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https://www.readbyqxmd.com/read/28531288/an-evaluation-of-systemic-reforms-of-public-hospitals-the-sanming-model-in-china
#1
Hongqiao Fu, Ling Li, Mingqiang Li, Chunyu Yang, William Hsiao
Low- and middle-income countries (LMICs) have been searching for effective strategies to reform their inefficient and wasteful public hospitals. Recently, China developed a model of systemic reforms called the Sanming model to address the inefficiency and waste at public hospitals. In this article, we explain and evaluate how the Sanming model reformed its 22 public hospitals in 2013 by simultaneously restructuring the hospital governance structure, altering the payment system to hospitals, and realigning physicians' incentives...
May 20, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28530076/-osteoporosis-and-diabetes-in-which-way-are-they-related
#2
REVIEW
Osnat Tell-Lebanon, Pnina Rotman-Pikielny
Diabetes and osteoporosis are common diseases with growing prevalence in the aging population. Many recent studies have reported an association between diabetes mellitus and an increased osteoporotic fracture rate. Compared to control subjects, decreased bone mineral density has been observed in patients with type 1 diabetes mellitus, while those with type 2 diabetes display a unique skeletal phenotype of increased bone mineral density, but impaired architectural structure and mineral properties. Accumulation of advanced glycation end products changes collagen structure and suppression of bone turnover causes impairment of repair and adaptation mechanisms...
November 2016: Harefuah
https://www.readbyqxmd.com/read/28528807/comparison-of-amicus-and-cobe-spectra-for-allogenic-peripheral-blood-stem-cell-harvest-study-from-tertiary-care-centre-in-india
#3
Rasika Dhawan Setia, Satyam Arora, Anil Handoo, Tina Dadu, Dharma Choudhary, Sajeev Kumar Sharma, Gaurav Kharya, Vipin Khandelwal, Prerna Sachdeva, Divya Doval, Anamika Bakliwal, Meenu Kapoor, Shalu Bajaj, Virendra Bachchas, Praveen Singh
INTRODUCTION: Most common source of stem cell graft for both autologous and allogenic haematopoietic transplants are peripheral blood haematopoietic progenitor stem cells. Adequate collection of the CD34+ cells and safety of the allogenic donor during the leukapheresis are of prime importance to an apheresis physician. Our retrospective analysis is a comparison between of two platforms namely, COBE Spectra and Amicus, for CD34+ mononuclear cell collection. MATERIAL AND METHOD: The study included the data of GSCF (Granulocyte-Colony-Stimulating Factor) mobilized allogenic PBSC collections at our centre from January 2015 to June 2016...
April 24, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28524363/donor-transmitted-mutation-of-the-abcb11-gene-and-ensuing-intra-hepatic-cholestasis-of-pregnancy-in-a-liver-transplant-recipient
#4
Tiong Yeng Lim, Iona Coltart, Pierre Foskett, Richard Thompson, Sandra Strautnieks, Leonie Penna, Catherine Williamson, Rosa Miquel, Michael A Heneghan
In liver transplant (LT) recipients, the cause of graft dysfunction in pregnancy is often difficult to ascertain. Moreover, a liver biopsy in late pregnancy is often avoided as a consequence of patient and physician factors. Management of graft dysfunction can be difficult in this setting. We report a 30-year-old female LT recipient who developed acutely deranged liver biochemistry during the third trimester of her first pregnancy. At 29 weeks gestation, her liver function test (LFT) became abnormal; AST peaked at 978 IU/L (normal range 10-50), GGT 25 IU/L (normal range 1-55), bilirubin 1...
May 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28523743/applying-lessons-from-social-psychology-to-transform-the-culture-of-error-disclosure
#5
Jason Han, Denise LaMarra, Neha Vapiwala
CONTEXT: The ability to carry out prompt and effective error disclosure has been described in the literature as an essential skill among physicians that can lead to improved patient satisfaction, staff well-being and hospital outcomes. However, few studies have addressed the social psychology principles that may influence physician behaviour. METHODS: The authors provide an overview of recent administrative measures designed to encourage physicians to disclose error, but note that deliberate practice, buttressed with lessons from social psychology, is needed to implement further productive behavioural changes...
