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Clinical Quality

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https://www.readbyqxmd.com/read/29793135/accuracy-of-magnetic-resonance-venography-in-diagnosing-cerebral-venous-sinus-thrombosis
#1
Liansheng Gao, Weilin Xu, Tao Li, Xiaobo Yu, Shenglong Cao, Hangzhe Xu, Feng Yan, Gao Chen
OBJECTIVES: The non-specific clinical manifestations and lack of effective diagnostic techniques have made cerebral venous sinus thrombosis (CVST) difficult to recognize and easy to misdiagnose. Several studies have suggested that different types of magnetic resonance venography (MRV) have advantages in diagnosing CVST. We conducted this meta-analysis to assess the accuracy of MRV in identifying CVST. MATERIAL AND METHODS: We searched the Embase, PubMed, and Chinese Biomedical (CBM) databases comprehensively to retrieve eligible articles up to Mar 31, 2018...
May 17, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29793112/3d-printed-membrane-as-an-alternative-to-amniotic-membrane-for-ocular-surface-conjunctival-defect-reconstruction-an-in-vitro-in-vivo-study
#2
Shima Dehghani, Morteza Rasoulianboroujeni, Hamed Ghasemi, Saeed Heidari Keshel, Zohreh Nozarian, Mohammad Naser Hashemian, Mehran Zarei-Ghanavati, Golshan Latifi, Reza Ghaffari, Zhanfeng Cui, Hua Ye, Lobat Tayebi
BACKGROUND: The aim of this study was to evaluate the surgical handling and clinical applicability of a specific 3D-printed membrane design fabricated using a gelatin, elastin and sodium hyaluronate blend for conjunctival reconstruction and compare it with amniotic membrane (AM), which is normally used in such surgeries. METHODS: 3D printing technique was employed to fabricate the membrane based on gradient design. Prior to printing, rheometry was employed to optimize the ink composition...
May 11, 2018: Biomaterials
https://www.readbyqxmd.com/read/29793071/extracting-similar-terms-from-multiple-emr-based-semantic-embeddings-to-support-chart-reviews
#3
M S Cheng Ye, Daniel Fabbri
OBJECTIVE: Word embeddings project semantically similar terms into nearby points in a vector space. When trained on clinical text, these embeddings can be leveraged to improve keyword search and text highlighting. In this paper, we present methods to refine the selection process of similar terms from multiple EMR-based word embeddings, and evaluate their performance quantitatively and qualitatively across multiple chart review tasks. MATERIALS AND METHODS: Word embeddings were trained on each clinical note type in an EMR...
May 21, 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29792994/lumbar-spinal-stenosis-comparison-of-surgical-practice-variation-and-clinical-outcome-in-three-national-spine-registries
#4
Greger Lønne, Peter Fritzell, Olle Hägg, Dennis Nordvall, Paul Gerdhem, Tobias Lagerbäck, Mikkel Andersen, Søren Eiskjaer, Martin Gehrchen, Wilco Jacobs, Miranda L van Hooff, Tore K Solberg
BACKGROUND: Decompression surgery for lumbar spinal stenosis (LSS) is the most common spinal procedure in the elderly. To avoid persisting low back pain, adding arthrodesis has been recommended, especially if there is a coexisting degenerative spondylolisthesis. However, this strategy remains controversial, resulting in practice-based variation. PURPOSE: To evaluate in a pragmatic study if surgical selection criteria and variation in use of arthrodesis in three Scandinavian countries can be linked to variation in treatment effectiveness...
May 21, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29792936/efficient-detection-of-copy-number-mutations-in-pms2-exons-with-close-homologs-detection-of-copy-number-variants-in-3-pms2-exons
#5
Daniel S Herman, Christina Smith, Chang Liu, Cecily P Vaughn, Selvi Palaniappan, Colin C Pritchard, Brian H Shirts
Detection of 3' PMS2 copy number mutations that cause Lynch syndrome is difficult, because of highly homologous pseudogenes. To improve the accuracy and efficiency of clinical screening for these mutations, we developed a new method to analyze standard capture-based, next-generation sequencing data to identify deletions and duplications in PMS2 exons 9 to 15. The approach captures sequence reads using PMS2 targets, maps sequences randomly amongst regions with equal mapping quality, counts reads aligned to homologous exons and introns, and flags read count ratios outside of empirically derived reference ranges...
May 21, 2018: Journal of Molecular Diagnostics: JMD
https://www.readbyqxmd.com/read/29792569/the-relationship-between-suicidal-responses-and-traumatic-brain-injury-and-severe-insomnia-in-active-duty-veteran-and-civilian-populations
#6
Kelly A Soberay, Jetta E Hanson, Megan Dwyer, E Ashby Plant, Peter M Gutierrez
OBJECTIVE: This study examined how a positive traumatic brain injury (TBI) screening and insomnia severity relates to suicidal outcomes across active duty, veteran, and civilian samples. METHODS: Data were used from 3,993 participants from 19 studies. We conducted a series of analyses by group to identify which significantly differed on the variables of interest. RESULTS: TBI and insomnia each had independent relationships with outcomes over and above the impact of the other factor...
