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Pathology value in healthcare

G Seliger, D Petroff, S Seeger, D Hoyer, M Tchirikov, U Schneider
OBJECTIVE: Short-term variation (STV) from computerized cardiotocogram heart rate analysis is a parameter that complements decision making, regarding the delivery of fetuses in several high-risk situations. Although studies on the effects of gestational age and fetal pathology are convincing, there is a lack of data exploring diurnal variation and the adequacy of a single measurement. STUDY DESIGN: In this prospective observational study, fetal STV was monitored with the AN24 fetal ECG monitor (Monica Healthcare) each hour for at least 10 h in total, beginning at different times...
November 10, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Stephanie Coward, Hashim Kareemi, Fiona Clement, Scott Zimmer, Elijah Dixon, Chad G Ball, Steven J Heitman, Mark Swain, Subrata Ghosh, Gilaad G Kaplan
IMPORTANCE: At the turn of the 21st century, studies evaluating the change in incidence of appendicitis over time have reported inconsistent findings. OBJECTIVES: We compared the differences in the incidence of appendicitis derived from a pathology registry versus an administrative database in order to validate coding in administrative databases and establish temporal trends in the incidence of appendicitis. DESIGN: We conducted a population-based comparative cohort study to identify all individuals with appendicitis from 2000 to2008...
2016: PloS One
Christian Young, Hasantha Gunasekera, Kelvin Kong, Alison Purcell, Sumithra Muthayya, Frank Vincent, Darryl Wright, Raylene Gordon, Jennifer Bell, Guy Gillor, Julie Booker, Peter Fernando, Deanna Kalucy, Simone Sherriff, Allison Tong, Carmen Parter, Sandra Bailey, Sally Redman, Emily Banks, Jonathan C Craig
OBJECTIVE: To describe and evaluate Hearing EAr health and Language Services (HEALS), a New South Wales (NSW) health initiative implemented in 2013 and 2014 as a model for enhanced clinical services arising from Aboriginal health research. METHODS: A case-study involving a mixed-methods evaluation of the origins and outcomes of HEALS, a collaboration among five NSW Aboriginal Community Controlled Health Services (ACCHS), the Sydney Children's Hospitals Network, NSW Health, the Aboriginal Health and Medical Research Council, and local service providers...
October 23, 2016: Australian and New Zealand Journal of Public Health
A J Sutton, R S Vohra, M Hollyman, P J Marriott, A Buja, D Alderson, S Pasquali, E A Griffiths
BACKGROUND: The optimal timing of cholecystectomy for patients admitted with acute gallbladder pathology is unclear. Some studies have shown that emergency cholecystectomy during the index admission can reduce length of hospital stay with similar rates of conversion to open surgery, complications and mortality compared with a 'delayed' operation following discharge. Others have reported that cholecystectomy during the index acute admission results in higher morbidity, extended length of stay and increased costs...
October 20, 2016: British Journal of Surgery
David Carrick, Caroline Haig, Jaclyn Carberry, Vannesa Teng Yue May, Peter McCartney, Paul Welsh, Nadeem Ahmed, Margaret McEntegart, Mark C Petrie, Hany Eteiba, Mitchell Lindsay, Stuart Hood, Stuart Watkins, Ahmed Mahrous, Samuli M O Rauhalammi, Ify Mordi, Ian Ford, Aleksandra Radjenovic, Naveed Sattar, Keith G Oldroyd, Colin Berry
BACKGROUND: Failed myocardial reperfusion is common and prognostically important after acute ST-elevation myocardial infarction (STEMI). The purpose of this study was to investigate coronary flow reserve (CFR), a measure of vasodilator capacity, and the index of microvascular resistance (IMR; mmHg × s) in the culprit artery of STEMI survivors. METHODS: IMR (n = 288) and CFR (n = 283; mean age [SD], 60 [12] years) were measured acutely using guide wire-based thermodilution...
May 5, 2016: JCI Insight
Alyce J M Anderson, Benjamin Click, Claudia Ramos-Rivers, Dmitriy Babichenko, Ioannis E Koutroubakis, Douglas J Hartman, Jana G Hashash, Marc Schwartz, Jason Swoger, Arthur M Barrie, Michael A Dunn, Miguel Regueiro, David G Binion
BACKGROUND: Inflammatory bowel disease (IBD) is a heterogeneous collection of chronic inflammatory disorders of the digestive tract. Clinical, genetic, and pathological heterogeneity makes it increasingly difficult to translate efficacy studies into real-world practice. Our objective was to develop a comprehensive natural history registry derived from multi-year observational data to facilitate effectiveness and clinical phenotypic research in IBD. METHODS: A longitudinal, consented registry with prospectively collected data was developed at UPMC...
