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https://www.readbyqxmd.com/read/28222233/case-mix-adjusted-variation-in-cesarean-section-rate-in-sweden
#1
Johan Mesterton, Lars Ladfors, Anna Ekenberg Abreu, Peter Lindgren, Sissel Saltvedt, Marianne Weichselbraun, Isis Amer-Wåhlin
INTRODUCTION: Cesarean section (CS) rate is a well-established indicator of performance in maternity care and is also related to resource use. Case mix adjustment of CS rates when performing comparisons between hospitals is important. The objective of this study was to estimate case mix adjusted variation in CS rate between hospitals in Sweden. MATERIAL AND METHODS: In total, 139756 deliveries in 2011 and 2012 were identified in administrative systems in 7 regions covering 67% of all deliveries in Sweden...
February 21, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28221159/what-should-we-do-with-residual-fragments
#2
Kemal Sarica, Emrah Yuruk
OBJECTIVE: To address various issues concerning the fate of residual fragments (and the patients carrying them), their detection, and current and future techniques to avoid them. METHODS: Narrative overview of the all relevant articles retrieved from Pubmed research together with the experiences of personal practice was conducted. RESULTS: Clinically insignificant residual fragments (CIRFs) are defined as asymptomatic, non-obstructing residual fragments smaller than 4 mm (1...
January 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28220410/an-audit-of-the-use-of-gonadorelin-analogues-to-prevent-recurrent-acute-symptoms-in-patients-with-acute-porphyria-in-the-united-kingdom
#3
Danja Schulenburg-Brand, Tricia Gardiner, Simon Guppy, David C Rees, Penelope Stein, Julian Barth, M Felicity Stewart, Michael Badminton
Severe recurrent acute attacks of porphyria have traditionally been treated with either prophylactic human haemin or gonadorelin analogues (GnA) in females. Evidence on the most effective treatment for this patient subgroup is lacking. This audit surveyed the use of prophylactic GnA in the UK.Twenty female patients (who experienced between 2 and 45 acute attacks of porphyria requiring hospitalisation and treatment with human haemin prior to GnA prophylaxis) were included in the audit. Data was retrospectively collected based on patient history and case review...
February 21, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28219445/a-cross-sectional-study-of-the-income-sources-of-primary-care-health-workers-in-the-democratic-republic-of-congo
#4
Rishma Maini, David R Hotchkiss, Josephine Borghi
BACKGROUND: In the Democratic Republic of Congo (DRC), the state system to remunerate health workers is poorly functional, encouraging diversification of income sources and corruption. Given the central role that health workers play in health systems, policy-makers need to ensure health workers are remunerated in a way which best incentivises them to provide effective and good quality services. This study describes the different sources and quantities of income paid to primary care health workers in Equateur, Maniema, Kasai Occidental, Province Orientale and Kasai Oriental provinces...
February 20, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28217424/joint-mobilization-in-the-management-of-persistent-insertional-achilles-tendinopathy-a-case-report
#5
Dhinu J Jayaseelan, Andrew A Post, John J Mischke, Josiah D Sault
BACKGROUND & PURPOSE: Insertional Achilles tendinopathy (IAT) can be a challenging condition to manage conservatively. Eccentric exercise is commonly used in the management of chronic tendinopathy; however, it may not be as helpful for insertional tendon problems as compared to mid-portion dysfunction. While current evidence describing the physical therapy management of IAT is developing, gaps still exist in descriptions of best practice. The purpose of this case report is to describe the management of a patient with persistent IAT utilizing impairment-based joint mobilization, self-mobilization, and exercise...
February 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/28216719/diagnosis-and-management-of-chronic-pruritus-an-expert-consensus-review
#6
REVIEW
Murlidhar Rajagopalan, Abir Saraswat, Kiran Godse, D S Krupa Shankar, Sanjiv Kandhari, Shrutakirthi D Shenoi, Sushil Tahiliani, V Vijay Zawar
The aim of this study is to formulate the best clinical practice in the diagnosis and management of chronic pruritus (CP). We searched PubMed, EMBASE, Scopus, Web of Science, and the WHO's regional databases, for studies on "Diagnosis and management of chronic pruritus" from January 1, 2014, to July 31, 2015. We included programmatic reports and hand-searched references of published reviews and articles. Two independent reviewers screened articles and extracted data. We screened 87 of 95 studies that contained qualitative data...
