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https://www.readbyqxmd.com/read/29350511/a-cost-effectiveness-analysis-of-cardiology-econsults-for-medicaid-patients
#1
Daren Anderson, Victor Villagra, Emil N Coman, Ianita Zlateva, Alex Hutchinson, Jose Villagra, J Nwando Olayiwola
OBJECTIVES: To evaluate the cost-effectiveness of electronic consultations (eConsults) for cardiology compared with traditional face-to-face consults. STUDY DESIGN: Cost-effectiveness analysis for a subset of Medicaid-insured patients in a cluster-randomized trial of eConsults versus the traditional face-to-face consultation process in a statewide federally qualified health center. METHODS: A total of 369 Medicaid patients were referred for cardiology consultations by primary care providers who were randomly assigned to use either eConsults or their usual face-to-face referral process...
January 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29348052/thirty-day-complication-rate-of-percutaneous-gastrojejunostomy-and-gastrostomy-tube-insertion-using-a-single-puncture-dual-anchor-technique
#2
Rebecca Zener, Alexandra C Istl, Kerollos N Wanis, David Hocking, Jacob Kachura, Shaker Alshehri, Amol Mujoomdar, Steven Latosinsky, Daniele Wiseman
PURPOSE: Our objective was to assess 30-day mortality and complication rates associated with percutaneous enteral feeding tube insertion using a single-puncture, dual-suture anchor gastropexy and peel-away sheath technique. We explored differences in complications based on indication and gastrostomy versus gastrojejunostomy tube. METHODS: A retrospective review was conducted of adult patients undergoing fluoroscopically guided gastrojejunostomy (GJ) and gastrostomy (G) tube insertions between July 2011 and 2014 by five interventional radiologists at a single tertiary care centre...
January 10, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29344315/a-topical-anti-inflammatory-healing-regimen-utilizing-conjugated-linolenic-acid-for-use-post-ablative-laser-resurfacing-of-the-face-a-randomized-controlled-trial
#3
Douglas C Wu, Mitchel P Goldman
Background: Fractionated, ablative lasers are usually associated with post-treatment erythema, edema, and crusting, which can last from 5 to 14 days. Conjugated linolenic acid, an omega-5 fatty acid, has significant antioxidant and anti-inflammatory properties, and has been shown to stimulate keratinocyte proliferation and epidermal regeneration. By modulating the early inflammatory milieu and directly affecting skin structure and function, conjugated linolenic acid might therefore shorten downtime following fractionated ablative laser resurfacing of the face...
October 2017: Journal of Clinical and Aesthetic Dermatology
https://www.readbyqxmd.com/read/29343303/comparison-of-modified-wet-suction-technique-and-dry-suction-technique-in-endoscopic-ultrasound-guided-fine-needle-aspiration-eus-fna-for-solid-lesions-study-protocol-for-a-randomized-controlled-trial
#4
Yun Wang, Qian Chen, Jinlin Wang, Xiaoli Wu, Yaqi Duan, Ping Yin, Qiaozhen Guo, Wei Hou, Bin Cheng
BACKGROUND: Several suction techniques have been developed recently to enhance tissue acquisition when sampling solid lesions using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The aim of this study is to determine whether a new modified wet suction technique (MWST) compared with the conventional dry suction technique (DRST) shall present better outcomes with respect to diagnostic yield and specimen quality of solid lesions in the intra-abdomen and mediastinum. METHODS/DESIGN: This is a single-blind, randomized, controlled, superiority trial conducted at four large tertiary care centers in China...