May 18, 2017: Medical Education
https://www.readbyqxmd.com/read/28523334/large-pleural-tumor-revealed-by-severe-hypoglycemia-doege-potter-syndrome
#6
Irina Ruxandra Strâmbu, Diana Gabriela Leonte, Ciprian Nicolae Bolca
AIM: Doege-Potter syndrome is a rare condition consisting of a mesenchymal tumor, either benign or malignant, accompanied by severe hypoglycemia. The syndrome was first described independently by two American physicians, Karl Walter Doege (1867-1932) and Roy Pilling Potter (1879-1968), in 1930, but it was not before 1988 that it was associated with non-islet cell tumor production of insulin growth factor (IGF) that induces hypoglycemia as a paraneoplastic syndrome. CASE PRESENTATION: We present the case of a 61-year-old woman with severe hypoglycemia that induced seizures...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28522038/injectable-and-topical-neurotoxins-in-dermatology-basic-science-anatomy-and-therapeutic-agents
#7
REVIEW
Cerrene N Giordano, Seth L Matarasso, David M Ozog
Botulinum toxin is a potentially deadly anaerobic bacterial toxin that acts by inhibiting release of acetylcholine at the neuromuscular junction, thereby inhibiting contraction of the exposed striated muscle. There are currently 4 botulinum toxin preparations approved by the US Food and Drug Administration (FDA): onabotulinumtoxin, abobotulinumtoxin, incobotulinumtoxin and rimabotulinumtoxin. While significant overlap exists, each product has unique properties and specifications, including dosing, diffusion, and storage...
June 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28514367/-the-new-possibilities-for-the-treatment-of-chronic-cough-associated-with-postnasal-drip
#8
A Yu Ovchinnikov, N A Miroshnichenko, A M Mityuk, V A Ryabinin, A G Gorban
Cough is considered to be one of the leading clinical symptoms associated with the pathological changes in the respiratory system. Notwithstanding a great variety of therapeutic pharmaceutical products possessed of the antitussive action, physicians tend the give preference to the preparations producing the combined effect. The present article reports the results of the clinical study designed to evaluate the effectiveness and safety of the application of rengalin exhibiting the combined antitussive, anti-inflammatory, and broncholytic action in the patients presenting with the postnasal drip syndrome...
2017: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/28513968/the-views-of-ethics-committee-members-and-medical-researchers-on-the-return-of-individual-research-results-and-incidental-findings-ownership-issues-and-benefit-sharing-in-biobanking-research-in-a-south-indian-city
#9
Manjulika Vaz, Mario Vaz, Srinivasan K
The return of individual research results and incidental findings from biobanking research is a much debated ethical issue globally but has extensive relevance in India where the burden of out of pocket health care expenses is high for the majority. The views of 21 ethics committee (EC) members and 22 researchers from Bengaluru, India, concerning the ethics of biobanking research were sought through in-depth interviews using an unfolding case vignette with probes. A shared view among most was that individual research results which are 'actionable' or have 'clinical significance' should be returned to the sample contributors through their treating physicians...
May 17, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28506972/career-and-research-outcomes-of-the-physician-scientist-training-program-at-the-university-of-calgary-a-retrospective-cohort-study
#10
Jason T Bau, Alexandra D Frolkis, Nabeela Nathoo, Bryan G Yipp, Morley D Hollenberg, Paul L Beck
BACKGROUND: Physician-scientists are integral to medical research, with medical programs throughout Canada invested in training hybrid physician-scientists. Few data exist as to whether these programs are generating the diversity, gender equity and numbers of trainees essential for the future of medical research and teaching. We aimed to identify factors that contribute to research productivity, diversity and retention of individuals as physician-scientists. METHODS: We completed a retrospective cohort study, for the period 1973 to 2015, of the University of Calgary Leaders in Medicine Program in Calgary, Alberta...
