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Quadruple aim

Jun Itakura, Masayuki Kurosaki, Chitomi Hasebe, Yukio Osaki, Kouji Joko, Hitoshi Yagisawa, Shinya Sakita, Hiroaki Okushin, Takashi Satou, Hiroyuki Hisai, Takehiko Abe, Keiji Tsuji, Takashi Tamada, Haruhiko Kobashi, Akeri Mitsuda, Yasushi Ide, Chikara Ogawa, Syotaro Tsuruta, Kouichi Takaguchi, Miyako Murakawa, Yasuhiro Asahina, Nobuyuki Enomoto, Namiki Izumi
BACKGROUNDS & AIMS: We aimed to clarify the characteristics of resistance-associated substitutions (RASs) after treatment failure with NS5A inhibitor, daclatasvir (DCV) in combination with NS3/4A inhibitor, asunaprevir (ASV), in patients with chronic hepatitis C virus genotype 1b infection. METHODS: This is a nationwide multicenter study conducted by the Japanese Red Cross Liver Study Group. The sera were obtained from 68 patients with virological failure after 24 weeks of DCV/ASV treatment...
2016: PloS One
Hilary Bradbury, Svante Lifvergren
We discuss action research healthcare as a transformative approach that continuously innovates in healthcare, attending to the "quadruple" aim. This article is shaped around a decade of evidence in Sweden. At the heart of healthcare action research is the endeavour to "learn by doing" with the participation of key stakeholders, including the patient. Experience suggests that an action research approach is particularly relevant when treating patients with chronic diseases and complex care needs. This inclusion is itself a social learning process and is key to realizing the improved outcomes...
October 20, 2016: Healthcare Management Forum
Jyh-Ming Liou, Yu-Jen Fang, Chieh-Chang Chen, Ming-Jong Bair, Chi-Yang Chang, Yi-Chia Lee, Mei-Jyh Chen, Chien-Chuan Chen, Cheng-Hao Tseng, Yao-Chun Hsu, Ji-Yuh Lee, Tsung-Hua Yang, Jiing-Chyuan Luo, Chun-Chao Chang, Chi-Yi Chen, Po-Yueh Chen, Chia-Tung Shun, Wen-Feng Hsu, Wen-Hao Hu, Yen-Nien Chen, Bor-Shyang Sheu, Jaw-Town Lin, Jeng-Yih Wu, Emad M El-Omar, Ming-Shiang Wu
BACKGROUND: Whether concomitant therapy is superior to bismuth quadruple therapy or 14-day triple therapy for the first-line treatment of Helicobacter pylori infection remains poorly understood. We aimed to compare the efficacy and safety of 10-day concomitant therapy, 10-day bismuth quadruple therapy, and 14-day triple therapy in the first-line treatment of H pylori. METHODS: In this multicentre, open-label, randomised trial, we recruited adult patients (aged >20 years) with H pylori infection from nine medical centres in Taiwan...
October 18, 2016: Lancet
Tuomas O Kiviniemi, Arto Pietilä, Jarmo M Gunn, Jenni M Aittokallio, Markku S Mähönen, Veikko V Salomaa, Teemu J Niiranen
AIMS: The aim of the study was to investigate the 20-year trends in rates, patient selection and prognosis of coronary revascularisations in Finland. METHODS AND RESULTS: We identified patients from nationwide registers who had undergone first-ever percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) between 1994 and 2013. We examined changes in procedure rates, patient characteristics and estimated hazard ratios (HR) and 95% confidence intervals for cardiovascular events during this period...
October 20, 2016: EuroIntervention
Murat Kekilli, Ibrahim K Onal, Serkan Ocal, Zeynal Dogan, Alpaslan Tanoglu
BACKGROUND/AIM: Increasing resistance of Helicobacter pylori to antimicrobials necessitated the development of new regimens and the modification of existing regimens. The present study aimed to compare the efficacy of two bismuth-containing quadruple regimens-one including clarithromycin (C) instead of metronidazole (M) and triple therapy. PATIENTS AND METHODS: Patients with H. pylori infection given the following regimens were sequentially enrolled in this retrospective study: (1) Triple therapy: Lansoprazole 30 mg b...
September 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Xiawen Liu, Lijun Zhu, Biyun Huang, Junjun Huang, Yi Cai, Liu Zhu, Bo Wu, Xiaojing Fu, Xingfei Zhang, Yi Rong, Qing Xiao, Jiewen Guo, Arong Li, Yifei Guo, Mu Yuan
Racemic naftopidil (NAF) is used to treat benign prostatic hyperplasia (BPH) and prostatic cancer (PCa). It exhibits greater efficacy but requires higher dose than other ɑ1-adrenoceptor blockers because of its poor bioavailability. It was previously shown that bioavailability of S(-)-NAF (14.5%) was twice that of R(+)-NAF (6.8%). The present study aimed to elucidate the major factors contributing to the poor and enantioselective bioavailability of NAF. First, absorption of NAF enantiomers was examined using a perfusated intestinal model...
