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https://www.readbyqxmd.com/read/28636749/annual-direct-medical-costs-associated-with-diabetes-related-complications-in-the-event-year-and-in-subsequent-years-in-hong-kong
#1
F Jiao, C K H Wong, S C W Tang, C S C Fung, K C B Tan, S McGhee, R Gangwani, C L K Lam
AIM: To develop models to estimate the direct medical costs associated with diabetes-related complicationsin the event year and in subsequent years. METHODS: The public direct medical costs associated with 13 diabetes-related complications were estimated among a cohort of 128 353 people with diabetes over 5 years. Private direct medical costs were estimated from a cross-sectional survey among 1825 people with diabetes. We used panel data regression with fixed effects to investigate the impact of each complication on direct medical costs in the event year and subsequent years, adjusting for age and co-existing complications...
June 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28634217/incident-cardiovascular-disease-among-adults-with-blood-pressure-140-90-mm-hg
#2
Gabriel S Tajeu, John N Booth, Lisandro D Colantonio, Rebecca F Gottesman, George Howard, Daniel T Lackland, Emily O'Brien, Suzanne Oparil, Joseph E Ravenell, Monika M Safford, Samantha R Seals, Daichi Shimbo, Steven Shea, Tanya M Spruill, Rikki M Tanner, Paul Muntner
Background -Data from before the 2000s indicate the majority of incident cardiovascular disease (CVD) events occur among US adults with systolic and diastolic blood pressure (SBP/DBP)≥140/90 mmHg. Over the past several decades, BP declined and hypertension control has improved. Methods -We estimated the percentage of incident CVD events that occur at SBP/DBP<140/90 mmHg in a pooled analysis of three contemporary US cohorts: the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, the Multi-Ethnic Study of Atherosclerosis (MESA), and the Jackson Heart Study (JHS) (n=31,856; REGARDS=21,208; MESA=6,779; JHS=3,869)...
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28629510/screening-strategies-for-atrial-fibrillation-a-systematic-review-and-cost-effectiveness-analysis
#3
Nicky J Welton, Alexandra McAleenan, Howard Hz Thom, Philippa Davies, Will Hollingworth, Julian Pt Higgins, George Okoli, Jonathan Ac Sterne, Gene Feder, Diane Eaton, Aroon Hingorani, Christopher Fawsitt, Trudie Lobban, Peter Bryden, Alison Richards, Reecha Sofat
BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources. OBJECTIVES: To conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28628594/telehealth-wearable-sensors-and-the-internet-will-they-improve-stroke-outcomes-through-increased-intensity-of-therapy-motivation-and-adherence-to-rehabilitation-programs
#4
Jane H Burridge, Alan Chong W Lee, Ruth Turk, Maria Stokes, Jill Whitall, Ravi Vaidyanathan, Phil Clatworthy, Ann-Marie Hughes, Claire Meagher, Enrico Franco, Lucy Yardley
BACKGROUND AND PURPOSE: Stroke, predominantly a condition of older age, is a major cause of acquired disability in the global population and puts an increasing burden on health care resources. Clear evidence for the importance of intensity of therapy in optimizing functional outcomes is found in animal models, supported by neuroimaging and behavioral research, and strengthened by recent meta-analyses from multiple clinical trials. However, providing intensive therapy using conventional treatment paradigms is expensive and sometimes not feasible because of social and environmental factors...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28627034/brief-mindfulness-meditation-group-training-in-aphasia-exploring-attention-language-and-psychophysiological-outcomes
#5
Rebecca Shisler Marshall, Jacqueline Laures-Gore, Kim Love
BACKGROUND: Stroke is currently the leading cause of long-term disability in adults in the United States. There is a need for accessible, low-cost treatments of stroke-related disabilities such as aphasia. AIMS: To explore an intervention for aphasia utilizing mindfulness meditation (MM). This preliminary study examines the feasibility of teaching MM to individuals with aphasia. Since physiological measures have not been collected for those with aphasia, the study was also an exploration of the potential attention, language and physiological changes after MM in adults with aphasia during a brief, daily group training...