November 2016: Digestive Diseases and Sciences
Ángela Bernabeu, Susana López-Celada, Arantxa Alfaro, Jesús J Mas, Javier Sánchez-González
OBJECTIVE: To evaluate the usefulness of diffusion tensor imaging (DTI) in the clinical setting as a complementary tool to conventional MRI in the study and assessment of the sciatic nerve and its pathologies. METHODS: 17 patients diagnosed with different types of sciatic neuropathy and 10 healthy controls underwent a conventional MRI and a DTI study in a 3-T MR scanner (Achieva(®) 3-T X-Series; Philips Healthcare, Netherlands). RESULTS: In the control group, we were able to track and visualize the common sciatic nerve and its main branches from hip to foot...
October 2016: British Journal of Radiology
Megan S Overby, Annette Baft-Neff
INTRODUCTION: Despite the growth of telecommunication applications to provide clinical healthcare services, there has been little attention to the pedagogical framework needed to train healthcare students to deliver these services. METHODS: In this exploratory investigation, perceptions of speech-language pathology/therapy (SLP/SLT) faculty (n = 31), graduate students (n = 16), and telehealth ("telepractice") clinicians (n = 16) were examined with a 15-item survey regarding the 1) comparative pedagogical importance of four skills common to telepractice and face-to-face service (f2f) delivery, and 2) relative pedagogical value of seven skills and competencies unique to telepractice...
June 30, 2016: Journal of Telemedicine and Telecare
P Dieppe, S Goldingay, M Greville-Harris
This paper reviews some recent advances in our understanding of the effects of sham or dummy interventions on pain and other symptoms in osteoarthritis (OA), and outlines two new approaches to the investigation of placebo and nocebo effects. We argue that the placebo effect provides us with a valuable way of investigating the nature of conditions like OA. For example, by examining which symptoms, biochemical markers or imaging features do or do not respond to placebo, we might learn more about the relationships between pathology and symptoms in OA...
June 20, 2016: Osteoarthritis and Cartilage
Anuradha Agarwal, Maithili R P Singh
One of the most important parts of healthcare system is diagnostics. Nowadays, Indians have become more aware of their health, due to improved and better availability of health related information, increase in medical tourism, and expanding health insurance. The demand for better diagnostic facilities have increased with the increase in lifestyle related diseases, excesses use of chemicals in agriculture practices and change in food habits. It is expected that the Indian diagnostic market will grow from USD $5 billion in the year 2012 to USD $32 billion by the year 2020 with 20% CAGR (India Brand Equity Foundation 2015 )...
April 2016: Hospital Topics
Ralph Crott, Georges Lawson, Marie-Cécile Nollevaux, Annick Castiaux, Bruno Krug
Head and neck cancer (HNC) is predominantly a locoregional disease. Sentinel lymph node (SLN) biopsy offers a minimally invasive means of accurately staging the neck. Value in healthcare is determined by both outcomes and the costs associated with achieving them. Time-driven activity-based costing (TDABC) may offer more precise estimates of the true cost. Process maps were developed for nuclear medicine, operating room and pathology care phases. TDABC estimates the costs by combining information about the process with the unit cost of each resource used...
September 2016: European Archives of Oto-rhino-laryngology
Jeroen S de Bruin, Klaus-Peter Adlassnig, Alexander Blacky, Walter Koller
BACKGROUND: Many electronic infection detection systems employ dichotomous classification methods, classifying patient data as pathological or normal with respect to one or several types of infection. An electronic monitoring and surveillance system for healthcare-associated infections (HAIs) known as Moni-ICU is being operated at the intensive care units (ICUs) of the Vienna General Hospital (VGH) in Austria. Instead of classifying patient data as pathological or normal, Moni-ICU introduces a third borderline class...
May 2016: Artificial Intelligence in Medicine
Michael C Montalto
This manuscript is an adaptation of the closing keynote presentation of the Digital Pathology Association Pathology Visions Conference 2015 in Boston, MA, USA. In this presentation, analogies are drawn between the adoption of whole slide imaging (WSI) and other mainstream digital technologies, including digital music and books. In doing so, it is revealed that the adoption of seemingly similar digital technologies does not follow the same adoption profiles and that understanding the unique aspects of value for each customer segment is critical...
2016: Journal of Pathology Informatics
L S van Galen, W van der Schors, N L Damen, Mhh Kramer, C Wagner, Pwb Nanayakkara
OBJECTIVE: Measuring patient-reported outcome measures (PROMs) is a challenge in Acute Admission Units (AAUs), where patients present with a variety of pathologies. Generic PROMs may be used to measure the quality of care in this population. The main objective of this study was to assess the feasibility of measuring generic PROMs in a Dutch AAU. DESIGN: Longitudinal cohort study Setting: An AAU of a tertiary hospital in Amsterdam, the Netherlands Participants: 123 patients admitted to the AAU during 5 weeks in May and June 2015 METHODS: Patients admitted to the AAU were asked to fill out a questionnaire relating to three time points: 7 days before, during, and within 2 weeks after admission...