May 24, 2018: Archives of Suicide Research: Official Journal of the International Academy for Suicide Research
https://www.readbyqxmd.com/read/29792274/ex-vivo-expanded-natural-regulatory-t-cells-from-patients-with-end-stage-renal-disease-or-kidney-transplantation-are-useful-for-autologous-cell-therapy
#7
Sybille Landwehr-Kenzel, Anne Zobel, Henrike Hoffmann, Niels Landwehr, Michael Schmueck-Henneresse, Thomas Schachtner, Andy Roemhild, Petra Reinke
Novel concepts employing autologous, ex vivo expanded natural regulatory T cells (nTreg) for adoptive transfer has potential to prevent organ rejection after kidney transplantation. However, the impact of dialysis and maintenance immunosuppression on the nTreg phenotype and peripheral survival is not well understood, but essential when assessing patient eligibility. The current study investigates regulatory T-cells in dialysis and kidney transplanted patients and the feasibility of generating a clinically useful nTreg product from these patients...
June 2018: Kidney International
https://www.readbyqxmd.com/read/29792259/going-digital-a-checklist-in-preparing-for-hospital-wide-electronic-medical-record-implementation-and-digital-transformation
#8
Ian A Scott, Clair Sullivan, Andrew Staib
Objective In an era of rapid digitisation of Australian hospitals, practical guidance is needed in how to successfully implement electronic medical records (EMRs) as both a technical innovation and a major transformative change in clinical care. The aim of the present study was to develop a checklist that clearly and comprehensively defines the steps that best prepare hospitals for EMR implementation and digital transformation. Methods The checklist was developed using a formal methodological framework comprised of: literature reviews of relevant issues; an interactive workshop involving a multidisciplinary group of digital leads from Queensland hospitals; a draft document based on literature and workshop proceedings; and a review and feedback from senior clinical leads...
May 24, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29792244/affective-problems-and-decline-in-cognitive-state-in-older-adults-a-systematic-review-and-meta-analysis
#9
A John, U Patel, J Rusted, M Richards, D Gaysina
Evidence suggests that affective problems, such as depression and anxiety, increase risk for late-life dementia. However, the extent to which affective problems influence cognitive decline, even many years prior to clinical diagnosis of dementia, is not clear. The present study systematically reviews and synthesises the evidence for the association between affective problems and decline in cognitive state (i.e., decline in non-specific cognitive function) in older adults. An electronic search of PubMed, PsycInfo, Cochrane, and ScienceDirect was conducted to identify studies of the association between depression and anxiety separately and decline in cognitive state...
May 24, 2018: Psychological Medicine
https://www.readbyqxmd.com/read/29792220/frailty-measurement-and-its-contribution-to-clinical-care-and-health-services-a-commentary
#10
Shannon Wu, Bruce Leff
Frailty is associated with poorer quality of life and higher healthcare utilization and spending. Despite its importance, no clear consensus exists on the definition of frailty. The recent IJHPR article by Buch et al. significantly contributes to the advancement of Israel's understanding of frailty by estimating for the first time the prevalence of frailty in the country. This commentary discusses the context of past and current advancements in measuring frailty and discusses how frailty measurement can contribute to both clinical care and the organization of health services to care for frail older adults in Israel and other developed countries...
May 23, 2018: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29792188/health-related-quality-of-life-in-multiple-sclerosis-temperament-outweighs-edss
#11
S Salhofer-Polanyi, F Friedrich, S Löffler, P S Rommer, A Gleiss, R Engelmaier, F Leutmezer, B Vyssoki
BACKGROUND: The influence of personality on health-related quality of life in patients with multiple sclerosis has been the focus of previous studies showing that introversion and neuroticism were related with reduced health related quality of life. However, no data exist on the impact of temperament on quality of life in this patient group. METHODS: Between April 2014 and March 2016 139 multiple sclerosis patients were recruited from a specialized outpatient clinic of the general hospital of Vienna...
May 23, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29792074/lessons-learned-conducting-a-multi-center-trial-with-a-military-population-the-tinnitus-retraining-therapy-trial
#12
Roberta W Scherer, Leonora D Sensinger, Benigno Sierra-Irizarry, Craig Formby
Background The Tinnitus Retraining Therapy Trial (TRTT), a randomized, placebo-controlled, multi-center trial, evaluated the efficacy of tinnitus retraining therapy and its individual components, tinnitus-specific educational counseling and sound therapy versus the standard of care, in military practice to improve study participants' quality of life. The trial was conducted at six US military hospitals to take advantage of the greater prevalence of tinnitus in the military population. Methods During the trial, various challenges arose that were uniquely related to the military setting...