June 19, 2017: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/28625670/carotid-occlusion-is-associated-with-more-frequent-neurovascular-events-than-moderately-severe-carotid-stenosis
#6
Matthew Janko, Ryan Moore, Ann H Kim, Andrew J Shevitz, Katherine L Morrow, David J Johnson, Vikram S Kashyap
OBJECTIVE: Asymptomatic internal carotid artery occlusion (CO) presents a clinical dilemma, and presently, the natural history, stroke risk, and optimal management remain ill defined. This study compared outcomes, including neurovascular events (NVEs) and health care costs, between patients with CO and patients with asymptomatic carotid artery stenosis (CS). METHODS: A prospectively maintained database was queried to identify patients with CO and CS with at least >50% carotid stenosis by duplex...
June 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28623598/cost-effectiveness-of-two-decision-strategies-for-shunt-use-during-carotid-endarterectomy
#7
Joe L P Kolkert, Rolf H H Groenwold, Vanessa J Leijdekkers, Joep Ter Haar, Clark J Zeebregts, Anco Vahl
BACKGROUND: Arterial shunting during carotid endarterectomy (CEA) is essential in some patients because of insufficient cerebral perfusion during cross-clamping. However, the optimal diagnostic modality identifying these patients is still debated. None of the currently used modalities has been proved superior to another. The aim of this study was to assess the cost-effectiveness of two modalities, stump pressure measurement (SPM) versus electroencephalography (EEG) combined with transcranial Doppler (TCD) during CEA...
June 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28623119/the-cost-effectiveness-of-a-stroke-unit-in-providing-enhanced-patient-outcomes-in-an-australian-teaching-hospital
#8
Shaun Zhai, Fergus Gardiner, Teresa Neeman, Brett Jones, Yash Gawarikar
BACKGROUND: Stroke is one of the leading causes of disability and mortality. Patients who receive organized inpatient care in a stroke unit (SU) have better clinical outcomes. However, evidence on the cost analysis of an SU is lacking. The objective of this study was to assess the performance and analyze the cost-effectiveness of an SU. METHODS: A retrospective observational study was conducted comparing the acute stroke patient care in a 6-month period before and after the establishment of an acute SU at Calvary Hospital in 2013-2014...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28619303/effect-of-light-pressure-stroking-massage-with-sesame-sesamum-indicum-l-oil-on-alleviating-acute-traumatic-limbs-pain-a-triple-blind-controlled-trial-in-emergency-department
#9
Morteza Nasiri, Zahra Farsi
OBJECTIVES: Due to adverse effects of common medications used for traumatic pain management, it is crucial to use complementary methods to alleviate this pain. Present study aimed to assess the effect of light pressure stroking massage with topical sesame oil on pain severity of patients with limbs trauma. METHODS: This triple-blinded randomized trial was conducted on 40 patients with upper or lower extremities trauma in emergency department of Busheher Amir Al-Momenian Hospital, Busheher, Iran, in 2015-2016...
June 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28612680/benefits-of-stroke-treatment-delivered-using-a-mobile-stroke-unit-trial
#10
Jose-Miguel Yamal, Suja S Rajan, Stephanie A Parker, Asha P Jacob, Michael O Gonzalez, Nicole R Gonzales, Ritvij Bowry, Andrew D Barreto, Tzu-Ching Wu, David R Lairson, David Persse, Barbara C Tilley, David Chiu, Jose I Suarez, William J Jones, Andrei Alexandrov, James C Grotta
Rationale Mobile stroke units speed treatment for acute ischemic stroke, thereby possibly improving outcomes. Aim To compare mobile stroke unit and standard management clinical outcomes, healthcare utilization, and cost-effectiveness in tissue plasminogen activator-eligible acute ischemic stroke patients calling 911. Sample size 693. Eighty percent power with 0.05 type I error rate to detect a difference of 0.09 in mean utility-weighted modified Rankin scale between groups. Design Phase III, multicenter, prospective cluster-randomized (mobile stroke unit versus standard management weeks) comparative effectiveness study in tissue plasminogen activator-eligible patients...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28610625/health-related-quality-of-life-and-health-preference-of-chinese-patients-with-diabetes-mellitus-managed-in-primary-care-and-secondary-care-setting-decrements-associated-with-individual-complication-and-number-of-complications
#11
Fangfang Jiao, Carlos King Ho Wong, Rita Gangwani, Kathryn Choon Beng Tan, Sydney Chi Wai Tang, Cindy Lo Kuen Lam
BACKGROUND: Health-related quality of life (HRQoL) and health preference of patients with diabetes mellitus (DM) are essential in health economic evaluations but data on Chinese population is rare. This study aims to evaluate HRQoL and health preference of diabetic patients with different diabetic complications in Chinese population. METHODS: A cross-sectional study was conducted in 1275 patients with DM, including 518 subjects with various DM-related complications...