January 2017: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/28216079/2016-caps-ethics-session-ein-debate-1-regionalization-of-pediatric-surgical-care-2-ethical-introduction-of-surgical-innovation-3-addressing-stress-in-a-surgical-practice-resiliency-well-being-and-burnout
#7
REVIEW
Charles E Bagwell, Priscilla Chiu, Annie Fecteau, Kenneth W Gow, Claudia M Mueller, David Price, Andrew F Zigman
The following is the conference proceeding of the Second Ein Debate from the 48th Annual Meeting of the Canadian Association of Paediatric Surgeons held in Vancouver, BC, from September 22 to 24, 2016. The three main topics for debate, as prepared by the members of the CAPS Ethics Committee, are: 1. Regionalization of care: pros and cons, 2. Innovation in clinical care: ethical considerations, and 3. Surgeon well-being: caring for the caregiver. The authors of this paper, as participants in the debate, were assigned their positions at random...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28214955/ranibizumab-versus-aflibercept-for-macular-edema-due-to-central-retinal-vein-occlusion-18-month-results-in-real-life-data
#8
Irini Chatziralli, George Theodossiadis, Marilita M Moschos, Panagiotis Mitropoulos, Panagiotis Theodossiadis
PURPOSE: The objective of this study was to compare the anatomical and functional outcomes of ranibizumab versus aflibercept for the treatment of macular edema due to central retinal vein occlusion (CRVO) in routine clinical practice. METHODS: Participants in this observational study included 62 treatment-naïve patients with CRVO who received intravitreal injections of either ranibizumab or aflibercept. The demographic data, best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) characteristics were evaluated at baseline and at months 1, 2, 3, 6, 12 and 18 post-treatment...
February 18, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28214485/outcome-of-peripheral-venous-reconstructions-during-tumor-resection
#9
Philip Y Sun, Mark D Fleming, Kendall Stauffer, Manju Kalra, Gustavo Oderich, Thomas Bower, Peter Gloviczki, Randall R DeMartino
OBJECTIVE: Peripheral venous reconstruction surgery may be necessary for appropriate oncologic resection; however, the operative approach and surgical outcomes are not well described. We report our experience with these complex reconstructions to identify best practice. METHODS: We retrospectively reviewed all adult patients who underwent peripheral vein reconstruction for tumor resection at Mayo Clinic, Rochester (2000-2015). Patients were classified into three subgroups by the location: iliac (IL), lower extremity (LE), and upper extremity (UE)...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214168/medication-adherence-a-practical-measurement-selection-guide-using-case-studies
#10
Leah L Zullig, Phil Mendys, Hayden B Bosworth
OBJECTIVES: Medication adherence is a complex problem and can be evaluated using a variety of methods. There is no single or perfect strategy to assess adherence. The "best" measure depends on contextual factors. Our objective is to provide a practical, illustrative guide for selecting the most appropriate measure of medication adherence in common contexts. METHODS: We present three case studies - from the perspectives of an academic researcher, health care payer, and clinical care provider - to describe common problems and processes for measuring medication adherence, as well as proposing possible solutions...
February 10, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28214078/the-optimize-heart-failure-care-program-initial-lessons-from-global-implementation
#11
Martin R Cowie, Yuri M Lopatin, Clara Saldarriaga, Cândida Fonseca, David Sim, Jose Antonio Magaña, Denilson Albuquerque, Marcelo Trivi, Gustavo Moncada, Baldomero A González Castillo, Mario Osvaldo Speranza Sánchez, Edward Chung
Hospitalization for heart failure (HF) places a major burden on healthcare services worldwide, and is a strong predictor of increased mortality especially in the first three months after discharge. Though undesirable, hospitalization is an opportunity to optimize HF therapy and advise clinicians and patients about the importance of continued adherence to HF medication and regular monitoring. The Optimize Heart Failure Care Program (www.optimize-hf.com), which has been implemented in 45 countries, is designed to improve outcomes following HF hospitalization through inexpensive initiatives to improve prescription of appropriate drug therapies, patient education and engagement, and post-discharge planning...
February 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#12
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28213561/primary-care-requests-for-anaemia-chemistry-tests-in-spain-potential-iron-transferrin-and-folate-over-requesting
#13
Maria Salinas, Maite López-Garrigós, Emilio Flores, Carlos Leiva-Salinas
AIM: To study the regional variability of requests for anaemia chemistry tests in primary care in Spain and the associated economic costs of potential over-requesting. METHODS: Requests for anaemia tests were examined in a cross-sectional study. Clinical laboratories from different autonomous communities (AACCs) were invited to report on primary care anaemia chemistry tests requested during 2014. Demand for iron, ferritin, vitamin B12 and folate tests per 1000 inhabitants and the ratios of the folate/vitamin B12 and transferrin/ferritin requests were compared between AACCs...