May 1, 2018: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/29792036/meeting-the-challenge-for-effective-antimicrobial-stewardship-programs-in-regional-rural-and-remote-hospitals-what-can-we-learn-from-the-published-literature
#13
Jaclyn Bishop, David Cm Kong, Thomas R Schulz, Karin A Thursky, Kirsty L Buising
INTRODUCTION: Antimicrobial resistance (AMR) has been recognised as an urgent health priority, both nationally and internationally. Australian hospitals are required to have an antimicrobial stewardship (AMS) program, yet the necessary resources may not be available in regional, rural or remote hospitals. This review will describe models for AMS programs that have been introduced in regional, rural or remote hospitals internationally and showcase achievements and key considerations that may guide Australian hospitals in establishing or sustaining AMS programs in the regional, rural or remote hospital setting...
May 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29791986/-revision-of-quality-indicators-for-the-endoscopy-quality-improvement-program-of-the-national-cancer-screening-program-in-korea
#14
REVIEW
Jun Ki Min, Jae Myung Cha, Yu Kyung Cho, Jie Hyun Kim, Soon Man Yoon, Jong Pil Im, Yunho Jung, Jeong Seop Moon, Jin Oh Kim, Yoon Tae Jeen
Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion...
May 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29791967/global-emergency-medicine-a-review-of-the-literature-from-2017
#15
Torben K Becker, Indi Trehan, Alison Schroth Hayward, Braden J Hexom, Sean M Kivlehan, Kevin M Lunney, Payal Modi, Maxwell Osei-Ampofo, Amelia Pousson, Daniel K Cho, Adam C Levine
OBJECTIVES: The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. METHODS: This year, 17,722 articles written in three languages were identified by our electronic search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM...
May 23, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29791945/global-health-epilepsy
#16
Amza Ali
Epilepsy is a frequently misunderstood and highly stigmatized condition. Major treatment gaps exist across the world, most so in areas of financial constraint. Classification permits the best approaches to treatment and to ascertaining prognosis. The International League Against Epilepsy's new classification system emphasizes clinical aspects and utilizes all available resources to determine whether it is a focal or generalized epilepsy. The most important tools are a careful history, clinical examination, electroencephalography, and appropriate neuroimaging...
April 2018: Seminars in Neurology
https://www.readbyqxmd.com/read/29791930/the-pediatric-emergency-care-applied-research-network-registry-a-multicenter-electronic-health-record-registry-of-pediatric-emergency-care
#17
Sara J Deakyne Davies, Robert W Grundmeier, Diego A Campos, Katie L Hayes, Jamie Bell, Evaline A Alessandrini, Lalit Bajaj, James M Chamberlain, Marc H Gorelick, Rene Enriquez, T Charles Casper, Beth Scheid, Marlena Kittick, J Michael Dean, Elizabeth R Alpern
BACKGROUND:  Electronic health record (EHR)-based registries allow for robust data to be derived directly from the patient clinical record and can provide important information about processes of care delivery and patient health outcomes. METHODS:  A data dictionary, and subsequent data model, were developed describing EHR data sources to include all processes of care within the emergency department (ED). ED visit data were deidentified and XML files were created and submitted to a central data coordinating center for inclusion in the registry...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29791926/meniscus-repair-in-children-and-adolescents-a-systematic-review-of-treatment-approaches-meniscal-healing-and-outcomes
#18
Márcio Balbinotti Ferrari, Colin P Murphy, João Luiz Ellera Gomes
Although the consequences of traumatic meniscus tears and the importance of meniscal repair are well-established in adults, the same cannot be said for the young population. Better evidence regarding the outcomes following traumatic meniscal tears in children would improve our understanding of this increasing pathology and help define important factors in deciding the best treatment option. A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines using the Cochrane Database of Systematic Review, Cochrane Central Register of Controlled Trials, MEDLINE Ovid, and MEDLINE PubMed databases...
May 23, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29791895/effect-of-postprandial-administration-of-esomeprazole-on-reflux-symptoms-in-gastroesophageal-reflux-disease-a-randomized-controlled-trial
#19
Doron Boltin, Ibrahim Zvidi, Maria Raskin, Hen Kayless, Hemda Schmilovitz-Weiss, Rachel Gingold-Belfer, Yaron Niv, Ram Dickman
BACKGROUND: Esomeprazole is commonly administered with food; however, clinical data to support this practice are lacking. We aimed to determine the effect of postprandial ingestion of esomeprazole on reflux symptoms among patients with gastroesophageal reflux disease (GERD). METHODS: Consecutive patients with GERD adequately controlled with esomeprazole 40 mg daily, entered a 2-week lead-in period during which esomeprazole was administered 30 min before breakfast...
May 23, 2018: Digestive Diseases
https://www.readbyqxmd.com/read/29791725/measuring-the-implementation-of-early-childhood-development-programs
#20
REVIEW
Frances E Aboud, Elizabeth L Prado
In this paper we describe ways to measure variables of interest when evaluating the implementation of a program to improve early childhood development (ECD). The variables apply to programs delivered to parents in group sessions and home or clinic visits, as well as in early group care for children. Measurements for four categories of variables are included: training and assessment of delivery agents and supervisors; program features such as quality of delivery, reach, and dosage; recipients' acceptance and enactment; and stakeholders' engagement...
May 2018: Annals of the New York Academy of Sciences
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