January 17, 2018: Trials
https://www.readbyqxmd.com/read/29342498/patient-reminder-and-recall-interventions-to-improve-immunization-rates
#5
REVIEW
Julie C Jacobson Vann, Robert M Jacobson, Tamera Coyne-Beasley, Josephine K Asafu-Adjei, Peter G Szilagyi
BACKGROUND: Immunization rates for children and adults are rising, but coverage levels have not reached optimal goals. As a result, vaccine-preventable diseases still occur. In an era of increasing complexity of immunization schedules, rising expectations about the performance of primary care, and large demands on primary care providers, it is important to understand and promote interventions that work in primary care settings to increase immunization coverage. One common theme across immunization programs in many nations involves the challenge of implementing a population-based approach and identifying all eligible recipients, for example the children who should receive the measles vaccine...
January 18, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29342066/resident-participation-in-fixation-of-intertrochanteric-hip-fractures-analysis-of-the-nsqip-database
#6
Alexander L Neuwirth, Russell N Stitzlein, Madalyn G Neuwirth, Rachel K Kelz, Samir Mehta
BACKGROUND: Future generations of orthopaedic surgeons must continue to be trained in the surgical management of hip fractures. This study assesses the effect of resident participation on outcomes for the treatment of intertrochanteric hip fractures. METHODS: The National Surgical Quality Improvement Program (NSQIP) database (2010 to 2013) was queried for intertrochanteric hip fractures (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] code 820...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29342059/patients-living-alone-can-be-safely-discharged-directly-home-after-total-joint-arthroplasty-a-prospective-cohort-study
#7
Andrew N Fleischman, Matthew S Austin, James J Purtill, Javad Parvizi, William J Hozack
BACKGROUND: Despite the expense and potential hazards of inpatient rehabilitation, there is a prevailing belief that patients living alone cannot be safely discharged directly home after total joint arthroplasty. The purpose of this study was to assess the safety and efficacy of direct home discharge for patients living alone during convalescence after primary total joint arthroplasty. METHODS: We prospectively studied 910 consecutive patients undergoing primary, unilateral total hip arthroplasty or total knee arthroplasty over an 8-month period...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29340680/association-of-bariatric-surgery-vs-medical-obesity-treatment-with-long-term-medical-complications-and-obesity-related-comorbidities
#8
Gunn Signe Jakobsen, Milada Cvancarova Småstuen, Rune Sandbu, Njord Nordstrand, Dag Hofsø, Morten Lindberg, Jens Kristoffer Hertel, Jøran Hjelmesæth
Importance: The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. Objective: To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Design, Setting, and Participants: Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29340166/withdrawal-of-antihypertensive-therapy-in-people-with-dementia-feasibility-study
#9
Veronika van der Wardt, Jennifer K Burton, Simon Conroy, Tomas Welsh, Pip Logan, Jaspal Taggar, Lukasz Tanajewski, John Gladman
Background: This study explored the feasibility of a randomised controlled withdrawal trial of antihypertensive medication in normotensive people with dementia. Feasibility aspects included response, recruitment, exclusion and drop-out rates, suitability of outcome measures, acceptability of study procedures and an indicative economic evaluation for a randomised controlled trial. Methods: A cohort study attempting the withdrawal of antihypertensive drugs where appropriate and a feasibility study of home-based blood pressure monitoring, in people with dementia treated for hypertension, was undertaken...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29334861/copd-management-by-swedish-general-practitioners-baseline-results-of-the-primair-study
#10
Hanna Sandelowsky, Natalia Natalishvili, Ingvar Krakau, Sonja Modin, Björn Ställberg, Anna Nager
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common cause of suffering and death. Evidence-based management of COPD by general practitioners (GPs) is crucial for decreasing the impact of the disease. Efficient strategies include early diagnosis, smoking cessation and multimodal treatment. AIM: To describe knowledge about and skills for managing COPD in GPs in Sweden. METHODS: Prior to COPD education (the PRIMAIR Study), GPs at primary health care centers (PHCCs) in Stockholm replied to 13 written, patient-case based, multiple choice and free-text questions about COPD...
