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Independent medical assessment

Samrat Yeramaneni, Jeffrey L Gum, Leah Y Carreon, Eric O Klineberg, Justin S Smith, Amit Jain, Richard A Hostin
BACKGROUND: Readmissions following adult spinal deformity surgical procedures frequently occur, placing a substantial burden on patients and providers. Existing literature on readmission costs, including reason-specific readmission costs, is limited. The purposes of this study were to determine the most expensive reasons for readmission, to assess the impact of reasons and timing on readmission costs, and to estimate the drivers of total costs associated with adult spinal deformity surgical procedures...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Gonzalo Agüero, Soledad Salmain, Belén Manzur, Enrique Berner
INTRODUCTION: The most common painful syndromes (headache, abdominal pain and musculoskeletal pain) develop or worsen during adolescence and are a common reason for consultation. OBJECTIVE: Evaluate the association of age, sex, obesity, pubertal development, schooling level, employment and family structure with consultation for pain in adolescents. POPULATION AND METHODS: Case-control study conducted between February 1st, 2014 and June 30th, 2015...
April 1, 2018: Archivos Argentinos de Pediatría
Richard Wennberg, Carmen Hiploylee, Peter Tai, Charles H Tator
BACKGROUND: Epidemiologic studies have suggested that concussion, or mild traumatic brain injury (mTBI), is associated with a twofold or greater increase in relative risk for the development of post-traumatic epilepsy. To assess the clinical validity of these findings, we analyzed the incidence of epilepsy in a large cohort of post-concussion patients in whom concussion was strictly defined according to international guidelines. METHODS: A retrospective cohort study of 330 consecutive post-concussion patients followed by a single concussion specialist...
March 20, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Justin M Famoso, Brady Laughlin, Ali McBride, Victor J Gonzalez
Purpose: Breast fibrosis is a common late effect after therapeutic irradiation that can result in pain, poor cosmesis, and functional impairment. Randomized trials have demonstrated that radiation fibrosis may be preventable with a medication regimen of pentoxifylline and vitamin E. This study investigates patient compliance with pentoxifylline therapy while examining possible correlations to compliance. Methods and materials: We identified 90 patients who were prescribed pentoxifylline (400 mg 3 times daily) and vitamin E (400 IU once daily) after adjuvant breast radiation...
January 2018: Advances in Radiation Oncology
Jinfeng Wang, Huacun Shi, Guang Yang, Guangjie Han, Man Zhao, Xiaoling Duan, Lili Mi, Xin Han, Ning Li, Jianfei Shi, Xiaolei Yin, Fei Yin
The aim of the present study was to evaluate the efficacy and safety of a combination of intra-arterial and intravenous chemotherapy in the treatment of unresectable, advanced gastric cancer, and assess which patients are likely to benefit from combined treatment. The clinical data of 128 patients diagnosed with unresectable, advanced gastric cancer at The Fourth Hospital of Hebei Medical University (Shijiazhuang, China) from January 2009 to September 2012 were retrospectively analyzed. The patients were divided into two groups as follows: Those who received regional intra-arterial chemoembolization plus systemic chemotherapy (combined group; n=62) and those who received systemic chemotherapy only (venous group; n=66)...
April 2018: Oncology Letters
Ronald L Eisenberg, Long H Ngo, Benedikt H Heidinger, Alexander A Bankier
RATIONALE AND OBJECTIVES: To analyze the pattern and longitudinal evolution of honorary authorship in major radiology journals. MATERIALS AND METHODS: In this Institutional Review Board-approved study, an electronic survey was sent to first authors of original research articles published in the American Journal of Roentgenology, European Radiology, the Journal of Magnetic Resonance Imaging, and Radiology during 2 years (July 2014 through June 2016). Questions addressed the perception of honorary authorship and contributing factors, as well as demographic information...
March 16, 2018: Academic Radiology
Stephen P Becker, Matthew A Jarrett, Aaron M Luebbe, Annie A Garner, G Leonard Burns, Michael J Kofler
OBJECTIVES: To (1) describe sleep problems in a large, multi-university sample of college students; (2) evaluate sex differences; and (3) examine the unique associations of mental health symptoms (i.e., anxiety, depression, attention-deficit/hyperactivity disorder inattention [ADHD-IN], ADHD hyperactivity-impulsivity [ADHD-HI]) in relation to sleep problems. METHODS: 7,626 students (70% female; 81% White) ages 18-29 years (M=19.14, SD=1.42) from six universities completed measures assessing mental health symptoms and the Pittsburgh Sleep Quality Index (PSQI)...
