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https://www.readbyqxmd.com/read/28335039/brain-temporal-complexity-in-explaining-the-therapeutic-and-cognitive-effects-of-seizure-therapy
#1
Faranak Farzan, Sravya Atluri, Ye Mei, Sylvain Moreno, Andrea J Levinson, Daniel M Blumberger, Zafiris J Daskalakis
Over 350 million people worldwide suffer from depression, a third of whom are medication-resistant. Seizure therapy remains the most effective treatment in depression, even when many treatments fail. The utility of seizure therapy is limited due to its cognitive side effects and stigma. The biological targets of seizure therapy remain unknown, hindering design of new treatments with comparable efficacy. Seizures impact the brains temporal dynamicity observed through electroencephalography. This dynamicity reflects richness of information processing across distributed brain networks subserving affective and cognitive processes...
March 3, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28335011/understanding-public-perception-of-the-need-for-major-change-in-latin-american-healthcare-systems
#2
Ricardo Pérez-Cuevas, Frederico C Guanais, Svetlana V Doubova, Leonardo Pinzón, Luis Tejerina, Diana Pinto Masis, Marcia Rocha, Donna O Harris, James Macinko
The opinions and experiences of the public regarding health services are valuable insights into identifying opportunities to improve healthcare systems. We analyzed the 2012-2013 Public Opinion Health Policy Survey carried out in Brazil (n = 1486), Colombia (n = 1485), El Salvador (n = 1460), Jamaica (n = 1480), México (n = 1492) and Panama (n = 1475). In these countries between 82 and 96% of participants perceived that their health systems needed fundamental changes. The most frequent barrier to access to healthcare was lack of the primary medical home, difficulties in obtaining medical care during the weekends and financial barriers...
March 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28335004/barriers-and-facilitators-for-institutional-delivery-among-poor-mesoamerican-women-a-cross-sectional-study
#3
Bernardo Hernandez, Danny V Colombara, Marielle C Gagnier, Sima S Desai, Annie Haakenstad, Casey Johanns, Claire R McNellan, Jennifer Nelson, Erin B Palmisano, Diego Ríos-Zertuche, Alexandra Schaefer, Paola Zúñiga-Brenes, Emma Iriarte, Ali H Mokdad
Professional skilled care has shown to be one of the most promising strategies to reduce maternal mortality, and in-facility deliveries are a cost-effective way to ensure safe births. Countries in Mesoamerica have emphasized in-facility delivery care by professionally skilled attendants, but access to good-quality delivery care is still lacking for many women. We examined the characteristics of women who had a delivery in a health facility and determinants of the decision to bypass a closer facility and travel to a distant one...
March 15, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334979/the-effectiveness-of-optimised-clinical-medication-reviews-for-geriatric-patients-opti-med-a-cluster-randomised-controlled-trial
#4
Floor Willeboordse, François G Schellevis, Sek Hung Chau, Jacqueline G Hugtenburg, Petra J M Elders
Background.: Inappropriate drug use is a frequent problem in older patients and associated with adverse clinical outcomes and an important determinant of geriatric problems. Clinical medication reviews (CMR) may reduce inappropriate drug use. Objective.: The aim of this study is to investigate the effectiveness of CMR on quality of life (QoL) and geriatric problems in comparison with usual care in older patients with geriatric problems in the general practice. Methods...
February 23, 2017: Family Practice
https://www.readbyqxmd.com/read/28334962/exposure-to-fictional-medical-television-and-health-a-systematic-review
#5
Beth L Hoffman, Ariel Shensa, Charles Wessel, Robert Hoffman, Brian A Primack
Fictional medical television programs have long been a staple of television programming, and they remain popular today. We aimed to examine published literature assessing the influence of medical television programs on health outcomes. We conducted systematic literature searches in PubMed, PsychINFO and CINAHL. Selected studies had to be scholarly research, to involve exposure to fictionalized medical television programming, and to assess associations between exposures and outcomes. Of 3541 unique studies identified, nineteen met selection criteria...