September 27, 2016: Journal of Pharmaceutical and Biomedical Analysis
Andrew Skeggs, Tricia McKeever, Lelia Duley, Eleanor Mitchell, Lucy Bradshaw, Kevin Mortimer, Samantha Walker, Steve Parrott, Andrew Wilson, Ian Pavord, Chris Brightling, Mike Thomas, David Price, Graham Devereux, Bernard Higgins, Tim Harrison, Rebecca Haydock
BACKGROUND: Asthma is one of the commonest chronic diseases in the UK. Acute exacerbations of asthma are unpredictable, disruptive and frightening. They cause considerable morbidity and account for a large component of the health service costs of asthma. The widespread use of an asthma self-management plan, designed to encourage disease monitoring and timely intervention, can reduce exacerbations and is, therefore, recommended for all patients with asthma. Unfortunately, the majority of patients are not provided with such a plan...
October 13, 2016: Trials
C R Macchi, Rodger Kessler, Andrea Auxier, Juvena R Hitt, Daniel Mullin, Constance van Eeghen, Benjamin Littenberg
Insufficient knowledge exists regarding how to measure the presence and degree of integrated care. Prior estimates of integration levels are neither grounded in theory nor psychometrically validated. They provide scant guidance to inform improvement activities, compare integration efforts, discriminate among practices by degree of integration, measure the effect of integration on quadruple aim outcomes, or address the needs of clinicians, regulators, and policymakers seeking new models of health care delivery and funding...
October 13, 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
S Miehlke, R Loibl, S Meszaros, J Labenz
Purpose: The acceptance and realization of clinical guidelines in daily routine practice is unknown. The aim of this study was to evaluate the behaviour of private gastroenterologists in Germany with respect to the diagnostic and therapeutic management of H. pylori infection in times of increasing antibiotic resistance. Methods: Between 12/2014 and 02/2015 a standardized questionnaire with 19 multiple choice questions were sent to 1507 private gastroenterologists in Germany. The data were electronically captured and analyzed using SurveyMonkey...
October 2016: Zeitschrift Für Gastroenterologie
G Bressy, V Brun, A Ferrier, D Dujardin, N Oubaya, N Morel, N Fontanin, X Ohl
INTRODUCTION: The use of the semitendinosus tendon alone for anterior cruciate ligament reconstruction keeps the gracilis muscle intact and decreases anterior pain in comparison with the use of the patellar tendon. Recently, Lubowitz described a new all-inside technique with an ST4 tendon fixed with a cortical button in both femoral and tibial sides. We hypothesized that this type of graft with cortical button fixation provides well-controlled residual anterior tibial translation (<3mm)...
October 4, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Afshin Shafaghi, Aydin Pourkazemi, Mohsen Khosravani, Saba Fakhrie Asl, Alireza Amir Maafi, Zahra Atrkar Roshan, Jafar Abaspour Rahimabad
BACKGROUND Standard anti-Helicobacter pylori (H. pylori) treatment fails in the eradication of the organism in almost 10-35% of the patients and has different side effects. Recent studies have proposed that probiotic supplementations with or without prebiotic may improve the eradication rate and diminish the side effects, although it is still a controversial issue. We aimed to investigate the effect of probiotic with prebiotic supplementation on the eradication rate and side effects of anti H. pylori quadruple therapy...
July 2016: Middle East Journal of Digestive Diseases
Esperanza Macarena López-Pliego, Miguel Ángel Giráldez-Sánchez, Juan Mora-Macías, Esther Reina-Romo, Jaime Domínguez
INTRODUCTION: Bone transport (BT) for segmentary bone defects is a well-known technique as it enables correction with new bone formation, which is similar to the previous bone. Despite the high number of experimental studies of distraction osteogenesis in bone lengthening, the types of ossification and histological changes that occur in the regenerate of the bone transport process remain controversial. OBJECTIVE: The aim of this study is to provide the complete evolution of tissues and the types of ossification in the regenerate during the different phases of bone formation after BT until the end of the remodelling period...
September 2016: Injury
Emna Toulgui, Sonia Jemni, Samia Frioui, Nadia Lazreg, Sahbi Mtaouaa, Fayçal Khachnaoui
OBJECTIVE: Tuberculous spondylitis, or Pott's disease, is a public health problem in Tunisia, where it occurs as an endemic disease. It is the most common and most severe articular bone tuberculosis. It is responsible for a major handicap because of its location and its destructive nature. This work aims to assess the contribution of rehabilitation for patients with Pott's disease. MATERIAL/PATIENTS AND METHODS: A retrospective study that included 29 patients with Pott's disease and hospitalized in PMR Service...