January 15, 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29333883/simultaneous-intestinal-and-kidney-transplantation-in-adults
#11
Irum Amin, Charlotte Rutter, Adam Barlow, Neil K Russell, J Andrew Bradley, Andrew Jackson, Andrew J Butler
AIM OF THE STUDY: Intestinal transplantation (IT) is a life-saving procedure for carefully selected patients with intestinal failure. We evaluated patients who had undergone simultaneous intestinal and kidney transplantation (SIKT) to determine whether UK guidelines for inclusion of a renal allograft (dialysis dependent or estimated glomerular filtration rate ((eGFR)) < 45 ml/min/1.73 m2) are justified. METHODS: A single centre analysis was undertaken of adults undergoing IT at the Cambridge Transplant Centre between December 2007 and January 2016...
January 15, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29333514/what-is-the-fate-of-artificial-urinary-sphincters-among-men-undergoing-repetitive-bladder-cancer-treatment
#12
S Mitchell Heiner, Boyd R Viers, Marcelino E Rivera, Brian J Linder, Daniel S Elliott
Purpose: Functional characteristics and durability of the artificial urinary sphincter (AUS) among patients who develop bladder cancer has been poorly characterized. We sought to evaluate AUS outcomes among patients subsequently diagnosed with bladder cancer, in order to describe device survivability when subject to diagnostic and therapeutic procedures such as cystoscopy, transurethral resection, and cystectomy. Materials and Methods: We retrospectively reviewed 1,803 male patients treated with AUS surgery at a single institution between 1983-2014...
January 2018: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/29332231/stage-specific-therapeutic-strategies-of-medication-related-osteonecrosis-of-the-jaws-a-systematic-review-and-meta-analysis-of-the-drug-suspension-protocol
#13
REVIEW
Luca Ramaglia, Agostino Guida, Vincenzo Iorio-Siciliano, Alessandro Cuozzo, Andrea Blasi, Anton Sculean
OBJECTIVE: The most debated topic about medication-related osteonecrosis of the jaws (MRONJ) is its therapy, as there are no definitive guidelines. The aims of this systematic review were (a) to outline the best therapeutic approach according to the stage at diagnosis and (b) to perform a meta-analysis to assess whether the drug-holiday protocol may be or not an effective method in the management of MRONJ patients. MATERIALS AND METHODS: The systematic review was performed following the PRISMA principles...
January 13, 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29331326/cryptorchidism-in-sweden-a-nationwide-study-of-prevalence-operative-management-and-complications
#14
Susanna Bergbrant, Erik Omling, Jonas Björk, Lars Hagander
OBJECTIVES: To review the cumulative prevalence, operative management, and complications of treatment for cryptorchidism in Sweden. STUDY DESIGN: A nationwide observational study from longitudinal register data of all Swedish-born boys 0-18 years of age, diagnosed with cryptorchidism from 2001 to 2014. Primary outcomes were occurrence and age at primary surgery. Secondary outcomes included type of procedure and surgical site infection. RESULTS: Of 20 375 boys diagnosed with cryptorchidism in 2001-2014, 12 766 were surgically treated...
January 10, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29330643/antihypertensive-medication-and-dementia-risk-in-older-adult-african-americans-with-hypertension-a-prospective-cohort-study
#15
Michael D Murray, Hugh C Hendrie, Kathleen A Lane, Mengjie Zheng, Roberta Ambuehl, Shanshan Li, Frederick W Unverzagt, Christopher M Callahan, Sujuan Gao
BACKGROUND: African Americans are especially at risk of hypertension and dementia. Antihypertensive medications reduce the risk of cardiovascular events, but may also reduce the risk of dementia. OBJECTIVE: To assess the longitudinal effects of antihypertensive medications and blood pressure on the onset of incident dementia in a cohort of African Americans. DESIGN: Prospective cohort. PARTICIPANTS: 1236 community-dwelling patients from an inner-city public health care system, aged 65 years and older, with a history of hypertension but no history of dementia, and who had at least three primary care visits and a prescription filled for any medication...
