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https://www.readbyqxmd.com/read/28531999/zro2-toughened-al2o3-based-near-net-shaped-femoral-head-unique-fabrication-approach-3d-microstructure-burst-strength-and-muscle-cell-response
#1
Debasish Sarkar, Sourav Mandal, B S Reddy, Nitu Bhaskar, D C Sundaresh, Bikramjit Basu
The development of reliable biomedical devices demands the use of an integrated manufacturing protocol with comprehensive understanding of prototype characterization in terms of 3D microstructural analysis along with biocompatibility. While addressing these issues for ZrO2 (3mol% Y2O3 stabilized)-toughened Al2O3-based femoral head prototypes, the present work reports a unique fabrication protocol involving a sequence of uniaxial compaction followed by pre-sintering, machining, final sintering and polishing to ensure dimensional tolerance with respect to the design of patient-specific femoral head...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28531775/a-protocol-for-sustained-reduction-of-total-parenteral-nutrition-and-cost-savings-by-improvement-of-nutritional-care-in-hospitals
#2
Rian van Schaik, Kurt Van den Abeele, Glenn Melsens, Peter Schepens, Truus Lanssens, Bernadette Vlaemynck, Maria Devisch, Theo A Niewold
BACKGROUND AND AIMS: Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14)...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28531395/nationwide-survey-of-nutritional-management-in-an-asian-upper-middle-income-developing-country-government-hospitals-combination-of-quantitative-survey-and-focus-group-discussion
#3
K Chittawatanarat, K Tosanguan, U Chaikledkaew, S Tejavanija, Y Teerawattananon
BACKGROUND & AIMS: The objective of this study was to identify the differences in pattern, process, and management of nutrition care in government hospitals in Thailand (an Asian upper-middle income developing country). METHODS: This is a combination of a quantitative nationwide questionnaire survey and focus group discussions. A total of 2300 questionnaires were sent to government hospitals across Thailand. The responders were divided by routine-nutrition screening/assessment unit vs...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28531097/evolution-not-revolution-nutrition-and-obesity
#4
Elaine C Rush, Mary R Yan
The increasing prevalence of obesity over the course of life is a global health challenge because of its strong and positive association with significant health problems such as type 2 diabetes, cardiovascular disease, stroke, and some cancers. The complex causes and drivers of obesity include genetic factors, social, ecological and political influences, food production and supply, and dietary patterns. Public health messages and government food and activity guidelines have little impact; the retail food environment has many low-priced, nutrient-poor, but energy-dense products and there is a gap between what an individual knows and what they do...
May 20, 2017: Nutrients
https://www.readbyqxmd.com/read/28530525/cost-effectiveness-of-nivolumab-ipilimumab-combination-therapy-compared-with-monotherapy-for-first-line-treatment-of-metastatic-melanoma-in-the-united-states
#5
Anna Oh, Dang M Tran, Leann C McDowell, Dor Keyvani, Jay Andrew Barcelon, Oscar Merino, Leslie Wilson
BACKGROUND: The approval of new immunotherapies has dramatically changed the treatment landscape of metastatic melanoma. These survival gains come with trade-offs in side effects and costs, as well as important considerations for third-party payer systems, physicians, and patients. OBJECTIVE: To develop a Markov model to determine the cost-effectiveness of nivolumab, ipilimumab, and nivolumab-ipilimumab combination as firstline therapy in metastatic melanoma, while accounting for differential effectiveness in programmed death-ligand 1 (PD-L1) positive and negative patients...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530453/two-case-studies-illustrating-a-shared-decision-making-approach-to-illicit-methamphetamine-use-and-breastfeeding
#6
Julie Blandthorn, Katie James, Ellen Bowman, Yvonne Bonomo, Lisa H Amir
Crystal methamphetamine (MA) is a potent psycho-stimulant that is increasingly used worldwide. It is highly addictive, is often made in clandestine laboratories, and can cause serious health issues in adults. Health professionals caring for women in the perinatal period must counsel women about the health risks to infants if they are exposed to MA in breast milk. Most guidelines recommend that women who have current or recent MA use do not breastfeed. This article explores approaches to breastfeeding advice in the context of MA use...
