Read by QxMD icon Read

Clinical Quality

Chao Xiong, Zhiquan Zhang, Gurpreet S Baht, Niccolo Terrando
Surgery is commonly used to improve and maintain quality of life. Unfortunately, in vulnerable patients such as the elderly, complications may occur and significantly diminish the outcome. Indeed, after routine orthopedic surgery to repair a fracture, as many as 50% of elderly patients suffer from neurologic complications like delirium. Also, the capacity to heal and regenerate tissue after surgery decreases with age, and can impact the quality of fracture repair and even osseous integration of implants. Thus, a better understanding of mechanisms that drive these age-dependent changes could provide strategic targets to minimize risk for such complications and optimize outcomes...
February 27, 2018: Journal of Visualized Experiments: JoVE
Zoheir Elkahtib
BACKGROUND: Most health-care organisations are increasingly interested in assessing the quality of their services. Patient satisfaction has a central role in the quality assessment in health care because it reflects the appropriateness of services from the clients' perspectives. The aim of this study was to assess the level of satisfaction in patients with non-communicable diseases (mainly diabetes and hypertension) who receive services from UNRWA health centres in Gaza governorates. METHODS: In this cross-sectional study we chose a random sample of participants who presented to the randomly selected six health centres for treatment of non-communicable diseases...
February 21, 2018: Lancet
Sanaa Al Najjar, Tamer Al Shaer
BACKGROUND: To meet the emerging needs of the increasing numbers of patients with non-communicable diseases and to provide optimum care with optimum contact time and minimum waiting time, as stated in UNRWA guidelines, the mobile phone text messaging system was implemented in UNRWA centres to remind patients of upcoming appointments and to thereby improve the quality of care for vulnerable patients and regulate the work load in the clinics for non-communicable diseases. The aim of this study was to assess the causes for lack of adherence to the appointment system at UNRWA centres...
February 21, 2018: Lancet
Samah W Al-Jabi, Ansam Sous, Fatimah Jorf, Mahmoud Taqatqa, Mahdi Allan, Lamees Sawalha, Enas Lubadeh, Sa'ed H Zyoud, Waleed M Sweileh
BACKGROUND: The increasing incidence of end-stage renal disease in the Palestinian population and the effect of the disease on the psychological status of the patient underlie the importance of increasing knowledge about the mental health status of patients with end-stage renal disease. The aim of this study was to estimate the prevalence of depression in Palestinian patients treated with haemodialysis and its correlation with patients' clinical characteristics, health-related quality of life (HRQoL), and adherence to medications...
February 21, 2018: Lancet
Musallam Abukhalil, Osama Mehjez, Mohammed Aladdam, Bettina Bottcher, Sobhi Skaik, Mohammed Matter
BACKGROUND: In 2013, al-Shifa Hospital, the largest hospital in the Gaza Strip, introduced an assessment programme for potential kidney donors on the basis of medical and radiological evaluation. The aims of this study and an associated clinical audit were to examine the final outcome of the potential live kidney donors assessment programme, to review the findings and determine the level of accuracy of the radiological evaluations, to assess the completeness and standard of radiological record keeping, and to evaluate adherence to guidelines...
February 21, 2018: Lancet
Natasha A Lannin, Louise Ada, Coralie English, Julie Ratcliffe, Maria Crotty
Rationale Although clinical practice guidelines recommend that management of moderate to severe spasticity include the use of botulinum toxin-A in conjunction with therapy, there is currently no evidence to support the addition of therapy. Aims To determine the effect and cost-benefit of adding evidence-based movement training to botulinum toxin-A. Sample size estimate A total of 136 participants will be recruited in order to be able to detect a between-group difference of seven points on the Goal Attainment Scale T-score with 80% power at a two-tailed significance level of 0...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Axel Pressler, Leonie Förschner, Jana Hummel, Bernhard Haller, Jeffrey W Christle, Martin Halle
Background Increased exercise capacity favourably influences clinical outcomes after transcatheter aortic valve implantation. In our SPORT:TAVI randomised pilot trial, eight weeks of endurance and resistance training (training group, TG) shortly after transcatheter aortic valve implantation resulted in significantly improved exercise capacity, muscular strength and quality of life compared to usual care (UC). However, the long-term clinical benefits of such an intervention are unknown. Design A randomised controlled trial...