March 14, 2017: Health Education Research
https://www.readbyqxmd.com/read/28334908/adherence-and-persistence-of-patients-using-oral-bone-sparing-drugs-in-primary-care
#6
Babette C van der Zwaard, Wesley van Hout, Jacqueline G Hugtenburg, Henriëtte E van der Horst, Petra J M Elders
Aim.: Studies based on pharmacy medication records have shown suboptimal adherence and persistence of osteoporosis treatment with oral bone sparing drugs (OBSD). Little is known about adherence and persistence of OBSD treatment in primary care. We assessed adherence and persistence of OBSD use of patients in general practices and identified associated factors. Methods.: Using electronic medical records, adherence and persistence of newly prescribed treatment with OBSD in patients from 16 general practices was retrospectively assessed...
March 8, 2017: Family Practice
https://www.readbyqxmd.com/read/28334886/glioblastoma-associated-microglia-and-macrophages-targets-for-therapies-to-improve-prognosis
#7
Candice C Poon, Susobhan Sarkar, V Wee Yong, John J P Kelly
Glioblastoma is the most common and most malignant primary adult human brain tumour. Diagnosis of glioblastoma carries a dismal prognosis. Treatment resistance and tumour recurrence are the result of both cancer cell proliferation and their interaction with the tumour microenvironment. A large proportion of the tumour microenvironment consists of an inflammatory infiltrate predominated by microglia and macrophages, which are thought to be subverted by glioblastoma cells for tumour growth. Thus, glioblastoma-associated microglia and macrophages are logical therapeutic targets...
February 4, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28334856/evaluating-the-effects-of-organizational-and-educational-interventions-on-adherence-to-clinical-practice-guidelines-in-a-low-resource-primary-care-setting-in-kenya
#8
Joseph R Egger, Kayla Stankevitz, Robert Korom, Philip Angwenyi, Brittney Sullivan, Jun Wang, Sonia Hatfield, Emma Smith, Karishma Popli, Jessica Gross
Background: Mid-level care providers serve as the backbone of primary care in many parts of sub-Saharan Africa. Despite this, research suggests that the quality and consistency of this care is uneven. This study assessed the degree to which a set of four simple, low-cost interventions could improve adherence to a set of clinical quality measures (CQMs) associated with four common health conditions seen in a resource-constrained primary care setting. Methods: A quasi-experimental, longitudinal study was carried out in three primary care clinics in Nairobi, Kenya from August 2014 to January, 2015...
March 15, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334770/smokers-perceptions-of-sources-of-advice-about-quitting-findings-from-the-australian-arm-of-the-itc-4-country-survey
#9
James Balmford, Ron Borland
Smokers are exposed to advice about quitting from numerous sources. Within the 2013 ITC 4-Country Survey, 1211 Australian smokers or recent ex-smokers rated the perceived importance of eight sources of advice, categorized into evidence-based, non evidence-based, personal experience and vicarious experience (two items each), and also rated their intention to quit, nicotine dependence, use of quit medication, health concerns and harm beliefs. The eight items were all positively correlated. Respondents who placed greater importance on their experiences (either personal or vicarious) were more likely to agree that the evidence for smoking-related harm is exaggerated, and although not more likely to intend to quit overall, these responses were most strongly related to quit intention...
