections were assessed in 267 adult renal transplant recipients who were ≥12 months post-transplantation...
March 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28349215/adherence-in-pediatric-kidney-transplant-recipients-solutions-for-the-system
#20
REVIEW
Elizabeth A Steinberg, Mary Moss, Cindy L Buchanan, Jens Goebel
Non-adherence remains a significant problem among pediatric (and adult) renal transplant recipients. Non-adherence among solid organ transplant recipients results in US$15-100 million annual costs. Estimates of non-adherence range from 30 to 70% among pediatric patients. Research demonstrates that a 10% decrement in adherence is associated with 8% higher hazard of graft failure and mortality. Focus has begun to shift from patient factors that impact adherence to the contributing healthcare and systems factors...
March 27, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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