June 13, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28607681/hydration-stickers-improving-oral-hydration-in-vulnerable-patients
#12
Alysha Bhatti, Javier Ash, Shyam Gokani, Suveer Singh
Dehydration is a growing problem among elderly patients in hospital wards. Incidents such as those raised in the Francis Report highlight a problem that may not have been sufficiently addressed by current schemes. This improvement project aimed to identify the barriers faced by staff in improving oral hydration and to design and implement an effective solution. A 33 patient pilot study carried out at Chelsea & Westminster Hospital NHS Trust, United Kingdom, revealed that a significant proportion of patients were reported to be dehydrated on admission, with few having their hydration needs addressed...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28606079/costs-of-major-intracranial-gastrointestinal-and-other-bleeding-events-in-patients-with-atrial-fibrillation-a-nationwide-cohort-study
#13
Marie Jakobsen, Christophe Kolodziejczyk, Eskild Klausen Fredslund, Peter Bo Poulsen, Lars Dybro, Søren Paaske Johnsen
BACKGROUND: Use of oral anticoagulation therapy in patients with atrial fibrillation (AF) involves a trade-off between a reduced risk of ischemic stroke and an increased risk of bleeding events. Different anticoagulation therapies have different safety profiles and data on the societal costs of both ischemic stroke and bleeding events are necessary for assessing the cost-effectiveness and budgetary impact of different treatment options. To our knowledge, no previous studies have estimated the societal costs of bleeding events in patients with AF...
June 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28603589/empirical-anticoagulation-for-patients-in-sinus-rhythm-at-high-risk-of-ischaemic-stroke-a-review-of-current-literature
#14
REVIEW
Irma Battipaglia, James O'Neill, Andrew J Hogarth, Muzahir H Tayebjee
Ischaemic stroke is one of the commonest causes of morbidity and mortality worldwide and around a fifth of events can be attributed to a cardioembolic source. This is typically due to atrial fibrillation (AF), the most common sustained cardiac arrhythmia. However, AF can, at times, be difficult to detect due to a relative lack of symptoms and the fact that it can be paroxysmal in nature. Studies have shown that diagnosis of AF improves as the length of cardiac monitoring increases. However, prolonged cardiac monitoring is not a cost-effective way of diagnosing AF...
May 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28600460/standard-operating-procedures-improve-acute-neurologic-care-in-a-sub-saharan-african-setting
#15
Lamin E S Jaiteh, Stefan A Helwig, Abubacarr Jagne, Andreas Ragoschke-Schumm, Catherine Sarr, Silke Walter, Martin Lesmeister, Matthias Manitz, Sebastian Blaß, Sarah Weis, Verena Schlund, Neneh Bah, Jil Kauffmann, Mathias Fousse, Sabina Kangankan, Asmell Ramos Cabrera, Kai Kronfeld, Christian Ruckes, Yang Liu, Ousman Nyan, Klaus Fassbender
OBJECTIVE: Quality of neurologic emergency management in an under-resourced country may be improved by standard operating procedures (SOPs). METHODS: Neurologic SOPs were implemented in a large urban (Banjul) and a small rural (Brikama) hospital in the Gambia. As quality indicators of neurologic emergency management, performance of key procedures was assessed at baseline and in the first and second implementation years. RESULTS: At Banjul, 100 patients of the first-year intervention group exhibited higher rates of general procedures of emergency management than 105 control patients, such as neurologic examination (99...