May 15, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28506255/retrospective-study-of-nonmucinous-appendiceal-adenocarcinomas-role-of-systemic-chemotherapy-and-cytoreductive-surgery
#11
Marc Uemura, Wei Qiao, Keith Fournier, Jeffrey Morris, Paul Mansfield, Cathy Eng, Richard E Royal, Robert A Wolff, Kanwal Raghav, Gary N Mann, Michael J Overman
BACKGROUND: Mucinous appendiceal adenocarcinomas (AAs) are the most common histological subset of AAs. Nonmucinous AAs have been infrequently studied. We performed a single-center retrospective study to investigate this histological subtype. METHODS: We reviewed 172 patient records with nonmucinous AAs treated at MD Anderson Cancer Center from Jan, 1990 to Jun, 2015 and recorded patient demographics, tumor characteristics, treatment, and outcomes. Response rate (RR) was assessed semi-quantitatively (response/no response) according to the treating physician's findings...
May 15, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28500566/an-update-on-addressing-important-peripheral-nerve-problems-challenges-and-potential-solutions
#12
Wilson Z Ray, Mark A Mahan, Danzhu Guo, Danqing Guo, Michel Kliot
From time to time it is thoughtful and productive to review a medical field and reflect upon what are the major issues that need to be addressed and what is being done to do so. This review article is not meant to be all-inclusive but rather focuses on four evolving areas in the field of peripheral nerve disorders and treatments: (1) nerve surgery under ultrasound guidance using a new ultra-minimally invasive thread technique; (2) evolving magnetic resonance imaging (MRI) and ultrasound imaging techniques that are helping to both diagnose and treat a variety of peripheral nerve problems including entrapment neuropathies, traumatic nerve injuries, and masses arising from nerves; (3) promoting recovery after nerve injury using electrical stimulation; and (4) developing animal models to reproduce a severe nerve injury (neurotmetic grade in continuity) that requires a surgical intervention and repair...
May 12, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28500459/personalized-feedback-on-staff-dose-in-fluoroscopy-guided-interventions-a-new-era-in-radiation-dose-monitoring
#13
Anna M Sailer, Laura Vergoossen, Leonie Paulis, Willem H van Zwam, Marco Das, Joachim E Wildberger, Cécile R L P N Jeukens
PURPOSE: Radiation safety and protection are a key component of fluoroscopy-guided interventions. We hypothesize that providing weekly personal dose feedback will increase radiation awareness and ultimately will lead to optimized behavior. Therefore, we designed and implemented a personalized feedback of procedure and personal doses for medical staff involved in fluoroscopy-guided interventions. MATERIALS AND METHODS: Medical staff (physicians and technicians, n = 27) involved in fluoroscopy-guided interventions were equipped with electronic personal dose meters (PDMs)...
May 12, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28492057/dermatologic-care-of-the-transgender-patient
#14
EDITORIAL
B A Ginsberg
Given the complexities of the transitioning process, transgender individuals may face unique dermatologic needs in addition to routine care. Exogenous hormones affect hair and sebum production, gender-confirming surgeries often require dermatologic pre- and postoperative interventions, and postoperative anatomy may show unique presentations of routine skin conditions. Aesthetic techniques that are often used for rejuvenation may have a role in facial feminization and masculinization and unfortunately are too frequently performed by nonmedical personnel with negative consequences...
March 2017: International Journal of Women's Dermatology
https://www.readbyqxmd.com/read/28488955/reporting-transfusion-related-acute-lung-injury-by-clinical-and-preclinical-disciplines
#15
Anna L Peters, Emma K Van De Weerdt, Eline J Goudswaard, Jan M Binnekade, Jaap J Zwaginga, Erik A M Beckers, Sacha S Zeerleder, Marian G J Van Kraaij, Nicole P Juffermans, Alexander P J Vlaar
BACKGROUND: Disciplines involved in diagnosing transfusion-related acute lung injury (TRALI) report according to a "one-hit" theory. However, studies showed that patients with an underlying condition are at increased risk of the development of TRALI. We investigated whether accumulating evidence on the "two-hit" theory has changed the practice of reporting TRALI. MATERIALS AND METHODS: Departments of haematology, haemovigilance, transfusion medicine, intensive care and anaesthesiology from all Dutch hospitals with at least five beds equipped for mechanical ventilation were invited to participate in an online survey...