September 2016: Annals of Physical and Rehabilitation Medicine
Amy E Vincent, Hannah S Rosa, Charlotte L Alston, John P Grady, Karolina A Rygiel, Mariana C Rocha, Rita Barresi, Robert W Taylor, Doug M Turnbull
Dysferlinopathies are caused by mutations in the DYSF gene and patients may present with proximal or distal myopathy. Dysferlin is responsible for membrane resealing, and mutations may result in a defect in membrane repair following mechanical or chemical stress, causing an influx of Ca(2+). Since mitochondria are involved in Ca(2+) buffering, we hypothesised that mitochondrial defects may be present in skeletal muscle biopsies from patients with mutations in this gene. The aim was to characterise mitochondrial defects in muscle from patients with dysferlinopathies...
August 29, 2016: Neuromuscular Disorders: NMD
Salima Gasmi, Nicholas H Ogden, Patrick A Leighton, L Robbin Lindsay, Karine Thivierge
Ixodes scapularis, the main vector of Borrelia burgdorferi, the spirochetal agent of Lyme disease, is expanding its range in southern Canada and bringing risk to the public from Lyme disease. The aims of this study were to (i) describe how risk of Lyme disease in Quebec, Canada, has changed from 2008 to 2014 by analysis of the number of tick submissions, the geographic scope of ticks submitted and the prevalence of B. burgdorferi in ticks removed from people and submitted through the Quebec passive tick surveillance program and (ii) explore whether exposure to ticks is influenced by age and sex...
October 2016: Ticks and Tick-borne Diseases
O H Edebal, E Devrim
Objective: The present study aims to establish the oxidant/antioxidant status in serum samples from pregnant women above the threshold for Down syndrome (DS) risk according to the quadruple test. Methods: Thirty maternal serum samples that were above threshold for DS risk (study group) were chosen from pregnant women whose quadruple tests were studied at Ankara University İbni Sina Hospital Central Laboratory. They have been matched with control group consisting of 30 pregnant women whose DS risk were below threshold...
October 23, 2015: West Indian Medical Journal
Tianlu Chen, Xiaojiao Zheng, Xiaojing Ma, Yuqian Bao, Yan Ni, Cheng Hu, Cynthia Rajani, Fengjie Huang, Aihua Zhao, Weiping Jia, Wei Jia
Recently, 5 amino acids were identified and verified as important metabolites highly associated with type 2 diabetes (T2D) development. This report aims to assess the association of tryptophan with the development of T2D and to evaluate its performance with existing amino acid markers. A total of 213 participants selected from a ten-year longitudinal Shanghai Diabetes Study (SHDS) were examined in two ways: 1) 51 subjects who developed diabetes and 162 individuals who remained metabolically healthy in 10 years; 2) the same 51 future diabetes and 23 strictly matched ones selected from the 162 healthy individuals...
2016: PloS One
Victoria Pillay-van Wyk, William Msemburi, Ria Laubscher, Rob E Dorrington, Pam Groenewald, Tracy Glass, Beatrice Nojilana, Jané D Joubert, Richard Matzopoulos, Megan Prinsloo, Nadine Nannan, Nomonde Gwebushe, Theo Vos, Nontuthuzelo Somdyala, Nomfuneko Sithole, Ian Neethling, Edward Nicol, Anastasia Rossouw, Debbie Bradshaw
BACKGROUND: The poor health of South Africans is known to be associated with a quadruple disease burden. In the second National Burden of Disease (NBD) study, we aimed to analyse cause of death data for 1997-2012 and develop national, population group, and provincial estimates of the levels and causes of mortality. METHOD: We used underlying cause of death data from death notifications for 1997-2012 obtained from Statistics South Africa. These data were adjusted for completeness using indirect demographic techniques for adults and comparison with survey and census estimates for child mortality...
September 2016: Lancet Global Health
M Javed Iqbal, Maryam Majeed, Maheen Humayun, David A Lightfoot, Ahmed J Afzal
Sudden death syndrome (SDS) is a complex of two diseases of soybean (Glycine max), caused by the soil borne pathogenic fungus Fusarium virguliforme. The root rot and leaf scorch diseases both result in significant yield losses worldwide. Partial SDS resistance has been demonstrated in multiple soybean cultivars. This study aimed to highlight proteomic changes in soybean roots by identifying proteins which are differentially expressed in near isogenic lines (NILs) contrasting at the Rhg1/Rfs2 locus for partial resistance or susceptibility to SDS...
August 5, 2016: Applied Biochemistry and Biotechnology
I Miralles, S E Jorge-Villar, B van Wesemael, R Lázaro
Lichens and cyanobacteria colonize inhospitable places covering a wide climate range due to their different survival strategies, such as the synthesis of protective biomolecules. The effect of ecological factors on the synthesis of biomolecules has not been widely analysed. This study aimed to assess the effects of four factors (species, microclimate, seasonality and hydration state) and their interactions on the biomolecule frequency detected by Raman Spectroscopy. We included cyanobacterial biocrusts, and the lichens Diploschistes diacapsis, Squamarina lentigera, and Lepraria isidiata; two contrasted microclimates (typical and marginal), two contrasted seasons (hot and dry vs cool and wet) and two hydration states (dry and wet)...
January 15, 2017: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
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