May 22, 2017: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/28530431/socioeconomic-status-and-parenting-during-adolescence-in-relation-to-ideal-cardiovascular-health-in-black-and-white-men
#7
Karen A Matthews, Jennifer M Boylan, Karen P Jakubowski, Jenny M Cundiff, Laisze Lee, Dustin A Pardini, J Richard Jennings
OBJECTIVE: American Heart Association (AHA) developed a new metric to evaluate ideal cardiovascular health based on optimal levels of 7 cardiovascular risk factors and health behaviors. We evaluated the relationships of parenting characteristics and academic achievement in adolescence in relation to ideal cardiovascular health in midlife men. METHOD: We measured cardiovascular risk factors in 171 Black and 136 White men and their ideal cardiovascular health score was constructed based on AHA guidelines...
May 22, 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28530033/concomitant-contraceptive-implant-and-efavirenz-use-in-women-living-with-hiv-perspectives-on-current-evidence-and-policy-implications-for-family-planning-and-hiv-treatment-guidelines
#8
REVIEW
Rena C Patel, Chelsea Morroni, Kimberly K Scarsi, Tabitha Sripipatana, James Kiarie, Craig R Cohen
INTRODUCTION: Preventing unintended pregnancies is important among all women, including those living with HIV. Increasing numbers of women, including HIV-positive women, choose progestin-containing subdermal implants, which are one of the most effective forms of contraception. However, drug-drug interactions between contraceptive hormones and efavirenz-based antiretroviral therapy (ART) may reduce implant effectiveness. We present four inter-related perspectives on this issue. DISCUSSION: First, as a case study, we discuss how limited data prompted country-level guidance against the use of implants among women concomitantly using efavirenz in South Africa and its subsequent negative effects on the use of implants in general...
May 11, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28529861/local-intra-wound-administration-of-powdered-antibiotics-in-orthopaedic-surgery
#9
REVIEW
Andrew N Fleischman, Matthew S Austin
Surgical site infection (SSI) is one of the most common complications after orthopaedic surgery, leading to significant morbidity and its associated costs. Surgical guidelines strongly recommend the use of systemic antibiotic prophylaxis to reduce the risk for developing SSI. Locally administered powdered antibiotics have the potential to provide remarkably high intra-wound concentrations without risk for systemic toxicity. However, a paucity of high quality evidence in the orthopaedic literature has prevented widespread adoption of this technique...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529747/amrubicin-monotherapy-may-be-an-effective-second-line-treatment-for-patients-with-large-cell-neuroendocrine-carcinoma-or-high-grade-non-small-cell-neuroendocrine-carcinoma
#10
Norimitsu Kasahara, Kazushige Wakuda, Shota Omori, Kazuhisa Nakashima, Akira Ono, Tetsuhiko Taira, Hirotsugu Kenmotsu, Tateaki Naito, Haruyasu Murakami, Keita Mori, Reiko Watanabe, Masahiro Endo, Takashi Nakajima, Masanobu Yamada, Toshiaki Takahashi
There is no standard chemotherapy for pulmonary large-cell neuroendocrine carcinoma (LCNEC) and this type of cancer is difficult to diagnose using biopsy specimens. At the Shizuoka Cancer Center, when small biopsy specimens are used, they are diagnosed as high-grade non-small-cell neuroendocrine carcinoma (HNSCNEC) and the patients are treated according to the small-cell lung cancer (SCLC) guidelines. Amrubicin is an effective second-line treatment for patients with SCLC, although it remains unclear whether amrubicin monotherapy is effective for patients with LCNEC or HNSCNEC...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28529185/care-2013-explanations-and-elaborations-reporting-guidelines-for-case-reports
#11
David S Riley, Melissa S Barber, Gunver S Kienle, Jeffry Aronson, Tido von Schoen-Angerer, Peter Tugwell, Helmut Kiene, Mark Helfand, Douglas G Altman, Harold Sox, Paul G Werthmann, David Moher, Richard A Rison, Larissa Shamseer, Christian A Koch, Gordon H Sun, Patrick Hanaway, Cleveland Clinic, Nancy L Sudak, Marietta Kaszkin-Bettag, Joel J Gagnier
Well-written and transparent case reports (1) reveal early signals of potential benefits, harms, and information on the use of resources; (2) provide information for clinical research and clinical practice guidelines (CPGs), and (3) inform medical education. High-quality case reports are more likely when authors follow reporting guidelines. During 2011-2012 a group of clinicians, researchers, and journal editors developed recommendations for the accurate reporting of information in case reports that resulted in the CARE (CAse REport) Statement and Checklist...