April 2018: Sleep Health
C Elizabeth Boudreau, Carlos E Dominguez, Jonathan M Levine, Joseph Mankin, Kimberly M Anderson, Andra K Voges, Geoffrey T Fosgate
OBJECTIVE To estimate reliability of interpretation of neurologic examination findings for localization of vestibular dysfunction in dogs. DESIGN Cross-sectional study. ANIMALS 496 dogs that underwent MRI of the head for diagnosis of a neurologic problem between September 2011 and September 2015. PROCEDURES Medical records were reviewed and data collected regarding signalment and neurologic examination, MRI, and CSF findings. Independent observers interpreted the findings, and agreement was assessed for a subset of dogs...
April 1, 2018: Journal of the American Veterinary Medical Association
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
Emily A Kringle, Lauren Terhorst, Meryl A Butters, Elizabeth R Skidmore
OBJECTIVES: The purpose of this exploratory study was to identify clinical predictors that could distinguish clients' level of engagement in inpatient rehabilitation following stroke. METHODS: This is a secondary analysis of pooled data from three randomized controlled trials that examined the effects of a behavioral intervention. The sample (n=208) consisted of clients with stroke who had cognitive deficits (Quick-EXIT≥3) and were admitted to inpatient rehabilitation facilities associated with a university medical center...
March 19, 2018: Journal of the International Neuropsychological Society: JINS
Karla Soares-Weiser, John Rathbone, Yusuke Ogawa, Kiyomi Shinohara, Hanna Bergman
BACKGROUND: Antipsychotic (neuroleptic) medication is used extensively to treat people with chronic mental illnesses. Its use, however, is associated with adverse effects, including movement disorders such as tardive dyskinesia (TD) - a problem often seen as repetitive involuntary movements around the mouth and face. This review, one in a series examining the treatment of TD, covers miscellaneous treatments not covered elsewhere. OBJECTIVES: To determine whether drugs, hormone-, dietary-, or herb-supplements not covered in other Cochrane reviews on TD treatments, surgical interventions, electroconvulsive therapy, and mind-body therapies were effective and safe for people with antipsychotic-induced TD...
March 19, 2018: Cochrane Database of Systematic Reviews
Kelly Lien, Alvin Chin, Anton Helman, Teresa M Chan
Introduction Podcasts and blog posts have gained popularity in Free Open Access Medical education (FOAM). Previous work suggests that podcasts may be useful for knowledge acquisition in undergraduate medical education. However, there remains a paucity of research comparing the two mediums. This study aims to investigate if there are differences in knowledge acquisition and usage conditions by medical students using podcasts and blog posts. Methods Medical students were randomized to either the podcast or blog post group...
January 15, 2018: Curēus
Agata Kosobucka, Piotr Michalski, Łukasz Pietrzykowski, Michał Kasprzak, Karolina Obońska, Tomasz Fabiszak, Mirosława Felsmann, Aldona Kubica
Introduction: A substantial subset of patients after myocardial infarction (MI) discontinue pivotal medication early after discharge. In particular, cessation of antiplatelet treatment may lead to catastrophic ischemic events. Thus, adherence to prescribed medication in patients after MI is an issue of medical and social concern. Purpose: The aim of the study was to evaluate the level of adherence to treatment using a newly developed scale in patients after MI treated with percutaneous coronary intervention...
2018: Patient Preference and Adherence
Lucine Vuitton, Elise Jacquin, Anne-Laure Parmentier, Elise Crochet, Francine Fein, Anne-Claire Dupont-Gossart, Laurianne Plastaras, Charles-Henri Bretagne, Frédéric Mauny, Stéphane Koch, Jean-Luc Prétet, Christiane Mougin, Séverine Valmary-Degano
BACKGROUND & AIMS: The increasing incidence of anal canal carcinomas requires better knowledge on anal human papillomavirus (HPV) infection. We aimed to assess anal canal HPV infection prevalence and risk factors among patients seen at a gastroenterology department in France. METHODS: We analyzed anal tissue samples collected from 469 consecutive patients (median age 54 years, 52% women), including 112 who received immunosuppressant therapies and 101 with inflammatory bowel disease (70 with Crohn's disease), who underwent colonoscopy examinations from April 1, 2012 to April 30, 2015...