April 5, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28485714/portugal-health-system-review
#16
Jorge de Almeida Simoes, Goncalo Figueiredo Augusto, Ines Fronteira, Cristina Hernandez-Quevedo
This analysis of the Portuguese health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Overall health indicators such as life expectancy at birth and at age 65 years have shown a notable improvement over the last decades. However, these improvements have not been followed at the same pace by other important dimensions of health: child poverty and its consequences, mental health and quality of life after 65...
March 2017: Health Systems in Transition
https://www.readbyqxmd.com/read/28480867/-the-evaluation-of-the-effectiveness-of-the-implementation-of-information-system-1c-enterprise-in-the-hospital
#17
A Baimagambetova, D Kulov, A Tsay, K Kairbekova, M Sakenova
The aim of research was to assess the impact of the introduction of information system 1C: Enterprise on the work of medical staff. It was evaluated staff satisfaction in terms of quality and speed of their duties, as well as sociological changes after the introduction in the work the information system 1C: Enterprise from 2010. The research involved 138 employees of the hospital, including 48 doctors and 90 nurses with experience of at least 5 years. The average age of respondents was 45 years. The study was conducted through questionnaires, including questions relating to life expectancy, changing the speed and quality of execution of tasks, also attended to questions about the change in the frequency of conflict situations and wages...
March 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28479860/rituximab-in-the-treatment-of-follicular-lymphoma-the-future-of-biosimilars-in-the-evolving-therapeutic-landscape
#18
REVIEW
Janakiraman Subramanian, Jamie Cavenagh, Bhardwaj Desai, Ira Jacobs
Follicular lymphoma (FL) is the second most common type of non-Hodgkin's lymphoma. FL is an incurable disease with treatment options ranging from a "watch-and-wait" approach to localized therapy with radiation or systemic therapy with rituximab in combination with chemotherapy regimens. This review summarizes the role of rituximab across the spectrum of FL treatment and the evolving therapeutic landscape with the emergence of novel agents currently in clinical development. Despite the prospect of new agents on the horizon, it is widely accepted that rituximab will remain as the cornerstone of therapy because of its established long-term efficacy...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28471780/well-being-in-graduate-medical-education-a-call-for-action
#19
Jonathan A Ripp, Michael R Privitera, Colin West, Richard Leiter, Lia Logio, Jo Shapiro, Hasan Bazari
Job burnout is highly prevalent in graduate medical trainees. Numerous demands and stressors drive the development of burnout in this population, leading to significant and potentially tragic consequences, not only for trainees but also for the patients and communities they serve. The literature on interventions to reduce resident burnout is limited but suggests that both individual- and system-level approaches are effective. Work hours limitations and mindfulness training are each likely to have modest benefit...
May 2, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28471205/-everolimus-in-daily-clinical-practice-focusing-to-oral-mucosa-damage-issues-single-oncology-centre-experience-within-the-course-of-the-year-2016
#20
S Vokurka, M Votavová, V Arnetová, H Korunková, T Svoboda, J Kulhánková, K Kališová, V M Matějka, O Fiala, J Fínek
BACKGROUND: Oral mucositis, mTOR associated stomatitis, is a major complication in everolimus (EVE) treatment with an incidence of 44-64%. The management of it in the daily practice has not been described enough, so far. PATIENTS AND METHODS: Retrospective analysis of patients treated with EVE in 2016 at our center, n = 42 patients (69% female), median age 66 (37-81) years, breast cancer in 20 (48%) and renal cell carcinoma in 22 (52%), starting EVE dose of 10mg/day in 34 (81%) and 5mg/day in 8 (19%) patients...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
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