January 1, 2018: European Journal of Preventive Cardiology
S Palacios, R E Nappi, N Bruyniks, M Particco, N Panay
OBJECTIVES: The primary objective of the European Vulvovaginal Epidemiological Survey (EVES) was to assess, at a country level, the prevalence of postmenopausal women with vulvovaginal atrophy (VVA) confirmed by gynecological clinical assessment among all postmenopausal women attending menopause centers. METHOD: Women aged 45-75 years old with their last menstrual period more than 12 months before and who attended menopause or gynecology centers were included...
March 19, 2018: Climacteric: the Journal of the International Menopause Society
Lonnie Wen, Christine Divers, Melissa Lingohr-Smith, Jay Lin, Scott Ramsey
OBJECTIVES: To provide an overview of alternative payment models (APMs) and describe how leading national organizations involved with oncology care and payment are linking quality improvement initiatives and payment reform. STUDY DESIGN: Literature review. METHODS: For this review, we summarized the literature on APMs and their goals of improving healthcare quality while jointly controlling the cost of care. We described the types of APMs that have been examined in the real-world setting, specifically in the area of oncology, and how they have affected the quality of oncology care...
March 1, 2018: American Journal of Managed Care
Nathan D Shippee, Michael Finch, Douglas R Wholey
OBJECTIVES: Patient-centered medical homes (PCMHs) represent a widespread model of healthcare transformation. Despite evidence that PCMHs can improve care quality, the mechanisms by which they improve outcomes are relatively unexamined. We aimed to assess the mechanisms linking certification as a Health Care Home (HCH), a statewide PCMH initiative, with asthma care quality and outcomes. We compared direct certification effects versus indirect clinical effects (via improved care process)...
March 1, 2018: American Journal of Managed Care
Amir S Steinberg, Anish B Parikh, Sara Kim, Damaris Peralta-Hernandez, Talaat Aggour, Luis Isola
OBJECTIVES: Antibiotic stewardship is an integral aspect of hospital care, limiting the potential for resistance while working to minimize waste. A similar system is needed in oncology, given the rapid proliferation of new therapies and the challenges of navigating a complicated reimbursement environment. A "cancer therapy stewardship program" has never been described in the literature. Here, we detail our efforts to design and implement such a program and share lessons learned to inform future projects...
March 2018: American Journal of Managed Care
Yasin Yurt, Gül Şener, Yavuz Yakut
BACKGROUND: Foot orthoses are widely used in conservative treatment of painful flexible flatfoot however research is limited to choose the best option in orthotic treatment. AIM: We aimed to compare the effects of computer-aided design/computer-aided manufacturing (CAD-CAM) and conventional insole types in comparison with sham insole, on pain and health related quality of life in patients with painful flexible flatfoot. DESIGN: Randomized controlled trial...
March 16, 2018: European Journal of Physical and Rehabilitation Medicine
Irina Tammenmaa-Aho, Rosie Asher, Karla Soares-Weiser, Hanna Bergman
BACKGROUND: Tardive dyskinesia (TD) remains a troublesome adverse effect of conventional antipsychotic (neuroleptic) medication. It has been proposed that TD could have a component of central cholinergic deficiency. Cholinergic drugs have been used to treat TD. OBJECTIVES: To determine the effects of cholinergic drugs (arecoline, choline, deanol, lecithin, meclofenoxate, physostigmine, RS 86, tacrine, metoxytacrine, galantamine, ipidacrine, donepezil, rivastigmine, eptastigmine, metrifonate, xanomeline, cevimeline) for treating antipsychotic-induced TD in people with schizophrenia or other chronic mental illness...