February 27, 2017: Health Education Research
https://www.readbyqxmd.com/read/28334592/using-an-electronic-perioperative-documentation-tool-to-identify-returns-to-operating-room-ror-in-a-tertiary-care-academic-medical-center
#10
Robert R Cima, Sarah R Dhanorker, Christopher L Ostendorf, Mfonabasi Ntekpe, Raghu V Mudundi, Elizabeth B Habermann, Claude Deschamps
BACKGROUND: The metric "Unplanned returns to operating room (ROR)" is being tracked in surgical quality dashboards; 70% of unplanned RORs may be related to surgical complications. With increasing regionalization of trauma and complex surgical care at tertiary care academic centers, it is unclear if a simple ROR metric is a valid assessment of surgical quality at such centers. METHOD: A real-time electronic tool was used to identify all RORs-planned and unplanned-in a high-volume, high-complexity academic surgical practice at Mayo Clinic-Rochester within 45 days of the index operation...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334584/delayed-workup-of-rectal-bleeding-in-adult-primary-care-examining-process-of-care-failures
#11
Saul N Weingart, Elena M Stoffel, Daniel C Chung, Thomas D Sequist, Ruth I Lederman, Stephen R Pelletier, Helen M Shields
BACKGROUND: Although delayed colorectal cancer diagnoses figure prominently in medical malpractice claims, little is known about the quality of primary care clinicians' workup of rectal bleeding. METHODS: In this study, 438 patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for rectal bleeding, hemorrhoids, and blood in the stool at 10 Boston adult primary care practices. Following nurse chart abstraction, physician reviewers assessed the overall quality of care and key care processes...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334563/quality-improvement-initiatives-lead-to-reduction-in-nulliparous-term-singleton-vertex-cesarean-delivery-rate
#12
Mary A Vadnais, Michele R Hacker, Neel T Shah, JoAnn Jordan, Anna M Modest, Molly Siegel, Toni H Golen
BACKGROUND: The nulliparous term singleton vertex (NTSV) cesarean delivery rate has been recognized as a meaningful benchmark. Variation in the NTSV cesarean delivery rate among hospitals and providers suggests many hospitals may be able to safely improve their rates. The NTSV cesarean delivery rate at the authors' institution was higher than state and national averages. This study was conducted to determine the influence of a set of quality improvement interventions on the NTSV cesarean delivery rate...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334561/determining-current-insulin-pen-use-practices-and-errors-in-the-inpatient-setting
#13
Katelyn E Brown, John B Hertig
BACKGROUND: The use of insulin pens in the inpatient setting has continued to be a controversial decision. Insulin pens provide several advantages, but given significant reports of medication errors, several organizations have issued alerts to caution users about safety concerns. A survey was conducted to assess the prevalence of insulin pen use and current utilization trends in the inpatient setting. METHODS: The 31-question guided-logic survey was developed based on review of primary literature regarding insulin pen utilization and evaluated by a panel of medication safety experts from a variety of health care settings...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334503/the-fetal-safety-of-clomiphene-citrate-a-population-based-retrospective-cohort-study
#14
Asher Weller, Sharon Daniel, Gideon Koren, Eitan Lunenfeld, Amalia Levy
OBJECTIVE: To evaluate whether exposure to CC for ovulation induction is associated with either overall major malformations or specific fetal anomalies. DESIGN: We conducted a population-based retrospective cohort. Exposure was defined as CC dispension from two months before conception through the first month of pregnancy. SETTINGS: Four databases were combined: medication, birth, hospitalization and pregnancy terminations. POPULATION: The study included all women in southern Israel who gave birth or underwent pregnancy termination at Soroka Medical Center from 1998 to 2009...
March 23, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28334471/the-clinical-applicability-of-a-daily-summary-of-patients-self-reported-postoperative-pain-a-repeated-measure-analysis
#15
Lotta Wikström, Kerstin Eriksson, Bengt Fridlund, Mats Nilsson, Kristofer Årestedt, Anders Broström
AIM AND OBJECTIVES: (I) to determine if a central tendency, median, based on patients' self-rated pain is a clinically applicable daily measure to show patients' postoperative pain on the first day after major surgery (II) and to determine the number of self-ratings required for the calculation of this measure. BACKGROUND: Perioperative pain traits in medical records are difficult to overview. The clinical applicability of a daily documented summarising measure of patients' self-rated pain scores is little explored...