May 18, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28529184/the-grade-working-group-clarifies-the-construct-of-certainty-of-evidence
#12
Monica Hultcrantz, David Rind, Elie A Akl, Shaun Treweek, Reem A Mustafa, Alfonso Iorio, Brian S Alper, Joerg J Meerpohl, M Hassan Murad, Mohammed T Ansari, Srinivasa Vittal Katikireddi, Pernilla Östlund, Sofia Tranæus, Robin Christensen, Gerald Gartlehner, Jan Brozek, Ariel Izcovich, Holger Schünemann, Gordon Guyatt
OBJECTIVE: To clarify the GRADE (grading of recommendations assessment, development and evaluation) definition of certainty of evidence and suggest possible approaches to rating certainty of the evidence for systematic reviews, health technology assessments and guidelines. STUDY DESIGN AND SETTING: This work was carried out by a project group within the GRADE Working Group, through brainstorming and iterative refinement of ideas, using input from workshops, presentations, and discussions at GRADE Working Group meetings to produce this document, which constitutes official GRADE guidance...
May 18, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28529124/shared-decision-making-in-spain-supportive-policies-and-research-initiatives-trends-and-directions-for-future
#13
Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Yolanda Alvarez-Perez, Pablo Alonso-Coello, Carola Orrego, Pedro Serrano-Aguilar
Patients' rights to autonomy, information and participation in their own health care are recognized in the Spanish legal system from the early 2000's. Public institutions have progressively launched several initiatives to promote and improve patients' empowerment and self-care. However, the concept of Shared Decision Making (SDM), although embedded in the more general concept of "active/empowered patient", usually has not been specifically advocated as an essential requisite for improving the quality of health services, either in the legal normative or the existing educational proposals...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28529122/shared-decision-making-a-buzz-word-in-the-netherlands-the-pace-quickens-towards-nationwide-implementation%C3%A2
#14
Trudy van der Weijden, Heleen Post, Paul L P Brand, Haske van Veenendaal, Ton Drenthen, Linda Aj van Mierlo, Peep Stalmeier, Olga C Damman, Anne Stiggelbout
Currently, shared decision making (SDM) is on the agenda among target patient representative groups, policy makers and professional bodies. Although the International Conference for Shared Decision Making (ISDM) 2011 generated a positive boost, hesitation was also felt among Dutch clinicians, who are challenged by many new tasks. No hesitation is seen among the majority of patients, opting mostly for the SDM model. We haven't reached these patients' needs fully yet, given disappointing research data on patients' experiences and professional behaviour...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28529116/italian-consensus-guidelines-for-the-management-of-hepatitis-b-virus-infections-in-patients-with-rheumatoid-arthritis
#15
Marco Sebastiani, Fabiola Atzeni, Laura Milazzo, Luca Quartuccio, Carlo Scirè, Giovanni Battista Gaeta, Giovanni Lapadula, Orlando Armignacco, Marcello Tavio, Ignazio Olivieri, Pierluigi Meroni, Laura Bazzichi, Walter Grassi, Alessandro Mathieu, Claudio Mastroianni, Evangelista Sagnelli, Teresa Santantonio, Caterina Uberti Foppa, Massimo Puoti, Loredana Sarmati, Paolo Airò, Oscar Massimiliano Epis, Rossana Scrivo, Miriam Gargiulo, Agostino Riva, Andreina Manfredi, Giovanni Ciancio, Gianguglielmo Zehender, Gloria Taliani, Luca Meroni, Salvatore Sollima, Piercarlo Sarzi-Puttini, Massimo Galli
OBJECTIVES: Hepatitis B (HBV) infection, which is prevalent worldwide, is also frequently seen in patients with rheumatoid arthritis (RA). The Italian Society of Rheumatology (SIR) and the Italian Society of Infectious and Tropical Diseases (SIMIT) endorsed a national consensus process to review the available evidence on HBV management in RA patients and to produce practical, hospital-wide recommendations. METHODS: The consensus panel consisted of infectious disease consultants, rheumatologists and epidemiologists and used the criteria of the Oxford Centre for Evidence-based Medicine to assess the quality of the evidence and the strength of their recommendations...