2016: Acute Medicine
José Carlos Garcia Júnior, Ana Maria Ferreira Paccola, Cristiane Tonoli, José Luis Amin Zabeu, Jesely Pereira Myrrha Garcia
UNLABELLED: To describe a specific surgical technique for arthroscopic decompression of the suprascapular nerve (SSN) and evaluate its preliminary results. METHODS: Ten shoulders of nine patients were operated using a technique with portals differing from the already-known techniques, which did not use traction and made use of materials available within the public healthcare system. RESULTS: Among the ten shoulders of nine patients, eight were right shoulders and two were left shoulders...
July 2011: Revista Brasileira de Ortopedia
Alan T Blank, Daniel M Lerman, Neeraj M Patel, Timothy B Rapp
BACKGROUND: Metastatic bone disease is a substantial burden to patients and the healthcare system as a whole. Metastatic disease can be painful, is associated with decreased survival, and is emotionally traumatic to patients when they discover their disease has progressed. In the United States, more than 250,000 patients have metastatic bone disease, with an estimated annual cost of USD 12 billion. Prior studies suggest that patients who receive prophylactic fixation for impending pathologic fractures, compared with those treated for realized pathologic fractures, have decreased pain levels, faster postoperative rehabilitation, and less in-hospital morbidity...
July 2016: Clinical Orthopaedics and related Research
Hoi Y Tong, Cristina Lucía Dávila-Fajardo, Alberto M Borobia, Luis Javier Martínez-González, Rubin Lubomirov, Laura María Perea León, María J Blanco Bañares, Xando Díaz-Villamarín, Carmen Fernández-Capitán, José Cabeza Barrera, Antonio J Carcas
There is a strong association between genetic polymorphisms and the acenocoumarol dosage requirements. Genotyping the polymorphisms involved in the pharmacokinetics and pharmacodynamics of acenocoumarol before starting anticoagulant therapy would result in a better quality of life and a more efficient use of healthcare resources. The objective of this study is to develop a new algorithm that includes clinical and genetic variables to predict the most appropriate acenocoumarol dosage for stable anticoagulation in a wide range of patients...
2016: PloS One
Stefano Respizzi, Elisabetta Covelli
The emotional coaching model uses quantitative and qualitative elements to demonstrate some assumptions relevant to new methods of treatment in physical rehabilitation, considering emotional, cognitive and behavioral aspects in patients, whether or not they are sportsmen. Through quantitative tools (Tampa Kinesiophobia Scale, Emotional Interview Test, Previous Re-Injury Test, and reports on test scores) and qualitative tools (training contracts and relationships of emotional alliance or "contagion"), we investigate initial assumptions regarding: the presence of a cognitive and emotional mental state of impasse in patients at the beginning of the rehabilitation pathway; the curative value of the emotional alliance or "emotional contagion" relationship between healthcare provider and patient; the link between the patient's pathology and type of contact with his own body and emotions; analysis of the psychosocial variables for the prediction of possible cases of re-injury for patients who have undergone or are afraid to undergo reconstruction of the anterior cruciate ligament (ACL)...
October 2015: Joints
Hiten D Patel, Michael H Johnson, Phillip M Pierorazio, Stephen M Sozio, Ritu Sharma, Emmanuel Iyoha, Eric B Bass, Mohamad E Allaf
PURPOSE: Clinical practice varies widely on the diagnostic role of biopsy for clinically localized renal masses suspicious for renal cell carcinoma. Therefore, we performed a systematic review of the available literature to quantify the accuracy and rate of adverse events of renal mass biopsy. MATERIALS AND METHODS: MEDLINE®, Embase® and the Cochrane databases were searched (January 1997 to May 2015) for relevant studies. The systematic review process established by the Agency for Healthcare Research and Quality was followed...
May 2016: Journal of Urology
P Reif, S Schott, C Boyon, J Richter, G Kavšek, K N Timoh, J Haas, P Pateisky, A Griesbacher, U Lang, D Ayres-de-Campos
OBJECTIVE: To investigate whether knowledge of fetal outcome influences retrospective interpretation of cardiotocographic tracings and subsequent management recommendations. DESIGN: Prospective online study. SETTING: Seven university hospitals in five European countries. POPULATION: Forty-two intrapartum tracings from women with singleton pregnancies and uneventful antepartum courses. METHODS: Using an online questionnaire, 123 healthcare professionals interpreted 42 tracings without any knowledge of fetal outcome and provided management recommendations according to the National Institute of Clinical Excellence guidelines (intrapartum care)...
February 16, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
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