March 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28334444/the-partial-dopamine-d2-receptor-agonist-aripiprazole-is-associated-with-weight-gain-in-adolescent-anorexia-nervosa
#16
Guido K W Frank, Megan E Shott, Jennifer O Hagman, Marissa A Schiel, Marisa C DeGuzman, Brogan Rossi
OBJECTIVE: Finding medication to support treatment of anorexia nervosa has been difficult. Neuroscience-based approaches may help in this effort. Recent brain imaging studies in adults and adolescents with anorexia nervosa suggest that dopamine-related reward circuits are hypersensitive and could provide a treatment target. METHODS: Here, we present a retrospective chart review of 106 adolescents with anorexia nervosa some of whom were treated with the dopamine D2 receptor partial agonist aripiprazole during treatment in a specialized eating disorder program...
March 23, 2017: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/28334414/association-of-a-haplotype-in-the-nr3c2-gene-encoding-the-mineralocorticoid-receptor-with-chronic-central-serous-chorioretinopathy
#17
Elon H C van Dijk, Rosa L Schellevis, Maaike G J M van Bergen, Myrte B Breukink, Lebriz Altay, Paula Scholz, Sascha Fauser, Onno C Meijer, Carel B Hoyng, Anneke I den Hollander, Camiel J F Boon, Eiko K de Jong
Importance: Chronic central serous chorioretinopathy (cCSC) is a chorioretinal disease with unknown disease etiology. The glucocorticoid receptor and the mineralocorticoid receptor, 2 glucocorticoid-binding receptors, might be involved in the pathogenesis of cCSC. Objective: To assess the association of functional variants and haplotypes in the glucocorticoid receptor (NR3C1) and mineralocorticoid receptor (NR3C2) genes with cCSC. Design, Setting, and Participants: In this case-control genetic association study, 336 patients with cCSC and 1314 unaffected controls, collected at 3 university medical centers from September 1, 2009, to May 1, 2016, underwent KASP genotyping for selected variants in NR3C1 (rs56149945, rs41423247, and rs6198) and NR3C2 (rs2070951 and rs5522)...
March 23, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28334382/concussion-like-symptom-reporting-in-non-concussed-collegiate-athletes
#18
Breton M Asken, Aliyah R Snyder, James R Clugston, Leslie S Gaynor, Molly J Sullan, Russell M Bauer
Objective: Non-concussed individuals may report a variety of concussion-like symptoms even in the absence of a diagnosed brain injury. Previous studies described concussion-like symptom reporting in adolescent athletes. This study provides complementary data on concussion-like symptoms in collegiate athletes. Methods: We analyzed baseline symptom scales from 738 collegiate athletes (452 men and 286 women) who completed either the Sport Concussion Assessment Tool, 3 Symptom Evaluation (S3SE; n = 377) or the Post-Concussion Scale (PCS; n = 361) and determined if subjects met criteria for diagnosis of International Classification of Diseases 10th Revision (ICD-10) postconcussional syndrome...
March 10, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28334371/comparative-study-of-functional-nasal-reconstruction-using-structural-reinforcement
#19
Waleed H Ezzat, Sara W Liu
Importance: Nasal reconstruction after Mohs surgery is a unique challenge in that it must satisfy both functional and aesthetic goals. Despite some advocacy in the literature for using structural reinforcement to achieve both functional and aesthetic outcomes in soft-tissue reconstruction, no study has validated this claim by comparing reconstruction with and without structural support. Objective: To evaluate the effectiveness of and need for structural reinforcement when reconstructing the nasal alar and sidewall subunits...
March 23, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28334328/vestibular-aqueduct-midpoint-width-and-hearing-loss-in-patients-with-an-enlarged-vestibular-aqueduct
#20
Mustafa S Ascha, Nauman Manzoor, Amit Gupta, Maroun Semaan, Cliff Megerian, Todd D Otteson
Importance: Elucidating the relationship between vestibular aqueduct size and hearing loss progression may inform the prognosis and counseling of patients who have an enlarged vestibular aqueduct (EVA). Objectives: To examine the association between vestibular aqueduct size and repeated measures of hearing loss. Design, Setting, and Participants: For this retrospective medical record review, 52 patients with a diagnosis of hearing loss and radiologic diagnosis of EVA according to the Valvassori criterion were included...
March 23, 2017: JAMA Otolaryngology—Head & Neck Surgery
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