February 17, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28213060/prediction-of-cesarean-delivery-in-the-term-nulliparous-woman-results-from-the-prospective-multi-center-genesis-study
#14
Naomi Burke, Gerard Burke, Fionnuala Breathnach, Fionnuala Mcauliffe, John J Morrison, Michael Turner, Samina Dornan, John R Higgins, Amanda Cotter, Michael Geary, Peter Mcparland, Sean Daly, Fiona Cody, Pat Dicker, Elizabeth Tully, Fergal D Malone
BACKGROUND: In contemporary practice many nulliparous women require intervention during childbirth such as operative vaginal delivery or Cesarean delivery (CD). Despite the knowledge that the rising CD rate is associated with increasing maternal age, obesity and larger infant birthweight, we lack a reliable method to predict the requirement for such potentially hazardous obstetric procedures during labor and delivery. This issue is important as there are higher rates of morbidity and mortality associated with unplanned CD performed in labor compared to scheduled Cesarean deliveries...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28212976/functional-lumen-imaging-probe-for-the-management-of-esophageal-disorders-expert-review-from-the-clinical-practice-updates-committee-of-the-aga-institute
#15
REVIEW
Ikuo Hirano, John E Pandolfino, Guy E Boeckxstaens
The functional luminal imaging probe is a Food and Drug Administration-approved measurement tool used to measure simultaneous pressure and diameter to guide management of various upper gastrointestinal disorders. Additionally, this tool is also approved to guide therapy during bariatric procedures and specialized esophageal surgery. Although it has been commercially available since 2009 as the endolumenal functional lumen imaging probe (EndoFLIP), the functional luminal imaging probe has had limited penetrance into clinical settings outside of specialized centers...
March 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28212957/a-systematic-review-of-health-economics-simulation-models-of-chronic-obstructive-pulmonary-disease
#16
REVIEW
Zafar Zafari, Stirling Bryan, Don D Sin, Tania Conte, Rahman Khakban, Mohsen Sadatsafavi
BACKGROUND: Many decision-analytic models with varying structures have been developed to inform resource allocation in chronic obstructive pulmonary disease (COPD). OBJECTIVES: To review COPD models for their adherence to the best practice modeling recommendations and their assumptions regarding important aspects of the natural history of COPD. METHODS: A systematic search of English articles reporting on the development or application of a decision-analytic model in COPD was performed in MEDLINE, Embase, and citations within reviewed articles...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212789/laboratory-diagnosis-of-echinococcus-spp-in-human-patients-and-infected-animals
#17
M Siles-Lucas, A Casulli, F J Conraths, N Müller
Among the species composing the genus Echinococcus, four species are of human clinical interest. The most prevalent species are Echinococcus granulosus and Echinococcus multilocularis, followed by Echinococcus vogeli and Echinococcus oligarthrus. The first two species cause cystic echinococcosis (CE) and alveolar echinococcosis (AE) respectively. Both diseases have a complex clinical management, in which laboratory diagnosis could be an adjunctive to the imaging techniques. To date, several approaches have been described for the laboratory diagnosis and followup of CE and AE, including antibody, antigen and cytokine detection...
2017: Advances in Parasitology
https://www.readbyqxmd.com/read/28212673/weight-compensation-characteristics-of-armeo%C3%A2-spring-exoskeleton-implications-for-clinical-practice-and-research
#18
Bonnie E Perry, Emily K Evans, Dobrivoje S Stokic
BACKGROUND: Armeo®Spring exoskeleton is widely used for upper extremity rehabilitation; however, weight compensation provided by the device appears insufficiently characterized to fully utilize it in clinical and research settings. METHODS: Weight compensation was quantified by measuring static force in the sagittal plane with a load cell attached to the elbow joint of Armeo®Spring. All upper spring settings were examined in 5° increments at the minimum, maximum, and two intermediate upper and lower module length settings, while keeping the lower spring at minimum...
February 17, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28211254/egyptian-tale-from-india-application-of-whole-exome-sequencing-in-diagnosis-of-atypical-familial-mediterranean-fever
#19
Pulukool Sandhya, Shamsudheen Karuthedath Vellarikkal, Aswin Nair, Rowmika Ravi, John Mathew, Rijith Jayarajan, Anoop Kumar, Ankit Verma, Ambily Sivadas, Debashish Danda, Sridhar Sivasubbu, Vinod Scaria
Clinical diagnosis of autoinflammatory diseases requires a high degree of clinical suspicion and clinching molecular evidence to substantiate the diagnosis. This is more so in populations with low prevalence of these disorders. In this report, we describe the case of a young man from India with recurrent fever and persistent arthritis. The patient's forefathers were of Egyptian ancestry who practiced consanguinity. Molecular genetic analysis using whole-exome sequencing suggested the presence of variants c...
February 17, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28210917/adjuvant-agents-in-regional-anesthesia-in-the-ambulatory-setting
#20
REVIEW
Veerandra Koyyalamudi, Sudipta Sen, Shilpadevi Patil, Justin B Creel, Elyse M Cornett, Charles J Fox, Alan D Kaye
PURPOSE OF REVIEW: A majority of surgical practice has involved ambulatory centers with the number of outpatient operations in the USA doubling to 26.8 million per year. Local anesthesia delivery provides numerous benefits, including increased satisfaction, earlier discharge, and reduction in unplanned hospital admission. Further, with the epidemic of opioid mediated overdoses, local anesthesia can be a key tool in providing an opportunity to reduce the need for other analgesics postoperatively...
January 2017: Current Pain and Headache Reports
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