May 18, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/28528939/aga-white-paper-training-and-implementation-of-endoscopic-image-enhancement-technologies
#16
Neil Gupta, Joel V Brill, Marcia Canto, Daniel DeMarco, Brian M Fennerty, Loren Laine, David Lieberman, Charles Lightdale, Elizabeth Montgomery, Robert Odze, Douglas Rex, Prateek Sharma, Jeffrey L Tokar, Michael L Kochman
Endoscopic image-enhancement technologies provide opportunities to visualize normal and abnormal tissues within the gastrointestinal (GI) tract in a manner that complements conventional white light endoscopic imaging. The additional information that is obtained enables the endoscopist to better identify, delineate, and characterize lesions and can facilitate targeted biopsies or, in some cases, eliminate the need to send samples for histologic analysis. Some of these technologies have been available for more than a decade, but despite this fact, there is limited use of these technologies by endoscopists...
June 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28528568/a-treatment-protocol-for-management-of-bacterial-and-fungal-malignant-external-otitis-a-large-cohort-in-tehran-iran
#17
Mehrdad Hasibi, Mohammadtaghi Khorsandi Ashtiani, Masoud Motassadi Zarandi, Nasrin Yazdani, Pedram Borghei, Ali Kuhi, Sasan Dabiri, Reza Hosseini, Sara Sardashti
AIMS: High rates of negative microbiologic test results highlight the potential role of empiric antimicrobial agents in management of malignant otitis externa (MOE). This study investigates the clinical presentation, laboratory findings, and response to empiric treatment in a large group of patients admitted to a tertiary academic hospital in Tehran, Iran. METHODS AND MATERIALS: We recruited 224 patients diagnosed with MOE in a prospective observation from 2009 through 2015...
May 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28528077/is-the-success-of-the-slimmer-diabetes-prevention-intervention-modified-by-socioeconomic-status-a-randomised-controlled-trial
#18
Andrea J Bukman, Geerke Duijzer, Annemien Haveman-Nies, Sophia C Jansen, Josien Ter Beek, Gerrit J Hiddink, Edith J M Feskens
AIM: To explore the role of socioeconomic status (SES) in participation, programme attendance, programme acceptability, adherence to lifestyle guidelines, drop-out, and effectiveness in the SLIMMER diabetes prevention intervention. METHODS: SLIMMER was a randomised controlled intervention, carried out in a real-world setting, targeting 40- to 70-year-old adults at increased risk of developing type 2 diabetes (n=316). The intervention group participated in a 10-month combined dietary and physical activity programme...
May 10, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28527934/variability-in-2-year-training-programs-in-vascular-surgery-based-on-results-of-an-association-of-program-directors-in-vascular-surgery-survey
#19
Keith D Calligaro, Danielle M Pineda, Sam Tyagi, Hong Zheng, Douglas A Troutman, Matthew J Dougherty
OBJECTIVE: Although a great deal of attention has recently focused on 5-year integrated (0+5) training programs in vascular surgery, a paucity of data exists concerning variability of daily assignments in 2-year (5+2) vascular fellowships. METHODS: We polled Association of Program Directors in Vascular Surgery members with 2-year vascular fellowships to determine the number of days in a 5-day work week that first- and second-year fellows were assigned to open vascular operations, endovascular procedures (hospital vs nonhospital facility), arterial clinic, venous clinic, noninvasive vascular laboratory (NIVL), and research...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527868/use-of-parenteral-antimicrobials-in-very-small-hospitals%C3%A2-in-inner-brazil-patterns-determinants-and-opportunities-for-interventions-in-developing-countries
#20
J L Giacomini, C M Fortaleza
Much of healthcare in developing countries takes place in small hospitals. Little is known about the use of antimicrobials in those settings. We studied the 60-day use of parenteral antimicrobials in 48 hospitals with up to 50 beds in inner Brazil. The overall use was 242.0 defined daily doses per 100 admissions, and broad-spectrum agents accounted for 26.8%. The existence of local guidelines, educational measures and restrictive policies for antimicrobial prescriptions, as well as infection control and microbiology resources, were significantly associated with lesser use...
April 20, 2017: Journal of Hospital Infection
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