March 15, 2018: Clinical Gastroenterology and Hepatology
Amanda M Rojek, Kassiani Gkolfinopoulou, Apostolos Veizis, Angeliki Lambrou, Lyndsey Castle, Theano Georgakopoulou, Karl Blanchet, Takis Panagiotopoulos, Peter W Horby
BACKGROUND: Refugees may have an increased vulnerability to infectious diseases, and the consequences of an outbreak are more severe in a refugee camp. When an outbreak is suspected, access to clinical information is critical for investigators to verify that an outbreak is occurring, to determine the cause and to select interventions to control it. Experience from previous outbreaks suggests that the accuracy and completeness of this information is poor. This study is the first to assess the adequacy of clinical characterisation of acute medical illnesses in refugee camps...
March 19, 2018: BMC Medicine
Amrita Aranake-Chrisinger, Jenny Zhao Cheng, Maxwell R Muench, Rose Tang, Angela Mickle, Hannah Maybrier, Nan Lin, Troy Wildes, Eric Lenze, Michael Simon Avidan
INTRODUCTION: Postoperative delirium (POD) is a common complication in elderly patients, characterised by a fluctuating course of altered consciousness, disordered thinking and inattention. Preliminary research has linked POD with persistent cognitive impairment and decreased quality of life. However, these findings maybe confounded by patient comorbidities, postoperative complications and frailty. Our objective is to determine whether POD is an independent risk factor for persistent impairments in attention and executive function after elective surgery...
March 17, 2018: BMJ Open
Tina H T Chiu, Wen-Harn Pan, Ming-Nan Lin, Chin-Lon Lin
BACKGROUND/OBJECTIVES: Vegetarian diets are inversely associated with diabetes in Westerners but their impact on Asians-whose pathophysiology differ from Westerners-is unknown. We aim to investigate the association between a vegetarian diet, change in dietary patterns and diabetes risk in a Taiwanese Buddhist population. METHODS: We prospectively followed 2918 non-smoking, non-alcohol drinking Buddhists free of diabetes, cancer, and cardiovascular diseases at baseline, for a median of 5 years, with 183 incident diabetes cases confirmed...
March 9, 2018: Nutrition & Diabetes
Valirie Ndip Agbor, Noah Fongwen Takah, Leopold Ndemnge Aminde
INTRODUCTION: Hypertension is the leading cardiovascular risk factor globally, associated with a high morbidity and mortality. The high prevalence of hypertension in sub-Saharan Africa (SSA) is associated with contrastingly low awareness, treatment and control rates. Adherence to medication remains a major determinant of optimal blood pressure control. This systematic review aims to determine the prevalence, and factors associated with adherence to antihypertensive pharmacotherapy among patients with hypertension in SSA...
March 16, 2018: BMJ Open
Marc-André Maheu-Cadotte, Sylvie Cossette, Véronique Dubé, Guillaume Fontaine, Tanya Mailhot, Patrick Lavoie, Alexis Cournoyer, Fabio Balli, Gabrielle Mathieu-Dupuis
INTRODUCTION: Serious games (SGs) are interactive and entertaining digital software with an educational purpose. They engage the learner by proposing challenges and through various design elements (DEs; eg, points, difficulty adaptation, story). Recent reviews suggest the effectiveness of SGs in healthcare professionals' and students' education is mixed. This could be explained by the variability in their DEs, which has been shown to be highly variable across studies. The aim of this systematic review is to identify, appraise and synthesise the best available evidence regarding the effectiveness of SGs and the impact of DEs on engagement and educational outcomes of healthcare professionals and students...
March 16, 2018: BMJ Open
Suvi Härmälä, Constantinos Parisinos, Laura Shallcross, Alastair O'Brien, Andrew Hayward
INTRODUCTION: In advanced chronic liver disease, diseases caused by common bacteria Streptococcus pneumoniae or influenza virus put people at an increased risk of serious health complications and death. The effectiveness of the available vaccines in reducing the risk of poor health outcomes, however, is less clear. METHODS AND ANALYSIS: We will search Medline (Ovid), Embase (Ovid), PubMed and Cochrane Central Register of Controlled Trials for published reports on randomised controlled trials and observational studies on the effectiveness of pneumococcal and influenza vaccines in people with chronic liver disease...
March 16, 2018: BMJ Open
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