January 12, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29330249/is-it-idiopathic-pulmonary-fibrosis-or-not
#16
REVIEW
Mary Salvatore, Genta Ishikawa, Maria Padilla
Pulmonary fibrosis is not uncommon. Usual interstitial pneumonitis (UIP)/idiopathic pulmonary fibrosis (IPF) is the most common of the idiopathic pulmonary fibrotic diseases and has the worst prognosis with a mean life expectancy of 3.8 years. The American Thoracic Society has provided guidelines for the accurate diagnosis of IPF.In 2014, 2 antifibrotic medications were approved in the United States that target the multiple fibrotic pathways of UIP, which increased the need for early and accurate diagnosis of IPF...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329975/risk-of-suicide-and-non-fatal-self-harm-after-bariatric-surgery-results-from-two-matched-cohort-studies
#17
Martin Neovius, Gustaf Bruze, Peter Jacobson, Kajsa Sjöholm, Kari Johansson, Fredrik Granath, Johan Sundström, Ingmar Näslund, Claude Marcus, Johan Ottosson, Markku Peltonen, Lena M S Carlsson
BACKGROUND: Bariatric surgery reduces mortality, but might have adverse effects on mental health. We assessed the risk of suicide and self-harm after bariatric surgery compared with non-surgical obesity treatment. METHODS: Suicide and non-fatal self-harm events retrieved from nationwide Swedish registers were examined in two cohorts. The non-randomised, prospective Swedish Obese Subjects (SOS) study compared bariatric surgery (n=2010; 1369 vertical-banded gastroplasty, 376 gastric banding, and 265 gastric bypass) with usual care (n=2037; recruitment 1987-2001)...
January 9, 2018: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29329764/-analysis-of-mortality-and-hospital-stay-in-cardiac-surgery-in-mexico-2015-data-from-the-national-cardiology-institute
#18
Alejandra Rodríguez-Hernández, Martha García-Torres, Eduardo Bucio Reta, Francisco Martín Baranda-Tovar
OBJECTIVE: To analyse hospital mortality in patients subjected to cardiac surgery in Mexico during the year 2015, and identify the mortality risks factors, and its correlation with days of hospital stay in the cardiovascular intensive care unit. METHOD: The database of Cardiovascular Intensive Care of the National Institute of Cardiology was examined for this cases and controls study that included only adult patients subjected to cardiac surgery during the year 2015...
January 9, 2018: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/29329145/orthopaedic-management-of-leg-length-discrepancy-in-proteus-syndrome-a-case-series
#19
Molly M Crenshaw, Cara G Goerlich, Lauren E Ivey, Julie C Sapp, Kim M Keppler-Noreuil, Allison C Scott, Leslie G Biesecker, Laura L Tosi
INTRODUCTION: Proteus syndrome (PS) is a rare mosaic disorder comprising asymmetric bony and soft tissue overgrowth leading to significant morbidity. Placement of growth inhibition hardware with subsequent epiphyseal arrest improves leg-length and angular deformities in pediatric patients without PS. The purpose of this study was to review the surgical approach and present outcomes, complications, and recommendations in 8 patients with PS and leg-length discrepancy (LLD). METHODS: We conducted a retrospective chart review of 8 patients with PS whose primary reason for surgery was LLD...
January 11, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29327433/factors-influencing-skin-cancer-excision-rates-in-scottish-primary-care
#20
R Korgul, S A Holme
Skin cancer incidence rates are rising in the UK, yet many areas are experiencing a shortage of dermatologists. We sought to compare skin cancer excision rates between general practice (GP) surgeons to identify factors associated with good practice, through a retrospective analysis of GP skin cancer histopathology reports in three Scottish Health Boards over a 4-year period. Postal questionnaires were used to explore factors affecting surgeons' excision rates. GPs excised 895 skin cancers (4.5% of the 19 853 regional total) during the period...
January 12, 2018: Clinical and Experimental Dermatology
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