June 9, 2017: Neurology
https://www.readbyqxmd.com/read/28596458/prevalence-of-fabry-disease-and-outcomes-in-young-canadian-patients-with-cryptogenic-ischemic-cerebrovascular-events
#16
Sylvain Lanthier, Gustavo Saposnik, Gerald Lebovic, Karen Pope, Daniel Selchen, David F Moore
BACKGROUND AND PURPOSE: Previous studies reported Fabry disease in 0% to 4% of young patients with cryptogenic ischemic stroke (IS). We sought to determine the prevalence of Fabry and outcomes among young Canadians with cryptogenic IS or transient ischemic attack (TIA). METHODS: We prospectively enrolled individuals aged 18 to 55 with IS or speech or motor TIA, and no cause identified despite predetermined investigation. α-galactosidase-A gene was sequenced for Fabry diagnosis...
June 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28595702/left-ventricular-assist-devices-for-lifelong%C3%A2-support
#17
REVIEW
Sean P Pinney, Anelechi C Anyanwu, Anuradha Lala, Jeffrey J Teuteberg, Nir Uriel, Mandeep R Mehra
Continuous-flow left ventricular assist devices (LVADs) have revolutionized advanced heart failure care. These compact, fully implantable heart pumps are capable of providing meaningful increases in survival, functional capacity, and quality of life. Implantation volumes continue to grow, but several challenges remain to be overcome before LVADs will be considered as the therapy of choice for all patients with advanced heart failure. They must be able to consistently extend survival for the long term (7 to 10 years), rather than the midterm (3 to 5 years) more typical of contemporary devices; they must incorporate design elements that reduce shear stress and avoid stasis to reduce the frequent adverse events of bleeding, stroke, and pump thrombosis; and they must become more cost-effective...
June 13, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28594478/what-influences-the-cost-effectiveness-of-dabigatran-versus-warfarin-for-stroke-prevention-in-atrial-fibrillation-a-systematic-review
#18
Jathishinie Jegathisawaran, Anne Holbrook, James M Bowen, Natasha Burke, Kaitryn Campbell, Jean-Eric Tarride
OBJECTIVES: The introduction of new oral anticoagulants for the prevention of stroke in atrial fibrillation (AF) has changed the clinical management of AF. To inform decision making around dabigatran by identifying factors influencing cost-effectiveness results, we undertook a systematic review of economic evaluations of dabigatran versus warfarin for the prevention of stroke in AF patients. METHODS: A systematic literature search of Ovid Medline and Embase, Wiley's Cochrane Library, HEED, PubMed databases and grey literature was carried out for primary economic evaluations comparing dabigatran versus warfarin in patients with AF...
May 2, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28589229/-stroke-in-children-and-adolescents
#19
REVIEW
S Meyer, M Poryo, M Flotats-Bastardas, D Ebrahimi-Fakhari, U Yilmaz
The occurrence of a stroke in children and adolescents constitutes a rare, critical event that is associated with substantial morbidity and mortality. In addition to the individual suffering for the young patient and the medical burden for the affected family, a stroke is also associated with high follow-up costs for the health system because of the necessary long-term rehabilitative treatment. Establishing an early and prompt diagnosis is of great therapeutic importance. Because of the rarity of the illness and the plethora of clinical manifestations, diagnosis is often delayed...
June 6, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28583117/population-awareness-of-cardiovascular-disease-and-its-risk-factors-in-buea-cameroon
#20
Leopold Ndemnge Aminde, Noah Takah, Calypse Ngwasiri, Jean Jacques Noubiap, Maxime Tindong, Anastase Dzudie, J Lennert Veerman
BACKGROUND: Adequate awareness of cardiovascular diseases (CVD) and their risk factors may help reduce the population's exposure to modifiable risk factors and thereby contribute to prevention and control strategies. There is limited data on knowledge among the general population in sub-Saharan Africa regarding CVD and risk factors. We aimed to assess the population awareness (and associated factors) of CVD types and risk factors in Buea, Cameroon. METHODS: This was a community-based cross-sectional study conducted in 2016 among randomly selected adults (>18 years)...
June 5, 2017: BMC Public Health
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