March 19, 2018: Cochrane Database of Systematic Reviews
Mini Kamboj, Teresa Childers, Jessica Sugalski, Donna Antonelli, Juliane Bingener-Casey, Jamie Cannon, Karie Cluff, Kimberly A Davis, E Patchen Dellinger, Sean C Dowdy, Kim Duncan, Julie Fedderson, Robert Glasgow, Bruce Hall, Marilyn Hirsch, Matthew Hutter, Lisa Kimbro, Boris Kuvshinoff, Martin Makary, Melanie Morris, Sharon Nehring, Sonia Ramamoorthy, Rebekah Scott, Mindy Sovel, Vivian Strong, Ashley Webster, Elizabeth Wick, Julio Garcia Aguilar, Robert Carlson, Kent Sepkowitz
BACKGROUND Surgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement. OBJECTIVE To examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRS DESIGN American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011-2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined...
March 19, 2018: Infection Control and Hospital Epidemiology
Vikram Thakur, Munmun Chattopadhyay
BACKGROUND: Nephropathy is a debilitating complication of diabetes associated with increased risk for renal failure, leading to poor quality of life of the affected patients and eventually to mortality. Early intervention is crucial to enhance the well-being of the patients with nephropathy. Albuminuria is a well-known predictor of weak renal outcomes in patients with diabetes and hypertension, unfortunately, it is not an early marker for kidney injury. OBJECTIVE: Assessment of new and precise markers is necessary to predict the early onset and progression of nephropathy...
March 19, 2018: Current Drug Targets
Ágnes Szirmai, Stefani Maihoub, László Tamás
INTRODUCTION: Physicians are found to have a great and increasing amount of patients suffering of vertigo in their everyday practice. For the treatment of the balance disorders, a vestibular training was introduced which played an influential role based on our study. AIM: Our aim was to create an easy and comprehensible training program which can be performed even with a family member. METHODS: Our clinical treatment consists of intravenous vasoactive medicine administration, combined with vestibular training...
March 2018: Orvosi Hetilap
James D Neaton, Birgit Grund, Deborah Wentworth
BACKGROUND: Data monitoring committees for randomized clinical trials have the responsibility of safeguarding interests of trial participants. To do so, the data monitoring committee must receive reports on safety and efficacy to assess risk/benefit and on trial conduct to ensure that the study can achieve its goals. This article outlines the key components of reports to the data monitoring committee and the important role of the unblinded statistician in preparing those reports. METHODS: Most data monitoring committee meetings include open and closed sessions...
March 1, 2018: Clinical Trials: Journal of the Society for Clinical Trials
Nathan McClane, Walter Jeske, Jeanine M Walenga, Vicki Escalante, Debra Hoppensteadt, Jeffrey Schwartz, Mamdouh Bakhos
Heart failure affects over 5 million people in the United States. Its rising prevalence and the limited supply of donor hearts is increasing the use of mechanical cardiac support with the implantation of continuous-flow ventricular assist devices (CF-VAD). Patients with CF-VAD implants are at risk of complications, specifically adverse hemostatic events such as nonsurgical bleeding and thrombosis. Development of a pump thrombus requires clinical intervention and/or surgical replacement significantly increasing the risk of patient morbidity and mortality...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
C Incorvaia, S Masieri, C Cavaliere, E Makri, B Sposato, F Frati
A large amount of data show that AR and asthma are associated both epidemiologically and clinically, introducing the definition of “united airway disease”. The mechanisms underlying such association were initially suggested to start from the nose, including the loss of the protective and homeostatic effects of nasal function, the activation of a naso-bronchial reflex and the spread of allergic inflammation from the nose to the lower airways. Later, other factors such as microbial stimuli and systemic inflammatory mechanisms, involving bloodstream and bone marrow, were advocated...
January 2018: Journal of Biological Regulators and Homeostatic Agents
C Incorvaia, C Cavaliere, F Frati, S Masieri
Allergic rhinitis (AR) was long considered a quite trivial disease, but the advance in epidemiological and clinical knowledge, with a major role for Allergic rhinitis and its Impact on Asthma (ARIA) initiative, substantially changed the scene. Now we know that AR has significant effects on patients’ quality of life and also has a relevant economic burden. The ARIA phenotypes related to the duration of symptoms and to the severity of AR are very useful in establishing the optimal strategy in each patient with AR, also according to the kind of allergens that cause rhinitis...
January 2018: Journal of Biological Regulators and Homeostatic Agents
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"